Bakgrund Förutfattade meningar mot vårdpersonal är ett fenomen inom vården, särskilt mot manliga sjuksköterskor, som är en minoritet inom sjuksköterskeyrket. Tidigare forskning har fokuserat på specifika problemsituationer som uppstår i yrket för manliga sjuksköterskor, samhällets syn på manliga sjuksköterskor och att manliga sjuksköterskor priviligierats i arbetsgruppen. I litteraturen nämns ofta olika förutfattade meningar om manliga sjuksköterskor, trots att det saknas forskning med fokus på manliga sjuksköterskors egna upplevelser av förutfattade meningar mot dem. Syfte Syftet med studien är att belysa vilka förutfattade meningar som manliga sjuksköterskor upplever finns mot dem. Metod Litteraturstudie i form av en beskrivande metasyntes. Resultat Manliga sjuksköterskor upplever flera förutfattade meningar som presenteras i fyra teman: “accepteras inte som sjuksköterskor”, “muskler, lyfthjälp och tekniskkompetens”, “antas vara homosexuella” och “antas ha sexuella avsikter motpatienter”. Slutsats Upplevda förutfattade meningar kan påverka manliga sjuksköterskors syn på sig själv och yrkesrollen samt patientmötet och omvårdnaden. Dessa förutfattade meningar kan skapa konflikter och missnöje på arbetsplatsen vilket kan störa patientmötet och vårdrelationen. Klinisk Betydelse Genom att belysa förutfattade meningar som manliga sjuksköterskor upplever kan åtgärder vidtas för att motverka dem som påverkar vårdarbetet negativt. / Background Preconceptions against health care workers is a phenomenon in health care, especially against male nurses, who are a minority within the nursing profession. Previous research has focused on specific problematic situations that arise in the profession for male nurses, society's view of male nurses and the fact that male nurses are privileged in the workgroup. Literature often mentions various preconceptions about male nurses, despite the lack of research focusing on male nurses' own experiences of prejudice against them. Purpose The purpose of this study is to shed light on the preconceptions that male nurses are experiences towards themselves. Method Literature review in the form of a descriptive meta-synthesis. Results Male nurses experience several preconceptions which are presented in four key concepts: "not accepted as nurses", "muscles, lift assistance and technical skills", "are assumed to be gay" and "are assumed to have sexual intentions towards patients". Conclusion Experienced preconceptions can affect male nurses' view of themselves and the professional role, meeting the patient and nursing care. These preconceptions can create conflicts and grievances in the workplace which can disrupt the nurse-patient relationship. Clinical Significance By shedding light on the preconceptions that male nurses are experiencing measures can be taken to reduce the ones that affect nursing work negatively.

Bakgrund: Att beröra någon annan ger känslor och känslouttryck hos både individen som utför handlingen och mottagaren. Mellanmänsklig beröring är ett uttryck för kärlek eller tillgivenhet inom familjer och även i andra miljöer. I kliniska sammanhang är beröring viktigt p.g.a. den lugnande effekt och emotionella påverkan som sker. Att lägga handen på någon som lider kan skapa trygghet. Inom omvårdnad är beröring det viktigaste av alla icke-verbala beteenden. Beröring lugnar, tryggar, ger värme och stimulerar patienten. Syfte: Syftet med denna studie var att beskriva patienters och sjuksköterskors erfarenheter av expressiv beröring. Metod: Litteraturöversikt innehållande 10 vetenskapliga artiklar varav nio kvalitativa och en kvantitativ. Artiklar söktes i databaserna CINAHL, MEDLINE samt manuell sökning i Google scholar. Resultat: Beröring var ett centralt behov för patienter. Vid beröring kände de sig sedda som individer. Sjuksköterskorna hade ett behov av att beröra patienter och att bli berörda. Sjuksköterskor använde beröring för att anknyta emotionellt. Sjuksköterskor och patienter hade behov av att beröra och att bli berörda på ett sätt som passade dem och beröringen gjorde att patienterna och sjuksköterskorna fick en samhörighet på ett djupare existentiellt plan. Det fanns skillnader i hur kvinnor och män uppfattade beröring. En god relation var avgörande för hur beröringen uppfattades. Slutsats: Sjuksköterskorna ser expressiv beröring som något positivt medan patienternas uppfattningar varierar stort. Relationen med sjuksköterskan som utför beröringen är avgörande för hur beröringen uppfattas. Detta visar på nödvändigheten i att stämma av med patienten vid fysisk kontakt och att anpassa beröringen individuellt. Klinisk betydelse: Att vara medveten om hur beröring används gör att sjuksköterskor kan skapa goda vårdrelationer från första ögonblicket och snabbt undvika missförstånd. / Background: Touching provides emotional expression to both parties involved. Human touch is an expression of love or affection within families and other environments. Expressive touch in a clinical context is important due to its calming and emotional effect. Laying a hand on a suffering individual can provide comfort. Touch is the most important non-verbal behavior in caring. Touching calms comforts and stimulates the patient. Aim: The aim of the study was to describe patient´s and nurse´s experiences of expressive touch. Method: A literature review of 10 scientific articles consisting of nine was qualitative and one was quantitative. Articles were found using the databases CINAHL, MEDLINE and manually searched in Google scholar. Result: Touch was a central need for patients. When they were touched, they felt that they were seen as individuals. Nurses also had the need to touch and to be touched by the patients. Nurses used touch to connect emotionally with patients. The touch made nurse´s and patient´s feel solidarity on a deeper existential level. There was a difference in perceptions of touch between men and women. A good nurse patient relationship was crucial to how the touch was perceived. Conclusion: The nurses see expressive touch as something positive whilst the patient's perceptions vary. The nurse patient relationship is crucial to how the touch is perceived. This shows the necessity of checking with the patient while engaging in physical contact and to adapt the touch to the individual. Clinical significance: Being aware of how expressive touch should be used enables nurses to establish good nurse patient relationships and quickly avoid misinterpretations.

護理專業對護病關係義涵的建構承襲南丁格爾時代的護理典範，以及Hildegard E. Peplau 的<護理的人際關係>，將護理的功能位置定義在理解與協助病患的需求，因此護病關係實屬<療癒性>的人際關係。 護士在不容質疑的護理價值中形構自己的護士角色，那是不自覺與缺乏自我省察的護病關係。事實上，護病關係是不對等關係，專業化的助人功能與角色本身蘊含權力關係的互動。本研究參照傅柯的觀點，對權力的體認其實大部分是正面或構成面；傅柯本身並不斥責權力的社會關係，權力的正面效應是構成與塑造人類生活的運作機制，而真理也是人類建構與塑造而成為實際人類生活的「真理」。護士身為照顧者必須提供助人的角色，但是自己也是醫療技術宰制的受困者，面對病患的需求召喚，護士如何承擔被他者喚起的主體，而自我情緒察覺是啟動自身照顧倫理的動能。 人的知識建構與變化受到體制一連串新的權力技術的演變所控制，病房常態的護理活動是受到醫療制度與社會文化的歷史因素的影響。台灣醫療生態在經濟與效用的實務趨向中，護病關係的事實內涵產生形變與爭議。而護士在照護決策中的權力運作展現，同時也承受臨床機構影響護士照護工作的權力因素。 本研究以批判民俗誌的知識論與方法學進行臨床護病關係現象的田野觀察，揭露臨床結構所習以為常且不自覺的權力關係中，以及護士的面對這權力現象的認同政治。研究場域為精神專科療養院的急性病房，進行近半年時期間斷的護理現場觀察，並訪談15位病房護士，透過敘述訪談對話歷程，協助護士自我察覺在護病關係中的權力互動與消長。發現從醫療專業、醫療空間與病房管理等架構脈絡，理解護士被賦予理所當然的權力地位；闡述醫療生態受到健保制度、機構評鑑與精神衛生法等脈絡影響，護病關係也走向經濟成本與價值效率的考驗；從對病患主體的關懷，轉向為配合醫療體制的經濟價值互動，因此病患主體的照護已經被現有體制邊緣化。 本研究的結果企圖啟動護士反思護病關係的質變化與工具化，護士的自覺可以實踐與再構以人文關懷為主的護病關係，並提供給學校護理教育在實務訓練的參照教材。 / Nurse-patient relationship in nursing takes on Florence Nightingale age , as well as Hildegard E. Peplau’s therapeutic relationship, defines the function of care in understanding and contributing to the patient's needs. Nurses in the nursing care of unquestionable value formulation in their nursing role; it is not self-consciousness and lack of self-examination of nurse-patient relations. In fact, the nurse-patient relationship is unequal relationship, as professional help functionality roles and power relations embedded interaction This study based on Foucault's power and knowledge view, recognition of power largely positive composition; Foucault does not rebuke the social relations of power, power is the positive effect of composition and operation mechanism of shaping human lives, and truth is the construction and shaping of mankind became the actual human life "truth". Nurse role as helper must be provided need for patient, but medical institute dominate self of nurse, then face to patients’ needs calling, nurses how to assume he associated with herself subject, and emotions awareness is self-care for nurse. Construction and changes of human knowledge are controlled by the institutional evolution of a series of new power technologies, Ward nursing routine and activity are under the influence of medical systems and factors of socio-cultural history. Taiwan medical ecology trends of eco-economy and effectiveness, nurse-patient relations is deformation and disputes. Power of nurses is in care decisions making, but also is coercion under the factors of clinical institutions. This research with epistemology and methodology of critical ethnography, observed nurse-patient relations of nursing field, discovered habit and unconsciously power of NPR, and identified politics for power relationship. Research field of mental acute ward of Psychiatry, observation and collection on the half-year, and interviewed 15-Ward nurse, through narrative interviews with dialogue process to help nurse self-awareness flowing power of nurse-patient relations. The outcomes are to be owned power of NPR from the medical profession, medical space and ward management routines.；and elaborated that medical ecology was challenged by health insurance system, the evaluation of medical and mental health law , nurse-patient relationship to economic cost and value efficiency tests; From the subjects care of patient turn to tie in with the economic value of health care system interactions, the subject of patient care has been marginalization of existing institutions. The results of the research attempts to start reflection on nursing quality for variation and tools of nurse-patient relations, the consciousness of power in NPR and active humanistic concern nurse-patient relations, and made available to schools of nursing education in the practical training of reference materials.

ABSTRACT Notions of quality of life dictate philosophies and policies for services for people with developmental disabilities. There is an abundance of research on quality of life, much of which has influenced the significant amount of study of quality of life for people with developmental disabilities. According to specialist developmental disability nurses, however, this research has little meaning for one group of people with developmental disabilities with whom they work - people with severe multiple impairments. Nevertheless, judgements and decisions about the lives of this group continue to be driven by the idea of quality of life. While the literature review found that researchers are urged to seek the perceptions of people regarding their own quality of life by asking them, some authors have noted the difficulty in pursuing such a method with people, such as people with severe multiple impairments, who are unable to communicate in the usual ways. Given, then, that it is difficult to directly determine the views of people with severe multiple impairments, this study sought the perceptions of nurses about the quality of life of the people with whom they work. In order to discover and conceptualise nurses' views, a symbolic interaction perspective was chosen to guide this study and data were analysed using the grounded theory approach. The study was conducted in two stages. Stage One consisted of semi-structured indepth interviews with expert nurses to explore their perceptions of quality of life for the people with whom they worked. A significant finding in these interviews was that perceptions of quality of life are mediated by interaction. Consequently, Stage Two involved a participant observation study in which the interactions of nurses and people with severe multiple impairments were examined. Specialist developmental disability nurses have a unique view of quality of life for people with severe multiple impairments. They refer to it as 'just little things', a phrase which masks complex nursing knowledge and skills, and which can be described by four interrelated categories which emerged from the data: humans being, supporting, becoming intimate, and situated belonging. As nurses become more intimate with individuals, they perceive that people with severe multiple impairments are humans being as they wish, and that quality resides in supporting their everyday lives in a context of situated belonging. This thesis represents a new conceptualisation of quality of life for people with severe multiple impairments, a conceptualisation which may have significance for other groups and, indeed, for the whole quality of life enterprise. This conceptualisation draws on knowledge not usually related to quality of life, that is, knowledge of the body, of the emotions, of identity and of humanness. Such findings demonstrate the power of an interpretive approach in explicating the meanings nurses have regarding quality of life. Further, these findings have implications for how the question of quality of life is approached, for how different ways of thinking about people impact on quality of life, and for the importance of the life in quality of life.

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