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Accessible Summary: What is known about the subject: Treatment groups in Mental Health Service is cost‐effective, increases patients´ self‐understanding and stimulate changeResearch shows that people with mental illness have different barriers to attend group sessions which often originates from a lack of trust in other people, but it is known that the possibility to build gradual trust among the participants encourages attendance. What the paper adds to existing knowledge: This study is based on the experience from outpatients and illuminates how discovery groups from the Tidal Model can be used as introductory sessions to build gradual trust among people with mental illness before engaging in a person‐centred group intervention.The study fills a research gap in methods to create a safe and trusting environment in treatment groups for people with mental illness working with recovery‐oriented person‐centred interventions. What are the implications for practice: This study emphasizes the importance of meeting concerns about social interactions in persons with mental illness when joining treatment groups. It presents a recovery‐oriented method which meets this requirement and is easy to implement in practice. Introduction: Recovery‐oriented interventions delivered individually or in groups are more and more common within mental health nursing. However, persons with mental illness may be cautious about engaging in groups. Therefore, it is important to provide a trusting basis in the group to allow for the best opportunities to promote engagement, attendance and impact of treatment. Aim: The aim was to explore how discovery group sessions were experienced as introductory sessions from the perspectives of participants and facilitators before engaging in a person‐centred group intervention. Method: A qualitative interview study was conducted, involving four group facilitators and 16 participants with mental illness from five completed groups. Data were analysed with Ricoeur's theory of interpretation. Results: The findings showed that the two discovery group sessions were experienced as useful and meaningful to all and created a safe atmosphere and a trusted relationship among group participants and facilitators. Discussion: Feeling safe and sharing experiences and emotions contribute to the relational climate in a group. Implication for practice: Addressing concerns about social interactions in persons with mental illness is important in group treatment. This study proved that engaging patients in designing or adapting interventions for mental health services is important to improve quality. [ABSTRACT FROM AUTHOR]

Objective: This study uses capital theory to investigate survivors' investments in their bodies and the resources they accumulate during their rehabilitation trajectory, and how these factors impact their perception of recovery from their impairments. Methods: Qualitative interviews were conducted with 20 patients of working age and their relatives, with audio recordings transcribed verbatim. Data analysis utilized an abductive approach informed by Bourdieu's capital theory. Findings: During the initial phases of rehabilitation (acute and subacute), survivors invest in their physical bodies and acquire physical capital. However, they encounter a range of complex barriers when attempting to convert this capital into the resources necessary for re‐entering the workforce or pursuing education. These difficulties are linked to the lack of specialized community services in the later phases of their rehabilitation trajectory. Discussion and Conclusion: Present‐day Danish healthcare rehabilitation focuses on restoring physical function and recovering physical capital. However, comprehensive rehabilitation to enhance mental and cognitive abilities and increase levels of emotional capital, which is crucial for working‐age individuals, is inadequately addressed within community services. This results in unequal treatment and care, contradicting the stated goal of equality in the Danish healthcare system. Patient or Public Contribution: This study incorporated the perspectives of 20 individuals who have survived severe traumatic brain injury, as well as their relatives, to gain insights into their experiences throughout the rehabilitation process, the resources they have accumulated and how these factors contribute to their sense of recovery. [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]

This current study explored the lived experiences of patients with long-term cognitive sequelae after recovering from COVID-19. A qualitative design with in-depth interviews and an analysis inspired by Ricoeur's interpretation theory was utilised. Contracting COVID-19 and suffering long-term sequelae presented as a life-altering event with significant consequences for one's social, psychological and vocational being in the world in the months following the infection. Patients living with long-term cognitive sequelae after COVID-19 were in an unknown life situation characterised by feelings of anxiety, uncertainty and concerns about the future, significantly disrupting their life trajectory and forcing them to change their ways of life. While awaiting studies on treatment, symptom management and recovery after persistent sequelae of COVID-19, clinicians and researchers may find inspiration in experiences of other health conditions with similar phenomenology, such as ME/chronic fatigue syndrome and chronic headaches. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Frontline forensic mental health staff often face challenges when providing recovery‐orientated care, as they must balance between caring for the forensic psychiatric patient and at the same time ensuring safety and security for all other patients and staff at the ward.Research shows that balancing between care and custody in everyday clinical practice is possible, but more practical nursing studies showing ways of balancing power relations are needed to guide clinical practice.Online video games are increasingly recognized as promising new tools to promote social relations, establish competencies and re‐articulate power relations in therapeutic environments. What the paper adds to existing knowledge?: This paper provides insights into how using online video gaming interventions may influence the establishment of social power relations of staff and forensic psychiatric patients. It adds to existing research by providing a conceptual way to study and understand how mental health nurses may balance between care and custody, delivering care to accommodate patients' needs without compromising safety and security at the ward.This study answers a call in current research by providing qualified knowledge regarding the use of online video gaming to build and sustain therapeutic relations in mental health care. What are the implications for practice?: Our paper suggests that balancing between care and custody is possible by using online video gaming interventions in forensic psychiatry. It moreover provides practice‐close knowledge that may inspire and guide clinical mental health nurses to further develop online video gaming interventions in mental health care for the benefit of their patients. Introduction: In recovery‐oriented care, forensic psychiatric nurses must engage in care relationships with forensic psychiatric patients (FPs) whilst focussing on ward security. Online video games (OVGs) may provide a platform for negotiating power and social relations. Studies showing how OVG interventions may influence power balances in forensic psychiatric care are needed to guide clinical practice. Aim: Our aim was to study how power relations were articulated between FPs and staff in an OVG intervention in a Danish forensic psychiatric ward. Method: Data consist of three months of observational data and interviews with three staff members and six patients. We used sociologist Pierre Bourdieu's framework of field, power and capital to analyze data. Results: The OVG intervention consisted of two power fields, "in‐game" and "over‐game." In‐game concerned the practice of gaming. Over‐game described the organization of the gaming intervention. Specific logics, skills and symbolic capitals drove power in each field. Discussion: Power in‐game was open to FPs and staff, leading to symmetric power relations. Power over‐game was open to staff only, resulting in asymmetrical power relations. Implications for practice: Online video game interventions may facilitate power balancing in forensic psychiatry. These insights may guide the development of new OVG interventions for patients and nurses in mental health care. [ABSTRACT FROM AUTHOR]

Aims and objectives: This paper explores the conditions for the possibilities of recovery in a Danish mental healthcare practice, expressed from the perspective of nurses. The results and discussion of the study help to make visible and explore the muddle of conceptualisations of recovery in mental healthcare practice. Background: Few studies examine the possibilities of recovery for inpatients and outpatients in mental health centres from a nursing perspective. Design: A qualitative design using a critical social constructionist frame of understanding, in which the real world is considered as a series of social constructions. Method: A Fairclough‐inspired critical discourse analysis was chosen as the analytical strategy. The analysis is comprised of ten interviews in mental health care and notes, written by nurses, in medical records of ten patients with a mental illness admitted to a mental healthcare centre in 2016–2017. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to secure accurate and complete reporting of the study (See Appendix S1). Results: From the findings of the textual analysis and the analysis of the discourse practice, it seems clear that the social relations and structures relating to recovery in Danish psychiatry are steered and controlled by discourses that reflect, in general terms, the essence of the core of neoliberal ideology. Conclusion: Recovery is generally articulated from an overall discourse of neoliberalism with its embedded discourses of paternalism, biomedicine, self‐care and holism. All these discourses coexist in nursing practice, but the paternalistic discourse becomes the framework for the conditions for the possibility of how recovery is expressed in practice. Relevance to clinical practice: Nurses need to be supported to seek clarity in the understanding and operationalisation of a recovery‐oriented approach, if the agenda is to be truly adopted and strengthened. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore quality of life (QOL) during the first year of recovery after stroke in North Norway and Central Denmark. Method: Individual in-depth interviews with 11 stroke survivors were performed twelve months after stroke onset. An interpretative, inductive approach shaped the interview process and the processing of data. Results: We found that QOL reflected the individuals' reconstruction of the embodied self, which was identified by three intertwined and negotiating processes: a familiar self, an unfamiliar self, and a recovery of self. Further, we found that reconstruction of the embodied self and QOL could be framed as an ongoing and interrelated process of "being, doing, belonging and becoming". Enriching social relations, successful return to work, and continuity and presence in professional support during recovery enhanced the experience of QOL. Fatigue and sustained reduced function hindered participation in meaningful activities and influenced the perceived QOL negatively. Conclusions: The two countries differed in descriptions of continuity and support in the professional follow-up during the recovery process, influencing the degree of encouragement in reconstructing the embodied self. Reconstruction of the embodied self is a means of understanding stroke survivors' QOL during the first year of recovery, supporting an individualized and tailored rehabilitation practice. [ABSTRACT FROM AUTHOR]

Many older community-living persons with schizophrenia report unmet psychological and social needs. The Amsterdam-based New Club is a novel facility that intends to foster self-reliance and social participation in this group. To explore participants' and staff perceptions, a naturalistic qualitative study combined participant observation with interviews. The results illustrate how the New Club contributes to the personal and social recovery of its participants. At the personal level, attending the facility, activation and feeling accepted were valued positively. At the social level, engaging with others, experiencing a sense of community, and learning from one another's social skills were positive contributors. Next, various environmental factors proved important. The New Club demonstrates the feasibility of creating a facility that offers an accepting and non-demanding social environment to older community-living individuals with severe mental illnesses. It may offer a suitable alternative for the more demanding psychotherapeutic interventions offered to younger populations. [ABSTRACT FROM AUTHOR]

In existing recovery studies, binary distinctions between 'spoiled' identities defined by drug-related practices and relationships on the one side, and 'un-spoiled' drug-free identities on the other, are dominant. Similarly, in contexts of youth drug-treatment, substance-using friends are generally viewed as 'bad company', while non-using friends are considered as recovery promoters. This article, however, joins the growing chorus of qualitative researchers beginning to question critically this 'spoiled-unspoiled' distinction. Based on 30 qualitative interviews with 15 young people recruited from a Danish drug-treatment database, we investigate how drug-experienced youth perform recovering identities vis-à-vis their still-using friends. Employing a performative approach to identity formation, we demonstrate how such identity processes play out, and the dilemmas and ambivalences they entail. For example, while drug-using friends are regularly positioned as 'bad company', this is often accompanied by sentiments such as loss and frustration. Our analysis suggests that young people in recovery are easily trapped between societal expectations related to factors such as education on the one hand, and comfortability and connectedness with friends on the other. However, by means of carefully balanced 'borderwork', participants did occasionally manage to integrate using friends into their recovering identities without positioning them as 'bad company' per se. On this basis, we discuss whether breaking bonds with friends who still use drugs is imperative for any process of recovery, and argue that treatment programmes should focus on reconfiguring drug-related friendships, while taking seriously the notion that recovering youth are not necessarily interested in abandoning relations with drug-using friends. [ABSTRACT FROM AUTHOR]

Despite an increasing attention towards recovery orientation in the mental health services, the provision of recovery‐oriented practice is challenged in the inpatient wards. Moreover, the existing research within this area is modest and we currently have limited knowledge of how recovery‐oriented practice is integrated into inpatient settings. A cornerstone of recovery‐oriented practice is the collaboration, patient involvement, and choices, particularly when deciding and planning treatment options. Thus, this ethnographic study aimed to explore how recovery‐oriented practice is reflected in the interactions between patients and health professionals around treatment in two mental health inpatient wards in Denmark. Participant observations were conducted in two mental health inpatient wards from November 2014 to January 2015. The Recovery Self‐Assessment scale inspired the observation guide and the initial data analysis. Field notes were analysed deductively and inductively using qualitative content analysis. One theme with four subthemes emerged showing that interactions were characterized by an 'as‐if collaboration' where 'negotiating on limited grounds' was an important feature of interactions, in which health professionals seemed to have superiority, acting on behalf of 'competing demands'. Patients had to navigate in a field of 'inconsistent guidance and postponed decisions' and faced tendencies of 'control and condescending communication'. The results suggest that recovery oriented values such as equal collaboration, choice and patients' personal preferences are reflected rhetorically in the interactions between patients and health professionals. However, they are negotiated within organizational logics and often overruled by competing demands. [ABSTRACT FROM AUTHOR]

Purpose Arts and cultural activities have been illustrated to be beneficial for mental health service users. The purpose of this paper is to explore the benefits of museum visits and engage in arts activities for mental health service users.Design/methodology/approach Semi-structured interviews were conducted with 17 mental health service users in Denmark. A thematic approach was used to analyse the data and theoretical lens of sociological theories of institutional logics was employed to explore the findings.Findings These benefits are perceived to include empowerment and meaning in life, which are two of the core principles of recovery; arts engagement can, therefore, be a useful tool in recovery. The findings also show that the experience of visiting a museum was not always positive and depended upon the interaction with the museum educators.Originality/value The service users identified arts engagement as creating meaning in life and empowerment, which are two element in the conceptual framework, CHIME (an acronym for: Connectedness, Hope and optimism, Identity, Meaning in life and Empowerment), that describes the human process of recovery. The findings also highlighted that if museums want to engage positively with people with mental health problems and contribute to their recovery then the training of staff and the improvement of institutional approaches to support working with vulnerable people are essential. [ABSTRACT FROM AUTHOR]

Aims To explore the structure and content of narratives about the recovery process among patients undergoing heart valve surgery participating in cardiac rehabilitation. Background Several studies with short-term follow-up have shown that recovering from cardiac surgery can be challenging, but evidence on the long-term recovery process is very limited, especially following heart valve surgery. Furthermore, few studies have explored the recovery process among cardiac rehabilitation participants. Design A qualitative study with serial interviews analysed using narrative methods. Methods We collected data over 18 months (April 2013-October 2014). We recruited nine patients undergoing heart valve surgery from a randomized trial, CopenHeart VR and conducted 27 individual narrative interviews at 2-3 weeks, 3-4 months and 8-9 months after surgery. Findings Following heart valve surgery, the participants expected to return to normality. The analysis identified four courses of recovery, with three non-linear complex pathways deviating from the classic restitution narrative: the frustrated struggle to resume normality, the challenged expectation of normality - being in a limbo and becoming a heart patient. These deviating pathways were characterized by physical, existential and mental challenges even up to 9 months after surgery. Conclusion The recovery processes of participants' in cardiac rehabilitation were often more complicated than anticipated. Patients undergoing heart valve surgery may benefit from more extensive medical follow-up immediately after discharge, individual psychological assessment and individualized, realistic information about the recovery trajectory. [ABSTRACT FROM AUTHOR]

Aim To explore the challenges and caring activities of spouses of intensive care unit survivors during the first year of patient recovery. Background Every year, millions of people globally are discharged from an intensive care unit after critical illness to continue treatment, care and rehabilitation in general hospital wards, rehabilitation facilities and at home. Consequently, millions of spouses become informal caregivers. Little is known, however, about the concrete challenges spouses face in post-intensive care unit everyday life. Design Explorative, qualitative grounded theory study. Methods Participants were spouses of intensive care unit survivors. The study was undertaken in Denmark in 2009-2010. Data consisted of 35 semi-structured dyad interviews at 3 and 12 months post-intensive care unit discharge, two group interviews with patients and two with spouses. Findings 'Shifting their role from spouse to caregiver and back' was identified as the core category of the study. The role shifts progressed in a dynamic process involving four elements: (1) committing to caregiving; (2) acquiring caregiving skills; (3) negotiating level of caregiving and (4) gradually leaving the caregiver role. Post- ICU caregiving comprised five patient dimensions: observing, assisting, coaching, advocating and managing activities. Conclusions Spouses play a vital and multifaceted role in post-intensive care unit recovery. The findings can inform healthcare professionals in their efforts to prepare intensive care unit patients' families for the time following intensive care unit and hospital discharge. Hospital staff, rehabilitation experts and primary care professionals must acknowledge spouses' important contribution from intensive care unit admission throughout recovery. [ABSTRACT FROM AUTHOR]