Background: Multiple Sclerosis (MS) is a chronic degenerative condition. It presents with highly varied physical and psychological symptoms and an unpredictable prognosis, causing difficulties for both professionals and patients. A high prevalence of comorbid psychological symptoms are reported in MS research, yet these may be underreported and underdiagnosed clinically in people with MS. Previous research has taken a dualistic approach, focussing on physical and psychological symptoms separately, resulting in a lack of knowledge on how MS is managed holistically. The aim of this research was to explore the experiences of both people with MS and professionals in the management of physical and psychological symptoms throughout the care pathway for people with MS.Methods: A qualitative approach was used. A systematic review was conducted to investigate existing qualitative literature exploring United Kingdom (UK) health care experiences of people with MS. A qualitative study using semi-structured interviews to explore the experiences of receiving or providing care for people with MS (n =24), general practitioners (n = 13), practice nurses (n = 13) and MS specialist nurses (n = 9). People with MS were purposively sampled from primary care and community settings in North West England. Primary care professionals were purposively sampled from across the North West. Specialist Nurses were purposively sampled from four NHS Foundation Trusts across the North of England. Transcripts formed the data and these were analysed using constant comparison analysis. Once themes had been derived from the data, this data was then interrogated using the concepts of candidacy and recursivity as a theoretical framework (Dixon Woods et al., 2006; Rogers, Hassell & Nicolaas, 1999).Results: Five studies meeting the review criteria were identified from the systematic review. The findings showed that previous UK research had focussed on the beginning (diagnosis) and the end (palliative care) of the care pathway for MS, resulting in a paucity of information regarding experiences of care between these points, for both people with MS and professionals. The subsequent qualitative study addressed this and identified central themes for people with MS: experiences of MS, managing self-care, access to services, interactions with health care professionals and continuity of care. For professionals the central themes identified were: the role of primary care for MS, patient-centred care for MS, access for MS care and management of people with MS. Conclusion: This study provides a unique contribution to the literature on the health care experiences of both people with MS and health care professionals responsible for their care. It has addressed the gaps in knowledge regarding the ongoing health care experiences of people with MS and the holistic management of psychological and physical symptoms. This study showed that candidacy is an appropriate theoretical framework to explain help-seeking and access to health care for MS: use of health services is based on both patient and professionals' interpretation of symptoms, perceptions of services and previous experiences. To improve identification of candidacy there is a need for greater education for patients and professionals on symptoms of MS and information on availability of local services.

The main purpose of the study was to examine the significance of contextual factors from a patient / support person perspective in order to be able to achieve quality experiences in health care for patients with an autism diagnosis. The research study was based on a member survey of the interest group Autism and Asperger's Association, whose questions mainly concerned experiences of contact with health care. From the survey, free text responses from respondents have been processed with a qualitative thematic analysis where the results show that contextual factors such as competence, attitude, accessibility and continuity according to the respondent group can contribute to quality experiences in health care. The results from the analysis also showed a correspondence between these factors and the fundament on which the thesis' theoretical starting point, the theory of person-centered care, rests. This means that tools to meet the needs of autism patients are already available for professionals within the line of health care, but that these probably need to be complied to a greater extent and adapted to a greater extent to this patient group.This research study is relevant for the line of social work because as a professional in this widespread working area you often come across individuals which has an autism spectrum disorder. This may involve work with users and patients in areas such as health care, social psychiatry or social welfare. Regardless of the profession in which professionals meet people with autism, a general knowledge of associated disabilities and the related needs that may arise is needed. / Studien hade som sitt huvudsakliga syfte att ur ett patient/stödpersonsperspektiv undersöka kontextuella faktorers betydelse för att skall kunna uppnå goda vårdupplevelser inom hälso- och sjukvård för patienter med en AST-diagnos. Studien utgick från en medlemsundersökning av intresseorganisationen Autism- ochAsperger förbundet vars frågor främst berörde upplevelser av kontakt med hälso- och sjukvård. Från undersökningen har fritextsvar från respondenter bearbetats med en kvalitativ temaanalys där resultaten visar att kontextuella faktorer som kompetens, bemötande, tillgänglighet och kontinuitet enligt respondentgruppen kan bidra till goda vårdupplevelser. Resultaten från analysen visade även en överenstämmelse mellan dessa faktorer och de fundament som uppsatsens teoretiska utgångspunkt, teorin kring personcentrerad vård vilar på. Detta innebär att verktyg för att tillgodose AST-patienters behov redan finns att tillgå för vården men att dessa troligtvis behöver efterlevas i högre grad och anpassas i högre utsträckning efter den aktuella patientgruppen. Studien är relevant för socialt arbete då man som yrkesutövare inom detta breda yrkesområde ofta kommer i kontakt med individer som diagnostiserats med AST. Det kan handla om arbete med brukare och patienter inom områden som exempelvis hälso- och sjukvård, socialpsykiatri eller biståndshandläggning. Oavsett inom vilken profession som professionella möter personer med AST behövs en generell kunskap om tillhörande funktionsnedsättningar och till dessa kopplade behov som kan uppstå.