umu.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Lindgren, Britt-MarieORCID iD iconorcid.org/0000-0002-3360-5589
Publications (10 of 33) 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
Lindgren, B.-M. (2019). Självskadebeteende (3ed.). In: Ingela Skärsäter & Lena Wiklund Gustin (Ed.), Omvårdnad vid psykisk ohälsa: på grundnivå (pp. 341-361). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Självskadebeteende
2019 (Swedish)In: Omvårdnad vid psykisk ohälsa: på grundnivå / [ed] Ingela Skärsäter & Lena Wiklund Gustin, Lund: Studentlitteratur AB, 2019, 3, p. 341-361Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 3
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-163930 (URN)9789144123691 (ISBN)
Available from: 2019-10-08 Created: 2019-10-08 Last updated: 2019-10-17Bibliographically approved
Lindgren, B.-M., Svedin, C. G. & Werkö, S. (2018). A Systematic Literature Review of Experiences of Professional Care and Support Among People Who Self-Harm. Archives of Suicide Research, 22(2), 173-192
Open this publication in new window or tab >>A Systematic Literature Review of Experiences of Professional Care and Support Among People Who Self-Harm
2018 (English)In: Archives of Suicide Research, ISSN 1381-1118, E-ISSN 1573-8159, Vol. 22, no 2, p. 173-192Article, review/survey (Refereed) Published
Abstract [en]

Self-harm is an increasing phenomenon among young people, with potentially fatal outcomes. Patient's perceptions of treatment and support are poorly documented. The aim was to synthesise the experiences of those who self-harm, with special reference to professional care and support by family, friends, and the school system. A systematic review of the literature was conducted. Following retrieval of 1,623 abstracts, 14 studies were included in the final analysis, 11 of which are reported here. Two quantitative studies as well as 1 mixed method study on self-care could not be reported on here due to word limitations. Adult people who self-harm described the importance of quality in the caring relationship and a tailored care designed for each individual. There is a need for more studies into adolescents who self-harm but of importance is the adolescents' need for support from the adult world. A positive relationship between patient and healthcare professional can be crucial in motivating continued treatment of people who self-harm. A major priority is radical improvement in the attitudes of healthcare personnel.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
adolescents, adults, experiences of care, school support, self-harm, systematic review
National Category
Psychiatry Psychology
Identifiers
urn:nbn:se:umu:diva-146821 (URN)10.1080/13811118.2017.1319309 (DOI)000429026900001 ()28426393 (PubMedID)
Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-06-09Bibliographically approved
Lindgren, B.-M., Molin, J., Lundström, M., Strömbäck, M., Salander Renberg, E. & Ringnér, A. (2018). Does a new spatial design in psychiatric inpatient care influence patients’ and staff’s perception of their care/working environment?: A study protocol of a pilot study using a single-system experimental design. Pilot and Feasibility Studies, 4, Article ID 191.
Open this publication in new window or tab >>Does a new spatial design in psychiatric inpatient care influence patients’ and staff’s perception of their care/working environment?: A study protocol of a pilot study using a single-system experimental design
Show others...
2018 (English)In: Pilot and Feasibility Studies, ISSN 2055-5784, Vol. 4, article id 191Article in journal (Refereed) Published
Abstract [en]

Background: Research shows that worn-out physical environments are obstacles to psychiatric inpatient care. Patients want better relationships with staff and things to do; staff want an environment that offers hope, a calm atmosphere, and joint activities. A county council in northern Sweden and Philips Healthcare partnered to create solutions to the environmental challenges of psychiatric inpatient care. One ward at a county psychiatric clinic was selected for a pilot project to test solutions that could improve the care environment for patients, staff, and relatives. The aim of the overall project is to evaluate the effects of a newly designed psychiatric inpatient ward on patients and staff in terms of quality of care and stress. In this study, we focus on the feasibility through testing questionnaires and exploring barriers to recruiting staff and patients.

Methods: This study had a single-system experimental design, comparing a psychiatric unit pre- and post-implementation of the novel spatial design, using repeated measures with the same questionnaires twice a week during baseline and intervention phases. Primary outcomes were quality interactions (patients) and perceived stress (staff). Secondary outcomes were levels of anxiety and depression (patients), and stress of conscience (staff). A process evaluation was aimed to describe contextual factors and participant experiences of the new design. Data was collected using questionnaires and semi-structured individual interviews with patients and focus group discussions with staff. Both visual and statistical methods were used to analyse the quantitative data and content analysis for the qualitative data.

Discussion: The findings will contribute insights into whether and how a new spatial design might contribute to quality interactions and reduced stress. This is relevant both nationally and internationally, as similar interventions are needed but sparse. The findings will be disseminated through peer-reviewed publications and conference presentations.

Trial registration: ClinicalTrials.gov, NCT03140618, registered 4 May 2017.

Keywords
Activity, Environment, Feasibility, Intervention, Nursing, Process evaluation, Protocol, Psychiatric inpatient care, Quality interactions, Single-system design
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-154939 (URN)10.1186/s40814-018-0383-4 (DOI)30607254 (PubMedID)
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-11Bibliographically 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
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
Melin, Y., Eklund, M. & Lindgren, B.-M. (2017). Experiences of living with opioid dependence: an interview study with individuals participating in medication-assisted treatment. Issues in Mental Health Nursing, 38(1), 9-17
Open this publication in new window or tab >>Experiences of living with opioid dependence: an interview study with individuals participating in medication-assisted treatment
2017 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 38, no 1, p. 9-17Article in journal (Refereed) Published
Abstract [en]

In order to describe experiences of living with opioid dependence, thirteen interviews were conducted with people participating in medication-assisted treatment. The results showed that living with opioid dependence is about the two-faced drug. The participant's past was a constant burden in life, and the drug filled a spiritual emptiness. The participant's described a life in chaos and pain, and furthermore, a life without dignity and in alienation. Opioid dependence means great suffering. Having a holistic view and by gaining an understanding of the complexities of opioid dependence, healthcare professionals can provide nonjudgmental and respectful treatment.

Place, publisher, year, edition, pages
Philadelpia: Taylor & Francis, 2017
Keywords
resilience, addiction, heroin, cohort, health
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-126174 (URN)10.1080/01612840.2016.1235638 (DOI)000393876600003 ()
Available from: 2016-09-30 Created: 2016-09-30 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
Molin, J., Hällgren Graneheim, U., Ringnér, A. & Lindgren, B.-M. (2016). From ideals to resignation: interprofessional teams perspectives on everyday life processes in psychiatric inpatient care. Journal of Psychiatric and Mental Health Nursing, 23(9-10), 595-604
Open this publication in new window or tab >>From ideals to resignation: interprofessional teams perspectives on everyday life processes in psychiatric inpatient care
2016 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 23, no 9-10, p. 595-604Article in journal (Refereed) Published
Abstract [en]

Introduction: Patients and ward staff describe psychiatric inpatient care as demanding, characterized by unpredictable events, yet research on interprofessional teams perspectives of everyday life processes in psychiatric inpatient care lacks. Aim: This study aims to explore everyday life processes in psychiatric inpatient care, as reported by staff in interprofessional teams. Method: A grounded theory design was used and 36 participants were interviewed. Results: The analysis resulted in a process-oriented core category From ideals to resignation. Related to this core category were three further categories: Knowing where to go, Walking a path of obstacles and Shifting focus from the patient's best interests to self-survival. The staff had ideals about care and collaboration, but a poor environment, power asymmetry, lacking structure and demands of managing chaos meant that they appeared to resign from putting their ideals into practice. Discussion: Different professions in general describe the same obstacles in everyday life on the wards but there are also profession-specific perspectives on distancing and feelings of abandonment. To our knowledge similar findings have not been reported in the international evidence. Implications: In order to support interprofessional teams to work according to their ideals, interventions such as Protected Engagement Time and reflective dialogues within the teams are suggested.

Keywords
collaboration, everyday life, experiences, grounded theory, interprofessional teams, psychiatric inpatient care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-127166 (URN)10.1111/jpm.12349 (DOI)000389034300008 ()27785861 (PubMedID)
Available from: 2016-11-01 Created: 2016-11-01 Last updated: 2018-06-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3360-5589

Search in DiVA

Show all publications