Syfte: att belysa barnmorskors upplevelser och erfarenheter av vårdmötet med förlossningsrädda kvinnor under aktiv förlossning. Design: kvalitativa intervjuer som analyserades med innehållsanalys. Lokalisation: studien utfördes på en mellanstor förlossningsklinik i Norra Sverige.  Deltagare: sex barnmorskor anställda och i aktiv tjänst på förlossningsavdelningen.  Resultat: tre beskrivande kategorier framkom; Att uppfatta och respektfullt bemöta rädsla; Att skapa en tillitsfull relation och Att utvecklas i professionen. Slutsats: Resultatet visade att barnmorskorna betraktade förlossningsrädsla som något normalt och uttryckte att de flesta kvinnor bar på någon form av oro och rädsla. Tillit och närvaro uttrycktes som viktiga grundförutsättningar för ett bra vårdmöte med en förlossningsrädd kvinna, och barnmorskorna efterfrågade forum i verksamheten som kunde främja deras professionella utveckling.  Praktiska implikationer: Resultatet tyder på att barnmorskor saknar regelbunden reflektion och handledning som en möjlighet att utvecklas och stärkas i vårdmötet med den förlossningsrädda kvinnan. / Objective: to highlight midwife's experience of care meeting with women with fear of childbirth. Design: qualitative interviews analyzed using content analysis.  Settings: the study was conducted on a medium sized childbirth clinic in Northern Sweden.  Participants: six midwives employees in active service at the delivery ward. Findings:Three descriptive categories emerged; To perceive and respectful response to fear; To create a trusting relationship and To develop in the profession.  Key conclusion: The results showed that midwives regarded the fear of childbirth as something normal and expressed that most women wore some form of fear. Presence and dialogue emerged as key prerequisites for a trusting relationship with the childbirth scared woman and midwives demanded forums in the business who could promote their professional development. Implications for practice:The results suggest that midwives have no regular reflection and tutoring as an opportunity to develop and strengthen the health care encounter with the woman with fear of childbirth

Background: It is valuable that the patients experience a good encounter with the nurse at the emergency department. There are several factors that can influence the encounter and the patients' perception of the nurses and the surroundings at the emergency department. To not be seen as the person you are or not treated well, is a common reason why patients feel health suffering. It is the patients' experience of the circumstances which determines whether situations cause health suffering or not. Aim: The aim of this study was to describe patients' experiences of the encounter with the nurse at the emergency department. Method: The method used in this study was a literature review, based on qualitative studies. Ten articles were analyzed according to Friberg's (2012) qualitative content analyze in five steps. Results: The researchers found five themes that specifically stood out when studies were researched. The themes were feelings of: participation, being seen, abandonment, being dependent and vulnerability. Conclusion: The experience of the encounter with the nurse at the emergency department differ from each patient. All patients want to meet a nurse who characterises kindness and warmth. The nurses are the ones who can control the outcome of the encounter at the emergency department.

Bakgrund: Självskadebeteende har funnits i decennier med många olika termer och definitioner. Självdestruktiva känslor kan grundas av olika övergrepp och kränkningar. Självskadebeteendet kan användas för att återfå kontroll samt som självbestraffning. I dagens samhälle finns större fokus på fenomenet än tidigare och ny forskning leder till nya insikter. Syfte: Syftet med litteraturstudien var att belysa sjuksköterskors attityder och faktorer som har betydelse i mötet med patienter som lider av självskadebeteende samt beskriva urvalsmetod i artiklarna. Metod: Detta är en deskriptiv litteraturstudie med artiklar från 2005-2015 i PubMed och PsycINFO. Resultatet baseras på 14 vetenskapliga artiklar med kvalitativ och/eller kvantitativ ansats. Resultat: Sjuksköterskors attityder är övervägande positiva till patienter med självskadebeteende. Trots detta uttrycker de även negativa attityder som antipati, frustration, maktlöshet och oro i mötet med självskadande patienter. Sjuksköterskorna upplever att de saknar kunskaper och resurser till att ge en god omvårdnad. Slutsats: För att sjuksköterskor ska känna sig självsäkra i sitt arbete och ge patienter med självskadebeteende en god omvårdnad så behöver de utbildning om självskador samt mer tid och stöd av ledning och kollegor. Klinisk betydelse: Förhoppningen är att denna studie ska ge insikt och förståelse för självskadebeteende hos vårdgivare och vårdchefer. / Background: People who self-harm is nothing new, this behavior has a lot of different terms and definitions. Self-destructive feelings can be rooted in assaults and violations. A self-harming behavior is sometimes used to regain control or to be used as self-punishment. Today there is a greater attention towards research in the subject of self-harm which brings new knowledge. Aim: The aim is to illuminate nurses’ attitudes an factors that is important in the encounter of patients who suffers from self-injurious behavior and to exanimate the samples selection in the articles of this study. Method: A descriptive literature study was conducted and fifteen articles from PsycINFO and PubMed between years 2005-2015. The chosen articles have qualitative and/or quantitative approach. Results: Nurses attitudes towards people who self-harm are predominantly positive. Negative attitudes are also presented in the encounter in form of antipathy, frustration, powerlessness and anxiety. Nurses are experiencing a lack of knowledge and resources. Conclusion: For nurses to feel confident in their work and give the best possible care to people who self-harm there is a need of education and organizational improvements such as more time and support from colleagues. Clinical significance: Our expectation with this study is to bring attention and understanding in the subject of self-harm.

Gustav Jonson's theory of the social heritage characterized social work in Sweden during the 1960s and onwards. The social policy issues debated then were about class society, labelling and alienation. After thirty years of professional work as a social worker, I find it interesting that the work still focuses on the theory of the social heritage and methods for breaking it. The aim of this study is to examine possible explanations to why this is so. The empirical material is taken from interviews with senior social workers. Issues examined are how they perceive social work and the theory of the social heritage. The results of the interviews have been processed based upon narrative analysis and reported in the form of meta-narratives. The stories provide a historical view of social work, encounters, situations and contexts. The final discussion is about how the social heritage is created, identified and carried forward. The conclusions show that the social heritage is a social construction created by the society and its inhabitants.The issue then, is to understand and to relate to this context, creating security control and balance in it. As a phenomenon, the social heritage can come to act as conservation and thus become a counterforce to change. Based on discussion and conclusions, it appears that efforts to break the social heritage are questionable. The study is a social psychological qualitative study worked with from a social constructionist perspective.

Objective: Chest pain is a common reason for an encounter in general practice. The present investigation was set out to characterize the consultation rate of chest pain, accompanying symptoms, frequency of diagnostic and therapeutic interventions, and results of the encounter. Materials and Methods: Cross‑sectional data were collected from randomly selected patients in the German Sächsische Epidemiologische Studie in der Allgemeinmedizin 2 (SESAM 2) and analyzed from the Dutch Transition Project. Results: Overall, 270 patients from the SESAM 2 study consulted a general practitioner due to chest pain (3% of all consultations). Chest pain was more frequent in people aged over 45 years. The most common diagnostic interventions were physical examination, electrocardiogram at rest and analysis of blood parameters. For the majority of cases, the physicians arranged a follow‑up consultation or prescribed drugs. The transition project documented 8117 patients reporting chest pain with a frequency of 44.5/1000 patient years (1.7% of all consultations). Physical examination was also the most common diagnostic intervention, and physician’s advice the most relevant therapeutic one. Conclusion: The most common causes for chest pain were musculoskeletal problems followed by cardiovascular diseases. Ischemic heart disease, psychogenic problems, and respiratory diseases each account for about 10% of the cases. However, acutely dangerous causes are rare in general practice.

Bakgrund: Psykisk ohälsa är vanligt förekommande hos Sveriges befolkning och räknas till en av folksjukdomarna. Personer med psykisk ohälsa kan drabbas av psykiska eller fysiska besvär och söker sig då till primärvården och kommer där att möta sjuksköterskor och annan vårdpersonal. Syfte: Syftet var att belysa vårdpersonals upplevelse av att bemöta patienter med psykisk ohälsa inom primärvården. Metod: En litteraturöversikt baserad på nio vetenskapliga kvalitativa artiklar genomfördes. Resultat: Två huvudkategorier med fyra subkategorier framkom. Den första huvudkategorin ”Kommunikationens betydelse för bemötandet” bestod av subkategorierna Verbal kommunikation och Icke-verbal kommunikation. Kommunikationen, både den verbala och icke-verbala, mellan vårdpersonal och patient hade stor betydelse för hur det upplevdes att bemöta patienten. Den andra huvudkategorin ”Begränsningar som påverkar bemötandet”, bestod av följande subkategorier: Begränsningar i den egna professionen och Begränsningar i organisationen. Brist på kunskap hos personalen eller brist på resurser i organisationen påverkade personalens möjlighet att bemöta patienten så som var önskvärt. Slutsats: Vårdpersonal behöver ta mer eget ansvar för att tillgodogöra sig ny forskning och information om bemötande och patienters sjukdomar, samtidigt bör staten fortsätta med uppmaningar och uppmuntran till utveckling av sjukvården och fortbildning av personal. / Background: Mental illness is common among the Swedish population and is one of the endemic diseases. People with mental illness can be sticken with psychological or physical inconveniences and then turn to primary health care and will there meet nurses and other health care professionals. Aim: Was to illustrate health care professionals experience of encounter patients with mental illness in primary health care. Method: A literature review was carried out based on nine scientific qualitative articles. Result: Two main categories and four subcategories emerged. The first category ”To experience the meaning of communication to the encounter” consisted of the subcategories Verbal communication and Non-verbal communication. The communication, both verbal and non-verbal, meant a lot for the experience to encount the patients. The other main category: ”To experience limitations that affect the encounter” consisted of following subcategories: Limitations within the own profession and Limitations within the organization. Lack of knowledge within the staff or lack of resources within the organization affected the staffs’ ability to encount patients as desirable. Conclusion: Health care professionals have their own responsibility to utilize new research and information about the encounters with and the diseases of patients. The government should continue to request and encourage to develop the health care.

Managers and researchers have become increasingly interested in linking marketing activities to firm financial performance. That is, they desire to make marketing more financially accountable. One approach to achieving this goal has been to “valuate” customers to determine their degrees of profitability over the lifetime of their relationships with firms. However, traditional customer valuation techniques are largely based on quantitative factors and do not account for softer measures such as a customer’s behavior and performance both during and after service encounters. Additionally, while customer profitability is commonly valuated, employees are not generally assessed in this manner in profit linkage frameworks. This indicates that employee factors have not been deemed to have an equivalent, direct impact on the bottom line. Instead, if included at all, employee factors have mainly been positioned as antecedents to customer factors in past linkage models. Because both customers and employees play essential roles in determining the success of service encounters, both customer and employee factors should be fully considered before profitability is determined. In this dissertation, an innovative theoretical model is presented in which past profit linkage research is extended to include nonfinancial considerations. This research merges traditional financial valuation methods with nonfinancial metrics to assess organizational performance. Furthermore, a conceptually parallel framework is developed in which both employee and customer factors are hypothesized as links through which service encounter dynamics can be connected to firm financial performance. This research examines the linkages between service interactions, customer and employee outcomes, and overall financial performance. Within the contexts of two studies, the overall structural model is dissected into comparable performance models and examined within the retail banking and computer services industries. The overall empirical findings provide some evidence of a positive flow of interconnected relationships between service encounter dynamics and firm financial performance. Accordingly, this research presents some indication of the importance of service encounters as antecedents to outcome behaviors that have critical financial consequences.

No description available.

The immediate catalyst for having taken up this study was the violent outbreak of weeks of public unrest in the Paris banlieus in the wake of the shooting of young man on the run from the police on October 27 2005. The obvious inability of local municipalities and police forces to explain, let alone to anticipate the swelling discontent with a system which is generally assumed to work effectively and to benefit all has led me to the assumption that we have entered a stage where the concept of representational democracy is seriously compromised. The sheer scale or projected growth rates of urban agglomerations worldwide is certainly a strong, if not the only indicator for the radical change of ‘lived experience’ in the wake of globalized economies, politics and communication networks. If once the lack of a ‘unitary theory’ was attributed to the field of urbanism (Lefebvre, 1991 [1974]), from a contemporary point of view the range of issues and problems at stake far exceed the boundaries of any discipline in particular. Furthermore, to start the inquiry by reasserting the importance of the human condition will allow us to delve into the process of individuation, the diverse realities of individuals, their gathering in groups, their dialogue amongst each other and with their environment in its totality in order to account for the complex interrelations within a highly dynamic network of associations, since the emergence of a fully emancipated Many – as opposed to the One of the state – requires more than the flawed promise of representational democracy to act for the ‘common good,’ or ‘general will’ (Rousseau, 2009 [1762]) of all. Clearly this task is ambitious, for we have to bridge the gap between the needs, aspirations, emotions, anxieties and dreams of individuals on the one hand, and the temporal emergence of collective co-operation on the other. ‘Official’ knowledge, incorporated by endless columns of statistical data, gathered and administered meticulously thanks to the firm grip of institutionalised observation, is of little help though, for we have become increasingly conscious that the representations thereof are a poor match for the complexity of networked realities ‘on the ground’. My artistic practice conducted together with Alexandra Berlinger under the name of Tat ort is precisely aimed at looking into “matters of concern” as opposed to “matters of fact” (Latour, 2005) in order to gain a genuine insight into the workings of existing settings, where we introduce ourselves as intermediaries for the initiation of a process of active participation by means of interventional apparatuses, conceived specifically for the context in question. Our respective experience has led me to the conclusion that instead of providing alternative representations based on presumed universal identity, the full-blown heterogeneity of the multitude thrives on the general intellect and the activity of the speaker. To speak is to act, and to act is the predominant trait of political praxis. It is through our acts and deeds that we disclose ourselves in public in the presence of others (Arendt, 1998 [1958]). And it is through acting that we start anew and leave our mark in a situation the moment we intervene in the circulation of empty signifiers upon which we assign a name, the name of an event. It is through our interventional participation that we allow for novelty to emerge in time, as a process without representation and based on sustained fidelity. My research is centred around two questions: First of all, is it possible to devise an interventional apparatus (physical infrastructure) which would work independent of contextual factors, and secondly, is it possible to retain the site-specificity through a process of dynamically mapping the amalgamation of existing information and the data obtained by participants based on face to face communication in order to draw up the ‘portraits’ of existing communities beyond the scope of institutionalised representation. Emancipating the Many therefore is a statement about difference marked as intervention. This intervention requires the presence of others and the intention to act. It is the emergence of a ‘constitution of time’.

Bakgrund: För många patienter blir besök på en akutmottagning den första kontakten med hälso- och sjukvården. Bemötandet från sjuksköterskor på akutmottagningen behöver därför bli lyckat för att patienten ska kunna känna sig sedd och omhändertagen. Ett lyckat första bemötande från sjuksköterskan lägger grunden för en fortsatt god och säker vård. Syfte: Syftet med litteraturöversikten var att beskriva hur patienter upplever bemötandet från sjuksköterskor på en akutmottagning. Metod: Examensarbetet genomfördes som en litteraturöversikt och inkluderar 12 vetenskapliga artiklar, varav fyra med kvalitativ ansats, sju med kvantitativ ansats och en med mixad metod. Artiklarna söktes i databaserna CINAHL och PubMed. Resultat: I litteraturöversiktens resultat presenteras hur patienters upplevelser av bemötande från sjuksköterskor på en akutmottagning kan påverkas positivt såväl som negativt. Faktorer som påverkade upplevelsen av bemötande var information, kommunikation och patientmedverkan. Slutsats: Litteraturöversikten visar att sjuksköterskan bör implementera ett arbetssätt som främjar god kommunikation och patientdelaktighet för att möjliggöra goda upplevelser för patienter på en akutmottagning. Av betydelse är att sjuksköterskan för en bra kommunikation till patienterna, informerar på ett adekvat sätt samt att patienterna får känna sig väl omhändertagna och trygga. / Background: For many patients the visit to an emergency department is their first contact with the healthcare system. The encounter between the nurse and patient at the emergency department needs to be successful, so the patient can feel taken care of and seen. The first encounter creates the structure for a continuous safe and good quality of care. Aim: The aim of the literature review was to describe how patients’ experience the encounter with nurses in a emergency department. Method: The thesis was conducted as a literature review and includes 12 scientific articles, out of which four had a qualitative approach, seven with a quantitative approach, and one with mixed method. Articles were searched in the databases CINAHL and PubMed. Results: The result presents how patients’ experiences of encounters with nurses in an emergency department can be affected positively as well as negatively. Factors that influenced the experience of treatment were information, communication and patient involvement. Conclusion: The literature review shows that the nurse should use an approach that promotes good communication and patient participation to enable good experiences for patients in an emergency department. Of importance is that the nurse use good communication skills with patients, informing adequately and that patients may feel well cared for and safe.