Swedish mental health nurses' responsibility in supervised community care of persons with long-term mental illness.
The aim of the present study was to describe psychiatric nurses' experience of how the changing focus of mental health care in Sweden, from in-patient treatment to community-based care, has influenced their professional autonomy. Eleven psychiatric nurses were interviewed and a qualitative content analysis was used to identify major themes in the data. Three main themes were found: pattern of responsibility, pattern of clinical judgement, and pattern of control through support and supervision. All themes were related to the nurse's identity, moral responsibility and the feelings of loneliness and independence in his/her daily work. Together, the three themes were found to constitute a process. This study shows the complexity involved in nursing care provided in the patient's home. Achieving control over the patient's everyday life through support and supervision does not imply taking over the patient's autonomy, but rather reducing the stigma attached to mental illness and facilitating the process of rehabilitation.
Magnusson
Annabella
A
Division of Psychiatry, Neurotec, Huddinge University Hospital, M58, SE-141 86 Stockholm, Sweden. annabella.magnusson@telia.com
Högberg
Torbjörn
T
Lützén
Kim
K
Severinsson
Elisabeth
E
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003152:Community Health Nursing / Q000458:organization & administration*; D003156:Community Mental Health Services / Q000458:organization & administration; D005260:Female; D018166:Health Care Reform / Q000458:organization & administration; D006801:Humans; D007389:Internal-External Control; D008132:Loneliness; D008134:Long-Term Care / Q000458:organization & administration; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology; D009745:Nursing, Supervisory / Q000458:organization & administration; D009936:Organizational Innovation; D017009:Professional Autonomy; D011568:Psychiatric Nursing / Q000458:organization & administration*; D036301:Qualitative Research; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden