<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Trine-Lise Jansen</style></author><author><style face="normal" font="default" size="100%">Lars Johan Danbolt</style></author><author><style face="normal" font="default" size="100%">Ingrid Hanssen</style></author><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">How may cultural and political ideals cause moral distress in acute psychiatry? A qualitative study</style></title><secondary-title><style face="normal" font="default" size="100%">BMJ Psychiatry</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Acute psychiatry; Coercion; Cultural ideals; Mental health nursing; Moral distress; Political ideals; Psychiatric nursing</style></keyword><keyword><style  face="normal" font="default" size="100%">akutt psykiatri</style></keyword><keyword><style  face="normal" font="default" size="100%">kulturelle</style></keyword><keyword><style  face="normal" font="default" size="100%">moral</style></keyword><keyword><style  face="normal" font="default" size="100%">politiske</style></keyword><keyword><style  face="normal" font="default" size="100%">Sykepleie</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2022</style></year><pub-dates><date><style  face="normal" font="default" size="100%">03/2022</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944013/</style></url></web-urls></urls><volume><style face="normal" font="default" size="100%">23</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;&lt;strong&gt;Background:&amp;nbsp;&lt;/strong&gt;There is growing public criticism of the use of restraints or coercion. Demands for strengthened patient participation and prevention of coercive measures in mental health care has become a priority for care professionals, researchers, and policymakers in Norway, as in many other countries. We have studied in what ways this current ideal of reducing the use of restraints or coercion and attempting to practice in a least restrictive manner may raise morals issues and create experiences of moral distress in nurses working in acute psychiatric contexts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&amp;nbsp;&lt;/strong&gt;Qualitative interview study, individual and focus group interviews, with altogether 30 nurses working in acute psychiatric wards in two mental health hospitals in Norway. Interviews were recorded and transcribed. A thematic analytic approach was chosen.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&amp;nbsp;&lt;/strong&gt;While nurses sense a strong expectation to minimise the use of restraints/coercion, patients on acute psychiatric wards are being increasingly ill with a greater tendency to violence. This creates moral doubt and dilemmas regarding how much nurses should endure on their own and their patients&amp;#39; behalf and may expose patients and healthcare personnel to greater risk of violence. Nurses worry that new legislation and ideals may prevent acutely mentally ill and vulnerable patients from receiving the treatment they need as well as their ability to create a psychological safe climate on the ward. Furthermore, persuading the patient to stay on the ward can cause guilt and uneasiness. Inadequate resources function as external constraints that may frustrate nurses from realising the treatment ideals set before them.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&amp;nbsp;&lt;/strong&gt;Mental health nurses working in acute psychiatric care are involved in a complex interplay between political and professional ideals to reduce the use of coercion while being responsible for the safety of both patients and staff as well as creating a therapeutic atmosphere. External constraints like inadequate resources may furthermore hinder the healthcare workers/nurses from realising the treatment ideals set before them. Caught in the middle nurses may experience moral distress that may lead to physical discomfort, uneasiness and feelings of guilt, shame, and defeat. Pressure on nurses and care providers to reduce or eliminate the use of coercion and reduction of health care spending are incompatible demands.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords:&amp;nbsp;&lt;/strong&gt;Acute psychiatry; Coercion; Cultural ideals; Mental health nursing; Moral distress; Political ideals; Psychiatric nursing.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">22</style></issue><label><style face="normal" font="default" size="100%">erfaringsbaserte</style></label></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Tonje Lossius Husum</style></author><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author><author><style face="normal" font="default" size="100%">Reidar Pedersen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">En studie av synet på etiske utfordringer relatert til arbeid med bruk av tvang hos ansatte i psykiske helsetjenester</style></title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Etikk</style></keyword><keyword><style  face="normal" font="default" size="100%">helsepersonell</style></keyword><keyword><style  face="normal" font="default" size="100%">psykiske helsetjenester</style></keyword><keyword><style  face="normal" font="default" size="100%">tvang</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2018</style></year></dates><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Senter for medisinsk etikk ved universitetet i Oslo har gjennomført en nettbasert spørreundersøkelse av helsepersonells erfaringer med etiske utfordringer, tvang og krenkelser innen psykiske helsetjenester. Denne artikkelen presenterer en analyse av svarene som ble gitt på et åpent spørsmål om hva helsepersonell erfarte som etisk utfordrende i arbeidet relatert til bruk av tvang. Totalt 439 ansatte med ulik yrkesbakgrunn beskrev en eller flere etiske utfordringer. Svarene ble analysert med manifest innholdsanalyse og rangert etter hvor ofte de ble nevnt. Følgende etiske utfordringene ble nevnt oftest: 1. Tvil og usikkerhet angående bruk av formell tvang, 2. Andre former for restriksjoner, 3. Tvangsmedisinering, 4. Uenighet mellom berørte parter, 5. Utfordringer relatert til utføring av tvangstiltak, 6. Organisatoriske faktorer og mangelfulle ressurser, 7. Overdreven bruk av makt, maktmisbruk og uegnet personell. Studien bidrar med ny kunnskap om hva helsepersonell innen psykiske helsetjenester opplever som etisk utfordrende i sammenheng med bruk av tvang.&lt;/p&gt;</style></abstract><label><style face="normal" font="default" size="100%">Etikk</style></label></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Reidun Norvoll</style></author><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author><author><style face="normal" font="default" size="100%">Reidar Pedersen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">The Role of Ethics in Reducing and Improving the Quality of Coercion in Mental Health Care</style></title><secondary-title><style face="normal" font="default" size="100%">HEC Forum</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2017</style></year><pub-dates><date><style  face="normal" font="default" size="100%">March 01</style></date></pub-dates></dates><number><style face="normal" font="default" size="100%">1</style></number><volume><style face="normal" font="default" size="100%">29</style></volume><pages><style face="normal" font="default" size="100%">59-74</style></pages><isbn><style face="normal" font="default" size="100%">1572-8498</style></isbn><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Coercion in mental health care gives rise to many ethical challenges. Many countries have recently implemented state policy programs or development projects aiming to reduce coercive practices and improve their quality. Few studies have explored the possible role of ethics (i.e., ethical theory, moral deliberation and clinical ethics support) in such initiatives. This study adds to this subject by exploring health professionals&amp;rsquo; descriptions of their ethical challenges and strategies in everyday life to ensure morally justified coercion and best practices. Seven semi-structured telephone interviews were carried out in 2012 with key informants in charge of central development projects and quality-assurance work in mental health services in Norway. No facilities used formal clinical ethics support. However, the informants described five areas in which ethics was of importance: moral concerns as implicit parts of local quality improvement initiatives; moral uneasiness and idealism as a motivational source of change; creating a normative basis for development work; value-based leadership; and increased staff reflexivity on coercive practices. The study shows that coercion entails both individual and institutional ethical aspects. Thus, various kinds of moral deliberation and ethics support could contribute to addressing coercion challenges by offering more systematic ways of dealing with moral concerns. However, more strategic use of implicit and institutional ethics is also needed.&lt;/p&gt;</style></abstract><issue><style face="normal" font="default" size="100%">1</style></issue><label><style face="normal" font="default" size="100%">Etikk</style></label></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author><author><style face="normal" font="default" size="100%">Elisabeth Gjerberg</style></author><author><style face="normal" font="default" size="100%">Tonje Lossius Husum</style></author><author><style face="normal" font="default" size="100%">Reidar Pedersen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Ethical challenges when using coercion in mental healthcare: A systematic literature review</style></title><secondary-title><style face="normal" font="default" size="100%">Nursing Ethics</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year></dates><urls><web-urls><url><style face="normal" font="default" size="100%">http://nej.sagepub.com/content/early/2016/02/29/0969733016629770</style></url></web-urls></urls><language><style face="normal" font="default" size="100%">eng</style></language><label><style face="normal" font="default" size="100%">Etikk</style></label></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Reidun Førde</style></author><author><style face="normal" font="default" size="100%">Reidun Norvoll</style></author><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author><author><style face="normal" font="default" size="100%">Reidar Pedersen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Next of kin’s experiences of involvement during involuntary hospitalization and coercion</style></title><secondary-title><style face="normal" font="default" size="100%">BMC Medical EthicsBMC Medical Ethics</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2016</style></year><pub-dates><date><style  face="normal" font="default" size="100%">24.11.2016</style></date></pub-dates></dates><number><style face="normal" font="default" size="100%">76</style></number><volume><style face="normal" font="default" size="100%">17</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><label><style face="normal" font="default" size="100%">Erfaringsbaserte</style></label></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Bert Molewijk</style></author><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author><author><style face="normal" font="default" size="100%">Reidar Pedersen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Dealing with ethical challenges: a focus group study with proessionals in mental health care</style></title><secondary-title><style face="normal" font="default" size="100%">BMC Medical Ethics</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2015</style></year></dates><number><style face="normal" font="default" size="100%">4</style></number><volume><style face="normal" font="default" size="100%">16</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><issue><style face="normal" font="default" size="100%">4</style></issue></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author><author><style face="normal" font="default" size="100%">Reidar Pedersen</style></author><author><style face="normal" font="default" size="100%">Reidun Norvoll</style></author><author><style face="normal" font="default" size="100%">Molewijk, Bert</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Evaluating clinical ethics support in mental healthcare: a systematic literature review</style></title><secondary-title><style face="normal" font="default" size="100%">Nursing Ethics</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2015</style></year></dates><number><style face="normal" font="default" size="100%">4</style></number><edition><style face="normal" font="default" size="100%">4.08.2014</style></edition><volume><style face="normal" font="default" size="100%">22</style></volume><pages><style face="normal" font="default" size="100%">452-66</style></pages><language><style face="normal" font="default" size="100%">eng</style></language><issue><style face="normal" font="default" size="100%">4</style></issue><label><style face="normal" font="default" size="100%">Erfaringsbaserte</style></label></record><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Marit Helene Hem</style></author><author><style face="normal" font="default" size="100%">Molewijk, Bert</style></author><author><style face="normal" font="default" size="100%">Reidar Pedersen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Ethical challenges in connection with the use of coercion: a focus group study of health care personnel in mental health care</style></title><secondary-title><style face="normal" font="default" size="100%">BMC Medical Ethics</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2014</style></year></dates><number><style face="normal" font="default" size="100%">82</style></number><volume><style face="normal" font="default" size="100%">15</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><issue><style face="normal" font="default" size="100%">82</style></issue></record></records></xml>