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- Ander, Cecilia, et al.
(author)
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Nurses’ experiences of using the NANDA International taxonomy in mental healthcare
- 2023
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In: Mental Health Practice. - : RCNi. - 1465-8720 .- 2047-895X.
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Journal article (peer-reviewed)abstract
- Background The lack of a standardised nursing taxonomy to clarify nurses’ assessments and other elements of the nursing process can potentially lead to a lack of care continuity and patient safety. The taxonomy published by NANDA International (NANDA-I) has been shown to improve the quality of mental health nurses’ documentation and clinical care.Aim To describe nurses’ experience of working in mental health inpatient care with a structured nursing taxonomy of diagnoses based on the NANDA-I taxonomy.Method Semi-structured interviews were conducted with five nurses working on three inpatient wards in a mental health unit in Sweden. The data were analysed using qualitative manifest content analysis.Findings The nurses’ experiences of using the NANDA-I taxonomy were described through three themes: ‘benefits of having a common language’, ‘usefulness of the NANDA-I taxonomy in the mental health context’, and ‘importance of how healthcare organisations apply the NANDA-I taxonomy’.Conclusion The common language provided by the NANDA-I taxonomy contributed to making nursing care more structured and person-centred. However, for the NANDA-I taxonomy to be effective, local nursing guidelines need to be synchronised with it.
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2. |
- Grbovic, Filip, et al.
(author)
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Assessing the Alignment of Short-Term Assessment of Risk and Treatability (START) with NANDA-I Taxonomy in Forensic Care Settings
- 2023
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In: Perspectives in psychiatric care. - : John Wiley & Sons. - 0031-5990 .- 1744-6163.
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Journal article (peer-reviewed)abstract
- Purpose. To investigate the alignment of START with NANDA-I in forensic psychiatric care. Design. A quantitative design was chosen to compare the START instrument with the NANDA-I taxonomy and analyze their alignment. Each item of the START was attempted to be matched with potentially relevant NANDA-I diagnoses, and the matched diagnoses were extracted and presented. Findings. The study demonstrated a strong alignment between START coding and NANDA-I diagnoses, with 99% of the START diagnoses finding a match within NANDA-I. These results support the use of NANDA-I in forensic psychiatric care, which facilitate providing comprehensive care and avoiding sole focus on psychiatric problems. Practice Implications. It is recommended to use a structured nursing taxonomy, such as NANDA-I, in forensic psychiatric care.
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3. |
- Okenwa-Emegwa, Leah, 1973-, et al.
(author)
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Dare to Ask! : A Model for Teaching Nursing Students about Identifying and Responding to Violence against Women and Domestic Violence
- 2024
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In: Nursing Reports. - : MDPI. - 2039-439X .- 2039-4403. ; 14:1, s. 603-615
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Journal article (peer-reviewed)abstract
- The role of nurses in identifying and responding to family violence and violence against women has long been established. However, nurses’ readiness to fully assume this role remains low due to various barriers and the sensitive nature of the subject. As part of capacity building to address this problem, an additional national qualitative learning target, i.e., to “show knowledge about men’s violence against women and violence in close relationships”, was introduced into the Swedish Higher Education Ordinance for nursing and seven other educational programs between 2017 and 2018. The aim of this paper is to describe how the national qualitative learning target is incorporated into the undergraduate nursing curriculum at the Swedish Red Cross University College. An overview of relevant teaching and learning activities and how they are organized is first presented, followed by the presentation of a proposed didactic model: Dare to Ask and Act! The model details a step-by-step progression from facts and figures, including the role of gender norms, to recognizing signs of abuse in complex clinical situations, as well as developing skills that enhance the courage to ask and act. Due to the sensitive nature of violence victimization, the proposed model reflects the importance of making the subject a reoccurring theme in undergraduate nursing education in order to boost nursing students’ interests and confidence to “Dare to Ask and Act!”. The model also shows that making the subject a recurring theme can be achieved with minimal disruptions to and without overcrowding an existing curriculum.
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4. |
- Okenwa-Emegwa, Leah, 1973-, et al.
(author)
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Våga fråga och agera! : Undervisnings- och lärandeaktiviteter om mäns våld mot kvinnor och våld i nära relationer i sjuksköterskeprogrammet vid Röda Korsets Högskola
- 2021
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In: Socialmedicinsk Tidskrift. - Stockholm : Socialmedicinsk tidskrift. - 0037-833X. ; 98:4, s. 671-683
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Journal article (peer-reviewed)abstract
- År 2017 infördes ett nytt nationellt examensmål ”visa kunskap om mäns våld mot kvinnor och våld i nära relationer” enligt SFS 2017: 857, i högskoleför-ordningen (SFS 1993:100) för vissa utbildningsprogram, där sjuksköterske-programmet är inkluderat. Syftet med denna artikel är att presentera hur det nationella examensmålet har implementerats i sjuksköterskeprogrammet vid Röda Korsets Högskola. Först ges en översikt avseende relevanta undervis-nings- och lärandeaktiviteter och hur de organiseras genom programmets utbildningsplan. I de avslutande reflektionerna presenteras den didaktiska Våga fråga och agera! -modellen. Modellen är en sammanfattning av Röda Korsets Högskolas tillvägagångssätt, det vill säga en stegvis progression i utbildningen från fakta, statistik, normer och värderingar, till att studenterna lär sig hur de kan upptäckta tecken på våld i komplexa kliniska situationer samt vikten av att ha mod att agera. Avslutningsvis är det vår uppfattning att ett tydligt upplägg är viktigt för att uppnå intentionerna med det nationella examensmålet, nämligen: Våga fråga och agera!
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5. |
- Åling, Maria, 1955-, et al.
(author)
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A Scoping Review to Identify Barriers and Enabling Factors for Nurse-Patient Discussions on Sexuality and Sexual Health
- 2021
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In: Nursing Reports. - : MDPI. - 2039-439X .- 2039-4403. ; 11:2, s. 253-266
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Research review (peer-reviewed)abstract
- Background: Sexuality and sexual health (SSH) are essential aspects of care that have evolved since a 1975 World Health Organization (WHO) report on SSH. However, nurses still consider discussing the subject with patients a challenge. This scoping review aimed to map, synthesize, and summarize findings from existing literature regarding barriers and enabling factors for nurse-patient SSH discussions in care contexts. Methods: A scoping review model inspired by Arksey and O'Malley was used to search for and synthesize studies published between 2009 and 2019. The databases searched were the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online, i.e., MEDLARS Online. A total of nineteen articles were eligible to be included. Results: Two main categories of enabling factors were identified, i.e., a professional approach via using core care values and availability of resources. Three major categories of barriers were identified: beliefs and attitudes related to age, gender, and sexual identity; fear and individual convictions; and work-related factors. Conclusions: Applying professionalism and core care values as well as making resources available are likely to promote SSH discussions between nurses and patients. Moreover, there is a need for a norm-critical approach in education and practice.
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7. |
- Åling, Maria, 1955-
(author)
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Implementation of Nursing Diagnosis (i.e. NANDA) in a Forensic Psychiatric setting
- 2016
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In: Abstracts. - Malmö : Psykiatriska riksföreningen för sjuksköterskor. ; , s. 36-
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Conference paper (peer-reviewed)abstract
- The Swedish legislation indicates that patients in the forensic psychiatric setting should be re-integrated into society through rehabilitative measures including nursing care. This was recognized by the National Board of Health and Welfare (i.e. Socialstyrelsen) in 2002, but concluded that there is a vast knowledge gap regarding the aim and the content of nursing care in forensic psychiatric settings. Still nursing care in forensic psychiatry is sparsely described. Recent research confirms this description of a knowledge gap and adds that there is a lack of structured nursing care in forensic psychiatry (Hörberg, 2012). Nonetheless, the content and outcome of nursing care in the forensic psychiatric setting is hard to visualize. The actual patient needs and problems has to be identified and defined. To meet this knowledge gap, structured and categorized descriptions of the patients’ nursing care needs need to be described. Frauenfelder et al., 2014) claims that NANDA could be the tool to label problems and risk diagnoses, although they call for further research.The implementation of nursing diagnoses according to NANDA started in 2011, one year after Forensic Psychiatry Care Stockholm became one department, and the implementation process is still on-going. Previously, the forensic psychiatric care in Stockholm had been spread out over three different departments with dissimilar culture. The new management wanted a “unified department”, and one way to achieve this was to use NANDA as a tool for a common language in nursing care. The implementation started with a meeting with the ward managers and Registered Nurses. A project plan for the implementation was presented and discussed. The project leader met all RNs in the department in small groups to describe and motivate the use of NANDA. Up till now eleven wards have been involved and at least two meetings have been held at each ward. The project leader has participated at ward rounds and supervised the RNs in the use of NANDA. In conclusion, more RNs need to be engaged to continue the progress of the project. Another task is to find a less time consuming implementation process and to evaluate the implementation to this point. It is also important, further down the line, to introduce the tools Nursing Diagnoses Interventions (NIC) and Nursing Diagnoses Outcome (NOC) in the forensic psychiatric setting. Apart from a common nursing language, the use of standardized descriptions, actions and goals would fill the knowledge gap regarding aim and content of nursing care in forensic psychiatric settings (Escalada-Hernandez et. al., 2015).
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8. |
- Åling, Maria, 1955-, et al.
(author)
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Nursing Diagnoses Panorama in a Swedish Forensic Psychiatric Setting Using NANDA-International Taxonomy
- 2018
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In: Journal of Forensic Nursing. - : Lippincott Williams & Wilkins. - 1939-3938 .- 1556-3693. ; 14:3, s. 141-147
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Journal article (peer-reviewed)abstract
- More than 1,000 Swedish hospital beds are occupied by patients in forensic psychiatric settings; their average length of hospitalization is 3-7 years. In this context, nursing diagnoses could be extremely useful to make nursing care structured, measurable, and internationally comparable. The study aimed to describe nursing diagnoses in a Swedish forensic psychiatric setting.METHODS: Data were collected from electronic patient records of 55 patients in a medium-secure forensic psychiatric setting in Sweden. Anonymized data were entered into a database where entries were transformed into figures. Descriptive statistics were used, and frequencies, means, and percentages were calculated. The variables employed were characteristics and related factors, according to NANDA-International (NANDA-I) and International Statistical Classification of Dieseases and Related Heatlh Problems, 10th Revision (ICD-10), diagnoses.RESULTS: The patients had between 1 and 13 NANDA-I diagnoses each. Forty-one of the 55 patients had psychosis as the primary ICD-10 code. The identified nursing diagnoses described the patients' status upon arrival in the forensic psychiatric setting. Of the 55 patients, entries in the patient records describing 300 signs and symptoms (i.e., characteristics and related factors) were found. From these signs and symptoms, 371 entries that fit NANDA-I diagnoses were identified, representing 20 different NANDA-I diagnoses.CONCLUSION: NANDA-I diagnoses individualize patient care, making care person centered. NANDA-I is used all over the world and has the potential to make nursing care structured, measurable, and internationally comparable.
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9. |
- Åling, Maria, 1955-, et al.
(author)
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Patients' Expressed Nursing Care Needs in a Forensic Psychiatric Setting
- 2021
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In: Journal of Forensic Nursing. - : Lippincott Williams & Wilkins. - 1939-3938 .- 1556-3693. ; 17:4, s. 244-252
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Journal article (peer-reviewed)abstract
- The aim of this study was to describe the patients' nursing care needs in a forensic psychiatric setting in line with the NANDA-I classification. Ten patients sentenced to forensic psychiatric care were interviewed. Data were analyzed by means of directed content analysis with a deductive approach, where we used "served time" as a factor in the analysis, thus creating three categories: newly arrived patients with a length of stay of only a couple of years, patients with a length of stay of around 5 years, and patients with a length of stay of more than 5 years. Thirteen NANDA-I diagnoses were identified during the analyses, distributed on seven different domains. When distributing the given NANDA-I diagnoses according to the created categories, an explanatory pattern emerged, and three themes became apparent: denial, insight, and listlessness. Considering the differences in views, the patients' own recognition of what is a problem, a potential, or a risk could improve a "working relation" and, eventually, a recovery. NANDA-I nursing diagnoses may improve individualized and person-centered care as NANDA-I makes care continuously consistent over time.
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10. |
- Åling, Maria, 1955-, et al.
(author)
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What is your story? : The experiences of patients and nurses in secure forensic environments
- 2016
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In: Abstracts. - Malmö : Psykiatriska riksföreningen för sjuksköterskor. ; , s. 35-
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Conference paper (peer-reviewed)abstract
- Nurses who work in forensic environments, practice at the shifting interface of the criminal justice system and the health care system. How they view those in their care, and more importantly, how they engage those in their care, is a significant concern for nursing. Forensic clients are members of a highly stigmatized and stereotyped population. The ability of forensic mental health nurses to provide competent and ethical nursing care is often compromised by personal, social, and political animosity regarding crime, criminality, and mental disorder. Pausing to reflect on the stories of clients and nurses, within a narrative context, evokes understanding, and contributes to the creation of person centered care.In paper one, the coercive treatments experienced by a man who has spent many years in compulsory care in a variety of secure psychiatric settings is explored in response to his confession “I don’t dare to tell them I feel okay!” In paper two, how nurses transition to their roles as forensic nurses is considered as they straddle the custodial and therapeutic aspects of their work, often expressing concerns with their perceptions of “education of the fly” or “faking it ‘til you make it.” In paper three, the mental health contributions of nurses who practice in prisons and correctional institutions is captured in the words “that’s why I bought into this profession, to instill hope and recovery.”Through the examination of these vignettes that have emerged through research and practice, participants will be engaged in an interactive discussion as we consider the implications of narrative nursing vis-à-vis the vast tensions that exist between theory, practice, and research in forensic mental health nursing. Finally, the universal nature of these issues, highlighting contributions from Sweden, Germany and Canada will be illustrated.
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