Background: Studies have shown that patients suffering from mental illness often feel that they are less well treated in health care than patients who do not suffer from a mental illness. What causes this is that patients with mental illness often become subject to stigmatization in healthcare in general. Aim: The aim of this study was to illuminate the experience of stigmatization in the healthcare encounter between nursing staff and patients with a mental illness. Method: Six qualitative and one quantitative article were analyzed to create a literature review. Results: Through the analysis two main-themes and seven sub-themes were identified. The two main-themes were: The feeling of powerlessness and The feeling of deviating. The seven sub-themes were: Not to be taken seriously, Not to be considered to have a real illness, Being malpracticed, Getting a worse response, To live with the fear of being labeled, To be identified with the diagnosis and To repress symptoms. Conclusions: Patients find that they are not taken seriously regarding their mental or physical problems and that they do not receive care on the same terms as patients without a psychiatric diagnosis. Healthcare professionals need better knowledge about experiences of stigmatization, in order to establish a better relationship between patient and nursing staff and to strengthen the patients' self-esteem. / Alla patienter ska få ett lika gott bemötande i mötet med vården oavsett vilken sjukdom de lider av. Idag finns det fortfarande många fördomar och en utbredd brist på kunskap gällande psykisk sjukdom, vilket leder till att patienter många gånger blir föremål för stigmatisering från hälso- och sjukvårdspersonal och genom detta får ett sämre bemötande än patienter som inte lider av psykisk sjukdom. Sjuksköterskan har en viktig roll när det gäller att få patienten att känna sig trygg och utifrån detta kunna skapa en förtroendefull relation med patienten där hen kan känna tillit. Detta för att kunna ge bästa möjliga omvårdnad. När patienten på grund av stigmatisering mister detta förtroende för vården minskar möjligheten för tillfrisknande och till att leva ett, för patienten, optimalt liv med en god upplevelse av hälsa. Syftet med det här examensarbetet var därför att belysa upplevelsen av stigmatisering i mötet med hälso- och sjukvården hos patienter med en psykisk sjukdom. I resultatet har sju vetenskapliga artiklar, sex kvalitativa och en kvantitativ, analyserats. Artiklarna som valdes till resultatet skulle utgå från ett patientperspektiv och därför exkluderades artiklar som belyste närståendes eller vårdpersonals upplevelser. Artiklarna granskades och analyserades med hjälp av Fribergs (2017) analysmetod för litteraturöversikt som syftar till att belysa likheter och skillnader i inkluderade artiklar. Resultatet visar att patienterna ofta känner att de inte blir tagna på allvar och att de inte bemöts på samma villkor som patienter utan en psykiatrisk diagnos. De känner sig även många gånger avvisade när de söker vård genom att de inte blir trodda eller att de upplevs som besvärliga. I tillägg till detta kämpar många patienter med sina egna fördomar kring psykisk sjukdom som får konsekvenser i deras dagliga liv och i mötet med vården. Sjuksköterskor behöver få kunskap om hur de ska bemöta dessa patienter på ett professionellt vis. Stigmatisering, det vill säga olika typer av fördomar kring psykisk sjukdom som får en negativ effekt för dessa patienter, bör lyftas fram och synliggöras inom såväl sjuksköterskeutbildningen som i det kliniska arbetat ute på sjukhus, primärvård och kommunal vård. Det är även viktigt att öka omvårdnadspersonalens kunskaper gällande patienternas upplevelser av stigmatisering, för att kunna arbeta för en bättre relation mellan patient och omvårdnadspersonal samt arbeta för att stärka patientens självkänsla vilket i sin tur kan leda till en bättre återhämtning och livskvalitet.

This study evaluated the use of a tok en, operant conditioning technique as a treatment procedure in a group setting with chronic, hospitalized, psychiatric patients. Fifteen patients were randomly assigned to two experimental groups and to one control group; each group included five patients. The two experimental groups received tokens during phases of contingent reinforcement for "Therapeutic Responses" and under a yoked-control phase of non-contingent token reinforcement; the sequence of these phases was the major difference between the two experimental groups. The control group met under conditions of no tokens, and the frequency of "Therapeutic Responses" was recorded on those subjects. "Therapeutic Responses" were characterized as open, confrontive, and problem-solving oriented interaction among group members as defined by Quadrant IV of the Hill Interaction Matrix (HIM). Results clearly supported the hypotheses that therapeutic responses did occur significantly more frequently and for longer durations in both the experimental groups in the following predicted directions: (1) under conditions of contingent token reinforcement as compared to conditions of non-contingent token reinforcement and to baseline and extinction phases; (2) in both of the experimental groups as compared to the control group. Reversal procedures demonstrated the expected extinction effects. Also, all three groups were compared on follow-up outcome data which included: (1) pre- and post-test ratings by hospital attendants of the group member's behavior changes on the ward as measured by The Behavioral Adjustment Scale; (2) pre- and post-test scores on the HIM-B (an unpublished instrument based on the HIM measuring attitudes toward group interaction). There were no differential effects among the three groups' MACC Behavioral Adjustment Scale and HIM-B posttest scores. These results were discussed in respect to the implications of applied research in the area of verbal conditioning, and implications for the treatment of chronic psychiatric patients. Recommendations for future research to examine possible generalization effects were offered.

Magister Curationis - MCur / The frequent readmission of patients in psychiatric hospitals is caused by the relapse in their different psychiatric conditions. With a shortage of professional nurses, lack of resources, and an ever-increasing workload, the frequent readmission of psychiatric patients further worsens the situation.

Die Arbeit befasst sich mit der Internetnutzung von psychiatrischen Patienten. Das Angebot an Therapien für Patienten mit psychiatrischen Erkrankungen steigt seit Jahren. Auch die Menge an Informationen, welche vor allem online zu bekommen sind, wird immer größer. Allerdings gibt es nur wenige Informationen zur Internetnutzung von psychiatrischen Patienten im Vergleich zur Gesamtbevölkerung. Sind psychiatrische Patienten bezüglich Zugang zum Internet und Nutzung von Internetinformationen und -therapien benachteiligt?

Mona Wilhelmsson Göstas, School of Health and Medical Sciences, Örebro University, SE-701 82 Örebro, Sweden, mona.vilhelmsson gostas@orebroll.se Attachment styles are relevant to psychotherapy since they highlight the way a person handles interpersonal and emotional stress. This thesis aimed to examine how psychotherapy patients in the public mental health care system report attachment styles related to interpersonal problems and diagnosis before and after psychotherapy and to examine problems and changes and psychotherapy contract and process from patients’ experiences of cognitive behavioural oriented therapy (CBT) and psychodynamic oriented psychotherapy (PDT). The studies are based on data from patients admitted to psychotherapy within the public psychiatric services in Örebro County Council. Studies I and IV were quantitative and used self-reports to examine attachment styles and interpersonal problems before and after psychotherapy. Studies II and III were qualitative interview studies examining patients experiences of problems, changes and psychotherapy process. The patients were diagnosed with mood disorders, anxiety disorders, adjustment disorders and personality disorders and reported insecure avoidant and anxious attachment styles that correlated positively with interpersonal problems when they started therapy. Psychotherapy with CBT or PDT enabled them to turn attachment styles into more secure ones and decrease interpersonal problems Patients aged between 26 and 39, patients who attended 11-25 sessions and patients diagnosed with a personality disorder reported greater changes in secure related attachment than others. Patients described their problems as emotions that could not be regulated, as cognitive disabilities and as problematic behaviours that implied a self-centredness. During the course of psychotherapy, the patients gained abilities to handle their problems. The perceived self-centeredness changed which increased their participation in their life-context. Similarities across the therapy orientations showed that the creation of a new context was essential to pay full attention to the patient’s problems, and that the working method and cooperation with the psychotherapist made up a whole. To make the therapy effective, it is important to build up confidence in cooperation and secure base functions like offering predictability and shaping interventions according to the needs of the patient and their ability to use them.

No description available.

No description available.

<p>Barn till psykisk sjuka kan ha ökad risk för psykisk ohälsa men detta kan uppvägas av tillgängliga skyddsfaktorer. Barn har blivit mer uppmärksammade inom vuxenpsykiatrin på senare år. Beardslees familjeintervention implementeras sedan 2008 i Sverige. Studien undersökte hur vuxenpsykiatrin stödjer barn till psykisk sjuka, speciellt angående interventionen. Tio anställda, utbildade i interventionen, från sju psykiatriska kliniker i Stockholm intervjuades. Materialet analyserades abduktivt. Barns reaktioner och behov visade sig påverkas av föräldrafunktionen och risk- och skyddsfaktorer hos barnet, i omgivningen och situationen. Interventionen upplevdes bli ett sätt att uppmärksamma barn och skapa dialog inom familjen. Samtidigt upplevde deltagarna bristande kunskap om hur man kommunicerar med barn. För att stödja barn som mår dåligt skulle ett samarbete med BUP behövas. Ingen barnpolicy på avdelningsnivå finns och barns delaktighet ansågs låg. Preventivt arbete kan minska riskfaktorerna, men fokus måste också vara att öka barns möjlighet att hantera vardagssituationen, vilken kan förändras av omständigheterna och över tid.</p> / <p>Children of mentally ill parents have a higher risk to develop psychiatric problems but this risk can be reduced by protective factors. In recent years children of mentally ill have received more attention within adult psychiatry. The Beardslee family intervention has been implemented in Sweden since 2008. This study examines how adult psychiatry supports children of mentally ill, with focusing specifically on this intervention.  Ten professionals, educated in the intervention, from seven psychiatric hospitals in Stockholm, were interviewed and data analyzed abductive. Children's reactions and needs was shown to be influenced by the parenting skills and factors of risk and protection within the child, the environment and the situation. The intervention was perceived as a way of paying attention to the child and to create a dialogue within the family. At the same time the participants experienced a lack of knowledge about how to communicate with children. In order to support children cooperation with child psychiatry is required. No policy of how to handle children was available at the hospital units and the participation of children is considered to be low. Prevention may decrease the risk factors but there must also be a focus on increasing the possibility for the child to cope with the everyday situation. This situation may also change depending on circumstances and over time.</p>

Non-compliance to treatment remains one of the greatest challenges in mental health care services, and knowledge about how to improve this is still a problem. The aim of this study is to critically synthesize the best available evidence regarding interventions to promote psychiatric patients’ compliance to mental health treatment. This study aims to provide the clinical practitioner with accessible information on interventions to promote psychiatric patients’ compliance to mental health treatment. Systematic review was chosen as a design method to identify primary studies that answer the following research question: What is the current evidence on interventions to promote psychiatric patients’ compliance to mental health treatment? Selected electronic databases that were accessible were thoroughly searched: SA-Nexus (NRF), ProQuest, EBSCOhost Platform, ScienceDirect, Web of Knowledge, Cochrane Library, Sabinet and Google Advanced Scholar were searched for primary studies that were published from 2001 to 2011. Primary studies in any language with an abstract in English were included in the search results. The following key words were used in the search: intervention, mental health treatment, psychiatric treatment, compliance, adherence, psychiatric patients, mental health care user and combinations thereof. Pre-determined inclusion and exclusion criteria were applied during the selection of studies. Sixteen studies (n = 16) were included for critical appraisal of methodology and quality using standard instruments from the Critical Appraisal Skills Program (CASP), the (JHNEBP) John Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool and the American Dietetic Association’s (ADA) Evidence Analysis manual. Finally only fourteen studies (n = 14) were identified as evidence that answers the literature review question appropriately. Evidence extraction, analysis and synthesis were conducted by means of the evidence class rating and grading of strength prescribed in ADA’s manual (ADA, 2008:62). The research was evaluated, a conclusion was given, limitations were identified and recommendations were formulated for nursing practice, education and research. Study findings indicated several interventions that can improve patients’ compliance in mental health treatment. Adherence therapy and motivational interviewing techniques during in-hospital stay improved the compliance of psychiatric patients. The use of Meds-help Pharmacy-based Intervention and Treatment Adherence Therapy Program for all Healthcare Professionals improved compliance to treatment for severely mentally ill. A Treatment Initiation and Participation Program and the use of Management Flow Sheet Interventions for Depressed Patients in Out-Patient Settings improved overall compliance of depressed patients in out-patient settings. Community mental health nurses trained in Medication Management improved psychiatric patients’ compliance to treatment at the community health care centres. Antipsychotic medication combined with therapeutic antipsychotic psycho-social interventions improved compliance of treatment for early-staged schizophrenia patients in out-patient settings. The use of Risperidone injections during the provision of home care and the long-acting injectable antipsychotic and atypical antipsychotic treatment used for schizophrenic patients served to improve compliance of mental health treatment in out-patient settings for schizophrenic patients. It is thus recommended that nurses should be exposed to clinical training regarding treatment compliance interventions of mental health care users during formal nursing education to enhance the mental health care practice and stimulate more innovative research on treatment compliance on the clinical field. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012

Psychiatric patients, particularly schizophrenics, tend to be less accurate decoders of facial expressions than normals. The involvement of three basic information processing stages in this deficit was investigated: attention; encoding; and processing. Psychiatric inpatients, classified by diagnosis and severity of pathology, and nonpatient controls were administered seven facial cue decoding tasks. Orientation of attention was assessed through rate of diversion of gaze from the stimuli. Encoding was assessed using simple tasks, requiring one contrast of two facial stimuli and selection from two response alternatives. Processing was assessed using a more complex task, requiring several contrasts between stimulus faces and selection from numerous response alternatives. Residualized error scores were used to statistically control for effects of attention on task performance. Processing task performance was evaluated using ANCOVA to control for effects of encoding. Schizophrenics were characterized by generalized information processing deficit while affective disorder subjects evidenced impairment only in attending. Attention impairments in both groups were related to severity of psychopathology. Problems in encoding and processing were related only to a schizophrenic diagnosis. Their decoding deficits appeared attributable to general visuospatial discrimination impairment rather than repression-sensitization defenses or the affective connotation of cues. Adequacy of interpersonal functioning was associated with measures of attending and processing but not encoding. The measures of encoding, however, may have lacked adequate discriminating power due to low difficulty.