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Health services in Norway have been described as fragmented with weak coordination between different care levels with respect to patient pathways. The Coordination Reform’s aim was to improve patient pathways and strengthen user participation. The aim of this study was to investigate health personnel ́s experiences with patient pathways in municipalities in Western Norway. A qualitative design was chosen. Six focus group interviews with health personnel working in municipalities in Western Norway were conducted in 2013 and 2014. The interviews revealed that health personnel experienced that local health services gave cohesive patient pathways and strengthened user participation. Cohesive patient pathways and locally adapted pathways were considered important. Coordination and electronic communication between primary and specialist health care services were seen as inadequate. Trust, teamwork, competence and necessary resources were considered vital. Health personnel ́s experiences indicated that the intended aim of cohesive patient pathways near the patient was met.

Learning and competence development in community health service – an interview study of cancer nurses The number of cancer patients is expected to increase 30% by 2020. To meet the needs of seriously ill and dying cancer patients the community health service must be strengthened. There is little knowledge about the development of competence in the community health service. The aim of this study was to get more knowledge about competence development of cancer nurses.The study has a phenomenological hermeneutical design. Data was based on eight qualitative interviews with cancer nurses. The content of daily work and the cooperation within the community of practice were found to be important. Experience, theoretical knowledge, expectations and attitudes were of importance in their learning, and this is accomplished in cooperation with others through trust, having enough time and responsibility. It will be a challenge to meet the demands to quality and competence in future cancer care. Employing advanced nurse practitioners can be a resource, strengthening quality, improving nursing and innovation.

Hensikta er å tilføre kunnskap om sjukepleiarstudentar si læring i praksisstudiet i somatiske sengeavdelingar. Forskingsspørsmåla er: Korleis lærer studentane ulike sjukepleiarfunksjonar?, Korleis samhandlar student og praksisrettleiar om læring? Observasjonar av sjukepleiarstudentar og intervju med studentar og praksisrettleiar er nytta for å samle det empiriske materialet. Studien viste at hjelperolla, den diagnostiske og overvakande funksjonen og den administrerande funksjonen til medisinsk behandling er tydelegast i materialet. Hjelperolla og samhandlinga med pasientane blir av studentane framheva som særleg verdfulle og synest å ha stor betyding for utviklinga av sjukepleiaridentitet. Rettleiing bidrar til at studentane tileignar seg avdelinga sitt repertoar.