I den  uppsatsen analyseras medias konstruktioner av flyktingar genom diskursanalys.  År 2015 kom ett ökat antal flyktingar till Sverige vilket skrevs om i media. Syftet med studien var att undersöka mediers konstruktioner och diskurser av flyktingar då dessa diskurser kan komma att påverka distriktssköterskor i möten med flyktingar. Det är av vikt att diskutera hur det kan ta sig uttryck och om det hindrar ett välfungerande möte mellan distriktssköterskor och flyktingar. Att möta flyktingar bör ske utifrån ett personcentrerat synsätt där hänsyn tas till patientens subjektiva upplevelser, det vill säga patientens berättelse om sin upplevelse. Personcentrerad vård värdesätter patientens berättelse och sätter hens upplevelse av denna i centrum. En personcentrerad vård bygger på en medveten etik kring vårdhandlingar, en god relation och ett gott förhållningssätt till patienteter. Det är nödvändigt att öka kunskap och förståelse hos vårdpersonal som möter flyktingar i sitt arbete som distriktssköterskor gör. Utgångspunkten för personcentrerad vård är att människor ska bemötas som fria och värdiga personer. Kärnan i personcentrerad vård är partnerskap mellan vårdpersonal och patienten och dess anhöriga. Partnerskap innebär gemensamt beslut om hälsoplan. Hälso- och sjukvårdslagen (1982:763) grundas utifrån en humanistisk människosyn. Detta innebär att människan har rätt att medverka och bestämma över sig. Distriktssköterskan bör ha en medvetenhet kring sin egen människosyn då de kan komma att styra ens handlingar.   Data för studien hämtades från tre olika dagstidningar; Dagens Nyheter, Sydsvenskan och Svenska Dagbladet och deras publiceringar under september, oktober och november, 2015. Artiklarna söktes fram via Mediearkivet. Totalt analyserades 4022 artiklar som innehöll begreppet flykting. I analysarbetet användes AntcConc som är ett datorprogram som gör det möjligt att sortera större mängd text.  Det framkom att flyktingar i media konstrueras som en homogen grupp vilket vi anser kan leda till en negativ påverkan på läsaren och därmed på distriktssköterskor i mötet med flyktingar. Att arbeta utifrån ett personcentrerat förhållningssätt i mötet med dessa patienter innebär att aktivt försöka se bakom den konstruerade flyktingen och istället se människan i sin helhet. Fyra diskurser utifrån 13 konstruktioner identifierades. De fyra diskurserna var: krisdiskurs, hjälplöshetsdiskurs, politisk diskurs och ekonomisk diskurs. Vården och mötet kan utifrån vad som framkommit av innehållet i diskurserna bli begränsande och negativ för patienten. Det i sin tur kan skapa enskilt lidande för patienterna i fråga men också på sikt ge en ökad belastning för vården. Det är därför viktigt att belysa ämnet så att en god och jämlik vård kan ges. / In 2015, the increased number of refugees arriving in Sweden was covered in media. Public health nurses may in their encounter with immigrants be influenced by discourses arising from medial constructions of refugees. The aim of this study was to examine mass medial constructions of and discourses about refugees, since preconceptions can influence district nurses in encounters with these persons. It is a matter of importance to discuss how this can manifest itself, in order to make public health nurses encounters with refugees as well-functioning as possible. Person-centred care has been uses as a theoretical frame of reference in this study. A qualitative approach was chosen. The methods used were corpus analysis and discourse analysis.  Data was collected from three daily newspapers: Dagens Nyheter, Sydsvenskan and Svenska Dagbladet, published in September, October and November 2015. During this time the concept refugee occurred in 4022 articles. The result shows that refugees in media are contoured as a homogenous group. Four discourses based on thirteen constructions were identified. The four discourses were a crisis discourse, a helplessness discourse, a political discourse, and an economical discourse. From the discourses, it is assumed that public health nurses reading of medial texts about refugees influences their view, and therefore their care, of refugees. Hence, it is important to illuminate the constructions of refugees in media

Primärvården ska verka som ett nav i hälso- och sjukvården i omställningen mot ett mer personcentrerat förhållnings- och arbetssätt. Forskning visar på positiva effekter,likväl är kunskapen kring vilka förutsättningar som krävs för en personcentrerad vård begränsad på organisations- och systemnivå. Övergripande definition av personcentrerad vård saknas vilket försvårar för distriktssköterskan att utarbeta konkreta arbetsrutiner. Syfte: Syftet med studien var att belysa distriktssköterskans erfarenhet kring organisatoriska möjligheter att bedriva personcentrerad vård inom primärvården. Metod: Kvalitativ intervjustudie med nio distriktssköterskor på fyra vårdcentraler genomfördes. Data analyserades genom latent kvalitativ innehållsanalys med induktiv ansats. Resultat: Temat möjligheter och begränsningar inom verksamhetens ramar omger sju underteman anpassa tiden efter patientens behov, tidsbrist som sätter gränser, strävan efter kontinuitet, journalen som ett verktyg, kommunikationsstöd, friheten att få styra sitt arbete samt specialistsjuksköterskeutbildningens betydelse. Slutsats: Anpassa besökstiden utefter patientens behov möjliggör, medan tidsbrist begränsar. Kontinuitet samt tydlig dokumentation där patientens vilja framgår underlättar personcentrerat omhändertagande. En verksamhetsledning som uppmuntrar till personcentrering samt stöd av professionell tolk verkar som möjliggörare.  Specialistsjuksköterskeutbildning anses öka kunskap och förståelse för personcentrerad vård. För att primärvården samt specialistsjuksköterskeutbildningen ska utvecklas mot ett mer personcentrerat förhållningsätt kan ytterligare forskning inom ämnet vara önskvärt. / Primary care shall act as a core within the healthcare in the transition toward a more person-centred attitude and working approach. Research shows positive effects,however the knowledge surrounding which necessities are required for person-centred care are limited on both organization and systematic level. A definition of personcentred care is missing, making it difficult for the district nurse to develop concrete working routines. Aim: The aim of the study was to illustrate the district nurses’ experiences surrounding organizational possibilities to conduct person-centred care within the primary care. Method: A qualitative interview study with nine districtnurses in four health centres was done. The data was analysed using latent qualitative content analysis with an inductive approach. Results: The theme possibilities and limitations within the health care framework embraces seven sub-themes adapt time to the patients’ needs, lack of time sets boundaries, ambition toward continuity, journal as a tool, communication support, independence to steer your own work and meaning of specialist nursing education. Conclusion: Adapt visiting time to the patients’ needs make it possible, while lack of time is limiting. Continuity and also a clear documentation regarding the patients’ want and needs facilitates person-centred care. A management that encourage person-centred care and support from a professional interpreter act as enablers. Specialist nursing education is considered to increase knowledge and understanding for person-centred care. If primary care aswell as specialist nursing education shall develop toward a more person-centred approach further research is desirable within this topic.

Background: The Public Health Agency of Canada published a strategic document recognising the elements associated with person-centred dementia care, including interactions with stakeholders and research mandates. One essential element identified was advanced therapies, containing non-pharmacological interventions, such as creative arts-based interventions. Objective: This thesis investigates the impact of creative arts-based interventions on individuals with dementia, living in residential care through a scoping review (ScR) and a mixed-methods systematic review (MMSR). Methods: The ScR surveyed the current literature base to identify which creative arts-based interventions improved the personhood, quality of life and well-being of persons with dementia (PwD); five studies were included. The MMSR explored the impact of dance interventions on the symptoms of dementia on persons with Alzheimer’s disease and related dementias, as dance was unrepresented in the ScR; three studies were included. Both reviews were narratively synthesized due to the heterogeneity in the results. Results: Each included study spoke of the impact the creative arts had on the PwD and which element(s) of their health improved. Results also showed that the creative arts were beneficial for the personhood of the PwD (ScR) and for decreasing symptoms while promoting the person (MMSR). Conclusion: We must continue to look past the condition and recognize that creativity, psychosocial needs, and creative arts are all interconnected in promoting the personhood of PwD. Creative arts-based interventions can be designed to promote the individual creativity of the person and showcase their intact abilities.

Bakgrund: Personcentrerad vård är ett globalt känt begrepp inom hälso- och sjukvård. Personcentrerad vård är ett etiskt förhållningssätt som innebär att se människans behov och önskemål och bortse från diagnos och sjukdom. Personcentrerad vård ses öka välbefinnande och hälsa hos den äldre individen. Det finns studier som beskriver hur personcentrerad vård används och dess fördelar och utmaningar inom vård- och omsorgsboenden, dock finns det få studier genomförda inom slutenvård. Syfte: Att beskriva sjuksköterskans erfarenheter av användandet av personcentrerad vård hos personer 65 år och äldre inom slutenvården samt beskriva om det fanns skillnad i skattning av användandet mellan grund- och specialistutbildad sjuksköterska, examensår och antal verksamma år i yrket. Metod: Beskrivande och jämförande enkätstudie med kvantitativ ansats. Enkätundersökningen utfördes med det validerade mätinstrumentet mP-CAT. Deltagare var 75 sjuksköterskor från olika slutenvårdsavdelningar i ett län i Mellansverige. Huvudresultat: Studiens resultat visar att sjuksköterskor erfar att de till stor del tillämpar personcentrerad vård av äldre inom slutenvård. Deltagarna beskriver att de ofta diskuterar hur de ska ge en vård som utgår från den enskildes behov och att de tar hänsyn till den enskildes önskningar i den vård som ges. Miljöfaktorer och organisatoriska strukturer var faktorer som identifierades försvåra eller hindra användningen av personcentrerad vård. Det framkommer ingen signifikant skillnad gällande tillämpningen av personcentrerad vård beroende på examensår, specialistutbildning och antal verksamma år. Slutsats: Sammanfattningsvis visar studien att en hög grad av personcentrerad vård av äldre inom slutenvård ges. För att ge medarbetare ytterligare förutsättningar att tillämpa en högre grad personcentrerad vård kan miljöfaktorer och organisatoriska strukturer utvecklas och förfinas. / Background: Person-centred care is a globally known concept in healthcare. Person-centered care is an ethical approach that means seeing the person's needs and wishes and disregarding diagnosis and illness. Person-centred care is seen to increase the well-being and health of the elderly person. There are studies that describe how person-centred care is used and its benefits and challenges within nursing homes, however, there are few studies conducted within inpatient care. Aim: To describe the nurse's experiences of the use of person-centred care for people aged 65 and older in inpatient care, and to describe whether there was a difference in the estimation of the use between basic and specialist trained nurses, year of graduation and number of active years in the profession. Method: Descriptive and comparative survey study with a quantitative approach. The survey was carried out with the validated measuring instrument mP-CAT. Participants were 75 nurses from different inpatient care departments in a county in central Sweden. Main results: The results of the study show that nurses experience that they use person-centred care for the elderly in inpatient care. The nurses describe that they often discuss how to provide care based on the individual's needs and that they take the individual's wishes into account in the care provided. Environmental factors and organizational structures were factors identified as obstacle or aggravate the use of person-centred care. There is no significant difference regarding the application of person-centred care depending on the year of graduation, specialist training and number of working years. Conclusion: The study shows a high degree of person-centred care for the elderly in inpatient care. In order to give employees additional conditions to apply a higher degree of person-centered care, environmental factors and organizational structures can be developed and refined.

Bakgrund: Bröstcancer är den vanligaste cancerformen i Sverige när det gäller cancerdiagnos hos kvinnor. Det är en livshotande diagnos som ofta behandlas med kirurgi i form av mastektomi. Mastektomi medför både psykisk och fysisk påfrestning på kvinnorna som kan ge upphov till lidande. Sjuksköterskan har ansvar för kvinnan och den personcentrerade vården där både psykiska, fysiska och sociala svårigheter ska uppmärksammas. Syfte: Syftet var att belysa kvinnors upplevelser av vårdprocessen i samband med mastektomi till följd av bröstcancer. Metod: En litteraturstudie baserad på kvalitativ forskning valdes som metod och analyserades systematiskt. Resultat: I resultatet framställs tre huvudteman med tillhörande subteman. Det första huvudtemat Ett förändrat liv med tillhörande subteman Den initiala reaktionen och Behov av stöd. Det andra huvudtemat Information och delaktighet med tillhörande subteman Individanpassad information och Delaktighet och påtryckning samt det tredje huvudtemat En förändrad livsvärld med subteman Förlust, sorg och rädsla och Acceptera det nya. Konklusion: Kvinnor som drabbas av bröstcancer, med efterföljande mastektomi, upplever känslor som kräver ökat stöd där vården behöver arbeta personcentrerat. Kvinnorna behöver känna delaktighet och trygghet i sin vård. Individanpassad information och närvarande vårdpersonal har positiv betydelse för vården av kvinnor efter mastektomi. / Background: Breast cancer is the leading cancer diagnosis amongst women in Sweden. Breast surgery referred to as mastectomy is the most common treatment for this life- threatening condition. A mastectomy is both physically and mentally challenging and as a result can lead to suffering. Nurses have a duty of care regarding individualised care and in the identification of physical, mental and social difficulties related to the diagnosis. Aim: The purpose of this study was to highlight women's experiences of the care process related to mastectomy due to breast cancer. Method: A qualitative literature review-based approach was chosen and the the literature was systematically analysed. Findings: The result identified three main themes with associated subthemes. The first main theme A changed life with associated subthemes The initial reaction and Need for support. The second main theme Information and participation with associated subthemes Individualised information and Participation and pressure, as well as the third main theme A changed lifeworld with subthemes Loss, grief and fear and Accept the new. Conclusion: Women who suffer from breast cancer, with a subsequent mastectomy, experience feelings that require increased support where care needs to be person-centred. These women need to feel participation and security in their care. Individualised information and high healthcare staff presence have a positive impact on the care of women after a mastectomy.

No / The author explains how Dementia Care Mapping can be used as powerful preventative tool for safeguarding people with dementia from abuse. Used as part of the process of developing person-centred care, the Dementia Care Mapping tool can be used to identify the preconditions of abuse within care settings.

Yes / People with dementia occupy up to one quarter of acute hospital beds. However, the quality of care delivered to this patient group is of national concern. Staff working in acute hospitals report lack of knowledge, skills and confidence in caring for people with dementia. There is limited evidence about the most effective approaches to supporting acute hospital staff to deliver more person-centred care. This study aimed to evaluate the efficacy of a specialist training programme for acute hospital staff regarding improving attitudes, satisfaction and feelings of caring efficacy, in provision of care to people with dementia. A repeated measures design, with measures completed immediately prior to commencing training (T1), after completion of Foundation level training (T2: 4–6 weeks post-baseline), and following Intermediate level training (T3: 3–4 months post-baseline). All participants received the 3.5 day Person-centred Care Training for Acute Hospitals (PCTAH) programme, comprised of two levels, Foundation (0.5 day) and Intermediate (3 days), delivered over a 3–4 months period. Staff demographics and previous exposure to dementia training were collected via a questionnaire. Staff attitudes were measured using the Approaches to Dementia Questionnaire (ADQ), satisfaction in caring for people with dementia was captured using the Staff Experiences of Working with Demented Residents questionnaire (SEWDR) and perceived caring efficacy was measured using the Caring Efficacy Scale (CES). The training programme was effective in producing a significant positive change on all three outcome measures following intermediate training compared to baseline. A significant positive effect was found on the ADQ between baseline and after completion of Foundation level training, but not for either of the other measures. Training acute hospital staff in Intermediate level person-centred dementia care is effective in producing significant improvements in attitudes towards and satisfaction in caring for people with dementia and feelings of caring efficacy. Foundation level training is effective in changing attitudes but does not seem to be sufficient to bring about change in satisfaction or caring efficacy. Keywords

Yes / This study assessed the effects of a person-centred care based psycho-educational intervention on direct care workers' communicative behaviours with people with dementia living in aged care facilities. An experimental study with a pre-posttest control group design was conducted in four aged care facilities. Two experimental facilities received an eight-weekly psycho-educational intervention aiming to develop workers’ knowledge about dementia, person-centred care competences and tools for stress management; control facilities received an education-only, with no support to deal with stress. A total of 332 morning care sessions, involving fifty-six direct care workers (female, mean age 44.72±9.02), were video-recorded before and two weeks after the intervention The frequency and duration of a list of verbal and non-verbal communicative behaviours were analysed. Within the experimental group there was a positive change from pre to post-test on the frequency of all workers’ communicative behaviours. Significant treatment effects in favour of the experimental group were obtained for the frequency of inform (p<0.01, ƞ2partial=0.09) and laugh (p<0.01, ƞ2 partial=0.18). Differences between groups emerged mainly in relation to non-verbal communicative behaviours. The findings suggest that a person-centred care based psycho-educational intervention can positively affect the direct care workers’ communicative behaviours with residents with dementia. Further research is required to determine the extent of the benefits of this approach. / Foundation for Science and Technology

Yes / This study aimed to assess the effects of a psycho-educational intervention, designed to improve direct care workers’ stress, burnout and job satisfaction and person-centered communicative behavior with people with dementia. A pretest-posttest control group design was conducted in four aged-care facilities. Two experimental facilities received a psycho-educational intervention; two control facilities received an education-only. Data were gathered from fifty three care workers at baseline, immediately and six months after the intervention, through self-administrated instruments and video-recorded morning care sessions. The experimental group showed a significant decrease in care workers’ burnout and a significant improvement in several communicative behaviors (e.g., involvement). Stress levels deteriorated at six months and no intervention effects were found for job satisfaction. The findings highlight the importance of providing care workers with both technical competences and tools for stress management as this might be associated with a reduction of their levels of exhaustion and improved communicative behaviors. / Foundation for Science and Technology

No / Introduction There is growing awareness of the importance of patient centered care (PCC) in health care. Within Radiography in the UK, elements of PCC are embedded within professional body publications and guidance documents. However, there is limited research evidence exploring whether perceptions of PCC are equivalent between those delivering (radiographers) and those experiencing (patient) care. This study aimed to address this gap by determining compatibility in perceptions of PCC between those using and those delivering radiography services. This is the first step in developing measurable indicators of PCC in diagnostic radiography. Methods A multi-method two stage approach was undertaken using survey and interview data collection techniques. Ethical approval was granted by University of Derby College of Health & Social Care Ethics committee. This paper reports Stage 1 of the study, the online, cross sectional survey. Participants were asked to indicate their level of agreement to a series of attitudinal statements using a 5-point Likert scale. Statements were paired, but not co-located to increase validity. Participants were invited to provide free text comments to supplement their responses. Stage 2 of the project is reported separately. Results Survey responses were received from all 3 participant subgroups. A minimum response rate of 30 participants per sub-group was set as a target. Response rates varied across subgroups, with only radiography managers failing to meet the expected response threshold. Wide disparity between perceptions of service users and those delivering radiography services on what constitutes high quality PCC was evident. Conclusion It is evident that there is still work required to ensure parity between expectations of service users and deliverers on what constitutes high quality PCC. Implications for practice Further work is required to identify measurable service delivery outcomes that represent PCC within radiographic practice.