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Objectives: Time Together (TT) is a nursing intervention designed with a focus on increasing the possibility of patients and staff engaging in joint activities. Previous research points towards implementation difficulties but there are no studies specifically investigating the process of implementing TT in psychiatric inpatient care (PIC). Therefore, the aim of this study is to explore mid-level leaders’ and implementation leads’ perspectives on implementing TT in PIC, analysed through the Consolidated Framework for Implementation Research (CFIR).

Design: This qualitative study used semistructured interviews with 11 mid-level leaders and implementation leads who took part in implementing TT. The interviews were analysed using deductive qualitative content analysis, with the CFIR applied as a structured matrix in the analysis. 

Setting: The study was conducted in PIC settings at three wards within secondary care healthcare services in northern Sweden.

Participants: Participants were 11 mid-level leaders and implementation leads involved in the implementation of TT in PIC.

Interventions: TT is scheduled for 1 hour, 5 days a week. During this hour, nursing staff and patients engage in joint activities, while one or two staff members oversee administrative duties. No meetings, visits or other ward-related activities are scheduled during this hour.

Results: Deductive content analysis resulted in 15 categories sorted into 4 domains and 11 constructs. TT was perceived as advantageous and aligned with the wards’ mission. However, one key finding was that mid-level leaders and implementation leads found implementation challenging as they perceived that some innovation deliverers viewed joint activities within TT as lacking value and not being ‘proper work’. Furthermore, there was a need for more information and a clearer rationale for the intervention in order to improve implementation and delivery.

Conclusions: The findings indicate a discrepancy in values and attitudes between leaders and innovation deliverers regarding what constitutes meaningful care in psychiatric inpatient settings. Implementation was further influenced by challenges related to leadership and motivating others. Barriers to implementing TT may not be addressable through implementation and intervention training alone. Instead, implementation planning should also consider intervention deliverers’ values and beliefs.

Introduction: In compulsory psychiatric care and forensic psychiatric care, supportive functions with independent roles have been instituted to uphold patient rights, preserve self-determination and personal integrity, work toward recovery and fulfill the obligation to ensure that individuals remain at the center of decision making. In Sweden, independent support persons (ISP) provide personal support and companionship to patients during and shortly after involuntary care. Knowledge about the ISPs experiences of the role is needed to expand and further develop the ISP role. This study aimed to illuminate ISPs experiences of their role regarding patients treated in compulsory psychiatric care and forensic psychiatric care.

Methods: The study used a qualitative design with semi structured interviews and inductive qualitative content analysis. Nine ISPs participated.

Results: ISPs experiences were reflected in the main theme Managing boundaries in a borderland, interpreted through the themes Balancing personal and professional approaches, Serving as social support and Being in the hands of staff.

Discussion: Findings highlights the important role of ISPs in mental health recovery through supportive, friendship-like relationships that promote reciprocity. ISPs help bridge social gaps, especially for those lacking networks. However, misunderstandings about their role can limit their impact.

Mental health nursing in inpatient psychiatry is shaped by control and standardisation, yet little is known about how these conditions are sustained in everyday care for persons with anorexia nervosa. This study aimed to explore how nursing staff experience and understand care for persons with anorexia nervosa within general psychiatric inpatient care settings, with particular attention to the conditions shaping what comes to count as legitimate nursing practice. Nine nursing staff with experience caring for persons with anorexia nervosa in general psychiatric inpatient care in Sweden participated in the study. Data were collected in 2025 using semi-structured qualitative interviews and were subjected to qualitative content analysis with a Foucauldian-inspired abductive approach. Findings are presented as two themes, Nursing practice governed by a risk-oriented care logic and Responsibility as a burden and a possibility within nursing practices. Within those themes are five sub-themes, Making sense of AN through risk and stabilisation; Enacting control through routines and treatment plans; Normalising coercion in everyday care; Navigating responsibility under unstable care conditions and Producing alternative care practices through relational work. Findings suggest that discourses of risk and stabilisation organise nursing practice through a risk-oriented care logic that shapes what is recognised as legitimate care and professional competence. Within these conditions, relational and individualised nursing practices become difficult to sustain while responsibility and coercive measures are framed as necessary responses to risk. This study is reported in accordance with the COREQ guidelines.

Introduction: Persons with severe dissociative states constitute a vulnerable group in psychiatric inpatient care and are at risk of being misunderstood and mistreated. The aim was to describe experiences of psychiatric inpatient care among persons living with severe dissociative states.

Methods: Sixteen persons with lived experience of severe dissociative states and previous contact with psychiatric inpatient care participated in semi-structured interviews that were analyzed using qualitative content analysis. This study is reported in accordance with the COREQ guidelines.

Results: Participants' experiences are described in one theme, Stuck between a rock and an unnecessarily hard place, and three subthemes. At the mercy of others in a place intended to provide support, Distrusted and rejected in a place intended to allow existence and Lacking control in a place intended to be safe.

Discussion: The results suggest a gap in understanding of trauma dynamics in psychiatric inpatient care, implying a need for increased trauma awareness. Mental health nurses should lead the promotion of safe, person-centred and trauma-informed psychiatric inpatient care for persons with severe dissociative states, requiring authority, education, support, supervision and resources.

Background: Although anorexia nervosa has been the focus of numerous studies, most research has been conducted within specialized eating disorder services, where the primary emphasis is on food, weight and physical markers of illness. The condition is described as difficult to treat, with persons with anorexia nervosa portrayed as being dominated by the illness and hard to engage in care. Treatment approaches are often rigid and protocol-driven, particularly in inpatient settings, where the primary aim is to preserve life. Given the limited research on psychiatric inpatient care for anorexia nervosa in settings not specialized in eating disorder treatment this qualitative study aims to explore lived experiences of being treated for anorexia nervosa in the context of general psychiatric inpatient care. Methods: The study was conducted in Sweden between August and September 2023. Eighteen women participated. Seventeen submitted written narrative texts reflecting on their experiences, nine of whom also took part in individual interviews. Only one participant agreed to being interviewed only. Data were analysed using inductive qualitative content analysis, involving a systematic abstraction and interpretation of the textual content. Results: Findings revealed one main theme, Being kept alive—but not being supported to live; three themes, Being invisible as a person; Being chained by hopelessness; and Aiming to get on the road towards recovery; and eight subthemes, Lacking existential support; Having to stand up for myself; Being disconnected from real life; Being restricted; Being marked for life; Needing human connection; Finding ways to live; and Finding meaning and hope. Conclusion: The findings show that persons with anorexia nervosa may experience general psychiatric inpatient care as both life-saving and unsupportive. This calls for trauma-informed, recovery-oriented care that treats lived experience as essential expertise. Future work should focus on strategies to challenge entrenched assumptions in general psychiatric inpatient care and promote approaches that respect the complexity, autonomy, and meaning making of persons living with AN.

Aim: To identify key aspects of recovery-oriented practice in caring for people with mental ill-health in general emergencydepartments.

Design: A modified Delphi study with three rounds.

Methods: A 24-member expert panel was recruited consisting of people with lived experience of mental ill-health, registerednurses working in emergency care, registered nurses specialised in psychiatric and mental health nursing and mental healthrecovery researchers. In the initial round, important aspects of recovery-oriented practice were identified through focus groupinterviews. Thematic analysis generated statements that were then reformulated as a questionnaire for subsequent rounds. Theexperts rated each statement's perceived importance on a 5-point Likert scale. The consensus level was set at ≥ 80%. Descriptivestatistics were used to analyse the data.

Results: Consensus was reached on the importance of 39 of 73 statements, with ≥ 80% deemed 'very important' in recovery-oriented practice in general emergency departments.

Conclusion: The study emphasises the delicate balance between the essential elements of recovery-oriented practice, their prac-tical feasibility and the predominant biomedical perspective in general emergency department care. It proposes strategies toempower nursing staff and managers to adopt recovery-oriented practices that enhance the quality of care for people with mentalill-health. Enabling staff by providing the necessary prerequisites and a care environment that supports reflective practices iscrucial. The responsibility for facilitating these changes needs to be a shared commitment between nursing staff and managers.

Implications for the profession and/or patient care: The identified issues can serve as a framework for interventions, edu-cation and training to support the integration of recovery-oriented practice in general emergency care. They can also be used todevelop tools for evaluating emergency care environments and promoting alignment with recovery-oriented principles.

Objectives: Persons diagnosed with anorexia nervosa (AN) may receive care in general psychiatric inpatient care (GPIC) for several reasons including severity of their condition, comorbidities and lack of access to specialised inpatient care. However, scant research has explored how this specific setting may impact persons with AN, either positively or negatively. Additionally, there is limited evidence regarding the most effective form of care for AN within GPIC. This integrative literature review provides a comprehensive overview of research focusing on care for AN in GPIC settings, shedding light on person-centred care and power within this specific context.

Design: The review was conducted according to the methods of Whittemore and Knafl. We searched the academic databases PubMed, CINAHL and PsycInfo, with the latest search conducted in March 2025, in accordance with a specific search strategy and analysed the data using a constant comparison method. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for systematic reviews.

Results: The synthesis revealed three perspectives of care for persons with AN in the context of GPIC: management of the symptoms, treatment of the patient and support for the person. Overall, the findings suggest that GPIC can aid in weight gain, but the impact on recovery is unclear.

Conclusion: Research indicates that GPIC possesses the biomedical knowledge necessary to save lives, but there is a lack of research focusing on the perspectives of persons with AN. This gap in understanding may affect treatment outcomes, the possibility of recovery and the personal experience of care for those with AN in this context.

PROSPERO registration number CRD42023426095.

Introduction: Psychiatric inpatient care is often characterized by brief admissions and an orientation toward acute treatments. Persons with dissociative identity disorder have been recognized as a vulnerable group within psychiatric inpatient care and are at risk of not receiving correct support in psychiatric inpatient care. Research within the area is limited and includes no overview of how persons with dissociative identity disorder are cared for in psychiatric inpatient care.

Aim: The aim was to map the area of knowledge on psychiatric inpatient care for persons with dissociative identity disorder.

Method: This scoping review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews. The search strategy included both peer reviewed papers indexed in PubMed, Cinahl and PsycINFO, and grey literature.

Results and conclusions: The review identified eight studies, revealing a small base of knowledge on psychiatric inpatient care for persons with dissociative identity disorder, showing the importance of further research exploring the significance of trauma awareness in this area. Further research should include persons with lived experience, both as participants and as partners in the research process. Nurses are in a position to prevent retraumatisation and promote person-centered approaches to care by valuing the patients’ perspectives.

In Sweden, a lack of accessible specialist mental health services places the sole responsibility for caring for people with mental ill-health in rural areas on primary care. Caring for people with severe mental ill-health can pose challenges for district nurses in rural areas. The aim of this study is to describe district nurse’s experiences of encountering people with mental ill-health in rural primary care. Semi-structured interviews were conducted with nine district nurses working in primary care in rural areas in Northern Sweden. Interviews were analyzed with qualitative content analysis. The results describe district nurses’ experiences of encountering people with mental ill-health as a strive for a good relationship. They wanted to understand the core of patients’ needs and adjust their approach based on that. However, organizational obstacles and opportunities affected these encounters, particularly the lack of time and the importance of continuity. Being a primary care nurse in a rural setting provides specific challenges and opportunities when caring for people with mental ill health. District nurses would benefit from organizational support in establishing and maintaining good relationships as a foundation for quality care. Providing district nurses with greater autonomy over their time, along with enhanced support and access to resources would acknowledge and reinforce the critical professional role they play in rural healthcare delivery.

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.