Individuals’ experiences with brief admission during the implementation of the brief admission skåne RCT, a qualitative study

Helleman, Marjolein; Lundh, Lars‐Gunnar; Liljedahl, Sophie; Daukantaité, Daiva; Westling, Sofie

doi:10.1080/08039488.2018.1467966

Cited by 17 publications

(25 citation statements)

References 14 publications

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“…During the BA period (which varies from 1 to 3 days), participants experienced a positive approach from the staff along with daily conversations, which enabled them to view their problems from a different perspective. The importance of positive attitudes from staff corresponded with a previous study of BA in patients with emotional instability and self‐harm (Helleman, Lundh, Liljedahl, Daukantaite, & Westling, 2018). Similar to the current study, Helleman et al (2018) reported that patients received an open welcome from the start and were offered daily conversations, which led to feelings of increased security.…”

Section: Discussionsupporting

confidence: 80%

Brief admission for patients with emotional instability and self‐harm: A qualitative analysis of patients’ experiences during crisis

Eckerström

Flyckt

Carlborg

et al. 2020

Int J Mental Health Nurs

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Previous studies report that individuals diagnosed with borderline personality disorder have been met by negative attitudes from healthcare professionals and their care needs have often been neglected during hospitalizations. When symptoms of emotional instability are combined with self-harm, the resulting crisis often becomes difficult to handle for patients and healthcare professionals. To meet their care needs during these crises, an intervention called 'brief admission' (BA) has been developed. The purpose of BA is to provide a timeout, in situations of increased stress and threat, in order to foster self-management in a safe environment. In the present study, we explored the following research questions: What are patients' experiences with BA? What do patients consider to be the key components of BA? What improvements are considered relevant by patients? A qualitative design was employed, and 15 patients (13 females, 2 males; mean age 38.5 AE 12.9, range 20-67 years) were interviewed using a semi-structured interview guide. Thematic analyses were performed, which yielded four themes related to the patients' experiences: 'a timeout when life is tough', 'it is comforting to know that help exists', 'encouraged to take personal responsibility', and 'it is helpful to see the problems from a different perspective'. Four themes also described the key components: 'a clear treatment plan', 'a smooth admission procedure', 'a friendly and welcoming approach from the staff', and 'daily conversations'. Lastly, three themes described areas for improvements: 'feeling guilty about seeking BA', 'room occupancy issues', and 'differences in staff's competence'. Collectively, the findings indicate that BA constructively supports patients with emotional instability and self-harm during a period of crisis.

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Section: Discussionsupporting

confidence: 80%

Brief admission for patients with emotional instability and self‐harm: A qualitative analysis of patients’ experiences during crisis

Eckerström

Flyckt

Carlborg

et al. 2020

Int J Mental Health Nurs

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“…This furthermore relates to previous descriptions of hope as a paradox for people suffering from chronic pain, in which hope often involves balancing between hoping enough to carry on and at the same time keeping hopes in check to avoid the ever-present possibility of despair [32]. From other areas it is known that when experiencing a chronic condition there is a value in knowing where to turn to for help [19], and furthermore, that when health professionals are experienced as not available, this can lead to hopelessness [33]. The resignation and the despair the informants spoke of in the current study, can be seen as a movement from a hope of finally finding help towards a hopelessness when yet another treatment option turned out to be unavailable.…”

Section: Moving Between Hope Small Expectations and Hopelessnessmentioning

confidence: 56%

“…This is important since having a feeling of not being believed, in addition to experiencing a lack of compassion and understanding, have been related to consequences such as threats to self-image, loss of identity and isolation [34], as well as affecting future help-seeking behaviour [37]. Thus, similar experiences and mechanisms described in studies of persons with self-harm behaviour [19] and people suffering from diffuse symptoms and psychological distress [20] are present among persons with chronic pain rejected access to tertiary pain care.…”

Section: Desiring a Chance To Be Heard And Seenmentioning

confidence: 98%

“…However, we have not found any study investigating how persons with chronic pain experience rejections from pain care services. Related to other conditions, it has been found that persons with self-harm behaviour experiencing rejection may abstain from requesting future help [19], and that people suffering from diffuse symptoms and psychological distress perceived rejections as a sign of being a burden for others, which in turn prevented them from improving their health and to obtain adequate care [20]. Whether similar experiences and mechanisms are present when people with chronic pain is rejected access to specialised pain care, is unknown.…”

Section: Introductionmentioning

confidence: 99%

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“No one wants you” – a qualitative study on the experiences of receiving rejection from tertiary care pain centres

Nøst

Stedenfeldt

Steinsbekk

2020

Scandinavian Journal of Pain

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Background and aimsFour out of 10 referrals to tertiary care pain centres in Norway are not granted pain centre treatment, confirming earlier research on that this group of patients struggle to access the highest standard of care. Still, no study investigating how people with chronic pain experience rejections from pain centres was found. The aim of the study was therefore to investigate how people with chronic pain experience receiving a rejection from tertiary care pain centres after being referred by their general practitioners (GPs).MethodsThis was a qualitative study with semi-structured individual interviews with 12 persons, seven men and five women, rejected from the four different pain centres in Norway. The data were analysed thematically using systematic text condensation.ResultsThe pain centre rejection created strong reactions, partly because the rejection was perceived as a refusal from the health care system as a whole. This was especially so because the pain centre was regarded as the last remaining treatment option, and given the rejection, they were now declined help by the experts in the field. Even though some informants had received an explanation for why they had not been granted pain centre treatment, a prominent experience was that the informants found it difficult to understand why their referral had been rejected given the severity of their pain. The incomprehensibility of the rejection together with a feeling of lack of future treatment options, increased the hopelessness and frustration of their situation and made it challenging to move on and search for help elsewhere.ConclusionsThe experiences with the pain centre rejections indicate that the rejection can have grave consequences for each individual in the following months. An improved system for how to handle expectations towards referrals, including prepare for the possibility of rejection and how to follow up a rejection, seems warranted.ImplicationsBecause a pain centre rejection most likely is received by persons in a vulnerable position, there should be available health care services to help them understand the rejections. And furthermore, help them to move from disappointment and hopelessness, towards an experience of empowerment and reorientation, by for instance planning further actions and interventions, and thereby, acknowledge their need for help.

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“…Importantly, being faced with negative attitudes from care providers can evoke negative emotional responses in self-harming individuals and discourage helpseeking [19,20], making it crucial to target such attitudes among healthcare staff. In a recent interview study, selfharming individuals described it as essential to experience positive attitudes from staff during admission [21]. The issue of care providers' attitudes towards self-harm has only been examined sparsely in Sweden in the last decade [12].…”

Section: Introductionmentioning

confidence: 99%

Revising the Self-Harm Antipathy Scale: validation among staff in psychiatric healthcare in Sweden

Lantto

Jungert

Nilsson

et al. 2020

Nordic Journal of Psychiatry

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Background: The Self-Harm Antipathy Scale (SHAS) is a questionnaire designed to measure nurses' attitudes towards self-harm. This can be useful to improve the quality of care provided to individuals who self-harm. Aim: The purpose of this study was to revise and adapt the SHAS for use in Sweden and evaluate the psychometric properties of this Swedish version (Self-Harm Antipathy Scale -Swedish Revised; SHAS-SR). Methods: A sample of 596 employees within psychiatric healthcare was recruited (from a total of 3507, response rate 17.0%), the majority encountering self-harming individuals regularly at work. Participants completed the SHAS-SR questionnaire along with a scale assessing community attitudes towards individuals with mental illness (New CAMI-S). The sample was randomly split in half (n ¼ 298 each). Exploratory factor analysis was performed on one subsample and confirmatory on the other. Confirmatory factor analysis on the original SHAS model, and convergent validity testing against New CAMI-S, used the whole sample. Results: The final version of the SHAS-SR included 17 items forming three factors. Convergent validity was established (r ¼ À0.57, q ¼ À0.48, p < 0.001). The SHAS-SR and all its subscales demonstrated acceptable internal consistency (a ¼ 0.73-0.79, x ¼ 0.78-0.79). Conclusion: This study indicates that the SHAS-SR is reliable and valid when assessing attitudes towards self-harm among a sample of Swedish psychiatric healthcare staff. The scale could be useful for assessing the impact of attitude interventions to improve healthcare services. It may, however, have limited applicability for staff not working in caring roles. ARTICLE HISTORY

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Individuals’ experiences with brief admission during the implementation of the brief admission skåne RCT, a qualitative study

Abstract: NCT02985047.

Cited by 17 publications

References 14 publications

Brief admission for patients with emotional instability and self‐harm: A qualitative analysis of patients’ experiences during crisis

Brief admission for patients with emotional instability and self‐harm: A qualitative analysis of patients’ experiences during crisis

“No one wants you” – a qualitative study on the experiences of receiving rejection from tertiary care pain centres

Revising the Self-Harm Antipathy Scale: validation among staff in psychiatric healthcare in Sweden

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