| 1. |
- Ambrus, Livia, et al.
(författare)
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Plasma Brain-Derived Neurotrophic Factor and Psychopathology in Attempted Suicide
- 2016
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Ingår i: Neuropsychobiology. - : S. Karger AG. - 0302-282X .- 1423-0224. ; 73:4, s. 241-248
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Increasing evidence suggests a link between brain-derived neurotrophic factor (BDNF) and suicidal behaviour (SB). Furthermore, decreased peripheral BDNF levels have been associated with clinical symptoms in various psychiatric disorders as well as with personality dimensions in healthy individuals. However, the relationship between BDNF and psychopathology is poorly investigated regarding SB. Methods: Plasma BDNF concentrations were analysed in 61 recent suicide attempters. Clinical symptoms were evaluated using the Comprehensive Psychopathological Rating Scale. Personality dimensions were assessed using the Marke-Nyman Temperament Scale. Results: Plasma BDNF correlated positively and significantly with the personality dimension Solidity but not with the other personality dimensions or with clinical symptoms. Conclusion: BDNF plays an important role in the regulation of neuroplasticity and neurogenesis in humans. Our results indicate that lower BDNF concentrations are associated with higher levels of impulsiveness and changeability (low scores on the Solidity scale). Furthermore, low plasma BDNF levels may be proposed as a trait marker rather than a state marker for attempted suicide. (C) 2016 S. Karger AG, Basel
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| 2. |
- Lanthén, Klas, et al.
(författare)
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Psychiatric Patients Experiences with Mechanical Restraints : An Interview Study
- 2015
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Ingår i: Psychiatry Journal. - : Hindawi Publishing Corporation. - 2314-4327 .- 2314-4335. ; 2015
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To examine psychiatric patients' experience of mechanical restraints and to describe the care the patients received.Background. All around the world, threats and violence perpetrated by patients in psychiatric emergency inpatient units are quite common and are a prevalent factor concerning the application of mechanical restraints, although psychiatric patients' experiences of mechanical restraints are still moderately unknown.Method. A qualitative design with an inductive approach were used, based on interviews with patients who once been in restraints.Results. This study resulted in an overbridging theme: Physical Presence, Instruction and Composed Behaviour Can Reduce Discontent and Trauma, including five categories. These findings implicated the following: information must be given in a calm and sensitive way, staff must be physically present during the whole procedure, and debriefing after the incident must be conducted.Conclusions. When mechanical restraints were unavoidable, the presence of committed staff during mechanical restraint was important, demonstrating the significance of training acute psychiatric nurses correctly so that their presence is meaningful. Nurses in acute psychiatric settings should be required to be genuinely committed, aware of their actions, and fully present in coercive situations where patients are vulnerable.
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| 3. |
- Rajalin, Mia, 1965-
(författare)
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Distal risk factors, interpersonal functioning & family skills training in attempted suicide
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Suicidal behavior is an important global health problem affecting also significant others. Both genetic and environmental influences play an important role in the development of suicidal behavior. There is a need of interventions for family and friends after a suicide attempt. The aim of this thesis was to assess the impact of family history of suicide (FHS) and early life adversity (ELA) on severity of suicidal behavior and on level of interpersonal problems in suicide attempters. Furthermore it aimed to evaluate a DBT-based skills training program, Family Connections (FC), for relatives and friends of suicide attempters.Methods Studies I and II included 181 suicide attempters. FHS was assessed with the Karolinska Self-Harm History Interview or in patient records. ELA was assessed with the Karolinska Interpersonal Violence Scale (KIVS) measuring exposure to interpersonal violence in childhood. Suicide intent was measured with the Freeman scale. Interpersonal problems were assessed with the Inventory of Interpersonal Problems (IIP).Study III, a pilot study evaluating the effect of FC for family members of suicide attempters, included 13 participants who completed the program with pre- and post-questionnaires. The experience of burden was assessed with the Burden Assessment Scale (BAS), general wellbeing with Brief Symptom Inventory (BSI) and level of depression was assessed with Beck Depression Inventory (BDI). The Swedish scale Questions About Family Members (QAFM) was used to explore the quality of the participants’ relationship with the patient and the Quality of Life Inventory (QOLI) was used to measure satisfaction with life situation.Study IV included 132 family members, and investigated the feasibility and preliminary efficacy of FC in psychiatric care. Participants were assessed pre- and post-intervention with the following self-report questionnaires: BAS, QAFM and Five Facet Mindfulness Questionnaire.Results Male suicide attempters with FHS made more serious and well planned suicide attempts and had higher suicide risk. FHS and exposure to interpersonal violence as a child were independent predictors of suicide in male suicide attempters. Regarding interpersonal problems, suicide attempters with FHS had significantly more often an intrusive personal style, indicating that they might have an impaired ability to create stable, long-lasting relationships. In the pilot study the participants reported a significant reduction in burden, an improved psychic health and an improvement in the relationship with the patient after completing FC. In the fourth study, FC showed to be feasible and effectively implemented in a psychiatric outpatient services clinic. Regarding burden, results were in line with the pilot study, with a significant reduction in all subscales in BAS.Conclusions High-risk patients call for a consideration of both ELA and FHS in clinical suicide risk assessment. In suicide attempters at biological risk, suicide might be prevented with the early recognition of environmental risks. Further, the interpersonal problems associated with FHS may cause difficulties for suicide attempters to accept or benefit from treatment, and caregivers should take into account the characteristics of the suicide attempter´s interpersonal functioning. The results from the pilot study provide support for the need and importance of an educational program addressed specifically to family members of suicide attempters. Preliminary results support the feasibility and potential value of an implementation of FC in psychiatric open care clinics.
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| 4. |
- Sunnqvist, Charlotta, et al.
(författare)
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Depressive symptoms during pregnancy and postpartum in women and use of antidepressant treatment : a longitudinal cohort study
- 2019
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Ingår i: International Journal of Women's Health. - : Nakladatelstvi Lidove noviny. - 1179-1411. ; 11, s. 109-117
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Tidskriftsartikel (refereegranskat)abstract
- Objective; The aim of this study was to investigate whether women, who reported “symptoms of depression” during pregnancy and up to 1.5 years postpartum, who reported domestic violence or not, were treated with antidepressant medication. Material and Methods; A prospective longitudinal cohort study recruited primi- and multiparous women (n=1939). The Edinburgh Postnatal Depression Scale (EPDS), the NorVold Abuse Questionnaire, and a questionnaire about medication during pregnancy were distributed and administered three times, during early, late pregnancy and during the postpartum period. Antidepressant medication was compared between women with EPDS scores < 13 and scores EPDS ≥ 13 as the optimal cut-off for lower and higher symptoms of depression. Results; EPDS scores > 13 were detected in 10.1 % of the women during the whole pregnancy, of those 6.2 % had depressive symptoms already in early pregnancy and 10.0 % during the postpartum period. Women with EPDS scores ≥ 13 and non-exposure to domestic violence were more often non-medicated (p < 0.001). None of the women with EPDS scores ≥ 13 exposed to domestic violence had received any antidepressant medication, albeit the relationship was statistically non-significant. Conclusion; Pregnant women who experienced themselves as having several depressive symptoms, social vulnerability and even a history of domestic violence, did not receive any antidepressant treatment during pregnancy nor postpartum. This study shows the importance of detecting depressive symptoms already during early pregnancy and a need for standardized screening methods.
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| 5. |
- Sunnqvist, Charlotta, et al.
(författare)
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Virtual patient simulation in psychiatric care - A pilot study of digital support for collaborate learning
- 2016
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 17, s. 30-35
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Tidskriftsartikel (refereegranskat)abstract
- Psychiatric and mental health nursing is built on a trusted nurse and patient relationship. Therefore communication and clinical reasoning are two important issues. Our experiences as teachers in psychiatric educational programmes are that the students feel anxiety and fear before they start their clinical practices in psychiatry. Therefore there is a need for bridging over the fear. Technology enhanced learning might support such activities so we used Virtual patients (VPs), an interactive computer simulations of real-life clinical scenarios. The aim of this study was to investigate 4th term nursing students' opinions on the use of Virtual Patients for assessment in a Mental Health and Ill-health course module. We asked 24 volunteering students to practise with five different VP cases during almost 10 weeks before the exam. The participants were gathered together for participating in a written and an oral evaluation. The students were positive to the use of VPs in psychiatry and were very positive to use VPs in their continued nursing education. It seems that Virtual Patients can be an activity producing pedagogic model promoting students' independent knowledge development, critical thinking, reflection and problem solving ability for nurse students in psychiatric care.
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| 6. |
- Vuckovic, Verica, et al.
(författare)
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Preceptors' and nursing students' experiences of peer learning in a psychiatric context : A qualitative study
- 2019
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Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 41
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to investigate preceptors' and nursing students’ experiences of peer learning in a psychiatric context during their clinical education. Design: A qualitative research design was used in this study. Data were analysed with qualitative content analysis. The study was conducted in 2017 with 17 preceptors and 11 students, constituting four focus groups with preceptors and four focus groups with nursing students. Participants: The preceptors were nurses and specialist nurses who worked in inpatient psychiatric care. Nursing students seeking their bachelor's degrees were placed in clinical settings at different psychiatric units for 4 weeks during the fourth semester. Results: One theme emerged: Knowledge acquisition as an interactive process from the two shared categories for students and preceptors: reciprocal learning by communication, doing and reflection and the importance of a supportive relationship. Conclusions: The result of this study suggested that peer learning in clinical education in psychiatric care promoted the learning process for nursing students.
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| 7. |
- Örmon, Karin, et al.
(författare)
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Disclosure of abuse among female patients within general psychiatric care : a cross sectional study
- 2016
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Ingår i: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; :16
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Tidskriftsartikel (refereegranskat)abstract
- Background Experiences of abuse are common among women in general psychiatric care. Even so, there are to our knowledge no previous national or international studies exploring disclosure in a general psychiatric setting of female patient’s experiences of abuse to staff or to formal and informal networks. This study aimed to explore women’s disclosure of experiencing physical, emotional and/or sexual abuse during their most recent contact with staff at a general psychiatric clinic. The study also aimed to determine whether the women have previously disclosed abuse to anyone. Methods A consecutive sampling of eligible female patients at a general psychiatric clinic in an urban area of southern Sweden answered the NorVold Abuse Questionnaire, NorAQ, a self-administrated questionnaire. NorAQ has previously been used and further developed to compare the prevalence of abuse in women present in gynecological outpatient settings in the five Nordic countries. Seventy-seven women with experiences of abuse participated in the research. Descriptive statistics were used to analyse the data. Results Most respondents did not disclose their experiences of abuse to staff at the general psychiatric clinic. Women with experiences of physical abuse (n = 40), emotional abuse (n = 37) and sexual abuse (n = 37) chose not to disclose their experiences. Respondents disclosed abuse more often to others than to staff. Conclusions Our findings indicated the importance of including routine questions concerning abuse experiences as a natural part of female patients’ medical history.
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| 8. |
- Örmon, Karin, et al.
(författare)
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Experiences of the Provided Care in a General Psychiatric Context After Disclosure of Abuse
- 2015
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Ingår i: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 30:S1Abstracts of the 23rd European Congress of Psychiatry
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction Experiences of abuse during childhood and/or adulthood has an impact on women's mental health as well as generating frequent hospital admission. Experiences of abuse are common among female patients in general psychiatric care. Aims and Objectives The aim of the study is to elucidate how nine women with experiences of physical, emotional and/or sexual abuse experienced the care provided at a general psychiatric clinic after disclosure of abuse. Method Qualitative design with an inductive approach. Interviews with nine women who were recipients of general psychiatric care in an urban area in Sweden. The women had disclosed experiences of abuse to a member of staff. Qualitative inductive content analysis was used. Results The nine women reported being subjected to abuse during childhood and adulthood, only one of them reported only being abused as an adult. The overall theme emerging from the narratives, 'Dependency as a reality containing a duality of suffering and trust' describe the general psychiatric care as caring and noncaring. In a caring environment was the women acknowledged, listened to and treated with sensitivity. Experiences of noncaring were when the abuse was disregarded, the women were not believed in, offended or self-blamed for the abuse. A noncaring environment focused primarily on the diagnosis and the experienced abuse was seen as secondary. Conclusions Women who have experienced abuse experience the care provided as caring as well as noncaring. General psychiatric could be supportive as well as belittling depending on staff at the clinic.
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| 9. |
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| 10. |
- Örmon, Karin, et al.
(författare)
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The life course of women who have experienced abuse : a life chart study in general psychiatric care
- 2015
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : John Wiley & Sons. - 1351-0126 .- 1365-2850. ; 22:5, s. 316-325
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Tidskriftsartikel (refereegranskat)abstract
- Violence against women is a worldwide problem and has an impact on the lives of women and girls. The study aims to investigate the life course of women within psychiatric care who have experienced abuse. The women’s resources, stressful events, experience of abuse, perpetrators, mental ill health, and care and support throughout the life course are also highlighted. Eleven women who had all sought general psychiatric care in an urban area in Sweden participated. A computer software program was used for constructing life charts for each participant, and manifest content analysis was used to analyse the data. The women’s social status and resources differed, and some of them spoke of only experiencing few stressful events growing up, while others described a stressful childhood. All of the women had been abused sometime during their life course, and most of the perpetrators were known to the women. Even so, the women had seldom disclosed their childhood abuse. As adults, the women were diagnosed with psychiatric diagnoses, and suicidal behaviour increased. The life chart offers rich information and a broader picture of the life history of women who experienced abuse as well as constituting a tool useful for identifying women with experiences of abuse.
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