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Östman, Margareta
Publications (10 of 86) Show all publications
Wirsén, E., Åkerlund, S., Ingvarsdotter, K., Hjärthag, F., Östman, M. & Persson, K. (2020). Burdens experienced and perceived needs of relatives of persons with SMI: a systematic meta-synthesis (ed.). Journal of Mental Health, 29(6), 712-721
Open this publication in new window or tab >>Burdens experienced and perceived needs of relatives of persons with SMI: a systematic meta-synthesis
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2020 (English)In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 29, no 6, p. 712-721Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Close relatives of people with severe mental illness (SMI) experience problems known as family burdens. In addition, they may have their own needs for support, something often overlooked by the healthcare system. Meta-syntheses in this area may help explore the meaning of the experience of living with someone who has a SMI. AIM: Our aim was to describe the burdens experienced and needs perceived on a daily basis by relatives to someone who has a SMI. METHODS: The databases PubMed, CINAHL, and PsychInfo were searched using a systematic search strategy. Studies were screened for relevance and quality was appraised. A meta-synthesis of nine qualitative studies was then conducted. RESULTS: The nine studies discerned the following themes. Burden themes; Forced to carry a sometimes unbearable burden; Burdened by own ill-health and disrupted relationships; Distressed and stigmatized by society. Needs themes; strengthening protective factors; Skills and practical support greatly appreciated. CONCLUSIONS: The burdens and needs of relatives of persons with SMI strongly influence their lives. They require relief from both practical and emotional burdens. Family interventions and other programs to support relatives should be encouraged with this knowledge in mind

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Family burden, meta-synthesis, needs, qualitative research, severe mental illness, stigma
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-826 (URN)10.1080/09638237.2017.1370632 (DOI)000601092500015 ()28853618 (PubMedID)2-s2.0-85098010665 (Scopus ID)24017 (Local ID)24017 (Archive number)24017 (OAI)
Available from: 2020-02-27 Created: 2020-02-27 Last updated: 2023-09-04Bibliographically approved
Persson, K., Östman, M., Ingvarsdotter, K. & Hjarthag, F. (2019). A Mismatch of Paradigms Disrupts the Introduction of Psycho-Educative Interventions for Families of Persons with SMI: An Interview Study with Staff from Community Services (ed.). Community mental health journal, 55(4), 663-671
Open this publication in new window or tab >>A Mismatch of Paradigms Disrupts the Introduction of Psycho-Educative Interventions for Families of Persons with SMI: An Interview Study with Staff from Community Services
2019 (English)In: Community mental health journal, ISSN 0010-3853, E-ISSN 1573-2789, Vol. 55, no 4, p. 663-671Article in journal (Refereed) Published
Abstract [en]

Treatment and support of people diagnosed with severe mental illness in Sweden takes place in out-patient psychiatric services or municipality services. Most of the responsibility for support in daily life are provided by the close family. One crucial matter is how to support these families. This research project aimed to investigate the Swedish construction with shared responsibility between county psychiatric care and municipality social care for consumers with severe mental illness affects actions in municipalities in relation to family support. Ten representatives from five municipality settings were interviewed. Five semi-structured interviews were analysed using a thematic analysis. The following themes emerged; One overarching theme, "a mismatch of paradigms", and sub-themes: (a) "accentuating differences", (b) "doubts about including the entire family in the same session" and (c) "lack of a uniform family support policy". We conclude that a shared mandate needs a dialogue between psychiatric and municipality services concerning this mismatch.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Family support, Municipality support, Psycho-pedagogic models, Severe mental illness
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-14581 (URN)10.1007/s10597-018-0307-z (DOI)000463787900014 ()30109580 (PubMedID)2-s2.0-85051706863 (Scopus ID)26709 (Local ID)26709 (Archive number)26709 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Afzelius, M., Plantin, L. & Östman, M. (2018). Families living with parental mental illness and their experiences of family interventions (ed.). Journal of Psychiatric and Mental Health Nursing, 25(2), 69-77
Open this publication in new window or tab >>Families living with parental mental illness and their experiences of family interventions
2018 (English)In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 25, no 2, p. 69-77Article in journal (Refereed)
Abstract [en]

Introduction: Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim: This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method: Five families with children aged 10–12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both family and individual interviews were performed. Results: In striving to lead an ordinary life while coping with the parental mental illness, these families sought the support of the psychiatric services, especially in order to inform their children about the mental illness. Despite different family interventions, the family members felt supported and reported that the number of conflicts in the family had decreased. The parents were appreciative of help with child-rearing questions, and the children experienced a calmer family atmosphere. However, the partner of the person with mental illness experienced being left without support. Implications for practice: Our study shows that psychiatric services, and especially mental health nurses, are in a position to more regularly offer family interventions in supporting the children and the healthy partners.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Family, children of parents with mental illness, Family intervention
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-14726 (URN)10.1111/jpm.12433 (DOI)000424163500002 ()28906576 (PubMedID)2-s2.0-85041610832 (Scopus ID)23817 (Local ID)23817 (Archive number)23817 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Afzelius, M., Östman, M., Rastam, M. & Priebe, G. (2018). Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry (ed.). Nordic Journal of Psychiatry, 72(1), 31-38
Open this publication in new window or tab >>Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
2018 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 1, p. 31-38Article in journal (Refereed)
Abstract [en]

Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Parental mental illness, children, child-focused intervention, interagency collaboration, psychiatric services
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-15159 (URN)10.1080/08039488.2017.1377287 (DOI)000417846400005 ()28933586 (PubMedID)2-s2.0-85029677558 (Scopus ID)25837 (Local ID)25837 (Archive number)25837 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Afzelius, M., Plantin, L. & Östman, M. (2017). Children of parents with serious mental illness: the perspective of social workers (ed.). Practice, 29(4), 293-310
Open this publication in new window or tab >>Children of parents with serious mental illness: the perspective of social workers
2017 (English)In: Practice, ISSN 0950-3153, E-ISSN 1742-4909, Vol. 29, no 4, p. 293-310Article in journal (Refereed) Published
Abstract [en]

The aim of this study is to describe the experiences of children’s social workers in Sweden who work with families in which a parent suffers from serious mental illness, and how a child in such a family receives support. Data were collected through individual interviews and focus groups discussions with 13 professionals in 2 minor municipalities in southern Sweden. Interviewees stated that parental serious mental illness was not a main focus for children’s social workers. When parental serious mental illness became a barrier to caring for their children, the children’s social workers sought to collaborate with psychiatric services, but in many cases it did not turn out well. Providing support to the parent was one way of aiding the family, although at the price of setting the child’s perspective aside. Being faced with responsibility for the parent and the child left children’s social workers feeling they were the last outpost for the families. Children’s social workers require greater knowledge of how to handle parental serious mental illness, and more interagency collaboration with psychiatric services is needed to adequately support children of parents with a serious mental illness. Keywords: children of parents with serious mental illness; parental serious mental illness; children’s social workers; psychiatric services

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
children of parents with serious mental illness, parental serious mental illness, children’s social workers, psychiatric services
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-14682 (URN)10.1080/09503153.2016.1260705 (DOI)2-s2.0-85000673407 (Scopus ID)21763 (Local ID)21763 (Archive number)21763 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2023-08-21Bibliographically approved
Schlyter, M., Östman, M., Engström, G., André-Petersson, L., Tydén, P. & Leosdottir, M. (2017). Personality factors and depression as predictors of hospital-based health care utilization following acute myocardial infarction (ed.). European Journal of Cardiovascular Nursing, 16(4), 318-325
Open this publication in new window or tab >>Personality factors and depression as predictors of hospital-based health care utilization following acute myocardial infarction
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2017 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no 4, p. 318-325Article in journal (Refereed) Published
Abstract [en]

Background: Whether personality factors and depressive traits affect patients’ utilization of health care following an acute myocardial infarction is relatively unknown. The aim of this study was to examine whether hospital-based health care utilization after a myocardial infarction was correlated with patients’ personality factors and depressive symptoms. Methods: We studied 366 myocardial infarction patients admitted to Malmö University Hospital between 2002 and 2005 who subsequently participated in a cardiac rehabilitation programme. The patients were followed for two years after their index event. We investigated whether personality factors and depressive traits were correlated with the participants’ health care utilization, defined as a) out-patient Cardiology visits and phone calls to a physician, nurse or a social worker, and b) acute visits or admissions to the Emergency or Cardiology Departments, using negative binominal regression analysis. Results: In unadjusted comparisons neuroticism predicted more out-patient contacts. This significance remained after adjusting for age, sex, smoking, alcohol consumption and size of the myocardial infarction (measured as max level on troponin-I and left ventricular ejection fraction). There were no significant correlations between other personality factors or depression and out-patient contacts. None of the personality factors or depression predicted acute admissions. Conclusion: Apart from neuroticism, personality factors did not explain utilization of health care in terms of Cardiology out-patient contacts or acute admissions in myocardial infarction patients participating in a cardiac rehabilitation programme. Neither did depressive symptoms predict more health care utilization. This might indicate a robust cardiac rehabilitation programme offered to the study subjects, minimizing the need for additional health care contacts.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
Personality factors, depressive traits, myocardial infarction, health care utilization
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-4084 (URN)10.1177/1474515116666780 (DOI)000396200300007 ()27566599 (PubMedID)2-s2.0-85015094972 (Scopus ID)22621 (Local ID)22621 (Archive number)22621 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-02-05Bibliographically approved
Hjärthag, F., Persson, K., Ingvarsdotter, K. & Östman, M. (2017). Professional views of supporting relatives of mental health clients with severe mental illness (ed.). International Journal of Social Psychiatry, 63(1), 63-69
Open this publication in new window or tab >>Professional views of supporting relatives of mental health clients with severe mental illness
2017 (English)In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 63, no 1, p. 63-69Article in journal (Refereed) Published
Abstract [en]

Background: Supporting families where one person suffers from long-term severe mental illness (SMI) is essential, but seems hard to reach. The aim of this study was to examine professionals’ views of supporting relatives of persons with SMI. Material: Individual interviews mirroring personal narratives and group interviews reflecting group-processed answers were conducted among 23 professionals and analyzed thematically. Results: Three themes emerged: (a) information and group interaction reduces stigma and increases well-being, (b) professionals need to feel secure and confident about how the support structure works and (c) collaboration is difficult but required on several levels. Conclusion: Trusting relationships with families were considered important, although seldom achieved; professionals wished to feel secure in their role toward relatives of a person with SMI; and professionals wanted to feel confident when working together with other services to support families.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
severe mental illness, family member, professionals, support, family intervention
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-15228 (URN)10.1177/0020764016682268 (DOI)000394894700009 ()28135999 (PubMedID)2-s2.0-85011545362 (Scopus ID)22380 (Local ID)22380 (Archive number)22380 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Levinsson, H., Kjellin, L. & Östman, M. (2016). Autonomy and Severe Mental Illness: The Relationship between Social Network and Functioning (ed.). SOJ Nursing & Health Care, 2(2), 1-5
Open this publication in new window or tab >>Autonomy and Severe Mental Illness: The Relationship between Social Network and Functioning
2016 (English)In: SOJ Nursing & Health Care, ISSN 2471-6529, Vol. 2, no 2, p. 1-5Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of the present study was to illuminate a theoretical framework about autonomy as a capacity, which takes into consideration both the cognitive functioning of the individual as well as access to social networks. Design and Method: In order to illuminate a theoretical framework about autonomy as a capacity, a quantitative study comprising a dataset of involuntarily and voluntarily admitted patients at acute general psychiatric wards was used. Findings: Respondents who reported meeting friends, family, relatives or acquaintances often had a significant higher functioning in terms of total GAF score compared to respondents who reported meeting friends, family, relatives or acquaintances as seldom or never. Practice Implications: The efforts of nursing care practices to care for and treat severe mental illness may benefit from greater awareness about research on functioning and access to social networks. Such research is a valuable contribution to further develop a theoretical framework about autonomy within the nursing profession.

Place, publisher, year, edition, pages
Symbiosis, 2016
Keywords
Autonomy, Global Assessment of Functioning, Nursing Practice, Severe Mental Illness, Social Network
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-5230 (URN)22403 (Local ID)22403 (Archive number)22403 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2022-06-27Bibliographically approved
Wangel, A.-M., Ryding, E.-L., Schei, B., Östman, M., Lukasse, M. & The Bidens study group, . (2016). Emotional, physical, and sexual abuse and the association with depressive and posttraumatic stress symptoms in a multi-ethnic pregnant population in Southern Sweden (ed.). Sexual & Reproductive HealthCare, 9, 7-13
Open this publication in new window or tab >>Emotional, physical, and sexual abuse and the association with depressive and posttraumatic stress symptoms in a multi-ethnic pregnant population in Southern Sweden
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2016 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 9, p. 7-13Article in journal (Refereed) Published
Abstract [en]

Objectives This study aims to describe the prevalence of emotional, physical, and sexual abuse and analyze associations with symptoms of depression and posttraumatic stress (PTS) in pregnancy, by ethnic background. Study design This is a cross-sectional study of the Swedish data from the Bidens cohort study. Ethnicity was categorized as native and non-native Swedish-speakers. Women completed a questionnaire while attending routine antenatal care. The NorVold Abuse Questionnaire (NorAQ) assessed a history of emotional, physical or sexual abuse. The Edinburgh Depression Scale-5 measured symptoms of depression. Symptoms of Posttraumatic Stress (PTS) included intrusion, avoidance and numbness. Results Of 1003 women, 78.6% were native and 21.4% were non-native Swedish-speakers. Native and non-native Swedish-speakers experienced a similar proportion of lifetime abuse. Moderate emotional and physical abuse in childhood was significantly more common among non-native Swedish-speakers. Sexual abuse in adulthood was significantly more prevalent among native Swedish-speakers. Emotional and sexual abuse were significantly associated with symptoms of depression for both natives and non-natives. Physical abuse was significantly associated with symptoms of depression for non-natives only. All types of abuse were significantly associated with symptoms of PTS for both native and non-native Swedish-speakers. Adding ethnicity to the multiple binary regression analyses did not really alter the association between the different types of abuse and symptoms of depression and PTS. Conclusion The prevalence of lifetime abuse did not differ significantly for native and non-native Swedish-speakers but there were significant differences on a more detailed level. Abuse was associated with symptoms of depression and PTS. Being a non-native Swedish-speaker did not influence the association much.

Place, publisher, year, edition, pages
Elsevier, 2016
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mau:diva-15261 (URN)10.1016/j.srhc.2016.04.003 (DOI)000384787100002 ()27634658 (PubMedID)2-s2.0-84973558768 (Scopus ID)21605 (Local ID)21605 (Archive number)21605 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Ingvarsdotter, K., Persson, K., Hjärthag, F. & Östman, M. (2016). How Professionals View Multifamily Psychoeducation: A Qualitative Study (ed.). Psychiatric quarterly, 87(3), 479-491
Open this publication in new window or tab >>How Professionals View Multifamily Psychoeducation: A Qualitative Study
2016 (English)In: Psychiatric quarterly, ISSN 0033-2720, E-ISSN 1573-6709, Vol. 87, no 3, p. 479-491Article in journal (Refereed)
Abstract [en]

Severe mental illness causes suffering for the patient as well as the patientâ s immediate family. The Swedish National Board of Health and Welfare has recommended the implementation of multifamily psychoeducation in order to assist patient and family in the recovery process. The aim of this study was to determine how introducing multifamily psychoeducation in Sweden has been viewed by professionals. Semi-structured interviews were conducted with 11 service providers, who were involved in evaluating multifamily psychoeducation. Our main findings fell under the headings of defensive culture and unsuitable model. Resistance to introducing the new intervention was found on multiple levels. The model proposed was considered too rigid for both the target group and the organizations because it could not be adjusted to the needs of patients, families, or facilitators. Despite good evidence for the effectiveness of the intervention, there were difficulties introducing the multifamily psychoeducation model in clinical practice. The feasibility of an intervention needs to be evaluated before adopting it as a national guideline.

Place, publisher, year, edition, pages
Springer, 2016
Keywords
Clinical practice Family intervention, Mental health, Psychoeducation, Severe mental illness, Sweden
National Category
Social Sciences
Identifiers
urn:nbn:se:mau:diva-14573 (URN)10.1007/s11126-015-9401-3 (DOI)000380005500008 ()26597991 (PubMedID)2-s2.0-84947903666 (Scopus ID)22425 (Local ID)22425 (Archive number)22425 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
Projects
Mental ill-health in childbearing women: Markers and risk factors; Malmö högskola, Centre for Sexology and Sexuality Studies (CSS) (Closed down 2017-12-31)
Organisations

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