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.

Recente profusão de novos papéis profissionais do enfermeiro e mudanças nas práticas da enfermagem têm sido descritas mundialmente e exercem impacto no tipo de cuidado provido e nas formas de sua provisão. O interesse deste estudo é a ideia de papel clínico, que, apesar de ser uma expressão comumente usada no cotidiano, é pouco explorada em termos conceituais. Este estudo teve como objetivo desenvolver o conceito de papel clínico do enfermeiro. A Metodologia de Análise Qualitativa de Conceito foi aplicada em suas três fases: Identificação dos Atributos, Verificação dos Atributos e Identificação das Manifestações do Conceito. Na primeira fase, os atributos abstratos e universais do conceito foram identificados, utilizando-se a Análise Crítica da Literatura, que resultou no estudo de 24 publicações. Na segunda fase, aplicou-se a Teoria Fundamentada nos Dados para verificar os atributos do papel clínico na experiência do enfermeiro. Nessa fase, realizou-se estudo com sete enfermeiros assistenciais do Hospital Universitário da Universidade de São Paulo. Os dados foram coletados por entrevistas abertas, que foram analisadas e interpretadas em categorias inter-relacionadas, com a derivação de um modelo teórico da experiência do papel clínico do enfermeiro. Na terceira fase, os dados das fases anteriores foram comparados e integrados, possibilitando a proposição teórica do conceito. Os resultados da análise evidenciaram que papel clínico do enfermeiro é um processo psicossocial resultante da interação do enfermeiro com o paciente, com o contexto e consigo mesmo. Autonomia clínica configurou-se como elemento central da interação do enfermeiro com o paciente na experiência do papel clínico. O significado da experiência do papel clínico foi expresso no empoderamento do enfermeiro pelo exercício da autonomia clínica, que mostra o alcance de resultados manifestados na própria interação do enfermeiro com o paciente, consigo mesmo ou com o contexto. Os dados indicaram ter o paciente como o centro do cuidado, ter finalidades e intencionalidade como atributos principais do papel clínico. O desempenho do papel clínico requer que o enfermeiro tome posse da autonomia clínica, que a exerça nas interações e nas ações junto ao paciente e se perceba empoderado por esse exercício. Papel clínico é uma competência que se articula como uma forma de poder, mediado pela autonomia clínica. A autonomia clínica concede ao enfermeiro o poder de pensar, de imaginar, de planejar o cuidado e de influir na saúde do paciente. A análise do conceito do papel clínico contribuirá para reflexões sobre as dimensões envolvidas na prática e no ensino de enfermagem e para informar não só as políticas de ensino e de práticas profissionais, mas também as políticas de saúde. / Recent profusion of new professional roles of the nurse and changes in the practice of nursing have been worldwide described and have an impact on the type of care provided as well as on the forms of its provision. The interest of this study is the idea of the clinical role, which inspite of being a commonly used daily expression, is little explored in conceptual terms. This study has had as an objective the development of the concept of the clinical role of the nurse. The Methodology of Qualitative Analysis of Concept has been applied in its three phases: Identification of the Attributes, Verification of the Attributes and Identification of the Manifestations of the Concept. In the first phase, abstract and universal attributes of the concept have been identified using Critical Analysis of Literature, which resulted in the study of 24 publications. In the second phase, Grounded Theory has been applied to verify the attributes of the clinical role in the nurses experience. In this phase, a study has been carried out with seven assistential nurses from the São Paulo Universitys Hospital. Data has been collected by open interviews, which has been analysed and interpreted in interrelated categories, deriving to a theorical model of the nurses clinical roles experience. In the third phase, the data of the previous phases were compared and integrated, permitting the theorical proposition of the concept. The results of the analysis have proved that the nurses clinical role is a psychosocial process resulting from the interaction of the nurse with the patient, with the context and with himself. Clinical autonomy has configured as a central element in the interaction of the nurse with the patient in the clinical roles experience. The significance of the clinical roles experience has been expressed in the empowerment of the nurse through the exercise of clinical autonomy, which shows the range of achieved results shown in the nurses interaction with the patient, with himself or with the context. Data has indicated to have the patient as the center of attention, to have purposes and intentions as the main attributes of the clinical role. The performance of the clinical role requires that the nurse takes lead of the clinical autonomy, exercises it during interactions and actions with the patient and feels empowered by this exercise. The clinical role is an ability which, through clinical autonomy, is articulated as a form of power. Clinical autonomy concedes the nurse the power to think, to imagine, to make care plans and to influence the patients health. The analysis of the clinical roles concept will help to have reflections about the dimensions involved in the practice and teaching of nursing and to inform, not only the educational and professional practices politics, but health politics as well.

Background: Healthcare professionals meet patients with different cultural backgrounds. The patient’s culture can influence his view on health and disease, which indicates that cultural competence is an important feature of healthcare professionals in order to provide care with respect for the cultural differences that exist. Previous research shows that lack of knowledge for different cultures can lead to arising of poor attitudes at the healthcare professionals, which in turn can lead to discrimination. Healthcare professionals feel that there may be difficulties in caring for patients with different cultures as communication barriers. Aim: The aim of this thesis was to compile current research findings that illustrate how patients with different cultural backgrounds can experience the encounter with the medical care and which factors that can affect the experience. Method: A literature review based on 12 qualitative studies. Result: The way healthcare professionals act influences how people experience encounter in health care. The patients felt they were treated with respect. They experienced involvement and empathy, which strengthened the care relationship. They considered that they were seen as unique individuals by healthcare professionals and experienced equality in the encounter. Patientes felt that the experience of the encounter impaired due to language barriers. These communication barriers led to patients having a passive attitude in the care relationship and the patients experienced lack of participation. Patient felt that the encounter improved if the healthcare professionals were culturally competent. Patients did not experience any discrimination in the encounter, however, other patients considered that a poor encounter and prejudices among healthcare professionals could lead to patients feeling inferior. Conclusion: This literature review illustrates how patients with different culture backgrounds experience the encounter with the medical care and obstacles that can occur and complicate the medical encounter. The healthcare professionals should have knowledge about how patients with different culture backgrounds experience the medical encounter in order to apply it in health care and to give individualized care.

Bakgrund: Icke-verbal kommunikation definieras som all kommunikation utöver det talade ordet. Tidigare studier har visat att patienter värdesätter icke-verbala signaler såsom ögonkontakt, kroppsspråk och beröring, men att beröring sällan används som ett medvetet kommunikationsmedel. Det finns en underrepresentation av forskning kring icke-verbal kommunikation när det gäller sjuksköterskor, jämfört med andra yrkesgrupper. Syfte: Syftet med studien var att beskriva patienters upplevelser av icke-verbal kommunikation inom omvårdnadsrelationen. Metod: En allmän litteraturöversikt över åtta kvalitativa vetenskapliga artiklar. Resultat: Resultatet består av fem teman; varierande icke-verbal kommunikation i omvårdnadsrelationen, att göra patienten delaktig, beröringens påverkan på patienten, könets betydelse i upplevelsen av beröring och patientens utsatthet. Det var viktigt med en grundläggande relation innan beröring fick användas. Beröring hade positiva effekter på patienter såsom att få dem att känna sig sedda, accepterade och förankrade. Användandet av icke-verbal kommunikation kunde göra patienten delaktig eller stärka dess utsatthet. En problematik gällande sjuksköterskans eller patientens kön vid beröring framkom, då beröring exempelvis kunde väcka sexuell upphetsning. Slutsatser: Resultatet indikerar att sjuksköterskors kunskap om icke-verbal kommunikation och beröring behöver öka. Även i den kliniska praktiken behövs insatser för att sjuksköterskan ska ha tid att reflektera över och främja sin icke-verbala kommunikation. / Background: Nonverbal communication is defined as all means of communication beyond the spoken word. Previous studies show that patients value nonverbal signals such as eye contact, body language and touch, but also that touch is seldom used as a conscious means of communication. There is also an underrepresentation of research on nonverbal communication among nurses, compared to other professions. Aim: The aim of this study was to describe patients’ experiences of nonverbal communication in the nurse-patient relationship. Methods: A general literature review of eight scientific studies with a qualitative approach. Results: The results consist of five themes; variable nonverbal communication in the nurse-patient relationship, involving the patient, the impact of touch on the patient, the significance of gender on the experience of touch and the patient’s vulnerability. It was important to build a relationship with the patient before using touch. Touch had positive effects on patients, such as making them feel seen, accepted and anchored. The use of nonverbal communication could involve the patients or increase their vulnerability. An issue regarding the gender of the nurses or the patients arose while touching, which could cause sexual excitement for example. Conclusions: The results indicate that nurses’ knowledge concerning nonverbal communication and physical touch should be increased. In clinical practice, there is also a need for efforts to give nurses time to reflect on and increase their nonverbal communication.

Bakgrund: Psykisk ohälsa och sjukdom är vanligt förekommande i Sverige, tidigare studier har visat att personer med psykisk ohälsa eller sjukdom löper större risk att drabbas av somatiska sjukdomar jämfört med den generella populationen. Det förekommer att dessa patienter upplever stigmatisering i så väl samhället i stort som inom hälso- och sjukvården, vilket kan medföra risk för bristfällig omvårdnad av denna patientgrupp inom den somatiska vården. Syfte: Syftet var att utforska verksamma och blivande sjuksköterskors attityder gentemot patienter med psykisk ohälsa och sjukdom inom den somatiska vården. Metod: Elva vetenskapliga studier inkluderades i en litteraturstudie inom det valda forskningsområdet. Databaserna PubMed, CINAHL och PsycInfo användes för datainsamling. Samtliga artiklar kvalitetsgranskades och besvarade frågeställning och syfte. Resultat: Resultatanalysen resulterade i tre kategorier som beskriver attityder till psykisk ohälsa bland sjuksköterskor och blivande sjuksköterskor. Dessa kategorier är; Positiv attityd, Negativ attityd och Undvikande attityd. Erfarenhet, utbildning och kunskap är några av de viktigaste faktorerna som visat sig ha en inverkan på attityden till att vårda patienter med psykisk ohälsa. Slutsats: Sjuksköterskor och sjuksköterskestuderande har varierande attityder till att vårda patienter med psykisk ohälsa och sjukdom inom somatisk vård. Bristande kunskap och erfarenhet av psykisk ohälsa kan bidra till stigmatiserande och avståndstagande attityder, vilket kan leda till att patienten inte alltid får en optimal och likvärdig vård. Kunskap om dessa attityder kan bidra till att utveckla omvårdnaden för personer med psykisk sjukdom inom somatisk vård. / Background: Mental illness is common in Sweden, previous studies demonstrate that people with mental illness have an increased risk of physical illness compared to the general population. These patients often experience stigmatization generally in society, as well as within health care, which can result in a deficient care of these patients in the somatic care. Purpose: The aim of the study was to explore registered nurses and nursing students’ attitudes towards patients with mental illness in somatic care. Method: Ten scientific studies were included in a literature study of the chosen research field. The databases PubMed, CINAHL and PsycInfo was used for data collection. All the articles reviewed for quality and answered the purpose. Findings: The analysis resulted in three categories that describe attitudes to mental illness among nurses and nursing students. These categories are; Positive attitude, Negative attitude and Avoiding attitude. Experience, education and knowledge are some of the factors that can have an impact on the attitude towards caring for patients with mental illness. Conclusion: Nurses and nursing students express varying attitudes towards caring for patients with mental illness treated in somatic hospital settings. Lack of knowledge and experience of mental illness can result in stigmatization and rejection attitudes towards the patient, as well as an unequal care. Increased awareness about such attitudes can contribute to developing nursing care for these patients.

Bakgrund: God kommunikation och information är en förutsättning för patientdelaktighet. Det är av stor betydelse för patienter att vården byggs på en relation, där de känner sig värdefulla och bekräftade av sjuksköterskan. När patienter inte ges möjlighet att delta, kan det leda till att de känner bristande förtroende samt att de inte upplever sig respekterade. Problem: Patienter upplever att det inte alltid skapas förutsättningar för dem att delta i vård och behandling. De upplever sig nonchalerade och ignorerade när sjuksköterskan använder sin makt och kontroll. Syfte: Att beskriva sjuksköterskors erfarenheter av patientdelaktighet. Metod: En litteraturstudie med kvalitativ ansats. Tio vårdvetenskapliga artiklar valdes ut till analys enligt Evans. Resultat: Sjuksköterskor strävar efter att tillämpa patientdelaktighet, de beskriver även betydelsen av kommunikation, information samt relationen mellan patienten och sjuksköterskan. Vidare har de identifierat omständigheter som begränsar dem att skapa förutsättningar för patientdelaktighet. Slutsats: Patientdelaktighet är något som lätt kan tas förgivet av sjuksköterskor, och något som de tror att de tillämpar. Genom att lyfta fram sjuksköterskors erfarenheter kan Hälso- och sjukvården förhoppningsvis skapa bättre förutsättningar för yrkesverksamma samt framtida sjuksköterskor att tillämpa patientdelaktighet. / Background: Good communication and information is a prerequisite for patient participation. It´s important for patients that health care is built on a relationship where they feel valued and confirmed by the nurse. When patients are not given the opportunity to participate, it can lead to that they feel a lack of trust and they do not feel respected. Problem: Patients experience that there are not always conditions created for them to participate in their care. They feel neglected and ignored when the nurses uses their power and control. Objective/Aim: To describe nurses experience of patient participation. Method: A literature review with qualitative approach. Ten nursing science research articles were selected for analysis according to Evans. Results: Nurses strive to promote patient participation, they have also seen the importance of communication, information and the relationship between the patient and the nurse. Furthermore, they have identified circumstances that they feel are limitations to create conditions for patient participation. Conclusion: Patient participation is something that can easily be taken for granted by nurses, and something that they believe that they apply. By illustrating nurses experience can Health care hopefully create better conditions for professional and future nurses to apply patient participation.

Up to 60% of individuals with type 2 diabetes (T2DM) do not participate in regular physical activity (PA) despite the known benefits. To encourage these individuals to increase PA behavior, this study tested the feasibility and implementation of a nurse-directed counseling intervention using continuous glucose monitoring system (CGMS). The study used a framework derived from self-efficacy theory to 1) compare changes in self-efficacy, BP and activity counts between participants receiving CGMS counseling and standard T2DM counseling, 2) examine relationships between PA self-efficacy and BP and activity counts, 3) evaluate recruitment, retention, and screening strategies, and 4) assess instrument reliability and utility. Adults (N=52) with T2DM (non-insulin requiring, inactive) were randomized to intervention (n=27) or control groups (n=25). Both groups received 90 minutes of diabetes education with a follow-up phone call at 4 weeks. The intervention group also received feedback on their own CGMS graphs and a role model's graph depicting PA related reductions in glucose levels. PA benefits/barriers were discussed and goals were set. Outcomes were recorded at 1 and 8 weeks. Participants were older (57±14 years), predominantly (90%) white, about half (52%) female, and had diabetes for 8±7 years. Relative to the control group, participants receiving the intervention had higher self-efficacy scores at 8 weeks, indicating more confidence in sticking to a PA program. Their light/sedentary activity minutes decreased significantly and moderate activity minutes increased significantly; systolic BP, A1c and BMI decreased significantly. Only self-efficacy for "Sticking to it" was positively associated with moderate activity. The most successful recruitment media was multiple newspaper press releases. Most referrals came from endocrinology physicians. Of 231 study volunteers, 106 did not meet the criterion of A1c≥7.5%. These data suggest that CGMS feedback is feasible for counseling individuals with T2DM to improve PA and may improve risk factors for diabetes-related complications. Newspaper press releases are effective for recruiting participants with T2DM. Less restrictive inclusion criteria in a larger study may allow more participation by sedentary individuals with T2DM but may reduce effect size. CGMS was well tolerated and its data aided diabetes-related teaching.

Bakgrund: Suicid innebär att en människa avsiktligt och självförvållat skadar sig vilket leder till döden. Snabba och oförväntat försämrade tillstånd och död kan upplevas som oro och stress hos sjuksköterskan. Samtidigt är det sjuksköterskans plikt att möta, samtala och tolka patienten då det är i vårdrelationen en förståelse kan skapas för patientens suicidtankar. Attityder, kontext, tolkning av människosyn präglas av hur sjuksköterskans förhåller sig till den suicidala patienten. Syfte: Syftet var att beskriva sjuksköterskors upplevelser och erfarenheter i relation till suicid och den suicidnära patienten. Metod: En systematisk integrativ litteraturöversikt har använts som metod. Både kvantitativa och kvalitativa artiklar har hämtats från databaserna Cinahl, PubMed och PsycInfo. Totalt inkluderades 13 artiklar i resultatet. Resultat: Tre huvudteman teman framkom i resultatet, Sjuksköterskans känslor i mötet med suicid, närhet och distans, samt att förstå suicidhandlingen. Känslor av skuld beskrevs som en konsekvent genomgående i mötet med den suicidala patienten. Även svårigheter i att reglera närhet och distans till patienten medförde en obalans i att distansera sig kontra att närma sig i mötet. Kontext och sociokulturell tillhörighet påverkade relationen mellan sjuksköterskan och patienten. Diskussion: I resultatdiskussionen har delar av resultatet diskuterats utifrån Patrica Benners omvårdnadsteori, det femte och sista stadiet. Det är viktigt att erbjuda sjuksköterskans möjlighet till vidare utbildning i bemötandet men också i de egna psykologiska processer som mötet med negativa känslor och eventuella trauma kan innebära. / Background: Suicide means that a person intentionally and self-inflicted injures himself, which leads to death. Rapid and unexpectedly worsening conditions and deaths can be experienced as nurses' anxiety and stress. At the same time, it is the nurse's duty to meet, talk and interpret the patient as it is in the care relationship that an understanding can be created for the patient's suicidal thoughts. Attitudes, context, interpretation of human view are characterized by how the nurse's attitude to the suicidal patient. Aim: To describe nurses' experiences and experiences in relation to suicide and the suicidal patient. Method: A systematic integrative literature review has been selected. Both quantitative and qualitative articles have been used from the databases Cinahl, Pubmed and PsycInfo Knalf's integrative. Theoretical starting point was based on Patricia Benner's nursing theory where Benner's last and fifth stages were discussed. Results: Three main themes emerged in the result, Nurse's feelings in the meeting with suicide, proximity and distance, and understanding the suicide act. Feelings of guilt were described as consistent throughout the encounter with the suicidal patient. Difficulties in regulating proximity and distance to the patient also led to an imbalance in distancing versus approaching the meeting. Context and sociocultural belonging influenced the relationship between the nurse and the patient. Conclusions: In the result discussion, parts of the result have been discussed based on Patrica Benner's nursing theory, the fifth and last stage. It is important to offer the nurse's opportunity for further education in the treatment, but also in the own psychological processes that the encounter with negative emotions and possible trauma can entail.

Bakgrund: Både patienter och sjuksköterskor uppger att deras välmående är avsevärt bättre när sjuksköterskan vårdar med empati och de kan etablera en relation till varandra. Compassion fatigue (CF) är en stressrespons som drabbar personer i vårdgivande yrken, där sjuksköterskan påverkas både fysiskt och psykiskt.    Syfte: Att undersöka om och hur den personcentrerade omvårdnaden och dess kvalité påverkas när en sjuksköterska drabbats av CF.    Metod: Deskriptiv litteraturstudie som inkluderar 14 artiklar med kvalitativ och kvantitativ forskningsansats. Litteratursökningen utfördes i databaserna PubMed och CINAHL.    Resultat: Resultatet visar att den personcentrerade omvårdnaden indirekt försämras när sjuksköterskan drabbats av CF. Sjuksköterskans förhållningssätt gentemot patienten påverkades och patienterna ansåg att medkänsla var en huvudkomponent i god omvårdnad. Det identifierades två teman: Empatins betydelse för den personcentrerade omvårdnaden samt Emotionella och kognitiva reaktioner påverkar sjuksköterskans engagemang. Temat Empatins betydelse för den personcentrerade omvårdnaden har två underkategorier: Patienten upplever minskad förståelse och empati samt Bristande kvalité av omvårdnaden.    Slutsats: Det huvudsakliga resultatet visade att sjuksköterskans CF har en inverkan på patientens personcentrerade omvårdnad och kvalitén på omvårdnaden. När en sjuksköterska drabbas av CF får det ofta konsekvenser i sjuksköterskans yrkesutövning och omvårdnaden av patienter blir negativt påverkat. / Background: Both patients and nurses mention that their wellbeing is significantly better when the nurse care with compassion and a relationship is established. Compassion fatigue (CF) is a response of stress that affects caregiving professionals were nurses get physically and mentally affected.  Aim: To investigate if the person-centered care and quality of care are affected when a nurse has CF. Method: Literature review including 14 scientific articles with both qualitative and quantitative approach. Searches were made using the PubMed and CINAHL databases.   Results: The patient-centered care is affected and deteriorated by a nurse with CF. The nurses approach towards the patient were affected and the patients considerate that compassion was a major component of good nursing care. Themes that were identified were: The importance of empathy for person-centered care and Emotional and cognitive reactions affect the nurse's commitment. The theme of empathy for the person-centered care has two subcategories, the patient experiences reduced understanding and empathy and quality of nursing. Conclusion:  The nurse compassion fatigue has an impact on the patient-centered care and the quality of care. When a nurse is affected by CF there is consequences both in the professional life. The patients quality of care will be adversely affected.

Bakgrund Beroende ska ses som en sjukdom och kräver därmed vård anpassad till dess specifika behov. Patienter med substansberoende upplever stigmatisering och har negativa erfarenheter av vården, samtidigt som bemötandet från vårdpersonal är en viktig del i behandlingen för dessa patienter. Omvårdnadsbegreppet tillit är det här arbetets teoretiska utgångspunkt. Tillit är en förutsättning för att god omvårdnad ska kunna ges. Syfte Syftet var att belysa sjuksköterskors upplevelser och erfarenheter av mötet med patienter med substansberoende. Metod Metoden för detta arbete var en litteraturöversikt. Databaserna PubMed, CINAHL och PsycINFO användes för att söka fram artiklar. Femton vetenskapliga artiklar kvalitetsgranskades och sammanställdes i en matris. En integrerad analysmetod användes för att analysera och presentera datan i resultatet. Resultat Fem kategorier identifierades. Dessa var Sjuksköterskans arbets- och förhållningssätt, Attityder och fördomar, Brist på kunskap, Känslan av att inte få veta hela sanningen och Upplevda känslor i patientmötet. Sjuksköterskor upplevde en brist på kunskap gällande substansberoende patienter och även frustration, rädsla och oro i patientmötet. Sjuksköterskorna kände att patienterna inte berättade allt om sin smärta eller substansbruk, och hade mestadels negativa attityder och fördomar mot patienterna. De hade även olika tillvägagångssätt i bemötandet gentemot patienterna. Slutsats Det fanns stora brister i kunskap hos sjuksköterskor angående substansberoende patienter samt stora brister i tilliten dem emellan. Bristen på tillit bidrar till att patienters förtroende för sjuksköterskor minskar. En kompetenshöjning skulle kunna vara en lösning på en del av sjuksköterskornas upplevda problem