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Petersson, S., Clinton, D., Brudin, L. & Perseius, K.-I. (2018). Perfectionism in Eating Disorders: Are Long-Term Outcomes Influenced by Extent and Changeability in Initial Perfectionism?. Journal for Person-Oriented Research, 4(1), 1-14
Open this publication in new window or tab >>Perfectionism in Eating Disorders: Are Long-Term Outcomes Influenced by Extent and Changeability in Initial Perfectionism?
2018 (English)In: Journal for Person-Oriented Research, ISSN 2002-0244, Vol. 4, no 1, p. 1-14Article in journal (Refereed) Published
Abstract [en]

Purpose: Perfectionism has been found to predict outcomes in the treatment of eating disorders (ED). In the present study, we took advantage of longitudinal data to: a) investigate whether there are different patterns of perfectionism during the first six months after admission in a clinical sample of patients with ED, and b) describe how these patterns are related to long-term outcome. Methods: A sample of patients (N=294) from the Coordinated Evaluation and Research at Specialized Units for Eating Disorders database was divided into clusters according to perfectionism patterns measured with the EDI-2 perfectionism scale at baseline, and six months in treatment. Cluster analysis was performed on the extent and perseverance/changeability of self-oriented and socially described perfectionism. Outcome was measured with the EDI-2 and the SCL-63. Frequencies of eating disorder diagnoses were investigated. Results: Five clusters were identified. Low perfectionism was associated with lower levels of ED and psychiatric symptomatology at baseline. There were no significant differences between clusters on outcome variables at 36-month follow-up. Conclusions: Results indicated better psychiatric and psychological health three years after the initial measure. Patterns of relations between the extent and possible changes of perfectionism, measured with the EDI-P at baseline and after six months, did not appear to be associated with long-term outcomes on psychiatric health ratings.

Keywords
Perfectionism, Eating Disorders, Eating Disorder Inventory, Long term study, Cluster analysis
National Category
Psychiatry
Identifiers
urn:nbn:se:rkh:diva-2730 (URN)10.17505/jpor.2018.01 (DOI)
Available from: 2018-11-12 Created: 2018-11-12 Last updated: 2018-11-14Bibliographically approved
Petersson, S., Johnsson, P. & Perseius, K.-I. (2017). A Sisyphean task: experiences of perfectionism in patients with eating disorders. Journal of Eating Disorders, 5, Article ID 3.
Open this publication in new window or tab >>A Sisyphean task: experiences of perfectionism in patients with eating disorders
2017 (English)In: Journal of Eating Disorders, ISSN 2050-2974, Vol. 5, article id 3Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Despite the theoretical links between eating disorders and perfectionism, the definition of perfectionism in practice is complicated. The present study explored descriptions and experiences of perfectionism described by a transdiagnostic sample of patients.

METHODS: In-depth, semi-structured interviews were carried out with 15 patients. The interviews were analyzed by Thematic Analysis. A comparison between the patients' scorings on the Eating Disorder Inventory-Perfectionism scale was also performed.

RESULTS: Seven themes were found: The origins of perfectionism, Top performance, Order and self-control, A perfect body, Looking good in the eyes of others, A double-edged coping strategy, and A Sisyphean task. The women in this study did not emphasize weight and body as the main perfectionistic strivings. Core descriptions were instead order, self-control and top performances. All of the participants described the awareness of reaching perfectionism as impossible. Scorings of self-oriented perfectionism was significantly higher compared to socially prescribed perfectionism. No differences in the narratives related to perfectionism scores or eating disorder diagnoses were found.

CONCLUSIONS: The results showed that psychometric measures do not always capture the patients' definitions of perfectionism, but regarding that perfectionism serves as a means to regulate affects and may lead into an exacerbation of the eating disorder, and the development of obsessive-compulsive symptoms, it is important to investigate the personal definitions of perfectionism.

Keywords
Eating disorders, Perfectionism, Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-2344 (URN)10.1186/s40337-017-0136-4 (DOI)28261478 (PubMedID)
Available from: 2017-03-10 Created: 2017-03-10 Last updated: 2017-07-14Bibliographically approved
Lindh, M., Holmström, I. K., Perseius, K.-I. & Windahl, J. (2016). Enhancing adherence to infection control in Swedish community care: Factors of importance. Nursing and Health Sciences, 18(3), 275-282
Open this publication in new window or tab >>Enhancing adherence to infection control in Swedish community care: Factors of importance
2016 (English)In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 18, no 3, p. 275-282Article in journal (Refereed) Published
Abstract [en]

Healthcare-associated infections are the most frequent adverse event in healthcare delivery worldwide. The theory of planned behavior has proven helpful in hospital hygiene interventions and might be useful in community care. This study explored how medically-responsible nurses in Swedish community care perceived and ranked the impact of factors related to the theory of planned behavior, the factors" probability to change, enhancing the healthcare staff's adherence to infection control guidelines, and identified which theory of planned behavior subquestions should be focused on to enhance adherence to infection control. Medically-responsible nurses (n = 268) in Swedish communities answered a Web-based questionnaire regarding impact and probability to change theory of planned behavior factors in relation to infection control. Four theory of planned behavior factor constructs were found: (i) knowledge and encouragement from management; (ii) access and availability to materials and equipment, and interest among staff; (iii) influence by colleagues; and (iv) workload, and influence by patients and significant others. The theory of planned behavior factors are relevant for infection control in a home-like environment, and findings could be used as a basis for interventions enhancing hygiene in community care.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-2001 (URN)10.1111/nhs.12260 (DOI)26708352 (PubMedID)
Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2017-10-30Bibliographically approved
Björkdahl, A., Perseius, K.-I., Samuelsson, M. & Lindberg, M. H. (2016). Sensory rooms in psychiatric inpatient care: Staff experiences.. International Journal of Mental Health Nursing, 25(5), 472-479
Open this publication in new window or tab >>Sensory rooms in psychiatric inpatient care: Staff experiences.
2016 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 25, no 5, p. 472-479Article in journal (Refereed) Published
Abstract [en]

There is an increased interest in exploring the use of sensory rooms in psychiatric inpatient care. Sensory rooms can provide stimulation via sight, smell, hearing, touch and taste in a demand-free environment that is controlled by the patient. The rooms may reduce patients' distress and agitation, as well as rates of seclusion and restraint. Successful implementation of sensory rooms is influenced by the attitudes and approach of staff. This paper presents a study of the experiences of 126 staff members who worked with sensory rooms in a Swedish inpatient psychiatry setting. A cross-sectional descriptive survey design was used. Data were collected by a web based self-report 12-item questionnaire that included both open- and closed-ended questions. Our findings strengthen the results of previous research in this area in many ways. Content analyses revealed three main categories: hopes and concerns, focusing on patients' self-care, and the room as a sanctuary. Although staff initially described both negative and positive expectations of sensory rooms, after working with the rooms, there was a strong emphasis on more positive experiences, such as letting go of control and observing an increase in patients' self-confidence, emotional self-care and well-being. Our findings support the important principals of person-centred nursing and recovery-oriented mental health and the ability of staff to implement these principles by working with sensory rooms.

Keywords
comfort room; emotional stress; psychiatric nursing; recovery; sensory room
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:rkh:diva-2174 (URN)10.1111/inm.12205 (DOI)26875931 (PubMedID)
Available from: 2016-02-19 Created: 2016-02-19 Last updated: 2017-11-30Bibliographically approved
Jansson, I., Gunnarsson, A. B., Björklund, A., Brudin, L. H. & Perseius, K.-I. (2015). Problem-Based Self-care Groups Versus Cognitive Behavioural Therapy for Persons on Sick Leave Due to Common Mental Disorders: A Randomised Controlled Study. Journal of occupational rehabilitation, 25(1), 127-140
Open this publication in new window or tab >>Problem-Based Self-care Groups Versus Cognitive Behavioural Therapy for Persons on Sick Leave Due to Common Mental Disorders: A Randomised Controlled Study
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2015 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 25, no 1, p. 127-140Article in journal (Refereed) Published
Abstract [en]

Purpose To evaluate the interventional capacity of problem based method groups (PBM) regarding mental health and work ability compared to cognitive behavioural therapy (CBT) for persons on sick leave due to common mental disorders. Methods In a randomised controlled design the experimental group received PBM and the control group received CBT. Outcomes were measured by the Hospital Anxiety and Depression Scale (HADS), the Stress and Crisis Inventory 93 (SCI-93) and the Dialogue about Working Ability instrument (DOA). Results Twenty-two participants in the PBM group and 28 in the CBT group completed intervention. Both groups showed significant lower scores on the two HADS subscales. Regarding stress the PBM group showed significant decrease in one (out of three) subscales of SCI-93. The CBT group showed significant decrease on all subscales of SCI-93. Regarding work ability the PBM group showed significant higher scores on one of five subscales of DOA. The CBT group showed significant higher scores on four of five subscales of DOA. Between groups there were significant differences to the favour of CBT on one of two subscales of HADS, all three subscales of SCI-93 and on two of the five subscales of DOA. Conclusion PBM seem to be able to reduce anxiety- and depression symptoms. CBT showed to be superior to PBM in reducing symptoms in all aspects of mental health, except for anxiety, in which they seem equally effective. Regarding work ability CBT showed to be superior, with significant effect on more aspects compared to PBM.

Place, publisher, year, edition, pages
Springer-Verlag New York, 2015
Keywords
Anxiety; Depression; Intervention; Primary health care; Return to work; Sickness absence; Stress
National Category
Medical and Health Sciences Occupational Therapy
Identifiers
urn:nbn:se:rkh:diva-930 (URN)10.1007/s10926-014-9530-9 (DOI)24972663 (PubMedID)
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2017-12-05Bibliographically approved
Andersson, A.-C., Idvall, E., Perseius, K.-I. & Elg, M. (2014). Evaluating a Breakthrough Series Collaborative in a Swedish Health Care Context. Journal of Nursing Care Quality, 29(2), E1-E10
Open this publication in new window or tab >>Evaluating a Breakthrough Series Collaborative in a Swedish Health Care Context
2014 (English)In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065, Vol. 29, no 2, p. E1-E10Article in journal (Refereed) Published
Abstract [en]

This study evaluated the use of the Breakthrough Series Collaborative methodology in a Swedish county council improvement program, comparing measurements at the beginning and after 6 months. A questionnaire was used, and improvement processes and outcomes were analyzed. The results showed an overall large engagement in improvements, although the methodology and facilitators were seen as only moderately supportive.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2014
Keywords
Breakthrough Series Collaborative, nursing, organizational innovation, quality improvement
National Category
Nursing Health Sciences
Identifiers
urn:nbn:se:rkh:diva-786 (URN)10.1097/NCQ.0b013e3182a95ff6 (DOI)24052141 (PubMedID)
Available from: 2014-03-13 Created: 2014-03-13 Last updated: 2017-12-05Bibliographically approved
Ekdahl, S., Idvall, E. & Perseius, K.-I. (2014). Family skills training in dialectical behaviour therapy: The experience of the significant others. Archives of Psychiatric Nursing, 28(4), 235-241
Open this publication in new window or tab >>Family skills training in dialectical behaviour therapy: The experience of the significant others
2014 (English)In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 28, no 4, p. 235-241Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to describe significant others’ experiences of dialectical behaviour therapy- family skills training (DBT-FST), their life situation before and after DBT-FST, and measurement of their levels of anxiety and depressive symptoms. Methods: The study had a descriptive mixed method design. Data were collected with free text questionnaires (n= 44), group interviews (n= 53) and the HAD scale (n= 52) and analysed by qualitative content analysis and descriptive and inferential statistics. Results: The results show that life before DBT-FST was a struggle. DBT-FST gave hope for the future and provided strategies, helpful in daily life. For the subgroup without symptoms of anxiety and depression before DBT-FST, anxiety increased significantly. For the subgroup with symptoms of anxiety and depression the symptoms decreased significantly. This indicates, despite increased anxiety for one group, that DBT-FST is a beneficial intervention and most beneficial for those with the highest anxiety- and depressive symptoms.

Place, publisher, year, edition, pages
Saunders Elsevier, 2014
Keywords
Borderline Personality-Disorder; Hospital Anxiety; Depression Scale; Psychiatric-care; Members; Perceptions; Relatives; Distress; Suicide
National Category
Psychiatry
Identifiers
urn:nbn:se:rkh:diva-931 (URN)10.1016/j.apnu.2014.03.002 (DOI)25017556 (PubMedID)
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2017-12-05Bibliographically approved
Petersson, S., Perseius, K.-I. & Johnsson, P. (2014). Perfectionism and sense of coherence among patients with eating disorders. Nordic Journal of Psychiatry, 68(6), 409-415
Open this publication in new window or tab >>Perfectionism and sense of coherence among patients with eating disorders
2014 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 6, p. 409-415Article in journal (Refereed) Published
Abstract [en]

Background: There is a substantial body of research on eating disorders and perfectionism. Also there are several studies on eating disorders and sense of coherence (SOC), but studies regarding all three subjects are sparse. Perfectionism and the degree of SOC are considered central and aggravating aspects of psychiatric conditions, not least in relation to eating disorders. Aims: The present study aimed to describe the relationship between perfectionism as operationalized by Garner in the Eating Disorder Inventory-2 and SOC as defined by Antonovsky in the SOC-29 scale. The hypothesis was that SOC should be negatively associated with perfectionism. Methods: Data from the two self-measuring instruments collected from 95 consecutively recruited eating disorder outpatients were analysed with descriptive and inferential statistics. Results: The patients in the present study scored consistently with other Swedish eating disorder samples on the Perfectionism subscale in the Eating Disorder Inventory-2 (EDI-P) and on the SOC-29, indicating a higher degree of perfectionism and weaker SOC than normal population groups. Perfectionism was significantly correlated to SOC. The correlation was negative, confirming the study hypothesis. The hypothesis was further confirmed in a subgroup analysis comparing patients with different degrees of SOC related to their EDI-P scores. Conclusions: Perfectionism is associated with SOC in patients with eating disorders. Clinical implications: The clinical implications derived from the study could be a recommendation to focus on the SOC in patients with an eating disorder with the hope of lowering the patients’ perfectionism as well.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keywords
Eating disorders, Perfectionism, Sense of coherence, Treatment
National Category
Psychiatry
Identifiers
urn:nbn:se:rkh:diva-758 (URN)10.3109/08039488.2013.851738 (DOI)24228777 (PubMedID)
Available from: 2014-01-03 Created: 2014-01-03 Last updated: 2017-12-06Bibliographically approved
Perseius, K.-I. (2014). Personlighetsstörningar (2ed.). In: Ingela Skärsäter (Ed.), Omvårdnad vid psykisk ohälsa: på grundläggande nivå (pp. 215-245). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Personlighetsstörningar
2014 (Swedish)In: Omvårdnad vid psykisk ohälsa: på grundläggande nivå / [ed] Ingela Skärsäter, Lund: Studentlitteratur AB, 2014, 2, p. 215-245Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2014 Edition: 2
Keywords
psykiatrisk omvårdnad, psykiska sjukdomar
National Category
Psychiatry Nursing
Identifiers
urn:nbn:se:rkh:diva-1093 (URN)9789144095387 (ISBN)
Available from: 2014-10-03 Created: 2014-10-03 Last updated: 2015-10-15Bibliographically approved
Jansson, I., Perseius, K.-I., Gunnarsson, A. B. & Björklund, A. (2014). Work and everyday activities: experiences from two interventions addressing people with common mental disorders.. Scandinavian Journal of Occupational Therapy, 21(4), 295-304
Open this publication in new window or tab >>Work and everyday activities: experiences from two interventions addressing people with common mental disorders.
2014 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 4, p. 295-304Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Lengthy sick leave makes demands on work ability enhancing interventions in primary health care. Problem-based method (PBM) and cognitive behavioural therapy (CBT) are interventions aimed at people with common mental disorders. This study aimed to describe how individuals experienced interventions and the impact the interventions had on the individuals' ability to work and perform other everyday activities.

METHOD: Fourteen women and two men, eight each from two interventions, were interviewed. The interviews were analysed using qualitative content analysis.

RESULTS: The analysis revealed one overarching theme: "Reaching safe ground or continuing to seek help". Four categories were identified: "From being passive to making one's own efforts in the rehabilitation process", "Being stuck on a treadmill or daring to change", "Evolving from routine to more aware behaviour", and "Fitting in or not fitting in with workplace situations".

CONCLUSIONS: According to the participants, experiences from both PBM and CBT had a positive impact on their ability to work and perform other everyday activities in a more sustainable way. Reflecting on behaviour and achieving limiting strategies were perceived as helpful in both interventions, although varying abilities to incorporate strategies were described. In general, the results support the use of active coping-developing interventions rather than passive treatments.

Place, publisher, year, edition, pages
Informa Healthcare, 2014
Keywords
Anxiety; Cognitive behavioural therapy; Depression; Interview; Problem-based method; Qualitative content analysis; Sick leave; Stress; Swedish rehabilitation guarantee; Vocational rehabilitation
National Category
Health Sciences Occupational Therapy
Identifiers
urn:nbn:se:rkh:diva-954 (URN)10.3109/11038128.2014.894572 (DOI)24666197 (PubMedID)
Available from: 2014-09-02 Created: 2014-09-02 Last updated: 2017-12-05Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-1515-0485

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