| 1. |
- Hellzén, Maria, et al.
(författare)
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Psychiatric nurses attitudes towards identified in-patients as measured by the semantic differential technique
- 2005
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 19:1, s. 12-19
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Tidskriftsartikel (refereegranskat)abstract
- Nursing care can figuratively be described as a gift that is given by the nurse in the nurse-patient relationship where attitudes play an important role for the gift's appearance. Sometimes patients are unwilling to or incapable of accepting the gift and this can lead to situations in which nurses are not able to handle their situation in a professional manner. This research survey aimed to investigate nurses' attitudes and find a structure in nurses' attitudes towards their patients. 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. The semantic differential technique was used. The scale has 57 bipolar pairs of adjective, which estimate an unknown number of dimensions of nurses' attitudes towards an identified patient. The respondents' answers were analysed through factor analysis rotated using the Varimax method and etropy-based measures of association combined with structural plots were also used. Both the factor analysis and the entropy revealed three factors, which were interpreted as being of evaluative type. Factor 1 was interpreted as describing nurses' answers mainly as a combination of an ethical and aesthetic evaluation of the patients. Factor 2 was interpreted as being of an empathetic type and factor 3 as nurses' experiences of the patients' cognitive capacity. The study indicates that the dominant aspect of nurses' attitudes in a psychiatric context is the ethical/aesthetic dimension, which is an important finding for the understanding of nurses' attitudes and actions towards their patients.
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| 2. |
- Lilja, Lars, et al.
(författare)
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The meaning of depression : Swedish nurses' perceptions of depressed inpatients
- 2006
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 13:3, s. 269-278
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Tidskriftsartikel (refereegranskat)abstract
- People suffering from depressive disorder are affected by one of the western world's largest medical groups of disorders in both psychiatric and general medicine. Drug treatment is usually the first-line intervention and has been shown to be an effective treatment. Other therapies, including nursing interventions that could be implemented in care, are infrequently used. It is therefore important to understand whether nurses' perceptions of depressed people could be explained from the medical model by defining the nurses' view of psychiatric inpatients. Therefore, the aim of this study was, with the clinical picture as the starting point, to investigate the nurses' view of hospitalized patients with a diagnosis of depression. In this prospective study, 155 nurses' opinion of depression among depressive inpatients was assessed using a questionnaire based on the Montgomery-Asberg Depression Rating Scale. To elucidate the relationship between the variables in the questionnaire, factor analysis rotated by the Varimax method with Kaiser's normalization was used. The factor analysis identified five factors. The number of variables was reduced from 61 to 34. Based on the factor interpretation, an initial factor structure for the depressive inpatient was defined. The identified factors were interpreted and labelled to create the nurses' fused 'picture' or meaning of the depressed inpatient as an individual who experienced feelings of annihilation, alienation, fatigue, emptiness and affliction, an individual who is disconnected from the whole of temporality.
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| 3. |
- Ejneborn-Looi, Git-Marie, et al.
(författare)
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Nurses' perception of the relationship between themselves and the long-term psychiatric client - An interview study
- 2006
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Ingår i: Primary Care & Community Psychiatry. - : Informa Healthcare. - 1746-8841 .- 1746-885X. ; 11:4, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- Background: Even if the importance of a good relationship between staff and clients is well documented, there is a need for a deeper understanding of the interaction in communal settings. The aim of this study was to investigate how staffs at two municipal psychiatric group dwellings describe their relationships with their clients. Methods: A qualitative approach was chosen and in-depth interviews were performed and analysed through content analysis. Results: The analysis resulted in three categories: The good relationship that gives pleasure and nourishment at work', 'Relationships that are characterised by distance and frustration', and 'Striving towards mutual strategies leads to disunity and splits'. Conclusions: The main finding is the lack of general outlines in nurses' work, resulting in two different approaches to clients, which lead to conflicts in the staff group. The staff group that strives for structure and rules could be interpreted as being afraid of being engulfed by their clients. The opposite group, those who stress the close relationship, could be interpreted as engulfing their clients. This statement can be interpreted as the clients risking being alienated in both cases. The conclusion is therefore that the relationships are strongly influenced by the individual nurse's own view of what he/she sees as 'the right caring approach'.
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| 4. |
- 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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| 5. |
- 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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| 6. |
- Engström, J., et al.
(författare)
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Palliative sedation at end of life - A systematic literature review
- 2007
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 11:1, s. 26-35
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Tidskriftsartikel (refereegranskat)abstract
- Palliative sedation at the end of life to handle unmanageable symptoms has been much debated. A systematic literature review in three phases including a content analysis of 15 articles published between the years 1990 and 2005 has been conducted. The aim was to describe the phenomenon of 'palliative sedation at the end of life' from a nursing perspective. The results can be summarised in three themes: 'Important factors leading to the patient receiving sedation at the end of life', 'Attitudes to palliative sedation at the end of life' and 'Nurses' experience of palliative sedation at the end of a patient's life'. Together, the themes show that palliative sedation is a phenomenon that could be described as sedation given to fewer than 40% of dying patients during their Last 4 days of life. It is usually given because of the patient's pain, agitation and/or dyspnoea. Professionals usually have positive attitudes towards it and their view differs from that of the public's view regarding it as continuously deep sedation, whereas the public regards it as being close to euthanasia. Studies focusing on nursing care during palliative sedation are hard to find and this underlines the importance of further research in this area to elucidate the nurses' role during palliative sedation.
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| 7. |
- Hellzén, Ove, et al.
(författare)
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Nurses' narratives about their residents when caring for people with long-term mental illness in municipal group dwellings
- 2006
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Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 15:1, s. 60-69
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Tidskriftsartikel (refereegranskat)abstract
- Nurses working in community psychiatric care are expected to spend time with the residents, in a genuine, professional way, irrespective of their own feelings towards them. Fourteen nurses at two group dwellings in Sweden were interviewed about their experiences when caring for people with long-term mental illness. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur. The analyses were performed in two steps: the first shows that residents could be divided into four different typologies or patterns--the good, the disabled, the invisible, and the bad residents, of which the nurses liked the first two and disliked the last two. In the second analysis, two themes were formulated to describe the nurses' experiences of 'replenishing one's self-worth and self-esteem' and 'giving up the caring role'. These results were interpreted and reflected on in the light of a theoretical framework in order to obtain a deeper understanding of the text. The study indicates that the question of whether nurses liked or disliked the residents appears to be closely related to whether or not the individual resident confirmed the nurse. Residents who confirmed nurses were liked and given attention, whereas those who did not were disliked and given a minimum of time together with the nurse.
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| 8. |
- Holm, Birgitta, et al.
(författare)
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Importance of nutrition for elderly persons with pressure ulcers or a vulnerability for pressure ulcers: a systematic literature review
- 2007
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Ingår i: Australian journal of advanced nursing. - 0813-0531. ; 25:1, s. 77-84
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Forskningsöversikt (refereegranskat)abstract
- The number of elderly people, usually with multiple illnesses, is increasing in our society. In the public debate, many scientists predict that this could lead to a considerable increase in pressure ulcers. Since elderly care was reorganised in Sweden in 1993, the situation for older people has changed. In many cases, access to geriatric expertise and nurses has been reduced and the mortality rate among patients with pressure ulcers is increasing. A literature review, including a content analysis of 16 peer-reviewed articles published between 1995 and 2005, was conducted. The aim was to describe the importance of nutrition in reducing the risk of pressure ulcers and to focus on nursing interventions. The result shows that the analysis can be summarised around four areas: nutrition, prevention, nursing and economic aspects, which elucidate the importance of ensuring that an elderly person's need for energy is met and that nutritional supplements are effective for this group of patients. Early nursing intervention and the use of questionnaires are also stressed as being important. The economic aspects of pressure ulcers are also discussed.
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| 9. |
- Kristiansen, Lisbeth, et al.
(författare)
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Swedish assistant nurses´experiences of job satisfaction when caring for persons suffering from dementia and behavioural disturbances : An interview study
- 2006
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 1:4, s. 245-256
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Tidskriftsartikel (refereegranskat)abstract
- Job satisfaction is complex and is an important component in facilitating high quality nursing care. Behavioural and psychological symptoms of dementia (BPSD) can be clustered into one of five syndromes: psychosis, aggression, psychomotor agitation, depression and apathy, and comprise signs and symptoms of disturbed perception, thought content, mood or behaviour that frequently occur in patients with dementia. BPSD can cause tremendous distress both for the patients and for their caregivers and they have been seen as the most stressful aspect of care giving. Two registered nurses, 16 assistant nurses and two nursing assistants in Sweden talked about their job satisfaction when caring for residents suffering from dementia and BPSD. Thematic content analysis was conducted. The nurses' narrations indicate exposure, insufficiency, not being valued and doubt, as well as respect and importance and devotion towards the residents. One core theme was formulated: "Job satisfaction as a process moving between breaking down and occasionally building up the working person". A positive relationship with colleagues was the primary reason for nurses continuing to work at the group dwellings. The organization and resident behaviours were seen as very negative. Some nurses described insecurity in terms of how long they could continue to take rudeness, being spat at, being scratched or physically hit by residents, without "hitting back". In order to increase the well-being of the nurses, the pressure on them needs to be relieved. The development of leadership, education, supervision and reflection might be one possible way of reducing the prevalence of BPSD-related violence, enhancing job satisfaction and handling moral stress.
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| 10. |
- Kristiansen, Lisbeth, et al.
(författare)
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The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients
- 2005
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 12:6, s. 719-727
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Tidskriftsartikel (refereegranskat)abstract
- The impact of nurses' opinion of client behaviour and level of social functioning on the amount of time they spend with clients For people afflicted with different kinds of psychiatric disorder, suffering is a common denominator. The time the nurses spend with psychiatric clients may mirror their attitudes towards and feelings for these clients. The aim of this study was to investigate the connections between the time spent together and the nurses' opinion of client behaviour and social functioning in community-based psychiatry. In this quantitative study, 29 clients were assessed by 30 nurses, who answered the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Syndrome Scale (PANSS). At the same time, 11,200 non-participant observations of clients were registered using the Patient Activity Classification (PAC) to investigate how they spent their time at two psychiatric group dwellings. The PAC instrument revealed that clients spent an average of 60.8% of time alone, while only 20% of their daily time was spent with the nurses. Based on a factor analysis, indices were made by setting cut-off points for the PANSS and the GAF scores, and four small groups of clients were generated: a relatively high level of social functioning and a low degree of psychiatric symptoms (A); a relatively high level of social functioning and a high degree of psychiatric symptoms (B); a low level of social functioning and a low degree of psychiatric symptoms (C); and, finally, a low level of social functioning and a high degree of psychiatric symptoms (D). The clients judged as having a low level of social functioning in combination with high degrees of psychiatric symptoms, that is, the most vulnerable and dependent individuals, receive less staff attention (18%) and are the clients who spend the most time alone (71.4%). It might be possible to interpret the results of this study in the light of a process of dehumanization.
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