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Background: The health-promoting intervention BeWell™, which includes photo-supported conversations, is intended for people with stress-related illnesses. Its focus is on improving the individual’s health and well-being by addressing what contributes to well-being from the patient’s own perspective. There is no current knowledge of the experiences of occupational therapists of using BeWell™ in primary health care. It is thus important to gain knowledge of their experiences of using this intervention as part of investigating its feasibility. Aim: To describe the occupational therapists’ experiences of photo-supported conversations about well-being (BeWell™) with patients diagnosed with stress-related illnesses. Material and methods: Six occupational therapists, working in primary health care, who had conducted the photo-supported conversations about well-being (BeWell™), were interviewed individually, and one focus group discussion was also conducted. Systematic text condensation was used as the analysis method. Results: Three main themes with two to three subgroups in each were identified; Discovering well-being through images, Enhancing patient’s own efforts towards well-being, and Contributing to one’s own well-being. Conclusions and significance: The results provide important knowledge for the continued research work with BeWell™ by investigating how the users of the intervention experienced it.

Det finns många fördelar med att amma varför amning är förstahandsvalet. Antalet kvinnor som helammar sitt nyfödda barn minskar trots att majoriteten av svenska kvinnor planerar att helamma. WHO rekommenderar att barnet helammas till sex månaders ålder. Trots rekommendationen helammas 44 procent av barnen globalt vid sex månaders ålder. Amning är en del av barnmorskans kompetensområde vilket innebär att de ska främja amning. Barnmorskor har en plikt att genomföra amningsrådgivning till samtliga kvinnor. Många kvinnor upplever initialt amningssvårigheter och för att förhindra tidigt amningsstopp är barnmorskans amningsstöd grundläggande. För att utveckla barnmorskans amningsstöd är det därför viktigt att ta reda på hur kvinnor upplever att det är att ta emot amningsrådgivning. Syftet med studien var att undersöka kvinnors upplevelse av amningsstöd och amningsinformation från barnets födelse till sex månaders ålder. Metoden som valdes var en litteraturöversikt med systematisk metod. Studier med kvalitativ och mixad metod inkluderades och endast kvalitativa data användes i resultatet. Databassökning genomfördes i Pubmed och Cinahl. Därefter kvalitetsgranskades artiklarna och endast de som uppfyllde kvalitetskraven inkluderades i resultatet. Vald data analyserades sedan genom integrerad analys. I resultatet inkluderades femton artiklar. Likheter och skillnader i hur kvinnor upplevde amningsstödet identifierades och utformade subkategorierna: kontinuitet inom vårdkedjan, tid för amningsstöd, praktiskt amningsstöd, betydelsen av bekräftelse och uppmuntran samt information och rådgivning. Utifrån subkategorierna identifierades sedan kategorierna kontinuitet och tillgänglighet samt vårdpersonalens bemötande. Slutsatsen indikerade att kvinnorna hade både positiva och negativa upplevelser av amningsrådgivning. I resultatet framkom faktorer som barnmorskor kan påverka kvinnans amningsupplevelse på egen hand genom sitt bemötande. Vidare urskildes faktorer som barnmorskorna inte, There are many benefits to breastfeeding and it is the preferred choice. Despite the majority of the Swedish women intending to exclusively breastfeed, the numbers are decreasing. WHO recommends exclusive breastfeeding until six months, however only 44 percent globally follow through. Midwives are experts in the field of breastfeeding, they should promote and provide efficient support. Many women experience initial difficulties with breastfeeding, and to prevent early disruption of breastfeeding, the midwife's support is essential. Understanding women's perception of breastfeeding advice is key to improving midwives' support. The aim of the study was to examine women's experiences of breastfeeding support and breastfeeding information from birth to six months of age. The method was a literature review using a systematic approach. Studies with qualitative and mixed methods were included, and only qualitative data were used in the results. A database search was conducted in PubMed and Cinahl. The articles were quality-reviewed, and only those meeting the quality criteria were included in the results. The selected data was then analyzed through integrated analysis. The results included fifteen articles. Similarities and differences in how women experienced breastfeeding support were identified and constituted the subcategories: continuity within the healthcare chain, time for breastfeeding support, practical breastfeeding support, the significance of affirmation and encouragement and information and guidance. Based on the subcategories, these categories where formulated: continuity and accessibility, as well as healthcare professionals' approach. The conclusion indicated that women had both positive and negative experiences of breastfeeding advice. The results revealed factors that midwives can independently influence women’s breastfeeding experience with their approach. Furthermore, factors were identified that midwives cannot change on their own, such as the content

Bakgrund: Psykisk ohälsa innebär ofta plågsamma symtom och en ökad samsjuklighet för individen. Samhället har stigmatiserat personer med psykisk ohälsa långt tillbaka i vår historia. Psykiatrin har genomgått stora förändringar under det senaste århundradet. Idag är var tredje besök i primärvården av en person som har någon form av psykisk ohälsa. Sjuksköterskor inom primärvården upplever sig inte vara tillräckligt förberedda i mötet med den psykiatriska patientgruppen. Hur bemötandet utformas är betydande för patientens välbefinnande, värdighet, delaktighet, jämlikhet och säkerhet. Bemötandet bör vara personcentrerat och utgå från patientens livsvärld. En god dialog, inkluderande god kommunikation och information, krävs för att ge ett gott bemötande. Syfte: ​Syftet var att beskriva hur patienter med psykisk ohälsa upplever bemötandet i primärvården.​ Metod: ​En litteraturöversikt av tio redan publicerade originalartiklar. Datainsamlingen av artiklar utfördes i databaserna Cinahl och PubMed. Artiklarna analyserades enligt Fribergs analysmetod. Resultat: ​I resultatet framkom tre teman; ”Att se hela människan och möta individuella behov”, ”en respektfull vårdrelation“ och ”en kamp för att få likvärdig och rättvis vård”.​ Sammanfattning: ​Ur resultatet framkom att patienter med psykisk ohälsa upplever bemötandet inom primärvården på olika sätt. Vid ett bra bemötande etablerades en god vårdrelation och patienterna upplevde sig delaktiga och bemötta med respekt och värdighet. Vissa patienter beskrev istället ett dåligt bemötande, med dålig kommunikation och en fragmenterad vård. Patienter upplevde sig även stigmatiserade av vårdpersonal.​, Background: ​Mental illness often involves painful symtoms and an increased co-morbidity for the individual. Society has stigmatized people with mental illness far back in our history​. Psychiatry has undergone major changes over the past century. Today, every third visit to primary care is by a person who has some form of mental illness. Nurses in primary care do not fell sufficently prepared when meeting patients in the psychitric patient group. How the treatment is framed is important for the patients well-being, dignity, patient participation, equality and safety. Treatment should be person-centred and based on how the persons percive her world. A good dialogue, including good communication, is required to provide a good treatment. Aim: ​The aim was to describe how patients with mental illness experience encounters in primary care.​ Method: ​A literature review of ten original articles already published. The data collection of articles was carried out in the databases Cinahl and PubMed. The articles were analyzed according to Friberg's analysis method.​ Results: ​​In the result, three themes emerged; "Seeing the whole person and meeting individual needs", "a respectful care relationship" and "a fight to get equal and fair care".​ Summary: ​The result showed that patients with mental illness experience the treatment in primary care in different ways. With good treatment, a good care relationship was established and the patients felt involved and treated with respect and dignity. Some patients instead described poor treatment, with poor communicationand fragmented care. Patients also felt stigmatized by healthcare staff.

Det finns många fördelar med att amma varför amning är förstahandsvalet. Antalet kvinnor som helammar sitt nyfödda barn minskar trots att majoriteten av svenska kvinnor planerar att helamma. WHO rekommenderar att barnet helammas till sex månaders ålder. Trots rekommendationen helammas 44 procent av barnen globalt vid sex månaders ålder. Amning är en del av barnmorskans kompetensområde vilket innebär att de ska främja amning. Barnmorskor har en plikt att genomföra amningsrådgivning till samtliga kvinnor. Många kvinnor upplever initialt amningssvårigheter och för att förhindra tidigt amningsstopp är barnmorskans amningsstöd grundläggande. För att utveckla barnmorskans amningsstöd är det därför viktigt att ta reda på hur kvinnor upplever att det är att ta emot amningsrådgivning. Syftet med studien var att undersöka kvinnors upplevelse av amningsstöd och amningsinformation från barnets födelse till sex månaders ålder. Metoden som valdes var en litteraturöversikt med systematisk metod. Studier med kvalitativ och mixad metod inkluderades och endast kvalitativa data användes i resultatet. Databassökning genomfördes i Pubmed och Cinahl. Därefter kvalitetsgranskades artiklarna och endast de som uppfyllde kvalitetskraven inkluderades i resultatet. Vald data analyserades sedan genom integrerad analys. I resultatet inkluderades femton artiklar. Likheter och skillnader i hur kvinnor upplevde amningsstödet identifierades och utformade subkategorierna: kontinuitet inom vårdkedjan, tid för amningsstöd, praktiskt amningsstöd, betydelsen av bekräftelse och uppmuntran samt information och rådgivning. Utifrån subkategorierna identifierades sedan kategorierna kontinuitet och tillgänglighet samt vårdpersonalens bemötande. Slutsatsen indikerade att kvinnorna hade både positiva och negativa upplevelser av amningsrådgivning. I resultatet framkom faktorer som barnmorskor kan påverka kvinnans amningsupplevelse på egen hand genom sitt bemötande. Vidare urskildes faktorer som barnmorskorna inte, There are many benefits to breastfeeding and it is the preferred choice. Despite the majority of the Swedish women intending to exclusively breastfeed, the numbers are decreasing. WHO recommends exclusive breastfeeding until six months, however only 44 percent globally follow through. Midwives are experts in the field of breastfeeding, they should promote and provide efficient support. Many women experience initial difficulties with breastfeeding, and to prevent early disruption of breastfeeding, the midwife's support is essential. Understanding women's perception of breastfeeding advice is key to improving midwives' support. The aim of the study was to examine women's experiences of breastfeeding support and breastfeeding information from birth to six months of age. The method was a literature review using a systematic approach. Studies with qualitative and mixed methods were included, and only qualitative data were used in the results. A database search was conducted in PubMed and Cinahl. The articles were quality-reviewed, and only those meeting the quality criteria were included in the results. The selected data was then analyzed through integrated analysis. The results included fifteen articles. Similarities and differences in how women experienced breastfeeding support were identified and constituted the subcategories: continuity within the healthcare chain, time for breastfeeding support, practical breastfeeding support, the significance of affirmation and encouragement and information and guidance. Based on the subcategories, these categories where formulated: continuity and accessibility, as well as healthcare professionals' approach. The conclusion indicated that women had both positive and negative experiences of breastfeeding advice. The results revealed factors that midwives can independently influence women’s breastfeeding experience with their approach. Furthermore, factors were identified that midwives cannot change on their own, such as the content

Bakgrund: Psykisk ohälsa innebär ofta plågsamma symtom och en ökad samsjuklighet för individen. Samhället har stigmatiserat personer med psykisk ohälsa långt tillbaka i vår historia. Psykiatrin har genomgått stora förändringar under det senaste århundradet. Idag är var tredje besök i primärvården av en person som har någon form av psykisk ohälsa. Sjuksköterskor inom primärvården upplever sig inte vara tillräckligt förberedda i mötet med den psykiatriska patientgruppen. Hur bemötandet utformas är betydande för patientens välbefinnande, värdighet, delaktighet, jämlikhet och säkerhet. Bemötandet bör vara personcentrerat och utgå från patientens livsvärld. En god dialog, inkluderande god kommunikation och information, krävs för att ge ett gott bemötande. Syfte: ​Syftet var att beskriva hur patienter med psykisk ohälsa upplever bemötandet i primärvården.​ Metod: ​En litteraturöversikt av tio redan publicerade originalartiklar. Datainsamlingen av artiklar utfördes i databaserna Cinahl och PubMed. Artiklarna analyserades enligt Fribergs analysmetod. Resultat: ​I resultatet framkom tre teman; ”Att se hela människan och möta individuella behov”, ”en respektfull vårdrelation“ och ”en kamp för att få likvärdig och rättvis vård”.​ Sammanfattning: ​Ur resultatet framkom att patienter med psykisk ohälsa upplever bemötandet inom primärvården på olika sätt. Vid ett bra bemötande etablerades en god vårdrelation och patienterna upplevde sig delaktiga och bemötta med respekt och värdighet. Vissa patienter beskrev istället ett dåligt bemötande, med dålig kommunikation och en fragmenterad vård. Patienter upplevde sig även stigmatiserade av vårdpersonal.​, Background: ​Mental illness often involves painful symtoms and an increased co-morbidity for the individual. Society has stigmatized people with mental illness far back in our history​. Psychiatry has undergone major changes over the past century. Today, every third visit to primary care is by a person who has some form of mental illness. Nurses in primary care do not fell sufficently prepared when meeting patients in the psychitric patient group. How the treatment is framed is important for the patients well-being, dignity, patient participation, equality and safety. Treatment should be person-centred and based on how the persons percive her world. A good dialogue, including good communication, is required to provide a good treatment. Aim: ​The aim was to describe how patients with mental illness experience encounters in primary care.​ Method: ​A literature review of ten original articles already published. The data collection of articles was carried out in the databases Cinahl and PubMed. The articles were analyzed according to Friberg's analysis method.​ Results: ​​In the result, three themes emerged; "Seeing the whole person and meeting individual needs", "a respectful care relationship" and "a fight to get equal and fair care".​ Summary: ​The result showed that patients with mental illness experience the treatment in primary care in different ways. With good treatment, a good care relationship was established and the patients felt involved and treated with respect and dignity. Some patients instead described poor treatment, with poor communicationand fragmented care. Patients also felt stigmatized by healthcare staff.

Background: There is growing evidence that conversations between healthcare professionals and patients with serious illness can improve the quality of end-of-life cancer care. Yet, there is lack of insight into how different healthcare professions collaborate to deliver serious illness communication, as well as patients’ and caregivers’ perceptions of this collaboration between the nurse and physician. This study explores the interdisciplinary collaboration between nurses and physicians in serious illness conversations with patients diagnosed with multiple myeloma and their caregivers. Methods: Eleven dyadic interviews were conducted with 22 patients and caregivers, and two focus group interviews involving four nurses and the other with four physicians. Data analysis and reporting were conducted using reflexive thematic analysis within phenomenological epistemology. Results: The interdisciplinary collaboration was characterized by three main themes: (1) Importance of relationships, (2) Complementary perspectives, and (3) The common goal. Conclusion: This study highlights the importance of interdisciplinarity in serious illness conversations as it enhances the use of existential and descriptive language when addressing medical, holistic, and existential issues. The use of broader language also reflects that interdisciplinary interaction strengthens the expertise of each professional involved in patient care. Through interdisciplinary collaboration, the preferences, hopes, and values of the patient and caregiver can be integrated into the treatment plan, which is key in providing the delivery of optimal care. To promote cohesive and coordinated collaboration, organizational changes are recommended such as supporting continuity in patient–healthcare professional relationships, providing interdisciplinary training, and allocating time for pre-conversation preparation and post-conversation debriefing.

The tacit practical knowledge of psychologists and support staff to foster a real connection between support staff and people with intellectual disabilities and challenging behaviour was explored. Therefore, six dyads comprising individuals with intellectual disabilities and challenging behaviour and their support staff were video recorded during joint engagement in an activity. To tap into the implicit knowledge of professionals about when staff have ‘a real connection’ with a person with an intellectual disability, 10 psychologists and 10 support staff were asked to pinpoint these moments in the pre-recorded video compilation. They also shared their interpretations about what they considered to be a real connection. The results displayed that participants designated real connections as occurring when they noticed concrete interactions taking place. Based on thematic analysis of the data, four themes were identified that encapsulated what professionals deemed to be a real connection. In conclusion: joint engagement in an activity appears to be a context that fosters opportunities for real connection. Furthermore, support staff should adopt a sensitive attitude and create a safe atmosphere, to establish real connections. Participants designated real connections as occurring when they noticed concrete interactions taking place. Based on thematic analysis of the data, four themes were identified that encapsulated what professionals deemed to be a real connection.

Background: There is growing evidence that conversations between healthcare professionals and patients with serious illness can improve the quality of end-of-life cancer care. Yet, there is lack of insight into how different healthcare professions collaborate to deliver serious illness communication, as well as patients’ and caregivers’ perceptions of this collaboration between the nurse and physician. This study explores the interdisciplinary collaboration between nurses and physicians in serious illness conversations with patients diagnosed with multiple myeloma and their caregivers. Methods: Eleven dyadic interviews were conducted with 22 patients and caregivers, and two focus group interviews involving four nurses and the other with four physicians. Data analysis and reporting were conducted using reflexive thematic analysis within phenomenological epistemology. Results: The interdisciplinary collaboration was characterized by three main themes: (1) Importance of relationships, (2) Complementary perspectives, and (3) The common goal. Conclusion: This study highlights the importance of interdisciplinarity in serious illness conversations as it enhances the use of existential and descriptive language when addressing medical, holistic, and existential issues. The use of broader language also reflects that interdisciplinary interaction strengthens the expertise of each professional involved in patient care. Through interdisciplinary collaboration, the preferences, hopes, and values of the patient and caregiver can be integrated into the treatment plan, which is key in providing the delivery of optimal care. To promote cohesive and coordinated collaboration, organizational changes are recommended such as supporting continuity in patient–healthcare professional relationships, providing interdisciplinary training, and allocating time for pre-conversation preparation and post-conversation debriefing.

BackgroundEfforts to reduce opioid overdose fatalities have resulted in tapering (i.e., reducing or discontinuing) opioid prescriptions despite a limited understanding of patients' experiences.ObjectiveTo explore patients' perspectives on opioid taper experiences to ultimately improve taper processes and outcomes.DesignQualitative study.ParticipantsPatients on long-term opioid therapy for chronic pain who had undergone a reduction of opioid daily prescribed dosage of ≥50% in the past 2 years in two distinct medical systems and regions.ApproachFrom 2019 to 2020, we conducted semi-structured interviews that were audio-recorded, transcribed, systematically coded, and analyzed to summarize the content and identify key themes regarding taper experiences overall and with particular attention to patient-provider relationships and provider communication during tapers.Key resultsParticipants (n=41) had lived with chronic pain for an average of 17.4 years (range, 3-36 years) and described generally adverse experiences with opioid tapers, the initiation of which was not always adequately justified or explained to them. Consequences of tapers ranged from minor to substantial and included withdrawal, mobility issues, emotional distress, exacerbated mental health symptoms, and feelings of social stigmatization for which adequate supports were typically unavailable. Narratives highlighted the consequential role of patient-provider relationships throughout taper experiences, with most participants describing significant interpersonal challenges including poor provider communication and limited patient engagement in decision making. A few participants identified qualities of providers, relationships, and communication that fostered more positive taper experiences and outcomes.ConclusionsFrom patients' perspectives, opioid tapers can produce significant physical, emotional, and social consequences, sometimes reducing trust and engagement in healthcare. Patient-provider relationships

Bakgrund: Transpersoner har betraktats som en marginaliserad och utsatt grupp i samhället. Det har framkommit exempel på diskriminering och stigmatisering från samhällsstrukturer och normer. Både från omgivningen och internaliserat. Vidare har det visat sig leda till att transpersoner löper ökad risk för psykisk ohälsa och missbruk utöver deras transspecifika omvårdnadsbehov. Syfte: Litteraturstudien beskrev transpersoners erfarenheter av bemötandet i hälso- och sjukvården. Metod: Studien var en beskrivande litteraturstudie. Huvudresultat: De mest framträdande fynden i resultatet innefattade kommunikationen mellan vårdgivare och transpersoner. Negativa upplevelser av vårdmöten karaktäriserades av när transpersonerna blev bemötta respektlöst utifrån affirmerat pronomen och identitet. Negativa upplevelser präglades även av vårdpersonalens egna värderingar, där transfobi beskrevs, eller en skillnad i kunskap mellan vårdgivare och transpersonen gällande transhälsa. Resultatet av respektlösheten kunde i sin tur leda till att vården fick minskad kvalité eller uteblev. Goda upplevelser i möten präglades av respekt för individen, kunskap om transhälsa samt acceptans och förståelse. Slutsats: Hur transpersoner bemötts inom hälso- och sjukvården har präglats av positiva och negativa erfarenheter. Att vårdpersonalen haft transhälsorelevanta kunskaper och förmåga att möta transpersonen med ett holistiskt och personcentrerat förhållningssätt har potential att kunna bidra till att öka hälsa och förebygga ohälsa., Background: Transgender people have been seen as a marginalized and vulnerable group in society. Examples of discrimination and stigmatization have emerged from societal structures and norms. Both from the environment and internalized. Furthermore, it has been shown that transgender people are at increased risk of mental illness and substance abuse in addition to their trans-specific nursing needs. Aim: The literature study described transgender persons experiences of professional-patient relations in health care. Method: The study was a descriptive literature review. Main results: The most prominent findings included communication between caregivers and transgender people. Negative experiences of care meetings were characterized by when the transgender people were treated disrespectfully by not referring to their affirmed pronoun and identity. Negative experiences were also characterized by the care staff's own values, where transphobia was described, as well as a difference in knowledge between caregivers and the transperson regarding transhealth. The result of this disrespect could in turn lead to quality of care being reduced or care being not available. Good experiences in meetings were characterized by respect for the individual, knowledge of transhealth as well as acceptance and understanding. Conclusion: How transgender people have been treated in health care has been characterized by positive and negative experiences. The fact that healthcare staff have had transhealth-relevant knowledge and the ability to meet the transgender person with a holistic and person-centered approach has the potential to contribute to increasing health and preventing ill health.

Bakgrund Sexuellt våld är ett utbrett folkhälsoproblem som drabbar kvinnor över hela världen. Det sexuella våldet kan komma att påverka kvinnors fysiska och psykiska hälsa livet ut. I vården sker möten ständigt och för hälso- och sjukvårdspersonal ingår det i den professionella hållningen att oavsett omständigheter främja ett gott bemötande gentemot patienten. Hälso- och sjukvården har ett stort ansvar i mötet med sexuellt våldsutsatta kvinnor, då mötet kan komma att påverka kvinnans möjligheter till stöd, återhämtning och tillit till vården. Syfte Syftet med studien var att beskriva sexuellt våldsutsatta kvinnors upplevelser och erfarenheter av mötet med hälso- och sjukvården. Metod En icke-systematisk litteraturöversikt genomfördes och resulterade i 15 vetenskapliga artiklar av kvalitativ och kvantitativ design. Artiklarna togs fram med hjälp av databaserna CINAHL och PubMed samt via manuella sökningar. De valda artiklarna kvalitetsgranskades med hjälp av Sophiahemmet Högskolas bedömningsunderlag och analyserades med hjälp av integrerad analys. Resultat Resultatet visade att positiva upplevelser och erfarenheter präglades av god kommunikation som genomsyrades av empati, respektfullhet och lyhördhet. I sin tur präglades negativa upplevelser och erfarenheter av okunskap hos personalen, dömande attityder och väntetid. Likaså lyftes lugn och avskild vårdmiljö, möjlighet att välja personal samt tillräcklig uppföljning och stöd som faktorer som saknades i mötet. Slutsats Sexuellt våldsutsatta kvinnor hade både positiva och negativa upplevelser och erfarenheter av hälso- och sjukvården och flera aspekter saknades i mötet. Med hjälp av ökad kunskap om kvinnors utsatthet och förbättrad förståelse för sexuellt våldsutsatta kvinnors upplevelser och erfarenheter kan nya riktlinjer kring omhändertagandet utformas och därmed förbättra vården och lindra lidande., Background Sexual violence is a widespread public health problem affecting women around the world. Sexual violence may affect women's physical and mental health throughout life. In healthcare encounters occur regularly and for personnel within healthcare, it is part of the professional attitude to promote a rewarding treatment to the patient, regardless of the circumstances. Health services have a great responsibility in the encounter with sexually abused women, as the encounter may affect the woman's opportunities for support, recovery and trust for healthcare. Aim The purpose of this study was to describe sexually abused women’s experience of their encounter with healthcare. Method A non-systematic literature review was conducted and resulted in 15 scientific articles of both qualitative and quantitative design. The articles were retrieved from the databases CINAHL, PubMed and through manual searches. The included articles were reviewed using Sophiahemmet University’s template for quality assessment and the results were analyzed with a thematic analysis approach. Results The results showed that positive experiences were characterized by good communication based on empathy, respect and sensitivity. In contrast, negative experiences were characterized by ignorance among the staff, judgmental attitudes and waiting time. Likewise, a calm and secluded care environment, the freedom to choose staff and sufficient support and follow-up were highlighted as factors that were lacking in the encounter. Conclusions Sexually abused women had both positive and negative experiences of health care, and several aspects were missing in the encounter. With the help of increased knowledge about women's vulnerability and an improved understanding of sexually abused women experiences, new guidelines regarding care can be developed, and thereby improve care and alleviate suffering.

Evidence for the nocebo effect, a phenomenon characterised by suboptimal treatment efficacy, worsening of symptoms, or the occurrence of adverse events caused by an individual's negative treatment expectations, is growing across a multitude of medical fields. Within dentistry, little attention has been paid to patients' negative expectations, despite a number of studies supporting the influence of related factors, such as dental fear and anxiety, on the severity of peri- and post-operative dental pain. Only recently, a small number of commentaries and letters have emerged, urging dentists to recognise the possible existence of nocebo effects in dentistry and its implications for patient care. The present review summarises essential evidence of the nocebo phenomenon especially in relation to pain and drug administration. Subsequently, an overview of the current evidence of the nocebo phenomenon in the dental field is presented. Finally, based on the general knowledge of the nocebo effect, the review indicates fruitful arrays of research into the nocebo effect in dentistry.

Bakgrund: Transpersoner har betraktats som en marginaliserad och utsatt grupp i samhället. Det har framkommit exempel på diskriminering och stigmatisering från samhällsstrukturer och normer. Både från omgivningen och internaliserat. Vidare har det visat sig leda till att transpersoner löper ökad risk för psykisk ohälsa och missbruk utöver deras transspecifika omvårdnadsbehov. Syfte: Litteraturstudien beskrev transpersoners erfarenheter av bemötandet i hälso- och sjukvården. Metod: Studien var en beskrivande litteraturstudie. Huvudresultat: De mest framträdande fynden i resultatet innefattade kommunikationen mellan vårdgivare och transpersoner. Negativa upplevelser av vårdmöten karaktäriserades av när transpersonerna blev bemötta respektlöst utifrån affirmerat pronomen och identitet. Negativa upplevelser präglades även av vårdpersonalens egna värderingar, där transfobi beskrevs, eller en skillnad i kunskap mellan vårdgivare och transpersonen gällande transhälsa. Resultatet av respektlösheten kunde i sin tur leda till att vården fick minskad kvalité eller uteblev. Goda upplevelser i möten präglades av respekt för individen, kunskap om transhälsa samt acceptans och förståelse. Slutsats: Hur transpersoner bemötts inom hälso- och sjukvården har präglats av positiva och negativa erfarenheter. Att vårdpersonalen haft transhälsorelevanta kunskaper och förmåga att möta transpersonen med ett holistiskt och personcentrerat förhållningssätt har potential att kunna bidra till att öka hälsa och förebygga ohälsa., Background: Transgender people have been seen as a marginalized and vulnerable group in society. Examples of discrimination and stigmatization have emerged from societal structures and norms. Both from the environment and internalized. Furthermore, it has been shown that transgender people are at increased risk of mental illness and substance abuse in addition to their trans-specific nursing needs. Aim: The literature study described transgender persons experiences of professional-patient relations in health care. Method: The study was a descriptive literature review. Main results: The most prominent findings included communication between caregivers and transgender people. Negative experiences of care meetings were characterized by when the transgender people were treated disrespectfully by not referring to their affirmed pronoun and identity. Negative experiences were also characterized by the care staff's own values, where transphobia was described, as well as a difference in knowledge between caregivers and the transperson regarding transhealth. The result of this disrespect could in turn lead to quality of care being reduced or care being not available. Good experiences in meetings were characterized by respect for the individual, knowledge of transhealth as well as acceptance and understanding. Conclusion: How transgender people have been treated in health care has been characterized by positive and negative experiences. The fact that healthcare staff have had transhealth-relevant knowledge and the ability to meet the transgender person with a holistic and person-centered approach has the potential to contribute to increasing health and preventing ill health.

Bakgrund Sexuellt våld är ett utbrett folkhälsoproblem som drabbar kvinnor över hela världen. Det sexuella våldet kan komma att påverka kvinnors fysiska och psykiska hälsa livet ut. I vården sker möten ständigt och för hälso- och sjukvårdspersonal ingår det i den professionella hållningen att oavsett omständigheter främja ett gott bemötande gentemot patienten. Hälso- och sjukvården har ett stort ansvar i mötet med sexuellt våldsutsatta kvinnor, då mötet kan komma att påverka kvinnans möjligheter till stöd, återhämtning och tillit till vården. Syfte Syftet med studien var att beskriva sexuellt våldsutsatta kvinnors upplevelser och erfarenheter av mötet med hälso- och sjukvården. Metod En icke-systematisk litteraturöversikt genomfördes och resulterade i 15 vetenskapliga artiklar av kvalitativ och kvantitativ design. Artiklarna togs fram med hjälp av databaserna CINAHL och PubMed samt via manuella sökningar. De valda artiklarna kvalitetsgranskades med hjälp av Sophiahemmet Högskolas bedömningsunderlag och analyserades med hjälp av integrerad analys. Resultat Resultatet visade att positiva upplevelser och erfarenheter präglades av god kommunikation som genomsyrades av empati, respektfullhet och lyhördhet. I sin tur präglades negativa upplevelser och erfarenheter av okunskap hos personalen, dömande attityder och väntetid. Likaså lyftes lugn och avskild vårdmiljö, möjlighet att välja personal samt tillräcklig uppföljning och stöd som faktorer som saknades i mötet. Slutsats Sexuellt våldsutsatta kvinnor hade både positiva och negativa upplevelser och erfarenheter av hälso- och sjukvården och flera aspekter saknades i mötet. Med hjälp av ökad kunskap om kvinnors utsatthet och förbättrad förståelse för sexuellt våldsutsatta kvinnors upplevelser och erfarenheter kan nya riktlinjer kring omhändertagandet utformas och därmed förbättra vården och lindra lidande., Background Sexual violence is a widespread public health problem affecting women around the world. Sexual violence may affect women's physical and mental health throughout life. In healthcare encounters occur regularly and for personnel within healthcare, it is part of the professional attitude to promote a rewarding treatment to the patient, regardless of the circumstances. Health services have a great responsibility in the encounter with sexually abused women, as the encounter may affect the woman's opportunities for support, recovery and trust for healthcare. Aim The purpose of this study was to describe sexually abused women’s experience of their encounter with healthcare. Method A non-systematic literature review was conducted and resulted in 15 scientific articles of both qualitative and quantitative design. The articles were retrieved from the databases CINAHL, PubMed and through manual searches. The included articles were reviewed using Sophiahemmet University’s template for quality assessment and the results were analyzed with a thematic analysis approach. Results The results showed that positive experiences were characterized by good communication based on empathy, respect and sensitivity. In contrast, negative experiences were characterized by ignorance among the staff, judgmental attitudes and waiting time. Likewise, a calm and secluded care environment, the freedom to choose staff and sufficient support and follow-up were highlighted as factors that were lacking in the encounter. Conclusions Sexually abused women had both positive and negative experiences of health care, and several aspects were missing in the encounter. With the help of increased knowledge about women's vulnerability and an improved understanding of sexually abused women experiences, new guidelines regarding care can be developed, and thereby improve care and alleviate suffering.

Bakgrund: Egentlig depression är ett växande folkhälsoproblem i Sverige. Sjukdomen drabbar samhället, vården och individen. En utmaning för personer med egentlig depression är att hålla en hälsosam struktur och regelbundenhet i sin vardag. Det leder till svårigheter med egenvård, att följa medicinska ordinationer och hälsoråd. Egenvård är handlingar som individen utför för att förbättra sin hälsa. Det är en viktig del i behandlingen av egentlig depression som kan lindra symtom och påskynda tillfrisknande. Syfte: Att undersöka hur relationen mellan patient och vårdpersonal påverkar motivationen till egenvård hos patienter med egentlig depression. Metod: En litteraturstudie av 13 kvalitativa vetenskapliga originalartiklar. Sökningen omfattade artiklar publicerade mellan 2002 och 2022 i databaserna PubMed, CINAHL och PsycInfo. En manifest litteraturanalys användes för att identifiera faktorer som påverkat patienternas motivation till egenvård. Materialet kondenserades till meningsbärande enheter varefter de kategoriserades. Resultat: Litteraturstudien identifierade två kategorier av avgörande delar i bemötandet: specifika ageranden och förhållningssätt. I kategorin specifika åtgärder inkluderas de enskilda handlingarna involvering, informerande, att ställa specifika frågor och att ge patienten tillräcklig tid. De är alla faktorer med en positiv effekt på patientens självbild, motivation och egenvårdsförmåga. Kategorin förhållningssätt innehåller subkategorierna tillit, förståelse, uppmuntran och kontinuitet. De beskriver delar i bemötandet som sjukvårdspersonalen behöver bemästra för att ge patienten goda förutsättningar att sköta sin egenvård. Slutsats: För att ge patienter med egentlig depression goda förutsättningar för egenvård måste vårdpersonalen tillgodose patientens behov av både specifika ageranden och förhållningssätt som ökar motivationen., Background: Major depressive disorder (MDD) is a growing public health concern in Sweden. The illness affects the society, healthcare system and the individual. One challenge for people with MDD is to maintain a healthy structure and regularity in everyday life. This leads to difficulties in self-care, following ordinations and medical advice. Self-care are actions performed by the individual to improve health. It is an important part of the treatment of MDD which can ease symptoms and expedite recovery. Aim: To investigate how the relation between patient and health professionals affect motivation related to self-care concerning patients with MDD. Method: A literature study of 13 qualitative original articles published between 2002 and 2022 in the databases PubMed, CINAHL and PsycInfo. A manifest literature analysis was employed to identify factors affecting the motivation to self-care. The material was condensed into meaningful units and then categorized. Results: The study identified two categories crucial to the approach: specific acts and disposition. The specific acts category includes involvement, information, asking specific questions and giving the patient enough time. All of them are factors with a positive effect on patients’ self-image, motivation and it strengthened capabilities for self-care. The category disposition included the subcategories trust, understanding, encouragement and continuity. They describe parts in the approach that healthcare professionals need to master to give good prerequisites for patients to handle their self-care. Conclusion: To provide patients with MDD optimal conditions for self-care, health professionals need to fulfil the patient’s requirements of both specific acts and disposition at every healthcare contact.

BackgroundEfforts to reduce opioid overdose fatalities have resulted in tapering (i.e., reducing or discontinuing) opioid prescriptions despite a limited understanding of patients' experiences.ObjectiveTo explore patients' perspectives on opioid taper experiences to ultimately improve taper processes and outcomes.DesignQualitative study.ParticipantsPatients on long-term opioid therapy for chronic pain who had undergone a reduction of opioid daily prescribed dosage of ≥50% in the past 2 years in two distinct medical systems and regions.ApproachFrom 2019 to 2020, we conducted semi-structured interviews that were audio-recorded, transcribed, systematically coded, and analyzed to summarize the content and identify key themes regarding taper experiences overall and with particular attention to patient-provider relationships and provider communication during tapers.Key resultsParticipants (n=41) had lived with chronic pain for an average of 17.4 years (range, 3-36 years) and described generally adverse experiences with opioid tapers, the initiation of which was not always adequately justified or explained to them. Consequences of tapers ranged from minor to substantial and included withdrawal, mobility issues, emotional distress, exacerbated mental health symptoms, and feelings of social stigmatization for which adequate supports were typically unavailable. Narratives highlighted the consequential role of patient-provider relationships throughout taper experiences, with most participants describing significant interpersonal challenges including poor provider communication and limited patient engagement in decision making. A few participants identified qualities of providers, relationships, and communication that fostered more positive taper experiences and outcomes.ConclusionsFrom patients' perspectives, opioid tapers can produce significant physical, emotional, and social consequences, sometimes reducing trust and engagement in healthcare. Patient-provider relationships

Background: Evidence for the nocebo effect, a phenomenon characterised by suboptimal treatment efficacy, worsening of symptoms, or the occurrence of adverse events caused by an individual’s negative treatment expectations, is growing across a multitude of medical fields. However, little attention has been paid to patients’ negative expectations and the nocebo effect within dentistry. Aim: This review summarises essential evidence of the nocebo phenomenon especially in relation to pain and drug administration. Subsequently, an overview of the current evidence of the nocebo phenomenon in the dental field is presented. Methods: A PubMed search was performed using keywords related to “nocebo,” “placebo,” “expectations,” and “dentistry.” In addition to the articles selected from the search, placebo/nocebo researchers and dental researchers added important references from their respective fields. Results: Although research on the nocebo effect in dentistry is limited, available current evidence suggests that the factors, which is related to the nocebo effect are likely to play a role in dental practice. Conclusion: Preliminary evidence from the review warrants further investigation into the nocebo effect in dentistry. Finally, based on the general knowledge of the nocebo effect, the review indicates fruitful arrays of research into the nocebo effect in dentistry.

Bakgrund: Egentlig depression är ett växande folkhälsoproblem i Sverige. Sjukdomen drabbar samhället, vården och individen. En utmaning för personer med egentlig depression är att hålla en hälsosam struktur och regelbundenhet i sin vardag. Det leder till svårigheter med egenvård, att följa medicinska ordinationer och hälsoråd. Egenvård är handlingar som individen utför för att förbättra sin hälsa. Det är en viktig del i behandlingen av egentlig depression som kan lindra symtom och påskynda tillfrisknande. Syfte: Att undersöka hur relationen mellan patient och vårdpersonal påverkar motivationen till egenvård hos patienter med egentlig depression. Metod: En litteraturstudie av 13 kvalitativa vetenskapliga originalartiklar. Sökningen omfattade artiklar publicerade mellan 2002 och 2022 i databaserna PubMed, CINAHL och PsycInfo. En manifest litteraturanalys användes för att identifiera faktorer som påverkat patienternas motivation till egenvård. Materialet kondenserades till meningsbärande enheter varefter de kategoriserades. Resultat: Litteraturstudien identifierade två kategorier av avgörande delar i bemötandet: specifika ageranden och förhållningssätt. I kategorin specifika åtgärder inkluderas de enskilda handlingarna involvering, informerande, att ställa specifika frågor och att ge patienten tillräcklig tid. De är alla faktorer med en positiv effekt på patientens självbild, motivation och egenvårdsförmåga. Kategorin förhållningssätt innehåller subkategorierna tillit, förståelse, uppmuntran och kontinuitet. De beskriver delar i bemötandet som sjukvårdspersonalen behöver bemästra för att ge patienten goda förutsättningar att sköta sin egenvård. Slutsats: För att ge patienter med egentlig depression goda förutsättningar för egenvård måste vårdpersonalen tillgodose patientens behov av både specifika ageranden och förhållningssätt som ökar motivationen., Background: Major depressive disorder (MDD) is a growing public health concern in Sweden. The illness affects the society, healthcare system and the individual. One challenge for people with MDD is to maintain a healthy structure and regularity in everyday life. This leads to difficulties in self-care, following ordinations and medical advice. Self-care are actions performed by the individual to improve health. It is an important part of the treatment of MDD which can ease symptoms and expedite recovery. Aim: To investigate how the relation between patient and health professionals affect motivation related to self-care concerning patients with MDD. Method: A literature study of 13 qualitative original articles published between 2002 and 2022 in the databases PubMed, CINAHL and PsycInfo. A manifest literature analysis was employed to identify factors affecting the motivation to self-care. The material was condensed into meaningful units and then categorized. Results: The study identified two categories crucial to the approach: specific acts and disposition. The specific acts category includes involvement, information, asking specific questions and giving the patient enough time. All of them are factors with a positive effect on patients’ self-image, motivation and it strengthened capabilities for self-care. The category disposition included the subcategories trust, understanding, encouragement and continuity. They describe parts in the approach that healthcare professionals need to master to give good prerequisites for patients to handle their self-care. Conclusion: To provide patients with MDD optimal conditions for self-care, health professionals need to fulfil the patient’s requirements of both specific acts and disposition at every healthcare contact.

Community housing services adopt care models such as rehabilitation, recovery-oriented care and person-centered planning to improve the quality of life of service users with an intellectual or psychiatric disability. However, the way these care models are implemented and practiced can negatively impact service users’ experience with the service as their complex needs go unmet. In this paper, we conceptualize these experiences through developing the counternarrative of burdens of support. For this we draw on burden of treatment theory. We conducted ethnographic fieldwork in a community service organization in the Netherlands. This included participant observation (84 h), interviews with service users (n = 20), experts-by-experience (n = 8), family members (n = 10) and photovoice workshops. Our analysis identifies four burdens of support: burden of self-determination; re-identification; responsibilisation and re-placement. The results show that burden of support is very much a relational concept: through their support, professionals can aggravate or alleviate burden.

The present study evaluated affective, relational, and emotional behaviors associated with symptom reduction and clinical outcomes in psychotherapy. It relied on 36 therapist-client dyads and assessed client symptoms using the Counseling Center Assessment of Psychological Symptoms (CCAPS-34) as the progress monitoring and outcome assessment tool used by university counseling centers before every psychotherapy session. The research examined the first administration scores and the last administration scores of the CCCAPS to determine the level of clinical improvement. The researcher used the revised Specific Affect Coding System (SPAFF) to code the therapist and client interactions throughout the entire first psychotherapy session. The results revealed significant effects between the affective exchanges in the therapeutic relationship of both the therapist and the client on clinical outcomes. The researcher employed multivariate statistics with appropriate univariate follow-up procedures to determine group differences between SPAFF codes on the symptom outcome groups and CCAPS subscales. The researcher also used path analysis following Actor Partner Independence Model assumptions (Kenny et al., 2020) to examine the interdependent emotional dynamics between therapist and client on client symptom outcomes, and these revealed significant effects between SPAFF scores observed in the first session on client outcomes at the termination of therapy. The results add to the current research literature, highlighting patterns of significant affective behaviors in the first psychotherapy session on client outcomes. The study reveals that the first session cannot be minimized, as it has a greater impact on client outcomes than previously believed. The conclusion also outlines the study’s implications for clinical practice, graduate training, and research., 2022, Includes bibliography., Degree granted: Dissertation (PhD)--Florida Atlantic University, 2022., Collection: FAU Electronic Theses and Dissertations Collection

Evidence for the nocebo effect, a phenomenon characterised by suboptimal treatment efficacy, worsening of symptoms, or the occurrence of adverse events caused by an individual's negative treatment expectations, is growing across a multitude of medical fields. Within dentistry, little attention has been paid to patients' negative expectations, despite a number of studies supporting the influence of related factors, such as dental fear and anxiety, on the severity of peri- and post-operative dental pain. Only recently, a small number of commentaries and letters have emerged, urging dentists to recognise the possible existence of nocebo effects in dentistry and its implications for patient care. The present review summarises essential evidence of the nocebo phenomenon especially in relation to pain and drug administration. Subsequently, an overview of the current evidence of the nocebo phenomenon in the dental field is presented. Finally, based on the general knowledge of the nocebo effect, the review indicates fruitful arrays of research into the nocebo effect in dentistry.

BACKGROUND: More than 1 million Americans receive primary care from federal homeless health care programs yearly. Vulnerabilities that can make care challenging include pain, addiction, psychological distress, and a lack of shelter. Research on the effectiveness of tailoring services for this population is limited. OBJECTIVE: The aim was to examine whether homeless-tailored primary care programs offer a superior patient experience compared with nontailored (mainstream) programs overall, and for highly vulnerable patients. RESEARCH DESIGN: National patient survey comparing 26 US Department of Veterans Affairs (VA) Medical Centers homeless-tailored primary care (H-PACTs) to mainstream primary care (mainstream PACTs) at the same locations. PARTICIPANTS: A total of 5766 homeless-experienced veterans. MEASURES: Primary care experience on 4 scales: Patient-Clinician Relationship, Cooperation, Accessibility/Coordination, and Homeless-Specific Needs. Mean scores (range: 1-4) were calculated and dichotomized as unfavorable versus not. We counted key vulnerabilities (chronic pain, unsheltered homelessness, severe psychological distress, and history of overdose, 0-4), and categorized homeless-experienced veterans as having fewer (≤1) and more (≥2) vulnerabilities. RESULTS: H-PACTs outscored mainstream PACTs on all scales (all P<0.001). Unfavorable care experiences were more common in mainstream PACTs compared with H-PACTs, with adjusted risk differences of 11.9% (95% CI=6.3-17.4), 12.6% (6.2-19.1), 11.7% (6.0-17.3), and 12.6% (6.2-19.1) for Relationship, Cooperation, Access/Coordination, and Homeless-Specific Needs, respectively. For the Relationship and Cooperation scales, H-PACTs were associated with a greater reduction in unfavorable experience for patients with ≥2 vulnerabilities versus ≤1 (interaction P<0.0001). CONCLUSIONS: Organizations that offer primary care for persons experiencing homelessness can improve the primary care experience by tailoring the design and

Mental health nurses are struggling to describe their nursing identity as professional discipline in a changing mental health care. Measuring nurse-sensitive patient outcomes and demonstrating nursing's effect(s) experienced by patients contribute to (re)discover the specific nursing identity. However, a valid and reliable scale is currently lacking. The aim of this study was the development and psychometric evaluation of the Mental Health Nurse-Sensitive Patient Outcome Scale (MH-NURSE-POS) for inpatient psychiatric hospital settings. This three-staged study resulted in a scale capturing how inpatients experience the contribution of nurses in their treatment in psychiatric hospitals. First, a draft questionnaire was developed based on a literature review, an independent expert's advice, and an experts panel. Second, the content validity was tested in a two-round Delphi-procedure and focus groups with patients. A pilot test, based on cognitive interviews, confirmed the feasibility of the questionnaire. Third, the psychometric properties of the mental health nurse-sensitive patient outcomes were determined in a sample of 353 patients. The cross-sectional study included a convenience sample of five psychiatric hospitals (Belgium). The factor structure (Kaiser-Meyer-Olkin measure of sampling adequacy 0.924; Bartlett's test of sphericity χ2 = 4162.537; df = 231; P < 0.001), convergent validity by the Individualized Care Scale (Pearson correlation 0.660; P < 0.001), and reliability (Cronbach's Alpha 0.854) were evaluated. The factor analysis resulted in a four-factor solution representing growth, expression, control, and motivation. The Mental Health Nurse-Sensitive Patient Outcome Scale is a valid and reliable tool to measure the effectiveness of mental health nurses from the patient perspective.

Objective: To analyze definitions and related requirements, processes, and operationalization of person-centered goal-setting in the physiotherapy research literature; to discuss those findings in relation to underlying principles of person-centeredness; and to provide an initial framework for how person-centered goal-setting could be conceptualized and operationalized in physiotherapy. Methods: A literature search was conducted in the databases: CINAHL, PubMed, PEDro, PsycINFO, REHABdata and Scopus. A content analysis was performed on how person-centered goal-setting was described. Results: A total of 21 articles were included in the content analysis. Five categories were identified: 1) Understanding goals that are meaningful to the patients; 2) Setting goals in collaboration; 3) Facing challenges with person-centered goal-setting; 4) Developing skills by experiences and education; and 5) Changing interaction and reflective practice. These categories were abstracted into two higher-ordered interlaced themes: 1) To seek mutual understanding of what is meaningful to the patient; and 2) To refine physiotherapy interaction skills, which we suggest would be useful for further conceptualization. Conclusion: In this analysis, we interpreted person-centered goal-setting in physiotherapy as a process of interaction toward a mutual understanding of what is meaningful to the patient. Future research may explore how to integrate mindful listening, embodied interaction and continuous ethical reflection with different assessments and treatment methods.

Objective: To analyze definitions and related requirements, processes, and operationalization of person-centered goal-setting in the physiotherapy research literature; to discuss those findings in relation to underlying principles of person-centeredness; and to provide an initial framework for how person-centered goal-setting could be conceptualized and operationalized in physiotherapy. Methods: A literature search was conducted in the databases: CINAHL, PubMed, PEDro, PsycINFO, REHABdata and Scopus. A content analysis was performed on how person-centered goal-setting was described. Results: A total of 21 articles were included in the content analysis. Five categories were identified: 1) Understanding goals that are meaningful to the patients; 2) Setting goals in collaboration; 3) Facing challenges with person-centered goal-setting; 4) Developing skills by experiences and education; and 5) Changing interaction and reflective practice. These categories were abstracted into two higher-ordered interlaced themes: 1) To seek mutual understanding of what is meaningful to the patient; and 2) To refine physiotherapy interaction skills, which we suggest would be useful for further conceptualization. Conclusion: In this analysis, we interpreted person-centered goal-setting in physiotherapy as a process of interaction toward a mutual understanding of what is meaningful to the patient. Future research may explore how to integrate mindful listening, embodied interaction and continuous ethical reflection with different assessments and treatment methods.

BackgroundAlthough there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives.MethodsQualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers.ResultsFour themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices.ConclusionYouth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care ex

BackgroundMultiple myeloma (MM) is an incurable cancer with complex treatment options. Trusting patient-clinician relationships are essential to promote effective shared decision-making that aligns best clinical practices with patient values and preferences. This study sought to shed light on the development of trust between MM patients and clinicians.MethodsNineteen individual semi-structured interviews were conducted with MM patients within 2 years of initial diagnosis or relapse for this qualitative study. Interviews were recorded and transcripts were coded thematically.ResultsWe identified three main themes: (1) externally validated trust describes patients' predisposition to trust or distrust clinicians based on factors outside of patient-clinician interactions; (2) internally validated trust describes how patients develop trust based on interactions with specific clinicians. Internally validated trust is driven primarily by clinician communication practices that demonstrate competence, responsiveness, listening, honesty, and empathy; and (3) trust in relation to shared decision-making describes how patients relate the feeling of trust, or lack thereof, to the process of shared decision-making.ConclusionMany factors contribute to the development of trust between MM patients and clinicians. While some are outside of clinicians' control, others derive from clinician behaviors and interpersonal communication skills. These findings suggest the possibility that trust can be enhanced through communication training or shared decision-making tools that emphasize relational communication. Given the important role trust plays in shared decision-making, clinicians working with MM patients should prioritize establishing positive, trusting relationships.

BackgroundAlthough there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives.MethodsQualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers.ResultsFour themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices.ConclusionYouth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care ex

Bakgrund Våld mot kvinnor, vilket innefattar intimt partnervåld (även benämnt våld i nära relationer) är ett erkänt globalt problem där cirka var tredje kvinna blir utsatt någon gång i livet. Många av dessa kvinnor har kontakt med hälso- och sjukvården under tiden de blir utsatta oavsett om det är direkt relaterat till våldet eller ej. Där har hälso- och sjukvården ett ansvar att bemöta och behandla dessa kvinnor på ett tillfredsställande och evidensbaserat sätt som upplevs emotionellt stärkande och hjälpande av den utsatta kvinnan. Syfte Syftet var att belysa den våldsutsatta kvinnans upplevelse av processen kring berättandet om intimt partnervåld för hälso- och sjukvårdspersonal. Metod En icke-systematisk litteraturöversikt gjordes i syfte att sammanställa existerande forskning i ämnet. Datainsamlingen gjordes i september 2021 genom sökningar i databaserna PubMed och CINAHL. Kvalitetsgranskning av inkluderade artiklar gjordes via Sophiahemmet högskolas bedömningsunderlag. Dataanalys gjordes i tre steg utifrån en integrerad modell där huvudteman och underteman identifierades. Resultat Under analysen av de 15 inkluderade artiklarna så återfanns tre huvudteman: upplevelse av barriärer som försvårar berättande, upplevelse under berättande om IPV samt upplevelse av förbättringsmöjligheter efter berättande. Dessa tre teman belyser olika aspekter av kvinnors upplevelse innan, under och efter berättande om intimt partnervåld för hälso- och sjukvårdspersonal. Slutsats Kvinnorna som deltagit i studierna hade många liknande upplevelser av att berätta om intimt partnervåld för hälso- och sjukvården. Många kvinnor beskrev att de upplevt mångabarriärer för att berätta om våldet och att de hade positiva och negativa upplevelser kring hur de blivit bemötta av hälso- och sjukvårdspersonal. För hälso- och sjukvården finns detstora möjligheter till förbättring i området och förslag på hur detta kan göras nämns även av kvinnorna., Background Violence against women, one aspect of which is intimate partner violence, is a globally recognized problem which approximately one third of all women will be exposed to during their lifetime. Many of these women are in contact with the health care system during the abuse, regardless if they are seeking help for something directly related to the violence or something else. The health care system has an obligation and responsibility to treat these women in a satisfactory and evidence-based way that the women experience as emotionally strengthening and aid-providing. Aim The aim was to illustrate the battered woman's experience of the process surrounding disclosure of intimate partner violence to health care personnel. Method The method of choice was a non-systematic literature review to compile previous research of the subject matter. The collection of data was made in September 2021 through using the databases PubMed and CINAHL. The quality of the included articles was examined using Sophiahemmet University’s template for quality assessment. Data analysis was made using an integrated method where main themes and subthemes were identified. Results During the data analysis of the 15 included articles three main themes were identified: the experience of barriers hindering disclosure, the experience of disclosing intimate partner violence and the experience of opportunities for improvement after disclosure. These three themes illustrate different aspects of women’s experience before, during and after disclosure of intimate partner violence to health care personnel. Conclusions The women who participated in the studies shared many similar experiences related to disclosing intimate partner violence in health care settings. Many women described how they had overcome many different barriers to be able to disclose the violence and that they had both positive and negative experiences when it came to how health care personnel reacted and processed this information. M

Bakgrund Personer som har problem orsakade av användandet av opioider kan påträffas inom vården i direkt koppling till deras användande av substansen eller vid uppsökande av vård av andra anledningar. Som sjuksköterska finns möjligheten att identifiera ett beroende eller riskbruk och stötta personen till en förändring i livsstilen eller till egenvård (Skärsäter & Wiklund, 2019). Genom att ge omvårdnad på den egna individens villkor respekteras individens värdighet och integritet vilket är avgörande för individens uppfattning av bemötandet (Svensk Sjuksköterskeförening, 2016). Syfte Syftet var att beskriva hur personer som använder opioider upplever mötet med hälso- och sjukvårdspersonal. Metod En icke-systematiskt litteraturöversikt utfördes och baserades på 17 vetenskapliga artiklar av kvalitativ design. Artiklarna eftersöktes i databaserna CINAHL och PubMed med hjälp av lämpliga sökord samt så genomfördes även en manuell sökning. Kvalitén på artiklarna granskades utefter Sophiahemmet Högskolas bedömningsunderlag och vidare användes en integrerad analys vilket resulterade i tre huvudkategorier och sex subkategorier. Resultat Resultatet bestod av tre huvudkategorier och sex subkategorier. Huvudkategorierna var Patienters upplevelser av vårdpersonalens kompetens, Patienters upplevelser av vårdpersonalens attityder och Patienters upplevelser av samarbetet med vårdpersonal. Subkategorierna var kunskap, kommunikation, stigmatisering, tillit, delaktighet och relationen mellan vårdpersonal och patient. Resultatet visade att majoriteten av patienter upplevt stigmatisering relaterat till deras bruk av opioider. Patienter upplevde även att de inte var delaktiga i sin vård samt förbisedda i sin behandling. Slutsats Resultatet från litteraturöversikten påvisade upplevd stigmatisering kring patienter som använder opioider. En stor del av stigmatiseringen kring patientgruppen grundade sig i okunskap hos hälso- och sjukvårdspersonal om “substance use disorder”, Background People with problems caused by the use of opioids may be found in healthcare, either directly related to their use of the substance or when outreaching for other reasons. As a nurse, you have the opportunity to identify an addiction or risk use, and support the person to a change in lifestyle or to self-care (Skärsäter & Wiklund, 2019). By providing care on the individual's terms, the dignity and integrity of the individual are respected, which is crucial to the individual's perception of the treatment (Svensk Sjuksköterskeförening, 2016). Aim The aim was to describe how people who use opioids experience the encounter with health care professionals Method A non-systematic literature review was performed and based on 17 scientific articles of qualitative design. The articles were searched in the CINAHL and PubMed databases using the applicable keywords. A manual search was performed. Subsequently, the quality of the articles was examined according to Sophiahemmet University's assessment data and an integrated analysis was further used, resulting in three main categories and six subcategories. Results The result consisted of three main categories and six subcategories. The main categories were: Patients’ experiences of Healthcare Professionals competence, Patients’ experiences of Healthcare Professionals’ attitudes and Patients’ experiences of collaboration with Healthcare Professionals. The subcategories were knowledge, communication, stigma, trust, participation and the relationship between healthcare professionals and patients. The results showed that the majority of patients experienced stigma related to their use of opioids. Conclusions The results of the literature review show perceived stigma around patients using opioids. Much of the stigma surrounding the patient group has been based on ignorance among health professionals about substance use disorder (SUD). A strong link between healthcare professionals' knowledge of SUD and their

BackgroundMultiple myeloma (MM) is an incurable cancer with complex treatment options. Trusting patient-clinician relationships are essential to promote effective shared decision-making that aligns best clinical practices with patient values and preferences. This study sought to shed light on the development of trust between MM patients and clinicians.MethodsNineteen individual semi-structured interviews were conducted with MM patients within 2 years of initial diagnosis or relapse for this qualitative study. Interviews were recorded and transcripts were coded thematically.ResultsWe identified three main themes: (1) externally validated trust describes patients' predisposition to trust or distrust clinicians based on factors outside of patient-clinician interactions; (2) internally validated trust describes how patients develop trust based on interactions with specific clinicians. Internally validated trust is driven primarily by clinician communication practices that demonstrate competence, responsiveness, listening, honesty, and empathy; and (3) trust in relation to shared decision-making describes how patients relate the feeling of trust, or lack thereof, to the process of shared decision-making.ConclusionMany factors contribute to the development of trust between MM patients and clinicians. While some are outside of clinicians' control, others derive from clinician behaviors and interpersonal communication skills. These findings suggest the possibility that trust can be enhanced through communication training or shared decision-making tools that emphasize relational communication. Given the important role trust plays in shared decision-making, clinicians working with MM patients should prioritize establishing positive, trusting relationships.

BackgroundAlthough there is growing recognition of the importance of person-centered maternity care, the needs and perspectives of pregnant adolescents are rarely considered. The purpose of this study was to compare the maternity care experiences of Mexican-origin adolescents in Guanajuato, Mexico and Fresno, California from both youth and healthcare provider perspectives.MethodsQualitative interviews and focus groups were conducted with a total of 89 respondents, including 74 pregnant and parenting adolescents as well as 15 providers between December 2016 and July 2017. Adolescents also completed a short demographic survey prior to participation. Transcripts in English and Spanish were coded and thematically analyzed using Dedoose software. Results were compared by location and between youth and providers.ResultsFour themes emerged regarding patient-provider interactions: the need for communication and clear explanations, respectful versus judgmental providers, engaging youth in decision-making, and a focus on the age of the youth and their partners. While youth had similar perspectives and priorities in both locations, youth in Mexico reported more negative healthcare experiences than youth in California. Perspectives varied between the youth and providers, with providers in both California and Mexico identifying several structural challenges in providing quality care to adolescents. In California, challenges to supporting immigrant Latina adolescents and their families included language and translation issues as well as barriers to care due to immigration status and documentation. In both locations, providers also mentioned high patient caseloads and their own concerns about the youth's life choices.ConclusionYouth-centered care requires more effective and respectful patient-provider communication, where adolescents are engaged in their healthcare decision-making and delivery options. Changes in patient-provider interactions can help improve the maternity care ex

Bakgrund Våld mot kvinnor, vilket innefattar intimt partnervåld (även benämnt våld i nära relationer) är ett erkänt globalt problem där cirka var tredje kvinna blir utsatt någon gång i livet. Många av dessa kvinnor har kontakt med hälso- och sjukvården under tiden de blir utsatta oavsett om det är direkt relaterat till våldet eller ej. Där har hälso- och sjukvården ett ansvar att bemöta och behandla dessa kvinnor på ett tillfredsställande och evidensbaserat sätt som upplevs emotionellt stärkande och hjälpande av den utsatta kvinnan. Syfte Syftet var att belysa den våldsutsatta kvinnans upplevelse av processen kring berättandet om intimt partnervåld för hälso- och sjukvårdspersonal. Metod En icke-systematisk litteraturöversikt gjordes i syfte att sammanställa existerande forskning i ämnet. Datainsamlingen gjordes i september 2021 genom sökningar i databaserna PubMed och CINAHL. Kvalitetsgranskning av inkluderade artiklar gjordes via Sophiahemmet högskolas bedömningsunderlag. Dataanalys gjordes i tre steg utifrån en integrerad modell där huvudteman och underteman identifierades. Resultat Under analysen av de 15 inkluderade artiklarna så återfanns tre huvudteman: upplevelse av barriärer som försvårar berättande, upplevelse under berättande om IPV samt upplevelse av förbättringsmöjligheter efter berättande. Dessa tre teman belyser olika aspekter av kvinnors upplevelse innan, under och efter berättande om intimt partnervåld för hälso- och sjukvårdspersonal. Slutsats Kvinnorna som deltagit i studierna hade många liknande upplevelser av att berätta om intimt partnervåld för hälso- och sjukvården. Många kvinnor beskrev att de upplevt mångabarriärer för att berätta om våldet och att de hade positiva och negativa upplevelser kring hur de blivit bemötta av hälso- och sjukvårdspersonal. För hälso- och sjukvården finns detstora möjligheter till förbättring i området och förslag på hur detta kan göras nämns även av kvinnorna., Background Violence against women, one aspect of which is intimate partner violence, is a globally recognized problem which approximately one third of all women will be exposed to during their lifetime. Many of these women are in contact with the health care system during the abuse, regardless if they are seeking help for something directly related to the violence or something else. The health care system has an obligation and responsibility to treat these women in a satisfactory and evidence-based way that the women experience as emotionally strengthening and aid-providing. Aim The aim was to illustrate the battered woman's experience of the process surrounding disclosure of intimate partner violence to health care personnel. Method The method of choice was a non-systematic literature review to compile previous research of the subject matter. The collection of data was made in September 2021 through using the databases PubMed and CINAHL. The quality of the included articles was examined using Sophiahemmet University’s template for quality assessment. Data analysis was made using an integrated method where main themes and subthemes were identified. Results During the data analysis of the 15 included articles three main themes were identified: the experience of barriers hindering disclosure, the experience of disclosing intimate partner violence and the experience of opportunities for improvement after disclosure. These three themes illustrate different aspects of women’s experience before, during and after disclosure of intimate partner violence to health care personnel. Conclusions The women who participated in the studies shared many similar experiences related to disclosing intimate partner violence in health care settings. Many women described how they had overcome many different barriers to be able to disclose the violence and that they had both positive and negative experiences when it came to how health care personnel reacted and processed this information. M

Bakgrund Personer som har problem orsakade av användandet av opioider kan påträffas inom vården i direkt koppling till deras användande av substansen eller vid uppsökande av vård av andra anledningar. Som sjuksköterska finns möjligheten att identifiera ett beroende eller riskbruk och stötta personen till en förändring i livsstilen eller till egenvård (Skärsäter & Wiklund, 2019). Genom att ge omvårdnad på den egna individens villkor respekteras individens värdighet och integritet vilket är avgörande för individens uppfattning av bemötandet (Svensk Sjuksköterskeförening, 2016). Syfte Syftet var att beskriva hur personer som använder opioider upplever mötet med hälso- och sjukvårdspersonal. Metod En icke-systematiskt litteraturöversikt utfördes och baserades på 17 vetenskapliga artiklar av kvalitativ design. Artiklarna eftersöktes i databaserna CINAHL och PubMed med hjälp av lämpliga sökord samt så genomfördes även en manuell sökning. Kvalitén på artiklarna granskades utefter Sophiahemmet Högskolas bedömningsunderlag och vidare användes en integrerad analys vilket resulterade i tre huvudkategorier och sex subkategorier. Resultat Resultatet bestod av tre huvudkategorier och sex subkategorier. Huvudkategorierna var Patienters upplevelser av vårdpersonalens kompetens, Patienters upplevelser av vårdpersonalens attityder och Patienters upplevelser av samarbetet med vårdpersonal. Subkategorierna var kunskap, kommunikation, stigmatisering, tillit, delaktighet och relationen mellan vårdpersonal och patient. Resultatet visade att majoriteten av patienter upplevt stigmatisering relaterat till deras bruk av opioider. Patienter upplevde även att de inte var delaktiga i sin vård samt förbisedda i sin behandling. Slutsats Resultatet från litteraturöversikten påvisade upplevd stigmatisering kring patienter som använder opioider. En stor del av stigmatiseringen kring patientgruppen grundade sig i okunskap hos hälso- och sjukvårdspersonal om “substance use disorder”, Background People with problems caused by the use of opioids may be found in healthcare, either directly related to their use of the substance or when outreaching for other reasons. As a nurse, you have the opportunity to identify an addiction or risk use, and support the person to a change in lifestyle or to self-care (Skärsäter & Wiklund, 2019). By providing care on the individual's terms, the dignity and integrity of the individual are respected, which is crucial to the individual's perception of the treatment (Svensk Sjuksköterskeförening, 2016). Aim The aim was to describe how people who use opioids experience the encounter with health care professionals Method A non-systematic literature review was performed and based on 17 scientific articles of qualitative design. The articles were searched in the CINAHL and PubMed databases using the applicable keywords. A manual search was performed. Subsequently, the quality of the articles was examined according to Sophiahemmet University's assessment data and an integrated analysis was further used, resulting in three main categories and six subcategories. Results The result consisted of three main categories and six subcategories. The main categories were: Patients’ experiences of Healthcare Professionals competence, Patients’ experiences of Healthcare Professionals’ attitudes and Patients’ experiences of collaboration with Healthcare Professionals. The subcategories were knowledge, communication, stigma, trust, participation and the relationship between healthcare professionals and patients. The results showed that the majority of patients experienced stigma related to their use of opioids. Conclusions The results of the literature review show perceived stigma around patients using opioids. Much of the stigma surrounding the patient group has been based on ignorance among health professionals about substance use disorder (SUD). A strong link between healthcare professionals' knowledge of SUD and their

Bakgrund Långvarig smärta är smärta som varat längre än tre månader, och utgör ett folkhälsoproblem som medför stora kostnader för samhället. Dessutom har tillståndet hög samsjuklighet vad gäller psykisk ohälsa och påverkar livskvaliteten negativt. Vårdpersonal upplever att de saknar kunskap om långvarig smärta och ser patientgruppen som komplex. De barriärer som finns i vårdandet av patienter med långvarig smärta kan leda till brister i såväl bemötandet som i det personcentrerade förhållningssättet. Syfte Syftet var att beskriva hur patienter med långvarig smärta upplever hälso- och sjukvårdspersonalens bemötande. Metod Designen icke-systematisk litteraturöversikt användes för att besvara syftet. Datainsamlingen skedde genom sökning efter artiklar i databaserna CINAHL och PubMed. Artiklarna kvalitetsgranskades innan det slugiltiga urvalet. Resultaten från 15 artiklar analyserades enligt en integrerad analysmetod. Litteraturöversikten utfördes i enlighet med Helsingforsdeklarationen. Resultat Resultatet presenteras i fyra kategorier som beskriver upplevelser kring olika aspekter av bemötande ur patienternas perspektiv. Kategorin om upplevelser av kommunikation handlade om samtalet och informationen från personalen. I kategorin om partnerskapet beskrevs upplevelser av delaktighet, tillit, stöd och kontinuitet. I en kategori beskrevs känslan av att inte vara önskad inom vården som kom från att patienterna kände sig förminskade, missförstådda, ifrågasatta samt övergivna av hälso- och sjukvården. I samma kategori framkom att patienterna kände att de måste agera på ett visst sätt och att det fanns en kunskapsbrist hos personalen. Patienterna hade även en önskan att bli sedda som individer och att bli tagna på allvar, vilket beskrevs i den sista kategorin. Slutsats Patienterna hade blandade negativa och positiva upplevelser av hälso- och sjukvårdspersonalens bemötande. De brister som fanns i bemötandet kan förklaras som en avsaknad av ett personcentrerat förhållnings, Background Long-term pain is pain that has lasted for longer than three months. It is seen as a public health issue and comes at a large cost to Swedish society. The condition also has a high comorbidity especially with psychiatric disease, and a negative impact on quality of life. Health professionals experience that they have a lack of knowledge about long term pain and view the patient group as complex. The barriers that exist in caring for these patients can lead to a lack of person-centered care. Aim The aim was to describe how patients with long-term pain experience their meetings with health professionals. Method A non-systematic literature review design was used for this study. The data was collected from two databases, CINAHL and PubMed. A review of the quality of the articles was carried out before the final selection. The results from 15 articles were analysed using an integrated analysis. The literature review was made in accordance with the Declaration of Helsinki. Results The results are presented using four categories describing different aspects of meetings between patients and health professionals. The category relating experiences of communication included conversation with and information from the staff. Within the category about partnership between patients and health professionals, experiences of participation, trust, support, and continuity were described. In one category the patient’s perception of not being wanted in healthcare was described, it came from feelings of being diminished, misunderstood, questioned, and abandoned by the health-care system. It emerged that long-term pain patients felt they must act in a certain way and also that there was a lack of knowledge on the part of the staff. The patients also wanted to be seen as individuals and taken seriously, which was described in the last category. Conclusions The patients had both negative and positive experiences of their meetings with health professionals. The shortcomings that e

Bakgrund: Bröstcancer drabbar cirka 9000 kvinnor varje år i Sverige. Kvinnor drabbas både psykisk och fysiskt. Beroende på vilket stadium man är i livet hanterar kvinnor bröstcancerdiagnoser på olika sätt. Som sjuksköterska är det viktigt att se hela patienten för att kunna skapa en god vårdrelation och ge god vård. Syfte: Syftet var att beskriva kvinnors upplevelser av vårdpersonalen bemötande vid bröstcancer. Metod: Litteraturöversikten har utförts av tio kvalitativa vetenskapliga studier som analyserats enligt Fribergs beskrivning av sammanställning av kvalitativ forskning. Vetenskapliga artiklar var hämtade från CINAHL Complete och Pubmed och har analyserats och delats upp i teman. Resultat: I resultatet presenteras fyra teman utifrån tio artiklar (1) Att känna stöd från vårdpersonal (2) Att känna sig ensam i sin sjukdom (3) Att känna sig informerad (4) Kvinnors behov av kommunikation. Slutsats: Kvinnor med bröstcancers känsla av delaktighet och trygghet påverkas av vårdpersonalens bemötande. Vårdpersonalens förmåga att inkludera och integrera med patienten i kombination med kommunikationen är viktig för att främja vård upplevelsen och ge kvinnor med bröstcancer hopp och trygghet., Background: Breast cancer affects about 9,000 women each year in Sweden. Women are affected both mentally and physically. Depending on the stage you are in in life, women handle breast cancer diagnoses in different ways. As a nurse, it is important to see the whole patient in order to create a good care relationship and to provide good care. Aim: The purpose was to describe women's experiences of healthcare professionls treatment of breast cancer. Method: The literature review that has been performed by ten qualitative scientific studies that have been analyzed according to Friberg's description of a compilation of qualitative research. Scientific articles were taken from CINAHL Complete and Pubmed and have been analyzed and divided into themes. Results: The result present four themes based on ten articles (1) Feeling supported by healthcare professionals (2) Feeling alone in their illness (3) Feeling informed (4) Women's need for communication. Conclusion: Breast cancer patient’s feeling of inclusion and safety depends on how they are received by health care professionals. Their ability to integrate with the patient and maintain healthy communication is paramount to further their experience and to give women with breast cancer hope and stability. Breast neoplasms, professional-patient relations, communication, qualitative studies, literature review, nurse-patient relations.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a multidrug-resistant bacterium that causes serious infections. Specific measures to prevent the spread of MRSA are required within health care, and insufficient knowledge and lack of compliance to these measures have been identified in healthcare professionals. The need to adhere to special guidelines in order to prevent the spread of infection have been shown to create negative feelings for carriers of multidrug-resistant bacterium. Aim: The aim of this study was to investigate different aspects of living and being cared for with known carriage of MRSA. The fist aspect aimed to investigate how people experience their knowledge and the information they receive from the healthcare. The second aspect aimed to investigate their feelings and existence in relation to their carriage. The third aspect aimed investigate their experiences and encounters with health care. Method: Literature study with systematic approach and inductive method. The results were analysed with inspiration from thematic synthesis and based on ten qualitative original articles. Results: Getting MRSA was shocking and shameful, and many blamed the health care for contracting MRSA. Living with MRSA had a negative impact on daily life. Life felt lonely and isolated, and people were scared to infect others. Being cared for with MRSA was described with experiences of lack knowledge from the health care professionals, inconsistencies in adherence to hygiene measures and unprofessional behaviour. Being cared for in isolation had a negative impact on the persons’ independence, their relations with the health care professionals and the quality of care. Conclusion: Getting MRSA is perceived as stigmatising and frightening, and the health care fails to provide adequate information to counteract these feelings. People feel sadness, abandonment and uncertainty about the future. The behaviour of health care professionals and their compliance with, Bakgrund: Meticillinresistenta Staphylococcus aureus (MRSA) är en multiresistent bakterie som orsakar allvarliga infektioner. För att förhindra spridning av MRSA krävs särskilda hygienrutiner inom vården, och otillräcklig kunskap och bristande följsamhet till dessa har identifierats hos vårdpersonal. För att inte sprida smitta behöver personer med bärarskap av multiresistenta bakterier förhålla sig till särskilda riktlinjer, vilket har visat sig skapa negativa känslor för personerna. Syfte: Syftet var att undersöka olika aspekter av att leva och vårdas med känt bärarskap av MRSA. Den första aspekten syftade till att undersöka hur personerna upplever sin kunskap och informationen de får från vården. Den andra aspekten syftade till att undersöka deras känslor och tillvaro i relation till bärarskapet. Den tredje aspekten syftade till att undersöka deras erfarenheter och upplevelser av mötet med vården. Metod: Litteraturstudie med systematisk ansats och induktiv metod. Resultatet analyserades med inspiration av tematisk syntes och baseras på tio kvalitativa originalartiklar. Resultat: Att få MRSA var chockartat och skamfyllt, och många beskyllde vården för att ha fått MRSA. Att leva med MRSA påverkade vardagen negativt. Livet kändes begränsat, ensamt och isolerat och personerna var rädda för att smitta andra. Att vårdas med MRSA beskrevs med upplevelser av bristande kunskap hos vårdpersonalen, inkonsekvens i följsamhet till hygienrutiner och oprofessionellt bemötande. Att vårdas under isolering för MRSA inverkade negativt på personernas upplevelse av självständighet, relationen till vårdpersonalen och kvaliteten på omvårdnaden. Slutsats: Att få MRSA upplevs stigmatiserande och skrämmande och vården misslyckas med att ge adekvat information för att motverka dessa känslor. Personerna känner sorg, övergivenhet och framtiden känns osäker. Vårdpersonalens beteende och följsamhet till hygienrutiner är inkonsek

Bakgrund Långvarig smärta är smärta som varat längre än tre månader, och utgör ett folkhälsoproblem som medför stora kostnader för samhället. Dessutom har tillståndet hög samsjuklighet vad gäller psykisk ohälsa och påverkar livskvaliteten negativt. Vårdpersonal upplever att de saknar kunskap om långvarig smärta och ser patientgruppen som komplex. De barriärer som finns i vårdandet av patienter med långvarig smärta kan leda till brister i såväl bemötandet som i det personcentrerade förhållningssättet. Syfte Syftet var att beskriva hur patienter med långvarig smärta upplever hälso- och sjukvårdspersonalens bemötande. Metod Designen icke-systematisk litteraturöversikt användes för att besvara syftet. Datainsamlingen skedde genom sökning efter artiklar i databaserna CINAHL och PubMed. Artiklarna kvalitetsgranskades innan det slugiltiga urvalet. Resultaten från 15 artiklar analyserades enligt en integrerad analysmetod. Litteraturöversikten utfördes i enlighet med Helsingforsdeklarationen. Resultat Resultatet presenteras i fyra kategorier som beskriver upplevelser kring olika aspekter av bemötande ur patienternas perspektiv. Kategorin om upplevelser av kommunikation handlade om samtalet och informationen från personalen. I kategorin om partnerskapet beskrevs upplevelser av delaktighet, tillit, stöd och kontinuitet. I en kategori beskrevs känslan av att inte vara önskad inom vården som kom från att patienterna kände sig förminskade, missförstådda, ifrågasatta samt övergivna av hälso- och sjukvården. I samma kategori framkom att patienterna kände att de måste agera på ett visst sätt och att det fanns en kunskapsbrist hos personalen. Patienterna hade även en önskan att bli sedda som individer och att bli tagna på allvar, vilket beskrevs i den sista kategorin. Slutsats Patienterna hade blandade negativa och positiva upplevelser av hälso- och sjukvårdspersonalens bemötande. De brister som fanns i bemötandet kan förklaras som en avsaknad av ett personcentrerat förhållnings, Background Long-term pain is pain that has lasted for longer than three months. It is seen as a public health issue and comes at a large cost to Swedish society. The condition also has a high comorbidity especially with psychiatric disease, and a negative impact on quality of life. Health professionals experience that they have a lack of knowledge about long term pain and view the patient group as complex. The barriers that exist in caring for these patients can lead to a lack of person-centered care. Aim The aim was to describe how patients with long-term pain experience their meetings with health professionals. Method A non-systematic literature review design was used for this study. The data was collected from two databases, CINAHL and PubMed. A review of the quality of the articles was carried out before the final selection. The results from 15 articles were analysed using an integrated analysis. The literature review was made in accordance with the Declaration of Helsinki. Results The results are presented using four categories describing different aspects of meetings between patients and health professionals. The category relating experiences of communication included conversation with and information from the staff. Within the category about partnership between patients and health professionals, experiences of participation, trust, support, and continuity were described. In one category the patient’s perception of not being wanted in healthcare was described, it came from feelings of being diminished, misunderstood, questioned, and abandoned by the health-care system. It emerged that long-term pain patients felt they must act in a certain way and also that there was a lack of knowledge on the part of the staff. The patients also wanted to be seen as individuals and taken seriously, which was described in the last category. Conclusions The patients had both negative and positive experiences of their meetings with health professionals. The shortcomings that e

Bakgrund: Bröstcancer drabbar cirka 9000 kvinnor varje år i Sverige. Kvinnor drabbas både psykisk och fysiskt. Beroende på vilket stadium man är i livet hanterar kvinnor bröstcancerdiagnoser på olika sätt. Som sjuksköterska är det viktigt att se hela patienten för att kunna skapa en god vårdrelation och ge god vård. Syfte: Syftet var att beskriva kvinnors upplevelser av vårdpersonalen bemötande vid bröstcancer. Metod: Litteraturöversikten har utförts av tio kvalitativa vetenskapliga studier som analyserats enligt Fribergs beskrivning av sammanställning av kvalitativ forskning. Vetenskapliga artiklar var hämtade från CINAHL Complete och Pubmed och har analyserats och delats upp i teman. Resultat: I resultatet presenteras fyra teman utifrån tio artiklar (1) Att känna stöd från vårdpersonal (2) Att känna sig ensam i sin sjukdom (3) Att känna sig informerad (4) Kvinnors behov av kommunikation. Slutsats: Kvinnor med bröstcancers känsla av delaktighet och trygghet påverkas av vårdpersonalens bemötande. Vårdpersonalens förmåga att inkludera och integrera med patienten i kombination med kommunikationen är viktig för att främja vård upplevelsen och ge kvinnor med bröstcancer hopp och trygghet., Background: Breast cancer affects about 9,000 women each year in Sweden. Women are affected both mentally and physically. Depending on the stage you are in in life, women handle breast cancer diagnoses in different ways. As a nurse, it is important to see the whole patient in order to create a good care relationship and to provide good care. Aim: The purpose was to describe women's experiences of healthcare professionls treatment of breast cancer. Method: The literature review that has been performed by ten qualitative scientific studies that have been analyzed according to Friberg's description of a compilation of qualitative research. Scientific articles were taken from CINAHL Complete and Pubmed and have been analyzed and divided into themes. Results: The result present four themes based on ten articles (1) Feeling supported by healthcare professionals (2) Feeling alone in their illness (3) Feeling informed (4) Women's need for communication. Conclusion: Breast cancer patient’s feeling of inclusion and safety depends on how they are received by health care professionals. Their ability to integrate with the patient and maintain healthy communication is paramount to further their experience and to give women with breast cancer hope and stability. Breast neoplasms, professional-patient relations, communication, qualitative studies, literature review, nurse-patient relations.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a multidrug-resistant bacterium that causes serious infections. Specific measures to prevent the spread of MRSA are required within health care, and insufficient knowledge and lack of compliance to these measures have been identified in healthcare professionals. The need to adhere to special guidelines in order to prevent the spread of infection have been shown to create negative feelings for carriers of multidrug-resistant bacterium. Aim: The aim of this study was to investigate different aspects of living and being cared for with known carriage of MRSA. The fist aspect aimed to investigate how people experience their knowledge and the information they receive from the healthcare. The second aspect aimed to investigate their feelings and existence in relation to their carriage. The third aspect aimed investigate their experiences and encounters with health care. Method: Literature study with systematic approach and inductive method. The results were analysed with inspiration from thematic synthesis and based on ten qualitative original articles. Results: Getting MRSA was shocking and shameful, and many blamed the health care for contracting MRSA. Living with MRSA had a negative impact on daily life. Life felt lonely and isolated, and people were scared to infect others. Being cared for with MRSA was described with experiences of lack knowledge from the health care professionals, inconsistencies in adherence to hygiene measures and unprofessional behaviour. Being cared for in isolation had a negative impact on the persons’ independence, their relations with the health care professionals and the quality of care. Conclusion: Getting MRSA is perceived as stigmatising and frightening, and the health care fails to provide adequate information to counteract these feelings. People feel sadness, abandonment and uncertainty about the future. The behaviour of health care professionals and their compliance with, Bakgrund: Meticillinresistenta Staphylococcus aureus (MRSA) är en multiresistent bakterie som orsakar allvarliga infektioner. För att förhindra spridning av MRSA krävs särskilda hygienrutiner inom vården, och otillräcklig kunskap och bristande följsamhet till dessa har identifierats hos vårdpersonal. För att inte sprida smitta behöver personer med bärarskap av multiresistenta bakterier förhålla sig till särskilda riktlinjer, vilket har visat sig skapa negativa känslor för personerna. Syfte: Syftet var att undersöka olika aspekter av att leva och vårdas med känt bärarskap av MRSA. Den första aspekten syftade till att undersöka hur personerna upplever sin kunskap och informationen de får från vården. Den andra aspekten syftade till att undersöka deras känslor och tillvaro i relation till bärarskapet. Den tredje aspekten syftade till att undersöka deras erfarenheter och upplevelser av mötet med vården. Metod: Litteraturstudie med systematisk ansats och induktiv metod. Resultatet analyserades med inspiration av tematisk syntes och baseras på tio kvalitativa originalartiklar. Resultat: Att få MRSA var chockartat och skamfyllt, och många beskyllde vården för att ha fått MRSA. Att leva med MRSA påverkade vardagen negativt. Livet kändes begränsat, ensamt och isolerat och personerna var rädda för att smitta andra. Att vårdas med MRSA beskrevs med upplevelser av bristande kunskap hos vårdpersonalen, inkonsekvens i följsamhet till hygienrutiner och oprofessionellt bemötande. Att vårdas under isolering för MRSA inverkade negativt på personernas upplevelse av självständighet, relationen till vårdpersonalen och kvaliteten på omvårdnaden. Slutsats: Att få MRSA upplevs stigmatiserande och skrämmande och vården misslyckas med att ge adekvat information för att motverka dessa känslor. Personerna känner sorg, övergivenhet och framtiden känns osäker. Vårdpersonalens beteende och följsamhet till hygienrutiner är inkonsek

BACKGROUND: Personalized medicine may increase the amount of probabilistic information patients encounter. Little guidance exists about communicating risk for multiple diseases simultaneously or about communicating how changes in risk factors affect risk (hereafter risk reduction). PURPOSE: To determine how to communicate personalized risk and risk reduction information for up to 5 diseases associated with insufficient physical activity in a way laypeople can understand and that increases intentions. METHODS: We recruited 500 participants with <150 min weekly of physical activity from community settings. Participants completed risk assessments for diabetes, heart disease, stroke, colon cancer, and breast cancer (women only) on a smartphone. Then, they were randomly assigned to view personalized risk and risk reduction information organized as a bulleted list, a simplified table, or a specialized vertical bar graph (risk ladder). Last, they completed a questionnaire assessing outcomes. Personalized risk and risk reduction information was presented as categories (e.g., very low). Our analytic sample (N = 372) included 41.3% individuals from underrepresented racial/ethnic backgrounds, 15.9% with vocational-technical training or less, 84.7% women, 43.8% aged 50 to 64 y, and 71.8% who were overweight/obese. RESULTS: Analyses of covariance with post hoc comparisons showed that the risk ladder elicited higher gist comprehension than the bulleted list (P = 0.01). There were no significant main effects on verbatim comprehension or physical activity intentions and no moderation by sex, race/ethnicity, education, numeracy, or graph literacy (P > 0.05). Sequential mediation analyses revealed a small beneficial indirect effect of risk ladder versus list on intentions through gist comprehension and then through perceived risk (bIndirectEffect = 0.02, 95% confidence interval: 0.00, 0.04). CONCLUSION: Risk ladders can communicate the gist meaning of multiple pieces of risk in

Introduction: Idiographic, or individual-level, methodology has been touted for its potential clinical utility. Empirically modeling relationships between symptoms for a single individual may offer both the client and therapist information that is useful for case conceptualization and treatment planning. However, few studies have investigated the feasibility and utility of integrating idiographic models in a clinical setting.Methods: Clients (n = 12) completed ecological momentary assessment regarding psychological symptoms five times per day for three weeks. Clients also generated predictions about the associative and directed relationships in their networks. Graphical vector autoregression was used to generate contemporaneous and directed networks from each client's data, and both clients and therapists completed self-report questionnaires regarding the feasibility and utility of these methods.Results: Results indicated that the idiographic model structures varied widely across participants and differed markedly from the client's own predictions. Clients found the models useful, whereas their therapists demonstrated a more tempered response.Discussion: These results echo previous findings suggesting that clients are willing to complete intensive data collection and are interested in the output, whereas therapists may be less open to idiographic methods. We provide recommendations for future implementation of personalized models in clinical settings.

This article looks at two pedagogical initiatives based on “Paideia Education” in order to analyze their contributions to the production of democratic relations and the co-production of care in primary health care. The first of these initiatives was a seminar on matrix support (2015-2016) that trained 94 specialists, and the second was a seminar on family care (2018-2020) that trained 149 professionals. The 243 participating health professionals came from five different municipalities in Brazil. The results obtained through questionnaires and field diaries kept during the seminars indicate that “Paideia Education” has the ability to motivate professionals to incorporate notions such as the expanded clinic and matrix support into primary health care, and fosters the sharing of care and the co-construction of autonomy with users. However, authoritarian management practices are still frequently directed towards professionals, practiced among professionals themselves, and directed towards patients, and therefore it is necessary to invest in a greater democratization of services beyond training., Este artículo parte de dos iniciativas pedagógicas de “formación Paideia” con el propósito de analizar sus contribuciones en la producción de relaciones democráticas y en la coproducción del cuidado en atención primaria de la salud. La primera iniciativa realizó una capacitación en apoyo matricial (2015-2016) que reunió a 94 especialistas y, la segunda, una capacitación en salud familiar (2018-2020), que reunió a 149 profesionales. Los 243 profesionales de la salud participantes provenían de cinco municipios brasileños. Los resultados obtenidos a través de cuestionarios y diarios de campo elaborados durante los cursos señalan que la formación Paideia motiva a los profesionales a incorporar una clínica ampliada y el apoyo matricial en atención primaria de la salud, y propicia compartir el cuidado y la co-construcción de la autonomía junto a los usuarios. Sin embargo, aún son frecuentes las prácticas autoritarias de la gestión hacia las y los profesionales, entre profesionales, y desde las y los profesionales hacia las personas usuarias, de modo que es necesario invertir, más allá de la formación, en una mayor democratización de los servicios.

Rather than measure demographic factors such as socioeconomics, the aim of this study was to examine the lived experience of frequent attenders by synthesizing findings on their encounters with healthcare personnel. The Scopus, CINAHL, PsycARTICLES, and PubMed (Medline) databases were searched in May 2020 in order to screen studies by title and abstract (n = 1794) and full‐text (n = 20). Findings from the included studies (n = 6) were then pooled using meta‐aggregation, yielding the following results: difficulties in resolving frequent attenders’ situations may create “service circles,” frustrating patients with their situation; frequent attenders’ own expertise regarding their condition should be recognized and valued alongside that of healthcare professionals when performing collaborative care; a lack of empathy and disparagement may make frequent attenders feel misunderstood and unappreciated; frequent attenders should be recognized as individuals by taking their circumstances into account and providing support accordingly. Frequent attenders’ experiences demonstrate the importance of shared decision‐making, continuity of care, and acknowledging these patients’ individual circumstances. Identifying the variety of frequent attenders’ service needs by synthesizing their experiences is a practical way of organizing patient‐centered healthcare services.

[Resumo] O proceso de converterse en nai está contemplado como un dos máis bonitos na vida, algo moi común pero que aínda así, trae grandes dúbidas e aumento do estrés na vida diaria dos pais. O persoal sanitario forma parte neste proceso de cara á maternidade xa que estamos presentes en todo o embarazo, formamos parte no momento do parto e tamén do puerperio, o que provoca que, cando os pais teñan dúbidas ou medos se dirixan a nós. O continuo contacto alimenta a interacción entre persoas, o que nos leva á comunicación, se esta contén un feedback positivo favorecerá o interese dos pacientes para preguntarnos máis dúbidas e así conseguiremos un fluxo de boa información que mellorará moito a satisfacción dos pais. Pero aínda así, sabendo isto, a relación da comunicación entre pacientes e profesionais segue sendo considerada insuficiente e mellorable nalgúns aspectos. OBXECTIVO O obxectivo principal deste proxecto é coñecer desde unha metodoloxía cualitativa de carácter descritivo que influencia, positiva ou negativa, ten a comunicación enfermeira na satisfacción co embarazo e puerperio. METODOLOXÍA O paradigma escollido é a investigación con enfoque e perspectiva cualitativa. Paradigma fenomenolóxico descritivo e simbólico. Recollerase información, un mes despois da súa alta, a través de entrevistas en profundidade ás pacientes que estiveran na planta de puerperio do Hospital Materno-Infantil Teresa Herrera de A Coruña. RESULTADOS ESPERADOS Os resultados que podemos esperar son a creación de protocolos, guías ou cursos de formación para mellorar as capacidades comunicativas do persoal sanitario para crear un ambiente de satisfacción cada vez maior. Dar visibilidade á importancia da comunicación en todo o proceso de embarazo, parto e puerperio por parte da enfermaría cara as pacientes., [Abstract] The process of becoming a mother is considered one of the most beautiful in life, something very common but still brings great doubts and an increase in stress in the parents' daily life. Healthcare personnel are part of this process with regard to motherhood since we are present throughout the pregnancy, we are part of the moment of delivery and also of the puerperium, which means that, when parents have doubts or fears, they turn to us .The continuous contact feeds the interaction between people, which leads us to communication, if it contains positive feedback, it will favor the interest of patients to ask us more questions, thus we will achieve a better information flow, which will greatly improve patient satisfaction. fathers. But even so knowing this, the communication relationship between patients and professionals is still considered insufficient in some aspects. OBJECTIVE The main objective of this project is to know from a qualitative methodology of a descriptive nature what influence, positive or negative, nursing communication has on satisfaction with pregnancy and the puerperium. METHODOLOGY The paradigm chosen is research with a qualitative focus and perspective. Descriptive and symbolic phenomenological paradigm. Information will be collected through in-depth interviews with patients who have been in the puerperium plant of the Teresa Herrera Maternal and Child Hospital in A Coruña, one month after discharge. EXPECTED RESULTS The results we can expect are the creation of protocols, guides or training courses to improve the communication skills of healthcare personnel to create an environment of increasing satisfaction., [Resumen] El proceso de convertirse en madre está contemplado como uno de los más bonitos en la vida, algo muy común pero que aún así trae grandes dudas y un aumento del estrés en la vida diaria de los padres. El personal sanitario forma parte de este proceso de cara a la maternidad ya que estamos presentes en todo el embarazo, formamos parte en el momento del parto y también del puerperio, lo que provoca que, cuando los padres tengan dudas o miedos se dirijan a nosotros. El contínuo contacto alimenta la interacción entre personas, lo que nos lleva a la comunicación, si ésta contiene un feedback positivo favorecerá al interés de los pacientes para preguntarnos más dudas, así conseguiremos un flujo de buena información que mejorará mucho la satisfacción de los padres. Pero aún así, sabiendo esto, la relación de la comunicación entre pacientes y profesionales sigue siendo considerada insuficiente en algunos aspectos. OBJETIVO El objetivo principal de este proyecto es conocer desde una metodología cualitativa de carácter descriptivo que influencia, positiva o negativa, tiene la comunicación enfermera en la satisfacción con el embarazo y el puerperio. METODOLOGÍA El paradigma escogido es la investigación con enfoque y perspectiva cualitativa. Paradigma fenomenológico descriptivo y simbólico. Se recogerá información, un mes después de recibir el alta, a través de entrevistas en profundidad a las pacientes que fueron atendidas en la planta de puerperio del Hospital Materno-Infantil Teresa Herrera de A Coruña.RESULTADOS ESPERADOS Creación de protocolos, guías o cursos de formación para mejorar las capacidades comunicativas del personal sanitario para crear un ambiente de satisfacción cada vez mayor. Dar visibilidad a la importancia de la comunicación en todo el proceso del embarazo, parto y puerperio por parte de enfermería de cara a las pacientes.

Background: Therapist’s emotional reactions toward patients in clinical facilities are a key concept in the treatment of personality disorders. Considering only clinical settings specialized in treatment of personality pathology the present paper aimed at: (1) assessing any direct relationship between patient symptom severity and therapist emotional response; (2) exploring patients’ functioning configurations that can be associated with specific therapist reactions (3) investigating whether these relationships remains significant when accounting for other setting variables related to patients or therapist. Methods: The present study included 43 outpatients with personality disorders who underwent a psychotherapy treatment in two Italian facilities dedicated to outpatients with personality disorders and their 19 psychotherapists. The Symptom Checklist-90-Revised (SCL-90R) was used to explore clinical severity condition. Psychotherapists completed the Therapist Response Questionnaire (TRQ) to identify pattern of therapists’ response and the Shedler-Westen Assessment Procedure-200 (SWAP-200) in order to assess personality traits of the patients. Results: No significant relationship between the clinical severity of the symptoms and the therapist’ responses was found. Even when controlled for clinical severity condition, duration of the treatment, age and educational level of the patient or years of therapist experience, most of SWAP-200 traits appeared to be significant predictors of therapist’ emotional responses. Conclusions: The present study confirms the value of therapists’ emotional response as a useful tool in understanding psychological processes related to clinical practice highlighting its context-dependent dimension.

[Abstract] A generic qualitative research, using a poststructuralist feminist perspective, was conducted in a Spanish gynaecology unit with the following aims: (a) to analyse how asymmetric power relations in relation to biomedical knowledge and gender shape the medical encounters between gynaecologists and women diagnosed with cervical intraepithelial neoplasia and (b) to explore the cognitive, moral, and emotional responses expressed by patients. A total of 21 women diagnosed with cervical intraepithelial neoplasia were recruited through purposive sampling. Semi-structured interviews were recorded and transcribed, and a thematic analysis was carried out. Two major themes were identified: (a) gendered relations in cervical intraepithelial neoplasia medical encounters are based on hidden, judgmental moral assumptions, making women feel irresponsible and blamed for contracting the human papillomavirus infection; (b) biomedical power is based on the positivist assumption of a single truth (scientific knowledge), creating asymmetric relations rendering women ignorant and infantilised. Women reacted vehemently during the interviews, revealing a nexus of cognitive, moral, and emotional reactions. In medical encounters for management of cervical intraepithelial neoplasia, patients feel they are being morally judged and given limited information, generating emotional distress. Healthcare professionals should question whether their practices are based on stereotypical gender assumptions which lead to power asymmetries during encounters.

[Abstract] Health professionals play an important role in addressing parents who are hesitant or reluctant to immunise their children. Despite the importance of this topic, gaps remain in the literature about these experiences. This meta-ethnography aimed to synthesise the available body of qualitative work about the care experiences of community and hospital health professionals in encounters with parents hesitant or reluctant to vaccinate their children. The aim is to provide key information for the creation of strategies that address vaccine hesitancy or refusal and ensure public trust in vaccination programs, which are required in a pandemic context such as the current one. (2) Methods: Noblit and Hare’s interpretive meta-ethnography of 12 studies was followed. A line of argument synthesis based on a metaphor was developed. (3) Results: The metaphor “The stone that refuses to be sculpted”, accompanied by three themes, symbolises the care experiences of health professionals in their encounters with parents that hesitate or refuse to vaccinate their children. (4) Conclusions: The creation of clearer communication strategies, the establishment of a therapeutic alliance, health literacy and the empowerment of parents are recommended. The incorporation of health professionals in decision making and the strengthening of multidisciplinary teams interacting with such parents are also included