| 1. |
- Hultsjö, Sally, 1973-, et al.
(författare)
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Forced to move on : An interview study with survivors who have lost a relative to suicide
- 2022
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Ingår i: Perspectives in psychiatric care. - : Wiley. - 0031-5990 .- 1744-6163. ; 58:4, s. 2215-2223
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To explore the loss of a relative due to suicide. Design and Methods Ten survivors of relatives who had taken their lives were interviewed. Data was analyzed from a phenomenological perspective. Findings The survivors described how they witnessed the darkness that took over their relatives lifeworld. During the time before and after the suicide, the survivor felt barred from having a role in the relatives care. Practice Implications Understanding and exploring implicit dynamics, such as "a feeling of darkness taking over," "a sense of relief," or "putting on a mask" could be important for developing person-centered suicide care.
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| 2. |
- Hultsjö, Sally, 1973-, et al.
(författare)
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The borderline between life and death : Mental healthcare professionals' experience of why patients commit suicide during ongoing care
- 2019
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 28:9-10, s. 1623-1632
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To explore mental health professionals' experiences in regard to circumstances that cause the patient to take their own life during ongoing care.BACKGROUND: Suicide is a worldwide health problem, and of those who take their own life, nearly 20% have had contact with a psychiatric unit. Mental health professionals may have extended intuitive knowledge that has not been made visible. Mental health professionals' experiences can contribute knowledge that can complement suicide risk assessments and can be helpful in developing approaches and strategies where the hope is to identify and draw attention to people at risk of taking their own life.DESIGN: A reflective lifeworld research.METHODS: Twelve interviews with mental health professionals with experience of working in caring relationships with patients that had taken their life during the period of care. The study was performed in accordance with COREQ (see Supporting Information Data S1).RESULTS: Mental health professionals' experiences regarding circumstances that cause the patient to take their own life are related to the patient's life circumstances that led to a loss of dignity, and finally beyond retrieval. Mental health professionals share patients' struggle to choose between life and death, the darkness of their life and their hopeless situation. This shared experience also makes the mental health professionals wish to relieve patient's suffering but also gives them an understanding of why patients take their own life.CONCLUSIONS: The mental health professionals experience how the patient loses the possibility of living a worthwhile life, recognise darkness within the patient and see how the patient's life is fragile. Suicide described as logical and expected, based on their life and life circumstances, has not been found in previous research. Bearing this in mind, should psychiatric care focus on a proactive approach and act when these circumstances are identified?RELEVANCE TO CLINICAL PRACTICE: The Mental health professionals' tacit knowledge may be used to strengthen uncertain suicide assessments.
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| 3. |
- Ovox, Säidi M., et al.
(författare)
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Trajectory of suicide as a transformation in obscurity-As told by the deceased's next of kin.
- 2024
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 33:1, s. 104-113
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Tidskriftsartikel (refereegranskat)abstract
- There is a collective call from the field of suicide research for studies on the individual dynamics of suicidality in order to understand the deadliness of the suicidal process. This study examines the deceased next of kin's ('survivor's) experience of the suicidal process in order to gain perspectives that can be used in the preventive care of suicidal patients. The aim of this study was to explore the suicide process through the suicide survivor's experience. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twelve in-depth interviews concerning lived experiences of a suicide were conducted. The suicide process is described as the emerging of an obscured transformation of self, and an aligning to this changing understanding of self that forms a unique suicidal death course. This death course contains the co-occurrence of life and death orientations. Survivors' collected knowledge of a suicidal trajectory helps us understand the life conditions of a suicidal person that has ended their life. Life orientation and experiences of self-governance are critical parts of a suicidal trajectory and can have great preventive potential for care and assessments during suicidality. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used for the reporting structure of this article.
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| 4. |
- Wärdig, Rikard, 1979-
(författare)
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Common People : Physical health, lifestyle and quality of life in persons with psychosis and their striving to be like everybody else
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: As psychosis is often a lifelong disorder, improved health-related quality of life (HRQoL) can be a relevant treatment goal. Persons with psychosis have significantly reduced physical health. Research has demonstrated a great excess of mortality due to cardiovascular diseases, as psychosis may lead to an inactive lifestyle and difficulties making healthy lifestyle choices. Metabolic side effects of second-generation antipsychotics are also common. Many are therefore affected by the metabolic syndrome. The overall situation calls for action by developing health promotion interventions suitable for this group. In recent years, there has been an increased interest in the physical health of persons with psychosis. However, efforts have not been optimally tailored to the needs of this group, and health care services have not done enough, despite being aware of the problem.Aim: The general aim of this thesis was to study HRQoL, and metabolic risk factors in persons with psychosis, and by a health promotion intervention and through the participants’ own perspective contribute to an improvement in lifestyle interventions.Methods: Study 1 had a cross-sectional cohort study design that was carried out in specialised psychiatric outpatient departments in Sweden. The patients (n=903) were diagnosed with a psychotic disorder and invited consecutively to participate. A prospective population-based study of public health in the south-east of Sweden (n=7238) served as reference group. Patients were assessed using psychiatric questionnaires, including the Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the EQ5D, both for patients and the population. Several other health status outcomes relevant to the metabolic syndrome were measured, together with lifestyle habits and clinical characteristics. Study II, III and IV were based on a lifestyle intervention for persons with psychosis. Study II was a longitudinal intervention study with a matched reference sample. The purpose of the lifestyle intervention was to promote a healthier lifestyle by combining theoretical education with physical activities. The intervention group consisted of 42 participants. A matching procedure was made in which two individuals per participant were matched (n=84) into a reference group. The reference sample was matched for sex, BMI class, and being of as similar an age as possible. Socio-demographics were collected and metabolic risk factors relevant to the metabolic syndrome were measured. Symptom severity was measured using Clinical Global Impression (CGI), and HRQoL was assessed using EQ5D. Measurements were made at baseline and at a one-year follow-up. In study III, a qualitative exploratory study was conducted in order to explore prerequisites for a healthy lifestyle. Data were collected through individual interviews (n=40), using a semi-structured interview guide with participants who had undergone the lifestyle intervention. Data were collected 6–7 months after the intervention had been completed. Conventional content analysis was used. Study IV was also based on these 40 interviews and aimed to describe how persons with psychosis perceive participation in a lifestyle intervention. A phenomenographic analysis approach was used.Results/conclusions: Persons with psychosis are at great additional risk of physical comorbidity. Almost half of the patients met the criteria for metabolic syndrome. In addition, persons with psychosis had significantly lower HRQoL in all dimensions in the EQ5D, except for the pain/discomfort dimension. The only risk factor included in the metabolic syndrome that was associated with lower HRQoL was elevated blood pressure. Raised LDL-cholesterol was also related to lower HRQoL, together with low GAF, older age, high BMI, and female gender. The intervention study demonstrated that HRQoL was significantly improved in the intervention group when comparing EQ-VAS at baseline and at the one-year follow-up. It can be concluded that our intervention was not powerful enough to influence the metabolic factors to any greater extent. The key prerequisite for a healthy lifestyle seemed to be a wish to take part in the society and a longing to live like everybody else. However, many became stuck in a constant state of planning instead of taking action towards achieving a healthy lifestyle. Support by health care professionals is therefore also a prerequisite for a healthy lifestyle. This support should target the transition from thought to action and facilitate the participants’ ability to mirror themselves against healthy people in society by introducing activities they perceive that “common people” do. The challenge for health care professionals is to find a moderate intervention level that does not underestimate or overestimate the person’s capacity. This can facilitate continued participation, and participants can thereby find new social contacts and achieve health benefits.
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| 5. |
- Wärdig, Rikard, 1979-, et al.
(författare)
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Nurses Experiences of Suicide Prevention in Primary Health Care (PHC) - A Qualitative Interview Study
- 2022
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Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis Inc. - 0161-2840 .- 1096-4673. ; 43:10, s. 903-912
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Tidskriftsartikel (refereegranskat)abstract
- Aim The purpose was to describe nurses experiences of suicide prevention work in primary health care (PHC). Background Suicide is the tenth most common cause of death among adults. PHC has an important role in suicide prevention work, as patients often had contact with PHC before their suicide rather than with specialist psychiatric care. Nurses often have the first contact with the patient and are responsible for triage and assessment, making them important in suicide prevention work. Previous studies shed light on suicide prevention in a primary care context, but the nurses voices are missing. Methods Fifteen qualitative interviews were conducted with nurses in primary health care. Data was analyzed according to conventional content analysis techniques. Findings Nurses may avoid asking questions about suicidality for fear of what to do with the answer. To support the nurses ability in suicide prevention work, both educational and practical experience are fundamental. There was a lack of clarity about who is carrying responsibility for the patient, and it turned out to be difficult to help the patient move further to the next care institution. There was a need for guidelines as well as routines for collaboration with other care actors in suicide prevention work. Conclusion The PHC organization does not support nurses in suicide prevention, therefore they need the right conditions for their work. Suicide prevention needs to be given greater focus and space within education as well as training in the ongoing clinical work, which can be performed with less extensive efforts.
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