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  • 1.
    Eckerström, Joachim
    et al.
    Karolinska institutet; Röda Korsets högskola; Norra Stockholms psykiatri, Stockholms läns sjukvårdsområde, Region Stockholm.
    Allenius, Emelie
    Norra Stockholms psykiatri, Stockholms läns sjukvårdsområde, Region Stockholm.
    Helleman, Marjolein
    Hanze University of Applied Sciences, Groningen, The Netherlands.
    Flyckt, Lena
    Karolinska institutet.
    Perseius, Kent-Inge
    Karolinska institutet; Röda Korsets högskola.
    Omérov, Pernilla
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Brief admission (BA) for patients with emotional instability and self-harm: nurses' perspectives - person-centred care in clinical practice.2019In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, no 1, p. 1-13, article id 1667133Article in journal (Refereed)
    Abstract [en]

    Purpose: Emotional instability and self-harm pose major problems for society and health care. There are effective interventions in outpatient care, but when patients need inpatient care, nurses often struggle meeting their patient's needs. Brief admission (BA) is a newly implemented crisis intervention and novel form of inpatient care. The aim of this study is to describe nurses' experiences working with BA related to patients with emotional instability and self-harm.

    Methods: Eight nurses were interviewed according to a semi-structured interview guide. The data was analysed using qualitative content analysis.

    Results: Four main categories emerged regarding nurses' experiences with BA: provides security and continuity, fosters caring relationships, shifts focus towards patient's health and empowers the patient. The nurse's role shifted from "handling problems" to establishing caring relationships with a focus on the person's health and possibilities for recovering instead of psychiatric symptoms.

    Conclusions: Previous studies on patients' perspective of BA describe positive experiences such as increased autonomy and participation in the healthcare process. This study supports those findings, albeit from the perspective of nurses. Our findings suggest that BA may reduce work-related stress experienced by nurses while caring for persons with emotional instability and self-harm. BA may also support nurses in their ability to provide more meaningful and constructive psychiatric inpatient care.

  • 2. Hjalmarsson, Erik
    et al.
    Kåver, Anna
    Perseius, Kent-Inge
    Cederberg, Kerstin
    Ghaderi, Ata
    Dialectical behaviour therapy for borderline personality disorder among adolescents and young adults: Pilot study, extending the research findings in new settings and cultures2008In: Clinical Psychologist, ISSN 1328-4207, E-ISSN 1742-9552, Clinical psychologist [Elektronisk resurs], ISSN 1742-9552, Vol. 12, no 1, p. 18-29Article in journal (Refereed)
    Abstract [en]

    The aim of this paper was to investigate the feasibility and impact of dialectical behaviour therapy (DBT) for patients with borderline personality disorder (BPD) in a clinical outpatient setting. Eighteen clinicians were trained and supervised in using DBT. Twenty-seven female patients were assessed on a number of variables before the treatment, as well as 5 and 12 months after the start of the DBT. Despite some barriers, DBT could be implemented successfully, and the professionals reported increased competence 1 year after the start of the therapy. Low treatment dropout rates suggested that DBT was well accepted by the patients. One year after the start of treatment, the patients reported significant decrease on most variables measuring psychological distress and number of parasuicidal behaviours. The study provides preliminary support for the feasibility and impact of DBT in the outpatient treatment of BPD in a cultural setting outside the United States.

  • 3.
    Lindh, Marianne
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Holmström, Inger K.
    Mälardalens högskola; Uppsala universitet.
    Perseius, Kent-Inge
    Röda Korsets högskola; Karolinska institutet.
    Windahl, Jenny
    Örebro universitet.
    Enhancing adherence to infection control in Swedish community care: Factors of importance2016In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 18, no 3, p. 275-282Article in journal (Refereed)
    Abstract [en]

    Healthcare-associated infections are the most frequent adverse event in healthcare delivery worldwide. The theory of planned behavior has proven helpful in hospital hygiene interventions andmight be useful in community care. This study explored howmedically-responsible nurses in Swedish community care perceived and ranked the impact of factors related to the theory of planned behavior, the factors“ probability to change, enhancing the healthcare staff’s adherence to infection control guidelines, and identified which theory of planned behavior subquestions should be focused on to enhance adherence to infection control. Medically-responsible nurses (n = 268) in Swedish communities answered a Web-based questionnaire regarding impact and probability to change theory of planned behavior factors in relation to infection control. Four theory of planned behavior factor constructs were found: (i) knowledge and encouragement from management; (ii) access and availability to materials and equipment, and interest among staff; (iii) influence by colleagues; and (iv) workload, and influence by patients and significant others. The theory of planned behavior factors are relevant for infection control in a home-like environment, and findings could be used as a basis for interventions enhancing hygiene in community care.

  • 4.
    Lindh, Marianne
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Perseius, Kent-Inge
    Ersta Sköndal University College, Department of Health Care Sciences.
    Factors influencing compliance to hygiene routines in community care: the viewpoint of medically responsible nurses in Sweden2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 224-230Article in journal (Refereed)
    Abstract [en]

    Aims and objectives:  The aim of the study was to describe factors influencing compliance to hygiene routines in community care in Swedish municipalities from the perspective of medically responsible nurses (MRN).

    Method:  A web-based questionnaire was sent to all MRNs in Swedish municipalities, N = 268. Beside demographical background data, the questionnaire contained two core open-ended questions generating free text data. Data were analysed with descriptive statistics and qualitative content analysis.

    Result:  Four categories of factors were found: resources, management, staff and external factors. All four categories contained subcategories.

    Conclusion:  To some extent, the challenges to uphold adequate compliance to hygiene routines seem different in community care than in hospitals. Resources regarding equipment and supplies seem as an uncertain asset and uneven distributed among municipalities. Home likeness was seen as a major obstacle for upholding adequate hygiene routines. To uphold sufficient hygiene routines in a person’s home or in a home-like environment might be one of the major challenges for community health care in the future. The MRN’s narratives suggest that Registered Nurses have a key role in upholding sufficient hygiene in community care. This report might contribute in providing them with more knowledge to take on this urgent task.

  • 5.
    Nilsson, Gunnel
    et al.
    Landstinget i Kalmar län.
    Ekdahl, Susanne
    Landstinget i Kalmar län.
    Perseius, Kent-Inge
    Landstinget i Kalmar län.
    Utvärdering av projektet ”Nyckelkurser på folkhögskolorna i Kalmar län för personer med långvarig benign smärta”: - här vet de hur man känner sig när man har ont…2008Report (Other academic)
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  • 6.
    Perseius, Kent-Inge
    Karolinska institutet.
    Borderline personality disorder: studies of suffering, quality of life and dialectical behavioural therapy2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aims of the present thesis were: * To investigate how women patients with borderline personality disorder (BPD) perceive their suffering, quality of life and encounter with psychiatric care (paper 11 and III). * To describe BPD patients' and psychiatric professionals' perceptions of receiving and giving dialectical behavioural therapy, DBT (paper I). * To investigate how starting treatment of BPD patients with DBT affected the psychiatric professionals' experience of occupational stress and professional burnout (paper IV) Due to the different types of research questions the thesis deal with, it uses a mix of qualitative and quantitative research methods. In two of the studies (11 and 111) the main methods were qualitative. Data from free format questionnaires, individual- as well as group interviews and biographical texts, were analysed with content analysis or a hermeneutic approach. In study Ill the methods were quantitative. A summated rating scale measuring healthrelated quality-of-life (HRQOL) was analysed with descriptive and inferential statistics. In study IV quantitative and qualitative methods were combined. Two burnout inventories were analysed with descriptive and inferential statistics, and data from free format questionnaires and group interviews were analysed with qualitative content analysis. The main findings were that BPD patients suffer to an extent that is often unendurable, leading to deliberate self-harm (DSH) and suicide attempts to relieve suffering or just try to get away from it all (paper 11). In study Ill the BPD patients showed significantly poorer quality-of-life (even physical) than normal population controls of comparable age. The suffering, suicide attempts, DSH and poor quality-of-life (paper 11 and 111) put the patients in a position of voluntarily or involuntarily getting involved with psychiatric care. Study II revealed a double role of the psychiatric care in relation to BPD patients. On one hand, psychiatric professionals can add to the suffering by not being understanding and being disrespectful, on the other hand they can be helpful and relieve suffering by being respectful, understanding and validating. There was a clear relationship between the patients' experience of validation and the experience of being helped. DBT seems (both from the patients' and psychiatric professionals' perspective) to be a treatment with a philosophy, content and structure being able to relieve BPD patients suffering and helping them to independence and a bearable life-situation (paper I). Study IV confirms previous findings that psychiatric professionals experience treatment of self-harming patients as profoundly stressful. DBT was seen as stressful in terms of learning demands, but decreased the experience of stress in the actual treatment of the patients due to its high degree of structure and specific techniques. The DBT team-work and supervision were felt to be supportive, as was one particular facet of DBT, namely mindfulness training which some professionals felt also improved their handling of other work stressors not related to DBT. This finding also corresponds to BPD patients' perceptions of the mindfulness component in DBT, which they reported as particularly helpful (paper 1). It should be noted that the patient samples in the thesis may be considered as a "worse off" subgroup among BPD patients, as they usually entered special treatment programs after a period of escalating symptoms, which standard psychiatric services had had difficulties handling. The rather small number of participants and the lack of equivalent andlor concurrent control groups in the quantitative studies limit the generalization of the results.

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  • 7.
    Perseius, Kent-Inge
    Ersta Sköndal University College, Department of Health Care Sciences.
    Personlighetsstörningar2010In: Omvårdnad vid psykisk ohälsa: på grundläggande nivå / [ed] Ingela Skärsäter, Lund: Studentlitteratur , 2010, 1, p. 173-195Chapter in book (Other academic)
  • 8. Perseius, Kent-Inge
    et al.
    Andersson, Eva
    Åsberg, Marie
    Samuelsson, Mats
    Health-related quality of life in women patients with borderline personality disorder.2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 3, p. 302-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aims of the study were to: (i) test the reliability of a health-related quality of life (HRQOL) instrument [Swedish Health-Related Quality of Life Survey (SWED-QUAL)] on women patients with borderline personality disorder (BPD); (ii) compare their HRQOL to a normal population group comparable in age; and (iii) test for subgroup differences in HRQOL considering psychiatric DSM axis-I comorbidity. METHOD: The study was conducted in connection to a randomized, controlled trial of psychotherapy for women BPD patients. Seventy-five women with BPD diagnosis were administered the SWED-QUAL. Statistic reliability was evaluated with inter-item correlations, total-item correlations and internal consistency criterions. The BPD patients' SWED-QUAL results were compared with data extracted from a published study and subgroup differences due to axis-I comorbidity were analysed. RESULTS AND CONCLUSIONS: SWED-QUAL could be considered as an instrument with acceptable reliability when assessing HRQOL in BPD patients. The BPD patients suffered significant impairments in HRQOL overall health dimensions compared to normal population. There were no subgroup differences due to axis-I comorbidity, which indicate that BPD in itself might be a predictor of substantial HRQOL impairment.

  • 9.
    Perseius, Kent-Inge
    et al.
    Länssjukhuset i Kalmar.
    Ekdahl, Susanne
    Länssjukhuset i Kalmar.
    Referensgruppen för Långvarig Orofacial Smärta: Multidisciplinär pedagogisk smärt- och stressmanagement som intervention vid orofacial smärta: - uppföljning av vårdkonsumtion och upplevelser hos patienter och personal. Rapport, del I : Upplevelser hos patienter och personal ”Det handlar ju om hela livet egentligen – mycket mer än om tänder”2008Report (Other academic)
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  • 10. Perseius, Kent-Inge
    et al.
    Ekdahl, Susanne
    Asberg, Marie
    Samuelsson, Mats
    To tame a volcano: patients with borderline personality disorder and their perceptions of suffering.2005In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 19, no 4, p. 160-8Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate life situations, suffering, and perceptions of encounter with psychiatric care among 10 patients with borderline personality disorder. The results are based on a hermeneutic interpretation of narrative interviews in addition to biographical material (diary excerpts and poems). The interpretation revealed three comprehensive theme areas: life on the edge , the struggle for health and dignity-a balance act on a slack wire over a volcano , and the good and the bad act of psychiatric care in the drama of suffering . These theme areas form a movement back and forth-from despair and unendurable suffering to struggle for health and dignity and a life worth living. Common beliefs regarding these patients among personnel and implications for psychiatric care are discussed in relation to the results.

  • 11. 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.

  • 12. Perseius, Kent-Inge
    et al.
    Ojehagen, Agneta
    Ekdahl, Susanne
    Asberg, Marie
    Samuelsson, Mats
    Treatment of suicidal and deliberate self-harming patients with borderline personality disorder using dialectical behavioral therapy: the patients' and the therapists' perceptions.2003In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 17, no 5, p. 218-27Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate patients and therapists perception of receiving and giving dialectical behavioral therapy (DBT). Ten deliberate self-harm patients with borderline personality disorder and four DBT-therapists were interviewed. The interviews were analyzed with qualitative content analysis. The patients unanimously regard the DBT-therapy as life saving and something that has given them a bearable life situation. The patients and the therapists are concordant on the effective components of the therapy: the understanding, respect, and confirmation in combination with the cognitive and behavioral skills. The experienced effectiveness of DBT is contrasted by the patient's pronouncedly negative experiences from psychiatric care before entering DBT.

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