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  • 1.
    Andersson, Urban
    et al.
    Psykiatriska kliniken, Mälarsjukhuset, Eskilstuna.
    Fathollahi, Jafar
    Psykiatriska kliniken, Mälarsjukhuset, Eskilstuna.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare. UiT Arctic Univ Norway, Tromso, Norway.
    Nurses’ experiences of informal coercion on adult psychiatric wards2020In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 27, no 3, p. 741-753Article in journal (Refereed)
    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
    Mälardalen University, School of Health, Care and Social Welfare.
    Handledning: att stödja andras professionella utveckling2019In: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Wiklund Gustin, Lena, Lund: Studentlitteratur AB, 2019, 3, p. 673-697Chapter in book (Other academic)
  • 3.
    Carnesten, Hillewi
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. The Arctic University of Norway Narvik Norway.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Skoglund, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Jaarsma, Tiny
    Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden;Julius Center University Medical Center Utrecht Utrecht Netherlands.
    Andreae, Christina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Centre for Clinical Research Sörmland Uppsala University Eskilstuna Sweden.
    Struggling in the dehumanized world of COVID—An exploratory mixed‐methods study of frontline healthcare workers' experiences2024In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, p. 1-15Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden.DesignAn online fully mixed-methods design.MethodsA web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.

    Results

    Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.

    Conclusions

    Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis.

  • 4.
    Carnesten, Hillewi
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Skoglund, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Andreae, Christina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Jaarsma, Tiny
    Struggling with frightening experiences in a transformed reality: A mixed methods study of healthcare workers’ experiences during the pandemic.2023Conference paper (Other academic)
    Abstract [en]

    Background: The COVID-19 pandemic continues to impact health care workers’ (HCWs’) mental health. Research show that psychological distress and hard challenges abide with strong commitment to contribute. Yet, in-depth understanding of HCWs’ experiences of the changed caring reality during the pandemic is missing. Mixed methods research (MMR) accommodates several features apart from employing either quantitative or qualitative methods. This presentation focuses on examples from the 13-step mixed method by Leech and Onwuegbuzie.

    Methods: 97 HCWs in one hard-hit region in Sweden answered a web-based questionnaire measuring symptoms of stress (using DSM-5 criteria for post-traumatic stress syndrome, PTSD) in relation to perceived sense of coherence (SOC-scale) and self-compassion (SCS) as well as HCWs’ experiences. First, qualitative data (experiences of the pandemic) was analyzed by qualitative content analysis, then quantitative data (associations between PTSD and SOC/SCS) were analyzed with linear regression adjusted for covariates. Thirdly, a synthesis, the meta-inference of qualitative and quantitative data, explained a new comprehensive understanding. 

    Results: By analyzing the categories and subcategories from the qualitative analysis in relation to symtoms of stress and SOC/SCS, a synthesis emerged. This was undertaken by merging and comparing the findings and discussing the new comprehensive understanding. Finally, to fully outline the mixed methods approach, qualitative and quantitative data were synthesized into a new comprehensive whole, a meta inference. 

    Conclusion: This study moves away from dichotomic traditions between qualitative or quantitative approaches. By broadening the methodological departure this study may provide a new comprehensive understanding and contribute to enhance quality in MMR. 

  • 5.
    Carnesten, Hillewi
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Health and Care Sciences, UiT/The Arctic University of Norway, Narvik, Norway.
    Skoglund, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Caring through barriers—Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic2023In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 79, no 6, p. 2269-2279Article in journal (Refereed)
    Abstract [en]

    Aim: To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic. Design: A phenomenological hermeneutical study guided by Lindseth and Norberg. Methods: In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. Results: The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. Conclusion: Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. Impact: The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. Public Contribution: This study involved new nurses in semi-structured interviews. 

  • 6.
    Carnesten, Hillewi
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT Arctic Univ Norway, Dept Hlth & Care Sci, Narvik, Norway.
    Skoglund, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Battling extraordinary situations and conflicting emotions: A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic2022In: Nursing Open, E-ISSN 2054-1058, Vol. 9, no 5, p. 2370-2380Article in journal (Refereed)
    Abstract [en]

    Aim: To describe newly graduated registered nurses' (NGRNs') experiences of encountering stress in emergency departments (EDs) during the COVID-19 pandemic. Design: A qualitative descriptive study. Methods: Data from 14 in-depth interviews with NGRNs working in an ED for 3-36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic. Results: Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.

  • 7.
    Donner, Lucas
    et al.
    Stiftelsen Hemmet, Åland.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Navigating between Compassion and Uncertainty – Psychiatric Nurses’ Lived Experiences of Communication with Patients Who Rarely Speak2020In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 42, no 4, p. 307-316Article in journal (Refereed)
    Abstract [en]

    Caring conversations are considered essential in psychiatric and mental health nursing. However, some patients are more or less silent and rarely express themselves verbally. This can be challenging for nurses who also need to find ways of communicating with these patients. Therefore, the aim of this study is to describe psychiatric nurses’ lived experiences of communication with patients who rarely speak. Five nurses were recruited from a psychiatric nursing home. Participants were encouraged in interviews to reflect on their experiences of caring for patients who are more or less silent. The transcribed interviews were subject to a phenomenological hermeneutic analysis. The findings are reflected in three main themes: (i) giving space for the unspoken narrative, (ii) remaining in uncertainty, and (iii) being in reflective vigilance. The themes were synthesised and reflected on in the light of Fredriksson’s theory of caring conversations. The comprehensive understanding reveals that nurses’ understanding of the patient’s unspoken narrative relies both on compassion and a willingness to engage, but also on a preparedness to remain in the uncertainty of not knowing. Balancing good intentions and the fear of one’s own shortcomings requires reflections not only in actions during encounters with the patient, but on actions. When nurses can apprehend and respond to what the patient expresses non-verbally, a joint narrative can emerge.

  • 8.
    Eriksson, Nadya Travina
    et al.
    Mälarsjukhuset Hospital, Eskilstuna, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Blessed Alienation: The Christian Monastery as a Caring and Restorative Environment2014In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 24, no 2, p. 172-182Article in journal (Refereed)
    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.

  • 9.
    Eriksson, Nadya Travina
    et al.
    Mälardalen University.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Hermeneutic Inquiry: Researching Lived Experience of Mental Health and Recovery in a Christian Monastery in Contemporary Sweden2018In: SAGE Research Methods Cases Part 1 / [ed] Gill, Michael, Sage Publications, 2018Chapter in book (Refereed)
    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.

  • 10.
    Fredriksson, Lennart
    et al.
    Centrum för forskning och utveckling, Uppsala Universitet & Region Gävleborg, Sweden.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vårdande kommunikation2022In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin, L. & Asp, M., Lund: Studentlitteratur AB, 2022, 3, p. 415-428Chapter in book (Other academic)
  • 11.
    Gabrielsson, Sebastian
    et al.
    Luleå tekniska universitet.
    Tuvesson, Hanna
    Linnéuniversitetet.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Jormfeldt, Henrika
    Högskolan i Halmstad.
    Positioning Psychiatric and Mental Health Nursing as a Transformative Force in Health Care2020In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 11, no 1, p. 976-984Article in journal (Refereed)
    Abstract [en]

    From the perspective of psychiatric and mental health nurses in Sweden, this discussion paper aims to position psychiatric and mental health nursing as a transformative force contributing to enforcing person-centered values and practices in health care. We argue the potential impact of psychiatric and mental health nursing on service user health and recovery, nursing student education and values, and the organization and management of health care. Psychiatric and mental health nursing is discussed as a caring, reflective, and therapeutic practice that promotes recovery and health. Implications for nursing education, research, management, and practice are outlined.

  • 12.
    Gabrielsson, Sebastian
    et al.
    Luleå tekniska universitet.
    Tuvesson, Hanna
    Linnéuniversitetet.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Jormfeldt, Henrika
    Högskolan i Halmstad.
    Psykiatrisk omvårdnad gör skillnad2020In: Psyche, ISSN 0283-3468, no 3, p. 6-9Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Som svar på ifrågasättandet av en nationellt reglerad specialistinriktning mot psykiatrisk vård har PRF tagit initiativ till att förtydliga vad psykiatrisk omvårdnad är och vad den bidrar med. Psykiatrisk omvårdnad har kraft att förändra människors hälsa och återhämtning, studenters kunskap och värderingar samt hur sjukvården organiseras och leds. Psykiatrisk omvårdnad är en vårdande, reflekterande och terapeutisk praktik som bidrar till återhämtning och hälsa.

  • 13.
    Gustafsson, Gabriella
    et al.
    Umeå Universitet, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Stress, utbrändhet och utmattningssyndrom2019In: Omvårdnad vid psykisk ohälsa: på grundnivå / [ed] Skärsäter, Ingela & Wiklund Gustin, Lena, Lund: Studentlitteratur AB, 2019, 3, p. 57-85Chapter in book (Other academic)
  • 14.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wiklund-Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindström, Unni Å
    Enheten för vårdvetenskap, Åbo Akademi, Finland.
    The meaning of reconciliation: Women’s stories about theirexperience of reconciliation with suffering from grief2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 525-532Article in journal (Refereed)
    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.

  • 15.
    Hammarbäck, Staffan
    et al.
    Linnaeus University, Sweden; Region Sörmland, Sweden; Uppsala University, Sweden.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden; Department of Ambulance Service, Region Sörmland, Katrineholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Health and Care Sciences, UiT/The Arctic University of Norway, Norway.
    Bremer, Anders
    Linneaus University, Sweden.
    Ambulance clinicians’ responsibility when encountering patients in a suicidal process2023In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed)
    Abstract [en]

    Background: Even though the traditional focus in emergency care is on life-threatening medical crisis, ambulance clinicians frequently encounter patients with mental illness, including suicidal ideation. A suicide is preceded by a complex process where most of the suicidal ideation is invisible to others. However, as most patients seek healthcare in the year before suicide, ambulance clinicians could have an important part to play in preventing suicide, as they encounter patients in different phases of the suicidal process. Aim: The aim of this study was to describe ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process. Research design: A qualitative inductive design using a phenomenographic approach was used. Participants and research context: Twenty-seven ambulance clinicians from two regions in southern Sweden were interviewed. Ethical considerations: The study was approved by the Swedish Ethical Review Authority. Findings: Three categories of descriptions captured a movement from responding to a biological being to responding to a social being. Conventional responsibility was perceived as a primary responsibility for emergency care. In conditional responsibility, the patient’s mental illness was given only limited importance and only if certain conditions were met. Ethical responsibility was perceived to have its primary focus on the encounter with the patient and listening to the patient’s life story. Conclusions: An ethical responsibility is favourable regarding suicide prevention in ambulance care, and competence development in mental illness and conversation skills could enable ambulance clinicians to have conversations with patients about suicidal ideation.

  • 16.
    Hemberg, Jessica
    et al.
    Åbo Akademi, Vasa, Finland.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Caring from the heart as belonging: The basis for mediating compassion2020In: Nursing Open, E-ISSN 2054-1058, Vol. 7, no 2, p. 660-668Article in journal (Refereed)
    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

  • 17.
    Johansson, Louice
    et al.
    Mälarsjukhuset MSE, Eskilstuna, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT-Norges Arktiske Universitet.
    The multifacetted vigilance - nurses’ experiences of caring encounters with patients suffering from substance use disorder2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 303-311Article in journal (Refereed)
    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.

  • 18.
    Kerstis, Birgitta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health, Care and Social Welfare, Mälardalen University, 722 20 Västerås, Sweden.
    Herlofson, Jorgen
    Empatica AB, 752 20 Uppsala, Sweden.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Health and Care Sciences, UiT The Arctic University of Norway, Campus Narvik, 8514 Narvik, Norway.
    Study Circles as a Possible Arena to Support Self-Care—A Swedish Pilot Study2024In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 21, no 4, article id 483Article in journal (Refereed)
    Abstract [en]

    Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of its content and structure, describing experiences of study circles as a means of supporting participants’ self-care and self-compassion. The overall design is a descriptive QUAL + quan design, where the quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion, as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others’ well-being, but are not considered an alternative to psychiatric care for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population and are a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders, as well as the dissemination of study circles.

  • 19.
    Kitzmüller, Gabriele
    et al.
    UiT, the Arctic University of Norway, Narvik, Norway.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT, the Arctic University of Norway, Narvik, Norway.
    Kalhovde, Anne Martha
    Jæren District Psychiatric Center, Bryne, Norway.
    Filling the void: the role of adult siblings caring for a brother or sister with severe mental illness2023In: Global Qualitative Nursing Research, E-ISSN 2333-3936, Vol. 10, article id 23333936231162230Article in journal (Refereed)
    Abstract [en]

    Little is known about the role of adult siblings’ caregiver role within the context of mental illness. Therefore, our purpose was to explore how siblings narrate their experiences of being the main caregivers of a brother or sister with severe mental illness and how they cooperate with their ill sibling and their family of origin. We used a narrative hermeneutic approach and performed a secondary analysis of two interviews of siblings derived from a study of peoples’ experiences of hearing voices. The findings illuminate the participants’ multifaceted roles and how differently siblings might deal with the multiple challenges of caring for an ill sibling. The mediating role between their ill sibling and their family of origin to reestablish the broken family bonds was a significant aspect. Nurses’ awareness of the important and multidimensional role of caregiving siblings can improve the provision of family support and promote involvement of siblings in the treatment of an ill family member.

  • 20.
    Koslander, Tiburtius
    et al.
    Integrierte Psychiatrie Winterthur - Zürcher Unterland, Winterthur, Switzerland..
    Rönning, Sonia
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Division of Psychiatry, County Council of Dalarna, Falun, Sweden.
    Magnusson, Sofia
    Division of Psychiatry, County Council of Dalarna, Falun, Sweden.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. The Arctic University of Norway, Tromsø, Norway.
    A ‘near‐life experience’: lived experiences of spirituality from the perspective of people who have been subject to inpatient psychiatric care2021In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 2, p. 512-520Article in journal (Refereed)
    Abstract [en]

    Aims: To describe lived experiences of spirituality from the perspective of people who have been subject to inpatient psychiatric care and to interpret these experiences from an understanding of health as dialectical.

    Methods: After approval from a regional ethical board, eleven participants were recruited from two organisations for people with mental health problems. Participants were asked to narrate about spiritual experiences and occasions where such experiences had come close. The transcribed interviews were analysed by means of a phenomenological hermeneutical approach.

    Findings: A structural analysis of the text resulted in three themes; perceiving the presence of something extra mundane, making sense of reality and struggling for acceptance. The comprehensive understanding highlights spiritual experiences as going beyond religion, even though religious experiences appear as part of it. These experiences can indeed be a resource contributing to experiences of hope, connectedness, meaning and coherence in life. However, they can also give rise to doubt, anxiety and feelings of loneliness and hopelessness. Rather than understanding spiritual experiences as being either ‘good’ or ‘bad’, we could approach spirituality as something that is always present in alternate and inter-related forms. Metaphorically, this could be understood as a ‘near-life experience’, summarising participants’ experiences related to their struggle with issues related to suffering and health which are simultaneously present.

    Conclusions: If psychiatric nurses could approach this complexity and, without being judgemental, explore seemingly positive and negative experiences of spirituality as dialectically related to each other, rather than viewing them as either resources or problems, this could contribute to insiderness care and hopefully also support people who struggle with these experiences to seek help when needed.

  • 21.
    Lassenius, O.
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Institutet, Sweden.
    Arman, M.
    Karolinska Institutet, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund-Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. 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 activity2014In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 35, no 9, p. 713-720Article in journal (Refereed)
    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.

  • 22.
    Lassenius, Oona
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Arman, Maria
    Karolinska Institutet, Department of Neurobiology.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Narvik University College.
    Moving toward Reclaiming Life: Lived Experiences of Being Physically Active Among Persons with Psychiatric Disabilities2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 10, p. 739-746Article in journal (Refereed)
    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.

  • 23.
    Lassenius, Oona
    et al.
    Karolinska Institutet, Sweden.
    Arman, Maria
    Karolinska Institutet, Sweden.
    Wiklund-Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare.
    Exploring the significance of interactive video games for physical activity among persons with psychiatric disabilities using experimental single case designManuscript (preprint) (Other academic)
    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.

  • 24.
    Lassenius, Oona
    et al.
    Karolinska Institutet.
    Åkerlind, Ingemar
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Arman, Maria
    Karolinska Institutet.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Self-reported health and physical activity among community mental healthcare users2013In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, no 1, p. 82-90Article in journal (Refereed)
    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.

  • 25.
    Lindgren, Sari J
    et al.
    Høgskolen i Narvik, Norway.
    Storli, Sissel L
    Universitetet i Tromsø, Norway.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Å leve i forhandlinger – Pasienterfaringer av å være i den diagnostiske prosessen med å få diagnosen KOLS2015In: Best Practice, Vol. 5, no 16, p. 23-28Article in journal (Other academic)
  • 26.
    Lindgren, Sari
    et al.
    UiT/Norges Arktiske Universitet, Norway.
    Lahm Høgbakk, Mona
    UiT/Norges Arktiske Universitet, Norway.
    Svelstad Evju, Anne
    UiT/Norges Arktiske Universitet, Norway.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT/Norges Arktiske Universitet, Norway.
    Å skape handlingsrom for pasientsikkerhet i sykehjem: Sykepleieres erfaringer med å delta i simulering in situ på sykehjem2020In: Handlingsrom for profesjonalisert velferd: Kommunale tjenster for helse, omsorg og barnevern / [ed] Lind Kassah, B. L., Nordahl-Pedersen, H., & Tingvoll, W-A, Oslo: Cappelen Damm Akademisk, 2020, p. 177-198Chapter in book (Refereed)
    Abstract [en]

    Some patients in nursing homes require extra attention to enable staff todetect and manage deterioration at an early stage. Nursing skills are vital to makesystematic observations and assessments of a patient’s condition. It is challenging fornurses in nursing homes to make professional decisions without being able to consultother nurses. To improve the quality and safety of health care for patients and theirrelatives, the focus must be on working to ensure patient safety in nursing homes.Simulation-based learning can be one way to increase reflection on patient safety anddevelop health professionals’ knowledge, skills and attitudes, while protecting patientsfrom unnecessary risks. Simulation-based learning as a method in medical educa-tion offers activities that mimic a clinical environment, where students can practiceprocedures and decision-making and where their critical thinking can be enhancedthrough role-play, videos or simulators. While simulation often takes place in a sim-ulation center, in situ simulation refers to a learning activity that takes place in par-ticipants’ everyday work environment where they actually provide patient care. Inthis chapter, we aim to describe nurses’ experiences of in situ simulation and theirsubsequent reflections on patient safety in nursing homes. Data were collected fromtwo focus groups with 5–6 nurses per group. The transcribed material was analyzedusing qualitative content analysis, and two categories were identified that describedthe nurses’ experiences: “to doubt oneself ” and “being dependent on others”.

  • 27.
    Lindgren, Sari
    et al.
    Narvik University College.
    Storli, Sissel Lisa
    Universitetet i Tromsö.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Living in negotiation: patients’ experiences of being in the diagnostic process of COPD2014In: International Journal of COPD, ISSN 1178-2005, Vol. 9, p. 441-451Article in journal (Refereed)
    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.

  • 28. Malm, Meta
    et al.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Själ2017In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin, L & Bergbom, I, Lund: Studentlitteratur AB, 2017, 2, p. 125-138Chapter in book (Other academic)
  • 29.
    Martinsson, Gunilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Lindholm, Christina
    Karolinska Institutet.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Struggling for existence: - Life situation experiences of older persons with mental disorders2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no Art. nr. 18422Article in journal (Refereed)
    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

  • 30.
    Martinsson, Gunilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindholm, Christina
    Karolinska Institutet.
    Specialist prescribing of psychotropic drugs to older persons in Sweden: a register-based study of 188 024 older persons2012In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 12, no 197Article in journal (Refereed)
    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.

  • 31.
    Martinsson, Gunilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindholm, Christina
    Karolinska Institutet.
    Mental disorders affect older persons in Sweden: a register-based study2011In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 26, no 3, p. 277-283Article in journal (Refereed)
    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.

  • 32.
    Martinsson, Gunilla
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindholm, Christina
    Karolinska Institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal Högskola.
    Being altruistically egoistic:  Nursing aides’ experiences of caring for older persons with mental disorders2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4, p. 7530-Article in journal (Refereed)
    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

  • 33.
    Petersson Troije, Charlotte
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Malmö universitet, Malmö university.
    Lisberg Jensen, Ebba
    Göteborgs universitet.
    Redmalm, David
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Unlocking the Transformative Potential of Outdoor Office Work: A Constructivist Grounded Theory StudyManuscript (preprint) (Other academic)
  • 34.
    Petersson Troije, Charlotte
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Sociology, School of Health, Care and Social Welfare, Mälardalen University, 72123 Västerås, Sweden;Department of Urban Studies, Faculty of Culture and Society, Malmö University, 20506 Malmö, Sweden.
    Lisberg Jensen, Ebba
    Department of Pedagogical, Curricular and Professional Studies, University of Gothenburg, 40530 Gothenburg, Sweden.
    Redmalm, David
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Health and Care Sciences, UiT/The Arctic University of Norway, 8514 Narvik, Norway.
    Unlocking the Transformative Potential of Outdoor Office Work: A Constructivist Grounded Theory Study2024In: Challenges, E-ISSN 2078-1547, Vol. 15, no 2, p. 25-25Article in journal (Refereed)
    Abstract [en]

    White-collar workers around the world are reconfiguring their ways of working. Some have found their way out, performing office work outdoors, through walk-and-talks, outdoor meetings, or reading sessions. Working outdoors has proved both invigorating and challenging. This qualitative interview study aims to develop a conceptual framework concerning the implications of white-collar workers incorporating the outdoors into their everyday work life. Applying a constructivist grounded theory approach, 27 interviews with a total of 15 participants were systematically analyzed. Findings evolved around the following categories: practicing outdoor office work, challenging the taken-for-granted, enjoying freedom and disconnection, feeling connected and interdependent, promoting health and well-being, enhancing performance, and finally adding a dimension to work. These categories were worked into a conceptual model, building on the dynamic relationship between the practice of working outdoors on one hand, and how this challenges the system in which office work traditionally takes place on the other. Interviews reflected the profound learning process of the employees. Drawing on the concepts of free space and resonance, we demonstrate how performing office work outdoors may unlock a transformative potential by opening up connectedness and interdependence and contribute to a sustainable work life as well as overall sustainable development.

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  • 35.
    Priebe, Åsa
    et al.
    County Council of Stockholm, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Fredriksson, Lennart
    Uppsala University, Sweden.
    A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 2, p. 856-865Article in journal (Refereed)
    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

  • 36.
    Salzmann-Erikson, M.
    et al.
    University of Gävle, Gävle, Sweden.
    Rydlo, Cecilia
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT-Norges Arktiske Univesitet, Norway.
    Getting to know the person behind the illness - the significance of interacting with patients hospitalised in forensic psychiatric settings2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 9-10, p. 1426-1434Article in journal (Refereed)
    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.

  • 37.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kumlin, Tomas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. 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
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. 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 recovery2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, article id 1287985Article in journal (Refereed)
    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.

  • 38.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wallsten, Tuula
    Uppsala Universitet, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT, Norges Arktiske Universitet.
    Philosophical Grounding in a Reflective Lifeworld Research Approach: Where Is the Place for Description vs. Interpretation?2016In: International Journal of Qualitative Methods, E-ISSN 1609-4069, Vol. 15, no 1Article in journal (Refereed)
  • 39.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wallsten, Tuula
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala University, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. 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 suicide2017In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 26, no 2, p. 200-207Article in journal (Refereed)
    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.

  • 40.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kumlin, Tomas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wallsten, Tuula
    Uppsala Univ, Cty Hosp, Clin Res Ctr, Vasteras, Sweden..
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT Archt Univ Norway, Narvik, Norway.
    Caring for the suicidal person: A Delphi study of what characterizes a recovery-oriented caring approach2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 6, p. 1756-1766Article in journal (Refereed)
    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.

  • 41.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kumlin, Tomas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wallsten, Tuula
    Uppsala Univ, Cty Hosp, Clin Res Ctr, Vasteras, Sweden..
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT Archt Univ Norway, Narvik, Norway.
    Experiences of a Recovery-Oriented Caring Approach to Suicidal Behavior: A single-case study2019In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 29, no 14, p. 2084-2095Article in journal (Refereed)
    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.

  • 42.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wallsten, Tuula
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Martin, Lene
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund-Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Development of suicide prevention based on a lifeworld perspective2014In: HVV2014, Abstract Book, 2014, p. 44-44Conference paper (Refereed)
  • 43.
    Sellin, Linda
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Samtal för återhämtning i livets ytterkanter2020In: Läkande samtal / [ed] Dahlberg, Karin, Stockholm: Liber, 2020, 1, p. 203-228Chapter in book (Other academic)
  • 44.
    Skärsäter, Ingela
    et al.
    Högskolan i Halmstad, Sweden.
    Wiklund Gustin, LenaMälardalen University, School of Health, Care and Social Welfare.
    Omvårdnad vid psykisk ohälsa: på grundnivå2019Collection (editor) (Other academic)
    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.

  • 45.
    Svelstad Evju, Anne
    et al.
    UiT/Norges arktiske universitet.
    Lahm Høgbakk, Mona
    UiT/Norges arktiske universitet, Norge.
    Lindgren, Sari Johanne
    UiT/Norges arktiske universitet, Norge.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare. UiT/Norges arktiske universitet, Norge.
    Balancing between challenges and trust: Nursing students’ experiences of participating in a course in wilderness medicine2020In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 48, article id 102863Article in journal (Refereed)
  • 46.
    Söderberg, Anja
    et al.
    Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
    Gabrielsson, Sebastian
    Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
    Looi, Git-Marie Ejneborn
    Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. UiT/The Arctic University of Norway, Tromsø, Norway.
    Bäckström, Josefin
    Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden;Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden.
    Lindgren, Britt-Marie
    Department of Nursing, Umeå University, Umeå, Sweden.
    Being Human under Inhuman Conditions: Meanings of Living with Severe Dissociative States Involving the Experience of Being in Parts2024In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673Article in journal (Refereed)
    Abstract [en]

    Severe dissociative states involving the experience of being in parts, typically associated with diagnosis such as dissociative identity disorder and other specified dissociative disorders, continue to be a controversial and rarely studied area of research. However, because persons with severe dissociative states are at risk of being harmed instead of helped within psychiatric care, their experiences of living with such states warrant further examination, while innovative ways to include them in research remain necessary. Against that background, this study aimed to illuminate the meanings of living with severe dissociative states involving the experience of being in parts. This is a phenomenological hermeneutic study with data collected from three social media sources, one personal blog and two Instagram accounts, in February and March 2023. The results were illuminated in light of four themes; Striving to remain in the world, Balancing exposure and trust, Balancing belonging and loneliness and Owning oneselves. The interpretation of the themes suggests that living with severe dissociative states means being a human under inhuman conditions, striving for coherence and meaning in a world that is often unsupportive. This calls for a trauma-informed care to better support recovery for persons with severe dissociative states.

  • 47.
    Vincze, Mattias
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karsudden Hospital, Katrineholm, Sweden .
    Fredriksson, L.
    Centre for Research and Development, Uppsala University/County Council of Gävleborg, Sweden .
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings2015In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 24, no 2, p. 149-157Article in journal (Refereed)
    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.

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  • 48.
    Wangberg, Silje C
    et al.
    Høgskolen i Narvik, Norway.
    Lejon, R M
    Eriksen, Trond
    Nebb, Ann-Heidi
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Løvold, M
    Wackers, Ger
    Aagaard, M
    Utprøving av Klient- og Resultatstyrt praksis (KOR) i tverrfaglig spesialisert rusbehandling på døgninstitusjon ved Nordlandsklinikken2015Report (Other academic)
    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.

  • 49.
    Waxell, Anni
    et al.
    Division of Psychiatry, Region Vastmanland, Västerås, Sweden.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare. Department of Health and Care Sciences, UiT/The Arctic University of Norway, Tromsø, Norway.
    “Walking Together Towards Freedom.” Patients’ Lived Experiences of Participation in Outpatient Forensic Care2022In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 43, no 5, p. 455-462Article in journal (Refereed)
    Abstract [en]

    There is a general agreement regarding the significance of patient participation in care. In forensic psychiatric care, however, this appears to be troublesome because of the paradoxical nature of having responsibility; to give person-centered, recovery-oriented psychiatric care and to protect society from potentially dangerous individuals. The aim of this study was to describe patients’ lived experiences of participation in outpatient forensic psychiatric care. Data were collected by means of individual interviews with five patients. The phenomenological hermeneutical analysis shed light on patient participation as having two dimensions. The outer dimension focuses on participation as “doing” and as a means of developing the understanding and skills necessary for being discharged from forensic care, while the inner dimension is related to “being” and experiences of acceptance and inclusion in communion with other people. This emphasises the importance of supporting patients’ experiences of being involved in everyday life together with others, even in periods when patients’ possibilities to affect decisions regarding their care are limited.

  • 50.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Att använda sin specialistkompetens i patientens tjänst2014In: Vårdande vid psykisk ohälsa: På avancerad nivå, Lund: Studentlitteratur AB, 2014, 2, p. 457--487Chapter in book (Other academic)
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