Background: It has been under discussion in Sweden that the psychiatric inpatients ward is in the need of developing more content and structure. Earlier science shows that implementation of new conversations methods has been appreciated and developing for both nurses and patients. There is also obstacle for nurse`s to prioritize time for conversations with their patients. Aim: The aim was to explore nurse`s experiences of using a manual based CBT in conversations with patients in psychiatric inpatient ward. Method: Research design was interviews with qualitative approach and thematic analysis, inductive approach. Six nurses who worked in a psychiatric inpatients ward were interviewed. Results: The results of the study were summarized in to two main themes; Feelings in work as a nurse and the nurse in the professional role. Six under themes was conducted into the two mentioned main themes. Its presenting feelings connected to these conversations with CBT methodand about the professional working role. It was described useful in the daily work and agood support for the patient recovery, person-centered treatment and difficulties associated to the implementation of the new work. Conclusion: Cbt makes it possible to make in dept-care relationship, strengthens patients' recovery and provides structure for the conversation which also requires support and adaptation for making it useful in the daily work. / Bakgrund: Det har diskuterats i Sverige om att den psykiatrisk heldygnsvården är i behov av utveckling vad gäller innehåll och struktur. Tidigare forskning har visat att införandet av samtalsmetoder har varit uppskattat och utvecklande för både sjuksköterskor och patienter. Det finns också hinder för sjuksköterskor att prioritera tid för samtal med patienter. Syfte: Syftet med denna magisteruppsats var att utforska sjuksköterskors erfarenheter av att använda sig av manualbaserad KBT i samtalet med patienter i psykiatrisk heldygnsvård. Metod: Designen var intervjustudie med kvalitativ ansats och tematisk analys med induktiv approach. Sex sjuksköterskor intervjuades och de var yrkesverksamma på psykiatriska heldygnsvårdsavdelningar. Resultat: Resultatet presenteras i två huvudteman; Känslor i arbetet som sjuksköterska och sjuksköterskan i sin professionella roll. Sex undertemandelades in under de två huvudkategorierna. Det presenteras känslor kopplade till sjuksköterskans arbete med KBT metoden i samtalet likväl som det handlade om den professionella yrkesrollen. Det beskrevs som hjälpsamt för patienters återhämtning, personcentrerat bemötande samt vissa svårigheter kopplat till det nya arbetssättet. Slutsats: KBT möjliggör fördjupad vårdrelation, stärker patienters återhämtning och ger struktur för samtalet. Vilket ocksåbör backas upp med stöd omkring införandet och med viss anpassning för att det skall bli användbart i det dagliga arbetet.

Aim: This study explores what type of information patients and nurses share with, or provide to, each other, and whether or not the information received was relevant and sufficient for their needs. Background: Information exchange, as part of shared decision-making, is advocated in policy and practice throughout the healthcare sector. Much of the literature on information exchange relates to one-to-one consultations with consultants or GPs. To date, no studies have explored information exchange between patients and nurses in ward settings. Nursing literature on patients’ information needs focuses on one-way information provision from nurses to patients, rather than on two-way information exchange between patients and nurses. Methods: Interactions between patients and nurses were observed and audio-recorded using a remotely controlled audio-recording system. Semi-structured individual face-to-face interviews were then conducted to clarify and add to the observation data. A multiple case study design was used for this study: each case comprised one patient, the nurses caring for that patient, and the interactions between them. A pilot study was undertaken to inform the methods for recruitment and data collection for the main study. Results: The pilot study comprised five cases (patients n=5, nurses n=3). Changes to the recruitment strategy for the main study included surgical patients being invited to participate in the same way as medical patients. There were no difficulties with the data collection methods. The main study comprised nineteen cases (patients n=19, nurses n=22). Information exchange seemed unfamiliar to ward-based nurses. The findings show that information exchange may not be a one-off event but a complex series of interactions. Patients did not distinguish between clinical and non-clinical information in the same way as nurses. Primary reasons for patients’ hospital admission were not discussed and nurses did not share information about nursing interventions. The relevance for patients and nurses differed; patients generally wanted information for reducing anxiety and socialization; nurses wanted information for assessment and care planning. In terms of sufficiency, observation sessions highlighted that insufficient information was provided, often due to lost opportunities and paternalistic practice. However, the majority of patients and nurses perceived that they had exchanged sufficient information. Conclusion: This multiple case study provides insights into the type, relevance and sufficiency of information for patients and nurses in ward settings. In ward settings, information exchange as conceptualised by Charles et al. (1997 and 1999) may be difficult to achieve due to the complexity of patient/nurse interactions. Therefore, there are implications for policy makers as policies are not context specific. However, information exchange may be helpful for reducing patients’ anxieties. The concepts of shared decision-making and information exchange are not part of ward-based cultures and philosophies, which suggests implications for patient and nurse education. Research on information exchange between patients and nurses in other ward contexts may contribute to further understanding of information exchange in ward settings.