Swedish forensic psychiatric nursing care, nurse's views of values theories and practice

Abstract: Introduction: The forensic psychiatric care of mentally disordered offenders is extensive in Sweden. Approximately 1000 persons are cared for on different treatment levels - the treatment periods are long (median slightly more than 3 years). The nursing care staffs are doing the majority of the treatment and rehabilitation work with these patients. Method: For this study a structured questionnaire, developed by Hallberg and co-workers and used in Swedish general psychiatric nursing care research, For this study the questionnaire was modified to suit forensic psychiatric nursing care and data have been gathered from nurses at five large forensic psychiatric units, in total 246 respondents. The aim of this study is mainly explorative. Results: The results of Paper I illuminate nurses' areas of responsibilities and content in daily work. The work content was mainly directed to the patients ADL and there were only small differences between the LMN group and the RN group. Paper II showed that the character of the interventions were mainly verbal interactions dominated by confrontative elements, even though other studies shows that patients with similar psychiatric disorders could get worse of these interventions. In Paper III it was found that, in spite of working in a stressful environment, work satisfaction was almost the same as nurses and occupational therapists in Swedish general psychiatric care. In Paper IV it was found that an interpersonal patient-nurse relationship based on trust, empathy, respect and responsibility for the patients' personal recourses and knowledge seems to be the essence of nursing care and a way to improve care. The organisation ought to be more influenced by and based on, nursing care including increased clinical supervision and access to the patient's social networks. The nurses' educational needs have their bases in different treatment modalities, how to perform different treatments, how to establish developing relationships and in-service training adapted to the ward-specific problems.