Service user involvement enhanced the research quality in a study using interpretative phenomenological analysis -the power of multiple perspectives. Journal of Advanced Nursing 73(1), 265-278. doi: 10.1111/jan.13093 Abstract Aim. The aim of this study was to examine how service user involvement can contribute to the development of interpretative phenomenological analysis methodology and enhance research quality. Background. Interpretative phenomenological analysis is a qualitative methodology used in nursing research internationally to understand human experiences that are essential to the participants. Service user involvement is requested in nursing research. Design. We share experiences from 4 years of collaboration (2012)(2013)(2014)(2015) on a mental health promotion project, which involved an advisory team. Methods. Five research advisors either with a diagnosis or related to a person with severe mental illness constituted the team. They collaborated with the research fellow throughout the entire research process and have co-authored this article. We examined the joint process of analysing the empirical data from interviews. Our analytical discussions were audiotaped, transcribed and subsequently interpreted following the guidelines for good qualitative analysis in interpretative phenomenological analysis studies. Results. The advisory team became 'the researcher's helping hand'. Multiple perspectives influenced the qualitative analysis, which gave more insightful interpretations of nuances, complexity, richness or ambiguity in the interviewed participants' accounts. The outcome of the service user involvement was increased breadth and depth in findings. Conclusion. Service user involvement improved the research quality in a nursing research project on mental health promotion. The interpretative element of interpretative phenomenological analysis was enhanced by the emergence of multiple perspectives in the qualitative analysis of the empirical data. We argue This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Abstract. Localized electrostatic wave packets in the frequency region of lower hybrid waves have been detected by the instruments on the FREJA satellite and also earlier by instrumented rocket payloads. These waves are often associated with local density depletions, indicating that the structures can be interpreted as wave-filled cavities which are strongly elongated along the magnetic field. The basic features of the observations are discussed, providing a survey of the conditions for occurrence and spatial distributions. The basic properties of the individual cavities and associated fluctuating electric fields are discussed as well, and typical densities, widths, and other characteristics are obtained for selected orbits. IntroductionThe Earth's ionosphere is rich in naturally occurring low- The paper is organized as follows: In section 2 we discuss the distribution of cavities and relate them to standard geomagnetic observations. In section 3 we discuss some of the basic statistical characteristics of the observations of the lower hybrid waves and associated density depletions. In section 4 we briefly discuss the relations of the present study to other observations of lower hybrid wave cavities, while section 5 contains our conclusions. We used the ISDAT program for visualizing the signals and presenting the data in a form suitable for analysis. 2.Occurrence of Cavities A large number of passes were analyzed in order to-determine the regions of occurrence for the wave-filled cavities. Table 1 gives a summary of the orbits which were analyzed for the present study. For a detailed analysis we selected four of these orbits, numbers 1234, 1547, 6663, and 7580, the orbits in parentheses. When selecting these orbits, we made certain that a time span of more than a year was covered. In Figure 2 we show an overview of the polar region, where thin lines indicate the orbits in Table 1 and bold lines show regions where cavities were observed. Note that some passes were void of cavities. The present analysis supplements that of Dovner et al. [1997]. Our database is not as complete as theirs, but the presentation of data and scope of analysis are different. Correlation With Kp IndexThe magnetospheric Kp index is one central parameter for describing the activity associated with the auroral oval, and we attempted a correlation between this index and the occurrence of cavities. In Table 1 we give a list of relevant Kp indexes in the rightmost column. By inspection we find no evident correlation between the Kp index and the presence of cavities. This could be a misleading conclusion, so to substantiate the argument we show in Figure 3 the relation between the Kp index and the distance (in degrees) from the cavity-containing region to the undisturbed auroral oval, the beginning and end of the region along the satellite orbit being marked by small vertical bars. The rationale behind this figure is that the Kp index can 26,633
Significant contributions from research advisors were promoted by facilitating the process of involvement. A supporting structure and atmosphere were consistent with a salutogenic service user involvement.
Objective: Paths toward referral to involuntary psychiatric admission mainly unfold in the contexts where people live their everyday lives. Modern health services are organized such that primary health care services are often those who provide long-term follow-up for people with severe mental illness and who serve as gatekeepers to involuntary admissions at the secondary care level. However, most efforts to reduce involuntary admissions have been directed toward the secondary health care level; interventions at the primary care level are sparse. To adapt effective measures for this care level, a better understanding is needed of the contextual characteristics surrounding individuals' paths ending in referrals for involuntary admission. This study aims to explore what characterizes such paths, based on the personal experiences of multiple stakeholders.Method: One hundred and three participants from five Norwegian municipalities participated in individual interviews or focus groups. They included professionals from the primary and secondary care levels and people with lived experience of severe mental illness and/or involuntary admission and carers. Data was subject to constant comparison in inductive analysis inspired by grounded theory.Results: Four main categories emerged from the analysis: deterioration and deprivation, difficult to get help, insufficient adaptation of services provided, and when things get acute. Combined, these illustrate typical characteristics of paths toward referral for involuntary psychiatric admission.Conclusion: The results demonstrate the complexity of individuals' paths toward referral to involuntary psychiatric admission and underline the importance of comprehensive and individualized approaches to reduce involuntary admissions. Furthermore, the findings indicate a gap in current practice between the policies to reduce involuntary admissions and the provision of, access to, and adaptation of less restrictive services for adults with severe mental illness at risk of involuntary admissions. To address this gap, further research is needed on effective measures and interventions at the primary care level.
Spacecraft‐plasma interactions are studied with self‐consistent numerical simulations of magnetized plasmas, where electrons are strongly magnetized whereas ions are weakly magnetized. It is found that for a spacecraft in such a magnetized plasma corresponding to a low Earth orbit, electrons can be reflected from a negatively charged spacecraft and then guided by geomagnetic field lines. The reflected electrons can leave a sharp trail like wings if the spacecraft size is greater than an average electron gyroradius of the environment. Such an electron wing‐like structure is associated with propagating Langmuir waves. This results in nontrivial asymmetric electrostatic potentials close to the spacecraft and even farther than the Debye screening distance. The convective electric field also gives rise to a differential potential of the spacecraft with respect to the plasma, resulting in yet another asymmetry in the plasma dynamics and the potential distribution around the spacecraft. These asymmetries in the plasma dynamics can significantly influence in‐situ measurements of space plasma. The results show a good qualitative agreement with actual measurements by a satellite in the polar regions.
Background: Compulsory hospitalisation in mental healthcare is contested. For ethical and legal reasons, it should only be used as a last resort. Geographical variation could indicate that some areas employ compulsory hospitalisation more frequently than is strictly necessary. Explaining variation in compulsory hospitalisation might contribute to reducing overuse, but research on associations with service characteristics remains patchy.Objectives: We aimed to investigate the associations between the levels of compulsory hospitalisation and the characteristics of primary mental health services in Norway between 2015 and 2018 and the amount of variance explained by groups of explanatory variables.Methods: We applied random-effects within–between Poisson regression of 461 municipalities/city districts, nested within 72 community mental health centre catchment areas (N = 1,828 municipality-years).Results: More general practitioners, mental health nurses, and the total labour-years in municipal mental health and addiction services per population are associated with lower levels of compulsory hospitalisations within the same areas, as measured by both persons (inpatients) and events (hospitalisations). Areas that, on average, have more general practitioners and public housing per population have lower levels of compulsory hospitalisation, while higher levels of compulsory hospitalisation are seen in areas with a longer history of supported employment and the systematic gathering of service users' experiences. In combination, all the variables, including the control variables, could account for 39–40% of the variation, with 5–6% related to municipal health services.Conclusion: Strengthening primary mental healthcare by increasing the number of general practitioners and mental health workers can reduce the use of compulsory hospitalisation and improve the quality of health services.
Background Reducing involuntary psychiatric admissions is a global concern. In Norway, the rate of involuntary admissions was 199 per 100,000 people 16 years and older in 2020. Individuals’ paths towards involuntary psychiatric admissions usually unfold when they live in the community and referrals to such admissions are often initiated by primary health care professionals. Interventions at the primary health care level can therefore have the potential to prevent such admissions. Interventions developed specifically for this care level are, however, lacking. To enhance the quality and development of services in a way that meets stakeholders’ needs and facilitates implementation to practice, involving both persons with lived experience and service providers in developing such interventions is requested. Aim To develop a comprehensive intervention for primary mental health care aiming to prevent involuntary admissions of adults. Methods This study had an action research approach with a participatory research design. Dialogue conferences with multiple stakeholders in five Norwegian municipalities, inductive thematic analysis of data material from the conferences, and a series of feedback meetings were conducted. Results The co-creation process resulted in the development of the ReCoN (Reducing Coercion in Norway) intervention. This is a comprehensive intervention that includes six strategy areas: [1] Management, [2] Involving Persons with Lived Experience and Family Carers, [3] Competence Development, [4] Collaboration across Primary and Specialist Care Levels, [5] Collaboration within the Primary Care Level, and [6] Tailoring Individual Services. Each strategy area has two to four action areas with specified measures that constitute the practical actions or tasks that are believed to collectively impact the need for involuntary admissions. Conclusions The ReCoN intervention has the potential for application to both national and international mental health services. The co-creation process with the full range of stakeholders ensures face validity, acceptability, and relevance. The effectiveness of the ReCoN intervention is currently being tested in a cluster randomised controlled trial. Given positive effects, the ReCoN intervention may impact individuals with a severe mental illness at risk of involuntary admissions, as more people may experience empowerment and autonomy instead of coercion in their recovery process.
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