Patients' perspectives on three-monthly administration of antipsychotic treatment with paliperidone palmitate - a qualitative interview study.

INTRODUCTION: Three-monthly dosage of paliperidone palmitate entails longer time to relapse after discontinuation, is similarly tolerable and safe compared to monthly injections of paliperidone palmitate and is beneficial for the caregivers. However, few studies have so far explored in depth the patients' experiences with paliperidone palmitate medication every three months, or with switching from monthly to three-monthly injections of paliperidone palmitate. MATERIAL AND METHODS: A qualitative study based on individual interviews with persons with schizophrenia who receive three-monthly paliperidone palmitate in Norway, Sweden and Denmark. Data was analysed according to qualitative content analysis. RESULTS: Twenty-four patients, 16 men and 8 women, took part in individual interviews. The patients' mental health care professionals mainly recommended the switch to three-monthly paliperidone palmitate, and few or no disadvantages were described. According to the patients, three-monthly paliperidone palmitate had several advantages, such as less frequent injections, less administration and planning and less focus on the illness. In addition, the participants described feeling more stability, being more physically and socially active, and that improvement processes were supported. For some, the use involved practical and economic challenges, and some worried whether the medicine 'wore off' before the next injection. According to the patients, switching to three-monthly paliperidone palmitate did not influence the frequency or content of patients' interaction with health care professionals. CONCLUSION: Switching from monthly to three-monthly injections with paliperidone palmitate seems to be experienced as advantageous for patients with schizophrenia.

What is important in rehabilitation for persons with epilepsy? Experiences from focus group interviews with patients and staff.

This study aimed to identify the issues experienced as essential in rehabilitation for persons with epilepsy. Six focus group interviews were conducted, five groups with patients that had completed comprehensive rehabilitation for persons with epilepsy, in a day-care setting, at the Neurological Rehabilitation Clinic at Stora Sköndal Hospital, between 2006 and 2009 (total n=17) and one group with staff members (n=5). Using content analysis, two themes emerged: life with epilepsy and rehabilitation experiences. The result emphasizes that rehabilitation for persons with epilepsy should be designed individually, in structure and in content. Encounters between patients were important, as well as the team's attitude in meeting with the patients. Therapeutic working alliance is essential between patients and staff for creating an individual rehabilitation.

Police experiences of committing people with mental illness to a hospital.

To a large extent today, caring for people with mental illness takes place outside of institutional care. Sometimes, assistance from a special police group may be required to commit the patient to a hospital for continued psychiatric treatment. The aim of this study was to describe a group of police officers and their experiences of committing individuals with mental illness to the hospital for treatment. Two specialised commitment groups within the police were interviewed. A qualitative content analysis was used to identify topics of greater significance in the data. The interviews show that the informants desire greater cooperation with psychiatric care personnel and want to know more about mental illness and how to approach those with mental illness.

Long-term follow-up after comprehensive rehabilitation of persons with epilepsy, with emphasis on participation in employment or education.

The objective of this study was to describe the current situation of patients with epilepsy after rehabilitation with emphasis on employment and education and to investigate if clinical factors at admission were associated with increase in employment or education. All patients that participated in a comprehensive rehabilitation were eligible. Data were collected from medical records at admission, during rehabilitation, at discharge and from a structured telephone interview at follow-up 1-17 years after admission. In total, 124 patients participated in the follow-up. Participation in employment or education improved from admission to follow-up in 38 patients. In univariable analysis, active epilepsy with tonic-clonic seizures at admission was significantly associated with increased participation in employment or education at follow-up, so was decreased frequency of tonic-clonic seizures from admission to follow-up. The significance of the associations disappeared in adjusted multivariable analysis. Participation in employment or education was improved for many patients at follow-up.

Physical activities and their importance to the health of people with severe mental illness in Sweden.

It is well known that people with severe mental illness often suffer from constant fatigue, insomnia, and somatic complaints that are too often overlooked. In addition, these persons die earlier in life than others in the population. The purpose of this study was to investigate patients' descriptions of activities and the importance of these activities for their health. Eight persons living in their own home were interviewed about both their views about exercise and their exercising activities. Two themes emerged: Getting Control over One's Life and The Need for Contact with Family & Friends. All of the informants were aware of the importance of physical activity to feel good. The informants described three different forms of activities: daily activities in the home, activities in a rehabilitation centre, and various forms of jogging. These different forms of activity were important to the informants since they reduced their anxiety and stress.

Basic attitudes toward life expressed by persons with long-term mental illness living in a Swedish community.

Previous research has shown that persons with long-term mental illness who require prolonged treatment and social support wish to, yet find it difficult to, find meaning or quality in life. A descriptive qualitative design using self-photography and in-depth interviews was used for data collection. The aim of this study was to explore basic attitudes to life as expressed by nine persons with long-term mental illness living in the community. The findings provide insight into the values of relationships, work, and the home for persons with long-term mental illness and indicate that they are cognizant of social norms yet have difficulty integrating these in their daily lives. The study also illuminates the informants' difficulties in creating satisfying and supporting relationships with others.

"I live, I don't work, but I live a very normal life"-A qualitative interview study of Scandinavian user experiences of schizophrenia, antipsychotic medication, and personal recovery processes.

PURPOSE: To illuminate user experiences of schizophrenia, reasons for receiving antipsychotic medication, and encounters with mental health services. DESIGN AND METHODS: 24 semistructured qualitative research interviews with schizophrenia patients treated with 3-monthly paliperidone palmitate across Scandinavia were synthesized in qualitative content analysis. FINDINGS: Participants describe considerable challenges in everyday functioning. Simultaneously, they rate their current mental and physical well-being high and seem satisfied with their lives. These pathways indicate personal recovery. PRACTICE IMPLICATIONS: The participants emphasize the importance of trustful relations with healthcare professionals, therapeutic conversations, antipsychotic medication in a 3-monthly formulation, and support from relatives.

Photography as a method of data collection: helping people with long-term mental illness to convey their life world.

PURPOSE: The purpose of this article is to describe a method to help patients with long-term mental illness describe their life situations--their "life worlds"--through photography. CONCLUSIONS: Photographs and interviews are useful for data collection. The positive effect of this method is allowing informants who have long-term mental illnesses to express their perceptions. PRACTICE IMPLICATIONS: Nurses can use photography in conjunction with interviews to ascertain the life worlds of their patients.

Social and existential alienation experienced by people with long-term mental illness.

The aim of this study was to explore how people suffering from long-term mental illness and who live in the community experience their daily lives. The study was based on an ethnographic framework involving participant observations with 23 individuals from two rehabilitation centres and interviews with six women and two men. The observational notes and interviews were recorded, transcribed into the data and analysed based on the phases of hermeneutic interpretation. The process consisted of identifying tentative interpretations that highlighted various impediments that prevent people with long-term mental illness from having an active life. The impediments can also be interpreted as a form of alienation, an interpersonal phenomenon and a consequence due to of the lack of social acceptance towards mental illness. The participants expressed concern about the future and lack of hope. Viewing themselves as being 'odd' is not a symptom of mental illness, but rather evidence of experiencing existential and social alienation not only as a consequence of other people's reactions but also their own negative attitudes towards mental illness and effects of their cognitive dysfunction.