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Eriksson M, Ekström-Bergström A, Arvidsson S, Jormfeldt H, Thorstensson S, Åström U, Lundgren I, Roxberg Å. Meaning of wellness in caring science based on Rodgers's evolutionary concept analysis. Scand J Caring Sci 2024; 38:185-199. [PMID: 37507842 DOI: 10.1111/scs.13196] [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: 03/17/2023] [Revised: 06/17/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. AIM To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. METHOD Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms 'wellness', 'health', 'health care', and 'health care and wellness'; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria. RESULTS Based on the findings from this concept analysis, a definition of wellness was developed: 'a holistic and multidimensional concept represented on a continuum of being well that goes beyond health'. Implications for nursing practice were correspondingly presented. CONCLUSION Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation.
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Affiliation(s)
- Monica Eriksson
- Department of Health Sciences, University West, Trollhättan, Sweden
| | | | - Susann Arvidsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | | | - Ulrica Åström
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ingela Lundgren
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Åsa Roxberg
- Department of Health Sciences, University West, Trollhättan, Sweden
- VID University, Bergen, Norway
- UiT Harstad, Harstad, Norway
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2
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Hovland JF, Langeland E, Ness O, Skogvang BO. Experiences with physical activity, health and well-being among young adults with serious mental illness. Int J Qual Stud Health Well-being 2023; 18:2221911. [PMID: 37300845 DOI: 10.1080/17482631.2023.2221911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE To explore how young adults with serious mental illness (SMI) experience physical activity and how these experiences influence their perceived health and well-being. METHODS Nine young adults with SMI who had participated in an aerobic high-intensity interval training program were interviewed in depth. The interviews were transcribed and subjected to reflexive thematic analysis. RESULTS The results indicated that people with SMI mainly experience physical activity as a meaningful activity that contributes to an increased sense of well-being and better health. However, to overcome various barriers, it is crucial to experience social support and encouragement. The following three main themes were identified through reflexive thematic analysis: (1) positive changes in focus and an increase in well-being occur through physical activity; (2) increased mental strength results from physical activity; and (3) a lack of support and feelings of safety prevent physical activity. CONCLUSIONS This study shows that adapted physical activity is an important resistance resource that can promote stronger self-identity, increased mental well-being and social engagement and thus contribute to an improved ability to manage stressors. Furthermore, the findings reveal that to engage in physical activity and promote sustainable life changes, it is important for individuals to choose a physical activity based on personal interest and meaning.
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Affiliation(s)
- Jan Freddy Hovland
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Vestfold Hospital Trust, Division of Mental Health & Addiction, Tønsberg, Norway
| | - Eva Langeland
- Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bente O Skogvang
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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3
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Zetterström L, Linde M, Blomqvist M, Jormfeldt H. Anxiety Communication Notes-A Tool to Facilitate Anxiety Management and Improve the Nurse-Patient Relationship in Mental Health Nursing. Issues Ment Health Nurs 2023; 44:900-910. [PMID: 37734062 DOI: 10.1080/01612840.2023.2251058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Mental health care tends to be dominated by a biomedical perspective at the expense of a more recovery-oriented approach. Research on nurse-led interventions intended to strengthen the patient's ability to manage anxiety is sparse in this context. The aim of this study was to describe nurses' experiences of the use of anxiety communication notes in nursing patients experiencing anxiety in mental health inpatient care. Data were collected by interviewing twelve nurses working in two mental health inpatient care wards in southwestern Sweden. Semi-structured interviews were conducted, and qualitative content analysis was used to analyze the data. Findings showed that the use of anxiety communication notes was perceived to provide a nursing structure to foster the development and practice of adaptive anxiety management through a visual representation for mutual understanding of the patient's anxiety pattern. The nurses could also use the anxiety communication notes to support nurse-patient communication and facilitate increased participation and empowerment in the patients' anxiety management.
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Affiliation(s)
| | - Maria Linde
- Department of Psychiatry, Region Halland, Halmstad, Sweden
| | - Marjut Blomqvist
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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4
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Hovland JF, Langeland E, Ness O, Skogvang BO. Experiences of the Quality of the Interplay between Home-Living Young Adults with Serious Mental Illness and Their Social Environments. Issues Ment Health Nurs 2023; 44:735-745. [PMID: 37428940 DOI: 10.1080/01612840.2023.2224877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
The purpose of this study is to explore the experiences of the interplay between home-living young adults in the community with a serious mental illness (SMI) and their social environment and how this experience influence their mental health and well-being in light of the theory of salutogenesis. In a qualitative study, nine young adults with SMI were interviewed. The interviews were transcribed and subjected to reflexive thematic analysis. The following three overarching themes characterized these young adults' experiences of such interplay: (1) a sense of shame and feeling less valued in society, (2) challenges in engagement and maintaining relationships, and (3) the significance of social support in one's family. Accordingly, the young adults experienced both the presence of good, constructive interplay with their social environment and deficits in this reciprocal feedback loop. Overall, this study illuminates the need for more tolerant health-promoting public attitudes to ensure that individuals with a SMI might experience better interplay by feeling that they are valued members of a nurturing society and that they can contribute to their local community. Participation in society should not be limited by one's illness or expectations of being recovered before one can fully participate in society. Experiencing social support and inclusion in society is essential to strengthen self-identity and fight against stigma, thus promoting a sense of coherence, health and well-being.
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Affiliation(s)
- Jan Freddy Hovland
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Hamarvegen, Elverum, Norway
- Division of Mental Health & Addiction, Vestfold Hospital Trust, Tønsberg, Norway
| | - Eva Langeland
- Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bente O Skogvang
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Hamarvegen, Elverum, Norway
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5
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Cappelen H, Ivarsson A, Jormfeldt H. The Effects of an Equine-Assisted Therapeutic Intervention on Well-Being in Persons Diagnosed with Schizophrenia. A Pilot Study. Issues Ment Health Nurs 2023; 44:104-111. [PMID: 36649626 DOI: 10.1080/01612840.2022.2158408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The process of personal recovery among persons diagnosed with schizophrenia may be facilitated through innovative health promotion interventions targeting multidimensional aspects of subjective well-being. The current pilot study aims to test the use of self-rated questionnaires as a means of evaluation of the effects of an equine-assisted intervention for persons diagnosed with schizophrenia. Twenty adults diagnosed with schizophrenia were offered a 12-week EAT intervention performed six times once every 14 days by a licensed mental health nurse. Two validated self-rated questionnaires, HSCL-25 and SHIS were used as outcome measurements at baseline and at post-treatment, additionally the self-rated questionnaire PANAS was completed twice a week starting 1 week before the 12 week-EAT intervention. Only six of the 20 participants managed to complete the validated questionnaires. Despite the low response rate of approximately 30%, a significant difference was found between pre and post scores for positive affect and well-being. Effect sizes, ranging from small to large for pre-to-post treatment scores indicated less depression and anxiety, more positive affect, less negative affect, and reinforced well-being. Results suggest that EAT interventions may have beneficial effects among persons diagnosed with schizophrenia and that a varied range of research methods are needed to create a solid evidence base for EAT interventions intended for the target group.
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Affiliation(s)
- H Cappelen
- Institute of Psychology Universiteit Leiden, Leiden, The Netherlands
| | - A Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - H Jormfeldt
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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6
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Punzo K, Skoglund M, Carlsson IM, Jormfeldt H. Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective. Issues Ment Health Nurs 2022; 43:1080-1092. [PMID: 36178465 DOI: 10.1080/01612840.2022.2126571] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7-18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.
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Affiliation(s)
- Kim Punzo
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Matilda Skoglund
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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7
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Ock M, Pyo J, Jo MW, Herdman M, Luo N. Perceptions of the General Public About Health-related Quality of Life and the EQ-5D Questionnaire: A Qualitative Study in Korea. J Prev Med Public Health 2022; 55:213-225. [PMID: 35677995 PMCID: PMC9201084 DOI: 10.3961/jpmph.22.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/04/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The aim of this qualitative study was to investigate how members of the general public in Korea interpret the concept of health, and which dimensions of health are most important to them. We also explored their perceptions of the EuroQoL 5-Dimension (EQ-5D), including the EuroQoL visual analogue scale (EQ-VAS). METHODS We conducted face-to-face, in-depth interviews with 20 individuals from the general population, using a semi-structured interview guide. Content analysis was performed with verbatim transcripts and field notes to identify codes and categorize them according to their similarities and associations. RESULTS In total, 734 different codes were derived and classified into 4 categories. Participants cited the importance of both the mental and physical aspects of health, although they emphasized that the physical aspects appeared to play a larger role in their conceptualization of health. Participants noted that the EQ-5D has the advantage of being composed of 5 dimensions that are simple and contain both physical and mental areas necessary to describe health. However, some of them mentioned the need to add more dimensions of mental health and social health. Participants showed great satisfaction with the visually well-presented EQ-VAS. However, participants opined that the EQ-VAS scores might not be comparable across respondents because of different ways of responding to the scale. CONCLUSIONS While physical health is a fundamental aspect of health, mental and social aspects are also important to Koreans. The content of the EQ-5D broadly matched the attributes of health considered important by Koreans.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.,Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeehee Pyo
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.,Department of Preventive Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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8
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Gabay G, Ben-Asher S. From a View of the Hospital as a System to a View of the Suffering Patient. Front Public Health 2022; 9:800603. [PMID: 35071174 PMCID: PMC8782256 DOI: 10.3389/fpubh.2021.800603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Hospitals aspire to provide patient-centered care but are far from achieving it. This qualitative mixed methods study explored the capacity of hospital directors to shift from a hospital systemic-view to a suffering patient-view applying the Salutogenic theory. Methods: Following IRB, we conducted in-depth narrative interviews with six directors of the six Israeli academic tertiary public hospitals, focusing on their managerial role. In a second meeting we conducted vignette interviews in which we presented each director with a narrative of a suffering young patient who died at 33 due to medical misconduct, allowing self-introspection. Provisional coding was performed for data analysis to identify categories and themes by the three dimensions of the sense-of-coherence, an anchor of Salutogenics: comprehensibility, manageability, and meaningfulness. Results: While at the system level, directors reported high comprehensibility and manageability in coping with complexity, at the patient level, when confronted with the vignette, directors acknowledged their poor comprehensibility of patients' needs and patient's experience during hospitalizations. They acknowledged their poor capacity to provide patient-centered care. Meaningfulness in the narrative interview focused on the system while meaningfulness in the vignette interview focused on providing patient care. Conclusions: The evident gaps between the system level and the patient level create lack of coherence, hindering the ability to cope with complexity, and are barriers to providing patient-centered care. To improve the delivery of patient-centered care, we suggest ways to consolidate the views, enabling the shift from a systemic-view to a patient-view.
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9
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Wenaas M, Bahl NKH, Kiik R, Juberg A. Patient Assessments of the Factors Facilitating and Impeding User Involvement During the First Phase of Substance Abuse Treatment. Subst Abuse 2021; 15:11782218211050368. [PMID: 34675525 PMCID: PMC8524676 DOI: 10.1177/11782218211050368] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 09/15/2021] [Indexed: 11/21/2022]
Abstract
User involvement in the first phase of treatment is essential for treatment satisfaction among patients with substance use disorders (SUDs). This study explores how patients perceive the first phase of specialized SUD treatment and identifies what promotes and inhibits user involvement. We used a qualitative approach, and semi-structured interviews were conducted with 14 informants admitted to a substance abuse treatment unit in central Norway. The analysis was inspired by a phenomenographical analysis approach, and 4 categories were identified as the core experiences of user involvement during the first phase of SUD treatment: (a) a new hold on life, (b) missing information, (c) the importance of a sense of community, and (d) ambivalence about the usefulness of the treatment. Overlapping elements with Aaron Antonovsky's theoretical framework of salutogenesis were used to support the main findings. The study indicates that activating personal resources (eg, the ability to envision a different life), conveying information in a matter sensitive to patients' current cognitive state, a sense of community, and therapeutic alliance are essential factors to promote user involvement in the first phase of specialized SUD treatment. Based on the findings, we suggest a salutogenesis approach to promote user involvement and provide several ways to employ this approach in the crucial first phase of specialized SUD treatment.
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Affiliation(s)
- Merethe Wenaas
- Department of Substance Abuse
Treatment, More and Romsdal Hospital Trust, Aalesund, Norway
| | - Nina Kavita Heggen Bahl
- Department of Research and Development,
Clinic of Substance Use and Addiction Medicine, St. Olav’s University Hospital,
Trondheim, Norway
| | - Riina Kiik
- Department of Social Work, Norwegian
University of Science and Technology, Trondheim, Norway
| | - Anne Juberg
- Department of Social Work, Norwegian
University of Science and Technology, Trondheim, Norway
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10
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Hovland JF, Skogvang BO, Ness O, Langeland E. Development of salutogenic coping skills: experiences with daily challenges among young adults suffering from serious mental illness. Int J Qual Stud Health Well-being 2021; 16:1879369. [PMID: 33504275 PMCID: PMC7850417 DOI: 10.1080/17482631.2021.1879369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The purpose of this study is to explore experiences with daily challenges and the development of salutogenic copings skills among young adults with serious mental illness. METHODS Nine young adults with serious mental illness were interviewed. The interviews were transcribed and subjected to reflexive thematic analysis. RESULTS Two main themes were identified through the analysis: "The influence of symptoms in everyday life and challenges with participating in the community" and "Making the small things matter." The findings show that different life experiences, or on-going challenges, often can affect or interfere their lives on a daily basis, and that previous experiences with psychosis can contribute to the development of salutogenic coping skills. CONCLUSIONS This study shows the importance of increased knowledge and awareness of different life experiences and challenges among people with serious mental illness such as schizophrenia spectrum disorders. It is significant to strengthen the ability to identify and use appropriate resistance resources to promote salutogenic coping skills and thus better health. Furthermore, it is important to be aware that the development of salutogenic coping skills must be personalized to cultural contexts and society as well as supported by local communities, families and services.
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Affiliation(s)
- Jan-Freddy Hovland
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences , Elverum, Norway
| | - Bente O Skogvang
- Department of Public Health and Sport Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences , Elverum, Norway
| | - Ottar Ness
- Department of Education and Lifelong Learning, Norwegian University of Science and Technology , Trondheim, Norway
| | - Eva Langeland
- Department of Health and Caring Science, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences , Bergen, Norway
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11
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Gabrielsson S, Tuvesson H, Wiklund Gustin L, Jormfeldt H. Positioning Psychiatric and Mental Health Nursing as a Transformative Force in Health Care. Issues Ment Health Nurs 2020; 41:976-984. [PMID: 32584618 DOI: 10.1080/01612840.2020.1756009] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
From the perspective of psychiatric and mental health nurses in Sweden, this discussion paper aims to position psychiatric and mental health nursing as a transformative force contributing to enforcing person-centered values and practices in health care. We argue the potential impact of psychiatric and mental health nursing on service user health and recovery, nursing student education and values, and the organization and management of health care. Psychiatric and mental health nursing is discussed as a caring, reflective, and therapeutic practice that promotes recovery and health. Implications for nursing education, research, management, and practice are outlined.
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Affiliation(s)
- S Gabrielsson
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
| | - H Tuvesson
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - L Wiklund Gustin
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.,Department of Health and Care Sciences, UIT/The Arctic University of Norway, Tromsø, Norway
| | - H Jormfeldt
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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12
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Al-Ghafri TS, Al-Harthi SM, Al-Farsi Y, Craigie AM, Bannerman E, Anderson AS. Perceived Changes in General Well-being: Findings from the 'MOVEdiabetes' Physical Activity Randomized Control Trial. Oman Med J 2020; 35:e149. [PMID: 32728484 PMCID: PMC7370892 DOI: 10.5001/omj.2020.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/03/2019] [Indexed: 12/16/2022] Open
Abstract
Objectives Studies have consistently reported the health benefits of physical activity (PA) in diabetes care. Our study aimed to explore perceptions of general well-being in participants of the ‘MOVEdiabetes’ intervention aimed at increasing PA in adults with type 2 diabetes in Oman. Methods ‘MOVEdiabetes’ is a cluster-randomized study where participants in the intervention group (IG) received PA consultations, pedometers, and WhatsApp messages versus the usual care in the control group (CG). At baseline and 12 months, perceptions on well-being were assessed using an English translated to Arabic 13-item questionnaire. Between groups differences in responses were compared using chi-squared tests. Spearman correlation analysis was utilized to explore associations between changes in responses and self-reported PA levels (metabolic equivalent of task.min/week). Results Of the 232 participants in the ‘MOVEdiabetes’ study, 75.0% completed the study. Overall, findings indicate a positive effect of the intervention on perceived general health, sleep, mental health, pain, and responses to quality of life. For the IG and CG, significant associations were shown between changes in self-reported PA and general health (r = 0.70 and 0.36, p < 0.001), feeling calm/peaceful (r = 0.86 and 0.93, p < 0.001), energetic (r = 0.86 and 0.82, p < 0.001), and depressed (r = -0.35 and -0.30, p < 0.001). However, the Cronbach’s alpha value was 0.50, indicating insufficient internal consistency of the assessment tool. Conclusions The intervention has a positive effect on many parameters of well-being. Further studies are needed to identify robust tools to measure associations between well-being and PA in culturally bounded Arabic speaking countries.
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Affiliation(s)
- Thamra S Al-Ghafri
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Saud M Al-Harthi
- Directorate General of Health Services, Ministry of Health, Muscat, Oman
| | - Yahya Al-Farsi
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Angela M Craigie
- Centre for Public Health Nutrition Research, University of Dundee, Scotland, UK
| | - Elaine Bannerman
- Global Academy of Agriculture and Food Security, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Scotland, UK
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Scotland, UK
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13
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Jormfeldt H. The scientific position of Qualitative studies-comprehensive understanding of health and well-being. Int J Qual Stud Health Well-being 2019; 14:1667661. [PMID: 31595841 PMCID: PMC6792039 DOI: 10.1080/17482631.2019.1667661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Henrika Jormfeldt
- Department of Health and Welfare, Halmstad University , Halmstad , Sweden
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14
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Bifarin OO, Jones S. Embedding recovery-based approaches into mental health nurse training. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjmh.2018.7.5.234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Oladayo O Bifarin
- Mental Health Student Nurse, Faculty of Health and Social Care, Edge Hill University, Ormskirk, England
| | - Steven Jones
- Programme Leader, Post Graduate Medical Institute, Edge Hill University, Ormskirk, England
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15
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Hempler NF, Pals RAS, Pedersbæk L, DeCosta P. Barriers and facilitators of effective health education targeting people with mental illness: a theory-based ethnographic study. BMC Psychiatry 2018; 18:353. [PMID: 30376824 PMCID: PMC6208025 DOI: 10.1186/s12888-018-1924-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health education is particularly important for people with mental illness because they are at higher risk of becoming overweight or obese and developing type 2 diabetes than are members of the general population. However, little is known about how to provide health education activities that promote engagement and motivation among people with mental illness. METHODS This study used ethnographic methods to examine barriers and facilitators of effective health education targeting people with mental illness by applying the concept of flow as a theoretical framework. Flow refers to immersion in an activity and is related to motivation. Data were collected through participant observation during eight health-educating activities and were thematically analysed using the concept of flow. Fieldwork was carried out between May and July 2015 in Denmark. RESULTS Barriers to flow included: 1) information overload, particularly of biomedical rationales for behaviour change; 2) a one-size-fits-all approach that failed to address the needs and preferences of the target group; and 3) one-way communication allowing little time for reflection. Educators promoted a state of flow when they spoke less and acted outside of a traditional expert role, thus engaging participants in the activity. Flow was facilitated when educators were attentive and responsive to people with mental illness, and when they stimulated reflection about health and health behaviour through open-ended questions, communication tools and in small group exercises. CONCLUSIONS This study suggests that more focus should be paid to training of educators in terms of skills to involve and engage people with mental illness in health education activities.
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Affiliation(s)
- N. F. Hempler
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
| | - R. A. S. Pals
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
| | - L. Pedersbæk
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
| | - P. DeCosta
- Diabetes Management Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820 Gentofte, Denmark
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Blomqvist M, Ivarsson A, Carlsson IM, Sandgren A, Jormfeldt H. Health Risks among People with Severe Mental Illness in Psychiatric Outpatient Settings. Issues Ment Health Nurs 2018; 39:585-591. [PMID: 29446657 DOI: 10.1080/01612840.2017.1422200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Life expectancy is greatly reduced in patients with schizophrenia, and cardiovascular diseases are a leading cause of mortality. The aim of this cross-sectional study was to investigate the prevalence of overweight, obesity, and cardiovascular disease (CVD) risk and to investigate the relationships between self-rated health, sense of coherence, CVD risk, and body mass index (BMI) among people with severe mental illness (SMI) in psychiatric outpatient settings. Nearly 50% of the participants were exposed to moderate/high risk of CVD and over 50% were obese. The results showed no statistically relationships between the subjective and objective measures (Bayes factor <1) of health. The integration of physical health into clinical psychiatric nursing practice is vital.
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Affiliation(s)
- Marjut Blomqvist
- a Halmstad University, School of Health and Welfare , Halmstad , Sweden
| | - Andreas Ivarsson
- a Halmstad University, School of Health and Welfare , Halmstad , Sweden
| | | | - Anna Sandgren
- b Linnaeus University, Center for Collaborative Palliative Care , Department of Health and Caring Sciences , Växjö , Sweden
| | - Henrika Jormfeldt
- a Halmstad University, School of Health and Welfare , Halmstad , Sweden
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Jormfeldt H, Doyle L, Ellilä H, Lahti M, Higgins A, Keogh B, Meade O, Stickley T, Sitvast J, Skärsäter I, Kilkku N. Master's level mental health nursing competencies, a prerequisite for equal health among service users in mental health care. Int J Qual Stud Health Well-being 2018; 13:1502013. [PMID: 30067476 PMCID: PMC6084491 DOI: 10.1080/17482631.2018.1502013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/11/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This discussion paper aims to explore the need of a clarified definition of master's level mental health nursing competencies in terms of knowledge, skills and attitudes in a European context. Mental health service users have, in spite of their right to equal overall health, higher rates of physical illness and are more likely to experience premature death than the general population. Implementation of a holistic concept of health comprising mental, physical and social aspects of health in mental health services has previously proved to be challenging. METHODS Master's level mental health nursing competencies in recent literature are discussed and illuminated in terms of knowledge, skills and attitudes in order to enable the promotion of equal overall health among service users in mental health services. RESULTS The discussion show contents, values and utility of master's level mental health nursing competencies in mental health services and contribute to reduced role ambiguity by distinguishing master's level responsibilities from undergraduate nursing tasks and obligations of other professionals in mental health care. CONCLUSION This discussion paper shapes implications for developments in master's level mental health nursing education curricula.
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Affiliation(s)
- Henrika Jormfeldt
- School of Health and Wellfare, Halmstad University, Halmstad, Sweden
| | - Louise Doyle
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Heikki Ellilä
- Health and Well-being, Turku University of Applied Science, Turku, Finland
| | - Mari Lahti
- Health and Well-being, Turku University of Applied Science, Turku, Finland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Brian Keogh
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Oonagh Meade
- School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Theodore Stickley
- School of Health Sciences, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Jan Sitvast
- Advanced Nursing Practice, University of Applied Sciences HU, Utrecht, The Netherlands
| | - Ingela Skärsäter
- School of Health and Wellfare, Halmstad University, Halmstad, Sweden
| | - Nina Kilkku
- Tampere University of Applied Sciences, Tampere, Finland
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Langeland E, Gjengedal E, Vinje HF. Building salutogenic capacity: a year of experience from a salutogenic talk-therapy group. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2016. [DOI: 10.1080/14623730.2016.1230070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jormfeldt H, Hallén M. Experiences of housing support in everyday life for persons with schizophrenia and the role of the media from a societal perspective. Int J Qual Stud Health Well-being 2016; 11:30571. [PMID: 27167557 PMCID: PMC4862953 DOI: 10.3402/qhw.v11.30571] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2016] [Indexed: 11/15/2022] Open
Abstract
Background The mental health-care system in Sweden, as in many other counties, has its main focus on the reduction of psychiatric symptoms and the prevention of relapses. People diagnosed with schizophrenia often have significant health issues and experience reduced well-being in everyday life. The social imaginary of mental illness as an imbalance of the brain has implications concerning general attitudes in society. The news media are an important source of information on psychiatric disorders and have an important role in cultivating public perceptions and stigma. News media can contribute to the mental illness stigma and place individuals with mental illnesses at risk of not receiving adequate care and support. The aim of this preliminary study was to describe users’ experiences of housing support in everyday life. Results The results revealed three themes of housing support, which were needed, but frequently insufficiently fulfilled in the municipality. The three themes were: “Support to Practice Healthy Routines in Daily Life,” “Support to Shape Meaningful Contents in Everyday Life,” and “Support to Meet Needs of Integrity and Respect.” Conclusions The findings support previous studies arguing that current health care and housing support fails to meet basic needs and may lead to significant and unnecessary health risks. Further investigation is needed regarding the links between attitudes to mental illness in society and political and financial principles for health care and housing support for persons with schizophrenia. Further research is needed regarding the role of the media in policymaking concerning health promotion interventions for people diagnosed with schizophrenia.
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Affiliation(s)
- Henrika Jormfeldt
- School of Health and Welfare, University of Halmstad, Halmstad, Sweden;
| | - Malin Hallén
- School of Health and Welfare, University of Halmstad, Halmstad, Sweden
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Looi GME, Sävenstedt S, Engström Å. "Easy But Not Simple"--Nursing Students' Descriptions of the Process of Care in a Psychiatric Context. Issues Ment Health Nurs 2016; 37:34-42. [PMID: 26818931 DOI: 10.3109/01612840.2015.1085607] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The nurse-patient interaction is the cornerstone of psychiatric care, yet the concept "mental health nursing" is difficult to describe. This article aims to address this problem through the experiences of nursing students. Online journals from 14 nursing students were analyzed using qualitative content analysis, resulting in three categories: Trusting the Trusting Relationship, Voicing the Unspoken Needs, and Balancing the Dynamics of Doing and Being. This study demonstrates that providing nursing care based on trusting relationships is not a demanding task, but it takes place in a complex environment that has a tendency to make easy things complicated.
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Affiliation(s)
| | - Stefan Sävenstedt
- a Luleå University of Technology , Department of Health Sciences , Luleå , Sweden
| | - Åsa Engström
- a Luleå University of Technology , Department of Health Sciences , Luleå , Sweden
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Park AL, McDaid D, Weiser P, Von Gottberg C, Becker T, Kilian R. Examining the cost effectiveness of interventions to promote the physical health of people with mental health problems: a systematic review. BMC Public Health 2013; 13:787. [PMID: 23988266 PMCID: PMC3765875 DOI: 10.1186/1471-2458-13-787] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 08/16/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recently attention has begun to focus not only on assessing the effectiveness of interventions to tackle mental health problems, but also on measures to prevent physical co-morbidity. Individuals with mental health problems are at significantly increased risk of chronic physical health problems, such as cardiovascular disease or diabetes, as well as reduced life expectancy. The excess costs of co-morbid physical and mental health problems are substantial. Potentially, measures to reduce the risk of co-morbid physical health problems may represent excellent value for money. METHODS To conduct a systematic review to determine what is known about economic evaluations of actions to promote better physical health in individuals identified as having a clinically diagnosed mental disorder, but no physical co-morbidity. Systematic searches of databases were supplemented by hand searches of relevant journals and websites. RESULTS Of 1970 studies originally assessed, 11 met our inclusion criteria. In addition, five protocols for other studies were also identified. Studies looked at exercise programmes, nutritional advice, smoking, alcohol and drug cessation, and reducing the risk of blood borne infectious diseases such as HIV/AIDS and hepatitis. All of the lifestyle and smoking cessation studies focused on people with depression and anxiety disorders. Substance abuse and infectious disease prevention studies focused on people with psychoses and bipolar disorder. CONCLUSIONS There is a very small, albeit growing, literature on the cost effectiveness of interventions to promote the physical health of people with mental health problems. Most studies suggest that value for money actions in specific contexts and settings are available. Given that the success or failure of health promoting interventions can be very context specific, more studies are needed in more settings, focused on different population groups with different mental health problems and reporting intermediate and long term outcomes. There is a need to better distinguish between resource use and costs in a transparent manner, including impacts outside of the health care system. Issues such as programme fidelity, uptake and adherence should also be accounted for in economic analysis. The role of behavioural psychological techniques to influence health behaviours might also be considered.
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Affiliation(s)
- A-La Park
- Personal Social Services Research Unit, London School of Economics and Political Science, London, UK.
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Jormfeldt H, Rask M, Brunt D, Bengtsson A, Svedberg P. Experiences of a person-centred health education group intervention--a qualitative study among people with a persistent mental illness. Issues Ment Health Nurs 2012; 33:209-16. [PMID: 22468586 DOI: 10.3109/01612840.2011.653041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Henrika Jormfeldt
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
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