Bakgrund: Kunskapen om sjuksköterskans roll i psykiatrisk vård ur ett historiskt perspektiv, är begränsad. Beskrivningen av den psykiatriska omvårdnaden är sparsam, det är därför viktigt att belysa sjuksköterskans omvårdnadsroll i den psykiatrihistoriska utvecklingen i Sverige. Syfte: Att ur ett historiskt perspektiv beskriva psykiatrisk omvårdnad och sjuksköterskans roll i psykiatrisk vård. Design: Deskriptiv litteraturstudie med kvalitativ ansats Metod: Litteratur i form av akademiska avhandlingar, antologier och läroböcker som identifierats via universitetsbiblioteks katalogen Disa. Insamlad data har analyserats med kvalitativ innehållsanalys. Resultat: På medeltiden ansågs sjukdomen som en förtrollning. Fram till 1800- talet var det prästen som behandlade de psykiskt sjuka. På 1800- talet kom de första centralhospitalen och det var diakonnisor som tog hand om patienterna.1900- talet första hälft arbetade sjuksköterskorna i en ledande befattningar. I mitten av 1900- talet inleddes en ny era i den psykiatriska vården genom inträdandet av psykofarmakan. Sjuksköterskor beskriver sitt arbete att vårda patienterna  som en moder och känslor av hjälplöshet. Slutsats: Omvårdnad av personer med psykisk ohälsa har under århundraden till stor del bedrivits isolerad från övriga samhället. Målet med vården har främst varit att få patienter lugna. Sjuksköterskerollen har befunnit sig i en underordnad ställning gentemot läkare men sjuksköterskorna har varit starka företrädare för vårdavdelningar, ibland i strid med manliga föreståndare utan sjuksköterskeutbildning. Sjuksköterskans roll har upplevts med inslag av att vara värdinna/moder till hjälplöshet av inte kunna hjälp personer med psykisk ohälsa. / Background: The knowledge of psychiatric nurses’ role in psychiatric care is from a historical perspective is limited. The description of the psychiatric nursing is modestly described, and therefore it is important to elucidate the caring role of the psychiatric nurse through the psychiatric history development in Sweden. Aim: From a historical perspective, describe psychiatric nursing and the psychiatric nurses’ role in psychiatric care. Design: A descriptive literature study with a qualitative approach. Method: Literature like thesis, anthologies, text-books have been identified via the university library catalogue Disa. Collected data have been analyzed with a qualitative content analysis. Results: During the middle Ages, mental illnesses were seen as an enchantment. Up to the 18th century it was the priest who treated the mentally ill. In the 18th hundred century the first central hospitals arrived and deaconess worked at these hospitals. The first half of the 19th century the nurses worked in leading positions. During the middle of 19th century a new era began in the psychiatric care when the new antipsychotic medicines arrived. Nurses describe their work, as being like a mother to their patients and the sensations of insecurity. Conclusion: The caring of persons with mental diseases has during centuries been isolated from the rest of society. The purpose of caring has been to calm the patients. The nursing role has been in a subordinated position towards the doctors. In addition, the nurses have been strong upholders for the wards, sometimes in conflict with male staff managers without nursing education. The nursing role has been experienced with elements of to be hostess/mother and experiences of to be helpless when not being able to help persons with mental illness.

No description available.

The purpose of this study was to design and implement the two phases of a three-phased approach to the integration of the psychiatric component into the PHC system in the Eastern Cape. The study included an educational approach in which the PHC nurses were trained to diagnose, treat and rehabilitate psychiatric patients. Case studies and surveys were used to collect data. A sample of six clinics in which twenty registered nurses were trained was conveniently selected. Nurses had to volunteer so that 50% of the registered nurses would take part in the study. Each clinic was seen as a case in which a record review and questionnaires were used to collect data. The data revealed that, given the training in the diagnosis, treatment and rehabilitation, nurses could provide the first line of psychiatric care efficiently if there is a backup support from a team of consultants at the secondary health services and a support and supervision from an advanced psychiatric nurse. / Thesis (Ph.D.)-University of Natal, Durban, 1996.

Bakgrund: Rapporter och studier belyser utvecklingsbehovet inom hälso- och sjukvården avseende salutogena förhållningssätt. Få systematiska hälsofrämjande arbetsmetoder existerar samt att ett helhetsperspektiv där den enskilde patientens resurser tillgodoses, bör vara centralt. Denna studie avser att skapa ökad kunskap om hur arbetet med patientens resurser ser ut. Syfte: Syftet var att undersöka hur specialistsjuksköterskan i psykiatrisk vård identifierar, värderar och använder sig av resurser hos patienter med psykisk ohälsa. Metod: Kvalitativ design valdes för att ge svar på syftet. Datainsamlingsmetoden var intervju där sex specialistsjuksköterskor inom psykiatrisk vård deltog. Forskningsfrågorna besvarades via frågor av öppen karaktär. Datamaterialet analyserades enligt kvalitativ innehållsanalys, induktiv ansats. Resultat: Informanterna beskrev att patientens resurser identifierades i alliansskapande möten, kartläggande samtal samt motiverande samtal. Vad informanterna värderade som resurser resulterade i kategorierna interna respektive externa resurser. Exempel på betydelsefulla resurser är att ha ett socialt nätverk, att ha insikt över sin situation samt motivation att göra förändringar i sin tillvaro. Att formulera resursdiagnoser och att interagera dem med åtgärderna i omvårdnadsplanen, beskrevs som ett effektivt verktyg för att förvalta patientens resurser. Samtliga informanter upplevde påtagliga förbättringsområden avseende resurshanteringen, till exempel saknades ett gemensamt språk angående hur resurser skall tillvaratas, arbetet upplevdes alltför probleminriktat samt önskades ett processmässigt tankesätt istället för att endast det akuta åtgärdas. Diskussion: Studiens resultat diskuterades gentemot Antonovskys salutogena perspektiv, vilken understryker vikten av att se det friska hos patienten och vilka resurser som bidrar till hälsa. Flera studier lyfter fram att det salutogena perspektivet och begreppet KASAM kan användas i praktiken samt ha betydelse i återhämningsprocessen mot psykisk hälsa. / Background: Studies show a need for development in mental health service for salutogenic approaches. Few systematic health promoting activities exist and a holistic perspective, where the patient’s individual resources are catered, should be the focus. This study intends to provide a better knowledge of how the work with the patient’s resources look like. Aim: The aim of this study was to examine how psychiatric nurses identify, value and use the resources of patients with mental illness. Method: A qualitative design was chosen. The data collection was done by interviews, in which six psychiatric nurses participated. Open-ended questions were used to answer the research questions. Data was analyzed according to qualitative content analysis, using an inductive approach. Results: The participants described that the patient’s resources were identified in sessions where the emphasis was laid on building a therapeutic alliance, information gathering and motivational interviewing. The resources that the participants valued resulted in two categories, internal versus external resources. To have a social network, to have awareness of one’s situation and motivation to change were all examples of meaningful resources according to the participants. To formulate resource diagnosis and to integrate these with the interventions in the care plan were described as effective tools in order to look after the patients’ resources. All participants experienced significant improvements in terms of managing their resources. For instance, there was no agreed understanding of how to utilize resources, the work was perceived as too problem focused and a preference for a more process focused way of thinking was expressed. Discussion: The study’s results were discussed against Antonovsky’s salutogenic         perspective, which emphasises the importance of viewing the healthy aspects in patients as well as the factors that contributes to good health. Many studies highlight that the salutogenic perspective and KASAM can be applied in practice and is useful for the recovery process in mental health.

In the 1994 Rwandan genocide, rape was widely used as a strategic weapon against Tutsi women. This study explored the long term psychological effects of rape experienced by these women in order to develop a middle range theory to guide the management of the lasting psychological effects of rape in the context of genocide. A Grounded Theory approach using Strauss and Corbin’s paradigm (Strauss and Corbin, 1990) was used. Data collection entailed in-depth interviews of twenty nine participants, twelve of whom were rape survivors, ten were women who had not been raped, and seven were men from their community. Open coding, axial coding and selective coding were used to analyse the data. The results have shown that women were negatively affected, physically, psychologically and socially, by the rape. Genocide Rape Trauma emerged as a concept that defines these outcomes. It includes unbearable memories, overwhelming feelings, sense of helplessness, somatic distress, negative self-image, altered intimate relationships and social isolation. The extreme brutality, the humiliation that accompanied the experience of rape and multiple losses were reported as risk factors for the lasting psychological effects of rape. These negative outcomes were maintained by poverty, poor physical health, the burden of raising the children born of rape, hostility and stigma from their community, and lack of appropriate support and effective health care services. Facilitating the management of Genocide Rape Trauma emerged as the core category of the middle range developed theory. Recovery from Genocide Rape Trauma required formal and informal support, including psychological and medical care, sensitivity in dealing with genocide rape survivors, and advocacy. Economic empowerment was a key element, while educating the community contributed to the social integration of rape survivors and their children born of rape into their community. Women had developed coping mechanisms of their own to attain psychological relief, and had organized themselves into support groups. This study contributed to clinical practice by providing a holistic approach to taking care of rape survivors. The inclusion of such theory in the curriculum of health care professionals should contribute to the understanding of the lasting impact of rape and how to handle it in an efficient manner. Key words: Rwanda, Genocide, women survivors, Genocide Rape Trauma, Management of the long term psychological effects of rape and Grounded theory. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2013.

Att leva med ADHD innefattar en rad problem som hos den drabbade individen kan leda till sociala svårigheter och i förlängningen till ytterligare psykiska sjukdomstillstånd, såsom ångest och depression. Det är därför angeläget att undersöka unga människors egna erfarenheter av vad det innebär att ha fått diagnosen ADHD, för att finna vägar som kan reducera riskerna som kommer med diagnosen. Denna studie riktar sig till unga vuxna med ADHD och syftar till att öka kunskapen om de unga vuxnas erfarenheter av att ha fått diagnosen ADHD. Till studien rekryterades fyra unga kvinnor som alla hade fått sin diagnos inom det gångna året. Informanterna randomiserades ur ett barnpsykiatriskt register inom Region Halland. Informanterna tillfrågades via telefon och vid intervjutillfället genom erhölls skriftlig information samt samtyckesformulär. Studiens resultat visar på sambandet mellan ADHD och andra problem. Flertalet av informanterna hade känslor av utanförskap och svårigheter med att passa in med flertalet misslyckande i sin historia. Att ha fått en diagnos bidrog till att få sina bekymmer förklarade inte minst för sig själv men även för sin omgivning. Studiens resultat visade även på gruppens rädsla inför att byta vårdkontakt främst gällande övergången från barnpsykiatri till vuxenpsykiatri. Den aktuella studien visade att det är vanligt med olika problem hos individer som har ADHD men även vilken betydande personlig vinst det kunde innebära att få diagnos och därmed den hjälp som är anpassad. Då studien enbart är gjord på fyra informanter är resultatet inte generaliserbart. Dock kan studien användas som bakgrund till en större studie med fler informanter. Kunskapsläget på området är idag bristfälligt då det handlar om enskildas individers erfarenheter. Studien kan därmed bidra till att ytterligare undersökningar genomförs och med det kan vården förbättras och anpassas ytterligare för att gynna patienterna. / Living with ADHD can lead to a number of problems for the individuals receiving the diagnosis. Social- and psychological difficulties and other mental illnesses like depression and anxiety are all conditions that can occur when individuals are diagnosed with ADHD. Based on these facts it is urgent to examine young adult’s own experiences of what it means to live with an ADHD diagnosis to find ways to reduce the risks following the diagnosis. This study’s aim turns focus on young adults with ADHD, and the purpose is to increase the knowledge in what’s important after receiving a diagnosis from a nursing perspective. Four young women who all had received their diagnosis during the past year were recruited to the study. The informants were randomized from a children's psychiatric registry in Region Halland . The informants were contacted by phone and asked to participate in the study. Before the interviews started they were asked to fill in a consent form. The findings from your study clearly show a correlation between ADHD and other troubles in young adults everyday life. The majority of the informants describe feelings of exclusion with multiple failures in adaption as a result. Receiving a diagnosis contributed to get an explanation for their troubles, not only for themselves but to their environment as well. The result of the study also show the group's fear of changing health care contact mainly concerning the transition from child psychiatry for adult psychiatry. The study shows a high prevalence of trouble among individuals who have ADHD but also what an enormous personal profit it may mean getting diagnosis when the support can be individually adjusted. The study is based on only four informants and the result is therefore not possible to generalize on a larger group, however, the study can be used as background for a larger study with more informants. The current state of scientific knowledge in the field today are insufficient and most facts are based on individuals own experiences. We hope that our findings can contribute to further research that can benefit the nursing care for the patients.

To be sentenced to care in the forensic psychiatric services can be seen as one of the most comprehensive encroachments society can make on a person's life and being, as it entails a limitation of the individual's freedom but with no time limit. The aim of this dissertation is to describe caring in forensic psychiatry based on how it is experienced by those who perform the caring and by those are cared for in a maximum secure unit. A reflective lifeworld approach, based on phenomenological philosophy, has been applied. The data has been collected in interviews that have been analyzed by use of a meaning analysis searching for the essence of the phenomenon. The results of the research are presented in two empirical studies and a general structure based on the empirical findings. The dissertation also contains an excursus, a philosophical intermediate chapter containing further analysis of the results of the studies. The results show how the forensic psychiatric care is experienced as being non-caring by the patients with only small "pockets" of good care. Caring consists of corrective techniques that are unreflected and contradictory, where the conditions are determined by the caregivers and the ward culture. The correcting takes place through the modification of the patients' behaviour with the aim of the patients having to adapt themselves to the terms of the care provision. This care results in the patients trying, by use of different strategies, to adapt them-selves to the demands of the caregivers in order to gain privileges. At the same time the patients long to get away from the care system and are lacking real, meaningful and close relationships. To be the subject of care entails struggling against an approaching overwhelming sense of resignation and to care entails experiencing both power and powerlessness in performing the care. A destructive power struggle is being waged within forensic psychiatric care that suppresses the caring potential and true caring is thus elusive. The characteristics of forensic psychiatric care, based on the results of the research, are clarified in the dissertation's excursus. These include the corrective and disciplinary nature of forensic psychiatric care, its power and how this is materialized in care situations as well as the influence of tradition on current forensic psychiatric care in the light of the work of the French philosopher Michel Foucault. The dissertation shows that if the caring potential is to be able to be developed and form a caring nucleus for forensic psychiatric care then education levels need to be further developed. A caring culture and caring environment is needed where true caring can gain a foothold. In order for this to become a possibility the current caring culture and environment must be clarified, questioned and examined. The prevalent fundamental ideas in forensic psychiatric care have to be "jeopardized" and challenged by new scientifically based ideas on what constitutes true caring in this context.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 6 uppsatser.