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  • 251.
    Johansson, Therése
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Mirblom, Elin
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hemsjukvården, en daglig utmaning: Sjuksköterskors erfarenheter av att vårda patienter i hemmet2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: With a greater life expectancy and patients being discharged from hospitals earlier than before, the health care profession has recognised an increasing need for qualified nurses in the in-home health sector. Health care provided from a patient’s home often expose its own set of challenges, such as offering care on their terms whilst being considerate of their needs. Aim: The aim of this study was to illustrate the experiences faced by nurses while providing care directly from a patient’s home. Method: Through a qualitative literature review where the findings analysed according to a five-step model. The qualitative analysis resulted in 4 main themes and 11 sub-themes. Results: Many nurses experienced heavy workload. Many nurses also felt they sometimes lacked the knowledge required when faced with different situations, highlighting a need for continued learning to improve competency. Relationships were viewed as important for the care sector; including patient, family of the patient and co-workers. The nurses also experienced deep personal involvement in the patient’s life-situation. Conclusion: A common observation made by nurses in the home-based healthcare sector is how a lack of knowledge and experience creates an unsafe work environment. Another important observation was how relationships with patients and their next of kin could make a great improvement to the quality of the homecare given. Many nurses express a huge commitment and duty of care to their patients; a trait which demonstrates great conviction to the nursing occupation.

  • 252.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Sweden.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Voices used by nurses when communicating with patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1640-E1650Article in journal (Refereed)
    Abstract [en]

    AIM: To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Communication is an essential tool for nurses when working with older patients and their relatives but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome.

    DESIGN: An ethnographic design informed by the sociocultural perspective was applied.

    METHOD: Forty participatory observations were conducted and analyzed during the period October 2015 to September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semi-structured follow-up interviews were conducted with five nurses.

    RESULTS: In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualized, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices this indicates a shift in the orientation or situation.

    CONCLUSION: The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved.

    RELEVANCE TO CLINICAL PRACTICE: Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse-patient-relative relationship, which is a basis for improving patient care and healthcare outcomes. This article is protected by copyright. All rights reserved.

  • 253.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Striving to establish a care relationship -Mission possible or impossible?: Triad encounters between patients, relatives and nurses2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 22, no 6, p. 1304-1313Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction.

    OBJECTIVE: To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people.

    DESIGN: A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective.

    METHOD: Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015-September 2016 and analysed together with field notes using ethnographic analysis.

    RESULT: The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view.

    CONCLUSION: The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives' stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health-care setting, therefore making the mission to establish a care relationship possible.

  • 254.
    Johnsson, Anette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, Jönköping University, Sweden.
    Boman, Åse
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    What are they talking about? Content of the communication exchanges between nurses, patients and relatives in a department of medicine for older people: An ethnographic study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. E1651-E1659Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore and describe the content of the communication exchanges between nurses, patients and their relatives in a department of medicine for older people in western Sweden.

    BACKGROUND: Information, messages and knowledge are constantly being communicated between nurses, older patients and relatives in the healthcare sector. The quality of communication between them has a major influence on patient outcomes. A prerequisite for good care to be given and received is that there is mutual understanding between the parties involved.

    DESIGN: An ethnographic study was informed by a sociocultural perspective.

    METHOD: Data were collected through 40 participatory observations of meetings between nurses and older patients and/or relatives which covered 135 hours of nurse-patient-relative interaction, field notes, 40 field conversations with 24 nurses and 40 field conversations with patients (n=40) and relatives (n=26). Five semi-structured interviews were conducted with nurses. An ethnographic analysis was performed.

    RESULTS: The analysis identified three categories of content of the communication exchanges: medical content focusing on the patient's medical condition, personal content focusing on the patient's life story, and explanatory content focusing on the patient's health and nursing needs. The content is influenced by the situation and context.

    CONCLUSIONS: Nurses would benefit from more awareness and understanding of the importance of the communication content and of the value of asking the didactic questions (how, when, what and why) in order to improve the patients' and relatives' understanding of the information exchanges and to increase patient safety.

    RELEVANCE TO CLINICAL PRACTICE: Nurses can use the communication content to create conditions enabling them to obtain a holistic view of the patient's life history and to develop an appropriate person-centered care plan. This article is protected by copyright. All rights reserved.

  • 255.
    Jonasson, Anette  
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Karlsson, Lena
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Vilka hinder kan patienter med typ 2-diabetes uppleva för sin egenvård?: En litteraturbaserad studie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes type 2 is a growing problem worldwide with increasing numbers of people suffering from the disease. Living with the diagnosis entails a great deal of agony for the patient. The disease can lead to serious health effects as well as huge economic consequences for society. Since self-care is an important part of treatment, it is important to find out what barriers patients experience in their self-care.

    Aim: The purpose of this study was to describe what barriers patients with type 2 diabetes experience in their self-care.

    Method: The method was a literature-based study where seven qualitative articles were analyzed.

    Result: The results showed that patients experienced several barriers in their self-care. Three main themes were identified: lack of motivation, feeling of loneliness and worries in everyday life. The results showed that barriers were often a result from lack of motivation, difficulty in changing habits, the fact that patients often felt alone in their illness and that the environment, and that family and friends did not show adequate amount of support and sometimes even sabotaged patients’ attempt to self-care. Insufficient relation to, and lack of support from healthcare providers were also described as barriers in self-care. There were also some barriers in everyday life that affected self-care.

    Conclusion: By meeting patients on their own terms and in their own social, economic and cultural environment, healthcare providers can help patients identify their specific barriers, and thus supporting and motivating patients in self-care. Healthcare providers need to find out more about how they can increase patients' inner motivation for change and develop treatment strategies in cooperation with patients. It is necessary that the nurse understands the barriers that may occur to support patients in self-care to achieve the goal of better health.

  • 256.
    Jonasson, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Schultz, Isabella
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Stress i sjuksköterskans vardag: En litteraturbaserad uppsats om copingstrategier2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Stress is well known to go hand in hand with registered nurses and the nursing field. The aim was to examine stress related coping strategies experienced and used by registered nurses from different countries all over the world. This qualitative study was done by analyzing the results from 10 different articles. The findings showed that there was multiple coping strategies that is being used by nurses to cope with the stress they experience at work. Some of the coping strategies were done after work; For instance, different physical activities including yoga and sports. Other coping strategies that were found are more work related. For example, the importance of knowing yourself in your nursing role, knowing your limits, and the importance of having a good relationship with your colleagues. Employers can use these strategies on a daily basis both and registered nurses to cope with work related stress.

  • 257.
    Jonsson, Bosse
    et al.
    Mälardalen University.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Work Integrated Learning and Learning Integrated Work: An Approach to Unite Theory and Practice to Praxis2016In: Handbook of Research on Quality Assurance and Value Management in Higher Education / [ed] Nuninger, Walter & Châtelet, Jean-Marie, Hersey, PA: IGI Global , 2016, p. 139-159Chapter in book (Refereed)
    Abstract [en]

    The difference between the professional competence conveyed during education and the competence demanded in working life is substantial and needs to be taken seriously. In this chapter where the case is nursing education, Work Integrated Learning (WIL) and Learning Integrated Work (LIW), are suggested as pedagogical approaches in Higher Education aiming to integrate scientific knowledge and with practical knowledge, and to provide an analytical perspective where students have the opportunity to develop metacognitive skills and praxis by learning through experiences during internship. One way to achieve this in vocational education to learn from the knowledge and skills used when performing inpractice. By integrating scientific and practical vocational knowledge, one promotes professionalization that is exhibited as Learning Integrated Work (LIW), i.e. the capability to perform the expected tasks and learn at work by using a critical and development-oriented attitude in daily work and actively participate in renewals of work assignments.

  • 258.
    Jonsson, Joakim
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Edström, Jonathan
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hur sjuksköterskan arbetar för att skapa trygghet vid mötet med patienten i sjukhusmiljön: En litteraturstudie med observationer från en akutmottagning i Namibia.2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To feel safe is one of our most fundamental biological needs. It can refer to being safe from danger, financial safety or to be illness free. When a person is sick or injured, the need for help from the outside increases to achieve a feeling of safety. Nurses in the hospital create comfort for patients and make them feel safe. Laws are constantly renewed and updated in the healthcare in favour for the patient to prevent healthcare related injuries.

    Aim: The aim of this study was to enlighten how nurses are working to make the patient feel safe in the hospital environment and how to achieve it.

    Method: To meet the objective of the study the purpose was split into two content areas, which were how nurses work to make the patient feel safe in the hospital environment and the work conditions for the work to create safety. A literature-based study with a literature review was used to analyse four articles that highlighted nurses' approach in the hospital. Simultaneously, eight nurses in the emergency room (ER) at a Hospital in Namibia were observed in patient care situations, using structured observation charts.

    Results: Two main categories were found in the literature-based study, each matching one content area. The categories were to meet the patient with competence and a satisfying work situation, and each category had two associated subcategories. The results of the observations suggest that nurses in Namibia uses factors that are associated with safety by using their body language and communication skills.

    Conclusion: Nurse's workload and the hospital environment affect their ability to provide safe care. The results from the observations agreed to a certain degree with the results of the literature-based method. 

  • 259.
    Jonsson, Kenneth
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Börjesson, Danny
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Sjuksköterskans upplevelseav patientsäkerhet i akutsjukvården: En litteraturstudie2020Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patient safety in the emergency department is a highly debated issue. Long waiting times, overcrowded wards, lack of communication, unsuitable environment and workload are factors associated with patient safety.

    Aim: To identify factors associated with patient safety in emergency care as experienced by nurses.

    Method: A literature study was conducted comprising nine qualitative articles.

    Results: Three themes that affect patient safety were identified: (1) Nurses' experience of the importance of the work environment for patient safety; (2) Nurses' experience of the impact of the organization on patient safety; and (3) Nurses' experience of the impact of communication on patient safety.

    Conclusion: This study highlights some of the factors that affect patient safety. These factors were experienced by the majority of the nurses working in the clinical environment.

  • 260.
    Josefsson Olsson, Mikaela
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Magnusson, Martina
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patienters upplevelser efter intensivsjukvård2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Nowadays people more often are surviving intensive care, which makes it important to increase the knowledge about the experiences. Illusions, nightmares and unreal experiences are common and often linger for quite some time.

    Aim: The aim of the study was to illuminate patients' experiences after intensive care.

    Method: A literature-based study of 16 qualitative studies was conducted

    Results: A lot of the patients have difficulties moving on, and are haunted by their experience. Memories from the hospital stay are often hazy, and evokes a sense of lacking a part of their life story. There is a need to understand in order to move on. Despite of this, some of the patients manage to find happiness. They find a new meaning in life, and learn to look at things from a brighter side.

    Conclusion: To process the experience, there seems to be a need of further support. Also, patients need to receive more information about what to expect after discharge.

  • 261.
    Jovander, Jeannette
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Kaveland, Cecilia
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hur sjuksköterskans arbetsmiljö påverkar deras hälsa: En litteraturöversikt2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Health is a crucial factor for a person’s well-being, but health is a subjective concept and can therefore be experienced differently between individuals. The work environment has a big influence on the nurse’s experience of health. Aim: The aim of this study was to describe what, in the work environment of a nurse, leads to health or illness. Method: A literature overview Results: A well-working organization and a good work environment led to experienced health and well-being among the nurses. The nurses experienced health and life quality when there was an opportunity to affect their working tasks, there was enough staff and got the opportunity to feel involved in the organization. Support from collegiate and the leadership was important, as well as the possibility to further training. Conclusion: A well-functioning organization and a leadership that cares about the health and appreciate the staff is important to create a good health and work environment. In order to achieve this nurses should have an opportunity to be involved in work decisions and to influence the working hours. It is also important to develop the skills through training and / or peer training.

  • 262.
    Jungestrand, Linda
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Höggren, Lovisa
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Kvinnors upplevelser av att insjukna i akut hjärtinfarkt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Myocardial infarction is a common cause of death in Sweden. The mortality has reduced in men but not in women. Research on myocardial infarction has been done mostly in men even though women suffer approximately to the same extent. Previous studies have shown that men have priority over women when seeking acute care for symptoms of heart-disease. This situation might lead to women suffering and is not supported by Swedish health care law.

    Aim: To describe women's experiences of symptoms of acute myocardial infarction and to answer following questions: How did the women experience their symptoms? How did the women manage their symptoms? How did the women experience the given care?

    Method: A systematic literature-based study based on content analysis of ten qualitative articles.

    Results: The result is presented in three main categories with following subcategories based on the questions. Women's experiences of their symptoms; descriptions of symptoms and interpretation of symptoms. Women's manageability of their experienced symptoms; reduction of symptoms, prioritize the needs of others and confirmation of next to kin. Women's experiences of the given care; fear of not being taken seriously and the meeting with medical staff.

    Conclusion: Nurses need to gain more knowledge about women's symptoms, how they manage their symptoms and how they experience the given care. Nurses need to take women's symptoms seriously, need more knowledge about how to support women to make sure they seek medical care in time and how to give women good care.

  • 263.
    Karam, Jihane
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Abdi, Sima
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Personers med diagnosen diabetes typ 2, upplevelse av mötet med sjuksköterskor i vården2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes type 2 is a global health problem that will change the life style related to diet and physical activity. Research has shown that the encounter with the nurse is important for the person to be able to change their lifestyle. The relation between nurse and patient is crucial in building trust and security. Aim: The aim was to describe persons with diabetes type two, experience of encountering registered nurses in health care.

    Methods: The study was conducted as aliterature study based on ten qualitative articles. The analysis was performed with the inspiration of Friberg (2012). Results: The result is presented as five categories. The experiences in the meeting were: To feel independent, to feel support, to feel depressed, to not feel involved and to feel seen. Conclusion: The results of the study, patients with type 2 diabetes need support and advice for changing lifestyle and manage their disease based on their own needs and their own situation.

  • 264.
    Karimi, Mohammad
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Olsson, Jenni
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Förebyggande åtgärder för att förhindra trycksår2020Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pressure ulcers are an unnecessary injury that still occurs to a greater extent in the healthcare which causes great suffering for the affected patient and high costs to society.

    Aim: The aim of the study was to describe the nursing care to prevent pressure ulcers in patients who are at risk of pressure ulcers.

    Method: This was a literature review study based on 11 quantitative studies. Systematic article search was made in the databases Cinahl and Pubmed as well as manual article searches. Main theme and subthemes were designed based to Friberg's (2012) analysis model based on their similarities and /or differences.

    Results: Two main themes were identified. The main theme Individual preventive measures with subthemes, pressure relief and pressure distribution and to support the normal function of the skin. The main theme combined preventive measures with subthemes pressure relief program with different components and theoretical knowledge and practical skills.

    Conclusion: A pressure ulcer is an adverse event that can be avoided effectively with the preventive measures, whether they were implemented as individual preventive measures or combined with further measures. The main findings in the study illuminated a number of preventive measures such as risk assessment, nutritional assessment, skin assessment and skin care, classification of pressure ulcers, skin care and incontinence care, pressure relief and pressure distribution, position change and mobilization, digital sensors and most importantly staff training demonstrated to have good effect to prevent pressure ulcers.

  • 265.
    Karlsson, Adam
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Behöver jag hjälp?: Aspekter som påverkar initiativtagande till vård hos patienter med riskbruk eller missbruk av alkohol2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Alcohol is the most widely used intoxicant in the western world. The negative effects of alcohol on the individual, group and societal level results in a wide array of problems which effect both the person using the substance and his/her relatives. Aim: The aim was to illuminate which aspects influence help-seeking for individuals with alcohol misuse. Method: The method was a literature review. Eleven articles were the base for the analysis. Both qualitative and quantitative articles were included. Results: Three themes and six sub-themes were identified. The themes were: Personal aspects, Social aspects and Structural aspects. The identified sub-themes were: "To have or to lack insight", "To feel guilt", "To believe that the problem can be solved on one´s own", "To feel stigma", "To feel a lack of trust in health care" and "To lack information and accessibility". Personal aspects were the most commonly described as both barriers and incentives for help-seeking. Another identified aspect of importance for help-seeking for individuals with alcohol misuse was the individual's perception of healthcare. A negative opinion of the available healthcare had a negative impact of help seeking while the opposite had a positive impact. Conclusion: The results showed that help-seeking behaviours is a complicated and multifaceted issue involving many different aspects which interacts with each other. It is important that nurses in every field of healthcare have knowledge of these aspects in order to have the tools and knowledge to motivate and support these patients to get the care they need.

  • 266.
    Karlsson, Alexandra
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Pettersson, Marie
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    När det inte blev som det var tänkt: en litteraturbaserad studie av kvinnors upplevelser av missfall2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Today approximately one pregnancy out of five ends with a miscarriage. The women who suffered miscarriages experienced a lot of mixed feelings. The nurse plays an important role for the affected women with regards to information and support. This study focuses to describe women's  actual experiences after at least one miscarriage, in order to make the nurses able to understand their feelings and reaction after a miscarriage.

    Aim The aim of the study was to describe women's experiences of miscarriage before 22nd week.

    Method A literature-based study based on analysis of ten qualitative articles was performed

    Results The result are presented in three theme "A ruined world", "Anger of the own body" and "Unfulfilled expectations of the healthcare professionals".

    Conclusion Many women became depressed after having been through a miscarriage. They felt a mix of emotions and they blamed themselves for what happened. The women need better support and information from the healthcare professionals. By supporting the women and giving them customized information, the nurses create a safer environment, which they need in the difficult situation they find themselves in after the miscarriage. In order to do this nurses need more knowledge about women's experiences of miscarriage to be able to understand their needs and to be able to support them in the best way possible.

  • 267.
    Karlsson, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Ahlström, Angelica
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Sjuksköterskans upplevelse av hot och våld inom slutenvården2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Within inpatient care violence and threats are a growing problem, which nurses are particularly exposed to in their workplace, especially by patients. It makes an impact on the relationship between them and it also creates consequences in the care of the patient and the ability of the nurse to provide it.  Aim: The aim of this study was to describe nurse experiences of threats and violence within inpatient care. Method: A literature study based on qualitative articles. Ten qualitative articles were used and analysed. Results: The results are grounded in three themes and ten sub-themes. Nurses experiences of violence and threats resulted in feelings of fear and concern when they were exposed to it. They felt difficulties to handle the problems and they asked for more strategies, both personally and in the working environment to deal with the issue.   Conclusion: The results showed that nurse's feelings in this subject were fear and concern in their profession were they need more strategies to handle situations in violence and threat. In the articles nurse's asked for more support programs and reflections from their managers.   

  • 268.
    Karlsson, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Lysell, Linda
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Personers upplevelser av att leva med KOL: En litteraturbaserad studie om att leva med kronisk obstruktiv lungsjukdom2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Chronic obstructive pulmonary disease (COPD) is one of the most common diseases today. COPD is a progressive disease that causes breathlessness, coughing and increased sputum. People living with COPD are often experiencing a hard time accepting the limits that this disease can cause while experiencing stigmatizing condemnation because the presumable cause of the disease.

    Aim: The aim was to describe the experience of living with COPD. 

    Method: This is a literature review based on ten qualitative scientific articles from 20072017, reviewed and quality analyzed. Results: Themes of living with COPD was found to be, loss of self -esteem, social constraints and a lack of resources in everyday life. To be dependent on others and to feel being a burden to your loved ones was associated with a loss of self- esteem. Feelings like fear, shame and isolation were experienced by many of the participants, which led to social constraints. Knowledge and positive thinking was important factors in coping with the disease.

    Conclusion: This study provides a good and useful insight into how people living with COPD experience their illness. Living with COPD affects your entire life. Participants losing their self-esteem because of no longer being able to perform the tasks and activities like before. Therefore, it is important to understand the people living with COPD in order to be able to handle their illness in the best possible way and work with person-centered care.

  • 269.
    Karlsson, Charlotta
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Svanström, Maria
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patientens upplevelse att leva med hemventilator2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are currently 2700 adults living with home ventilator (HMV) in Sweden. These patients have complex needs of caring in life. To live with HMV can change life both physically, mentally, social and existential. It is therefore important for nurses to have knowledge to support those patients. Aim: The aim of the study was to elucidate patients experience living with a home ventilator. Method: A literature based method, with a qualitative focus. The articles were analysed using the Friberg method of analysis. Result: The result is presented in two main themes and four subthemes. The first main theme is about how the patient´s life changes, When life changes, whilst the second main theme is about that their life goes on, When life goes on. In the subthemes for the theme life changes, the patients experience is compared to going out to sea in a stormy weather with feelings of fear and having no control and further on to control their one ship and get back control in life. The subthemes for the theme life goes on shows that the patients are experiencing mixed emotions both feeling free and in captivity and feeling healthy despite illness. Conclusion: Both positive and negative experiences in their entire life situation are shown in the results. Those different experiences contributes to a deeper knowledge and understanding for nurses and give them and better chance to give the best care for this patients.

  • 270.
    Karlsson, David
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Nikrad, Elham
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Sjuksköterskans roll i egenvården hos patienter med hjärtsvikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Heart failure causes great suffering and affects many elderly people. Through self-care, patients can improve their quality of life through, reduce time in hospital and increase their health. Self-care means that the patient knows and responds to symptoms and uses behaviors that minimize risks and promote good health. The nurse's main subject is nursing that aims to increase the patient's health experience. This can be done by improving the self-care of the heart failure patient. Orem writes that self-care is at natural behavior among humans.

    Aim: The purpose of the study was to describe the general nurse's competence in relation to hear failure and its influence on self-care in patients with heart failure.

    Method: The method of making a literature review was used. A search for relevant literature was made using PubMed and Cinahl.

    Results: The results showed that nurses had a lack of knowledge concerning self-care in heart failure. It also shows that nurses request more knowledge about self-care in heart failure. The patient needs individual support and guidance. This can be achieved by the nurse using various customized methods such as telephone counseling, home visits and information calendar.

    Conclusion: The nurse can improve the patients' self-care using methods like phone-support and home visits. With increased knowledge about the patient the nurse can improve the patients' self-care behavior more efficiently. Patient-centered care is an important part in a successful outcome. The earlier the education of the patient begins the better. The patient's individual needs must be considered by the nurse to identify the obstacles and opportunities for the patient.

  • 271.
    Karlsson, Elin
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Bengtsson, Månia
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patienters erfarenheter av livsstilsförändringar vid nydebuterad diabetes typ 2: En litteraturbaserad studie2020Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes type 2 is an increasing global health issue. Research has shown that lifestyle changes such as diet and physical activity have a significant impact on the treatment of type 2 diabetes. Lifestyle changes are important to prevent complications and to gain a better control of the self-care.

    Aim: The aim of this study was to describe patients' experiences of lifestyle changes regarding diet and physical activity in newly diagnosed type 2 diabetes.

    Method: A method to contribute to evidencebased practise based on analysis of qualitative research was performed. Eight articles were analyzed according to Friberg (2017). The findings were two main themes and nine sub-themes.

    Results: The two main themes were obstacles during lifestyle changes and supportive factors in lifestyle changes.

    Conclusion: The result showed that patients experience different feelings about lifestyle changes. Nurses need more knowledge about patients' experiences of lifestyle changes in order to provide a person-centered care and support patient's self-care.

  • 272.
    Karlsson, Emma
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Karlsson, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Att vårda barn med cancer: En litteraturbaserad studie om sjuksköterskors erfarenheter2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are 2,2 million children living in Sweden and every day about one child is diagnosed with cancer. Nurses have an important role in nursing the sick child and comforting it´s families. Little is known about the nurses´ experiences in working with this severely ill children. Aim: The aim of this study was to highlight nurses´ experiences of caring for children with cancer. Method: A method to contribute to evidence-based nursing with the ground in analysis of qualitative research was conducted. An analysis of fourteen qualitative articles was carried out. The analysis resulted in four main themes and eleven subthemes. Result: Four main themes emerged; The adequate knowledge needed, Difficulties in ethical stance, Caring relationships where the child is in the centre, Emotional contrasts. The results of the study showed that the nurses experienced that they were not fully-trained and that the knowledge was not sufficient when they were new to childhood cancer. The nurses experienced a lot of emotions caring for children with cancer and felt it valuable to use coping to deal with the upcoming emotions and prevent emotional burn-out. Conclusion:More knowledge in childhood cancer is needed for nurses caring for children sick with cancer. It is important for the nurses to see the child's best, but also to work family-centered. The work is emotionally stressful and requires coping strategies to prevent emotional burnout.

  • 273.
    Karlsson, Fredrik
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Lidbeck, Pia
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patienters upplevelser av sjuksköterskors bemötande på en akutmottagning: En litteraturöversikt2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Many people visit the emergency departments every day and the complaints from patients in health care are increasing. Patients need to feel they are being seen and the care must be based on respect for each persons’ equal value, which meets the need for security and safety in each patient.

    Objective: The aim of the study was to describe patients’ experiences of nurses’ encounters in emergency departments

    Method: A literature review was made from eleven quantitative studies and one qualitative study.

    Results: Three main themes; To be seen as a patient, To be helped and get information, To get care at the emergency department with a total of six sub themes. The result showed that the patients’ need, in contrast to the nurses’ characteristics, could affect the patients’ experiences of how nurses’ encounters them. Factors that also affect patients´ experience of encounters were mainly confirmation, information and the environment.

    Conclusion: When the patients have the feeling of being confirmed, involved and informed by the nurse the meeting between patients’ and nurses’ were experienced as more satisfying.

    Keywords: Encounters, Emergency department, Nursing care, Patient satisfaction, Person centred care.

  • 274.
    Karlsson, Inger
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Enhus-Krancher, Malin
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hinder för och möjligheter till att ge nutritiv omvårdnad2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Undernourishment occurs when the body no longer receives enough nutrition in the form of vitamins, minerals, proteins and other nutrients, which is necessary to maintain the normal function of the body, but also in the inability to digest and absorb food. Older people are therefore at high risk of suffering from complications and admission to hospital care, which entails huge costs, both financially and humanitary. Different forms or assessments are often used to identify the risk of malnutrition. The nurse has a key position regarding assessment, planning, implementation and evaluation of healthcare and care needs. Aim: To identify obstacles and opportunities to provide nutritional care. Method: A literature review based on eleven articles analyzed by content analysis. Results: In order to provide nutritional care of their elderly patients the nursing staff should receive basic information about the elderly resident’s routines and nutritional needs. Nurses described their need of internal courses for nursing staff, on nutrition. Education could be an opportunity to remind the staff the importance of nutrition for the elderly person. Conclusion: Knowledge and education are important parts for nurses to identify malnutrition in patients. The sometimes negative attitude among

  • 275.
    Karlsson, Ketty
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Nylund, Lina
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Sjuksköterskors upplevelse i mötet med den döende patienten och närstående2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: During 2014 a total of 89062 people died in Sweden. Nurses' will meet patients who are in the end of their life. The work with dying patients can be emotionally draining but also very rewarding for the nurses.

    Aim: The aim of this study was to explore nurses' experiences of meeting the dying patients and their close ones.

    Method: The method used is a litterature based study with focus on qualitative studies. The articles were processed using the Friberg method of analysis.

    Results: There were ten articles which were analysed and compiled to a result. There are three themes and ten subthemes. The first theme is about seeing the work as a privilege - it's about happiness, gratefulness and benevolence. The second theme is about feeling frustration - it's about not being ready to meet the patient and their close ones, being uncertain and being alone during work. The third and last theme is to experience stress - it's about feeling pressure, feel sadness and to feel stress and anxiety.

    Conclusion: Both positive and negative experiences are shown in the result. The palliative care isn't just about caring for the patient, but also about supporting their next of kin in their mourning process. The nurses experiences can sometimes reflect in their work towards the patient and their kin, which puts the nurses in a difficult situation.

  • 276.
    Karlsson, Linda
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Jonsson, Maria
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    När luften inte räcker till: upplevelser av att leva med KOL2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: COPD is one of today's major diseases with at least half a million sufferers in Sweden. COPD is a disease that develops slowly and the symptoms are insidious at first. The symptoms of COPD are breathlessness, cough, phlegm, fatigue, and sometimes weight loss. The disease can't be cured, only symptoms can be relieved. Smoking cessation is the most important treatment. Living with a chronic disease can cause suffering, bringing a sense of life being unfair and create a sense of alienation.

    Aim: The aim was to illuminate person' experiences of living with COPD

    Method: Literature-based study in which 12 qualitative research articles are reviewed and analyzed by both authors. It has been under Friberg (2012) recommendations for analysis. Articles that are used from Cinahl and PubMed are published between 2005-2015.

    Results: Seven major themes were identified: "To feel that you can´t get air", "To feel weakness", "To feel socially isolated", "To feel guilt and shame", "To feel fear", "To feel dependent" and "To feel meaningfulness and affinity".

    Conclusion: Living with COPD have a big impact on daily life. This means that persons often become increasingly socially isolated in their homes. They experience a shrinking life-world, they adapt life after the disease.

  • 277.
    Karlsson, Malin
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Rydberg, Magdalena
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Äldre sköra personer söker främst akutvård?: erfarenheter av kontakt med akutmottagningen.2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Two million of Sweden’s population is 65 years of age or older and the number is increasing. Elderly patients are more frequent users of the emergency department. Forty percent of the visitors in the emergency department are represented by this patient category. Nurses need to understand how individual experiences of care might affect the next visit for the patient. Frail elderly has limited resources to spare and the emergency department is not suited for them. Nurses need to see how they can change and/or adapt to fulfil the needs of this group. The need for knowledge is always a requirement for nurses.

    Aim The purpose of this study was to describe frail elderly person´s experiences of the emergency department.

    Method The method was a literature-based study based on the analysis of nine qualitative studies.

    Results Three main themes emerged in the results; accessibility of the emergency department, experiences leading to seek care in the emergency department and moments that has affected the experience of the emergency department. Experience of the emergency department was also affected by the patient’s health-literacy.

    Conclusion The quality of care, the past experience of care and the accessibility to comprehensive care were factors that influenced why frail elderly choose to seek non urgent treatment in the emergency department, even though they knew they would have to wait. The main reason for seeking care in the emergency department was based on the experience of convenience.

  • 278.
    Karlsson, Margareta
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    The struggle of health care providers to reconcile as human beings in end-of-life care2018In: 39th Annual International Association for Human Caring (IAHC) Conference in Minneapolis, Minnesota, USA May 30th through June 1st 2018., 2018Conference paper (Other academic)
  • 279.
    Karlsson, Margareta
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Vidrörd av livet i dödens närhet: Att varda som människa och vårdare i vårdandets gemenskap2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the study is to create a theory model of "becoming" as a human being and health care provider in the caring communion at the end-of-life. The theoretical perspective of the study is caring science as it is developed at Åbo Academy University in Finland outlined in Eriksson's theory of caritative caring with focus on caring ethics. The thesis consists of four sub-studies reported as scientific articles and a summary section. The study has an overarching hermeneutic research approach. The sub-studies I-IV are reinterpreted from viewpoint of the overall question. Empirical assumptions could then be discerned from the substance of the four substudies, which raised questions. The answers to these questions were sought in dialogue with selected texts by Kierkegaard and resulted in a theory model. The theory model results in following theses: 1. To "become" as a human being is to remain in an endless guilt. Guilt is a form of love. It is guilt that give strength and willingness to act in love and mercy when caring for patients at the end-of-life. The guilt as love allows becoming as a human being to be at home in love and mercy. 2. The human being's courage is characterized as the willingness to obtain contact with the life of fellow human beings. This courage develops over time to stand for itself, with a foundation of belief in human beings, and resulting in a selfless, loving way to help the patients grieve and reconcile at the end-of-life. 3. To be "touched" can be illustrated as an inner awakening; an inner movement towards consciousness for the examination of the love for one another, and to love unselfishly. 4. The human being's evolution in its own understanding of life occurs in the care of another human being who is at the end-of-life, as well as to be at home in ethos, love and mercy. Becoming in this context means that the human being evolves to become responsive to the heart's inner voice; an inner strength and joy which opens to the eternal and holy. 5. To overcome external obstacles is characterized as serving human beings in a selfless love; a caring in love that has requirements that need to be expressed by what is true, beautiful and good for patients at the end-of-life. An awareness and understanding of what it means to become as a human being and health care provider in caring community can help health care providers to easily focus on the patient.

  • 280.
    Karlsson, Margareta
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hedemalm, Azar
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Berggren, Ingela
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Assessment and decision-making of Swedish primary care nurses in relation to the use of interpreters2017In: Journal of Health Visiting, ISSN 2050-8719, Vol. 5, no 9, p. 454-460Article in journal (Refereed)
    Abstract [en]

    Communicating with immigrants in primary care can be a challenge for nurses who must assess language proficiency and decide whether to use an interpreter. The aim of this study was to examine primary care nurses’ experiences of assessment and decision-making in relation to the use of interpreters. A qualitative inductive research design was chosen and nurses with experience of professional interpreters were recruited for focus group interviews. The study results showed that primary care nurses respected immigrants as human beings and recognised their right to decline an interpreter in sensitive situations. The purpose of primary care nurses’ experiences of assessment and decision-making in relation to the use of interpreters was ensuring patient safety, the importance of reciprocal information and respect for patient autonomy.

  • 281.
    Karlsson, Margareta
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Karlsson, Ingrid
    Capio Läkarhus Almö, Myggenäs, Sweden.
    Follow-up visits to older patients after a hospital stay: nurses' perspectives.2019In: British Journal of Community Nursing, ISSN 1462-4753, E-ISSN 2052-2215, Vol. 24, no 2, p. 80-86Article in journal (Refereed)
    Abstract [en]

    Older patients with multimorbidity and extensive healthcare needs are at risk of frequent readmission to hospital after discharge. With a Swedish report entitled 'Follow-up 48-72' as its basis, the present study aimed to describe nurses' experiences of follow-up visits to older patients with multimorbidity 48 to 72 hours after discharge from hospital. Semi-structured interviews were conducted with 10 nurses experienced with such home visits to older patients, and the material was analysed by qualitative content analysis. The results indicate that such visits by nurses can relieve patient anxiety, as patients are often unsure of the next steps, in terms of medication and care. According to the nurses, these visits created trust in the nurse-patient relationship and ensured patient safety. Follow-up visits soon after discharge from hospital should become a part of routine nursing, especially for older people with multimorbidity.

  • 282.
    Karlsson, Margareta
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Kasén, Anne
    Faculty of Professional Studies, NordUniversity, Bodø, Norway .
    Health care providers becoming as human beings in end-of-life care: a tentative theory model2017In: The 15th World Congress of the European Association for Palliative Care (EAPC): Abstracts, Hayward Medical Communications, 2017, p. 853-853, article id P02-172Conference paper (Refereed)
    Abstract [en]

    Aim: The aim is to elucidate dimensions in a tentative theory model of health care providers becoming as human beings in end-of-life care. Health care providers as fellow human beings are vulnerable and caring for patients at the end-of-life is usually something that not goes without a trace for health care providers. The awareness of death can give meaning and understanding of one's own life. Health care providers' existential situation has received small extent of attention. Design, methods and approach: A caring science perspective based on Eriksson's theory of caritative caring, was used to reveal dimensions of health care providers becoming as human beings. The material consists of two substudies with interviews, one meta-synthesis and three focus groups interviews with a total of 1635 nurses. In the interpretation of the material a hermeneutic overall approach was chosen. Result: The theory model indicates that health care providers in a caring communion in end of-life allows contact with life and oneself as human beings. It is an inner awakening for health care provider as human beings, an inner movement to the awareness to be able to love unselfishly in the caring of patient. When health care providers get contact with life and oneself as human beings they struggle to be reconciled with their own life situations. Becoming, as human beings can be revealed as an understanding of life and feelings of inner strength and happiness as human beings and as health care providers in end-of-life care. Conclusion: The dimensions of the theory model can give a deeper understanding of health care providers becoming as human being. In caring community health care providers can experiencing difficult situations where there inner as human beings will be touched and existential questions raises about health and suffering, dying and death. Becoming as human beings and health care providers in caring communion is to be at home in ethos, love, charity and reconciliation.

  • 283.
    Karlsson, Margareta
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level. Department of Caring Science, Åbo Academy University.
    Kasén, Anne
    Åbo Academy University, Department of Caring Science and Faculty of Professional Studies, Nord Universitet, Bodø.
    Wärnå-Furu, Carola
    Åbo Academy University, Department of Caring Science.
    Reflecting on one's own death: the existential questions that nurses face in end-of-life care2017In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 15, no 2, p. 158-167Article in journal (Refereed)
    Abstract [en]

    When registered nurses care for patients at the end of life, they are often confronted with different issues related to suffering, dying, and death whether working in hospital or community care. Serious existential questions that challenge nurses' identities as human beings can arise as a result of these situations. The aim of our study was to describe and gain a deeper understanding of nurses' existential questions when caring for dying patients. Focus-group interviews with registered nurses who shared similar experiences and backgrounds about experiences in end-of-life care were employed to gain a deeper understanding about this sensitive subject. Focus-group interviews were performed in hospice care, in community care, and in a palliative care unit in western Sweden. A qualitative hermeneutic approach was employed to interpret the data. Nurses' existential questions balanced between responsibility and guilt in relation to their patients, between fear and courage in relation to being professional caregivers and fellow human beings, and between hope and despair in relation to the other's and their own death. Nurses in end-of-life care experience various emotions from patients related to things physical, spatial, and temporal. When nurses encounter these emotions as expressing a patient's suffering, they lead to challenges of balancing between different feelings in relation to patients, as both professional caregivers and fellow human beings. Nurses can experience growth both professionally and as human beings when caring for patients at the end of life.

  • 284.
    Karlsson , Maria-Therese
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Tausis Bryngelsson,, Malin
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patienters erfarenheter av att leva med förmaksflimmer2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: atrial fibrillation is increasing in the society and approximately 300 000 people in Sweden has the disease. Atrial fibrillation gives symptoms that can be scary and disturbing. The feeling that the heart is racing and lack of energy contributes to a negative experience that affect the everyday life of these patients. It keeps them from traveling, exercising, meeting friends and even going to the grocery store. Patient's with atrial fibrillation is at great risk of having a stroke, due to thrombosis building up in the atrium, which is why most of them use antikoagulantia on a daily basis. This treatment requires regular visits to the hospital and adherence to medication, diet, alcohol use and exercise.

    Aim: the aim of this study was to describe patients' experiences of living with atrial fibrillation.

    Method: a five-step model was used to analyse ten scientific articles in this literature-based study.

    Results: three main-themes emerged during the analysing process. The first was symptoms negatively affect the daily life; both physical and psychological symptoms were described. The second theme focused on patient's thoughts about their lack of knowledge of disease and treatment. Here two subthemes were described, adjustments to their own body and insecurities about treatment. The third main-theme describes that patients need more support from the nurse. Subthemes were that health professional's lack of knowledge increase patients' insecurity, involvement in the decision-making process, and person-centred care gives patients comfort and control.

    Conclusion: patients with atrial fibrillation lack knowledge about their disease. Many were unaware of symptoms and that lead to delayed care and treatment, and causing a risk for stroke. Furthermore, the symptoms caused the patients' pain, anxiety and limited them in their daily life. In encounters with the nurse, a person-centred care with individually adjusted information to each patient lead to security for the patient, which positively affects the experience of living with atrial fibrillation.

  • 285.
    Karlsson, Sofie
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Björkgren, Victoria
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Hur sjuksköterskan kan lindra smärta, oro och rädsla för barn under venpunktion: En litteraturöversikt2020Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Venipuncture is one of the most painful procedures that a child goes through in the medical care which creates both pain, anxiety and fear. Non-pharmacological interventions are not used enough to alleviate the children's suffering. This is why it is important for the nurse to be aware of which non-pharmacological intervention that is effective to practice during venipuncture.

    Aim: The aim of the study was to describe how the nurse can alleviate pain, anxiety and fear by using non-pharmacological interventions in children ages 0-12 years during venipuncture.

    Method: A literature review was cunducted based on both quantitative and qualitative research. Eighteen articles were analysed and critically reviewed.

    Results: The results revealed two main themes supportive interventions during venipuncture and distraction interventions during venipuncture following five subthemes. The result showed that the nurse can alleviate pain, anxiety and fear in children during venipuncture by an age-appropriate information, play with the child and use different methods to make the child feel secure. The result also showed that the nurse can use both active and passive distraction to alleviate pain, anxiety and fear in children during venipuncture.

    Conclusion: The main finding was that the nurse should use both supportive interventions to create security and distraction which is an effective method to reduce pain, anxiety and fear through making the child focus on something else than the venipuncture. It is important that the non-pharmacological interventions are adapted according to each child's needs.

  • 286.
    Kisch, Annika M
    et al.
    Department of Haematology, Skåne University Hospital, Lund, Sweden.
    Forsberg, Anna
    Lund University, Institute of Health Sciences Lund, Sweden..
    Fridh, Isabell
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden..
    Almgren, Matilda
    Lund University, Institute of Health Sciences ,Lund, Sweden.
    Lundmark, Martina
    Lund University, Institute of Health Sciences ,Lund, Sweden.
    Lovén, Charlotte
    Transplant Unit, Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden..
    Flodén, Anne
    Transplant Unit, Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden..
    Nilsson, Madeleine
    Department of Neurology, Psychiatry and Habilitation, Queen Silvia's Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden..
    Karlsson, Veronika
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Lennerling, Annette
    Department of Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden.
    The Meaning of Being a Living Kidney, Liver or Stem Cell Donor: A Meta-Ethnography2018In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 102, no 5, p. 744-756Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Studies on living donors from the donors' perspective show that the donation process involves both positive and negative feelings involving vulnerability. Qualitative studies of living kidney, liver, and allogeneic hematopoietic stem cell donors have not previously been merged in the same analysis. Therefore, our aim was to synthesize current knowledge of these donors' experiences in order to deepen understanding of the meaning of being a living donor for the purpose of saving or extending someone's life.

    METHODS: The meta-ethnography steps presented by Noblit & Hare in 1988 were used.

    RESULTS: Forty-one qualitative studies from 1968 to 2016 that fulfilled the inclusion criteria were analyzed. The studies comprised experiences of over 670 donors. The time since donation varied from 2 days to 29 years. A majority of the studies, 25 out of 41, were on living kidney donors. The synthesis revealed that the essential meaning of being a donor is doing what one feels one has to do, involving 6 themes; A sense of responsibility, Loneliness and abandonment, Suffering, Pride and gratitude, A sense of togetherness, and A life changing event.

    CONCLUSION: The main issue is that one donates irrespective of what one donates. The relationship to the recipient determines the motives for donation. The deeper insight into the donors' experiences provides implications for their psychological care.

  • 287.
    Klang, Mikaela
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Overbridging linguistic barriers in Namibian healthcare2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Namibia there are a lot of different native languages even if the official language is English. Since communication is an important tool for nurses and studies about communication across language barriers mostly is done in western countries, there is need for more knowledge regarding the nurse's experience with language barriers in multilingual and multicultural context, like Namibia. Aim: To describe the experiences of Namibian nurses caring for patients who speak another native language. Method: Qualitative interviews were held with four nurses and one student nurse at Katutura State hospital in Windhoek, Namibia. Results: Two themes with subthemes were identified in the results. The first theme, Establishing the patient-nurse relationship, describes the importance of trust for communication and what the interviewees found important when creating a bond with the patient. The other theme, Establishing the communication, describes the importance of interpretation and how they tackled the language barrier. Conclusion: When meeting a patient with another native language it is of great importance to establish trust with the patient and that interpreters are used. The use of sublingual nurses, who found interpreting to be a natural part of their work, was beneficial.

  • 288.
    Kopsch, Andreas
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Wetterhamn, Alexander
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patienters erfarenheter av psykiatrisk tvångsvård: en litteraturbaserad studie2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When a person suffers from mental illness, involuntary hospital admission can be necessary as a protection from self-harm or from hurting others. Involuntary hospital admission is often the last resort to help a patient. Patients who have been cared for involuntarily sometimes experience a lack of communication and information during the care. Many of these patients may need it several times during their lives. Individual action plans on how the caregiver should act could help the patient and help to minimize the patients' negative experiences of the care under compulsory admission.

    Aim: The aim of this study was to highlight patients' experiences of involuntary psychiatric care.

    Method: A literature-based study with the aim to contribute to evidence-based care with an analysis based on qualitative research were used. Ten scientific qualitative articles were analyzed.

    Results: The results showed a mix of positive and negative emotions and experiences of being under involuntarily psychiatric care which are described under two main themes: To be given space as an individual and Having a mutual partnership.

    Conclusion: Patients often felt powerless, uninformed and like their voice is not being heard. Lack of information was the biggest problem experienced by patients that resulted in a negative experience. Patients want their family to be included in the planning of their care. Patients' negative experiences could be reduced by further education for staff and by working person-centered.

  • 289.
    Krasniqi, Sabina
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Kumlin, Siri
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Sjuksköterskans möten med suicidala patienter i vården: En litteraturöversikt2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Suicide is a global public health problem and is one of the ten most common causes of death in the world. In Sweden, suicide is the most common cause of death for men and the second leading cause of death for women. Each year about 1100 persons commit suicide in Sweden, which are about three suicides a day. Suicidal patients occur in all health care, which explains why it is important for nurses to have adequate knowledge about this patient group. Aim: The aim was to describe nurses’ encounters with suicidal patients within care. Method: This literature review was conducted in accordance to Friberg. Nine scientific articles were included and have been analyzed to constitute the result. The analysis resulted in three categories and seven sub-categories. Results: The categories that emerged were: Attitudes matters, Feelings arise, and the Importance of being awarded. The sub-categories that emerged were: Attitudes that affect care, attitudes that affect the relationship, mixed feelings, hopelessness, insufficiency, assessment of the patient´s condition and observe risk assessments.  Conclusion: The result showed that different feelings of the nurse arose during the encounter with suicidal patients. Nurses’ attitudes that emerged from the encounter with suicidal patients were dependent on age, experience and education level. The more education and experience the nurse had, the more positive the attitude towards suicidal patients. It was revealed that nurses created a relationship with patients in the encounter and that the conditions for the relationship depended on the nurse’s approach.

  • 290.
    Kristensen, Erika
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Petersson, Lise-Lotte
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Närståendes erfarenheter av att leva med en person under 65 år som har en demenssjukdom: En litteraturbaserad studie med kvalitativ ansats2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden approximately 10 000 people under 65 years of age suffer from dementia. Dementia means pathological changes in the brain. It is a chronic condition that worsens over time. As a great share of the care is provided by family members, it becomes a strain for them and can have negative effects. It is therefore of importance to highlight the experiences of family members in order to promote health and ease suffering.

    Aim: The aim was to highlight the experiences of family members living with a person under 65 years of age suffering from dementia.

    Method: A method to contribute to evidence-based nursing with ground in analysis of qualitative research was performed. Eight scientific articles were analyzed according to Friberg's (2012) qualitative content analyze in five steps.

    Results: The result of the study showed two themes. The first theme; Life changes with three subthemes; Changed family roles, Changed social relationships and Being in need of information and support. The second theme; Increased strain also with three subthemes; To experience stress, To have coping strategies and To worry about the future.

    Conclusion: The study revealed that experienced great changes and were in great need of support as well as information. They experienced different kinds of stress and this affected their daily lives. The nurse needs knowledge and experience in order to meet these and to best promote health and ease suffering.

  • 291.
    Kristensson, Erika
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Johansson, Linda
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    När livet närmar sig slutet: Patienters erfarenheter2019Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Each year about 90 000–100 000 people die in Sweden, the majority of these people are in need of palliative care. Nurses have a responsibility to ensure that patients’ keeps the dignity. Knowledge about patients’ experiences of palliative care are of great importance for the nurse to be able to meet their individual needs and desires. Aim: The aim of this study was to highlight adult patients’ experiences of being in palliative phase. Method: A literature study with the aim to contribute to evidence based care with an analysis based on qualitative research were used. Seven scientific articles were analyzed. Results: The results showed that patients in a palliative phase felt a need of being involved in their care, to make their own choices and to be heard. Many patients felt like a burden to their family, and found it difficult to ask for help. The lack of independency in the end of life was central, and the patients experienced that in different ways. Also, the spiritual and existential questions emerge to the patients, leaving them in acceptance of the situation, or the opposite – to find it hard to accept the fact that this was the end. Conclusions: Patients in a palliative phase is part of a multi-dimensional context. As a nurse, working personcentered creates a good foundation for being able to apply holistic nursing, relieving suffering and promoting a dignified death, given the patient’s individual needs.

  • 292.
    Kruslind, Annika
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Upplevelser av att vara syskon till ett barn med cancer: En litteraturbaserad studie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    When a child is ill with cancer family members are affected by grief and anxiety and siblings are not prepared to cope with the situation. Siblings to a child with cancer have a higher risk of reduced well-being. It is important that nurses and society gain an understanding of siblings' experiences when a brother or sister is ill with cancer and how it impacts their lives.

    The aim of the study was to illuminate siblings' lived experiences when a child in the family gets cancer.

    This study is a literature review based on results from ten qualitative scientific articles, which have been analyzed through a method of five steps according to Friberg.

    The overall theme of the result is 'The whole world has been turned upside down' which symbolizes the siblings´ overall experience that their entire existence suddenly became different. The result consists of four main themes and twelve sub themes. The main themes are ´An emotional rollercoaster', 'Just being the one standing behind the stage´, ´Trying to cope´ and ´Life on my own is shaken´.

    Conclusions are that siblings need support and information and have a desire to be included in the cancer situation and in the care of the sick child. The nurse has an important and central role in reducing the suffering of siblings and improving their health.

  • 293.
    Krusmon, Hanna
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Ljungqvist, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Barns och vuxna barns upplevelser av att växa upp med en förälder med alkoholproblematik: en litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In a worldwide perspective the alcohol consumption is high, which can lead to problems for both the individual and the society. The alcohol consumption in Sweden is rife and a big part of the population has an intense consume of alcohol. Many children in Sweden is living in a household were risk consumption exists which can have a negative impact on children. This study proceeds from a child perspective because children's experiences need to be noticed. Aim: The purpose of this study was to describe how children and adult children experience a growth with a parent with an alcohol problem. Method: A literature review was used as a method and data was collected by systematic and unsystematic searches that resulted in eight articles, both qualitative and quantitative. Results: The result consists of four themes including "A lost childhood", "To live with exposedness", "The life situation creates own coping strategies" and "The support matters", including ten subthemes: "Take on an adult role", "Shame and guilt", "Abandonment", "Insecurity", "Violence", "Make distance", "Confide in someone", "Confront and acting out", "Inner problem-solving methods", "Relations that helps" and "When the support is missing". Conclusion: A life situation with a parent with an alcohol problem is difficult and a great burden for a child. The results of this study can lead to better meetings with children in exposed situations because professionals can increase knowledge and understanding about children's experiences.

  • 294.
    Kuti, Alexandra
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Jussinoja, Susanna
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patienters erfarenheter av att leva med kronisk obstruktiv lungsjukdom2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Chronic obstructive pulmonary disease (COPD) is an irreversible progressive disorder that affects the pulmonary ventilation. The disease causes suffering and makes it difficult to handle everyday life. COPD is a fatal disease and the leading cause of developing the disease is smoking. The nurse's role is to individualize nursing care and alleviate the suffering of the patient and to promote a healthy lifestyle through encouragement and sharing knowledge. Aim: The aim of this study was to illuminate patients’ experiences of living with COPD. Method: A method aimed to contribute to evidence-based nursing care based on analysis of qualitative research, was used. The data was collected from two databases and ten scientific articles were analysed. Results: The analysis resulted in four categories: adjust the life after the disease, alienation from the "healthy world", guilt and shame for the disease and emotional affection. Twelve subcategories were revealed. The main result shows that the experience of anxiety was associated with inability to get air. Patients felt guilt and blame for inflicting the disease on themselves, due to previous smoking. Physical symptoms of the disease caused constraints, leading to social isolation and loneliness, and strategic planning of everyday life. This put patients in a position of dependence on other people. Conclusion: The conclusion shows that support from the community is important for patients with COPD and that the environment shows an understanding that the disease is affecting patients’ lives and daily living. Community and a sense of coherence affected patients in a positive way. It was revealed that the patient's self-confidence and self-care capacity is strengthened when the nurse provides support and involve the patients in their own care.

  • 295.
    Kuusela, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Olsson, Sara
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Erfarenheter av bemötande i skolan hos elever med ADHD diagnos2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: ADHD is a neuropsychiatric diagnosis that has increased in recent years. When students start school and the requirements to be able to concentrate increases visibility students with ADHD clearer. Students' perceptions of the school environment is affected by the school's response. Aim and method: The aim of this literature review is to describe experiences of being treated at school as a student with an ADHD diagnose. Results: Students' experiences was affected by the response of teachers and classmates depended on if their approach were friendly or not. Students experienced non friendly approach as an insult. They feel lower self-esteem, became sad and angry, they got worse outcomes, feel excluded when replaced in remedial classes. When teachers and classmates were friendly in their approach students could experience joy and happiness, they understood the instructions better and had they felt like there was in the group. An important part of the experience was also due to how much knowledge the teachers had about the diagnosis, what demands they made and how the school environment in general looked. Students' perception was that the teachers with more knowledge had better approach which also classmates embraced and student feelings became less stressful and that feeling of exclusion reduced. Conclusion: This study provides a deeper understanding of how students with ADHD experience their education and treatment in their school enviroment. These findings may be useful in the school environment, by health care and other care contexts.

  • 296.
    Kämper, Benedikt
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Kämper, Mona
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Personers upplevelser av att leva med Diabetes Mellitus typ 22016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes Mellitus Type 2 is a common disease which can be found all over the world. Diet and inactivity are common reasons to Diabetes Mellitus Type 2. The main treatment of this disease includes changes in lifestyle in terms of healthier food and physical activity. These lifestyle changes can be difficult to integrate in people's life and may cause emotional struggles. Aim: The aim of the study was to illuminate persons' experience of living with Diabetes Mellitus Type 2. Method: This is a study with a literature-based method. This method type has been used to illuminate life experience of persons with diabetes. To achieve this goal a content analysis in five steps has been selected, the analysis resulted in four themes and eight subthemes. Result: The result showed that Diabetes Mellitus Type 2 have a great influence in peoples life. People experienced an ongoing fight in their daily-life, they gain control, they can see a light in the darkness and they begin to understand how to live with the disease. Conclusion: The conclusion is that an integration of the disease was very important. A successful integration of the disease in a person's life was the key factor to recreate a normal everyday life, which was important to gain a feeling of health.

  • 297.
    Kängström, Ann-Caroline
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Majberger Klemetz, Sara
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Vad väntar jag på? Äldre patienters erfarenheter av att besöka akutmottagningen: En litteraturbaserad studie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background The older population in Sweden is increasing. In order to meet the growing needs of this patients it´s important to identify the areas for improvement. Aim The aim of this study was to describe elderly patients' experiences of visiting the emergency department. Method A method to contribute to evidence-based nursing based on qualitative research was used. An analysis of seven qualitative articles was carried out.

    Results The analysis resulted in three main themes and six subthemes. The main themes were a feeling of not being seen, a feeling of being exposed and being cared for. Conclusion The result of our study showed that older patients often are dissatisfied with the care given at the emergency department. Though some patients are satisfied with their received care. Our conclusion is that the emergency departments' care of older patients need to improve.

  • 298.
    Körle, Anna
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Jensen, Lars
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Patienters upplevelser av postoperativ smärta och smärtlindring: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Approximately 2,8 million surgical procedures were performed in Sweden 2016. After surgery, patients experienced different degrees of postoperative pain. Under treated postoperative pain created great suffering for patients, delayed the recovery after surgery and could increase the risk of complications. Therefore, it is of importance to explore and describe patients’ experiences regarding pain in conjunction with surgery, in order to improve postoperative pain relief from a nursing perspective. Aim: To describe how patients experience postoperative pain and pain relief. Method: A literature review was conducted in which four qualitative studies and three quantitative studies were included. The studies were subjected to assurance of quality and Friberg’s three-step analysis was used. Results: Two categories and eight subcategories emerged. The two categories were (1) The time before surgery and (2) The time after surgery. The categories illustrated how patients experienced postoperative pain and pain relief before and after surgical procedures. Conclusion: Patients had previous experiences, expectations, knowledge and beliefs about postoperative pain and pain relief that affected their experiences before surgery. After the procedure, patients' difficulty in communicating, their participation, the attitudes of healthcare professionals and the degree of attendance of the nurse were important experiences related to postoperative pain and pain relief.

  • 299.
    Landgren, Ellen
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Niklasson, Ann-Louise
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Det dagliga livet efter en stroke: Erfarenheter från vuxna under 65 år2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year the number of young and middle-aged persons who receive stroke are increasing. Stroke is often considered as a disease of old people. A stroke often leads to changes in life. The consequences can be cognitive impairments and movement disabilities. These consequences can have a high impact of the person's life.

    Aim: The aim was to describe experiences of daily life after a stroke from the perspective of adults younger than 65 years old.

    Method: To analyze data, Friberg's (2012) method aimed to contribute to evidence-based care based on analyzing qualitative research, was used. Ten scientific articles were chosen and analyzed.

    Results: The result showed that adults younger than 65 who suffered from a stroke experiences a lot of difficulties in life afterwards. The analyze process generated four categories and nine subcategories. The four categories are "an altered work situation", "lack in rehabilitation", "to loose myself", "difficulties in social meetings".

    Conclusion: The study showed that rehabilitation is very important for adults younger than 65 who suffered from a stroke. Their experiences showed a lack in rehabilitation when it comes to their age category. To go back to work, live family life and participate in other social events is important. It's different to suffer from a stroke at younger age when it comes to their needs. Health staff should be aware of these needs.

  • 300.
    Larson, Sara
    et al.
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Lundin, Emelie
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Stickrädsla: sjuksköterskans bemötande för att minska vuxna patienters stickrädsla inom akutsjukvård.2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When an adult suffers from fear-of-needles he is anxious and fearful of needle injections. Fear–of needles is common and can be caused by previous negative needle experiences. The nurse is responsible to have a holistic view of the patient to be able to judge the need of care and ease the suffering.

    Aim: The aim is to describe the nurse's treatment of adult patients with needle fear in emergency care.

    Method: A literature-based study consisting of two qualitative and nine quantitative papers was performed. The themes where defined and categorized into one main theme.

    Results: The main theme was: Treatment that reduces fear-of-needles. The five subthemes were: the importance of being understood, the importance of having control, treatment options when fear-of needles is pain caused, importance of communication and importance of care environment.

    Conclusion: The nurse needs to be aware of fear-of-needles and possible methods of care when it comes to needle injections of adults. Pain relieving methods that do not yet exist in Sweden were found. It is important that the nurse uses different treatments like communication, distraction, person oriented care and give the patient opportunity to choose different care methods like cooling spray and EMLA to reduce the pain for patients suffering from fear-of-needles.

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