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  • 1.
    Björkdahl, A
    et al.
    Karolinska institutet.
    Nyberg, U
    Karolinska institutet.
    Runeson, B
    Karolinska institutet.
    Omérov, Pernilla
    Karolinska institutet.
    The development of the Suicidal Patient Observation Chart (SPOC): Delphi study2011In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 18, no 6, p. 558-561Article in journal (Refereed)
    Abstract [en]

    Constant observation is a method used to insure the safety of suicidal inpatients. It involves structure and control as well as flexibility and the development of a relationship between the observer and the patient. It has been found that important observations may go unnoticed by the observer or fail to be communicated to the multidisciplinary team because of a lack of sufficient training and systematic documentation. We therefore conducted a Delphi survey to collect opinions on what would be important to observe during constant observation of suicidal patients. A panel of experienced clinicians, service users and researchers reached consensus on 37 of 40 observation items (92%). Of these, 28 were rated as the most important. As a result, we developed a form for systematic observer documentation in clinical practice, the Suicidal Patient Observation Chart. The Suicidal Patient Observation Chart includes the 28 items and covers 24 separate observation periods.

  • 2. Björkdahl, A.
    et al.
    Palmstierna, T.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    The bulldozer and the ballet dancer: aspects of nurses´ caring approaches in acute psychiatric intensive wards2010In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 17, no 6, p. 510-518Article in journal (Refereed)
  • 3.
    Björkdahl, Anna
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska Institutet.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Palmstierna, Tom
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska Institutet.
    The influence of staff training on the violence prevention and management climate in psychiatric inpatient units2013In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, no 5Article in journal (Refereed)
  • 4. Dahlqvist, Vera
    et al.
    Söderberg, Anna
    Norberg, Astrid
    Ersta Sköndal University College, Department of palliative care research. Ersta Sköndal University College, Department of Health Care Sciences.
    Facing inadequacy and being good enough: psychiatric care providers' narratives about experiencing and coping with troubled conscience.2009In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 16, no 3, p. 242-7Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to illuminate the meaning of encounters with a troubled conscience among psychiatric therapists. Psychiatric care involves ethical dilemmas which may affect conscience. Conscience relates to keeping or losing a sense of personal integrity when making judgments about one's actions. Ten psychiatric therapists were interviewed in June 2006. The interviews were tape-recorded, transcribed verbatim and interpreted using a phenomenological-hermeneutic method. Two themes 'Facing inadequacy' and 'Struggling to view oneself as being 'good enough'' are presented. In the therapists interviewed, awareness of their use of power, a sense of powerlessness and a sense of blame gave rise to feelings of betrayals and shameful inadequacy. By sharing their inadequacy with co-workers, they managed to endure the sense of their inadequacy which otherwise would have threatened to paralyse them. Finding consolation in sharing wearing feelings, becoming realistic and attesting their worthiness, they reached reconciliation and found confirmation of being good enough. The findings are interpreted in light of Lögstrup's ethics of trust, according to which conscience alerts us to silent but radical ethical demand and the risk of self-deception.

  • 5.
    Erdner, Anette
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Andersson, Lars
    Ersta Sköndal University College, Department of Health Care Sciences.
    Magnusson, Annabella
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lützén, Kim
    Varying views of life among people with long-term mental illness2009In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 16, no 1, p. 54-60Article in journal (Refereed)
    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.

  • 6.
    Erdner, Anette
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Magnusson, Annabella
    Ersta Sköndal University College, Department of Health Care Sciences.
    Caregivers’ difficulties in activating long-term mental illness patients with low self-esteem2012In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, no 2, p. 140-145Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe psychiatric caregivers’ perceptions of self-esteem and activities for patients with long-term mental illness. The study design used a qualitative approach, based on an open lifeworld perspective. A total of 13 caregivers at four psychiatric hospital units in a large Swedish city were interviewed about their views on patients’ physical activity and/or other pastimes, as well as their self-esteem and its bearing on the patients’ well-being. According to the caregivers, it is up to the patients themselves to decide what they wish to occupy themselves with. In the same time the caregivers’ opinions are that patients have difficulties to occupy themselves.The caregivers believe that patients’ disability is based in a lack of self-esteem, commitment and capacity to realize their wishes. The caregivers in this study argue that activities are valuable for self-esteem and physical health of people with long-term mental illness. The caregivers consider that it is the patient’s responsibility to initiate their needs of activities. This means that the caregivers do not use their knowledge about the importance of activities for the patient’s health.Search terms: activity, caregivers, mental illness.

  • 7.
    Erdner, Anette
    et al.
    Huddinge sjukhus.
    Nyström, M
    Severinsson, E
    Lützén, K
    Psychosocial disadvantages in the lives of persons with long-term mental illness living in a Swedish community.2002In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, no 4, p. 457-63Article in journal (Refereed)
    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.

  • 8.
    Ewertzon, Mats
    et al.
    Örebro universitet. ; Högskolan Dalarna.
    Andershed, Birgitta
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Svensson, E
    Lützén, Kim
    Family member’s expectations of the psychiatric health-care professionals´ approach towards them2011In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 18, no 2, p. 146-157Article in journal (Refereed)
  • 9.
    Ewertzon, Mats
    et al.
    Örebro universitet. ; Högskolan Dalarna.
    Lützén, Kim
    Högskolan Dalarna.
    Svensson, Elisabeth
    Örebro universitet.
    Andershed, Birgitta
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Family members´ involvement in psychiatric care: experiences of the health-care professionals´ approach and feeling of alienation.2010In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 17, p. 422-432-Article in journal (Refereed)
  • 10.
    Fagerberg, Ingegerd
    et al.
    Mälardalens högskola.
    Jönhagen, Maria Eriksdotter
    Temporary confusion: a fearful experience2002In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, no 3, p. 339-346Article in journal (Refereed)
    Abstract [en]

    Older people admitted to hospital often develop acute temporary confusion. Earlier studies have focused on problems in providing care to the confused, causes of the confusion and the key aspects of caring. The aims of this study were to describe, from a nursing perspective, how older people experienced the phenomenon of temporary confusion and to describe the older peoples’ reasoning when they described their experiences. Interviews with five older informants who had recovered from their confusional state were conducted and analysed using the phenomenological method. Two phenomena were studied, ‘being temporarily confused’ and ‘reasoning about experiences of temporary confusion’, each was found to be represented by four inter-related constituents. The phenomena can be understood as aspects of suffering and power imbalance between staff and older people.

  • 11. Gilje, F
    et al.
    Talseth, A G
    Norberg, Astrid
    Ersta Sköndal University College, Department of palliative care research. Ersta Sköndal University College, Department of Health Care Sciences.
    Psychiatric nurses' response to suicidal psychiatric inpatients: struggling with self and sufferer.2005In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 12, no 5, p. 519-26Article in journal (Refereed)
    Abstract [en]

    Research on nurses' responses to suicidal patients is sparse. The purpose of this secondary analysis of qualitative data from interviews with 19 nurses employed in Norway was to describe nurses' responses to suicidal psychiatric inpatients. Thematic analyses revealed four themes: 'struggling with discernment of self and sufferer'; 'reconciling inner dialogue'; 'opening up while envisioning self from sufferer'; and 'revisioning the meaning of life revealed over time'. The main theme was 'struggling with self and sufferer'. While these findings reveal existential issues and self reflections of psychiatric nurses' struggle with the suffering of suicidal patients, they also contribute to a methodological debate. Further research is needed to examine nurses' responses to suicidal patients in various settings and to develop secondary analysis of qualitative data.

  • 12. Högberg, Torbjörn
    et al.
    Magnusson, Annabella
    Karolinska institutet.
    Lützén, Kim
    Ersta Sköndal University College, Department of Health Care Sciences.
    Living by themselves?: Psychiatric nurses’ views on supported housing for persons with severe and persistent mental illness2006In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 13, no 6, p. 735-741Article in journal (Refereed)
    Abstract [en]

    The main principle directing the development of supported dwellings for persons with long-term mental illness is that to live in the community would improve their quality of life. The aim of this study was to describe psychiatric nurses’ experiences of different types of supported dwelling for persons with long-term mental illness, and their views on what they consider to be important principles to provide for in order to facilitate their social integration into the community. Nine psychiatric nurses were interviewed. A qualitative content analysis revealed ‘attempting to uphold the principle, respect for the patient’s right to self-determination’ as the main theme, which was linked to three sub-themes: the nurses’ view on their moral responsibility; the nurses’ views on social norms that patients must follow in order to be accepted by their neighbours; and the nurses’ views on supported dwelling of good quality. The nurses perceived that personal contact between the neighbour and the mentally ill person was one essential way to reduce fear of the mentally ill person. They viewed themselves as a link between the mentally ill person and other neighbours. Without the personal contact between the mentally ill person and the neighbours, there may be a risk that the integration will fail no matter how excellent the supported dwelling is framed.

  • 13.
    Kristiansen, Lisbeth
    et al.
    Mittuniversitetet.
    Dahl, Annika
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Hellzén, Ove
    Mittuniversitetet.
    The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients2005In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 12, no 6, p. 719-727Article in journal (Refereed)
    Abstract [en]

    The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients For people afflicted with different kinds of psychiatric disorder, suffering is a common denominator. The time the nurses spend with psychiatric clients may mirror their attitudes towards and feelings for these clients. The aim of this study was to investigate the connections between the time spent together and the nurses' opinion of client behaviour and social functioning in community-based psychiatry. In this quantitative study, 29 clients were assessed by 30 nurses, who answered the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Syndrome Scale (PANSS). At the same time, 11,200 non-participant observations of clients were registered using the Patient Activity Classification (PAC) to investigate how they spent their time at two psychiatric group dwellings. The PAC instrument revealed that clients spent an average of 60.8% of time alone, while only 20% of their daily time was spent with the nurses. Based on a factor analysis, indices were made by setting cut-off points for the PANSS and the GAF scores, and four small groups of clients were generated: a relatively high level of social functioning and a low degree of psychiatric symptoms (A); a relatively high level of social functioning and a high degree of psychiatric symptoms (B); a low level of social functioning and a low degree of psychiatric symptoms (C); and, finally, a low level of social functioning and a high degree of psychiatric symptoms (D). The clients judged as having a low level of social functioning in combination with high degrees of psychiatric symptoms, that is, the most vulnerable and dependent individuals, receive less staff attention (18%) and are the clients who spend the most time alone (71.4%). It might be possible to interpret the results of this study in the light of a process of dehumanization.

  • 14.
    Pejlert, Anita
    et al.
    Mittuniversitetet & Umeå universitet.
    Asplund, Kenneth
    Mittuniversitetet & University of Tromsø, Norway.
    Gilje, Fredricka
    College of Nursing, University of North Dakota, Grand Forks, ND, USA.
    Norberg, Astrid
    Umeå universitet.
    The meaning of caring for patients on a long-term psychiatric ward as narrated by formal care providers1998In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 5, no 4, p. 255-264Article in journal (Refereed)
    Abstract [en]

    Seventeen care providers were interviewed about their caring experiences on a hospital psychiatric ward. The interviews focused on the meaning of their work, including the care they provide and the nature of the patient as a person. The study was guided by a phenomenological hermeneutic perspective inspired by Ricoeur (1976). The analysis focused on context and form. Three themes illuminate the meaning of care provided. These themes are as follows; being in the midst of human storage, moving towards a human care of relations, and struggling with 'the old' and 'the new'. Experiencing work as being in the midst of a human storage reflects the historical and human situation of warehousing psychiatric patients. The care providers are experiencing a shift in their view of the patient and the meaning of their work, towards a more human care of relations. For these care providers, there is a struggle between the past, the present and the future. This struggle between 'the old' and 'the new' conveys a struggle between doing as a nurse, which dominates the past, and relating, which is, or needs to be, the current and future focus in psychiatric care. The shift in view distinguished itself by the care providers viewing the patient as being vulnerable and having problems with relations. The results have been interpreted and discussed in the light of a previously published interview study with the patients, carried out at the same time on the same ward. Attending to ingrained attitudes of the past and their influence on new approaches to care is essential to understanding not only changes in ways of doing nursing tasks, but also ways of relating.

  • 15.
    Pejlert, Anita
    et al.
    Mittuniversitetet & Umeå universitet.
    Asplund, Kenneth
    Mittuniversitetet, Umeå universitet & University of Tromsø, Norway.
    Norberg, Astrid
    Umeå universitet.
    Stories about living in a hospital ward as narrated by schizophrenic patients1995In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 2, no 5, p. 269-277Article in journal (Refereed)
    Abstract [en]

    Ten schizophrenic patients were interviewed about their own experiences of life in a hospital ward, of their care provider and of the care received. The interview texts were analysed using a phenomenological hermeneutic method. Fatigue, thinking about problems/inner activities, relations and longings for the pre-illness days were themes that occurred in the stories. Seven of the ten interviewees stated that they suffered from fatigue. They were preoccupied with an inner dialogue, trying to solve problems on their own. The patients were alone in their stories. The problems that the patients expressed with regard to relationships arose because they both longed for and feared contact with others, and they felt that they were not 'themselves' when they were with others. For developing care, the importance of learning more about the patients' experiences, especially regarding fatigue, is emphasized.

  • 16. Perseius, Kent-Inge
    et al.
    Kåver, A
    Ekdahl, S
    Åsberg, Marie
    Samuelsson, Mats
    Stress and burnout in psychiatric professionals when starting to use dialectical behavioural therapy in the work with young self-harming women showing borderline personality symptoms.2007In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 14, no 7, p. 635-43Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate how starting to use dialectical behavioural therapy (DBT) in the work with young self-harming women showing symptoms of borderline personality disorder affected the psychiatric professionals (n = 22) experience of occupational stress and levels of professional burnout. The study was carried out in relation to an 18-month clinical psychiatric development project, and used a mix of quantitative and qualitative research methods [a burnout inventory, the Maslach burnout inventory-General Survey (MBI-GS), free format questionnaires and group interviews]. The result confirms previous reports that psychiatric health professionals experience treatment of self-harming patients as very stressful. DBT was seen as stressful in terms of learning demands, but decreased the experience of stress in the actual treatment of the patients. The teamwork and supervision were felt to be supportive, as was one particular facet of DBT, namely mindfulness training which some therapists felt also improved their handling of other work stressors not related to DBT. The inventory for professional burnout, the MBI-GS, showed no significant changes over the 18-month period, although there was a tendency for increased burnout levels at the 6-month assessment, which had returned to baseline levels at 18 months.

  • 17. Skaalvik, MW
    et al.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Norrmann, K
    Fjelltun, AM
    Asplund, K
    The experience of self and threats to sense of self among relatives caring for people with Alzheimer's disease2014In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850Article in journal (Refereed)
1 - 17 of 17
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