Being Human Under Inhuman Conditions: Meanings of Living with Severe Dissociative States Involving the Experience of Being in Parts.

Severe dissociative states involving the experience of being in parts, typically associated with diagnosis such as dissociative identity disorder and other specified dissociative disorders, continue to be a controversial and rarely studied area of research. However, because persons with severe dissociative states are at risk of being harmed instead of helped within psychiatric care, their experiences of living with such states warrant further examination, while innovative ways to include them in research remain necessary. Against that background, this study aimed to illuminate the meanings of living with severe dissociative states involving the experience of being in parts. This is a phenomenological hermeneutic study with data collected from three social media sources, one personal blog and two Instagram accounts, in February and March 2023. The results were illuminated in light of four themes; Striving to remain in the world, Balancing exposure and trust, Balancing belonging and loneliness and Owning oneselves. The interpretation of the themes suggests that living with severe dissociative states means being a human under inhuman conditions, striving for coherence and meaning in a world that is often unsupportive. This calls for a trauma-informed care to better support recovery for persons with severe dissociative states.

Men who self-harm-A scoping review of a complex phenomenon.

BACKGROUND: To understand and care for men who self-harm, it is important that healthcare professionals have understanding of how and why men self-harm, men's experiences of self-harm and what can be done to hinder or prevent self-harm. AIMS: The aim of this study was to synthesize the existing knowledge on men who self-harm, with a special emphasis on background, self-harming methods, experiences and reported therapeutic interventions and/or care approaches. DESIGN: Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. DATA SOURCES: Systematic electronic database searches were conducted in CINAHL, MEDLINE (Ovid) and PsycINFO. From a total of 684 studies found, 24 studies met the inclusion criteria: full-text, published in English, peer-reviewed studies and grey literature including a focus on men who self-harm, men aged between 18 and 65 years, and published between 2010 and 2019. RESULTS: Men's self-harm was understood as being related to mental disorders, a means of affect regulation, a loss of self-control, and a means of interpersonal communication. Self-harm can be a positive or negative experience, and there is a wide variety in the methods that men use to self-harm: sharp objects, injection, ingestion, without aids or riskful behaviour. Few studies reported on therapeutic interventions and/or care approaches for men who self-harm. CONCLUSION: Men's self-harm should be understood as a complex, socially and culturally conditioned phenomenon and studied from a multitude of perspectives. IMPACT: This scoping review concludes that self-harm among men should be understood as a complex, socially and culturally conditioned phenomenon. To empower men and support their recovery from self-harm, a person-centred approach should be incorporated into research on the subject and practice.

Nursing Staff's Experiences of Caring for People with Mental Ill-Health in General Emergency Departments: A Qualitative Descriptive Study.

While people with mental ill-health report unsatisfying experiences and poor treatment in general emergency departments, nursing staff report a lack of adequate knowledge and training. This study describes nursing staff's experiences caring for people with mental ill-health in general emergency departments. A qualitative descriptive design was used and 14 interviews were subjected to qualitative content analysis. Results show that nursing staff are dealing with uncertainty and competing priorities when caring for people with mental ill-health. Nursing staff must both take and be given the opportunity to maintain and develop confidence and independence and need support in promoting mental health recovery.

'Treat me with respect': transgender persons' experiences of encounters with healthcare staff.

BACKGROUND: Transgender persons face barriers to health care including discrimination and lack of awareness by professionals. This study aimed to describe transgender persons' experiences of encounters with healthcare staff. METHODS: Participants were recruited through postings in social media and on websites targeting people identifying as transgender. Through an online form, 21 people identifying as transgender provided written self-reports. These were analysed using a method for inductive qualitative content analysis. The study was conducted in Sweden in 2018. RESULTS: The results describe transgender persons' experiences and perceptions of encounters with healthcare staff in one theme: treat me with respect, and three main categories: accept me for who I am; treat me according to my needs; and meet me with competence. CONCLUSIONS: Healthcare professionals can contribute in restoring and upholding transgender people's trust in health care by accepting their identity and focusing on their healthcare needs while also being informed about transgender people's needs and realities. A key point in this is recognising transgender person's vulnerability to violations of dignity in relation to health care.

Zombies Wanted! Descriptions of Nurses in Psychiatric-Mental Health Care in Swedish Recruitment Advertisements.

Knowledge of how nurses are described in recruitment advertisements can aid assessment of the current status of professional psychiatric-mental health nursing and inform services dealing with the challenges of nurse recruitment. This study used content analysis to explore descriptions of nurses in psychiatric-mental health care in a purposive sample of 75 recruitment advertisements collected in Sweden in February 2019. The descriptions were interpreted as focussing on their being willing and able to function in discouraging practice environments, matching the ideal of psychiatric-mental health nursing poorly. The study suggested a need to align the ideals and realities of the nursing profession.

Predatory nursing journals: A case study of author prevalence and characteristics.

BACKGROUND: Predatory publishing poses a fundamental threat to the development of nursing knowledge. Previous research has suggested that authors of papers published in predatory journals are mainly inexperienced researchers from low- and middle-income countries. Less attention has been paid to contributors from high-income countries. AIM: To describe the prevalence and characteristics of Swedish authors publishing in predatory nursing journals. DESIGN: Quantitative descriptive case study. PARTICIPANTS AND RESEARCH CONTEXT: Descriptive statistics were used to analyse the academic positions and academic affiliations of the authors of 39 papers published in predatory nursing journals during 2018 and 2019. Predatory nursing journals with Swedish contributors were identified by searching public listings of papers and applying a set of criteria. Journal site archives were used to identify additional papers with Swedish authors. ETHICAL CONSIDERATIONS: This study was conducted in accordance with national regulations and ethical principles of research. RESULTS: Almost two-thirds of Swedish authors publishing in predatory nursing journals hold senior academic positions. A small group of higher education institutions account for a majority of academic affiliations. Findings suggest that higher education institutions and experienced nursing researchers from Sweden make substantial contributions to predatory nursing journals, but that predatory publication habits might be concentrated in a limited number of academics and research milieus. A year-to-year comparison indicates that the prevalence of publishing in predatory journals might be diminishing. DISCUSSION: Swedish nurse researchers help legitimize predatory journals, thus jeopardizing the trustworthiness of academic nursing knowledge. Substandard papers in predatory journals may pass as legitimate and be used to further academic careers. Experienced researchers are misleading junior colleagues, as joint publications might become embarrassments and liabilities. CONCLUSION: While the academic nursing community needs to address the problem of predatory publishing, there is some hope that educational efforts might have an effect on combating predatory publishing in nursing.

Patient Satisfaction With Telephone Nursing: A Call for Calm, Clarity, and Competence.

BACKGROUND: Studies of patient satisfaction with telephone nursing can provide a better understanding of callers' needs and inform the improvement of services. PURPOSE: This study described patients' experiences and perceptions of satisfaction with telephone nursing. METHODS: The design was nonexperimental and descriptive, with an inductive approach. Data were collected using open-ended questions in a questionnaire that was dispatched to 500 randomly selected callers to the Swedish Healthcare Direct in Northern Sweden. RESULTS: Patients' satisfaction with telephone nursing was related to calm, clarity, and competence. Calm referred to the nurse remaining calm and composed during the call. Clarity was described as distinct, concrete, and practical advice on how to act, what to observe, and where to seek further assistance. Competence referred to both health care knowledge and caring skills. CONCLUSION: These aspects of nursing are dependent on each other and on-call telephone nursing services, which value patient satisfaction need to target all 3.

Recovery-Oriented Reflective Practice Groups: Conceptual Framework and Group Structure.

The recovery-oriented reflective practice group (RORPG) is a staff-directed intervention aimed at achieving the recovery-focused transformation of mental health settings. This discussion paper aims to outline and reflect on the conceptual framework and group structure of recovery-oriented reflective practice groups. RORPGs build on conceptualizations of reflective practice, personal recovery, mental health nursing as a relational and reflective practice, and abductive reasoning. Dewey's phases of reflection, together with an understanding of nursing practice as a dynamic process of care, provide a structure for group sessions in which abductive reasoning can be considered a core activity. This paper outlines a sound theoretical foundation and suggests that RORPGs might prove useful for providing a space for learning in practice, informed by both theoretical and practical knowledge.

Person-centred care: clarifying the concept in the context of inpatient psychiatry.

This paper reports an analysis of the concept of person-centred care in the context of inpatient psychiatry. It has been suggested that person-centred care in inpatient psychiatry might differ from person-centred care in other contexts, indicating a need to clarify the concept in this specific context. Scholarly papers from health-related disciplines were identified following a systematic search of the electronic databases CINAHL, PUBMED and PsycINFO, covering records indexed up until March 2014. An evolutionary approach to concept analysis was applied, integrating principles for data extraction and analysis in integrative reviews. The concept of person-centred care was defined as cultural, relational and recovery-oriented. It aspires to improve care and calls for a transformation of inpatient psychiatry. The concept is closely related to the concepts of recovery and interpersonal nursing. The result is described in terms of attributes, antecedents, consequences and related concepts. It is concluded that the further development of the concept needs to consider the contexts of the concept at both conceptual and praxis levels. Further research should explore the nature of and relationships between context, culture, care practice and outcomes in inpatient psychiatry from a perspective of person-centred care. The results of this analysis can provide a framework for such research.

Knowledge of the patient as decision-making power: staff members' perceptions of interprofessional collaboration in challenging situations in psychiatric inpatient care.

Challenging situations in psychiatric inpatient settings call for interprofessional collaboration, but the roles and responsibilities held by members of different professions is unclear. The aim of this study was to describe staff members' perceptions of interprofessional collaboration in the context of challenging situations in psychiatric inpatient care. Prior to the study taking place, ethical approval was granted. Focus group interviews were conducted with 26 physicians, ward managers, psychiatric nurses, and nursing assistants. These interviews were then transcribed and analysed using qualitative content analysis. Results described participants' perceptions of shared responsibilities, profession-specific responsibilities and professional approaches. In this, recognising knowledge of the patient as decision-making power was understood to be a recurring theme. This is a delimited qualitative study that reflects the specific working conditions of the participants at the time the study was conducted. The findings suggest that nursing assistants are the most influential professionals due to their closeness to and first-hand knowledge of patients. The results also point to the possibility of other professionals gaining influence by getting closer to patients and utilising their professional knowledge, thus contributing to a more person-centred care.

Solving the staff's problem or meeting the patients' needs: staff members' reasoning about choice of action in challenging situations in psychiatric inpatient care.

Coercion in challenging situations is often seen as a necessary component of psychiatric care. This study aims to describe staff members' reasoning about their choice of action in challenging situations in inpatient psychiatric care. Focus group interviews with 26 staff members were analyzed using qualitative content analysis. The results provide an overview of the integrated structure of participants' reasoning and suggest that staff members' reasoning about choice of action can be described as a matter of either solving the staff's problems or meeting the patients' needs. These results can be of use in further research, educational interventions, and staff development activities.

When the time is right: Men's experiences of recovery in self-harm.

Previous research has mainly focused on self-harm among women, defining what it is, what functions it has, how to manage and prevent self-harm, and how to recover from it. A recent review of the literature on self-harm among men concluded that research need to consider both clinical and personal aspects of recovery and pointed out the need to explore recovery from men's point of view. This study aimed to describe men's experiences of recovery in self-harm. Data were collected in Sweden in 2020 using semi-structured interviews. Eleven men who had recovered in self-harm were interviewed. Interviews were analysed using an abductive approach to qualitative content analysis. The analysis involved the application of an established framework for personal recovery in mental illness: connectedness, hope, identity, meaning, and empowerment (CHIME). The analysis identified one main theme: when the time is right, and five sub-themes: finding support in others; trusting that change is possible; getting to know yourself; reaching a new understanding; and developing new strategies to manage life. While the cessation of self-harm might both be a sign of and contribute to recovery, it is not the defining feature of recovery. Mental health professionals should be persistent in providing person-centred, recovery-oriented care for men who self-harm. The CHIME framework can be applied in the context of men's recovery in self-harm. This study is reported in accordance with the COREQ guidelines.

Psychiatric inpatient care for persons with dissociative identity disorder: a scoping review protocol.

INTRODUCTION: Psychiatric inpatient care (PIC) is often characterised by high pressure and thresholds for admission, brief periods of care and limited time for caring activities. Dissociative identity disorder (DID) is a contested diagnosis, and persons with DID are at risk of not receiving adequate support when cared for in PIC. Because the limited literature addressing the topic includes no overview on how persons with DID are cared for in psychiatric inpatient settings, the aim of this scoping review is to map the area of knowledge on PIC for persons experiencing DID. This scoping review will provide an overview with the possibility to elucidate gaps in the evidence base and needs for future research on PIC for persons experiencing DID. METHODS AND ANALYSIS: This scoping review will follow Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Reviews and steps 1-5 described in the established method for scoping reviews: identifying research question, identifying relevant studies, study selection, charting the data and collating, summarising and reporting results. ETHICS APPROVAL: Not applicable. DISSEMINATION: This scoping review will be submitted for publication in an international, peer-reviewed journal.

Further development of the reflective practice questionnaire.

Background: This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction. Methods: A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire. Results: Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.

General psychiatric inpatient care for persons with anorexia nervosa-an integrative literature review protocol.

INTRODUCTION: People diagnosed with anorexia nervosa are offered or compelled to undergo various treatments and therapies. In Sweden, the lack of highly specialised eating disorder services means that people with anorexia nervosa might be cared for in general psychiatric wards. However, there has been limited research attention paid to how this specific context might benefit or harm persons with anorexia nervosa. There is also limited evidence regarding which form of care is most effective in anorexia nervosa and which type of treatment is optimal in general psychiatric inpatient care. Our intention is to highlight personal and professional perspectives of care for patients with anorexia nervosa in this context, with a focus on person-centred care, gender and power. This protocol describes an integrative literature review aiming to synthesise existing knowledge on general psychiatric inpatient care for persons with anorexia nervosa. METHODS AND ANALYSIS: The study will be an integrative literature review following Whittemore and Knafl. We will search the academic databases PubMed, CINAHL and PsycInfo in accordance with a specific search strategy determined in collaboration with a librarian with expertise on systematic reviews. Data will be analysed using a constant comparison method. Persons with their own experience of anorexia nervosa in general psychiatric inpatient care will be involved as coresearchers. ETHICS AND DISSEMINATION: As this is a literature review, formal ethical review is not required. The findings will be disseminated through peer-reviewed publication and presented at conferences related to this field. AMENDMENTS: If we need to amend this protocol, we will give the date of each amendment, describe the change and give the rationale in this section. PROSPERO REGISTRATION NUMBER: CRD42023426095.

Constrained nursing: Nurses' and assistant nurses' experiences working in a child and adolescent psychiatric ward.

The role of nurses and nursing in CAP inpatient care is unclear, and nurses are at risk of moral distress due to having to deal with complex demands while lacking organizational support. This study aimed to describe nurses' and assistant nurses' experiences working in child and adolescent psychiatric inpatient care. Eight nurses and seven assistant nurses working in a child and adolescent ward in Sweden participated in the study. Data were collected in 2019 using semi-structured qualitative interviews and subject to qualitative content analysis. Results describe nurses' and assistant nurses' experiences of child and adolescent psychiatric inpatient care in one theme, Constrained nursing, and four categories: Striving to be there for children and parents; Finding a way to manage work; Depending on others; Lacking nursing leadership. Findings suggest that good, person-centred and recovery-oriented nursing practice can exist in CAP inpatient care but remain unrecognized and lacking support due to unclear roles and responsibilities and lack of nursing leadership. This study is reported in accordance with the COREQ guidelines.

Learning your limits: Nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care.

Young unaccompanied refugees come in contact with acute psychiatric care due to pre-existing mental health conditions as well as stressful and traumatic experiences before, during, and after migration. Previous research on nurses' experiences of caring for refugees has primarily reported on difficulties related to cultural differences and communication and how nurses might distrust refugees. This study aimed to describe registered nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care. Semi-structured interviews with ten nurses were analysed using a method for qualitative content analysis. Data were collected in Sweden during 2019 and 2020. Results describe nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care in one theme: learning your limits and three sub-themes: feeling powerless but doing what you can; taking a stance in a politicized environment; and being frustrated and in need of support. Findings highlight the potential and limitations of mental health nursing, the importance of reflection and peer support, and the importance of viewing the roles and responsibilities of mental health nurses and nursing in a societal context. These findings suggest that nurses can make a difference for young unaccompanied refugees in acute psychiatric care. However, in doing so, nurses need support in realizing what they can and cannot achieve. The study is reported in accordance with the COREQ guidelines.

Predatory conferences: a systematic scoping review.

OBJECTIVE: To systematically map the scholarly literature on predatory conferences and describe the present state of research and the prevalent attitudes about these conferences. METHODS: This scoping review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four databases were searched (PubMed/Medline, Web of Science, Scopus and ProQuest Social Sciences Premium Collection). In addition, the included studies' reference lists were scanned for additional papers not found in the searches. Peer-reviewed publications were included irrespective of study design. Letters and commentary were included if they were peer reviewed. Editorials and literature reviews were excluded. RESULTS: From 809 initial publications, 20 papers were included in the review, from 12 countries and covered a wide range of science disciplines, from nursing/medicine to energy/technology and computer science. More than half were empirical and published after 2017. In most papers, a definition of the term predatory conferences was put forward. Spam email invitations with flattering language were the most common characteristics, and the conferences were often hosted by unknown organisations that used copied pictures without permission. High fees, lack of peer review, and a multidisciplinary scope were signal features. All papers explicitly or implicitly suggested possible reasons for participating in predatory conferences. Some reasons were related to the overall context of academic work, the nature of predatory conferences (eg, researchers falling prey to misleading information about a conference or choosing a conference based on an attractive location) and the personal characteristics of researchers. Only one paper reported empirically identified reasons for participating in predatory conferences. The three countermeasures proposed most frequently to deal with predatory conferences were increasing education, emphasising responsibilities of universities and funders, and publishing lists of predatory publishers associated with conferences. CONCLUSIONS: This review identified a scarcity of research concerning predatory conferences. Future empirical as well as fully analytical research should be encouraged by funders, journals and research institutions.

'Don't abandon me': Young people's experiences of child and adolescent psychiatric inpatient care supporting recovery described in blogs.

Child and adolescent psychiatric (CAP) inpatient care has the potential to support or hinder young people's mental-health recovery. Research describing inpatient care from the perspective of young people is rare. Personal blogs provide an opportunity to further understand how inpatient care relates to young people's recovery processes. This study aimed to explore young people's experiences of CAP inpatient care supporting mental-health recovery. The study is reported in accordance with the COREQ guidelines. Data were created during 2018 from twenty-seven personal blogs describing first-hand experiences of being a patient in a CAP inpatient care facility in Sweden and analysed using a method for interpretive description. Information in blogs suggests they were written by women, a majority of which had experienced eating disorders. Findings describe young people's experiences of CAP inpatient care supporting mental-health recovery in an interpretive explanation with one theme, 'Don't abandon me', and three sub-themes: 'Listen to me', 'Believe in me', and 'Allow me to feel safe'. This study adds to the growing body of empirical work suggesting the importance of the concept of recovery in young people's mental health. To support recovery, CAP inpatient care needs to focus on developing the content of care rather than minimizing the length of the stay. User experience should be at the heart of efforts aimed at improving services.

'Acknowledge me as a capable person': How people with mental ill health describe their experiences with general emergency care staff - A qualitative interview study.

People with mental ill health attend general emergency care more often than others for physical and psychiatric care needs. Staff in general emergency care report they lack knowledge and strategies to meet with and care for people with mental ill health. This study aimed to describe how people with mental ill health experience encounters with staff in general emergency care. We conducted individual semi-structured interviews with 11 people with mental ill health about their experiences in general emergency care and subjected the interview data to qualitative content analysis. Our results show the importance to people with mental ill health of being acknowledged as capable persons, and how this relates to their experiences of being recognized, ignored, or dismissed by staff in general emergency care. Even small, ordinary aspects of staff/patient interactions can have major impacts on a person's recovery and well-being. The study is reported according to the consolidated criteria for reporting qualitative research (COREQ) guidelines.