Bakgrund: Individer med narkotikamissbruk tillhör en stigmatiserad grupp som löper stor risk att drabbas av ohälsa och därför kan förväntas ha mycket kontakt med hälso- och sjukvården. Studier har visat att sjuksköterskor har negativa attityder och försämrat bemötande gentemot denna grupp. Syfte: Syftet var att beskriva vilka upplevelser personer med aktivt eller tidigare narkotikamissbruk haft av bemötande från sjuksköterskor och annan vårdpersonal samt deras inställning till hälso- och sjukvård. Metod: En intervjustudie med kvalitativ ansats genomfördes. Resultat: Analysen av intervjuerna resulterade i fyra teman: Stigmatiserande bemötande, Motarbetande bemötande, Attityder till hälso- och sjukvården och Mänskligt bemötande är gott bemötande. Slutsatser: Deltagarna i den här studien har inom hälso- och sjukvården upplevt negativt bemötande kopplat till deras aktiva eller tidigare missbruksproblematik. Negativt bemötande mot en utsatt grupp kan leda till förstärkt utanförskap, känslor av maktlöshet och ökad risk för ohälsa. Med ökad kunskap kan sjuksköterskan ge bättre bemötande vilket skulle kunna ha hälsofrämjande effekt. Implikationer: Mer specifikt utbildningsinnehåll om beroende och narkotikamissbruk behövs både på grundutbildningen och som fortbildning för redan verksamma sjuksköterskor för att denna patientgrupp ska få ett bättre bemötande. / Background: Individuals with drug abuse belong to a stigmatized group at high risk of ill-health and can therefore be expected to be in much contact with health care. Studies have shown that nurses have negative attitudes and deficient encounter towards this group. Aim: The aim was to describe what experiences persons with present or former drug abuse has had regarding encounters with nurses and other health care personnel and also their attitude regarding health care. Method: An interview study with a qualitative approach was conducted. Result: The analysis of the interviews resulted in four themes: Stigmatizing encounters, Opposing encounters, Attitudes regarding health care and Humanly encounters are good encounters. Conclusions: The participants in this study have experienced negative encounters in health care related to their present or former drug abuse. Negative encounters towards an exposed group can lead to strengthened exclusion, feelings of powerlessness and increased risk of illness. With enhanced knowledge, the nurse can provide better encounters which could have a health promoting effect. Implications: More specific education about addiction and drug abuse is needed both in the undergraduate program and as further training for practicing nurses in order to give this patient group a better encounter.

Bakgrund Missbrukssyndrom är vanligt förekommande i samhället och innebär en skadlig användning av olika substanser t.ex. alkohol och droger. Användningen pågår trots negativa konsekvenser för personens livssituation och ökar risken för en instabil hälsa. Vilket leder till ett ökat behov av hälso- och sjukvård. Forskning har visat att personer med missbrukssyndrom upplevde utanförskap, stigmatisering och skam vid kontakt med sjukvården.  Syftet Att beskriva sjuksköterskors upplevelser av att möta personer med missbrukssyndrom och sjuksköterskans attityder i vårdmötet, samt att beskriva inkluderade artiklars undersökningsgrupper.  Metod En beskrivande litteraturstudie. Tio artiklar inkluderandes i resultatet. Artikelsökning gjordes i databaserna PubMed och Cinahl. Diskussion fördes mellan författarna för att sammanställa ett objektivt resultat.   Huvudresultat Sjuksköterskor hade skilda meningar om missbrukssyndrom var en sjukdom. Personer med missbrukssyndrom ansågs som oansvariga över sitt hälsotillstånd enligt sjuksköterskor. Sjuksköterskorna beskrev hur de upplevde patientgruppen som oberäknelig och manipulativ samt att den orsakade ökad arbetsbelastning. Vidare uppkom en känsla av frustration över den egna misstron och osäkerheten kring patientgruppen. Önskemål om utbildning uttrycktes. Enligt sjuksköterskorna var tålmodighet och att vara stödjande viktiga delar i vårdandet samt att inte spegla det egna tyckandet.   Slutsatser Beroende på om sjuksköterskor såg missbrukssyndromet som ett sjukdomstillstånd eller som självförvållat, framkom positiva eller negativa attityder och upplevelser. Kunskap och utbildning inom missbrukssyndrom behövs för att upprätthålla ett etiskt förhållningssätt i sjuksköterskans profession. / Background Substance-use disorder is common in society and involves harmful use of different substances, for example. alcohol and drugs. The use is in progress despite adverse consequences for the person's life situation and increases the risk of unstable health. Which leads to an increased need for healthcare. Research has shown that people with substance-use disorder experience exclusion, stigma and shame in contact with healthcare   Aim To describe nursing experience of meeting people with substance-use disorder and the nurse's attitudes in the healthcare meeting, as well as describing the survey articles of the included articles.   Method A descriptive literature study. Ten items are included in the result. Article search was made in the PubMed and Cinahl databases. Discussion was conducted between the authors to compile an objective result.   Results Nurses had different opinions about if substance-use disorder were a disease or not. Persons with substance-use disorder were considered irresponsible for their health status according to nurses. Nurses described how they experienced the patient group as erratic and manipulative and that caused increased workload. Furthermore, a sense of frustration arose over their own missile and the uncertainty surrounding the patient group. Requests for education were expressed. According to the nurses, patience and support were important parts of care and to not reflect their own opinion.   Conclusion Depending on whether nurses saw the substance-use disorder as a state of illness or as self-inflicted, positive or negative attitudes and experiences have emerged. Knowledge and education in substance-use disorder is necessary to maintain an ethical approach within the nurse's profession.

Durante minha trajetória profissional experenciando o cuidar de clientes portadores de doença onco-hematológica percebi a luta destes seres humanos pela vida e como a relação enfermeiro-cliente era vital para a realização do cuidado. O enfermeiro interage grande parte do tempo com esta clientela a qual percorre uma trajetória de re-internações e longos períodos de tratamento. Nesse sentido, entendendo que a relação interpessoal como uma condição importante para que o enfermeiro compreenda o outro em sua totalidade e preste um cuidado singular, delimitei como objeto de estudo as relações interpessoais do enfermeiro na ação de cuidar do cliente internado para tratamento onco-hematológico. Para tanto, o objetivo foi compreender o significado das relações interpessoais na ação de cuidar do enfermeiro junto ao cliente internado para tratamento onco-hematlógico. Trata-se de estudo de natureza qualitativa, cujo referencial teórico pautou-se nas concepções da fenomenologia sociológica de Alfred Schutz. O cenário de realização do estudo foi a enfermaria de Hematologia de um Hospital Universitário Federal do estado do Rio de Janeiro e os sujeitos foram todos os seis enfermeiros lotados nessa unidade. Antes da etapa de campo e em cumprimento aos princípios éticos da Resolução 196/96 do CNS que trata da pesquisa com seres humanos, o projeto foi submetido ao Comitê de Ética dessa instituição cenário do estudo, sendo aprovado com o Parecer n 092/11. A captação das falas deu-se por meio de entrevista com a utilização das seguintes questões orientadoras: fale para mim sobre as ações que você desenvolve junto ao cliente internado para tratamento onco-hematológico; o que significam as relações interpessoais na ação de cuidar do cliente internado para tratamento onco-hematológico?; e o que você faz para que esta relação aconteça? A análise compreensiva das falas possibilitou a apreensão das categorias: cuidar através de procedimentos técnicos e científicos, orientando para o enfrentamento da doença e atender o paciente na perspectiva de suas necessidades estabelecendo a relação interpessoal entre enfermeiro e o cliente. O enfermeiro descreve as ações desenvolvidas junto ao cliente em tratamento onco-hematológico como um fazer técnico, rico em procedimentos, que tem em vista apoiar o cliente para enfrentar o tratamento difícil de uma doença grave, a partir de suas necessidades, estabelecendo uma relação íntima, transparente e forte, ocorrendo de forma espontânea e natural. Para estabelecer esta relação os enfermeiros utilizam estratégias como: a empatia, a brincadeira, o carinho, a confiança e a disponibilidade para promover o cuidado de enfermagem. As relações interpessoais se mostraram inerentes à ação de cuidar desse enfermeiro, ator social da equipe de saúde, o qual possui a disponibilidade para interagir com o cliente, transcendendo o aspecto tecnicista, fazendo parte de sua identidade profissional o constituinte relacional. / During my professional trajectory experiencing the take care of the clients with onco-hematological disease, I perceived the fight of these human beings for the life and how the nurse-client relationship was vital for the care realization. The nurse interacts much of the time with this clientele which comes a way of re-hospitalizations and long ways of treatment. In this sense, understanding that the interpersonal relation be an important condition so that the nurse understand the other in its totality and take a singular care I delineated as study object the nurse s interpersonal relations in the action of take care of the client hospitalized for onco-hematological treatment. For such, the objective was to understand the meaning of the interpersonal relationship in the action of take care of the nurse with the hospitalized client for onco-hematological treatment. It treats of study of qualitative nature, which theoretical reference based on the conceptions of the sociological phenomenology of Alfred Schütz. The Scenario of the study realization was the nursery of Hematology of a Federal University Hospital of the Rio de Janeiro state and the subjects were all the six (06), nurses placed in this unit. Before the field step and in compliance with the ethical principles of the 196/96 Resolution of the CNS that treats of the research with human beings, the project was submitted to the Ethical Committee of this institution scenario of this study, being approved with the Opinion n. 092/11. The speeches capture occurred by means of interview with the utilization of the following guiding questions: Talk to me about the actions that you develop with the hospitalized client for onco-hematological treatment. What means the interpersonal relationships in the action of take care of the hospitalized client for onco-hematological treatment? What do you do so that this relationship occurs? The comprehensive analysis of the speeches made possible the categories apprehension: To take care through technical and scientific procedures guiding to the confronting of the disease and Attend the patient in the perspective of its needs establishing the interpersonal relationship between nurse and the client. The nurse describes the actions developed with the client in onco-hematological treatment as a technical making, rich in procedures that have in view to support the client to confront the hard treatment of a serious disease, from its needs, establishing a close, transparent and strong relationship occurring in a spontaneous and natural way. To establish this relationship the nurses use strategies like: the empathy, the joke, the confidence, the availability to promote the care of nursing. The interpersonal relationships showed inherent to the action of take care of this nurse, social actor of the health team, which has the possibility to interact with the client, transcending the technicality aspect, being part of its professional identity the relational constituent.

Språkliga hinder kan vara en utmaning för sjuksköterskor i mötet med patienter som talar ett annat språk än svenska. Vårdrelationen kan bli lidande på grund av språkliga hinder och sjuksköterskor får det svårare att vårda patienterna utifrån deras unika behov. Att vårdrelationen blir lidande kan vara förödande för patienten då vårdrelationen mellan sjuksköterska och patient är av avgörande betydelse för en patients hälsoprocesser. Syftet var att beskriva sjuksköterskors erfarenheter och upplevelser av möten med patienter som talar ett annat språk än svenska. Examensarbetet är en litteraturstudie som grundar sig på elva vetenskapliga studier som beskriver sjuksköterskors upplevelse av språkliga hinder i vården. Resultatet visar att sjuksköterskors erfarenheter är att det kan vara svårare att skapa en god vårdrelation med patienter som inte talar samma språk som sjuksköterskan själv gör. Dessa språkliga hinder gör att patienterna inte kan uttrycka sina behov och sjuksköterskor får svårt med att göra adekvata bedömningar av patientens hälsa. Därmed anses denna patientgrupp vara svårare att vårda. Språkliga hinder kan upplevas som en barriär mellan sjuksköterska och patient och därmed blir det svårare att bygga en vårdrelation tillsammans. Patienters hälsoprocesser beror till stor del på vårdrelationen och att kunna uttrycka sina behov. Tolkanvändning i vården är däremot ett bra exempel på hjälpmedel som kan göra att vårdrelationen kan byggas trots språkliga hinder. Icke-verbala kommunikationsuttryck har också visat sig fungera bra för att göra det möjligt för sjuksköterskan att ge den vård som varje patienten har rätt till, trots språkliga hinder dessa emellan.

The thesis is focused on the comparison of the differences in nursing the clients who went through the operation of legs´ varicose veins. Specifically, the nursing after an ambulatory Sumery made with a laser and the nursing after a conventional surgary with subsequent hospitalization were compared. The research was also aimed at the communication and the education of the nurses which are considered as an inherent part of the nursing. The results of the study show that the transfer of information, education and the communication in general are crucial in nursing and require an individual approach to the client.

O nascimento de um bebê malformado, especialmente, quando a aparência é defigurada, provoca um impacto nos profissionais que prestam atendimento ao recémnascido, imediatamente, após o nascimento, repercutindo na qualidade da assistência prestada. Este estudo foi motivado pela inquietação da pesquisadora procurar compreender as ações e reações dos enfermeiros quando assistem o nascimento de recém-nascidos com malformação desfigurante no contexto da sala de parto. O estudo teve como objetivo: compreender a experiência dos enfermeiros que assistem o nascimento de um recém-nascido com malformação desfigurante. Optou-se por realizar uma pesquisa com abordagem qualitativa, estudo de caso coletivo, e os dados foram analisados à luz do referencial teórico do Interacionismo Simbólico. A coleta de dados ocorreu por meio de entrevista semi-estruturada com enfermeiros que atuam no centro obstétrico de um Hospital Municipal, situado na zona sul da cidade de São Paulo. As entrevistas foram gravadas em fita cassete, posteriormente, transcritas em sua íntegra e analisadas. A análise dos dados permitiu identificar categorias conceituais que compuseram os dois temas: Compartilhando com a equipe médica a assistência ao recém-nascido e Assumindo a responsabilidade da assistência ao binômio mãe-recém-nascido. Os resultados do estudo salientaram a dificuldade enfrentada pelo enfermeiro na assistência do nascimento de um bebê malformado em decorrência do despreparo na formação profissional, relacionada ao processo de comunicação enfermeiro-paciente e dificuldade de lidar com as próprias emoções / The birth of a malformed child, specially when the malformation affects the baby appearance, provokes impact on caregivers who attend the baby immediately after childbirth and on quality of attendance. This study was motivated by the necessity of understanding the performance of nurses when they attend babies with visible congenital malformation. The aim of this study was to understand the nurse`s experience for attending babies with visible congenital disfigurement in the context of delivery room. The qualitative methodological approach used in this study was the Collective Case Study and to analyse data it was used the Symbolic Interactionism theoretical framework. The sample was composed by ten nurses that work at the birth center of a public hospital located in the south district of São Paulo city. Data was obtained by interview that was recorded, transcripted and analysed. From data analysis categories emerged that composed two themes: Sharing the newborn care with medical staff and Assuming the responsibility of the mother-infant care. The results point out the difficulties faced by the nurses when they need to take care of the babies who have visible congenital disfigurement due to their unprepared formation related to the nurse-patient relationship and the difficulties to deal with their emotions

Background: Since the beginning of the epidemic, more than 70 million people have been infected with Human Immunodeficiency Virus (HIV) and the disease continues to be a public health issue all around the world. There are around 42.000 people in the Philippines living with HIV and therefor the nurses and other health care personal play a key part of the persons lives when undergoing treatments. Aim: The aim of this study was to describe Philippine nurses’ experiences of caring for patients with HIV. Method: A qualitative method was used and data was collected through semi structured interviews with five Philippine nurses at a hospital in Baguio. The interviews were analyzed with qualitative content analysis. Results: The findings resulted in two main themes. The first theme, Nurse patient relationship, shows that a nurse patient relationship is important when caring for HIV patients, including getting to know the patient, the importance of trust and giving person centered care. Factors that may be obstacles in the process of building a relationship is also included in this theme. The second theme, Important aspects of caring, including factors such as having conversations, listening and supporting the patient. Discussion: The main findings were discussed in relation to the literature and Travelbee’s human to human theory. The main focus in the discussion was the nurse and patient relationship and important aspects of caring for HIV patients. / Bakgrund: Mer än 70 miljoner personer har drabbats av Humant immunbristvirus (HIV) sedan epidemin startade och sjukdomen är idag fortfarande ett globalt hälsoproblem. I Filippinerna lever cirka 42 tusen personer med HIV och därför har sjuksköterskor och annan sjukvårdspersonal en viktig roll i patienternas liv när det gäller att möta och vårda dessa patienter. Syfte: Syftet med denna studie var att beskriva Filippinska sjuksköterskors upplevelse av att vårda patienter med HIV. Metod: För att genomföra studien användes en kvalitativ metod där data samlades in genom semistrukturerade intervjuer med fem Filippinska sjuksköterskor på ett sjukhus i Baguio. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Resultatet i studien inkluderar två huvudteman. I det första temat: relationen mellan sjuksköterskan och patienten, beskrivs vikten av att skapa en relation med sina patienter. För att skapa en relation bör sjuksköterskan lära känna patienten, skapa tillit och ge personcentrerad vård. Hinder och svårigheter i processen att skapa en förtroendefull relation med sin patient tas även upp i detta tema. I det andra temat beskrivs viktiga aspekter som sjuksköterskorna bör ha i åtanke när de träffar och vårdar patienter med HIV. Diskussion: Resultatet från intervjuerna i studien diskuterades i relation till relevant litteratur och Travelbee’s teori. Fokus i diskussionen var relationen mellan sjuksköterskan och patienten samt viktiga aspekter vid vårdande av HIV patienter.

Compassion fatigue är ett psykiskt och fysiskt tillstånd som utvecklas över tid när sjuksköterskan känner medkänsla och empati för sina patienter, då resultatet visar att stödjande insatser kan hjälpa att förebygga tillståndet hos sjuksköterskor borde detta fenomen lyftas fram. Compassion fatigue kan påverka sjuksköterskans koncentrations- och bedömningsförmåga och resultera i att olika misstag i arbetet begås. Compassion fatigue är ett problem för sjukvården i stort, eftersom tillståndet påverkar omvårdnaden, arbetssituationen samt den enskilda sjuksköterskan negativt. Syftet med litteraturstudien var att belysa compassion fatigue ur ett sjuksköterskeperspektiv, i vilken studiens teoretiska utgångspunkt var Joyce Travelbees interaktionsteori. Studien genomfördes som en allmän litteraturstudie, databassökning gjordes systematiskt med sökord som var relevanta för syftet. Litteraturstudien baserades på tre kvalitativa och åtta kvantitativa artiklar som analyserades och kvalitetsgranskades. Resultatet visade att Bidragande orsaker till compassion fatigue, Upplevelser relaterat till compassion fatigue och Att förebygga compassion fatigue. Med en insikt om att hög arbetsbelastning och en hög stressnivå hos sjuksköterskor kan leda till compassion fatigue går det att arbeta preventivt, vilket är det mest effektiva. Detta skulle bespara både vårdpersonal och patienter lidande och förbättra kvaliteten i omvårdnaden. Vidare forskning skulle kunna ligga till grund för fortsatt förbättringsarbete inom klinisk verksamhet. / Compassion fatigue is a mental and physical condition that develops over time when the nurse feels compassion and empathy for her patients, since the results show that supportive interventions can help prevent the condition, this phenomenon should be emphasized. Compassion fatigue can lead to changes in the nurse's ability to concentrate and judge and result in various mistakes in the work. Compassion fatigue is a major concern for healthcare as the condition adversely affects the nursing, the work situation and the individual nurse. The purpose of the literature study was to emphasize compassion fatigue from a nursing perspective, in which the theoretical starting point of the study was Joyce Travelbee's interaction theory. The study was conducted as a general literature study, database search was done systematically with keywords that were relevant to the aim. The literature study was based on three qualitative and eight quantitative articles that were analyzed and quality-reviewed. The results show Contributing causes of Compassion Fatigue, Experiences Related to Fatigue and Preventing Compassion Fatigue. With an insight that high workload and a high levels of stress in nurses can lead to compassion fatigue, one can work preventively, which is most effective. This would save both healthcare and patients suffering and improving the quality of nursing care. Further research could provide a basis for continued improvement work in clinical operations.

The study of communication was born with the study of rhetoric, and scholars have been examining the creation and reception of messages for thousands of years. However, the term rhetoric often has negative connotations, as we hear people label some statement as “just rhetoric” or we hear them say, “The action doesn't match the rhetoric.” However, rhetoric is a style of communication that takes into account the effective use of both verbal and non-verbal languages, and it is one of the main ingredients in the day to day communication in organizations, healthcare organizations being no exception. It is virtually impossible to communicate without the use of rhetoric. This study focused on healthcare organizations because the delivery of healthcare is built on communication, and there is more to understand about the usage of language and organizational rhetoric in healthcare organizations. To these effects, the study examined communication in healthcare organizations and the perceived use of rhetoric among healthcare professionals; it explored how healthcare professionals perceive communication with their audiences, how the use of rhetoric, as perceived by healthcare professionals, affects communication in healthcare organizations and the contribution of rhetoric, as perceived by healthcare professionals, in motivating healthcare audience in healthcare organizations. The five canons of rhetoric were employed as a theoretical framework, and semi-structured interviews were used as tools for data collection. While contributing to existing literature on health and organizational communication, this study will also contribute in providing both government and private organizations insights into the use of rhetoric in professional communication with the hope of enhancing the quality of communication in the workplace.

Bakgrund: The World Health Organization betraktar sexuell hälsa som en betydande del för god hälsa, välbefinnande och livskvalitet. Sexuell hälsa kan på olika vis påverkas av sjukdom men är ändå en viktig aspekt för hälsan. Sjuksköterskan har ett ansvar att vårda patienten med ett holistiskt perspektiv där alla hälsoaspekter beaktas. Trots detta är sexuell hälsa ofta ett åsidosatt ämne i vården och i samtal med patienter. Syfte: Syftet var att undersöka vilka faktorer som hindrar respektive främjar sjuksköterskans samtal om sexuell hälsa med patienten. Metod: En strukturerad litteraturöversikt. Resultatet baseras på totalt 12 artiklar, med både kvalitativ och kvantitativ metod. Resultat: Totalt framkom 53 faktorer, 35 hindrande samt 18 främjande faktorer. Alla faktorer formade följande åtta kategorier; ett tabubelagt ämne, otillräckliga resurser och förutsättningar, brist på utbildning, träning och kunskap, sjuksköterskans inställning och patientens karaktärsdrag, tillräckliga resurser och förutsättningar, adekvat utbildning, träning och kunskap, yrkeserfarenhet och självförtroende samt vårdrelationen mellan sjuksköterska och patient. Slutsats: Sexuell hälsa upplevdes vara ett känsligt ämne att samtala om med patienten. Det är viktigt att identifiera barriärer och att adekvata metoder tillämpas för att överkomma dem. Utbildning kan bidra till ökad kunskap och medvetenhet om sexuell hälsa och vidare främja samtal. Styrdokument och riktlinjer bör utvecklas för att ge sjuksköterskan redskap att tillämpa i samtalet med patienten. Dessa verktyg kan eventuellt bidra till goda samtal mellan patient och sjuksköterska. Sjuksköterskan bör se sexuell hälsa som en naturlig del av den holistiska vården. / Background: The World Health Organization regards sexual health as a significant part of good health, well-being and quality of life. Sexual health can in different ways be affected by illness, but is nevertheless an important aspect of health. The nurse has a responsibility to care for the patient from a holistic perspective where all aspects of health are taken into account. Despite this, sexual health is often a neglected subject in health care and in dicussions with patients. Aim: The aim of this study was to examine what factors acts as barriers and facilitators for the nurse to discuss sexual health with the patient. Method: A structured literature review. The result is based on a total of 12 articles, with both qualitative and quantitative methods. Results: A total of 53 factors were identified, 35 inhibited factors and 18 promoting factors. The factors resulted in following eight categories; a taboo subject, insufficient resources and conditions, lack of education, training and knowledge, the nurse's attitude and the patient's characteristics, sufficient resources and conditions, adequate education, training and knowledge, experience and confidence and the nurse-patient relationship. Conclusion: Sexual health is perceived to be a sensitive topic to talk about with patients. It is important to identify barriers and to apply appropriate methods to overcome them. Education can contribute to greater knowledge and awareness of sexual health and further promote the conversations. Regulatory documents and guidelines should be developed to provide nurses adequate tools to use in the conversation with the patient. These tools may contribute to good conversations between the patient and the nurse. The nurse should regard sexual health as an integral part of the holistic care.