Perioden efter förlossningen kan vara en speciell och utmanande tid för den nya familjen. Sjukhusvistelserna i Sverige har blivit allt kortare, där vårdtiden efter förlossningen ligger på i genomsnitt 1,6 dygn och eftervårdsbesök vanligtvis sker cirka 6 till 12 veckor postpartum. Besvär som ej uppmärksammas kan leda till onödigt lidande, otrygghet och onödiga akuta sjukvårdsbesök som hade kunnat undvikas. Tidigare kartläggningar och rapporter pekar på brister inom svensk eftervård där det krävs prioriterade förbättringsåtgärder.

Syftet med studien var att undersöka faktorer som påverkar föräldrars upplevelser av eftervården.

Metoden som valdes var en litteraturöversikt med systematisk metod. Sökningar gjordes i PubMed och CINAHL där endast kvalitativa artiklar inkluderades. Artiklarna kvalitetsgranskades för att säkerställa att de höll god kvalitet. Resultatet från de utvalda artiklarna sammanställdes genom integrerad analys.

I resultatet framkom att föräldrars upplevelser påverkades av både eftervårdens organisation och vårdpersonalens bemötande och stöd. Faktorer såsom bra vårdkvalitet under sjukhusvistelsen, lättillgänglig vård och information efter utskrivningen, lyhört bemötande, bekräftelse, delaktighet och kontinuitet ansågs positivt av föräldrarna. Däremot påtalades otillräcklig föräldraförberedelse, samt en bristande uppföljning efter hemgång. Föräldrar önskade även mer familjecentrerat stöd och ökade stödinsatser.

Slutsatsen indikerar vikten av att stödja föräldrar i övergången till föräldraskapet där barnmorskan spelar en viktig roll. Behovet av en bra struktur på vården framhävs för att säkerställa tillgänglighet och kontinuitet vården. Vidare lyfts behovet av att hitta nya informationsvägar för att förbättra föräldraförberedelsen, och implementering av andra vårdformer skulle kunna minska det upplevda glappet efter utskrivning och ge föräldrar en mer positiv upplevelse av eftervården.

Bakgrund

Döendet är en naturlig del av livet, men att närma sig döden kan innebära att känslor av ångest uppstår. Den palliativa vårdens filosofi är att verka för symtomlindring och att patienten ska ha en så god livskvalitet som möjligt. Sjuksköterskor kan använda komplementära terapier för att lindra ångest hos patienter inom palliativ vård. Att beskriva hur patienter upplever ångestlindring genom komplementära terapier kan ha ett värde för sjuksköterskor och ge en ökad kunskap inom det området.

Syfte

Syftet var att beskriva upplevelser av ångestlindrande terapier hos patienter som vårdas inom palliativ vård.

Metod

Den valda metoden var en icke-systematisk litteraturöversikt baserad på tio vetenskapliga artiklar med mixad-metod och kvantitativ ansats. Artikelsökningar genomfördes i databaserna PubMed och CINAHL. Artiklarna har kvalitetsgranskats utifrån ett bedömningsinstrument utifrån Caldwell et al. modifierat av Sophiahemmet Högskola. Resultatet analyserades och sammanställdes med en integrerad dataanalys.

Resultat

Utifrån analysen av de vetenskapliga artiklarna framkom två huvudkategorier. I kategorin Ångestlindring genom kropp och själ upplevde patienterna en lindring av ångest genom att en känsla av lugn och avslappning. Patienterna upplevde även lindring genom andlighet och att få uttrycka spirituella tankar. De komplementära terapierna ökade patienternas delaktighet genom meningsfulla och kreativa aktiviteter vilket stärkte självkänslan. I kategorin Ångestlindring genom stöd kände patienterna ett utökat stöd genom relationer och genom terapin.

Slutsats

Resultatet visar att komplementära terapier kan spela en avgörande roll för att lindra ångest hos patienter inom palliativ vård. Genom att främja ett helhetsperspektiv som adresserar både fysiskt och existentiellt lidande, kan komplementära terapier förbättra patienters emotionella och andliga välbefinnande. Vidare tydliggörs vikten av att inkludera komplementära terapier i palliativ vård för att öka patienternas livskvalitet och lindra deras lidande.

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.

Bakgrund 

Den ökade digitaliseringen av vårdmöten, särskilt under Covid-19 pandemin, har förändrat hur hälsopersonal och patienter interagerar med varandra. Digitala vårdmöten breddar tillgången till vård, och erbjuds idag av många vårdgivare. Med en ökad användning av ett digitalt format väcks frågor om hur patienter upplever mötesformen. Digitala vårdmöten är ett relevant och aktuellt område, det är angeläget att sammanställa aktuell forskning för att säkerställa att digital vård utvecklas på ett sätt som förbättrar patientens upplevelse och vårdprocesser, utan att förlora den mänskliga aspekten. 

Syfte 

Syftet var att belysa patienters erfarenhet och upplevelser av digitala vårdmöten. 

Metod 

En icke-systematisk litteraturöversikt baserad på tio vetenskapliga artiklar, varav fem kvantitativa och fem kvalitativa. Artiklarna hämtades från databaserna PubMed och CINAHL. Artiklarna valdes genom sökstrategi med relevanta sökord och kvalitetsgranskades därefter med Sophiahemmets Högskolas bedömningsunderlag. Integrerad dataanalys användes för att analysera och sammanställa data i resultatet. 

Resultat 

Resultatet delades in i tre huvudkategorier: Upplevelser av patientnöjdhet, Upplevelser av personcentrerad vård och Patienters upplevelser av utmaningar, med tillhörande underkategorier. Resultatet visade generellt hög patientnöjdhet utifrån tillgänglighet, flexibilitet och effektivitet, men vissa patienter saknade den mänskliga aspekten av fysiska vårdmöten. Tekniska problem och brist på teknisk kompetens minskade patientnöjdheten och påverkade patienters upplevelser negativt. 

Slutsats 

Litteraturöversikten visade att digital vård har fördelar som kan öka upplevelsen av självbestämmande och delaktighet. Samtidigt finns begränsningar i att möta patienters behov, tekniska förutsättningar och preferenser. En hybridmodell där patienten väljer vårdform verkar vara det bästa alternativet för att möta patientens behov, öka självbestämmande och optimera vårdupplevelsen. Med ökad kunskap, utbildning och stöd för både patienter och vårdgivare, kan användandet av digitala vårdformer fylla en viktig funktion i framtidens vård och upprätthålla vård av hög kvalitet. 

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.

Bakgrund

Prostatacancer är den vanligaste cancerdiagnosen hos män. I nuläget finns endast en säkerställd metod för att fastställa en misstänkt cancerdiagnos och det är genom en prostatabiopsi. I Sverige genomgår cirka 15 000 män per år en prostatabiopsi. Inför denna biopsi väcks det mycket oro, funderingar och frågor hos dessa patienter. Att genomgå en biopsi kan även vara väldigt smärtsamt för patienten. Idag finns det många olika metoder för att minska smärtan vid biopsi. Dessa metoder har olika effekt och biverkningar för olika patienter. Det finns därför ett behov av att sammanställa aktuell forskning för att försöka förstå patienternas upplevelser och för att öka vårdpersonalens kunskap inom detta område för att förbättra patienternas upplevelser.

Syfte

Syftet var att belysa patienters upplevelse av smärta vid en prostatabiopsi.

Metod

En icke-systematisk strukturerad litteraturöversikt. Artiklarna samlades in från databaserna PubMed och CINAHL genom användning av olika kombinationer av sökord. Artiklarnas kvalitet granskades enligt Sophiahemmet Högskolas kriterier för vetenskaplig klassificering och kvalitet. Resultaten sammanställdes och analyserades genom en integrerad dataanalys.

Resultat

Efter systematisk sammanställning och analys av resultatet som baserades på 13 vetenskapliga artiklar framkom tre huvudkategorier: Upplevelser av farmakologiska metoder, Upplevelser av icke-farmakologiska metoder och Upplevelser av provtagning. Resultaten visade att bemötande, information och förväntningar var avgörande för patientens smärtupplevelse. Andra faktorer som antal prover, provens lokalisering och vilken typ av smärtlindring som användes hade även en betydande roll för smärtan.

Slutsats

När smärtlindring kombineras med ett bra bemötande och information om biopsin minskar både smärtan och oron hos patienterna signifikant.

Bakgrund

Hjärtat är en central muskel i kroppen som pumpar syrerikt blod till kroppen. Ett hjärtstopp är när hjärtats pumpförmåga plötsligt avtar, vilket leder till medvetslöshet och kräver snabb insats. Det finns flera faktorer som kan orsaka hjärtstopp. För att öka överlevnadschanserna vid ett hjärtstopp krävs snabb behandling, vilket inkluderar betydelsen av samhällets kunskap och sjukvårdens kompetens. Forskning belyser sjuksköterskans professionella roll både vid akuta situationer och i eftervården för att optimera resultat och stödja patienterna efteråt.

Syfte

Syftet var att belysa patienters upplevelser av att ha överlevt ett hjärtstopp.

Metod

En icke-systematisk metod användes och inkluderade vetenskapliga artiklar mellan 2014 och 2024, på engelska, innefattande vuxna patienter. Efter att ha identifierat relevanta artiklar genomfördes en kvalitetsgranskning och sedan en integrerad dataanalys. Etiska aspekter beaktades, inklusive följsamhet med etiska principer och riktlinjer.

Resultat

Resultatet baseras på 12 vetenskapliga artiklar som sammanställdes och gav två huvudkategorier: Behov av stöttning efter hjärtstopp och Påverkan av livskvalité efter hjärtstopp. Studien visade att patienter ofta kände sig oförberedda och chockade av hjärtstoppets plötsliga skede. De erfarenheter som delades inkluderade också brist på stöd och vård samt känslor av tacksamhet och rädsla. Efter sjukhusvistelsen upplevde patienterna en osäkerhet inför livet utanför sjukhuset och ett behov av att hantera nya levnadsvanor. Psykisk ohälsa var vanligt förekommande bland överlevare, med utmaningar som ångest, utmattning och minskad livskvalitet.

Slutsats

De studier som presenterats i denna litteraturöversikt visar att patienter som överlever ett hjärtstopp möter en rad utmaningar. De visar att patienter som överlever ett hjärtstopp ofta drabbas av psykisk ohälsa och minskad livskvalité. Kvinnor och yngre drabbas i högre grad. Patienterna möter även fysisk utmattning och känslor av utsatthet och osäkerhet. Bristen på information och stöd medför att deras återhämtningsprocess blir sämre och påverkar deras livskvalitet negativt. Trots tacksamhet över att ha överlevt, kämpar de med att återgå till en normal vardag och känner en stark känsla av misstro till sin egen kropp.