Os transtornos alimentares (TA) são doenças graves de etiologia multifatorial, que cursam com alterações importantes no comportamento alimentar e complicações clínicas como desnutrição e distúrbios hidroeletrolíticos, além de comorbidades psiquiátricas. A hospitalização integral é uma modalidade terapêutica indicada quando o seguimento ambulatorial não atinge resultados satisfatórios associados à piora dos sintomas. O objetivo deste estudo foi descrever as características e resultados da hospitalização dos pacientes com TA atendidos pelo Grupo de Assistência em Transtornos Alimentares do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto-USP. Dados antropométricos, bioquímicos e clínicos foram coletados a partir da revisão de prontuários dos pacientes internados durante o período de 1982 a 2011. Como resultado, observou-se que das 186 pessoas que receberam atendimento pelo serviço, 44,6% deles (n=83) necessitaram de no mínimo, uma internação durante o tratamento. A predominância foi do sexo feminino (95,2%), da raça branca (94%), solteira (76%) e sem filhos (78,3%). Cursavam o ensino médio (50,6%) com idade de 23,3±10,8 anos. O diagnóstico era de anorexia do tipo restritivo (AN-R) para 54,2% (n=45) deles, 31,3% (n=.26) apresentavam anorexia do subtipo compulsão periódica/purgativo (AN-CP) e 14,5% (n=12) tinham bulimia nervosa (BN). A média de internações foi de 1,9±3,9 vezes sendo que 73,5% (n=61) dos pacientes foram internados apenas uma vez, por 41,2±37,6 dias. Para aqueles que precisaram dessa modalidade de tratamento por mais de uma vez, a duração da hospitalização, considerando todas as internações, foi de 70,6±115,9 dias com extensa variação (3 a 804 dias). Não foi observada associação entre o número de internações com o Índice de Massa Corporal (IMC) e com o tempo de sintomas antes do diagnóstico. O IMC dos pacientes mudou significativamente (p<0,05) durante a internação (para o grupo com AN-R: de 13,5kg/m2 para 14,8kg/m2 ; para os com AN-CP: de 15,7kg/m2 para 16,9kg/m2 ; naqueles com BN: de 22,0kg/m2 para 21,0kg/m2 ). A amenorréia esteve presente em 69% (n=45) das mulheres, sendo mais frequente naquelas com AN-R (65,1%). Dos 23 pacientes (27,7%) que realizaram o exame de densitometria óssea, 44,4% (n=10) apresentam osteopenia e 29,7% (n=7) osteoporose. Os valores médios da maioria dos parâmetros bioquímicos avaliados estavam dentro da normalidade, com exceção do beta-caroteno, que encontrava-se elevado, tanto no início quanto no final da internação. A Nutrologia foi a enfermaria na qual a maioria das internações ocorreu (79,5%) e a necessidade de terapia nutricional foi a indicação mais frequente (62,3%). A via de administração de nutrientes preferencialmente utilizada foi a via oral (67,5%), apesar de ter sido observado aumento de 2,3 vezes na escolha da terapia nutricional enteral exclusiva nos pacientes que foram internados mais de uma vez. O acompanhamento multidisciplinar foi evidenciado, pois além do médico, houve a participação maciça de nutricionistas (87,9%) e psiquiatras (72,3%). Como conclusão, a hospitalização integral é uma modalidade bastante indicada no tratamento de pacientes com TA, mas sua duração é prolongada e requer a assistência de diversos profissionais. No entanto, quando indicada a partir de critérios bem estabelecidos proporciona melhora no estado nutricional. Futuros estudos são necessários para ampliar e aprofundar os resultados encontrados possibilitando o aprimoramento de condutas terapêuticas. / Eating disorders (ED) are serious diseases with multiple etiologies that course with major changes in eating behavior and clinical complications such as malnutrition and electrolyte disturbances, and also psychiatric comorbidities. Inpatient treatment is a modality of treatment used when the outpatient follow-up did not reach satisfactory results associated with worsening of clinical status. The aim of this study was to describe the characteristics and outcomes of the hospitalization in patients with ED who were treated by Assistance Group on Eating Disorders from the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - USP. Anthropometric, biochemical and clinical data were collected from the medical records of patients admitted between 1982 and 2011. It was observed that among 186 patients attended by the service, 44.6% (n = 83) required at least one inpatient treatment. Most patients were female (95.2%) and white (94%). The majority was single (76%), with no children 78.3%) and were high school students (50.6%). The mean age was 23.3± 10.8 years old. According to the diagnosis, 54.2% of patients had anorexia nervosa, restricting subtype (AN-R), 31.3% had anorexia nervosa binge-eating/purging subtype (AN-CP) and 14.5% had bulimia nervosa (BN). The mean age at admission was 23.3 ± 10.8 years (range 8-58 years), 73.5% of patients were hospitalized only once. The mean number of admissions was 1.9 ± 3.9 times and 73.5% (n=61) were hospitalized only once, during 41.2 ± 37.6 days. For those who needed this type of treatment more than once, the length of stay, considering all admissions, was 70.6 ± 115.9 days with extensive variation (3-804 days). No associations were observed between the number of hospitalizations and Body Mass Index (BMI) and duration of symptoms before diagnosis. The BMI of the patients changed significantly (p <0.05) during hospitalization (for the group with AN-R, from 13.5 kg/m2 to 14.8 kg/m2 ; for AN-CP: 15.7 kg/m2 to 16.9 kg/m2 , those with BN: from 22.0 kg/m2 to 21.0 kg/m2 ). Amenorrhea was present in 69% (n = 45) women, most frequently in those with AN-R (65.1%). According to exam of bone densitometry of 23 patients (27.7%), 44.4% (n=10) had osteopenia and 29.7% (n=7) had osteoporosis. The mean values of most biochemical parameters were within normal limits, except for beta- carotene, which was above the normal range, both in admission and discharge. The Nutrology was the infirmary where the majority of hospitalizations occurred (79.5%), nutritional support was the most frequent indication for hospitalization (62.3%). The route of administration of nutrients preferably used was oral (67.5%), although it has been observed an increase at 2.3 times on exclusively enteral feeding in patients admitted more than once. The multidisciplinary team reveals, besides the doctor, the massive presence of dietitians (87.9%) and extensive involvement of psychiatrists (72.3%). It is concluded that inpatient treatment is needed in patients with ED, often shows prolonged duration and requires the assistance of various professionals. However, when indicated based on criteria well established can provide improvement in nutritional status. Future studies are needed to broaden the results enabling the improvement of therapeutic approaches.

A assistência em saúde mental e, mais especificamente, os cuidados às pessoas que fazem uso problemático de álcool e outras drogas foram por muito tempo negligenciadas pelo Estado. Atualmente, existem diferentes formas de tratamento para o uso problemático de drogas, contudo, as políticas públicas atuais têm aumentado o financiamento para internações em Comunidades Terapêuticas. O objetivo deste estudo é compreender os sentidos construídos sobre a internação em Comunidades Terapêuticas por indivíduos que passaram por estas instituições e atualmente são usuários de um Centro de Atenção Psicossocial II álcool e drogas. Para isto, foram realizadas entrevistas semi-estruturadas com pessoas em tratamento em um CAPS- AD do município de Ribeirão Preto SP, que passaram por pelo menos uma internação em Comunidades Terapêuticas. Foi realizada uma análise de categoria temática tendo como referencial epistemológico o construcionismo social, levando-se em consideração a influência dos tempos longo, vivido e curto na produção de sentidos. A discussão realizada dialogou com a literatura sobre a Reforma Psiquiátrica. O projeto foi aprovado pelo Comitê de Ética em Pesquisa, respeitando-se os critérios éticos da resolução n.º 466 de 12 de Dezembro de 2012. A análise e resultados foi realizada com 10 entrevistas, sendo construídas quatro categorias: 1) Comunidades Terapêuticas e equipamentos da rede de atenção psicossocial; 2) Momentos marcantes como desencadeadores da decisão de internação e suas expectativas; 3) Funcionamento das Comunidades Terapêuticas; e 4) A saída da Comunidade Terapêutica: decisão e experiências na sociedade. As políticas públicas, ao abrir espaço para financiamento das, CTs, tem investido em um modelo pouco estudado e que age em contradição com as diretrizes da Reforma Psiquiátrica. As CTs trabalham unicamente com a abstinência propondo atividades domesticas, do campo (laborterapia) e espirituais, como principais intervenções. Há uma construção social, pautada no discurso moral religioso e jurídico, de que as internações prolongadas seriam a resolução para os problemas relacionados ao uso de drogas, sendo as CTs privilegiadas pelo financiamento público. Contudo, os usuários e familiares são constantemente enganados e expostos a situações de violência (coerção, imposição e punições). Tem-se desconsiderado a complexidade desse campo, impactando na forma como usuários de drogas são descritos e se descrevem. / Mental health assistance and specifically problematic alcohol and drug use care has been neglected by state policies for a long time. Nowadays, there are different sorts of possible treatments for problematic drug use, however, the current public policies has grown funding for Therapeutic Communities (TC) inpatient treatment. This study aims to comprehend the constructed meanings regarding Therapeutic Communities inpatient treatment experienced by patients whose had been treated by this kind of strategy and now are under treatment on Centro de Átenção Psicosocial - Álcool e Drogas of Ribeirão Preto (CAPS-AD).To achieve this, semi-structured interviews were conducted with people on treatment in a CAPS- AD Ribeirão Preto - SP, who have undergone at least one inpatient experience on Therapeutic Communities. A thematic-categorial analysis was carried out using social constructionist epistemology as reference, taking into account the influence of the long-time, short-time and lived-time in the production of meanings. The discussion held dialogued with the literature on the Brazilian psychiatric reform. The project was approved by the Research Ethics Committee, respecting the ethical criteria of Resolution No. 466 of December 12, 2012. The presented analysis and results were based on 10 interviews, being constructed four categories: 1) Therapeutic Communities and equipment of psychosocial care network; 2) Memorable moments as triggers of inpatient admission decision and their expectations; 3) Operation of Therapeutic Communities; and 4) The output of the Therapeutic Community: decision and experiences in society. The public policies fostering funding for TCs, has invested in an understudied model and acts in contradiction with the guidelines of the Brazilian Psychiatric Reform. The TCs works only with the perspective of abstinence treatment, proposing as key interventions: domestic, field (larbotheraphy) and spiritual activities. There is a social construction based on moral-religious and legal discourse that extended inpatient stays would be a resolution for problems related to drug use, and this has made the CTs privileged by public funding. However, TCs users and their family members are constantly deceived and exposed to violence (coercion, enforcement and punishment). It has disregarded the complexity of this field, impacting the way drug users are described and describe themselves.

O presente estudo enfoca as atividades expressivas e recreativas no contexto hospitalar e, sendo os familiares um elemento importante nesse processo, objetiva-se verificar a visão dos familiares a respeito da influência dessas atividades na hospitalização de crianças com fissura labiopalatina, procurando identificar os benefícios dessas atividades no período pré e pós-operatório, a influência no processo de recuperação cirúrgica, a atividade preferencial das crianças e a importância da participação dos familiares nas atividades. Participaram, deste estudo, 138 familiares de crianças com fissura labiopalatina, na faixa etária de 07 a 12 anos, hospitalizados no HRAC, e que freqüentaram o Serviço de Educação e Terapia Ocupacional. Realizou-se um estudo descritivo por meio de aplicação de formulário de entrevista, abordando questões referentes ao tema estudado, envolvendo familiares de criaças, em condição pré e pós-operatória. Dos 138 familiares questionados, 135 (97,83%) acham que as atividades expressivas e recreativas no período pré-operatório deixam a criança mais calma. Todos 138 (100%) responderam que as atividades expressivas e recreativas aceleram o processo de recuperação cirúrgica. Dentre as atividades das quais participaram com a criança, 127 (92,03%) dos participantes referiram-se a brinquedoteca e, na opinião de 103 (74,64%) dos familiares questionados, esta participação contribui para melhorar o estado emocional da criança, favorecendo, na opinião de 125 (90,58%) familiares, seu relacionamento interpessoal e 137 (99,27%), acham que as atividades contribuem para o crescimento e desenvolvimento das crianças hospitalizadas. Concluiu-se que, na visão da maioria dos familiares, 136 (98,55%), as atividades expressivas e recreativas amenizam os efeitos negativos advindos da hospitalização. / This study addresses the expressive and recreational activities within a hospital context; since the family is an important element in this process, this study investigated the standpoint of the family on the influence of these activities on the hospitalization of children with cleft lip and palate, to identify the benefits of these activities both pre- and postoperatively, their influence on postoperative recovery, preferential activities of the children, and the importance of family participation in the activities. The study was conducted on 138 relatives of inpatient children with cleft lip and palate at HRAC, aged 7 to 12 years, attending the Education and Occupational Therapy Service. A descriptive study was conducted by application of an interview comprising questions related to the subject, involving families of children both pre- and postoperatively. Among the 138 relatives, 135 (97.83%) consider that expressive and recreational activities performed at the preoperative period reassure the child. All 138 interviewees (100%) stated that the expressive and recreational activities accelerate the process of postoperative recovery. Among the activities in which they participated with the child, 127 participants (92.03%) mentioned the toy room; according to 103 relatives (74.64%), this participation contributes to improve the emotional status of the child, favoring their interpersonal relationships according to 125 relatives (90.58%); 137 interviewees (99.27%) stated that the activities contribute to the growth and development of inpatient children. In conclusion, according to the standpoint of the family, 136 relatives (98.55%) believe that expressive and recreational activities reduce the negative effects of hospitalization.

Forskning kring patientdelaktighet i förhållande till omvårdnad har pågått sedan 1960-talet och att göra patienten delaktig i sin egen vård är lagstyrt enligt hälso- och sjukvårdslag. Syftet med litteraturstudien var att beskriva patienters delaktighet inom omvårdnad i sluten somatisk vård. Resultatet visar att patientdelaktighet är multifaktoriellt och behöver förstås i relation till förhållningssätt, roller, kommunikation, villighet och resurser. Personalens förhållningssätt, vilken förmåga de har att bjuda in patienter i en vårdande gemenskap, vilka roller sjuksköterskan och patienten har, om patienten är villig att delta, på vilket sätt kommunikation sker och information delas samt vilka resurser som finns att tillgå påverkar patientens möjligheter att vara delaktig. Litteraturstudien visar att patientdelaktighet har en stor betydelse i den slutna somatiska vården. Patientdelaktighet saknas som vårdvetenskapligt begrepp och detta gestaltar sig genom att det råder förvirring kring tolkningen. Det finns ett behov av att definiera begreppet patientdelaktighet vetenskapligt för att sjuksköterskor ska veta hur de ska förhålla sig till detta. / Research on patient participation in relation to nursing has taken place since the 1960s, and to involve the patient in his own care, is governed by the healthcare system. The purpose of the literature study was to describe patients' involvement in nursing in inpatient somatic care. The result shows that patient participation is multifactorial and needs to be understood in relation to the attitude, roles, communication, willingness and resources. The attitude of the staff, the capacity they have to invite patients in a caring community, the roles the nurse and patient have, if the patient is willing to participate, how communication takes place and information is shared and what resources are available affects the patient's ability to be involved. The literature study shows that patient participation is of major importance in the inpatient somatic care. Patient participation is lacking as a medical science concept, and this is due to confusion about interpretation. There is a need to define the concept of patient participation scientifically in order for nurses to know how to relate.

Bakgrund: Mellan år 1998 och 2008 ökade inläggningarna drastiskt inom den psykiatriska slutenvården. Ändå finns bristande kunskaper om patienternas upplevelser av densamma. För att kunna utveckla vården i rätt riktning, krävs att patienternas upplevelser beaktas. Syfte: Att beskriva patienters upplevelser av psykiatrisk slutenvård. Metod: En litteraturöversikt där kvalitativa vetenskapliga artiklar analyserats. Artiklarnas resultat delades upp i meningsbärande enheter, som sedan sattes samman till den nya helhet som bildade denna studies resultat. Resultat: Ur analysen framträdde sex teman: Förväntningar, Värdet av att få vara en egen individ, Begränsningar på avdelningen, Samtal och stöd på avdelningen, Kontakt och stöd patienter emellan och Tiden på avdelningen. Slutsats: Patienternas upplevelser skilde sig många gånger åt, men genomgående var att de alla önskade behålla sin autonomi och att få bli sedda och respekterade som egna individer. Önskan om att få vara delaktig i sin vård och få samtalsstöd, uttrycktes starkt. Dessa faktorer var av största vikt för att patienterna skulle kunna uppleva att de fick en god vård. / Background: Between the year of 1998 and 2008 the hospitalisations of psychiatric inpatient care increased drastically. Despite that, the understanding of the patients’ experiences of the inpatient care is deficient. To develop the care in the right direction, the patients’ experiences need to be elucidated. Aim: To describe the patients’ experiences of psychiatric inpatient care. Method: A literature study of qualitative scientific papers. Seven articles were analyzed. The articles’ results have been divided into themes, which then have been put together to form the result of this study. Result: From the analyze six themes were formed: Expectations, The importance of being your own individual, Restraints on the ward, Dialogue and support on the ward, Contact and support between patients and The time on the ward. Conclusion: The patients’ experiences were in many cases diverged, but they were all in agreement that the valued to contain their autonomy and to be treated and respected as an own individual. The desire to participate in their own care and to have a dialogue with the nurses, were clearly expressed. For the patient to experience good care, these were the most important parts.

Psychiatric inpatient services provide important care for individuals with serious mental health problems. Studies show that passivity and social disengagement prevail in inpatient settings, and the transition to outpatient care is associated with increased suicide risk. Behavioural Activation is an intervention that targets depression by increasing personally meaningful activities. Preliminary research shows that Behavioural Activation can be used in inpatient settings. The overall aim of this thesis was to evaluate the feasibility and effectiveness of Behavioural Activation for individuals in psychiatric inpatient settings, and in the transition between inpatient and outpatient care. Study I investigated inpatient activities and associated experiences. Study II was a pilot single-case experimental study of the feasibility and effectiveness of inpatient Behavioural Activation. Study III, was an interrupted time series evaluation of nursing-adapted Behavioural Activation across three wards. In Study IV Behavioural Activation in the transition from inpatient to outpatient care was compared to Supportive Therapy in a randomised controlled trial with 64 participants. The primary outcome was that of self-reported depressive symptoms and participants were followed up 12 months after treatment completion. Doing nothing was the most common inpatient activity, along with meal related activities. Passive and solitary activities were associated with negative distress and reward profiles. The preliminary evaluation of Behavioural Activation found high patient and staff satisfaction, and four of six participants showed improvement in depressive symptoms and functioning. After nursing-adapted Behavioural Activation was implemented on three wards, engagement increased. Avoidance decreased but later returned to baseline levels. Depressive symptoms and global clinical severity did not improve after nursing-adapted Behavioural Activations was introduced. The randomised controlled trial found that adding Behavioural Activation in the transition to outpatient care had a small, short-term, advantage over Supportive Therapy for self-reported depression. In conclusion, inpatient disengagement is associated with distress, and Behavioural Activation is a feasible intervention in inpatient settings that can be used by both trained therapists and nursing staff to increase patients’ treatment engagement. Behavioural Activation seems useful in targeting depressive symptoms in the transition from inpatient to outpatient care, a period associated with increased risk of suicide and clinical deterioration.

Bakgrund: Tidigare studier visar att anhöriga till personer med psykisk ohälsa riskerar själva en försämrad psykisk hälsa och lidande. Känslor av skam, skuld och oro är vanliga. Anhöriga kan också behöva sluta arbeta och flytta för sin närståendes skull vilket kan leda till negativa sociala konsekvenser. Anhöriga önskar ha kontakt med vården och känna sig delaktiga i sin närståendes vård men upplever ofta sig exkluderade. Riktlinjer och lagar betonar vikten av att anhöriga görs delaktiga men ofta fallerar detta. Det saknas kunskap om hur sjuksköterskor i sluten psykiatrisk vård upplever kontakten med anhöriga. Syfte: Syftet med denna studie var att beskriva sjuksköterskors erfarenhet av kontakt med anhöriga i psykiatrisk slutenvård för personer med psykossjukdom. Metod: Studien har en kvalitativ design med induktiv ansats. Sju sjuksköterskor som arbetade inom psykiatrisk slutenvård för personer med psykossjukdom intervjuades individuellt med semistrukturerade intervjufrågor. Materialet analyserades enligt kvalitativ innehållsanalys. Resultat: Resultatet från intervjuerna utmynnade i fem huvudkategorier: Organisatoriska faktorer som inverkar på kontakten med sjuksköterska och anhöriga, Egenskaper hos sjuksköterskan som inverkar på kontakten med anhöriga, Patientens inverkan på kontakten mellan sjuksköterska och anhöriga, Anhörigas inverkan på kontakten med sjuksköterskan samt Betydelsen av kontakt med anhöriga. Diskussion: Centrala fynd från studiens resultat diskuteras utifrån forskningsfrågorna. Som stöd i diskussionen används tidigare forskning samt Birgitta Andersheds teori Delaktighet i ljuset - Delaktighet i mörkret. / Background: Previous studies have shown that family members of individuals with mental illness are themselves at risk for worsened mental health and psychological distress. Family members desire contact with psychiatric caregivers in order to feel actively engaged in the care of their loved one, and the importance of caregiver - family member contact is emphasized in both current care guidelines and Swedish law. Despite this, many family members feel excluded. The experience of inpatient psychiatric caregivers of contact with family members has not been investigated in detail, and is crucial to remedying this situation. Aim: The aim of this study was to describe nurses’ experiences of family members in inpatient psychiatric care for persons with psychosis. Method: Qualitative, semi-structured interviews were conducted on an individual basis with seven nurses working at an inpatient psychiatric clinic for patients diagnosed with psychosis, located in Stockholm, Sweden. The results were analyzed using inductive content analysis. Results: The results from the interviews could be separated into five categories affecting nurse – family contact; organizational factors, personal qualities of the nurse, influence of the patient; influence of family members and perceived meaningfulness of contact with family members. Discussions: The main findings of the study are discussed in the context of current research, as well as Birgitta Andershed’s theory of “Involvement in the Light / Involvement in the Dark”.

The thesis deals with efficiency of inpatient facilities in the Czech Republic in the period 2008 to 2013. The first chapter describes the importance of inpatient facilities in the health care system and methods of evaluation of efficiency with focus on the method of DEA. Additionally it defines the necessary concepts for other parts of the work. The content of the following chapter is the analysis of the development of inpatient fund according to selected criteria. In the last chapter are first analyzed the determinants which may influence the efficiency of the hospital and the possibilities of their monitoring in the Czech Republic. This is followed by a key part of the thesis - analysis of technical and cost efficiency of hospitals, on the basis of which conclusions and recommendations are drawn into practice.

This thesis is focused on description of the DRG (Diagnosis Related Groups) classification system and its application as the inpatient care financing tool. The objectives of this thesis are to sum up the possible applications of DRG system, to describe the calculation of indicators needed for health care payment in 2012 and to suggest some improvements to the algorithm to enhance the quality of data processing in the years ahead. The first part of this thesis is theoretical and it includes especially the history of the DRG classification system and an explanation of the basic concepts and the calculation methods. In the second part there is the description of the data file, which was used for the calculation of the inpatient care payments for 2012, its processing (specifically the determination of the relative weights of DRG) and the possibility to automate the whole solution.

Background: Playing is a natural part of the child's nature. Through play, the child can relate to his or her surroundings. Play therapy is used in healthcare, a tool to help children and adolescents through difficult circumstances. Aim: The aim was to explore children and adolescents experience of and attitude towards play therapy and the impact on perceived health in connection with inpatient care. The aim was also to investigate the significance of play for children and adolescents during hospital stays. Method: Data was collected through a survey with quantitative and qualitative elements. In addition, a supplemental literature study was conducted. Results: A total of 12 children and adolescents completed the survey, and 5 articles were reviewed in the literature study. The majority (n=10) had a positive attitude towards play therapy. Correlation analysis showed that the younger the children were, the higher they scored on “if it was easier to stay at the hospital after they had been in contact with play therapy” (r = -0.738, p = 0.006). In the qualitative survey it emerged that children and adolescents experienced that the best thing about play therapy was the staff. It emerged in the literature study that through play, the children experienced an increased sense of security, happiness and wellbeing. Play reduced their anxiety, fear and stress. Conclusions: Most participants in the survey had positive experiences and attitudes towards play therapy. Play therapy was perceived as health beneficial and was considered positive in the reviewed studies. Play helped children and adolescents with coping of anxiety, fear and stress. / Bakgrund: Att leka är en naturlig del av barnets natur. Leken bidrar till att förhindra samt minska oro hos barnet. Lekterapin används inom sjukvården och är ett verktyg för att underlätta barn och ungdomars svåra omständigheter. Lekterapin ska vara en plats där barn och ungdomar får komma bort från sjukhusmiljön. En plats där de bara får vara barn. Syfte: Studiens syfte var att undersöka barn och ungdomars erfarenhet av och inställning till lekterapin samt påverkan på upplevd hälsa i samband med inneliggande vård. Syftet var dessutom att undersöka lekens betydelse för barn och ungdomar under sjukhusvistelser. Metod: Studien består av en enkätundersökning med kvantitativa och kvalitativa inslag samt en litteraturstudie för att komplettera resultatet. Resultat: Totalt deltog 12 barn och ungdomar i enkätundersökningen och fem artiklar granskades i litteraturstudien. Majoriteten av barnen och ungdomarna (n=10) var positivt inställda till lekterapin. Korrelationsanalys visade att ju yngre barnen var, desto högre skattade de att det var lättare att vara på sjukhuset efter kontakt med lekterapin (r= -0,738, p=0,006). Enligt de kvalitativa enkätfrågorna upplevde barnen och ungdomarna att personalen var det bästa med lekterapin. I litteraturstudien framkom det att genom leken upplevde barnen en ökad trygghet, glädje samt välbefinnande. Leken minskade deras oro, ångest, rädsla och stress. Slutsats: Majoriteten av deltagarna i enkätundersökningen hade positiva erfarenheter av samt inställning till lekterapin. Lekterapin uppfattades även som hälsofrämjande. Lek ansågs i de granskade studierna som positivt och förbättrade hanteringen av till exempel oro, ångest, rädsla och stress hos barnen och ungdomarna.