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Berättelser om ensamhetens vardag hos människor med psykiska funktionshinder
Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.ORCID iD: 0000-0003-4021-2393
2006 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This dissertation deals with people with mental illness that currently live in their own accommodation in the community. Common to all mentally ill people is their serious difficulties in carrying out activities and meeting needs in important areas of life. Terms such as "normalisation" and "integration" into the community of this group were important words full of promise at the time the psychiatric reform was carried out. However, there is some strong evidence that the psychiatric reform has not been completely successful. Despite the knowledge that loneliness and social isolation commonly occur among people with mental illness, there is little research that describes how mentally ill people themselves experience their life situation. The overall aim of the dissertation was to gain deeper understanding of the life situation of peop with mental illness via their own narratives on how their day-to-day life appears to them, ar through this gain knowledge of the type of support needed for them to live a satisfactory life. Various data acquisition methods were applied. Study I involved in-depth interview of two men and two women on their daily life. Data acquisition in Study II was via participant observations, an activity unit for people with mental illness. Photographs were used for Studies III and IV Eight informants were issued with disposable cameras and asked to take approximately 10 pictures of objects, situations and/or individuals. These photographs were then used as a basis for follow-up interviews. Results from Study I showed that informants were aware both of their illness and their psychosocial disadvantages, and that they had insight into what was required of them to influence their situation, while simultaneously having insight into their poor ability to tak initiatives. Informants in Study II experienced themselves as unwelcome, vulnerable and marginalised individuals with little hope of a change in existence, resulting in anxiety over the future. They felt trust was lacking in relation to other people and experienced themselves as not accepted in the company of others or by society. Study III provided description of informants occupied with themselves and their existence. The informants tell of a form of spirituality giving them a sense of peace and tranquillity, but which only exists for them at the beginning and end ol life.

 Animals are more loyal than people and make no demands, but are however, according to the informants, in a position of dependence on humans. Possessions are of significance to the informants, meaning they see their possessions as part of themselves. In Study IV informants related how they would like their future to appear. They also told what having an identity meant to them, how identity is formed in individuals, what having a mental illness and feeling good means. The informants showed a longing to be seen, but at the same time not wanting to be seen. Finding a meaning with life was important since it could end at any moment.

In summary, the findings point to an existential loneliness that consists of a life pattern consisting of an interaction between the impact of the mental illness and the identity as a mentally ill person feelings of marginalisation and abandonment. Experiencing that life has a meaning, possibility o social exchange and a sense of control seem to be important for the persons with mental illness in this study. Consequently, it can be inferred that if the care of people with mental illness pays attention to the dimensions of existential loneliness persons with mental illness may be helped to experience that life has a meaning despite their disability.

Place, publisher, year, edition, pages
Stockholm: Karolinska University Press , 2006. , p. 90
Keywords [en]
alienation, ethnography, existential loneliness, photography, participant observation, mental illness
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-559Libris ID: 10270185ISBN: 91-7357-023-0 (print)OAI: oai:DiVA.org:esh-559DiVA, id: diva2:346068
Public defence
2006-12-08, Novum, Hörsalen plan 4, Blickagången 6/Hälsovägen 7, Huddinge, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2010-08-30 Created: 2010-08-30 Last updated: 2022-01-03Bibliographically approved
List of papers
1. Psychosocial disadvantages in the lives of persons with long-term mental illness living in a Swedish community.
Open this publication in new window or tab >>Psychosocial disadvantages in the lives of persons with long-term mental illness living in a Swedish community.
2002 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, no 4, p. 457-63Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to gain in-depth knowledge of how persons with long-term mental illness experience their everyday situation, in order to identify potential psychosocial obstacles to a meaningful existence. The focus was on psychosocial aspects, such as contact with others and the quality of these contacts. An ethnographic design was used, in order to provide an inside perspective. Four persons with long-term mental illness participated in the study. Three open-ended interviews, at 1-week intervals, were conducted with each informant. Analysis of transcribed material consisted of naive reading and content analysis guided by the investigators' understanding of the psychiatric context. Three themes were generated: feeling lonely but being unable to establish friendships; knowledge of what to do but lacking initiative; and awareness of the need for support but not wanting to be subject to control. These themes reflect contradictions between thoughts, feelings and actions, which seem to contribute to a psychosocial disadvantage in the life of persons with long-term mental illness.

National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-555 (URN)10.1046/j.1365-2850.2002.00481.x (DOI)12164908 (PubMedID)
Available from: 2010-08-20 Created: 2010-08-20 Last updated: 2020-12-07Bibliographically approved
2. Social and existential alienation experienced by people with long-term mental illness
Open this publication in new window or tab >>Social and existential alienation experienced by people with long-term mental illness
2005 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 373-380Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore how people suffering from long-term mental illness and who live in the community experience their daily lives. The study was based on an ethnographic framework involving participant observations with 23 individuals from two rehabilitation centres and interviews with six women and two men. The observational notes and interviews were recorded, transcribed into the data and analysed based on the phases of hermeneutic interpretation. The process consisted of identifying tentative interpretations that highlighted various impediments that prevent people with long-term mental illness from having an active life. The impediments can also be interpreted as a form of alienation, an interpersonal phenomenon and a consequence due to of the lack of social acceptance towards mental illness. The participants expressed concern about the future and lack of hope. Viewing themselves as being ‘odd’ is not a symptom of mental illness, but rather evidence of experiencing existential and social alienation not only as a consequence of other people's reactions but also their own negative attitudes towards mental illness and effects of their cognitive dysfunction.

National Category
Psychology
Identifiers
urn:nbn:se:esh:diva-97 (URN)10.1111/j.1471-6712.2005.00364.x (DOI)
Available from: 2010-05-10 Created: 2010-05-10 Last updated: 2020-12-07Bibliographically approved
3. Varying views of life among people with long-term mental illness
Open this publication in new window or tab >>Varying views of life among people with long-term mental illness
2009 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 16, no 1, p. 54-60Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to explore views of life among people with long-term mental illnesses. The participants' possible cognitive inability to express such views dictated a research design that was both fit for purpose and respectful of their integrity. The study, based on an ethnographic framework, involved photographs and interviews with five women and three men. The participants were the photographers, as well as the authors of their own narratives, and the photographs served as a starting point for the interviews. The interview material was analysed in terms of the phases of interpretation. Four main themes were identified: 'thoughts about God and the meaning of life and death', 'the meaning of relationships with others', 'how animals give meaning to life without demands' and 'the symbolic bearing of objects on life'. These four themes represent key existential issues among people with long-term mental illnesses, but they lack confidants to share or discuss these matters with.

Keywords
Existential issue, Interview, Long-term mental illness, Photo, Views of life
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-556 (URN)10.1111/j.1365-2850.2008.01329.x (DOI)000262477900008 ()19192086 (PubMedID)
Note

Title in dissertation: Variations in views of life of persons with long-term mental illness

Publication status in dissertation: Submitted

Available from: 2010-08-20 Created: 2010-08-20 Last updated: 2022-11-02Bibliographically approved
4. Basic attitudes toward life expressed by persons with long-term mental illness living in a Swedish community
Open this publication in new window or tab >>Basic attitudes toward life expressed by persons with long-term mental illness living in a Swedish community
2012 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 33, no 6, p. 387-393Article in journal (Refereed) Published
Abstract [en]

Previous research has shown that persons with long-term mental illness who require prolonged treatment and social support wish to, yet find it difficult to, find meaning or quality in life. A descriptive qualitative design using self-photography and in-depth interviews was used for data collection. The aim of this study was to explore basic attitudes to life as expressed by nine persons with long-term mental illness living in the community. The findings provide insight into the values of relationships, work, and the home for persons with long-term mental illness and indicate that they are cognizant of social norms yet have difficulty integrating these in their daily lives. The study also illuminates the informants' difficulties in creating satisfying and supporting relationships with others.

National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-557 (URN)10.3109/01612840.2012.661520 (DOI)22646203 (PubMedID)
Note

Title in dissertation: Cautiousness : a basic attitudes towards life for persons with long-term mental illness

Publication status in dissertation: Submitted

Available from: 2010-08-20 Created: 2010-08-20 Last updated: 2022-01-03Bibliographically approved

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