BACKGROUND: Associations of objectively assessed physical activity in different intensities and risk of developing chronic disease that requires hospital care have not yet been examined in long term population-based studies. Studies addressing the link between physical activity and sedentary time and subsequent hospital admissions are lacking.

OBJECTIVE: To examine the prospective associations between physical activity and sedentary time with morbidity defined as: 1) a registered main diagnosis of cardiovascular disease, cancer, type-2 diabetes, dementia, obesity or depression; 2) number of in- and outpatient hospital visits; and 3) number of in-hospital days.

METHODS: In total, 1220 women and men, 18-75 years, from the population-based Sweden Attitude Behaviour and Change study 2000-2001 were included. Time spent sedentary, in light-intensity physical activity and in moderate-to-vigorous physical activity, and total accelerometer counts were assessed using the ActiGraph 7164 accelerometer. Morbidity data were obtained 2016 from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of morbidity with 95% confidence intervals (CI) and negative binomial regression estimated incidence rate ratio (IRR) with 95% CI for number of hospital visits, and length of hospital stay.

RESULTS: Over a follow-up of 14.4 years (SD = 1.6), 342 persons had at least one registered hospital visit due to any of the included diagnoses. Higher moderate-to-vigorous physical activity was associated with significant risk reductions for combined morbidity (all included diagnoses) (HR: 0.65, 95% CI: 0.48-0.88) and cardiovascular disease (HR: 0.52, 95% CI: 0.33-0.82). Higher total counts showed similar results, and was also associated with fewer hospital visits (IRR = 0.56, 95% CI: 0.37-0.85). Higher sedentary time increased the risk of in-hospital days. (IRR = 2.38, 95% CI: 1.20-4.74).

CONCLUSION: This study supports the importance of moderate-to-vigorous physical activity for preventing chronic disease that requires hospital care, especially cardiovascular disease. High volumes of sedentary behavior may increase the risk of future hospitalization. Our results support the public health message "sit less and move more".

BACKGROUND: Today, there are various short- and long-acting contraceptive alternatives available for those who wish to prevent unintended pregnancy. Long-acting reversible contraception are considered effective methods with a high user satisfaction. High-quality information about contraception is essential in order to empower individuals to reach informed decisions based on sufficient knowledge. Use of the Web for information about contraception is widespread, and there is a risk that those who use it for this purpose could come in contact with sources of low quality.

OBJECTIVE: The overarching aim was to investigate the quality of websites about long-acting reversible contraception.

METHODS: Swedish client-oriented websites were identified through searches in Google (n = 46 included websites). Reliability and information about long-acting reversible contraceptive choices were assessed by two assessors with the DISCERN instrument, transparency was analyzed with the Journal of the American Medical Association benchmarks, completeness was assessed with inductive content analysis and readability was analyzed with Readability Index.

RESULTS: The mean DISCERN was 44.1/80 (SD 7.7) for total score, 19.7/40 (SD 3.7) for reliability, 22.1/35 (SD 4.1) for information about long-acting reversible contraceptive choices, and 2.3/5 (SD 1.1) for overall quality. A majority of the included websites had low quality with regard to what sources were used to compile the information (n = 41/46, 89%), when the information was produced (n = 40/46, 87%), and if it provided additional sources of support and information (n = 30/46, 65%). Less than half of the websites adhered to any of the JAMA benchmarks. We identified 23 categories of comprehensiveness. The most frequent was contraceptive mechanism (n = 39/46, 85%) and the least frequent was when contraception may be initiated following an abortion (n = 3/46, 7%). The mean Readability Index was 42.5 (SD 6.3, Range 29-55) indicating moderate to difficult readability levels, corresponding to a grade level of 9.

CONCLUSIONS: The quality of client-oriented websites about long-acting reversible contraception is poor. There is an undeniable need to support and guide laypersons that intend to use web-based sources about contraceptive alternatives, so that they may reach informed decisions based on sufficient knowledge.

Atrial fibrillation is the most common arrhythmia. The symptoms and diagnosis has shown to cause experiences of worry, fear, uncertainty and reduced quality of life. Even though these experiences can be relieved by information, it is not clear what need of help and support from healthcare the persons has. That is why the aim of this study was too investigate the perceived need for aftercare in persons with atrial fibrillation. The method that have been used is a descriptive design with nine qualitative semi-structured interviews, follow by a manifest content analysis.

In the result three categories that described the aim is presented. The category The need for knowledge showed that the persons experience a need to ask questions and get them answered, among other things answers about current treatment. The category also describes the need for information, which varied, as well as how information is best collected. In the category Responsibility for follow-up and aftercare different experiences of where the responsibility for aftercare lays arose. Some persons felt that it was their responsibility to contact the healthcare, while other persons felt that the responsibilities laid with the healthcare. Continuous follow-up is a need that many people experience, but the need can be controlled by the current mood and medication. The third category is Care and self-care, the need for support. It was characterized by the need for management of atrial fibrillation, which in part could be perceived as a cure for the disease. The need for guidance from the healthcare, in form of a physical therapist, curators and practical aids was pointed out. The category also describes the need for support from healthcare and conversation therapy group was a proposal that came up to meet the need for support.

The conclusion is that the perceived need for aftercare with atrial fibrillation varies. The need for follow-up stands out, even though not all experience that need. In order to accommodate the persons individual needs the nurse play a pivotal role in informatics, health informatics and person-centered care. The aftercare must accommodate the individual persons need.

Background

Globally 3 million people die every year from diseases related to overconsumption of alcohol. In Sweden over 300 000 suffer from some form of alcohol addiction. These people are frequent visitors in the healthcare community and in growing numbers. For nurses to manage a person-centered care for these patients an understanding of their innate suffering and the difficulties surrounding their healthcare relationships need to be addressed.

Aim

To enlighten the experiences of patients with alcohol addiction in their encounters with the healthcare community.

Method

General review based on 14 qualitative scientific articles obtained from academic databases CINAHL complete, PsycINFO and PubMed. Chosen articles were selected through a qualitative review and compiled into a matrix. Analysis of data was performed using an integrated method.

Results

Two main categories emerged: stigma and non-care, each with underlying subcategories. Experiences of stigma related to alcohol addiction as a medical diagnosis could be seen as having a direct effect on suffering caused by care. Insufficient care in form of non-care, loss of medical aid, and poor treatment in healthcare encounters resulted in additional suffering.

Conclusion

Nurses and other healthcare personnel need to reach a greater understanding of the suffering effects of stigma related to alcohol addiction and its effect on these patients and their desire and ability to seek medical care. By doing so relieving unnecessary suffering and enabling a person-centered and secure care for these patients in their strive toward health when facing alcohol addiction.

Background

Non-malignant prostatic conditions are a prevalent problem in society and a common reason as to why people seek medical care. Prostatitis and benign prostatic hyperplasia are two examples of non-malignant conditions that can appear in different ways and that could cause the afflicted person suffering, oftentimes through symptoms like pain and lower urinary tract symptoms. Alleviating suffering is an undertaking of health-care professionals’ and a nurse’s responsibility.  

Aim

The aim of this literature review was to illuminate what it is like to live with a non-malignant prostatic condition. 

Method

Non-systematic literature review where 18 articles were analyzed.  

Results

The results of the included and analyzed studies show that non-malignant prostatic conditions can influence intimate relationships, cause feelings of shame, fear and worry, that there are factors that can be more or less favourable in relation to these conditions and that there is room for improvement in the meeting with healthcare professionals. 

Conclusions

The results in this non-systematic literature review show that living with non-malignant prostatic conditions, and the symptoms they cause, can have a significant influence on the affected persons’ lives and quality of life in several aspects.  

Bakgrund

Demens är ett samlingsbegrepp för ett flertal sjukdomar som drabbar hjärnan och är vanligast i åldersgruppen 65 år och äldre. I Sverige insjuknar varje år cirka 24 000-25 000 personer i en demenssjukdom. Demenssjukdomarna indelas vanligtvis in i tre huvudgrupper, primärdegenerativa demenssjukdomar, vaskulära demenssjukdomar och sekundära demenssjukdomar. Termen BPSD är en förkortning för Beteendemässiga och Psykiska Symptom vid Demens. BPSD kan orsaka svårigheter för personen med en demenssjukdom, men även för hans/hennes närstående och sjuksköterskan i det dagliga arbetet.

Syfte

Syftet är att belysa förutsättningar som kan leda till en förbättrad interaktion mellan sjuksköterskan och personer med Beteendemässiga och Psykiska Symptom vid Demens (BPSD) inom äldrevård.

Metod

En litteraturöversikt genomfördes och i resultatet inkluderades artiklar från databaserna PubMed, SweMed+ och CINAHL.

Resultat

Resultatet består av fem kategorier: Musikterapi och dess effekter på symptom vid demens, Social interaktion, Kommunikationsstrategier, Kulturella och etiska förutsättningar, och Hund-assisterad intervention och dess effekter på symptom vid demens.

Slutsats

I studien framkom det vilka förutsättningar det finns, som kan förbättra interaktionen mellan sjuksköterskan och personer med beteendemässiga och psykiska symptom vid demens. Resultatet visar hur olika förutsättningar som musikterapi, social interaktion, aktiviteter, hänsyn till personens bakgrund och hund-assisterad intervention kan användas i vård av personer med demens. Mer kunskap inom dessa områden kan medföra att sjuksköterskan blir medveten om vilka möjligheter som finns för att användas i äldrevården för personer med demens.

ABSTRACT

Background

Today, there are around 43,000 people in Sweden living with an ostomy and since 2006 the number of patients has been increased in all over the country. Changing the patient's life situation and their experience of the new everyday life after the ostomy operation affects the individual's quality of life. The nurse's role in meetings with this group of patients is to alleviate their suffering and promote their quality of life. Patients' changed well-being and quality of life after the ostomy operation lies demand on the nurse's capacity to promote quality of life.

Aim

The purpose was to describe challenges, quality of life in patients after ostomy surgery and the need for support from the nurse.

Method

This literature review is based on 15 scientific articles, both qualitative and quantitative studies. The database search was carried out in the databases PubMed and CINAHL. The included articles were peer-reviewed according to Sophiahemmet's assessment table and analyzed with support from Integrated analysis.

Results

The study identified three categories that were considered important to describe the patient's challenges, the quality of life of patients after ostomy surgery and the need for nurse support.

Conclusions

In summary, the results show that patients who have an ostomy experience negatively to a greater extent that have a lower impact on their quality of life. Nurse support through counseling, ostomy education and self-care can reduce problems and complications in everyday life that have a better impact on quality of life.

Endometriosis is a chronic inflammatory disease which affects approximately ten percent of all persons in reproductive ages, born with a uterus. The disease can entail troublesome pains for the persons who live with it. Delay of diagnosis and treatment occurs which indicates a lack of knowledge among care staff towards the persons living with endometriosis. The aim of this literature review was to describe the experiences of persons living with endometriosis. The applied method was literature review. Seventeen peer reviewed articles were retrieved from PubMed and CINAHL. Inclusion criteria were that the study participants had to be between 18 and 55 years of age and live with confirmed endometriosis. Sophiahemmet Högskolas assessment tool was utilised during the quality audit. The articles were read repeatedly, and their contents were then divided into categories and subcategories. Three categories and eleven subcategories were identified: to live with symptoms (symptoms, physical activity/functional ability, private relationships, sexuality/reproduction, emotions/mental health and coping), encounters with health care (to be diagnosed and personal treatment), and consequences in everyday life (education, employment/absenteeism, and personal finances). In essence, almost all of the aspects of the persons’ lives were affected by living with endometriosis. Pain had a particular influence on mental, physical, social, and economical aspects of their lives. Living with endometriosis can entail troublesome negative experiences of painful symptoms, reduced ability to function physically, working ability, personal finances and mental health, negative encounters with health care staff, and negative influences on private relationships and sexuality/reproduction. Further research and dissemination of knowledge about endometriosis is necessary. Knowledge among health care staff, caretaking and personal treatment may be improved by increased awareness of how endometriosis affects the lives of people living with the condition. Hence, the persons’ vulnerability may be affirmed and their trust towards health care may hopefully improve.

BACKGROUND: Despite complex illness trajectories and a high symptom burden, palliative care has been sub-optimal for patients with end-stage kidney disease and hemodialysis treatment who have a high rate of hospitalization and intensive care towards end of life. There is a growing awareness that further development of palliative care is required to meet the needs of these patients and their family members. In this process, it is important to explore healthcare professionals' views on provision of care. The aim of this study was therefore to describe nurses' and physicians' perspectives on end-of-life and palliative care of patients treated with maintenance hemodialysis.

METHODS: Four focus group interviews were conducted with renal nurses (17) and physicians (5) in Sweden. Qualitative content analysis was used to analyze data.

RESULTS: Participants were committed to giving the best possible care to their patients, but there were challenges and barriers to providing quality palliative care in nephrology settings. Professionals described palliative care as end-of-life care associated with hemodialysis withdrawal or palliative dialysis, but also identified care needs and possibilities that are in line with an earlier integrated palliative approach. This was perceived as complex from an organizational point of view. Participants identified challenges related to coordination of care and different perspectives on care responsibilities that impacted symptom management and patients' quality of life. Communication issues relating to the provision of palliative care were revealed where the hemodialysis setting was regarded as an impediment, and personal and professional experiences, beliefs and knowledge were considered of major importance.

CONCLUSIONS: Nurses and physicians identified a need for the improvement of both late and earlier palliative care approaches. The results highlighted a requirement for and possibilities of training, counselling and support of health care professionals in the dialysis context. Further, multi-professional palliative care collaborations should be developed to improve the coordination and organization of end-of-life and palliative care of patients and their family members. A climate allowing conversations about advance care planning throughout the illness trajectory may facilitate the gradual integration of palliative care alongside life-prolonging treatment for improved support of patients and families.

BACKGROUND: Sexual and reproductive health and rights (SRHR) have historically been regarded as a woman's issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives' thoughts and experiences regarding preventive work for men's sexual and reproductive health and rights in the primary care setting.

METHODS: An exploratory qualitative study. Five focus group interviews, including 4-5 participants in each group, were conducted with 22 midwives aged 31-64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis.

RESULTS: One overall theme emerged, in everybody's interest, but no one's assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife's role and responsibility, and (iii) beliefs about men and women: same, but different.

CONCLUSIONS: Midwives believed that preventive work for men's sexual and reproductive health and rights was in everybody's interest, but no one's assigned responsibility. To improve men's access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.

OBJECTIVES: The effect of a healthy lifestyle on the prognosis of neck pain is unknown. This study aimed to investigate if a healthy lifestyle behaviour influences the risk of long-duration troublesome neck pain among men and women with occasional neck pain.

DESIGN: Longitudinal cohort study.

SETTINGS: General population, and a subsample of the working population, in Stockholm County, Sweden.

PARTICIPANTS: This study involved 5342 men and 7298 women, age 18 to 84, from the Stockholm Public Health Cohort, reporting occasional neck pain at baseline in 2006.

MEASURES: Baseline information about leisure physical activity, smoking, alcohol consumption and consumption of fruits and vegetables were dichotomised into recommendations for healthy/not healthy behaviour. The exposure, a healthy lifestyle behaviour, was categorised into four levels according to the number of healthy behaviours (HB) met. Generalised linear models were applied to assess the exposure on the outcome long-duration troublesome neck pain (activity-limiting neck pain ≥2 days/week during the past 6 months), at follow-up in 2010.

RESULTS: The adjusted risk of long-duration troublesome neck pain decreased with increasing adherence to a healthy lifestyle behaviour among both men and women (trend test: p<0.05). Compared with the reference category, none or one HB, the risk decreased by 24% (risk ratio 0.76, 95% CI 0.58 to 0.98) among men and by 34% (0.66, 0.54 to 0.81) among women, with three or four HBs. The same comparison showed an absolute reduction of the outcome by 3% in men (risk difference -0.03, 95% CI -0.05 to -0.01) and 5% in women (-0.05,-0.08 to -0.03). Similar results were found in the working population subsample.

CONCLUSION: Adhering to a healthy lifestyle behaviour decreased the risk of long-duration troublesome neck pain among men and women with occasional neck pain. The results add to previous research and supports the importance of promoting a healthy lifestyle behaviour.

BACKGROUND: Parkinson's disease (PD) affects many physiological systems essential for balance control. Recent studies suggest that intensive and cognitively demanding physical exercise programs are capable of inducing plastic brain changes in PD. We have developed a highly challenging balance training (the HiBalance) program that emphasizes critical aspects of balance control through progressively introducing more challenging exercises which incorporates dual-tasking. Earlier studies have shown it to be effective in improving balance, gait and dual-tasking. The study design has thereafter been adjusted to link intervention-induced behavioral changes to brain morphology and function. Specifically, in this randomized controlled trial, we will determine the effects of the HiBalance program on balance, gait and cognition and relate this to task-evoked functional MRI (fMRI), as well as brain-derived neurotrophic factor (BDNF) in participants with mild-moderate PD.

METHODS: One hundred participants with idiopathic PD, Hoehn & Yahr stage 2 or 3, ≥ 60 years of age, ≥ 21 on Montreal Cognitive Assessment will be recruited in successive waves and randomized into either the HiBalance program or to an active control group (the HiCommunication program, targeting speech and communication). Both interventions will be performed in small groups, twice a week with 1 h sessions for 10 weeks. In addition, a 1 h, once a week, home exercise program will also be performed. A double-blinded design will be used. At the pre- and post-assessments, participants will be assessed on balance (main outcome), gait, cognitive functions, physical activity, voice/speech function, BDNF in serum and fMRI (3 T Philips) during performance of motor-cognitive tasks.

DISCUSSION: Since there is currently no cure for PD, findings of neuroplastic brain changes in response to exercise would revolutionize the way we treat PD, and, in turn, provide new hope to patients for a life with better health, greater independence and improved quality of life.

TRIAL REGISTRATION: ClincalTrials.gov: NCT03213873, first posted July 11, 2017.

BACKGROUND: Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga's effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60-80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied.

DISCUSSION: Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences.

TRIAL REGISTRATION: The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051.

Background

Hope means that we believe in a potential future. When a child is suffering from a critical illness the illness often triggers fluctuating feelings between hope and hopelessness due to complications during the treatment-process. Nurses ability to provide good nursing in the meeting with families requires family-focused care. The nurse can use parents' knowledge to develop the best possible relationship with the child meanwhile guiding the parents through the treatment process. 

Aim

The aim was to describe how the nurse can inspire and maintain hope within parents whose child is treated in a hospital due to critical illness.

Method

This literature review was based on 15 research articles. A database search was conducted through CINAHL and PubMed, from which both qualitative and quantitative studies were included. The articles were later quality-assessed in accordance to Sophiahemmet’s matrix and analyzed through Kristensson’s (2014) Integrated analysis. 

Results

Four categories were created; The nurse's need of knowledge about the meaning of hope to parents, The nurse´s conversational-, supportive- and comforting function, Adapted information and education and The use of strategies. The result shows that parental hope is constantly present, although it occasionally can be difficult to retain. Parental hope consists of a reliance in the child's recovery while hoping that the child won’t suffer through too many negative experiences. The result also describes how the nurse can provide customized information through individualized education and support. 

Conclusions

In summary, the result shows that the nurse, through a holistic perspective and the use of different coping strategies, can improve the family's wellbeing and sense of hope. Through conversations, education and adapted information, the nurse can inspire and maintain hope within parents whose children are treated due to critical illness without conveying an unrealistic image of the child's prognosis.

Bakgrund

Sepsis är en livshotande dysfunktion i ett eller flera organsystem orsakad av stört systemiskt svar på infektion. Patienterna som överlevt sepsis upplever ofta övergående eller permanenta komplikationer med påverkan på deras livskvalitet. Livskvalitet är inget fast begrepp men kan beskrivas som personens nivå av välmående. Det går att mäta livskvalitet. De vanligaste mätinstrumenten är EQ-5D och SF-36. Patienter med sepsis finns i de flesta områden som allmänsjuksköterskans kompetens täcker och därför är det viktigt att öka kunskapen och förståelsen kring patientgruppen och hur patienternas livskvalitet påverkas efter sjukdomsförloppet. 

Syfte

Syftet med studien var att belysa patienters livskvalitet efter sepsis. 

Metod

I den här studien användes litteraturöversikt som design. Resultatet är baserat på 14 artiklar av kvantitativ design, och en artikel med kvalitativ design från databaserna PubMed och CINAHL som publicerats mellan 2009–2019. Artiklarna har kvalitetsgranskats med hjälp av Sophiahemmet Högskolas modifierade bedömningsunderlag. Artiklarna analyserades genom integrerad analys.

Resultat

Livskvaliteten påverkas negativt av att drabbas av sepsis. Resultatet visade att patienter som överlevt sepsis upplever en lägre grad av livskvalitet efter sepsis än innan insjuknandet, samt att patienterna har en lägre grad av upplevd livskvalitet efter sepsis jämfört med generell population utan sepsis. Resultatet presenteras i fyra domäner: fysisk, psykisk, social och funktionell livskvalitet. 

Slutsats

Livskvaliteten hos personer som överlevt sepsis är lägre än allmänhetens. Livskvaliteten påverkas i domänerna fysisk-, psykisk-, social- och funktionell livskvalitet. Sjuksköterskans kunskap och förståelse kring livskvaliteten hos personer som överlevt sepsis är viktig för att bedriva omvårdnad som förbättrar patientgruppens livskvalitet.

Background

Trans person is a term that encompasses multiple gender identities, many transgender people suffer from gender dysphoria. They often have a desire to undergo gender reassignment surgery, but in order to do so, a gender identity investigation is required, which is a long and stressful process. The wait for treatment to feel at home in one's own body, being deprived of the possibility of biological children, breaking the norm and constantly having to face situations when it is necessary to "come out" could affect health, both mentally and physically. 

Aim

The aim was to describe trans people´s experiences of health.

Method

A literature review has been conducted with a total of 16 included articles, using quantitative as well as qualitative method, published between the years 2012 and 2019.

Results

Four categories were identified; Quality of life, General health, Suicide and suicidal acts and Contact with health care. The quality of life and experienced health among transgender people is poorer than in the rest of the population. Suicide rates are higher and transgender people are often subjected to both discrimination and violence. Their social network is lacking which has a negative effect on the perceived health. Contact with health care is often postponed due to bad encounters and ignorance from the health care professionals.

Conclusion

Transgender people are a vulnerable group nationally as well as internationally, and the experienced health in this group is poorer than in the rest of the population. The knowledge about trans is low among healthcare professionals. One way to ensure competence of healthcare staff is to include education on trans and LGBTQ in the physician- and nurse educational programs. There is also a need for the gender identity investigation to be reviewed.

Bakgrund: Sömnens fysiologi, stadier och struktur förändras i och med åldrandet. Dålig sömn påverkar flera organsystem och hormonutsöndring negativt. Långvarig sömnbrist kan leda till flera sjukdomstillstånd. Den allvarligaste sömnbristen är insomnia och många äldre lever med dess konsekvenser. Beroendeframkallande sedativa läkemedel skrivs ut som lösning på problemet, men detta ger oönskade biverkningar och inskränkningar på vardagligt liv med försämrad livskvalitet, som följd.  

Syfte: Syftet var att beskriva omvårdnadsåtgärder som främjar god sömn hos äldre.  

Metod: En icke systematisk litteraturöversikt, byggd på 17 vetenskapliga artiklar med kvantitativ design, valdes. Artiklarna söktes i CINAHL, PubMed samt via manuell sökning. Dessa granskades vad avser vetenskaplig kvalitet. Resultatet har sedan utarbetats genom en integrerad analys.   

Resultat: Studien visar att det finns god evidens för att omvårdnadsåtgärder såsom; ljusterapi, massage, yoga, oljor, te, mindfulness, Tai Chi, kognitiv beteendeterapi, narrativ omvårdnadsåtgärd och musik, kan förbättra äldres sömn signifikant. Dessa åtgärder är många gånger mer kostnadseffektiva och ger mindre biverkningar än traditionell läkemedelsbehandling.  

Slutsats: Icke farmakologiska åtgärder i främjandet av sömn hos äldre är att föredra då det ger mindre biverkningar samt minskar kostnader för individ och samhälle. Bästa effekt av denna behandling nås genom användandet av personcentrerad omvårdnad där individens önskningar och behov sätts i fokus. Sjuksköterskans uppgift är att genuint engagera sig, ta initiativ och att tillsammans med patienten våga prova alternativa metoder för att avhjälpa sömnproblem hos de äldre.

Bakgrund

Beroende ska ses som en sjukdom och kräver därmed vård anpassad till dess specifika behov. Patienter med substansberoende upplever stigmatisering och har negativa erfarenheter av vården, samtidigt som bemötandet från vårdpersonal är en viktig del i behandlingen för dessa patienter. Omvårdnadsbegreppet tillit är det här arbetets teoretiska utgångspunkt. Tillit är en förutsättning för att god omvårdnad ska kunna ges.

Syfte

Syftet var att belysa sjuksköterskors upplevelser och erfarenheter av mötet med patienter med substansberoende.

Metod

Metoden för detta arbete var en litteraturöversikt. Databaserna PubMed, CINAHL och PsycINFO användes för att söka fram artiklar. Femton vetenskapliga artiklar kvalitetsgranskades och sammanställdes i en matris. En integrerad analysmetod användes för att analysera och presentera datan i resultatet.

Resultat

Fem kategorier identifierades. Dessa var Sjuksköterskans arbets- och förhållningssätt, Attityder och fördomar, Brist på kunskap, Känslan av att inte få veta hela sanningen och Upplevda känslor i patientmötet. Sjuksköterskor upplevde en brist på kunskap gällande substansberoende patienter och även frustration, rädsla och oro i patientmötet. Sjuksköterskorna kände att patienterna inte berättade allt om sin smärta eller substansbruk, och hade mestadels negativa attityder och fördomar mot patienterna. De hade även olika tillvägagångssätt i bemötandet gentemot patienterna.

Slutsats

Det fanns stora brister i kunskap hos sjuksköterskor angående substansberoende patienter samt stora brister i tilliten dem emellan. Bristen på tillit bidrar till att patienters förtroende för sjuksköterskor minskar. En kompetenshöjning skulle kunna vara en lösning på en del av sjuksköterskornas upplevda problem

Background

Eating disorders are an increasing problem in the current society. Although it is considered a global disease, it is most common in the western world, and the highest prevalence is seen among young females aged 15-25. The ideal of being slim is considered equivalent to beauty and success and can easily be a risk factor of becoming ill. The onset of eating disorders could be connected to biological, psychological and/or sociocultural factors. In order to create a positive encounter between the ill person and the healthcare professionals, it is important to see the person behind the disease as well as to create a relationship with knowledge, trust, comfort and hope.

Aim

The aim was to illuminate the patient experience of what promotes recovery from an eating disorder when meeting healthcare professionals.

Method

The method used was a literature review. Databases Cinahl, PubMed and PsycINFO was used to find relevant scientific articles. 16 articles with mainly qualitative design, but also quantitative design and mixed methods, were chosen for the result.

Results

Six main categories constitute what patients with an eating disorder found was important in the interrelationship to promote recovery: The need of surrendering control, The importance of feeling trust in the relationship, The meaning of a maternal figure, Health care professionals’ knowledge and experience, To see the person behind the disease and The meaning of hope.

Conclusions

Health care professionals should carry a non-prejudiced attitude while caring for a patient suffering from an eating disorder. To be able to support recovery it is shown to be important for caregivers to possess knowledge about eating disorders and to convey trust, hope and the feeling of being safe in the relationship. The patient with an eating disorder wish to be distinguished from the eating disorder and for caregivers to see the person behind the disease. It is of great importance for health care professionals, including nurses, being able to distinguish the person from the eating disorder in order to establish a trusting relationship and promoting health.

Background

In Sweden, 100-200 children are diagnosed with Autism spectrum disorder (ASD) annually. Having a child in the family with ASD affects the whole family and can initiate feelings of anxiety, grief and anger. The diagnosis involves several contacts with multiple healthcare professionals, situations where the family is in great need of support. Familycentered care aims to involve the whole family in the care process, and collaboration, participation and respect are important components.

Aim

The aim was to describe families' experiences of support in the healthcare meeting when a child in the family has Autism spectrum disorders.

Method

The study was conducted as a literature review. Article searches were made in three databases relevant to the topic, as well as an additional manual search. Fifteen articles were analyzed with an integrated analysis inspired by Kristensson (2014).

Results

The results revealed a specific need for support when families have a child with ASD, such as respectful care, personalized information, guidance during and after the diagnosis process and support in terms of including the family in the care process. 

Conclusions

Families with children with ASD experience a predominant lack of support in the care meeting such as unpleasant treatment, lack of adequate information and guidance, and lack of participation in the child's care. Through family-centered care, the nurse and the multidisciplinary team can consider the needs of the entire family, which leads to increased family support. Thus, the professional team has an important role in providing familycentered care as it can improve families' care experiences. It is of great importance that the multidisciplinary team gain more knowledge about ASD, and also receives more training in how to provide support to families with children with ASD.

Background

The design of the environment in emergency care leads to difficulties in safeguarding the patient's privacy. Responsiveness is required from the nurse's side to provide individualized care based on the patient's own preferences and culture. Privacy has several dimensions and includes personal, psychological and physical privacy. Privacy is linked to the human experience of dignity and intrinsic value. The individual's ethical stance can create an awareness of other people's dignity, something that is changeable throughout life. A fundamental aspect of nursing care is to protect the patient's dignity and thus autonomy.

Aim

The purpose of this literature review was to illustrate the patient experience of privacy in emergency care.

Method

The design for this study was a literature review covering scientific articles. These have been developed through database search. Searches were separated into CINAHL and PubMed. The result is based on 17 articles for review and analysis. Of the 17 articles, seven were of qualitative design, seven of quantitative designs while three were of both qualitative and quantitative design. The articles were then quality-reviewed according to Sophiahemmet University's assessment dossier. The data analysis was carried out using an integrated analytical method.

Results

The results consisted of that the patient ́s experience of privacy depended on environmental factors, the nurse ́s approach in the care relationship and the nurse ́s ability to apply privacy-protection behaviors. Environmental factors and the nurse's approach were crucial to maintaining the patient's dignity.

Conclusions

The literature review highlights privacy as a context-dependent phenomenon. Privacy is considered to be person bound and can be determined by human culture. The knowledge and reflection of the nurse regarding privacy behaviors had a central role in maintaining the patient's privacy. Dignity and thereby autonomy could be experienced by the patients when the privacy was exploited.

The nurses’ professional responsibility is to further people's health, prevent disease, reconstruct health and ease pain, this can be done through person centered care. In person- centered care it is the person in need of care that should be in the center. Emergency medical service means not only to give critically ill patients fast care, it should also be fitted to the individual seeking care. Intimate partner violence [IPV] is a global problem that affects both women and men. It can cause consequences though the direct physical trauma and a range of secondary diseases that can have a more psychological influence on the victim’s quality of life. To the society it causes high costs yearly. All the consequences of IPV can cause the person affected to seek health care, where nurses at the Emergency department [ED] have an opportunity to identify these patients. There are several charted factors that affect this, some are encouragement, and some are barriers that inhibits identification and person-centered care.

The aim of this study was to describe nurses experience of factors that can affect the meeting with patients subjected to intimate partner violence.

This study has a qualitative research design. Eight semi structured interviews were conducted at Emergency Departments at three hospitals in the middle of Sweden. The raw data was the analyzed with inductive content analysis.

The results showed factors that affected the meeting with patients subjected to IPV and was split into two categories “Work Environment” and “Knowledge”. The factors were connected to the specific workplace and the interprofessional support from colleagues in situations that needed to take time. They also dealt with the nurses own acquired knowledge and the perceived inadequacies that was generally in the ED about meeting patients subjected to IPV. The factors could be regarded as good pre-requisites to give person centered care and barriers against person centered care towards patients subjected to IPV.

The nurses that were interviewed used person-centered care to give care to patients subjected to IPV. There were a lack of education and a lack of established routines and knowledge about existing routines for how the nurse should and could act in meeting patients subjected to IPV. There were often lacking a clear establishment about the problematics surrounding IPV at the clinic management. Collaboration with both colleges, other professions and other authorities was something that could be both a barrier against giving person centered care but also an encouragement.