The use of coercion in psychiatry involves clinical, legal, scientific, ethical and emotional considerations. This thesis represents an attempt to further increase our understanding of some empirical aspects of this phenomenon. Interviews with 202 involuntarily admitted psychiatric patients and 201 voluntarily admitted patients and 295 of their next of kins were performed and analysed together with data from records and assessments made by professionals. Data was collected during two different periods of time with a compulsory psychiatric care law reform in between. Experience of at least one coercive measure was more common amongst patients who had been committed during the most recent legislation. Otherwise there were no differences in patient experiences during the different laws. Subjective short-term outcome was associated with having a contact person at the ward and being subjectively treated well. There were no relationships between subjective and assessed outcome or between legal status, perceived coercion at admission and subjective or assessed improvement. The changed legislation had no clear effect on the attitudes of patients and next of kins towards coercion. A majority of patients were able to accurately answer the question whether they had been restrained by belt or not during a specific treatment episode. Nineteen of 115 patients reported they had been restrained by belt. Eleven of these cases were true positive and 8 cases were false positive. In conclusion, the main results were first that when it comes to issues related to psychiatric coercion there are typically considerable differences between how these are perceived and interpreted by the professional and by the patient, and second that efforts made to change the face of psychiatric coercion in the minds of patients as well as the public on part of public policymakers have had limited effects.

När en socialsekreterare ska utreda en klient enligt Lag om Vård av Missbrukare i vissa fall (LVM) behöver denne ta ställning utifrån många olika perspektiv. Syftet med denna studie var att ge kunskap om LVM-ärenden ur socialsekreterarens perspektiv samt att belysa deras tankar, uppfattningar och erfarenheter av LVM-handläggning. Undersökningens empiriska material grundar sig på kvalitativa semistrukturerade intervjuer med åtta socialsekreterare. För att kunna tolka och analysera vårt material använde vi oss av utilitarismen och det salutogena perspektivet som tolkningsram. Resultatet visar på att socialsekreterarna upplever både för- och nackdelar i arbetet med lagstiftningen. Socialsekreterarna upplever handläggningen av LVM-ärenden likt ett dilemma. Socialsekreterarna anser att lagen är nödvändig då de i avsaknad av denna skulle känna en stor maktlöshet av att inte kunna ingripa i allvarliga situationer där klienten riskerar att avlida till följd av sitt missbruk. De anser även att tillämpningen av lagen medför stora inskränkningar i den enskilda klientens integritet och att klienten i mötet riskerar att bli kränkt utan noga eftertanke från socialsekreterarens sida. Resultatet visar även på att socialsekreterarna så långt som det är möjligt respekterar klientens autonomi men att autonomin vid fråga om liv och död måste förbises. / There are many different perspective to take under consideration when a social secretary is about to investigate a client according to the Law on Care of Addicts in certain cases (LVM). The purpose of this study was to provide knowledge, from a social secretaries perspective, about their thoughts, perceptions and experiences of the LVM-process. The studies empirical material was based on qualitative semi-structured interviews with eight social secretaries. We used the utilitarianism and the salutongenic perspective, sense of coherence as interpretative framework to analyze and interpret our empirical material. The result shows that social secretaries experiences about the legislation have both advantages and disadvantages. They feel that LVM-processing is like a dilemma. Social secretaries think that the law is necessary for them to be able to intervene in serious situations when the clients are likely to die as a result of their addiction. They also feel that the application of the law entails large restriction for the clients individual integrity and that the client, without careful consideration from the social secretary´s side, risk to be violated. The result also shows that the social secretaries, as far as possible, wants to respect the client´s autonomy but it must be overlooked in matter of life and death.

To this point research on firms’ political behavior has contributed knowledge concerning large firms’ relationships and strategies with political actors and their surrounding environment. Less is known about small firms’ behavior towards political organizations. As a matter of fact, the fields of international marketing, international business and corporate political science have left the political behavior of small firms almost untouched. Therefore, extant literature assumes that small firms due to their resource constraints are passive receivers of political initiatives. About 99 percent of all firms within the European Union are small firms, and it is therefore questioned whether all these firms are passive receivers of political initiatives. The intention with this thesis is to challenge some assumptions regarding how small firms manage their relationships with political actors concerning EU related rules and regulations. Consequently, the study raises the overarching research question; how do small firms manage their political environment? Theoretically, the study takes a network perspective on business political interaction to examine both individual and/or collective political behavior of small firms. It develops a theoretical view constituted of knowledge, commitment and legitimacy. Methodologically, two sequential stages are followed: first an in-depth qualitative case study of three successful cases is presented and second, the in-depth understanding is broadened to a wider population of firms based on a quantitative survey. A central contribution of this thesis is to aid research on the political behavior of small firms. It is found that small firms, in contrast to prevailing assumptions, do possess political resources. They are not passive receivers of political initiatives. Instead, the findings show that small firms are active and can exercise influence. This, however, is shown to be dependent on the firm’s political commitment, political knowledge and competency and business-political legitimacy. It is also shown that small firms mobilize these critical resources not only directly, but also indirectly through various intermediating actors. Besides the theoretical contributions, these conclusions are important not just because of the managerial implications but also, and perhaps more importantly, for the policy implications that can be drawn from the study. Being exploratory and opening up the black box of small firm’s political behavior, the thesis ends with a number of future research directions.

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Bakgrund: Lagen om psykiatrisk tvångsvård och Lagen om rättspsykiatrisk vård ger rätt att vårda patienter mot deras vilja. I psykiatrisk vård förekommer specifika omvårdnadsåtgärder som bältesläggning, tvångsmedicinering och avskiljning. Dessa väcker många känslor och kräver att sjuksköterskan arbetar med hänsyn och respekt. Relationen är en central del inom psykiatrisk omvårdnad och ska baseras på tillit och empati. Syfte: Att belysa sjuksköterskors uppfattning om tvångsåtgärders inverkan på omvårdnadsrelationen. Metod: Semi-strukturerade intervjuer med hjälp av en intervjuguide genomfördes med yrkesverksamma sjuksköterskor på en psykiatrisk klinik. Data bearbetades med en kvalitativ manifest innehållsanalys. Resultat: Studien resulterade i sex kategorier; professionellt förhållningssätt, vårdande samtal, tillitsfull relation, tvång som maktmedel, sjuksköterskans uppfattning av patientens känslor och sjuksköterskans känslor. Slutsats: Tvångsåtgärder väckte flera känslor hos sjuksköterskan. Med hjälp av ett professionellt förhållningssätt och vårdande samtal skapades en tillitsfull relation med patienten. Detta medförde att tvångsåtgärderna inte hade en negativ inverkan på omvårdnadsrelationen. / Background: The Compulsory Psychiatric Care Act and the Forensic Psychiatric Care Act gives the right to treat patients involuntarily. Specific nursing interventions in the form of restraint, coerced medication and seclusion occur in psychiatric care. These evoke a lot of emotions and require that the nurse work with consideration and respect. The nurse-patient relationship is an essential part within psychiatric nursing and should be based on trust and empathy. Aim: To illuminate nurses perception of coercive measures impact on the nurse-patient relationship. Method: Semi-structured interviews with the help of a topic guide were conducted with nurses on a psychiatric clinic. The data were processed through a qualitative manifest content analysis. Results: The study resulted in six categories; professional approach, caring dialogue, trusting relationship, coercion as an instrument of power, the nurse´s perception of patients emotions and the nurse´s emotions. Conclusion: Coercive measures raised several emotions within the nurse. With the use of a professional approach and a caring dialogue a trusting relationship was created with the patient. This meant that coercive measures didn't have a negative impact on the nurse-patient relationship.

Minimal scientific research has been conducted regarding female sexual offenders within the South African context, despite its prevalence. This study explores behavioural and contextual characteristics of female sexual offenders to gain an understanding of the phenomenon. This qualitative study in the form of a systematic review, focuses on the findings of ten original international research articles published from 2002 to 2012 regarding the behavioural and contextual characteristics of female sexual offenders. The epistemological foundation of this study was postmodernism and social constructionism. Three main themes and various subthemes emerged from the data by applying the thematic content analysis. The aim of this study was to explore the similarities and differences between the findings of the research articles. Lacunas in the existing literature were explored in an attempt to extend scientific knowledge on female sexual offenders. Finally, recommendations for future scientific studies on female sexual offenders were discussed. / Psychology / M.A. (Clinical Psychology)

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