Vulnerable and without protection: Lifetime experiences of abuse and its influence on mental ill health -—An interview study among Swedish women within general psychiatric care

Violence against women is a major global public health issue, and experiencing violence has substantial consequences for the lives of abused women. This study aims to illustrate experiences of abuse and its influence on mental ill health among women seeking general psychiatric care. Ten women seeking general psychiatric care in southern Sweden participated in a qualitative interview study. Content analysis resulted in four categories: Living in fear that persistently influences the substance of life, living with the sense of being worthless, living with a constant question about who you are and living between hope and despair. The theme evolving from the analysis was: Being vulnerable and without protection in a frightful reality that limits one’s possibilities of living and being the person one wishes to be. The results showed that the women described their mental ill health not only in terms of depression, anxiety and suicidal ideation and self-harm, but also in relation to feelings of hope and despair, fear, worthlessness and living with a constant question about who they are. The abuse reduces freedom of action, and leads to feelings of insecurity, of not having any boundaries, isolation, and self-contempt and a need to escape. This study provides knowledge of abused women self-reported mental ill health in relation to abuse.

Symptoms, Illness Perceptions, Self-Efficacy and Health-Related Quality of Life Following Colorectal Cancer Treatment

Introduction: Lower health-related quality of life (HRQoL) is associated with fatigue, poor mental and poor gastrointestinal health during the first three months after colorectal cancer (CRC) treatment. Research indicates that maintaining usual activities has a positive impact on HRQoL after treatment for CRC. Illness perceptions have been associated with HRQoL in other cancer diseases, and self-efficacy has been associated with HRQoL in gastrointestinal cancer survivors. Our knowledge about illness perceptions and self-efficacy in relation to maintaining everyday activities and HRQoL following CRC treatment is incomplete. Aim: To explore associations between HRQoL, fatigue, mental health, gastrointestinal health, illness perceptions and self-efficacy in relation to maintaining everyday activities, three months after surgical CRC treatment. A further aim was to test the Maintain Function Scale in a CRC population. Method: The study was cross-sectional. Forty-six persons participated. Data were collected using questionnaires. Descriptive and analytical statistics were used. Results: Persons who were more fatigued, depressed, worried, and had more diarrhea were more likely to report lower HRQoL. Increased fatigue and diarrhea were associated with decreased HRQoL. Concerning illness perceptions, persons who reported negative emotions and negative consequences of CRC were more likely to report lower HRQoL. Persons scoring higher on self-efficacy were more likely to report higher HRQoL. Increased self-efficacy was associated with increased HRQoL. The Maintain Function Scale was suitable for assessing self-efficacy in relation to maintaining everyday activities. Conclusions: Nursing support to improve self-efficacy and illness perceptions and to minimize symptoms during recovery should have a favorable impact on HRQoL.

Living in the Wake of Chronic Obstructive Pulmonary Disease and Long-Term Oxygen Therapy

Background: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world. COPD is a progressive disease that could lead to chronic hypoxemia, which requires treatment as domiciliary Long-Term Oxygen Therapy (LTOT). There is a need for increased knowledge about self-care strategies used by individuals living with COPD and LTOT. Objective: The aim was to explore experiences and self-care strategies in patients living with both COPD and LTOT. Sample: The sample consisted of five men and five women diagnosed with COPD being prescribed LTOT for more than one year. Method: Ten interviews were undertaken and analyzed for both manifest and latent content. Results: Living with COPD and LTOT was associated with experiences of guilt although there were doubts about what had caused the lung disease. Both the lung disease and the oxygen therapy had a negative impact on their self-image. Anxiety was expressed when thoughts about the remaining time occurred. There was a constant balance between diminishing abilities and increasing restrictions related to the lung disease and the therapy. In order to compensate for arising imbalance, self-care strategies had been initiated aimed at preserving the present state of health, enabling and facilitating physical activity and promoting a positive attitude. Conclusion: The current study suggests that individuals living with COPD and LTOT are encouraged to adopt self-care strategies directed towards maintaining stability with regard to the lung disease, the oxygen therapy, physical capability and emotional reactions.

“I Dread the Heart Surgery but it Keeps My Child Alive”—Experiences of Parents of Children with Right Ventricular Outflow Tract Anomalies during the Assessment for Cardiac Reoperation

Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.

Health Care Students’ Attitudes towards People with Schizophrenia—A Survey of Eight University Training Programs

Background: Discrimination and stigmatization of people with mental illness are a global and complex phenomenon and there is evidence that negative attitudes and discrimination are also prevalent among health care staff and health care students. Methods: Attitudes towards people with schizophrenia among 1101 students in eight different university programs providing training for work in the health care and social sectors were explored, using a cross-sectional design. Results: In five of the eight training programs the majority of the students’ perceived people with schizophrenia as a danger to others. In several aspects police students were found to hold more negative attitudes than students from other programs. Students with previous experiences of work in mental health services and students knowing a person with schizophrenia showed more positive attitudes. Discussion: In order to decrease negative attitudes and prejudices towards people with schizophrenia among students, it is essential that the training includes personal contact with people with experience of being mental illness.

Psychometric evaluation of a Swedish version of Krantz Health Opinion Survey

The purpose of this study was to evaluate the psychometric properties of a Swedish version of The Krantz Health Opinion Survey (KHOS). A convenience sample of 79 persons (47 men and 32 women) was recruited from The Heart and Lung Patients’ National Association at ten local meeting places in different areas in Sweden. The questionnaire was examined for face and content validity, internal consistency and test-retest reliability. The findings showed that the Swedish version of KHOS is acceptable in terms of face and content validity, internal consistency and test-retest reliability over time among 79 individuals >65 years of age and with a cardiac disease. In conclusion, wider evaluations of the psychometric use of KHOS for other populations and settings are recommended.

Registered Nurses’ Perceptions of Factors Contributing to Trust-Based Public Management

Aim: The aim of this study was to illuminate registered nurses’ (RNs) perceptions of Trust-Based Public Management (TBPM) in Swedish health care. Design: This study follows a phenomenografic approach guided by Ference Marton’s philosophy. Methods: Semi-structured interviews were used to identify variations in RNs’ perceptions of TBPM. Between February and April 2019, 24 RNs from five Swedish public healthcare departments participated in the study. Results: The results show that none of the participants had previously heard about the work of the Swedish Delegation for TBPM. The study revealed perceptions those politicians and managers were absent from the workplace, that power had been displaced to HR, and that perceptions of trust in the leadership and of working to guidelines varied. Perceptions varied between RNs employed by the municipalities and by the hospitals concerning administration, the time allotted for work, cooperation, and education.

Behavioral involvement and preference for information among male and females with cardiac disease

The aim of this pilot study was to explore and compare preferences for involvement and preferences for information among men and women who had suffered from cardiac disease. A convenience sample of 79 respondents (47 men and 32 women) was recruited from The National Association of Heart and Lung Patients in Sweden at ten local meeting places in different areas. Krantz Health Opinion Survey, KHOS, a 16-item self-rating questionnaire, was used to measure patients’ desire for involvement in healthcare. The results indicate that patients’ information preferences and behavioural preferences are not very high though the total score in KHOS was 5.47. A difference between the genders was also found, seen as higher scores in females than males;5.93 vs 4.44, p = 0.032, indicating that women prefer a more active role in decision making than men do. The main practical conclusion drawn from this empirical study is that patients are still not as active in seeking information or in behavioural involvement as is desirable.

Determination of cytokine regulated glycan expression by using molecularly imprinted polymers targeting sialic acid

Cancer cells often have an increased amount of glycans, such as sialic acid (SA), on the cell surface, which normally play an important role in cell growth, proliferation and differentiation. In this study, SA expression is determined by fluorescent nanoprobes, molecularly imprinted polymers, SA-MIPs. The nanoprobes are synthesized with an imprinting approach to produce tailor-made fluorescent core-shell particles with high affinity for cell surface SA. Inflammation and cytokine production are well known tumor promoters, modulating the cellular microenvironment, including an aberrant cell surface glycan pattern. The recombinant cytokines IL-4, IL-6, IL-8 and a cocktail of cytokines collected from stimulated T leukemia Jurkat cells were used to induce in vitro inflammation in two cell lines, and thereafter analyzed with the use of SA-MIPs and flow cytometry. One of the cell lines showed a different binding pattern of SA-MIPs after treatment with recombinant cytokines and the cytokine cocktail. This study shows that SA-MIPs can be an important tool in the investigation of overexpressed glycans in the tumor microenvironment.