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  • 1. Ekstrand, Per
    et al.
    Kumpula, Esa
    Om sportens betydelse för manliga relationer i vården2010Ingår i: Norma, ISSN 1890-2138, E-ISSN 1890-2146, Vol. 05, nr 1, s. 60-73Artikel i tidskrift (Refereegranskat)
  • 2.
    Kumpula, Esa
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Vårdarnas patientnära arbete inom rättspsykiatrisk vård: det komplexa samspelet mellan samhällsskydd och vårdande utifrån genusperspektiv2020Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background Forensic psychiatric care (FPC) is characterized by the complex interaction between mental illness and the crime the patient has committed. For patient care, this means that male nursing staff are often assigned a superior position within FPC, while female nursing staff are presented as especially suited for providing the care itself. The overall aim was, from a gender perspective, to map patterns of patient care within FPC. Method: The dissertation is based on four qualitative studies. One is a literature study, while the other three adopt an ethnographic approach. The data in Study I consists of peer-reviewed articles that were theoretically analyzed. The Data in Study II consists of interviews that were analyzed by discourse psychology. The data in Study III consists of four focus groups. A thematic analysis was performed on the data. In Study IV, the data consists of observations, field notes and interviews, which were analyzed by thematic analysis. Results: Study I show that health in FPC can be perceived as a complex interplay between protecting society, constructions of masculinity and the physical body. Study II illustrates that nursing staff’s talk about patient care should not be separated from structures framing FPC. Study III illuminates that when nursing staff ignore gender in FPC, this may render invisible patients’ unique health needs linked to their life situation. Study IV reveals a pattern in how protecting society is constructed as superior to providing care. This result can be linked to a gender order that results in unequal conditions for nursing staff’s patient care. Conclusion: The results show how the dual goals are intertwined with nursing staff’s gender values, which affect the nurse-patient relationship and health-promoting activities. By constructing protection of society as having higher priority than care, a gender order is maintained that justifies categorization of patients. Failure to pay attention to the interaction between the dual goals and gender may lead to nursing staff overlooking patients’ individual situations and health needs.

  • 3.
    Kumpula, Esa
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Ekstrand, Per
    Red Cross Univ Coll, Stockholm, Sweden.
    Challenges and Possibilities for Understanding Men's Health in Twenty-First Century Forensic Psychiatric Care2014Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 35, nr 8, s. 613-619Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Forensic psychiatric care in Sweden constitutes a specific institutional environment in health care in terms of gender and power relationships. This context emphasizes safety and protection in an environment where men constitute a majority of the patients and staff. It involves relationships among men's health, constructions of masculinities, and issues regarding equality between women's and men's caring work. The aim of this theoretical article is to problematize men's health in relation to constructions of masculinities. Our analysis shows how the perception of health is involved in the construction of masculinities and how this plays out in daily interactions between caregivers and patients.

  • 4.
    Kumpula, Esa
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Ekstrand, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Doing things together': male caregivers' experiences of giving care to patients in forensic psychiatric care2013Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, nr 1, s. 64-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Studies into work carried out by male caregivers in a care environment in which male patients and male caregivers constitute a majority are lacking. The purpose of this study was to illuminate the experiences of male caregivers in providing care for patients in forensic psychiatric care. The study has a qualitative design and data were constituted by interviews with six male caregivers at a clinic of forensic psychiatry in a town in central Sweden. The method of analysis chosen was latent content analysis. The results consist of four themes: Activities as a component of care, Social training as the basis of care, Feelings of powerlessness and Seeing the complete person. The experience that comes out most distinctly in the descriptions given by caregivers involves performing activities together with the patients. The activities had different significances and these contribute to creating a more secure care relationship, in which the boundaries between personnel and patients become less clear. Physical activities contribute to recreating the patient's health. Social training appears as a component of the care in which the significance of rules and routines in the operations was integrated. Feelings of powerlessness arise when the caregivers do not experience that the care given on the ward contributes to recreating health for the patients. Seeing the complete person behind the crime constitutes the themes that can be said to summarize the meaning of the work carried out by male caregivers.

  • 5. Kumpula, Esa
    et al.
    Ekstrand, Per
    Mälardalens högskola, Akademin för hållbar samhälls- och teknikutveckling.
    Men and Masculinities in Forensic Psyciatric Care:: An interview Study Concerning Male Nurses Experiences of Working with Male Caregivrs and Male Patients2009Ingår i: Issues In Mental Health Nursing, ISSN 0161-2840, Vol. 30, s. 538-546Artikel i tidskrift (Refereegranskat)
    Abstract [en]

     

    Forensic psychiatric care is largely populated by men—as pa-

    tients, caregivers, and nurses. Previous research has not focused on

    the meaning of gender in this context. The aim of this study is to

    analyse male nurses’ experiences of working with male caregivers

    and attending to male patients in forensic psychiatric care. Data

    were collected through interviews with sixmale nurses. The results

    consist of five themes. Protection and defence are key aspects of

    care and male caregivers gain status and authority through their

    physical strength. This could hamper caring and provide male

    caregivers with a superior position in the department.

     

  • 6.
    Kumpula, Esa
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Ekstrand, Per
    Röda korsets högskola, Stockholm.
    Gustafsson, Lena-Karin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    The interplay between security and gender in forensic psychiatric care: an ethnographic study among nursing staffIngår i: Journal of Forensic Nursing, ISSN 1556-3693Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The fact that violence affects nursing staff’s ability to care for patients in Forensic Psychiatric Care (FPC) has been well documented. What has not been adequately addressed is how the interaction between security and gender affects the care given the patients. The aim was to illuminate, from a gender perspective, patterns of nursing staff´s views on security and its consequences for care in FPC. This study adopts an ethnographic approach and the data consists of field notes from participatory observations and interviews with nursing staff at two different FPC clinics in Sweden. Data was processed with thematic analysis. The results showed that when protecting society is given higher priority than care, it should not be separated from nursing staff´s values about gender.  For the female nursing staff this means that the care was linked to a mothering role, whereas male nursing staff duties were not linked to a fathering role. The latter’s focus on security created obstacles for the nurse-patient relationship, which were not experienced to the same extent by female staff. Making gender invisible in FPC creates unequal conditions for nursing staff’s tasks, which can lead to difficulties in achieving improved health for patients.

  • 7.
    Kumpula, Esa
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Gustafsson, Lena-Karin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Ekstrand, P.
    The Swedish Red Cross University College, Flemingsberg Stockholm, Sweden.
    Illuminating the gendered nature of health-promoting activities among nursing staff in forensic psychiatric care2019Ingår i: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, artikel-id e12332Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    When people in Sweden are sentenced and handed over to forensic psychiatric care (FPC), the authorities have overall responsibility for their health recovery. How nursing staff construct gender through their relations in this context affects their understanding of health promotion activities. The aim of this study was to illuminate, using a gender perspective, the understanding of nursing staff with respect to health promotion activities for patients. Four focus group interviews were conducted with nursing staff in two FPC clinics in Sweden. The study has a qualitative inductive design with an ethnographic approach. This study sheds new light on FPC in which its dual goals of protecting society and providing care are viewed from a gender perspective. When relationships within the nursing staff group and the nurse–patient relationship are justified by the goal of protecting society, gender becomes invisible. This might cause patients' individual conditions and needs for certain types of activities to go unnoticed. One of the implications of ignoring gender relations in nursing staff health promotion activities is that it risks contributing to gender stereotypes which impact on the nurse–patient relationship and the quality of care.

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