O presente estudo teve como objetivo central descrever questões da identidade do ser enfermeiro negro formado pela Escola de Enfermagem da Universidade de São Paulo, a partir da perspectiva da Teoria da Enfermagem Transcultural através da análise de situações de preconceito vividas por esses enfermeiros frente a sua escolha profissional, sua formação acadêmica e a sua inserção no mercado de trabalho. Por ser o presente trabalho de natureza descritiva, histórico-social e exploratória, optou-se pelo método da História Oral, que é um método de pesquisa que utiliza a técnica da entrevista e outros procedimentos articulados entre si, no registro de narrativa da experiência humana. Optou-se também pelo método da História Oral Temática pelo fato desse ser um método que possibilita que as pessoas falem livremente, em seus respectivos contextos. A Escola de Enfermagem da USP formou, no período de 1947 a 2006, 2.886 enfermeiros, dos quais, 128 se declararam como não brancos. Foram localizados, no estado de São Paulo, 45 dos acima identificados, dos quais 14 cederam entrevistas para a presente investigação. Pode-se observar que a terminologia moreno(a) foi a mais utilizada para a autodeclaração e que, dos entrevistados, todos afirmam ter sofrido preconceito racial em algum momento de suas trajetórias de vida, em especial de forma velada, forma essa mais difícil de ser enfrentada. A presente investigação propiciou fazer da História uma atividade mais democrática a cargo das próprias comunidades, uma vez que permitiu construir a História a partir das próprias palavras daqueles que a vivenciaram e que participaram de um determinado período, mediante suas referências e, também, do seu imaginário, possibilitando o registro de reminiscências das memórias individuais ou a reinterpretação do passado. / This study aimed to describe the central issues of being a black nurse graduated by the School of Nursing, University of São Paulo, from the perspective of the Theory of Transcultural Nursing trough the analysis situations of prejudice experienced by these nurses facing their career choice, their academic training and their integration into the labor market. As the study has a descriptive, historical, social and exploratory character, was chosen the method of Oral History, which is a method that uses the interview and other processes linked together in the narrative record of human experience. It was also chosen the method of Oral History Thematic considering the fact that this method helps people to speak freely in their respective contexts. The School of Nursing graduated, in the period of 1947 to 2006, 2,886 nurses, of which 128 identified themselves as non-whites. Located, in the state of São Paulo, 45 of the above identified, of which 14 were interviewed for this research. It was noted that the terminology \"moreno\" was the most used for self reporting and that of those interviewed, all stated have suffered racial discrimination at some point in their life trajectories, especially in hidden form, which is the harder form to face. This research led to a more democratic history over the view of its own communities, because it allows the construction of history from the very words of those who participated and experienced, in a given period of time, through its references and imagination, allowing the registration of reminiscences of individual memories or the reinterpretation of the past.

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

Sammanfattning Bakgrund: Sverige har aldrig tidigare tagit emot så många flyktingar under så kort period som man gjorde under 2015. Många av dessa flyktingar kommer från länder med krig och förföljelse. Skolsköterskan möter flyktingbarnen och deras hälsorelaterade problem i skolan. Studien handlar om skolsköterskans upplevelser och erfarenheter av arbetet med och kring flyktingbarnen. Syfte: Syftet är att belysa skolsköterskans erfarenheter av arbetet med flyktingbarn inom skolhälsovården. Metod: Studien genomfördes med en kvalitativ induktiv ansats med semistrukturerade intervjufrågor. Sex skolsköterskor intervjuades från Kalmar och Nybro kommun i södra Sverige. Data analyserades med en kvalitativ innehållsanalys. Resultat: Skolsköterskorna hade erfarenheter av att arbetet med flyktingbarnen påverkade och förändrade deras arbetssituation. Det som utmärkte sig i skolsköterskornas erfarenheter av arbetet med flyktingbarnen var dels ett ökat arbete med journalgranskning inför vaccinationer. Det framkom också att skolsköterskorna hade erfarenheter av ökade behov av hälsovårdande insatser inom följande områden hos flyktingbarnen: svårtolkade uttrycksformer från flyktingbarnen för olika hälsotillstånd, kulturella skillnader i attityder om hälsa och egenvårdsråd, brister i tolksituationen, samt att de önskade mer utbildning kring arbetet med flyktingbarn, framförallt inom psykisk ohälsa.   Slutsats: Skolsköterskans arbete med flyktingbarnen utmärkte sig genom en ökad arbetsbelastning. Det ställdes nya krav på skolsköterskornas kompetens och arbete då andra uttrycksformer och attityder till hälsa och ohälsa gestaltades från flyktingbarnen än de som skolsköterskan tidigare var vana vid. Även brister i tolksituationen framkom. Detta var faktorer som påverkade arbetssituationen för skolsköterskorna och det framkom flera idéer om förbättring inom området. / Abstract Background: Sweden has ever received as many refugees as during the year of 2015. Many refugees migrate from countries with war and persecution. The nurses meet the refugee children on a regular basis and are confronted with their health-related problems in school. This study investigates the experience of the nurses related to their work with these children. Aim: The aim is to highlight the experience from the school nurses perspective of working with refugee children within school health care. Method: The study was conducted by using a qualitative inductive approach with semi- structured interview questions. Six school nurses were interviewed from Kalmar and Nybro, cities in the south of Sweden. Data was analyzed with a qualitative content analysis. Results: The school nurses generally felt that the work with the refugee children affected their work situation. It was also found that the school nurses experienced these children were in need of an increased amount of health care attention. The results of this study showed that the nurses needed to spend more time on reading the medical records before vaccination appointments with refugee children, as well as it was time consuming to read up on the need of supplementary vaccinations. Moreover, they found that the refugee children had different ways of communicating health care related problems and had different perspective on self-care advices. Honor-related complications as well as lingual misunderstandings were some of the new challenges for the nurses. Finally, the nurses signaled that they wanted to learn more about the work with refugee children, especially within the field of mental illness. Conclusion: The school nurse's work with the refugee children was characterized by a workload. The nurses experienced that the refugee children were communicating health care related problems differently from what the nurses were used to. There were also shortcomings in the interpretation situation. This was all factors which changed their work tasks and work situation.  The study revealed several areas of improvement regarding the school nurse's work with refugee children. These were factors that affected the workforce of the school nurses

Dagens mångkulturella samhälle avspeglas inom vården där vårdpersonal dagligen möter patienter från olika kulturer. Kommunikationssvårigheter relaterade till språkbrister kan uppkomma i mötet med patienter som inte förstår och talar svenska. I omvårdnadsarbetet ställs detta på sin spets, i synnerhet när det gäller vård vid livets slutskede. Denna studie syftade till att kartlägga och tolka vårdpersonalens upplevelser av möjligheter och svårigheter i omvårdnaden av denna patientgrupp. I studien har en kvalitativ metod med en hermeneutisk forskningsansats använts. Totalt åtta semistrukturerade djupintervjuer genomfördes med undersköterskor och sjuksköterskor som arbetade på en hospiceavdelning i södra Sverige. Studien resulterade i tio deltolkningar som sedan bildade tre nya deltolkningar på en högre nivå. Slutligen gjordes en huvudtolkning: att en individanpassad vård kan ses som en möjlighet för att överbygga svårigheter och problem som uppkommer i mötet med patientgruppen. Möjligheterna och svårigheterna för att åstadkomma en individanpassad vård återfanns i yttre faktorer, hos patienten och hos personalen. Culture Care teorin användes för att skapa en djupare förståelse för delar av studiens resultat. Vidare multidisciplinär forskning och utbildning krävs för att vården ska kunna leva upp till hälso- och sjukvårdslagens krav om vård på lika villkor. / Today’s multicultural society is reflected in healthcare as professionals encounter patients from different cultures on a daily basis. Communication problems related to language deficiencies consequently occur in interactions with these patients. This can lead to inadequate care delivery at the end stage of life. The aim of this study was to identify and interpret health care professionals’ experiences of opportunities and challenges in delivery of nursing care to this patient group. A qualitative method was used with a hermeneutic approach. Eight semi-structured in-depth interviews were conducted with healthcare professionals working at a hospice in Southern Sweden. The results identified ten sub-interpretations which were distilled into three over-arching interpretations which lead to the following singular conceptual interpretation: Individualized care is viewed as an opportunity to overcome problems that arise when meeting this group of patients. The possibilities and challenges to achieve individualized care came from a combination of external, patient and staff factors. Cultural Care Theory was applied to parts of the study results to achieve greater understanding of the subject. Furthermore, multi-disciplinary research and education is necessary to ensure that health care providers can live up to The Act of Health Care requirements for care delivery on equal terms.

Bakgrund  Drygt 110 miljoner människor är på flykt världen över, med målet att söka skydd och få fristad i ett nytt land. Flykten och att etablera sig i ett nytt land kan vara präglat av många utmaningar vilket påverkar både den psykiska och fysiska hälsan. Förekomsten av ohälsa är hög bland flyktingar och forskning visar att denna population generellt sett söker vård i lägre utsträckning än den övriga befolkningen. Sjuksköterskor ska erbjuda jämlik vård till alla med ett personcentrerat förhållningssätt. Det är fördelaktigt att sjuksköterskor innehar insikter om specifika patientgrupper, såsom flyktingar, och deras upplevelser samt erfarenheter av att söka vård.  Syfte  Syftet var att belysa flyktingars upplevelser och erfarenheter av att söka hälso- och sjukvård i ett nytt land.  Metod  En icke-systematisk litteraturöversikt som baserades på 17 vetenskapliga originalartiklar varav 16 av kvalitativ ansats och en av kvantitativ ansats. Datainsamlingen skedde med sökord kombinerade i olika sökblock i databaserna PubMed och CINAHL. Resultatet analyserades och sammanställdes sedan med en integrerad dataanalys. Med hjälp av Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet kunde artiklarnas kvalitet granskas.  Resultat  Resultatet i denna litteraturöversikt redogör för flyktingars upplevelser och erfarenheter av att söka hälso- och sjukvård i ett nytt land, där både positiva och negativa aspekter framkom. Tre huvudkategorier identifierades som centrala: Tillgänglighet av hälso- och sjukvård, kommunikation samt existentiella och psykologiska upplevelser och erfarenheter vid vårdbesök. Individuella upplevelser och erfarenheter lyfts fram, som påverkats av såväl samhälleliga som individuella faktorer.  Slutsats  Denna litteraturöversikt påvisade att flyktingars erfarenheter och upplevelser av att söka hälso- och sjukvård i ett nytt land kan skilja sig. I många fall upplevdes bristande bemötande från vårdpersonal genomsyrat av respektlöshet, språkbarriärer samt diskriminering och rasism. Vårdpersonalens kulturella kompetens och förståelse för individuella behov och förutsättningar belystes som central i mötet med flyktingar för en positiv upplevelse. / Background  About 110 million people are displaced worldwide, aiming to seek protection and asylum in a new country. The process of fleeing and establishing in a new country can be characterized by numerous challenges that impact both the mental and physical health. The prevalence of mental and physical health issues is high among refugees, and research indicates that the refugee population generally seeks healthcare to a lesser extent than the rest of the population. Nurses should provide equitable care to all people with a person- centered approach. It is beneficial for nurses to have insights into specific patient groups, such as refugees, and their experiences in seeking healthcare.  Aim  The aim of this study was to highlight refugees' experiences of seeking healthcare in a new country.  Method  A non-systematic literature review based on 17 scientific original articles, comprising 16 articles with a qualitative study design and one with a quantitative study design. Data collection was retrieved using keywords combined in different search blocks in the databases PubMed and CINAHL. The results were analyzed and compiled through an integrated data analysis. The quality of the articles was reviewed by using the evaluation criteria for scientific classification and quality from Sophiahemmet University.  Results  The results of this study describe refugees' experiences of seeking health care in a new country, revealing both positive and negative experiences. Three main categories were identified as central: Accessibility of healthcare, communication, existential and psychological experiences in the encounter with health care. Individual experiences were highlighted, influenced by both societal and individual factors.  Conclusions  This literature review demonstrated that refugees' experiences of seeking health care in a new country can vary. In many cases, there was a perceived lack of respect from healthcare personnel, marked by disrespect, language barriers, discrimination, and racism. The cultural competence and understanding of individual needs and circumstances by healthcare personnel were emphasized as crucial in interactions with refugees for a positive experience.

Bakgrund: Antalet människor som bor utanför sitt födelseland har ökat både i Sverige och globalt. Denna ökning av internationell rörlighet har medfört en ökad kulturell diversitet och mångfald inom våra samhällen. I detta sammanhang blir kulturell kompetens och personcentrerad vård alltmer viktiga, särskilt för sjuksköterskor som möter palliativa patienter med olika kulturella bakgrunder. Syftet: Att beskriva sjuksköterskors upplevelser av palliativ vård med patienter med annan kulturell bakgrund. Metod: Studien genomfördes som en litteraturöversikt, där det inkluderades 12 vetenskapliga artiklar med kvalitativ design. Databaserna som användes var Cinahl, Sociology database och Medline. Fribergs femstegsanalys användes för dataanalys. Resultat: Dataanalysen resulterade i 2 huvudteman: utmaningar som påverkar sjuksköterskans roll och kulturella anpassade strategier som bidrar till en god palliativ vård. Subteman som framkom är: språkbarriär och kommunikationssvårigheter, bristande kunskap inom kulturell kompetens, familjens roll, förståelse för olika kulturer, delaktighet och partnerskap, förbättrade kommunikationsfärdigheter. Slutsats: Sjuksköterskor inom palliativ vård av patienter med en annan kulturell bakgrund upplever att det är viktigt att besitta kulturell kompetens i åtanke vid behandling av dessa patienter. Utmaningar som betonades av sjuksköterskor inkluderade familjens roll, bristande kulturell kompetens och språkbarriärer. Olika strategier för att hantera dessa utmaningar inkluderade att förstå olika kulturer, utveckla kommunikationsfärdigheter och skapa partnerskap som främjar patientens delaktighet. / Background: The number of people living outside their country of birth has increased both in Sweden and globally. This rise in international mobility has led to increased cultural diversity and multiculturalism within our societies. In this context, cultural competence and person-centered care become increasingly crucial, especially for nurses who encounter palliative patients with diverse cultural backgrounds. Aim: The aim of this study is to describe nurses' experiences to care for palliative patients with a different cultural background. Method: The study was conducted as a literature review, where 12 scientific articles with a qualitative design were included. The databases used were Cinahl, Sociology database and Medline. Friberg's five-step analysis was used for data analysis. Result: The data analysis resulted in 2 main themes: challenges that affect the nurse's role and culturally adapted strategies that contribute to good palliative care. The subthemes were: language barrier and communication difficulties, deepening knowledge in cultural competence, the role of the family, understanding of different cultures, participation and partnership, improved communication skills. Conclusion: In summary, nurses in palliative care of patients with a different cultural background felt that it is important to have cultural competence in mind when treating these patients. Challenges highlighted by nurses included the role of the family, lack of cultural competence and language barriers. Various strategies to address these challenges included understanding different cultures, developing communication skills, and creating partnerships that promote patient participation.

Increased demand for culturally sensitive healthcare services suggests that interprofessional beginning healthcare students need to gain the necessary cultural competency skills to be successful in delivering positive health outcomes for diverse patients. Bandura's theory of observational learning, Mezirow's theory of transformative learning, and Purnell's and Paulanka's model of cultural competence informed the framework for this research. The purpose of this quasi-experimental quantitative study was to determine the relationship between mode of instruction (observing role models in videotaped role-play simulation) and increased transcultural self-efficacy in cultural competence instruction. A convenience sample of 196 students enrolled in an interprofessional education (IPE) course was randomly assigned at the time of course enrollment to either control or experiment course sections. Pretest and posttest data were collected anonymously through paper-and-pencil administration of the Transcultural Self-Efficacy Tool-Multidisciplinary Healthcare Provider (TSET-MHP). Paired-samples t test showed that students in the intervention group had statistically higher (p < .05) posttest scores in perceived transcultural self-efficacy after observation of standardized patient actors in a videotaped role-play simulation than did students in the control group. These results support the use of videotaped role-play simulation for cultural competence instruction as a means to achieve improved patient care within the culturally diverse population in the healthcare system.

This thesis 'The Symphony of Care' consists of four studies focusing on care relationships between patients and professional caregivers. Care relationships are central to the health process and a fundamental element in caregiving. The term care relationship is widely used in caring science but lacks a clear definition, which can create misunderstanding and can constitute an obstacle when attempting to optimize care relationships. The aim of this thesis is to describe the phenomenon of care relationships in order to add to the body of knowledge in caring science.The main research questions are: • What is a care relationship within the caring science field? • How can a care relationship be optimized to improve its caring function, in order to promote health? The ontological foundation of this thesis is caring science. Phenomenology and Lifeworld theory are used as its epistemological bases. Reflective Lifeworld Research is used as a methodological approach. The four studies were conducted in different contexts and cultures- the first two empirical studies were performed in China and the remaining two, a metasynthesis and a secondary analysis, were carried out in a Swedish context. The results show that care relationships are temporary intentional relationships between a person who needs help and a helper. The purpose of this relationship is to support the patient in his/her dynamic health process, which is unique for each person in different times and contexts. Care relationships are fragile because the patient is vulnerable and the demand on the helper is great. It is an inter-human relationship between equals, which can at the same time be an asymmetric relationship due to the professionalism with the caregiver and the vulnerability with the patient. A care relationship is not independent, but is affected by internal factors such as the two individuals' lifeworlds and external factors such as health policies, organization, economics, health culture and environment. To optimize the effectiveness of caring, the relationship and its surrounding need to be in harmony. The view of care relationships should be broadened to include the external resources in order to optimize their caring potential.

Bakgrund: Den växande kulturella mångfalden i Sverige har lett till nya utmaningar för samhället och inte minst för sjukvården. Kultur är universellt för alla människor och speglas bland annat av faktorer som religion, värderingar, språk, miljö och kön. Den kulturella bakgrunden influerar våra uppfattningar av hälsa och sjukdom och hur vi ger uttryck för smärta och obehag. Det finns likheter och olikheter som leder till att vårdande kan förstås på olika sätt och kräver därför kulturellt kompetenta vårdgivare. Syfte: Syftet är att belysa hur vårdtagare med olika kulturella bakgrunder och vårdpersonal upplever transkulturella möten inom den svenska sjukvården. Metod: Litteraturöversikt där tolv kvalitativa studiers resultat har syntetiserats och sammanställts. Sex artiklar utgår från ett vårdtagarperspektiv och sex från ett vårdpersonalperspektiv. Gemensamt för studierna är att de belyser upplevelser av transkulturella möten i svensk sjukvård. Resultat: Tre teman framkom med två subteman vardera. Det första temat är ”Utmaningar relaterat till kommunikation”, med två subteman, ”Språket som hinder” och ”Användning av tolk”. Det andra temat är ”Utmaningar relaterat till kulturella olikheter”, med två subteman, ”Olikheter i synen på vård och vårdande” och ”Uppfattningar om könsskillnader”. Det tredje temat är ”Fördomar och kränkande bemötande”, med två subteman, ”Fördomar och misstro” och ”Upplevelser och tankar om kränkande bemötande”. Diskussion: Resultatet i denna studie ger en bild av att transkulturella möten i vården inte är helt okomplicerade. Det saknas verktyg att närma sig varandra i transkulturella möten och det handlar om att hitta nya vägar att kommunicera, både verbalt men också icke-verbalt. Vårdpersonal upplever känslor av frustration och osäkerhet när de vårdar människor med andra kulturella bakgrunder än den egna. Dessa känslor kan ses som exempel på ett etnocentriskt förhållningssätt. För att vårdpersonal ska kunna utveckla kulturell kompetens krävs utbildning och reflektion om transkulturell omvårdnad. / Background: The increasing cultural diversity in Sweden has led to new challenges for the society and the health care services. Culture is universal for all humans and is reflected by factors such as religion, values, language, environment and gender. The cultural background influence our perceptions about health and sickness and how we express pain and discomfort. There are similarities and differences which leads to different understandings about caring hence the importance of cultural competence among health care staff. Aim: To illuminate clients and health care staff´s experiences of transcultural meetings in the context of Swedish health care. Methods: A litterature overview. The results of twelve qualitative studys have been synthesized and summarized. Six articles are from a clients perspective and the other six from a health care staff perspective. All of the studys have in common that they illuminate experiences of transcultural meetings in Swedish health care. Results: Three themes emerged with two subthemes each. The first theme is ”Challenges related to communication” with two subthemes, ”Language as a barrier” and ”The use of interpreter”. The second theme is ”Challenges related to cultural differences” with two subthemes, ”Different views of care and caring” and ”Perceptions about gender-differences”. The third theme is ”Prejudices and offensive treatment” with two subthemes, ”Prejudices and disbeliefs” and ”Perceptions and thoughts about offensive treatments”. Discussion: The result in this study provides a picture that transcultural meetings are not entirely uncomplicated. There are lack of tools to approach one another in transcultural meetings and it is a matter of finding new ways to communicate, both verbally and non-verbally. Health care staff experience feelings of frustration and insecurity when they care for people with different cultural backgrounds than their own. These feelings can be understood as examples of an ethnocentric approach. In order to develope cultural competence the health care staff needs education and reflection of transcultural care.

Mångkulturell hälso- och sjukvård har ökat i Sverige på senare år på grund av krig i Syrien, och oro i andra länder i bland annat Mellanöstern och Afghanistan. Det har medfört mänskliga tragedier och stora flyktingströmmar. Sverige har tagit emot en stor andel av flyktingströmmen. Detta ställer nya krav på distriktssköterskan som i ett tidigt skede möter flyktingarna. Syftet med studien var att beskriva distriktssköterskans erfarenheter av hälsofrämjande och förebyggande arbete med nyanlända flyktingar ur ett vårdcentralsperspektiv. Metod: En kvalitativ intervjustudie med sju distriktssköterskor från olika vårdcentraler inom en västsvensk region. Materialet analyserades med en kvalitativ innehållsanalys. Resultat: Det framkom åtta subteman och fyra teman i analysen. Huvudteman var: Egenvårdens betydelse för att främja hälsan, Förebyggande arbete ur ett vårdcentralsperspektiv, Att kommunicera via tredje part samt Samordning mellan parter. Slutsats: Distriktssköterskornas hälsofrämjande och förebyggande arbete var betydelsefullt för de nyanlända flyktingarna eftersom distriktssköterskan var en av de yrkesprofessioner som de träffade i ett tidigt skede. Egenvårdsråd utmärkte det hälsofrämjande arbetet med nyanlända flyktingar men kunde vara svårt då många nyanlända flyktingar var vana från sina hemländer att alltid möta en läkare. Det utmärkande för det förebyggande arbetet var framförallt arbetet med vaccinationsuppföljning, som innebar en stor och krävande arbetsinsats för distriktssköterskorna. / Multicultural health and medical care has increased in Sweden during the last few years due to war in Syria and unrest in other countries among others in the Middle East and in Afghanistan. This has led to human tragedies and big streams of refugees. Sweden has received a large number of these refugees. This poses new demands on district nurses who at an early stage meet the refugees. The purpose of the study was to describe district nurses experience of health promoting and preventive care of newly arrived refugees from a perspective of the care centre. Method: A qualitative interview study with seven district nurses from different care centres within a region in West Sweden. The material was analysed with a qualitative analysis of content. Result: The analysis resulted in eight subthemes and four themes. Main themes were: The importance of self-care in order to promote health, Preventive work from a perspective of the care centre, To communicate through a third party and Co-ordination between parties. Conclusion: District nurses health promoting and preventive care was important for newly arrived refugees as the district nurse was one of the professionals they met at an early stage. Advice on self-care characterized the health promoting work with newly arrived refugees but could be difficult, as many refugees were used always to meet a doctor in their home countries. Characteristic for the preventive work was above all the follow-up of vaccinations, which required big and demanding efforts for district nurses.