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  • 1.
    Debyser, Bart
    et al.
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; VIVES University of Applied Sciences, Kortrijk, Belgium; Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium.
    Berben, Kevin
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Alexian Psychiatric Hospital, Tienen, Alexianen Care Group, Tienen, Belgium.
    Beeckman, Dimitri
    Örebro University, School of Health Sciences. Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland.
    Deproost, Eddy
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; VIVES University of Applied Sciences, Kortrijk, Belgium; Psychiatric Hospital, Centre for Psychiatry & Psychotherapy Clinic St-Joseph, Pittem, Belgium.
    Van Hecke, Ann
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Staff member Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Verhaeghe, Sofie
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; VIVES University of Applied Sciences, Kortrijk, Belgium.
    The transition from patient to mental health peer worker: A grounded theory approach2019In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 2, p. 560-571Article in journal (Refereed)
    Abstract [en]

    Peer workers are increasingly being engaged in contemporary mental healthcare. To become a peer worker, patients must evolve from having a patient identity to a peer worker identity. This study aims to understand how mental health peer workers experience their transition and how it affects their view of themselves and their direct working context. A grounded theory approach was used. Seventeen mental health peer workers in Belgium were recruited through theoretical sampling. Semi-structured interviews were conducted and analysed according to the constant comparative method. The results indicate that novice peer workers experience peer work as an opportunity to liberate themselves from the process of mental suffering and realise an acceptable form of personal self-maintenance. As peer workers become more experienced, they are confronted with external factors that influence their self-maintenance and personal development. Experiencing clarity in their duties and responsibilities, equality, and transparency in the workplace reinforce their experience of self-maintenance and positively influence their self-development. Experiencing a lack of clarity in their duties and responsibilities, inequality, and lack of openness discourage peer workers' self-development process. These experiences challenge their personal motivations to become peer workers, which are usually linked to building a meaningful life for themselves. The insights can encourage organisations to build up a supportive environment collaboratively with peer workers and ensure that peer workers can exert their authentically unique role in mental healthcare.

  • 2.
    Debyser, Bart
    et al.
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Duprez, Veerle
    Department of Public Health, Ghent University, Ghent, Belgium.
    Beeckman, Dimitri
    Department of Public Health, Ghent University, Ghent, Belgium.
    Vandewalle, Joeri
    Department of Public Health, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, Ghent University Hospital, Ghent, Belgium.
    Deproost, Eddy
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Verhaeghe, Sofie
    Department of Public Health, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    Mental health nurses and mental health peer workers: Self-perceptions of role-related clinical competences2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 3, p. 987-1001Article in journal (Refereed)
    Abstract [en]

    In a mental healthcare that embraces a recovery-oriented practice, the employment of mental health peer workers is encouraged. Although peer workers are increasingly working together with nurses, there is a lack of research that explores how nurses and peer workers perceive their role-related competences in clinical practice. The aim of this study was to clarify and understand these self-perceptions in order to identify the specificity and potential complementarity of both roles. This insight is needed to underpin a successful partnership between both vocations. A qualitative descriptive research design based on principles of critical incident methodology was used. Twelve nurses and eight peer workers from different mental healthcare organizations participated. A total of 132 reported cases were analysed. Rigour was achieved through thick description, audit trail, investigator triangulation and peer review. Nurses relate their role-related competences predominantly with being compliant with instructions, being a team player and ensuring security and control. Peer workers relate their role-related competences with being able to maintain themselves as a peer worker, building up a relationship that is supportive for both the patient and themselves, and to utilize their lived experience. Both nurses and peer workers assign a major role to the team in determining their satisfaction with their competences. Consequently, what is perceived as important for the team appears to overshadow their self-assessment of competences. The findings highlighted the importance of paying more attention to identity construction, empowerment and role competence development of nurses and peer workers in their respective education and ongoing training.

  • 3.
    Ewertzon, Mats
    et al.
    Örebro University, School of Health and Medical Sciences.
    Lützén, Kim
    Svensson, Elisabeth
    Örebro University, Swedish Business School at Örebro University.
    Andershed, Birgitta
    Örebro University, School of Health and Medical Sciences.
    Developing the concept of family involvement and the alienation questionnaire in the context of psychiatric care2008In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 17, no 6, p. 439-449Article in journal (Refereed)
    Abstract [en]

    Research shows that family members of persons with a mental illness often experience a lack of involvement in the psychiatric care of their relative. An interpretation of the findings of these studies raises the question whether the family members’ experience of not being involved can be conceptualised in terms of alienation towards mental health services from their encounter with psychiatric care. 

    In order to explore this possibility, the Family Involvement and Alienation Questionnaire (FIAQ) was constructed, guided by relevant theoretical frameworks and empirical research. The content validity of the questionnaire was evaluated by two groups of experienced researchers who had sound knowledge of the theoretical frameworks used. Validity based on the response process was evaluated by parents of persons with mental illness. The reliability of the questionnaire was evaluated by a test-retest design, in a group of 15 family members. The data were analysed by a non-parametric statistical method.

     

    The results of the validity and reliability evaluations show that of the 46 original items 28 items in the questionnaire would be useful in exploring the concept of family involvement and alienation in the context of psychiatric care. Further, minor modification may make the FIAQ useful in exploring these concepts in other settings.

  • 4.
    Hylén, Ulrika
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Kjellin, Lars
    University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Pelto-Piri, Veikko
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Warg, Lars-Erik
    Department of Occupational and Environmental Medicine, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden.
    Psychosocial work environment within psychiatric inpatient care in Sweden: Violence, stress, and value incongruence among nursing staff2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 3, p. 1086-1098Article in journal (Refereed)
  • 5. Högberg, Torbjörn
    et al.
    Magnusson, Annabella
    Ewertzon, Mats
    Örebro University, Department of Health Sciences.
    Lützén, Kim
    Attitudes towards mental illness in Sweden: adaptation and development of the Community Attitudes towards Mental Illness questionnaire2008In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 17, no 5, p. 302-310Article in journal (Refereed)
    Abstract [en]

    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. The overall Cronbach's alpha coefficient on the 20 items (new CAMI-S) that 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.

  • 6. Karpowicz, Ewa
    et al.
    Skarsater, Ingela
    Nevonen, Lauri
    Örebro University, School of Health and Medical Sciences.
    Self-esteem in patients treated for anorexia nervosa2009In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, no 5, p. 318-325Article in journal (Refereed)
    Abstract [en]

    Anorexia nervosa (AN) mainly affects girls or women between 13 and 45 years of age. According to previous studies, one of the reasons for the desire to be thin is low self-esteem. The purpose of the study was to examine the self-esteem of 38 female patients with AN between 16 and 25 years of age, before and after 3 months of treatment at a specialist ward for eating disorders in Goteborg, Sweden. A quantitative pre- and post-assessment based on two self-rating questionnaires, the Rosenberg Self-Esteem Scale (RSE-S) and three subscales (weight phobia, body dissatisfaction, and ineffectiveness) of Eating Disorder Inventory-2 (EDI-2), together with body mass index (BMI), were used in the study, which was conducted between June 2005 and March 2008. The results reveal that self-esteem, BMI, weight phobia, and body dissatisfaction improved significantly between pre- and post-treatment. The RSE-S and EDI-2 ineffectiveness correlate highly with one another, which lends support to convergent validity, and the internal consistency was high for both the RSE-S and EDI-2 ineffectiveness. The results indicate that the treatment was effective, as both patients' self-esteem and BMI increased after completed treatment, which was the primary goal of the treatment at this ward. Future studies should focus on follow up and the way self-esteem manifests itself at different points in time within an individual.

  • 7. Salzmann-Erikson, M.
    et al.
    Lützén, Kim
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences.
    Eriksson, H.
    The core characteristics and nursing care activities in psychiatric intensive care units in Sweden2008In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 17, no 2, p. 98-107Article in journal (Refereed)
    Abstract [en]

    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. © 2008 Australian College of Mental Health Nurses Inc.

  • 8.
    Schröder, Agneta
    et al.
    Psychiatric Research Centre, Örebro County Council, Örebro, Sweden.
    Ahlström, Gerd
    Swedish Institute for Health Science, Lund University, Lund, Sweden.
    Wilde Larsson, Bodil
    Department of Nursing, Karlstad University, Karlstad, Sweden; Department of Nursing, Hedmark University College, Elverum, Norway.
    Lundqvist, Lars-Olov
    Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden.
    Psychometric properties of the Quality in Psychiatric Care: Out-Patient (QPC-OP) instrument2011In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, no 6, p. 445-453Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to test the psychometric properties and dimensionality of the Quality in Psychiatric Care – Outpatient (QPC–OP) instrument, in order to determine whether the model of QPC that is applicable to the inpatient clinic is also applicable to the outpatient clinic, and to briefly describe the patients' perceptions of quality of psychiatric outpatient care. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden participated in the study. A confirmatory factor analysis revealed that the QPC–OP consists of eight dimensions, and has a factor structure largely corresponding to that of the QCP – Inpatient instrument. The internal consistency of the factors was generally acceptable, except in the case of two, where there were not enough items. Thus, the QPC–OP shows adequate psychometric properties. The patients' ratings of quality of care were generally high; the highest rating was for ‘encounter’ and the lowest for ‘discharge’. The quality of discharge was rated as the lowest among the eight dimensions in 14 of the participating outpatient clinics. Thus, this dimension would seem to indicate an important area for improvement. The QPC–OP includes important aspects of patients' assessments of quality of care, and offers a simple and inexpensive way to evaluate psychiatric outpatient care.

  • 9.
    Vandewalle, Joeri
    et al.
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Research Foundation-Flanders (FWO), Brussels, Belgium.
    Beeckman, Dimitri
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.
    Van Hecke, Ann
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Nursing Department, Ghent University Hospital, Ghent, Belgium.
    Debyser, Bart
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Deproost, Eddy
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Centre for Psychiatry and Psychotherapy Clinic St Joseph, Psychiatric Hospital, Pittem, Belgium.
    Verhaeghe, Sofie
    Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium; Department of Nursing, VIVES University College, Roeselare, Belgium.
    'Promoting and preserving safety and a life-oriented perspective': A qualitative study of nurses' interactions with patients experiencing suicidal ideation2019In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 5, p. 1119-1131Article in journal (Refereed)
    Abstract [en]

    Suicide prevention is an important imperative in psychiatric hospitals, where nurses have a crucial role in and make essential contributions to suicide prevention and promoting the recovery of patients experiencing suicidal ideation. The present qualitative grounded theory study aimed to uncover and understand the actions and aims of nurses in psychiatric hospitals during their interactions with patients experiencing suicidal ideation. Interviews were conducted with 26 nurses employed on 12 wards in four psychiatric hospitals. The data analysis was inspired by the Qualitative Analysis Guide of Leuven. The findings show that nurses' actions and aims in their interactions with patients experiencing suicidal ideation are captured in the core element 'promoting and preserving safety and a life-oriented perspective'. This core element represents the three interconnected elements 'managing the risk of suicide', 'guiding patients away from suicidal ideation', and 'searching for balance in the minefield'. The enhanced understanding of nurses' actions and aims can inform concrete strategies for nursing practice and education. These strategies should aim to challenge overly controlling and directing nursing approaches and support nurses' capacity and ability to connect and collaborate with patients experiencing suicidal ideation.

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