Bakgrund: Inom psykiatrisk omvårdnad används stödjande samtal som en omvårdnadsåtgärd. Det har framkommit i forskning att patienter upplever god effekt av stödjande samtal. Däremot saknas det forskning kring vad ett stödjande samtal är, utifrån psykiatrisjuksköterskans perspektiv. Syfte: Syftet med studien var att belysa vad ett stödjande samtal är utifrån psykiatrisjuksköterskans perspektiv. Metod: Kvalitativ metod med induktiv ansats har använts. Datamaterialet har analyserats med kvalitativ innehållsanalys. Psykiatrisjuksköterskor inom vuxenpsykiatrisk öppenvård har intervjuats i två regioner i sydvästra Sverige. Tio stycken semistrukturerade intervjuer har genomförts. Resultat: I resultatet framkommer att psykiatrisjuksköterskor anser att det stödjande samtalet ska stärka och identifiera patientens egna resurser. Relationen mellan psykiatrisjuksköterskan och patienten är betydelsefull. Det stödjande samtalet beskrivs som otydligt, saknar struktur och syfte samt tenderar att ha en låg status då det ibland används i väntan på annan behandling. Samtidigt framkommer att det finns en stor frihet med det stödjande samtalet då det inte behöver anpassas till ramar som i en terapi. Konklusion: Det stödjande samtalet är en betydelsefull uppgift där psykiatrisjuksköterskan är bäst lämpad att utföra samtalet. Detta på grund av det omvårdnadsperspektiv psykiatrisjuksköterskan besitter. Det stödjande samtalet är en insats som bör prioriteras inom den vuxenpsykiatriska öppenvården. / Background: In psychiatric nursing, supportive conversations are used as a nursing measure. Research has shown that patients experience a good effect of supportive conversations. On the other hand, there is a lack of research on what a supportive conversation is from the psychiatric nurse's perspective. Aim: The aim of this study was to shed light on what a supportive conversation is from the psychiatric nurse's perspective. Method: Qualitative method with inductive approach has been used. The data material has been analyzed with qualitative content analysis. Psychiatric nurses in adult psychiatric outpatient care have been interviewed in two regions in southwest of Sweden. Ten semi-structured interviews were conducted. Result: The results show that psychiatric nurses believe that the supportive conversation should strengthen and identify the patient's own resources. The relationship between the psychiatric nurse and the patient is of great importance. The supportive conversation is described as unclear, lacks structure and purpose and tends to have a low status as it is sometimes used while the patient is waiting for other treatment. At the same time, it becomes clear that supportive conversation offers a great deal of freedom as it does not need to be adapted to the framework as in a therapy. Conclusion: The supportive conversation is an important task where the psychiatric nurse is best suited to carry out the conversation. This is due to the nursing perspective of the psychiatric nurse. The supportive conversation is an initiative that should be prioritized in adult psychiatric outpatient care.

Syftet med studien var att undersöka sjuksköterskors och skötares upplevelser av möten med patienter i psykiatrisk öppenvård.   Bakgrund – I psykiatrisk öppenvård möter sjuksköterskor och skötare många olika människor med individuella behov. Sedan tidigare forskning har det framkommit att patienters känsla av trygghet uppkommer genom faktorer som personalens inställning och empati. Relationen mellan personal och patient är viktig för patientens känsla av att bli tagen på allvar samt att bli bekräftad. För personer som lever med psykisk sjukdom är det viktigt med en långsiktig relation som grundar sig i förtroende och öppenhet. En god relation kan byggas om personalen kan befinna sig på patientens nivå och få patienten att känna sig viktig och betydelsefull. En fungerande allians tar tid att utveckla, men den utgör sedan en god grund för ett gott samarbete och har goda effekter på psykisk ohälsa.   Design – Kvalitativ design med fenomenologiskt förhållningssätt användes.   Metod – 8 intervjuer genomfördes med sjuksköterskor och skötare i psykiatrisk öppenvård på tre öppenvårdsmottagningar i norra Sverige under december 2015 – februari 2016 och analys gjordes med kvalitativ innehållsanalys.   Resultat – I psykiatrisk öppenvård ansågs relationen mellan vårdare och patient utgöra en stor grund, och fram för allt att det var en trygg relation. Denna trygghet kunde bland annat skapas genom vårdarnas tillgänglighet till patienterna. Fyra kategorier identifierades; Bemöta patienter, Upplevelser av att göra bedömningar, Upplevelser av att vara i patientens hemmiljö och Upplevelser av att arbeta i öppenvård.   Slutsats – Det arbete som sjuksköterskor och skötare utför genom möten med patienter i psykiatrisk öppenvård är betydelsefullt för så många människor med psykisk ohälsa. Genom att få ta del av vårdarnas upplevelser kan det bidra med ökad förståelse om deras betydelse för patienternas psykiska mående. Men samtidigt deras utsatthet då de kan försättas i problematiska situationer. Resultatet kan på så sätt bidra till att relevanta utbildningar och insatser kan identifieras och förhoppningsvis implementeras i verksamheterna. / The aim of this study was to investigate the nurses and assisted nurse mentals experiences of encounters with patients in psychiatric outpatient care.   Background – In psychiatric outpatient care nurses and assisted nurse mentals meets many different people with individual needs. Since previous research has shown that patients' sense of security generated by factors such as staff attitude and empathy. The relationship between staff and patients is important for the patient's feeling of being taken seriously and to be confirmed. For people living with mental illness, it is important to have a long-term relationship based on trust and transparency. A good relationship can be built if the staff can be at the patient level and make the patient feel important and significant. A working alliance takes time to develop, but it then forms a good basis for a good working relationship and has good effects on mental health.   Design – A qualitative design with a phenomenological approach was used.   Method – 8 interviews were conducted with nurses and assisted nurse mentals in psychiatric outpatient care in three outpatient clinics in northern Sweden during December 2015 - February 2016 and analyzed using qualitative content analysis.   Results – In psychiatric outpatient care the relationship between caregiver and patient was considered as a significant basis, and above all that it was a secure relationship. This security could, among other things be created by carers’ availability to patients. Four categories were identified; Meet patients, Make the right assessments, Be in the patient's home environment and Work in outpatient care.   Conclusion – The work that nurses and assisted nurse mentals carrying through in their meetings with patients in psychiatric outpatient care is important for so many people with mental illness. By getting the benefit of carers’ experiences it may contribute to a better understanding of their importance to the patients’ psychological being. But at the same time their vulnerability as they can be placed in problematic situations. The results can therefore contribute to relevant educations and initiatives can be identified and hopefully implemented in the clinics.

The work discusses the analysis, proposal and implementation of simplified outpatient information system of general practitioner (GP), which communicates with IZIP information system. The proposal of system uses the Model-View-Controller architecture; the design patterns and subject simulated technique use UML. The way of communication with IZIP system, the structure of sent data and the communication security is also described in the work. C++ programming language is used for the implementation of the proposed system, parser Xerces-C++ for XML documents processing, toolkit Qt for graphical user's interface; and the data are stored into the Firebird relational database.

No description available.

Abstract Introduction: Obesity amongst children is a major health problem. At the outpatient paediatric clinic at Södertälje hospital in Region Stockholm, there is a large and well-established treatment model against childhood obesity. During spring 2020 all elective care in Region Stockholm, including visits to the obesity team, was cancelled for 3 months due to relocation of health care professionals because of the Covid-19 pandemic. Aim: To investigate whether the first wave of the Covid-19 pandemic affected the outcome of childhood obesity treatment at one outpatient paediatric clinic in Region Stockholm. Methods: A retrospective controlled cohort study comparing two groups regarding results of first year of obesity treatment for children. One group had their first year of treatment during the first wave of the Covid-19 pandemic and the control group before the pandemic. Data was retrieved from BORIS and complemented by a review of medical records. Results: Mean change in BMI SDS after one year of treatment in the Covid group was -0.10 units and in the control group -0.11 (ns). In the Covid group more patients quit the treatment programme and had a smaller number of visits to a nurse compared to controls. Conclusion: This study showed no difference in outcome regarding change in BMI SDS. However, it seems that the cancellation of visits might have affected the number of children lost to follow-up. Therefore, clinics should consider “digi-physical” care (e.g., via telephone, videocalls or other media) to secure the child and parents motivation and participation in the obesity treatment programme.

Bakgrund: Barns delaktighet i sin vård uppmuntras i flera lagar. Forskning visar att sjuksköterskor upplever det som viktigt att barnet är delaktig i sin vård och att delaktigheten måste anpassas efter barnets mognad. Inom psykiatrin har forskning visat att barns delaktighet är svårare att tillgodose. För sjuksköterskor finns det olika vårdmodeller att arbeta efter och även utarbetade delaktighetsmodeller för att synliggöra barns delaktighet. Sjuksköterskors erfarenhet av barns delaktighet inom den svenska öppenvårdspsykiatrin finns det fortfarande behov av att utforska.  Syfte: Att belysa sjuksköterskors erfarenheter av barns delaktighet i sin vård inom barn och ungdomspsykiatrisk öppenvård.  Metod: Kvalitativ intervjustudie utförd med Stimulated Recall Interview. Totalt 12 stycken sjuksköterskor intervjuades och det transkriberade materialet analyserades med hjälp av innehållsanalys. Resultat: Dataanalysen resulterade i två huvudkategorier: Att anpassa det unika mötet och Att balansera mellan barnet och föräldrarna.  Slutsats: Sjuksköterskorna inom barn och ungdomspsykiatrins öppenvård arbetar aktivt för att göra barn delaktiga i sin vård. Detta ansågs som både viktigt och centralt i deras yrkesutövning. De använde sig själva och relationen till barnet som en del i att göra barnet delaktig. Anpassningar i mötet med barnet var en del av det dagliga arbetet. Sjuksköterskor upplevde att de behövde balansera på en fin linje mellan barn och föräldrar. Detta kunde ses som ett etiskt dilemma. / Background: Children's participation in their care is encouraged in several laws. Research suggests that nurses experience that it is essential that the child is involved in their care, and that the involvement must be adjusted depending on the maturity of the child. Within child psychiatry, research shows that participation is more difficult to achieve. For nurses there are different care models to work from, and even models of participation to make children's participation visible. Nurses’ experiences of children's participation within the Swedish psychiatric outpatient care, is so far an unexplored area. Method: Qualitative interview study with 12 participants. Implemented through the method Stimulated Recall Interview. The transcribed data was analyzed with content analysis. Purpose: To highlight nurses experiences of children´s participation in their care within child and adolescent psychiatric outpatient clinics. Results: The findings resulted in two main categories: To adapt the unique meeting and To balance between the child and the parents. Conclusions: Nurses at child and adolescent psychiatric outpatient clinics work actively to make children involved in their care. This was experienced as important and central in their professional practice. They used themselves and the relationship with the child as a way to make the child involved.  Adaptations in the meeting with the child was part of the daily work. Nurses experienced that they had to balance on a fine line between the children and the parents. This could be seen as an ethical dilemma.

Abstract:Aims: Due to large inconsistencies in previous studies, it remains unclear how alcohol use is related to health care utilization. The aim of this study was to examine associations between alcohol drinking status with utilization of outpatient and inpatient health care services in Germany. Methodology: Survey data of the GEDA 2014/2015-EHIS study with n = 23,561 German adults were analyzed (response rate: 27 %). Respondents were categorized as lifetime abstainers, former drinkers, and non-weekly drinkers, as well as weekly low-risk drinkers and risky drinkers. Outpatient services included GP, specialist, and hospital visits; inpatient services included hospital overnight stays in the last 12 months. For both settings, binary logistic regression models were applied, adjusted for possible confounders. Results: For specialist visits, elevated odds were found among former drinkers (odds ratio (OR) = 1.93, 95 % confidence interval (95 % CI) = 1.50-2.49), non-weekly drinkers (OR = 1.24, 95 % CI = 1.05-1.47), weekly low-risk drinkers (OR = 1.39, 95 % CI = 1.17-1.67), and risky drinkers (OR = 1.28, 95 % CI = 1.04-1.57) compared to lifetime abstainers. In contrast, lower odds for inpatient service use were found among non-weekly drinkers (OR = 0.76, 95 % CI = 0.62-0.93), low-risk drinkers (OR = 0.66, 95 % CI = 0.53-0.81), and risky drinkers (OR = 0.65, 95 % CI = 0.51-0.84). No differences were observed for GP and outpatient hospital visits. Conclusions: While the increased odds of consulting a specialist are consistent with higher health care needs among former and current drinkers, the lower use of inpatient care among current drinkers is contrary to known health risks associated with alcohol consumption and evidence from hospitalized populations. The findings also highlight the need to differentiate between lifetime abstainers and former drinkers in their use of health services.

No description available.

This study examines collaboration between social services, inpatient- and outpatient psychiatric care regarding to discharge from psychiatric inpatient care. The research questions examined in the study were how professionals working in these organizations perceive the discharge process with regards to limiting factors, facilitating factors and their experiences of how the patient have experienced discharge. The study is based on two focus group interviews with professionals working in psychiatric inpatient- and outpatient care and three individual interviews with professionals working in the social services. The results show that facilitating factors for collaboration are clear communication, when patients already have contact with the social services since before, and when the professionals already have an established professional relationship. Poor communication, unclear responsibilities, and lack of respectfor each individual profession, were the main limiting factors. The legislative requirement for a fast discharge process was a limiting factor due to social care efforts long lead time. / Den här studien undersöker samverkan mellan socialtjänst och psykiatrisk sluten- och öppenvård när patienter ska skrivas ut från psykiatrisk slutenvård. Forskningsfrågan för studien är hur professionella som arbetar inom dessa verksamheter ser på utskrivningsprocessen utifrån begränsande och främjade faktorer samt hur de tror att utskrivningarna upplevs av patienterna. Studien bestod av två fokusgrupper med professionella från psykiatrisk sluten- och öppenvård samt tre individuella intervjuer med socialsekreterare. Resultaten visar att främjande faktorer för samverkan är när det finns tydlig kommunikation, när patienter redan har kontakt med socialtjänsten sedan tidigare samt när samverkansaktörerna har upparbetade relationer. Bristande kommunikation, oklara ansvar och brist på respekt för yrkesroller var begränsande faktorer i samverkan. Lagstiftningenskrav på en skyndsam utskrivningsprocess var en begränsande faktor utifrån långa uppstartstider för vissa sociala omsorgsinsatser.

Bakgrund: Hjärtsvikt är en diagnos som ökar i takt med att populationen i världen blir äldre. Patienter med hjärtsvikt kan via egenvård uppnå symtomlindring. Kommunikationen från sjukvården kring hur patienten ska uppnå en god egenvård är bristfällig.  Syfte: Syftet var att beskriva upplevelser av egenvård vid hjärtsvikt för vuxna patienter inom öppenvården. Metod: En kvalitativ litteraturöversikt med en induktiv ansats.  Resultat: I resultatet framkom fyra huvudkategorier, “Förståelse och kunskap kring egenvård”, “Behov av stöd för att utföra egenvård”, “Behov av att känna sig delaktig” och “Begränsningar i det vardagliga livet” med tillhörande subkategorier.  Slutsats: För att uppnå en god egenvård krävdes stöd från hälso-sjukvården samt anhöriga. Patienten behövde få känna sig delaktig i egenvården. Informationen kring egenvård från sjukvården ansågs bristande. / Background: Heart failure is a diagnosis that increases as the world's population ages. Patients with heart failure can achieve symptom relief through self-care. Communication from the healthcare system regarding how the patient should achieve good self-care is deficient.  Aim: The aim was to describe experiences of self-care in heart failure for adult patients in outpatient care.  Method: A qualitative literature review with an inductive approach.  Results: The result was four main categories, "Understanding and knowledge of self-care", “Need for support to carry out self-care", "Need to feel involved" and "Limitations in everyday life" with associated subheadings.  Conclusion: In order to achieve good self-care, support from health care and relatives was required. The patient needed to feel involved in self-care. Information about self-care from the healthcare system was considered insufficient.