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  • 1.
    Blomqvist, Marjut
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Health among people with psychotic disorders and effects of an individualized lifestyle intervention to promote health2020Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of the thesis was to increase knowledge of health among people with psychotic disorders such as schizophrenia and other long-term psychotic conditions. The aim was also to investigate health effects, in terms of clinical health outcomes and self-reported questionnaires, of atwo-year individualized lifestyle intervention implemented in psychiatric outpatient services involving cooperation with the municipal social psychiatry services. The motivation for the study was to generate new knowledge in order to be able to promote health in people with psychotic disorders and to improve the care and support provided for this target group. The thesis consists of four studies. A quantitative study (Study I), was conducted using a cross-sectional design to investigate the prevalence of overweight, obesity, risk of cardiovascular disease (CVD) and the relationships between self-rated salutogenic health, sense of coherence, CVD risk, and body mass index among people with psychoticdisorders (n=57). The study was conducted in four psychiatric outpatient services; questionnaires were completed by the participants and clinical health measurements were collected by the participant’s contact nurse at the psychiatric outpatient services. The participants showed a moderate/high risk of CVD, the mean for BMI was 31.9 (59.6% were obese) and 31.6% were overweight. The results did not reveal any relationships between the subjective and objective measuresof health indicating the need for both subjective and objective assessments of health in psychiatric care. In a qualitative study (Study II), data were collected with semi-structured interviews (n=16) andanalyzed with qualitative content analysis. The interviews resulted in an overall theme “Being regarded as a whole human being by self and others”, which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a wholeperson if healthy living is to be enabled. In a quasi-experimental study (Study III), the potential effects of participation in the two-year lifestyle intervention (intervention group n=54 and control group (n=13) were investigated. The data were collected at baseline, after 12 months and after 24 months using the self-reported questionnaire the Salutogenic Health Indicator Scale (SHIS), the Hopkins Symptom Checklist (HSCL-25) and the National Public Health Survey. Measures of clinical healthoutcomes were conducted by the participant’s contact nurse at the psychiatric outpatient services. Multilevel modeling was used to test differences in changes over time. Significant changes were foundin physical activity, HbA1c and waist circumference after participation in individualized lifestyle intervention. The relationship between changes in physical activity, levels of salutogenic health and glycated hemoglobin (Hb1Ac) were investigated (n=54) in Study IV. The data were collected atbaseline, after 12 months and after 24 months using the self-reported questionnaires Salutogenic Health Indicator Scale (SHIS) and National Public Health Survey. Within-person changes in physical activity between baseline and at the end of the twenty-four-month intervention were calculated. Selfreported increased physical activity was positively associated with self-rated salutogenic health and negatively associated with level of HbA1c after participation in the intervention. The thesis shows that a well-founded assessment of general health needs must consider both the individual's subjective experiences and objective measurements in order to form a solid foundation for dialogue and shareddecision-making about essential care services. The results also show that it is possible to stimulate healthy behavioral changes with a two-year individualized lifestyle intervention and bring both subjectively and objectively measured health benefits for people with psychotic disorders. The importance of nurses in psychiatric care applying a holistic approach and integrating lifestyle interventions into daily person-centered psychiatric care in collaboration with other healthcare providers to facilitate changes towards a healthy lifestyle in persons with psychotic illness is emphasized in the thesis.

  • 2.
    Blomqvist, Marjut
    Högskolan i Halmstad, Akademin för hälsa och välfärd. Psykiatrin Halland, Falkenberg, Sverige.
    LIV-P Levnadsvaneinterventioner för personer med psykossjukdom2014Konferansepaper (Annet vitenskapelig)
  • 3.
    Blomqvist, Marjut
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Experiences of data collection issues in qualitative studies involving people diagnosed with schizophrenia2016Inngår i: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016, 2016, s. 41-41Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: The viewpoint and special needs of individuals with severe mental illness are crucial for the development of mental health nursing. In-depth knowledge of the perspectives of people with schizophrenia is primarily established in dialogue with individuals with experience of the phenomenon investigated. Attaining trustworthiness in the findings in qualitative studies is of great importance and the interview approach used should assure trustworthiness in the data collection at different levels with regard to the perspectives of the individual, which is essential for developing nursing research and practice.

    Aim: The aim of the paper was to describe and discuss the issues related to data collection in qualitative studies involving people diagnosed with schizophrenia.

    Method: Six qualitative interview studies regarding experiences of different aspects of life among people diagnosed with schizophrenia were reflected on and discussed in terms of issues related to data collection involving people with severe mental illness such as schizophrenia (N=75).

    Results: The discussions that generated the results revealed three topics in qualitative studies involving individuals diagnosed with schizophrenia: 1) Selection of research context with respect to participants’ different aspects of life, 2) Sampling issues with regard to judgements of participants’ ability to contribute with information and 3) Choice of data collection methods to meet the aim of the enquiry.

    Conclusion: Three crucial areas in data collection in qualitative studies with individuals diagnosed with schizophrenia were revealed. Further studies regarding sampling procedures and analysis of collected data are needed to ensure trustworthiness of findings regarding interviews involving people with severe mental illness.

  • 4.
    Blomqvist, Marjut
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Sandgren, Anna
    Linneaus University, Växjö, Sweden.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    How to facilitate healthy living described by persons with persistent psychiatric disorders in psychiatric out-patient settings – challenging health care professionals2016Inngår i: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016, 2016, s. 13-13Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Over the previous decades, scientific research has demonstrated that people with persistent mental illness like schizophrenia and other psychotic disorders have a reduced life expectancy and have a higher risk of being affected of preventable physical illnesses such as developing metabolic syndrome, cardiovascular disease and type 2 diabetes. Additionally it have made evident for lower quality of life as well. These risk factors make health promoting essential in the care providing and therefore it ́s important for the health professionals to have a deeper knowledge about the facilitating factors to healthy living described by persons themselves.

    Aim: The aim of this qualitative study was to describe the experiences of persons affected by persistent mental illness such as schizophrenia or other psychotic disorders what facilitates healthy living in their everyday life. The presentation has the focus on the facilitative factors applying health professionals when providing care for persons in psychiatric out-patient settings.

    Method: The study was carried out in three different psychiatric out-patient settings in the southern Sweden. The data was collected through qualitative interviews (N= 16) and analyses by qualitative, inductive approach abased on Granheim and Lundmans ́ conceptualization of content analysis.

    Results: First, it is essential for persons with persistent and severe mental illness that they get support to bring out their needs to healthier living by having a dialogue about the issues of healthy living in their everyday life. In this dialog they may also need support to reflect and find out their own motivating factors to healthier living. Additionally, in this dialogue it is important to be aware of that they will be regarded as a whole person and include many areas of life like daily structure and social life. The professionals should show a truly involvement and active interest to persons when increasing healthy living.

    Conclusion: Many persons with persistent mental illness need practical support in their everyday life to maintaining healthier living. This requires the close cooperation between psychiatric out-patient settings, the housing support professionals from municipalities and the social services.

  • 5.
    Blomqvist, Marjut
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Ivarsson, Andreas
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Sandgren, Anna
    Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-Up2019Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, nr 10, s. 839-850Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    People with psychotic disorders experience to a great extent avoidable physical illnesses and early mortality. The aim of the study was to investigate the potential effects for this group of participating in a lifestyle intervention. A multi-component nurse-led lifestyle intervention using quasi-experimental design was performed. Changes in biomedical and clinical measurements, self-reported health, symptoms of illness and health behavior were investigated. Multilevel modeling was used to statistically test differences in changes over time. Statistically significant changes were found in physical activity, HbA1c and waist circumference. A lifestyle intervention for people with severe mental illness can be beneficial for increasing physical activity. © 2019 Blomqvist et al. Published with license by Taylor & Francis Group, LLC.

  • 6.
    Blomqvist, Marjut
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Ivarsson, Andreas
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och idrott.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Sandgren, Anna
    Linnaeus University, Center for Collaborative Palliative Care , Department of Health and Caring Sciences, Växjö, Sweden.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Health Risks among People with Severe Mental Illness in Psychiatric Outpatient Settings2018Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, nr 7, s. 585-591Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Life expectancy is greatly reduced in patients with schizophrenia, and cardiovascular diseases are a leading cause of mortality. The aim of this cross-sectional study was to investigate the prevalence of overweight, obesity, and cardiovascular disease (CVD) risk and to investigate the relationships between self-rated health, sense of coherence, CVD risk, and body mass index (BMI) among people with severe mental illness (SMI) in psychiatric outpatient settings. Nearly 50% of the participants were exposed to moderate/high risk of CVD and over 50% were obese. The results showed no statistically relationships between the subjective and objective measures (Bayes factor <1) of health. The integration of physical health into clinical psychiatric nursing practice is vital. © 2018 Taylor & Francis Group, LLC

  • 7.
    Blomqvist, Marjut
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Ivarsson, Andreas
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och idrott.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Sandgren, Anna
    Linnaeus University, Växjö, Sweden.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Relationship between physical activity and health outcomes in persons with psychotic disorders after participation in a two-year individualized lifestyle interventionInngår i: Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    People with psychotic disorders have a significantly increased risk of cardiovascular disease, Type 2 diabetes, and excessive mortality rates which makes lifestyle interventions imperative in mental health care. The aim of the study was to investigate relationships between changes in physical activity, levels of salutogenic health, and glycated hemoglobin (Hb1Ac) among people with psychotic disorders after participation in a two-year individualized lifestyle intervention in psychiatric outpatient services. The results from latent change score (LCS) analyses showed that self-reported increased physical activity was positively associated with the level of salutogenic health and negatively associated with the level of HbA1c after participation in a two-year lifestyle intervention. The results of this study suggest that an individualized two-year lifestyle intervention brings benefits regarding both subjectively and objectively measured health for people with psychotic disorders.

  • 8.
    Blomqvist, Marjut
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Experiences of methodological issues in qualitative studies involving people with severe mental illness such as schizophrenia2016Inngår i: Programme: Second Nordic Conference in Nursing Research, 2016, s. 60-60Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: The viewpoint and special needs of individuals with severe mental illness is crucial in development of mental health nursing. In-depth knowledge of the perspectives of people with severe mental illness is primarily established in dialog with individuals experienced in the phenomenon investigated. To reach trustworthiness of findings in qualitative studies is central and the interview approach used should assure trustworthiness in data collection regarding perspectives of the individual essential in developing nursing research and practice.

    Aim: The aim of the paper was to describe and discuss methodological issues related to research interviews involving people with severe and persistent mental illness.

    Method: Five qualitative interview studies regarding experiences of different aspects of life among people with severe mental illness were reflected and discussed regarding methodological issues related to the interview situation involving people with severe and persistent mental illness (N=51).

    Results: The discussions forming the results revealed three crucial topics in qualitative interview studies with individuals with severe mental illness. Use previous experiences of interactions with persons with mental disabilities with an open mind without prejudices. Balance the interviewee’s need of support and encouragement during the interview without manipulating contents of statements. Comprehend the essential meaning in the interviewee’s statements even when statements are short and narrow.

    Discussion: Three crucial topics in qualitative interview studies with individuals with severe mental illness were revealed. Further studies regarding sampling procedures and analysis of collected data are needed to ensure trustworthiness of findings regarding interviews involving people with severe mental illness.

  • 9.
    Blomqvist, Marjut
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Sandgren, Anna
    Linneaus University, Växjö, Sweden.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services2018Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 1, s. 236-246Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness. © 2017 Australian College of Mental Health Nurses Inc.

  • 10.
    Blomqvist, Marjut
    et al.
    Department of Psychiatry, Central County Hospital Halmstad, Sweden.
    Ziegert, Kristina
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    "Family in the waiting room": A Swedish study of nurses' conceptions of family participation in acute psychiatric in-patient setting2011Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, s. 185-194Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Family plays an important role in the care provided for patients in all areas of nursing. However, relatively few studies deal with the focus of the present study: the ways that nurses experience family participation in acute psychiatric inpatient settings. Data were collected by interviewing 18 nurses who had experience working in such settings. A phenomenographical approach was used to analyse the interviews. Three descriptive categories were found: family participation as a part of the caring process, barriers to family participation, and nurses' resources in family participation. The findings show that the nurses' conceptions of family participation varied, and that the family was not always a priority in this caring context. The implementation of family participation was often only based on the nurses' own interests and insights. This could mean that family participation differed substantially, depending on which nurse a family encountered, and which unit the patient was admitted at. Finally, nurses had little professional autonomy, and organizational support and education were also lacking.

  • 11.
    Carlsson, Ing-Marie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Blomqvist, Marjut
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Ethical and methodological issues in qualitative studies involving people with severe and persistent mental illness such as schizophrenia and other psychotic conditions: a critical review2017Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, nr Sup. 2, artikkel-id 1368323Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Undertaking research studies in the field of mental health is essential in mental health nursing. Qualitative research methodologies enable human experiences to become visible and recognize the importance of lived experiences. This paper argues that involving people with schizophrenia in research is critical to promote their health and well-being. The quality of qualitative research needs scrutinizing according to methodological issues such as trustworthiness and ethical standards that are a fundamental part of qualitative research and nursing curricula. The aim of this study was to critically review recent qualitative studies involving people with severe and persistent mental illness such as schizophrenia and other psychotic conditions, regarding descriptions of ethical and methodological issues in data collection and analysis. A search for relevant papers was conducted in three electronic databases, in December 2016. Fifteen qualitative interview studies were included and reviewed regarding methodological issues related to ethics, and data collection and analysis. The results revealed insufficient descriptions of methodology regarding ethical considerations and issues related to recruitment and sampling in qualitative interview studies with individuals with severe mental illness, putting trustworthiness at risk despite detailed descriptions of data analysis. Knowledge from the perspective of individuals with their own experience of mental illness is essential. Issues regarding sampling and trustworthiness in qualitative studies involving people with severe mental illness are vital to counteract the stigmatization of mental illness.

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