KUNSKAPSUTVECKLING OCH FÖRBÄTTRINGSARBETE
BILAGA 3 Huvud och subkategorier.
Huvudkategori RELATION TRYGGHET ENGAGEMANG
Subkategorier → Studier ↓ Icke- dömande attityd Ingjuta hopp Bli sedd/hörd som unik individ
Tillgänglighet Tillit Vårdmiljö (kontext)
Delaktighet Empati Tid
Cardell & Rogers Pitula (1999) X X X X X X Ghio m.fl. (2011) X X X X X X Hagen m.fl. (2018) X X X X X X X Mc Laughlin (1999) X X X X X Samuelsson m.fl. (2000) X X X X X X X Sellin m.fl. (2017) X X X X X X X Sellin m.fl. (2018) X X X X X X Sun m.fl. (2006a) Sun m.fl. (2006) X X X X X X X
Sun & Long (2013)
Huvudteman RELATION TRYGGHET ENGAGEMANG Subkategorier → Studier ↓ Icke- dömande attityd Ingjuta hopp Bli sedd/hörd som unik individ
Tillgänglighet Tillit Vårdmiljö (kontext)
Delaktighet Empati Tid
Talseth m.fl.
(1999) X X X X X X X X
Talseth m.fl.
(2003) X X X X X X X
Vatne & Nåden
(2014) X X X X X X
Vatne & Nåden
(2016) X X X X X X X X
Vatne & Nåden (2018)
X X X X X X X
Wiklander m.fl. (2003)
BILAGA 4
Artikelmatriser.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the study
Cardell R & Rogers Pitula C “Suicidal inpatients perceptions of therapeutic and nontherapeutic aspects of constant observation” 1999 Psychiatric Services United States of America “Patients’ experiences of constant observation to determine whether they derived any therapeutic benefits beyond the
intended protective benefit.”
A qualitative research method based on extensive in-depht, audiotaped interviews were used. Each participant was interviewed at least twice and the interviews of three patients who refused to be
audiotaped were recorded in writing. Analysis was consistent with
Hutchinson’s recommended management of grounded theory data.
The population were selected nonrandomly from three psychiatric facilities in the US and they had all been placed under constant observation within two weeks before being
interviewed. They consisted of 20 suicidal inpatients, 13 women and 7 men, with a mean age of 32 years.
The participants viewed constant observation not only as a protective
intervention but as one that had therapeutic benefit. The benefits were attributed to the observers being perceived as having positive attitude and engaging them in active supportive interventions. The participants found the observers
acknowledgment of them as unique and meaningful human beings to be
therapeutic. Adverse effects were lack of acknowledgment, lack of privacy, intrusion in personal space and feelings of confinement. Medium quality Population consists of suicidal patients.* No ethical considerations.* No description of relationship researcher/population.
Data collection clearly presented.*
Analysis not clearly presented.*
Researchers preunderstanding related to data collection and analysis not described.
Result of the study not clearly presented.*
Mixed methods study.
Only the patients’ perspective is used in this literature review.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study Ghio L, Zanelli E, Gotelli S, Rossi P, Natta W, Gabrielli F “Involving patients who attempt suicide in suicide prevention: a focus groups study” 2011
Journal of Psychiatric and Mental Health Nursing
Italien
“Gain insight into the individual experiences of patients who attempt suicide in order to better understand the reasons for and emotions behind a suicide attempt, thus also gaining insight, through the patients’ own input, into the risk and protective factors which might influence possible repeat attempts and the attitude towards the assistance they receive.”
Qualitative study with a focus group to carry out research. Data was collected using recorded sessions of the group discussions. Analysis was obtained by listening to and reading transcripts of the recording of the said discussion. Relevant themes were classified and coded into three general themes. The population were divided into two focus groups with a total of 17 patients, 10 women and 7 men. The mean age was 45,6 years. All were undergoing treatment following suicide attempts, in the University Hospital of San Marino in Genoa, Italy.
Acknowledging the point of view and experiences of a person who attempts suicide proves an important tool when providing insight into suicidal behavior. Interpersonal relationships and an empathic environment were perceived as therapeutic and
protective and enabled the expression of thoughts and self- understanding. Therapeutic interventions and prevention strategies should provide a warm and positive experience for the patient.
Focus should be aimed at forming a healthy relationship, conveying acceptance and
understanding, inspire hope and promoting communication and connection with others.
High quality
Population undergoing treatment following suicide attempt.*
Study approved by ethics committee.*
Population selection procedure not clearly described.
No description of relationship
researcher/population. Data collection, analysis and result clearly presented.* Researchers
preunderstanding in relation to data collection not
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study Hagen J, Knizek BL, Hjelmeland H “Former suicidal inpatients experiences of treatment and care in psychiatric wards in Norway”
2018
International Journal of Qualitative Studies in Health and Well- being
Norway
“How former suicidal inpatients experienced
treatment and care in psychiatric wards in Norway.”
Qualitative study based on Interpretative
Phenomenological Analysis with individual, in-depth and semi-
structured interviews. Data was analyzed by means of Interpretative
Phenomenological Analysis. All interviews were recorded and transcribed verbatim. The population were 5 persons, 4 women and one man, aged between 33 to 54 years. They had all been previously
hospitalized in psychiatric wards in mid-Norway because of suicidality.
The findings indicate that suicidal inpatients emphasize to encounter nurses who make them feel safe and
comfortable enough to open and share their suffering and suicidality, and who recognize them as a valuable person and respond to their needs. Insufficient care lead to suicidal patients
withdrawing and keeping their pain and suicidality to
themselves, which might be harmful for their wellbeing and safety.
High quality
Population previously hospitalized because of suicidality.*
Study approved by ethics committee.*
Researchers
preunderstanding in relation to data collection and analysis not described. Data collection, analysis and result clearly presented.* Result not presented in relation to theoretical reference frame.
No hypothesis presented. Few participants in the study.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study
Mc Laughlin C “An exploration of psychiatric nurses’ and patients’ opinions regarding inpatient care for suicidal patients” 1999 Journal of Advanced Nursing Northern Ireland “To explore psychiatric nurses and patients’ opinions regarding the care proffered to suicidal patients and find out how care for suicidal patients could be improved.”
Exploration study. Using content analysis
described by Field & Morse, data was collected through face- to-face interviews. Questions were read exactly as they were worded, and answers were written down verbatim. Responses were analyzed using content analysis.
The population consisted of 17 suicidal inpatients, 10 women and 7 men, from a psychiatric hospital in Northern Ireland. Their ages ranged between early 20s to late 60s. All had received inpatient care for at least 7 days.
Patients identified communication skills as being the most important skill and they wanted nurses to spend more time with them helping them to problem-solve. They also identified situational factors such as staff shortages and lack of time as limiting factors.
Medium quality
Population hospitalized because of suicidality.* Study approved by ethics committee.*
Population selection procedure not clearly described.
No description of relationship
researcher/population. Data collection and analysis not clearly presented.*
Result clearly presented.* Result not presented in relation to theoretical reference frame. Mixed methods study. Only the patients’
perspective is used in this literature review.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study Samuelsson M, Wiklander M, Åsberg M, Saveman B-I “Psychiatric care as seen by the attempted suicide patient” 2000 Journal of Advanced Nursing Sweden “Describe the attempted suicide patients’ perceptions of receiving specialized in-patient psychiatric care.” A qualitative content analysis, inspired by Burnard, was used to collect and analyze data. Content analysis is concerned with meanings, intentions, consequences and context. Face-to-face interviews, all
transcribed verbatim and tape-recorded.
The population consisted of 18 patients, 6 women and 12 men, ranging in age from 18 to 53 years. All were admitted to a ward at the psychiatric clinic of Karolinska Hospital in Sweden because of suicide attempts.
Patients perceived the time at the hospital mostly as helpful, although with mixed feelings about being a psychiatric patient. Patients stressed the need for someone to talk to, a need that in most cases were fulfilled. The conversations with the staff were essential for the process of healing and for the desire to go on living. Some patients also described negative situations such as lack of commitment and respect from the staff.
High quality
Population hospitalized because of suicidality.* Study approved by ethics committee.*
Researchers
preunderstanding in relation to data collection and analysis not described. Data collection, analysis and result clearly presented.* Result not presented in relation to theoretical reference frame.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study Sellin L, Asp M, Wallsten T, Wiklund Gustin L “Reconnecting with oneself while struggling between life and death: The phenomenon of recovery as experienced by persons at risk of suicide” 2017 International Journal of Mental Health Nursing Sweden “Describe the phenomenon of recovery in a context of nursing care as experienced by persons at risk of suicide.”
The study was conducted with a reflective
lifeworld research approach, based on phenomenological philosophy. Data were collected using
phenomenon-oriented interviews which were digitally recorded and transcribed verbatim. Meaning units were identified and compared to identify differences and similarities. The population for the study were recruited from a psychiatric clinic in central Sweden and consisted of 14 persons, 11 women and 3 men, aged between 20 to 70 years. All were admitted to psychiatric inpatient care related to suicide risk defined by a clinical suicide risk assessment.
The results reveal that the phenomenon of recovery means “reconnecting with oneself while struggling between life and death” Three meaning
constitutes emerged: being in an expressive space and giving voice to oneself, regaining dignity through nurturing
connectedness, and finding a balance in the tension between life and death. Professionals need to acknowledge patients’ lifeworld in a way that enable patients to
experience themselves as capable of managing their own life.
Medium quality
Population hospitalized because of suicidality.* Study approved by ethics committee.*
No description of relationship
researcher/population. Data analysis not clearly presented.*
Data collection clearly presented.*
Result of the study not clearly presented.*
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study
Sellin L, Kumlin T, Wallsten T, Wiklund Gustin L “Caring for the suicidal person: a Delphi study of what characterizes a recovery-oriented caring approach” 2018 International Journal of Mental Health Nursing Sweden “Describe what characterizes a recovery-oriented caring approach, and how this can be expressed through caring acts involving suicidal patients and their relatives.”
The study was conducted by means of a Delphi approach, which meant that the research was conducted step by step following Delphi methodological principles. Data were collected using focus group interviews, recorded with a digital voice recorder. Analysis were carried out by thematic analysis of interview data.
Population consisted in 5 people who were
considered to have special knowledge about suicide prevention due to personal experiences.
The results of the study suggested that a
recovery-oriented caring approach is characterized by “communicative togetherness”, which is associated with sensitive listening and talking about both dark and light life events of relevance for the patient. The nurses who care for suicidal patients should spend more time
communicating with the patients, acknowledging their intentions, dreams, hopes and fears in a way that supports their experiences of being a capable human being. The recovery-oriented caring approach indicates to mediate support for suicidal patients to feel more able to manage both challenges and possibilities in everyday life, even though the dark is still present in their lives.
High quality
Population previously suicidal.*
Study approved by ethics committee.*
Researchers
preunderstanding in relation to analysis not described. Data collection, analysis and result clearly presented.* Result not presented in relation to theoretical reference frame.
No hypothesis presented. Mixed methods study. Only the patients’
perspective is used in this literature review.
Few participants in the study.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study
Sun F-K, Long A, Boore J, Tsao L-I
“A theory for the nursing care of patients at risk of suicide” 2006a Journal of Advanced Nursing Taiwan & UK “Explore and examine psychiatric nurses’ and patients’ perceptions of the care offered to patients with suicidal ideations on
psychiatric wards and develop a nursing theory to guide the care of patients at risk of suicide.”
A grounded theory was used. Collection, coding and analysis are a simultaneous process from the beginning of a study to its conclusion. Data were analyzed using a synthesis of the Strauss and Corbin analytical framework, comprising open, axial and selective coding, with Eaves 12 analytical steps to increase understanding and enhance the clarity of grounded theory data analysis.
Population consisted in 15 patients, 9 women and 6 men, aged between 16 to 47 years. All were considered suicidal, with either suicidal ideas or having previous suicide attempts. The study took place in three hospitals in Taiwan.
The study found that patients wanted the nurses to spend more time with them and to help them explore their problems.
Patients wanted the nurses to “provide basic nursing care”, which meant being with
patients, both physically and emotionally, to instill hope.
High quality
Population hospitalized because of suicidality.* Study approved by ethics committee.*
Context not clearly described.
Researchers
preunderstanding in relation to data collection and analysis not described. Data collection, analysis and result clearly presented.* Two patients in the study under 18 years of age.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study
Sun F-K, Long A, Boore J, Tsao L-I
“Patients and nurses’ perceptions of ward environmental factors and support systems in the care of suicidal patients”
2006b
Journal of Clinical Nursing
Taiwan & UK
“Present and discuss the findings that emerged from a qualitative study exploring nurses and patients’ views of the acute psychiatric ward (the context) and the type of care received (the intervening conditions).”
Qualitative research using the grounded theory approach. Data collection used
participant observation and semi-structured, tape-recorded interviews. Data were analyzed using open, axial and selective coding.
The population consisted of 15 patients, 9 women and 6 men, aged between 16 to 47 years, who had either suicidal ideas or had attempted suicide. All were admitted to psychiatric wards from three different hospitals in Taiwan.
The two categories that emerged were
teamworking and the psychiatric ward
environment. In addition, the four categories nurses´ attitudes and beliefs influence caring, barriers to caring, patients´ negative thoughts and feelings about the care provided.
High quality
Population hospitalized because of suicidality.* Study approved by ethics committee.*
Context not clearly described.
Researchers
preunderstanding in relation to data collection and analysis not described. Data collection, analysis and result clearly presented.* Two patients in the study under 18 years of age.
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study
Sun F-K & Long A “A suicidal recovery theory to guide individuals on their healing and recovering process following a suicide attempt” 2013 Journal of Advanced Nursing Taiwan & UK
“To develop a theory to guide the recovery of individuals who had a recent suicide attempt.”
A qualitative, grounded theory approach was used. Semi-structured, audio-taped interviews were used to collect data. Data were then analyzed using open, axial, and selective coding and using the constant comparison technique. The population consisted of 14 patients,10 women and 4 men, aged from 22 to 83 years, who
recovered from suicide attempts in a Taiwanese hospital.
A core category to guide the recovery process was “striving to accept the value of self-in-
existence”. Patients felt the need to become flexible and open- minded, re-build a
positive sense of self, and endeavor to live a
peaceful and contented life.
High quality
Population undergoing treatment following suicide attempt.*
Study approved by ethics committee.*
Population selection procedure not clearly described.
Researchers
preunderstanding in relation to data collection and analysis not described. Data collection, analysis and result clearly presented.*
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study Talseth A-G, Lindseth A, Jacobsson L, Norberg A “The meaning of suicidal psychiatric inpatients experiences of being cared for by mental health nurses” 1999
Journal of Advanced Nursing
Sweden and Norway
“Illuminate the meaning of suicidal psychiatric in-
patients´ experiences of being cared for by mental health nurses, as narrated in
interviews.”
Phenomenological- hermeneutic method inspired by Ricoeur. Data was collected using tape- recorded narrative interviews. Data were analyzed using structural analysis, dividing the text into meaning units, coded, condensed into subthemes and themes. The population consisted of 21 psychiatric
inpatients, 9 men and 12 women, from five hospital wards in
Norway. All had thought about, expressed the wish or attempted suicide.
Two main themes were found. Confirming: attending to patients` basic needs, seeing the patient, having time, listening without prejudice,
communicating hope, accept patient´s feelings, being there, being open. And Lack of
confirmation: which
included the opposite of above themes.
High quality
Population hospitalized because of suicidality.* Study approved by ethics committee.*
Researchers
preunderstanding in relation to data collection and analysis not described. Data collection, analysis and result clearly presented.*
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study
Talseth A-G, Gilje F, Norberg A “Struggling to become ready for consolation: experiences of suicidal patients” 2003 Nursing Ethics Sweden “Describe a process of consolation revealed by two suicidal patients’ experiences in the light of the model of consolation
described by Norberg m.fl..”
Qualitative data, through a phenomenological hermeneutic approach inspired by Riceur, were gathered from two narrative interviews from previous study focusing on suicide by Talseth m.fl. Data were analyzed using thematic structural analysis.
Participants were two middle-aged Norwegian suicidal patients who were hospitalized for psychiatric care. The interviews focused on the expressed meaning of care and were selected because of their richness, depth and descriptiveness of data relating to the aim of this study.
The result indicate that outer and inner
dialoguing and inner dialoguing is a complex interwoven process of relating to self, others and the world. These processes reveal and conceal desiring, longing, expecting, thinking, feeling and reflecting. In the result inner dialoguing is seen as very potent throughout the process of
consolation. The process is channeled through the personnel openness, listening, presence and availability.
High quality
Population hospitalized because of suicidality.* Study approved by ethics committee.*
Researchers
preunderstanding in relation to data collection and analysis not described. Only two participants in the study.
Data collection, analysis and result clearly presented.*
Authors, title, year, journal, country
Aim Study design, method,
population
Results Overall quality of the
study
Vatne M & Nåden D “Patients’ experiences in the aftermath of suicidal crises” 2014 Nursing Ethics Norway “Investigate patients’ experiences in the aftermath of suicidal crises and what appears to have helped them.”
Qualitative research with Gadamer’s hermeneutic methodology. A holistic view based on Eriksson’s theory of health. Data were collected by semi- structured interviews. A thematic analysis was then carried out to identify, analyze and refer themes.
The population included in the study consisted in