Bakgrund: Studier visar att hundar har en positiv effekt på den fysiska hälsan. De kan också öka det sociala samspelet, minska depression, öka självförtroende och självbestämmande samt reducera ångest genom hundassisterad aktivitet eller hundassisterad intervention. Syfte: Syftet med denna studie är att undersöka om hundar inom ramen för omvårdnad på en rättspsykiatrisk avdelning kan påverka patienternas välbefinnande. Metod: För att undersöka patienternas upplevelser användes en kvalitativ studiedesign. För att besvara syfte och frågeställningar gjordes semistukturerade intervjuer som analyserades med en kvalitativ innehållsanalys.   Resultat: Hundar på avdelningen upplevdes både positivt och negativt. De inverkade på välbefinnandet genom att de genererade glädje och välmående men också irritation och ilska. De gav också en känsla av att bli sedd som människa, ökade den fysiska aktiviteten, förbättrade sömnen och påverkade självkänslan och självförtroendet. Vårdmiljön påverkades också genom ett förbättrat klimat på avdelningen. De gav en meningsfullhet i vardagen, en möjlighet till närhet, en känsla av mindre kontrollerande miljö samt att de hade en inverkan på hur patienterna rörde sig på avdelningen. Det identifierades en ståndpunkt för hundar på avdelningen, men också en emot att ha hundar på avdelningen. Slutsats: Resultaten tyder på att det positiva överväger det negativa då majoriteten av resultatet belyser aspekter som ökar välbefinnandet hos patienterna. Hundar inom vården anses därför vara en bra komplementär omvårdnadsform för att som sjuksköterska på en rättspsykiatrisk avdelning. Detta för att kunna utföra god omvårdnad, främja välbefinnande och upprätthålla ett samhällsskydd och samtidigt reducera känslan hos patienten av att vara underordnad och kontrollerad. Det är dock viktigt att beakta olika individers åsikter för att hitta en form som passar. / Background: Studies have shown that dogs have a positive effect on humans physical health. They may also increase social interactions, decrease depression, increase peoples selfconfidence and autonomy and reduce anxiety trough animal-assisted interventions. Aim: The aim of this studie is to investigate if dogs can effect well-being in patients within forensic psychiatric care. Method: To investigate the patients experiences a qalitative reserch method were used. Semi-structured interviews were used to answer to the aim of the studie, and analysed with a content analysis. Result: The patients had both positive and negative experiences regarding the presence of the dogs at the unit. The dogs had an impact on the patients well-being by generating joy as well as anger and irritation. They gave a sense of being perceived as an individual, they increased physical activity, improved quality of sleep and had an inpact on self-esteem and self-confidence. The dogs also had an impact on the health facility environment trough an inprovement of the atmosphere at the unit. The dogs gave sense of mening in the everday life, an opportunity for intimacy, a sense of a less controlling environment and they also had an impact on how the patients moved at the unit. Some where proponents and some opponents to the impementation of dogs at the unit. Conclusion: The results shows that the positive experiences tops the negative because the majority of the results shows aspects of improved well-being. Dogs within healthcare facilities are therefore concidered to be a good complementary form of care for nurses working in forensic psychiatric care. This to perform good nursing care, promote well-being and maintain the civil protection and at the same time reduce feelings of being inferior, subordinated and controlled. It is however important to pay regards to the different idividual opinions and find a resolution that suits best.

This study examines the most vital criteria for being discharged from forensic psychiatric care in 1915-1945. To do so a qualitative oriented comparative text analysis has been made on medical records from the forensic psychiatric departement at Sankt Sigfrids mental hospital in Växjö, Sweden. The result shows that the most vital criteria for the whole period is that a patient proves himself to be diligent, hard-working and that he can return to an environment where he can live and make a living for himself. Furthermore, from 1940 and forward the result shows that the discharge trial has been expanded, which results in that the criteria for being discharged should to a greater extent been showed in the free rather than in the institution. The conclusion of this is that the psychiatry during the later years of the study aimed to create a more socially adapted and producitve citizen out of the patient than it did in the earlier years.

Delaktighet är viktig för patientens livskvalité, självkänsla, egenmakt samt känsla av kontroll och inflytande. Patienter inom rättspsykiatrisk vård har en minskad autonomi till följd av de begränsningar som tvångslagarna innebär. Forskning samt litteratur kring patienters delaktighet i den rättspsykiatriska vården är bristfällig och behöver utforskas vidare. Syftet med studien var att belysa hur sjuksköterskor upplever att patienters delaktighet möjliggörs inom den rättspsykiatriska vården. Studien har en omvårdnadsvetenskaplig utgångspunkt och kvalitativa intervjuer med nio sjuksköterskor från rättspsykiatriska avdelningar i södra Sverige har genomförts. I resultatet framkom att sjuksköterskorna upplever att delaktighet är en viktig del i omvårdnaden men att personal och patienter ibland ser olika på begreppet. Delaktigheten finns hela tiden med i arbetet med patienterna men den kan skifta beroende på vilket brott patienten vårdas för dock finns det en framtidstro om att den rättspsykiatriska vården ska fortsätta att utvecklas och att vården i framtiden kommer att bli ännu mer individanpassad. ”Vi försöker” blev det övergripande temat som visar att sjuksköterskorna försöker att få patienterna delaktiga i den rättspsykiatriska vården. / Participation is important for the patient's quality of life, self-esteem and sense of control and influence. Patients in forensic psychiatric care have reduced autonomy as a result of the constraints imposed by the compulsion laws. Research and literature on patient participation in forensic psychiatric care are inadequate and need further research. The purpose of the study was to highlight how nurses experience patient participation in forensic psychiatric care. The study has a nursing science starting point and qualitative interviews with nine nurses from forensic psychiatric departments in southern Sweden have been carried out. The results show that nurses feel that participation is an important part of the nursing, but that staff and patients sometimes view the concept differently. Participation is always included in the work with patients, but it may change depending on the custody of the patient, however, there is a belief that the forensic psychiatric care will continue to develop and that future care will be even more individualized.” We are trying” became the overall theme and shows that nurses try to get patients involved in forensic psychiatric care.

I dagens samhälle finns ett stort behov av att förbättra den psykiska hälsan hos befolkningen. En liten del av personer med diagnostiserad psykisk ohälsa hamnar inom rättspsykiatrisk vård – personen har då begått ett brott under psykisk störning. Syftet med studien var att undersöka den rättspsykiatriska vårdpersonalens tankar om hur fysisk aktivitet används som hälsopromotiv insats i dagsläget, vad som kan förbättras och hur det kan främja patienternas hälsa. För att besvara syftet har kvalitativ forskning gjorts, med öppna brev som metod. De 15 personer som deltog i studien fick skriva sin berättelse utifrån meningen “Nu ska jag berätta hur vi kan använda fysisk aktivitet som hälsopromotiv insats för att förbättra hälsan hos patienterna… “. Data analyserades med hjälp av manifest innehållsanalys, som resulterade i tre underkategorier, samt en huvudkategori; “Ju högre grad patienterna har möjlighet att röra på sig, desto bättre för deras välbefinnande” med underkategorierna “Stillasittande vardag”, “Bredare utbud av aktiviteter” och “Ökat välbefinnande”. Resultatet visade att fysisk aktivitet som hälsofrämjande insats inte används i den utsträckning som det skulle kunna, som det ser ut idag, inom rättspsykiatrisk vård. Slutsatsen är att fler hälsopromotiva insatser i form av fysisk aktivitet behövs inom rättspsykiatrin, och att den troliga effekten skulle resultera både i förbättrad fysisk och psykisk hälsa hos patienterna. / In today's society, there is a great need to improve the mental health of the population. A small proportion of people with diagnosed mental illness end up in forensic psychiatric inpatient care when they have committed a crime under a mental disorder. The purpose of the study was to investigate the forensic psychiatric care staff's thoughts on how physical activity is used as a health-promoting input in the current situation, what can be improved and how it can promote patients' health. To answer the question, qualitative research has been done with open letters as a research method. Fifteen forensic psychiatric care staff participated in the study, and were encouraged to write their story based on the sentence “Now I will tell you how we can use physical activity as a health promotion initiative to improve the health of the patients…”. The data was analyzed using manifest content analysis, which resulted in three subcategories as well as one main category; “The more patients are able to move, the better for their well-being” with the subcategories “Sedentary everyday life”, “Wider range of activities”, and “Increased well-being”.  According to the results, health-promoting input in the forensic psychiatric care is not used in the extent it could be used. The conclusion is that more health-promoting interventions in the form of physical activity are needed in forensic psychiatric inpatient care, and it is presumed that increased physical activity would result in both improved mental health and physical health among the patients.

No description available.

Bakgrund: I tidigare forskning beskrivs svårigheter i att vårda patienter med självskadebeteende. Utbildning och erfarenhet ses av sjuksköterskorna vara av stor vikt för ett professionellt agerande gentemot patienterna. Patienterna uppger svårigheter i att söka vård då de uppfattar självskadebeteendet som skambelagt och att de ofta får erfara ett oprofessionellt bemötande från omvårdnadspersonal. Tidigare forskning gällande patienter med självskadebeteende inom den rättspsykiatriska vårdkontexten är knapphändig och det finns behov av mer studier i ämnet. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda patienter med självskadebeteende inom rättspsykiatrisk slutenvård. Metod: Tio semistrukturerade intervjuer genomfördes. Deltagarna i studien var fem grundutbildade sjuksköterskor och fem specialistutbildade sjuksköterskor inom psykiatrisk vård. Insamlade data analyserades utifrån en kvalitativ innehållsanalys med induktiv ansats. Resultat: Sjuksköterskorna erfar att det är viktigt i vårdandet av en patient med självskadebeteende att skapa trygghet hos patienten och att vara lyhörd inför patientens situation. Att vårda en patient med självskadebeteende ses av sjuksköterskorna som ett krävande arbete och det finns risk att känna sig otillräcklig. Slutsats: Omvårdnaden skulle vinna på att patientens berättelse får stå i centrum för vården. Skapandet av en trygg relation med patienten möjliggör förståelse för patientens självskadebeteende. Samarbete mellan kollegor ses kunna vara avgörande för hur vården bedrivs. Sjuksköterskorna efterfrågar mer kunskap i hur vården bäst utformas för patienter med självskadebeteende inom rättspsykiatrisk slutenvård. / Background: Previous research describes difficulties in caring for patients with self-harming behavior. Education and experience are seen by the nurses to be of great importance for a professional action towards the patients. Patients report difficulties in seeking care as they perceive the self-harming behavior as shameful and that they often experience unprofessional treatment from nursing staff. Previous research regarding patients with self-harming behavior in the forensic psychiatric care context is scarce and there is a need for more studies in the subject. Aim: To describe nurses experiences of caring for patients with self-harming behavior in forensic psychiatric inpatient care. Method: Ten semi-structured interviews were conducted. The participants in the study were five basic nurses and five specialized in psychiatric care. Collected data were analyzed on the basis of a qualitative content analysis with an inductive approach. Result: The nurses experience that it is important in the care of a patient with self-harming behavior to create a feeling of security for the patient and to be sensitive to the patient's situation. Caring for a patient with self-harming behavior is seen by nurses as a demanding job and there is a risk of feeling inadequate. Conclusion: Nursing would benefit from the patient's story being at the center of care. The creation of a secure relationship with the patient enables an understanding of the patient's self-harming behavior. Cooperation between colleagues can be seen to be decisive for how care is conducted. The nurses demand more knowledge in how care is best designed for patients with self-harming behavior in forensic psychiatric inpatient care.

Thesis (M. Medicine (Psychiatry)) -- University of Limpopo, 2022 / BACKGROUND: The challenge of sexual offence crimes against women and children is notably increasing worldwide with an accompanying impact on the mental and physical well-being of the victims and society, in general. Despite the impact, sexual offenders remain a complex group, not well studied in forensic psychiatry settings globally. Previous studies identify psychosocial factors and mental illness associated with sexual offending. Adequate care, treatment and rehabilitation of sexual offenders are crucial to reduce the impact of sexual offence and re-offending. AIMS: To determine the demographic variations, clinical factors, and observation outcomes in terms of diagnosis, fitness to stand trial, and criminal responsibility among the alleged sexual offenders referred to Thabamoopo Hospital. OBJECTIVES: To determine the prevalence of mental disorders among alleged sexual offenders, to determine the number of offenders fit or unfit to stand trial and who are criminal or not criminally responsible, to determine factors associated with vulnerability to sexual offending behaviour. METHOD: This study is based on a review of clinical records and files and psychiatrists' observation reports of all alleged sexual offenders referred by the courts for forensic psychiatric observation between the period January 2015 to December 2018 at Thabamoopo Hospital. RESULTS: The sample consists of 94 participants, only one female; all were black Africans. The majority were in middle adulthood, unemployed, of a lower level of education and not married. All participants had been charged with rape. A large number of the alleged sexual offenders were diagnosed with mental conditions. The most common diagnoses were Intellectual disability disorders, psychotic disorders and substance-related disorders. More than half of the sample was fit to stand trial and criminally responsible. CONCLUSION: More than half of the participants charged with rape were found fit to stand trial and to be criminally responsible. A significant number were diagnosed with mental illness. The outcomes of being unfit to stand trial and not being criminally responsible were common among mentally ill sexual offenders. The results signify that this group of offenders needs adequate psychiatric care, treatment and rehabilitation in order to reduce sexual offending and re-offending due to the impact of mental illness.

Self-concept is the individual's subjective view of themselves. It impacts interaction with others and, in turn, further the development of the self. Cultural aspects, gender differences, and psychiatric and substance use disorders further impact the subjective view of the self. Structural Analysis of Social Behavior (SASB) is a model rooted in interpersonal theory and the interpersonal circle that divides the self-concept into eight behavioral clusters over love-hate and autonomy-control. The individual's measured self-beliefs can be used in motivational work and treatment. The forensic psychiatric population is complex, with high levels of comorbidity, but little is known about how they view themselves. This study aims to capture their self-concept and examine if different psychiatric diagnostic groups have distinct self-concept profiles. One hundred and six patients who had previously completed the SASB introject questionnaire were included. Demographic data and other variables were also coded from their electronic journal. The participant's descriptives showed differences from the normative group and slight differences between the psychiatric groups. Inferential statistical analysis showed a significant difference regarding the negative clusters between the Neurodevelopmental and Psychosis groups and a trend of differing scores between the Neurodevelopmental and Personality Disorders groups. Study limitations make it hard to point to distinct self-concept profiles, but SASB-results indicate that the patients generally feel positive about themselves. Further research is needed to increase the findings' generalizability and better capture self-concept in comorbid inpatients. / FOR-SATA

Emotionsreglering har de senaste åren fått alltmer uppmärksamhet och stöd som en faktor associerat med substansbruk. Däremot finns till författarnas vetskap ingen tidigare forskning som undersökt sambandet mellan emotionsreglering och substansbruk i ett rättspsykiatriskt urval. Syftet med denna studie var att beskriva substansbruket och utforska associationer mellan emotionsreglering och substansbruk i ett rättspsykiatriskt urval. Deltagarna (N = 98; 13 % kvinnor) rekryterades från en kohort av rättspsykiatriska patienter i Sverige från 2016-11-01 till 2020-11-30.  Data samlades in genom journalgranskningar, självskattningar och kompletterades med semistrukturerade intervjuer. För att beskriva substansbruk i gruppen användes deskriptiv statistik. Vidare användes instrumentet Difficulties in Emotional Regulation Scale (DERS) för att undersöka deltagarnas svårigheter med emotionsreglering. Som mått på substansbruk använde författarna debutålder av substanskonsumtion och antalet testade substanser. För att utforska sambandet mellan emotionsreglering och substansbruk användes korrelationsmatriser.  Resultatet visade att 64,3 % av deltagarna någon gång hade diagnostiserats med substansbrukssyndrom. Vidare hade 79.5 % av urvalet någon gång använt cannabis och hade i större utsträckning använt andra substanser jämfört med en generell svensk population. Studien fann inga signifikanta samband mellan emotionsreglering och substansbruk, vilket går emot tidigare forskning. Det motsägelsefulla resultatet kan bero på metodologiska skillnader och/eller att deltagarna hade andra gemensamma och inflytelserika erfarenheter i relation till emotionsreglering som påverkade resultatet. / Emotional regulation has in recent years gained more attention and support as a factor associated with substance use. However, to the authors knowledge, no research has examined the association between emotional regulation and substance use in a forensic psychiatric sample. The aims of this study were to describe substance use and examine associations between emotional regulation and substance use in a sample of forensic psychiatric patients. Participants (N = 98; 13% female) were recruited from a cohort of forensic psychiatric patients in Sweden from 2016-11-01 to 2020-11-30.  Data were collected through file information, self-reports and complemented with semi-structured interviews. The study used descriptive data to report the use of substances within the sample. Furthermore, the study used the instrument Difficulties in Emotional Regulation Scale (DERS) to examine the participants' emotional dysregulation. To measure substance use, the authors used age of onset of substance consumption and the number of substances tested as variables. Correlational matrices were used to explore the association between emotional regulation and substance use.  The results showed that 64.3% of the participants had at some point been diagnosed with SUD. Furthermore, 79.5 % of the sample had at some point used cannabis and had to a large extent used other substances. No significant associations were found between emotional regulation and substance use. The result goes against previous research, methodological differences may cause this contradiction. Another possible explanation is that the participants had other common and influential experiences in relation to emotional regulation that influenced the result.

The purpose of this study was to develop a medico-judicial framework for the rehabilitation of forensic psychiatric patients in Zimbabwe. The study used the grounded theory approach utilising a mixed sequential dominant status design. Purposive sampling of key stakeholders was the primary method and theoretical sampling became necessary as the study evolved in the qualitative phase. A confirmatory retrospective document review of 119 files of patients was done in the quantitative phase. Pierre Bourdieu’s conceptual canon of field, habitus and capital was utilised as the theoretical point of departure for the study. Findings and results showed dislocation and dissonance between and within the habitus of social fields the judiciary, health (medical) and the prison systems with an ensuing hysteretic effect that negatively affected the outcome of forensic psychiatric rehabilitation in special institutions in Zimbabwe. Forensic psychiatric patients were caught up in a double bind situation of aligning to both of the contradictory functions of the medical and the prison systems. The result of this hysteretic scenario seemed to breed some kind of rehabilitative schizophrenia. The developed medico-judicial framework is projected to transform the libido dominandi of the present into a widened scope of therapeutic jurisprudence. The medico-judicial framework is forwarding the forensic psychiatric practitioner to a new address since it has changed its residence from the special institution to the forensic psychiatric hospital. It is inviting the person involved with forensic psychiatric rehabilitation to begin again, inciting him or her to be open to the possibilities of mapping a path through the tangled growth of current realities into an increased width and depth of comprehensive forensic psychiatric practice that follows an empowering legislative prescript / Health Studies / D. Litt. et Phil. (Health Studies)