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Encounters with persons who frequently use psychiatric emergency services: healthcare professionals' views
Faculty of Health Science, Kristianstad University, Kristianstad, Sweden; Department of Health Sciences, Lund University, Lund, Sweden.ORCID iD: 0000-0002-3113-6432
Department of Health Sciences, Lund University, Lund, Sweden.
Faculty of Health Science, Kristianstad University, Kristianstad, Sweden; Department of Health Sciences, Lund University, Lund, Sweden.
Faculty of Health Science, Kristianstad University, Kristianstad, Sweden.
2020 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 3, p. 1-16, article id 1012Article in journal (Refereed) Published
Abstract [en]

Encounters and interactions between healthcare professionals and patients are central in healthcare services and delivery. Encountering persons who frequently use psychiatric emergency services (PES), a complex patient group in a complex context, may be particularly challenging for healthcare professionals. The aim of the study was to explore healthcare professionals' experiences of such encounters. Data were collected via individual interviews (N = 19) and a focus group interview with healthcare professionals consisting of psychiatric nurses, assistant nurses, and physicians. The data were analyzed with qualitative content analysis. This study focused on the latent content of the interview data to gain a rich understanding of the professionals' experiences of the encounters. Two themes were identified: "Nurturing the encounter with oneself and colleagues for continuous, professional improvement" and "Striving for a meaningful connection with the patient". The professionals experienced their encounters with persons who frequently use PES as caring, professional, and humane processes. Prerequisites to those encounters were knowing and understanding oneself, having self-acceptance and self-compassion, and working within person-centered cultures and care environments.

Place, publisher, year, edition, pages
MDPI, 2020. Vol. 17, no 3, p. 1-16, article id 1012
Keywords [en]
caring, content analysis, emergency care, encounter, experiences, interpersonal communication, mental health nursing, person-centeredness, therapeutic relationships, Nursing, Omvårdnad
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-58183DOI: 10.3390/ijerph17031012ISI: 000517783300337PubMedID: 1498948OAI: oai:DiVA.org:hj-58183DiVA, id: diva2:1687554
Available from: 2022-08-16 Created: 2022-08-16 Last updated: 2022-10-31Bibliographically approved
In thesis
1. Persons who frequently use psychiatric emergency services: perspectives on who they are, what their needs are and howthey are encountered by healthcare professionals
Open this publication in new window or tab >>Persons who frequently use psychiatric emergency services: perspectives on who they are, what their needs are and howthey are encountered by healthcare professionals
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall objective of the thesis was to describe who persons that frequently use psychiatric emergency services (PES) in Sweden are, to explore what needs they experience as well as how healthcare professionals working at PES view the needs of those persons and experience encounters with them.

This thesis includes both quantitative (I, II) and qualitative (II, III, IV) research designs and applies a broad range of data collection methods, such as use of register data (I), use of survey data (II), individual interviews and focus group interviews (III, IV). Data were analysed with statistical tests (I, II) and with qualitative content analysis (II, III, IV).

Study I is based on visits to PES during 2013–2015. A total of 27,282 persons made 67,031 visits. Of those 27,282 persons, 8.1% could be identified as frequent PES users, accounting for nearly two fifths of all visits. In Study II, 81 persons who frequently visited PES participated. The participants in Studies III and IV were healthcare professionals working at PES, such as assistant nurses, nurses with specialised education in psychiatry, and physicians. Nineteen healthcare professionals participated in individual interviews in both Study III and Study IV, and each of the studies was complemented with a focus group interview involving five and six professionals respectively.

The findings of this thesis were as follows: persons who frequently use PES in Sweden are a small, yet highly heterogeneous group who make a disproportionately high number of visits and differ significantly from other PES visitors; persons who frequently use PES and healthcare professionals at PES are in agreement about the complex and intertwined need patterns of the patients that originate from problems in everyday living, acute psychiatric suffering, and insufficient care possibilities, and thus were found to suffer from illness, unfavourable life circumstances and inadequate care; healthcare professionals at PES experienced the encounter as consisting of caring, professional, and humane processes where persons who frequently use PES were seen as fellow human beings and as unique, and were treated with as much respect, kindness, humility, confirmation, and empowerment as possible; and that in order to have caring encounters with persons who frequently use PES, the healthcare professionals also needed to nurture the relationship with oneself and with colleagues. Those results were interpreted by means of person-centredness and in light of a recovery-oriented care approach. Even though the latter has received more acknowledgement and acceptance within psychiatric care in the last decade, it needs to be developed and implemented further in the Swedish psychiatric care context. 

Place, publisher, year, edition, pages
Lund: Lund University, 2020. p. 101
Series
Doctoral Dissertation Series, ISSN 1652-8220 ; 2020:60
Keywords
Nursing, Omvårdnad
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-58184 (URN)9789176199213 (ISBN)
Supervisors
Available from: 2022-08-16 Created: 2022-08-15 Last updated: 2022-10-31Bibliographically approved

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