Bakgrund: Enligt personcentrerad vård skall patienten ses som en jämlik part och vara delaktig under hela vårdprocessen. Centrala delar i personcentrerad vård är det omfattande perspektivet som ser patientens hela situation, patientens egen förståelse och egna erfarenhet av situationen och deltagandet i beslutfattande. Studier visar att arbetssättet personcentrerad vård bidrar till ökad delaktighet inom den psykiatriska vården och leder till känslor av trygghet och tillit hos patienter.

Syfte: Syftet med denna intervjustudie var att beskriva sjuksköterskors erfarenheter av att skapa samt upprätthålla patientdelaktighet i vård av personer med psykossjukdom.

Metod: Semistrukturerade intervjuer gjordes i denna studie med tio sjuksköterskor verksamma inom psykiatrisk vård i två verksamheter inom sjukvårdsområden i Stockholm. Kvalitativ innehållsanalys valdes som metod vid analysen av materialet.

Resultat: Resultatet visar på att patientdelaktighet är viktig då det leder till gynnsamma effekter för både personal och patienter och kan leda till mer effektiva och kortare vårdtider.

Diskussion: Ramverket för McCormack och McCances (2006) teori om personcentrerad vård och tidigare forskning om patientdeltagande i psykiatrisk vård har hjälpt författaren att diskutera resultat som erhållits i denna intervjustudie.

Språkbarriärer är en utmaning inom hälso- och sjukvården. Sjuksköterskors professionella ansvar är att förmedla korrekt, lämplig och tillräcklig information till patienten. Det har visat sig att sjuksköterskor haft svårighet att tillgodose en personcentrerad och säker vård när språkbarriärer förelåg. 

Background: There are several diseases that may cause a person to undergo a stoma surgery. Those who get a stoma surgery may need to adjust their lives based on new conditions. Getting adequate information, support and care from the nurse can be of great help to those people who recently received a stoma.

Aim: The aim was to describe how it is to live with a stoma.

Method: A literature review was conducted where eleven peer reviewed articles were sought from three databases. The articles were analysed, reviewed and compiled. Differences and similarities identified in the previous research were sought and formed the basis for results.

Results: Four themes were identified: The first was Life changes, the second: Sexuality and intimacy, the third: Support from nurses and allied and finally: Accept living with the stoma.

Discussion: In the light of Katie Eriksson`s theories regarding health care and health, aspects such as suffering and awareness that increased knowledge and understanding of people`s own experiences, feeling and thoughts should help to promote health and relieve suffering.

Migration within Europe has increased in recent years, leading to many migrating and seeking asylum in other countries. This type of migration is called forced migration, which is unplanned when you have to move.The purpose is to describe the health professionals' experiences of caring for migrants.

A literature review was conducted according to Friberg's method. The work is based on ten scientific articles obtained from the databases CINAHL, PubMed and Medline. All scientific articles are Qualitative to produce experiences. The articles were analyzed using Friberg's method of analysis. 

The result sets out five themes. Where the first themes are language difficulties, the second themes are cultural differences, the third themes are the health professionals' experience of mental ill-health in refugees, the fourth themes are the nursing relationship and the fifth themes are the nursing staff's knowledge.

The results showed that the healthcare staff experienced difficulties with communication, and that it was more difficult for them to establish a relationship with the migrants compared to other patients. Cultural differences were also a challenge that staff experienced, because of the different cultural differences that arise, it was difficult for the healthcare staff to care for the patients. Furthermore, the result is discussed in connection with Katie Eriksson's suffering theory

Background: Type 2 diabetes is a chronic disease that may lead to a number of dangerous complications. Type 2 diabetes is a global health problem and a long-term disease, which can have serious consequences for the individual and enormous costs for society. In order for people with type 2 diabetes to be able to reduce future complications, it is important that these people accept the disease, learn about the disease and receive training on self-care. In this context, the role of the nurse becomes even more important in educating patients with type 2 diabetes about self-care and encouraging the individual to participate in their care and to promote their health.

Aim: The purpose of this literature review is to describe person's experiences of living with type 2 diabetes.

Method: A literature review was conducted according to Friberg and the databases CINAHL Complete and PubMed were used in the search to find scientific articles. Nine scientific articles were selected to be used in the results and to identify themes.

Results:The result revealed 4 themes; Feeling fear and anxiety about the future, The importance of Motivation in managing one's illness, The need for support from family, health and medical staff and The importance of the care relationship for self-care.

Conclusion: Social support (family, friends, relatives) and a good care relationship with health care professionals are important factors for the person with type 2 diabetes to get motives to participate in care, promote the ability to manage their illness, perform self-care regarding type 2 diabetes and experience well-being.

Background: Depression is a common disease that causes great suffering for patients and their relatives. The disease is often under diagnosed because of comorbidity with physical disorders. Increased knowledge about depression is needed to a good response between patients and health care professionals.

Aim: The aim of this study was to describe how the patient with depression experiences treatment from healthcare professionals.

Method: A literature review based on ten scientific articles that were analyzed in accordance with Friberg (2012). Ten qualitative studies were retrieved from the database CINAHL, PsycINFO and PubMed. As a theoretical base used Rosemarie Rizzo Parse's theory.

Results: The result demonstrates two main themes and the six sub-themes. The first main theme highlights the relationship with the nursing staff with three sub-themes: participation, information, treatment and care available. The second main theme is the interaction with health care professionals with three sub-themes: communication, experience to be listened to and competent and present staff.

Discussion: The results discussed from Rosemarie Rizzo Parse's theory, and also additional ten scientific articles, with the aim to show that depressed patients who feel a lack trust, commitment from health care professionals and continuity had bad experiences of treatment with health care professionals. The needed a mutual relationship between patients and health care professionals in order to patients to have a good experience with health care professionals.

Background: Diabetes is a common disease globally where there is a constant increase around the world. The treatment of diabetes can be both medical and lifestyle changes, for example physical activity and a healthier diet. Diet is of great importance when it comes to treating diabetes. 

Aim: The aim of this literature review was to describe individuals’ experiences of recommended diet when diagnosed with diabetes type 2.  

Method: The method is a literature review with a systematic selection of articles from two databases Pubmed and Cinahl Complete. The keywords used in the database searches were diabetes mellitus, type 2, diet, attitude, experience, and management. Selected articles are from the years 2017-2020. All articles had a qualitative design. When analyzing the method Friberg's method analysis is applied, and the choice of theoretical starting point is applied to Roy's theoretical perspective. 

Results: This review shows that the family had a significant impact of what was eaten. Support from the family was of importance with diagnosed with diabetes. There has also had been a noticeable difference with the nutrition around the world, some people ate fried foods even though it is not perceived as a diet for people with diabetes. The financial aspect played a big part of which assets you got. 

Conclusion: Individuals experiences of diet in diabetes type 2 have shown that dietary advice should be based on different themes. These themes are culture, knowledge, family, and economics. The different themes show how patients manage their diabetes disease based on their diet.

Bakgrund: Kvinnlig könsstympning (KKS) är ett skadligt ingrepp där delar av kvinnors könsorgan avlägsnas eller förändras utan medicinskt syfte. Idag finns så många som över 200 miljoner kvinnor och unga flickor som gått igenom någon form av könsstympning. Ingreppet är fäst vid kulturella värderingar, trosuppfattningar och sociala mönster.

Syfte: Syftet var att beskriva sjuksköterskors attityder i möten med könsstympade kvinnor.

Metod: En litteraturöversikt som innefattar två kvalitativa och åtta kvantitativa vetenskapliga artiklar. Informationssökningen gjordes på databaserna CINAHL Complete och Pubmed. Artiklarna granskades och analyserades enligt Fribergs metod.

Resultat: Resultatet visade att de flesta sjuksköterskorna i studien hade varierande kunskaper och medvetenhet om KKS. Majoriteten av sjuksköterskorna visste att KKS hade skadliga konsekvenser. Kulturella, religiösa, sociala och sexuella faktorer tillskrevs som skäl för utövandet av KKS. En del av de hade en inställning på att vilja utföra KKS. Majoriteten av sjuksköterskorna i studien var motvilliga att låta sina döttrar genomgå KKS. Som en strategi för att eliminera KKS hade många åsikten att lagen mot KKS skulle tillämpas strikt.

Diskussion: Litteraturöversikten diskuteras med Madeleine Leiningers transkulturella omvårdnadsteori som grund. Diskussionen tar upp vikten av att ha förståelse för kulturella skillnader och anpassa omvårdnaden på ett sådant sätt att kvinnans perspektiv är väl sedd utan att sjuksköterskor behöver utföra kvinnlig könsstympning.

Bakgrund: Palliativ vård innebär en holistisk och personcentrerad vård som syftar till att minimera lidande och främja livskvalitet vid livshotande sjukdom. De flesta människor avlider i en verksamhet där minst en sjuksköterska är verksam och ansvarar för personen. Detta innebär att den grundutbildade sjuksköterskan genom sin utbildning behöver förberedas på att vårda människor i livets slutskede. Sjuksköterskornas föreställningarna har en direkt inverkan på den palliativa vårdens kvalitet.

Syfte: Syftet var att beskriva sjuksköterskestudenters föreställningar om att möta och vårda patienter i livets slutskede.

Metod: En integrativ litteraturöversikt med systematiskt tillvägagångssätt. Studien genomfördes med mixad metodik där både kvalitativa och kvantitativa artiklar analyserades och syntetiserades.

Resultat: I den integrativa syntesen framkom tre övergripande teman. Det första temat var föreställningar inför att möta döden. Studenterna föreställde sig överlag att det var meningsfullt och givande att vårda döende patienter. Dock fanns en osäkerhet och rädsla kring att vårda en döende patient. Det andra temat var föreställningar om att samtala om döden. Studenterna ansåg att det var viktigt att samtala med patient och närstående samtidigt som de kände sig obekväma att prata om döden, då det fanns föreställningar om att de kunde säga fel saker. Det tredje temat var föreställningar om den egna förmågan. Det uppstod en ambivalens mellan studenternas ideal och deras förmåga. De ville göra gott och vara starka inför patienten men upplevde att de inte var vuxna för uppgiften.

Slutsats: Sjuksköterskestudenter i olika länder vill gärna kunna ge god omvårdnad i livets slutskede. Dock upplever studenterna rädsla och osäkerhet att möta och vårda människor i livets slutskede på grund av bristande kunskap och erfarenhet i palliativ vård. Utbildning, teoretisk så väl som verksamhetsförlagd, är viktig för att sjuksköterskestudenterna ska kunna ge en god palliativ vård.

Background: Dementia is an incurable disease. Dementia can lead to serious symptoms such as language difficulties, dysfunction and behavioral changes. People with dementia need a special and well-suited environment. People with dementia need security in their daily lives, which becomes an important task for the nurse. In nursing work, the nurse will aim to increase the wellbeing of patients. In this case, the environment is designed in the dining room based on the patient's conditions.

Aim: To describe the design of the meal environment and how it affects people with dementia.

Method: A literature review has been carried out. Eleven quantitative scientific articles have been used for the study. The articles have been selected from the CINAHL and PubMed databases corresponding to the purpose. The articles have been analyzed with Friberg’s analysis method to be completed as material for the result.

Results: The result is based on a theme; the environment around the patients when they eat and three subtemes; the importance of music in the meal situation; the importance of lighting in the meal situation; the meaning of a home-like dining room. These describe the various resources required to increase the well-being of patients with dementia.

Discussion: The meal environment had a major impact on people with dementia. The environment in the dining room was adapted to the patient's requirements. The changing meal environment increased patient wellbeing. The home-like environment, calm background music and sufficient lighting during the meal were of great importance to the patient. The positive effect could contribute to increased calorie intake and decreased negative behavior in patients.

Background: Schizophrenia is a serious mental illness that can lead to physical, psychological and social problems for the victim and adversely affects the quality of life of the patient. There is insufficient knowledge in the treatment of people with schizophrenia. Patients' subjective experiences are often neglected although they are of great importance in the care of patients and patient life. A better understanding of the patient's experiences can lead to better treatment and change of negative attitudes, thus making it possible to provide the care and treatment people with schizophrenia need.

Aim: To describe patients' subjective experiences of living with schizophrenia.

Method: A literature review based on ten qualitative studies found in the databases: PsycINFO, PubMed and CINAHL. The studies were processed and analyzed with meta synthesis and common themes identified.

Results: Five main themes were identified: schizophrenia is a complicated disease with severe symptoms, experiences of diagnosis and treatment, severe emotional experiences during childhood, importance of social relations for recovery and good insight and acceptance is the key to recovery.

Discussion: Patients' subjective experiences differ significantly from the objective observations and the perceptions of healthcare professionals. Changed attitudes towards schizophrenia in society and between healthcare professionals can contribute to empathetic and better treatment, which can promote living conditions for people with schizophrenia. More qualitative research and better education about patients' subjective experiences are needed.

Background: Breast cancer is the most common form of cancer that affects women. Many women experience side effects from breast cancer treatments. One of the most common side effects is fatigue that can be perceived in different dimensions. The nurse has an important role by informing, supporting and motivating the patient to perform self-care activities before, during and after breast cancer treatment.

Aim: Illustrate different forms of physical activity and its effect on fatigue in women undergoing breast cancer treatment.

Method: A literature review has been conducted where eleven quantitative studies were selected. The databases used were PubMed, MEDLINE with Full Text and ProQuest Nursing & Allied Health Database. The articles have been reviewed, discussed and summarized in order to distinguish between similarities and differences.

Results: It was found that physical activity, in various forms, had an effect to reduce fatigue. The result led to a main heading: Physical activity’s effect on fatigue with three subheadings: Aerobic physical activity, Combination of aerobic and muscle strengthening physical activity and Walking as physical activity.

Discussion: Four parts emerged from the result: The physical activity’s planning and structure, Barriers to perform physical activity, Positive experiences of physical activity and Nurse’s supportive function. The content has been discussed in conjunction with Dorothea E. Orem’s self-care theory and new applied qualitative data.

Background: Type 2 diabetes mellitus (DMT2) is a public health disease that is found around the world. Diabetes is a disease that can be life-threatening if the patient does not receive medical care. It is classified as a non-communicable public disease, in addition to the bodily injuries such as DMT2, it can also cause financial difficulties for the patient as well as for health care. DMT2 disease negatively affects the patient as they cause daily problems. In the long term, it can also contribute to complications and in order to be able to prevent it, the patient needs knowledge about the disease insight as well as risk factors that may arise and which treatment can be effective for their quality of life.

Aim: To describe how people with type 2 diabetes experience their self-care.

Method: The overview for the literature search was made with the help of two databases Cinahl Complete and PubMED, where a selection of 11 scientific articles that focus on qualitative methods were selected

Results: The literature review shows 4 main areas: management of blood sugar value, diet management, physical activity and support.

Conclusion: The literature review has concluded that patients with type 2 diabetes need a lot of support from both health care but also from relatives and friends. In the literature review, it is also found that lifestyle habits have a great impact on patients, if they make a lifestyle change that benefits them, they can live a life of quality.

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

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

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

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

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

Ämnet i denna studie är egna och informella strategiers betydelse i organisatoriska sammanhang. Empirin baseras på hur socionomer förhåller sig till informella strategier i syfte att bli starkare individer och mer resistenta mot stress. För yrkesutövare inom socialt arbete är stress och ohälsa ett vanligt förekommande fenomen som ofta orsakats av hög arbetsbelastning. Ohälsa på arbetet kan få negativa konsekvenser för det sociala arbetet som utförs. Brist på återhämtningsmöjligheter på arbetsplatsen är vanligt då många verksamheter ställer krav på effektivitet hos socionomer. För att finna utrymme för att hantera stress använder sig därför många av egna tillvägagångssätt för att generera inre välbehag och stabilitet. Åtta intervjuer med socionomer som arbetar på olika sociala verksamheter inom den offentliga sektorn har deltagit i studien. Det teoretiska ramverk som använts för att förtydliga och belysa empirins innehåll är gräsrotsbyråkrati och empowerment. I resultatet beskriver socionomerna varför och hur de använder sig av informella strategier till vardags för att stärka sig själva. Vidare förstås empirin utifrån ramverk som handlar om individens egna resurser och den kontext de befinner sig i. I studien framkommer det att socionomer väljer strategier utifrån att det finns ett behov av tid för återhämtning och att de förespråkar att själva välja strategier utifrån sig själva. De menar att det viktigaste är att välja strategier som är individanpassade, som genererar glädje och som bidrar till känslomässig balans. Kreativiteten sätter gränserna för hur strategierna kan användas och verktygen tycks finnas inom var och en.

Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor i världen. Behandlingen medför olika konsekvenser som påverkar kvinnors liv och välbefinnande som kan leda till kvinnors sexuella hälsa, sexualitet samt relation till sig själv och sin partner blir påverkad.

Syfte: Syftet var att beskriva upplevelser av sexuell hälsa hos kvinnor i samband med bröstcancer.

Metod: En litteraturöversikt gjordes som innehåller fyra kvalitativa, fem kvantitativa och två vetenskapliga artiklar med mixad metod. Artiklarna analyserades och granskades enligt Fribergs metod.

Resultat: Resultatet presenteras i sex temaområden som beskriver upplevelser av sexuell hälsa hos kvinnor med bröstcancer: Förändrad sexuell hälsa, Psykologiska konsekvenser, Kvinnans relation till sig själv och sin kropp, Relationer med partner, Kommunikationen med hälso- och sjukvårdspersonal och Fördomar kring bröstcancerbehandling.

Diskussion: Diskussionen inkluderar en metoddiskussion och en resultatdiskussion. I metoddiskussionen diskuteras styrkor och svagheter, genomförda tillvägagångssätt samt kvalitetsgranskning av resultatartiklar. Vidare i resultatdiskussion diskuteras resultatets fynd utifrån Katie Erikssons teori om lidande samt andra studier och egna reflektioner.

Background: Self-harm behavior evokes many emotions and there is some misunderstanding about the phenomenon. The behavior is likely to be more common amongst women than men and often starts in the early teens but can affect anyone. Caring for people with self-harm behavior is a challenge for healthcare professionals. Therefore it is important to clarify how people with self-harm behavior describe their experiences of what may represent significant care interventions.

Aim: The aim was to find out how people with self-harm behavior experience healthcare.

Method: A literature review of 12 qualitative articles has been carried out to systematically account for the research done in the specific field.

Results: Individuals with self-harm behavior experienced both a lack of and access to trustful interpersonal relationships with healthcare professionals. In inpatient care they could be met by incomprehensible and disrespectful nursing staffs who were more interested in rules and upbringing than by individuals in need of care and interpersonal relationships. One of the main obstacles to the recovery process was the exposure to other people's self-harm behavior. The foundation for an interpersonal relationship was staffs that were genuinely thoughtful and took the time to really listen to each individual's unique story. If there was a mutual and trustful care relationship there was a greater tendency to seek care in the future.

Discussion: The method and result are discussed towards the background, the theory of care, laws, competence descriptions and scientific articles.

BACKGROUND: The influence of maternal temperament on child behavior, and whether maternal temperament impact boys and girls differently is not thoroughly studied. The aim was to investigate the impact of maternal temperament and character on child externalizing and internalizing problems at age 3.

METHODS: A birth-cohort of 1723 mothers and their children were followed from birth to age 3. At the child's age of 3 months, the mothers filled out standardized instruments on their temperament and character using the Temperament and Character Inventory (TCI) and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). At the child's age of 3 years, the mothers reported on child behavior using the Child Behaviour Checklist (CBCL).

RESULTS: Maternal temperamental trait novelty seeking was positively associated with externalizing problems in the total population and in girls. Harm avoidance was positively associated with externalizing problems in the total population and in boys, and with internalizing problems in the total population and boys and girls respectively. Maternal character traits of self-directedness and cooperativeness were negatively associated with both externalizing and internalizing problems in the total population and in boys and girls respectively.

CONCLUSIONS: Maternal character traits were more influential on child behavior than were temperamental traits, and thus the opportunities for intervention targeted at parental support are good. Maternal mental health and socioeconomic aspects also increased the risk for child behavior problems, indicating the need for recognition and support in clinical settings.

In 2018 around 8 900 children and youth were placed in compulsory care under the Care of Young Persons Act (LVU). One of the prerequisites of the compulsory law is the expression other socially destructive behavior, a prerequisite open for interpretation. This study aims to examine the expression other socially destructive behavior to see what behavior, actions and characteristics is ascribed the youth when the social welfare committee apply for compulsory care under 3 § of the Swedish Care of Young Persons Act (LVU) at the Administrative court. Our selection contained 40 judgments from the Administrative court in Stockholm, regarding youth under the age of 18 and was selected due to its relevance, the socially destructive behavior being described as the issue at hand. Our study was based on a qualitative critical discourse analysis with the help of Fairclough's three dimensional model.

Our results showed four different categories labelled as socially destructive behavior. We named these categories the rebellious behavior, the dangerous behavior, descriptions of vulnerability and the everyday norm breaking behavior. The social welfare committee describes actions performed by the young persons, mixed with behavioral issues and descriptions of the individuals personality. However, the socially destructive behavior cannot be regarded as a single behavior or action, it is a combination of the above where an assesment is made in each individual case. The discourse regarding youths norm breaking behavior is generally controlled by adults, it is intensively discussed in media, politics and the society. The voice that seems to be missing is the one of the youth themselves. 

Bakgrund: Beröring kommer alltid att vara en del av vården. Affektiv beröring är en typ av frivillig beröring som kan uppstå såväl medvetet som omedvetet. Denna typ av beröring används av sjuksköterskan i det dagliga omvårdnadsarbetet för att trösta, lugna, vårda och lindra patienters lidande. Sjuksköterskors olika beröringsstilar grundas i deras personlighet, livserfarenhet, kulturella bakgrund, utbildning och arbetsstil. Vidare forskning inom området anses vara av betydelse, då kunskaperna kring affektiv beröring är bristande bland sjuksköterskor.

Syfte: Syftet med denna litteraturöversikt var att belysa vuxna patienters upplevelse av sjuksköterskans affektiva beröring i daglig omvårdnad.

Metod: En litteraturöversikt baserad på åtta kvalitativa och två kvantitativa vetenskapliga artiklar.

Resultat: Resultatet tematiserades i sex teman: Att knyta band, betydelsen av kommunikation, kroppsdelarnas olika betydelser, att bli berörd med närvaro, beröring och genus betydelse och betydelsen av att ha kontroll över situationen.

Diskussion: Resultatet diskuterades mot Virginia Hendersons omvårdnadsteori om människans behov samt relaterades till vetenskapliga artiklar för att stärka resultatet. I denna del diskuteras vuxna patienters upplevelser av affektiv beröring i daglig omvårdnad samt hur sjuksköterskor skall förhålla sig för att patientens hela vårdupplevelse skall upplevas som god.

Background: Healthy kidneys are a requirement for the body's other organs to function well. Renal failure causes renal function to deteriorate and there are two conditions, acute and chronic. The chronic condition develops slowly over a long time, and in a late stage, some form of continuous dialysis treatment is required to purify the blood. One alternative is hemodialysis treatment performed in a dialysis unit several times a week a requires a lot of time from the patient's everyday life, which may affect well-being in various aspects. Well-being and quality of life are described as subjective experiences, and from the humanistic perspective it can be influenced on physical, mental and spiritual levels. With the help and support of healthcare professionals, it is still possible for patients to experience well-being and quality of life despite chronic illness. 

Aim: To describe how well-being is affected among patients during chronic renal failure and hemodialysis treatment.

Method: A literature review based on 13 scientific articles from two databases. The articles were reviewed and analyzed by Friberg’s method to find similarities and differences that later compiled in five themes.

Results: After the analysis, five themes were identified that describes how well-being is affected by a life with chronic renal failure and hemodialysis treatment: limitations in the everyday life, dependence on humans and machines, the impact of symptoms, emotional impact and also acceptance and coping. 

Discussion: The method discussion is based on the strenghts and weaknesses of the literature review. The results were discussed in relation to Rosemarie Rizzo Parse’s Humanbecoming theory and the three principles meaning, rhythmicity and transcendence.

Background: Heroin is an illicit narcotic drug that is highly addictive. The drug has a negative impact on the physical, mental and social health of the user, which implies complex needs of healthcare. Users are exposed to stigmatization in society. One factor that may constitute barriers to good care on equal terms is the healthcare professionals' attitudes towards patients they care for.

Aim: The aim was to highlight attitudes of health personnel towards patients who are or have been users of heroin. 

Method: A literature review based upon ten scientific articles was conducted according to Friberg’s method. The articles were based on qualitative and quantitative studies as well as studies performed with mixed method.

Results: The result shows the presence of positive and negative attitudes. The negative attitudes were more prominent. Further on a polarization of attitudes within the group of healthcare professionals was revealed. However, the difference was not linked to a certain profession but instead linked to education and experiences of working with the current patient group. Those who worked closest to the patients held predominantly positive attitudes and vice versa.

Discussion: The results are discussed on the basis of key concepts and ideas of Travelbee and how the result fits in relation to science and legal texts. Possible reasons for the presence of negative attitudes are discussed. A ‘we-and-them ' mentality contributes to the difficulties of health professionals in empathizing with patients, which precludes the caring relationship. Awareness-raising, experience and education are highlighted as crucial to the facilitation of change.

The aim of this study was to describe the social care provided for different age groups of people with intellectual disability, 55 years or above, and to investigate the association between such care and frailty factors for those with diagnosed level of intellectual disabilities. Descriptive and logistic regression analyses were used. Commonest forms of social care among the 7936 people were Residential care, Daily activities and Contact person. Home help and Security alarm increased with age. The frailty factors significantly associated with increased social care were age, polypharmacy and severe levels of intellectual disabilities. Persons most likely to be in residential care were in the age group 65-79 with polypharmacy and severe disability. The results indicate a need for further research of how frailty factors are considered in social care and longstanding medication, especially then severe intellectual disability hinders communication. A national strategic plan for preventive interventions should be developed to ensure the best possible healthy ageing.

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

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

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

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

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

After the 2016 election of president Duterte, the Philippines have been actively fighting a war on drugs inside their own country according to the new policies developed by the newly chosen regime. These policies have led to the several thousands of dead in police operations which are by many called out as extrajudicial executions. The purpose of this study is to research the experience of urban people living in a society pervaded by a war on drugs with the goal of contributing to the understanding of how they handle the situation and how it affects their lives. The authors have spent two months in the Philippines, mainly in the Metro Manila area to gather the data for the study through mainly participant observation and semi-structured interviews for an ethnographic study. The results show who are being targeted in the war, how people experience it and create labeling and stigma according to the societal rules and norms as well as how people cope with difficult circumstances out of their control.

Background: Type 1 diabetes is a long-term disease that most often occurs in children and adolescents. This means that the pancreas can no longer produce enough insulin. It is not only the children who suffer from this disease but also the parents who get a change in their everyday lives.

Aim: The purpose was to investigate parents' experiences of living with children with type 1 diabetes.

Method: A literature review with ten qualitative articles taken from the databases PubMed and CINAHL complete, which have been analyzed based on Friberg’s analysis method.

Results: Three themes emerged in the result: 1). anxiety of parents 2). changing family relationships and 3). increased responsibility. The results describe parents' experiences and feelings about the child's self-care, as well as the responsibility that arises in the treatment of type 1 diabetes. The concern that exists about complications and how this can affect the mental health.

Conclusion: The results show how parents are affected by having a child with type 1 diabetes and that support from healthcare professionals was an important factor in their parents' everyday lives. Therefore, the nurse has a significant role in creating understanding and empathy for the affected family. This can create reduced suffering and a better processing around care and treatment of type 1 diabetes.

This study intends to investigate how young women, who have been subjected to honor-related violence and oppression, experience the support of the social services based on the power perspective and the KASAM theory. We have in the study used qualitative methods to conduct semi-structured interviews. Eight young women who had been in contact with the social services were interviewed.

Previous research has primarily studied the client's experience of contact with the social services. Studies that concern women who have been subjected to honor-related violence and oppression are very limited. Research in this area should therefore be sought.

The study's results showed that young women's expectations did not match the experience of contact with the social services. The results analysis showed that the social services support and assistance efforts are far too short-term where women are left behind and are expected to handle their difficulties on their own.

Background: Relatively many people suffer from type 2-diabetes which is a chronic disease, this means that it is seen as a growing public health problem, both nationally and globally. The diabetes treatment includes pharmacological treatments but also non-pharmacological treatments, where the responsibility lies with the patient and how they manages their own self-care. The self-care capacity is individual and can be strengthened by the nurses gathering more knowledge, showing support and teaching the patient. This helps the patient achieve optimal lifestyle changes. It is therefore important to explore the patient´s experience of living with the disease in order to identify what is needed to achieve optimal health.

Aim:To describe the patient´s experience of living with type 2-diabetes.

Method: The literature review is based on eleven qualitative scientific studies, through the following databases; CINAHL Complete, Nursing Allied Database and Pubmed. the articles were thereafter analyzed based on Friberg´s and Östlund´s methods.

Results: The result is presented in one main theme Experiences associated with type 2-diabetes with four subthemes; the subthemes: Feelings associated with diagnosis, Eating habit, Physical activity, Support from the environment.

Discussion: The main findings were discussed based on Orem´s self-care theory. In the discussion three main point were discussed with connection to the results. These three main points were emphasized, which were; Self-care, the emotional impact of type 2-diabetes, support and person-centered care. These main points are essential in order to be able to implement an optimal lifestyle change.

Background: Self-injurious behavior is not an illness but a behavior that include repetitive self-injury. Self-injurious behavior is a growing public health problem in our society that usually take place among people with mental illness. It is very important to raise the experience from people with self-injurious behavior, when they are seeking for healthcare, to make it possible to ensure patient focused care, support and treatment for them. It is important to have an ethical and holistic view as a nurse and to include the person´s mental health and not only the physical self-injury.    

Aim: The aim was to describe how people with self-injurious behavior experiences the contact in somatic and psychiatric outpatient and inpatient care after self-injury.  

Method: The research method of the study was a literature review. The article searching was made in academic databases, PubMed, CINAHL Complete and Psychology and Behavioral Sciences Collection. For the result, there were twelve qualitative articles found and used. From the result three main themes with four sub themes were created.

Results: The results include three main themes “Relationships of care”, “Guiding and support” and “Necessary improvement”. The results showed that the most people with self-injurious behavior had a negative experience of health care staff's approach and the feeling that the care was limited. This led to negative self-esteem and affected the trust for the care.           

Conclusion: People with self-injurious behavior experiences stigma, neglect and lack of empathy and compassion of healthcare staff. When the experiences of care was negative and judgmental, people with self-injurious behavior felt shame and guilt, which prevented them from seeking care. A treatment characterized by empathy and carefulness improved quality of life and strengthened the person. The nurse should create a supportive environment for people with self- injurious behavior, without stigma.

Bakgrund: Cancer är den näst största folksjukdomen och den näst vanligaste dödsorsaken efter hjärt-kärlsjukdomar. Prevalensen av insjuknandet ökar för varje år och innebär därmed att allt fler unga vuxna drabbas. Forskning kring unga vuxnas upplevelser av cancer är undermålig samtidigt som definitionen av unga vuxna är vag. Detta gör att det idag inte finns ett tydligt och hållbart behandlingsprogram för denna patientgrupp. Unga vuxna befinner sig i en fas i livet där stort fokus ligger på att utvecklas och att upptäcka världen. Att som ung vuxen drabbas av en livshotande sjukdom som cancer innebär därför en unik upplevelse och krisreaktion. För att sjuksköterskor ska ha möjlighet att ge de drabbade personcentrerad vård av god kvalitet, krävs en bättre förståelse för deras specifika situation. Syfte: Syftet var att belysa unga vuxnas upplevelser av att leva med cancer. Metod: En litteraturöversikt gjordes i enlighet med Fribergs metod. Resultatet är baserat på tio kvalitativa, vetenskapliga artiklar som beskriver unga vuxnas upplevelser av att leva med cancer. Artiklarna analyserades genom tematisering och kategorisering. Sökningarna gjordes i databaserna CINAHL Complete och PubMed. Resultat: Fyra teman identifierades: Att drabbas av cancer som ung vuxen, Behov av stöd, Identitetsförändringar och Behov av att ta kontroll. Samtliga teman beskriver upplevelser som är typiska för unga vuxna med cancer. En stor del av resultatet innefattar känslor och frågor av existentiell karaktär. Diskussion: Metoden diskuteras utifrån litteraturöversiktens styrkor och svagheter. I resultatet diskuteras framkomna teman med hjälp av ett livsåskådningsperspektiv, detta för att skapa en djupare förståelse för den unika situation som unga vuxna ställs inför i samband med cancer.

En del av det svenska biståndets insatser planerade för Mellanöstern kan bli omöjliga att ­genomföra. Sidas analytiker har inte tagit tillräcklig hänsyn till en ökande religiös ­våldsbejakande extremism och dess genomslag i hela området.

Background: Happiness is a feeling of deep joy in the life situation itself. Previous research has concluded that persons with Schizophrenia experiences just as much positive emotions as people without a Schizophrenia diagnosis. Health is seen as a feeling of balance and reflects a person’s current life situations and integrated part of her life. The caring relation is based on mutual cooperation and should be characterized by care given without any expectations. Increased understanding of their experiences of happiness and health can lead to better respond and support from the psychiatric nurse.

Aim: The purpose of this litterature review was to describe how persons with Schizophrenia experience their happiness and the meaning for their health.

Method: An intergrativ litterature review was choosen with an intergrativ design, both qualitative and quantitative studies has been used to increase the understanding of the phenomenon. In this study eleven articles has been analyzed based on Whittenmore and Knalf method.

Results: Four themes were identified: Living with schizophrenia, To be independent, Having relations and Living a normal life. The participants wanted to maintain close relationships to avoid loneliness and isolation, and expressed the importance of a stabel care relationship. They experienced an alienation and expressed their desire to feel normal and be able to live a normal life.

Conclusions: The result showed experiences that both facilitated and constituted obstacles for their own happiness. It is important to pay attention to and understand persons with schizophrenia and their experiences in order for the specialist nurse to improve nursing care.

Sweden’s social services are today characterized by having high staff turnover which has resulted in various work-related problems, such as high workload, stress and insufficient resources. This study aims to investigate and quantify the work environment-related factors that, to the greatest extent, lead to the social secretaries staying at their workplaces within Stockholm's social services. The study's data collection method consisted of a survey that received a total of 35 respondents. The conclusions showed a certain hierarchy between the work environment-related factors, where the personal characteristics of the social secretaries turned out to be the strongest / most important factor in keeping them at their workplace. Support and supervision were the second strongest factor that had certain significance for the social secretaries in the field of child-welfare. Recovery and self-awareness were the third strongest factor. Stimulation and development was the fourth strongest factor that had certain significance for social secretaries that had longer periods of employment. The weakest factor for the social secretaries in this study was call and driving forces.

Background: Breathlessness is a symptom that makes breathing difficult which can lead to experiences of anxiety and fear. It is one of the most common symptoms experienced by patients with advanced stage disease. Several diseases such as COPD, cancer and heart failure can cause breathlessness. Palliative care aims to alleviate suffering by treating and preventing symptoms, such as breathlessness. Nurses need to be aware of patients´ experiences in order to provide and individually adjust symptomatic relief.

Aim: Describe patients´ experiences of breathlessness, while receiving palliative care or receiving care for an advanced disease, including their strategies for managing breathlessness.

Method: A literature review was carried out with data collection from five databases that resulted in 12 scientific articles of which 11 were qualitative and one was quantitative. The data analysis was made with Friberg (2017) method and resulted in two themes.

Results: The two main themes that emerged were Experiences of breathlessness and Strategies for managing breathlessness. The result showed that breathlessness can cause anxiety and fear, physical fatigue and severe coughing. In addition, breathlessness implied limitations of patients´ daily life and could lead to patients being isolated in their homes, intended or unintended. Different strategies for managing breathlessness are presented.

Discussion: In the discussion the pros and cons regarding the authors' joint work, challenges and considerations were addressed. The main findings of the result were discussed using Sister Callista Roy’s adaptation model.

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

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

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

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

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

BACKGROUND: The study aims to determine possible dose-volume response relationships between the rectum, sigmoid colon and small intestine and the 'excessive mucus discharge' syndrome after pelvic radiotherapy for gynaecological cancer.

METHODS AND MATERIALS: From a larger cohort, 98 gynaecological cancer survivors were included in this study. These survivors, who were followed for 2 to 14 years, received external beam radiation therapy but not brachytherapy and not did not have stoma. Thirteen of the 98 developed excessive mucus discharge syndrome. Three self-assessed symptoms were weighted together to produce a score interpreted as 'excessive mucus discharge' syndrome based on the factor loadings from factor analysis. The dose-volume histograms (DVHs) for rectum, sigmoid colon, small intestine for each survivor were exported from the treatment planning systems. The dose-volume response relationships for excessive mucus discharge and each organ at risk were estimated by fitting the data to the Probit, RS, LKB and gEUD models.

RESULTS: The small intestine was found to have steep dose-response curves, having estimated dose-response parameters: γ50: 1.28, 1.23, 1.32, D50: 61.6, 63.1, 60.2 for Probit, RS and LKB respectively. The sigmoid colon (AUC: 0.68) and the small intestine (AUC: 0.65) had the highest AUC values. For the small intestine, the DVHs for survivors with and without excessive mucus discharge were well separated for low to intermediate doses; this was not true for the sigmoid colon. Based on all results, we interpret the results for the small intestine to reflect a relevant link.

CONCLUSION: An association was found between the mean dose to the small intestine and the occurrence of 'excessive mucus discharge'. When trying to reduce and even eliminate the incidence of 'excessive mucus discharge', it would be useful and important to separately delineate the small intestine and implement the dose-response estimations reported in the study.

PURPOSE: To find out what organs and doses are most relevant for 'radiation-induced urgency syndrome' in order to derive the corresponding dose-response relationships as an aid for avoiding the syndrome in the future.

MATERIAL AND METHODS: From a larger group of gynecological cancer survivors followed-up 2-14 years, we identified 98 whom had undergone external beam radiation therapy but not brachytherapy and not having a stoma. Of those survivors, 24 developed urgency syndrome. Based on the loading factor from a factor analysis, and symptom frequency, 15 symptoms were weighted together to a score interpreted as the intensity of radiation-induced urgency symptom. On reactivated dose plans, we contoured the small intestine, sigmoid colon and the rectum (separate from the anal-sphincter region) and we exported the dose-volume histograms for each survivor. Dose-response relationships from respective risk organ and urgency syndrome were estimated by fitting the data to the Probit, RS, LKB and gEUD models.

RESULTS: The rectum and sigmoid colon have steep dose-response relationships for urgency syndrome for Probit, RS and LKB. The dose-response parameters for the rectum were D_50: 51.3, 51.4, and 51.3 Gy, γ₅₀ = 1.19 for all models, s was 7.0e^-09 for RS and n was 9.9 × 10⁷ for LKB. For Sigmoid colon, D₅₀ were 51.6, 51.6, and 51.5 Gy, γ₅₀ were 1.20, 1.25, and 1.27, s was 2.8 for RS and n was 0.079 for LKB.

CONCLUSIONS: Primarily the dose to sigmoid colon as well as the rectum is related to urgency syndrome among gynecological cancer survivors. Separate delineation of the rectum and sigmoid colon in order to incorporate the dose-response results may aid in reduction of the incidence of the urgency syndrome.

I denna studie beskrivs och analyseras den svenska fattigvårdens, socialvårdens och socialtjänstens ”värdehistoria”. Det är berättelsen om hur mellanmänskliga värden har använts för offentliga lösningar byggda på dygder, plikter och nyttoidéer.

Värdefrågor har alltid varit grundläggande i lagar och förarbeten inom området, men det är ovanligt med uttalat etiska analyser, reflektioner och ställningstaganden i statliga utredningar, propositioner och betänkanden från riksdagsutskott. Det gäller både i äldre tid och under de senaste decennierna.

Människosynen i lagar och förarbeten om socialtjänsten betonar den enskildes individualitet, möjligheter och behov. Det finns ett tydligt fokus på individuellt oberoende samtidigt som socialtjänstlagens ”portalparagraf” bär spår av en gemenskapsmoral med rötter i akademisk diskussion.

I dag finns det tecken på skillnader i värden mellan olika grupper, såsom rättigheter för barn och människor med funktionsnedsättningar och en mer traditionellt etisk värdegrund för äldreomsorgen.

Background: Inflammatory bowel disease (IBD) is a chronic illness that includes Crohn´s disease (CD) and ulcerative colitis (UK). Both diseases have in common that they have relapse and periods with improvement. The diseases effects relatively young people. It is important that the nurse can support these individuals through evidence based and person-centred care in order to provide the best possible care.

Aim: Describe individuals experiences of living with inflammatory bowel disease 

Method: A literature review was chosen as the method. The article search was carried out in the databases CINAHL complete and PubMed. The limitations made in the database searches were scientific original articles, written in English, peer-reviewed and published over the last ten years. A total of eleven articles was included in the result, of which ten were of qualitative design and one was quantitative design.

Results: The results showed that the individuals experienced that the disease affected their working life, social life, feelings and identity. Their meeting with healthcare services affected their trust in the care and their willingness to seek care in the future. It was also shown that people with inflammatory bowel disease underwent a transition period after the diagnosis. How the individuals experienced living with IBD was affected by whether they were relapsing or in remission. People currently in a relapse had a more negative view of the disease. 

Discussion: The result was discussed based on Katie Eriksson´s theory of suffering and health. The authors reasoned if the negative impact of the individuals could be linked to the stigma and shame of the disease. They also discussed the long-term impact of the absence from work and social activities. The authors found in the results that individuals with IBD experienced the disease differently in their daily lives depending on how long they had the disease and what attitude they had towards their IBD. The care should be adapted to the individual needs to ensure that the efforts promotes health.

Bakgrund: Ökad global migration ställer krav på sjuksköterskor i omvårdnadssituationer där patientens etnicitet och sårbarhet behöver beaktas. Sårbarheten kan bestå i flyktingars hälsosituation och den stress flyktingar upplever under migrationsprocessen. Sjuksköterskor och sjuksköterskestudenter behöver ta kulturen i beaktande vid möte med dessa patienter.

Syfte: Att belysa sjuksköterskors och sjuksköterskestudenters kulturkompetens.

Metod: Litteraturöversikten grundar sig på tio vetenskapliga artiklar, varav två kvantitativa och åtta kvalitativa.

Resultat: Sjuksköterskor och sjuksköterskestudenter finner kommunikationsproblemet som största hindret, där språkbarriärer är en tydlig faktor. Detta gör att sjuksköterskor och sjuksköterskestudenter anser att omvårdnaden i dessa fall tar mer tid i anspråk, och att tolkanvändningen förekommer alltför sällan. Sjuksköterskor och sjuksköterskestudenter anser att de har en viss kulturkompetens men att en önskan finns om ytterligare utbildning i ämnet.

Diskussion: En önskan hos sjuksköterskor och sjuksköterskestudenter om fördjupade kunskaper i kulturkompetens kan utläsas av de resultat som framkommit i litteraturöversikten. Kulturkompetens har i litteraturöversikten diskuterats utifrån Madeleine Leiningers transkulturella omvårdnadsteori.