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- Haglund, Kristina, 1950-
(författare)
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Patient and Staff Perceptions of Medication Administration and Locked Entrance Doors at Psychiatric Wards
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim was, within psychiatric inpatient care, to explore patient and staff perceptions with regard to medication administration and locked entrance doors. In Study I, medication administration was illuminated according to a mini-ethnographic approach. Nurses and voluntarily admitted patients were observed and interviewed. Two central categories of patient and nurse experiences were identified, get control and leave control. In Study II, patients and nurses were interviewed about patient experiences of forced medication. Identified experiences were related to the disease, being forcibly medicated, and the drug. In Study III, the frequency of and reasons for locked entrance doors on Swedish psychiatric inpatient wards were investigated. Seventy three per cent of the doors were locked on a specific day. According to ward managers, doors were most often locked in order to prevent patients from escaping, provide security and safety, and because legalisation. In Study IV/V, voluntarily admitted patients/mental nurse assistants and nurses were interviewed about advantages and disadvantages about being cared for/working on a psychiatric inpatient ward with a locked entrance door. Most advantages mentioned by patients and staff were categorised as protection against “the outside”, secure and efficient care, and control over patients. Most disadvantages mentioned by patients were categorised as confinement, dependence on the staff, and emotional problems for patients. Most disadvantages mentioned by staff were categorised as extra work, confinement, dependence on the staff, and a non-caring environment. In conclusion, medication administration and locked entrance doors are perceived as connected with staff’s control and restricted freedom for patients. Increased reflection among staff about how medication administration and locked entrance doors are perceived by patients would increase staff’s possibilities to prevent potential experiences of coercion due to these situations among patients in psychiatric inpatient care.
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| 2. |
- Haglund, Kristina, et al.
(författare)
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Forced medication in psychiatric care : patient experiences and nurse perceptions
- 2003
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 10:1, s. 65-72
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to describe: patient experiences of and nurse perceptions of patient experiences of forced medication before, during and after forced medication; patient and nurse perceptions of alternatives to forced medication; and whether patients, according to patients and nurses, retrospectively approved of forced medication. Eleven patients and nurses were interviewed about a certain situation of forced medication. Data were analysed by content analysis. The findings demonstrate that forced medication evokes a number of patient experiences according to patients and nurses. These are related to the disease, the situation of being forcibly medicated and the drug. Patients mentioned several alternatives to the forced medication, whereas nurses mentioned no alternatives. A minority of the patients, and not as many patients as the nurses’ thought, retrospectively approved of the use of forced medication. It can be concluded that patients and nurses do not share the same perceptions about what patients experience when forcibly medicated.
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| 3. |
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| 4. |
- Haglund, Kristina, et al.
(författare)
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Psychiatric care behind locked doors. A study regarding the frequency of and the reasons for locked psychiatric wards in Sweden
- 2007
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 14:1, s. 49-54
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Tidskriftsartikel (refereegranskat)abstract
- The general aim was to describe the frequency of and the reasons for locked doors at wards within Swedish psychiatric care. A questionnaire was answered by 193 ward managers. The findings demonstrated that 73% (n = 193) of the wards were locked on the day of investigation. Wards were sometimes locked in the absence of committed patients and sometimes open in the presence of committed patients. Wards were more often locked if at least one committed patient was present. Fewer wards for children and adolescents, than for adults and old people, were locked. More wards in the areas of Sweden's three largest cities, than in the rest of the country, were locked. Fourteen categories of reasons for locking wards were generated by a content analysis of answers to an open-ended question. Most answers were categorized as: prevent patients from escaping, legislation, provide patients and others with safety and security, prevent import and unwelcome visits, and staff's need of control. Staff working in psychiatric care ought to reflect upon and articulate reasons for, and decisions about, locking or opening entrance doors, with the limitation of patients' freedom in mind.
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| 5. |
- Haglund, Kristina, et al.
(författare)
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Psychiatric wards with locked doors : advantages and disadvantages according to nurses and mental health nurse assistants
- 2006
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 15:4, s. 387-394
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objective. To describe nurses’ and mental health nurse assistants’ perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door. Background. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent. Design. The study was explorative and descriptive. Method. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis. Results. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against ‘the outside’. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients’ needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants. Conclusion. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients’ experiences. Relevance to clinical practice. It is important for staff working within psychiatric care to reflect upon the fact that a locked entrance door is connected with a range of negative as well as positive perceptions and to minimize patient and own concerns connected to the locked door.
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| 7. |
- Bergdahl, Lena, 1980-, et al.
(författare)
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Auricular Acupuncture and Cognitive Behavioural Therapy for Insomnia : A Randomised Controlled Study
- 2016
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Ingår i: Sleep Disorders. - : Hindawi Publishing Corporation. - 2090-3545 .- 2090-3553. ; 2016
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i). However CBT-i may not suit everyone. Auricular acupuncture (AA) is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4), with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression scale (HAD), were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder.
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| 9. |
- Bergdahl, Lena, 1980-
(författare)
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Auricular acupuncture for insomnia
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cognitive behavioural therapy for insomnia (CBT-i) is the most effective treatment for insomnia. Studies show that auricular acupuncture (AA) may alleviate insomnia symptoms.The overall aim of the thesis was to compare treatment effects of auricular acupuncture (AA) with cognitive behavioural therapy for insomnia (CBT-i) on symptoms of insomnia, anxiety, depression, hypnotic drugs consumption and quality of life from short- and long-term perspectives.Paper I had a qualitative approach with a descriptive design. 16 participants received group-treatment with AA during their protracted withdrawal phase and were interviewed about their experiences. They participants experienced a reduction in protracted withdrawal symptoms, improved subjective sleep quality, a strong sensation of peacefulness and increased wellbeing.Paper II, III and IV present results from a randomised controlled trial in where the effects of group-treatment with AA and CBT-i were compared in short- and long-term using subjective (questionnaires and sleep diary) and objective (actigraphy) measurements.The results showed that CBT-i was superior to AA in reducing insomnia symptoms in both the short and long run. Both groups experienced significant long-term reduction of depressive symptoms. Further, both groups managed to maintain a decreased intake of hypnotic drugs at the end of the treatment when compared to baseline measurement. Short-term reduction of symptoms of anxiety and depression improved only in the AA group. The results from the objective actigraph recordings showed that the AA group slept more and the CBT-i group less after the treatment and that sleep patterns in both groups reverted to pre-treatment levels after 6 months.Conclusively: AA, as administered in this study, was not as good as CBT-i in treating insomnia symptoms, and should not be used as a stand-alone treatment for insomnia. Our results also demonstrate that prolonged sleep time does not necessarily yield better sleep, and that the perception of insomnia symptoms is not inevitably affected by sleep duration. AA was as effective as CBT-i in ending hypnotic drugs consumption. Moreover, AA was more successful than CBT-i in reducing symptoms of anxiety and depression in the short run. Further studies investigating AA for anxiety and depression are motivated.
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| 10. |
- Bergdahl, Lena, 1980-, et al.
(författare)
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Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage and treatment effects of anxiety-, depression and insomnia symptoms
- 2017
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Ingår i: European Journal of Integrative Medicine. - : Elsevier BV. - 1876-3820 .- 1876-3839. ; 16, s. 15-21
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The interest in non-pharmacological interventions for insomnia disorder has increased. The aim was to assess the immediate treatment effects of auricular acupuncture (AA) and cognitive behavioural therapy for insomnia (CBT-i) regarding discontinuation of hypnotic usage and symptoms of anxiety, depression and insomnia.Method: Prospective randomised controlled study. Fifty-seven participants (mean age 61 years (SD 8.6)) with insomnia disorder and long-term use of non-benzodiazepine hypnotics received group-treatment with AA or CBT-i. Pre- and post-treatment measures included symptoms of anxiety, depression and insomnia via self-report questionnaires: Hospital Anxiety and Depression scale (HAD-A, HAD-D) and Insomnia Severity Index (ISI). Other sleep parameters and hypnotic consumption were measured with a sleep diary. Linear mixed models were performed to examine treatment effect over time within and between the groups.Results: Seventy-one percent of the AA participants and 84% of the CBT-i participants managed to discontinue their hypnotic drug consumption post-treatment. Symptoms of anxiety and depression decreased within the AA group (HAD-A (p < 0.05), HAD-D (p < 0.05)) and insomnia symptoms decreased within the CBT-i group (ISI (p < 0.001)). The only between-group difference occurred in ISI (p < 0.001), in favour of CBT-i. According to the within-group sleep diary results, the CBT-i group went to bed later (p < 0.001), fell asleep quicker (p < 0.05), increased their sleep efficiency (p < 0.001) and self-rated sleep quality (p < 0.05) post-treatment.Conclusions: Both groups ended/maintained low hypnotic drug consumption post-treatment. Short-term reductions occurred in the AA group in anxiety and depression symptoms and in the CBT-i group regarding insomnia symptoms.
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