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Skärsäter, Ingela, ProfessorORCID iD iconorcid.org/0000-0001-7838-6802
Publications (10 of 108) Show all publications
Nilsson, A.-M., Skärsäter, I., Ehnvall, A., Beskow, J. & Waern, M. (2023). Application of an accident approach to the study of acute suicidal episodes through repeated in-depth interviews. Death Studies, 47(1), 75-83
Open this publication in new window or tab >>Application of an accident approach to the study of acute suicidal episodes through repeated in-depth interviews
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2023 (English)In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683, Vol. 47, no 1, p. 75-83Article in journal (Refereed) Published
Abstract [en]

We modified an accident analysis model for the study of acute suicidal episodes (ASEs). Our aim was to use this model (SCREAM, Suicidal Cognitions’ Reliability and Error Analysis Method) as a lens to understand the worst-ever ASEs of nine patients who took part in repeated in-depth interviews. Guided by the theory of SCREAM including four predetermined categories, nine themes were identified. ASEs were triggered by interactions with the interpersonal and physical environment and spiraled into a state of lost control. Timing and the availability of promoters and barriers in the environment were salient features. Findings may aid person-centered safety planning. © 2022 The Author(s).

Place, publisher, year, edition, pages
Philadelphia, PA: Routledge, 2023
National Category
Psychiatry
Identifiers
urn:nbn:se:hh:diva-43703 (URN)10.1080/07481187.2021.2021566 (DOI)000741184800001 ()35014947 (PubMedID)2-s2.0-85122809109 (Scopus ID)
Funder
Swedish Research Council, 5212011-299, 2016–01590
Note

Funding: The Swedish Research Council [5212011-299, 2016–01590], the Swedish state through the ALF agreement [ALFGBG-433511, ALFGBG-715841], the Gothenburg Center for Person-centred Care, and the Gunnar and Märtha Bergendahl Foundation.

Available from: 2020-12-15 Created: 2020-12-15 Last updated: 2023-02-15Bibliographically approved
de Ruiter, H. P., Clisbee, D., Houston, R. & Skärsäter, I. (2023). The Ethical, Care, and Client-Caregiver Relationship Impacts Resulting From Introduction of Digital Communication and Surveillance Technologies in the Home Setting: Qualitative Inductive Study. JMIR Human Factors, 10(1), Article ID e47586.
Open this publication in new window or tab >>The Ethical, Care, and Client-Caregiver Relationship Impacts Resulting From Introduction of Digital Communication and Surveillance Technologies in the Home Setting: Qualitative Inductive Study
2023 (English)In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 10, no 1, article id e47586Article in journal (Refereed) Published
Abstract [en]

Background: Embedding communication and surveillance technology into the home health care setting has demonstrated the capacity for increased data efficiency, assumptions of convenience, and smart solutions to pressing problems such as caregiver shortages amid a rise in the aging population. The race to develop and implement these technologies within home care and public health nursing often leaves several ethical questions needing to be answered. Objective: The aim of this study was to understand the ethical and care implications of implementing digital communication and surveillance technologies in the home setting as perceived by health caregivers practicing in the region of Halland in Sweden with clients receiving home care services. Methods: A questionnaire was completed by 1260 home health caregivers and the written responses were evaluated by qualitative inductive content analysis. The researchers reviewed data independently and consensus was used to determine themes. Results: This study identified three main themes that illustrate ethical issues and unintended effects as perceived by caregivers of introducing digital communication and surveillance technologies in the home: (1) digital dependence vulnerability, (2) moral distress, and (3) interruptions to caregiving. This study highlights the consequences of technology developers and health systems leaders unintentionally ignoring the perspectives of caregivers who practice the intuitive artistry of providing care to other humans. Conclusions: Beyond the obtrusiveness of devices and impersonal data collection designed to emphasize health care system priorities, this study discovered a multifaceted shadow side of unintended consequences that arise from misalignment between system priorities and caregiver expertise, resulting in ethical issues. To develop communication and surveillance technologies that meet the needs of all stakeholders, it is important to involve caregivers who work with clients in the development process of new health care technology to improve both the quality of life of clients and the services offered by caregivers. © 2023 The Author(s).

Place, publisher, year, edition, pages
Toronto, ON: JMIR Publications, 2023
Keywords
care of the elderly, caregivers, communication technology, digital vulnerability, ethical implications, home care, public health nursing practices, surveillance technology
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-52205 (URN)10.2196/47586 (DOI)001104692200002 ()37921843 (PubMedID)2-s2.0-85177869601 (Scopus ID)
Note

Funding: The Glen Taylor Institute for Family and Societal Nursing by offering a dissemination grant for this study.

Available from: 2023-12-08 Created: 2023-12-08 Last updated: 2024-02-05Bibliographically approved
Nilsson, A. M., Waern, M., Ehnvall, A. & Skärsäter, I. (2023). The Meaning of Mental Imagery in Acute Suicidal Episodes: A Qualitative Exploration of Lived Experiences. Omega
Open this publication in new window or tab >>The Meaning of Mental Imagery in Acute Suicidal Episodes: A Qualitative Exploration of Lived Experiences
2023 (English)In: Omega, ISSN 0030-2228, E-ISSN 1541-3764Article in journal (Refereed) Epub ahead of print
Abstract [en]

Clinical assessment of suicidal ideation focuses on cognitions in the form of verbal thoughts. However, cognitions also take the shape of mental imagery. The aim of this qualitative study was to explore the meaning of mental imagery in acute suicidal episodes (ASEs). Eight persons with severe previous ASEs participated in repeated in-depth interviews and in the semi-structured Suicidal Cognitions Interview. Textual data from both sources underwent content analysis. All participants experienced suicide-related imagery during ASEs. Analysis resulted in two themes. (1) Suicide-approaching imagery: intrusive looming images that contributed to loss of control, flashforwards that clarified the suicidal solution, or desirable but unattainable images. (2) Suicide preventive imagery: death-alienating, life-affirming, or potentially helpful images. The meaning of mental imagery in ASEs is suggested to be understood in relation to the context of the individual ASE. A narrative approach is encouraged, as is an increased clinical focus on mental imagery in general. © The Author(s) 2023.

Place, publisher, year, edition, pages
Thousand Oaks, CA: Sage Publications, 2023
Keywords
acute suicidal episodes, mental imagery, qualitative content analysis, repeated in-depth interviews, suicidal cognitions interview
National Category
Psychiatry
Identifiers
urn:nbn:se:hh:diva-52230 (URN)10.1177/00302228231218562 (DOI)001114047200001 ()38006244 (PubMedID)2-s2.0-85178368785& (Scopus ID)
Funder
Swedish Research Council, 2016–01590, 5212011-299, ALFGBG-433511, ALFGBG-715841, ALFGBG-942-684
Note

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the grants from the Swedish Research Council (5212011-299, 2016–01590), the Swedish state through the ALF agreement (ALFGBG-433511, ALFGBG-715841, ALFGBG-942-684), and the Gunnar and Märtha Bergendahl Foundation. This work was also supported by The University of Gothenburg Centre for Person-centred Care (GPCC), Sweden. GPCC is funded by the Swedish Government’s grant for Strategic Research Areas (Care Sciences) and the University of Gothenburg, Sweden.

Available from: 2023-12-15 Created: 2023-12-15 Last updated: 2023-12-15Bibliographically approved
de Ruiter, H. & Skärsäter, I. (2020). Introducing a Future-Oriented Approach to Health-Care Technologies and Welfare Policies: An Innovative Ethics Project in Sweden. Creative Nursing, 26(1), e35-e39
Open this publication in new window or tab >>Introducing a Future-Oriented Approach to Health-Care Technologies and Welfare Policies: An Innovative Ethics Project in Sweden
2020 (English)In: Creative Nursing, ISSN 1078-4535, E-ISSN 1946-1895, Vol. 26, no 1, p. e35-e39Article in journal (Refereed) Published
Abstract [en]

This article is a description of a 2-year program (May 2017–April 2019) intended to introduce new approaches to addressing ethical issues resulting from the introduction of new health-care technologies and welfare policies. In contrast to the traditional retrospective approach in addressing ethical issues after they occur, this program intended to address ethical issues proactively, before they occurred. This future-focused approach is one way to better keep up with the acceleration of change that society confronts. This project introduced innovative approaches in dealing with unintended consequences and ethical issues resulting from the implementation of new health-care technologies and welfare policies in the Halland region of Sweden. © Copyright 2020 Creative Health Care Management.

Place, publisher, year, edition, pages
New York, NY: Springer Publishing Company, 2020
Keywords
Digga Halland, HICube, ethics of technology, innovations, new health technologies, welfare policies
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-40921 (URN)10.1891/1078-4535.26.1.e35 (DOI)000512994800005 ()32024746 (PubMedID)2-s2.0-85079064643 (Scopus ID)
Projects
Digga Halland
Funder
Knowledge Foundation, 240009
Available from: 2019-11-13 Created: 2019-11-13 Last updated: 2024-02-05Bibliographically approved
Lundström, S., Jormfeldt, H., Hedman Ahlström, B. & Skärsäter, I. (2020). Mental health nurses’ experience of physical health care and health promotion initiatives for people with severe mental illness. International Journal of Mental Health Nursing, 29(2), 244-253
Open this publication in new window or tab >>Mental health nurses’ experience of physical health care and health promotion initiatives for people with severe mental illness
2020 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 29, no 2, p. 244-253Article in journal (Refereed) Published
Abstract [en]

Health care for people with severe mental illness is often divided into physical health care and mental health care despite the importance of a holistic approach to caring for the whole person. Mental health nurses have an important role not only in preventing ill health, but also in promoting health, to improve the overall health among people with severe mental illness and to develop a more person-centred, integrated physical and mental health care. Thus, the aim of this study was to describe mental health nurses’ experiences of facilitating aspects that promote physical health and support a healthy lifestyle for people with severe mental illness. Interviews were conducted with mental health nurses (n = 15), and a qualitative content analysis was used to capture the nurse’s experiences. Analysis of the interviews generated three categories: (i) to have a health promotion focus in every encounter, (ii) to support with each person’s unique prerequisites in mind and (iii) to take responsibility for health promotion in every level of the organization. The results show the importance of a health promotion focus that permeates the entire organization of mental health care. Shared responsibility for health and health promotion activities should exist at all levels: in the person-centred care in the relation with the patient, embedded in a joint vision within the working unit, and in decisions at management level. © 2019 Australian College of Mental Health Nurses Inc.

Place, publisher, year, edition, pages
Richmond: Wiley-Blackwell, 2020
Keywords
health promotion, lifestyle, mental health nursing, person-centred care, severe mental illness
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-40958 (URN)10.1111/inm.12669 (DOI)000519140700013 ()31663262 (PubMedID)2-s2.0-85074834866 (Scopus ID)
Available from: 2019-11-15 Created: 2019-11-15 Last updated: 2022-12-07Bibliographically approved
Millberg German, L., Söderberg, M., Lindström, P., Andersson, J., Petersson, L. & Skärsäter, I. (2020). Slutrapport: Samverkansprojektet Digga Halland.
Open this publication in new window or tab >>Slutrapport: Samverkansprojektet Digga Halland
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2020 (Swedish)Report (Other (popular science, discussion, etc.))
Publisher
p. 49
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health Innovation
Identifiers
urn:nbn:se:hh:diva-47657 (URN)
Funder
European Social Fund (ESF), 2017/00544
Available from: 2022-08-04 Created: 2022-08-04 Last updated: 2022-08-23Bibliographically approved
Melin, K., Skarphedinsson, G., Thomsen, P. H., Weidle, B., Torp, N. C., Valderhaug, R., . . . Ivarsson, T. (2020). Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder: Three-Year Follow-Up From the NordLOTS. Journal of the American Academy of Child and Adolescent Psychiatry, 59(2), 244-253
Open this publication in new window or tab >>Treatment Gains Are Sustainable in Pediatric Obsessive-Compulsive Disorder: Three-Year Follow-Up From the NordLOTS
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2020 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 59, no 2, p. 244-253Article in journal (Refereed) Published
Abstract [en]

Objective: This study evaluated the long-term outcomes of a stepped care treatment for pediatric obsessive-compulsive disorder (OCD) and investigated whether response to first-step cognitive-behavioral therapy (CBT) is an important indicator of 3-year outcomes. Method: This study is a part of the Nordic Long-term OCD Treatment Study (NordLOTS), in which 269 children and adolescents were treated with CBT. Nonresponders to CBT were randomized to extended treatment with continued CBT or pharmacotherapy with sertraline. Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) scores no higher than 15 and no higher than 10 were defined as treatment response and remission, respectively. Participants were assessed 2 and 3 years after first-step CBT. Linear mixed-effects models were used to analyze the outcomes. Results: Intent-to-treat analyses showed a significant decrease in CY-BOCS total score from baseline (24.6) to 3-year follow-up (5.0; p =. 001), with a mean decrease of 5.9 from after treatment to 3-year follow-up. Three years after treatment, 90% (n = 242) of participants were rated as responders and 73% were in clinical remission. The duration of treatment did not influence the symptom level at 3-year follow-up (p =. 998) and no significant difference was found (p =. 169) between the extended treatment conditions. Conclusion: The results suggest that evidence-based treatment for pediatric OCD has long-term positive effects, whether a first step of manual-based CBT or extended treatment with CBT or sertraline. The improvements were maintained, and the symptoms decreased further during follow-up and were, after 3 years, similarly independent of treatment duration and form of extended treatment. Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119. © 2019 American Academy of Child and Adolescent Psychiatry

Place, publisher, year, edition, pages
Amsterdam: Elsevier, 2020
Keywords
obsessive-compulsive disorder, follow-up, pediatric, cognitive-behavioral therapy, sertraline
National Category
Psychiatry
Identifiers
urn:nbn:se:hh:diva-43272 (URN)10.1016/j.jaac.2019.01.010 (DOI)000518536000012 ()30768383 (PubMedID)2-s2.0-85065021449 (Scopus ID)
Available from: 2020-12-09 Created: 2020-12-09 Last updated: 2020-12-09Bibliographically approved
Pejner, N. M., Ourique de Morais, W., Lundström, J., Laurell, H. & Skärsäter, I. (2019). A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study. JMIR Research Protocols, 8(4), Article ID e12447.
Open this publication in new window or tab >>A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study
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2019 (English)In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 8, no 4, article id e12447Article in journal (Refereed) Published
Abstract [en]

Background: Older adults often want to stay in a familiar place, such as their home, as they get older. This so-called aging in place, which may involve support from relatives or care professionals, can promote older people’s independence and well-being. The combination of aging and disease, however, can lead to complex medication regimes, and difficulties for care providers in correctly assessing the older person's health. In addition, the organization of the health care is fragmented, which makes it difficult for health professionals to encourage older people to participate in their care. It is also a challenge to perform adequate health assessment and appropriate communication between health care professionals.

Objective: The purpose of this paper is to describe the design for an integrated home-based system that can acquire and compile health-related evidence for guidance and information sharing among care providers and care receivers in order to support and promote medication self-management among older people.

Methods: The authors used a participatory design (PD) approach for this mixed-method project, which was divided into four phases: Phase I, Conceptualization, consisted of the conceptualization of a system to support medication self- management, objective health assessments, and communication between health care professionals. Phase II, Development of a System, consisted of building and bringing together the conceptualized systems from phase I. Phases III (pilot study) and IV (a full-scale study) are described briefly.

Results: Our participants in phase I were people who were involved in some way in the care of older adults, and included older adults themselves, relatives of older adults, care professionals, and industrial partners. With input from phase I participants, we identified two relevant concepts for promoting medication self-management, both of which related to systems that participants believed could provide guidance for the older adults themselves, relatives of older adults, and care professionals. The system will also encourage information sharing between care providers and care receivers. The first is the concept of the Intelligent Friendly Home (IAFH), defined as an integrated residential system that evolves to sense, reason and act in response to individual needs, preferences and behaviors as these change over time. The second concept is the MedOP system, a system that would be supported by the IAFH, and which consists of three related components: one that assess health behaviors, another that communicates health data, and a third that promotes medication self-management.

Conclusions: The participants in this project were older adults, relatives of older adults, care professionals, and our industrial partners. With input from the participants, we identified two main concepts that could comprise a system for health assessment, communication and medication self-management: the Intelligent Friendly Home (IAFH), and the MedOP system. These concepts will be tested in this study to determine whether they can facilitate and promote medication self-management in older people. © The authors. All rights reserved. 

Place, publisher, year, edition, pages
Toronto: J M I R Publications, Inc., 2019
Keywords
assessments, medication, mixed methods, older people, self-management, smart homes
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-39753 (URN)10.2196/12447 (DOI)000466496800024 ()31038459 (PubMedID)2-s2.0-85067859310 (Scopus ID)
Available from: 2019-06-13 Created: 2019-06-13 Last updated: 2024-01-17Bibliographically approved
Skärsäter, I. (2019). Att möta människor som sörjer (3ed.). In: Lena Wiklund Gustin (Ed.), Vårdande vid psykisk ohälsa – på avancerad nivå: (pp. 451-469). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Att möta människor som sörjer
2019 (Swedish)In: Vårdande vid psykisk ohälsa – på avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur AB, 2019, 3, p. 451-469Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 3
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-41243 (URN)978-91-44-12368-4 (ISBN)
Available from: 2019-12-12 Created: 2019-12-12 Last updated: 2019-12-17Bibliographically approved
Skärsäter, I. (2019). Förstämningssyndrom (3ed.). In: Ingela Skärsäter & Lena Wiklund Gustin (Ed.), Omvårdnad vid psykisk ohälsa – på grundnivå: (pp. 109-163). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Förstämningssyndrom
2019 (Swedish)In: Omvårdnad vid psykisk ohälsa – på grundnivå / [ed] Ingela Skärsäter & Lena Wiklund Gustin, Lund: Studentlitteratur AB, 2019, 3, p. 109-163Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 3
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-41242 (URN)978-91-44-12369-1 (ISBN)
Available from: 2019-12-12 Created: 2019-12-12 Last updated: 2019-12-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7838-6802

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