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  • 301.
    Forsberg, Mårten
    et al.
    Red Cross University College of Nursing.
    Rittengren, Martin
    Red Cross University College of Nursing.
    Kvinnors erfarenheter av att leva med män med prostatacancer: en litteraturöversikt2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Prostate cancer is one of the most common cancers globally and the most common cancer in Sweden. If the men when diagnosed are in a relationship with someone, this person may be affected by this. The purpose of this study was to examine the partner's experience of living with a man with prostate cancer. A literature review based on qualitative material was carried out. Fifteen articles were analyzed and eight categories were identified: Changed outlook on life, Caregiver, Information, Support, Sexuality and Intimacy, Team, Communication, and Daily Life. The results showed that women often take on the role of caregivers and that they showed a need for additional information and support. According to women, the impotence the men suffered from after treatment had an impact on their sex-life. Although the women prioritized that their husbands were still alive instead of a functional sex-life many felt that their sex-life had been affected in a negative sense. Some women described how they responded to the cancer with her husband as a unit. Good communication between women and their husbands were perceived by some women as important. Many women described how their life changed and that they used various strategies to cope with everyday life. When women assume the role of caregivers it's important for them to have the right kind of information at the right time given to them by health care providers, this in order to be able to prepare for and respond to the role as a caregiver. Health services therefore need to develop guidelines to ensure that the needs of women are included in the care processes of the men. 

  • 302.
    Forsgren, Cina
    The Swedish Red Cross University College.
    Upplevelser hos föräldrar till barn som drabbats av cancer2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden about 300 children are diagnosed with cancer yearly. When a child is struck by cancer it affects the whole family and is very traumatic especially for the parents. At diagnosis many parents experience confusion and helplessness. When the child starts treatment, an adaptation to the new situation is necessary where the parents need to help their child through the treatment. When treatment is over another phase starts, concerning anxiety about relapse. Parents often perceive nursing staff as an important support during the child's illness. Aim: The purpose of this study is to highlights how parents to children with cancer experience and handle their situation. Method: A litterature review was made of the 10 included studies. The studies were analyzed in terms of highlighting parent's experiences and copingstrategies when their child was struck by cancer. Results: The results show that parents of children with cancer is at great risk of having psychological problems. Initially it was important for the parents to try to understand the situation and make it comprehensive. During the treatment many parents experienced that they took the role of the child's "guardian angel" which made the situation manageable. When treatment is finished it is important to try to regain the normal life they had before and try to find the meaning of life again. The results show that it is important for the health of the whole family to have a family focused perspective when caring for children with cancer.

  • 303.
    Forsman, Ida
    et al.
    The Swedish Red Cross University College.
    Hedman, Linnea
    The Swedish Red Cross University College.
    Någon kunde ha förberett mig för detta: En litteraturstudie om sexuell hälsa och gynekologisk cancer2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Gynecological cancer is an expanded spectrum of cancer diseases among women and the treatments have importance for the experience of sexual health. Sexual health is important for the total experience of health. If the sexual health is perceived unsatisfactory, a suffering can arise. Aim: The aim is to describe women’s experience of sexual health within gynecological cancer. Method: A literature review of twelve qualitative articles was performed. Results: The analysis resulted in experienced barriers for sexual health within gynecological cancer. The barriers are presented in three main categories: The sexual body, Sexual obstacles and Sexual relations. Conclusion: Women with gynecological cancer mainly experience several barriers for sexual health. The barriers can lead to an unsatisfied sexual health which can cause a suffering. By knowledge about the experience of sexual health within gynecological cancer, the health care can provide care including several aspects of the disease and thereby decrease the risk for suffering. Clinical significance: This study can contribute knowledge about women’s perceived sexual health within gynecological cancer. Health care providers have an important role to fulfill regarding women’s experience of lack of information. Education and discussion about sexual health in the nursing education creates conditions for conversations about sexual health to become an obvious part of the health care.

  • 304.
    Forsner, Maria
    et al.
    Karolinska University Hospital.
    Mattsson, Janet
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet, Karolinska University Hospital.
    Caring for Dying Children in the Pediatric Intensive Care Unit, Nurses and Parent’s Perspective2019In: Online Journal of Complimentary & Alternative Medicine, Vol. 1, no 2, p. 1-7, article id 000510Article in journal (Refereed)
    Abstract [en]

    Caring for dying children is complex and requires coordination of all resources. In PICU the main objective is to save lives and ensure vital functions in critically ill children. However due to the child’s critical and life-threatening condition, there is always the possibility the child will not survive. The acuity and technical nature of the intensive care context can provide an obstacle in the transition to palliative care and furthermore conflict with the affected families’ needs. The study aim was to enlightening caring as it is represented in caring situations of dying children at PICU. An Interpretative Phenomenological design was applied. The data collection was performed at three PICU in Sweden in two different occasions at 2011 and 2016 [1,2]. Caring situations of a total of 18 children were observed, of these five cases were estimated as end of life care or lifethreatening conditions. Additionally, nurses and parents were interviewed in direct connection to the observation. Results showed that for nurses, it was a challenge to change perspective from curative to palliative care. Furthermore, medical examinations and treatment was experienced to disturb the dying child thus causing unnecessary suffering. Parents found it difficult to leave their dying children even just for a moment. At the same time the space in PICU usually did not support closeness and parenting but rather separated the dying child from her/his family. In conclusion, since it isn´t possible to always care for dying children in specialized palliative care units these results illuminate the importance of guidelines and training in palliative care in PICU and other acute pediatric care units. Children and their family ought to have the best care possibly when affected by life-limiting or life-threatening illness.

  • 305.
    Fossum, Björn
    et al.
    Red Cross University College of Nursing. Stockholm Centre of Public Health / Karolinska Hospital, Karolinska Institutet.
    Arborelius, E.
    Karolinska Hospital, Karolinska Institutet.
    Theorell, T.
    Karolinska Institutet.
    How physicians experience patient consultations at on orthopaedic out-patient clinic: A qualitative study2002In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 47, no 2, p. 127-135Article in journal (Refereed)
  • 306.
    Fossum, Bjöörn
    et al.
    Red Cross University College of Nursing. Karolinska Institutet.
    Arborelius, E.
    Karolinska Institutet.
    Bremberg, S.
    National Institute of Public Health, Stockholm.
    Evaluation of a counseling method for the prevention of child exposure to tobacco smoke: An example of client-centered communication2004In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 38, no 3, p. 295-301Article in journal (Refereed)
  • 307.
    Fossum, Bjöörn
    et al.
    Red Cross University College of Nursing. Karolinska Hospital.
    Arborelius, E.
    Karolinska Hospital.
    Theorell, T.
    National Institute for Psychosocial Factors and Health Stockholm.
    How do patients experience consultations at an orthopaedic out-patient clinic?: Eighteen patients comment on video-taped consultations: A qualitative study1998In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 8, no 1, p. 59-65Article in journal (Refereed)
  • 308.
    Fossum, Maren
    et al.
    Norwegian University of Science and Technology, Trondheim, Norway / KTH.
    Strömberg, Emma
    KTH.
    Sanchez, Javier
    Karolinska Institutet.
    Rotstein, Samuel
    Karolinska Institutet.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Nursing and Care. Karolinska Institutet.
    Aune, Ragnhild E
    Norwegian University of Science and Technology, Trondheim, Norway.
    Preliminary In-Vitro Study of Surface Altera1ons of Subcutaneous Venous Access Ports Exposed to Antineoplastic Drugs and Whole Blood2015In: TMS 2015, 144th Annual Meeting & Exhibition: Supplemental Proceedings, John Wiley & Sons, 2015, p. 645-652Conference paper (Refereed)
  • 309.
    Fossum, Maren
    et al.
    Norwegian University of Science and Technology, Trondheim, Norway.
    Tunc, Zozan
    KTH.
    Strömberg, Emma
    KTH.
    Frostell, Claes
    Karolinska Institutet.
    Liljegren, Annelie
    Karolinska Institutet.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Aune, Ragnhild
    Norwegian University of Science and Technology, Trondheim, Norway.
    In-vitro and In-vivo Exposure of Intravascular Catheters to Cytostatic Drugs2018Conference paper (Refereed)
  • 310.
    Frank, Agnes
    et al.
    Red Cross University College of Nursing.
    Thelin, Karl
    Red Cross University College of Nursing.
    Män och kvinnors smärtupplevelse: en litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pain is the most common reason for people to seek healthcare. Pain is a regular symptom associated with many illnesses and affects the patient’s quality of life negatively. The pain experience is highly subjective and there are a lot of factors that can affect it. Gender and sex may possibly be included in these factors. Pain causes suffering, and potentially harms both physiologically and psychologically. Therefore it's important for nurses to have the knowledge to make a correct and precise assessment and treatment of a patient’s pain.

    Aim: The aim of this study was to examine if differences could be found between men and women in pain and how this may affect nursing.

    Method: Literature review with a quantitative approach.

    Result: No differences that could be applicable to mankind as a whole could be found. In five of the articles analyzed women were found to have greater pain, one found men had greater pain and four could find no significant differences at all.

    Conclusion: With results split into three groups no consensus could be found. These findings support the thesis that there are no differences in pain experience between men and women, or that they are so small that they are irrelevant in a nursing perspective.

    Relevance to clinical practice: This study might evoke nurses and students to reflect on their own thoughts about the relevance of gender and sex related to pain experience.

  • 311.
    Fredriksson, Sara
    et al.
    The Swedish Red Cross University College.
    Ter Schüren, Catharina
    The Swedish Red Cross University College.
    Sjuksköterskors upplevelse av att arbeta på en akutsjukvårdsavdelning2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research demonstrates that negative stress in the current situation is common among nurses working in emergency care. The stress is demonstrated to be associated with poorer provided care for patients and impaired health of nurses. Aim: The purpose of the study was to highlight nurses' perception of stress and their work for a good nursing care on an emergency care department. Method: An empirical design with qualitative approach has been used. Five semi-structured interviews were conducted with nurses and forms the basis of the results of the study. The collected data were analysed using a content analysis. Result: From the analysis crystallized five themes: Organisational structure, Loss of control, Stress-reducing factors, Positive stress and Experience-based security. The result demonstrates that the nurses rarely experience negative stress despite a heavy workload in emergency care department. There is an ambition to accomplish the nursing care but a medical priority focus of the department contributes to the delegation of nursing care to another profession. Conclusion: Nurses in the emergency care department have a high workload but doesn’t despite that feel negative stress. Clinical relevance: The study is of clinical relevance because it’s enlights different aspects that emerged as significant for avoiding negative stress.

  • 312.
    Frendin, Jessica
    et al.
    The Swedish Red Cross University College.
    Jonsson, Diana
    The Swedish Red Cross University College.
    Jag behöver få sova!: Interventioner för att främja sömn hos patienter som vårdas på intensivvårdsavdelningar2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Sleep is a basic human need and should be addressed in patients being treated in hospital. Patients cared for in intensive care units often experience repeated interruptions of sleep and sleep deprivation, which can lead to both physical and psychological adverse consequences. The intensive care environment with its noise, strong lighting and frequent care-related interaction often leads to the inability of patients to get adequate sleep. Aim: To illustrate the various interventions the nurse can implement to improve the sleep environment and quality of sleep in patients who are cared for in an intensive care unit. Methods: A literature review with its basis in an analysis of quantitative research. Results: The result emerged in seven interventions that were divided into three different categories: creating a better sleep environment, shielding from light and sound, and preparing the patient for sleep. The seven interventions identified were: quiet/non-disturbance periods, guidelines/framework including activities to control disturbing environmental factors, education, ear plugs and eye mask, added "white noise", music and acupressure. Conclusion: By applying one or more of the seven interventions the sleep environment and sleep quality for patients cared for in intensive care units may improve. However, as some interventions produced conflicting results, further research in the area is required. Clinical significance: Sleep is an essential requirement and has great importance in the recovery from illness and should therefore be carefully understood by the nurse. Findings from the literature review can provide a better understanding of which interventions nurses can apply in their work to improve the sleep environment and sleep quality for patients cared for in intensive care units.

  • 313.
    Freudmann, Gabriella
    et al.
    The Swedish Red Cross University College.
    Ewerode Riddarström, Kristina
    The Swedish Red Cross University College.
    "Det blir ingen kamasutra längre, kanske, men det funkar! Man får hitta nya vägar": en litteraturstudie som beskriver ryggmärgsskadades upplevelse kring sin sexualitet2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Spinal cord injury implicates that the body changes and it results in change in sensation and function. Sexuality is humanly and need to be included in the care. Nurses should illustrate, document and talk about sexuality. However, the pre-understanding must be considered. Aim: To describe the experiences of persons with spinal cord injury concerning sexuality. Method: A descriptive literature review with both qualitative and quantitative research. Result: People with spinal cord injury were experiencing anxiety about sexuality. Some were dissatisfied because of e.g. decreased sensation and desire. Many had to prepare a lot before having intercourse and this had an effect on spontaneity. Routine and time increased self-esteem and self-confidence in sexuality. Some experienced pleasure and described that they now could explore their whole sexuality. Many discovered new erogenous zones. It was perceived as more difficult to meet partners and several described having a separation. Communicating and providing partner with pleasure became central. Sexual rehabilitation was perceived as inadequate and individual needs aroused. Conclusion: People with spinal cord injury experienced sexuality in different ways and many had found an altered sexuality. Therefore there is a need of nursing within sexuality where the individual's needs should be addressed.

  • 314.
    Friberg, Emma
    et al.
    The Swedish Red Cross University College.
    Abdulla, Hawzheen
    The Swedish Red Cross University College.
    Viktrelaterat lidande: en litteraturstudie om vuxnas upplevelser av att leva med övervikt eller fetma2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Obesity is one of our society's greatest public health problems. Overweight and obesity are a global problem that is increasing among the population which may lead to future complications such as cardiovascular disease and diabetes. The stigma of obesity is a problem when it involves an individual suffering due to disparaging comments. Obesity affects people negatively in both physical and psychological ways. Aim: The aim of this study was to describe adult human experience of living with overweight and obesity. Method: A literature review with qualitative approach, based on ten scientific articles. Results: The study showed that overweight people had experienced much suffering in situations related to their body. These situations triggered feelings of guilt and shame. The worst experiences of stigmatization and discrimination suffered in the adult life and they consisted mainly of negative comments related to weight. People with overweight were unable to perform social activities due to limited capacity for moving. This led to the isolation and loneliness. Many overweight people described a strong self-loathing as a result of a low self-esteem. Conclusion: It is important to pay attention to the overweight situation in life in order to provide support and motivate these people to a changed lifestyle. 

  • 315.
    Friberg, Therese
    et al.
    The Swedish Red Cross University College.
    Chan, Wan-Yin Susanna
    The Swedish Red Cross University College.
    Kvinnor drabbade av gynekologisk cancer upplever hinder för att nå tillfredsställande sexuell hälsa2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Gynecological cancer involves organs related to femininity and sexual life. The disease and treatment can have a negative impact on the woman's sexual health, which is an important part of life and can have a major impact on quality of life. The nurse´s profession includes promoting and preserving the health of the patient and thus the sexual health. Aim: The aim of this study was to highlight women's experiences of sexual health in gynecological cancer. Method: A literature review was conducted with a qualitative approach based on an analysis of 10 articles. Results: Women suffering from gynecological cancer experienced that the disease and its treatments had an impact on their sexual health. Six themes were identified of which, lack of information was the most prominent. Conclusion: Women with gynecological cancer experienced several obstacles to achieve satisfactory sexual health. The main obstacle and the common denominator was the lack of information on which impact treatments and their side effects had on sexual health, causing unnecessary suffering and impaired quality of life. Clinical suggestions: An increased understanding of women´s experiences can help nurses to meet the care, such as sexual health. Because of the sensitive nature of the topic, the authors consider that it needs to be emphasized in the nursing education, for students to become familiar with and feel comfortable with the topic to become an integrated part of clinical care. The PLISSIT-model should be implemented as an instrument for nurses to use in conversations with patients about sexual health.

  • 316.
    Friis, Viktoria
    et al.
    The Swedish Red Cross University College.
    Hemborg, Kerstin
    The Swedish Red Cross University College.
    Självskadebeteende: Patienters upplevelser av bemötande i vården2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: During 2011 more than 7700 people were hospitalized for self-injuries in Sweden. Self-injury behavior is often used as a coping strategy to manage and relieve mental pain and anguish, but can also be a cry for help. The actions often generate strong emotions, such as anger, powerlessness and antipathy, among health care staff. This group of patients is often perceived difficult to provide good care for and the patients are exposed to many coercive measures. Purpose: The purpose is to illustrate how patients with self-injury behavior experience their treatment. Method: The study, a qualitative content analysis with an inductive approach, has been performed by analyzing three autobiographies written by persons with a previous self-injury behavior. Result: The patients/authors experiences of their treatment were divided into two main categories; positive and negative experiences. Under positive experiences four categories crystallized; Security and trust, Receive information, Be taken seriously and feel understood and Care and support. Under the main category negative experiences four categories were developed; Left out and powerlessness, Not be taken seriously and not feel understood, Not feel worthy of care and Lack of information. Conclusion: The treatment in health care is critical to the relationship between caregiver and care recipient. When the patients´ had positive experiences of the treatment from the staff a trusting relationship was founded. A bad attitude contributed to patients suffering. Clinical significance: The results may give health care professionals a better knowledge and understanding of the treatment that is perceived positively or negatively by the patient. This can lead to an improved and more professional treatment of these patients, which is important for a good recovery.

  • 317.
    Friman, Anne
    et al.
    Karolinska Institutet.
    Klang, Birgitta
    Red Cross University College of Nursing.
    Ebbeskog, Britt
    Karolinska Institutet.
    Wound care by district nurses at primary healthcare centres: A challenging task without authority or resources2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 426-434Article in journal (Refereed)
  • 318.
    Friman, Anne
    et al.
    Karolinska Institutet.
    Klang, Birgitta
    Red Cross University College of Nursing.
    Ebbeskog, Britt
    Karolinska Institutet.
    Wound care in primary health care: District nurses' needs for co-operation and well-functioning organization2010In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 24, no 1, p. 90-99Article in journal (Refereed)
  • 319.
    Friman Karlsson, Caroline
    et al.
    The Swedish Red Cross University College.
    Josefsson, Mimmi
    The Swedish Red Cross University College.
    Omvårdnad över kulturgränser: En litteraturstudie om sjuksköterskors erfarenheter av transkulturell medvetenhet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Nurses should according to Socialstyrelsens kompetensbeskrivning för sjuksköterskor, take into consideration the human as a whole, this includes many different parts, among those culture. In a increasingly multicultural society the demands on nurses to practice transcultural nursing increases.

    Aim: The aim of this study is to describe nurses experiences of transcultural awareness in a caring relationship.

    Method: In a literature review eleven articles were examined and summarized according to similarities and differences.

    Results: The phenomenon can be clarified by two themes with subthemes. 1) Communication with subthemes; Language barriers, Body language, and Interpreters and Cultural differences with subthemes; Expectations, Relatives and Us and them.

    Conclusion: To be able to give good care nurses need to see the unique individual and her needs. This requires that nurses sees the person behind the culture and has insight on its influence on human behavior. When this is not taken into consideration the risk of care suffering and defective patient safety increases.

  • 320.
    Frostell, Claes
    et al.
    Danderyd Hospital, Karolinska Institutet.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Nursing and Care. Danderyd Hospital, Karolinska Institutet.
    Strömberg, Emma
    KTH.
    Karlsson, Sigbritt
    KTH.
    Aune, Ragnhild E
    Norwegian University of Science and Technology, Trondheim, Norway.
    Tracheal implants revisited2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 389, no 10075, p. 1191-Article in journal (Other (popular science, discussion, etc.))
  • 321.
    Frölander, Marie
    The Swedish Red Cross University College.
    Sambandet mellan känsla av sammanhang och mental hälsa hos intensivvårdspatienter: Sekundäranalys av en prospektiv kohortstudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Intensive care is constantly progressing and improving. This leads to lower mortality rates and increasing number of patients recieving intensive care. Intensive care can be a traumatic experience which in some cases lead to psycological problems. For identification of patients at risk, questionnaires are used at follow-up visits. More research is needed on the different methods. The questionnaire SOC-13 measures coping ability which has been shown to be of great importance regarding mental health. This form is not previously used for intensive care patients. Purpose: To investigate whether there is a relationship between sense of coherence and patients' self-rated mental health after intensive care. Method: Secondary analysis of a prospective study of adult patients (n = 236) after intensive care. Correlation analysis of two questionnaires, SOC-13 and HAD. Result: The number of participants was 146 (62 %). The respondents were older than the nonrespondents (p = 0,03). Strong sence of coherence correlated in this cohort with low self-rated anxiety and depression (p <0.001 versus p <0.001). Conclusion: The study shows that mental health after intensive correlates to the sense of coherence in the studied cohort. The stronger sense of connection, the better mental health. The study generates weak evidence depending on the study design.

  • 322.
    Furuhagen, Hanna
    et al.
    The Swedish Red Cross University College.
    Andersson, Ellinor
    The Swedish Red Cross University College.
    Att famla i blindo: En litteraturstudie om sjuksköterskors erfarenheter av papperslösa och asylsökande i hälso- och sjukvården2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Undocumented migrants and asylum seekers are part of society’s most vulnerable groups which the UN Human Rights seeks to protect. Swedish legislation does not comply with these rights. Undocumented migrants and asylum seekers often suffer physical and psychological problems and the road to health care is paved with obstacles. The Swedish Ethical Code for nurses describes a professional duty to provide care for all under the same conditions. Factors that prevent nurses from providing equitable care, cause problems and dilemmas. Aim: The aim of this study is to describe nurses' experiences of undocumented migrants and asylum seekers in the health care system. Method: Literature review with qualitative approach. Ten articles were reviewed and formed the basis for this study. Result: The findings of this study revealed four major themes Flying blind, Frustration, Cultural competence and An emotional challenge with eight subthemes. Conclusion: The lack of / ignorance of guidelines were clear. The writing and implementation of guidelines is therefore essential. Leininger transcultural nursing theory can inspire nurses to develop cultural appropriate care. Published research in this subject was limited therefore suggesting a lack of interest in this area of research. Clinical significance: By studying nurses' experiences, organizational barriers were identified. These may possibly be eliminated by clear guidance and knowledge. Highlighting this problem can lead to structural changes, thereby helping to incorporate equitable health care for all.

  • 323.
    Furulund, Linda
    et al.
    The Swedish Red Cross University College.
    Holm, Anneli
    The Swedish Red Cross University College.
    Upplevelser i bemötandet av patienter med psykossjukdomar: ur ett sjuksköterskeperspektiv inom den somatiska slutenvården2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research shows that patients with psychotic illnesses receive a negative attitude in somatic inpatient care. Nurses´ prejudices and lack of knowledge is something that can affect the care. This attitude characterizes society in general, both today and historically. Preconditions for a person-centered care implies a relationship of trust and confidence. Nurses often lack the knowledge and experience to accommodate in the meeting with patients with psychotic illnesses.

    Objectives: From a nurse perspective describe nurses’ experiences of encounters with patients with psychotic illness in somatic inpatient care.

    Methods: A literature review was used to highlight nurses' perceived treatment of patients with psychotic illness in somatic inpatient care. The results are based on the twelve peer-reviewed articles, seven were qualitative and five were quantitative, these were analyzed according to Friberg (2012) method for analysis of results.

    Results: The results show that nurses are experiencing gaps in knowledge, experience, support and time. Negative attitudes such as frustration and fear are common.

    Conclusions: Nurses request increased education in psychiatric nursing to eliminate the negative attitudes in treatment of patients with psychotic illnesses. Lack of time is also considered to be a significant problem in nursing.

  • 324.
    Fält, Marie
    The Swedish Red Cross University College.
    Ventrikeldränagerelaterade infektioner inom neurokirurgisk vård: en journalstudie före och efter införandet av ett åtgärdspaket2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: External ventricular drainage (EVD) is used within neurosurgical care for medical treatment, temporary drainage of cerebrospinal fluid (CSF) and to measure intracranial pressure. An infection related to an EVD can be life threatening and cause permanent damage to the patient. Objective: To analyze the documented differences in EVD related infections, length of hospitalization and mortality, before and after the introduction of new hygiene routines – a bundle. Method: A package with medical and nursing interventions has been developed using a breakthrough method to reduce EVD related infections. The study is quantitative and has an empirical approach. A consecutive sample of patients who received an EVD during the first half of 2008 and 2009 respectively were chosen. In total 150 patients were included in the study. The data was analyzed with descriptive and analytical statistics. Results: The EVD related infections have decreased between the two time periods. No clear correlation between which actions had a direct effect on the reduction of infections was found. Those patients that had a better adherence to the package suffered fewer infections. A prevalent correlation was found between high risk actions such as flushing the EVD and CSF leaks from the site of puncture, and subsequent infections. Conclusion: The study indicates that the EVD related infections have decreased after the implementation of the package.

  • 325.
    Gahm Erkapers, Emma
    et al.
    The Swedish Red Cross University College.
    Edoff, Johanna
    The Swedish Red Cross University College.
    De osynliga barnen: En litteraturstudie om barns upplevelser av att leva med en förälder med psykisk sjukdom2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are few health care establishments who have the routines and the knowledge required to respond to the children with parents with mental illness. Nurses lack of knowledge and equipment to support these children leads to children becoming invisible and do not receive the information and support they need. Aim: To describe the children's experiences of living with a parent with a mental illness. Method: Literature review of ten scientific articles with an qualitative approach. Results: The results presented from the four main categories. Support and information was one of the key elements that the children expressed. Living with a parent with mental illness affects children, they live in unpredictability, experience anxiety, fear, guilt and responsibility for the parent. Lack of information about the parent's illness to the children and the support of health care led to the children's situation was complicated. All children expressed a desire for support from healthcare. Conclusion: This study has shown that aid is important for children of mentally ill parents. Nurses need more knowledge and equipment to make these invisible children visible and help them to appropriate support. Clinical significance: By illuminate children's experiences can support, equipment and education developed for caregivers so that these children receive the support they need. 

  • 326.
    Gardell, Malin
    et al.
    The Swedish Red Cross University College.
    Lindström, Hanna
    The Swedish Red Cross University College.
    Jag är inte bara en knarkare: En litteraturstudie om upplevelsen av kontroll och stigma vid substitutionsbehandling vid opioidberoende2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Opioid dependence is a chronic disease. Substitution treatment for opioid addiction involves a lot of rules and control that can lead to stigmatization.

    Purpose: To describe the experience of control and stigma in people with substitution treatment during opioid dependence.

    Method: A literature review with qualitative content analysis inspired by Graneheim & Lundman (2004). The study is based on 14 scientific articles that were applied mainly through the databases Cinahl and Pubmed.

    Result: Two main themes with eight sub-themes emerged. The most prominent in the result was that people with substitution treatment feel stamped as a drug addict. They can also feel suspicious and less credible. Having substitution treatment is associated with shame. One does not always dare to tell the surroundings that one has treatment. Within the framework of treatment, they feel controlled and supervised.

    Conclusion: People with substitution treatment experience stigma in terms of discrimination, preconceived opinions and reduced credibility. Stigma arises in several different contexts, such as work, friends and family, but also in health care and even in substitution treatment. This is because this form of treatment includes a number of rules and controls that make you feel controlled and supervised. This risks contributing to further stigmatization.

  • 327.
    Gardulf, Ann
    et al.
    Red Cross University College of Nursing.
    Nilsson, Jan
    Red Cross University College of Nursing.
    Hamada, Etsuko
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Higashiura, Hiroshi
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Kawashima, Midori
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Takei, Asako
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Sasaki, Ikumi
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Honjo, Keiko
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Kawahara, Yukari
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Yoshida, Mitsuko
    Japanese Red Cross College of Nursing, Tokyo, Japan.
    Nurses' competence within the Red Cross and Red Crescent Movment: a 30-year follow-up on Red Cross and Red Crescent Nursing Education and Activites Responding to Local and Global Vulnerability2010Report (Other academic)
  • 328.
    Gedin, F
    et al.
    Karolinska Institutet / Scandinavian College of Chiropractic.
    Dansk, V
    Scandinavian College of Chiropractic.
    Egmar, Ann-Charlotte
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Sundberg, T
    Karolinska Institutet.
    Burström, K
    Karolinska Institutet / Stockholm County Council.
    Patient-reported improvements of pain, disability, and health-related quality of life following chiropractic care for back pain - A national observational study in Sweden2019In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 23, no 2, p. 241-246Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chiropractic care is a common but not often investigated treatment option for back pain in Sweden. The aim of this study was to explore patient-reported outcomes (PRO) for patients with back pain seeking chiropractic care in Sweden.

    METHODS: Prospective observational study. Patients 18 years and older, with non-specific back pain of any duration, seeking care at 23 chiropractic clinics throughout Sweden were invited to answer PRO questionnaires at baseline with the main follow-up after four weeks targeting the following outcomes: Numerical Rating Scale for back pain intensity (NRS), Oswestry Disability Index for back pain disability (ODI), health-related quality of life (EQ-5D index) and a visual analogue scale for self-rated health (EQ VAS).

    RESULTS: 246 back pain patients answered baseline questionnaires and 138 (56%) completed follow-up after four weeks. Statistically significant improvements over the four weeks were reported for all PRO by acute back pain patients (n = 81), mean change scores: NRS -2.98 (p < 0.001), ODI -13.58 (p < 0.001), EQ VAS 9.63 (p < 0.001), EQ-5D index 0.22 (p < 0.001); and for three out of four PRO for patients with chronic back pain (n = 57), mean change scores: NRS -0.90 (p = 0.002), ODI -2.88 (p = 0.010), EQ VAS 3.77 (p = 0.164), EQ-5D index 0.04 (p = 0.022).

    CONCLUSIONS: Patients with acute and chronic back pain reported statistically significant improvements in PRO four weeks after initiated chiropractic care. Albeit the observational study design limits causal inference, the relatively rapid improvements of PRO scores warrant further clinical investigations.

  • 329.
    Gellerstedt, Linda
    et al.
    Sophiahemmet University / Karolinska Institutet.
    Medin, Jörgen
    The Swedish Red Cross University College, Department of Health Sciences. Sophiahemmet Univeristy.
    Kumlin, Maria
    Sophiahemmet University / Karolinska Institutet.
    Karlsson, Monica Rydell
    Karolinska Institutet / Ersta Sköndal Bräcke Univeristy College.
    Nursing care and management of patients' sleep during hospitalisation: A cross-sectional study2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 19-20, p. 3400-3407Article in journal (Refereed)
    Abstract [en]

    Aim To explore and describe how patients' sleep is addressed at acute-care hospitals in Sweden with regard to nursing care, management and the development of knowledge in this area. Background Sleep is a basic human need and thus important for health and health maintenance. Patients describe sleeping in hospital as a stressor, and research shows that nurses tend to underestimate patients' perceived problems with sleep during hospitalisation. How do nursing staff at acute hospitals address patients' sleep and the development of knowledge in this area? Design/Method A cross-sectional descriptive study was conducted based on data collected through a web survey. Head nurses, registered nurses, nursing care developers and local training supervisors at 36 randomised acute-care hospitals in Sweden were invited to participate. This study was executed and reported in accordance with SQUIRE 2.0. Results The results of the survey (53 responses from 19 wards at 15 acute-care hospitals) showed that no policy documents exist and no current training addresses sleep during hospital stay. All participants agreed that sleep should be considered a nursing topic and that it is important for hospitalised patients. Conclusion Patients' sleep during hospitalisation is undermanaged at acute-care hospitals. Nurses, health care managers and organisations face challenges if they are to achieve better outcomes. Relevance to clinical practice This study shows that nurses do consider patients' sleep important and addressing sleep as part of nursing care. Future studies in the area should focus on what kinds of support and education are needed in the clinical context.

  • 330.
    Gellerstedt, Linda
    et al.
    Sophiahemmet University / Danderyd Hospital, Karolinska Institutet.
    Medin, Jörgen
    The Swedish Red Cross University College, Department of Health Sciences. Sophiahemmet University.
    Kumlin, Maria
    Sophiahemmet University / Karolinska Institutet.
    Karlsson, Monica Rydell
    Ersta Sköndal Bräcke University College / Danderyd Hospital, Karolinska Institutet.
    Sleep as a topic in nursing education programs?: A mixed method study of syllabuses and nursing students' perceptions2019In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 79, p. 168-174Article in journal (Refereed)
    Abstract [en]

    Background: Sleep is a basic human need and is considered important for maintaining health. It is even more important during illness due to its impact for example on our immune system. Nurses have an important role in identifying sleep deprivation. They are also in a unique position to promote and address sleep among patients. However, it is essential that they are provided with the appropriate knowledge during training.

    Aim: To explore and describe nursing students' perceptions of preparedness to adress and support patients' sleep during hospitalization and to apply sleep-promoting interventions in a clinical context. Furthermore, the aim was to investigate if, and how, the topic of sleep is explicitly incorporated in nursing education programs.

    Design: A descriptive study based on a mixed method approach.

    Methods: Quantitative and qualitative data were collected from program and course syllabuses and intended learning outcomes from three universities. Twenty-one nursing students from the same universities were interviewed during their final year of education.

    Results: The results of both quantitative and qualitative data consistently show that education regarding sleep and patients' sleep is limited and, in some respects, absent in the Bachelor of Science Nursing programs investigated.

    Conclusion: This study indicates that education about sleep and patients' sleep in the nursing programs studied is insufficient and limited. This gap in knowledge may lead to prospective registered nurses using their own experiences instead of evidence-based knowledge when assessing, supporting and applying sleep-promoting interventions.

  • 331.
    Georgsson, Susanne
    et al.
    The Swedish Red Cross University College. Karolinska Institutet.
    Carlsson, Tommy
    Sophiahemmet University / Uppsala University.
    Pain and pain management during induced abortions: a web-based exploratory study of recollections from previous patients2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIMS: To explore recollections of pain and pain management during induced abortions.

    DESIGN: Mixed-methods exploratory study in Sweden.

    METHODS: A web-based survey was distributed between October 2017 - July 2018 via Swedish discussion boards and social media. Open-ended questions were asked about recollection of pain and pain management, followed by self-report ratings. The survey was answered by 185 participants, responses analyzed with qualitative content analysis.

    FINDINGS: Recollections of pain intensity illustrated considerable pain and a traumatic event, described in temporal aspects and likened to other painful conditions such as dysmenorrhea and childbirth. Recollections of pain management illustrated experiences of insufficient treatment of pain and dissatisfaction with pain management, including inefficient treatment and lack of professional attendance. Psychological aspects and consequences illustrated that participants related psychological distress to physical pain, felt unprepared for the physical pain and emphasized the importance of psychological support. Those who experienced intense pain described long-term psychological consequences, including fear of childbirth.

    CONCLUSION: Physical pain and psychological distress can manifest as considerable challenges during induced abortion. Abortion-related pain is a multidimensional phenomenon involving physical and psychological components that needs to be rigorously treated. When physical pain is unsuccessfully treated, women may experience long-term psychological consequences after an abortion.

    IMPACT: The results illustrate the importance of holistic abortion care where the multidimensional components of abortion-related pain are considered. Patients need to be offered sufficient preparatory information about potential physical pain and psychological distress. This study indicates that there is room for improvement in pain management. Larger studies are needed.

  • 332.
    Georgsson, Susanne
    et al.
    The Swedish Red Cross University College. Karolinska Institutet.
    Krautmeyer, Stina
    Sophiahemmet University.
    Sundqvist, Emilia
    Sophiahemmet University.
    Carlsson, Tommy
    Sophiahemmet University / Uppsala University.
    Abortion-related worries, fears and preparedness: a Swedish Web-based exploratory and retrospective qualitative study2019In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Objective: A survey was conducted to explore worries, fears and preparedness relating to the recollected experience of having an induced abortion. Methods: The Web-based survey was carried out in Sweden among 185 women. Respondents answered open-ended questions and gave retrospective self-reported ratings about their abortion-related worries, fears, preparedness and satisfaction with information obtained from health professionals and the Web. Data were analysed using qualitative content analysis and descriptive statistics. Results: Worries and fears included the abortion process, physical reactions and psychosocial aspects. The abortion was associated with unexpected events, including the abortion process, poor health professional treatment and support, and side effects and complications. Respondents described a lack of preparatory information, leading to uncertainties due to insufficient information. Many searched for Web-based information, but respondents experienced difficulties finding high-quality sources. Respondents also recounted that the preparatory information received did not reflect the actual abortion experience. Conclusion: There is room for improvement with regard to informing, preparing and supporting women who seek an abortion. The results emphasise the importance of health professionals' giving sufficient preparatory information to enable preparedness and lessen the impact of possible unexpected events. There is a need for the development of a trustworthy Web-based service that contains honest and high-quality information.

  • 333.
    Georgsson, Susanne
    et al.
    The Swedish Red Cross University College. Karolinska Institutet.
    van der Spoel, Linde
    Uppsala University.
    Ferm, Johanna
    Uppsala University.
    Carlsson, Tommy
    Uppsala University / Sophiahemmet University.
    Quality of web pages about second-trimester medical abortion: A cross-sectional study of readability, comprehensiveness, and transparency2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIMS: To investigate the readability, comprehensiveness and transparency of web pages about medical abortion in the second trimester of pregnancy.

    DESIGN: A cross-sectional descriptive study of Swedish web pages.

    METHODS: Six systematic searches were performed in Google during January 2017. The first 10 hits of each search were screened, resulting in 46 included Swedish web pages. The web pages were analyzed with readability index (LIX) to investigate readability, inductive manifest content analysis to investigate comprehensiveness, and Journal of the Medical Association benchmarks to investigate transparency.

    RESULTS: Median LIX was 29.0 and the largest proportion had LIX 31-40 (N = 17), indicating moderate readability. Visual components were observed in 13 websites. Content analysis resulted in 12 categories illustrating comprehensiveness, but eight of these were only included in ≤50% web pages. With regard to transparency, 29 (63%) adhered to no benchmark, 15 (33%) adhered to one benchmark, and 2 (4%) adhered to two benchmarks. Most web pages were written or reviewed by laypersons (N = 25) and health professionals (N = 11).

    CONCLUSION: The results indicate that web pages about medical abortion have moderate readability, varied comprehensiveness and poor transparency.

    IMPACT: Health professionals need to acknowledge the risk of contact with web-based information about poor quality. There is a need for research that aims to increase the chances that patients encounter high-quality web-based information about medical abortion in the second trimester of pregnancy.

  • 334.
    Georgsson Öhman, Susanne
    et al.
    The Swedish Red Cross University College. Sophiahemmet Högskola / Karolinska Institutet.
    Björklund, Ulla
    Södersjukhuset.
    Marsk, Anna
    Läkarhuset Odenplan.
    Does an informational film increase women's possibility to make an informed choice about second trimester ultrasound?2012In: Prenatal Diagnosis, ISSN 0197-3851, E-ISSN 1097-0223, Vol. 32, no 9, p. 833-839Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate effects of an informational film on making an informed choice regarding second trimester ultrasound.

    METHOD: Randomized controlled study. The intervention was an informational film about prenatal examinations. Data were collected at gestational week 26.

    RESULTS: A total of 184 women in the intervention group and 206 women in the control group participated in the study. Of those in the intervention group, 81.3% made an informed choice regarding second trimester ultrasound examination compared with 76.1% in the control group (p = 0.21). Women making an informed choice scored higher in knowledge about the examination (p < 0.001), had higher degree of education (p < 0.001), and spoke more frequently Swedish as mother tongue (89.5% vs 74.7%, p = 0.01).

    CONCLUSIONS: An informational film does not increase women's knowledge or the number of women making an informed choice about the second trimester ultrasound. Women who did not make an informed choice about the second trimester ultrasound had a lower level of education and less knowledge about second trimester ultrasound screening.

  • 335.
    Gerber, Anna
    et al.
    The Swedish Red Cross University College.
    Falk, Olivia
    The Swedish Red Cross University College.
    Kartläggnng av patienters preoperativa fastetider, dryckintag och upplevelse av törst2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Existing guidelines for preoperative fasting means that patients with a minimal risk of aspiration can take solid food until six hours, and clear drinks until two hours before start of anesthesia. Studies have shown that many patients are fasting longer, which may be detrimental both physiologically and on wellbeing, for example, dehydration, thirst, nausea, headache and reduced insulin sensitivity. The purpose of this study was to map and describe fasting times, beverage intake and the incidence of thirst preoperatively in patients who were undergoing elective surgery. Structured interviews were conducted over five days with 50 patients who were enrolled consecutively in two preoperative departments. The results showed that fasting times in patients with strict fasting ranged from 7.75 to 13.25 hours (MD 10) and beverage intake between 0.5 to 7.5 glasses (3.14 SD 1,98). Fasting times in patients with float fasting ranged from 0.75 to 11.25 hours (MD 3,5) and beverage intake between 1 to 9 glasses (4,31 SD 1,91). Of the 50 interviewed patients, 44 % said they experienced thirst. The results indicated a wide variation in preoperative fasting times and beverage intake, where the oldest patients tended to have long duration of fasting and intake of small amounts of beverage preoperatively.

  • 336.
    Gerschman, Helena
    et al.
    The Swedish Red Cross University College.
    Hansson, Frida
    The Swedish Red Cross University College.
    God omvårdnad, trots allt!: Sjuksköterskans upplevda hälsa i relation till hennes upplevda möjlighet att ge god omvårdnad2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Internationally, there is an existing knowledge about nurses’ workload, stress factors in workplaces and its negative impact on nurses’ health. In acute care settings, the nurses experience a strong work-related stress, where time pressure and heavy workload are recurring phenomena. A lack of knowledge exists about the nurse's perceived health, specifically in relation to her experienced ability to provide good care. Aim: The aim of this study was to examine nurses’ experienced health, in relation to her experienced ability to provide good nursing, in acute care settings. Method: A survey of empirical descriptive design with quantitative approach. Result: Based on nurses' estimates of health and good nursing, the questions were arranged under the following headlines: experienced health – good nursing, lack of health – absence of nursing, experienced health – absence of nursing and lack of health – good nursing. Conclusion: The study is a good example of the relation between a nurse's experienced health, her cognition of well performed nursing and sense of coherence. The nurse may have a high or low sense of coherence due to high comprehensibility and manageability but low meaningfulness, or low comprehensibility and manageability but high meaningfulness. Due to high comprehensibility and manageability the nurse can experience good health, but it may not be related to good nursing. The nurse can also experience a lack of health but perform good nursing, due to high meaningfulness. Clinical significance: The study indicates that it requires an understanding for the relation between health and well-being of the nurses, put in context with the main task, the nursing.

  • 337.
    Ghaderi, Mahnaz
    et al.
    The Swedish Red Cross University College.
    Larsson, Valentina
    The Swedish Red Cross University College.
    Personcentrerad omvårdnad för personer med demenssjukdom: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Dementia is a collection of diseases related to memory disorder, reduced thought and communication skills due to some form of brain injury. Dimentia as a disease is growing rapidly nowadays and is one of the largest public diseases in Sweden. Personcentered care is an important aspect of nursing care for people with dementia, which means that it is not only the disease at its core, but also the human being is seen as an active partner whose personal unique experiences and personality are put in focus. Nurse has an important role in optimizing of person-centered care for people with dementia. Aim: The purpose of this literature study is to describe how nurses can contribute to a personcentered care for people with dementia in the health care system. Method: The study is a literature review based on an analysis of eleven scientific articles with quantitative and qualitative design. Results: Person-centered care of demented persons is created by the nurse with the help of various measures including increasing of knowledge of care skills, taking care of the patient's life stories etc., which allows to design the healthcare environment and to perform meaningful activities which are adapted to the individual's unique ability. Conclusion: Person-centered nursing of demented people increases their quality of life and well-being by not only seeing a person as a person living with dementia but also by seeing the whole person with his/her unique abilities and needs, as well as it contributes to the care being individually adapted. Healthcare professionals' knowledge, person's life stories, meaningful activities and personally adapted healthcare environment are the resources that person-centered nursing is about, which in its turn results that people with dementia feel increasing of wellbeing.

  • 338.
    Gidlund, Åse
    et al.
    The Swedish Red Cross University College.
    Malmqvist, Maria
    The Swedish Red Cross University College.
    Existentiella upplevelser hos närstående till patienter i palliativ vård: En litteraturstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Next-of-kin to patients in palliative care often experience a difficult life situation. Life is put on trial and next-of-kin experience both physical and mental stresses of various kinds. The National Board of Health and Welfare (Socialstyrelsen) has issued a knowledge support for palliative care, which states that next-of-kin to palliative patients should be offered support in the form of conversations about emotional and existential issues. Despite this, research suggests that next-of-kin still feel that they do not get the support they need to manage difficult emotions and existential musings.

    Aim: To illuminate the existential experiences of next-of-kin to patients in palliative care. Method: A general literature review based on ten articles comprising qualitative data.

    Result: Seven patterns were identified: powerlessness – control; anxiety, stress – assurance; hopelessness – hope; loneliness – togetherness; reduced self – personal growth; meaninglessness – meaningfulness and restricted life – complete life. These patterns describe seven continua of existential experiences that next-of-kin can move along, back and forth, over time.

    Conclusion: Next-of-kin’s existential experiences are affected by both the patient ́s wellbeing, the next-of-kin's own resources and nursing staff support. It is experienced as important to come to acceptance by using ones own resources and with the support of health professionals, to be included in the care of the patient, to get information and knowledge, to be able to maintain everyday life, to get the opportunity to share thoughts and to be met as a unique individual with own interests and needs.

    Clinical significance: Relief of existential suffering is one of the nurse's most important and difficult tasks. This study contributes to the knowledge of next-of-kin’s existential experiences and discusses how nurses can respond to and support these experiences. 

  • 339.
    Gill, Josefin
    Red Cross University College of Nursing.
    Ett verktyg som avser mäta omvårdnadsdiagnostisk förmåga2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The fact that nurses identify valid nursing diagnoses is important in order for patients to recieve the nursing care they need. Even though it is imposed on the nurse education to equip the future nurses with this ability, diagnostic competency in nursing isn’t tested among nurse students. There is in Sweden today no tool available for measuring diagnostic competency. The aim of this methodological study was to develop a tool that indended to measure diagnostic competency in nursing. The tool was developed gradually through cognitive interviews, in dialogue with experts and by having students and nurses complete a test in nursing diagnostics based on two case studies. The tool was validated in relation to nursing literature and measuring instruments along with an expert group. In addition to the test in diagnostic competency, the tool was also constituted of a point form, a manual for awarding points and a correcting model. The study created a tool that was sensitive for variations in knowledge within the test group and that seemed to have room for improved results. The point form, the manual for awarding points and the correcting model showed a high reliability. The abilities that the tool measure is the capability to distinguish relevant characteristics, make an analysis of the characteristics and the etiology together with labeling the diagnosis; i.e. analytic ability, logical reasoning and to some extent professional skills in nursing. Diagnostic competency embodies several different abilities and all of these can’t be measured by the developed tool.

  • 340.
    Ginman, Felicia
    et al.
    The Swedish Red Cross University College.
    Simon, Carolina
    The Swedish Red Cross University College.
    Skolsjuksköterskans strategier i preventionsarbetet mot minderårigas alkoholkonsumtion2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are several causes for the consumption of alcohol among young people. Laws and regulations aim to prevent minors from using alcohol. A high number of minors break the laws and have a risky lifestyle related to alcohol. The school nurse plays a significant role in this prevention and uses multiple strategies to promote children’s and young people’s health.

    Objective: To describe the school nurse's health promotion strategies against underage drinking.

    Method: A literature review based on ten qualitative articles.

    Results: Two categories could be identified based on the aim: health dialogue and family strategies. From the category health dialogue two subcategories where acknowledged: health survey and motivational intervening. These strategies have proven to be effective in health promotion performed by the school nurse. An incidental finding is presented in the results as barriers to health promotion strategies.

    Conclusion: The strategies that school nurses use as prevention to reduce alcohol drinking among minors is beneficial for individual targeting and to motivate behavioral change. Alcohol prevention from a school nurses perspective is challenging due to social and organizational obstacles.

    Clinical significance: By studying the school nurse health promotion strategies against underage drinking the study refers to develop and recognize work and prevention strategies. This is because the school nurse should be able to reach out to minors that today develop a risk behavior related to alcohol.

  • 341.
    Good, Madeleine
    et al.
    The Swedish Red Cross University College.
    Olsson, Lovisa
    The Swedish Red Cross University College.
    Att leva med en osynlig diagnos: Livskvalitet hos vuxna med ADHD2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Uppfattningen har länge varit att Attention-deficit/hyperactivity disorder, ADHD, är en diagnos som växer bort och inte kvarstår in i vuxenlivet och därav har forskning runt ADHD, fram till det senaste decenniet, nästan uteslutande bedrivits runt barn. Då symtomyttringen ter sig annorlunda hos vuxna än hos barn saknas kunskap och förståelse bland annat inom vården och om hur dessa vuxna ska vårdas och bemötas. För att vårda vuxna med ADHD på ett medmänskligt sätt behövs kunskap om hur de upplever sin hälsa mätt som livskvalitet. 

    Syfte: Studien syftar till att beskriva hur vuxnas livskvalitet påverkas av ADHD.

    Metod: Litteraturstudie med kvalitativa och kvantitativa artiklar som underlag. Materialet har analyserats med WHO:s definition av livskvalitet med dess sex olika domäner som utgångspunkt.

    Resultat: Livskvaliteten hos vuxna med ADHD påverkades negativt inom samtliga domäner. Positiva aspekter framkom under domänen psykiskt välbefinnande och grad av oberoende. Vuxna som diagnostiserats i tidig ålder har högre livskvalitet än de som får diagnosen senare i livet.

    Slutsats: Vuxna med diagnosen har en generellt lägre livskvalitet jämfört med om de varit utan diagnosen. Tidig diagnostisering och kontinuerligt stöd är faktorer som kan öka livskvaliteten för vuxna med ADHD. 

  • 342.
    Gottvall, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Uppsala University.
    Sjölund, Sara
    The Swedish Red Cross University College, Department of Health Sciences.
    Arwidson, Charlotta
    The Swedish Red Cross University College, Department of Health Sciences.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Instiutet.
    Health-related quality of life among Syrian refugees resettled in Sweden2019In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649Article in journal (Refereed)
    Abstract [en]

    Purpose The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population. Methods This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis. Results Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score. Conclusions Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support.

  • 343.
    Gottvall, Maria
    et al.
    The Swedish Red Cross University College, Department of Public Health and Medicine. Uppsala University.
    Stenhammar, Christina
    Uppsala University.
    Grandahl, Maria
    Uppsala University.
    Parents' views of including young boys in the Swedish national school-based HPV vaccination programme: a qualitative study2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 2, article id e014255Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore parents' views of extending the human papillomavirus (HPV) vaccination programme to also include boys.

    DESIGN: Explorative qualitative design using individual, face-to-face, interviews and inductive thematic analysis.

    SETTING: 11 strategically chosen municipalities in central Sweden.

    PARTICIPANTS: Parents (n=42) who were offered HPV vaccination for their 11-12 years old daughter in the national school-based vaccination programme.

    RESULTS: The key themes were: equality from a public health perspective and perception of risk for disease. Parents expressed low knowledge and awareness about the health benefits of male HPV vaccination, and they perceived low risk for boys to get HPV. Some parents could not see any reason for vaccinating boys. However, many parents preferred gender-neutral vaccination, and some of the parents who had not accepted HPV vaccination for their daughter expressed that they would be willing to accept vaccination for their son, if it was offered. It was evident that there was both trust and distrust in authorities' decision to only vaccinate girls. Parents expressed a preference for increased sexual and reproductive health promotion such as more information about condom use. Some parents shared that it was more important to vaccinate girls than boys since they believed girls face a higher risk of deadly diseases associated with HPV, but some also believed girls might be more vulnerable to side effects of the vaccine.

    CONCLUSIONS: A vaccine offered only to girls may cause parents to be hesitant to vaccinate, while also including boys in the national vaccination programme might improve parents' trust in the vaccine. More information about the health benefits of HPV vaccination for males is necessary to increase HPV vaccination among boys. This may eventually lead to increased HPV vaccine coverage among both girls and boys.

  • 344.
    Gottvall, Maria
    et al.
    The Swedish Red Cross University College, Department of Health Sciences. Uppsala University.
    Vaez, Marjan
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Social support attenuates the link between torture exposure and post-traumatic stress disorder among male and female Syrian refugees in Sweden2019In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 19, no 1, article id 28Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and PTSD; (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender.

    METHODS: Data from a cross-sectional and population-based study of a random sample of Syrian refugees (n = 1215) resettled in Sweden 2011-2013 was analyzed within a Structural Equation Modeling (SEM) framework.

    RESULTS: Our results indicate adequate fit and gender invariance for a unidimensional model of ESSI. Exposure to torture was associated with lower social support (B = -0.22, p < 0.01) and with higher odds ratio (OR) for PTSD (OR 2.52, 95% Confidence interval (CI) 1.83-3.40). Furthermore, higher social support was associated with less likelihood for PTSD (B = -0.56, p < 0.001). Social support partially mediated the effect of torture exposure on PTSD (OR 1.13, 95% bias corrected bootstrap CI 1.06-1.26). Gender did not moderate this pattern.

    CONCLUSION: The results indicate that social support attenuates the link between torture exposure and PTSD, and may function as a protective factor for PTSD among both torture-exposed refugee men and women.

  • 345.
    Graham, Christina
    et al.
    Red Cross University College of Nursing.
    Kaur Sahota, Kuldip
    Red Cross University College of Nursing.
    Smärtproblematik och smärtlindring i omvårdnaden av personer med demenssjukdom: en litteraturstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Literature reveals that undiagnosed and untreated pain among older persons with dementia are common occurrences. This is in contrast to the principles of equal value among human beings, the dignity of the individual, and the alleviation of human suffering. There are many types of dementia, and there exists a belief that persons with dementia feel no pain. A common consequence of dementia is inability to communicate or locate the origin of pain. Selfassessment and observational pain scales are frequently not used. Aim: The aim of this literature review was to shed light upon the challenges associated with pain and the practice of pain relief in the care of older adults with dementia. Method: This is literature review study, where ten quantitative scientific articles have been analyzed using manifest context analysis. The results of the articles were sorted into four categories, each with subcategories, that describe the challenges associated with pain and the practice of pain relief. Results: The following result was obtained. Older persons with dementia often received inadequate pain relief, and the risk for under treatment increased with increasing level of cognitive impairment. Under treatment of pain was common even when pain assessment scales were used. Persons with assumed vascular and Alzheimer's dementia often stated that they felt more pain and less pain, respectively, than older adults with no cognitive impairment did. A group of persons with dementia were shown to experience no anticipatory effect of analgesics. Conclusion: Under treatment of pain was a common occurrence among older persons with dementia and more research is needed regarding how to estimate pain in persons with cognitive impairment.

  • 346.
    Granat, Nicklas
    et al.
    The Swedish Red Cross University College.
    Malmström, Sofie
    The Swedish Red Cross University College.
    Internetbaserade interventioners effekter vid långvarig smärta: En begränsad systematisk litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Chronic pain is one of the primary causes to abiding suffering and disabilities in Sweden and globally. Today’s treatment methods are somewhat considered lacking. In a high technology society, as the one we are living in today, the developing of electronic aids for persons with different disease states increases. Internet-based interventions is considered a part of the future in health care. Aim: The aim of this study was to describe the effects of Internet-based interventions designed for people with chronic pain. Method: A rapid systematic review with eleven quantitative studies. Result: Five studies used CBT, three studies used ACT and three is denominated as self-management. Four effects became clear; mental health, pain management, pain reducing, and quality of life. Pain management showed significant improvement, the other three effects showed improvement, although no significant improvement. At follow-up after post intervention the effects improved, some with significance. Conclusion: To implement internet-based interventions as an addition to clinical care could mean health benefits for the community as well as the individual person. However, this intervention type is not accessible on a larger population. Further Research: There should be focus on gender equality, broader geographic areas and longer follow-ups in future research.

  • 347.
    Granath, Jeanette
    et al.
    The Swedish Red Cross University College.
    Hedin Mannelkvist, Caroline
    The Swedish Red Cross University College.
    Den expressiva beröringens effekt på personer med demenssjukdom2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Touch is an integral part of human behavior and can improve well-being and provide a moment of peace and quiet. In nursing, an interest in complementary and alternative therapies has increased to treat dementia-related symptoms, such as agitation and aggression. Expressive touch in the form of massage and acupressure are of interest since these treatments are cost-effective and side effects are limited.

    Aim: To examine the effects of expressive touch on agitated and aggressive behavior in people with dementia.

    Method: Literature review containing ten scientific articles with quantitative approach. Articles were searched in the databases CINAHL, MEDLINE and PubMed.

    Result: The findings demonstrate that when receiving hand massage and acupressure, agitation and aggression were significantly decreased. When soft massage and foot massage were received results varied, agitation and aggression both decreased and increased.

    Conclusion: Since not all studies were of adequate quality, it was difficult to draw conclusions and generalize the results of the power of touch. However, a trend in decreased agitated and aggressive behavior was observed when people with dementia were touched.

    Clinical significance: Knowledge and information about the effects of expressive touch to reduce agitated and aggressive behavior in people with dementia are missing. To have knowledge about the effects of touch are therefore of importance as a nurse. 

  • 348.
    Granqvist, Mimmi
    et al.
    The Swedish Red Cross University College.
    Speks, Jenny
    The Swedish Red Cross University College.
    Att hjälpa en sårad tiger: Sjuksköterskors upplevelser av att vårda patienter med självskadebeteende2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Självskadebeteende anses vara vanligt förekommande i dagens samhälle. Beteendet anses inte vara ett uttryck för en vilja att dö utan ett sätt att hantera inre svårhanterad psykisk smärta. Självskadebeteende kan vara svårt att definiera eftersom det finns många olika metoder och svårighetsgrader. Det finns olika uppfattningar om hur prevalensen av självskadebeteende är fördelat mellan könen, den vanligaste uppfattningen är dock att beteendet är mer vanligt förekommande bland kvinnor. Enligt DSM-5 är självskadebeteende ännu inte en egen psykiatrisk diagnos. Syfte: Syftet med studien var att beskriva sjuksköterskors upplevelser av att vårda patienter med självskadebeteende. Metod: Detta är en allmän litteraturöversikt baserad på tio artiklar med kvalitativ ansats publicerade mellan 2002-2014. Resultat: Studien resulterade i fem teman. Dessa teman var: Positiva och negativa känslor, Uppfattning av självskadebeteende, Omvårdnadsrelationen, Upplevelsen av hjälpstrategier samt Arbetsgrupp och arbetsmiljö. Slutsats: Upplevelsen bland sjuksköterskor är att deras okunskap om ämnet är problematiskt i vården av patienter med självskadebeteende, vilket leder till upplevelser av frustration och maktlöshet som kan påverka den vårdande relationen negativt. Relationen bör präglas av visad förståelse, acceptans och engagemang för patienten. Ett realistiskt mål är att sjuksköterskans uppgift inte är att bota patienten, utan snarare att hjälpa patienten till självhjälp. Klinisk betydelse: Denna studie kan vara ett bidrag till kunskap för sjuksköterskor som möter den självskadande patienten, då resultatet ger en inblick i olika vårdkulturer och det kan vara givande att utvärdera arbetet på den egna avdelningen. Detta kan i sin tur bidra med kunskap till intern utbildning och kan användas som diskussionsunderlag.

  • 349.
    Gransjön Craftman, Åsa
    et al.
    Sophiahemmet University; Aging Research Center (ARC) Karolinska Institutet and Stockholm University.
    Hammar, Lena M
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet; School of Health Care and Social Welfare, Mälardalen University; .
    von Strauss, Eva
    The Swedish Red Cross University College, Department of Public Health and Medicine. Aging Research Center (ARC) Karolinska Institutet and Stockholm University.
    Hillerås, Pernilla
    Sophiahemmet University; Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet.
    Westerbotn, Margareta
    Sophiahemmet University; Division of Caring Science, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet.
    Unlicensed personnel administering medications to older persons living at home: a challenge for social and care services2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 201-210Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.

    AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.

    METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.

    RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.

    CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients.

    IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

  • 350.
    Gransjön Craftman, Åsa
    et al.
    Sophiahemmet University and Aging Research Center (ARC), Karolinska Institutet and Stockholm University.
    Westerbotn, Margareta
    Sophiahemmet University and Division of Nursing, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet.
    von Strauss, Eva
    The Swedish Red Cross University College, Department of Public Health and Medicine. Aging Research Center (ARC), Karolinska Institutet and Stockholm University .
    Hillerås, Pernilla
    Sophiahemmet University and Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Marmstål Hammar, Lena
    School of Health, Care, and Social Welfare, Mälardalen University.
    Older people's experience of utilisation and administration of medicines in a health- and social care context.2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 760-768Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.

    AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.

    DESIGN: A qualitative descriptive study.

    METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.

    FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.

    CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.

    RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.

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