The acute care setting is designed to provide short-term care for people who require treatment for a severe episode of acute illness and exacerbations of chronic conditions. Yet, more than half of Canadians die in acute hospitals every year. Evidence shows that nurses in acute care units feel limited in their ability to provide quality end-of-life care due to a variety of factors. As a result, the needs of patients that are dying are often overlooked, which can cause them to experience a loss of identity and control, as well as suffering at the end-of-life; a unique time in one’s life trajectory marked by significant changes in personhood. Personhood is the philosophical underpinning of the frequently used concept ‘person-centered care’ – one of the fundamental ideologies of nursing and a central concept in palliative care. An interpretive description design was used to explore the following research question: What do nurses’ stories reveal about the ways in which they engage, or fail to engage, with personhood in end-of-life care in acute care units? To appreciate the culture in which participant stories were situated, a literature review of acute care culture, end-of-life care in acute care units, and the concept of personhood was conducted. Eight nurses from an acute medical-surgical ward of a tertiary care hospital in Eastern Ontario were interviewed for this study. Thematic analysis was used to analyze the data, which elucidated tensions between participants’ ability to enact ethical end-of- life care reflective of their values and the contextual constraints of working in a culture of biomedicine. Exploring these tensions provided insight on the nuances and complexities of navigating ethical end-of-life care in an acute care setting as well as implications for nursing practice, education, and research with particular attention to promoting moral communities in acute care that value personhood and biomedicine equally.

According to World Health Organization 1.5 million people die every year due to diarrhoeal diseases. Diarrhoeal diseases may be caused by a multitude of different reasons, though WHO highlights the fact that 58% of these, are caused by lack of clean water, sanitation and hygiene. A qualitative study conducted with nurses working at different departments at a hospital in Tanzania. Semi-structured interviews were performed with ten nurses and the interviews were analysed through content analysis. The purpose was to describe nurses' experiences of working with self-care for patients suffering from gastroenteritis. Nurses experience that patients need more self-care knowledge, and the common perception is that patients are happy to receive the nurses’ advice regarding basic hygiene. It appears that the nurses find that there are no social structures that can help people maintain good health, despite their own efforts to maintain good health, there is not always prerequisite to maintain it. The community health workers are considered important for all people entitled to experienced health, for human rights and for people to get the right care when they need it. / Titel: Egenvård vid gastroenterit i Tanzania - Sjuksköterskors perspektiv. Enligt Världshälsoorganisationen dör 1,5 miljoner människor varje år på grund av diarrésjukdomar. Diarrésjukdomar kan bero på flera olika orsaker, däremot framhäver Världshälsoorganisationen att 58% av dessa orsakas av brist på rent vatten, sanitär utrustning och hygien. En kvalitativ studie utförd med sjuksköterskor som arbetar vid olika avdelningar på ett sjukhus i Tanzania. Semistrukturerade intervjuer genomfördes med 10 sjuksköterskor och intervjuerna analyserades med en kvalitativ innehållsanalys. Syftet var att beskriva sjuksköterskors upplevelse av arbetet med egenvård för patienter som är drabbade av gastroenterit. Sjuksköterskor beskriver att de upplever att patienter behöver mer kunskaper gällande egenvård, och den gemensamma uppfattningen är att patienterna är tacksamma för att få sjuksköterskans råd angående basal hygien. Det framkommer att sjuksköterskorna upplever att det saknas samhälleliga strukturer som kan hjälpa människor att kunna bibehålla en god hälsa, trots deras egna försök att upprätthålla en god hälsa så finns inte alltid förutsättningen att underhålla den. De lokala hälsoarbetarna som finns anses vara viktiga för alla människors rätt till upplevd hälsa, för mänskliga rättigheter och för att människor ska få rätt vård när de behöver det.

Bakgrund: För att skapa en så bra livskvalitet som möjligt för personen med demenssjukdom behöver vården och omsorgen ges utifrån ett personcentrerat förhållningssätt med personen i fokus istället för demenssjukdomen i sig. Levnadsberättelsen är ett betydelsefullt verktyg för att lära känna personen med demenssjukdom. Syfte: Att beskriva vårdpersonalens erfarenheter av att använda levnadsberättelsen inom särskilda boenden för personer med demenssjukdom.Metod: Kvalitativ intervjustudie med vårdpersonal på särskilda boenden för personer med demenssjukdom. Resultat: Levnadsberättelsen var viktig för att lära känna personen vilket var betydelsefullt för att planera omvårdnaden och bemöta personen på bästa sätt. Den kunde bidra till att bibehålla funktioner och vanor samt vara en hjälp vid samtal som kunde stimulera och väcka minnen. Levnadsberättelsen kunde också vara en hjälp för att förebygga och lindra BPSD. Utbildning och ett gott ledarskap sågs som framgångsfaktorer för ett väl fungerande arbete med levnadsberättelsen. Slutsats: Levnadsberättelsen är en förutsättning för att kunna bedriva personcentrerad vård inom särskilt boende för personer med demenssjukdom. Den är en hjälp för att kunna respektera personens vilja och önskemål samt för att kunna planera vården och omsorgen därefter. Utbildning av vårdpersonal samt goda chefsegenskaper har kunnat ses som framgångsfaktorer för ett lyckat arbete med levnadsberättelsen. / Background: In order to create as good quality of life as possible for the person with dementia, care need to be given based on a person-centered approach with the person in focus instead of the dementia itself. The life-story is important for getting to know the person with dementia. Purpose: To describe the health professionals experience of using the life-story in nursing homes for people with dementia. Method: Qualitative interview study with healthcare professionals experience of using life-stories in nursing homes for people with dementia. Results: The life-story was important in order to get to know the person, which was important for planning nursing and responding to the person in the best way. It could help maintain functions and habits as well as help in conversations that could stimulate and wake up memories. The life-story could also help to prevent and alleviate BPSD. Education and good leadership were seen as success factors for a well-functional work with the life-story. Conclusion: The life-story is a prerequisite for being able to conduct personal care in nursing homes for people with dementia. It is a help to respect the person's will and wishes, and by acting on the basis of the life-story, then plan the care. Education of health professionals and good management skills has been seen as success factors for successful work with the life-story.

MIRANDA, Carmen Silvia Nunes de. Ética radical e psicoterapia centrada na pessoa: uma investigação acerca da abertura à alteridade radical na relação terapêutica a partir de discursos de psicoterapeutas sobre o inusitado em sua prática clínica. 2012. 129f. – Dissertação (Mestrado) – Universidade Federal do Ceará, Programa de Pós-graduação em Psicologia, Fortaleza (CE), 2012. / Submitted by Márcia Araújo (marcia_m_bezerra@yahoo.com.br) on 2013-11-26T11:29:24Z No. of bitstreams: 1 2012-DIS-CSNMIRANDA.pdf: 1067246 bytes, checksum: 70313fc650d77dcb1a38b6929249161b (MD5) / Approved for entry into archive by Márcia Araújo(marcia_m_bezerra@yahoo.com.br) on 2013-11-26T14:17:24Z (GMT) No. of bitstreams: 1 2012-DIS-CSNMIRANDA.pdf: 1067246 bytes, checksum: 70313fc650d77dcb1a38b6929249161b (MD5) / Made available in DSpace on 2013-11-26T14:17:24Z (GMT). No. of bitstreams: 1 2012-DIS-CSNMIRANDA.pdf: 1067246 bytes, checksum: 70313fc650d77dcb1a38b6929249161b (MD5) Previous issue date: 2012 / This study constitutes of a qualitative research with a descriptive and exploratory character. It intends to contribute to a discussion of ethics in clinical practice, with reference to the radical ethics of Emmanuel Levinas and the Person-Centered Psychotherapy. The overall goal is to understand the possibilities of opening to radical alterity in the therapeutic relationship from discourses of person-centered psychotherapists about their clinical practice. Thus, we performed semi-structured interviews with five psychotherapists about the unexpected experiences in their clinical practice. The interpretation of the discourses was inspired in Derrida's hermeneutics, focusing on how the idea of deconstruction was proposed, allowing the arising of the difference in speech itself. In the deconstruction of the discourses we get closer to potential areas of openness to otherness in the therapeutic relationship, talking about the therapist vulnerability and responsibility against the unexpected. In a welcoming position the therapist would have to allow the use of his sensitivity and the intuition in their attendance, being with the client in its suffering, from the facilitative attitudes as enablers of a understanding of the client as an enigma. / Este estudo se constitui numa pesquisa de natureza qualitativa, de caráter descritivo e exploratório. Intenta contribuir para uma discussão ética no campo da prática clínica, tendo como referências a ética radical de Emannuel Lévinas e a Psicoterapia Centrada na Pessoa. O objetivo geral é compreender as possibilidades de abertura à alteridade radical na relação terapêutica a partir de discursos de psicoterapeutas centrados na pessoa sobre sua prática clínica. Para tanto, realizamos entrevistas semiestruturadas com cinco psicoterapeutas acerca de experiências com o inusitado em sua prática clínica. A interpretação dos discursos teve inspiração na hermenêutica derridiana, focalizando como proposta a ideia de desconstrução, por permitir a emergência da diferença advinda do próprio discurso. Na desconstrução dos discursos, pudemos nos aproximar de possíveis espaços de abertura à alteridade na relação terapêutica, discorrendo sobre a vulnerabilidade e responsabilidade do terapeuta frente ao inusitado. Numa postura de acolhimento, o terapeuta deveria permitir-se a utilização da sensibilidade e da intuição nos atendimentos, estando com o cliente em seu sofrimento a partir das atitudes facilitadoras como possibilitadoras de uma compreensão do cliente como enigma.

A presente dissertação tem por objeto elaborar um relato histórico da emergência da Abordagem Centrada na Pessoa (ACP) no Brasil, com especial observância ao eixo Rio-São Paulo nas décadas de 1950, 1960 e 1970. A ACP faz parte da chamada Psicologia Humanista, um movimento inicialmente organizado pelo psicólogo norte-americano Abraham Maslow (1908-1970) na década de 1950, que contou com a forte participação de Carl Rogers (1902-1987), também psicólogo norte-americano, e fundador da atualmente denominada Abordagem Centrada na Pessoa. A trajetória profissional de Rogers foi marcada pelos acontecimentos de sua época, como a crise econômica americana da década de 1930, a Segunda Guerra Mundial, a Guerra Fria e os conflitos globais por questões étnicas, religiosas e raciais. Para uma melhor compreensão do desenvolvimento da ACP, este foi narrado em conjunto com a história dos principais acontecimentos políticos, econômicos e culturais dos EUA, buscando construir uma narrativa situada historicamente. O mesmo foi feito em relação à história da ACP no Brasil, nas décadas de 1950 a 1970, ressaltando-se o objetivo dos governantes nacionais de transformar o Brasil em uma grande nação em termos culturais e educacionais, para isso se valendo da criação de diversas instituições voltadas às crianças, adolescentes e jovens adultos, para seu atendimento psicológico, educacional, orientação profissional e aprimoramento técnico. A instauração da ditadura civil-militar iniciada em 1964, o processo de regulamentação da profissão de psicólogo e a criação dos primeiros cursos de psicologia no Brasil são destaque. Registrar a história da ACP no Brasil é uma tarefa que se justifica dado o contingente de profissionais que atuam neste referencial teórico e para incentivar a pesquisa em história da psicologia. A metodologia de trabalho adotada foi a revisão bibliográfica e o relato oral instrumentalizado por entrevistas com profissionais de destacada relevância na história da ACP no Rio de Janeiro e em São Paulo. Este estudo tem como marco final a vinda de Carl Rogers e sua equipe em 1977 ao Brasil para a realização do I Encontro Brasileiro Centrado na Pessoa (Arcozelo I), o que possibilitou a reunião, o reconhecimento mútuo e a troca de experiências entre os profissionais brasileiros, fechando desta forma o período da emergência da ACP no Brasil e favoreceu uma nova fase de desenvolvimento por todo o país. / This dissertation is to develop a historical object of emergence of Person Centred Approach (PCA) in Brazil, with special observance to the Rio-São Paulo in the 1950s, 1960s and 1970. The ACP is part of the so-called humanistic psychology, a movement initially organized by the american psychologist Abraham Maslow (1908-1970) in the 1950s, which saw the participation of strong Carl Rogers (1902-1987), also American psychologist and founder of the currently named the Person Centred Approach. The professional trajectory of Rogers was marked by the events of his time, as the american economic crisis of the 1930s, Worldwide War, the Cold War and by ethnic, religious and racial global conflicts. For a better understanding the development of ACP, this was narrated in conjunction with the main political, economic and cultural history of U.S., seeking construct a narrative historically situated. The same was done to the history of ACP in Brazil, in the decades from 1950 to 1970, emphasizing the political rulers goal of transforming Brazil into a great nation in cultural and educational for it is worth creating several institutions devoted to children, adolescents and young adults for their psychological care, educational, vocational guidance and technician improvement. The establishment of civil-military dictatorship that began in 1964, the process of regulating the profession of psychologist and the creation of first courses in psychology in Brazil are highlighted. Register the history of ACP in Brazil is a task that is justified given the contingent of professionals theoretical engaged and to encourage research into the history of psychology. The methodology of work adopted was the oral report and literature review instrumentalized by interviews with prominent professionals relevance in the history of ACP in Rio de Janeiro and Sao Paulo. This study is the final milestone coming of Carl Rogers and his team in 1977 to Brazil for the realization of the First Brazilian Meeting Focused on Person (Arcozelo I), which allowed the meeting, recognition and mutual exchange of experience among Brazilian professionals,thus closing the period of the emergency and the ACP in Brazil favoring a new phase of development across the country.

A presente dissertação tem por objeto elaborar um relato histórico da emergência da Abordagem Centrada na Pessoa (ACP) no Brasil, com especial observância ao eixo Rio-São Paulo nas décadas de 1950, 1960 e 1970. A ACP faz parte da chamada Psicologia Humanista, um movimento inicialmente organizado pelo psicólogo norte-americano Abraham Maslow (1908-1970) na década de 1950, que contou com a forte participação de Carl Rogers (1902-1987), também psicólogo norte-americano, e fundador da atualmente denominada Abordagem Centrada na Pessoa. A trajetória profissional de Rogers foi marcada pelos acontecimentos de sua época, como a crise econômica americana da década de 1930, a Segunda Guerra Mundial, a Guerra Fria e os conflitos globais por questões étnicas, religiosas e raciais. Para uma melhor compreensão do desenvolvimento da ACP, este foi narrado em conjunto com a história dos principais acontecimentos políticos, econômicos e culturais dos EUA, buscando construir uma narrativa situada historicamente. O mesmo foi feito em relação à história da ACP no Brasil, nas décadas de 1950 a 1970, ressaltando-se o objetivo dos governantes nacionais de transformar o Brasil em uma grande nação em termos culturais e educacionais, para isso se valendo da criação de diversas instituições voltadas às crianças, adolescentes e jovens adultos, para seu atendimento psicológico, educacional, orientação profissional e aprimoramento técnico. A instauração da ditadura civil-militar iniciada em 1964, o processo de regulamentação da profissão de psicólogo e a criação dos primeiros cursos de psicologia no Brasil são destaque. Registrar a história da ACP no Brasil é uma tarefa que se justifica dado o contingente de profissionais que atuam neste referencial teórico e para incentivar a pesquisa em história da psicologia. A metodologia de trabalho adotada foi a revisão bibliográfica e o relato oral instrumentalizado por entrevistas com profissionais de destacada relevância na história da ACP no Rio de Janeiro e em São Paulo. Este estudo tem como marco final a vinda de Carl Rogers e sua equipe em 1977 ao Brasil para a realização do I Encontro Brasileiro Centrado na Pessoa (Arcozelo I), o que possibilitou a reunião, o reconhecimento mútuo e a troca de experiências entre os profissionais brasileiros, fechando desta forma o período da emergência da ACP no Brasil e favoreceu uma nova fase de desenvolvimento por todo o país. / This dissertation is to develop a historical object of emergence of Person Centred Approach (PCA) in Brazil, with special observance to the Rio-São Paulo in the 1950s, 1960s and 1970. The ACP is part of the so-called humanistic psychology, a movement initially organized by the american psychologist Abraham Maslow (1908-1970) in the 1950s, which saw the participation of strong Carl Rogers (1902-1987), also American psychologist and founder of the currently named the Person Centred Approach. The professional trajectory of Rogers was marked by the events of his time, as the american economic crisis of the 1930s, Worldwide War, the Cold War and by ethnic, religious and racial global conflicts. For a better understanding the development of ACP, this was narrated in conjunction with the main political, economic and cultural history of U.S., seeking construct a narrative historically situated. The same was done to the history of ACP in Brazil, in the decades from 1950 to 1970, emphasizing the political rulers goal of transforming Brazil into a great nation in cultural and educational for it is worth creating several institutions devoted to children, adolescents and young adults for their psychological care, educational, vocational guidance and technician improvement. The establishment of civil-military dictatorship that began in 1964, the process of regulating the profession of psychologist and the creation of first courses in psychology in Brazil are highlighted. Register the history of ACP in Brazil is a task that is justified given the contingent of professionals theoretical engaged and to encourage research into the history of psychology. The methodology of work adopted was the oral report and literature review instrumentalized by interviews with prominent professionals relevance in the history of ACP in Rio de Janeiro and Sao Paulo. This study is the final milestone coming of Carl Rogers and his team in 1977 to Brazil for the realization of the First Brazilian Meeting Focused on Person (Arcozelo I), which allowed the meeting, recognition and mutual exchange of experience among Brazilian professionals,thus closing the period of the emergency and the ACP in Brazil favoring a new phase of development across the country.

Background Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a neurologic disease. Between 0,1-2,6% of the world’s population is estimated to have ME/CFS. Even though a lot of people are affected there is a lack of knowledge about the disease. Its symptomatology affects the whole body and is severely debilitating. It’s at utmost importance that this subject is studied so that nurses can get an increased knowledge about ME/CFS. Aim The aim was to highlight people's experiences of living with ME/CFS. Method A literature-based study based on analysis of ten qualitative scientific studies was performed. Results Four main themes and fourteen subthemes were revealed. The main themes were about changing living conditions, lack of knowledge, changes in the body and existential changes. Changes were a major part of the result and people with ME / CFS experienced that the changes could be both positive and negative. The results showed that there is a knowledge gap regarding ME / CFS, which has serious consequences for people with the diagnosis. Conclusion The conclusion of the study was that knowledge, information and support is important for people with ME / CFS. By working person-centered, the nurse can help people with ME / CFS feel better.

Bakgrund: Demens är ett samlingsnamn för en grupp olika sjukdomar som drabbar hjärnan och dess funktioner. Terapidjur används för att lugna och förbättra livskvaliteten hos personer med demenssjukdomar. För att undvika problem som allergier, kostnader för skötsel och skador som kan uppstå vid användandet av levande djur har därför robotdjur utvecklats. Syfte: Att sammanställa aktuell forskning som beskrivit effekter och erfarenheter av robotdjur inom demensvården. Metod: En litteraturöversikt grundad på 15 vetenskapliga artiklar, publicerade mellan åren 2013 och 2018. Resultat: De flesta studierna visade på positiva effekter på social interaktion och att intervention med robotdjur kunde främja psykiskt välbefinnande och reducera ensamhet hos äldre med demenssjukdom. Resultatet från de olika studierna visade att med hjälp av ett robotdjur kunde isolering och avskärmning brytas. Inverkan på aggression och utåtagerande beteende varierade vid interaktion med robotdjur. Slutsats: Resultatet av denna studie visade att användande av robotdjur kan ha positiv effekt på social interaktion och livskvalitet. Vidare kan användande av robotdjur ha en lugnande inverkan och dämpa agitation samt reducera nedstämdhet hos äldre personer med demenssjukdom. / Background: Dementia is an umbrella term which involves a number of diseases that effects the brain and its functions. Animal assisted therapy is being used to calm and enhance the overall quality of life for people who suffers from dementia. To avoid problems like allergies and costs that involves care for the animals and for the damages that they might cause, the development of the robotic animal has begun. Aim: To compile current research, which highlights the effects and experiences of using robotic animal in the care of people who suffers from dementia. Method: Literature review based upon 15 scientific studies, published between the years 2013 and 2018. Results: Most studies pointed towards a positive effect upon social interaction and that intervention with a robotic animal could promote mentaly well-being as well as reducing loneliness in elderly people suffering from dementia. The result from the studies showed that using a robotic animal could help break isolation among the participants. The effects on aggression and extroverted behaviour when using an robotic animal showed a varying result. Conclusion: The results of this study shows that the use of robotic animals could have positive effects on social interaction and quality of life. A robotic animal could also have a calming impact on agitation and reduce depression in people who suffers from dementia.

Bakgrund: Ronden är en central punkt gällande planering och utvärdering av patientens vård. Sjukvårdspersonalen ansvarar för att personcentrera omvårdnaden där patienten sätts i fokus, och där vården byggs på respekt för patientens självbestämmande och integritet. Den traditionella ronden utförs i större del utan patientens närvaro. Bedside-rond (BR) syftar till att alla inblandade professioner rondar tillsammans med patienten vid patientens sängkant eller i ett avskilt rum för att göra patienten delaktig i sin egen vård.   Syfte: Litteraturstudiens syfte var att beskriva om BR bidrar till personcentrerad vård, delaktighet och förbättrat teamarbete, ur patienten och sjukvårdspersonalens perspektiv.   Metod: En litteraturstudie baserad på tio vetenskapliga originalartiklar. Databaser som användes i studien var PubMed, CINAHL och SveMed+. Resultatanalysen gjordes utifrån Graneheim och Lundmans (2004) kvalitativa innehållsanalys.   Resultat: Resultatet av denna studie indikerar på att patienten och sjukvårdspersonalen upplever en ökad delaktighet genom BR. Sjukvårdspersonal upplever förbättring i utfallet av vården eftersom hela sjukvårdsteamet får en helhetsbild av patienten. Flera studier styrker att samarbetet i teamet förbättrades, och att BR bidrog till en ökad förståelse för varandras yrkesroller. Oenigheter rörande rondens mål framkom, men även avsaknad av en tydlig struktur försvårade genomförandet. Kommunikationen förbättrades enligt flertal studier, vilket framförallt berodde på den direkta kommunikationen mellan berörda teamdeltagare.   Slutsats: BR skulle kunna införas som arbetsmodell istället för den traditionella ronden. Patienten blir mer delaktig i sin vård och samarbetet förbättras genom en effektivare kommunikation. Resultatet visar att patientens delaktighet ökar men för att kunna säkerhetsställa evidensen att patienten upplever att BR bidrar till en personcentrerad vård, behövs ännu mer forskning ur ett patientperspektiv. / Background: The round is a central part regarding planning and evaluating the patients’ health. Healthcare professional are responsible for the person-centered healthcare where the patient is the center of attention, and where the healthcare is based on the patient’s integrity and autonomy. The traditional round is carried out mainly without the patient’s presence. Bedside-round (BR) aims at all professions involved with the patient at the patient’s bedside or in a separate room to make the patient involved in his or her own care.   Aim: The purpose of the literature study was to describe whether BR contributes to person-centered care, participation and improved teamwork, from the patients’ and the healthcare professionals’ perspective.   Method: A literature study based on 10 scientific original articles. Databases used in the study were PubMed, CINAHL and SveMed +. The results analysis was based on Graneheim and Lundman's (2004) qualitative analysis method.   Results: The result of this study indicates that the patient and healthcare professionals experience increased participation through bedside-round. Healthcare professionals experience improvement in the outcome of care as the entire healthcare team gets an overall picture of the patient. Several studies confirm that team collaboration improved, and bedside-round contributed to an increased understanding of each other's professional roles. Disagreements concerning the goal of the round came true, but lack of a clear structure also complicated implementation. Communication improved according to several studies, mainly due to the direct communication between relevant team participants.   Conclusion: BR could be introduced as a working model instead of the traditional round. The patients becomes more involved in their care and the collaboration is improved through more effective communication. The result shows that the patient's participation increases but in order to ensure the evidence that the patient experiences that BR contributes to a person-centered care, even more research is needed from a patient perspective.

Sammanfattning Bakgrund: I Sverige har cirka 200 000 personer hjärtsvikt. Sjukdomen kan vara kronisk, komplex och innebär en livslång behandling. Det är en allvarlig sjukdom där cirka 50 % med svår hjärtsvikt dör inom ett år. Det finns inga klara riktlinjer när transition till palliativ vård för patienter med hjärtsvikt sker. Syfte: Syftet var att identifiera erfarenheter som sjuksköterskor ansåg vara av betydelse för att initiera palliativ vård för patienter med hjärtsvikt, samt vilka åtgärder som därefter vidtogs. Metod: En kvalitativ design med induktiv ansats valdes. Totalt genomfördes 15 ostrukturerade intervjuer, alla intervjuer analyserades utifrån Critical Incident Technique. Resultat: Det framkom att ett allmänt försämrat hälsotillstånd var erfarenheter som sjuksköterskan ansåg vara av betydelse för transition till palliativ vård. I resultatet framkom även att åtgärder som vidtogs ledde till att vården blev mer palliativt inriktad. Slutsats: Att identifiera patienter med hjärtsvikt som var i behov av palliativ vård var viktigt men svårt och krävde kunskap. Det finns behov av att utarbeta hjälpmedel och verktyg för att underlätta identifieringen till palliativ vård, eftersom det leder till att vården blir mer personcentrerad och behandlingsstrategin förändras. / Abstract Background: In Sweden, approximately 200,000 people have heart failure. Heart failure can be chronic, complex and involves lifelong treatment. It is a serious disease in which about 50% with severe heart failure die within a year. There are no clear guidelines when transition to palliative care for patients with heart failure occurs. Objective: The purpose was to identify experiences that nurses considered to be important for initiating palliative care for patients with heart failure, and what actions thereafter were taken. Methods: A qualitative design with inductive approach was chosen for this study. A total of 15 unstructured interviews were conducted and analyzed on the basis of the Critical Incident Technique. Results: The result was divided into two parts. It was found that a generally deteriorated health were experiences that the nurse considered to be of importance for transition to palliative care. In the results it emerged that measures that was taken led to more oriented palliative care for the patients. Conclusion: To identify patients with heart failure who were in need of palliative care was important but difficult and required knowledge. There is a need to develop aids and tools to facilitate identification for palliative care, as it causes care to be more person-centered and the treatment strategy changes.