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  • 1.
    Ander, Cecilia
    et al.
    Psykiatricentrum Södertälje, Sweden .
    Åling, Maria
    Swedish Red Cross University, Department of Health Sciences.
    Nahlén Bose, Catarina
    Swedish Red Cross University, Department of Health Sciences.
    Nurses’ experiences of using the NANDA International taxonomy in mental healthcare2023In: Mental Health Practice, ISSN 1465-8720, E-ISSN 2047-895XArticle in journal (Refereed)
    Abstract [en]

    Background The lack of a standardised nursing taxonomy to clarify nurses’ assessments and other elements of the nursing process can potentially lead to a lack of care continuity and patient safety. The taxonomy published by NANDA International (NANDA-I) has been shown to improve the quality of mental health nurses’ documentation and clinical care.

    Aim To describe nurses’ experience of working in mental health inpatient care with a structured nursing taxonomy of diagnoses based on the NANDA-I taxonomy.

    Method Semi-structured interviews were conducted with five nurses working on three inpatient wards in a mental health unit in Sweden. The data were analysed using qualitative manifest content analysis.

    Findings The nurses’ experiences of using the NANDA-I taxonomy were described through three themes: ‘benefits of having a common language’, ‘usefulness of the NANDA-I taxonomy in the mental health context’, and ‘importance of how healthcare organisations apply the NANDA-I taxonomy’.

    Conclusion The common language provided by the NANDA-I taxonomy contributed to making nursing care more structured and person-centred. However, for the NANDA-I taxonomy to be effective, local nursing guidelines need to be synchronised with it.

  • 2.
    Grbovic, Filip
    et al.
    Ambulance Care in Great Stockholm Ltd. on Behalf of Health Care Services Stockholm County, Sweden.
    Åling, Maria
    Swedish Red Cross University, Department of Health Sciences.
    Strömberg, Lars
    Swedish Red Cross University, Department of Health Sciences.
    Mazaheri, Monir
    Karolinska Institutet, Sweden; Sophiahemmet University, Sweden.
    Assessing the Alignment of Short-Term Assessment of Risk and Treatability (START) with NANDA-I Taxonomy in Forensic Care Settings2023In: Perspectives in psychiatric care, ISSN 0031-5990, E-ISSN 1744-6163, article id 8073893Article in journal (Refereed)
    Abstract [en]

    Purpose. To investigate the alignment of START with NANDA-I in forensic psychiatric care. Design. A quantitative design was chosen to compare the START instrument with the NANDA-I taxonomy and analyze their alignment. Each item of the START was attempted to be matched with potentially relevant NANDA-I diagnoses, and the matched diagnoses were extracted and presented. Findings. The study demonstrated a strong alignment between START coding and NANDA-I diagnoses, with 99% of the START diagnoses finding a match within NANDA-I. These results support the use of NANDA-I in forensic psychiatric care, which facilitate providing comprehensive care and avoiding sole focus on psychiatric problems. Practice Implications. It is recommended to use a structured nursing taxonomy, such as NANDA-I, in forensic psychiatric care.

  • 3.
    Okenwa-Emegwa, Leah
    et al.
    Swedish Red Cross University, Department of Health Sciences. Högskolan i Gävle, Sverige.
    Paillard-Borg, Stéphanie
    Swedish Red Cross University, Department of Health Sciences.
    Wallin Lundell, Inger
    Swedish Red Cross University, Department of Health Sciences. Linköpings universitet, Sverige.
    Stålberg, Anna
    Swedish Red Cross University, Department of Health Sciences.
    Åling, Maria
    Swedish Red Cross University, Department of Health Sciences.
    Ahlenius, Gabriella
    Swedish Red Cross University, Department of Health Sciences.
    Eriksson, Henrik
    Swedish Red Cross University, Department of Health Sciences. Högskolan Väst, Sverige.
    Våga fråga och agera!: Undervisnings- och lärandeaktiviteter om mäns våld mot kvinnor och våld i nära relationer i sjuksköterskeprogrammet vid Röda Korsets Högskola2021In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 98, no 4, p. 671-683Article in journal (Refereed)
    Abstract [sv]

    År 2017 infördes ett nytt nationellt examensmål ”visa kunskap om mäns våld mot kvinnor och våld i nära relationer” enligt SFS 2017: 857, i högskoleför-ordningen (SFS 1993:100) för vissa utbildningsprogram, där sjuksköterske-programmet är inkluderat. Syftet med denna artikel är att presentera hur det nationella examensmålet har implementerats i sjuksköterskeprogrammet vid Röda Korsets Högskola. Först ges en översikt avseende relevanta undervis-nings- och lärandeaktiviteter och hur de organiseras genom programmets utbildningsplan. I de avslutande reflektionerna presenteras den didaktiska Våga fråga och agera! -modellen. Modellen är en sammanfattning av Röda Korsets Högskolas tillvägagångssätt, det vill säga en stegvis progression i utbildningen från fakta, statistik, normer och värderingar, till att studenterna lär sig hur de kan upptäckta tecken på våld i komplexa kliniska situationer samt vikten av att ha mod att agera. Avslutningsvis är det vår uppfattning att ett tydligt upplägg är viktigt för att uppnå intentionerna med det nationella examensmålet, nämligen: Våga fråga och agera!   

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  • 4.
    Åling, Maria
    The Swedish Red Cross University College, Department of Health Sciences.
    Identifying nursing care needs for patients in forensic psychiatry: in search for a sustainable and co-created person centred care2018Conference paper (Other academic)
  • 5.
    Åling, Maria
    The Swedish Red Cross University College, Department of Technology and Welfare.
    Implementation of Nursing Diagnosis (i.e. NANDA) in a Forensic Psychiatric setting2016In: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016 Börshuset – Malmö, Malmö: Psykiatriska riksföreningen för sjuksköterskor , 2016, p. 36-Conference paper (Refereed)
    Abstract [en]

    The Swedish legislation indicates that patients in the forensic psychiatric setting should be re-integrated into society through rehabilitative measures including nursing care. This was recognized by the National Board of Health and Welfare (i.e. Socialstyrelsen) in 2002, but concluded that there is a vast knowledge gap regarding the aim and the content of nursing care in forensic psychiatric settings. Still nursing care in forensic psychiatry is sparsely described. Recent research confirms this description of a knowledge gap and adds that there is a lack of structured nursing care in forensic psychiatry (Hörberg, 2012). Nonetheless, the content and outcome of nursing care in the forensic psychiatric setting is hard to visualize. The actual patient needs and problems has to be identified and defined. To meet this knowledge gap, structured and categorized descriptions of the patients’ nursing care needs need to be described. Frauenfelder et al., 2014) claims that NANDA could be the tool to label problems and risk diagnoses, although they call for further research.

    The implementation of nursing diagnoses according to NANDA started in 2011, one year after Forensic Psychiatry Care Stockholm became one department, and the implementation process is still on-going. Previously, the forensic psychiatric care in Stockholm had been spread out over three different departments with dissimilar culture. The new management wanted a “unified department”, and one way to achieve this was to use NANDA as a tool for a common language in nursing care. The implementation started with a meeting with the ward managers and Registered Nurses. A project plan for the implementation was presented and discussed. The project leader met all RNs in the department in small groups to describe and motivate the use of NANDA. Up till now eleven wards have been involved and at least two meetings have been held at each ward. The project leader has participated at ward rounds and supervised the RNs in the use of NANDA. In conclusion, more RNs need to be engaged to continue the progress of the project. Another task is to find a less time consuming implementation process and to evaluate the implementation to this point. It is also important, further down the line, to introduce the tools Nursing Diagnoses Interventions (NIC) and Nursing Diagnoses Outcome (NOC) in the forensic psychiatric setting. Apart from a common nursing language, the use of standardized descriptions, actions and goals would fill the knowledge gap regarding aim and content of nursing care in forensic psychiatric settings (Escalada-Hernandez et. al., 2015).

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  • 6.
    Åling, Maria
    et al.
    The Swedish Red Cross University College, Department of Technology and Welfare.
    Kasel, Daniel
    LWL-MRVK Forensic Hospital Herne, Germany.
    Peternelj-Taylor, Cindy
    University of Saskatchewan, Canada.
    What is your story?: The experiences of patients and nurses in secure forensic environments2016In: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016 Börshuset – Malmö, Malmö: Psykiatriska riksföreningen för sjuksköterskor , 2016, p. 35-Conference paper (Refereed)
    Abstract [en]

    Nurses who work in forensic environments, practice at the shifting interface of the criminal justice system and the health care system.  How they view those in their care, and more importantly, how they engage those in their care, is a significant concern for nursing.  Forensic clients are members of a highly stigmatized and stereotyped population. The ability of forensic mental health nurses to provide competent and ethical nursing care is often compromised by personal, social, and political animosity regarding crime, criminality, and mental disorder.  Pausing to reflect on the stories of clients and nurses, within a narrative context, evokes understanding, and contributes to the creation of person centered care.

    In paper one, the coercive treatments experienced by a man who has spent many years in compulsory care in a variety of secure psychiatric settings is explored in response to his confession “I don’t dare to tell them I feel okay!” In paper two, how nurses transition to their roles as forensic nurses is considered as they straddle the custodial and therapeutic aspects of their work, often expressing concerns with their perceptions of “education of the fly” or “faking it ‘til you make it.” In paper three, the mental health contributions of nurses who practice in prisons and correctional institutions is captured in the words “that’s why I bought into this profession, to instill hope and recovery.”

    Through the examination of these vignettes that have emerged through research and practice, participants will be engaged in an interactive discussion as we consider the implications of narrative nursing vis-à-vis the vast tensions that exist between theory, practice, and research in forensic mental health nursing.  Finally, the universal nature of these issues, highlighting contributions from Sweden, Germany and Canada will be illustrated.

     

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  • 7.
    Åling, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Lindgren, Agnes
    The Swedish Red Cross University College.
    Löfall, Hillevi
    The Swedish Red Cross University College.
    Okenwa-Emegwa, Leah
    The Swedish Red Cross University College, Department of Health Sciences. Högskolan i Gävle.
    A Scoping Review to Identify Barriers and Enabling Factors for Nurse-Patient Discussions on Sexuality and Sexual Health2021In: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 11, no 2, p. 253-266Article, review/survey (Refereed)
    Abstract [en]

    Background: Sexuality and sexual health (SSH) are essential aspects of care that have evolved since a 1975 World Health Organization (WHO) report on SSH. However, nurses still consider discussing the subject with patients a challenge. This scoping review aimed to map, synthesize, and summarize findings from existing literature regarding barriers and enabling factors for nurse-patient SSH discussions in care contexts. Methods: A scoping review model inspired by Arksey and O'Malley was used to search for and synthesize studies published between 2009 and 2019. The databases searched were the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online, i.e., MEDLARS Online. A total of nineteen articles were eligible to be included. Results: Two main categories of enabling factors were identified, i.e., a professional approach via using core care values and availability of resources. Three major categories of barriers were identified: beliefs and attitudes related to age, gender, and sexual identity; fear and individual convictions; and work-related factors. Conclusions: Applying professionalism and core care values as well as making resources available are likely to promote SSH discussions between nurses and patients. Moreover, there is a need for a norm-critical approach in education and practice.

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  • 8.
    Åling, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Nilsson, Evelina R
    European Medicines Agency.
    Garpstål, Björn
    Capio S:t Görans Sjukhus.
    Strömberg, Lars
    The Swedish Red Cross University College, Department of Health Sciences.
    Nursing Diagnoses Panorama in a Swedish Forensic Psychiatric Setting Using NANDA-International Taxonomy2018In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 14, no 3, p. 141-147Article in journal (Refereed)
    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.

  • 9.
    Åling, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Syrén, Susanne
    Linnaeus University, Sweden.
    Strömberg, Lars
    The Swedish Red Cross University College, Department of Health Sciences.
    Patients' Expressed Nursing Care Needs in a Forensic Psychiatric Setting2021In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 17, no 4, p. 244-252Article in journal (Refereed)
    Abstract [en]

    ABSTRACT: The aim of this study was to describe the patients' nursing care needs in a forensic psychiatric setting in line with the NANDA-I classification. Ten patients sentenced to forensic psychiatric care were interviewed. Data were analyzed by means of directed content analysis with a deductive approach, where we used "served time" as a factor in the analysis, thus creating three categories: newly arrived patients with a length of stay of only a couple of years, patients with a length of stay of around 5 years, and patients with a length of stay of more than 5 years. Thirteen NANDA-I diagnoses were identified during the analyses, distributed on seven different domains. When distributing the given NANDA-I diagnoses according to the created categories, an explanatory pattern emerged, and three themes became apparent: denial, insight, and listlessness. Considering the differences in views, the patients' own recognition of what is a problem, a potential, or a risk could improve a "working relation" and, eventually, a recovery. NANDA-I nursing diagnoses may improve individualized and person-centered care as NANDA-I makes care continuously consistent over time.

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