Background 

Substance use disorder (SUD) is a significant global public health issue, complicating diagnosis and treatment. Due to its physical and psychological consequences, individuals with SUD often frequent emergency departments. Here, nurses must consider the patient's overall perspective, as understanding their experiences is vital for enhancing care quality and ensuring patient safety through person-centered care.

Aim 

The purpose of this study was to highlight the experiences of patients with SBS during encounters with healthcare services in the emergency department.

Method 

The study includes a non-systematic literature review with ten original scientific articles, two of which were quantitative and eight of which were qualitative. The articles were retrieved from the PubMed and CINAHL databases, through structured searches with carefully selected combinations of terms. The quality of the articles was ensured by reviewing them according to Sophiahemmet University's assessment criteria. The results were analysed and compiled with an integrated data analysis that provided a deeper understanding of the experiences of patients with SUD during encounters with healthcare services in the emergency department.

Results 

The results consist of two main categories, each with two subcategories. The first is “Experiences of Respectful Treatment” including “Being Treated with Empathy” and “Feeling Comfortable in the Care Encounter” The second is “Experiences of Powerlessness” with “Stigma” and “Vulnerability”. Findings show that experiences in emergency care vary, often highlighting discrimination and stigmatization leading to negative health outcomes like untreated pain and overshadowing of the actual illness by SUD. These results are discussed in relation to Katie Eriksson's nursing theory.

Conclusion 

A respectful and non-judgmental approach is essential to improving healthcare experiences and outcomes for patients with SUD. Through education and self-reflection, nurses can reduce stigma, increase patients’ trust, and promote timely access to care—ultimately supporting public health and more equitable use of healthcare resources.

Background

Chronic pain is a comprehensive and complex health problem that affects several aspects of the individual´s life, physically, psychologically, and socially. This health issue is best treated through a combination of pharmacological and non-pharmacological interventions, called a multimodal approach. Physical activity, as a treatment, has previously shown positive effects both physiologically and psychologically. Nurses play a vital role in supporting individuals with chronic pain by promoting healthy lifestyle habits, offering guidance, and strengthening the individual's capacity for self-care. To enable physical activity as a treatment, nurses require a thorough understanding of how patients experience physical activity in relation to their pain.

Aim

This study aimed to describe people's experiences of using physical activity as a treatment for chronic pain.  

Method

The method used in this study is a non-systematic literature review with a systematic approach. This work is based on collected evidence from ten articles that have undergone quality control by the authors. The collected data has been analyzed and categorized into main and subcategories based on a model of integrated analysis.

Results 

The use of physical activity as treatment for chronic pain has been shown to have a good impact on pain as well as on the consequences caused by the pain. Physical activity can have a positive effect on physical, mental, and social well-being. People with chronic pain may find it difficult to perform physical activity based on identified barriers, the limitations of pain, practical and social obstacles, and a lack of motivation and knowledge. Factors that facilitated physical activity performance were also identified, including social support, willingness, motivation, and help and support from caregivers.

Conclusions

People with chronic pain describe positive experiences of physical activity as part of their treatment.. However, patients may need support from the nurse as there are barriers that prevent them from engaging in physical activity. 

Background 

Anorexia nervosa is one of the more serious eating disorders, often affecting young people and placing great strain on parents. Although healthcare professionals meet these individuals and parents, knowledge of the severity of the illness and the parents' experiences is limited, which can negatively affect the response. By describing how parents experience the situation, healthcare professionals understanding can increase, which can contribute to a more understanding response and improved support efforts.

Aim 

The aim of this literature review was to describe parents' experiences of living with a child or young adult diagnosed with anorexia nervosa.

Method 

This non-systematic literature review is based on 11 scientific articles with both qualitative and quantitative approaches. The articles were identified through a structured search strategy in the databases CINAHL and PubMed, with a time frame of 2015–2025. The articles were analyzed through an integrated data analysis where the texts were reviewed, categorized and compiled to provide an overview of common findings in the studies.

Results 

The results were presented in two main categories: Parents' emotional and relational stresses related to anorexia nervosa and Parents management of everyday life and care – a changed life situation. The results showed that parents experience a strong emotional burden when a child falls ill with AN, where guilt was a prominent feeling. A lack of knowledge and understanding from the healthcare system was perceived as an obstacle to care contact.

Conclusions 

Parents are emotionally and psychosocially affected by the changed life situation. They described feelings of guilt, shame, and isolation, while stress took a toll on family relationships. Parents expressed a need for better treatment and support from health and medical care to cope with the difficult life situation.

Background

Ischemic heart disease is one of the most common diseases in the world. Risk factors include old age, poor lifestyle habits, diabetes and obesity. Secondary prevention, which includes healthy lifestyle habits, is an important part of preventing recurrence. People with ischemic heart disease often have low health literacy and low knowledge of their own care. The nurse is responsible for the care and should help patients with rehabilitation after ischemic heart disease and in this work could digital solutions be a tool. Digital health is a new segment for promoting health and a summarization is needed to see the effects of the digital interventions to patients diagnosed with ischemic heart disease.

Aim

The aim was to highlight the effects of digital interventions as support for changing lifestyle habits in patients with ischemic heart disease.

Method

This non-systematic literature review includes twelve scientific articles. The articles were collected from the two databases CINAHL and PubMed. All the articles were reviewed according to Sophiahemmet University's assessment criteria. The articles were analyzed and the results compiled according to integrated data analysis

Results

The integrated analysis resulted in one main category Digital nursing to support self-care and four subcategories’ Telephone follow-up, Text messages, Applications and Websites. The results show that the effects on participants' lifestyle behaviors improved where physical activity and dietary habits were significant. The effects on participants' well-being improved and stress management showed a significant difference. The effects on participants' knowledge and self-efficacy improved where self-efficacy showed a significant difference.

Conclusion

The results indicate an improvement in the participants' lifestyle habits, well-being, knowledge and self-efficacy. The interventions provided significant improvements in lifestyle habits, self-efficacy and stress management. It is difficult to determine the best digital solution. However, it is likely that digital solutions can have a positive effect in patients with ischemic heart disease by educating the nurse to master these

Background 

Palliative care aims to improve the quality of life of both the patient living with terminal illness, and their loved ones. It is based on symptom relief, teamwork, communication and support for family members. Hospice is a specific type of care that provides care for people with palliative illness, which also offers a period of respite and support to family members.

Aim 

The aim was to highlight relatives’ experiences of hospice care.

Method 

A non-systematic litterature review that used the databases PubMed and CINAHL to obtain 12 scientific articles, constitues the result. The articles consisted of quantitative and qualitative aproaches and were reviewed with Sophiahemmet University College’s assessment to determine the quality. The results o the articles were analyzed and reviewed through an intergrated data analysis.

Results 

Three main categories were identified: communication, existential and emotional experiences, and practical contitions and environment. The results showed that the relatives’ experiences varied, but described an increased sense of safety and calmness, when the staff were attentive, responsive and showed commitment to the patient’s situation. Preparatory conversations about death were perceived as important for gope and meaning, as well as the opportunity to participate in care. When lack of support, family members experienced a stressfull change of role. Family mambers experienced a homelike environment as something that created security and safety, while hospital environments could create forms of distance and uncertainty.

Conclusions 

The litterature review shows that relatives’ experiences of hospice are affected by the staffs empathy, continuity of communication and clear information. Preparatory conversations, meaning-making and relief, create safety and hope. Hospice’s holistic perpective and homelike environment are apreciated, but the concept hospice can be percevied as stigmatized and varies between different countries. Continued clarification and development of hospice care is important to ensure equal access and support for family members.

Background

The COVID-19 pandemic was caused by the SARS-CoV-2 virus. It affected individuals and the health care system globally. The disease caused everything from flu-like symptoms to the need for ventilators. Protective measures like basic hygiene procedures, personal protective equipment and isolation of infected patients, were central to limiting the spread. The pandemic shined a light on deficiency in crisismanegment and communication. This paper uses Katie Erikssons nursing theory, the concepts of dignity and suffering are central.

Aim

The aim was to describe the experiences of hospitalized patients regarding their care during the COVID-19 pandemic, regardless of the reason for seeking care or their medical condition, as well as any challenges faced by the healthcare system.

Method

The study was conducted through a non-systematic literature review, including 10 scientific articles. Data collection was carried out via searches in the databases PubMed and CINAHL. Selection was based on clear delimitations and inclusion criteria, and the included articles were quality-reviewed according to the modified assessment criteria of Sophiahemmet University. After compiling the results, the articles were analyzed using an integrated analysis supported by Popenoe et al., a guide to data analysis for literature reviews. The data was categorized and applied in the results.

Results

The results of the literature review are based on 10 scientific articles, and three main categories were identified: Psychological Impact, Experiences of Staff Interactions, and Trust in Care. Additionally, seven subcategories were established. Most participants reported negative experiences such as worry, anxiety, and loneliness due to isolation, positive experiences were also prevalent.

Conclusions

Hospitalized patients during the COVID-19 pandemic experienced suffering for several reasons. The overall themes in the results describe a negative psychological impact related to worry and anxiety about their future and the patients' own health. Although many understood the healthcare measures and recognized the stress faced by healthcare staff, the negative experiences of patients cannot be minimized. Underlying structural problems in the healthcare system became evident in this work, highlighted by resource shortages and unequal care. These issues had already been problematic before the pandemic, and the deficiencies in healthcare must not be overlooked in preparation for the next pandemic, as they are also important aspects to address arising from the COVID-19 pandemic.

Background 

Since the 1980s HIV/AIDS has claimed over 42 million lives globally. While antiretroviral therapy can suppress transmission, Indonesia still faces rising AIDS-related deaths and is not on track to meet 2030 targets. Stigma and discrimination remain major barriers for PLHIV, manifesting in violence, exclusion, and shame across families, communities, and healthcare. These experiences often lead PLHIV to withdraw from social life and internalize feelings of shame related to their identity and condition. Nurses play a vital role in reducing stigma by building trust, offering respectful care, and supporting treatment adherence, especially for those who have faced discrimination in healthcare settings. 

Aim 

The aim of this study was to explore non-governmental health care workers' perceptions of stigma and discrimination towards people living with HIV in Bali, Indonesia 

Method 

A qualitative design was used, and six semi-structured interviews were conducted with a purposive sampling. Participants were purposely recruited from one non-governmental organization. The interviews were transcribed and analyzed through a content analysis with an inductive approach. 

Result

The participants perceptions were that stigma and discrimination toward PLHIV were primarily driven by cultural and religious beliefs, as well as a lack of education. These factors contributed to significant consequences, including avoidance of healthcare and treatment, social exclusion from family and community, and breaches of confidentiality within healthcare settings. The findings also indicated that tourism and increased access to technology have played a positive role in reducing stigma and discrimination. Additionally, notable differences were observed between urban and rural areas, with urban settings generally demonstrating more progressive attitudes. 

Conclusion 

The study highlights how stigma and discrimination impact the lives of people living with HIV. It emphasizes nurses’ critical responsibility to deliver compassionate, actively challenge both structural and interpersonal stigma, and protect the dignity and rights of vulnerable populations.

Background

HIV remains a major global public health concern, requiring lifelong treatment and preventive efforts. Although effective treatment and prevention exist, Indonesia is still far behind achieving global HIV targets, with stigma, limited awareness, and unequal access to care continuing to hinder progress. In this context, NGO healthcare workers, especially nurses, often serve as the first point of contact for people at risk of or living with HIV, playing a key role in health promotion, education, and supporting treatment adherence.

Aim

The aim of this study was to describe non-governmental (NGO) health care workers’ experiences of working with HIV-prevention in Bali, Indonesia.

Method

This qualitative study, based on semi-structured interviews, was conducted at an NGO in Bali, Indonesia. Six interviews were carried out with healthcare personnel actively working with HIV prevention. Participants were recruited through purposive and snowball sampling. The interviews were transcribed, and the data was analysed using inductive content analysis.

Results

The results were organized into two main categories: Barriers and facilitators to HIV prevention and Supportive strategies used by NGO healthcare workers. Key barriers included limited awareness, fear of disclosure, and cultural or religious obstacles, while facilitators involved improved access to prevention services and increasing societal openness. Supportive strategies centred on trust-building, adherence support, and educational efforts including counselling.

Conclusions

The study highlights how HIV prevention is shaped by complex cultural, social, and structural factors. Culturally sensitive strategies, such as trust-building, tailored education, and the use of digital platforms, can support engagement and improve outcomes, especially among key populations. These findings may inform nursing interventions in similar contexts where social norms and limited access remain major barriers.

Background: Malignant brain tumors are among the most severe forms of cancer, affecting both children and adults. The disease often carries a poor prognosis, especially in aggressive tumor types such as gliomas, where the average survival time is twelve to fifteen months. It impacts not only the patient but the entire family. For relatives, this entails significant emotional, existential, and practical challenges. Despite the nurses’ vital role in providing support, research shows that the needs of family members are often overlooked in healthcare.

Aim: The aim of this study was to describe the experiences of relatives living with a family member diagnosed with a malignant brain tumor.

Method: The study is a non-systematic literature review based on 14 scientific articles with a qualitative approach. The articles were identified through structured searches in the PubMed and CINAHL databases using relevant keywords. An integrated analysis method was used to compile and analyze the results. All articles were quality assessed using the evaluation criteria from Sophiahemmet University.

Results: Three main categories were identified a) Emotional and existential suffering, including feelings of shock, helplessness, grief, and the search for meaning, b) Changed life situation and the strains of everyday life, involving altered life roles, anticipatory grief, and fear of the future, c) Need for support and information, with relatives expressing a lack of communication and insufficient psychosocial support. Relatives described feeling vulnerable, alone, and in need of guidance throughout the disease trajectory.

Conclusions: The lives of relatives are profoundly affected by the progression of the disease and the associated uncertainty. By applying a person-cantered and family-oriented approach, nurses can help reduce suffering, enhance security, and strengthen the involvement of family members. A greater focus on the needs of relatives can lead to improved care quality and more sustainable support. 

Background: During pregnancy and childbirth, women are closely monitored to identify various risks and to prevent complications. After childbirth, the aftercare is responsible for continuing the care of the women. Despite these preventive efforts, women still experience childbirth complications, which can be both physical and psychological, and may cause significant suffering. Today, there is extensive research on how to prevent childbirth complications, but there is a knowledge gap regarding how affected women are followed up and treated in the aftercare.

Aim: To describe how women who have experienced a childbirth complication perceive the aftercare.

Method: A non-systematic literature review. R

Results: Presented in two categories: “Being trivialized and seeking help” and “The importance of receiving proper care and the desire for change.” Each category is divided into two subcategories: “Normalization, ignorance, and a sense of hopelessness,” “Lack of information and encountering ignorance,” “Receiving proper support, validation, and finding one’s key person,” and “The desire for better woman-centered aftercare and follow-up". Conclusion: The women experienced a need for improvements in aftercare. They especially emphasized the importance of good treatment, being validated, and receiving accurate information and care. Aftercare was perceived to work well when the women received support from a committed and supportive key person.

Background 

Around 1.8 million people worldwide live with the neurological disease multiple sclerosis. In Sweden, approximately 18 000 people live with the disease, where mainly women are affected, but the reasons why are still unknown. Having the disease often causes physical, mental, and not least, social limitations. In addition, there are prejudices and stigma surrounding the disease that can affect the quality of health.

Aim 

The aim was to describe adults' experiences of living with Multiple Sclerosis.

Method 

This study is a non-systematic literature review based on ten original scientific qualitative articles. The databases used were PubMed and CINAHL for data collection and the data were processed with integrated analysis by both authors.

Results 

Multiple sclerosis (MS) is a disease that affects individuals on several levels, physically, mentally, socially and existentially. Symptoms such as balance difficulties and fatigue are common and limit everyday life, while the disease can lead to both anxiety and poor selfimage. Social challenges such as stigma and misunderstanding can contribute to isolation and exclusion, but with the help of social support from family and others with the same diagnosis, it is easier to manage the disease. Experiences of care are characterized by challenges that are linked to a lack of knowledge and individual adaptation that leads to frustration. Despite the different impacts of the disease, many develop strategies for adaptation and have hope for the future.

Conclusions 

People living with MS describe a complex everyday life that affects the physical, mental and social life. The experiences described reflect an everyday life that is characterized by a changed self-image, limitations related to the physical and mental symptoms and uncertainty about the future. Despite this, positive aspects emerge, such as the importance of emotional, social and practical support in managing the disease. Healthcare has a central role in supporting people living with MS, but the experiences of this were not always so positive. The result provides an increased understanding of what it is like to live with multiple sclerosis.

Background

Heart failure is a serious chronic condition with a high global prevalence, affecting both quality of life and survival. It is characterized by a reduced cardiac pumping ability. This condition requires extensive self-care to stabilise the condition and reduce the risk of both deterioration and hospital readmissions. It presents both physical and psychological challenges for the patient. Inadequate knowledge, lack of social support, and emotional difficulties impact adherence to self-care. The nurse plays a central role in supporting the patient's self-care. Dorothea Orem's Self-Care Theory is applied to understand self-care and the patient's involvement in their care.

Aim

To describe adult patients experience of self-care in heart failure.

Method

A non-systematic literature review based on eleven original scientific articles retrieved from PubMed and Cinahl, through search terms in different combinations and through manual search. All articles underwent a quality assessment based on Sophiahemmet University's evaluation framework and were analysed through an integrated data analysis.

Results

The results were compiled into two main categories and six subcategories. The first main category "Mental well-being and inner experiences" includes the three subcategories "Experiences of anxiety, depression and stress", "Attitude, motivation for self-care" and "Managing symptoms". The second main category was "Life situation and social support". This category had also three subcategories: "A new life situation", "Relationships, social support" and "The importance of knowledge". The results from this review show that heart failure patients have many challenges in self-care. The patients experiences are characterised by emotional strain, uncertainty and the need for support in everyday life. At the same time, it appears that knowledge, motivation and social support play a crucial role in ensuring that self-care works and contribute to an improved quality of life.

Conclusions

Patients experience of self-care in heart failure are complex and individual. Self-care can provide a sense of control and improved quality of life, but at the same time arouses anxiety, stress and uncertainty. Lack of knowledge and difficulties in putting information into practice are obstacles to effective self-care. Social support and ongoing guidance from healthcare professionals are essential. Strengthening patients self-care requires support and increased knowledge dissemination. Through an increased understanding, the nurse can better handle the individual's needs.

AIM: To evaluate the quality of care from the patients' perspective after receiving either person-centred, nurse-led follow-up or standard care after surgical treatment of intermittent claudication.

DESIGN: Secondary analysis of a randomised controlled trial.

METHODS: Patients at two centres for vascular surgery in Stockholm, Sweden were randomised to either a person-centred, nurse-led follow-up programme (intervention group) or a standard follow-up programme with surgeons. During their visits at 4 to 8 weeks and 1 year after surgery, they received the questionnaire Quality from patients' perspective with 28 items. The patients responded to each item from two aspects: (1) how they perceived the quality of received care and (2) subjective importance (how important the care was for them).

RESULTS: A total of 104 of 138 patients at 4-8 weeks and 159 of 193 patients at 1 year after surgery completed the questionnaire. At 4-8 weeks, the intervention group scored significantly higher perceived quality of care regarding five items: receiving useful information about "How I should take care of myself" and "Which nurse were responsible for my care", "Nurses were respectful towards me", "Nurses showed commitment/cared about me" and "Easy to get in contact with the clinic through telephone". At 1 year, the intervention group scored higher regarding two items: "Which nurses were responsible for my care" and "Next of kin treated well".

CONCLUSION: Person-centred, nurse-led follow-up as implemented in this study has been shown to lead to a higher perception of quality of care regarding information about self-care, the experience of being respected, and knowing the care provider responsible for their care. Thus, it could contribute towards improved patient satisfaction without compromising the perception of quality of care regarding other factors such as receiving the best medical care or timeliness.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study addresses how patients with intermittent claudication, who underwent revascularisation, perceive a follow-up care that is person-centred and nurse-led compared to standard care delivered by surgeons. The results indicate that patients find the person-centred and nurse-led follow-up programme satisfactory, with equal or higher quality of care and that follow-up can be delivered by nurses with retained patient safety. Thus, vascular units may consider transitioning follow-up care from surgeons to nurses while maintaining positive patient's perception of quality of care, patient satisfaction and safety.

REPORTING METHOD: Reporting of the work was made using the Consolidated Standards of Reporting Trials (CONSORT) statement.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

TRIAL REGISTRATION: Study Details | Person-centred Follow-up and Health Promotion Programme After Revascularization for Intermittent Claudication | ClinicalTrials.gov: NCT03283358.

BACKGROUND: Life-threatening illness affects both patients and spouses, and spousal caregivers report high levels of distress. Web-based interventions could benefit spouses' and patients' needs and shared everyday life.

AIM: To explore how a family caregiver-targeted web-based psychoeducational intervention influences couples' experiences of sharing everyday life at home while facing life-threatening illness.

DESIGN: This qualitative sub-study involved dyadic interviews with couples (spouse-patient) where the spouse was allocated to the intervention arm of a randomized controlled trial evaluating a web-based family caregiver-targeted intervention. Data were analyzed using Interpretive description.

SETTING/PARTICIPANTS: Participants were recruited from five specialized home care services in Sweden. In total, 32 participants, spouses (n = 16) and patients (n = 16) were interviewed as couples after the spouse had accessed the intervention for 4 weeks.

RESULTS: Couples described how the spouses' access to the intervention had provided knowledge that enhanced the couple's understanding of each other's strategies for managing the impacts of the illness. The topics covered in the intervention prompted the spouses to initiate conversations that helped couples maintain a sense of mutuality. The intervention provided support to balance the tension between previous and new relational roles, which had changed due to the patient's illness.

CONCLUSIONS: Altogether, the results show that the benefits of family caregiver-targeted interventions may extend from spouse to patient, facilitating their everyday life. Our findings complement previous intervention evaluations by providing insights into how they may be effective. The goal should be that interventions potentially benefit patients and family caregivers.

TRIAL REGISTRY: The randomized controlled trial is registered at ClinicalTrials.gov, ID NCT05785494.

Background

Patients in palliative care are often in an existentially vulnerable situation where emotional and psychosocial support is crucial for their sense of security, dignity and quality of life. Despite the holistic philosophy of palliative care, research shows that patients’ emotional and psychosocial needs are not always adequately addressed. 

Aim

The aim of this literature review was to highlight how patients experience the emotional and psychosocial support provided by healthcare professionals in palliative care.

Method

This study is a non- systematic literature review based on 10 peer- reviewed articles with both qualitative and quantitative approaches. The searches were conducted using a systematic strategy in PubMed, CINAHL and PsycInfo, and the analysis was carried out using integrated data analysis.

Results

The results showed that an empathetic and attentive approach from healthcare professionals, continuity in care relationships and access to emotional support strengthened patients’ sense of security, involvement and dignity. At the same time, shortcomings in communication, coordination and access to psychosocial support were perceived as sources of distress and psychological burden. Existential and spiritual needs were present but rarely addressed in a systematic way. The need for emotional and psychosocial support varied and required an individualized approach.

Conclusions

Emotional and psychosocial support is an integral part of palliative care. To meet patients’ holistic needs, healthcare professionals must be given time, competence and organizational support to provide person- centered care that addresses the whole person- body, soul and emotions. Presence, attentiveness and adaptability are key to meeting patients’ needs and promoting quality of life until the end of life.

Background 

Stroke affects many people worldwide and for some it can lead to aphasia, which is a language disorder. The language disorder can affect a person's speaking, writing and communication skills. It has been shown that many people do not know what aphasia is. Therefore, information about people's experiences of living with aphasia can help healthcare professionals, but also society at large, to gain a deeper understanding of the language disorder.

Aim 

The aim of this literature review was to describe people's experiences of living with aphasia after a stroke.

Method 

This study design was a non-systematic literature review that contained 12 scientific articles with quantitative and qualitative approaches. Articles were searched in PubMed and CINAHL databases and were reviewed for quality based on Sophiahemmet's assessment documents. The results were analyzed through an integrated data analysis.

Results 

The results were divided into four main categories: the importance of meaningful occupation after aphasia, emotional consequences of aphasia, social consequences and relational changes, and practical and functional barriers after aphasia. The results indicated that after people suffer from aphasia, there can be many complications that can lead to changes in social relationships, motor-and emotional challenges and communication-and reading difficulties. Family, friends, rehabilitation services and social participation/occupation were considered important building blocks that can positively affect a person with aphasia.

Conclusions 

The results show that people with aphasia were affected by their language disorder in daily life both emotionally and in social relationships. Studies emphasized the importance of occupation and therapies for rehabilitation. The results revealed experiences of a lack of knowledge about aphasia, which negatively affected encounters in healthcare and in society, as well as an increased need for knowledge about the language disorder.

Background: Palliative care is an active and holistic approach aimed at preventing and alleviating suffering while supporting the best possible quality of life in cases of serious and incurable illness. Care interventions should, in addition to providing relief, create conditions for comfort and meet multidimensional needs throughout the course of the illness. In cases of complex illness-related suffering and reduced quality of life, it is justified to provide health-promoting interventions that consider the patient’s own understanding of health. Non-pharmacological interventions, such as dog-assisted therapy, have been introduced as part of the holistic care approach. The specialist nurse in palliative care shall — in light of the philosophy and core values of the care model  —translate new research findings into clinical practice and exercise their professional responsibility with expertise, that foregrounds the patient’s individual needs and perceptions of health.

Aim: The aim was to describe experiences of therapy dogs for patients with palliative care needs. 

Method: An integrative literature review with an inductive approach was conducted, including both qualitative and quantitative studies. Systematic database searches were performed in CINAHL, PubMed, and PsycINFO, guided by the PEO model. A total of ten articles were analyzed using qualitative content analysis according to Lundman and Hällgren Graneheim (2017). Kolcaba’s Comfort Theory (1994) was applied as the theoretical framework.

Results: The results were based on ten original articles and were compiled into three main categories: Physical Responses and Relief, Psychological Well-being and Presence, and Animal-related Experiences. Among patients with palliative care needs, symptom relief, relaxation, and improved mobility emerged as significant physiological effects. Psychological well-being was promoted through experiences of inner calm, closeness, and distraction, as well as through feelings of joy, anticipation, and expressed longing. Furthermore, existential and social interaction were recurring elements, often touching upon the terminal nature of the illness. Animal-related experiences evoked memories, recognition, and emotional bonds with former pets. The presence of therapy dogs was associated with positive changes in the care environment, where calmness and a sense of home were emphasized.

Conclusion: For patients with palliative care needs, interventions involving therapy dogs have demonstrated potential to promote health and comfort from a multifaceted perspective. This literature review highlights a relatively unexplored area and indicates that therapy dogs may serve as a meaningful, non-pharmacological, and health-promoting complement within the framework of person-centered palliative care. The findings suggest that dog-assisted interventions may contribute to alleviating complex suffering and reducing the experience of total pain.

Background: The definition of intrauterine fetal death is when a baby dies in the womb after the 22nd week of pregnancy, although this threshold may vary between countries. Globally, approximately 2.6 million stillbirths occur each year, the majority of which take place in low-income countries. In Sweden, around 360 babies are stillborn annually. Risk factors include fetal growth restriction, unhealthy lifestyle habits, high BMI, high maternal age, and socioeconomic vulnerability. Despite risk assessments, there is currently no reliable method to fully prevent intrauterine fetal death. Exploring parents’ experiences of intrauterine fetal death provides valuable insights for creating meaningful care in an extremely vulnerable life situation.

Aim: The aim was to illuminate parents’ experiences of losing, giving birth to, and meeting their dead child, from the moment of the disclosure to the time that follows.

Method: A non-systematic literature review including a total of 17 scientific articles, of which 15 were qualitative and two quantitative.

Results: The results are presented in three main categories: “The experience of losing a child during pregnancy”, “The experience of giving birth to and meeting one’s stillborn child”, “The time following an intrauterine fetal death” along with seven subcategories. The findings revealed that parents wished for continuous and clear information, as well as support throughout the grieving process. Experiences of care varied widely, ranging from feeling well cared for to feeling invisible and forgotten.

Conclusion: Intrauterine fetal death brings profound pain and grief for both parents and healthcare professionals. The conclusion suggests that midwives play a crucial role in the parental grieving process, and that both midwives and parents express a need for increased knowledge about intrauterine fetal death. Appropriate education enhances the midwife’s ability to provide a safe and supportive environment in a deeply traumatic situation. 

BACKGROUND: Empathy and compassion are integral to person-centred care. Contemporary literature also provides evidence of the impact of empathic and compassionate care on patient outcomes, including enhanced satisfaction with care and improved patient safety. Notably, a previous scoping review identified only a limited number of studies exploring patients' experiences of empathic and compassionate care, underscoring the need for further research on patients' and their significant others' perspectives and experiences of empathic and compassionate healthcare encounters.

OBJECTIVE: The aim of this paper is to explore patients' and their significant others' perceptions of empathic and compassionate healthcare encounters.

METHODS: This qualitative descriptive international survey recruited people who were willing to report on a personal experience with a healthcare professional that demonstrated positive or negative examples of empathic and/or compassionate care. Data were analysed using Framework Analysis.

RESULTS: A total of 84 participants from the Pacific region, the United States of America, and Europe reported encounters with nurses, doctors, allied health professionals, and multidisciplinary teams. Analysis revealed four overarching themes: (1) Verbal and non-verbal communication; (2) Clinician attitudes and attributes; (3) The power of small, thoughtful gestures; and (4) Enduring impact of empathic care.

CONCLUSIONS: To promote empathic and compassionate care, there needs to be a holistic focus on practitioner communication across the bio-psycho-social-spiritual domains. When these elements are included in interactions with patients and their significant others, healthcare providers can have a powerful and long-lasting impact on people's experiences and health outcomes.

BACKGROUND: The maternity continuum of care (MCC) is an integral component of universal health coverage and a crucial strategy for reducing maternal and neonatal mortality. Despite its importance, MCC coverage remains low in low- and middle-income countries (LMICs), including Ethiopia, which bear the highest burden of maternal and neonatal mortality. This underscores the need for proactive interventions. In this perspective, the primary health care (PHC) approach holds significant potential for enhancing MCC. Exploring demand- and/or supply-side opportunities for improving MCC within the PHC system could help inform policy, practice, and further research. However, there is limited evidence on these aspects in Ethiopia. Therefore, this study aims to explore demand- and/or supply-side opportunities for MCC enhancement within the PHC system in northwest Ethiopia.

METHODS: We conducted a qualitative study using an interpretive description approach within the PHC system in northwest Ethiopia from March 3 to November 27, 2022. Data collection included four key informant interviews, three focus group discussions with 29 participants, and 28 in-depth interviews, all selected through maximum variation sampling. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using reflexive thematic analysis in ATLAS.ti version 7.1.4 software.

RESULTS: Three themes and 11 sub-themes have emerged. These include: (1) PHC structural enhancement with its categories: onsite mentorship, decentralized ambulance service platform, structural networks, and expansion of the scope of frontline PHC facilities; (2) PHC input enhancement with its categories: expansion of the maternity service workforce and technological advancements; and (3) PHC maternity service delivery enhancement with its categories: community engagement, approaches for reducing wait times, tailored maternity service provision in conflict-affected communities, flexible schedules for maternity service, and integrated midwifery model of care.

CONCLUSIONS: This study finds that there are several structural, input, and service delivery opportunities for enhancing the MCC within the PHC system in northwest Ethiopia. These opportunities indicate potential pathways to strengthen PHC resilience for MCC. Widespread utilization of these opportunities could significantly improve the existing MCC within the PHC system. We also recommend further research to assess the impact of these opportunities on MCC.

OBJECTIVE: The aim of this study was to explore the knowledge adolescents with low back pain (LBP) need and already claim to have about being in motion despite pain, and how they search to increase this knowledge.

METHODS: Face-to-face semi-structured, in-depth interviews based on an interview guide were conducted with 15 adolescents with LBP recruited from a senior secondary school in Gothenburg, Sweden and analyzed using qualitative content analysis.

RESULTS: An overarching theme "Stuck in ambivalence" emerged, comprising three categories: "Existing knowledge is insufficient," "Searching for trustworthy information" and "Making sense of the new information" based on six sub-categories that together illustrate the participants' thoughts and beliefs about being physically active despite LBP. Their lives were negatively affected by not fully understanding the cause of their pain or what they can do to alleviate it. They wanted information tailored to their specific needs and searched for support and guidance to feel safe and gain confidence in the ability of their body to move and exercise.

CONCLUSION: The participants were aware of the benefits of remaining physically active despite LBP but were unsure how to apply this knowledge. Healthcare professionals should support adolescents with LBP by means of person-centered guidance about how they can turn information about pain and activity into health-promoting knowledge. It is of the utmost importance to apply a person-centered approach when providing evidence-based information.

BACKGROUND: The use of digital health technology in diabetes self-care is increasing, making eHealth literacy an important factor to consider among people with type 1 diabetes. There are very few studies investigating eHealth literacy among adults with type 1 diabetes, highlighting the need to explore this area further.

OBJECTIVE: The aim of this study was to explore associations between eHealth literacy and demographic factors, disease-specific factors, and well-being among adults with type 1 diabetes.

METHODS: The study used data from a larger cross-sectional survey conducted among adults with type 1 diabetes in Sweden (N=301). Participants were recruited using a convenience sampling method primarily through advertisements on social media. Data were collected between September and November 2022 primarily through a web-based survey, although participants could opt to answer a paper-based survey. Screening questions at the beginning of the survey determined eligibility to participate. In this study, eHealth literacy was assessed using the Swedish version of the eHealth Literacy Scale (Sw-eHEALS). The predictor variables, well-being was assessed using the World Health Organization-5 Well-Being Index and psychosocial self-efficacy using the Swedish version of the Diabetes Empowerment Scale. The survey also included research group-developed questions on demographic and disease-specific variables as well as digital health technology use. Data were analyzed using multiple linear regression presented as nested models. A sample size of 270 participants was required in order to detect an association between the dependent and predictor variables using a regression model based on an F test. The final sample size included in the nested regression model was 285.

RESULTS: The mean Sw-eHEALS score was 33.42 (SD 5.32; range 8-40). The model involving both demographic and disease-specific variables explained 31.5% of the total variation in eHealth literacy and was deemed the best-fitting model. Younger age (P=.01; B=-0.07, SE=0.03;95% CI -0.12 to -0.02), lower self-reported glycated hemoglobin levels (P=.04; B=-0.06, SE=0.03; 95% CI -0.12 to 0.00), and higher psychosocial self-efficacy (P<.001; B=3.72, SE=0.53; 95% CI 2.68-4.75) were found associated with higher Sw-eHEALS scores when adjusted for demographic and disease-specific variables in this model. Well-being was not associated with eHealth literacy in this study.

CONCLUSIONS: The demographic and disease-specific factors explained the variation in eHealth literacy in this sample. Further studies in this area using newer eHealth literacy tools are important to validate our findings. The study highlights the importance of development and testing of interventions to improve eHealth literacy in this population for better glucose control. These eHealth literacy interventions should be tailored to meet the needs of people in varying age groups and with differing levels of psychosocial self-efficacy.

Background 

Type 2 diabetes is a chronic and progressive disease that constitutes a growing global public health concern. The condition is characterized by insulin resistance and/or a diminished capacity of the pancreas to produce insulin, which increases the risk of longterm complications. Diabetes mellitus type 2 is largely associated with modifiable lifestyle factors, with physical inactivity, unhealthy dietary habits, overweight, and obesity being key contributors. Lifestyle changes are a central part of the treatment following a diagnosis of Diabetes mellitus type 2 and, if implemented, can help delay or reduce the need for medication.

Aim 

The purpose was to highlight what experiences people with type Diabetes mellitus type 2 has of implementing lifestyle changes.

Method

A non-systematic method was applied to answer the purpose of the work. 15 scientific articles were selected from the CINAHL and PubMed databases. The studies quality was reviewed based on Sophiahemmet University's review template and the results were further analyzed based on an integrated analysis.

Results 

Three main categories were identified in the results: Changes in everyday life, maintenance of changes and need for support and advice. The results showed that lifestyle changes such as physical activity, stress management and diet have a significant impact on the wellbeing of people with Diabetes mellitus type 2. The results also showed that people with the disease need support from the health care system and loved ones to implement and maintain lifestyle changes.

Conclusions 

Lifestyle changes are crucial for the physical and mental well-being of people with type 2 diabetes mellitus. Physical activity and dietary changes improve health but face obstacles such as financial difficulties, lack of motivation and social challenges. Individualized advice and social support from the health and medical services, especially the nurse, are central factors in promoting self-care and sustainable habits. A person-centered and holistic approach can strengthen the patient's self-confidence and enable long-term change.

Background: Heart failure occurs due to reduced function in the heart muscle, leading to the heart being unable to pump blood efficiently. The disease is a global health problem. Heart failure significantly impacts quality of life and involves severe symptoms such as fatigue, shortness of breath, pain, and thirst. Palliative care is offered to a lesser extent compared to other diagnoses. Suffering at the end of life is distressing but common among dying patients. Despite this, suffering and its treatment are often overlooked.

Aim: The aim was to investigate the dimensions of suffering in patients living with severe heart failure in a palliative care situation.

Method: A literature review with a qualitative deductive approach based on Katie Eriksson's theory of the suffering person was conducted. Database searches were carried out in PubMed and CINAHL, resulting in 698 hits. Finally, 14 studies were included and analyzed thematically with the support of Clark & Braun (2006). Based on predetermined themes from Katie Eriksson's theory of the suffering person, the theory was then tested against patients with severe heart failure.

Results: Disease suffering, care suffering, and life suffering are present in patients with severe heart failure in a palliative care situation. Disease suffering was expressed through physical symptoms such as fatigue, thirst, and edema. Emotional reactions such as fear, stress, anxiety, and depression were also common. Care suffering occurred in contact with healthcare, for example, when staff expressed themselves offensively or deprived patients of hope. Life suffering appeared as a reaction to the lack of safe and close relationships.

Conclusion: Patients with severe heart failure in a palliative care situation experience extensive and multidimensional suffering, including disease suffering, care suffering, and life suffering. The results of this review highlight the importance of healthcare professionals developing a deeper understanding of the patient's subjective experiences of suffering, which can lead to improved care interventions and more empathetic and patient-centered care.

Background: Nurses have a central role in palliative care by creating security and addressing the multidimensional needs of patients and relatives. During the Covid-19 pandemic, both patients who contracted Covid-19 and patients with severe pre-existing illnesses required palliative care. Restrictions to prevent the spread of infection and increased strain affected healthcare during the Covid-19 pandemic.

Aim: The aim was to describe nurses’ experiences of caring for patients with palliative care needs during the Covid-19 pandemic.

Method: The study was conducted as a literature review based on twelve qualitative articles. The material was analyzed using Braun and Clarke's (2006) model for thematic analysis.

Results: The results are presented based on three main themes, each containing two to three sub-themes: To provide care and prevent the spread of infection: Separation between the patients and relatives, having a controlling role, changed routines after death. Consequences of an unknown infectious disease: Caring with limited resources, dealing with an unpredictable disease course. Challenges and opportunities in communication: Hindered by protective equipment in interacting with patients, communication between patients and relatives, communication and collaboration within the care team.

Conclusion: It was difficult for nurses to achieve the definition palliative care during the covid-19 pandemic. Nurses’ experiences reflect that the unique needs of patients and relatives from a holistic perspective could not be met.