I och med att samhället blir mer mångkulturellt möter sjuksköterskan och annan vårdpersonal allt oftare människor med olika etnisk bakgrund. Individer som tillhör en etnisk minoritet riskerar att bli diskriminerade. Ett gott bemötande är viktigt för att uppnå jämlik vård, dock har det visats att vård på lika villkor inte förekommer överallt. En del individer upplever ett sämre bemötande på grund av sin etniska bakgrund. / Since the society is becoming more multicultural, nurses and other healthcare providers more often meet people with different ethical backgrounds. Individuals who is a part of a ethnical minority is at risk to be discriminated against. A good encounter is important to achieve equal healthcare, but it has been proven that equal healthcare does not occur everywhere. Some individuals experience an inferior encounter because of their ethnical background.

This thesis sets out to explore how immigrant women encounter urban green spaces in Istanbul and Stockholm in their everyday lives. Underlying this focus is the importance of urban green spaces’ in providing a sustainable future and a healthy life for all and inequalities in accessing these spaces. Considering a lack of focus on gender and power dynamics in the environmental perception studies and urban green spaces, this thesis inductively explores how women encounter and experience urban green spaces and how power shapes these experiences by adopting a feminist epistemology and methodology through the use of in-depth interviews and qualitative GIS. Using Google Earth as a qualitative GIS method allows for non-verbal expressions to come forward during the interviews and creates a more collaborative and inclusive research process in line with a feminist methodology adopted in this thesis. My findings further contribute to how to practically design inclusive urban green spaces. The findings show that the cultural and gendered constructions of urban green spaces shape how these spaces were experienced by the women participants. The findings also show that body is an important source of knowledge in understanding how women encounter and experience these spaces. Through understanding the role of gender and culture in shaping these spaces and hence the experiences, my findings contribute to scholarship on the accessibility of urban green spaces. How my research participants experience green spaces in the case study locations highlighted the need to understand accessibility beyond physical proximity

The aim of the thesis is to understand how professionals within different needle exchange programs in Sweden describe the surroundings impact of the contact with patients. Further the aim is to understand how the professionals work with their treatment towards the patients within the clinic due to the impact of the surroundings. The method used is a qualitative method, specifically semi-structured interviews with a various group of six informants. The selections are professionals with different professions who have worked within the needle exchange program, chosen by a targeted selection method. With a semi- structured method, the intention is to capture a secondhand view of patients experiences within the healthcare system in general but also within the needle exchange program.  The results are analyzed with previous research and social science theories based on stigma, labeling and systems. Findings show that patients' experiences are influenced by the surroundings such as social and structural perceptions and attitudes. The society's resistance against the needle exchange program affects the trust against authorities such as social services, police and health care systems. Previous wrong experience with different authorities, more specific healthcare does affect the target group to search for help. Other parts that the results show is internalized stigma within the group of people who inject drugs, either by the individual themselves or by others who consume drugs. The results create an insight on how injecting drugs while being a parent or a woman may involve an additional vulnerability. The thesis shows that professionals that work at the needle exchange program consider the structural impact of their patients while encountering them. Finally, the discussion indicates that the workers accepting, and welcoming approach does help the patients to seek help and to evolve trust. By considering a holistic perspective of the patients and working with harm reduction the professionals do create a neutral environment without the risk of getting stigmatized.

Att ta hand om patienter som är aktivt missbrukande är en utmaning. För att bättreförstå de svåra relationer som kan uppstå i mötet mellan patienter som harmissbruksproblem och sjuksköterskan är det viktigt att identifiera dessarelationsproblem. Ett av de stora problemen är misstro till patienter när de har smärta.Syftet med litteraturstudien var att identifiera faktorer som påverkar sjuksköterskan imötet med patienter som har missbruksproblem. Metoden var en allmänlitteraturstudie med åtta vetenskapliga artiklar som analyserades med hjälp av femsteg för analys av kvalitativ forskning. Resultatet presenteras i tre kategorier;sjuksköterskans kompetens, sjuksköterskans kulturella bakgrund och erfarenhet samtsjuksköterskans hjälpmedel. Faktorer som påverkar sjuksköterskan i mötet medpatienter som har missbruksproblem är sjuksköterskans kompetens, kulturellabakgrund och erfarenhet men också vilka hjälpmedel som finns tillgängligt försjuksköterskans omvårdnad. Konklusionen är att när sjuksköterskan visarengagemang och icke-dömande stöd i mötet med patienter som har missbruksproblemkan en god vårdrelation med öppen kommunikation och god smärtlindring uppnås. / Taking care of patients who are actively abusive is a challenge. To better understandthe difficult relationships that can arise in the meeting between patients who havesubstance abuse problems and the nurse, it is important to identify these relationshipproblems. One of major problem is mistrust of the patients when they are in pain. Thepurpose of this literature study was to identify factors that affect the nurse's in theencounter with patientes who have substance abuse problems. The method was ageneral literature study with eight scientific articles that were analyzed using fivesteps for analysis of qualitative research. The results were presented in threecategorie's; the nurse´s competence, the nurse´s cultural background and experienceand the nurse´s aids. Factors that affect the nurse in the meeting with patients whohave substance abuse problems are the nurse´s competence, cultural background andexperience also what aids are available for the nurse’s nursing. The conclusion is thatwhen the nurse shows commitment and non-judgemental support in the meeting withpatients who have substance abuse problems, good care relationship with open communication and good pain relief can be achieved.

Bakgrund: I tidigare forskning beskrivs anhörigas och vårdpersonalens perspektiv i möten på akutmottagningar. För att skapa en vård med hög kvalitét behöver patienters perspektiv också uppmärksammas. Detta eftersom patienten bör vara i fokus i vården som ges. Syfte: Syftet är att skapa en översikt över patienters upplevelser av möten med vårdpersonal på akutmottagningar. Metod: Allmän litteraturöversikt där fem kvalitativa och fem kvantitativa vetenskapliga studier analyserats. Resultat: Patienter upplevde att deras behov inte alltid tillfredsställs i möten med vårdpersonal på akutmottagningar. De upplevde att vårdpersonal brister i sin kommunikation vilket skapar en rädsla för att förlora sin autonomi. Patienter kunde uppleva en tillit till vårdpersonalen om de bemöttes med respekt. Patienter kunde uppskatta att inte vara delaktiga i sin vård om de upplevde en tillit till vårdpersonalens kunskap och kompetens. Slutsats: Det kan konstateras utifrån resultatet att patienters behov inte alltid uppfylls i mötet med vårdpersonalen. När behov som respekt, information, djupare samtal och delaktighet möts skapar det positiva upplevelser för patienter samtidigt som det skapar en förtroendefull vårdande relation mellan vårdpersonalen och patienter på akutmottagningar. / Background: Previous research describes the perspectives of relatives and healthcare staff in encounters at emergency departments. Patients’ perspectives need to be noticed in order to provide the care with high quality. This because the patient should be the focus of the care that is provided. Aim: The aim is to create an overview of patients' experiences of encounters with healthcare staff at the emergency department. Method: General literature review where five qualitative and five quantitative scientific articles are analyzed. Results: Patient experience that healthcare staff lack communication, which creates a fear of the patient losing their autonomy. Patients could experience a trust in the healthcare staff if they treated the patients with respect. Patients could appreciate not being involved in their care if they experienced a trust in the competence of the healthcare staff. Conclusion: It can be stated on the basis of results that patients' needs are not always met in the encounters with the healthcare staff. When needs such as respect, information, deeper conversation and participation in the care are met, it creates positive experiences for patients at the same time as it creates a trusting and caring relationship between the healthcare staff and patients.

Bakgrund   Långvarig smärta är ett folkhälsoproblem med en skadlig påverkan på människors hälsa, funktion och livskvalitet. Behandling av smärta innebär farmakologiska och icke-farmakologiska metoder. Dessa metoder används med fördel i kombination men detta görs inte i tillräckligt stor utsträckning. Den biopsykosociala synen på behandling flyttar fokus från den fysiska smärtlindringen till strategier som ökar individens funktionsförmåga och välbefinnande. Enligt Erikssons omvårdnadsteori är kunskap om lidande, det holistiska synsättet och den hela människan är av stor vikt för patientens upplevelse av gott bemötande i vården.   Syfte   Syftet var att belysa bemötandets betydelse för patienters smärtupplevelser vid långvarig smärta.  Metod  En icke-systematisk litteraturöversikt med 19 valda artiklar har utförts där en integrerad analysmetod använts. Artiklarnas kvalitet har bedömts med hjälp av Sophiahemmet högskolas matris.  Resultat  Resultatet i litteraturöversikten tydde på att patienter upplevde både positivt och negativt bemötande. Patienterna belyste vikten av ett empatiskt bemötande från hälso- och sjukvårdspersonalen, vikten av att bli sedda som hel människa, vikten av att få ta del av information och betydelsen av kompetent hälso- och sjukvårdspersonal. Resultatet kom även fram till vikten av att inte misstro patienternas smärtupplevelser. Ett negativt bemötande resulterade i känslor som frustration, ilska, besvikelse, rädsla och hopplöshet. Ett positivt bemötande korrelerade indirekt med ökad patientnöjdhet.   Slutsats  Resultatet i denna litteraturstudie tyder på att patienter har både negativa och positiva upplevelser av bemötandet i hälso-och sjukvården. Utifrån studiens resultat kan slutsats dras att det fanns en önskan om patientdelaktighet, mer kunnig personal. Patienterna önskade även att bli trodd i sin smärta och önskade en empatisk attityd från hälso- och sjukvårdspersonalen. Resultatet tyder även på att det fanns en korrelation mellan gott bemötande och ökad patientnöjdhet. / Background  Chronic pain is a public health issue with harmful effects on the health of people, their function and quality of life. Pain treatment involves pharmaceutical and non-pharmaceutical methods. These methods are most preferably used in combination but are not used enough. The bio-psychological view on treatment takes away focus from physical pain management to strategies that increase the individuals’ function and wellbeing. According to Eriksson's nursing theory, knowledge of suffering and the holistic approach to the whole being is of importance for the patient's experience of good treatment in care.  Aim  The aim was to enlighten the meaning of the encounter with the health-care professionals for patients with chronic pain and their pain experience.   Method  A non-systematic literature review with 19 selected articles has been performed where an integrated analysis method has been used. The quality of the articles has been assessed with the help of Sophiahemmet University's matrix.  Results  The result of this literature review indicated that patients experienced both positive and negative encounters. The patients highlighted the importance of an empathic encounter from the health-care staff, the importance of being seen as a whole being and the importance of receiving information and having competent health-care professionals. The result also showed the importance of not being distrusted in their pain experience. A negative encounter resulted in feelings such as frustration, anger, fear, hopelessness and disappointment. A positive encounter correlates indirectly with increased patient satisfaction.   Conclusions  The results of this literature study indicate that patients have both negative and positive experiences of the treatment in health care. Based on the results of the study, it can be concluded that there was a desire for patient participation and more knowledgeable staff. Patients described their desire to be believed in their pain and wished for an empathic attitude from health care staff of the patients. The results also implied that there was a correlation between a positive encounter with health professionals and patient satisfaction.

Bakgrund: Endometrios är en kronisk sjukdom som drabbar ungefär var tionde kvinna i fertil ålder. Sjukdomen kännetecknas bland annat av smärtor och infertilitetsproblematik. Tidigare forskning tyder på att det i dagens sjukvård existerar en normalisering av symtom och att det kan finnas viss kunskapsbrist om sjukdomen. Det kan vara så att vårdpersonal behöver ökad kunskap om symtomen och diagnosen för att på ett bättre sätt kunna erbjuda adekvat vård och bemötande till patienter med endometrios.  Syfte: Syftet var att belysa hur kvinnor som givits diagnosen endometrios upplever mötet med hälso- och sjukvården.  Metod: Litteraturöversikt med beskrivande design, baserad på tio kvalitativa originalartiklar. De inkluderade artiklarna analyserades genom kodning som sedan kondenserades till kategorier och teman.  Resultat: Studien visar att kvinnor upplever brister i informationen och kommunikationen i sina möten med vården. Kvinnor menar att vårdpersonal normaliserar symtomen och att det finns en kunskapsbrist om endometrios. Vårdpersonalens attityder till sjukdomen påverkar kvinnornas upplevda stöd från sjukvården.  Slutsats: Resultaten belyser en kunskapsbrist, en normalisering av symtom och brister i kommunikation och informationsutbyte mellan endometriospatienter och vårdpersonal. Det finns en förbättringspotential i dessa vårdmöten. Dels för hur vårdpersonal bör bemöta, dels hjälpa kvinnor som söker vård för endometrios. För att skapa en bra grund för förbättrad utbildning om vårdmöten med endometriospatienter, krävs ytterligare forskning om sjukdomens symtombild. / Background: Endometriosis is a chronic disease that approximately affects every tenth woman of fertile age. The disease is characterized by, among other things, pain and infertility problems. Previous research indicates that in today's healthcare there is a normalization of symptoms and that there may be some lack of knowledge about the disease. It may be that healthcare professionals need increased knowledge of the symptoms and diagnosis in order to be able to provide accurate care and encounter to patients with endometriosis in a better way.  Aim: The aim of this study was to investigate how women diagnosed with endometriosis experience the encounter with healthcare.  Method: Literature review with descriptive design, based on ten original articles that was of qualitative design. The included articles were analyzed by coding which was then condensed into categories and themes.  Results: This study showed that women experienced deficiency in information and communication in the encounter with healthcare. Women experienced that healthcare personnel normalized the symptoms and that there was a lack of knowledge about endometriosis. The attitudes to the disease from the healthcare personnel affected the women's perceived support from the healthcare system.  Conclusion: The results highlight both a lack of knowledge but also a normalization of symptoms and deficiencies in communication and exchange of information between endometriosis patients and healthcare personnel. There is a potential for improvement in how healthcare professionals should respond to and help women seeking care for endometriosis. More research and education in the field is required to improve future care encounters.

Bakgrund: Litteraturgenomgången visar att samhället genomsyras av heteronormativitet. Kunskapsbrister finns i utbildningarna inom sjukvården och i den kliniska verksamheten om möten med HBTQ- personer. En kunskapslucka kan identifieras om hur möten skapas mellan sjuksköterskor och HBTQ- personer på en akutmottagning. Syfte: Studiens syfte var att beskriva hur legitimerade sjuksköterskor på en akutmottagning möter HBTQ- personer. Metod: Deskriptiv empirisk studie med kvalitativ ansats, interaktiva samtalsintervjuer med sex legitimerade sjuksköterskor genomfördes och analyserades med modifierad innehållsanalys, editing analysis style. Resultat: Ur analysen utkristalliserades fyra kategorier: spirande genuserfarenhet, en krävande men öppen arbetsmiljö, tvetydig relation och god och värdig vård. Slutsats: Analysfynden från interaktiva samtalsintervjuer med sex legitimerade sjuksköterskor på en akutmottagning förklarades med begrepp ur queerteorin. Trots att den spirande genuserfarenheten hämmas av den förhärskande heteronormativiteten och kunskapsbristen om kön, genus och sexualitet bidrar till tvetydigheten hos sjuksköterskorna på akutmottagningen, skapas det, även under rådande förutsättningar, möten inom vilka HBTQ- personer ges en god och värdig vård. / Background: The literature review shows that society is permeated by heteronormativity. Knowledge gaps in education programs in health care and in clinical practice concerning encounters with LGBTQ people. A knowledge gap can be identified on how encounters are created between nurses and LGBTQ people in an emergency department. Aim: The aim of this study was to describe how registered nurses in a hospital emergency department encounter LGBTQ- people. Method: Descriptive empirical study with qualitative approach, interactive conversation interviews with six registered nurses was conducted and analyzed with modified content analysis, editing analysis style. Results: From the analysis emerged four categories: emerging gender experience, a demanding but open work environment, the ambivalent pair and good and dignified care. Conclusion: The findings from interactive conversation interviews with six registered nurses in an emergency department were explained with concepts of queer theory. Despite the emerging gender experience is hampered by the dominant heteronormativity and lack of knowledge concerning sex, gender and sexuality contributes to the ambiguity of the nurses in the emergency department, even under present conditions, encounters are created with LGBTQ people, in which they are given a good and dignified care.

Bakgrund: Vårdpersonal behöver kunskap och förståelse för vårdtagarens livsvärld för att kunna ge ett gott bemötande. En aspekt av en människas livsvärld är dennes sexuella läggning. Idag är diskriminering på grund sexuell läggning olagligt i Sverige. Upprätthållandet av detta försvåras dock av att heterosexualitet är den rådande normen vilket leder till att homosexualitet utgör ett normbrott. Dessa normer föreligger även inom hälso- och sjukvården. Syfte: Studiens syfte var att beskriva homosexuella vårdtagares upplevelse av bemötande från vårdpersonal inom hälso- och sjukvården. Metod: En litteraturstudie genomfördes baserad på tio kvalitativa studier. Resultat: Resultatet visade på att vårdpersonal brister i sitt bemötande av homosexuella vårdtagare. Bemötandet av de homosexuella vårdtagarna var heteronormativt. Vårdtagarna kände sig inte sedda som de personer de är samt upplevde att vårdpersonalen saknade kunskap om homosexuellas hälsosituation och livsvärld. Det upplevdes som ett risktagande att delge vårdpersonalen sin sexuella läggning. Slutsats: Heteronormen påverkade vårdgivarens syn på homosexuella vårdtagare. Vårdtagare antogs vara heterosexuella och kände sig därför osynliggjorda och marginaliserade. För att kunna skapa förutsättningar för ett fullgott bemötande behövs ökad kunskap och medvetenhet inom vården. / Background: In encountering patients, an understanding of the patients world view is necessary for the health care professional to provide good care. A basic aspect of a person‟s view of the world is sexual orientation. Discrimination based on sexuality is illegal in Sweden. The maintenance of this law is obstructed by the fact that heterosexuality is the current norm leading to homosexuality being in violation of this norm. These norms are also present in the health care system. Aim: The aim of this study was to describe homosexual patients‟ experience of encounters with health care professionals. Method: This literature study was based on ten qualitative studies. Results: Findings showed that patients experienced that the health care professionals were inadequate in their treatment of homosexual patients. Patients felt that they weren‟t seen and treated as their true self, the treatment was heteronormative and health care professionals lacked specific knowledge of their situation. It was expressed that to disclose their sexual orientation was perceived as a risk. Conclusion: Homosexual patients felt that heteronormativity influenced health professionals and how they perceived the patients. Patients were assumed to be heterosexual and therefore felt invisible and marginalized.

The climate at the emergency room is stressful and the staff is under high pressure. Communication between staff and patients is suffering from this and the number of complaints about communication has increased in Sweden. Patients want to be seen as human beings, taken seriously and given attention. There are several factors that can affect the encounter. The purpose of this literature review is to describe the patient's experience of the encounter with the care staff at a visit to the emergency room.  Literature review based on 14 qualitative articles with descriptive design that’s been published between 1999-2019. The databases PubMed and CINAHL were used in the data collection. Joyce Travelbee's nursing theory formed the theoretical framework of the literature review.  Three categories were identified: The first encounter, information and communication, and vulnerable patient groups. The majority of patients feel that a good response includes active listening, good eye contact, respect for privacy and integrity as well as a common respect between patient and staff. A distinct difference between patients´ experience before and after the triage as identified and several felt lonely and forgotten while waiting for help.  Several factors that would improve patients' experience of the encounter at the emergency room were identified. However, there are difficulties in implementing these because the staffs´ situation is stressed and many show signs of burnout, leading to impaired treatment of patients. More research on the subject is needed to be able to draw stronger conclusions.