Dissertations / Theses on the topic 'Psychiatry in literature'

Twenty seven consecutive black male patients who were admitted as acute admissions to FEH were examined in this thesis. The following demographic information characterized the sample group. a) Age: Bimodal distribution with peaks at 21-25 years and 31-35 years. Five patients were older than 35 years. b) Marital Status: In the sample. 59.2% were single. 11.1 % married and 29.6% the marital status was unknown. c) Number of Children: In the sample. 75% did not know how many children they had. Numbers ranged from no children (14.3%) to 2 children (7.1% of the sample). d) Employment Status: In the sample 81 .1 % were unemployed. e) Level of Schooling: In one third of cases, level of schooling was unknown. Most men did reach secondary level of education.

This thesis examines the theme of women’s madness in the 1960s and 1970s through the works of four English and French writers and film-makers: Chantal Akerman, Emma Santos, Jane Arden and Mary Barnes. It examines how these four writers and film-makers inscribe madness into their texts from a sociological angle, presenting the texts and films discussed as socio-historical artefacts while analysing each writer and film-maker’s representation of women’s madness. Inspired by psychologist Phyllis Chesler, who argues that madness is tied to socially defined gender roles and used to demarcate violations of expected gendered behaviour, this research analyses various manifestations of ‘madness’ from the everyday madness of Chantal Akerman, to psychiatrically incarcerated madness in the texts of Emma Santos, to madness influenced by anti-psychiatry through the works of Jane Arden, to complete immersion in anti-psychiatry with Mary Barnes. The interdisciplinary and cross-cultural nature of this thesis combines fields from both English and French studies, from the study of female writers and film-makers, psychoanalytic theory, the history of psychiatry and how they intersect with gender combined with contemporary feminist writings of philosophy, psychology, and theology.

Previous discussions of the category of homosexual panic have tended to dismiss it as anachronistic or homophobic. In contrast to these approaches, this thesis takes the term more seriously, arguing for its structural necessity to particular instances of literature, psychiatry and law in the United States. This interdisciplinary endeavor tracks the histories of the term, examining the impact of homosexual panic on contemporary understandings of sexuality, time and personhood. Adopting a Foucauldian framework, the chapters avoid offering a singular definition of homosexual panic in order to articulate the forces that historically make sense of the category. Divided into three sections, each organized around one of the areas in which homosexual panic occurs (literature, psychiatry and law), the thesis returns to the primary texts on homosexual panic, reading them against their source texts and in the context of current approaches to homosexual panic within the field of sexuality studies. In the literature section, I focus on Eve Kosofsky Sedgwick's appropriation of the term in Between Men and Epistemology of the Closet, reading this against her sources (both literary and critical) including Henry James' 'The Beast in the Jungle,' Gayle Rubin's 'The Traffic In Women,' James Hogg's Confessions of a Justified Sinner and contemporary uses of Sedgwick's concept in P.J. Smith's Lesbian Panic. The chapters explore the imploded time of homosexual panic to expand upon theorizations of temporality by queer scholars, including Lee Edelman, Judith Halberstam and Elizabeth Freeman. Secondly, the psychiatry section reads the origin of homosexual panic in Edward Kempf's 1920's text Psychopathology in context with its dismissal in 1980's psychiatric articles. Here, the mythologization of Kempf is read as establishing the American Psychiatric Association as coherent. Developing a theory of myth from psychoanalytic theorist, Shoshana Felman, the section creates alternate possible histories of homosexual panic through close readings of parallel concepts like Freud's derealization and Roger Caillois' dark space. Thirdly, the legal section offers close readings of Cynthia Lee's 'The Homosexual Panic Defense' and two court cases, the murder of Matthew Shepard and the trail of John Stephan Parisie, to articulate the components of the Homosexual Panic Defense (HPD). The chapters suggest that arguments against the HPD work by upholding panic-structures of revelation, outing and latency, while failing to address how homosexual panic is prefigured in certain versions of the U.S. Law. These readings show how homosexual panic has become an example of, and strategy for, people living moments 'beside' their literary, psychiatric and legal selves. I call these moments 'paratime', which, I argue, enables new queer theorizations of concepts constituting these fields. By showing how homosexual panic structures queer time in literature, mythology in psychiatry and truth in law, the thesis demonstrates the influence of homosexual panic on the terms placed at the center of each field. The conclusion argues that homosexual panic troubles the centrality of these concepts and, invoking Judith Butler, proposes alternate modes of theorization that enable us to recognize how particular lives continue to be made unlivable.

Background: While cognition is the dominant view of understanding in psychology, there appear to be few occupational therapy interventions within this field that are cognitive. Objective: A systematic literature review was conducted to identify how occupational therapists work with interventions that are cognitive in the field of psychiatry and mental health internationally. Methods: Searches were conducted in the Academic Search Elite, CINAHL, PubMed, OVID Medline, Google Scholar, AMED, OTSeeker, PsycInfo and Cochrane Library databases between the years 1997 to 2017 and identified 21 publications for inclusion. Results: Three themes were identified and consequently discussed: Occupational therapy as a cognitive intervention, specifically named as cognitive interventions used by occupational therapists and multi-professional cognitive interventions. Conclusions: The findings indicate that interventions used by occupational therapists on a broad range of psychiatric diagnoses contain everyday occupations such as cooking, grocery-shopping and occupations meaningful to the client. These occupations are the notion of occupational therapy while simultaneously improving the cognition and can be considered to be cognitive. This connection needs to be researched further in the future. Significance: Occupational therapy interventions can be considered to improve on cognition and are therefore important in psychiatry and mental health.

The year 2012 was a year of great controversy surrounding autism in France. Thus it is an ideal time for an investigation of the treatment of and attitudes about autism in France, specifically in comparison with the United States. This investigation encompass several specific categories, and the Freudian psychoanalytic method against the behavior modification method, the French education system and the identification of autism, "Maternal Madness" - the connection between sexism and autism, the philosophy of humanity and the history of medical experimentation and psychiatry in France. This paper questions how is it that all these categories influence the opinions and and treatment of autism in France and what importance these attitudes have in French society.

This thesis centres on the intersection between four French nineteenth-century novels and the writings of the Scottish psychiatrist R.D. Laing, work which appeared in the 1960s and early 1970s and which has been given the label ‘anti-psychiatric’ because of its hostility to established psychiatric practices. The aims of this thesis are, firstly, to demonstrate that a congruence of concerns exists between the two domains in spite of the wide distance which may seem to separate them, and secondly, to argue the case for using Laingian anti-psychiatry as an analytical framework within which to examine the de-motivated turning point of each novel - for example why Julien Sorel attempts to kill Madame de Rênal in Le Rouge et le Noir or why Claude Lantier commits suicide in Zola’s L’Œuvre. In chapter one, I lay out the founding principles of the anti-psychiatry movement as well as its many shortcomings, focusing on the work of Laing and his involvement in the ill-fated anti-psychiatric therapeutic community at Kingsley Hall in London. I argue that although anti-psychiatric practice has today fallen into disrepute among mainstream psychiatric clinicians, in part because of the failings of Kingsley Hall, it nonetheless offers a fruitful if vastly under-utilised interpretative framework within which to analyse literary texts. In chapter two, I demonstrate the relevance of anti-psychiatric theory to the four novels under consideration by means of an analysis of the de-motivated turning point of each novel. I argue that the congruence of concerns shared by anti-psychiatry and the four novels centres on foregrounding notions of authenticity and on questioning received views of madness. I also outline in the conclusion to this chapter a series of questions which ask why the main protagonist of each novel, much like the schizophrenic as described by Laing, acts in a manner which is seemingly inexplicable and contrary to their self-interest, particularly at the moment in the text when it is least expected or least ‘vraisemblable’. In the third chapter, I review the approaches other critics have taken to these questions, enabling me to propose that there does indeed remain room for a Laingian anti-psychiatric approach.

Bakgrund: Lag om psykiatrisk tvångsvård innebär att sjukvården har rätt att ta bort självbestämmanderätten från en individ om denne lider av en allvarlig psykisk störning. Restriktioner och tvångsåtgärder som tvångsmedicinering, avskiljning och fastspänning kan förekomma. Syfte: Syftet är att belysa hur patienter upplever tvångsåtgärder inom psykiatrisk vård. Metod: En allmän litteraturstudie baserad på 12 vetenskapliga artiklar med kvalitativ ansats. Antonovskys Känsla av sammahang har använts som teoretisk referensram. Resultat: Det framkom att patienter generellt upplevde tvångsåtgärderna som negativa. Åtgärderna väckte en rad olika känslor hos patienterna såsom obehag, rädsla och förlorad autonomi, även återuppväckta minnen förknippade med våldtäkt och andra trauman. Det var många patienter som hade svårt att förstå varför dessa åtgärder utfördes, vilket visade sig som brister i kommunikationen mellan patient och sjuksköterska. Patienterna uttryckte önskan om att få utnyttja sin medbestämmanderätt, själva påverka tvångsåtgärderna och eftersökte en närmare relation till vårdpersonalen. Även om tvångsåtgärderna i största utsträckning var en negativ upplevelse så fanns det patienter som förstod att det var för deras eget bästa liksom för andra patienters och personals säkerhet. Slutsats: Patienterna rapporterade att de ville bli informerade, förstådda och bemötta som medmänniskor med respekt och inte behöva känna sig ensamma och övergivna. Tvångsåtgärder och lidande kan lindras genom att personal utvecklar sitt aktiva lyssnande och kunskap genom att ge adekvat information. Klinisk betydelse: Ökad förståelse för patienter som utsatts för tvångsåtgärder kan ge sjuksköterskor möjligheten att stärka patientens känsla av sammanhang vid tvångsåtgärder genom ökad begriplighet, hanterbarhet och meningsfullhet. Nyckelord: KASAM, tvångsåtgärder, patient upplevelse, psykiatrisk vård & litteraturstudie
Background: The Compulsory Psychiatric Care Act means that healthcare is entitled to remove the autonomy of an individual if he or she suffers from a serious mental disorder. Coercive measures may occur, such as forced medication, isolation and physical restraint. Aim: The aim is to illustrate how patients experience coercive measures in psychiatric care. Method: A literary review based on 12 scientific articles with qualitative approach. Antonovskys Sense of coherence has been used as a theoretical framework. Result: The results show that patients experienced coercive measures as negative. The measures provoked feelings in patients, such as discomfort, fear and loss of autonomy. There were patients who had trouble understanding why these measures were performed, which showed flaws in communication between patient and nurse. The patients expressed the desire to use their right to co-decide, to influence the measures and sought a closer relationship to the caregivers. Although the coercive measures were found to be a highly unpleasant experience, there were patients who understood that it was in their best interests. Conclusion: The patients reported that they wanted to be informed, listened to and treated with respect, and not have to feel alone and abandoned. Coercive measures and the associated suffering could be alleviated by active listening from the staff and the skills to provide adequate information. Clinical Implications: Increased understanding of patients subjected to coercive measures can give nurses the opportunity to strengthen the patients’ sense of coherence when exposed to coercive measures, by increasing their comprehensibility, manageability and meaningfulness.  Keywords: SOC, coercive measures, patient experience, psychiatric care & literature review

INTRODUÇÃO: As humanidades médicas têm sido cada vez mais valorizadas mundialmente. No entanto, são poucos os estudos psiquiátricos nessa área no Brasil. A obra de Lima Barreto (1881-1922) reveste-se de importância para o psiquiatra pelo fato de este escritor ter tido grande contato com o meio psiquiátrico de sua época, em virtude da doença mental de seu pai e de seu quadro de alcoolismo, que motivou duas internações no Hospício Nacional de Alienados do Rio de Janeiro. Neste trabalho, procuramos relacionar a obra de Lima Barreto ao contexto histórico da psiquiatria e à sua biografia, testando ainda a hipótese de que o autor tenha apresentado declínio cognitivo expresso na elaboração de sua última obra, em virtude do alcoolismo. MÉTODOS: A obra do autor foi pesquisada, sendo analisadas as representações de doença mental. Como referencial teórico, utilizou-se os conceitos de carnavalização e de cronotopo de Mikhail Bakhtin. Foi usado, ainda, um software (WordSmith tools 3.0) para encontrar variáveis linguísticas que pudessem ter relação com declínio cognitivo do autor. RESULTADOS: Nas primeiras obras, há tendência para caracterizar a doença mental de forma idealizada ou caricatural; nas últimas, de forma mais naturalista e objetiva. Os percursos dos personagens dos últimos romances têm tendências mais fatalistas, com menor grau de mudança psicológica dos personagens, quando comparados com os romances iniciais. Com os relatos do autor sobre sua internação, tem-se acesso a uma descrição das condições do Hospício Nacional de Alienados, de seus internos e do caráter das internações. Observou-se, também, menor diversidade lexical na última obra do autor, aferido pelo software. CONCLUSÕES: A obra de Lima Barreto é uma fonte representativa para aqueles que estudam história da psiquiatria brasileira do início do século XX e fornece elementos diversos daqueles presentes em vários estudos, principalmente ligados a ideologias críticas à psiquiatria. As diferenças nas representações da doença mental no início e no fim da obra provavelmente refletem elementos biográficos e psicológicos do autor. O achado de menor diversidade lexical presente na última obra pode ter relação com declínio cognitivo do autor.
INTRODUCTION: The medical humanities have been increasingly valued worldwide. However, there are few psychiatric studies in this area in Brazil. The work of Lima Barreto (1881-1922) is important to the psychiatrist because this writer had great contact with the psychiatric medium of his time, because of his father\'s mental illness and because of his picture of alcoholism, which led him to two hospitalizations in the National Asylum for the Insane in Rio de Janeiro. In this paper we try to relate the work of Lima Barreto to the historical context of psychiatry and his biography, testing also the hypothesis that the author had cognitive decline expressed in the preparation of his latest book, due to alcoholism. METHODS: The author\'s work was investigated, and the representations of mental illness analyzed. The theoretical framework used included Mikhail Bakhtin\'s concepts of chronotope and carnivalization. It was also used a software (WordSmith tools 3.0) to find linguistic variables that could be related to cognitive decline of the author. RESULTS: In early works, there is a tendency to characterize mental illness in an idealized or caricatured way, and in the late ones, in a more naturalistic and objective way. The paths of the characters in later novels have more fatalistic tendencies, with lower levels of psychological change of the characters, when compared to the early novels. With the reports of the author on his admission in the psychiatric hospital, we have access to a description of condition of the National Asylum for the Insane, its internals and the character of admissions. It was also observed that there was less lexical diversity in the last work of the author, as measured by the software. CONCLUSIONS: Lima Barreto\'s work is a representative source for those studying the history of psychiatry of the early twentieth century and provides different elements compared to those present in several studies, mainly linked to ideologies critical to psychiatry. The differences in the representations of mental illness at the beginning and the end of the work probably reflect biographical and psychological elements of the author. The finding of lower lexical diversity present in the latest work may be related to cognitive decline of the author.

Bakgrund: Återhämtning är ett begrepp som tolkas på olika sätt i den psykiatriska vården eftersom det saknas konsensus i frågan. De flesta definitionerna framhåller patientens egna erfarenheter av vad hen finner hjälpsamt för att skapa en meningsfull tillvaro, även vid kvarvarande psykiska symtom. Återhämtning har beskrivits som ett återtagande av makten över sitt liv. I studien används termen psykiatriska tillstånd vilket innebär diagnostiserade, allvarliga former av psykisk ohälsa. Syfte: Syftet var att beskriva vuxna patienters erfarenheter av den egna återhämtningsprocessen vid psykiatriska tillstånd. Metod: Studien är en litteraturöversikt baserad på tio kvalitativa artiklar. Dessa analyserades med hjälp av en konceptuell modell från Phil Barkers tidvattenmodell; de tre domänerna “Självet”, “Världen” och “Andra”. Tidvattenmodellen användes också som teoretisk utgångspunkt i diskussionen.   Resultat: Patienterna beskrev personliga erfarenheter av återhämtning ur individuella, relationella och samhälleliga perspektiv. Faktorer som främjade återhämtningsprocessen var försoning, kunskap, omtolkning av livsberättelsen, ansvarstagande samt goda relationer till närstående, familj och vårdpersonal. Faktorer som försvårade återhämtningsprocessen var förlust av identitet, stigmatisering samt brist på information och delaktighet. Diskussion: Utifrån resultatet diskuterades tre teman; “acceptans”, “delaktighet vid beslutsfattande” och “patienters behov av ömsesidiga relationer”. Områdena problematiserades genom att knytas an till tidvattenmodellen samt arbetsmodellen “delat beslutsfattande” (Shared Decision Making, SDM). Dessutom diskuterades det sociala nätverkets betydelse i återhämtningsprocessen.
Background: Recovery is a concept that is interpreted differently in psychiatric care since there is no consensus about the issue. Most definitions emphasize the patient's own experiences of what he/she finds helpful in creating a meaningful life, despite any remaining psychological symptoms. Recovery has been described as a reclamation of power over one’s life. This study uses the term psychiatric conditions, which means diagnosed, serious forms of mental illness. Aim: The aim was to describe adult patients' experiences of their own recovering process in relation to psychiatric conditions. Method: The study is a literature review based on ten qualitative articles. These were analyzed using a conceptual model from Phil Barker's tidal model; the three domains of "Self", "World" and "Others". The tidal model was also used as a theoretical framework in the discussion. Results: Patients described personal experiences of recovery from individual, relational and societal perspectives. Factors that promoted the recovery process were reconciliation, knowledge, reinterpretation of one’s life story, responsibility, as well as good relations with close relatives, family and healthcare professionals. Factors that complicated the recovery process were loss of identity, stigmatization and lack of information and participation. Discussion: Based on the outcome, three themes were discussed; "Acceptance", "participation in decision making" and "patients' need for reciprocity in relationships". These areas were problematized by being linked to the tidal model and the Shared Decision Making (SDM) working model. In addition, the importance of social networking in the recovery process was discussed.

Women are twice as likely as men to become depressed. While they seek help for mental disorders more often than men, they also seek to help others, trying to keep everyone happy while taking care of parents, spouses, and children. Sometimes, doing it all is doing too much. In Finding Your Emotional Balance, Dr. Merry Noel Miller offers women of all ages advice for coping with life’s challenges while increasing its joys. Drawing on her three decades of experience as a psychiatrist specializing in women’s mental health―as well as her own personal struggles with depression and grief―she explains the special vulnerabilities and strengths of women during adolescence, the childbearing years, menopause, and late in life. Dr. Miller opens each chapter with stories about women who are dealing with issues related to their stage in life. She discusses common mental disorders in the context of life stages, exploring the symptoms of depression, anxiety, substance abuse, bipolar disorder, and unresolved grief. She also offers a variety of remedies, suggesting medical and non-medical approaches to finding emotional balance even in the most stressful times. Each chapter ends with a list of suggested readings and websites.
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Objectives: The process of service intensity (SI) or level of care (LOC) determination regarding mental health services has a problematic history. There is a need for reliable and valid SI/LOC determination tools for youth in the child welfare system. Methods: In 2004 and 2005, the Tennessee Child Program Outcome Review Team (CPORT) reviewed 437 children and youth in the child welfare system (277 in state custody, 160 at risk of custody) of whom 61.6% were male, 64.8% Caucasian and 28.4% African American. Instruments used included the CASII, CAFAS, CBCL, YSR, TRF, and the CPORT Child and Family Indicators. Results: All CASII subscales significantly correlated to the CAFAS Total Scores (Pearson coefficients 0.225 to 0.454). The CASII Total Score and the CASII SI determinations were highly correlated to CBCL, YSR, and TRF total and sub-scales. Significant correlations between the CASII SI determinations were found across all of the 13 CPORT Child and Family Indicators, while actual placement significantly correlated with only three of the 13 dimensions. The actual SI/LOC placements were significantly divergent from the placement recommendations derived using the CASII instrument (p < 0.000) with the majority of CASII SI/LOCs recommendations being for less restrictive placements. Conclusions: The CASII SI/LOC tool demonstrates high levels of reliability and validity in multiple care contexts, including child welfare, juvenile justice, and mental health settings. Expanded use of the CASII could potentially result in less restrictive, more appropriate, and less costly services becoming available to youth in these systems.

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.

Fenomenologin har sin grund inom filosofin och intresserar sig för att studera upplevelser och upplevelsen av personens mening, hur personen upplevde en viss händelse och vad personen upplevde. Syftet med den här studien är att studera den versionen av fenomenologi som beskrivs i kurslitteraturen som användes på kandidatprogrammet Socialpsykiatri på Malmö Universitet. Studien är en kvalitativ litteraturstudie. Fenomenologerna är intresserade av att gå tillbaka till själva upplevelsen och studera individens livs erfarenheter av respektive fenomen. Fenomenologin vill studera fenomen och upplevelser för att få ett holistiskt perspektiv av individen. Vid arbete med psykisk ohälsa vill fenomenologerna att den professionella ska ta hänsyn till personens egna livserfarenheter.
Phenomenology is based on philosophy and is interested in studying experiences and the experiences of the person´s meaning, how the person experienced a certain event and what the person experienced. The purpose of this study is to study the version of phenomenology described in the course literature used in the bachelor's program Social Psychiatry at Malmö University. The study is a qualitative literature study. The phenomenologists are interested in going back to the experience itself and studying the individual's life experiences of each phenomenon. Phenomenology wants to study phenomena and experiences in order to get a holistic perspective of the individual. When working with mental illness, the phenomenologists want the professional to take the person's own life experiences into account.

Bakgrund: Det framkommer centrala aspekter vid omvårdnaden av patienter som skadar sig själva som i sin tur ställer krav på vårdpersonalens förmåga att förhålla sig till mötet med dessa patienter. Syfte: Syftet med litteraturstudien var att belysa psykiatrisk vårdpersonals upplevelser i mötet med patienter som skadar sig själva. Metod: En systematisk litteraturstudie baserad på Evans analysmetod och resultatet grundar sig på 22 artiklar av kvalitativ ansats. Resultat: Vårdpersonalens möten med patienter som skadar sig själva redovisas sex teman; Att utmanas av negativa känslor, Att stänga av sin empatiska förmåga, Att vara osäker på vad som komma skall, En svår balansgång, Ett gynnsamt möte och Professionell utveckling. Slutsats: Resultatet visade på att vårdpersonal i psykiatrisk vård har att hantera flera negativa känslor i sina möten med patienter som skadar sig själva. Kontinuerlig fortbildning och handledning framstår som nödvändiga förutsättningar för att möjliggöra gynnsamma möten med patientgruppen.
Background: It appears to be central aspects regarding the care of patients who self-harm and these aspects set requirements on psychiatric health care personnel's ability to relate to the meeting with the patients. Aim: To illustrate psychiatric health care personnel's experiences of meeting with patients who self-harm. Method: A systematic literature review based on a method described by Evans with a result based on 22 articles of qualitative design. Result: To meet patients who self-harm can be seen out of the six themes described in the result of the present study; To be challenged by negative emotions, To disconnect from your empathic ability, To be unsure of what´s to come, A difficult balancing act, A favorably meeting and Professional development. Conclusion: The result of the present study shows that the negative emotions were prominent. Continuous further training and tutorial appears necessary conditions to enable favorable meetings with the patient group.

Background: Health care settings are generally regarded as stress inducing environments. Stress can alter the immune response, impair wound healing and create a greater risk for asthma, diabetes, gastrointestinal disorder and myocardial infarction. Beginning in the 1980s and 1990s, there has been increasing interest in healing environments and evidence-based design concepts. Yet, there has been little progress developing healing environments and using evidence-based design for psychiatric inpatient units, a uniquely stressful environment. Psychiatric units today continue to use designs such as caged in outdoor patio areas that resemble facilities that incarcerate rather than facilities which reduce stress and facilitate healing. The purpose of this systematic literature review was to identify design features that are evidence-based which can be used to create an optimal inpatient psychiatric patient room by: (1) analyzing the research literature for evidence of architectural and design elements that could be used in the inpatient psychiatric care setting to reduce stress and improve the well-being; (2) identifying design elements that are consistent with accreditation and licensing standards for inpatient psychiatric units; and (3) designing a psychiatric inpatient room that has evidence-based elements to reduce stress and improve well-being. Methods: A systematic literature review was conducted to identify factors in the inpatient healthcare environment that support an optimal healing environment. The PICO question for this review was what design factors in the inpatient healthcare environment support an optimal healing environment? A search of five databases and a hand search of reference lists were conducted. The search included studies from 1980 to the present, original research conducted on inpatient units with adult patients that investigated an intervention with an outcome that promotes a healing environment. Experimental, quasi-experimental, non-experimental, systematic literature reviews and expert opinions were sought and evaluated using a scale to analyze scientific rigor and research quality. Results: A total of 6,874 articles were identified in the search. Seventy-six articles were eligible for full text screening. After review of the full text, 38 articles were determined to be eligible for evidence analysis. After removing 11 inadmissible articles due to poor quality, 27 articles were included in the final synthesis. The search found research on eight hospital design features which may support optimal healing environments: artwork (n = 7), building configuration (n = 2), finish materials (n = 7), interior details (n = 6), lighting (n = 11), nature and view (n = 8), noise (n = 10), room configuration (n = 6). More than 50% of the research on optimal healing environments used quasi-experimental and non-experimental designs with rare use of experimental research designs. Overall, the quality of the research on optimal healing environments is not high, but results were reasonably consistent across studies. Conclusions: Evidence suggests seven design features for healing inpatient psychiatric environments, including: (a) single rooms, (b) calm, naturalistic and domestic artwork or photographs, (c) east facing windows, (d) plants, (e) acoustic ceiling tiles, (f) patient rooms removed from noise producing unit areas and (g) a window view of nature. These seven recommendations were examined for consistency with existing Arizona statutes and industry standards for behavioral health care environments. Recommendations found to be inconsistent with these statutes and standards were modified to reach congruency with the statutes and guidelines, and then an evidence-based design of a psychiatric inpatient room design was formulated and is illustrated. Future research on interventions to create healing environments at the greatest scientific rigor is needed along with measurement techniques to quantify stress responses to the environment.

Bakgrund: Personer med psykisk ohälsa har en ökad risk för metabola sjukdomar till följd aven ohälsosam livsstil. Ett sätt att motverka dessa risker är genom fysisk aktivitet. Det är därförangeläget att undersöka vilket vetenskapligt stöd som finns för hur fysisk aktivitet kan stärkapatienters hälsa inom psykiatrisk slutenvård. Syfte: Studiens syfte var att undersöka förutsättningar och metoder för, samt hälsoeffekter av,egenvård i form av fysisk aktivitet för patienter inom psykiatrisk slutenvård. Metod: Studien är en litteraturöversikt med kvantitativ ansats där 13 vetenskapligaoriginalartiklar granskades och sammanställdes. Resultat: Fem övergripande teman identifierades, Motivation, Stöd, hjälp och råd,Utbildning, Fysiska hälsoeffekter samt Psykologiska hälsoeffekter. Resultatet pekar på mångasomatiska och psykiska fördelar med regelbunden fysisk aktivitet hos patienterna samt attriskfaktorer för metabola sjukdomar minskades. Depressiva och positiva psykotiska symptomminskades. Patienter som var generellt mer fysiskt aktiva vårdades mindre tid i slutenvårdenjämfört med dem som inte var fysiskt aktiva. Slutsats: Fysisk aktivitet har potential att komma till stor nytta för patienterna och det går attstärka deras hälsa på flera olika sätt med hjälp av fysisk aktivitet.
Background: People with mental illness have an increased risk of metabolic diseases as a result of an unhealthy lifestyle. One way to counteract these risks is through physical activity. It is therefore important to investigate what scientific support there is for how physical activity can strengthen patients' health in psychiatric inpatient care. Aim: The aim of the study was to investigate the conditions and methods for, and health effects of, self-care in the form of physical activity for patients in psychiatric inpatient care. Method: The study is a literature review with a quantitative approach where 13 scientific original articles were reviewed and compiled. Results: Five overall themes were identified, Motivation, Support, help and advice, Education, Physical effects and Psychological effects. The results point to many somatic and psychological benefits of regular physical activity in patients and that risk factors for metabolic diseases were reduced. Depressive and positive psychotic symptoms were reduced. Patients who were generally more physically active spent less time in inpatient care compared with those who were not physically active. Conclusion: Physical activity has the potential to be of great benefit to patients and it is possible to strengthen their health in several different ways with the help of physical activity.

Concepts of mental health and normality cannot be understood apart from cultural norms and values. The most significant of cultural constructions that shape our view of madness is gender. Madness has been perceived for centuries metaphorically and symbolically as a feminine illness and continues to be gendered into the twenty-first century. Works of art and literature and psychiatric medicine influence each other as well as our understanding and perception of mental illness. Throughout history, images of mental illness in women send the message that women are weak, dangerous, and require containment. What are the cultural links between femininity and insanity, and how are they represented? Through the lenses of disciplines such as theatre criticism, feminist theory, and psychiatry, this thesis examines the history of madness as a gendered concept and its depictions in art and literature. Additionally, it will explore the representation of female madness in contemporary dramatic literature as compared to the medical model used during the era in which it was written as well as the social and cultural conditions and expectations of the period. The three plays under consideration are: Long Day’s Journey Into Night, written in 1941 by Eugene O’Neill; Fefu and Her Friends, written in 1977 by Maria Irene Fornés; and Next to Normal, produced on Broadway in its current form in 2009 and written and scored by Brian Yorkey and Tom Kitts. None of these plays tell a tidy story with a straightforward ending. In none do treatment facilities offer refuge or health professionals offer answers. Struggling characters resort to drug abuse, fall prey to internalization, or leave treatment all together, having been subjected to enough victimization. The relationship between patient and physician is depicted to be, at best, ambivalent. The themes in these plays illuminate women’s mental illness as an extensive problem with many contributing factors, and the origins of which are quite complex.

The goal of this thesis is to investigate the literature on physician-assisted death (PAD) in the United States and argue for the legalization of PAD. This thesis discusses the historical and contemporary legal literature of PAD as well as the concerns voiced by opponents of PAD. This thesis addresses the concerns of PAD opponents and invalidating some concerns and and attenuating others. Proper implementation of PAD is proposed via Mandatory Psychiatric Review (MPR) and other psychological services. Further improvements needed in PAD policy are discussed as well as the current benefits of PAD.

Introdução: O Projeto Terapêutico Singular (PTS) é um conjunto de condutas e propostas terapêuticas que orientam o trabalho direcionado a um sujeito singular e coletivo, que resulta da discussão coletiva interdisciplinar de profissionais de determinado serviço de saúde e se consolida em cenário histórico e de Políticas Públicas, orientado em âmbito nacional pelo Sistema Único de Saúde. Objetivos: Realizar uma Revisão Integrativa da Literatura sobre o tema PTS. Identificar, na literatura, se a construção do PTS no campo psicossocial atende a seus pressupostos teóricos e conceituais e, indicar a re-organização do trabalho com vistas à construção compartilhada do PTS junto ao usuário, no campo psicossocial, a partir das normativas e diretrizes do Ministério da Saúde, na vigência da RAPS. Método: Trata-se de um estudo de Revisão Integrativa da Literatura. Utilizou-se dois descritores de assuntos combinados: Assistência Integral à Saúde e Serviços de Saúde Mental. A palavra-chave Projeto Terapêutico Singular foi utilizada em algumas bases de dados com o intuito de refinar buscas que se mostraram muito amplas. Os dados foram coletados no Banco de Teses e Dissertações da CAPES e da USP, Biblioteca Virtual em Saúde e, nas bases de dados, Cinahl, Pubmed e Web of Science. O período de publicação das referências localizadas não foi limitado. Resultados: Foram selecionados 14 estudos, produzidos no período de 1997 a 2014, sendo que 13 deles realizados em âmbito nacional e, apenas um foi produzido em âmbito internacional. Para análise dos estudos, buscou-se a categorização dos achados em cinco grupos: 1) conceitos e bases teóricas do campo psicossocial e da reabilitação como cidadania; 2) estrutura, forma e o como-fazer dos projetos terapêuticos singulares; 3) vantagens do emprego do projeto terapêutico singular nas práticas assistenciais; 4) os desafios, obstáculos e dificuldades nos quais o PTS esbarra; 5) as propostas para superação dos desafios relacionados ao PTS. Conclusões: A presente revisão integrativa valeu-se da combinação do uso de descritores de assunto e palavra-chave, o que permitiu a recuperação de maior número de estudos, pertinentes ao objetivo estabelecido. O PTS é ferramenta potente de cuidado, porém enfrenta muitos desafios para seu desenvolvimento o que pode restringir suas potencialidades. Foi recomendado que estudos futuros proponham um registro norteador de ações, que corresponda aos saberes teóricos e conceituais do campo psicossocial e da reabilitação como cidadania, de modo a contribuir com a elaboração do PTS. Esse norteador de ações deve apontar para a possibilidade de guiar a construção coletiva do PTS para atingir de forma efetiva a reabilitação psicossocial, a qualidade de vida, a dignidade, o poder de troca de mercadorias, de apoio social e familiar e de direito de pertencimento, ou seja, do verdadeiro direito à cidadania e a vida.
Introduction: The Singular Therapeutic Project (known as PTS in Brazil) is an arrangement of therapeuct actions that is due to guide the work process directed towards a singular person or a collective subjects, that results in an interdisciplinary collective discussion of employees of health services and has its bases in a historical setting and Public Policies, oriented at the national level by the National Health System. Objective: Identify if the development of the PTS in the psychosocial field meets its theoretical and conceptual assumptions, as well as propose the rearrangement of the work processes, aiming the shared development of the PTS with the user of the health services, in the psychosocial field, through the regulations and guidelines of the Ministry of Health, in the presence of the governement program Attention Networks to Psychosocial Health (known as RAPS). Method: Its an Integrative Literature Review. Were combined in this review two index-terms: Comprehensive Health Care and Mental Health Services. The keyword Therapeutic Project was used in same databases in order to refine searches that were very broad. Data were collected at the Bank of Theses and Dissertations of CAPES and USP, Virtual Health Library and, in the databases, Cinahl, Pubmed and Web of Science. The period of publication of localized references was not limited. Results: A total of fourteen (14) studies, producted from 1997 to 2014. Thirteen (13) of them were performed at the national level and only one of them was produced internationally. For analysis of the studies, we sought to categorize the findings into five groups: 1) concepts and theoretical bases of the psychosocial field and the rehabilitation as citizenship; 2) structure, shape and the how-to of the PTS; 3) advantages of using the PTS in the health care practices; 4) the challenges, obstacles and difficulties that the PTS faces; 5) proposals for overcoming the challenges related to PTS. Conclusion: This Integrative Review drew on the combination of the index-terms and keyword, which allowed the recovery of the greatest number of relevant studies to the proposed goal. The PTS is a powerful tool care, but it faces many challenges to its development which may restrict its potentialities. It is recommended that future studies could propose a registration that guides actions, which corresponds to the theoretical and conceptual knowledge of the psychosocial field and the rehabilitation as citizenship, in order to contribute to the development of the PTS. This guide for the actions should point the possibility of guiding the collective construction of the PTS to achieve effectively the psychosocial rehabilitation, the quality of life, the dignity, the social exchanges, the labor, the social and family support and the right of belonging, in other words, the true right to citizenship and life.

A majority of inpatients in acute psychiatric settings have histories of trauma, especially sexual violence. The purpose of this content analysis review of the periodical literature was to gain a better understanding of the issues faced by involuntarily held female survivors of rape and sexual assault within acute inpatient psychiatric settings and explore what existing inpatient trauma-informed training was in place. Often times, the external coping mechanisms for these individuals appear in the form of self-injurious behaviors, which are then responded to by professionals with the mindset of impending suicide. As the content analysis of the 30 reviewed studies demonstrated, the lack of education and training regarding the connections between sexual assault and coping mechanisms continues to be reflected in the modern interventions utilized within psychiatric settings. For this reason, a paradigm shift is warranted, so as to reduce the risk of re-traumatization for rape and sexual assault survivors under involuntary hold, within these institutions.

Consultation is a crucial role for school psychology practitioners. Psychologists routinely use consultation within the schools and actually wish they could spend more of their work hours on this activity. However, when authors write about consultation in the school psychology literature, they use numerous terms and phrases, which cause confusion as to what models of consultation are prominent in the field. The focus of the current study is to examine the articles that mention consultation in School Psychology Review (Digest) in order to determine whether the three traditional models (behavioral, mental health, and organizational consultation) are still prominent in consultation research and school psychology literature. Analyses of all articles containing the word "consultation" and all words preceding the word "consultation" were done to find the most frequently mentioned consultation terms. Analyses were then done on just the consultation research articles as well as other sources in order to find which terms are most frequently mentioned as part of studies and how the most prominent terms originated. The findings revealed that while behavioral consultation seems to be the traditional model still dominating the literature, mental health and organizational are beginning to fall behind in a shift from using specific models to more frequently using generic terms such as school, school-based or teacher consultation.

This thesis is an examination of euthanasia, eugenics, the ethic of patient care, and linguistic propaganda in the Second World War. The examination of euthanasia discusses not only the history and involvement of the facility at Hadamar in Germany, but also discuss the current euthanasia debate. Euthanasia in World War II arose out of the Nazi desire to cleanse the Reich and was greatly influenced by the American eugenics movement of the early 20th century. Eugenics was built up to include anyone considered undesirable and unworthy of life and killed many thousands of people before the invasion of allied troops in 1944. Paramount to euthanasia is forced sterilization, the ethic of patient care, and how the results of the research conducted on euthanasia victims before their deaths should be used. The Nazis were able to change the generally accepted terms that researchers use to describe their experiments and this change affected how modern doctors and researchers use the terms in current research. This thesis includes research conducted in Germany and the United States from varied resources.

More than 2.6 million troops have deployed in support of the wars in Iraq and Afghanistan. Still, surveys reveal that more than half feel “disconnected” from their civilian counterparts, and this feeling persists despite ongoing efforts, in the academy and elsewhere, to help returning veterans overcome physical and mental wounds, seek an education, and find meaningful ways to contribute to society after taking off the uniform. This dissertation argues that Iraq and Afghanistan War veterans struggle with reassimilation because they lack healthy, complete models of veteran identity to draw upon in their postwar lives, a problem they’re working through collectively in literature and artwork. The war veteran—returning home transformed by the harsh realities of military training and service, having seen humanity at its extremes, and interacting with a society apathetic toward his or her experiences—should engage in the act of storytelling. This act of sharing experiences and crafting-self subverts stereotypes. Storytelling, whether in a book read by millions, or in a single conversation with a close family member, should instruct civilians on the topic of human resiliency; it should instruct veterans on the topic of homecoming. But typically, veterans do not tell stories. Civilians create barriers to storytelling in the form of hollow platitudes—“thank you for your service” or “I can never understand what you’ve been through”—disconnected from the meaning of wartime service itself. The dissonance between veteran and civilian only becomes more complicated when one considers the implicit demands and expectations attached to patriotism. These often well-intentioned gestures and government programs fail to convey a message of appreciation because they refuse to convey a message of acceptance; the exceptional treatment of veterans by larger society implies also that they are insufficient, broken, or incomplete. So, many veterans chose conformity and silence, adopting one of two identities available to them: the forever pitied “Wounded Warrior” or the superficially praised “Hero.” These identities are not complete. They’re not even identities as much as they are collections of rumors, misrepresentations, and expectations of conformity. Once an individual veteran begins unconsciously performing the “Wounded Warrior” or “Hero” character, the number of potential outcomes available in that individual’s life is severely diminished. Society reinforces a feeling among veterans that they are “different.” This shared experience has resulted in commiseration, camaraderie, and also the proliferation of veterans’ creative communities. As storytellers, the members of these communities are restoring meaning to veteran-civilian discourse by privileging the nuanced experiences of the individual over stereotypes and emotionless rhetoric. They are instructing on the topics of war and homecoming, producing fictional and nonfictional representations of the veteran capable of competing with stereotypes, capable of reassimilation. The Introduction establishes the existence of veteran culture, deconstructs notions of there being a single or binary set of veteran identities, and critiques the social and cultural rhetoric used to maintain symbolic boundaries between veterans and civilians. It begins by establishing an approach rooted in interdisciplinary literary theory, taking veteran identity as its topic of consideration and the American unconscious as the text it seeks to examine, asking readers to suspend belief in patriotic rhetoric long enough to critically examine veteran identity as an apparatus used to sell war to each generation of new recruits. Patriotism, beyond the well-meaning gestures and entitlements afforded to veterans, also results in feelings of “difference,” in the veteran feeling apart from larger society. The inescapability of veteran “difference” is a trait which sets it apart from other cultures, and it is one bolstered by inaccurate and, at times, offensive portrayals of veterans in mass media and Hollywood films such as The Manchurian Candidate (1962), First Blood (1982), or Taxi Driver (1976). To understand this inescapability the chapter engages with theories of race, discussing the Korean War veteran in Home (2012) and other works by Toni Morrison to directly and indirectly explore descriptions of “difference” by African Americans and “others” not in positions of power. From there, the chapter traces veteran identity back to the Italian renaissance, arguing that modern notions of veteran identity are founded upon fears of returning veterans causing chaos and disorder. At the same time, writers such as Sebastian Junger, who are intimately familiar with veteran culture, repeatedly emphasize the camaraderie and “tribal” bonds found among members of the military, and instead of creating symbolic categories in which veterans might exist exceptionally as “Heroes,” or pitied as “Wounded Warriors,” the chapter argues that the altruistic nature which leads recruits to war, their capabilities as leaders and educators, and the need of larger society for examples of human resiliency are more appropriate starting points for establishing veteran identity. The Introduction is followed by an independent “Example” section, a brief examination of a student veteran named “Bingo,” one who demonstrates an ability to challenge, even employ veteran stereotypes to maintain his right to self-definition. Bingo’s story, as told in a “spotlight” article meant to attract student veterans to a college campus, portrays the veteran as a “Wounded Warrior” who overcomes mental illness and the scars of war through education, emerging as an exceptional example—a “Hero”—that other student veterans can model by enrolling at the school. Bingo’s story sets the stage for close examinations of the “Hero” and the “Wounded Warrior” in the first and second chapters. Chapter One deconstructs notions of heroism, primarily the belief that all veterans are “Heroes.” The chapter examines military training and indoctrination, Medal of Honor award citations, and film examples such as All Quiet on the Western Front (1930), Heroes for Sale (1933), Sergeant York (1941), and Top Gun (1986) to distinguish between actual feats of heroism and “Heroes” as they are presented in patriotic rhetoric. The chapter provides the Medal of Honor citations attached to awards presented to Donald Cook, Dakota Meyer, and Kyle Carpenter, examining the postwar lives of Meyer and Carpenter, identifying attempts by media and government officials to appropriate heroism—to steal the right to self-definition possessed by these men. Among these Medal of Honor recipients one finds two types of heroism: Sacrificing Heroes give something of themselves to protect others; Attacking Heroes make a difference during battle offensively. Enduring Heroes, the third type of heroism discussed in the chapter, are a new construct. Colloquially, and for all intents and purposes, an Enduring Hero is simply a veteran who enjoys praise and few questions. Importantly, veterans enjoy the “Hero Treatment” in exchange for silence and conforming to larger narratives which obfuscate past wars and pave the way for new ones. This chapter engages with theorists of gender—such as Jack Judith Halberstam, whose Female Masculinities (1998) anticipates the agency increasingly available to women through military service; like Leo Braudy, whose From Chivalry to Terrorism (2003) traces the historical relationship between war and gender before commenting on the evolution of military masculinity—to discuss the relationship between heroism and agency, begging a question: What do veterans have to lose from the perpetuation of stereotypes? This question frames a detailed examination of William A. Wellman’s film, Heroes for Sale (1933), in the chapter’s final section. This story of stolen valor and the Great Depression depicts the homecoming of a WWI veteran separated from his heroism. The example, when combined with a deeper understanding of the intersection between veteran identity and gender, illustrates not only the impact of stolen valor in the life of a legitimate hero, but it also comments on the destructive nature of appropriation, revealing the ways in which a veteran stereotypes rob service men and women of the right to draw upon memories of military service which complete with those stereotypes. The military “Hero” occupies a moral high ground, but most conceptions of military “Heroes” are socially constructed advertisements for war. Real heroes are much rarer. And, as the Medal of Honor recipients discussed in the chapter reveal, they, too, struggle with lifelong disabilities as well as constant attempts by society to appropriate their narratives. Chapter Two traces the evolution of the modern “Wounded Warrior” from depictions of cowardice in Stephen Crane’s The Red Badge of Courage (1895), to the denigration of World War I veterans afflicted with Shell Shock, to Kevin Powers’s Iraq War novel, The Yellow Birds (2012). As with “Heroes,” “Wounded Warriors” perform a stereotype in place of an authentic, individualized identity, and the chapter uses Walt Kowalski, the protagonist of Clint Eastwood’s film, Gran Torino (2008), as its major example. The chapter discusses “therapeutic culture,” Judith Butler’s work on identity-formation, and Eva Illouz’s examination of a culture obsessed with trauma to comment on veteran performances of victimhood. Butler’s attempts to conceive of new identities absent the influence of systems of definition rooted in the state, in particular, reveal power in the opposite of silence, begging another question: What do civilians have to gain from the perpetuation of veteran stereotypes? Largely, the chapter finds, the “Wounded Warrior” persists in the minds of civilians who fear the veteran’s capacity for violence. A broken, damaged veteran is less of a threat. The story of the “Wounded Warrior” is not one of sacrifice. The “Wounded Warrior” exists after sacrifice, beyond any measure of “honor” achieved in uniform. “Wounded Warriors” are not expected to find a cure because the wound itself is an apparatus of the state that is commodified and injected into the currency of emotional capitalism. This chapter argues that military service and a damaged psyche need not always occur together. Following the second chapter, a close examination of “The Bear That Stands,” a short story by Suzanne S. Rancourt which confronts the author’s sexual assault while serving in the Marines, offers an alternative to both the “Hero” and the “Wounded Warrior” stereotypes. Rancourt, a veteran “Storyteller,” gives testimony of that crime, intervening in social conceptions of veteran identity to include a female perspective. As with the example of Bingo, the author demonstrates an innate ability to recognize and challenge the stereotypes discussed in the first and second chapters. This “Example” sets the stage for a more detailed examination of “Veteran Storytellers” and their communities in the final chapter. Chapter Three looks for examples of veteran “difference,” patriotism, the “Wounded Warrior,” and the “Hero” in nonfiction, fiction, and artwork emerging from the creative arts community, Military Experience and the Arts, an organization which provides workshops, writing consultation, and publishing venues to veterans and their families. The chapter examines veteran “difference” in a short story by Bradley Johnson, “My Life as a Soldier in the ‘War on Terror.’” In “Cold Day in Bridgewater,” a work of short fiction by Jerad W. Alexander, a veteran must confront the inescapability of that difference as well as expectations of conformity from his bigoted, civilian bartender. The final section analyzes artwork by Tif Holmes and Giuseppe Pellicano, which deal with the problems of military sexual assault and the effects of war on the family, respectively. Together, Johnson, Alexander, Holmes, and Pellicano demonstrate skills in recognizing stereotypes, crafting postwar identities, and producing alternative representations of veteran identity which other veterans can then draw upon in their own homecomings. Presently, no unified theory of veteran identity exists. This dissertation begins that discussion, treating individual performances of veteran identity, existing historical, sociological, and psychological scholarship about veterans, and cultural representations of the wars they fight as equal parts of a single text. Further, it invites future considerations of veteran identity which build upon, challenge, or refute its claims. Conversations about veteran identity are the opposite of silence; they force awareness of war’s uncomfortable truths and homecoming’s eventual triumphs. Complicating veteran identity subverts conformity; it provides a steady stream of traits, qualities, and motivations that veterans use to craft postwar selves. The serious considerations of war and homecoming presented in this text will be useful for Iraq and Afghanistan War veterans attempting to piece together postwar identities; they will be useful to scholars hoping to facilitate homecoming for future generations of war veterans. Finally, the Afterword to the dissertation proposes a program for reassimilation capable of harnessing the veteran’s symbolic and moral authority in such a way that self-definition and homecoming might become two parts of a single act.

Bakgrund: Vårdkvalitet är ett mångfacetterat begrepp som inte går att beskriva på ett ensidigtsätt. Vårdkvalitet kan ses ur många olika perspektiv, där patientperspektivet är ett. Begreppetdelaktighet framkommer som centralt när vårdkvalitet beskrivs. Patientens delaktighet iutvecklingen av hälso- och sjukvården regleras enligt lag och patienten ses som en naturligdel av utvecklingsarbetet. Tidigare studier visar att patienterna betonade interpersonellprocess som viktigast, för hur vårdkvalitet uppfattades. Syfte: Syftet är att sammanställa forskning ur ett patientperspektiv beträffande vårdkvalitet ipsykiatrisk vård. Metod: En litteraturstudie baserad på 8 granskade kvalitativa artiklar. Analysen genomfördes i enlighet med Evans fyrstegsmetod. Nyckelfynd identifierades och därefter skapades temanoch subteman vilket utgjorde resultatet. Resultat: Vårdkvalitet är enligt patienterna en kombination av flera faktorer. Det mestframträdande är personalen som bryr sig med ett gott bemötande och där patienterna får varadelaktiga. Vårdmiljön är också en viktig faktor för att patienterna ska uppleva vårdkvalitetoch då innefattar det en trygg och estetisk miljö. Resultatet presenteras i två teman, Personalsom bryr sig och En lugn, vacker och trygg miljö med fyra subteman; Bemötande,Delaktighet, Estetik och Trygghet. Slutsats: Personal med en förmåga att skapa ett möte som innefattar delaktighet under tryggaformer i en vacker miljö är en förutsättning för att patienter inom den psykiatriska vården skauppleva vårdkvalitet. Litteraturstudien bidrar med en sammanställning av kunskap om vadpatienter inom psykiatrisk vård upplever är vårdkvalitet, varför den kan användas för attfrämja utveckling, patientens delaktighet samt personalens förmåga att ge patienterna en godvårdkvalitet oavsett vårdkontext.
Background: Quality of care is a multi-faceted concept that cannot be described in a unilateral way. Quality of care can be seen from many different perspectives, where the patient perspective is one. The concept of participation appears as central when the quality of care is described. The patient's involvement in the development of health and medical care is regulated by law and the patient is seen as a natural part of the development work. Previous studies show that patients emphasized interpersonal process as most important, for how care quality was perceived. Purpose: The aim is to compile research from a patient perspective regarding the quality of care in psychiatric care. Methodology: A literature study based on 8 reviewed qualitative articles. The analysis was carried out in accordance with Evans' four-way method. Key concepts were identified and then themes and sub-themes were created that generated the result. Result: The quality of care according to the patients is a combination of several factors. The most prominent are the staff who care about good treatment and where the patients may be involved. The care environment is also an important factor for the patients to experience quality of care and then it includes a safe and aesthetic environment. The result is presented in two themes, Staff who care and A quiet, beautiful and safe environment with four sub- themes; Treatment, Participation, Aesthetics and Security. Conclusion: Staff with an ability to create a meeting that involves participation in safe forms in a beautiful environment is a prerequisite for patients in the psychiatric care to experience quality of care. The literature study contributes with a compilation of knowledge about what patients within psychiatric care experience is quality of care, why it can be used to promote development, patient involvement and the staff's ability to give patients a good quality of careregardless of the health context.

Bakgrund: Psykisk ohälsa har ökat sedan 1990-talet och det finns en korrelation med behovet av psykiatrisk vård. Patienter med psykiatriska sjukdomar förekommer inom den somatiska vården samt har en ökad risk för att drabbas av somatiska sjukdomar. Det medför ett ökat krav av att kunna vårda patienter med psykiatriska sjukdomar även inom somatisk vård.    Syfte: Syftet med litteraturöversikten är att belysa sjuksköterskors erfarenhet av att vårda patienter med psykiatrisk sjukdom inom somatisk vård.    Metod: Litteraturöversikt med vetenskapliga artiklar, som har hittats med relevanta sökord på olika databaser och granskats med hjälp av granskningsmallar.    Resultat: Resultatet bygger på 14 granskade artiklar, 10 kvalitativa och 4 kvantitativa. I resultatet kunde sju övergripande kategorier identifieras, dessa var Tidsbrist, Bristande miljö, Kompetens och kunskap, Utsatthet, Kommunikation och Emotionell aspekt. Resultatet visade på kunskapsbrist hos sjuksköterskor, samt att majoriteten känner negativa känslor till att vårda patienter med psykiatrisk sjukdom. Tidsbrist var ett stort hinder för sjuksköterskors möjlighet till att vårda och vårdmiljön tillät inte god vård för patienter med psykiatrisk sjukdom.     Slutsats: Sjuksköterskor behöver mer resurser för att vårda patienter med psykiatriska sjukdomar inom den somatiska vården för att uppnå en god vård för patienter. Vidare krävs utbildning inom psykiatriska sjukdomar för sjuksköterskor och en förändring av vårdmiljön behöver initieras för att främja vården av patienter med psykiatriska sjukdomar
Background: Mental health problems have increased since the 1990s and there is a correlation to the need for psychiatric care. Patients with psychiatric disorders occur in the general healthcare and the patient group has an increased risk of somatic diseases. This puts pressure on the educational level for treating patients with psychiatric disorders in general hospitals.     Aim: The purpose of this literature review is to highlight the nurses' experience of caring for patients with psychiatric illness in general care.   Method: A literature review with scientific articles, which have been found with relevant keywords on different databases and reviewed with the help of review templates.   Results: 14 reviewed articles, 10 qualitative and 4 quantitative were used in the literature review. In the results, seven categories could be identified, these were Lack of time, Lack of environment, Competence and knowledge, Vulnerability, Communication and Emotional aspect. The results showed a lack of knowledge among nurses, also the majority have negative feelings to nursing patients with psychiatric illness. Lack of time was a major obstacle to nurses' ability to care and the care environment did not allow good care for patients with psychiatric illness.   Conclusion: Nurses need more resources to care for patients with psychiatric disorders in the somatic care to achieve good patient care. Furthermore, education in psychiatrics for nurses is required and a change in the care environment needs to be initiated to promote the care of patients with psychiatric diseases.

En psykossjukdom medför att perceptionen av världen och andra människor förändras. Patienter med en psykossjukdom upplever sig ha sämre livskvalitet och hälsa än andra individer i samhället och de upplever ofta lidande på grund av sin sjukdom. Sjuksköterskor upplever blandade känslor i samband med vård av patienter med en psykossjukdom, men deras grundläggande uppgift är trots detta att främja hälsa, förebygga sjukdom, återställa hälsa och att lindra lidande. Syftet med denna studie är att belysa hur patienter med en psykossjukdom upplever vården på en psykiatrisk slutenvårdsavdelning, ur ett patientperspektiv. Studien är en systematisk litteraturstudie och data analyserades med en induktiv latent innehållsanalys. Resultatet visade att patienternas upplevelser kan beskrivas i fyra områden: rädsla och osäkerhet påverkar interaktionen med andra; tvångsåtgärder: skrämmande men nödvändiga; självbestämmande, delaktighet och välbefinnande; samt vårdpersonalen är avgörande för patienternas upplevelser. I studien diskuteras rädsla och osäkerhet; att vårdpersonalen och upplevelserna påverkar attityden till behandlingen; vårdpersonalens betydelsefulla roll när patienten har svåra symtom; individualiserad vård och god kommunikation bidrar till ökat välbefinnande samt att mer kompetens hos vårdpersonal kan minska bruket av tvångsåtgärder. Studiens slutsats är att sjuksköterskor har en central roll i patienternas upplevelse av vården. De har ansvar för att interaktionen med patienten och relationsbyggande fortlöper samt att användandet av tvångsinsatser motiveras och enbart sker när det är absolut nödvändigt, annars finns risk att behandlingsresultat och följsamhet av behandling efter utskrivning påverkas negativt.
A psychosis means that the perception of the world and other people change. Patients with a psychotic disorder perceive themselves as having poorer quality of life and health than other individuals in the community and they often experience suffering because of their illness. Nurses experience mixed feelings while caring for patients with a psychotic disorder, but in spite of this a nurse’s fundamental duty is to promote health, prevent disease, restore health and to alleviate suffering. The purpose of this study is to highlight how patients with a psychotic disorder experience health care in a psychiatric inpatient ward, from a patient perspective. The study is a systematic literature review and data were analyzed using an inductive latent content analysis. The results showed that patients 'experiences involved four areas: fear and insecurity affects the interaction with others; coercive measures: scary but necessary; autonomy, participation and welfare, and nursing staff is crucial for patients' experiences. In the study, several areas were discussed about the patient's experiences: fear and insecurity; that care staff and experiences affect the attitude to treatment; healthcare personnel's important role when the patient experience severe symptoms; individualized care and good communication contribute to increased well-being, and that more skills in healthcare professionals can reduce the use of coercive measures. The study's conclusion is that nurses have a central role in the patients' experience of the health care. They are responsible for the interaction with the patient and for keeping the building of the nurse-patient relationship in progress. They are also responsible so that the use of coercive action is justified and only occurs when it is absolutely necessary, otherwise there is a risk that the treatment results and adherence to treatment after discharge are adversely affected.

This thesis examines the methods used by the Ministerium für Staatssicherheit (MfS), more commonly known as the Stasi, or East German secret police, for extraction of information from citizens of the German Democratic Republic for the purpose of espionage and covert operations inside East Germany, as it pertains to the deliberate brainwashing of East German citizens. As one of the most efficient intelligence agencies to ever exist, the Stasi’s main purpose was to monitor the population, gather intelligence, and collect or turn informants. They used brainwashing techniques to control the people of the GDR, keeping the populace paralyzed with fear and paranoia. By surrounding themselves with a network of informants they prevented actions against the dictatorial communist regime. Using the video testimonies of former prisoners, and former confidential informants who worked closely with and collaborated with Stasi agents, in combination with periodicals and previous historical studies, this work argues that the East German Police State’s brainwashing techniques had long and lasting consequences both for German citizens, and for the psychiatric health of former GDR citizens. The scope and breadth of the techniques and data compiled for use by the Stasi were exhaustive, and the repercussions of their use are still being felt and discovered twenty five years after the fall of the Berlin Wall. This study aims to show the lasting effects brainwashing had on former informants and the Stasi’s victims.

Bakgrund: Globalt har substansmissbruk blivit ett växande problem och oron har ökat gällande omfattningen av olagliga droger inom den psykiatriska vården. Det har blivit vanligare med substansbrukssyndrom bland personer med psykisk ohälsa jämfört med befolkningen i övrigt, vilket har lett till att fler sjuksköterskor möter dessa patienter inom den psykiatriska vården. Syfte: var att belysa sjuksköterskors erfarenheter av att vårda patienter med samsjuklighet av psykisk ohälsa och substansbrukssyndrom, inom psykiatrisk vård. Metod: en litteraturstudie baserad på 13 vetenskapliga artiklar genomfördes och analyserades med en kvalitativ design. Analysen ledde fram till två kategorier och sju underkategorier. Resultat: visade att sjuksköterskorna inom den psykiatriska vården såg flera utmaningar i vårdprocessen, såsom bristande rutiner och kunskapsbrist, men även möjligheter i sin vård av dessa patienter. Sjuksköterskorna efterlyste tydligare rutiner, bättre samverkan och mer utbildning om missbruk. Diskussion: Beskriver vikten av tydliga rutiner och samverkan i kombination med behovet av adekvat kompetens hos sjuksköterskorna. Slutsats: Tydligare rutiner, med förbättrad samverkan till omgivande instanser skulle i kombination med utbildning, förbättra omvårdnaden till patienterna.
Background: Globally, substance abuse has become a growing problem and concerns have increased regarding the extent of illicit drugs in psychiatric care. Substance use syndrome has become more common among people with mental illness compared to the general population, which has led to more nurses meeting these patients in psychiatric care. Aim: was to elucidate nurses' experiences of caring for patients with mental illness and substance use syndrome, in psychiatric care. Method: a literature study based on 13 scientific articles was conducted and analyzed with a qualitative design. The analysis led to two categories and seven subcategories. Result: showed that the nurses in psychiatric care saw several challenges in the care process, such as lack of routines and lack of knowledge, but also opportunities in their care of these patients. The nurses called for clearer routines, better collaboration and more education about abuse. Discussion: describes the importance of clear routines and collaboration in combination with the need for adequate expertise among the nurses. Conclusion: clearer routines, with improved collaboration with surrounding agencies, in combination with education, would improve the care of patients.

Godkännandedatum: 2020-01-15

Bakgrund: Sjuksköterskan möter dagligen patienter som lider av depression. Det är ett allvarligt tillstånd och innebär ett svårt lidande för de som drabbas. Patienter med depression som går obehandlade under en längre tid riskerar en försämrad funktionsförmåga, långvarig och ihållande sjukdom samt återinsjuknande. Att hjälpa dessa patienter kan vara en stor utmaning för sjuksköterskan då goda kunskaper, egenskaper och erfarenheter krävs för att kunna ge en personcentrerad omvårdnad för individen. Syfte: Beskriva sjuksköterskors erfarenheter av omvårdnad till patienter med depression. Metod: En litteraturstudie som baseras på 18 vetenskapliga artiklar. Sökningar i Cinahl, PubMedoch PsycInfo har utförts, artiklarna har kvalitetsgranskats, analyserats och sammanställts. Resultat: Fyra kategorier framkom vilka beskriver den psykiatriska omvårdnaden. Dessa är: Sjuksköterskans personliga och professionella kvalitéer, Mellanmänskliga relationer, Sjuksköterskans bedömning av patientens tillstånd och Hälsofrämjande interventioner. Diskussion: För en god vård krävs att sjuksköterskan hade en vilja och en ambition att lindra lidande, främja återhämtning och återställa hälsa för dessa människor. Patienten ska alltid vara i fokus och deras upplevelse av sjukdom och omvårdnad bekräftade om tillfredställande omvårdnadsåtgärder hade utförts av vården och gett de resultat som eftersträvats. Slutsats: Sjuksköterskan har med sin expertis inom den psykiatriska omvårdnaden en betydelsefull roll som behöver värdesättas och prioriteras i framtidens sjukvård.
Background: The nurse meets patients suffering from depression daily. It is a serious condition and causes severe suffering for those affected. Patients with depression who go untreated for an extended period of time risk impairment, long-term and persistent illnessand re-illness. Assisting these patients can be a major challenge for the nurse as good knowledge, characteristics and experiences are required to provide a person-centered care for the individual. Aim: Describe nurses' experiences of nursing for patients with depression. Method: A literature study based on 18 scientific articles. Searches in Cinahl, PubMed and PsycInfo have been carried out, the articles have been quality checked, analyzed and compiled. Result: Four categories emerged that describe psychiatric nursing. These are: "Nurse's personal and professional qualities", "Interpersonal relationships", "Nurse's assessment of the patient's condition" and "Health promotion interventions". Discussion: For good care, the nurse must have a will and ambition to relieve suffering, promote recovery and restore health for these people. The patient should always be in focus and their experience of illness and the caregiver confirms whether satisfactory nursing measures have been performed by the healthcare system and given the results that are sought. Conclusion: The nurse, with her expertise in psychiatric nursing, has an important role that needs to be valued and prioritized in future healthcare.

Godkännandedatum: 2020-01-16

In first-year composition courses, there are three aspects of teaching that are researched well so far: disclosure of trauma in student writing, instructor feedback, and emotional labor. The disclosure of trauma is almost completely unavoidable in first-year composition. We encounter an issue with instructor feedback; how do we provide feedback to student writing, like grammar and mechanics, when the student has disclosed trauma in the writing? Additionally, we can build off this with emotional labor, which already occurs consistently in teaching but is heightened in this instance. When providing feedback to a student who has disclosed trauma, this can be emotionally taxing on the instructor, as they may have to hide emotions regarding feedback to disclosure. How can the instructor manage their emotional labor in this instance – or how can instructors provide feedback to student disclosure of trauma in a manner that both prioritizes the student and instructor’s mental health?

Bakgrund: Depressioner hos äldre kan vara svårupptäckta till följd av en diffus symtombild samt då diagnossystemen DSM-5 och ICD-11 inte är anpassade för äldre. Många sjuksköterskor har svårigheter i att korrekt identifiera depressioner hos äldre personer. Mer kunskap och förståelse kring depressiva tillstånd hos äldre kan underlätta för psykiatrisjuksköterskor och andra specialistsjuksköterskor att identifiera dessa tillstånd samt leda till en förbättrad psykiatrisk omvårdnad av äldre personer. Syfte: Syftet var att belysa äldre personers erfarenheter av depressiva tillstånd i ålderdomen. Metod: En systematisk litteraturstudie baserad på nio kvalitativa studier genomfördes med Statens beredning för medicinsk och social utvärderings [SBU] metod som grundstruktur. Syntes av de kvalitativa studiernas resultat genomfördes enligt Howell Major och Savin-Baden. Resultat: Två tredje nivåns tema framkom: Det första tredje nivåns temat Att befinna sig på botten speglade den psykiska och existentiella förtvivlan de äldre befann sig i; en situation präglad av orkeslöshet, hopplöshet, självnedvärdering, skuld, skam, stigma, brist på stöd, ensamhet och alienation. Det andra tredje nivåns temat Att ta sig uppåt genom coping och andras stöd återgav de copingstrategier de äldre upplevde hjälpsamma samt betydelsen av andra människors stöd. Slutsats: Äldre personer som lider av depressiva tillstånd i ålderdomen bär erfarenheter av djup förtvivlan ur flera hänseenden och finner kraft i copingstrategier och stöd från andra. Nyckelord: depressiva tillstånd, erfarenheter, psykiatrisk omvårdnad, systematisk litteraturstudie, äldre
Background: Depressions in the elderly can be difficult to detect due to a diffuse symptomatology and because the diagnostic manuals DSM-5 and ICD-11 are not adapted for the elderly. Many nurses have difficulties in correctly identifying depressions in older people. More knowledge and understanding of depressive conditions in the elderly may facilitate for psychiatric-mental health nurses and other advanced practice nurses to identify these conditions and may conduce to an improved psychiatric-mental health nursing care for the elderly. Aim: To shed light on elderly persons’ experiences of depressive conditions in old age. Method: A systematic literature review based on nine qualitative studies was conducted, using Swedish Agency for Health Technology Assessment and Assessment of Social Services [SBU] as basic structure. Synthesis of the qualitative studies was carried out according to Howell Major and Savin-Baden. Result: Two third order themes emerged: The first third order theme, Being at rock bottom, reflected the existential and mental despair the elderly was in; a situation characterized by decrepitude, hopelessness, self-deprecating, guilt, shame, stigma, lack of support, loneliness and alienation. The second third order theme, Moving forward through coping and support from others, portrayed the coping strategies the elderly experienced as helpful and the importance of support from others. Conclusion: Elderly persons suffering from depressive conditions in old age experience different aspects of despair and find their path forward through coping strategies and support from others. Keywords: depressive conditions, elderly, experiences, psychiatric-mental health nursing, systematic literature review

This dissertation is focused on phenomenon of madness in French surrealism and genre called "écrits bruts". The main theme is confrontation of surrealism aesthetics madness with written production of psychotic and mostly schizophrenic patients. The primary outcome is presented by analysis and interpretation of two chosen literary works, which are collection of experimental poetry by André Breton and Paul Éluard called L'Immaculée conception (Immaculate Conception, 1930) and diary entries, known as Premier Cahier: de l'ordre des messages, mai 1935, written by one of the most significant French women representatives Jeanne Tripier,. The aim of this analysis is on one hand to identify and characterize forms through which simulated and "real" madness in texts presented are, and on the other hand to describe its poetic function. The methodology part is based on structural and genre analysis of both aforementioned movements and moreover is formed on outcomes of the phenomenologically oriented psychiatry and psychoanalysis.

Au XIXe siècle, la science et le fantastique produisent le même effet chez les gens : en mettant ceux-ci en contact avec des phénomènes inouïs, ils les inscrivent dans un rapport dialectique – entre le connu et l’inconnu – qui doit déboucher sur le non-encore-connu, comme s’ils recelaient la promesse d’une révélation. En effet, à la fois les sciences de l’esprit et le récit fantastique permettent de franchir les frontières entre le moi et l’autre, la vie et la mort, le corps et l’esprit. Explorant autant de domaines inconnus relatifs à l’homme, ils redéfinissent les contours de celui-ci. C’est donc en tant que moyens de savoir que ce mémoire met en relation ces sciences (psychiatrie, psychophysiologie, hypnotisme…) et trois récits fantastiques, « Onuphrius » de Théophile Gautier, « La Mort d’Olivier Bécaille » d’Émile Zola et « L’Homme voilé » de Marcel Schwob, où une crise de catalepsie subie par le héros déclenche le processus dialectique.
In the 19th century, science and the fantastic generated the same effect in people’s minds: by making them encounter incredible phenomena, they place them in a dialectical relation – between what is known and the unknown – which leads to the not-yet-known, as if they were concealing a promise of revelation. Indeed, both sciences of the mind and fantastic narratives enable the crossing of frontiers between the self and the other, life and death, body and mind. Exploring all these unknown territories related to man, they redefine his contours. Therefore, it is as means of knowledge that this dissertation is establishing a link between these sciences (psychiatry, psychophysiology, hypnotism...) and three fantastic narratives, “Onuphrius” by Théophile Gautier, “La Mort d’Olivier Bécaille” by Émile Zola and “L’Homme voilé” by Marcel Schwob, where catalepsy crises trigger the dialectical process.

This work asks how and for whom humiliation can be therapeutic. J. M. Coetzee, in his works Waiting for the Barbarians, Life & Times of Michael K and Disgrace, does not simply critique the mentality of Empire, an “Enlightenment” or colonialist mode of knowing that knows no bounds to reason, but offers an alternative through the Magistrate, Michael K and David Lurie, all of whom are brutally shamed and “abjected”. Each character, I propose, experiences a Lacanian “therapy of humiliation” resulting in a subversion of their egos, which they come to understand as antagonistic, a site of misrecognition. In doing so, these characters confront limitation, whether by means of a Lacanian “death drive” or the abjection of the self. I argue, this subversion of their egos necessitates a return to the humility of the body resulting in a new ethical openness to others and an engagement with the world through “care” or “love” or “beauty” which manifests as careful negotiation and attentiveness. Confrontation with death, thus, allows the Magistrate, Michael K and David Lurie to slough off “Enlightenment” values in favor of an anti-humanist way of living.

Background: Statistics reveal that approximately 10.7% of the global population have mental health disorders. In Sweden, 14% of persons with psychiatric diagnoses have had direct contact with a registered nurse. Based on studies, it is evident that registered nurses experience a lack of knowledge regarding psychiatric diagnoses, which negatively affects their ability to provide person-centered care. Furthermore, there is also a desire among registered nurses for increased knowledge regarding psychiatric diagnoses. The aim of this study was to explore how persons with psychiatric diagnoses experience care as a patient within general health care. Method: A literature review based on qualitative research results was performed and data were analyzed through a content analytical technique. It emerged three themes in the results: (1) Feeling subjected to prejudice, (2) Variations in the quality of support, and (3) Impression of the environment. The themes are presented with two sub-themes each. The participants’ experiences were mostly negative, grounded in discrimination, lack of support and knowledge from caregivers, and stressful surroundings. Conclusion: This study highlights persons with psychiatric diagnoses experiences within the general health care setting. Results can give an insight into how a registered nurse can provide a better person-centered.
Bakgrund: Statistik visar att ungefär 10,7% av världens befolkning har en psykiatrisk diagnos. I Sverige har 14% av personer med psykiatriska diagnoser haft direktkontakt med en grundutbildad sjuksköterska. Tidigare forskning visar att det finns en upplevd kunskapsbrist bland grundutbildade sjuksköterskor angående psykiatriska diagnoser, vilket påverkar deras förmåga att ge personcentrerad vård negativt. Forskning visar även på att det finns en önskan för utökad kunskap om psykiatriska diagnoser bland grundutbildade sjuksköterskor. Syfte: Att utforska hur personer med psykiatriska diagnoser upplever vård som patient inom allmän hälso-och sjukvård. Metod: En litteraturstudie baserade på kvalitativa forskningsresultat utfördes, och data analyserades med en innehållsanalytisk teknik. I resultatet framkom tre teman: (1) Känsla av att vara utsatt för fördomar, (2) Variationer i kvalitén av stöd, och (3) Intryck av omgivningen. Teman presenteras med två underteman var. Upplevelserna var mestadels negativa baserade på diskriminering, brist på stöd och förståelse, samt stressig miljö. Konklusion: Den här litteraturstudien belyser personer med psykiatriska diagnosers upplevelse av vård. Resultatet kan ge en inblick i hur en grundutbildad sjuksköterska kan ge personcentrerad vård.

Research Doctorate - Doctor of Philosophy (PhD)
Psychiatric nursing scholarship has a long history. The first psychiatric nursing text written by a sole nurse author was published in 1920. Texts authored by psychiatric nursing scholars provide a source for the ideas that have informed practice over the decades. This study examines the history of these ideas over time, tracing the development of ideas about practice and psychiatric nursing. Knowledge of these ideas and the scholars who promulgated them can help us understand the development of the discipline of psychiatric nursing. Clear descriptions of the ideas that have and do inform practice can lead to a better understanding of practice and provide a basis for education, research and development. Post analytic philosophy is the methodology used in this study. Bevir’s Logic of the History of Ideas is the specific approach adopted for this work. Concepts that are important to the study of the history of ideas such as meaning, belief, objectivity and explanation are defined and discussed. Textbooks are the primary source documents for this work as textbooks are the publicly available record of ideas that inform practice. Textual interpretation, using a method that integrates Bevir’s concepts and those of McKee, was used to develop an understanding of the ideas that inform practice and their history. Descriptions of important ideas from the literature are discussed in chapters 4 and 5. The ideas are organised into two epochs; the first epoch ending in 1945 and the second epoch starting from this date. Important ideas such as therapeutic relationships, managing difficult behaviours, relationships between doctors and nurses, physical health care, observations and other issues are discussed. Explanations of the ideas identified in the previous chapters are provided in chapter 6. This chapter uses traditions and dilemmas (disruptive ideas) as the explanatory framework and discusses a range of traditions that inform practice and dilemmas that may be disruptive for the discipline of psychiatric nursing. Some of the longstanding traditions that still inform current practice include the use of interpersonal relationships and the management of difficult behaviours. Some of the disruptive ideas that were identified included the relationships between nurses and doctors, introduction of psychotropic medications and the introduction of recovery focused practice. The final chapter considers the implications of this study for research, education and practice. The unique qualities of psychiatric nursing are discussed considering the ideas evident in this study. Ideas for research include determining whether our current education practices adequately prepare nurses for practice. Ideas about education include a possible need to revisit some practices from the past such as supervision of postgraduate students but combining this with emerging technologies such as new videoconferencing applications. The unique qualities of psychiatric nurses are discussed using the paradigm of liminal space, that is, the space that nurses occupy between doctors and patients.

The dissertation focuses on the impact of authority and grotesque in the U.S. literature of the 1960s. The key theoretical approaches used for the analysis were: Bakhtinian theory concerning popular carnival culture and Vizenor's theory concerning tricksters, Deleuzian notion of repetition and schizoanalysis and the theory of Foucault concerning power and anti- authority struggles. The main task of the analysis was to trace the common and differentiating features which were demonstrated in the novels in the form of anti-authority struggles and forms of madness, which is viewed as a deliberating force. The authors were chosen for their challenging attitudes toward the forms of power exercised over the American society and for the usage of the grotesque as a tool to convey a subversive message. The analysed authors were John Kennedy Toole and his A Confederacy of Dunces, Kurt Vonnegut Jr. and his Slaughterhouse 5 and Ken Kesey's One Flew Over the Cuckoo's Nest.

French text
Si nous pouvons constater, d’une part, que l’univers carcéral occupe une place très importante dans les textes de Tahar Ben Jelloun, nous ne pouvons cependant ignorer, de l’autre, les efforts des personnages de la diégèse ben jellounienne pour trouver une libération quelconque. De ce fait, la libération constitue l’objet de notre étude par excellence. Nous avons choisi cinq textes de l’écrivain marocain : Moha le fou Moha le sage (1978), L’enfant de sable (1985), La nuit sacrée (1987), Cette aveuglante absence de lumière (2001) et Amours sorcières (2003). Après un survol rapide de l’incarcération sous ses différentes formes, allant des plus concrètes aux plus abstraites, nous étudions les paradigmes les plus communs vers lesquels l’homme maghrébin moderne se tourne dans le but de se libérer des carcans qui l’entravent et nous en relevons tour à tour les limitations ou lacunes. Ainsi, nous remettons en question le modèle matérialiste qui échoue pour ce qui de la libération de l’individu en raison de ses excès. Puis, nous étudions le modèle psychologique mettant l’accent sur ses limites dans la mesure où il comprend un mouvement vertical vers le bas. Or, sans un mouvement vers le haut, aucune libération n’est possible. Très particulière à la société maghrébine est la praxis islamique moderne qui, loin de libérer l’individu, ne fait que l’étouffer davantage. Ensuite, nous soulevons des questions au sujet de la sorcellerie et des dangers qu’elle comprend. Loin d’être un élément libérateur, elle constitue un piège. Nous arrivons éventuellement à la seule clé capable d’apporter la libération intérieure au Maghrébin : la métaphysique et, dans le contexte de la civilisation arabo-islamique, il s’agit de l’ésotérisme islamique ou le soufisme. Ce mémoire requiert une approche très scientifique telle que l’exige la nature même de notre problématique. Nous avons opté pour une approche métaphysique pour conduire notre étude à bon port.
If we cannot deny the fact that the realm of incarceration holds an important place in the texts of Tahar Ben Jelloun, we also have to acknowledge the endeavours of the characters to find liberation in some way or another. Therefore, above all else, liberation constitutes the object of our study. We have chosen five texts of the Moroccan author: Moha le fou Moha le sage (1978), L’enfant de sable (1985), La nuit sacrée (1987), Cette aveuglante absence de lumière (2001) and Amours sorcières (2003). After a quick glance at the different forms of incarceration, starting from the most tangible and moving to the most abstract ones, we study the most common paradigms to which the Moroccan turns to in order to free himself from the shackles that imprison him and we study simultaneously their shortcomings. Hence, we call into question the materialistic model that fails in liberating the individual on account of its excesses. Then, we study the psychological model laying emphasis on its limitations in that it comprises a vertical downward movement while no liberation is possible without an upward movement. Quite specific of the Moroccan society is the modern Islamic praxis that, in lieu of freeing the individual, only stifles him more. Afterwards, we raise questions concerning sorcery and dangers that it represents. Far from being a liberating agent, it constitutes a trap. Ultimately we come to the only key capable of bringing internal liberation to the Moroccan: metaphysics and, in the arabo-islamic context, it is Islamic esotericism or Sufism. This thesis requires a most scientific approach as demands the very nature of our problematic. We have thus chosen a metaphysical approach that best suits our study.
Classics and World Languages
M.A. (French)