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  • 251.
    Astros, Josefin
    et al.
    Sophiahemmet University.
    Eriksson, Matilda
    Sophiahemmet University.
    Alkoholberoendes och alkoholmissbrukares upplevelser av bemötande i den svenska sjukvården2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Överkonsumtion av alkohol är ett vanligt problem i Sverige och ett beroende eller missbruk av alkohol kan orsaka både kroppslig och själslig skada hos individen. Därför påträffas personer som överkonsumerar alkohol ofta inom den svenska sjukvården. Tidigare forskning har visat att vårdpersonal har fördomar gentemot dessa personer och att personalens attityder och fördomar kan påverka bemötandet. Samtidigt har alla rätt till vård på lika villkor, oavsett vad de har för problem.

    Syfte

    Studiens syfte var att beskriva hur personer med alkoholberoende eller alkoholmissbruk upplever sig bli bemötta inom svensk sjukvård.

    Metod

    För att besvara studiens syfte valdes en kvalitativ metod. Nio personer med nuvarande eller tidigare alkoholberoende eller alkoholmissbruk intervjuades. Intervjumaterialet sammanställdes och analyserades med hjälp av en kvalitativ innehållsanalys.

    Resultat

    Alla deltagare i denna studie hade både bra och dåliga upplevelser av bemötande inom den svenska sjukvården. Under intervjuerna framkom att ett personcentrerat bemötande och noggrannhet från personalens sida fick informanterna att känna sig sedda och uppleva bemötandet som bra. Då personalen sett bortom alkoholproblemen och behandlat informanterna på samma villkor som andra patienter har vårdmötet blivit tryggt och ömsesidig respekt har uppstått.

    Misstänksamhet och nonchalans upplevdes som dåligt bemötande, men kunde i vissa fall enligt informanterna själva ha berott på deras eget beteende. Dåligt bemötande och brist på respekt, oavsett från vilken sida, har lett till negativa upplevelser och att en del personer senare undvikit att söka vård.

    Slutsats

    Slutsatsen är att alkoholberoendes och alkoholmissbrukares upplevelser av bemötande varierar från individ till individ, och att det beror på vad personen själv klassar som bra eller dåligt bemötande. Det mest centrala för att bemötandet ska ses som bra är att det är personcentrerat, och att inte alkoholproblemen tar all fokus. Alkoholberoendes och alkoholmissbrukares eget agerande och förhållningssätt gentemot vårdpersonalen påverkar också bemötandet.

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    K36 Astros Eriksson 2012-02-03
  • 252. Atthayasai, Jarutsri
    et al.
    Chatchumni, Manaporn
    Eriksson, Henrik
    Mazaheri, Monir
    Sophiahemmet University.
    Surgical nurses' perceptions of strategies to enhance pain management proficiency: A qualitative study2023In: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 13, no 2, p. 923-933Article in journal (Refereed)
    Abstract [en]

    To describe surgical nurses' strategies for enhancing their pain management proficiency. A qualitative design was used to conduct the study. The participants were forty surgical nurses who had at least six years of nursing experience in caring for patients with pain. They responded to open-ended questions based on a review of the policy documents concerning the main elements of the pain management programme to be implemented by surgical nurses. Three key themes emerged from the surgical nurses' suggested strategies: partnering, disrupting, and becoming familiar with pain management competency concerns. Surgical nurses' strategies in acute and chronic pain management nursing units included solving patients' problems and promoting and enhancing pain strategies to address health challenges in organisations. The themes presented in the results include enhancing pain management in nursing competencies. State-of-the-art healthcare technologies are being applied to pain management. Surgical nurses' strategies should improve the quality of nursing care, especially post-surgery recovery time. It is recommended to engage patients, their families, and multidisciplinary care teams in other healthcare fields.

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  • 253.
    Au, Hok-Jan
    et al.
    Sophiahemmet University.
    Persson, Malin
    Sophiahemmet University.
    Sjuksköterskans bedömning och dokumentation av vätskebalans inom akutsjukvård: en litteraturöversikt2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Acute care is time sensitive care interventions given to patients who are acutely ill. Acute illness may imply deterioration of chronic disease or newly sudden illness that needs urgent treatment. In this state the risk of fluid balance disorders, such as dehydration and hyperhydration, increases. Fluid balance disorders may lead to increased morbidity and social costs. The nurse has a responsibility to assess and document fluid balance. This should be done with a holistic view and largely consists of three components; assessment of clinical status, clinical chemistry and documentation in fluid balance charts. Fluid balance management in the care of the acutely ill is a fundamental part of patient care. The aim of the assessment and documentation of fluid balance is to discover deviations early, and a suboptimal management of fluid balance implies an increases risk of care related injury.

    The aim was to illuminate the nurse’s implementation of fluid balance assessment and documentation in patients within acute care.

    The study was executed through a literature review. Only articles published between 2007 and 2017, conducted in acute care settings and of adult patients were included. The data collection was carried out using the electronic databases PubMed, CINAHL complete, MEDLINE and SveMed+ using keywords based on the purpose of the literature review. Both thesaurus and free text words were used as keywords. Thereafter a manual search was performed. The data collection process resulted in 17 original articles that were included in the literature review. The quality of the articles was assessed using the review template compiled by Sophiahemmet University. The results of the articles were analyzed using integrated analysis and presented within an integrated text.

    The findings revealed shortcomings in the nurse’s assessment and documentation of fluid balance. There was a delay in action after the detection of fluid imbalances and abnormal values ​​in the clinical chemistry. The nurse did not adequately document the patient's bodyweight or fluid balance in the fluid balance chart. Factors such as communication, knowledge, and the patient’s medical condition could affect the nurse’s assessment and documentation of fluid balance. In addition, the findings indicated that the measurement methods used to assess fluid balance do not appear to be entirely suitable for elderly patients. Applicable guidelines do not seem to recognize the diverse needs of these patients. Additional research is needed to explore this further.

    The conclusions of this literature review indicates that the nursing assessment and documentation of fluid balance is inadequate. Efforts to increase the nurse’s knowledge of fluid balance might be of value to improve this. Further research is needed to evaluate whether the measurement methods used for the assessment and documentation of the fluid balance are well suited for acute care settings.

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    Hok-JanAuochMalinPersson
  • 254.
    Augustsson, Elin
    et al.
    Sophiahemmet University.
    Holewa Hanve, Eira
    Sophiahemmet University.
    Musik som omvårdnadsåtgärd för personer med kognitiv sjukdom: en litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Neurocognitive disorders are one of the leading global health concerns and the occurrence is increasing as the world's population ages. Living with a neurocognitive disorder affects the health of individuals on a multidimensional level, leading them to suffer from difficult symptoms, social stigmatization, a threatened autonomy and a decreased quality of life. Nursing interventions play a central role in alleviating the suffering of these people in healthcare situations. However, the nursing care of people living with neurocognitive disorders is insufficient. Music interventions have been shown to be effective as alternative nursing tools to contribute to a more holistic and person-centered care.  

    Aim

    The aim was to illuminate the value of music as a nursing intervention for the health of people living with neurocognitive disorders.

    Method

    The study consisted of an unsystematic literature review with an inductive approach. Systematic searches were conducted in the databases PubMed, CINAHL and PsycINFO in order to achieve the aim using a specific selection of criteria. Collected data was examined using a quality-assessment tool from Sophiahemmet University. A total of 15 scientific articles with quantitative and qualitative approaches were included in the results and were analyzed using an integrative data analysis.

    Results

    A compilation of the results was presented within three main categories: Value as a symptom-relieving measure, Value for social interactions and Value for well-being. The results show that music as a nursing intervention relieves behavioral and psychological symptoms as well as cognitive symptoms. The results also show that music is of great value in encouraging social interactions, with an increase of social engagement, cooperation and communication. The music was also shown to be of value in promoting an improved mood and well-being for people living with a neurocognitive disorder.

    Conclusions

    The literature review highlighted the potential of music to be used in the care of people with neurocognitive disorders. Person-centeredness emerged as a central element in strengthening the effects of music on health by contributing to a sense of well-being, meaningfulness and social connection. An increased understanding regarding the value of music for health is considered valuable knowledge for nurses in their care of people with neurocognitive disorders. 

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    Elin Augustsson och Eira Holewa Hanve
  • 255.
    Augustsson Hedman, Kaj
    et al.
    Sophiahemmet University.
    Nkobo, Laura
    Sophiahemmet University.
    Hälsorelaterad livskvalitet hos personer med diabetes typ-1: en litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund Diabetes typ 1 är en vanlig sjukdom. Sjukdomen kan medföra komplikationer som kan påverkar livskvalitet hos de drabbade. Denna typ av sjukdom kräver livsstilsförändringar som påverkar till exempel kost och motion. Dessa förändringar är viktiga för både individen och behandlingseffekten. En av de viktigaste delarna i behandlingen av sjukdomen, är att ha kontroll över sin blodsockernivå för att på så sätt ha ett relativt bra liv.

    Syfte Syftet var att beskriva den hälsorelaterade livskvaliteten hos patienter med diabetes typ 1.

    Metod Metoden var en beskrivande litteraturöversikt där författarna har använt 15 vetenskapliga artiklar. Artiklarna identifierades genom sökning i databaserna Cinahl och PubMed.

    Resultat Resultatet visar att depression var en av de mest förekommande symtomen som påverkade livskvalitet hos patienter med diabetes typ1. Resultatet visade att komplikationer påverkade den hälsorelaterade livskvaliteten. Vidare framkom att beroende på formen av komplikation, kunde själva behandlingen antigen förbättra eller försämra individens livskvalitet.

    Slutsats Diabetes typ 1 är en växande sjukdom som drabbar individer över hela världen. Sjukvårdens arbete behöver inrikta sig på att förebygga redan i ett tidigt stadium, allt för att kunna undvika mentala, somatiska och psykosociala komplikationer.

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  • 256.
    Aurell, Susanna
    et al.
    Sophiahemmet University.
    Simola, Moa
    Sophiahemmet University.
    Patienters upplevelser av hemmonitorering som egenvårdsstöd vid hjärtsvikt: en litteraturstudie2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Heart failure is a chronic disease that leads to reduced quality of life and risk of premature death. Patients connected to a heart failure clinic have better prognosis as patient education can slow down the progression of the disease through an increased understanding of the disease’s phases and manifestations. Self-care improves both prognosis and increases quality of life. Patient education about self-care takes place in several ways, in person, in writing and through various digital tools where E-health is a form and includes home monitoring of heart failure symptoms. Home monitoring of heart failure symptoms is a cost effective intervention, easy to implement and increases patients ability to self-care.

    The aim was to study patients’ experiences of home monitoring of symptoms as support of self-care in heart failure.

    A literature review was performed trough an integrated analysis of fifteen scientific articles from the CINAHL and PubMed databases, which resulted in eight subcategories and three main categories.

    The results showed that home monitoring in heart failure was experienced positively by patients as the technology was user-friendly and contributed to increased knowledge about self-care. There were experiences of limitation or fears as well as psychological and physiological obstacles. There was an experience of the care provider's importance.

    The conclusion was that patients’ experiences of home monitoring of heart failure symptoms was almost exclusively positive.

  • 257. Avelin, Pernilla
    et al.
    Erlandsson, Kerstin
    Hildingsson, Ingegerd
    Rådestad, Ingela
    Sophiahemmet University.
    Swedish parents' experiences of parenthood and the need for support to siblings when a baby is stillborn2011In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 38, no 2, p. 150-8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It has been argued that having a stillborn baby in the family affects older siblings more than parents realize. The aim of this study was to describe parenthood and the needs of siblings after stillbirth from the parents' perspective.

    METHODS: Six focus groups were held with 27 parents who had experienced a stillbirth and who had had children before the loss. The discussion concerned parents' support to the siblings, and the sibling's meeting, farewell, and memories of their little sister or brother. Data were analyzed using qualitative content analysis.

    RESULTS: The overall theme of the findings was parenthood in a balance between grief and everyday life. In the analysis, three categories emerged that described the construction of the theme: support in an acute situation, sharing the experiences within the family, and adjusting to the situation.

    CONCLUSIONS: The siblings' situation is characterized by having a parent who tries to maintain a balance between grief and everyday life. Parents are present and engaged in joint activities around the stillbirth together with the siblings of the stillborn baby. Although parents are aware of the sibling's situation, they feel that they are left somewhat alone in their parenthood after stillbirth and therefore need support and guidance from others.

  • 258. Avelin, Pernilla
    et al.
    Hildingsson, Ingegerd
    Davidsson-Bremborg, Anna
    Rådestad, Ingela
    Sophiahemmet University.
    Make the stillborn baby and the loss real for the siblings: parents' advice on how the siblings of a stillborn baby can be supported2012In: Journal of Perinatal Education, ISSN 1058-1243, EISSN 1548-8519, Vol. 21, no 2, p. 90-98Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate parents' advice to other parents on the basis of their own experiences of siblings' taking leave of a stillborn sister or brother. The study was a Web questionnaire study of 411 parents. The thematic content analysis resulted in two categories: "Make the stillborn baby and the loss real for the siblings" and "Take the siblings' resources and prerequisites into account." Parents' advised that siblings should see and hold the stillborn baby and, thus, be invited and included into the leave-taking process with respect to the siblings' feelings, resources, and prerequisites. Based on these findings, professional caregivers can usefully be proactive in their approach to facilitate and encourage the involvement of siblings.

  • 259. Avelin, Pernilla
    et al.
    Rådestad, Ingela
    Sophiahemmet University.
    Säflund, Karin
    Wredling, Regina
    Erlandsson, Kerstin
    Parental grief and relationships after the loss of a stillborn baby2013In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 29, no 6, p. 668-673Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: to describe the grief of mothers and fathers and its influence on their relationships after the loss of a stillborn baby. DESIGN: a postal questionnaire at three months, one year and two years after stillbirth. SETTING: a study of mothers and fathers of babies stillborn during a one-year period in the Stockholm region of Sweden. PARTICIPANTS: 55 parents, 33 mothers and 22 fathers. FINDINGS: mothers and fathers stated that they became closer after the loss, and that the feeling deepened over the course of the following year. The parents said that they began grieving immediately as a gradual process, both as individuals, and together as a couple. During this grieving process their expectations, expressions and personal and joint needs might have threatened their relationship as a couple, in that they individually felt alone at this time of withdrawal. While some mothers and fathers had similar grieving styles, the intensity and expression of grief varied, and the effects were profound and unique for each individual. KEY CONCLUSIONS: experiences following a loss are complex, with each partner attempting to come to terms with the loss and the resultant effect on the relationship with their partner. IMPLICATIONS FOR PRACTICE: anticipating and being able to acknowledge the different aspects of grief will enable professionals to implement more effective intervention in helping couples grieve both individually and together.

  • 260.
    Avidago, Lisa
    et al.
    Sophiahemmet University.
    Wikman, Maria
    Sophiahemmet University.
    Patienters upplevelser och erfarenheter av transition från barn- till vuxensjukvård: en litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund Att vara barn och leva med en kronisk sjukdom innefattar återkommande besök inom barnsjukvården. Alla barn med deras familjer hanterar situationen på olika sätt och utifrån deras förutsättningar. Barnsjukvården arbetar utifrån ett förhållningssätt som är familjefokuserat, där trygghet är centralt. De flesta barn med kroniska sjukdomar blir unga vuxna och beräknas återgå till vuxensjukvården vid 18 års ålder. Transitionens utgång kan återspeglas i personernas egna förutsättningar, därför är alla transitioner unika.

    Syfte Syftet var att belysa patienters upplevelser och erfarenheter i transitionen från barn- till vuxensjukvård vid kronisk sjukdom.

    Metod Vald metod var en litteraturöversikt. Sökningar genomfördes i CINAHL samt PubMed. Integrerad analys användes och de 15 utvalda artiklarna kvalitetsgranskades utifrån Sophiahemmet Högskolas bedömningsunderlag. Dessa sammanställdes i en Matris.

    Resultat I resultatet framkom patienters delade uppfattningar och erfarenheter genom sina transitionsprocesser, många hade upplevt sorg och oro över att lämna en trygg barnsjukvård med en tillåtande miljö. Vidare beskrev patienter vikten av att kunna erhålla individanpassad information. I denna litteraturöversikt framträdde kategorierna: patienters intryck under transitionsprocessen, förberedelse, självständighet och egenvårdsförmåga i samband med transition samt vårdpersonalens betydelse i transition.

    Slutsats Förberedelse och en individuell utformad informationsåtergivelse ansågs vara viktiga aspekter för en lyckad transitionsprocess. Patienter hade delade upplevelser och erfarenheter gällande sin transition från barn- till vuxensjukvård. För att möjliggöra lyckade transitioner för patienten var ett personcentrerat förhållningssätt hos sjuksköterskan viktigt för att stödja patienten i processen.

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  • 261.
    Axell, Karin
    Sophiahemmet University College.
    Gravida kvinnor och typ 1-diabetes: stress, oro och välbefinnande under graviditetens trimestrar2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 262.
    Axelsson, Christina
    et al.
    Sophiahemmet University College.
    Sondell, Pernilla
    Sophiahemmet University College.
    Vård på lika villkor: en genusfråga vid hjärtinfarkt?2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 263.
    Axelsson, Jenny
    et al.
    Sophiahemmet University.
    Cimarosa Holmström, Andrea
    Sophiahemmet University.
    Sjuksköterskors perspektiv på mötet med närstående vid trauma på akutmottagningen2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Trauma uppstår genom yttre faktorer eller händelser som påverkar kroppen fysiskt eller psykiskt. Traumasituationer sker plötsligt, oväntat och kan leda till stress och oro. Under traumaomhändertagandet är närstående ofta närvarande och utgör en del av patientens vård. Vid dessa händelser kan närstående vara chockade och i behov av omhändertagande och stöttning. Vårdpersonalens primära ansvar är omhändertagandet av patienten vilket medför att närstående riskerar bli lidande på grund av avsaknad av stöd. Vidare beskrivs att vårdpersonalens förhållningssätt och inställning till närstående spelar en viktig roll i hur mötet upplevs.

    Syfte

    Syftet var att beskriva sjuksköterskans perspektiv avseende faktorer som påverkade mötet med närstående till patienter som vårdats för trauma på en akutmottagning.

    Metod

    En kvalitativ intervjustudie med semistrukturerade frågor genomfördes där sju sjuksköterskor verksamma på fem olika akutmottagningar inom Stockholms län intervjuades. Insamlad data analyserades genom en innehållsanalys.

    Resultat

    Två teman och sju subteman framkom ur analysen. Det första temat beskriver förutsättningar i mötet där bland annat informationsöverföringen och teamarbetet belyses som viktigt och det andra temat beskriver faktorer som kan utgöra hinder i mötet med närstående i traumasituationen, exempelvis bemanningsfrågor och utbildning.

    Slutsats

    Ett utarbetat arbetssätt för hur närstående skall omhändertas och mötas på akutmottagningen, tillgång till vårdpersonal avsatt för ändamålet, tydlig kommunikation och informationshantering samt relevant utbildning för vårdpersonalen ansågs vara viktiga faktorer för att mötet med närstående skulle optimeras på akutmottagningarna. 

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  • 264.
    Axelsson, Jenny
    et al.
    Sophiahemmet University.
    Melin, Sandra
    Sophiahemmet University.
    Faktorer som påverkar patientens tillfredsställelse i kontakten med specialistsjuksköterskan inom akutsjukvården: en litteraturöversikt2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Emergency care is provided 24 hours a day. Emergency care is provided prehospital, hospital but also in primary care and cares for thousands of patients every day. The environment in emergency care is hectic and changing rapidly. In addition, the emergency rooms are overcrowded related to a reduced number of hospital beds, which affects patient safety and patient care. The tasks of the emergency nurse vary greatly and place high demands on his or her competence in order to meet the patient's needs in a person-centered manner.

    The aim of the study was to illustrate factors that affect the patient's satisfaction in contact with advanced nurse in emergency care. The method used to answer the aim is a general literature review using a systematic method. The data collection has been performed in Public / Publisher Medical Literature On-Line and Cumulative Index to Nursing and Allied Health Literature. The study included 20 articles that had a qualitative and quantitative approach, and these have been analyzed with an integrated analysis, which created six categories and two themes.

    Based on two categories, the results showed that patients' satisfaction with care increased if the nurses cared for the patients as individuals and not as a disease or condition. In the nurse's care, it was important to have a friendly attitude, that the nurse was polite and had compassion and treated the patient with respect and dignity. When the nurses listened carefully to the patient, this was another factor that increased the patient's satisfaction with their visit. One factor that affects patient satisfaction was the waiting time and was strongly linked to information. Receiving information about what the patient was waiting for, getting continuous updates and an estimated waiting time increased satisfaction and made the patient not feel forgotten. Our conclusion is that the results show that there are many factors that affect the patient's satisfaction in contact with the advanced nurse in emergency care. Through knowledge of the factors that affect patient satisfaction, the advanced nurse can develop her work close to the patient and continue to develop the person-centered care.

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  • 265.
    Axelsson, Lena
    Sophiahemmet University.
    Living with haemodialysis close to death - patients' and close relatives' experiences2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis is to generate  understanding and knowledge a bout the experiences of  patients living with haemodialysis, and their close relati ves, near the end of life. In studies I and II we  conducted a series of 31 qualitative interviews over a period of 12 months with 8 severely ill patients  (aged 66–87) treated with haemodialysis. For study I the text of the interviews was analysed using  phenomenological hermeneutics to describe and to el ucidate the meanings of being severely ill living  with haemodialysis when nearing end of life. For study II the text was analysed using qualitative content  analysis to describe inner thoughts and feelings  relating to death and dying of these patients. For studies III and IV, we conducted 14 retrospective qualitative interviews with close relatives of  deceased patients treated with haemodialysis about th eir experiences during end of the patient’s life.  For paper III the interview text was analysed usi ng phenomenological hermeneu tics to describe and  elucidate the meanings of being a close relative at the  end of life of a severely ill family member treated  with maintenance haemodialysis. For paper IV the text was analysed using qualitative content analysis to  describe end of life for the patients from the perspective of their close relatives. The findings of study I suggest that being severely i ll and living with haemodialysis near the end of life  means living with suffering from a deteriorating body, a high symptom burden, and dependence on  advanced medical technology, simultaneously with r econciliation and well-being. The meanings of living  with illness and dialysis are intertwined with the meanings of being old.  Study II shows that thoughts and feelings about deat h and dying are significant and complex for those  living with haemodialysis as they approach the end of life. Patients experience  a multifaceted presence of  death. Their awareness of approaching death may include their repressing of thoughts of death, not as  denial, but to allow them to focus on living as fully as possible the time they have left. Study III shows that close relatives strive to maintain balance and well-being for themselves and for  the patient, which we interpreted as their striving to regain balance, and inner equilibrium in their  changed and challenged rhythm of life. Study IV shows that after gradual deterioration and increasing  care needs, older patients in haemodialysis care with  co-morbidities follow three different main paths at  the end of life: uncertain anticipation of death; awaiting death after dialysis withdrawal; and sudden but  not unexpected death. The ends of their lives are marked by complex symptoms and existential issues  related to haemodialysis treatment and withdrawal, and  their uncertainty of what  to expect at the end of  life suggests the need for increased continuity and coordination of whole person care. Both patients and  their close relatives are often alone with their existential thoughts. In their complex lifeworlds, intertwined meanings  of living with illness and maintenance of life with  haemodialysis treatment near the end of life show that patients live in a borderland of living-dying that is  shared by the close relative. Patients and close relatives focus on living when death is close but uncertain,  with severe illness and the maintenance of life through advanced technology.  Integrating the philosophy of palliative care (with a focus on symptom relief, team work,  communication, relationships, and support of family members) into dialysis care, may support health  care professionals in haemodialysis units and other re nal contexts, to improve the care of severely ill  patients, both earlier in their illness and as they approach the end of their lives.

  • 266.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Alvariza, Anette
    Carlsson, Nina
    Cohen, S. Robin
    Sawatzky, Richard
    Årestedt, Kristofer
    Measuring quality of life in life-threatening illness: Content validity and response processes of MQOL-E and QOLLTI-F in Swedish patients and family carers2019Conference paper (Other academic)
  • 267.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Alvariza, Anette
    Carlsson, Nina
    Cohen, S Robin
    Sawatzky, Richard
    Årestedt, Kristofer
    Measuring quality of life in life-threatening illness: Content validity and response processes of MQOL-E and QOLLTI-F in Swedish patients and family carers2020In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 19, no 1, article id 40Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The McGill Quality of Life Questionnaire - Expanded (MQOL-E) and the Quality of Life in Life-Threatening Illness-Family Carer/Caregiver version (QOLLTI-F) are developed for use with patients facing the end of life and their family carers, respectively. They are also developed for possible use as companion instruments. Contemporary measurement validity theory places emphasis on response processes, i.e. what people feel and think when responding to items. Response processes may be affected when measurement instruments are translated and adapted for use in different cultures. The aim of this study was to translate and examine content validity and response processes during completion of MQOL-E and QOLLTI-F version 2 (v2) among Swedish patients with life-threatening illness and their family carers.

    METHODS: The study was conducted in two stages (I) translation and adaptation (II) examination of content validity and response processes using cognitive interviews with 15 patients and 9 family carers. Participants were recruited from the hemodialysis unit, heart clinic, lung clinic and specialized palliative care of a Swedish county hospital. Patients had life-threatening illness such as advanced heart failure, advanced chronic obstructive pulmonary disease, end-stage kidney disease or advanced cancer. Patients were outpatients, inpatients or receiving home care.

    RESULTS: Patients and family carers respectively believed that the items of the MQOL-E and QOLLTI-F v2 reflect relevant and important areas of their quality of life. Although some items needed more time for reflection, both instruments were considered easy to understand. Some changes were made to resolve issues of translation. Participants expressed that reflecting on their situation while answering questions was valuable and meaningful to them, and that responding was an opportunity to express feelings.

    CONCLUSIONS: The results of response processes pertaining to the Swedish translations of both MQOL-E and QOLLTI-F v2 contribute evidence regarding content validity, linguistic equivalence and cultural appropriateness of the translated instruments. In addition, results show that the instruments may support conversations on matters of importance for quality of life between patients and/or family carers and health care professionals. Further research is needed to study the psychometric properties of Swedish translations.

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  • 268.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Alvariza, Anette
    Holm, Maja
    Sophiahemmet University.
    Årestedt, Kristofer
    Intensity of predeath grief and postdeath grief of family caregivers in palliative care in relation to preparedness for caregiving, caregiver burden, and social support2020In: Palliative Medicine Reports, ISSN 2689-2820, Vol. 1, no 1, p. 191-200Article in journal (Refereed)
    Abstract [en]

    Background: The intensity of predeath grief is associated with postdeath grief in family caregivers of patients in palliative care. Different factors during caregiving may influence this association.

    Objective: To examine (1) the intensity of grief in relation to preparedness for caregiving, caregiver burden, and social support, and (2) if these variables moderate associations between predeath and postdeath grief.

    Methods: This prospective correlational study used unpaired t-test to compare grief in relation to preparedness for caregiving, caregiver burden, and social support. Hierarchical multiple linear regression analysis investigated moderation effects. Family caregivers were recruited from 10 palliative homecare facilities. The Anticipatory Grief Scale, Texas Revised Inventory of Grief, Preparedness for Caregiving Scale, Caregiver Burden Scale, and Multidimensional Scale of Perceived Social Support were used. Ethical approval for the study was granted by the Regional Ethical Review Board in Stockholm, Sweden.

    Results: In total, 128 family caregivers participated. Those with high caregiver burden scored significantly higher intensity of predeath but not postdeath grief. Caregiver burden and social support moderated the association between intensity of predeath grief and postdeath grief. There was a stronger association between predeath and postdeath grief among caregivers with low caregiver burden or low social support. Preparedness for caregiving had no moderating effect.

    Discussion: Attention should be directed to caregiver burden and social support during family caregiving, as these variables seem to be significant for the intensity of grief before and after the patient's death. Acknowledging predeath grief during caregiving and recognizing pre- and postdeath grief as parts of the same process are of importance in clinical practice and when designing supportive interventions.

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  • 269.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Alvariza, Anette
    Lindberg, Jenny
    Öhlén, Joakim
    Håkanson, Cecilia
    Sophiahemmet University.
    Reimertz, Helene
    Fürst, Carl Johan
    Årestedt, Kristofer
    Unmet palliative care needs among patients with end-stage kidney disease: A national registry study about the last week of life2017Conference paper (Other academic)
  • 270.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Alvariza, Anette
    Lindberg, Jenny
    Öhlén, Joakim
    Håkanson, Cecilia
    Sophiahemmet University.
    Reimertz, Helene
    Fürst, Carl-Johan
    Årestedt, Kristofer
    Unmet palliative care needs among patients with end-stage kidney disease: a national registry study about the last week of life2018In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 55, no 2, p. 236-244Article in journal (Refereed)
    Abstract [en]

    CONTEXT: End-stage kidney disease (ESKD) is characterized by high physical and psychological burden and therefore, more knowledge about the palliative care provided close to death is needed.

    OBJECTIVES: To describe symptom prevalence, relief and management during the last week of life, as well as end-of-life communication, in patients with ESKD.

    METHODS: This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (ICD-10-SE; N18.5 or N18.9), during 2011 and 2012 were selected.

    RESULTS: 472 patients were included. Of six predefined symptoms, pain was the most prevalent (69%), followed by respiratory secretion (46%), anxiety (41%), confusion (30%), shortness of breath (22%), and nausea (17%). Of patients with pain and/or anxiety, 32% and 44% respectively were only partly relieved or not relieved at all. Of patients with the other symptoms, a majority (55%-84%) were partly relieved or not relieved at all. End-of-life discussions were reported in 41% of patients and 71% of families. A minority died in specialized palliative care: 8% in hospice/in-patient palliative care and 5% in palliative home care. Of all patients, 19% died alone. Bereavement support was offered to 38% of families.

    CONCLUSION: Even if death is expected, the majority of patients dying with ESKD had unmet palliative care needs regarding symptom management, advance care planning, and bereavement support.

  • 271.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Benzein, Eva
    Lindberg, Jenny
    Persson, Carina
    End-of-life and palliative care of patients on maintenance hemodialysis treatment: A focus group study2019In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 18, no 1, article id 89Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 272.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Benzein, Eva
    Lindberg, Jenny
    Persson, Carina
    Processes toward the end of life and dialysis withdrawal: Physicians' and nurses' perspectives2020In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 27, no 2, p. 419-432, article id 969733019848050Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nurses and physicians in nephrology settings provide care for patients with end-stage kidney disease receiving hemodialysis treatment along a complex illness trajectory.

    AIM: The aim was to explore physicians' and nurses' perspectives on the trajectories toward the end of life involving decisions regarding hemodialysis withdrawal for patients with end-stage kidney disease.

    RESEARCH DESIGN AND PARTICIPANTS: A qualitative research approach was used. Four mixed focus group interviews were conducted with renal physicians (5) and nurses (17) in Sweden. Qualitative content analysis was used to analyse data.

    ETHICAL CONSIDERATIONS: Ethical approval was obtained (Dnr 2014/304-31).

    FINDINGS AND DISCUSSION: Findings illuminated multi-faceted, intertwined processes encompassing healthcare professionals, patients, and family members. The analysis resulted in four themes: Complexities of initiating end-of-life conversations, Genuine attentiveness to the patient's decision-making process, The challenge awaiting the family members' processes, and Negotiating different professional responsibilities. Findings showed complexities and challenges when striving to provide good, ethical care which are related to beneficence, nonmaleficence, and self-determination, and which can give rise to moral distress.

    CONCLUSION: There are ethical challenges and strains in the dialysis context that healthcare professionals may not always be prepared for. Supporting healthcare professionals in not allowing complexities to hinder the patient's possibilities for shared decision-making seems important. An open and continual communication, including family meetings, from dialysis initiation could serve to make conversations involving decisions about hemodialysis withdrawal a more natural routine, as well as build up a relationship of trust necessary for the advance care planning about the end of life. Healthcare professionals should also receive support in ethical reasoning to meet these challenges and handle potential moral distress in the dialysis context.

  • 273.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Benzein, Eva
    Persson, Carina
    Complexities of the processes towards palliative care for patients with end-stage kidney disease: Physicians' and nurses' perspectives2017Conference paper (Other academic)
  • 274.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Björvell, Catrin
    Mattiasson, Anne-Cathrine
    Sophiahemmet University.
    Randers, Ingrid
    Sophiahemmet University.
    Swedish Registered Nurses' incentives to use nursing diagnoses in clinical practice2006In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, no 8, p. 936-45Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The purpose of this study was to describe Registered Nurses' incentives to use nursing diagnoses in clinical practice. BACKGROUND: The use of nursing diagnoses is scarce in Swedish patient records. However, there are hospital wards were all nurses formulate and use nursing diagnoses in their daily work. This leads to the question of what motivates these nurses who do use nursing diagnoses in clinical practice. DESIGN: A qualitative descriptive design. METHODS: A purposeful sampling of 12 Registered Nurses was used. Qualitative interviews to collect data and a content analysis were performed. RESULTS: Five categories were identified: identification of the patient as an individual and as a whole, a working tool for facilitating nursing care, increasing awareness within nursing, support from the management and influence on the professional role. The principle findings of this study were: (i) that the Registered Nurses perceived that nursing diagnoses clarified the patient's individual needs and thereby enabled them to decide on more specific nursing interventions, (ii) that nursing diagnoses were found to facilitate communication between colleagues concerning patient care and thus promoted continuity of care and saved time and (iii) that nursing diagnoses were perceived to increase the Registered Nurses' reflective thinking leading to a continuous development of professional knowledge. CONCLUSIONS: The present findings suggest that the incentives to use nursing diagnoses originate from effects generated from performing a deeper analysis of the patient's nursing needs. Further research is needed to test and validate the usability and consequences of using nursing diagnoses in clinical practice. Motivating factors found in this study may be valuable to Registered Nurses for the use and development of nursing diagnoses in clinical care. Moreover, these factors may be of relevance in other countries that are in a similar situation as Sweden concerning application of nursing diagnoses.

  • 275.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Klang, Birgitta
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Jacobson, Stefan H
    Andreassen Gleissman, Sissel
    Sophiahemmet University.
    End of life of patients treated with haemodialysis as narrated by their close relatives2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 776-784Article in journal (Refereed)
    Abstract [en]

    AIM: The study aimed to describe end of life for patients treated with maintenance haemodialysis as narrated by their close relatives.

    INTRODUCTION: Many patients undergoing haemodialysis are older, have several comorbidities and underestimated symptoms and are in their last year of life. To improve care, we need to know more about their end-of-life situation.

    DESIGN: Qualitative and descriptive.

    METHODS: Qualitative retrospective interviews were conducted with 14 close relatives of deceased haemodialysis patients (3-13 months after death). Data were analysed using qualitative content analysis. The study is ethically approved.

    FINDINGS: In the last months, a gradual deterioration in health with acute episodes necessitating hospital admissions was described. This involved diminishing living space and expressions of dejection, but also of joy. Three patterns emerged in the last weeks: uncertain anticipation of death as life fades away; awaiting death after haemodialysis withdrawal; and sudden but not unexpected death following intensive care. Findings show complexities of decisions on haemodialysis withdrawal.

    CONCLUSIONS: Different end-of-life patterns all involved increasingly complex care needs and existential issues. Findings show a need for earlier care planning. The identification of organisational factors to facilitate continuity and whole person care to meet these patients' specific care needs with their complex symptom burdens and comorbidities is needed. Findings indicate the need for integration of a palliative care approach in the treatment of patients in haemodialysis care.

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  • 276.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Klang, Birgitta
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Jacobson, Stefan H
    Andreassen Gleissman, Sissel
    Sophiahemmet University.
    Meanings of being a close relative of a family member treated with haemodialysis2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 3/4, p. 447-456Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To describe and elucidate the meanings of being a close relative of a severely ill family member treated with maintenance haemodialysis approaching the end of life.

    BACKGROUND:

    End-stage renal disease together with comorbidities, haemodialysis treatment and high mortality rates also affects the lives of close relatives, who report burdens and impaired quality of life. To improve care, more understanding is needed of close relatives' experiences during these patients' end of life.

    DESIGN:

    This study has a qualitative interpretative design.

    METHODS:

    Fourteen retrospective qualitative interviews were conducted with close relatives (aged 48-93 years) of deceased patients who had been treated with haemodialysis. The interview text was interpreted using a phenomenological hermeneutical method in three phases.

    RESULTS:

    The findings of the structural analysis were formulated as six themes: Striving to be supportive and helpful without doing harm to the ill person's self; Needing increasing strength and support; Balancing the will to help with one's own ongoing life; Increasing responsibility involving dilemmas; Striving for a good life together in the present and Living with awareness of death.

    CONCLUSIONS:

    Close relatives strive for balance and well-being accompanying their ill family member through the end of life. They are facing moral dilemmas and growing demands as their responsibility increases with the deterioration of their family member. Support from and interaction with the healthcare professionals is then of significance.

    RELEVANCE TO CLINICAL PRACTICE:

    Findings challenge healthcare professionals in haemodialysis settings to identify close relatives' individual resources and needs towards the patients' end of life. Healthcare professionals in haemodialysis settings need to offer close relatives opportunities to talk about the future and what may be expected at end of life, with or without haemodialysis. They should also contact the closest relative after the death as they may need confirmation and closure.

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  • 277.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Randers, Ingrid
    Sophiahemmet University.
    Jacobson, Stefan H
    Klang, Birgitta
    Living with haemodialysis when nearing end of life2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 45-52Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of this study was to describe and to elucidate the meanings of being severely ill living with haemodialysis when nearing end of life.

    INTRODUCTION: To have end stage renal disease and to be treated with maintenance haemodialysis implies being dependent on lifelong treatment. Several studies have reported that these patients suffer a high symptom burden and an impaired quality of life due to both disease and treatment. In the dialysis unit, where the focus is on handling technology and maintaining life, end of life care may be neglected or overlooked. Nevertheless, mortality rates show that about one-fourth of patients in haemodialysis care are in their last year of life.

    DESIGN: A qualitative interpretative design was used.

    METHODS: Serial qualitative interviews over a period of 12 months were conducted with eight patients (aged 66-87). Altogether text of 31 interviews was interpreted using a phenomenological hermeneutical method in three phases. The study is ethically approved.

    FINDINGS: The structural analysis resulted in 11 subthemes and thereafter the following three themes were formulated; being subordinate to the deteriorating body, changing outlook on life and striving for upheld dignity. The comprehensive interpretation revealed that being severely ill living with haemodialysis near the end of life means living with suffering simultaneously with reconciliation and well-being. Further, the meanings are understood as intertwined with being old.

    CONCLUSIONS: Findings contribute to an increased awareness of the complexities of these patients' life worlds and their meanings, and thus of the importance to listen to their experiences and their understandings. Findings suggest that to integrate the philosophy of palliative care in haemodialysis units may improve care for patients who are living with haemodialysis and approaching the end of their lives.

  • 278.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Randers, Ingrid
    Sophiahemmet University.
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Jacobson, Stefan H
    Klang, Birgitta
    Thoughts on death and dying when living with haemodialysis approaching end of life2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 15-16, p. 2149-59Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe inner thoughts and feelings relating to death and dying when living with haemodialysis approaching end of life.

    BACKGROUND: Patients who undergo maintenance haemodialysis suffer a significant symptom burden and an impaired quality of life. The high mortality rate in these patients indicates that about one-fourth of them are in their last year of life, suggesting the presence of death and dying in the haemodialysis unit.

    DESIGN: A qualitative descriptive design was used. Methods.  A total of 31 qualitative interviews were conducted with eight patients (aged 66-87) over a period of 12 months. Qualitative content analysis was used to analyse data.

    RESULTS: The analysis revealed 10 subthemes that were sorted into three main themes. Being aware that death may be near comprises being reminded of death and dying by the deteriorating body, by the worsening conditions and deaths of fellow patients, and by knowing haemodialysis treatment as a border to death. Adapting to approaching death comprises looking upon death as natural, preparing to face death, hoping for a quick death and repressing thoughts of death and dying. Being alone with existential thoughts comprises a wish to avoid burdening family, lack of communication with healthcare professionals and reflections on haemodialysis withdrawal as an hypothetic option.

    CONCLUSIONS: Living with haemodialysis approaching, the end of life involves significant and complex existential issues and suffering, and patients are often alone with their existential thoughts.

    RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals in haemodialysis settings need to combine technical and medical abilities with committed listening and communication skills and be open to talking about death and dying, with sensitivity to individual and changeable needs.

  • 279.
    Axelsson, Lena
    et al.
    Sophiahemmet University.
    Årestedt, Kristofer
    Holm, Maja
    Sophiahemmet University.
    Alvariza, Anette
    Pre- and post-death grief in family caregivers in palliative care in relation to preparedness for caregiving, caregiver burden and social support2020Conference paper (Other academic)
  • 280.
    Axelsson, Linda
    Sophiahemmet University.
    Behov och bemötande - den sexuellt våldsutsatta kvinnans upplevelse av vården efter övergrepp: en litteraturöversikt2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background 

    Sexual violence is a common problem in today’s society followed by physical and psychological health effects both short- and long term. The health consequences are many but include depression, trauma, unwanted pregnancy and sexually transmitted infections. Healthcare professionals play a significant role, however, they often lack the knowledge and experience to identify and respond to sexually vulnerable women. 

    Aim 

    The purpose of this study was to describe how the sexually abused woman experiences the encounter with health professionals and her care needs following abuse. 

    Method 

    This non-systematic literature review includes 19 original scientific articles of both quantitative and qualitative design. These have been retrieved from the databases PubMed and CINAHL, by several keyword combinations. All articles have been quality reviewed on the basis of Sophiahemmet University's assessment data. They have been analyzed with an integrated analysis. 

    Result 

    Important aspects of the care staff's interaction with sexually abused women, in order for it to increase healing, are respect, integrity, confirmation and safeguarding the woman's self- determination. Sexually abused women are particularly vulnerable because of aspects regarding norms and lawsystems, as well as how she relates to the perpetrator. There is a need for specialized care. The results are divided into three main categories, namely The experience of seeking and receiving care, The sexually abused woman's vulnerability in health care and The need to be taken seriously. 

    Conclusion 

    The results show that healthcare professionals have a significant role in facilitating healing when encountering sexually abused people in healthcare. Positive experiences can lay a foundation for recovery at the same time as negative experiences can lead to revictimization as well as delayed or absent care. The interaction requires presence and sensitivity for the care to be experienced as respectful and compassionate. The results also show that sexually abused women demand, and have positive experiences of, specialized care. 

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    BEHOV OCH BEMÖTANDE - DEN SEXUELLT VÅLDSUTSATTA KVINNANS UPPLEVELSE AV VÅRDEN EFTER ÖVERGREPP
  • 281.
    Axelsson, Martina
    Sophiahemmet University College.
    Sjuksköterskors bekräftelse av patienters känsla av sammanhang inom vård och omsorg av äldre2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 282.
    Axelsson, Sophie
    et al.
    Sophiahemmet University.
    Strada, Julia
    Sophiahemmet University.
    Kvinnors kroppsuppfattning efter mastektomi på grund av bröstcancer: en litteraturöversikt2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Breast cancer is the most common disease worldwide among women. Although mortality has decreased, the number of women developing breast cancer is increasing yearly. The most common treatment for breast cancer is mastectomy, a surgical treatment that can have both a psychological and physical effect on the women who receive it. Mastectomy entails a change in the women’s body structure, which in turn can affect body image. In order to meet and care for these women in a person-centred way, nurses need to have a broad knowledge and understanding of their situation.

    Aim

    The purpose of this study was to describe the body image of women after mastectomy due to breast cancer.

    Method

    A non-systematic literature review based on seventeen original scientific articles using both a qualitative and a quantitative approach. The databases PubMed, CINAHL and PsychInfo were used in finding these articles. The articles included have been evaluated using a template for quality review developed by Sophiahemmet Högskola. The results were compiled and analyzed using an integrative analysis method.

    Results

    The analysis resulted in three main categories: A new body image and its influence on everyday life and The importance of support in coping with a new body image. The results showed that the women experienced a change in their body image and it impacted on their sexuality and identity. The women used different coping strategies to deal with an altered body. Their faith was a central aspect of the women’s adjustment to their new situation in life. Person-centered care and good communication were of importance to their experience of support.

    Conclusions

    This literature review provides an increased understanding on how a mastectomy can affect women and their body image. The loss of one or two breasts is more than a physical loss, it can also be experienced as a loss of female identity. The nurse can support adaptation for the women through good individualized care.

  • 283.
    Axelsson, Åsa
    Sophiahemmet University.
    Patientens självskattade perioperativa smärta vid lokalbedövningsmetoden wide awake och traditionell lokalbedövningsmetod vid handkirurgiska ingrepp: en jämförande pilotstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Handen har en mycket central roll för människans funktion och benämns ofta som hjärnans förlängning mot världen. Huvudsyftet inom handkirurgi är att vid skador, återskapa handens funktion för att förbättra människans livskvalité. De flesta operationer inom handkirurgi sker i någon form av lokalanestesi och majoriteten kräver blodtomhet i operationsområdet. Dagens former av lokalanestesi medför vissa begränsningar av operationstiden då trycket av blodtomhetsmanschetten orsakar smärta och obehag för patienten. Då det vid vissa handkirurgiska operationer är av stor fördel för operationsresultatet att patienten är vaken och vid uppmaning aktivt kan medverka vid operationen är det bra med vaken patient och därför bra om generell anestesi kan undvikas. Genom att bedöva patienten med en buffrad lokalbedövningsblandning med adrenalin kan patienten bli bedövad samtidigt som blodtomhet uppnås i operationsområdet, patienten behåller sin rörelseförmåga och kan på så sätt medverka vid operationen. Denna metod kallas Wide Awake.

    Syftet: Syftet med denna studie var att jämföra patientens smärtskattning vid Wide Awake lokalbedövningsmetod och den nuvarande lokalbedövningsmetoden som används vid handkirurgiska kliniken, samt beskriva patientens smärtupplevelse vid båda metoderna.

    Metod: Studien utfördes som en pilotstudie med både kvalitativ och kvantitativ ansats, en så kallad mixad metod. Tjugo forskningspatienter följdes under operationsprocessen med numeriskt kvantitativt protokoll där smärtskattningsdata samlades in och analyserades enligt Mann-Whitney U test. Ett uppföljande samtal dagen efter operation gjordes och sammanställdes med en manifest innehållsanalys enligt Graneheim och Lundman.

    Resultat: Studien visar på en skillnad i smärtupplevelse där patienter som opereras i Wide Awake lokalbedövningsmetod upplever mindre smärta och obehag än patienter som opereras i nuvarande lokalbedövningsmetod.

    Slutsats: Slutsatsen av denna studie visar på att Wide Awake är en bedövningsform som är lindrigare ur smärtsynpunkt för patienten vid mindre handkirurgiska ingrepp än den nuvarande traditionella lokalbedövning som används idag på handkirurgiska kliniken.

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  • 284.
    Axhed, Malin
    et al.
    Sophiahemmet University. Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Stenvall, Marie-Charlotte
    Sophiahemmet University. Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Sjuksköterskors erfarenheter av att samtala om existentiella frågor med patienter i livets slutskede: en litteraturstudie2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Att leva med en oövervinnerlig sjukdom som på längre eller kortare sikt kommer att leda till döden och livets slutskede kan väcka många känslor, frågor och tankar, inte bara hos patienten utan även hos sjuksköterskan. Samtal om existentiella frågor som livet och döden kan hjälpa patienten att sätta ord på vad som är värdefullt den sista tiden i livet. Kunskap om hur existentiella samtal förs med patienter som befinner sig i livets slutskede är viktigt att identifiera, beskriva och förbättra. Därför är det betydelsefullt att beskriva sjuksköterskors erfarenheter av att samtala om livet och döden med patienter i livets slutskede.

    Syfte: Syftet med litteraturöversikten var att beskriva sjuksköterskors erfarenheter av existentiella samtal med patienter i livets slutskede.

    Metod: Studien är en kvalitativ litteraturöversikt. En tematisk analys med induktiv ansats genomfördes utifrån Braun och Clarkes tematiska analysmetod. Totalt 12 artiklar valdes ut från databaserna CINAHL, Pubmed och Psychinfo.

    Resultat: Erfarenheter av tidsbrist, osäkerhet, egna rädslor samt okunskap avseende existentiella frågor och sammanhang beskrevs. Erfarenhet, kunskap och kännedom om sin egen inställning till döden och döendet kunde bidra till ökad förmåga att närma sig det svåra. Det var viktigt att skapa förtroende och en relation med patienterna. Dokumentation avseende existentiellt mående uppvisade brister. Det fanns en uppfattning om att den var viktig för att kunna följa patientens själsliga mående men osäkerhet beskrevs och några menade att den inte var viktig eller alls lästes.

    Slutsats: Att i mötet och i samtalet våga och kunna lämna görandet och istället vara kan öppna upp för att se och förstå människan bakom patienten.

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  • 285.
    Axner, Anna
    et al.
    Sophiahemmet University College.
    Wekesa, Brunhilda
    Sophiahemmet University College.
    Kvinnors upplevelser vid missfall : en forskningsöversikt2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 286.
    Axén, Louise
    et al.
    Sophiahemmet University.
    Brorsson, Mika
    Sophiahemmet University.
    Fysisk aktivitet vid depressiva tillstånd - hindrande och främjande faktorer: en icke-systematisk litteraturöversikt2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background 

    Physical activity has positive effects on health and can reduce symptoms in depressive conditions that negatively impact people's daily lives. Using physical activity as a treatment method can be equated with antidepressant medication for mild and moderate depression. To enable nurses to support individuals with depressive conditions in engaging in physical activity, a compilation of existing research on inhibiting and facilitating factors affecting participation is needed. 

    Aim 

    The aim was to illustrate inhibiting and facilitating factors for physical activity in individuals with depressive conditions. 

    Method 

    The literature review was based on 16 scientific original articles employing both qualitative and quantitative approaches within a non-systematic design. Data collection was conducted through searches in the PubMed, CINAHL, and PsycINFO databases using combined search terms. Selected articles underwent quality assessment based on Sophiahemmet University College's criteria for scientific classification and quality. An integrated data analysis was employed for the compilation and analysis of all 16 articles, and the results were discussed in relation to Prochaska and DiClemente's transtheoretical model of change. 

    Results 

    In the results, two main categories were identified: Inhibiting factors and Successful factors. The factors considered to limit the engagement in physical activity included the impact of depression, encompassing symptoms and their severity, lack of motivation, and the ability to translate intention into action. Factors promoting engagement in physical activity included continuous, professional, and social support in the form of scheduled exercise sessions, encouragement, and expected participation. 

    Conclusions 

    The symptoms of depression and the severity of the condition significantly impacted the engagement in physical activity. Through continuous, professional, and social support, strategies can be identified to overcome inhibiting factors. Physical activity increased when it felt manageable, was done for enjoyment, and involved a personal trainer. Nurses have the ability to establish trusting partnerships through a person-centered approach. Through exploratory conversations and persistent follow-up, they can support individuals with depressive conditions in symptom relief by encouraging increased physical activity. 

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    Självständigt arbete, Louise Axén, Mika Brorsson
  • 287.
    Ayata, Arvid
    et al.
    Sophiahemmet University.
    Söderkvist, Gustav
    Sophiahemmet University.
    Attityder och uppfattningar till dödshjälp hos patienter i palliativt skede: en litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Dödshjälp innebär att en läkare administrerar en dödlig dos läkemedel med avsikt att patientens liv avslutas. Dödshjälp är idag olagligt i Sverige och större delen av världen men i takt med att dödshjälp i olika former legaliserats i länder som Belgien, Nederländerna, Canada och USA pågår debatten om legalisering i Sverige. Patienter som vårdas i ett palliativt skede är ofta de som ber om dödshjälp för att lindra det lidande som kan uppstå i livets slutskede.

    Syfte

    Syftet var att belysa attityder och uppfattningar till dödshjälp hos patienter i ett palliativt skede.

    Metod

    Metoden som användes var allmän litteraturöversikt. 15 artiklar inkluderades ifrån databaserna PubMed och CINAHL. Dessa artiklar kvalitetsgranskades samt analyserades med integrerad analys.

    Resultat

    Attityderna och uppfattningarna till dödshjälp hos patienterna var både positiva och negativa. Att lindra lidande sågs som ett starkt argument till utförandet dödshjälp. Däremot fanns en något komplex syn kring just lidande då vissa hade uppfattningar om att lidande aldrig kan vara så outhärdligt att döden är att föredra. En förbättrad palliativ vård med ett ökad personcentrerat förhållningsätt ansågs vara ett alternativ till dödshjälp, men i vissa fall skulle förmodligen inte det vara tillräckligt.

    Slutsats

    Cirka en tredjedel av patienterna som deltog i studierna önskade dödshjälp. Önskan skiljde sig dock åt beroende på vilket land studien var utförd i, där förfrågan var vanligare i länder där dödshjälp var lagligt. Sjukdomssymtom som smärta och depression framkom vara de vanligaste anledningarna till att patienterna önskade dödshjälp. Lidandet är ett subjektivt fenomen där livslidandet kan nå dimensioner där sjukvården lämnas maktlös och då ansågs dödshjälp kunna vara att föredra.

    Nyckelord: Attityd, eutanasi, palliativ vård, patient, uppfattning.

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    Arvid Ayata & Gustav Söderkvist självständigt arbete
  • 288.
    Azodi Ghajar, Sahar
    Sophiahemmet University.
    Smärtbedömning av patienter med demenssjukdom inom akutsjukvård: en litteraturöversikt2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    När en individ drabbas av en demenssjukdom och kognitiv svikt kan det leda till oförmågan att uttrycka smärta, på ett sätt som omgivningen kan förstå. Personer med demenssjukdom är ofta äldre och vårdas inom akutsjukvård på grund akut sjukdomstillstånd eller fall i hemmet som kräver omedelbar smärtbedömning och smärtlindring. Smärtbedömning samt smärtlindring för patienter med demenssjukdom är komplext och en utmaning för sjuksköterskor inom akutsjukvården. Syftet med studien var att belysa smärtbedömning av patienter med demenssjukdom inom akutsjukvård. En litteraturöversikt valdes som metod för att identifiera och lyfta fram aktuell forskning inom området. Mellan december 2015 och januari och februari 2016 gjordes sökningar i databaserna CINAHL, PubMed och PsykINFO. Totalt inkluderades 15 vetenskapliga artiklar, publicerade mellan 2004-2015. Artiklarna kvalitetsgranskades och analyserade utifrån syftet med studien och kring likheter och skillnader. Resultatet kom att beskriva tre huvudteman: kroppsspråk och beteendeförändringar; smärtskattninginstrument och sjuksköterskans erfarenhet. Slutsatsen från studien är att smärta orsakar lidande, vidare att smärtbedömning av patienter med demenssjukdom inom akutsjukvård är komplicerad. Flera smärtbedömningsinstrument identifierades som kan vara till hjälp vid smärtbedömning av patienter med demenssjukdom. Vårdrelation, personcentrerat förhållningssätt samt användning av flera strategier kan säkerställa en korrekt smärtbedömning av patient med demenssjukdom vid vård inom akutsjukvården. Fortsatt forskning behövs för att utvärdera olika smärtbedömningsinstrument inom svensk sjukvård.

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  • 289.
    Backlund, Elin
    et al.
    Sophiahemmet University.
    Gitzia, Maria
    Sophiahemmet University.
    Personers upplevelse av hur livskvaliteten kan påverkas av behandling med läkemedlet Simdax® vid kronisk hjärtsvikt: en kvalitativ intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Kronisk hjärtsvikt är en progressiv och allvarlig sjukdom och har symtom som påverkar personernas livskvalitet negativt. Försämring i hjärtsvikt medför en ökad mortalitet samt återinläggningar på sjukhus. De vanligaste symtomen som uppstår är bland annat dyspné, trötthet och ödem. Målet med hjärtsviktsbehandlingen är att lindra symtom, förbättra livskvalitet, förhindra progress, minska behovet av sjukhusvård, samt förlänga överlevnaden. Behandlingen av hjärtsvikt består av den icke farmakologiska behandlingen som syftar till egenvård samt den farmakologiska behandlingen. Sjuksköterskan har en viktig roll genom att undervisa och stötta personen genom att hitta strategier för egenvård. När den medicinska grundbehandlingen för hjärtsvikt inte är tillräcklig kan behandling med Simdax® bli aktuell. Simdax® är ett läkemedel med den aktiva substansen levosimendan som vanligtvis ges som en infusion under 24 timmar och förbättrar hjärtats pumpförmåga. Behandling med Simdax® har visat sig minska symtom och mortalitet samt förbättrar hemodynamiken och stärker hjärtats ejektionsfraktion.

    Syftet var att beskriva hur personer med kronisk hjärtsvikt upplever sin livskvalitet före och efter behandling med Simdax®.

    Som metod valdes en empirisk intervjustudie med kvalitativ ansats. Informationen inhämtades via semistrukturerade intervjuer. Totalt åtta intervjuer genomfördes på tre olika sjukhus i mellansverige. Intervjuerna spelades in för att sedan transkriberas i sin helhet. Texten analyserades enligt en manifest innehållsanalys, då man ser till det som direkt uttrycks i transkriberingen. Meningsenheter arbetades fram som sedan kondenserades, kodades och sorterades in i fem subkategorier, deltagarnas definition av livskvalitet, längtan efter social samvaro, begränsningar i det dagliga livet, behandlingens betydelse och fysisk aktivitet och ork. Subkategorierna resulterade i två kategorier, upplevd livskvalitet före behandling och livskvalitetens betydelse efter behandling.

    De flesta deltagarna upplevde en positiv effekt av att få regelbundna behandlingar med Simdax®. Deltagarna uttryckte att behandlingen med Simdax® bidrog till återinläggningarna i sjukvården minskade vilket skapade en trygghet hos dem. Alla deltagare uttryckte att lindring av symtomen bidrog till att de mådde bättre fysiskt samt att de hade ork att utföra vardagsaktiviteter samt umgås med familj och vänner. Simdax® behandling som helhet upplevdes ha god effekt och bidrog till ökad livskvalitet.

    Regelbundna behandlingar med Simdax® upplevdes öka livskvaliteten med minskade symtom kortare sjukhusvistelser och förbättrad ork. Behandlingen av kronisk hjärtsvikt ska i första hand förbättra personens livskvalitet, i enlighet med vårt resultat skulle Simdax® behandling kunna ges till fler personer än vad som ges idag.

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  • 290.
    Backlund, Emilie
    et al.
    Sophiahemmet University.
    Ludvigsen, Jannich
    Sophiahemmet University.
    Egenvård vid hjärtsvikt: egenvårdens påverkan på livssituationen2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Många patienter formar deras liv utifrån deras hjärtsvikt och här hjälper sjuksköterskan genom att öka egenvårdsförmågan. Dorothea Orem har skapat en omvårdnadsteori som bygger på tillämpningen av egenvård också kallad self-care. Hon betonar att patienten ska göra så mycket egenvård som möjligt och att sjuksköterskan ska uppmana till detta. Enligt svensk lag har patienten rätt till att medverka i sin egen vård. Vi vill undersöka hur egenvården påverkar livssituationen hos personer med hjärtsvikt.

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    Backlund Emilie och Ludvigsen Jannich
  • 291.
    Backlund, Johanna
    et al.
    Sophiahemmet University College.
    Johansson, Anna
    Sophiahemmet University College.
    Åtgärder för att minska suicidrisken hos tonåringar2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 292.
    Backlund, Linnéa
    et al.
    Sophiahemmet University.
    Manitski, Malin
    Sophiahemmet University.
    Patienters förkunskap om symtom på hjärtinfarkt: en kvantitativ enkätstudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Patients with non ST elevation myocardial infarction [NSTEMI] and ST elevation myocardial infarction [STEMI] enter the hospital too late for the treatment to lead to preservation of heart muscle function. There is inadequate information to the public, but mainly to people at risk of developing myocardial infarction, about what they can do to shorten delay, from symptoms to care contact. Primary preventive information is important and the recommendation is to inform and assess people primarily preventively in order to improve knowledge. These prerequisites give patients the opportunity to pay attention to symptoms and quickly make informed decisions in seeking care, which reduces the damage to the heart after an NSTEMI/STEMI.

     

    The aim was to investigate prior knowledge of symptoms of myocardial infarction in patients undergoing NSTEMI/STEMI.

     

    A quantitative approach was chosen to answer the study's purpose, the design is a non-experimental descriptive, retrospective cross-sectional study. A survey was conducted at a hospital in central Sweden, a total of n = 32 participants. The questionnaire initially contains demographic questions to then focus on subject-specific issues with the help of the likert scale, multiple choice questions and open free text questions.

     

    The results showed that the participants' self-rated knowledge of heart attack symptoms was deficient, especially in atypical symptoms. The participants' symptoms at NSTEMI/STEMI didn’t match their expected symptoms, which constituted an uncertainty as to whether it really was derived from the heart. Therefore it took a long time from symptoms to first care contact and the participants sought care because of persistent symptoms or at the relatives' request. Few participants had received information about symptoms or had been offered a health survey before the onset of illness and the information they had received from relatives or health care. The majority of participants experienced no remaining complications two to three days after their NSTEMI/STEMIN.

     

    The conclusion is that there is lack of knowledge of symptoms of NSTEMI/STEMI, especially atypical symptoms and what measures should be taken in the event of symptoms. The majority considered that the symptoms did not match the expected symptom picture and believed that they had not received information about cardiovascular disease before the onset of the disease. The nursing profession needs to work to clarify the information, then reach out to society and primarily preventive in the health care sector.

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    Patienters förkunskap om symtom på hjärtinfarkt, en kvantitativ enkätstudie
  • 293.
    Backman, Elin
    et al.
    Sophiahemmet University.
    Kainu, Jenny
    Sophiahemmet University.
    Föräldrars upplevelse och behov av vårdpersonalens stöd och omsorg - när deras barn insjuknat i cancer: en litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Bakgrund

    I Sverige drabbas årligen ungefär 250 – 300 barn mellan 0 – 18 år av cancer. När barn får cancer kan det innebära en påverkan på barnets föräldrar. I sjuksköterskans roll ingår både att ta hand om barnet och dess närstående. Medan barnet diagnostiseras och behandlas går föräldrarna igenom olika känslor och tankar som de kan behöva hjälp med att hantera.

    Syfte

    Att belysa föräldrars upplevelse och behov av vårdpersonalens stöd och omsorg när deras barn insjuknat i cancer.

    Metod

    En litteraturöversikt valdes som metod. Sökningar efter relevanta artiklar gjordes i olika databaser samt via manuell sökning. Femton artiklar identifierades som besvarade föreliggande studies syfte.

    Resultat

    Kommunikation, information, socialt och emotionellt stöd samt omsorg är de fyra teman som presenteras i resultatet. Kommunikation ansågs vara viktig då den kunde ha en lugnande effekt hos föräldrar. Information var ett verktyg som kunde ge föräldrarna större inblick i barnets sjukdom vilket i sin tur leder till ökad möjlighet att kunna hantera situationen. Socialt och emotionellt stöd behövdes och kunde hjälpa föräldrarna att hantera sina känslor. Omsorg i form av att vårdpersonalen visade empati samt brydde sig om barnen var betydelsefullt.

    Slutsats

    Föräldrar till barn med en cancersjukdom går igenom en svår tid medan deras barn vårdas. Sjuksköterskan behöver ha kunskap om föräldrarnas behov för att kunna erbjuda dem den hjälp och det stöd de behöver. En bra vårdrelation kan leda till att föräldrarna känner sig lugna och trygga med den omvårdnad som deras barn får.

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  • 294.
    Backman, Josefin
    et al.
    Sophiahemmet University.
    Drakander, Andrea
    Sophiahemmet University.
    Hur sjuksköterskan kan hantera arbetsrelaterad stress: metoder, modeller och dess effekter2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Bakgrund

    Sjuksköterskeyrket har visat sig vara ett stressfyllt yrke med många olika stressfaktorer såsom hot och våld, bristande kunskap, oregelbundna arbetstider samt den fysiska och psykiska arbetsmiljön. Långvarig stress kan leda till allvarliga konsekvenser, både för sjuksköterskan som individ och även för den vård sjuksköterskan utför, vilket i sin tur kan påverka patientsäkerheten. Därför är det av största vikt att finna effektiva metoder att hantera stress för sjuksköterskor.

    Syfte

    Att beskriva hur sjuksköterskan med hjälp av coping och mindfulness kan hantera arbetsrelaterad stress inom den sjukvård som bedrivs på akutsjukhus samt effekten av dessa.

    Metod

    Metoden som valdes för denna studie var litteraturöversikt. Databassökningar gjordes i CINAHL, PubMed och PsycINFO. Arton artiklar inkluderades och granskades i studien.

    Resultat

    Tre teman framkom efter granskning: coping, mindfulness och socialt stöd. Val av använd metod att hantera stress visade sig vara individuell och effektiviteten av stresshanteringen varierade mellan individer och mellan de olika metoderna. Problemfokuserad coping visade sig vara mer effektiv gentemot stress än emotionsfokuserad coping. Mindfulness i form av mindfulnessbaserad stressreduktion och socialt stöd visade sig effektivt vid stresshantering, inte bara för individen utan även för arbetsgruppen.

    Slutsats

    En god stresshantering hos sjuksköterskan i form av problemfokuserad coping, mindfulnessbaserad stressreduktion och socialt stöd kan med fördel leda till förbättrad fysisk och psykisk hälsa hos sjuksköterskan samt främja omvårdnadsarbetet.

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  • 295.
    Backman, Linda
    et al.
    Sophiahemmet University.
    Hagström, Ulrika
    Sophiahemmet University.
    Patienters upplevelser av akutsjuksköterskans bemötande på akutmottagningen: en litteraturöversikt2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    To many people the visit to the emergency department becomes the first contact with healthcare. The specialist nurse of emergency care has a leading function in the meeting with the patient and in the caring of the patient. The contacts are supposed to be professional, and the emergency nurse should have an empathic and an ethical approach, so the patients feel noticed and cared for. The nurse's initial contact and caring are essential for the proceeding care and the patient's experience.

    The aim of the study was to describe patients' experiences of the emergency nurse's treatment in the emergency department.

    The method used was a literature review with a systematic method was performed to analyze existing research where the purpose was describing patients' experiences. Databases used for searching scientific articles were CINAHL, MEDLINE and PubMed.

    The result was divided into two main categories: emergency nurses professional perspective and emergency nurses attitude towards patients wellbeing. In our literature review, several perspectives emerged of how patients experience the emergency nurse's treatment in the emergency department that they consider to be very important. The most important aspects of a positive experience for the patient were to be treated professionally with respect, empathy, holistic care, participation, good communication, encouragement and security.

    The conclusion is that the patients' experiences of the emergency nurse's treatment in the emergency department are positive when the patient is treated in a professional, pleasant and respectful manner. The patients felt safe when the emergency nurse showed mutual respect, worked in a structured and professional manner. Another important aspect was that they were clear in their communication where the patient continuously receives personal information about the continued care. The patient's experience becomes negative when there is a lack of treatment, communication, where the patient does not feel seen, heard. Through this literature review, it was clear that the emergency nurse's treatment played an important role in the patients' experience of care.

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    Ulrika Hagström och Linda Backman
  • 296. Backman, Sara
    et al.
    Björling, Gunilla
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Lysdahl, Michael
    Markström, Agneta
    Schedin, Ulla
    Aune, Ragnhild E
    Frostell, Claes
    Karlsson, Sigbritt
    Material wear of polymeric tracheostomy tubes: a six-month study2009In: The Laryngoscope, ISSN 1531-4995, Vol. 119, no 4, p. 657-64Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objectives were to study long-term material wear of tracheostomy tubes made of silicone (Si), polyvinyl chloride (PVC), and polyurethane (PU) after 3 and 6 months of clinical use. STUDY DESIGN: The study has a prospective and comparative design. METHODS: Nineteen patients with long-term tracheostomy, attending the National Respiratory Center in Sweden, were included, n = 6 with Si tubes, n = 8 with PVC tubes, and n = 5 with PU tubes. The tubes were exposed to the local environment in the trachea for 3 and 6 months and analyzed by scanning electron microscopy, attenuated total reflectance Fourier transform infrared spectroscopy, and differential scanning calorimetry. RESULTS: All tubes revealed severe surface changes. No significant differences were established after 3 or 6 months of exposure between the various materials. The changes had progressed significantly after this period, compared to previously reported changes after 30 days of exposure. The results from all analyzing techniques correlated well. CONCLUSIONS: All tubes, exposed in the trachea for 3-6 months, revealed major degradation and changes in the surface of the material. Polymeric tracheostomy tubes should be changed before the end of 3 months of clinical use.

  • 297.
    Bager, Carina
    et al.
    Sophiahemmet University.
    von Rosen, Amanda
    Sophiahemmet University.
    "Jag fick stöd utifrån mina önskemål": en enkätstudie om föräldrars tankar om amning/uppfödning och hur de önskar att få stöd2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breastmilk contains all the nutrients an infant need. WHO recommends exclusive breastfeeding for six months and then in addition to other foods. Breastfeeding has several positive health effects for both mother and child and is also an environmentally friendly and economical way to feed a child. Most mothers want to breastfeed but many mothers quit before the baby is six months old. This could be avoided with the right support. Aim: The aim of this study was to investigate if and from where parents get knowledge and support regarding breastfeeding/nourishing before and after the child is born and what support they want. Method: Quantitative method with descriptive approach was chosen to answer the aim of this study. A cross-sectional study was conducted. A survey designed as a questionnaire with closed and open questions was distributed to parents who participated in the child's eight-month check up on the child health services through a consecutive sample. A total of 124 parents were included. Data from the closed questions were analyzed with descriptive statistics. The open questions were analyzed with qualitative content analysis. Result: Most of the parents (92%) had thought their child would breastfeed exclusively from the beginning but only 37,1 percent of the parents had planned to exclusively breastfeed for the first six months. It was 29,8 percent of the parents who stated that they had received sufficient knowledge of breastfeeding before or during pregnancy. Most commonly this knowledge had been obtained from maternal health care (59,7%) followed by the internet (43,5%). Most parents (79%) thought that they could turn to the child health services with breastfeeding issues after the child was born. It was from the child health services most (58,1%) parents received support with breastfeeding/nourishing when the child was newborn. It was also from the child health services that most parents (54%) received support when the child was older than four weeks. The parents were satisfied with the support when healthcare professionals were available, provided clear advice and security and were experienced highly competent. They were not satisfied when this failed or when healthcare professionals gave contradictory advice. The parents wanted more practical help in both breastfeeding and bottle feeding and more preparatory information during pregnancy. Conclusion: All parents do not get the information they think they need regarding breastfeeding/nourishing during pregnancy. More support and education should be provided during this time. Maternal healthcare and the internet are important sources of information and therefore suitable websites should be recommended by the midwife. The support that the parents receive after the birth of the child comes mainly from the child health services but also from other parts of the chain of care, especially during the first few weeks. The support and information provided should be consistent throughout the chain of care and should be based on a person-centered perspective, be evidence-based and not be judgmental.

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    Examensarbete Amanda och Carina
  • 298.
    Bagger, Tina
    Sophiahemmet University College.
    Copingstrategier hos individer med långvarig icke-malign smärta2004Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 299.
    Bahramy, Zahra
    et al.
    Sophiahemmet University.
    Wennergren, Inga
    Sophiahemmet University.
    Kvinnors upplevelse av ett dagligt liv efter hjärtinfarkt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 300.
    Bakhtiari, Miranda
    et al.
    Sophiahemmet University.
    Segerman, Dannielle
    Sophiahemmet University.
    Människors upplevelser av yoga vid långvarig nack- och ryggsmärta2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att leva med långvarig smärta i rygg och nacke under en längre tid innebär en fysisk och psykisk påfrestning. Funktionsnedsättning, sjukskrivning, dagar med inställda aktiviteter och depression är endast några av smärtans följder. Det kan vara svårt att hitta en effektiv behandling, och i majoriteten av fallen har de drabbade människorna redan provat de flesta metoderna. Yoga är en behandlingsmetod som inte har fått en lika stor utbredning inom vården som exempelvis fysioterapi. Trots detta har yogan både fysiska och psykiska positiva effekter.

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    fulltext
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