Background   The patient's rights to self-determine their own health care is described in Swedish legislation and guidelines. However, due to infancy, unconsciousness, severe brain damage or certain diseases, some patients might be unable to make such decisions. Ethically difficult situations do occur, not infrequently associated with culture. Since the patient is vulnerable, there is a risk that the patient in the treatment and care can not be bothered to maintain right to autonomy and that the nurse violates patient integrity.Aim                 The aim of this study was to illustrate the nurse's dilemma when the patient refuses vital caring efforts.Method           A literature review of eight scientific articles with a qualitative approach was performed.Results           The results revealed the following domains to describe the nurse's dilemma when the patient refuses vital care interventions: patients? reasons for treatment refusal, the nurse's understanding of the patient's refusal of care and contradictory legislationConclusion     More knowledge and discussion of the patient's decision-making competence is needed for both the nursing profession and those who make decisions on legislation..

Background:Studies show that when nurses are experiencing problems in the care of non-Swedish speaking patients, it is often due to obstacles in the communication. Studies also show that a prerequisite for adequate care is that there is a basis for a direct communication. Nurses perceive interpreters as an important link to the patient when they do not share a mutual language, the nurses perceive interpreters as a bridge in the conversation.Aim:The purpose of the study is to describe nurses' experiences of the quality of assessments done with the help of an interpreter.Method:The study was conducted through interviews with ten nurses, working at psychiatric clinics. Qualitative content analysis was used for the analysis, which resulted in five categories.Results:The analysis resulted in one theme: "it´s the interpreter who tells me and have not the feeling that the patient has" and five categories: "shades of the language", "conversation structure", "the interpreter's competence", "interpreting implementing" and "the interpreter's gender and origin". The nurses experience working with interpreters as a challenge.

The purpose of this study was to examine the school counsellors and social service workers experience of how the child psychiatry manage their authority in the collaboration concerning children with mental health problems. The study was conducted using qualitative interviews with school counsellors, social service workers and one former employee of the Swedish child psychiatric care. Our results are divided into two themes: Collaboration and distribution of responsibility and Children who fall between the cracks. Examples of groups of children who according to our study are at risk of falling between the cracks are those who apart from mental issues have substance abuse issues or social issues, those whose parents are in a child custody dispute, children who are acting out and children with self-harm issues. The study also reveals that it's easier for children whose parents are active and knowledgeable to get help from the child psychiatric care and that it's a requirement for both parents and children to be highly motivated.There are established social hierarchs between agencies who partake in collaboration regarding children with mental illness.

Abstract. Aim: The aim of this study is to determine certain health, demographic and socioeconomic factors that affect the costs for specialized health care between the municipalities within the Västra Götaland region. Method: The method is explorative and analytical. The costs for specialized health care was divided into three different subgroups; independent somatic specialized health care, specialized health care provided by private practices or outside the region and psychiatric specialized health care. The data was age-standardized.

Background: The patient meets nurses in the emergency department that provide both nursing and has medical skills. The care that the patients are receiving should be individually adjusted. The care is shaped by the individual meeting with the patient according to the nursing theorist Orlando. There are large variations between the number of patients in an emergency department and it sets high demands on the staff, both physically and mentally. When the emergency department is highly loaded there is a priority for medical care and psycho-social and aesthetic aspects will have to wait.

Background: Effective treatment of patients with type 2 diabetes needs a good communication between nurse and patient. This creats a good relation and leads to a more effective patient education. Aim: The aim with the literature study was to describe how nurses trough patient education can achieve self-care for patients with diabetes type 2. Methods: Literature studies with both qualitative and quantitative articles were examined. Findings: The articles that were chosen for the results were sorted in the two categories relation and communication.

The objective of this study is to understand how people with psychiatric diseases who are enrolled at a psychiatric clinic experience the recovery process and which internal motivations and external factors influence the process. The study is based on interviews with five people who have been enrolled at a psychiatric clinic. Another aim of the study is to understand how the importance of the outpatient care for the personal recovery and the improvement opportunities of the support from the rehabilitation unit that the interviewees see. The study is qualitative and abductive approach was chosen. This means that the study is based on empirical data supported by established theories.

Det är sjuksköterskans ansvar att etablera en vårdrelation där patienten känner sig trygg, därför var det viktigt att belysa patientens egen uppfattning om vårdrelationens innebörd och vad det kan ha för betydelse för omvårdnaden. Syftet med studien var att undersöka vårdrelationens innebörd för vuxna patienter inom psykiatrisk tvångsvård. Studien är litteraturstudie med kvalitativ och deskriptiv design. Det gjordes en artikelsökning i Cinahl och PubMed med sökorden psychiatric care, caring relationship, coercion samt patients experiences. Artiklarna som valdes ut kvalitetsgranskades och sedan gjordes en manifest innehållsanalys.

The objective of this study is to understand how people with psychiatric diseases who are enrolled at a psychiatric clinic experience the recovery process and which internal motivations and external factors influence the process. The study is based on interviews with five people who have been enrolled at a psychiatric clinic. Another aim of the study is to understand how the importance of the outpatient care for the personal recovery and the improvement opportunities of the support from the rehabilitation unit that the interviewees see. The study is qualitative and abductive approach was chosen. This means that the study is based on empirical data supported by established theories.

Background: Relatives are those persons who are closest to the patient, regardless of relationship and included into the patient´s life world. When a person is in a palliative stage this affects not only the patient but also the relatives, as it implies such a big change in life for all. The nurse has an important role for both the patient and the relatives. Aim: The aim is to highlight the relative´s needs of support for palliative care. Method: A literature review based on previous research. Ten articles were found, nine with a qualitative approach and one with both qualitative and quantitative approach. Results: The analysis resulted in six themes, these were the result of the study. The six themes were, ?to be seen an confirmed?, ?good communication?, ?continuous information?, ?availability and continuity?, ?to participate? and ?to share responsibility with the staff?. Conclusion: As a nurse we come in contact with relatives of patients in a palliative setting in any form.

Introduction: Anxiety and depression are common among patients enrolled in psychiatric outpatient care. Ear Acupuncture is an alternative form of treatment that has been shown to relieve anxiety and depression in previous studies.Aim: To evaluate ear acupuncture as a group treatment for depression and anxietyMethod: A psychiatric outpatient clinic has been offering group treatments with ear acupuncture for anxiety and depression for 5 weeks. Participants of the study have answered self-rating scales Montgomery Åsberg Depression Rating Scale, Beck Anxiety Inventory and Sheehan Disability scale before and after the treatment period. Material was collected in the period 2008-2012 and has been analyzed in SPSS.Results: Data from 31 patients were included in the study. The results from the study showed a significant difference, between the measurements before and after treatment, with a reduction of the average values in the three different scales.Summary: From this study, it is difficult to draw any conclusions about the effect of ear acupuncture.

Achievements within the fields of computer- and telecommunication technology have led to a revolution when it comes to managing information. These achievements have made it possible to offer new services in healthcare, especially in telemedicine. New technology has become a complement to traditional care, thus partly compensating for insufficient time and resources. Telephone Linked Care (TLC) is a telecommunication technology that enables automated dialog counselling and monitoring of patients in their homes. During the last two decades numerous randomized controlled studies with TLC have demonstrated improvement among outpatients with chronic and health behaviour disorders.

Background: Palliative care is a type of care, which does not cure but eases the suffering caused by the disease. The goal of palliative care is not to extend or shorten the patient's life, but to relieve pain and distressing symptoms and to promote the patients? quality of life (QOL). QOL can be understood as a subjective sense of happiness of existence, which means that the patient is experiencing life when her total life situation is consistent with her ??wishes.

The number of people with another culture isincreasing in Sweden. This change in society bringsconsequences in health care that has not any methodsto manage. The Muslim woman?s meeting with thehealth care is one of those areas. The aim with thisstudy was to describe the nurses meeting with femaleMuslim patient.

Background: Sleeping is a condition that is necessary for all people because the body isgiven time to recover. Studies have shown that patients found it difficult to sleep during thehospital stay and it turned out to be several factors that disturbed the sleep during the night.The nurse should note the patient?s need for sleep and take into account environmental andother sleep disturbances to be able to implement nursing interventions. Purpose: The purposeof this study was to elucidate the factors that interfere with patient?s sleep duringhospitalization and nursing care to promote the patient?s ability to sleep.