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dc.contributor.advisorHøyer, Georg
dc.contributor.authorStensrud, Bjørn
dc.date.accessioned2016-10-21T11:13:51Z
dc.date.available2016-10-21T11:13:51Z
dc.date.issued2016-10-27
dc.description.abstractCompulsory outpatient psychiatric care or outpatient commitment (OC) is intended to ensure treatment of people with severe psychotic disorders after discharge from inpatient care. Although OC has long been used in Norway, there is little research-based knowledge of the extent and content of the scheme and a particular lack of knowledge of the experiences of those involved. The studies are based on qualitative interviews with patients subject to OC and their relatives, and focus group interviews with health professionals. The results show that patients found OC to be an obstacle to social integration and prevented them from basing their recovery process on their own experiences. Relatives found that scheme relieved them, but they felt that health professionals did not acknowledge their expertise and experiences. Health professionals experienced a dilemma in attempting to combine therapeutic responsibility with the management of coercion. Recovery from mental illness is largely a question of patients developing everyday coping skills. Health professionals should therefore increasingly consider whether OC is equally useful for all patients with psychosis and whether poor cooperation on treatment may partly be due to patients having other priorities for their lives. Since the use of OC is largely justified by the patient’s treatment needs, the scheme must facilitate patients’ involvement in their own recovery, and use resources in the patient’s environment to enhance treatment. The results show that the interaction between patients, relatives and OC decision makers should be improved compared to how the scheme is practiced today.en_US
dc.description.doctoraltypeph.d.en_US
dc.description.popularabstractTvungent psykisk helsevern uten døgnopphold (TUD) skal sikre behandlingen av mennesker med alvorlige psykoselidelser etter utskrivelse fra sykehus. Selv om TUD har vært brukt lenge i Norge finnes lite forskningsbasert kunnskap om omfang og innhold i ordningen. Særlig savnes de berørtes erfaringer. Studiene er basert på kvalitative intervju med pasienter underlagt TUD, pårørende og fokusgruppeintervju med helsepersonell. Resultatene viser at pasienter opplever ordningen som en hindring for sosial integrering, og å ta i bruk egne erfaringer for egen tilfriskning. Pårørende opplever ordningen som en avlastning, men føler at helsepersonell ikke anerkjenner deres kompetanse og erfaringer. Helsepersonell opplever dilemma når de skal kombinere terapeutisk ansvar med det å forvalte tvang. Bedring av psykisk lidelse handler i stor grad om at pasienter utvikler ferdigheter til å takle egen hverdag. Helsepersonell bør derfor i større grad vurdere om TUD er like nyttig for alle aktuelle pasienter med psykose, og om manglende samarbeid om behandlingen også kan skyldes at pasientene har andre prioriteringer for egen hverdag. Når TUD i stor grad begrunnes i pasientens behandlingsbehov, må ordningen tilrettelegge for at pasienten får medvirke til egen bedring, og at ressurser i pasientens omgivelser utnyttes til beste for pasientens behandling. Resultatene viser at samhandlingen mellom pasienter, pårørende og vedtaksansvarlige må forbedres sammenlignet med hvordan ordningen praktiseres i dag.en_US
dc.description.sponsorshipExtraStiftelsen Helse og Rehabilitering/The Norwegian ExtraFoundation for Health and Rehabilitation through EXTRA funds, Sykehuset Innlandet HF/Innlandet Hospital Trust og/and Nasjonal kompetansetjeneste for samtidig rusmisbruk og psykisk lidelse/ the Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disordersen_US
dc.identifier.urihttps://hdl.handle.net/10037/9877
dc.language.isoengen_US
dc.publisherUiT The Arctic University of Norwayen_US
dc.publisherUiT Norges arktiske universiteten_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2016 The Author(s)
dc.subject.courseIDDOKTOR-003
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800en_US
dc.titleExperiences with outpatient commitment orders from the perspectives of patients, relatives and staff - A qualitative studyen_US
dc.typeDoctoral thesisen_US
dc.typeDoktorgradsavhandlingen_US


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