Introduktion: Antalet personer i Sverige som vårdades inom slutenvård enligt lagen om psykiatrisk tvångsvård under 2022 var ungefär 12 600 personer. Tvångsvård kan endast genomföras om strikta kriterier uppfylls, inklusive ett akut och oundgängligt vårdbehov som inte kan tillgodoses frivilligt. Tvångsvård syftar till att patienter ska bli kapabla att frivilligt delta i vidare behandling, men det saknas forskning kring dess effektivitet och patientupplevelser. Syftet: Syftet med examensarbetet var att undersöka patienters upplevelser av tvångsvård på psykiatrisk vårdavdelning Metod: Examensarbetet kombinerar deskriptiv design med en litteraturöversikt och kvalitativ metodologi. Tio artiklar söktes via databaser PubMed, Psycinfo och CINAHL som sedan kvalitetsgranskades och analyserades. Salutogena modellen KASAM som har tre dimensioner: begriplighet, meningsfullhet och hanterbarhet användes som teoretisk referensram. Resultat: Analysen resulterade i två huvudkategorier. Den första var upplevelser av brist på sammanhang med underkategorierna: maktlöshet och kontrollförlust, meningslöshet, hopplöshet och hjälplöshet, maktobalans och att inte bli sedd och förlusten av autonomi och identitet. Den andra huvudkategorin var upplevelser av återvunnet sammanhang med underkategorierna: återtagandet av kontrollen, gott bemötande och nödvändig process till förbättring.  Slutsats: Resultatet visar att tvångsvård kan leda till negativa upplevelser som maktlöshet och kontrollförlust, och att vårdtiden upplevs som meningslös. Det kan även leda till positiva upplevelser och förbättra den psykiska hälsan. / Introduction: The number of people in Sweden who were hospitalized under the Compulsory Psychiatric Care Act in 2022 was approximately 12,600. Compulsory care can only be implemented if strict criteria are met, including an acute and indispensable need for care that cannot be voluntarily met. The purpose of compulsory care is to enable patients to voluntarily participate in further treatment, but there is a lack of research regarding its effectiveness and patients’ experiences. Aim: The purpose of the thesis was to investigate patients' experiences of compulsory care in psychiatric wards. Method: The thesis combines descriptive design with a literature review and qualitative methodology. Ten articles were searched through the databases PubMed, Psycinfo, and CINAHL, which were then quality assessed and analyzed. The salutogenic model Sense of Coherence (SOC), which has three dimensions: comprehensibility, meaningfulness, and manageability, was used as the theoretical framework. Results: The analysis resulted in two main categories. The first was experiences of a lack of coherence with the subcategories: powerlessness and loss of control, meaninglessness, hopelessness and helplessness, power imbalance and not being seen, and loss of autonomy and identity. The second main category was experiences of regained coherence with the subcategories: regaining control, positive treatment, and necessary process for improvement. Conclusion: The results show that compulsory care can lead to negative experiences such as powerlessness and loss of control, and that the time in care is perceived as meaningless. It can also lead to positive experiences and improve mental health.

The aim of this study have been to examine how lagen (1988:870) om vård av missbrukare i vissa fall [LVM] (involuntary treatment for addicts) is constructed in Swedish news press and what discourses are being produced regarding LVM and involuntary treatment. Out of the 195 articles that fit the search criteria, extending a period of ten years, 36 were selected and analyzed, using a critical discourse analysis according to the three-dimensional model proposed by Fairclough. The theoretical perspective derives from the hypothesis of social constructionism. This study shows that LVM is subject to a silent assumption of an economic constraints discourse that´s being produced in news press, regarding the shortage of funds in public sector. In turn, this discourse also exhibits close relationship with the greater addiction discourse, which deems drug- and alcohol abuse as sickness, or disease. Furthermore, a set of minor discourses are identified, that to some degree stems from the economic constraints discourse. The media depiction presents an ongoing medicalization process that in social practice results in a higher death rate among drug abusers. The notion that medicinal treatment of addiction is more cost effective than LVM, nonetheless spurs society in adding evermore medicinal treatment of addicts. / <p>VT, 2016</p>

Notre recherche concerne l’éthique des soins prodigués aux personnes âgées institutionnalisées, spécialement les questions de la capacité à consentir et du traitement involontaire. Notre travail est basé sur la Théorie Fonctionnelle de l'Intégration de l'information de N.H. Anderson (1981). En ce qui concerne l'étude portant sur la capacité à consentir : 98 Hommes de la rue, 21 psychologues, 37 infirmières et 14 médecins ont jugé de la capacité de la personne âgée à faire des choix dans chacun des 50 scénarios proposés, résultants de la combinaison de trois facteurs: "type de Décision", "type de Trouble", et "Soutien social". Pour l'étude portant sur le traitement involontaire : 101 personnes du grand public, 20 psychologues, 20 infirmières et 10 médecins ont jugé de l'acceptabilité du traitement involontaire des 48 scénarios proposés, combinaison de quatre facteurs: "type de Trouble", "Décision du médecin", "Explications données au résident ", "état Cognitif". Les résultats montrent que pour les deux études, le grand public et les professionnels de santé ont intégré les facteurs de la même manière. Pour la première étude, le facteur « type de Trouble » a le plus de poids, suivi par le facteur « Soutien social ». Quatre groupes de répondants se distinguent par les poids qu'ils donnent aux différents facteurs. Concernant l'étude portant sur le traitement involontaire, le facteur le plus influent est « Explications», suivi par « Décision du médecin ». Trois groupes de répondants se distinguent en fonction des patterns de réponse. Les variables individuelles telles que l’âge, le sexe, le niveau d’éducation et l’expérience n’ont pas d’effet. L'évaluation de la capacité à consentir et l’acceptabilité du traitement involontaire sont influencées par les facteurs proposés et il apparaît qu’il existe des positions différentes face à ces questions éthiques. / Our research deals with ethical questions in gerontology, especially the capacity to consent and involuntary treatment. Our research is based on the Integration Information Theory of N.H. Anderson (1981). 98 lay people, 21 psychologists, 37 nurses and 14 physicians judged a nursing home resident’s capacity to consent on 50 scenarios combining 3 factors : “type of Decision”, “type of Problem”, “social Support”. 101 lay people, 20 psychologists, 20 nurses and 10 physicians judged the acceptability of involuntary treatment on 48 scenarios combining 4 factors : “type of Disease”, “physician’s Decision”, “Explanations”, and “Cognitive status”. Results don’t show differences between lay people and health professionals in the way they integrate the factors presented. In the first study, the factor “type of Problem” is the most significant, followed by “social Support”. 4 groups of participants distinguish themselves by the way the weigh the factors. In the second study, the factor “Explanations” is the most significant, followed by “physician’s Decision”. 3 groups of participants distinguish themselves. Individual variables like age, gender, educational level or experience have no effect. Assessment of the capacity to consent and acceptability of involuntary are influenced by the factors presented and it appears that there are different positions among the participants.

Bakgrund: Stödpersoner är en utomstående resurs som är frikopplad vårdapparaten och kan tilldelas patienter som vårdas under psykiatrisk tvångsvård. Stödpersonens arbete syftar till att stötta patienten i en sårbar period i livet genom social interaktion och uppmuntran. Syfte: Att undersöka vårdpersonalens erfarenheter av och uppfattningar om stödpersonens roll och betydelse för patienter inom psykiatriskt tvångsvård. Metod: Deskriptiv design med en kvalitativ ansats. Som datainsamlingsmetod användes intervjuer med nio öppna frågor. Ett bekvämlighetsurval gjordes för att uppnå åtta informanter ur vårdpersonalen på en psykiatrisk avdelning. Som analysmetod användes innehållsanalys. Joyce Travelbees omvårdnadsteori användes som utgångspunkt. Resultat: Vårdpersonalen hade överlag, trots viss variation, god kunskap och erfarenhet av stödpersoner och deras roll. Stödpersonen uppfattades också ha en generellt positiv och stärkande roll för patienten. Slutsats: Vårdpersonalen visste att stödpersoner fanns men det rådde viss oklarhet i vad som ingick i deras arbetsuppgifter. Stödpersoner uppfattades dock ha en meningsfull roll i patientens välbefinnande. Den upplevda känslan var att stödpersonen kunde bidra med ett medmänskligt stöd i en utsatt situation och att det var av stor betydelse för patienten. / Background: Support persons are an outside resource who are disconnected from the healthcare system and can be assigned to patients who are cared for during involuntary treatment. The support person's work aims to support the patient in an vulnerable period in life through social interaction and encouragement. Purpose: To investigate the healthcare staff's experience and opinions about the support person's role and importance for patients in psychiatric compulsory care. Methods: Descriptive design with a qualitative approach. As a data collection method, interviews with nine open ended questions were used. A convenience selection was made to achieve eight informants from the healthcare staff at a psychiatric department. As analysis method, content analysis was used. Joyce Travelbees' nursing theory was used as a starting point. Results: Overall, the healthcare staff had good knowledge and experience of support persons and their role, despite some variation. The support person was also perceived to have a generally positive and strengthening role for the patient. Conclusion: The healthcare staff knew that support persons existed, but there was some uncertainty in what was included in their duties. However, support persons were perceived to have a meaningful role in the patient's well-being. The feeling was that the support person could contribute with a charitable support in a vulnerable situation and that it was of great importance to the patient

Ofrivillig barnlöshet är ett stort problem i Sverige idag och av kvinnor i barnafödande ålder är ca 1 av 10 drabbade. De flesta som lider av infertilitet använder sig av medicinsk hjälp som förstahandsmetod. Misslyckas man med den medicinska hjälpen går vissa par vidare med adoption direkt medan andra ser detta som en sista utväg. Adoptionsprocessen, som den oftast beskrivs i media, är en arbetsam process och upplevelsen av väntan är central. Tidigare forskning kring adoption fokuserar mest på adoptivbarns upplevelse. Tidsramen för att få adoptera ett barn innebär ofta en väntan på flera år. I studien belyses tankar och känslor som uppkommer under adoptionsprocessen hos par som önskar adoptera barn. Syftet med studien är att beskriva dessa pars upplevelse av infertilitet och adoptionsprocessen. Studien är en kvalitativ empirisk studie där datainsamlingsmetod är intervjuer och insamlat material analyserats med hjälp av kvalitativ innehållsanalys.I resultatet finner vi fyra huvudkategorier som lättnad, hoppfullhet, frustration och maktlöshet. Dessa huvudkategorier har svarat väl till vårt syfte. Abstract: Involuntary infertility is today a major problem in Sweden and 1 out of 10 women in childbearing age are affected. Most of them who suffer from infertility use medical help as their first choice. If the medical help fails, some couples directly move on to adoption while some see this as a last resort. The adoption progress, as it is commonly referred to in media, is a laborious procedure and the experience from the wait is central.Previous research on adoption focuses mainly at the experience of the adopted child. The timeframe to be granted an adoption often implies a wait of many years. Through our study we wish to highlight the thoughts and emotions that arise among the couples that wish to adopt a child during the adoption process. The purpose of our study is to describe the couples experience of infertility and adoption process. The study is a qualitative empirical study where data is collected using interviews and the collected material has been analyzed using a qualitative content analysis.We found four main categories as a result: relief, hopefulness, frustration and powerlessness. These main themes have matched our purpose well. / Program: Barnmorskeutbildning

Made available in DSpace on 2014-12-17T14:34:47Z (GMT). No. of bitstreams: 1 DenziLR_DISSERT.pdf: 1746686 bytes, checksum: a4778fc2b93d8d203fc9d671d3c7f36f (MD5) Previous issue date: 2014-04-25 / This paper aims to make a theoretical reflection on the theoretical compatibility between the program State Employer of Last Resort (ELR) and the Democratic experimentalism (ED). The ED arises in political thought as an alternative to neo-liberal and social democratic programs in order to rescue the discussion about the institutional organization of society and the market economy. About the involuntary unemployment, it proposes tax changes incidents on payroll and proposes work fronts to the most vulnerable or poorly trained. The hypothesis of this paper is that this approach is compatible with the ELR program, the post- Keynesian line. The ELR is presented as transgression of the mainstream of economic thought by proposing that the State acts as guarantor of employment, working as a stabilizing anchor for the economy. On the edge, the ELR proposes eliminate completely involuntary unemployment. The implementation of the ELR, however, requires the construction of institutions that aim to remake the market economy, as well as deepen and energize politics and democracy, goals that are part of the ED program. Thus, the ED would, in theory, an environment conducive to innovative policies guarantors of training and occupation of the individual, essential for their emancipation institutional environment. In Brazil, which has serious infrastructure problems and qualification of manpower, such a program has enormous potential benefit. However when transposed to the Northeast of Brazil through the Plan for the region based on the principles of the ED and the hypothetical coupling to the ELR could not confirm or reject the hypothesis sub-compatibility of these two theoretical frameworks. The findings point to a partial convergence between these two programs / O presente trabalho tem por objetivo fazer uma reflex?o te?rica sobre a compatibilidade entre o programa do Estado como Empregador de ?ltima Inst?ncia (ELR) e o programa do Experimentalismo Democr?tico (ED). O ED surge no pensamento pol?tico como uma alternativa aos programas neoliberal e social democrata, visando a resgatar a discuss?o sobre a organiza??o institucional da sociedade e a economia de mercado. Para o desemprego involunt?rio, prop?e mudan?as fiscais incidentes sobre a folha salarial e frentes de trabalho para os mais prec?rios ou pouco capacitados. A hip?tese do trabalho ? que abordagem tem compatibilidade com o programa do ELR, da linhagem p?s-keynesiana. O ELR se apresenta como transgress?o ao mainstream do pensamento econ?mico ao propor que o Estado atue como garantidor de emprego, funcionando como ?ncora estabilizadora da economia. No limite, o ELR se prop?e a eliminar completamente o desemprego involunt?rio. A implanta??o do ELR, por?m, demanda a constru??o de institui??es que tenham como objetivo refazer a economia de mercado, bem como aprofundar e energizar a pol?tica e a democracia, objetivos que fazem parte do programa do ED. Dessa forma, o ED proporcionaria, no campo te?rico, um ambiente institucional prop?cio a pol?ticas inovadoras garantidoras da capacita??o e ocupa??o do indiv?duo, essenciais para sua emancipa??o. No Brasil, que possui graves problemas de infraestrutura e de qualifica??o de m?o de obra, um programa como esse tem enorme potencial ben?fico. No entanto quando transposto para o Nordeste do Brasil atrav?s do Plano para a regi?o baseado nos princ?pios do ED e o hipot?tico acoplamento ao ELR n?o foi poss?vel confirmar nem rejeitar a sub-hip?tese de compatibilidade desses dois arcabou?os te?ricos. As conclus?es apontam para uma parcial converg?ncia entre esses dois programas

The objective of my work is to survey what kinds of social work tools motivate, from the view of a social worker, an involuntary client to change his/her current situation and start working with a social worker. In the theoretical part of my diploma work I first deal with general topics, I focus on the typology of clients and relation and communication with clients. Within the section that is dedicated to the involuntary client solely I deal with the characteristics of such a client and ethical dilemmas in respect of the relation to this client. Furthermore, I present some recommendations for work with an involuntary client and I concentrate more on motivating the client. The chapter that deals with specific features of social work with addictive substances users, as one of the groups of involuntary clients, forms an extensive part of the theoretical part. In order to achieve the set objective, I have chosen a combination of quantitative and qualitative research. The data have been collected by means of anonymous questionnaires and non-standardized dialogues with 144 social workers in the Vysočina Region. Within the research I study the experience of social workers with work with involuntary clientele, further I focus on methods and techniques used at work with involuntary clients and on theoretical bases of this work as well. The survey also aims to determine the diversity in the approach of social workers in respect of voluntary and involuntary clientele. Following the evaluation of the survey outputs it can be said that a majority of social workers meet involuntary clients at their work. However, not all the workers consider the use of a specific approach to such clients important. A possible improvement in this respect may, in my opinion, be brought by educational courses that focus on the issues of involuntary clientele. Supervision plays an irreplaceable role here, too. The results of my diploma work may be used for the needs of further research, teaching and in order to enhance the knowledge of the issues of involuntary clientele.

This paper contributes to the field of research on entrepreneurship and self-employment. More explicitly, it contributes to the research regarding heterogeneity by studying the ‘necessity’ self-employed. In this paper, we question the notion of ‘necessity’ and its connection to weak labour market attainment by measuring individual’s human capital in relation to local labour market structures. The used data derives from relevant labour market data combined with data from a postal survey study conducted in 2011, containing self-employed between the age 25–64. The results show no connection between labour market attainment and ‘necessity’ self-employment. The results however indicate a correlation between sociodemographic-aspects and ‘necessity’ self-employment.

Bakgrund: Vård i Sverige ska bedrivas med patientens självbestämmande i fokus. I vissa fall kan patienter inom psykiatrin dock vårdas mot sin vilja. Sjuksköterskor i Sverige ska arbeta för att främja patientens autonomi och delaktighet. Att då använda tvång kan ge upphov till etiska dilemman. Att beskriva hur sjuksköterskor hanterar arbete med tvångsvård anses viktigt för att öka förståelsen för en svår situation i arbetet, och kan i förlängningen öka vårdens kvalitet.   Syfte: Att beskriva sjuksköterskors upplevelser och erfarenheter av att arbeta med tvångsvård i den psykiatriska vården samt beskriva hur utvalda artiklar presenterar sina urvalsgrupper.  Metod: Studien genomfördes som en deskriptiv litteraturstudie. Artiklar söktes i Medline och Cinahl. Totalt valdes 14 artiklar ut och bearbetades till fyra underrubriker och en metodologisk aspekt för att svara på syftet.  Resultat: Resultatet visade att sjuksköterskor upplever mestadels negativa känslor som oro, rädsla och sårbarhet vid arbete med tvångsvård. Användandet av tvång rättfärdigades genom att det beskrevs som en del av sjuksköterskornas jobb. Tvånget beskrevs skada vårdrelationen och gav upphov till etiska konflikter i sjuksköterskorna. Resultatet beskrevs i fyra underrubriker Känslor kring utförandet av tvångsåtgärder, Rättfärdigande av tvångsåtgärder, Tvångets inverkan på vårdrelationen och Etiska konflikter i samband med tvångsåtgärder. Artiklarna varierade i sina beskrivningar av urvalsgrupper, men flertalet beskrev deltagarnas kön, ålder och arbetslivserfarenhet. Majoriteten av artiklarna har 11-50 deltagare.   Slutsats: Föreliggande litteraturstudie har funnit att sjuksköterskor upplever tvångsvård som övervägande negativt. Det har påvisats att utbildningsgraden hos sjuksköterskan har en effekt på utförandet och hanterandet av tvångsmedel. Författarna drar slutsatsen att sjuksköterskor önskar minska på användandet av tvång, och att forskning bör koncentreras på att skapa alternativa behandlingsmetoder. / Background: Health care in Sweden shall be conducted with the patients’ autonomy in center. However, in some cases in the psychiatric care, patients can be treated against their will. A nurse shall work towards increasing patient autonomy and participation. The use of involuntary treatment can due to this cause ethical dilemmas. To describe how nurses cope with using involuntary treatment is important since it can increase the understanding of a complicated situation, and in the long run increase the quality of the health care services. Aim: To describe the experiences of a nurse working with involuntary treatment and to describe how the chosen articles presents their selection groups. Method: The study was conducted as a descriptive literature review. Articles was searched in the databases Medline and Cinahl with a ten-year age limit. A total of fourteen articles was selected and processed into four subcategories and a methodological aspect to answer to the study’s aim. Results: The results show that nurses experience mostly negative feelings like anxiety, fear and vulnerability while working with involuntary treatment. The use of involuntary treatment was justified by the thought that the practice was a part of the nurses’ job and duty. The use of involuntary treatment was describes as damaging on the nurse-patient relationship and caused ethical conflicts. The result was described in four subcategories Feelings about the use of involuntary treatment, Justifying involuntary treatment, Involuntary treatment and the effects on the nurse-patient relationship and Ethical conflicts due to involuntary treatment. The articles varied in their descriptions of their selection groups. Most described the participants gender, age and work experience. Most of the articles had 11-50 participants.    Conclusions: This study has found that nurses experience involuntary treatment as having mostly negative effects. It has been shown that the nurses’ level of education has an effect on both the execution and the handling of involuntary treatment. The writers of this study have come to the conclusion that nurses wish to decrease the use of involuntary treatment, and that research should be focused on finding alternative methods of treatment.

La considération des passions dans les Essais met au jour un phénomène complexe et transversal, où se manifeste le grand présupposé de l’anthropologie de Montaigne : l’homme est une unité indivisible de corps et d’âme. Comme l’homme, les passions sont des phénomènes mixtes qui ont une double étiologie : elle peuvent naître dans le corps ou dans l’âme. Par sa propre constitution, l’homme est donc naturellement sujet à un « nombre infiny des passions », et la sagesse des Essais n’est que la capacité de gouverner et modérer les forces passionnelles pour réaliser la perfection humaine qui seule soit possible : savoir « jouyr » de son propre être singulier. L’éthique demandera ainsi une connaissance préalable des limites et des pouvoirs physiologiques et psychologiques qui sont propres à l’homme, car la sagesse doit être efficace et réellement utile. La connaissance du corps conduira à une critique de l’hylémorphisme psychologique et à l’affirmation de l’indépendance des dynamiques corporelles : l’expérience des actes involontaires, l’affectivité organique, les passions sensibles se développent sans aucune référence animique mais, au contraire, ils affectent profondément l’âme. La connaissance psychologique, quant à elle, cherchera à saisir, par l’introspection directe, les dynamiques qui constituent les passions de l’âme. Cette connaissance permettra à l’âme de découvrir son propre pouvoir d’engendrer des passions, ce qui lui permettra de gérer les conflits et les tensions entre les passions par le moyen d’autres passions. Se dessine ainsi, dans le livre III des Essais, une discipline de l’âme qui est une gestion de ses propres mouvements passionnels mais aussi des passions corporelles : l’âme doit en fait pratiquer un constant retour à son corps, et par cela intensifier l’unité psychosomatique. C’est dans cette unité, toujours à rétablir, que l’homme a accès à la jouissance de son être et à la perfection morale. / The study of the emotions in the Essais of Montaigne shows a complex phenomenon, which demonstrate the great assumption of the Montaigne’s anthropology: man is an undividable unity of body and soul. Like human being, the emotion is a mixture experience that has a double aetiology: it raise in the body and in the soul. For his particular constitution, man is naturally subject to « nombre infiny des passions », and the wisdom of the Essais is nothing else that the ability of governing and harmonising the emotional forces, for realise the only human possible perfection: enjoy the proper life in his immanent singularity (sçavoir jouyr loiallement de son estre). For that goal, the moral philosophy needs to know the real physiological and psychological powers and limits of human being, because wisdom must be useful et practicable. The knowing of the body in the Essais will lead to a deconstruction of the hylomorphic psychology and to the affirmation of the independence and autonomy of the body’s dynamism: the experience of the involuntary actions and sensible emotions arise without any reference to the aristotelic psyché, and the soul fell this events as affections. On the other side, the psychological knowledge tries to understand, b the introspection, the psychological acts (linked to imagination and judgement) that constitutes the emotions of the soul. By that understanding, the soul discover his power of arising the emotions, that witch give him the concrete possibility of manage the conflicts and the tensions between passions, using the power of other different passions. This process, in the third book of the Essais, sketch a real discipline of the soul that is an administration of the soul’s emotions («passions de l’ âme») and of the body’s emotions («passions corporelles»): the soul has to rest in connection with his body, and in doing so it can intensify the psychosomatic unity. It is in that unity, constantly reaffirmed, that man has access to the enjoyment of his proper being and to the moral perfection.