Working in forensic psychiatric care might be challenging in different ways due to that the patients are not there by their own volition and they also have a serious mental disease. This study aims to describe nurses experience of working in forensic care.  A qualitative descriptive design was adopted. The data were collected through interviews and were analyzed using a thematic content analysis. Participants in this study were eleven nurses in Sweden. Inclusion criteria for the study were registered nurses with or without specialist education in psychiatric care. They should have worked in the same location for at least six months and worked in a closed forensic care facility.  The result showed five main themes. The importance of being professional; The importance of building a trustful relationship; To care for patients with jurisdiction and with force; Challenges to handle and Lack of knowledge. One of the main findings was how the relationship between nurse and patient was built and what experience nurses have in different situations.  The findings showed that nurses in forensic care are exposed to many challenges in their work. To stay professional and at the same time be open can be difficult. The study showed that it is important with a good relationship with the patient. Participants highlighted the importance of being aware of the power they have and actively reflecting on how their power was used.

Bakgrund:Schizofreni är en psykossjukdom som orsakar lidande, lägre livskvalité och ökad risk för suicid. Att uppleva mening i tillvaron främjar psykisk hälsa och livskvalité samt kan vara en skyddsfaktor mot suicidalt beteende. Mening är ett existentiellt behov och anses vara gynnsamt för individens återhämtning. Det behövs mer kunskap om hur upplevelse av mening uttrycker sig hos personer med schizofreni. Syfte: Syftet var att beskriva hur upplevelse av mening tar sig uttryck hos personer med en schizofrenidiagnos. Metod:En kvalitativ systematisk litteraturöversikt valdes som metod. Fjorton kvalitativa artiklar inkluderades och analyserades med Braun & Clarkes mall för tematisk analys. Analysen gjordes i 6 steg och resulterade i 3 teman, med 2 tillhörande subteman var. Resultat:Trots närvaro av sjukdom och stort lidande framkommer det att personer med schizofreni upplever mening i sin vardag. Det finns även en strävan efter att leva meningsfullt. Uttryck för mening framträdde i tre huvudsakliga teman: mening genom sällskap, mening genom självkännedom samt mening genom andlighet och religion. Meningsfullhet visar sig genom både handlingar och upplevelser. Slutsats: Uttryck för mening hos personer med schizofreni framträdde i tre dimensioner som handlade om relationer till andra människor, sig själv, och till en högre makt. Kunskapen kan användas inom omvårdnad för att stödja personer med schizofreni i att skapa en meningsfull tillvaro. / Background: Schizophrenia is a psychotic disorder that causes suffering, lower quality of life and increased risk of suicide. Experiencing meaning in life promotes mental health, quality of life and can be a protective factor against suicidal behavior. Meaning is an existential need and is considered favorable for the individual's recovery. More knowledge is needed about how the experience of meaning is expressed in people with schizophrenia. Aim: The purpose was to describe how the experience of meaning is expressed in people with a schizophrenia diagnosis. Method: A qualitative systematic literature review was chosen as the method. Fourteen qualitative articles were included and analyzed as described by Braun & Clarke's template for thematic analysis. The analysis was done in 6 steps and resulted in 3 themes, with 2 associated sub themes each. Results: Despite the presence of illness and great suffering, it appears that people with schizophrenia experience meaning in their everyday lives. There is also a desire to live meaningfully. Expressions of meaning appeared in three main themes: meaning through company, meaning through self-knowledge, and meaning through spirituality and religion. Meaningfulness is shown through both actions and experiences. Conclusion: Expressions of meaning in people with schizophrenia appeared in three dimensions that were about relationships with other people, oneself, and a higher power. The knowledge can be used in nursing to support people with schizophrenia in creating a meaningful life.

Background: Person-centered care is one of the nurse's core competencies where the nurse's role is to enable the patient's care based on participation and self-determination. According to research, person-centered care has positive effects such as higher quality of life, reduced cost and satisfaction in both patients and care staff. Despite this, the implementation of personcentered care is slow, which is most often referred to various obstructive factors such as lack of time and shortcomings in the work environment. Aim: The aim of the study was to investigate how nurses describe their experiences of person-centered care in psychiatric outpatient care. Method: The study was done with a qualitative design and the data collection took place through semi-structured interviews of eleven nurses at a psychiatric outpatient clinic. These interviews analyzed by inductive content analysis. Results: The overall category Person-centered care - opportunities and challenges shows that nurses' experiences of person-centered care are complex. The results of this study are presented through four subcategories. 1. With patient in focus. 2. Collaboration as a prerequisite for Participation. 3.To adapt and strive for good communication. 4. Organizational work and knowledge. Conclusion: Joint responsibility is required to provide person-centered care. Nurses cannot provide person-centered care on their own, but greater organizational change work is needed. On the other hand, specialist nurses in psychiatric care, with their in-depth care scientific knowledge, must be able to lead the nursing work based on the person-centered approach. Suggestions for further research: This study is important as it sheds light on knowledgegaps based on the nurses' previous experiences, while at the same time it sheds light on the specialist nurse's opportunities to develop person-centered care. Finally, more knowledge is requested in person-centered care, including communication, collaboration, participation and documentation with a focus on care plans.

Submitted in fulfillment of requirements for the Degree of Master of Technology: Nursing, Durban University of Technology, Durban, South Africa, 2015. / Introducion Mental health nurses face challenging positions in practice. They are required to support and care for people hospitalised for treatment of mental illnesses on their recovery journeys but are also expected to manage ward administrative tasks, admit patients, attend meetings, dispense medication and communicate with patients (Gunasekara, Pentland, Rodgers and Patterson 2014: 101; Fourie, Mc Donald, Connor and Bartlett 2005: 135). It has been suggested that mental health nurses spend more time managing the ward environment and staff matters resulting in little time to develop and maintain therapeutic patient relationships (Fourie et al. 2005: 135). Problem Statement Research conducted in other countries identified the roles of the psychiatric nurse and mental health care nurses as attending to patients’ basic needs, assistance with self-care activities, monitoring and administering medication, ensuring safe environments in the health care setting and health education (Rungapadiachy, Madill and Gough 2004; Bowers 2005; Seed, Torkelson and Alnatour 2010). Although there is evidence of studies in psychiatric and mental health nursing locally, little is known about the roles of registered nurses and psychiatric nurses at in-patient facilities. OBJECTIVES • To explore which mental health problems are most commonly seen amongst psychiatric patients at these facilities. • To investigate the challenges faced by psychiatric nurses when caring for psychiatric patients. • To investigate what specialized knowledge and skills are required when nursing such patients. • To investigate whether their education and training prepared them adequately to deal with psychiatric patients and suggest guidelines to strengthen nursing education. METHODOLOGY The study utilized a quantitative non-experimental descriptive design to survey registered nurses and psychiatric nurses at in-patient psychiatric facilities in KwaZulu-Natal. A census was utilized in this study as the entire population was sampled. Data were collected using survey questionnaires. Phase two of the study, qualitative content analysis of Psychiatric nursing curricula strengthened the survey findings. FINDINGS Findings of this study showed that 98.4% of respondents believe psychiatric nursing care is an important aspect of holistic nursing practice. Respondents agree that challenges are commonly encountered in psychiatric nursing practice and that they are prepared to deal with these patients. However the aspects most frequently identified as needing greater attention in the Psychiatric nursing curricula were The Mental Health Care Act no 17 of 2002 and practical management of aggression, violence and de-escalation / M

by Ng Tin-fu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 79-85). / Abstract also in Chinese. / ACKNOWLEDGMENTS --- p.i / ABSTRACT --- p.ii / ABSTRACT (CHINESE VERSION) --- p.iv / TABLE OF CONTENTS --- p.vi / LIST OF TABLES --- p.viii / LIST OF APPENDICES --- p.ix / Chapter CHAPTER 1 --- INTRODUCTION / Background of the study --- p.1 / Purpose of the study --- p.3 / Chapter CHAPTER 2 --- LITERATURE REVIEW / Introduction --- p.4 / The concept of case management --- p.5 / The definition of case management --- p.5 / Outcome evaluation of case management --- p.7 / Case management models --- p.11 / The application of case management in CPNS --- p.14 / Who should be the case managers --- p.16 / Qualifications of case managers --- p.17 / "The roles, functions and work practices of case managers" --- p.18 / Difficulties encountered by case managers --- p.20 / Perceptions of case managers towards case management --- p.22 / Summary --- p.25 / Chapter CHAPTER 3 --- METHODOLOGY / Introduction --- p.27 / Objectives of the study --- p.27 / Context of the study --- p.28 / Operational definitions --- p.28 / Methodology --- p.29 / Sampling --- p.31 / Data collection --- p.32 / Gaining assess to the field --- p.36 / Ethical consideration --- p.37 / Pre-pilot preparation --- p.38 / Pilot study --- p.38 / Data analysis --- p.39 / Issues of validity and reliability --- p.42 / Chapter CHAPTER 4 --- RESULT AND DISCUSSION / Introduction --- p.45 / Description of the community psychiatric nursing service under this study --- p.46 / Demographic characteristics of case managers --- p.47 / "The roles, functions and work practices of case managers" --- p.49 / Difficulties perceived by case managers --- p.62 / Perception of case managers towards case management --- p.66 / Summary --- p.69 / Chapter CHAPTER 5 --- Conclusions / Limitation of the study --- p.71 / Implication for nursing practice --- p.72 / Recommendation for further research --- p.76 / Conclusions --- p.77 / REFERENCES --- p.79

D.Cur. / South Africa is currently undergoing radical transformational changes in all facets of its society. This is an era immediately following the first democratic elections in the country. The new Government, the Government of National Unity (GNU) which is dominated by the African National Congress (ANC), has introduced what is known as the Reconstruction and Development Programme (RDP)(ANC, 1994), which seeks to redress disparities of the past. This programme has significant social, political and economical implications for the South African community. It proposes that statutory bodies and institutions should be rationalized and restructured to reflect the diversity of the South African people and should be better able to promote and protect the standards of health care and training. It aims to, inter alia, promote mental health and to increase the accessibility, quality and quantity of mental health support and counselling services. In line with this goal and based on problems that arise because of anxieties and fears that are inherent in change, the mental health of nurse educators and nursing students of a selected nursing college was investigated utilizing a qualitative, theory – generative design which is exploratory, descriptive and contextual in nature. The study was conducted in two phases. In Phase 1, in-depth phenomenological interviews were conducted individually with ten nurse educators and nine nursing students to explore and describe their experience of interaction with one another. Follow-up interviews were also conducted with some of the participants. Data was analysed using Tesch's method. Based on the results of the analysis, the major concept, understanding was identified as the essence of a model for constructive nurse educator - student interaction envisaged. In Phase 2, a theory -generative design was utilized to develop a constructive nurse educator - student interaction model, founded on a mental health approach. The identified concept was examined in existing writings to determine essential criteria of the concept. In addition, a model case was written in which the concept was constructed to the best of the researcher's understanding. Essential criteria of the concept were identified and a concept map was drawn to depict the essential criteria in relation to each other. The related concepts were identified and portrayed in a structural form. The visual model depicts nurse educators and nursing students who function as a family, as the recipients of activity, and the advanced psychiatric nurse practitioner, who facilitates their interaction, as the agent. By utilizing the deductive reasoning strategy, relationship statements were inferred from the model. Guidelines were described for the advanced psychiatric nurse practitioner with regard to all three phases, namely, the Interaction Initiation Phase, the Interaction Cohesiveness Phase and the Interaction Dissolution Phase, in terms of objectives, strategies and proposed activities.

Bakgrund: Sjuksköterskor inom psykiatrisk vård kommer dagligen i kontakt med suicidnära patienter och är delaktiga i det suicidpreventiva arbetet. Studier beskriver att sjuksköterskor kan använda sig av sin kunskap, erfarenhet och intuition för att upptäcka att en patient är suicidal. Suicidavsikt kan kommuniceras icke verbalt genom subtila tecken, som kan uppfattas av sjuksköterskan. Syfte: Syftet med studien är att beskriva sjuksköterskors erfarenheter av den icke verbala kommunikationen inför ett suicid, för att öka medvetenheten om och förståelsen av detta fenomen vid suicidprevention. Metod: Kvalitativ metod med fenomenologisk hermeneutisk ansats har använts. Sju sjuksköterskor verksamma inom psykiatrisk vård intervjuades om sina erfarenheter av det studerade fenomenet, där intervjumetoden var narrativ och ostrukturerad till sin form. Resultat: Sjuksköterskornas erfarenheter av fenomenet presenteras i sex teman: Att se en förändring hos patienten, Att uppleva patienten som svårtolkad, Att känna patientens existentiella ångest, Att förstå patienten utifrån en helhetssyn, Att se patienten få insikt samt Att uppfatta att patienten gör ett avslut. I den tolkade helhetsförståelsen ger teorier om suicid en djupare förståelse för fenomenet som beskrivs i temana. Konklusion: Sjuksköterskor inom psykiatrisk vård kan uppfatta och tolka icke verbala budskap från patienter som är suicidnära och de kan använda denna kunskap som ett komplement till en suicidbedömning.

I dagens samhälle bemöts patienter med psykisk ohälsa och beroende-problematik inom psykiatriskvård inte alltid med respekt. Syftet med studien var att beskriva sjuksköterskors erfarenheter av att bemöta personer med psykisk ohälsa och beroendeproblematik inom psykaitrisk vård. Tio sjuksköterskor inom sluten-och öppenpsykaitrisk vård deltog. Data samlades in genom narrativa intervjuer. Materialet analyserades med hjälp avkvalitativ innehållsanalys. Sjuksköterskorna beskrev hinder och möjligheter i bemötandet av personer med psykisk ohälsa och beroendeproblematik. Hinderför ett gott bemötande var krävande patienter, osäkerhet och brister i verksamheten. Möjligheter för ett gott bemötande var relationsarbete och trygghet. Sjuksköterskorna upplevde att det var en svår patientgrupp att möta samtidigt som mycket kunskap saknades angående beroendeproblematik. Sjuksköterskorna kunde känna sig psykiskt påverkade av arbetet och en stor osäkerhet fanns gällande bedömningar och omvårdnad. Trots svårigheterna att möta patienter med beroendeproblematik beskrevs arbetet som intressant, utmanande och ett privilegium. Trygghet beskrevs öka med erfarenhet och med bra samarbete och stöd från kollegorna. Om inte sjuksköterskors kunskap angående beroendeproblematik tillgodoses och ökas finns en risk för allvarliga brister inom den psykiatriska vården.

Within the framework of ethnography, an inquiry was made into the many dimensions of psychological treatment and training in a psychiatric hospital, with particular reference to State Patients. Ethnography is the study of an intact cultural or social group based mainly on observations over a prolonged period of time in which the researcher is a participant. The multicultural aspects of the therapeutic community were also inquired into. Ethnographic data was collected and processed over a period of 16 years in three psychiatric hospitals, the main source of data gathered from Weskoppies Hospital in Pretoria. The ecosystemic psychotherapeutic perspective was used as a meta-model to describe eight therapeutic approaches in which intern-psychologists were trained. The hospital is described as a therapeutic community in which rehabilitation is a multi-professional responsibility. Each profession, or sub-culture, has its own framework and culture in which it works within the broader system of the psychiatric hospital. Ethical considerations and recommendations are levelled at the academic and practical aspects of clinical psychology, hospital management, and different levels of government. / Psychology / D.Litt. et Phil.

Introduktion: Sjuksköterskor inom somatisk vård möter och vårdar vid ett antal tillfällen per år patienter med diagnosen anorexia nervosa. Anorexia nervosa är en allvarlig sjukdom med hög dödlighet. Diagnosen påverkar både patientens somatiska och psykiatriska status. Patienter med diagnosen anorexia nervosa beskriver ett omvårdnadsbehov ur både ett somatiskt- och psykiatriskt omvårdnadsperspektiv. En framgångsrik allians är viktig för att vård och behandling ska kunna uppnås och upprätthållas. Sjuksköterskor inom somatisk vård upplever flera utmaningar i mötet med patientgruppen, däribland fördjupad förståelse för sjukdomens komplexitet. Syfte: Att undersöka hur sjuksköterskor inom somatisk vård upplever omvårdnaden i förhållande till patienter med diagnosen anorexia nervosa. Metod: Intervjustudie med kvalitativ ansats samt ett induktivt förhållningssätt. Studien bygger på åtta semistrukturerade intervjuer med sjuksköterskor på en somatisk vårdavdelning. Tematisk analys användes för analys av intervjuerna. Resultat: Dataanalysen resulterade i tre övergripande teman: Sjuksköterskan och anorexi, Komplex somatisk omvårdnad samt Ropet efter psykiatrin. Sjuksköterskorna upplevde svårigheter som starka känslor, bristande vårdstruktur och otillräcklig kunskap om diagnosen anorexia nervosa i omvårdnadsarbetet med patientgruppen. Sjuksköterskorna önskade handledning och utbildning om sjukdomens komplexitet samt ett förbättrat samarbete mellan somatiken och psykiatrin. Slutsats: Sjuksköterskor inom somatisk vård upplevde flera svårigheter i mötet med patienter med diagnosen anorexia nervosa. Brist på tid, omvårdnadsstruktur och fördjupad kunskap om sjukdomen upplevdes försvåra möjligheterna till god kommunikation och allians med patientgruppen. Stöd, kunskap och ett välfungerande samarbete med psykiatrin ansågs kunna förbättra och utveckla omvårdnadsarbetet på den somatiska avdelningen för patienter med diagnosen anorexia nervosa. / Introduction: Nurses working in an acute medical care setting sometimes participate in the treatment of patients diagnosed with anorexia nervosa. Anorexia nervosa is a serious disease with a high mortality-rate. The disease affects the body as well as the mind. Patients diagnosed with anorexia nervosa describe nurses' lack of knowledge about the diagnosis. Nurses in medical care settings describe several challenges in the nursing process involving patients diagnosed with anorexia nervosa. Purpose: To examine the experiences of nurses working in an acute medical care setting when treating and nursing patients diagnosed with anorexia nervosa. Method: A qualitative interview study. Semi-structured interviews were conducted with eight nurses working in an acute medical care setting. The text material was analyzed with thematic analysis. Results: The nurses experienced strong feelings when nursing patients diagnosed with anorexia nervosa. The nurses described unclear treatment structures and insufficient knowledge about the diagnosis. A well-established cooperation with the psychiatric unit as well as improved knowledge about the diagnosis were described as requirements in order to offer the patients advanced nursing. Conclusion: Nurses in a medical care unit experienced several challenges when nursing patients with anorexia nervosa. The nurses described a constant lack of time, unclear treatment structures and insufficient knowledge about the diagnosis. Tutorials, education and cooperation with the psychiatric unit could support nurses in medical health units to improve in order to understand the complex needs of patients diagnosed with anorexia nervosa.