This paper describes videotaped recording as a data collection method when conducting participant observation in a psychiatric nursing study. The videotaped episodes were part of the daily life of psychiatric nursing in a hospital environment. The advantages and limitations of using videotaped recording in nursing research will be discussed. This paper is based on two studies. The data consisted of 21 videotaped episodes of nursing report sessions or interdisciplinary team meetings in the psychiatric clinic of a university hospital. The participants consisted of patients, their significant others, nurses, doctors, social workers and physiotherapists. All videotaped material was transcribed verbatim. An essential advantage of videotaping is that most potentially useful interaction and behaviour can be captured. The advantage in terms of the credibility of videotaping was that the investigator was able to review the same videotaped situations again and again. Videotaped material is rich and provides several possibilities for analysing the data. In these studies data and source triangulation enabled the researchers to reduce personal influence on the results. The investigator must also be aware of the limitations concerning this method. The most essential limitations are mechanical problems and the influence of videotaping on behaviour. Careful ethical considerations are important concerning personal privacy, informed consent and respect for the self-determination of psychiatric patients.
The purpose of this article is to describe patients' experiences of being helped during a period of psychiatric hospital care. Psychosis has traditionally been defined in medical and psychological terminology. The focus of psychiatric nursing is the human experience of distress associated with mental illness. The aim of psychiatric care is to promote healing and coping in daily life through support, validation and understanding. The main aim is to re-empower the patient with psychosis by using psychiatric care. The purposive sample consisted of interviews with nine voluntary patients recovering from psychosis. The interviewees told about their experiences of care. The verbatim transcripts were analysed using Giorgi's phenomenological method. Patients experienced care as helpful but unstructured: care facilitated their situation by alleviating the disorders, but it had not been defined by nurses, and the patients made their own conclusions about what care should be like. The care did not reach the inner world of the patients with psychosis. From the patients' point of view, care should protect them from vulnerability and empower/restructure their selves for coping in daily life.
The qualitative study reported in this paper aims to describe the planning and assessment of psychiatric nursing in a hospital environment. The theoretical framework consists of the three types of psychiatric nursing outlined in a developmental model of nursing: confirmatory, educational and catalytic. Confirmatory psychiatric nursing is based on a hierarchical and authoritarian model. Educational psychiatric nursing is based on a professionally driven and behavioural model. Catalytic psychiatric nursing is systematic, theoretical, and research-based. Catalytic psychiatric nursing may vary, depending on the patient's needs, from confirmatory and educational to situationally determined nursing. However, it always enables patient initiatives. The purpose of this paper is to describe patient initiatives during the assessment and planning of patient care by an interdisciplinary mental health team in a psychiatric hospital environment, and the assessment and planning as described by nurses working in a hospital environment. The data, which were collected in two psychiatric hospitals by videotaping interdisciplinary teamwork situations and recording interviews of nurses afterwards, consisted of 384 pages of written text. A total of 640 sentences were identified in the text as reflecting the assessment of care by the interdisciplinary team and by the nurses working in the hospital environment. Deductive content analysis techniques were used to analyse the written data. The results showed that nursing was described by the nurses to be catalytic in 13% of the cases, while the same nurses assessed psychiatric nursing to be most commonly educational (40%) or confirmatory (47%).
The aim of this paper is to describe patients' experiences of shame and the way in which this experience is discussed in co-operative team meetings in acute psychiatric care. As an experience, shame is described as a painful and ugly feeling, which results in personal devaluation, isolation and a feeling of inferiority compared to others. This paper is based on 11 videotaped episodes of co-operative team meetings in two psychiatric units. The study approach was narrative. Shame was found to be the core narrative. The narrative of shame was laid out as an experience, and shame caused difficulties in the patients' daily lives and finally led to feelings of difference and loneliness. When the psychiatric patients and significant others tried to speak about the experience of shame with the professionals, the professionals either did not respond or changed the topic of discussion by asking questions about the patient's daily life and rationalizing the experience of shame. The participants did not share a common objective in the co-operative team meetings. Further research is needed to find new ways of co-operative team discussion and to develop the co-operative team meetings towards a patient-orientated model.
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