In einer explorativen Studie über die Haltung von Pflegenden gegenüber alten Personen mit der Diagnose „chronische Schizophrenie” sollte die Sichtweise der Pflegenden bezüglich einer fiktiven Fallgeschichte über eine alte Person mit chronischer Schizophrenie untersucht werden.[2] Alle Pflegenden aus einer Kommune und sieben verschiedenen Einrichtungen in Nordschweden wurden in die Studie eingeschlossen. Nach kleineren Änderungen kam eine Fallgeschichte über eine 84-jährige Frau mit schwerer Demenz und auffälligem Verhalten zum Einsatz, die bereits in einer vorherigen Studie benutzt worden war. In der vorliegenden Studie wurde das Alter der Frau von 84 auf 68 Jahre und die Diagnose von Demenz zu chronischer Schizophrenie geändert. Ansonsten blieb die Darstellung gleich. Hauptergebnis der Studie ist, dass es den Pflegenden nicht gelang, die Person unabhängig von ihrem „Label”, der Diagnose, zu sehen. Es kann gezeigt werden, dass die Pflegenden sich in einem Loyalitätskonflikt befinden. So steht die Loyalität zur Institution mit ihren traditionellen Zielen und Maßnahmen der Loyalität zu den Bewohnern mit ihren Wünschen gegenüber.
Literatur
-
1 APA .Diagnostic and Statistical Manual of Mental Disorders (DSM IV). Washington, DC; American Psychiatric Association 1994 4th edn
-
2
Asplund K, Norberg A, Adolfsson R. et al .
Facial expressions in severly demented patients: a stimulus-reponse study of four patients with dementia of the Alzheimer type.
International Journal of Geriatric Psychiatry.
1991;
6
599-606
-
3 Bayles K L, Kaszniak A W. Cognition in Communication and Normal Aging and Dementia. London, UK; Little Brown Company 1987
-
4 Becker H S. Outsiders: Studies in Sociology of Deviance. NY; Free Press 1997
-
5 Carson R C, Butcher J N, Mineka S. Abnormal Psychology and Modern Life. New York, NY; Addison-Wesley Longman Inc 1998 10th edn
-
6 Cohen A, Eisdorfer M. Loss of Self. New York, NY; W.W. Norton 1996
-
7
Cohen-Mansfield J, Marx M S, Rosenthal A.
A description of agitation in a nursing home.
Journal of Gerontology.
1989;
44
77-84
-
8
Coyne A C, Gjeertsen R.
Characteristics of older adults referred to a psychiatric emergency outreach service.
Journal of Mental Health Administration.
1993;
20
208-211
-
9
Duxbury J.
An exploratory account of registered nurses’ experiences of aggression in both mental and general nursing setting.
Journal of Psychiatric and Mental Health Nursing.
1999;
6
107-114
-
10
Dwork A J, Susser E S, Keilp J. et al .
Senile degeneration and cognitive impairment in chronic schizophrenia.
American Journal of Psychiatry.
1998;
155
1536-1543
-
11
Folsom J C.
Reality orientation for elderly patients.
International Journal of Geriatric Psychiatry.
1968;
1
209-215
-
12
Greenwald B S, Marin D B, Silverman S M.
Seronergic treatment of screaming and banging in dementia.
Lancet.
1986;
2
1464-1465
-
13
Hallberg I R, Norberg A.
Staff’s interpretation of the experience behind vocally disruptive behaviour in severely demented patients and their feelings about it.
International Journal of Aging and Human Development.
1990;
31
297-307
-
14
Hellzén O, Asplund K, Gilje F. et al .
From optimism to pessimism. A case study of a psychiatric patient.
Journal of Clinical Nursing.
1998;
7
360-370
-
15
Hellzén O, Asplund K, Sandman P O. et al .
Unwillingness to be violated: nurses’ experiences of caring for a person acting in a disturbing manner. An interview study.
Journal of Clinical Nursing.
1999;
8
653-662
-
16
Hellzén O, Kristiansen L, Norbergh K G.
Nurses’ attitudes towards elderly residents with long-term schizophrenia in municipal settings.
Journal of Advanced nursing.
2003;
43
1-7
-
17 Holst G. Bridging the communicative gap between a person with dementia and caregivers - A nursing perspective. Medical Dissertation Lund; Centre of Caring Sciences and Department of Psychogeriatrics, Department of Clinical Neuroscience, Lund University 2000 Bulletin No. 3
-
18
Ingham R, Fielding P.
A review of nursing literature on attitudes towards old people.
International Journal of Nursing Studies.
1985;
22
171-181
-
19
Jansson L, Norberg A.
Ethical reasoning concerning the feeding of terminally ill cancer patients. Interviews with registered nurses experienced in the care of cancer patients.
Cancer Nursing.
1989;
12
352-358
-
20
Jeffery R.
Normal rubbish: deviant patients in casualty departments.
Sociological Health Illness.
1979;
1
90-107
-
21
Karlsson S, Bucht G, Rasmussen B H. et al .
Restraint use in elder care: decision making among registered nurses.
Journal of Clinical Nursing.
2000;
9
842-850
-
22 Lasch C. The Culture of Narcissism. New York, NY; W.W. Norton 1979
-
23 Levinas E. Transcendence and evil (original French work published in 1978). Levinas E Collceted Philiosophical Papers the Hague, the Netherlands; Martinus-Nijhoff Publishers 1987: 175-186
-
24 Link B, Struve A. Psychotic symptoms and violent/illegal behaviour of mental patients compared to community controls. Monahan J, Steadman JH Violence and Mental Disorder: Developments in Risk Assessment Chicago, IL; The University of Chicago Press 137-159
-
25
Lucera M, Hutchinson S, Lager-Krall S. et al .
Wandering in Alzheimer dementia patients.
Clinical Nursing Research.
1993;
2
160-175
-
26 Lyotard J F. The Inhuman: Reflections on Time. Oxford, UK; Blackwell 1991
-
27 Malmberg L, Fenton M. Individual psychodynamic psychotherapy and psychoanlalysis for schizophrenia and severe mental illness. The Cochrane Libray. Available at: http://www.update-software.com/abstracts/ab 001 360.htm,. 2001
-
28
Morgan D L.
Qualitative content analysis: a guide to paths not taken.
Qualitative Health Research.
1993;
3
112-121
-
29 Normann H K, Asplund K K. Episodes of lucidity in people with severe dementia. Edberg AK To Meet People with Dementia (in Swedish) Lund, Sweden; Studentlitteratur 2002: 82-95
-
30
Normann H K, Asplund K, Norberg A.
Nurses’ attitudes towards patients with severe dementia.
Journal of Clinical Nursing.
1999;
8
252-359
-
31 Patton M Q. Qualitative Evaluation and Research Methods. Newsbury Park, CA; Sage 1990 2nd edn
-
32 Royce J. The Philosophy of Loyalty. Nashville, TN; Vanderbilt University Press 1995
-
33
Sandelowski M.
Qualitative analysis: what it is and how to begin.
Research in Nursing and Health.
1995;
18
371-375
-
34 Sass L A. Madness and Modernism Insanity in the Light of Modern Art, Literature and Thougt. Cambridge, Ma; Harvard University Press 1992
-
35
Seno H, Shibata M, Fujimoto A. et al .
Evaluation of Mini Mental State Examination and Brief Psychiatric Rating. Scale on aged schizophrenic patients.
Psychiatry and Clinical Neuroscience.
1998;
52
567-570
-
36
Shanley E.
Common experiences of mental health nurses and consumers: ingredients of a symbiotic relationship?.
Australian and New Zealand Journal of Mental Health Nursing.
2001;
10
243-251
-
37 Spritzer R L, Skodol A E, Gibbon M. et al .Psychopathology: A Case Book. New York, NY; McGraw-Hill 1983
-
38
Taft L B, Cronin-Stubbs D.
Behavioural symptoms in dementia: an update.
Research in Nursing and Health.
1995;
18
143-163
-
39
Weller M P.
A biomedical hypothesis of wandering.
Medicine, Science and the Law.
1987;
27
40-41
-
40
White M, Elander G.
Translation of an instrument.
candinavian Journal of Caring Science.
1992;
6
161-164
-
41
Zingmark K, Norberg A, Sandman P O.
Experience of at-homeness in patients with Alzheimer’s disesase.
American Journal of Alzheimer Care and Related Disorders and Research.
1993;
8
10-16
1 Der Artikel ist zuerst erschienen im „Journal of Psychiatric and Mental Health Nursing 2004; 11: 213 - 220. Der Abdruck erfolgt mit freundlicher Genehmigung des Verlages Blackwell Publishing Ltd. Übersetzung aus dem Englischen: Thomas Fischer.
2 Zugunsten der besseren Lesbarkeit wurde auf die Differenzierung der Geschlechterbezeichungen verzichtet. Es sind selbstverständlich immer beide Geschlechter gemeint (Anm. d. Ü.).
O. Hellzén
Department of Nursing and Health Science, Mid - Sweden University
SE - 851 70 Sundsvall
Sweden
eMail: ove.hellzen@mh.se
