Background: Good parent-child connectedness, general and substance use specific communication are protective against alcohol, tobacco and drug use during adolescence. Previous research also suggests that general communication with foster and other statutory carers is associated with more positive outcomes, including relationships with caregivers and siblings. However, no studies have examined substance use specific communication between looked after young people and their carers. Aims: The aim of this study was to gain an understanding of how carers and looked after young people communicate about alcohol, tobacco and drug use and the factors that shape communication, including the use of digital media. Methods: A qualitative study was conducted, using in-depth interviews with 13 looked after young people in foster and residential care; two social workers; six foster carers and eight residential care workers. Interviews were audio-recorded, transcribed verbatim and the data were analysed thematically. Findings: Relationships between carers and young people were crucial and acted as the antecedent to communication. Carers' role identity influenced their relationships with young people and their approach to and communication about substance use. Shared doing provided a way in which communication about substances could be facilitated in an environment which feels natural. The context in which communication occurred was important, with differences between foster and residential care. Digital media were viewed with caution, as something used to gain information about substances but not as a way of communicating with young people. Conclusions: The findings have implications for foster carers and residential care staff working with looked after young people, in terms of relationships and communication about substance use. Carers should continue to develop positive relationships with young people, whilst considering the potentially negative effects of conflicts in professional role identity. Techniques such as shared doing and encouraging natural conversations about substance use may help.

Bakgrund: Palliativ omvårdnad bör utföras utifrån en humanistisk helhetssyn med utgångspunkt i att upprätthålla livskvalitet och autonomi. Patienter och anhöriga eftersträvade välfungerande kommunikation och stöd för att kunna förberedas inför döden och lindra lidande. Patienter och anhöriga påverkades negativt av sjuksköterskors bristande kompetenser och kommunikation samt vid otrygga vårdmiljöer. Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av palliativ omvårdnad. Metod: En allmän litteraturöversikt genomfördes och tolv artiklar analyserades, varav tio artiklar var kvalitativa och två artiklar kvantitativa. Resultat: I resultatet identifierades fyra teman gällande arbetsrelaterade utmaningar, kommunikation, emotionella erfarenheter och vårdrelationer. Sjuksköterskorna beskrev arbetsrelaterade utmaningar som bristande kompetenser, försvårade samarbeten, hög arbetsbelastning och tidsbrist. Sjuksköterskorna beskrev att välfungerande kommunikation underlättade omvårdnadsarbete, medan bristfällig försvårade. Sjuksköterskorna beskrev att palliativ omvårdnad medförde emotionella utmaningar, men att det inte var enbart negativt utan bidrog till utveckling. Slutligen beskrev sjuksköterskorna betydelsen av att etablera vårdrelationer inom palliativ omvårdnad. Slutsats: Palliativ omvårdnad var komplex att utföra. Sjuksköterskorna var i behov av kompetensutveckling och gynnsamma arbetsmiljöer för att utförande av palliativ omvårdnad skulle kunna förbättras. Välfungerande, respektfull kommunikation bidrog till att värdighet hos patienter och anhöriga upprätthölls. Reflektion var en strategi som bidrog till utveckling. Etablerade vårdrelationer och personcentrerad omvårdnad var väsentliga för palliativ omvårdnad. / Background: Palliative care should be carried out based on a humanistic holistic view with the starting point of maintaining quality of life and autonomy. Patients and relatives strived for well-functioning communication and support in order to prepare for death and alleviate suffering. Patients and relatives were negatively affected by nurses’ lack of competence and communication and by an unsafe care environment. Aim: The aim was to describe nurses’ experiences of palliative care. Method: A literature review was conducted and twelve articles were analyzed, of which ten articles were qualitative and two articles were quantitative. Result: Four themes were identified in the results about work-related challenges, communication, emotional experiences, and care relationships. The nurses described work-related challenges such as lack of competence, difficult collaboration, high workload, and lack of time. The importance of communication was made clear when well-functioning communication made the work easier and when poor communication made the work difficult for the nurses. The nurses described emotional distress in palliative care. Emotional distress did not only have a negative impact but contributed to development. Finally, the nurses described the importance of establishing care relationships within palliative care. Conclusion: Palliative care was complex to perform. The nurses needed competence development and favorable working environments so that performance of palliative care could be improved. Well-functioning, respectful communication contributed to maintaining the dignity of patients and relatives. Reflection was an important strategy that contributed to development. Established care relationships and person-centred care were essential to palliative care.

Bakgrund Humant immunbristvirus, HIV, är en kronisk sjukdom som attackerar kroppens immunförsvar. Sjukdomen är en global epidemi som startade på mitten av 1900-talet. HIV är en folksjukdom som går under smittskyddslagen. Det finns inget botemedel, men antiretroviral behandling gör att infektionen inte blir värre och hämmar symtomen samt stärker immunförsvaret. Den psykiska hälsan påverkas ofta negativt för patienter med HIV, ofta till följd av samhällets okunskap. Vårdpersonals inställning och attityd kring HIV speglar samhällets generella stigmatisering, samt okunskap och rädsla för att bli smittad. Sjuksköterskans omvårdad ska grundas på jämlikhet och rätt till lika vård för alla patienter, oavsett sjukdom, bakgrund och kultur.  Syfte Syftet var att beskriva hur personer med HIV upplever bemötandet i vården. Metod Detta är en litteraturöversikt som baserats på tolv vetenskapliga artiklar där tio var av kvalitativ metod och två av både kvalitativ och kvantitativ metod som är inhämtade från Cinahl complete och PubMed. Dataanalysen grundar sig i Fribergs beskrivning.  Resultat Resultatet delades in i tre teman. Dessa var “Vårdrelationens betydelse för vårdandet” vars resultat visade vikten av vänlighet, välkomnande och uppföljning som faktorer till ett gott bemötande. Temat “Att bli stigmatiserad som HIV patient” präglades av patienters erfarenheter av diskriminering och sämre bemötande på grund av sin sjukdom. “God kommunikation och information förmedlar trygghet” förklarade hur sjukvårdspersonal skapar och bibehåller trygghet byggt på kunskap och god kommunikation utifrån patienternas upplevelser och preferenser.  Slutsats Det finns kvarvarande stigma gentemot patienter med HIV hos sjukvårdspersonal på vårdinrättningar globalt. Ett dåligt bemötande behöver inte alltid bero på stigmat utan kan ha ett flertal faktorer, dock visar resultatet att ett bemötande som inte är byggt på respekt kan motverka att patienter söker vård. Det kan även påverka patienternas följsamhet av behandlingen, även kallad compliance, negativt. Dåligt bemötande från vårdpersonal gav patienterna en känsla av diskriminering och stigma på grund av sin HIV- sjukdom, vilket resulterade i psykisk ohälsa hos många patienter. Något som däremot är ett givande och gott bemötande ur patientperspektivet, visar sig vara ett gott välkomnande som bibehålls under mötet, respekt, kunskap gällande HIV och regelbunden uppföljning. / Background Human Immunodeficiency Virus, HIV, is a chronic disease that attacks the body's immune system. The disease is a global epidemic that started in the mid-20th century. HIV is a notifiable disease under infectious disease control laws. There is no cure, but antiretroviral treatment prevents the infection from worsening, alleviates symptoms, and strengthens the immune system. The mental health of HIV patients is often negatively affected, often due to societal ignorance. The attitudes and approach of healthcare professionals towards HIV reflect society's general stigma, as well as ignorance and fear of transmission. Nursing care should be based on equality and the right to equal care for all patients, regardless of illness, background, and culture. Aim The aim is to describe how individuals with HIV experience the treatment in healthcare. Method This is a literature review based on twelve original articles, where ten were of qualitative methodology and two of both qualitative and quantitative methodology, gathered from Cinahl Complete and PubMed. The data analysis is based on Friberg's description. Results The results were categorized into three themes. These were "The importance of care relations in caring," which showed the importance of kindness, welcoming attitude, and follow-up as factors for good treatment. The theme "Being stigmatized as an HIV patient" was characterized by patients' experiences of discrimination and poorer treatment due to their illness. "Good communication and information convey security" explained how healthcare professionals create and maintain security based on knowledge and good communication according to patients' experiences and preferences.

Background: Research shows that transgender people are disproportionally represented in term of physical and mental illness compared to cis people. Stigmatization and discrimination in society results in transgender people having low trust in society's institutions, including health care. A good care relationship and equal care are of great importance for a patient's well-being and health. However, nurses feel that they do not have enough competence or experience in caring for transgender people. Aim: The aim of this literature study was to describe transgender people's experiences of care relationships with health care staff. Method: A qualitative literature study with an inductive approach consisting of twelve articles that were analyzed through a qualitative content analysis. Results: Three categories were identified: Lack of competence in the care meeting, Abusive care meetings and Affirmingcare meetings. Seven subcategories were also identified. These findings highlight that transgender people experience incompetence and violations in care meetings. However, positive experiences in the form of affirmative care meetings have also been described. Conclusions: The healthcare institution needs to implement education on cis-normativity and transgender people's specific care needs. Therefore, more research is needed on how transgender people believe that care can become more inclusive for this group of individuals.

Background: Childhood cancer drastically changes the lives of both the child and the family. Nurses play a key role in providing support and care. Family-centered care can facilitate listening to parents' needs and enable them to actively participate in their child's care. Aim: To describe parents' experiences of living with a child with cancer. Method: A literature study based on five autobiographies written by parents of children with cancer. Results: The parents' experience is characterized by their individual ability to implement strategies to cope with the challenges that their child's illness brings. Coping strategies could be divided into three subcategories: emotional management, practical problem-solving, and the impact of healthcare on the patient experience. Information and collaboration from the nurse affect the experience of care, and individualized nursing care was perceived as the best. Conclusion: Collaboration between healthcare and parents is crucial to enable the most effective management of the challenges that come with having a child with cancer. Healthcare workers needs to provide individualized support to ensure that parents feel well cared for, and in this way improve the experience of living with a child who has cancer. / Bakgrund: Barncancer innebär en drastisk förändring för både barnet och familjen. Sjuksköterskor har en central roll i att ge stöd och vård. Familjecentrerad omvårdnad kan underlätta för att lyssna på föräldrars behov och ge dem möjlighet att delta aktivt i barnets vård. Syfte: Att beskriva föräldrars upplevelser av att leva med ett barn med cancer. Metod: En litteraturstudie baserad på fem självbiografier skrivna av föräldrar till barn med cancer. Huvudresultat: Föräldrarnas upplevelse präglades av deras individuella förmåga av att implementera strategier för att hantera utmaningarna som barnets sjukdom tillför. Hanteringsstrategierna kunde delas in i tre underkategorier: hantering av känslor, praktisk problemlösning och vårdens inverkan på upplevelsen. Information och samarbete från sjuksköterskan påverkade upplevelsen av vården. Individanpassad omvårdnad upplevdes bäst av föräldrarna. Slutsats: Samarbetet mellan vården och föräldrarna är avgörande för att kunna möjliggöra en så effektiv hantering av dessa utmaningar som möjligt. Vården behöver tillhandahålla individanpassat stöd för att föräldrarna ska känna sig väl omhändertagna, och på så sätt förbättra upplevelsen av att leva med ett barn som har cancer.

No description available.

The number of informal carers in the UK is rising, yet the dynamics of care within informal care relationships remain poorly understood. The present research examined adaptation of informal care relationships affected by Acquired Brain Injury. The research addresses four pairs of questions: (1a) Are there any disagreements and/or misunderstandings between carers and people with Acquired Brain Injury (PwABI) regarding carer identity? (1b) How can the pattern of divergences be explained? (2a) Are there any disagreements and/or misunderstandings between carers and PwABI regarding PwABI identity? (2b) How can the pattern of divergences be explained? (3a) What strategies do carers and PwABI use in collaboration on a joint task? (3b) Is the type of input provided by carers on the joint task comparable to scaffolding as described in the child development literature? (4a) What happens when carers and PwABI collaborate to fill in the Disability Living Allowance (DLA) claim form? (4b) Why do carers see more disability than PwABI when filling in the DLA form? Four mixed-method data sets were used to answer these questions: (1) numerical ratings given by PwABI and carers to map out convergences and divergences (2) videos of discussions between participants and researcher during rating tasks (3) videos of carers and PwABI engaging in a joint task - planning inviting a friend or relative round for a meal and (4) videos of carers and PwABI filling in part of the DLA claim form. All data was collected from the same 28 PwABI/carer dyads who were two or more years post injury. Chapter 4 addresses questions 1a and 1b. Carers’ and PwABIs’ perspective ratings revealed a number of disagreements regarding carer identity. Carers perceived themselves negatively compared to their partners’ view of them. Regarding question 1b, carers feel negatively about themselves due to difficulties in the transition to the role of ‘carer’. They experience a lack of recognition for this caring role as a result of concealing the burden of care. Carers require more long term support from health services to help them achieve recognition for their role, such as facilitating attendance at support groups. Chapter 5 addresses questions 2a and 2b. Carers’ and PwABIs’ perspective ratings revealed only one disagreement and corresponding misunderstanding regarding PwABI identity. Regarding question 2b, alignment was found between the perspectives of carers and PwABI regarding PwABI due to the relational rating method used. It is carer identity which is the source of most divergences of perspective, not PwABI identity as commonly assumed. Using a relational rating method shows promise as a tool to explore perspectives as it treats all viewpoints as equal and avoids pathologising the perspective of PwABI. Chapter 6 addresses questions 3a and 3b. Analysis of strategies shows that completing a joint task is a collaborative process. Carers direct the background of the task but PwABI are in charge of the foreground, making task decisions. However, carers dominate the process and control where and how PwABI contribute. Regarding question 3b, the interaction meets the criteria for scaffolding in the strategies chosen and the flexibility of collaboration. However, removal of supports is often an unrealistic goal, leading to frustration in carers. Examination of processes of collaboration has elucidated the strategies used by carers and PwABI and can enhance theoretical discussion of the applicability of the scaffolding metaphor for a cognitively impaired adult sample. Chapter 7 address questions 4a and 4b. Disagreements were frequent when completing the DLA form. Contestations were almost exclusively in the direction of carers seeing greater disability than PwABI. Regarding question 4b, carers see greater disability due to the communication required to complete the form. Dyads are forced to confront disability, a pattern of interaction they avoid in everyday life. Carers marginalise PwABI point of view and position themselves as ‘expert’ on the PwABI. Differences in frames of reference regarding audience, aim and scope lead carers to maximise the disability and PwABI to minimise this. The impact of completing complex forms on relationships and identity needs to be considered during development of disability benefit assessment methods. A relational approach which studies both halves of informal care partnerships simultaneously allows us to go beyond outcomes of ABI and affords a greater understanding of processes of adaptation.

Este trabalho se concentra na discussão sobre relações de cuidado em processos terapêuticoeducacionais junto a pessoas diagnosticadas com Transtorno do Espectro do autismo - TEA. Noções biomédicas descrevem o TEA como um transtorno do desenvolvimento que afeta as áreas da interação social, da comunicação, dos comportamentos e do processamento sensorial da pessoa (Whitman, 2015). Esta pesquisa se situa no Construtivismo Semiótico-Cultural em psicologia que favorece a compreensão sobre a relação pessoa-cultura focalizando um olhar sobre a construção de significados pertinentes a cultura pessoal e coletiva (Simão, 2010; Valsiner, 2012). As reflexões presentes neste trabalho partem da discussão de como os constructos teórico-metodológicos do Construtivismo Semiótico-Cultural em psicologia podem contribuir para a compreensão das dimensões do cuidado (Figueiredo, 2007) como processo terapêutico-educacional junto a pessoas diagnosticadas com TEA. Na metodologia articulam-se noções dialógicas de interpretação dos dados de pesquisa em trajetórias ascendentes e descendentes (Guimarães, 2016) que permitem o transitar sobre o Conhecimento Geral e Particular. Foram analisados dados de um experimento sobre processos de Transmissão Cultural, bem como dados coletados através do estudo de casos clínicos conduzidos no Centro Terapêutico-Educacional Potencializar CETEP localizado em Jundiaí/SP. Destaca-se que ao falar de compreensão e intervenção terapêutico-educacional sobre o desenvolvimento de pessoas diagnosticadas com TEA estão implicados processos: 1) ligados a níveis Filogenéticos, Ontogenéticos e Sociogenéticos de seleção/variação de formas pessoais e coletivas de funcionamento na relação pessoa-cultura (Darwin,1859/2002; Baldwin, 1896); 2) imbricados a níveis Microgenéticos, Mesogenéticos e Ontogenéticos de experiência afetiva humana na construção da cultura pessoal e coletiva (Valsiner, 1998, 2012a); 3) que guiam a forma de intervenção terapêutico-educacional junto a pessoas diagnosticadas com TEA a partir de relações de cuidado / This research concentrates in the discussion on care relationships regarding therapeuticeducational processes for people diagnosed with autism spectrum disorder (ASD), which is a developmental disorder affecting social interaction, communication, behavior and sensorial processing areas (Whitman, 2015). This thesis is oriented on Semiotic-Cultural Constructivism in psychology in ways that it helps to comprehend the relations between person-culture and to shed a light on meaning making processes related to the personal and collective culture (Simão, 2010; Valsiner, 2012). The ideas presented here have as a starting point the discussion on how the theoretic-methodological constructs of the Semiotic-Cultural Constructivism in psychology can contribute to comprehend the care dimension (Figueiredo, 2007) as a therapeuticeducational process with the people who are diagnosed with ASD. It is articulated in the methodology the dialogical notions of research data interpretation in ascendant and descendent trajectories (Guimarães, 2016) allowing a broad view about the General and Particular Knowledge. Data from an experiment on Cultural Transmission Processes were analyzed as well as data collected from clinical cases studies which were held on the Centro Terapêutico- Educacional Potencializar CETEP - located in Jundiaí, Sao Paulo. What is brought to light here is that when we talk on therapeutic-educational comprehension and intervention on people diagnosed with ASD, the following processes are implicated: 1) processes related to the Phylogenetic, Ontogenetic and Sociogenetic levels of personal and collective ways of selection/variation functioning within the person-culture relation (Darwin, 1859/2002; Baldwin, 1896); 2) interwoven to a Microgenetic, Mesogenetic and Ontogenetic levels of affective experiences within the personal and collective cultural development (Valsiner, 1998, 2012a); 3) that guide the therapeutic-educational intervention with the people diagnosed with ASD, considering the care relationship within them

Este trabalho se concentra na discussão sobre relações de cuidado em processos terapêuticoeducacionais junto a pessoas diagnosticadas com Transtorno do Espectro do autismo - TEA. Noções biomédicas descrevem o TEA como um transtorno do desenvolvimento que afeta as áreas da interação social, da comunicação, dos comportamentos e do processamento sensorial da pessoa (Whitman, 2015). Esta pesquisa se situa no Construtivismo Semiótico-Cultural em psicologia que favorece a compreensão sobre a relação pessoa-cultura focalizando um olhar sobre a construção de significados pertinentes a cultura pessoal e coletiva (Simão, 2010; Valsiner, 2012). As reflexões presentes neste trabalho partem da discussão de como os constructos teórico-metodológicos do Construtivismo Semiótico-Cultural em psicologia podem contribuir para a compreensão das dimensões do cuidado (Figueiredo, 2007) como processo terapêutico-educacional junto a pessoas diagnosticadas com TEA. Na metodologia articulam-se noções dialógicas de interpretação dos dados de pesquisa em trajetórias ascendentes e descendentes (Guimarães, 2016) que permitem o transitar sobre o Conhecimento Geral e Particular. Foram analisados dados de um experimento sobre processos de Transmissão Cultural, bem como dados coletados através do estudo de casos clínicos conduzidos no Centro Terapêutico-Educacional Potencializar CETEP localizado em Jundiaí/SP. Destaca-se que ao falar de compreensão e intervenção terapêutico-educacional sobre o desenvolvimento de pessoas diagnosticadas com TEA estão implicados processos: 1) ligados a níveis Filogenéticos, Ontogenéticos e Sociogenéticos de seleção/variação de formas pessoais e coletivas de funcionamento na relação pessoa-cultura (Darwin,1859/2002; Baldwin, 1896); 2) imbricados a níveis Microgenéticos, Mesogenéticos e Ontogenéticos de experiência afetiva humana na construção da cultura pessoal e coletiva (Valsiner, 1998, 2012a); 3) que guiam a forma de intervenção terapêutico-educacional junto a pessoas diagnosticadas com TEA a partir de relações de cuidado / This research concentrates in the discussion on care relationships regarding therapeuticeducational processes for people diagnosed with autism spectrum disorder (ASD), which is a developmental disorder affecting social interaction, communication, behavior and sensorial processing areas (Whitman, 2015). This thesis is oriented on Semiotic-Cultural Constructivism in psychology in ways that it helps to comprehend the relations between person-culture and to shed a light on meaning making processes related to the personal and collective culture (Simão, 2010; Valsiner, 2012). The ideas presented here have as a starting point the discussion on how the theoretic-methodological constructs of the Semiotic-Cultural Constructivism in psychology can contribute to comprehend the care dimension (Figueiredo, 2007) as a therapeuticeducational process with the people who are diagnosed with ASD. It is articulated in the methodology the dialogical notions of research data interpretation in ascendant and descendent trajectories (Guimarães, 2016) allowing a broad view about the General and Particular Knowledge. Data from an experiment on Cultural Transmission Processes were analyzed as well as data collected from clinical cases studies which were held on the Centro Terapêutico- Educacional Potencializar CETEP - located in Jundiaí, Sao Paulo. What is brought to light here is that when we talk on therapeutic-educational comprehension and intervention on people diagnosed with ASD, the following processes are implicated: 1) processes related to the Phylogenetic, Ontogenetic and Sociogenetic levels of personal and collective ways of selection/variation functioning within the person-culture relation (Darwin, 1859/2002; Baldwin, 1896); 2) interwoven to a Microgenetic, Mesogenetic and Ontogenetic levels of affective experiences within the personal and collective cultural development (Valsiner, 1998, 2012a); 3) that guide the therapeutic-educational intervention with the people diagnosed with ASD, considering the care relationship within them

Psykiatrisk öppenvård utgör en viktig komponent inom den svenska psykiatriska vården och behovet av sådan verksamhet ökar för varje år. Specialistsjuksköterskans kompetens och patientdelaktighet utgör en framgångsfaktor för en god psykiatrisk vård, samtidigt som denna delaktighet ofta kommer med utmaningar. Utebliven delaktighet riskerar att leda till vårdlidande. Den här studiens syfte var att undersöka sjuksköterskors upplevelser av patientdelaktighet inom den svenska psykiatriska öppenvården. Upplevelsen av patientdelaktighet utforskas genom kvalitativa intervjuer med sju sjuksköterskor, som arbetar i den öppen psykiatriska vården i Västra Götalandsregionen. Studien har sin metodologiska utgångspunkt i reflekterande livsvärldsforskning och intervjuerna analyserades med hjälp av induktiv innehållsanalys. Resultatet sammanfattades till tre huvudkategorier, Främja patientens deltagande, att skapa rum för patientens röst och sjuksköterskans roll i patientens vårdresa, vilka sammanfattade intervjuernas huvudlinjer. Resultatet indikerar att patientdelaktighet i likhet med tidigare forskning är central för ökad vårdkvalitet, men också hur denna begränsas av resursbrist. Vårdrelationen framträder som en nyckelfaktor i patientdelaktigheten, men resursbrist hindrar sjuksköterskan från att bygga och bibehålla dessa. Studien bidrar med insikter gällande resurstilldelning och organisatoriska förändringar, som kan stärka patientens delaktighet, öka vårdkvalitet och minska vårdlidande. Genom att åskådliggöra sjuksköterskornas röster, belyser denna studie behovet av förändringar som möjliggör ökat patientengagemang och ökad patientdelaktighet inom psykiatrisk öppenvård. Studien belyser behovet av att adressera resursbegränsningar och implementering av individuellt anpassad delaktighet genom exempelvis tekniska hjälpmedel. Fortsatt forskning föreslås fokusera på just detta. Studien uppmanar specialistsjuksköterskor inom psykiatri att prioritera byggandet av starka, förtroendefulla relationer till sina patienter i syfte att främja patientdelaktigheten samt att använda sin expertis för att individanpassa denna. / Psychiatric outpatient care is an important component of Swedish psychiatric care, and the need for such activities increases every year. The specialist nurse's competence and patient participation are a success factor for good psychiatric care, while this participation often comes with challenges. Non-participation risks leading to poor care. The purpose of this study was to investigate nurses' experiences of patient participation in Swedish psychiatric outpatient care. The experience of patient participation is explored through qualitative interviews with seven nurses, who work in outpatient psychiatric care in the Västra Götaland region. The study has its methodological point of departure in reflective life-world research and the interviews were analyzed using inductive content analysis. The results were summarized into three main categories, promote the Patient´s Participation, to Create Space for the Patient's Voice and The Nurse's Role in the Patient's Care Journey, which summarized the main lines of the interviews. The results indicate that, similar to previous research, patient participation is central to increased quality of care, but also how this is limited by a lack of resources. The care relationship appears as a key factor in patient participation, but a lack of resources prevents the nurse from building and maintaining these. The study contributes insights regarding resource allocation and organizational changes, which can strengthen patient participation, increase care quality and reduce care suffering. By illustrating the nurses' voices, this study highlights the need for changes that enable increased patient engagement and increased patient participation in psychiatric outpatient care. The study highlights the need to address resource limitations and implementation of individually adapted participation through, for example, technical aids. It is suggested that further research focus on precisely this. The study urges specialist nurses in psychiatry to prioritize the building of strong, trusting relationships with their patients in order to promote patient participation and to use their expertise to tailor this to the individual.