Children's Perceptions and Experiences of Their Involvement in Their Parents' Mental Health Care - A Qualitative Literature Review.

This systematic review aims to synthesise the research on children's perceptions and experiences of their involvement in a parent's mental health care. After an extensive search and quality appraisal, 22 articles remained and were included in the review. The results show that children-although resourceful and with good intentions-frequently felt excluded. They hungered for information and felt their questions were abandoned. They also felt caught in a tumultuous life situation and struggled for support. Finally, they expressed the need to be seen and ultimately did not feel involved in their parent's mental health care.

Nurse anesthetists' perceptions of heat conservation measures in connection with surgery - a phenomenographic study.

BACKGROUND: To minimize the risk of perioperative hypothermia, it is recommended that healthcare professionals be familiar with heat conservation measures and use passive and active warming methods, in line with international guidelines. However, there is a low level of adherence perioperatively to the use of heat conservation measures. To understand why, there is a need to capture the nurse anesthetists' perspective. The aim is to describe nurse anesthetists' perceptions of heat conservation measures in connection with surgery. METHODS: An inductive descriptive design with a phenomenographic approach was chosen. A total of 19 nurse anesthetists participated and were interviewed. Data were analyzed according to Larsson and Holmström's phenomenographic seven-step model. RESULTS: Six ways of understanding the phenomenon heat conservation measures in connection with surgery were found: the preventive, the useable, the untenable, the caring, the adaptive, and the routine care approach. These approaches were related to each other in a flexible way, allowing for several to co-exist at the same time, depending on the situation. CONCLUSIONS: Nurse anesthetists want to prevent the patients' heat loss and maintain normothermia, regardless of the type of surgery. This willingness, motivation, and intention enable the use of heat conservation measures. However, there are perceptions that have an impact, such as doubts and uncertainty, access, time and financial constraints, preconditions, routines or habits, and lack of availability of education/training. These barriers will require support from an organizational level to promote lifelong education and guidelines. As well as offer education at the nurse anesthetists' program.

Being Able to Be Yourself: The Lived Experience of Female Patients in Forensic Psychiatric Care.

People in Sweden who commit at least one crime and suffer from a severe mental disorder can be sentenced to forensic psychiatric care. The aim of this study was to describe and gain a greater understanding of the female patients' experiences of their life situation while being cared for in forensic psychiatric care. Interviews with 15 women were conducted and analyzed with a phenomenological hermeneutical method. The results showed the care and the care environment to be dualistic. The women had to be aware that a close neighbor could also be an enemy. They received care in an environment that was unknown, frightening but at the same time a place where they felt secure, and which was predictable.

"A Lonely Road to Walk Along" - The Experiences of Being a Next of Kin to a Woman in Need of Compulsory Psychiatric Inpatient Care.

It is seldom that it is only the patient who is affected when someone is admitted to compulsory psychiatric inpatient care, the next of kin is usually also impacted. The aim was to describe the lived experiences of being a next of kin to a woman in need of compulsory psychiatric inpatient care. Ten next of kin were interviewed and the material was analyzed with a Reflective Lifeworld Research approach. The results show loneliness and feelings that their existence has collapsed. An emotional duality is described in the realization that the care is needed but they are devastated that the woman is there. A trust exists, but it changes when the next of kin are no longer a part of the care process.

Selfcare Strategies Shown to Be Useful in Daily Life for Adults Diagnosed with Attention Deficit Hyperactivity Disorder - A Systematic Review.

Adults with ADHD experience a wide range of difficulties in daily life, and RNs and other healthcare professionals need to know how to support them. The aim was to conduct a systematic review of which selfcare strategies adults with ADHD use and need in order to manage daily life. A literature review based on the PRISMA model was performed, and seven articles with a qualitative design were found. Data were analyzed with thematic analysis. The analysis generated one major theme Enabling ways to manage the consequences of disability in daily life based on three subthemes; Establishing ways of acting to help yourself, Finding encouraging and helping relationships, and Using external aids for managing daily life. Professionals may benefit from knowing about these selfcare strategies when meeting people with ADHD.

Predictors of problems reported on the EQ-5D-3L dimensions among people with impaired vision in northern Portugal.

BACKGROUND: The EQ-5D index often fails to detect the effect of ophthalmic diseases and sight loss. Investigating predictors of individual EQ-5D health dimensions might reveal the underlying reasons. The aim of this study was to investigate predictors of health dimension ratings obtained with the EQ-5D-3L from participants with impaired vision representing a spectrum of eye diseases. METHODS: Observational cross-sectional study with participants recruited at four public hospitals in Portugal. Outpatients with visual acuity of 0.30 logMAR(6/12) or worse in the better-seeing eye were invited to participate. Participants completed two instruments: the EQ-5D-3L (measures participants' perceived health-related quality-of-life) and the Massof Activity Inventory (measures visual ability-ability to perform vision-related activities). This study used logistic regression models to identify factors associated with responses to the EQ-5D-3L. RESULTS: The study included 492 participants, mean age 63.4 years (range = 18-93), 50% females. The most common diagnosis was diabetic retinopathy (37%). The mean visual acuity in the better seeing eye was 0.65 logMAR (SD = 0.48) and the mean visual ability was 0.62 logits (SD = 2.04), the correlation between the two was r = - 0.511 (p < 0.001). Mobility and self-care were the health dimensions with the fewest problems (1% reported extreme problems), anxiety and depression the dimension with the most problems (24% reported extreme problems). ROC curve analysis showed that the EQ-5D index was a poor predictor of cases of vision impairment whilst visual ability given was a good predictor of cases of vision impairment. Visual ability was an independent predictor of the response for all dimensions, higher ability was always associated with a reduced odds of reporting problems. The odds of reporting problems were increased for females in 3 out of 5 dimensions. Comorbidities, visual acuity and age-category were predictors of the odds of reporting problems for one dimension each. CONCLUSIONS: The odds of reporting problems for the five health dimensions of the EQ-5D-3L were strongly influenced by the ability to perform vision-related activities (visual ability). The EQ-5D index showed poor performance at detecting vision impairment. These findings are informative and relevant for the clinic and for research evaluating the impact of eye diseases and disease treatments in ophthalmology.

Psychometric Properties of the Verbal and Social Interaction Questionnaire for Psychiatric Outpatient Care (VSI-OP), Staff and Patient Versions.

The aim of this paper is to investigate the psychometric properties of the Verbal and Social Interaction questionnaire for psychiatric outpatient care (VSI-OP) by using a confirmatory factor analysis. A further aim is to present the patient and staff perceptions of the frequency of these interactions in this context. The factor structure of the VSI-OP could be explained by three factors for both the staff and the patient versions. The three factors are: 'Inviting the patient to establish a relationship', 'Showing interest in the patients' feelings, experiences and behaviour' and 'Helping the patients to establish structure and routines in their everyday life'. The two first factors were the most frequently occurring actions according to the staff and the patients.

Patients' Experiences of Participation in High-Security, Forensic Psychiatric Care.

The role of patient participation in forensic psychiatric care is unclear, but has been emphasised as important in recent research. This study aims to describe patients' lived experiences of participation in high-security, forensic psychiatric settings. Sixteen patient interviews were performed in this phenomenological study and analysed with a Reflective Lifeworld Research approach (RLR). Results show that participation must be understood in relation to its opposite construct, non-participation. Participation can thus be explained as situations where non-participation is less visible. Actions to develop the training of patient-staff interactions for forensic psychiatric staff to promote patient participation are called for.

Patients' Experiences and Perceptions of Recovering from Anorexia Nervosa While Having Contact with Psychiatric Care: A Literature Review and Narrative Synthesis of Qualitative Studies.

Anorexia nervosa (AN) is a serious disease which is difficult to treat. Little is known about the recovery from AN, and therefore, this review's aim was to review and synthesise patients' experiences and perceptions of what is meaningful for recovery from anorexia nervosa while having contact with psychiatric care. Cinahl, PubMed, and PsycINFO were systematically searched, and 24 studies met the inclusion criteria and were included in the review. Three themes were identified: Being in a trustful and secure care relationship, Finding oneself again, and Being in an engaging and personal treatment. Efforts supporting staff learning and person-centred care should be emphasised and researched further.

Multidimensional factors affecting care needs in daily living among community-dwelling older adults: A structural equation modelling approach.

AIMS: To develop a model illustrating the factors that can influence care needs in daily living (CNDL) of older adults and the pathways between these. BACKGROUND: The care needs in community-dwelling older adults have increased sharply. A better understanding of the elderly's CNDL would thus help policymakers define which types of support and services should be given. METHODS: A multicentre study with structural equation modelling was conducted in this study. We recruited 3,448 community-dwelling older adults in China by using a stratified random cluster sampling technique. RESULTS: Physical and mental health was the strongest predictor of CNDL. Both age and living situation had positive effects on CNDL, while economic factors, social support and family support were the major risk factors for CNDL. CONCLUSION: The presented model provides a better understanding of how to address CNDL in the targeted population. The older adults who are the oldest, low-income, non-empty nesters, and with poor self-rated health or the signs of loneliness should be firstly targeted for daily assistance. IMPLICATIONS FOR NURSING MANAGEMENT: Using this model could provide health authorities and managers with the information of distinguishing between the priority group and the strategies for easing the caregiving burden in older adults care, and thus improving resource utilization.

Using firefighters as medical first responders to shorten response time in rural areas in Sweden.

OBJECTIVE: To map out and describe an earlier response by using firefighters as medical first responders on while waiting for the ambulance and first incident person assignments focusing on frequency, event time and survival >30 days after performed cardiopulmonary resuscitation. DESIGN: Retrospective descriptive design. SETTING: Ambulance service in a county of southern Sweden with a population of 200 000 inhabitants (23/km2 ). PARTICIPANTS: Data were collected from four data systems within different organizations; emergency medical communication centre, fire deparment, ambulance services and conty hospital analysis unit. MAIN OUTCOME MEASURE(S): Data from 600 while waiting for the ambulance assignments, whereof 120 with first incident person present, collected between 1 January 2012 and 31 December 2016. Between 1 June 2014 and 1 October 2015, the two fire departments were dually dispatched on out-of-hospital cardiac arrests. RESULTS: Three main findings were made: there was a prolonged process time for dispatching fire fighters on while waiting for the ambulance assignments. Dual dispatches did not shorten the process time for dispatching full-time firefighters, and, in a majority of while waiting for the ambulance assignments where cardiopulmonary resuscitation was performed, firefighters or first incident persons arrived first on the scene. CONCLUSION: Minimising every minute that delays the performance of life-saving actions is crucial. By dispatching firefighters on while waiting for the ambulance assignments in rural areas, the response time in a majority of assignments was shortened. However, there was substantial delay in dispatching firefighters due to prolonged process time at the emergency medical communication centre. The emergency medical communication centre operator's ability to quickly assess the need for while waiting for the ambulance assignments plays a crucial role in the chain of survival.

Cross-cultural adaptation and psychometric testing of the Verbal and Social Interaction Questionnaire: A cross-sectional study among nursing students in China.

AIMS AND OBJECTIVES: To develop and validate the Chinese version of Verbal and Social Interaction Questionnaire for Nursing Students. BACKGROUND: The development of caring interaction skills is particularly important for achieving better nursing student-patient interactions. Nursing students in China, as in most countries, have often failed to establish a caring interaction with their patients. There is a lack of instruments to explore the difficulties and problems in nursing student-patient interactions in China. DESIGN: A descriptive, cross-sectional survey was carried out. METHODS: Data for cross-cultural adaptation and psychometric testing purposes were collected between May 10, 2017 and November 11, 2017. Exploratory and confirmatory factor analyses were performed; pilot testing, content validity and reliability were assessed for the translated questionnaire. EQUATOR guidelines for observational studies (strengthening the reporting of observational studies in epidemiology) were applied. RESULTS: 716 nursing students from four universities in China completed the questionnaire. A pilot testing (n = 32) was conducted at a university hospital. The internal consistency reliability and the intra-class correlation coefficients were satisfactory. The overall content validity index was 0.95. Exploratory factor analysis resulted in a four-factor solution, explaining 61.26% of the variance, and the items had factor loadings ranging from 0.46-0.82. The final model's fit indexes were relatively acceptable. Overall, this instrument demonstrated sound psychometric properties. CONCLUSION: The Chinese version of Verbal and Social Interaction Questionnaire for Nursing Students has a high level of reliability and acceptable content validity. However, some values in the construct validity assessment were lower than was hypothesised, suggesting a need for further model modification. RELEVANCE TO CLINICAL PRACTICE: This easy-to-use instrument may help nursing educators, clinicians and managers in the assessment and development of students' interactional skills during their training or student-nurse transition period. Using the questionnaire could both provide the students with a greater understanding of caring interactions and help the nursing educators gain a better comprehension of the students' verbal, social and interactional skills.

Residents' Perceptions of Quality in Supported Housing for People with Psychiatric Disabilities.

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.

Challenges in everyday life among recently diagnosed and more experienced adults with type 2 diabetes: A multistage focus group study.

AIMS AND OBJECTIVES: To identify perceived challenges related to self-management among recently diagnosed adults and those with longer experience of type 2 diabetes as a foundation for the future development of a person-centred information and communication technology service. BACKGROUND: Learning self-management of type 2 diabetes includes mastering the skills required to complete complex emotional and physical tasks. A service developed with the participation of stakeholders may be an alternative way to meet rising needs for self-management. DESIGN: Qualitative descriptive design influenced by a participatory approach. METHODS: Multistage focus group interviews among one group of recently diagnosed (≤3 years, n = 4) adults and one group with longer experience (≥5 years, n = 7) of type 2 diabetes. RESULTS: Challenges in self-management in everyday life with type 2 diabetes were identified: understanding; developing skills and abilities; and mobilising personal strengths. Both groups described challenges in understanding the causes of fluctuating blood glucose and in developing and mobilising skills for choosing healthful food and eating regularly. The recently diagnosed group was more challenged by learning to accept the diagnosis and becoming motivated to change habits while the experienced group was mainly challenged by issues about complications and medications. CONCLUSION: Adults with diabetes have different needs for support during different phases of the disease. From a person-centred perspective, it would be desirable to meet individual needs for self-management on peoples' own terms through a technological service that could reach and connect to a large number of people. RELEVANCE TO CLINICAL PRACTICE: Diabetes nurses need to address the knowledge needs of patients with diabetes and support them in developing self-management skills. Consistent with person-centred care, practitioners should also encourage patients' abilities to mobilise their own personal strengths to maintain self-management.

Residents' perceptions of the most positive and negative aspects of the housing situation for people with psychiatric disabilities.

The major aim of the present study was to explore what people with psychiatric disabilities, living in two different types of housing, consider to be the best and the worst in their housing situation. A secondary aim was to explore to what extent additional questions to a questionnaire with a free-response format can provide complementary information to the previous knowledge in the field. The content analysis revealed that the physical attributes were of great significance for the residents in ordinary housing, while both psychosocial aspects and physical attributes were important for those living in supported housing. When providing good housing solutions for people with psychiatric disabilities, attention needs to be given to these aspects by politicians, policymakers as well as by nursing staff.

Residents' View of Quality in Ordinary Housing with Housing Support for People with Psychiatric Disabilities.

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.

The Nurse Anesthetists' Adherence to Swedish National Recommendations to Maintain Normothermia in Patients During Surgery.

PURPOSE: The aim of this study was to determine if nurse anesthetists (NAs) have access, knowledge, and adhere to recommended guidelines to maintain normal body temperature during the perioperative period. DESIGN: A descriptive survey design. METHODS: Questionnaires were sent to heads of the department (n = 56) and NAs in the operating departments in Sweden. FINDING: The level of access to the recommendations is high, but only one third of the operating departments have included the recommendations in their own local guidelines. The NAs' adherence was low, between 5% and 67%, and their knowledge levels were 57% to 60%. CONCLUSIONS: A high level of knowledge, access, and adherence are important for the organization of operating departments to prevent barriers against implementation of new recommendations or guidelines. There are needs for education about patients' heat loss due to redistribution and clear recommendations.

Measuring quality in community based housing support - the QPC-H instrument.

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.

'Is gestational diabetes a severe illness?' exploring beliefs and self-care behaviour among women with gestational diabetes living in a rural area of the south east of China.

OBJECTIVE: This study explores beliefs about illness and health and self-care behaviour among women with gestational diabetes living in a rural area of the south east of China. DESIGN: A qualitative exploratory study using semi-structured interviews and qualitative content analysis. SETTING: A hospital located in the outskirts of a city in the south east of China. PARTICIPANTS: Seventeen women with gestational diabetes in 34-38th pregnant weeks. RESULTS: The beliefs about gestational diabetes among the women in the present study were found to be bidirectional. Some of them feared the illness and its negative influence on health, while others believed that it was not a severe illness and disbelieved the diagnosis of gestational diabetes. They related their illness and health to the individual, social and natural factors. They mainly sought help from the professional sector, but did not fully comply with the professionals' advice. Diet control and exercise were their main self-care measures, but none of them self-monitored their blood glucose. They demonstrated their misunderstanding about diet control and self-monitoring of blood glucose. CONCLUSIONS: This study highlighted the serious lack of knowledge, lower level of risk awareness and poor self-care behaviour among women in this group. Health professionals were found to be the most important source of knowledge about gestational diabetes for these women. The influence of Chinese culture was demonstrated. Gestational diabetes among these women can most likely be improved by training the health professionals and by health education involving individuals, families and the rural communities.

Satisfaction with housing and housing support for people with psychiatric disabilities.

The aim of this study was to investigate the degree of satisfaction with housing and housing support for people with psychiatric disabilities in Sweden. A total of 370 residents, in supported housing and in ordinary housing with housing support, completed a new questionnaire and reported a high degree of overall satisfaction, but many of them wanted to move somewhere else. Differences were found between the two different types of housing concerning satisfaction with housing support, social life and available choices. Security and privacy, as well as other's influence on the choice of residential area and dwelling proved to be important predictors for satisfaction.