Bakgrund Trauma orsakas oftast av högenergivåld och de flesta som råkar ut för trauma är personer mellan 18 och 64 år. Sjuksköterskans ansvar vid omhändertagande av patienter som har råkat ut för trauma är att utföra personcentrerad omvårdnad med omvårdnadsprocessen som stöd. För att kunna tillgodose patientens behov i samband med omhändertagande av patienter som råkat ut för trauma behöver sjuksköterskan förstå vilka omvårdnadsbehoven är. Syfte Syftet var att identifiera omvårdnadsbehov hos patienter som blivit omhändertagna på sjukhus efter att ha råkat ut för trauma. Metod Studien genomfördes som en strukturerad litteraturstudie med inslag av den metodologi som används vid systematiska översikt med en kvalitativ ansats. För sökningen användes databaserna CINAHL och PubMed där tolv artiklar identifierades och sedan analyserades. Resultat I resultatet identifierades två kategorier och sex underkategorier som belyser att patienter som har råkat ut för trauma har flertalet fysiska- och psykiska omvårdnadsbehov i samband med omhändertagandet. Fysiska behov som identifierats är behov av adekvat smärtlindring, behov av varsamhet vid förflyttning samt behov av stöttning vid daglig aktivitet. Psykiska behov som identifierats är trygghet, närvaro, bemötande samt känslomässigt stöd. Framför allt de psykiska behoven hos patienter som råkat ut för trauma behöver fyllas av sjuksköterskan. Slutsats Vid utförande av personcentrerad omvårdnad kan patientens psykiska behov i högre grad tillgodoses. / Background Trauma is often caused by high energy mechanisms and often affects younger people between 18 and 64 years. Nurses’ responsibility for trauma care is to perform personcentred nursing with the nursing process as support. The nurse needs to understand patients’ needs to be able to meet them in connection with trauma care. Aim The aim of this study was to identify patients caring needs while receiving hospital care after suffering from trauma. Method This study was implemented as a structured literature study with the elements of the methodology used in systematic reviews with a qualitative approach. The databases CINAHL and PubMed were used for searching articles and twelve articles were identified and analysed. Results In the result two categories and six subcategories describe patients caring needs after suffering from trauma. Physical needs that have been identified are the need of pain relief, need of caution when moving and need of support during daily activities. Mental needs that have been identified are the need of security, need of presence, need of good reception, and need of emotional support. Above all, the mental needs of patients suffering from trauma need to be met by the nurse. Conclusions If nurses perform a person- centred nursing, the patient’s mental needs are met to a greater extent.

Introduction: As medical treatment has improved, patients with heart failure (HF) now live longer and care mostly takes place at home with partners providing the main assistance. Taking care of an ill or disabled individual imposes a well-documented burden on the partner’s healthrelated quality of life. The awareness of partners’ burdensome situation is increasing, but few interventions have targeted the needs of patientpartner dyads with HF. The results have been inconclusive and give no clear guidance on how interventional programmes should be designed to improve both patient and partner outcomes. Aim: The overall aim of this thesis was to evaluate the effects of a psychoeducational intervention delivered to patient-partner dyads with HF during long-term follow-up, and to explore the dyads’ perceived caring needs. Methods: The thesis is based on four papers that used both quantitative and qualitative data. Study I and II used a randomized controlled design with a follow-up assessment after 24 months including 155 patientpartner dyads. The control group received care as usual. The intervention group received care as usual, and in addition they participated in the nurse-led psycho-educational intervention. Data was collected using questionnaires before and 24 months after the intervention, in order to determine the long-term effects on patients and partners regarding health related quality of life, perceived control, symptoms of depression and partners’ caregiver burden (I, II). A conceptual health promotion model inspired the intervention. To describe how the model was applied, a qualitative approach analysing nurses’ documentation of the sessions with 71 dyads in the intervention group (III) was used. Study IV has an explorative design. To further explore the dyads’ perceived caring needs, focus groups interviews with 19 patient-partner dyads with heart failure (IV) were performed. Results: The intervention did not have any significant effect on physical or mental health- related quality of life, depressive symptoms, or perceived control over the heart failure among the dyads (I) or caregiver burden in the partners (II) after 24 months. Furthermore, time to first event did not differ significantly between the dyads in the intervention group and the control group (I, II). As for the partners, both the intervention and control group reported decreased physical health between the baseline assessment and the 24-month follow-up (I). The intervention was composed of three components; 1) cognitive 2) supportive, and 3) behavioural component. The analysis of the nurses’ documentation confirmed the coverage of all the components and the analysis revealed a vide range of caring needs among the dyads (III). The dyads described a need to learn about HF to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital and both the patient and the partner need to be present at the clinic visits. Meeting others who are in the same situation and sharing the burden in nurse-led group sessions was proposed as an opportunity to support each other and others (IV). Conclusions: Over the 24-month follow-up period, the intervention had a neutral effect on health- related quality of life, depressive symptoms and perceived control over the HF among the dyads, and on partners’ caregiver burden. Considering the fact that partners serve as a critical extension of the formal healthcare system, and that both patients and partners ask for more support, it will become crucial to find new ways to support dyads affected by heart failure. This thesis may be viewed as a first step in trying to understand dyads’ perceived caring needs, and it can serve as a guide in clinical work and when designing new dyadic interventions.