Bakgrund: Könsdysfori är en beskrivande term som redogör för individens känslo- eller tankemässiga missnöje med det kön som tilldelats vid födseln vilket medför ett lidande för individen. Personer med könsdysfori har hög förekomst av samtidiga psykiatriska diagnoser. Syfte: Syftet med studien var att beskriva hur personal inom psykiatrin erfar omvårdnaden av personer med könsdysfori. Metod: Kvalitativ studie med semistrukturerade intervjuer. Urvalet bestod av tio respondenter arbetandes inom psykiatrisk öppenvård och slutenvård. Materialet har analyserats med tematisk innehållsanalys. Resultat: Det framkommer att patientgruppen kan upplevas som utmanande att möta utifrån olika aspekter. Detta är delvis kopplat till personalens vilja att ge god vård och bidra till minskat lidande för patienterna samtidigt som personalen ofta känner osäkerhet i mötena. Omvårdnadshandlingar sker främst via samtal och psykiatripersonalen visar delvis förståelse för patientens livsvärld och lidande. Utöver detta framkommer det också att personalen upplever kunskapsbrist och ser ett behov av ökad kunskap. Konklusion: Att möta patienter med könsdysfori kan upplevas komplext och svårt. Inom vården finns en okunskap som sannolikt adderar till redan befintligt stigma. Dock utförs omvårdnadshandlingar som ligger i linje med aktuell forskning samt nationella och internationella riktlinjer. / Background: Gender dysphoria is a descriptive term that describes the individual's emotional or mental dissatisfaction with the gender assigned at birth, which causes suffering for the individual. People with gender dysphoria have a high incidence of concomitant psychiatric diagnosis. Aim: The purpose of the study was to describe how staff in psychiatry experience the care of people with gender dysphoria. Method: Qualitative study with semi-structured interviews. The sample consisted of ten respondents working in psychiatry. The material has been analyzed using thematic analysis. Results: The results shows that the patient group can be experienced as challenging to meet based on different aspects. This is partly linked to the staff's willingness to provide good care and contribute to reduced suffering for the patients, while the staff often feel insecurity. Nursing actions take place mainly through conversations and the psychiatric staff show a partial understanding of the patient's lifeworld and suffering. In addition to this, it also appears that the staff experience a lack of knowledge and sees a need for increased knowledge. Conclusion: Meeting patients with gender dysphoria can be experienced as complex and difficult. Healthcare services sometimes lacks knowledge that probably adds to an already existing stigma. However, to some extent nursing actions are delivered in line with current research as well as national and international guidelines.

Topic: Structuring of inpatient behavioral programming in child-adolescent psychiatric, residential treatment, and juvenile justice settings. Purpose: To review the underlying theory underpinning current practices and recommend remedies to the uncovered problems. Sources: A review of the literature from 1965 to 2001 from selected nursing and medical psychiatric and mental health publications. Conclusions: Intensive professional and staff education and greater precision in communication about patients' behaviors are needed in many settings. There is also a need to move away from generic treatment approaches and return to individual treatment planning based on individual assessments and the unique needs of an increasingly volatile and complex in-patient population.

No description available.

Background: Psychiatric inpatient staff members work with arguably the most challenging service users. However, reference to these challenges often does not go beyond ‘challenging behaviour’, offering no insight into the actual presentation, thus preventing formulation of the perceived challenges, or subsequent interventions. Moreover, studies have shown that staff responses to challenging presentations can impact on both the staff member and the service user. In particular, staff causal attributions have been shown to impact on their therapeutic response (Apel & Bar-Tal, 1996), as well as being associated with staff emotions (Colson et al., 1987). In turn, the emotional response has been found to be associated with coping, both of which have also been found to effect staff behavioural response, as well as staff members’ psychological well-being (Wykes & Whittington, 1998). However, there have been limited studies assessing these relationships with psychiatric inpatient staff. This may be due to the lack of assessment tools developed for this staff group to measure these particular domains. A specifically designed tool would enable consistent assessment to take place to build on our theoretical knowledge of psychiatric inpatient staff members’ perceived challenges, and their responses to them, as well as highlight specific areas within these domains where further staff training and support is required. Aims: The first aim of the study was to explore psychiatric staff’s views on the challenges they faced when working with service users in inpatient settings, their emotional responses, attributions, and coping strategies about those challenges and then to develop a measure which would accurately capture these (the SEACCS). The second aim was to assess the reliability of the new scale as well as explore relationships within the SEACCS. Finally, the third aim was to assess content and face validity, as well as conduct preliminary psychometric investigations of the construct validity of the newly developed measure. Method: The study was conducted using various methods across three phases. In order to generate items for the SEACCS, a systematic review of the relevant literature and semi-structured interviews took place during the first phase. Secondly, the results of Phase I were combined in order to develop and construct the SEACCS. The third phase involved a postal survey of the SEACCS (including re-test), followed by psychometric investigations to scrutinise the items, explore the reliability, and construct validity of the SEACCS.Results: Twenty three studies were included in the systematic review. The results highlighted inconsistent measurement and findings of the domains concerned. Seven multi-disciplinary staff interviews took place. Thematic analysis was used to conduct four separate analyses focusing on each of the research questions. Several themes and sub-themes were found. Themes such as: ‘Engagement’, ‘Attributions of controllability’, and ‘Behavioural responses’. Findings from the review, thematic analyses, and consultation groups (content and face validity) were combined in order to develop the 64 item SEACCS. A total of 76 multi-disciplinary psychiatric inpatient staff members completed the SEACCS, 15 of which completed re-tests. No items were removed following item scrutiny assessments. Preliminary psychometric investigations indicated good reliability, significant relationships across domains within the SEACCS, and partial construct validity with the GHQ-28.Conclusion: The results of the current study provide the first step in the development and construction of a clinically relevant tool that can be used to assess these domains. The methodological limitations and clinical implications are considered, and future directions for research in this area are suggested.