Most long-term patients who had moved out of psychiatric institutions were satisfied with their living situation and reported a relatively high quality of life.

PurposeTo explore relationships of socio-demographic variables, health behaviours, environmental characteristics and personal factors, with physical and mental health variables in persons with morbid obesity, and to compare their health-related quality of life (HRQoL) scores with scores from the general population.MethodsA cross-sectional correlation study design was used. Data were collected by self-reported questionnaire from adult patients within the first 2 days of commencement of a mandatory educational course. Of 185 course attendees, 142 (76.8%) volunteered to participate in the study. Valid responses on all items were recorded for 128 participants. HRQoL was measured with the Short Form 12v2 from which physical (PCS) and mental component summary (MCS) scores were computed. Other standardized instruments measured regular physical activity, social support, self-esteem, sense of coherence, self-efficacy and coping style.ResultsRespondents scored lower on all the HRQoL sub-domains compared with norms. Linear regression analyses showed that personal factors that included self-esteem, self-efficacy, sense of coherence and coping style explained 3.6% of the variance in PCS scores and 41.6% in MCS scores.ConclusionPersonal factors such as self-esteem, sense of coherence and a high approaching coping style are strongly related to mental health in obese persons.

BackgroundMorbid obesity is a progressive, chronic condition associated with failed attempts at change and repeated relapses.AimThere seems to be little previous research into the understanding of the everyday life of morbidly obese adults. We wanted to gain more knowledge about characteristics of eating habits and body image as well as motivational forces for change.MethodsA qualitative approach was chosen in order to gain insight into how morbidly obese adults experience everyday life. Qualitative interviews are well suited to provide insight into themes from the interviewee's life story from the subjects’ own perspectives. To gain insight into such processes, a narrative approach that allowed the informants to give voice to their ways of doing, thinking and feeling in daily life, was adopted. The informants comprised seven women and four men aged of 26–56 years, recruited from a population of obese individuals who had participated in a weight reduction course. A hermeneutic approach was used where the research question was the basis for a reflective interpretation.ResultsThe following meaning-units were identified: to be perceived as overweight; and to see oneself as overweight. Ingrained habits: the struggle between knowing and doing; acting without knowing; and eating is soothing.ConclusionsSeeing oneself as an obese person is a gradual process that implied experiencing oneself as different from significant others, such as (slim) siblings and friends. To experience a gap between knowing and doing concerning food habits in everyday life indicates that informants value they have a choice. This is an important insight to consider when framing interventions to support this vulnerable group.

Introduction: Few studies have addressed staff and patient experiences of the therapeutic milieus at psychiatric institutions from a learning perspective. The purpose of this study was to gain more knowledge about the meaning and value the psychiatric institution may have as a place for learning in time and space for patients with various mental disorders, and how the staff may contribute in the learning processes of the patients. We were especially interested in studying patients' experiences by taking part in their own learning processes together with others. We wanted to study the meaning this might have for them, and how the staff and the surrounding culture, context and the place might promote or obstruct learning to take place. Material and methods:In this thesis data are gathered from two different institutions. In the first part data were gathered from an open psychiatric institution. Fifteen qualitative interviews with patients with nonpsychotic mental disorders were conducted shortly before discharge, and 14 of these were reinterviewed after discharge. The other institution was a closed ward at a district psychiatric center for patients with dual diagnosis. Qualitative interviews with 20 patients and 24 staff were conducted, and nine of the staff was reinterviewed 12 months later. The study has a qualitative explorative and descriptive design with a hermeneutic-phenomenological approach, and is theoretically anchored in the learning model of Illeris (2012). This model views learning as situated, meaning that it takes place in a social and societal context, and a sociocultural understanding is emphasized. Results:The results from the four papers are condensed and discussed in five main themes; Environment (healing environment), Learning climate as a source of motivation, Insight and mastery through knowledge and experiences, Collaborative learning, and Tensions in the learning climate (barriers against learning).The surroundings-world (the physical and aesthetical aspects of the surroundings) is healing environments and give patients experiences of wholeness and self-worth. This is experienced through the atmosphere of the place and the meeting with the staff, who acknowledge them as equal human beings. The learning climate at the institution, comprising the attitudes, friendliness, engagement, professionalism, structure and flexibility from the staff, and ability for patients to take achieve part in their own treatment, motivates learning to take place and be maintained. Therapeutic methods, like cognitive therapy, physical exercise, group activities and education contribute to provide tools in the learning process for patients and staff. Sufficient time enables personal learning and acquisition of new knowledge.Physical exercise provides useful experiential knowledge and is a self-help method. It seemed especially useful for those struggling with learning the cognitive method. Appreciating relations from staff are important for motivation, learning and mastery. Fellow patients have an important role in...

The focus is on voluntarily hospitalized patients' subjective experiences of learning and gaining personal knowledge during a stay at a mental hospital. The aim was to explore and describe patients' learning as personal knowledge acquisition related to the therapeutic process during hospitalization. The study was exploratory and descriptive, with a hermeneutic--phenomenological approach in data collection and analysis. Qualitative interviews were carried out with 15 patients during and after their stay. A re-analysis was conducted. The results underline the importance of the environmental effects on patients' motivation for learning and self-esteem in an acknowledging milieu. Moving towards relearning presupposes that the patient's motivation is aroused. Patients must participate in the treatment and the validity of the knowledge must be tested in the individual patient's life. The patients confirmed and helped each other to increase insight through recognizing each other's problems and reactions. Time in itself seemed to increase self-reflection. Receiving impulses and getting concrete tools through therapy stimulated meaning and hope for future living. The professionals must use a holistic approach including a learning climate in pleasant surroundings and a conjoint contribution from fellow patients and staff. Further research should focus on how to combine therapy with learning--preferably by means of a co-operative inquiry design.