Aim: To illuminate relatives need of support when caring for or supporting a person suffering from mental illness Background: Relatives of a person suffering from mental illness have different needs. It has for the past few years merely been little improvements in the relative's situation. Methods: Focus group interviews with fourteen relatives. Data were analyzed through manifest content analysis. Findings: Three categories were found: Functioning contact channels to the psychiatric health care organization, Need of an active support from the psychiatric health care organization and Need of support from community resources. Conclusion: The relatives need more attention and understanding for their situation. The support of relatives must be designed and monitored individually. A collaboration or a well-functioning relation with the psychiatric nurses, other professionals working in the health care organisation and social services gives a mutual respect and trust which in turn leads to that the relative is confirmed as an important resource in the care of the mentally ill person. The relatives need an increased support and understanding from the community.

This essay reflects my process in the making of a final body of work. In chapter one I investigate and describe two mental disorders commonly associated with women, Hysteria and Borderline, and compare them to the material and the use of pearls. Also giving some background on how mental patients have been treated and to the Swedish psychiatric care. Chapter two is a further discussion on the theme mind/body, offering the reader some insight on how I approach the making. Chapter three is what came after

This study examines effects of a hospital-based psychiatric day program on eight subjects over a six month period. Each subject underwent a semi-structured interview at admission to the Program, and then at three and sixth months or on discharge with concurrent Psychometric testing. Quantitative and qualitative data were compared with information from "significant others" and unit staff reports to determine changes in subjects' behaviours over the study period. To consider any effects of the Program on psychiatric re-admissions, relevant data dating back to 1980 from both regional admitting centres were examined for patients who were identified as having had multiple re-admission for psychiatric care as well as a minimum of twenty-four days attendance at the Day Program ( n = 73 ). The results indicated a trend towards improved quality of life, improvement in selfcare, social supports, ability to form relationships and in the quality of family relationships. Reduction in number and intensity of symptoms, and improvement in coping skills was reported for 88% of subjects. Subjects were found to agree in their perception of the most and least helpful elements of the Program. Re-admission data showed that the Program was most beneficial for number of admissions, rate of admissions, length of stay and rate of length of stay for the diagnostic group of Depressions and for the group as a whole. There were also positive effects in some of these areas for the diagnostic groups of Anxiety Disorders and Personality Disorders (confidence level of 95%).

<p>Telefonrådgivning via en sjuksköterska har funnits ända sedan 1930-talet men det är först de senaste åren som denna kompetens har erkänts som en egen specialitet. Inom vården sker allt fler möten mellan vårdgivare och vårdsökande via telefonen vilket leder till att allt högre krav ställs på sjuksköterskans yrkeskunnighet. Studiens syfte var att beskriva vad sjuksköterskor upplever vid telefonrådgivning till personer med psykiska problem. Metoden som använts i denna litteraturstudie var kvalitativ innehållsanalys med manifest och latent ansats. Resultatet baseras på 10 vetenskapliga artiklar där fyra kategorier framkom: trygghet, utsatthet, ett känsligt öra samt meningsfullhet. I resultatet framkom att kunskap och klinisk erfarenhet är faktorer som har stor betydelse för yrkesrollen inom telefonrådgivning. Som rådgivningssjuksköterska inom psykiatrisk vård upplevde många en hög stressnivå vad gäller den komplexa yrkesrollen. Att inte se patienten med sina egna ögon upplevdes som att delvis arbeta i blindo. Detta ledde till att rådgivningssjuksköterskorna lyssnade aktivt för att försöka förstå vad som uttrycktes mellan raderna i samtalet med den vårdsökande. Ett etiskt dilemma som rådgivningssjuksköterskor beskriver är upplevelse av svårigheter att hantera andrahandsinformation vid telefonrådgivning. Dessa svårigheter uppkommer då rådgivningssjuksköterskan ej har möjlighet att tala direkt till den person som telefonråden gäller. För övrigt gavs uttryck för att arbetet som rådgivningssjuksköterska är stimulerande och utmanande</p>

<p> </p><p> </p><p> </p><p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p><p> </p></p><p><p><strong><p>Abstract</p><strong><p>Aims:</p></strong><p> </p><p>To explore whether and in that case how nurses question women in the psychiatric care about violence in close relationships and how nurses respond to women who have been exposed to domestic violence.</p><strong><strong><p>Method:</p></strong><p> </p><p>A qualitative descriptive interview study with twelve nurses from four psychiatric wards was carried out in Uppsala. Informants were chosen from a convenient selection. The interviews with semi-structured interview questions were recorded on tape, transcribed and analyzed with content analysis.</p><strong><strong><p>Results:</p></strong><p> </p><p>There is no routine to ask all female patients if they are victims of violence. It happens only in cases where the suspicion arises or is confirmed. It is individually whether and how the nurse asks the woman if she is subjected to violence in a close relationship, depending on patient and nurse. Nurse handles the violence exposed woman by supporting her to share their experiences. Then consult and discuss with their nurse colleagues and other professionals for further follow-up and approach.</p><strong><strong><p>Conclusions:</p></strong><p> </p><p>The study has in accordance with previous research further highlighted the need for more education for nurses on how to handle women who are victims of violence in close relationships. More research should be done in Sweden to develop and implement standardized questionnaire for nurses in all health care.</p></strong></strong></strong></strong></p></p>

The present study focuses on the phenomenology of the violent encounter, and is to be understood as the study of the violent encounter as a phenomenon, i.e. as experienced. The overall aim is to elucidate, analyse and describe violent encounters within psychiatric care as experienced by carers and patients. Moreover, the study aims at promoting the development of a phenomenological research approach in caring science in general and elucidating tacit caring knowledge in particular. The thesis includes three empirical studies and one methodological study. The research is guided by a phenomenological and lifeworld theoretical approach. Research data consist of narratives and qualitative interviews, as well as reenactment interviews with carers and patients. Data are analysed for meaning. The analysis and synthesis of meaning are aimed at openness and meaning sensitivity through a reflective attitude characterised by the intent to bridle the process of understanding. The goal of the analysis is to describe the general structure of the phenomenon and its meaning constituents. The result shows that violence and threat do not evolve in “naked” caring, characterised by encounters where carers are able to touch their patients at the same time as being touched, speaking both literally and figuratively. It is through “naked” caring and caring touch that the carers are able to reach the patients and to give undisguised invitations to genuine presence. The possibilities of touch rely on the carers’ capacity to be authentic and to genuinely wish well. Violence is on the contrary nourished by touch without caring intention, or non-touch, i.e. caring where the reciprocity of touching and being touched is missing between patients and caregivers. In the discussion, the different meanings of the violent encounter are related to the philosophy of Merleau-Ponty and Lévinas. The philosophical dimensions of touch are investigated and it is discussed how the “naked” encounter can be understood from a phenomenological ethical standpoint. The discussion focuses on the caregivers’ vulnerability and the high demands they are subjected to. It is also argued that a foundation of caring science is needed in caring practice in order to make possible a development of a caring attitude that prevents violence.

Telefonrådgivning via en sjuksköterska har funnits ända sedan 1930-talet men det är först de senaste åren som denna kompetens har erkänts som en egen specialitet. Inom vården sker allt fler möten mellan vårdgivare och vårdsökande via telefonen vilket leder till att allt högre krav ställs på sjuksköterskans yrkeskunnighet. Studiens syfte var att beskriva vad sjuksköterskor upplever vid telefonrådgivning till personer med psykiska problem. Metoden som använts i denna litteraturstudie var kvalitativ innehållsanalys med manifest och latent ansats. Resultatet baseras på 10 vetenskapliga artiklar där fyra kategorier framkom: trygghet, utsatthet, ett känsligt öra samt meningsfullhet. I resultatet framkom att kunskap och klinisk erfarenhet är faktorer som har stor betydelse för yrkesrollen inom telefonrådgivning. Som rådgivningssjuksköterska inom psykiatrisk vård upplevde många en hög stressnivå vad gäller den komplexa yrkesrollen. Att inte se patienten med sina egna ögon upplevdes som att delvis arbeta i blindo. Detta ledde till att rådgivningssjuksköterskorna lyssnade aktivt för att försöka förstå vad som uttrycktes mellan raderna i samtalet med den vårdsökande. Ett etiskt dilemma som rådgivningssjuksköterskor beskriver är upplevelse av svårigheter att hantera andrahandsinformation vid telefonrådgivning. Dessa svårigheter uppkommer då rådgivningssjuksköterskan ej har möjlighet att tala direkt till den person som telefonråden gäller. För övrigt gavs uttryck för att arbetet som rådgivningssjuksköterska är stimulerande och utmanande

Abstract Aims:   To explore whether and in that case how nurses question women in the psychiatric care about violence in close relationships and how nurses respond to women who have been exposed to domestic violence. Method:   A qualitative descriptive interview study with twelve nurses from four psychiatric wards was carried out in Uppsala. Informants were chosen from a convenient selection. The interviews with semi-structured interview questions were recorded on tape, transcribed and analyzed with content analysis. Results:   There is no routine to ask all female patients if they are victims of violence. It happens only in cases where the suspicion arises or is confirmed. It is individually whether and how the nurse asks the woman if she is subjected to violence in a close relationship, depending on patient and nurse. Nurse handles the violence exposed woman by supporting her to share their experiences. Then consult and discuss with their nurse colleagues and other professionals for further follow-up and approach. Conclusions:   The study has in accordance with previous research further highlighted the need for more education for nurses on how to handle women who are victims of violence in close relationships. More research should be done in Sweden to develop and implement standardized questionnaire for nurses in all health care.

Background: The need for structured practice has in recent years appeared in connection with the request for a more evidence-based nursing. In psychiatric care with its complex disabilities, it is important to have methods to identify these. Research has demonstrated the importance of patient participation in nursing that has been shown to affect their mental health. It is essential to get to know how patients with mental illness are capable of involvement in their life situation. The ICF emerged as a useful theoretical framework for development of questionnaires of patient participation. Aim: The aim of the present pilotstudy was to develop and test a questionnaire for participation, based on ICF. Method: This pilotstudy had a quantitative approach and was based on a draft for the purpose described. For the development process two expertgroups were used, one consisted of nurses with experience of ICF and one by former patients recruited from psychiatric patient organizations to discuss participation and item selection. The final questionnaire was answered by 29 nurses, who also could comment on the content in three open questions used for face validity. Cronbach´s alpha was used to calculate internal consistency. The final goal is to develop a concept of two questionnaires for participation. One that will be answered by nurses and another part based on patients self-assessment. During this pilotstudy, the nurse`s part was focused. Result: The result indicated good internal consistency both in the whole Assessment of Participation in Psychiatric care (APP) (0.900) and for each item (0.892-0.904). We also found indication for good face validity.  The result of this pilot study can be useful for further research and development.

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