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  • 1.
    Atwine, Fortunate
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Mbarara University of Science and Technology, Uganda.
    Hultsjö, Sally
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linköping University.
    Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews2015In: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 20, p. 1-13, article id 76Article in journal (Refereed)
    Abstract [en]

    Introduction: Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers.

    Methods: Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups.

    Results: Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends.

    Conclusion: The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care. © Katarina Hjelm et al.

  • 2.
    Hultsjö, Sally
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Cty Hosp, Jönköping.
    Mental healthcare staff's knowledge and experiences of diabetes care for persons with psychosis - a qualitative interview study2013In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, no 3, p. 281-292Article in journal (Refereed)
    Abstract [en]

    Aim: This paper aims to explore and analyse mental healthcare staff's (MHCS) knowledge and experiences of diabetes care for persons with psychosis. Background: There are a range of studies concerning the increased risk of type 2 diabetes mellitus among persons with psychosis, and the need for healthy lifestyle interventions to prevent the illness. MHCS are often trusted and have regular follow-ups with the patients, and their attitudes and actions often play an important role for the person's care behaviour. There is still little documentation of their experiences of diabetes care. Methods: A qualitative, explorative design was used, collecting data through semi-structured interviews with 12 MHCS working in psychosis outpatient care in Sweden. Data were analysed with qualitative content analysis. Findings: Three categories emerged and provide a deeper understanding of how staff were aware of the risks of type 2 diabetes among their patients and therefore performed lifestyle interventions to promote these. Nevertheless, they lacked knowledge of diabetes care and simultaneo usly felt a lack of training among diabetes nurses to adapt diabetes care to suit persons with cognitive dysfunctions. Patients who were overconfident in their ability to manage diabetes care reported to have experienced most difficulties. Cooperation among those involved in these persons' health was considered necessary. Implications: Diabetes care for persons with psychosis could improve if knowledge of type 2 diabetes was increased among MHCS and training in how to adapt diabetes care to persons with cognitive dysfunctions was enlarged among diabetes nurses. A challenge for nurses is to see how the care of different illnesses and support given by the family and others affect the persons total life situation and health. Healthcare plans and cooperation among all those involved in these persons' health is necessary for this.

  • 3.
    Hultsjö, Sally
    et al.
    Ryhov County Council, Sweden;Linköping University, Sweden.
    Bachrach-Lindström, Margareta
    Linköping University, Sweden.
    Safipour, Jalal
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    “Cultural awareness requires more than theoretical education”: nursing students’ experiences2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 39, p. 73-79Article in journal (Refereed)
    Abstract [en]

    Cultural awareness in healthcare providers is considered one of the most important factors in improving the efficiency and quality of care in a diverse population. Thus, education in cultural awareness needs to be an essential component in nursing education. This study, which uses a qualitative design, aimed to investigate cultural awareness in nursing students in Sweden. Focus groups were used to collect data from 12 students. Three categories were identified as follows after qualitative data analysis of the interviews: 1) desire to learn, 2) learning by doing and 3) caring beyond boundaries. The result clearly indicates that students are willing to learn more about how to care for people with different cultural backgrounds. However, this learning is not always available in official lecture-based education. In fact, most awareness about cultural aspects of healthcare is developed from practice and informal education.

    Finally, the result also revealed the importance of nurses being able to see the individual beyond the culture, and being aware of their own prejudice. In conclusion, education offers limited opportunities for nursing students to become culturally aware. Nursing education can be improved by strengthening both theoretical and practical tasks involving cultural awareness.

  • 4.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Berterö, Carina
    IMH, Avd för omvårdnad, Hälsouniversitetet, Linköping.
    Arvidsson, Hans
    IMH, Avd för Omvårdnad, Hälsouniversitetet, Linköping.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Core components in the care of immigrants with psychoses:: A Delphi survey of patients, families, and health-care staff.2011In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, no 3, p. 174-184Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to identify core components in the care of immigrants with psychosis in Sweden. Experts (n = 43) from different perspectives (immigrants, families, and health-care staff) were assembled and used to score the importance of statements regarding components in the care for a person with psychosis in three questionnaire rounds. After each round, the opinions were consolidated and compared to identify whether consensus was reached. Consensus was reached about the importance of being treated on equal terms, regardless of country of birth. Staff interest and respect, shown in different ways of understanding, was valued. Consensus could not be reached on approximately half of the statements, of which four tended to be ranked towards unimportant. Those included that staff should have specific cultural knowledge or that the patient should be allowed to decide whether to be cared for by male or female staff. Nor was it regarded as important to identify a person's religious or ethnic background. The results illustrate the importance of fundamental psychiatric nursing, which should enable nurses to identify and meet the basic needs of all patients, regardless of country of origin. Areas for which consensus was not reached illustrate a future challenge for health-care staff to identify situations when cultural clashes could appear. Staff should have strategies to accomplish cultural negotiations to build an effective treatment alliance with the patient, as well as the family, to meet individual needs.

  • 5.
    Hultsjö, Sally
    et al.
    Linköping University.
    Berterö, Carina
    Linköping University.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Foreign-born and Swedish-born families' perceptions of psychosis care.2009In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, no 1, p. 62-71Article in journal (Refereed)
    Abstract [en]

    Aim: To describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Methods: Eleven foreign-born and 15 Swedish-born family members were interviewed. Data were analyzed using a phenomenographic approach. Findings: Three main descriptive categories were found: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. Conclusion: The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families' previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.

  • 6. Hultsjö, Sally
    et al.
    Berterö, Carina
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.2007In: Journal of Advanced Nursing: Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders., Vol. 16, no 1, p. 168-78Article in journal (Refereed)
    Abstract [en]

    Aim: to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.

    Method: A phenomenographic study was conducted in 2005–2006 using semi-structured interviews with a sample of 12 foreign-born and 10 Swedish-born persons with psychosis.

    Findings: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born differed from Swedish-born persons as they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and held religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.

  • 7.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Community health-care staff's experiences of support to prevent type 2 diabetes among people with psychosis: An interview study with health staff.2012In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 21, no 5, p. 480-489Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe mental health staff experiences of giving support to prevent type 2 diabetes mellitus (DM) among people with psychosis in community psychiatry. A qualitative interview study with a purposeful sample of 12 community health staff was conducted. Data were analysed using qualitative content analysis. The results show how staff reported continuously supporting people with psychosis to adapt to healthy lifestyles, but stated that support is not given until after a person becomes overweight or is diagnosed with type 2 DM. Support was described as a never-ending process of motivation facing many reverses. Individually-adapted support given in practical situations was perceived as most successful. Cooperation between health-care organizations was seen as essential, but inadequate. Limitations in income and social network, and easy access to fast food and alcohol, were seen as obstacles to support. The results indicate that community health staff are in a position to make a considerable impact in motivating and supporting healthy lifestyle changes in practical situations in daily life among people with psychosis. This study raises awareness of how community health staff's support can be useful when developing nursing skills and health-care plans for people with psychosis.

  • 8.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 22012In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, no 10, p. 891-902Article in journal (Refereed)
    Abstract [en]

    This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes.

    Methods: qualitative and quantitative studies in the area were identified and reviewed. 

    Results: It were indicated that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow-ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self-care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow-ups of glycaemic control.

  • 9.
    Hultsjö, Sally
    et al.
    County Hospital, Ryhov.
    Syrén, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Beliefs about health, health risks and health expectations from the perspective of people with a psychotic disorder2013In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 7, no 1, p. 114-122Article in journal (Refereed)
    Abstract [en]

    Aim: To examine beliefs about health, health risks and health expectations from the perspective of people diagnosed with a psychotic disorder Background: People with psychotic disorders have a threefold higher risk of developing physical health problems than the general population, and prevention of these problems is warranted. Examining patientś health beliefs could help deepen our understanding of how to plan successful health interventions with this group.Methods: Qualitative semi-structured interviews were conducted from November 2010 to October 2011 with 17 people with psychotic disorders. Data were analyzed using a qualitative content analysis.Results: An overall positive picture of health was found despite the fact that physical health was found to be hard to verbalize and understand. Health was mainly associated with psychological wellbeing, while health risks were found to be related to uncertain bodily identity, troublesome thoughts and inner voices, and exclusion from society. Interest in learning, and visions and goals of health seemed to increase awareness of health risks and health expectations, while not worrying could be viewed as a hindrance for health expectations.Conclusion: There is a lack of expressed awareness of physical health risks, but such awareness is fundamental to performing life-style changes [14]. Nurses thus have an important task to help patients understand and verbalize potential physical health risks, and to find out what motivates them to adopt health behaviors.

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