Title: The nurse's dilemma in psychiatric Inpatient care - a balancing act between good and evil Objective: To describe the nurse's experience of relieving patient suffering caused by coercive measures on a closed psychiatric ward . Frame of reference : The results are discussed in light of Eriksson´s theory of suffering and caring relationships Method: A qualitative analysis based on focus group discussions Results: The analysis resulted in six categories, to protect the patient , to involve the patient , not to lose control , to remain , to justify compulsion , and to be touched . The results showed that nurses had the experience of being able to relieve the suffering of patients caused by coercive measures. It was also found that the nurses had a tendency to justify coercive measures , the more experience they had of performing these . Conclusion: The results describe that nurses have the experience and knowledge of how to relieve patients' suffering caused by coercion but also their experiences of performing these .

SAMMANFATTNINGIntroduktion: Utvecklingen inom somatisk slutenvård har under de senaste decennierna gått mot kortare vårdtider. En del patienter på sjukhus vårdas under betydligt längre tid än genomsnittet. Detta skulle kunna leda till fysiskt lidande för patienten, en känsla av hopplöshet på grund av ovisshet gällande sjukdomsförlopp och vårdtidens längd, saknad av familj, en längtan tillbaka till arbetslivet och övrigt socialt liv. Få studier inom medicinsk slutenvård har undersökt patienters upplevelser av att vårdas länge på sjukhus. Syfte: Syftet med studien var att beskriva patienters upplevelser av att vårdas mer är 40 dagar på sjukhus.

De senaste tio åren har det i Sverige visat en ökande trend med psykiatriska sjukdomar. I Sverige insjuknar cirka 15 personer av 100,000 i psykos årligen. Tiden från första symptomdebut till insjuknande kan vara mellan några dagar till flera år och symptomen för psykos kan variera och misstas för depression och ångest. Syftet med studien var att belysa synen på vad omvårdnad är vid psykos och genomfördes som en systematisk litteraturstudie där tio artiklar användes i resultatet. Insjuknande i psykos beskrivs som en oförmåga att kontrollera sig själv och leder ofta till stor rädsla hos patienterna.

Title: The nurse's dilemma in psychiatric Inpatient care - a balancing act between good and evil Objective: To describe the nurse's experience of relieving patient suffering caused by coercive measures on a closed psychiatric ward . Frame of reference : The results are discussed in light of Eriksson´s theory of suffering and caring relationships Method: A qualitative analysis based on focus group discussions Results: The analysis resulted in six categories, to protect the patient , to involve the patient , not to lose control , to remain , to justify compulsion , and to be touched . The results showed that nurses had the experience of being able to relieve the suffering of patients caused by coercive measures. It was also found that the nurses had a tendency to justify coercive measures , the more experience they had of performing these . Conclusion: The results describe that nurses have the experience and knowledge of how to relieve patients' suffering caused by coercion but also their experiences of performing these .

Problemformulering: Sjuksköterskan behöver ge patienten förutsättning till delaktighet i vårdandet. En patient som är delaktig i sin vård upplever minde obehag över situationer och mindre stress. Syftet med denna litteraturstudie var att belysa vilka faktorer som påverkar patientdelaktighet vid sjukhusvistelse och vad sjuksköterskan kunde göra för att underlätta detta. Metod: Studien genomfördes som en litteraturstudie och grundar sig på 13 kvalitativa artiklar. Resultat: I resultatet framkom att sjuksköterskan behövde bygga upp en relation till patienten och ge patienten tid och kunskap för att öka delaktigheten i vårdandet.

Bakgrund: I Sverige tvångsvårdas 3000 personer varje dag utifrån Lagen om psykiatrisk tvångsvård eller Lagen om rättspsykiatrisk vård. Tvångsvård får endast ges om personen lider av en allvarlig psykisk störning, eller på grund av sitt psykiska tillstånd har ett nödvändigt behov av psykiatrisk vård, som inte kan tillgodoses på annat sätt än att personen är intagen på en psykiatrisk vårdavdelning. Viktiga principer att praktisera vid tvångsvård är autonomiprincipen, människovärdesprincipen, legalitetsprincipen och integritetsprincipen.Syftet: Syftet i denna litteraturstudie var att belysa patientens upplevelse av psykiatrisk tvångsvård inom slutenvård.Metod: En systematisk litteraturstudie med 14 kvalitativa artiklar som inkluderats efter sökning i databaserna Cinahl, PubMed och PsycINFO.Resultat: Åtta olika kategorier framkom, Att medicineras under tvång, Att bli frihetsberövad, Att få adekvat stöd från personal och familj, Att få adekvat och kompetent vård, Att inte få tillräckligt med information, Att inte bli bemött som en värdig människa, Att inte få behålla sin autonomi, Att inte få behålla sin identitet.Diskussion: Resultatdiskussionen är baserad på tre huvudfynd, Delaktighet, Information, Människovärde. Dessa fynd har diskuterats med hjälp av viktiga principer att praktisera vid tvångsvård, samt med hjälp av annan forskning inom psykiatrin..

The aim of this study was to, using previously collected data from self-declared antisocial behaviour questionnaires, examine if the crime frequency has been different between adolescents that have either been referred to two different forms of open care in social service, child and youth psychiatric Inpatient care or have been sent to Homes for Specialised Supervision. The criminality frequency and the most common crimes committed were compared between the study groups and further between genders in each particular study group. Statistical significance testing was used and the results of the survey revealed that juvenile delinquents that had committed severe criminal acts were represented in all four groups. The study group with adolescents in national care was the most different from other groups. These youths seemed to have had a lower crime frequency than the other groups with the exception assault and robbery.

Background:Patients with mental disabilities are more prone to somatic illnesses than the general public. Unhealthier lifestyles and side effects of medication might be causes of conditions that lead to diabetes, cardiovascular diseases and premature death. According to the Social Board patients with mental disabilities receive poorer treatment than patients with only somatic diagnosis.Aim:The aim of the study was to describe nurses' experiences to identify, assess and manage somatic symptoms and problems within the psychiatric care.Method:The study is based on interviews with 12 nurses working in psychiatric outpatient and Inpatient care. A qualitative content analysis was chosen.Result:The nurses performed nursing through talking, blood sampling and measuring for example blood pressure. They followed up side effects of medication.

Tvång är en realitet i psykiatrisk slutenvård och påverkan på individens autonomi utgör en viktig kunskapskälla för omvårdnadspersonal. Under 1990-talet genomfördes betydande förändringar inom psykiatrins område med uppkomst av Psykiatrireformen, Lag om psykiatrisk tvångsvård och Lag om rättspsykiatrisk vård, i syfte att förbättra vård och behandling av individer med psykiatriska åkommor. Tvångsåtgärder som förekommer inom den psykiatriska vården utgörs av bältning, isolering, kvarhållande på en sluten psykiatrisk vårdenhet och dylika frihetsberövande åtgärder. Syftet var att beskriva upplevelser och erfarenheter hos individer som genomgått psykiatrisk tvångsvård inom slutenvården. Metoden var en litteraturstudie av kvalitativ design med induktiv ansats.

Title: From openness and presence to distance and control: to be medicated and to administrate from a patient and nurse perspective.Background: Within forensic psychiatric care the patients are admitted against their will, under heavy security with long term treatments. Self-care seems, based on scientific studies, to be dependent on what the nurses involved can provide. Emphasis should focus on a humane and respectful approach when the patient is exposed to coercive measures.Aim: From a patient and nurse perspective describe experiences of beeing medicated with and to administrate antipsychotic drugs within the psychiatric Inpatient care.Method: Interviews with patients and nurses, which were analyzed using qualitative content analysis with an inductive approach.Results: Patients experience frustration over not beeing able to participate in or influence descisions made regarding their neuroleptic treatment. The neuroleptic treatment is described as a coercive measure and is characterized as an experience of losing control and independence. Nurses? experiences of administering antipsychotics were described as having to do what is needed for the long term benefit of patients? well-being.

Introduction: On the surgical wards in most hospitals in Sweden patients with different surgical needs are cared for. Patients with gastrointestinal conditions are, for example, nurtured alongside patients with urological disorders or patients in need of observation for head trauma. When the nurse, in addition to these patients, have to care for patients with palliative care needs can be perceived as problematic for nurse and patient alike.Purpose: The purpose of this study is to explore nurses' perceptions of care for patients with palliative care needs on an acute surgical ward, based on a person-centered perspective.Method: A focus group interview was conducted with the strategic selection of nurses from two acute surgical wards in a county hospital in western Sweden. The data from the interview were analyzed with qualitative directed, deductive content analysis with person-centered care as a theoretical framework. The theoretical background shows that person-centered care includes partnership, participation and structured documentation.Results: The results of this study show that even a fourth category, organization, emerged and needed to be reported.

Bakgrund: Omvårdnadsdokumentationen ligger till grund för många beslut som fattas inom hälso- och sjukvården gällande patientens vård och behandling. Kvalitén på sjuksköterskors dokumentation är ett uppmärksammat problem. För att höja kvalitén behöver sjuksköterskors syn på dokumentation och dess innehåll kartläggas. Syfte: Målet med studien är att skapa en bild över sjuksköterskors perspektiv på dokumentation av psykiatrisk omvårdnad vid sluten psykiatrisk heldygnsvård. Metod: Studien baseras på data från intervjuer med totalt 10 sjuksköterskor från två olika kliniker vilka bedriver sluten psykiatrisk heldygnsvård.

Bakgrund: Hot och va?ld riktat mot va?rdpersonal a?r idag ett va?xande problem o?ver hela va?rlden. Va?rdpersonal tillho?r en av de yrkeskategorier da?r det fo?religger en o?kad risk att bli utsatt fo?r hot och va?ld fra?n patienter. Va?rdpersonal a?r de som sta?r fo?r omva?rdnaden av patienterna och forskning visar att om personalen blir utsatta fo?r hot och va?ld kan det uppsta? konsekvenser fo?r ba?de va?rdpersonal och patienter.Syfte: Syftet med denna litteraturstudie var att belysa upplevelsen av hot och va?ld hos va?rdpersonal inom ha?lso- och sjukva?rden.Metod: I litteraturstudien har 8 vetenskapliga, kvalitativa artiklar sammansta?llts och analyserats med kvalitativ inneha?llsanalys med induktiv ansats.

The study is based on a new approach on how Swedish healthcare is supposed to be controlled and organized. There is a renowned administration problem within Swedish healthcare, which seems to be an obstacle to exploit the resources to the fullest. The latest venture within the healthcare system is patient involvement, where the patients become co-producers of their own care, which aims to both improve and make healthcare more efficient. A few wards in Sweden have implemented this new approach whereupon the study intends to discuss the effectiveness and efficiency in some of these.The study is restricted to three wards, whereof two of these are Inpatient wards and the other one is an outpatient ward, within the medical clinic in Jönköping County Council, which has implemented the patient involvement approach in their daily work. The methodology for this study is qualitative in its nature where a time study of personnel time allocation and supplementary interviews with managing nurses on the wards have been conducted.

The study is based on a new approach on how Swedish healthcare is supposed to be controlled and organized. There is a renowned administration problem within Swedish healthcare, which seems to be an obstacle to exploit the resources to the fullest. The latest venture within the healthcare system is patient involvement, where the patients become co-producers of their own care, which aims to both improve and make healthcare more efficient. A few wards in Sweden have implemented this new approach whereupon the study intends to discuss the effectiveness and efficiency in some of these.The study is restricted to three wards, whereof two of these are Inpatient wards and the other one is an outpatient ward, within the medical clinic in Jönköping County Council, which has implemented the patient involvement approach in their daily work. The methodology for this study is qualitative in its nature where a time study of personnel time allocation and supplementary interviews with managing nurses on the wards have been conducted.