Mental health promotion as perceived by Norwegian adolescents with somatically ill parents - an interpretative phenomenological analysis.

Objective: Having a somatically ill parent can influence adolescents' daily lives and mental health. This study aimed to explore the lived experiences of mental health promotion among adolescents with a somatically ill parent, based on a salutogenic orientation. Methods: Individual interviews with 11 adolescents (13-18 years of age) with a somatically ill parent were conducted. The data were analysed according to interpretative phenomenological analysis. Results: A superordinate theme, feeling at home in a house of mental health-promoting conversations, frames the participants' perceptions of a prominent mental health promotion experience, including decisive characteristics of the significant conversation partners and different important conversation contexts. The metaphor of feeling at home expresses that the participants ascribe the conversations taking place there as promoting mental health. The themes elucidate the superordinate theme: (a) significant conversation partners characterised by the three subthemes: (i) being available, (ii) being competent and (iii) being caring and (b) rooms reflecting conversation contexts containing four subthemes: (i) room of increased knowledge, (ii) room of disclosure, (iii) room for meeting points and (iv) room for breaks. Conclusion: Adolescents with a somatically ill parent perceived that conversations about important topics with significant others with special characteristics in distinct contexts promoted mental health.

Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study.

AIMS: Our aim was to investigate labor-force participation, working hours, job changes, and education over 9 years among persons who have survived more than 10 years after cancer, and compare it to controls. METHODS: Register data on 2629 persons who survived cancer were stratified by gender and compared to data on 5258 matched controls. Persons who survived cancer were aged 30-50 when diagnosed with cancer and had a work contract prior to diagnosis. Descriptive analysis and t-tests were performed. RESULTS: The proportion of female persons who survived cancer in the labor force was reduced from 100% to 83.9% during follow-up, demonstrating a significant difference compared to controls for each year measured. The proportion of male persons who survived cancer dropped from 100% to 84.8%, but was only significantly different compared to controls in 2 years. The proportion of female persons who had survived cancer who worked full-time was lower in all years compared to both controls and male persons who survived cancer; in turn, male persons who had survived cancer worked full-time less than male controls. The proportion of female persons who had survived cancer who worked less than 20 hours per week increased compared to controls. The frequency of change of employer was higher among female persons who survived cancer compared to controls for some years, but no significant differences between male persons who survived cancer and controls were found. Female persons who survived cancer were in education more often than male persons who survived cancer. CONCLUSIONS: Persons who survived cancer experienced reduced labor-force participation and working hours 9 years after diagnosis, and the reduction was more pronounced for women than for men. Working patterns were also different between genders and between persons who survived cancer and controls.

Mental health as perceived by Norwegian adolescents living with parental somatic illness: Living in an earthquake zone.

PURPOSE: Severe parental somatic illnesses can influence the entire family, including adolescents' everyday life, psychosocial functioning and health. Within salutogenesis, it is highlighted that stressor life events, such as parental somatic illness, might lead to a chain of events that can produce tension. There is a lack of in-depth understanding regarding how adolescents living in a situation with a severely somatically ill parent (SIP) perceive their own mental health. The aim of this study was therefore to explore the lived experience of Norwegian adolescents living with an SIP, and their perception of the parental illness' influence on their mental health. METHODS: Interpretative phenomenological analysis was used. In-depth interviews were conducted with 11 adolescents (aged 13-18 years) who had an SIP. Two adolescents with an SIP participated in study preparation and data analysis. RESULTS: Adolescents perceived parental somatic illness as a multifaceted influence on their mental health as it represented both personal and relational strain and growth. Their perceptions can be conceptualized by the super-ordinate theme "living in an earthquake zone", and by two themes, "inner shakes-but not falling apart" and "relational aftershocks-gains and losses". CONCLUSION: For adolescents, parental somatic illness means personal and relational strain and growth.

From shaky grounds to solid foundations: A salutogenic perspective on return to work after cancer.

Background: Almost a third of employed individuals of working age fall out of work after cancer treatment.Aim: To explore cancer survivors' successful return to work, focusing on assets and resources utilized to resolve cancer- and work-related obstacles to achieve long-term employment.Methods: We interviewed eight cancer survivors who had remained at work for at least 3 years after cancer treatment. We performed interpretative phenomenological analysis and applied Antonovsky's salutogenic model of health as a framework.Results: The participants experienced uncertainty regarding cancer recurrence, impairments, and long-lasting effects on work ability. They utilized a wide range of resistance resources at personal, interpersonal, and social levels. Their determination to return to work was generally strong, but the time needed to find sustainable work and strategies to return to work varied. All participants prioritized activities that energized them and adapted actively to their new situation. When unsure about outcomes, they focused on the best alternative and controlled fear cognitively.Conclusions/Significance: Finding meaningful activities, testing actual work ability, and focusing on the best possible outcome seemed important to remain in work after cancer. It may be helpful to identify available resources and utilize them to resolve tensions resulting from cancer and cancer treatment.

Reorienting Norwegian mental healthcare services: listen to patients' learning appetite.

Reorientation of healthcare services towards more efficient health promotion interventions is an urgent matter. Despite policies and guidelines being in place, it is the least developed key action area of the Ottawa charter. User involvement, or the voice of the patient, is missing from the knowledge base of health promotion in the mental healthcare services. The aim of this study was to add experiential knowledge from former patients. We explored the lived experience of 12 former inpatients at a mental healthcare hospital. We describe what they perceive as mental health promoting efforts. A salutogenic theoretical framework and the methodology of interpretative phenomenological analysis were used. The analysis revealed an appetite for learning in order to develop an in depth understanding of their former experiences. This was motivated by a desire to master daily life despite living with an illness and to increase health and well-being. The participants perceived the learning processes within the healthcare setting as mental health promoting. This craving for a better life is compatible with health promotion. It may turn out to be an opportunity to complement the curative activity of healthcare services with health promotion educational activities.

Salutogenic service user involvement in nursing research: A case study.

AIM: The aim was to explore the process of involving mental healthcare service users in a mental health promotion research project as research advisors and to articulate features of the collaboration which encouraged and empowered the advisors to make significant contributions to the research process and outcome. BACKGROUND: There is an increasing interest in evaluating aspects of service user involvement in nursing research. Few descriptions exist of features that enable meaningful service user involvement. We draw on experiences from conducting research which used the methodology interpretative phenomenological analysis to explore how persons with mental disorders perceived mental health. Apart from the participants in the project, five research advisors with service user experience were involved in the entire research process. DESIGN: We applied a case study design to explore the ongoing processes of service user involvement. METHODS: Documents and texts produced while conducting the project (2012-2016), as well as transcripts from multistage focus group discussions with the research advisors, were analysed. RESULTS: The level of involvement was dynamic and varied throughout the different stages of the research process. Six features: leadership, meeting structure, role clarification, being members of a team, a focus on possibilities and being seen and treated as holistic individuals, were guiding principles for a salutogenic service user involvement. These features strengthened the advisors' perception of themselves as valuable and competent contributors. CONCLUSION: Significant contributions from research advisors were promoted by facilitating the process of involvement. A supporting structure and atmosphere were consistent with a salutogenic service user involvement.

Service user involvement enhanced the research quality in a study using interpretative phenomenological analysis - the power of multiple perspectives.

AIM: The aim of this study was to examine how service user involvement can contribute to the development of interpretative phenomenological analysis methodology and enhance research quality. BACKGROUND: Interpretative phenomenological analysis is a qualitative methodology used in nursing research internationally to understand human experiences that are essential to the participants. Service user involvement is requested in nursing research. DESIGN: We share experiences from 4 years of collaboration (2012-2015) on a mental health promotion project, which involved an advisory team. METHODS: Five research advisors either with a diagnosis or related to a person with severe mental illness constituted the team. They collaborated with the research fellow throughout the entire research process and have co-authored this article. We examined the joint process of analysing the empirical data from interviews. Our analytical discussions were audiotaped, transcribed and subsequently interpreted following the guidelines for good qualitative analysis in interpretative phenomenological analysis studies. RESULTS: The advisory team became 'the researcher's helping hand'. Multiple perspectives influenced the qualitative analysis, which gave more insightful interpretations of nuances, complexity, richness or ambiguity in the interviewed participants' accounts. The outcome of the service user involvement was increased breadth and depth in findings. CONCLUSION: Service user involvement improved the research quality in a nursing research project on mental health promotion. The interpretative element of interpretative phenomenological analysis was enhanced by the emergence of multiple perspectives in the qualitative analysis of the empirical data. We argue that service user involvement and interpretative phenomenological analysis methodology can mutually reinforce each other and strengthen qualitative methodology.

Characteristics of patients frequently subjected to pharmacological and mechanical restraint--a register study in three Norwegian acute psychiatric wards.

This retrospective study from three catchment-area-based acute psychiatric wards showed that of all the pharmacologically and mechanically restrained patients (n=373) 34 (9.1%) had been frequently restrained (6 or more times). These patients accounted for 39.2% of all restraint episodes during the two-year study period. Adjusted binary logistic regression analyses showed that the odds for being frequently restrained were 91% lower among patients above 50 years compared to those aged 18-29 years; a threefold increase (OR=3.1) for those admitted 3 times or more compared to patients with only one stay; and, finally, a threefold increase (OR=3.1) if the length of stay was 16 days or more compared to those admitted for 0-4 days. Among frequently restrained patients, males (n=15) had significantly longer stays than women (n=19), and 8 of the females had a diagnosis of personality disorder, compared to none among males. Our study showed that being frequently restrained was associated with long inpatient stay, many admissions and young age. Teasing out patient characteristics associated with the risk of being frequently restraint may contribute to reduce use of restraint by developing alternative interventions for these patients.