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A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations
Cty Council Stockholm, Stockholm, Sweden.
Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden;Arctic Univ Norway, Dept Hlth & Care Sci, Tromso, Norway.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
2018 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 2, p. 856-865Article in journal (Refereed) Published
Abstract [en]

The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously-used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self-esteem is restored. When synthesized, these themes gave rise to a main theme - a sanctuary of safety - where suffering is alleviated and dignity and self-esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients' recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self-esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses' caring expertise.

Place, publisher, year, edition, pages
WILEY , 2018. Vol. 27, no 2, p. 856-865
Keyword [en]
dual diagnosis, mental illness, nurse-patient relationship, psychiatric illness, substance use disorder
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-353110DOI: 10.1111/inm.12374ISI: 000428413100036PubMedID: 28786170OAI: oai:DiVA.org:uu-353110DiVA, id: diva2:1216127
Available from: 2018-06-11 Created: 2018-06-11 Last updated: 2018-06-11Bibliographically approved

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Fredriksson, Lennart

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