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Bakgrund: Under de senaste decennierna har patienters återhämtning lyfts fram som ett centralt tema inom psykiatrisk omvårdnad och otaliga artiklar har skrivits på området. Tidigare forskning visar att långt ifrån alla patienter upplever att den vård de fått bidragit till återhämtning. En förklaring kan vara att patienters och personals uppfattningar av vad återhämtning innebär skiljer sig åt, inte minst på grund av de olika perspektiv på återhämtning som beskrivs i litteraturen. Syfte: Syftet med studien var att utforska betydelsen av personlig återhämtning genom att syntetisera tidigare kvalitativ forskning av hur personer med psykisk ohälsa erfar återhämtning samt söka förståelse för hur psykiatrisk omvårdnad kan bidra till återhämtning. Metod: Metaetnografi baserad på 18 artiklar. Resultat: Analysen visar dels att tidigare forskning ofta bedrivs inom ramen för en avgränsad teoretisk disciplin, och med det också ett perspektiv på återhämtning som är snävare än det patienterna själva inkluderar i begreppet. Ur ett patientperspektiv är således fler aspekter av återhämtning inkluderade i återhämtningsprocessen som upplevs och förstås som att leva i ständig förändring där förbättring är en aspekt, men där också det som vårdpersonal ofta uppfattar som bakslag ses som en viktig del i ens egen återhämtningsresa. Slutsats: Psykiatrisk omvårdnad behöver vila på en mångdimensionell förståelse av återhämtning, så att den inte reduceras till avgränsade teoretiska perspektiv. Vårdare behöver också ha förståelse för att återhämtning inte enbart handlar om att ”gå framåt”, utan lika mycket om att kunna leva med motgångar samt att få stöd – men också utrymme – i balansgången mellan att vara samtidigt sårbar och kapabel.

Introduction: It is well-known that people with dementia living in residential care facilities spend most of their time not engaged in meaningful activities. Being involved in activities can improve their quality of life. Animal-assisted therapy is an activity that can evoke engagement and joy. Another way to create engagement and promote communication between people with dementia and caregivers is to use photos.

Methods: In this observational study, the researchers combined animal-assisted therapy and photobooks in order to explore whether photos of people with dementia who were engaged in animal-assisted therapy could be used as a tool for communication in dementia care. Ten persons (4 men and 6 women; aged 72-92) with dementia were video recorded during photo-elicited conversations with a dog handler/assistant nurse. The recordings were conducted in two residential care facilities in Sweden during 2017-2018. Each participant was video recorded 2-4 times. The recordings were analysed using The Observed Emotion Rating Scale and The Observational Measurement of Engagement-OME Modified. In addition, the video recordings were interpreted from a hermeneutic perspective.

Findings: The findings showed that the most frequently observed effects were pleasure and general alertness, and the participants were observed to be attentive most of the time. The most common attitude during the conversations was 'somewhat positive'. The hermeneutic interpretations were grouped into four themes: Conveys a structure for the conversation with an inherent beginning and ending; An opportunity to recognise oneself and recall a sense of belonging; Awakens emotions and creates fellowship and Entails confirmation and revitalises their identity.

Conclusion: Photobooks can be used by caregivers as a tool for meaningful and joyful communication with people with dementia, even those with severe dementia.

Patients in forensic psychiatric settings not only have to deal with their mental illness, but also memories of criminal activities and being involuntarily hospitalized. The aim of the present study was to explore how nurses working in forensic psychiatric services understand and approach patients' experiences of suffering. Data were generated by semistructured interviews with psychiatric nurses from two different forensic psychiatric units in Sweden. Data were analysed by means of a hermeneutic approach inspired by Ricoeur's hermeneutics. The findings are reflected in four main themes: (i) ignoring suffering; (ii) explaining suffering as a natural and inevitable part of daily life in the forensic context; (iii) ascribing meaning to suffering; and, (iv) being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering means that nurses are not only confronted with patients' suffering, but also their own reactions to those patients. If suffering is not recognized or encountered, there is a risk that actions may have a negative impact on patients.