Search

Background: Building friendship is crucial for attaining and upholding recovery from problematic substance use. However, how people who have used substances problematically develop friendships needs to be investigated more from a first-person perspective. Aim: To provide insight into how people in long-term recovery find meaning in their experience of building friendships. Method: In semi-structured interviews, 17 people in recovery drew network maps and reflected on how friendships had developed during the long-term process. We analysed the narratives by way of a thematic narrative approach. Results: Participants presented the friendship-formation process through four distinct storylines: (1) 'I don't make friends easily'; (2) overcoming barriers to building friendships; (3) 'birds of a feather flock together'; and (4) 'having "regular" friends makes me feel like an "average" person'. Conclusion: People in long-term recovery from problematic substance use felt haunted and hindered by past experiences when building friendships. These experiences created a social divide between those who had experienced problematic substance use and those who had not. The valuable insights that social workers can gain from this study can support friendship development for people in long-term recovery on multiple levels. By understanding someone's self-perceptions and their perspectives on others, social workers can engage with barriers when people in recovery enter social environments such as work. We emphasise the significance of a long-term approach to overcoming barriers to building new friendships. [ABSTRACT FROM AUTHOR]

Sex, relationships, and substance use often go hand in hand. Despite this, the impact of sex and relationships on recovery are often overlooked in the field of substance use disorder treatment (SUDT). This study aims to explore sex, relationships, and relapse risk for people in recovery and as an overlooked area of importance in SUDT. This qualitative study uses semi-structured interviews with people currently and/or formerly in prison, together with ethnographic field data from four high security prisons in Norway, collected between July 2021–April 2022. Common sources of anguish around sex after release and recovery included both forming new and maintaining long-term relationships with partners at a different stage in their recovery, dating and initiating sexual relationships with new partners, concerns about sexual performance and fears around attaining sexual pleasure without chemical enhancements. The implications that sex, dating and intimate relationships may have for individual relapse to substance use, can and should play a greater role in both SUD treatment and preparation for release from prison. These problems are exacerbated in carceral settings and should be considered when planning re-entry to the community and in the development of individual relapse prevention strategies. [ABSTRACT FROM AUTHOR]

Purpose: To explore the recovery narratives of 13 young women who had fallen ill with severe Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), during childhood and adolescence, with the focus on what they had to say about their past experiences from the perspective of the present. Method: A qualitative narrative approach, informed by a phenomenological theoretical perspective, was adopted to explore what the women found significant and meaningful in their recovery process. Data analysis of in-depth narrative interviews was performed which are presented to readers through the stories of two particular participants. Results: The first story describes how one participant made a recovery by testing her body's tolerance and working to create a more confident self. The second story describes a complex exploration of possibilities for action in recovery, along with a struggle to make sense of setbacks and hold on to what has been gained. Conclusion: Recovering from ME/CFS emerges as an inter-personal, contextual, fragile and nonlinear process of homecoming, based on gradually rising bodily based self-knowledge. Illness slowly fades away into the background, and there is the prospect of a healthier tomorrow. [ABSTRACT FROM AUTHOR]

Purpose: There is a pressing need for substance use services to know more about how to promote recovery from substance use problems, particularly in later life. Psychological sense of community (PSOC) is an important recovery dimension. This study aims to clarify in what ways PSOC and communities influence later life recovery processes. Method: A collaborative and deductive reflexive thematic approach was used to analyse 23 interviews with older adults in recovery from different substance use problems. Results: The findings suggest that PSOC and recovery in later life include multiple communities (relational, geographical, substance use-related, ideal and service-related) and affective states (PSOC and NPSOC). Older adults' recovery, moreover, can be described as personal and heterogenic (with respect to community relationships, individual needs, type of substance use problem, age of onset and meaningful activities). Conclusions: The findings confirm age of onset, type of substance use problem and community memberships as essential to later life recovery. They also supplement prior evidence on community resources and challenges to later life recovery. Importantly, the new findings extend and nuance current understandings of later life recovery. Taken together, the article illustrates MPSOC as a useful concept, with central practical and theoretical implications for later life recovery. [ABSTRACT FROM AUTHOR]

Rebuilding one's social network is essential to long-term social recovery from a substance-use problem. Despite this awareness, studies are needed for showing how people in long-term social recovery describe their networks and what they perceive as important in developing these networks. This study has sought to investigate (i) how people in long-term social recovery from substance-use problems describe their social networks and (ii) what they experience as key factors in developing their networks. We interviewed seventeen participants in long-term social recovery and mapped out their person-centred networks. Most of the participants were satisfied with their social networks, although some felt their networks were small and wanted more friends in the future. The qualitative thematic content analysis suggested that rebuilding networks was experienced as a demanding, anxiety-filled, long-term process. Access to social arenas, prolonged time spent with others and identification with and recognition from others were key to developing social networks. We argue that there is a need for tailored assistance and long-term support for people in long-term recovery to help them cope with the stresses of entering new social arenas, overcome societal stigma and develop social networks. [ABSTRACT FROM AUTHOR]

Musculoskeletal and mental health complaints are common in the general population and frequent reasons for healthcare utilization and work absence. Illness perceptions, coping expectancies, rumination and self-stigma are important factors in the management of these health complaints and factors closely linked to health literacy (HL). The aims of the study were to identify helpful elements in a brief intervention (BI) targeting HL regarding common musculoskeletal and mental health complaints and to identify patient perceptions of how the intervention was helpful and whether it affected their subsequent coping. Three focus group interviews with 14 patients were conducted. Systematic text condensation was used for the analysis, supported by the health literacy skill (HLS) framework to sharpen the focus on intervention elements related to the acquisition and utilization of HLSs. Results revealed the importance of receiving comprehensible health information and guidance, the use of metaphors to create recognizable narratives and the use of practical examples and exercises. Normalizing the experienced health complaints, together with a safe and accommodating clinical environment, facilitated the change process. The BI initiated processes that contributed to acceptance, resilience and empowerment, aiding work–life balance and return to work. The study presents authentic narratives of value for future focus in BI. [ABSTRACT FROM AUTHOR]

While recovery has been highlighted as a prime aspect in the flexible assertive community treatment (FACT) model, research on the application of this model in Norway suggests that there is still a potential for providing service users with better participation in the local society. Music therapy has been highlighted as a form of intersubjective activity that is relational and can promote empowerment and personal recovery. The social aspect of recovery has been highlighted in recent years, and this article explores how music therapy, offered through FACT, may support social recovery for service users. The research design was that of a qualitative interview study. Six semi-structured, joint interviews were conducted with FACT service users and their music therapist. Using reflexive thematic analysis, the main theme music therapy as social recovery was generated, with four relating sub-themes: musicking as activity, musicking as social handcraft, musicking as togetherness, and musicking as network. Using the framework of social recovery, this article discusses the potential of music therapy within FACT as a collaborative activity that can provide recovery capital – including social and musical capital – and potentially contribute to social recovery. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to gain insight into how practitioners in mental health care support people with severe psychiatric disabilities in setting and pursuing personal goals that are meaningful to them. Method: We conducted focus groups with 36 mental health practitioners in Norway and interpreted the data by using reflexive thematic analysis. Results: Four themes emerged from the analysis: (a) active collaboration to understand what is meaningful to the individual, (b) being nonjudgmental during the process of goal setting, (c) helping individuals break goals into smaller goals and steps, and (d) allowing time for the process of trying to achieve goals. Conclusions and Implications for Practice: Although goal setting is central to the Illness Management and Recovery program, practitioners perceive the work as quite demanding. To succeed, practitioners need to acknowledge goal setting as a long-lasting and shared process, not as a means to an end. As people with severe psychiatric disability often need help in goal setting, practitioners should play an important role in supporting them in setting goals, making plans for achieving them, and taking actual steps in that direction. Impact and Implications: Goal setting is a shared process where true collaboration is needed. Practitioners should monitor an individual's ambitions and goals even when they face increasing demands to treat individuals quickly, cheaply, and efficiently. If practitioners let financial and administrative priorities dictate their clinical practice, there is a risk that they will become less responsive to individuals' ambitions, rush to set goals too quickly, and not really attend to where individuals are. [ABSTRACT FROM AUTHOR]

Fibromyalgia is a contested illness with unknown aetiology and poorly understood development. The present aim is to explore the pre-diagnostic illness trajectory narrated by individuals recently diagnosed with fibromyalgia (FM). Individual interviews about the course of the illness were conducted with seven women and three men (age from early 20s to 50s) who had recently been diagnosed with FM. A narrative analysis of what the interviewees told and how the stories were narrated was conducted. The findings are expressed by three storylines. "Strenuous life and alerted body preluding illness" displays a difficult, unsupported life and bodily sensitivity to stimuli. "Recurrent pains unfolding to become a lasting and complex illness" describes individuals pushing themselves to meet social obligations until they come to a full stop. "Diagnosed but still uncertain presence and future" portrays satisfaction with finally being diagnosed with FM and being supported by others, but still there are no solutions as to do about it. The three storylines portray a long, winding trajectory of suffering starting before the onset of illness, and unfolding illness gradually becoming persistent and overwhelming. Finally, a diagnosis of FM is arrived at, but how the situation will evolve is uncertain. [ABSTRACT FROM AUTHOR]

The aims of this study are to examine the one-year trajectory of sleep problems, identify clinical correlates, and describe subjective experiences related to persistent sleep problems during recovery from substance use disorders (SUD). This study builds on a sequential mixed method design. The quantitative component features data from a prospective longitudinal study of 127 poly-SUD patients in the Stavanger area in Norway, while the qualitative component describes a thematic analysis of interviews with 16 persons from this study still experiencing sleep problems after at least one year of abstinence. The prevalence of sleep problems at baseline for the whole cohort was 79%. Among the 59 patients who were abstinent after one year, N = 20 (33.9%) had moderate and N = 11 (18.6%) had severe sleep problems. Persistent sleep problems were associated with psychological distress and were experienced as a major challenge in the struggle to stay drug free. Establishing daily routines related to work, school, and care for children were coping strategies for participants with persistent sleep problems. Persistent sleep problems are often overlooked in a clinical setting. Based on our findings, these issues pose a major challenge in the struggle to stay drug free. For patients with psychological distress, and lack of responsibilities that established daily routines, sleep difficulties may result in increased risk of drug use episodes that result in relapse. These results argue that screening and evidence-based methods for insomnia and sleep health-programs should be commonplace adjunct intervention for patients with SUDs. [ABSTRACT FROM AUTHOR]

Peer recovery services (PRS) in Norwegian municipalities fill a gap in available care in mental health care and/ or substance abuse treatment. In this qualitative study, we interviewed six peer recovery workers (PRWs). Our aim was to explore how the PRWs understood their competences as vital for carrying out the work in PRS. Through a thematic analysis, we found themes the PRWs recognize as important in their recovery competence. The findings can be of practical relevance to those aiming to develop more recovery oriented mental health distress and substance abuse services. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore and describe staff working in a Norwegian supportive housing site's experiences with promoting social community participation for residents with co-occurring problems. The research question addressed was: how does residential support staff experience promoting social community participation for residents with co-occurring problems? Design/methodology/approach: Nine residential support staff participated in qualitative interviews. All interviews were recorded and transcribed verbatim. The transcripts were analysed using Braun and Clarke's approach to thematic analysis. Findings: The analysis process resulted in two themes: "It is all about economics" and "Who will pay for it?" Practical implications: Regarding the Nordic welfare system, the need for a redistribution of financial resources in health services is discussed. The authors recommend that further studies explore people outside the regular health-care system perspectives on how they can contribute to making community inclusion a reality for persons experiencing co-occurring problems. Originality: This study provides a nuanced understanding of how financial resources can impede or support efforts and opportunities to promote community inclusion for residents experiencing co-occurring problems. [ABSTRACT FROM AUTHOR]

Objective: The aim of this paper was to explore child sexually abused survivors' experiences of dental treatment in order to obtain a deeper understanding of them as dental patients. Methods: Data were drawn from qualitative semi‐structured interviews with 16 adult informants recruited from four different Centres against Sexual Abuse in Norway. Data analysis was developed according to the principles of grounded theory suggested by Charmaz. Results: A conceptual framework was generated, and a core concept was constructed from the informants' reports of their experiences of dental treatment: Preparing for attack and recovering from battle based on four main categories: (a) Expecting danger, (b) Battling anxiety, (c) Reliving abuse and (d) Struggling with the aftermath. Conclusions: The analyses increase the understanding of how child sexual abuse survivors prepare before—battle during—and recover after dental treatment. This study revealed child sexual abuse survivors' experiences of extensive anxiety, triggered by sensory stimuli such as sensations, movement, muscles, touch, sight, sound, smell and taste, associated with dental procedures per se, but also sensory stimuli similar to previous traumatic experiences. The findings suggest that child sexual abuse survivors' dental anxiety is primarily trauma‐driven and possibly being one of the long‐term effects of child sexual abuse. This may be an important contribution to the understanding of CSA survivors and should affect the approach of clinicians treating dental patients with such a history. [ABSTRACT FROM AUTHOR]

Social factors seem to play an important role in people's recovery processes, yet little attention has been given to such aspects in relation to early psychosis. In this study, we explored how young adults with first episode psychosis experienced relationships inside and outside the mental healthcare services related to their early recovery processes. We interviewed ten young adults who had been in contact with an early detection team for psychosis. The analysis involved thematic and reflexive team-based methods and drew on hermeneutic–phenomenological perspectives. We identified two themes concerning relationships with professionals: 1) being seen as a unique person with preferences and 2) getting help when you are lost. We came across three additional themes, this time, in relation to family and friends: 3) supportive family networks, 4) they cannot understand everything, and 5) different kinds of friendships. Our findings revealed that people both within and outside mental healthcare services were seen as essential (for better or worse) and often played complementary roles. [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]

This study explores the lived experience of hospitalisation from the perspective of people with a mental health disorder. This hermeneutic‐phenomenological study, which forms part of a larger qualitative serial inquiry, uses a participatory research design, with analysis inspired by interpretative phenomenological analysis. Fourteen participants were interviewed twice: first during hospitalisation and then again 3 months following hospital discharge. Findings are reported from the entire interview data set. Our findings suggest that mental health hospitalisation is a contradictory experience for patients. On one hand, our study participants experienced the hospital as a place where it is alright to be vulnerable, while on the other hand participants experienced hospitalisation as a burden of everyday stigma and signs of depersonalisation. We conclude that it is important to recognise that patients in need of inpatient treatment for mental illnesses are, in fact, people first and foremost. More reflective practice can be developed by shifting the focus to recovery‐oriented practices to and open dialogue‐based approaches. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore aspects that promote and challenge long‐term ICU patients' inner strength and willpower. Background: Considerable research has been devoted to ICU patients' experiences; however, research on long‐term ICU patients is limited. Studies in a health‐promoting perspective focusing on long‐term ICU patients' inner strength and willpower are scarce. Design: A qualitative, hermeneutic‐phenomenological approach, using in‐depth interviews. Methods: Seventeen long‐term Norwegian ICU patients were interviewed once, at 6–18 months after ICU discharge. The consolidated criteria for reporting qualitative research was used (Data S1). Results: The lived experience of the phenomenon "inner strength and willpower" and what promotes and challenges this phenomenon in long‐term ICU patients were represented by four main themes and nine subthemes. Promoting aspects comprised of two main themes and five subthemes: (a) "No doubt about coming back to life" with subthemes; "Strong connectedness to life; feeling alive and present," "Meaning and purpose; feeling valuable to somebody." (b) "How to ignite and maintain the spark of life," with the subthemes: "Practical solutions, coping skills from previous life experiences," "Provocative and inspiring experiences" and "Vivid dream experiences that ignite the willpower." Two main categories and four subcategories represented challenging aspects: (a) Exhaustion, weakness and discomfort; subthemes; "Physical challenges" and "Mental discomfort" and (b) "Tiring delusions," subthemes; "Living in the worst horror movie" and "Feeling trapped." Conclusion: This study expands on previous studies by providing insights about what promotes and challenges long‐term ICU patients' inner strength and willpower during their recovery trajectory. Relevance to clinical practice: Insights into the variety of long‐term ICU patients' experiences during the recovery trajectory are important for ICU nurses to support and facilitate ICU patients' inner strength and willpower. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to explore embodiment as a meaning‐making experience in the daily life of Norwegian adults living with joint hypermobility syndrome/Ehlers‐Danlos syndrome, hypermobility type (JHS/EDS‐HT). The work of Drew Leder and his distinction between bodily dis‐ and dys‐appearance contributes to the description and analysis of individuals' bodily experiences of living with this chronic illness. Methods: An explorative and qualitative design was applied to in‐depth interviews with seven participants. The theoretical framework was phenomenological, and the method of analysis was thematic, involving descriptive and interpretative approaches. Results: Participants' bodily experiences were closely connected to a timeline viewing their illness in the past, the present and from future perspectives. The following central themes emerged from the data: (a) visible to invisible signs of a former body; (b) standing up and falling down of a present body; and (b) future thoughts of an inner and outer body. Conclusions: The study found that living with JHS/EDS‐HT revealed complex experiences of having flexible bodies and restricted lives. Our findings also showed a meaning‐making process of embodied experiences that evolved over time, as well as a sliding transition from social to personal dys‐appearance. In the course of time, a bodily disruptions in social interactions comes to the fore, with invisible symptoms such as pain and fatigue. Individual bodily suffering determines the existence of hope or hopelessness regarding recovery from this condition. [ABSTRACT FROM AUTHOR]

Hope is a pivotal part of recovery in a broad range of health conditions, including those relating to the field of mental health and substance abuse. People who experience co-occurring mental health and substance-use problems are often bound to use services that are not suited to their needs. In this study, our aim is to explore how service users experience barriers to help and assistance, and to determine the manner by which these barriers may influence their experiences of hope. Data were collected through in-depth interviews with nine participants, and these were analyzed using a thematic approach. This analysis produced the following three overarching themes: "battles with bureaucracy"; "distance, disempowerment, and de-individualization"; and "no clean slates." [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe breast cancer (BC) survivors' experiences of participating in a 2‐day educational programme (Breast Cancer School, BCS) and their critical reflection on information received during and after adjuvant treatment. The following research questions guided the study. How do BC survivors experience their participation in an educational programme? How do BC survivors experience the information trajectory during and after adjuvant treatment? Background: BC is the most prevalent cancer among women in Norway. BC survivors have a substantial need for information about the disease, treatment and recovery. During the past few years, BC treatment in Norway has changed from inpatient‐ to outpatient‐based treatment. Oncology nurses and oncologists are obliged to provide patients and their families with information, which has necessitated reorganisation of the procedures for providing information. New arenas such as the Breast Cancer School (BCS) offer the opportunity to learn from experts and fellow patients. Design: Qualitative, descriptive design. Methods: Focus groups with 20 BC survivors after having participated in the BCS were used to enable critical reflection. The COREQ checklist was followed to ensure rigour in the study. Results: Two themes emerged from qualitative analysis: Balancing between the need for and the fear of information and Moving from a safe structure to lonely recovery. We identified differences between BC survivors in diversity, uniqueness and need for information. Continuity and expert knowledge provided by a primary oncology nurse and oncologists were highlighted as important. Conclusion: The study reveals the need for information tailored to each BC survivor's unique needs. The BC survivors expressed both the need for and the fear of information. BCS takes both a systematic and individual approach to provide expert information, dialog and the opportunity to meet with fellow patients. The transition from the structure of the treatment to lonely recovery after the most intensive treatment was perceived as unsafe and challenging. BC patients' experiences must be continuously valued and used to improve educational programmes, care and treatment. Oncology nurses play an important part in the information chain and continuity. Relevance to clinical practice: This study highlights the importance of including BC survivors in the design and evaluation of educational programmes. The provision of information and supportive care with continuity between oncology nurses and oncologists through the trajectory of treatment and care is crucial. [ABSTRACT FROM AUTHOR]

The impact of stress on health can depend on factors such as frequency, heightening of stress during a given period or the presence of one or a few repeated hassles of psychological importance. The aim of this study was to gain a deeper understanding of how adult women experience and cope with daily hassles after sexual abuse. Ten interviews were analysed using the grounded theory method. The theoretical model of 'protecting armor in daily life' emerged. The aftermath of sexual abuse related coping with daily stress can be understood as a three‐phase process: (1) avoiding and escaping—coping after experiencing sexual abuse; (2) accepting and disclosing—starting a process of recovery; and (3) reconciling and repossessing—living with the experience in the present. The model contributes to a deeper understanding of the everyday life of women who have experienced sexual abuse. Increased knowledge of coping behaviours that can be used to deal with daily hassles may also serve as a tool for health professionals, other helpers and family to help these women rebuild a good life. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aims to describe surgically treated lung cancer patients' experiences of coming home after discharge from hospital to expand the knowledge about their supportive care needs. Background: Existing research reports that patients suffer from a high symptom burden after lung cancer surgery. Such burden has negative impacts on their physical, emotional and social wellbeing. Few studies have explored the surgically treated patients' supportive care needs after being discharged from hospital. Design: This study used a qualitative descriptive design, following the EQUATOR guidelines (COREQ). Methods: The information about 14 patients' experiences was collected from semi‐structured interviews. The interviews were conducted in their homes within three weeks after their discharge from hospital. The data were analysed using qualitative content analysis. Results: The main theme of the study, "Longing to get back on track with their lives", consisted of four categories: "Burdened with problems related to postoperative symptoms and treatment", "Struggling for the needed support", "A pendulum between being in need of support and being independent", and "Striving to adapt to a new way of life". The participants experienced many problems related to postoperative symptoms and treatment. Information and support from healthcare professionals were deficient. Life was characterised by striving to be independent and adapting to a new lifestyle. Conclusions: The findings demonstrate the supportive care needs of surgically treated lung cancer patients. Nurses and other healthcare professionals could offer more individualised support during the first few weeks after the patients' discharge by including them and their caregivers in the discharge planning. Relevance to clinical practice: Knowledge of patients' perspectives and experiences of everyday life at home after lung cancer surgery can provide hospital nurses with a better understanding of what is important for such patients beyond hospitalisation. This knowledge should be included in discharge planning. [ABSTRACT FROM AUTHOR]

Introduction: Pharmacological interventions are viewed as central to clinical work with people diagnosed with bipolar disorder. But what is the meaning of medicine? How do clinicians view the role of medication in recovery processes in bipolar disorder? The aim of this study was to explore the perspectives of experienced therapists regarding the role of medicine in the treatment of people with bipolar disorder. Methods: In a Norwegian specialist mental health care setting, we conducted 12 semi‐structured individual interviews with experienced therapists and analysed the resulting transcripts using a team‐based thematic analysis method. Findings: We identified four themes: (a) the bedrock of therapy; (b) an imperfect answer and a dangerous tool; (c) the hallmark of insight; and (d) negotiating medicine, negotiating meaning. Conclusion: We relate our findings to the shortcomings of the dominant medical model and argue that a recovery perspective can be a helpful tool for counsellors and psychotherapists in understanding the meaning of medicine for people with bipolar disorder. [ABSTRACT FROM AUTHOR]

Few studies address the many challenges that are faced by staff and patients in the inpatient mental health context. In particular, there is a lack of research that explores first-hand patient experiences in order to establish what treatment practices best assist patient recovery and what are the barriers to these practices. This qualitative study, which utilises a user-involved research framework, collaborates with a co-researcher patient group throughout the study. Fourteen patients, all of whom had been in inpatient treatment for at least three weeks, were recruited to the study. Study participants were interviewed in-depth in the period September 2016 to March 2017. Data underwent a thematic analysis that was inspired by interpretative phenomenological analysis. A core theme of the findings was the importance of being recognised as a whole person, and the patient–professional relationship was regarded as a fundamental factor in fostering recovery, with two underlying themes: (i) a need to have one's self-identity recognised and supported, and (ii) an experience of ambivalence between needing closeness and distance. This study suggests ways nurses can give priority to interpersonal interactions and relationships with hospitalised patients over task-oriented duties, highlighting the need for nurses to balance patient competing needs for both closeness and distance. [ABSTRACT FROM AUTHOR]

Traditionally, there has been a sharp division between 'personal' and 'clinical' recovery. What role, then, might therapy play in personal recovery? To explore how female adult trauma survivors experience working towards recovery after participation in trauma-specific group therapy, we carried out semi-structured qualitative interviews with 13 clients one year after their completion of a stabilization group approach. A hermeneutic-phenomenological approach was used to analyze interview transcripts. After therapy, the participants consolidated and continued their positive processes of change. Experiences from therapy gave rise to personal recovery processes that were categorized into two main themes: "tapping into pre-therapy resources" and "using therapy-related resources." Therapy might play an important role in personal recovery through helping clients to rediscover and utilize existing resources, as well as being a source of new resources. The participants were active agents in this recovery, putting their therapies to use in the context of their daily living. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore two research questions: how do people with concurrent substance abuse and mental health disorders (concurrent conditions) experience and describe meaningful activities? And how do meaningful activities influence the recovery process?Design/methodology/approach This qualitative study uses an explorative and interpretive design in a phenomenological-hermeneutic approach. Transcribed interviews are analysed using a phenomenological-hermeneutic method for researching lived experience. The study was submitted to the Norwegian Center for Research Data where it was approved (Case No. 54661).Findings Structural analysis resulted in three overarching themes: achieving a positive identity through actions and feeling worthwhile; physically outside but inside the norms of society, and idleness, isolation, and obstacles on the road to recovery. Meaningful activities, considered a cornerstone in the recovery process, vary widely and are primarily described in social contexts, thereby confirming the significance of social aspects of recovery in addition to recovery as an individual journey. The findings also show that experiencing meaningful activities contributes to recovery capital and the development of recovery-promotive identities.Research limitations/implications The study consisted of a small sample size, recruited at one location which served as a primary research limitation.Practical implications This paper provides insights for health care practitioners and health care decision makers regarding the importance of meaningful activities viewed through a recovery perspective.Originality/value Few studies to date have used a comprehensive approach to describe the influence of experiencing meaningful activities on the recovery process. [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty is experienced as a painful procedure, and pain after surgery seems to be the most limiting factor for early mobilisation. Physical exercise is of utter importance for avoiding complications such as persistent pain and functional limitations. A fast‐track pathway aims at improving patient outcome, and patients are now discharged 2–3 days after surgery. Little is known about how the patients cope with pain, exercise or daily activities at home. Aim: To explore the experience of patients undergoing total knee arthroplasty in a fast‐track pathway during the first 2 weeks after surgery. Design: Qualitative design. Methods: Three focus group interviews, including 13 patients from two different units of an orthopaedic department in central Norway, were conducted from May to June 2015. The interviews were analysed using Malteruds` method of systematic text condensation. Findings: The main finding was the patients' determination and ability to cope at home. The fast‐track pathway seemed to enable patients to take an active role in own self‐care. The patient's coping capacity was strengthened by education, knowledge and predictability. Four main areas related to coping emerged after discharge. First, the majority of patients expressed that it was good to come home and take responsibility for their own rehabilitation. Second, prerequisites for feeling secure after returning home were highlighted. Third, the patients seemed empowered by sharing experiences with others. Fourth, postoperative pain was prevalent in many patients after discharge, but the patients seemed prepared by information provided in the fast‐track pathway. Conclusion: The fast‐track pathway released coping skills and resources among the patients. The expectation of, and preparation for early discharge made the patients feel confident when discharged few days after surgery. The patients expected to take great responsibility for their own rehabilitation process. [ABSTRACT FROM AUTHOR]

Abstract: Recovery is a crucial concept in the mental health field. The research of recovery is split into the categories of personal, social and clinical recovery. The purpose of this study was to explore the fragmented concept of recovery in light of assertive community treatment (ACT) in Norway. The study has a mixed methods design with a pragmatic approach. The Questionnaire about the Process of Recovery and open‐ended questions posed to 70 participants from 12 ACT teams in Norway, gathered by the “Users interview users” method, are combined with interviews or focus groups with eight of these participants. Surprisingly those under a community treatment order (CTO) report the highest degree of personal recovery. The qualitative material shows that the service users interpreted the concept of recovery differently than researchers and professionals. The ACT service users highlighted three important elements: flexible treatment, medication and access to a car. They emphasized the necessity for basic needs to be met in order to experience a meaningful recovery process, and these basic needs may be of even greater importance to those under CTOs. Their experiences should imply a greater emphasis on securing basic needs such as secure housing, sounder finances and access to the normal benefits offered by society. [ABSTRACT FROM AUTHOR]

Aim To explore, describe and understand former patients' experiences of recovery from self-harm. Background Previous research shows that a person's development towards a more secure self-image, mastery of their emotions, an understanding of what triggers self-harm and mastery of new ways to cope with problems are central to recovery. Recovery from self-harm is still a relatively new field of research. Design A phenomenological hermeneutical approach. Methods Eight participants were interviewed in 2013. Inclusion criteria were as follows: to have committed no self-harm during the past 2 years, to have experienced recovery and to be 18 or older. We analysed data using a phenomenological hermeneutical method. Findings The findings resulted in three themes with subthemes. The first theme, the turning point, occurred at the start of the recovery process. Participants learned to choose life, verbally express their inner pain and reconcile with their life histories. In the second theme, coping with everyday life, participants learned how to choose alternative actions instead of self-harm and attend to their basic, physical needs. In the third theme, valuing close relationships and relationships with mental health nurses, participants learned to receive support from close relationships with others and mental health nurses. A tentative model illustrates the comprehensive understanding of the recovery process, described as an individual, prolonged learning process. Conclusion To achieve recovery, persons who self-harm need guidance and knowledge of how to realize a personal learning process. More research is needed on how mental health nurses can support individual transition processes and thereby facilitate recovery. [ABSTRACT FROM AUTHOR]

Background Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. Objective The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Method Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. Results The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. Limitations The transferability of the results may be limited by the small number of participants. Conclusions The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues, social life, education, work and financial issues. [ABSTRACT FROM AUTHOR]

Objectives: Atrioventricular nodal ablation (AVNA) is recommended for patients (pts) with cardiac resynchronization therapy (CRT) having atrial fibrillation (AF) and incomplete ventricular capture (Class IIa, level B). AVNA reduces mortality and improves the New York Heart Association (NYHA) functional class during intermediate term follow-up. The objectives were to study the long-term outcome regarding quality of life (QoL) and survival of our CRT pts after AVNA.Design: 37 CRT-pts undergoing AVNA due to inadequate biventricular pacing were included in the study. Data were retrospectively obtained from clinical records and through telephone interviews.Results: Twenty pts died during the follow-up period of average 30.6 ± 24 months. After AVNA the ventricular capture improved significantly from 68.4 ± 23% to 98.5 ± 2% (p < 0.001). A significant and sustained improvement of average 0.3 ± 0.5 (p = 0.001) in NYHA functional class was found. Additionally a large percentage of pts discontinued taking rate reducing drugs with potential severe side effects.Conclusion: AVNA in CRT pts was safe and effective. The treatment resulted in a sustained improvement in QoL, including long-term improvement in NYHA functional class. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore and describe experiences of recovery among people with co-occurring mental health and substance use conditions (co-occurring conditions) in a rural community in Norway.Design/methodology/approach In-depth individual interviews with eight persons with co-occurring conditions were conducted, audiotaped, transcribed and analysed using a phenomenological approach. This study is part of a research project investigating recovery orientation of services in a Norwegian district.Findings The analysis yielded four dimensions of recovery: feeling useful and accepted; coming to love oneself; mastering life; and emerging as a person. Insecure and inadequate housing and limited solutions to financial problems were described as major obstacles to recovery.Research limitations/implications Further research into the facilitation of recovery as defined by persons with concurrent disorders is needed, particularly regarding the facilitation of community participation.Practical implications This study supports an increased focus on societal and community factors in promoting recovery for persons with co-occurring conditions, as well as service designs that allow for an integration of social services and health care, and for collaboration among services.Social implications The results suggest that the community can aid recovery by accepting persons with co-occurring conditions as fellow citizens and welcoming their contributions.Originality/value The paper provides an enhanced understanding of how persons with co-occurring conditions may experience recovery. [ABSTRACT FROM AUTHOR]

Fibromyalgia syndrome (FMS), a chronic musculoskeletal pain condition, is often accompanied by fatigue. In this study, inspired by narrative approaches to health and illness, we explore how women who have regained their health after FMS describe tiredness along a storyline from before they fell ill, through their illness, recovery process, and present-day health. The data derive from qualitative interviews with eight Norwegian women who previously suffered from FMS but who no longer had the condition at the time of interview. We undertook a narrative analysis to understand the complexity of the stories about tiredness and fatigue and on this basis identified a storyline based on four sub-narratives: 1) Alarming but ignored tiredness (before illness); 2) paralyzing fatigue (during illness); 3) making sense of fatigue (recovery process); and 4) integrating tiredness into life (today). The findings highlight participants’ different understandings and meanings of tiredness and fatigue and the ways in which these link past, present, and future. Significantly, a clear distinction between tiredness and fatigue was not always found. Overall, the storyline that emerges from the narratives is about balancing tiredness/fatigue with everyday life, and how this unfolds in different ways across the span of FMS, from falling ill to recovering and regaining health. [ABSTRACT FROM PUBLISHER]

People living with chronic inflammatory bowel disease (IBD) experienced that knowledge about their embodied tolerance limits, diet, mental problem solving, and change in lifestyle together with integrative health care could promote recovery from their diagnosed disease in calmer periods of suffering. A hermeneutic approach was used to analyze interviews with patients living with IBD outside hospitals. Thirteen young adults between 18 and 45 years of age in calmer phases of IBD participated in the study. Three main themes emerged from the analysis of the interviews: (1) Understanding limits in embodied tolerance, (2) Restoring balance is creating a new equilibrium, and (3) Creating resilience through integrative care. Anxiety, depression, stress, insomnia, and fatigue are known consequences of IBD and create a lower degree of well-being for the patients. The digestive system is very important in establishing the interface between the body and the external world. Properly functioning digestion, psychosocial stress reduction, and sleep quality are important to rebuild a balanced immune system. Stress resilience during a patient's recovery from IBD requires self-understanding, self-recognition, and psychosocial support from health care professionals at hospital outpatient clinics. [ABSTRACT FROM AUTHOR]

Purpose:To explore traumatic brain injury (TBI) as a biographical disruption and to study the reconstruction of everyday occupations and work participation among individuals with mild TBI. Methods:Seven focus groups were conducted with 12 women and 8 men (22–60 years) who had sustained mild TBI and participated in a return-to-work program. Interviews were analyzed using qualitative content analysis. Results:Four interrelated themes emerged: disruption of occupational capacity and balance; changes in self-perceptions; experience of time; and occupational adjustment and reconstruction. The meaning of the impairments lies in their impact on the individual’s everyday occupations. The abandonment of meaningful daily occupations and the feeling of not recognizing oneself were experienced as threats to the sense of self. Successful integration of the past, present and future was paramount to continuing life activities. The unpredictability of the future seemed to permeate the entire process of adjustment and reconstruction of daily life. Conclusions:Our findings show that the concept of time is important in understanding and supporting the reconstruction of daily life after TBI. The fundamental work of rehabilitation is to ameliorate the disruptions caused by the injury, restoring a sense of personal narrative and supporting the ability to move forward with life.Implications for RehabilitationIndividuals with a protracted recovery after a mild traumatic brain injury must reconstruct a new way of being and acting in the world to achieve biographical continuity.The perceived anxiety regarding changes in self and occupational identity, as well as loss of control over the future, can be attenuated through informational sessions during the hospital stay and at follow-up visits.The significant personal costs of returning to full-time employment too early indicate the need for early and ongoing vocational support in achieving a successful return to work. [ABSTRACT FROM PUBLISHER]

Weight loss surgery (WLS) is gaining ground as the most effective treatment against obesity. In the literature, however, we see a divide among individuals who have undergone WLS based on the amount of weight lost and maintained: successful and unsuccessful patients. In this article, we focus on the notion of unsuccessful patients—exploring the accounts of three women who have regained weight following WLS. In doing so, we endeavor to better understand how weight regain has meaning, and its impact and implications for the lives of individuals who undergo WLS. The findings reveal how weight-regain stories are easily silenced, buried beneath social, cultural, and institutional/medical narratives of successful weight loss and transformation. People who have such experiences may feel reticent to reveal them and in doing so increase their own suffering, therefore leaving the popular narratives unchallenged. [ABSTRACT FROM PUBLISHER]

The purpose of this study is to explore and describe service users’ subjective experiences of mental health crisis. The main research question is: How do people with severe mental health problems experience and understand mental health crisis? Based on a hermeneutic-phenomenological methodology, in-depth interviews with seven participants have been carried out to encourage reflections on mental health crisis experiences. The findings reveal the crisis as being complex and multifaceted, which contains two dimensions in experiencing crisis—an existential dimension (personal) and a contextual (social) dimension. Three main themes identified through the analysis, “Feeling out of control,” “Emotional darkness,” and “Loneliness and seeking togetherness”. Mental health crisis is experienced as chaos, losing control, loss of energy, and feelings of hopelessness. During mental health crisis, one’s social life can be difficult and involve many paradoxes and daily challenges. However, the participants revealed an understanding of a need for help, as mental health crisis emerges as a continuity of struggles in complex situations. There is a need for more comprehensive and broader perspectives of mental health crisis as a phenomenon, especially from the person’s perspective. Conceptualizing mental health crisis experiences from the person-perspective offers an opportunity for understanding this as an integral part of people’s lives. The nature of mental health crisis explicitly captured and understood in light of the complexity of personal lives is critical in developing recovery-oriented mental health care. [ABSTRACT FROM PUBLISHER]

A qualitative study was conducted among 18 abused women from different parts of Norway to explore what paid work means for women exposed to partner violence and how living with an abusive partner affected their working life. Based on systematic text condensation analyses of their experiences as described in individual and focus group interviews, the study's findings reveal two major themes. The first is about recovery and survival, and the other about the spillover of problems caused by a violent partner into paid work. Work was important to the women, as it represented time off from violence, contact with others who cared for them, and maintenance of self-esteem and self-confidence. Having their own money provided security and strengthened the belief that they could manage on their own. The spillover of intimate partner violence problems appeared through feelings of fear, shame and guilt at work. [ABSTRACT FROM AUTHOR]

Background: Self-help strategies and various contextual factors support recovery. However, more in-depth knowledge is needed about how self-help strategies and supportive environments facilitate the recovery process. Aims: To explore what individuals who have recently been referred to a specialist Community Mental Health Center experience as helpful and what they do to help themselves. Method: Ten service users participated in in-depth interviews within a collaborative-reflexive framework. A hermeneutic-phenomenological approach was used. Results: Participants described a variety of helpful strategies and environmental supports. Four relevant main themes were identified: helpful activities, helpful people and places, self-instruction and learning about mental problems and medication and self-medication. Conclusions: The process of recovery is initiated before people become users of mental health services. This study confirms that recovery takes place within the person's daily life context and involves the interplay of contextual factors, such as family, friends, good places, work and other meaningful activities. The coping strategies reported may represent an important focus for attention and clinical intervention. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is an increasing interest in the possible healing factors connected to the presence of nature elements in health institutions. OBJECTIVE: The aim of the present study is to get a deeper understanding of how residents in a residential rehabilitation center experience the views through windows and the indoor plants, and whether and how the view and the plants can impact their recovery process. METHODS: In-depth individual and group interviews were conducted among 16 residents at a rehabilitation center in Norway. RESULTS: The participants said that the indoor plants and the view of nature were pleasant to look at and elicited feelings of relaxation and positive emotions which contributed to opportunities for reflection and contemplation. They expressed a feeling of connectedness to nature: a feeling of wholeness and spirituality elicited by the nature elements. They also expressed that the presence of nature elements contributed to a sense of being taken care of. CONCLUSIONS: The nature elements, such as a view of nature or indoor plants, seem to enhance opportunities for reflection, feelings of meaningfulness and sense of being taken care of which may strengthen their feeling of well-being and make them more resilient to the stressors in life. [ABSTRACT FROM AUTHOR]

Background: For mild-to-moderate stroke survivors, early supported discharge from hospital, followed by home rehabilitation is preferred over conventional care. How this mode of service contributes to recovery from stroke survivors' perspective needs further investigation. Aim: The aim of this study was to explore mild-tomoderate stroke survivors' experiences with home rehabilitation after early supported discharge from hospital. Methods: A qualitative interpretive interview design was used in the context of a randomised controlled trial. A purposive sample of eight participants (45-80 years) was followed by an ambulant team, and a specific healthcare team provided home rehabilitation. Data were analysed using interpretive description, systematic text condensation and coping theory. Findings: A crucial determinant for the participants' hopes for a life worth living was the mutual confidence expressed in encounters with healthcare professionals and the participants' ability to make sense of their nowaltered body. The professional caretakers' communication qualities and their ability to attend to individual needs were important. Help in processing the emotional reactions caused by a changed body and in socialising was requested by participants. Professional caretakers providing home rehabilitation should strive for a more flexibleand individually tailored service and should seek increased cooperation among stakeholders. Conclusion: The focus on therapeutic communicative qualities, bodily changes, emotional processes, social concerns and long-term follow-up should be increased in order to achieve a more beneficial experience for stroke survivors. [ABSTRACT FROM AUTHOR]

Understanding how a self-help program with a positive psychology focus and professional leaders influences change is important to guide support programs. We used a qualitative, explanatory, organizational case study including method and source triangulation to describe and explain leadership mechanisms supporting recovery. Horizontal leadership processes included overcoming stigma and becoming a helper, and vertical processes included internalized willingness to lead, vision formation, pride and professionalization, continuity and accessibility, and flexible leadership. Resource-focused and professionally led self-help is likely compatible and complementary to 12-step programs, as it integrates peer support and collaborative leadership with the best of professional programs, including sober leadership. [ABSTRACT FROM AUTHOR]

Background Takotsubo cardiomyopathy is a reversible condition mimicking acute myocardial infarction. The phenomenon is associated with emotional and physical stressful trigger events. Evidence-based patient counselling should be based on disease-specific knowledge of patient experiences. Aim The aim of the study was to describe women's experiences of Takotsubo cardiomyopathy in a short-term perspective. Design The study design was explorative and descriptive. Method Semi-structured interviews were conducted with 14 women diagnosed with Takotsubo cardiomyopathy, 1 day to 9 months after hospitalisation. The transcriptions underwent qualitative content analysis. Findings The main theme that emerged was Takotsubo cardiomyopathy as a continuous process of making sense and adapting. To begin with, understanding and coping with signs and symptoms were described as having a diversity of signs and symptoms, taking actions towards signs and symptoms, receiving treatment for suspected ST/non ST-elevation myocardial infarction diagnosis and finally being diagnosed with Takotsubo cardiomyopathy. Understanding the context of illness was expressed as getting treated for Takotsubo cardiomyopathy diagnosis and having previous stressful conditions of life. The changing perspective that emanated was a combination of having prospects and expectations and experiencing limitations. Finally, managing to live with Takotsubo cardiomyopathy was manifested as returning home with the illness and receiving follow-up health care. Conclusion Information on regaining prior health status and capacity within a short-term perspective may not be accurate. These women struggle and require education and counselling from healthcare professionals to comprehend and manage having a Takotsubo cardiomyopathy diagnosis. Women experiencing Takotsubo cardiomyopathy may be a target group for holistic and individual health care with a longer duration of follow-up. [ABSTRACT FROM AUTHOR]

This study examined the peri-trauma coping responses of 325 survivors, mostly youth, after the July 22, 2011 terror attack on Utøya Island in Norway. The aim was to understand peri-trauma coping responses and their relation to subsequent post-traumatic stress ( PTS) reactions. Respondents were interviewed face-to-face 4-5 months after the shooting, and most were interviewed at their homes. Peri-trauma coping was assessed using ten selected items from the 'How I Cope Under Pressure Scale' ( HICUPS), covering the dimensions of problem solving, positive cognitive restructuring, avoidance, support seeking, seeking understanding, and religious coping. PTS reactions were assessed with the UCLA PTSD Reaction Index. The participants reported using a wide variety of coping strategies. Problem solving, positive cognitive restructuring, and seeking understanding strategies were reported most often. Men reported using more problem-solving strategies, whereas women reported more emotion-focused strategies. There were no significant associations between age and the use of coping strategies. Problem solving and positive cognitive restructuring were significantly associated with fewer PTS reactions. The results are discussed in light of previous research and may help to inform early intervention efforts for survivors of traumatic events. [ABSTRACT FROM AUTHOR]

This study aimed at gaining knowledge of users' experience of green care services (interventions using nature to improve health) for people with mental health or drug problems. Data were obtained from interviews with 20 participants in green care services and were analyzed qualitatively. Findings revealed that work in a social context close to nature and work with animals increased mastery and meaningfulness. Participation resulted in personal changes, new practical skills, improved social networks, and feelings of well-being. There appears to be powerful potential in using green care services as a recovery tool for people with mental health or drug-related problems. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the activities carried out and the conditions required to enable satisfactory work in an intermediate unit for patients aged 60 and older. Background In recent years, several intermediate units have been established to improve the clinical pathway from hospital to home for older patients. Design Qualitative study. Methods Data were obtained from interviews with eight patients and 16 healthcare providers working in the unit and from observations in six multidisciplinary meetings and six report meetings in the unit. Transcripts of interviews and field notes were analysed using a method for systematic text condensation. Results Care performed as a balance between relational, practical and moral aspects seems to be important to render good service to patients and to ensure the providers' job satisfaction. Most patients experienced their stay in the unit as positive. The providers highlighted 'suitable patients', an appropriate physical environment and communicating computer systems as significant factors for performing treatment and for providing nursing and rehabilitation in a caring manner. Conclusions When environmental and organisational conditions exert pressure on the working situation, care as a practical activity seems to be prioritised at the expense of the two other aspects. The findings indicate that unfavourable environmental and organisational conditions impede patients' recovery process and thereby a good clinical pathway. Relevance to clinical practice To recruit, support and retain a multidisciplinary staff to the best interest of patients, it seems to be important to perform care work as a balance between relational, practical and moral activities. [ABSTRACT FROM AUTHOR]

Being in recovery from bipolar disorder involves work-related concerns. The specific aims of this study are to: 1) understand the role of work in recovery from bipolar disorders, and 2) understand how people with such disorders deal with work-related challenges. These topics are examined from the stance of the recovery process, in which work-related activities were explored. Semi-structured, qualitative interviews were conducted with persons who had experienced recovery from bipolar disorder. Analysis was performed through thematic and phenomenological analysis, with hermeneutic phenomenology and reflexive methodology as a framework. The findings are presented through the following themes: 1) many types of work – finding meaning and a focus; 2) helpful roles and contexts – to be much more than a person with an illness; 3) making work possible – the role of supportive relationships and supportive medications, and 4) the costs of working too much – finding a meaningful and healthy balance. [ABSTRACT FROM PUBLISHER]

Scand J Caring Sci; 2013; 27; 92-98 Eating disorders: challenges in the later phases of the recovery process Little is known about how patients experience the later recovery phases of eating disorders. The aim of this study was to describe such experiences using an explorative and descriptive design based on content analysis. Thirteen female patients participated in qualitative interviews. The analysis resulted in four main categories, that is, (i) realising negative consequences, (ii) searching for alternative coping, (iii) searching for normality and identity and (iv) accepting the losses. The categories represent normal psychological processes related to grief, commitment and reconciliation. Such processes may be functionally or dysfunctionally resolved. The clinical implication is that patients in the later recovery phases may need professional help or counselling to accomplish a functional resolving. While in the initial phases of illness and recovery, a focus is on controlling symptoms and the changing of overvalued ideas about weight and shape, therapy in the later recovery phases should focus on the psychological management of the challenges represented in the four categories resulting from the present study. [ABSTRACT FROM AUTHOR]

This article aims at achieving insight into acquiring an understanding of parenting while dealing with one's own bipolar disorder. It is based on results from in-depth interviews of six parents with bipolar disorder, and analyzed using guidelines from interpretative phenomenological analysis (IPA). The results from the study suggest the parents experienced diverse, complex, compound, and demanding challenges. However, the results also highlighted the fact that parents went through a “change and growth” process, in which they developed an experience-based competence perceived as being useful due to their living situation, including the strengthening of their parenting function and their personal recovery process. Aspects about how the time dimension in recovery, as well as how parents' dependence on their children can play both a central and paradoxical role in their lives, are discussed, which is then followed by implications for the support system. [ABSTRACT FROM PUBLISHER]

HLDING A-G and HEGGDAL K. Nursing Inquiry 2012; 19: 345-356 Patients' experiences of health transitions in pulmonary rehabilitation People who live with chronic obstructive pulmonary disease (COPD) experience major changes in health. Coping with the illness and caring for themselves places extensive demands on them. Thus, pulmonary rehabilitation (PR) is recommended as a means to facilitate healthy transitions in everyday life with COPD. This study explores the experience of patients with COPD in terms of their transitions in health during and after PR. The research was inspired by interpretive phenomenology. Thirty-three individual qualitative interviews were conducted with eighteen patients recruited from Norwegian PR units. A thematic analysis of the interviews was performed. The interviewees described participation in PR as a time of increasing awareness of opportunities for health and well-being with strengthened hope. The year following PR was dominated by their ongoing challenge to acknowledge limitations and explore opportunities in everyday life. Continuation of healthy transitions was facilitated by peer and professional support. The study highlights the personal resources that patients with COPD have access to in order to promote their own health. The study also highlights their vulnerability during illness and rehabilitation. The findings critique time-limited PR and support the current trends towards patient-centred rehabilitation efforts that incorporate user involvement and self-management education. [ABSTRACT FROM AUTHOR]