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Hällgren Graneheim, Ulla
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Publications (10 of 65) Show all publications
Lindgren, B.-M., Ringnér, A., Molin, J. & Hällgren Graneheim, U. (2019). Patients' experiences of isolation in psychiatric inpatient care: insights from a meta-ethnographic study. International Journal of Mental Health Nursing, 28(1), 7-21
Open this publication in new window or tab >>Patients' experiences of isolation in psychiatric inpatient care: insights from a meta-ethnographic study
2019 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 1, p. 7-21Article in journal (Refereed) Published
Abstract [en]

Historically, people with mental ill-health have been isolated from society. Although mental health care has moved from closed to more open forms of care, in many societies care is still provided in locked wards, and people with mental ill-health are sometimes secluded from their fellow patients, families, friends, and visitors. The aim of this study was to illuminate patients' experiences of isolation in psychiatric inpatient care. A systematic review of qualitative research was conducted, and the key findings were subjected to meta-ethnographic synthesis. The findings were twofold: 'being admitted to prison' and 'having access to shelter'. The experience of isolated care as prison-like symbolizes patients' longing for freedom and feeling restricted and limited by rules, stripped of rights, abandoned, controlled, powerless, and unsupported. In contrast, the experience of isolation as shelter symbolizes safety and the opportunity to regain control over one's own situation. A stigmatizing public view holds that people with mental ill-health are dangerous and unpredictable and, therefore, unsafe to themselves and others. Being placed in isolation because these fears contribute to self-stigma among patients. Promoting a sheltered experience in which isolation is used with respect for patients and the reasons are made explicit may encourage recovery. A shift in emphasis in ward culture from observation to engagement is needed to reduce blame, shift patient experiences from prison to shelter, and to support autonomy as a therapeutic intervention.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
experiences, isolation, locked ward, psychiatric inpatient care, seclusion
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-154952 (URN)10.1111/inm.12519 (DOI)000459619300002 ()29975446 (PubMedID)
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-03-27Bibliographically approved
Molin, J., Hällgren Graneheim, U., Ringnér, A. & Lindgren, B.-M. (2019). Patients' experiences of taking part in Time Together - A nursing intervention in psychiatric inpatient care. International Journal of Mental Health Nursing, 28(2), 551-559
Open this publication in new window or tab >>Patients' experiences of taking part in Time Together - A nursing intervention in psychiatric inpatient care
2019 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 2, p. 551-559Article in journal (Refereed) Published
Abstract [en]

This qualitative study aimed to illuminate patients' experiences of taking part in the nursing intervention Time Together. The data were drawn from 11 individual semi-structured interviews with patients and analysed with qualitative content analysis using an inductive approach. The results show that patients taking part in Time Together felt confirmed and participated on equal terms; thus, they experienced being seen as humans among other humans. Time Together offered patients a break, and they felt strengthened, which contributed to their hopes for recovery. Furthermore, when Time Together was absent patients felt disconfirmed, which fostered feelings of distance from staff. The results support the effectiveness of the intervention, indicating that Time Together may be a tool to facilitate patients' personal recovery. However, the success of the intervention depends on staff compliance with the predetermined structure of the intervention in combination with engagement.

Place, publisher, year, edition, pages
Australian College of Mental Health Nurses Inc., 2019
Keywords
Time Together, engagement, mental health nursing, nursing intervention, psychiatric inpatient care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-155311 (URN)10.1111/inm.12560 (DOI)000460556300016 ()30501013 (PubMedID)
Funder
The Kempe Foundations
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-04-08Bibliographically approved
Ozanne, A., Verdinelli, C., Olsson, I., Edelvik, A., Hällgren Graneheim, U. & Malmgren, K. (2018). Callosotomy in children - Parental experiences reported at long-term follow-up. Epilepsy & Behavior, 86, 91-97
Open this publication in new window or tab >>Callosotomy in children - Parental experiences reported at long-term follow-up
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2018 (English)In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 86, p. 91-97Article in journal (Refereed) Published
Abstract [en]

Callosotomy is a palliative surgery method for selected individuals with severe, drug-resistant epilepsy. The aim of this retrospective study was to explore parental experiences of the family's life situation before and long after their child had undergone callosotomy. Semistructured interviews of the parents of 12 children were analyzed using a combination of inductive and deductive qualitative content analysis.

Before surgery, parents felt that they lived in a chaotic bubble with an unbearable situation; their child had severe and frequent seizures and had to be looked after constantly. Most parents were both satisfied and dissatisfied with the given support and information. However, if the child did not improve after surgery, parents often felt that the information before surgery had not been adequate. After surgery, they found a glimpse of hope. They felt that the family got a new life; the reduced seizure severity led to a better life situation for the family. The support was described as both good and poor. The family life situation was complex, and even if they were partly satisfied with the support, it was still not enough. However, the life situation was also very stressful because of remaining seizures, behavioral problems, and sometimes, adverse effects of surgery. The families lived in disappointment and difficulty and had to fight for their rights. This indicates that these families need more information and social service coordination both before and long after surgery. They need not only tools to manage the child's disabilities but also substantial help to care for the child and to receive the social support they need. 

Place, publisher, year, edition, pages
Academic Press, 2018
Keywords
Childhood epilepsy, Epilepsy surgery, Callosotomy, Parental experiences, Qualitative content analysis
National Category
Pediatrics Nursing
Identifiers
urn:nbn:se:umu:diva-151533 (URN)10.1016/j.yebeh.2018.06.020 (DOI)000442624500015 ()30153937 (PubMedID)
Available from: 2018-09-13 Created: 2018-09-13 Last updated: 2018-09-13Bibliographically approved
Jansson, L. & Hällgren Graneheim, U. (2018). Nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas. Issues in Mental Health Nursing, 39(7), 554-560
Open this publication in new window or tab >>Nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas
2018 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 7, p. 554-560Article in journal (Refereed) Published
Abstract [en]

This study describes nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas in Sweden. We used a qualitative, descriptive design based on twelve interviews that were subjected to qualitative content analysis. The results showed that the nurses felt anguish due to a lack of control. They expressed uncertainty and loneliness, and they struggled with ethical issues and organisational challenges. Having the sole responsibility to assess suicide risk can increase a person's emotional vulnerability and moral stress. Consequently, in order to prevent ill health among these nurses, there is a need for a tolerant work climate and an organisation that provides support to its employees.Assessing suicide risk is a demanding task within mental health outpatient care. Further, nurses operating in rural areas have to initiate and conduct assessments on their own, and they are, together with the physician in charge, also held individually responsible for their assessments. Consequently, it is important to describe nurses' experiences of how they deal with questions concerning suicide risk. Their experiences can foster awareness of the responsibility and the ethical standpoints related to assessing suicide risk, can help outline the need for further education and supervision, and can improve support from co-workers and management.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-153843 (URN)10.1080/01612840.2018.1431823 (DOI)000445651800003 ()29533690 (PubMedID)
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2018-12-11Bibliographically approved
Molin, J., Lindgren, B.-M., Graneheim, U. H. & Ringnér, A. (2018). Time Together: a nursing intervention in psychiatric inpatient care : feasibility and effects. International Journal of Mental Health Nursing, 27(6), 1698-1708
Open this publication in new window or tab >>Time Together: a nursing intervention in psychiatric inpatient care : feasibility and effects
2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 6, p. 1698-1708Article in journal (Refereed) Published
Abstract [en]

The facilitation of quality time between patients and staff in psychiatric inpatient care is useful to promote recovery and reduce stress experienced by staff. However, interventions are reported to be complex to implement and are poorly described in the literature. This multisite study aimed to evaluate the feasibility and effects of the nursing intervention Time Together, using mixed methods. Data consisted of notes from participant observations and logs to evaluate feasibility, and questionnaires to evaluate effects. The primary outcome for patients was quality of interactions, and for staff, it was perceived stress. The secondary outcome for patients was anxiety and depression symptom levels, and for staff, it was stress of conscience. Data were analysed using visual analysis, percentage of nonoverlapping data, and qualitative content analysis. The results showed that Time Together was a feasible intervention, but measurements showed no effects on the two patient outcomes: quality of interactions and anxiety and depressive symptoms and, questionable effects on perceived stress and stress of conscience among staff. Shared responsibility, a friendly approach, and a predictable structure enabled Time Together, while a distant approach and an unpredictable structure hindered the intervention. In conclusion, the intervention proved to be feasible with potential to enable quality interactions between patients and staff using the enabling factors as supportive components. It also had some effects on perceived stress and stress of conscience among staff. Further evaluation is needed to build on the evidence for the intervention.

Place, publisher, year, edition, pages
Australian College of Mental Health Nurses Inc., 2018
Keywords
engagement, intervention, mental health nursing, mixed methods, psychiatric inpatient care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-147611 (URN)10.1111/inm.12468 (DOI)000451782800010 ()29691976 (PubMedID)
Funder
The Kempe Foundations
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2019-01-08Bibliographically approved
Ozanne, A. & Graneheim, U. H. (2018). Understanding the incomprehensible: patients' and spouses' experiences of comprehensibility before, at and after diagnosis of amyotrophic lateral sclerosis. Scandinavian Journal of Caring Sciences, 32(2), 663-671
Open this publication in new window or tab >>Understanding the incomprehensible: patients' and spouses' experiences of comprehensibility before, at and after diagnosis of amyotrophic lateral sclerosis
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 663-671Article in journal (Refereed) Published
Abstract [en]

Background: Previous studies have examined manageability and meaningfulness in amyotrophic lateral sclerosis (ALS), but there is a lack of studies examining the comprehensibility of ALS among patients and their spouses.

Aim: This qualitative retrospective study aimed to illuminate patients' and spouses' experiences of comprehensibility in ALS from a long-term perspective, when symptoms appeared before diagnosis, and when the diagnosis was given and in life after diagnosis.

Methods: Individual semi-structured interviews with 14 patients and 13 spouses were performed. The transcribed interviews were subjected to qualitative content analysis.

Findings:Through the whole disease process, patients and spouses feared the unknown regardless of whether they comprehended the disease or not. They described that they before diagnosis felt uncertainty. It was problematic to comprehend what was wrong and what the deterioration implied. At the diagnosis, they described feelings of losing their foothold. Long-term after diagnosis, they still lived in fear and looked for reasons why they were afflicted.

Conclusions: Findings of similar experiences in comprehensibility between patients and spouses strengthen the importance of support and information to both parties. Since they hovered between comprehensibility and incomprehensibility during the whole disease process, it is important that their questions, fears and worries are met, from the first visit at hospital and through the whole process. Multiprofessional teams, such as ALS teams and palliative teams can from a holistic perspective increase the possibility of meeting their needs in their unique situation.

Keywords
amyotrophic lateral sclerosis, comprehensibility, interviews, motor neuron disease, qualitative content analysis, sense of coherence, spouse
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-150867 (URN)10.1111/scs.12492 (DOI)000436254800022 ()28869647 (PubMedID)
Available from: 2018-09-03 Created: 2018-09-03 Last updated: 2018-09-03Bibliographically approved
Ozanne, A., Johansson, D., Hällgren Graneheim, U., Malmgren, K., Bergquist, F. & Murphy, M. A. (2018). Wearables in epilepsy and Parkinson's disease: A focus group study. Acta Neurologica Scandinavica, 137(2), 188-194
Open this publication in new window or tab >>Wearables in epilepsy and Parkinson's disease: A focus group study
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2018 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 137, no 2, p. 188-194Article in journal (Refereed) Published
Abstract [en]

Objectives: Wearable sensors that measure movement and physiological variables are attractive for clinical evaluation of neurological diseases such as epilepsy and Parkinson's disease (PD). The aim of this study was to explore perceptions regarding the use of wearable technology in disease monitoring and management as reported by individuals with epilepsy and Parkinson's disease as well as health professionals working with these patient groups.

Materials and Methods: Six patient groups (n=25) and two groups with health professionals (n=15) participated in this qualitative, descriptive study with focus group interviews. A manifest qualitative content analysis was used.

Results: Four categories and nine subcategories emerged from the analysis. Participants saw possible benefits for improved treatment effect and valued this benefit more than possible inconvenience of wearing the sensors. Discrete design and simplicity were considered as facilitators for improved usability. They emphasized the importance of interactive information between patients and health professionals. However, they were concerned about unclear information and inconclusive recordings and some fears about personal integrity were at odds with the expectations on interactivity.

Conclusions: Patients need to feel well informed and find an added value in using wearables. Wearables need to be user-friendly, have an attractive design, and show clinical efficacy in improving disease management. Variations in perceptions regarding integrity, benefits, and effectiveness of monitoring indicate possible conflicts of expectations among participants. The engagement of end users, patients, and health professionals, in the design and implementation process, is crucial for the development of wearable devices that enhance and facilitate neurological rehabilitation practice.

Keywords
epilepsy, focus group, health professionals, motor activity, movement, Parkinson's disease, alitative content analysis, wearable sensors
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-144080 (URN)10.1111/ane.12798 (DOI)000419583500005 ()28714112 (PubMedID)
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-06-09Bibliographically approved
Molin, J., Lindgren, B.-M., Hällgren Graneheim, U. & Ringnér, A. (2017). Does 'Time Together' increase quality of interaction and decrease stress?: A study protocol of a multisite nursing intervention in psychiatric inpatient care, using a mixed method approach. BMJ Open, 7(8), Article ID e015677.
Open this publication in new window or tab >>Does 'Time Together' increase quality of interaction and decrease stress?: A study protocol of a multisite nursing intervention in psychiatric inpatient care, using a mixed method approach
2017 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 8, article id e015677Article in journal (Refereed) Published
Abstract [en]

Introduction: Despite the long-known significance of the nurse–patient relationship, research in psychiatric inpatient care still reports unfulfilled expectations of, and difficulties in, interactions and relationships between patients and staff. Interventions that create structures to allow quality interactions between patients and staff are needed to solve these problems. The aim of this project is to test effects of the nursing intervention Time Together and to evaluate the intervention process.

Methods and analysis: This is a multisite study with a single-system experimental design using frequent measures. The primary outcomes are quality interactions for patients and perceived stress for staff. Secondary outcomes are levels of symptoms of anxiety and depression for patients and stress of conscience for staff. A process evaluation is performed to describe contextual factors and experiences. Data are collected using questionnaires, participant observations and semistructured interviews. For analysis of quantitative data, both visual and statistical methods will be used. Qualitative data will be analysed using qualitative content analysis.

Ethics and dissemination: Ethical approval was granted by the Ethical Review Board in the region (Dnr 2016/339-31). The findings will contribute to the development of nursing interventions in general, but more specifically to the development of the intervention. This is relevant both nationally and internationally as similar interventions are needed but sparse. The findings will be disseminated through conference presentations and peer-reviewed publications.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2017
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-138827 (URN)10.1136/bmjopen-2016-015677 (DOI)000411802700079 ()28851774 (PubMedID)
Available from: 2017-09-01 Created: 2017-09-01 Last updated: 2018-06-09Bibliographically approved
Graneheim, U. H., Lindgren, B.-M. & Lundman, B. (2017). Methodological challenges in qualitative content analysis: A discussion paper. Nurse Education Today, 56, 29-34
Open this publication in new window or tab >>Methodological challenges in qualitative content analysis: A discussion paper
2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 56, p. 29-34Article in journal (Refereed) Published
Abstract [en]

This discussion paper is aimed to map content analysis in the qualitative paradigm and explore common methodological challenges. We discuss phenomenological descriptions of manifest content and hermeneutical interpretations of latent content. We demonstrate inductive, deductive, and abductive approaches to qualitative content analysis, and elaborate on the level of abstraction and degree of interpretation used in constructing categories, descriptive themes, and themes of meaning. With increased abstraction and interpretation comes an increased challenge to demonstrate the credibility and authenticity of the analysis. A key issue is to show the logic in how categories and themes are abstracted, interpreted, and connected to the aim and to each other. Qualitative content analysis is an autonomous method and can be used at varying levels of abstraction and interpretation.

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE, 2017
Keywords
Abstraction level, Categories, Interpretation degree, Latent content, Manifest content, Qualitative content analysis, Themes
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-138630 (URN)10.1016/j.nedt.2017.06.002 (DOI)000406725700006 ()28651100 (PubMedID)
Available from: 2017-08-29 Created: 2017-08-29 Last updated: 2018-06-09Bibliographically approved
Antonsson, H., Hällgren Graneheim, U., Isaksson, U., Åström, S. & Lundström, M. O. (2016). Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design. Issues in Mental Health Nursing, 37(10), 734-743
Open this publication in new window or tab >>Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design
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2016 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 734-743Article in journal (Refereed) Published
Abstract [en]

The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.

Keywords
learning disabilities, challenging behaviour, web-based training, ssed-design, communication, interaction
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-126068 (URN)10.1080/01612840.2016.1189636 (DOI)000388646100006 ()27351080 (PubMedID)
Available from: 2016-09-28 Created: 2016-09-28 Last updated: 2018-06-07Bibliographically approved
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