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Fisker Christensen L, Bilberg R, Birkemose I, Nielsen AS, Kaarsted T, Overgaard AK, Sheldrick-Michel TM, Nielsen B, Andersen K. A feasibility study of a participatory designed program for preventing cardiovascular disease in mentally vulnerable patients. Nord J Psychiatry 2024; 78:627-633. [PMID: 39305274 DOI: 10.1080/08039488.2024.2402241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/22/2024] [Accepted: 09/05/2024] [Indexed: 10/02/2024]
Abstract
AIM To test the feasibility of a participatory design intervention aimed at reducing the risk of cardio-vascular disease among patients suffering from alcohol use disorder (AUD) or severe mental illness (SMI). METHODS The intervention was developed by patients from the Community Mental Health Center and the Alcohol Treatment Facility in Odense, Denmark, and consisted of eight modules (health interviews, screening and treatment, introduction, diet/alcohol, physical activity, smoking, health app, and sleep problems). The intervention was tested using pre- and post-measurements of selected variables, patients' intervention attendance, and interviews and dialogue workshops at the end of the study. RESULTS A total of 21 out of 42 eligible patients from the Alcohol Treatment Facility and two out of 443 eligible patients from the Community Mental Health Center accepted participation in the study. The two patients from the Community Mental Health Center were not included in the analyses due to General Data Protection Regulation (GDPR). All patients accepted being screened for risk factors at inclusion, and the majority enrolled in at least one of the subsequent modules. The study indicated that the patients followed recommendations from their GPs. CONCLUSIONS There is a great need for focus on cardio-vascular disease in patients with SMI and those with AUD. Results indicate that the intervention is feasible for patients with AUD, but due to inclusion of too few patients with SMI, nothing can be concluded for this patient group. Patients and staff in the Alcohol Treatment Facility agreed that the intervention has future perspectives.
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Affiliation(s)
- Lone Fisker Christensen
- Unit of Clinical Alcohol Research, Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Inge Birkemose
- Alcohol and Substance Use Disorder Treatment Facility, Svendborg, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Kaarsted
- Citizen Science Knowledge Center, University of Southern Denmark, Odense, Denmark
| | | | | | - Bent Nielsen
- Unit of Clinical Alcohol Research, Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kjeld Andersen
- Department of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Westerink HJ, Oirbans T, Garvelink MM, van Uden-Kraan CF, Zouitni O, Bart HAJ, van der Wees PJ, van der Nat PB. Barriers and facilitators of meaningful patient participation at the collective level in healthcare organizations: A systematic review. Health Policy 2023; 138:104946. [PMID: 38000333 DOI: 10.1016/j.healthpol.2023.104946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Collective patient participation, such as patient participation in policy making, has become increasingly important to achieve high-quality care. However, there is little knowledge on how to let patients participate in a meaningful manner at this level. The aim of this systematic literature review was to provide an overview of barriers, facilitators, and associated impact of collective patient participation. METHODS PubMed and EMBASE were searched until May 2023 for studies that evaluated collective patient participation. Study characteristics, methods for patient participation, barriers and facilitators, and impact (if measured) of patient participation were extracted from the articles. RESULTS We included 59 articles. Identified barriers and facilitators of collective patient participation were grouped into five categories: (1) preconditions for patient participation, (2) strategy for patient participation, (3) preparation of patients and staff for patient participation, (4) support for patients and staff during patient participation, and (5) evaluation of patient participation. Impact of patient participation was reported in 34 included studies at three levels: quality of care and research, the team and organization, and the participants themselves. Only three studies reported quantitative outcomes. CONCLUSION Interestingly, similar challenges were experienced during a period of twenty years, indicating that little progress has been made in structuring patient participation. Our overview of barriers and facilitators will therefore help to improve and structure collective patient participation.
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Affiliation(s)
- Henrike J Westerink
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Tom Oirbans
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam M Garvelink
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
| | | | - Ouisam Zouitni
- Client Council, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
| | - Hans A J Bart
- Independent patient advocate (former policymaker for the Netherlands Patients Federation, now retired)
| | - Philip J van der Wees
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul B van der Nat
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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Dengsø KE, Lindholm ST, Herling SF, Pedersen M, Nørskov KH, Collet MO, Nielsen IH, Christiansen MG, Engedal MS, Moen HW, Piil K, Egerod I, Hørder M, Jarden M. Patient and public involvement in Nordic healthcare research: a scoping review of contemporary practice. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:72. [PMID: 37649111 PMCID: PMC10466765 DOI: 10.1186/s40900-023-00490-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Over the past decades, there has been a growing international interest in user involvement in healthcare research. However, evidence on the management and impact of patient and public involvement in Nordic healthcare research remains limited. OBJECTIVE The aim was to explore and delineate the current state, practice, and impact of patient and public involvement in healthcare research across different areas of healthcare and patient populations in the Nordic countries. METHODS We conducted a scoping review using nine scientific databases and gray literature from 1992-2023. Sources were categorized as empirical or non-empirical. We used the Guidance for Reporting Involvement of Patients and the Public Short Form 2 checklist for reporting of patient and public involvement in healthcare research and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. RESULTS A total of 56 publications were included, consisting of 39 empirical and 17 non-empirical sources. Gray literature varied among countries and institutions encompassing different types of documents. We found an increase in the number of publications on patient and public involvement in Nordic healthcare research. This was evidenced by the growing number of references and institutional initiatives intended at involving the public, indicating the increasing emphasis on patient and public involvement in Nordic healthcare research. The terminology used to describe patient and public involvement varied over time. However, there has been a gradual narrowing down of terms as the concept of PPI has become more integrated into research practices, particularly with the involvement of funding agencies. CONCLUSION The utilization of patient and public involvement in Nordic healthcare research has substantially increased, proliferated, and gained widespread acceptance across diverse healthcare domains. The variety of approaches challenged our scoping review in terms of systematic description and impact. Patient and public involvement was applied in one or more research stages using different methodologies and terms. International agreement on terms and definitions is needed for reliable interpretation of the use of patient and public involvement in Nordic healthcare research.
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Affiliation(s)
- Kristine Elberg Dengsø
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark.
| | - Sofie Tscherning Lindholm
- Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Suzanne Forsyth Herling
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Maja Pedersen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | | | - Marie Oxenbøll Collet
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Iben Husted Nielsen
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | | | - Mette Schaufuss Engedal
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Helga Wallin Moen
- Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Ingrid Egerod
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
| | - Mogens Hørder
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mary Jarden
- Department of Clinical Medicine, University of Copenhagen, Copenhagen Ø, Denmark
- Department of Hematology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark
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Classen B, Tudor K, Johnson F, McKenna B. Embedding lived experience expertise across the mental health tertiary education sector: An integrative review in the context of Aotearoa New Zealand. J Psychiatr Ment Health Nurs 2021; 28:1140-1152. [PMID: 33772965 DOI: 10.1111/jpm.12756] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 12/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: An important step towards improving mental health outcomes is the realignment of tertiary mental health education and research in a way which places strategic value on experience-driven involvement in mental health and addiction-related care. One of the most widely recognized ways of achieving this is by increasing representation of individuals with first-hand experience of mental health and addiction distress (also known or referred to as Experts by Experience or EBE) within the tertiary sector. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Benefits of tertiary EBE representation such as improving student's preparedness for practice and the empowerment of mental health consumers are consistently reported throughout the literature. In striving towards these outcomes, it is crucial we remain mindful of relevant and often-reported hurdles such as stigma and improper implementation. By using Aotearoa New Zealand as a case study, the need for approaches to increasing EBE representation which is conscious of diverse cultural contexts, perspectives and identities is highlighted. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This review draws together a broad range of factors associated with improving clinical practice. These include the potential for EBE representation to improve outcomes for trainee clinicians, and the incorporation of consumer-driven perspectives into evidence-based practice. This review further highlights the need for EBE representation to be implemented in a way which is responsive to the cultural needs and nuances of mental health education and practice in Aotearoa New Zealand, and, similarly in other countries. ABSTRACT: Introduction There is potential value in increasing representation of expert by experience (EBE) involvement in mental health education sectors. This approach to improving mental health outcomes is here explored in the context of Aotearoa New Zealand's tertiary education sector. Aim/Question This review sought to identify potential outcomes, benefits and barriers associated with EBE representation in tertiary institutions, whilst critically analysing these strategies in the context of Aotearoa New Zealand's mental health education sector. Method Data retrieved from electronic databases were subjected to critical appraisal and thematic analysis. The integrative review drew from a final data set of 113 articles. Results An integrative review of our search results indicated that moving towards a tertiary mental health model in which lived experience plays a central role has the potential to benefit both teaching and research in the tertiary sector. Discussion The interplay between contemporary perspectives on tertiary EBE representation and the cultural needs and nuances of Aotearoa New Zealand's tertiary sector highlights the need for critical and careful approaches to EBE representation. Implications for clinical practice Findings surrounding tertiary EBE representation have direct implications for the training of mental health practitioners and the evaluation and development of clinical practice outcomes and procedures.
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Affiliation(s)
- Ben Classen
- Auckland University of Technology, Auckland, New Zealand
| | - Keith Tudor
- Auckland University of Technology, Auckland, New Zealand
| | | | - Brian McKenna
- Auckland University of Technology, Auckland, New Zealand
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Berring LL, Buus N, Hybholt L. Exploring the Dynamics of a Research Partnership in a Co-Operative Inquiry: A Qualitative Study. Issues Ment Health Nurs 2021; 42:818-826. [PMID: 33555962 DOI: 10.1080/01612840.2021.1875275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Establishing a genuine partnership is a prerequisite when service-users become co-researchers. The practices of co-research challenges conventional scientific communities to rethink research processes and to learn to develop a genuine participatory research culture. This analysis investigated how a research partnership was created by exploring small group collaborative processes in a cooperative inquiry dealing with an interview study about psychosocial rehabilitation of elderly individuals bereaved by suicide late in life. The analysis highlighted how reciprocity can facilitate "epistemic user participation" and promote a research outcome that is co-created in a genuine partnership that reflects the perspective of service-users.
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Affiliation(s)
- Lene Lauge Berring
- Centre for Relationships and De-escalation, Psychiatry Region Zealand, Slagelse, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Niels Buus
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,St. Vincent's Hospital Sydney, Darlinghurst, Australia.,St. Vincent's Private Hospital Sydney, Darlinghurst, Australia
| | - Lisbeth Hybholt
- Centre for Relationships and De-escalation, Psychiatry Region Zealand, Slagelse, Denmark
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Brook J, Leanne Aitken, MacLaren DJA, Salmon D. Co-production of an intervention to increase retention of early career nurses: Acceptability and feasibility. Nurse Educ Pract 2020; 47:102861. [PMID: 32858300 PMCID: PMC7428677 DOI: 10.1016/j.nepr.2020.102861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 07/25/2020] [Accepted: 08/13/2020] [Indexed: 02/05/2023]
Abstract
Co-production is a process employed to solve complex issues, recognising the expertise of all stakeholders. This paper reports on co-production undertaken by nursing students, early career nurses and researchers as part of a larger study to design an intervention to increase retention of early career nurses. Mixed methods were used to evaluate the acceptability and feasibility of the co-production process in a UK university. Data were collected prospectively, concurrently and retrospectively via interview and questionnaire, between April 2018 and January 2019. Twelve co-production group members completed the questionnaire and six group members and facilitators were interviewed. Students and early career nurses reported personal benefit from participating; they developed and practised transferrable communication and problem-solving skills, believed they were able to make a difference, enjoyed contributing, found benefit from using the group as a reflective space and considered that co-production produced a credible intervention. Findings indicated co-production equipped participants to function more effectively in their nursing roles; incorporating co-production into the development of future interventions may prove beneficial. The relative novelty of this approach, and the potential application of the findings to a diverse range of geographical and organisational settings, add to the utility of the findings. Co-production is acceptable and effective for designing nurse retention interventions 84. Co-production helped develop skills that were transferrable to the clinical area. Facilitators found co-production subject to competing demands and expectations. Co-production should be considered to promote a credible retention interventions.
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Affiliation(s)
- Judy Brook
- City, University of London, Northampton Square London, EC1V 0HB, UK.
| | - Leanne Aitken
- City, University of London, Northampton Square London, EC1V 0HB, UK.
| | | | - Debra Salmon
- City, University of London, Northampton Square London, EC1V 0HB, UK.
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Scheffelaar A, Bos N, de Jong M, Triemstra M, van Dulmen S, Luijkx K. Lessons learned from participatory research to enhance client participation in long-term care research: a multiple case study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:27. [PMID: 32518688 PMCID: PMC7268743 DOI: 10.1186/s40900-020-00187-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/26/2020] [Indexed: 06/04/2023]
Abstract
BACKGROUND Although participatory research is known to have advantages, it is unclear how participatory research can best be performed. This study aims to report on lessons learned in collaboration with service users involved as co-researchers in three participatory teams in long-term care. METHODS A multiple case study design was chosen to explore the collaboration in three teams, each covering one specific client group receiving long-term care: physically or mentally frail elderly people, people with mental health problems or people with intellectual disabilities. RESULTS A good working environment and a good collaboration were found to be crucial requirements for participatory research. A good working environment was developed by discussing reasons for engagement and wishes, formulating basic rules, organizing training sessions, offering financial appreciation, and the availability of the researcher to give travel support. The actual collaboration was established by developing a bond and equal positioning, deciding on the role division, holding on to transparency and a clear structure, and have sufficient time for the collaboration. Moreover, the motivations and unique contributions of the co-researchers and differences between the teams were reported. The motivations of co-researchers ranged from individual goals - such as personal development, creating a new social identity and belonging to a social group - to more external goals, such as being valuable for other service users and increasing the quality of care. An inclusive collaboration required valuing the individual contributions of co-researchers and adjustment to team differences. CONCLUSIONS The results showed the importance of developing a good working environment and establishing a good collaboration for participatory research. Furthermore, the study shows that individual and team differences should be taken into account. These results can be used by researchers for designing and shaping future research projects in long-term care in collaboration with co-researchers.
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Affiliation(s)
- Aukelien Scheffelaar
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Nanne Bos
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, The Netherlands
| | | | - Mattanja Triemstra
- Nivel (Netherlands Institute for Health Services Research), PO Box 1568, 3500 BN Utrecht, The Netherlands
| | - Sandra van Dulmen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Katrien Luijkx
- Tranzo Academic Centre for Transformation in Care and Welfare, Tilburg University, Tilburg, The Netherlands
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Sangill C, Buus N, Hybholt L, Berring LL. Service user's actual involvement in mental health research practices: A scoping review. Int J Ment Health Nurs 2019; 28:798-815. [PMID: 30938019 DOI: 10.1111/inm.12594] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2019] [Indexed: 02/01/2023]
Abstract
Service user involvement in mental health research is on the international political agenda, for example mirrored by an emphasis on user involvement in funding of research. The idea is that service users contribute with their lived experiences of mental distress to the research process and thereby heighten the quality and relevance of the research. The purpose of this scoping review was to identify and evaluate empirical research of how mental health service users actually partake in collaborative research processes and to summarize this research in dialogue with mental health user-researchers. The review included 32 studies. Main findings indicated that actual involvement of service user-researchers in research processes encompassed a complex set of precarious negotiation practices, where academics and service user-researchers were positioned and positioned themselves in alternative ways. The review accounts for how mental health service users were involved in collaborative research processes. The extracted themes concerned: (i) Expectations of research processes, (ii) Contribution to research processes, and (iii) Training and learning from research processes. The study reveals that collaborative research in mental health requires changes to traditional research practices to create and support genuine collaborative partnerships and thereby avoid tokenism and power inequalities.
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Affiliation(s)
- Carina Sangill
- Centre for Relationships and De-escalation, Mental Health Services Region Zealand, Slagelse, Denmark
| | - Niels Buus
- Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,St. Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.,St. Vincent's Private Hospital Sydney, Darlinghurst, New South Wales, Australia.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lisbeth Hybholt
- Centre for Relationships and De-escalation, Mental Health Services Region Zealand, Slagelse, Denmark
| | - Lene Lauge Berring
- Centre for Relationships and De-escalation, Mental Health Services Region Zealand, Slagelse, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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