Patients with mental illness generally make their initial healthcare contact via a registered nurse. Although studies show that encountering and providing care to care-seekers with mental illness might be a challenge, little research exists regarding Primary Care Nurses' (PCN) view of the challenges they face. The aim of this study was to qualitatively explore PCNs' reflections on encountering care-seekers with mental illness in primary healthcare settings. The results consist of three themes: constantly experiencing patients falling through the cracks, being restricted by lack of knowledge and resources, and establishing a trustful relationship to overcome taboo, shame, and guilt.

Purpose: Our aim was to describe Swedish Healthcare Direct (SHD) and its features as a complex system.

Methods: Qualitative interviews were conducted with 20 SHD telenurses, covering their experiences and skills when encountering and advising callers with mental illness. Complexity science was used as an a priori theoretical framework to enhance understanding of the complex nature of telenursing.

Results: SHD was described as a complex system as nurses were constantly interacting with other agents and agencies. During these interactions, dynamic processes were found between the agents in which the nurses adapted to every new situation. They were constantly aware of their impact on the care-seekers, and perceived their encounters with callers with psychiatric illness as "balancing on a thin line". SHD was also described as both an authority and a dumping ground. The openness of the system did not give the nurses possibility to control the number of incoming calls and the callers' intentions.

Conclusions: These new insights into SHD have important implications for organization developers and nursing management in terms of overcoming linear thinking.

Purpose – The purpose of this paper is to explore and describe online communication about the experiencesand attitudes toward Swedish Healthcare Direct, a national telephone advice nursing (TAN) service.

Design/methodology/approach – A descriptive research design was adopted using a six-step netnographicmethod. Three Swedish forums were purposefully selected and data from the virtual discussions were collected.

Findings – Three themes emerged: expectancy and performativity of the nurses, absurdity in accessibilityand the scrutinizing game. The most prominent finding was the scrutinizing game, which included aspects ofbidirectional mistrust from both nurses and callers. Another salient finding was the attitudes that callers heldtoward nurses who used a technique interpreted as “passing the buck.”

Research limitations/implications – The use of a nethnographic method is novel in this area of research.Consequently, the body of knowledge has regarding telephone advise nursing service has significantly beenbroadened. A limitation in this study is that demographic data for the posters are not available.

Practical implications – Bidirectional distrust is an important issue that must be acknowledged by TANservices, since it might damage the service on a fundamental level. Healthcare providers, politicians, andresearchers should account for the power and availability of virtual discussions when seeking consumers’opinions and evaluating the quality of the care provided.

Originality/value – This analysis of the ongoing discussions that take place on the internet provides insightinto callers’ perceptions of a national TAN service. The bidirectional mistrust found from both the nurses andthe callers might be a threat to callers’ compliance with the advice given and their care-seeking behavior.

The aim of the study was to describe the telephone nurses' experiences of encountering callers with mental illnesses. Telenursing services are solely staffed with telenurses, who with the support of a decision support system (CDSS) independently triage callers based on the severity of the main symptoms presented by the care seeker. The system focuses on somatic symptoms, while information regarding mental health and mental illnesses is limited. Information about telenurses' experiences of encountering care seekers with mental illnesses is scarce, despite the increase in mental illnesses in the population. The study used a descriptive design with a qualitative approach. Twenty telenurses were interviewed, and the data were then analysed using inductive qualitative content analysis. The results are elaborated in the following three categories: (i) Experiences of encountering care seekers with mental illnesses; (ii) Experiences of facing difficulties and challenges; and (iii) Experiences of facing dissatisfaction and threats. Encountering care seekers with mental illnesses is metaphorically addressed as 'when all other doors are closed'. Encountering care seekers with mental illnesses was perceived as time-consuming and did not adequately correspond to the resources given by the service. Even though telenurses strive to achieve agreement, there is a collision between human needs and organizational structures. The study pinpoints the lack of resources for and education about mental illnesses and the limitations of the decision system, which needs to be updated in order to provide all care seekers care on equal terms.

Purpose

The aim of this literature review is to describe how eating disorders among adolescents affect family relationships and the family’s daily living conditions and to describe the family’s experienced need for professional support.

Design/methodology/approach

An integrative literature review based on the method of Whittemore and Knafl (2005). 15 articles with both qualitative and quantitative approaches were reviewed.

Findings

The results are presented in two main themes: A disharmonic family and The need for input from healthcare professionals. The results are discussed using Callista Roy's adaptation model and the adaptive modes; Group Identity Mode, Role Function and Interdependence.

Originality/value

This review article will be of interest to clinical nurses and other professionals who encounter families to clarify how the relationships and roles change within the family. To our knowledge, no integrative review has paid attention to how the relational aspects of the family members, their social roles and role constructions within the family affect daily living.

It is highly likely that artificial intelligence (AI) will be implemented in nursing robotics in various forms, both in medical and surgical robotic instruments, but also as different types of droids and humanoids, physical reinforcements, and also animal/pet robots. Exploring and discussing AI and robotics in nursing and health care before these tools become commonplace is of great importance. We propose that monsters in popular culture might be studied with the hope of learning about situations and relationships that generate empathic capacities in their monstrous existences. The aim of the article is to introduce the theoretical framework and assumptions behind this idea. Both robots and monsters are posthuman creations. The knowledge we present here gives ideas about how nursing science can address the postmodern, technologic, and global world to come. Monsters therefore serve as an entrance to explore technologic innovations such as AI. Analyzing when and why monsters step out of character can provide important insights into the conceptualization of caring and nursing as a science, which is important for discussing these empathic protocols, as well as more general insight into human knowledge. The relationship between caring, monsters, robotics, and AI is not as farfetched as it might seem at first glance.

The aims of this study were to present themes in nursing motifs as depicted in tattoos and to describe how it reflects upon nursing in popular culture as well as within professional nursing culture. An archival and cross-sectional observational study was conducted online to search for images of nursing tattoos that were freely available, by utilizing the netnographic methodology. The 400 images were analyzed in a process that consisted of four analytical steps focusing on metaphors and meanings in the tattoos.

The findings present four themes: angels of mercy and domination; hegemonic nursing technology; embodying the corps; and nurses within the belly of the monster. The tattoos serve as a mirror of popular culture and the professional culture of nurses and nursing practice within the context of body art. Body art policy statements have been included in nursing personnel dress code policies. Usually these policies prohibit tattoos that are sexist, symbolize sex or could contribute and reproduce racial oppression. The results show that the tattoos can be interpreted according to several layers of meanings in relation to such policies. We therefore stress that this is an area highly relevant for further analyses in nursing research.

There have been few attempts to express in words and conceptualise ‘the Internet’ and ‘health’ within a framework. The aim of this study was to present a conceptual framework concerning virtual self-care and online caring. The results show that the concepts of virtual communities, virtual self-care and torrenting frame these very specific interactions and environments and that the concepts of keyboard cowboy, cyber aid and health interests trader stipulate different ways in which to express expertise in cyber nursing. Alongside cyber-bullying, cyber nursing is also present in virtual arenas. Nursing researchers need to explore and monitor cyber nursing activities using concepts developed within the field of nursing.

Background

The imperative to gather information online and to become an ‘expert’ by locating effective advice for oneself and others is a fairly new support phenomenon in relation to health advice. The creation of new positions for health ‘experts’ within the space of the Internet has been addressed as a cybernursing activity. A focused analysis of communication in health forums might give insight into the new roles that are available for health experts in cyberspace.

Aim

The aim of this study is to describe approaches to being an ‘expert’ in lifestyle health choice forums on the Internet and to elaborate on the communicative performances that take place in the forums.

Method

An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online. 2640 pages of data from two health Internet forums were gathered and analyzed.

Findings

The results reveal three distinctive types of experts that emerge in the forums: (1) those that build their expertise by creating a presence in the forum based on lengthy and frequent postings, (2) those who build a presence through reciprocal exchanges with individual posters with questions or concerns, and (3) those who build expertise around a “life long learning” perspective based on logic and reason.

Discussion

The results suggest that experts not only co-exist in the forums, but more importantly they reinforce each others’ positions. This effect is central; alongside one another, the posts of the three types of experts we identify constitute a whole for those seeking the forum for advice and support. Users are provided with strong opinions and advice, support and Socratic reasoning, and a problem-oriented approach. The Internet is now an integral part of everyday living, not least of which among those who seek and offer support in cyberspace. As such, cyber nursing has become an important activity to monitor, and formal health care professionals and nursing researchers must stay abreast of developments.

The aim of this study was to present the functionality and design of nursing care robots as depicted in pictures posted on social media. A netnographic study was conducted using social media postings over a period of 3 years. One hundred and Seventy-two images were analyzed using netnographic methodology. The findings show that nursing care robots exist in various designs and functionalities, all with a common denominator of supporting the care of one's own and others' health and/or well-being as a main function. The results also show that functionality and design are influenced by recent popular sci-fi/cartoon contexts as portrayed in blockbuster movies, for example. Robots'designs seem more influenced by popular sci-fi/cartoon culture than professional nursing culture. We therefore stress that it is relevant for nursing researchers to critically reflect upon the development of nursing care robots as a thoughtful discussion about embracing technology also might generate a range of epistemological possibilities when entering a postmodern era of science and practice.

Popular culture; literature, movies and comics, is full of monsters. Monsters that both scare and amuse. Through history people has been fascinated, feared and amused by the idea of mysterious creatures, the monsters. Passing stories and constructing the “monsters” are part of all cultures and over times, although the representation of monsters are projected in variance over time and are historical and contextual bounded. Just as monsters are the binary opposition of the ‘good citizen’, monsters also perform as embodied representations of the “Other”. Monster is therefore best understood as embodiment of difference, a breaker of categories and a resistant other. Monsters are “tricksters” challenging our coding of the world by challenging our knowledge. The monster ask us how we as humans perceive the world and about our perception of difference. The aim of this project is to explore the caring activities of monsters in popular culture. The project will catalog monsters’ caring activities around the globe and analyze why, when and under what circumstances monster characters actually do care. In this presentation the initial analyzes of data gathered from the project website (http://www.caringmonsters.com/) will be presented. The initial readings based on a straight forward content analysis of why monsters sometimes go out of character and suddenly engage in some kind of caring activities will be presented. The result will contribute to a critical discussion of the impact of caring and the ethics of caring from which we could learn about humanity, when reflecting upon it from an “outside” and monstrous perspective.

Background: People use social media to express perceptions, attitudes and a wide range of concerns regarding human life. Aim: This study aims at analysing the ongoing discussions on the internet microblog Twitter and offers some coming predicaments regarding developments in geriatric nursing regarding nursing robots.

Methods: Data were retrospectively collected from Twitter. 1322 mentions were included in the final analyses, where principles of interpreting data by using netnography were utilized.

Results: Many ideas are presented expressing functional, psychological and social aspects of robots in nursing care. Most postings come from metropolitan cities around the globe. The discussion focuses on market-driven, science fiction solutions for aged care. Twitter users overall seem to be positive using various nursing robots in aged care. These discussions offer a window into the attitudes and ideas of this group of users.

Conclusion: We suggest that monitoring Twitter discussions on social media can provide valuable insights into current attitudes as well as forecast coming trends.

Given the proliferation of support technology for men entering parenthood in virtual forums this project’s aim was to explore a virtual forum exclusively for fathers and elaborate on gendered questions for men’s parenthood within that milieu. An archival forum study was undertaken using principles for nethnography. The categories presented in the results overall indicate that the online venue creates a privileged invisibility from experiences in “real life” gender relations. This suggests that both horizontal and vertical homo-social dimensions are present in the forum support/negotiations which occur among the forum posters, whereby issues of invisibility and entitlement in some cases take a central position. We suggest that being virtual invisible men entails participation in both a marketplace of opinions and a homo-social competition.

Nurses who exert coercive measures on patients within psychiatric care are emotionally affected. However, research on their working conditions and environment is limited. The purpose of the current study was to describe nurses' experiences and thoughts concerning the exertion of coercive measures in forensic psychiatric care. The investigation was a qualitative interview study using unstructured interviews; data were analyzed with inductive content analysis. Results described participants' thoughts and experiences of coercive measures from four main categories: (a) acting against the patients' will, (b) reasoning about ethical justifications, (c) feelings of compassion, and (d) the need for debriefing. The current study illuminates the working conditions of nurses who exert coercive measures in clinical practice with patients who have a long-term relationship with severe symptomatology. The findings are important to further discuss how nurses and leaders can promote a healthier working environment.

Objective

The objective was to describe registered nurse anesthetists’ reflections and strategies in relation to supervision of specialist nursing students in anesthetic care.

Background

In anesthesiology care, registered nurse anesthetists work with advanced care in a high-technology environment. The complexity of working with production requirements, time pressure and patient safety creates great challenges. Registered nurse anesthetists have a unique position and are responsible for the patient’s life during surgery. At the same time, they must supervise students without risking patient safety. Little research to date has focused on the clinical supervisory role in this context.

Design

A qualitative design was used.

Methods

The data were collected in 2018 from qualitative interviews with a purposive sample of twelve student registered nurse anesthetists from a large hospital in Sweden. The data were analyzed using content analysis.

Results

The results demonstrated that the dual role of registered nurse anesthetist and supervisor was experienced as satisfying, important and promoting development, although it also involved several challenges. Creating opportunities for supervision and learning in perioperative care improved supervisors’ prerequisites for supporting students and helping them develop. Being a supervisor was also rewarding, and given the interplay with students, supervision was viewed as a process of mutual growth.

Conclusion

By focusing on students and their learning, we can help produce well-qualified registered nurse anesthetists who have positive experiences of the workplace and who want to stay in their profession.

Background: Several models for how to support students and provide them with the skills needed to write their degree projects have been proposed. However, few attempts have been made to present a general model for students’ academic work based on reasoning and communication skills rather than memorizing and mimicking their supervisors during their independent degree project.

Objective: In the present paper, we propose a well-structured model that assists supervisors in promoting students’ responsibility and autonomy, while at the same time maintaining a high level of support.

Presentation: We present a step-by-step protocol based on a partnership model with a contractual style that focuses on students’ academic work with their own texts through a process of alternating between abstract and concrete writing. This protocol, which is called the ESRA (Escorting the Students into Responsibility and Autonomy) model, can be utilized regardless of the content, specific aim and scope of the individual student’s degree project.

Discussion and Conclusions: We argue that this model promotes high levels of engagement and assumption of responsibility among students, while also offering a feasible structure for ensuring the steps to empowerment and autonomy. Use of the ESRA model is suitable when a constructive interaction between students and supervisors is desirable as a tool to achieve the learning outcomes of the degree project. Thus, the proposed model is one step toward giving a new generation of nurses the skills and ability they need to adapt in the changing world of the 21st century and to make promoting health a core mission of their profession.

Given the fact that women in homelessness face considerable health inequities, the question of how digitalization can be understood in relation to social rights and right to health surfaces. The objective of this qualitative interview study was to explore the use of mobile phones and internet for women experiencing homelessness. Women (n = 26) shared experiences of healthcare access by using a mobile phone or internet. Data were analyzed using NVivo software. The results are presented in two themes: Conditions and circumstances of having a mobile phone; and Structural and intrapersonal challenges affecting social rights. The results show that digitalization actively influenced everyday life for women experiencing homelessness. Whether women wanted it to or not, digitalization presents a line of demarcation for participation and inclusion or exclusion, in health- and social-care services.

Introduction

Mental health issues are common among women in homelessness, alongside undertreated chronic physical conditions leading to serious and unnecessary complications. Even though homelessness and risks of impaired health have been researched, broader perspectives of health are absent.

Aim

To describe reflections on health among women with experiences of homelessness.MethodWe conducted thirteen interviews with women in homelessness using researcher-driven photo elicitation. Together with an advisory board of women with lived experience of homelessness, researchers were guided by the DEPICT model for collaborative data analysis and performed a thematic analysis.

Findings

Women with experiences of homelessness emphasized three main resources for achieving health and well-being: feelings of having a home, being involved in authentic relationships and experiences of preserved dignity.

Implication for practice

Healthcare needs to integrate the perceived resources for health and well-being when caring for women in homelessness. It is imperative since women will return to the healthcare setting only if they feel safe and secure, and only if dignity is preserved or restored. The results promote utilization of an integrative nursing approach; understanding that the health of women in homelessness is inseparable from their environment and social determinants for health, such as housing and social integration.

Background: A much more substantial European evidence base on the accessibility of healthcare services among women experiencing homelessness across healthcare systems in Europe is warranted.; Objective: To give voice to women with experiences of homelessness, and to explore their perspectives of healthcare services in an EU country with universal healthcare.; Design: The study is part of a research program striving to promote equal healthcare through co-production with women in homelessness. An advisory board of women with lived experience of homelessness was established and a qualitative, interpretive and exploratory design was employed.; Participants: 26 women with experience of homelessness were interviewed. Their median age was 46 years (range 42) and 70% were roofless/houseless.; Methods: Data were analyzed with content analysis. Co-production and joint analyses were conducted by researchers and three women with experience of homelessness, using the DEPICT model for collaborative analysis.; Results: The analysis resulted in one overall theme: Visiting healthcare from the outskirts of society, comprising three sub-themes: Demand for a life in order - Exclusion in action; Unwell, unsafe and a woman - Multifaceted needs challenge healthcare; and Abuse versus humanity - power of healthcare encounters to raise or reduce. Women's experiences of care encounters were disparate, with prevalent control, mistrust and stigma, yet healthcare professionals that demonstrated respect for the woman's human dignity was described both as life-altering and lifesaving.; Conclusions: Women in homelessness live on the outskirts of society and have multiple experiences of exclusion and loss of dignity within healthcare services. The multifaceted care needs challenge healthcare, leading to women feeling alienated, invisible, disconnected and worthless. We urge registered nurses to take actions for inclusion health, i.e. focusing health efforts of people experiencing extreme health inequities. We can lead the way by speaking up and confronting discriminating behaviors, protecting and restoring human dignity in caring relationships, and framing healthcare services for all citizens. Tweetable abstract: Women in homelessness have multiple experiences of exclusion and loss of dignity within healthcare services. Nurses must frame healthcare to include all citizens. 

Burnout syndrome limits work capacity and the ability to manage a social and family life. Such limitations may lead to alienation from oneself and can result in frustration and anger. The recovery process may include a search for quick fixes from professionals but responsibility is in the hands of the ill with support from professionals, family, and work. Learning about limitations, the need to rest and accepting illness, are vital in the recovery process, but they are also associated with feelings of shame and blaming oneself for causing one’s own burnout by neglecting bodily signals. Objective: Burnout syndrome affects the individual as a whole because it involves emotional exhaustion, depersonalization, and a low sense of personal accomplishment. Research into burnout syndrome has predominantly focused on treatment outcomes measured using quantitative methods. The existing qualitative research has deepened theoretical insights from a lifeworld perspective, although, methodologically speaking, previous qualitative studies have been restricted to interviews. The qualitative interview method is somewhat limited. Hence, the objective of the present study was to analyze how autobiographers narrate their experiences of burnout syndrome and to describe their recovery process. Design: An inductive qualitative approach with a descriptive design was used to gain insights into the authors’ experience of burnout and recovery process, as expressed in writing. Setting/Subjects: The data comprised six autobiographies written by authors from Sweden. Results: The results are presented in three categories: 1) descriptions of estrangement from one’s own body, 2) descriptions of how the phenomenon is manifested in everyday life, and 3) descriptions of recovery processes. Conclusion: Burnout syndrome intersects both work life and family life and reveals the individual as a whole, integrated being. It is vital for healthcare professionals to adopt a person-centered approach that sees the individual as an integrated whole, consisting of body, mind, and soul.

Objectives: Previous research found that burdens are put on relatives to patients with serious mental illness. A majority of the studies have described the situation of being a husband/wife or parent of someone who is mentally ill. However, little is known about the perspective of childhood experiences and the effect on adult life from having a parent with mental illness. Hence, the purpose of this review was to investigate experiences of having a parent with serious mental illness.

Methods: We used a qualitative interpretive meta-synthesis. Five relevant databases were chosen: Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PsycINFO, PubMed and Psychology and Behavioral Sciences Collection. We found 4302 studies in our initial search. Fourteen met the inclusion criteria and the quality assessment.

Results: The findings are presented in four themes: (1) Growing up in a dysfunctional home environment; (2) The child’s feelings and thoughts; (3) The need of support; and (4) The lingering effects in adult life.

Conclusions: We found that experiences of growing up in a dysfunctional home can result in relational issues later in life and that the need for support can persist into adult life. This has implications for clinical practice when encountering these patients. 

Background

This article is part of a larger study exploring the collaborative dynamics between key stakeholders in providing care to youths suffering from alcohol or substance use and their families in formulating policies and operational practices for county and country-wide application in similar settings. The focus of this article is to describe the collaborative processes between two stakeholders, a municipality, and a county council, in establishing a MiniMaria treatment center. While collaborative efforts between municipalities and county councils in health service provision are often acknowledged, little is known about how communication and decision-making processes between these entities shape the success of such initiatives. This study aims to fill this gap by providing insights into the communicative processes that foster organizational cohesion, agility, and innovation. The guiding research question is: What communicative processes occur between the county council and municipal stakeholders during the planning phase of the MiniMaria treatment center?

Methods

The municipality and county council were selected based on purposive sampling, owing to the proximity and accessibility of the field. An exploratory and descriptive design, incorporating a participatory research approach, was employed for this qualitative investigation.

Results

Two central themes, each underpinned by specific subthemes sum up the essence of our findings. The first theme underscores the collaborative dynamics and shared objectives that have emerged through the project, thus showing the importance of a unified vision and mutual understanding in driving the initiative forward. The second theme points to the practical aspects of implementing the project, including recruitment strategies, and the significance of interpersonal communication.

Conclusions

This article sheds light on the establishment of a MiniMaria treatment center through collaboration between a municipality and county council, using the Four Flows Model to interpret communicative processes. Membership negotiation was crucial for defining roles and building a unified team identity, while activity coordination ensured aligned stakeholder efforts. Self-structuring facilitated internal organization and operational clarity, and institutional positioning aligned the initiative with broader healthcare norms, enhancing its credibility and impact. These communicative practices were central to get a grip on inter-organizational complexities, emphasizing communication’s constitutive role in organizational development and innovation.

Background Women in homelessness face extreme health- and social inequities. It could be postulated that during societal crises, they become even more vulnerable. Thus, the aim was to explore experiences related to the COVID-19 pandemic among women in homelessness.

Methods Ten interviews were conducted with women in homelessness, in Stockholm, Sweden, using researcher-driven photo elicitation. The data analysis was guided by the DEPICT model for collaborative data analysis and a qualitative content analysis was performed. A collaborative reference group of women with lived experience of homelessness contributed to the research process through designing the data collection, performing the data analysis, and providing feedback during report writing.

Results For women in homelessness, the COVID-19 pandemic was adding insult to injury, as it significantly affected everyday life and permeated most aspects of existence, leading to diminished interactions with others and reduced societal support. Thus, in an already dire situation, the virus amplified health- and social issues to another level. The women strived to find their balance on the shifting sands of guidelines and restrictions due to the pandemic. Adhering to the new social distancing rules and guidelines in line with the rest of society, was simply impossible when experiencing homelessness. However, for some women the pandemic was nothing but a storm in a teacup. The harsh reality continued irrespectively, living one day at a time and prioritizing provision for basic human needs.

Conclusions The COVID-19 pandemic and homelessness can be viewed as two intersecting crises. However, the women’s aggregated experiences were greater than the sum of experiencing homelessness and meeting the threat of the virus. Gender, exposure to violence, poverty, social isolation, and substance use were additional factors that further marginalized the women during the pandemic. To rebuild a better and more sustainable post-pandemic future for all, global commitment to ending homelessness is crucial. In addition, addressing social determinants of health must be the number one health intervention.

Objective: To map areas of discussion about use of seclusion and restraint in healthcare, as expressed in motifs posted on Twitter.

Materials and method: We adopted a qualitative approach with an archival and cross-sectional observational design. 188 images from Twitter postings were analyzed.

Results: Five categories were identified: Informative and educational messages; Equipment as artifacts; Spatiality; The restrained subjects; Sociopolitical connotations of restraint.

Conclusions: Based on our results we conclude that restraint and seclusion images posted on Twitter included several aspects; the intention to educate others, show the spatiality in relation to restraint, imagining characterized by objects and persons, and a sociopolitical connotation. This in turn means that Twitter posts offer nurses a chance to engage in social marketing and connoting an ethical dimension to a person associated with measures used to exert power over others. This is because communication surrounding certain controversial issues in healthcare is free from hierarchies on Twitter.

AIM: To describe intensive care nurses' reflections on being part of interdisciplinary emergency teams involved in in-hospital cardiopulmonary resuscitation.

DESIGN: A qualitative descriptive design.

METHODS: Eighteen intensive care nurses from two regions and three hospitals in Sweden were interviewed. The data were analysed with General Inductive Analysis.

RESULTS: The work for intensive care nurses in the emergency team was reflected in three phases: prevention, intervention and mitigation-referred as before, during and after the CPR situation.

CONCLUSIONS: The findings describe the complexity of being an intensive care nurse in an interdisciplinary emergency team, which entails managing advanced care with limited and unknown resources in a non-familiar environment. The present findings have important clinical implications concerning the value of having debriefing sessions to reflect on and to talk about obstacles to and prerequisites for performing successful resuscitation.

Abstract: Aim To describe how complexity science has been integrated into nursing.

Design: A scoping review. Data source/review method Academic Search Elite, Scopus, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, PubMed and Web of Science were searched November 2016, updated in October 2017 and January 2020. The working process included: problem identification, literature search, data evaluation, synthesizing and presentation. Results Four categories were found in the included 89 articles: 1) how complexity science is integrated into the nursing literature in relation to nursing education and teaching; 2) patients? symptoms, illness outcome and safety as characteristics of complexity science in nursing; 3) that leaders and managers should see organizations as complex and adaptive systems, rather than as linear machines; and 4) the need for a novel approach to studying complex phenomena such as healthcare organizations. Lastly, the literature explains how complexity science has been incorporated into the discourse in nursing and its development.

Conclusion: The review provided strong support for use in complexity science in the contemporary nursing literature. Complexity science is also highly applicable and relevant to clinical nursing practice and nursing management from an organizational perspective. The application of complexity science as a tool in the analysis of complex nursing systems could improve our understanding of effective interactions among patients, families, physicians and hospital and skilled nursing facility staff as well as of education.

Impact: Understanding complexity science in relation to the key role of nurses in the healthcare environment can improve nursing work and nursing theory development. The use of complexity science provides nurses with a language that liberates them from the reductionist view on nursing education, practice and management.

Introduction: Nursing diagnosis classification systems have been developed to help nurses identify problems and patient needs. However, the question of how classification systems have adopted the concept of health has been given little attention. Aim: The aim was to explore and analyse which perspectives on health are incorporated into the NANDA-I-based care plans of individuals with bipolar disorder. Methods: A document analysis was used to systematically review and analyse care plans based on nursing diagnosis classification system. Thematic analysis was used as an analytic tool. Findings: The results are presented in three themes: (i) health as strengths; (ii) health as satisfaction; and (iii) health as behaviour and functionality. Discussion: We discuss how health is deeply embedded in nursing diagnosis classification system-based care plans. The care plans correspond to the holistic perspective, as they acknowledge the existence of health even during illness. Further, health is viewed as nonstatic and discussed from the perspective of person-centred care. 

Communication in healthcare extends beyond patient care, impacting the work environment and job satisfaction. Interprofessional communication is essential for fostering collaboration, but challenges arise from differences in training, roles, and hierarchies. The study aimed to explore psychiatric outpatient clinicians’ experiences of interprofessional communication and their perceptions of how the communication intersects the organizational and social work environment of healthcare. Qualitative research involved focus group interviews with clinicians from five psychiatric outpatient units in Central Sweden, representing diverse professions. The authors analyzed semi-structured interview data thematically to uncover clinicians’ perspectives on interprofessional communication. An overarching theme, “Adjustment of communication,” with subthemes “Synchronized communication” and “Dislocated communication,” emerged. Clinicians adapted communication strategies based on situations and needs, with synchronized communication promoting collaboration and dislocated communication hindering it. Communicating with each other was highly valued, as it contributed to a positive work environment. The study underscores the importance of an open, supportive environment that fosters trust, and respect among healthcare clinicians. Consistent with prior research, collaboration gaps underscore the urgent need to improve interprofessional communication.

Background

Communication in healthcare has been extensively studied, but most research has focused on miscommunication and the importance of communication for patient safety. Previous research on interprofessional communication has mainly focused on relationships between physicians and nurses in non-psychiatric settings. Since communication is one of the core competencies in psychiatric care, more research on interprofessional communication between other clinicians is needed, and should be explored from a broader perspective. This study aimed to explore and describe interprofessional communication in a psychiatric outpatient unit.

Method

During spring 2022, data consisting of over 100 h of fieldwork were collected from observations, formal semi-structured interviews and informal conversations inspired by the focused ethnography method. Data was collected at an outpatient unit in central Sweden, and various clinicians participated in the study. The data analysis was a back-and-forth process between initial codes and emerging themes, but also cyclical as the data analysis process was ongoing and repeated and took place simultaneously with the data collection.

Results

We found that a workplace’s history, clinicians´ workload, responsibilities and hierarchies influence interprofessional communication. The results showed that the prerequisites for interprofessional communication were created through the unit’s code of conduct, clear and engaging leadership, and trust in the ability of the various clinicians to perform new tasks.

Conclusion

Our results indicate that leadership, an involving working style, and an environment where speaking up is encouraged and valued can foster interprofessional communication and respect for each other´s professional roles is key to achieving this. Interprofessional communication between different clinicians is an important part of psychiatric outpatient work, where efficiency, insufficient staffing and long patient queues are commonplace. Research can help shed light on these parts by highlighting aspects influencing communication.

Objective

Autoethnography combines personal experiences with cultural analysis, emerging as a response to the limitations of traditional ethnography. This review aimed to explore, describe, and delineate the utilization of autoethnography by nurses published in peer-reviewed journals.

Methods

A scoping review was conducted according to the Arksey and O’Malley framework. On October 12, 2023, autoethnographic studies in nursing were identified through searches of CINAHL, PubMed, PsycINFO, and Scopus. Peer-reviewed articles published in English language were retrieved. We applied no date restriction. Data were extracted on nursing, epiphany, results, style of writing, implications for nursing, and ethical considerations.

Results

Twenty-six articles met the inclusion criteria. Mental health nursing, covered by nine articles, elucidated experiences of stigma, ethical dilemmas, and professional identity. Nursing education, represented by seven articles, highlighted identity struggles, systemic biases, and evolving pedagogies. Palliative care, addressed by three articles, provided insights into communication challenges and emotional complexities in end-of-life care. The remaining articles explored rehabilitation, cultural competence, and chronic pain management. A conceptual framework integrating ontological, epistemological, ethical, and practical dimensions was developed, emphasizing the interplay between personal and professional roles.

Conclusions

This review underscores autoethnography’s value in uncovering the cultural and ethical dimensions of nursing. This framework advocates for a reflective, culturally attuned approach to healthcare, fostering transformative changes in nursing. Further research should explore underrepresented nursing specialties to harness autoethnography’s potential fully.

Psychiatric intensive care units (PICUs) provide care and treatment when psychiatric symptoms and behaviors exceed general inpatient resources. This integrative review aimed to synthesize PICU research published over the past 5 years. A comprehensive search in MEDLINE, PsycINFO, PubMed and Scopus identified 47 recent articles on PICU care delivery, populations, environments, and models. Research continues describing patient demographics, and high rates of challenging behaviors, self-harm, and aggression continue being reported. Research on relatives was minimal. Patients describe restrictive practices incongruent with recovery philosophies, including controlling approaches and sensory deprivation. Some initiatives promote greater patient autonomy and responsibility in shaping recovery, yet full emancipatory integration remains limited within PICU environments. Multidisciplinary collaboration is needed to holistically advance patient-centered, equitable, and integrative PICU care. This review reveals the complex tensions between clinical risk management and emancipatory values in contemporary PICU settings. Ongoing reporting of controlling practices counters the recovery movement progressing in wider mental healthcare contexts. However, care innovations centered on patient empowerment and humane environments provide hope for continued evolution toward more liberation-focused PICU approaches that uphold both patient and provider perspectives.

Comments on an article What are PICUs for? by Len Bowers (2012). Len Bowers held that traditional psychiatric intensive care units (PICUs) are under threat due to organisational changes in the health care system. In addition, PICUs are often assessed when exploring cost-cutting measures, since a traditional 10-bed PICU is almost never occupied by ten patients with a need for PICU environment. The author argues that developing a PICU cultural-specific language and teaching nurses to become more self-reflective in their roles in the PICU care culture may not only justify the existence of PICU; it may also shift the view of PICU as a whole, from being 'the punitive ward' to becoming 'the elite ward' where competence flourishes.

Objective

This study is the first to explore user behavior and characterize the content shared about digital inclusion on Twitter.

Methods

This mixed-methods research consists of 14,000 tweets featuring the hashtag “#digitalinclusion,” posted on Twitter over 15 months. A machine learning technique, latent Dirichlet allocation, was utilized to discover abstract topics within the tweets statistically. The algorithm identified important keywords and text associated with each topic by modeling the underlying word co-occurrence patterns in the dataset. A manual qualitative content analysis was applied to the qualitative data (1000 tweets).

Results

Tweets containing #digitalinclusion are driven by four motives: 1) warning against the risks of digital exclusion; 2) tweets that promote actions to increase digital inclusion; 3) tweets that call for others to take action to improve digitalization; and 4) tweets that are neutral but fuel the debate by being active. Quantitative analysis revealed that users discussing digital inclusion come from various continents, including the USA, Europe, Africa, and Asia. There were 3931 unique user accounts, with individuals posting between one and 368 tweets. Approximately half of the tweets contained some embedded media.

Conclusion

The study concludes that digital inclusion is a subject that engages Twitter users worldwide. Tweets that were associated with community and local initiatives and sustainable development had the highest engagement in terms of the number of retweets and likes. The interpretation is that digital inclusion is crucial for achieving equity in living conditions and enhancing access to health information and services. While initiatives to increase digital inclusion are underway, Twitter users call for more efforts to prevent growing digital exclusion. Twitter, as a social media platform, is valuable for studying the motivations that drive digital inclusion and help counter digital exclusion.

Research on academic cultures and specifically on the activity of attending conferences is sparse. The aim of this article is to describe the academic cultural activity of actively attending professional conferences and to provide novice researchers with structured guidance. The data is based on my own experiences of attending several conferences. The main goals of Active Participation in Professional Conferences (APPC) are to spread research results, gain insight from other researchers and their research, networking and, attaining merits. APPC is presented here as comprising three main phases: pre-conference preparation, on-site participation and post-conference review. In this study, APPC is viewed as an activity through which the identity of a researcher is socially constructed, involving disciplinary processes of being enculturated into the scientific culture, its norms and values.

Syfte

I tidigare forskning om hemlöshet har fokus varit hur hemlöshet påverkar hälsa negativt. Få studier har lyft fram vad hälsa innebär för kvinnor som lever i hemlöshet. Syftet med våras tudier var att utforska och beskriva hur kvinnor i hemlöshet ser på begreppet ”hälsa” samt deras erfarenheter av möte med sjukvården.

Metod

Forskningen grundar sig i ”Public Involvement” och innebär att vi inte bara har forskat om kvinnor i hemlöshet utan genomfört forskning tillsammans med kvinnorna. Data har samlats in genom kvalitativa intervjuer där ”photo-elicitation” har använts, dvs. kvinnorna har fått titta på vardagliga fotografier och tänkt högt kring hur bilderna relaterar till deras eget liv. En referensgrupp av kvinnor med erfarenhet av hemlöshet var högst delaktig genom hela dataanalysen genom att välja ut citat, bekräfta forskarnas tolkningar och tematiseringar.

Resultat

Att ha en ett hem ansågs som en förutsättning för hälsa och stabilitet i livet. Hälsa var nära förbundet med ”Hemmet”. Hemmet representerade rogivande samtidigt som det förpliktigade ett ansvar, men också en förutsättning för sociala relationer. Hälsa associerades med att vara i autentiska relation och inspirerade till hopp om en bättre framtid. Hälsa associerades också till värdighet och att bli bemött på lika villkor som andra. I kontakt med socialtjänst och sjukvård upplevde kvinnorna snarare att de blev i fråntagen sin värdighet. Sjukvården ställde krav på kvinnorna på ett sätt som de inte kunde uppfylla, ex. att ha ID-kort eller kontaktuppgifter. Kvinnorna beskrev också hur delas värdighet fråntogs dem genom sjukvårdens brist på bemötande. 

Purpose

The aim of this study was to describe how the limitation of patients is being practiced in psychiatric intensive care units.

Design and Methods

A focused ethnographic methodology was applied. To gather data, the author conducted fieldwork involving participant observation.

Findings

The results of the study are presented in two categories, which describe the limited access patients had to items and in the ward environments.

Practice Implications

It is advisable for practitioners to critically reflect upon local regulations and policies related to the practice of limiting patients during the worst phase of their mental illness.

Scholars across different disciplines use Twitter to promote research and to communicate with society. Most conferences nowadays have their unique hashtag in which participants can communicate in real time. Previous research has reported on conference participants' use of Twitter, but no such studies are available in the field of mental health nursing. Thus, the explicit aim of the present study was to examine conference participants' use of Twitter during the 42nd International Mental Health Nursing Conference. Freely-accessible data were mined via a social media platform under the hashtag #acmhn2016. The total dataset consisted of 1973 tweets, and was analysed with descriptive statistics and a directed content analysis. The results demonstrated that 37% of the tweets were original posts, and 63% were engagements. In total, 184 individual accounts engaged in Twitter during the conference, and 16.4 tweets were posted hourly. Most tweets were categorized as conference/session-related content, but Twitter was also used for socializing with other participants. The most frequently-used words mirror a clear connection to a person-centred approach, and deviate from the biomedical terminology. However, not all of the conference participants engaged on Twitter, and might thereby risk being excluded from this backchannel.

Healthcare professionals working on inpatient wards face the externalizing or challenging behaviour of the patients who are admitted. Ethical values and principles in psychiatric nursing have been reported to be important when approaching patients during the most acute phase of deterioration in their mental health. Hence, the aim of this study was to discover and describe staff members' ethical and moral concerns about their work as healthcare professionals in a psychiatric intensive care unit. The study has a qualitative descriptive design and makes use of Framework Analysis. Registered nurses and psychiatric aides in a psychiatric intensive care unit in Sweden were observed during ethical reflection meetings. Four to six staff attended the 90-min meetings. The data comprise observations from six meetings, which provided 94 pages of text. The results demonstrate that the work was described as being both motivating and exhausting. The staff faced ethical concerns in their daily work, as patients often demonstrated challenging behaviours. Three themes were identified as follows: (i) concerns about the staff impacting on patients' experience of care, (ii) concerns about establishing a safe working environment, and (iii) concerns about becoming unprofessional due to expectations and a high workload. Ethical concerns included simultaneously taking into account both the patients' dignity and safety aspects, while also being exposed to high workloads. These elements of work are theorized as influencing complex psychiatric nursing. If we are to bring these influential factors to light in the workplace, advanced nursing practice must be grounded in moral mindfulness.

• Akut omvårdnad – ta del av konkreta åtgärder att ta till i olika situationer

• Hur kan du arbeta för att reducera tvångsåtgärder?

• Hur bemöter och hanterar du olika tillstånd – ta del av olika exempel!

• Att skapa en hållbar relation genom flexibilitet

Det kändes som om jag hade kunnat byta om, stämpla in och börja jobba på avdelningen”. I samband med en konferens om psykiatrisk omvårdnad i Ankara passade forskaren och psykiatrisjuksköterskan Martin Salzmann-Erikson på att besöka en psykiatrisk slutenvårdsavdelning.

This study aims to present culturally situated artefacts as depicted in nursing home environments and to analyze the underlying understandings of disciplining structures that are manifested in these kinds of places. Our personal geographies are often taken for granted, but when moving to a nursing home, geographies are glaringly rearranged. The study design is archival and cross-sectional observational, and the data is comprised of 38 photos and 13 videos showing environments from nursing homes. The analysis was inspired by the methodological steps in Roper’s and Shapira’s description of conducting an ethnography. The results are presented in four categories: 1) public areas, 2) orderliness, 3) staff’s places and 4) devices. The rearrangement of geography implies a degrading of agency and loss of authority over one’s place. The places should be understood in their relation to the agents and their temporarily claims upon them. The material and immaterial artefacts, that is the items, people and behaviours, transform the nursing staff into “space invaders”. Future inquiries may take into consideration the ways that space invasion in participative space intersect and construct the identities of the agents it invades upon.

Introduction: The body of evidence about synthetic cannabinoids and their harmful physiological and psychological effects is increasing due to laboratory research and clinical case reports. However, little attention in research has been paid to users’ perceived intoxication experiences. Therefore, the insider perspective is accounted in this paper. Purpose: The study aims to explore and describe anecdotal communication about “spice”, a synthetic cannabinoid, among users. Methods: A netnographic methodology was applied using data from forum discussions. Results: The findings are presented in two categories: 1th) communication sharing experience-based knowledge from intoxication and 2nd) communication sharing attitudes, norms and values. The analysis that follows posits that there is near-consensus among the posters (users who has submitted a message) that synthetic cannabinoids are associated with negative experiences and should be avoided. Conclusions: The performativity of interactivity may be pivotal in helping frightened users make sense of their experiences. Therefore, a platform for communication among Spice users has important intrinsic value.