Background

Violence is a tool of dominance in a relationship, where it can cause physical and psychological harm with the aim of establishing power and control over the victim. Intimate partner violence is defined as repeated violence that escalates over time, committed by someone with an emotional connection to the victim. Healthcare plays a crucial role in identifying these women and guiding them further with a supportive approach, demonstrating knowledge, empathy, and applying person-centered care.

Aim

The aim was to highlight how women subjected to intimate partner violence experience their encounters with healthcare services.

Method

This literature review includes ten qualitative studies sourced from PubMed, CINAHL, and PsycINFO. The articles were quality-assessed using Sophiahemmet University's criteria and analyzed through integrated data analysis for scientific classification and quality.

Results

The results were structured into three main categories: Experiences of communication and collaboration, Experiences of support and responsibility and Experiences of desired treatment, with five associated subcategories. The results showed that women exposed to violence find it important that the healthcare system treats them with empathy and respect to create trust, where they can talk about the violence. The results revealed largely negative experiences of the treatment from the healthcare professionals, as the women perceived a lack of interest and commitment regarding intimate partner violence.

Conclusions

This literature review showed how an empathetic and respectful approach can create a trustworthy relationship between a patient who has been subjected to intimate partner violence and the healthcare. The study identified the experience of trust and understanding as central factors in the interaction with the abused patient. With increased knowledge about intimate partner violence and how to address the topic, more patients can receive support in leaving destructive relationships.

Background

Intimate partner violence can affect anyone, regardless of gender or age. A third of women worldwide have exposed to violence by someone close to them during their lifetime. Women exposed to violence can be found in all areas of healthcare. Meanwhile, healthcare professionals report a lack of knowledge required to provide a trusting approach. By compiling and analyzing current research that highlights the experiences of women exposed to violence in their interactions with healthcare professionals, the knowledge and understanding of healthcare staff can be strengthened, enabling the development of a more trusting and supportive approach.

Aim

The purpose was to highlight the experiences of women exposed to violence when they interact with healthcare professionals.

Method

A non-systematic literature review based on 11 qualitative scientific articles. The scientific articles included were identified using various keyword combinations in the databases PubMed and CINAHL. The quality of the included articles was reviewed, and an integrated data analysis was performed.

Results

The results were compiled into two main categories: Experiences of relationship-building and Experiences of trust and commitment. The result highlighted abused women’s experience of inadequate treatment by healthcare professionals, characterized by a lack of knowledge, time, trust, and interest, resulting in a reduced frequency of disclosure of intimate partner violence. Women’s experiences and desire for empathetic treatment and trusting relationships were also emphasized.

Conclusions

The literature review highlighted the importance of a safe approach from healthcare professionals towards women exposed to intimate partner violence. Predominant experiences reported by women were a lack of interest and knowledge from the healthcare staff, leading to a lack of trust and confidence, causing them to refrain from disclosing the violence. Regardless, experiences of empathy and safety were described as contributing to a sense of teamwork, and the women experienced a feeling of hope and relief. Enhancing healthcare professionals' knowledge of interacting with women exposed to intimate partner violence, the conditions for adequate care and support could be improved.

Background

In Sweden, the number of suicides amounts to approximately 1,200 people per year, which means approximately four deaths every day. Patients who have attempted suicide or who have committed successful suicide have been in contact with the health and medical services within the last year. Forty-five percent as close as the month before the occasion occurred. It is therefore important that all personnel who come into contact with these people have sufficient knowledge.

Aim

The aim was to illuminate the care experience of patients with suicidal thoughts.

Method

A non-systematic literature review was performed based on 11 scientific articles. The scientific articles were obtained using the CINAHL and PubMed databases where different search terms were combined. An integrated data analysis was performed and is presented in the study results. All articles went through Sophiahemmet University's assessment documents for scientific classification and quality.

Results

In the results, two main categories are presented: Patients with suicidal thoughts and their experience of the communication and relationship with healthcare personnel, and The experience of contact with various forms of care. The results showed that the experience of an empathetic treatment where one is listened to without being judged was of central importance in daring to open up and talk about one's suicidality. The feeling of control and participation appeared to be important in strengthening the therapeutic alliance between the carer and the patient.

Conclusions

This literature study showed valuable insights when it comes to the importance of the emotional relationship and the understanding of the needs of patients with suicidal thoughts from a holistic perspective. At the same time, the study points to challenges linked to the need for increased knowledge about mental illness among healthcare professionals and the development of healthcare environments. Safe care relationships create opportunities for patient participation and increased self-control emerged as other important findings in the study.

The postpartum period can be a special and challenging time for the new family. Hospital stays in Sweden have become increasingly shorter, with postnatal care averaging 1.6 days and aftercare visits usually occurring around 6 to 12 weeks postpartum. Unrecognized problems can lead to unnecessary suffering, insecurity and unnecessary emergency care visits that could have been avoided. Previous surveys and reports point to deficiencies in Swedish aftercare where prioritized improvement measures are needed.

The aim of the study was to investigate factors that influence parents experiences of postnatal care.

The method chosen was a literature review with a systematic method. Searches were made in PubMed and CINAHL where only qualitative studies were included. The articles were quality reviewed to ensure they were of good quality. The results from the selected articles were compiled through integrated analysis.

The results showed that the parents experiences were influenced by both the organization of the post-birth care and the care staff’s treatment and support. Factors such as good quality of care during the hospital stay, easily accessible care and information after discharge, responsive treatment, confirmation, participation and continuity were considered positively by the parents. Insufficient parental preparation and lack of follow-up after going home were criticized. Parents also wanted more family-centered support and increased support efforts.

The conclusion indicates the importance of supporting parents in the transition to parenthood where the midwife plays an important role. The need for a good structure in care is highlighted to ensure availability and continuity of care. Furthermore, the need to find new information paths to improve parental preparation is highlighted, and the implementation of other forms of care could reduce the perceived gap after discharge and give parents a more positive experience of aftercare.

Background

Dying is a natural part of life, but approaching death can mean that feelings of anxiety arise. The philosophy of palliative care is to work towards symptom relief and for the patient to have the best possible quality of life. Nurses can use complementary therapies to relieve anxiety in palliative care patients. Describing how patients experience anxiety relief through complementary therapies can have value for nurses and provide an increased knowledge in that area.

Aim

The aim was to describe experiences of anxiety-relieving therapies in patients treated in palliative care.

Method

The selected method was a non-systematic literature review based on ten scientific articles with a mixed method and quantitative approach. Article searches were carried out in the PubMed and CINAHL databases. The articles were quality-assessed using an assessment instrument based on Caldwell et al. modified by Sophiahemmet University. The results were analyzed and compiled with an integrated data analysis.

Results

Based on the analysis of the scientific articles, two main categories emerged. In the category Anxiety relief through body and mind, patients experienced relief from anxiety through a sense of calm and relaxation. Patients also experienced relief through spirituality and being able to express spiritual thoughts. Complementary therapies increased the participation of the patients through meaningful and creative activities, which strengthened self-esteem. In the category Anxiety relief through support, patients felt increased support through relationships and through therapy.

Conclusions

The results show that complementary therapies can play a crucial role in alleviating anxiety in patients in palliative care. By promoting a holistic perspective that addresses both physical and existential suffering, complementary therapies can improve patients' emotional and spiritual well-being. Furthermore, the importance of including complementary therapies in palliative care is clarified to increase patients' quality of life and alleviate their suffering.

BACKGROUND: Research waste is defined as research outcomes with no or minimal societal benefits. It is a widespread problem in the healthcare field. Four primary sources of research waste have been defined: (1) irrelevant or low priority research questions, (2) poor design or methodology, (3) lack of publication, and (4) biased or inadequate reporting. This commentary, which was developed by a multidisciplinary group of researchers with spinal manipulative therapy (SMT) research expertise, discusses waste in SMT research and provides suggestions to improve future research.

MAIN TEXT: This commentary examines common sources of waste in SMT research, focusing on design and methodological issues, by drawing on prior research and examples from clinical and mechanistic SMT studies. Clinical research is dominated by small studies and studies with a high risk of bias. This problem is compounded by systematic reviews that pool heterogenous data from varying populations, settings, and application of SMT. Research focusing on the mechanisms of SMT often fails to address the clinical relevance of mechanisms, relies on very short follow-up periods, and has inadequate control for contextual factors.

CONCLUSIONS: This call to action is directed to researchers in the field of SMT. It is critical that the SMT research community act to improve the way research is designed, conducted, and disseminated. We present specific key action points and resources, which should enhance the quality and usefulness of future SMT research.

Insulin degrading enzyme (IDE) plays a critical role in degrading insulin and beta-forming proteins, implicating its significance as a biomarker in metabolic dysfunction and neurocognitive disorders, including Alzheimer's disease (AD). Understanding the impact of pre-analytic conditions of in vitro IDE levels is imperative for reliable biomarker assessment. This study explored the influence of freeze-thaw cycles, storage temperature, and storage time on IDE levels in human serum. Serum samples from seven healthy volunteers were subjected to various storage conditions, including refrigeration (4 °C) and freezing (-20 °C and -80 °C) for 24 h and six months, with differing freeze-thaw cycles. In vitro IDE levels were measured at 24 h and after 6 months using ELISA. Results indicate that while short-term storage at either -20 °C or -80 °C yielded similar IDE levels, prolonged storage and multiple freeze-thaw cycles significantly impacted IDE stability, with colder temperatures exhibiting better preservation. Although further research with larger cohorts and longer storage time is warranted to establish clinical significance, our study suggests preferential use of unthawed samples or consistent freeze-thaw conditions for accurate IDE assessment. Thus, optimizing sample storage conditions is paramount for reliable IDE biomarker analysis in clinical and research settings.

Thawing of viably frozen human tissue T cells, ILCs, and NK cells and subsequent single-cell RNA sequencing reveals that recovery of cellular subclusters is variably impacted. While freeze-thawing does not alter the transcriptional profiles of cells, it upregulates genes and gene pathways associated with stress and activation.

BACKGROUND: Acellular dermal matrices (ADMs) are sometimes used in implant-based breast reconstructions (IBR), but long-term ADM-related evaluations are scarce. In this study, we evaluated early and late complications and patient-related outcomes (PROs) over an 8-year postoperative period in women who had undergone immediate IBR following risk-reducing mastectomy with bovine ADM (SurgiMend).

METHODS: This prospective observational single-center analysis involved 34 women at high risk for breast carcinoma. Complications were prospectively recorded during the first year, followed by 4 years of postoperative retrospective chart reviews. Long-term evaluations were done using a questionnaire. Preoperative, 1 year, and 5- to 8-year postoperative PRO assessments were obtained based on results from the BREAST-Q questionnaire.

RESULTS: In 56 breasts, complications after a mean of 12.4 months follow-up included implant loss (7.1%), implant change (1.8%), hematoma (7.1%), breast redness (41.1%), and seroma (8.9%). Most breasts (80.3%) were graded Baker I/II, which indicated a low capsular contracture incidence. After a mean of 6.9 years, the total implant explantation rate was 33.9%, and the revision surgery rate was 21.4%. Two cases of breast cancer were reported during the long-term evaluation. BREAST-Q results indicated significantly decreased satisfaction with outcome (P = 0.024). A positive trend regarding psychosocial well-being and declining trend regarding satisfaction with both breast physical- and sexual well-being parameters were reported.

CONCLUSIONS: The observed complication rates agree with previous findings concerning ADM-assisted IBR. A high demand for revision surgery exists, and PROs remain relatively stable over time.

Background 

The increased digitalization of healthcare meetings, particularly during the COVID-19 pandemic, has changed the way healthcare professionals and patients interact. Digital meetings broaden access to healthcare and are today offered by many care providers. With an increased use of digital platforms, questions arise regarding how patients experience this format. Digital care meetings are a relevant and current area, it is important to compile current research to ensure that digital care develops in a way that improves the patient ́s experience and care process, without losing the human aspect. 

Aim 

The purpose was to illuminate patients' experiences and perceptions of digital healthcare encounters. 

Method 

A non-systematic literature review based on ten scientific articles, five quantitative and five qualitative. The articles were retrieved from the databases PubMed and CINAHL databases. The articles were selected through a search strategy using relevant keywords. All articles were assessed for quality using Sophiahemmet University assessment document. Integrated data analysis was used to analyze and compile the quantitative and qualitative data in the results. 

Results 

The results were divided into three main categories: Experiences of patient satisfaction, Experiences of person-centered care, and Patients' experiences of challenges, with associated subcategories. The results generally showed high patient satisfaction in terms of accessibility, flexibility, and efficiency, but some patients lacked the human aspect of physical meetings. Technical problems and a lack of technical competence reduced patient satisfaction and negatively affected patient experiences. 

Conclusions 

This literature review found that digital healthcare has advantages, that can increase self- determination and participation. However, there are limitations in meeting patients' needs, technical conditions and preferences. A hybrid model, where the patient chooses preferred meeting format, seems to be the best option for meeting patient ́s needs, increase self- determination and optimize the care experience. With increased knowledge, education and support for both patients and providers, digital healthcare can fulfil an important function in future healthcare and main high-quality care. 

BACKGROUND: There is a need to address the implementation of technological innovation into emergency medical services to facilitate and improve information exchange between prehospital emergency care providers, command centers, and hospitals during major incidents to enable better allocation of resources and minimize loss of life. At present, there is a lack of technology supporting real-time information sharing in managing major incidents to optimize the use of resources available.

OBJECTIVE: The aim of this protocol is to develop, design, and evaluate information technology innovations for use in medical response to major incidents.

METHODS: This study has a qualitative action research design. This research approach is suitable for developing and changing practice in health care settings since it is cyclical in nature and involves development, evaluation, redevelopment, and replanning. The qualitative data collection will include workshops, structured meetings, semistructured interviews, questionnaires, observations, and focus group interviews. This study assesses the use of a digital solution for real-time information sharing by involving 3 groups of indented users: prehospital emergency care personnel, hospital personnel, and designated duty officers with experience and specific knowledge in managing major incidents. This study will explore end users' experiences and needs, and a digital solution for prehospital and hospital settings will be developed in collaboration with technology producers.

RESULTS: The trial implementation and evaluation phase for this study is from April 2024 to May 2026. Interviews and questionnaires with end users were conducted during the planning phase. We have performed observations in connection with 2 major exercises in April 2024 and November 2024. The outcome of this analysis will form the basis for the design and development of a new information technology system. We aim to complete the observations in training sessions and exercises (phase 3) by September 2025, followed by modification of the technology solutions tested (phase 4) before dissemination in a scientific journal.

CONCLUSIONS: This protocol includes several methods for data collection that will form the basis for the design and development process of a digital solution for real-time information sharing to support efficient management in major incidents based on the experiences and requirements of end users. The findings from this study will contribute to the limited research on users' perspectives and the development of digital solutions for real-time information during major incidents.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/57819.

BACKGROUND: Meta-analyses of randomized trials suggest that health checks and health promotion interventions targeting behavior change in primary care do not prevent cardiovascular morbidity and mortality in the general population. However, whether such interventions are more effective in high-risk populations, such as people living in low socioeconomic settings, remains unclear, as they have been poorly represented in previous trials. Therefore, we aim to evaluate the effectiveness, cost-effectiveness, and implementation of systematic screening followed by an individually oriented, lifestyle-focused, health dialogue intervention for prevention of type 2 diabetes and cardiovascular disease, as compared to opportunistic screening, in primary care in socioeconomically disadvantaged areas.

METHODS: Using an overall pragmatic approach and a cluster-randomized design with two arms, we aim to enroll 3000 participants aged 50-59 years from 30 primary care centers (PCCs) with an above-average level of Care Need Index in Stockholm Region, Sweden. PCCs will be randomized (1:1) either to a health dialogue intervention, which includes inviting enlisted patients to a systematic screening of risk factors followed by an individually oriented lifestyle-focused health dialogue, or to opportunistic screening, which includes screening patients for a smaller set of risk factors during an appointment at their PCC taking place for other reasons. The main outcome will be change in systolic blood pressure during 6- and 12-month follow-ups. Additional short-term outcomes will be changes in other biological risk factors, health-related quality-of-life, and lifestyle habits, as well as process and implementation outcomes, and unintended side effects. The long-term effect on type 2 diabetes and cardiovascular disease incidence and mortality will be examined using regional and nationwide registers. Changes in systolic blood pressure and other health outcomes will be analyzed using mixed-effect generalized linear modeling and mixed-effect Cox regression to capture variability between and within PCCs. A health economic evaluation will assess resource use and costs in the short- and long-term.

DISCUSSION: This trial of lifestyle-focused health dialogues and opportunistic screening in primary care in socioeconomically disadvantaged areas in the largest region of Sweden has the potential to yield valuable insights that could support evidence-based policymaking.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT06067178). Prospectively registered September 27, 2023.

PURPOSE: To investigate the association between common measures of trunk and lower extremity range of motion (ROM), strength, the results of one-leg jump tests at baseline and the incidence of subsequent substantial knee injuries in adolescent female football players.

METHODS: Players were assessed at baseline regarding (1) ROM of trunk, hip, and ankle; (2) trunk, hip, and knee strength; and (3) one-leg jump tests. Players were prospectively monitored weekly for 1 year regarding knee injuries and the volume of matches and training. Hazard rate ratios (HRRs) and 95% confidence intervals (CIs) were calculated with Cox regression for the association between the baseline tests and the incidence of substantial knee injury (moderate/severe reduction in training volume or performance, or complete inability to participate in football). Exposures were categorized in tertiles (high, medium and low values). The highest tertile was used as reference.

RESULTS: 376 players were included without substantial knee injury at baseline (mean age, 13.9 ± 1.1 years), and 71 (19%) reported at least one substantial knee injury during the follow-up. Several associations were found; the strongest was that players in the lowest tertile of knee extension strength had a higher incidence of knee injuries than players in the highest tertile (HRR, 2.28; 95% CI, 1.20-4.38). Players in the lowest tertile of trunk rotation ROM in lunge position half-kneeling (HRR, 0.50; 95% CI, 0.27-0.94) had lower incidence of knee injuries than players in the highest tertile.

CONCLUSIONS: Poor knee strength and high trunk ROM were associated with an increased incidence of substantial knee injury in adolescent female football players. Therefore, knee-strengthening exercises during season may be recommended.

LEVEL OF EVIDENCE: Level II.

OBJECTIVE: An exercise programme in primary care soon after radical cystectomy for urinary bladder cancer was previously evaluated regarding its effects on physical function. A secondary aim, presented herein, was to evaluate the programme in terms of its effect on postoperative complications.

MATERIALS AND METHODS: Patients who were planned for robot-assisted radical cystectomy for urinary bladder cancer at Karolinska University Hospital between September 2019 and October 2022 were invited to participate. At discharge from hospital, they were randomised to intervention group including aerobic and resistance exercises with physiotherapist in primary care twice a week for 12 weeks and daily walks, or to unsupervised home-based exercise including daily walks. Readmission rates between 30 and 90 days after discharge, and complications according to Clavien Dindo were collected from the medical records and analysed.

RESULTS: Ninety patients were randomised, with a mean (SD) age of 72 (9) years. Readmission rates between 30 and 90 days showed no difference between the groups. For readmitted patients, the intervention group had significantly fewer complications reported as Clavien Dindo grade 2 compared to the control group.  Conclusion: An exercise programme in primary care soon after robot-assisted radical cystectomy appears to be safe for patients, as measured by hospital readmission rates.  Trial registration: Clinical Trials (NCT03998579).

BACKGROUND: Web-based interventions targeted at family caregivers has become a quickly expanding research field, none the least since a growing number of patients with incurable illness are being cared for at home. Spouses, who are also family caregivers, constitute an especially vulnerable group in need of support when they are cohabitating with the ill patient and research shows that communication regarding the illness is important, yet challenging. This study therefore explored effects of a family caregiver-targeted web-based psycho-educational intervention on communication about incurable illness and remaining life between spouses and patients receiving specialized home care.

METHODS: The study had a pre-post-design. An intervention containing videos and texts about family caregiving was developed and made accessible via a website. Thirty-nine spouses (67% women, median age: 61) were recruited from specialised home care services. At baseline, and after 4 weeks of access to the website, spouses completed a questionnaire about communication with the patient regarding incurable illness and remaining life. Data was analyzed using the Wilcoxon signed-rank test.

RESULTS: No significant changes were found between baseline and follow-up. Most spouses did, however, report having talked with the patient about the illness being incurable (64%) and how the illness affected the patient physically (64%) and psychologically (77%) during the past month already at baseline. Regarding communication about the remaining life and how to manage once the patient had passed away, 46-59% instead reported not having had these conversations with the patient ever.

CONCLUSIONS: A majority of the spouses had talked about aspects of the illness and its consequences already at baseline, indicating that these matters are important to spousal caregivers of patients with incurable illness. However, a sizeable portion had not ever talked to the patient about how to manage once the patient had passed away, suggesting there are barriers to such conversations that need to be further explored. Future research on web-based psychoeducational interventions targeted at family caregivers need to address barriers and the diverse support needs regarding communication, especially about the remaining life, among spouses of patients with incurable illness.

TRIAL REGISTRATION: The study was first registered on clinicaltrials.gov(NCT03676283) on 2018.09.12.

Studies addressing patients' experiences of person-centered care (PCC) in the context of allogeneic hematopoietic stem cell transplantation (allo-HSCT) are scarce; hence, this study aimed to explore patients' experiences of PCC, and its associations with individual characteristics and health-related quality of life, in the context of allogeneic stem cell transplantation. It is a cross-sectional survey study, in patients who had undergone an allo-HSCT at one center in Sweden. The PCC instrument for outpatient care in rheumatology (PCCoc/rheum) was used. Descriptive and analytical statistics were employed. The study had 126 participants, evenly distributed males and females, 18-79 years old (>60% were 50-69 years old), and most were (>70%) married or cohabiting. The sum score for all items on PCCoc/rheum ranged from 20 to 72 (higher score = higher degree of PCC), with a mean value of 62.67 (SD: 9.863). Most participants (87-99%) agreed with the level of person-centeredness for 22 of the 24 items. Of the participants, 83.3% agreed that they had undisturbed conversations, that their problems had been taken seriously (79.0%), that they had an opportunity to tell their story (77.8%), and collaboration with the nurse was good (77.6%). A sizeable proportion disagreed that the care environment was welcoming (11.9%), family members' involvement (13.7%), and the possibility to influence the care (15.5%). The fulfillment of PCC was rated as high, but the results indicate that there is room for improvement regarding the possibility of influencing the care and family members' involvement.

BACKGROUND: The professional education of dentists and nurses includes literacy, academic and professional literacy, and professional knowledge. These have a reciprocal relationship and contribute to the development of students and professionals. However, this is an area in need of further exploration. Therefore, this study aimed to investigate dentists' and nurses' experiences of academic and professional literacy and professional knowledge at the time of their graduation, and five years into their profession.

METHODS: The material consisted of an evaluation distributed twice to dentists and nurses. The first time was immediately after graduation (degree evaluation), and the second time was five years after graduation (alum evaluation). Approximately 30% of the dentists and the nurses responded both times. We analyzed the data using non-parametrical methods.

RESULTS: Upon graduation, the dentists scored high in academic and professional literacy and knowledge. Five years into the profession, dentists reported experiencing challenges with communication in English and tasks related to equitable treatment and equal rights. Nurses followed a similar pattern as the dentists. Still, by graduation, the newly graduated nurses expressed concerns about communication in English, and promoting sustainable development within their profession. The challenges persisted five years into their profession, particularly in areas such as communication in English and sustainable development, as well as work related to equitable treatment and equal rights.

CONCLUSIONS: The level of confidence and perception of a sufficient degree of knowledge regarding academic literacy, professional literacy, and professional knowledge is higher at the time of graduation in both professions compared to five years into the profession, where there is a decrease in areas concerning work related to equitability, and equality, and for dentists also in communication in English. Furthermore, nurses had a constant low confidence rating in both evaluations concerning sustainable development and communication in English. This indicates that targeted and continuous professional development is crucial to address these challenges and to bridge the gap between the knowledge and confidence levels at graduation and the evolving demands of professional practice over time. Thus, when reconstructing the overall curriculum in professional educations it is of great importance to provide tools to enhance future professional development rather than the perception of that they can rely solely on their education at graduation time.

Objectives: Person-centered care emphasizes patient choice and autonomy and is considered an important means for improving the quality of care and quality of life for older adults with multiple chronic conditions and functional limitations. In implementing person-centered care, goals of care based on the patient's preferences are considered fundamental. Psychiatry is generally practiced in a curative paradigm, and little is known about the goals of care in geriatric psychiatric settings. In this study, goals of care as documented in care plans and medical records in geriatric psychiatric outpatient care have been explored, with a special focus on the end of life.

Methods: This study was based on a descriptive qualitative content analysis of medical records of patients enrolled at an outpatient clinic for geriatric psychiatry at the time of death. It was complemented by a basic quantitative analysis of patient characteristics.

Results: A total of 66 medical records were included, with a male/female ratio of 41/59% and a mean age of 83 years (66-104 years). Among psychiatric diagnoses, depression predominated. The dataset was generally limited, and clearly defined goals of care were sparsely presented. Therefore, the included medical records were analyzed twice: first regarding goals of care and second regarding patient wishes and requests. In both cases, the highest level of abstraction in terms of themes was achieved. Analysis of goals of care resulted in the themes patient well-being and care arrangements. Analysis of patient wishes resulted in the themes active patienthood and living and being.

Conclusion: Goals of care were often disease-oriented, focusing on recovery or symptom management, whereas analysis of patients' wishes revealed personal goals other than remission, including outspoken existential needs. The results call for further research on the interplay between person-centered care and the goal-planning process and point to the potential of a palliative approach in geriatric psychiatric care involving patients with complex comorbidities and multilevel needs.

BACKGROUND: The inclusion of palliative care in policy has been encouraged internationally, and gradually implemented, including in Sweden. Care should be driven by policy; hence, examining how palliative care is included in national policy documents is paramount.

OBJECTIVES: This study aimed to examine how palliative care is included in national disease-specific policy documents for adults with chronic conditions, cancer and non-cancer, with potential palliative care needs.

DESIGN: Document analysis.

METHODS: A document analysis of Swedish policy documents for different disease-specific groups with severe chronic conditions, cancer and non-cancer, was performed. In total, 96 documents were analysed.

RESULTS: How palliative care was included in the policy documents varied from mentioning the term without explanation to detailed discussion regarding palliative care practice. Such discussion encompassed several conceptualisations of palliative care: defined through authorities' definitions; as care of dying persons; integrated with disease-specific care and treatment; limited to disease-specific medical treatments or based on detail regarding certain key elements of palliative care such as specialised palliative care and end-of-life conversations.

CONCLUSION: There may be large variations in how palliative care is conceptualised in national disease-specific policy documents, as disclosed by this analysis of the Swedish case. Limiting palliative care to disease-specific medical treatments (most commonly palliative oncological treatments) or the care of dying persons limits its scope in ways contrary to current evidence supporting early integrated palliative care. The lack of palliative care recommendations adapted for each specific diagnosis indicates a gap in policy. To promote equal access to palliative care regardless of patients' diseases or medical conditions, the importance of how palliative care is included in national policy documents needs to be further acknowledged and discussed - with palliative care consistently included in such documents.

Background

Prostate cancer is the most common cancer diagnosis among men. Currently, there is only one surefire method to determine a suspected cancer diagnosis, and that is through a prostate biopsy. In Sweden about 15,000 men undergo a prostate biopsy annually. Ahead of the biopsy, a lot of anxiety, thoughts and questions are raised within these patients. Undergoing a biopsy can also be very painful for the patient. Today, there are many different methods used to reduce the pain. These methods have different effects and side effects for different patients. There is therefore a need to compile current research to try to understand the patients' experiences and to increase the knowledge of healthcare professionals in this area to improve these patients' experiences.

Aim

The aim of this study was to illuminate patients' pain when undergoing a prostate biopsy.

Method

A non-systematic structured literature review based on 13 scientific articles. The articles were retrieved from the databases PubMed and CHINAL using different combinations of search terms. The articles underwent a quality review based on Sophiahemmet University’s criteria for scientific classification and quality. The results were compiled and analysed through an integrated data analysis.

Results

After compiling and analysing the results, three main categories emerged: Experiences of pharmacological methods, Experiences of non-pharmacological methods and Experiences of sampling. The results showed that attitudes of health personnel, information and expectations were decisive factors for the patient's pain experience. Other factors such as number of samples, what part of the prostate the samples were taken from and the type of pain relief used also played a significant role in pain management.

Conclusions

When pain relief is combined with patient centred care and information about the biopsy, both the patient's pain and anxiety were significantly reduced.

Background

The heart is a central muscle in the body that pumps oxygen-rich blood to the body. A cardiac arrest is when the heart's pumping ability suddenly decreases, leading to unconsciousness and requiring rapid intervention. Several factors can cause cardiac arrest. To increase the chances of survival in the event of a cardiac arrest, prompt treatment includes the importance of community knowledge and the competence of healthcare. Research highlights the professional role of the nurse in acute situations and aftercare to optimize results and support patients and their relatives afterward.

Aim

The aim was to shed light on patients' experiences of having survived a cardiac arrest.

Method

A non-systematic method was used and included scientific articles between 2014 and 2024, in English, including adult patients. After identifying relevant articles, a quality review and then an integrated data analysis was conducted. Ethical aspects were considered, including compliance with ethical principles and guidelines.

Results

The result is based on 12 scientific articles that compiled and yielded two main categories: Need for support after cardiac arrest and Impact on quality of life after cardiac arrest. The study showed that patients often felt unprepared and shocked by the suddenness of the cardiac arrest. The experiences shared also included lack of support and care as well as feelings of gratitude and fear. After the hospital stay, the patients experienced an uncertainty about life outside the hospital and a need to manage new lifestyle habits. Mental illness was common among survivors, with challenges such as anxiety, exhaustion and reduced quality of life.

Conclusions

The conclusion from the studies presented in this literature review shows that patients who survive a cardiac arrest face a number of challenges. It shows that patients who survive a cardiac arrest often suffer from mental illness and reduced quality of life. Women and younger people are affected to a greater extent. Patients also face physical exhaustion and feelings of vulnerability and insecurity. The lack of information and support makes their recovery process worse and negatively affects their quality of life. Despite being grateful to have survived, they struggle to return to normal everyday life and feel a strong sense of distrust in their own bodies.