Qualitative interviews are generally conducted in person. As the coronavirus pandemic (COVID-19) prevents in-person interviews, methodological studies which investigate the use of the telephone for persons with different illness experiences are needed. The aim was to explore experiences of the use of telephone during semi-structured research interviews, from the perspective of participants and researchers. Data were collected from mobile phone interviews with 32 individuals who had common mental disorders or multimorbidity which were analyzed thematically, as well as field notes reflecting researchers’ experiences. The findings reveal several advantages of conducting interviews using mobile phones: flexibility, balanced anonymity and power relations, as well as a positive effect on self-disclosure and emotional display (leading to less emotional work and social responsibility). Challenges included the loss of human encounter, intense listening, and worries about technology, as well as sounds or disturbances in the environment. However, the positive aspects of not seeing each other were regarded as more important. In addition, we present some strategies before, during, and after conducting telephone interviews. Telephone interviews can be a valuable first option for data collection, allowing more individuals to be given a fair opportunity to share their experiences.

The aim of this study was to investigate how district nurses work with their emotions and how they experience their discretion and stress in the workplace. To answer the study's purpose and questions, a qualitative method was used in the form of six semi-structured interviews with district nurses. The study is based on theories of emotional work and street-levelbureaucracy.

The study results show that the district nurses organize their emotions in a number of different ways and through different strategies, such as through deep and superficial emotional action. The most common strategies that are used by district nurses to manage their emotions are both mental and work-related management systems. Furthermore, the results show that the districtnurses experience a large discretion when performing a medical assessment and when prioritizing patient visits. Furthermore, the results show that the district nurses' discretion isnot limited by regulations, but it is the lack of time that limits their room for discretion andwhich leads to stress experiences. This problem is addressed by all district nurses through theuse of different management systems.

We interviewed 20 adolescents who were coercively placed in residential or psychiatric care. The aim was to explore their views on the way staff relate and perform their duties, favorable characteristics in staff, consequences of different treatment from staff and their safety experiences. Thematic analysis identified the following themes: Situational triggers of frustration; Care-based; rule-based; or passive-avoidant interaction styles toward adolescents and their responses; Adolescents' reflections about staff's interaction styles; and the Consequences on the unit atmosphere depending on different interaction styles toward the adolescents. Adolescents preferred staff who showed them respect and a clear wish to make life easier.

Today, it is common that a team of clinicians, from different disciplines, instead of one single doctor, care for a patient. This is especially true when it concerns more complicated diseases in highly specialised health care. Going from one doctor to a team of doctors raises new dimensions/problems/issues when deciding about the diagnosis and how to treat the patient. Instead of one person deciding, based on the information given from others, a group of people need to agree on a decision. How do the participants during such decision meetings argue for their experience and skill? What kind of technologies are available and how do they support the communication in the meeting? Måseide (2006), for example, focuses on how different forms of evidence influence and regulate the judgements and decisions of medical practitioners during such meetings. Groth et al. (2008), for example, focuses on the technology used during such meetings, with a focus on audio, video, and images.

The aim was to describe the nursing staff and ward managers' experiences of safety and violence in everyday meetings with the patients. The qualitative content analyses resulted in four themes: the relationship with the patient is the basis of care; the organizational culture affects the care given; knowledge and competence are important for safe care; and the importance of balancing influence and coercion in care. The staff had a varied ability to meet patients in a respectful way. One way of creating a common approach could be to discuss and reflect upon different options in the meeting with the patient.

Background: eHealth systems have been increasingly used to manage depressive symptoms in patients with somatic illnesses. However, understanding the factors that drive their use, particularly among patients with breast and prostate cancer, remains a critical area of research.

Objective: This study aimed to determine the factors influencing use of the NEVERMIND eHealth system among patients with breast and prostate cancer over 12 weeks, with a focus on the Technology Acceptance Model.

Methods: Data from the NEVERMIND trial, which included 129 patients with breast and prostate cancer, were retrieved. At baseline, participants completed questionnaires detailing demographic data and measuring depressive and stress symptoms using the Beck Depression Inventory–II and the Depression, Anxiety, and Stress Scale–21, respectively. Over a 12-week period, patients engaged with the NEVERMIND system, with follow-up questionnaires administered at 4 weeks and after 12 weeks assessing the system’s perceived ease of use and usefulness. Use log data were collected at the 2- and 12-week marks. The relationships among sex, education, baseline depressive and stress symptoms, perceived ease of use, perceived usefulness (PU), and system use at various stages were examined using Bayesian structural equation modeling in a path analysis, a technique that differs from traditional frequentist methods.

Results: The path analysis was conducted among 100 patients with breast and prostate cancer, with 66% (n=66) being female and 81% (n=81) having a college education. Patients reported good mental health scores, with low levels of depression and stress at baseline. System use was approximately 6 days in the initial 2 weeks and 45 days over the 12-week study period. The results revealed that PU was the strongest predictor of system use at 12 weeks (βuse at 12 weeks is predicted by PU at 12 weeks=.384), whereas system use at 2 weeks moderately predicted system use at 12 weeks (βuse at 12 weeks is predicted by use at 2 weeks=.239). Notably, there were uncertain associations between baseline variables (education, sex, and mental health symptoms) and system use at 2 weeks, indicating a need for better predictors for early system use.

Conclusions: This study underscores the importance of PU and early engagement in patient engagement with eHealth systems such as NEVERMIND. This suggests that, in general eHealth implementations, caregivers should educate patients about the benefits and functionalities of such systems, thus enhancing their understanding of potential health impacts. Concentrating resources on promoting early engagement is also essential given its influence on sustained use. Further research is necessary to clarify the remaining uncertainties, enabling us to refine our strategies and maximize the benefits of eHealth systems in health care settings.

The relations of power between healthcare-related institutions and the professionals that interact with them are changing. Generally, the institutions are gaining the upper hand. Consequently, the intellectual abilities necessary for professionals to pursue the internal goods of healthcare are changing as well. A concrete case is the struggle over sickness benefits in Sweden, in which the Swedish Social Insurance Agency (SSIA) and physicians are important stakeholders. The SSIA has recently consolidated its power over the sickness certificates that doctors issue for their patients. The result has been a stricter gatekeeping of sickness benefits. In order to combat the inroads made by state institutions into sickness certification, and into the sphere of medical practice, some doctors have developed cunning "techniques" to maximize the chance to have their sickness certificates accepted by the SSIA. This article attempts to demonstrate that cunning intelligence-the ability of the weak to "outsmart" a stronger adversary-plays an important role in the practice of medicine. Cunning intelligence is not merely a defective form of prudence (phronesis), nor is it simply an instance of instrumental reason (techne), but rather an ability that occupies a distinct place among the intellectual abilities generally ascribed to professionals.

The commonly occurring metaphors and models of the doctor-patient relationship can be divided into three clusters, depending on what distribution of power they represent: in the paternalist cluster, power resides with the physician; in the consumer model, power resides with the patient; in the partnership model, power is distributed equally between doctor and patient. Often, this tripartite division is accepted as an exhaustive typology of doctor-patient relationships. The main objective of this paper is to challenge this idea by introducing a fourth possibility and distribution of power, namely, the distribution in which power resides with neither doctor nor patient. This equality in powerlessness-the hallmark of "the age of bureaucratic parsimony"-is the point of departure for a qualitatively new doctor-patient relationship, which is best described in terms of solidarity between comrades. This paper specifies the characteristics of this specific type of solidarity and illustrates it with a case study of how Swedish doctors and patients interrelate in the sickness certification practice.

Situationen för LGBTI-personer i de nordiska länderna har förändrats radikalt de senaste årtiondena. Detta har medfört ökad tillgång till rättigheter på det sociala och juridiska området, förstärkt skydd mot diskriminering, ökad synlighet och fler möjligheter till gemenskap. Trots detta framgår det i studier att en könsidentitet eller sexuell läggning som inte följer den konventionella normen fortfarandesignifikant ökar risken för ohälsa. Hur påverkar dessa villkor förutsättningar för äldre LGBTI-personers möjligheter i åldrandet och vad som sker i kontakten med vård och omsorg? Nordiska ministerrådet har tagit initiativ till ett projekt som ska bidra till ökad kunskap om äldre LGBTI-personers levnadsvillkor och livskvalitet, särskilt i mötet med hälso- och omsorgsvård. Rapporten baseras på 38 publikationer som utgörs av kvantitativa såväl som kvalitativa studier

De senaste decennierna har sjuksköterskeutbildningen i Sverige gått från en praktisk utbildning till en professionsutbildning. Professionsperspektivet har inneburit ett ökat fokus på studenternas utveckling av academic literacies (Lea & Street, 2006). I denna presentation redovisas ett högskolepedagogiskt projekt om litteracitetsutveckling på Röda Korsets Högskola (RKH). Det har involverat både studenter och lärare inom sjuksköterskeutbildningen.

Under samma period som utbildningen har professionaliserats har rekryteringen till högskolan breddats vilket lett till en förändrad studentgrupp inom sjuksköterskeutbildningen (Borglin & Fagerström, 2012). Studenter överlag upplever en svårighet med att utveckla en akademisk litteracitet (Ask, 2007). Svårigheterna kan bland annat kopplas till att studenterna har svårt att förstå vad som förväntas av dem i deras akademiska texter. Men inte bara studenterna ser det akademiska skrivandet som svårt. Många lärare som arbetar på RKH uttrycker att det är svårt att veta vad som är bra arbetssätt för att stödja studenternas litteracitetsutveckling.

I samband med RKH:s flytt till Campus Flemingsberg startade RKH 2018 ett samarbete med Södertörns högskolas högskolepedagogiska enhet, studieverkstad och bibliotek om en introduktion till akademiskt skrivande. På Södertörns högskola pågår sedan några år en satsning på ämnesintegrerat akademiskt skrivande som omfattar arbete med att söka, värdera, läsa och skriva akademiska texter.

Syftet med momentet akademiskt skrivande inom RKH har varit att under första terminen och samtidigt med examinationen av ämnesinnehållet, introducera studenterna till det akademiska skrivandet. Olika aktiviteter som formativ respons har använts för att stimulera studenternas lärande och lägga en grund för deras fortsatta utveckling av akademisk och professionell litteracitet. Flertalet studenter säger att det varit givande att tidigt i utbildningen få starta lärprocessen gällande ett vetenskapligt förhållningssätt, även om många studenter uttrycker att det akademiska skrivandet är svårt.

En viktig del av samarbetet mellan högskolorna har varit att skapa förutsättningar för hållbarhet även vad gäller ämneslärarnas kunskaper om litteracitetsutveckling. Bland annat har workshoppar hållits med hela lärarkollegiet, inte bara med de lärare som arbetar på den aktuella kursen. Lärarna, som ofta implicit har lärt sig det akademiska skrivandet, har fått bekanta sig med verktyg och nyckelbegrepp för att diskutera text med studenter, och har funnit arbetssättet stimulerande. För hållbarheten i utbildningen gäller att alla lärare kan fortsätta att ge stöd i utvecklingen av studenternas litteracitet. Precis som studenterna har konstaterat i sina utvärderingar lär sig ingen ett väl utvecklat akademiskt och professionellt skrivande på första terminen.

Referenser

Ask, S. (2007). Vägar till ett akademiskt skriftspråk [Roads to academic written language] In Swedish. Växjö University, Växjö University Press. (No 115/2007)

Borglin, G., & Fagerström, C. (2012). Nursing students' understanding och critical thinking and appraisal and academic writing: A descriptive, qualitative study. Nurse Education in Practice, 12, 356-360. doi:10.1016/j.nepr.2012.04.009

Lea, M. R., & Street, B. V. (2006). The "Academic Literacies Model: Theory and Application. Theory Into Practice, 45, 368-377. doi:10.1207/s15430421tip4504_11

Empathy is an everyday phenomenon and a basic moral capacity, and it is also the most central professional skill and ethical guiding tool of nursing care. To be empathic as a nurse means to be able to feel and see things from the point of view of the patient and act in accordance with this knowledge when caring for his/her good and attempting to relieve his/her suffering. Nurses need to be dedicated but still humble when it comes to empathy: to endeavour the step into the perspective of the patient does not mean that this is possible in any total or infallible sense; only the patient feels and knows what it is like to experience this particular suffering as this particular person at this particular time. If or when empathy is complemented by a dialogue with the patient, it becomes possible to reach a more complete and confirmed understanding of his/her predicament. The chapter offers a phenomenological theory of empathy in nursing, inspired by Edith Stein, which brings out the emotional aspects of the phenomenon in concordance with its cognitive features.

Whereas empathy is most often looked upon as a virtue and essential skill in contemporary health care, the relationship to sympathy is more complicated. Empathic approaches that lead to emotional arousal on the part of the health care professional and strong feelings for the individual patient run the risk of becoming unprofessional in nature and having the effect of so-called compassion fatigue or burnout. In this paper I want to show that approaches to empathy in health care that attempt to solve these problems by cutting empathy loose from sympathy-from empathic concern-are mistaken. Instead, I argue, a certain kind of sympathy, which I call professional concern, is a necessary ingredient in good health care. Feeling oneself into the experiences and situation of the patient cannot be pursued without caring for the patient in question if the empathy is going to be successful. Sympathy is not only a thing that empathy makes possible and more or less spontaneously provides a way for but is something that we find at work in connection to empathy itself. In the paper I try to show how empathy is a particular form of emotion in which I feel with, about, and for the other person in developing an interpretation of his predicament. The with and for aspects of the empathy process are typically infused by a sympathy for the person one is empathizing with. Sympathy can be modulated into other ways of feeling with and for the person in the empathy process, but these sympathy-replacement feelings nevertheless always display some form of motivating concern for the target. Such an understanding of empathy is of particular importance for health care and other professions dealing with suffering clients.

One way to examine the enigmatic meaningfulness of human life is to ask under which conditions persons ask in earnest for assistance to die, either through euthanasia or physician assisted suicide. The counterpart of intolerable suffering must consist in some form of, however minimal, flourishing that makes people want to go on with their lives, disregarding other reasons to reject assisted dying that have more to do with religious prohibitions. To learn more about why persons want to hasten death during the last days, weeks or months of their lives, what kinds of suffering they fear and what they hold to be the main reasons to carry on or not carry on living, the paper offers some examples from a book written by the physician Uwe-Christian Arnold. He has helped hundreds of persons in Germany to die with the aid of sedative drugs the last 25 years, despite the professional societies and codes in Germany that prohibit such actions. The paper discusses various examples from Arnold’s book and makes use of them to better understand not only why people sometimes want to die but what made their lives meaningful before they reached this final decision.

Whereas employee participation is generally conceived to facilitate implementation of organizational change, only limited research has investigated whether it may reduce the negative effects of downsizing. The present study compares two Swedish hospitals that implemented downsizing in different ways. While there were no major differences in stressors between hospitals, proactive implementation was associated with more employee participation. Moreover, employee participation variables were positively associated with employee work attitudes and well-being at both hospitals. These findings provide insights concerning the importance of a long-term strategic implementation of organizational change.

Background: Paid work is one of the most important aspects in life among working-aged women diagnosed withbreast cancer. Despite several attempts, no previous study provides a comprehensive overview from the women’s perspective about factors of importance for being able to work or not. Therefore, the aim of this study was to gainknowledge about factors that women themselves state are of decisive importance for being able to work or not during the frst two years after breast cancer surgery.

Methods: Data was collected in a two-year follow-up questionnaire within the frame of a prospective cohort studyof working-aged women who had undergone breast cancer surgery. 749 were included in the questionnaire studyand of the 616 (82%) responding women, 462 (75%) wrote statements on an open-ended question about factors ofdecisive importance for being able to work or not work during the past two years. The statements were analyzed withcontent analysis.

Results: Five categories of factors of importance for being able to work or not were identifed, each covering severalsub-categories: Health and wellbeing, Contacts and encounters, Flexibility and adjustment possibilities, Socioeconomic consequences from working/not working, and Own motivation and characteristics. A wide variety of factorswere mentioned by the women and the fndings give a multifaceted picture of many single but interrelated factors ofdecisive importance for being able to work/not work. The importance of fexibility in the return-to-work process wasstressed, as well as the importance of supportive encounters from, e.g., colleagues, managers, as well as relatives.

Conclusions: The results give a comprehensive overview over a variety of diferent types of factors for being ableto return to/remain in work or to not work after breast cancer surgery, adding new knowledge about e.g. the importance of colleagues, and the women’s own preferences or characteristics. These are factors that diferent stakeholders, both from healthcare but also from the work place and the insurance ofce, need to be aware of and collaboratearound to support women with breast cancer during the period of treatment, rehabilitation and return to work.

Since 2017, opportunistic screening for cognitive impairment takes place at the geriatric ward of a local hospital in Sweden. Persons above the age of 65 who are admitted to the ward, who have not been tested for cognitive impairment during the last six months nor have a previously known cognitive impairment, are offered the Mini-Mental State Examination and the Clock-Drawing Test. This article analyses what the opportunistic screening practice means for patients and healthcare professionals. It combines a phenomenologically-oriented focus on subjectivity and sense-making with a focus that is inspired by science and technology studies on what the tests become within the specific context in which they are used, which allows a dual focus on subjectivity and performativity. The article shows how the tests become several different, not infrequently seemingly contradictory, things: an offer, an important tool for knowledge-production, something unproblematic yet also emotionally troubling, something one can fail and an indicator that one belongs to a risk group and needs to be tested. Further, the article shows how the practice is shaped by the sociocultural context. It examines the role of the affective responses to the test for subjectivity - particularly patient subjectivity - and offers a set of recommendations, if this practice were to expand to other hospitals.

Akut vård och akutsjukhus är ett av samhällets mest sammansatta servicesystem. Detta förhållande har alltmer uppmärksammats i skuggan av hälso- och sjukvårdens övergripande problem - de totala kostnaderna och finansieringen - vilka i början av 1990-talet framkallade en serie reformer inom landets landsting. Den kanske mest radikala åtgärden var bolagiseringen (1994) och sedermera privatiseringen (1999) av S:t Görans Sjukhus i Stockholm. Exemplet S:t Göran har också ansetts så framgångsrikt att det har följts av nya bolagiseringar och fr.o.m. årsskiftet 2000/2001 förväntas i stort sett all akutsjukvård i Stockholm bedrivas inom bolag. Detta till trots saknas nästan helt litteratur som analyserar denna unika utveckling.Denna bok skärskådar utvecklingen (1994 - 1999) inom S:t Görans Sjukhus AB (bolaget) respektive Södertälje Sjukhus (förvaltningen) - två akutsjukhus i Stockholm med olika driftsformer, varierande historia och olika förutsättningar att utnyttja de möjligheter som 1990-talet förde med sig. Boken tar upp hälso- och sjukvårdens effektivitet, lyfter fram osäkerhet som ett av de framträdande arbetsvillkoren för sjukvården och beskriver chefernas osäkerhet och i kontrast till denna läkarnas, sjuksköterskornas och undersköterskornas trygghet samt förklarar meningsskapandets (sensemaking) centrala betydelse i vården.