Parent-teen sex conversations reduce Black adolescents’ HIV/STI risk. Nationally, most studies about Black teens’ sexual risk behaviors omit Afro-Caribbean groups whom are disproportionately burdened by HIV/STIs. Therefore, this exploratory study guided by the PEN-3 model (a) characterized the nature, perceptions, enablers, and nurturers of sexuality conversations between Haitian and Jamaican parents and adolescents and (b) explained the relationship between sexuality conversations and adolescent sexual activity. Using narrative inquiry, 6 Haitian and 8 Jamaican mother-teen dyads’ and triads’ (N=31) experiences were used to characterize the nature, perceptions, enablers, and nurturers of parent-teen sex conversations. Thematic content analysis generated common themes. In phase two, Black adolescents (African American, Haitian, and Jamaican) N=157, completed a validated 52-item questionnaire. Scales included ASAI; measuring recent pre-coital and coital activities; FSCQ measuring families’ orientation towards sex-conversations, and PTSRC-III measuring sexual topics discussed with each parent. Linear and logistic regression determined the relationship between parent-teen sex conversations and teens’ sexual activity. Mothers’ mean age was (41.85±5.50) and teens’ mean age was (16±1.31). Qualitative findings suggest that Afro-Caribbean mothers’ limited childhood and adolescent sex conversations and outcomes of those interactions shaped mothers’ existing attitudes, beliefs, and behaviors about sexual topics, and hindered their ability to discuss sex with their teens. Dyads believed modifying parents’ approach, improving parents’ sexual health knowledge, and increasing families’ comfort with sex- conversations would improve sexual discussions. Survey participants’ mean age was (16±1.49) and mean age of penile-vaginal/anal sexual debut was (14.95±1.71). Twenty percent of sexually active teens had their first parent-teen sex conversation after penile-vaginal/anal sexual debut, p=.01, and 27% after penile-oral/vaginal-oral sexual debut, p=.001. Haitians had lower comfort with family-sex conversations than African Americans, p=.03 and Jamaicans, p=.004. African American teens’ higher comfort for family-sex conversations was predictive of delayed penile-vaginal/anal sexual debut, p=.009 and virginity, OR=1.5, 95% CI [1.154, 1.866]. Teens who never spoke to their fathers about protection from HIV/STI were four times more likely OR= 4.41, 95% CI [1.466, 13.30] to not use condoms. In summary, culturally-responsive, family focused interventions are needed to equip Afro-Caribbean parents for sex conversations with their teens in order to reduce teens’ sexual risk.

La thèse rapportée dans ce manuscrit étudie l'impact de ces propriétés dans la composition de services Web. La considération de telles propriétés soulève plusieurs problèmes auxquels on a essayé d'apporter une solution. Le premier aspect consiste à définir un modèle qui tienne compte des abstractions nécessaires afin de pouvoir analyser et synthétiser une composition, à savoir les messages, les données, les contraintes de données, les propriétés temporelles et l'aspect asynchrone des communications des services. En se basant sur ce modèle, le deuxième problème consiste à proposer une approche d'analyse de compatibilité. Cette analyse vise à caractériser la compatibilité ou la non-compatibilité des services Web et ce en prenant en considération les abstractions précédemment citées. Nous étudions particulièrement l'impact des propriétés temporelles dans une chorégraphie dans laquelle les services Web supportent des communications asynchrones. Nous proposons une démarche basée sur le model checking qui permet de détecter les éventuels conflits temporisés qui peuvent surgir dans une chorégraphie. Finalement, le dernier problème auquel nous nous intéressons est celui de la construction d'une composition qui essaie de répondre au besoin du client et ce en prenant en compte les aspects temporels. L'approche que l'on propose est basée sur la génération d'un médiateur pour essayer, quand c'est possible, de contourner les incompatibilités temporisées et non-temporisées qui peuvent surgir lors d'une collaboration. Des mécanismes et des algorithmes ont été développés afin de mettre en oeuvre ces objectifs / Web services are based on standrards and Web technologies to interact by exchanging messages. Apart from the sequences of messages, other factors affect the interoperability of Web services, such as temporal constraints that specify the required delay to exchange messages. This thesis studies the impact of these properties in the composition of Web services. The consideration of such properties raises several problems that need several investigations. The first aspect is to define a formal model that takes into account the necessary abstractions in order to analyze and synthesize a composition. The abstractions we have considered are: messages, data, data constraints, temporal properties and the asynchronous nature of services communications. Based on this model, the second problem we handled is the compatibility analysis. This later aims at characterizing the compatibility or incompatibility of Web services by taking into account the abstractions mentioned above. We propose an approach based on model checking to detect the conflicts that may arise in timed choreography. Finally, the last problem we dealt with is the construction of a composition which attempts to satisfy the client need. The approach that we propose is based on the generation of a mediator to try, whenever possible, to resolve the incompatibilities that may arise during a collaboration. Mechanisms and algorithms have been developed to implement these primitives

Bakgrund: En stor del av distriktssköterskors arbete inom primärvården består av telefonrådgivning. Det krävs stor kunskap inom omvårdnad, kommunikation, medicin och teknik för att kunna göra en korrekt bedömning av patientens hälsotillstånd. Inom telefonrådgivning finns det flertalet faktorer som försvårar bedömningen. Syfte: Syftet med denna studie var att beskriva distriktssköterskors upplevelser av svåra samtal vid telefonrådgivning inom primärvården. Metod: I studien användes en kvalitativ innehållsanalys med induktiv ansats. Intervjuer genomfördes med åtta distriktssköterskor. Resultat: I resultatet framkom fyra kategorier vilka var: Svårt att bedöma via telefonen, Svårt att inte kunna tillgodose allas önskemål, Organisationsrelaterade problem samt Stöd i bedömningen med tillhörande nio underkategorier. Distriktssköterskorna upplever att svåra samtal kan uppstå i många olika situationer samt att dessa påverkar distriktssköterskorna känslomässigt och deras arbete inom telefonrådgivning. Konklusion: Denna studie tydliggör vad distriktssköterskor upplever som svåra samtal och att dessa påverkar dem känslomässigt. Resultatet kan bidra till att öka medvetenheten av vad distriktssköterskor upplever sig behöva för att lättare kunna hantera svåra samtal. / Background: A large part of the district nurses’ work in primary health care consists of telephone counseling. This requires extensive knowledge of nursing, communications, medicine and technology to be able to make an accurate assessment of the patient's health. In the telephone counseling there are several factors that complicate the assessment. Aim: The purpose of this study was to describe district nurses’ experiences of difficult conversations in telephone counseling in primary health care. Method: The study used a qualitative content analysis with inductive approach. Interviews were conducted with eight district nurses. Results: The result shows four categories: Difficult to assess through the telephone, Difficult to not be able to accommodate everyone, Organizational problems and Support in the assessment. District nurses feel that difficult conversations can occur in many different situations and that they affect the district nurses emotionally and their work with telephone counseling. Conclusion: This study clarifies what the district nurses’ experience as difficult conversations and that they affect them emotionally. The results can help to raise awareness of what the district nurses feel they need to manage difficult conversations easier.

Philosophiae Doctor - PhD / The 'conversations' under investigation have all been initiated by the National Department of Education (DoE) and are identified in this thesis as the following: the Values Report (2000); Opening Pathways (2002), the Manifesto (2001); and the Baseline Report (2004). During 2000 the Minister of Education, who recognised the need for public discussion on values in education, appointed a working group to produce a document on values in education, namely the Values Report. That report proposed six values to be nurtured in schools. The DoE invited public comment on the Values Report and these comments were taken into account when a conference on values in education was held during February 2001, namely the Saamtrek Conference. Meanwhile, the DoE commissioned school-based research during 2000. The purpose of the research was to establish what meanings school communities assigned to the values that were proposed in the Values Report. The research findings were published in 2002, but an interim report, Opening Pathways, was published during 2001, and informed discussions at the Saamtrek Conference. The Manifesto was published later during 2001, and proposed ten values to be nurtured in schools. It also proposed sixteen educational strategies that could be employed to nurture these values. During 2004 the DoE again commissioned school-based research, the baseline research, which culminated in the Baseline Report. The purpose of the baseline research was to establish what were the perceptions and practices of school communities in respect of values and human rights. There was vigorous engagement with the issue of values in education during the first few years of the 21st century. During 2002 the DoE launched a Values in Education Programme of Action in order to promote the nurturing of values in education. One of the initiatives of this programme was the introduction of an Advanced Certificate in Education (ACE) programme aimed at practising teachers. This was the ACE: Integrating values and human rights across the curriculum, which was funded by the DoE, and offered at various institutions of Higher Education from July 2003 to June 2005. There was less vigorous engagement with the issue of values in education after 2004, when a new Minister of Education was appointed. An example of less vigorous engagement with values in education is the following: the ACE on values and human rights was not state-funded beyond 2005. It is against this background that I engaged with the mentioned conversations about values in education. My interest in conversations about values in education arose out of my involvement, from 2003 to 2005, with the ACE programme on values and human rights which was offered by the University of the Western Cape. My thesis format differs from the majority of theses in this country since my research was entirely text-based, thus devoid of fieldwork. This thesis corresponds to what I have identified as a topic-based format. Each chapter, with the exclusion of the .introductory, research methodology and conclusions and recommendations chapters, investigates a specific topic that forms part of the conversations about values in education. My research data consisted of conversations about values in education as captured in the documents mentioned above, namely the Values Report. Opening Pathways, the Manifesto and the Baseline Report. My thesis does not have a separate literature review chapter. Neither does it have a chapter in which research findings are presented, analysed and discussed. Separate chapters on a review of the literature and on presentation, analysis and discussion of research findings are usually features of a thesis which relies for its data on fieldwork. However, a review of the literature and research findings are infused in five of the eight chapters that comprise this thesis. I made use of relevant literature in order to interrogate DoE conversations about values in education. That interrogation led me to arrive at research findings in respect of DoE conversations about values in education. My research methodology was located within a qualitative research paradigm, with an interpretive metatheoretical approach. I identified my research design as philosophy as social practice, and my research method as philosophical investigation. I undertook an investigation of the grammar of these conversations about values in education, that is, an investigation of the arguments provided by the DoE for claims made in respect of values in education. That investigation included the following: a clarification of assumptions underpinning DoE arguments; uncovering of DoE conceptions about the goals and purposes of schooling; establishing the extent of continuity amongst DoE conversations; highlighting the extent of conceptual clarity in DoE conversation; and exploring what meanings are assigned by the DoE to value concepts. The investigation of the grammar of the relevant DoE conversations illuminated DoE engagement with the following concepts: 'values', 'character', 'morality', 'conversation', 'education', 'inquiry', 'schooling', 'ethics', 'citizenship' and 'whole school'. In the process of this investigation I developed a conceptual framework for thinking about values in education, engaged with the notion of developing shared understandings in respect of values in education, drew attention to inquiry as a type of conversation that is conceptually linked to education, and investigated the notion of deliberation as a way of nurturing values in education.

In an everchanging world where information flows freely and we are continually awash with new truths, we need to equip our children and our youth with the ability to face it with confidence and knowledge. To understand values such as democracy and the equal value of all, reflection and argumentation must take place in the room. Our young people must be able to communicate, critically examine and take a position on arguments. Our young people also need to be able to create trusting relationships and develop other pro-social skills. The school is an arena that has the mission to educate and equip our young people with these skills. The educational system must therefore create opportunities for our pupils to become part of their word not just a person in the world. Key to philosophical dialogue as a method, on which this intervention study is based, is the common exploration of different perspectives and arguments. To listen to and show respect for the thoughts and opinions of others but still, in a constructive way, dare to challenge each other's thoughts and ideas. The purpose of this study was to investigate whether a series of six conversations, based on the model of philosophical dialogue, contributed to students experiencing an increased sense of participation in conversations with each other and the teacher. To investigate this, the special education authority's (SPSM) definition of participation was used through the six aspects of the participatory model (Delaktighetsmodellen), accessibility, belonging, autonomy, recognition, engagement, and co-operation. The study involved two intervention groups and two control groups; the two intervention groups participated in the philosophical dialogue series. Before the intervention started, the groups conducted a pre-survey and after the intervention was completed, a final survey was carried out. The results of the surveys were analyzed and after that a respondent validation was carried out with some of the participants. In comparison with previous studies, this study is considered a short intervention. The results of this study showed that even a short series of philosophical dialogue had a bearing on students' sense of participation. Not for the intervention group as a whole but for some of the participants. Participants described that with these dialogues they have gotten to know each other better and gained an increased sense of security. The participants also told us that it has been fun to talk to each other and to listen to other people's opinions and share their own with others. / I en föränderlig värld där informationen flödar fritt och vi översköljs av nya sanningar kontinuerligt krävs det att vi rustar våra barn och ungdomar att möta den med tillförsikt och kunskap. För att förstå värden som demokrati och allas lika värde måste reflektionen och argumentationen ta plats i rummet. Våra unga måste kunna kommunicera, kritiskt granska och ta ställning till argument. Våra unga behöver också kunna skapa tillitsfulla relationer och utveckla andra prosociala färdigheter. Skolan är en arena som har uppdraget att utbilda och rusta våra unga med dessa färdigheter. Skolan måste därför skapa möjligheter för våra elever att bli delaktiga i sin omvärld. Centralt för metoden filosofiska samtal, som denna interventionsstudie bygger på, är det gemensamma utforskandet av olika perspektiv och argument. Att lyssna till och visa respekt för andras tankar och åsikter men ändå, på ett konstruktivt sätt, våga utmana varandras tankar och idéer. Syftet med denna studie var att undersöka om en serie på sex samtal, baserade på modellen filosofiska samtal, bidrog till att eleverna upplevde en ökad känsla av delaktighet i samtal med varandra och läraren. För att undersöka detta användes specialpedagogiska skolmyndighetens definition av delaktighet genom Delaktighetsmodellens sex aspekter, tillgänglighet, tillhörighet, autonomi, erkännande, engagemang, och samhandling. I studien deltog två interventionsgrupper och två kontrollgrupper, de två interventionsgrupperna deltog i den filosofiska samtalsserien. Innan interventionen startade gjorde grupperna en förenkät och efter att interventionen avslutades genomfördes en slutenkät. Resultatet av enkäterna analyserades och efter det genomfördes en respondentvalidering med några av deltagarna. I jämförelse med tidigare forskning är denna studie att betrakta som en kort intervention. Resultatet av denna studie visade att även en kort serie med filosofiska samtal har betydelse för elevers känsla av delaktighet. Inte för interventionsgruppen som helhet men hos några av deltagarna. Deltagare beskrev att de i och med dessa samtal hade lärt känna varandra bättre och fått en ökad känsla av trygghet. Deltagarna berättade också att det var roligt att få samtala med varandra och att få lyssna på andras åsikter och få delge sina egna till andra.

Previous research shows that collegial conversations and co-assessment can contribute to increased equivalence in assessment and grading. The purpose of the present study is to investigate how music teachers who are active in upper secondary schools express themselves about their experiences of equal assessment and grading and how they believe that the collegial knowledge among subject teachers in music affects them in their work with equal assessment and grading. To investigate this, a qualitative study has been done with e-mail interviews as a data collection method. Four music teachers aged 27–33 years participated in the study. The results show that all music teachers in one way or another take part in collegiate conversations or joint assessment. There are differences between the teachers about how they can share the thoughts and experiences of other music colleagues. For some of the teachers, there are opportunities for collegial conversations and joint assessment at the school, as well as opportunities for subject meetings in the municipality. For one of the participants in the study, there are no organized meetings for music teachers to meet and talk.

Bakgrund: Inom psykiatrisk omvårdnad används stödjande samtal som en omvårdnadsåtgärd. Det har framkommit i forskning att patienter upplever god effekt av stödjande samtal. Däremot saknas det forskning kring vad ett stödjande samtal är, utifrån psykiatrisjuksköterskans perspektiv. Syfte: Syftet med studien var att belysa vad ett stödjande samtal är utifrån psykiatrisjuksköterskans perspektiv. Metod: Kvalitativ metod med induktiv ansats har använts. Datamaterialet har analyserats med kvalitativ innehållsanalys. Psykiatrisjuksköterskor inom vuxenpsykiatrisk öppenvård har intervjuats i två regioner i sydvästra Sverige. Tio stycken semistrukturerade intervjuer har genomförts. Resultat: I resultatet framkommer att psykiatrisjuksköterskor anser att det stödjande samtalet ska stärka och identifiera patientens egna resurser. Relationen mellan psykiatrisjuksköterskan och patienten är betydelsefull. Det stödjande samtalet beskrivs som otydligt, saknar struktur och syfte samt tenderar att ha en låg status då det ibland används i väntan på annan behandling. Samtidigt framkommer att det finns en stor frihet med det stödjande samtalet då det inte behöver anpassas till ramar som i en terapi. Konklusion: Det stödjande samtalet är en betydelsefull uppgift där psykiatrisjuksköterskan är bäst lämpad att utföra samtalet. Detta på grund av det omvårdnadsperspektiv psykiatrisjuksköterskan besitter. Det stödjande samtalet är en insats som bör prioriteras inom den vuxenpsykiatriska öppenvården. / Background: In psychiatric nursing, supportive conversations are used as a nursing measure. Research has shown that patients experience a good effect of supportive conversations. On the other hand, there is a lack of research on what a supportive conversation is from the psychiatric nurse's perspective. Aim: The aim of this study was to shed light on what a supportive conversation is from the psychiatric nurse's perspective. Method: Qualitative method with inductive approach has been used. The data material has been analyzed with qualitative content analysis. Psychiatric nurses in adult psychiatric outpatient care have been interviewed in two regions in southwest of Sweden. Ten semi-structured interviews were conducted. Result: The results show that psychiatric nurses believe that the supportive conversation should strengthen and identify the patient's own resources. The relationship between the psychiatric nurse and the patient is of great importance. The supportive conversation is described as unclear, lacks structure and purpose and tends to have a low status as it is sometimes used while the patient is waiting for other treatment. At the same time, it becomes clear that supportive conversation offers a great deal of freedom as it does not need to be adapted to the framework as in a therapy. Conclusion: The supportive conversation is an important task where the psychiatric nurse is best suited to carry out the conversation. This is due to the nursing perspective of the psychiatric nurse. The supportive conversation is an initiative that should be prioritized in adult psychiatric outpatient care.

A qualitative study that examines the view of book conversations and its relation to norms from a critical literacy perspective.  The truth of a book does not have to be the only truth.  As individuals living in society, we are constantly influenced by norms of the outside world in the form of images and texts. From a child’s perspective, it is not easy to categorise and understand all information, as well as to question what is true or not. Therefore, we believe that preschool is an important arena where we can exchange experiences and take on texts and images together to create an understanding and a place to problematize and reconstruct norms. This qualitative study is based on interviews, where the purpose is to examine and analyze the experience of preschool teachers and child educators of book conversations in relation to norms. We seek to answer the two following research questions: How do preschool teachers and child educators reflect about book talks and their role in in preschool in relation to norms? And what significance do preschool teachers and child educators believe that book conversations in preschool have for children's learning regarding norms? To answer how the preschool works to make visible and reconstruct norms and values, this study relates to the concept of critical literacy. In summary, it can be described as a process where the ultimate goal is to be able to reproduce a text independently.  The study demonstrates that preschool often tends to focus on children's language development in book conversations rather than working with norms. However, there are indications that preschool teachers and child educators, to a certain extent, work to make norms visible, but that it is not further developed into a process of reconstructing stories through book conversations.

Studiens syfte var att få kunskap om hur barn upplever och förhåller sig till utomhusvistelse i en naturförskola respektive förskola utan specifik inriktning. Detta har utformats med stöd av följande frågeställningar: Hur upplever barnen i respektive förskola utomhusvistelsen? Hur leker barnen i respektive förskola i samband med deras utomhusvistelse? Studien har tagit sin utgångspunkt ur två kvalitativa metoder, nämligen fokusgruppintervjuer och strukturerade observationer med stöd av observationsscheman. Avsikten med fokusgruppintervjuerna var att inhämta kunskap om barnens egna åsikter och tankar gällande den utomhusvistelse som de tar del av under sin förskolevistelse. Vidare var avsikten med de strukturerade observationerna att tolka barnens utomhusvistelse genom att inta ett barnperspektiv. Den nämnda jämförelsen utgick från tre barnavdelningar på en naturförskola och två barnavdelningar från en förskola utan specifik inriktning. I resultatet framkom det både likheter och skillnader mellan barnen från respektive förskola gällande deras utomhusvistelse. Det synliggjordes bland annat att den största delen av barnen från naturförskolan uppskattade utomhusvistelse mer i jämförelse med barnen som befann sig i förskoleverksamheten utan specifik inriktning. Turtle m.fl. (2015) för fram att en större mängd vistelse i naturen bidrar till en ökad positiv inställning gentemot utomhusvistelse. Fortsättningsvis framkom det även att barnens fantasiförmåga och samarbetsförmåga, i samband med utomhusvistelsen i förskolan, var lika förekommande bland barnen i naturförskolan som i förskolan utan inriktning.

Bakgrund. En stor och viktig del av den palliativa vården är kommunikation med patienter och dess närstående. Sjuksköterskan finns närvarande runt patienten och dennes familj genom alla vårdinstanser och kan få frågor av olika karaktär i alla möjliga situationer. Svåra samtal kan exempelvis vara existentiella eller prognosrelaterade samt handla om döden. Vård i livets slut sker i varierande utsträckning inom de flesta vårdinstanser. Samtal om och kring döden kan vara känsligt för samtliga deltagare då det berör vår existens på djupet. Syftet med studien var att belysa sjuksköterskors upplevelser av svåra samtal med patienter och närstående inom palliativ vård. Litteraturöversikt var den metod som ansågs bäst svara på syftet genom att undersöka kunskapsläget inom området. Då studien undersöker upplevelser valdes endast kvalitativa artiklar till översikten. Innehållsanalys av resultaten användes för att undersöka likheter och skillnader mellan artiklarna med syftet att belysa sjuksköterskornas upplevelser. En förförståelse kring erfarenhetens påverkan fanns med genom hela studiens gång. Patricia Benners teori Från Novis till Expert ansågs därför lämplig som den teoretiska referensramen. Materialet analyserades även förutsättningslöst för att inte värdefullt material skulle missas. Resultaten visade att sjuksköterskornas förhållningssätt påverkade i hög grad den relation som skapas till patient och närstående och som följaktligen har stor påverkan på upplevelsen av samtalen. Sjuksköterskornas förhållningssätt inom palliativ vård passade väl in på teorin kring personcentrerad vård. Hur sjuksköterskorna berördes av samtalen påverkades i hög grad av tidigare erfarenhet, vilket var den viktigaste faktorn för att sjuksköterskorna skulle uppleva trygghet med att hålla svåra samtal. Osäkerhet lyftes som det största hindret för att en vårdrelation och således svåra men meningsfulla samtal skulle kunna uppstå. Slutsatsen av studien är att ett personcentrerad förhållningssätt behövs för att skapa en vårdande relation mellan sjuksköterska och patient. Äkta närvaro upplevdes viktigare än att ha alla svar. Erfarenhet var det som gav sjuksköterskorna störst trygghet i de svåra situationerna. Med tanke på hur viktigt samtalen är för att bland annat lindra existentiellt lidande är det av största vikt för utbildning och arbetsgivare att förbereda sjuksköterskestudenter respektive nyanställda för att minska osäkerheten i möjligaste mån. Stöd och utbildning för alla som möter patienter med svår sjukdom både inom specialiserad och allmän palliativ vård är av vikt. / Abstract. An important part of palliative care is communication with patients and their families. The nurse is close to the patient and their family wherever healthcare is provided and can receive different types of questions in any situation. Difficult conversations maycontainspiritual distress or concerns related to prognosis and death. End of life care is conducted in varyingextentwithin most places where care is provided. Discussions about death and dying can affect all members participating in the conversation on a deeper level. The aim of the study was to illustrate nurses experiences of difficult conversations with patients and their families in palliative care. The chosen method for the study was a literature review, as it was considered the best way to examine the current knowledge within the area. Since the focus of the study was on experiences, onlyarticles based on a qualitative approachwere included in the review. Content analysis of the results wasused to discover similarities and differences betweenthe articlesto highlight nursesexperiences. The authors had a preunderstanding that work experience would influence the nurses’ experiences and perceptions of difficult conversations. Patricia Benner's theory, From Novice to Expert, was therefore seen as an appropriate theoretical framework for the study. The material was also analyzedwith an open mind with the aim of minimizing the risk of leaving out othervaluable information. The results revealedthat the nurses approach highly affectedthe relationship with the patients and their families and further affected the experience of difficult conversations. The approach used by the nurses in palliative care correspondswell with the theory of person-centered care. How the nurses were affected by the conversations, was highly influenced by previous experience. Previous experience was the main factor enabling the nurses in feeling secure and comfortable enough to take part in difficult conversations. Insecurity was the most common barrier against creating caring relationships and dealing with difficult conversations. The conclusion of this study is that a person-centered care approach is needed to create a caring relationship between nurse and patient. A genuine presence was seen as more important than having all the answers. Previous experience gave most confidence in difficult situations. Considering how important conversations can be to alleviate spiritual distress as well asother difficult issues, it is of great importance for nursing education and employers to be aware of situations affecting nurses. Better preparationby educationand workplaceintroduction is vital forreducing uncertainty. Support and an education for all personnel working with patients in any form of palliative care is of importance.