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Rättspsykiatrisk vård: En svängdörr? 
University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
2009 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Bakgrund: Alla, som vårdas inom rättspsykiatrisk vård, har någon form av psykiskt funktionshinder och har också begått ett eller flera brott. Vården regleras av ett antal lagar. I rehabiliteringen ingår utslussning av patienten till öppna vårdformer genom så kallad permission. Ett antal av de patienter som har permission återintas emellanåt till slutenvården av olika orsaker. De benämns ibland som svängdörrspatienter.

Syfte: Syftet var att belysa olika berörda personalgruppers syn på och erfarenheter av vad som har betydelse för om en patient som vårdas enligt lagen om rättspsykiatrisk vård, lyckas eller misslyckas med sin permission.

Metod: En kvalitativ ansats valdes och två fokusgruppsintervjuer med sex deltagare i varje grupp genomfördes. Texten analyserades med hjälp av en kvalitativ innehållsanalys.

Resultat: Tre huvudteman som hade betydelse för om en permission lyckades framkom: samsjuklighet, hur grundläggande behov mötts och samverkan runt patienten. Under dessa framkom 14 subteman: rätt psykiatrisk diagnos, samtidigt missbruk, följsamhet i medicinering, socialt nätverk, sysselsättning, tryggt boende, patientens ekonomi, se patientens behov, tydlig planering, kunskap och motivation, otydlig ansvarsfördelning, samverkan inför permission, kontaktmannaskap och uppföljning i öppenvård.

Konklusion: Mycket fungerar bra i vården runt patienten inom rättspsykiatrisk vård. Brister finns dock som behöver förbättras och utvecklas. Det är viktigt att patienterna är delaktiga i vården och att olika instanser skapar individuella förutsättningar och flexibla lösningar för att permissionen ska lyckas. Ordnad ekonomi är av stor betydelse för att permissionen ska lyckas, då det påverkar många delar i patientens vardag. När patienten misslyckas med permissionen kan orsaken vara att man inte har tagit reda på dennes verkliga behov eller inte tagit tillräcklig hänsyn till dessa i permissionsplaneringen. Bristande resurser i samhället bidrar ibland till att patienter inom rättspsykiatrisk vård inte får rätt eller tillräckliga insatser, vilket är ett problem.

Abstract [en]

Background: Everyone in forensic care has some type of psychiatric disability and has carried out one or more criminal acts. The care is regulated in a number of laws. One part of the patient’s rehabilitation is the transition from closed to open care by so-called leave. A number of the patients that are on leave are sometimes readmitted to closed care for different reasons. These patients are sometimes referred to as “revolving door patients”.

Aim: The aim was to determine different concerned personnel groups’ opinions and experiences of what is important, if a patient that is cared for according to the law of forensic care, is to be successful or unsuccessful with his/her leave.

Method: A qualitative approach was chosen and two focus group interviews, with six participants in each group, were performed. The text was analyzed with the help of a qualitative content analysis.

Results: Three main themes came to light that have significance as to how successful a leave is: comorbidity, how fundamental needs are taken care of and collaboration concerning the patient. 14 subthemes were found under the three main themes: correct psychiatric diagnosis, concurrent misuses, compliance in medication, social networks, employment, safe accommodation, the patient’s economy, seeing the patients needs, clear planning, knowledge and motivation, indistinct line of responsibility, collaboration prior to leave, contacts and follow-up in open care.

Conclusion: Many functions are adequate in the care of patients within forensic care. Though there are deficiencies that need to be improved and developed. It is important that the patients participate in the care and that different authorities create individual conditions and flexible solutions if a leave is to be successful. Arranged economy is important if a leave is to be successful, as much of the patient’s everyday existence is affected. When the patient is unsuccessful with a leave, the reason could be that the patient’s real needs are not known, or not enough consideration has been taken to the patients needs when planning the leave. Inadequate public recourses sometimes contribute to patients, in forensic care, not receiving correct or sufficient measures (help), which is a problem.

Place, publisher, year, edition, pages
2009. , 34 p.
Keyword [en]
Focusgroupinterview, psychiatry, qualitative content analyses, readmission, rehabilitation.
Keyword [sv]
Fokusgruppsintervju, kvalitativ innehållsanalys, psykiatri, rehabilitering, återintagning.
National Category
Nursing Psychiatry
Identifiers
URN: urn:nbn:se:hv:diva-3108OAI: oai:DiVA.org:hv-3108DiVA: diva2:392375
Uppsok
Medicine
Supervisors
Examiners
Available from: 2011-02-09 Created: 2011-01-26 Last updated: 2011-02-09Bibliographically approved

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