Investigating the Associations between Patient-Reported Quality of Care and Perceived Coercion: A Norwegian Cross-Sectional Study.

Patient perspectives on the quality of care received are fundamental to mental health care. This study aimed to investigate the association between patient-reported mental health care quality, perceived coercion, and various demographic, clinical, and ward-related factors. Using a cross-sectional design, data were collected from 169 patients in Norwegian mental health wards using the quality in psychiatric care-inpatient (QPC-IP) instrument and experienced coercion scale (ECS). The analysis revealed a consistent pattern in which patients with higher perceived coercion consistently rated lower quality on all QPC-IP dimensions. The significant findings of the multiple regression models further supported this association. Beyond coercion, the factors influencing quality ratings include self-reported treatment results, participation in treatment planning, and knowledge of complaint procedures. Emphasizing the pivotal role of coercion in enhancing mental health care quality, these findings contribute to a nuanced understanding of patient experiences and underscore the importance of patient participation in mental health care improvement efforts.

School Nurses' Experiences in Dealing with Adolescents Having Mental Health Problems.

Introduction: An increased number of adolescents experience mental health problems. School nurses have described spending more than 50% of their time working with mental health in students. The lack of knowledge and necessary training to meet students' mental health needs has been described previously. School nurses have a responsibility to find and guide those who need help with mental health problems. Objectives: The aim of this study was, therefore, to explore school nurses' experiences with mental health and how they in this work identify, talk, and intervene with adolescents having mental health problems. Methods: A qualitative study was conducted with 21 school nurses using focus group interviews which were analyzed by means of content analysis. Results: Three descriptive categories emerged: Health-promoting or preventive approaches, Enabling students to talk about feelings, and Collaborating partners. Conclusion: School nurses highlight their mandate to work with health promotion and prevention but also draw attention to their difficulties in identifying those who need help. School nurses use their creativity, intuition, and knowledge but have difficulty identifying those students who need help with mental health problems. They also highlight collaboration with other professionals both in schools and in the health system.

Adaption and Cultural Validation of the Quality in Psychiatric Care-Outpatient Staff (QPC-OPS) Instrument to a Norwegian Community Mental Health Context.

The aim was to culturally adapt and validate the Swedish Quality in Psychiatric Care-Outpatient Staff (QPC-OPS) instrument for use in a Norwegian community mental health service context. The translated and culturally adapted instrument was named Quality in Psychiatric Care-Community Outpatient Staff (QPC-COPS). Three expert panels of mental health staff (n = 9) assessed the face and content validity. The internal consistency and test-retest reliability were assessed on a sample of community mental health staff (n = 64). The QCP-COPS had adequate face and content validity, and the full instrument showed excellent internal consistency (alpha = 0.90) and test-retest reliability (ICC = 0.87:0.94). In conclusion, the QPC-COPS is a valid and reliable instrument suitable for measuring staff's perception of the quality of care they deliver in community mental health services.

Family support and quality of community mental health care: Perspectives from families living with mental illness.

AIM AND OBJECTIVES: Describe patients' and family members' perceptions of family support from nurses and other mental healthcare professionals, and quality of care in community mental healthcare service. Further, compare the perceptions of patients and family members. BACKGROUND: While patients value family involvement, family members feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Family perceived support and quality of community mental health care may vary across patients and family members. DESIGN AND METHODS: Cross-sectional study with patients suffering from mental illness and family members in community mental healthcare services in Norway. Altogether 86 participants, of whom 33 patients and 33 family members had a family relationship-paired samples. Participants filled in the translated version of the Iceland Family Perceived Support Questionnaire (FPSQ-N) and Quality in Psychiatric Care-Community Out-Patient (QPC-COP) and Community Out-Patient Next of Kin (QPC-COPNK). STROBE checklist was used. RESULTS: Family members scored family perceived support and quality of community mental health care lower than patients. Family members feel the loss of support. Patient and family members found the Patient-healthcare professionals' relationship to be of high quality, while family members gave low score to being respected and invited to take part in care by nurses and other mental healthcare professionals. CONCLUSION: Family members' unmet need of support highlights the need for nurses and other community mental healthcare professionals to assess complex family needs and to intervene. Barriers to collaboration exist, and family members need to be respected and invited into community mental health care. RELEVANCE TO CLINICAL PRACTICE: Contributes knowledge of how to meet the family's needs and provides a basis for further care and treatment development in similar contexts nationally and internationally.

Young adults suffering from mental illness: Evaluation of the family-centred support conversation intervention from the perspective of mental healthcare professionals.

AIMS AND OBJECTIVES: To explore how mental healthcare professionals' experience and evaluate the use of Family-Centred Support Conversation Intervention. BACKGROUND: Mental health professionals working in the community mental health service provide treatment, care and support to young adults suffering from mental illness. Young adults suffering from mental illness are dependent on other family members and live close to the family. The Family-Centred Support Conversation promotes healing and alleviates the suffering of the family. DESIGN AND METHODS: A qualitative explorative design was used. Individual interviews with health professionals (n = 13) were conducted in Norway and analysed using a phenomenographic approach. The COREQ checklist was used. RESULTS: Three descriptive categories emerged: A new tool in the toolbox, the family as a conversational partner and Implementing the intervention, with seven conceptions. The mental health professionals had no previous routine for family support. The conversations helped them to structure the involvement of family members. Having the family as a conversational partner together with the patients was considered both somewhat new and rewarding but also challenging. The mental health professionals described a need to adjust the intervention. CONCLUSIONS: The Family-Centred Support Conversation was described as a complement to care, as usual, structuring the involvement of families. The knowledge exchange between the families and the mental health professionals may create a context of changing beliefs, strengths and resources. RELEVANCE TO CLINICAL PRACTICE: Clinical practice is challenged to work on establishing a mindset; whereby, the family is regarded as a resource with important skills and life experience. The family should be offered individualised support and follow-up, and FCSC may be a relevant intervention.

The Relationships between Health Professionals' Perceived Quality of Care, Family Involvement and Sense of Coherence in Community Mental Health Services.

Mental health professionals have a responsibility to ensure the best possible quality of care. Family is strongly involved in the patient's everyday life. The aim of this study was to investigate the relationship between health care professionals' perception of the quality of care, attitudes of family involvement and their own sense of coherence. A descriptive quantitative study with fifty-six health professionals, completed "Quality in Psychiatric Care-Community Outpatient Psychiatric Staff", "Families' Importance in Nursing Care-health professionals' attitudes", "The Sense of Coherence Scale-13". The health professionals perceived quality as high and did not perceive the families as a burden.

It's Not a Race, It's a Marathon! Families Living with a Young Adult Suffering from Mental Illness.

The aim of this study is to explore families' perceptions of everyday life when living with a young adult suffering from mental illness. Findings include: 1) Families balance between letting go and enabling the young adult to become independent while remaining close to help him/her complete education, work and have a social life. 2) Young adults try to deal with symptoms of mental illness by themselves and not be a burden, although longing for family members to understand them and the situation. 3) Healthcare professionals still hold back information although young adults have consented to giving family members insight.

Young Adults and Their Families Living With Mental Illness: Evaluation of the Usefulness of Family-Centered Support Conversations in Community Mental Health care Settings.

The aim of this study was to evaluate the usefulness of Family-Centered Support Conversations (FCSC) offered in community mental health care in Norway to young adults and their families experiencing mental illness. The FCSC is a family nursing intervention based on the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model and is focused on how family members can be supportive to each other, how to identify strengths and resources of the family, and how to share and reflect on the experiences of everyday life together while living with mental illness. Interviews were conducted with young adults and their family members in Norway who had received the FCSC intervention and were analyzed using phenomenography. Two descriptive categories were identified: "Facilitating the sharing of reflections about everyday life" and "Possibility of change in everyday life." The family nursing conversations about family structure and function in the context of mental illness allowed families to find new meanings and possibilities in everyday life. Health care professionals can play an important role in facilitating a safe environment for young adults and their families to talk openly about the experience of living with and managing mental illness.

Mental Health Professionals' Experiences with Applying a Family-Centred Care Focus in Their Clinical Work.

Family members play vital roles in supporting their young adults with mental health challenges, implying that professionals are challenged to apply a Family-Centred Care approach (FCC) in community mental health services. By applying a qualitative phenomengraphic approach, this study aimed to explore and describe professionals' experiences of applying a FCC approach. Based on data from 13 individual interviews, the descriptive categories were: Mutual understanding, Facing dilemmas and Dealing with barriers. Despite the professionals' expressed desires to involve the family, individual treatment and follow-up seemed to characterize their daily clinical practice, often due to the young adults' own wishes.

Parents Experiences Raising a Child with Food Allergy; A Qualitative Review.

PROBLEM: Food allergies are one of the fastest growing public health concerns without a cure, affecting approximately 8% of the world's child population. Being the parent of a child with allergies may lead to concerns, and affect everyday life in the family. The aim was to synthesize and describe parents' experiences of living with food allergies in families when one of the children has a food allergy. ELIGIBILITY CRITERIA: A systematic search using subject terms and text words was performed in Cinahl (Ebsco), Swemed+, Medline (OVID) and Scopus in October 2017. The search was limited to parents with children and adolescents, for the years from 2006 to October 2017. SAMPLE: One hundred and forty articles were screened and 24 were included. RESULTS: A meta-summery of the results from the included studies were conducted. The parents lived in fear, after their child had their first reaction and had become allergic, a life threatening experience. They tried to live an ordinary family life and parents had to learn how to be one-step ahead and understand early signs. The family's social life was also influenced. Parents asked for support and information from health professionals and more knowledge and skills increased parents' manageability. CONCLUSION: Parents need support and a seamless encounter with health professionals, with multidisciplinary collaboration and knowledge sharing to develop the parents' self-efficacy. IMPLICATIONS: Health professionals must provide information and support parents on their path through the health-care system in having a child with a food allergy.

Mental health work in school health services and school nurses' involvement and attitudes, in a Norwegian context.

AIMS AND OBJECTIVES: To explore school nurses' experiences with and attitudes towards working with young people with mental health problem in the school health services. BACKGROUND: Worldwide, 10%-20% of children and adolescents are affected by mental health problems. When these occur during youth, they constitute a considerable burden and are one of the main causes of disability among adolescents. School nurses are at the forefront of care for children and adolescents, identifying pupils struggling with physical, mental, psychosocial or emotional issues. DESIGN: A qualitative, explorative study was performed based on open-ended questions in a cross-sectional study of 284 school nurses in Norway. Inclusion criteria were as follows: working as a school nurse in the school health services with children and adolescents between the ages of 11-18 years. A qualitative inductive content analysis was conducted. RESULTS: Three generic categories emerged: perception of their role and experiences with mental health: the school nurses acknowledge their important role in work with adolescents focusing on their mental health. Perception of their professional competence: the school nurses described a lack of confidence and unmet training needs concerning mental health problems. Experiences with collaboration: the school nurses requested more knowledge about inter- and multidisciplinary cooperation regarding follow-up of pupils with mental health problems. CONCLUSIONS: The school nurses lacked knowledge and confidence in respect of working with children and adolescents suffering from mental health problems. This may be a barrier to giving pupils adequate aid. RELEVANCE TO CLINICAL PRACTICE: Nurses need to acquire more knowledge about mental health problems among children and adolescents as this is a growing public health issue. Educational programmes for school nurses need to be revised to achieve this.

Undergraduate Nursing Students' Evaluation of the Debriefing Phase in Mental Health Nursing Simulation.

The debriefing phase in mental health nursing simulation promotes a reflexive learning process with the opportunity to develop metacognitive and nontechnical skills. The aim of this quantitative study was to describe undergraduate nursing students' evaluation of their experience during the debriefing phase following high fidelity human simulation (HFHS). Data was collected using the "Debriefing Experience Scale" and analysed with descriptive and comparative tests. The debriefing phase was evaluated as very good. Background data and group size revealed few significant differences. Students with little clinical praxis evaluated having time to acknowledge feelings as important. Differences between groups revealed that groups should consist of up to eighteen students.

Parental perception of family functioning in everyday life with a child with ADHD.

AIM: The aim of this study was to describe and investigate family characteristics in relation to support, behaviour of the child, family functioning and sense of coherence from the parents' perspective in families with a child with attention deficit hyperactivity disorder (ADHD). A further aim was to explore predictors of family functioning. METHODS: The study population consisted of 1964 parents of children with ADHD aged 15 years old and younger. In all, 265 parents responded to a questionnaire (response rate 48.2%; 217 mothers and 48 fathers). In addition to questions about the parents, children, family characteristics and support from health services, the questionnaire included the Family Assessment Device (FAD), the Strengths and Difficulties Questionnaire (SDQ), Sense of Coherence (SOC) and Social Cohesion and Support Index (SCS). Data were analysed with descriptive, comparative and standard multiple regression analyses. RESULTS: Parents with ADHD reported a weaker SOC and poorer FAD in the family than parents without ADHD. Parents with children medicated for ADHD were significantly more satisfied with social support (SCS), rated their children's behaviour as less problematic and reported better family functioning. Parents' age, SOC, SCS, SDQ and support from the community health services explained 46.2% of the variation in FAD. CONCLUSIONS: A strong SOC, social support and support from the community health services were strongly associated with a positive effect on family functioning. Parents with ADHD reported a weaker SOC and poorer family functioning than parents without ADHD. This knowledge may be useful and should be taken into account when planning support for such families.

Living in a family with a child with attention deficit hyperactivity disorder: a phenomenographic study.

AIMS AND OBJECTIVES: To describe experiences of everyday life in families with a child with attention deficit hyperactivity disorder. BACKGROUND: Attention deficit hyperactivity disorder is a highly prevalent, clinically heterogeneous disorder characterised by behavioural symptoms of inattention, hyperactivity and impulsivity that creates impairments for the child and affects the family life. The impairments vary with age and context, and the same symptoms do not necessarily have the same effects in different contexts and persons. DESIGN: A qualitative design with a phenomenographic approach. METHODS: Family members, mothers, fathers, siblings and children with attention deficit hyperactivity disorder (n = 17) were interviewed individually. RESULTS: The findings include two descriptive categories 'safeguarding a functioning family' and 'fighting for acceptance and inclusion'. To create a stable and structured family life to avoid conflicts within the family and manage their daily life were crucial. The child with attention deficit hyperactivity disorder and their parents developed special skills and strategies to live with attention deficit hyperactivity disorder in the family sphere and the social context. To apply for help before the problems in the family become too severe and to share responsibility with professionals, who have competence, to meet the families in their worries were stressed. The striving in the family strengthened the companionship in the families, and they conceived growth. CONCLUSIONS: This study contributes to knowledge of the parents, siblings and children with attention deficit hyperactivity disorder experiences of everyday life with a child with attention deficit hyperactivity disorder. All family members need support before their problems become too severe. RELEVANCE TO CLINICAL PRACTICE: There is a need of family-focused approach with a dialogue with family members to share the view of their situation and identify their individual resources and needs. Nurses should help these families with family supervision.

Public health nurses' conceptions of their role related to families with a child having attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder is one of the most common behavioural disorders diagnosed in children. Children who have this disorder have difficulties regarding regulation of their emotions, maintaining attention and impulse control. Parents may need guidance in creating structure and predictable boundaries. One of the personnel who meet these families is the public health nurse. The aim of this study was to explore the public health nurses role in relation to these families. A qualitative explorative design with a phenomenographic approach was used. Interviews were performed with 19 nurses, six in group and one individual. In the data analyses, three descriptive categories emerged: 'supporting the family-unit', which describes the nurses supervising the parents and the child in everyday challenges; 'understanding the child', which describes how the public health nurses use professional competence and choose the time and arena to observe the child and; 'collaborating multidisciplinary', which describes how the public health nurses define their own role and conceive their collaboration with other professionals. The public health nurse (PHN)'s support for the parents and the entire family is important, and the PHN is the first encounter and trustful follower throughout the course of diagnosis and care.

Contending and adapting every day: norwegian parents' lived experience of having a child with ADHD.

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders, and little attention has been paid to the parents and their experiences. The aim of this study was to gain a deeper understanding of the Norwegian parents' lived experiences of having a child with an ADHD diagnosis. A descriptive design using phenomenological approach was chosen as the research method. Individual qualitative interviews with nine parents, who were members of the ADHD Association, were conducted. The interviews were analyzed according to Colaizzi's method. The essential structure of the parents' experiences was Contending and Adapting Every Day-Windsurfing in unpredictable waters which was embedded in the interrelated main themes: Maintaining the Self and Parenthood, and Interacting With the Surrounding World. Being the parent of a child with ADHD is a demanding situation. Nurses need to address the needs of these parents and focus on the family unit.