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”Nu handlar det om gränsdragning.” En reflexiv tematisk analys av klinikers uppfattning om patientbemötande i svensk vuxenpsykiatrisk öppenvård

Arvidson, Lotta LU and Kvernes, Kristofer LU (2026) PSPR14 20252
Department of Psychology
Abstract
The purpose of this study was to extend the understanding of dilemmas experienced by psychiatric staff regarding the interaction with patients in Swedish psychiatric outpatient care. The study was a part of the research project “Violations in adult psychiatric care” at Lund University. The research questions were: “Which dilemmas do clinicians and managers experience when interacting with patients?”, and “What are clinicians’ and managers’ opinions regarding why such dilemmas occur?" Semi structured interviews were conducted with six clinicians and six managers in adult psychiatric outpatient care in four Swedish regions. The data was analysed using a critical realistic, reflective thematic analysis. Three main themes were generated: We... (More)
The purpose of this study was to extend the understanding of dilemmas experienced by psychiatric staff regarding the interaction with patients in Swedish psychiatric outpatient care. The study was a part of the research project “Violations in adult psychiatric care” at Lund University. The research questions were: “Which dilemmas do clinicians and managers experience when interacting with patients?”, and “What are clinicians’ and managers’ opinions regarding why such dilemmas occur?" Semi structured interviews were conducted with six clinicians and six managers in adult psychiatric outpatient care in four Swedish regions. The data was analysed using a critical realistic, reflective thematic analysis. Three main themes were generated: We must hold, We have to set boundaries, and We are heading towards something new, but it´s tricky. The results indicated that participants in the study mainly see organizational shortcomings as an obstacle to good quality interactions with patients. Clinicians and managers are challenged by two types of dilemmas. First, the dilemma of balancing stability and flexibility in the organization. Clinicians are inclined to prefer stability, in order to provide the care they favour. Second, the dilemma of balancing accessibility and the need to draw boundaries. The study indicated a need among participants for a more stringent setting of boundaries towards patients and other levels of care. The tensions that arise when trying to balance these dilemmas may lead to interaction deficiencies in individual encounters, as well as in patients meeting the outpatient ward or hospital as a system. (Less)
Abstract (Swedish)
Syftet med denna studie var att fördjupa kunskapen om dilemman som vårdpersonal upplever i bemötandet av patienter i svensk vuxenpsykiatrisk öppenvård. Studien var en del av forskningsprojektet “Bemötandebrister i vuxenpsykiatrisk vård” vid Lunds universitet. Frågeställningarna var: “Vilka dilemman upplever behandlare och chefer i mötet med patienter?” och “Vilka tankar har behandlare och chefer om varför sådana dilemman uppstår?” För att besvara frågeställningarna genomfördes semistrukturerade intervjuer med sex behandlare och sex chefer i vuxenpsykiatrisk öppenvård i fyra svenska regioner. Materialet analyserades genom en kritisk realistisk, reflexiv tematisk analys. Detta genererade tre huvudteman: Vi ska hålla, Vi måste markera gränser... (More)
Syftet med denna studie var att fördjupa kunskapen om dilemman som vårdpersonal upplever i bemötandet av patienter i svensk vuxenpsykiatrisk öppenvård. Studien var en del av forskningsprojektet “Bemötandebrister i vuxenpsykiatrisk vård” vid Lunds universitet. Frågeställningarna var: “Vilka dilemman upplever behandlare och chefer i mötet med patienter?” och “Vilka tankar har behandlare och chefer om varför sådana dilemman uppstår?” För att besvara frågeställningarna genomfördes semistrukturerade intervjuer med sex behandlare och sex chefer i vuxenpsykiatrisk öppenvård i fyra svenska regioner. Materialet analyserades genom en kritisk realistisk, reflexiv tematisk analys. Detta genererade tre huvudteman: Vi ska hålla, Vi måste markera gränser samt Vi är på väg mot något nytt, men det är svårt. Resultatet pekade på att deltagarna främst ser brister på organisatorisk systemnivå som det som påverkar möjligheterna till ett gott bemötande på individnivå. Vi fann två huvudsakliga dilemman som behandlare och chefer utmanas av. Det första dilemmat handlade om balansen mellan stabilitet och flexibilitet i verksamheten. Vi såg en dragning mot stabilitet, eftersom det behövs för den vård deltagarna önskar ge. Det andra dilemmat handlade om att navigera mellan tillgänglighet och gränssättning. Studien visade på ett behov hos deltagarna av skarpare gränsdragning gentemot patienter och andra vårdinstanser. Sammantaget såg vi att öppenvårdspsykiatrin söker efter nya balanspunkter avseende de dilemman som beskrivits i studien. De spänningar som uppstår i det arbetet leder till bristande patientbemötande, både från öppenvårdspsykiatrin som system och i det individuella mötet. (Less)
Please use this url to cite or link to this publication:
author
Arvidson, Lotta LU and Kvernes, Kristofer LU
supervisor
organization
course
PSPR14 20252
year
type
H2 - Master's Degree (Two Years)
subject
keywords
patientbemötande, vårdpersonal, öppenvårdspsykiatri, organisatorisk flexibilitet clinician-patient interaction, psychiatric staff, outpatient psychiatry, organizational flexibility
language
Swedish
id
9218576
date added to LUP
2026-01-15 15:54:42
date last changed
2026-01-15 15:54:42
@misc{9218576,
  abstract     = {{The purpose of this study was to extend the understanding of dilemmas experienced by psychiatric staff regarding the interaction with patients in Swedish psychiatric outpatient care. The study was a part of the research project “Violations in adult psychiatric care” at Lund University. The research questions were: “Which dilemmas do clinicians and managers experience when interacting with patients?”, and “What are clinicians’ and managers’ opinions regarding why such dilemmas occur?" Semi structured interviews were conducted with six clinicians and six managers in adult psychiatric outpatient care in four Swedish regions. The data was analysed using a critical realistic, reflective thematic analysis. Three main themes were generated: We must hold, We have to set boundaries, and We are heading towards something new, but it´s tricky. The results indicated that participants in the study mainly see organizational shortcomings as an obstacle to good quality interactions with patients. Clinicians and managers are challenged by two types of dilemmas. First, the dilemma of balancing stability and flexibility in the organization. Clinicians are inclined to prefer stability, in order to provide the care they favour. Second, the dilemma of balancing accessibility and the need to draw boundaries. The study indicated a need among participants for a more stringent setting of boundaries towards patients and other levels of care. The tensions that arise when trying to balance these dilemmas may lead to interaction deficiencies in individual encounters, as well as in patients meeting the outpatient ward or hospital as a system.}},
  author       = {{Arvidson, Lotta and Kvernes, Kristofer}},
  language     = {{swe}},
  note         = {{Student Paper}},
  title        = {{”Nu handlar det om gränsdragning.” En reflexiv tematisk analys av klinikers uppfattning om patientbemötande i svensk vuxenpsykiatrisk öppenvård}},
  year         = {{2026}},
}