Bakgrund: Specialistsjuksköterskans kompetens är en fördjupning av de kunskaper och förmågor som erhållits i grundutbildningen. Behovet av specialiserade sjuksköterskor ökar men då arbets-uppgifterna mellan grund- och specialistutbildade sjuksköterskor inte skiljer sig nämnvärt åt kan detta få till följd att specialistsjuksköterskorna lämnar det kliniska arbetet. Den specialistkompetens som efterfrågats riskerar därmed att försvinna. På denna grund, och som ett led i att förtydliga specialistsjuksköterskans roll i psykiatrisk slutenvård, är det av intresse att uppmärksamma hur specialistsjuksköterskan uppfattas och vilka förväntningar som finns på dennes kompetens. Syfte: att beskriva läkares uppfattningar av specialistsjuksköterskans kompetens i psykiatrisk vård. Metod: Åtta kvalitativa semistrukturerade intervjuer analyserades med en fenomenografisk ansats. Resultat: Huvudresultaten sammanfattades i fem kategorier: Specialistsjuksköterskans roll är otydlig och osynlig; Specialistsjuksköterskan utför särskilda arbetsuppgifter; Specialistsjuk-sköterskan besitter fördjupad kompetens; Specialistkompetens leder till personlig utveckling samt Specialistsjuksköterskan är en ambassadör. Slutsats: Det behövs en ökad förståelse för specialist-sjuksköterskans kompetens. För att detta ska kunna ske efterfrågas en tydligare beskrivning av vad det innebär att arbeta som specialistsjuksköterska på en psykiatrisk slutenvårdsavdelning. / Background: The competence of the specialised nurse is a development of the knowledge and skill obtained in the elementary nursing education. The need for specialised nurses increases but as the work tasks of specialised and general nurses do not differ considerably, this may lead to the specialised nurses leaving the clinical area of work. The requested expertise will then be at risk of disappearing. On these grounds and as a way of clarifying the role of the specialised nurse in psychiatric in-patient care, it is of interest to observe how the specialised nurse is perceived and what the expectations of her competence are. Aim: to describe doctors' conceptions of the competence of the specialised nurse in psychiatric in-patient care. Method: Eight qualitative semi-structured interviews were analysed using a phenomenographic approach. Results: The main findings were summarised in five categories: The role of the specialised nurse is unclear and unseen; The specialised nurse executes special tasks; The specialised nurse possesses in-depth competence; Specialist skill leads to personal development and finally The specialised nurse is an ambassador. Conclusion: There is a need for an increased understanding of the competence of the specialised nurse in psychiatric in-patient care. In order for this to happen a clearer descripton of what it entails to work as a specialised nurse in in-patient care is requested.

The prevalence of mental health disorders in the United States is estimated at 1 in 5 persons in any given year, with a lifetime prevalence of approximately 50% (National Institute of Mental Health, 2016a, 2016b). Despite scientific progress towards effective behavioral and psychopharmacological treatment, nearly 50% of Americans with mental illness do not receive treatment (Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). This project will identify key geographical and logistical factors restricting recruitment and retention of psychiatric providers (MD or NP) for an underserved region in California. The results of the study will be used to develop a model for effective partnerships aimed at a “grow your own” approach to addressing the shortage of psychiatric providers. In California, the Mental Health Services Act (MHSA) was approved by the voters as Proposition 63 in 2004, funding expansion of mental health resources and specifically, workforce development (California Department of Health Care Services [DHCS], 2017). National funding also supports the expansion of PMHNP training and capacity through Health Resources and Service Administration (HRSA) and SAMHSA. Despite administrative and funding resources from MHSA and HRSA, the shortage of psychiatric providers continues in rural and remote areas. While few national studies have included nurse practitioners in the findings, a growing body of evidence suggests that nurse practitioners can serve similar if not the same function as physician colleagues (DiCicco-Bloom & Cunningham, 2014; National Governors Association, 2012; Newhouse et al, 2011). Barriers to mental health services in rural communities include challenges around a) availability, b) accessibility, c) affordability, and d) acceptability (Wilson, Bangs, & Hatting, 2015). Using a descriptive design, this project explores these factors necessary for patient access to psychiatric services in rural areas. A logic model is used to create a summary of the findings, which will be used to propose a clinical training partnership between an urban university-based PMHNP education and a rural clinic-based training to be completed upon conclusion of the project.

Public health concerns were prominent during the COVID-19 pandemic, particularly regarding rising cases of anxiety and depression among adults. U.S. healthcare providers were especially affected by the unrelenting demands on their time and service. Psychiatric Mental Health Nurse Practitioners (PMHNPs) provided patient care during the pandemic to meet the increasing need for mental health services as people began experiencing mood disturbances such as anxiety, depression, and grief. The purpose of this qualitative study was to explore the perceived effect of the COVID-19 pandemic on the mental health of PMHNPs. A qualitative design using the interpretive description method allows researchers to use pre-existing knowledge to inform their research and actively participate in knowledge synthesis, focusing on variations in data. Individual interviews with 18 PMHNPs were conducted via video teleconferencing, and their data were evaluated and interpreted for meaning. After a thorough analysis of the interview transcripts, nine themes were identified: adaptive coping, improved access, support, self-care, work strain, complications, maladaptive coping, pandemic strain, and polarization. This study illuminated the challenges PMHNPs faced during the pandemic and the strategies they employed to cope with difficulties and will inform future research and practice in mental health care.

Depression påverkar den äldre personens hela livssituation då tillståndet medför ett stort lidande och sänkt livskvalité. Psykiatrisk hälso- och sjukvård har ett huvudsakligt fokus på att reducera symtom vid depression som riskerar att förstärka den äldre personens upplevelse av maktlöshet. Specialistsjuksköterskans omvårdnad beaktar hela livssituationen och avser att stärka individens egen förmåga att uppnå och bibehålla hälsa. Syftet var att beskriva specialistsjuksköterskans erfarenheter av omvårdnad vid depression hos äldre personer inom psykiatrisk vård. Kvalitativ metod med induktiv ansats där tio semistrukturerade intervjuer med specialistsjuksköterskorgenomfördes. Data analyserades med kvalitativ innehållsanalys. I resultatet framkom kategorierna ”Värdet av att beakta den äldre personens levnadsberättelse”, ”Betydelsen av att understödja den äldre personens vardagsfunktion” och ” Vikten av att stimulera den äldre personens sociala samvaro”. Levnadsberättelsen skaparförutsättningar för en omvårdnad som är utformad utifrån den äldre personens individuella behov och önskemål. Hälsosamma vardagsrutiner och att vara inkluderad i ett socialt sammanhang kan stärka den äldre personens känsla av att ha kontroll över sin livssituation. För att psykiatrisk hälso- och sjukvård ska kunna främja en god hälsa hos äldre personer behöver specialistsjuksköterskan ta ett större ansvar för vården som helhet. Fortsatt forskning inriktad på äldre personers upplevelser vid depression behövs för att utveckla omvårdnaden ytterligare. / Depression affects the elderly person's entire life situation as the condition causesgreat suffering and reduced quality of life. Psychiatric health care has a main focus onreducing symptoms of depression that risk reinforcing the elderly person's experienceof powerlessness. Master level mental health nurse ́s takes into account the entire lifesituation and intends to strengthen the individual's own ability to achieve andmaintain health. The purpose was to describe the master level mental health nurse'sexperiences of nursing in depression in the elderly. Qualitative method with inductivean approach where ten semi-structured interviews with master level mental healthnurses in psychiatric care were conducted. Data were analyzed with qualitativecontent analysis. The results showed the categories "The value of considering theelderly person's life story", "The importance of supporting the elderly person'severyday function" and "The importance of stimulate the elderly person's socialinteraction". The life story creates the conditions for a care that is designed based onthe elderly person's individual needs and wishes. Healthy daily routines and beingincluded in a social context can strengthen the elderly person's sense of having controlover their life situation. In order for psychiatric health care to be able to promote goodhealth in the elderly, the master level mental health nurse's need to take a largerresponsibility for the care as a whole. Continued research focused on elderly people'sexperiences of depression is needed to further develop nursing.

Bakgrund: Stigmatisering, negativa attityder och diskriminering av patienter med psykisk ohälsa är vanligt förekommande både i samhället och i vården. En konsekvens av stigmatisering vid psykisk ohälsa är att många patienter inte söker vård. Negativa attityder hindrar återhämtning och medför att patienten med psykisk ohälsa riskerar att få sämre behandling för sina somatiska sjukdomar. Hälso- och sjukvården har en betydelsefull roll för att minska stigmatiseringen. Specialistsjuksköterskan i psykiatrisk vård ska främja återhämtningen hos patienter med psykisk ohälsa. Attityder till patienter med psykisk ohälsa beskrivs vara en betydande faktor i psykiatrisk omvårdnad. Syfte: Syftet med studien var att belysa faktorer som påverkar attityder till patienter med psykisk ohälsa hos specialistsjuksköterskan i psykiatrisk vård. Metod: Studien genomfördes som en systematisk litteraturstudie baserad på 11 kvantitativa artiklar och data extraherades, syntetiserades och summerades. Resultat: Resultatet presenterades i fyra huvudkategorier; patientens diagnos, sjuksköterskans personliga erfarenheter, sjuksköterskans utbildning och arbetsplatsens kulturella påverkan. Konklusion: Specialistsjuksköterskan i psykiatrisk vård har generellt en mer positiv attityd gentemot patienter med psykisk ohälsa jämfört med grundutbildade sjuksköterskor. Specialistsjuksköterskans personliga erfarenheter så som arbetslivserfarenhet, civilstånd och erfarenhet av att ha släktingar eller vänner med psykisk ohälsa genererar mer positiva attityder till psykisk ohälsa. Utbildning synes vara en väsentlig faktor då specialistsjuksköterskor i psykiatrisk vård generellt har en mer positiv attityd till patienter med psykisk ohälsa. / Background: Stigma, negative attitudes, and discrimination against patients with mental illness are common both in society and globally. A consequence of stigmatization in mental illness is that many patients do not seek care. Negative attitudes hinder recovery and mean that patients with mental illness risk receiving worse treatment for their somatic illnesses. Health care has an important role to play in reducing stigma. The specialist nurse in psychiatric care must promote the recovery of patients with mental illness. Attitudes towards patients with mental illness are described as an influential factor in psychiatric nursing. Aim: The purpose of the study was to highlight which factors influence psychiatric nurses' attitudes towards patients with mental illness. Method: The study was conducted as a systematic literature study based on 11 quantitative articles and data were extracted, synthesized, and summarized. Results: The results were presented in four main categories; the patient's diagnosis, the nurse's personal experiences, the nurse's education, and workplace cultural influences. Conclusion: Specialist nurses in psychiatric care generally have a more positive attitude towards patients with mental illness compared to nurses with basic training. The specialist nurse's personal experiences such as work experience, marital status, and experience of having relatives or friends with mental illness generate more positive attitudes. Education seems to be a significant factor as specialist nurses with education in psychiatric nursing generally have a more positive attitude to patients with mental illness.

Bakgrund: Tidigare forskning visar att patienter som kommer i kontakt med psykiatrin eftersuicidförsök ofta upplever känslor av skam och rädsla. Det första mötet med sjuksköterskan är ofta avgörande för hur vårdtiden av patienten utvecklas. Upplever patienten sig inte tagen på allvar, sedd eller hörd kan detta leda till flyktkänslor eller att man drar sig undan. Syfte: Syftet med studien är att utifrån vetenskaplig litteratur beskriva patienter och sjuksköterskors upplevelser av att få samt ge vård efter ett suicidförsök. Metod: Kvalitativ forskningsöversikt inkluderat åtta vetenskapliga studier från databaserna CINAHL och PsychINFO. Data har analyserats med stöd av Evans fyrstegsanalys. Resultat: Resultatet visar att patienter har ett behov att känna sig tagna på allvar för att lindra lidande. Resultatet visar även att sjuksköterskan upplever svårigheter i mötet med den suicidala patienten. Sjuksköterskans bemötande och engagemang i patienten har en central roll för patientens möte med psykiatrisk vård efter ett suicidförsök. Diskussion: Mötet mellan patienten och sjuksköterskan avspeglar sig i sjuksköterskans bemötande och engagemang i patienten, genom att ta patienten på allvar kan lidande lindras och patientens välbefinnande kan ökas. Genom engagemang stöttas patienten och genom eliminering av negativa upplevda känslor kan sjuksköterskan nå patienten på ett sätt som gör att patienten kan inspireras att förändra sin livssituation. / Background: Previous researches shows patients who come in contact with a psychiatric ward after suicide attempt often experience feelings of shame and fear. The first meeting is determined by how the time at the ward develops. If a patient experience not being taken seriously or heard it usually leads to feelings of escaping or withdrawing. Aim: The purpose of the study is based on scientific literature describing patients and nurses' experiences in receiving and providing care after a suicide attempt. Method: Qualitative research review included eight scientific studies from the databases CINAHL and PsychINFO. Data were analyzed with the aid of Evans four steps analysis. Results: The results show that patients have a need to feel that they are being taken seriously in order to alleviate suffering. The result also shows that nurses are experiencing difficulties in meeting with the suicidal patient. The nurse's attitude and commitment to the patient has a central role in the patient's encounter with psychiatric care after a suicide attempt. Discussion: The meeting between the patient and the nurse is reflected in the nurse's attitude and commitment to the patient, by taking the patient seriously suffering can be alleviated and the patient's well being can be increased. Through dedication supported the patient and by the elimination of negative emotions experienced nurse can reach the patient in a way that allows a patient to be inspired to change their lives.

Bakgrund: Patienter med emotionell instabil personlighetsstörning (EIPS) innebär en stor utmaning för den psykiatriska heldygnsvården. Specialistsjuksköterskorna upplever patienter med EIPS som påfrestande och svårare att vårda än andra patienter. Det innebär en utmaning inte bara för specialistsjuksköterskorna i deras yrke utan också för deras känslomässiga välbefinnande, vilket har en negativ inverkan på kvaliteten på den vård som ges. Syfte: Syftet med studien var att undersöka specialistsjuksköterskors copingstrategier för att vårda patienter med emotionell instabil personlighetsstörning inom psykiatrisk heldygnsvård.    Metod: Kvalitativ metod med induktiv ansats. Data samlades in genom 10 semistrukturerade intervjuer. Intervjuerna analyserades med hjälp av Burnards innehållsanalys. Resultat: Resultatet visar att specialistsjuksköterskorna använder sig av flertalet copingstrategier. Analysen resulterade i två kategorier och fem subkategorier. Kategorierna var: använda kunskap som stöd samt söka stöd hos kollegor. Subkategorierna presenteras under: att avleda, finna acceptans, finna trygghet i sin professionella roll; bekräftelse från kollegor och lämna över till kollegor.   Slutsats: Copingstrategierna hjälpte specialistsjuksköterskorna i vården av patienter med EIPS och visade sig vara viktiga för att bibehålla deras psykiska hälsa och fortsätta vårda patienterna. Resultatet antyder att copingstrategier spelar en viktig roll i specialistsjuksköterskornas yrkesutövning och att ämnet behöver lyftas fram. Mer utbildning om självkännedom och copingstrategier kan ge specialistsjuksköterskorna ytterliga redskap i att applicera fungerande strategier. / Background: Patients suffering from borderline personality disorder constitutes a great challenge to the psychiatric inpatient care. Mental health nurses experience these patients as more difficult to attend to than other patients. This imposes a challenge not only to the nurses in their profession but also to their emotional wellness thus imposing a negative influence on the quality of the care given.         Aim: The aim of this study was to examine the coping strategies used by the mental health nurse to care for patients suffering from borderline personality disorder within the realms of the psychiatric inpatient care. Method: Qualitative method with an inductive approach. Data was collected through 10 semi-structured interviews processed with the aid of Burnards method of content analysis. Result: The result shows a varied set of coping strategies used by the mental health nurses. The analysis resulted in two main categories and five subcategories. The main categories consist of: Seeking support in knowledge and seeking support from colleagues. The subcategories are presented under: to divert, to find acceptance, to find comfort in their professional role, confirmation from colleagues and tox§x     hand over tasks to colleagues.    Conclusion: Coping strategies helped the mental health nurses in their care of patients with borderline personality disorder and proved to be important to maintain their mental health and ability to provide care. The result implies that coping strategies play an important role in the professional practice of mental health nurses and needs to be emphasized. More education on self-awareness can provide mental health nurses with additional tools to apply effective strategies.

Registered nurses and registered psychiatric nurses are members of multidisciplinary mental health teams that address the assessment and treatment of vulnerable youth. The phenomenon of interest for this study is nursing's distinct contribution to a multidisciplinary team in this clinical domain. An interpretive description drawing on the perspectives of seven nurses and seven clinicians from the professions of psychiatry, psychology, social work, child and youth care, and registered clinical counselling provides insight into understanding nursing's distinct contribution (NDC) to multidisciplinary mental health teams that serve vulnerable youth (MMHTSVY). Six major themes and multiple subthemes were inductively derived. The findings make explicit nursing’s contribution to MMHTSVY in ways that are meaningful to the clinical practice. / Graduate