Relatives of persons with severe mental illness face a straining life situation and need support. Exclusion of relatives in mental health care has long been reported. The aim of this study was to describe conceptions of nurses in mental health care about supporting relatives of persons with severe mental illness. Focus group interviews with nurses from all levels of mental health care in Norway were performed. A phenomenographic approach was used. The nurses found that their responsibility first and foremost was the patient, especially to develop an alliance with him or her. Additional premises for supporting relatives were the context framing the nursing care, aspects of the actors, and relational concerns between them. Competing or contradictory demands were found within these premises. Two paths were identified concerning the nurses' support of relatives: seeing the relative in the shadow of the patient or as an individual person.
Relatives of persons with severe mental illness experience burden and straining changes in their lives that put their health at risk. Consequently, they need support from health professionals. The aim of this study was to describe experiences from encounters with mental health services as seen from the point of view of relatives of persons with severe mental illness. A qualitative, explorative study was performed, based on two open-ended questions in a cross-sectional study of relatives' health, burden, and sense of coherence (n = 216). A manifest qualitative content analysis was used to describe the relatives' experiences. The findings show that some relatives had experienced positive encounters with health personnel, but the majority of experiences reported were negative. The encounters can be summarized into one main category: "Left Alone with Straining but Inescapable Responsibilities." Two categories emerged: "Striving for Involvement for the Sake of the Mentally Ill Person," and "Wanting Inclusion for the Sake of Oneself." There is a gap between relatives' needs for support in order to handle their own situation in relation to their mentally ill next of kin, and what they actually receive from the mental health services. The findings suggest that health professionals should collaborate with and support these relatives.
This study describes and investigates burden to and health of relatives of persons with severe mental illness in relation to background variables, everyday life with the mentally ill person, and sense of coherence. A cross-sectional design was used. The respondents were 226 relatives from the Norwegian National Association for Families of Mentally Ill Persons. In addition to background variables and variables about everyday life with the mentally ill person, the questionnaire was comprised of the Burden Assessment Schedule (BAS), Short Form Health Survey (SF-36), and Sense of Coherence Instrument (SOC). This study shows that the relatives were burdened and also reported poor health. Greater burden was experienced by women and by relatives who did not have anyone with whom to share the caregiving of the mentally ill person. For relatives who were single, divorced, or widowed, burden was greater and health was poorer; likewise for relatives who reported financial problems and frequent phone calls with the mentally ill person. Burden and poor health were associated with low SOC. The findings suggest a need for the health services to include and support these relatives in order for them to sustain health.
Relatives of those suffering from severe mental illness experience multiple challenges and a complex life situation. The aim of this study was to describe life-sharing experiences from the perspective of relatives of someone with severe mental illness. A qualitative, descriptive study was performed, and interviews were carried out with eighteen relatives of persons with severe mental illness. A phenomenographic analysis, according to the steps described by Dahlgren and Fallsberg, was used to describe the relatives' conceptions of their situation. The findings show that the experiences of these relatives can be summarized in one main category: 'The art of balancing between multiple concerns'. Two descriptive categories emerged: 'Making choices on behalf of others and oneself' and 'Constantly struggling between opposing feelings and between reflections'. Relatives report that they have to manoeuvre between different ways to act and to prioritize between different wishes and needs. In addition, they face a wide range of strong feelings and they search for hope and meaning. Relatives of someone with severe mental illness have to balance multiple concerns, which induce ethical dilemmas. They felt love, compassion or sense of duty towards the mentally ill person. The changeable situation made it difficult for the relatives to establish a balance in their lives. To be able to prioritize some private time was important. Relatives need own support and sufficient follow-up of the mentally ill next of kin from the mental health services.
In order for adolescents to learn about sex and relationships, the education must be of significance and meet their needs and interests. The study investigated adolescents' conceptions of learning and education about sex and relationships. A phenomenographic approach was used. Six focus group interviews were conducted with adolescents ages 18-19 in Sweden. The results showed that stable ground for learning implies select issues of importance, that is, values and prejudices, up-to-date knowledge, and practical skills. These issues should be dispersed throughout the school years in relation to the students' own maturity. This seemed to enable internalization of different aspects of sex and relationships. Learning about sex and relationships can create meaning for youth and generate progress by fostering autonomy and identity, correcting misconceptions, counteract prejudices, not in isolation rather in society in a defined culture.
The advantages and disadvantages of terminal care in open-plan patient rooms have been discussed in the literature. This article describes the results of a study on relatives' experience of care in open-plan rooms. It describes how relatives experienced the patient and the ward environment and how they participated in the care. The content of interviews with relatives of long-term geriatric patients was interpreted according to Erik H. Erikson's theory of "eight stages of man". The findings indicated that the information to the relatives was insufficient and relatives' participation in planning the care was scarce. The open-plan room environment was experienced as deterrent and the patient as deserted. A majority of the relatives experienced emotional contact with the patient. Open-plan patient rooms with a task assignment organisation of care do not provide patients and relatives with the conditions necessary for the experience of integrity, and this could disturb the relationship between the patient and his relatives.
Background: The total number of people with dementia symptoms is expected to double every 20 years and there will also be an increase in the number of older immigrants in several countries. There are considerable deficiencies in the present knowledge of how to conduct well-functioning health care for immigrants with dementia symptoms. The aim of this study was to explore caring and uncaring encounters between assistant nurses and immigrants in two group homes for persons with dementia symptoms in Sweden: a Finnish-speaking as well as a Swedish-speaking context. In addition, this study aims to describe how caring and uncaring encounters are manifested in these two contexts according to Halldórsdóttir’s theory of “Caring and Uncaring encounters”. Method: Descriptive field notes from 30 separate observations were analyzed using qualitative deductive content analysis. Results: The main category “caring encounters” focused on reaching out to initiate connection through communication, removing masks of anonymity by acknowledging the unique person, acknowledgment of connection by being personal. Reaching a level of truthfulness by being present and showing respect, raising the level of solidarity by equality and true negotiation of care, based on the residents’ needs. The main category, uncaring encounters, focused on disinterest in and insensitivity towards the other, coldness in the connection and lack of humanity in care situations. The observations showed that caring encounters occurred more in the Finnish-speaking context and uncaring encounters more often in the Swedish context. Conclusion: Encounters could be caring, uncaring, and carried out using a person-centered approach. Communication and relationships could be facilitated using the same language but also through learning to interpret residents’ needs and desires.
Background: Negative consequences for sexual health may be caused by risky sexual behavior related to attitudes, norms and self-efficacy regarding sexuality. Research has not resulted in a consensus on the associations between self-esteem and adolescents' sexual behavior. Aims and Objectives: The aim of the study was to describe high school students' sexual behavior and self-esteem, along with investigating the relationship of attitudes, norms, self-efficacy, and self-esteem to sexual risk behavior. Another aim was to describe and compare gender differences in self-esteem and sexual risk behavior in high school students in a rural context. Methodological Design: A crosssectional design was used. The participants were 139 high school students, 16 to 18 years of age, sample size was decided by power calculation, and systematic randomized sampling was used. The students replied to a questionnaire about self-esteem, factors affecting sexual risk behavior, and sexual behavior. Results: Swedish high school students reported having few sexual partners, a low use of alcohol along with sex, yet a low consistency in condom use. The students reported both high basic self-esteem as well as earned self-esteem. Basic self-esteem was higher for male students while earned self-esteem was higher for female students. Significant correlations were found between self-esteem and some factors affecting sexual risk behavior related to condom use. Conclusion: High school students exhibited positive sexual behaviors and high levels of selfesteem, yet they put themselves at risk by inconsistent use of condoms. Our findings can contribute the need of to an awareness of the role self-esteem, attitudes, norms and self-efficacy plays in adolescents' sexual behavior. Nurses working at the youth clinics are in a key position to discuss sexual health issues with adolescents to promote healthy outcomes in sexual health.
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