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  • 1.
    Lindgren, Britt-Marie
    et al.
    Umeå University, Department of Nursing, Umeå, Sweden.
    Ringnér, Anders
    Umeå University, Department of Nursing, Umeå, Sweden. Umeå University, Department of Paediatrics, Umeå, Sweden..
    Molin, Jenny
    Umeå University, Department of Nursing, Umeå, Sweden.
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level. Umeå University, Department of Nursing, Umeå, Sweden.
    Patients' experiences of isolation in psychiatric inpatient care: Insights from a meta-ethnographic study.2019In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 1, p. 7-21Article in journal (Refereed)
    Abstract [en]

    Historically, people with mental ill-health have been isolated from society. Although mental health care has moved from closed to more open forms of care, in many societies care is still provided in locked wards, and people with mental ill-health are sometimes secluded from their fellow patients, families, friends, and visitors. The aim of this study was to illuminate patients' experiences of isolation in psychiatric inpatient care. A systematic review of qualitative research was conducted, and the key findings were subjected to meta-ethnographic synthesis. The findings were twofold: 'being admitted to prison' and 'having access to shelter'. The experience of isolated care as prison-like symbolizes patients' longing for freedom and feeling restricted and limited by rules, stripped of rights, abandoned, controlled, powerless, and unsupported. In contrast, the experience of isolation as shelter symbolizes safety and the opportunity to regain control over one's own situation. A stigmatizing public view holds that people with mental ill-health are dangerous and unpredictable and, therefore, unsafe to themselves and others. Being placed in isolation because these fears contribute to self-stigma among patients. Promoting a sheltered experience in which isolation is used with respect for patients and the reasons are made explicit may encourage recovery. A shift in emphasis in ward culture from observation to engagement is needed to reduce blame, shift patient experiences from prison to shelter, and to support autonomy as a therapeutic intervention.

  • 2.
    Lundström, Sofie
    et al.
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Hedman Ahlström, Britt
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Skärsäter, Ingela
    Halmstad University, School of Health and Welfare, Halmstad, Sweden.
    Mental health nurses' experience of physical health care and health promotion initiatives for people with severe mental illness2019In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349Article in journal (Refereed)
    Abstract [en]

    Health care for people with severe mental illness is often divided into physical health care and mental health care despite the importance of a holistic approach to caring for the whole person. Mental health nurses have an important role not only in preventing ill health, but also in promoting health, to improve the overall health among people with severe mental illness and to develop a more person-centred, integrated physical and mental health care. Thus, the aim of this study was to describe mental health nurses' experiences of facilitating aspects that promote physical health and support a healthy lifestyle for people with severe mental illness. Interviews were conducted with mental health nurses (n = 15), and a qualitative content analysis was used to capture the nurse's experiences. Analysis of the interviews generated three categories: (i) to have a health promotion focus in every encounter, (ii) to support with each person's unique prerequisites in mind and (iii) to take responsibility for health promotion in every level of the organization. The results show the importance of a health promotion focus that permeates the entire organization of mental health care. Shared responsibility for health and health promotion activities should exist at all levels: in the person-centred care in the relation with the patient, embedded in a joint vision within the working unit, and in decisions at management level.

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