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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.

Background:  Individuals born with cleft lip and/or palate (CLP) may experience functional, esthetic and psychosocial challenges. While orthognathic surgery is performed to correct jaw discrepancies, knowledge about patients' experiences of this treatment remains limited, as previous research has largely relied on quantitative quality-of-life measures.

Objective:  This study aimed to illuminate the experiences of individuals with CLP undergoing orthognathic surgery.

Methods:  An inductive qualitative design was used. Individual semi-structured interviews were conducted with 16 adults treated with orthognathic surgery. Data were analyzed using qualitative content analysis.

Results:  One overarching theme, Emerging empowered through a life-changing challenge, described surgery as, for many, a transformative process extending beyond functional and esthetic correction. Three themes described participants' experiences: being highly motivated for change, overcoming tough setbacks through a stable backing system, and enhancing self-confidence. While many participants described increased confidence and social ease over time, empowerment was neither universal nor immediate, with some reported neutral or context-dependent psychosocial outcomes.

Conclusions:  Orthognathic surgery may be experienced as a transformative process within a lifelong CLP trajectory, with potential to foster psychosocial empowerment and renewed self-confidence. These findings highlight both the transformative possibilities and the contextual variability of surgical outcomes in person-centered cleft care.

Despite improvements in substance abuse care in Sweden, variations in accessibility persist, particularly in rural areas where patients with dual diagnosis receive fewer follow-ups than patients in urban areas. This study aims to illuminate nursing staff’s experience when caring for patients with dual diagnosis in psychiatric outpatient care in rural areas. Eleven semi-structured interviews were conducted with nursing staff at psychiatric outpatient clinics in rural areas. Qualitative content analysis was used to analyze the data. The findings show that caring for patients with dual diagnosis in rural areas can mean being close for better or worse, dealing with unequal care at distance, and bridging barriers to accessibility. For good nurse–patient relationships, nursing staff need to be aware of power structures and strive to overcome stigma. Additionally, organizations could benefit from drawing on the implementation competence of RNs with master’s level education. More research with an intersectional approach is needed on digital solutions for patients with dual diagnosis in rural areas.

Forming therapeutic relationships is considered important within psychiatric and mental health nursing. One way of achieving this is through social interaction when engaging in joint activities. However, introducing and using nursing interventions based on joint activities in psychiatric inpatient care has proven challenging. Since staff motivation is important, researching the meaning of engaging in joint activities from the nursing professional's point of view can provide information that is relevant in this area. This study aims to illuminate the meaning of participating in joint activities with patients as narrated by nursing professionals in psychiatric inpatient care. Narrative interviews with 14 nursing professionals with experience from psychiatric inpatient care were conducted. Data were analysed using phenomenological hermeneutics and reported following the consolidated criteria for reporting qualitative research (COREQ) guidelines. Results illuminate that engaging in joint activities means being open to a process of learning. Four themes contributed to this understanding: Struggling with uncertainty, discovering aspects of the other, unfolding paths to self-fulfilment and sharing personhood. Being open to a process of learning means being willing to face uncertainty when engaging in activities as well as being open to learning about oneself as well as the other. Through openness to this process of learning, a sharing of personhood can be achieved, where the nursing professional and the patient approach becoming two persons. Illuminating the meaning of joint activities from the nursing professionals' perspective may provide valuable insights related to introducing and using interventions focusing on joint activities.

Background: Although emergency call centre operators are not physically present at the scene of emergencies, they are still significantly impacted by these events. They are exposed to distressed individuals who express feelings of fear, desperation, and helplessness. Emergency call centre operators must endure this emotional exposure while simultaneously collecting crucial information from callers, relaying this information to responding units, and potentially instructing callers in critical first aid.

Motive: Limited research exists on the work environment and health conditions of emergency call centre operators. The motive of this study is to enhance understanding of the work environment and challenges faced by emergency call operators. The findings are relevant for employers and other professionals within the emergency care chain.

Aim: This study aims to describe the experiences of work-related psychosocial health among emergency call centre operators.

Methods: This study employed a qualitative approach, with data collected through 16 semi-structured interviews. The analysis was conducted using qualitative content analysis.

Result: The analysis revealed one main theme, four themes, and 12 subthemes. The main theme was “Having oneself as a stake,” built on the themes “Facing challenges,” “Being affected as a person,” “Feeling ignored by organisational conditions,” and “Drawing strength from rewarding conditions.”

Conclusion: The workplace environment of emergency call centre operators can have a negative impact on their psychosocial health. This can lead to decreased quality of emergency call responses and less accurate assessments of critical situations. Further research is needed to identify improvements in operational conditions for emergency call centre operators and establish goals for enhancing work-related health.

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.

Background: Depression is common and increasing in young people, who seem especially vulnerable, both in the probability of developing depression, and in the resulting negative consequences across the lifespan. Unfortunately, available treatments rarely lead to full remission and even in cases of remission relapse rates are high. Different explanatory models have been proposed, and research indicates a multifaceted etiology. The descriptive DSM-5 has low diagnostic validity in this age-group, especially for depressive disorders, and limited attention has been given to young people’s own experiences of becoming depressed. Hence, there is a risk of missing clinical information that is important for the therapeutic alliance and treatment.

Objective: This study aimed to explore young people’s experiences of becoming depressed.

Method: A qualitative study was performed. Six participants with clinical depression, currently in treatment at child and adolescent psychiatric outpatient clinics in northern Sweden were recruited. Interviews followed a semi-structured manual, and data was analyzed with inductive qualitative content analysis.

Results: Participants described different reasons for their depression, and from their stories four categories were identified: “Being subjected to violence”, “Suffering separation and loss”, “Feeling abandoned”, and “Feeling burdened and vulnerable”. These categories were interpreted in the theme: “Dealing with an overwhelming life situation”.

Conclusions: The participants presented mainly stressful external and relational events preceding their depression. A combination of overwhelming stressors, lack of support and lack of time for recovery was described. This points to the importance of validating the narratives of young patients with depression and to offer trauma-informed treatment approaches in mental health care.

Objective: To explore experiences of caries prevention in adult patients with recurrent cavities among experienced dentists. 

Method: Five focus group discussions consisting of seven men and nine women, 38-61 years of age, and with working experience as dentists between 5 and 35 years, were conducted. The participants represented Public Dental Health Service clinics and private practitioners. Qualitative content analysis was used to analyze data. 

Results: The participants emphasized the importance of effective communication and patient engagement in caries prevention. They described their experiences as an endless trail, making fillings. They expressed their inability to take necessary responsibility and being stuck in the dental care system due to various circumstances. The understanding of caries was contradictory, and an inadequate mandate to control time to fulfill their preventive work was evident. They felt responsible to do the best for their patients, but how to share responsibility with colleagues and patients and having enough time for this seemed difficult and unclear. These problems did not motivate to further education in cariology.

Conclusion: The findings underscore the urgent need for improvement in preventive caries treatment and the necessity of allocating sufficient time for dentists to engage in this crucial aspect of their work.

Persons with severe mental ill-health die early from preventable physical ill-health. Registered nurses in psychiatric outpatient care play a key role in improving persons’ physical health, and it is important to examine how they view their responsibility, their experiences of care, and the obstacles they meet in providing person-centred care. The purpose of this study was to explore registered nurses’ experiences of caring for persons with mental ill-health and somatic comorbidity in psychiatric outpatient care, using qualitative content analysis to analyze data from semi-structured interviews. The results show that these nurses monitored the person’s right to equal care, embraced the whole of the persons suffering, and dealt with unclear boundaries in care. This highlights the unique role that registered nurses play in psychiatric outpatient care via their ability to interpret symptoms and find ways to adapt care based on persons’ needs. Registered nurses consider physical health in all care and provide a link between psychiatric and somatic care. Together with mental health nurses at primary health care centers, they are key in reducing persons’ suffering. There is a need for structural and functional changes in line with person-centred care including collaboration both within and outside healthcare organizations.