Background: Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality in HIV-infected adults. Research in noninfected populations suggests that knowledge of CVD risk factors significantly influences perception of risk. Understanding the level of risk factor knowledge and risk perception can inform the development of innovative interventions to reduce risk. The purpose of this study was to describe cardiovascular risk factor knowledge and risk perception in a cohort of HIV-infected adults. Specific aims included (a) describing the estimated risk of CVD, the perceived risk of CVD, and the level of CVD risk factor knowledge; (b) describing the relationship between estimated and perceived risk, and (c) examining the influence of risk factor knowledge on perceived risk of CVD. The Health Belief Model was the theoretical framework that guided the study. Methods: A prospective observational cohort; cross-sectional design. A convenience sample of 130 HIV-infected adults was recruited from two hospital-based HIV clinics. Each participant had one study visit in which all data were collected by direct interview. Results: Results: Mean age of enrollees was 48 years (SD 8.4); 62% were male; 41.5% White, 32% Black, 23% Hispanic; 56% current smokers; mean years since HIV diagnosis were 14.7; mean BMI 27 (SD 5.5); 48.5% had prehypertension. Higher scores on the Heart Disease Fact Questionnaire indicate a higher degree of knowledge. In this sample, the Mean was 19, (S.D. 3.5; range 6–25), indicating a fair degree of knowledge. Estimated and perceived risk were significantly, though weakly, correlated r (126) = .24, p = .01. Controlling for age, risk factor knowledge was not predictive of perceived risk (F[1,117] = 0.13, p > .05). Conclusions: HIV-infected adults are at increased risk for cardiovascular disease. Traditional CVD risk factors such as smoking, prehypertension, and being overweight are highly prevalent. Despite having a fair level of risk factor knowledge, knowledge did not influence perception of risk for CVD. Research to improve risk perception and to develop innovative interventions that reduce CVD risk is needed for this population.

Introduktion: Hälften av alla vårdskador uppkommer i samband med operation. Operationsteamet är ett multidisciplinärt samarbete där många människor från flera yrkeskategorier arbetar tillsammans i olika konstellationer med patientsäkerheten som en av de viktigaste delarna. Operationssjuksköterskan och anestesisjuksköterskan ansvarar för patientens omvårdnad före, under och efter operationen. Syfte: Att beskriva hur omvårdnadsteamet arbetar intraoperativt beträffande patientsäkerheten. Metod: En integrerad systematisk litteraturstudie där artiklar söktes i databaserna Cinahl och PubMed. Elva artiklar med kvantitativ, kvalitativ och mixed method valdes ut och analyserades. Resultat: Materialet resulterade i tre kategorier: Att vara förberedd, att utbyta information med varandra och att vara förtrogen med varandras färdigheter. Konklusion: En stor del av resultatet visade på att förberedelser där hela omvårdnadsteamet involveras, kontinuerligt utbyter information med varandra och är förtrogna med varandras yrkesprofessionella färdigheter stärker patientsäkerheten. Resultatet av denna litteraturstudie kan leda till en ökad förståelse för operationsteamets betydelse för patientsäkerheten intraoperativt. / Introduction: Half of all health care-associated injuries occur in conjunction with surgery. The patient care team is a multidisciplinary collaboration where many people from different professions work together in different configurations with patient safety as one of the most important aspects. The operating theatre nurse and the nurse anesthetist are responsible for the patients nursing care before, during and after the surgery. Aim: To describe how the patient care team works intraoperatively regarding the patient safety. Method: An integrated systematic literature study were articles searches where made using the databases Cinahl and PubMed. Eleven articles with quantitative, qualitative and mixed method analysis has been reviewed. Result: The material resulted in three categories: To be prepared, to exchange information with each other and to be familiar with each other’s skills. Conclusion: A large part of the result showed that preparations where the whole patient care team was involved, continuously exchanging information with each other and were familiar with each other’s professional skills enhances the patient safety. The result of this literature study might lead to an increased understanding of the importance of the patient care team for patient safety intraoperatively.

Bakgrund: Patientnära rond är ett teamarbete mellan framförallt patient, sjuksköterska och läkare. Ett bra samarbete förbättrar relationen dem emellan. Dessutom har en framgångsrik rond mellan patient och sjukvårdspersonal stor betydelse för att patienten ska kunna få en säker och personcentrerad vård. Därför är det viktigt att få en djupare förståelse för hur patienter och sjukvårdpersonal upplever patientnära rond samt för betydelsen av teamarbetet vid patientnära rond. Syfte: Att belysa vilka effekter patientnära rond har på vårdteam samt att undersöka upplevelsen av patientnära rond utifrån perspektiven från både patienter och sjukvårdspersonal (sjuksköterskor, läkare och medicinstudenter). Metod: En litteraturstudie baserad på 14 vetenskapliga originalartiklar. Databaser som användes i studien var PubMed, Cochrane Library, Cinahl, SBU och SveMed. Resultat: Resultatet av denna studie indikerar att både patienter och sjukvårdspersonal upplever en ökad tillfredsställelse vid patientnära rond. Vidare visar resultatet att patientnära rond bidrar till att sjukvårdpersonal kan ge patienter en proaktiv omvårdnad, att samarbetet sjukvårdpersonal emellan blir mer effektivt och att patientnära rond gynnar medicinstudenters utveckling samt ökar studenters tillfredsställelse med sin utbildning. En utmaning som sjuksköterskor upplever i samband med patientnära rond är tidsbegränsning – framför allt upplever de att det tar tid för sjuksköterskor och läkare att synkronisera och koordinera mötet mellan patient och vårdpersonal samt att tid för dokumentation är bristande. Läkare upplever dessutom att deras autonomi minskas i samband med patientnära rond. Slutsats: Överlag kan patientnära rond vara ett effektivt sätt att främja personcentrerad vård. Patientnära rond har en positiv inverkan på teamarbete sjukvårdpersonal emellan samt bidrar till ökad tillfredsställelse hos både patienter och sjukvårdspersonal. Det finns dock behov av ytterligare forskning om patienters upplevelse av patientnära rond och vilka specifika åtgärder som kan vidtas för att sjukvårdpersonalen ska kunna samarbeta på ett mer effektivt sätt. / Background: The ward round is a team collaboration mainly between patient, nurse and physician. A good collaboration enhances the relationship between them. In addition, a successful round between the patient and the medical personnel is of great significance for the patient to have a safe and person-centered care. Therefore it is important to gain a deeper understanding of how patients and medical staff experience ward rounds, as well as of the importance of team work during the ward rounds. Aim: To shed light upon the effects of ward rounding on healthcare teams and to explore the experience of ward rounds from the perspectives of both patients and medical staff (nurses, physicians and medical students). Method: A literature study based on 14 scientific articles. Databases used in the study were PubMed, Cochrane Library, CINAHL, SBU and SveMed. Results: The results of this study indicate that both patients and medical personnel experience an increased satisfaction during ward rounds. Furthermore, the results show that ward rounds contribute in making medical personnel provide a proactive care to their patients, that cooperation between medical staff becomes more efficient, and that ward rounding benefits medical students’ development and increases students’ satisfaction with their education. A challenge that nurses experience during ward rounds is time limitation – mainly they experience that it takes time for nurses and physicians to synchronize and coordinate the meeting between patient and medical personnel, and also that the time for documentation is inadequate. Physicians also experience that their autonomy is reduced in relation to ward rounds. Conclusion: Overall, ward rounding can be an effective way to promote person-centered care. Ward rounds have a positive impact on teamwork between medical personnel and contribute to increased satisfaction among both patients and medical staff. However, there is need for further research on patients' perception of ward rounding and which specific measures that can be taken for the medical staff to be able to collaborate more efficiently.

Introdução: Nos serviços de urgência e emergência hospitalares, a complexidade das necessidades de saúde exige cada vez mais o trabalho colaborativo em equipes interprofissionais, sendo necessária a identificação das ações para a construção das competências específicas, comuns e colaborativas. Essa identificação clarifica os papéis e fortalece o trabalho colaborativo nas equipes de urgência e emergência. Objetivos: identificar as ações específicas, comuns e colaborativas dos enfermeiros em urgência e emergência hospitalar de um hospital público do Estado de São Paulo. Método: Pesquisa descritiva, exploratória e de abordagem qualitativa, que utilizou como categorias conceituais as competências, conforme a definição de Zarifian (2003); as competências complementares, comuns e colaborativas de Barr (1998); as competências para a prática interprofissional colaborativa, propostas pelo Canadian Interprofessional Health Collaborative (CIHC) de 2010, e a definição de equipe de referência e apoio matricial segundo Campos & Domitti (2007). Para a coleta de dados foram realizadas entrevistas individuais e semiestruturadas com os enfermeiros que atuam no Pronto-Socorro de um hospital público do estado de São Paulo. Para a análise do material proveniente das entrevistas foi utilizada a técnica de análise temática de Bardin (2011). Os dados das entrevistas foram analisados para identificação do conjunto de ações específicas, comuns e colaborativas. Resultados: Os achados revelam que os enfermeiros desempenham mais ações voltadas para a gestão e articulação do cuidado, comparando-se à prática centrada na família e no paciente, que ainda é pouco realizada pelos enfermeiros. A clarificação dos papéis e a importância do saber comum destaca que o enfermeiro reconhece o seu próprio papel, porém tem dificuldade em reconhecer os papéis dos demais profissionais da equipe. A comunicação é a principal ferramenta utilizada pelo enfermeiro dentro das ações específicas, comuns e colaborativas, e está mais relacionada à comunicação instrumental e tecnicista, ou seja, à passagem de informação entre profissionais, o que mostra a necessidade de uma comunicação mais ampla, com a troca de experiências, compartilhamento de informações, entendimento mútuo e a confiança entre os profissionais. A dinâmica do setor de urgência e emergência dificulta a realização de reuniões e encontros de equipe interprofissional de urgência e emergência, portanto se faz necessária a implantação de protocolos e fluxos de atendimento para o entendimento mútuo dos processos estabelecidos, o que facilitaria o trabalho interprofissional em equipe e em colaboração dentro do Pronto-Socorro. Conclusões: Espera-se que a identificação das ações possa levar à construção de um quadro de competências específicas, comuns e colaborativas para o enfermeiro em urgência e emergência, e clarifique o papel do enfermeiro no contexto das equipes interprofissionais, fortalecendo a colaboração e contribuindo para o desenvolvimento de novas práticas de saúde neste cenário. / Introduction: In both urgent care and hospital emergency room services, the complexity of the health needs urges more collaborative work among interprofessional teams, which is necessary to identify the actions in order to build specific, common and collaborative skills. This identification clarifies the roles and strengthens the collaborative work in urgent and emergency teams. Objectives: Identify the specific, common and collaborative actions of nurses in hospital emergency care at a public hospital in the State of São Paulo. Method: Descriptive, exploratory and qualitative approach, which adopted as conceptual categories the competences, as defined by Zarifian (2003); the complementary, common and collaborative skills of Barr (1998); competencies for collaborative interprofessional practice, proposed by the Canadian Interprofessional Health Collaborative (CIHC) in 2010, and the definition of reference team and matrix support according to Campos and Domitti (2007). For data collection, individual and semi-structured interviews were conducted with nurses who work in the emergency room of a public hospital in the state of São Paulo. For the analysis of the material collected from the interviews, the technique of thematic analysis of Bardin (2011) was employed. The interview data were analyzed to identify the set of specific, common and collaborative actions. Results: The findings show that nurses perform more actions related to management and care coordination, rather than focus on family and patient issues, which are still not carried out by nurses. The clarification of roles and the importance of common knowledge highlight that nurses recognize their own role, but have difficulty in recognizing the roles of other members from the staff. Communication is the main tool used by the nurse among the specific, common and collaborative actions, and it is more related to the instrumental and technical communication, i.e. passage of information between professional, which shows the need of a broader communication, with exchange of experiences, information sharing, mutual understanding and trust among professionals. The dynamics of the urgent and emergency sectors make it difficult to hold meetings with the interprofessional teams, and those are necessary to implement protocols and service flows for the mutual understanding of established processes, which would facilitate the interprofessional work in team and in collaboration within the first-aid station. Conclusions: It is expected that the identification of actions can lead to the construction of a specific competency framework, common and collaborative, for nurses in emergency care, and also clarify the role of the nurse in the context of interprofessional teams, strengthening collaboration and contributing to the development of new health practices in this setting.

O trabalho em equipe de saúde e enfermagem tem sido apontado como um importante aspecto da organização dos serviços para alcançar a produção do cuidado integral. Assim, o estudo tem como objetivo identificar e analisar as concepções dos profissionais de enfermagem sobre o trabalho em equipe de enfermagem bem como as concepções sobre a prática do cuidado integral e da integralidade à saúde. A pesquisa, de abordagem qualitativa, foi realizada num hospital especializado em oncologia em duas unidades, ambulatório de especialidades e clínica cirúrgica. Foram entrevistadas 21 profissionais, enfermeiras e técnicas de enfermagem e no tratamento do material empírico, utilizou-se a técnica de análise de conteúdo. Os resultados mostram que a concepção de trabalho em equipe de enfermagem é majoritariamente, ação interprofissional e que as entrevistadas elegem como elementos necessários para o trabalho em equipe a comunicação, confiança, vínculo, respeito mútuo, reconhecimento do trabalho do outro e colaboração. Identifica-se a presença de conflitos na equipe de enfermagem que ocorrem predominantemente entre enfermeiras e técnicas de enfermagem e obstaculizam o trabalho em equipe. Os conflitos em sua maioria são decorrentes da ausência de reconhecimento das contribuições das técnicas de enfermagem por parte das enfermeiras e da ausência de colaboração e compartilhamento do plano de cuidados entre as distintas categorias. Quanto às concepções sobre o cuidado integral de enfermagem as entrevistadas o referem como alternativo ao modelo de organização funcional, ancorado na abordagem biopsicossocial e fortalecido pelo modelo de enfermeiro referência. No tocante às práticas de integralidade à saúde identificam-se três categorias, a articulação entre os profissionais da equipe no atendimento do paciente, a articulação dos setores do hospital e a articulação do hospital na rede de atenção à saúde. Conclui-se que o trabalho em equipe de enfermagem caracteriza-se pela estreita interface com as ações desenvolvidas pela equipe interprofissional e que a colaboração e o planejamento dos cuidados de enfermagem realizado em conjunto entre enfermeiras e técnicas de enfermagem podem ampliar a qualidade da assistência de enfermagem com foco nas necessidades de cuidado do paciente. / The teamwork in the health and nursing area has been pointed as an important aspect from services organization seeking for the achievement of the integrated care concept. This study aims to identify and analyze the concepts sustained by nursing professionals concerning the teamwork in the nursing area as well as the concepts related to the practice of an integrated care and comprehensive health care. This qualitative research was developed in two different areas, out patient clinic and surgical clinic, from an oncology specialized hospital. There were 21 professionals interviewed including nurses and the nursing assistants. For the empirical treatment the content analysis technique was used. The results demonstrate that the understanding related to teamwork in nursing is mostly interprofessional practice and the interviewed people point as necessary elements for the teamwork the communication, trust environment, linkage among the professionals, respectful environment and the valorization of the work performed by each of the team members as well as the collaboration along with them. Conflicts mostly between nurses and the nursing assistants can be identified, establishing a barrier for the team work achievement. The majority of the conflicts derive from the lack of valorization from the nurses towards the contributions delivered by the nursing assistants as well as the lack of collaboration and sharing with regards to nursing care plan. With respect to the concept concerning the comprehensive health care the interviewed professionals mention it as an alternative model to functional organization, sustained by the biopsychosocial approach and reinforced by the primary nursing model. With regards to the integrated care practices three categories can be identified: the articulation between the professionals from the team when treating the patient, the articulation from the different sectors in the hospital and the articulation from the hospital in the health care system. It concludes that the nursing teamwork characterizes itself by the strict interface with actions carried out by the interprofessional team and that collaboration and nursing health care planning, performed together both by nurses and the nursing assistants, can increase the quality of the nursing assistance focusing on the patient centered care.

O trabalho em equipe de saúde e enfermagem tem sido apontado como um importante aspecto da organização dos serviços para alcançar a produção do cuidado integral. Assim, o estudo tem como objetivo identificar e analisar as concepções dos profissionais de enfermagem sobre o trabalho em equipe de enfermagem bem como as concepções sobre a prática do cuidado integral e da integralidade à saúde. A pesquisa, de abordagem qualitativa, foi realizada num hospital especializado em oncologia em duas unidades, ambulatório de especialidades e clínica cirúrgica. Foram entrevistadas 21 profissionais, enfermeiras e técnicas de enfermagem e no tratamento do material empírico, utilizou-se a técnica de análise de conteúdo. Os resultados mostram que a concepção de trabalho em equipe de enfermagem é majoritariamente, ação interprofissional e que as entrevistadas elegem como elementos necessários para o trabalho em equipe a comunicação, confiança, vínculo, respeito mútuo, reconhecimento do trabalho do outro e colaboração. Identifica-se a presença de conflitos na equipe de enfermagem que ocorrem predominantemente entre enfermeiras e técnicas de enfermagem e obstaculizam o trabalho em equipe. Os conflitos em sua maioria são decorrentes da ausência de reconhecimento das contribuições das técnicas de enfermagem por parte das enfermeiras e da ausência de colaboração e compartilhamento do plano de cuidados entre as distintas categorias. Quanto às concepções sobre o cuidado integral de enfermagem as entrevistadas o referem como alternativo ao modelo de organização funcional, ancorado na abordagem biopsicossocial e fortalecido pelo modelo de enfermeiro referência. No tocante às práticas de integralidade à saúde identificam-se três categorias, a articulação entre os profissionais da equipe no atendimento do paciente, a articulação dos setores do hospital e a articulação do hospital na rede de atenção à saúde. Conclui-se que o trabalho em equipe de enfermagem caracteriza-se pela estreita interface com as ações desenvolvidas pela equipe interprofissional e que a colaboração e o planejamento dos cuidados de enfermagem realizado em conjunto entre enfermeiras e técnicas de enfermagem podem ampliar a qualidade da assistência de enfermagem com foco nas necessidades de cuidado do paciente. / The teamwork in the health and nursing area has been pointed as an important aspect from services organization seeking for the achievement of the integrated care concept. This study aims to identify and analyze the concepts sustained by nursing professionals concerning the teamwork in the nursing area as well as the concepts related to the practice of an integrated care and comprehensive health care. This qualitative research was developed in two different areas, out patient clinic and surgical clinic, from an oncology specialized hospital. There were 21 professionals interviewed including nurses and the nursing assistants. For the empirical treatment the content analysis technique was used. The results demonstrate that the understanding related to teamwork in nursing is mostly interprofessional practice and the interviewed people point as necessary elements for the teamwork the communication, trust environment, linkage among the professionals, respectful environment and the valorization of the work performed by each of the team members as well as the collaboration along with them. Conflicts mostly between nurses and the nursing assistants can be identified, establishing a barrier for the team work achievement. The majority of the conflicts derive from the lack of valorization from the nurses towards the contributions delivered by the nursing assistants as well as the lack of collaboration and sharing with regards to nursing care plan. With respect to the concept concerning the comprehensive health care the interviewed professionals mention it as an alternative model to functional organization, sustained by the biopsychosocial approach and reinforced by the primary nursing model. With regards to the integrated care practices three categories can be identified: the articulation between the professionals from the team when treating the patient, the articulation from the different sectors in the hospital and the articulation from the hospital in the health care system. It concludes that the nursing teamwork characterizes itself by the strict interface with actions carried out by the interprofessional team and that collaboration and nursing health care planning, performed together both by nurses and the nursing assistants, can increase the quality of the nursing assistance focusing on the patient centered care.

Purpose: The purpose of this study was to explore the efficacy of an interdisciplinary intervention on interdisciplinary teamwork and patient functional outcomes in an acute inpatient rehabilitation unit at a mid-sized regional hospital. Design: Pilot mixed-methods pre-post intervention study. Methods: Interdisciplinary teamwork and patient functional outcomes were measured before and after a teamwork intervention. Interdisciplinary teamwork was measured with the Healthcare Team Vitality Instrument (HTVI) and a qualitative staff questionnaire developed by a content expert. Patient functional outcomes were measured by aggregated Functional Independence Measure (FIM®) scores. Findings: Post-intervention FIM® gain scores increased significantly (p = .008). Staff questionnaire revealed improvement in interdisciplinary teamwork, with the major themes of teamwork and appreciation/respect. Post-intervention HTVI showed no significant change (p=.528). Conclusions: Initial results of this intervention are promising; additional research is needed to study the effectiveness of this intervention in a variety of acute rehabilitation settings. Clinical Relevance: Rehabilitation leaders can implement low-cost teamwork interventions to improve interdisciplinary teamwork and patient outcomes.

Quality of care is identified as a major problem in the current health care system. Multidisciplinary teamwork has been proposed to address quality-of-care problems because, theoretically, a health-care team can expand knowledge and follow up patients more efficiently. However, questions about how to successfully implement team-based care in ambulatory settings and its long-term costs are still unanswered. The first objective of this dissertation is to estimate the marginal effects of process measures including number of counseling sessions about lifestyle modification and number of specified-dose antihypertensive medications provided by a physician-pharmacist collaborative intervention and usual care on blood pressure reduction and direct treatment costs by comparing the results from as-treated and instrumental variable methods. The second objective is to estimate the long-term cost changes attributable to the physician-pharmacist collaborative intervention by considering costs related to coronary heart disease, stroke, and heart failure. To accomplish both objectives, data from two prospective, clustered randomized controlled clinical trials implementing a physician-pharmacist collaborative intervention in the Midwest were used. In the first study, multiple linear regression models included blood pressure reduction and costs as outcome variables, and the two process measures and other control variables as explanatory variables. As-treated methods revealed insignificant associations between the two process measures and blood pressure reduction outcomes. On the other hand, both process measures were significantly associated with the costs. By using instrumental variable methods, utilizing two instruments of randomization and the trial indicator, the models were unidentified and showed no significant associations between the process measures and all of the outcomes. However, the post-hoc analysis of the instrumental variable models, evaluating one process measure at a time without controlling for the other process measure, showed significant associations between the process measures and all of the outcomes. The estimates from instrumental variable methods were larger than the estimates from the as-treated methods. The second study used a Markov model cohort simulation in a 10-year timeframe, transition probabilities estimated by several risk estimation systems and published statistics, and published event costs. The reference case employed a sample of patients aged 30 to 74 years from the trials and assumed that blood pressure after the intervention was constant. The total costs of the intervention for hypertension care and the costs related to the vascular diseases in the intervention group were shown to be lower than the usual care group at 6.5 years. However, cost-savings by the intervention were sensitive to patient risk profiles and sustainability of blood pressure after the intervention. To conclude, from the first study, combining multiple studies and using instrumental variable methods may be useful for evaluating marginal effects of the care process but further research is needed to address under-identification problems. The results of the second study suggested that it was likely that the physician-pharmacist collaborative intervention to treat hypertension was appropriate for high-risk patients.

<p><strong>Syfte: </strong>Studiens syfte var att ta del av teamets samlade erfarenheter av deras uppfattningar om vilka känslor, existentiella tankar och reaktioner döende patienter kan ge uttryck för, hur team-medlemmarna bemöter dessa samt deras uppfattning om teamets betydelse. <strong>Urval:</strong> Tio deltagare ur vårdteamet på hospice, nio kvinnor och en man, deltog i studien.<strong> Metod: </strong>Data samlades in genom semistrukturerade kvalitativa intervjuer. <strong>Analysresultat: </strong>Analysarbetet resulterade i tre teman. Dessa teman var <em>Döende patienters existentiella tankar och reaktioner, Personalens bemötande </em>samt <em>Teamets betydelse</em>. <strong>Resultat:</strong> Döende människors tankar och reaktioner kan yttra sig på flera olika sätt. Detta beroende på exempelvis individens personlighet, var i sjukdoms- respektive anpassningsprocessen patienten befinner sig samt möjligheten till stöd från närstående. Informanterna beskrev ett gott bemötande som; att vara närvarande, ge fysisk beröring, prioritera, se individen, vara lyhörd, respektera individen, bekräfta, inge hopp, skapa trygghet samt skapa förtroende. De nämnde även teamets betydelse för patienten, de närstående samt team-medlemmarna själva. <strong>Slutsats: </strong>Grundläggande för ett gott bemötande är att patienten känner förtroende för personalen. Detta förtroende kan skapas genom att bland annat stanna upp och lyssna på patienten, se och bekräfta denne, ge fysisk beröring samt vara ärlig och uppriktig. Ett gott bemötande kräver också att personalen flyttar fokus från sig själv till patienten och möter individen där denne är.</p> / <p><strong>Aim:</strong> The aim of this study was to investigate the team members collected perception of the feelings, existential thoughts and reactions expressed by terminal patients, how the different team members respond to such feelings and their perception of the importance of the team. <strong>Sample:</strong> Ten members of the healthcare team at the hospice, consisting of nine women and one man, participated in the study. <strong>Method:</strong> Data was collected during the spring of 2009 through semi-structured qualitative interviews. <strong>Analysis Results:</strong> The analytical process resulted in three themes. These themes were: <em>Terminal patients’ thoughts and reactions to existential questions</em>, <em>Interaction with the personnel</em> and <em>The importance of the healthcare team</em>. <strong>Results:</strong> Terminal patients express their thoughts and reactions in different ways. Many factors contribute to the patient’s individual response: his/her personality, how long the patient has been ill, as well as support received from family and friends. The informants described a good response like; to be present, giving physical touch, prioritize, see the individual, listening, respecting individual, acknowledge, inspire hope, creating a haven and creating confidence. They also mentioned the team's importance to the patient, family and friends and the team members themselves. <strong>Conclusion:</strong> It is fundamental that the patient has confidence in the personnel. According to some of the participants, this confidence is earned by: listening to the patient, respecting and affirming the patient, answering his/her questions, physical contact, and by being honest and frank. Good care requires that the caregiver does not focus on himself but on the patient, meeting each patient as an individual.</p>

Syfte: Studiens syfte var att ta del av teamets samlade erfarenheter av deras uppfattningar om vilka känslor, existentiella tankar och reaktioner döende patienter kan ge uttryck för, hur team-medlemmarna bemöter dessa samt deras uppfattning om teamets betydelse. Urval: Tio deltagare ur vårdteamet på hospice, nio kvinnor och en man, deltog i studien. Metod: Data samlades in genom semistrukturerade kvalitativa intervjuer. Analysresultat: Analysarbetet resulterade i tre teman. Dessa teman var Döende patienters existentiella tankar och reaktioner, Personalens bemötande samt Teamets betydelse. Resultat: Döende människors tankar och reaktioner kan yttra sig på flera olika sätt. Detta beroende på exempelvis individens personlighet, var i sjukdoms- respektive anpassningsprocessen patienten befinner sig samt möjligheten till stöd från närstående. Informanterna beskrev ett gott bemötande som; att vara närvarande, ge fysisk beröring, prioritera, se individen, vara lyhörd, respektera individen, bekräfta, inge hopp, skapa trygghet samt skapa förtroende. De nämnde även teamets betydelse för patienten, de närstående samt team-medlemmarna själva. Slutsats: Grundläggande för ett gott bemötande är att patienten känner förtroende för personalen. Detta förtroende kan skapas genom att bland annat stanna upp och lyssna på patienten, se och bekräfta denne, ge fysisk beröring samt vara ärlig och uppriktig. Ett gott bemötande kräver också att personalen flyttar fokus från sig själv till patienten och möter individen där denne är. / Aim: The aim of this study was to investigate the team members collected perception of the feelings, existential thoughts and reactions expressed by terminal patients, how the different team members respond to such feelings and their perception of the importance of the team. Sample: Ten members of the healthcare team at the hospice, consisting of nine women and one man, participated in the study. Method: Data was collected during the spring of 2009 through semi-structured qualitative interviews. Analysis Results: The analytical process resulted in three themes. These themes were: Terminal patients’ thoughts and reactions to existential questions, Interaction with the personnel and The importance of the healthcare team. Results: Terminal patients express their thoughts and reactions in different ways. Many factors contribute to the patient’s individual response: his/her personality, how long the patient has been ill, as well as support received from family and friends. The informants described a good response like; to be present, giving physical touch, prioritize, see the individual, listening, respecting individual, acknowledge, inspire hope, creating a haven and creating confidence. They also mentioned the team's importance to the patient, family and friends and the team members themselves. Conclusion: It is fundamental that the patient has confidence in the personnel. According to some of the participants, this confidence is earned by: listening to the patient, respecting and affirming the patient, answering his/her questions, physical contact, and by being honest and frank. Good care requires that the caregiver does not focus on himself but on the patient, meeting each patient as an individual.