Foreign-born and Swedish-born families' perceptions of psychosis care

Support Interventions for Family Members of Adults with Mental Illness: A Narrative Literature Review

The aim of this review was to describe research related to support interventions for adult family members of people with mental illness and the significance that support may have. The results indicate the importance of flexible and individualized forms of support from both professionals and people with personal experience as a family member of someone with mental illness. In many cases, the intervention studies revealed that family members' burden decreased, their knowledge of the disease and treatment increased, and their ability to cope with the situation was improved. The results highlight the importance of support both from professionals and peers.

Cross-cultural care encounters in paediatric care: minority ethnic parents' experiences

BACKGROUND

Because of worldwide migration, the healthcare staff in general as well as in paedi"atric care specifically is challenged increasingly by people from various ethnic backgrounds. The challenge is related to providing culturally competent care and effectively communicating with people from diverse cultural and ethnic backgrounds who have different health beliefs, practices, values and languages. This also applies to the Swedish society and to Swedish paediatric care.

AIM

The purpose of this study was to describe the expectations and experiences of cross-cultural care encounters among minority ethnic parents in Swedish paediatric care.

METHOD

A qualitative design was used in the study. Data were collected using semi-structured interviews between October 2011 and March 2012. The sample consisted of 12 parents of minority ethnic backgrounds who had their child in a ward at a children's hospital in the Stockholm County Council. The interviews were analysed using manifest content analysis.

ETHICAL CONSIDERATIONS

The Regional Ethical Review Committee approved the study (Ref: Nr: 2011/927-31/5).

RESULTS

The analysis of the interviews led to three categories: fundamentals in nursing, cultural sensitivity and understanding, and influencing conditions.

CONCLUSIONS

Generic knowledge and skills of nurses outweighed the need for the nurses to have culture-specific knowledge of their patients or relatives in cross-cultural care encounters. Language skills and the availability of bilingual nurses in a multi-ethnic society can facilitate communication and increase parents' satisfaction in cross-cultural care encounters.

Recent research on the mental health of immigrants to Sweden: a literature review

The arrival of large numbers of economic migrants and refugees has seen the Swedish immigrant population increase rapidly. Research has shown that immigrants may be more susceptible to mental disorders because of traumatic events prior to immigration and adverse circumstances in their new country. The aim of this literature review is to summarize and interpret recent research on the mental health of immigrants to Sweden.

METHODS

A systematic search for relevant literature in PubMed was performed on 13 February 2014. Relevant literature was limited to original research articles published between 1 January 1994 and 13 February 2014. Content relating to mental disorders and suicide was reviewed and summarized.

RESULTS

Nationwide studies showed increased risks of common mental disorders such as depression, as well as psychotic disorders, in immigrants to Sweden compared to native Swedes. However, the results are complex, with notable differences between different immigrant groups and between males and females. Risk of suicide was increased in some immigrant groups, but decreased in others. There has been little qualitative research on the mental health of immigrants and few intervention studies have targeted immigrants.

CONCLUSION

Immigrants to Sweden are a mixed group with differing, but often increased, risks of mental disorders. Targeted qualitative and intervention studies may facilitate efforts to develop and implement preventive methods for immigrants at high risk of mental ill health, and to tailor treatment to the specific needs of different immigrant groups.

A striving towards 'normality': illness-related beliefs among individuals living with a psychotic disorder

Beliefs related to illness constrain or facilitate health and wellbeing, and are of importance in how people understand and manage their illness. The aim of this study was to identify illness beliefs among individuals living with illness from a psychotic disorder. Data collected through two qualitative interview studies was secondary analysed by means of a method for directed content analysis. Beliefs of being different and odd, and of what constitutes 'normality', are prominent and constrain, in several respects, wellbeing among the individuals with psychotic illness. Beliefs about possible wellbeing are preferably related to existential, human desires of caretaking and responsibility for self and others. An awareness among mental healthcare staff that one does not hold the unequivocal truth about what is normal and healthy, is of importance. They need to ask questions about illness beliefs and not ignore or judge the answers received, but instead discuss them. Relationship-centred care, where a mutual dialogue occurs between the individual, the family and mental healthcare staff, is highlighted.

Community health-care staff's experiences of support to prevent type 2 diabetes among people with psychosis: an interview study with health staff

The aim of the study was to describe mental health staff experiences of giving support to prevent type 2 diabetes mellitus (DM) among people with psychosis in community psychiatry. A qualitative interview study with a purposeful sample of 12 community health staff was conducted. Data were analysed using qualitative content analysis. The results show how staff reported continuously supporting people with psychosis to adapt to healthy lifestyles, but stated that support is not given until after a person becomes overweight or is diagnosed with type 2 DM. Support was described as a never-ending process of motivation facing many reverses. Individually-adapted support given in practical situations was perceived as most successful. Cooperation between health-care organizations was seen as essential, but inadequate. Limitations in income and social network, and easy access to fast food and alcohol, were seen as obstacles to support. The results indicate that community health staff are in a position to make a considerable impact in motivating and supporting healthy lifestyle changes in practical situations in daily life among people with psychosis. This study raises awareness of how community health staff's support can be useful when developing nursing skills and health-care plans for people with psychosis.

Core components in the care of immigrants with psychoses: a Delphi survey of patients, families, and health-care staff

The aim of the present study was to identify core components in the care of immigrants with psychosis in Sweden. Experts (n=43) from different perspectives (immigrants, families, and health-care staff) were assembled and used to score the importance of statements regarding components in the care for a person with psychosis in three questionnaire rounds. After each round, the opinions were consolidated and compared to identify whether consensus was reached. Consensus was reached about the importance of being treated on equal terms, regardless of country of birth. Staff interest and respect, shown in different ways of understanding, was valued. Consensus could not be reached on approximately half of the statements, of which four tended to be ranked towards unimportant. Those included that staff should have specific cultural knowledge or that the patient should be allowed to decide whether to be cared for by male or female staff. Nor was it regarded as important to identify a person's religious or ethnic background. The results illustrate the importance of fundamental psychiatric nursing, which should enable nurses to identify and meet the basic needs of all patients, regardless of country of origin. Areas for which consensus was not reached illustrate a future challenge for health-care staff to identify situations when cultural clashes could appear. Staff should have strategies to accomplish cultural negotiations to build an effective treatment alliance with the patient, as well as the family, to meet individual needs.

Estigma e violências no trato com a loucura: narrativas de centros de atenção psicossocial, Bahia e Sergipe

OBJETIVO: Analisar processos de estigmatização e modalidades de violência vividos por portadores de transtornos mentais. MÉTODOS: Estudo qualitativo baseado em entrevistas individuais com usuários e grupos focais com familiares e profissionais de cinco centros de atenção psicossocial, nos municípios de Itaberaba, Lauro de Freitas, Salvador e Vitória da Conquista (BA) e em Aracaju (SE), em 2006-2007. As categorias de análise foram construídas com base no conceito de estigma proposto por Goffman e foram sistematizadas quatro tipos de violência: interpessoal, institucional, simbólica e estrutural. RESULTADOS: Usuários e familiares relataram exemplos de desqualificações, repreensões, constrangimentos, humilhações, negligência e agressões físicas, com fins de dominação, exploração e opressão. Profissionais referiram que pessoas que sofrem transtornos mentais permanecem como alvo de preconceitos arraigados e naturalizados na cultura. A principal conseqüência foi a manutenção do isolamento, da vida social como forma de "tratamento" ou como atitude excludente manifestada por reações discriminatórias, que se apresentam como rejeição, indiferença e agressividade verbal ou física. CONCLUSÕES: As variadas formas de expressão do estigma denotam uma situação sociocultural de violências contra os portadores de transtornos mentais. Propõe-se a constituição de observatórios estaduais capazes de planejar e avaliar contra-ações às estigmatizações.