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Eckerström, J., Flyckt, L., Carlborg, A., Jayaram-Lindström, N. & Perseius, K.-I. (2020). Brief admission for patients with emotional instability and self-harm: A qualitative analysis of patients' experiences during crisis. International Journal of Mental Health Nursing, 29(5), 962-971
Open this publication in new window or tab >>Brief admission for patients with emotional instability and self-harm: A qualitative analysis of patients' experiences during crisis
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2020 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 29, no 5, p. 962-971Article in journal (Refereed) Published
Abstract [en]

Previous studies report that individuals diagnosed with borderline personality disorder have been met by negative attitudes from healthcare professionals and their care needs have often been neglected during hospitalizations. When symptoms of emotional instability are combined with self-harm, the resulting crisis often becomes difficult to handle for patients and healthcare professionals. To meet their care needs during these crises, an intervention called 'brief admission' (BA) has been developed. The purpose of BA is to provide a timeout, in situations of increased stress and threat, in order to foster self-management in a safe environment. In the present study, we explored the following research questions: What are patients' experiences with BA? What do patients consider to be the key components of BA? What improvements are considered relevant by patients? A qualitative design was employed, and 15 patients (13 females, 2 males; mean age 38.5 ± 12.9, range 20-67 years) were interviewed using a semi-structured interview guide. Thematic analyses were performed, which yielded four themes related to the patients' experiences: 'a timeout when life is tough', 'it is comforting to know that help exists', 'encouraged to take personal responsibility', and 'it is helpful to see the problems from a different perspective'. Four themes also described the key components: 'a clear treatment plan', 'a smooth admission procedure', 'a friendly and welcoming approach from the staff', and 'daily conversations'. Lastly, three themes described areas for improvements: 'feeling guilty about seeking BA', 'room occupancy issues', and 'differences in staff's competence'. Collectively, the findings indicate that BA constructively supports patients with emotional instability and self-harm during a period of crisis.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
borderline personality disorder, crisis intervention, patient admission, psychiatric nursing, self-injurious behaviour
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-3408 (URN)10.1111/inm.12736 (DOI)32406168 (PubMedID)
Available from: 2020-05-19 Created: 2020-05-19 Last updated: 2021-01-14Bibliographically approved
Eckerström, J., Allenius, E., Helleman, M., Flyckt, L., Perseius, K.-I. & Omerov, P. (2019). Brief admission (BA) for patients with emotional instability and self-harm: nurses’ perspectives - person-centred care in clinical practice. International Journal of Qualitative Studies on Health and Well-being, 14(1), Article ID 1667133.
Open this publication in new window or tab >>Brief admission (BA) for patients with emotional instability and self-harm: nurses’ perspectives - person-centred care in clinical practice
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2019 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, no 1, article id 1667133Article in journal (Refereed) Published
Abstract [en]

Purpose: Emotional instability and self-harm pose major problems for society and health care. There are effective interventions in outpatient care, but when patients need inpatient care, nurses often struggle meeting their patient’s needs. Brief admission (BA) is a newly implemented crisis intervention and novel form of inpatient care. The aim of this study is to describe nurses’ experiences working with BA related to patients with emotional instability and self-harm.

Methods: Eight nurses were interviewed according to a semi-structured interview guide. The data was analysed using qualitative content analysis.

Results: Four main categories emerged regarding nurses’ experiences with BA: provides security and continuity, fosters caring relationships, shifts focus towards patient’s health and empowers the patient. The nurse’s role shifted from “handling problems” to establishing caring relationships with a focus on the person’s health and possibilities for recovering instead of psychiatric symptoms.

Conclusions: Previous studies on patients’ perspective of BA describe positive experiences such as increased autonomy and participation in the healthcare process. This study supports those findings, albeit from the perspective of nurses. Our findings suggest that BA may reduce work-related stress experienced by nurses while caring for persons with emotional instability and self-harm. BA may also support nurses in their ability to provide more meaningful and constructive psychiatric inpatient care.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Borderline personality disorder, brief admission, crisis intervention, emotional instability, mental health nursing, patient admission, person-centred care, psychiatric nursing, self-harm
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-3043 (URN)10.1080/17482631.2019.1667133 (DOI)31526310 (PubMedID)
Funder
Swedish Research Council, 2015-02446
Available from: 2019-09-24 Created: 2019-09-24 Last updated: 2020-12-21Bibliographically approved
Hedlund Lindberg, M., Samuelsson, M., Perseius, K.-I. & Björkdahl, A. (2019). The experiences of patients in using sensory rooms in psychiatric inpatient care. International Journal of Mental Health Nursing, 28(4), 930-939
Open this publication in new window or tab >>The experiences of patients in using sensory rooms in psychiatric inpatient care
2019 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 28, no 4, p. 930-939Article in journal (Refereed) Published
Abstract [en]

The use of sensory rooms and similar sensory approaches in psychiatric inpatient settings is becoming increasingly common. In sensory rooms, patients can choose different sensory stimulating items that may help regulate distress and enhance well-being. Outcomes are often measured as effects on patients' self-rated distress and rates of seclusion and restraint. The subjective experiences of patients using sensory rooms have been less explored. This paper presents a qualitative study of the experiences of 28 patients who chose to use sensory rooms on seven different types of psychiatric inpatient wards. Data were collected by individual patient interviews and by texts written by patients. A qualitative content analysis resulted in four categories: emotional calm, bodily calm, empowerment, and unexpected effects. A majority of the participants described several positive experiences, such as enhanced well-being, reduced anxiety, increased self-management, and enhanced self-esteem. Our findings align with previous research that has shown similar positive patient experiences, and support the use of sensory rooms as part of person-centred care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
comfort room, empowerment, patient experience, sensory room, well-being
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-2789 (URN)10.1111/inm.12593 (DOI)30931543 (PubMedID)
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-08-06Bibliographically approved
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.

Place, publisher, year, edition, pages
Scandinavian Society for Person-Oriented Research, 2018
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: 2021-09-09Bibliographically 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, E-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: 2022-02-10Bibliographically 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
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1515-0485

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