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Nurses’ dilemmas concerning support of relatives in mental health care
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.ORCID iD: 0000-0003-3385-3731
Karlstad University, Faculty of Social and Life Sciences, Department of Nursing. (Omvårdnad)
2013 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 3, 285-299 p.Article in journal (Refereed) Published
Abstract [en]

Relatives of persons with severe mental illness face a straining life situation, and need support. Exclusion of relatives in mental healthcare has long been reported. The aim of this study was to describe conceptions of nurses in mental health care about supporting relatives of persons with severe mental illness.

Focus group interviews with nurses from all levels of mental healthcare in Norway were performed. A Phenomenographic approach was used. The nurses found that their responsibility first and foremost was the patient, especially to develop an alliance with him or her. Additional premises for supporting relatives were: The context framing the nursing care, the aspects of the actors, and relational concerns between them. Competing or contradictory demands were found within these premises.

Two paths were identified concerning the nurses’ support of relatives: seeing the relative in the shadow of the patient, or as an individual person.

Place, publisher, year, edition, pages
2013. Vol. 20, no 3, 285-299 p.
Keyword [en]
focus group interviews, moral distress, nurses in mental health care, phenomenography, relatives of persons with severe mental illness, support.
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-13690ISI: 000341633900005PubMedID: 23361144OAI: oai:DiVA.org:kau-13690DiVA: diva2:533783
Note

Delarbete i avhandlingen: Relatives of persons with severe mental illness - life situation and need for support, Karlstad university studies 2012:17

Available from: 2012-06-14 Created: 2012-06-14 Last updated: 2016-04-13Bibliographically approved
In thesis
1. Experiences and Nursing Support of Relatives of Persons with Severe Mental Illness
Open this publication in new window or tab >>Experiences and Nursing Support of Relatives of Persons with Severe Mental Illness
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[no]
Pårørende til personer med alvorlig psykisk lidelse : Deres erfaringer og støtte fra sykepleiere
Abstract [en]

Aim: The overall aim of this thesis was to illuminate experiences of relatives of persons with severe mental illness, and their need for support from formal care. Furthermore, to illuminate nursing support of relatives of persons with severe mental illness.

Methods: A mixed methods design was used. In study I, data was collected with a questionnaire responded by 226 relatives and analysed with statistics. In study II, data was gathered with interviews with a strategic sample of 18 relatives, analysed with phenomenography. Study III gathered data from 216 relatives using open-ended questions in the questionnaire (I), analysed with qualitative content analysis. In study IV, data was collected by means of focus-group interviews with 4 groups of nurses, working in mental healthcare and analysed with phenomenography.

Main findings: The relatives experienced that their lives were intertwined with the life of their severely mentally ill next of kin. The relatives experienced burden and a poor health, and there were associations between burden and health (I). The relatives had to balance between multiple concerns and make choices on behalf of others and themselves, constantly struggling between opposing feelings and between reflections (II). Relatives’ encounters with mental health personnel were mainly negative, although some had positive experiences. They strived for involvement in mental healthcare for the sake of their severely mentally ill next of kin, and wanted inclusion and support for their own sake, but mostly felt left alone with straining but inescapable responsibilities (III). The nurses conceived that their responsibility was first and foremost the patient and to develop an alliance with him or her. The nurses often felt they had to exclude relatives, but were sometimes able to support them (IV).

Conclusions: Relatives’ lives are intertwined with the life of their severely mentally ill next of kin. Relatives’ overall demanding life situation means that the mental health services must involve relatives for the sake of the severely mentally ill person but also include them for their own sake. They need practical and emotional support. Guidelines must be designed to address relatives’ needs, and support must be adapted to the individual relative.

Abstract [no]

Hensikt: Avhandlingens overordnete hensikt var å belyse erfaringer med å være pårørende til personer med alvorlig psykisk lidelse, og deres behov for støtte fra helsevesenet. Videre å belyse støtte fra sykepleiere til pårørende til personer med alvorlig psykisk lidelse.

Metode: Mixed methods design ble benyttet. I studie I ble data samlet med spørreskjema besvart av 226 pårørende, og analysert med statistikk. I studie II ble data samlet ved hjelp av intervju med et strategisk utvalg av 18 pårørende, analysert med fenomenografi. I studie III ble data samlet gjennom åpne spørsmål i et spørreskjema (I), besvart av 216 pårørende og analysert med kvalitativ innholdsanalyse. I studie IV ble data samlet ved hjelp av fokusgruppeintervju med 4 grupper sykepleiere fra psykisk helsevern, analysert med fenomenografi.

Hovedfunn: Pårørende opplevde at deres liv var sammenvevd med livet til den som hadde en alvorlig psykisk lidelse. De pårørende opplevde byrde og dårlig helse, og det var sammenheng mellom byrde og helse (I). De pårørende måtte balansere en rekke hensyn, gjøre valg på vegne av andre og seg selv, og samtidig kjempe med motstridende følelser og motstridende tanker (II). Pårørendes erfaringer med møter med helsepersonell i psykisk helsevern var hovedsakelig negative, men noen hadde positive opplevelser. De strevde for å bli involvert i behandlingen for familiemedlemmet med den alvorlige psykiske lidelsen sin del, de ønsket å bli inkludert og motta støtte for egen del, men følte seg overlatt med strevsomt ansvar som de ikke kunne unnslippe (III). Sykepleierne anså at deres ansvar først og fremst var overfor pasienten, og å skape en allianse med vedkommende. Sykepleierne opplevde ofte at de måtte ekskludere pårørende, men var noen ganger i stand til å støtte dem (IV).

Konklusjoner: Pårørendes liv er sammenvevd med livet til den som har en alvorlig psykisk lidelse. Pårørendes krevende livssituasjon innebærer at psykisk helsevern må involvere dem for den som har den alvorlige psykiske lidelsen, samt inkludere pårørende for deres egen del. De har behov for praktisk og emosjonell støtte. Retningslinjer må på plass for å ivareta pårørendes behov, og støtten må tilpasses den enkelte pårørende

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2012. 150 p.
Series
Karlstad University Studies, ISSN 1403-8099 ; 2012:17
Keyword
Burden, everyday life, health, mental healthcare, relational ethics, relatives of persons with severe mental illness, support of relatives, Byrde, dagligliv, helse, nærhetsetikk, psykisk helsevern, pårørende til personer med alvorlig psykisk lidelse, støtte til pårørende
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-12821 (URN)978-91-7063-421-5 (ISBN)
Public defence
2012-09-14, 1A 305 Lagerlöfsalen, Karlstad, 11:00 (Norwegian)
Opponent
Supervisors
Available from: 2012-08-24 Created: 2012-04-03 Last updated: 2016-04-13Bibliographically approved

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