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ABSTRACT Aim Methods Results Conclusion Implications for the Profession and Patient Care Impact Reporting To explore how Danish registered nurses (RNs) in hospitals experience documenting nursing care in electronic patient records when the content is accessible to patients.In a qualitative research design, data were generated in six focus groups conducted in late 2022 and early 2023, comprising 31 RNs employed in inpatient wards at a university hospital in Denmark. Subsequently, qualitative content analysis was applied to the gathered data.The findings include three themes: (1) weighing one's words, (2) building trust or triggering conflicts and (3) risking loss of knowledge. Together, these three themes illustrate the complexities that RNs navigate when patients have access to the content of nursing documentation.Patients' access to nursing documentation requires RNs to navigate a complex interplay of factors, including awareness of language‐use, influence on the nurse–patient–relative relationships, and the risk of losing essential knowledge. Therefore, although patients' access to nursing documentation can induce a positive change in terms of strengthening the professional focus on documentation, it can also result in changes in documentation practices in ways that may compromise nursing documentation as a working tool.The findings emphasize an urgent need to explore and discuss how sensitive nursing observations can be shared in a safe and appropriate way when patients have access to the documentation. Furthermore, to prevent misunderstandings and conflicts with patients, it is essential to focus on and prioritize patient involvement in nursing documentation.RNs navigate complex practices when patients have direct online access to nursing documentation content. It is crucial to clarify which content nursing documentation should entail and how sensitive nursing observations can be shared in a safe and appropriate way.The COREQ checklist was used for reporting. [ABSTRACT FROM AUTHOR]

AbstractThis qualitative study explored the perspectives of Flexible Assertive Community Treatment managers on preparation and employment of peer support workers. The study was based on semi-structured interviews with managers (n = 5) in Outpatient Services in the North Denmark Region. The analysis was based on an inductive approach to content analysis which led to three themes: (1) An exploratory but energy-loaded process—deciding to employ peer support workers, (2) Paving the road while walking—preparing employment of peer support workers, and (3) Uncertainty about the “how” and the “what”—preparing mental health professionals for collaborating with peer support workers. Together these themes describe an exploratory and unstructured implementation process, revealing a lack of structure during implementation. Such circumstances are known to potentially compromise staff wellbeing, feeling insecure about own professional role, and lack of readiness to embrace peer support workers as colleagues. Applying an implementation framework and addressing the literature on barriers and facilitators may promote successful implementation of peer support worker employment. [ABSTRACT FROM AUTHOR]

Patient participation in mental health care is recognized as essential for achieving positive outcomes. However, the complexities and challenges inherent in this process necessitate further investigation. Aim: This scoping review aims to synthesize findings from fourteen selected articles to provide a comprehensive understanding of patient participation in mental healthcare. Method: The review analyzed articles employing various qualitative methodologies, including interviews and observations, to explore patient and healthcare professional perspectives. Articles were selected based on their relevance to the topic of patient participation in mental health care. Results: The analysis revealed diverse perspectives on patient participation. Patients' preferences varied, with some preferring shared decision-making while others preferred minimal involvement. Barriers to shared decision-making included fear of judgment and substance misuse concerns. Strategies to manage disagreements and foster trusting relationships were identified. Challenges in implementing patient and public involvement in mental health services were noted, including stigma and inadequate professional training. Interprofessional collaboration was deemed fundamental, although fragmented care pathways and communication breakdowns persisted. Structural conditions and professional expectations significantly influenced patient participation, with a paternalistic approach perpetuating power imbalances. Conclusion: Despite challenges, the findings underscored the importance of empowering patients in treatment decision-making, promoting collaborative relationships, and addressing barriers to enhance patient-centered care in mental health settings. Insights from this review contribute to the discourse on patient-centered care, emphasizing the need for holistic approaches prioritizing patient dignity and well-being. [ABSTRACT FROM AUTHOR]

Peer support is a collaborative practice where people with lived experience of mental health conditions engage in supporting like‐minded. Peer support impacts on personal recovery and empowerment and creates value at an organisational level. However, the implementation of peer support into existing mental health services is often impeded by barriers embedded in organisational culture and support in role expectations. Non‐peer professionals' recovery orientation and attitudes towards peer support workers (PSWs) are essential factors in the implementation of peer support, and this study explored non‐peer professionals' understanding of recovery and their attitudes towards PSWs joining existing community mental health teams in one region of Denmark. In total, 17 non‐peer professionals participated in three focus groups. Thematic analysis led to three themes: (1) Recovery is a process of “getting better” and balancing personal and clinical perspectives; (2) Realising recovery‐oriented practice: a challenging task with conflicting values; and (3) Expectations and concerns about peer support workers joining the team. Recovery‐oriented practice faces challenging conditions in contemporary mental health services due to a dominant focus on biomedical aspects in care and treatment. Implementation facilitators and barriers in the employment of PSWs point towards fundamental aspects that must be present when employing PSWs in an organisation. The issues described leading up to the employment of PSWs reflected in this study underpin the importance of preparing an organisation for the employment of PSWs based on the available knowledge. [ABSTRACT FROM AUTHOR]

The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses' experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care. [ABSTRACT FROM AUTHOR]

Provision of physical health care to people diagnosed with severe mental illness is widely reported as inadequate. This interview study explored perspectives of a group of key informants on current practices of providing physical health care within two mental health care settings in Denmark. Thematic analysis of their accounts provided insights into 1) barriers to the provision of physical health care in mental health settings, and 2) possible solutions to overcome existing barriers. Negative attitudes and limited specialist health care knowledge among mental health care professionals constituted serious barriers. To effectively address these barriers, mental health services need to be reoriented towards the prioritisation of physical health alongside mental health. This will require equipping mental health professionals with relevant knowledge and skills and organisational resources, to effectively work with people experiencing or at risk of physical comorbidities. [ABSTRACT FROM AUTHOR]

Assertive community treatment (ACT) case managers provide healthcare services to people with severe and persistent mental illness. These case managers take on generic roles in multidisciplinary teams and provide all-around services in the clients' private homes. This focus group study aimed to gain insight into Danish ACT case managers' professional identity work by examining their discussions of ethical dilemmas and collaboration in their everyday practice. Data were collected during five focus groups at three ACT teams in the North Denmark Region and subjected to discourse analysis emphasizing how identity work was accomplished through talk. The findings indicated that the case managers constructed professional identities by actively positioning themselves and the particular ACT approach in relation to other mental healthcare professionals and clients. They represented themselves as achieving better client-related outcomes by being more assertive and persistent, and as responsible caregivers who provided the help that their clients needed when other services had failed to do so. They depicted their services as being focused on the clients' well-being, and their persistent efforts to establish and sustain interpersonal relationships with clients were an important part of their service. Basic nursing tasks were described as an important part of their everyday work, and even though such tasks were not distinctive for ACT case managers, the representations of their work seemed to give them a sense of worth as professionals and legitimized a unique role in the community mental healthcare services. [ABSTRACT FROM AUTHOR]

The aim of this ethnographic study was to explore how a group of nine Danish people with schizophrenia managed physical health issues as they naturally occurred in everyday life. Qualitative methods were used to generate of data. Thematic analysis led to the description of two typical strategies used by participants to manage debilitating physical health issues in everyday life. Modifying everyday life to manage discomfort was a strategy employed to manage potential or actual discomfort associated with ongoing poor physical health, while retreating from everyday life to recover was a strategy used by participants who experienced recurring discrete episodes of poor physical health characterized by fast deterioration. Both management strategies were inexpedient as they failed to produce any positive progress in terms of the participants regaining health. The social context of participants' everyday life was characterized by a lack of interactions with others about their prevailing and ongoing physical health issues. Repeated use of these inexpedient strategies to manage physical health caused potential worsening rather than improvements to physical health. There is a need for future research that explores aspects of beneficial management of physical health issues among people with severe mental illness. Relevant foci of such research include enhancing self-management of physical health, active help-seeking behaviours, and opportunities to engage in interactions with others about physical health issues., (© 2021 John Wiley & Sons Australia, Ltd.)

The context of care in assertive community treatment (ACT) can be precarious and generate ethical issues involving the principles of autonomy and paternalism. This focus group study examined case managers' situated accounts of moral reasoning. Our findings show how they expressed strong moral obligation towards helping the clients. Their moral reasoning reflected a paternalistic position where, on different occasions, the potential benefits of their interventions would be prioritised at the expense of protecting the clients' personal autonomy. The case managers' reasoning emphasised situational awareness, but there was a risk of supporting paternalistic interventions and denying the clients' right to autonomy.