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  • 1.
    Adam, Christina
    et al.
    1 St. Savvas Anticancer Hospital, Athens, Greece.
    Patiraki, Elisabeth
    National and Kapodistrian University of Athens, Athens, Greec.
    Lemonidou, Chryssoula
    National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece.
    Radwin, Laurel
    Research Health Scientist, Center for Health Care Organization and Implementation Research, Boston VA Health Care System, Boston, MA USA.
    Charalambouss, Andreas
    Cyprus University of Technology, Department of Nursing Studies, Limassol, Cyprus and Docent, University of Turku, Department of Nursing Science, Finland.
    Charalambous, Melanie
    Cyprus Ministry of Health, Nursing Services, Educational Sector, Nicosia, Cyprus.
    Berg, Agneta
    University West, Department of Health Sciences, Section for nursing - graduate level. Kristianstad University, Kristianstad.
    Sjövall, Katarina
    Skane University Hospital and Medical faculty, Lund University, Sweden.
    Katajisto, Jouko
    Statistician University of Turku, Department of Mathematics and Statistics, Turku, Finland.
    Stolti, Minna
    University of Turku, Department of Nursing Science, Turku, Finland.
    Suhonen, Riitta
    University of Turku, Department of Nursing Science/Turku University Hospital and City of Turku, Welfare Division, Turku, Finland.
    Quality of nursing care as perceived by cancer patients: A cross-sectional survey in four European countries2017In: Balkan Union of Oncology. Journal, ISSN 1107-0625, Vol. 22, no 3, p. 777-782Article in journal (Refereed)
    Abstract [en]

    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.

  • 2.
    Ahlström, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Vahtera Eliasson, Katarina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Skolsköterskors tillvägagångssätt för att stödja flickor i grundskolan vars vårdnadshavare begränsar deltagande i hälsofrämjande insatser2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    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.

  • 3.
    Ali, Tara
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Gustavsson, Anna-Lena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Distriktssköterskans erfarenhet av sin arbetssituation på vårdcentral2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    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.

  • 4.
    Alsen, Pia
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Thörn, Susanna
    Primary Health Care, Sollentuna, Sweden.
    Nordqvist, Linnea
    Primary Health Care, Munkedal, Sweden.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Men’s Experience of Difficulties during First Year Following Myocardial Infarction: Not OnlyFatigue2016In: Health, ISSN 1949-4998, Vol. 8, p. 1654-1667Article in journal (Refereed)
    Abstract [en]

    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.

  • 5.
    Andersson, Erika
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ett vårdverksamhetsperspektiv på samverkan i sjuksköterskeprogrammets verksamhetsförlagda utbildning2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    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.

  • 6.
    Andersson, Marina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Individuell anpassning och uppföljning av fysisk aktivitet på recept (FaR): en kvalitativ studie med fokus på patienters erfarenheter2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    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.

  • 7.
    Antonsson, Helena
    et al.
    University of Umeå , Department of Nursing , Umeå , Sweden.
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Umeå , Department of Nursing , Umeå , Sweden.
    Isaksson, Ulf
    University of Umeå , Department of Nursing , Umeå , Sweden.
    Åström, Sture
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Umeå , Department of Nursing , Umeå , Sweden.
    Lundström, Mats O
    University of Umeå , Department of Nursing , Umeå , Swede.
    Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design.2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 734-743Article in journal (Refereed)
    Abstract [en]

    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.

  • 8.
    Antonsson, Helena
    et al.
    Umeå universitet.
    Hällgren Graneheim, Ulla
    University West, Department of Health Sciences, Section for nursing - graduate level. Umeå universitet.
    Isaksson, Ulf
    Umeå universitet.
    Åström, Sture
    University West, Department of Health Sciences, Section for nursing - graduate level. Umeå universitet.
    Lundström, s O.
    Umeå universitet.
    Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 734-743Article in journal (Refereed)
    Abstract [en]

    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.

  • 9.
    Arakelian, Erebouni
    et al.
    Uppsala University Hospital,Department of Surgical Sciences, Entrance 70, SE-751 28..
    Swenne, Christine Leo
    Uppsala University, Department of Public Health and Caring Sciences, Box 564, SE-751 22, Uppsala, Sweden.
    Lindberg, Susan
    Skaraborg Hospital, Department of Anaesthesia, SE-541 85, Skövde, Swede.
    Rudolfsson, Gudrun
    University West, Department of Health Sciences, Section for nursing - graduate level. Faculty of Professional Studies, University of Nordland, 8049, Bodø, Norway..
    von Vogelsang, Ann-Christin
    Karolinska Institutet, Department of Clinical Neuroscience,Stockholm, Sweden..
    The meaning of person-centred care in the perioperative nursing context from the patient's perspective: an integrative review2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 17-18, p. 2527-2544Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To determine the meaning of person-centred care from the patient's perspective and in the context of perioperative nursing. BACKGROUND: Person-centred care (PCC) is used but not defined in the perioperative context. The concept indicates an interest in the patient's own experience of health, illness, needs and preferences. As with many terms that are frequently used, there is a tendency for person-centred care to mean different things to different people in different contexts. METHODS: A two-part search strategy was employed; firstly, a computerized database search of PubMed and CINAHL, using Medical Subject Headings and free terms to search articles dating from 2004 to 2014, and secondly, a hand-search of those articles' reference lists was performed. Twenty-three articles were selected and an integrative review was conducted. RESULTS: Four themes were discovered: 'Being recognized as a unique entity and being allowed to be the person you are', 'Being considered important by having one's personal wishes taken into account', 'The presence of a perioperative nurse is calming; prevents feelings of loneliness and promotes wellbeing, which may speed up recovery', and 'Being close to and being touched by the perioperative nurse during surgery'. CONCLUSIONS: PCC means respecting the patient as a unique individual, considering the patient's particularities and wishes, and involving the patient in their own care. PCC also implies having access to one's own nurse who is present both physically and emotionally through the entire perioperative process and who guides the patient and follows up postoperatively, guaranteeing that the patient is not alone. RELEVANCE TO CLINICAL PRACTICE: By having a common understanding of the concept of PCC, the nurse anaesthetists' and theatre nurses' caring actions or concerns will be directed towards the patient', resulting in personalization of care rather than simply defining the concept. This article is protected by copyright. All rights reserved.

  • 10.
    Askland, Daniel
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ahmad Sadik, Nawsaid
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Patientutbildning för personer med bipolär sjukdom: Upplägg och innehåll av utbildningar inom psykiatrisk öppenvård2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    To suffer from bipolar disorder can cause significant distress. Bipolar disorder causes severe shifts in mood. The person can, apart from having a normal mood, experience depressive episodes or a highly elevated mood – hypomania or mania. Psychoeducation as a complement to medicine treatment can help persons manage their disorder and reduce severe changes in mood. Little is known about psychoeducation programs in the country as a whole. Knowledge about these programs can be useful for evaluation and can contribute to valuable insights. The aim of this study was to survey the setup and content of psychoeducation programs for people with bipolar disorder in outpatient care in the country. To accomplish this a cross-sectional study was made through a web-based questionnaire sent to staff involved in outpatient psychoeducation. The Swedish National Quality Register for Bipolar Disorder – BipoläR contributed with contact information to the outpatient clinics. All 234 clinics involved were linked to BipoläR, 56 answers were returned resulting in the following information: Most of the psychoeducation programs were group-based. The major part used programs designed by themselves. Nurses were the most frequently staff involved. The mean amount of time for education delivery was 12 hours. The psychoeducation content was rich in important aspects related to the disorder. The programs were delivered through lectures and discussion. The conclusion of this study was the emphasis on group-based programs developed at the clinics, the quality content of programs and the possible need for more evidence-based programs.

  • 11.
    Asplund, Charlotta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Hallgren, Magdalena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    "En tickande bomb": Sjuksköterskors upplevelser av att vårda hotfulla och våldsamma patienter i psykiatrisk slutenvård2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Inpatient aggression is common as a phenomenon in psychiatric inpatient care. Inpatient aggression arises for several reasons. It disturbs the nurses in their work assignments and causes negative emotions, which can be reflected in the interaction with the patients.

    Aim: To describe nurse's experiences of caring for aggressive patients in psychiatric inpatient care

    Method: An interview study was conducted with eight nurses at two psychiatric clinics at a hospital in a big town in Western Sweden. The material was analysed through qualitative content analysis.

    Results: The analysis resulted in four main categories. The first category is uneasiness, with subcategories: to feel anxiety, to feel stress, to feel sad and to feel offended. The second category is fear, with subcategories: to feel fear for the aggressive patient and to feel fear for others sake. The third category is powerlessness, with subcategories: to lose control, to feel frustration and to work with a ticking time bomb. The fourth category is work to create security policies with subcategories: understanding the patients' situation and courage to remain in an aggressive encounter.

    Conclusion: Inpatient aggression is often associated to symtoms and/or drug abuse, which also was confirmed in our study. In most scenarios the nurses had a deeper understanding for the patients behavior and thereby a higher tolerance towards inpatient aggresion. The nurses claimed that beeing available to the patients was very important, since that created an atmosphere of security for both parties and it was assumed a presumtion for a good caring relationship.

  • 12.
    Ax Hansson, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Derdziak, Anna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Närståendes behov av stöd då de vårdar eller stödjer en person med långvarig psykisk sjukdom2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To illuminate relatives need of support when caring for or supporting a person suffering from mental illness

    Background: Relatives of a person suffering from mental illness have different needs. It has for the past few years merely been little improvements in the relative's situation.

    Methods: Focus group interviews with fourteen relatives. Data were analyzed through manifest content analysis.

    Findings: Three categories were found: Functioning contact channels to the psychiatric health care organization, Need of an active support from the psychiatric health care organization and Need of support from community resources.

    Conclusion: The relatives need more attention and understanding for their situation. The support of relatives must be designed and monitored individually. A collaboration or a well-functioning relation with the psychiatric nurses, other professionals working in the health care organisation and social services gives a mutual respect and trust which in turn leads to that the relative is confirmed as an important resource in the care of the mentally ill person. The relatives need an increased support and understanding from the community.

  • 13.
    Axelsson, Madeleine
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Olsson, Susanne
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ensamhet. En begreppsanalys: Den ensamhet som råder i den djupaste skog2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Loneliness can be experienced in different ways. By visualizing the dimensions of loneliness, healthcare professionals have a deeper understanding of what the concept of loneliness is. The purpose of this study was to analyze the meaning of the word loneliness through a concept analysis. The method used in this study was a concept analysis according to Peep Koort´s semantic method. Loneliness was defined according to etymological dictionaries as in the relationship to be lonely, for example,”A frozen trail that disappears in the loneliness of the forest”. In the definition of loneliness the analysis of the dictionaries resulted in several synonyms, three of which were chosen for further analysis. The most prominent synonyms was ”ödslighet” (desolation),” enslighet” (solitude) and ”isolering” (isolation). The theoretical definition of the outcome was discussed in a philosophical and health science perspective. The result showed both positive and negative aspects of loneliness. Loneliness can be a time of silence and reflection, but can also mean human suffering. From a scientific perspective, it is important to pay attention to the experiences of loneliness in patients and relatives in order to be able to provide appropiate support as a heathcare professional. In summary, loneliness can be illustrated by the metaphor ” The loneliness that exists in the deepest forest”.

  • 14.
    Baatz Asplund, Catarina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lundgren Andersson, Ann-Katrin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors attityder och erfarenheter av att arbeta med patienter med en ohälsosam alkoholkonsumtion: En empirisk studie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year 3.3 million people die in the world due to harmful use of alcohol. Alcohol is a public health problem in Sweden as well, where one in ten people considered having risky drinking habits. Research shows that excessive alcohol consumption leads to the development of alcohol-related illnesses. Nurses' dialog with patients is important to support them to change unhealthy habits. What experiences have nurses about discussion concerning the patients' drinking habits?

    Aim: The purpose of this study was to investigate nurses' attitudes to, and experiences of, dialog with patients about their alcohol use habits.

    Method: A descriptive cross-sectional study was conducted with the help of a questionnaire.

    Results: Most nurses felt that they have a good knowledge and were secure in their work with patients who have unhealthy alcohol consumption. They asked the patients about their drinking habits and used the AUDIT screening form for mapping unhealthy consumption.

    Conclusion: Nurses in specialist psychiatric services have a good knowledge of the causes of alcohol problems and can provide consultative support. Their experience of success helping patients with alcohol problems varies.

  • 15.
    Baldock, Karina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Anhörigas upplevelser av bemötande inom psykiatrisk vård: Den utfrysta anhöriggruppen2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Making people feel safe and secure in health care is one of the most importanttasks of nursing. A good response is not only important to patients but also to their relatives. Previously, for most of last century, relatives were not welcome to the psychiatric health care. But research show they are in need of information and support from the health care. It istherefore important that nursing staff learn what kind of response the relatives require.

    Aim: To investigate how relatives experience the response from nursing staff within thepsychiatric care.

    Method: Qualitative interviews with eight respondents, where the answers were transcribedand analysed to learn how they had experienced the response from nursing staff. In theanalysis the text was condensed and abstracted into subcategories and categories.

    Result: The analysis resulted in twelve subcategories and three categories; Feeling valued andmaking a difference, Feeling left out and not wanted, Response improvement suggestions.

    Conclusion: This study shows that relatives still to a large extent are left out fromparticipation in psychiatric care, although society has placed the main responsibility on themto support their next of kin. The result shows that relatives require more information andparticipation to be able to support their next of kin. Getting a good response from nursing caremeans for them to be seen, listened to and getting information and support. They don´t wantto be left out any more.

  • 16.
    Bancks, Ann-Sofie
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Ivarsson, Karin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Förutsättningar som behövs för att implementera personcentrerad vård inom Kommunal Hemsjukvård: En kvalitativ intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background According to the Swedish Association of Local Authorities and Regions should all healthcare professionals within the regions, municipalities and county councils work for an introduction of person-centered care, which will aim to promote good and equitable health care and to enhance patients and users as co-creators in their own care process.

    Aim The aim of this study was to describe the district nurses' perception of person-centered care and the conditions required to implement person-centered care in home care.

    Method A qualitative study was conducted using eleven face-to face interviews.

    Results The analysis showed that the district nurses perceive person-centered care was to have the person at the center when it comes to planning and implementation of health care. To achieve this goal the nurses declared the need for certain conditions. These are reported to be team work, support from the organization and patient involvement in their care.

    Conclusion All nurses in the study were positive to a person-centered care approach and basically they were aware of the meaning of the term. The district nurses who had recently undergone specialized training focusing on district nursing had a more scientifically based definition of what person-centered mean In relation to those with older training. The former appeared more likely to work on a basies of a person-centred approach and were more positive to develop such approach in health care.

  • 17.
    Bardhi, Razije
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Björling, Sonja
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Distriktsköterskors och diabetessköterskors erfarenheter av att möta patienter med diabetes som riskerar att få fotsår2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:  Diabetes is one of the most common chronic diseases in the world and according to studies, the disease has a rapid development, especially type 2 diabetes that may be similar to an epidemic. Foot complications are among the most risky and costly late complications of diabetes mellitus. Neuropathy is the commonest complication and affects about half of all with diabetes. An important part of the preventive work of diabetes-related foot ulcers to provide both patient and family with knowledge, information and self-care education. Aim:  The aim of this study was to describe district nurse's and diabetic nurse's experience of meeting patients with diabetes who are at risk of foot ulcers Method:  The study had a qualitative approach. The study was based on individual interviews, with nine participants. Data analysis was then done using qualitative content analysis. Results:   The study resulted in four categories: conditions for a good start of a long-term relationship, different care depending on where the patient lives, the nurse as a mediator of knowledge and difficulties in preventive work. Conclusion:  This study shows that a large part of the preventive work is about self-care. It also appears that it is a challenge for nurses when patients do not want to take care of the advice and information they receive.

  • 18.
    Bay, Annika
    et al.
    Umeå University, Department of Public Health and Clinical Medicine, Umeå University, Sweden; Department of Nursing, Sweden.
    Dellborg, Mikael
    Gothenburg University, Institute of Medicine, The Sahlgrenska Academy, Sweden..
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden.
    Sandberg, Camilla
    Umeå University, Department of Public Health and Clinical Medicine, Sweden.
    Engström, Gunnar
    Umeå University, Department of Surgical and Perioperative Science, Cardiothoracic Surgery Division,.
    Moons, Philip
    KU Leuven Department of Public Health and Primary Care, KU Leuven - University of Leuven, Belgium; Institute of Health and Care Sciences, University of Gothenburg, Sweden..
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Sweden..
    Patient reported outcomes are associated with physical activity level in adults with congenital heart disease.2017In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 243, p. 174-179Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO).

    METHODS: Patients with CHD (n=471) were randomly selected from the national register on CHD and categorized according to complexity of lesions - simple (n=172, 39.1±14.6years), moderate (n=212, 39±14.1years), and severe (n=87, 31.7±10.7years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression.

    RESULTS: PAL was categorized into high (≥3 METs ≥2.5h/week, n=192) and low (≥3 METs <2.5h/week, n=279). Patients with low PAL were older (42.6 vs. 35.8years, p≤0.001), had more prescribed medications (51% vs. 39%, p=0.009), more symptoms (25% vs. 16%, p=0.02) and comorbidity (45% vs. 34% p=0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p<0.001), satisfaction with life (25.6 vs. 27.3, p=0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p<0.001) and Mental Component Summary score (MCS) (73.5 vs. 79.5, p<0.001). Complexity of heart lesion was not associated with PAL. The included PROs - separately tested in the model, together with age were associated with PAL.

    CONCLUSIONS: PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.

  • 19.
    Bay, Annika
    et al.
    Umeå University, Department of Public Health and Clinical Medicine Department of Nursing.
    Lämås, Kristina
    Umeå University, Department of Nursing, .
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sandberg, Camilla
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy, Sweden.
    Johansson, Bengt
    Department of Public Health and Clinical Medicine.
    It's like balancing on a slackline: A description of how adults with congenital heart disease describe themselves in relation to physical activity2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 15-16, p. 3131-3138Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To illuminate how adults with CHD describe themselves in relation to physical activity.

    BACKGROUND: Several studies have shown that adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of immense importance to investigate how this population experiences physical activity.

    DESIGN: Qualitative study with semi-structured interviews analysed with qualitative content analysis.

    METHODS: Semi-structured interviews were individually performed with fourteen adults (women=7, age 19-68 years) with complex CHD. Patients were purposively recruited from the clinic waiting list, based on a scheduled follow-up and diagnosis.

    RESULTS: The overall theme, It's like balancing on a slackline, illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four subthemes: (1) Being an adventurer- enjoying the challenges of physical activity; (2) Being a realist- adapting to physical ability; (3) Being a non-doer- lacking prerequisites for physical activity; and (4) Being an outsider- feeling excluded depending on physical ability.

    CONCLUSIONS: Adults with CHD seem to have a diverse relationship to physical activity and it involves various aspects throughout the lifespan. The findings point out factors that might constitute as obstacles for being physically active, specific for people with chronic conditions like CHD. This highlights the importance of further exploring the hindering and facilitating factors for being physically active in order to get a deeper understanding of how to support adults with CHD to be physically active.

    RELEVANCE TO CLINICAL PRACTICE: Given the diverse relationship to physical activity, nurses have to further investigate the patients' relationship to physical activity, in order to support a healthy lifestyle. Nurses and allied health professionals should offer individualized exercise prescriptions and education about suitable physical activities in relation to physical ability. This article is protected by copyright. All rights reserved.

  • 20.
    Bengtsson, Victoria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bloom, Emelia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Det är inte bara att ge en spruta...: barnhälsovårdssjuksköterskors upplevelser av att vaccinera barn2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In child health care immunization is a common task for the child health nurse. Often children are unprepared, afraid and preoccupied with pain in the vaccination situation. Most children experience the presence of the parents as important during the procedure. Parents who prepare their child reduce the child's stress during the vaccination situation. An interaction occurs between the child health nurse and the child where participation is a prerequisite for the experience to be a positive outcome. Aim: The aim of the study was to describe the child health nurses' experiences of vaccinating children aged 0-6 years.Method: Semi-structured qualitative interviews were performed with twelve child health nurses. Data was analyzed using a content analysis focusing in manifest content. Results: Child health nurses' experiences of vaccinating commuted between the sense of power and confident. The crucial experience was the support and cooperation that the child health nurses experienced with the parents. It emerged a theme: Participation, three main categories: Sense of power, sense of confidence and cooperation with parents and six subcategories: Abuse, powerlessness, experiences, strategies, common goals and approaches and different goals and approaches. Conclusion: The result indicates that the parents have a dominant role in the vaccination situations with the ability to affect the health nurse's experience. Child health nurse, child and parents must cooperate to vaccinations to be carried out and be perceived in a positive way

  • 21.
    Berg, Ann
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Fohlin Johansson, Leone
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Äldre personer med diabetes mellitus och deras upplevelse av egenvård: En litteraturöversikt2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Diabetes is a growing health problem and the risk of getting diabetes is increasing with age. Beside diabetes, older persons often have several diseases which makes their situation complex. Self-care is an important part of treatment and how the older persons experience this is relatively unknown. The aim of the literature review was to investigate how older persons with diabetes experience self-care to find out how support for self-care can be developed. Systematic searches were made in the databases Cinahl, Pub/Medline and PsychInfo for the period 2007-2017. Fifteen articles were found and analysed using a descriptive synthesis. Three themes were identified: 1) To be responsive to the body's signals, 2) To be able to understand the life situation, and 3) To participate creates security. Older persons with diabetes usually had good knowledge of self-care but had difficulty to perform it. The result indicates that to support older people with diabetes to self-care, nurses need more knowledge how to involve and support older people in their care, create support-groups and meeting others with the same diagnosis, and develop a person-centred action plan.

  • 22.
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Is being physically active the key to a good quality of life for patients living with Fontan circulation?2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 11, p. 1257-1258Article in journal (Other academic)
  • 23.
    Berghammer, Malin C.
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. Sahlgrenska Academy, Institute of Medicine.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Rydberg, Annika M.
    University of Umeå, Department of Clinical Sciences, Pediatrics.
    Dellborg, Mikael
    Sahlgrenska Academy, Institute of Medicine.
    Ekman, Inger
    University of Gothenburg, Centre for Person-Centred Care.
    Committed to Life: Adolescents’ and Young Adults’ Experiences of Living with Fontan Circulation2015In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 10, no 5, p. 403-412Article in journal (Refereed)
    Abstract [en]

    Background Single ventricle defects are among the most complex congenital heart defects and the development of advanced surgical procedures in recent decades has created the first generation of adolescents and young adults living with this condition. Yet little is known about how these individuals experience life and what impact the heart defect has on their life in general. Objective The aim was to illuminate and gain a deeper understanding of adolescents’ and young adults’ experiences of living with a surgically palliated univentricular heart. Design Seven open-ended in-depth interviews were conducted, transcribed, and analyzed according to the henomenological hermeneutical method. All adolescents and young adults operated before 1995 according to the Fontan procedure or the total cavo-pulmonary connection procedure at one pediatric cardiology unit were included in the study. They were 17–32 years of age (median age 22 years). Results The interpretation of the interview transcripts showed that the participants experienced living with a surgically palliated univentricular heart in terms of feeling exceptional, strong, and healthy. This was supported by two structural analyses, where three themes emerged: happiness over being me, focusing on possibilities, and being committed to life. Conclusion Living with a Fontan circulation included negative experiences but the analyses clearly demonstrated a feeling of being strong and healthy. An appreciation of having survived and being committed to life was found to be an integral part of the development of the interviewees’ existential growth. This probably strengthens them further in their ability to balance expectations and hurdles in life. This study provides valuable insights into the experience of patients after the Fontan procedure and the importance of a positive health care environment throughout their lives.

  • 24.
    Berghammer, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level. The Sahlgrenska Academy at University of Gothenburg, Institute of Medicine, Gothenburg, Sweden.
    Mattsson, Eva
    Karolinska University Hospital, Department of Cardiology, Stockholm, Sweden.
    Johansson, Bengt
    Umeå University, Department of Public Health and Clinical Medicine, Umeå, Sweden.
    Moons, Philip
    University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Dellborg, M.
    The Sahlgrenska Academy at University of Gothenburg, Institute of Medicine, Gothenburg, Sweden.
    Comparison of participants and non-participants in patient-reported outcome surveys: the case of Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study2017In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 27, no 3, p. 427-434Article in journal (Refereed)
    Abstract [en]

    Background: The last decade has seen a vast increase in the use of patient-reported outcomes. As patient-reported outcomes are used in order to capture patients’ perspectives of their health and illness, it is a prerequisite for accurate patient-reported outcome evaluations to use representative samples. In order to evaluate representativeness, the present study focussed on the comparison between participants and non-participants in the Swedish branch of the international study APPROACH-IS (Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease – International Study), regarding demographic, clinical, and health status characteristics. Methods: Eligible patients for APPROACH-IS were identified and selected from SWEDCON, the Swedish registry for congenital heart disease (CHD). Overall, 912 eligible patients were identified, of whom 471 participated, 398 did not participate, and 43 were either unreachable or declined to participate in APPROACH-IS. The participants and non-participants were compared in terms of statistical significance and effect sizes. Results: Significant differences were observed between participants and non-participants for sex, age, primary diagnosis, number of cardiac operations, and fatigue; however, the effect sizes were in general small, except for the difference in primary diagnosis. No differences between the two groups were found in number of catheterisations, implanted device, the distribution of NYHA functional class, or health status and symptoms. Conclusions: This study shows that participants and non-participants are relatively comparable groups, which confirms the representativeness of the participants. The Swedish data from APPROACH-IS can therefore be reliably generalised to the population of adults with CHD in Sweden. © Cambridge University Press 2016

  • 25.
    Bergqvist, Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tingberg, Sofia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    En fråga med dolda svar: en registerstudie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Since 2008 there is a law stating that patients who do not require institutional forensic psychiatric care may be moved to non-institutional forensic care, with special conditions. RättspsyK is a national quality register where all of the 25 forensic care units in Sweden collect information about their patients and their care. Previous analysis showed that a considerable amount of patients continue to receive institutional forensic psychiatric care despite they are assessed and found ready to move onto non-institutional forensic care. Aim: The objective of this study was to identify factors affecting why patients were still in institutional forensic care despite assessed to be ready for non-institutional forensic care.Method: First, yearly assessment of each patient between 2009 and 2014 was drawn from the RättspsyK register. Answers to the specific question, Question 10, were analyzed with descriptive statistics and were planned to be used in regression analyses as dependent variable. Result: 1900 patients were included. During analyses the fact that answers to this question were not trustable was found, therefore no exact prevalence of inpatients kept in institutional forensic care despite assessed ready for non-institutional care could be determined. Other information revealed that lack of housing and lack of collaboration were the most frequent reasons for this phenomenon. Conclusion: The present study could not give answer to the original question, but pointed out avalidity problem in the Swedish Forensic Psychiatry Register. The result calls for caution and for the need of validation of RättspsyK register.

  • 26.
    Berholt, Camilla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Lilienberg, Ann-Charlotte
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Psykisk ohälsa hos intagna med självriktad aggressivitet: Effekt av 10 veckors yoga2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental ill-health is common among prisons inmates. More than half of inmates in Swedish prisons suffer from different psychiatric problems that untreated can contribute to aggressive behaviors, including self-directed aggressive behaviors such as self-harm, suicide attempt or completed suicide. Evidence shows that participation in yoga exercise may improve mental health in the general but even in prison inmates population. The effect of yoga on self-directed aggressive behavior in prison inmates population has not yet been specifically studied, according to our knowledge.

    Aim: To examine the self-reported prevalence of psychiatric diagnoses by gender among prison inmates, and to study the effect of 10 weeks yoga on the prevalence and severity of self-directed aggression in this population.

    Method/Study population: From nine prisons in Sweden, 211 inmates participated voluntarily in the 10 weeks of study. They were randomized into two groups, one yoga group in which inmates participated in 90 minutes of hatha yoga once every week and a control group including those who were placed into a waiting list for yoga and asked to participate in 90 minutes of physical activity of free choice, once a week during the study.

    Results: Major depression, substance use disorder, anxiety disorder, and attention deficit hyperactivity disorder were the most common psychiatric diagnoses among inmates. The prevalence of many psychiatric diagnoses was significantly higher in female inmates than in male inmates. Both yoga and freely chosen physical activity reduced self-directed aggression during incarceration, but the improvement was better in the group that preformed yoga.

    Conclusion: The study provides evidence that yoga made on a regular basis have a positive effect on reducing self-directed aggression. Since no side effects of yoga exercise have previously or in this study detected, it can be concluded that yoga can be effective measure to increase inmates well-being.

  • 27.
    Bern, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Saltell, Mikaela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Motivation till livsstilsförändringar: en utmaning för distriktssköterskan2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Hypertension increases all over the world and with the disease there is a risk för complications and personal suffering. The treatment involves lifestyle changes and pharmacological treatment. The district nurse has an important role in care of patients with hypertension and through health interviews, the district nurse can create possibilities for lifestyle changes. Motivation plays an essential role in implementing lifestyle changes and it varies in between individuals.

    Aim: The aim of the study was to examine district nurse's perceptions of what motivates and what creates obstacles and holds back patients with hypertension to implement lifestyle changes.

    Method: Eight district nurses who on daily bases worked with patients with hypertension and lifestyle changes were interviewed. The interviews were analyzed by qualitative content analysis with an inductive approach to reach the aim of the study.

    Results: The district nurses experienced that both positive as well as negative factors were found to have an impact on a patient's motivation for lifestyle changes. These factors were both found in the district nurse and in the patient. The patient's inner drive force and the district nurse's professionalism created conditions for patients to implement lifestyle changes while as a patient's own negative attitude and a district nurse's lack of commitment and understanding created barriers for patients to implement lifestyle changes.

    Conclusion: The district nurses experienced that both the district nurse and the patient's involvement in health interviews influenced the patient's motivation for lifestyle changes.

  • 28.
    Bernling, Sigrid
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kucukcelik, Nadire
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Medias konstruktioner av flyktingar och hur dessa kan påverka distriktssköterskor i deras möte med flyktingar2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In 2015, the increased number of refugees arriving in Sweden was covered in media. Public health nurses may in their encounter with immigrants be influenced by discourses arising from medial constructions of refugees. The aim of this study was to examine mass medial constructions of and discourses about refugees, since preconceptions can influence district nurses in encounters with these persons. It is a matter of importance to discuss how this can manifest itself, in order to make public health nurses encounters with refugees as well-functioning as possible. Person-centred care has been uses as a theoretical frame of reference in this study. A qualitative approach was chosen. The methods used were corpus analysis and discourse analysis.  Data was collected from three daily newspapers: Dagens Nyheter, Sydsvenskan and Svenska Dagbladet, published in September, October and November 2015. During this time the concept refugee occurred in 4022 articles. The result shows that refugees in media are contoured as a homogenous group. Four discourses based on thirteen constructions were identified. The four discourses were a crisis discourse, a helplessness discourse, a political discourse, and an economical discourse. From the discourses, it is assumed that public health nurses reading of medial texts about refugees influences their view, and therefore their care, of refugees. Hence, it is important to illuminate the constructions of refugees in media

  • 29.
    Berntsson, Shala Ghaderi
    et al.
    Uppsala University, Department of Neuroscience, Neurology, University Hospital, Uppsala, Sweden.
    Landtblom, Anne-Marie
    Uppsala University, Department of Neuroscience, Neurology, University Hospital, Uppsala, Sweden, Department of Clinical and Experimental Medicine, Neurology, Medical Faculty, University of Linköping, Linköping, Sweden.
    Flensner, Gullvi
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Cerebellar ataxia and intrathecal baclofen therapy: Focus on patients´ experiences2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 2, no 6, article id e0180054Article in journal (Refereed)
    Abstract [en]

    Elucidating patients´ experiences of living with chronic progressive hereditary ataxia and the symptomatic treatment with intrathecal baclofen (ITB) is the objective of the current study. A multicenter qualitative study with four patients included due to the rare combination of hereditary ataxia and ITB therapy was designed to elucidate participants' experiences through semi-structured interviews. The transcribed text was analyzed according to content analysis guidelines. Overall we identified living in the present/ taking one day at a time as the main theme covering the following categories: 1) Uncertainty about the future as a consequence of living with a hereditary disease; The disease; 2) Impact on life as a whole, 3) Influence on personal life in terms of feeling forced to terminate employment, 4) Limiting daily activities, and 5) ITB therapy, advantages, and disadvantages. Uncertainty about the future was the category that affected participants' personal life, employment, and daily activities. The participants' experience of receiving ITB therapy was expressed in terms of improved quality of life due to better body position and movement as well as better sleep and pain relief.

  • 30.
    Björk, Theres
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Torstensson, Annalena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Erfarenheter av att vara närstående till en anhörig med palliativ vård i hemmet2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: More and more patients with terminal illness choose to die in their own home. Next of kin play a central role in the care of their loved one. They are entitled to the support of health care, both in the relative´s illness and after the death in the form of survivor calls.

    Aim: To describe the experience of being closely related to a loved one in palliative home care.

    Method: A qualitative inductive approach was used. Eight relatives to patients who had received palliative home care were interviewed. The interviews were analyzed using content analysis.

    Results: The results are presented in three categories: "Not having a life of its own", "Feeling safe" and "Losing trust in caregivers". These are based on 11 subcategories that affect the experience of being related to a loved one with palliative home care. Next of kin described the responsibility for the loved one which affected their entire life situation with lack of rest and recovery as a result. When caregivers gave the help they were in need of, it created a sense of security. It could mean that they came quickly to urgent situations or that they met the next of kin's need for relief. When the care could not meet the needs of family members, or when they perceived shortcomings in care, this led to a loss of confidence for caregivers.

    Conclusion: Next of kin are in an emotional and stressful situation, and caregivers needs to be better at ensuring their needs and offer bereavement support.

  • 31.
    Bodri, Titti
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Karlsson, Maja-Stina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Evidensbaserad vård för personer med KOL: En journalgranskning utifrån Socialstyrelsens riktlinjer/indikatorer på en primärvårdsenhet2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Sufferers of COPD do not always receive the healthcare which guidelines and evidence suggest they should be given. In November 2015, The National Board of Health and Welfare issued new guidelines and indicators for care administered to sufferers of COPD. Aim: To investigate documentation of indicators and vaccination administered to COPD sufferers at a primary care unit.Method:The method was a retrospective journal review of total of n=118 journals. Aquantitative analysis with deductive approach was performed using a review template based on indicators for COPD care.Results: According to the documentation, 89% of subjects had their COPD diagnosis confirmed through spirometry and 90% were offered assistance with smoking cessation. The journals indicated that 8.5% of subjects had been vaccinated against influenza and pneumococcus, 15.3% of subjects had received structured patient education, the health status of 10.2% of subjects had been documented through CAT, 34.6% of subjects received nutritional treatment for those with a BMI under 22, 3.4% of subjects had their physical activity measured, 3.4% had been diagnosed cardiovascular exercise and/or weight training and the patient's next appointment had been documented in 80.5% of cases. None of the subjects involved in the study had received a written treatment plan or documented mMRCsymptom assessment. Conclusion: The primary care unit neither documents nor administers evidence-based care to COPD sufferers to a satisfactory degree in line with The National Board of Health andWelfare's domestic guidelines.

  • 32.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Learning by supporting others: experienced parents' development process when supporting other parents with a child with Type 1 diabetes2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. E1171-E1178Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: This study's purpose was to describe and analyze coach-parents' development process when supporting parents of children recently diagnosed with Type 1 Diabetes Mellitus (T1DM).

    BACKGROUND: It has been found repeatedly that providing social support for families with a child diagnosed with T1DM promotes health and wellbeing for both the child and the parents. Less explored are the processes experienced by those who provide this support. However, research has found that acting as a provider of social support promotes personal development, strengthens communication skills, and increases self-confidence.

    METHODS: The study design was based on Constructivist Grounded Theory and data were collected, through Repeated Focus Group Discussions, from eight coach-parents at a Swedish hospital from 2012-2015.

    RESULTS: The core category in the data was identified as a learning process where coach-parents emphasized their own learning in the dyad supporter - supported, and in the interaction with other parents in the Repeated Focus Group Discussions. The coach-parents' motivation for participation was a wish to learn more and to help other parents in a life-changing situation. They also pointed out hindrances and their frustration when unable to provide support.

    CONCLUSIONS: This study leads to the conclusion that people who provide support benefit from doing so. Encountering people with similar experiences in a supportive situation promotes a reciprocal learning process, based on the supporter's wish to help people in a situation they recognize. A further conclusion is that social support is not only essential initially, but is also important over a longer period and that it follows various life stages.

    RELEVANCE TO CLINICAL PRACTICE: Setting up repeated focus group discussions might be a relevant and effective tool for pediatric diabetes nurses to use in promoting health and wellbeing for both families with a newly diagnosed child and experienced families. This article is protected by copyright. All rights reserved.

  • 33.
    Boman, Åse
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Bohlin, Margareta
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Eklöf, Mats
    University of Gothenburg, Department of Psychology, Gothenburg, Sweden.
    Forsander, Gun
    The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Munthe, Christian
    University of Gothenburg, Department of Philosophy, Linguistics and Theory of Science, Gothenburg, Sweden.
    Törner, Marianne
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background2017In: SAGE Open Medicine, E-ISSN 2050-3121, Vol. 5, article id 2050312117700056Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not.

    OBJECTIVE: The aim of this study was to identify elements in the patient-pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus.

    METHODS: A total of 12 pediatrician-adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background.

    RESULTS: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent's experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration.

    CONCLUSION: An extended person-centered approach with focus on the adolescent's experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician-adolescent consultations may increase integration of the disease.

  • 34.
    Bratt, Ewa-Lena
    et al.
    University of Gothenburg, Institution of Health and Care Sciences, Gothenburg, Sweden..
    Burström, Å
    Karolinska Institute, Institution for Women's and Children's Health, Stockholm, Sweden..
    Hanseus, K
    Department of Pediatric Cardiology, Skåne University Hospital, Lund, Sweden.
    Rydberg, A
    Umeå University, Department of Clinical Sciences, Pediatrics, Umeå, Sweden..
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. Department of Pediatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
    Do not forget the parents: Parents' concerns during transition to adult care for adolescents with congenital heart disease2018In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 44, no 2, p. 278-284Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Growing up with congenital heart disease (CHD) often means transfer to adult care and lifelong medical follow-up. An optimal transition process usually involves a multipart collaboration between the patient, their parents and other family members, and the healthcare providers. Taking an active role while knowing when it is time to step aside can be difficult for all the concerned parties, even the healthcare professionals. The aim of the present study therefore, was to explore parents' expectations and needs during their adolescent's transition to adult care.

    METHOD: Semi-structured interviews were conducted with 18 parents of 16 adolescents (aged 13-18 years) with CHD in 4 pediatric cardiology settings in Sweden. The interviews were analysed with qualitative content analysis.

    RESULTS: The analysis resulted in 2 main themes: (a) Feeling secure-the importance of being prepared and informed. This theme focused on the need to be prepared and informed about transition and future transfer to adult care. (b) Recognizing when to hand over at the right time. This theme addressed the process of handing over the responsibility from the parent to the adolescents and contained handing over from pediatric care to adult care.

    CONCLUSION: Being prepared and informed about the upcoming transition process was essential. The parents underlined the importance of being involved in the transition planning for gradually handing over responsibility to the adolescent. They also considered establishing contact with the adult healthcare team before transfer as important and needed to be assured that CHD-related information of importance for the young person's daily life would be given.

  • 35.
    Böhn, Veronica
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Emanuelsson, Pia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Regnsbågsfamiljers erfarenheter av möten på BVC2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Within child health care, staff meets more and more same sex partnership. Changes in legislation have made it possible for same sex couples to become parents through artificial insemination, surrogacy and adoption.

    Aim: The aim of the study was to illuminate how HBQ families experienced the encounter with a nurse or physician within child health care. Our aim has been to focus on HBQ fathers’ parent ship, as we haven’t been able to find any previous research within this area.

    Method: A qualitative interview study with a content analysis was conducted and resulted in six themes.

    Result: The overall results showed that the informants had a positive experience and that they felt confidence and trust for their child care nurse and that they felt accepted as being a same-sex-parents. Negative aspects in the study were: To feel lack of knowledge around the family constellation, to feel lack of respect from child care nurse, to feel excluded and to feel anxiety before the encounters with nurses or physicians within healthcare.

    Conclusion: Conclusion of our study is that all parents want to be seen, and to be included in topics concerning their child and being seen as a family.

  • 36.
    Carlbo, Adam
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Persic Claesson, Hanna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Nurses' experiences in using physical activity as complementary treatment in patients with schizophrenia2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Schizophrenia is a common disease with a high risk of comorbidity in both psychiatric and somatic diseases. Physical activity is proven effective in decreasing symptoms of schizophrenia and increasing overall health. Still it is not a natural part of the care in persons with schizophrenia. Aim: The aim of this study is to describe nurses' experience in using physical activity as complementary treatment in patients with schizophrenia. Method: Three focus groups with 12 participants were conducted. Qualitative content analysis was used to analyze data. Results: An uncertainty of the benefits was expressed through continuous query of questioning the result of physical activity. Nurses also expressed that physical activity was commonly used but questioned, in caring for persons with schizophrenia. However, it was perceived as a non-evidence based form of intervention and was used with uncertainty of the effects. Conclusion: The uncertainty of the benefits of physical activity is evident in nursing staff and pose a resistance to implement physical activity as a complementary treatment in schizophrenia. A new awareness of evidence based nursing is suggested to promote a wider and more offensive care to reduce patient vulnerability in persons with schizophrenia.

  • 37.
    Carlsson, Michaela
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Henriksson, Sofia
    University West, Department of Health Sciences, Section for nursing - graduate level.
    BHV-sjuksköterskors arbete för att motverka stress hos föräldrar2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The demands and norms of modern society cause increasing stress levels amongst the population where parents of young children have proven to be a particularly vulnerable group. Research indicates that parents with high stress levels often have a negative impact on the whole family, including their children as well, who then might present signs of a lower physical health and difficulties concentrating. Aim: The purpose of the study was to describe Child Health Care (CHC) nurses’ work to reduce stress among parents. Method: Eight semi-structured interviews based on a convenience sampling were conducted and analyzed according to qualitative content analysis. Results: The analysis identified three categories: ”Using Oneself as an Asset”, ”Strengthen the Parents” and ”Working in a Whole Family Approach”. Conclusion: The CHC nurses worked with a salutogenic perspective using multiple approaches when helping parents reduce stress. It was prominent that the conversation was of importance when meeting the parents and having good counseling skills seemed to be one of the most important areas to master. One area where more focus on stress reduction could be beneficial is as part of the education offered in parent groups and this would be a way of better emphasizing the occurrence of stress and the importance of useful stress management strategies.

  • 38.
    Caruana, Maryanne
    et al.
    Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Msida, MSD 2090, Malta.
    Apers, Silke
    University of Leuven, Department of Public Health and Primary Care, KU Leuven - 3000, Leuven, Belgium.
    Kovacs, Adrienne H
    Oregon Health & Science University, Portland,Knight Cardiovascular Institute, OR, USA..
    Luyckx, Koen
    University of Leuven, School Psychology and Child and Adolescent Development, KU Leuven - 3000, Leuven, Belgium.
    Thomet, Corina
    Center for Congenital Heart Disease, University Hospital Bern, Bern, Switzerland..
    Budts, Werner
    University of Leuven, Division of Congenital and Structural Cardiology, University Hospitals Leuven, KU Leuven - 3000, Leuven, Belgium..
    Sluman, Maayke
    Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands..
    Eriksen, Katrine
    Oslo University Hospital, Rikshospitalet, Oslo, Norway.
    Dellborg, Mikael
    The Sahlgrenska Academy at University of Gothenburg,Institute of Medicine, Gothenburg, Sweden..
    Berghammer, Malin
    University West, Department of Health Sciences, Section for nursing - graduate level. University of Gothenburg, Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Johansson, Bengt
    Umeå University, Department of Clinical Medicine and Public Health, Umeå, Sweden..
    Soufi, Alexandra
    Hospital Louis Pradel, Lyon, France.
    Callus, Edward
    Clinical Psychology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy..
    Moons, Philip
    University of Leuven, Department of Public Health and Primary Care, KU Leuven - 3000, Leuven, Belgium..
    Grech, Victor
    University of Malta Medical School, Department of Paediatrics, MSD 2090, Msida, Malta..
    Red Flags for Maltese Adults with Congenital Heart Disease: Poorer Dental Care and Less Sports Participation Compared to Other European Patients-An APPROACH-IS Substudy.2017In: Pediatric Cardiology, ISSN 0172-0643, E-ISSN 1432-1971, Vol. 38, no 5, p. 965-973Article in journal (Refereed)
    Abstract [en]

    Studies in recent years have explored lifestyle habits and health-risk behaviours in adult congenital heart disease (ACHD) patients when compared to controls. The aim of this study was to investigate differences in lifestyle habits between Maltese and other European ACHD patients. Data on alcohol consumption, cigarette smoking, substance misuse, dental care and physical activity collected in 2013-2015 during "Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease-International Study" (APPROACH-IS) were analysed. Responses from 119 Maltese participants were compared to those of 1616 participants from Belgium, France, Italy, Norway, Sweden, Switzerland and the Netherlands. Significantly fewer Maltese patients with simple (Maltese 84.1% vs. European 97.5%, p < 0.001) and moderately complex CHD (Maltese 83.6% vs. European 97.4%, p < 0.001) brushed their teeth daily. Only 67.2% of Maltese with moderately complex disease had dental reviews in the previous year compared to 80.3% of Europeans (p = 0.02). Maltese patients with simple (Maltese 31.8% vs. European 56.1%, p = 0.002) and moderately complex lesions (Maltese 30.0% vs. European 59.2%, p < 0.001) performed less regular sport activities. Comparison by country showed Maltese patients to have significantly poorer tooth brushing and sports participation than patients from any other participating country. Alcohol consumption, cigarette smoking and substance misuse were not significantly different. This study highlights lifestyle aspects that Maltese ACHD patients need to improve on, which might not be evident upon comparing patients to non-CHD controls. These findings should also caution researchers against considering behaviours among patients in one country as necessarily representative of patients on the larger scale.

  • 39.
    Celinder, Anna
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Hovering between hope and despair: Healthcare workers' experiences of children's health in Cambodia2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Cambodia is one of the poorest countries in Asia and children here are vulnerable. Suffering is a substantial part of life and children become prohibited from attaining their developmental potential. The whole environment affects the children's health in different grades. "Convention on the Right of the Child" declare that all children have the same right to the best health possible. Good health among children in Cambodia are a crucial issue for the future development of the country. The aim of this study was to illuminate healthcare worker´s experiences of children's health in Cambodia. The method was a qualitative interview study. The data was collected through interviews with seven health-care workers in Cambodia. The data was subjected to qualitative content analyse. The result shows the fact that children can die, the power of tradition and absence of parental influence all have a negative effect on children´s health. There were also experiences of improvements for the children´s health. The challenges brought feelings of despair but there were also feelings of hope when the healthcare workers experienced opportunities for the children to obtain health. The conclusion was that healthcare workers were hovering between hope and despair towards the health of the Cambodian children.

  • 40.
    Cullberg, Lena
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Hur distriktssköterskans förskrivningsrätt används på vårdcentraler2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Prescribing rights were introduced for district nurses in 1994. A follow-up by the National Board of health and welfare in 2004 showed that the prescribing right was not used to its full potential. It has now passed 10 years since this follow-up and it would therefore be interesting to examine developments in this area as it can be seen as an advantage for the patient if the district nurse integrate concepts of nursing care and curative, where prescription is a part.

    Aim: The aim of the study was to investigate how the nurse at the Health Center uses her prescribing right of medicines.

    Method: The study was conducted with quantitative method in which questionnaires were used. A total of 130 questionnaires were sent out to all health centres of Fyrbodal. Response rate was 79,3% and failure1%.

    Results: There was no sigificant difference in the frequency of prescribing medicine and number of years in the profession. All district nurses were using their prescription right. The majority of study participants believe that there are benefits of having prescribing right, but that the number of drugs that may be prescribed is too limited.

    Conclusion: All district nurses in this study uses their prescribing right of medicines, but in varying degrees. The majority of study participants believe that there are benefits of having prescribing right, but that the number of drugs that may be prescribed is too limited.

  • 41.
    Dahlborg Lyckhage, Elisabeth
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Health care systems in transition: Equality, access and health literacy in three Scandinavian welfare states.: “The Emperor’s new clothes”: discourse analysis on how the patient is constructed in the new Swedish Patient Act2017Conference paper (Refereed)
    Abstract [en]

    The Swedish welfare debate increasingly focuses on market liberal notions and its healthcare perspective aims for more patient-centered care. This article examines the new Swedish Patient Act describing and analyzing how the patient is constructed in government documents. This study takes a Foucauldian discourse analysis approach following Willig’s analysis guide. The act contains an entitlement discourse for patients and a requirement discourse for healthcare personnel. These two discourses are governed by a values-based healthcare discourse. Neo-liberal ideology, in the form of New Public Management discourse, focusing on the value of efficiency and competition, is given a hegemonic position as laws and regulations are used to strengthen it. The new Swedish Patient Act seems to further strengthen this development. The Act underlines the increased entitlement for patients, but it is not legally binding as it offers patients only indirect entitlement to influence and control their care. To safeguard the patient’s entitlement under the Patient Act, healthcare personnel should be made aware of the contents of the Act, so that they can contribute to the creation of systems and working methods that facilitate respect of the Act’s provisions in daily healthcare work.

  • 42.
    Dahlin, Sanna
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Johansson, Jessica
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Patienters upplevelser efter sin njurtransplantation: Att bidra till evidensbaserad omvårdnad med grund i analys av kvalitativ forskning2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Kidney failure require for certain, method of treatment by dialysis. Dialysis require a lot of time from the patients life. For some patient are kidney transplantation the last way out to recover. After a kidney transplantation patients need to take medications for a lifetime, so they don’t get a rejection of the new kidney.

    Aim: The aim of this study was to describe patients' experiences of life after a kidney transplant.

    Method: A literature review based on 9 articles with a qualitative approach.

    Results: After analysis two themes emerged; Emotional roller coaster and New me. It showed that patients who has been transplant are having mixed experiences of the life after transplantation. For example, some patient´s felt fear of rejection for the new organ and some felt hope for a new life, and fear of going back to dialysis. Some patient´s felt gratefulness to the people how were willing to donate a kidney for them, and they felt hope for a better life.

    Conclusion: People who have undergone a kidney transplant, are having both mental, physical and emotional strain

  • 43.
    Dahlkvist, Eva
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Delaktighet i geriatrisk vård: en kvalitativ intervjustudie om närståendes delaktighet2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: With the new Patient care laws' entry the care is in need of creating the conditions for their relatives ' involvement in patient care. In support of this, this study was carried out in order to take advantage of their relatives ' experiences of participation on a geriatric ward. This is a part in the quality of operations and as a basis for work of improvement.

    Aim: The study of related party experiences of participation at a geriatric Department. Method: Qualitative research method with inductive approach. Semi-structured interviews were conducted with nine related to patients, who have been admitted on a geriatric ward. The interviews were analyzed using qualitative content analysis.

    Findings: The analysis of the collected data appeared three categories; experiences of involvement in a safe environment, experiences of communication and medical contact and related resource in health care, which finally resulted in a theme: the interaction of care sets the stage but also constitute barriers to the participation of close relatives. The main findings were that related experience participation when they are given the opportunity to take part of the information while getting a hearing for questions and comments. Related felt secure with care when they felt that the patient was seen and well looked after. Not to be seen or where the interaction with the professional team burst was obstacles to perceived involvement. Related would be involved and care must take advantage of their relatives ' knowledge of the patient as well as their desire for participation.

    Conclusion: Related parties are involved in the patient's care. They have broad knowledge of the patient and should be leveraged as a resource in health care. The interpersonal process requires an interaction in which the professional team with the patient and next of kin are working together in order to achieve good results for the patient's benefit. To communicate and maintain a continuous dialogue with related parties are important aspects and that the related individual is seen and verified, a requirement for the related to experience participation. The results of the study supports earlier research of related parties ' experiences of participation, however, was the focus of this study a specific geriatric ward. More research on the subject with a focus on their relatives ' experiences are needed.

  • 44.
    Danielsson, Marie
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Teliander Trostensson, Annika
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Upplevelser av vardagliga, psykosociala situationer hos personer med ADHD2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background ADHD is a neuro-psychiatric disability which includes concentration difficulties, difficulty in maintaining attention and lack of impulse control. People with ADHD often experience difficulties in school as well as working life and they often have major difficulties in social interaction.  Aim The aim of the study was to describe how persons with ADHD experience their everyday, psychosocial situation.   Method By searching the Internet through the search engine Google.com we found blogs written by persons with ADHD. The texts were then analyzed using qualitative content analysis.   Results  The analysis resulted in three main categories; unstable functions and relationships, thought and action and coping strategies. Conclusion Persons with ADHD experience different difficulties in their daily life, which imply different limitations for them. They have insight into their disabilities and have different strategies how to cope with them. The psychiatric nurse needs to explore how the patient takes care of herself, and the nurse must be   open to the fact that the patient’s life situation changes over time and she therefore needs to make new assessments on a regular basis.

  • 45.
    Dautovic, Alma
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Edell, Camilla
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors erfarenheter av preventiva åtgärder för att minska risken för fotsår hos personer med diabetes mellitus typ II: en kvalitativ intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Studies show that the future of health care is person-centeredness and nurses should meet people in a health-oriented perspective. Self-care should be adapted to the person with diabetes and nurses should take differences in views regarding health and disease into account. Aim: The aim of this study was to describe nurses' experiences of preventive measures to reduce the risk of foot ulcers in people with diabetes mellitus type II. Method: Ten qualitative semi-structured interviews were conducted. The material was transcribed and analyzed using qualitative content analysis.

    Results: The results are presented in two categories: expectations on the nurse and support to the person with diabetes. Expectations of the nurses was to strive to see the person behind diabetes and to focus on the measurable. They must strive to meet the individual where it is located and strive for good relationships. It is through good relationships that self-care advice can be more easily implemented and foot ulcers prevented, this is presented in the subcategory self-care, which is located below main category support to person with diabetes. This is to reduce suffering for the individuals and avoid high costs for the society. Nurses had good intentions with their care and teaching. The nurses saw advantage in motivating groups by reaching out to several people at the same time and offer them the opportunity to exchange experiences. Nurses felt that they had the ability to turn to instances and contacts with partners is obvious in diabetes care today. Conclusion: The results of this study show that nurses in primary care can help prevent foot ulcers through living up to the expectations placed on them by seeing the person behind diabetes and to offer its wide expertise, motivation work, self-care and cooperation with partners.

  • 46.
    Dauzhuk, Kristina
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Annerstedt, Christine
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Förstagångsföräldrars upplevelser av BHV-sjuksköterskans första hembesök: en kvalitativ intervjustudie2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND Most mothers in Sweden appreciate the home visit they receive from the child health care nurse, a few days after being back home from the maternity ward. Despite that, the number of home visit is decreasing, mostly due to lack of time, too long distance and also due to the parents decline a home visit. Yet the home visit is a great opportunity for the child health care nurse to establish trust and support for the first-time parents and also to create a trustful relationship. AIM The aim of this study was to illustrate first-time parent’s experiences of the first home visit by the child health care nurse. METHOD A qualitative approach were used by the authors in order to perform nine semi-structured interviews. It was conducted with an inductive approach. The data were analyzed using qualitative content analysis. RESULTS The result is presented in two categories and twelve subcategories. The first category describes the ambivalence before the first home visit.The second category illustrate the child health care nurse’s professional behavior. The home visit can be seen as a first step in the creation of a trustful relationship between the parent and the child health care nurse. CONCLUSION By creating a trustful relationship and by answering to the firstparent’s individual need of support during the home visit, the child health care nurse can contribute to increase parents nursing of the infant. The support benefit therefore both the infant as the first-time parents.

  • 47.
    Davidsson, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Tellström, Emeli
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Främjande av den sköra äldres delaktighet i palliativ vård vid livets slutskede på geriatrisk akutvårdsavdelning: Ur ett sjuksköterskeperspektiv2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The care of older people is complex and are affected by several medical conditions and involve a large number of different caregivers that need to cooperate. Flexibility and mutual trust are required for the collaboration to work. Older people have the right to participate and receive good palliative care at the end of life regardless of where they are and which caregivers is responsible. The nurse has a significant role to play in promoting the older patient's participation in his or her end of life care.

    Aim: The aim of the study was to describe how nurses facilitate participation for frail older people in end of life care in geriatric emergency wards.

    Method: The data collection consisted of three semi structured focus group interviews where a total of ten nurses participated. The analysis was conducted with qualitative content analysis.

    Results: The results revealed three main categories and eight subcategories. The categories that emerged were; Collaboration, Responsiveness to the patient's will and Surrounding environmental factors.

    Conclusion: To promote the older patient's participation in care at the end of life, it is important that the patient's desires is reflected in the care. It is crucial that all parties involved have a common vision to meet the wishes of the older people.

  • 48.
    Ebbesson, Alexandra
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Widlund, Matilda
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Omvårdnadspersonalens erfarenheter av att arbeta inom psykiatrisk vård2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Psychiatric care has through the history been facing a negative reputation as well as the view of mental health. Personnel working in psychiatric care are also often negatively described and are far from flattering. Psychiatric nursing is not considered to be an attractive choice for nurses or nursing students, as previous research shows. Aim: The purpose of this study was to describe nursing staff i.e. nurses and assistant nurses experiences of working in psychiatric care. Method: The study was based on individual semi-structured interviews with 14 nursing staff in psychiatric inpatient care. Qualitative content analysis was conducted as analytical method. Results: The result showed that the nursing staff looked at their work as a unique workplace. Teamwork was emphasized as valuable and important factor for them staying. Furthermore, work was described as an ongoing learning. The result also showed that they faced multifaceted challenges to handle in their work. Where prejudices and ideas from the surrounding caused reactions. Difficulties in the work were described, such as consequences of time and resource shortages. Also difficulties with collaboration with care neighbors and municipalities that created frustration. Conclusion: It was clear that the gap between psychiatric care and society is felt to be too big. Increased cooperation between different actors is required to provide good care on equal terms. Another important conclusion is the need for more psychiatric content in nursing education. Due to that mental illness occurs everywhere in health care, but also in order to promote the recruitment of nurses to psychiatric care.

  • 49.
    Ek, Sofia
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johannesson, Evelina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Distriktssköterskors erfarenheter av att arbeta med patienter med övervikt och fetma2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Overweight and obesity is a still growing problem for public health. A change in lifestyle through change of diet and increased physical activity is fundamental in treatment for permanent weight loss. The district nurse has a central role in health promotion and the work involves using methods to support and motivate these patients.

    The aim of the study was to illustrate the district nurse´s experiences in the course of action in the treatment of patients suffering from overweight or obesity.

    Eight district nurses and nurses working in primary health care were interviewed. The data was analyzed using a qualitative content analysis with an inductive approach.

    In the analysis of the data material, the theme that emerged was to emanate from the person. Four categories emerged; Get to know the patient, educating and advising the patient, individualized methods and also impeding and helping factors for success, with eleven subcategories.

    The district nurse has a central and significant role in the work with patients who are overweight or obese. The work consists of continuous contact with the patients, knowledge communication and methods for lifestyle changes. The central part, however, is to emanate from the person and to adjust the work according to the patient´s level of motivation. The involvement of the patient's relatives is seen as a prerequisite for the patient to succeed. The work is considered time consuming and knowledge-intensive but at the same time exciting and challenging.

  • 50.
    Eklund, Annika
    et al.
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Skyvell Nilsson, Maria
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Kliniskt basår för nyutexaminerade sjuksköterskor inom Västra Götalandsregionen: en utvärderingsrapport2018Report (Other academic)
    Abstract [sv]

    Newly graduate nurses (NGN) transition between basic education and work in a complex health care practice, as well as their intention of leaving the profession during the first year of work and how this can be prevented, is a global concern. NGN experience difficulties integrating workplace environment, expectations, and educational experiences. This is an evaluation study of a one-year transition program, which was implemented as a project during 2016-17, at six hospitals in Sweden.

    An explorative research design was used and data consist of focus group and individual interviews with NGNs, interviews with first-line managers, observations of simulation training, and survey material from the hospitals. Data was analyzed using thematic analysis. Results show an overarching structure for all hospitals in the region, the NGNs are engaged in the following learning activities; introduction at the ward and a senior RN as preceptor, lectures and/or simulations, change of ward, process-oriented reflection seminars and mentorship.

    The different learning activities contribute to the overall learning in different ways. Continuous supervision and structured reflection are central to NGNs professional learning. Organizational conditions create prerequisites for learning during the transition program and a change of ward is a particular challenge to get organized. The results, also provides a deeper understanding of the foundational components in NGNs early development of expertise, security as professionals, and essential knowledge for bridging the practices of the first cycle program and healthcare practice at hospitals.

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