Praktisering av brukermedvirkning krever at sykepleierne ser på brukerne som likeverdige partnere. Det bryter med det tradisjonelle sykepleier–pasientforholdet og krever andre arbeidsmetoder og holdninger. For å kunne få til en slik endring forutsetter det at sykepleierne har nødvendig kunnskap og forståelse for brukermedvirkning og den bakenforliggende ideologien. Hensikt: Hensikten med studiet var å studere sykepleiernes teoretiske forståelse av begrepet brukermedvirkning og kartlegge hvordan sykepleierne selv opplever at de praktiserte brukermedvirkning i kommunens omsorgstjeneste. Metode: Det har blitt gjennomført en kvalitativ studie med halvstrukturerte intervjuer. Analysemetode var meningsfortettning og meningskategorisering etter beskrivelse av Kvale. Studien har 20 respondentern fra sykehjem og hjemmetjenesten i en stor norsk kommune. Resultater: Sykepleiernes kunnskap om brukermedvirkning var i stor grad situasjonsbestemt. Den ble beskrevet ut fra pasientene de selv arbeider med, situasjonene og konteksten. Det ble knyttet usikkerhet til den teoretiske forståelse av begrepet. Brukermedvirkning blir i hovedsak beskrevet som samråd og må forstås som symbolsk deltagelse der pasientenes deltar og gir uttrykker behov eller gir råd uten at de har reell innflytelse eller myndighet. Langt færre beskrev brukermedvirkning som brukerinnflytelse i form av partnerskap der pasienten gis anledning til å ta avgjørelse og oppleve kontroll.I hvilken grad brukermedvirkning praktiseres avhenger av avveininger i tjenesteutforming, institusjonelle forhold og strukturelle rammer. Sykepleiere opplevde ved håndtering av meningsforskjeller mellom pasient og pårørende en lojalitet overfor pasienten samtidig som de viser forståelse overfor pårørende. Konklusjon: Sykepleiernes forståelse av brukermedvirkning handler i stor grad om symbolsk deltagelse fordi de gis mulighet til å uttrykke ønsker men ikke fatte endelig avgjørelse. Implementering av brukermedvirkning på systemnivå og en kombinasjonen av teoretisk kunnskap og refleksjon over praksis, vil kunne styrke bevisstheten og vektleggingen av brukermedvirkning. / The practice of user participation requires nurses to regard users as equal partners. It breaks with the traditional nurse-patient relationship and demands different working methods and attitudes. Achieving such a change requires nurses to have the necessary knowledge and understanding of user participation and the ideology behind it. Objective: This study aimed to investigate nurses’ understanding and practice of user participation in the municipal care service. Method: We implemented a qualitative study by conducting semi-structured interviews with 20 respondents from nursing homes and home care services in a major Norwegian municipality.Analysis involved consolidating and categorizing the subjects’ intent, as described by Kvale. Results: The nurses’ knowledge of user participation was situational (i.e., they based their descriptions on current patients, situations, and context). Their theoretical understanding of the concept was uncertain. Most described user participation as a consultation that must be understood as symbolic participation, where the patients express their needs or give advice without having any real influence or authority. Far fewer nurses described user participation as user influence in the form of a partnership, where patients are given the opportunity to make decisions and experience control. The extent to which nurses practice user participation depends on trade-offs among services, institutional situations, and structural frameworks. When faced with differing opinions between patients and their relatives, nurses experienced loyalty toward their patients and simultaneously showed empathy for the relatives. Conclusion: Nurses’ understanding of user participation largely deals with symbolic participation because it enables patients to express desires without making any final decisions. Implementing user participation at the system level and combining theoretical knowledge and reflection in practice would strengthen awareness and focus attention on user participation / <p>ISBN 978-91-85721-73-3</p>

När befolkningen i Sverige blir allt äldre kommer det bland annat leda till ett ökat sjukvårdsbehov. I genomsnitt har människor födda i länder långt från Norden sämre hälsa än personer födda inom Norden, de kan ha en annan kultur och tolka kommunikationen inom vården annorlunda. Syfte: Att beskriva faktorer som påverkar omvårdnaden av patienter och anhöriga från andra kulturer inom palliativ vård. Metod: En litteraturöversikt. Resultat: Är baserat på nio vetenskapliga artiklar. Det fanns kulturella skillnader i synen på allvarlig sjukdom och död. Inom flera kulturer är det tabubelagt att tala om döden och detta var sjuksköterskorna inom västerländsk kultur oerfarna vid, de var mer vana vid en rak och ärlig kommunikation med patienterna. Sjuksköterskorna hade kommunikationssvårigheter med patienter och närstående då de inte hade samma språk. Det var även svårt och tidskrävande att finna lämpliga tolkar som kunde hantera känsliga ämnen relaterat till palliativ vård. Konklusion: Sjuksköterskor upplevde att möten med patienter och anhöriga från andra kulturer ofta var svåra om de inte pratade samma språk. Trots detta upplevde sjuksköterskorna arbetet som tillfredsställande. Det framkom att för lite tid och stress var ett av problemen samt att behovet av tolkar var stort. / Background: As the population in Sweden is getting older, it will also lead to increased health care needs. On average, the immigrants have poorer health than people born in the Nordic region, they can have an other culture and interpret the communication in care different. Aim: To describe the factors that affect the care of patients and families from other cultures in palliative care. Methods: a literature review. Results: Is based on nine scientific articles. There are cultural differences in the perception of serious illness and death. In many cultures, it is taboo to talk about death and this was the nurses of Western culture inexperienced with, they were more experienced with a straight and honest communication with the patients. The nurses had communication difficulties with patients and families as they did not have the same language. They also found it more difficult and time consuming to find suitable interpreters who could handle the sensitive issues related to palliative care. Conclusion: Nurses felt that when confronted with patients and families from other cultures it was often difficult if they were not talking the same language. Despite this, nurses experienced work as satisfaying. It appeared that lack of time and stress was one of the problems and the need for interpreters was large.

Bakgrund: Enligt svensk lagstiftning har patienten en laglig rätt att vara delaktig i sin vård. Detta betyder också att sjuksköterskan har en skyldighet gentemot patienten att göra hen delaktig. Trots denna rättighet upplever patienter att de ibland inte ges möjlighet till att vara delaktiga. Syfte: Syftet med den här studien är att beskriva patientdelaktighet och sjuksköterskans möjlighet att främja respektive hindra patientens upplevelse av delaktighet. Metod: Studien är en litteraturöversikt vars resultat är baserat på tio vetenskapliga artiklar som publicerats mellan åren 2005-2016. Resultat: Patienten anser att det är viktigt att sjuksköterskan ger möjlighet för patienten att uttrycka sig och tilldelas information om vårdsituationen. Genom detta gavs patienten möjlighet till att vara delaktig. Patienten vill bli sedd och hörd samt ses som en jämlik partner i vården. För detta behövs en etablerad relation mellan sjuksköterska och patient. Konklusion: Studier visar att patienten upplever att det finns hinder för att upprätthålla patientdelaktighet samt att sjuksköterskans förhållningssätt har betydelse för patientens upplevelse av delaktighet. / Background: According to Swedish law, patients have a legal right to be involved in their care. This also means that the nurse has a obligation towards the patient to make her/him involved. Despite this right, patients feels that they are not given the opportunity to be involved in their care. Aim: The aim of this study is to describe patient participation and nurses opportunity to promote and prevent the patient’s experience of participation. Method: The study is a literature review whose results are based on ten scientific articles published between the years 2005-2016. Results: The patient believes it is important that the nurse give the opportunity towards the patient to express themselves and be informed about the care situation. Through this the patient was given the opportunity to be involved. Patients want to be seen and heard, and seen as an equal partner in care. This requires an established relationship between nurse and patient. Conclusion: Studies show that patients find that there are obstacles to maintain patient participation and that the nurse’s approach is relevant to the patient’s experience of participation.

Syfte: Syftet var att belysa vårdrelationens betydelse i samband med vård av patienter med Anorexia Nervosa. Metod: En systematisk litteraturstudie utfördes. Artikelsökningen som var relevant för syftet gjordes i databaserna Cinahl och PubMed. Tio kvalitativa artiklar identifierades. Dessa kvalitetsgranskades och en manifest innehållsanalys utfördes. Resultat: Resultat som framkom i studien var att vårdrelationen var av stor vikt och att patienterna ansåg att stöd från sjuksköterskorna var hjälpsamt. Svårigheter i vårdrelationen kunde uppstå när patienterna motsatte sig vård. Patienterna upplevde blandade känslor i vårdrelationen. Kommunikationen och vårdrelationen är av stor vikt för upplevelsen av välbefinnande och för fortsatt behandling. Det kategorier som framkom i analysen var: Vårdrelation, Känslomässiga upplevelser och Kommunikation. Slutsatser: Det finns bristande kunskap om vårdrelationens betydelse. En stark terapeutisk relation är av stor vikt för att förhindra att återfall uppkommer och för att kunna bygga en tillit för varandra. Kommunikationssvårigheter uppkommer då patienterna inte är villiga att ta emot behandlingens mål. Detta kan leda till att sjuksköterskan upplevs icke-hjälpsam. Trots patienternas ibland negativa känslomässiga upplevelser ska sjuksköterskorna alltid behandla patienterna med värdighet, respekt och vänlighet. Kommunikationen mellan båda parter är viktig för att få en helhetsbild av patientens situation. Nyckelord: Anorexia Nervosa, Patientupplevelse och Sjuksköterskans-patientens relation. / Objective: The aim was to illuminate the health care relationship in relation to patient care with Anorexia Nervosa. Methods: A systematic literature review was conducted. Articles relevant to the aim of the study was sought in the databases Cinahl and PubMed. Ten qualitative articles were identified. A quality valuation and a manifest content analysis was conducted. Results: The results in this the study showed that the care relationship is of great importance and the patient considered that support from nurses was helpful. The categories found in the analysis were: Care relations, Emotional experiences and Communication. Difficulties in the care relationship could arise when patients opposed care. The patients also experiences mixed feelings in the care relationship. However, communication and care relationshipa are of great importance for the perception of well-being and for continued treatment. Conclusions: There is insufficient knowledge of the importance of the care relationship in treating Anorexia Nervosa. A strong terapeutic relationship is of great importance to prevent relapses from occurring and to build trust in each other. Despite the patient’s fluctuating emotional experiences, nurses should treat patients with dignity, respect and kindness. Communication between both parties is important in order to get an overall picture of the patient’s situation for optimal care and treatment. Keywords: Anorexia Nervosa, Patient experience and nurse-patient relations.

Bakgrund: Patienter med substansbrukssyndrom har ofta komplexa problem och sjuksköterskan behöver ha   kunskap och medkänsla för att vårdrelationen skall fungera. Sjuksköterskan behöver hantera både sina egna och patientens känslor för att vårdrelationen skall fungera. Sjuksköterskan behöver vara ett stöd för patienten när hen skall hitta en hälsosam livsstil utan substansbruk. En fungerande vårdrelation mellan sjuksköterska och patient med substansbrukssyndrom är betydelsefull för att omvårdnaden skall fungera. Syfte: Syftet var att beskriva vårdrelationen mellan sjuksköterska och patient med substansbrukssyndrom ur ett sjuksköterskeperspektiv.   Metod: En litteraturstudie valdes som metod. Artiklarna söktes databaserna PubMed och Cinahl. Totalt inkluderades 18 vetenskapliga originalartiklar i resultatet. Resultat: Resultatet visade att synsätt och perspektiv samt negativa erfarenheter påverkar relationen mellan sjuksköterska och patient med substansbrukssyndrom. Sjuksköterskan upplever svårigheter med kunskapsbrist och patienters manipulativa beteende. Slutsats: Vårdrelationen mellan sjuksköterskan och patienten med substansbrukssyndrom kan utvecklas genom stöd och utbildning till sjuksköterskor i deras yrkesroll. / Background: Patients with substance use disorder often have complex problems and the nurse needs knowledge and compassion to make the care relationship work. The nurse needs to handle both her own and the patient's feelings in order for the care relationship to work. The nurse needs to support the patient as he or she finds a healthy lifestyle without substance use. A functioning care relationship between nurse and patient with substance use disorder is important for the care to work successfully. Aim: The aim of the study was to describe the care relationship between nurse and patient with substance use disorder from a nursing perspective. Method: A literature review was chosen as method. The article search was conducted in   the databases PubMed and Cinahl. In total, 18 original scientific articles were included in the results. Results: The results showed that attitude and perspective as well as negative experience   affect the relationship between nurse and patient with substance use disorder. The nurse experiences difficulties related to lack of knowledge and patients' manipulative behavior. Conclusions: The care relationship between the nurse and patient with substance use disorder can be improved by providing support and education for nurses in their professional role.

Thesis advisor: Dorothy Jones / The importance of the nurse-patient relationship to the overall well- being of the person has been explored extensively by nurses. What is largely missing from this knowledge developed to date is the patient's perspective. The purpose of this study was to develop a reliable and valid measure of patients' perceptions of feeling known by their nurses during an acute, surgical, hospital admission. The development of the PPFKN Scale was guided by Newman's theoretical framework of Health as Expanding Consciousness (1994) and data from a qualitative descriptive study conducted in 2003 (Somerville). The current investigation focused on the development and psychometric testing of the PPFKN Scale. The four themes that emerged from the earlier qualitative study were used to guide the development of the 85-item scale. This scale was exposed to a panel of nurse experts to establish inter-rater agreement and content validity, item understandability and readability. The revised scale was piloted with five participants who had experienced an inpatient, surgical admission to determine content validity, item readability and understandability. The revised 77-item scale was then administered to 327 surgical inpatients across seven general care units at a large academic urban medical center. A sample size of 296 completed surveys was analyzed. A four-component solution was devised using Principal Components Analysis with Varimax rotation. This four-component solution accounted for 63.3% variance, with a total scale Cronbach's alpha coefficient of 0.99. A component loading cut-off was set at 0.3 and items not loading at this value on the expected component were dropped. This process resulted in a reliable and valid 48 item PPFKN Scale with four components and a total scale Cronbach's alpha coefficient of 0.98. / Thesis (PhD) — Boston College, 2009. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

O objeto deste estudo é a atuação de enfermagem na segurança do paciente submetido à cirurgia bariátrica no período transoperatório. Embora o movimento mundial de cirurgia segura já esteja em andamento em muitos hospitais, contudo, a prática demonstra insuficiência de planejamento e recursos humanos e materiais, tanto para identificar quanto para atender necessidades especiais de pacientes. Neste grupo, inserem-se os pacientes com obesidade mórbida, submetidos à cirurgia bariátrica. Apesar da importância dessa cirurgia na melhoria das condições de saúde desses indivíduos, ela não é isenta de riscos, o que determina atuações preventivas específicas para um procedimento seguro, seja definindo critérios para sua realização, seja prevendo e provendo necessidades especiais dos pacientes em todo o período perioperatório. Não há dúvidas sobre a importância da atuação da enfermagem, principalmente na fase transoperatória, momento crítico do ato anestésico-cirúrgico. No entanto, não é amplamente conhecido se e como a enfermagem vem produzindo conhecimento para atuar nessa problemática, e suas evidências. Para esse reconhecimento, o presente estudo realizou uma revisão integrativa da literatura científica, a partir da questão: Há evidências no conhecimento produzido pela enfermagem sobre necessidades de segurança do paciente no período transoperatório de cirurgia bariátrica que subsidiem a prática clínica? A busca da literatura, a partir de descritores previamente selecionados, foi realizada nas bases eletrônicas PubMEd, Medline, LILACS, Scielo, CINAHL, Cochrane, Nursing Consult, Joanna Briggs e International Journal of Evidence Based Healthcare, sendo identificados 589 estudos. Submetidos a três processos de seleção, desse total foram incluídos 14 estudos, ao atenderem especificamente à questão formulada. Todos esses estudos foram publicados a partir de 2003, oriundos basicamente dos Estados Unidos da América (13-92,85%), no idioma inglês, com exceção de um, do Brasil (7,14%), escrito em português. A maioria deles (8) constitui opiniões/reflexões/informações, seguindo-se propostas de programa, protocolo e ou guias de recomendações (5). Destes, 4 foram desenvolvidos por meio de pesquisa secundária (revisão de literatura). Apenas um estudo correspondeu a pesquisa primária, no caso, exploratória descritiva. Somente dois estudos incluídos tratam especificamente da temática desta revisão integrativa - período transoperatório; os demais se referem a todo o período perioperatório, desde a decisão pela cirurgia até acompanhamento após a alta, considerando, portanto, o transoperatório enquanto etapa desse contexto. Pela classificação de evidência utilizada os estudos analisados inserem-se nos níveis C e D. Desse modo, o conhecimento de enfermagem identificado para atuação em necessidades de segurança do paciente no período transoperatório (e também em todo o perioperatório) de cirurgia bariátrica não constitui evidências fortes, permanecendo predominantemente no nível racional teórico, portanto, carecendo de demonstração por meio de pesquisas primárias. A partir de uma classificação arbitrária desse conhecimento produzido constata-se que predominam considerações sobre ambiente físico, incluindo estrutura e previsão/provisão de recursos materiais, nas formas de mobiliário e insumos de assistência. Conclui-se pela pertinência de realização de estudos primários de variados enfoques, tanto para evidenciar o impacto e a eficiência do conhecimento atualmente disponível, quanto para identificar outras necessidades ou gerar outras ações inovadoras. / The object of this study is the nursing role in patient safety in the perioperative period of bariatric surgery. Although a global movement to promote a system-wide approach to safer surgical is already ongoing in many hospitals, the clinical practice shows lack of material and human resources, as well as health care planning to identify and respond to special needs of the patients. Patients with morbidly obese undergoing to bariatric surgery can be included in this group. Despite the importance of this surgery at the improvement of health conditions of these individuals, it is not a procedure free of risks, which determines specific preventive interventions for a safe procedure, that includes surgery criteria, prevention of special needs of the patient during the perioperative period. There is no doubt about the importance of nursing, especially in the intraoperative phase, the critical moment of the surgical anesthetic procedures. However, it is not widely known the evidences and how and if the nurses has produced knowledge to intervene in this issue. For this identification, this study conducted an integrative review of scientific literature based on this question: There is evidence in the knowledge produced by nursing on security needs of the patient during the perioperative period of bariatric surgery that support clinical practice? The literature search with descriptors previously selected was performed in the electronic databases PubMed, Medline, LILACS, SciELO, CINAHL, Cochrane, Nursing Consult, and Joanna Briggs International Journal of Evidence Based Healthcare and identified 589 studies. After three selection processes, it was included 14 studies that matched the eligibility criteria. All these studies have been published since 2003, primarily from the United States of America (13 to 92.85%), in English, except one, of Brazil (7.14%), written in Portuguese. Most of them (8) expresses opinions, ideas and informations that follow program proposals, protocols, guidelines and recommendations (5). Of these, 4 was secondary research (literature review). Only one study was a primary research, which means an exploratory descriptive study. Only two studies included was about the perioperative period - theme of this integrative review. The other ones referred to the entire perioperative period, since the decision to undergo to the surgery until the follow up discharge, considering the perioperative as a step at the perioperative context. The studies analyzed were at level C and D according to the evidence classification adopted. Thus, the knowledge of nursing identified to intervene in security needs of the patient during the perioperative period (and also throughout the period) of bariatric surgery is not a strong evidence, remaining predominantly in the theoretical rationale level, therefore, lacking of primary researches. From an arbitrary classification of knowledge produced, it is demonstrated that the physical environment, including structure and prediction or provision of material resources, such as furniture and supplies of assistance are predominant concerns. We concluded that it is relevant to conduct primary studies with different study designs and objectives to evidence the impact and effectiveness of currently available knowledge, and to identify other needs or create others innovative interventions.

Bakgrund: Målet med omvårdnad är att uppnå hälsa hos patienten genom ett personcentrerat förhållningssätt. Många sjuksköterskor uttrycker att de vill ge god omvårdnad men begreppets innebörd förefaller skilja sig åt sjuksköterskor emellan. Att tillämpa god omvårdnad förhindras av strukturella samt organisatoriska barriärer vilket påverkar patientsäkerheten. För att diskrepansen mellan kunskapen om vad god omvårdnad innebär och kvaliteten på den omvårdnad som ges ska minska, behövs ökad kunskap om vad patienter uppfattar som god omvårdnad. Syfte: Syftet var att belysa patienternas uppfattning om vad god omvårdnad innebär inom slutenvården. Metod: Litteraturöversikten har utförts i enlighet med Fribergs metod. Sökningar utfördes i databaserna CINAHL complete, PsychINFO och PubMed, vilket resulterade i tio kvalitativa artiklar som analyserades och tematiserades och därmed utgör resultatet. Resultat: Två huvudteman och fem subteman identifierades; Ett personcentrerat vårdande med subtemana; Se mig, jag är unik, Behovet av en medmänsklig relation samt Betydelsen av sjuksköterskans närvaro. Sjuksköterskans förhållningssätt med subtemana; Compassion-en vårdande hållning samt Vikten av kompetens och information. Diskussion: Litteraturöversiktens metod diskuteras utifrån dess styrkor och svagheter. Resultatet diskuteras i relation till begreppen i Jean Watsons omvårdnadsteori. God omvårdnad karakteriseras enligt patienterna av en närvarande sjuksköterska vars personliga hållning präglas av compassion. Hållningen främjar en medmänsklig vårdrelation och ett personcentrerat förhållningssätt. / Background: The purpose of nursing care is to achieve patient health through a person-centred approach. Many nurses claim that they want to provide good nursing care but the concept varies between nurses. Implementing good nursing care is prevented by structural and organisational barriers that affect patient safety. To reduce the discrepancy between the knowledge of what quality care means and the quality of the actual care provided, increased knowledge of what patients perceive as good nursing care is needed. Aim: The aim was to illuminate patients’ perceptions of what good nursing care signifies in an inpatient setting. Method: The literature review has been made in accordance with Fribergs method. Searches were conducted using the databases CINAHL complete, PsychINFO and PubMed, resulting in ten qualitative articles that were analyzed and thematized and thus constitute the result. Results: Two main themes and five subthemes were identified; A person-centred care with the subthemes; See me, I am unique, The need for a person to person relationship and The importance of the presence of the nurse. The nurses’ approach with the subthemes; Compassion- a caring attitude and The importance of competence and information. Discussion: The method of the literature review is discussed from its strengths and weaknesses. The result of the literature review is discussed in relation to the concepts in Jean Watsons’ nursing theory. Good nursing care is characterized according to patients by a present nurse whose personal attitude is characterized by compassion. The attitude favours a human caring relationship and a person-centred approach.

Bakgrund: Kommunikation mellan patienter och vårdpersonal är en faktor som kan påverka vårdresultat, patientsäkerhet och patienttillfredsställelse. Tidigare forskning har visat att patienternas perspektiv av kommunikation behöver undersökas mer då det skulle kunna effektivisera förbättringsarbetet inom området. Syfte: Att undersöka sjukhuspatienters erfarenheter av och inställning till kommunikation med sjuksköterskor. Metod: En systematisk litteraturstudie av kvalitativa studier. Sökningar utfördes i PubMed, CINAHL och PsycINFO. Efter sökning, relevans- och kvalitetsgranskning analyserades tio artiklar via induktiv innehållsanalys. Resultat: Patienter beskrev kommunikation som en central del i deras vård. Ett empatiskt, vänligt och respektfullt bemötande var en grundläggande förutsättning för en effektiv kommunikation, då det fick patienterna att känna sig trygga och sedda. Patienterna efterfrågade även individanpassad information och att vara involverade i beslutsfattande. Ett bristande bemötande och delaktighet gav patienterna känslor av att vara övergivna och i vissa fall orsakade det integritetskränkningar, särskilt i samband med omvårdnad. Sjuksköterskor som hade fullt upp och/eller inte fick patienterna att känna sig sedda och förstådda gjorde att vissa patienter inte kontaktade personalen vid förändringar i deras tillstånd eller när vårdbehov uppstod. Slutsats: Denna studie visade att patienters vårdskador reduceras eller förebyggs av effektiv kommunikation med vårdpersonal som är baserad på vänlighet, empati och respekt för patienten. Ett bristande bemötande leder ofta till känslor av övergivenhet och/eller integritetskränkningar. / Background: Professional-patient communication impacts the patients’ health outcome, safety and satisfaction. Earlier research shows a need to further explore patient perspectives of communication as it could make improvements more efficient. Aim: To examine inpatient’s experiences and attitudes towards nurse-patient communication. Method: A systematic review of qualitative studies. Following databases were searched: PubMed, CINAHL and PsycINFO. After searching, checking for relevance and quality assessment, ten articles were examined with inductive content analysis. Results: The patients described communication as a centerpiece of their care. Kindness, empathy and respect was considered key elements in establishing effective communication as it made the patient feel safe and acknowledged. Individualized information was highly requested by the patients, as well as being involved in decision-making. Questionable attitudes and inadequate information/involvement made the patients feel abandoned and in some cases, especially during nursing care, it caused a sense of violated personal integrity. Registered nurses that were busy and/or failed to make patients feel acknowledged and understood made some of the patients omit signs of deterioration or less likely to approach them when in need of nursing care. Conclusion: Patient harm is reduced or prevented when nurses are able to establish effective communication based on kindness, empathy and respect towards the patient. When effective communication fails, patients are likely to feel abandoned and/or miss-treated.

Bakgrund: Diabetes typ 2 är en kronisk sjukdom som kan medföra olika komplikationer. Personer med sjukdomen har ofta regelbunden kontakt med vården, de får stöttning och råd vad gäller livsstilsförändringar samt självhantering av sjukdomen.  Syfte: Att beskriva hur sjuksköterskans bemötande upplevs av personer med diabetes mellitus typ 2.  Metod: En litteraturöversikt baserad på elva vetenskapliga artiklar med kvalitativ design. Artiklarnas resultat tolkades med en induktiv ansats.  Resultat: HuvudkategoriernaIngå i team tillsammans med sjuksköterskanoch Känna sig utelämnad beskriver upplevelser av en god relation där vården planerades gemensamt och personer upplevde delaktighet i mötet, samt upplevelser av att inte bli sedda som individer, att bli ignorerade och att känna sig dömda.  Slutsats: Sjuksköterskans bemötande har en betydande inverkan på personer med diabetes mellitus typ 2. När en god relation skapats, där personer erfar stöd har de lättare att anpassa sig till behandlingar och godare förutsättningar att genomgå livsstilsförändringar. En god relation relateras till personers upplevelser av trygghet, tillit och lugn. Ett bristande bemötande kan istället leda till negativa upplevelser av sjukvården och minska motivationen att se efter sin sjukdom. Avsaknad av stöd ledde till upplevelser av besvikelse, ensamhet och att bli missförstådd. / Background: Diabetes type 2 is a chronic disease that can cause various complications. People living with the disease often have regular contact with the healthcare, they receive support and advice on lifestyle changes and self-management of the disease. Aim:To describehow the nurse’s approach is experienced by people with diabetes mellitus type 2.  Method: A literature review based on eleven scientific articles with a qualitative design. The results of the articles were interpreted with an inductive approach.  Results: The main categories Being a part of a team with the nurse and Feeling left outdescribes experiences of a good relationship where the care was planned jointly and people experienced participation in the meeting, as well as experiences of not being seen as individuals, to be ignored and to feel condemned.  Conclusion: The nurse’s approach has a significant impact on people with diabetes type 2. When a good relationship is created, where people experience support, they are more likely to adapt to treatments and has better means for undergoing lifestyle changes. A good relationship is related to people’s experiences of security, trust and serenity. A failing approach can instead lead to negative experiences of the healthcare and reduce motivation for self-management. Lack of support led to experiences of disappointment, loneliness and being misunderstood.