As relações interpessoais são discutidas em vários campos da enfermagem; na saúde mental e na psiquiátrica elas se desenvolvem como relações terapêuticas sendo abordadas como relação de ajuda ou relacionamento interpessoal. Na Abordagem Centrada na Pessoa as atitudes de consideração positiva incondicional, atitude empática e congruência são imprescindíveis para se desenvolver relações interpessoais terapêuticas promovendo nelas um clima de facilitação do crescimento e desenvolvimento do sujeito no cuidado. Na literatura brasileira de enfermagem não foram encontradas medidas de avaliação de tais atitudes embora se acredite que serão necessárias tanto no campo do cuidado quanto da educação. Através deste estudo, buscou-se desenvolver um instrumento de avaliação das relações interpessoais, abrangendo as três atitudes facilitadoras: consideração positiva incondicional, atitude empática e congruência e realizar a análise exploratória quanto à dimensionalidade e a fidedignidade do instrumento. O polo teórico envolveu a explicação dos construtos, a elaboração dos itens e as análises empíricas; o polo empírico relacionou-se a fase de experimentação do instrumento. Trata-se da escala de observação da interação enfermeiro-cliente constituída de itens positivos e reversos, tipo likert com cinco pontos. A consideração positiva incondicional ficou com 22 itens (15 reversos); a atitude empática compôs-se de 18 itens (2 reversos) e a congruência totalizou em 8 itens (2 reversos). Tais itens expressam o componente comportamental, verbal e motor de cada construto e foram indicados para o uso em situações de observação durante o cuidado. Optou-se pela filmagem das relações interpessoais desenvolvidas por 10 enfermeiros com 92 pessoas diagnosticadas com transtornos mentais durante consultas de enfermagem realizadas nas Estratégias de Saúde da Família de uma cidade do interior de Minas Gerais. No polo analítico, utilizou-se da análise fatorial (AF) e a consistência interna (coeficiente alfa de Cronbach) segundo referencial teórico-metodológico utilizado. O instrumento foi avaliado segundo modelo teórico apresentando alfa da escala global de 0,82, do atributo um (consideração positiva incondicional) 0,68, do atributo dois (atitude empática) 0,76 e do atributo três (congruência) 0,49. Devido à baixa consistência interna do atributo três em conformidade com os resultados das cargas fatoriais, analisou-se um modelo sugerido pela AF de 36 itens, o que se mostrou frágil em relação aos conceitos constitutivos e a operacionalização. Os melhores resultados apontaram para um instrumento composto de três subescalas. A escala global de consideração positiva incondicional apresentou alfa de 0,687, a escala de atitude empática teve escore global de 0,769 e a terceira de 0,517. Itens com cargas fatorais abaixo de 0,40 foram eliminados. Todos os coeficientes foram significativos com valor-p <0,01 e correlação significativa observada pelo coeficiente de Spearman. Consideram- se necessários ajustes no construto/atributo três, devido à fragilidade dos resultados, embora estejam dentro dos parâmetros considerados aceitáveis. O instrumento construído pode ser utilizado por profissionais que desejam avaliar as relações interpessoais no cuidado de enfermagem que tenha a finalidade de pesquisa ou didática. / The interpersonal relations are discussed in many nursing fields and in mental health or psychiatric nursing they develop themselves as therapeutic relations that are approached as help relations or interpersonal relationship. In the Person-Centred Approach, unconditional positive consideration attitudes, empathetic attitudes and congruence are indispensable to develop therapeutic interpersonal relations and to promote an environment of growing and development facilitation for the subject on care. In Brazilian nursing literature, evaluation measures for these attitudes were not found although one believes that they will be necessary so far as in care and education fields. Through this study, one had as an objective to develop an interpersonal relationship evaluation instrument that enfolds the three facilitating attitudes, unconditional positive consideration attitudes, empathetic attitudes and congruence, and to perform the exploratory analysis concerning the dimensionality and reliability of such an instrument. The theoretic pole involved the explanation of the constructs, elaboration of the items and empirical analysis; the empirical pole related to the experimentation phase of the instrument. It is a matter of nurse-customer interaction observation scale constituted of positive and reverse items like a Likert-scale with five points. The unconditional positive consideration stayed with 22 items (15 reverse); the empathetic attitude was composed of 18 items (2 reverse) and the congruence counted for 8 items (2 reverse). Such items express the behavioral, oral and motor component of each construct and were indicated for using in conditions of observation during care. One chose for recording the interpersonal relations developed by 10 nurses involving 92 subjects with mental-impaired patients during nursing inquiries performed in Family Health Strategies in an inland city of Minas Gerais. In the analytical pole one made use of the factorial analysis (FA) and the internal consistency (Cronbach\'s alpha-coefficient) according the used theoretic-methodological referential. The instrument evaluated concerning to the theoretical model presented an alpha-scale global outcome of 0.82, being 0.68 for attribute one (unconditional positive consideration), 0.76 for attribute two (empathetic attitude) and 0.49 for attribute three (congruence). Due to the low internal consistency of attribute three in relation to the factorial load results, one analyzed a model of 36 items suggested by FA that showed itself fragile in relation to constitutive concepts and operationalization. The best outcomes indicate a three-subscale instrument. The unconditional positive consideration global scale presented an alpha of 0.687, the empathetic attitude scale got a global score of 0.769, and congruence featured 0.517. Items with factorial load below 0.40 were eliminated. All coefficients were significant for p<0.01 and significant correlation confirmed by Spearman coefficient. Some adjustments are necessary for the third construct/item due to the fragility of the results, although they are within acceptable parameters. The instrument so developed can be used by professionals who wish to evaluate the interpersonal relations in nursing care with research or didactic purpose.

Aims: Exercise and physical activity have been found to be beneficial in managing disabilities caused by multiple sclerosis (MS). Despite the known benefits, people with MS (pwMS) are inactive. Research has focused on structured exercise programmes, rarely considering a broader range of activities, which pwMS integrate into everyday life. The aims of this study were to gain in-depth understanding of the priorities and meanings of exercise and physical activity from the perspective of pwMS and to explore how these might inform clinical practice. Methods: a mixed methods approach using three interconnected studies was adopted: Study 1: A four-round Delphi questionnaire scoped and determined consensus of priorities for exercise and physical activity and the reasons why pwMS (n=101) engaged in these activities. Content and statistical analyses were utilised. Study 2: Sixteen face-to-face, semi-structured interviews were conducted with pwMS to explore the meanings ascribed to exercise and physical activity in relation to the Delphi study. Study 3: Three focus groups involving 14 physiotherapists explored perceptions about exercise and physical activity. Data were analysed for studies 2 and 3 using Framework Analysis and themes developed. Results: outcome from each phase 1. Study 1 revealed that the prioritised exercise and physical activity practices and the reasons why pwMS (n=70) undertook these activities were diverse. Consensus was found for the exercise and physical activity practices (W=0.744, p < 0.0001) and the reasons why pwMS engaged in these activities (W=0.723, p < 0.0001). 2. Study 2 demonstrated that the meanings pwMS ascribed to exercise and physical activity was beyond ‘movement’ reflecting how they lived with a variable and progressive condition. Contextual factors, specifically personal factors were dominant influences. 3. Study 3 highlighted that physiotherapists shared similar views in some aspects to pwMS, however physiotherapists perceptions of exercise and physical activity were predominately influenced by their theoretical knowledge. Conclusion: The priorities and meanings ascribed to exercise and physical activity were ‘a matter of perspective’ and context driven. Understanding the strategies used by pwMS for prioritisation might help clinicians support pwMS more effectively in their decision making about exercise and physical activity. Taking this approach creates the opportunity to deliver a more focused patient-centred approach in the management of MS. Recommendations for clinical practice and further research were identified.

Bakgrund I arbetet möter sjuksköterskan många olika individer. En grupp individer som har ett stort behov av personcentrerad vård är intellektuellt funktionsnedsatta. Bemötandet och personcentrerad omvårdnad av denna individgrupp upplevs variera allt efter sjuksköterskans erfarenhet och kunskap. Syfte Studiens syfte var att undersöka personcentrerad omvårdnad utifrån sjuksköterskans upplevelse till individer med intellektuell funktionsnedsättning. Metod Litteraturstudien består av 13 kvalitativa och två kvantitativa artiklar och är från olika länder. Artiklarna har publicerats mellan år 2007-2017. Sökningar har gjorts i databaserna Cinahl och PubMed. Resultat Resultatet presenteras i fem kategorier med respektive underrubriker; Individanpassat bemötande (bemötande i vården, utåtagerande beteende, vikten av informationsutbyte); Kommunikation i vården (faktorer som kan påverka kommunikationen, anpassad kommunikation); Samarbete med anhöriga; Behov av kunskap och utbildning; Stöd och samarbete. Konklusion Personcentrerad omvårdnad som möter individens behov framkommer i studien som viktiga beståndsdelar i mötet med individer med intellektuell funktionsnedsättning. För att arbeta personcentrerat och med utgångspunkt från individens behov behöver sjuksköterskan ha förståelse för individgruppen, kunskap och praktisk utbildning för att bli mer trygg i sitt bemötande. / Background At work, the nurse meets many different individuals. A group of individuals with a high need for person-centered care is intellectually impaired. The perception and person-centered care of this individual group is experienced varies according to the nurse's experience and knowledge. Aim The purpose of the study was to investigate the person-centered nursing based on the nurse's experience with individuals with intellectual impairment. Method The literature study consists of 13 qualitative and two quantitative articles and is from different countries. The articles have been published between 2007-2017. Searches have been made in the databases Cinahl and PubMed . Results The result is presented in five categories with respective subheadings; Individualized treatment (treatment in care, outpatient behavior, importance of information exchange); Communication in healthcare (factors that may affect communication, custom communication); Collaboration with relatives; Need for knowledge and education; Support and cooperation. Conclusion Person-centered nursing that meets the needs of the individual appears in the study as important elements in the meeting with individuals with intellectual disabilities. To work personally and based on the needs of the individual, the nurse needs an understanding of the individual group, knowledge and practical training to be more confident in their treatment.

This thesis considers the provision of person-centred care (PCC) in acute healthcare. In recent years it has been increasingly recognised that healthcare should be delivered in a person-centred manner and that staff should receive training and support in relation to this. There is a growing body of literature investigating the potential benefits of PCC in relation to both patient and service level outcomes. Paper one of this thesis is a systematic review of the literature examining staff training interventions for improving PCC in acute healthcare settings. The findings offer preliminary support for the positive impact of such training interventions on patient and service level outcomes in hospital environments. The research in this area is not of a uniformly high standard and this paper concludes that further research in this area is required. Paper two is an examination of a modified version of Dementia Care Mapping (Care Mapping – Neurorehabilitation: DCM-NR), an observational tool for measuring and improving PCC. Results provide evidence of the feasibility and validity of DCM-NR in a range of Clinical Neuroscience settings. Future research should examine the impact of DCM-NR on person-centred practices over time.The critical reflection paper considers both the systematic review and the empirical study. It aims to consider both the strengths and limitations of the research, challenges encountered, clinical implications and highlights areas for future research.

Kraven på hälso- och sjukvård växer i takt med den globala populationen. Forskning visar att behovet av vård ökar men att kvalitén på den blir allt lägre, vilket leder till en problematisering huruvida personcentrerad vård går att uppnå eller om det är en idealbild för vården. Vårdpersonal inom hälso- och sjukvård tror sig arbeta utifrån personcentrerad vård där patienten ses som person och sätts i centrum av vårdandet. Av föregående utformades litteraturstudiens syfte, att undersöka hur sjuksköterskans prioriteringar i omvårdnadsarbetet överensstämmer med en personcentrerad vård. Studien genomfördes som en allmän litteraturstudie med stöd av innehållsanalys där en jämförelse tog grund i att finna likheter och skillnader mellan hur sjuksköterskan prioriterade utifrån definitionen av personcentrerad vård. I litteraturstudiens resultat framkommer att sjuksköterskor uttryckte önskan om att bedriva vård utöver den, för dem, nödvändiga vården och att vården snarare genomfördes enligt rutiner där främst de medicinska behoven tillgodosågs än att identifiera patienters samtliga behov. Att bedriva vård i samråd med patienten har visats ha goda och gynnsamma följder för vårdandet, vilket karaktäriseras av den personcentrerade vården. Det anses vara av vikt att mer forskning fastställer hur personcentrerad vård kan implementeras inom hälso- och sjukvård. / With a growing global population the demands on health care increases. Research shows that the need of care is getting bigger but quality is decreasing. A question rises, whether it is even possible to provide person-centred care or if it is an ideal picture of care. Healthcare professionals believe that they work based on person- centered care where the patient is seen as a person and at the heart of care. This led up to the aim of the study which was to show how registered nurses priorities in caring correspond with person-centered care. The study was conducted as a general literature study. Guided by content analysis similarities and differences, in registered nurses priorities related to person-centered care where found. The results show that registered nurses felt, unlike what they would want, that the care provided was not person-centered but rather what was necessary from a medical perspective. Instead of being person-centered and adapted to the individual at hand, care was based on routines. Providing care together with the patient is what characterizes person- centered care and it has beneficial consequences. It is of importance that future research explores how person-centered care could be implemented in health care.

Bakgrund: Stroke är ett samlingsbegrepp för hjärninfarkter och hjärnblödningar. Stroke ger ofta livslånga men, såsom afasi. Afasi innebär en reducerad förmåga att förstå talat/skrivet språk och/eller en reducerad förmåga att uttrycka sig adekvat. För att en god och personcentrerad vård ska kunna erbjudas patienter med stroke så är en fungerande kommunikation en förutsättning. Syfte: Syftet är att beskriva faktorer som påverkar personcentrerad vård och kommunikation mellan sjuksköterskan och patienter som drabbats av strokeinducerad afasi. Metod: Studien är en litteraturöversikt. Studien är baserad på 15 vetenskapliga artiklar som lästs och analyserats och där gemensamma teman identifierats. Resultat: Resultatet visade på ett antal strategier som främjade eller försvårade en god kommunikation mellan sjuksköterskan och patienter som drabbats av strokeinducerad afasi. Dessa strategier berörde sju områden: Verbal kommunikation, Icke verbal kommunikation, Att se patienten som en kompetent och unik individ, Uppmärksamhet och engagemang, Tidsaspekten vid kommunikation med afasidrabbade, Den omgivande miljöns betydelse för kommunikationen samt Personalens utbildning och kompetens. Konklusion: Det finns inget standardsvar på hur kommunikationen ska gå till, varje individ är unik och varje situation kräver sin unika lösning. Dock finns det ett antal aspekter och metoder som är betydelsefulla och användbara vid kommunikation med afasidrabbade. Dessa används i olika utsträckning inom vården. / Background: Stroke is a collective term for cerebral infarction and cerebral hemorrhage. Stroke often causes lifelong detrimental effects, such as aphasia. Aphasia means a reduced ability to understand spoken/written language and/or a reduced ability to express oneself adequately. To enable a good and person-centred care for the patients, an effective communication is a prerequisite. Aim: The aim of this study is to describe the factors that influence the person-centred care and communication between the nurse and patients affected by stroke induced aphasia. Method: The study is a literature review on bachelor level. The study is based on 15 scientific articles that have been red and analyzed and where common themes have been identified. Result: The results revealed a number of strategies that promoted and hindered good communication between the nurse and people affected by stroke induced aphasia. These strategies concern seven areas: Verbal communication, Nonverbal communication, Seeing the patient as a competent and unique individual, Attention and involvement, The time aspect of communication with patients with aphasia, The importance of the surrounding environment for communication and The personnel's education and skills . Conclusion: There is no standard answer to how communication shall be achieved, each individual is unique and every situation requires a different solution. However, there are a number of aspects and methods that are important and useful when communicating with aphasic people. These are used to different degrees in health care.

The aim of this qualitative research project was to investigate the experiences of clients who had received Cognitive Behavioural Therapy (CBT) and Person Centred Therapy (PCT) in primary care. The rationale for the investigation was to inform the assessment and referral process whereby prospective clients are assigned to the two different therapies. A total of 16 clients responded to an invitation to attend an unstructured interview (PCT = 9; CBT = 7) to talk about their experiences of therapy. The resulting transcripts were analysed using Grounded Theory methodology. Transcripts were broken down into meaning units and conceptualised as categories, using the constant comparison method. The categories were integrated, a core category conceptualised and a theory generated. A comparison of the accounts revealed similar and contrasting experiences. The main categories (eg Accessing therapy, Engaging with the therapy) could be organised in the chronological order of the client`s journey through therapy. All participants entered therapy with a particular view of reality. In successful therapy this view changed and they went on to manage their lives in a more constructive way. Participants attributed this change to different elements of the therapy (categorised as It did the trick) which brought about a new understanding (categorised as The key). Where therapy was unsuccessful this did not occur. The mechanism of change was personal to the individual and did not appear to be specific to either therapy. Some of the mechanisms appeared to be consistent with the therapy received (eg. Carrying out tasks, in the CBT group). Others appeared counterintuitive (eg. Putting me straight, in the PCT group). The differences and similarities in the participant`s experiences appeared to be due to the therapist and client`s capacity to respond to each other in order to make the therapy “work.” The Core Category, Reciprocal Responsiveness, was chosen to explain this. The findings also suggest that the ability of the therapist and client to respond to each other will affect the outcome of therapy. The theory was constructed that the outcome of therapy is determined by the occurrence of a sufficient degree of Reciprocal Responsiveness. This study has implications for the assessment process as the findings suggests that, when making a referral, it may be helpful, to take into account the potential client`s activity and responsiveness rather than relying solely on diagnosis. It also contributes to the growing body of literature emphasising the importance of therapist responsiveness to the individual needs of the client, rather than strict adherence to one therapeutic approach. The study is limited to two therapies within primary care. Future studies may consider clients experiences within other settings and with other therapeutic approaches.

Anderson, P & Sinclair, F. Omvårdnad vid gynekologisk cancer. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö universitet: Fakulteten för hälsa och samhälle, Institutionen för vårdvetenskap, 2019.Bakgrund: Årligen insjuknar cirka 3000 kvinnor i gynekologiska cancersjukdomar i Sverige. Detta omfattar maligna sjukdomar i ovarier, uterus, endometriet, cervix, och äggledare. Kvinnor i alla åldrar och livsfaser insjuknar i sjukdomar som på olika sätt och beroende på vilken livssituation kvinnan befinner sig i, påverkar henne. Sjukdomarna har olika prognos, symtom och behandling och medför således olika behov av omvårdnad. Syfte: Syftet med litteraturstudien var att sammanställa kvinnors erfarenheter av omvårdnad vid gynekologisk cancer. Metod: Litteraturstudier genomfördes med sökningar i databaserna PubMed, Cinahl och PsycINFO, 13 kvalitativa artiklar valdes ut och sammanställdes i resultatet genom innehållsanalys där texterna lästes upprepade gånger, meningsbärande och återkommande delar valdes ut, tolkades och sammanställdes i gemensamma teman. Resultat: Ett huvudtema identifierades under analysens gång; Att bli sedd. Detta konkretiserades i tre teman; Kommunikation, Tillgänglighet och Tillit med totalt fem subteman. Konklusion: Gynekologisk cancer berör de kvinnor som insjuknar på olika sätt, bland annat beroende på vilken livsfas de befinner sig i. Kvinnor som insjuknar i gynekologisk cancersjukdom har en önskan om att ses som en individ och har olika behov av stöd och omvårdnad. Att bli sedd var ett genomgående tema som framkom i litteraturstudierna. Personcentrerad omvårdnad bör vara ett ledord i omvårdnad av gynekologiska cancersjukdomar.Nyckelord: gynekologisk cancer, omvårdnad, personcentrerad vård, sjuksköterska, upplevelser / Anderson, P & Sinclair, F. Nursing care during treatment for gynecological cancer. Degree project in nursing 15 Credits. Malmö University: Faculty of Health and Society, Department of Care Science, 2019.Background: Each year approximately 3000 women in Sweden is diagnosed with gynecological cancer. This includes malignant diseases of the ovaries, uterus, endometrium, cervix and the fallopian tubes. Women of all ages and in all phases of life are afflicted differently, depending upon the phase of life she is in and when the cancer is detected. Gynecological cancers have different prognoses, symptoms and treatments. Aim: The aim of this literature review was to compile women´s perceptions and experiences of nursing care during gynecological cancer. Method: A literature review was conducted using the databases PubMed, Cinahl and PsycINFO, 13 qualitative studies were chosen and analyzed through content analysis. Meaningful parts of the articles were extracted and interpreted. Parts with similar messages were then compiled into themes. Findings: One main theme was identified through the analysis; To be seen. Three themes were then further identified during the analysis; Communication, Accessibility and Trust. Five sub-themes were additionaly included in the results. Conclusion: Gynecological cancer affects women in different ways depending on the phase of life and age they are in. Women are afflicted differently and want to be seen as individuals. To be seen was a recurring theme in the literature review. Person-centred care should be considered a leading word in nursing care for gynecological cancer.Key words: Experiences, gynecological cancer, nurse, nursing care, person-centred care

No description available.

Background: In Sweden there are approximately 130 000 to 150 000 people suffering from dementia and according to research this number may double by the year 2050. Dementia is a chronic disorder meaning it is irreversible and those suffering from dementia will deteriorate with time, therefore patients often need specialist care. Knowledge and experience within the field of the various dementia disorders is necessary to provide effective care and ensure quality of life for these patients. According to patients, and relatives of those suffering, the quality of care depends on the relationship between the nurse and patient, and whether nurses have specialist training in dementia care and person centred care (PCC). Aim: The aim of this literature study is to describe nurses' experience of caring for people with dementia. Method: A literature study with descriptive design was conducted based on twelve scientific articles from three different databases: PubMed, Cinahl and PsycINFO. Main results: Through thematic analysing of the twelve chosen scientific articles three main headings emerged along with eight subheadings describing nurses experiences of caring for people with dementia. Theme number one described the importance of individual care in terms of examination, communication, activities and environmental factors. Theme number two focused on relationships that according to the nurses affected the quality of care they provided for the patients. The third theme described nurses' experiences of how resources such as further education as well as better organisation of work and staffing affected their quality of care for patients suffering from dementia. Conclusion: The literature study shows that nurses within dementia care need further education and practical experience to deliver good quality PCC. To make this possible well organised staffing and work structuring from a higher level of management is necessary to create a secure and caring environment where both nurses and patients are satisfied. / Bakgrund: I Sverige finns det mellan 130 000 till 150 000 personer som lider av en demenssjukdom och enligt rapporter kan detta antal komma att fördubblas till år 2050. Demenssjukdomar är kroniska och innebär att tillståndet hos patienten försämras med tiden. Detta innebär att dessa patienter kräver en allt mer anpassad och specialiserad omvårdnad där kunskap och erfarenheter kring demenssjukdom spelar en vital roll för patienternas välmående och livskvalité. Vårdkvalitén enligt patienter och anhöriga avgörs beroende på relationen mellan sjuksköterska och patient samt sjuksköterskornas utbildning och kunskap gällande personcentrerad vård (PCV). Syfte: Att beskriva sjuksköterskors erfarenheter kring omvårdnaden av människor med demenssjukdom. Metod: En beskrivande litteraturstudie där tolv artiklar från databaserna PubMed, Cinahl och PsycINFO står för litteraturstudiens resultat. Huvudresultat: En tematisk analys av de tolv utvalda artiklarna resulterade i tre huvudteman samt åtta underteman där sjuksköterskors upplevelser kring omvårdnaden av människor med demenssjukdom beskrevs. Det första temat fokuserade på individanpassning av vård i form av undersökning, kommunikation, aktiviteter och miljö. Tema nummer två fokuserade på relationer som enligt sjuksköterskorna påverkade kvalitén av omvårdanden av patienterna. Det sista och tredje temat beskrev hur sjuksköterskors erfarenheter av varierande resurser i form av utbildning och organisation av deras arbete och personal påverkade deras omvårdnad för patienter med demenssjukdom. Slutsats: Resultatet av litteraturstudien visar att sjuksköterskor inom demenssjukvården behöver ytterligare specialistutbildning samt praktisk erfarenhet för att möjliggöra god kvalitativ vård i form av PCV. Detta kräver att organisationen kring omvårdnadsarbetet förbättras och stöds på en organisatorisk nivå som resulterar i en trygg och säker arbets- och omvårdnadsmiljö där både sjuksköterskor och patienter trivs.