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: Dementia is a growing health problem that not only affects the individual but also their relatives. Symptoms cause impairment to varying degrees making life difficult for both the individual and their relatives. At first the demented person may be able to cope by himself but often need assistance from family member and healthcare the further down into the disease. Aim: The aim of the study was to describe experiences of being a relative of a person afflicted with dementia, Method: A literature-based study was performed based on ten scientific qualitative studies. Result: Three themes with seven subthemes emerged from the analysis: to get support, a changed relationship and a need for information and education. Conclusion The results showed that a change happens within the relationship to the demented person and that relatives needed support from different places and information and education to manage the changes and their health. The result clearly shows that being a relative to a demented person comes with hardships and changes to one daily life. To be able to withstand the hardships and changes relatives need support throughout the entire disease. They also need information and education about the disease itself but also about death and its process. The nurse has a vital role to support and provide tools for the relative’s wellbeing

Background: According to the World Health Organization, stress is a threat to global health, where there is an increase in healthcare personnel. Previous studies show that the nurses in the emergency room are extra vulnerable. Internationally, major challenges in modern emergency department are seen as a result of overcrowding and extended stay times.

Aim: The purpose was to examine the nurse's experiences of stress in work at the emergency department.

Method: A qualitative literature study was selected to describe nurses' experiences of stress following traumatic events in emergency department. Qualitative studies increase the understanding of the individual's experiences and needs, and how this affects the individual's health.

Results: The result shows that stress at the emergency department is a common problem. Complex care situations, high workload, lack of experience and conflicts in the working group were factors that lead to stress. Effects on physical and emotional health also emerged. Stress can affect the nurse and the quality of care.

Conclusion: The nurse at the emergency department is often exposed in a work environment where stress is common. Therefore, it is important for the nurse to receive support from work management and colleagues in order to be able to handle situations that may lead to impaired patient safety as well as the health of the nurse.

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: World Health Orginazation (WHO) reported that cancer is the second leading cause of death globally with estimated 9.6 million deaths in 2018. Sleeplessness is a common problem for people with a cancer diagnosis. Humans sleep around eight hours a day which adds up to a third of life. It is the responsibility of nurses to see to the nursing of patients, including sleep. Limited sleep can lead to a greater risk of contracting immunological diseases. In Swedish hospitals there are few guidelines for handling sleeplessness with patients, therefore a study regarding factors influencing sleep negatively is important for the nursing profession.

Aim: The aim of this study was to describe experiences that influence night sleep for patients with a cancer diagnosis.

Method: The method for this study is a literature review using quantitative and qualitative articles.

Results: Among the factors that influence sleep, the most common were pain, urinary and bowel issues, depression, anxiety, social constraints and cancer related loneliness.

Conclusion: The conclusion of the study is that more guidelines regarding sleep is necessary for the development of nursing.

Since the first successful organ transplant in 1954 performed by the surgeon Joseph Murray this procedure has become the most effective treatment of organ failure. Although the majority has a positive attitude towards organ transplantation, the supply does not meet demand. As a result of this the patients sometimes must wait years for a new organ and some of them dies while waiting.

The aim of this study was to describe patients experiences of waiting for an organ transplant and the method used was a literature study.

Result shows that these patients went through physical, psychological and financial changes during the waiting time. Patients described mixed emotions and different ways of perceiving hope. They long for a "normal" life and the waiting gets harder over time. It's essential for the patients that both they and their next of kin gets repeated and continuously information during the waiting time.

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: Diabetes mellitus type 1 is a lifelong chronic disease, which means constant contact with health care. Newly diagnosed patients with diabetes mellitus type 1 are admitted to hospital for approximately four days, during which time they and their relatives receive sufficient education to cope with everyday life at home.

Aim: To illuminate nurses' experiences of educating newly diagnosed patients with diabetes mellitus type 1 in a hospital environment.

Method: Six qualitative, two quantitative and two mixed-method articles were analysed. The studies took place in a hospital environment where nurses played a vital role in education about type 1 diabetes mellitus.

Results: Three themes emerged; Continuous staff training, which demonstrated that lack of time was the main reason for not having continuous staff training, Individualizing patient education, which illustrated the importance of individualized education for encouraging both patients and relatives to become more involved in the care and Working in a multi-professional team, which enabled nurses to individualize and take a person-centred approach to patient care.

Conclusion: Overall, nurses cite lack of time as a common reason for inadequate care as well as the absence of education for both patients and nurses. Individualizing patient education with regard to age, family situation and previous knowledge increases the likelihood of a safe and secure discharge. In order to create safe patient care, multi-professional collaboration is necessary to allow nurses to focus on providing individualized and person-centred care.

Background: Burns are a global problem and more people survive today. After a burn injury a long rehabilitation time can wait, both physical and psychological and little is known about the patients' experiences after a burn injury. 

Aim: The aim of this study is to illuminate patients' experience of life after a burn injury. 

Method: A method is used to contribute to evidence-based nursing, based on analysis of qualitative research. Data was collected from analyzing eleven scientific articles. 

Results: Two themes with five sub-themes emerged. Results show that patients' experience increased vulnerability in relation to changes in the skin, the changed appearance and the mental stress. The feeling of pain, itching, stigmatization and anxiety are some of the experiences that create problems in everyday life. They also found that the experience of support and acceptance by the burned was part of the process of returning to life. 

Conclusion: The result showed that suffering from a burn causes remaining problems after the injury. The patients needed support to be able to accept what happened and return to life.

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.

Background; The nurse often works in teams with other professional groups. Communication is a key factor for the collaboration in a well functioning team. The system theory is a useful to apply within teamwork at the health center, to better gain understanding of the roles and responsibilities of the team members. Studies show that there is a need to set aside time for team meetings and that the current lack of time in the health center has a negative impact on teamwork and patient safety. Therefore it is important to explore the nurse's experience of teamwork.

Aim; Nurse's experience of teamwork in primary care.

Method; A qualitative content analysis was used to analyse the data collection, where semi structured interviews were applied to elucidate the purpose of the study. The number of informants interviewed was 11 from four different health centers in four different municipalities.

Result; Three categories emerged from the experience of teamwork at the health center. These were described as competence that provides security and that the work structure facilitates the team's workload and that there were impediments in the work. The result showed that the nurse felt that, with the right skills, the nurse could provide security to colleagues, patient and their relatives. An impediment was lack of time to conduct team meetings. This made it a challenge to plan for the patient's continued care. Despite this, the nurse did her best to prevent the patient from being adversely affected. It turned out that when the nurse structured up the day's work, the workload is facilitated and errands that arose got solved more quickly.

Conclusions; The barriers in the development of the teamwork mentioned are lack of time and resources. In order to develop teamwork, additional communication tools are needed to facilitate communication within the team.

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.

Background: Threats and violence against healthcare staff is an international concern worldwide. Specifically nurses are at high risk of experiencing threats and violence at their workplace. A threatening and violent work environment creates huge difficulties for the nurses involved. Aim: The purpose of the study was to describe nurse's experience of threats and violence in their workplace by patients and people that are related to the patient. Method: The method used was a literature study based on qualitative research. Ten articles were analyzed according to Friberg's five step model and resulted in two main themes and eight sub-themes. Results: The nurses experience were divided into two main categories; experience of feelings and the nurse's experience of consequences. Conclusion: The result showed that the nurses experience of threats and violence in the workplace affected their ability to work and their private life negatively. Consequently, having a negative influence on their patient care. Therefore, it is necessary to pay more attention to nurses working environment by applying different strategies to combat the threats and violence experienced by identifying the root cause and managing the problem.

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: People that suffer from stroke become a regular patient category in hospitals. A severe change in the patient's living situation occurs both physically, mentally and socially. A stroke can cause physical as well as cognitive impairments. When patients lose their physical ability it often leads to a sense of loss. The disability prevents the stroke survivors from living as before and they feel they are no longer in control of their lives.

Aim: To describe patient's experiences of performing activities of daily living after a stroke.

Method: Method of contributing to evidence-based nursing based on analysis of qualitative research.

Results: The result is described in two main themes: being physically limited and being psychosocially limited. Patients described traumatic and emotional experiences when they were not able to control their body and suddenly became dependent on nursing. Nurses have an important role in making the patient involved in nursing care to facilitate the patient's sense of dignity. The patients had difficulty processing their feelings after the stroke and they felt worried about the future. Social relations could be adversely affected when cognitive impairments prevented the patients and they felt sorrow when their future plans changed dramatically.

Conclusion: Patients affected by stroke were in an exposed situation. They perceived that their changed body affected them both emotionally and existentially and they had trouble accepting their functional difficulties. Everyday life became complex because of the complications after the stroke.

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 use of physical restraint in Swedish psychiatric healthcare against children under the age of 18 years has been critized against the United Nations. The psychiatric compulsory care act is used when a patient is suffering from a serious mental illness, and it may mean that the patient receives physical coercive measures against his/her will. When a patient obtains a physical coercive measure, a registered nurse is involved in the procedure. For a nurse, being involved with the use of physical coercive measures against the patients will could be perceived as a violation against the patients autonomy and also going against the essence of caring. Research shows that registered nurses experiences of being involved in the usage of physical coercive measures can cause an ethical dilemma.

Aim: To illustrate registered nurses' experiences of participating in the usage of physical coercive measures against children and teenagers that is hospitalized under the psychiatric compulsory care act.

Method: An interview study was conducted with seven registered nurses from all over Sweden. The interview material was analyzed through a qualitative content analysis.

Results: Three themes appeared during the analysis. The first main theme is Go against one's ethical beliefs with the subthemes experiencing ethical dilemmas, meeting the fragile child and to abandon one's professional assignment. The second theme is Questioning, with the subthemes questioning the benefit of coercive measures, to be questioned by other health care professionals and questioning one's own approach. The third theme that appeared was Change, with the subthemes to find alternative ways of dealing with the situation, a desire to contribute to a positive development of healthcare and to have contributed to a positive change for the patient.

Conclusion: The registered nurses' experiences of participating in the usage of physical coercive measures against children under the age of 18 years is described as a feeling of going against one's ethical values. The nurses also describe a questioning against the actual benefit of physical coercive measures. However, there's a hope for a change in the form of finding other ways than using physical coercive measures.

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.

In the nurse's profession, protecting health is an answer, some patients may need motivation and support in their lifestyle change. A method that can be used for lifestyle changes is Motivational Interviewing (MI). MI is a method who initially was intended to be used for patients with alcohol problems. However, it was seen that the method also worked to apply in other areas. The aim of this study was to explore nurses and patients´ experiences in MI. In this literature study a qualitative method was used. The result of this study was based on twelve articles. The nurses consider that MI has a person-centered approach where the patients came into focus. They felt that MI had a respectful and valuable approach towards the patient. It also appeared how important the nurses thought it was with training and practice of the method and that they felt support in using the method. The patients experienced that MI gave them the possibility to change their own thoughts instead of being forced to a change that they were not ready to do. MI is a method that can be used in various areas during lifestyle changes. The result of this study shows that if nurses are being trained, get the chance to develop their skills than their experienceis that MI is a good method to use. It is also important that nurses are given the opportunity to use the method. The patients' experience was that MI makes them involved and self-determined in their own care.

Aims and objectives: To investigate changes in self-reported fatigue and depression from four months to two years following a myocardial infarction, as well as to explore gender differences, identify the incidence of fatigue without coexisting depression and finally predict health-related quality of life at a two-year follow-up. Background: Depression and fatigue are associated with decreased health-related quality of life after myocardial infarction. Although there is a close relationship between fatigue and depression, it has been shown that symptoms of fatigue can occur without coexisting depression. Design: Quantitative and longitudinal design. Methods: Participants (n = 155) were asked to complete the following questionnaires: the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory-20 (MFI-20) and the Short Form Survey (SF-36) following myocardial infarction (after four months and two years). Descriptive statistics, paired t-tests and multiple regressions were carried out. Results: In the entire group, self-reported fatigue had decreased from four months to two years after myocardial infarction. After two years, 18% of respondents reported depression together with fatigue and 30% reported fatigued without depression. Women scored higher than men on the fatigue dimensions reduced activity, reduced motivation and mental fatigue. Moreover, the physical dimension of health-related quality of life two years after myocardial infarction was predicted by experienced general fatigue at four months. Conclusion: Fatigue with or without coexisting possible/probable depression remains as a significant symptom two years after myocardial infarction in nearly half of the entire group. Relevance to clinical practice: Fatigue is a problem following myocardial infarction. Therefore, systematic screening and early identification of patients experiencing symptoms of depression and fatigue after myocardial infarction are important for suitable care planning. In contemporary coronary care, strategies aimed at relieving fatigue should be developed. ￜ 2013 Blackwell Publishing Ltd.

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.

The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.

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: Research shows that persons from the Middle East are at higher risk to develop type 2 diabetes which increases the risk of diabetic complications and early death. Both illness perception and self care are significant factors for the disease process. The diabetes nurse needs to search for knowledge of illness perception thus they have a central role in strengthening the individuals' ability to handle treatment, symptoms, emotional, cognitive and physical consequences as well as lifestyle changes.

Aim: The aim of this study was to investigate illness perception of type 2 diabetes among persons from The Middle East living in Sweden.

Method: A descriptive analysis of a pilot study was conducted in the region of VästraGötaland during spring 2019. 27 individuals answered the Brief Illness Perception Questionnaire about their illness perception of type 2 diabetes.

Results: The participants perceived type 2 diabetes to be a chronic disease and reported a very high degree of coherence of the disease. They also perceived that type 2 diabetes can be controlled by both treatment and themselves to a very high degree and to a relatively high degree. Trust in treatment was greater than in their own control. The study shows a significant difference in coherence of type 2 diabetes between women and men in the study, where women experienced a higher degree of coherence than men. Identity and consequences were the dimensions of illness perception with the lowest median.

Conclusion: Illness perception affects the degree of self care and disease progress. The results can be used to give an increased understanding of illness perception of type 2 diabetes among persons from the Middle East living in Sweden.

Background: Elderly are a heterogeneous and growing group and therefore they have to be seen as separate individuals with different needs. In Sweden the municipality has the overall responsibility of elderly care and the social welfare board has to make sure that the elderly get to live independently under safe conditions.

Aim: The aim of this study is to describe different factors that affects social isolation and loneliness among elderly.

Method: The method that was chosen for this study was a literature review. Systematic and unsystematic searches were conducted to find articles for the results. Eight articles were chosen for this study, four quantitative and four qualitative.

Results: The result includes two themes and four subthemes. One factor that was found was the loss of earlier life with two subthemes the body that no longer works and when the significant other pass away. Another factor was the importance of context with two subthemes importance of family and friends and in the absence of social connection.

Conclusion: Factors that were shown to have an impact on social isolation and loneliness were individual and could depend on body function, losses and personality. The elderly need to feel safe in their environment and that there is someone who can help them.

Background: Considering the increasing requirements and needs facing primary health care, the aspiration to use nurses as care providers has increased. This is done to improve the availability, effectiveness, and to dispense the available resources.

Aim: The purpose of this study is to illuminate the patient's experiences of meeting nurses as care providers in primary health care.

Method: Six qualitative, three quantitative, and one mixed method articles were analyzed to create a literature review.

Results: Generally, the patients were satisfied with meeting nurses as care providers in primary health care. The result showed that the patients described relationship, trust, participation, and communication with nurses as significant aspects to feel secure. That the nurses made time available, as well as were easy to contact, were also aspects that contributed to the patients feeling secure. Uncertainties regarding the nurse's role, competence, and not being able to choose level of care were aspects that affected the insecurity.

Conclusion: Nurses in primary health care have big opportunities to develop the meeting in a way that the patient feels secure in health care. Most patients experience great satisfaction with care provided by nurses. Considering the above facts, it seems possible to develop health care led by nurses. 

The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back-evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

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.

Background: The purpose of palliative care is to give the patients a good quality in the end of life, relive suffering and help them live life as normal as possible. The patients should always be involved in their own care.

Aim: The purpose of this study was to illustrate how patients experience palliative care.

Method: This is a literature-based study that is based on nine qualitative analyzed articles. The articles analyze was based on Friberg five step model.

Results: The results presented in two categories: I´m changing and A safe response. The results show that it´s important to be aware of every human's individual needs and thoughts in palliative care to give the best care.

Conclusion: This study shows that lack of time on hospital care affect patients care negatively. The best palliative care is the one given to patients at their own home.

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.