Background: The occupational therapy intervention, Active in My Home (AiMH), puts occupational engagement, participation in society and personal recovery in focus and includes increased staff support.

Aims/Objectives: To investigate how the residents experienced the AiMH support, with a focus on their possibilities for engaging in occupations and participating in society after the intervention.

Material and Methods: Sixteen AiMH participants were interviewed at completion, and/or 6-9 months after completion. Data were analysed using content analysis.

Results: The main theme was: Boosting personal recovery by discovering new capacities and activity opportunities. Four categories also emerged: Stimulating with new approaches to support and interaction from the staff, Opportunities to reflect on personal recovery were essential, Engaging in reflection and exploring new activities initiated a positive cycle of change and Interacting with group participants and staff provided new perspectives and motivation.

Conclusion: The participants gained knowledge about how to engage in meaningful everyday life activities. AiMH contributed to a more supportive housing climate and increased sense of security and connectedness.

Significance: AiMH can fill a gap in occupational therapy interventions for residents in supported housing (SH) in Sweden and has potential to change the caregiving culture by promoting a more recovery-oriented form of support.

Background: The therapeutic relationship has been identified as essential for ensuring high-quality care in psychiatric outpatient services, as highlighted in several studies. This study focuses on the content of interactions between patients and staff in psychiatric outpatient care, as well as the quality of care provided, as perceived by the patients.

Aim: The aim of this study is to explore the relationship between these interactions and aspects of the perceived quality of care from the perspective of patients in psychiatric outpatient services.

Methods: A sample of 706 patients from psychiatric outpatient clinics in Sweden completed the Verbal and Social Interaction Outpatient (VSI-OP) and the Quality in Psychiatric Care—Outpatient (QPC-OP) instruments. A structural equation model was conducted to explore these associations. The study was approved by the Regional Ethical Review Board in Uppsala, Sweden (Dnr. 2018/186).

Results: The model revealed that the staff showing an interest in the patients' feelings, experiences and behaviour influences the patients' perceived quality of participation through an intricate network of mediator variables, including the staff's ability to establish a relationship, a good encounter, support and a high level of information to the patients. High levels of Participation/Empowerment indicate a high level of quality of care in a psychiatric outpatient context.

Implication for Practice: The presented model provides an understanding of the associations between staff and patient interactions and perceived quality of care and sheds light on important aspects of quality of care from the perspective of the patients.

Objective To investigate the relationship between perceived mental health service provision and quality of life (QoL) as perceived by patients in psychiatric outpatient care.Methods A total of 373 adult patients registered at 15 psychiatric outpatient clinics in three regions in central and southern Sweden were included in the study. Survey data were collected using a questionnaire on mental health service provision, symptom severity, recovery, clinical diagnosis, sociodemographics (serving as independent variables) and QoL (serving as the dependent variable). Three aspects of mental health service provision were used: patients' perceived quality of care, perceived staff-patient interaction, and patient reported psychiatric treatments. Structural equation modelling was used to model the relationship among the variables.Results Variables in mental health service provision showed few direct associations with patients' perceived QoL. Instead, the associations of mental health service provision on QoL were mainly mediated through symptom severity and recovery. These relationships were retained after adjusting for sociodemographic variables and clinical diagnoses. The final model achieved excellent goodness of fit (chi 2 = 49.502, p = 0.230, RMSEA = 0.020, CFI = 0.997 and a SRMR = 0.024).Conclusion This study shows that mental health service provision is associated with patients' perceived QoL; however, this association is mostly indirect and mediated by reduced symptom severity and increased recovery. This finding can help inform the design of future interventions to enhance service provision to improve patients' QoL.

Background: The goals for staff in Supported Housing for people with psychiatric disabilities include helping to develop the residents’ independence and self-confidence in activities. However, staff have expressed frustration about providing this type of support when motivating residents to engage in meaningful activities and also about the difficulty in finding suitable levels of independence within a housing setting with limitations.

Objective: The aim is to explore the views and experiences of housing staff in Supported Housing on how they can stimulate and support engagement in activities for people with psychiatric disabilities.

Methods: Twenty-six members of staff from 20 supported housing units in 10 municipalities in Sweden were interviewed in five focus groups. A semi-structured interview guide was used, and the transcribed material was analyzed using qualitative content analysis.

Results: Three main categories emerged from the analysis: Multi-faceted factors influencing the staff’s provision of activity support, Staff’s approach for supporting activities, and Staff’s struggles to develop their work. Obstacles to participating in activities in the community were identified. Many contrasting factors were found, such as spontaneous or structured activities and individual or group activities, which affected the staff’s ability to motivate to activity.

Conclusion: A broad approach encompassing in-house training including a focus on values, recruitment policies, staff supervision and interventions focusing on both residents and staff are ways to support staff in motivating residents toward being more active within Supported Housing.

Opportunities and barriers for occupational engagement among residents in supported housing. Background Research shows that people with psychiatric disabilities view supported housing (SH) as a possibility for social contact, but also as entailing a risk of deprived self-determination. There is, however, little research on the target group's engagement in everyday occupations. Aim To explore SH residents' opportunities and barriers for occupational engagement. Materials and methods Sixteen participants were interviewed, and data was analysed using content analysis. Results An overarching theme, Struggling to create meaning and seeking affection, and three underlying categories, emerged. Finding meaning through self-chosen occupations and support focussed on receiving support, doing self-chosen occupations, and having social contacts. Feeling neglected and insecure limits engagement in occupations was related to feelings of not being seen by staff, and insecurity, which hampered daily life. The third theme was Having a negative self-image and low level of ability hinders an active life. Conclusion Residents' self-view and ability to create an inner drive for being active was important for occupational engagement, which was linked to social connectedness. Occupational based interventions and a personal recovery approach is warranted in order to facilitate needs for meaningful occupations. Significance The results from the study can be used to further develop optimal support within SH units.

The aim was to describe and gain a greater understanding of the phenomenon “caring-learning space” based on the perspectives of patients, nursing students, and supervisors in clinical practice contexts.

A general structure of the phenomenon “caring-learning space” was created based on essential structures from five empirical studies. The analysis is based on a reflective lifeworld research approach (RLR).

The “caring-learning” space shows itself in terms of interpersonal relationships between patients, students, supervisors, and other actors in the care environment. It is first when the learning space is accepted as a part of caring, that a “caring-learning space” is created. A flexibility and a receptivity are seen where the learning is allowed to become visible and be integrated in the caring processes when caring and learning to interact.

A caring-learning space is established by the patient being the focal point, but also a co-creator in caring as well as learning regardless of her/his health status. This entails that the ”caring-learning space” exists when patients, students, supervisors and other healthcare professionals interact based on their ability and role in the space.KEYWORDS:

The aim of this paper is to investigate the psychometric properties of the Verbal and Social Interaction questionnaire for psychiatric outpatient care (VSI-OP) by using a confirmatory factor analysis. A further aim is to present the patient and staff perceptions of the frequency of these interactions in this context. The factor structure of the VSI-OP could be explained by three factors for both the staff and the patient versions. The three factors are: 'Inviting the patient to establish a relationship', 'Showing interest in the patients' feelings, experiences and behaviour' and 'Helping the patients to establish structure and routines in their everyday life'. The two first factors were the most frequently occurring actions according to the staff and the patients.

Aim: To explore the long-term learning process in movement awareness development supported by a video-based learning model.

Participants: Eleven undergraduate nursing students.

Method: The students participated in learning sessions comprising video modelling, video feedback and reflective enquiry with a focus on inter-personal interaction. Each student participated in three individual video sessions during a four-month period. Three individual interviews were carried out, the last one 12–18 months after the final session. Visual, verbal and written material were collected from the video sessions, individual interviews and diaries, and interpreted within a hermeneutical approach.

Results: The learning process was described in three themes: motivation for change, exploring alternative perspectives and movement changes through challenges.

Conclusions: The video-based learning model implies a challenging experience on a personal level that supports motivation and a deep approach to learning. It adds a powerful base for reflection, which encourages student-centred active learning. The facilitator’s reflective approach is essential to allow the student to explore her/his own movement, in contrast to delivering instructions. The learning model may be valuable in the physiotherapist’s clinical work in facilitating patients’ movement awareness in the process of movement improvements.

Background People with severe mental illness (SMI) living in supported housing (SH) struggle in everyday life and we currently lack a comprehensive body of knowledge concerning how the residents experience their day. This paper aimed to gain knowledge about how people with SMI describe a day in SH in Sweden, in particular the activities they most frequently engage in and how they experience what they do in or outside their home. Furthermore, it is important to gain knowledge of which activities motivate residents to leave the housing facility and to participate in the community. This new knowledge can help staff to encourage a recovery process among the residents. Methods One hundred thirty-three people living in SH completed a time-use diary and a mixed-methods approach was applied, including calculations of what activity that was most frequently performed and a manifest content analysis addressing experiences of activity. Results The residents had a low activity level and were often alone. Approximately one-half of the reported activities were performed in their own apartments, and generally unaccompanied. A quarter of the activities were performed in the common areas and a further quarter outside the SH. The most frequently performed activities were quiet and tranquil ones, e.g. listening to music and resting. Doing errands and group activities with staff and residents were the main activities that motivated leaving the facility. The participant experience of a day is presented in three categories: "Experiences of chosen and enforced togetherness and overcoming loneliness", "Environmental change and emotional balance can generate activity", and "Met and unmet needs for support, friendship and security". Conclusions The residents were generally satisfied with their quiet and tranquil lifestyle and appeared to demand little of life, which may relate to previous experiences of institutional life and can constitute a challenge for staff. The findings highlight experiences that can help to improve SH. Services need to support individually adjusted contextual stimuli and individualize the support to help residents find a good balance and motivate them to be active in and outside SH, which can support a recovery process.