Introdução: Pacientes com Transtorno Bipolar (TB) e seus familiares apresentam níveis de estresse significativamente mais elevados que a população geral. Coping, utilizado para gerenciar situações estressantes, tem sido alvo de investigação e intervenções psicossociais em pacientes bipolares, auxiliando-os no manejo destes fatores e melhorando desfechos clínicos no tratamento. Objetivos: O presente estudo tem por objetivo primário comparar pacientes com TB, seus familiares de primeiro grau e um grupo de controles saudáveis quanto ao uso de estratégias de coping adaptativas e desadaptativas. Como objetivos secundários, serão feitas análises explorando diferenças de tipos específicos de coping utilizados pelos indivíduos dos diferentes grupos (pacientes, familiares e controles), através da escala Brief COPE. Outras correlações com variáveis clínicas serão exploradas, como fatores sociodemográficos e clínicos, buscando encontrar relações com as estratégias de coping na amostra de pacientes com TB. Método: Trata-se de um estudo transversal com amostragem por conveniência. O estudo incluiu 36 pacientes eutímicos com TB, 39 familiares de primeiro grau destes pacientes e 44 controles. As estratégias de coping foram avaliadas através da Escala Brief COPE. Resultados: Diferenças significativas foram encontradas quanto ao uso de estratégias adaptativas e desadaptativas entre pacientes, familiares e controles. Pacientes utilizam em menor grau estratégias adaptativas, quando comparados aos controles. Por outro lado, os familiares demonstram maior uso de estratégias desadaptativas, semelhante ao que é observado nos pacientes, diferindo do grupo controle. Limitações: O tamanho amostral é um importante limitador para as conclusões do estudo. Ainda, as conclusões foram baseadas em dados transversais. A utilização de avaliações psicológicas e clínicas em estudos longitudinais permitiriam um melhor mapeamento das mudanças ou manutenção nos padrões psicológicos dos participantes. Conclusões: O grupo de familiares encontra-se em um nível intermediário entre pacientes e controles, ou seja, familiares fazem uso de estratégias desadaptativas em níveis semelhantes ao grupo de pacientes, mas apresentam maior uso de estratégias adaptativas, assim como o grupo controle. Intervenções psicossociais com este grupo são justificadas, favorecendo o uso das estratégias adaptativas em detrimento das estratégias desadaptativas. / Background: Patients with Bipolar disorder (BD) and their relatives exhibit significantly higher stress levels than the general population. Coping strategies, used to manage stressful situations, have been the subject of research and have also been used in psychosocial interventions with bipolar patients in order to help them manage stress factors and improve the clinical outcome of treatment. Objectives: This study has the objective to compare BD patients, their first-degree relatives and a group of healthy controls on the use of adaptive strategies and maladaptive coping. The specific objectives, analyzes will be made by exploiting differences in specific types of coping used by individuals from different groups (patients, relatives and controls) through the Brief COPE scale. Other correlations with clinical variables will be explored, such as demographic and clinical factors, trying to find relations with coping strategies in the sample of patients with BD. Method: This was a cross-sectional study with sampling by convenience, enrolling 36 patients with BD, 39 of their first-degree relatives and 44 controls. Coping strategies were assessed using the Brief COPE scale. Results: Significant differences were detected between use of adaptive and maladaptive strategies by patients, patients' relatives and controls. Patients used adaptive strategies less often than the patients' relatives and controls. In contrast, the patients' relatives reported greater use of maladaptive strategies than the controls and were similar to the patients in this respect. Limitations: The sample size is an important factor limiting the conclusions that can be drawn from this study. Furthermore, these conclusions are based on cross-sectional data. Conclusions: The group of patients' relatives were at an intermediate level between the patients and the healthy controls, i.e. family make use of maladaptive strategies at similar levels to the group of patients, but greater use of adaptive strategies, as well as the control group. This group merits psychosocial interventions to encourage use of adaptive strategies rather than maladaptive strategies.

Introdução: Pacientes com Transtorno Bipolar (TB) e seus familiares apresentam níveis de estresse significativamente mais elevados que a população geral. Coping, utilizado para gerenciar situações estressantes, tem sido alvo de investigação e intervenções psicossociais em pacientes bipolares, auxiliando-os no manejo destes fatores e melhorando desfechos clínicos no tratamento. Objetivos: O presente estudo tem por objetivo primário comparar pacientes com TB, seus familiares de primeiro grau e um grupo de controles saudáveis quanto ao uso de estratégias de coping adaptativas e desadaptativas. Como objetivos secundários, serão feitas análises explorando diferenças de tipos específicos de coping utilizados pelos indivíduos dos diferentes grupos (pacientes, familiares e controles), através da escala Brief COPE. Outras correlações com variáveis clínicas serão exploradas, como fatores sociodemográficos e clínicos, buscando encontrar relações com as estratégias de coping na amostra de pacientes com TB. Método: Trata-se de um estudo transversal com amostragem por conveniência. O estudo incluiu 36 pacientes eutímicos com TB, 39 familiares de primeiro grau destes pacientes e 44 controles. As estratégias de coping foram avaliadas através da Escala Brief COPE. Resultados: Diferenças significativas foram encontradas quanto ao uso de estratégias adaptativas e desadaptativas entre pacientes, familiares e controles. Pacientes utilizam em menor grau estratégias adaptativas, quando comparados aos controles. Por outro lado, os familiares demonstram maior uso de estratégias desadaptativas, semelhante ao que é observado nos pacientes, diferindo do grupo controle. Limitações: O tamanho amostral é um importante limitador para as conclusões do estudo. Ainda, as conclusões foram baseadas em dados transversais. A utilização de avaliações psicológicas e clínicas em estudos longitudinais permitiriam um melhor mapeamento das mudanças ou manutenção nos padrões psicológicos dos participantes. Conclusões: O grupo de familiares encontra-se em um nível intermediário entre pacientes e controles, ou seja, familiares fazem uso de estratégias desadaptativas em níveis semelhantes ao grupo de pacientes, mas apresentam maior uso de estratégias adaptativas, assim como o grupo controle. Intervenções psicossociais com este grupo são justificadas, favorecendo o uso das estratégias adaptativas em detrimento das estratégias desadaptativas. / Background: Patients with Bipolar disorder (BD) and their relatives exhibit significantly higher stress levels than the general population. Coping strategies, used to manage stressful situations, have been the subject of research and have also been used in psychosocial interventions with bipolar patients in order to help them manage stress factors and improve the clinical outcome of treatment. Objectives: This study has the objective to compare BD patients, their first-degree relatives and a group of healthy controls on the use of adaptive strategies and maladaptive coping. The specific objectives, analyzes will be made by exploiting differences in specific types of coping used by individuals from different groups (patients, relatives and controls) through the Brief COPE scale. Other correlations with clinical variables will be explored, such as demographic and clinical factors, trying to find relations with coping strategies in the sample of patients with BD. Method: This was a cross-sectional study with sampling by convenience, enrolling 36 patients with BD, 39 of their first-degree relatives and 44 controls. Coping strategies were assessed using the Brief COPE scale. Results: Significant differences were detected between use of adaptive and maladaptive strategies by patients, patients' relatives and controls. Patients used adaptive strategies less often than the patients' relatives and controls. In contrast, the patients' relatives reported greater use of maladaptive strategies than the controls and were similar to the patients in this respect. Limitations: The sample size is an important factor limiting the conclusions that can be drawn from this study. Furthermore, these conclusions are based on cross-sectional data. Conclusions: The group of patients' relatives were at an intermediate level between the patients and the healthy controls, i.e. family make use of maladaptive strategies at similar levels to the group of patients, but greater use of adaptive strategies, as well as the control group. This group merits psychosocial interventions to encourage use of adaptive strategies rather than maladaptive strategies.

Abstract Keywords: elderly people, dementia, person-centered care and relatives. Title: To visit someone who is no longer there Author: Ulrika Stenmarck As the number of elderly people increase, the amount of people suffering from age-related illnesses is growing. Such a disease is dementia, which today is a priority research area, both nationally and internationally. It has been found that working in a person-centered way and involving the patient’s relative’s is important for the people cared for by the dementia departments. Despite this, research has shown that the support for relatives is inadequate. The purpose of this study is to identify how individual support, in the field of nursing for dementia patients, can be better adapted to support relatives. By interviewing five relatives and four staff members in a nursing home for dementia patients, answers were sought for regarding; what kind of support the relatives need and how staff work to support relatives. The relatives´ responses were analyzed based on the theories concerning crisis processing related to their relatives´ dementia diagnoses. The answers given from the staff were analyzed based on the theories concerning organizational culture The analysis indicates that the goal of crisis processing for relatives should be to “create their new life”, which seems to be a challenge for a staff that is already carrying a large workload. The results indicate that the staff have succeeded in creating a foundation of values that relatives seem to experience as a safe atmosphere. This atmosphere can be interpreted as the most important support for relatives and a necessity for progress in their crisis processing. As a complement to the unit’s staff, external support for the families can be a solution.

O destaque em humanização nos setores fechados da instituição é a inclusão dos familiares de hospitalizados como clientes da equipe de saúde, por se observar que eles necessitam de cuidados, além de informações sobre o estado de saúde. Portanto, indaga-se: Quais são as necessidades de acolhimento e informação sobre saúde, pela equipe de enfermagem, apresentadas por familiares de clientes em Unidade de Terapia Intensiva (UTI)? Tem-se como objetivo analisar a dimensão imaginativa dos familiares de clientes de UTI, identificando suas necessidades de acolhimento e informações sobre saúde, visando contribuir para uma prática institucional de acolhimento e inclusão aos familiares de clientes hospitalizados. Utilizou-se o referencial teórico-metodológico da sociopoética, aplicando-se dinâmicas de sensibilidade, vivência dos lugares geomíticos, prática artística Corte e Colagem e aplicação de questionário. A pesquisa foi desenvolvida por um Grupo Pesquisador (GP) formado por familiares de clientes em UTI, no periodo de 2007 a 2008, em um hospital geral, particular, do Rio de Janeiro, interessado em implantar a política pública de humanização, nesse setor. Aplicou-se análise categorial aos dados produzidos, cujos resultados são descritos nos estudos sociopoéticos: Transversal-Superando os anseios do viver com um familiar internado em UTI; Subindo Degraus no viver com um familiar internado em UTI e Caminhos da Sobrevivência de uma internação de um familiar em UTI; Surreal -Refletindo sobre o desconhecido, Fontes para superação de dificuldades e Novo Mundo: Necessário Afastamento do meu ente querido. Da Corte e Colagem delimitaram-se as categorias: Sentimentos negativos na internação de um familiar em UTI, Sentimentos positivos na internação de um familiar em UTI, Transcendendo a realidade da internação de um familiar em UTI e As necessidades dos familiares de clientes internado em UTI. Resultados do questionário: Reflexões quanto às normas institucionais, Sentimentos frente ao acolhimento e Sentimentos frente às informações sobre a saúde dos familiares internados na UTI. Principais confetos (conceito+afeto) produzidos: Sentir-se Inseguro e Tornar-se Seguro, Enfrentamento da Realidade e o Acolhimento propriamente dito. Conclui-se, que através da dimensão imaginativa os familiares expressaram segurança, insegurança e esperança quanto à internação do cliente, tendo a necessidade de ser ouvido, acolhido e incluído nos cuidados institucionais de enfermagem, além de obterem informações sobre a saúde. Suas falas expressam que essas medidas definirão seus sentimentos, direcionando seus objetivos de aguardar a recuperação do seu familiar. Assim, necessitam de ajuda, apoio e acolhimento da equipe de saúde para que possam sobreviver, refletir e crescer superando esse processo. Na prática institucional vigente as informações prestadas não suprem suas necessidades, gerando aflição e angústia. Então, para uma prática de humanização, o GP sugere um acolhimento e informações em ambiente próprio, atenção individualizada à família, explicitação do processo de adoecimento e possibilidades de recuperação do cliente internado. Quanto ao acolhimento pela equipe de saúde, para o GP este é a base para um bom relacionamento, facilitando a troca de informações, criando relação de ajuda e confiança entre familiares e profissionais. Assim, com essa ajuda os familiares esperam ultrapassar suas expectativas com possibilidade de crescimento e superação nas habilidades e virtudes humanas. / The emphasis in humanization in the closed up sectors of the institution is the inclusion of the relatives of hospitalized patients as clients of the health team, because it was observed that they need cares, besides information on patients condition. So, it is inquired: What are the necessities of welcome and information on health, for the nursing team, reported by clients' relatives in Intensive Care Unit (ICU)? The objective is to analyze the imaginative dimension of relatives of ICU clients, identifying your necessities of welcome and information on health, aiming to contribute with welcome institutional practices and inclusion of relatives of hospitalized patients. Referential theoretical-methodological of sociopoética was used, applying sensibility dynamics, experience in geomitcs places, artistic practice Cut and collage and submission of questionnaire. The search was developed by Researcher Group (RG) formed by relatives of clients into ICU, in the period from 2007 to 2008, in private hospital, in Rio de Janeiro, interested in introduce public policy of humanization in that sector. It was applied categorical analyses in produced data, which results are described in sociopoéticos studies: Transverse Surpassing anxious of living with patient hospitalized at ICU; Climbing Steps of living with patient hospitalized at ICU and Ways of survival from admission of a patient at UCI; Surrealism - Thinking about unknown, Sources to overcome difficulties and New World: Required Moving away from my loved one. From the Cut and Collage the following categories were delimited: Negatives feelings regarding family members admission into ICU, Positive feelings regarding family members admission into UTI, Transcending the reality regarding family members admission into ICU and The necessities of relatives of hospitalized clients into UTI. Questionnaires results: Reflections about institutional rules, Feelings up against welcome and Feelings up against information about condition of patients admitted in ICU. Main confetos concepts affection produced: To feel unsafe and to become safely To face up to reality and the Welcome. It was concluded that through imaginative dimension, the relatives expressed safe, unsafe and hope in relation to patient admission, having the necessities of being heard, better welcome and included in nursing institutional care, besides getting information about patients health. Your talks express that, these attitudes will be defined your feelings, to guide your objectives for awaiting patients recover. So, they need help, support and welcome by health team to survive, to reflect and to grow overcoming this process. In actually institutional practice the information given does not complete their necessities, generating anxiety and anguish. Then, for a humanization practice, the RP suggests a better welcome and information in a good environment, individualized attention to the family, explanation about the process of illness and the patient recovered chances. Regarding to the welcome by health team, the RP believes that is the basis for a good relationship, helping in exchange of information, by creating relation of help and confidence among relatives and professionals. So, by this help, the relatives wait bypass their expectations with the possibility of growing and overcoming their abilities and human virtues.

O destaque em humanização nos setores fechados da instituição é a inclusão dos familiares de hospitalizados como clientes da equipe de saúde, por se observar que eles necessitam de cuidados, além de informações sobre o estado de saúde. Portanto, indaga-se: Quais são as necessidades de acolhimento e informação sobre saúde, pela equipe de enfermagem, apresentadas por familiares de clientes em Unidade de Terapia Intensiva (UTI)? Tem-se como objetivo analisar a dimensão imaginativa dos familiares de clientes de UTI, identificando suas necessidades de acolhimento e informações sobre saúde, visando contribuir para uma prática institucional de acolhimento e inclusão aos familiares de clientes hospitalizados. Utilizou-se o referencial teórico-metodológico da sociopoética, aplicando-se dinâmicas de sensibilidade, vivência dos lugares geomíticos, prática artística Corte e Colagem e aplicação de questionário. A pesquisa foi desenvolvida por um Grupo Pesquisador (GP) formado por familiares de clientes em UTI, no periodo de 2007 a 2008, em um hospital geral, particular, do Rio de Janeiro, interessado em implantar a política pública de humanização, nesse setor. Aplicou-se análise categorial aos dados produzidos, cujos resultados são descritos nos estudos sociopoéticos: Transversal-Superando os anseios do viver com um familiar internado em UTI; Subindo Degraus no viver com um familiar internado em UTI e Caminhos da Sobrevivência de uma internação de um familiar em UTI; Surreal -Refletindo sobre o desconhecido, Fontes para superação de dificuldades e Novo Mundo: Necessário Afastamento do meu ente querido. Da Corte e Colagem delimitaram-se as categorias: Sentimentos negativos na internação de um familiar em UTI, Sentimentos positivos na internação de um familiar em UTI, Transcendendo a realidade da internação de um familiar em UTI e As necessidades dos familiares de clientes internado em UTI. Resultados do questionário: Reflexões quanto às normas institucionais, Sentimentos frente ao acolhimento e Sentimentos frente às informações sobre a saúde dos familiares internados na UTI. Principais confetos (conceito+afeto) produzidos: Sentir-se Inseguro e Tornar-se Seguro, Enfrentamento da Realidade e o Acolhimento propriamente dito. Conclui-se, que através da dimensão imaginativa os familiares expressaram segurança, insegurança e esperança quanto à internação do cliente, tendo a necessidade de ser ouvido, acolhido e incluído nos cuidados institucionais de enfermagem, além de obterem informações sobre a saúde. Suas falas expressam que essas medidas definirão seus sentimentos, direcionando seus objetivos de aguardar a recuperação do seu familiar. Assim, necessitam de ajuda, apoio e acolhimento da equipe de saúde para que possam sobreviver, refletir e crescer superando esse processo. Na prática institucional vigente as informações prestadas não suprem suas necessidades, gerando aflição e angústia. Então, para uma prática de humanização, o GP sugere um acolhimento e informações em ambiente próprio, atenção individualizada à família, explicitação do processo de adoecimento e possibilidades de recuperação do cliente internado. Quanto ao acolhimento pela equipe de saúde, para o GP este é a base para um bom relacionamento, facilitando a troca de informações, criando relação de ajuda e confiança entre familiares e profissionais. Assim, com essa ajuda os familiares esperam ultrapassar suas expectativas com possibilidade de crescimento e superação nas habilidades e virtudes humanas. / The emphasis in humanization in the closed up sectors of the institution is the inclusion of the relatives of hospitalized patients as clients of the health team, because it was observed that they need cares, besides information on patients condition. So, it is inquired: What are the necessities of welcome and information on health, for the nursing team, reported by clients' relatives in Intensive Care Unit (ICU)? The objective is to analyze the imaginative dimension of relatives of ICU clients, identifying your necessities of welcome and information on health, aiming to contribute with welcome institutional practices and inclusion of relatives of hospitalized patients. Referential theoretical-methodological of sociopoética was used, applying sensibility dynamics, experience in geomitcs places, artistic practice Cut and collage and submission of questionnaire. The search was developed by Researcher Group (RG) formed by relatives of clients into ICU, in the period from 2007 to 2008, in private hospital, in Rio de Janeiro, interested in introduce public policy of humanization in that sector. It was applied categorical analyses in produced data, which results are described in sociopoéticos studies: Transverse Surpassing anxious of living with patient hospitalized at ICU; Climbing Steps of living with patient hospitalized at ICU and Ways of survival from admission of a patient at UCI; Surrealism - Thinking about unknown, Sources to overcome difficulties and New World: Required Moving away from my loved one. From the Cut and Collage the following categories were delimited: Negatives feelings regarding family members admission into ICU, Positive feelings regarding family members admission into UTI, Transcending the reality regarding family members admission into ICU and The necessities of relatives of hospitalized clients into UTI. Questionnaires results: Reflections about institutional rules, Feelings up against welcome and Feelings up against information about condition of patients admitted in ICU. Main confetos concepts affection produced: To feel unsafe and to become safely To face up to reality and the Welcome. It was concluded that through imaginative dimension, the relatives expressed safe, unsafe and hope in relation to patient admission, having the necessities of being heard, better welcome and included in nursing institutional care, besides getting information about patients health. Your talks express that, these attitudes will be defined your feelings, to guide your objectives for awaiting patients recover. So, they need help, support and welcome by health team to survive, to reflect and to grow overcoming this process. In actually institutional practice the information given does not complete their necessities, generating anxiety and anguish. Then, for a humanization practice, the RP suggests a better welcome and information in a good environment, individualized attention to the family, explanation about the process of illness and the patient recovered chances. Regarding to the welcome by health team, the RP believes that is the basis for a good relationship, helping in exchange of information, by creating relation of help and confidence among relatives and professionals. So, by this help, the relatives wait bypass their expectations with the possibility of growing and overcoming their abilities and human virtues.

Introdução: Pacientes com Transtorno Bipolar (TB) e seus familiares apresentam níveis de estresse significativamente mais elevados que a população geral. Coping, utilizado para gerenciar situações estressantes, tem sido alvo de investigação e intervenções psicossociais em pacientes bipolares, auxiliando-os no manejo destes fatores e melhorando desfechos clínicos no tratamento. Objetivos: O presente estudo tem por objetivo primário comparar pacientes com TB, seus familiares de primeiro grau e um grupo de controles saudáveis quanto ao uso de estratégias de coping adaptativas e desadaptativas. Como objetivos secundários, serão feitas análises explorando diferenças de tipos específicos de coping utilizados pelos indivíduos dos diferentes grupos (pacientes, familiares e controles), através da escala Brief COPE. Outras correlações com variáveis clínicas serão exploradas, como fatores sociodemográficos e clínicos, buscando encontrar relações com as estratégias de coping na amostra de pacientes com TB. Método: Trata-se de um estudo transversal com amostragem por conveniência. O estudo incluiu 36 pacientes eutímicos com TB, 39 familiares de primeiro grau destes pacientes e 44 controles. As estratégias de coping foram avaliadas através da Escala Brief COPE. Resultados: Diferenças significativas foram encontradas quanto ao uso de estratégias adaptativas e desadaptativas entre pacientes, familiares e controles. Pacientes utilizam em menor grau estratégias adaptativas, quando comparados aos controles. Por outro lado, os familiares demonstram maior uso de estratégias desadaptativas, semelhante ao que é observado nos pacientes, diferindo do grupo controle. Limitações: O tamanho amostral é um importante limitador para as conclusões do estudo. Ainda, as conclusões foram baseadas em dados transversais. A utilização de avaliações psicológicas e clínicas em estudos longitudinais permitiriam um melhor mapeamento das mudanças ou manutenção nos padrões psicológicos dos participantes. Conclusões: O grupo de familiares encontra-se em um nível intermediário entre pacientes e controles, ou seja, familiares fazem uso de estratégias desadaptativas em níveis semelhantes ao grupo de pacientes, mas apresentam maior uso de estratégias adaptativas, assim como o grupo controle. Intervenções psicossociais com este grupo são justificadas, favorecendo o uso das estratégias adaptativas em detrimento das estratégias desadaptativas. / Background: Patients with Bipolar disorder (BD) and their relatives exhibit significantly higher stress levels than the general population. Coping strategies, used to manage stressful situations, have been the subject of research and have also been used in psychosocial interventions with bipolar patients in order to help them manage stress factors and improve the clinical outcome of treatment. Objectives: This study has the objective to compare BD patients, their first-degree relatives and a group of healthy controls on the use of adaptive strategies and maladaptive coping. The specific objectives, analyzes will be made by exploiting differences in specific types of coping used by individuals from different groups (patients, relatives and controls) through the Brief COPE scale. Other correlations with clinical variables will be explored, such as demographic and clinical factors, trying to find relations with coping strategies in the sample of patients with BD. Method: This was a cross-sectional study with sampling by convenience, enrolling 36 patients with BD, 39 of their first-degree relatives and 44 controls. Coping strategies were assessed using the Brief COPE scale. Results: Significant differences were detected between use of adaptive and maladaptive strategies by patients, patients' relatives and controls. Patients used adaptive strategies less often than the patients' relatives and controls. In contrast, the patients' relatives reported greater use of maladaptive strategies than the controls and were similar to the patients in this respect. Limitations: The sample size is an important factor limiting the conclusions that can be drawn from this study. Furthermore, these conclusions are based on cross-sectional data. Conclusions: The group of patients' relatives were at an intermediate level between the patients and the healthy controls, i.e. family make use of maladaptive strategies at similar levels to the group of patients, but greater use of adaptive strategies, as well as the control group. This group merits psychosocial interventions to encourage use of adaptive strategies rather than maladaptive strategies.

According to the Social Services Act relatives have a fundamental right to receive support that facilitates the care of their related. In Sweden 1,3 million people regularly nurture, support and assist a related. With their knowledge and experience the relatives therefore plays an important role in the life of the related. Previous research shows that relatives take a lot of responsibility and feel left to themselves in the care of their related (Ali, 2013). The purpose of this study is to gain a better understanding of how relatives caring for a related with mental disorders experience their everyday lives. A qualitative approach was used and a total of four interviews were conducted with relatives between the ages of 25-35. The analysis of the results revealed three themes with six subcategories. The results were analyzed on the theoretical concepts of normality, resilience, coping and the theories stigma and identity along with previous research. The results show that relatives of people with mental illness early realized that the related parties state in relation to other adults were different. While some relatives had a fear of becoming infected with the same mental illness as their related, the other experienced that they were labeled as diseased only by association. Relatives had during their childhood a great desire to be normal. In the care of their loved one the relatives had to take a responsibility that many times perceived as inevitable. By accepting the related parties mental illness, there was a fear among the relatives that it normalized the related parties illness. Finally, we make recommendations to the social work practice that relatives is a large group that should not be ignored. Active social workers need to a greater extent seize the relatives experiences and thus respond to the relatives need for support. / Enligt Socialtjänstlagen har anhöriga som grundläggande rätt att få stöd som underlättar vården av deras närstående. I Sverige vårdar, hjälper och stödjer över 1,3 miljoner människor regelbundet en närstående (Socialstyrelsen, 2015). Med sina kunskaper och erfarenheter spelar därför  anhöriga en viktig roll i den närståendes liv. Tidigare forskning visar  att anhöriga får ta ett stort ansvar och känner sig lämnade till sig själva i vården av sin närstående (Ali, 2013). Syftet med denna studie är att få en ökad förståelse kring hur anhöriga som vårdar närstående med psykisk ohälsa upplever sin vardag. En kvalitativ metod har använts och totalt fyra intervjuer genomfördes med anhöriga mellan 25-35 år. I analysen av resultatet framkom tre teman med sex underkategorier. Resultatet analyserades utifrån begreppen normalitet, resilience, coping och teorierna stigmatisering och identitet tillsammans med tidigare forskning. Studiens resultat visar att anhöriga till personer med psykisk ohälsa tidigt förstod att den närståendes tillstånd i relation till andra vuxna människor var annorlunda. Medan en del anhöriga hade en rädsla över att bli smittade med samma psykiska sjukdom som sin närstående, upplevde majoriteten att de blev stämplade som sjuka enbart genom association. Anhöriga hade under sin uppväxt en stor önskan om att få vara normal. I vården av sin närstående har anhöriga många gånger fått ta ett ofrånkomligt ansvar. Genom att acceptera den närståendes psykiska ohälsa, fanns det en rädsla bland de anhöriga om att de normaliserade den närståendes sjukdom. Slutligen ger författarna rekommendationer till det sociala arbetets praktik om att anhöriga är en stor grupp som inte bör ignoreras. Verksamma socialarbetare behöver i en större omfattning ta vara på anhörigas upplevelser och därmed bemöta den anhöriges behov av stöd.

Doctorat en philosophie et lettres / info:eu-repo/semantics/nonPublished

Background Mental illness is increasing in the society and it affects the person in the daily life. Relatives are helpful in the recovering of the person with mental illness. In order to provide a good nursing it is important that the nurse knows how relatives experience how it is to live with a person with mental illness. Aim The aim of this study was to illuminate relatives experiences of living with a person with mental illness. Method This study was literature- based and 11 qualitative articles were analyzed for the results. The articles were analyzed by the method of contributing to evidence-based nursing based on analysis of qualitative research. Results The results of this study showed that relatives living with a person that suffers from mental illness experienced a heavy burden. Feelings of guilt and shame was described, which had an impact on the daily life because of constant worry for the person with the mental illness. Relatives also experienced anxiety for the future. The relatives felt excluded from the healthcare and they felt that the healthcare did not take responsibility for the person with the mental illness. The rights to be provided with adequate care, both for the patient and for their relative was described as a constant fight. Conclusion The relatives experienced social isolation, feelings of guilt and loneliness. A need for greater support from the hospital staff desired due the relatives had a need for care and experiences of being excluded from the healthcare was described.

Det blir allt vanligare med människor som vårdas palliativt i hemmet. I och med det blir det vanligare att närstående är en del av vårdprocessen. Närstående ställs då inför en helt ny roll gentemot den anhörige. De upplever svårigheter med att bibehålla ett normalt familjeliv då hemmet mer och mer börjar likna ett sjukhus, samtidigt som de vet att de inte skulle klara sig utan hjälpmedlen. Upplevelsen för närstående att ha en döende familjemedlem är påfrestande. Den närstående är inte längre bara en familjemedlem eller vän utan någon som den sjuke är beroende av. För att kunna axla denna roll behöver den närstående stöttning från sjuksköterskan, vänner och familj.   För att sjuksköterskan ska kunna ge det stöd närstående behöver är det viktigt att få en uppfattning om den närståendes upplevelse av den palliativa vården i hemmet. För att ta reda på detta valdes en litteraturstudie till examensarbetet. 12 kvalitativa artiklar analyserades till resultatet vilket mynnade ut i tre teman, att ta ansvar i vårdandet, att ha behov av stöd och att möta döden.  Resultatet visar att de närstående känner ett ansvar i vårdandet. Vissa uttrycker att de inte har något val, de sätter sig själva åt sidan för att kunna uppfylla löftet att vårda den sjuke. Andra känner att det är en självklarhet. De tycker att det är en naturlig del av livet och en möjlighet att få vara nära sin älskade på slutet. Det är viktigt med stöd från sjukvårdspersonal, vänner och familj för de närstående. Brist på stöd gör att närstående känner sig övergivna. Det är lätt att den närstående blir isolerad och bunden till hemmet under vårdtiden och för att klara av det krävs det stöd från utomstående. Närstående tycker att det var svårt att prata om döden, speciellt med den sjuke. De upplever att det är lättare att diskutera döden och sjukdomen med sjuksköterskan för att inte oroa den sjuke i onödan. De känner sig ständigt konfronterande med döden men de uppskattar att de kan vara närvarande och där för den sjuke på slutet. / Background: In recent years, it has become increasingly common for patients to choose to end their life at home. Relatives often wants to fulfill the wishes of the sick person, but are often poorly prepared to act as caregivers and experience lack of continuity, insufficient information and poor treatment. The experience of relatives having a dying family member is stressful. Aim: The aim of this study was to describe the experiences of relatives in palliative homecare.  Method: A literature based study with 12 qualitative articles were performed using the Friberg method of analysis. Results: The result showed that some relatives felt that taking care of their family member where a matter of course and others felt that they had no choice. It was important for the relatives to have support from healthcare professionals, family and friends. Lack of support made them feel abandoned. It was difficult to talk about death with the dying family member and relatives expressed that it was easier to talk to the nurse about it.  Conclusion: Death was constantly present, despite that death was hard to talk about with the sick person. It was also hard for the relative to be responsible for someone else and they felt that they were isolated in their own home. The relatives felt therefore the need to be supported by the nurse. They needed to be able to talk to the nurse and feel safe to fulfill the feeling of support.