Background: First responders (firefighters, paramedics, and police officers) are often exposed to potentially psychologically traumatic events. When combined with insufficient social support and reduced help-seeking behaviours, such exposures may increase the risk of mental health challenges, particularly among paramedics who report the highest rates of mental disorders. Objective: The current study used the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR) to identify critical barriers and facilitators to help-seeking and accessing mental health care, and the feasibility and sustainability of a first responder clinic. Methods: Semi-structured qualitative interviews included 11 paramedics (frontline, mid-and-senior management, and union), recruited using purposive and snowball sampling. Interviews were analyzed using content and thematic analyses. The TDF and CFIR guided study design, interview content, data collection, and analysis. Results: Barriers included the complexities of stigma, confidentiality, cultural competency, and trust. Conclusions: The findings will be instrumental in developing evidence-based approaches to mental health care for paramedics.

Bakgrund: Alzheimers sjukdom medför många förändringar som inte bara påverkar de drabbade utan även de anhöriga. Dessa förändringar hanteras med hjälp av olika copingstrategier. Syfte: Att beskriva vilka copingstrategier anhöriga till personer med Alzheimers sjukdom använder sig av. Metod: Studien genomfördes som en kvalitativ studie med en deduktiv ansats, där materialet samlats in från självbiografier. Det insamlade materialet analyserades och delades in med hjälp av formuläret “Ways of Coping”. Resultat: Anhöriga använde sig av copingstrategier så som att till exempel “sätta ner foten” (konfronterande coping), skylla på annat (avståndstagande), dölja sina känslor (självkontrollerande) samt hjälp och stöd från omgivningen (söka socialt stöd), att lägga skulden på sig själva (accepterande av ansvaret), distraherande tankar och aktiviteter (undkommande och undvikande), informationssökande (planerande problemlösning) och positiv självförändring (positiv omvärdering). Slutsats: Kunskap om copingstrategier hos vårdpersonal kan hjälpa anhöriga i sin roll som vårdare till personer med Alzheimers sjukdom. / Background: With Alzheimer's disease comes many changes that affect not only the affected but also their families. These changes are managed using a variety of coping strategies. Aim: To describe coping strategies among informal caregivers of people with Alzheimer's disease. Method: The study was conducted as a qualitative study with a deductive approach, where the data is collected from autobiographies. The data was analyzed and sorted with help from the instrument "Ways of Coping". Result: The caregivers of the study used coping strategies such as, for example, putting the foot down (confrontive coping), blame others (distancing), hiding emotions (self-controlling) and help and support from the surroundings (seeking social support), to blame oneself (accepting responsibility), distracting thoughts and activities (escape-avoidance), information seeking (planful problem solving) and positive personal change (positive reappraisal). Conclusion: Knowledge of coping strategies among health care workers could help families in their role as caregivers of the person with Alzheimer's disease.