Background: It's a fundamental principal to protect children's rights. Through legislation, child abuse has been prohibited in many countries. Nurses working with children has a frontline role in identifying and reporting suspected or known child abuse. Mandatory reporting is one of the nurse's duty, reluctancy to report can lead to misconduct but it also leads to children suffering.

Aim: The purpose of this degree project was to identify factors preventing nurses from mandatory reporting of children in health care.

Method: A literature study based on using and analysing nine qualitative articles.

Results: Three themes emerged in the result. The first theme was knowledge deficit, with two subthemes which were the need of education of signs and symptoms and the other subtheme was insufficient experiences. The second theme was nurses strained work environment with three subthemes. The first subtheme was the lack of routines, the second one miss information and the third one lack of cooperation and communication. The third theme consists of two subthemes, which were the lack of emotional support and the experience of fear. The results showed that nurses due to different factors relinquished from mandatory reporting. 

Conclusion: The results highlighted that education and training was needed among nurses to gain knowledge on how to safeguard children and establish mandatory reporting. Thus, support from colleagues and managers agencies dealing with child safety was highly valued by nurses. Implementation of education, training and support could improve the cooperation in protecting children.

Background: Fibromyalgia is a chronic disease that is difficult to treat and diagnose. The illness is of unknown etiology. The majority of the ill is women. Aim: The aim of this study was to describe women ́s experiences of living with long term pain associated with fibromyalgia. Method: A literature -based study was performed. The database Cinahl was used in the search process. This study includes 11 qualitative articles that have been analysed by a review template. The analysis resulted in two categories "experiences of a changed me" and "experiences of social life" with six subcategories. Results: The consequences of fibromyalgia were that the family life, spare time, social life and working life changed in different ways. The articles also showed that women with fibromyalgia did not receive the understanding they needed from their families or the environment. Conclusion: Women with fibromyalgia feel that they do not get understanding from the outside world. It is important that health care professionals understand and acknowledge these individuals' subjective experiences so that they can give professional care and support.

Purpose: To explore and compare cancer patients’ perceptions on the quality of nursing care in four European countries. Methods: Data were collected in Cyprus, Finland, Greece and Sweden. The sample comprised 596 hospitalized cancer patients. The quality of nursing care was measured using the “Oncology Patients’ Perceptions of the Quality of Nursing Care Scale” (OPPQNCS). Patient characteristics were also collected. Analysis of variance was used to examine the effects of country on the perceptions of the quality of nursing care. Results: Patients’ age ranged from 18 to 86 years, and 58% were male. The comparison of cancer patients’ perceptions regarding the quality of nursing care between the four countries showed a statistically significant difference in the total OPPQNCS scores (p <0.001) as well as in the subscales responsiveness (p <0.001), individualization (p<0.001), co ordination (p<0.001) and proficiency (p<0.001). The Cronbach’s alpha coefficient for the OPPQNCS ranged between 0.89 and 0.95. A multivariate analysis of variance for the OPPQNCS controlled by respondents’ demographic characteristics revealed that only the patient’s country was significantly related with the patients’ perceptions of quality care. Conclusion: Quality of nursing care as perceived by cancer patients was high, but differed between the four countries. The impact of the clinical status of cancer patients on the quality of nursing care and managerial factors such as staffing/nursing care delivery models that influence the ability of nurses to offer high quality care should also be explored by more focused studies.

Background: Mental illness is defined differently depending on the context, ranging from symptoms of anxiety and depression to schizophrenia. Mental illness among the population has increased since 1990. A survey done by the Central Bureau of Statistics in Sweden (2006) shows that issues such as anxiety are more common now than before. Twenty-three percent of women aged 16-84 said they had experienced symptoms of anxiety. Thirteen percent of the men aged 16-64 said they had experienced the same. Pre-conceived notions often meet people with mental health issues and there is a stigma surrounding them and their situation.

Aim: The aim of the study was to examine how patients with mental illness experience their contact with health care professionals in health care.

Method: The study was designed as a literature based study. Eleven articles were analyzed, nine articles were found by a systematic search and two articles were found in an unsystematic search.

Results: This study showed two main themes and eight subthemes. The main themes were patients desire to have a good relationship and good interaction with health care professionals. The subthemes were patient confidence in health care professionals, a dedicated staff, patients desire to get person-centered care and to feel involved, to have good continuity in their health care and to have highly available health care professionals around them, to have a good dialogue, be actively listened to, competent health care professionals and being labeled.

Conclusion: The conclusion is that patients that lack trust, commitment from health care professionals or continuity had bad experiences with the health care system. Patients needed to have a mutual relationship with the health care staff to have a good experience with the health care system.

Background: Research have shown children to be a large patient group within the health care sector. Nurses, should therefore, have knowledge about how to individually adapt meetings so it will be a positive experience for the child, the parents, and for themselves. Historically, this has not been the case and created immense care suffering for several families.

Aim: The aim of this study was to illuminate nurses' experiences of meeting children and their parents within the health care sector.

Method: A method to contribute to evidence-based nursing with ground in analysis of qualitative research was performed. An analysis of nine scientific articles was carried out. The analysis resulted in three main themes and eight subthemes.

Results: The main themes were: "To see the child as an individual", "to built trust", and "knowledge and experience are crucial". Knowledge were fundamental for creating a positive meeting.

Conclusion: By individually adapting communication to the child and the parents, good conditions allowed for a trusting relationship to emerge. Time was needed to create a safe and trusting relationship. However, it did not always exist. With knowledge and experience the nurse could see the child as an individual and adapt the meeting to the child. It was the responsibility of the nurse to gain the necessary knowledge, and to reflect with colleagues was seen as an important source to attain new knowledge.

Background: Humour has been a part of mankind since ancient time and affects the human being in several ways. Communication is essential in creating a relationship and humour may improve the possibility that a nurse and a patient succeed in building a therapeutic relationship.

Aim: The aim of this literature review was to illuminate humour in the therapeutic relationship between nurse and patient.

Method: The method used was a literature review. Systematic searches were conducted in the databases Cinahl and PubMed where eight articles were found, a ninth article was found by a non-systematic search. The articles were then analyzed through Friberg's five-step model for literature reviews.

Results: Four themes occurred. Humour as a brick in building a bridge in the therapeutic relationship, Experiences and effects of humour in the therapeutic relationship, Barriers and fears when using humour in the therapeutic relationship and Gender and humour in the therapeutic relationship. The result suggests that humour is useful in building a therapeutic relationship and is being used frequently, yet there are times when nurses hesitate to use humour due to the lack of experience. There also occurred a difference in how humour is used due to the gender of the patient.

Conclusion: Humour is mainly a positive experience in the therapeutic relationship and should be used as it makes communication easier and makes it easier for nurses and patients to bond. The way using humour differs in gender must be considered by the nurse.

Background: During the recent years a great amount of unaccompanied children have arrived to Sweden. They constitute a vulnerable group since they lack the protection of an adult. Previous research shows that they often have traumatic experiences and suffer from mental health problems. Nurses need to be aware of these issues to be able to provide good care for the asylum seeking children. Aim: The aim of this study was to describe the experiences of unaccompanied children seeking asylum. Method: A literature review based on the content of six qualitative studies, four quantitative studies and two studies of mixed method. Results: The findings revealed four main themes; Being a survivor, Almost in safety, Mental vulnerability and Creating a new life. The results show that the children have survived war and persecution and have had to leave their families to search for safety. They have a great fear of being sent back and express a need for support and encouragement. It also appears that many of the children feel lonely and isolated and that a significant part suffer from mental health problems such as Post Traumatic Stress Disorder, depression and anxiety. The children strive to create a new network and to succeed. Conclusion: To be able to help unaccompanied children with traumatic experiences and consequences thereof, it is important for the nurse to build a relation based on trust. It is useful for nurses to engage a life-world perspective, since it includes a holistic view of the children and their lived reality.

Background According to the Swedish law "skollagen" the school shall encourage all children’s development and strive to mitigate differences in pupils individual conditions to utilize their education. The role of the school nurse is to proactively prevent illness amongst the pupils. With some girls, absence is high in physical exercises and their presence in other activities that aim for increased health is limited. This absence affects these pupils’ ratings and limits their chances of having physical activities, but it also reduces their possibilities to interact in social activities within and outside school.

Aim The aim of this study was to describe school nurses’ approach to strengthen girls who are in a situation where their guardians restrict their participation in health promotive activities.

Method This is a qualitative, descriptive study based on individual semi-structured interviews with nine school nurses. The transcribed interviews were subjected to qualitative content analysis.

Results The school nurses had an active approach to create a mutual understanding between the girls, their guardians and the school. This was conducted by strengthening of democratic appraisals, finding new ways to reach girls and their guardians and finally building and widening the school nurses’ own competence in the situation.

Conclusions: The studie shows that school nurses make use of the steering documents that exists within the school system in order to strengthen girls’ equality rights. A prerequisite for the school nurse to influence guardians and girls was to create a good relation for all of them. The school nurses were interested in understanding the family’s situation and their life experiences as well as inform about the core values of the school in order to create mutual understanding and build a foundation for further work based on each family’s situation. In the role of a school nurse it was not found viable to reach results only by informing the guardians and girls. Instead the school nurses tried to reach an open discussion with respect for both parties.

Only through such a dialogue the school nurses argued that they could reach out and create the right conditions for a positive change to support the girls’ equality rights.

Background: Each year there are thousands of children abused in Sweden. This can result in lifelong consequences not only for the children, but also for the society. Verified statistics show an increasing number of child abuse in Sweden in recent years. As per Swedish law, nurses are required to report child abuse, but despite the law requirement the studies indicated that reporting is not always done.

Aim: The aim of this study was to describe nurses' experiences of reporting a suspected child abuse to social services.

Method: A method to contribute to evidence-based nursing based on analysis of qualitative research was performed to deepen understanding. An analysis of eight qualitative research articles was carried out. The analysis resulted in four main categories and nine sub categories.

Results: The main categories were: Worksite factors, barriers for not reporting, personal factors caused by the nurse, lack of or poor functioning cooperation with social services.

Conclusion: This study indicates, that nurses need experience, training, support and information and also clear guidelines and feedback from social services.

Background: Palliative care is an approach that aims to increase both the quality of life of patients and related parties, as far as possible, to relieve suffering and promote health at the end of life. Palliative care is based on teamwork, where relatives play an important role. Participation from related parties have a large significant role which is emotionally and physically exhausting. Communication and language is prerequisite understanding the experiences and realities of health and suffering.

Aim: The purpose of this study was to illuminate the relatives experiences of nurse communication, support and treatment in a palliative care in the home.

Method: The method is a systematic literature review of the basis of qualitative research, contributing to evidence-based nursing. A total of eight scientific articles have been used on studying closely related experiences.

Results: The results show that relatives were in need of support from the nurse to participate in care. As well as communication and response from the nurse was important in how relatives experienced support and how this contributed to a good quality of care. The results are divided into two main themes and seven sub-themes.

Conclusion: Inadequate communication and response from the nurse emerges and this led to the suffering and feeling of abandonment and disappointment among of the relatives. More research is needed on the basis of relatives perspectives because they became more involved in the care. Nurses need to increase their knowledge and understanding of communication and treatment of disease process and the dying process, as this can allow for better care. The relatives felt the support from the nurse as important.

Background: Anxiety is a common and unpleasant emotional state that affects many patients while waiting for surgery. Anxiety is described as an undesirable feeling of nervousness caused of a potential threat. It is an uncomfortable state of mind and can elicit physiological responses. Adequate nurse interventions that relieve anxiety improve the patient's condition, which lead to better recovery.

Aim: The purpose of this study was to describe the preoperative care, that can alleviate the patient's anxiety associated with surgery. Method: The method of study is a literature review of 12 scientific articles, of which 11 quantitative and one qualitative which cover nursing interventions that can alleviate preoperative anxiety. The search took place in the databases PubMed and Cinahl. This study was based on Friberg's model for the literature review.

Results: Result of the study presents three categories that contain different care interventions to alleviate the patient's preoperative anxiety: auditory, physical, and informational. Six care interventions are described in total. Music and aromatherapy proved to be simple and cost-effective care interventions. Acupuncture, hand massage and heating can be considered more expensive in comparison, because they require additional staff training, equipment and require more time. Person-centred information helps the patient to better understand the upcoming operation, which is seen as a way to promote and protect the patient's well-being. Conclusion: Nurses should understand that it is important to reduce preoperative anxiety in patients. It is equally important that nurses can balance patient care needs and appropriate nursing interventions for each patient. Through active listening and attention to non-verbal signals from patients, nurses understand better the patient's needs and can decide which care interventions can reduce anxiety.

Background: Occupational stress is a growing problem in caring professions, with consequences such as mental and physical ill health for the individual, which in turn can lead to increased long-term sick leave. Research shows that long-term sickness caused by mental illness can be associated with working conditions, where individuals who work in caring professions tend to be more vulnerable.

Aim: The aim with this study was to illuminate the social workers' experience of occupational stress within the unit of financial aid in the social service.

Method: A qualitative study was performed where six respondents participated in interviews. Content analysis was used to analyze the interviews. 

Results: Three themes emerged during the analysis; to feel pressure in the work situation, to feel support and to feel wellbeing. The result shows that workload and lack of time were factors that caused stress at work. A promoting factor was colleagues at work. Social workers experienced the tasks at work as meaningful but could sometimes feel insufficient.

Conclusion: The findings of this study point out that social workers experience stress at work and it affects their physical and mental health. This study wants to increase knowledge of occupational stress which can be a profit for social workers in the financial aid. Prevention can help social workers to improve their health and wellbeing. New findings in this study point out that social workers highlights the absence from work as a contributing factor to experience stress at work.

The original version of this article unfortunately contained a mistake in Fig. 2 part labels, the label "d" was incorrectly labelled as "c" and the subsequent labels should be corrected as d, e, and f. The corrected Fig. 2 is given below.

With increasing numbers of children being diagnosed with neurodevelopmental disorders (NDDs) attention has been drawn to these children's physical health. We aimed to identify the prevalence of defined physical problems (epilepsy, migraine, asthma, cancer, diabetes, psoriasis, lactose intolerance, celiac disease, diarrhea, constipation, daytime enuresis, encopresis) in a nationwide population of 9- and 12-year-old twins subdivided into those with and without indications of NDDs. Parents of 28,058 twins participated in a well-validated telephone interview regarding their children's mental health and answered questions about their physical problems. The results indicate a high rate of physical problems in children with NDDs, particularly in those with indications of the presence of combinations of several NDDs.

Background: One of ten women in Sweden will at some point in her life get breast cancer. In today's society, more women than ever before suffer from breast cancer, but the chance of survival increases. As a nurse, it is important to have knowledge about the woman's experiences of breast cancer in order to provide as optimal and individualized care possible.

Aim: The aim of the study was to elucidate how the woman experience the first time with breast cancer.

Method: A literature-based method is used to bring out the woman´s experiences of getting breast cancer. The results of the studies were analyzed using a qualitative content analysis consists of five steps. The analysis resulted in four themes and twelve subthemes.

Results: The results showed that the woman are in great need of support, feeling anxiety and fear, experiencing an altered self-image, and that treatment hinders.

Conclusion: The conclusion showed that regardless of the situation, it was important for the woman that someone always was there for them as support. An important aspect was the need for information to reduce fear and anxiety. Breast cancer affecting the whole of the woman's lives and she strove to reclaim as much as possible of her previous life. This could be difficult because of fatigue and other major changes the woman experienced after the treatments, both physically and mentally.

In this study, we explore more closely how different organizations in society work and do their business to learn about sex and social information for newly arrived young people. In the study, the participants' own stories will provide an insight into how it may appear to work with sex and social information for newly arrived young people. These organizations work to provide sex education to newly arrived young people in diverse ways, which made it interesting to rigorously compare the organizations work methods with each other and then highlight the forces in the diverse ways of working. The purpose of this study is to investigate how some organizations in society work with sex and social information aimed at newly arrived young people. Furthermore, an aim is to investigate these organizations own perceptions of this work and look at similarities and differences in their way of working. In this qualitative study, interviews have been chosen as data collection methods. Qualitative content analysis was used to analyze data for this study. The main result of the study was presented in the form of "Change". The theme Change shows the informants' desire for change in both working methods and perceptions. The theme consists of two domains. The first domain is "Way of working" and represents how the different organizations look at the work, and what are the shortcomings. For example, more resources and continuity at work are needed, and generally how the work on sex and cohabitation information looks. Under the domain of Work, there are four categories "more resources", "continuity", "grouping" and "participation and interaction". The second domain is "Knowledge Situation and Needs", which represent the actors' perceptions of how the knowledge situation among the youths. Under the Knowledge and Requirements domain, there are two categories, "ignorance" and "attitudes". In these categories, the group's attitudes towards sexual and social information and the meetings with the organizations, as well as the attitudes of the activities, are emphasized. An illumination of the lack of knowledge of the group is in the category of ignorance, deviant ignorance compared to young people in general. In conclusion, it is generally necessary to add more resources and the theme 'Change' summarizes the whole of how the organizations work with sex and social information or how they want to work with it. More resources should be invested in the field and they need to work continuously with this area for a lengthy period. A common picture and perception was established regarding that more involvement and cooperation between organizations. The organizations consider that diverse ways of grouping at the meeting with young people are needed and constructive work with the attitudes of young people and the ignorance that the organizations consider is associated with sex and cohabitation among young people.

Background: According to World Health Organization is palliative care a human right. The focus of palliative care is relieving suffering and having quality of life as the main goal. The nurse's role is to enable symptom control, to be a support for the patient and close relatives, as well as contributing to a good and worthy death. Although death is a part of life, strong feelings arise about death and the dying. Aim: The aim of this study was to describe nurse experiences of palliative care. Method: The method used was a literature study based on international qualitative research. Eleven articles were analyzed and resulted in four main themes and nine sub-themes. Results: The findings were four main themes; the profession, relationships, work environment and feelings as well as nine sub themes; experiences and knowledges, the patient, relatives, stress, support from colleagues, lack of support from colleagues, grief and impotency, satisfaction and mental strain. Conclusion: The nurse’s experience of palliative care is individual and varies depending on, experience, interaction with colleagues and self-perception regarding individual values and existential questions.

Heart failure is one of the most common diagnoses in Swedish health care. Approximately 250 000 people in Sweden are estimated to have a heart failure and approximately 30 000 new patients are diagnosed every year. Heart failure is a serious illness with server symptoms and high mortality. The aim of this study was to illustrate patients with heart failures experiences of quality of life. The method that was used is a literature-based study of 12 qualitative articles that was based on their results. The included articles were published between 2003-2014. The majority of the participants were in the scale between NYHA-II-III. The result shows that patients with heart failure experienced symptom burden that limited their daily life. They described a constant struggle between the illness and the feeling of maintaining the roll they once had. The most important thing was to find strategies to maintain the quality in life and to have good spirit and positive thought. The result was presented in four themes: When the body sets limits, feelings taking over, captive in your own home and an uncertain future. The conclusion that can be drawn from the results of this study is that the experience of quality of life is highly individual and depends mostly on how the experience of the disease is being managed by the individual.

Burnout due to work-related stress is increasing in the society. Many studies concern the causes and effects of burnout, but rarely concern the experiences of those who are living with burnout. The aim of this study was to examine the experience of living with burnout. The concepts of health, suffering, burnout, stress and coping are briefly described in the background. The method that was used is a literature-based study with the analysis of qualitative research. This study is based on eight qualitative articles. Six themes emerged; Physical experiences, Psychological experiences and Existential experiences, Work experiences, Experiences of relations in private life and Experiences of demands and expectations. The results shows that burnout affects a person on many different levels. Dealing with burnout involves a range of varieties of symtoms, physical as well as psychological and social. Physical symtoms that appeared among the participants were for instance fatigue, brain fog, headache and palpitations. Social and relational problems as bad conscience, low self- esteem and feelings of inadequacy were experienced. Emotional disturbances and existential reflections were common amongst those who were suffering from burnout.

Background: The work done by the nurse at the primary health care center includes meeting with people of different ages and with different health problems and diseases. It is important that the work is carried out in a good environment. Former studies show that the workload for the district nurse has increased and become more stressful with threats and violence from patients who expect more treatment.

Aim: To describe the district nurse's experiences of their work situation.

Method: A qualitative interview study with eight district nurses working in primary health care in Sweden were interviewed. The data was analysed using a qualitative content analysis with an inductive approach.

Results: Three main categories and nine subcategories were generated by the authors. The categories included: The content of a good day is when all the colleagues are present, and the timetable is good planned with enough work containing good meetings. When planning fails is the change of planning because of more patients and obstacles in communication skills. Experience of their environment is the impact of the physical environment such as good working environment and threatening environment.

Conclusion: There was negative employment in the district nurses' work situation, but despite that, the experience was positive to work independently, make decisions and use their resources. They felt collegial support and it was important to know where to turn when things went wrong.

Background: Mental illness is a growing problem in society and is increasingly seen in younger people. Deliberate self-harm is seen as a complication of mental illness. Self-harm means that people intentionally injure themselves as a habit and with more or less severe de-gree, but with no intention to take their own life. Aim: The aim of the study is to illustrate parents’ experiences of their child’s deliberate self-harm behavior. Method: A literature-based study based on analysis of ten qualitative articles. Results: The results are presented in three main themes and ten subthemes. The first main theme is "A roller coaster of feelings", with three subthemes "First battle", "Feelings of guilt and shame" and "Anxiety and fear". The second main theme is "Parenthood and family rela-tionship" with four subthemes "Changing positions of power", "Parents in conflict", "Not being enough as a parent" and "A changed relationship". The last main theme is "Parents ex-perience of support" with three subthemes "The insufficient support", "Feeling seen" and "To get support from the surroundings". Conclusion: Health care professionals need to create a good relationship with both parents and patients, which can be done by meeting the parents' feelings and being responsive.

Background Colorectal cancer is the third most common form of cancer among men and women in Sweden. The disease is shown to have a higher incidence among older individuals. Recent studies showed that the individuals may ignore their symptoms. To make a choice in what treatment to go for individuals got support from family and friends. With the focus on getting through the treatment. Understanding the individual's experience of living with colorectal cancer is important for the nurse profession. The nurse roll is to inform, support, care for these individuals and give a person-centered care.

Aim The aim of this study was to describe individual's experience of living with colorectal cancer after completed treatment.

Method The method used in the study was designed by Friberg (2012) to contribute with evidenced based caring in qualitative science research. Eleven science articles were analyzed using Friberg (2012) five step method of analysis. The analysis resulted into three main themes and eight subthemes.

Results The results were formed into three main themed named: the uncontrollable body, becoming depended on the environment and a new view of life after treatment.

Conclusion To live with colorectal cancer after completed treatment, affects the individual life situation and quality of life. Therefore, it is important for the nurse to be aware of the disease and the effects of the trearment on the individual.

Background The UN Convention on the Rights of the Child, CRC, claims that children should be heard in decisions about themselves. Children also have the right to play. This need to be applied in healthcare environment. Swedish laws and guidelines for children's healthcare confirm this. What do children themselves propose as important support to participate? Aim The aim of this study was to describe children and young people's experience in healthcare environment. Method A literature-based study of nine qualitative academic articles was conducted. 556 children altogether were asked about their experience from healthcare environment. Results The result is presented by five themes: To be afraid and sad To feel comfort and safety To understand To be included in decisions To know the nurse Conclusion Children and young people in healthcare environment feel discomfort and insecurity. They need help with symptoms and fear. If the nurse is perceived as a "bad nurse", the child is exposed to feel helpless. A child need a certain amount of comfort, playing and contact with peers to be motivated to participate. When invited to ask questions and express their worries, they want to be involved. Children want to participate in decisions about themselves. The nurse has a key role to involve the child. Confidence is built through technical skills in achieving procedures, good communication and personal attributes, such as being helping, kind, friendly and humorous.

Recovery from a myocardial infarction (MI) can be a very difficult process and some patients are also stricken by fatigue. The aim of the study was to describe the difficulties experienced by men with fatigue during the first year following their MI. The study was conducted using qualitative content analysis of semi-structured interviews with nine men in working age (mean age: 55 years) with verified fatigue (≥12 of 20 on the Multidimensional Fatigue Scale with a mean of 17) one year after their MI. During the first year after the MI the men suffering from fatigue experienced various difficulties in terms of both themselves and the care received. The analysis generated three themes with difficulties described by the interviewed men. 1) Going through involuntary change: not recognizing their body and the inability to recognize themselves. 2) Lacking individualized care: To be denied satisfactory health care treatment and to be denied respectful treatment. 3) Not being seen in the light of the social context: The MI affects the whole family and caregivers do not pay attention to the family. In order to make both the patient and relatives feel secure and cared for, it is essential that caregivers be aware of the importance of providing individualized care over time with particular attention for the patient’s social context.

Background: The implementation of evidence-based methods in hospital settings is challenging and multifaceted. There are several different factors that may affect implementation processes, of which the organisational culture may be one. It is well known that conservative organisational culture can hinder implementations; accordingly, a mix of different organisational cultures is preferable. Aim: The aim of this thesis was to follow the implementation process of an ICF-based assessment tool regarding cultural differences associated with the implementation in a psychiatric clinic. As part of the project, an assessment tool based on the International classifi cation of functioning disability and health (ICF) was developed and implemented. Method: In Study I, three Swedish expert groups participated and analysis of inter-rater reliability was conducted through simulated patient cases. In Study II, data were collected through focus group interviews pre- and post-implementation of the ICF-based assessment tool; thereafter, data were analysed using directed content analysis guided by Normalization Process Theory (NPT). Data from 109 nursing staff who completed the organisational values questionnaire (OVQ) and resistance to change (RTC) were investigated, and the association between the OVQ and RTC was examined with regression analysis (Study III). Patients n=50 representing the intervention hospital and n=64 representing the control hospital answered the Empowerment scale (ES) and Quality in psychiatric care (QPC-IP) (n=45 from intervention hospital and n=64 from control hospital). Staff n=37 at the control hospital answered the OVQ which was presented as descriptive data (Study IV). Results: Inter-rater reliability of the ICF-based assessment tool (DLDA) displayed acceptable kappa values (Study I). The DLDA tool showed the potential for empowering patients. Furthermore, it was considered useful for dialogues, refl ection and for identifying patients’ strengths. Nonetheless, it was diffi cult to implement it in practice due to contributing factors such as time pressure, heavy workload, stress and lack of routine in using the tool (Study II). The intervention hospital was characterised by an organisational culture of trust, belongingness and fl exibility, i.e. a human relation culture. One ward (I.W.3), however, was not dominated by a human relation culture. This ward had an almost equal mix of different cultures (human relation, open system, internal processes and rational goal) (Study III). The results of Study IV were non-signifi cant; however, it indicated that intervention ward 3 proved to be the most prominent ward regarding patient participation and empowerment among the intervention group. The results suggest hospital wards with equal mix of different cultures is more successful than cultural polarisation. Conclusion: Only one of fi ve wards succeeded in implementing the DLDA successfully (ward 5). Ward number three was the most successful of the inpatient intervention wards. The intent of the DLDA method was considered to be good and its use in a psychiatric nursing context can provide structured support in order to improve the dialogue with the patient, but it was not used in practice in all the studied wards. The organisational culture of the intervention hospital was dominated by human relation properties, however with one exception, ward number three. The results tentatively show that organisational culture may affect outcomes of implementation processes. Consequently, it appears that an equal mix of different cultures are more auspicious than cultural polarisations. The results seems to confi rm previous research, where one ward with a balanced mix of different cultures succeeded best to implement DLDA, of the wards representing psychiatric inpatient care. Ward number three did also show the best results in terms of empowerment and patient participation of the intervention wards. Further research aims to continue developing and conducting psychometric testing of the DLDA tool. The DLDAs impact on patient assessed empowerment and patient participation requires studies on larger populations than the current study

An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

Background: Osteoarthrosis is considered the 11th most common disorder that causes the greatest disability and gradually decline the patient’s quality of life. Studies have shown that 80% of the patients have different types of disabilities and 25% can not perform their daily activities. Aim: The purpose of this study was to describe patients’ experiences of being stricken with knee osteoarthritis. Method: A literature-based study was chosen as the method that conduce to evidence-based nursing by analyzing qualitative research. The analysis resulted in three main themes and seven subthemes. Results: Three main themes were: “Daily challenges”, “To relieve symptoms” and “To be cared”. The main finding was that knee osteoarthritis considered to be the central focus in the patients’ lives which caused physical and socio-economies limitations. This worsened their quality of life and mental well-being. Although surgery considered to be the only solution, the expectations regarding the outcome differed. Conclusion: It is important to treat knee osteoarthritis in early course of the disease to prevent limitations and other diseases. The patient’s need information and support to manage their symptoms.

Background: Every year 25 000- 30 000 people strikes with stroke. Out of these, at least every fifth is affected with aphasia. Affected with aphasia may cause an essential impact and change in the everyday life. The changes may also result in a suffering for the adult with aphasia. Therefore it’s important that the nurse has adequate knowledge of what aphasia is and treats the person for whom it is, not for its illness. Aim: The aim of this study was to illuminate the adult’s experience of aphasia’s impact in the changed life after stroke. Method: A qualitative method to contribute to evidence-based nursing with a ground in analysis of qualitative research, was used to enable a deeper understanding of adult’s experiences of aphasia. Ten qualitative articles were analysed, four themes and eight subthemes emerged. Results: The results showed that the adult with aphasia experienced a loss of the identity, loved ones and work. Aphasia also caused a change in the language ability that affected participation in social activities. All resulting in a suffering. To cope with the aphasia’s difficulties, different strategies evolved. The adult with aphasia also described the social support to be important but also to accept what aphasia had contributed in the changed life. Conclusion: According to the results the language appeared to be a central part to whom we are. When the language ability no longer existed, a suffering emerged. Keywords: Aphasia, communication, patient’s perspective, stroke, suffering.

Background According to the Public Health Agency of Sweden, mental ill-health is increasing in Sweden and the affected are becoming younger and younger. There is therefore an increasing need for more research on children and their mental ill-health. To be able to stop this negative development it is of foremost importance that children get help as early as possible. Preschool staff members play a vital role in the identification of mental ill-health among young children and making sure that the right help is given. Aim The aim of the study is to illustrate preschool staff member´s experience of identifying children with mental illhealth. Method The method used is qualitative interview study. Six female preschool staff members have been interviewed and a content analysis has been applied on the answers. Results Children´s mental ill-health is a very complex subject and something that is not included in the Swedish curriculum. Additionally, the education of preschool staff members does not include anything concerning children's mental ill-health. Consequently, preschool staff members battle with a situation where they play a crucial role in the identification of mental ill-health among the children however they do not possess neither the knowledge nor the skills to do so. Conclusion Mental ill-health among children in preschool is a very complex subject. Preschool staff members face a very tough responsibility in identifying the signs of mental ill-health among the children and the reasons for this are many.

Background: It is valuable that the patients experience a good encounter with the nurse at the emergency department. There are several factors that can influence the encounter and the patients' perception of the nurses and the surroundings at the emergency department. To not be seen as the person you are or not treated well, is a common reason why patients feel health suffering. It is the patients' experience of the circumstances which determines whether situations cause health suffering or not. Aim: The aim of this study was to describe patients' experiences of the encounter with the nurse at the emergency department.

Method: The method used in this study was a literature review, based on qualitative studies. Ten articles were analyzed according to Friberg's (2012) qualitative content analyze in five steps. Results: The researchers found five themes that specifically stood out when studies were researched. The themes were feelings of: participation, being seen, abandonment, being dependent and vulnerability. Conclusion: The experience of the encounter with the nurse at the emergency department differ from each patient. All patients want to meet a nurse who characterises kindness and warmth. The nurses are the ones who can control the outcome of the encounter at the emergency department.

Society is constantly evolving and changes are taking place, which creates the opportunity to collaborate around several different areas. Working for a work-integrated learning (WIL) could mean that you work structured together with healthcare and college with common goals and collaborative issues. The content of the study deals with healthcare representatives´ perceptions of the importance of collaboration, the possibility of nursing education's vocational education. Method used in the study is qualitative method with focus group interviews. In the study, three focus groups and one interview were interviewed. Interviewees consisted of managers, supervisors and supervisors. The care activities that the informants represented were somatic care in emergency medical care, psychiatric care and home care. A qualitative content analysis was made by the interviews that were themed by interpretation of the interviews. Healthcare representatives wanted a collaborative perspective in various areas, such as development and collaboration of teaching models, assessment and evaluation. Working together with work-integrated learning as a model can be a way of interacting. There is a hope that the healthcare and higher education institutions will find development pathways in the future to ensure the knowledge of nursing students and their future occupational role, as to ensure the quality of care.

Background: Sickness absence in Swedish municipalities have increased during the past five years. This is a trend that follows all Swedish municipalities. A municipality in Western Sweden has worked much to prevent sickness absence through rehabilitation. However, the municipality now wants to shift focus and work more with those who are healthy by investigating what creates health among their employees.

Purpose & Issue: This study aims to investigate which resource factors of health that contributes to the working presence in a municipality in Western Sweden. Method: A qualitative method with inspiration from phenomenography has been used for the study design, for gathering data and for the data analysis.

Result – Outcome space & Conclusions: Four main categories emerged identifying The result shows four categories identified as the most important resource factors for health among for the informants. These four categories were: job satisfaction, morale, opportunity to influence and wholeness.

Objectives We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. Materials & methods The Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital. Results Of 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient’s decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital. Conclusions Patients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.

Background: Studies indicate that both patients and nurses are positive to have relatives present at the cardiopulmonary resuscitation (CPR) situation. They see relatives as a resource and support, and also that the afterward crisis management may be facilitated. Routine should be created for the nurse to offer the relatives to attend and that it will become a natural part of CPR situation.

Aim: To illustrate the experiences of close relatives attending cardiopulmonary resuscitation.

Method: A literature study with qualitative approach. Seven articles were reviewed and analyzed according to content analysis method.

Results: We found that relatives appreciated and felt it was important to attend the CPR-situation. They found it easier to move on after the incident, especially if the patient died. They wanted to be sure that everything that could be done also was done. The feeling that their presence in some way protected their dear ones from danger and harm was also important. Honest information was considered essential and the relatives appreciated the efforts and care that the healthcare personal gave their relatives.

Conclusions: The vast majority of relatives to patients undergoing CPR choose to feel that it's important to be present at the CPR. Based on this knowledge, further work can lead to create routines concerning relatives' wishes to attend CPR situations.

Background: Self harm has increased among adolescents during the last years. Studies reveal nurses' attitudes as an issue. The need to investigate nurses' experience of patients who self-harm is very important to see what is missing. Relation between nurses and patients is a vital part of caring and studies show that very little research is done in this area.

Aim: The aim of this study is to overlook nurses' experience when they meet a patient that is self- harming.

Metod: A literature study with a mixed approach. Articles where chosen, read, reviewed and analysed to find similarities and differences in their result.

Results: The result came out with three main categories and seven sub categories. The first category is Difficult to understand self-injury which has two sub categories; Difficult to understand the behaviour and Difficult to understand the reason. The second category is Self- injury evokes emotions and has three sub categories; Anger, concern and anxiety, Empathy and conflicting emotions and Creates conflicts. The third category is The environmental impact on nursing care which has two sub categories; The meaning of time and Environmental influences and care.

Conclusion: The results show that nurses felt that they needed further education about self- harm, that many of them were negative or insecure while meeting patients and did not know what to say in fear of making the behaviour worse. Many nurses also considered it hard to understand self-harm and why someone would like to harm themselves.

Background: Hypertension is a common disease and over half of all deaths in cardiovascular disease are caused by complications of hypertension. The basis of the treatment is non-pharma-cological and includes lifestyle changes such as physical activity and diet change. Only few patients reach the treatment goal and are well treated, therefor it’s important for the health care service to have a greater understanding on how patients experience implementing lifestyle changes in hypertension.

Aim: The aim of this study was to describe patient’s experience of implementing lifestyle changes in hypertension.

Method: A qualitative-based literature study was used. Ten qualitative articles from PubMed, Cinahl and Proquest was analysed by the five-step method described by Friberg (2012).

Results: Two main themes emerged under the analyse process. The two main themes were: opportunities and barriers, with the sub themes: knowledge, attitude, social, comorbidity, time, society and economy.

Conclusion: Patients with hypertension experience opportunities and barriers to implement lifestyle changes in hypertension. Patients with good knowledge and a more positive attitude towards their disease had a greater opportunity to implement lifestyle changes in their life. The results also showed that patients had different recourses and assets that affect their possibility to follow and succeed with lifestyle changes. Therefore the nurse should work towards a person-centred care. This provided opportunities for each patient as an individual to obtain knowledge, motivation and good conditions to create and establish self-care.

Background: Dementia not only affects the individual patient, but also healthcare professionals and the relatives. It is an increasing incurable disease that affects the mind of the afflicted person. He or she will experience difficulties with either expressing oneself, recognizing daily things, performing tasks that he or she previously were able to managed or the ability to plan, initiate or complete various tasks.

Aim: The aim of this study was to illuminate experiences of being a relative of an older person afflicted of dementia.

Method: A literature based study was performed, analyzing 10 qualitative articles.

Results: The results consist of two main themes, relatives experiences of support, with two subthemes, support in the care relationship and support from others in the same situation. The second theme progression of the disease and its affects on relations and feelings, with three subthemes, the partners behavioral change, a new kind of relationship and impact of the disease on feelings. These highlight significant experiences the relatives go through in relation to the disease. Support was something that may be given in different ways and the need for support was necessary. The behavioral change that comes with the disease, results in a new form of relationship with the affected. Feelings of sadness, guilt and shame were constantly present.

Conclusion: The results shows that the relatives need support through the entire disease progression when the behavior of the affected changes and a new relationship is formed. When accepting the disease, the relatives found it easier to deal with life in general. Nurses need to have the means to respond to these relatives and to know how they experience their situation, to be able to support them in the best possible way.

Background: Breast cancer is the most common form of cancer among women in Sweden. The cancer diagnosis has under the past few years increased and are expected to increase even more in the future. As cancer diagnosis increases, the ability to survive a cancer disease becomes more apparent with the help of advanced treatments. Aim: The aim of this study was to describe women´s emotional reactions when receiving a breast cancer diagnosis. Metod: A literature-based study was performed in order to describe women´s experience about their emotional reactions towards a breast cancer diagnosis. To analyse the result of the 11 included articles, a five step qualitative analytical method was used. The analysis resulted in one major theme and five subthemes. Results: To receive a breast cancer diagnosis was a huge change in life that affected women´s emotional reactions in many different ways. The result showed that women was chocked, they denied the breast cancer diagnosis, felt anger and grief. The women also felt hopefulness to fight and conquer the breast cancer disease. Conclusion: According to the result this study showed that a breast cancer diagnosis transforms a women´s life, from a healthy life to a life in illness. A breast cancer diagnosis did not only bring out negative feelings like frustration and hopelessness. It´s also bring out positive feelings like relief and fighting spirit.

Physical activity on prescription, so-called FaR is an important task for the district nurse in order to promote the individual´s health. Physical activity can relieve pain and symptoms as well as lead to reduced medication. The purpose of this study was to examine adult patients’ experiences of having been prescribed FaR. An interview study using an inductive qualitative approach was set up and ten patients were interviewed. The interviews were analyzed using content analysis according to Graneheim and Lundman’s description of the method. The results show that those who received tailored FaR had, in different ways, been offered, given to reason and discuss, agree and given the choice of activity and degree of activity the following individual condition and disease. To be asked to increase activity was almost as common as getting tailored FaR. Monitoring and support varied from close contacts if necessary to no follow-up at all. Those who had close contact described they had been met with a motivational interview. Some patients had no need of frequent follow-ups and were pleased to have received encouragement to the increased activity. The medical staff need ongoing training in motivational interviewing and in being flexible when there is a prescribed FaR to be consistent in patients undergoing treatment. To get repeated encouragement at follow-ups was one of the main categories that made the patients motivated progressively, increased activity and reduced resistance.

Background: Self-harming behavior has increased globally and has recently become its own diagnosis in the Diagnostic and Statistic Manual of Mental Disorders (DSM). Methods of self-harm can consist in cutting, burning, hitting and starving yourself. Self-harming behaviors are more frequent among women in a prison environment than in rest of society. Aim: The purpose of this study was to identify risk factors for self-harming behavior among females serving a prison sentence. Method: A literature review was performed and data was collected from eight scientific articles with both quantitative and qualitative approach.

Results: The results were analyzed and compiled into three main themes considering risk factors for self-harm: 1) Social strains and past negative life-experiences, 2) Mental illness and 3) Prison environment. The subthemes describe factors as family relations, age and ethnicity, abuse and traumas in the past; mental stresses, psychiatric diagnosis, substance abuse and withdrawal and relationships; and finally imprisonment, activities and restrictions in the environment and relations. Conclusion: Women who engage in self-harming behavior while serving a prison sentence often carry a problematic background with severe events who has affected them. The prison environment does not support their health and risk factors for self-harming behavior remains and even increases. This study can reinforce increased knowledge about self-harming behavior in women prisons and improve preventive work.

Immigrants from the Middle East have higher prevalence and incidence of type 2 diabetes (T2D) compared with native Swedes. The aim of the study was to describe and understand health beliefs in relation to T2D as well as attitudes regarding participation in a screening process in a local group of Assyrian immigrants living in Sweden. A qualitative and quantitative method was chosen in which 43 individuals participated in a health check-up and 13 agreed to be interviewed. Interviews were conducted, anthropometric measurements and blood tests were collected, and an oral glucose tolerance test was performed. In total, 13 of the 43 participants were diagnosed with impaired glucose metabolism, 4 of these 13 had TD2. The interviewed participants perceived that screening was an opportunity to discover more about their health and to care for themselves and their families. Nevertheless, they were not necessarily committed to taking action as a consequence of the screening. Instead, they professed that their health was not solely in their own hands and that they felt safe that God would provide for them. Assyrians’ background and religion affect their health beliefs and willingness to participate in screening for TD2.

Background: Dementia is a degenerative disease which effects the brains cognitive functions and there are several different types of dementia. A person who has dementia is likely to wander, shout, be aggressive, memory loss and poor perception of time. All of these symptoms affect the partner to the person with dementia. Every year over 25'000 persons gets dementia and many of these persons lives at home. The partner is often the one who takes care of the person with dementia.

Aim: The aim of this study was to investigate partners experiences of living with a person who has dementia. Method: The method used in this study was literature study and fifteen qualitative articles were analysed.

Results: Two main themes emerged: a changed relationship and to manage the situation.Dementia affects the relationship of a couple. There will be changes in the emotional relationship because the person who once was there disappears as the dementia deteriorates. At the same time there is a change in the roles. The chores that the person with dementia did earlier is now the partner’s responsibility. To be able to take care of the person with dementia the partner had his or hers own resources.These resources could consist of practical and emotional strategies. Also external resources where available, such as support from family, friends, church or support groups. Conclusion: The conclusion is that the partner is doing everything in its power to keep the person with dementia at home as long as possible.

Background: Stress among ´nurses´ at the emergency department is a common problem. Emergency departments are often overcrowded and the lack of staff is a usual issue. The work pace in the emergency department is often high and dealing with stressful situations is often forgotten.

Aim: The aim of this study was to explore ´nurses´ experience of occupational stress in the emergency department.

Method: A literature review has been made of 7 qualitative and 7 quantitative articles. Articles were analyzed by searching for similarities and differences. The analyzed articles were published between 2008-2016.

Results: The results showed that ´nurses´ showed a high level of occupational stress due to high workload and lack of staff. The results also showed that consequenses of stress were fatigue syndrome and depression. The most effective coping strategy among ´nurses´ were a strong social support, and the use of debriefing.

Conclusion: To work as a ´nurse´ at the emergency department can be stressful. To be able to deal with stress effectively ´nurses´ need to be educated in coping strategies. Clear guidelines in the emergency department are an effective method in dealing with stress.

Backround: Many people today live with mental illness. But what is often forgotten is their families that also they will be affected. Knowledge of how families perceive their situation is of great importance to health care. This is to be able to involve family members in care and meet their needs for support, which in the long term is vital for patient recovery. Aim: To illustrate the relatives' experiences of having a loved one with mental illness. Metod: A literature study with qualitative approach. Ten articles where chosen to be read, reviewed and analyzed according to Friberg (2012a) analysis model.

Results: Two themes with eight subthemes appeared. The first theme was: Experiences of inner suffering. The theme was marked by feelings of concern, fear, shame, guilt, and sorrow. The second theme was: Experiences of increased responsibility. This revealed feelings of a wasted life, feelings of lack of knowledge and the need of confirmation. Conclusion: The result of this study shows that the need for support from health care his huge for the next of kin. The feelings of concern, fear, shame, guilt and sorrow leads to inner suffering, and can there for involve to a depression for themselves. With a few actions from the nurse, which involves to listen to the next of kin, give emotional and practical support and to give knowledge of the mental illness, there can lift a huge load of the mental stress the next of kin is feeling.

Background: Diabetes is one of Sweden's national diseases. Around 7000 children live with type 1 diabetes in Sweden today. The diagnosis requires planning of everyday life and revaluation of routines which places great demands on the family.

Aim: The aim of this study was to describe parents and siblings' experiences of living with a child or young adult diagnosed with type 1 diabetes.

Method: The study was designed as a literature-based study to contribute to evidence-based nursing based on analysis of qualitative research to reach a deeper understanding of families' experiences. An analysis of thirteen qualitative articles resulted in four main themes and ten subthemes.

Results: The results of the study showed that the whole family is affected when a child gets diabetes. That the child was diagnosed was a shock that caused many feelings with both parents and siblings. There was a constant concern for complications in both the long and short term, resulting in a fear to hand over responsibility, causing a huge pressure on parents who could feel isolated.

Conclusion: The families experienced strong feelings when the child was diagnosed. The families needed support from the healthcare professionals to be able to handle the disease.

The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.

Background: Diabetes is an incurable and chronic disease and a risk factor for both stroke and cardiovascular disease. Type 2 Diabetes mostly affect people over the age of 40 however, in recent years even a lot of younger people got this disease. Since every patient is a unique person with its own needs and conditions the experiences of how to live with this disease is an important acknowledge in the caring of these patients.

Aim: The aim with this study was to illuminate experiences of living with diabetes type 2.

Method: 10 articles has been analyzed by Friberg's five step model.

Results: The analysis resulted in three themes; The environmental impact, with sub team the feeling of shame, blame and grief; the need of support with sub themes support and information and information for self-care; and another life with sub themes lifestyle changes and self-care and fear of complications. 

Conclusion: The results showed that the need for support and information about self-care was important to increase patient motivation. Lack of knowledge about the disease gave negative experiences such as difficulty in accepting the disease and also the feeling of guilt and shame occurred.

Background Parkinson’s disease is a chronic progressive neurological disease. About 10 million people are living with the disease today, knowing that there is no cure. There are different types of pharmacological ways to slow down the development of the symptoms but little is known about people’s experiences of living with the disease. Aim The aim of this study was to describe people’s experiences of living with Parkinson’s disease. Method A literaturebased study based on analysis of eleven qualitative scientific studies to get a deeper understanding of people’s experiences. Result The analysis resulted in three themes with ten sub themes. The themes that emerged was Readjustment of life, Changed as a person and The body does not work properly. People suffering from Parkinson’s disease experienced physical, mental, social and existential challenges which led to feelings of shame and isolation. It also affected their daily lives and relationships. Shame and anxiety was constantly present causing them to withdraw from others and made them worry about the future. Conclusion Due to the results the conclusion was that an early effort in psychological support, continuous follow-up and information is necessary to give the people the opportunity to manage their disease and to increase their quality of life

Background: Different kinds of physical activity were and had been of interest to both of us for the larger part of our lives. This made us decide to create a quantitative survey study. The focus of this study would be on motivation for being physically active. The reason for this decision being, that we both thought it would be interesting to study what motivates gym-goers to be and stay physically active. The positive effects of physical activity are well documented in today’s society. It helps diminish the effects of heart problems, strengthens the immune system, and makes the individual more energetic.

Purpose & Issues: The purpose of this study, was to investigate, and try to pinpoint what makes people motivated to be and stay physically active. Further important topics and issues that were to be investigated in this study, was if there were any differences regarding gender, and how motivation could differentiate between subgroups regarding the subject of physical activity.

Method: This study has been a quantitative cross-sectional study, using a survey to collect data.

Results: The result shows that most people who responded to this survey, indicated that the health and pleasure that exists within physical activity are the main motivational factors. Further comparisons also show that there are some differences in what men and women prefer to do in correlation of physical activity, and how the level of motivation may differ from earlier exercise experiences. Our results showed, that in general strength training was more popular among men, while endurance training was more popular among women.

Conclusion: After the analysis of the result of this study, the conclusion could be made that people are motivated by what they think is fun. To preserve the health and joy in their physical activity, was what appeared to be the main motivation sources. A further conclusion was also that people became more motivated, the longer they had been regularly physically active. A slight difference was also observed between men and women regarding training habits. Men engage more in strength training, whilst women are more active regarding endurance training.

Purpose To investigate why nurse anesthetists and operating room nurses choose to stay in the same workplace.

Design Qualitative design.

Methods Individual interviews were conducted with 15 nurse specialists from four hospitals in Sweden. Two men and 13 women aged between 43 and 63 participated. Data were analyzed with systematic text condensation according to Malterud.

Findings Three themes were identified. (1) Organizational stability contributed to low staff turnover, with good spirits between colleagues, representing everyone’s equal value and resulting in a feeling of homelikeness. (2) Sustained development in one’s own profession. (3) A humane head nurse who was at hand, who was a facilitator, who knew staff members, and eliminated obstacles for them.

Conclusions In a nonhierarchical and stable organization with a head nurse with caritative leadership skills, a welcoming working environment with opportunities for professional development is created. Thus, nurse specialists choose to stay, contributing to organizational development.