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Objective: Based on the principle of the autonomy of the patient, shared decision-making (SDM) is the ideal approach in clinical encounters. In SDM, patients and healthcare professionals (HCPs) share knowledge and power when faced with the task of making decisions. However, patients are often not involved in the decision-making process. In this study, we explore medication decision-making during hospitalization and how power in the specific patient--HCP relationship is articulated, as analysed by Foucauldian theory. Methods: A qualitative case study, comprising observations of patient-HCP encounters at an internal medicines ward at a university hospital in Norway, followed by semi-structured interviews. The narratives (n = 4 patients) were selected from a larger study (n = 15 patients). The rationale behind the choice of these patients was to include diverse and rich accounts. The four patients in their 40s--70s were included close to the day of presumed discharge. Results: The narratives provide an insight into the patients as persons, their perspectives, including what mattered to them during their hospitalization, especially in relation to medications. Overall, SDM was not observed in this study. Even though all the participants actively tried to keep their autonomous capacity and to resist the HCPs' use of power, they were not able to change the established dynamics. Moreover, they were not allowed an equal voice to those of HCPs and thus not to escape the system's objectification and subjectification of them. Conclusion: There is a need for HCPs to get more familiarized with SDM. The healthcare system and the individual HCP need to make more room for dialogue with the patients about their preferences. A part of this is also how health care systems are structured and scheduled, thus, it is important to empower patients and HCPs alike. [ABSTRACT FROM AUTHOR]

Background: Patients are expected to participate in the hospital discharge process, assume self‐management after discharge and communicate relevant information to their general practitioner; however, patients report that they are not being sufficiently empowered to take on these responsibilities. The aim of this study was to explore and understand the discharge process with a focus on medicines communication, from the patient perspective. Methods: Patients were included at a hospital ward, observed during health‐care personnel encounters on the day of discharge and interviewed 1‐2 weeks after discharge. A process analysis was performed, and a content analysis combined data from observations and data from patient interviews focusing on medicines communication in the discharge process. Results: A total of 9 patients were observed on the day of discharge, equalling 67.5 hours of observations. The analysis resulted in the following themes: (a) the observed discharge process; (b) patient initiatives; and (c) the patient role. The medicines communication in the discharge process appeared unstructured. Various patient preferences and needs were revealed. The elements of the best practice structured discharge conversation were observed; however, some patients did not have a discharge conversation at all. Conclusions: The study contributes to a broader understanding of the discharge process, how patients experience it, including their role. It is evident that the discharge process is not always tailored to meet the patients' needs. More focus on early patient involvement and communication, in order to better prepare patients for self‐management of their medications, is important for their health outcomes. [ABSTRACT FROM AUTHOR]

First-hand experience of being a client is regarded by many psychotherapists as making an essential contribution to professional development. Although research has not established any direct influence on client outcome, arising from therapist participation in personal therapy, qualitative studies have explored how therapists transfer learning from one context to the other. A group of six therapists-researchers engaged in a collective autoethnography in which we shared narrative accounts of our own experiences as clients. Together we covered a wide set of therapies, sought for varied purposes, and from different stages in the life-course. Different areas of learning were identified: negative experiences could strengthen own convictions for acting differently; positive experiences worked as inspiration and support; being in therapy early in life represented a significant formative experience; working through complex personal issues in therapy gave the courage to identify similar conflicts in phantasies and realities of clients. The link between having been a client and working as a therapist is a subjective, reflective process of reworking figure and ground in the search for professional sensitivity. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to gain knowledge about how the integration of personal and professional experiences affects therapeutic work. Method: Therapists (N = 14) who had been recommended by their leaders at their individual workplaces were interviewed twice with semi-structured qualitative interviews, which were then subjected to thematic and Interpretative Phenomenological Analysis. Results: All the therapists in the sample described their personal qualities as an experienced tension between their personal strengths and vulnerabilities in the therapeutic setting. This tension came to expression through four subordinate themes: (a) The tension between perceiving oneself as a helper while dealing with one's own needs for attention and care; (b) The tension between the ability for embodied listening to the patient while tuning into oneself; (c) The tension between staying present while handling aggression and rejection from clients; and (d) The tension in striving for a constructive balance between closeness and distance. Conclusion: The results point to ways in which the personal selves of the therapists may affect their professional role performance. Drawing upon previous research and literature on the topic, the paper discusses how therapists' personal qualities are experienced as affecting their work and suggests several implications for psychotherapy training and practice. [ABSTRACT FROM AUTHOR]