Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.

Background: In 2021, it was estimated that 12.9 percent of Sweden's population had an alcohol or drug-related substance use disorder. Alcohol and drugs cause various harmful effects that pose a danger to health and can also result in economic and social damages. Nurses play a significant role in the recovery and treatment of patients with substancerelated disorders. Nurses may encounter this patient group across all healthcare settings. Previous studies showed that patients experienced a lot of stigmas and negative attitudes during their care. Purpose: This study aimed to describe nurses' experiences of caring for patients with substance-related disorders in inpatient care. Method: A descriptive literature study was conducted, using the PubMed-database to search for articles. The results were based on ten primary studies with a qualitative approach. Main results: Nurses faced challenging caregiving experiences when treating patients with substancerelated disorders. Nurses found it particularly difficult to treat pain. Caring for patients with substance-related disorders was also described as mentally demanding due to increased workloads. The results also highlighted the presence of threats and violence, stigma, and lack of knowledge. Nurses expressed a need for further education and increased support. Conclusion: Nurses´ lack of knowledge and experience were central factors behind the challenges they faced. To improve the quality of care and promote person-centered nursing, further education and support is required. Reducing stigma around substance-related disorders is also crucial in creating a supportive care environment for patients. By increasing knowledge and comprehension, nurses can better address the challenges that arises.

Background: Schizophrenia is a form of psychosis, it is rare but a very serious disease and the lifetime risk of becoming sick is 0.8% in Sweden. People with schizophrenia experience altered perception of reality because of symptoms such as hallucinations and delusions. Many relatives of people with schizophrenia argue that there is a lack of knowledge that leads to distorted view of themselves and the environment. The diagnosis of schizophrenia is based on symptoms, which consequently means that nurses have an important role which should include plenty hospitality, communication and understanding of patients' quality of life.

Aim: The aim of this study is to describe how people with schizophrenia experience their quality of life and to describe the method of selection of the articles included.

Method: The present study has a descriptive design and contains a total of 12 articles with qualitative and quantitative effort. The majority of the articles that have been used has the qualitative approach. Data collection has been conducted via PsycINFO.

Main Results: The diagnosis of schizophrenia contributed to confusion and difficulties to accept their disease. Symptoms and side effects of the medicine were the most conspicuous factors that resulted in the loss. Experiences of stigmatization and rejection by the environment were also a contributing factor for a poorer quality of life. The 12 included articles have mainly used the interviews to reach people's subjective experiences of living with schizophrenia.

Conclusion: Schizophrenia affects people's daily lives and relationships with other people negatively which led to the suffering and poorer quality of life. Knowledge of how people with schizophrenia experience their quality of life is important information for nurses that can lead to greater understanding, better reception, care and treatment.

Background: Obesity is now a growing problem in the world and as a result, several do gastric bypass surgery for weight loss. It is important that the experiences from a physical, mental and social approach is illuminated to provide a better understanding and to help them to right direction.

Aim: To describe the experience situation of life a one person after doing a gastric bypass surgery from a physical, psychological and social perspective.

Method: A descriptive study of eleven scientific articles.

Results: After a gastric bypass, the people have a more positive attitude towards life according the three perspectives. They experienced that they fit into society and could participate in the social and physical context in a better way than before. Sometime after the surgery, the participants experienced that they were back into the old habits which gave them a worse quality of life. They ment that the operation was a tool but the hard part remained and they expected a challenge, as some managed better than others.

Conclusions: It is important to give people good support, and information to enable them to preserve their new lifestyle. They are making a great mental effort, therefore they are indeed of psychotherapy and guidence to find a suitable copingstrategy to handle different situations.

Background: Diabetes mellitus is a chronic metabolic disease that has risen from 108 million to 422 million between 1980 and 2014. The disease is caused by elevated levels of glucose in the bloodstream related to insulin deficiency or insulin-resistant tissue cells. The disease requires lifelong medical treatment and adherence to healthy lifestyles. Health professionals have an important role in the development of the person's ability to coexist with the disease.

Purpose: to describe person's experiences of living with diabetes mellitus. 

Method: a descriptive literature review based on 15 qualitative studies relevant to the purpose of the study. Databases PubMed and CINAHL were used when searching for relevant scientific studies. 

Main result: Coexistence with diabetes mellitus requires an approach to healthy lifestyles and follow-up of medical recommendations, which affects the person's quality of life and well-being in different ways. Person with diabetes saw health professionals and family have a supporting role in managing diabetes. 

Conclusion: Diabetes mellitus is a chronic disease that affects a person's state of health and quality of life. Person`s experience a lack of knowledge related to lack of information and guidance from caregivers. In order to achieve good quality of life and well-being in patients, it is important that nurses carry out their work based on person-centered nursing.

Background: Health-related infections (HRI) are the most frequent occurring care damages in inpatient care. HRI’s does not only impact the individual patient, but it also creates high costs and causes high levels of stress at the organization, as well as the community level. Nurses’ application of and compliance with evidence-based guidelines regarding basic hygiene routines is the most effective way to prevent HRI. An examination of the various factors that contributes to the lack of compliance with the different guidelines are crucial in order to increase the theoretical and practical knowledge amongst nurses. This automatically leads to the performing of a safer patient care.

Aim: The purpose of this literature study was to identify and describe the various factors that may impact the nurse's compliance with basic hygiene routines in the prevention of healthcare related infections and to describe the data collection methods in the academic literature.

Method: A descriptive literature study with results from 12 scientific articles. The literature research was performed in the databases PubMed and Cinahl. The articles were also reviewed based on their data collection method.

Main results: Several factors contributed to how the nurses followed evidence-based guidelines regarding basic hygiene routines. The accessibility that nurses had to hygiene products was a primary cause. Lack of knowledge, time shortage, and high workload were additional causes as to why the basic hygiene routines were not properly performed. Contrary to this, good colleagues, good communication, and a safe workplace proved to be factors with a positive impact on preventive work. Surveys, observations and combined data collection methods were used in the included scientific articles.

Conclusion: There are several factors that affect nurses compliance with guidelines regarding basic hygiene routines. By creating awareness among nurses regarding these factors, they are given the possibility of improving the preventive work against HRI.

Bakgrund: Sverige var det första landet i världen att förbjuda våld mot barn. Trots denna lag har idag vart sjunde barn någon gång blivit utsatt för våld av en vuxen. Flera undersökningar visar att den vanligaste platsen där barn blir utsatta är i hemmet där förövaren är en vuxen i familjen. När barnet förövats sin trygghet i familjen är det statens skyldighet att skydda och stödja barnet. All hälso- och sjukvårdpersonal har enligt lag skyldighet att anmäla vid misstanke om ett barn far illa, där sjuksköterskan är en nyckelperson i mötet med familjen och barnet. Att agera på misstanke om misshandel är avgörande för att säkerställa barnets välbefinnande och framtida trygghet, dessvärre visar statistik på att bara en liten del av alla misshandelsbrott mot barn rapporteras.

Syfte: Att beskriva sjuksköterskan upplevelser av att hantera situationer där våld mot barn misstänks i familjen. 

Introduction: Tens of thousands of children die every day across the world, some of which die at hospitals. Nurses form relationships with mutual influence to children they care for. Caring relationships are also formed with adult patients. When adult patients die, nurses experience negative emotions and use coping. They consider elders' deaths to be easier to cope with than those of younger patients. Method: A narrative literature review based on the results of 11 articles with qualitative data. Identified data units have been translated, coded and organized thematically. Results: Nurses experienced negative feelings such as helplessness, sadness, grief and guilt. The emotions could be exacerbated by attachment to the child and to the dead child’s family, as well as professional experience. The death of a child could be perceived as a professional failure and nurses felt unprepared by their earlier education. They used cognitive and behavioral strategies to cope with feelings and situations that related to the death of children. Conclusion: Nurses experienced the death of children as negative and painful. To cope with the incident, nurses use coping strategies. They felt unprepared to face and cope with the death of children and should therefore be offered education regarding this.

Introduction: Statistics show that 8% of all licensed nurses do not work in healthcare. Causes are high workload and work-related stress. Previous research presents that workplaces proactively work for the well-being of staff have more prosperous employees. Without the feeling of well-being of the nurse, patient safety and the quality of care will be worse.

Aim: Aim to describe the primary care nurse’s assessment of the psychosocial work environment and well-being and study the relationship between these variables.

Method: A quantitative cross-sectional study with descriptive and correlational design. A total of 170 questionnaires were sent out to nurses and district nurses working in regionally managed and privately owned primary care in Central Sweden. Response rate: 58%. Instrument used; Factors perceived stress symptoms, Thriving Scale, Copenhagen Psychosocial Questionnaire Version III.

Result: Strong correlation between high work-privacy conflicts and higher stress symptoms were seen, this means the variables co-vary negatively. High work pace correlates negatively with stress symptoms. Positive correlation was seen between feeling pride in the organization and well-being, vitality, learning and thriving at the workplace. Vitality and learning were rated high, which indicates high levels of thriving.

Conclusion: Several statistically significant relationships between psychosocial work environments and well-being were found. This implies that psychosocial work environment affects primary care nurse’s well-being. It underlines the importance of organizations prioritizing creating a sustainable work environment for the well-being to be preserved and improved.

Background Diabetes mellitus type 2 is a condition that is increasing in the world and targets the youth. There is much that the patients can do themselves to influence the disease in form of self-care, for example through physical activity. Aim The aim was to describe the effect of physical activity on adult patients with type 2 diabetes mellitus. Method This was a literature study in which 11 original articles with a quantitative approach had been reviewed and analyzed. Results Physical activity improved both bodily functions, biomedical markers and patients’ quality of life. The results were influenced by the type of exercise and intensity of physical activity they practiced. Hypoglycemic drug inhibited the good results of physical activity. Conclusion Physical activity was a effective form of treatment where the most favorable results were shown. The effect depended on the form of exercise, intensity and the patients’ compliance. As a nurse it can be important to motivate, inform and support the patients towards a healthier lifestyle.

Background:

Stroke is an endemic disease, which in Sweden approximately 30 000 persons yearly are taken by and is estimated to cost society around 18 billion Swedish kronor (SEK). Dysphagia (eating difficulty in swallowing) is a common and known disorder in stroke patients. Dysphagia is not a disease itself, but rather a symptom of something underlying for example stroke. Dysphagia can lead to malnutrition and the risk of increased mortality.

The purpose of the study was to describe what attitudes there were among recipients and donors about the guiding principles that should comply with oocyte- and sperm donation. The purpose was also to investigate if there were any differences within the groups of recipient women and men and the donor group considering disclosure to the child about their origin.

The study became a part of a national project. Data were collected with questionnaire that included earlier described aspects. It was formed with statements to take stands towards in form of “agree” or “disagree”. Number of participants were 333 and data were collected from April 2005 until spring 2008.

The main results found that among donors and the attitudes toward the child’s right to get knowledge about their origin showed that women was significantly more positive in several aspects then the men. The results also showed that considering the guiding principles that should comply with gametes donation the recipients and donors had just about similar attitudes. For the recipients there was only the women who had a significant difference in one of the statements, otherwise there was no difference in either of both groups for the attitudes about disclosure to the child.

Purpose: Performing venepuncture is one of the most routinely performed invasive procedures in nursing care. The aim of this study was to develop instruments for the assessment of nursing students' knowledge and skills when performing venepuncture and inserting a peripheral venous catheter. 
Methods: Two instruments were developed using the following steps. 1) Assessment items of importance for the procedures (venepuncture 48 items and peripheral venous catheter 51 items) were collected from focus groups including nurses, lecturers and patients. 2) The number of items was reduced using a method based on the Delphi method. Experts (n=51) reviewed the instruments in two rounds. The revised versions included 31 items for venepuncture and 33 items for peripheral venous catheter insertion. 3) Usability tests were conducted by nurses who tested the instruments to confirm that items were possible to assess. 4) Inter-rater reliability was assessed by twelve lecturers who in pairs, but independently of each other, used the instruments to assess 50 nursing students. 
Results: Proportion of agreement and Cohen's kappa coefficient were calculated for each item to determine inter-rater reliability. Among the tested items for both instruments, the median proportion of agreement was 1 (range 0.66-1) and the median kappa was 0.52 (range 0.22-1). 
Conclusions: The instruments developed for assessing nursing students' knowledge and skills of venepuncture and peripheral venous catheter insertion showed satisfactory inter-rater reliability.

The purpose of the present project has been to carry out international studies on meaning-making coping among people who have been affected by cancer in a number of societies and, thereby, to try to understand the influence of culture on use of these coping methods. Five countries—Sweden, South Korea, China, Japan, and Turkey—are included in the project. Qualitative semistructured interviews have been conducted with persons with a cancer diagnosis. The research group in each country has used, as a foundation, the interview questions developed for the Swedish study. These questions were, however, modified to better suite the sociocultural context of each participating country. The results presented here concern only Turkey and are restricted to religious coping methods. The study consists of 25 cancer patients (18 females and 7 males) between 20 and 71 years of age. The results of the study in Turkey indicated that the RCOPE (Religious Coping) methods are highly relevant for the interviewees. A sociological analysis of the study made from a cultural perspective showed clearly the importance of the idea of being tolerant (Sabr) for patients when coping with the psychological problems brought about by cancer. The study made it clear that culture plays an essential role in the choice of coping methods.

Background: HIV is a viral disease that is caused by a retro virus which damage the immune system. AIDS is the final stage of the disease and there are two types of HIV; type 1 and type 2. The carer and the patient are dependent on each other to make the medical care optimal. The meeting is an important part of patients’ experience of medical care, especially for people living with a contagious disease. Earlier research showed that healthcare professionals could have a potentially critical view on people living with HIV/AIDS (PLHA). Knowledge about how PLHA experience the meeting when in contact with the healthcare sector today is missing, therefore the authors of this study wanted to examine this topic further. Aim: The aim was to describe how PLHA experience the meeting within the healthcare sector when seeking help because of the disease, and also to describe the sample used in the articles that were used in this study. Method: Descriptive literature review, nine articles both qualitative and quantitative where used. Key findings: : According to PLHA was a positive encounter important to the career-patient-relationship. Trough more information and increased knowledge about the disease in nurses and other healthcare personnel did PLHA describe that the encounter became more positive and the HIV-related stigma could be reduced. An individual education for PLHA were also an important factor to reduce the self-experienced stigma that often were based upon shame. That internal shame and the feeling that needing to hide something could lead to depression and negative feelings. A negative encounter could for example be lack of dedications and an un-welcoming attitude and furthermore reluctance in the healthcare personnel to treat and support PLHA both physically and psychological Conclusions: PLHA doesn't experience as much stigma or discrimination today as before, but there are still a certain degree of preconceptions. Further education of both healthcare personnel that doesn't encounter these kind of patients on a regular basis and information to the society could help reduce the preconceptions and the stigma that still exist around this disease.

Background: Schizophrenia is a psychosis mental illness which the cognitive functions are somehow impaired. This sickness is still surrounded by prejudice, fear and ignorance.Aim: The aim of this descriptive literature study was to describe the experiences of stigma outside the hospital for people with schizophrenia.Method: This literature study was based on 10 scientific articles searched in the databases Medline via PubMed and PsykINFO.Main results: The articles in this literature study showed that stigma was experienced among patients with schizophrenia in their encounter with people outside of care. Patients are faced with discrimination and violence both from family members and others. Stigmatization also exists in the media. The results also showed that stigma had a great impact on the participants' self-esteem and affected their perception of the disease.Conclusion: The results of this literature study show that patients with schizophrenia face stigma and discrimination in society. This has mainly been shown to be due to ignorance about the disease. In the work to reduce stigma, more people should stand up and support those patients. More knowledge about stigma is needed in this subject.

Background: Diabetes mellitus ( DM) is a serious threat to comprehensive health and diabetes- related foot ulcers (DFU) is one of the frequent complications of DM. High blood sugar levels and uncontrolled diabetes over an extended period can lead to never damage and poor blood flow in the feet resulting in numbness in the feet, which can make patients unaware of their foot injury. This increases the risk of people with diabetes developing foot ulcers and infections, which can lead to amputation of the diabetes-related foot if not treated early. Purpose: The purpose of the study was to describe the patients' experiences of self-care in diabetic foot and diabetes-related foot ulcers. Method: Descriptive literature study where 14 scientific articles were processed and reviewed using a qualitative method. Results: The literature study resulted in two main themes: Barriers that prevent the application of self-care and enabling factors that support the application of self-care. In addition, eight sub-themes were compiled. Conclusion: There are several possible factors for diabetes-related foot ulcers heal, the most important of which are education and training, self-care skills, and continuity of care. In addition, nurses and counselors can help promote patients' health, independence, and well-being by increasing their knowledge of self-care and understanding the psychosocial impact of self-care on patients. Extensive knowledge of self-care experiences of people with diabetes-related foot ulcers can be used as a tool for nurses in their professional life.

 Keywords: Diabetic foot, diabetes mellitus, experiences, self-care.

Sammanfattning

Bakgrund Historiskt sett har sjuksköterskeyrket ansetts ha låg status och varit dominerat av kvinnor. Yrkesrollen har associerats till det kvinnliga och att vara omhändertagande, varm och moderlig. Denna stereotyp finns kvar ännu idag. I Sverige antog inte sjuksköterskeutbildningen män förrän under 1950-talet, och viss forskning har visat att patienter och kvinnliga kollegor varit skeptiska till män i yrkesrollen.

Syfte Syftet med denna litteraturstudie var att beskriva manliga sjuksköterskors erfarenheter av att vara man i yrket.

Metod En beskrivande litteraturstudie. Databaserna Medline via Pubmed och Cinahl användes för att finna 13 artiklar, dessa analyserades genom en innehållsanalys. 

Huvudresultat Studien presenterar manliga sjuksköterskors erfarenheter av yrket i fem kategorier: Upplevelsen av marginalisering och exkludering, Förväntningar på män i yrket, Manliga sjuksköterskors syn på yrket, I mötet med patienten samt Fördomar om manliga sjuksköterskors sexuella läggning.

Slutsats Manliga sjuksköterskor har upplevt motstånd i sitt yrke och begränsats av fördomar om att män inte platsar i yrkesrollen. De upplevde sig exkluderade och marginaliserade kopplat till mansrollen, samt att de förväntades utföra tungt och tekniskt arbete. Trots sin minoritetsställning upplevde de ändå patriarkaliska fördelar. I samhället finns en uppfattning om att manliga sjuksköterskor är homosexuella. Resultatet vittnar om att könsroller och genusstrukturer påverkar arbetet, vilket kan relateras till Raewyn Connells maskulinitetsteori.

Background: Heart failure is a serious illness with high mortality. The global figures show that approximately 64 million people have heart failure. In Sweden, there are approximately 250,000 individuals that has the disease. Today, heart failure is the most common cause of hospitalizations among people over 65 years of age. Aim: The aim of this literature review was to describe patients' experiences of living with heart failure. Method: The literature review had a descriptive design and was based on ten qualitative scientific articles. The articles were retrieved through the PubMed database. Main results: The result revealed the main theme; Changed everyday life with subthemes physical impact, psychological impact, social and economic impact. Another main theme that emerges was; Managing one's illness with subthemes lifestyle adjustments, spirituality and experiences of information from healthcare. Conclusion: Heart failure patients experiences physical, psychological and social challenges, while deficiencies in communication and information regarding self-care were revealed. The study also revealed a deficiency in care regarding continuity. It is crucial for nurses to provide support and information to patients to ensure high-quality care and tailored information. 

Background: Each year 370 children in Sweden suffer from childhood cancer. These numbers also reflect those 70 families that suffer alongside the child from this burdened information that will change their entire life situation. To work with family-centeredcare means that the parents are given room for participation and to engage in the child’s care.

Aim: The aim of this literature study is to describe parents´ experiences with living with a child with cancer.

Method: A literature study with a descriptive design, based on 12 scientific articles. The literature research was conducted using the Pubmed database.

Results: The results consisted of two main categories: Life is turned upside down and The new “normal” which had the following subcategories: Initial reaction, Changed family dynamics and everyday life, Support, Acceptance and From the hospital to the home.

Conclusion: Parents´ experienced a variety of emotions such as shock, sadness, denialand powerlessness. Support in its various forms from healthcare and the surrounding environment eased the suffering that the parents experienced and enabled them to cope with the difficult period they were going through.

Keywords: Neoplasm, Parents’ experience, pediatric cancer, support

Background: The corona pandemic is a high topic in today's society and nurses have gained experience in caring for patients with Covid-19 worldwide. Over 4,800,000 people have died in Covid-19 and research shows that only seven percent of 150 wards had a budget for isolation and quarantine and that nurses during previous viral outbreak experienced hopelessness and loneliness while performing demanding work in protective equipment that was difficult to work in. Aim: The aim of this study was to describe nurses' experiences of caring for patients with Covid-19 at hospitals. Method:A descriptive literature study that consisted of 13 empirical studies with qualitative approaches. Database searching was performed in the PubMed database through searches related to the topic. In the review of selected studies, two main categories, nine subcategories followed by five subcategories could be presented. Main result: Negative experiences such as not feeling at mindpeace were something nurses experienced at the same time as they suffered from fatigue and burnout. Participants had experience of not feeling appreciated. Protective equipment was challenging to wear for the nurses, through the use of these and also lack of materials and that it caused ethical dilemmas for the concerned participants. The nurses found not only positive experiences such as pridefulness and teamwork, but also professional growth. Social support and own strategies formed the basis for overcoming the challenges of nurses. Conclusion:Knowledge of nurses' experiences are important as these provide an understanding of nurses' work and challenges in the care of patients with Covid-19. The same knowledge provides opportunities for work improvement that benefits nurses in their work to contribute to better care for the individual.

Abstract

Background: Mental illness is defined as a collective term for various mental conditions, ranging from anxiety, depression, insomnia, stomach pain, and headaches to fatigue syndrome, depression, bipolar disorder, anxiety disorder, and psychosis. Mental illness will account for the largest disease burden in the world as early as 2030. Every second Swede will experience mental illness at some point in their lives. Mental illness has thus increased globally and nationally in recent years and patients with mental illness continue to increase. Aim: The purpose of this study was to describe nurses' experiences and attitudes toward encountering patients with mental illness in primary care. Method: A literature study with a descriptive design was based on fifteen scientific articles of qualitative and quantitative approaches. The databases used in the searches for the included articles were Cinahl and PubMed via Medline. Results: The present literature study resulted in two main themes and three sub-themes in which nurses' experiences and attitudes of encountering patients with mental illness in primary care were described. The first theme is barriers to helping patients with mental illness, that consist of a lack of knowledge about mental illness and insufficient resources. The second theme is attitudes towards patients, which consists of nurses' attitudes towards patients with mental illness. Conclusion: This literature study showed that nurses in primary care experienced difficulties in dealing with patients with mental illness due to a lack of knowledge. Lack of knowledge gave negative and stigmatizing attitudes towards this patient group and contributed to patients not receiving the care they needed. However, the present literature study showed that nurses also had positive attitudes towards these patients.

Syftet: var att beskriva sjuksköterskans agerande och vilka faktorer som kan påverka beslutet om att anmäla eller inte vid misstanke om barnmisshandel samt att granska kvaliteten avseende de metodologiska aspekterna urval- och datainsamlingsmetod i studiens ingående artiklar.

Metod: Deskriptiv litteraturstudie baserad på femton vetenskapliga artiklar som söktes från databaserna Pubmed och Cinahl.

Resultat: Sjuksköterskor känner sig osäkra när tecken/symtom var otydliga och avvaktade för att samla information innan hon eller han bestämde sig för att anmäla. Sjuksköterskor var bekväma i sina observationer när arbetsplatsen stod bakom beslut om att anmäla misstanke om barnmisshandel. Faktorer som visade sig påverka sjuksköterskans beslut om att anmäla var utbildning, kunskap, samarbete, riktlinjer, självförtroende, attityder och inställning.

Slutsats: Screening för barnmisshandel, tydliga riktlinjer, mer stöd från kollegor samt utbildning inom området behövs.

Syftet med studien var att beskriva kvinnors upplevelser av livet första året efter en Gastric bypass operation. Metoden var en kvalitativ blogganalys av beskrivande design som använde sig av ett ändamålsurval med inklusion- exklusionkriterier. Åtta kvinnor deltog i studien. Det insamlande materialet analyserades genom en manifest innehållsanalys. 

Syftet med studien var att beskriva kvinnors upplevelser av livet första året efter en Gastric bypass operation. Metoden var en kvalitativ blogganalys av beskrivande design som använde sig av ett ändamålsurval med inklusion- exklusionkriterier. Åtta kvinnor deltog i studien. Det insamlande materialet analyserades genom en manifest innehållsanalys. 

Slutsatsen var att ingen av informanterna ångrade ingreppet då de upplevde att operationen var den enda vägen ur tillståndet. Informanterna upplevde att stödet och attityderna från sjukvården var sämre än väntat samt att informationen om vad som väntade efter operation var till och från var bristfällig. Attityden från omgivningen men även ibland från vården upplevdes som dålig och informanterna kändes sig missförstådda, inte tagna på allvar och ibland utanförskap.

Bakgrund: Diabetes typ 2 ökar globalt, riskfaktorer för utvecklingen är bland annat ärftlighet och levnadssätt. Främsta behandlingen är egenvård i form av regelbunden motion och hälsosam kosthållning.

Syfte: Syftet med litteraturstudien var att beskriva erfarenheter av egenvård hos vuxna personer med Diabetes typ 2.

Metod: En beskrivande litteraturstudie som inkluderade 15 artiklar, vilka svarade på litteraturstudiens syfte. Genom databaserna MEDLINE via PubMed och CINAHL söktes artiklar fram systematiskt, varav en var manuell sökning.

Resultat: Resultatet visade att personer kände oro vid diagnostisering av Diabetes typ 2. Oron minskade när personerna accepterade sjukdomen och tog ansvar genom egenvård. Personer förklarade att de behövde upprätthålla egenvårdsåtgärder för att det skulle ske en livsstilsförändring, dock beskrevs det som svårt. Även om personer påbörjat sin väg mot livsstilsförändring kunde de stöta på svårigheter att hantera sociala sammanhang, vilket var ett hinder i deras vardag. Närstående till personer kunde också upplevas som ett hinder, men främst ansågs de närstående vara ett stort stöd. Personer beskrev också sjuksköterskan som ett viktigt stöd, framförallt med motivation. Andra personer beskrev istället att sjuksköterskan endast utförde praktiska procedurer.

Slutsats: Utifrån litteraturstudiens resultat kan sjuksköterskan få en uppfattning av personernas erfarenheter. Detta kan underlätta för sjuksköterskan att främja hälsa genom att ge anpassad information och vård. Om personer får en sådan hjälp kan de ta eget ansvar för sin behandling och därav påbörja sin egenvård. Genom att personerna upprätthåller sin egenvård kan de i längden förbättra sin livskvalitet.

Breast cancer is the most common form of cancer among women around the world, which can be painful and cause suffering. Living with advanced breast cancer means that the life expectancy is shortened as the disease progresses. The nurse's responsibility is to provide good care, support, and advice. For the women to be able to process the disease and get their potential questions answered.

Bakgrund: Förekomsten av diabetes mellitus typ 2 ökar globalt. DMT2 har olika riskfaktorer som kan leda till sjukdomen såsom övervikt, rökning och ärftlighet. En viktig del av behandlingen vid DMT2 är egenvårdsåtgärder och dessa är de hälso- och sjukvårdsåtgärder som personer kan utföra själv hemma eller med hjälp av en anhörig eller en personlig assistent.

Syfte: Syftet med litteraturstudien var att beskriva personers upplevelser av egenvård vid diabetes mellitus typ 2.

Metod: En beskrivande litteraturstudie som innefattade 15 artiklar med kvalitativ ansats. Databassökningen utfördes i databaserna CINAHL och PubMed.

Huvudresultat: Vårdpersonalen var en nyckelsten till upplevelsen av egenvården då deras inflytande skapade grunden för en fungerande egenvård. Digitala hjälpmedel kunde ha en positiv inverkan på upplevelsen av egenvården då den ökar tillgängligheten till information och vårdpersonal. Livsstilsförändring vid DMT2 kunde bidra till en upplevelse av isolering och hjälplöshet i sjukdomen. Familjen kunde agera som ett stöd och ett hinder i egenvården. Egenvården upplevdes som ett hinder till att delta i sociala sammanhang. Begränsningar i egenvårdskvalitén kunde orsakas av socioekonomiska aspekter.

Slutsats: Professionella stödinsatser ansågs inverka på upplevelsen av egenvården. Diabetesanpassad kost kunde orsaka sociala hinder och försämra livskvalitén. Självtester av blodsocker samt fysisk aktivitet motiverade till fortsatt egenvård. Resultatet av litteraturstudien kan användas för att vårdpersonal ska få en ökad förståelse av personers upplevelser av egenvård.

Background: Care- and hospital environment are often an unknown environment for children where lack of knowledge together with social and physical expectations can cause uncertainty and fear. Children can react differently to medical procedures but almost everyone experience worry and fear in connection with phlebotomy. Aim: To describe the effects of interventions used on children undergoing phlebotomy. Method: A descriptive literature review with a quantitative design based on twelve articles searched through the database PubMed. Study group were children between four and twelve years old. Thematic analysis was used to analyze data. Main result: Active distraction methods such as balloon blowing, cough methods and ball squeezing significantly reduced pain and fear. TICK-B significantly reduced pain and anxiety. Flippits significantly reduced pain. Bubble blowing showed no significant effect on pain but significantly reduced fear. VR reduced pain, fear and anxiety significantly. When it comes to passive distraction methods Buzzy significantly reduced pain and fear. Aromatherapy did not have a significant effect on pain and fear. Kaleidoscope and watching cartoons through VR significantly reduced pain and anxiety while watching cartoons on a tablet did not have a significant effect. Acupressure reduced pain significantly but didn’t have an effect on anxiety. The pharmacological Jet Lidocaine did not have a significant effect on pain or fear. Conclusion: There are several different interventions, both passive and active distraction methods, that reduce pain, fear and anxiety in children undergoing venipuncture. Based on the result nurses can, no matter their workplace, get a better understanding on how the children’s phlebotomy experience can improve. The interventions were easy to use, cost effective and didn’t give any side effects and should therefore be used by nurses to create a better care experience for children. 

Purpose: The purpose of this study was to describe the experiences of terminal cancer patients’ receiving palliative care in hospice or in an in-patient care unit, and illuminate what these patients believe that good palliative care involves. Method:  The Literature study had a descriptive design and was based on 14 scientific articles that were retrieved from the databases Cinahl, PubMed, PsycInfo and by manual search. The results of the analysis were compiled into 5 categories containing 23 subcategories. Main Result: Patients experienced that the issue of most importance in palliative care was to obtain adequate pain relief without reservation or delay. Good communication and interaction between the nurse and the patient was the basis for good health care to be developed. Trust in health professionals' skills and abilities were essential to patients' perceptions of security. Autonomy was central for the patients’ participation in their health care, and it created a sense of control and meaning. The environment at the hospice had a negative impact on the patients’ self-image and made them lose their identity. Finding meaning in their suffering helped the patients gradually to accept their situation in order to find peace in their knowing of the inevitable. Conclusion: The interpersonal communication and nursing skills is of crucial importance for patients' perceptions of good health care. More research is needed to meet the growing request of qualified professional palliative care.

The aim of this descriptive review was to elucidate how the literature describes how children of parents with mental illness experience and have knowledge about their parent’s illness. The aim was furthermore to describe how the children’s existence is affected, can be improved and why the children so often are invisible. Search through Medline (through PubMed) database and additional manual search was conducted. In total fourteen articles fulfilled the inclusion criteria and were reviewed. The chosen method for analysis was qualitative and the results are presented on the basis of different subjects that elucidated the questions at issue. The study shows that children of parents with mental disorder often takes responsibility for the parents disease, a disease that has to be kept a secret and often lead to social isolation for the children. The children often have poor knowledge of the parent’s illness. Due to different obstacles these children are difficult to identify and thereby also difficult to help. The children themselves have clear opinions of what kind of help they want, mainly economic and domestic support, conversational support and information. One of the authors’ conclusions is that new research needs to be done regarding Swedish conditions.

The aim of this study was that, with focus on experiences of participation and life satisfaction, work situation and consumtion of non institutional care, compare two groups that had participated versus not participated in a stroke program for Strokescreening. A questionnaire was sent retrospective to a consequetive group of people. The results were analyzed with Chi2-test, Mann Whitney-test, T-test, linear regression analyzes and multiple logistic analyze. No significant differences could be shown between the groups even though some tendences were noted. The group who participated in the Strokescreening program experienced less participation in personal care than the group who did not participate. The strokepatients that participated in this study experienced a significant lower level of life satisfaction than a reference group of a normal population of Swedes. There was a prominent difference between the groups about occupation before the stroke. In time of this study there where some higher percentes in the group who participated in the Strokescreening program that had returned to work. Several of the participants in the group that had not participated in the Strokescreening program had a regulary contact with the non institutional care. The results of the present study arouse some questions about the benefit with the Strokescreening program related to the expences. The method of a questionnairy study had some weekness, both in a relatively high level of reduction of participants and a question about the relevace of the questions asked. Therefore, it would be of great interest to make an interview study of this population. It would also be of great interest to examin if there are any differences in the frequency of how many of the participants who gets another stroke in respective group. The purpose of that would be to see if the Strokescreening program has any secondary preventive effect.

Bakgrund: Allvarliga tarmsjukdomar kan leda till svåra besvär som personer inte står ut med och då är tarmstomi en lösning för att bli av med besvären och göra livet enklare för personerna. Tarmstomi innebär att det via en operation görs en öppning i magen så att en bit av tarmen sticker ut ur magen där avföring kommer ut och samlas i en specifik påse som sitter fast med klister. Att hantera påsarna som kontinuerligt behöver tömmas och bytas ut kan vara en stor utmaning för många personer. I samband med att personer får tarmstomi uppkommer även psykiska och sociala svårigheter som blir en utmaning i livet. Det är sjuksköterskans uppgift att med utbildning och stöd hjälpa personerna att bli självständiga med att hantera samtliga problem för att nå en god hälsa. Syfte: Att beskriva personers upplevelser av att leva med tarmstomi. Metod: En beskrivande litteraturstudie med narrativt förhållningssätt som baseras på 13 vetenskapliga artiklar med enbart kvalitativ ansats och publicerade i databasen Pubmed.Huvudresultat: Upplevelserna av att ha tarmstomi varierar från person till person där en del personer ser tarmstomi som en befrielse från de mycket svåra besvär som de har haft tidigare och andra ser tarmstomi som ett straff för livet. Den första tiden med tarmstomi är svårast då det tar tid för personerna att vänja sig vid alla förändringar som sker med stomin och lära sig att hantera dem. Slutsats: Personer som har tarmstomi står inför psykiska, sociala och fysiska utmaningar som de ofta behöver hjälp med och där har sjuksköterskan en viktig roll i att ge stöd till dem för att underlätta och främja deras liv. Att personerna ändrar sin syn på stomin från att vara negativ till att bli positiv har visat sig ha en stor betydelse för deras möjlighet till att snabbt och effektivt återgå till ett normalt liv. Konsekvensen av stomi blir ofta att personer isolerar sig från samhället och därmed är stöd från vänner och familj avgörande för en god hälsa

Background: Diabetes is a chronic metabolic disease in which approximately 422 million people worldwide have the disease. The disease is divided into two types, type 2 is the most common form and has increased the most in recent years. The disease state is caused by insulin resistance or insulin deficiency which leads to elevated glucose levels in the blood. Adhering to healthy lifestyle habits such as physical activity and a healthy diet is important for the treatment and healthcare professionals have an important role in encouraging self-care. Aim: To describe people’s experience of their changed lifestyles with type 2 diabetes. Method: The literature study is based on 12 qualitative articles and one with a mixed method. Main results: The results showed that people experienced challenges in changing their lifestyle after diagnosis, especially regarding diet and physical activity due to cultural and socioeconomic factors. Because healthy food was perceived as expensive and physical activity as difficult to integrate into everyday life. Family influence and emotional aspects such as fear and shame were found to have an impact on how people adapted to new lifestyles. Several people lacked information and support from the healthcare system, which caused difficulties in following the recommendations. Conclusion: People experienced obstacles in adapting their lifestyles linked to cultural, socioeconomic, emotional and familial factors. The need for customized support and training was missing, which allows nurses to work more person-centered by including all these aspects in the treatment process for people to better manage their lifestyles. 

Bakgrund: Arbetsrelaterad stress bland sjuksköterskor på akutmottagningar är vanligtförekommande och är ett kvarstående problem inom hälso- och sjukvården. Hälso- ochsjukvården är en arbetsmiljö där det är hög arbetsstress som på långt sikt kan leda tillfysiska problem och sjukskrivningar. Akutmottagningar är en arbetsplats som ärbemannad dygnet runt med komplex omvårdnad och där snabba beslut sker.Syfte: Litteraturstudiens syfte är att beskriva sjuksköterskors upplevelser avarbetsrelaterad stress på akutmottagningar.

Metod: En deskriptiv litteraturstudie med tematisk analysmetod. Analyserades medrelevans och kvalitets mall för kvalitativa och kvantitativa ansats artiklar.

Huvudresultat: Sjuksköterskornas upplevelser av den arbetsrelaterade stressen påakutmottagningar gav både psykiska och fysiska konsekvenser. Det som upplevdes somkonsekvenser var hög puls, muskelsmärta, huvudvärk, oro och rädsla för våld.Det som upplevdes som triggande stressfaktorer för sjuksköterskorna var högarbetsbelastning, hot och våld, högt tryck och stor patient mängd.

Slutsats: Arbetsrelaterad stress på akutmottagningar är ett kvarstående problem blandsjuksköterskor som behöver arbetas med för att minskas.För att hantera arbetsrelaterad stress på akutmottagningar är det viktigt attsjuksköterskorna får förståelse kring hantering av arbetsrelaterad stress. Sämrevälmående och negativa känslor kan utvecklas vid arbetsrelaterad stress detta kan skapaen otrygg miljö för patienterna.

Bakgrund: Sjuksköterskorna behövde vara flexibla för att kunna hjälpa patienterna med sitt vardagliga liv. Det är viktigt att sjuksköterskan är redo att tillhandahålla palliativ vård på ett professionellt sätt och för att uppnå detta krävs det att sjuksköterskan har ett bra bemötande samt att patienten ges bästa möjliga omvårdnad. Sjuksköterskans arbete inom den palliativa vården är krävande och därför efterfrågas kunskap och erfarenhet hos sjuksköterskan. Syfte: Syftet med studien var att beskriva sjuksköterskors upplevelser av att ge omvårdnad till vuxna patienter som ges palliativ vård i hemmet, samt att beskriva hur de valda artiklarna beskriver undersökningsgruppen. Metod: En deskriptiv litteraturanalys. 11 artiklar granskades och sammanfattades.  Huvudresultat: Att handskas med ett arbete nära döden och anhöriga som ofta hellre vill ha sin egen röst hörd istället för patientens röst är svårt för sjuksköterskan. Sjuksköterskor upplevde palliativ vård som emotionellt påfrestande. Sjuksköterskor beskriver att de genom professionella gränser och kollegialt stöd hanterar arbetet. Slutsats: Att upprätthålla de professionella gränserna är viktigt för sjuksköterskan, samt att kunna få kollegialt stöd. Att få läkaren att förstå vikten av situationen är inte alltid lätt, men är viktigt för sjuksköterskan att kunna göra för att ge patienten den bästa vården och minska patientens lidande.  

Background: Diabetes Mellitus Type 1 debuts in childhood and adolescence. The treatment is self-care that involves blood glucose control, drug treatment and following recommendations on diet and exercise. Nursing's professional area includes children and adolescents. Deviating from self-care activities and secrecy around the disease affects the quality of care for young people. Purpose: To describe the young people's experience of living with Diabetes Mellitus type 1 as well as describing the study groups of the studies examined. Method: Descriptive literature study with twelve scientific articles with qualitative as well as qualitative and quantitative approach. Consequences and differences in the results of the articles have been categorized and themes and subthemes have been identified. Results: Young people experienced difficulties in accepting their illness and wanted to have control over and take responsibility for their illness and increase independence. Young people experienced the feeling of being different and avoiding self-care in social contexts. Difficulties to follow dietary recommendations varied and blood glucose controls were exerted. Support from friends and peers facilitated the performance of self-care. It was positive that nurses showed interest in the lives of adolescents in addition to their DMT1. Nurses were found to fail to get into the situation of young people and to be an emotional support. Conclusion: There is a need for increased support and understanding from nurses. Through increased understanding, the nurse can help to facilitate the transfer of responsibility. This can lead to increased safety and sense of control among adolescents, which may help them dare to share their illness with the environment.

Background: Today live about 450 000 people with diabetes in Sweden and it makes the disease one of the major diseases. Diabetes mellitus type 1 is a chronic autoimmune disease primarily affects young people. In Sweden live about 7000 children with the disease and fall ill every year approximately 700 children under 15 years. This makes the disease one of the most common chronic diseases in children in Sweden.

Aims: The purpose of this study was to describe parents' experience of living with a child (0-13 years) with type 1 diabetes mellitus and to describe the data collection methods of the included articles.

Methods: A descriptive literature study, which included 11 scientific articles, nine articles of qualitative approach, one quantitative and one mixed study. These were analyzed objectively by both authors. The searches took place in PubMed and Cinahl.

Results: The results show that parents experienced stress and life adjustment when child get diabetes. They felt a sense of worry and they found it difficult to assign responsibility to someone else. Support and information perceived as flawed in different situations, but a healthcare team or a mentor perceived as positive. Data collection methods in the included articles were mostly interviews except one who applied the questionnaire.

Conclusions: Parents experienced constant worry, lack of support and information. With the right support and information would reduce parents' anxiety and it could also strengthen the child's self-care ability.

Background: Studies show that about 10% of the world population suffer from needle fear. Consequences for the person with this phobia who knows needle fear is anxiety and avoidance of medical procedures involving injections. This can lead to health problems for the individual and in the worst case lead to the person avoiding all healthcare. It is important that the nurse has knowledge of the factors that can lead to needle fear and what the nursing interventions that can alleviate the suffering of the patient.

Aim: The purpose of this study was to highlight nurses nursing care measures required to preclude the fear of needles in children. The aim was also to describe the selection groups in the included articles.

Method: A literature review in which the results of the 12 articles reviewed, analyzed and compiled. Searches were conducted in PubMed, CINAHL and PsycINFO.

Main Results: The result showed that the environment's design is important as children get injections, and how well the child was prepared for needle insertion. The result showed that even small children have the opportunity to benefit from training on needle insertion procedures. Adjusting the time it takes for a baby and a toddler to adapt must be allowed to steer healthcare. Distraction was used as a method before the needle insertion but that the best were of distraction was not needed.

Conclusions: The environment´s design is important as children get injections and nurse can reduce the feeling of a hospital or clinic by adapting the environment and provide for distracting toys. It is important that children know what would happen at the needle insertion procedure and even smaller children can benefit from education about needle injection procedures and understand the importance of them. The nurse can by adjusting the session time for the child's needs and validate the child's feelings reduce anxiety and fear of the needle fearing children.

Abstract (MB och AA)

District and registered nurses work with various tasks and in different services includinghome care. The patient’s home becomes the nurse’s workplace. The aim of the study was to describe district nurses’/registered nurses’ perceptions and experiences of the work environment in municipalized home care, among those with short and long professional experience. Descriptive design and qualitative approach was used. Five participants with shortand six with long professional experiences were interviewed. The material was analyzed using qualitative content analysis. The results for participants with short work experience led to fivecategories: factors influencing workload, factors affecting collaboration, relationships and ethical dilemmas, organizational conditions and leadership, and lack of communicationreduce patient safety. The work was experienced physically diverse increased number ofpatients and time constraints led to stress. The work also felt joyful with good relationships to patients and families. Ethical dilemmas arose from divergent views of the patient’s health care needs. The results among participants with long professional experience revealed four categories: nursing in home environment, factors affecting communication and collaboration, tomunicipalize home care is a conversion process and a lack of leadership. The work was described as physically demanding but varied. Shortcomings of communication and information meant that important patient information was missing. District nurses felt theirspecialist competence undervalued. The conclusion is that regardless short or long professional experience, the participants witnessed of positive and negative aspects in their work environment. The work was perceived sensed but increased understanding and supportfrom managers about the work situation was desired. When working in home care, it can be difficult to affect work environment factors of importance because the work is performed inpatients’ homes.

Abstract

Background: Diabetic foot ulcer (DFU) is a global threat to people with diabetes due tothe complications that can arise as a result of diabetes. Neuropathy is a common secondary result of diabetes which carries the risk of DFU. Neuropathy causes decreased sensation in the lower legs and feet which can cause the patient not to feel objects in the shoes rubbing and pressing against the feet which can cause DFU. Aim:The purpose of the literature study was to describe nurses' prevention strategies for reducing the development of foot ulcers in patients with diabetes. Method: This study was conducted as a descriptive literature study based on 12 scientific articles consisting of four qualitative and eight quantitative articles. Main results: The results showed that nurses are in need of increased knowledge through wound care training after thebachelor's degree. It appears that the nurses 'knowledge has a major role in the treatmentof DFU, of which the patients' self-care ability is highlighted in order to jointly find theright strategies for each patient in their DFU treatment. Conclusion: Advanced knowledge of prevention strategies to reduce the development of DFU in patients with diabetes could benefit both patients, nurses and Swedish health care. The knowledge of prevention strategies among nurses in the work of DFU varied in health care activitiesworldwide. There are several strategies to continue working with as a nurse in the prevention of DFU. Two important aspects in prevention strategies are increased training for undergraduate nurses in wound care at DFU. Patient education in self-care in the prevention of complications of DFU is an important strategy in the nurse'sprofessional role in order to be able to contribute with good conditions and health promoting care.

The purpose of the study was to describe how care givers experience working with people who suffer from dementia and acting out behaviour and to illustrate the importance of the care givers approach. Sixteen caregivers were interviewed from different nursing homes in the middle of Sweden. The interviews were analyzed with qualitative content analysis. The result is divided into two content areas. The analysis of the first content area, care givers experiences of meeting people with dementia and acting out behaviour, resulted in three categories, which deals with the approach. The categories were; to be insecure, to feel a challenge and to be secure. To have co-workers nearby resulted in feeling secure. A challenge was to make the person suffering from dementia feel well once again. To be inexperienced resulted in insecurity among the care givers. The second area of content was, the care givers description of the value of a good approach when meeting people suffering from dementia and acting out behaviour. The analysis of that content area resulted in four categories; to be clear, to be calm, to be experienced and to be accepted. To be calm and use few words was successful. To have knowledge and to be appreciated made the care giving work easier. The result of the study illustrates different approaches from care givers in their contact with patients with dementia and how care givers experienced that contact.

Background:

To be a Nurse Anesthetist is advanced and involves high demands for competence and independence. Research has shown that newly graduated nurse anesthetists experience stress and insecurity in their new profession.

Aim:

The study was aimed to describe how newly graduated nurse anesthetists experience their first time at a surgical ward.

Method:

Descriptive design with qualitative approach. A total of ten nurse anesthetists from two middle-sized and one small hospital in Sweden were included in the study. Purposive sampling has been used. The data were collected by semi-structured interviews with help from an interview guide. The data have been analyzed with a qualitative content analysis.

Findings:

The nurse anesthetist’s descriptions in the interviews were sorted in to four main categories and ten subcategories. The main categories were; The new profession, Personal development, Experience, and Organizational elements. The subcategories were: Newly graduated nurse anesthetist’s, To have responsibility, Performance anxiety, Belief in own ability, Job satisfaction, To progress, Lack of experience, Experience creates security, Lack of support from the organization and Support from the organization.

The nurse anesthetists describe their first period at the surgical ward as demanding but also interesting and stimulating. New assignments and the large responsibility were described as burdensome at first. The lack of experience was at times hard to deal with but the support from the organization increased their feelings of security. In the study, nurse anesthetists’ wanted more support in the form of mentorship and coaching, as lack of support increased their feelings of insecurity and loneliness.

Conclusion:

The study describes how newly graduated nurse anesthetists’ experience feelings of stress and loneliness during their first period in a surgical ward. Lack of experience was demanding at first but with support from colleagues their feelings of security increased. The results show that newly graduated nurse anesthetists’ wanted more support in the form of mentorship and coaching. The study provides a deeper

understanding of how newly graduated nurse anesthetists’ experience their first period in a surgical ward.

Sammanfattning Bakgrund: Ungefär två miljoner människor i Sverige är drabbade utav en hjärtsjukdom, vilket innebär att det är den vanligaste orsaken att dö av. Hjärtsjukdomar kan vara hjärtinfarkt, hjärtklaffssjukdom, hjärtrytmrubbningar, hjärtsvikt, hjärtstopp och kärlkramp. När en människa drabbas av en hjärtsjukdom är det av vikt att se till hela människans behov och inte enbart de medicinska delarna. Sexualiteten påverkar våra tankar, känslor, handlingar och mottagande, därmed vår psykiska och fysiska hälsa och är idag enligt forskning ett område patienter och sjuksköterskor undviker av olika skäl. Det är då relevant att öka kunskapen om hur patienter upplever sitt sexuella samliv vid hjärtsjukdom för att förbättra omvårdnaden kring den. Syfte: Att beskriva patienters erfarenheter av sitt sexuella samliv vid hjärtsjukdom. Metod: Beskrivande litteraturstudie, artikelsökning skedde i Medline via PubMed och Cinhal, vilket resulterade i elva artiklar, varav fyra kvalitativa och sju kvantitativa. Huvudresultat: Patienter som drabbades av en hjärtsjukdom kände oro och/eller rädsla inför sitt sexuella samliv, en rädsla för att få ytterligare en hjärtinfarkt eller att känna symtom som hjärtklappning och smärta i bröstet. Det framkom att patienterna erfarande en brist av information från sjuksköterskor och uttryckte att det fanns ett behov av information kring sexuell hälsa. Slutsats: Det sexuella samlivet påverkades, psykiskt och fysiskt, emotionellt och själsligt. En oro och rädsla upplevdes i samband med fysiska symtom. Patienters sätt att hantera det sexuella samlivet vid hjärtsjukdomen skiljdes åt och bristfällig information från sjuksköterskor upplevdes betydligt samt ett ökat behov av information.

Background: Loneliness is a growing problem in society and especially among the elderly population. Loneliness is symbolized as an experience and can be a voluntary orinvoluntary choice. Previous research has shown that involuntary loneliness can have negative health effects. Aim: To describe elderly peoples experiences of loneliness.Method: A literature study with descriptive design. The results are based on 12scientific articles with a qualitative approach. The articles were searched in the Medline database via PubMed. Main Result: The elderly descibed the experience of lonelinessfrom different perspectives. Loneliness was mainly described as something negative, but there were also positive experiences. The elderly portrayed the negative experiences as painful and isolating while the positive experiences were partly associated withfreedom. Conclusion: Some elderly think that loneliness is one of the worst things there is, while some don´t suffer from it at all or even see it as something positive. The nurse has an important role in paying attention to and reducing the negative experiences that the elderly may feel. By supporting the elderly in their life situation, the nurse can relieve suffering and contribute to the elderly`s maintained health and thereby reduce possible negative health effects caused by the perceived loneliness. 

Background: Patient isolation is a common form of care in somatic inpatient care that is applied to prevent the spread of infectious diseases. Isolated patients are cared for in a single ward and may not stay in common areas. Special precautions and hygiene routines are also applied to minimize the spread of infection. The environment has a direct impact on patients recovery and length of stay. Nurses have testified to a poorer quality of care for isolated patients due to the healthcare staff's shortcomings in knowledge about and fear of infectious diseases. Aim: The purpose of this study was to describe patients experiences of patient isolation in somatic inpatient care. Method: A descriptive literature review with a thematic data analysis method. The result is based on twelve scientific articles with qualitative, quantitative and mixed-method approaches. Result: Isolation care resulted in both positive and negative experiences among patients. A major finding was that patients felt trapped and controlled due to the restrictions. The lack of information and poor treatment from the staff made the hospital stay stressful and contributed to difficult feelings. The environment in the single room and the possibility for activity were important factors for recovery and the overall experience of the care. Conclusion: Isolation care leads to strong feelings of loneliness and suffering, this could be prevented by a good attitude and information from the nurse as well as a homely environment with something to distract oneself with. This literature study can inspire nurses in their work to improve the quality of care for isolated patients.

Bakgrund: Klimakteriet är en naturlig del av det fysiologiska åldrandet. Hormonell obalans uppstår under klimakteriet vilket ger uttryck i svaga till starka symtom. Förutsättningar för upprätthållen och bibehållen hälsa varierar stort mellan olika individer vilket påverkar måendet och det sociala livet. Genom att undersöka upplevd hälsa under klimakteriet kan förståelse och stöd under klimakterieprocessen förbättras. Syfte: Att beskriva biologiska kvinnors upplever av hälsa under klimakterieprocessen.  Metod: En deskriptiv litteraturstudie baserat på åtta kvalitativa vetenskapliga artiklar och två artiklar med mixad metod från databasen PubMed. Studien genomfördes i enlighet med Popenoe, Langius – Eklöf, Stenwall och Jervaeus guide. Huvudresultat: Studien beskriver tre tema: klimakterieprocessen, behovsprocessen samt existentiell process vilket påverkade upplevelsen av hälsa. Klimakteriet kunde innebära både en lättnad och en utmaning, vilket påverkade det sociala livet, arbetet, familj och vänner. Minskad libido och torra slemhinnor påverkade samlivet och relationen. Ökat behov av information och stöttning uppstod. Ensamhet och egentid tog ny plats under klimakterieprocessen. Tankar om åldrandet och döden förekom under klimakteriet, vilket kunde generera antingen ångest eller ett intresse för den egna hälsan och ett hälsosamt åldrande. Slutsats: Symtomen påverkade flera dimensioner i personens liv, vilket gav en direkt påverkan på det dagliga livet. Under klimakterieprocessen behövdes ökat stöd och information för den som genomgick processen men också för anhöriga, arbetslivet och samhället. Med rätt stöd och förståelse kan klimakterieprocessen upplevas mindre påfrestande.