Dissertations / Theses: 'Forensic nursing'

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Hammarström, Lars. "Encounters with patients in forensic inpatient care : Nurses lived experiences of patient encounters and compassion in forensic inpatient care." Licentiate thesis, Mittuniversitetet, Institutionen för omvårdnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-39955.

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Background: Forensic psychiatry is characterised by compulsory care and long hospital stays, where nurses care for patients with severe mental illness, who often have committed crimes. The main objective is to rehabilitate the patient to once again become a part of society by improving mental health and decreasing the risk of criminal relapse. This is mainly achieved through encounters with the patients. Encountering patients in forensic psychiatry means coming face to face with suffering and the duality of caring, doing what is best for the patient and protecting society. Aim: The purpose of the study was to obtain a deeper understanding of encounters with patients with mental illness in forensic inpatient care as experienced by nurses. Method: This licentiate thesis consists of two studies (I, II), both conducted with a qualitative design. A total of 13 nurses working at a forensic psychiatric hospital in Sweden were recruited through a purposive sample to participate in the studies through narrative interviews. Study I was analysed with phenomenological hermeneutics in line with Lindseth and Norbergh (2004) in order to illuminate the lived experience of nurses’ encounters. Study II was a secondary supplementary analysis, which applied hermeneutics in line with Fleming, Gaidys, and Robb (2003) to gain a deeper understanding of nurses’ compassion in forensic psychiatry. The two studies were merged to provide a comprehensive understanding in this licentiate thesis. Findings: Study I illuminated the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care, that is the nurses’ desire to do good despite being confronted with their own emotions as fear, humiliation, and disappointment. Encounters were also occasionally perceived as positive, awakening emotions of compassion, competence, pride, trust, satisfaction, and gratification regarding the patient’s recovery. However, a source of conflict was the struggle between doing what was best for the patient and protecting society. The study comprised of four themes: being frustrated, protecting oneself, being open-minded, and striving for control. Study II aimed to gain a deeper understanding of nurses’ compassion in providing forensic psychiatric inpatient care with three themes: recognising suffering and need for support, responding to patient suffering, and reacting to one’s own vulnerability. Abstracting to a main theme of being compassionate in forensic psychiatry which is described as an emotional journey, an ongoing inner negotiation between own vulnerability and expressions of suffering. This inner negotiation of making sense of patients’ plea and how they were perceived was crucial for determining the development of compassion rather than turning to control and rules as a means to protect oneself. Discussion: A interpretation of the studies (I, II) revealed two topics, being sensitive and responsive and keeping distance, which were reflected upon against the theoretical framework of Kari Martinsen. The studies showed that nurses faced a variety of encounters that forced them to face their own vulnerability and that trust could reduce power imbalances as well as help deal with societal, man-made constructs. The nurses’ encounters with incomprehensible expressions of suffering also show that nurses need to find a way to make room for “expressions of life”– taking a step back and turning their gaze inwards – in order to regulate their own emotions. This may better equip nurses to encounter patients with compassion and kindness rather than turning to norms and rules to protect themselves and guard their own vulnerability. Rather than distancing themselves from the patients, nurses can instead take a step back to come closer to their patients.

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Fallon, Ashley-Christopher. "Forensic inpatient sexuality : a qualitative investigation of the nursing perspective." Thesis, Lancaster University, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.442053.

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Dickens, Geoff. "Nursing in secure and forensic psychiatry : contexts, contributions and concepts." Thesis, University of Northampton, 2011. http://nectar.northampton.ac.uk/8854/.

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Robinson, David Keith. "Developing clinical quality indicators in psychiatric nursing." Thesis, Anglia Ruskin University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259517.

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Inglis, Pamela. "Discourse and forensic learning disability nursing practice : ideology, paradox and truth." Thesis, Northumbria University, 2009. http://nrl.northumbria.ac.uk/136/.

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Central to successful therapeutic relationships in working with people with a learning disability is the language used by nurses; the discourses which they create and perpetuate; and resultant implications for practice. These are key issues in the current investigation. Employing retrospective data obtained during an action research programme carried out in a medium security forensic unit (MSU), it analyse types of discourse employed by the men who reside there and the staff. Part of the analysis shows having a learning disability as viewed through the eyes of the men themselves in a study extending over twenty months. Literary analyses on method, representations of learning disabilities, security and discipline, and forensic practice were carried out concurrently. Aims These are to (1) develop a critical and a post-modern approach to investigating given 'truths' about; the positives of learning disability; men with learning disability who offend; and the nature of forensic nursing: (2) develop a socio-political overview by applying critical discourse analysis to examine micro discourses and macro models associated with learning disabilities, related national and local policies, and models of nursing and disability: (3) combine the products of (1) and (2) to illustrate discourse, repertoires, paradoxes and practical ideologies justifying treatment in the MSU, revealing ideologies and beliefs regarding learning disabilities in this setting. Theory and method Foucault shows how linguistic constructions, written protocols and customary oral dialogue are used to create and sustain dominant views of 'reality' — and may also be used to challenge these. Retrospective data regarding six men living in the MSU and their staff [total N=17] were obtained using diaries, observational notes, semi-structured interviews, focus groups and evaluations originally collected as part of an action research project. National and local policies were also interrogated. Data were then reanalysed using critical discourse-analytic techniques. Outcomes Findings suggest that the men are viewed paradoxically. On one hand, they are seen negatively as different, dangerous, lacking ability: and staff as custodians restricting their rights. Paradoxically, affirmative discourse is also abundant — the men are talented and pleasant companions. Repertoires illustrate warm therapeutic relationships existing between the men and staff, demonstrating 'good nurse' characteristics expressed within a complex and restrictive environment, with humour playing an important part. These paradoxical repertoires reveal practical ideologies which defend forensic practice and justify treatment. Results have implications for the men (their views are acknowledged and disseminated); for practice through enhancing the evidence base; for nurse education through reflection on ideologies and justifications on which forensic practice is based.

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Finn, Christine Kay. "Forensic nurses' experience of receiving child abuse disclosures /." Connect to full text via ProQuest. Limited to UCD Anschutz Medical Campus, 2008.

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Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008.
Typescript. Includes bibliographical references (leaves 122-135). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

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Skinner, Elise. "Ethics of Finitude: Nursing and the Palliative Approach." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37290.

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Purpose: Within the contemporary socio-political context of palliative care and an aging demography, there is a called-for shift to an upstream provision of palliative care in the form of a palliative approach to care as well as to frame access to palliative care within a health equity perspective. In the literature, there is a paucity of nurses’ experiences in the provision of palliative care within psychiatric settings. Moreover, little is known of the process by which nurses engage in a palliative approach to care for patients experiencing multiple marginalities, including institutionalization, mental health, and advanced age. This research explored how nurses in forensic and geriatric psychiatry engage with aging patients and mortal considerations to discern how ethical dimensions of care, aligned within the palliative approach, are enacted. An ethical lens by which to apprehend dimensions of human finitude, reflective of central elements of the palliative approach and public health palliative care, was proposed to help to delineate a process of recognition through which values can be identified in the care of patients. The purpose of this thesis was to explore the phenomenon by which nurses engaged with mortality as both an antecedent to adopting a palliative approach and as a phenomenon that captures nurses’ continued engagement with patients within this approach. Objectives: There were three objectives to the project: 1) explore nurses’ engagement with mortality within an ethics of finitude; 2) identify enablers and barriers, and related historical and socio-political discourses, to engagement of nurses with their patients within an ethics of finitude, and; 3) articulate and deepen understanding of the palliative approach, including ethical dimensions and considerations. The research was an analytical elaboration of a qualitative study at the University of Ottawa that examined the palliative approach to nursing care in forensic and geriatric psychiatry at a mental health facility in eastern Ontario. Methods: Situated within a constructivist epistemic stance, the analytical framework elaborated for this analysis drew from both interpretive description (ID) and interpretive phenomenological analysis (IPA). Utilizing convenience sampling, eight Registered Nurses (7 women and 1 man) working in forensic or geriatric psychiatry completed interviews. Findings: Engagement of nurses within an ethics of finitude was revealed to surface through a process of recognition (recognition of mortality, recognition of the increased vulnerability of patients, and recognition of a corresponding increased responsibility for vulnerable patients) and through the affirmation of values including human connection, dignity, comfort, family, familiarity, and personhood. Barriers and enablers to this engagement emerged related to the care environment, the psychiatric nurse and patient construction, and factors related to family. The implications of the related discourses in the articulation of the palliative approach emerged in relation to health system considerations and to the language of the palliative approach. Conclusion: The process of recognition explored through the proposed ethical lens and revealed in the findings delineated values that underpin the palliative approach by offering an alternate conceptualization to their identification and enactment. Insights from this project underscore preliminary insights on a process to identify care practices aligned within the palliative approach as well as possibilities for critical questioning related to interconnected axes of an ethics of finitude in both the care of individual patients and in the enactment of health policy.

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Domingue, Jean-Laurent. "Exploring the Production of “Dangerous Persons” in Forensic Psychiatry: A Critical Ethnography of the Ontario Review Board (ORB)." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42688.

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Forensic psychiatric nursing is a specialty at the junction of two well-researched intersecting systems with two different mandates: criminal justice (public protection) and health care (public good). Nurses’ involvement at one of the systems’ points of juncture, review board (RB) hearings, has largely been left unexplored. At RB hearings, a panel of legal and health care professionals determines if persons unfit to stand trial (UST) or not criminally responsible on account of mental disorder (NCRMD) represent significant threats to the safety of the public, and orders conditions aimed at keeping the community safe. The aim of this research project was to explore how psychiatric and public safety discourses construct the identity of persons UST or NCRMD during RB hearings, and nurses’ contribution to such identity construction. Critical ethnography methodology was employed, mobilizing three data sources: interviews with forensic psychiatric nurses, observations of RB hearings, and RB documentary artifacts. A poststructuralist lens was used to discern how RB culture produces truths about persons UST or NCRMD that sustain the hegemony of public safety and psychiatric discourses. The main finding was that the forensic psychiatric structure leverages therapeutic nursing interventions and documentation as evidence of deviancy, so that persons UST or NCRMD can be objectified and produced as dangerous, prior to socially rehabilitating them. Discursive structures sustaining the forensic psychiatric system inscribe nursing care within a disciplinary scheme, rendering it coercive and punitive. Thus, a care-and-custody dichotomy is insufficient to explain the complex processes at play in forensic psychiatry. These findings have implications for research, practice, and education in forensic psychiatric nursing, nursing ethics, and other nursing specialties on the medico-legal borderland.

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Holtzinger, Pamela Susan. "Nonfatal Strangulation Continuing Education Program for Forensic Nurses." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7301.

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Patients experiencing nonfatal strangulation during intimate partner violence (IPV) are suffering the consequences of unrecognized injuries and delayed life-threatening medical sequela. Forensic nurses offer expertise in the physical assessment and documentation to a variety of assault victims including those impacted by IPV. This project addressed whether an educational program on nonfatal strangulation increased the knowledge and assessment skills of forensic nurse examiners. The purpose of this doctoral project was to develop a continuing education program on the topic of nonfatal strangulation for forensic nurse examiners. The project design was created using Knowles's adult learning theory principles. The content outline was guided by the International Association of Forensic Nurses Nonfatal Strangulation Toolkit as well as input from content experts on nonfatal strangulation. The evaluation of the project was through pre- and posttest scores. The nonfatal strangulation continuing education training resulted in a statistically significant increase in participants' posttest scores (z-value= -3.064; p value =.002) indicating that the training material and teaching modality positively affected the participants test scores. This continuing education program on nonfatal strangulation increased knowledge of forensic nurse examiners and its application in the field might contribute to positive social change by increasing the identification of IPV and providing appropriate intervention.

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Woods, Phil. "The Behavioural Status Index (BSI) : descriptive studies within a forensic context." Thesis, Anglia Ruskin University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300347.

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Bradshaw, Atalie M. "Non-Anogenital and Anogenital Injuries of Females Following Sexual Assault: A Retrospective, Descriptive Study from 5,464 Sexual Assault Forensic Medical Examination (SAFME) Reports." BYU ScholarsArchive, 2021. https://scholarsarchive.byu.edu/etd/8945.

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The focus of this retrospective, descriptive study is to describe non-anogenital and anogenital injuries documented in over 5,000 sexual assault forensic medical examination (SAFME) reports of female patients. The study findings expand understanding of injuries documented following sexual assault by exploring associations between injuries and a multitude of variables: patient demographics (age, race, gender); time between assault and examination; patient-perpetrator relationship; perpetrator actions (strangulation, hit, verbally threatened/coerced, use of restraints, grabbed/held); number of assaultive acts; multiple-perpetrators; suspected drug-facilitated assaults; patient and perpetrator use of alcohol and drugs; and physically or mentally impaired patients. The various types and locations of injuries are discussed in relationship to assault history. Implications of findings on forensic nursing practice are shared to improve patient assessment and care. In addition, methods to share findings with interdisciplinary partners, including law enforcement and criminal justice system professionals, are described to improve interdisciplinary collaboration and education.

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Bergqvist, Caroline, and Sofia Tingberg. "En fråga med dolda svar : en registerstudie." Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-9411.

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Background: Since 2008 there is a law stating that patients who do not require institutional forensic psychiatric care may be moved to non-institutional forensic care, with special conditions. RättspsyK is a national quality register where all of the 25 forensic care units in Sweden collect information about their patients and their care. Previous analysis showed that a considerable amount of patients continue to receive institutional forensic psychiatric care despite they are assessed and found ready to move onto non-institutional forensic care. Aim: The objective of this study was to identify factors affecting why patients were still in institutional forensic care despite assessed to be ready for non-institutional forensic care.Method: First, yearly assessment of each patient between 2009 and 2014 was drawn from the RättspsyK register. Answers to the specific question, Question 10, were analyzed with descriptive statistics and were planned to be used in regression analyses as dependent variable. Result: 1900 patients were included. During analyses the fact that answers to this question were not trustable was found, therefore no exact prevalence of inpatients kept in institutional forensic care despite assessed ready for non-institutional care could be determined. Other information revealed that lack of housing and lack of collaboration were the most frequent reasons for this phenomenon. Conclusion: The present study could not give answer to the original question, but pointed out avalidity problem in the Swedish Forensic Psychiatry Register. The result calls for caution and for the need of validation of RättspsyK register.

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Meyer, Leigh Anne. "Professional Quality of Life Indicators and Turnover Intention in Forensic Nurses." Otterbein University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1622051900393966.

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Doyle, Patrick. "Social climate and staff based interventions in forensic mental health settings : a research portfolio." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/26016.

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Aims: The aims of this thesis were focused on the social climate of inpatient forensic mental health settings. Firstly, the study reviewed the literature of qualitative studies of staff and patient experiences of social climate. Secondly, the utility of a case study methodology to examine innovations to practice in forensic mental health settings are discussed. Thirdly, a longitudinal case study aimed to examine the impact of a Mentalization based treatment (MBT) training and case consultation intervention on the functioning of a low secure ward. Method: A systematic review and qualitative synthesis of social climate in forensic mental health settings was completed using the ‘best-fit’ framework approach. Secondly, a critical analysis of case study methodology was presented based on key decision points. A longitudinal ward case study with staff (n=37) and patient (n=7) participants examined the impact of staff MBT training and MBT based case consultation sessions. MBT based case consultation sessions ran on the ward over an eight month period. Data was collected through a range of methods including questionnaires, semi-structured interviews, ward observations and routinely reported data. The case study data was tested through a pattern matching approach with reference to rival explanations. Results: The systematic review identified 20 papers that met the inclusion criteria. The framework synthesis identified 22 themes related to social climate, which were organised in a conceptual model. Ten themes were seen to represent the experience of social climate. Consideration of the applicability of the case study method to forensic settings found the method to be feasible and acceptable to staff though a limitation is that outcomes are tentative and open to rival explanations. Positive impacts of the training and case consultation intervention included an increase in enthusiasm for working with patients with a personality disorder diagnosis and evidence of some increased team cohesion. The main rival explanation identified was the impact of changes to the composition of the staff and patient group. Conclusions: The systematic review findings highlight that current quantitative measures of social climate may not fully represent the construct. The conceptual model developed allows for generation of potential interventions to improve social climate. In the case study, staff reported positive perspectives of both MBT training and the case consultation sessions. The intervention did not appear to impact on patient motivation, though patients reported positive changes in staff behaviour. The case study method was seen as applicable to forensic mental health settings and provided interpretable data useful for analytical generalisations, and clinically in considering innovations to practice.

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Carnell, Heidi. "Forensic nursing staff and aggressive challenging behaviour : the influence of psychiatric diagnosis on causal attributions, explanations and therapeutic optimism." Thesis, University of Leicester, 2005. http://hdl.handle.net/2381/31207.

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Objectives: The aim of the current study was to investigate whether forensic nursing staff who worked with different patient groups (i.e. learning disability, mental illness, or personality disorder): made different causal attributions for an episode of aggressive challenging behaviour; drew on different causal models to explain the behaviour; reported different levels of optimism regarding the efficacy of therapeutic intervention for the behaviour; and reported different beliefs about the future risk of the behaviour.;Design and Method: A between-subjects design was employed. Eighty-eight nursing staff working within one of three Directorates in a high security hospital, read a vignette depicting an episode of aggressive challenging behaviour and completed a self-report questionnaire. Participants were required to make causal attributions along Weiner's (1980) dimensions of controllability, locus and stability and to provide causal explanations in accordance with five models of challenging behaviour (Hastings, 1997b). Participants also rated their therapeutic optimism and beliefs about future risk of the challenging behaviour occurring. Data were analysed using non-parametric tests of difference (Kruskal-Wallis test) and association (Spearman's Rank Order Correlation).;Results: Overall, the three participant groups did not make significantly different causal attributions, report different levels of therapeutic optimism, or different beliefs about future risk. Participants who worked with patients with a personality disorder were significantly more likely than participants who worked with patients with learning disabilities to consider an emotional causal model when seeking to explain the behaviour. All three participant groups held concurrent explanations for the behaviour. Participants cited psychological interventions as being useful in reducing the behaviour, but mainly referred to reactive physical strategies with commenting on their training.;Conclusions: Clinical implications of the current study are explored and suggestions made concerning the role of forensic nursing staff and clinical psychologists in addressing aggressive challenging behaviour. Directions for future research are suggested.

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Johansson, Elina. "Innebörden av vårdande och miljö ur ett kliniskt förbättringsarbete i rättspsykiatrisk vård : En analys av genomförda förbättringsförslag." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-6050.

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Bakgrund: Tidigare forskning visar att patienter inom rättspsykiatrisk vård upplever saknad av autonomi, delaktighet och respekt. Det ligger i sjuksköterskans intresse att värna om patientens resurser och planera omvårdnadsarbetet därefter. Genom att arbeta med förbättringsförslag från patienter, anhöriga och vårdpersonal kan vården anpassas efter önskat behov. Syfte: Syftet med denna studie är att utforska områdena delaktighet, vårdrelation, vårdmiljö och bemötande i genomförda PDSA-cykler riktade mot patientens vård i ett kliniskt förbättringsarbete i rättspsykiatrisk vård. Metod: Studien består av två delar, en explorativ kvalitativ design med en induktiv ansats samt en deskriptiv kvantitativ design. Datamaterial från nio enheter samlades in från det redan pågående implementeringsarbetet i den aktuella verksamheten. Kvalitativ innehållsanalys enligt Graneheim och Lundman användes sedan vid analysen av datamaterialet. Resultat: Resultatet har kategoriserats i åtta subkategorier; påverka sin vårdprocess, möjligheten till inflytande, eget ansvar, förbättringar av gemensamma ytor, att skapa en trivsam miljö, stimulans för kropp och själ, ökad kännedom och att tillsammans uppnå uppsatta mål, som senare ledde till fyra huvudkategorier: delaktighet, vårdrelation, vårdmiljö och bemötande Diskussion: Med hjälp av kvalitetsbegreppen trovärdighet, konfimerbarhet, pålitlighet och överförbarhet diskuteras studiens metodavsnitt. Studiens resultat ställs emot tidigare forskning och kopplas även samman med Erikssons teori om vårdandet och vilken betydelse det har i delaktighet, vårdrelation, vårdmiljö och bemötande.
Background: Research has shown that patients in forensic psychiatric care experience a lack of autonomy, participation and respect. It is in the nurse's interest to take care of the patient's resources and to plan the nursing thereafter. Care can be adapted to the desired needs by working with improvement suggestions from patients, relatives and healthcare professionals. Aim: The aim of this study is to explore the areas of participation, care relationship, nursing environment and treatment in implemented PDSA cycles aimed at patient care in a clinical improvement work in forensic psychiatric care. Method: The study consists of two parts, an explorative qualitative design with an inductive approach and a descriptive quantitative design. Data from nine units were collected from the ongoing implementation in the current work. The qualitative content analysis was used according to Graneheim and Lundman in the analysis of the data. Results: The result has been categorized into eight subcategories; implicate the care process, ability to influence, own responsibility, improvement of social areas, creating a pleasant environment, stimulus for body and mind, increased awareness and jointly achieving set goals, which later resulted in four main categories: participation, care relationship, nursing environment and treatment. Discussions: The methodology of the study is discussed using the quality concepts credibility, confidentiality, reliability and transferability. The results of the study are compared to previous research and are also linked to Eriksson's theory of care and its importance in participation, care relationship, nursing environment and treatment.

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Andersson, Theres, and Kajsa Åkesson. "Sjuksköterskors erfarenheter och den yrkesprofessionella betydelsen för ett adekvat omhändertagande av patienter utsatta för sexuella övergrepp : - En systematisk litteraturöversikt." Thesis, Högskolan Väst, Avdelningen för omvårdnad - grundnivå, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-16314.

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Abstract: Sexual assault is a serious matter, the World Health Organization calls the violence against women, a global health problem of epidemic proportions. The nurse has a personal and moral responsibility to address this public health problem in order to try to influence a positive change towards improved health. Aim: This literature review aims to describe nurses´experiences in the care of patients exposed to sexual assault. Results: The results shows that many aspects affect the nurses´ experiences. Many countries struggled, trying to keep up with an adequate care, especially with regard to forensic care, which is very important aiming to also satisfy the justice aspect for the victims. Political, institutional and organizational structures create the conditions that constitute the nurse´s experience. Most nurses did not have sufficient training nor education to perform forensic care even though most did. Many nurses described difficult emotional demands of working with these victims and asked for better support. Interdisciplinary teamwork proved to be important taking into account the holistic perspective. Conclusion: Sustainable improvement work is required to start the work of being able to handle adequate care for patients affected by sexual abuse. Sustainable improvement work that starts from the top with political, institutional and organizational changes which in turn can providea positive healthcare development with the help of the staff's commitment and job satisfaction.
Tvingande sexuella handlingar orsakar fysiskt och psykiskt lidande som kan leda till tidskrävande och svår rehabilitering. I den Nationella trygghetsundersökningen uppger totalt 5,6 procent av de tillfrågade att de utsattes för sexualbrott under 2019 i Sverige. Sexuella övergrepp är ett allvarligt problem och Världshälsoorganisationen kallar det fysiska och sexuella våldet mot kvinnor för ett globalt hälsoproblem av episka mått. Sjuksköterskan har ett personligt och moraliskt ansvar att uppmärksamma folkhälsoproblem och att försöka påverka till positiva förändringar mot en förbättrad hälsa. Litteraturöversikten syftar till att beskriva sjuksköterskors erfarenheter vid omhändertagandet av patienter utsatta för sexuella övergrepp. Resultatet visade att många aspekter påverkade sjuksköterskans erfarenheter. Många olika länder strävade med förbättringar för ett adekvat omhändertagande och särskilt fokus låg på den forensiska vården, vilket är viktigt för att tillgodose rättviseperspektivet för patienterna. Kunskapshöjande utbildning för sjuksköterskor sågs som en viktig del i vården och omvårdnaden av personer utsatta för sexuella övergrepp. Sjuksköterskor ville bland annat lära sig mer om forensisk vård och omvårdnad vilket de tyckte var viktigt, samt hur de bättre kunde hantera omhändertagandet utifrån ett holistiskt perspektiv. Politiska, institutionella och organisatoriska strukturer skapar förutsättningar för sjuksköterskors erfarenheter. De flesta sjuksköterskor hade dock varken någon praktisk övning eller utbildning för att utföra forensisk vård eller omvårdnad, trots att de flesta ändå gjorde det. Många sjuksköterskor beskrev svåra känslomässiga påfrestningar i sitt arbete och önskade bättre stödåtgärder för att motverka stress och utbrändhet. Sjuksköterskor beskrev också en stor oro när det gällde patienternas fysiska och psykiska konsekvenser efter att de lämnat sjukhusen och önskade en förbättrad och mer långsiktig uppföljning för patienterna. Interdisciplinärt samarbete visade sig vara avgörande för att, utifrån ett holistisktperspektiv, kunna ge en god, säker och personcentrerad vård. För att starta upp arbetet med att kunna hantera ett adekvat omhändertagande för patienter drabbade av sexuella övergrepp krävs ett hållbart förbättringsarbete. Ett hållbart förbättringsarbete som startar uppifrån med politiska, institutionella och organisatoriska förändringar som i sin tur kan ge en positiv verksamhetsutveckling med hjälp av sjukvårdspersonalens engagemang och arbetstillfredsställelse.

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Cicolella, Dayane de Aguiar. "Entre o delito e a loucura : a enfermagem em manicômio judiciário." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/114544.

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Os manicômios judiciários são instituições responsáveis pelo cuidado dos incapazes, destinados à proteção do todo social. Possuem o duplo objetivo de custodiar e tratar pessoas com doenças mentais declaradas perigosas, podendo ser considerados uma fusão entre hospital psiquiátrico e presídio. Essa instituição utiliza técnicas e procedimentos disciplinares com objetivo de normalizar loucos criminosos para torná-los aptos ao convívio social. A pesquisa propõe estudar os dispositivos disciplinares utilizados por profissionais da enfermagem que atuam no Instituto Psiquiátrico Forense Doutor Mauricio Cardoso - Porto Alegre. O referencial teórico-metodológico que orienta as análises situa-se no campo dos Estudos Culturais, na vertente Pós-Estruturalista, norteada por pensamentos do filósofo Michel Foucault. Foram utilizados instrumentos de investigação etnográfica, a saber: entrevistas gravadas em áudio com 14 trabalhadores de enfermagem, observação do trabalho nos turnos manhã, tarde e noite, análise de livros de registro das unidades da instituição, imagens fotográficas capturadas pela autora e demais imagens disponíveis em meio eletrônico. Os resultados das análises foram organizados em unidades intituladas: Casa de loucos ou casa de presos?; A organização dos espaços; O controle do tempo e Fábrica de loucos. Este movimento analítico possibilitou problematizar o trabalho dos profissionais de enfermagem. Conclui-se que as heranças históricas da profissão, nesta instituição, são naturalizadas pelos profissionais. A figura do louco delinquente foi uma construção histórica atravessada por diferentes discursos ao longo dos tempos e a associação da loucura com a criminalidade fez surgir o personagem louco criminoso que, por ser um irracional, não responde pelo seu crime. Nos manicômios judiciários o controle dos loucos criminosos não é privativo de médicos psiquiatras, sendo necessária a inclusão de outras categorias, tais como juízes de direito, psicólogos, assistentes sociais, terapeutas ocupacionais e, inclusive, a profissão de enfermagem,que associa seus saberes de cuidado a outras formas de adestramento e controle.O Instituto Psiquiátrico Forense carrega heranças do sistema carcerário, manifestadas pelos profissionais da enfermagem em suas rotinas diárias.Tais trabalhadores tiveram como “tutores” agentes penitenciários e guardam modelos desse trabalho quando ordenam e distribuem os espaços para controlar os corpos dos pacientes.Tal jeito de trabalhar parece diverso dos locais de atuação da profissão. Esse modo de cuidar, naturalizado ao longo do tempo, produz profissionais repetem os ensinamentos dos carcereiros sem perceber a fusão de papéis. Por outro lado, esses parecem não estar em acordo com a situação vivenciada e tentam não se associar aos métodos disciplinares vigentes nas instituições totais. Também, se pode observar que os trabalhadores passam a maior parte do tempo organizando e adestrando os pacientes que circulam nos ambientes. Trata-se de um esquadrinhamento do tempo e do espaço, onde o corpo é controlado e manipulado por técnicas disciplinares. Essas técnicas inserem, combinam e classificam os pacientes nos espaços. Assim, cabe a enfermagem “transformar” os pacientes naquilo que seria a proposta normalizadora da Instituição: fabricar um determinado tipo de paciente, como um objeto moldado, manipulado e revisado em uma fábrica para apresentar determinado comportamento e pensamento. Assim, o louco internado no Instituto Psiquiátrico Forense deve ser reajustado às regras de convívio social, tarefa na qual participa ativamente a enfermagem.
Forensic psychiatric hospitals are responsible for caring for mentally-impaired people and are intended to protect society as a whole. They have the dual purpose of guarding and treating dangerous mentally ill individuals and could be considered a cross between a psychiatric hospital and a prison. These institutions make use of disciplinary techniques and procedures in order to normalize insane criminals and make them apt for social conviviality. The study intends to look into the disciplinary procedures used by nursing professionals working at the Doutor Mauricio Cardoso Forensic Psychiatric Institute in Porto Alegre. The theoretical and methodological framework guiding the analysis is grounded in the field of Cultural Studies, in the Poststructuralist movement, guided by ideas of the philosopher Michel Foucault. The following ethnographic research instruments were used to guide the fieldwork: interviews with 14 nursing workers recorded on audio, observation of their work in the morning, afternoon and night shifts, analysis of record books in the institution units, and photos taken by the author and available electronically. The results of the analyses were organized into units titled: Madhouse or jailhouse?; Organization of spaces; Time Control and Loony Factory. This analytical procedure generated a discussion on the work of nurses in patient management and control. My conclusion is that the historical legacies of the profession, in this institution, are naturalized and repeated by the professionals. The figure of the mad offender has been a historical construct intersected by different discourses over time, and the association of madness with crime gave rise to a new character, the mad criminal who, as a result of being an irrational person, did not answer for his/her crime. In forensic psychiatric hospitals, the control of mentally ill criminals is not exclusive to psychiatrists, the inclusion of other categories, such as court judges, psychologists, social workers, occupational therapists, and even nursing professionals, who link their knowledge of care to other forms of training and control, is required. The Forensic Psychiatric Institute, as a cross between a jail and a mental hospital, carries a legacy from the prison system, which is expressed by the nursing staff in their daily routines. These workers had jailers as their “tutors” and stick to the latter’s work as a model when they arrange and distribute spaces in order to control the bodies of their patients, a task that is assigned to nurses. This way of working seemed different from other places of professional practice. This mode of caring, naturalized over time, produces nursing professionals who repeat the teachings from jailers without realizing that their roles have been merged. On the other hand, the nursing staff does not seem to agree with the situation experienced and try not to associate themselves with disciplinary methods enforced in total institutions. I also observed that these workers spent most of their time organizing and training the patients who were present in these facilities. It is an exploration of time and place whereby the body is controlled and manipulated by disciplinary techniques. These techniques insert, combine and sort out patients into spaces. Therefore, the role of the nursing staff is to “transform” patients into that which is the normalizing purpose of the Institution: to manufacture a certain kind of patient, just like an object that is shaped, manipulated and revised in a factory to display a specific type of behavior and thinking. Thus, a demented person institutionalized at the Forensic Psychiatric Institute must be readjusted to social conviviality rules, a task in which the nursing staff actively participates.
Los manicomios judiciales son las instituciones responsables por el cuidados de incapaces, destinados a la protección del todo social. Cuentan con el doble objetivo de cuidar y tratar enfermos mentales peligrosos, y pueden ser considerados una fusión entre hospital psiquiátrico y cárcel. Esa institución utiliza técnicas y procedimientos disciplinares con objetivo de normalizar locos criminales para volverlos aptos a la convivencia social. El estudio propone estudiar los dispositivos disciplinares utilizados por profesionales de la enfermería que actúan en el ‘Instituto Psiquiátrico Forense Doutor Mauricio Cardoso’ - Porto Alegre. La referencia teóricometodológica que orienta los análisis está ubicada en el campo de los Estudios Culturales, en la vertiente postestructuralista, norteada por pensamientos del filósofo Michel Foucault. Se emplearon instrumentos de investigación etnográfica, a saber: entrevistas con 14 trabajadores de enfermería, grabadas en audio; observación del trabajo en los turnos de los turnos matutino, vespertino y nocturno; análisis de libros de registro de las unidades de la institución e imágenes fotográficas captadas por la autora y disponibles en medio electrónico. Los resultados de los análisis han sido organizados en unidades con los títulos: ¿Casa de locos o casa de presos?; La organización de los espacios; El control del tiempo y Fábrica de Locos. Este movimiento analítico permitió discutir el trabajo de los profesionales de enfermería en el manejo y control de los pacientes. Concluyo que las herencias históricas de la profesión, en esta institución, son naturalizadas y repetidas por sus profesionales. La figura del loco delincuente es una construcción histórica atravesada por diferentes discursos a lo largo de los tiempos, siendo que la asociación de la locura a la criminalidad hizo surgir el loco criminal que, como es un sujeto irracional, no respondía por su crimen. En los manicomios judiciales el control de los locos criminales no es exclusivo a los médicos psiquiatras, es necesaria la inclusión de otras categorías, como jueces de derecho, psicólogos, asistentes sociales, terapeutas ocupacionales e, incluso, el profesional de enfermería, que asocian sus saberes sobre el cuidado a otras formas de adiestramiento y control. El Instituto Psiquiátrico Forense convive con herencias del sistema carcelario, manifestadas por los profesionales de enfermería en sus rutinas diarias. Esos trabajadores tuvieron como "tutores" a agentes carcelarios y guardan modelos de trabajo, cuando ordenan y distribuyen los espacios para el control de los cuerpos de los pacientes. Esa forma de trabajar me pareció diferente de los lugares de actuación profesional. Esa forma de cuidar, naturalizada a lo largo del tiempo, produce profesionales de enfermería que repitan lo que les fue enseñado por carceleros, sin notar la fusión de roles. Por otro lado, el personal de enfermería parece no estar de acuerdo con la situación en la que viven e intentan no asociarse a los métodos disciplinares vigentes en esas instituciones. También he observado que los trabajadores pasan la mayor parte del tiempo organizando y adiestrando a los pacientes que circulan por los ambientes. Se trata de una organización minuciosa del tiempo y del espacio, en que el cuerpo es controlado y manipulado por técnicas disciplinares. Esas técnicas insieren, combinan y clasifican a los pacientes en los espacios. Así, a la enfermería le cabe "transformar" a los pacientes en aquello que sería la propuesta normalizadora de la Institución; fabricar determinado tipo de paciente, como un objeto que es moldeado, manipulado y revisado en una fábrica para presentar determinado comportamiento y pensamiento. Así, el loco internado en el Instituto Psiquiátrico Forense debe ser reajustado a las normas de la convivencia social, tarea en la cual la enfermería actúa activamente.

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Rosenlund, Linda, and Erika Larsson. ""...jag tror inte vi förstår varann." : Patienters och sjuksköterskors erfarenheter av tvärkulturella möten inom rättspsykiatrisk vård." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-54050.

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Bakgrund: I tidigare forskning framkommer komplexiteten i tvärkulturell vård. Felbedömningar sker kopplat till kulturella uttryck. Ökad kulturkompetens hos vårdaren kan bidra till mer jämlik vård. Kulturkompetens är en ständigt pågående process men måste användas med en ödmjuk inställning till det egna kunnandet. Behov finns av mer studier kring patienters erfarenheter av tvärkulturell vård. Syfte: Att beskriva patienters och sjuksköterskors erfarenheter av tvärkulturella möten i rättspsykiatrisk vård. Metod: 14 semistrukturerade intervjuer genomfördes med patienter och sjuksköterskor på en rättspsykiatrisk klinik. En kvalitativ innehållsanalys med induktiv ansats följt av ett abduktionssprång genomfördes. Resultat: Patienternas erfarenheter redogörs för i Att inte höra till, Att inte bli förstådd, Att känna sig välkomnad, Att skapa relationer och känna samhörighet, Att anpassa sig på gott och ont samt Att sträva mot samförstånd. Sjuksköterskornas erfarenheter presenteras i Att blunda för kulturen, Att uppleva kulturen som hinder, Att försöka skapa relationer och Att utvecklas som person. Ett övergripande tema identifierades som Att sträva efter ömsesidig förståelse. Slutsats: Synen på kultur skiljer mellan patienter och sjuksköterskor. Det finns behov av ökad medvetenhet om kulturens påverkan. Omvårdnaden skulle vinna på att patientens kultur och erfarenheter beaktas. Kulturkompetens behöver uppmärksammas i både verksamhet och utbildning.
Background: Previous research shows the complexity of cross-cultural care. There are misjudgements linked to cultural expressions. Increased cultural competence among caregivers can contribute to a more equal care. Cultural competence is an ongoing process, but it must be used with a humble attitude to one's own knowledge. There is a need for more studies on patients' experiences of cross-cultural care. Aim: To describe patients' and nurses' experiences of cross-cultural encounters in forensic psychiatric care. Method: 14 semi-structured interviews were conducted with patients and nurses at a forensic psychiatric clinic. A qualitative content analysis with an inductive approach and an abductive leap was conducted. Results: The patients' experiences are described as To not belong, To not being understood, To feel welcome, To establish relationships and feel affinity, To adapt for better or worse and To strive for consensus. The nurses' experiences are presented in To wink at culture, To experience culture as an obstacle, To try to establish relationships and To develop as a person. An overarching theme is identified as To strive for mutual understanding. Conclusion: The view on culture differs between patients and nurses. There is a need for increased awareness of the impact of culture. Nursing would benefit from the patients culture and experiences being taken into account. Cultural competence needs attention in both work and education.

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Marchetti, Carol Anne. "Regret and Police Reporting Among Individuals Who Have Experienced Sexual Assault." Thesis, Boston College, 2010. http://hdl.handle.net/2345/1168.

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Thesis advisor: Ann W. Burgess
Sexual assault (SA) is the most widely underreported violent crime in the United States. Reporting is significant because it is through this process that people access resources that can mitigate psychiatric and other health consequences of SA. The purpose of this study was to describe regret among individuals who have experienced SA regarding their decision of whether or not to report the assault to the police. The Ottawa Decision Support Framework underpins this study and posits that evaluation of regret, a powerful negative emotion, influences the decision-making process. The sample included 78 individuals, 18-25 years, who experienced SA during the past five years. Participants completed a 34-item, electronic questionnaire. A multiple regression model was generated to describe how selected independent variables explain variation in levels of regret. In the final model, the following, combined independent variables accounted for 33.3% (adjusted R2) of the variation in levels of regret: Weight change, the only variable associated with increased regret, was the most significant and accounted for the greatest amount of variance, followed by stranger assailant, seeking professional treatment, and reporting, which were associated with decreased regret. On average, people who chose to report their assault experienced less regret regarding their decision to do so as compared to people who did not report. This research fills a gap in the nursing, psychiatric, and victimology literature and improves clinical practice by describing post-decisional regret. The findings from this study provide a foundation for future research on the development of strategies (e.g., the development of decision-making tools) that nurses and other clinicians can use to assist people with their decision-making. Additionally, the findings can contribute to the development of a midrange, nursing theory of regret
Thesis (PhD) — Boston College, 2010
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing

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Forsgren, Emma, and Natalia Wodniok. ""Man känner igen missbrukets ansikte efter ett tag..." : En kvalitativ studie om kompetens och bemötande av patienter som är drogpåverkade på rättspsykiatriska avdelningar." Thesis, Högskolan Väst, Avdelningen for hälsopromotion och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-11094.

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Background. Research shows that 91.2% of inpatients at forensic psychiatric wards have a history of drug use and a third of those patients use drugs frequently. To be able to confront and address patients with substance abuse on the ward, the working staff needs to have adequate competence concerning the ability to understand who the patients are. Aim. The aim of this study was to explore how the working staff use their competence when interacting with patients who are influenced by drugs on forensic psychiatric wards. Method. The study was conducted in the western parts of Sweden and at three forensic psychiatric wards. The study was designed after a qualitative design and based on an empirical approach with interviews. The data was collected by interviewing a total of six informants through semi-structured interviews. The interviews were analysed using a qualitative content analysis. Results. The result ended up in eight themes, showing that informants in this study used their competence to recognize substance abuse, to help the patients navigating around potential dangers and create a caring relation. Further they trusted their experience, but all informants requested further education. Conclusion. The informants in this study expressed that they had good strategies in terms of supporting and rehabilitating patients with substance abuse. All informants requested further education about preventing relapse, knowledge about drug abuse and knowing how to work after a relapse.

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Borén, Magda, and Elin Vinterhed. ""Att mötas nånstans på mitten" : Sjuksköterskans möjlighet att tillämpa sin professionella kunskap inom den rättspsykiatriska slutenvården." Thesis, Röda Korsets Högskola, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-465.

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Bakgrund: Internationell forskning påvisar att sjuksköterskans genuina omvårdnadsarbete försvåras inom den rättspsykiatriska vården. Kärnan i denna problematik är den tvetydighet som uppstår då sjuksköterskan förväntas bedriva en etiskt grundad omvårdnad gentemot patienter som vårdas mot sin vilja. Forskning, särskilt ur ett kunskapsteoretiskt perspektiv, saknas gällande sjuksköterskors möjlighet att använda sin professionsspecifika kunskap inom den rättspsykiatriska slutenvården. Syfte: Studiens syfte var att beskriva sjuksköterskans möjlighet att tillämpa sin professionella kunskap inom den rättspsykiatriska slutenvården. Metod: Empirisk studie med kvalitativ ansats baserad på tematiskt utarbetade, interaktiva intervjuer med sex sjuksköterskor verksamma vid en rättspsykiatrisk klinik i en svensk storstad. Deduktiv innehållsanalys utifrån Carpers (1975) teori om sjuksköterskors kunskap och dess begrepp. Resultat: Ur analysen utkristalliserades åtta kategorier vilka beskriver sjuksköterskans möjlighet att tillämpa sin professionella kunskap inom den rättspsykiatriska slutenvården: (1) brist på incitament, (2) en ny kunskapsgeneration, (3) tvång utan kränkning, (4) högt och lågt i tak, (5) nödvändig distans, (6) försvårad identifikation, (7) flexibilitet gentemot regler och (8) vårda i motvind. Slutsats: Studiens resultat visar att sjuksköterskans möjlighet att tillämpa sin professionella kunskap inom den rättspsykiatriska slutenvården begränsas av en rad faktorer, både inom och utanför det egna inflytandet. Begränsningar som identifierades var en omvårdnadsfientlig miljö, gamla traditioner, bristande forskningsincitament och en patientgrupp med mångfacetterad problematik. Trots dessa utmaningar lyckas sjuksköterskorna hävda sin profession och därmed bedriva en omvårdnad som de ser som acceptabel, om än med stor förbättringspotential. Klinisk betydelse: Förhoppningen med studien är att inom den rättspsykiatriska slutenvården skapa en medvetenhet om sjuksköterskors unika kunskap så att omvårdnadsvetenskapen får större utrymme i klinisk praxis.
Background: International research indicates that it is difficult for nurses to provide genuine nursing care within the forensic inpatient psychiatry. The dual role taken on by nurses when expected to ethically care for patients subject to involuntary treatment is at the core of this issue. Research, especially from an epistemological point of view, is lacking regarding nurses’ possibility to apply their specific professional knowledge within the forensic inpatient psychiatry. Aim: The aim of this study was to describe nurses' possibility to apply their professional knowledge within the forensic inpatient psychiatry. Method: Empirical study with qualitative approach based on thematic interactive interviews with six nurses employed at a forensic inpatient clinic in one of Sweden's bigger cities. Deductive content analysis based on Carper's (1975) theory of nursing knowledge and its concepts. Results: From the analysis emerged eight categories which describe nurses' possibility to apply their specific professional knowledge in a forensic inpatient psychiatry setting: (1) lack of incentives, (2) a new generation of knowledge, (3) coercion without affront, (4) tolerance in a rigid environment, (5) necessary distance, (6) challenging identification, (7) flexibility towards rules and (8) nursing against a headwind. Conclusion: The findings show that nurses' possibility to apply their professional knowledge within the forensic inpatient psychiatry is limited by factors both in and beyond their power. The identified limitations were a custodial environment, old traditions, a lack of research incentives and a clientele with multifaceted issues. In spite of these challenges, nurses were able to assert their profession and provide nursing care in a way they saw as acceptable, though not without potential for improvement. Implications for practice: Hopefully, this study can raise awareness of nurses’ unique knowledge within the forensic inpatient psychiatry in order to promote nursing science in clinical practice.

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Hörberg, Ulrica. "Att vårdas eller fostras. Det rättspsykiatriska vårdandet och traditionens grepp." Doctoral thesis, Växjö universitet, Institutionen för vårdvetenskap och socialt arbete, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-1943.

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To be sentenced to care in the forensic psychiatric services can be seen as one of the most comprehensive encroachments society can make on a person's life and being, as it entails a limitation of the individual's freedom but with no time limit. The aim of this dissertation is to describe caring in forensic psychiatry based on how it is experienced by those who perform the caring and by those are cared for in a maximum secure unit. A reflective lifeworld approach, based on phenomenological philosophy, has been applied. The data has been collected in interviews that have been analyzed by use of a meaning analysis searching for the essence of the phenomenon. The results of the research are presented in two empirical studies and a general structure based on the empirical findings. The dissertation also contains an excursus, a philosophical intermediate chapter containing further analysis of the results of the studies. The results show how the forensic psychiatric care is experienced as being non-caring by the patients with only small "pockets" of good care. Caring consists of corrective techniques that are unreflected and contradictory, where the conditions are determined by the caregivers and the ward culture. The correcting takes place through the modification of the patients' behaviour with the aim of the patients having to adapt themselves to the terms of the care provision. This care results in the patients trying, by use of different strategies, to adapt them-selves to the demands of the caregivers in order to gain privileges. At the same time the patients long to get away from the care system and are lacking real, meaningful and close relationships. To be the subject of care entails struggling against an approaching overwhelming sense of resignation and to care entails experiencing both power and powerlessness in performing the care. A destructive power struggle is being waged within forensic psychiatric care that suppresses the caring potential and true caring is thus elusive. The characteristics of forensic psychiatric care, based on the results of the research, are clarified in the dissertation's excursus. These include the corrective and disciplinary nature of forensic psychiatric care, its power and how this is materialized in care situations as well as the influence of tradition on current forensic psychiatric care in the light of the work of the French philosopher Michel Foucault. The dissertation shows that if the caring potential is to be able to be developed and form a caring nucleus for forensic psychiatric care then education levels need to be further developed. A caring culture and caring environment is needed where true caring can gain a foothold. In order for this to become a possibility the current caring culture and environment must be clarified, questioned and examined. The prevalent fundamental ideas in forensic psychiatric care have to be "jeopardized" and challenged by new scientifically based ideas on what constitutes true caring in this context.

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Engel, Alexander Adolf. "Die afbakening van die rol en funksies van die forensiese psigiatriese verpleegpraktisyn in 'n geselekteerde forensiese psigiatriese eenheid in die Wes-Kaap." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53366.

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Thesis (MCur)--Stellenbosch University, 2003.
ENGLISH ABSTRACT: No clear description exists in S.A. of the role and functions of a forensic psychiatric nurse. The researcher conducted a research project based on more than 20 years of practice experience to define and describe the role and functions of the forensic nurse practitioner. A non-experimental descriptive study was done. Questionnaires and checklists were compiled to determine the perceptions of forensic psychiatric patients/clients (n =24) and nursing staff (n = 15) .The nursing activities in a selected forensic psychiatric unit was evaluated through nonparticipative observation. Results indicated that: • Patients experienced their environment as isolated and has a need for better support by the nursing staff; • Nursing staff indicated their need for more specific training in forensic psychiatric nursing; and • A need exists for specific protocols and procedures to guide his/her practice. The recommendations are made that: • A special training program for forensic psychiatric nursing needs to be planned and implemented; and • Procedures and guidelines must be established to guide the practice of the nurse practitioner.
AFRIKAANSE OPSOMMING: Daar bestaan in S.A. geen duidelike omskrywing van die rol en funksies van die forensiese psigiatriese verpleegkundige nie. Die navorser het gegrond op meer as 20 jaar praktykervaring 'n navorsingsprojek gedoen om die rol en funksies van die verpleegpraktisyn te definieer en te omskryf. 'n Nie-eksperimentele, beskrywende studie is gedoen. Vraelyste en kontrolelyste is opgestel om die persepsies van forensiese psigiatriese pasiënte/kliënte (n=24) en verpleegpersoneel (n=15) te bepaal. Die verpleegaktiwiteite in 'n geselekteerde forensiese psigiatriese eenheid is deur nie-deelnemende observasie geëvalueer. Resultate het daarop gedui dat: • Pasiënte hulle omgewing as geïsoleerd ervaar en het 'n behoefte aan beter ondersteuning deur die verpleegpersoneel; • Verpleegpersoneel het aangedui dat hulle 'n behoefte het aan spesifieke opleiding in forensiese psigiatriese verpJeging;en • Daar 'n behoefte is aan spesifieke protokolle en prosedures om sy/haar praktyk te rig . Die aanbevelings word gemaak dat: • 'n Spesiale opleidingsprogram vir forensiese psigiatriese verpleging beplan en geïmplementeer word; en • Prosedures en riglyne daargestel moet word om die praktyk van die verpleegpraktisyn te rig.

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Kim, Öberg, and Johansson Sara. "FRÅN ÖPPENHET OCH NÄRVARO-TILL DISTANS OCH KONTROLL : Att medicineras och att administrera ur ett patient- och sjuksköterskeperspektiv." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-24956.

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Title: From openness and presence to distance and control: to be medicated and to administrate from a patient and nurse perspective. Background: Within forensic psychiatric care the patients are admitted against their will, under heavy security with long term treatments. Self-care seems, based on scientific studies, to be dependent on what the nurses involved can provide. Emphasis should focus on a humane and respectful approach when the patient is exposed to coercive measures. Aim: From a patient and nurse perspective describe experiences of beeing medicated with and to administrate antipsychotic drugs within the psychiatric inpatient care. Method: Interviews with patients and nurses, which were analyzed using qualitative content analysis with an inductive approach. Results: Patients experience frustration over not beeing able to participate in or influence descisions made regarding their neuroleptic treatment. The neuroleptic treatment is described as a coercive measure and is characterized as an experience of losing control and independence. Nurses’ experiences of administering antipsychotics were described as having to do what is needed for the long term benefit of patients’ well-being. Medicating patients meant more than just handing out pills. It was beneficial to have knowledge of patients and their problems in order to meet patients where they are in the moment. The administration of neuroleptics led to feelings of frustration as it implied that the nurse had to assume an authoritarian role. Discussion: Nurses can promote self-care by inviting the patients to participate and by showing presence open up for cooperation. Patients experience that the feeling of powerlessness characterize their existence. When nurses see the patients as individuals and not as an assignment the feeling of powerlessness whitin the patients can be alleviated.
Titel: Från öppenhet och närvaro- till distans och kontroll: Att medicineras och att administrera ur ett patient- och sjuksköterskeperspektiv. Bakgrund: Patienter inom rättspsykiatrin vårdas mot sin vilja, under hög säkerhet med långa vårdtider. Egenvård förefaller, utifrån studerad forskning, vara i beroende av vad andra människor kan erbjuda. Vid tvångsåtgärder betonas att vikt ska läggas på ett humant förhållningssätt och respektfullt bemötande gentemot patienten. Syfte: Ur ett patient- och sjuksköterskeperspektiv beskriva erfarenheter av att medicineras med och av att administrera neuroleptikaläkemedel inom rättspsykiatrisk slutenvård. Metod: En intervjustudie med patienter och sjuksköterskor som analyserats utifrån kvalitativ innehållsanalys med induktiv ansats. Resultat: Patienter upplever frustration över att inte vara delaktiga eller påverka beslut som tas gällande deras neuroleptikabehandling. Att medicineras med neuroleptika präglas av upplevelsen att förlora kontrollen och sitt självbestämmande då neuroleptikabehandling beskrevs som en tvångsåtgärd. Sjuksköterskors erfarenheter av att administrera neuroleptika beskrevs som att behöva göra det som krävs för att på längre sikt gynna patienters välbefinnande. Att medicinera patienter innebar mer än att bara dela ut tabletter. Det var gynnsamt att ha kännedom om patienter och deras problematik för att kunna möta patienter där de är. Administrering av neuroleptika medförde känslor av frustration när det innebar att sjuksköterskor behövde inta en auktoritär roll. Diskussion: Sjuksköterskor kan främja egenvård genom att invitera patienter till delaktighet och visa tillgänglighet som öppnar upp för samarbete. Patienter upplever att känslan av maktlöshet präglar deras tillvaro, vilket kan lindras genom att sjuksköterskor ser patienten som person och inte en arbetsuppgift.

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Johansson, Emma, and Martina Lindqvist. "Etisk medvetenhet och empatiskt förhållningssätt hos personalen inom rättspsykiatrisk slutenvård." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-200281.

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Inledning: Inom rättspsykiatrisk vård är det viktigt att personalen har förmåga att leva sig in i det unika hos en person samt att etisk reflektion och hänsyn måste ges plats. Det är således relevant att undersöka vad personalen inom rättspsykiatrisk vård har för inställning till begreppen etisk medvetenhet och empatiskt förhållningssätt. Syfte: Syftet med arbetet var att undersöka personalens inställning till begreppen empatiskt förhållningssätt och etisk medvetenhet inom den rättspsykiatriska vården. Metod: En kvalitativ enkätstudie bestående av sju öppna frågor som besvarades av 15 personal inom rättspsykiatrisk vård. Svaren analyserades med kvalitativ innehållsanalys. Resultat: Resultatet visar att vårdpersonalen betonar vikten av att se människan bakom brottet, att använda sig själv som verktyg i vården samt att bemöta patienterna såsom du själv skulle vilja bli bemött i en liknande situation. Vårdpersonalen upplever även att det finns dubbla roller, en stödjande roll och en kontrollerande roll inom rättspsykiatri och att balansgången däremellan stundtals är svår. Slutsats: Etik och empati är någonting som anses viktigt och som personalen reflekterar över men som de tycker skulle behöva uppmärksammas mer på avdelningen.
Background: In forensic care, it’s important that staff are able to empathize with the uniqueness of a person, and that ethical reflection and consideration must be given space. Thus, it is relevant to examine attitudes to the concepts ethical awareness and empathetic approach among staff in forensic care. Aim: The aim of this study was to investigate the staff's attitude to the concepts empathetic approach and ethical awareness within the forensic psychiatric care. Method: A qualitative study consisting of seven open-ended questions that were answered by 15 staff in forensic psychiatric care. The responses were analyzed using qualitative content analysis. Result: The results show that the staff emphasizes the importance of seeing the person behind the crime, using theirselves as a tool in health care and to respond to patients as you would want to be treated in a similar situation. The staff also feels that they have dual roles, a supportive role and a controlling role in forensic psychiatry and to balance between these two roles is difficult at times. Conclusion: Ethics and empathy is something that is considered important, and something that the staff reflects on. However the staff thinks that there is a need for more attention in the workplace.

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Beckvid, Nathalie, and Amanda Winberg. "Det rättspsykiatriska vårdandet : Litteraturstudie om patientens upplevelse av rättpsykiatrisk vård." Thesis, Malmö universitet, Malmö högskola, Institutionen för vårdvetenskap (VV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-40823.

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Bakgrund: Rättspsykiatrisk slutenvård är en komplex vårdform där dengrundutbildade sjuksköterskans uppgift, förutom att ge god omvårdnad och stöd,är att vakta, förvara och skydda patienter som är överlämnade av domstol enligtsvensk lag. Syfte: Syftet med litteraturstudien är att få en förståelse över hurpatienterna upplever den rättspsykiatriska vården och vilken betydelse relationeroch miljö har för rehabilitering. Metod: Författarparet har gjort en systematisklitteraturstudie där tidigare publicerade studier valts ut, granskats och vars resultatsedan sammanställts och diskuterats. Tretton studier uppfyllde författarparetsinklusionskriterier och dessa genomgick sedan en latent innehållsanalys där trehuvudteman identifierades. Resultat: Resultatet visar att olika delar somrelationer, miljö och trygghet spelar roll för hur patienten upplever denrättspsykiatriska vården, samt delaktighet och autonomi inom den komplexavårdformen. Vidare identifierades underteman gällande bemötande och maktspelfrån vårdpersonalen gentemot patienterna. Avslutning: Utifrån resultatet kan flerabrister identifieras där omvårdnad och rehabiliteringen kan bli lidande, vilketmåste brytas för att tillgodose de rättspsykiatriska patienterna med god omvårdnadoch för att kunna ombesörja deras behov av den grundutbildade sjuksköterskanoch resterande vårdpersonal.
Background: Forensic psychiatric in-patient care is a complex form of care inwhich the registered nurse must, apart from giving good care and support to thepatients, both guard, contain and protect patients who are admitted to forensicpsychiatric care by the Swedish court of law. Aim: The aim of this degree projectis to gain understanding for how forensic psychiatric patients experience their careand the importance of relations’ and milieu’s effect on rehabilitation. Method: Theauthors of this literature review made a systematic literature review wherepreviously published studies were chosen, reviewed and whose results later wereput together and discussed. Thirteen studies met the criteria of inclusion and wereput through a latent content analysis, where three main themes were identified.Result: The results show that different parts, such as relations, environment andsafety matter for how the patient experience the forensic psychiatric care, alongwith participation and autonomy within the complex form of care. Furthermore,subthemes concerning social treatment and powerplay from staff towards thepatients were identified. Conclusion: Given the results, several flaws could beidentified where care and rehabilitation could be suffering and must thereforedispan to ensure that the needs and care of the forensic psychiatric patients aremet by the registered nurse and nursing staff.

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Kumpula, Tomi, and Tomas Sundström. "Sjuksköterskans attityder inom den rättspsykiatriska omvårdnaden : Litteraturöversikt." Thesis, Högskolan Dalarna, Omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:du-27013.

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Bakgrund : Sjuksköterskans roll i omvårdnad inom rättspsykiatrin är komplex. Detta på grund av att utöver omvårdnaden, skall även en säker miljö upprätthållas. Tvångsåtgärder kanske också måste utföras, vilket kan påverka sjuksköterskans etiska och moraliska principer. Den mest framträdande uppgiften sjuksköterskan har är dock att genom en sjuksköterska-patient relation skapa hälsa och välbefinnande samt ge patienter en chans till att växa och utveckla sina beteende. Syfte: Syftet med studien var att beskriva aktuell forskning om sjuksköterskans attityder inom den rättspsykiatriska omvårdnaden. Metod: Litteraturöversikt som inkluderar elva kvalitativa studier. Studierna som tagits fram har analyserats och teman identifierats. Databassökningar har genomförts i PubMed, CINAHL, SveMed+ och PsycINFO. Resultat: Tre huvudteman och två subteman identifierades. Första huvudtemat var sjuksköterskans roll med subteman relationens faser och säkerhet och tvångsåtgärder. De andra två huvudteman som identifierades var maskulinitet och copingstrategier. Slutsats : De affektiva attityderna som sjuksköterskan upplever kan styra mycket av de beslut och handlingar som utförs. Detta kan påverka patienters hälsa, välbefinnande och utvecklande. Män ansåg sig själva att genom handlingskomponenten bidra till en trygg och säker miljö.
Background: The nurse has a complex role of nursing care in a forensic care setting. This due to in addition to nursing care, also a safe environment should be preserved. Coercive measures may also have to be carried out, which can affect nurse´s ethical and moral principles. The most prominent task the nurse has are however to create health and wellbeing through nurse-patient relation as well as to offer the patient an opportunity to grow and to develop his behavior. Aim: The aim with this study was to describe current research of the nurse’s attitudes about nursing care in forensic care settings Method: Literature review including eleven qualitative studies. The studies have been analyzed and themes has identified. Database searches are made in PubMed, CINAHL, SveMed+ and PsycINFO. Results: Three main themes and two sub themes were identified. The first main theme was the nurse role with the sub themes the phases of a relationship and safety and coercive measures. The two other main themes that were identified are masculinity and coping strategies. Conclusion: The affective attitudes that the nurse experiences can control much of the decisions and actions that are performed. This can affect patients' health, well-being and development. Men considered themselves to contribute, through the action component, to a safe and secure environment.

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Magnusson, Emilie. ""Vi försöker" : Hur sjuksköterskor upplever att patienters delaktighet möjliggörs inom rättspsykiatrisk vård." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-35925.

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Delaktighet är viktig för patientens livskvalité, självkänsla, egenmakt samt känsla av kontroll och inflytande. Patienter inom rättspsykiatrisk vård har en minskad autonomi till följd av de begränsningar som tvångslagarna innebär. Forskning samt litteratur kring patienters delaktighet i den rättspsykiatriska vården är bristfällig och behöver utforskas vidare. Syftet med studien var att belysa hur sjuksköterskor upplever att patienters delaktighet möjliggörs inom den rättspsykiatriska vården. Studien har en omvårdnadsvetenskaplig utgångspunkt och kvalitativa intervjuer med nio sjuksköterskor från rättspsykiatriska avdelningar i södra Sverige har genomförts. I resultatet framkom att sjuksköterskorna upplever att delaktighet är en viktig del i omvårdnaden men att personal och patienter ibland ser olika på begreppet. Delaktigheten finns hela tiden med i arbetet med patienterna men den kan skifta beroende på vilket brott patienten vårdas för dock finns det en framtidstro om att den rättspsykiatriska vården ska fortsätta att utvecklas och att vården i framtiden kommer att bli ännu mer individanpassad. ”Vi försöker” blev det övergripande temat som visar att sjuksköterskorna försöker att få patienterna delaktiga i den rättspsykiatriska vården.
Participation is important for the patient's quality of life, self-esteem and sense of control and influence. Patients in forensic psychiatric care have reduced autonomy as a result of the constraints imposed by the compulsion laws. Research and literature on patient participation in forensic psychiatric care are inadequate and need further research. The purpose of the study was to highlight how nurses experience patient participation in forensic psychiatric care. The study has a nursing science starting point and qualitative interviews with nine nurses from forensic psychiatric departments in southern Sweden have been carried out. The results show that nurses feel that participation is an important part of the nursing, but that staff and patients sometimes view the concept differently. Participation is always included in the work with patients, but it may change depending on the custody of the patient, however, there is a belief that the forensic psychiatric care will continue to develop and that future care will be even more individualized.” We are trying” became the overall theme and shows that nurses try to get patients involved in forensic psychiatric care.

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Jones, Jane. "How distress is understood and communicated by women patients detained in high secure forensic healthcare, and how nurses interpret that distress : an exploration using a multi-perspective interpretative phenomenological analysis." Thesis, University of Derby, 2017. http://hdl.handle.net/10545/621901.

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Background: The context for this study is the National High Secure Healthcare Service for Women (NHSHSW). This service opened in 2007 following the closure of all other high secure healthcare services for women. Consequently the NHSHSW is the UK’s only facility to provide assessment and treatment for women detained under the Mental Health Act and who are classified as posing a grave and immediate danger to others. Care delivered within the NHSHSW is grounded within the guiding principles of trauma informed environments. This philosophy of care understands that women patients in high secure forensic healthcare experience heightened and usually chronic levels of distress which can be communicated through violent and dangerous behaviour (McMillan & Aiyegbusi, 2009). This group of marginalised women are an important but small group of people with unique experiences. These women patients’ experiences have yet to be explored from the perspective of the women themselves. This is the first study to explore how women patients detained in the NHSHSW experience distress and the impact that distress has on their behaviour from the perspective of the women patients themselves and their care-givers. The care-givers referred to are named nurses whose perspective provides perceptual and interactional context to this study. Insight into the women patients’ experiences is important to ensure that the development of healthcare can respond effectively to need. The importance of service user involvement has been increasingly recognised in general mental health settings. However, user involvement in forensic research is less well developed. This has now been recognised and for the first time this study included the women patients as research facilitators. Method: Women patients were invited to attend discussion groups to identify a research project that would form a baseline evaluation for an evidence based development of the NHSHSW. A working party including the researcher and voluntary women patients was established to facilitate the research process. The number of women patients contributing to the working party ranged between eight and thirteen depending on availability. Feminist principles provided a framework for this enquiry (Lykke, 2010). The experiences identified for exploration were: How women patients in high secure healthcare understand their distress. How women patients in high secure healthcare communicate their distress. How nurses interpret the women patients’ distress. Multi-perspective Interpretative Phenomenological Analysis (IPA) was used to analyse semi-structured interviews (Loaring, Larkin, Shaw & Flowers 2015). Twenty three voluntary patient interviews, representing 57% of the overall patient population and thirteen voluntary named nurse interviews took place, representing 34% of the named nurse population. No participants dropped out or withdrew their contribution. Findings: Themes regarding the women patient participants’ understanding and communication were identified as: Observable behaviours and responses; Blocks to getting help; Change over time; An entity to be endured; An emotional experience; A physical experience; Being alone. The themes identified from the nurse interviews were: Perception of the distress experience. What influences my response and what is expected of me? The patient and the nurse interviews evidenced differences in understanding related to the women patients’ experience of distress. The women patients placed emphasis on the physiological/sensory aspect of their distress, whereas nurses placed emphasis on the emotional aspect of the women patients’ distress. The implication is that at times of heightened distress the women patients did not feel they were understood. The findings also highlighted areas of unmet need including family involvement in care and a perceived lack of support to enhance family contact. In addition loneliness was emphasised as a significant stressor for the women patients as was being perceived as an on-going risk of harm. All the findings were validated by the participants and subject to peer review. Conclusion: This study provides the first evidence base for healthcare practice specifically for women patients detained in the NHSHSW. This is also the first study to involve the women patients in the NHSHSW as co-facilitators of research. This experience was described as empowering by the women patients who took part and whose involvement ensured that the research subject was relevant and meaningful. The depth of the women patients’ involvement has set precedents for policy, procedure and practice development within the NHSHSW and evidenced the women patients’ ability to be co-producers of the services they use. The study was conducted for women by women and as such was guided by feminist principles seeking the right to provide services based on women patients’ needs and experiences. As a consequence this study has made a unique and significant contribution to available literature and the development and provision of services for women detained in high secure care. The study originally aimed to provide an evidence base for the development of the NHSHSW; however, continued interest from lesser secure services clearly demonstrates the applicability of the findings to services beyond the NHSHSW. Limitations There were limitations to this study which could have influenced the findings. The researcher was known to the patient and nurse participants. Established relationships between researchers and participants have the potential to bias an outcome; however it can also provide a baseline of trust. Service user involvement as both researcher and participant potentially allows participants to purposefully respond to questions with the aim to confirm their original pattern of thinking rather than exploring a concept to uncover new findings. The balance of findings in this research suggests that while some bias can be argued it did not invalidate the findings.

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Tina, Hosseini, and Linnea Moberg. "Att främja patienters delaktighet inom rättspsykiatrisk vård : En allmän litteraturöversikt." Thesis, Röda Korsets Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-4035.

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Background: Forensic psychiatric care is a non-voluntary care form for people with severe mental disorders and criminal backgrounds. These patients have a restricted autonomy based on predetermined guidelines regulating this careform. The legislation governing forensic psychiatry confines the patient's power to influence the decision making concerning their treatment plan. Enabling patient involvement in this non-voluntary careform can be challenging for healthcare staff. Aim:To identify how patient involvement can be encouraged within forensic psychiatry. Method: A literature overview proceeding from eleven scientific qualitative articles that were analysed using thematic analysis method. Result: The patients stated that they wanted a greater influence over their care form. Furthermore, they lifted the importance of being informed about their treatment plan and medications by the caregivers to increase their involvement. Patients and healthcare staff relations are characterized by honesty and constitute a central role in patient involvement encouragement. Conclusion: Based on the literature study’s result the authors identified two key factors that affect the patients' experience of their involvement negatively, these factors were lack of information and exclusion from treatment conferences. Further research through qualitative studies should be carried out focusing on the working and non-working methods regarding the promotion of forensic psychiatric patients' involvement.
Bakgrund: Rättspsykiatrisk vård är en ofrivillig vårdform som personer med en allvarlig psykiatrisk störning som begår ett brott kan dömas till. Patienter inom rättspsykiatrisk vård har en begränsad autonomi vilket grundar sig i förutbestämda riktlinjer som styr denna vårdform. Att möjliggöra patientens delaktighet inom rättspsykiatrisk vård kan vara en utmaning för vårdpersonalen då vården inte utgår från samtycke. Syfte: Att identifiera hur patienters delaktighet kan främjas inom den rättspsykiatriska vården. Metod: En litteraturöversikt som utgick från elva vetenskapliga artiklar med kvalitativ ansats. Artiklarna som inkluderades analyserades med tematisk innehållsanalys. Resultat: Patienterna uppgav att de ville ha större inflytande över den vård de erhöll. Vidare lyfte de vikten av att vårdpersonal gav dem information kring deras behandling och medicinering för att främja deras delaktighet i vården. Vårdrelationen mellan patienter och vårdpersonal präglas av ärlighet och utgör en central roll vid främjande av patienters delaktighet. Slutsats: Utifrån litteraturstudiens resultat identifierade författarparet att två nyckelfaktorer som visades påverka patienternas upplevelse av delaktighet negativt var brist på information och exkludering från behandlingskonferenser. Fortsatt forskning genom kvalitativa studier bör utföras med fokus på de arbetsmetoder som fungerat och inte fungerat gällande främjandet av rättspsykiatriska patienters delaktighet.

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Hosseini, Tina, and Linnea Moberg. "Att främja patienters delaktighet inom rättspsykiatrisk vård : En allmän litteraturöversikt." Thesis, Röda Korsets Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-4035.

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Background: Forensic psychiatric care is a non-voluntary care form for people with severe mental disorders and criminal backgrounds. These patients have a restricted autonomy based on predetermined guidelines regulating this careform. The legislation governing forensic psychiatry confines the patient's power to influence the decision making concerning their treatment plan. Enabling patient involvement in this non-voluntary careform can be challenging for healthcare staff. Aim:To identify how patient involvement can be encouraged within forensic psychiatry. Method: A literature overview proceeding from eleven scientific qualitative articles that were analysed using thematic analysis method. Result: The patients stated that they wanted a greater influence over their care form. Furthermore, they lifted the importance of being informed about their treatment plan and medications by the caregivers to increase their involvement. Patients and healthcare staff relations are characterized by honesty and constitute a central role in patient involvement encouragement. Conclusion: Based on the literature study’s result the authors identified two key factors that affect the patients' experience of their involvement negatively, these factors were lack of information and exclusion from treatment conferences. Further research through qualitative studies should be carried out focusing on the working and non-working methods regarding the promotion of forensic psychiatric patients' involvement.
Bakgrund: Rättspsykiatrisk vård är en ofrivillig vårdform som personer med en allvarlig psykiatrisk störning som begår ett brott kan dömas till. Patienter inom rättspsykiatrisk vård har en begränsad autonomi vilket grundar sig i förutbestämda riktlinjer som styr denna vårdform. Att möjliggöra patientens delaktighet inom rättspsykiatrisk vård kan vara en utmaning för vårdpersonalen då vården inte utgår från samtycke. Syfte: Att identifiera hur patienters delaktighet kan främjas inom den rättspsykiatriska vården. Metod: En litteraturöversikt som utgick från elva vetenskapliga artiklar med kvalitativ ansats. Artiklarna som inkluderades analyserades med tematisk innehållsanalys. Resultat: Patienterna uppgav att de ville ha större inflytande över den vård de erhöll. Vidare lyfte de vikten av att vårdpersonal gav dem information kring deras behandling och medicinering för att främja deras delaktighet i vården. Vårdrelationen mellan patienter och vårdpersonal präglas av ärlighet och utgör en central roll vid främjande av patienters delaktighet. Slutsats: Utifrån litteraturstudiens resultat identifierade författarparet att två nyckelfaktorer som visades påverka patienternas upplevelse av delaktighet negativt var brist på information och exkludering från behandlingskonferenser. Fortsatt forskning genom kvalitativa studier bör utföras med fokus på de arbetsmetoder som fungerat och inte fungerat gällande främjandet av rättspsykiatriska patienters delaktighet.

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Andersson, Liselotte, and Päivi Jakum. "Inte som i Gökboet : sjuksköterskors beskrivningar av omvårdnadsprocessen inom den rättspsykiatriska vården : en kvalitativ studie." Thesis, University West, Department of Nursing, Health and Culture, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-1564.

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Forensic psyhiatric care protects the society by giving patients care to diminish risks of serious crimes. In their work the nurses use different care methods to help and support the patient in managing his or her life situation. To clarify how a group of nurses describe the nursing process in forensic psychiatric care. A qualitative study based on interviews. Six nurses were interviewed about their work in four different forensic psychiatric care units. The nursing process in is divided into four categories: evaluation, planning, implementation and assessment. The results are based on the way the interviewed nurses described the essential roles of nurse-patient relationship and structured routines in nursing process. The study also shows some specific difficulties in nursing work, for example the mental dysfunctions of patients, the level of competence among staff and the patients need for social interaction and existence beyond their specific needs.

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Andersson, Johan, and Jonas Lindvall. "Att vårda någon som slåss : Vårdares upplevelse av våldssituationer och hur dessa påverkar vårdrelationen inom rättspsykiatrisk vård." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-70226.

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Abstrakt Bakgrund: Rättspsykiatrin i Sverige vårdar psykiskt sjuka lagöverträdare. Våld är vanligt förekommande och ett stort problem inom den rättspsykiatriska vården. Vårdare som blir utsatta för våld trivs sämre med sitt arbete och har högre sjukfrånvaro. Inom rättspsykiatrisk vård beskrivs en god vårdrelation mellan vårdare och patient som en förutsättning för att kunna vårda. Syfte: Studiens syfte var att belysa vårdares upplevelse av våldssituationer och hur dessa påverkar vårdrelationen inom rättspsykiatrin. Metod: Studien har en kvalitativ ansats och utgår från livsvärldsteorin. Studien baseras på intervjuer med tolv vårdare. Intervjuerna har analyserats med hjälp av kvalitativ innehållsanalys. Resultat: I intervjuerna framkom att våldsamma situationer mellan patienter och vårdare inom rättspsykiatrisk vård kan leda till att en patient flyttas eller att det uppstår en distans mellan vårdare och patient. Våld kan även leda till att vårdare blir sjukskrivna under en period, eller slutar sitt arbete. Erfarna vårdare beskriver att de ständigt har en mental beredskap för att våld plötsligt kan uppstå. De använder även en hård jargong som ett verktyg för att kunna hantera den påfrestande miljön. Slutsats: Det kan upplevas kontraproduktivt att flytta en patient efter en våldsam situation och därmed omöjliggöra mötet mellan patienten och den vårdare som blev utsatt för våld. Ett undvikande av mötet riskerar att försämra vårdrelationen. Istället kan patienten bjudas in till ett samtal tillsammans med denne vårdare. Vårdare efterfrågar stöd ur ett längre tidsperspektiv efter en våldsam situation. För att skapa förutsättningar för ett stöd på mellanmänsklig nivå efter en våldsam situation behövs ett långsiktigt och strukturerat stöd. Det krävs ytterligare forskning för att bättre förstå den tidvis hårda jargongen och hur den påverkar vårdandet.
Abstract Background: The forensic psychiatry in Sweden offers care to people who have committed a crime under the influence of a mental disorder. Violence against staff is a common and major problem in the forensic psychiatry. Caregivers who have been exposed to violence feel less satisfied in their work, and are more often staying at home on sick leaves, compared to other caregivers. A good caring relationship between caregivers and patients is described as a prerequisite for giving a good care in the context of forensic psychiatry. Aim: The aim of the study was to highlight the health professionals' experiences of violent situations and how these affect the caring relationship in forensic psychiatric care. Method: The study has a qualitative approach based on the lifeworld theory. The study is based on interviews with twelve caregivers. The interviews were analyzed using qualitative content analysis. Result: The interviews revealed that violent situations between patients and caregivers in forensic psychiatric care can lead to a distance between the caregiver and the patient, or that the patient is being moved. Violence can also lead to sick leave for caregivers or a permanent quit from work. Caregivers with long experience of forensic psychiatry describe that they constantly have a mental preparedness for violence to suddenly arise. They also use a rough jargon as a tool to handle the stressful context. Conclusion: It may be counterproductive to move a patient after a violent situation, thus making it impossible for the patient and the victim to meet each other after a violent situation. An avoidance of the meeting is likely to worsen the caring relationship. Instead of creating a distance, the patient can be invited to a conversation with this caregiver. Caregivers demand support for a longer period of time after a violent situation. In order to create the conditions for interpersonal support after a violent situation, long-term and structured support is needed. Further research is needed to better understand the occasionally rough jargon and how it affects caring.

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Berg, Sascha, and Maria Pakou. "Delaktighet i rättspsykiatrisk vård : En kulturanalys av meningsskapande sammanhang." Thesis, Linköpings universitet, Avdelningen för omvårdnad och reproduktiv hälsa, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-171444.

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Bakgrund: Begreppet personcentrerad har internationellt blivit vedertaget inom omvårdnadsvetenskap och används för att beskriva en vårdform där vården utgår från ett partnerskap med patienten. Engagemang, trygghet, tillit, att vara delaktig i planeringen av vården och en vårdande relation upplevs vara viktiga komponenter som främjar delaktigheten. För att öka förståelsen om delaktighetens och personcentreringens syfte inom den rättspsykiatriska vårdkontexten krävs studier som beskriver de mångfacetterade begreppen ur vårdarens och patientens perspektiv. Syfte: Att förstå upplevelser av delaktighet och personcentrerad vård hos patienter och personal på en rättspsykiatrisk avdelning och diskutera hur delaktighet kan möjliggöras. Design: Studien är en kulturanalys och ansatsen är hermeneutisk. Metod: Enskilda halvstrukturerade intervjuer med fyra vårdare och fyra patienter på en rättspsykiatrisk avdelning i Mellansverige genomfördes. Intervjuerna har bearbetats utifrån en kulturanalytisk hermeneutisk arbetsmodell i sju faser. Interna dokument från sjukhuset analyserades avseende delaktighet. Resultat: Oklarheter gällande vårdprocessen och rättspsykiatrins strukturer som är inte fullkomligt tydliga inverkar på upplevelsen av delaktighet. Konklusion: Personal och patienter har olika uppfattningar om strukturernas funktion. Personalen anser att patienternas delaktighet är en förutsättning för vårdprocessen. Patienter uttrycker osäkerhet kring vad som förväntas av dem. Identitet och tolkning av den egna rollen kan påverka delaktigheten hos patienter inom rättspsykiatri.
Background: The concept of person-centered care is internationally accepted in nursing science and describes a form of care with an active patient included in all aspects of care. Commitment, trust, and involvement in the planning of care and a caring relationship are perceived to promote participation. To increase understanding person-centering in the forensic psychiatric care context, studies on the multifaceted concepts from carers’ and patients’ perspectives are required. Aim: To understand experiences of participation and person-centered care among patients and staff in a forensic psychiatric ward and discuss how participation can be promoted. Method: Individual semi-structured interviews with four carers and four patients in a forensic psychiatric hospital in Central Sweden were conducted. A seven-phase cultural analysis model was used. Internal documents were analyzed for statements about participation. Design: The study is a cultural analysis with a hermeneutic approach. Result: Unclear care process and structures of forensic care affect the experience of participation. Conclusion: The perceptions of the function of the structures differ. Staff believe that patient participation is a prerequisite for the care process. Patients express uncertainty about what is expected of them. Identity and interpretation of one's own role can influence the participation of patients in forensic psychiatry.

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Enheim, Glenn, and Karin Hamrin. "Omvårdnadspersonalens erfarenheter av riskhantering : med HCR-20 som underlag." Thesis, Umeå universitet, Institutionen för omvårdnad, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-89048.

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Bakgrund Målet med den rättspsykiatriska vården är att patienterna skall kunna återvända till ett gott liv utanför vården utan återfall i kriminalitet. Socialstyrelsen har klargjort att patienter inom den specialiserade psykiatriska vården ska riskbedömas. Den strukturerade professionella bedömningen, som HCR-20, är en vetenskapligt framtagen checklista och har visat sig ha både hög validitet och reliabilitet. Arbetet med bedömning av och förståelse för risk för våld och eller återfall i brottslighet är något av det säregna i arbetet för sjuksköterskor inom den rättspsykiatriska vården Syfte Belysa hur den kunskap som framkommer genom riskbedömningsformuläret HCR-20 omsätts i omvårdnadsarbetet vid rättspsykiatrisk vård. Metod Datainsamlingen gjordes med åtta intervjuer som sedan analyserades genom en kvalitativ innehållsanalys. Resultatet I resultatet har två kategorier framträtt som är att Synliggör risker och Underlag till planering. Under dessa två kategorier finns ett antal underkategorier. Personalen ser i stort inga uppenbara brister med HCR-20 utan anser att det är ett bra system som fyller sin funktion. Vid HCR-20 bedömning förs dialog om vad man som personal kan lägga fokus på och vilka risker som kan minskas. Det upplevs intressant att se när risker minskas samt att man tolkar den förändring som skattningsinstrumentet visar som framsteg i arbetet. Diskussion Författarna menar att resultatet belyser något om hur arbetet runt HCR-20 och riskhantering vid rättspsykiatrisk vård uppfattas av omvårdnadspersonal samt att utvecklingsmöjligheter har identifierats.
Background The purpose of forensic psychiatric care is that patients are able to return to a good life outside care without criminal recidivism . Swedish law has clarified that the patients in specialist mental health services should be risk assessed . The structured professional risk assessment, like the HCR- 20, is a scientifically formulated checklist and have been shown to have both high validity and reliability. Work on the assessment and understanding of the risk of violence and recidivism is one of the peculiarity of the work of nurses in forensic psychiatry Aim Highlighting how the knowledge obtained from the risk assessment form, HCR- 20 is put into the nursing work in forensic nursing. Methods The data was collected with eight interviews then analyzed by qualitative content analysis. Results The result has two categories emerged as Visualize risks and Basis for planning. Within these two categories there are a number of subcategories. The staff looks basically no obvious flaws with the HCR- 20, and believe it is a good system that fulfills its function. At HCR- 20 assessment dialogue is conducted on what personnel can focus on and what risks that can be reduced. It felt interesting to see when the risks are reduced and that we interpret the change that estimate the instrument as progress in working with the patients. Discussion The authors believe that the results illustrate how the work around the HCR- 20 and risk management in forensic nursing is perceived by the nursing staff as well as development opportunities have been identified.

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Herrdin, Rebecca, and Maria Falk. "Patienters upplevelse av vården inom rättspsykiatrin : En allmän litteraturöversikt." Thesis, Röda Korsets Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-3785.

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Background: A person with a serious mental disorder who commits a crime can be sentenced to forensic psychiatric care. Forensic psychiatric care is permeated by a high sense of security, while patients are expected to follow a predetermined treatment plan. This restrictive environment, where patients are forcibly cared for during indeterminate time leads to a complex ethical dilemma. Patients are treated for their mental illness whilst the restrictive nature of the care environment deprives them of the opportunity for full autonomy, which can affect their overall experience of the care period. Aim: The aim was to describe patients' experience of their care in forensic psychiatry. Method: A general literature review based on ten scientific articles with a qualitative approach that were analyzed with a content analysis. Results: Three main categories were identified: Being locked up and supervised, The importance of interpersonal encounters and Rehabilitation process in forensic psychiatry. Mentioned main categories were divided into six subcategories. Conclusion: The strict requirements of the forensic psychiatric care form require an adaptation of the admitted patients. Patients' experience the lack of meaningful activities and autonomy. Central are the relationships between care recipients and care providers to evoke a sense of safety and meaningfulness for the patients. A therapeutic approach is important and seeing the human behind the crime. Suggestions for further research: The results show the absence of therapeutic roles in forensic psychiatry. The need for guidelines regarding the therapeutic treatment of forensic psychiatric patients should thus be considered to be developed. This to create a safe and empathetic existence that contributes to a health-promoting environment for forensic psychiatric patients.
Bakgrund: Personer med en allvarlig psykisk störning som begår ett brott kan dömas till rättspsykiatrisk vård. Rättspsykiatrisk slutenvård genomsyras av strikta riktlinjer kring säkerhet samtidigt som patienterna förväntas följa en förutbestämd behandlingsplan. Denna restriktiva miljö där patienterna tvångsvårdas under en obestämd tid bidrar till ett komplext etiskt dilemma, då personer behandlas för sin psykiska ohälsa samtidigt som vårdmiljöns restriktiva natur fråntar deras möjlighet till full autonomi, vilket kan påverka deras helhetsupplevelse av vårdtiden. Syfte: Syftet var att beskriva patienters upplevelse av vården inom rättspsykiatrin. Metod: En allmän litteraturöversikt baserat på tio vetenskapliga artiklar med kvalitativ ansats som analyserades med en innehållsanalys. Resultat: Tre huvudkategorier identifierades: Att vara inlåst och övervakad, Betydelsen av mellanmänskliga möten och Rehabiliteringsprocessen inom rättspsykiatrin. Nämnda huvudkategorier delades in i sex underkategorier. Slutsats: Den rättspsykiatriska vårdformens strikta krav kräver en anpassning av de inlagda patienterna. Patienterna upplever avsaknad av meningsfulla aktiviteter och autonomi. Centralt är relationerna mellan vårdtagare och vårdgivare för att framkalla en känsla av trygghet samt meningsfullhet hos patienterna. Terapeutiska förhållningssätt identifieras som viktiga samt att se människan bakom brottet. Förslag på fortsatt forskning: Resultatet visar frånvaron av terapeutiska roller inom rättspsykiatrin. Behovet av riktlinjer kring terapeutiskt bemötandet av rättspsykiatriska patienter anses således behöva utvecklas. Detta för att skapa en trygg och empatisk tillvaro som bidrar till en hälsofrämjande miljö för rättspsykiatriska patienter.

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Dahlström, Fredrik, and Sophia Åbrink. ""Dom var bara allmänt trevliga och bemötte mig som en människa" : Patienter och sjuksköterskors erfarenheter av vad som möjliggör respektive försvårar en vårdande relation inom rättspsykiatrisk vård." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-39906.

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Bakgrund: Det finns tidigare forskning inom området vårdande relation. Dock är den begränsad inom rättspsykiatrisk vård. I synnerhet forskning som integrerar patienter och sjuksköterskors erfarenheter av det undersökta fenomenet. Syfte: Att beskriva patienter och sjuksköterskors erfarenheter om vad som möjliggör respektive försvårar en vårdande relation inom rättspsykiatrisk vård. Metod: Studiens resultat bygger på intervjuer av fem patienter som är inneliggande på en rättspsykiatrisk klinik respektive fem sjuksköterskor som arbetar på samma klinik. Studien genomfördes med en induktiv ansats. Insamlade data analyserades utifrån en kvalitativ innehållsanalys. Resultat: Studiens resultat visar att patienterna upplever det viktigt att de blir sedda som människor, att vårdare gör det lilla extra och att vårdare samt patient drar åt samma håll för att vårdande relation ska kunna etableras. Sjuksköterskorna tyckte det var viktigt att sätta sig in i patienten, att ha en fungerande arbetsgrupp, att göra något utöver det vanliga och får förtroende att samspela. Slutsatser: Resultatet svarar an till studiens syfte. Såväl patienterna som sjuksköterskorna ansåg att vårdarna hade det yttersta ansvaret för att en vårdande relation skulle kunna etableras. I båda grupperna sågs flera gemensamma nämnare såsom tidsaspekt, närvaro och att vårdaren har ett genuint intresse. NYCKELORD:, bemötande, erfarenheter, patientperspektiv, rättspsykiatrisk vård, sjuksköterskeperspektiv, vårdande relation
Background: Previous research in the field caring relationship is available. However, it is limited in forensic psychiatric care. Especially studies that integrate patients and nurses experiences of the investigated phenomenon. Aim: The aim of this study was to describe patients and nurses experiences of what enables and aggravate a caring relationship in forensic psychiatry care. Methods: The results of the study are based on interviews of five patient in a forensic clinic and five nurses who works on the clinic. The study was performed with an inductive approach. Data were analyzed based on a qualitative content analysis. Results: In order for a caring relationship to be established the results indicates that the patients find it important to be seen as humans, that the carers do ”that little extra” and that the carers and patients works at the same direction. The nurses found it important to familiarize themselves in the patient, to have a stabilized work with the team, to do “the little extra” and get the trust to cooperate. Conclusion: The results corresponds to the aim of the study. Both patients and nurses agreed that the nurse had the responsibility of the caring relationship. A similarity were shown between both of the groups such as time aspect, presence and a genuin interest from the carrier. Keywords: caring relationship, encounter, experiences, forensic psychiatric care, nurse, patient.

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Dahlström, Fredrik, and Sophia Åbrink. ""Dom var bara allmänt trevliga och bemötte mig som en människa" : Patienter och sjuksköterskor erfarenheter av vad som möjliggör respektive försvårar en vårdande relation inom rättspsykiatrisk vård." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-39938.

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Bakgrund: Det finns tidigare forskning inom området vårdande relation. Dock är den begränsad inom rättspsykiatrisk vård. I synnerhet forskning som integrerar patienter och sjuksköterskors erfarenheter av det undersökta fenomenet. Syfte: Att beskriva patienter och sjuksköterskors erfarenheter om vad som möjliggör respektive försvårar en vårdande relation inom rättspsykiatrisk vård. Metod: Studiens resultat bygger på intervjuer av fem patienter som är inneliggande på en rättspsykiatrisk klinik respektive fem sjuksköterskor som arbetar på samma klinik. Studien genomfördes med en induktiv ansats. Insamlade data analyserades utifrån en kvalitativ innehållsanalys. Resultat: Studiens resultat visar att patienterna upplever det viktigt att de blir sedda som människor, att vårdare gör det lilla extra och att vårdare samt patient drar åt samma håll för att vårdande relation ska kunna etableras. Sjuksköterskorna tyckte det var viktigt att sätta sig in i patienten, att ha en fungerande arbetsgrupp, att göra något utöver det vanliga och får förtroende att samspela. Slutsatser: Resultatet svarar an till studiens syfte. Såväl patienterna som sjuksköterskorna ansåg att vårdarna hade det yttersta ansvaret för att en vårdande relation skulle kunna etableras. I båda grupperna sågs flera gemensamma nämnare såsom tidsaspekt, närvaro och att vårdaren har ett genuint intresse.
Background: Previous research in the field caring relationship is available. However, it is limited in forensic psychiatric care. Especially studies that integrate patients and nurses experiences of the investigated phenomenon. Aim: The aim of this study was to describe patients and nurses experiences of what enables and aggravate a caring relationship in forensic psychiatry care. Methods: The results of the study are based on interviews of five patient in a forensic clinic and five nurses who works on the clinic. The study was performed with an inductive approach. Data were analyzed based on a qualitative content analysis. Results: In order for a caring relationship to be established the results indicates that the patients find it important to be seen as humans, that the carers do "that little extra" and that the carers and patients works at the same direction. The nurses found it important to familiarize themselves in the patient, to have a stabilized work with the team, to do "the little extra" and get the trust to cooperate. Conclusion: The results corresponds to the aim of the study. Both patients and nurses agreed that the nurse had the responsibility of the caring relationship. A similarity were shown between both of the groups such as time aspect, presence and a genuin interest from the carrier. Keywords: caring relationship, encounter, experiences, forensic psychiatric care, nurse, patient.

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Silva, Céu da Conceição Rito da. "A promoção do autocuidado de doentes internados em psiquiatria forense como contributo para o seu processo reabilitativo : contributos do enfermeiro especialista em saúde mental e psiquiatria, para a promoção do autocuidado e da saúde mental." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2013. http://hdl.handle.net/10400.26/6275.

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Dissertação apresentada para cumprimento dos requisitos necessários à obtenção do grau de mestre em Enfermagem de Saúde Mental e Psiquiátrica
A saúde mental, de acordo com a OMS, é fundamental e básica para a saúde global da população. A psiquiatria forense é uma realidade atual mas a institucionalização, assim como a cronicidade da doença mental, são aspetos pouco favoráveis na recuperação destes doentes tornando-se fundamental que seja estabelecido com eles precocemente um plano reabilitativo para uma integração social com sucesso. O trabalho aqui exposto apresenta um projeto de intervenção no serviço e o processo desenvolvido para aquisição das competências de Mestre em Enfermagem de Saúde Mental e Psiquiatria. O projeto de intervenção foi desenvolvido num serviço de psiquiatria forense e tem como objetivos promover o autocuidado dos doentes e incentivar à reflexão. Foi aplicada metodologia de projeto. Identificou-se como problemática a necessidade de medidas reabilitativas para promoção da saúde e futura integração social destes doentes e como prioridade a prestação de cuidados de enfermagem dirigidos à promoção do autocuidado destes envolvendo-os na sua recuperação. A Pergunta de partida foi: Quais são as necessidades de autocuidado dos doentes do serviço de psiquiatria forense, como contributo para o seu processo de reabilitação, que são sensíveis aos cuidados de enfermagem? O diagnóstico foi feito através do olhar dos enfermeiros do serviço. A intervenção debruçou-se sobre um grupo de doentes pré-selecionados com o qual foram realizadas sessões psicoeducativas. Nos resultados verificou-se adesão dos doentes, aumento do relacionamento interpessoal, entusiasmo em aprender e progressivo interesse pelo autocuidado. Concluiu-se que necessidades de autocuidado como alimentação, higiene e vestuário, compreensão da doença e adesão terapêutica são sensíveis aos cuidados de enfermagem. Este processo permitiu também o desenvolvimento das competências de Mestre em Enfermagem de Saúde Mental e Psiquiátrica. Pretende-se que este artigo contribua para a promoção do autocuidado e processo reabilitativo dos doentes em psiquiatria forense, favoreça a discussão, o aumento de conhecimentos e melhoria na intervenção em saúde mental.
Abstract: The mental health according to the WHO (World Health Organization) is fundamental and basic to the population’s global health. The forensic psychiatry is a current reality but the institutionalization, as well as the chronicity of the mental disease are less favourable aspects in the recovery of patients becoming crucial to establish early with them a rehabilitation plan for a successful social integration. This assignment presents an intervention project in the service and the process developed for acquiring the skills of Master in Science in Mental Health Nursing and Psychiatry. The intervention project was developed in a forensic psychiatric service and aims to promote the patients’ self-care and encourage reflection. Project methodology was applied. It was identified as problematic the need for rehabilitative measures for health promotion and future social integration of these patients and as priority the provision of nursing care directed to promote their self-care, involving them in their own recovery. The starting question was: What are the self-care needs of patients of the forensic psychiatry service, as contribute to their rehabilitation process that is sensitive to nursing care? The diagnosis was made through the eyes of the service’s nurses. The intervention focused on a pre-selected group of patients with whom psychoeducation sessions were held. In the results was verified the adhesion of the patients, progression in the interpersonal relationship, learning enthusiasm and progressive interest in self-care. It follows that self-care needs such as feeding, hygiene and clothing, understanding of the disease and therapeutic adherence are sensitive to nursing care. This process also allowed the development of the skills of Master in Science in Mental Health Nursing and Psychiatry. It is intended that this article contributes to promote self-care and rehabilitation process of patients in forensic psychiatry, favours debate, increases knowledge and improves the intervention in mental health.

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Attar, Osama. "Relationen mellan vårdaren och vårdtagaren inom rättspsykiatrin." Thesis, Linnéuniversitetet, Institutionen för socialt arbete (SA), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-35326.

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Syftet med uppsatsen har varit att undersöka hur anställda inom rättspsykiatrin ser på relationen mellan sig själva och vårdtagarna, samt att studera de olika aspekter som berör relationen i vårdandet, bland annat maktrelationen och vänskapsrelationen. Uppsatsen baseras på en kvalitativ studiemetod med semistrukturerade intervjuer. Nio stycken anställda vårdare (undersköterskor och skötare) från en avdelning inom rättspsykiatrin i Växjö deltar i studien. Resultatet visar att relationen mellan vårdare och vårdtagare är en viktig aspekt inom vården, och att relationen är basen inom vården för att kunna erbjuda bra vård till patienten. Intervjupersonerna menar att: En bra relation mellan vårdare och vårdtagare kännetecknas av att vårdaren ska kunna skapa förtroende, tillit i relationen, samt stödja och tillfredsställa patientens behov med hjälp av relationen. Studien belyser svårigheterna inom relationen mellan vårdare och vårdtagare samt de risker som kan förekomma. Resultatet visar även att en viss synlig och osynlig makt utövas; den makten är svår att definiera, personalen är delvis omedvetna om att de själva utövar makt dagligen.
The purposes of this essay are to examine how employees in a psychiatric ward experience the relationships between them and the caretakers, and to study the different aspects of relationships between them. For instance the power relation and the friend relation. The essay is based on a qualitative method with semi structured interviews from 9 employees, whom are nurses and caregivers at a ward in Växjö psychiatric institution. The results from this study illuminate that the relationship between caregivers and caretakers is a vital aspect of the care itself. And that this relationship is the foundation for caregiver to be able to offer necessary care. A good relationship between caregiver and caretaker is characterized by the abilities of the caregiver to create trust and confidence in their relationship to the caretaker, as well as supporting and satisfying the caretakers’ needs by help of their relationship. This study highlights the issues in the relationship between caregivers and caretakers as well as the risk that pertain to this relationship. The results indicate that certain power exertions overt and covert are factors in some relationships. These power exertion are, however, hard to define, the caregivers also seem partly unaware of them.

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Engström, Lotta, and Pia Pettersson. "Förutsättningar och hinder för patientdelaktighet i psykiatrisk tvångsvård : en integrativ litteraturöversikt." Thesis, Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-83066.

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Abstrakt Trots att det i Sverige finns lagar som säger att patienten så långt det är möjligt ska vara delaktig i sin egen vård, så verkar inte det vara fallet. Inom den psykiatriska tvångsvården är det ofta en obalans mellan personalen och patientens makt, därav vikten av att arbeta mot patientens delaktighet. Syftet med den integrerade litteraturöversikten var att sammanställa kunskap om patientdelaktighet vid sluten psykiatrisk tvångsvård. Följande frågor besvarades: Vilka förutsättningar för delaktighet finns i den slutna psykiatriska tvångsvården? Vilka hinder för delaktighet finns i den psykiatriska tvångsvården? Metod Integrerad litteraturstudie. Sökningar gjordes i tre databaser utifrån tre sökblock. Det resulterade i sexton artiklar som svarade mot syftet, två kvantitativa, en mixad metod och tretton kvalitativa. Inklusions kriterier: peer-review, engelska och inte äldre än tio år. Detta resulterade i sexton artiklar. Artiklar lästes igenom både enskilt och tillsammans, därefter vidtog dataextraktion där enheter togs ut som svarade mot syftet. Resultat: Analysen resulterade i elva kategorier, varav attityd, engagemang, relation och tvångsvård var mest framträdande. Det som kom fram är att för att det ska kunna jobbas utifrån patient delaktighet krävs det att personalen har en öppen, engagerad och ärlig attityd. Detta gör det möjligt att bygga en god relation mellan patient och personal, vilket i sin tur kan leda till patientdelaktighet. Slutsats Vad behövs för patientdelaktighet beror på vilken attityd man har. Är man som personal öppen, engagerad och ärlig då kan man bygga en relation till patienten och lägga grunden för patientdelaktighet

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Lund, Christian, and Jessica Revelj. "Vårdrelationen inom rättspsykiatrisk vård : -en litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-64631.

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Bakgrund: Patienter som vårdas enligt Lagen om Rättspsykiatrisk vård är dömda till vård. Vårdformen och de eventuella tvångsåtgärderna kan medföra att patienterna har svårt att uppleva tillit ifrån vårdpersonalen. Det är av vikt i rättspsykiatrisk vård verka för att skapa en trygg och tillitsfull vårdrelation. Syfte: Studiens syfte är att belysa aspekter som kan påverka vårdrelationen mellan patient och vårdpersonal inom rättspsykiatrisk heldygnsvård. Metod: Studien är en systematisk litteraturstudie där vetenskapliga artiklar med kvalitativ ansats söktes. Artiklar som överensstämde med studiens syfte genomgick en kvalitetsgranskning. Därefter genomfördes en kvalitativ innehållsanalys för att nå ett resultat. Resultat: Vårdrelationen inom rättspsykiatrisk vård påverkas av flera aspekter som redovisas i följande kategorier; Mötets möjligheter och svårigheter definierar vårdrelationen, Att införliva en hoppfull framtid genom att ge och ta emot stöd, Att förhålla sig till gränser med måttfullhet, Den rättspsykiatriska vårdmiljön i förhållande till vårdrelationen samt Vårdrelationens betydelse för rädsla och aggression. Slutsats: Genom en god vårdrelation kan patient tillsammans med vårdpersonal finna möjliga vägar att på ett gott sätt hantera vardagssituationer och de utmaningar som kan uppkomma. Om patienten med hjälp av den goda vårdrelationen ges möjlighet att lära om sig själv och sin sjukdom kan även andra relationer gynnas.
Background: Patients who are being cared for under Forensic Psychiatric care is ruled to this. The form of care and the possible coercive measures may lead to the difficulty of experiencing trust from the healthcare staff. It is important in Forensic Psychiatric care create a safe and trustworthy care relationship. Aim: The aim of the study is to highlight aspects that can affect the care relationship between patients and health professionals within forensic psychiatric care. Method: The study is a systematic literature review of scientific articles where articles with qualitative approach was searched. Articles that were consistent with the aim of the study underwent a quality audit based on a review template. Then a qualitative content analysis was conducted to achieve a result. Result: The care relationship in the forensic psychiatric care is influenced by several aspects that are reported in following categories; The opportunities and difficulties of the meeting define the care relationship, To incorporate a hopeful future by giving and receiving support, Relating to limits with moderation, The forensic psychiatric care environment in relation to the care relationship and The importance of care relationship to fear and aggression. Conclusion: A good care relationship between the patient and health professionals may identify possible paths to handle everyday situations and the challenges that may arise. If the patient is given the opportunity to learn about himself and his illness by means of the good care relationship, other relationships can also be benefited.

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Holmgren, Cecilia. "Forensisk omvårdnad inom akutsjukvård." Thesis, Sophiahemmet Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2283.

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Forensisk omvårdnad där ett relativt nytt begrepp i Sverige. Den utvecklades under 1980-talet i USA av Virginia Lynch och numera en del av grundutbildningen av sjuksköterskor i USA, det finnas även flera olika specialistsjuksköterskespår inom forensisk omvårdnad. Forensisk omvårdnad handlar om att knyta ihop den sedvanliga omvårdnaden med juridiska processer. Syftet med studien var att belysa den forensiska omvårdnadsprocessen inom akutsjukvård. Metoden som användes var en litteraturöversikt och inkluderade 15 vetenskapliga artiklar. Sökningarna gjordes i databaserna PubMed och CINAHL. Resultatet redovisas i utgångspunkt från tre rubriker: Identifiering av våldsutsatta personer, omhändertagande av de våldsutsatta patienterna och utbildning/träning. Resultatet visar att sjuksköterskor tycker att det är lättare att identifiera patienter som utsatts för våld när de har synliga fysiska skador. Sjuksköterskor upplever det svårt att fråga om våld på grund av deras arbetsmiljö. Likaså upplever sjuksköterskorna att de är otillräckliga kring omvårdnaden av de våldsutsatta. Sjuksköterskorna känner att de bara hinner utföra de mest akuta åtgärderna, sedan går patienten hem eller till någon annan vårdavdelning. Resultatet visar att sjuksköterskor vill få utbildning och träning i hur de ska bemöta, handlägga och var de kan hänvisa patienterna till fortsatt vård och behandling. De sjuksköterskor som har utbildning i forensisk omvårdnad ger en mer informativ behandling av de våldsutsatta patienterna, de kriminaltekniska prover som tas i samband med besöket är bättre utfört av de sjuksköterskor som har fått utbildning i detta än de sjuksköterskor som saknar utbildning. Slutsatsen är att sjuksköterskor på akutmottagningar känner en osäkerhet kring forensisk omvårdnad och utbildning/träning i ämnet är uttalat hos sjuksköterskor.

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Qvarfordt, Malin, and Louise Malmberg. "Hundar som ett komplement till omvårdnaden inom rättspsykiatrin - En kvalitativ studie om patienters upplevelser. : “Vi lever ju här tillsammans och hjälper varandra å, därför är det viktigt att hitta en form som passar alla.”." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-270304.

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Bakgrund: Studier visar att hundar har en positiv effekt på den fysiska hälsan. De kan också öka det sociala samspelet, minska depression, öka självförtroende och självbestämmande samt reducera ångest genom hundassisterad aktivitet eller hundassisterad intervention. Syfte: Syftet med denna studie är att undersöka om hundar inom ramen för omvårdnad på en rättspsykiatrisk avdelning kan påverka patienternas välbefinnande. Metod: För att undersöka patienternas upplevelser användes en kvalitativ studiedesign. För att besvara syfte och frågeställningar gjordes semistukturerade intervjuer som analyserades med en kvalitativ innehållsanalys. Resultat: Hundar på avdelningen upplevdes både positivt och negativt. De inverkade på välbefinnandet genom att de genererade glädje och välmående men också irritation och ilska. De gav också en känsla av att bli sedd som människa, ökade den fysiska aktiviteten, förbättrade sömnen och påverkade självkänslan och självförtroendet. Vårdmiljön påverkades också genom ett förbättrat klimat på avdelningen. De gav en meningsfullhet i vardagen, en möjlighet till närhet, en känsla av mindre kontrollerande miljö samt att de hade en inverkan på hur patienterna rörde sig på avdelningen. Det identifierades en ståndpunkt för hundar på avdelningen, men också en emot att ha hundar på avdelningen. Slutsats: Resultaten tyder på att det positiva överväger det negativa då majoriteten av resultatet belyser aspekter som ökar välbefinnandet hos patienterna. Hundar inom vården anses därför vara en bra komplementär omvårdnadsform för att som sjuksköterska på en rättspsykiatrisk avdelning. Detta för att kunna utföra god omvårdnad, främja välbefinnande och upprätthålla ett samhällsskydd och samtidigt reducera känslan hos patienten av att vara underordnad och kontrollerad. Det är dock viktigt att beakta olika individers åsikter för att hitta en form som passar.
Background: Studies have shown that dogs have a positive effect on humans physical health. They may also increase social interactions, decrease depression, increase peoples selfconfidence and autonomy and reduce anxiety trough animal-assisted interventions. Aim: The aim of this studie is to investigate if dogs can effect well-being in patients within forensic psychiatric care. Method: To investigate the patients experiences a qalitative reserch method were used. Semi-structured interviews were used to answer to the aim of the studie, and analysed with a content analysis. Result: The patients had both positive and negative experiences regarding the presence of the dogs at the unit. The dogs had an impact on the patients well-being by generating joy as well as anger and irritation. They gave a sense of being perceived as an individual, they increased physical activity, improved quality of sleep and had an inpact on self-esteem and self-confidence. The dogs also had an impact on the health facility environment trough an inprovement of the atmosphere at the unit. The dogs gave sense of mening in the everday life, an opportunity for intimacy, a sense of a less controlling environment and they also had an impact on how the patients moved at the unit. Some where proponents and some opponents to the impementation of dogs at the unit. Conclusion: The results shows that the positive experiences tops the negative because the majority of the results shows aspects of improved well-being. Dogs within healthcare facilities are therefore concidered to be a good complementary form of care for nurses working in forensic psychiatric care. This to perform good nursing care, promote well-being and maintain the civil protection and at the same time reduce feelings of being inferior, subordinated and controlled. It is however important to pay regards to the different idividual opinions and find a resolution that suits best.

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Nordlund, Therese, and Katarina Larsson. "Patienters upplevelser av delaktighet i rättspsykiatrisk vård." Thesis, Luleå tekniska universitet, Institutionen för hälsovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-77394.

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Bakgrund: Forskning visar att ökad delaktighet leder till en högre vårdkvalitet, men studier visar på brister i patientdelaktigheten. Syfte: Syftet med denna studie var att beskriva patienters upplevelse av delaktighet inom rättspsykiatrisk heldygnsvård. Metod: Examensarbetet har en kvalitativ metod med induktiv ansats och analyserades utifrån en kvalitativ innehållsanalys. Sju patienter med erfarenheter av att vårdas inom rättspsykiatrisk heldygnsvård intervjuades genom semistrukturerade intervjuer. Resultat: Analysen resulterade i tre slutkategorier; ”Att ingen lyssnar och informerar”, ”Att vara fast i en miljö styrd av lagar och regler”, ”Att tillitsfulla relationer ger styrka”. Det som hindrar delaktighet beskrivs av deltagarna som att inte känna sig lyssnad på, inte bli bemötta utifrån den person de är och att vara fast i en miljö som styrs av lagar och regler. De känner sig begränsade i vården och tycker det är svårt att ta sig framåt. Det som underlättar delaktighet upplevs kopplat till tillitsfulla relationer som avgörande för att kunna känna att man har kontroll och makt över sitt liv. Slutsats: Resultatet bidrar med en fördjupad förståelse av betydelsen av delaktighet i rättspsykiatrisk vård, och vad som kan hindra och underlätta den. Delaktighet är något som patienterna inte tar för givet och vården behöver utveckla förståelse för relationens betydelse som är helt avgörande för vilka möjligheter patienten får till delaktighet och återhämtning. Den rättspsykiatriska vården skulle kunna utvecklas i en riktning mot ökad delaktighet med hjälp av personcentrerad vård.

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Aronsson, Jenny, and Josefin Huisman. "Forensisk omvårdnad : Sjuksköterskans upplevelser av att vårda brottsoffer och gärningsmän." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-41341.

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Bakgrund: Forensisk omvårdnad kan beskrivas som länken mellan sjukvård och rättssystem. Sjuksköterskans uppgift inom den forensiska omvårdnaden innebär att hålla ett opartiskt förhållningssätt som främjar patientens rättigheter och en eventuell påföljande rättsprocess. I mötet mellan patient och sjuksköterska ger kunskap om forensisk omvårdnad en möjlighet till samhörighet som skapar god omvårdnad och minskat lidande. Syfte: Syftet var att skildra sjuksköterskors upplevelser och erfarenheter av att arbeta med forensisk omvårdnad inom sjukvården. Metod: Metoden var en allmän litteraturstudie som innefattade tio artiklar. Databearbetning genomfördes med kodning och tematisering och sammanställdes senare till ett resultat med teman och subteman. Resultat: Resultatet delades in i tre huvudteman som var Sjuksköterskans emotionella börda, Forensisk Omvårdnad – utmanande och krävande och Kunskap som brist och tillgång. Därefter tillkom tre subteman Sjuksköterskans hantering av den emotionella bördan, Omvårdnad av familj och Omvårdnad av gärningsmän. Sjuksköterskan upplevde en stor emotionell påverkan av att arbeta med våldsutsatta patienter och belyste behovet av utökad kunskap för att kunna vårda patienter inom forensisk omvårdnad optimalt. Slutsats: Studien tydliggjorde hur den emotionella bördan till följd av forensisk omvårdnad påverkade sjuksköterskan och därmed vårdkvaliteten negativt. Sjuksköterskans upplevelser visade på ett stort behov av kunskap inom området för att samhörigheten mellan sjuksköterska och patient ska kunna växa fram och bidra till att lindra patientens lidande.

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Löfgren, Lisa, and Lisa Rexin. "Sjuksköterskans erfarenheter av forensisk omvårdnad på en akutmottagning : en kvalitativ intervjustudie." Thesis, Sophiahemmet Högskola, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1516.

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Bakgrund Forensisk omvårdnad involverar kontakt med brottsoffer, misstänkta, förövare och vittnen till våld. Att bli utsatt för brott kan medföra både fysiska och psykiska konsekvenser och det skiljer sig individuellt hur en person reagerar efter att ha blivit utsatt för ett brott. Ett brottsoffer ska behandlas med medkänsla och respekt och har rätt till nödvändig materiell,medicinsk, psykisk och social hjälp av frivilliga eller offentliga organ. Tidigare forskning visar att hälso-och sjukvårdspersonal saknar kunskaper rörande patienter med ett forensiskt omvårdnadsbehov vilket kan leda till att dessa patienter inte får den omvårdnad de är i behov av. Att ha personal med kunskaper inom ämnet är viktigt för att kunna känna igenoch uppmärksamma symtom och tecken på våld och psykologiska reaktioner. Syfte Syftet var att beskriva sjuksköterskors erfarenheter av forensisk omvårdnad på en akutmottagning. Metod En kvalitativ intervjustudie användes som metod. Det genomfördes sex intervjuer med sjuksköterskor som var mellan 31 och 51 år gamla. Alla deltagare var verksamma på en akutmottagning och hade olika erfarenheter kring mötet med patienter med ett forensiskt omvårdnadsbehov. Samtliga intervjuer spelades in, transkriberades och analyserades sedan med en kvalitativ innehållsanalys. Resultat I resultatet framträdde två huvudområden. Dessa var upplevelser i mötet med brottsoffer och gärningsmän samt sjuksköterskans erfarenheter rörande forensisk omvårdnad.Gemensamt för de två huvudområdena var att sjuksköterskorna såg ett behov av utbildning. I resultatet framkom att sjuksköterskorna tycker att det i och med det korta patientmötet är svårt att hinna se till hela patienten. Även patienters varierande psykiska reaktioner sågs som en svårighet att bemöta. Resultatet visade också att det finns en skillnad i bemötandet mellan kvinnor och män som kommer från en brottssituation. Det framkom dessutom att det råder en osäkerhet kring rutiner och riktlinjer rörande patienter med ett forensiskt omvårdnadsbehov samt att det finns ett behov av reflektion hos personalgruppen. Slutsats Sjuksköterskorna ser och känner ett behov av vidare utbildning inom ämnet forensisk omvårdnad. Dels för att förbättra omhändertagandet av den forensiska patientgruppen men också för att uppmärksamma begreppet forensisk omvårdnad

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Örnberg, Emma. "Forensisk omvårdnad: när sjukvården möter rättsväsendet." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-106718.

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Bakgrund: Forensisk omvårdnad är kedjan mellan rättsväsendet och sjukvården. Omvårdnaden innefattar att omhänderta bevis, dokumentera skador och tillvarata patientens mänskliga och lagliga rättigheter. Syfte: Syftet var att beskriva sjuksköterskors erfarenheter inom forensisk omvårdnad. Metod: En systematisk litteraturstudie med kvalitativ ansats där tolv artiklar analyserades och bearbetades. Resultat: I resultatet kom följande fyra olika teman fram; Att identifiera patienter utsatta för våld; Att omhänderta bevis; Att inneha kunskaper inom forensisk omvårdnad och Att det uppstår negativa känslor i omvårdnaden av forensiska patienter. Det är svårt för sjuksköterskor utan utbildning i forensisk omvårdnad att identifiera dessa patienter och ge dem rätt omvårdnad. Dessa patienter kräver ett tryggt och empatiskt omhändertagande utan fördomar eller en förförståelse som hindrar en god omvårdnad. Patienterna känner ofta en skam eller skuld, vilket sjuksköterskor måste ta hänsyn till. Utbildning inom forensisk omvårdnad är viktigt för att patienterna ska erhålla ett korrekt omhändertagande och för att sjuksköterskorna ska känna en trygghet i att vårda dessa patienter. Slutsats: Våldsbrott är ett ökande samhällsproblem och genom forensisk omvårdnad kan sjuksköterskor hjälpa till att fälla gärningsmän och upptäcka och förebygga våldsbrott. Detta kräver utbildning inom forensisk omvårdnad för sjuksköterskor.

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Castañeda, Elin, and Espili Narges Hassani. "Att vårda med bakbundna händer : en litteraturstudie om vårdares erfarenheter av att vårda i en rättspsykiatrisk vårdkontext." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-2033.

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Dissertations / Theses on the topic 'Forensic nursing'

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