<p><strong>Background and Objectives: </strong>Previous research has examined the effect of family physician continuity of care within end-of-life care cancer patients and its association with reduced use of acute care services. However, such research has not been examined in the end of life homecare cancer population.<strong> Objectives: </strong>To investigate the association of family physician continuity with location of death, hospital and emergency room (ER) visits in the last 2 weeks of life in end of life homecare cancer patients.<strong> Research Design: </strong>Retrospective study involving secondary data analysis of 7 linked databases<strong>. Subjects: </strong>All those who died of cancer between January 1, 2006 to December 31, 2006 in Ontario who had at least 1 visit to a family physician and enrolled in homecare for at least 2 weeks.<strong> Methods: </strong>The relationship of family physician continuity of care and location of death, and hospital and ER visits in the last 2 weeks of life was examined using logistic regression.<strong> Results: </strong>The Usual Provider of Care (UPC) measure demonstrated a dose response relationship with increasing continuity resulting in decreased odds of dying in the hospital and visiting the hospital and ER in the last 2 weeks of life. The Family Physician visits per week measure demonstrated a threshold effect relationship with location of death and hospital visits and dose response relationship with ER visits in the last 2 weeks of life. <strong>Conclusions:</strong> These results demonstrate an association between family physician continuity of care and location of death and visits to the hospital and ER in the last 2 weeks of life. This indicates the need for more involvement of family physicians in end of life cancer care.</p> / Master of Science (MSc)

Syftet med examensarbetet var att undersöka hur enhetschefer inom äldreomsorgen uppfattar möjligheterna för att uppmärksamma och förebygga vanvård och försummelse hos äldre personer som mottar hemtjänstinsatser i ordinärt boende. Metoden involverar en kvalitativ design med semistrukturerade intervjuer utifrån ett bekvämlighetsurval av enhetschefer inom hemtjänsten. Datainsamlingen inkluderade öppna frågor om möjligheter och resurser för att upptäcka vanvård och försummelse. Reflexiv tematisk analys användes för att analysera datamaterialet. Metoden bidrar till en djupare förståelse av enhetschefernas perspektiv på att förebygga vanvård hos äldre personer. Resultatet visade att en ökad kontinuitet mellan personal och den äldre personen i vardagen ökar förutsättningen att upptäcka vanvård och försummelse, kontinuerlig och kompetenshöjande utbildning krävs för att ge personalen rätt förutsättningar i sin yrkesroll att motverka och förebygga vanvård och försummelse och att samverkan mellan olika aktörer är en förutsättning för att identifiera och motverka vanvård och försummelse mot äldre personer. / The purpose of the undergraduate thesis was to explore home care unit managers' possibilities of identifying and preventing elder abuse and neglect. The study employs a qualitative design with semi-structured interviews in a convenience sample of unit managers from different municipalities and with different experiences. Reflexive thematic analysis was used to analyze data contributing to a deeper understanding of unit managers' perspectives on preventing elder abuse. Results found that increased continuity between staff and the older person in everyday life increases the possibilities to detect elder abuse and neglect. Continuous and competence-enhancing training is required to provide staff with tools in their professional role to counteract and prevent elder abuse and neglect. Additionally, collaboration between different stakeholders is essential for identifying and combating abuse and neglect of older adults.

Globalt kommer ca 75 miljoner människor leva med demenssjukdom år 2030. Beteendemässiga och psykiska symtom vid demenssjukdom (BPSD) drabbar uppskattningsvis nio av tio patienter. Att vårda människor som uppvisar BPSD - symtom är komplext och ställer höga krav på sjuksköterskan i vårdandet och att stödja och leda övrig omvårdnadspersonal. Syftet med examensarbetet är att belysa sjuksköterskors erfarenheter av att vårda människor som uppvisar BPSD-symtom inom hemsjukvården. En litteraturöversikt har genomförts där 12 artiklar inkluderats och analyserats enligt Fribergs modell för litteraturöversikt. Resultatet presenteras i tre huvudteman: Utmaningar i vårdandet, ett vårdande bemötande och förutsättningar för att kunna ge god vård i hemmet. Åtta subteman identifierades vilket tydligt beskriver hur sjuksköterskor upplever det utmanande när vårdandet kunde innebära manipulation och tvång, närståendes betydelse för att kunna nå livsvärlden och att sjuksköterskor erfar bristande kunskap i det komplexa vårdandet. Det framkommer i resultatet vikten av att omvärdera synen på vad god vård är för att motverka känslor som maktlöshet och frustration. I diskussionsdelen lyfts sjuksköterskors erfarenheter kring vårdande och att se människan bakom sjukdomen, samt de närståendes upplevelser som stärker vikten av att använda sig av livsvärlden i vårdandet. Kunskap och arbetsmiljö diskuteras utifrån ett hållbarhetsperspektiv där organisationen har en viktig roll. Slutsatser belyser vikten av kunskap och rätt förutsättningar för sjuksköterskor att våga stanna i mötet med människan. / Globally around 75 million people will live with dementia in year 2030. Behavioral and psychiatric symptoms following dementia (BPSD) is estimated in nine out of ten patients. Caring for people with behavioral and psychiatric symptoms is complex and places high demands on the nurse in the care and to support and lead other nursing staff. The aim of this study was to illustrate nurses experience in caring for patients with BPSD - symptoms in home health care. A literature review was conducted, 12 articles were included and reviewed according to Friberg´s model for literature review. The result describes nurses experience and is presented in three main themes: challenges in caring, caring treatment and conditions to enable good care in a home environment. Eight subthemes were identified which clearly describes how nurses experience the challenges in caring when caring results in force and manipulation, the importance of family to reach patients lifeworld and nurses lack of experience to provide complex care. The result presents the importance of reevaluation in nurses caring approach to what is seen as good care in order to counteract the feeling of frustration and feeling powerless. The discussion lifts nurses´ experiences around caring and how to see the individual behind the disease along with family’s experience strengths the importance of how to use the patient’s lifeworld in a caring sense. Knowledge and work environment is discussed through a sustainability perspective where organisation plays an important roll. Conclusions illustrate importance of knowledge and the right conditions for nurses’ opportunities to dare to remain in the encounter with the human being.

Der Nutzen von Telemedizin und Telecare/Homecare ist heute nicht mehr umstritten. Es existiert eine große Anzahl von Lösungen und Konzepten. Zum Teil werden sie bereits in der Routine eingesetzt. Die Systeme sind in der Regel vom Typ "stand-alone" bzw. "Insellösung". Ansätze einer Plattformtechnologie sind bei einigen Systemen erkennbar. Gemeinsame Probleme der vorhandenen Lösungen liegen im Bereich fehlender Standardisierung von Dateninhalten und Verfahren sowie einer soliden gesetzlichen und abrechnungstechnischen Grundlage. Von diesem Zustand bis zum flächendeckenden Einsatz von Telemedizin/Telecare ist noch ein weiter Weg. Die vorliegende Arbeit beschäftigt sich vorwiegend mit einem Teilaspekt dieses breiten Themas. Es ist die Frage, wie Telemedizin und Telecare sich optimal in den Arbeitsablauf eines Allgemeinmediziners integrieren lassen. Die Analyse zeigte, dass die Probleme in folgenden Bereichen zu finden sind: * Fehlende allgemeine und internationale Telemedizin-Plattform * Fehlende zentrale elektronische Patientenakte * Unzureichende Offenheit der Praxissoftware * Unzureichende Ko-Existenz von herkömmlichen und telemedizinischen Lösungen * Unzureichende gesetzliche und abrechnungstechnische Grundlage Folgerichtig muss ein Anforderungskatalog aufgestellt werden, der hilft, diese Mängel zu beseitigen. Auf der Basis dieses Anforderungskatalogs wurde ein Konzept entwickelt, in dessen Zentrum die allgemein-medizinische Praxis steht. Im Hintergrund der Praxis ist eine auf vorhandenen Standards fußenden Plattform, die eine flächendeckende Kommunikation aller Teilnehmer ermöglicht, vom Patienten über den Arzt bis zur Fachklinik, Apotheke und Kassenärztlichen Vereinigung sowie Versicherungen. Der Anschluss der Praxissoftware an diese Plattform ist eine wesentliche Voraussetzung zur Implementierung. Ein wichtiger Bestandteil des Konzeptes ist der Vorschlag einer international anerkannten Ontologie (UMLS), die neben der Vereinheitlichung der Dateninhalte auch bei der Internationalisierung helfen wird. Hier werden die gesetzlichen Aspekte nur soweit behandelt, als sie der klaren Vorgabe der Konzeption dienen. Die Implementierung ist nicht in einem Schnellgang möglich. Der Grund liegt darin, dass hier neben den in der Regel langwierigen Gesetzgebungsprozessen eine große Anzahl von Verbänden Mitbestimmung geltend macht, deren Interessen oft in entgegengesetzte Richtungen wirken. Es wird daher notwendig sein, die Einführung erstens schrittweise und zweitens immer im Gleichschritt mit diesen Organen zu gestalten. Ist dies jedoch gelungen, eine solche Plattform zu etablieren, so ergibt sich hieraus ein breites Spektrum von Anwendungsgebieten, wie ein weltweites Gesundheitssystem, bei dem der Patient überall auf der Welt die gleiche medizinische Behandlung wie in seinem Heimatland erfährt. / Today there is no question that telemedicine and telecare/homecare can provide benefit to their users. A large number of such systems are available. Partially they are used for daily works. Normally they are stand-alone, without an underlying platform. In the last few years one can recognize the beginning of a platform technology. The most common problems of existing solutions are caused by the lack of standardisation of data items and procedures, the lack of a reliable legal basis and billing possibilities. It is a long way to go to get the telemedicine/telecare running. This document describes a sub-aspect of the large topic telemedicine/telecare. It includes the question how one can integrate telemedicine/telecare into the daily workflow of a private doctor office. The system analysis shows that problems occurring during the integration can be subdivided into following topics: * Lack of a general and international telemedicine platform * Lack of a generally accepted electronic patient record * Lack of a interoperability of the medical information systems * Lack of a harmonized co-existence of telemedicine and medical works * Lack of a legal basis and billing possibilities As a consequence of the analysis` results a catalogue of requirements must be established which provides the basis for a system concept. The central point of the concept must be the doctor office. Its background should be a set of standards which establishes the platform for the communication between every participant to the telemedicine: patients, doctors, clinics, pharmacy, medical invoice organisations and insurance companies. The most essential requirement to implement this platform is the connection of the IT equipment in private doctor offices to the applications and databases of the platform. The key feature of the proposed concept is the integration of a international accepted ontology. We recommend the UMLS concept of the NIH. UMLS provide a set of standardized terms, the so called "concepts", and the possibilities to implement multilingual applications. In this document legal aspects are discussed only if they can contribute to the construction of the platform. Due to the never ending legislative process and the opposite interest of the participants to the platform a high-speed implementation of the platform can not be expected. A stepwise implementation which continuously accompanies the legislative processes is therefore required. However based on a successful implementation of the platform the gate is open to a large range of applications in a widely used healthcare system which can provide medical care to every patient at any time and at any location - worldwide - on the same quality level like in his home country.

Les résultats de cette recherche faite auprès de cadres intermédiaires qui sont les gestionnaires des infirmières travaillant dans des programmes de personnes âgées en perte d'autonomie liée au vieillissement(PALV) montrent qu'il est difficile d'y attirer de nouvelles infirmières en raison du peu de popularité du domaine de la gériatrie.Afin d'y attirer des candidates, les cadres peuvent faire valoir le défi de gérer des situations de santé souvent complexes, la flexibilité des horaires de travail,l'autonomie dont elles disposent dans l'organisation de leur travail, le nombre de week-end de travail moins élevé que dans les hôpitaux et l'absence de travail supplémentaire obligatoire. Selon ces cadres, la rétention des infirmières dans de tels programmes PALV ne crée pas problème. Pour favoriser davantage cette rétention, des mesures élaborées d'orientation et d'encadrement des nouvelles infirmières de même que des mécanismes d'évaluation formelle doivent être mis en place, des efforts doivent être faits pour répartir équitablement les tâches, pour amener les infirmières à agir en tant que gestionnaires de cas et à se délester de tâches au profit des infirmières auxiliaires, et pour les sensibiliser à l'importance de la notion de prise en charge de sa santé par le client; des activités de formation continue significatives pour les infirmières doivent être élaborées à partir de l'analyse de leurs propres besoins et enfin des charges de travail particulières doivent être offertes aux infirmiàres de 55 ans et plus dans le but de les retenir au travail. / The results of this research done with middle managers who are the immediate superior to nurses working in programs for persons with loss of autonomy related to aging (PALV), also known as home care, show that it is difficult to attrack new nurses to these programs because of a lack of popularity in the field of geriatrics. In order to attrack candidates to these programs, the managers responsible for the organization of work could promote the challenge of managing health situations which are often complex, the flexible work hours, the autonomy that the nurses have in scheduling their route, the fewer weekends of work as compared to hospitals and the lack of obligatory overtime. According to the managers there are no more departures from these programs than for other programs. To further support this retention, managers must put into place a well developed orientation and structure for nurses, mechanisms must be instituted for formal performance evaluations,close attention must be paid to the equitable distribution of tasks, and efforts must be made to guide nurses to function as case mangers and to benefit from assigning tasks to nursing assistants. To sensitize them to the importance of the notion of the client taking charge of their health, pertinent continuing education activities must be developed and offered to nurses based on an analysis of their particular needs, and finally, specific workloads must be offered to nurses 55 years of age and older in order to keep them at work.

Bakgrund: Merparten av patienter med en palliativ diagnos vill vårdas i hemmet, vilket är möjligt med hjälp av bland andra distriktssköterska, hemtjänst samt anhöriga. Patienter som vårdas i hemmet upplever ofta bättre livskvalitet än dem som vårdas på sjukhus. Distriktssköterskan ansvarar för att vården fungerar och är den bästa möjliga för patienten. Vad patienten värdesätter i bemötandet för att det ska kännas genuint och trovärdigt är viktigt för att denne ska känna sig sedd och vara involverad i sin egen vård. Syfte:Syftet med studien var att beskriva patienters upplevelser av bemötandet från distriktssköterskan i palliativ hemsjukvård. Metod: En kvalitativ ansats med beskrivande design har använts i studien och data har samlats in med semistrukturerade intervjuer med totalt åtta patienter. Resultat: De tre kategorierna som framkom under studien var: att få tid, bli sedd och få respekt, att känna kontinuitet och trygghet, att bli tagen på allvar och känna delaktighet i vården. Slutsats:För att patienterna ska uppleva ett bra bemötande krävs kontinuitet, korrekt information och delaktighet i vården och få tid med distriktssköterskan och känna sig sedd som medmänniska. / Background: Most of the patients with a palliative diagnose want to be taken care of in their own homes. This is possible with help from a team consisting of among others; district nurses, assistant nurses and significant others. Patients living at home often experience better quality of life, compared to them taken care of at the hospital. The district nurse is responsible that the care is well functioning and is the best care for the patient. How the patient experience the treatment from the district nurse is very interesting. What the patient value in the treatment to make it feel genuine and credible. The encounter in the care relationship is important for the patient to feel seen and be involved in their own care. Aim: The aim of the study was to describe patients with a palliative diagnosis how they experienced the encounter from the district nurse in home care. Method: A qualitative approach has been used and eight patients has been interviewed. Results: The results became three categories: To have time, be seen and have respect. To feel safe and continuity, and to be takenseriously and involved in their own care. Conclusion: For the patients to experience a good encounter it takes continuity, correct information and a possibility to take part in their own care. To have time with the district nurse and to feel seen by the district nurse is important.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-03-21T12:44:02Z No. of bitstreams: 1 Patrícia Mara dos Santos Machado.pdf: 20669829 bytes, checksum: 19260be2036960d8f0b8c918973bd6b5 (MD5) / Made available in DSpace on 2017-03-21T12:44:02Z (GMT). No. of bitstreams: 1 Patrícia Mara dos Santos Machado.pdf: 20669829 bytes, checksum: 19260be2036960d8f0b8c918973bd6b5 (MD5) Previous issue date: 2017-03-09 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Fundação São Paulo - FUNDASP / The present work reflects on the pioneer experience of pedagogical homecare developed in Feira de Santana, backwoods of Bahia, and the restraints to setting it up, on Special Education point of view. This dissertation is the result of pedagogical experience on child with cerebral palsy, not allowed to attend a regular school because of health problems, opening a new path not already taken. At this point, on this dissertation, I have as a goal to analyze the process of appliance of this kind of care, pointing out the paths taken on the process of child scholarship. From this perspective, I report the implication of different sectors of society, searching for an efficient and successful educational care for everyone in need. On this opportunity, we bring up legal and pedagogical aspects, examining official documents which directs this unique experience, pointing out the implementation of educational law for everyone, on municipal department of education. Basing this research on educational care, which emerges from intentions to offer a good quality scholarship for this new demand, purposing a human care for every person involved, I use as reference, authors such as Sacristán, Rousseau, Tomaz Tadeu da Silva, Paulo Freire and so on / O presente trabalho traz uma reflexão acerca da experiência pioneira do atendimento pedagógico domiciliar no município de Feira de Santana, no sertão da Bahia, e os entraves para a consolidação deste, dentro da perspectiva da Educação Especial. Esta dissertação que é fruto da experiência pedagógica no atendimento à uma criança com paralisia cerebral, impossibilitada de frequentar a escola por problemas de saúde, abre uma trilha que até então não tinha sido percorrida. Assim, nesta dissertação, tenho como objetivo analisar o processo de implantação deste atendimento, ressaltando os caminhos trilhados no processo de escolarização da criança. Nesta perspectiva, relato o envolvimento entre diferentes setores, em busca de um atendimento eficiente e exitoso para todos que dele necessitem. Na oportunidade, abordaremos os aspectos legais e pedagógicos, visitando os documentos oficiais que direcionam esta experiência ímpar, ressaltando o cumprimento da lei de educação para todos, pelo sistema de municipal de educação. Referendando a pesquisa desse atendimento, que surge com pretensões de oferecer um ensino público de qualidade a esta nova demanda, propondo a humanização de todos os sujeitos envolvidos, utilizo como referencial, autores como Sacristán, Rousseau, Tomaz Tadeu da Silva, Paulo Freire e outros

<p>Dagens och framtidens avancerade vård flyttas alltmer ut i patientens hem. Utskrivning från den slutna vården sker i allt snabbare takt, större krav ställs på hemsjukvården. Överlämning och rapportering av patienten mellan olika funktioner och personal skall ske så att patientens omvårdnadsbehov tillgodoses på ett tillfredsställande sätt. Studiens syfte var att beskriva överlämnande och rapportering i patientens hem från distriktssköterska till ambulanspersonal. Postenkät, med slutna frågor av Likert typ och med möjlighet att motivera svaren, har använts i studien. Databearbetningen har gjorts med statistical package for social sciencies (SPSS). Enkäten avslutades med fem öppna frågor, vars svar analyserats enligt kvalitativ innehållsanalys. Studien beskriver hur uppfattningarna mellan distriktssköterskor och ambulanspersonal inte alltid är samstämmiga. Om ambulanspersonal frågar efter eller om distriktssköterskor lämnar viss information vid överlämning av patient. Professionernas insikt i varandras yrken är begränsad och en vilja uttrycktes om att öka denna kunskap. Detta kunde vara ett steg i riktning mot att förbättra kommunikationen i överlämnandet och därmed säkra att viktig information följer patienten genom hela vårdkedjan. Ökad kunskap om hur kommunikationen sker mellan yrkesgrupper vid överlämnandet av patienten till annan vårdgivare i vårdkedjan är nödvändig. Framtida forskning utgående från denna studies syfte och population där kvalitativa djupintervjuer är metod skulle kunna ge en djupare insikt i de svar informanten i denna studie givit.</p> / <p>The advanced care of today, and the future, relocates more and more to the home of the patient. Discharge from the institutional care occurs more rapidly, greater demands are made on home nursing, and the link between these two nursing methods is the ambulance care. The hand over of a patient and the reports of the patient between different functions and personnel shall occur in a way that provides for the patient`s nursing needs in a satisfactory way. The purpose of the study was to describe patient hand over´s and reports in the patient´s home, from district nurse to ambulance personnel. In the stydy a questionnaire sent out by mail, containing of closed questions, formulated according to the Likert model and with a possibility to motivate the answers, has been used. The processing of the data has been made with a statistical package for social sciences (SPSS). The questionnaire was completed with five open questions, whose answers have been analyzed according to qualitative analysis of content. The study describes how perceptions between district nurses and ambulance personnel not always are in accordance. If ambulance personnel ask for or district nurses provides certain information when delivering a patient. The professions` knowledge of each others work is limited and a wish to increase this knowledge has been expressed. It could be a step towards improving the communication when handing over a patient and by those means secure that important information follows the patient throughout the entire treatment process. Increased knowledge about communication between different occupational groups at the hand over of the patient to a colleague in the nursing staff is necessary. Future research based on this study´s purpose and population where qualitative in-depth interviews are method could give a deeper insight into the answers this study has resulted in.</p>

In the light of an ageing society with shrinking economic resources, deinstitutionalization of elderly care is a general trend. As a result, homecare is increasing, and increasingly shared between different health and social care organizations. To provide a holistic overview about the patient care process, i.e. to be patient-centred, shared homecare needs to be integrated. This requires improved support for information sharing and cooperation between different actors, such as care professionals, patients and their relatives. The research objectives of this thesis are therefore to study information and communication needs for patient-centered shared homecare, to explore how integrated information and communication technology (ICT) can support information sharing, and to analyze how current standards for continuity of care and semantic interoperability meet requirements of patient-centered shared homecare. An action research approach, characterized by an iterative cycle, an emphasis on change and close collaboration with practitioners, patients and their relatives, was used. Studying one specific homecare setting closely, intersection points between involved actors and specific needs for information sharing were identified and described as shared information objects. An integration architecture making shared information objects available through integration of existing systems was designed and implemented. Mobile virtual health record (VHR) applications thereby enable a seamless flow of information between involved actors. These applications were tested and validated in the OLD@HOME-project. Moreover, the underlying information model for a shared care plan was mapped against current standards. Some important discrepancies were identified between these results and current standards for continuity of care, stressing the importance of evaluating standardized models against requirements of evolving healthcare contexts. In conclusion, this thesis gives important insights into the needs and requirements of shared homecare, enabling a shift towards patient-centered homecare through mobile access to aggregated information from current feeder systems and documentation at the point of need.

Dagens och framtidens avancerade vård flyttas alltmer ut i patientens hem. Utskrivning från den slutna vården sker i allt snabbare takt, större krav ställs på hemsjukvården. Överlämning och rapportering av patienten mellan olika funktioner och personal skall ske så att patientens omvårdnadsbehov tillgodoses på ett tillfredsställande sätt. Studiens syfte var att beskriva överlämnande och rapportering i patientens hem från distriktssköterska till ambulanspersonal. Postenkät, med slutna frågor av Likert typ och med möjlighet att motivera svaren, har använts i studien. Databearbetningen har gjorts med statistical package for social sciencies (SPSS). Enkäten avslutades med fem öppna frågor, vars svar analyserats enligt kvalitativ innehållsanalys. Studien beskriver hur uppfattningarna mellan distriktssköterskor och ambulanspersonal inte alltid är samstämmiga. Om ambulanspersonal frågar efter eller om distriktssköterskor lämnar viss information vid överlämning av patient. Professionernas insikt i varandras yrken är begränsad och en vilja uttrycktes om att öka denna kunskap. Detta kunde vara ett steg i riktning mot att förbättra kommunikationen i överlämnandet och därmed säkra att viktig information följer patienten genom hela vårdkedjan. Ökad kunskap om hur kommunikationen sker mellan yrkesgrupper vid överlämnandet av patienten till annan vårdgivare i vårdkedjan är nödvändig. Framtida forskning utgående från denna studies syfte och population där kvalitativa djupintervjuer är metod skulle kunna ge en djupare insikt i de svar informanten i denna studie givit. / The advanced care of today, and the future, relocates more and more to the home of the patient. Discharge from the institutional care occurs more rapidly, greater demands are made on home nursing, and the link between these two nursing methods is the ambulance care. The hand over of a patient and the reports of the patient between different functions and personnel shall occur in a way that provides for the patient`s nursing needs in a satisfactory way. The purpose of the study was to describe patient hand over´s and reports in the patient´s home, from district nurse to ambulance personnel. In the stydy a questionnaire sent out by mail, containing of closed questions, formulated according to the Likert model and with a possibility to motivate the answers, has been used. The processing of the data has been made with a statistical package for social sciences (SPSS). The questionnaire was completed with five open questions, whose answers have been analyzed according to qualitative analysis of content. The study describes how perceptions between district nurses and ambulance personnel not always are in accordance. If ambulance personnel ask for or district nurses provides certain information when delivering a patient. The professions` knowledge of each others work is limited and a wish to increase this knowledge has been expressed. It could be a step towards improving the communication when handing over a patient and by those means secure that important information follows the patient throughout the entire treatment process. Increased knowledge about communication between different occupational groups at the hand over of the patient to a colleague in the nursing staff is necessary. Future research based on this study´s purpose and population where qualitative in-depth interviews are method could give a deeper insight into the answers this study has resulted in.