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Aim: The study aimed to explore the experiences of care and recovery among older patients treated for physical trauma. Design: A qualitative study with a constructivist grounded theory design. Methods: Fifteen in‐depth interviews with older adults recovering from physical trauma were conducted and analysed between 2019 and 2023, in accordance with grounded theory methodology. Results: The findings show that for older patients who suffered physical trauma, the core category was the strive to recapture autonomy. This was achieved by means of Adaptation, Reflection and Interactions, which constitute the three main categories. Recovery involves facing and navigating various new life challenges, such as increased dependency on others, managing difficult symptoms and adapting in various ways to everyday life. The recovery process was influenced by fear, hope and the attitude towards new challenges. Conclusion: Older adults being cared for after a traumatic event have a difficult path to recovery ahead of them. Dealing with increased unwanted dependency on others was a main concern for the participants. Undertreated symptoms can lead to undesired isolation, delayed recovery and further increase unwanted dependency. On the other hand, hope, which was defined as having a positive approach to life and longing for the future, was a strong accelerating factor in the recovery process. Impact: As a result of this study, we have established that older patients experience the initial period after trauma as difficult and that support in the initial phase can be helpful when returning home. As healthcare services are under increasing pressure because of an ageing population, this study contributes by addressing an understudied population and clarifying their concerns. Reporting Method: Reporting adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. Patient or Public Contribution: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to illuminate the lived experiences and the path of recovery for adults sustaining a hip fracture before the age of 60. Methods: Participants were purposively sampled from a prospective multicenter cohort study in Sweden and Denmark, and narrative interviews were conducted with 19 individuals 0.7-3.5 years after the fracture. We used a phenomenological hermeneutic method to describe the participants' expressed essential meaning. Results: The experience of sustaining a hip fracture was expressed as a painful and protracted process of regaining self-confidence, function, and independence. It also implied a sense of growing old from one day to the next. Participants were afraid of new falls and fractures, resulting in an increased wariness. When expressing fears and persisting symptoms, participants described being neglected and marginalized by the healthcare system, which was perceived as non-receptive and routinely driven by a notion that hip fractures affect only the elderly. Rehabilitation targeted towards needs different from those of elderly individuals was requested. Conclusion: The lived experience of sustaining a hip fracture in individuals under 60 includes substantial challenges in everyday life, even up to 3.5 years after the injury. Rehabilitation pathways tailored to the needs of younger patients are requested. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the experiences of people with stress-related illness participating in a nature-based intervention programme in a northern natural setting. Methods: A longitudinal case study was conducted with two women participating in a nature-based intervention programme on a farm. Data were collected by semi-structured interviews, diaries, rating scales, and self-assessment. Qualitative data were analysed by qualitative content analysis and quantitative data are presented descriptively. Results: The theme of finding a source for recovery and well-being permeates all categories. The participants perceived the farm and nature to be a calming refuge; they learned to be in the present and could manage the tasks. In togetherness with each other and the facilitator on the farm they felt understood and confident, experienced joy, and found opportunities for change. They gained knowledge and positive memories and found new approaches in life. Self-assessment questionnaires indicated improvements of functioning in everyday life and reduced stress-related exhaustion at the end of the NBI programme. Conclusions: Nature-based interventions lasting for a relatively short period seem to promote health and may be a complement to other treatments of stress-related illness. Further research is needed with a larger number of participants and in various natural settings. [ABSTRACT FROM AUTHOR]

Opportunities and barriers for occupational engagement among residents in supported housing. Research shows that people with psychiatric disabilities view supported housing (SH) as a possibility for social contact, but also as entailing a risk of deprived self-determination. There is, however, little research on the target group's engagement in everyday occupations. To explore SH residents' opportunities and barriers for occupational engagement. Sixteen participants were interviewed, and data was analysed using content analysis. An overarching theme, Struggling to create meaning and seeking affection, and three underlying categories, emerged. Finding meaning through self-chosen occupations and support focussed on receiving support, doing self-chosen occupations, and having social contacts. Feeling neglected and insecure limits engagement in occupations was related to feelings of not being seen by staff, and insecurity, which hampered daily life. The third theme was Having a negative self-image and low level of ability hinders an active life. Residents' self-view and ability to create an inner drive for being active was important for occupational engagement, which was linked to social connectedness. Occupational based interventions and a personal recovery approach is warranted in order to facilitate needs for meaningful occupations. The results from the study can be used to further develop optimal support within SH units. [ABSTRACT FROM AUTHOR]

Self-efficacy plays a role in the process of making lifestyle changes. After bariatric surgery, patients must adapt to several lifelong lifestyle changes. The aim of this study was to explore patients' experiences of recovery after bariatric surgery in those reporting low preoperative self-efficacy. This qualitative inductive interview study included 18 participants. Individual interviews were conducted approximately one year after the surgery. Data were analysed using thematic analysis. The analysis identified one theme, and five subthemes describing recovery after bariatric surgery. Participants described being at a crossroads before surgery and having to make a change. After surgery, they had to learn to handle their new situation, which included getting to know their new body, handling thoughts about themselves, and managing social relations. To enhance their situation, support and information were essential. Social relations, support, successes, and challenges influenced their self-efficacy, and thoughts about adopting lifestyle changes, maintaining motivation, and handling setbacks. Recovery one year after bariatric surgery is an ongoing process that involves challenges encountered in lifestyle changes and physical and psychological transformations. Self-efficacy is not static and is influenced during the recovery process. Support and information are essential to enhance patient recovery after bariatric surgery. [ABSTRACT FROM AUTHOR]

People with mental ill health attend general emergency care more often than others for physical and psychiatric care needs. Staff in general emergency care report they lack knowledge and strategies to meet with and care for people with mental ill health. This study aimed to describe how people with mental ill health experience encounters with staff in general emergency care. We conducted individual semi‐structured interviews with 11 people with mental ill health about their experiences in general emergency care and subjected the interview data to qualitative content analysis. Our results show the importance to people with mental ill health of being acknowledged as capable persons, and how this relates to their experiences of being recognized, ignored, or dismissed by staff in general emergency care. Even small, ordinary aspects of staff/patient interactions can have major impacts on a person's recovery and well‐being. The study is reported according to the consolidated criteria for reporting qualitative research (COREQ) guidelines. [ABSTRACT FROM AUTHOR]

This article investigates how treatment factors are described by different client groups and by treatment staff. The material consists of interviews with clients (n = 81) and treatment staff (n = 18). The analysis focuses on two central themes - the importance of the treatment group and of the treatment staff, along with how these descriptions relate to the concept of the therapeutic alliance. The descriptions differ in parts between the client groups and between clients and staff. Clients as well as staff highlight structural and qualitative aspects of cohesion, but general patterns of how these are expressed in the groups are hard to grasp. However, some exceptions appear; while the clients often relate recognition to own experience of substance abuse, the staff often refer to external aspects of recognition, such as gender and/or experience of parenting. The results indicate that the social preconditions of the group members can influence group cohesion. In the treatment, focus is initially on cohesion and later on making change possible. This might create a dilemma; the homogeneity that initially creates cohesion can also act as a restraint on change. This is described in the results in relation to gender homogeneous client groups in treatment. [ABSTRACT FROM AUTHOR]

Rationale: There is a lack of long‐term follow‐up studies focused on injured and uninjured survivors’ experiences of the recovery process after major traffic crashes. Aim: To explore all survivors’ experiences of long‐term physical and psychological consequences and recovery 5 years after a major bus crash. Methodological design and justification: A qualitative design was used to explore experiences in a 5‐year follow‐up study. Research methods: Participants were 54 survivors of a bus crash with 56 survivors and six fatalities. Telephone interviews were analysed with qualitative content analysis. Results: The first category, ‘Being resilient or suffering in daily life’, has four subcategories covering quick recovery, suffering in daily life, distress in traffic situations and long‐term pain. Reasons for quick recovery among survivors were previous crisis experiences, travelling alone, being uninjured and not being exposed to traumatic impressions. For the other survivors, being reminded of the crash caused disturbing reactions, such as sweating, anxiety and flashbacks. Survivors avoided going by bus if they could. A group of the injured survivors was still suffering from limiting and painful injuries. The second category, ‘Reassessing oneself and social connections’, has three subcategories covering self‐awareness, impact on relationships and connectedness. Survivors either developed a stronger bond to their significant other or separated from their partner within the first couple of years. Friendships and a sense of connectedness among survivors were sources of long‐lasting comfort and support. The theme overarching the categories is ‘Visible and existential marks in everyday life’, representing the various ways in which the crash influence the survivors’ lives. Conclusion: There is a need for more information about disruptive long‐lasting consequences, such as travel anxiety, and available treatments. Initially, health‐promoting connectedness can be facilitated by treating survivors as a group of people who belong together, from the day of the crash and throughout the recovery process. [ABSTRACT FROM AUTHOR]

Injuries due to trauma are the leading cause of death in Sweden among people younger than 45 years, and more than 120,000 patients were admitted to hospitals in 2014 as a result of trauma. Patients suffering from less serious physical trauma are often discharged directly from the trauma unit, commonly without any follow-up plans. There is a lack of knowledge about how these patients experience their recovery process. Eight women and 6 men were interviewed 3 months after being directly discharged from a trauma unit. Data were analyzed using the constructive grounded theory approach. The main finding was the core category of social support, the key to recovery. Patients' roads to recapturing their health and to recovery had several barriers, which can be clustered together to either physical or psychological symptoms that enhanced their feelings of ill health and delayed their recovery. Participants described different strategies that they used to deal with these barriers. Most important was the support of others, that is, family, social life, work, and health care (primary health care). The participants in this study described managing the recovery process by themselves as troublesome. This is partly because they do not view themselves as healthy, as the health care providers do, and many are in need of further health care after discharge. Health care providers should give better information on the expected process of recovery and the importance of social support, as it might enable patients to better overcome physical and psychological barriers in their recovery. [ABSTRACT FROM AUTHOR]

Background: Forensic psychiatry is characterized by involuntary treatment and risk of violence. The concept of recovery is rarely in focus as the primary focus is on risk assessment, violence prevention and reducing coercion in care. Aim: To determine what resources forensic staff use to avoid or prevent violent situations, and to explore how these practices resemble the domains of recovery-oriented care. Method: Semi-structured interviews with staff who were identified by forensic patients as key workers in their recovery process. Interview texts were analyzed using interpretive content analysis. Results: Staff prevent violent situations using tacit knowledge and experience, and through a shared collegial responsibility. Staff safeguard patients, encourage patient participation, and provide staff consistency. Conclusions: The results have implications for forensic care as well as psychiatry regarding the process of making recovery a reality for patients in the forensic care setting. [ABSTRACT FROM AUTHOR]

Most patients in intensive care units suffer from critical diseases/injuries and are in need of life-saving medical treatment. Recovery after such diseases/injuries may be lengthy and may vary. Little is known about older patients' own assessment of recovery following intensive care. The aim of this study was to explore and describe older patients' experiences of recovery and need of care within 2 months following discharge from hospital after being cared for in an intensive care unit. Fifteen patients 65 years or older, who had received care in an intensive care unit, were telephone-interviewed 2 months following discharge. The interview texts were analysed using qualitative content analysis. Six themes were identified: 'Discharge - a matter of physicians' and nurses' decisions', 'Wanted to go home', 'Feeling well and feeling better, but...', 'Recovered or not, that is the question', 'In need of help from others' and 'In need of care'. Patients trusted in the medical experts' assessment of their condition as regarded hospital discharge, but they also stated that they wanted to go home, as soon as possible, to their own familiar and private environment. Patients did not see the hospital as a place for recovery. Patients claimed that they were used to taking care of themselves within the limits of their strength and energy. If they need help, they first of all turn to family members or relatives. Patients who reported comorbidity did not assess themselves as recovered, while others stated that they had recovered but also suffered from a variety of discomforting symptoms. [ABSTRACT FROM AUTHOR]

Aims and objective. The aim of this study was to describe and interpret the essential meaning of the lived experiences of being in a critical illness-recovery process after a life-threatening condition. Background. The critical illness-recovery process after a life-threatening condition takes several years and does not only include patients' experiences during intensive care. Previous research has mainly focused on what critically ill patients recall. However, from a phenomenological point of view, experiences are more than memories alone. To plan and perform relevant health care and social support for patients who have survived a life-threatening condition, a more profound understanding about their lived experiences is needed. Design and method. In this qualitative study, a phenomenological hermeneutical approach was used. Interviews were conducted with seven patients, two to four years after they had received care in an intensive care unit in Sweden. Results. The comprehensive understanding of the results shows that the critical illness-recovery process after a life-threatening condition means an existential struggle to reconcile with an unfamiliar body and with ordinary life. This can be understood as an 'unhomelikeness' implying a struggle to create meaning and coherence from scary and fragmented memories. The previous life projects, such as work and social life become unfamiliar when the patient's fragile and weak body is disobedient and brings on altered sensations. Conclusions. Patients who survive a life-threatening condition have an immense need for care and support during the entire critical illness-recovery process, and also after the initial acute phase. They need a coherent understanding of what happened, and support to be able to perform their changed life projects. Relevance to clinical practice. Supporting and caring for patients' recovery from a life- threatening condition involves recognising the patients' struggle and responding to their existential concerns. [ABSTRACT FROM AUTHOR]

Aim To describe experiences of recovery from bulimia nervosa among young adult women. Background Most studies into recovery from eating disorders focus on anorexia nervosa, although some include both anorexia and bulimia nervosa. Recovery has been described as beginning with renewed self-esteem. Design Qualitative interview study. Methods Fourteen women were invited to participate; five women, between 23-26 years of age, who assessed themselves as healthy for at least 2 years agreed to take part in narrative interviews. Tape-recorded interviews lasting 45-60 minutes (median 49 minutes) were conducted from February-April 2010 and transcribed verbatim. Data were analysed using qualitative content analysis. Findings The interviews revealed four themes in recovery from bulimia nervosa: feeling stuck in bulimia nervosa, getting ready to change, breaking free of bulimia nervosa and grasping a new reality, each comprising two or more subthemes. The process of recovery was not linear, but rather went back and forth between progress and relapse. The women expressed strong ambivalence about leaving the illness behind. An important part of their recovery was their ability to accept themselves. It was essential for their recovery to be supported in developing a unique explanation of the cause of their illness. Conclusion Women's ability to recover from bulimia nervosa and take control over their lives is based on their self-efficacy. Effective care should therefore strive to strengthen women's beliefs in their own abilities, to instil hope for recovery and thus to bolster their self-efficacy. [ABSTRACT FROM AUTHOR]

In Sweden, the duration of treatment is increasing for patients admitted to forensic psychiatric care. To reduce the length of stay, it is important for the forensic rehabilitation and recovery process to be effective and safe. Not much is known about how the process of recovery and transition begins and how it is described by the forensic patients. The purpose of this study was to explore how forensic patients with a history of high risk for violence experienced the turn towards recovery. A qualitative content analysis was used to analyse interviews with 10 patients who had decreased their assessed risk for violence on the risk assessment instrument HCR-20 and who were successfully managed a lower level of security. Three themes were identified: (i) the high-risk phase: facing intense negative emotions and feelings (ii) the turning point phase: reflecting on and approaching oneself and life in a new way (iii) the recovery phase: recognising, accepting and maturing. In the high-risk phase, chaotic and overwhelming feelings were experienced. The turning point phase was experienced as a sensitive stage, and it was marked by being forced to find a new, constructive way of being. The recovery phase was characterised by recognising personal circumstances in life, including accepting the need for structure, a feeling of maturity and a sense of responsibility for their own life. In order to ensure a successful recovery, the forensic nursing staff needs to recognise and support processes related to treatment motivation and turning points. Recommendations for best nursing practice are given accordingly. [ABSTRACT FROM AUTHOR]

Background: Research on recovery from mental illness and the influence of compulsory psychiatric institutional care has revealed the complexity of this concept. There is also limited knowledge regarding the impact of gender-role expectations in these contexts, and how such expectations may influence both the care and individuals' recovery processes. Aim: To explore women's and men's perceptions of the impact of compulsory inpatient care on recovery from severe mental illness. Method: Grounded theory was used to analyse 30 first-person accounts of recovery from mental illness, elicited via interviews with individuals who had been compulsorily treated in hospital and diagnosed with a severe mental illness. Results: Inpatient care at an early stage was crucial for the informants' recovery. However, there was ambivalence in their perceptions of the impact of compulsory inpatient care. The narratives confirmed gender differences as well as gender stereotypes. Conclusions: The results have implications for recovery research, in that they emphasise the importance of understanding recovery as a gender-influenced process. [ABSTRACT FROM AUTHOR]

To describe and interpret couples' thoughts and expectations about their future life after the patient's discharge following acute myocardial infarction. An acute myocardial infarction is a challenge for both the patient and his/her partner, as it can disrupt family functioning and dynamics. Earlier research has generally focused on either the patient or the partner, and few studies have explored the experiences of the couple. Qualitative descriptive and interpretative. Fifteen couples took part in individual interviews, 4-8 weeks after discharge. Data were analysed in two phases using qualitative content analysis. The first phase of the analysis revealed two categories: 'an active approach to the future' and 'a wait-and-see approach to the future' , both of which described the participants' thoughts about the future. In the second phase, the couples' stories were interpreted and grouped into four positions: 'the life companions', 'the tightrope walkers', 'the pathfinders' and 'the observers' , which illustrated their visions of the future. Our results reveal differences in the couples' thoughts about and expectations of their future life, most of them managed the situation by having a positive attitude to life and their future. The couples discovered their resources and compensated for or balanced each other in the early recovery period. The results indicate the importance of giving both partners the opportunity to express their views of the situation, as this increases nurses' understanding of the impact of the illness on their life and relationship. However, the results also highlight the significance of seeing the couple and showing them consideration both as individuals and as a unit. [ABSTRACT FROM AUTHOR]

Scand J Caring Sci; 2010; 24; 557–564 Recovery from severe mental illness, a gender perspective Background and research objectives: Recovery from mental illness is an individual process characterized by regaining a positive sense of self and developing a new meaning. Knowledge concerning differences between male and female recovery processes is, however, limited. The objective of this study was to determine gender diversity in what individuals described as decisive factors for their recovery. Subjects and methods: In this qualitative study based on grounded theory, 30 first-person accounts of recovery from mental illness are examined. After informed consent from the participants, data were collected through in-depth interviews with people in recovery from psychosis, bipolar disorders or personality disorders. Results: The results show that in spite of structural gender inequalities, female gender norms seem to be an advantage in the recovery process. The female participants were focused on making sense and meaning in their recovery process, while the male participants were focused on control over symptoms and reinforcement of traditional roles such as occupation and independence. Another result showed psychiatric hospitalization to mainly contribute to male recovery processes. Conclusion: These results provide new insights into gender as an important factor in understanding recovery processes and in providing care to facilitate these processes. [ABSTRACT FROM AUTHOR]

Work-related stress is an increasing health problem among nursing teachers, contributing to health problems, disengagement and poor job satisfaction. Negative coping strategies impact on both teachers' and students' teaching-learning experiences. Several interventions have been developed to address work-related stress. There has been less focus on how nursing teachers can learn to recover from work-related stress before it has severe consequences for their health, and to understand it from a nursing perspective. The aim of this study was to explore how nursing teachers who participated in a cognitive relational group programme experienced the process of recovery from work-related stress. Data were collected by means of three focus groups and subjected to qualitative content analysis, resulting in three categories: relatedness, evoking the inner caregiver, and re-orientation in life. These categories were reflected on in relation to Benner and Wrubel's "primacy of caring" and synthesised into a metaphorical theme: "finding one's footings". The findings imply that the development of positive coping strategies as well as knowledge and understanding about psychological processes are vehicles in the process of recovery. We conclude that interventions also need to account for the process of recovery as related to an ontological level and the person's Being-in-the-World. • For nursing teachers the work they love can be an unavoidable stressor. • Distancing oneself from what matters is not a desirable solution to reduce stress. • Recovery from work-related stress goes beyond learning coping strategies. • Recovery is associated with a sense of finding oneself and one's place in the world. • Interventions need to address work-related stress also on an ontological level. [ABSTRACT FROM AUTHOR]

The body of knowledge regarding health and recovery as experienced by patients at risk of suicide is limited. More research is needed into the meaning of recovery and what strengthens the desire to live. The aim of this study was to describe the phenomenon of recovery in a context of nursing care as experienced by persons at risk of suicide. In line with a reflective lifeworld research approach, 14 patients from a psychiatric clinic in Sweden participated in phenomenon-oriented interviews. Data were analyzed to describe the essence of the phenomenon. The results reveal that the phenomenon of recovery means 'reconnecting with oneself while struggling between life and death'. Three meaning constituents emerged: being in an expressive space and giving voice to oneself, regaining dignity through nurturing connectedness, and finding a balance in the tension between life and death. In conclusion, the meaning of recovery is to experience the ability to manage one's own life. Professional caregivers need to acknowledge patients' lifeworlds, in a way that enable patients to experience themselves as capable of managing their own lives. Professional caregivers should also facilitate the involvement of supportive relatives. [ABSTRACT FROM AUTHOR]