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  • 1.
    Aho, Anna Carin
    et al.
    Linnaeus Univ, Dept Hlth & Caring Sci, Vaxjo, Sweden.
    Hultsjö, Sally
    Cty Hosp, Psychiat Clin, Jonkoping, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Young adults' experiences of living with recessive limb-girdle muscular dystrophy from a salutogenic orientation: an interview study.2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 22, p. 2083-2091Article in journal (Refereed)
    Abstract [en]

    To describe young adults' experiences of living with recessive limb-girdle muscular dystrophy (LGMD2) from a salutogenic orientation. Methods: A qualitative explorative interview study, including 14 participants aged 20-30 years, was performed focusing on comprehensibility, manageability and meaningfulness in daily life. Content analysis was used for data analysis. Result: Living with LGMD2 not only implies learning to live with the disease and the variations between good and bad periods but also means trying to make sense of a progressive disease that brings uncertainty about future health, by striving to make the best of the situation. Disease progression involves practical and mental struggle, trying to maintain control over one's life despite vanished physical functions that require continual adjustments to the body. Restrictions in a double sense were described, not only due to the disease but also due to poor comprehension of the disease in society. Lack of knowledge about LGMD2 among professionals often results in having to fight for the support needed. Conclusion: In order to manage daily life, it is important to be seen and understood as an individual in contacts with professionals and in society in general, to have informal social support and meaningful activities as well as access to personal assistance if necessary. Implications for Rehabilitation Recessive limb-girdle muscular dystrophy (LGMD2) is a group of progressive disorders, which manifest in physical and psychological consequences for the individual. According to the salutogenic orientation, people need to find life comprehensible, manageable and meaningful, i.e. to achieve a sense of coherence (SOC), but living with LGMD2 may recurrently challenge the individual's SOC. Through the holistic view of the individual's situation that the salutogenic orientation provides, professionals may support the individual to strengthen SOC and thereby facilitate the movement towards health.

  • 2.
    Arvidsson, Hans
    et al.
    University of Gothenburg, Ucklum, Sweden.
    Hultsjö, Sally
    Ryhov County Hospital, Jönköping, Sweden.
    Needs and care of migrants considered as severely mentally ill: cross-sectional and longitudinal studies of a Swedish sample2009In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 24, no 8, p. 533-539Article in journal (Refereed)
    Abstract [en]

    Purpose

    Higher incidence of mental illnesses and less access to care is previously reported concerning migrants but few studies focus on the needs and care of migrant groups in psychiatry. The aim of this study was to compare differences in needs and care between migrant and nonmigrant groups of severely and persistently mentally ill (SMI) after the 1995 Swedish mental health care reform.

    Methods

    In a Swedish area, inventories were made in 2001 and 2006 of persons considered as SMI. These persons were interviewed and their needs were assessed. In a cross-sectional study in 2006, needs and care were compared between migrants and nonmigrants. In a longitudinal study, migrants and nonmigrants interviewed in both 2001 and 2006 were compared concerning the development of needs and care.

    Results

    The needs of the migrant group were less taken care of. In 2006, there were more unmet needs in this group concerning accommodation, physical health, psychological distress, basic education and economy.

    Conclusion

    The improvement of groups considered as SMI concerning functional disability and efforts of care found in the actual area did not seem to include the migrant group, at least not to the same degree.

  • 3.
    Atwine, Fortunate
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden; Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda.
    Hultsjö, Sally
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Albin, Björn
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews2015In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 20, no 76Article in journal (Refereed)
    Abstract [en]

    Introduction: health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The purpose of the study was to describe health-care seeking behaviour and understand reasons for using therapies offered by traditional healers.

    Methods: descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups.

    Results: reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends.

    Conclusion: the pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care.

  • 4.
    Bergqvist, Anette
    et al.
    County Hospital Ryhov, Jönköping, Sweden.
    Karlsson, Maria
    County Hospital Ryhov, Jönköping, Sweden.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Wärdig, Rikard
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hultsjö, Sally
    County Hospital Ryhov, Jönköping, Sweden.
    Preventing the Development of Metabolic Syndrome in People with Psychotic Disorders—Difficult, but Possible: Experiences of Staff Working in Psychosis Outpatient Care in Sweden2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 5, p. 350-358Article in journal (Refereed)
    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.

  • 5.
    Hultsjö, Sally
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Caring for foreign‐born persons with psychosis and their families: Perceptions of psychosis care2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to describe and analyse perceptions of psychosis care among those involved in care, foreign-born persons with psychoses, their families and health care staff, and further to reach agreement about core components in psychosis care. This was in order to find out whether current psychosis care in Sweden is suitable for foreign-born persons and their families. The study design was explorative and descriptive. Health care staff (n=35), persons with psychosis (n=22) and families (n=26) of persons with psychosis were chosen from different regions in Southern Sweden. To capture health care staff’s experiences and to explore whether specific needs occurred within psychiatric care, nine focus group interviews were held. The perspectives of psychosis care among persons with psychoses and their families were captured through individual interviews. Finally, a study was accomplished all over Sweden in which staff, foreign-born persons with psychosis and foreign-born families of persons with psychoses answered a questionnaire to identify core components in psychosis care of foreign-born persons and their families. There was agreement that the core components in psychosis care concern general psychiatric caring, even though varying perceptions were identified. Asking about foreign-born persons’ religious and ethnic background or having the possibility to decide whether care should be provided by male or female staff were agreed to be less important. No agreement could be reached concerning the importance of considering different perceptions of psychosis care, treatments and different ways of managing the psychosis. Nor could agreement be reached as to whether staff should have specific cultural knowledge and whether interpreters should be unknown to the family but speak the right dialect. Perceptions among staff in somatic and psychiatric care as well as perceptions among foreign- and Swedish-born persons with psychosis and their families were more similar than different. General psychiatric care is important for Swedish-born as well as foreign-born persons with psychosis and their families, indicating the importance of not letting culturally determined perceptions dictate the care and take away energy from health care staff and make them lose their focus on the basic elements in general psychiatric care. However, within the general care there were individual perceptions on whose importance those involved in care did not agree. Further development suggested is to illuminate the importance of identifying individual perceptions which may differ between different persons and could be related to cultural background. Staff need to acquire strategies so they can easily manage to encounter and offer general care to foreign-born persons. Development must be achieved on both an organizational level and an individual level.

    List of papers
    1. Immigrants in emergency care: Swedish health care staff's experiences
    Open this publication in new window or tab >>Immigrants in emergency care: Swedish health care staff's experiences
    2005 (English)In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 52, no 4, p. 276-285Article in journal (Refereed) Published
    Abstract [en]

    Background: During the past few decades Sweden has developed into a multicultural society. The proportion of patients with different cultural backgrounds increases, which naturally makes new demands on health care staff.

    Aim: To identify whether staff in somatic and psychiatric emergency care experienced problems in the care of migrants, and if so to compare these.

    Method: The study design was explorative. Focus group interviews of 22 women and 13 men working as nurses and assistant nurses at an emergency ward, an ambulance service and a psychiatric intensive care unit were held.

    Findings: The results showed that the main problems experienced in all wards were difficulties related to caring for asylum-seeking refugees. Some dissimilarities were revealed: unexpected behaviours in migrants related to cultural differences described by staff working in the emergency ward; migrants' refusal to eat and drink and their inactive behaviour in the psychiatric ward; and a lot of non-emergency runs by the ambulance staff because of language barriers between the emergency services centre and migrants.

    Conclusion: The main problems experienced by the health care staff were situations in which they were confronted with the need to care for asylum-seeking refugees. Practice implications: These emphasize the importance of support from organizational structures and national policies to develop models for caring for asylum-seeking refugees. Simple routines and facilities to communicate with foreign-language-speaking migrants need to be developed. Health care staff need a deeper understanding of individual needs in the light of migrational and cultural background.

    Place, publisher, year, edition, pages
    Wiley InterScience, 2005
    Keywords
    Ambulance, Asylum-seeking Refugees, Emergency, Health Care Staff, Migrants, Psychiatry
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18083 (URN)10.1111/j.1466-7657.2005.00418.x (DOI)
    Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2017-12-13Bibliographically approved
    2. Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders
    Open this publication in new window or tab >>Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders
    2007 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 3, p. 279-288Article in journal (Refereed) Published
    Abstract [en]

    AIM: This paper is a report of a study to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.

    BACKGROUND: Research from different countries reports a high-incidence of psychosis among migrants. The risk-factors discussed are social disadvantages in the new country. To understand and meet the needs of people from different countries, their perspective of psychiatric care must be illuminated and taken into consideration.

    METHOD: A phenomenographic study was conducted in 2005-2006 using semi-structured interviews with a convenience sample of 12 foreign-born people and 10 Swedish-born people with psychosis.

    FINDINGS: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born people differed from Swedish-born people in that they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and had religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.

    CONCLUSION: It is important to identify individual perceptions and needs, which may be influenced by cultural origins, when caring for patients with psychosis. Previous experience of care, different ways of relating to staff, and individual needs should be identified and met with respect. Social needs should not be medicalized but taken into consideration when planning care, which illustrates the importance of multi-professional co-operation.

    Keywords
    Interviews, migrants, nursing, patients’ perceptions, phenomenography, psychiatric nursing, psychotic disorder
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18084 (URN)10.1111/j.1365-2648.2007.04391.x (DOI)17822426 (PubMedID)
    Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2017-12-13Bibliographically approved
    3. Foreign-born and Swedish-born families perceptions of psychosis care
    Open this publication in new window or tab >>Foreign-born and Swedish-born families perceptions of psychosis care
    2009 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, no 1, p. 62-71Article in journal (Refereed) Published
    Abstract [en]

    The aim of the study was to describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Eleven foreign-born and 15 Swedish-born family members were interviewed and the data were analyzed using a phenomenographic approach. The findings showed three main descriptive categories: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.

    Keywords
    Family, phenomenography, psychosis, psychosis care, quality of care
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-17154 (URN)10.1111/j.1447-0349.2008.00587.x (DOI)
    Available from: 2009-03-07 Created: 2009-03-07 Last updated: 2017-12-13Bibliographically approved
    4. Identifying core components in care of foreign-born persons with psychosis and their families: Using the Delphi technique
    Open this publication in new window or tab >>Identifying core components in care of foreign-born persons with psychosis and their families: Using the Delphi technique
    (English)Manuscript (Other academic)
    Abstract [en]

    The purpose of this study was to let persons involved in psychosis care (foreign-born persons, families and health care staff) identify the core components in care of foreign-born persons with psychosis and their families in Sweden. The results from three previous qualitative studies consisting of perceptions of psychosis care were reformulated and structured into statements in a questionnaire which was delivered to 43 persons involved in psychosis care. The statements were scored in terms of perceived importance in two rounds using the Delphi technique. The results revealed agreement about the importance of general psychiatric care. Individual perceptions on which importance there was no agreement, suggested that staff must seek to understand a person’s individual perceptions to gain insight about ways to build an effective care alliance with foreign born persons with psychosis and their families.

    Keywords
    Delphi technique, foreign-born persons, psychosis care, nursing
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18085 (URN)
    Available from: 2009-05-05 Created: 2009-05-05 Last updated: 2013-09-12Bibliographically approved
  • 6.
    Hultsjö, Sally
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Mental healthcare staff's knowledge and experiences of diabetes care for persons with psychosis: a qualitative interview study2013In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, no 3, p. 281-292Article in journal (Refereed)
    Abstract [en]

    Aim

    This paper aims to explore and analyse mental healthcare staff's (MHCS) knowledge and experiences of diabetes care for persons with psychosis.

    Background

    There are a range of studies concerning the increased risk of type 2 diabetes mellitus among persons with psychosis, and the need for healthy lifestyle interventions to prevent the illness. MHCS are often trusted and have regular follow-ups with the patients, and their attitudes and actions often play an important role for the person's care behaviour. There is still little documentation of their experiences of diabetes care.

    Methods

    A qualitative, explorative design was used, collecting data through semi-structured interviews with 12 MHCS working in psychosis outpatient care in Sweden. Data were analysed with qualitative content analysis.

    Findings

    Three categories emerged and provide a deeper understanding of how staff were aware of the risks of type 2 diabetes among their patients and therefore performed lifestyle interventions to promote these. Nevertheless, they lacked knowledge of diabetes care and simultaneously felt a lack of training among diabetes nurses to adapt diabetes care to suit persons with cognitive dysfunctions. Patients who were overconfident in their ability to manage diabetes care reported to have experienced most difficulties. Cooperation among those involved in these persons’ health was considered necessary.

    Implications

    Diabetes care for persons with psychosis could improve if knowledge of type 2 diabetes was increased among MHCS and training in how to adapt diabetes care to persons with cognitive dysfunctions was enlarged among diabetes nurses. A challenge for nurses is to see how the care of different illnesses and support given by the family and others affect the persons total life situation and health. Healthcare plans and cooperation among all those involved in these persons’ health is necessary for this.

  • 7.
    Hultsjö, Sally
    et al.
    Ryhov County Hospital, Jönköping; Linnaeus University, Växjö, Sweden.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Arvidsson, Hans
    The University of Gothenburg, Gothenburg, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden.
    Core components in the care of immigrants with psychoses: a Delphi survey of patients, families, and health-care staff2011In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, no 3, p. 174-184Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to identify core components in the care of immigrants with psychosis in Sweden. Experts (n = 43) from different perspectives (immigrants, families, and health‐care staff) were assembled and used to score the importance of statements regarding components in the care for a person with psychosis in three questionnaire rounds. After each round, the opinions were consolidated and compared to identify whether consensus was reached. Consensus was reached about the importance of being treated on equal terms, regardless of country of birth. Staff interest and respect, shown in different ways of understanding, was valued. Consensus could not be reached on approximately half of the statements, of which four tended to be ranked towards unimportant. Those included that staff should have specific cultural knowledge or that the patient should be allowed to decide whether to be cared for by male or female staff. Nor was it regarded as important to identify a person's religious or ethnic background. The results illustrate the importance of fundamental psychiatric nursing, which should enable nurses to identify and meet the basic needs of all patients, regardless of country of origin. Areas for which consensus was not reached illustrate a future challenge for health‐care staff to identify situations when cultural clashes could appear. Staff should have strategies to accomplish cultural negotiations to build an effective treatment alliance with the patient, as well as the family, to meet individual needs.

  • 8.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Arvidsson, Hans
    School of Health Sciences and Social Work, Växjö University, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Identifying core components in care of foreign-born persons with psychosis and their families: Using the Delphi techniqueManuscript (Other academic)
    Abstract [en]

    The purpose of this study was to let persons involved in psychosis care (foreign-born persons, families and health care staff) identify the core components in care of foreign-born persons with psychosis and their families in Sweden. The results from three previous qualitative studies consisting of perceptions of psychosis care were reformulated and structured into statements in a questionnaire which was delivered to 43 persons involved in psychosis care. The statements were scored in terms of perceived importance in two rounds using the Delphi technique. The results revealed agreement about the importance of general psychiatric care. Individual perceptions on which importance there was no agreement, suggested that staff must seek to understand a person’s individual perceptions to gain insight about ways to build an effective care alliance with foreign born persons with psychosis and their families.

  • 9.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hjelm , Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Foreign-born and Swedish-born families perceptions of psychosis care2009In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, no 1, p. 62-71Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Eleven foreign-born and 15 Swedish-born family members were interviewed and the data were analyzed using a phenomenographic approach. The findings showed three main descriptive categories: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.

  • 10.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hjelm, Katarina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 3, p. 279-288Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.

    BACKGROUND: Research from different countries reports a high-incidence of psychosis among migrants. The risk-factors discussed are social disadvantages in the new country. To understand and meet the needs of people from different countries, their perspective of psychiatric care must be illuminated and taken into consideration.

    METHOD: A phenomenographic study was conducted in 2005-2006 using semi-structured interviews with a convenience sample of 12 foreign-born people and 10 Swedish-born people with psychosis.

    FINDINGS: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born people differed from Swedish-born people in that they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and had religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.

    CONCLUSION: It is important to identify individual perceptions and needs, which may be influenced by cultural origins, when caring for patients with psychosis. Previous experience of care, different ways of relating to staff, and individual needs should be identified and met with respect. Social needs should not be medicalized but taken into consideration when planning care, which illustrates the importance of multi-professional co-operation.

  • 11.
    Hultsjö, Sally
    et al.
    County Hospital Ryhov, Jönköping, Sweden.
    Brenner Blomqvist, Kristina
    Jönköping, University, Jönköping, Sweden.
    Health behaviors as conceptualized by individuals diagnosed with a psychotic disorder2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 9, p. 665-672Article in journal (Refereed)
    Abstract [en]

    The purpose of this study is to describe health behaviors as conceptualized by individuals diagnosed with a psychotic disorder. Data were collected by qualitative interviews (n = 20) and were analyzed using phenomenography. Mental well-being took priority over physical health and guided health behaviors. Social relations were significant, and when they proved insufficient, health care professionals were utilized as a substitute. Some relied on religion, complementary treatments, and folk beliefs for health. Interventions not dependent on mental well-being, and assisting individuals to participate in appropriate networks could have advantages. Interventions adapted to the individual's financial situation and cultural values are useful as issues related to these areas can obstruct implementation of health behaviors. Implementing the findings of this study in nursing research and education will prepare nurses to meet the varying health needs of different individuals.

  • 12.
    Hultsjö, Sally
    et al.
    Psychiatric Clinic, County Hospital, Ryhov, Jönköping; Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden.
    Community health-care staff's experiences of support to prevent type 2 diabetes among people with psychosis: An interview study with health staff2012In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 21, no 5, p. 480-490Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe mental health staff experiences of giving support to prevent type 2 diabetes mellitus (DM) among people with psychosis in community psychiatry. A qualitative interview study with a purposeful sample of 12 community health staff was conducted. Data were analysed using qualitative content analysis. The results show how staff reported continuously supporting people with psychosis to adapt to healthy lifestyles, but stated that support is not given until after a person becomes overweight or is diagnosed with type 2 DM. Support was described as a never‐ending process of motivation facing many reverses. Individually‐adapted support given in practical situations was perceived as most successful. Cooperation between health‐care organizations was seen as essential, but inadequate. Limitations in income and social network, and easy access to fast food and alcohol, were seen as obstacles to support. The results indicate that community health staff are in a position to make a considerable impact in motivating and supporting healthy lifestyle changes in practical situations in daily life among people with psychosis. This study raises awareness of how community health staff's support can be useful when developing nursing skills and health‐care plans for people with psychosis.

  • 13.
    Hultsjö, Sally
    et al.
    Ryhov County Hospital.
    Hjelm, Katarina
    University of Lund.
    Immigrants in emergency care: Swedish health care staff's experiences2005In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 52, no 4, p. 276-285Article in journal (Refereed)
    Abstract [en]

    Background: During the past few decades Sweden has developed into a multicultural society. The proportion of patients with different cultural backgrounds increases, which naturally makes new demands on health care staff.

    Aim: To identify whether staff in somatic and psychiatric emergency care experienced problems in the care of migrants, and if so to compare these.

    Method: The study design was explorative. Focus group interviews of 22 women and 13 men working as nurses and assistant nurses at an emergency ward, an ambulance service and a psychiatric intensive care unit were held.

    Findings: The results showed that the main problems experienced in all wards were difficulties related to caring for asylum-seeking refugees. Some dissimilarities were revealed: unexpected behaviours in migrants related to cultural differences described by staff working in the emergency ward; migrants' refusal to eat and drink and their inactive behaviour in the psychiatric ward; and a lot of non-emergency runs by the ambulance staff because of language barriers between the emergency services centre and migrants.

    Conclusion: The main problems experienced by the health care staff were situations in which they were confronted with the need to care for asylum-seeking refugees. Practice implications: These emphasize the importance of support from organizational structures and national policies to develop models for caring for asylum-seeking refugees. Simple routines and facilities to communicate with foreign-language-speaking migrants need to be developed. Health care staff need a deeper understanding of individual needs in the light of migrational and cultural background.

  • 14.
    Hultsjö, Sally
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Hjelm, Katarina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Mötet mellan vårdpersonal och patienter med utländsk bakgrund inom akutsjukvården i Sverige2006In: Flervetenskapliga perspektiv i migrationsforskning: årsbok 2006 från forskningsprofilen Arbetsmarknad, migration och etniska relationer (AMER) vid Växjö universitet / [ed] Katarina Hjelm, Växjö University Press , 2006, 1, p. 15-29Chapter in book (Other academic)
    Abstract [sv]

       

    Under mångkulturåret 2006 publiceras denna bok som är den fjärde årsboken från Växjö universitets forskningsprofil ”Arbetsmarknad, Migration och Etniska relationer (AMER). Forskningsprofilen inrättades år 2001 och får årligen betydande ekonomiskt stöd av Växjö universitet. Avsikten har varit att utveckla en forskningsmiljö omfattande fyra ämnen: historia, nationalekonomi, sociologi och vårdvetenskap. Via tilldelat anslag stöds även forskning inom den nationalekonomiska arbetsmarknadsforskargruppen CAFO och Växjö universitets samarbete med Svenska Emigrantinstitutet. Avsikten med forskningsmiljön är att utveckla och stimulera forskning och forskarutbildning inom området. Syftet är också att utveckla grundutbildningens innehåll och samverkan med det omgivande samhället.

    Bokens innehåll speglar flera vetenskapers syn på frågor inom migrationsområdet och känns extra viktig att publicera under år 2006 som utnämnts till mångkulturåret. Författarna i boken representerar inte enbart olika ämnesdiscipliner utan utgörs också av personer som kommer ifrån olika länder och med varierande erfarenhet och kompetens inom forskning.

    Att flytta till ett nytt land innebär en anpassningsprocess som kan inverka på migrantens hälsa. I boken återfinns tre kapitel som berör detta, två av dessa kommer ifrån ämnet vårdvetenskap och ett ifrån ämnet nationalekonomi. Unika resultat från Björn Albins doktorsavhandling redovisas i avsnittet ”Hälsa bland invandrare i Sverige i ett långtidsperspektiv”. Ny kunskap om erfarenheter av att vårda invandrare inom det svenska hälso-och sjukvårdssystemet har doktoranden Sally Hultsjö och docent Katarina Hjelm skrivit om i kapitlet ”Mötet mellan vårdpersonal och patienter med utländsk bakgrund inom akutsjukvården i Sverige”. Nydisputerade Maria Nilsson redovisar kunskapsläget kring ”Sjukfrånvaron bland invandrare i Sverige – Utvecklingen under perioden 1981-1991”. Faktorer som kan inverka på hälsa och sjukdom har att göra med t ex diskriminering men också med vilken generation av invandrare man tillhör. En junior- och en seniorforskare i ämnet nationalekonomi diskuterar metodologiska aspekter på dessa faktorer: Filosofie doktor Ali Ahmed och professor Jan Ekberg i kapitlet ”Kan diskriminering studeras med experimentella metoder?” och professor Jan Ekberg i avsnittet ”Kan man studera tre generationer invandrare i Sverige?”. En annan faktor av betydelse för anpassningen i det nya landet och levnadsvillkoren där är yrket och två avsnitt inom det sociologiska fältet berör detta: ”Svenska mot modersmål – utvecklingen av två olika lärargrupper” och ”Den gode invandraren bakar inte pizza – Invandrares företagande i svensk forskning och politik” vilka har författats av doktoranderna Anna-Maria Sarstrand respektive Henrik Hultman. Slutligen behöver vi historiska kunskaper för att förstå såväl vår samtid som framtid och boken avslutas med kapitlen ”…en, efter förhållandena utmärkt tillvaro…”- De danska flyktingarna, arbetsmarknadskommissionen och hjälpkommittén för danska flyktingar i Kalmar 1943” och ”Invandrare som önskade stanna. Ungerska lantarbetare i Sverige i slutet av 1940-talet” författade av filosofie doktorerna Malin Thor respektive Attila Lajos.

    Som redaktör är det särskilt glädjande att konstatera att de flesta av årsbokens kapitel är författade av doktorander eller tidigare doktorander inom forskningsprofilen AMER.

    Förhoppningen med boken är att de flervetenskapliga perspektiven skall bidraga till en ökad förståelse för mångkulturella spörsmål!

    Växjö i september 2006

  • 15.
    Hultsjö, Sally
    et al.
    Ryhov County Hospital, Jönköping, Sweden; Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden.
    Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 22012In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, no 10, p. 891-902Article in journal (Refereed)
    Abstract [en]

    This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes. Sixteen qualitative and quantitative studies in the area were identified and summarized. The studies together indicate that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow‐ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self‐care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow‐ups of glycaemic control.

  • 16.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. County Hospital, Ryhov, Jönköping, Sweden.
    Syren, Susan
    Linnaeus University, Växjö, Sweden.
    Beliefs About Health, Health Risks and Health Expectations from the Perspective of People with a Psychotic Disorder2013In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 7, p. 114-122Article in journal (Refereed)
    Abstract [en]

    Aim:

    To examine beliefs about health, health risks and health expectations from the perspective of people diagnosed with a psychotic disorder

    Background:

    People with psychotic disorders have a threefold higher risk of developing physical health problems than the general population, and prevention of these problems is warranted. Examining patients´ health beliefs could help deepen our understanding of how to plan successful health interventions with this group.

    Methods:

    Qualitative semi-structured interviews were conducted from November 2010 to October 2011 with 17 people with psychotic disorders. Data were analyzed using a qualitative content analysis.

    Results:

    An overall positive picture of health was found despite the fact that physical health was found to be hard to verbalize and understand. Health was mainly associated with psychological wellbeing, while health risks were found to be related to uncertain bodily identity, troublesome thoughts and inner voices, and exclusion from society. Interest in learning, and visions and goals of health seemed to increase awareness of health risks and health expectations, while not worrying could be viewed as a hindrance for health expectations.

    Conclusion:

    There is a lack of expressed awareness of physical health risks, but such awareness is fundamental to performing life-style changes [14]. Nurses thus have an important task to help patients understand and verbalize potential physical health risks, and to find out what motivates them to adopt health behaviors.

  • 17.
    Hultsjö, Sally
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Ryhov County Council, Jönköping, Sweden.
    Wärdig, Rikard
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences.
    The borderline between life and death: Mental healthcare professionals' experience of why patients commit suicide during ongoing care2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 9-10, p. 1623-1632Article in journal (Refereed)
    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.

  • 18.
    Wärdig, Rikard
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Bachrach-Lindström, Margaretha
    Linköping University.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lindström, Thomas
    Linköping University, Department of Management and Engineering, Solid Mechanics. Linköping University, Faculty of Science & Engineering.
    Hultsjö, Sally
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Ryhov County Hospital, Jönköping, Sweden.
    Prerequisites for A Healthy Lifestyle: Experiences of Persons with Psychosis2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 8, p. 602-610Article in journal (Refereed)
    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.

1 - 18 of 18
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