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  • 1.
    Antonsson, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hällgren Graneheim, Ulla
    Umeå University, Faculty of Medicine, Department of Nursing. University West, Department of Health Sciences, Trollhättan, Sweden.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing. University West, Department of Health Sciences, Trollhättan, Sweden.
    Lundström, Mats O.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 734-743Article in journal (Refereed)
    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.

  • 2.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Commentary on: Sullivan and Willis (2018). Towards Changing the Long-Term Care (LTC) Paradigm: Explicating the Concept of Thriving in Older Adults Living in LTC2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 7, p. 639-640Article in journal (Refereed)
  • 3.
    Berglund, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindgren, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Patients' Experiences After Attempted Suicide: A Literature Review2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 715-726Article, review/survey (Refereed)
    Abstract [en]

    The aim of this study has been to synthesize research on suicidal patients' experiences of the suicide process. A literature search was performed in CINAHL, PubMed, and PsycINFO, and the analysis of the 15 articles covered was based on meta-synthesis. Patients experience a wide variety of feelings regarding their situation during the suicide process, and these exist on two levels: they relate to the different aspects of care that the patients receive and the patients' need to communicate with others and regain hope. The patients in this study described the struggle to maintain hope when life became too difficult and their suffering despite a sense of security, and they sought to achieve emotional balance. A good understanding of how suicidal individuals live with and manage suicidal ideation, while maintaining hope is important for planning effective nursing care. Further research from the patient perspective is needed to further develop psychiatric care for people at risk of suicide.

  • 4. Carlbo, Adam
    et al.
    Claesson, Hanna Persic
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses' experiences in using physical activity as complementary treatment in patients with schizophrenia2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 7, p. 600-607Article in journal (Refereed)
    Abstract [en]

    Introduction: Schizophrenia is a common disease with a high risk of comorbidity in both psychiatric and somatic diseases. Physical activity is proven effective in reducing symptoms of schizophrenia and increasing overall health. Still it is not used systematically in the care of persons with schizophrenia.

    Aim: The aim of this study is to describe nurses' experience, including personal motivation, in using physical activity as complementary treatment in patients with schizophrenia.

    Method: Interviews in three focus groups with 12 participating nurses were conducted. Qualitative content analysis was used to analyze data.

    Results: Physical activity was commonly used. Although several nurses signaled positive patient response, i.e. less anxiety and better quality of sleep, the overall consensus was an uncertainty regarding the benefits. It was perceived as non-evidence based form of intervention.

    Conclusion: The uncertainty of the benefits of physical activity is evident in nursing staff and poses a resistance to implement systematic physical activity as a complementary treatment in schizophrenia. A new awareness of evidence based nursing is suggested to promote a wider and more receptive attitude to reduce patient vulnerability in persons with schizophrenia.

  • 5. Eivergård, Kristina
    et al.
    Enmarker, Ingela
    Livholts, Mona
    Aléx, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hellzén, Ove
    The Importance of Being Acceptable: psychiatric Staffs' Talk about Women Patients in Forensic Care2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 2, p. 124-132Article in journal (Refereed)
    Abstract [en]

    Currently, women comprise about ten percent of those sentenced to psychiatric forensic clinics in Sweden. Those who are sentenced to forensic care because of offending and violent behaviour have already taken a step away from the usually expected female behaviour. On the other hand, there are many women in forensic care who have not committed crimes, but who instead self-harm. Studies have identified a gender bias in diagnosing and care in psychiatric settings, but there are few studies conducted on women in forensic care. The present study therefore examined how the situation of women patients and female norms are expressed in the staff's talk about these women during verbal handovers and ward rounds at a forensic clinic in Sweden. The aim was to explore how psychiatric staff, in a context of verbal handovers and ward rounds, talk about women who have been committed to forensic psychiatric care, and what consequences this might have for the care of the patients. The content of speech was examined using audio recordings and a method of analysis that was inspired by thematic analysis. The analysis identified that the staff talked about the women in a way that indicates that they expected the women to follow the rules and take responsibility for their bodies in order to be regarded as acceptable patients.

  • 6.
    Hallgren Graneheim, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jansson, Lilian
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindgren, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hovering between Heaven and Hell: An Observational Study Focusing on the Interactions between One Woman with Schizophrenia, Dementia, and Challenging Behaviour and her Care Providers2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 7, p. 543-550Article in journal (Refereed)
    Abstract [en]

    This case study aims to illuminate the interactions between one woman (Alice) with schizophrenia, dementia, and challenging behaviour and her professional caregivers. We performed participant observations of these interactions and conducted informal interviews at the residential home where the woman lived. The transcripts were subjected to qualitative content analysis. The results showed that the interactions between Alice and her caregivers were experienced as hovering between heaven and hell. Alice struggled to bring order into her chaotic life world by splitting herself and others, and her caregivers struggled to protect Alice's and their own dignity by limiting her challenging behaviours. They also strived to understand their own and Alice's behaviour. Current practice in caring for people with challenging behaviour usually focuses on symptom reduction through medication and behavioural modification. Instead, we suggest moving toward an understanding of the experiences behind the challenging behaviours and designing person-centred care based on each patients' reality.

  • 7.
    Hällgren Graneheim, Ulla H
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Slotte, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Markström Säfsten, Helena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindgren, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Contradictions between ideals and reality: registered nurses' experiences of dialogues with in-patients in psychiatric care2014In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 35, no 5, p. 395-402Article in journal (Refereed)
    Abstract [en]

    This study explored ten registered nurses’ experiences of di- alogues with inpatients in psychiatric care. Data were collected through four focus group discussions, and two individual inter- views. The nurses described contradictions between their nursing ideals about dialogues and the reality faced in psychiatric inpatient care, resulting in an unsatisfactory work situation and feelings of insufficiency. We conclude that in order to improve quality of care and increase well-being for both patients and health care workers, nursing interventions, such as dialogues and meaningful activities, need to be offered to patients. A management that is visible and present on-site should encourage and facilitate health care work- ers’ participation in clinical supervision.

  • 8.
    Hällgren Graneheim, Ulla
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. University West, Department of Health Sciences, Trollhattan, Sweden.
    Åstrom, Sture
    Umeå University, Faculty of Medicine, Department of Nursing. University West, Department of Health Sciences, Trollhattan, Sweden.
    Until Death Do Us Part: Adult Relatives' Experiences of Everyday Life Close to Persons with Mental Ill-Health2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 8, p. 602-608Article in journal (Refereed)
    Abstract [en]

    This study illuminates adult relatives' experiences of everyday life close to a person with mental ill-health. The study was based on nine diaries and four narrative interviews with relatives of people with mental ill-health. Data were subjected to qualitative content analysis. The participants experienced everyday life as a constant fight, for better and for worse, with psychiatric care. They were fighting for the mentally ill person's right to care; sometimes they felt resigned, but yet they had a confidence in the care. Their mission in life was to sacrifice themselves, meaning that they felt indispensable and became lonely and socially isolated. They considered their mission to last until death set them apart because they were keeping a family secret, and had great worries about the future. We conclude that relatives experience a two-folded stigma in living close to a person with mental ill-health and in becoming lonely and socially isolated.

  • 9.
    Jansson, Leila
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hällgren Graneheim, Ulla
    Umeå University, Faculty of Medicine, Department of Nursing. bDepartment of Health Sciences, University West, Trollhättan, Sweden.
    Nurses' experiences of assessing suicide risk in specialised mental health outpatient care in rural areas2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 7, p. 554-560Article in journal (Refereed)
    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.

  • 10.
    Lindgren, Britt-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Aminoff, Carina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hällgren Graneheim, Ulla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Features of every day life in psychiatric inpatient care for self-harming: an observational study of six women2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 2, p. 82-88Article in journal (Refereed)
    Abstract [en]

    This study aimed to describe the features of everyday life in psychiatric inpatient care as experienced by women who self-harm. Participant observations and informal interviews were conducted with six women and were subjected to qualitative content analysis. The major feature of everyday life in psychiatric inpatient care was ‘being surrounded by disorder’, which consisted of ‘living in a confusing environment, being subject to routines and rules that offer safety but lack consistency’ and ‘waiting both in loneliness and in togetherness’. The nursing staff spent minimal time with the patients and the women turned to each other for support, care and companionship.

  • 11.
    Lindgren, Britt-Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eklund, Margita
    Umeå University, Faculty of Medicine, Department of Nursing.
    Melin, Ylva
    Umeå University, Faculty of Medicine, Department of Nursing.
    Graneheim, Ulla Hällgren
    Umeå University, Faculty of Medicine, Department of Nursing.
    From Resistance to Existence-Experiences of Medication-Assisted Treatment as Disclosed by People with Opioid Dependence2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 12, p. 963-970Article in journal (Refereed)
    Abstract [en]

    This study aimed to describe the lived experiences of participating in a medication-assisted treatment as disclosed by individuals with opioid dependence. Eleven narrative interviews were conducted and subjected to qualitative content analysis. The experiences of participating in the programme were described as a process from resistance to existence. The participants seized the chance to claim a life lived with dignity, struggled with hidden challenges, and eventually were freed from their pasts and were grateful for an existence with dignity. The recovery process was a long-term commitment and participants asked for a more individual and flexible process based on personal needs and values.

  • 12.
    Melin, Ylva
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eklund, Margita
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindgren, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Experiences of living with opioid dependence: an interview study with individuals participating in medication-assisted treatment2017In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 38, no 1, p. 9-17Article in journal (Refereed)
    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.

  • 13.
    Richter, Jörg
    et al.
    Regional Centre of Child and Adolescent Mental Health, Oslo, Norway.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Personality characteristics of staff in elderly care-a cross-cultural comparison2012In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 33, no 2, p. 96-100Article in journal (Refereed)
    Abstract [en]

    Communication and interaction between carers and residents in elderly and dementia care can be challenging and demanding. The carer's personality, one factor shaping this interaction, seems to have been neglected in the literature. This article looks at cross-cultural comparisons of staff in elderly and dementia care with individuals from the general population matched by age and gender. Compared to individuals in the general population, elderly and dementia care staff are usually slower tempered, more stoic and reflective, tolerant to monotony, and more systematic. They also have more optimistic attitudes in situations that might worry most people, and more confidence in social situations and in the face of danger and uncertainty.

  • 14.
    Rørtveit, Kristine
    et al.
    Stavanger District Psychiatric Centre, Stavanger University Hospital, Stavanger Norway.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Severinsson, Elisabeth
    Centre for Women, Families and Children's Health, Vestfold University College, Tönsberg, Norway.
    Experiences of guilt as a mother in the context of eating difficulties2009In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 30, no 10, p. 603-610Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore motherhood in the context of eating difficulties. The research question was: What are mothers' daily life experiences when suffering from ED? An explorative design was used. In-depth interviews (n = 8) focused on experiences of motherhood and eating difficulties. Data were interpreted by hermeneutic analysis. The main theme, "experiencing guilt as a mother in the context of eating difficulties," comprised two themes: (1) having a guilty conscience in relation to being a good enough mother and (2) being preoccupied about not involving the children in the eating difficulties. The study illuminates the importance of identifying mothers with eating difficulties and offering them treatment and support.

  • 15. Wästberg, Birgitta A.
    et al.
    Sandström, Boel
    Pooremamali, Parvin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    A Turning Point Towards Recovery: An Interview Study with Participants in the Culture and Health Programme for Clients with Long-Term Mental Health Disorders in Sweden2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 5, p. 373-381Article in journal (Refereed)
    Abstract [en]

    The study aimed to explore participants' perceptions and experiences of the Culture and Health programme in Sweden for clients with long-term mental health disorders. A qualitative approach with interviews was applied. Grounded Theory guided the analysis and selection of informants. A total of 15 informants were interviewed. A core category 'A turning point in dealing with everyday life beyond the mental illness' with three categories: inner life, social life and occupational life emerged. A theory indicating the importance of asking clients about their expectations, was formulated. Further studies are warranted, including studies of effects.

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