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  • 1.
    Glantz, Andreas
    et al.
    Region Skåne, SWE.
    Örmon, Karin
    Malmö Högskola, SWE.
    Sandström, Boel
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    "how do we use the time?": An observational study measuring the task time distribution of nurses in psychiatric care2019In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, no 1, article id 67Article in journal (Refereed)
    Abstract [en]

    Background: The nurse's primary task in psychiatric care should be to plan for the patient's care in cooperation with the patient and spend the time needed to build a relationship. Psychiatric care nurses however claim that they lack the necessary time to communicate with patients. To investigate the validity of such claims, this time-motion study aimed at identifying how nurses working at inpatient psychiatric wards distribute their time between a variety of tasks during a working day. Methods: During the period of December 2015 and February 2016, a total of 129 h and 23 min of structured observations of 12 nurses were carried out at six inpatient wards at one psychiatric clinic in southern Sweden. Time, frequency of tasks and number of interruptions were recorded and analysed using descriptive statistics. Results: Administering drugs or medications accounted for the largest part of the measured time (17.5%) followed by indirect care (16%). Relatively little time was spent on direct care, the third largest category in the study (15.3%), while an unexpectedly high proportion of time (11.3%) was spent on ward related tasks. Nurses were also interrupted in 75% of all medication administering tasks. Conclusions: Nurses working in inpatient psychiatric care spend little time in direct contact with the patients and medication administration is interrupted very often. As a result, it is difficult to establish therapeutic relationships with patients. This is an area of concern for both patient safety and nurses' job satisfaction. © 2019 The Author(s).

  • 2.
    Sandström, Boel
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Svensson, Bengt
    Borglin, Gunilla
    Mapping attitudes and awareness with regard to national guidelines: An e-mail survey among decision makers2014In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 22, no 7, p. 884-893Article in journal (Refereed)
    Abstract [en]

    The adoption of evidence-based guidelines within the mental health field has been slow. Changing inadequate practice is therefore a formidable challenge for mental health-care managers. Aim: To explore decision-makers' attitudes and awareness regarding the national guidelines for psychosocial interventions targeting people with schizophrenia. Method: A questionnaire distributed by e-mail to 592 Swedish decision-makers was analysed using descriptive and comparative techniques. Results: Significantly more of the top-level mental health-care managers than politicians stated that they knew about the national guidelines (i.e. their release and content) and they considered the guidelines to be a good source of support for planning and allocating resources. Conclusion: If those responsible for allocating resources (i.e. politicians) are unaware of the dissemination of national guidelines or their content, and they do not perceive the national guidelines to be a good source of support for planning and allocating resources, this is likely to have a negative influence on the remit of nurse managers as well as nursing practice. Implications for nursing management: Top-level mental health-care managers have a vital role to play in the implementation of national guidelines. However, our findings indicate that implementing national guidelines in practice could be virtually impossible without strategic government support.

  • 3.
    Sandström, Boel
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Svensson, Bengt
    Borglin, Gunilla
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis2015In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 10, no 1, article id 43Article in journal (Refereed)
    Abstract [en]

    Background: National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. Methods: The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis. Results: Our deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants' perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the organisational context. Conclusions: Our findings have highlighted that, regardless of by whom guidelines are released, they are not likely to be utilised or implemented if those who are responsible for implementing them do not trust the source. This aspect (i.e. contextual trust) is not covered by PARIHS.

  • 4.
    Wästberg, Birgitta
    et al.
    Skånes universitetssjukhus, SWE.
    Sandström, Boel
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Pooremamali, Parvin
    Umeå Universitet, SWE.
    A Turning Point Towards Recovery: An Interview Study with Participants in the Culture and Health Programme for Clients with Long-Term Mental Health Disorders in Sweden2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 5, p. 373-381Article in journal (Refereed)
    Abstract [en]

    The study aimed to explore participants’ perceptions and experiences of the Culture and Health programme in Sweden for clients with long-term mental health disorders. A qualitative approach with interviews was applied. Grounded Theory guided the analysis and selection of informants. A total of 15 informants were interviewed. A core category ‘A turning point in dealing with everyday life beyond the mental illness’ with three categories: inner life, social life and occupational life emerged. A theory indicating the importance of asking clients about their expectations, was formulated. Further studies are warranted, including studies of effects. © 2019, © 2019 Taylor & Francis Group, LLC.

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