Bakgrund: Sjuksköterskor berör patienter, ibland med en speciell intention till exempel för att trösta, andra gånger på grund av nödvändighet för att kunna utföra arbetsuppgifter. Dessa två typer av beröring benämns expressiv respektive instrumentell beröring. Beröring har visat sig kunna stärka relationen sjuksköterskor och patienter emellan, samt främja patienters välbefinnande. Syfte: Syftet med denna litteraturöversikt var att belysa vuxna patienters upplevelser av fysisk beröring inom somatisk vård. Metod: Metoden för studien var en litteraturöversikt. Resultat: Fyra huvudteman och två subteman återfanns i analysen; att bli sedd som människa med subtemat kommunikationens betydelse för upplevelsen av att bli berörd, hur beröring kan ingjuta förtroende och trygghet, betydelsen av att ha kontroll och att inte vilja ha en manlig sjuksköterska med subtemat inställning till kön avseende intim beröring. Diskussion: Det framkomna resultatet bidrar till kunskapen om hur patienter upplever fysisk beröring vid omvårdnad, och kan implementeras i sjuksköterskors vårdarbete med patienter för att göra vården mer patientcentrerad. Dock anser författarna att vidare forskning inom detta område behövs för att bidra till kunskap om patienters upplevelser av beröring och en ökad förståelse som kan generera i en mer patientcentrerad vård. / Background: Nurses use touch on a daily basis in their work. They use touch to comfort, and because of necessity in their job assignments. These two kinds of touch are called expressive and instrumental touch. Touch has been shown to strengthen the relationship between nurses and patients, also to support patients’ well-being. Aim: The aim of this literature review was to illustrate adult patients’ experiences of touch in somatic care. Method: The method for the study was a literature review. Results: Four main themes and two subthemes emerged in the analyze; to be seen as a human being with the subtheme the meaning of communication in the experience of being touched, how touch can convey trust and security, the meaning of being in control and to dislike a male nurse with the subtheme attitudes towards gender regarding intimate care. Discussion: The outcome highlights the importance of making nursing care more patient-centered. Yet the authors consider that further research in this domain is needed about patients’ experience of touch to enable better patient-centered care.

Bakgrund: Sömnen har stor betydelse för återhämtning vid sjukdom och bevarande av god hälsa. Många gånger skiljer sig vårdmiljön från patienternas normala omvärld och möjligheten för inlagda patienter att påverka sin sovsituation är ofta liten. Syfte: Syftet med denna litteraturstudie var att belysa de faktorer som vuxna patienter upplever som störande för sömnen under sjukhusvistelsen. Metod: Litteraturstudien som genomfördes grundades på tolv utvalda vetenskapliga artiklar. Dessa artiklar granskades, analyserades och sammanställdes. Resultat: Studien visade att det fanns flera olika faktorer som patienterna upplevde som störande för sömnen under sjukhusvistelsen. Det visade sig även förekomma delade meningar kring hur mycket sömnen påverkats utav vistelsen på sjukhus. De faktorer som identifierades som störande för sömnen presenteras under följande kategorier: medicinska faktorer, omvårdnad & sjuksköterske faktorer, omgivningsfaktorer och personliga faktorer. Slutsats: Denna studie visar att den verksamhet som bedrivs idag och de bestämmelser som styr vården bidrar till att patienter upplever svårigheter att sova under sjukhusvistelsen. Det hela tyder på att det är mycket som behöver förbättras i vården, men vården är ett komplext område att förändra. / Background: Sleep is very important for recovery during illness and the preservation of good health. The hospital environment is many times different from the patient’s normal world and the patients' ability to influence their sleep situation is often small. Aim: The aim of this study was to illustrate the factors that adult patients experiencing disruptive for their sleep during hospitalization. Methods: This literature study is based on twelve scholarly articles. These articles were reviewed, analyzed and summarized. Results: The study showed that there were several factors that patients experienced as disturbing for their sleep during hospitalization. It was also shown to be disagreement about how much the hospital stay influenced on the sleep. The factors that were identified in this study are presented under the following categories: medical factors, nursing care and nursing factors, environmental factors and personal factors. Conclusion: This study shows that the activity today and the rules governing the health care contribute to patients’ experience of difficulties to sleep during hospitalization. It all indicates that much improvement is needed in the health care, but it is a complex area to change.

Bakgrund: Ett bra bemötande karaktäriseras av ett respektfullt, kompetent och empatiskt samspel som är individanpassat. Patienter med substansbrukssyndrom är en grupp som uppfattas som vårdkrävande och är föremål för stigmatisering, därmed kan bemötandet ses som en utmaning. Patientcentrerad vård innebär att sträva efter individens välmående. Med hjälp av ett motiverande förhållningssätt kan sjuksköterskan öka patienternas empowerment. Syfte: Att undersöka hur patienter med substansbrukssyndrom upplever bemötandet från vårdpersonal, med fokus på sjuksköterskor. Metod: Litteraturöversikt där både kvalitativa och kvantitativa artiklar ingick. Resultat: Tre kategorier angående bemötande identifierades: att se hela individen, vårdande möte och stigma. Under varje kategori urskildes både positiva och negativa upplevelser av bemötande. Diskussion: Ett patientcentrerat förhållningssätt kan förstås som ett empatiskt, omtänksamt, engagerat och hjälpsamt bemötande. Många patienter hade upplevelser av diskriminering och stigmatisering inom vården, detta kunde delvis förklaras som en maktobalans i relationen mellan vårdgivare och patient.  Slutsats: Sjuksköterskans bemötande kan både öka och minska vårdlidande. Ett gott bemötande är betydelsefullt för att främja hälsa och optimera resultatet av vården. Omvårdnaden av personer med substansbrukssyndrom kan förbättras. / Introduction: The responsibility of the nurse is to have competence and to treat every patient with respect and empathy. Patients with substance use disorders are a group that can be viewed as a group with a large demand of care. They are exposed to stigmatization and therefor they need specialized care. The meaning of patient centered care is to strive to optimize every individual’s well-being. Nurses may increase patient’s empowerment through a motivating approach. Aim: To explore patients’ perceptions of the nurse-patient relation of patients with substance use disorder. Method: A literature review, including both qualitative and quantitative studies. Result: Three categories were identified: To see the whole person, caring encounter and stigma. Both positive and negative aspects of every category were discovered. Discussion: A patient centered approach can be understood as an emphatic, caring, committed and helpful encounter. Many patients had experiences of discrimination and stigma during care. This could partly be understood as an unbalanced power-control relationship between caregiver and patient. Conclusion: The nurses actions can increase as well as decrease patients suffering. A caring encounter is important to promote health and to optimize the results of care. There is room for development of nursing skills in care of patients with substance use disorders.

Introdução Este trabalho objetivou analisar a recente inserção da saúde bucal no Programa Saúde da Família (PSF) no que se refere ao vínculo, ao acesso, à integralidade da atenção e à resolutividade dos problemas de saúde bucal. Objetivo - Identificar as opiniões, percepções e necessidades dos usuários adultos da UBS Vila Espanhola, município de São Paulo, em relação à sua saúde bucal e ao serviço de atenção à saúde bucal a eles oferecido pelo PSF. Metodologia Pesquisa qualitativa, composta pelas seguintes etapas: observação sistemática das atividades da equipe de saúde bucal da UBS estudada e entrevista com os usuários adultos, maiores de 18 anos, que tiveram algum tipo de atendimento odontológico na UBS nos últimos 6 meses. Na fase de análise optou-se pela técnica de análise de conteúdo. Resultados Realizaram-se 25 entrevistas e percebeu-se que a inserção do PSF aumentou o acesso da população estudada na região da UBS, aumento que trouxe maior demanda por serviços especializados em odontologia. Contudo, os usuários não estão conseguindo utilizar esses serviços de atenção secundária em saúde bucal. As entrevistas também trouxeram algumas questões levantadas pelos usuários, como a constante troca de dentistas na equipe, comprometendo o vínculo, a falta de autonomia dos usuários com relação à própria saúde bucal, a da falta de credibilidade no setor público, a do papel do ACS na equipe, a da forma como são efetuados os grupos de escovação, a questão do espaço físico onde são realizados os atendimentos e a forma como é aplicado o princípio da equidade para priorizar os atendimentos. Conclusão - A inserção da saúde bucal no PSF trouxe alguns avanços, porém precisa ser reavaliada para realmente conseguir atingir suas principais propostas, como a integralidade da atenção, a equidade, entre outras. / Introduction This study aims to analyze the recent insertion of oral health in the Family Health Program PSF considering link, access, integrity of attention and in to oral problems resolution. Buccal Health, which has always been apart from health public politics in this country, has now the opportunity to, at last, be part of the Unified Health System. Objective Identify opinions, perceptions and necessities of the adults patients from Vila Espanhola UBS (Health Basic Unity), São Paulo city, in relation to dental health and the service of attention to buccal health offered by the PSF. Methodology Qualitative research made of the following steps: systematic observation of the activities done by the buccal health team of the studied UBS, and interview with the adult patients, older than 18, that had any kind of attention in the past six months. In the analyses phase, we opted by the content analysis. Results: It was done 25 interviews and it was noticed that the insertion of PSF increased the access of the studied population in the UBS region, however this increase brought a bigger demand by specialized oral services. The patients are not being able to have access to those secondary attentions in buccal health. The interviews also brought some patients question such as the constant changing of the dentists in the team - compromising the link, lack of patients autonomy in relation to their own oral health, lack of credibility of public politics, the roll of the ACS in the team, the way how it is applied the equity principle to prioritize the cares. Conclusion: The insertion of buccal health in the PSF brought some advances, however it needs to be reevaluated to really reach its main proposals as integrality of attention, equity among others needs.

Thesis advisor: Dorothy Jones / The importance of the nurse-patient relationship to the overall well- being of the person has been explored extensively by nurses. What is largely missing from this knowledge developed to date is the patient's perspective. The purpose of this study was to develop a reliable and valid measure of patients' perceptions of feeling known by their nurses during an acute, surgical, hospital admission. The development of the PPFKN Scale was guided by Newman's theoretical framework of Health as Expanding Consciousness (1994) and data from a qualitative descriptive study conducted in 2003 (Somerville). The current investigation focused on the development and psychometric testing of the PPFKN Scale. The four themes that emerged from the earlier qualitative study were used to guide the development of the 85-item scale. This scale was exposed to a panel of nurse experts to establish inter-rater agreement and content validity, item understandability and readability. The revised scale was piloted with five participants who had experienced an inpatient, surgical admission to determine content validity, item readability and understandability. The revised 77-item scale was then administered to 327 surgical inpatients across seven general care units at a large academic urban medical center. A sample size of 296 completed surveys was analyzed. A four-component solution was devised using Principal Components Analysis with Varimax rotation. This four-component solution accounted for 63.3% variance, with a total scale Cronbach's alpha coefficient of 0.99. A component loading cut-off was set at 0.3 and items not loading at this value on the expected component were dropped. This process resulted in a reliable and valid 48 item PPFKN Scale with four components and a total scale Cronbach's alpha coefficient of 0.98. / Thesis (PhD) — Boston College, 2009. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Introdução Este trabalho objetivou analisar a recente inserção da saúde bucal no Programa Saúde da Família (PSF) no que se refere ao vínculo, ao acesso, à integralidade da atenção e à resolutividade dos problemas de saúde bucal. Objetivo - Identificar as opiniões, percepções e necessidades dos usuários adultos da UBS Vila Espanhola, município de São Paulo, em relação à sua saúde bucal e ao serviço de atenção à saúde bucal a eles oferecido pelo PSF. Metodologia Pesquisa qualitativa, composta pelas seguintes etapas: observação sistemática das atividades da equipe de saúde bucal da UBS estudada e entrevista com os usuários adultos, maiores de 18 anos, que tiveram algum tipo de atendimento odontológico na UBS nos últimos 6 meses. Na fase de análise optou-se pela técnica de análise de conteúdo. Resultados Realizaram-se 25 entrevistas e percebeu-se que a inserção do PSF aumentou o acesso da população estudada na região da UBS, aumento que trouxe maior demanda por serviços especializados em odontologia. Contudo, os usuários não estão conseguindo utilizar esses serviços de atenção secundária em saúde bucal. As entrevistas também trouxeram algumas questões levantadas pelos usuários, como a constante troca de dentistas na equipe, comprometendo o vínculo, a falta de autonomia dos usuários com relação à própria saúde bucal, a da falta de credibilidade no setor público, a do papel do ACS na equipe, a da forma como são efetuados os grupos de escovação, a questão do espaço físico onde são realizados os atendimentos e a forma como é aplicado o princípio da equidade para priorizar os atendimentos. Conclusão - A inserção da saúde bucal no PSF trouxe alguns avanços, porém precisa ser reavaliada para realmente conseguir atingir suas principais propostas, como a integralidade da atenção, a equidade, entre outras. / Introduction This study aims to analyze the recent insertion of oral health in the Family Health Program PSF considering link, access, integrity of attention and in to oral problems resolution. Buccal Health, which has always been apart from health public politics in this country, has now the opportunity to, at last, be part of the Unified Health System. Objective Identify opinions, perceptions and necessities of the adults patients from Vila Espanhola UBS (Health Basic Unity), São Paulo city, in relation to dental health and the service of attention to buccal health offered by the PSF. Methodology Qualitative research made of the following steps: systematic observation of the activities done by the buccal health team of the studied UBS, and interview with the adult patients, older than 18, that had any kind of attention in the past six months. In the analyses phase, we opted by the content analysis. Results: It was done 25 interviews and it was noticed that the insertion of PSF increased the access of the studied population in the UBS region, however this increase brought a bigger demand by specialized oral services. The patients are not being able to have access to those secondary attentions in buccal health. The interviews also brought some patients question such as the constant changing of the dentists in the team - compromising the link, lack of patients autonomy in relation to their own oral health, lack of credibility of public politics, the roll of the ACS in the team, the way how it is applied the equity principle to prioritize the cares. Conclusion: The insertion of buccal health in the PSF brought some advances, however it needs to be reevaluated to really reach its main proposals as integrality of attention, equity among others needs.

Bakgrund: Personer med substansbrukssyndrom (SUD) är en stigmatiserad och marginaliserad population i samhället som har ett stort vårdbehov. Tidigare forskning visar på att hälso- och sjukvårdspersonal har stigmatiserade fördomar och attityder gentemot denna patientgrupp. Denna studies syfte var att undersöka och belysa hur personer med SUD upplever hälso- och sjukvårdens bemötande vid vårdkontakter. Metod: Med hjälp av en deskriptiv litteraturöversikt, har material samlats in från tre databaser, PubMed, PsycInfo och CINAHL. Elva artiklar valdes ut och analyserades för att identifiera individer med SUD och deras upplevelse av bemötande inom hälso- och sjukvården. Resultat: Både positiva och negativa upplevelser rapporterades av deltagarna. Av resultatet framkom det att upplevd stigmatisering, en sämre kommunikation mellan patient och personal, en upplevd misstro och en negativ relation med personalen bidrog till ett sämre uppfattat bemötande. Det kunde bidra till att deltagarna var mindre angelägna att uppsöka vård. Ett gott bemötandet beskrevs som öppet och empatiskt, icke-dömande, en god kommunikation och en relation med vårdpersonalen som grundades på tillit. Det kunde resultera i att deltagarna var mer angelägna att uppsöka vård. Åtta teman och fyra subteman framkom när materialet studerades och resultatet presenteras utifrån dessa teman. Slutsats: Hälso- och sjukvården har en betydande roll i sitt inflytande på denna patientgrupp och har en stor möjlighet att lindra lidandet samt främja en god omvårdnad genom sitt bemötande. / Background: People with substance use disorders (SUD) are stigmatized and marginalized in society with a great need for care. Previous research shows that healthcare professionals have stigmatized prejudices and attitudes towards this patient group. This study aimed to investigate and shed light on how people with SUD experience the health service’s treatment at care contacts. Method: Using a descriptive literature review, the material has been collected from three databases, PubMed, PsycInfo and CINAHL. Eleven articles were selected and analyzed to identify individuals' with SUD experience of treatment in healthcare. Results: The results showed that perceived stigma, poorer communication between patient and staff, perceived mistrust and a negative relationship with the staff contributed to a more negative experience of the encounter. This could contribute to the participants being less likely to seek care. The better encounter was described as open and empathetic, non-judgmental, good communication and a relationship with the care staff that was based on trust. This could result in the participants being more likely to seek care. Eight themes and four sub-themes emerged when the material for this study was reviewed, and the results are presented based on these themes. Conclusion: Healthcare has a significant role in its influence on this patient group and has a great opportunity to alleviate suffering and to promote good care through its treatment.

Soft skills include communication skills and personality traits that are important when choosing a dentist, but other factors within the dental office also seem to be important for patients. The aim of this study is to evaluate factors that are important to people in a dentist as well as characteristics of the ideal dentist and to evaluate possible age-, gender-, and residence of living specific differences. A telephone survey with participants aged 35 years or older (ag—age group: ag 1: 35–50 years, ag 2: 70–84 years, ag 3: >85 years) in three German cities was conducted. Data were analyzed with respect to gender and age. Most of the participants (n = 298, 64.2%), regardless of their own gender, age, or place of residence did not care about the gender of the dentist. In general, the price of the treatment does not play a role in choosing the ideal dentist. Women differ significantly from men in their choice of dentist (ANOVA p < 0.001 (preference of non-smoker), ANOVA p < 0.001 (preference, that the dentist does not smell of smoke, importance of appearance (ANOVA p < 0.001) and psycho-social skills, etc.). As age increases, professional experience and psycho-social competencies are rated as important. With the increase in age, the mean value of the desired years of professional experience increases without significant differences between age groups. The importance of advanced training (ANOVA p < 0.001; Bonferoni correction: significant difference between ag 1 and ag 2 p < 0.001, and ag 1 and ag 3 p < 0.001) decreases with age. Especially for participants aged 70 to 84 years, a relationship of trust is important. Between the places of residence, statistical differences for almost all surveyed items were found (e.g., importance that the dentist speaks the patients’ native language ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig, Berlin and Mainz, and Leipzig and Mainz (each p < 0.001), dentist has a specialization ANOVA p < 0.001, Bonferoni correction: significant difference between Berlin and Leipzig and Berlin and Mainz (each p < 0.001), etc.). Dentists should be trained to develop psycho-social skills to meet the special demands of the increasing older population.

Patients’ perceptions of health care and support is a key determinant in self-efficacy and active participation in the management of chronic conditions. Nurses play a significant role in Diabetes Self-Management Education by providing clients with tools, empowerment and knowledge to self-manage their condition. The purpose of this study was to examine and describe diabetes patients’ perceptions of nurses’ support for self-management in Botswana. The aim was to improve clients’ skills in self-management and to strengthen diabetes health care management. This study was carried out at the Diabetes Clinic of Excellence, in the city of Francistown, the second largest city in Botswana. The study population comprised of Type 2 Diabetes patients registered at the Diabetes Clinic for their follow-up. All were aged 18 years and above. Three hundred and fifty-four (354) patients participated in the study. The study used a non-experimental, descriptive, quantitative design. Probability sampling method was used to recruit diabetes patients from the selected clinic. Data were were collected using a structured, researcher developed, questionnaire mostly in face-to-face interviews, a few participants completed the questionnaire. The Quantitative data analysis included descriptive and inferential statistics using SPSS (Statistical Package for Social Science Software (version 25). Spearman rho was used to determine statistical correlation between patients’ perceptions and their self-management practices. The findings showed that generally, patients’ perceptions of professional support was positive regarding most of the constructs measured. However, there were areas that showed less satisfaction with the support such as foot-care, risk control, and ability to identify signs of low and high blood sugar level and carrying of Identification Band (ID). Perceptions of nurses’ motivational behaviour showed varied responses. Patients’ self-care activities were sub-optimal and showed some variations which tended to correspond with their perceptions of professionals support. The Spearman's correlation results ranged from strong, moderate, and weak positive correlation. A few demographic variables showed some impact on self-care activities. Based on the findings, the study concludes that professional support through DSME and DSMS, self-management and patients’ perceptions of care play a significant role in diabetes management. / Health Studies / M.A. (Nursing Science)