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In 2021, we were designing a research study in Sweden in which we planned to use newspaper articles focusing on children and adolescents under the age of eighteen during the Covid-19 pandemic as empirical material. As we developed this study, an ethical question arose: do studies using journalistic articles that may contain health information about individuals as empirical material have to be approved by an ethics review committee? Sweden, in contrast to other countries, requires the approval of an ethics review committee for the use of publicly available material in research when such material might include sensitive personal data such as health-related information. This case study calls for harmonized laws and policies that support global research by clarifying what kinds of empirical material and what types of research must be assessed by national ethics review committees, including with consideration for children's safety and rights.
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Ethical Review , Ethics Committees, Research , Child , Adolescent , Humans , Sweden , Pandemics , MinorsABSTRACT
This study aims to explore circumstances affecting patients' euthanasia and medically assisted suicide (MAS) decisions from the perspectives of patients, relatives, and healthcare professionals. A qualitative systematic review was performed following PRISMA recommendations. The review protocol is registered in PROSPERO (CRD42022303034). Literature searches were conducted in MEDLINE, EMBASE, CINAHL Complete, Eric, PsycInfo, and citation pearl search in Scopus from 2012 to 2022. In total, 6840 publications were initially retrieved. The analysis included a descriptive numerical summary analysis and a qualitative thematic analysis of 27 publications, resulting in two main themes-Contexts and factors influencing actions and interactions, and Finding support while dealing with resistance in euthanasia and MAS decisions-and related sub-themes. The results illuminated the dynamics in (inter)actions between patients and involved parties that might both impede and facilitate patients' decisions related to euthanasia/MAS, potentially influencing patients' decision-making experiences, and the roles and experiences of involved parties.
Subject(s)
Euthanasia , Suicide, Assisted , Humans , Qualitative Research , Health Personnel , Delivery of Health CareABSTRACT
Picture books are often part of children's socialisation processes, contributing to the children forming images of the world, including ideas about (categories of) people, such as nurses. The study aims to explore how nurses/nursing are portrayed in children's picture books in a Swedish context. Through a systematic search, 44 books were included for analysis using thematic analysis and a theoretical lens inspired by Goffman. The results were presented in three themes: 'The costume characterised and designated nurses', 'Nurses and nursing were defined through specific activities and accessories', and 'Nurses' role as caregivers and decency practitioners'. The results showed that nurses were depicted/described in varied contexts, performing their roles mainly front stage in 'hands-on work' in close contact with patients and relatives. Nurses were attributed different accessories and personality characteristics. Nurses/nursing were generally set within a healthcare context, oftentimes within an overarching medical logic. Historical depictions of nurses' uniforms still appeared as a signifier for nurses/nursing. The presentation of nurses/nursing might have potential implications on children's understanding of and for reputations of nurses/nursing in the long term as primary socialisation and related understandings of the (sub)world(s) are deeply rooted in humans.
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Patient-initiated brief admission (PIBA) allows patients to decide when admission to psychiatric care is necessary. This may prevent long-term hospitalisation and promote patient participation. Research on psychiatric nurses' experiences with PIBA is lacking, therefore 11 nurses were interviewed and data analysed using content analysis. Prominent categories were: improved personal development for the patient, more equal nurse-patient relationship, rapid access to a safe environment and strengthened professional collaboration. PIBA is a helpful intervention for patients in crisis, giving both patients and nurses a sense of security. Future studies should explore how this impacts nurses' work environment and job satisfaction.
Subject(s)
Nurses , Psychiatry , Humans , Inpatients , Outpatients , Qualitative ResearchABSTRACT
BACKGROUND: People with mental health issues often experience difficulties with sensory modulation affecting occupational engagement. Research conducted in inpatient units has shown positive effects of individual sensory modulation interventions, however, research on experiences of group-based interventions in outpatient units is limited. Hence, a group-based sensory modulation intervention was adapted and tested within Swedish mental health outpatient units. AIM: To explore the experiences of participating in a group-based sensory modulation intervention for service users in mental health outpatient units. MATERIAL AND METHODS: This qualitative study involved interviews with 25 informants who had participated in the intervention. The interview data were analysed using reflexive thematic analysis. RESULTS: Synthesis of the interviews resulted in one overarching theme of 'Embodied awareness facilitates improved coping and sense of self' organised into four themes: (1) 'Developing embodied awareness and strategies', (2) 'Taking control of everyday life', (3) 'Creating a stronger sense of self', and (4) 'From alienation to belonging'. CONCLUSION AND SIGNIFICANCE: The informants experienced the intervention to provide new embodied coping strategies that had previously been neglected. This understanding may enrich occupational therapy practice in new ways to support service users' engagement in occupations.
Subject(s)
Mental Disorders , Mental Health Services , Humans , Mental Health , Qualitative Research , Coping Skills , Sweden , Mental Disorders/therapy , Mental Disorders/psychologyABSTRACT
Daily life with severe mental health (SMI) and cancer comorbidity entails multiple challenges. The study aims to explore everyday life experiences among individuals with SMI and cancer comorbidity from the perspectives of patients, significant others, and involved healthcare professionals. The study is registered in PROSPERO (CRD42021259604). A qualitative systematic review was conducted through searches in the databases MEDLINE, CINAHL, PsychInfo, and Web of Sciences (last search 14 February 2023). Inclusion criteria were empirical qualitative research studies investigating experiences of healthcare and everyday life among persons living with SMI and who were subsequently diagnosed with cancer from the perspective of the individuals themselves, their significant others, and healthcare professionals involved in their care. Exclusion criteria: Literature reviews, quantitative studies, intervention studies, quantitative parts of mix-methods studies, non-English languages, persons <18 years, dementia/learning disabilities, diagnosed with anxiety/depression as a consequence of cancer. Seven articles, published between January 2011 and February 2023, were included and analysed through a thematic analysis. The PRISMA 2020 checklist guided the study. The results were presented in four themes: 'Navigating between different worlds and logics', 'Decision-making capacity depending on the assessor', 'Cancer must give way to severe mental illness or vice versa', and 'Significant others as a safety net'. Research about the everyday lives of persons with SMI and cancer comorbidities from patients' and relatives' perspectives is lacking and thus called for.
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Parental dying is a life changing experience for children. This study explores children's strategies and (inter)actions in their everyday life when facing critically ill parents and imminent death, from the children's and parents' perspectives. A qualitative systematic review was carried out, registered in PROSPERO (CRD42022306862). A literature search and screening in six databases resulted in eighteen articles. Thematic analysis showed that children were capable of developing various strategies to cope in everyday life, even in vulnerable situations. From parents' and children's perspectives, inclusion, openness, and communication about parents' situations, taking children's age and needs into consideration, were important to face and cope with the situation. Children were life-capable, also in vulnerable and difficult situations. This calls for the necessity of developing children-led support, by acknowledging, and taking the children's experiences, and resources, as starting points to tailor adequate support for children of critically ill parents.
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This article illuminates (inter)actions and group dynamics of adult volunteers in programs for bereaved children and parents. A focus group interview with seven volunteers in Swedish was conducted. A latent, thematic analysis was conducted, inspired by Braun and Clarke, and Goffman. Two themes were constructed: Personal despair as a motivation for establishing and consolidating voluntary involvement and The volunteers acted as an extended family. Group dynamics within the group contributed to uphold volunteers' adherence to formal and informal guidance related to the program. Strong engagement among volunteers and internal recruitment strategies contributed to uphold and consolidate the program's implementation.
Subject(s)
Motivation , Volunteers , Humans , Adult , Child , Focus Groups , Parents , Extended FamilyABSTRACT
Aim: Extensive COVID-19 information can generate information overload and confusion. Denmark and Sweden adopted different COVID-19 management strategies. Aim: This study aimed to compare search strategies, perceptions and effects of COVID-19 information, in general and specifically in social media, in residents in Denmark and Sweden. Subject and methods: Quantitative data from a sample of respondents (n = 616) from Denmark and Sweden on an international web-based survey was analysed using descriptive and analytical statistics. Results: The results showed similarities between the countries regarding preferred and trusted information sources, use of (social) media, and psychosocial and behavioural effects of such information. Traditional media and social media were frequently used for COVID-19 information. Especially health authorities and researchers were trusted sources, representing the dominant medico-political discourse. There were no differences in negative effect and social behaviour. Residents in Denmark experienced significantly more positive effects than residents in Sweden. Conclusion: Summarily, the study showed similarities and small differences among residents in both countries related to usage patterns, perceptions and effects of COVID-19 information from (social) media, despite diverging strategies.
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The COVID-19 pandemic was declared as such in March 2020 [...].
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There is a knowledge gap about nurses' use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to explore how nurses in the Scandinavian countries used social media for professional purposes in relation to the first 15 months of the COVID-19 pandemic. Qualitative, semi-structured interviews with 30 nurses in three Scandinavian countries (Denmark, Norway, and Sweden) were conducted. Thematic analyses were made, methodically inspired by Braun and Clarke, and theoretically inspired by Berger and Luckmann's theory about the construction of social reality. The Standards for Reporting Qualitative Research (SRQR) checklist was used. The results showed that social media was a socialisation tool for establishing new routines in clinical practice. Virtual meeting places supported collective understandings of a specific COVID-19 'reality' and 'knowledge' amongst nurses, with the pandemic bringing to the fore the issue of e-professionalism among nurses relating to their clinical practice. However, social media and virtual education were not commonly used in patient contacts. Further, nurses attempted a re-socialisation of the public to proper COVID-19 behaviour through social media. Moreover, blurred boundaries between acting as a private individual and a professional nurse were identified, where ethics of the nursing profession extended to nurses' private lives.
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The concept of 'patient involvement' is highlighted in healthcare. However, hindrances can prevent its implementation. This article explored how 'patient involvement' is understood and on what ideas this understanding is based through a critical textual analysis of the European document on patient involvement in health systems using a Fairclough-inspired critical discourse analysis. The findings showed that the document arose from a social discourse based on a mix of a neoliberal ideology, with a marketisation of care focusing on a cost-effective and evidence-based logic of care, and a humanistic ideology of patient involvement. It had the form of a normative, consensus-based standard, supported by European organisations. The document incorporated a visionary, well-intentioned abstract guide to promote patient involvement across European care contexts, however without addressing hindrances nor differences across the contexts in which it ought to be implemented. It raises questions about its usability, inviting further research into empirical applications.
Subject(s)
Patient Participation , HumansABSTRACT
BACKGROUND: During the COVID-19 pandemic, nurses stand in an unknown situation while facing continuous news feeds. Social media is a ubiquitous tool to gain and share reliable knowledge and experiences regarding COVID-19. The article aims to explore how nurses use social media in relation to the COVID-19 pandemic. METHOD: A scoping review inspired by Arksey and O'Mally was conducted by searches in Medline, CINAHL, Academic Search Complete and Web of Sciences. Empirical research studies investigating nurses' use of social media in relation to COVID-19 were included. Exclusion criteria were: Literature reviews, articles in languages other than English, articles about E-health, and articles investigating healthcare professionals without specification of nurses included. Articles, published in January-November 2020, were included and analysed through a thematic analysis. The PRISMA-ScR checklist was used. RESULTS: Most of the eleven included studies were cross-sectional surveys, conducted in developing countries, and had neither social media nor nurses as their main focus of interest. Three themes were identified: 'Social media as a knowledge node', 'Social media functioned as profession-promoting channels' and 'Social media as a disciplinary tool'. Nurses used social media as channels to gain and share information about COVID-19, and to support each other by highlighting the need for training and changes in delivery of care and redeployment. Further, social media functioned as profession-promoting channels partly sharing heroic self-representations and acknowledgment of frontline persons in the pandemic, partly by displaying critical working conditions. Finally, nurses used social media to educate people to perform the 'right 'COVID-19' behaviours in society. CONCLUSION: This review provided snapshots of nurses' uses of social media from various regions in the world, but revealed a need for studies from further countries and continents. The study calls for further multi-methodological and in depth qualitative research, including theoretically framed studies, with a specific focus on the uses of social media among nurses during the pandemic.
Subject(s)
COVID-19/psychology , Nurses/statistics & numerical data , Social Media/statistics & numerical data , Social Support/statistics & numerical data , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Information Dissemination , Nurses/psychology , Pandemics/statistics & numerical data , Professional Role/psychology , Social Support/psychologyABSTRACT
[This corrects the article DOI: 10.1007/s10389-021-01539-5.].
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The focus on recovery within psychiatric care is increasing, where peer support may play a pivotal role. Previous research shows both mixed and promising results in terms of beneficial outcomes for patients and peer support workers (PSW). The study's aim was to investigate PSW' experiences of their professional role and associated relationships with healthcare staff and patients. Semi-structured in-depth interviews were conducted with 10 PSW. Data was analyzed with content analysis. Three themes were constructed; "Experience of stigma", "Authenticity and balance in the patient relationship" and "Opportunities and setbacks in the team". Challenges included stigmatization, loyalty conflicts, lack of a clear job description and feelings of insecurity and disinterest among other staff. However, the peer support role was perceived as deeply meaningful. The peer support role comes with challenges and opportunities for the PSW, and potentially for the patients and the surrounding work team. Further research is needed to illuminate the value of peer support for patients, PSW and healthcare staff, and potential barriers and facilitators to the integration of peer support within psychiatric care.Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1978596 .
Subject(s)
Mental Health Services , Mental Health , Humans , Peer Group , Qualitative Research , SwedenABSTRACT
COVID-19 represents a risk to people's life and societies in their current shapes and functions, with institutionalised responses redefining everyday life. Crises in society can induce fear and tensions that can unite and divide people, inducing acts of solidarity and polarisation. The study explored articulations of solidarity and polarisation in relation to the COVID-19 pandemic and related risks. A Foucault-inspired thematic analysis was pursued on qualitative data from an international survey about COVID-19 and social media. The analysis resulted in four themes illustrating articulations of solidarity and polarisation related to the COVID-19 pandemic. The analysis showed solidarity and polarisation as each other's premise and contradiction. Socialisation into a 'new normal' was characterised by the balance between solidarity and polarisation as well as aspirations to enhance future solidarity. The study illustrated that social media functioned as social technology for control and manipulation towards social normalisation. However, it was also used to voice attempts to rectify (or overthrow) the dominant medico-political discourse and norms with own preferences, opinions and a functioning daily life. In short, the articulations and social media uses could be interpreted as expressions of power and counter-power.
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BACKGROUND: Frontline nurses have been directly exposed to the SARS-CoV-2 virus and come in close contact with patients during the COVID-19 pandemic. Nurses execute tasks related to disease control and face multiple psychosocial challenges in their frontline work, potentially affecting their mental well-being and ability to satisfyingly perform their tasks. OBJECTIVES: To explore the psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic. DESIGN: The qualitative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Registered in PROSPERO (CRD42021259111). DATA SOURCES: Literature searches were performed through PubMed, CINAHL, and the WHO COVID-19 database. Inclusion criteria were: All types of nurses having direct contact with or taking care of patients; Primary, secondary, and tertiary health-care services admitting and treating COVID-19 patients; Experiences, perceptions, feelings, views in psychosocial aspects from the identified population group; Qualitative studies; Mixed methods studies; Language in English; Published date 2019-2021. Exclusion criteria were: Commentaries; Reviews; Discussion papers; Quantitative studies; Language other than English; Published in 2018 or earlier; Studies without an ethical approval and ethical statement. REVIEW METHODS: The studies were screened and selected based on the inclusion and exclusion criteria. Quality appraisal was conducted according to the Critical Appraisal Skills Program qualitative study checklist. Data was extracted from included studies and a thematic synthesis was made. RESULTS: A total of 28 studies were included in the review. The experiences of 1141 nurses from 12 countries were synthesised. Three themes were constructed: 'Nurses' emotional, mental and physical reactions to COVID-19', 'Internally and externally supported coping strategies', and 'A call for future help and support'. CONCLUSION: Nurses working frontline during the COVID-19 pandemic have experienced psychological, social, and emotional distress in coping with work demands, social relationships, and their personal life. The results pointed to a need for increased psychological and social support for frontline nurses to cope with stress and maintain mental well-being, which may subsequently affect nursing care outcomes.
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Early trauma and failures in attachment attunement can affect future relational patterns, health and well-being. The processing of trauma, especially complex trauma, through adequate interventions may help integrate traumatic experiences, enhance health and quality of life. Despite years of clinical practice with Identity oriented psychotrauma therapy (IoPT), there is a lack of scientific research on the subject. Objective: The study's aim was to explore the experiences and value of IoPT for persons with experiences of IoPT, whether as a therapist, client, representative and/or observer. Methods: The study has an explorative, qualitative design. Data collection through individual in-depth interviews and focus groups with 20 participants and data analysis were inspired by grounded theory. Results: The results showed an exploratory process of self-discovery and self-development, Getting to know the inner self, to which all categories were interrelated through their contribution to the process. The findings shed light on the experiences and tangible value of IoPT for the participants from the perspectives of client, therapist, representative and observer. These perspectives were intertwined and illuminated in terms of their contribution to the process. Conclusion: IoPT seems to have transformative potential in terms of a self-exploratory journey from multiple perspectives. The need for effective treatments to enhance health and prevent further ill health in persons affected by complex trauma motivates the exploration of novel treatment approaches and formats to support clients toward health enhancing strategies. Further quantitative and qualitative research is motivated to enhance our understanding of the workings and value of IoPT for self-development, health and quality of life.
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Encounters and interactions between healthcare professionals and patients are central in healthcare services and delivery. Encountering persons who frequently use psychiatric emergency services (PES), a complex patient group in a complex context, may be particularly challenging for healthcare professionals. The aim of the study was to explore healthcare professionals' experiences of such encounters. Data were collected via individual interviews (N = 19) and a focus group interview with healthcare professionals consisting of psychiatric nurses, assistant nurses, and physicians. The data were analyzed with qualitative content analysis. This study focused on the latent content of the interview data to gain a rich understanding of the professionals' experiences of the encounters. Two themes were identified: "Nurturing the encounter with oneself and colleagues for continuous, professional improvement" and "Striving for a meaningful connection with the patient". The professionals experienced their encounters with persons who frequently use PES as caring, professional, and humane processes. Prerequisites to those encounters were knowing and understanding oneself, having self-acceptance and self-compassion, and working within person-centered cultures and care environments.