The aim of the study is to deepen the understanding of abused women's vulnerability in relation to how the abuse and encounters with health care professionals affect life. A further aim is to highlight abused women's vulnerability with a caring science perspective.
Experience of abuse has consequences for the mental health of women and girls. Abused women may experience health care as unsupportive, and as a result, often chose not to disclose their experiences of abuse.
The results of two qualitative empirical studies were analysed along with a phenomenological meaning analysis in accordance with the methodological principles of Reflective Lifeworld Research.
Living one's life with experiences of abuse implies vulnerability, which can prevent abused women from achieving good health. This vulnerability results from insecurity regarding identity, along with the sense that one could have been a different individual if it were not for the abuse and thereby have a more fair chance in life. Being cared for within general psychiatric care could further increase this vulnerability. The healthcare professional's ability to care for the women who have experienced abuse leads to either an encounter of trust or else further suffering for the women.
A lifeworld-oriented caring science perspective as a foundation for care can contribute to care for abused women which reaches the existential dimensions of their vulnerability and vulnerable life situation.
It is evident that healthcare professionals should deepen their understanding of how abused women live, within a general psychiatric context. This study enables a deeper understanding of abused women's vulnerability in relation to how the abuse and encounters with healthcare professionals affect life.
The main purpose for the expansion of supported community care for persons with serious mental illness in Sweden was to ensure the right for these persons to live as citizens in the community. However, earlier research shows that negative attitudes towards mental illness present an obstacle for social integration of persons with serious mental illness. The aim of this study, conducted in Sweden, was to evaluate an existing instrument's (Community Attitudes towards Mental Illness, CAMI), validity and reliability. An additional aim was to adapt and develop the questionnaire to Swedish circumstances. After translation and modification of the original CAMI, the Swedish version of the questionnaire (CAMI-S) was distributed to all student nurses at three different universities in Sweden. The overall Cronbach's alpha coefficient was 0.90 of the original CAMI-S. A corrected inter-item total correlation excluded 20 items because they showed loading 0.43, was 0.903. A factor analysis of these items revealed that the data could be extracted in three factors labelled as: open-minded and pro-integration, fear and avoidance and community mental health ideology. Finally, in order to reach reliable results in attitude research, it is important to measure the respondent's attitude towards the object in common as well as the respondent's attitude to interact with the object. Accordingly, it is important to add behavioural intention items to the 'new CAMI-S'. Statements exemplifying how something 'ought to be' in an impersonal way have a good degree of stability over time and place.
Previous research has shown that persons with long-term mental illness who require prolonged treatment and social support wish to, yet find it difficult to, find meaning or quality in life. A descriptive qualitative design using self-photography and in-depth interviews was used for data collection. The aim of this study was to explore basic attitudes to life as expressed by nine persons with long-term mental illness living in the community. The findings provide insight into the values of relationships, work, and the home for persons with long-term mental illness and indicate that they are cognizant of social norms yet have difficulty integrating these in their daily lives. The study also illuminates the informants' difficulties in creating satisfying and supporting relationships with others.
Building an Indigenous mental health workforce is a strategy used to develop culturally responsive and effective mental health services in New Zealand. However, researchers know little about Indigenous (Maori) mental health nursing. We undertook a Maori-centered methodology and grounded theory using focus groups to collect data from 10 Maori mental health nurses. We then analyzed the data using constant comparative analysis and theoretical sampling until saturation of the core category and subcategories emerged. "Bridging two worlds," together with two subcategories, "going beyond" and "practicing differently," explains the process Maori mental health nurses used to resolve the tensions they encountered working in the worlds of mainstream and Maori health services. This research provides insight into the tensions Indigenous and minority nurses experience when attempting to integrate cultural perspectives and practices to meet the needs of their patients.
INTRODUCTION: The aims of this study were to investigate: (1) the prevalence of childhood abuse in women admitted to psychiatric services in a county in the south of Sweden; (2) who the perpetrators were; and (3) the women's self-reported consequences of childhood abuse. METHOD: The study had a cross-sectional design and was a part of a more comprehensive study. An anonymous self-reported questionnaire was used which included both closed and open-ended questions. The data material were analysed by means of descriptive statistics, Mann-Whitney U-test and manifest content analysis. RESULTS: The total number of women who participated in the study was 259, 51% of whom reported experiences of abuse during childhood, with 53% of these having been exposed to more than one type of abuse. The most frequent perpetrator was the woman's parents; mainly the fathers but also the mothers turned out to be frequent perpetrators of abuse. Some 75% of the women reported current psychological problems in adulthood related to abuse in childhood. According to a manifest content analysis, five themes of self-reported psychological problems emerged: psychiatric problems, shortcomings in social relations, poor self-confidence, fears and bad memories.
Nowadays many people suffering from severe and persistent mental disorders are cared for in ambulatory settings by multidisciplinary teams. Nurses take an important part in these teams. What is nursing practice in this type of setting? A case study was developed from a nurse's clinical practice in order to answer this question. The results suggest that these nursing services are of an advanced practice nature as defined by Hamric et al. (2000).
Within an international network study involving four European countries (COMSKILLS), results on clinical-qualitative data are reported and discussed. A total of 103 semi-structured interviews were conducted, representing 45 per cent of the patients involved in the project (N=231).
The coding framework represents a means of identifying and measuring aspects of complexity and specificity in the way in which key workers talk about care in relation to individual patients.
Respondents talked about patient care most frequently in terms of coping behavior and working relationships with patients. The commonest method cited for information gathering was observation. Out of three conceptual levels, ranging from complex and specific responses (conceptual level 3), to relatively general and unspecific remarks (level 1), most responses were coded at Levels 1 or 2.
Taking into account the apparent reluctance of many clinical staff to make use of standardized assessment instruments, systematic treatment-oriented methods able to both allow for valid and reliable assessments and to structure clinical experience is needed. It is expected that complexity and specificity care is referred to will profit from the regular use of such a method (e.g. the BEST-Index).
Erratum In: Int J Psychiatr Nurs Res. 2007 May;12(3):1473
Internationally, research on psychiatric intensive care units (PICUs) commonly reports results from demographic studies such as criteria for admission, need for involuntary treatment, and the occurrence of violent behaviour. A few international studies describe the caring aspect of the PICUs based specifically on caregivers' experiences. The concept of PICU in Sweden is not clearly defined. The aim of this study is to describe the core characteristics of a PICU in Sweden and to describe the care activities provided for patients admitted to the PICUs. Critical incident technique was used as the research method. Eighteen caregivers at a PICU participated in the study by completing a semistructured questionnaire. In-depth interviews with three nurses and two assistant nurses also constitute the data. An analysis of the content identified four categories that characterize the core of PICU: the dramatic admission, protests and refusal of treatment, escalating behaviours, and temporarily coercive measure. Care activities for PICUs were also analysed and identified as controlling - establishing boundaries, protecting - warding off, supporting - giving intensive assistance, and structuring the environment. Finally, the discussion put focus on determining the intensive aspect of psychiatric care which has not been done in a Swedish perspective before. PICUs were interpreted as a level of care as it is composed by limited structures and closeness in care.
Erratum In: Int J Ment Health Nurs. 2008 Jun;17(3):224Salzmann-Krikson, Martin [corrected to Salzmann-Erikson, Martin]
The ideal of trust pervades nursing. This article uses empirical material from acute psychiatry that reveals that it is distrust rather than trust that is prevalent in this field. Our data analyses show how distrust is expressed in the therapeutic environment and in the relationship between nurse and patient. We point out how trust can nonetheless be created in an environment that is characterized by distrust. Both trust and distrust are exposed as ;fragile' phenomena that can easily ;tip over' towards their opposites. Trust is not something that nurses possess or are given; it is rather something that they earn and have to work hard to achieve. Regarding themselves as potential causes of distrust and active wielders of power can contribute to nurses developing a more realistic view of their practice. Assuming a realistic middle-way perspective can help to manoeuvre between the extremities of excellence and resignation, which in turn can lead to processes that create trust between psychotic patients and nurses.