This thesis examines the ways Hellblade: Senua’s Sacrifice (Ninja Theory, 2017) represents mental illness and why the game is considered partly groundbreaking in the subject of mental health representation within video games. This examination is done by taking a brief overview of previous games tackling the same subject matter as well as examining how Hellblade: Senua’s Sacrifice represents psychosis narratively and mechanically. This is done through the method of player-as-analyst by playing the game all the way through once and viewing a full length playthrough video following the methodology and theory of Diane Carr (2014).  The data gathered during play and viewing of the playthrough is then analyzed. / Denna avhandling undersöker hur Hellblade: Senua’s Sacrifice (Ninja Theory, 2017) representerar mental ohälsa och varför spelet uppehålls som delvis banbrytande inom spel som behandlar mental ohälsa. Undersökningen i fråga är gjord via att göra en kort översikt av hur tidigare spel handlat samma ämne och ta en titt på hur Hellblade: Senua’s Sacrifice representerar psykos i sin mekanik och narrativ. Detta åstadkoms genom metoden Player-as-analyst genom att spela igenom hela spelet en gång och kolla igenom en playthrough video och genom att följa metodologi och teori av Diane Carr (2014). Datan samlad under spelningen och video tittandet sedan analyseras.

The aim of this study was to analyze how social workers in social assistance use communication and treatment in their work for clients with psychosis. The study is based on a qualitative method, where a vignette method and a semi-structured interview have been conducted with four social workers within the investigation unit for social assistance. Thematic analysis was used to analyze the empirical material where three themes were created; 1) Flexibility in contact, meetings and the work with clients, 2) The significance of the relationship, and 3) crooked path to self-sufficiency. The empirical material was analyzed through communication theory, discretion and empowerment. The results showed that relationship building is an important part between the social worker and client diagnosed with psychosis, to have a functional communication and to motivate the client to a plan which leads to self-sufficiency. Social workers can use empowerment to motivate clients to self-sufficiency, by raising the strengths of the client. Further it appeared that social workers need to use their discretion to plan the work with the target group. The result from this study also showed the social worker had good opportunities to use their discretional space to adapt the work individually with the target group. / Syftet med denna studie var att studera hur socialsekreterare inom ekonomiskt bistånd använder kommunikation och bemötande i sitt arbete för klienter med psykosproblematik. Studien utgick från en kvalitativ metod, där en vinjettstudie och semistrukturerade intervjuer genomfördes tillsammans med fyra socialsekreterare inom utredningsenheten på ekonomiskt bistånd. Tematisk analys tillämpades som dataanalys där tre teman identifierades; 1) Flexibilitet i kontakter, mötet och arbetet med klienter, 2) Relationens betydelse samt 3) Krokig väg till självförsörjning. Studiens empiriska material analyserades utifrån teorierna kommunikationsteori, handlingsutrymme och empowerment. Resultatet från denna studie visade att relationsskapande mellan socialsekreterarna och klienter diagnostiserade med psykossjukdomar var en viktig del för en fungerande kommunikation, samt motivera klienten till planering som leder till självförsörjning. Socialsekreterarna kan använda Empowerment för att motivera klienten till en självförsörjning, genom att lyfta upp styrkor hos klienten. Det framkom även att socialsekreterarna hade goda förutsättningar att använda sitt handlingsutrymme till att individanpassa arbetet med klienterna i målgruppen.

Background: Studies have shown that people with mental health issues such as psychosis to a greater extent is affected by violence exposure and that healthcare does not identify this issue to a great extent. Aim: The aim of the study was to examine if a web-based course could affect health care staff’s approach and use of procedure in working with violence exposure for their patients. Methods: The selected study groups were health staff working with in- and outpatient care in a psychosis care facility. It was based on a convenience selection sample. The design of the study was a quantitative interventions research with before and after measurement using an Internetbased questionnaire. Results: The result showed that there’s a lack of use in standardized methods and the participants of the study expressed a desire for a routine-based procedure when working with violence vulnerability and exposure. Moreover, education, coaching and guidelines were more frequently requested after the web-based course, but the participants especially requested more local guiding principles in their workplace. Conclusion: The authors can see a clear need for additional studies with the purpose of bringing forth evidence-based methods for how health staff can ask about violence exposure and subsequently, what should or can be done if such information is gathered. The future prospect is thus that more scientific evidence will be able to form clearer and more favourable guidelines in different types of healthcare facilities to accomplish this endeavor.

<p><strong><p>Purpose:</p><p>mental illness and the effect it has on individuals social network and relationships, and vice versa.</p><p>The purpose of this study is to shed light on the rarely mentioned subject of severe<strong> </strong></p><p>Method:</p><p>analysis was performed on a total of 15 interviews, which consists of three individuals with severe mental illness. The focus of the study was the subjects’ description of the social network, excluding clinicians and other professionals.</p>This study is inspired and conducted in a Grounded Theory manner. A secondary<strong><p>Findings:</p><p>may it be with specific individuals or groups. They describe the importance of surrounding themselves with people who do not judge them and it is through them they get validated.</p><p>Places have been emphasised as having special meaning for the social interaction and overall wellbeing for the subjects.</p>There is active actions for social interactions/relationships taken by the subjects,<strong><p>Conclusion:</p><p>their social network. The stigmatization which comes with severe mental illness diagnoses effect their social network constellation. It is therefore of importance for clinicians and other professionals, to recognize patients efforts and active attempts for social interaction.</p><p>The subjects in the study are aware of the demands and expectations that exist in</p></strong></strong></strong></p>

Purpose: mental illness and the effect it has on individuals social network and relationships, and vice versa. The purpose of this study is to shed light on the rarely mentioned subject of severe Method: analysis was performed on a total of 15 interviews, which consists of three individuals with severe mental illness. The focus of the study was the subjects’ description of the social network, excluding clinicians and other professionals. This study is inspired and conducted in a Grounded Theory manner. A secondaryFindings: may it be with specific individuals or groups. They describe the importance of surrounding themselves with people who do not judge them and it is through them they get validated. Places have been emphasised as having special meaning for the social interaction and overall wellbeing for the subjects. There is active actions for social interactions/relationships taken by the subjects,Conclusion: their social network. The stigmatization which comes with severe mental illness diagnoses effect their social network constellation. It is therefore of importance for clinicians and other professionals, to recognize patients efforts and active attempts for social interaction. The subjects in the study are aware of the demands and expectations that exist in

Syftet med studien var att undersöka hur sjuksköterskor skildrar och kommunicerar med psykospatienter och vilket lärande de upplever i dessa möten inom slutenvården. Metoden var halvstrukturerade intervjuer som transkriberats och sedan analyserats med hjälp av van Manens fenomenologiska och hermeneutiska metod och hans livsvärldsexistentialer; relationen, rummet, tiden och kroppen. Sjuksköterskorna beskrev patienter med skilda egenskaper som från att vara starkt fysiskt påverkade och ha kramper till att vara vältränade och se bra ut men också från att vara skrämmande till att vara trevliga. Patienter kunde ha press från anhöriga, ha mycket resurser och de kunde förbättras snabbt men också snart återkomma för inläggning. Strategier vid kommunikation beskrevs som: Ett fokus på här, nu och framåt; ett balanserat, känsligt och kärleksfullt bemötande som förmedlar ett budskap av hopp, delaktighet och realistisk framtidstro. Fysisk omvårdnad kan motverka känslor av rädsla, misstänksamhet och skygghet. Sjuksköterskan kan behöva både sätta egna känslor åt sidan och tänka sig in i patientens situation. För en lyckad kommunikation krävs: Intresse, tålamod, lust och förmåga att se problem som en utmaning vilket skapar möjligheter till lärande för både vårdtagare och personal; utrymme för reflektion som kan förbättra arbetssätt; tid och tillgänglighet för ömsesidigt lärande mellan patient, anhöriga och sjuksköterskor. Humor kan förmedla hopp och avdramatisera kitsliga stämningar. Attityder till patienter som ”jobbig, tråkig eller obegriplig” skadar möjligheten för patienten att känna hoppfullhet. Tvångslagens utformning kan påverka attityder. Jag har funnit att sjuksköterskan bör ställa krav på sig att försöka förstå; inte ge upp; ha tålamod; känsligt möta patientens uppfattning; ingjuta hopp och inspirera till uthållighet; vara uppmärksam på patientens fysiska välbefinnande. Kärlek sågs som vägledande för ett etiskt lärande möte och erfarenheter från dessa användes i framtida möten med patienter. Kommunikationen måste anpassas till olika patienters behov och förutsättningar. / The aim of this study was to investigate how nurses depict meetings with psychosis patients, how they communicate with psychosis in-patients and what kind of learning they experience in these meetings. Semi structure interviews were transcripted and then analyzed with the phenomenological and hermeneutic perspective from van Manen and his life-world existentials; lived relation, lived space, lived time and lived body. The nurses described patients with varied characteristics, ranging from strong physical influence with spasms, to fit and good-looking but also as frightening or being pleasant. Patients could be exposed to pressure from relatives, have a lot of resources and quickly improve and despite these circumstances fall back into needing treatment. Strategies among the nurses when communicating with patients were described as: To focus on here, now and onwards; to give a balanced, sensitive and loving treatment that leaves an actual message of hope, participation and a realistic faith in the future. Physical care could work against feelings of fear, suspicion and shyness. Nurses need to both put their own feelings aside and to imagine themselves in the situation of the patient. To succeed in communicating the nurses need to have: Interest, patience, a will to help and the ability to see a problem as a challenge. These factors create possibilities for learning for both the patients and the staff, and also create time for reflection that can improve working methods, and give time and accessibility for mutual learning between patients, relatives and nurses. Humor could support the patient´s hope and calm an irritable atmosphere. Attitudes to patients as “trying, boring or incomprehensible” indicate a lack of competence and damage the possibility for a patient to perceive hope. The compulsory law design can have an influence on attitudes.  I have found that nurses should demand of themselves to try to understand; not give up; have patience; sensitively meet the patient’s concept; encourage hope and inspire to hold on and be aware of patient’s physical well-being. Love was seen as guide for an ethical learning in meetings with patients and the experiences from these meetings were used when meeting patients later on. Communication has to be adjusted to the patient´s individual needs and conditions.

The aim of the essay was to see how the respondents reasoned about different themes like, isolation, integration and barriers to integration, given that they had all been diagnosed with a psychosis diagnosis. The essay takes part of secondary data that had been gathered through interviews by researchers at the department of Research and Development Psychiatric South Stockholm during a 3 year period. To work with the interview data a qualitative interview analysis method was used. The interviews were analyzed against theories of social interaction, labeling, stigma and the theory of ”role exit”. The analysis showed that to be given a psychosis diagnosis is an indicator that one will be isolated from society in terms of work, economy and social relations. A more surprising find of this essay was that even though one is viewed as isolated in terms of the points given above, it does not mean that one necessarily want to strive for a full integration again. One possible interpretation of this find is that one thinks that one is more well off in the current situation than in an integrated situation.

Bakgrund: En psykos innebär att tappa fotfästet i verkligheten. Risken för att drabbas av försämrad livskvalitet med stort lidande är hög. Tidigt insatta interventioner hos personer med nydebuterad psykos kan hindra ett ogynnsamt sjukdomsförlopp men forskning av nyinsjuknade genererar sällan kunskap gällande omvårdnad. Patienters symptombild med starka vanföreställningar och oro komplicerar ofta försök att interagera och en gynnsam vårdrelation kan vara svår att utveckla i och med patienternas speciella tillstånd. Syfte: Att beskriva hur personalen kan skapa en vårdprocessfrämjande relation med personen som drabbats av nydebuterad psykos på en slutenvårdsavdelning. Metod: Systematisk litteraturöversikt inkluderat femton artiklar med kvalitativt perspektiv för att besvara syftet. Data har analyserats med hjälp av kvalitativ metasummering. Resultat: Resultatet antyder på fördelar med att skapa tillit på ett tidigt stadium med hjälp av vårdrelationen. I och med ökande tillit till omgivningen ökar också behovet av att ha personalen som stöd med kunskap och förståelse för att kunna lösa problem i ett ömsesidigt samarbete. Personalen bör vara tillgänglig, vänlig, kunnig, tydlig, empatisk, flexibel med positiv hållning för gynnsamt skapande av hälsoprocessfrämjande omvårdnad.  Diskussion: I den optimala vårdrelationen sker ett samarbete runt mål och hälsoprocessfrämjande interventioner där personalen stöttar patienternas val med kunskap, uppmuntran och positiv feedback. Att få patienten att acceptera sin situation, att det kanske aldrig blir som förr och att leda in patienten på nya realistiska banor som inger livsmod och hopp kan vara en av personalens största utmaningar. / Background: A psychosis brings a lost sense of reality and generates a high risk of impaired quality of life with great suffering. Research shows that early intervention can prevent a disadvantageous health course whilst seldom generates knowledge regarding nursing as such. The nurse patient relationship is essential but often complicated by lack of trust due to symptoms such as strong delusions and anxiety. Aim: To describe how staff can create a care process promoting relationship with persons affected by recent-onset psychosis at an inpatient ward. Methods: Systematic literature review based on fifteen articles with a qualitative perspective. A qualitative meta-summary was chosen as method for synthesizing and analyzing the findings. Results: The result shows that the caring relationships focus may be on gaining trust at an early stage. As the patient gains trust in the surrounding environment the need for support from staff increases. Problem solving, together with staff, becomes more appreciated as symptoms fade away. Staff who are accessible, friendly, knowledgeable, clear, empathetic, flexible with a positive attitude are beneficial in creating a healthy process of promoting nursing. Discussions: Optimal nurse patient relationship interacts around goals and health process promotion interventions where staff supports the patients’ choices with the use of knowledge, encouragement and positive feedback. Getting the patient to accept their situation, making them realize that life may never be the same, leading them onto new realistic paths inspiring courage and hope, can be one of the staff's greatest challenges.

The similarities between psychosis and different mystical experiences are striking. Professor Jens-Ivar Nergård (1998, 2006) has pointed out similarities between the calling of the Sami shaman/nåjd and the state of psychosis and high-lights the reciprocal meanings andpurposes of these similarities in a Saami context where the calling and the called are regarded as meaningful for the community. By comparing what psychodynamic theorynames psychosis with the calling process of the nåjd the aim of this work is to investigatethe question of how the latter’s discourse finds individual and contextual purpose andmeaning in the psychological functions leading to the former. Since this comparison andinvestigation concerns two different ontologies and discourses, with their own conceptsand views on the psychological functions mentioned, it is done in a qualitative comparativemethod of discourse analysis.The psychodynamic discourse through the books of professor Johan Cullberg classifiespsychosis as a psychological regression to a more primitive psychological state in whichthe individual is caught in primary process thoughts; characterized by dilutions, hallucinations and magical thinking. The psychodynamic discourse sees no contextual, and verylittle individual, meaning or purpose with these functions. This theory is what I will compare to the material given by primarily Jens-Ivar Nergård from a Saami discourse.What I find in the discourse material is an ontology - simultaneously psychological, spiritual, practical and religious (hence the interest from the perspective of psychology of religion) – which differs from the ontology of the psychodynamic discourse in crucial ways.In the Saami discourse the individual experiencing what the theory would name hallucinations, dilutions or psychosis is never disconnected from his or her community and contextbut is instead seen as an important and strong bringer of insights and knowledge. This isconnected to the ontology mentioned above in which relating to - seeing, hearing and interacting with - non-human persons is viewed as a natural experience to understand andrelate to nature, the community, the past and present. The psychological functions in which these interactions take place are regarded as meaningful, significant and sacred.

Bakgrund: Psykossjukdom är en av de allvarligaste psykiatriska sjukdomarna. Trots att det finns effektiva behandlingsstrategier får inte alla med psykossjukdom specialiserad vård, vilket kan ha allvarliga konsekvenser för deras livslängd och välbefinnande. Diskriminering och stigma kring psykossjukdom kan påverka patientens hälsa och prognos. Det är viktigt att tidigt upptäcka och behandla psykossjukdomar för att minimera funktionsnedsättning och förbättra prognosen. En utmaning inom vården för personer med förstagångsinsjuknande är att bibehålla terapeutisk allians och främja återhämtning. Syfte: Syftet var att beskriva patienters erfarenheter av vården vid förstagångsinsjuknande i psykos. Metod: En litteraturstudie med strukturerat tillvägagångssätt och kvalitativ ansats. 15 originalartiklar inkluderades och tematisk dataanalys genomfördes enligt Braun och Clarke. Resultat: Litteraturstudien sammanställer tidigare forskning inom området och efter dataanalys framkom tre teman: Värdefulla relationer, Hjälpande insatser, Hinder och utmaningar för delaktighet med respektive subteman. Slutsats: Erfarenheterna från vården för personer med förstagångsinsjuknande med psykos berör relationer till personal och medpatienter, praktiskt stöd och psykoedukation, och faktorer som rädsla för vården, bristande tillit och kontinuitet. / Background: Psychotic disorders are among the most severe psychiatric illnesses. Despite the availability of effective treatment strategies, not all individuals with psychotic disorders receive specialized care, which can have serious consequences for their longevity and well-being. Discrimination and stigma surrounding psychotic disorders can impact the patient's health and prognosis. Early detection and treatment of psychotic disorders are crucial to minimize disability and improve prognosis. One challenge in the care of individuals experiencing first-episode psychosis is maintaining therapeutic alliance and promoting recovery. Aim: The objective was to describe patients' experiences of care during first-episode psychosis. Method: A literature study with a structured approach and qualitative approach. 15 original articles were included and thematic data analysis was conducted according to Braun and Clarke. Results: The literature review compiles previous research in the field, and after data analysis, three themes emerged: Valuable relationships, Supportive interventions, and Barriers and challenges to engagement, each with respective sub themes. Conclusions: The experiences of healthcare for individuals with first-episode psychosis involve relationships with staff and fellow patients, practical support and psychoeducation, as well as factors such as fear of healthcare, lack of trust, and continuity.