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- Hellzén, Ove, et al.
(författare)
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Being an outsider : nurses' statements about a vignette of an elderly resident with a schizophrenia diagnosis and dementia behaviour.
- 2004
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 11:2, s. 213-220
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Tidskriftsartikel (refereegranskat)abstract
- In an exploratory study of nurses' approach to elderly people with a diagnosis of long-term schizophrenia, the aim was to investigate nurses' views of the care of an elderly fictitious person with long-term schizophrenia. All the nurses in one municipality in northern Sweden working at seven different units were investigated. A vignette, which was based on a case description in a previous study of an 84-year-old woman with severe dementia and problematic behaviour, was used after a minor alteration. In this study, the woman's age in the case description was changed from 84 to 68 years and the diagnosis was changed from severe dementia to long-term schizophrenia; otherwise, the description was the same as in the original case. The main finding was the nurses' inability to see the resident as anything other than what the 'label', the diagnosis, said. The nurses are interpreted as being caught in a dilemma of loyalty - on the one hand, the loyalty to the organization with its traditional goals and means and, on the other hand, the loyalty to the resident with her wishes in the forefront of their minds.
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| 2. |
- Hellzén, Ove, et al.
(författare)
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Being in a fragmented and isolated world : Iinterviews with carers working with a person with severely autistic disorder. An interview study
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 37:4, s. 346-354
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To illuminate the meaning of being a carer for a person having a severe autistic disorder. Background: Carers working with people with severe autim are occasionally exposed to residents’ self-injurious behaviours and violent actions and at time residents appear resistant to all forms of treatment. Design/Method: A qualitative case study was conducted. Six Swedish carers (ENs), working at a special ward on a nursing home were interviewed about their lived experiences when caring for an individual having a severe autistic disorder. Narrative interviews were conducted and interpreted using a phenomenological-hermeneutic method inspired by Paul Ricoeur. Findings: Two themes were formulated which describe the carers’ reality and their dream of an ideal, which described carers’ experiences of being trapped in a segmented and isolated care reality and thier longing to achieve a sense of wholeness. The findings were interpreted and reflected on in the light of a framework inspired by the German philosopher Karl Jaspers in order to achieve a deeper understanding of the text. Concusions: In their desperation the carers used their empirical knowledge based on scientific knowledge, which could be understood as a substitute for their vision of a consolating wholeness. This paper shows that searching for a substitute to consolation seems to be an important aspect of the meaning of being a carer for a person with severe autistic disorder.
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| 6. |
- Hellzén, Ove, et al.
(författare)
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Living in a group dwelling : how do residents spend their time in a psychiatric group dwelling?
- 2004
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 41:6, s. 651-659
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate how residents at psychiatric group dwellings spend their time. The study consisted of two parts: questionnaires and an observation survey. It included all the staff at two municipal psychiatric group dwellings where the residents were primarily diagnosed as having long-term schizophrenia. This study indicated that, even if the dwellings had a creative climate, there was a negative process in terms of nurses' well-being with a high level of depersonalisation. The residents who displayed a predominant picture of negative symptoms were left alone for 84% of the day, and 29.5% of this could be explained by their illness. The remainder of the residents' time alone remains unexplained. Copyright 2004 Elsevier Ltd
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| 7. |
- Hellzén, Ove, et al.
(författare)
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Nurses' attitudes towards older residents with long-term schizophrenia.
- 2003
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 43:6, s. 616-622
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Tidskriftsartikel (refereegranskat)abstract
- Aim: to investigate whether the carers’ approach could be explained as referring to the clinical picture or the fact that the patient had a diagnosis of schizophrenia. Background: In institutional care, a symptom-oriented approach is a frequently used but seldom-discussed method for treating people with severe mental illness. Design/method: An exploratory study of the staff’s view of a caring approach for a fictitious elderly long-term schizophrenic resident was conducted. All the carers working in the field of psychiatry at seven different units in one municipality in northern Sweden were an integral part of the study. The units were divided into two groups and classified as ‘dwelling’ and ‘support’. The ‘dwelling group’ was characterised by carers working at traditional group dwellings, the ‘support group’ by carers working in small teams and visiting people with long-term mental illness in their homes. Answers were received from 62 women and 23 men, of whom 14 were RNs and 69 were ENs. Measurements: A questionnaire was used; it was developed from a case description of a 68-year-old woman with typical symptoms of severe cognitive decline with problematic behaviour and a diagnosis of long-term schizophrenia. Findings: The main finding in this study is that carers with long experience become less sensitive in their relationship with the resident than less experienced carers. There appears to be a tendency for long work experience to have a negative effect on the carers’ attitude towards the resident. Conclusions: The carers could be interpreted as being caught in a moral dilemma between ends and means. On the one hand, the ‘conformist mode’, with the acceptance of ends and means, and, on the other hand, the ‘innovation mode’, with acceptance of ends but with few legitimate means to achieve them.
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| 8. |
- Hellzén, Ove
(författare)
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Nurses' personal statements about factors that influence their decisions about the time they spend with residents with long-term mental illness living in psychiatric group dwellings
- 2004
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 18:3, s. 257-263
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Tidskriftsartikel (refereegranskat)abstract
- One seldom-discussed issue is the factors that influence nurses' decisions about the time they spend with residents in psychiatric care. This study uses a qualitative naturalistic approach and consists of an analysis of focus-group interviews with nurses, which aimed to identify factors affecting nurses' decisions about being with or being nonattendant in their relationship with their residents. Two series of focus-group interviews were conducted, interpreted and analysed through content analysis. The study included all the staff (n=32) at two municipal psychiatric group dwellings housing residents mainly with a diagnosis of long-term schizophrenia. This study revealed that the main factor that determined nurses' nurse/resident time together or nonattendance time was whether they liked or disliked the individual resident. One possible explanation is the carers' change from a perspective in which the nursing care was given on the basis of each resident's needs and rights, based on the individual nurse's professional judgement, to a consumer perspective, which leads to a change in responsibility from themselves to the individual residents.
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| 10. |
- Lilja, Lars, et al.
(författare)
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Judging the Other : Psychiatric nurses´ attitudes towards identified inpatients as measured by semantic differential technique
- 2004
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 11:5, s. 546-553
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Tidskriftsartikel (refereegranskat)abstract
- Nurses' attitudes towards psychiatric patients can be expressed in terms of either a symptom-oriented approach or a personhood-focused approach where the latter is characterized by the ambition to establish a genuine and lasting relationship, while the former places the emphasis on correcting 'defective' patient behaviour. To study whether previous typologies found in a qualitative in-depth interview study exist in a larger quantitative investigation and, if so, to identify and describe a structure for the nurses' attitudes connected to each of the identified typologies. Six psychiatric group dwellings and six acute psychiatric hospital wards participated in the study. In all, 2700 assessments of 163 patients were sent out to 160 respondents and 2436 answers were returned, that is, the external dropout rate was 9.8%. The semantic differential technique was used. This is a method for quantifying the meaning that is attached to an identified phenomenon through series of bipolar pairs of adjectives. The scale has 57 bipolar pairs of adjectives, which estimates an unknown number of dimensions of nurses' attitudes towards an identified patient. The respondents' answers were analysed through entropy-based measures of association combined with structural plots. The analysis revealed that the four typologies existed as a delimited group, especially the groups of 'good' and 'evil' patients, while the 'crazy' and 'invisible' patients existed in a more blurred form. The analysis also revealed that the two groups, 'good' and 'evil', were connected to the nurses' ethical and aesthetic attitude structure, while the 'crazy' patients were linked to the cognitive structure and the 'invisible' patients to the empathetic structure. The study indicates that the two typologies, 'good' and 'evil', could be seen as each other's antithesis and, together with the other two typologies, 'crazy' and 'invisible', they touched upon a structure of the nurses' attitudes that was closely connected to a negative view of the patient except in one case -'the good' patients, which was probably based on his/her exterior symptoms.
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