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Medication-free mental health treatment: a focus group study of milieu therapeutic settings
Get PDFBackground: Medication-free treatment within mental health care aims to offer therapeutic support as an alternative to psychotropic medication. Introducing milieu therapy for severely mentally ill persons in a medication-free unit requires significant changes to the traditional medication-based psychiatric setting. The present study examines how milieu therapists experience working with medication-free treatment for people with severe mental health challenges. The research question was “What may be required to succeed with medication-free treatment in milieu therapeutic settings?”
Methods: A qualitative study with four focus groups were conducted with 23 milieu therapists from three inpatient units in two mental health institutions. Thematic analysis was performed.
Results: One main theme was identified: medication-free treatment involves therapists and patients working together on holistic and personal health promotion. This common thread links the four themes: helping patients to make changes in their life; having time to focus on the individual patient; being a professional companion; and working together as a team with the patient.
Conclusions: A holistic approach is necessary for medication-free treatment to succeed. This requires working together in multidisciplinary teams with a focus on the individual patient. Milieu therapists must engage and take more responsibility in the patient’s process of health promotion. A change from a medical to a humanistic paradigm within mental health care is needed.publishedVersio
Omsorg i en kaffekopp. Pårørende til eldre sykehjemspasienter; behov for ivaretagelse ved livets slutt
Get PDFBakgrunn: Pårørende og etterlatte til sykehjemsbeboere er en variert gruppe med ulike behov for ivaretakelse, oppfølging og inkludering. Hvilke opplevelser de sitter igjen med som etterlatte kan ha stor betydning for sorgprosess og livet etterpå. Helsevesenet, som i denne studien stort sett er sykehjem har flere offentlige føringer som beskriver hvordan pårørende og etterlatte skal ivaretas, inkluderes og følges opp.
Hensikt: Formålet med denne studien var å få større innsikt i hvilke behov de pårørende egentlig har, og hvordan de opplever å bli ivaretatt av helsepersonell i tiden rundt deres nære og kjæres død. Studien gjennomføres med følgende problemstilling: Hvilke behov har pårørende til døende sykehjemsbeboere, og hvordan opplever de å bli ivaretatt av helsevesenet? Ved å innhente kunnskap og forståelse fra et pårørendeperspektiv kan man i større grad forstå og imøtekomme de konkrete behovene de har.
Metode: Studien ble gjennomført med et kvalitativt forskningsdesign, med bruk av semistrukturerte intervju av seks etterlatte av sykehjemspasienter. Alle informantene hadde erfaring med å ha mistet en av sine nære og kjære på sykehjem. Datamaterialet som ble innhentet ble transkribert og videre analysert med bruk av Malteruds systematiske tekstkondensering.
Resultater: Gjennom analyse av datamaterialet ble det gjort fire hovedfunn som resulterte i fire resultatkategorier; Det gode møtet er utgangspunktet, Praktisk omtanke har stor betydning, Tillit er grunnmuren og Kunnskap gir trygghet. Alle resultatkategoriene ble videre delt opp i to-tre subkategorier, som belyste hoved kategorien. De etterlatte hadde både ulike og like utfordringer og opplevelser som belyste problemstillingen, og sammen skapte dette både et variert og samstemt innhold i datamaterialet.
Konklusjon: Funnene i denne studien viser at pårørende har behov for tidlig inkludering og samarbeid, allerede i første møte med helsepersonell på sykehjem eller i hjemmetjenesten. Dette bidrar til å bygge en grunnmur av tillit eller mistillit, som videre er grunnlaget for hvordan de pårørende og senere etterlatte følte seg ivaretatt og inkludert. Pårørende verdsetter praktisk omtanke som at helsepersonell henter en ekstra stol, serverer mat og drikke eller bare har tid til å sette seg ned og prate med dem. I tillegg har pårørende et ønske om å kunne bidra og være en ressurs, men dette må kartlegges ut i fra hver enkelt sin VIII kapasitet, slik at dette ikke blir en belastning. Stabil og nok bemanning, med faglig kunnskap rundt sykdom, sykdomsforløp og palliativ behandling skaper trygghet blant pårørende. Pårørende påpeker at i de tilfellene ting ikke fungerte så godt var det stort sett ikke pleierne sin skyld, men systemet og organiseringen av sykehjemmet eller helsetjenesten
Training in shared decision-making for registered nurses taking a master’s degree and/or a postgraduate programme
Get PDFAttribution 4.0 International (CC BY 4.0)Background: Registered nurses play a decisive role in supporting patients to participate in decisions on their own health, also referred to as shared decisionmaking. Official recommendations and up-to-date knowledge demonstrate that, although shared decision-making is necessary for patients, there are few training programmes within or outside the education system that can meet this need for competence.
Objective: To gain insight into how RNs taking a master’s degree and/or a postgraduate programme respond to a three-hour training module in SDM and decision coaching, and how students perceive the effect on learning. We also wanted to identify possible barriers and facilitators in relation to the use of decision coaching.
Method: We used a multi-method research design based on Kirkpatrick’s four-step model for evaluating training interventions. We reported on the first two levels – reaction and learning – using a questionnaire to assess how students reacted to and learned from the training. The quantitative data were analysed using descriptive statistics, but we analysed the free-text questions using qualitative content analysis.
Results: Eighty-two registered nurses taking a master’s degree and/or a postgraduate programme in cancer nursing or nephrology nursing participated in the course, and 76 of them consented to take part in the study. The registered nurses reported that the teaching was useful for clinical practice and recommended it to others. They also wanted more skills training in order to increase their competence in shared decisionmaking. They highlighted the ‘Six steps to shared decision-making’ in addition to role play and exercises as among the most useful elements of the training. A broad spectrum of barriers and facilitators across individual, organisational and systemic levels were reported.
Conclusion: The study shows that the registered nurses found that the training provided them with relevant knowledge that they could use in their daily work in order to promote the development of knowledge about the shared decision-making process. Further training is both desirable and necessary in order to increase registered nurses’ self-confidence and skills in practising decision coaching.publishedVersio
Social work(ers) and homeless EU migrants. Welfare bordering in Norway
Get PDFAll rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, without permission.This thesis explores the ‘doing’ and experiences of social work with persons who have very limited rights to assistance from the welfare state – specifically homeless EU migrants – from the perspective of the Norwegian situation. It is an ethnographic study drawing on fieldwork that took place in Oslo between August 2017 and November 2018. The fieldwork included participant observation in settings where encounters between social workers and persons with severely restricted access to public welfare in Norway took place, participation in biweekly meetings of a collaborating unit set up by the City Government of Oslo to coordinate efforts directed at ‘visiting homeless EEA citizens’, in-depth interviews with interlocutors and various stakeholders and engagement with texts such as policy documents and legal sources.
The key question guiding the thesis as a whole is: How does the ‘doing’ of social work in encounters with persons who have limited rights to public social welfare intersect with the Norwegian (welfare) state’s concerns with migration management in general and internal bordering processes specifically? The observations and arguments of the three articles forming part of the thesis accentuate the manifold – seldom straightforward and sometimes conflicting – ways in which Norwegian social welfare policies and the (welfare) state’s concerns with migration management are intertwined and thus how welfare policies and provisions both operate as and create internal bordering practices. Second, the articles show how this intertwinement frames and moulds the configurations of social service provision to, as well as the ‘doing’ of social work with, homeless EU migrants in Norway. In sum, the thesis brings forth how both social workers mandated with administering public social welfare provisions and those who are not get implicated in and contribute to the ‘internalization of borders’ (Persdotter et al., 2021) and ‘welfare bordering’ (Guentner et al., 2016) specifically. Parallelly, the manifold dilemmas this position entails for social workers and the lived experiences of those who are subjected to such bordering processes are explored. A key observation is that these processes are configured and experienced differently for different migrants, and that the regulating and disciplining dimensions are most harshly felt by those most in need of (humanitarian) social services.
The study demonstrates that homeless EU migrants are not simply excluded from the country’s welfare system but rather precariously included (Karlsen, 2021) through policies and provisions directed at ensuring bodily survival. In effect, homeless EU migrants in Norway are left dependent on charity-based social service structures to meet their basic needs. The restrictedness, unpredictability and fragility inherent in this form of inclusion contrasts vi with the principles of social justice, entitlements and equality – principles that are considered cornerstones of the Norwegian welfare state.
The particular combination of measures of care and control in social welfare policies directed not only at homeless EU migrants but also at migrants with precarious citizenship statuses in general, the study asserts, allows the Norwegian (welfare) state to simultaneously manage migration and retain the nation’s self-image of being caring and compassionate. Welfare policies that are both exclusionary and inclusionary, then, implicate individual social workers, as well as the social work profession, in the differentiation of human worth within Norway’s borders and in internal migration control.
Accordingly, my work brings out how the close interrelationship – even interdependency – of the Norwegian social work profession and the national welfare state excludes homeless EU migrants from the mainstream social work field of practice and mandate, including (facilitation of) access to the comprehensive and rights-oriented public social welfare provisions characteristic of the welfare state. Meeting people in precarious situations, who often are visibly poor and live in destitution, while being unable to resort to rights-oriented public social welfare provisions to better such situations appears to create bewilderment and professional insecurity amongst social workers.
While asserting that national borders do indeed produce specific ideas of and demarcations between the ‘belonging’/ ‘deserving’ and the ‘nonbelonging’/ ‘undeserving’ inside Norway’s borders, the thesis asks whether the processes of welfare – and moral – bordering that homeless EU migrants are subjected to may also be interpreted both as indicative of wider transformations of the welfare state and as a continuation of the manners in which the Norwegian state and social workers historically have marked ‘the boundaries of organised social solidarity’ (Lorenz, 2006). Consequently, it urges social workers and the social work profession in Norway to scrutinise and monitor carefully whether their entanglement in processes of welfare bordering risks resulting in the (return to the pre-welfare state’s) ‘policing of the poor’ and reflect on potential implications of such a development for a profession mandated with promoting and realising human rights principles – for all.
Paper I: Misje, T. (2020). Social work and welfare bordering: The case of homeless EU migrants in Norway. European Journal of Social Work, 23 (3), 401–413. https://doi.org/10.1080/13691457.2019.1682975
Paper II: Misje, T. (2021). Queuing for food and playing lottery for beds: A parallel social service system and the lived experiences of humanitarian service provision to homeless EU migrants in Norway. Nordic Social Work Research, 11 (2), 103–116. https://doi.org/10.1080/2156857X.2020.1857820
Paper III: Misje, T. (2022). The precarious inclusion of homeless EU migrants in Norwegian public social welfare: Moral bordering and social workers’ dilemmas. Critical Social Policy, 42 (3), 448–468. https://doi.org/10.1177%2F02610183211036580publishedVersio
O pensamento crítico dos estudantes de graduação em enfermagem brasileiros precisa ser ampliado: estudo transversal Es necesario aumentar el pensamiento crítico de los estudiantes brasileños de graduación en enfermería: estudio transversal
Get PDFObjectives: to map Brazilian undergraduate nursing students’ critical thinking level and investigate the correlation between selected sociodemographic data and critical thinking domains.
Methods: in this descriptive cross-sectional study, participants’ (N=89) critical thinking was assessed using the Health Science Reasoning Test. Correlation between critical thinking domains and sociodemographic data was assessed using the Pearson correlation coefficient.
Results: the overall results showed a moderate level of participants’ critical thinking (mean = 70.7; standard deviation 5.7). A poor performance was identified in 5 of the 8 critical thinking domains. A significant positive correlation was found between education period and critical thinking (p<.001).
Conclusions: poor level in students critical thinking domains may lead to negative consequences for their learning outcomes. Further studies should be carried out to confirm our results, in addition to investigation of teaching methods that encourage and ensure the development of students’ critical thinking skills during nursing education.publishedVersio
Negative social media-related experiences and lower general self-efficacy are associated with depressive symptoms in adolescents
Get PDFThis is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Social media are an integral part of adolescents’ daily lives, and reviews have suggested an overall small association between more social media use and mental health problems. However, researchers have commonly investigated social media use in a time use perspective, rendering nuances in adolescents’ social media experience less well explored. Thus, studies of relationships between social media use and mental health problems need also examine the nature of the events taking place on social media. This study aimed to examine depressive symptoms in adolescents in relationship to time spent on social media, negative social media-related experiences, and general self-e cacy. Data collected in a national survey, Ungdata 2021 (n = 139,841), was used. Multivariate linear regression analyses showed that time spent on social media was associated with depressive symptoms (β = 0.09, p < 0.001). However, negative social media-related experiences were more strongly associated with depressive symptoms (β ranging 0.09–0.22, all p < 0.001), and their inclusion weakened the initial association between time on social media and depressive symptoms. General self-e cacy was directly associated with lower symptom levels (β = −0.29, p < 0.001) but did not change the associations between social media use and depressive symptoms. The findings imply that not only time spent on social media, but in particular negative social media-related experiences, are related to depressive symptoms in Norwegian adolescents. General self-e cacy is an important resource for adolescents’ mental health.publishedVersio
What are the advantages and disadvantages of having a foreign background as a female academic and working at a university in Europe?
No full textThis is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).The main goal of this project was to explore foreign female academics’ experiences working at universities in Europe. The Bologna Declaration has enabled the cross-border exchange of academic staff within Europe. Female academics represent an essential and steadily growing group within academia; they are occupying desirable academic positions at unprecedented rates. For women, building their teaching and scientific career at another university is associated with both privileges and challenges. The main goal of this project was to explore foreign female academics’ experiences working at universities in Europe. Methodology, this study had a qualitative design. Twelve female academics with a foreign background participated in the study. Data were collected via a digital workshop and analysed using the story dialogue method. The results show that the participants have faced daily challenges in the form of discrimination, bullying, and injustice regarding their personal, pedagogical, and research skills. All participants emphasized the importance of a structured introduction to a new country and university with a designated mentor. To retain female foreign academics who are an important scientific resource European universities, as employers, must develop and implement clear guidelines for a good, welcoming working environment.publishedVersio
Nettverksmobilisering – familie- og nettverksorienterte tiltak. Delrapport 3 i prosjektet «Virkning av hjelpetiltak i barnevernet»
Get PDFDenne rapporten handler om nettverksmobilisering – familie- og nettverksorienterte tiltak og er en delrapport i prosjektet «Virkninger av hjelpetiltak i barnevernet». Ulike begreper brukes om nettverksmobiliserende tiltak i barnevernet og i litteraturen. I dette prosjektet har vi brukt nettverksmobiliserende tiltak, nettverksarbeid og nettverkstiltak om hverandre. Vi forstår det som tiltak der familie og/eller øvrig nettverk involveres i barnevernets arbeid med hjelpetiltak. Nettverksmobiliserende tiltak bygger på en systemteoretisk og utviklingsøkologisk forståelse.publishedVersio
Besøkshjem og støttekontakt. Delrapport 2 i prosjektet «Virkning av hjelpetiltak i barnevernet»
Get PDFDenne rapporten handler om hjelpetiltakene besøkshjem og støttekontakt og er en delrapport i prosjektet «Virkning av hjelpetiltak i barnevernet». Studien bygger på flere metodiske tilnærminger. Vi har gjennomført en litteraturgjennomgang, kvalitative intervjuer med ansatte i barneverntjenester og personer som er engasjert som besøkshjem og støttekontakter, samt foreldre til barn som mottar besøkshjem og støttekontakt som barnevernstiltak. Studien bygger også på et feltarbeid i flere barneverntjenester der vi har vært til stede på drøftingsmøter i barneverntjenesten. I tillegg har vi gjennomført en studie av barnevernsmapper. Intervjuene, feltarbeidet og mappegjennomgangen omfatter alle tiltakene som inngår i prosjektet om virkninger av hjelpetiltak; også tiltakene besøkshjem, støttekontakt og COS-P.publishedVersio
Spor av Gud i Emmanuel Levinas’ filosofi
Get PDFForedrag holdt i Katolsk Forum, St. Dominikus Kloster, Oslo, 21.03.2023publishedVersio