From pattern appraisal to unitary appreciative inquiry - a critical reflection on the development of the unitary appreciative inquiry method

Summative Assessment of the Core Module „Theoretical Developments in the Science and Art of Nursing“. The purpose of this article is to place Cowling’s unitary appreciative inquiry method in the context of nursing science and the development of unique nursing research methods. Unitary appreciative inquiry is one of a few nursing research and practice methodologies based on Martha Rogers’ theory, the Science of Unitary Human Beings. This article is reflecting the development of the unitary appreciative inquiry method in analyzing articles and literature published by Cowling and other authors that are related to Cowling’s ideas and approaches. A brief overview of the basic concepts, assumptions and principles of Rogers’ theory is given as well as some insights on other major influences on Cowling’s work. The changes that have been made over the past seventeen years from pattern appraisal to pattern appreciation and unitary appreciative inquiry in its current use are mapped and its contribution to current nursing knowledge and practice is critically reviewed. The author of this article strongly beliefs that nursing needs to develop its own research methods based on nursing theories for further development and improvement of nursing science as an independent and accepted discipline in human health care. It is from that perspective that Cowling’s work is reviewed

Negotiating uncertainty: an aspect of personal recovery in people living with mental illness - a workshop

Uncertainty in illness is a well known concept among many health conditions including chronic illnesses. Much has been investigated in research in how people adapt to different health conditions and how the concept of uncertainty in illness relates to those populations. However, in mental health, even though there is a strong interest in coping strategies, the aspect of negotiating uncertainty has not been fully investigated. In the context of a larger doctoral programme, where several researchers are focusing on aspects around negotiating uncertainty in people living with chronic health conditions, the author of this paper is focusing on people with mental illnesses and the relation of uncertainty within their personal recovery from a nursing perspective. The paper/presentation explores the available literature, interprets its findings and puts them in context with the current developments in mental health nursing, e.g. personal recovery and social inclusion. However, this is only the first step of a study conducted by the author that is still at the very beginning of its development. Therefore, the presentation is meant to be set up as a workshop in the form of a dialogue between participants of the conference and the researcher. What are important aspects in dealing with uncertainty and adapting to life with mental illness? How do we get to know about them? How could those aspects be used to support people in their personal recovery? The discussion in the workshop will hopefully help to guide the future development of the proposed research project

Creating meaning - understanding the experiences of people living with mental illness in Switzerland: a qualitative study.

Mental illnesses have a large impact on individuals, their families and friends and communities. People living with mental illness often face discrimination and not the least within the health-care system. However, there is an ongoing shift from a paternalistic to a person-centred approach in the treatment of people living with mental illness. User involvement in the development of care has become common practice and personal recovery rather than cure is at the core of treatment. However, to further improve professional practice, there is a need to understand more about the experiences of people living with mental illness. The aim of this research is to explore and evaluate the personal experiences of people living with mental illness in Switzerland and to identify aspects that are most relevant to this population in living with and adapting to mental illness. Therefore, the study aims to create an understanding of the adaptation process to mental illness from a patient perspective. A constructivist and reflexive Grounded Theory approach was chosen for the main study. Ten participants, people living with mental illness in Switzerland, were interviewed. However, the project also includes a preliminary study, comprising a focus group with mental health professionals, that used qualitative thematic analysis. Three categories were generated from the data of the main study: Constructing explanations refers to the process of participants trying to understand what is going on in their lives. Defining self-identity points out that people living with mental illness provide themselves with an understanding of who they are. Making sense-of-life refers to the aspect, that the participants give situations meaning and take control over them. The three categories form the theoretical framework of the Creating Meaning Theory, which summarises the experiences of the people interviewed for this study. The findings support existing theories but add a new and unique understanding of people’s experiences in living with mental illness that will help to further improve concepts such as empowerment and recovery

Betagte Psychosepatienten in Alters- und Pflegeheimen / Elderly Psychosis Patients in Elderly- and Nursing Homes

Changes in the Swiss Healthcare System demand new ways of dealing with people living with mental illness in elderly- and nursing homes. In a workshop current knowledge and experiences have been discussed Full abstract/conference paper in German available

Pflegerische Fallführung in der ambulanten psychiatrischen Versorgung – ein Zukunftsmodell? Erfahrungen und Erkenntnisse aus Praxis und Forschung im Diskurs/Nurse lead case management in ambulant mental health care - a model of the future? Experiences and findings of research and practice on discourse

Nurses in the position of "case leading / case responsible" carers in ambulant mental health care settings are still fairly uncommon in German speaking countries due to legal and other reasons. However, in Switzerland there are more and more mental health institutions that accept this new and extended role of nurses. The presentation provides insights into experiences as well as results of a study that focused on the topic

Creating Meaning - People Living with Mental Illness in Switzerland

Introduction: Mental illnesses have a large impact on individuals, their families and friends and communities. People living with mental illness often face discrimination and not the least within the health-care system. In this research project people living with mental illness in Switzerland share their stories. Out of these stories the Creating Meaning Theory was developed which sheds light on how the people concerned deal with their life situations. Objectives: The aim of this research project was to explore and evaluate the personal experiences of people living with mental illness and to outline the process of adaptation within a new theory. This new understanding may help health-care providers and nurses to promote an improved quality of life and increased wellbeing. Methodology: A constructivist and reflexive Grounded Theory approach was chosen for the study. Ten participants, people living with mental illness in Switzerland, were interviewed and additional data from various sources were included in the data analysis. Results: Three categories form the theoretical framework of the Creating Meaning Theory, which summarises the experiences of the people interviewed for this study: Constructing explanations refers to the process of participants trying to understand what is going on in their lives. Defining self-identity points out that people living with mental illness provide themselves with an understanding of who they are. Making sense-of-life refers to the aspect, that the participants give situations meaning and take control over them. The findings support existing theories but add a new and unique understanding of people’s experiences in living with mental illness. Conclusions: The Creating Meaning Theory provides a new and unique understanding of the adaptation process to living with mental illness from a service user perspective. It is a non-linear, infinite and ongoing process. Their stories need to be heard, understood and transformed into action in real life, health-care and society

Uncertainty in illness among people living with mental ill health - a mental health nursing perspective

Background: Uncertainty in illness is a well-known concept in health care literature. A considerable volume of research has investigated how people adapt to different health conditions and how the concept of uncertainty in illness relates to those populations. However, while there is substantial literature focusing on coping strategies and personal recovery, there is a paucity of research about uncertainty in illness among people living with mental ill health. Aims: To explore the concept of uncertainty in illness among mental health nurses and to provide an understanding of its relevance to people living with mental ill health. Method: Thematic analysis of a focus group of mental health nurses. Findings: Uncertainty in illness among people living with mental ill health exists and manifests itself in various ways: uncertainty in the context of loss, uncertainty as a stimulus for change and uncertainty as an integral part of the human experience and existence. Conclusions: Even though contemporary approaches in mental health nursing do not directly address uncertainty, the concept and its implications need to be considered and raised further among mental health professionals in order to improve support for people living with mental ill health in their process of personal recovery

Adverse Outcomes of Patients with Non-Ventilator-Associated Hospital-Acquired Pneumonia (nvHAP)—A Single Centre Cohort Study

Non-ventilator associated hospital-acquired pneumonia (nvHAP) is a common nosocomial infection, but little is known about the outcomes of patients with nvHAP and the risk factors for adverse outcomes. In this retrospective study conducted in a Swiss tertiary care centre, adverse outcomes like in-hospital mortality, intensive care unit (ICU) admission, and mechanical ventilation, both all-cause and nvHAP-associated, were investigated. Of 244 patients with nvHAP, 72 (30%) died, 35 (14%) deaths were attributed to nvHAP. While 36 (15%) patients acquired nvHAP on the ICU, another 173 patients were eligible for ICU-transferral, and 76 (43.9%) needed ICU-admission. Of all patients hospitalized on the ICU 58 (51.8%) needed intubation due to nvHAP. Multivariable logistic regression analysis identified lower body mass index (OR per unit increase: 0.90, 95%CI: 0.82–0.98) and lower haemoglobin on admission (OR per unit in g/l increase: 0.98, 95%CI: 0.97–1.00) as patient specific factors independently associated with nvHAP-associated mortality. Given the frequency of nvHAP adverse outcomes, hospitals should evaluate increasing nvHAP prevention efforts, especially for patients at high risk for nvHAP mortality. To what extent pneumonia prevention interventions do lower nvHAP mortality in these patients is still to be evaluated

Recovery oriented mental health nursing: a pilot Intervention study

Based on previous studies that have been focusing on current practices in mental health nursing and the on-going development in mental health practice towards a more recovery-oriented approach this pilot intervention study focuses on improving mental health nursing practice through providing specific training sessions for nurses and the implementation of goal-oriented care in close collaboration with service users. Results are measured within a pre- and post-test design among health professionals and service users. The presentation will contain an introduction of the study protocol, an experience report and hopefully some initial results of the study