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  • Dudmish, Jennie
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Personers upplevelser att leva med diabetes typ 1: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Diabetes type 1 involves a chronic shortage of insulin that will regulate a person´s blood sugar. The condition puts the person at risk for diabetes-related complications if it is not treated correctly. The main care is self-care, which can be challenging for the person both practical and emotionally in everyday life with type 1 diabetes.

  • Garberg, Malin
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors erfarenheter av kontakt med anhöriga i sluten psykiatrisk vård: en intervjustudie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous studies have shown that family members of individuals with mental illness are themselves at risk for worsened mental health and psychological distress. Family members desire contact with psychiatric caregivers in order to feel actively engaged in the care of their loved one, and the importance of caregiver - family member contact is emphasized in both current care guidelines and Swedish law. Despite this, many family members feel excluded. The experience of inpatient psychiatric caregivers of contact with family members has not been investigated in detail, and is crucial to remedying this situation.

    Aim: The aim of this study was to describe nurses’ experiences of family members in inpatient psychiatric care for persons with psychosis.

    Method: Qualitative, semi-structured interviews were conducted on an individual basis with seven nurses working at an inpatient psychiatric clinic for patients diagnosed with psychosis, located in Stockholm, Sweden. The results were analyzed using inductive content analysis.

    Results: The results from the interviews could be separated into five categories affecting nurse – family contact; organizational factors, personal qualities of the nurse, influence of the patient; influence of family members and perceived meaningfulness of contact with family members.

    Discussions: The main findings of the study are discussed in the context of current research, as well as Birgitta Andershed’s theory of “Involvement in the Light / Involvement in the Dark”.

  • Bjerkenstedt, Monica
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att arbeta enligt ACT-modellen: Specialistsjuksköterskans erfarenheter av sin kompetens i teamet2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The ACT model developed in the 70's and 80's when many psychiatric clinics were closed in the United States. The original ACT model can be seen as a full service model but has since been modified and adapted to the current conditions of society and health care. As it appears today, several models have been developed based on the ACT model but can be distinguished by which components are included. The model has shown positive results regarding patient participation and recovery. The nurse has a wide professional background and is considered to be an important part of the team. With their skills, they have the basic knowledge to perform medical and psychiatric care, but several studies have shown that there is a need for specialist educated nurses, as many of the patients are severely ill.

    Aim: The aim of this study was to describe the psychiatric specialist nurse's experience of their competence and role in teams working under the ACT model.

    Method: A qualitative design has been selected. Data collection was done with semi-structured interviews. A qualitative content analysis with inductive approach was used to process the material.

    Results: The content analysis resulted in two main categories, skills in the team and the versatile nurse, with six associated subcategories.

    Discussions: The result was discussed based on the two main categories, skills in the team and the versatile nurse. In support of the discussion, relevant topics and literature were used as well as Phil Barker's ten obligations as a starting point.

  • Örsell, Susanna
    Ersta Sköndal University College, Department of Health Care Sciences.
    Medberoende eller god omvårdnad: en kvalitativ intervjustudie med sjuksköterskor inom beroendevården med fokus på substansbrukssyndrom2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The background describes aspects of the nurse’s profession and care responsibility within both general care and in dependent care. Furthermore, it describes the patient group with its problems, the concept of co-dependency and how it can impact the choice of nursing.  

    Aim: The aim of this study has been to explore nurses’ view of what characterizes good care and co-dependency within the closed depending care.

    Method: This study has a qualitative design with an inductive approach. Seven nurses at a   depending care unit in Stockholm were interviewed using an unstructured method. The material was then analyzed using qualitative content analysis.

    Results: The result from the interviews developed into three categories: The nurse’s view of what   constitutes good care within depending care, The view of the phenomenon of co-dependency within depending care and finally, The nurse’s perception of what differentiates good care and co-dependency. The result reveals, among   other things, the fact that while the nurse, intellectually, had no major problems in separating the concepts of good care and co-dependency, in practice it proved to be harder to implement.

    Discussions: The results are discussed in the context of previous research, other relevant literature and from Ida Jean Orlando’s interaction theory. In the discussion it reveals, among other things, how the nurses responsibility of care can develop into co-dependency.

  • Ketterer, Silvia
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Likt men olikt: alliansen i ISTDP och Klassisk Psykodynamisk Terapi2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Different therapy methods provide different help. ISTDP is distinguished by being more intensive and, as in all methods, also here alliance is important. Therapists are the one who are working with the alliance but how they experienced it, what similarities and differences there are in the different methods they work with, has rarely been investigated. The goal with the study is to illustrate psychodynamic psychotherapists view on alliance in both ISTDP and classic psychodynamic psychotherapy.

    Questions: How do clinically effective psychodynamic psychotherapists see the therapeutic alliance in both classic psychotherapy and ISTDP? What are the differences and similarities in how they create and maintain it?

    Method: Six licensed psychodynamic psychotherapists who also are educated in ISTDP have been interviewed. The research is based on grounded theory.

    Result: Differences that are found are the need for contract and frame and how the method is applied. A gender difference is in the therapist's view of the possibility of engagement, in ascribing signification to the interventions that bring about alliance and in the way alliance, attachment and emotional contact has been used. Similarities are regarding the importance of therapist's engagement, competence and patient's problems.

    Discussion: The result was discussed on base of the therapist's view upon alliance. Therapist's engagement and patient's problems as well as how the method has an impact on creating the alliance has been discussed. Therapist's experience of being able to create and maintain the alliance has been discussed from a gender perspective and legibility.

  • Eriksson, Maria
    Mälardalens högskola.
    Barns rätt som anhöriga BRA: Utvärdering av ett utvecklingsarbete2014Report (Other academic)
    Abstract [sv]

    Rapporten redovisar iakttagelser och slutsatser om Allmänna Barnhusets utvecklingsarbete med namnet BRA – Barns Rätt som Anhöriga, och den modell för information, råd och stöd till anhöriga barn som arbetet resulterade i: BRA-modellen. Utvärderingsuppdragets fokus har legat på att skaffa en så bred bild som möjligt av BRA modellen, och att ta vara på synpunkter, tankar och förändringsförslag som kan bidra till att tydliggöra och förbättra modellen. Det empiriska underlaget består av basuppgifter om 46 av de 56 barn och unga som deltagit i BRA-samtal och läger, intervjuer med 8 av de deltagande barnen, intervjuer och samtal med 11 personer från de 3 pilotverksamheter som ingick i projektet, och samtal med de 2 projektledarna från Barnhuset.

    Utvecklingsarbetet prövade en modell med följande komponenter: barn och föräldrar får vid ett första samtal tillsammans information om de rättigheter som barnets anhörigskap medför. Barnet erbjuds sen 1-2 enskilda samtal. Om barnet önskar genomförs därefter ytterligare ett samtal tillsammans med föräldern. Efter de enskilda samtalen erbjuds barnet att träffa andra barn med liknande erfarenhet under ett läger en helg eller ett skollov.

    Utifrån uppgifter om deltagande barn och de insatser som genomförts kan man dra slutsatsen att det är två olika versioner av BRA som prövats i praktiken: ”fullständig-BRA” där modellen har i relativt hög grad prövats utifrån samtliga komponenter och ”mini-BRA” där BRA-insatsen framförallt har bestått av ett inledande informationssamtal och i vissa fall ytterligare ett individuellt samtal. Vidare har de olika versionerna av BRA riktats till delvis olika målgrupper, vilket betyder att BRA-modellen i sin helhet framförallt har prövats på tonårstjejer med erfarenhet av föräldrars psykiska ohälsa, medan yngre flickor och pojkar vars föräldrar har någon typ av somatisk problematik endast tagit del av mini-BRA. Det är endast barn från de verksamheter som åtminstone i några fall prövat fullständig-BRA som kommer till tals i intervjuerna. Sammantaget betyder detta att slutsatserna om hur modellen fungerar för yngre barn och barn till föräldrar med somatiska sjukdomar blir ganska osäkra.

    Såväl de intervjuade barnens utsagor som det samtalsledarna säger tyder på att när det gäller individdelen av BRA har målsättningarna uppfyllts i hög grad vad gäller att barnen har fått kunskap om sina rättigheter med anledning av förälderns fysiska sjukdom/psykiska störning/missbruk, att de har fått den information de behöver om sin förälders sjukdom/psykiska störning/missbruk, och att de har fått hjälp att uttrycka eventuellt behov av råd och stöd. Både barn och samtalsledare kommenterar också det pedagogiska redskap som används i samtalen och menar att det har varit viktigt och till stor hjälp. Det är dock inte lika tydligt att barnets behov av råd och stöd blivit synliggjort för föräldrar/närstående vuxna, eller att barnet eller familjen vid behov har länkats till personer/verksamheter som kan ge hjälp; råd, stöd, behandling, och så vidare. I synnerhet dessa frågor kan alltså behöva stå i fokus i fortsatt utvecklingsarbete. I och med de begränsningar som finns i materialet om och från de deltagande barnen går det inte att utifrån barnen uttala sig om det är några grupper barn som individdelen av BRA inte fungerar lika bra för. Piloternas tankar om eventuella begränsningar handlar framförallt om att BRA-modellen skulle behöva anpassas till barn med olika former av funktionsnedsättningar och kommunikationssvårigheter. Sammantaget framstår individdelen av modellen som mycket lovande och utifrån de intervjuer som rapporten bygger på kan man tolka det som att BRA-samtal kan stärka barns känsla av sammanhang.

    Målsättningarna för lägret verkar de ha uppfyllts i mycket hög grad när det gäller att stärka barnen genom att de får träffa andra i samma situation, uppleva gemenskap och dela erfarenheter, bli hörda och få uttrycka sina åsikter, samt att ha kul och lära sig mer om sina rättigheter. Det är mer oklart i vilken lägret bidragit till att barnen fått fler strategier att hantera vardagen som anhörig. De barn som deltagit i ett läger talar alla mycket positivt om den erfarenheten. Mer kritiska synpunkter från barnen handlar - vid sidan om att lägret varit lite för komprimerat tidsmässigt - framförallt om att lägerledarna behöver vara observanta på att det kan vara påfrestande känslomässigt för deltagarna att vara på läger. Ett inslag i lägerprogrammet är inspirerat av norska Forandringsfabrikkens deltagandemodell höringar och i den här delen får barnen möjlighet att som grupp förmedla erfarenheter, goda råd och förslag på förbättringar för anhöriga barn till politiker och beslutsfattare. Att döma av de barn som kommit till tals i intervjuerna var relationen till och utbytet med de andra barnen betydligt viktigare än detta mer barnpolitiska inslag. Barns rätt till att komma till tals också i ett vidare perspektiv verkar inte ha stått högst på agendan för de barn som deltog i lägret. Det kan bland annat ha att göra med att de inte träffat varandra tidigare utan etablerade sina relationer där och då.

    BRA är en modell som sätter barnets rättigheter i fokus. Arbetet bygger på barns delaktighet och förutsätter de vuxnas lyssnande. De barn som intervjuats bekräftar att det är viktigt att BRA-modellen har barnets rättigheter som utgångspunkt, och man kan tolka barnintervjuerna som att samtalsledarna i hög grad lyckats bidra till att barnen fått mer kunskap om sina rättigheter. Det som för många av pilotverksamhetens medlemmar har varit nytt med BRA-modellen är dels att insatsen riktar sig direkt till barnet och sedan just detta att arbetet utgår från barns rättigheter och delaktighet. Piloterna betonar att det är ett nytt perspektiv de har lärt sig att arbeta utifrån, som ifrågasätter vuxnas tolkningsföreträde. Även utgångspunkten i rätten till information ger ett annat arbetssätt och en mer lyssnande inställning, medan det ”vanliga” sättet att arbeta framstår som tydligare styrt av de professionella. Det kan dock vara en utmaning att arbeta utifrån barns delaktighet och egenmakt inom ramen för relationer som inte är jämlika utan i stället präglas av vuxnas överordning och barns beroende och underordning. En annan utmaning med att arbeta på det här sättet är att rättigheter kan framstå som något ganska abstrakt och att det kan vara svårt att ”översätta” så att det blir möjligt för barn att ta till sig kunskap om sina rättigheter. Ytterligare en utmaning är förknippad med ansatsen att lära barn något. En erfarenhet från pilotomgången är att medan det första individuella samtalet väldigt tydligt har fokus på det enskilda barnet, kan det vid det andra samtalet vara lätt att börja ”undervisa” om rättigheter, så att samtalets innehåll inte kommer lika mycket från barnen själva, och barnen får en lägre grad av delaktighet. Ytterligare en utmaning som piloterna lyfter fram är att det inte är givet att BRA-tanken om barns rättigheter och barns delaktighet också i ett vidare perspektiv får gehör i den egna organisationen eller hos andra samhällsinstanser.

    En analys av hinder och möjligheter när det gäller tillämpningen av modellen bekräftar väl känd kunskap om betydelsen av såväl organisatorisk förankring och beredskap som ledningsstöd vid implementeringen av nya metoder eller arbetssätt. Det blir också tydligt det kanske ställs särskilda krav på organisatorisk förberedelse om BRA-modellen ska implementeras inom verksamheter med vuxna som primär målgrupp. Det behöver också finnas en grundläggande kunskap i hela organisationen om anhöriga barn och deras rättigheter för att det ska bli möjligt att rekrytera barn till BRA-insatsen. Under utvecklingsarbetet var en utgångspunkt att BRA-modellen ska vara så grundläggande att även av personal som inte är särskilt inriktade på barn ska kunna använda den. Piloterna menar dock att även om modellen är tydlig och enkel ställer exempelvis BRA-samtal krav på den som leder samtalen, och den förutsätter viss vana och erfarenhet att luta sig mot. Den utbildning i modellen piloterna genomgått får genomgående högt betyg, liksom stödet i förberedelse och genomförande av lägren. Kritiska kommentarer handlar mer om olika besked under projektet gång om exempelvis rekrytering till lägret. Det faktum att BRA framställs som en modell kan också vara något av en utmaning för dem som ska omsätta den i praktik, och det ställer krav på handledning från Barnhusets sida. Detta eftersom en del professionella, inte minst inom socialtjänsten, är ovana vid att arbeta manualbaserat. En del piloter uttrycker exempelvis en osäkerhet om de måste följa anvisningarna ”till punkt och pricka” för att de ska genomföra ”riktiga” BRA-samtal. En fråga för det vidare arbetet med BRA är att tydliggöra instruktionen till BRA-samtal och diskutera hur strikt denna måste följas för att det ska vara fråga om just ”BRA: Barns Rätt som Anhöriga”.

    Helhetsbedömningen blir att detta är ett i många avseenden framgångsrikt utvecklingsarbete. Det material som ligger till grund för analysen tyder på att arbetet med BRA-samtal och läger lyckats uppfylla målsättningarna. Vidare har utvecklingsarbetet resulterat i en modell som framstår som lovande inte bara när det handlar om att informera anhöriga barn om deras rättigheter och kartlägga behov av vidare stöd, utan som även tycks kunna stärka barns känsla av sammanhang. När nu modellen är utvecklad blir det därför angeläget att på allvar pröva den i olika verksamheter, och att studera hur BRA modellen fungerar i jämförelse med andra metoder eller modeller för information och stöd till barn som anhöriga.

  • Johansson, Elina
    Ersta Sköndal University College, Department of Health Care Sciences.
    Innebörden av vårdande och miljö ur ett kliniskt förbättringsarbete i rättspsykiatrisk vård: En analys av genomförda förbättringsförslag2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research has shown that patients in forensic psychiatric care experience a lack of autonomy, participation and respect. It is in the nurse's interest to take care of the patient's resources and to plan the nursing thereafter. Care can be adapted to the desired needs by working with improvement suggestions from patients, relatives and healthcare professionals.

    Aim: The aim of this study is to explore the areas of participation, care relationship, nursing environment and treatment in implemented PDSA cycles aimed at patient care in a clinical improvement work in forensic psychiatric care.

    Method: The study consists of two parts, an explorative qualitative design with an inductive approach and a descriptive quantitative design. Data from nine units were collected from the ongoing implementation in the current work. The qualitative content analysis was used according to Graneheim and Lundman in the analysis of the data.

    Results: The result has been categorized into eight subcategories; implicate the care process, ability to influence, own responsibility, improvement of social areas, creating a pleasant environment, stimulus for body and mind, increased awareness and jointly achieving set goals, which later resulted in four main categories: participation, care relationship, nursing environment and treatment.

    Discussions: The methodology of the study is discussed using the quality concepts credibility, confidentiality, reliability and transferability. The results of the study are compared to previous research and are also linked to Eriksson's theory of care and its importance in participation, care relationship, nursing environment and treatment.

  • Sjödin, Marie
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Individuella upplevelser av antipsykotisk medicinering: En litteraturstudie med kvalitativ ansats2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • Yifter, Lilly
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienter med aggressvt beteende och en förklaringsmodell om vad som kan trigga igång aggressivitet: - En Integrativ litteraturöversikt2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The care environment within psychiatric inpatient care has been described to create different emotions and is characterized as a hard environment where patients sometimes are treated against their will and can be exposed to coercive measures and restrictions. Aggressiveness is common at these wards and is considered a problem. There is a knowledge gap when it comes to patients and situations that increase the risk for aggressiveness in the context of psychiatric inpatient care.

    Aim: To identify characteristic features of aggressive patients and to identify aspects that effects situations where threats and violence has occurred in psychiatric inpatient care and to synthesise an explanatory model.

    Method: An integrative literature overview containing both qualitative and quantitative articles. The data were analysed using Whittemore and Knafl’s (2005) working procedure.

    Results: The result generated in three main themes and ten subthemes. Following three main themes were identified: the patient as a trigger, the care environment as a trigger and the staff as a trigger.

    Discussion: The method is discussed in relation to these concepts: trustworthiness, dependability, confirmability and transferability. The results are discussed with support of previous research and in relation to Phil Barker's theory the Tidal model.

  • Klintberg Holmqvist, Kristina
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Lidin, Max
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskans arbetsmiljö på akutmottagning: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Akutmottagningar behöver vara utformade för att kunna erbjuda en varierad patientgrupp akut vård. Arbetet på en akutmottagning karakteriseras av teamwork där sjuksköterskan förväntas kunna handla snabbt och kombinera omvårdnadsarbetet med medicinska och administrativa arbetsuppgifter. För att kunna uppleva en god arbetsmiljö krävs ett socialt kapital på arbetsplatsen, förmågan att uppleva mening och tillfredsställelse i arbetet samt ett gott stöd från organisationens olika skikt. 

    Syfte: Belysa sjuksköterskans arbetsmiljö på en akutmottagning. 

    Metod: Metoden som använts är en litteraturöversikt enligt Fribergs metod med syftet att skapa en överblick över det aktuella kunskapsläget inom ämnesområdet. Översikten utformades på tio vetenskapliga artiklar hämtade från CINAHL Complete och PubMed. Artiklarna analyserades enligt Fribergs modell för en litteraturöversikt, likheter och skillnader identifierades och tematiserades. Som teoretisk utgångspunkt användes Watsons omvårdnadsteori. 

    Resultat: Resultatet presenteras i form av tre huvudteman; fysiska, psykologiska och sociala aspekter av arbetsmiljön. De fysiska aspekterna utgjordes av undertemana Lokaler och säkerhet samt Bemanning och patienttäthet. De psykologiska aspekterna behandlade ämnena Att arbeta under tidspress samt Förekomst av utmattning, ångest och arbetsrelaterad stress. De sociala aspekterna inkluderade Teamwork och Konflikthantering. 

    Diskussion: Resultatet diskuterades med utgångspunkt i Watsons omvårdnadsteori och analyserades i relation till hur organisationen och ledningen såväl som sjuksköterskans inställning till omvårdnad kunde påverka arbetsmiljön. Resultatet tolkades även utifrån arbetsmiljöns påverkan på sjuksköterskans patientbemötande.

  • Junger, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Barns upplevelse av intensiv familjeterapi (IFT)2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Roberntz, Ann-Sofie
    Ersta Sköndal University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Psykoterapeuters kroppsliga och känslomässiga reaktioner i arbete med traumatiserade patienter2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: There are few research references on psychotherapists physical and emotional reactions in the patient work. This thematic analysis is based on psychotherapists who work with people suffering from trauma, as previous studies indicate powerful physical and emotional reactions in the work with this target group. The purpose of the study is to illustrate how psychotherapists describe their experiences, both negative and positive, and how they handle them.

    Questions: How do psychodynamic psychotherapists describe theirphysical and emotional reactions in the work with traumatized patients? How do they handle their own reactions?

    Method: Five licensed psychotherapists with psychodynamic training in Sweden working with patients with trauma were interviewed. This qualitative researchapproach was processed with a thematic analysis.

    Results: Psychotherapists describe difficulties facing the unimaginable violence in the patients' stories, how to protect themselves, how they carry hope, how they can cope with it and how they can use their reactions in therapy sessions. It also highlights the consequences regarding themselves and the need for recovery.

    Discussion: The result is discussed from the theoretical concepts of countertransference, projective identification, containment and trauma. The psychotherapists´ reactions confirm earlier research of physical and emotional reactions, and isbeing discussed out of the wide impact the reactions have on psychotherapists´ professional and personal life.

  • Sundvall, Nina
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Psykoterapeuters upplevelse av ansvar2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to examine the psychotherapist's experience of responsibility towards their patients and how this affects her in her professional work and private life. The study seeks to answer the following questions: 1.) How do psychotherapists describe the experience of existential responsibility? 2.) How do psychotherapists describe different factors that affect the responsibility experience? 3.) How do psychotherapists describe the impact of responsibility experience on an existential level? 4.) What do psychotherapists describe as helpful in managing the responsibility experience? The author has chosen a qualitative method where semi-structured interviews were conducted with six licensed psychotherapists. These were transcribed and analyzed using thematic analysis. The result shows that the existential responsibility towards the patient is perceived as profound, and that the power of responsibility is influenced by both structural, patient-dependent and personal factors. Responsibility seems to be linked to human existence rather than to formal rules and guidelines. The psychotherapist is influenced by her work both in the private and professional life. This is perceived as relatively unproblematic of psychotherapist if/when she has found a way to relate to it. Several factors are helpful to manage the experience of responsibility has emerged, several of which is about self-care.

  • Hannar, Frida
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    McAllister, John
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Vi är alla människor - Personer med psykiatriska tillstånd i den somatiska vården: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Living with a psychiatric diagnosis may entail numerous challenges for the individual. People diagnosed with mental illness can daily experience a vulnerability to prejudice, not only in their everyday life in society but also within the healthcare context. Comorbidity is a substantial problem among a considerable part of the population with psychiatric diagnosis. Healthcare staff has described experiences of fear and uncertainty when dealing with people with psychiatric diagnosis, they enlightened a lack of knowledge when it comes to properly responding to the needs of people with a psychiatric diagnosis.

    Aim: The aim of this study was to investigate the experiences people with mental illness describe in contact with somatic healthcare.

    Method: The authors carried out a literature review. Through searches in databases such as Cinahl Complete and PubMed they have found articles that were analyzed and divided into themes.

    Result: The result of the literature review identified one main theme: Psychiatric patients’ experiences of somatic care and two subthemes: Healthcare staffs’ treatment and the treatments effect on patient participation.

    Discussion: The results found in the literature review were discussed in relation to chosen commitments from the tidal model. Reasoning arguments concerning treatment and ways to promote patient participation were held and discussed.

  • Carlsson, Anna
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Christensen, Ellen
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors erfarenheter av palliativ sedering: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Palliative sedation refers to an intentional lowering of consciousness of a patient in the end of life who is suffering from unbearable symptoms. The care is performed by a multi-professional team where the nurses’ duties are to prepare, administer and evaluate prescribed pharmaceuticals. In addition to the practical skills required by the nurses, this treatment also requires ability to reflect as well as critical and ethical thinking.

    Aim: The aim of this literature review was to explore nurses’ experiences of palliative sedation.

    Method: A literature review was conducted and ten scientific articles were chosen for analysis. Literature searches were made in the databases CINAHL Complete and PubMed.

    Results: Three themes with subthemes were identified. Good palliative care included giving palliative sedation to offer patients, families and the staff a peaceful ending and to meet the patient’s wishes. Palliative sedation and euthanasia could be difficult to separate and there was a sense that palliative sedation hastened the patient’s death. Teamwork was an important factor for how nurses experienced working with palliative sedation. It was easier if the decision to sedate was taken jointly and support within the team was meaningful to nurses during their work with palliative sedation.

    Discussion: The results were discussed in relation to Jean Watson’s Theory of Human Caring and the three caritas processes The practice of loving kindness and equanimity, Promotion and acceptance of the expression of positive and negative feelings and Developing and sustaining a helping-trusting caring relationship. 

  • Hillerström, Susanna
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Vannisse, Anja
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Närståendes upplevelser av vård vid livets slutskede på vårdavdelningar: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Receiving end-of-life care can turn into a big adjustment for both the patient and the next of kin. According to previous research the knowledge is inadequate regarding this type of care-giving, which turned out to be a relevant area for further research. The nurse carries a great responsibility when it comes to the wishes and requirements of the next of kin, and is also providing information, support and involvement in this trying situation.

    Aim: The aim was to describe how someone who is a next of kin might experience the end-of-life care in hospital wards.

    Method: Literature review. Eight qualitative articles, one quantitative article and one article with mixed method were collected from the databases CINAHL Complete and PUBMED. The searches were limited to full text, peer reviewed, in English and the years of publishing from 2006 to 2016.

    Results: Four themes emerged during the analysis; The importance of communication for end-of-life care, the relationship’s importance and the need of closeness, experience of support, comfort and attitude and next of kin’s involvement in end-of-life care. The importance of communication was vital. This emerged from the experiences the next of kin described as inadequate, and thus feeling unable to make the right decisions. Also, some positive and negative aspects regarding the next of kin’s experiences of support emerged. This included the meaning of the relationships for the caring, which leads to an improved chance for them to get involved.

    Discussion: The results showed great similarities in terms of information and knowledge, which leads to improved communication between the nurse and next of kin. Direct communication was considered, according to the next of kin, as an essential factor in the development of the perception of nursing care. This is discussed on the basis of Andershed’s theory, as well as other perspectives, of the nurses and the patients, and the way in which the next of kin’s involvement is affected.

  • Despres, Sara
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Wikström, Mark
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Närståendes upplevelser av palliativ vård på intensivvårdsavdelningar: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The care in the intensive care units intends to save lives. In spite of that aim, 20 percent of the deaths in Sweden occur at the intensive care units and the transition between curative and palliative care can be very quick. Death often occurs shortly thereafter, and this can be experienced in different ways depending on how the staff informs and communicates with the next-of-kin.

    Aim: The purpose of the literature review is to examine how the next-of-kin experience palliative care in intensive care units.

    Method: A literature review was made and ten scientific articles were selected. Six were quantitative and four qualitative.

    Results: Five main themes with subthemes were identified. Information on diagnosis and prognosis was crucial. Communication was also important. The next of kin appreciated emotional and existential support. Interaction, as in practical involvement and as in the physical and existential presence, turned out to be very important. Finally, results show that the environment with a lot of technical equipment and little space for privacy and tranquility affects the experience for next-of-kin.

    Discussion: The results are discussed in relation to Andershed’s theoretical framework “Involvement in the light - Involvement in the dark.” and her main concepts“ to know”, “to be” and “to do”. In addition, Andershed’s concepts of humanistic approach and “extra resources” are being discussed.

  • Adolfsson Blomqvist, Josefin
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Strömsén, Emmy
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Vårdpersonals erfarenheter av patienter med demenssjukdom som vårdas palliativt: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: A great amount of elderly people suffer from different forms of dementia and unless these individuals suffer from another terminal disease the dementia will by its nature lead to death of the patient. Palliative care is often associated with cancer and cardiovascular diseases, however the palliative care is beginning to see the introduction of treatment for people with dementia.

    Aim: The aim was to highlight nursing staffs' experiences of patients suffering from dementia within gerontological care in end of life.

    Method: A literature review has been done based on search results from databases CINAHL complete, Pubmed and Ageline. The selected articles consisted of eight qualitative studies and two cross-sectional studies. The authors have based the analysis on Friberg's method of analysis.  

    Results: In the result describes Introduction of palliative care for the people suffering from dementia, nursing staffs´experience of symptom relief, the importance of good communication as well as hindrance and possibilities for good palliative care. It was discovered that it can be perceived as harder to judge when a patient suffering from dementia is in need of palliative care compared to patients with other medical conditions. This also resulted in the caring relationship between patient and nursing staff is of high importance for the recognition of symptoms. Nursing staff perceived there were flaws in the emotional support after having nursed a patient with dementia.

    Discussion: In the method discussion pros and cons regarding the chosen method is discussed, as well as the choice of articles and why some restrictions have been made. In the result discussion the result in relation to the theoretical entry points 6 S:s  is discussed. Correlations to person-centered care is discussed through the discussion of the result.

  • Lindström Akhondi, Sara
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Alevad, Hanna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors erfarenhet av att arbeta med motiverande samtal vid livsstilförändringar: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Unhealthy living habits create an increased risk of suffering from lifestyle-related illnesses, which poses a challenge for healthcare. In clinical praxis nurses should work through a health promoting and person-centered approach. Motivational interviewing is a supportive and an indicative evidence based approach to lifestyle changes that through compassion aims to strengthen the person's own motivation for change.

    Aim: To describe nurses' experiences of working with motivational interviewing with lifestyle changes.

    Method: The thesis work is a literature review of 11 scientific articles searched for in Cinahl complete and PubMed that have been examined using Fribergs analysis method.

    Results: Nurse's experiences with motivating interviewing about lifestyle changes are presented in the results under three themes; experiences of motivational interviewing, prerequisites for motivational interviewing and approaches of working with motivational interviewing.

    Discussion: The discussion was based on Rosemarie Rizzo Parse's theory Human Becoming and Scientific Literature. Nurses' experiences of working with motivational interviewing in lifestyle changes are highlighted through three themes; person centered care, participation in an equal care relationship and development.                    

  • Verina, Laura
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Wallin, Nicklas
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Indian nurses' experiences of caring for women exposed to gender-based violence: A qualitative study2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Men’s violence against women is a serious and extensive problem in the Indian society that affects the lives of these women entirely. The level of violence against women occur independent from all classes and ages. The estimated number of unknown cases is high and the uncertainty regarding number of victims is large. On a global perspective, the situation is even more confusing since the definitions of what makes a violent act varies substantially between countries and can range from anything between psychological, physical to sexual violence.

    Aim: To describe Indian nurse’s experience of caring for women exposed to gender-based violence. 

    Methods: A qualitative study with semi-structured interviews was conducted. The interviews were made in four different hospitals in Mumbai, India. Five separated interviews were conducted with duration between 30-45 minutes with working nurses who all have experience in caring for women exposed to violence. Data was analyzed using content analysis described by Graneheim and Lundman (2004).

    Results: The data analysis revealed four main categories: Nurse patient relationship, Nurses ability to detect gender based violence, a part of the nursing process, Challenges in the nursing profession and Management of emotional impact. The nurses talked about the importance of building a trustful relationship and to observe the patient in order to identify violence. Challenges as language barriers, getting the women to open up about their situation and getting emotionally affected while caring for the women were described. Family support and teambuilding were of importance in order to handle these challenges.

    Discussions:  It can be very difficult for women who have been exposed to violence to seek help. It is therefore important for the nurse to create a trustful relationship in order to get the woman to open up about her situation. However, studies show that nurses often get emotionally stressed from work and that many newly graduated nurses are thinking about leaving the profession. For this reason it is important that nurses get support in coping with the emotional impact and stress that comes from work.

  • Yarandpour, Golli
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Unga vuxnas upplevelse av livet med pappa efter militärt utlandsuppdrag2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: An overseas service in the defense forces is no single concern of the defense staff, but affects the entire family. Research shows that when parents leave the children for military service abroad, the child's mood and ability to cope with a period of separation greatly depending on how the child’s life is in general. Based on the understanding and interpretation of previous research, this study will see into how it’s manifested for these children to continue to live a life with their father after military foreign missions. Is it possible for the relationship to repair completely, re-attach and return to the roles that the family system once had, or is there more complications?

    Question: How is life portrayed for young adults to live with their father after his military missions abroad?

    Method used in this research for carrying out semi-structured interviews are qualitative approach, where six respondents, three men two women participated. The collected data were analyzed with thematic analysis with inductive approach. What is described is the phenomenon; respondents' thoughts, experiences and feelings about their own subjective experience and its meaning in their life.

    The results are linked to the three main themes: separation from the parent, the impact of military missions abroad to the system and re-attachment with the father. There are also eight sub-themes that collectively describe the respondents' subjective experience. Respondents perceive a lack of openness in the dialogue and communication between their father and themselves regarding the subject of the father's international assignment as military. The separation has touched the respondents in varied way, but the general opinion is that respondents also believe that the father's decision to go on military assignments abroad affected the entire family system, not least, the role changes and frictions that arise as a consequence. 

    Discussion: The relational problems are consequences of previous attachment failures. Repairing the communication to their father enables re-attachment, which can improve the relational difficulties between the father and the young adult. When communication in adulthood increased the respondents had the opportunity to express the emotions associated with the separation that can act as a healing effect on the relationship and association with their father.

  • Forell, Lisa
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Genusperspektiv i psykoterapi2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: There are few studies about the role of gender perspective and it’s use in psychotherapy. The purpose with this study is to describe how a group of legitimized psychotherapists use gender perspective in the therapeutic room and how they define the concept.

    Question formulations: How do psychodynamic orientated psychotherapists define gender perspective and its meaning for them? In what way do they use gender perspective in the therapeutic work?

    Method: A qualitative investigative method has been used where five legitimized psychotherapists, all women was interviewed in-depth. The result was analyzed and processed through thematic analysis method.

    Result: The participants share awareness of the different conditions between men and women in society. The study shows that the therapists have different approach to the practice with gender perspective. Some of the informants believe that openness and transparency with gender perspective towards the patient is required while others bring it as a silent knowledge into the therapy room.

    Discussion: The results are discussed from earlier research on feministic theory. The problem with connecting the own knowledge to the practice agree with earlier research and studies.

  • Guevara, Sari
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Lindroos, Catrine
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att handskas med en förändrad livssituation: En litteraturöversikt över närståendes erfarenheter av att hantera livet tillsammans med någon med psykisk ohälsa2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is something that affects many people and it is the most common reason for sick leave in Sweden. Except for changed life circumstances regarding the patient, it may also have negative or positive effects on relatives. Relatives to patients suffering from mental illness may experience challenging life circumstances and various kinds of burdens. It is also common for relatives to receive a role as an informal caregiver.

    Aim: Based on relative's experiences, the aim of this study was to explore how relatives manage life together with someone with mental illness.

    Method: A literature overview was conducted. In the search for articles three different databases were used. The work is based on twelve articles with qualitative, quantitative and mixed-method design. Roy's Adaptation Model was used as a theoretical framework.

    Results: The results describe how relatives manage and process their life, which is being described from the overall theme adaption along with the sub-themes acceptance, change and enhanced knowledge, control and balance, alienation and a search for support. A search for support and acceptance was most prominent regarding to how relatives managed their life. An example of this could be that relatives accepted the current situation as it was or searched for support within the family or from friends.

    Discussion: The results are being discussed on the basis of Roy's Adaptation Model and its four adaptive modes; physiologic-physical, self-concept, role function and interdependence.

  • Phromloka, Minelle K
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sasuwan, Somkhuan
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att hantera det dagliga livet som anhörig till en person drabbad av schizofreni: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Schizophrenia is a mental disease, which has effects on both the person and the relatives. A person suffering from schizophrenia has often difficulties in living a normal life and is in need of a great care from the relatives. The relative who takes the role as primary guardian can be in constant preparedness to provide support and help. Responsibilities sometimes become so extensive and may result being a burden in both the subjective and objective sense.

    Aim: The aim was to examine relatives’ experience of caring for persons who suffering from schizophrenia and how they managing daily life in order to maintain their own health.

    Method: A literature review in accordance with Friberg was conducted. Systematic searches have been performed in the database CINAHL Complete and PsycINFO. The result of the literature review is based on 13 original articles.

    Results: A literature review resulted in two main themes: the beginning of change and the way forward. The beginning of change consisted of two subthemes: shock and guilt and responsibility and burden. The main theme described the relatives' experiences of caring for the person who suffered from schizophrenia. The way forward consisted of two sub-themes: adaptation and a search for help, which in turn was presented to the relatives in order to help self-management of life changes and obtaining support.

    Discussion: The main findings of the literature review discussed by Antonovsky's theory sense of coherence (SOC). Positive performance contributes to acceptance that further leads to effective adaptation. Cultural and religious aspects proved to strengthen the inner resources of the relatives as well as support groups brought the feeling of solidarity.

  • Woolford, Caroline
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors erfarenheter av samtal med patienter i palliativ vård: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In difficult situations where life comes to a head, it is common that difficult issues and feelings are raised. This also raises the demands on those who care for these patients and knowledge of communication in palliative care is required. Because of this, nurses take on a great responsibility, not only for the patients they care for, but also the entire context patient is in. Therefore, the communication between nurses and patients an important part of health care.

    Aim: To highlight nurses’ experiences of conversations with patients in palliative care.

    Method: A literature review has been constructed by eight scientific articles from CINAHL complete and PubMed. The keywords used are: hospice and palliative nursing, terminal care, conversations, nurse experience och communication.

    Results: The results that emerged were divided and presented under different headings, these were: Nurses' experiences of calls in palliative care and factors that affect conversations in palliative care. Several subheadings were then created. It was revealed that many nurses experienced end-of-life conversations as difficult and it was something that required training and experience to handle in the best way.

    Discussion: The discussion was divided results into two headings: the actual responsibility and the importance of communication. This was also discussed using further literature confirming the result.

  • Ahlund, Angelica
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Frank, Lovisa
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Kvinnors sexuella hälsa efter diagnostisering av cervixcancer: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Sexuality and sexual health are two concepts that belong together. Sexuality means proximity and contact while sexual health means that it is safe and secure to perform sexual activities. Cervix is a part of women's inner reproductive organs. Cervical cancer is globally seen as one of the most common forms of cancer amongst women where pain is a late symptom of cervical cancer. Mortality is higher in developing countries than industrialized countries. Human papillomavirus, HPV is the most common cause of cervical cancer, where surgery, cytostatic and radiation therapy are different types of treatment. Cytological changes do not always mean cancer. Getting a cancer message can induce emotional reactions such as anxiety, anger and concern. At different coping strategies; Active and passive, the woman can adapt to the new life situation. A cancer diagnosis can develop reactions that affect both the physical and the mental health.

    Aim: The purpose was to highlight women’s sexual health after diagnosis of cervical cancer.

    Method: This literature review was compiled by collecting material from previous research within a healthcare knowledge area. Ten scientific articles related to cervical cancer and sexuality are the basis for the outcome. The material was reviewed and analyzed according to Fribergs method and finally summarized into mainthemes and subthemes in a literature review.

    Results: The result is presented in three main themes; Physical aspects, Mental aspects, and Social aspects. The results showed that cervical cancer affected women’s sexuality and sexual health. Positive experiences expressed by the women were an increased estimation on sexual activity after the disease. While negative experiences that were reported was a fear of performing sexual activities where dyspareunia was a cause. Sexual barriers affected the sexual function and created a concern among the women. The treatment of cervical cancer affected the woman through various bodily changes and discomfort during sexual intercourse.  

    Discussion: The physical changes that the woman experience is affecting her sexuality and identity. A need for knowledge about cervical cancer related to sexuality was noted in the women, where the nurse's responsibility is to provide women with this information. Virginia Henderson's behavior theory and the Cancer center care program may be a support for the nurse. 

  • Carson, Anna
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Grimgarn, Tove
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Depression hos äldre: Vårdpersonals beskrivning och förståelse - en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Depression is common in old age and can have a significant impact on older patients’ health. Depression among the elderly differs in several aspects from depression in younger patients. The differences occur in the appearance of symptoms, causes, and risk factors for depression. Somatic comorbidity is common among older patients which can worsen the course of depression and obstruct identification and treatment.  

    Aim: The aim of the review was to describe approaches to depression in the elderly among health care personnel in somatic care.

    Method: A literature review was conducted based on ten scientific articles, nine qualitative and one mixed method. The content was analyzed and organized in categories. Databases used were: CINAHL complete, PubMed and PsycINFO.

    Results: Three categories with subcategories were constructed. In Health personnel's understanding of depression three subcategories emerged; Underlying causes and risk factors, Obstacles to identify and screen for depression, and Knowledge and training. The category Attitudes towards depression is divided in two subcategories; Stigma in old age and Depression as a normal part of ageing. In the category Health personnel’s conditions to manage depression in older patients, two subcategories emerged; Roles and functions of health personnel and Timeframes in healthcare.        

    Discussion: The results of the literature review are discussed from the perspective of previous studies as well as the theoretical framework of the review, the tidal model. To indicate the relevance and significance of health personnel’s approaches to depression in old age the results are also discussed from a patient perspective. 

  • Färg, Tanya
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Kindgren, Maja
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienter med psykisk ohälsa i somatisk vård: En litteraturöversikt om upplevelser och erfarenheter av bemötande från vårdpersonal2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Somatic and psychiatric comorbidity are frequent in patients with mental illness. There is a risk that patients with common mental disorders don’t get adequate treatment for their somatic health problems. Lack of care quality and availability to somatic health care are issues considered contributory to years of life lost to these patients. Patients with mental disorders have the right to receive care without discrimination, though research indicates that negative attitudes and discrimination by health-care personnel towards these patients may occur.

    Aim: The aim of this literature review was to reveal how patients with mental illness experience the encounter with health care personnel in somatic care.

    Method: A literature review with 13 original research articles from six different countries was retrieved from the databases Cinahl and PsycINFO. The studies were analyzed based on Fribergs method.

    Results: Four main themes were crystallized: Experiences of being marginalized, Positive experiences of health care, Experiences of health care not being good enough and Consequences of negative attitudes.

    Discussion: The article result was discussed related to Orlando’s nursing process The dynamic nurse-patient relationship and her key concepts: evidence-based nursing, communication, dialogue and reflection. The need for additional   expertise in caring for patients with mental illness was one of the points raised.

  • Janson, Jennifer
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Tuomi, Hanna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Hälso- och sjukvårdspersonals uttryckta attityder gentemot patienter med psykisk störning: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is a growing problem in the society. Attitudes of negative character are presented as the ground for stigmatizing and since the old Greeks we have been forming the meaning of the word stigma. Stigma has become wider and more integrated in the society. The integration of stigma is a growing problem due to its impact and influence in the way we humans think and act. In addition this can be a contribution to how the healthcare relationship turns out, it may be positive or negative. However the expressed attitudes against patients play an important role in the hope of providing good care.

    Aim: The aim of this study is to describe how healthcare professionals express their attitudes towards patients with mental disorder.

    Method: The method used by the authors is a structured review of the literature using databases such as CINAHL Complete, Medline and PsycINFO.

    Results: The result showed that healthcare workers express both positive and negative attitudes, even stigmatization occurs. Patients with mental disorder were also misbelieved for their physical symptoms. Healthcare professionals mixed attitudes varied depending on work experience, education and place of work. The need for more education was expressed by a big number   of participants.

    Discussion: The result has been discussed based on the background and Joyce Travelbee’s theory, Human-to-Human Relationship. The result revealed both positive and negative attitudes towards people with mental illness. Also stigmatization was highlighted in the form of expressed attitudes and structural problem. Healthcare professionals also underline their knowledge of mental illness as being inadequate and a wish for increased knowledge was expressed.

  • Samawi, Nora
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Toscano Westman, Claudia
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Hälsorelaterad livskvalitet hos vuxna personer efter en svår brännskada: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: A severe burn is defined as a deep dermal damage in which the body's underlying organs can become affected and can result in a critical condition. The consequences of a burn can affect the physical, psychological, social and existential health. Since a severe burn is evaluated on a case to case basis, the nurse's caring interventions are based on the specific consequences from the burn. With the nurse's holistic approach on caring, he/she can identify different aspects and factors in the patient’s general health of which the patient experiences as suffering. Therefore it is of great importance that the nurse cares for the patient's health-related quality of life, since this is described as a subjective measurement of health and compounds the patient’s unique experiences of his/her wellbeing.

    Aim: To describe the health-related quality of life among adults with a severe burn injury.

    Method: A literature review was done in accordance with the Friberg analytical method. Ten scientific articles were selected, all of which consisted of a quantitative design. The articles were found in the CINAHL Complete and PubMed databases. As a theoretical base, Katie Eriksson’s caring theory was selected and used as framework in the results discussion.

    Results: Three main themes with subthemes were identified; physical aspects of quality of life with subthemes “pain and movement capability” and “factors that affect the physical quality of life”, psychosocial aspects of quality of life” with subthemes “psychological ill-health” and “factors that affect the psychosocial quality of life” and general aspects of quality of life with subthemes “length of hospital stay, caring interventions and time since injury” and “age/gender”.

    Discussion: In the method discussion the authors have discussed the pros and cons of the execution of this literature review. In the results discussion, the results that were of greater interest to the authors have been discussed, in accordance with Katie Eriksson's caring theory as well as the background in this literature review and previous research.

  • Halvorsen, Camilla
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Söderholm, Elina
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Stress - ett hot mot sjuksköterskans hälsa: Belysa stressfaktorer samt upplevelser av stress hos sjuksköterskor inom akutsjukvården. En litteraturöversikt.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    entails large responsibilities and high demands for the nurse. We had an interest to highlight how stress affects the nurse in her work.

    Aim: To highlight stress factors and experiences of stress in nurses in emergency care.

    Method: A literature review of eight qualitative and four quantitative articles has been made. The results have been arranged into six themes.

    Results: The six themes were: lack of support and appreciation, understaffing, work load and lack of time, lack of influence over the work situation and power- sharing, conflicts and bullying in the work place, physical work environment and caring for severely ill patients.

    Discussion: The results have been discussed in relation to Antonovsky’s theory of SOC, Sense of Coherence, where comprehensibility, meaningfulness and manageability have been related to the nurse’s experience of stress. The results have also been discussed in relation to previous research and our own reflections.

  • Viitanen Berglund, Anne
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Barns upplevelse av att ha ett syskon med psykisk ohälsa2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Mental health issues in children seem to be an increasing problem, and is causing an impaired quality of life for those affected (Socialstyrelsen, 2013). From a systemic perspective all members in the family are affected when one member is suffering from mental health problems. This study aims to describe what it is like to be a sibling and close relative to a child/adolescent suffering from mental health problems.

    Question formulation: How did the child acquire knowledge about the siblings mental health problems? How does the child experience the relationship to the sibling with a mental health problem? How is the child dealing with the emotional experience?

    Method: A qualitative study with data collected through interviews with five children age 8 – 11 years old. The interviewees all had siblings who were treated in a child psychiatric clinic at the time of the interviews. The data was analyzed with a thematic analyses.

    Result: The children in the study express little knowledge about their siblings mental health problems. They describe their sibling as odd, sometimes threatening and tell about lots of trouble and conflicts at home. Conflicts are verbal as well as physical. The children’s stories show that they deal with the difficult situations in different ways. Some of the children withdraw and spend time by themselves, other seek security with their parents, other siblings or just goes to friends. The children express affection with their siblings although they are also very angry with them at the same time. Being together with the family and doing activities together is something that all children value.

    Discussion: The result of this study is connected to previous research showing that having a sibling with mental health problems or disabilities can have both positive and negative consequences. For the sibling it is not the type or severity of the disease or mental health problem that determine how the child is affected, but rather the extent of emotional support from the family and their environment.

  • Alm, Annie
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Åström, Madeleine
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienters erfarenhet av faktorer som hindrar eller främjar egenvård vid diabetes typ 2: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes is an increasing problem and self-care is of great importance to prevent complications. Nurses have an important role in supporting or compensating in areas that the patient is not sufficient enough to self-manage. The interest in this topic originated in several clinical encounters with patients showing self-care deficits and tools for supporting these patients are in demand.

    Aim: The aim of this literature review is to illuminate patients’ experiences of barriers and promoters of self-care in type 2 diabetes.

    Method: Literature review. The result is based on 13 scholarly articles. The articles were identified from searching the databases Cinahl Complete, Academic Search Complete, PubMed and Nursing & Allied Health Database. This literature review focused on qualitative studies. A matrix method was used in compiling the results. The results were then analyzed and categorized.

    Results: Many factors affect individuals' ability of self-care. These are presented in the main themes: "Barriers" and "Promotors". Both internal and external factors influence a persons’ ability of self-care. A recurrent problem and barrier were lack of motivation and understanding of the importance of self-care. Coping, compliance and self-efficacy have a positive influence on self-care as demonstrated in the promotors theme.

    Discussion: Self-image and a persons’ emotional state affect his or hers self-care capacity and ability to change habits. Nurses need opportunities to improve their knowledge and understanding about lifestyle and diabetes counselling in order to help these patients. The results of this literature review were partially discussed using Dorothea Orem's "Self-care nursing deficit theory".

  • Jakobsson, Jenny
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Ungdomars upplevelse av delaktighet i familjebehandling2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Children who participate in family therapy in social services in Sweden have the right to relevant information, the right to be heard and the right to have influence. These aspects of children's right is based on UN Convention but also from the Social Services Act and the BBIC.

    Research questions: What does adolescents who participated in family therapy think about their participation? What do they think is important to make adolescents participate in family therapy? Had it been possible to do something more or differently to increase their experience of influence?

    Method: Since the purpose was to investigate adolescents' subjective experience of participation the method of choice was a qualitative study using semi-structured interviews in which five young people who participated in family therapy was interviewed.

    Result: The results show that the respondents felt that they were involved in a high degree, and link this to a number of factors that they also believe is important for adolescents in general. What they raised as important was to get to choose to participate and what they took part in, to be heard individually in the early stages, to get active help to be heard in the joined family sessions with parents, to be involved and formulate goals, to be involved in decisions about the method and that the therapist to be "right person" for them.

    Discussion: A common theme in the interviewees' stories is how important it was to not only be invited to participate but also to be enlaced as equal partners of equal value and influence of parents but who sometimes need more help to be heard.

  • Aleson, Marie
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Häggqvist, Lina
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienters upplevelser av att vårdas inom somatisk sjukvård i samband med psykisk ohälsa: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is nowadays considered a public health problem. Patients with mental illness often suffer co-morbidity and are therefore often cared for within somatic care. According to caring science the holistic perspective of the human with both body and soul is advocated where one part can never be excluded. Sensitivity in the caring relationship can be crucial for a patient suffering from mental illness. However, health personnel themselves experience a lack of knowledge caring for patients with mental illness.

    Aim: The aim of the literature review was to illustrate patients´ experiences of being cared for within somatic care in conjunction with mental illness.

    Method: Literature review including ten scientific articles was implemented, eight with a qualitative design and two with a quantitative design. The articles were analyzed according to Friberg’s (2012) method for literature review.

    Results: Six main themes were identified: experiences of meeting health personnel, experiences of being understood, follow-up by the caregiver, experiences of being involved, experiences of barriers for care and security.

    Discussion: The result is discussed according to Eriksson's theory of the caring relationship and suffering. Lack of knowledge within mental illness creates insecurity among health personnel and also creates suffering for the patient. The importance of seeing to the human as a whole is discussed.

  • Paulsdotter, Karoline
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Winroth, Jannike
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienters upplevelser av isolering vid smittorisk: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Isolation is the practice whereby a patient who carries an infection or a contagious disease is taken care of in such a manner that other individuals are protected from likewise becoming infected. The aim of healthcare law is to provide both equal care and good health for the entire population. Research that has focused on the importance of the patient's quality of life has also shown how isolation runs the risk of undermining or diminishing such quality of life. Moreover, patients who become infected are more vulnerable due to the lack of knowledge among some medical staff concerning how infections are spread.

    Aim: The aim of the literature review is to highlight how the contagious patient experiences isolation.

    Method: A literature review was carrid out in accordanse with Friberg (2012). Ten articles, accessed in th databases CINAHL Complete, PubMed, PsycINFO and Nursing and Allied Health, were identified for the results.

    Results: The literature review showed three main themes that were negative experiences of isolation, experiences of being contagious and positive experiences of isolation. Negative experiences of isolation were more prominent than positive. Patients experienced negative feelings like loneliness, sadness and frustration. The experience of being isolated could be stigmatizing and gave patients anxiety and fear. Isolation can also be perceived as positive when the room can be a place for relaxation and privacy.

    Discussion: Sister Callista Roys adaptation model was used in the discussion where patients' ability to adapt to the isolation was discussed. The authors discuss the role of the staff in this adaptation as well as what causes loneliness to be perceived as positive or negative.

  • Västberg, Helen
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Familjeperspektivet på BVC: En kvalitativ studie om BVC-sköterskors erfarenheter i sitt arbete med barns psykiska hälsa och utveckling2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study explores the BVC nurses' experience of using the family perspective to highlight children's mental health and development. The relevance stems from the child health care in Sweden has a unique opportunity and challenge in terms of both preventive and therapeutic work with families.

    The study is based on qualitative interviews with five childcare nurses from three different child healthcare centers in Stockholm. The collected data was processed with thematic analysis. The results show several challenges that arise in the work of meeting family-related issues. It is both experiences of lack of skills, a frustration about not knowing where to turn with families when identifying deficiencies in for example mental health. The results also show the importance of working in these fields, despite the difficulties, not least from developmental psychological aspects. The results are in line with theory and current research and raise questions about how well the child health care mission is fulfilled.

  • Olsson, Annie
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Aulin, Hedda
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Mastektomi och sexuell hälsa - Kvinnors upplevelser: En litteraturöversikt2017Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common cancer diagnosis for women in Sweden and worldwide. A consequence of breast cancer can be mastectomy which means that the diseased breast is removed. For many women the breasts have an important impact to their sexuality and femininity. Many women wanted more information from the healthcare about how the sexual health would be affected by the mastectomy. At the same time many nurses have a fear talking about sexuality with patients.

    Aim: The aim of this literature review was to illustrate women's experiences of sexual health after completing a mastectomy caused by breast cancer.

    Method: The literature review consists of 10 articles: six have qualitative method, two with mixed method and two with quantitative method. These were examined according to Fribergs (2012) method to find similarities which then were divided into major themes and sub themes.

    Results: The results are presented in three main themes with five subthemes. These main themes are: The altered body image, Changes in the intimate relationship and No change in sexual health. Women felt that they had lost their femininity and that they did not see themselves as attractive anymore. It also emerged that women experienced an uncertainty about showing their bodies in an intimate relationship after the mastectomy. Many experienced a change in sexual desire and a lack of the breasts and the nipples in the intimate relationship. The results also showed that some women were left by their partners since they could not handle the situation. Some women experienced no change in the sexual health.

    Discussion: The authors used the theory of Eriksson about suffering. Social media has in today's society a big part in people's life and an impact in women's appearance and ideal body image. Talking about sexual health is something that should be lifted by the nursing staff to provide greater understanding and support for the individual and the changes that might appear. Since we live in a heteronormative society, it is essential that we pay attention to bi- and homosexual women's sexual health.

  • Augustsson, Linnea
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Chamoun, Carolina
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Riskfaktorer för depression och sjuksköterskors möjligheter att identifiera depression hos äldre: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Depression is becoming more common but only half of the cases are getting diagnosed. The difficulties of getting a diagnose increases with age and the elderly have more somatic symptoms of depression. There is a huge knowledge gap within healthcare sector relating to the identification of depression and the risk factors that influence it.

    Aim: The aim is to highlight the risk factors that may influence the development of depression among the elderly and the opportunities nurses have to identify depression among the older people.

    Method: A litterature review was made on the chosen topic. Studies were searched through the databases: MEDLINE, CINAHL Complete, ASSIA and Psychology and Behavioral Sciences Collection. The keywords that were used was: depression, older adults, older, nurse/nurses, identify, recognize, risk factors and elderly. Friberg’s analytical method was used to analys the articles.

    Results: Two categories were presented in the result. The first category descibes the risk factors that may effect depression among the elderly and the second category describes the nurses possibilities to identify depression. The risk factors that may effect a depression are: quality of life and somatic impact. The nurses ability to identify depression among elderly were compiled into knowledge, education and time for dialog.

    Discussion: Strength and weaknesses are discussed in the method discussion while the results are discussed in relation to the purpose, background and Barkers tidalmodel in the result discussion.

  • Kullén, Julia
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Neumann Nordenbäck, Linnea
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Vuxna patienters upplevelser av fysisk beröring vid omvårdnad: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Nurses use touch on a daily basis in their work. They use touch to comfort, and because of necessity in their job assignments. These two kinds of touch are called expressive and instrumental touch. Touch has been shown to strengthen the relationship between nurses and patients, also to support patients’ well-being.

    Aim: The aim of this literature review was to illustrate adult patients’ experiences of touch in somatic care.

    Method: The method for the study was a literature review.

    Results: Four main themes and two subthemes emerged in the analyze; to be seen as a human being with the subtheme the meaning of communication in the experience of being touched, how touch can convey trust and security, the meaning of being in control and to dislike a male nurse with the subtheme attitudes towards gender regarding intimate care.

    Discussion: The outcome highlights the importance of making nursing care more patient-centered. Yet the authors consider that further research in this domain is needed about patients’ experience of touch to enable better patient-centered care.

  • Levin, Saga
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Lundvik, Elin
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors upplevelser av att vårda patienter med psykiatriska diagnoser inom somatisk vård: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients with psychiatric diagnoses and their families feel that somatic care does not live up to their expectations and that health professionals lack competence in the assessment and treatment for these diagnosis. Patients feel disbelieved when they present their symptoms, which leads to feelings of guilt and shame. Mental illness is increasing worldwide and the healthcare providers have not managed to meet the increased need for care.

    Aim: The aim was to describe nurses experiences of caring for patients with psychiatric diagnosis in a somatic care setting.

    Method: A literature review was conducted to gain a wider knowledge in this area. The authors chose ten scientific articles, all of which were of qualitative design and responded to the specific purpose.

    Results: Three categories emerged. The first was Nurses experience in practice with the sub-category Experiences of patients where the authors presented how nurses expressed that they lacked skills, focused on the patients physical symptoms and experienced patient´s as unpredictable and time consuming, which led to feelings of frustration and fear. The second category, Nurses experience of their work environment described how the physical and the psychosocial environment prevented nurses from meeting the patients care needs. The third category was Nurses experienced competence with the subcategory Experiences of nursing. Nurses felt that they lacked adequate education, which had a direct impact on the experience of caring for patients with psychiatric diagnosis.

    Discussion: The literature reviews result showed a perceived lack of knowledge for nurses and a work environment that hinder patient care. This was discussed on the basis of the background, result and Phil Barker´s nursing theory.

  • Andersson, Stina
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Lindström, Sofie
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienters upplevelser av att vara MRSA-bärare: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There is a continuous increase in antibiotic-resistant bacteria in Sweden, but the situation is still relatively manageable compared to other countries. The development of resistance is a result of the amount of antibiotics used in today's society. The bacteria Staphylococcus aureus is the cause of many types of infections, from mild to life threatening. The bacteria have caused problems at hospitals since 1955 and are the most notorious cause of healthcare-associated infections. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the associated strains of Staphylococcus aureus that have developed resistance to antibiotics. The communicable diseases act (smittskyddslagen) stipulates that methicillin-resistant Staphylococcus aureus (MRSA) is a dangerous disease. General dangerous diseases are infectious and cause suffering, prolonged periods of illness and other serious consequences.

    Aim: To describe patients’ experiences of being MRSA-carrier.

    Method: A literature review according to Fribergs` method where ten scientific articles were elected to the result. The articles were selected from Cinahl Complete and Medline.

    Results: In the articles analyzed the authors identified six themes: getting a diagnosis, experiences of isolation, experiences of treatment, experiences of knowledge and information, fear of infecting others and thoughts about the future.

    Discussion: Based on Callista Roys adaptation theory, the concept of health, background and other research the result is being discussed. The main findings chosen for discussion are the isolation impact, lack of knowledge and adaptation to life with MRSA.

  • Johansson Sahlin, AnnMarie
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    När goda relationer uppstår: Familjehemsplacerade ungdomars upplevelser och erfarenheter av goda relationer med familjehemsföräldrar2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: The study aims to understand and learn from the experiences of foster children with good relationships with foster parents. Many children and youth are placed in foster homes every year, and disruptions and unplanned terminations of care are common. At the same time, many youth give evidence that the time in the foster home has been crucial for their possibilities to master difficult family relationships and reach a functional life.

    Research questions: What experiences do foster children pay attention to when telling about their good relationship with foster parents? How can their experiences be explained and understood?

    Research method: Qualitative study using semi-structured interviews with five teenagers in foster care.

    Results: The study shows the significance of safety and belonging for the youth, and that the experiences are created from, among other, absence of conflicts and scolding, and from the conversational practices established in the foster home.

    Discussion: The results are discussed in the light of attachment theory and a systemic perspective. 

  • Lind, Felicia
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Skoglund, Kristin
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Nyutexaminerade sjuksköterskors erfarenheter av sitt första år i yrket: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The nursing profession is a profession with complexity where the professional nurses must have knowledge and understanding, skills and abilities, judgment and approach, to be able to lead and be responsible for good and safe patient care. Approximately 5000 nurses graduate every year in Sweden. Nursing students approaching graduation experienced mixed feelings. Both a delight to soon be finished nursing while concern was expressed about not possessing the skills enough for the role, as well as an uncertainty to work independently and be responsible for decisions in patient-related health issues. After two years in the profession approximately 30 % of the newly graduated nurses choose to leave the profession.

    Aim: The aim was to gain a deeper understanding of how the newly graduated nurses experience their first year in the professional clinical work.

    Method: The method used is a literature review based on eleven articles consisting of two with mixed method, one of qualitative design and seven with quantitative study design with Benner's (1984) theory from Novis to Expert as support for discussion of the results.

    Results: Four major themes emerged: Role Expectations, Work Culture and Environment, Development of expertise and Focus shift. Subthemes to Role Expectations is Uncertainty and Chaos. Subthemes to Work Culture are Environment's Introduction and Mentoring. The newly graduated nurses had expectations about the nursing role that led to a terrifying experience in clinical practice. Positive experiences of the graduate nurses were associated with having a good supervisor and a supportive work environment. After practicing the profession for nearly a year, the newly graduated nurses experienced satisfaction with the development of the professional skill. During the first six to twelve months the newly graduated nurses concentrated their energy on getting to know the environment and receive acceptance from colleagues. When security grew in the nursing role, the nurse shifted the focus from their own needs to the patient's needs. Positive experiences of the newly graduated nurses were associated with having a good supervisor and a supportive work environment.

    Discussion: The results were discussed with Benners theory. The results showed that the majority of the newly graduated nurses did not perceive themselves ready to act independently, manage and organize care, and felt a need for more empirical experience to handle the nursing role. The newly graduated nurses stated a need for support from an experienced nurse, in which Benners agrees and describes in her theory. Experience support of colleagues and other nurses with more experience was extremely important factors for the newly graduates health and development of competence, but most of the studies showed that newly graduated nurses felt that they lacked support. As the competence increased the newly graduated nurse experienced that their previous focus on getting acceptance from colleagues was replaced by a focus on the patient and their care. According to Benners theory the newly graduated nurses concentrate on their own development and guidelines, which can cause the newly graduated nurse to lack focus on the patient.