D I S E R T A Č N Í P R Á C E Autor: Mgr. Jiří Motl Spiritualita a duševní nemoc Role spirituality v životě lidí se zkušeností s psychotickým onemocněním Spirituality and Mental Disorder: The Role of Spirituality in the Lives of People with Experience of Psychosis Abstract The dissertation investigates the relationship of mental illness and religion. It focuses on the role of spirituality in people with experience of psychosis. In the theoretical part, the problem of drawing the line between pathological and normal spirituality is discussed, stressing the importance of a functional point of view and the need for a dialogic relationship with the ill person. The theoretical part goes on with mapping the potential of spirituality in the recovery process. Spirituality often helps the afflicted to perceive their illness as a meaningful process, making it easier to cope with the illness. At the end of the theoretical part, four alternative or complementary conceptual frameworks are presented. The empirical part consists of a qualitative research of nine subjects (believers with the experience of psychosis). The data collection and analysis is based mainly in the IPA method (interpretative phenomenological analysis). The research aims to map how mental illness affected the subjects' spirituality and vice versa....

Association of education with mental illness in Czech population Abstract This master thesis aimed to study the association of education with mental disorders in the Czech population. Data were used from a nationally representative cross-sectional study - the CZEch Mental health Study (CZEMS). Mental disorders were assessed with Mini-International Neuropsychiatric Interview and divided into four groups - affective, anxiety, substance use and alcohol use. Information about the highest completed education was self-reported by participants during an interview. Binary logistic regresion examined the association of education with mental disorders, group-wise adjusting for sociodemographic, social and health-related characteristics. The analysis was conducted on 3 175 participants (54 % women, median age 49 years). Lower education (primary and vocational) was associated with higher occurrence of mental disorders, this association remained after adjustment for all characteristics. The association was strongest for alcohol use disorders and weakest for anxiety disorders and did not differ by sex. The relationship between education and alcohol use as well as substance use disorders was apparent in particular in younger individuals. The observed educational differences in the occurrence of mental disorders should be...

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The aim of this work was to explore the nature of self-efficacy construct in patients with dual diagnose in the final phase of psychiatric hospitalisation. In the theoretical part, three topics are discussed: the self-efficacy construct, hospitalisation, and specific mental disorders. In the empirical part a qualitative methodology, based on the elements of interpretative phenomenological analysis, was used. The research sample consists of 5 patients with dual diagnoses, and a psychologist treating these patients in the Department of Dual Diagnoses in Bohnice hospital. Semi-structured interviews were conducted with all participants. The presented results include a separate analysis of key topics for each participant, as well as an overall analysis of all data. A new perspective of self-efficacy is emerging, spreading through three distinct levels - intrapersonal, interpersonal, and systemic. The discussion consists of the results linked to existing literature, as well as answers to research questions. KEYWORDS Self-efficacy - dual diagnose - hospitalisation - mental disorder

Research consistently demonstrates that prison inmates are more likely than the general population to suffer from both mental disorders and substance abuse. The current study explored the relationship between diagnoses of mental disorders and maladaptive substance use among state and federal prison inmates. Linear regression analysis was used to ascertain the prevalence of comorbidity of substance abuse and mental disorder, and multiple models were constructed to determine the direction of relationship between the two disorders. Overall, mental disorders and substance use were positively related within the sample, though mixed conclusions were drawn regarding the exact nature of their relationship. Recommendations for future study and improvements to the specificity of mental disorders and substance use measures are made.

This thesis is a young adult fictional novel from the perspective of Rachel Jackson, or Rae, a seventeen year-old girl with Williams Syndrome, a rare developmental disorder caused by missing genes on chromosome 7 that causes those with it to lack logical connections, yet possess very gregarious, social, and musical personalities. Think of it as an inverted form of autism. At the genesis of the novel, Rae becomes pregnant. Upon misunderstanding her mother's sugar-coated reasoning for giving the baby up for adoption, Rae spends the novel trying to find a man to marry so that, in her understanding, she may keep her child. Along her journey, Rae meets Theo, a well-meaning Christian boy, who appears to be a possible match. Rae falls in love with Theo and gets into various kinds of trouble as she discovers how to take care of herself as well as how to accept herself, disorder and all. Along with her hardworking mother, her feisty grandmother, and her sassy little sister, Rae endeavors this bildungsroman to discover who she is and how she fits into society.

Sammanfattning: Bakgrund: Psykisk ohälsa ökar globalt och vård, omsorg och behandling kan skilja sig mellan länder. De som är sjuka har ofta behov av hjälp och stöd från familj och närstående för att kunna leva ett fullgott liv. Stödet kan vara i egenskap av medföljare till vårdbesök eller som känslomässigt eller ekonomiskt stöd i vardagen. Det i sig kan medföra ökat ansvar och press på de anhöriga. Syfte: Att beskriva anhörigas erfarenheter av att leva tillsammans med en person med psykisk ohälsa. Metod: En deskriptiv litteraturstudie med tematisk dataanalys. Sökningar gjordes i databaserna PubMed och Cinahl. Elva kvalitativa primärstudier inkluderades efter relevans- och kvalitetsgranskning och dessa analyserades sedan med tematisk analysmetod. Huvudresultat: Många anhöriga upplevde att de inte fick vara delaktiga i sin närståendes vård, behandling och omsorg. Otillräcklig information och brister i kommunikation med vårdpersonal samt ett otillräckligt stöd i den stress som uppstår i vardagslivet som anhörig framkom. Det resulterade i två huvudteman: Kommunikation med vårdpersonal samt Anhörigas stress i vardagen. Fem subteman identifierades till dessa. Slutsats: Anhöriga behöver involveras mera i vårdsituationer om och när den som är sjuk med psykisk ohälsa medger detta. Vårdpersonal behöver kontinuerlig fortbildning inom området psykisk ohälsa för att kunna ge tydlig information baserad på vetenskaplig grund. Vårdpersonal bör också våga ställa direkta frågor till de anhöriga och ta del av deras svar. Det skulle bidra till ökad känsla av sammanhang (KASAM) hos de anhöriga. / Abstract: Background: Mental illness is increasing globally. Care and treatment differ between countries. A person with mental illness often needs help from family and relatives in order to cope with their everyday life. The support can be as a companion to healthcare appointments or emotional or financial support in everyday life. This often led to increased responsibility and pressure on relatives. Aim: Relatives’ experiences of living with a person with mental illness Method: A descriptive literature review with a thematic analysis. Searches were performed in the databases PubMed and Cinahl. Eleven qualitative primary studies were included after relevance and quality review and those were then analyzed using a thematic analysis method. Result: Many relatives felt they were not allowed to participate in their loved ones care and treatment. Lack of information and communication and insufficient support in the stress that occurs in everyday life as a relative, emerged. In the result two main themes were acknowledged: Communication with healthcare staff and Relatives' stress in everyday life. Five sub themes were identified. Conclusion: Relatives need to be more involved in care situations if and when their loved ones with mental illness consents to this. Nursing staff need continuous education in the field of mental illness to be able to provide correct and science based information. Care personnel should also dare to ask direct questions to the relatives and take note of their answers. It would contribute to an increased Sense Of Coherence (SOC) among the relatives.

Bakgrund: Patienter med psykisk ohälsa har länge varit en stigmatiserad grupp inom vården och samhället och med psykiatriska diagnoser följer ofta förutfattade meningar hos omgivningen vilket påverkar patientgruppen negativt. Patienter med psykisk ohälsa löper också större risk att dö i förtid, bland annat på grund av att deras somatiska besvär underdiagnostiseras och misstolkas för att vara psykiska åkommor.   Syfte: Att beskriva sjuksköterskors erfarenheter av att möta och vårda patienter med psykisk ohälsa inom den somatiska vården.   Metod: Detta är en litteraturstudie baserat på åtta kvalitativa studier.   Resultat: Litteraturstudien resulterade i tre huvudkategorier: organisatoriska faktorer, sjuksköterskans kompetens och mötet med patienten. Dessa delades in i ytterligare sju subkategorier.  Konklusion: Sjuksköterskorna inom den somatiska vården upplevde patienter med psykiska ohälsa som svåra och oförutsägbara och de efterfrågade mer kunskap inom ämnet. Det organisatoriska och kollegiala stödet var också bristfälligt och skapade hinder för sjuksköterskorna att ge den goda vård de önskade. Vidare forskning på ämnet är önskvärt. / Background: For a long time, patients with mental disorders have been stigmatized in both society and in care settings. It has shown that psychiatric diagnoses often come with prejudice. This affects this group of patients negatively, as it creates a barrier towards seeking somatic health care. They also have a higher mortality rate, because of misinterpreted somatic symptoms and limited care access.   Aim: To describe nurses' experiences of meeting and caring for patients with mental disorders in somatic care.   Methods: A literature review based on eight qualitative studies.   Results: This literature study resulted in three main categories: organizational factors, the nurse’s competence and the meeting with the patients. These were further divided into seven subcategories.   Conclusion: The somatic nurses’ experienced patients with mental disorder as difficult and unpredictable and they requested more knowledge in the subject. They were also affected by the lack of organizational and collegial support which created obstacles in providing adequate care for these patients. Further research on the topic is suggested.

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Bakgrund: Psykisk ohälsa och substansbruk utgör båda separat globala hälsoproblem. Samsjuklighet i form av psykisk ohälsa och substansbruk är vanligt förekommande och komplexiteten av denna sjukdomsbild utgör utmaningar för hälso- och sjukvården.  Syfte: Studiens syfte var att beskriva upplevelser av möten med omvårdnadspersonal bland personer med samsjuklighet i form av psykisk ohälsa och substansbruk.  Metod: En allmän litteraturstudie genomfördes, i enlighet med Nio-Stegsmodellen av Polit och Beck. Denna översikt inkluderade och metodiskt analyserade nio originalartiklar, med användning av innehållsanalysmetodiken som beskrivits av Graneheim och Lundman.  Resultat: Tre huvudkategorier framträdde: Personen bakom substansbruket, Vårdrelations betydelse och Utmaningar kopplade till samsjuklighet, tillsammans med sex underliggande subkategorier.  Slutsats: Personer med samsjuklighet i form av psykisk ohälsa och substansbruk utgör en komplex patientgrupp. Studiens resultat tyder på att vårdsystemets utformning och upplevd bristande kunskap hos omvårdnadspersonalen utgör hinder för dessa patienter att erhålla adekvat vård. Det krävs en ökad kunskap och förståelse hos omvårdnadspersonal för de unika utmaningar som dessa personer står inför för att bättre kunna möta deras behov. Ytterligare forskning på detta område behövs därmed för att förbättra vården av denna patientgrupp. / Background: Mental health and substance use both separately constitute global health challenges. Comorbidity of mental health issues and substance use is common, and the complexity of this clinical picture poses challenges for healthcare.  Aim: The study's aim was to describe experiences of encounters with nursing staff among individuals with comorbidity of mental illness and substance use.  Method: A general literature review was conducted, adhering to the Nine-Step model by Polit and Beck. This review included and methodically analyzed nine original articles, employing the content analysis methodology outlined by Graneheim and Lundman.  Results: Three main categories were identified: The person behind the substance use, The significance of the care relationship, and Challenges related to comorbidity, along with six associated subcategories.  Conclusions: People with comorbidity in the form of mental disorder and substance use constitute a complex patient group. This study’s results imply that the design of the healthcare system and the perceived lack of knowledge among nursing staff pose barriers for these patients to receive adequate care. There is a need for increased knowledge and understanding among nursing staff regarding the unique challenges faced by these people to better meet their needs. Further research in this area is therefore needed to improve the care of this patient group.