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  • 1.
    Andersson, Urban
    et al.
    Psykiatriska kliniken, Mälarsjukhuset, Eskilstuna.
    Fathollahi, Jafar
    Psykiatriska kliniken, Mälarsjukhuset, Eskilstuna.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Nurses’ experiences of informal coercion on adult psychiatric wards2020Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 27, nr 3, s. 741-753Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as ‘a necessary evil’, confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients’ dignity and autonomy.

    Aim:

    To describe nurses’ experiences of being involved in informal coercion in adult psychiatric inpatient care.

    Research design:

    The study has a qualitative, inductive design.

    Participants and research context:

    Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis.

    Ethical considerations:

    The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university.

    Findings:

    Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one’s actions and learning together.

    Discussion:

    Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and ‘house rules’ in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients’ dignity and autonomy.

    Conclusion:

    If there is a need for coercion, that is, if the coercion is found to be an ‘unpleasant good’, rather than ‘necessary evil’ considering the consequences for the patient, it should be subject to reflecting and learning together with the patient

  • 2.
    Boussaid, Lena
    et al.
    Karlstads Universitet, Sweden.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Handledning: att stödja andras professionella utveckling2019Inngår i: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Wiklund Gustin, Lena, Lund: Studentlitteratur AB, 2019, 3, s. 673-697Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 3.
    Eriksson, Nadya Travina
    et al.
    Mälarsjukhuset Hospital, Eskilstuna, Sweden.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Blessed Alienation: The Christian Monastery as a Caring and Restorative Environment2014Inngår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 24, nr 2, s. 172-182Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Being mentally ill is often associated with experiencing alienation from society because sensations are not easily shared with others. Modern health care leads us to pose many questions. Some sufferers search and find their way to monasteries as they did centuries ago. We interviewed six persons staying in a monastery to understand the meaning of health and care in a monastic environment in contemporary Sweden. We analyzed the transcripts by means of a hermeneutic approach and discovered that the helping effect of the monastery was based on its contradictory/paradoxical structure that corresponded to the lifeworld of a person suffering from mental illness. The monastery was a place where one could be different but equal, and simultaneously provided freedom within boundaries, calmness and intensity, privacy and relations, demands and confirmation. This facilitated experiences of health and wholeness, necessary to manage the challenges of recovery.

  • 4.
    Eriksson, Nadya Travina
    et al.
    Mälardalens högskola.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Hermeneutic Inquiry: Researching Lived Experience of Mental Health and Recovery in a Christian Monastery in Contemporary Sweden2018Annet (Fagfellevurdert)
    Abstract [en]

    In this case study, we, the student Nadya and her supervisor Lena, will describe the processand challenges associated with conducting an empirical study for a master’s degree in caringscience in psychiatric nursing. We will describe how the idea for the thesis evolved, theoreticaland practical preparations, as well as methodological procedures in relation to data collectionand analysis. We will also share some reflections we made in relation to challengesencountered during this study. Many of these reflections were directed toward methodologicalaspects of the study. However, along the way, it also became clear that experiences fromconducting the study also yielded important knowledge and understanding about mental healthcare. The reflections about what happened in the encounter between Nadya and theparticipants added depth not only to our understanding of the subject for this study, that is,how mental health, care, and recovery are experienced by people in a Christian monastery incontemporary Sweden, but also shed light on important aspects of mental health nursing inrelation to modern psychiatry.

  • 5.
    Gustafsson, Gabriella
    et al.
    Umeå Universitet, Sweden.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Stress, utbrändhet och utmattningssyndrom2019Inngår i: Omvårdnad vid psykisk ohälsa: på grundnivå / [ed] Skärsäter, Ingela & Wiklund Gustin, Lena, Lund: Studentlitteratur AB, 2019, 3, s. 57-85Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 6.
    Gustafsson, Lena-Karin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Wiklund-Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Lindström, Unni Å
    Enheten för vårdvetenskap, Åbo Akademi, Finland.
    The meaning of reconciliation: Women’s stories about theirexperience of reconciliation with suffering from grief2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 525-532Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Grief can be seen as a form of suffering. In this study grief was not only defined as loss, but as the process of inner suffering caused of some kinds of loss. We must recognise the importance of increased understanding for patient reconciliation with grief to expand earlier formulated knowledge about health and suffering. The aim in this study was ti illuminate the meaning of reconciliation among women suffering from grief.

    Methods:A qualitative explorative design with a hermeneutic narrative approach was used to analyse and interpret the interviews. Caring theory abouth health, suffering and hermeneutical philosophy about understanding provided the point of departure for the analysis. The study was approved by an ethical research committé.

    Results:Findings reveal different plots that give light to the meaning of reconciliation in the different phases of analysis. In the Women´s narratives the meaning of reconciliation is a process to a new way of seeing, but also to opening and transition from the experience of grief and suffering to the experience of health and holiness.

    Conclusions: Reconciliation has a progressive form and the meaning of reconciliation cannot be seen as synonymous or homogenous but an understanding of reconciliation as a heterogenic synthesis of health and suffering. Understanding the reconciliation process will enable nurses to plan and provide professional care, based on caring science.

  • 7.
    Hemberg, Jessica
    et al.
    Åbo Akademi, Vasa, Finland.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Caring from the heart as belonging: —The basis for mediating compassion2020Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 7, nr 2, s. 660-668-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Informal coercion, that is, situations where caregivers use subtle coercive measures to impose their will on patients, is common in adult psychiatric inpatient care. It has been described as ‘a necessary evil’, confronting nurses with an ethical dilemma where they need to balance between a wish to do good, and the risk of violating patients’ dignity and autonomy.

    Aim:

    To describe nurses’ experiences of being involved in informal coercion in adult psychiatric inpatient care.

    Research design:

    The study has a qualitative, inductive design.

    Participants and research context:

    Semi-structured interviews with 10 Swedish psychiatric nurses were analysed with qualitative content analysis.

    Ethical considerations:

    The study was performed in accordance with the Declaration of Helsinki. In line with the Swedish Ethical Review Act, it was also subject to ethical procedures at the university.

    Findings:

    Four domains comprise informal coercion as a process over time. These domains contain 11 categories focusing on different experiences involved in the process: Striving to connect, involving others, adjusting to the caring culture, dealing with laws, justifying coercion, waiting for the patient, persuading the patient, negotiating with the patient, using professional power, scrutinizing one’s actions and learning together.

    Discussion:

    Informal coercion is associated with moral stress as nurses might find themselves torn between a wish to do good for the patient, general practices and ‘house rules’ in the caring culture. In addition, nurses need to be aware of the asymmetry of the caring relationship, in order to avoid compliance becoming a consequence of patients subordinating to nurse power, rather than a result of mutual understanding. Reflections are thus necessary through the process to promote mutual learning and to avoid violations of patients’ dignity and autonomy.

    Conclusion:

    If there is a need for coercion, that is, if the coercion is found to be an ‘unpleasant good’, rather than ‘necessary evil’ considering the consequences for the patient, it should be subject to reflecting and learning together with the patient

  • 8.
    Johansson, Louice
    et al.
    Mälarsjukhuset MSE, Eskilstuna, Sweden.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT-Norges Arktiske Universitet.
    The multifacetted vigilance - nurses’ experiences of caring encounters with patients suffering from substance use disorder2016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 1, s. 303-311Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Nursing care is guided by a value base focusing on promoting dignity and health by means of the caring relationship. However, previous research has revealed that negative attitudes towards ‘addicted’ patients, as well as these patients’ behaviour, can give rise to negative emotions such as frustration and disappointment among nurses. This can contribute to a judgmental and controlling attitude towards patients. To preserve order, nursing interventions focusing on creating structure and stability could be applied in a way that challenges caring values.

    Aims and objectives

    This study aimed to describe how nurses’ working in inpatient psychiatric care experience caring encounters with patients suffering from substance use disorder (SUD).

    Design

    This qualitative study is part of a clinical application project focusing on value-based care of patients suffering from SUD. Data were obtained during four reflective group dialogues with six nurses in a psychiatric hospital.

    Methods

    The transcribed dialogues were subjected to latent qualitative content analysis.

    Results

    The analysis facilitated the organisation of the findings into a coherent pattern. A common thread of meaning was conceptualised as a theme labelled ‘the multifaceted vigilance’, describing how nurses strived to deliver good care, while at the same time being vigilant towards patients’ behaviour as well as their own reactions to it. Within that theme, four categories described experiences related to different challenges nurses face in caring encounters.

    Conclusion

    We suggest that this perhaps unavoidable aspect of caring encounters can be an asset. Thus, if acknowledged and subject to reflection, being vigilant could be understood as a strength enabling nurses to safeguard caring values, and to use their authority to promote patients’ health and alleviate suffering.

  • 9. Koslander, Tiburtius
    et al.
    Rönning, Sonia
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Region Västmanland.
    Magnusson, Sofia
    Refion Dalarna.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    A ‘near‐life experience’: lived experiences of spirituality from the perspective of people who have been subject to inpatient psychiatric care2020Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To describe lived experiences of spirituality fromthe perspective of people who have been subject to inpa-tient psychiatric care and to interpret these experiencesfrom an understanding of health as dialectical.Methods: After approval from a regional ethical board,eleven participants were recruited from two organisationsfor people with mental health problems. Participantswere asked to narrate about spiritual experiences andoccasions where such experiences had come close. Thetranscribed interviews were analysed by means of a phe-nomenological hermeneutical approach.Findings: A structural analysis of the text resulted inthree themes; perceiving the presence of something extramundane, making sense of reality and struggling foracceptance. The comprehensive understanding highlightsspiritual experiences as going beyond religion, eventhough religious experiences appear as part of it. Theseexperiences can indeed be a resource contributing toexperiences of hope, connectedness, meaning and coher-ence in life. However, they can also give rise to doubt,anxiety and feelings of loneliness and hopelessness.Rather than understanding spiritual experiences as beingeither ‘good’ or ‘bad’, we could approach spirituality assomething that is always present in alternate and inter-related forms. Metaphorically, this could be understoodas a ‘near-life experience’, summarising participants’experiences related to their struggle with issues related tosuffering and health which are simultaneously present.Conclusions: If psychiatric nurses could approach thiscomplexity and, without being judgemental, exploreseemingly positive and negative experiences of spiritual-ity as dialectically related to each other, rather thanviewing them as either resources or problems, this couldcontribute to insiderness care and hopefully also supportpeople who struggle with these experiences to seek helpwhen needed

  • 10.
    Lassenius, O.
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Karolinska Institutet, Sweden.
    Arman, M.
    Karolinska Institutet, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund-Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Narvik University College, Norway.
    Motivation does not come with an ending-it's the beginning of something new: Experiences of motivating persons with psychiatric disabilities to physical activity2014Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 35, nr 9, s. 713-720Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Despite strong evidence for the positive relationship between physical activity and mental health, physical activity is used far too little to promote health in mental health care. Fourteen caregivers working in community mental health services were interviewed about their experiences of motivating adult persons with psychiatric disabilities to be physically active, and data were analysed using a phenomenological-hermeneutical approach. Three themes emerged: (1) An approach of conscious acts, (2) Companionship as a joint creation, and (3) Understanding as a way to create meaning. The interpreted meaning of motivating to physical activity was expressed as a dynamic way of being, relating, and understanding.

  • 11.
    Lassenius, Oona
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Arman, Maria
    Karolinska Institutet, Department of Neurobiology.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Åkerlind, Ingemar
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Narvik University College.
    Moving toward Reclaiming Life: Lived Experiences of Being Physically Active Among Persons with Psychiatric Disabilities2013Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, nr 10, s. 739-746Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There is abundant documentation in research about the significant relationship between physical activity and mental health, but there is still more to be learned about what can enhance motivation to become more physically active. Fourteen persons with psychiatric disabilities were interviewed about their experiences of being physically active, and data was analyzed using a phenomenologicalhermeneutic method. Five themes emerged: Capability for Living, Liberation from a Heavy Mind, Companionship in Being in Motion, Longing for Living One’s Life, and Struggling with Limitations. The interpreted meaning of being physically active was to be moving toward reclaiming one’s life.

  • 12.
    Lassenius, Oona
    et al.
    Karolinska Institutet, Sweden.
    Arman, Maria
    Karolinska Institutet, Sweden.
    Wiklund-Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Exploring the significance of interactive video games for physical activity among persons with psychiatric disabilities using experimental single case designManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Problem: Persons with psychiatric disabilities exhibit low levels of physical activity, which is a known general health risk factor. Nonetheless, physical activity is used far too little as health promotion in mental health care. Interactive video games are an emerging technology that can be used to increase physical activity levels. This study primarily aimed at exploring the significance of these games as a way to promote physical activity and health among persons with psychiatric disabilities.

    Method: Two participants played the interactive video game during an intervention for a period of 15 weeks. The study was conducted as a pilot study with a single case design and with an applied mixed methods approach.

    Results: Both participants increased their playing time during the intervention, and playing the game was experienced as fun, stimulating, and evolving. Through the challenge that the game provided, the participants’ motivation to continue playing seemed to be reinforced. Playing the game was found to strengthen the participants’ sense of capability and provided an experience of companionship with oneself.

    Conclusions: Being physically active in this manner enabled experiences of evolvement and competence, which could be considered an essential driving force of recovery and reconnection with one’s own life. The technique can therefore be regarded as an enabling tool for physical activity — however, the value of the support from another human being cannot be overlooked.

  • 13.
    Lassenius, Oona
    et al.
    Karolinska Institutet.
    Åkerlind, Ingemar
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Arman, Maria
    Karolinska Institutet.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Self-reported health and physical activity among community mental healthcare users2013Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, nr 1, s. 82-90Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to survey the self-reported health and physical activity in a sample of community mental healthcare users in a city of Sweden. The study was conducted through a cross-sectional design with participants requested to fill out a self-report questionnaire. Participants (n =103) were persons with psychiatric disabilities living in residential psychiatric settings and/or participating in daily activities provided by community mental healthcare services. The results showed that the group is affected with serious risk factors, such as high body mass index, low rated extent and frequency of physical activity and low self-estimated general state of health. Even though some difficulties associated with the answering process of this questionnaire emerged, these self-reported results clearly confirm the fact that persons with psychiatric disabilities constitute a vulnerable group in need for health-promoting caring activities and interventions.

  • 14.
    Lindgren, Sari J
    et al.
    Høgskolen i Narvik, Norway.
    Storli, Sissel L
    Universitetet i Tromsø, Norway.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Å leve i forhandlinger – Pasienterfaringer av å være i den diagnostiske prosessen med å få diagnosen KOLS2015Inngår i: Best Practice, Vol. 5, nr 16, s. 23-28Artikkel i tidsskrift (Annet vitenskapelig)
  • 15.
    Lindgren, Sari
    et al.
    Narvik University College.
    Storli, Sissel Lisa
    Universitetet i Tromsö.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Living in negotiation: patients’ experiences of being in the diagnostic process of COPD2014Inngår i: International Journal of COPD, ISSN 1178-2005, Vol. 9, s. 441-451Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To illuminate patients’ lived experiences of going through the process of being diagnosed with chronic obstructive pulmonary disease (COPD). Patients and methods: A phenomenological-hermeneutic analysis was applied in the inter- pretation of interviews with eight persons diagnosed with mild or moderate COPD.

    Results: One main theme ‘living in negotiation’, and three themes ‘living with a body out of step with the diagnosis’, ‘dealing with the past’, and ‘being challenged by the future’ reflected the process participants were living through in their quest for acceptance and a new balance in life. Participants found that the diagnostic processes were confusing, and that the diagnosis itself was ‘a slap in the face’. Unclear messages gave rise to fluctuating between an under- standing of the condition as ‘not too severe’, insecurity, and fear. Shame and guilt related to the diagnosis had origins in the past, and in combination with the idea of ‘chronic’ the COPD diagnosis interfered with the present moment and gave rise to uncertainty for the future. The understanding of the present is related to negotiations not only with the past, but also with the future. Thus temporal aspects of the diagnosis are of great significance for the process of finding acceptance.

    Conclusion: Regardless of disease severity, the diagnosis seems to be a breakdown of life, which puts life itself at stake. Medical professionals should be aware that the way the diagnosis is disclosed and communicated has considerable significance for how individuals understand and deal with their illness. The diagnosis should be communicated face-to-face, clearly and with empathy, and followed by information about COPD. Physicians should allow time and listen to the patients’ stories, and thus develop a shared understanding of the temporal aspect of the illness and patients’ needs and concerns. Thus, good communication is essential in determin- ing whether the patient remains in negotiation, or enters a process toward acceptance and new understanding.

  • 16. Malm, Meta
    et al.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Själ2017Inngår i: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin, L & Bergbom, I, Lund: Studentlitteratur AB, 2017, 2, s. 125-138Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 17.
    Martinsson, Gunilla
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Lindholm, Christina
    Karolinska Institutet.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Struggling for existence: - Life situation experiences of older persons with mental disorders2012Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, nr Art. nr. 18422Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. ‘‘Struggling for existence’’ emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care

  • 18.
    Martinsson, Gunilla
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Lindholm, Christina
    Karolinska Institutet.
    Specialist prescribing of psychotropic drugs to older persons in Sweden: a register-based study of 188 024 older persons2012Inngår i: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 12, nr 197Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    The situation for older persons with mental disorders other than dementia disorders has scarcely been studied. The older population is increasing worldwide and along with this increase the prevalence of mental disorders will also rise. The treatment of older persons with mental disorders entails complex challenges, with drugs constituting the major medical treatment. Knowledge of geriatric psychiatry is essential for providing older persons with appropriate treatment and care. This study aimed to evaluate the prescription of drugs for mental disorders to older persons (>=65) in Sweden, focused on the medical specialties of the prescribing physicians.

    Methods

    Data concerning drug treatment for older persons from 2006 to 2008 was gathered from the Swedish Prescribed Drug Register. Mental disorders, defined as affective, psychotic and anxiety disorders (ICD-10 F20-42) were evaluated in order to identify associated drugs. Included was a total of 188 024 older individuals, who collectively filled 2 013 079 prescriptions for the treatment of mental disorders. Descriptive analyses were performed, including frequency distribution and 95% CI. The competence of the prescribers was analyzed by subdividing them into five groups: geriatricians, psychiatrists, general practitioners (GPs), other specialists, and physicians without specialist education.

    Results

    GPs represented the main prescribers, whereas geriatricians and psychiatrists rarely prescribed drugs to older persons. Benzodiazepines and tricyclic antidepressants were the most commonly prescribed drugs. Women were prescribed drugs from geriatricians and psychiatrists to a greater extent than men.

    Conclusions

    This study examined the prescription of psychotropic drugs to older persons. Physicians specialized in older persons' disorders and mental health were rarely the prescribers of these drugs. Contrary to clinical guidelines, benzodiazepines and tricyclic antidepressants were commonly prescribed to older persons, emphasizing the need for continuous examination of pharmaceutical treatment for older persons. The results indicate a future need of more specialists in geriatrics and psychiatry.

  • 19.
    Martinsson, Gunilla
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Fagerberg, Ingegerd
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Lindholm, Christina
    Karolinska Institutet.
    Mental disorders affect older persons in Sweden: a register-based study2011Inngår i: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 26, nr 3, s. 277-283Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The study aimed to estimate the prevalence of mental disorders based on pharmaceutical use among the old (age >/= 65) in Sweden for the years 2006-2008. METHODS: Data on the mental health of older persons were approximated on the basis of recommended prescriptions for pharmaceuticals, gathered from the Swedish Register on Prescribed Pharmaceuticals (SRPP). Each disorder (ICD-10, F20-F42, and F60-F61) was analyzed to identify associated recommended pharmaceuticals. Anatomical Therapeutic Chemical Classification codes were applied. The data covered 188 024 individuals who received 2 013 079 prescriptions for pharmaceuticals for mental disorders during a 3-year period. Persons with pharmaceuticals for dementia disorders were excluded from the calculations of the prevalence of mental disorders. RESULTS: The prevalence of mental disorders among the old in Sweden, measured on the basis of pharmaceutical use, was 6.6% in 2006, 2007, and 2008, respectively. Men constituted one-third of cases and women two-thirds. Prevalence was lowest in the age group 65-69 and increased subsequently with age. CONCLUSIONS: This fundamental register-based study included a great number of older persons and shows that mental disorders affect every fifteenth older person in Sweden. The prevalence of mental disorders increases with increasing age. The results highlight the extent of mental disorders among older persons, which is important to know when planning care for these patients. This study, by investigating a large population, provides a solid basis for general planning as well as for future mental disorder research.

  • 20.
    Martinsson, Gunilla
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Lindholm, Christina
    Karolinska Institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Being altruistically egoistic:  Nursing aides’ experiences of caring for older persons with mental disorders2011Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, nr 4, s. 7530-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given

  • 21.
    Priebe, Åsa
    et al.
    County Council of Stockholm, Sweden.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Fredriksson, Lennart
    Uppsala University, Sweden.
    A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations2018Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 2, s. 856-865Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously-used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self-esteem is restored. When synthesized, these themes gave rise to a main theme - a sanctuary of safety - where suffering is alleviated and dignity and self-esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients' recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self-esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses' caring expertise

  • 22.
    Salzmann-Erikson, M.
    et al.
    University of Gävle, Gävle, Sweden.
    Rydlo, Cecilia
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT-Norges Arktiske Univesitet, Norway.
    Getting to know the person behind the illness - the significance of interacting with patients hospitalised in forensic psychiatric settings2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 9-10, s. 1426-1434Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives: To describe what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings. Background: Relationships between staff and patients in forensic psychiatric settings should be grounded in trust and confidence, and the patients need opportunities for emotional reconciliation. However, relationships can be challenging for nurses, who sometimes distance themselves from patients' expressions of suffering. The role of forensic mental health nurses is nebulous, as are the prescriptives and the implementation of nursing practices. Design: Qualitative descriptive design. Methods: In-depth interviews with five nurses who all work in forensic psychiatric settings. Results: We present a descriptive analysis of what nurses want to accomplish in relationships with patients who are hospitalised in forensic psychiatric settings. The results are presented in two main categories: (1) getting to know the person behind the illness and (2) making a difference. Conclusion: Care in forensic psychiatry needs to shift towards a more long-term view of the role of nursing, focusing less on the traditional and stereotypical identity of the productive nurse and more on the care given when nurses slow down and take the time to see the patients as individuals. Establishing trusting relationships with patients in forensic psychiatric settings is viewed as a less oppressive way to control patients and guide them in directions that are preferable for the nurses and for the society. Relevance to clinical practice: Nurses may use simple strategies in their daily practice such as sitting on the sofa with patients to establish trust. We stress that nurses should abandon policing roles and custodial activities in favour of guiding principles that promote individual recovery, treatment and health-promoting care.

  • 23.
    Sellin, Linda
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Asp, Margareta
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Kumlin, Tomas
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Malardalen Univ, Sch Hlth Care & Social Welf, Box 883, S-72123 Vasteras, Sweden..
    Wallsten, Tuula
    Uppsala Univ, Cty Hosp, Clin Res Ctr, Vasteras, Sweden..
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT Archt Univ Norway, Dept Hlth & Care Sci, Campus Narvik, Narvik, Norway.
    To be present, share and nurture: a lifeworld phenomenological study of relatives' participation in the suicidal person's recovery2017Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, artikkel-id 1287985Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In today's health care, participation is acknowledged as important. However, there is limited research on how relatives of patients at risk of suicide experience their opportunities to participate in care during periods when their close ones are subject to inpatient care. The aim of this study was to describe the phenomenon of participation, as experienced by relatives of persons who are subject to inpatient psychiatric care due to a risk of suicide. The study was conducted through a reflective lifeworld research (RLR) approach, based on phenomenological philosophy. Eight relatives of patients receiving care from professionals in a psychiatric specialist health care context in Sweden participated in phenomenon-oriented interviews. Data were analysed to elucidate a meaning structure of the phenomenon. The findings show that the phenomenon of participation was more associated with patients' recovery processes than with the caring process, and means "being actively involved in a process in which the person regains the desire to live". The meaning of participation is further described by its meaning constituents: struggling for being able to be present for the person at risk of suicide, being able to share everyday life, and nurturing sources for vitality. These insights into the meaning of participation highlight the importance of allowing supportive relatives to be a part of the patient's life, while the person is cared for in an inpatient hospital setting. Thus, participation enables relatives to be acknowledged as resourceful human beings in the patient's recovery process, and thereby facilitates a sense of being able to manage and share life itself together with the person. This means that mental health nurses need to recognize individual variations of relatives' participation processes, and take on the responsibility of acknowledging relatives' lifeworlds.

  • 24.
    Sellin, Linda
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Asp, Margareta
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallsten, Tuula
    Uppsala Universitet, Sweden.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT, Norges Arktiske Universitet.
    Philosophical Grounding in a Reflective Lifeworld Research Approach: Where Is the Place for Description vs. Interpretation?2016Inngår i: International Journal of Qualitative Methods, ISSN 1609-4069, E-ISSN 1609-4069, Vol. 15, nr 1Artikkel i tidsskrift (Fagfellevurdert)
  • 25.
    Sellin, Linda
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Asp, Margareta
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallsten, Tuula
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Uppsala University, Sweden.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT-Norges Arktiske Universitet, Norway.
    Reconnecting with oneself while struggling between life and death: The phenomenon of recovery as experienced by persons at risk of suicide2017Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 26, nr 2, s. 200-207Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The body of knowledge regarding health and recovery as experienced by patients at risk of suicide is limited. More research is needed into the meaning of recovery and what strengthens the desire to live. The aim of this study was to describe the phenomenon of recovery in a context of nursing care as experienced by persons at risk of suicide. In line with a reflective lifeworld research approach, 14 patients from a psychiatric clinic in Sweden participated in phenomenon-oriented interviews. Data were analyzed to describe the essence of the phenomenon. The results reveal that the phenomenon of recovery means ‘reconnecting with oneself while struggling between life and death’. Three meaning constituents emerged: being in an expressive space and giving voice to oneself, regaining dignity through nurturing connectedness, and finding a balance in the tension between life and death. In conclusion, the meaning of recovery is to experience the ability to manage one's own life. Professional caregivers need to acknowledge patients' lifeworlds, in a way that enable patients to experience themselves as capable of managing their own lives. Professional caregivers should also facilitate the involvement of supportive relatives.

  • 26.
    Sellin, Linda
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Kumlin, Tomas
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallsten, Tuula
    Uppsala Univ, Cty Hosp, Clin Res Ctr, Vasteras, Sweden..
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT Archt Univ Norway, Narvik, Norway.
    Caring for the suicidal person: A Delphi study of what characterizes a recovery-oriented caring approach2018Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 6, s. 1756-1766Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    More research is needed for supporting mental health nurses in their caring for suicidal individuals. This study aimed to describe what characterizes a recovery‐oriented caring approach, and how this can be expressed through caring acts involving suicidal patients and their relatives. Delphi methodology was used, and research participants were recruited as experts by experience to explore a recovery‐oriented caring approach in a dialogical process between the experts and the researchers. The results highlight that it is important to acknowledge the view of the uniqueness of each person and reflected understanding of each individual person and experience. The results also reveal that a recovery‐oriented caring approach is characterized by a ‘communicative togetherness’. This communicative togetherness is associated with enabling a nurturing and caring space for suicidal patients to really express themselves and to reach for their own resources. The recovery‐oriented caring approach has thereby potential to facilitate a mutual understanding of the complexities of the patient's situation, and supports patients in influencing their care and regaining authority over their own lives. Accordingly, mental health nurses need to listen sensitively to what suicidal patients really say by acknowledging their lifeworlds and being open to individual variations of their recovery processes. This includes recognizing available and supportive relatives as capable of contributing to the patient's life project to continue living.

  • 27.
    Sellin, Linda
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Kumlin, Tomas
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallsten, Tuula
    Uppsala Univ, Cty Hosp, Clin Res Ctr, Vasteras, Sweden..
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT Archt Univ Norway, Narvik, Norway.
    Experiences of a Recovery-Oriented Caring Approach to Suicidal Behavior: A single-case study2019Inngår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 29, nr 14, s. 2084-2095Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Research considering the basis for mental health nurses wanting to enable recovery among people who suffer from suicidal behavior is sparse. The aim of this study is to explore and evaluate how a new recovery-oriented caring approach (ROCA) was experienced by a suicidal patient in a context of close relatives and nurses. A single-case study with a qual-quan mixed-method design was chosen. Participants were recruited from a psychiatric clinic in Sweden and consisted of one patient, one close relative to the patient, and three nurses. The results reveal that the ROCA enabled the patient to narrate, bear experiences of hopelessness, and ask for support, rather than view suicide as the only possible solution. ROCA has the potential to support patients, relatives, and nurses to develop a common language, considering the patient’s life situation and struggles and to use this as a source for the patient’s individual care planning.

  • 28.
    Sellin, Linda
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallsten, Tuula
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund-Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Development of suicide prevention based on a lifeworld perspective2014Inngår i: HVV2014, Abstract Book, 2014, s. 44-44Konferansepaper (Fagfellevurdert)
  • 29.
    Sellin, Linda
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Samtal för återhämtning i livets ytterkanter2020Inngår i: Läkande samtal / [ed] Dahlberg, Karin, Stockholm: Liber, 2020, 1, s. 203-228Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 30.
    Skärsäter, Ingela
    et al.
    Högskolan i Halmstad, Sweden.
    Wiklund Gustin, LenaMälardalens högskola, Akademin för hälsa, vård och välfärd.
    Omvårdnad vid psykisk ohälsa: på grundnivå2019Collection/Antologi (Annet vitenskapelig)
    Abstract [sv]

    Boken presenterar översiktlig kunskap om psykisk ohälsa,psykiatriska sjukdomar och individers problematik rörande psykisk ohälsa. Den första delen fokuserar på den mest förekommande ohälsan inom psykiatrisk vård. Den senare delen belyser viktiga områden som har betydelse för hur vården kring patienten kan förstås och hanteras, såsom vårdens miljö och organisation, attityder kring psykiska dilemman, närståendes medverkan och kvalitetsarbete inom psykiatrisk vård. I denna tredje upplaga har tidigare kapitel uppdateras med ny forskning,och utvecklats med tanke på att sjuksköterskor träffar personer som lider av psykisk ohälsa också i andra former av vård än inom den psykiatriska vården. Dessutom har några nya kapitel tillkommit som belyser barns övergång från barnpsykiatrisk vård till vuxen psykiatrisk vård och våld i nära relationer. Ytterligare två kapitel finns med som fokuserar på interaktioner och reflektioner kring vård av personer inom psykiatrisk heldygnsvård.

    I fokus står den unga, den vuxna och den äldre individen och dennes problematik. Utgångspunkten är ett omvårdnadsperspektiv med hänvisningar till omgivande områden såsom medicin,sociologi, farmakologi och psykologi. Det genomgående perspektivet är omvårdnad vid psykisk ohälsa, även om de konkreta åtgärder som beskrivs också kan inspirera och vägleda andra professioner i deras hälsoarbete.

    Boken vänder sig främst till studenter i grundutbildningen till sjuksköterska, men den kan också med fördel användas inom utbildningar med inriktning mot folkhälsa samt av kliniskt verksamma sjuksköterskor inom kommunal vård och primär- eller specialistvård.

    Omvårdnad vid psykisk ohälsa – på grundnivå omfattar också en digital del. Vid sidan av den digitala versionen av boken finns material som underlättar studierna i form av kapitelsammanfattningar, övningar och sluttest.

  • 31.
    Vincze, M.
    et al.
    Karsudden Hospital, Katrineholm, Sweden .
    Fredriksson, L.
    Centre for Research and Development, Uppsala University/County Council of Gävleborg, Sweden .
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings2015Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 24, nr 2, s. 149-157Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Patients in forensic psychiatric settings not only have to deal with their mental illness, but also memories of criminal activities and being involuntarily hospitalized. The aim of the present study was to explore how nurses working in forensic psychiatric services understand and approach patients' experiences of suffering. Data were generated by semistructured interviews with psychiatric nurses from two different forensic psychiatric units in Sweden. Data were analysed by means of a hermeneutic approach inspired by Ricoeur's hermeneutics. The findings are reflected in four main themes: (i) ignoring suffering; (ii) explaining suffering as a natural and inevitable part of daily life in the forensic context; (iii) ascribing meaning to suffering; and, (iv) being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering means that nurses are not only confronted with patients' suffering, but also their own reactions to those patients. If suffering is not recognized or encountered, there is a risk that actions may have a negative impact on patients.

    Fulltekst (pdf)
    fulltext
  • 32.
    Wangberg, Silje C
    et al.
    Høgskolen i Narvik, Norway.
    Lejon, R M
    Eriksen, Trond
    Nebb, Ann-Heidi
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Løvold, M
    Wackers, Ger
    Aagaard, M
    Utprøving av Klient- og Resultatstyrt praksis (KOR) i tverrfaglig spesialisert rusbehandling på døgninstitusjon ved Nordlandsklinikken2015Rapport (Annet vitenskapelig)
    Abstract [no]

    Psykoterapiforskning viser at mesteparten av det som spiller en rolle for bedring fra psykiske lidelser foregår i klientens hverdagsliv og i relasjonen til terapeuten. ”Partners for change outcome management system” (PCOMS; https://heartandsoulofchange.com/norway.php) er utviklet med henblikk på å få fatt i og å jobbe med disse to faktorene. I praksis gjør man dette ved utgangspunkt i to spørreskjema som på norsk kalles for Klient- og resultatstyrt praksis (KOR). KOR er vesentlig forskjellig fra andre evidensbaserte tiltak ved at det kan anvendes på tvers av diagnostiske grupper og metoder.

    Bruk av KOR i polikliniske settinger viser gode effekter. Ingen har derimot undersøkt hvorvidt KOR også kan egne seg i en rusdøgnbehandlingsinstitusjon. Vi ville finne ut om henholdsvis terapeutene og klientene får til å fylle ut skjemaene etter hver samtale, å snakke om resultatene, og om det oppleves som nyttig for behandlingen å gjøre det. Våre tre hovedutfallsmål var (1) drop-out, eller rettere sagt, prediksjon og forebygging av frafall fra behandlingen før den er planlagt avsluttet, (2) symptombedring, og (3) opplevd nytte. Kvalitative data ble også samlet inn og sett i sammenheng med de kvantitative for å forsøke å belyse om og hvordan behandlerne endrer sin praksis ved innføring av KOR.

    Siden kun 5% av pasientene i prosjektperioden hadde fått registrert dato og grunn for avslutning av behandling, kunne vi ikke teste vår hovedhypotese; hvorvidt KOR bidrar til reduksjon av frafall fra behandling. Og i det store og det hele fikk vi ikke ut de kvantitative data vi hadde håpet på i dette prosjektet. Vi presenterer likevel vårt opprinnelige design i sin helhet i håp om at andre kan finne noe av nytte der for planlegging av fremtidige studier.

    I de kvalitative intervjuene fortalte imidlertid pasientene at de opplever KOR som et godt verktøy som bidrar til å gjøre behandlingen mer rett på sak og at de får større innvirkning på den. Det ble dog pekt på utfordringer som vi fortolker som et gjenstående behov for veiledning i bruken av KOR, altså at de fleste negative erfaringene pasientene hadde, som å bli redusert til et nummer, handlet om at KOR ikke ble anvendt i tråd med intensjonen. Dette ble også bekreftet i avslutningsmøte med koordinatorene; at de ønsket at vi hadde tilbydd mer informasjon og veiledning i starten av prosjektet.

    De kvalitative intervjuene med behandlerne tyder på at behandlerne opplever at KOR er et godt verktøy på mange vis, men at det i sin nåværende form ikke helt passer i døgnbehandling. Nordlandsklinikken har imidlertid valgt å innføre bruk av KOR som standard praksis ved poliklinikken.

  • 33.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Att använda sin specialistkompetens i patientens tjänst2014Inngår i: Vårdande vid psykisk ohälsa: På avancerad nivå, Lund: Studentlitteratur AB, 2014, 2, s. 457--487Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 34.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Att balansera mellan värdighet och skam2014Inngår i: Vårdande vid psykisk ohälsa: På avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur AB, 2014, 2, s. 231-246Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 35.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Att balansera mellan värdighet och skam2010Inngår i: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur , 2010, 1, s. 217-234Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 36.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Att evidensbasera och utveckla psykiatrisk omvårdnad2019Inngår i: Vårdande vid psykisk ohälsa - på avancerad nivå / [ed] Wiklund Gustin, Lena, Lund: Studentlitteratur AB, 2019, 3, s. 619-646Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 37.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Høgskolen i Narvik.
    Att förstå något genom något annat - metaforer i narrativ hermeneutik2014Inngår i: Hermeneutik i vårdpraxis. : Det nära, detflyktiga, det dolda / [ed] Erna Lassenius & Elisabet Severinsson, Malmö: Gleerups Utbildning AB, 2014, s. 107-120Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 38.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Att integrera teori och praktik i personcentrerad vård2019Inngår i: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Wiklund Gustin, Lena, Lund: Studentlitteratur AB, 2019, 3, s. 545--567Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 39.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Att närma sig det svårförståeliga2014Inngår i: Vårdande vid psykisk ohälsa: På avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur AB, 2014, 2, s. 21-37Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 40.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Att utbilda sig till specialistsjuksköterska inom psykiatrisk vård2019Inngår i: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Wiklund Gustin, Lena, Lund: Studentlitteratur AB, 2019, 3, s. 29-47Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 41.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. UiT/The Arctic University of Norway.
    Att möta och bära andras lidande.2017Konferansepaper (Annet vitenskapelig)
  • 42.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Being mindful as a phenomenological attitude2018Inngår i: Journal of Holistic Nursing, ISSN 0898-0101, E-ISSN 1552-5724, Vol. 36, nr 3, s. 272-281Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this article is to reflect on being mindful as a phenomenological attitude rather than on describing mindfulness as a therapeutic intervention. I will also explore the possibilities that being mindful might open up in relation to nursing research and holistic nursing. Design and Method: I will describe and interpret mindfulness as a state of being by means of van Manen’s phenomenological method, using the language of phenomenology rather than the language of reductionist science. Thus, this article can be considered a reflective narrative, describing both the process of orienting to the phenomenon, making preunderstandings—including own experiences of mindfulness—visible, and a thematic analysis of nine scientific articles describing the phenomenon. Findings: Being mindful as a phenomenological attitude can be described as a deliberate intentionality, where the person is present in the moment and open to what is going on, bridling personal values and accepting the unfamiliar, thus achieving a sense of being peacefully situated in the world, and able to apprehend one’s being-in-the-world. Conclusions: Being mindful as a phenomenological attitude can contribute not only to phenomenological nursing research but also support nurses’ presence and awareness

  • 43.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Beroende och frihet2014Inngår i: Vårdande vid psykisk ohälsa: På avancerad nivå, Lund: Studentlitteratur AB, 2014, 2, s. 381-396Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 44.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Beroende och frihet - vårdandets paradox2010Inngår i: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur , 2010, 1, s. 315-333Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 45.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT-Norges Arktiske Universitet, Sweden.
    Co-creation of Narrative Data: An Ethical and Methodological Challenge2016Inngår i: International Journal of Qualitative Methods, ISSN 1609-4069, E-ISSN 1609-4069, Vol. 15, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In qualitative research articles, different approaches to narrative analysis are frequently described. Even though methods for collecting data are described, less focus has been put on narrative data from an epistemological point of view. However, as humans, we live in a storied world. To narrate is a way to create meaning by organizing and structuring events, and the narrative is also considered to have an identity-creating nature. This has implications for research not only for how we represent the world in our research but also for how we understand the interaction between interviewer and interviewee. Hence, narration cannot be reduced to the transformation of data from the participant to the researcher. Rather narration must be understood as a way to relate to another human being. In this presentation, I will take my point of departure in narration as an aspect of self-understanding, and the ethical and methodological challenges associated with the dialogical relationship between the researcher and the participant. Influenced by Paul Ricoeur’s philosophy as well as theories about caring conversation I will reflect on the significance of concepts like autonomy, mutuality, asymmetry, and presence in relation to narrative research. This reflection will provide basis not only for ethical reflections but also for methodological considerations concerning trustworthiness and narrative truth.

  • 46.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Compassion for self and others as key aspects of wellbeing in changing times2017Inngår i: Nordic College of Caring Science (NCCS), European Academy of Caring Science (EACS) & Nord Universitetet, 2017Konferansepaper (Annet vitenskapelig)
  • 47.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. UiT/The Arctic University of Norway.
    Compassion for self and others as key aspects of well-being in changing times2017Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, nr 3, s. 427-433Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Compassion has been put forth as a core concept in caring science, although there has also been a debate over whether it is a nonprofessional sentiment or not. In this theoretical article, I reflect on compassion not only for others but also for oneself as being important for patients' as well as professionals' well-being. My reflections on compassion as being essential in caring are grounded not only in caring science but also in research from other disciplines, as a means of exploring why we need compassion in caring from different perspectives. My conclusion is that in changing times, where patients as well as caregivers are confronted with challenges in life, compassion for self as well as others must be acknowledged as pivotal in relation to well-being and care

  • 48.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Experiential and Reflective Learning of Caring Theory2012Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Reflective and experiential learning is put forth as essential for understanding caring (Johns, 2009), and could also be understood as a way to recognize multiple ways of knowing and create genuine teaching-learning experiences.

     

    In this project a group consisting of eight nursing teachers met for ten one and a half hour long sessions, aiming to enhance participant’s ability to deal with stress in daily life by exploring personal thoughts and feelings and how they contribute to every-day-stress, as well as developing a more mindful and authentic way of living in line with personal values. Between each session participants assign themselves to “homework” focusing different kinds of self-care.

     

    After each session and a break for personal reflection and refreshment participants joined again in order to reflect upon their experiences in relation to Watson’s (2008) ten caritas processes. Basic learning principle adopted from Kolb (1984), i.e. to have an experience and make observations during that experience, to reflect on the experience, make theoretical links and finally plan how to implement the new understanding aimed as a didactic framework in order to enhance learning and understanding.

     

    The poster presents the structure and content of these sessions, and findings from an evaluation of the project, focusing on what aspects that contributed to learning and understanding Caring Theory.

  • 49.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Förståelse och personcentrerad vård inom psykiatrisk omvårdnad2017Inngår i: Vägen till patientens värld och personcentrerad vård / [ed] Dahlberg, Karin & Ekman, Inger, Stockholm: Liber, 2017, 1, s. 243-268Kapittel i bok, del av antologi (Fagfellevurdert)
  • 50.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Implications for theory: a challenge for researchers?2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 417-418Artikkel i tidsskrift (Annet vitenskapelig)
123 1 - 50 of 109
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