Bakgrund: Den psykiska ohälsan ökar i samhället och är i dag den vanligaste orsaken till sjukskrivning och längre sjukfrånvaro i Sverige. Vården av patienter med psykisk ohälsa är tidskrävande och behovet av resurser som denna patientgrupp kräver öppnar upp för nya arbetssätt för sjuksköterskan utöver dennes traditionella yrkesgräns. Syfte: Syftet med litteraturöversikten är att beskriva vilka sjuksköterskeledda omvårdnadsåtgärder som vidtas för patienter med psykisk ohälsa inom den öppna vården. Metod: En litteraturöversikt har genomförts, vilket i detta arbete innebär att åtta vetenskapliga artiklar har analyserats, fyra av dessa var av kvalitativ design, tre av kvantitativ design och en av mixad metod. Resultat: Litteraturöversikten resulterade i två huvudteman och fyra respektive två underteman. I huvudtemat genomförda omvårdnadsåtgärder beskrivs hur sjuksköterskan arbetar med bedömningssamtal, information, utbildning, guidning, kontinuerliga samtal samt psykoterapi. I andra huvudtemat effekter av genomförd omvårdnad beskrivs vilken inverkan sjuksköterskans omvårdnadsåtgärder kan få relaterat till sjuksköterskans engagemang samt på patientens symtom och behandling. Diskussion: De omvårdnadsåtgärder som beskrivs i resultatet diskuteras utifrån sjuksköterskan som en bidragande arbetskraft inom den öppna vården för patienter med psykisk ohälsa. Fynden diskuteras också utifrån omvårdnadsteoretikern Phil Barkers tidvattenmodell samt konsensusbegreppet människa. / Background: Mental illness is increasing in society and is today the leading cause off sick leave and extended sick leave in Sweden. The care of patients with mental illness are time consuming, and the need for resources that this group of patients requires are opening up for new ways for nurses to work, beyond their traditional profession. Aim: The aim of this literature review is to describe the nursing care for patients with mental illness in general outpatient care. Method: The method that was used in this paper is a literature review. Eight scientific articles were reviewed, four were of qualitative design, three of quantitative design and one of mixed method. Results: The literature review resulted in two main themes, divided in four and two sub themes. The main theme, performed nursing care, describes how the nurse is working with assessments, information, education, guidance, continuous talks and psychotherapy. The second main theme, the effects of the implemented nursing care, describes the impact of how nursing care measures may have affected the nurse’s commitment as well as on the patient’s symptoms and treatment. Discussion: The nursing care described in the results are discussed with the view of the nurse as a contributing labor in outpatient care for patients with mental illness. The findings are also discussed from the tidal model of nursing theorist Phil Barker, and the consensus concept of man.

Background: Mental illness is defined differently depending on the context, ranging from symptoms of anxiety and depression to schizophrenia. Mental illness among the population has increased since 1990. A survey done by the Central Bureau of Statistics in Sweden (2006) shows that issues such as anxiety are more common now than before. Twenty-three percent of women aged 16-84 said they had experienced symptoms of anxiety. Thirteen percent of the men aged 16-64 said they had experienced the same. Pre-conceived notions often meet people with mental health issues and there is a stigma surrounding them and their situation. Aim: The aim of the study was to examine how patients with mental illness experience their contact with health care professionals in health care. Method: The study was designed as a literature based study. Eleven articles were analyzed, nine articles were found by a systematic search and two articles were found in an unsystematic search. Results: This study showed two main themes and eight subthemes. The main themes were patients desire to have a good relationship and good interaction with health care professionals. The subthemes were patient confidence in health care professionals, a dedicated staff, patients desire to get person-centered care and to feel involved, to have good continuity in their health care and to have highly available health care professionals around them, to have a good dialogue, be actively listened to, competent health care professionals and being labeled. Conclusion: The conclusion is that patients that lack trust, commitment from health care professionals or continuity had bad experiences with the health care system. Patients needed to have a mutual relationship with the health care staff to have a good experience with the health care system.

Bakgrund: Psykisk ohälsa är ett folkhälsoproblem världen över och i Sverige har det framkommitatt patienter med psykisk ohälsa har sämre förutsättningar för att få ett adekvat omhändertagande vid somatisk sjukdom,och att allmänsjuksköterskor gör skillnad i omvårdnaden av patienter med psykisk ohälsa. Tidigare forskning har visat att allmänsjuksköterskor har haft en ytlig förståelse för psykisk ohälsa och haft svårigheteratt bedöma vad som är somatiskt och vad som är psykiskt. Syfte: Syftet med studien var att beskriva vilka faktorer som allmänsjuksköterskor upplever påverkar deras bemötande av patienter med psykisk ohälsa som söker somatisk sjukvård. Metod: En allmän litteraturstudie. Resultat: Faktorer som påverkade allmänsjuksköterskors bemötande av patienter med psykisk ohälsa identifierades i fyra teman: Rädslor, tid, psykisk ohälsa i somatisk kontext samt kompetens. Slutsats: Det krävs mer utbildning för allmänsjuksköterskor i områden som berör bemötandet och omvårdnad gentemot patienter med psykisk ohälsa, och det krävs mer utbildning för att reducera sjuksköterskors rädslor genom att öka förståelsen för patienternas beteende. Klinisk betydelse: Genom att bli medveten om kunskapsbristen så kan det leda till ett mer reflekterande förhållningssätt över hur man bemöter och uppfattar patienter med psykisk ohälsa vilket kan möjliggöra att utöka vidare kunskap. / Background: Mental health is a public health problem worldwide and in Sweden there is awareness that health care contributes to poorer care of patients with mental illness, which for instance is verified by general nurses who have made difference in the care of patients with mental illness. Overall, previous research has shown that nurses have had a superficial understanding of mental illness which has led to difficulties to estimate what is somatic and what is mental. Patients with mental disorders are a vulnerable group which been exposed by stigmatization and studies have shown that it reflects the nurse and patient relationship in the performance of the nursing care. Aim:The aim of this study was to describe the factors that general nurses experience affects their treatment of patients with mental illness who are searching for somatic health care. Method: A literature review. Results: Factors affecting general nurse’s treatment of patients with mental illness identified four themes: Fears, time, mental illness in a somatic context, and competence. Conclusion: It requires more training for general nurses in areas related to treatment and care towards patients with mental illness, and more training is required to increase nurse ́s understanding of patients behavior to reduce nurse’s fears. Clinical significance: By becoming aware of the lack of knowledge it can lead to a more reflective approach over how to respond and perceive patients with mental illness, which could enable to strengthen further knowledge.

Bakgrund: I den somatiska vården finns det patienter med psykiska sjukdomar. De vanligaste psykiska sjukdomarna är schizofreni, psykoser, depression, ångestsyndrom och bipolära sjukdomar. Behovet av somatisk vård är större för patienter med psykiska sjukdomar än de utan, på grund av ökad risk för somatiska sjukdomar. Patienter upplevde att vardagslivet påverkas av de psykiska sjukdomarna. Vårdpersonal upplevde en osäkerhet och rädsla inför denna patientgrupp. Syfte: Att beskriva hur patienter med psykisk sjukdom upplever att bli vårdad i den somatiska vården. Metod: Litteraturöversikten baserades på 13 vetenskapliga artiklar. Dessa artiklar hämtades från CINAHL Complete och Pubmed. De huvudsakliga sökorden bestod av: mental illness, mental health, healthcare experience, patients’ experience, physical illness, primary care, communication och physical care. Resultat: Fyra teman utformades i resultatet. Ett tema var upplevelser av att bli stämplad av sjukvården på grund av den psykiska sjukdomen och det gjorde att patienterna kände sig bortprioriterade. När de kände sig stämplade upplevde de känslor av skam och maktlöshet. Ett tema var upplevelser att inte bli trodd som handlade om att fysiska symtom inte blir tagna på allvar. Det tredje temat var hur upplevelser om bristande kunskap hos vårdpersonal om psykiska sjukdomar påverkade vården. Detta upplevde patienter ledde till brist på information och delaktighet. Positiva erfarenheter och önskemål var det sista temat som visades i form av upplevelser av en personcentrerad vård, då vårdpersonal visade empati. Diskussion: Valda delar i resultatet diskuterades utifrån Katie Erikssons teori om att lindra lidande. Centrala begrepp inom teorin som användes var vårdlidande och konsensusbegreppet människan. / Background: In the somatic care, there are patients with mental illnesses. The most common mental illnesses are schizophrenia, psychoses, depression, anxiety disorders and bipolar disorders. The need for somatic care is bigger for patients with mental illnesses than those without, because of an increased risk of getting a somatic disease. Patients were experiencing that their daily life was affected by the mental illness. Healthcare professionals experienced uncertainty and fear of treating these patients. Aim: To describe how patients with mental illness are experiencing to be cared in the somatic care. Method: The literature review consisted of 13 scientific articles. These articles were found in the databases CINAHL Complete and PubMed. Main search words consisted of: mental illness, mental health, healthcare experience, patients experience, physical illness, primary care, communication and physical care. Results: Four themes were formed in the result. One theme was the experience of being labeled because of the metal illnesses and that made the patients feel not prioritized. When they felt labeled, they experienced feelings of shame and powerlessness. One theme was the experiences of not being believed and included patients experience that symptoms were not taken seriously. The third theme was how the experience of a lack of knowledge among health professionals about mental illnesses affected the care. Patiens experienced that it led to lack of information and participation. Positive experiences and desires were the last theme that appeared in form of experiences of a person centred care, when health professionals showed empathy. Discussion: Based on Katie Eriksson´s theory about relieving suffering, chosen parts from the results were discussed. The key concepts in the theory that were used were care suffering and the consensus concept human.

Using secondary analysis of in-depth interviews of men with schizophrenia (N=59), in this thesis I explore the interplay between the performance of hegemonic masculinity and the treatment career of men with serious mental illness (SMI), and in doing so begin a conversation about how mental health providers can better address issues of masculinity. My findings are that significant barriers to masculinity performance are caused by the diagnosis and treatment of SMI, leading to roll loss, subsequent stress, and strategic modification of masculinity performance to attain hegemonic complicity. I identify six emergent themes and three masculinities within the data, and offer a theoretical framework with recommendations for application and future research.

Sammanfattning Kandidatuppsats, fördjupning i sociologi  Författare: Rojin Coskun & Izabella Kiraly Handledare: Per Dannefjord Examinator: Sven Hort Titel: Psykisk ohälsa i arbetslivet- Varför är exempelvis undersköterskor ofta sjukskrivna på grund av psykisk ohälsa Nyckelord: Psykisk ohälsa, sjukskrivning, sociala relationer, undersköterska Bakgrund: Statistiken över sjukfrånvarons utveckling i Sverige pekar på att allt fler individer drabbas av försämrat hälsotillstånd, med sjukskrivningar som följd. Sjukskrivningar som beror på någon form av psykisk ohälsa ökar allra mest. Att olika delar av arbetsmiljön kan påverka människors psykiska hälsa negativt, är många forskare eniga om, och arbetsmiljöfaktorers påverkan på den psykiska ohälsan undersöks än i dag.  I vår uppsats valde vi att inte fokusera på arbetsmiljöfaktorer, utan istället leta efter andra faktorer som kan förklara skillnaderna i psykisk ohälsa mellan olika yrkesgrupper. Syfte och frågeställning: I denna uppsats vill vi förklara psykisk ohälsa i arbetslivet. Med utgångspunkt att undersköterskor är den största yrkesgruppen i Sverige som har höga sjukfall och väldigt många av dem beror på psykisk ohälsa, blir vår problemformulering följande: -          Varför är undersköterskor så oerhört drabbade av psykisk ohälsa? Delfrågor som arbetas med under uppsatsens gång är: -          Hur ser sjukskrivningarna ut för samtliga yrkesgrupper vad gäller psykisk ohälsa? -          Vilka skillnader finns det mellan yrkesgrupper med hög respektive låg psykisk ohälsa? Metod: Studien är baserat på sekundärundersökning i form av offentlig statistik. Försäkringskassans statistiska underlag över sjukskrivningar användes och samtliga yrkesgrupper delades in efter hög respektive låg psykisk ohälsa. Resultat: Enligt vår mening, är det aspekter av arbetsinnehållet, och inte yrkesbenämningen som behöver undersökas för att kunna förklara varför vissa yrkesgrupper är mer benägna för sjukskrivningar som beror på psykisk ohälsa. Att endast utgå ifrån yrkestitel vid redovisning av sjukskrivningsstatistik, är enligt oss felaktigt därför att skillnader i arbetsuppgifterna finns även mellan samma yrkesgrupper med olika inriktningar.

The treatment of alcoholism has had a unique historical development in the United States. This study provides a chronology of how the problem of alcoholism was defined and handled during various time periods in United States history. The process that evolved resulted in an abstinence based, comprehensive, multidisciplinary approach to the treatment of alcoholism as a primary disease based on the principles of Alcoholics Anonymous. This treatment modality, that developed outside of established medicine, is currently used by the majority of treatment providers. Seven individuals who have been actively involved in alcoholism treatment were interviewed. In addition to archival research, biographies and autobiographies were examined to gain a broad perspective. Because alcoholism is both a collective and an individual problem an effort was made to include a microsociological frame of reference within a broad sociological view. Alcoholism, or inebriety, was first perceived as a legal and moral problem. By the end of the 19th century, inebriety was recognized as an illness differing from mental illness, and separate asylums were established for its treatment. Alcoholism is currently accepted and treated as a primary disease by the majority of social institutions, but the legal and moral implications remain. National Prohibition in the early part of the 20th century targeted alcohol instead of the alcoholic delaying any progress toward treatment which was made in the 19th century. The advent of Alcoholics Anonymous brought the first widely accepted hope for alcoholics. The treatment process that developed utilized the principles of Alcoholics Anonymous in a setting of shared recovery which has been difficult to quantify. In 1970 the allocation of federal funds for treatment and research brought the involvement of new disciplines creating both conflicts and possibilities. Alcoholism recovery has elucidated the connection of mind, body, and spirit.

Recent research on the contribution of cognitive and social factors to psychopathology has been narrowly focused on isolated cognitive-social aspects of adjustment. This study takes a broader perspective by examining a) cognitive structure in addition to cognitive content and b) general aspects of interpersonal style rather than isolated social behaviors. Maladjustment was. examined with respect to premorbid history as well as current adjustment. The hypotheses were that cognitive integration interacts with cognitive complexity to influence psychological disturbance; that a positive relationship exists between interpersonal flexibility and psychopathology; and that a positive relationship exists between the proportion of ambiguous constructs which they employ and a person's level of psychopathology.

To test predictions of learned helplessness theory and attribution theory, depressed and nondepressed subjects were exposed to a word-association task in a skill, chance, or no-instructional-set condition. Subjects were asked to make attributions of success and failure to four factors--ability, effort, task difficulty, and luck--and rate expectancy of success. The predictions of both theories were only partially confirmed. Difficulties relating to the experimental design may account for the failure of nondepressed/skill subjects to show greater expectancy change. As predicted, all subjects in the chance condition displayed similar expectancy changes. Also as predicted, nondepressed subjects did not rate effort as being the least influential factor. Depressed subjects, however, rated all factors equivalently, instead of rating effort least influential.

This study was undertaken to determine whether the Mini-Mult is able to function as well as the MMPI for a limited clinical purpose, the discrimination of psychosis and neurosis by Goldberg's rule. The smaller size of the Mini-Mult (71 items) allows conservation of time .and energy by subjects and professionals. Thirty male residents of the Austin State Hospital completed two standard MMPIs and one oral Mini-Mult. A fourth set of scores was obtained by extracting Mini-Mult from the first MMPI. Correlations and tests of significance were computed for raw scores and Goldberg's index scores. Results indicate no significant differences in the discrimination of psychosis and neurosis between the MMPI and the Mini-Mult.