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  • 1.
    Kumpula, Esa
    et al.
    Mälardalens University.
    Gustafsson, Lena-Karin
    Mälardalens University.
    Ekstrand, Per
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Nursing Staff Talk: Resource or Obstacle for Forensic Psychiatric Patient Care?2019Ingår i: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 15, nr 1, s. 52-59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although forensic psychiatric care is located at the intersection of health care and the Swedish legal system, nursing research has not yet evaluated how language is context bound or its consequences for understanding patient care. The aim of this study was to explore how nursing staff talk about patient care in Swedish forensic psychiatric care and the implications for the care given to patients. The theoretical framework is based on social constructionism and sheds light on how language use can be understood as a social action. Twelve interviews were conducted with nursing staff working in forensic psychiatric settings. The questions focused on patient care in relation to activities, security, relationships with patients, and rules and routines. The results show that nursing staff assignments are encouraging them to use various interpretative repertoires to make meaning about their practice. The three interpretative repertoires were "taking responsibility for correcting patients' behavior," "justifying patient care as contradictory practice," and "patients as unpredictable." However, although forensic psychiatric care emphasizes both security and care, nursing staff's use of these interpretative repertoires provided multiple interpretations that lead to contradictory ways of understanding patient care. These findings show that talk itself can be understood as problematic in various situations. A possible implication for clinical forensic nursing practice might be that the nurse-patient relationship does not support patients' best interests. For example, when language endows the patient with certain characteristics, this talk is justified and given meaning by its context and thus has an influence on a patient's individual need for care.

  • 2.
    Pollak, Charlotte
    et al.
    Stockholm County Council.
    Palmstierna, Tom
    Kald, Magnus
    Linköping University.
    Ekstrand, Per
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    It Had Only Been a Matter of Time Before I Had Relapsed Into Crime: Aspects of Care and Personal Recovery in Forensic Mental Health2018Ingår i: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 14, nr 4, s. 230-237Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Forensic psychiatry has the dual task of focusing on the prevention of reoffending as well as maintaining psychiatric rehabilitation. No previous studies addressing the patients' own views on reducing their risk of serious reoffending were found.

    AIM: This study describes forensic psychiatric inpatients' own views on what aspects of care and personal recovery are important in reducing their risk of serious reoffending.

    METHODS: A structured qualitative approach was used. Data were collected from semistructured interviews and analyzed with a systematic qualitative content analysis.

    RESULTS: The results highlight aspects of care and personal recovery. Four themes emerged: "time: opportunity for change," "trust: creating a context with meaningful relations," "hope: to reach a future goal," and "toolbox: tools needed for recovery."

    DISCUSSION: The themes present with a continuum. At one end, there are patients who appreciated possibilities to participate actively in care and treatment. At the other end, patients felt they had no use for their care. Interestingly, although patients in our study were asked for their opinion on how they could reduce their dangerousness, all themes fit into established personal recovery processes found in general psychiatric populations. The theme "time: opportunity for change" seems to have an overarching importance.

    IMPLICATIONS FOR PRACTICE: By understanding the specific content along these themes, relevant to the individual patient, carers may be able to better support their personal recovery journey. Because time spent as inpatients in forensic psychiatry is an overarching issue, carers need to be persistent over time.

  • 3.
    Åling, Maria
    et al.
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Nilsson, Evelina R
    European Medicines Agency.
    Garpstål, Björn
    Capio S:t Görans Sjukhus.
    Strömberg, Lars
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Nursing Diagnoses Panorama in a Swedish Forensic Psychiatric Setting Using NANDA-International Taxonomy2018Ingår i: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 14, nr 3, s. 141-147Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    More than 1,000 Swedish hospital beds are occupied by patients in forensic psychiatric settings; their average length of hospitalization is 3-7 years. In this context, nursing diagnoses could be extremely useful to make nursing care structured, measurable, and internationally comparable. The study aimed to describe nursing diagnoses in a Swedish forensic psychiatric setting.

    METHODS: Data were collected from electronic patient records of 55 patients in a medium-secure forensic psychiatric setting in Sweden. Anonymized data were entered into a database where entries were transformed into figures. Descriptive statistics were used, and frequencies, means, and percentages were calculated. The variables employed were characteristics and related factors, according to NANDA-International (NANDA-I) and International Statistical Classification of Dieseases and Related Heatlh Problems, 10th Revision (ICD-10), diagnoses.

    RESULTS: The patients had between 1 and 13 NANDA-I diagnoses each. Forty-one of the 55 patients had psychosis as the primary ICD-10 code. The identified nursing diagnoses described the patients' status upon arrival in the forensic psychiatric setting. Of the 55 patients, entries in the patient records describing 300 signs and symptoms (i.e., characteristics and related factors) were found. From these signs and symptoms, 371 entries that fit NANDA-I diagnoses were identified, representing 20 different NANDA-I diagnoses.

    CONCLUSION: NANDA-I diagnoses individualize patient care, making care person centered. NANDA-I is used all over the world and has the potential to make nursing care structured, measurable, and internationally comparable.

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