37 research outputs found
âFleeingâ as a strategy for navigating resistance in patient encounters within forensic care
publishedVersio
A meta-ethnographic review of forensic psychiatry inpatient care. Nursing staff experiences of the nurse-patient encounter
publishedVersio
âThey can do whatever they wantâ: Meanings of receiving psychiatric care based on a common staff approach
This study deepens our understanding of how patients, when cared for in a psychiatric ward, experience situations that involve being handled according to a common staff approach. Interviews with nine former psychiatric in-patients were analyzed using a phenomenologicalâhermeneutic method to illuminate the lived experience of receiving care based on a common staff approach. The results revealed several meanings: discovering that you are as subjected to a common staff approach, becoming aware that no one cares, becoming aware that your freedom is restricted, being afflicted, becoming aware that a common staff approach is not applied by all staff, and feeling safe because someone else is responsible. The comprehensive understanding was that the patient's understanding of being cared for according to a common staff approach was to be seen and treated in accordance with others' beliefs and valuations, not in line with the patients' own self-image, while experiencing feelings of affliction
Subordinated masculinities : A critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care
Aims and objectives To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender. Background During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms. Design Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used. Results While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family-oriented care. The overarching discourse, which we labelledsubordinated masculinities, was supported by three other discourses:being unable to take responsibility,being drug-addictedandperforming masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms. Conclusion The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients ' responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them. Relevance to clinical practice Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.Peer reviewe
Der Konflikt in Afghanistan : Historischer und gesellschaftlicher Hintergrund, Evolution und Lageentwicklung â ein Positionspapier
This study is part of a larger project, the aim of which is to elucidate âmental health nursesâ attitudes towards their patients'. In this study, nurses' and patients' attitudes are described from the perspective of both parties using a qualitative approach. The informants were selected from a rehabilitation unit for young adults, below 40, suffering from psychosis at a psychiatric clinic that provides acute psychiatric care. The informant group consisted of three dyads: three patients with various diagnoses and three nurses with primary responsibility for the patients' daily care. The aim of this particular study was to extend our preliminary understanding of nurses' attitudes towards psychiatric patients in the context of psychiatric in-patient care, by elucidating the patient's âinnerâ picture of her/his past, present and future and the nurse's picture of the same patient's past, present and future. Data were collected and analysed using a phenomenological-hermeneutic approach and the narrative picturing technique. For each picture and group, 15 related sub-themes emerged, on the basis of which six themes were formulated. The findings show that the nurses overrate their own importance when it comes to the patient's well-being on the ward. All the nurses emphasize confirmation and safety as the basis of their nursing care, while in the patient's picture the nurses represent a replication of childhood demands, which probably means that nursing care risks becoming a continuation of the patient's childhood estrangement
Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse : A Grounded Theory
Introduction: Intraoperative care includes a unique knowledge of how to perform a safe and effective surgery procedure. Surgery performed under regional or local anaesthesia allows the patient to remain conscious during the procedure and is rather common in Swedish healthcare today. Aim: The aim was to obtain a deeper understanding of the main concerns of operating theatre nurses (OTN) when caring for conscious patients during the intraoperative phase. Methods: Interviews were conducted with 23 OTNs from five different hospitals in Sweden and analysed according to grounded theory. Findings: The main concern among the OTNs was to take the patient in consideration. The core category âachieve and maintain ethical treatment of patientsâ in the operating theatre (OT) was a strategy used throughout the intraoperative process. Ethical treatment was described as moral behaviour at different levels and included the teamâs behaviour, respectful and individualised patientcare, and the working-morale of the professionals. Being vigilant and being flexible were the categories related to the core category. The OTNs constantly assessed where to pay most attention as they balanced between the needs of the patient, the team, and the surgery procedure. Conclusion: It is important that every patient is taken into consideration and that ethical principles are held to the highest standards in the OT. A familiar team can facilitate that. The complex skills that operating theatre nurses develop can be added to explain important competencies within the profession
The preservation of order: the use of common approach among staff toward clients in long-term psychiatric care
The authors performed this grounded theory study to gain a deeper understanding of the kinds of social processes that lead to a need among psychiatric nursing staff to reach a common approach on how to act toward individual clients in long-term psychiatric care. They present a theory about the development of such common approaches among staff. The main findings were that in psychiatric group dwellings, when the internal order is perceived as having been disturbed, the staff preserve or restore the internal order by formulating and reaching a common approach. The staff negotiated with each other to achieve an agreement on how to act and behave toward the individual client. The authors isolate and describe different types of order-disturbing incidents and the common approaches taken by the staff in dealing with them. However, their data also show that staff often had difficulties in maintaining a common approach over time
Lifestyle Changes in Diet and Physical Activities after Group Education for Type 2 Diabetes : The Active Ingredient in the Education. A Qualitative Study
Background: Diabetes self-management education (DSME) for patients with type 2 diabetes requires efficient teaching methods that make patients want to change lifestyle in terms of their diabetes. The study looks at what may be the active ingredient in this DSME. Objective: To explore how participants in DSME, with an interactive learning method, experienced changes in relation to diet and physical activity. Method: We studied possible changes in diet and physical activity by semi-structured individual interviews of 16 participants attending DSME. Results: Before the DSME, the participants felt insecure about what to eat, and they expressed little interest in changing their physical activity. Just after the DSME, they were more optimistic about diet because they had learned how to interpret food labels and compose their meals. Furthermore, they had experienced the benefit of physical activity in relation to their blood glucose levels. Behavior changes appeared to persist the following half year. We discuss the findings in light of the principles of interactive learning. The participants experienced an effect of their behavior changes, and blood glucose measurement was used as a tool to gain control and reach a state of well-being. Conclusion: From being insecure about what to eat, the patients acquired knowledge to handle their diet through the DSME. They learned how to compose their meals and use physical activity to regulate their blood glucose. We suggest that the interactive learning used in the DSME was an active ingredient that led to changes in behavior and should be considered as an educational method in DSME for patient with type 2 diabetes
Swedish assistant nursesÂŽexperiences of job satisfaction when caring for persons suffering from dementia and behavioural disturbances : An interview study
Job satisfaction is complex and is an important component in facilitating high quality nursing care. Behavioural and psychological symptoms of dementia (BPSD) can be clustered into one of five syndromes: psychosis, aggression, psychomotor agitation, depression and apathy, and comprise signs and symptoms of disturbed perception, thought content, mood or behaviour that frequently occur in patients with dementia. BPSD can cause tremendous distress both for the patients and for their caregivers and they have been seen as the most stressful aspect of care giving. Two registered nurses, 16 assistant nurses and two nursing assistants in Sweden talked about their job satisfaction when caring for residents suffering from dementia and BPSD. Thematic content analysis was conducted. The nurses' narrations indicate exposure, insufficiency, not being valued and doubt, as well as respect and importance and devotion towards the residents. One core theme was formulated: "Job satisfaction as a process moving between breaking down and occasionally building up the working person". A positive relationship with colleagues was the primary reason for nurses continuing to work at the group dwellings. The organization and resident behaviours were seen as very negative. Some nurses described insecurity in terms of how long they could continue to take rudeness, being spat at, being scratched or physically hit by residents, without "hitting back". In order to increase the well-being of the nurses, the pressure on them needs to be relieved. The development of leadership, education, supervision and reflection might be one possible way of reducing the prevalence of BPSD-related violence, enhancing job satisfaction and handling moral stress