Factors that influence collaboration between psychiatric care and CSSs : experiences of working together in the interest of persons with long-term mental illness living in the community

Background: Since de-institutionalization of psychiatric care (PC) took place in Sweden during the second half of the 20th century, the intended collaboration between the two organizations, PC and community social service (CSS) has been evaluated as inadequate in providing care for persons with long-term mental illness living in the community. Aim: The aim of this explorative study was to examine factors that influence interdisciplinary teamwork between PC and CSSs based on the experience of nursing staff within two separate organizations. Method: Five focus groups were selected as an appropriate method to collect data. Two of these groups were recruited from the PC and three from the CSSs. The focus groups consisted of psychiatric nurses and mental healthcare workers. A qualitative content analysis was used to identify major themes in the data. Findings: Two main themes were found, external organizational factors and interpersonal factors that deter or enhance collaboration between PC and CSS. Separate care plans, unclear times for meetings were found to be a plausible reason for communication failure. The focus groups representing each of the two organizations viewed themselves as 'us and them'. Different ideologies and goals for caring and service and how to use each other's competence seemed to be explanations as well as consequences of not finding ways to work together. Conclusion: The results of this study points to the need for the two organizations to find ways to work more effectively together to realize a joint responsibility for the patient/client

Student nurses and the general population in Sweden : trends in attitudes towards mental illness

Objective: To evaluate attitudes towards mental illness displayed by student nurses’ with previous contact with mentally disordered persons prior to education in psychiatric nursing and to evaluate trends in attitudes towards mental illness exhibited by student nurses and the public in Sweden. Methods: Altogether 246 student nurses enrolled in three universities in Sweden (mean age = 27.9 ± 7.5 years) out of which 210 were females and 36 males, completed prior to their obligatory course in psychiatric nursing a shortened version of 11 internally reliable (Cronbach's alpha 0.84) items from the Swedish version of the Community Attitudes towards Mental Illness questionnarie. The selected items were named the Student Nurse Attitude Index (SNAI) and formed the basis for an evaluation of trends exhibited by student nurses and the attitudes of the general population towards mental illness by means of Jonkheere's trend test. By linear regression analysis, the impact of previous contact with mental illness on student nurses’ attitudes towards mental illness prior to education in psychiatric nursing was assessed. Results: Student nurses did not demonstrate, in contrast to the public in Sweden, a trend of positive attitudes toward persons with mental illness. Even so, it was revealed that student nurses who had experienced some type of contact with mental illness prior to education in psychiatric nursing exhibited a positive attitude, more so than those lacking contact, toward mental illness. Conclusions: The findings corroborated the “contact hypothesis”, implying that direct contact with persons with mental illness will encourage acceptance and enhance a positive attitude towards mental illness in general

Patients as 'Safeguard' and Nurses as 'Substitute' in Home Health Care

One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as ‘safeguard’, and the nurses’ subject position as ‘substitute’ for themselves. These subject positions provided the opportunities, and the obstacles, for the patients’ possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care

The core characteristics and nursing care activities in psychiatric intensive care units in Sweden

Internationally, research on psychiatric intensive care units (PICUs) commonly reportsresults from demographic studies such as criteria for admission, need for involuntary treatment, andthe occurrence of violent behaviour. A few international studies describe the caring aspect of thePICUs based specifically on caregivers’ experiences. The concept of PICU in Sweden is not clearlydefined. The aim of this study is to describe the core characteristics of a PICU in Sweden and todescribe the care activities provided for patients admitted to the PICUs. Critical incident techniquewas used as the research method. Eighteen caregivers at a PICU participated in the study bycompleting a semistructured questionnaire. In-depth interviews with three nurses and two assistantnurses also constitute the data. An analysis of the content identified four categories that characterizethe core of PICU: the dramatic admission, protests and refusal of treatment, escalating behaviours, andtemporarily coercive measure. Care activities for PICUs were also analysed and identified as controlling– establishing boundaries, protecting – warding off, supporting – giving intensive assistance, andstructuring the environment. Finally, the discussion put focus on determining the intensive aspect ofpsychiatric care which has not been done in a Swedish perspective before. PICUs were interpreted asa level of care as it is composed by limited structures and closeness in care