| 1. |
- Enarsson, Per, 1962-, et al.
(författare)
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“Being good or evil” : applying a common staff approach when caring for patients with psychiatric disease
- 2008
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 3:4, s. 219-229
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Tidskriftsartikel (refereegranskat)abstract
- AbstractThis study was performed to gain a deeper understanding of how psychiatric staff, when caring for patients with psychiatric disease, experience situations that include a common staff approach directed toward an individual client. Nine nurses were interviewed. The interviews were analyzed with a phenomenological-hermeneutic method in order to illuminate the livedexperience of applying a common staff approach. The results revealed several meanings: shedding light on carers’ mutual relationships; being deserted by nurse colleagues; being aware of one’s own basis of evaluation, and that of others; beingjudged by the patient as good or evil; and becoming sensitive to the patient’s suffering. The comprehensive understandingwas that the nurse has a difficult choice*to focus on relations with one’s colleagues or to focus on the situation of the patient, who seems to suffer when a common staff approach is used.
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| 2. |
- Enarsson, Per, 1962-, et al.
(författare)
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Handledningsstrategier i omvårdnad : en kartläggande studie av handledningsmodeller och analys av handledarparadigm
- 1998
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Ingår i: Vård i Norden. - : SAGE Publications. - 0107-4083 .- 1890-4238. ; 18:4, s. 15-21
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Tidskriftsartikel (refereegranskat)abstract
- The study aimed a) to describe existing models in clinical nursing supervision in Sweden and b) to obtain a deeper understanding of the paradigms governing different supervision models. All University Colleges of Nursing and Health Sciences in Sweden were mailed a questionnaire concerning different aspects of clinical nursing supervision. Of the one third (n=13) of the Colleges who had some kind of educational program in nursing supervision, five different models of supervision were identified. The Colleges educational programs in nursing supervision were used as a base to select at random four clinical nursing supervisors, who then were interviewed. The interviews were analysed using a paradigm interpreting method resulting in a chart of the paradigm components held by the clinical nursing supervisors. The results showed that although the supervision programmes of the 13 colleges were of different direction, length and content, there were some pervading components in all programmes. The Colleges showed poor knowledge about each others programs. Analysis of the interviews with the clinical nursing supervisors showed they had difficulties in articulating the theoretical frame of their supervision, whereas the practical aspects were easier to express. The rituals around the supervision sessions seemed more important than the theoretical frame. Another interpretation were that the supervisors personal paradigm also influenced the way the supervision was carried out.
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| 3. |
- Enarsson, Per, 1962-
(författare)
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Mellan frihet och trygghet : personalgemensamt förhållningssätt i psykiatrisk omvårdnad
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The common staff approach in psychiatric care has not been studied explicitly before. Earlier studies in related areas of social processes in psychiatric care highlight the importance of the interaction between the patient and the carer to understanding communication patterns and attitudes. Other studies on social order and power in psychiatric care shows carers and patients as taking part in a hierarchical system in which patients are subordinate to carers. Aim: The overall aim of this thesis is to study the phenomenon of the common staff approach in psychiatric care, how it emerges, and how it is used and experienced by both carers and patients. Method: In the first study, grounded theory was applied to data from observations and interviews carried out with carers and clients in two psychiatric care group dwellings. In the second and third studies, a phenomenological hermeneutic method was used to analyse narrative interviews conducted with nine careers working on psychiatric wards and nine patients with experience of psychiatric in-care, respectively. In the fourth study, qualitative content analysis was used to analyse data obtained by a vignette method from interviews with 13 carers with experience of working in psychiatric in-care. Results: A common staff approach can be understood as a social process in municipality-level group dwellings and psychiatric in-care, imposed by carers on clients or patients with the aim of restoring a predetermined order desired by the carers. When the order is disturbed the carers try to restore it by adopting a common and consistent approach towards the single patient perceived as the threat to order. Barriers to the success of a common staff approach, from the point of view of the carers, include the likelihood that colleagues will interpret situations differently, the chance that patients might succeed in dividing carers into “good” and “bad” camps, and the knowledge that the patient suffers under a common staff approach. The patients’ experiences partly confirm those of the carers – the dominant picture is that the patient feels persecuted and suffers under a common staff approach. However in some situations, patients can perceived the common approach as supportive and aimed to promote their recovery. Carers’ ethical reasoning about the common staff approach is usually applied on an individual basis; it can change depending upon the patient, the situation, and the proposed approach, as well as upon how the approach might affect other patients, staff members, or the carers themselves. Conclusions: The overall results from the four studies show that the common staff approach may meet carers’ needs, which under the approach take precedence over those of patients, but that the approach is more an exercise in asserting power and maintaining control than it is a therapeutic technique; that it is a difficult choice for the single carer to choose between the interests of the patient and the approval of colleagues; that the patient often suffers when a common staff approach is used; and that carers are seldom aware of the suffering experienced by the patient being managed by such an approach. A common staff approach has no part in a care-strategy; it is not an intentional care-plan; instead it appears to be a way for carers who feel vulnerable and under pressure to maintain order by controlling particular patients.
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| 4. |
- Enarsson, Per, et al.
(författare)
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The preservation of order : the use of common approach among staff toward clients in long-term psychiatric care
- 2007
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 17:6, s. 718-729
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Tidskriftsartikel (refereegranskat)abstract
- The authors performed this grounded theory study to gain a deeper understanding of the kinds of social processes that lead to a need among psychiatric nursing staff to reach a common approach on how to act toward individual clients in long-term psychiatric care. They present a theory about the development of such common approaches among staff. The main findings were that in psychiatric group dwellings, when the internal order is perceived as having been disturbed, the staff preserve or restore the internal order by formulating and reaching a common approach. The staff negotiated with each other to achieve an agreement on how to act and behave toward the individual client. The authors isolate and describe different types of order-disturbing incidents and the common approaches taken by the staff in dealing with them. However, their data also show that staff often had difficulties in maintaining a common approach over time.
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| 5. |
- Enarsson, Per, 1962-, et al.
(författare)
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'There should be something gained' : Carers’ ethical reasoning about using a common staff approach in psychiatric in-care
- 2017
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 37:4, s. 217-225
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Tidskriftsartikel (refereegranskat)abstract
- Thirteen carers were interviewed about their ethical reasoning when using a common staff approach to restricting smoking for a psychiatric in-patient. A constructed case structure and a vignette method were used in the interviews, and manifest content analysis of the texts exposed five ethical positions adopted by the carers: ‘best for the person’, ‘best for the patient’, ‘best for others involved with the person/patient’, ‘best for me as a carer’, and ‘best according to rules and regulations’. A second manifest content analysis of language showed terms that expressed value judgments in regard to the carers’ personal experiences. Some carers argued at first from one ethical position, but when the question was changed, they argued from an opposite ethical position. Results may be understood in light of dialog philosophy; ethical reasoning during use of a common staff approach tends to focus either on relations with others or with oneself.
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| 6. |
- Enarsson, Per, 1962-, et al.
(författare)
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"There should be something gained" : carers' ethical reasoning about using a common staff approach in psychiatric in-care
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Thirteen carers experienced in caring for psychiatric in-patients were interviewed about their ethical reasoning when using a common staff approach to restricting smoking for a psychiatric in-patient. A constructed case structure and a vignette method were used in the interviews, and manifest content analysis of the texts exposed five ethical positions (i.e. categories) adopted by the carers: “It is best for the person,” “It is best for the patient,” “It is best for people related to the person/patient,” “It is best for me as a carer,” and “It is best according to rules and regulations”. A second manifest content analysis of language showed 101 terms that expressed value judgments; 97 that concerned rights and obligations, mostly about responsibility and restricting other people’s actions; and 210 that concerned human actions, mainly in regard to personal experiences. Some carers argued at first from one ethical position, but when the question in the vignette was changed, abandoned their earlier position and argued from an opposite ethical position. These results may be understood in light of dialog philosophy; ethical reasoning during use of a common staff approach tends to focus either on relations with others or with oneself.
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| 7. |
- Enarsson, Per, 1962-, et al.
(författare)
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They can do whatever they want’’ : Meanings of receiving psychiatric care based on a common staff approach
- 2011
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 6:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- This study deepens our understanding of how patients, when cared for in a psychiatric ward, experience situations that involve being handled according to a common staff approach. Interviews with nine former psychiatric in-patients were analyzed using a phenomenological–hermeneutic method to illuminate the lived experience of receiving care based on a common staff approach. The results revealed several meanings: discovering that you are as subjected to a common staff approach, becoming aware that no one cares, becoming aware that your freedom is restricted, being afflicted, becoming aware that a common staff approach is not applied by all staff, and feeling safe because someone else is responsible. The comprehensive understanding was that the patient's understanding of being cared for according to a common staff approach was to be seen and treated in accordance with others’ beliefs and valuations, not in line with the patients’ own self-image, while experiencing feelings of affliction.
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| 8. |
- Ehrenberg, Anna, et al.
(författare)
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Äldre personers rätt till omvårdnad : behov, kompetenser, myter och evidens
- 2015
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Rapport (populärvet., debatt m.m.)abstract
- År 2030 beräknas var fjärde person i Sverige vara 65 år eller äldre. Dettaställer stora krav på kunskapen om åldrandet och åldrandets sjukdomaroch omvårdnad av äldre personer – i synnerhet när det gäller de allra äldsta.Äldre personer som bor på särskilda boenden är ofta multisjuka ellerhar nedsatt beslutsförmåga, i huvudsak till följd av demenssjukdom.De finns i dag goda kunskapsunderlag som visar att hög omvårdnadskompetensinte bara ger en kvalitativt bättre omvårdnad, det ger också eneffektivare vård. Ändå förefaller varken stat, landsting eller kommuner haen strategi för hur omvårdnadskompetensen i vården av äldre skall kunnasäkras och utvecklas.Vård och omsorg av äldre skall vara personcentrerad och bygga påevidensbaserad kunskap där vetenskapliga metoder används för att förståoch bedöma den äldre personens komplexa vårdbehov. Trots det stora behovethar idag bara två procent av sjuksköterskorna en specialistutbildninginom äldrevård.Svensk sjuksköterskeförening har i mer än 100 år arbetat med att utvecklaomvårdnad. Svensk sjuksköterskeförening vill gärna ha dialog medkommuner och landsting, staten, pensionärsorganisationer och alla som ärintresserade av en god omvårdnad för äldre personer.
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| 9. |
- Enarsson, Per, 1962-
(författare)
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Kartläggning av utvecklingsbehov inom verksamhetsområdet stöd till personer med funktionsnedsättning :
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Staten och Sveriges Kommuner och Landsting (SKL) har för år 2011 och 2012 tecknat ettåriga överenskommelser om nationella insatser för att stödja utvecklingen aven evidensbaserad praktikinomsocialtjänsten. Det har tidigare saknats en samlad nationell bild av vilka utvecklingsbehov som finns inom verksamhetsområdetstöd till personer med funktionsnedsättning. Som ett led i att stödja socialtjänsten i arbetet med att utveckla detta verksamhetsområdehar SKL under 2012 genomfört en nationell kartläggning avvilka utvecklingsbehov som finns. Målen med kartläggningen har varit att:• Få en nationell bild i form av en rapport av aktuella utvecklingsbehov, som ska fungerasom underlag för kommande överenskommelser.• De län/regionersom ännu inte har gjort egna regionala kartläggningar får stöd i att påbörjaensådan,som kan tjäna som underlag även för regionala prioriteringar och utvecklingsarbeten.En skriftlig sammanfattning och bedömning av respektive läns/regions behov av kompetensutveckling inom områdetfunktionsnedsättning har lämnats av 17 av 21 län/regionerochsammanställts i denna rapport.Länens/regionernasbedömningar av kompetensutvecklingsbehov har bearbetats och presenteras under ett antal teman:1.Värdegrund–det behövs en mer utvecklad medvetenhet om vilka värden som styr verksamheterinom områdetfunktionsnedsättning.2.Brukarinflytande–brukares och anhörigas inflytande behöver stärkas.3.Hälsa–personalens kompetens att stödja bra hälsoval behöver stärkas.4.Människa i samhället–nya brukargrupper behöver få stöd med nya metoder,men även befintliga brukargrupper behöver få ett mer differentierat stöd.5.Barn och ungdom–särskild kompetens behöver utvecklas för att stödja barn med funktionsnedsättning.6.Äldre –särskild kompetens behöver utvecklas för att stödja äldre personer med funktionsnedsättning.7.Personalens kompetens–behov finns av att utveckla nationella utbildningar för personal som arbetar med att stödja personer med funktionsnedsättning.8.Metodutveckling–länen/regionernaser omfattande behov av metodutveckling inom hela området stöd till personer med funktionsnedsättning.9.Organisation och samverkan–behov av att utveckla fler strukturerade samverkansforapå olika nivåer där flera huvudmän är involverade.10.Nationell nivå –staten och SKL behöver aktivt stödja länen/regionernaoch kommunerna i den fortsatta kompetensutvecklingen inom områdetfunktionsnedsättning.Vidare visar kartläggningen att:- Länen/regionernaredovisar omfattande utvecklingsbehov inom området funktionsnedsättning.- Länen/regionernahar varit mycket positiva till initiativet att kartlägga kompetensutvecklingsbehovetinomdettaområde.- Länen/regionernamenar att utvecklingen inom detta område har blivit eftersatt i relation till socialtjänstens andra områden.Flertalet av länen arbetar endast i mindre utsträckning systematiskt med kompetensutveckling inom områdetfunktionsnedsättning, även om undantag finns.
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| 10. |
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