Common mental disorders such as anxiety, depression and stress-related disorders are increasing worldwide, resulting in long-term sick leave and lower quality of life. Traditional treatment is often insufficient to facilitate the recovery process, and the need for holistic interventions that enable successful recovery is evident. Equine-assisted interventions have shown promising results in health promotion among people with mental disorders, and further research is needed to implement them within the range of available care. The aim of the study is therefore to describe experiences of a therapeutic equine-assisted group intervention for people with common mental disorders on sick leave. The study has a descriptive qualitative design with an inductive approach. Ten participants with common mental disorders on sick leave were interviewed after participating in a 12-week equine-assisted intervention and the data were analysed with conventional content analysis. The analysis generated the overall theme "The equine-assisted group intervention facilitates recovery," which summons the four categories "The environment of the horses contributes to relaxation and an ability to be in the present," "The presence of the horses facilitates supportive relationships in the group," "Interplay with the horses entails physical activity and bodily improvements" and "Emotional interactions with the horses strengthen inner power." In conclusion, equine-assisted interventions have the potential to facilitate recovery for people with common mental disorders by providing relaxation, promoting the ability to be in the present, cultivating supportive relationships and providing physical activity and bodily improvements as well as emotional interactions that strengthen the participants' inner power.

ObjectivesTo describe nurses experiences of caring for individuals who have attempted suicide in specialized palliative care and to describe if the care of these individuals changed after the suicide attempt. MethodsA qualitative, descriptive study was conducted. Nine nurses working in specialized palliative care units were interviewed following a semi-structured interview guide. Conventional content analysis was used in the analysis process. ResultsThe results are presented in 3 categories: "A suicide attempt evokes strong emotions," "Health-care efforts changed after the suicide attempt," and "Experiences for the rest of working life." Suicide attempts aroused emotions in nurses such as frustration, compassion, and feelings of being manipulated. The relationship between the nurse and the individual was strengthened after the suicide attempt, and their conversations became deeper and changed in nature. Health-care efforts relating to the individual increased after the suicide attempt. Significance of resultsThe results of the study can create an awareness that the palliative process also includes the risk of suicide and can be used to create conditions for nurses to be able to handle questions about suicide without fear. The results of the study can be used as an "eye opener" to the fact that suicidality occurs in palliative care. In summary, there is a critical need for nursing education in suicide risk assessment and continued follow-up care for patients at risk of suicide within palliative care.

There is a collective call from the field of suicide research for studies on the individual dynamics of suicidality in order to understand the deadliness of the suicidal process. This study examines the deceased next of kin's ('survivor's) experience of the suicidal process in order to gain perspectives that can be used in the preventive care of suicidal patients. The aim of this study was to explore the suicide process through the suicide survivor's experience. The study is designed and conducted through a phenomenological, reflective lifeworld approach. Twelve in-depth interviews concerning lived experiences of a suicide were conducted. The suicide process is described as the emerging of an obscured transformation of self, and an aligning to this changing understanding of self that forms a unique suicidal death course. This death course contains the co-occurrence of life and death orientations. Survivors' collected knowledge of a suicidal trajectory helps us understand the life conditions of a suicidal person that has ended their life. Life orientation and experiences of self-governance are critical parts of a suicidal trajectory and can have great preventive potential for care and assessments during suicidality. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were used for the reporting structure of this article.

Purpose To explore the loss of a relative due to suicide. Design and Methods Ten survivors of relatives who had taken their lives were interviewed. Data was analyzed from a phenomenological perspective. Findings The survivors described how they witnessed the darkness that took over their relatives lifeworld. During the time before and after the suicide, the survivor felt barred from having a role in the relatives care. Practice Implications Understanding and exploring implicit dynamics, such as "a feeling of darkness taking over," "a sense of relief," or "putting on a mask" could be important for developing person-centered suicide care.

Aim The purpose was to describe nurses experiences of suicide prevention work in primary health care (PHC). Background Suicide is the tenth most common cause of death among adults. PHC has an important role in suicide prevention work, as patients often had contact with PHC before their suicide rather than with specialist psychiatric care. Nurses often have the first contact with the patient and are responsible for triage and assessment, making them important in suicide prevention work. Previous studies shed light on suicide prevention in a primary care context, but the nurses voices are missing. Methods Fifteen qualitative interviews were conducted with nurses in primary health care. Data was analyzed according to conventional content analysis techniques. Findings Nurses may avoid asking questions about suicidality for fear of what to do with the answer. To support the nurses ability in suicide prevention work, both educational and practical experience are fundamental. There was a lack of clarity about who is carrying responsibility for the patient, and it turned out to be difficult to help the patient move further to the next care institution. There was a need for guidelines as well as routines for collaboration with other care actors in suicide prevention work. Conclusion The PHC organization does not support nurses in suicide prevention, therefore they need the right conditions for their work. Suicide prevention needs to be given greater focus and space within education as well as training in the ongoing clinical work, which can be performed with less extensive efforts.

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.

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.

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.

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.

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.