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Latent or manifest observers: two dichotomous approaches of surveillance in mental health nursing.
Örebro University, School of Health and Medical Sciences.
Mälardalens Högskola.
2011 (English)In: Nursing research and practice, ISSN 2090-1437, Vol. 2011, 254041- p.Article in journal (Refereed) Published
Abstract [en]

Background. Surveillance is a central activity among mental health nursing, but it is also questioned for its therapeutic value and considered to be custodial. Aim. The aim of this study was to describe how mental health nurses use different approaches to observe patients in relation to the practice of surveillance in psychiatric nursing care. Methods. In this study, Spradley's twelve-step ethnographic method was used. Results. Mental health nurses use their cultural knowing to observe patients in psychiatric care in various ways. Two dichotomous approaches were identified: the latent and the manifest approach. Discussion. Different strategies and techniques for observing patients are structured along two dichotomies. The underlying relationships between these two different dichotomous positions transform the act of observing into surveillance. This is further developed in a theoretical model called the powerful scheme of observation and surveillance (PSOS).

Place, publisher, year, edition, pages
2011. Vol. 2011, 254041- p.
National Category
Medical and Health Sciences
Research subject
Nursing Science
URN: urn:nbn:se:oru:diva-20584DOI: 10.1155/2011/254041PubMedID: 21994817OAI: diva2:467052
Available from: 2011-12-19 Created: 2011-12-18 Last updated: 2013-10-07Bibliographically approved
In thesis
1. Caring in intensive psychiatry: rhythm and movements in a culture of stability
Open this publication in new window or tab >>Caring in intensive psychiatry: rhythm and movements in a culture of stability
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis is to describe and explore the concept of caring in intensive psychiatry. An initial inventory was made of nursing care activities in a PICU, based on an analysis of critical incidents. This inventory resulted in four categories: supporting, protecting and use of the structured environment (Study I). Caring in intensive psychiatry was also studied through ethnographic fieldwork that that led to the conceptualization of the PICU staff as projecting a culture of stability. Within this culture, the overall goal was to prevent, maintain and restore stability as turbulence occurred. Cultural knowing, as expressed through nursing care, was further described in terms of providing surveillance, soothing, being present, trading information, maintaining security, and what has been termed reducing (Study II). A focused approach was applied to study the staff’s different approaches to observing patients in relation to the practice of surveillance in psychiatric nursing care. PICU staff moved flexibly between a latent and a manifest approach to surveillance (Study III). Having conceptualized the culture as one of stability, a concept analysis was conducted upon the concept of stability. The analysis revealed that stability is by no means a static condition; it fluctuates and can be distorted. Intervening with nursing care when turbulence occurs, can involve both the use of active and passive stability systems (Study IV). Further, I argue that caring in intensive psychiatry can be accurately described as the projection of rhythm and movements. Nursing care in terms of movements creates fluctuations in stability as it entails a rhythm of caring in intensive psychiatry. In conclusion, physical boundaries and incorporated control along with tactful sensibility involve rhythm and movements within limited structures and closeness in care. This thesis contributes to articulating advanced nursing practice within intensive psychiatry 

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2013. 81 p.
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 47
Acute psychiatric care, concept analysis, critical incident technique, ethnography, intensive psychiatry, nursing staff, psychiatric care, psychiatric hospitals, psychiatric nursing
National Category
Research subject
Caring Sciences w. Medical Focus
urn:nbn:se:oru:diva-30069 (URN)978-91-7668-956-1 (ISBN)
Public defence
2013-10-03, 09:15
Available from: 2013-07-30 Created: 2013-07-30 Last updated: 2013-10-09Bibliographically approved

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