An estimated 50% of mortality from the 10 leading causes of death is due to behaviour. Individuals can make important contributions to their own health by adopting health-related behaviours and avoiding others. Motivational interviewing (MI) has emerged as a counselling approach for behavioural change that builds on a patient empowerment perspective by supporting autonomy and self-efficacy. The overall aim of this thesis is to contribute to improved understanding of the different factors that impact on general health care professionals’ learning and practice of MI. Specific aims are; study I was to identify barriers, facilitators and modifiers to use MI with pharmacy clients in community pharmacies; study II was to identify barriers and facilitators to use MI with overweight and obese children in child welfare and school health services; study III was to evaluate the attitudes towards MI and clinical use of MI with children´s weight issues one year after child health care nurses’ participation in MI training; study IV was to systematically review studies that have evaluated the contents and outcomes of MI training for general health care professionals. Participants in study I were 15 community pharmacy pharmacists in Östergötland, Sweden. Participants in study II were five child welfare centre nurses from the county council and six municipally-employed school health service nurses, all from Östergötland, Sweden. Data for both studies were obtained through focus group interviews. Study III, participants were 76 nurses from child health care centres in Östergötland, Sweden. 1-year after MI training they answered a survey. Study IV, the material was 10 empirical studies that have evaluated different aspects of MI training. MI training for general health care providers is generally of short duration and tends to focus on specific topics such as diabetes, smoking, and alcohol. The training seems to contain more training on phase I elements, such as clients’ inner motivation, than on phase II, which involves strengthening clients’ commitment to change. MI is seen as practical and useful in work with lifestyle and health promotion issues, especially with issues that may be perceived as sensitive, such as alcohol and obesity. General health care providers have positive attitudes to MI and view MI as being compatible with their values and norms about how they want to work. Clients’ resistance reactions are difficult to handle in the first stages of learning MI, and may lead to frustration. Strategies to avoid resistance are including in the final stages of learning MI. Learning and clinical use of MI for general health care providers is influenced by interactions with their environment (colleagues, staff and organization). Unlearning of old knowledge can be a problem for general health care providers in the learning and clinical use of MI.

Background: Statistics reveal that approximately 10.7% of the global population have mental health disorders. In Sweden, 14% of persons with psychiatric diagnoses have had direct contact with a registered nurse. Based on studies, it is evident that registered nurses experience a lack of knowledge regarding psychiatric diagnoses, which negatively affects their ability to provide person-centered care. Furthermore, there is also a desire among registered nurses for increased knowledge regarding psychiatric diagnoses. The aim of this study was to explore how persons with psychiatric diagnoses experience care as a patient within general health care. Method: A literature review based on qualitative research results was performed and data were analyzed through a content analytical technique. It emerged three themes in the results: (1) Feeling subjected to prejudice, (2) Variations in the quality of support, and (3) Impression of the environment. The themes are presented with two sub-themes each. The participants’ experiences were mostly negative, grounded in discrimination, lack of support and knowledge from caregivers, and stressful surroundings. Conclusion: This study highlights persons with psychiatric diagnoses experiences within the general health care setting. Results can give an insight into how a registered nurse can provide a better person-centered. / Bakgrund: Statistik visar att ungefär 10,7% av världens befolkning har en psykiatrisk diagnos. I Sverige har 14% av personer med psykiatriska diagnoser haft direktkontakt med en grundutbildad sjuksköterska. Tidigare forskning visar att det finns en upplevd kunskapsbrist bland grundutbildade sjuksköterskor angående psykiatriska diagnoser, vilket påverkar deras förmåga att ge personcentrerad vård negativt. Forskning visar även på att det finns en önskan för utökad kunskap om psykiatriska diagnoser bland grundutbildade sjuksköterskor. Syfte: Att utforska hur personer med psykiatriska diagnoser upplever vård som patient inom allmän hälso-och sjukvård. Metod: En litteraturstudie baserade på kvalitativa forskningsresultat utfördes, och data analyserades med en innehållsanalytisk teknik. I resultatet framkom tre teman: (1) Känsla av att vara utsatt för fördomar, (2) Variationer i kvalitén av stöd, och (3) Intryck av omgivningen. Teman presenteras med två underteman var. Upplevelserna var mestadels negativa baserade på diskriminering, brist på stöd och förståelse, samt stressig miljö. Konklusion: Den här litteraturstudien belyser personer med psykiatriska diagnosers upplevelse av vård. Resultatet kan ge en inblick i hur en grundutbildad sjuksköterska kan ge personcentrerad vård.

Patienter med psykisk ohälsa löper större risk att drabbas av somatiska sjukdomar. Utvecklingen av psykiatrivården gör att allt fler patienter med psykisk ohälsa vårdas inom somatisk vård. Psykisk ohälsa är ett växande folkhälsoproblem. Personer med psykisk ohälsa är en stigmatiserad grupp både i samhället i stort och inom vården. Sjuksköterskan kommer med största sannolikhet att möta patienter med psykisk ohälsa i sitt arbete inom somatisk vård.Syfte: att beskriva sjuksköterskors upplevelser av att vårda patienter med psykisk ohälsa inom somatisk vård.Metod: litteraturstudie med nio kvalitativa artiklar och en mixed method som underlag. Artiklarna hittades i databaserna PubMed och CINAHL. Resultat: analysen resulterade i tre teman: upplevda känslor, påverkan av självbild och upplevd kunskapstörst. Arbetet med patienterna med psykisk ohälsa genererade mestadels negativa känslor och en negativ påverkan av sjuksköterskornas självbild. Kunskapsbehovet inom detta område upplevdes som stort.Slutsats: de negativa känslorna och den negativa påverkan på sjuksköterskornas självbild kan påverka sjuksköterskornas känsla av sammanhang negativt. Den brist på kunskap som sjuksköterskorna upplever har de själva ett ansvar att fylla. / Patients with mental ill-health run a greater risk of becoming physically ill. The development of psychiatric care brings an increasing number of patients with mental ill-health to be taken care of within somatic care. Psychiatric ill-health is a growing public health problem. Persons suffering from mental ill-health are a stigmatized group both within society and health care. General nurses will with all probability meet patients with mental ill-health in their work.Aim: to describe nurses’ experiences of caring for patients with mental ill-health within somatic care.Method: a literature review in which nine qualitative articles and one article with mixed method were used as base. The articles were found in the databases PubMed and CINAHL.Results: the analysis resulted in three themes: perceived emotions, influenced perception of self and perceived thirst for knowledge. The work with patients with mental ill-health generated mostly negative emotions and a negative perception of self among the nurses. The need for more knowledge within this area was perceived as substantial.Conclusion: the negative emotions and the nurses’ negative influence on the perception of self may influence the nurses’ sense of coherence in a negative way. The nurses have a responsibility for filling the lack of knowledge they experience.