Despite a growing literature base related to both compassionate care and work-related stress in healthcare settings, there is a lack of empirical studies investigating the relationship between these concepts, particularly in medium secure settings. This mixed methods study explored the relationship between compassion (The Compassion Scale) and work-related stress (The HSE Management Standards Toolkit) from the self-report of 51 members of staff in a medium secure setting, including semi-structured interviews with 12 participants. On the quantitative measures, the relationship between self-reported compassion and work-related stress on the quantitative measures was found to be statistically non-significant. However, elements of compassion were found to significantly predict subscales of work-related stress such that high levels of elements of compassion were found to predict higher levels of subscales of work-related stress. Participants constructed several meanings of compassion and its role in the care of the patients they worked with. Several consequences of occupational demands were cited including an increase in work-related stress and less time to build therapeutic relationships or to develop compassion towards patients. The findings of this study can be used to inform the development of staff interventions. Increased consistency of staff groups, increased debriefing opportunities and a review of paperwork responsibilities within staff teams have also been recommended.

Introduktion: Antalet patienter med psykisk ohälsa har setts öka de senaste åren. Ambulansens funktion har också vuxit från att vara ett transportmedel till att bedriva avancerad sjukvård, vilket även avspeglas i den prehospitala vården av patienter med psykisk ohälsa. Forskning visar att sjuksköterskor har en negativ syn på patienter med psykisk ohälsa samt att de upplever rädsla och osäkerhet i vårdandet på grund av bristande kunskap. Att inte känna sig trygg kan leda till felaktiga bedömningar av patientens verkliga vårdbehov. Syfte: Syftet med studien var att undersöka ambulanssjuksköterskors upplevelser av att vårda patienter med psykisk ohälsa i de olika delarna av vårdkedjan i den prehospitala vårdmiljön. Metod: Tio stycken intervjuer genomfördes med ambulanssjuksköterskor från fem ambulansstationer i Mellansverige. Intervjuerna analyserades med en kvalitativ innehållsanalys. Resultat/Slutsats: Studien visade att ambulanssjuksköterskor upplevde en bristande kunskap i att bemöta, bedöma och vårda patienter med psykisk ohälsa i den prehospitala miljön. Den upplevda kunskapsbristen upplevdes leda till osäkerhet i samband med patientmötet och således sämre vård för patienten. Hot och våld var något som också upplevdes i samband med vården av patienter med psykisk ohälsa där utbildning i bemötande och riskförebyggande arbete skulle kunna förbättra arbetsmiljön för ambulanssjuksköterskor och öka tryggheten i vårdandet av patienterna. De upplevde också att kommunikationen och patientomhändertagande hade blivit bättre på psykiatriska akutmottagningen under senaste tiden, men där en ökad förståelse och insikt i varandras verksamheter skulle kunna göra samarbetet och kommunikationen ännu bättre. / Introduction: The number of patients with mental illness has increased in recent years. The ambulance has also grown from being a means of transport to being able to give advanced medical care, which is also reflected in the prehospital care of patients with mental illness. Research shows that nurses have a negative view of a patient with mental illness and nurses experience fear and insecurity in nursing for the patients due to insufficient knowledge. The uncertainty can lead to incorrect assessments of the patient's actual care needs. Purpose: The purpose of the study was to investigate ambulance nurses experiences of caring for patients with mental illness in the various parts of the care chain in the prehospital environment. Method: Ten interviews were conducted with ambulance nurses from five stations in central Sweden. The interviews were then analyzed with a "qualitative content analysis". Result/Conclusion: The result showed that ambulance nurses experienced a lack of knowledge in responding, assessing and caring for patients with mental illness in the prehospital environment. The perceived lack of knowledge leads to insecurity of caring and thus poorer care for the patient. Threat and violence was also experienced in the care of patients with mental illness, where education in communication and risk prevention could improve the working environment for ambulance nurses and increase the safety of patient care. They also felt that communication and patient care had improved on psychiatric emergency services in recent years, but with better understanding and insight into each other's operations could make collaboration and communication even better.

The study aimed to examine the relationship between wellbeing, burden, distress and third-wave factors, including self-compassion and psychological flexibility, in caregivers of people with psychosis. The study secondly aimed to trial a new brief group intervention, combining Acceptance and Commitment Therapy (ACT) and Compassion-focused Therapy (CFT) for this population. Twenty-nine participants were assessed at baseline on primary measures of wellbeing, distress, psychological flexibility and self-compassion. Secondary factors including burden and mindfulness were also collected. Correlation analyses were used. Fourteen participants completed the group in intervention and follow-up measures, and pre-post investigations were employed. Lower levels of psychological flexibility and self-compassion were related to lower levels of wellbeing and higher levels of burden and distress. There was a potential mediating effect of psychological flexibility on the relationship between self-compassion and wellbeing. The group intervention was acceptable to caregivers, and there were significant positive changes in self-compassion, distress, burden and mindfulness. The study adds to the existing data regarding wellbeing and burden in caregivers of people with psychosis. This study provides new insights into the factors of self-compassion and psychological flexibility within this population. The ACT with Compassion intervention is a promising, brief intervention which would benefit from further application and evaluation.

Little evidence exists in the literature for how to manage clients who self-harm within low, medium and high secure forensic wards, despite the identified high rates of self-harm within these services. This study sought to investigate the management practices used with clients who self-harm in low, medium and high secure forensic wards, how helpful staff consider these practices and what understanding staff have of the reasons for which clients self-harm. A Delphi survey methodology was employed across three rounds using a multidisciplinary cohort of forensic ward staff, across low, medium and high wards. Physical management strategies were reported as most frequently employed to manage self-harm. Relational approaches to managing self-harm showed the highest rate of consensus for their helpfulness in practice. Consensus was reached across numerous domains explaining reasons for self-harm, including as a ‘communication of distressing feelings’. Statements indicating a negative view of self-harm such as ‘to manipulate staff and gain attention’ received consensus of disagreement. Psychological models and approaches used by clinical and forensic psychologists in the cohort were identified, and helpful elements of these models were identified, including ‘positive focus of approach’ and ‘emphasis on relational working’.

Background: Mental illness is growing rapidly today, with a population that is getting worse within a younger age. Parts of mental illness is linked to what we callself-harm, or self-mutilation. This in order to alleviate his/her anxiety as a result of a compulsion or impulse to add injury to one’s body, motivated by a need to master mental health or to regain emotional balance. Purpose: The purpose of this study was to illustrate how patients with self-injury behavior experience the attitudes and treatment in their received care. Method: This study is a qualitative content analysis with an inductive approach of autobiographies written by persons with self-harm. Result: Positive treatment strengthens patient self-esteem, relieves inner suffering and anxiety, and provides a foundation for a trustworthy relationship between caregivers and patients, while negative treatment, stigmatization, preconceptions and ignorance of healthcare professionals contribute to an insecure care experience for this patient group. Conclusion: Nurses working with self-injurypatients should reflect on their treatment, occupational role and responsibility towards the patient, as this group often feels poorly treated in care. Clinical significance: The content of this study addresses the problemsof caring for patients with self-harm, which may help nurses and healthcare staff to contribute to better treatment and better care. / Bakgrund: Den psykiska ohälsan kraftigt ökar i dagens samhälle, med en befolkning som mår sämre i allt yngre åldrar. En del av den psykiska ohälsan är kopplad till det vi idag kallar Självskadebeteende. Detta i syfte att lindra sin ångest som en följd av ett tvång eller en impulsatt tillfoga sin kropp skada, motiverat av ett behov att bemästra psykisk ohälsa eller av att återvinna känslomässig balans. Syfte: Syftet var att belysa hur patienter med självskadebeteende upplever bemötandet inom vården. Metod: Denna studie är en kvalitativ innehållsanalys med induktiv ansats av självbiografier skrivna av personer med självskadebeteende. Resultat: Positivt bemötande stärker patienternas självkänsla, lindrar det inre lidandet och ångesten och gav en grund för en tillitsfull relation mellan vårdgivare och patient, där istället negativt bemötande, stigmatisering, förutfattade uppfattningar och okunskap hos vårdpersonalen bidrar till en otrygg vårdupplevelse för denna patientgrupp. Slutsats: Vårdpersonal som jobbar med självskadande patienter bör reflektera över sitt bemötande, sin yrkesroll och sitt ansvar gentemot patienten, då denna grupp ofta känner sig illa bemötta inom vården. Klinisk betydelse: Denna studie lyfter problematiken runt vårdandet av patienter med självskadebeteende, vilket kan hjälpa sjuksköterskor och vårdgivande personal vid vårdmöten.

Personal construct psychology, as formulated by George Kelly (1955), contributed substantial knowledge to the study of psychopathology. The small amount of research in the area of depression has focused generally on the content of self-constructs and the cognitive complexity characteristic. The purpose of this study was to examine the construct system of the depressed patient specifically by investigating the endogenicity, exogenicity, and severity of depressive symptoms in relationship to construct content as applied to others, cognitive complexity, and ordination.

In this paper we analyze the conceptions of high school students about mental health issues, and discuss the creation of mental basic health programs in schools. We base our findings in a quantitative survey carried out by us with 156 high school students of CTISM (Colégio Técnico Industrial de Santa Maria) school, located in Santa Maria city, Brazil. We have find that: (a) 28 students relate the subject mental health with psychiatric hospitals and lunatic asylums; (b) 28 students have relatives affected by mental diseases; (c) 76 students believe that mental patients, if treated, can live a healthy life; (d) depression, schizophrenia and bipolar disorder are the most cited diseases; (e) 84 students have contact with mental patients, but know nothing about the disease; (f) 123 students have never been instructed about mental diseases while in the school; and (g) 135 students think that a mental health program would be important in the school. We argue that these numbers reflects a vision on mental health that can be related to the reductionist education still present in schools and to the lack of integration between health professionals, sciences teachers and students. Furthermore, this vision can be also related to a stigmatization process, which interferes with the interactions and with the representations regarding mental disorders and mental patients in society. / Esta pesquisa tem caráter investigativo e objetiva analisar as concepções de estudantes do ensino médio a respeito de temas em saúde mental e pretende ser um instrumento para a discussão e criação de um programa básico de saúde mental nas escolas. Foram aplicados questionários anônimos, quantitativos para 156 estudantes do ensino médio do CTISM (Colégio Técnico Industrial de Santa Maria) na cidade de Santa Maria, RS. Constatamos que: 1) 28 alunos relacionam o tema saúde mental com hospitais psiquiátricos e manicômios; 2) 28 alunos possuem familiares com doenças mentais; 3) 76 alunos acreditam que o doente mental pode ter uma vida saudável se tratado adequadamente; 4) a depressão, a esquizofrenia e o transtorno bipolar foram as doenças mais citadas; 5) 84 alunos convivem com doente mental, mas não tem conhecimento da doença; 6) 123 alunos nunca obtiveram esclarecimentos a respeito de doenças mentais na escola e 135 achariam importante um programa básico de saúde mental nas escolas. Essa visão pode estar vinculada à educação reducionista ainda presente nas escolas e à falta de integração entre profissionais de saúde, professores de ciências e estudantes e a todo um processo de estigmatização que interfere nas interações e nas representações acerca da doença e dos doentes mentais na sociedade

Magister Curationis - MCur / Background: The integration of mental health into primary health care meant that patients were admitted into a less restrictive environment. They received treatment for mental illness in their communities, therefore, averting unnecessary hospitalisation in psychiatric hospitals. However, given that patients with mental illnesses were admitted to district hospitals as involuntary mental health care users (MHCUs), this setting was purported to be fraught with challenges for both staff and patients. Aim and objectives: The aim of this study was to explore and describe the experiences of professional nurses, working at selected district hospitals in the Western Cape metropole, where 72-hour assessments of involuntary mental health care users are conducted. The objectives of this study were to determine how the 72-hour unit functioned in the general ward, the experiences of professional nurses regarding the integration of the 72-hour assessment units in the general ward and suggested improvements. Methodology: A qualitative research approach, with a descriptive phenomenological design, was used to collect data through semi-structured interviews from eight (8) professional nurses, working in the two selected district hospitals in the Cape Town metropole area. Purposive sampling was employed to select the participants. Data were analysed using Tesch’s method of qualitative data analysis. Four themes, namely, patient management process affected the functioning of the ward, patient management challenges in rendering patient care, burden of caring on the Self, and staff and patient support to create a therapeutic environment, emerged during data analysis, which encapsulated the nurse's experience of working in 72-hour assessment units in selected district hospitals. Findings: The findings of this revealed that the district hospitals were ill prepared for the admission of involuntary mental health care users. There were challenges, in terms of resources, namely, infrastructure to create a therapeutic environment, knowledgeable and skilled staff to care for the MHCUs. The MHCUs were contained in the district hospitals for longer than was legislated, rather than receiving therapeutic interventions at psychiatric facilities. Needs were identified to improve the functioning of the 72-hour assessment units, which included education and training of personnel, Discussion: The non-therapeutic environment had a negative impact on the staff working in the 72-hour assessment units. Nursing staff were burdened with caring for patients in an environment where they, as well as the MHCUs, were stigmatised due to the diagnosis of mental illness. However, the participants internalised their own experiences, as they prioritised the MHCUs well-being. The findings supported previous studies, which revealed that the objectives of the Mental Health Care Act (No. 17 of 2002), which supported the integration of mental health into primary health care, were not realised after more than a decade of implementation. Recommendations: Given the limited scope of this thesis, replications of this study in other district hospitals are recommended, in order to ascertain whether the objectives of the MHCA (2002), regarding 72-hour assessments, have been realised. A therapeutic environment, which includes infrastructure and resources to ensure that MHCUs receive care, treatment and rehabilitation within the district hospitals, is required. The recruitment and retention of adequate, skilled permanent staff is crucial, to ensure that MHCUs receive care, treatment and rehabilitation. Finally, the training and education of all personnel (including security) working in the selected district hospitals should be mandatory, in order to address patient care and stigma related to mental illness.

The diploma thesis deals with guardianship for people with mental illness. The tehoretical part is divided into six chapters, where the concept of mental disorder is defined within various documents. Furthermore the process of stigmatization, both from the family and the health care professionals, is also discussed here as self - esteem as a serious consequence of society's access to mental illness. The student also mentioned the process of providing psychiatric care, outlined the reform of psychatric care as a significant milestone in health care. A greta part of the theory consits od a complete description of a guardianship and self - administration. The last chapter focuses on social work with people with mental illnesss. The practical part aims to find out how the guardianship system for people with mental disorders works and how custodians loom at guardianship. The student used qualitative surveys ans semi - structured interviews. Using open encoding , several categories were identified and then responded to the main research question.

Contrary to the long-held assumptions, borderline personality disorder (BPD) is now considered a treatable disorder. Timely assessment has been recognised as one of the key treatment enablers and basic assessment standards have been stipulated by the UK’s National Institute for Health and Clinical Excellence (NICE). The current study was the first to have specifically investigated the quality of the diagnostic process in light of the government recommendations. Interpretative phenomenological analysis was used to analyse semi-structured interviews with eight adult female service users about their lived experiences with the original diagnostic disclosure of BPD. Five master themes and several subthemes featured in the majority of the participants’ experience: a) answer with a question mark; b) if only…; c) BPD like a star sign; d) star signs are not enough; it’s what happens afterwards!; e) being at the mercy of the system. Most participants’ experiences suggested that the original diagnostic process was largely negative and did not follow the national guidelines. Nevertheless, a minority of positive views also emerged. The findings are discussed with reference to the existing literature, whilst also detailing the study’s limitations, clinical and research implications.