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  • 1.
    Kristiansen, Lisbeth
    et al.
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Institutionen för hälsovetenskap, Mittuniversitetet, Sundsvall.
    Rättspsykiatri2010In: Omvårdnad vid psykisk ohälsa - på grundläggande nivå / [ed] Ingela Skärsäter, Lund: Studentlitteratur , 2010, 1, p. 279-303Chapter in book (Other academic)
  • 2.
    Olsson, Helen
    et al.
    Dalarna University.
    Audulv, Åsa
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall; Sundsvall Forensic Psychiatric Hospital.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Reducing or Increasing Violence in Forensic Care: A Qualitative Study of Inpatient Experiences2015In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 29, no 6, p. 393-400Article in journal (Refereed)
    Abstract [en]

    Semi-structured interviews with 13 forensic psychiatric inpatients that had decreased their assessed risk of violence were analyzed using interpretive description. The main contribution from this study is a detailed description of patients' own strategies to avoid violence. Participants described having an ongoing inner dialog in which they encouraged themselves, thereby increasing their self-esteem and trying to accept their current situation. An unsafe and overcrowded ward with uninterested and nonchalant staff increased the risk of aggressive behavior. In the process of decreasing violence, the patients and the forensic psychiatric nursing staff interacted to create and maintain a safe environment.

  • 3.
    Olsson, Helen
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Turning points and treatment readiness in forensic patients: A study based on staff experiences.2014In: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 4, no 3, p. 175-188Article in journal (Refereed)
    Abstract [en]

    Many individuals sentenced to forensic psychiatric care fail in the rehabilitation process, resulting in long-term inpatient hospital care. The concepts of turning points and treatment readiness in forensic settings should therefore be afforded more attention. Much can be learned from the features that characterize trajectories of recovery and processes related to turning points. The aim of this study was to explore forensic nursing staff’s experiences of forensic psychiatric patients’ turning towards recovery. A qualitative content analysis was used to analyse interviews with 13 forensic psychiatric nursing staff. Analysis of the data revealed two main themes with implications for clinical practice: promoting a turning point and recognizing a turning point. In the first of these, the emphasis was on actions and conditions that must exist to promote a turning. In the second, the main experiences related to recognizing a turning point were stories about visible and perceptible changes in the patient. The experiences that stood out most distinctly were those of being able to wait out the patient, and having patience when there was a lack of progression. The composition of staff and patients contributed to whether or not the environment was perceived as salutary.

  • 4.
    Olsson, Helen
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Reaching a turning point – how patients in forensic care describe trajectories of recovery2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 505-514Article in journal (Refereed)
    Abstract [en]

    In Sweden, the duration of treatment is increasing for patients admitted to forensic psychiatric care. To reduce the length of stay it is important for the forensic rehabilitation and recovery process to be effective and safe. Not much is known about how the process of recovery and transition begins and how it is described by the forensic patients. The purpose of this study was to explore how forensic patients with a history of high risk for violence experienced the turn towards recovery. A qualitative content analysis was used to analyze interviews with 10 patients who had decreased their assessed risk for violence on the risk assessment instrument HCR-20, and who were successfully managed a lower level of security. Three themes were identified: (1) the high risk phase; facing intense negative emotions and feelings (2) the turning point phase; reflecting on and approaching oneself and life in a new way (3) the recovery phase; recognizing, accepting and maturing. In the high risk phase chaotic and overwhelming feelings were experienced. The turning point phase was experienced as a sensitive stage and it was marked by being forced to find a new, constructive way of being. The recovery phase was characterized by recognizing personal circumstances in life, including accepting the need for structure, a feeling of maturity and a sense of responsibility for their own life. In order to ensure a successful recovery, the forensic nursing staff needs to recognize and support processes related to treatment motivation and turning points. Recommendations for best nursing practice are given accordingly.

  • 5.
    Olsson, Helen
    et al.
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Strand, Susanne
    Avdelningen för samhällsvetenskap, Mittuniversitetet, Sundsvall; Sundsvall Forensic Psychiatric Hospital, Sweden.
    Kristiansen, Lisbeth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Sjöling, Mats
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Asplund, Kenneth
    Avdelningen för omvårdnad, Mittuniversitetet, Sundsvall.
    Decreased risk for violence in patients admitted to forensic care, measured with the HCR-202013In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, no 4, p. 191-197Article in journal (Refereed)
    Abstract [en]

    Aim: To explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the Clinical (C) and Risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data.

    Methods: The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment.

    Results: The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce.

    Conclusion: The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.

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