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  • 1.
    Algilani, Samal
    et al.
    Örebro University, School of Health Sciences.
    Östlund-Lagerström, Lina
    Örebro University, School of Medical Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Schröder, Agneta
    Örebro University, School of Health Sciences.
    Mental health as a prerequisite for functioning as optimally as possible in old age: a phenomenological approachManuscript (preprint) (Other academic)
  • 2.
    Brunt, David
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences.
    Rask, Mikael
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Residents' Perceptions of Quality in Supported Housing for People with Psychiatric Disabilities2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 8, p. 697-705Article in journal (Refereed)
    Abstract [en]

    The residents' perspective of the quality of housing support for people with psychiatric disabilities living in congregate supported housing has been studied and a comparison has been made with the findings from those from a previous study in ordinary housing with outreach support. One-hundred and seventy-eight residents from 27 supported housing facilities in eight Swedish municipalities completed the Quality of Psychiatric Care-Housing (QPC-H) instrument. The highest quality ratings were found for: Secluded Environment, Encounter and Support, while Participation, Housing Specific and Secure Environment were rated at lower levels. Despite relatively high ratings, a majority of items did not attain the 80% cutoff point deemed as defining satisfactory quality of service. The residents in ordinary housing with outreach support rated higher levels for the majority of the QPC-H dimensions in comparison with those in supported housing. A conclusion is that the quality of care in supported housing facilities has a number of deficiencies that need to be addressed. Supported housing is generally rated as having a lower quality of care than in ordinary housing with outreach support. Suggestions for the content of staff training are made based on the results.

  • 3.
    Elwin, Marie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ek, Lena
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Schröder, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kjellin, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Autobiographical Accounts of Sensing in Asperger Syndrome and High-Functioning Autism2012In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 26, no 5, p. 420-429Article in journal (Refereed)
    Abstract [en]

    Sensory experiences in Asperger syndrome (AS) or high-functioning autism (HFA) were explored by qualitative content analysis of autobiographical texts by persons with AS/HFA. Predetermined categories of hyper- and hyposensitivity were applied to texts. Hypersensitivity consists of strong reactions and heightened apprehension in reaction to external stimuli, sometimes together with overfocused or unselective attention. It was common in vision, hearing, and touch. In contrast, hyposensitivity was frequent in reaction to internal and body stimuli such as interoception, proprioception, and pain. It consists of less registration, discrimination, and recognition of stimuli as well as cravings for specific stimuli. Awareness of the strong impact of sensitivity is essential for creating good environments and encounters in the context of psychiatric and other health care.

  • 4.
    Elwin, Marie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre.
    Schröder, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre.
    Ek, Lena
    Habilitation and Rehabilitation For Adults, Växjö, Sweden.
    Kjellin, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre.
    Development and pilot validation of a sensory reactivity scale for adults with high functioning autism spectrum conditions: Sensory Reactivity in Autism Spectrum (SR-AS)2016In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 2, p. 103-110Article in journal (Refereed)
    Abstract [en]

    Background: Unusual reactions to sensory stimuli are experienced by 90-95% of people with an autism spectrum condition (ASC). Self-reported sensory reactivity in ASC has mainly been measured with generic questionnaires developed and validated on data from the general population. Interest in sensory reactivity in ASC increased after the inclusion of hyper- and hypo-reactivity together with unusual sensory interest as diagnostic markers of ASC in the DSM-5.

    Aims: To develop and pilot validate a self-report questionnaire designed from first-hand descriptions of the target group of adults diagnosed with high functioning ASC. Psychometric properties of the questionnaire were evaluated on a sample of participants with ASC diagnoses (N = 71) and a random sample from the general population (N = 162).

    Results: The Sensory Reactivity in Autism Spectrum (SR-AS is intended to be used as a screening tool in diagnostic processes with adults and for support in adapting compensating strategies and environmental adjustments. The internal consistency was high for both the SR-AS and its subscales. The total scale Cronbach's alpha was 0.96 and the subscales alphas were 0.80. Confirmatory factor analysis (CFA) showed best fit for a four-factor model of inter-correlated factors: hyper and hypo-reactivity, strong sensory interest and a sensory/motor factor. The questionnaire discriminated well between ASC-diagnosed participants and participants from the general population.

    Conclusions: The SR-AS displayed good internal consistency and discriminatory power and promising factorial validity.

  • 5.
    Elwin, Marie
    et al.
    Örebro University, School of Health Sciences.
    Schröder, Agneta
    Örebro University, School of Health Sciences.
    Ek, Lena
    Department of Psychology, Lund University, Lund, Sweden.
    Wallsten, Tuula
    Centre for Clinical Research, Uppsala University, the County Hospital, Västerås, Sweden.
    Kjellin, Lars
    Örebro University, School of Health Sciences.
    Sensory clusters of adults with and without autism spectrum conditionsManuscript (preprint) (Other academic)
  • 6.
    Elwin, Marie
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Ek, Lena
    Department of Psychology, Lund University, Lund, Sweden.
    Wallsten, Tuula
    Centre for Clinical Research, Uppsala University, Uppsala, Sweden.
    Kjellin, Lars
    Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Sensory Clusters of Adults With and Without Autism Spectrum Conditions2017In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 47, no 3, p. 579-589Article in journal (Refereed)
    Abstract [en]

    We identified clusters of atypical sensory functioning adults with ASC by hierarchical cluster analysis. A new scale for commonly self-reported sensory reactivity was used as a measure. In a low frequency group (n = 37), all subscale scores were relatively low, in particular atypical sensory/motor reactivity. In the intermediate group (n = 17) hyperreactivity, sensory interests and sensory/motor issues were significantly elevated in relation to the first group, but not hyporeactivity. In a high frequency subgroup (n = 17) all subscale scores were significantly elevated and co-occurrence of hyper- and hyporeactivity was evident. In a population sample, a cluster of low scorers (n = 136) and high scorers relative to the other cluster (n = 26) was found. Identification of atypical sensory reactivity is important for targeting support.

  • 7.
    Höglund, Erik
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Schröder, Agneta
    Örebro University, School of Health Sciences.
    Möller, Margareta
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Andersson-Hagiwara, Magnus
    Borås University, Borås, Sweden.
    Ohlsson Nevo, Emma
    Örebro University, School of Health Sciences. University Health Care Research Center.
    The ambulance nurse experiences of non-conveying patients2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 1-2, p. 235-244Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore ambulance nurses' (ANs) experiences of non-conveying patients to alternate levels of care.

    BACKGROUND: Increases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care.

    DESIGN: A qualitative interview study was conducted using an inductive research approach.

    METHODS: The study was conducted in a region in the middle of Sweden during 2016-2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist.

    RESULTS: The ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines.

    CONCLUSION: If ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care.

    RELEVANCE TO CLINICAL PRACTICE: This study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care.

  • 8.
    Kjerstin, Larsson
    et al.
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Wallroth, Veronika
    Örebro University, School of Law, Psychology and Social Work.
    Schröder, Agneta
    Örebro University Hospital. Örebro University, School of Health Sciences. Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    "Du blir aldrig van vid ensamhet": Äldre personers erfarenhet av ensamhet innan de deltar i ett äldrekollo2019Conference paper (Other academic)
    Abstract [sv]

    Ensamhet ses som en riskfaktor för att utveckla fysisk och mental ohälsa. I Sverige uppskattas var tionde äldre vuxen besväras av ensamhet och psykisk ohälsa. I denna fenomenologiskt inspirerade studie har 19 äldre personer mellan 66-94 år intervjuats om varför de är ensamma och hur de upplever ensamheten, detta innan de deltog i ett äldre kollo sommaren 2017.

    Målgruppen för äldre kollot var äldre personer som upplever att de är ensamma och har ett begränsat socialt umgänge och som inte har möjlighet att själva att ta initiativ till att delta i olika aktiviteter och bryta ensamheten.

    Syftet med studien var att få kunskap om varför informanterna upplevde ensamhet samt hur de beskrev sina erfarenheter av att vara ensamma innan de deltog i äldre kollot.

    Informanterna angav flera orsaker till sin ensamhet och det som framkom i resultaten var bl.a. att det var svårare att få kontakt med andra personer på äldre dar, vänner och bekanta har dött och vänskapsrelationer som de haft tidigare har varit svåra att behålla. Många av informanterna var anhörigvårdare till sin make/maka, några hade nyligen flyttat, de hade sämre ekonomi och att de inte kunde förflytta sig lika flexibelt som tidigare då de inte hade en bil att tillgå. När det gäller upplevelsen om ensamhet utryckte många informanter att de kände sig väldigt ensamma trots att de hade ett aktivt socialt liv. De saknade meningsfulla relationer, någon som de kunde vända sig till i förtroende och utveckla en nära vänskapsrelation med. De upplevde behovet av att tillhöra något eller behovet av en förändring i vardagen.

  • 9.
    Kjerstin, Larsson
    et al.
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Wallroth, Veronika
    Örebro University, School of Law, Psychology and Social Work.
    Schröder, Agneta
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Understanding loneliness at older ages: Insight from a Swedish study on summer camps for older adults2018Conference paper (Other academic)
    Abstract [en]

    Loneliness is seen as a risk factor for decreased physical and mental health. Swedish studies have shown that every ten older adults experience severe anxiety and 15 percent are often bothered by loneliness. According to Swedish law all older adults should have an active and meaningful life in community with others. Thus, loneliness among older people has become an important concern in Sweden. Within municipalities various projects are taking place to decrease loneliness among older adults, but these projects are often poorly evaluated. Therefore, knowledge of interventions to decrease loneliness among older adults is essential. From a larger phenomenological inspired study based on interviews with 19 older adults (4 men and 15 women) who had been attending a summer camp, this presentation will bring attention to the reason that these older adults were applying for this experience. Thus, the aim in this part of the study was to explore why they were feeling lonely and considered themselves in need of attending a summer camp and also how they experience loneliness. Often, anxiety and illness are associated with loneliness, but our analysis showed a complex picture of why the interviewees were feeling lonely. Furthermore their experience of loneliness was due not only to an absence of other people to socialize with, but also with the quality of the relationship. This study makes an important contribution in understanding loneliness at older ages and identifies factors that might lead to loneliness among older adults.

  • 10.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Rehabilitation Research.
    Ahlström, G.
    Swedish Institute for Health Sciences, Lund University, Lund, Sweden.
    Wilde-Larsson, B.
    Department of Nursing, Karlstad University, Karlstad, Sweden; Department of Nursing, Hedmark University College, Hedmark, Norway.
    Schröder, Agneta
    Psychiatric Research Centre, Örebro County Council, Örebro, Sweden.
    The patient's view of quality in psychiatric outpatient care2012In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, no 7, p. 629-637Article in journal (Refereed)
    Abstract [en]

    Accessible summary: This paper describes Swedish outpatients' perception of the quality of psychiatric care they received. A large number of patients (1340) from 15 outpatient clinics participated in the study. A newly developed and tested questionnaire, the Quality in Psychiatric Care Out-Patient, was used. The patients' highest ratings were for Encounter (staffpatient interaction), the lowest were for Discharge. Most notably, quality of care was rated higher by women, older people, those with a partner, those with a lower educational level and those who were gainfully employed. In relation to the visit to the clinic, higher quality of care was associated with shorter waiting time, better information and meeting with fewer professions. Older people and those gainfully employed reported better mental health. The longer the waiting time and the greater the number of professions met, the poorer mental health was reported. The conclusion was that although a majority of the patients rated the quality of outpatient care as high, aspects of it remain unsatisfactory. The Quality in Psychiatric Care Out-Patient offers an easy way to assess patients' perception of the quality of care they receive as an outpatient and has a useful role to play in quality-assurance evaluations. Abstract The influence of demographic characteristics on patients' ratings of the quality of psychiatric outpatient care has been given little attention in research. The aim of the present study is to elucidate the quality of psychiatric care among outpatients and investigate demographic and clinical factors associated with the way in which this quality is perceived. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden completed the Quality in Psychiatric Care Out-Patient (QPCOP), with a response rate of 71%. The patients' highest ratings were for Encounter; the lowest were for Discharge. Most notably, quality of care was rated higher by women, older people, those with a partner, those with a lower educational level and those who were gainfully employed. In regard to visits to the clinic, higher quality of care was associated with shorter waiting time, better information and fewer professions encounters. Older people and those gainfully employed reported better mental health. Thus the QPCOP was associated with both demographic and clinical factors. In particular, wanting to come back to the clinic was the single strongest predictor of quality.

  • 11.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Law, Psychology and Social Work. Centre for Rehabilitation Research, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Brunt, David
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Rask, Mikael
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Schröder, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre, Örebro University Hospital, Örebro, Sweden.
    Quality of community-based day centre services for people with psychiatric disabilities: psychometric properties of the Quality in Psychiatric Care - Daily Activities (QPC-DA)2016In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 2, p. 91-96Article in journal (Refereed)
    Abstract [en]

    Background/aims: The aim of the present study was to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care - Daily Activities (QPC-DA) and to briefly describe the day centre attendees' perception of the quality at community-based day centre services.

    Methods: A sample of 218 attendees from 14 community-based day centre services in seven municipalities in Sweden participated in the study.

    Results: Confirmatory factor analysis revealed that the QPC-DA consists of six dimensions and has a factor structure that to a large extent corresponds to that found in other studies of quality in psychiatric care settings, such as inpatient, outpatient, forensic inpatient, and housing support for people with psychiatric disabilities. The internal consistency of the factors was satisfactory and thus the QPC-DA showed adequate psychometric properties. The attendees' ratings of quality of community-based day centre services were generally high. The highest rating was for the encounter dimension and the lowest for the participation and the secluded environment dimensions, indicating areas for improvement.

    Conclusion/significance: The QPC-DA includes important aspects of the attendees' assessment of quality of community-based day centre services and offers a simple and inexpensive way to evaluate quality from their perspective.

  • 12.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Health Sciences.
    Ivarsson, Ann-Britt
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Rask, Mikael
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Brunt, David
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    The attendees' view of quality in community-based day centre services for people with psychiatric disabilities2018In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 25, no 3, p. 162-171Article in journal (Refereed)
    Abstract [en]

    Background/Aims: Community-based day centres in Sweden are well-established arenas for psychiatric rehabilitation, but little is known of the attendees' perception of the quality of the service provided. The aim of the study was thus to describe and investigate the quality of the services in community-based day centre for people with psychiatric disabilities.

    Methods: A sample of 218 attendees in 14 community-based day centre services in Sweden completed the Quality in Psychiatric Care - Daily Activities (QPC-DA).

    Results: The results showed that people with psychiatric disabilities perceived the quality of community-based day centre services as high. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the centre, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement.

    Conclusion/Significance: From an occupational science perspective, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the centre.

  • 13.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Law, Psychology and Social Work. Örebro University Hospital. Centre for Rehabilitation Research, Örebro City Council, Örebro, Sweden.
    Lorentzen, Kirsten
    Public Health and Quality Improvement Centre, Örebro City Council, Örebro, Sweden.
    Riiskjaer, Erik
    Public Health and Quality Improvement Centre, Örebro City Council, Örebro, Sweden.
    Schröder, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Psychiatric Research Centre, Örebro City Council, Örebro, Sweden.
    A Danish adaptation of the quality in psychiatric care-forensic in-patient questionnaire: psychometric properties and factor structure2014In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 10, no 3, p. 168-174Article in journal (Refereed)
    Abstract [en]

    Objective: The aims of this study were to adapt and evaluate the psychometric properties and factor structure of the Danish version of the Quality in Psychiatric Care-Forensic In-Patient (QPC-FIP) questionnaire.

    Methods: A sample of 139 inpatients from 25 wards in Denmark who received care during 5 weeks in March and April 2012 participated in the study by completing the QPC-FIP instrument.

    Results: Confirmatory factor analysis revealed that the factor structure of the Danish version was equivalent to that of the original Swedish QPC-FIP. The results indicate that the concept of quality of care expressed in the QPC-FIP is equivalent among forensic inpatients in nationally different healthcare systems and cultural contexts.

    Conclusion: The Danish version of QPC-FIP is a reliable and valid measurement instrument recommended for use in evaluating quality of care in forensic inpatient care.

  • 14. Lundqvist, Lars-Olov
    et al.
    Rask, M.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    David, B.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Schröder, Agneta
    Örebro University, School of Health Sciences.
    Quality in community-based day center services for people with psychiatric disabilities from the attendees' perspective2017In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 41, no Suppl., p. S790-S790Article in journal (Other academic)
    Abstract [en]

    Community-based day centers in Sweden are well-established arenas for psychiatric rehabilitation. Little is, however, known of the attendees’ perception of the quality of the service provided. Therefore, the aim of the study was to describe and investigate the quality of community-based day center services for people with psychiatric disabilities. A sample of 218 attendees (44% females) between 18 and 71 years old in 14 community-based day center services in Sweden completed the quality in psychiatric care–daily activities (QPC-DA) instrument. The results showed that people with psychiatric disabilities perceived the quality of community-based day center services as high and 87% perceived the overall quality as satisfactory. The highest ratings were found in encounter followed by support, daily activity-specific, secure environment, participation, and the lowest quality was found in secluded environment dimensions of the QPC-DA. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the center, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement. In conclusion, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the center.

  • 15.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Rask, Mikael
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Brunt, David
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, School of Health Sciences.
    Schröder, Agneta
    Örebro University, School of Health Sciences. RNT, Fac Med & Hlth, Univ Hlth Care Res Ctr, Univ Örebro, Örebro, Sweden..
    Measuring quality in community based housing support: the QPC-H instrument2016In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 29, no 3, p. 267-275Article in journal (Refereed)
    Abstract [en]

    Purpose - The purpose of this paper is to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Housing (QPC-H) and briefly describe the residents' perception of quality of housing support. Design/methodology/approach - A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis (CFA) revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care (QPC) family of instruments. Findings - CFA revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the QPC family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC-H shows adequate psychometric properties. Social implications - The residents' ratings of quality of housing service were generally high; the highest rating was for secluded environment and the lowest for participation. This dimension would thus seem to indicate an important area for improvement. Originality/value - The QPC-H includes important aspects of residents' assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents' perspective.

  • 16.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Law, Psychology and Social Work. Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Rehabilitation Research, Örebro County Council, Örebro, Sweden.
    Riiskjaer, Erik
    Public Health and Quality Improvement Centre, Central Denmark Region, Århus, Denmark.
    Lorentzen, Kirsten
    Public Health and Quality Improvement Centre, Central Denmark Region, Århus, Denmark.
    Schröder, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Psychiatric Research Centre, Örebro County Council, Örebro, Sweden.
    Factor structure and psychometric properties of the Danish adaptation of the Quality in Psychiatric Care: Forensic In-patient Staff (QPC-FIPS)2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, p. 878-885Article in journal (Refereed)
    Abstract [en]

    There is a need for an internationally standardized and psychometrically tested instrument to measure the perceptions of staff members on the quality of forensic inpatient care provided. The aim of the present study was to adapt the Swedish instrument Quality of Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) to the Danish context and to evaluate its psychometric properties and factor structure in this context. All permanently employed staff members at all 27 forensic inpatient wards in Denmark were invited to answer the Danish version of the QPC-FIPS. In total, 641 staff members participated, resulting in a response rate of 80%. The Danish version of the QPCFIPS showed adequate psychometric properties and excellent goodness of fit of the hypothesised factor structure. Hence, the Danish QPC-FIPS is an excellent instrument for evaluating quality of forensic inpatient care both in clinical practice and in cross-cultural research. The members of staff generally reported that the care provided to patients was of high quality. The quality of the forensic-specific dimension was rated the highest, followed by the support, secluded environment, encounter, discharge and participation. The quality of the secure environment dimension was perceived to be the worst. The QPC-FIPS includes important aspects of staff members’ assessments of quality of care and offers a simple and inexpensive way to evaluate psychiatric forensic inpatient care. The QPC-FIPS can be used together with the Quality of Psychiatric Care-Forensic In-Patient (QPC-FIP) instrument, which covers the same items and dimensions as the QPC-FIPS, to identify patients’ and staff members’ views on quality of care and to improve the quality of forensic psychiatric care and benchmarking.

  • 17.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Law, Psychology and Social Work. Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Rehabilitation Research, Örebro University Hospital, Örebro, Sweden.
    Schröder, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Psychiatric Research Centre, Örebro University Hospital, Örebro, Sweden.
    Patient and staff views of quality in forensic psychiatric inpatient care2015In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 11, no 1, p. 51-58Article in journal (Refereed)
    Abstract [en]

    The study describes and compares perceived quality of care among patients and staff using the Quality in Psychiatric Care–Forensic In-Patient and the Quality in Psychiatric Care–Forensic In-Patient Staff questionnaires. The questionnaires are both based on the perception of the quality of the forensic psychiatric care given to the patients, but the wording is adjusted to fit patients or staff. The study sample consisted of 66 patients and 202 staff members from 12 forensic units in Sweden. Using multiple regression analyses to adjust for demographic variables, it was found that patients perceived the quality of support and secluded environment lower than did staff, whereas staff had lower perceptions than patients of the quality of secure environment. The combination of these questionnaires provides new possibilities for assessing the quality of forensic psychiatric care and evaluating interventions, important factors in the management and planning of forensic care.

  • 18.
    Lundqvist, Lars-Olov
    et al.
    Örebro University, School of Health Sciences.
    Suryani,
    Faculty of Nursing, Padjajaran University, Padjajaran, Indonesia.
    Anna, Nur
    Faculty of Nursing, Padjajaran University, Padjajaran, Indonesia.
    Rafiyah, Imas
    Faculty of Nursing, Padjajaran University, Padjajaran, Indonesia.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Health Science, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    Indonesian adaptation of the Quality in Psychiatric Care-Inpatient (QPC-IP) instrument: Psychometric properties and factor structure2018In: Asian Journal of Psychiatry, ISSN 1876-2018, E-ISSN 1876-2026, Vol. 34, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the present study was to adapt and evaluate the psychometric properties and factor structure of the Indonesian version of the Quality in Psychiatric Care - Inpatient (QPC-IP) instrument.

    Methods: The QPC-IP is based on a definition of quality of care from the patient's perspective; it consists of 30 items covering six factors. A sample of 150 inpatients at general psychiatric wards in Indonesia completed the QPC-IP questionnaire.

    Results: Confirmatory factor analysis revealed that the factor structure of the Indonesian version was equivalent to that of the original Swedish QPC-IP, with the exception of the secluded environment factor. The results thus demonstrate that the concept of quality of care expressed in the QPC-IP is to a large extent equivalent among inpatients in fundamentally different health care systems and cultural contexts. Internal consistency for the full QPC-IP was adequate, but poor for the separate factors.

    Conclusion: The Indonesian QPC-IP is a useful instrument for evaluating psychiatric inpatient care, and thus contributes to health care improvement in the field of psychiatry.

  • 19.
    Rask, Mikael
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    Lundqvist, Lars-Olov
    Ivarsson, Ann-Britt
    Örebro University, School of Health Sciences.
    Brunt, David
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Residents' View of Quality in Ordinary Housing with Housing Support for People With Psychiatric Disabilities2017In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 38, no 2, p. 132-138Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the quality of housing support provided in housing services for people with psychiatric disabilities living in ordinary housing with housing support from the residents' perspective, by using the QPC-H instrument. A sample of 174 residents in ordinary housing, receiving housing support from 22 housing support services in nine Swedish municipalities, participated in this study. The results show that the quality of psychiatric care in housing services was mainly rated highly as measured with the QPC-H instrument. The dimensions Encounter and Secluded Environment were the aspects that were rated as the two with the highest quality of housing service. The dimensions Participation and Secure Environment were rated as those with the lowest quality. There were more residents who totally disagreed with the statements in the dimensions Participation and Housing Specific than in the other dimensions. The perceived lower quality in Encounter, Participation, Support and the Housing Specific dimensions was associated with a low frequency of psychiatric outpatient clinic contacts. A conclusion is that the support staff could be more observant regarding the residents' need for support and also talk more with them about what could be done to assist them. It also seems important that the support staff discuss with the residents regarding how they can help them to feel more secure in their accommodation.

  • 20.
    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.

  • 21.
    Schröder, Agneta
    et al.
    Psychiatric Research Centre, Örebro County Council, Örebro, Sweden.
    Björk, Tabita
    Department of Clinical Neuroscience, Örebro University Hospital, Örebro, Sweden; Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Patients' judgements of quality of care in psychiatric observation and intensive inpatient care2013In: Journal of Psychiatric Intensive Care, ISSN 1742-6464, E-ISSN 1744-2206, Vol. 9, no 2, p. 91-100Article in journal (Refereed)
  • 22.
    Schröder, Agneta
    et al.
    Örebro University, School of Health Sciences.
    Lorentzen, K.
    Public Health and Quality Improvement Centre, Central Denmark Region, Aarhus, Denmark .
    Riiskjaer, E.
    Public Health and Quality Improvement Centre, Central Denmark Region, Aarhus, Denmark .
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work.
    Patients' views of the quality of Danish forensic psychiatric inpatient care2016In: Journal of Forensic Psychiatry & Psychology, ISSN 1478-9949, E-ISSN 1478-9957, Vol. 27, no 4, p. 551-568Article in journal (Refereed)
    Abstract [en]

    The present study describes the quality of psychiatric care among forensic inpatients in Denmark who answered the Danish version of the Quality in Psychiatric Care-Forensic In-Patient (QPC-FIP) instrument. A sample of 143 patients (response rate 53%) from 25 of the 27 specialized forensic units in Denmark participated in the study. The patients' ratings of the quality of care were generally high. The highest rating was found for the quality of the secluded environment and the lowest for patient participation in the care. The results showed that several factors influenced the patients' ratings. Women rated the quality of care lower in comparison to men. Patients living together with someone before admission, patients with a lower level of education, and patients who were better informed regarding their diagnosis, who was the responsible physician, and where to complain rated the quality of care higher. We can recommend the use of the Danish version of the QPC-FIP instrument for measuring and improving the quality of care in forensic inpatient care.

  • 23.
    Schröder, Agneta
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Health Science, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work.
    International comparisons of patients and staff views of quality in psychiatric care with the QPC instrument2017Conference paper (Other academic)
  • 24.
    Schröder, Agneta
    et al.
    Örebro University, School of Health Sciences.
    Lundqvist, Lars-Olov
    International comparisons of patients´and staff views of quality in psychiatric care with the instrument QPC2018Conference paper (Refereed)
  • 25.
    Schröder, Agneta
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences.
    Patients' and staff's experiences of quality of psychiatric care: An international comparison2018Conference paper (Refereed)
  • 26.
    Schröder, Agneta
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Psychiatric Research Centre.
    Lundqvist, Lars-Olov
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The Quality in Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) instrument: Psychometric properties and staff views of the quality of forensic psychiatric services in Sweden2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 3, p. 330-341Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to evaluate the psy- chometric properties and dimensionality of the in- strument Quality in Psychiatric Care-Forensic In-Pa- tient Staff (QPC-FIPS) and to describe the perceived quality of psychiatric care among forensic inpatient service staff. A sample of 348 forensic inpatient staff from 18 forensic wards in Sweden participated in the study. A confirmatory factor analysis revealed a seven-factor structure with item loadings > 0.50 on expected factors, indicating adequate psychometric properties. The staff’s ratings of quality of care were high, 94% being positive. The highest ratings were found for the secluded-environment dimension and the lowest for the secure-environment dimension. Several factors influenced the ratings of quality of care, for instance, staff’s time to perform their duties and staff’s age. It is concluded that the QPC-FIPS can give valuable information about staff’s percep- tions of the quality of care provided at inpatient fo- rensic psychiatric care services, which can be used to identify areas for quality improvement. Use of the QPC-FIPS is an easy and inexpensive way to evaluate quality in forensic inpatient care, preferably in con- junction with the QPC-FIP instrument developed for forensic inpatients and covering the same items and dimensions.

  • 27.
    Schröder, Agneta
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences.
    What patients think about quality of psychiatric care in different countries2019In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 56, p. S373-S373Article in journal (Other academic)
  • 28.
    Schröder, Agneta
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Psychiatric Research Centre.
    Ågrim, Joakim
    Regional Forensic Psychiatric Centre, Östergötland County Council, Linköping, Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Law, Psychology and Social Work. Centre for Rehabilitation Research, Örebro University, Örebro, Sweden.
    The Quality in Psychiatric Care-Forensic In-Patient Instrument: Psychometric properties and patient views of the quality of forensic psychiatric services in Sweden2013In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 9, no 4, p. 225-234Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Forensic In-Patient and to describe the quality of psychiatric care among forensic in-patients. The study group consisted of patients all receiving care during 2 weeks in September 2009 and meeting the inclusion criteria. A sample of 134 in-patients from 34 forensic wards in Sweden participated. Confirmatory factor analysis revealed a seven-factor structure, and 69% of the patients reported the quality of care as high. The highest rating was for the secluded environment dimension, and the lowest was for the participation dimension. The Quality in Psychiatric Care-Forensic In-Patient is a reliable and valid measurement instrument recommended foruse in evaluating quality in forensic in-patient care.

  • 29.
    Selvin, Mikael
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Almqvist, Kjerstin
    Department for Social and Psychological studies, Karlstad University, Karlstad, Sweden.
    Kjellin, Lars
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway.
    Patient and staff experiences of quality in Swedish forensic psychiatric care: a repeated cross-sectional survey with yearly sampling at two clinics2019In: International Journal of Mental Health Systems, ISSN 1752-4458, E-ISSN 1752-4458, Vol. 13, article id 8Article in journal (Refereed)
    Abstract [en]

    Background: Systematic efforts to improve the quality, safety and value of health care have increased over the last decades. Even so, it is hard to choose priorities and to know when the desired results are reached, especially in forensic psychiatric care where there can be a discrepancy between patient and staff expectations of what good quality of care is and how it should be reached. The aim of the present study was to describe and compare patient and staff experiences of quality of care in two forensic psychiatric clinics over a period of 4years.

    Methods: A quantitative design was used and yearly between 2011 and 2014, a total of 105 questionnaires were answered by patients and 598 by staff.

    Results: The sample consisted of four different groups; patient and staff in Clinic A and Clinic B respectively. The repeated measurements showed that quality of care, as described by the patients, varied over time, with significant changes over the 4years. The staff evaluations of the quality of care were more stable over time in both clinics compared with the patients. Generally, the staff rated the quality as being better than the patients but these differences tended to decrease when efforts were made to improve the care.

    Conclusions: It is important to highlight both what staff and patients perceive as both high and low quality care. With regular measurements and sufficient resources, training, support and leadership, the chances of successful improvement work increase. This knowledge is important in forensic nursing practice, for teaching and for management and decision makers in the constant work of improving forensic psychiatric care.

  • 30.
    Selvin, Mikael
    et al.
    Örebro University, School of Health Sciences. University Health Care Center, Region Örebro County, Örebro, Sweden.
    Almqvist, Kjerstin
    Department for Social and Psychological studies, Karlstad University, Karlstad, Sweden.
    Kjellin, Lars
    Örebro University, School of Health Sciences. University Health Care Center, Region Örebro County, Örebro, Sweden.
    Schröder, Agneta
    Örebro University, School of Health Sciences. University Health Care Center, Region Örebro County, Örebro, Sweden.
    The Concept of Patient Participation in Forensic Psychiatric Care: The Patient Perspective2016In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 12, no 2, p. 57-63Article in journal (Refereed)
    Abstract [en]

    The importance of patient participation is advocated in medical treatment and nursing care and has been linked to increased quality of care, increased patient satisfaction, and treatment adherence. Still, patients in forensic psychiatric care often report being unhappy with their experienced level of participation. The concept of patient participation is complex and has several definitions, thus it is important to investigate it from different perspectives in different contexts. The aim of this study was to describe patients' perceptions of the concept of patient participation in forensic psychiatric care. A qualitative design with a phenomenographic approach was used, and interviews with 19 participants in a Swedish setting were completed. The participants described the concept of patient participation in forensic psychiatric care as follows: influence, to have good communication and to be involved; confidence, to trust the treatment and to have mutual trust; and own responsibility, to participate in activities and to take the initiative. On the basis of the results of this study, improved patient participation in forensic psychiatric care may be achieved with active communication, by building up and maintaining trust for the professional competence and by encouraging patients' own responsibility. It is important that knowledge about patients' views of the concept of patient participation is included in the planning and improvement of forensic care.

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