This work is to them who have recently received the diagnosed with Multiple Sclerosis (MS), since the disease is quite a life changer this by creating limitations and cause serious health problems. Problems that would changes their life forever, this in adapting to their new life situation where communication has become harder this to express in an understandable way and understanding has become even harder. Since being diagnosed with MS it affect more than a single person, the one diagnosed family is also experiencing almost the same sort of difficulties and life changer. In not knowing what their family member is trying to express, this in order to make the family understand them will create a gap between them of misunderstanding. Evan the healthcare experience this sort of troubles when they are trying to understand what their patient is trying to express, without the proper understanding it might cause mistreatment of the patient. With a clearer understanding of their patient could they early understand their patients in knowing what they are trying to express. Since the healthcare staffs has been educated about this sort of disease would an easy understanding about their patient be helpful, this to provide the patient with the proper care. People that has never heard and been in contact with this sort of disease and what sort of features it could cause would be enlighten about the disease as well how it is to live with it. Providing an eye-opener to the public in what this disease is and what sort of problems it causes, this to inform and sharing the information. By sharing the information concerning this would the public be enlighten and have an understanding about the problems, which the person with MS experience. In order of enable, this sort of understanding between those with MS and the healthy ones would to use design in order of creating a sort of platform of common understanding. Creating a sort of bridge of understanding between healthy people and those with MS, it would improve the understanding of the person with MS as well the disease itself. This sort of tool would be helpful in the health care in helping those who recently been diagnosed with MS, reducing the stress in knowing their disease. This would as well ease and milder the shock of them diagnosed, providing them some sort of comfort in knowing their disease. To understand this sort of problems and symptoms, it would be possible to enlighten people as well health care, about the hardship that those who live with MS which they are enduring each day. To be diagnosed with MS and not knowing about what it is could cause extreme stress, worsening the diseases, being in a new situation with an unknown disease, without having someone to ask about this, expect the healthcare. In healthcare there exists no book written by one having MS describing the different symptoms as well the troubles, which they experience, this sort of information would be helpful since the one having MS wants to know from one experience the same troubles as they. To feel the comfort regarding their disease as well to feel that there is someone that has gone through the same experience as they have gone through. The result, which is a book that would act as a tool for understanding the disease, its troubles and problems in a clear as well informed way. This would create a sort of bridge of understanding between those with MS and those without. The pictures in the book are illustrating and informing in a clear way about the disease and its different symptoms. Since the disease is difficult to understand due to its diversity of problems, the book is displaying some of the most common problems in how it is to experience MS. This sort of book could help the already diagnosed in understanding their disease and be something they could find comfort to know as well knowing that someone else has experienced the same things as them.

Bakgrund: Det är uppskattningsvis 2,5 miljoner svenskar som söker akutsjukvård på akutmottagningar per år (Socialstyrelsen, 2015). Detta gör att belastningen blir hög då resurser ofta saknas vilket bidrar till ökade väntetider. Patienters missnöje och organisatoriska problem är något som ofta framkommer i media. Genom att ta reda på patienternas faktiska upplevelse skapas förutsättningar för att mottagandet och omhändertagandet kan förbättras och i sin tur också vårdsituationen på akutmottagningen. Syfte: Med grund i Travelbees teori beskriva personers upplevelse av att vårdas på en akutmottagning. Metod: En deduktiv litteraturöversikt genomfördes och nio artiklar analyserades utifrån Travelbees omvårdnadsteori. Resultat: Travelbees begrepp lidande, mening, mellanmänskliga relationer, människan som individ och kommunikation utgör teman. Patienter upplever att kommunikationen mellan dem och vårdpersonal har stor betydelse. Den mänskliga kontakten som detta möte innebär gör att patienten känner sig bekräftad. Saknar patienten bekräftelse i form av mänsklig kontakt eller kommunikation leder det till missnöjdhet i vårdsituationen. Slutsatser: Vårdpersonalens bemötande påverkar patientens upplevelse av akutmottagningen och hjälper patienterna att hantera situationen. Kontinuerlig kontakt med vårdpersonal har visat sig ha betydelse för patienten då de blir bekräftade. Sjuksköterskan bör vara medveten om vilka förväntningar patienten har och kunna hantera de olika vårdsituationerna på ett professionellt sätt. / Background:  It´ about 2,5 million Swedes who seek emergency treatment per year (Socialstyrelsen, 2015).  This leads to high pressure at the emergency department. Resources are often scarce and contributes to increased waiting times. Media shows a negative image of care and organizational problems often appears. Looking at patients' experiences of the situation at the emergency department, creates conditions for improving the healthcare situation at emergency department.  Aim: To describe peoples experience of being treated at the emergency department by using Travelbees nursing theory. Method: A deductive literature review was conducted and nine articles were analyzed by Travelbees nursing theory. Results: Travelbees concepts suffering, meaning, human relation, human as an individual and communication creates theme in the result. Patients experiencing that communication between them and the healthcare professionals is of great importance. This contact makes the patient feel confirmed. If the patient feel that they are not confirmed because of lacking communication or human contact it leads to a feeling of dissatisfaction.  Conclusion: Healthcare professional’s treatment affects the patients experience in the emergency department and helps them to cope with the situation. Continuous contact with health professionals is of importance for the patient and makes them feel confirmed. The nurse must be aware of which expectations the patient has when they seek emergency care and be able to give professional care.

Bakgrund: Stickrädsla är ett vanligt problem när det gäller barn. Om inte detta problem studeras så att sjuksköterskan kan få en bredare kunskap i omvårdnadsarbetet, kan detta i sin tur leda till att barn inte söker vård i framtiden. Idag saknas det forskning som belyser fenomenet stickrädsla hos barn. Syfte: Var att belysa erfarenheter från stickrädda barn och deras föräldrar i mötet med vården. Metod: Denna litteraturstudie bygger på tio vetenskapliga artiklar som utgått från kvalitativ och induktiv ansats. Datamaterialet analyserades med hjälp av en innehållsanalys. Resultat: Återger faktorer som påverka barnets stickrädsla negativt. Vad barn och föräldrar har haft för förväntningar och föreställningar av mötet i vården. Barnens och föräldrarnas negativa och positiva upplevelser i mötet med vården. Slutsatser: Stickrädda barn behöver få vara mer delaktiga i sin vård oavsett ålder. För att få barnets tillit behöver sjuksköterskan dessutom vara mer lyhörd och ta vara på barnets erfarenheter samt föräldern i mötet. Detta görs för att få ta del av barnets livsvärld. För att ytterligare öka kunskapen och förståelsen utifrån ett stickräddabarns perspektiv och erfarenheter. Det behövs mer kvalitativ forskning inom området, för att kunna skapa en tryggare plats för barnet och stärka sjuksköterskans kunskapsområde.

Bakgrund Övervikt och obesitas är en global epidemi med negativa konsekvenser för folkhälsan. Behandlingen kan ske genom förändrade levnadsvanor, farmakologisk- eller kirurgisk behandling. Dock är vården ojämnt fördelad där skillnader finns i utbud och kvalitet. Vad personer anser är stödjande vid behandling av övervikt eller obesitas kan vara avgörande för behandlingsutfallet och hållbarheten över tid. Därför är det viktigt att undersöka personernas perspektiv. Syfte Syftet med studien var att beskriva personers perspektiv av stöd vid behandling av övervikt och obesitas inom vården. Metod En icke-systematisk litteraturöversikt baserat på 15 vetenskapliga originalartiklar. Artikelsökningarna är gjorda, utifrån relevanta sökord för syftet, i databaserna PubMed och CINAHL. Samtliga artiklar har kvalitetsgranskats utifrån bedömningsunderlaget av Sophiahemmets Högskola. En integrerad dataanalys utfördes för sammanställandet av resultatet. Resultat Tre huvudkategorier identifierades: Behovet av individanpassning, Vårdpersonalens betydande roll och Betydelsen av sociala interaktioner. Resultatet visade på att behovet av stöd är högst subjektivt och bör anpassas utifrån varje persons behov och resurser. Vidare ska hela personen bejakas. Vårdpersonal bör inneha kunskap, visa medkänsla, lyssna och vara icke-dömmande för att ses som stödjande. Därtill ansåg många av deltagarna att behovet av stöd kvarstår under lång tid. Slutsats För att stöd ska kunna upplevas som värdefullt av personer vilka behandlas för sin övervikt eller obesitas behöver individanpassning ske. När behandlingen utformas tillsammans med och utgår från personen kan ett holistiskt synsätt intas. Detta kan medföra att sjukdoms- och vårdlidandet blir mindre samtidigt som personers välbefinnande främjas. Därtill kan obesitasrelaterade komplikationer minska som ett resultat av god personcentrerad omvårdnad med en effektivare och stödjande behandling. / Background Overweight and obesity is a global epidemic with negative consequences for public health. Treatment offered can include lifestyle changes, pharmacological or surgical treatment. However, care services are unevenly distributed with differences in supply and quality. What people with overweight or obesity consider supportive in regard to treatment can impact on treatment outcomes and sustainability over time. Therefore, it is important to investigate the person's perspective. Aim The aim of the study was to describe the person's perspective of support in the treatment of overweight and obesity in healthcare. Method A non-systematic literature review based on 15 original scientific articles. The articles were retrieved, based on various keywords for the purpose, in the databases PubMed and CINAHL. All articles have been quality reviewed based on Sophiahemmet University assessment documents. An integrated data analysis was performed to compile the results. Results Three main categories were identified: The need for individual adaptation, The important role of healthcare staff and The importance of social interactions. The results showed that the need for support is highly subjective and should be adapted based on each person's needs and resources. Healthcare professionals should possess knowledge, show compassion, listen and be non-judgmental to be seen as supportive. The need for support is belived to remain for a long time. Conclusions In order for support to be perceived as valuable by people who are being treated for their overweight or obesity, the treatment needs to be individualized. When the treatment is designed together with and based on the person, a holistic approach can be adopted. This can lead to less suffering and at the same time promote the people's well-being. In addition, obesity-related complications can be reduced as a result of good person-centered care with more effective and supportive treatment

A Organização Mundial de Saúde define o termo adesão como “o grau em que a conduta de um paciente, em relação à sua tomada de medicamentos, seguimento de uma dieta ou modificações nos seus hábitos de vida, correspondem com as recomendações acordadas com os profissionais de saúde”. As estimativas de adesão em doenças crônicas variam de 17% a 80% e a não-adesão pode levar ao aumento de morbidade, mortalidade e custos em saúde. A falta de adesão frente a tratamentos crônicos, com as suas implicações negativas clínicas e econômicas, é considerada um tema prioritário de saúde pública. Diversos estudos tem focado em intervenções para melhorar a adesão a medicamentos em doenças crônicas, porém os métodos atuais são muitas vezes complexos e pouco eficazes, de modo que os benefícios aos tratamentos não sejam realizados. A habilidade de pacientes seguirem o tratamento de maneira correta freqüentemente se vê comprometida por mais de uma barreira, geralmente relacionada a diferentes aspectos do problema, incluindo fatores econômicos e sociais, sistema de saúde, características da doença, fatores relacionados ao regime terapêutico além de fatores relacionados ao próprio paciente. Os métodos disponíveis para mensurar a adesão são classificados em métodos diretos e indiretos, e, nenhum é considerado “padrão ouro”. Além disso, ao medir o comportamento de adesão, não se revela o motivo da não-adesão. Baseado nisto, se propôs a realização deste estudo, objetivandose identificar tanto os fatores relacionados à não-adesão, segundo a visão de pacientes ambulatoriais, assim como as principais barreiras para a não-adesão às recomendações dos profissionais da saúde através de elaboração de um questionário semi-estruturado. Foram incluídos no estudo pacientes portadores de doenças crônicas, com no mínimo 18 anos de idade. A amostra é constituída por usuários de medicamentos, estando próximos da terceira idade (58,7 anos), portadores de morbidades crônicas e em tratamento com polifarmácia (54%). Foram entrevistados 405 pacientes nas áreas de acesso ao ambulatórios no Hospital de Clínicas de Porto Alegre. As perguntas referentes às questões 5 a, 6, 7 a e 8, foram as que permitiram, conforme as respostas dos pacientes, a divisão entre 2 grupos: aqueles que relataram alguma dificuldade, ou queixa em relação a medicamentos ou ainda, maior facilidade de esquecimento no momento de administrar seus medicamentos e aqueles que não relataram nenhum desses fatores. A questão 5, que se refere ao tipo de medicamento que os pacientes mais esquecem de tomar ou acham mais fácil esquecê-lo de tomar, apresentou as variáveis depressão, enxaqueca, osteoartrite e dor abdominal com significância estatística. Na questão 6, que se refere às dificuldades que as pessoas possam ter para seguir um tratamento, não houve significância estatística para as variáveis osteoartrite e idade e, somente estas variáveis apresentaram significância na questão 7, que se refere aos motivos que levam os pacientes a esquecer de tomar um medicamento. As questões 8 e 35, que se referem ao fator que causa incômodo ao usuário e existência de forma farmacêutica apontada no mostruário com alguma dificuldade de adesão, respectivamente, apresentaram as variáveis dor abdominal, na primeira, e idade (+ jovens), na segunda questão com significância estatística (p<0,05). As intervenções dirigidas à adesão terapêutica devem adaptar-se às exigências particulares relacionadas com a enfermidade do paciente. / According to the World Health Organization, the term adherence is characterized as “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”. Estimates of adherence in chronic diseases range from 17% to 80% and non adherence can lead to increased morbidity, mortality and health cost. The lack of adherence to chronic disease with its negative implications for clinical and economic, is considered a priority for public health. Several studies have focused on interventions to improve adherence to medication in chronic diseases, but current methods are often complex and inefficient, so the benefits of the treatments are not made. The ability of patients to follow the treatment properly often is compromised for over a barrier, usually related to different aspects of the problem, including economic and social factors, health care, disease characteristics, factors related to the therapeutic regimen as well as factors related to the patient. The available methods to measure adherence are classified into direct and indirect methods, and none are considered “gold standard”. Furthermore, by measuring the adherence behavior, doesn’t reveal the reason for non-adherence. Based on this, we proposed this study, aiming to identify both the factors related to non-adherence to the vision of outpatients, as well as the major barriers of non-adherence to the recommendations of health professionals through development of a semi-structured questionnaire. The study included patients with chronic diseases, with at least 18 years of age. The samples consists of drug users, with the third coming of age (58,7%) with chronic morbidity and treated with polypharmacy (54%). We interviewed 405 patients in the areas of access to outpatient clinics at the Hospital de Clínicas de Porto Alegre. Questions concerning matters within the 5, 6, 7 and 8, were they allowed, as patient’s responses, the division between two groups: those who reported some difficulty, or complaint in relation to drugs or even more easily forgotten at the time of administering their medications and those who reported no such factors. In question 5, the statistically significant variables were depression, migraine, osteoarthritis and abdominal pain. In question 6, no significance statistics for the variables age and osteoarthritis, and only these variables had significance in question 7. The question 5, which refers to the type of medicine that most patients forget to take or find it easier to forget to take it, presented the variables depression, migraine, abdominal pain and osteoarthritis with statiscal significance. In question 6, which refers to the difficulties that people may have to follow a treatment, there was stastical significance variables for osteoarthritis and age, these variables were significant only in question 7, which refers to the reasons that lead patients to forget to take a medicine. Questions 8 and 35, which refers to the factor that causes discomfort to the user and the existence of the dosage form indicated in the showcase, with some difficulty of adherence, respectively, had the variables abdominal pain, at first, and age (youngers), the second concerned with statistical significance (p<0,05). Interventions aimed at treatment adherence must be tailored to the particular requirements related to the illness of the patient.

A Organização Mundial de Saúde define o termo adesão como “o grau em que a conduta de um paciente, em relação à sua tomada de medicamentos, seguimento de uma dieta ou modificações nos seus hábitos de vida, correspondem com as recomendações acordadas com os profissionais de saúde”. As estimativas de adesão em doenças crônicas variam de 17% a 80% e a não-adesão pode levar ao aumento de morbidade, mortalidade e custos em saúde. A falta de adesão frente a tratamentos crônicos, com as suas implicações negativas clínicas e econômicas, é considerada um tema prioritário de saúde pública. Diversos estudos tem focado em intervenções para melhorar a adesão a medicamentos em doenças crônicas, porém os métodos atuais são muitas vezes complexos e pouco eficazes, de modo que os benefícios aos tratamentos não sejam realizados. A habilidade de pacientes seguirem o tratamento de maneira correta freqüentemente se vê comprometida por mais de uma barreira, geralmente relacionada a diferentes aspectos do problema, incluindo fatores econômicos e sociais, sistema de saúde, características da doença, fatores relacionados ao regime terapêutico além de fatores relacionados ao próprio paciente. Os métodos disponíveis para mensurar a adesão são classificados em métodos diretos e indiretos, e, nenhum é considerado “padrão ouro”. Além disso, ao medir o comportamento de adesão, não se revela o motivo da não-adesão. Baseado nisto, se propôs a realização deste estudo, objetivandose identificar tanto os fatores relacionados à não-adesão, segundo a visão de pacientes ambulatoriais, assim como as principais barreiras para a não-adesão às recomendações dos profissionais da saúde através de elaboração de um questionário semi-estruturado. Foram incluídos no estudo pacientes portadores de doenças crônicas, com no mínimo 18 anos de idade. A amostra é constituída por usuários de medicamentos, estando próximos da terceira idade (58,7 anos), portadores de morbidades crônicas e em tratamento com polifarmácia (54%). Foram entrevistados 405 pacientes nas áreas de acesso ao ambulatórios no Hospital de Clínicas de Porto Alegre. As perguntas referentes às questões 5 a, 6, 7 a e 8, foram as que permitiram, conforme as respostas dos pacientes, a divisão entre 2 grupos: aqueles que relataram alguma dificuldade, ou queixa em relação a medicamentos ou ainda, maior facilidade de esquecimento no momento de administrar seus medicamentos e aqueles que não relataram nenhum desses fatores. A questão 5, que se refere ao tipo de medicamento que os pacientes mais esquecem de tomar ou acham mais fácil esquecê-lo de tomar, apresentou as variáveis depressão, enxaqueca, osteoartrite e dor abdominal com significância estatística. Na questão 6, que se refere às dificuldades que as pessoas possam ter para seguir um tratamento, não houve significância estatística para as variáveis osteoartrite e idade e, somente estas variáveis apresentaram significância na questão 7, que se refere aos motivos que levam os pacientes a esquecer de tomar um medicamento. As questões 8 e 35, que se referem ao fator que causa incômodo ao usuário e existência de forma farmacêutica apontada no mostruário com alguma dificuldade de adesão, respectivamente, apresentaram as variáveis dor abdominal, na primeira, e idade (+ jovens), na segunda questão com significância estatística (p<0,05). As intervenções dirigidas à adesão terapêutica devem adaptar-se às exigências particulares relacionadas com a enfermidade do paciente. / According to the World Health Organization, the term adherence is characterized as “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”. Estimates of adherence in chronic diseases range from 17% to 80% and non adherence can lead to increased morbidity, mortality and health cost. The lack of adherence to chronic disease with its negative implications for clinical and economic, is considered a priority for public health. Several studies have focused on interventions to improve adherence to medication in chronic diseases, but current methods are often complex and inefficient, so the benefits of the treatments are not made. The ability of patients to follow the treatment properly often is compromised for over a barrier, usually related to different aspects of the problem, including economic and social factors, health care, disease characteristics, factors related to the therapeutic regimen as well as factors related to the patient. The available methods to measure adherence are classified into direct and indirect methods, and none are considered “gold standard”. Furthermore, by measuring the adherence behavior, doesn’t reveal the reason for non-adherence. Based on this, we proposed this study, aiming to identify both the factors related to non-adherence to the vision of outpatients, as well as the major barriers of non-adherence to the recommendations of health professionals through development of a semi-structured questionnaire. The study included patients with chronic diseases, with at least 18 years of age. The samples consists of drug users, with the third coming of age (58,7%) with chronic morbidity and treated with polypharmacy (54%). We interviewed 405 patients in the areas of access to outpatient clinics at the Hospital de Clínicas de Porto Alegre. Questions concerning matters within the 5, 6, 7 and 8, were they allowed, as patient’s responses, the division between two groups: those who reported some difficulty, or complaint in relation to drugs or even more easily forgotten at the time of administering their medications and those who reported no such factors. In question 5, the statistically significant variables were depression, migraine, osteoarthritis and abdominal pain. In question 6, no significance statistics for the variables age and osteoarthritis, and only these variables had significance in question 7. The question 5, which refers to the type of medicine that most patients forget to take or find it easier to forget to take it, presented the variables depression, migraine, abdominal pain and osteoarthritis with statiscal significance. In question 6, which refers to the difficulties that people may have to follow a treatment, there was stastical significance variables for osteoarthritis and age, these variables were significant only in question 7, which refers to the reasons that lead patients to forget to take a medicine. Questions 8 and 35, which refers to the factor that causes discomfort to the user and the existence of the dosage form indicated in the showcase, with some difficulty of adherence, respectively, had the variables abdominal pain, at first, and age (youngers), the second concerned with statistical significance (p<0,05). Interventions aimed at treatment adherence must be tailored to the particular requirements related to the illness of the patient.

A Organização Mundial de Saúde define o termo adesão como “o grau em que a conduta de um paciente, em relação à sua tomada de medicamentos, seguimento de uma dieta ou modificações nos seus hábitos de vida, correspondem com as recomendações acordadas com os profissionais de saúde”. As estimativas de adesão em doenças crônicas variam de 17% a 80% e a não-adesão pode levar ao aumento de morbidade, mortalidade e custos em saúde. A falta de adesão frente a tratamentos crônicos, com as suas implicações negativas clínicas e econômicas, é considerada um tema prioritário de saúde pública. Diversos estudos tem focado em intervenções para melhorar a adesão a medicamentos em doenças crônicas, porém os métodos atuais são muitas vezes complexos e pouco eficazes, de modo que os benefícios aos tratamentos não sejam realizados. A habilidade de pacientes seguirem o tratamento de maneira correta freqüentemente se vê comprometida por mais de uma barreira, geralmente relacionada a diferentes aspectos do problema, incluindo fatores econômicos e sociais, sistema de saúde, características da doença, fatores relacionados ao regime terapêutico além de fatores relacionados ao próprio paciente. Os métodos disponíveis para mensurar a adesão são classificados em métodos diretos e indiretos, e, nenhum é considerado “padrão ouro”. Além disso, ao medir o comportamento de adesão, não se revela o motivo da não-adesão. Baseado nisto, se propôs a realização deste estudo, objetivandose identificar tanto os fatores relacionados à não-adesão, segundo a visão de pacientes ambulatoriais, assim como as principais barreiras para a não-adesão às recomendações dos profissionais da saúde através de elaboração de um questionário semi-estruturado. Foram incluídos no estudo pacientes portadores de doenças crônicas, com no mínimo 18 anos de idade. A amostra é constituída por usuários de medicamentos, estando próximos da terceira idade (58,7 anos), portadores de morbidades crônicas e em tratamento com polifarmácia (54%). Foram entrevistados 405 pacientes nas áreas de acesso ao ambulatórios no Hospital de Clínicas de Porto Alegre. As perguntas referentes às questões 5 a, 6, 7 a e 8, foram as que permitiram, conforme as respostas dos pacientes, a divisão entre 2 grupos: aqueles que relataram alguma dificuldade, ou queixa em relação a medicamentos ou ainda, maior facilidade de esquecimento no momento de administrar seus medicamentos e aqueles que não relataram nenhum desses fatores. A questão 5, que se refere ao tipo de medicamento que os pacientes mais esquecem de tomar ou acham mais fácil esquecê-lo de tomar, apresentou as variáveis depressão, enxaqueca, osteoartrite e dor abdominal com significância estatística. Na questão 6, que se refere às dificuldades que as pessoas possam ter para seguir um tratamento, não houve significância estatística para as variáveis osteoartrite e idade e, somente estas variáveis apresentaram significância na questão 7, que se refere aos motivos que levam os pacientes a esquecer de tomar um medicamento. As questões 8 e 35, que se referem ao fator que causa incômodo ao usuário e existência de forma farmacêutica apontada no mostruário com alguma dificuldade de adesão, respectivamente, apresentaram as variáveis dor abdominal, na primeira, e idade (+ jovens), na segunda questão com significância estatística (p<0,05). As intervenções dirigidas à adesão terapêutica devem adaptar-se às exigências particulares relacionadas com a enfermidade do paciente. / According to the World Health Organization, the term adherence is characterized as “the extent to which a person’s behavior – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”. Estimates of adherence in chronic diseases range from 17% to 80% and non adherence can lead to increased morbidity, mortality and health cost. The lack of adherence to chronic disease with its negative implications for clinical and economic, is considered a priority for public health. Several studies have focused on interventions to improve adherence to medication in chronic diseases, but current methods are often complex and inefficient, so the benefits of the treatments are not made. The ability of patients to follow the treatment properly often is compromised for over a barrier, usually related to different aspects of the problem, including economic and social factors, health care, disease characteristics, factors related to the therapeutic regimen as well as factors related to the patient. The available methods to measure adherence are classified into direct and indirect methods, and none are considered “gold standard”. Furthermore, by measuring the adherence behavior, doesn’t reveal the reason for non-adherence. Based on this, we proposed this study, aiming to identify both the factors related to non-adherence to the vision of outpatients, as well as the major barriers of non-adherence to the recommendations of health professionals through development of a semi-structured questionnaire. The study included patients with chronic diseases, with at least 18 years of age. The samples consists of drug users, with the third coming of age (58,7%) with chronic morbidity and treated with polypharmacy (54%). We interviewed 405 patients in the areas of access to outpatient clinics at the Hospital de Clínicas de Porto Alegre. Questions concerning matters within the 5, 6, 7 and 8, were they allowed, as patient’s responses, the division between two groups: those who reported some difficulty, or complaint in relation to drugs or even more easily forgotten at the time of administering their medications and those who reported no such factors. In question 5, the statistically significant variables were depression, migraine, osteoarthritis and abdominal pain. In question 6, no significance statistics for the variables age and osteoarthritis, and only these variables had significance in question 7. The question 5, which refers to the type of medicine that most patients forget to take or find it easier to forget to take it, presented the variables depression, migraine, abdominal pain and osteoarthritis with statiscal significance. In question 6, which refers to the difficulties that people may have to follow a treatment, there was stastical significance variables for osteoarthritis and age, these variables were significant only in question 7, which refers to the reasons that lead patients to forget to take a medicine. Questions 8 and 35, which refers to the factor that causes discomfort to the user and the existence of the dosage form indicated in the showcase, with some difficulty of adherence, respectively, had the variables abdominal pain, at first, and age (youngers), the second concerned with statistical significance (p<0,05). Interventions aimed at treatment adherence must be tailored to the particular requirements related to the illness of the patient.

Bakgrund:Diabetes mellitus typ 2 (DM2) är en folksjukdom som innebär ett tillstånd av kronisk hyperglykemi. Sjukdomen har ökat och uppskattas fortsätta öka globalt. Samhälleliga insatser är väsentliga för att bevara människors hälsa och sätta stopp på den snabba ökningen. Kost, fysisk aktivitet, glukosmätning samt medicinering är alla en del av den egenvård som DM2 kräver. DM2 klassas som en kronisk sjukdom, en sådan sjukdom som kan påverka de drabbade individerna både fysiskt och psykiskt. Sjuksköterskan har en central roll i vården av patienter med DM2 för att utbilda, informera, vårda och stötta dem. Syfte: Syftet var att undersöka patienters upplevelse av egenvård vid diabetes mellitus typ 2. Metod: En litteraturöversikt med 10 vetenskapliga artiklar, hämtade från databaserna CINAHL complete och Pubmed. Dessa analyserades genom Fribergs beskrivning.  Resultat: Sex huvudteman identifierades. “Källor till stöd vid diabetes”, “Att vara i kontroll över sin sjukdom”, “Känslor, attityder och förhållningssätt till egenvård”, “Kost och fysisk aktivitet”, “Ekonomiska aspekter”, “Hälso- och sjukvårdspersonalens roll vid egenvården av diabetes”. Sammanfattning: Stöd från närstående vid egenvård samt kunskap och utbildning kring DM2 var centrala faktorer för deltagarna i studierna. Vid bristande kunskap var egenvård svårt att uppnå men vid god kunskap upplevdes en känsla av kontroll över sjukdomen. De mest förekommande hindren för egenvård var relaterade till kost, ekonomi och sociala sammanhang. Vårdpersonalen behöver förbättra den information och utbildning som är nödvändig för patienter med DM2 för att de ska kunna uppnå god egenvård. / Background: Diabetes mellitus type 2 (DM2) is a public health disease that implies a state of chronic hyperglycemia. The disease has increased and is estimated to globally continue to increase significantly. Societal inputs are essential to preserve people's health and to stop the large increase. Diet, physical activity, glucose monitoring and medication are all a part of the self-care that DM2 requires. DM2 is classified as a chronic illness, a kind of illness that can impact the affected individuals both physically and mentally. Nurses have a central role in the care of patients with DM2 to educate, inform, care and support them. Aim: The aim was to explore patients experience of self-care in diabetes type 2. Method: A literature review with 10 scientific articles, chosen from the databases CINAHL complete and Pubmed. These were analyzed through Fribergs description. Results: Six main themes were identified. “Souces of support within diabetes”, “To be in control of the disease”, “Feelings, attitudes and approach in self-care", “Diet and physical activity”, “Economic aspects”, “Healthcare professionals roll within the self-care of diabetes”. Conclusion: Support from loved ones with self-care and knowledge and education about DM2 were key factors for the participants. In lack of knowledge was self-care difficult to achieve but with good knowledge, was a feeling of control over the illness experienced. The most occurring obstacles for self-care was related to diet, economy, and social settings were among other things. Healthcare providers need to improve the information and education that is necessary for patients with DM2 so that they can achieve good self-care.