The maintenance of hope in the treatment of a forensic psychiatric patient

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Arvo building, auditorium F115, address: Arvo Ylpön katu 34

Saija Turpeinen

Doctoral defence of M.Sc. (Health Sciences) Saija Turpeinen

Substantiivinen teoria oikeuspsykiatrisen potilaan toivon ylläpitämisestä (The maintenance of hope in the treatment of a forensic psychiatric patient: a substantive theory)

The field of science of the dissertation is Nursing Science.

The opponent is Associate Professor Tarja Kvist (University of Eastern Finland). Docent Jari Kylmä acts as the custos.

The language of the dissertation defence is Finnish.

For psychiatric patients hope is a mainstay which helps the patient from day to day

A Psychiatric patient refers to a person designated for treatment by the Health and Welfare Department (THL) as a part of the criminal justice system. Offenses committed by patients with psychiatric disorders are mostly violent crimes, homicides and sexual offenses. Of the patients legally diagnosed with a psychiatric disorder, half have committed a violent crime, and often this violent crime has been a homicide. In Finland, there are approximately 400 patients with a statutory psychiatric status.

It is important to maintain hope during treatment because hope is the basic resource of life. Hope has been found to be a core value of treatment. Hope and its significance in health sciences have been studied in several patient groups and from different perspectives. Hope is widely recognized as one of the critical factors in coping with mental disorders. Hope has a positive effect on depression symptoms, anxiety, and well-being.

Recovery from a serious mental health disorder requires that the nursing staff take into account the patient’s view of what is required to survive everyday life? Understanding the patient’s point of view is the foundation for helping a patient. The importance of family and close friends is also emphasized when it comes to improving the rehabilitation of psychiatric patients. Loved ones are an important resource for the psychiatric patient and they have a significant role in the patient’s rehabilitation process.

The purpose of this study was to describe hope and to develop a substantive theory of the maintenance of hope in the treatment psychiatric patients. The material consisted of both individual and group interviews of patients, their relatives, and their nurses and doctors (n = 51). This study indicated that hope is important for psychiatric patients because it carries them through life.

The core category of this substantive theory was established to be the development of trustful cooperation during the process of caring for the patient. The theory can be summarised as follows: hope is the driving force of a psychiatric patient. The legal psychiatric nursing system and valuation of the care of psychiatric nurses act as a base for maintaining the patient’s hope. Interventions in psychiatric treatment maintain the patient’s hope, thereby contributing to the patient’s recovery. The patient’s close relationships during treatment maintain the patient’s hope.

The theory takes into account the interaction between the patient and the nursing staff, the interaction between the patient and the close relatives, and the interaction between the close relatives and the nursing staff. Cooperation between these individuals is integral at all stages of care. The results of this study illustrate the multifactorial nature of the maintenance of the hope in a psychiatric patient from the perspective of patients for whom this is a reality.


The dissertation is published in the publication series of Acta Universitatis Tamperensis; 2354, Tampere University Press, Tampere 2018. The dissertation is also published in the e-series Acta Electronica Universitatis Tamperensis; 1860, Tampere University Press 2018.

The dissertation can be ordered at: Juvenes Verkkokirjakauppa or by e-mail:


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