Kjellaug Klock Myklebust

• Pérez-Toribio, Alonso; Moreno-Poyato, Antonio R.; Lluch-Canut, Maria Teresa; Nash, Michael; Cañabate-Ros, Montserrat & Myklebust, Kjellaug Klock [Vis alle 9 forfattere av denne artikkelen] (2023). Transcultural adaptation and assessment of psychometric properties of the Spanish version of the Scale for the Evaluation of Staff-Patient Interactions in Progress Notes. PLOS ONE. ISSN 1932-6203. 18(3), s. 1–11. doi: 10.1371/journal.pone.0281832.
• Myklebust, Kjellaug Klock; Rønning, Solrun Brenk; Vatnar, Solveig Karin Bø & Bjørkly, Stål (2022). Terapeutisk relasjon – en hjørnestein i miljøterapi – hva viser sykepleierapportene? Nordisk sygeplejeforskning. ISSN 1892-2678. 12(3), s. 1–15. doi: 10.18261/nsf.12.3.2. Vis sammendrag

  Bakgrunn og hensikt: Det er faglig enighet om at terapeutiske relasjoner skal være et hovedfundament i miljøterapi i psykisk helsevern. Likevel mangler det forskning på hvordan relasjonelt arbeid dokumenteres. Metode: Denne studien er en kvalitativ og deskriptiv analyse av daglige rapporter i sykepleiedokumentasjon. Vi har undersøkt hvordan miljøpersonalet ved en akuttavdeling i psykisk helsevern dokumenterte inntoning og samspill med pasienter. Et utvalg på 363 rapportutdrag som beskrev pasienters opplevelser ble hentet fra 14 pasientjournaler. Resultat: 94% av rapportene dokumenterte ubehagelige pasientopplevelser og 6% positive pasientopplevelser. Det ble identifisert to hovedkategorier av rapporterte tilnærminger til pasientopplevelsene:Ingen beskrivelse av inntoning og Beskrivelser av forsøk på inntoning. Kun 25% av rapportutdragene beskrev forsøk på inntoning. Majoriteten av tilnærmingene var observasjons- og handlingsorienterte uten at det var lagt vekt på pasientopplevelse og gjensidige samspill. Konklusjon: Videre forskning på sykepleiedokumentasjon bør inkludere miljøpersonalets inntoning og pasientenes medvirkning i rapportskriving. Nøkkelord: inntoning, miljøterapi, psykisk lidelse, sykepleiedokumentasjon, sykepleie-pasient-forhold, terapeutisk relasjon

• Myklebust, Kjellaug Klock & Bjørkly, Stål (2019). The quality and quantity of staff-patient interactions as recorded by staff : a registry study of nursing documentation in two inpatient mental health wards. BMC Psychiatry. ISSN 1471-244X. 19, s. 1–12. doi: 10.1186/s12888-019-2236-y. Fulltekst i vitenarkiv Vis sammendrag

  Background: Therapeutic staff-patient interaction is fundamental in psychiatric care. It is recognized as a key to healing in and of itself, or a premise to enhance psychiatric treatment adherence. Still, little is known about how these interactions are recorded in nursing documentation. The purpose of the study was to assess the quality and quantity of staff-patient interactions as recorded in progress notes in nursing documentation. Methods: The study has an observational registry study design. A random sample of 3858 excerpts was selected from progress notes in 90 patient journals on an acute psychiatric unit and an open inpatient district psychiatric centre (DPC) in Norway. The Scale for the Evaluation of Staff-Patient Interactions in progress notes (SESPI) was used to assess the progress note excerpts. It is developed to assess the quality and quantity in excerpt descriptions of staff-patient interactions in terms of empathic attunement. Descriptive statistics were calculated for the total sample and for each ward separately. Ordinal and multinomial logistic regression were used to estimate control for shift type, staff education level, and type of hospital ward. Results: Only 7.6% of the total number of excerpts (N = 3858) described staff-patient interactions sufficiently to analyze them in terms of attunement. Compared to the DPC, the acute ward reported more staff-patient interactions. The evening excerpts reported more successful types of attunement than those from the night shifts. Education level did not contribute significantly to our models. Conclusion: These findings present a unique insight into the quality and quantity of mental health nursing documentation regarding staff-patient interactions. Therapeutic interactions where staff tried to attune to the patients were rarely described. However, this is the first study measuring nursing documentation with the SESPI, and more studies are required to validate the scale and our findings. One potential clinical implication of this research is the development of a scale that personnel in psychiatric wards can have for evaluation of the quality of their reporting practice with emphasis on staff-patient interactions. By regular use this may help keeping up emphasis on emphatic attunement in milieu treatment contexts.

• Myklebust, Kjellaug Klock & Bjørkly, Stål (2019). Development and reliability testing of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI) : an assessment instrument of mental health nursing documentation. Nursing Open. ISSN 2054-1058. 6(3), s. 790–798. doi: 10.1002/nop2.254. Fulltekst i vitenarkiv Vis sammendrag

  Aim: To develop and test the reliability of the Scale for the Evaluation of Staff‐Patient Interactions in Progress Notes (SESPI). Therapeutic nurse–patient interactions are fundamental in mental health nursing. However, little is known about how these interactions are recorded in nursing documentation and there is no instrument available for collecting this type of information for quantitative analysis. Design: Instrument development and reliability testing. Methods: The development of the SESPI was based on qualitative analyses of progress notes retrieved from patient records in two mental health services. A self psychological attunement perspective guided the analyses. SESPI was tested for internal consistency and inter‐rater reliability after 22 nurses independently scored 10 progress notes. Results: Cronbach's alpha for the entire instrument was 0.977, indicating that the raters’ scores had very high internal consistency. ICC was 0.770. The alpha and ICC values for each step were high, varying between 0.970 and 0.992. Keywords: empathy, inpatients, instrument development, medical record, nurse–patient relations, nursing assessment, psychiatric nursing

• Myklebust, Kjellaug Klock; Bjørkly, Stål & Råheim, Målfrid (2017). Nursing documentation in inpatient psychiatry : the relevance of nurse-patient interactions in progress notes : a focus group study with mental health staff. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 27(3-4), s. e611–e622. doi: 10.1111/jocn.14108. Vis sammendrag

  Aims and objectives: To gain insight into mental health staff’s perception of writing progress notes in an acute and subacute psychiatric ward context. Background: The nursing process structures nursing documentation. Progress notes are intended to be an evaluation of a patient’s nursing diagnoses, interventions and outcomes. Within this template, a patient’s status and the care provided are to be recorded. The therapeutic nurse–patient relationship is recognised as a key compo- nent of psychiatric care today. At the same time, the biomedical model remains strong. Research literature exploring nursing staff’s experiences with writing pro- gress notes in psychiatric contexts, and especially the space given to staff–patient relations, is sparse. Design: Qualitative design. Methods: Focus group interviews with mental health staff working in one acute and one subacute psychiatric ward were conducted. Systematic text condensation, a method for transverse thematic analysis, was used. Results: Two main categories emerged from the analysis: the position of the profes- sional as an expert and distant observer in the progress notes, and the weak posi- tion of professional–patient interactions in progress notes. Conclusions: The participants did not perceive that the current recording model, which is based on the nursing process, supported a focus on patients’ resources or reporting professional–patient interactions. This model appeared to put ward staff in an expert position in relation to patients, which made it challenging to involve patients in the recording process. Essential aspects of nursing care related to recovery and person-centred care were not prioritised for documentation. Relevance to clinical practice: This study contributes to the critical examination of the documentation praxis, as well as to the critical examination of the documentation tool as to what is considered important to document. Keywords: documentation, mental health nursing, nurse–patient interactions, nurse–patient relations, nursing process, psychiatric nursing

• Myklebust, Kjellaug Klock & Bjørkly, Stål (2011). Selvpsykologiske tilnærminger til utfordringer i brukermedvirkningsrelasjoner – en kvalitativ studie blant psykisk helsearbeidere. Vård i Norden. ISSN 0107-4083. 31(3), s. 35–39. Vis sammendrag

  Research exploring users´ and professionals´ experiences of user participation in practice is not extensive and so far findings appear inconclusive. This study aimed to generate knowledge about how mental health workers perceive user participation in challenging interactions. Data were collected from qualitative interviews with mental health workers in Norwegian community services. Vignettes describing challenging situations were used in the interviews in order to elicit reflections pertaining to user participation. Kvale’s phenomenological- hermeneutical method was employed to analyze interview data according to his three levels of interpretation: 1) self-understanding, 2) critical “common sense” understanding, and 3) theoretical understanding. Self-psychology was used to interpret data at the third level. The informants emphasized three main strategies to secure user participation:Working towards the user’s goals, facilitating flexible communication and enhancing a good relationship. Still, informants perceived the challenging interactions as either being dominated by the user or the mental health worker. This dichotomy indicates that a better understanding of the relationship and improved communication skills are required to enhance mutual participation for user and caregiver.

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• Ødegård, Atle; Hoemsnes, Helene; Myklebust, Kjellaug Klock & Willumsen, Elisabeth (2013). Interprofessional education (IPE) in two (of four) post-graduate programs.
• Myklebust, Kjellaug Klock (2020). Rapporteringer av miljøterapeutiske interaksjoner i sykepleiedokumentasjon : en "mixed methods" studie i psykisk helsevern. Høgskolen i Molde - Vitenskapelig høgskole i logstikk. ISSN 978-82-7962-284-0. Vis sammendrag

  Avhandlingen undersøker sykepleiedokumentasjon i pasientjournaler ved to avdelinger i psykisk helsevern. I tillegg til kvantitativ analyse av et omfattende materiale i pasientjournaler, er personal ved psykiatriske avdelinger intervjuet om deres dokumentasjonspraksis. Avhandlingen har avdekket en rapporteringspraksis der personalet i liten grad beskriver hva de gjør, og hvordan de møter pasienten. Personalet dokumenterte jevnlig følelser og opplevelser hos pasientene (f.eks. at pasienten var trist, sint eller engstelig), men en fant få beskrivelser om hva personalet hadde gjort for å imøtekomme pasientens opplevelse. Dette er et nytt forskningsområde, og funnene er bemerkelsesverdige sett i lys av at en terapeutisk relasjon er ansett som et kjerne-element i psykisk helsearbeid.

• Ødegård, Atle; Sæbjørnsen, Siv Elin Nord; Hegdal, Tone; Bergum, Inger Elisabeth; Brask, Ole David & Inderhaug, Hans [Vis alle 13 forfattere av denne artikkelen] (2015). Tverrprofesjonell samarbeidslæring (TPS) ved Høgskolen i Molde. Høgskolen i Molde - Vitenskapelig høgskole i logistikk. ISSN 978-82-7962-205-5. Vis sammendrag

  Tverrprofesjonell samarbeidslæring (tps) er nødvendig for å sikre god kvalitet på helseog sosialtjenestene. Ved Høgskolen i Molde arbeides det aktivt for å anvende tps som virkemiddel på tvers av profesjonsutdanningene og langs utdanningsnivåene.

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