Background: Endometriosis is a common disease that affects approximately 10 % of people born with a uterus. The most common and noticeable symptom of endometriosis is pain. Symptoms usually occur in adolescence and can be lifelong, but often subside with menopause. Aim: To describe how women with endometriosis experience health care encounters Method: A literature-based study was used to obtain an enhanced understanding of the phenomenon. Nine qualitative articles and one mixed method article were analyzed. Results: Two main themes were identified; The theme relinquishing power to external sources describes the vulnerability and objectification experienced by women during healthcare encounters. Conversely, trust can be established if the women feel acknowledged and validated. The theme being stigmatized describes how women experience stigmatization and a lack of credibility in their interactions with healthcare professionals, resulting in a sense of distrust. Conclusion: In order to improve healthcare experience for women with endometriosis nurses must address the issues of vulnerability, objectification, stigmatization, and lack of credibility these women encounter. By applying the core competencies, the nurse enables the fulfillment of nursing needs for women with endometriosis.

The ability to work can be reduced if a person has health problems which may lead to periods of sick leave. In Sweden sickness certification is issued by physicians. Many general practitioners (GPs) find sickness certification to be problematic. Some studies indicate that collaboration with other health care professions could be beneficial. The aim of the thesis was to provide knowledge on how the work with the sick leave process in primary health care can be improved and how occupational therapists’ (OT) assessment could be used prior to the decision on sick leave and rehabilitation. Initially seven focus groups were held, four with OTs and three with physicians. The discussions in the focus gropes were analysed by qualitative content analysis. An intervention project was initiated, where four health care centres in northern Sweden tested a working approach where sick listed patients were offered a supplementary assessment of activity and work-related problems by an OT. Data on sick leave, sickness certificates and patient questionnaires were collected from intervention health care centres (IHCC) and other health care centres (OHCC). Interviews were conducted with patients, GPs and OTs. The quality of the information in the collected sickness certificates was evaluated. Average values of sick leave were compared between the IHCCs and the OHCCs in the county. The interviews with sick listed patients were analysed by qualitative content analysis. In order to analyse the implementation of the intervention the Consolidated Framework for Implementation Research, CFIR, was used. An overall theme and four categories emerged from the focus groups. The theme expressed work ability as an obscure, complex and unique concept. The four categories illustrate the affecting factors and confirmed the complex structure of work ability: the person, the context of life, the work, and the society. No significant differences between IHCCs and OHCCs in data on sick leave or the mandatory information in the certificates were found. Thirty-four percent of the collected sickness certificates did not contain all requested information. More certificates issued for women than certificates issued for men lacked the required information. Full-time sick leave was significantly more often prescribed for male patients than for female. Two themes revealed that highlight important areas for persons on sick leave in their healthcare encounters. The theme ‘Trust in the relationship’ contains categories describing the patients’ feelings of participation, being believed, confirmed, and listened to. The second theme ‘Structure and balance’ contains the participants’ views on important factors that could facilitate the return-to-work process such as a structured plan and support to balance activity. The analysis with CFIR clarified that coaching and education for all the users are crucial to get fidelity when new interventions are tested as well as involvement by the clinical department manager. The work with sick leave issues in primary health care can be improved by developing cooperation with several different professionals. To achieve an increased cooperation new working approaches are required. These working approaches must be anchored in management and requires an applied implementation strategy. More focus on the quality of encounters with healthcare professionals can also improve the sick leave process in primary health care centres. The healthcare encounters must build on a mutual trust and sick-listed persons’ return to work can be facilitated by providing a clear structure in the process and support in occupational balance. For issuing sickness certification further education about the descriptions of functioning and the tasks included in the patient’s work is needed. A better gender awareness in the health care encounters is also necessary.

Background: Endometriosis is a chronic disease that approximately one out of ten women suffer from. The disease affects many aspects of the women’s lives. The health care’s lack of knowledge results in a delayed diagnosis, which increases the risk of infertility, a negative psychological impact and an unnecessary suffering. The professionals describe the lack of knowledge as a barrier which complicates the interactions and care they want these women to receive. The women´s partners describe a feeling of being powerless and a concern about women´s wellbeing and the consequences of the disease. Aim: Was to describe women´s experience of living with endometriosis. Method: Literature review of 15 scientific articles. Results: The result of the study describes women’s experiences of living with endometriosis. The authors concluded the women’s experiences in five different themes, pain, fertility, psychological impact, health care encounters and limitations of life. These themes describe the disease’s impact on women’s lives and what limitations they experience due to endometriosis, but also the women’s health care encounters, which for the most part is described as negative and trivializing. Discussion: The discussions are based on the following headings, life with endometriosis, the Swedish National Board of Health's guidelines, education might be the answer and the multidisciplinary work. The authors discussed women’s experience of the disease and how the guidelines from The Swedish National Board of Health´s are supposed to improve care of endometriosis patients. They also discussed how education of both caregivers and patients can improve these women’s situation, and lastly what roll the multidisciplinary team can play. The discussion originated from Katie Eriksson’s nursing theory. / Bakgrund: Endometrios är en kronisk sjukdom som drabbar ca en av tio kvinnor och som påverkar många aspekter av hennes tillvaro. Bristande kunskap hos vårdgivarna gör att dessa kvinnor får vänta på diagnos vilket medför ökad risk för infertilitet, psykisk påverkan och ett onödigt lidande. Vårdgivarna beskriver att deras bristande kunskap försvårar möjligheterna till ett bemötande och en vård som de vill att kvinnorna ska få. Kvinnornas partners beskriver en maktlöshet och en oro kring kvinnornas mående samt sjukdomens konsekvenser. Syfte: Var att beskriva kvinnors upplevelser av att leva med endometrios. Metod: Litteraturöversikt av 15 vetenskapliga artiklar. Resultat: Resultatet av litteraturöversikten beskriver kvinnornas upplevelser av att leva med sjukdomen endometrios. Författarna summerade upplevelserna i fem teman, smärta, fertilitet, psykisk påverkan, bemötande i vården och begränsningar i vardagen. Alla dessa teman beskriver hur kvinnorna påverkas av sjukdomen och hur de upplever att sjukdomen begränsar deras liv på olika sätt, men också deras upplevelser av vården, som till största del består av negativa erfarenheter och trivialisering av sjukdomen.  Diskussion: Diskussionen förs kring följande rubriker, livet med endometrios, Socialstyrelsens riktlinjer, utbildning kan vara lösningen och multidisciplinärt arbete. Författarna har under dessa rubriker diskuterat kvinnornas upplevelser av sjukdomen, hur Socialstyrelsens riktlinjer ska förbättra vården, på vilka sätt författarna tror att utbildning kan förbättra kvinnornas situation samt vilken roll det multiprofessionella teamet har för kvinnorna. Diskussionen har förts med Katie Erikssons omvårdnadsteori som utgångspunkt.

Bakgrund: Endometrios är en kronisk inflammatorisk sjukdom som drabbar en av tio kvinnor i fertil ålder. Vanliga symtom är intensiv smärta i samband med menstruation, kraftiga och oregelbundna blödningar, samlagssmärta och infertilitet. Det tar ofta flera år innan kvinnor får en diagnos vilket medför ett stort lidande. Forskning om endometrios går framåt men det finns fortfarande okunskap inom vården och vårdpersonalen behöver fortbildning för att kunna ge stöd och råd. Den teoretiska referensram som användes var Joyce Travelbees omvårdnadsteori samt personcentrerad omvårdnad. Syfte: Att belysa hur kvinnor med endometrios upplever bemötandet i vården. Metod: Litteraturstudien genomfördes med en kvalitativ ansats. Efter kvalitetsgranskningen återstod tio artiklar som användes i litteraturstudien. Resultat: De tio artiklar som ligger till grund för resultatet kommer från Sverige, Ungern, Australien, Storbritannien och Nederländerna. Dataanalysen genererade i tre kategorier: Vårdpersonalens förminskande attityd, Kunskap och information samt Fertilitet, med sex subkategorier som representerade olika aspekter av upplevelsen av bemötandet i vården. Kvinnorna upplevde att de fört en kamp under flera år för att få en diagnos, vårdpersonalen tog dem inte på allvar samt normaliserade deras symtom. Kvinnorna upplevde även att vårdpersonalen hade bristande kunskaper om sjukdomen samt fokuserade för mycket på fertiliteten. Positiva upplevelser var när vårdpersonalen lyssnade och bekräftade dem. Konklusion: Kvinnorna hade övervägande negativa upplevelser av bemötandet i vården och saknade stöd från vårdpersonalen. Det är viktigt att höja kunskapsnivån för att minska det långdragna lidandet. Sjuksköterskan behöver arbeta empatiskt och personcentrerat för att kunna tillgodose kvinnornas behov. / Background: Endometriosis is a chronic inflammatory disease that affects one in ten women in their fertile age. Typical symptoms of endometriosis are dysmenorrhea, heavy irregular bleedings, dyspareunia and infertility. The diagnostic delay is often many years, which could cause suffering. Research of endometriosis is progressing, yet there still exists ignorance in health care and health care staff need training to be able to provide support. The theoretical frameworks used were the nursing theory by Joyce Travelbee and person-centered nursing. Aim: To illustrate how women with endometriosis experience health care encounters. Method: The literature review was performed with a qualitative approach. After the quality review ten articles remained that were included in the literature review. Results: The ten articles used in the literature review came from Sweden, Hungary, Australia, United Kingdom and the Netherlands. The data analysis generated three categories: Health care provider ́s diminishing attitude, Knowledge and information and Fertility, with six subcategories that represented different aspects of the experience in the health care encounter. The women fought several years to get a diagnosis, health care providers did not take them seriously and normalized their symptoms. The women also felt that the health care providers lacked knowledge about the disease and focused too much on fertility. Positive health care encounters were when the health care providers listened and confirmed them. Conclusion: Women mostly had negative experiences of health care encounters and lacked support from the health care staff. It is significant to raise the level of knowledge in order to reduce women’s suffering from the disease. The nurse needs to work empathically with a person-centered approach to be able to meet the women’s needs.

Bakgrund  Sedan sjukdomens uppkomst har 40,1 miljoner människor mist sitt liv till följd av HIV; en kronisk virusinfektion som i obehandlat tillstånd kan vara livshotande. Adekvat behandling kan leda till ett normalt liv med omätbara virusnivåer, god vård och god behandling är således livsviktigt. Att belysa hur personer med HIV upplever vårdmöten med vårdpersonal är väsentligt för att erhålla kunskap om hur vårdpersonal skall förhålla sig i mötet. Vårdmöten av hög kvalitet med ett personcentrerat förhållningssätt kan leda till ökad medicinsk följsamhet, ett ökat välbefinnande och ökad livskvalitet för personer med HIV.  Syfte  Syftet var att belysa hur patienter med HIV upplever möten med vårdpersonal inom vården.  Metod  En icke-systematisk litteraturöversikt genomfördes baserad på 16 vetenskapliga originalartiklar av både kvantitativ och kvalitativ ansats. Data inhämtades från databaserna PubMed och CINAHL. Artiklarna kvalitetsgranskades  Resultat  Resultatet sammanställdes i fyra huvudkategorier: Upplevelser av stigmatisering och diskriminering, upplevelser av kommunikation, upplevelser av relationen mellan patient och vårdpersonal samt upplevelser av bemötande. Upplevelser av respekt och tillit visades vara det mest centrala för att uppnå en relation med vårdpersonal samt för att uppleva en god kommunikation och ett gott bemötande. Fördomar, förutfattade meningar och diskriminerande handlingar visade sig utgöra ett hinder för detta.  Slutsats  Denna litteraturöversikt visade att patientupplevelser av vårdmöten var komplexa. Upplevelser som skildrades i resultatet visade att patienter som kände sig sedda som personer utöver sin sjukdom, blev behandlade med respekt eller kände tillit till personalen upplevde vårdmöten som positiva. Resultatet visade även upplevelser som utgjorde hinder för ett positivt vårdmöte. Ökad förståelse om patienters upplevelser kan ge värdefulla insikter gällande hur vårdpersonalen genom ett professionellt och personcentrerat förhållningssätt kan bidra till upplevelser av positiva vårdmöten. / Background  HIV is a chronic viral infection that can be life-threatening if not treated. Since the emerge of the disease 40,1 million people have deceased. Thus, adequate treatment is vital. Illustrating patient experiences of encounters with healthcare professionals is important to gain knowledge about actions and attitudes that contribute to positive experiences. Encounters of high quality, with a person-centered approach can lead to increased medical compliance, wellbeing and a greater life quality for people with HIV.  Aim  The aim of this literature review was to illustrate how patients with HIV experience encounters with health care professionals within health care settings.  Method  A non-systematic literature review was carried out, with data collected from 16 original scientific articles of both quantitative and qualitative approaches. The data was obtained from the databases PubMed and CINAHL. The articles were quality-reviewed based on Sophiahemmet University's assessment basis for scientific classification. The results from the articles were categorized, collated, and analyzed using an integrated data analysis.  Results  The results were compiled into four main categories: Experiences of stigmatization and discrimination, experiences of communication, experiences of the relationship between patient and health care professionals and experiences of treatment. Experiences of respect and trust were shown to be the most central in encounters to achieve a relationship with healthcare professionals with communication and treatment of good quality. Prejudice, preconceptions, and discriminatory actions proved to be obstacles of positive experiences.  Conclusions  This literature review showed that patient experiences of healthcare encounters were complex. Experiences in the results suggested that patients who felt seen as individuals beyond their illness, were treated with respect and trusted health care professionals had positive experiences. Improved understanding of patients' experiences can provide valuable insights of how healthcare professionals, through a professional and person-centered approach, can contribute to positive experiences of healthcare encounters.