liu.seSearch for publications in DiVA
Change search
Link to record
Permanent link

Direct link
BETA
Wärdig, Rikard
Publications (10 of 10) Show all publications
Hultsjö, S., Wärdig, R. & Rytterström, P. (2019). The borderline between life and death: Mental healthcare professionals' experience of why patients commit suicide during ongoing care. Journal of Clinical Nursing, 28(9-10), 1623-1632
Open this publication in new window or tab >>The borderline between life and death: Mental healthcare professionals' experience of why patients commit suicide during ongoing care
2019 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 9-10, p. 1623-1632Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To explore mental health professionals' experiences in regard to circumstances that cause the patient to take their own life during ongoing care.

BACKGROUND: Suicide is a worldwide health problem, and of those who take their own life, nearly 20% have had contact with a psychiatric unit. Mental health professionals may have extended intuitive knowledge that has not been made visible. Mental health professionals' experiences can contribute knowledge that can complement suicide risk assessments and can be helpful in developing approaches and strategies where the hope is to identify and draw attention to people at risk of taking their own life.

DESIGN: A reflective lifeworld research.

METHODS: Twelve interviews with mental health professionals with experience of working in caring relationships with patients that had taken their life during the period of care. The study was performed in accordance with COREQ (see Supporting Information Data S1).

RESULTS: Mental health professionals' experiences regarding circumstances that cause the patient to take their own life are related to the patient's life circumstances that led to a loss of dignity, and finally beyond retrieval. Mental health professionals share patients' struggle to choose between life and death, the darkness of their life and their hopeless situation. This shared experience also makes the mental health professionals wish to relieve patient's suffering but also gives them an understanding of why patients take their own life.

CONCLUSIONS: The mental health professionals experience how the patient loses the possibility of living a worthwhile life, recognise darkness within the patient and see how the patient's life is fragile. Suicide described as logical and expected, based on their life and life circumstances, has not been found in previous research. Bearing this in mind, should psychiatric care focus on a proactive approach and act when these circumstances are identified?

RELEVANCE TO CLINICAL PRACTICE: The Mental health professionals' tacit knowledge may be used to strengthen uncertain suicide assessments.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
experiences, nursing, phenomenology, qualitative interviews, suicide
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-154918 (URN)10.1111/jocn.14754 (DOI)000468589500024 ()30589485 (PubMedID)
Note

Funding agencies: Futurum - the academy for health and care; Department of Psychiatry, Jonkoping, Ryhov County Council; Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden

Available from: 2019-03-05 Created: 2019-03-05 Last updated: 2019-08-20
Wärdig, R., Foldemo, A., Hultsjö, S., Lindström, T. & Bachrach-Lindström, M. (2016). An intervention with physical activity and lifestyle counseling improves health-related quality of life and shows small improvements in metabolic risk factors in persons with psychosis. Issues in Mental Health Nursing, 37(1), 43-52
Open this publication in new window or tab >>An intervention with physical activity and lifestyle counseling improves health-related quality of life and shows small improvements in metabolic risk factors in persons with psychosis
Show others...
2016 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 1, p. 43-52Article in journal (Refereed) Published
Abstract [en]

General purpose: To study the effects of a lifestyle intervention on health-related quality of life (HRQoL) and metabolic risk factors in persons with psychosis.

Methodology: A longitudinal intervention study with a matched reference sample.

Results: HRQoL measured by the EQ-VAS improved from 57.6 to 63.3 (17.8) in the intervention group (p=0.05). The HDL cholesterol concentration increased from 1.03 to 1.11 (0.19) mmol/l in the intervention group (p=0.02). There was no significant change in body weight.

Conclusion: A lifestyle intervention based on group meetings improves HRQoL in patients with psychosis. There are also small improvements in metabolic risk factors.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Health-related quality of life, lifestyle intervention, metabolic syndrome, physical health, psychosis
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:liu:diva-122367 (URN)10.3109/01612840.2015.1092187 (DOI)000369505500007 ()26818932 (PubMedID)
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2018-01-08Bibliographically approved
Wärdig, R. (2015). Common People: Physical health, lifestyle and quality of life in persons with psychosis and their striving to be like everybody else. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Common People: Physical health, lifestyle and quality of life in persons with psychosis and their striving to be like everybody else
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: As psychosis is often a lifelong disorder, improved health-related quality of life (HRQoL) can be a relevant treatment goal. Persons with psychosis have significantly reduced physical health. Research has demonstrated a great excess of mortality due to cardiovascular diseases, as psychosis may lead to an inactive lifestyle and difficulties making healthy lifestyle choices. Metabolic side effects of second-generation antipsychotics are also common. Many are therefore affected by the metabolic syndrome. The overall situation calls for action by developing health promotion interventions suitable for this group. In recent years, there has been an increased interest in the physical health of persons with psychosis. However, efforts have not been optimally tailored to the needs of this group, and health care services have not done enough, despite being aware of the problem.

Aim: The general aim of this thesis was to study HRQoL, and metabolic risk factors in persons with psychosis, and by a health promotion intervention and through the participants’ own perspective contribute to an improvement in lifestyle interventions.

Methods: Study 1 had a cross-sectional cohort study design that was carried out in specialised psychiatric outpatient departments in Sweden. The patients (n=903) were diagnosed with a psychotic disorder and invited consecutively to participate. A prospective population-based study of public health in the south-east of Sweden (n=7238) served as reference group. Patients were assessed using psychiatric questionnaires, including the Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the EQ5D, both for patients and the population. Several other health status outcomes relevant to the metabolic syndrome were measured, together with lifestyle habits and clinical characteristics. Study II, III and IV were based on a lifestyle intervention for persons with psychosis. Study II was a longitudinal intervention study with a matched reference sample. The purpose of the lifestyle intervention  was to promote a healthier lifestyle by combining theoretical education with physical activities. The intervention group consisted of 42 participants. A matching procedure was made in which two individuals per participant were matched (n=84) into a reference group. The reference sample was matched for sex, BMI class, and being of as similar an age as possible. Socio-demographics were collected and metabolic risk factors relevant to the metabolic syndrome were measured. Symptom severity was measured using Clinical Global Impression (CGI), and HRQoL was assessed using EQ5D. Measurements were made at baseline and at a one-year follow-up. In study III, a qualitative exploratory study was conducted in order to explore prerequisites for a healthy lifestyle. Data were collected through individual interviews (n=40), using a semi-structured interview guide with participants who had undergone the lifestyle intervention. Data were collected 6–7 months after the intervention had been completed. Conventional content analysis was used. Study IV was also based on these 40 interviews and aimed to describe how persons with psychosis perceive participation in a lifestyle intervention. A phenomenographic analysis approach was used.

Results/conclusions: Persons with psychosis are at great additional risk of physical comorbidity. Almost half of the patients met the criteria for metabolic syndrome. In addition, persons with psychosis had significantly lower HRQoL in all dimensions in the EQ5D, except for the pain/discomfort dimension. The only risk factor included in the metabolic syndrome that was associated with lower HRQoL was elevated blood pressure. Raised LDL-cholesterol was also related to lower HRQoL, together with low GAF, older age, high BMI, and female gender. The intervention study demonstrated that HRQoL was significantly improved in the intervention group when comparing EQ-VAS at baseline and at the one-year follow-up. It can be concluded that our intervention was not powerful enough to influence the metabolic factors to any greater extent. The key prerequisite for a healthy lifestyle seemed to be a wish to take part in the society and a longing to live like everybody else. However, many became stuck in a constant state of planning instead of taking action towards achieving a healthy lifestyle. Support by health care professionals is therefore also a prerequisite for a healthy lifestyle. This support should target the transition from thought to action and facilitate the participants’ ability to mirror themselves against healthy people in society by introducing activities they perceive that “common people” do. The challenge for health care professionals is to find a moderate intervention level that does not underestimate or overestimate the person’s capacity. This can facilitate continued participation, and participants can thereby find new social contacts and achieve health benefits.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. p. 106
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1478
Keywords
Health promotion, HRQoL, Lifestyle, Metabolic syndrome, Phenomenography, Physical health, Psychosis, Qualitative content analysis, Self-care, Stigma
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:liu:diva-122368 (URN)10.3384/diss.diva-122368 (DOI)978-91-7685-962-9 (ISBN)
Public defence
2015-11-27, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2016-06-14Bibliographically approved
Wärdig, R., Bachrach-Lindström, M., Hultsjö, S., Lindström, T. & Foldemo, A. (2015). Persons with psychosis perceptions of participating in a lifestyle intervention. Journal of Clinical Nursing, 24(13-14), 1815-1824
Open this publication in new window or tab >>Persons with psychosis perceptions of participating in a lifestyle intervention
Show others...
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 13-14, p. 1815-1824Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To describe how persons with psychosis perceive participation in a lifestyle intervention, and use these perceptions to present factors to for consideration in future interventions.

BACKGROUND:

Metabolic syndrome is common in persons with psychosis. A healthy lifestyle is the primary option for preventing and treating metabolic syndrome, which is why the importance of lifestyle interventions has come into focus among health care professionals. Identifying perceptions of participation in a lifestyle intervention can increase the understanding of how to design future interventions.

DESIGN:

A qualitative, phenomenographic approach was selected, using semi-structured interviews.

METHODS:

The sample consisted of 40 participants with a psychotic disorder, who had undergone a lifestyle intervention focusing on theoretical education in healthy eating and physical activities. The interviews were conducted in 2011 and 2012, six to seven months after the intervention had been completed.

RESULTS:

The findings comprise three categories that emphasise the need for a moderate intervention level that facilitates participation and thereby social interactions among group members. The experience of success in the intervention supported the perception of oneself as a capable individual. However, it could also be the opposite, another experience of failure.

CONCLUSION:

Content in moderation can facilitate participation, and participants can thereby achieve health benefits and find social contacts. In addition to physical activity and lifestyle habits, interventions should have a social focus and be continuous. Professional support is a prerequisite and should facilitate the participants' ability to mirror themselves against healthy people in society by introducing activities that ordinary people do.

RELEVANCE FOR CLINICAL PRACTICE:

Identifying perceptions of participation in a lifestyle intervention can increase the understanding of how to design and manage future interventions. This is also an aspect that is important to consider in everyday clinical practice.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-115726 (URN)10.1111/jocn.12782 (DOI)000356872900007 ()25664402 (PubMedID)
Available from: 2015-03-18 Created: 2015-03-18 Last updated: 2017-12-04
Foldemo, A., Wärdig, R., Bachrach-Lindstrom, M., Edman, G., Holmberg, T., Lindström, T., . . . Osby, U. (2014). Health-related quality of life and metabolic risk in patients with psychosis. Schizophrenia Research, 152(1), 295-299
Open this publication in new window or tab >>Health-related quality of life and metabolic risk in patients with psychosis
Show others...
2014 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 152, no 1, p. 295-299Article in journal (Refereed) Published
Abstract [en]

Improved Health-related quality of life (HRQoL) is an alternative treatment goal for individuals with psychosis, who have up to two times greater prevalence of type 2 diabetes, hypertension and obesity than the general population. Aim: to compare HRQoL in patients with psychosis, especially schizophrenia, with a reference sample and explore the relationship between HRQoL and metabolic risk factors in these patients. Methods: a prospective cohort study was carried out in specialized psychiatric outpatient departments in Sweden. The patients were invited consecutively. A prospective population-based study of public health in the south-east of Sweden served as reference group. Patients were assessed with psychiatric questionnaires that included Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the questionnaire EQ5D, both for patients and the population, and several other health status outcomes were used. Results: At 73%, schizophrenia and schizoaffective disorder were the most common diagnoses in the patient group. The results in patients (n = 903) and population (n = 7238) showed significant differences in lower EQ5D among patients. According to the definition by the International Diabetes Federation (IDF), elevated blood pressure was the only metabolic risk associated with lower HRQoL in patients. Raised LDL-cholesterol levels were also significantly related to lower HRQoL. Conclusion: patients suffering from psychosis had significantly lower HRQoL regarding all components in EQ5D, except for the pain/discomfort component. Almost half of the patient group met the criteria for metabolic syndrome. According to the IDF criteria, elevated blood pressure was the only metabolic risk factor that had an impact on HRQoL.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Metabolic syndrome; Schizophrenia; Health-related quality of life; Reference group
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-104125 (URN)10.1016/j.schres.2013.11.029 (DOI)000329217000043 ()
Available from: 2014-02-07 Created: 2014-02-07 Last updated: 2017-12-06
Wärdig, R., Bachrach-Lindström, M., Hultsjö, S., Lindström, T. & Foldemo, A. (2014). Perceptions of participating in a lifestyle intervention - from the perspective of patients with psychosis. In: : . Paper presented at The 4th Biennial Schizophrenia International Research Society Conference, 5-9 April 2014, Florens, Italy.
Open this publication in new window or tab >>Perceptions of participating in a lifestyle intervention - from the perspective of patients with psychosis
Show others...
2014 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

 

 

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107561 (URN)
Conference
The 4th Biennial Schizophrenia International Research Society Conference, 5-9 April 2014, Florens, Italy
Available from: 2014-06-16 Created: 2014-06-16 Last updated: 2014-08-07
Wärdig, R., Bachrach-Lindström, M., Foldemo, A., Lindström, T. & Hultsjö, S. (2013). Conditions for a healthy lifestyle - from the perspective of individuals with psychosis. Paper presented at International congress on schizophrenia research,21-25/4 2013, Orlando, USA.
Open this publication in new window or tab >>Conditions for a healthy lifestyle - from the perspective of individuals with psychosis
Show others...
2013 (English)Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91806 (URN)
Conference
International congress on schizophrenia research,21-25/4 2013, Orlando, USA
Available from: 2013-05-02 Created: 2013-05-02 Last updated: 2013-05-02
Wärdig, R., Bachrach-Lindström, M., Foldemo, A., Lindström, T. & Hultsjö, S. (2013). Prerequisites for a healthy lifestyle - experiences of persons with psychosis. Issues in Mental Health Nursing, 34(8), 602-610
Open this publication in new window or tab >>Prerequisites for a healthy lifestyle - experiences of persons with psychosis
Show others...
2013 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 8, p. 602-610Article in journal (Refereed) Published
Abstract [en]

The purpose of this study is to explore prerequisites for a healthy lifestyle as described by individuals diagnosed with psychosis. Forty participants who had performed a lifestyle intervention focusing on physical activities and lifestyle education were interviewed. Conventional content analysis was used. The results are described in two categories: (1) Individual Prerequisites and (2) Being a Part of Society. The individuals said that they got stuck in a state of planning without taking action. It was pointless to make a bigger effort because the psychotic disorder could, at any time, worsen the prerequisites. They also said that they wanted to live like everybody else and therefore tried to adopt a normal lifestyle. Future interventions or professional support by mental health nurses and other health care givers should target the transition from planning to action to achieve a healthy lifestyle, and should help the individual to taking part in society.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-95907 (URN)10.3109/01612840.2013.790525 (DOI)23909672 (PubMedID)
Available from: 2013-08-08 Created: 2013-08-08 Last updated: 2017-12-06Bibliographically approved
Bergqvist, A., Karlsson, M., Foldemo, A., Wärdig, R. & Hultsjö, S. (2013). Preventing the development of metabolic syndrome in people with psychotic disorders-difficult, but possible: experiences of staff working in psychosis outpatient care in sweden. Issues in Mental Health Nursing, 34(5), 350-358
Open this publication in new window or tab >>Preventing the development of metabolic syndrome in people with psychotic disorders-difficult, but possible: experiences of staff working in psychosis outpatient care in sweden
Show others...
2013 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 5, p. 350-358Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore mental health staffs' experiences of assisting people with psychotic disorders to implement lifestyle changes in an effort to prevent metabolic syndrome. Qualitative interviews were conducted with 12 health care professionals working in psychosis outpatient care in Sweden. Data were analysed using a qualitative content analysis. The results illustrate that implementation of lifestyle changes among people with psychotic disorders was experienced as difficult, but possible. The greatest obstacles experienced in this work were difficulties due to the reduction of cognitive functions associated with the disease. Guidelines available to staff in order to help them identify and prevent physical health problems in the group were not always followed and the content was not always relevant. Staff further described feelings of uncertainty about having to motivate people to take anti-psychotic medication while simultaneously being aware of the risks of metabolic deviations. Nursing interventions focusing on organising daily routines before conducting a more active prevention of metabolic syndrome, including information and practical support, were experienced as necessary. The importance of healthy eating and physical activity needs to be communicated in such a way that it is adjusted to the person's cognitive ability, and should be repeated over time, both verbally and in writing. Such efforts, in combination with empathic and seriously committed community-based social support, were experienced as having the best effect over time. Permanent lifestyle changes were experienced as having to be carried out on the patient's terms and in his or her home environment.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-92765 (URN)10.3109/01612840.2013.771234 (DOI)23663022 (PubMedID)
Available from: 2013-05-21 Created: 2013-05-21 Last updated: 2017-12-06Bibliographically approved
Foldemo, A., Wärdig, R., Holmberg, T., Valter, L. & Osby, U. (2011). QUALITY OF LIFE IN METABOLIC RISK PATIENTS WITH PSYCHOSIS IN RELATION TO THE POPULATION in SCHIZOPHRENIA BULLETIN, vol 37, issue , pp 264-264. In: SCHIZOPHRENIA BULLETIN (pp. 264-264). Oxford University Press, 37
Open this publication in new window or tab >>QUALITY OF LIFE IN METABOLIC RISK PATIENTS WITH PSYCHOSIS IN RELATION TO THE POPULATION in SCHIZOPHRENIA BULLETIN, vol 37, issue , pp 264-264
Show others...
2011 (English)In: SCHIZOPHRENIA BULLETIN, Oxford University Press , 2011, Vol. 37, p. 264-264Conference paper, Published paper (Refereed)
Abstract [en]

n/a

Place, publisher, year, edition, pages
Oxford University Press, 2011
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-67004 (URN)000287746000749 ()
Available from: 2011-03-25 Created: 2011-03-25 Last updated: 2011-04-26Bibliographically approved
Organisations

Search in DiVA

Show all publications