| 1. |
- Jormfeldt, Henrika, et al.
(author)
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Perceptions of the concept of health among nurses working in mental health services : a phenomenographic study
- 2007
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In: International Journal of Mental Health Nursing. - Oxford : Blackwell Publishing. - 1445-8330 .- 1447-0349. ; 16:1, s. 50-56
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Journal article (peer-reviewed)abstract
- A new understanding of the concept of health is needed to meet the goal of mental health nursing, which besides reducing disease is to strengthen the patient's health. The aim of the present study was to describe perceptions of the concept of health among nurses working in mental health services. Twelve Swedish nurses working in mental health services were interviewed and data were analysed with a phenomenographic approach. The nurses expressed 10 perceptions, which constituted three description categories: autonomy, process, and participation. The result showed that health was more than absence of disease. Simultaneously, perceptions were expressed indicating that health was viewed as absence of disease, which implies that the concept is not sufficiently defined. The result emphasizes the need to clarify the concept of health if it is to be used as a goal in mental health nursing and to integrate a clarified definition of health at all hierarchical levels in mental health care services.
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| 2. |
- Svedberg, Petra, 1973-, et al.
(author)
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Psychometric characteristics of a self-report questionnaire (HPIQ) focusing on health promotion interventions in mental health services
- 2008
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In: International Journal of Mental Health Nursing. - : Blackwell Publishing. - 1445-8330 .- 1447-0349. ; 17:3, s. 171-179
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Journal article (peer-reviewed)abstract
- The aim of this study was to develop and investigate psychometric properties of the Health Promotion Intervention Questionnaire, a newly developed instrument intended to measure patients' subjective experiences of health promotion interventions in the mental health services. Health promotion practice has often been contested; therefore, it is important to produce convincing evidence that health promotion initiated by the health-care services actually works. A cross-sectional study was performed in order to investigate health promotion interventions among mental health service outpatients. A sample of 135 patients was used to test the psychometric properties of a new questionnaire designed to measure subjective experiences of health promotion interventions carried out by the mental health services. The factor structure of the questionnaire was tested by means of principal component factor analysis with varimax rotation. Reliability was measured in terms of internal consistency of the factors and test-retest reliability in a subsample of patients. The final scale contained 19 items derived from four factors: alliance, empowerment, educational support, and practical support. In terms of internal consistency, reliability was found to be good, both for the overall scale and the subscales. Test-retest reliability was moderate or higher in 13 out of 19 items and poor in only one item. This questionnaire, developed to evaluate patients' experiences of health promotion interventions in mental health services, may be used as an alternative in further empirical studies. With additional testing, the questionnaire could facilitate the work of defining and evaluating health promotion interventions conducted by the mental health services.
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| 3. |
- Bengtsson Tops, Anita, et al.
(author)
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Self-reported consequences and needs for support associated with abuse in female users of psychiatric care
- 2007
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In: International Journal of Mental Health Nursing. - 1445-8330 .- 1447-0349. ; 16:1, s. 35-43
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Journal article (peer-reviewed)abstract
- The aims of the study were to investigate the prevalence of adult abuse in female users of psychiatric care, the relationship between abuse and self-esteem and self-reported consequences of abuse, and women's self-reported needs of support. A total of 1382 women participated in the study. A self-administrated anonymous questionnaire with both closed-ended and open-ended questions was used. Quantitative data were analysed by mainly descriptive statistics and qualitative data were analysed by content analysis. Forty-six per cent (n = 638) of the women had been exposed to emotional, sexual, and/or physical abuse in adulthood. Twenty-eight per cent (n = 385) reported experiences of moderate physical abuse, 27% (n = 373) reported threats of injury, and 20% (n = 277) reported threats of being killed. Further, 19% (n = 261) reported experience of sexual violence, and 12% (n = 164) had experiences of serious physical violence. Women who had been abused rated lower self-esteem than those who were not abused. Self-reported consequences of abuse included intrapersonal problems such as poor self-esteem, fears, anxiety, and worries but also problems in social relations especially with regard to close relationships and reliance to others. To a lesser extent, disease-specific manifestations were reported. The needs of support included interventions directed to the experiences of abuse by professionals trained in the area, family interventions, self-help groups, medical care, legal support, or practical help to find new housing situations. It is concluded that female users of psychiatric care services constitute a vulnerable group with regard to abuse. To meet the women's needs, the care system has to adopt a perspective that includes personal, social, and societal factors.
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| 4. |
- Carlen, Pontus, et al.
(author)
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Suicidal patients as experienced by psychiatric nurses in inpatient care
- 2007
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In: International Journal of Mental Health Nursing. - 1445-8330 .- 1447-0349. ; 16:4, s. 257-265
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Journal article (peer-reviewed)abstract
- Psychiatric nurses have a major influence on the lives of patients with suicidal behaviour in inpatient care. Despite this, there is a lack of knowledge about how nurses experience patients with suicidal behaviour in a deeper sense. The aim of this study was to investigate how psychiatric nurses experience patients with suicidal behaviour within an inpatient psychiatric context. Semi-structured interviews were carried out with 11 psychiatric nurses, each of whom had more than 5 years of experience caring for patients with suicidal behaviour. Data were analysed using qualitative latent content analysis. Two main themes emerged from the data analysis. These are 'labelled' and 'suffering'. In the nurses' natural attitude, they saw patients as being labelled with different conditions and/or behaviours based on objective signs. These were categorized into different groups or identities such as psychiatric diagnosis, mask wearer, screened-off, or the social, relapsing or determined patient. On reflection, however, the nurses described the patients' suffering in terms related to feelings of hopelessness, meaninglessness, and being out of control. The nurses' experiences of the patients as suffering were based on their subjective reflective experience of the patients. The study gives support to the conclusion that two main logic systems are represented in the care of patients with suicidal behaviour: technical practical and nursing perspectives. In order to ensure that these two logic systems combine, it is necessary for the psychiatric care organization to intervene to support the nurses in reflecting on their everyday work.
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| 5. |
- Ewertzon, Mats, 1956-, et al.
(author)
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Developing the concept of family involvement and the alienation questionnaire in the context of psychiatric care
- 2008
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In: International Journal of Mental Health Nursing. - London : Wiley- Blackwell. - 1445-8330 .- 1447-0349. ; 17:6, s. 439-449
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Journal article (peer-reviewed)abstract
- Research shows that family members of persons with a mental illness often experience a lack of involvement in the psychiatric care of their relative. An interpretation of the findings of these studies raises the question whether the family members’ experience of not being involved can be conceptualised in terms of alienation towards mental health services from their encounter with psychiatric care. In order to explore this possibility, the Family Involvement and Alienation Questionnaire (FIAQ) was constructed, guided by relevant theoretical frameworks and empirical research. The content validity of the questionnaire was evaluated by two groups of experienced researchers who had sound knowledge of the theoretical frameworks used. Validity based on the response process was evaluated by parents of persons with mental illness. The reliability of the questionnaire was evaluated by a test-retest design, in a group of 15 family members. The data were analysed by a non-parametric statistical method. The results of the validity and reliability evaluations show that of the 46 original items 28 items in the questionnaire would be useful in exploring the concept of family involvement and alienation in the context of psychiatric care. Further, minor modification may make the FIAQ useful in exploring these concepts in other settings.
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| 6. |
- Gustafsson, Gabriella, et al.
(author)
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Personality traits among burnt out and non-burnt out health-care personnel at the same workplaces : a pilot study
- 2009
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In: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 18:5, s. 336-348
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Journal article (peer-reviewed)abstract
- Stress-related illnesses, such as burnout, have increased over the last decade, but not everyone at the same workplace develops burnout, suggesting that individual factors may contribute to this phenomenon. The aim of this study was to describe patterns of personality traits among two groups of health-care personnel from the same workplaces, one group on sick leave due to medically-assessed burnout, and one group with no indication of burnout, respectively. Fourteen psychiatric- (n = 7) and elderly (n = 7)-care units, located in one specific area in a municipality in northern Sweden, participated in this questionnaire-based study. The participants (n = 40), on sick leave due to medically-assessed burnout (n = 20), and those with no indication of burnout (n = 20), respectively, completed Cattell's 16 Personality Factors Questionnaire between February and December 2004. Conventional statistical methods and partial least square regression were used to analyze data. The results showed that the burnout group had lower scores regarding emotional stability and higher scores regarding anxiety than the non-burnout group, but the results also showed a wide variation of personality traits within groups. The most important indicators for belonging to the burnout group were 'openness to changes' and 'anxiety', and for belonging to the non-burnout group, 'emotional stability', 'liveliness', 'privateness' (i.e. forthright or discreet), and 'tension'. The result indicates complex interactions between personality traits and the context in which the individual lives. It seems to be important to increase our awareness of when personality traits may constitute opportunities versus risks in dealing with one's existing circumstances.
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| 7. |
- Hellzén, Ove, et al.
(author)
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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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In: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 15:1, s. 60-69
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Journal article (peer-reviewed)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. |
- Hultsjö, Sally, et al.
(author)
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Foreign-born and Swedish-born families' perceptions of psychosis care.
- 2009
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In: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 18:1, s. 62-71
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Journal article (peer-reviewed)abstract
- Aim: To describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Methods: Eleven foreign-born and 15 Swedish-born family members were interviewed. Data were analyzed using a phenomenographic approach. Findings: Three main descriptive categories were found: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. Conclusion: The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families' previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.
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| 9. |
- Högberg, Torbjörn, et al.
(author)
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Attitudes towards mental illness in Sweden : adaptation and development of the Community Attitudes towards Mental Illness questionnaire
- 2008
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In: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 17:5, s. 302-310
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Journal article (peer-reviewed)abstract
- The main purpose for the expansion of supported community care for persons with serious mental illness in Sweden was to ensure the right for these persons to live as citizens in the community. However, earlier research shows that negative attitudes towards mental illness present an obstacle for social integration of persons with serious mental illness. The aim of this study, conducted in Sweden, was to evaluate an existing instrument's (Community Attitudes towards Mental Illness, CAMI), validity and reliability. An additional aim was to adapt and develop the questionnaire to Swedish circumstances. After translation and modification of the original CAMI, the Swedish version of the questionnaire (CAMI-S) was distributed to all student nurses at three different universities in Sweden. The overall Cronbach's alpha coefficient was 0.90 of the original CAMI-S. A corrected inter-item total correlation excluded 20 items because they showed loading <0.43. The overall Cronbach's alpha coefficient on the 20 items (new CAMI-S) that showed loading, >0.43, was 0.903. A factor analysis of these items revealed that the data could be extracted in three factors labelled as: open-minded and pro-integration, fear and avoidance and community mental health ideology. Finally, in order to reach reliable results in attitude research, it is important to measure the respondent's attitude towards the object in common as well as the respondent's attitude to interact with the object. Accordingly, it is important to add behavioural intention items to the 'new CAMI-S'. Statements exemplifying how something 'ought to be' in an impersonal way have a good degree of stability over time and place.
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| 10. |
- Johansson, Inger M., 1951, et al.
(author)
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The health-care environment on a locked psychiatric ward: an ethnographic study
- 2006
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In: International Journal of Mental Health Nursing. - Richmond : Wiley-Blackwell. - 1445-8330 .- 1447-0349. ; 15:4, s. 242-250
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Journal article (peer-reviewed)abstract
- Recent changes in psychiatric hospital care involving a reduction in the number of beds and time spent in hospital motivated the study of conditions of inpatient care on such wards. An ethnographic study of a locked, acute psychiatric ward in a department of psychiatry was performed with the aim of describing the health-care environment in such a ward. The ward admitted patients on both a voluntarily and involuntarily basis. Data were collected by means of 3.5 months of participant observations. The results showed a health-care environment that was overshadowed by control. Staff were in control but they also lacked control; they attempted to master the situation in line with organizational demands and they sometimes failed. At the same time, the staff tried to share the responsibility of caring for patients and next of kin. Patients were controlled by staff; they were the underdogs and dependent on staff for their care and the freedom to leave the ward. Patients tried to make themselves heard and reacted to the control by developing counter-strategies. What this study adds to earlier research is patients' pressure on staff and sometimes quite an open struggle for more control, which may be an expression for an unacceptable imbalance in power between patients and staff.
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| 11. |
- Karpowicz, Ewa, et al.
(author)
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Self-esteem in patients treated for anorexia nervosa.
- 2009
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In: International journal of mental health nursing. - Richmond : Wiley. - 1447-0349 .- 1445-8330. ; 18:5, s. 318-25
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Journal article (peer-reviewed)abstract
- Anorexia nervosa (AN) mainly affects girls or women between 13 and 45 years of age. According to previous studies, one of the reasons for the desire to be thin is low self-esteem. The purpose of the study was to examine the self-esteem of 38 female patients with AN between 16 and 25 years of age, before and after 3 months of treatment at a specialist ward for eating disorders in Göteborg, Sweden. A quantitative pre- and post-assessment based on two self-rating questionnaires, the Rosenberg Self-Esteem Scale (RSE-S) and three subscales (weight phobia, body dissatisfaction, and ineffectiveness) of Eating Disorder Inventory-2 (EDI-2), together with body mass index (BMI), were used in the study, which was conducted between June 2005 and March 2008. The results reveal that self-esteem, BMI, weight phobia, and body dissatisfaction improved significantly between pre- and post-treatment. The RSE-S and EDI-2 ineffectiveness correlate highly with one another, which lends support to convergent validity, and the internal consistency was high for both the RSE-S and EDI-2 ineffectiveness. The results indicate that the treatment was effective, as both patients' self-esteem and BMI increased after completed treatment, which was the primary goal of the treatment at this ward. Future studies should focus on follow up and the way self-esteem manifests itself at different points in time within an individual.
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| 12. |
- Lilja, Lars, et al.
(author)
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Former patients' experience of psychiatric care: a qualitative investigation
- 2008
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In: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 17:4, s. 279-286
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Journal article (peer-reviewed)abstract
- In this study, 10 former patients' experiences of hospitalization are described using a qualitative approach. The informant group consisted of three men and seven women with different diagnoses and each with his or her individual experience of life as an inpatient. The aim of this study was to extend our understanding of former psychiatric inpatients' experience their time of admission to a psychiatric inpatients unit. Data were collected and analysed using a content analysis approach. From the former patients' descriptions, the following five themes emerged: being seen as a disease, striving for a sense of control in an alienating and frightening context, succumbing to repressive care, meeting an omniscient master, and care as a light in the darkness. In conclusion, the experience of psychiatric inpatient care could be interpreted and understood from former patients' narratives as a struggle for dignity in the face of discrimination and rejection.
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| 13. |
- Rørtveit, Kristine, et al.
(author)
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The feeling of being trapped in and ashamed of one's own body : A qualitative study of women who suffer from eating difficulties
- 2009
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In: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 18:2, s. 91-99
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore women's bodily experiences of suffering from eating difficulties (ED). The research question was: How do women who suffer from ED experience the bodily aspects related to their condition? Women suffering from ED experience problems in both the physical and emotional areas. Few qualitative studies have specifically addressed sufferers' bodily experiences related to ED. An explorative design was used. The data were collected by means of focus group interviews on the subject of ED-related problems, guilt and shame, and being a mother. The interpretation of the qualitative data was inspired by hermeneutic content analysis. The main theme, 'Powerful feelings of being trapped in and ashamed of one's own body', comprised two themes: 'The feeling of being trapped by overwhelming physical sensations' and 'The feeling of being ashamed of one's own body'. Bodily experiences were reported as strong. One clinical implication for nurses is to acknowledge this fact and make it possible for these women to articulate their difficulties, especially those connected to the feelings of being trapped and ashamed. Support groups focusing on these themes could be one way of assisting women and easing some of the negative feelings associated with ED.
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| 14. |
- Salzmann-Erikson, M., et al.
(author)
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The core characteristics and nursing care activities in psychiatric intensive care units in Sweden
- 2008
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In: International Journal of Mental Health Nursing. - UK : Wiley. - 1445-8330 .- 1447-0349. ; 17:2, s. 98-107
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Journal article (peer-reviewed)abstract
- Internationally, research on psychiatric intensive care units (PICUs) commonly reports results from demographic studies such as criteria for admission, need for involuntary treatment, and the occurrence of violent behaviour. A few international studies describe the caring aspect of the PICUs based specifically on caregivers' experiences. The concept of PICU in Sweden is not clearly defined. The aim of this study is to describe the core characteristics of a PICU in Sweden and to describe the care activities provided for patients admitted to the PICUs. Critical incident technique was used as the research method. Eighteen caregivers at a PICU participated in the study by completing a semistructured questionnaire. In-depth interviews with three nurses and two assistant nurses also constitute the data. An analysis of the content identified four categories that characterize the core of PICU: the dramatic admission, protests and refusal of treatment, escalating behaviours, and temporarily coercive measure. Care activities for PICUs were also analysed and identified as controlling - establishing boundaries, protecting - warding off, supporting - giving intensive assistance, and structuring the environment. Finally, the discussion put focus on determining the intensive aspect of psychiatric care which has not been done in a Swedish perspective before. PICUs were interpreted as a level of care as it is composed by limited structures and closeness in care. © 2008 Australian College of Mental Health Nurses Inc.
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| 15. |
- Schröder, Agneta, et al.
(author)
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Next of kin’s conceptions of the quality of care in the psychiatric setting : a phenomenographic study
- 2007
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In: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 16:5, s. 307-317
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Journal article (peer-reviewed)abstract
- The next of kin play a decisive role in the care provided for patients. This and their unique experience of psychiatric care make it important to include them when defining quality of care. The aim of the present study was to describe how next of kin perceive the concept of quality of care in the case of psychiatric care. Twelve next of kin were included in a qualitative interview study and a phenomenographic approach was used for the analysis of the interviews. The next of kin described quality of care mainly from their own perspective but also to a large extent from the patient's perspective as well. Five descriptive categories resulted: dignity, security, participation, recovery, and health-promoting surroundings. Good relations and communication between staff, patients, and next of kin emerged as the central factors regarding the quality of psychiatric care. The next of kin asked for information about psychiatric illnesses and wanted to cooperate in the care. They avoid telling others about their family member's psychiatric illness because of a feeling of shame and guilt. Staff education regarding such feelings and stigmatization could be useful in furthering the understanding of the next of kin's distress and developing interventions to alleviate it. Clinical practice can be improved by guidelines and instruments developed on the basis of this study.
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| 16. |
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| 17. |
- Skärsäter, Ingela, 1952-, et al.
(author)
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Sense of coherence and social support in relation to recovery in first-episode patients with major depression : a one-year prospective study
- 2005
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In: International Journal of Mental Health Nursing. - Richmond, Australia : Wiley-Blackwell. - 1445-8330 .- 1447-0349. ; 14:4, s. 258-264
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Journal article (peer-reviewed)abstract
- Major depression is a common illness, with a lifetime prevalence rate of 10-13% for men and 21-24% for women. The experience of having a serious illness such as major depression affects the individual's quality of life and requires significant adaptation in order to cope. The aim of this study was to explore sense of coherence and social support in patients treated for a first episode of major depression in a 1-year follow up. The study design was prospective and longitudinal. A total of 24 patients, aged 18 years or over, with a first episode of major depression were included. Semi-structured interviews and self-assessment questionnaires were used at baseline as well as in a 1-year follow up in order to measure the level of severity of the depression, social support, and sense of coherence. The result showed that 71% of the patients had recovered at follow up. The sense of coherence scores were low at baseline, although the patients who recovered increased their sense of coherence scores significantly. Another factor of importance for recovery was a significant increase in social support. Social support is an important cornerstone in the restoration of a person's sense of coherence. It can be used in interventions that include the patient's family or close social network in combination with support to assist the patient to view his/her situation as comprehensible, manageable, and meaningful, thereby promoting or improving health. Mental health nurses are in a key position to identify patients' strengths and weaknesses so that the support and interventions provided can be tailored to meet the needs of each patient.
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| 18. |
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| 19. |
- Skärsäter, Ingela, 1952, et al.
(author)
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Sense of coherence and social support in relation to recovery in first-episode patients with major depression: a one-year prospective study
- 2005
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In: International Journal of Mental Health Nursing. - 1445-8330. ; :14, s. 258-264
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Journal article (peer-reviewed)abstract
- Major depression is a common illness, with a lifetime prevalence rate of 10-13% for men and 21-24% for women. The experience of having a serious illness such as major depression affects the individuals quality of life and requires significant adaptation in order to cope. The aim of this study was to explore sense of coherence and social support in patients treated for a first episode of major depression in a one-year follow up. The study design was prospective and longitudinal. Twenty-four patients, aged 18 years or over, with a first episode of major depression were included. Semi-structured interviews and self-assessment questionnaires were used at baseline as well as in a one-year follow-up in order to measure the level of severity of the depression, social support and sense of coherence. The result showed that 71 % of the patients had recovered at follow up. The sense of coherence scores were low at baseline, although the patients who recovered increased their sense of coherence scores significantly. Another factor of importance for recovery was a significant increase in social support. Social support is an important cornerstone in the restoration of a persons sense of coherence. It can be utilised in interventions that include the patients family or close social network in combination with support to assist the patient to view his/her situation as comprehensible, manageable and meaningful, thereby promoting or improving health. Mental health nurses are in a key position to identify patients strengths and weaknesses so that the support and interventions provided can be tailored to meet the needs of each patient.
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