Bakgrund: När patienter vårdas i sen palliativ fas är existentiellt lidande något som kan drabba patienterna oavsett om de vårdas på vårdavdelningar, genom hemsjukvård eller på specialiserad palliativ vårdavdelning. Detta kan innebära att de behöver få stöd och lindring i sitt existentiella lidande av vårdpersonalen då existentiella behov ska bli mötta för att dessa patienter ska erhålla en god livskvalitet. Syfte: Att beskriva vårdpersonals erfarenheter av att vårda patienter med existentiellt lidande i sen palliativ fas. Metod: Kvalitativ litteraturstudie med beskrivande syntes.Resultat: Efter analysen framkom två teman och sex subteman. Temat Meningsfullt vårdande inkluderar Att få patienterna att öppna upp genom förtroendefulla relationer och Att hitta sätt att stödja patienterna. Temat Utmaningar i vårdandet inkluderar Att finna en balans i sin professionella roll, Att identifiera existentiellt lidande, Att hantera svåra samtal och Att begränsas av yttre förutsättningar. Slutsats: Vårdpersonalen använder enkla medel i omvårdnaden såsom att enbart dela tystanden vilket ger ett meningsfullt vårdande men möjligheterna att identifiera och lindra patienternas existentiella lidande hämmas av tidsbrist och patienternas mentala och fysiska hälsa. Även vårdpersonalens egen dödsrädsla och tron att deras kunskaper brister eller att samtal om döden ökar lidandet minskar möjligheterna för att lindra existentiellt lidande. / Background: Existential suffering can afflict patients in late palliative phase, regardless whether they are cared for in a ward, receive home healthcare or in a specialized palliative care unite. This may mean that health professionals need to support the patients and provide relief in their existential suffering since meeting their existential needs is important in order for the patients to receive a good quality of life. Aim: To describe health professionals' experiences of caring for patients with existential suffering in late palliative phase. Method: A qualitative approach, through a literature study with a descriptive synthesis. Results: After the analysis two themes and six subthemes emerged. The theme Meaningful caring includes Getting the patients to open up through trustful relationships and Finding ways to support the patients. The theme Challenges in caring includes Finding a work-life balance, Identifying existential suffering, Managing difficult conversations and Being limited by external conditions. Conclusion: Nursing actions such as solely sharing the silence resulting in meaningful caring are often used but time restraints and the patients’ overall health conditions limits the possibilities to identify and ease their existential suffering. Additionally, health professionals' death anxiety and experienced knowledge gaps or beliefs that death conversations increase suffering limits the possibilities to ease existential suffering.

Bakgrund: Hemodialys är en livslång behandling av njursvikt som är en allvarlig kronisk sjukdom. Hemodialyspatienter har frekventa möten med sjuksköterskor och utvecklar ofta en nära kontakt som kan sträcka sig över flera år. Sjuksköterskan behöver arbeta personcentrerat för att främja patienternas hälsa. Syfte: Syftet med studien var att belysa kroniskt njursjuka patienters upplevelser av att leva med hemodialys.Metod: Litteraturstudie med kvalitativ ansats. Olika sökblock byggdes upp baserade på forskningsfrågan och sökningar utfördes i databaserna CINAHL och PubMed. Efter att ha relevans- och kvalitetsgranskats befanns 12 artiklar vara relevanta för analys. Forsberg och Wengströms förenklade innehållsanalys användes för att analysera materialet.Resultat: Fem teman trädde fram: Tiden då, nu och framåt, Uppfattningen om jaget och kroppen, Relationer, Beroenden och begränsningar samt Förlust, acceptans och tacksamhet.Konklusion: Livet med hemodialys påverkar patienterna både socialt, mentalt och fysiskt. Patienterna upplevde sig begränsade, i beroendeposition och deras sociala relationer förändrades. Sjuksköterskan behöver finnas tillgänglig för patienten för att denne ska uppleva hälsa.Nyckelord: Hemodialys, mellanmänskliga relationer, patient, personcentrerad vård upplevelse. / Background: Hemodialysis is a lifelong treatment of chronic kidney failure - a severe and demanding disease. Patients going through hemodialysis have frequent interaction with nurses and often develop a personal relationship which can continue for several years. The nurse has to apply patient centered care to promote health for the patient.Aim: The aim of this study was to illuminate the lived experience of patients with chronic kidney failure receiving hemodialysis.Method: This study was conducted as a literature review with a qualitative approach. The database searches were conducted in CINAHL and PubMed. 12 articles passed the relevance- and quality review. A content analysis method of five steps was used to analyse the material.Result: Five themes emerged; The past, the now and the future, The perception of self and the body, Relationships, Dependency and limitations and Loss, acceptance and gratitude.Conclusion: Life on hemodialysis affects the patients both socially, mentally and physically. The patients felt restricted, in dependency and that their social relationships were changed. The nurse has to be there for the patient in order for the patient to experience healthKeywords: Experience, hemodialysis, human-to-human relationship, patient, patient centered care.

The purpose of this study was to explore nurse-patient encounters from the perspective of the Home Healthcare Registered Nurse. A qualitative descriptive design was used to collect data from a purposive sample of 20 home healthcare registered nurses from Connecticut, Massachusetts, and Rhode Island currently or previously employed as a home healthcare nurse. Four themes and one interconnecting theme emerged from the data: Objective Language; Navigating the Unknown; Mitigating Risk; Looking for Reciprocality in the Encounter; and the interconnecting theme of Acknowledging Not All Nurse-Patient Encounters Go Well. One goal of the study was to propose an empirically informed definition of what constituted a difficult encounter. An important early finding was that the terms difficult patient and difficult encounter were not generally used by study participants. HHC RNs voiced a preference for objective and nonjudgmental language to communicate outcomes of nurse-patient encounters. Three types of HHC RN-patient interactions emerged from the data, with constructive encounters the norm and non-constructive or destructive encounters less frequent. A constructive encounter is when two or more human beings, the nurse on the one side, and the patient, caregiver, or both on the other, interact to achieve a mutually agreed upon outcome. A nonconstructive encounter is when one or more human beings obstruct efforts to achieve at least one positive outcome. A destructive encounter is when one or more human beings direct anger at or physically aggress toward another human being. Strategies to promote reciprocality are routinely employed during HHC RN-patient encounters, but HHC RNs who miss cues that a strategy is ineffective or failed may be at risk in the home. Study data lend support to key concepts, assumptions, and propositions of Travelbee’s (1971) Human-to-Human Relationship Model. Study results provide a foundation for further research to increase the understanding, recognition, and development of empirically derived responses to non-constructive or destructive encounters such that HHC RNs are safe and best able to meet patients’ healthcare needs.