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Sjuksköterskors upplevelser av utmaningar i personcentrerad vård med multisjuka patienter inom slutenvården: En allmän litteraturstudie
Halmstad University, School of Health and Welfare.
Halmstad University, School of Health and Welfare.
2025 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesisAlternative title
Nurse’s Experiences of Challenges in Person-centred Care for Multimorbid Patients in Inpatient Care : A general literature study (English)
Abstract [sv]

Bakgrund: En globalt åldrande befolkning och ett ökat antal kroniska sjukdomar gör multisjuklighet till ett växande problem. Slutenvården erbjuder avancerad akutsjukvård utformad för att behandla specifika sjukdomstillstånd. Omvårdnaden kring multisjuklighet är komplex där polyfarmaci och vårdplanering utgör centrala delar. Multisjuka patienter upplever ofta brister i samordning och kommunikation då omvårdnaden inte blir personcentrerad. Syfte: Syftet var att belysa sjuksköterskors upplevelser av utmaningar i utförandet av personcentrerad vård med multisjuka patienter inom slutenvården. Metod: En allmän litteraturstudie med abduktiv ansats, där nio artiklar kodades och underkategorier skapades vilka sorterades utifrån McCormack och McCances teoretiska ramverk för personcentrerad vård. Resultat: Resultatet presenteras i fyra kategorier med tillhörande underkategorier: makrosammanhang inklusive fragmenterad vård och tidsbrist, förutsättningar inklusive kunskapsbrist och emotionella påfrestningar, vårdmiljön inklusive resursbrist och bristande teamsamarbete, personcentrerade processer inklusive komplexiteten hos multisjuka patienter, hinder i vårdrelationer och en komplex vårdplanering. Konklusion: Slutenvårdens akuta och sjukdomsinriktade utformning resulterar i stora utmaningar för sjuksköterskor i utförandet av personcentrerad och helhetsinriktad vård. En personcentrerad vård har stor betydelse vid multisjuklighet där vårdbehovet är komplext, vilket medför betydande utmaningar i omvårdnaden. Sjuksköterskor upplever emotionella påfrestningar i form av höga förväntningar samt tids- och resursbrist, vilket i sin tur påverkar vårdrelationen negativt.

Abstract [en]

Background: An aging population and an increasing number of chronic diseases make multimorbidity a growing problem. Inpatient care provides advanced acute care designed to treat specific conditions. Caring for multimorbid patients is complex, with polypharmacy and healthcare planning being central aspects. Multimorbid patients can experience lack of coordination and communication resulting in nursing that is not personcentred. Aim: The aim was to highlight nurses’ experiences of challenges in providing person-centred care with multimorbid patients in inpatient care. Method: A general literature review with an abductive approach, where nine articles were coded, subcategories were created and sorted based on McCormack and McCance’s theoretical framework for person-centred care. Results: The findings are presented in four categories with associated subcategories: macro context including fragmented care and lack of time, prerequisites including lack of knowledge and emotional strain, the care environment including resource shortages and lack of team collaboration, person-centred processes including the complexity of multimorbid patients, obstacles in the care relationship and a complex care planning. Conclusion: The acute and disease-oriented design of inpatient care results in significant challenges for nurses to deliver person-centred and holistic care. Person-centred care is particularly important in cases of multimorbidity where the care needs are complex, posing substantial challenges in nursing. Nurses experience emotional strain due to high expectations, time constraints and resource shortages, which negatively impacts the care relationship.

Place, publisher, year, edition, pages
2025. , p. 26
Keywords [en]
Multimorbidity, inpatient care, nurses' experiences, person centred care
Keywords [sv]
Multisjuklighet, personcentrerad vård, sjuksköterskors upplevelser, slutenvård
National Category
Nursing
Identifiers
URN: urn:nbn:se:hh:diva-55760OAI: oai:DiVA.org:hh-55760DiVA, id: diva2:1949581
Educational program
Nursing Programme, 180 credits
Presentation
, Varberg (Swedish)
Supervisors
Examiners
Available from: 2025-04-08 Created: 2025-04-03 Last updated: 2025-04-08Bibliographically approved

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