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 .

The purpose of this article is to explore the technologies of government that are created within gender disorder assessments as an institution. I have done so by utilizing Norman Faircloughs discourse analysing instrument ?communicative action?, which focus on the social institution as relational.The material is strategically chosen by gathering texts from the Swedish state, the psychiatric clinics, NGO:s and by performing interviews with transsexual patients.When analysing the communication of the main agents, I have concluded that practices highly are a result of repeating text and speech inside the institution. The psychiatric assessments can also be seen as an illustration in changes in how citizens are governed in advanced liberal societies, where the role of the state has been gradually reduced in favour of other agents.I consider that the change illustrates an ?acting at a distance?-mentality where the patient is introduced to participate in the definition of the care in what I call ?negotiation as a technology?.

This study examines whether or not there are inherit flaws in Swedish legislation concerning psychiatric institutional care, or in the application of the act, which might lead to the failure of rule of law for the private citizen. Law (1991:1128) concerning psychiatric institutional care in certain instances (LPIC) aims to establish rules which will ensure rule of law for the mentally ill in case of psychiatric institutional care. Despite this, there are legal cases which indicate that these rules, and their implications, are not always considered at the psychiatric wards.The questions at issues which this study aims to answer are thus: Are there any deficiencies concerning rule of law in LPIC 2?3 §§, 4?6 §§, 7?10 §§,15?25 §§ and 32?33 §§ ? This section focuses on LPIC and its design. Whether or not the act adheres to rule of law is examined through a definition which has evolved through discussions of concept based in Peczeniks definition of rule of law.

           AbstractAims: To explore whether and in that case how nurses question women in the psychiatric care about violence in close relationships and how nurses respond to women who have been exposed to domestic violence.Method: A qualitative descriptive interview study with twelve nurses from four psychiatric wards was carried out in Uppsala. Informants were chosen from a convenient selection. The interviews with semi-structured interview questions were recorded on tape, transcribed and analyzed with content analysis.Results: There is no routine to ask all female patients if they are victims of violence. It happens only in cases where the suspicion arises or is confirmed. It is individually whether and how the nurse asks the woman if she is subjected to violence in a close relationship, depending on patient and nurse.

ABSTRACTIntroduction: Violence towards employees in the psychiatric ward is increasing at an alarming rate. Reports concerning the effect on the staff?s psychological health are disturbing. These workforces are those most affected by brutality and for ages it has been looked upon as a part of the psychiatric line of work. This viciousness is threatening the safety for both the personnel and the patients.

Background:The adult inpatient psychiatric care is regulated by law and allows certain amount of coercion, most commonly restraint, forced medication and seclusion. To be treated according to this law you need to suffer from a serious mental disorder, oppose to the care and have an indispensable need of care. Many studies describe patients experiences to be treated with coercion but few about health care workers experiences.Aim:To describe health care workers experiences of performing coercion in psychiatric compulsory care.Method:A literature review was made and eight articles is the basis for the result.Results:From the articles used inthis study four themes were created. These are coercions impact on relations, health care workers feelings during coercion, coercion as a necessary evil and health care workers need for reflection. The themes are presented as headlines in the result.Conclusion:To use coercive measures brings out many different feelings among health care workers.

ABSTRACTIntroduction: Violence towards employees in the psychiatric ward is increasing at an alarming rate. Reports concerning the effect on the staff?s psychological health are disturbing. These workforces are those most affected by brutality and for ages it has been looked upon as a part of the psychiatric line of work. This viciousness is threatening the safety for both the personnel and the patients.

Suicide and attempted suicide frequently occur in society today and represent a major public health problem. In inpatient psychiatric care the nurse have a central role when caring for suicidal patients. Few systematic studies exists that address the nurse?s practical work with these patients. The purpose of this study was therefore to describe the nursing care of suicidal patients as it was perceived by registered clinical expert nurses.

Background: More focus has been placed towards autonomy when it comes to care and in special towards palliative care. The purpose with palliative care is to relieve and support at the end of the life. When the patient has difficulties to communicate to those around him due to his illness it is hard to preserve the patients right of self-determination. It is very important to consider the patient as autonomous during the course of the illness. Different alternatives have been developed to preserve the patient?s autonomy such as dedicate a deputy or plan the care of the patient in advance.Aim: The aim of this study was to describe, from an ethical point of view, how the patient?s autonomy could preserved at palliative care.Method: A general literature study where 11 scientific articles have been analysed from a qualitative checklist whereof the result has been discussed based on the principles of ethics.

Background: More focus has been placed towards autonomy when it comes to care and in special towards palliative care. The purpose with palliative care is to relieve and support at the end of the life. When the patient has difficulties to communicate to those around him due to his illness it is hard to preserve the patients right of self-determination. It is very important to consider the patient as autonomous during the course of the illness. Different alternatives have been developed to preserve the patient?s autonomy such as dedicate a deputy or plan the care of the patient in advance.

Background: Suicidal patients feelings and experiences of the psychiatric service can be a decisive moment of the following treatment. Although suicide is a common problem all over the world we know very little about the feelings that the patients are feeling in residential psychiatric care. Purpose: The aim of this litterature studie was to describe suicidal patients feelings and experiences of the psychiatric service. Method: Literature study was conducted through a search of articles in different databases. The data has been done as an overview and the data has been analysed with content analysis.

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.

Aim Our aim is to highlight perceptions of fibromyalgia among health care personell.MethodsA systematic literature review conducted with a deductive approach.FindingsHealth care personell felt insecure because of a lack of understanding which lead to avoiding contact with these patients. Many felt that the fibromyalgia patient was categorised and that they would have been better served with another name of their disease. There was a great distrust against the diagnosis and its aetiology. The patient was perceived as troublesome, illness-fixated and draining the personell of energy. The paradox that the patient is looking so healthy but bearing so much pain was confusing for the health care personell.Conclusions Communication and an empathic encounter was identified as important elements for patient care.

Aim: The aim of this qualitative interview study was to describe the nurse's professional role and the role as a patient during different time periods. Data were collected through semi-structured interviews, where respondents had a link to the nursing profession, either as a student, now working nurse or retired nurse. Method: The data were analyzed using a content analysis. Result: The older nurses believe that nurses today has a high status and is seen as a well-read and well informed person. Most respondents believe that collaboration between nurses and doctors has improved since past.

Background: There are many possible reasons why a patient gets a stoma and in every case it?s of importance for the nurse to adjust nursing care, information and patient education from individual presuppositions. Problem: Patient education regarding stoma self-care is an important part of the nurse?s work within stoma care. The patient is depending on the guidance of the nurse and therefore it is relevant to illuminate the importance of education regarding gaining ability to perform self-care.