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Lindgren, Britt-MarieORCID iD iconorcid.org/0000-0002-3360-5589
Publications (10 of 68) Show all publications
Sandsten, A., Gabrielsson, S., Strömbäck, M., Looi, G.-M. E. & Lindgren, B.-M. (2025). “Being kept alive—but not being supported to live”: experiences of general psychiatric inpatient care among persons with anorexia nervosa. Journal of Eating Disorders, 13(1), Article ID 282.
Open this publication in new window or tab >>“Being kept alive—but not being supported to live”: experiences of general psychiatric inpatient care among persons with anorexia nervosa
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2025 (English)In: Journal of Eating Disorders, E-ISSN 2050-2974, Vol. 13, no 1, article id 282Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2025
Keywords
Anorexia nervosa, Diagnostic identity, Hospitalization, Mental health, Personal recovery, Qualitative research
National Category
Psychiatry Nursing
Identifiers
urn:nbn:se:umu:diva-247588 (URN)10.1186/s40337-025-01483-9 (DOI)001635439300001 ()41339958 (PubMedID)2-s2.0-105024248812 (Scopus ID)
Available from: 2025-12-18 Created: 2025-12-18 Last updated: 2025-12-18Bibliographically approved
Derblom, K., Dahlberg, K., Gabrielsson, S., Lindgren, B.-M. & Molin, J. (2025). Key aspects of recovery-oriented practice in caring for people with mental ill-health in general emergency departments: a modified Delphi study. Journal of Clinical Nursing, 34(2), 565-579
Open this publication in new window or tab >>Key aspects of recovery-oriented practice in caring for people with mental ill-health in general emergency departments: a modified Delphi study
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2025 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 34, no 2, p. 565-579Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
Delphi study, Delphi technique, emergency department, emergency nursing, mental ill-health, mental illness, Recovery-oriented practice
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-231960 (URN)10.1111/jocn.17631 (DOI)001381153200001 ()39710600 (PubMedID)2-s2.0-85212779784 (Scopus ID)
Funder
The Kempe Foundations
Available from: 2024-11-19 Created: 2024-11-19 Last updated: 2025-05-28Bibliographically approved
Sandsten, A., Lindgren, B.-M., Strömbäck, M., Looi, G.-M. E., Larsson, H. & Gabrielsson, S. (2025). Perspectives of general psychiatric inpatient care for persons with anorexia nervosa: an integrative literature review. BMJ Open, 15(5), Article ID e098772.
Open this publication in new window or tab >>Perspectives of general psychiatric inpatient care for persons with anorexia nervosa: an integrative literature review
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2025 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 15, no 5, article id e098772Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2025
Keywords
Eating disorders, Hospitalization, MENTAL HEALTH, PSYCHIATRY, Systematic Review
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-239164 (URN)10.1136/bmjopen-2025-098772 (DOI)001490294200001 ()40379342 (PubMedID)2-s2.0-105005369186 (Scopus ID)
Available from: 2025-06-16 Created: 2025-06-16 Last updated: 2025-06-16Bibliographically approved
Söderberg, A., Lindgren, B.-M., Looi, G.-M. E., Bäckström, J. & Gabrielsson, S. (2025). Psychiatric inpatient care for persons with dissociative identity disorder: a scoping review. Issues in Mental Health Nursing, 46(11), 1088-1098
Open this publication in new window or tab >>Psychiatric inpatient care for persons with dissociative identity disorder: a scoping review
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2025 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 46, no 11, p. 1088-1098Article, review/survey (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Taylor & Francis, 2025
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-245507 (URN)10.1080/01612840.2025.2553164 (DOI)001581748100001 ()41004449 (PubMedID)2-s2.0-105017865174 (Scopus ID)
Funder
Luleå University of Technology
Available from: 2025-10-14 Created: 2025-10-14 Last updated: 2025-11-28Bibliographically approved
Lundgren, H., Lindgren, B.-M., Derblom, K. & Gabrielsson, S. (2025). Rural mental health: district nurses’ experiences of encountering people with mental ill-health in rural primary care in Northern Sweden. Issues in Mental Health Nursing, 46(2), 148-155
Open this publication in new window or tab >>Rural mental health: district nurses’ experiences of encountering people with mental ill-health in rural primary care in Northern Sweden
2025 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 46, no 2, p. 148-155Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Taylor & Francis, 2025
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-236587 (URN)10.1080/01612840.2025.2456177 (DOI)001414970000001 ()39913894 (PubMedID)2-s2.0-86000380181 (Scopus ID)
Available from: 2025-03-18 Created: 2025-03-18 Last updated: 2025-03-28Bibliographically approved
Söderberg, A., Gabrielsson, S., Looi, G.-M. E., Wiklund Gustin, L., Bäckström, J. & Lindgren, B.-M. (2024). Being human under inhuman conditions: meanings of living with severe dissociative states involving the experience of being in parts. Issues in Mental Health Nursing, 45(6), 597-606
Open this publication in new window or tab >>Being human under inhuman conditions: meanings of living with severe dissociative states involving the experience of being in parts
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2024 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 45, no 6, p. 597-606Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-224374 (URN)10.1080/01612840.2024.2330572 (DOI)001205238200001 ()38640493 (PubMedID)2-s2.0-85192354938 (Scopus ID)
Available from: 2024-05-24 Created: 2024-05-24 Last updated: 2024-07-16Bibliographically approved
Sunnegårdh Grönberg, K., Molin, J., Flink, H. & Lindgren, B.-M. (2024). 'Feeling more like a mechanic' - a qualitative study on experiences of caries prevention to patients with recurrent cavities among experienced dentists. Acta Odontologica Scandinavica, 83, 603-610
Open this publication in new window or tab >>'Feeling more like a mechanic' - a qualitative study on experiences of caries prevention to patients with recurrent cavities among experienced dentists
2024 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 83, p. 603-610Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Medical Journals Sweden, 2024
Keywords
Caries, clinical practice, oral health, dentistry, patient-centered dental care
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-231631 (URN)10.2340/aos.v83.42271 (DOI)001359544800003 ()39479897 (PubMedID)2-s2.0-85208168427 (Scopus ID)
Available from: 2024-11-20 Created: 2024-11-20 Last updated: 2025-04-24Bibliographically approved
Söderberg, A., Lindgren, B.-M., Looi, G.-M. E., Bäckström, J. & Gabrielsson, S. (2024). Psychiatric inpatient care for persons with dissociative identity disorder: a scoping review protocol. BMJ Open, 14(2), Article ID e079207.
Open this publication in new window or tab >>Psychiatric inpatient care for persons with dissociative identity disorder: a scoping review protocol
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2024 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 14, no 2, article id e079207Article, review/survey (Refereed) Published
Abstract [en]

Introduction: Psychiatric inpatient care (PIC) is often characterised by high pressure and thresholds for admission, brief periods of care and limited time for caring activities. Dissociative identity disorder (DID) is a contested diagnosis, and persons with DID are at risk of not receiving adequate support when cared for in PIC. Because the limited literature addressing the topic includes no overview on how persons with DID are cared for in psychiatric inpatient settings, the aim of this scoping review is to map the area of knowledge on PIC for persons experiencing DID. This scoping review will provide an overview with the possibility to elucidate gaps in the evidence base and needs for future research on PIC for persons experiencing DID.

Methods and analysis: This scoping review will follow Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews and steps 1-5 described in the established method for scoping reviews: identifying research question, identifying relevant studies, study selection, charting the data and collating, summarising and reporting results.

Ethics approval: Not applicable.

Dissemination: This scoping review will be submitted for publication in an international, peer-reviewed journal.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
Hospitalization, Hospitals, Mental health, Psychiatry
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-221793 (URN)10.1136/bmjopen-2023-079207 (DOI)001184391200020 ()38365290 (PubMedID)2-s2.0-85185302088 (Scopus ID)
Funder
Luleå University of Technology
Available from: 2024-03-12 Created: 2024-03-12 Last updated: 2025-04-24Bibliographically approved
Gabrielsson, S., Wolpher, N., Zammata, E., Fagerström, L. & Lindgren, B.-M. (2024). When the time is right: men's experiences of recovery in self-harm. International Journal of Mental Health Nursing, 33(4), 1110-1118
Open this publication in new window or tab >>When the time is right: men's experiences of recovery in self-harm
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2024 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 33, no 4, p. 1110-1118Article in journal (Refereed) Published
Abstract [en]

Previous research has mainly focused on self-harm among women, defining what it is, what functions it has, how to manage and prevent self-harm, and how to recover from it. A recent review of the literature on self-harm among men concluded that research need to consider both clinical and personal aspects of recovery and pointed out the need to explore recovery from men's point of view. This study aimed to describe men's experiences of recovery in self-harm. Data were collected in Sweden in 2020 using semi-structured interviews. Eleven men who had recovered in self-harm were interviewed. Interviews were analysed using an abductive approach to qualitative content analysis. The analysis involved the application of an established framework for personal recovery in mental illness: connectedness, hope, identity, meaning, and empowerment (CHIME). The analysis identified one main theme: when the time is right, and five sub-themes: finding support in others; trusting that change is possible; getting to know yourself; reaching a new understanding; and developing new strategies to manage life. While the cessation of self-harm might both be a sign of and contribute to recovery, it is not the defining feature of recovery. Mental health professionals should be persistent in providing person-centred, recovery-oriented care for men who self-harm. The CHIME framework can be applied in the context of men's recovery in self-harm. This study is reported in accordance with the COREQ guidelines.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
men's health, mental health recovery, qualitative research, self-injurious behaviour
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-222426 (URN)10.1111/inm.13319 (DOI)001180874800001 ()38459624 (PubMedID)2-s2.0-85187168251 (Scopus ID)
Available from: 2024-03-19 Created: 2024-03-19 Last updated: 2024-08-21Bibliographically approved
Sandsten, A., Lindgren, B.-M., Strömbäck, M., Ejneborn-Looi, G.-M. & Gabrielsson, S. (2023). General psychiatric inpatient care for persons with anorexia nervosa: an integrative literature review protocol. BMJ Open, 13(9), Article ID e076437.
Open this publication in new window or tab >>General psychiatric inpatient care for persons with anorexia nervosa: an integrative literature review protocol
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2023 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 13, no 9, article id e076437Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: People diagnosed with anorexia nervosa are offered or compelled to undergo various treatments and therapies. In Sweden, the lack of highly specialised eating disorder services means that people with anorexia nervosa might be cared for in general psychiatric wards. However, there has been limited research attention paid to how this specific context might benefit or harm persons with anorexia nervosa. There is also limited evidence regarding which form of care is most effective in anorexia nervosa and which type of treatment is optimal in general psychiatric inpatient care. Our intention is to highlight personal and professional perspectives of care for patients with anorexia nervosa in this context, with a focus on person-centred care, gender and power. This protocol describes an integrative literature review aiming to synthesise existing knowledge on general psychiatric inpatient care for persons with anorexia nervosa.

METHODS AND ANALYSIS: The study will be an integrative literature review following Whittemore and Knafl. We will search the academic databases PubMed, CINAHL and PsycInfo in accordance with a specific search strategy determined in collaboration with a librarian with expertise on systematic reviews. Data will be analysed using a constant comparison method. Persons with their own experience of anorexia nervosa in general psychiatric inpatient care will be involved as coresearchers.

ETHICS AND DISSEMINATION: As this is a literature review, formal ethical review is not required. The findings will be disseminated through peer-reviewed publication and presented at conferences related to this field.

AMENDMENTS: If we need to amend this protocol, we will give the date of each amendment, describe the change and give the rationale in this section.

PROSPERO REGISTRATION NUMBER: CRD42023426095.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023
Keywords
eating disorders, hospitalization, mental health, psychiatry
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-215082 (URN)10.1136/bmjopen-2023-076437 (DOI)001079088100011 ()37775291 (PubMedID)2-s2.0-85172829502 (Scopus ID)
Available from: 2023-10-13 Created: 2023-10-13 Last updated: 2025-04-24Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-3360-5589

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