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  • 201.
    Fyhr, Sofia
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sexuella behov hos äldre personer i särskilt boende: vård - och omsorgspersonals och sjuksköterskors upplevelser, bemötande och handlingsberedskap2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Sexuality has been shown to be important for the experience of a healthy life, and one of the human's basic needs consisting through the entire life is the physical touch. However, it has been found that residential homes is not suited for a private life, people with dementia are deemed to be easily exploited, and there are disputes in terms of individual rights, freedom and protection. When the topic sexuality has discussed in health care, it has rather have an emphasis as a problem rather than as a human need.

    Aim: The purpose of this study was to examine the experience of health – care personal and registered nurses and their attitude to older people’s sexual needs in special housing for the elderly.

    Method: A qualitative method with semi- structured interviews was used. A total of three different special accommodations with focus on elderly with dementia or general nursing home there the area of Stockholm were involved. The participants consisted of registered nurses, assistant-nurses, nursing assistants, and a total of  eleven participants. The methodology used for data analysis was inductive content analysis.   

    Results: The analysis resulted in five major themes, and five subthemes. The main topics was The health – care personal and registered nurses thoughts of older people and sexuality, The health – care personal and registered nurses experience of the resident sexual expression within the special housing for the elderly,   The health – care personal and registered nurses experience of reactions among the residents when sexual expression were shown by others, The health – care personal and registered nurses management and treatment of the residents sexual expression and needs, and Residents opportunities to vent out there   sexual needs.

    Discussions: A qualitative method with semi- structured interviews was used where the informants had   the opportunity to express theirs experience, though limited by the predestined main topic. A another alterative could have been to use only one opening question to get a results with broader spectrum, where the informants could have speak free around the topic and where the author could have used supplementary questions to move the conversation forward.

    The author discussed the eventual meaning of the participant’s age, personal attitude, education and commitment as well as experience of sexual expressions in health- care. All the interviews conducted at the participant’s workplace and during working hours. The result was discussed against a framework of Tzeng, Lin, Shyr och Wens (2009).

    The result discussion showed differences among the participant’s experiences about older people and sexuality. There were very different perceptions about if the elderly had or not had sexual needs and experiences about that   the older people’s sexual behavior or needs would have taken a different direction and turn in to a different pattern of behavior or needs.

  • 202.
    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.

  • 203.
    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”.

  • 204.
    Gellerstedt, Linda
    et al.
    Sophiahemmet högskola & Karolinska institutet.
    Medin, Jörgen
    Sophiahemmet högskola & Röda korsets högskola.
    Kumlin, Maria
    Sophiahemmet högskola & Karolinska institutet.
    Rydell Karlsson, Monica
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Karolinska institutet.
    Nursing care and management of patients' sleep during hospitalisation: A cross-sectional study.2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Article in journal (Refereed)
    Abstract [en]

    AIM: To explore and describe how patients' sleep is addressed at acute-care hospitals in Sweden with regard to nursing care, management and the development of knowledge in this area.

    BACKGROUND: Sleep is a basic human need and thus important for health and health maintenance. Patients describe sleeping in hospital as a stressor, and research shows that nurses tend to underestimate patients' perceived problems with sleep during hospitalisation. How do nursing staff at acute hospitals address patients' sleep and the development of knowledge in this area?

    DESIGN/METHOD: A cross-sectional descriptive study was conducted based on data collected through a web survey. Head nurses, registered nurses, nursing care developers and local training supervisors at 36 randomised acute-care hospitals in Sweden were invited to participate. This study was executed and reported in accordance with SQUIRE 2.0.

    RESULTS: The results of the survey (53 responses from 19 wards at 15 acute-care hospitals) showed that no policy documents exist and no current training addresses sleep during hospital stay. All participants agreed that sleep should be considered a nursing topic and that it is important for hospitalised patients.

    CONCLUSION: Patients' sleep during hospitalisation is undermanaged at acute-care hospitals. Nurses, health care managers and organisations face challenges if they are to achieve better outcomes.

    RELEVANCE TO CLINICAL PRACTICE: This study shows that nurses do consider patients' sleep important and addressing sleep as part of nursing care. Future studies in the area should focus on what kinds of support and education are needed in the clinical context.

  • 205.
    Gellerstedt, Linda
    et al.
    Sophiahemmet högskola & Karolinska institutet.
    Medin, Jörgen
    Sophiahemmet högskola & Röda korsets högskola.
    Kumlin, Maria
    Sophiahemmet högskola & Karolinska institutet.
    Rydell Karlsson, Monica
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Karolinska institutet.
    Sleep as a topic in nursing education programs? A mixed method study of syllabuses and nursing students' perceptions.2019In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 79, p. 168-174, article id S0260-6917(18)30846-3Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sleep is a basic human need and is considered important for maintaining health. It is even more important during illness due to its impact for example on our immune system. Nurses have an important role in identifying sleep deprivation. They are also in a unique position to promote and address sleep among patients. However, it is essential that they are provided with the appropriate knowledge during training.

    AIM: To explore and describe nursing students' perceptions of preparedness to adress and support patients' sleep during hospitalization and to apply sleep-promoting interventions in a clinical context. Furthermore, the aim was to investigate if, and how, the topic of sleep is explicitly incorporated in nursing education programs.

    DESIGN: A descriptive study based on a mixed method approach.

    METHODS: Quantitative and qualitative data were collected from program and course syllabuses and intended learning outcomes from three universities. Twenty-one nursing students from the same universities were interviewed during their final year of education.

    RESULTS: The results of both quantitative and qualitative data consistently show that education regarding sleep and patients' sleep is limited and, in some respects, absent in the Bachelor of Science Nursing programs investigated.

    CONCLUSION: This study indicates that education about sleep and patients' sleep in the nursing programs studied is insufficient and limited. This gap in knowledge may lead to prospective registered nurses using their own experiences instead of evidence-based knowledge when assessing, supporting and applying sleep-promoting interventions.

  • 206.
    Gillensjö, Tina
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Jakobsson, Emelie
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att beskriva vilka faktorer som påverkar sjuksköterskans attityd till att vårda patienter med alkoholmissbruk: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Alkoholmissbrukare är en patientgrupp sjuksköterskor möter i det dagliga arbetet. Alkoholmissbruk leder till fysiska, psykiska och sociala problem. Sjuksköterskors attityder och kunskaper är av stor vikt för att bemöta och vårda patienter med ett alkoholmissbruk.

    Syfte: Att beskriva vilka faktorer som påverkar sjuksköterskans attityd till att vårda patienter med alkoholmissbruk.

    Metod: Denna litteraturöversikt har grundats i vetenskapliga artiklar som har bearbetats och analyserats. Översikten bygger på tre kvalitativa artiklar, sex kvantitativa artiklar samt en artikel som haft mixad metod.

    Resultat: Resultatet visar att sjuksköterskors attityder till att vårda alkoholmissbrukare är ambivalent. Sjuksköterskans attityder är kopplat till ålder, livserfarenheter, arbetslivserfarenheter samt vilken vårdavdelning sjuksköterskan arbetar på. Det framkommer hur sjuksköterskor efterlyser mer utbildning och kunskap för att ge alkoholmissbrukare adekvat vård.

    Diskussion: Bemötandet och vårdrelationen är av stor vikt för vårdandet av alkoholmissbrukare. Sjuksköterskorna är i behov av mer kunskap och utbildning för att attityderna till denna patientgrupp ska vara positiv. Det är av vikt att se personen bakom missbruket och att attityderna till missbrukarna överensstämmer med synen på alkoholmissbruk. Synen på alkoholmissbruket har genom tiderna förändrats, där alkoholmissbruket nu är klassat som en sjukdom, men stigmatiseringen av dessa personer fortgår.

  • 207.
    Glemmefors, Anna
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Ottosson, Simon
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Mitt hjärta – mitt liv: Kvinnors upplevelser efter en hjärtinfarkt - en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Myocardial infarction is the dominant cause of death in Sweden. Each year approximately 11 000 women are affected, however due to advances in research and improved treatment methods, about two thirds of these women survive. Stress is a common underlying cause of myocardial infarction in women. The society's expectations of women, such as care and main responsibility for the family, can be seen as contributing to this. Nursing care is focused on support and motivation for lifestyle changes and self-care with the aim of avoiding a relapse and increasing the woman's health and independence.

    Aim: To illustrate womens´experiences after a myocardial infarction.

    Method: The method used was a literature review and based on ten qualitative articles retrieved from the CINAHL, PsycINFO and PubMed databases. All articles were quality-reviewed and compiled based on the similarities and differences of the results. The result is reported through an integrated analysis.

    Results: Women experienced a change in life after a myocardial infarction, with both physical and psychosocial problems. The family, social network and health care contacts played a crucial role in women's ability to recover. The information received regarding the disease was not experienced as adapted to their needs. The result is presented in three main categories, a changed life, meaning of relationships and the way back.

    Discussion: The result is discussed based on women´s experiences, Dorothea Orem's nursing theory and previous research. The results of the literature review show that women experience a changed existence and identity. Lack of knowledge and motivation reduces the self-care capacity. By planning nursing based on the individual woman's knowledge, needs and conditions, her opportunities for self-care are strengthened.

  • 208.
    Godskesen, Tove
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Centrum för forsknings- och bioetik, Centre for Research Ethics & Bioethics, Uppsala universitet.
    Cancerpatienter i kliniska prövningar.2016In: Onkologi i Sverige, ISSN 1653-1582, no 1, p. 16-25Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Var tredje person i Sverige kommer under sin livstid att drabbas av cancer, vilket innebär att cancer är en folksjukdom. Stora summor pengar läggs ner på cancerforskning. Många säger att det inte alls är en omöjlig uppgift att besegra cancer, medan andra säger att det kommer att bli mycket svårt. Säkert är dock att om forskningen ska gå framåt krävs mycket pengar och hängivna forskare. Men intebara det. En grundförutsättning för att vi ska kunna få fram nya eller bättre cancerbehandlingar är att nya substanser testas på patienter i läkemedelsstudier, så kallade kliniska prövningar. Om inte patienter vill delta i medicinsk forskning kommer inte cancerforskningen att lyckas. Det är därför viktigt att undersöka hur patienter ser på deltagande i läkemedelsforskning. Trots att många cancerpatienter i Sverige deltar i läkemedelsstudier finns det väldigt lite forskning om varför de väljer att delta, om de förstått informationen de fått och hur de upplever sitt deltagande.

  • 209.
    Godskesen, Tove E.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Centrum för forsknings- och bioetik, Centre for Research Ethics & Bioethics, Uppsala universitet.
    God vård innebär att sällsynta sjukdomar ges resurser.2018In: Dagens Medicin, ISSN 1104-7488Article in journal (Other (popular science, discussion, etc.))
  • 210.
    Godskesen, Tove E
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Uppsala universitet.
    Fernow, Josepine
    Uppsala universitet.
    Eriksson, Stefan
    Uppsala universitet.
    Quality of online information about phase I clinical cancer trials in Sweden, Denmark and Norway.2018In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 27, no 6, article id e12937Article in journal (Refereed)
    Abstract [en]

    Patients increasingly search for online information about clinical trials. Little is known about the quality and readability of the information in these databases. Therefore, the aim of this study was to assess the quality and readability of online information available to the public on phase I clinical cancer trials in Sweden, Denmark and Norway. A qualitative content analysis was made of 19 online trial descriptions from three public websites in Sweden, Denmark and Norway, and the readability of the documents was tested. Both the quality of the content and the readability scores were best for the Danish information. The Swedish texts were very short and were the least readable. Overall, the quality of the information was highly variable and nearly all the documents were misleading in part. Furthermore, the descriptions provided almost no information about possible adverse effects or disadvantages of study participation. This study highlights a communication problem and proposes new ways of presenting studies that are less suggestive of positive outcomes, arguing that we should be more careful to include information about adverse effects, and that the use of simple measures like readability testing can be useful as an indicator of text quality.

  • 211.
    Godskesen, Tove E.
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Centre for Research Ethics & Bioethics, Uppsala University, Sweden.
    Suzanne, Petri
    Rigshospitalet, Copenhagen University Hospital, Denmark.
    Eriksson, Stefan
    Centrum för forsknings- och bioetik, Centre for Research Ethics & Bioethics, Uppsala universitet.
    Halkoaho, Arja
    Tampere University of Applied Sciences, Finland.
    Mangset, Margrete
    Oslo universitetssykehus, Oslo University Hospital, Norway.
    Engelbak Nielsen, Zandra
    Rigshospitalet, Copenhagen University Hospital, Denmark.
    The culture of hope and ethical challenges in clinical trials: A qualitative study of oncologists and haematologists’ views2019In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101XArticle in journal (Refereed)
    Abstract [en]

    We do not know how much clinical physicians carrying out clinical trials in oncology and haematology struggle with ethical concerns. To our knowledge, no empirical research exists on these questions in a Nordic context. Therefore, this study aims to learn what kinds of ethical challenges physicians in Sweden, Denmark and Finland (n = 29) face when caring for patients in clinical trials; and what strategies, if any, they have developed to deal with them. The main findings were that clinical cancer trials pose ethical challenges related to autonomy issues, unreasonable hope for benefits and the therapeutic misconception. Nevertheless, some physicians expressed that struggling with such challenges was not of great concern. This conveys a culture of hope where health care professionals and patients uphold hope and mutually support belief in clinical trials. This culture being implicit, physicians need opportunities to deliberately reflect over the characteristics that should constitute this culture.

  • 212.
    Godskesen, Tove E.
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Centrum för forsknings- och bioetik, Centre for Research Ethics & Bioethics, Uppsala universitet.
    Suzanne, Petri
    Danmark.
    Eriksson, Stefan
    Uppsala universitet.
    Halkoaho, Arja
    Finland.
    Mangset, Margrete
    Norge.
    Pirinen, Merja
    Finland.
    Engelbak Nielsen, Zandra
    Danmark.
    When Nursing Care and Clinical Trials Coincide: A Qualitative Study of the Views of Nordic Oncology and Hematology Nurses on Ethical Work Challenges2018In: Journal of Empirical Research on Human Research Ethics, ISSN 1556-2646, E-ISSN 1556-2654, Journal of Empirical Research on Human Research Ethics, ISSN 1556-2646, Vol. 13, no 5, p. 475-485Article in journal (Refereed)
    Abstract [en]

    This study investigated the kinds of ethical challenges experienced by nurses in oncology and hematology when nursing care and research overlap in clinical trials, and how the nurses handle such challenges. Individual interviews with 39 nurses from Sweden, Denmark, and Finland indicated that all nurses were positive about research, considering it essential for developing the best care. Ethical challenges exist, however; the most difficult were associated with the end-of-life patients, no longer responsive to standard therapy, who eagerly volunteer for cutting-edge drug trials in the hope of gaining therapeutic benefit. Many nurses lacked systematic strategies for addressing such challenges but found support from their nursing colleagues and relied on the research protocols to guide them.

  • 213.
    Godskesen, Tove
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Uppsala universitet.
    Eriksson, Stefan
    Uppsala universitet.
    Selektiv rapportering av kliniska prövningar2019In: Dagens Medicin, ISSN 1402-1943Article in journal (Other (popular science, discussion, etc.))
  • 214.
    Gotti, Maria
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Post mortem care: att vården den avlidne patienten: Sjuksköterskors upplevelser av att vårda den avlidna patienten i palliativ vård2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: När en patient avlider fortsätter vården även efter dödsögonblicket, vårdpersonal tar hand om både patient och närstående även efter att döden har inträtt. Att göra iordning den avlidne (post mortem care) är en uppgift omgärdad av symboliska handlingar och ritualer. Utbildningar lägger ringa vikt vid att lära ut färdigheter kring denna typ av vård och upplevelsen av att vårda en avliden patient är sparsamt undersökt i forskning och litteratur.

    Syfte: Att beskriva vad sjuksköterskor upplever som viktigt och meningsfullt i sitt arbete med vård av avlidna patienter i palliativ verksamhet.

    Metod: Arbetet har en deskriptiv design och är en kvalitativ intervjustudie med både fokusgruppintervju och enskild intervju som datainsamlingsmetod. Materialet bearbetades med kvalitativ innehållsanalys.

    Resultat: Analysen resulterade i tre huvudkategorier och sju underkategorier:

    Kunskap och erfarenhet:

    • teoretisk kunskap
    • erfarenhetsbaserad kunskap

    Relationer och roller:

    • sjuksköterskors relation till patienten
    • närståendes roll och betydelse för sjuksköterskor

    Handlingar och ritualer:

    • symboliska handlingar
    • avslut och avsked
    • reflektion

    Diskussion: Resultatet diskuterades med KASAM som teoretisk referensram och överensstämmer med tidigare forskning. I resultatet framkom att vården av avlidna ansågs vara meningsfull och en arbetsuppgift som sträcker sig längre än omvårdnad, t.ex. inkluderades närståendestöd och egen reflektion som delar av post mortem care. Resultatet visar också att kunskapen till största del är erfarenhetsbaserad och att deltagarna i studien tycker det är viktigt att erfarna får tid och möjlighet att lära nya/oerfarna.

  • 215.
    Granlund, Victoria
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Fäste, Hanna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors egna upplevelser av sorg i vårdarbete: En litteraturöversikt om deras upplevelser vid dödsfall2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 216.
    Gravenfors, Frida
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Jonsson, Ella
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors upplevelse av vårdrelationen inom palliativ hemsjukvård: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Palliative care is focused on improving the quality of life for patients with an incurable disease. This form of care is expected to increase as the population is getting older. Also, more and more people want to be cared for in their home, partly because it means being able to be close to relatives. When the nurse enters the patient’s home, it is important that he or she has knowledge of how the home affects the patient, and to preserve the patient’s integrity. A caring relationship is created at the meeting between nurse and patient or relatives. Deficiencies in the caring relationship can cause the patient to lose confidence in health care. By illustrating nurses’ experience of the caring relationship within palliative care in the home, the authors aim to gain understanding and increase knowledge in the creation of the caring relationship.

    Aim: The aim was to describe nurses’ experiences of the caring relationship within palliative care in the home.

    Method: A literature review based on ten qualitative articles in health care sciences. The databases CINAHL Complete and PubMed were used.

    Results: This literature review resulted in one theme: to meet the patient and their relatives. The theme is based on three subthemes: to enter the patient’s home, to meet the patient and to meet the relatives.

    Discussion: In the method discussion the authors discussed the strengths and weaknesses of the literature review. In the result discussion the emotional impact the nurses experienced in the meeting with patients and relatives was discussed. Nurses’ support in creating a caring relationship was also discussed. The result discussion was discussed against previous research and Watson’s theory of human care.

  • 217.
    Grusell, Annelie
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Pirzadeh, Jeerawan
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Vårdrelationen mellan sjuksköterska och patient med sustansbrukssyndrom: Litteraturöversikt2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Patients with substance use disorder often have complex problems and the nurse needs knowledge and compassion to make the care relationship work. The nurse needs to handle both her own and the patient's feelings in order for the care relationship to work. The nurse needs to support the patient as he or she finds a healthy lifestyle without substance use.

    A functioning care relationship between nurse and patient with substance use disorder is important for the care to work successfully.

    Aim:

    The aim of the study was to describe the care relationship between nurse and patient with substance use disorder from a nursing perspective.

    Method:

    A literature review was chosen as method. The article search was conducted in   the databases PubMed and Cinahl. In total, 18 original scientific articles were included in the results.

    Results:

    The results showed that attitude and perspective as well as negative experience   affect the relationship between nurse and patient with substance use disorder. The nurse experiences difficulties related to lack of knowledge and patients' manipulative behavior.

    Conclusions:

    The care relationship between the nurse and patient with substance use disorder can be improved by providing support and education for nurses in their professional role.

  • 218.
    Grönberg, Emmy
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Hultén, Natalia
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att leva med bipolär sjukdom: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Bipolar disease is characterized by a state of mind that commutes between high and low mood swings. The variating episodes contribute to a complex life situation for the patient. The patient’s symptoms are used for diagnosing bipolar disorder and treatment is primarily pharmacological treatment and psychotherapy commonly used when needed. Furthermore good cooperation between relatives, patients and healthcare professionals are required. This is essential so that the patient can receive adequate support and also increase presumptions for good compliance with treatment. 

    Aim: The purpose was to illustrate patients’ experiences of living with bipolar disorder.

    Method: This essay is a literature review and eleven scientific articles with qualitative method have been analyzed.  

    Results: Based on the analysis, five main themes were created with associated subtheme. Five main themes emerged: The social context, Identity and loss of control, The experience of disease symptoms, Becoming stigmatized and Being medicated- An ambivalent experience. The result shows that patients experienced insufficient knowledge from the environment regarding bipolar disorder which has led to isolation and a sense of identity loss in patients. 

    Discussion: Bipolar disorder requires in many cases a strong social network in order for the patients to receive support in their management of the disease and the environment can contribute with both positive and negative experiences for the patient. In order for the patient to receive adequate support, bipolar disorder requires knowledge and understanding from the environment as well as healthcare professionals. Phil Barker's Nursing Theory illustrates collaboration with relatives and evidence-based tools, that focus on the patient's story, as crucial parts of the patient's nursing process.

  • 219.
    Grönlund, Catarina Fischer
    et al.
    Umeå universitet.
    Söderberg, Anna
    Umeå universitet.
    Dahlqvist, Vera
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Andersson, Lars
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Isaksson, Ulf
    Umeå universitet.
    Development, validity and reliability testing the Swedish Ethical Climate Questionnaire.2019In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, article id 969733018819122Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:: An ethical climate has been described as a working climate embracing shared perceptions about morally correct behaviour concerning ethical issues. Various ethical climate questionnaires have been developed and validated for different contexts, but no questionnaire has been found concerning the ethical climate from an inter-professional perspective in a healthcare context. The Swedish Ethical Climate Questionnaire, based on Habermas' four requirements for a democratic dialogue, attempts to assess and measure the ethical climate at various inter-professional workplaces. This study aimed to present the construction of and to test the psychometric properties of the Swedish Ethical Climate Questionnaire.

    METHOD:: An expert group of six researchers, skilled in ethics, evaluated the content validity. The questionnaire was tested among 355 healthcare workers at three hospitals in Sweden. A parallel analysis (PA), an exploratory factor analysis and confirmatory factor analysis were performed.

    ETHICAL CONSIDERATIONS:: The participants included in the psychometric analysis were informed about the study, asked to participate in person and informed that they could withdraw at any time without giving any reason. They were also assured of confidentiality in the reporting of the results.

    FINDINGS:: The parallel analysis (PA) recommended one factor as a solution. The initial exploratory factor analysis with a four-factor solution showed low concordance with a four-factor model. Cronbach's alpha varied from 0.75 to 0.82; however, since two factors only consisted of one item, alpha could not be reported. Cronbach's alpha for the entire scale showed good homogeneity (α = 0.86). A confirmatory factory analysis was carried out based on the four requirements and showed a goodness-of-fit after deleting two items. After deletion of these items, Cronbach's alpha was 0.82.

    DISCUSSION:: Based on the exploratory factor analysis, we suggest that the scale should be treated as a one-factor model. The result indicates that the instrument is unidimensional and assesses ethical climate as a whole.

    CONCLUSION:: After testing the Swedish Ethical Climate Questionnaire, we found support for the validity and reliability of the instrument. We found the 10-item version of Swedish Ethical Climate Questionnaire satisfactory. However, we found no support for measuring different dimensions and, therefore, this instrument should be seen as assessing ethical climate as of whole.

  • 220.
    Grönlund, Catarina Fischer
    et al.
    Umeå universitet.
    Söderberg, Anna
    Umeå universitet.
    Dahlqvist, Vera
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sandlund, Mikael
    Umeå universitet.
    Zingmark, Karin
    Luleå tekniska universitet.
    Communicative and organizational aspects of clinical ethics support.2018In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Studies show that healthcare professionals need inter-professional clinical ethics support (CES) in order to communicate and reflect on ethically difficult care situations that they experience in their clinical practice. Internationally, various CES interventions have been performed, but the communication processes and organisation of these interventions are rarely described in detail. The aim of this study was to explore communicative and organisational conditions of a CES intervention with the intention of promoting inter-professional communication about ethically difficult care situations. Eight audio- and video-recorded inter-professional CES sessions, inspired by Habermas' theory of communicative actions, were conducted. The observations were transcribed, sorted, and analysed using concept- and data-driven content analysis methods. The findings show three approaches to promoting communicative agreement, which include the CES facilitators' and participants' approaches to promoting a permissive communication, extended views, and mutual understanding. The CES sessions had organizational aspects for facilitating communicative agreement with both a given structure and openness for variation. The dynamic structure of the organization, promoted both safety and stability as well as a creativity and responsiveness, which in turn opened up for a free and dynamic inter-professional dialogue concerning ethically difficult care situations. The findings constitute a step towards a theory-based CES method inspired by Habermas' theory of communicative action. Further research is needed in order to fully develop the method and obtain increased knowledge about how to promote an inter-professional dialogue about ethically difficulties.

  • 221.
    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.

  • 222.
    Gustafsson, Linnea
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Wernersson, Amanda
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Philippine nurses’ experiences of caring for patients with HIV: An interview study conducted in Baguio, Philippines2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Since the beginning of the epidemic, more than 70 million people have been infected with Human Immunodeficiency Virus (HIV) and the disease continues to be a public health issue all around the world. There are around 42.000 people in the Philippines living with HIV and therefor the nurses and other health care personal play a key part of the persons lives when undergoing treatments.

    Aim: The aim of this study was to describe Philippine nurses’ experiences of caring for patients with HIV.

    Method: A qualitative method was used and data was collected through semi structured interviews with five Philippine nurses at a hospital in Baguio. The interviews were analyzed with qualitative content analysis.

    Results: The findings resulted in two main themes. The first theme, Nurse patient relationship, shows that a nurse patient relationship is important when caring for HIV patients, including getting to know the patient, the importance of trust and giving person centered care. Factors that may be obstacles in the process of building a relationship is also included in this theme. The second theme, Important aspects of caring, including factors such as having conversations, listening and supporting the patient.

    Discussion: The main findings were discussed in relation to the literature and Travelbee’s human to human theory. The main focus in the discussion was the nurse and patient relationship and important aspects of caring for HIV patients.

  • 223.
    Gustavsson, Emma
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Persson, Annelie
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Balinese nurses’ experiences of caring for patients in palliative care: An interview study with nurses in Bali, Indonesia2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Working as a nurse means close contact with dying patients and mourning relatives. To care for severely ill and dying patients is part of the nursing profession and this places great expectations on the nurse to meet the needs of all individual patients and their relatives. Therefore, it is essential that the healthcare professionals have a deeper understanding of all the various needs a human being can have at the end of time.

  • 224.
    Gutierrez Alé, Nicole
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Brändström, Frida
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienters upplevelse av mat och måltid: en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Food and meals are something that all people have a relation to and reflect our social life. The nurse has the overall responsibility for nutrition care. Healthcare professionals today experience lack of knowledge in this complex area. Food is a part of the medical treatment in case of illness. It is important to maintain a stable and individualized nutritional intake to help improve health and prevent complications.

    Aim: The aim of the study was to highlight patients’ experiences of food and meals.

    Method: A literature review was made based on ten nursing studies with qualitative design. The articles were studied based on the aim of the study and complied by identifying main themes and substhemes.

    Results: The literature review highlighted patient's experiences of food and meals. The result entailed five main themes and six subthemes. In these themes, the authors identified patient’s different experiences. In summary, patients experienced changes in taste and smell and also food choices and their health impact, the healthcare professionals’ lack of knowledge, and how organization affected patient’s meals and how patients experienced mental and social limits associated with food and meals.

    Discussion: The result was discussed based on Katie Erikssons’ caritative theory of the suffering human, anchored in the background and other scientific studies. Patients who have problems with food and meals experience suffering in different dimensions. The strengths and weaknesses of the method are discussed by the authors.

  • 225.
    Gutke, Annelie
    et al.
    Göteborgs universitet.
    Bullington, Jennifer
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Lund, Madeleine
    Göteborgs stad.
    Lundberg, Mari
    Karolinska Institutet; Sahlgrenska Universitetssjukhuset.
    Adaptation to a changed body: Experiences of living with long-term pelvic girdle pain after childbirth2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 25, p. 3054-3060Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore how women experience living with long-term pregnancy-related pelvic girdle pain.

    Materials and methods: Nine women with persistent pregnancy-related pelvic girdle pain of 2–13 years were recruited by means of purposive sampling from long-term follow-up studies. The women were 28–42 years of age and had given birth to 2–3 children. Audio-taped in-depth interview with open-ended questions were used with the guiding question 'How do you experience living with pregnancy-related pelvic girdle pain?'. The Empirical Phenomenological Psychological method was chosen for analysis.

    Results: The pregnancy-related pelvic girdle pain syndrome has a profound impact on everyday life for many years after pregnancy. Three constituents were identified as central to the experience of living with pregnancy-related pelvic girdle pain: (1) the importance of the body for identity, (2) the understanding of pain, and (3) stages of change. The manner in which the women experienced their pain was interpreted in terms of two typologies: the ongoing struggle against the pain, and adaptation and acceptance.

    Conclusion: The participants’ narratives highlighted that the pain led to severe functional limitations that threatened their capability to perform meaningful daily activities, and interfered with their sense of identity. It appears essential to meet with each patient individually and to manage long-term pregnancy-related pelvic girdle pain as a pain syndrome.

    IMPLICATIONS FOR REHABILITATION

    Chronic pregnancy-related pelvic girdle pain

    • Pregnancy-related pelvic girdle pain impairs women’s capacity to perform meaningful activities of daily life for many years after pregnancy.
    • The participants’ narratives highlighted that the pain interfered with their sense of identity.
    • It appears essential to meet with each patient individually and to manage long-term pregnancy-related pelvic girdle pain as a pain syndrome.
  • 226.
    Hagberg, Annelie
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Louise, Steger
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    När diagnosen är bröstcancer: En litteraturöversikt om kvinnors hantering av beskedet2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common form of cancer among women. Receiving news regarding a life-threatening disease can cause strong emotions. How women handle such news is due to defense mechanisms and conscious coping strategies that can all be multifaceted. The nurse has an important role to support these coping strategies and to promote good caregiving.

    Aim: The purpose was to highlight women’s feelings and coping strategies after breast cancer diagnosis.

    MethodTwelve scientific articles were analyzed in the present literature review according to the method recommended by Friberg. The articles were written between year 2010 and 2018, which were of qualitative, quantitative and mixed methods. Based on the results of the articles, similarities and differences were identified which became two head categories and eight sub-categories.

    ResultsThe result showed that common kinds of feelings and coping strategies when receiving the news of breast cancer were feelings such as shockfear and anxiety and worries. It also showed coping strategies such as denialchange of focuspositive attitudesocial support and faith.

    Discussion: The discussion concerns that anxiety can occur before, during and after a breast cancer message. Anxiety is therefore existential and can affect quality of life for longer time than at the time of diagnosis. The change of focus and prioritizing matters that were significant were discussed to give a sense of control. Social support was a coping strategy that was discussed to have a positive and negative effect for the women.

  • 227.
    Haglund Svensson, Jeanette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Att ha deltagit i föräldragrupp för anhöriga till beroende: en studie av klienttillfredsställelse2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Being a relative of a person with an addiction disease involves a strong mental and physical stress. An important protection factor for the relatives is breaking the silence and shame and seek help. Ersta Vändpunkten is a clinic for these relatives and offers educational groups with a therapeutic objective. This study focuses on program for parents/relatives to children in the so-called little child group (4-6 years). Focus in the program is to support the parents in how they can help the child to understand what is happening in the family and how to take the child’s perspective. The aim of the study is to share the parent’s experiences of participating in this group. Questions: How has participation in the parenting program affected parenting ability? How has participation in the parent group affected the family? Methods: This is a web-based survey, the questionnaire has been analyzed with descriptive statistics. Results: 30 parents/relatives have been asked to participate of whom 17 responded (57%). The survey reveals that the parent/relative now has an improved relationship with the child and that communication in the family has changed for the better. Other relationships, to relatives, friends and to the addictive part have not changed noticeably. All respondents feel the child’s and their own self-esteem have become much better/better after participating. There is also a consensus among respondents that their ability to set boundaries towards the addicted part has become much better/better. Discussion: While the high non-response rate endangers firm conclusions, the findings are nevertheless promising.

  • 228.
    Hagnell, Martina
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Ljung, Charlotta
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskans upplevelse av att utsättas för våld av patienter och besökare på arbetsplatsen: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 229.
    Hagos, Betleheim
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Bapir, Sara
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors erfarenheter av att vårda flyktingar: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: As a result of war, anxiety and oppression, millions of human´s are fleeing the world. Due to this, most health professionals, especially nurses, will face these vulnerable and exposed patients. It´s reported that refugees have complex health needs, which   includes mental and somatic health problems, which have arisen as a result of difficult circumstances, before, during and after the escape. The cultural affiliation can influence the perception of how health, ill-health and illness is perceived, which implies the importance of as a nurse having knowledge of adapting and catering for the patients’ needs based on the individual´s unique cultural context.

    Aim: The aim of this study was to explore nurse´s experiences of caring for refugees.

    Method: The literature review was conducted according to Friberg´s method, with the basis of eleven qualitative scientific articles that were found in the databases CINAHL Complete and PubMed. Analyses of collected data produced the results categories and subcategories.

    Results: The result of the literature review was presented on the basis of four main categories: Communication barriers, The organisation´s influence, Cultural challenges and The   importance of caring relationships. Main categories are presented with associated subcategories: Healthcare systems, Ethical standpoints, Need of knowledge, The caring meeting, Emotional influence and A rewarding work.

    Discussion: The Method discussion is discussed on the basis of strengths, weaknesses, implemented approach and quality review of results articles. The findings of the discussion are discussed on the basis of Madeleine Leninger's theory of transcultural nursing, scientific literature, the background of the study and the authors own reflections. 

  • 230.
    Hakola, Pia
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Changes in professionals' beliefs following a palliative care implemenation programe at a curgical department: a qualitative evaluation2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One ambition regarding palliative care is that it should be more accessible to patients and families regardless of care setting. Previous studies show many difficulties and shortcomings in the care of patients with palliative care needs in acute care facilities, but also challenges regarding efforts to implement palliative care. The purpose of this study is to evaluate how the implementation of palliative care, using guidance and tutorial from the specialist palliative care team as an implementation strategy, can change the beliefs of professionals in a surgical department with regard to palliative care.

    Method: In order to explore professionals’ experiential outcome of an educational implementation strategy, a comparative before-after qualitative design was used. The study was based on three focus group discussions. Two discussions were conducted before the educational intervention and one was conducted after. The participants consisted of five nurses and two specialist surgeons from a surgical department in Sweden. The focus group 3 discussions revealed a variety of different attitudes and beliefs, which were analysed using qualitative systematic text condensation.

    Results: Beliefs regarding palliative care were identified in seven areas; the importance of palliative care, working methods in palliative care, team collaboration in palliative care, collegial support, discussions about diagnosis, symptoms at the end of life, and families of patients in palliative care. Changes in beliefs were seen in all areas except one: team collaboration in palliative care.

    Conclusion: It is possible to change the beliefs of health care professionals in a surgical department regarding palliative care through the implementation of palliative knowledge. Beliefs were changed from an individual to a collective development where the group initiated a shared palliative working method. The changes observed were palliative care being described as more complex and participants differentiating between surgical care and palliative care.

  • 231.
    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.

  • 232.
    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.

  • 233.
    Hartman, Amanda
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Familjebehandling under tvång: Familjebehandlares upplevelser kring den terapeutiska alliansens betydlese inom kommunal familjebehandling2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: The study investigates how family treatment done under coercion affects the ability of family therapists to create therapeutic alliance with families, and if this affects the therapist’s feelings of the possibility of creating changes. Questions: How family therapists are affected in their work to create a therapeutic alliance when the family is under / threatening care of young persons act (LVU)? Are there important relational elements in treatment that contribute to change when there is LVU or threat of LVU? Method: Qualitative interview investigation and thematic analysis. Results: The results of the study show that therapists feel it is of the utmost importance that they prove to be a "normal person", are given the opportunity to co-operate with the family and that they raise strengths rather than weaknesses, to reach an alliance. The result also shows that respondents experience it as aggravating when it comes to the creation of alliance, as collaboration with social services is sometimes complicated. They find it easier to create alliance when the family themselves ask for treatment. They believe that change is possible, albeit more difficult, when coercion exists. Discussion: The outcome of the study is discussed, partly from an intersubjective and systemic perspective.

  • 234.
    Hedberg Nyqvist, Kerstin
    et al.
    Uppsala universitet.
    Rosenblad, Andreas
    Uppsala universitet.
    Volgsten, Helena
    Uppsala universitet.
    Funkquist, Eva-Lotta
    Uppsala universitet.
    Mattsson, Elisabet
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Uppsala universitet.
    Early skin-to-skin contact between healthy late preterm infants and their parents: an observational cohort study2017In: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 5, p. e3949-Article in journal (Refereed)
    Abstract [en]

    Background Skin-to-skin contact (SSC) is an important factor to consider in the care of late preterm infants (born between 34 0/7 and 36 6/7 completed weeks of gestation). The literature suggests that SSC between preterm infants and their mothers facilitates breastfeeding. However, more studies are needed to explore potential dose-response effects between SSC and breastfeeding as well as studies that explicitly investigate SSC by fathers among late preterm infants. The aim was to investigate the duration of healthy late preterm infants’ SSC with the mother and father, respectively, during the first 48 h after birth and the associations with breastfeeding (exclusive/partial at discharged), clinical and demographic variables. Methods This was an observational cohort study in which parents to healthy late preterm infants, born between 34 5/7 and 36 6/7 completed weeks of gestation, recorded duration of SSC provided by mother and father, respectively. Demographic and clinical variables were retrieved from the medical records and were used as predictors. Multiple linear regression analysis was used to assess the association between the predictors and the outcome, SSC (hours), separately for mothers and fathers. Results The mean (standard deviation [SD]) time per day spent with SSC with mothers (n = 64) and fathers (n = 64), was 14.7 (5.6) and 4.4 (3.3) hours during the first day (24 h) after birth and 9.2 (7.1) and 3.1 (3.3) hours during the second day (24 h), respectively. Regarding SSC with mothers, no variable was significantly associated with SSC during the first day, while the mean (95% confidence interval [CI]) time of SSC during the second day was 6.9 (1.4–12.4) hours shorter for each additional kg of birthweight (p = 0.014). Concerning SSC with fathers, the mean (95% CI) time of SSC during the first day was 2.1 (0.4–3.7) hours longer for infants born at night (p = 0.015), 1.7 (0.1–3.2) hours longer for boys (p = 0.033), 3.2 (1.2–5.2) hours longer for infants born by caesarean section (p = 0.003), and 1.6 (0.1–3.1) hours longer for infants exclusively breastfed at discharge (p = 0.040). During the second day, the mean (95% CI) time of SSC with fathers was 3.0 (0.6–5.4) hours shorter for each additional kg of birthweight (p = 0.014), 2.0 (0.5–3.6) hours longer for infants born during night-time (p = 0.011), 2.9 (1.4–4.4) hours longer if the mother was primipara (p < 0.001), and 1.9 (0.3–3.5) hours shorter if supplementary artificial milk feeds were given. None of the other predictors, i.e., mother’s age, gestational age, or induction of labor were significantly associated with infants’ SSC with mothers or fathers during any of the first two days after birth. Conclusion Future studies are warranted that investigate duration of SSC between late preterm infants and their parents separately and the associations with breastfeeding and other variables of clinical importance.

  • 235.
    Hedelin, Maria
    et al.
    Göteborgs universitet.
    Skokic, Viktor
    Göteborgs universitet.
    Wilderäng, Ulrica
    Göteborgs universitet.
    Ahlin, Rebecca
    Göteborgs universitet.
    Bull, Cecilia
    Göteborgs universitet.
    Sjöberg, Fei
    Göteborgs universitet.
    Dunberger, Gail
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Bergmark, Karin
    Göteborgs universitet.
    Stringer, Andrea
    Australien.
    Steineck, Gunnar
    Göteborgs universitet, Karolinska institutet.
    Intake of citrus fruits and vegetables and the intensity of defecation urgency syndrome among gynecological cancer survivors.2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 1, article id e0208115Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite the experimental evidence that certain dietary compounds lower the risk of radiation-induced damage to the intestine, clinical data are missing and dietary advice to irradiated patients is not evidence-based.

    MATERIALS AND METHODS: We have previously identified 28 intestinal health-related symptoms among 623 gynaecological-cancer survivors (three to fifteen years after radiotherapy) and 344 matched population-based controls. The 28 symptoms were grouped into five radiation-induced survivorship syndromes: defecation-urgency syndrome, fecal-leakage syndrome, excessive mucus discharge, excessive gas discharge and blood discharge. The grouping was based on factor scores produced by Exploratory Factor Analysis in combination with the Variable Cutoff Method. Frequency of food intake was measured by a questionnaire. We evaluated the relationship between dietary intake and the intensity of the five syndromes.

    RESULTS: With the exception of excessive mucus discharge, the intensity of all syndromes declined with increasing intake of citrus fruits. The intensity of defecation-urgency and fecal-leakage syndrome declined with combined intake of vegetables and citrus fruits. The intensity of excessive mucus discharge was increased with increasing intake of gluten.

    CONCLUSION: In this observational study, we found an association between a high intake of citrus fruits and vegetables and a lower intensity of the studied radiation-induced cancer survivorship syndromes. Our data suggest it may be worthwhile to continue to search for a role of the diet before, during and after radiotherapy to help the cancer survivor restore her or his intestinal health after irradiation.

  • 236.
    Hedman, Ragnhild
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Norberg, Astrid
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Umeå universitet.
    Hellström, Ingrid
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Linköpings universitet.
    Agency and communion in people with Alzheimer's disease, as described by themselves and their spousal carers.2017In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, article id 1471301217706268Article in journal (Refereed)
    Abstract [en]

    Agency (individuality) and communion (togetherness) are vital to a positive sense of self. People with Alzheimer's disease are at risk of experiencing diminished agency and decreased communion. Their family members', especially their partner's, view on their agency and communion is also likely to influence their sense of agency, communion, and self. In the present study, individual interviews with 10 people with Alzheimer's disease and their spousal carers were qualitatively analysed to describe how in each couple the two spouses viewed the agency and communion of the person with Alzheimer's disease from an individual perspective. The findings show that the carers generally described the agency of the person with Alzheimer's disease as slightly weaker compared with the persons with Alzheimer's disease themselves. The carers also appeared to have poor knowledge of what supported and threatened the sense of communion of the person with Alzheimer's disease.

  • 237.
    Hedström, Anna
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Rylin, Maria
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Anhörigas upplevelser när en närstående med demenssjukdom har flyttat till ett särskilt boende: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
  • 238.
    Hedström, Mikael
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, St Lukas Educational Institute.
    Allians med ungdomar i familjeterapi2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This paper discusses and examines how a number of family therapists look at the processes and factors related to how to build alliance with adolescents in family therapy. The current state of knowledge on this issue raises the important thing to get right alliance with adolescents in family therapy in terms of how successful and Goal Completions therapy becomes. The study shows that therapists have to consider that youth are in a development psychological position when they approach the young people with a generous dose of respect and sensitivity, as well as the growing awareness that young people are particularly sensitive and observant of how family therapists act in relation to them and their parents.

  • 239.
    Heidari, Claudia
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Poureh Hernandez, Nataly
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att belysa upplevelsen av och identifiera faktorer som inverkar på förlossningsdepression hos personer som fött barn- i en västerländsk samt icke västerländsk kontext: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Förlossningsdepression är ett förekommande psykiatriskt tillstånd som drabbar cirka 10-15 procent av personer som fött barn. Riskfaktorer för uppkomsten av förlossningsdepression är bland andra; tidigare abort, tidigare psykisk ohälsa samt föda sitt barn genom akut kejsarsnitt. Personer med förlossningsdepression påverkas inte enbart själva av depressionen utan det gör även människor i deras omgivning. Allmänsjuksköterskan kommer med sannolikhet möta personer med förlossningsdepression inom exempelvis primärvården. Därav har de en viktig roll vad gäller identifiering av depressiva symtom.

    Syftet var att belysa upplevelsen av och identifiera faktorer som inverkar på förlossningsdepression hos personer som fött barn- i en västerländsk samt ickevästerländsk kontext.

    En litteraturöversikt enligt Friberg (2017) genomfördes där de elva vetenskapliga artiklar identifierades. Samtliga artiklar var av kvalitativ design, peer reviewed, etiskt granskade, inte mer än 13 år gamla samt besvarade syftet.

    I resultatet formulerades två övergripande teman; Föräldraskap som transition samt Socialt stöd. Baserat på deltagarnas upplevelser samt de inverkade faktorerna, utformades underteman som berörde; Upplevelsen av att förlora sig själv, Att känna sig isolerad, Att känna sig bristfällig, Amning, Den förändrade kroppen, Att känna misstro och inte känna sig sedd samt kulturella traditioner och familjerelationer.

    Resultatdiskussionen resonerade kring upplevelsen och faktorer av förlossningsdepression hos västerländska samt icke västerländska deltagare och genomsyrades av Leiningers transkulturella teori.

  • 240.
    Heimdahl, Sofia
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att delta i famljebaserad ätstörningsvård: En litteraturstudie om föräldrars erfarenheter2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    About 1-2 percent of all women fulfil the criteria for anorexia nervosa at some point of their life. The disorder, which entails elevated mortality and might result in serious somatic and   psychiatric long-term complications, often becomes apparent during the teenage years. Today, the prevailing view is that children and youths with eating disorders should be treated together with their parents as far as possible. During the last decade different types of family-based care, were the parents play a central role in their child's recovery, have become more common in step with growing research evidence. Research has also shown how an eating disorder in a child causes a big strain on the rest of the family members. Regarding this, it would be valuable to achieve deeper knowledge about parents’ experiences of engaging in family-based eating disorder care.  A number of qualitative studies concerning this topic exists, but more compiled knowledge is still missing.

    Aim:

    The aim of the study was to investigate parents’ experiences of engaging in family-based eating disorder care.

    Method:

    A qualitative literature review on the subject was conducted according to Thomas and Hardens (2008) model of thematic synthesis of qualitative research.

    Results:

    The study resulted in four descriptive themes; The experience of the setup of the family-based eating disorder care, A change in the approach to the eating disorder, Changes within the family and To meet other parents in the same situation and three analytic themes; To feel less alone, To experience failure and feel judged as a parent and To feel confident that you are doing the right thing for your child.

    Discussion:

    The findings were discussed based on Dorothea Orem’s self-care-deficit theory and in relation to other relevant research concerning family-based care and eating disorders in children and youths.

  • 241.
    Heinonen, Van
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Wahl, Helena
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskansupplevelser av vård i livets slutskede för äldre patienter i hemmet: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Almost 90 percent of the total amount who dies annually in Sweden is 65 or older and their own home is the place that many choose getting palliative care in. The nurse should have a holistic approach in end of life care and the professional responsibility include alleviate the suffering, a dignified treatment of the patient and person-centered care. 

    Aim:To describe the nurse experience of palliative care to elderly patients in their home. 

    Method: A literature review has been carried out in which nine qualitative and one quantitative article were included. They were extracted from the databases CINAHL complete, Ageline and PubMedThe quality of the articles follows the guidelines of Friberg’s analysis method. 

    Results: The analysis resulted in four themes Emotional experiences, Importance of nurse-patient relations, Importance of teamworkand Need of support and education. The nurses described both positive and negative experiences of end of life care to elderly patients in their home. The nurses felt satisfaction in end of life care where they created a strong relationship with the dying patient. The negative experiences were based on external factors that made the nurses feel powerless and vulnerable in their professional role.

    Discussion: The method discussion raises strengths and weaknesses in the literature review. The authors discussed the results based on the background and previous research, along with parts of Katie Eriksson’s theory of caring, suffering and the concept of health.

  • 242.
    Helander Greitz, Matilda
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Svensson, Emil
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Mäns upplevelser av sexualitet vid prostatacancer: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Prostate cancer is the most common cancer disease for men in the western world. There are several common side effects from different treatments and sexual dysfunction is one of them. It is the nurse’s responsibility to care for the patient as a whole and to promote participation. However, it has been shown that nurses found it difficult to talk about sexuality with patients since the subject is considered to be taboo.

    Aim: The aim was to explore experiences of sexuality for men with prostate cancer.  

    Method: A general literature review according to Friberg (2017) was made and based on eleven scientific articles. Eight were of qualitative method and three of mixed. They were obtained from the databases CINAHL Complete, PubMed and PsycINFO. The following key words were used: experience, experienc*, lived experience, prostate cancer, prostatic neoplasms, sexuality and sexual health.

    Results: The result was presented by two main themes. The first one was: The treatments impact on the sexuality which showed different emotions associated with having a changed sexual function, intimacy and masculinity and a reduced sexual desire. The second main theme was: The external and internal resources to be able to handle the side effects of the treatments which showed that care staff, partners and support groups helped the men to handle the changes.

    Discussion: The authors discussed men’s need of adequate information about the side effects of different treatments and how the disease could affect the masculinity, the communication in relationships and the nurse’s supporting role. The discussion was highlighted in relation to Katie Eriksson´shealth cross”, previous research and the authors’ reflections.

  • 243.
    Helgesson, Gert
    et al.
    Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management, and Ethics, Karolinska Insitutet, Stockholm.
    Bülow, William
    Department of Philosophy, Stockholm University.
    Eriksson, Stefan
    Centrum för forsknings- och bioetik, Centre for Research Ethics & Bioethics, Uppsala universitet.
    Godskesen, Tove E.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Centre for Research Ethics & Bioethics, Uppsala University, Sweden.
    Should the deceased be listed as authors?2019In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, no 0, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Sometimes participants in research collaborationdie before the paper is accepted for publication. Thequestion we raise in this paper is how authorship shouldbe handled in such situations. First, the outcome of aliterature survey is presented. Taking this as our startingpoint, we then go on to discuss authorship of the deadin relation to the requirements of the Vancouver rules.We argue that in principle the deceased can meet therequirements laid down in these authorship guidelines.However, to include a deceased researcher as authorrequires a strong justification. The more the person has been involved in the research and writing process beforehe or she passes away, the stronger the justification forinclusion.

  • 244.
    Hellgren, Emma
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Mårtensson, Josefin
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Utsatt för sexuellt våld: En litteraturöversikt om kvinnors upplevelser av hälso- och sjukvården2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One of three women worldwide have experienced sexual or physical violence. The violence and the abuse that women face causes serious short- and long-term physical and mental problems for women. Sexual violence is an extensive public health problem. Healthcare meets individuals exposed to sexual violence in various healthcare context and have a significant functions for women. Healthcare need to provide adequate/appropriate care and knowledge is important.

    Aim: The aim of the literature review was to describe how women exposed to sexual violence experience the healthcare.

    Method: A literature review has been conducted. Eleven original scientific articles were selected from databases PubMed and CINAHL Complete. Similarites and differences were identified and analyzed.

    Results: The analysis of healthcare experiences of women suffered from sexual violence  resulted in five themes. These were treament, information, patient participation, the health facility environment and medical care.

    Discussion: Methods and results have been discussed. Parts of the literature review were discussed based on Callista Roys theory of adaptation combined with other literature, previous research and the authors own reflections. Aspects such as secondary victimization, equal healthcare, the importance of adaptation, roles and expectations, stimuli and how to improve patient involvement by information, were highlighted.

  • 245.
    Henebratt, Caroline
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Söderlund, Malin
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskans erfarenheter av närstående inom palliativ vård: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 246.
    Henoch, Ingela
    et al.
    Göteborgs universitet.
    Carlander, Ida
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Holm, Maja
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    James, Inger
    Örebro universitet.
    Sarenmalm, Elisabeth Kenne
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Skaraborgs sjukhus.
    Hagelin, Carina Lundh
    Karolinska institutet, Sophiahemmet högskola, Stockholms sjukhem.
    Lind, Susanne
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Sandgren, Anna
    Jönköping university, Linnéuniversitetet.
    Öhlén, Joakim
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Göteborgs universitet.
    Palliative Care Research: A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 2012.2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 5-25Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In 2007, a literature review was undertaken of palliative care research from Sweden during the 1970s-2006, paving the way for a follow-up study to explore the recent developments. The aim was to systematically examine palliative care research from Sweden between 2007 and 2012, with special attention to methods, designs and research foci.

    METHODS: A literature review was undertaken. The databases Academic search elite, Age line, Ahmed, Cinahl, PsychInfo, PubMed, Scopus, Soc abstracts, Web of science and Libris were reviewed for Swedish palliative care research studies published from 2007 to 2012, applying the search criteria 'palliative care OR palliative medicine OR end-of-life care OR terminal care OR hospice care OR dying OR death'.

    RESULTS: A total of 263 papers met the inclusion criteria, indicating an increased volume of research compared to the 133 articles identified in the previous review. Common study foci were symptom assessment and management, experiences of illness and care planning. Targeting non-cancer-specific populations and utilisation of population-based register studies were identified as new features. There was continued domination of cross-sectional, qualitative and mono-disciplinary studies, not including ethnic minority groups, nonverbally communicable people or children <18 years of age.

    CONCLUSIONS: The trend is that Swedish palliative care research has expanded in volume from 2007 to 2012 compared to during the 1970s to 2006, with increasing participation of non-cancer-specific populations. A domination of qualitative approaches and small, cross-sectional studies with few interventions is still characteristic. Still more strategies are needed to expand the knowledge development of palliative care to respond to demographical, epidemiological, therapeutic and healthcare structure changes.

  • 247.
    Henoch, Ingela
    et al.
    Göteborgs universitet, Angereds närsjukhus.
    Melin-Johansson, Christina
    Göteborgs universitet, Mittuniversitetet.
    Bergh, Ingrid
    Högskolan i Skövde.
    Strang, Susann
    Göteborgs universitet, Angereds närsjukhus.
    Ek, Kristina
    Högskolan i Skövde.
    Hammarlund, Kina
    Högskolan i Skövde.
    Lundh Hagelin, Carina
    Sophiahemmets högskola, Stockholms sjukhem, Karolinska institutet.
    Westin, Lars
    Högskolan i Skövde.
    Österlind, Jane
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Ersta sjukhus.
    Browall, Maria
    Högskolan i Skövde, Karolinska institutet.
    Undergraduate nursing students' attitudes and preparedness toward caring for dying persons: A longitudinal study2017In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 26, p. 12-20Article in journal (Refereed)
    Abstract [en]

    Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives.

  • 248.
    Henoch, Ingela
    et al.
    Göteborgs universitet, Angereds närsjukhus.
    Österlind, Jane
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Development of the 6S Dialogue Tool to facilitate person-centred palliative care.2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, p. 3138-3146Article in journal (Refereed)
    Abstract [en]

    AIMS: To develop and psychometrically test the 6S Dialogue Tool.

    BACKGROUND: The 6S Dialogue Tool was elaborated to provide knowledge to nurses about patients' preferences in congruence with the 6S person-centred palliative care model, which includes the S-concepts of self-image, symptom relief, self-determination, social relationships, synthesis and strategies. The tool needs to be scrutinized for appropriateness.

    DESIGN: A qualitative study investigating construct validity of the 6S Dialogue Tool.

    METHODS: Forty-six patients in palliative care services in Sweden responded to 15 questions from May 2015 - August 2016. Responses were analysed with qualitative content analysis.

    RESULTS: Six categories, capturing the meaning of the 6S-concepts, were formulated: Maintaining everyday life; Challenges in everyday life; Maintaining control; Maintaining selected relationships; Appraisal of life; and Appraisal of the future.

    CONCLUSION: The responses to the 6S Dialogue Tool questions reflect the intent of the 6S-concepts. Nurses should integrate the 6S-concepts and the questions in their approach to facilitate to co-create meaningful palliative care in dialogue with the patient.

    IMPACT: Patients' preferences must be explored to co-create palliative care in accordance with their own needs and beliefs. The 6S Dialogue Tool questions are suitable for obtaining patients' preferences and could be used as an approach in palliative care. Patients, families and nurses will have the potential to co-create palliative care and to improve possibilities for patients to have an appropriate death.

  • 249.
    Henriksson (Alvariza), Anette
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Capio Geriatrik Dalen sjukhus, Ersta sjukhus, Karolinska institutet.
    Carlander, Ida
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Ersta sjukhus, Karolinska institutet.
    Årestedt, Kristofer
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Linköpings universitet, Linnéuniversitetet .
    Factors associated with feelings of reward during ongoing family palliative caregiving.2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 3, p. 505-12Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Of the few studies that have paid attention to feelings of reward in family palliative caregiving, most are retrospective and examine the experiences of bereaved family caregivers. Although feeling rewarded has been described as an influence that may facilitate the way family caregivers handle the caregiving situation, no study has sought to identify the factors associated with feelings of reward while providing ongoing family palliative care. The aim of this study, therefore, was to identify influential factors in feelings of reward experienced by family palliative caregivers.

    METHOD: Our study had a correlational cross-sectional design. Family caregivers (n = 125) of patients receiving specialized palliative care were consecutively recruited from four settings. These caregivers answered a questionnaire that included the Rewards of Caregiving Scale (RCS). This questionnaire included questions about demographic background and scales to measure preparedness for caregiving, feelings of hope, perceived health, and symptoms of anxiety and depression. Correlation and regression analyses were conducted to identify factors associated with rewards.

    RESULTS: The results demonstrated that the more prepared caregivers with higher levels of hope felt more rewarded, while caregivers with higher levels of anxiety and those in a spousal relationship with the patient felt less rewarded by caregiving.

    SIGNIFICANCE OF RESULTS: It seems reasonable that feeling rewarded can be a significant contributor to the overall experience of providing ongoing palliative care. The situation of family caregivers has been shown to be multifaceted and complex, and such covariant factors as preparedness, anxiety, hope, and being in a spousal relationship with the patient to influence this experience.

  • 250.
    Henriksson, Anna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Cuban nurses' views of nursing care in relation to smoking and smoking cessation: An interview-based study performed in Havanna, Cuba2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: A significant association between cigarette use and illness makes smoking the dominant cause of preventable death in the world. As a provider of health promotion efforts, the nurse has a great opportunity to guide patients towards smoking cessation. Studies show that nurses’ perceptions of their profession color their attitudes towards health promotion efforts, something that has resulted in insufficient participation in health promotion actions that can be implemented related to smoking. Cuba provides effective and free health care for the entire population. However, a prevalence of 40,1% male smokers and 15,1% female smokers places Cuba as one of the countries with the highest smoking prevalence in the world.

    Aim: This study aimed to describe Cuban nurses' views of nursing care in relation to smoking and smoking cessation.

    Method: This study was performed using a qualitative design method. Data was collected by semi-structured interviews with four nurses in Havana, Cuba. A qualitative content analysis with an inductive approach was used as a method to analyse the collected data.

    Results: The results are presented in an overall theme: Balancing professional and personal views -  nurses’ approach, and three sub-themes: Perceptions, attitudes and cultural aspects affecting nurses’ work; Challenges of implementing theoretical nursing knowledge in clinical practice; Factors and strategies for helping relatives with smoking cessation.

    Discussion: The findings are discussed against the background and aim of this study, as well as the theoretical framework of Madeleine Leininger’s cultural care diversity and universality theory. Nurses’ approaches towards smoking and smoking cessation showed similarities with the approach in the culture they lived in. Health promotion efforts expected to be implemented by nurses in their professional role towards patients, was instead performed towards relatives.

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