PURPOSE: This study aimed to explore correlations between insulin-degrading enzyme (IDE) and markers of metabolic function in a group of patients diagnosed with type 2 diabetes mellitus (T2DM) or Alzheimer's disease (AD) and metabolically healthy volunteers.

METHOD: We included 120 individuals (47 with T2DM, 9 with AD, and 64 healthy controls). Serum levels of IDE were measured with commercial kits for ELISA. Differences in IDE levels between groups were analyzed with non-parametric ANCOVA, and correlations were analyzed with Spearman's rank correlations. We also investigated the influence of age, sex, and the use of insulin on the correlation using a non-parametric version of partial correlation.

RESULTS: Patients diagnosed with T2DM had higher IDE levels than patients diagnosed with AD and healthy controls after adjustment for age and sex. IDE was increasingly associated with body mass index (BMI), fasting blood glucose, C-peptide, hemoglobin A1c (HbA1c), insulin resistance, and triglycerides. In stratified analyses, we found a decreasing partial correlation between IDE and HbA1c in patients diagnosed with AD and a decreasing partial correlation between IDE and C-peptide in healthy controls. In patients diagnosed with T2DM, we found no partial correlations.

CONCLUSION: These results indicate that IDE is essential in metabolic function and might reflect metabolic status, although it is not yet a biomarker that can be utilized in clinical practice. Further research on IDE in human blood may provide crucial insights into the full function of the enzyme.

BACKGROUND: Movement behaviours, such as sedentary behaviour (SB) and moderate to vigorous physical activity (MVPA), are linked with multiple aspects of health and can be influenced by various pain-related psychological factors, such as fear of movement, pain catastrophising and self-efficacy for exercise. However, the relationships between these factors and postoperative SB and MVPA remain unclear in patients undergoing surgery for lumbar degenerative conditions. This study aimed to investigate the association between preoperative pain-related psychological factors and postoperative SB and MVPA in patients with low back pain (LBP) and degenerative disc disorder at 6 and 12 months after lumbar fusion surgery.

METHODS: Secondary data were collected from 118 patients (63 women and 55 men; mean age 46 years) who underwent lumbar fusion surgery in a randomised controlled trial. SB and MVPA were measured using the triaxial accelerometer ActiGraph GT3X+. Fear of movement, pain catastrophising and self-efficacy for exercise served as predictors. The association between these factors and the relative time spent in SB and MVPA 6 and 12 months after surgery was analysed via linear regression models, adjusting for potential confounders.

RESULTS: Preoperative fear of movement was significantly associated with relative time spent in SB at 6 and 12 months after surgery (β = 0.013, 95% confidence interval = 0.004 to 0.022, p = 0.007). Neither pain catastrophising nor self-efficacy for exercise showed significant associations with relative time spent in SB and MVPA at these time points.

CONCLUSIONS: Our study demonstrated that preoperative fear of movement was significantly associated with postoperative SB in patients with LBP and degenerative disc disorder. This finding underscores the potential benefits of preoperative screening for pain-related psychological factors, including fear of movement, preoperatively. Such screenings could aid in identifying patients who might benefit from targeted interventions to promote healthier postoperative movement behaviour and improved health outcomes.

BACKGROUND: Integrating evidence-based midwifery practices improves healthcare quality for women and newborns, but an evidence-to-practice gap exists. Co-created quality improvement initiatives led by midwives could bridge this gap, prevent resource waste and ensure intervention relevance. However, how to co-create a midwife-led quality improvement intervention has not been scientifically explored.

OBJECTIVE: The objective of this study is to describe the co-creation process and explore the needs and determinants of a midwife-led quality improvement targeting evidence-based midwifery practices.

METHODS: A qualitative deductive approach using the Consolidated Framework for Advancing Implementation Science was employed. An analysis matrix based on the framework was developed, and the data were coded according to categories. Data were gathered from interviews, focus group discussions, observations and workshops. New mothers and birth companions (n = 19) were included through convenience sampling. Midwives (n = 26), professional association representatives, educators, policymakers, managers, and doctors (n = 7) were purposely sampled.

RESULTS: The co-creation process of the midwife-led Quality Improvement intervention took place in four stages. Firstly, core elements of the intervention were established, featuring a group of midwife champions leading a quality improvement initiative using a train-the-trainers approach. Secondly, the intervention needs, context and determinants were explored, which showed knowledge and skills gaps, a lack of shared goals among staff, and limited resources. However, there was clear relevance, compatibility, and mission alignment for a midwife-led quality improvement at all levels. Thirdly, during co-creation workshops with new mothers and companions, the consensus was to prioritise improved intrapartum support, while workshops with midwives identified enhancing the use of birth positions and perineal protection as key focus areas for the forthcoming Quality Improvement intervention. Lastly, the findings guided intervention strategies, including peer-assisted learning, using existing structures, developing educational material, and building stakeholder relationships.

CONCLUSIONS: This study provides a practical example of a co-creation process for a midwife-led quality improvement intervention, which can be relevant in different maternity care settings.

PURPOSE: To examine differences in health-related quality of life (HRQoL) between native and foreign-born gynaecological cancer patients in Sweden, taking into account clinical, demographic, and socioeconomic factors.

METHODS: The 30-item European Organisation for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) and a study-specific questionnaire covering demographic and socioeconomic factors were answered by 684 women aged ≥ 18 years old, diagnosed in 2014, 2016, or 2018 with gynaecological cancer in the Stockholm-Gotland health care region, Sweden. Clinical data were obtained from the Swedish Cancer Register. Data were analysed using the Kruskal-Wallis test and linear regression.

RESULTS: The women had a mean age of 65.4 years, with 555 (81.1%) born in Sweden, 54 (7.9%) in other Nordic countries (ONC), 43 (6.3%) in other European countries (OEC), and 32 (4.7%) in non-European countries (NEC). HRQoL differed significantly between the four groups for 14 of the 15 QLQ-C30 scales/items. On average, Swedish-born women scored 2.0, 15.2, and 16.7 points higher for QoL/functioning scales/items and 2.2, 14.1, and 18.7 points lower for symptom scales/items, compared with ONC-, OEC-, and NEC-born women, respectively. In adjusted analyses, none of the differences between Swedish-born and ONC-born women were significant, while for OEC- and NEC-born women the differences were significant for most QLQ-C30 scales/items.

CONCLUSION: HRQoL differs between native and foreign-born gynaecological cancer patients in Sweden, with lower HRQoL the further from Sweden the women are born. A more individualised cancer care, with tailored support to optimize HRQoL is needed for this vulnerable group of patients.

AIM: With an interest in providing knowledge for person-centred care, our overall goal is to contribute a greater understanding of diversity among patients in terms of their preparedness before and up to six months after colorectal cancer surgery. Our aim was to describe and provide a tentative explanation for differences in preparedness trajectory profiles.

MATERIAL AND METHODS: The study was explorative and used prospective longitudinal data from a previously published intervention study evaluating person-centred information and communication. The project was conducted at three hospitals in Sweden. Patient-reported outcomes measures, including the Longitudinal Preparedness for Colorectal Cancer Surgery Questionnaire, were collected before surgery, at discharge, and four to six weeks, three months, and six months after surgery. Clinical data were retrospectively obtained from patients' medical records. We used latent class growth models (LCGMs) to identify latent classes that distinguish subgroups of patients who represent different preparedness trajectory profiles. To determine the most plausible number of latent classes, we considered statistical information about model fit and clinical practice relevance. We used multivariable regression models to identify variables that explain the latent classes.

RESULTS: The sample (N = 488) comprised people with a mean age of 68 years (SD = 11) of which 44% were women. Regarding diagnoses, 60% had colon cancer and 40% rectal cancer. The LCGMs identified six latent classes with different preparedness for surgery and recovery trajectories. The latent classes were predominantly explained by differences in age, sex, physical classification based on comorbidities, treatment hospital, global health status, distress, and sense of coherence (comprehensibility and meaningfulness).

CONCLUSION: Contrary to the received view that emphasizes standardized care practices, our results point to the need for adding person-centred and tailored approaches that consider individual differences in how patients are prepared before and during the recovery period related to colorectal cancer surgery.

Background

Bipolar disorder affects about two percent of the world population yearly which causes suffering for many people. Bipolar disorder affects one’s entire life and can lead to negative consequences for one's life situation. The disease implies both a psychosocial disability and a reduced work ability. Patients with bipolar disorder have a vast and varied need for nursing care and it’s important to shine a light on these patients’ experiences to improve future nursing care. 

Aim

The aim of this study was to describe patients’ experiences of nursing care for bipolar disorder in psychiatric inpatient and outpatient care. 

Method

This study was a non-systematic literature review based on 15 scientific articles with a qualitative approach, found in the databases PubMed and CINAHL. Sophiahemmet University’s assessment basis for scientific classification and quality has been used to review the articles’ quality. The results from the articles have been compiled and analysed using integrated data analysis. 

Results

In the result compilation three main categories were identified; experiences of interpersonal interaction, experiences of nurses in the care environment and experiences of receiving support to promote recovery. The three main categories were divided into seven subcategories. The result showed that care relationships, characteristics of the nursing staff and receiving personalized care based on individual needs were significant in terms of patients’ experiences of psychiatric nursing care and their recovery. 

Conclusions

From analyzing the result it is evident that care relationships, characteristics of the nursing staff, and receiving personalized care based on individual needs all affect each other and the patients’ experience of care. Characteristics of nursing staff are vital in creating a good care relationship. That in turn is necessary for patients to be able to open up and share their problems. Patients being able to open up is a prerequisite for nurses to be able to provide individualized care.

Background: Approximately ten percent of Sweden's population has reported feelings of loneliness. It is a widespread issue, particularly among the elderly, and is described to increase the risk of conditions such as, depression, suicidality, cardiovascular disease, and overall mortality. Dogs have demonstrated, playing a role, providing both emotional and social support and can be utilized as a resource in healthcare. Since the 1990s, nurses have had the authority to employ dogs as a nursing intervention. However, clear implementation guidelines are still lacking.

Aim: To examine the impact of dogs on the health of the elderly in relation to loneliness.

Method: A rapid review was conducted. Sixteen scientific articles of high to moderate quality, employing both quantitative and qualitative approaches, were included. Data collection was conducted using purpose-relevant keywords and terms in CINAHL, PubMed, PsychInfo, and Web of Science, supplemented by manual searches and Google Scholar.

Results: The results of this review highlight the impact of dogs on measurable as well as perceived health of both owners and intervention participants. Four main categories were identified: Social Impact, Physical Impact, Mental Impact and Emotional Impact. Dog ownership and dog-assisted interventions were associated with reduced loneliness and isolation, promoting a sense of belonging and community, in part by facilitating social interaction. Dogs also promoted a maintained/increased physical activity, reduced depressive symptoms and anxiety, as well as enhanced well-being and motivation.

Conclusions: This literature-review indicated, despite absence of direct causal relationships, that relationships and therapies involving dogs can alleviate loneliness, promote a sense of belonging, and positively impact the physical, mental, and emotional well-being of older individuals. Integrating dogs into care could be a suitable complement for lonely elderly.

Background 

Each year approximately 13,000 cardiac arrests occur in Sweden, and it is one of the most common causes of death internationally. In the event of cardiac arrest, cardiopulmonary resuscitation is the main measure to save life. A key aspect is relatives' experience. There are plenty of studies on how staff in hospitals experience cardiac arrest and how they experience presence of relatives. It is important to shed light on relatives' experiences witnessing cardiopulmonary resuscitation.

Aim 

To shed light on the experiences and consequences of being present at cardiopulmonary resuscitation as a relative.

Method 

This study constituted a literature review containing 15 original articles with both quantitative and qualitative methodology. Systematic data collection took place through database searches in PubMed and CINAHL. To assess the articles, assessment criteria from Sophiahemmet University were applied, and the results from the included studies underwent an integrated process for data analysis.

Results 

Three categories were identified; to stay, to be seen and to live on. It showed both negative and positive experiences in being present. When an overview was made, it emerged that relatives wanted to be present during resuscitation. Some felt respected and cared for, while others felt forgotten and alone. A new everyday life was created for relatives after witnessing cardiac arrest. Some suffered symptoms, as anxiety and stress or developed depression due to not being able to be present. Relatives could find support in talking to someone to process the event and be able to appreciate life again.

Conclusions 

Relatives were more likely to be present during cardiopulmonary resuscitation, rather than absent. It was obvious that the majority of relatives experienced lack of information from the healthcare staff. A new everyday life was designed, some suffered from depression, anxiety, and stress while others were able to find new meaning in life.

Background: One of the major causes of disability in the world is stroke. Stroke can cause a number of complications, one of the most common of which is difficulties with communication. Communication is an important part of the meeting between patient and carer, and it is cnetral for the nurse to have knowledge of different ways of communicating with patients that have communication difficulties. The nurse needs to have knowledge of these communication barriers and the patients’ experience of communication during and after the period of care in order to provide good person-centred care where the patients' needs are met. 

Aim: The aim of this study was to illuminate patients' experience of communication difficulties due to stroke. 

Method: This non-systematic literature review included 15 scientific articles, of which 13 consisted  of a qualitative approach and two of a mixed method. Using different combinations of search terms, all articles were obtained from PubMed and CINAHL. These have then undergone a quality review based on Sophiahemmet University's assessment basis for scientific classification and quality. An integrated data analysis has been used to analyze and compile the results. 

Results: The results were divided into two main categories; communication in care and communication after the care period. Five subcategories have also been identified; trust and treatment, independence and support, social activities and interaction, hope and feelings as a result of communication difficulties. The results showed both positive and negative experiences regarding communication difficulties. A pattern that was discovered was that negative emotions were linked to the acute phase and that positive emotions emerged at a later stage.

Conclusion: The study shows that nurses need to meet and support stroke survivors and use good communication by talking directly to the patient, letting the person speak to the end, as well as listening to the patient and adapting the information to the patient. This will strengthen the patient's trust in care, independence, social ability, sense of hope and reduce the negative feelings that arise after a stroke.

Background

When children are hospitalized, parents often participate in the care, in accordance with the nursing philosophy of family-centered care. This is usually beneficial for both parents and children, but it can also lead to difficulties in the encounter between parents and healthcare professionals as they share the responsibility of care. To make parents feel secure in this, healthcare professionals should encourage their empowerment. By ensuring that parents have a positive experience when interacting with healthcare professionals, a partnership between healthcare professionals and parents can be established.

Aim

The aim was to highlight how parents to hospitalized children experience the encounter with the healthcare professionals.

Method

The study design was a literature review which was conducted, based on 21 scientific original articles with both qualitative and quantitative approaches. The databases PubMed and CINAHL were used for data collection, and articles were retrieved by combining keywords in search blocks. The articles were assessed for quality based on the evaluation criteria from Sophiahemmet Högskola for scientific classification and quality. An integrated data analysis was performed.

Results

The results were compiled into four main categories: relationship-building encounters, information in the encounter, roles in the encounter, and emotions and needs in the encounter. The results showed, for example, that parents found it significant that healthcare professionals were trustworthy, showed respect, and could serve as guides. Other important abilities included being able to communicate and provide information in an appropriate manner and helping parents find and feel secure in their roles, as well as assisting them in managing their emotions.

Conclusions

Parents experienced that the quality of the encounter with healthcare professionals could affect their sense of empowerment and how they could manage their emotions. By adapting the encounter to their preferences and circumstances, parents can increase their participation in caregiving, enabling a beneficial partnership to be established.

Background 

The need for palliative care is more pressing and extensive in today's society than ever before. According to estimates, approximately 56.8 million people worldwide find themselves in a palliative stage every year, with only around 12 percent of the global palliative care demand considered to be met. Prior research has revealed a lack of understanding and knowledge about palliative care within both the public and healthcare professionals. Compiling existing research is of paramount importance and can contribute to enhancing the understanding and knowledge of palliative care, which can improve the care and quality of life for these patients. 

Aim 

The aim with this literature review was to illustrate experiences of suffering among patients in a palliative stage. 

Method 

Non-systematic literature review based on 19 scientific articles retrieved from the PubMed and CINAHL databases. Following the evaluation criteria for scientific classification and quality provided by Sophiahemmet University, all articles utilized in this study have been classified. The findings of the literature review were subjected to analysis using the integrated data analysis method with deductive analysis. 

Results

In the compilation of the result within the literature review, three themes were presented: disease-related suffering, care-related suffering and existential suffering. The findings indicated that effective communication, comprehension, empathy, and symptom management were central aspects in achieving high-quality palliative care, preserving dignity, and alleviating suffering for palliative patients. 

Conclusions 

This literature review identified experiences of various forms of suffering within palliative care and provided insights to contribute to the development and improvement of palliative care, with a primary focus on minimizing and alleviating suffering in this patient population. Key premises identified included effective communication, comprehension, empathy, support, and appropriate symptom management. The literature review can enhance knowledge and understanding of patients in a palliative stage and their specific needs. 

Background

Decision-making regarding cardiopulmonary resuscitation (CPR) involves assessing the medical benefits and associated risks, while also considering the patient's preferences. Patients may require support to actively participate in decisions about their healthcare, and it is the nurse's responsibility to guide the patient in this process. With the assistance of a nurse existential well-being can be promoted through discussions about life and perspectives on death and suffering. To enhance understanding and knowledge of these decisions, there is a need to highlight the patient's opportunity for involvement.

Aim 

The aim was to illuminate the patient's opportunity to be involved in decision-making regarding cardiopulmonary resuscitation (CPR) during inpatient hospital care. 

Method 

The design was a non-systematic literature review and the results were formulated with the support of 15 scientific articles. Data collection was conducted in the PubMed and CINAHL databases using search terms and the articles in the results were quality-assessed based on Sophiahemmet University's assessment criteria. An integrated data analysis was performed for the compilation of the results. 

Results 

Based on the content of the results, three main categories were formulated: Knowledge about cardiopulmonary resuscitation in decision-making, Clear documentation and early information about decision-making and Individual discussions with the attending physician in decision-making. The results indicated that most patients want to be involved in decision-making regarding CPR however, many did not get the opportunity. The results highlighted circumstances and reasons for why and how we can include patients.  

Conclusions 

In certain instances, healthcare professionals choose to exclude the patient from decision-making. The findings of the study emphasize how this lack of involvement can lead to unnecessary suffering for the patient and how it can be prevented through various measures. Most notably, the study illuminated an enhanced potential for participation when the patient receives early information, there is clear documentation and healthcare personnel exhibit a positive attitude towards patient involvement.

Background

Within palliative care families are an important part who need their support needs addressed by healthcare professionals. Being family of a patient in palliative care can be experienced as a burden with implications on physical, existential, psychological and emotional health. Healthcare professionals play an important part in supporting families within palliative care. Fields of potential improvement concerning unmet needs exists and may cause consequences in family members quality of life and health.

Aim

The aim was to put light on families experiences related to support from healthcare professionals within palliative care.

Method

A non-systematic literature review was conducted based on 15 original scientific articles with qualitative, mixed-method and quantitative design. The articles included were retrieved from the databases PubMed and CINAHL. The articles were subjected to a qualitative review based on Sophiahemmet University´s assessment basis for scientific classification and quality. The results were compiled and analyzed using integrated data analysis.

Results

Three main categories were identified: Experiences of information as support, Experiences of practical support and Experiences of emotional support. Honest, adjusted and timely information, empathic and mutual relationships to healthcare professionals, invitation to partake in care, practical help, experience of family and patients being in good hands and accessibility were central aspects for the families in order to experience themselves as supported.

Conclusions

The literature review showed that family members in palliative care experienced support from healthcare professionals as important. Satisfied support needs led to self-confidence, feeling of a lightened burden and coping. Unmet support needs led to increased vulnerability, feelings of abandonment and frustration. A reciprocity emerged between patients and families, as patients were well cared for the families experienced being in good hands. Heightened understanding of family members experiences of support from healthcare professionals within palliative care may raise awareness and increase quality of palliative care.

Background

As a result of stroke, changes and loss of bodily functions can occur. The changes can affect the person's ability to eat and the experience of the meal in different ways. The meal is an integrated part of social life and is associated with culture, lifestyle, togetherness and well-being. Eating difficulties after stroke can therefore have several psychosocial consequences and affect daily life and well-being.

Aim

The aim was to shed light on psychosocial aspects of the mealtime situation in people with eating difficulties following stroke.

Method

A non-systematic literature review was performed based on 15 original scientific articles with a qualitative and quantitative design. The articles were retrieved from the databases PubMed and CINAHL using selected relevant search terms for the aim. All articles were reviewed based on Sophiahemmet University's assessment basis for scientific classification and quality. The results were compiled and analyzed using an integrated data analysis. 

Results

In the compilation of the results, three main categories were identified; A changed existence, Unfamiliar emotions and The interaction with the surroundings.

The results showed that eating difficulties caused various forms of limitations in meal situations and social life. Adaptations were required to deal with new situations and for that different strategies were used. Eating difficulties evoked negative feelings, which affected one's own self-image. There was a desire to fit in with the surroundings and the interaction with the surroundings was experienced differently.

Conclusions

Eating difficulties had several psychosocial consequences, which affected emotional and social processes in daily life. The eating difficulties caused limitations during the meal and meal-related activities where the relationship to the meal as a social, contextual and enjoyable activity came to change. The results suggest that eating difficulties are very complex because they affect several aspects of living and being human. 

Background

Mental illness in elderly patients is a major growing societal problem. Elderly patients have a greater tendency to suffer from mental illness due to lifestyle changes. This growing problem requires knowledge and adequate training on the part of healthcare professionals to respond to these patients in a person-centered and dignified manner.

Aim

The aim of this study was to describe elderly patients' experience of treatment of mental health issues in healthcare services.

Method

This non-systematic literature review is based on 14 scientific articles with a qualitative, mixed-method and quantitative approach. The articles were retrieved from the databases PubMed, CINAHL and PsycInfo. Using Sophiahemmet University assessment basis, the articles have undergone a quality review to ensure scientific classification and quality. The results were processed and analyzed with an integrated data analysis.

Results

Three main categories were identified when compiling the results, these three main categories are: Being listened to, communication and participation in self-care. The results showed what the elderly value in the meeting with healthcare personnel and which factors can lead to the elderly not choosing to seek care for mental illness. Respect, commitment and being taken seriously are central parts of the meeting between patients and healthcare staff.

Conclusions

Older patients tend to deprioritize the importance of seeking help for mental illness. This is because mental illness is seen as a natural part of aging in both patients and healthcare staff, as well as fear of being treated badly.

Background

The number of patients in emergency departments has increased globally and patient safety problems is reported worldwide. The emergency department is characterized by a high workload, few resources and little time, which can be perceived as chaotic and unpredictable. This can lead to challenges in the meeting between the two parties. Good care promotes empowerment and increases self-esteem, which is crucial for health and well-being, while poor care can have consequences for the patient.  

Aim

The aim of this study was to illuminate adult patients’ experiences of care at the emergency department. 

Method

A non-systematic literature review with 15 original scientific articles with a qualitative, quantitative or mixed method design was conducted. The articles were collected via the databases PubMed and CINAHL and have been quality checked based on Sophiahemmet University´s assessment tool for scientific classification and quality. Integrated data analysis was used to compile the results.

Results

The results were presented with two main categories: positive experiences of care and negative experiences of care. The positive experiences consisted of being informed and participating, being respected, and listened to, and being treated as an individual. The negative experiences consisted of not being taken seriously, feeling forgotten, loss of control and lack of communication.

Conclusions

The experience of care was influenced by the care provided by the health care staff. Those who were treated with a person-centered approach had positive experiences such as care based on the individual person's needs while being respected and listened to. Care that was not based on the patient's needs made them feel forgotten and not taken seriously, while some experienced powerlessness, lack of control and a sense of vulnerability. This literature review contributes knowledge of how patients experience the care at the emergency department.

Background

The feeling of loneliness is a common challenge in the aging process, a subjective feeling that can be voluntary or involuntary. Involuntary loneliness can severely impact an individual's health. Older adults in special housing for the elderly are particularly susceptible to this issue, as moving to such facilities often leads to significant life changes, including reduced social connections, interactions, and support networks. From a healthcare perspective, it is crucial to understand and address loneliness among elderly residents in special housing for the elderly. Effective nursing interventions must be identified and implemented to prevent and alleviate loneliness in this population, as it has far-reaching implications for their overall well-being.

Aim

The aim was to describe nursing interventions that reduce and prevent the feeling of loneliness among elderly residents in special care facilities.

Method

A non-systematic literature review was conducted, based on 15 scientific original articles with both qualitative and quantitative designs. The articles were retrieved from the databases PubMed, CINAHL, and PsycInfo using various combinations of search terms. The articles underwent quality assessment based on the evaluation criteria of Sophiahemmet University for scientific classification and quality.

Results

The results indicate that therapy, meaningful social interactions, and participation in activities have a positive impact on preventing and reducing loneliness among older individuals in special housing for the elderly. The integration of these aspects into elderly care programs is essential for enhancing the quality of life and well-being of the elderly residents.The results were analyzed using integrated data analysis and categorized into three main themes: Therapy, Meaningful social interactions and relationships, and Participation in activities.

Conclusions

Therapeutic methods like laughter therapy, animal-assisted therapy, and horticultural therapy, in combination with engaging activities, positive staff relationships, and community involvement, play a pivotal role in improving the mental and physical well-being of older adults and mitigating loneliness. Additionally, therapies that focus on aspects of KASAM (Coherence, Comprehensibility, Manageability, and Meaningfulness) are vital in reducing feelings of loneliness and enhancing the overall well-being of older individuals. A robust sense of KASAM helps diminish the risk of loneliness by strengthening the ability to understand, manage, and find meaning in social relationships and activities.

Background

Obesity and overweight are public health diseases that have increased globally over the years to the point where the WHO classifies them as an epidemic. In Sweden, every other adult suffers from one of these conditions and there are several follow up health complication related to overweight/obesity. Many studies concerning weight loss combine digital health tools where results are often positive in the short term, but not effective long-term. Different meta-analysis's lift digital tools as an opportunity to improve healthcare for people with overweight and obesity. The term “Long-term” is of the utmost importance in healthcare when it comes to maintaining weight loss. Six months has therefore been used as the starting point for what “long-term” entails.

Aim

The aim of this study is to highlight e-health and its effect on long-term weight loss among individuals who are overweight or obese.

Method

Non-systematic literature review based on 15 scientific articles with a quantitative approach. The databases PubMed and Cinahl were used to retrieve the articles using relevant search terms for the study. All articles have peer reviewed based on Sophiahemmet University assessment basis for scientific classifications and quality. An integrated data analysis was used to compile the results.

Results

Physical activity, diet, notices/reminders and multi-component interventions were identified categories. The result highlights that the interventions offered over longer periods of time show better results regarding long-term weight loss. Supporting the individuals through personal contact or digital reminders and messages is important and contributes to continued weight loss and weight loss management.

Conclusions

Personalised interventions yield better results when also targeting multiple aspects ofweight-loss and during longer periods of time. Results in the field vary and more research is needed to make conclusions in how to optimize the given interventions.

Keywords: Weight loss, overweight, obesity, e-health, digital tools, long-term.

Background: Prior research has demonstrated an elevated risk of Alzheimer's disease (AD) among individuals diagnosed with type 2 diabetes mellitus (T2DM). Insulin resistance is a potential common link between these conditions, and it is associated with AD due to the insulin-degrading enzyme (IDE), which also degrades amyloid-β (Aβ) in the brain. It has been suggested that high insulin levels may hinder IDE's effective degradation of Aβ, contributing to plaque formation. IDE is measurable in blood and is a promising biomarker for AD risk assessment and diagnosis. IDE has been demonstrated to decrease in blood from patients with cognitive impairment, but the overall knowledge about IDE in human blood is sparse. The aim of the thesis was to increase knowledge of the relationship between insulin resistance and AD, focusing on IDE as a biomarker for risk assessment and diagnosis of AD.

Study participants: In study I, we included patients with type 2 diabetes (n=46) and compared them with patients without metabolic diseases (n=18). Serum samples were obtained from the Sophiahemmet biobank. In study II, we used post-mortem plasma samples from patients with Alzheimer's disease (n=18) and compared them with non-demented controls (n=6). These samples were obtained from the Netherlands Brain Bank. In study III, where we had three groups, we recruited patients with Alzheimer's disease (n=9) from a dementia care facility and healthy volunteers from Sophiahemmet University and Sophiahemmet Health Center (n=64). The serum samples from these individuals were then compared with serum samples from patients diagnosed with type 2 diabetes from Study I.

In Study IV, we utilized data from the Swedish BPSD (Behavioral and Psychological Symptoms of Dementia) registry. This registry is used by healthcare units that work with patients with neurocognitive disorders and contains information about the patient's diagnosis, drug treatment, and behavioral and psychological symptoms. We selected a group of AD patients prescribed some form of antidiabetic drug treatment and analyzed whether the type of treatment impacted the registered behavioral and psychological symptoms.

Methods: In study I-III, ELISA was used to analyze blood samples for levels of IDE and other metabolic markers. In study II, Luminex multiplex was used to measure inflammatory markers. These biomarkers and clinical data were analyzed statistically to investigate differences between groups and correlations between variables. In study IV, the association between BPSD and antidiabetic drug treatment was investigated using a bivariate logistic regression model, adjusted for age, sex, specific diagnosis, and drug treatment.

Results: The results showed that patients with T2DM had higher serum IDE levels than patients without metabolic diseases, patients diagnosed with AD, and healthy volunteers. The results also indicated that higher IDE levels were associated with older age, higher weight, and elevated blood glucose. In the samples from the brain bank, we found that higher IDE levels were correlated to increased levels of inflammatory markers and total tau.

In the analysis of registry data, we found that the prescription of metformin, one of the most common drugs for type 2 diabetes, was associated with lower odds for symptoms of depression and anxiety. This association was not observed for any other antidiabetic drug.

Conclusion: The results suggest that IDE may be an essential factor in metabolic function but may also be associated with significant risk factors for neurocognitive disorders, such as inflammation. Although based on smaller studies, these findings contribute to the limited knowledge of IDE in human blood. Reduced IDE levels have been linked to an increased risk of AD. If patients diagnosed with T2DM have elevated IDE levels, a decrease in IDE levels possibly would indicate that the patient is at higher risk of or even in an early stage of AD. As interest in blood-based biomarkers grows, IDE emerges as a stable and reliable candidate in this thesis. Additionally, the research raises attractive possibilities for enhancing treatment strategies for AD patients experiencing affective symptoms. Metformin is believed to increase IDE levels and has previously been suggested to treat affective disorders and AD. Further investigation is needed to explore this promising avenue.

Background

The number of inductions in Sweden has increased since the maternity ward have changed their guidelines regarding this procedure. This means that more and more women are undergoing treatments during their childbirth that can be stressful for them. Previous research has shown that women's experiences of participation and support are important factors for a positive birth experience. Knowledge of women's experiences of induction can give the midwife better conditions to support these women to a positive birth experience.

Purpose

The purpose was to describe women's experiences of induction at full term pregnancy.

Method

A literature review using a systematic method was performed. Article searches were conducted in the databases Pubmed and CINAHL, where 16 articles were selected as the result. To ensure the quality of the selected articles, a quality matrix was used to review the articles. An integrated analysis method has been applied to compile results.

Results

Four main categories representing women's experiences of induction emerged. These were; Information, A new journey, The decision process and The birth experience. Within these categories, subcategories emerged; Changing, A feeling of relief, Varying experiences of information, Information related to the risks, Participation and A decision colored by the judgments of others and a fear of harming the child.

Conclusion

It is common for women to feel that something is lost with the induction, but they have an ability to readjust and find meaning in the new. With clear and comprehensive information, women's experiences of participation increase both during the decision-making process and during childbirth. Women can experience the induction as stressful, but through participation and support from the midwife, the birth experience can be positive.

Background: Self-harm is a problem that has increased in society. People with self-injurious behavior that seek care experience that they are often met with stigmatizing attitudes and that they are not seen as individuals. Healthcare staff state that they lack knowledge about self-harm and that this contributes to a judgmental attitude towards the patient group. Stigmatization can make people who self-harm feel less valuable. This could hinder a trusting relationship between them and healthcare staff. By compiling existing research, it could contribute to an increased awareness of how interactions with the healthcare staff affect people with self-injurious behavior.

Aim: The aim of this study was to describe how people with self-injurious behavior experience the interaction within healthcare.

Method: A non-systematic literature review based on 18 original scientific articles using a qualitative or mixed method. The articles were collected from the databases PubMed, CINAHL and PsycINFO. All articles underwent a quality review based on Sophiahemmet University's assessment document for scientific classification and quality. The results were compiled and analyzed using an integrated data analysis.

Results: When compiling the results, four main categories were identified; Negative interaction, Positive Interaction, Experiences of the healthcare environment and Wishes to healthcare staff. The results showed that people with self-injurious behavior often experienced a stigmatizing attitude from healthcare staff. Experiences of negative interactions led to feelings of shame and distrust. People with self-injurious behavior described that an empathic and non-judgmental encounter, where they were seen as unique individuals, was of great importance.

Conclusions: This literature review showed the importance of a professional approach. Education about self-injurious behavior and communication strategies can contribute to further understanding and knowledge of the patient group. This, in turn, can promote interactions where the nurse and people with self-injurious behavior meet on an interpersonal level.

Background

When a child is seriously ill, a suitable form of care could be pediatric palliative care, which focuses on providing relief when the illness can’t be treated curatively. It is a form of total care of the child and the parents both physically and mentally. The nurse’s job within the pediatric palliative care is to treat and build a relationship with the child and the family. The nurse should promote parent participation and help and support when it is needed. The theory of person-centered care emphasizes the relationship between nurse and patient as well as family in order to promote participation in nursing care.

Aim

The aim was to describe parents’ experience of participation in nursing care in the pediatric palliative care.

Method

This literature study was non-systematic and the 15 original articles included were of qualitative, quantitative and mixed methods. The searches for articles were made in the databases PubMed and CINAHL and the articles were quality checked according to Sophiahemmet University’s assessment basis. The data was analyzed with an integrated review method.

Results

The results generated three main themes; participation through two-way communication, participation through decision-making, and participation through presence in the care. All studies showed that parents have a need for sufficient information from nurses and other healthcare personnel in order for them to be able to participate in the child’s care. When parents received the information that they needed, anxiety and worry decreased, while willingness and opportunity to participate increased.

Conclusions

This literature study showed that parents wanted to be involved in their child’s care to varying degrees. The nurse has to work person-centered to make sure that children and parents can be involved in the way they wish. When care is person-centered, its quality increases and the degree of satisfaction increases.