Bakgrund: Forskning tyder på att preoperativ ångest utgör ett vanligt förekommande problem hos patienter som skall genomgå kirurgi. Flera studier visade att den kan leda till olika postoperativa komplikationer. Det är sjuksköterskans ansvar att både identifiera och åtgärda ångest inför ett kirurgiskt ingrepp. Syfte: Att beskriva vilka icke-farmakologiska interventioner finns för att minska preoperativ ångest hos vuxna patienter. Metod: Studiens design var en litteraturöversikt som genomfördes enligt Fribergs metodbeskrivning. Litteraturöversikten bygger på tolv kvantitativa studier publicerade mellan 01/2007 och 09/2017. Sökningar utfördes i databaserna CINAHL Complete och PubMed. Resultat: Denna litteraturöversikt tyder på att det finns flera, olika interventioner som kan användas som komplement till farmakologisk behandling för att effektivt minska preoperativ ångest hos vuxna patienter. Ångest i den preoperativa fasen kan lindras om patienten får en utökad, individuell anpassad information. Ångest kan också minskas om patienten får ett känslomässigt stöd eller hjälp med att finna tröst i andlighet/religion. Litteraturöversiktens resultat tyder dessutom på att ångestnivå kan sänkas med hjälp av en lugn musik, naturljud eller vägledd dagdröm. Det framkom även att den preoperativa ångesten kan minskas genom avslappningsövningar, aromaterapi, akupunktur och zonterapi. Endast en fotografisk utställning har inte visats vara effektiv för att minska ångest i det preoperativa skedet. Diskussion: Resultatet av litteraturöversikten har diskuterats i relation till sjuksköterskans ansvarsområde. Resultatdiskussionen koncentreras kring praktiska frågor gällande implementering av de icke-farmakologiska metoderna i vården. Jean Watsons teori om mänsklig omsorg utgjorde översiktens teoretiska referensram som hjälpte författaren i resultatdiskussionen. / Background: Research indicates that preoperative anxiety is a widespread problem among patients undergoing surgery. It has been shown in several studies that preoperative anxiety may lead to different postoperative complications. It is the nurse's responsibility to identify and to reduce patients' anxiety. Aim: To describe which non-pharmacological interventions are available to reduce preoperative anxiety in adult patients. Method: The study was designed as a literature review performed according to the Fribergs method. This literature review is based on twelve quantitative articles published between 01/2007 and 09/2017. The search for the articles was conducted in CINAHL Complete database and PubMed database. Results: The result of this review indicates that there are several, different interventions that may be used in addition to pharmacological treatment in order to effectively reduce preoperative anxiety in adult patients. Anxiety in the preoperative phase can be alleviated by providing the patient with information tailored to the individual's needs. Anxiety can also be reduced by providing emotional support or by helping the patient to find comfort in spirituality/religion. The result of this review indicates moreover that the level of anxious can be minimized by listening to soothing music, nature sounds or guided imagery. Relaxation exercises, aromatherapy, acupuncture and reflexology were also found to reduce preoperative anxiety. Only the photographic display was not found to be effective in reducing anxiety in the preoperative phase. Discussion: The result of this review was discussed in relation to the nurse's responsibilities. The discussion of the results was focused on the practical issues about implementation of the non-pharmacological methods in the clinical practice. Jean Watson's Theory of Human Caring was used as a theoretical framework that helped the author in results analysis.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A lot of vegetable species synthesize and accumulate organic substances, such as essential oils, that can be turned in alternative income for rural producers. Pelargonium graveolens L. is a native aromatic species from South Africa, commonly known as geranium. Its essential oil is largely used in perfume, cosmetics and fragrances industries, besides the aromatherapy. The conventional vegetative propagation methods of geranium do not present considerable success, which difficult the production of transplants in large scale. This way it is important to look for alternative production techniques, such as micropropagation, for this commercially important species. The aims of this work were to establish a protocol for micropopagation and acclimatization of geranium, besides investigating of essential oil content and chemical composition. The completely randomized design was used. For the micropropagation assays were tested different concentrations and immersion times of sodium hypochlorite and mercury chloride, different types of explants and MS salts concentrations, besides testing different concentrations of the plant growth regulators BAP, NAA, kinetin and IAA at presence and absence of light. For the acclimatization assay different substrates were tested. To analyze the essential oil we use plants propagated by rooting of cuttings and by micropropagation. Sodium hypochlorite at 1.2% for 12 minutes can be used for disinfestation of geranium explants, as well as mercury chloride at 0.09 and 0.08% for 12 and 14 minutes, respectively. The leaf explant is more effective for geranium micropropagation using MS medium with 39.8% of its salts. BAP and IAA proportionate the best results for in vitro multiplication and regeneration and number of shoots per explant. For acclimatization the substrates vermiculite and weekly addition of solution with salts of MS medium, coconut dust + Biosafra® (3-12-6) (12 g.L-1) + lime stone (1 g.L-1) and coconut dust + Biosafra® (3-12-6) (12 g.L-1) + lime stone (1 g.L-1) + vermiculite (1:1) can be used. There is a difference in geranium essential oil content and chemical composition between plants obtained from rooted cuttings and micropropagation. / Muitas espécies vegetais sintetizam e acumulam substâncias orgânicas, tais como os óleos essenciais, que podem se tornar alternativa de renda para muitos agricultores. O Pelargonium graveolens L. é uma espécie aromática nativa da África do Sul, popularmente conhecida como gerânio. Seu óleo essencial é amplamente empregado em indústrias de perfumes, cosméticos e fragrâncias, além da aromaterapia. Os métodos convencionais de propagação vegetativa do gerânio não apresentam sucesso considerável, o que tem dificultado a produção de mudas em larga escala. Dessa forma, é importante buscar técnicas alternativas de propagação, como a micropropagação, dessa espécie comercialmente importante. Os objetivos do presente trabalho foram estabelecer um protocolo de micropropagação e aclimatização da espécie, além de verificar o teor e a composição química do seu óleo essencial. Foi utilizado o delineamento inteiramente casualizado. Nos ensaios de micropropagação foram testadas diferentes concentrações e tempos de imersão de hipoclorito de sódio e cloreto de mercúrio, diferentes tipos de explantes e concentrações de sais MS, além de testar os reguladores de crescimento BAP, ANA, cinetina e AIA em diferentes concentrações na ausência e presença de luz. Para o ensaio de aclimatização foram testados diferentes substratos. Por fim, para a análise do óleo essencial foram utilizadas plantas propagadas através da estaquia e micropropagadas. O hipoclorito de sódio a 1,2% por 12 minutos pode ser usado na desinfestação dos explantes de gerânio, assim como o cloreto de mercúrio nas concentrações de 0,09 e 0,08% por 12 e 14 minutos, respectivamente. O explante foliar é o mais eficiente para a micropropagação em meio MS com 39,8% dos sais. Para a multiplicação in vitro o uso de BAP e AIA proporciona os melhores resultados para a regeneração e para o número de brotos por explante e na aclimatização pode-se usar os substratos vermiculita com adição semanal de sais MS, pó de coco + Biosafra® (3-12-6) (12 g.L-1) + calcário (1 g.L-1) e pó de coco + Biosafra® (3-12-6) (12 g.L-1) + calcário (1 g.L-1) + vermiculita (1:1). Há diferença no teor e composição química do óleo de gerânio proveniente de plantas propagadas por estaquia e micropropagadas.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The aim of this study was to evaluate the potential anxiolytic effect of sweet orange aroma in healthy volunteers submitted to an anxiogenic situation. For this purpose, forty male volunteers, aged between 18 and 30 years, were allocated to five different groups (n=8) for the inhalation of sweet orange essential oil (test aroma: 2.5, 5 or 10 drops), Melaleuca alternifolia essential oil (control aroma: 2.5 drops) or distilled water (non-aromatic control: 2.5 drops). Immediately after inhalation, each volunteer was submitted to a model of anxiety, the video-monitored version of the Stroop Colour Word Test. Psychological parameters (state-anxiety, subjective tension, tranquilization and sedation) and physiological parameters (heart rate and gastrocnemius electromyogram) were evaluated before the inhalation period and before, during and after the test. The results of the psychological parameters were analyzed by Friedman s ANOVA, for each treatment group, followed by Tukey-type test for post hoc comparisons. The results of the physiological parameters were analyzed using a two-factor analysis of variance (ANOVA) for repeated measures followed by Tukey s test for post hoc comparisons. All significance tests were two-tailed and were performed at the 5% significance level. It s worth calling attention to the fact that the treatment s effect is revealed by the lack of significant alterations in the observed parameters throughout the test. Unlike the control groups, the individuals exposed to the test aroma in the doses of 2.5 drops and 10 drops did not present significant alterations (p > 0.05) in state anxiety, subjective tension and tranquillity levels throughout the anxiogenic situation, revealing an anxiolytic activity of sweet orange essential oil. Physiological alterations along the test were not prevented in any treatment group, as has previously been observed for diazepam. Although more studies are needed to find out the clinical relevance of aromatherapy for anxiety disorders, the present results indicate an acute anxiolytic activity of sweet orange aroma, giving some scientific support to its use as a tranquilizer by aromatherapists. / O presente estudo teve por objetivo avaliar o potencial efeito ansiolítico do aroma de laranja doce (C. sinensis) em voluntários saudáveis submetidos a um modelo experimental de indução de ansiedade. Para tanto, quarenta voluntários do sexo masculino, com idade entre 18 e 30 anos, foram alocados em cinco diferentes grupos (n=8) para inalação do óleo essencial de laranja doce (aroma teste: 2,5, 5 ou 10 gotas), do óleo essencial de Melaleuca alternifolia (controle aromático: 2,5 gotas) ou de água destilada (controle não-aromático: 2,5 gotas). Imediatamente após a inalação, cada voluntário foi submetido à situação ansiogênica do Teste de Stroop Monitorado por Vídeo (TSMV), sendo que antes, durante e depois do TSMV foram realizadas medidas psicológicas (níveis de ansiedade-estado, de tensão subjetiva, de tranquilização e sedação) e fisiológicas (frequência cardíaca e eletromiograma do músculo gastrocnêmio). Todos estes parâmetros também foram avaliados previamente ao tratamento. Os resultados dos parâmetros psicológicos foram analisados por ANOVA de Friedman, para cada grupo de tratamento, seguido de teste a posteriori tipo Tukey. Já os resultados dos parâmetros fisiológicos foram analisados por ANOVA de duas vias para medidas repetidas, seguido de teste a posteriori de Tukey. Ambas as análises estatísticas foram realizadas com nível de significância de 5%. A existência de efeito ansiolítico deveria refletir-se nos resultados na forma de ausência de diferenças significativas entre as situações de teste. Assim sendo, diferentemente dos grupos controles, os grupos tratados com óleo de laranja doce nas doses de 2,5 e 10 gotas não apresentaram alterações significativas (p > 0,05) nos níveis de ansiedadeestado, tensão subjetiva e tranquilização ao longo do TSMV. Já em relação aos parâmetros fisiológicos, este efeito não foi observado, assim como ocorreu com o clássico ansiolítico, diazepam, em estudo anterior. Embora mais estudos sejam necessários para constatar a relevância clínica da aromaterapia no tratamento dos transtornos de ansiedade, os resultados do presente estudo demonstraram um efeito ansiolítico agudo do aroma de laranja doce, trazendo certo apoio científico para sua utilização como tranquilizante pelos aromaterapeutas.

SAMMANFATTNING Bakgrund   Psykisk ohälsa och sömnproblem är stora folkhälsoproblem idag både i Sverige och globalt. Dessa två faktorer har en dubbelriktad verkan där personer med psykisk ohälsa ofta även besväras av sömnproblem. Sömnproblem har negativa konsekvenser både för den psykiska och fysiska hälsan men får trots detta ofta låg prioritet vid behandling av patienter med både psykisk ohälsa och sömnproblem. Syfte  Syftet är att belysa omvårdnadsåtgärder som beskrivs att kunna förbättra sömnen hos personer med psykisk ohälsa.  Metod  En icke-systematisk litteraturöversikt gjordes baserad på 15 stycken vetenskapliga artiklar. Samtliga inkluderade artiklar var av kvantitativ metod. Litteratursökningen genomfördes i databaserna CINAHL och PubMed. Artiklarnas kvalitet granskades med hjälp av Sophiahemmets bedömningsunderlag för vetenskaplig kvalitetsgranskning och klassificering. Sedan gjordes en integrativ dataanalys av artiklarna där de olika datakällorna kombinerades och analyserades som en helhet. Resultat Fyra stycken teman och 12 subteman på sömnfrämjande åtgärder hittades. Teman på sömnfrämjande åtgärder funna i de analyserade artiklarna är KBT, sömnhygien, mindfulness och alternativa metoder såsom aromaterapi och musik. Resultaten visar generellt en positiv effekt av riktad behandling mot sömnproblem och med det ofta även en positiv effekt på den mentala hälsan hos personen.  Slutsats Flertalet alternativ till sömnfrämjande åtgärder med måttligt till god effekt på sömnproblem hittades i resultatet och detta har även ofta en positiv inverkan på personens mentala hälsa. Det finns dock bristande tillgänglighet till denna typ av vård vilket visar på en förbättringspotential. Hur tillgängligheten kan förbättras är ett ämne för vidare studier men våra resultat pekar mot att sjuksköterskor skulle kunna ha en nyckelroll i detta. / ABSTRACT Background Mental health issues and sleep problems are big health issues in society today both in Sweden and globally around the world.  These two factors of mental health issues and sleep problems often correlate. Sleepi problems have a negative impact on both mental and physical health but is despite this not prioritized when treating patients with both mental health issues and sleep problem Aim The aim was to highlight nursing care that can help improve sleep for people with mental health issues.  Method A non-systematic literature review was made based on 15 different articles. All of the included articles used quantitative research methods.  The literature search was made using the databases CINAHL and PubMed. Furthermore, chosen articles were quality reviewed using the Sophiahemmet assessment basis for quality evaluation and classification. After this an integrative data analysis was made of the articles where the different data sets were combined and analyzed as a whole. Results Four themes and 12 sub themes were found with working practices for sleep-improvement. These themes that were found in the analyzed articles were cognitive-behavioural therapy, sleep hygiene, mindfulness and alternative methods such as aromatherapy and music therapy. The results show a positive outcome and improvement for sleep problems when using focused treatment and the results also indicate an improved mental health.  Conclusions There are several different methods available which can give moderate to good impact on sleep problems. When sleep improves in most cases the mental health also improves. All methods are not available in all places and there is a potential for improvement of nursing care for persons with mental health issues and sleep problems.

Émotions et nouvelles technologies apparaissent le plus souvent comme une alliance impossible. Pourtant, ces dernières années, les nouvelles technologies, telles que les capteurs portés et les logiciels de reconnaissance d’activités, ont permis une évaluation plus fine des émotions. A travers cette thèse notre objectif était de développer et de tester divers instruments technologiques permettant l’évaluation et la prise en charge des émotions que ce soit au niveau comportemental, physiologique ou cognitif. Nous avons commencé par faire un état des lieux des nouvelles technologies disponibles pour l’évaluation et la prise en charge des troubles émotionnels. Nous avons ensuite recueilli les recommandations d’experts pour leur utilisation ainsi que l’avis des internes de psychiatrie et des médecins généralistes. Au sein de notre deuxième étude, nous avons développé un test informatisé permettant de mesurer les défauts de ressenti et de régulation des émotions propres aux composantes physiologique et cognitive des émotions. Notre troisième étude a consisté à élaborer une prise en charge des troubles émotionnels dans ces deux composantes par une immersion sensori-virtuelle et à étudier l’effet de cette dernière sur le langage de patients avec et sans troubles cognitifs. Enfin, notre quatrième étude a visé à développer une plateforme automatisée d’évaluation et de prise en charge des troubles émotionnels dans la composante comportementale. Nous avons développé et évalué l’intérêt des algorithmes de reconnaissance d’activité pour leur détection et des solutions non pharmacologiques basées sur l’aromathérapie, la musicothérapie et les serious games pour leur prise en charge. / Emotions and new technologies often sound as an impossible association. However, in recent years, new Information and Communication Technologies (nICT) such as wearable sensors and software for activity recognition have enabled to assess emotions more accurately. This dissertation aimed at developing and testing various nICT-based tools allowing a better assessment and management of emotions, either at the behavioral, physiological or cognitive level. I started with a literature review of the existing nICT for the assessment and management of emotional disorders. I then gathered recommendations for the use of nICT from experts in the field, as well from interns in psychiatry and general practitioners (Study 1). Next, I developed a computerized test to assess impairments in emotional experience and emotion regulation at the physiological and cognitive level (Study 2). Study 3 consisted in developing a tool to manage emotional disorders at the physiological and cognitive level by means of a multisensory, virtual immersion, and assessing the effects of this immersion on the verbal ability of patients with and without cognitive impairment. Finally, in Study 4 I developed an automated platform for the assessment and management of emotional disorders at the behavioral level. In this context, I developed and evaluated the interest of employing activity recognition algorithms for the detection of behavioral emotional disorders, and I evaluated the effects of nonpharmacological solutions based on aromatherapy, music therapy and serious games for the management of these disorders.

El presente proyecto “SAMAY” tiene como objetivo impulsar un modelo de negocio basado en la innovación, permitiendo su escalabilidad a través del tiempo. Actualmente, atravesamos una coyuntura particular, COVID-19, en la que se ha identificado un problema habitual, la alteración de la salud física y emocional en la población. De este modo, se plantea como solución, kits de relajamiento de 5 tipos, diseñados adecuadamente para atender problemas específicos como estrés/ansiedad, problemas de sueño, problemas de concentración, combatir la mala energía y el alivio dolores. Mediante el uso de distintos productos orgánicos que componen cada kit, se logrará la relajación a través de la estimulación de los cinco sentidos, brindando una experiencia completa. Cabe señalar que el público objetivo está conformado por mujeres modernas de 18 años a 55 años, pertenecientes a niveles socioeconómicos A y B que viven en Lima, quienes desean aliviar el estrés o problemas relacionados mediante el uso de productos relajantes y de aromaterapia. El proyecto será promovido mediante diversas estrategias, sin embargo, el mayor enfoque será el e-commerce, dando a conocer la marca a través de las redes sociales y página web. Es necesario mencionar que este proyecto ha sido validado, teniendo en consideración la gran acogida a causa de las diversas ventas de los kits de relajamiento. En suma, las personas que han utilizado el producto han señalado buenas referencias y su satisfacción acerca de este mismo, lo que representa el potencial de crecimiento de este negocio. / The present “SAMAY” project aims to promote a business model based on innovation, allowing its scalability over time. Currently, we are going through a particular situation, COVID-19, in which a common problem has been identified, the alteration of physical and emotional health in the population. Thus, as a solution, relaxation kits of 5 types are proposed, appropriately designed to address specific problems such as stress / anxiety, sleep problems, concentration problems, combat poor energy and pain relief. Using different organic products that make up each kit, relaxation will be achieved through the stimulation of the five senses, providing a complete experience. It should be noted that the target audience is made up of modern women aged 18 to 55, belonging to socioeconomic levels A and B living in Lima, who want to relieve stress or related problems through the use of relaxing and aromatherapy products. The project will be promoted through various strategies; however, the focus will be e-commerce, making the brand known through social networks and website. It is necessary to mention that this project has been validated, taking into consideration the great reception due to the various sales of the relaxation kits. In sum, the people who have used the product have indicated good references and their satisfaction about it, which represents the growth potential of this business. / Trabajo de investigación

Background: Common sleeping problems in the elderly are difficulties falling asleep and waking up several times during the night. Waking up several times during the night means that the important recovery that takes place during deep sleep is absent. Longer stretches of bad sleep negatively affect feelings of hunger and the immune system. Lack of sleep can also lead to memory problems and severe fatigue during the day, which increases the risk of falling and fall injuries. At high age, the body's conditions for distributing drugs change and side effects become more common, which justifies non-pharmacological nursing measures that promote sleep for the elderly. Aim: The aim was to describe nursing measures that promote sleep for the elderly. Method: A literature study. Result: Measures that were shown to promote sleep were aromatherapy, chamomile extract, relaxation exercises, acupressure, hand bath with hand massage, yoga, physical activity and natural daylight. Relaxation exercises should be performed in the evening to give the best effect. Physical activity of the degree recommended by the WHO is sufficient to have an effect on sleep quality. Staying in daylight during the morning proved to be the best time to contribute to a better sleep. Conclusion: Many of the elderly get a better quality of sleep from non-pharmacological nursing measures, and in addition, they do not cause any side effects. This suggests that they should be used by nurses in the care of the elderly with sleeping problems. / Bakgrund: Sömnstörningar kan vara av olika karaktär. De vanligaste sömnproblemen äldre har är svårigheter med att somna och även att de vaknar flera gånger under natten. Att vakna flera gånger under natten leder till att den viktiga återhämtningen som sker under djupsömnen uteblir. Sömnbristen påverkar hungerkänslor och immunförsvar negativt. Sömnbrist kan även leda till minnesbesvär och svår trötthet dagtid, vilket ökar risken för fall och fallskador. Vid hög ålder ändras kroppens förutsättningar att distribuera läkemedel och biverkningar blir vanligare, vilket motiverar icke farmakologiska omvårdnadsåtgärder som främjar sömnen hos äldre. Syfte: Syftet var att beskriva omvårdnadsåtgärder som främjar sömnen hos äldre personer. Metod: Allmän litteraturstudie. Resultat: Åtgärder som visade sig vara sömnfrämjande var aromaterapi, kamomillextrakt, avslappningsövningar, akupressur, handbad med handmassage, yoga, fysisk aktivitet samt dagsljus. Avslappningsövningar ska utföras på kvällen för att ge bäst effekt. Fysisk aktivitet av den grad som WHO rekommenderar är tillräckligt för att ge effekt på sömnen. Vistelse i dagsljus under förmiddagen visade sig vara bäst tidpunkt för att bidra till en bättre sömn. Konklusion: Många av de äldre får en bättre sömn av icke farmakologiska omvårdnadsåtgärder, dessutom ger de inga biverkningar. Detta talar för att de bör användas av sjuksköterskor i vården av äldre med sömnproblem.

SAMMANFATTNING Bakgrund: Brist på sömn och störningsmoment under sömnen har negativa inverkningar på immunförsvar, återhämtningstid, smärta med mera. Trots sömnens betydelse sover patienter signifikant sämre på sjukhus än de gör i hemmet. Kroppen följer en dygnsrytm som varar i ungefär 24 timmar. Ljud, ljus, temperatur och andra stimuli påverkar kroppens dygnsrytm för att anpassa den till omgivningen. En störande omgivning kan ge kroppen falska signaler vilket kan påverka sömnen. Sjuksköterskan behöver därför evidensbaserade interventionsmetoder för att förbättra patienters sömn. Syfte: Att undersöka vilka åtgärder som är effektiva för att förbättra patienters sömnkvalitet och sömnkvantitet på sjukhus. Metod: En litteraturöversikt med 13 kvantitativa studier har sammanställts och analyserats med narrativ metod. Resultat: Tre olika kategorier av interventioner framkom. Minskat stimuli i form av öronproppar och ögonmasker, utbytt stimuli i form av musik och naturljud samt farmakologisk intervention i form av melatonin har alla visats vara effektiva åtgärder då patienter själva har bedömt sin sömnkvalitet och sömnkvantitet. Minskat stimuli genom Quiet time och utbytt stimuli genom aromterapi har inte visat på något statistiskt signifikant resultat. Slutsats: Att stänga ute eller ersätta störande stimuli har genom flera interventionsmetoder visats förbättra patienters självskattade sömnupplevelse. Placeboeffekten går dock inte att utesluta. En sovmeny där patienter själva får välja sömnstödjande åtgärder med evidensbaserade alternativ är fördelaktig och ger en ökad patientdelaktighet. / ABSTRACT Background: Lack of sleep and disturbance during sleep has a negative impact on the immune system, recovery, increased pain etc. Despite the importance of sleep, patients sleep significantly worse in hospitals than they do in their own homes. The body follows a circadian rhythm that lasts approximately 24 hours. Sounds, light, temperature and other stimuli affect the circadian rhythm to synchronize it to its environment. A disturbing environment can give the body false signals that may affect its sleep. The nurse therefore needs evidence-based intervention methods to improve patients sleep. Aim: To examine which interventions are effective in improving patients sleep quality and sleep quantity in hospitals. Method: A review of literature with 13 quantitative studies has been compiled and analyzed with a narrative method. Results: Three different categories were found. Reduced stimuli in form of earplugs and eye masks, replaced stimuli in form of music and nature sounds and pharmacological intervention in form of melatonin have all been shown to be effective when patients’ have self-assessed their own sleep quality and quantity. Reduced stimuli through Quiet time and replaced stimuli through aromatherapy have not shown any statistically significant results. Conclusion: Reducing or replacing disturbing stimuli has shown through several interventions to improve the patients subjective sleep experience. Placebo effect could not be ruled out. A sleep menu containing evidence-based interventions for improving sleep for patients to pick from is a beneficial idea that improves patient participation.

Bakgrund   Sömn är en subjektiv upplevelse och en förutsättning för att kroppen ska må bra och ha möjlighet för återhämtning. Inom slutenvården är det välkänt att patienter inte sover tillräckligt bra. Konsekvenser av sömnbrist kan innebära en fördröjning på kroppens läkningsförmåga. Patientens tillfrisknande riskerar därmed att fördröjas och följden kan bli en längre vårdtid. Att identifiera omvårdnadsåtgärder som främjar sömn av god kvalitet är ett av sjuksköterskans professionella ansvar. Genom en personcentrerad omvårdnad kan tillit mellan vårdgivare och vårdtagare skapas och en individuell vårdplan verkställas för att främja en god sömnkvalitet. Syfte Syftet var att beskriva hur alternativa omvårdnadsåtgärder som främjar sömnkvalitet ur ett patientperspektiv inom slutenvården. Metod Studiens syfte besvarades med hjälp av metoden litteraturöversikt. Data samlades in via databaserna PubMed och CINAHL och studien inkluderade 18 artiklar efter en integrerad dataanalys och kvalitetsgranskning. Artiklarna var av kvalitativ och kvantitativ studiedesign.  Resultat  Sömn av god kvalitet kan implementeras med hjälp av alternativa omvårdnadsåtgärder såsom användning av öronproppar och ögonmasker, aromaterapi, massage med eteriska oljor samt stämningsfylld musik. Studien fann även att bemötande, tillgänglighet och en anpassad miljö skapade trygghetskänslor och ett inre lugn hos inneliggande patienter vilket underlättade sömnen. Slutsats  Studiens resultat belyser tillämpbara alternativa omvårdnadsåtgärder som främjar sömn av god kvalitet inom slutenvården. Personcentrerade omvårdnadsåtgärder kan främja sömnens kvalitet genom att patienterna har möjlighet att komma till ro samt uppleva mindre oro och ångest. / Background Sleep is a subjective experience and a prerequisite for the human body to feel good and have the opportunity for recovery. It is well-known that patients do not sleep well enough in the inpatient care. The consequence of sleep deprivation can be a delay in the body’s healing ability. This may cause the patients' affliction to be prolonged, resulting in a longer period of hospitalization. Identifying alternative nursing measures that promote a better quality sleep is one of the nurses’ professional responsibilities. Through a patient-centered care trust can be built between nurse and patient and an individual care plan can be implemented to promote a better sleep quality for the patient. Aim The aim was to describe alternative nursing measures that promote better sleep quality from the patient perspective during hospitalization. Method The aim of the study was answered through a literature review. Data was collected through PubMed and CINAHL, and after an integrated data analysis and quality control this study included 18 articles. The articles were both qualitative and quantitative. Results A better sleep quality can be implemented using alternative nursing measures such as the use of earplugs and eye masks, aromatherapy, massage with essential oils and mood-filled music. The study also found that a good treatment, availability and a customized environment created a feeling of safety and an inner peace for the patients, which facilitated the sleep. Conclusions The results of this study describe applicable alternative nursing measures that promote a better sleep quality during hospitalization. A patient-centered care can promote sleep quality due to patients being more able to relax and experiencing less anxiety.

Bakgrund: Kronisk njursvikt innebär att njurens funktioner gradvis minskar och blir nedsatta över tid, vilket kräver dialysbehandling i flera omgångar. Några av symtomen som kan uppstå i samband med kronisk njursvikt är bland annat klåda. Uremisk klåda kan besväras av både fysiskt och psykiskt då det bidrar till sår, ökad trötthet, försämrad livskvalitet. Lidande och obehag som orsakade av uremisk klåda kan ytterligare leda till depression och ångest. Det är därför viktigt att sjuksköterskor kan bemöta och hjälpa patienter som lider av uremisk klåda att lindra symtomen. Syfte: Syftet var att beskriva sjuksköterskors omvårdnadsåtgärder för att lindra uremisk klåda vid kronisk njursvikt Metod: Litteraturöversikten med tolv vetenskapliga artiklar. Databaserna PubMed och CINALH complete användes. Artiklarna analyserades med hjälp av Fribergs analysmodell. Resultat: I resultatet framkom fem teman; (1) Aromaterapi, (2) Termisk terapi, (3) Akupressur, (4) Krämer och (5) Övriga metoder. Dessa fem teman har visat vara effektiva för att lindra uremisk klåda. Slutsats: Sammanfattningsvis har aromaterapi, termisk terapi, akupressur, krämer och övriga omvårdnadsåtgärder visat sig verkande lindrande på uremisk klåda. Genom att tillämpa dessa omvårdnadsåtgärder kan det ytterligare bidra till bättre sömnkvalitet samt livskvalitet för patienterna som lider av uremisk klåda. Dessutom är omvårdnadsåtgärder kostnadseffektiva alternativ gentemot medicinska behandlingen. / Background: Chronic kidney failure means that the kidney's functions gradually decrease and become impaired over time, which requires dialysis treatment several rounds. Some of the symptoms that can occur in connection with chronic kidney failure is itching. Uremic itching can be troublesome both physically and psychologically as it contributes to ulcers, increased fatigue and reduced quality of life. Pain and discomfort caused by uremic pruritus can further lead to depression and anxiety. Therefore, it is necessary that nurses can address and help patients that are suffering from uremic pruritus to relieve the symptoms. Aim: The aim was to describe nurses care measure to treat pruritus in patients with chronic kidney failure. Method: The litterature review based on twelve scientific articles. The databases Pubmed and CINALH complete were used. The scientific articles were analyzed using Friberg´s model. Results: The results showed five themes; (1) Aromatherapy, (2) Thermal therapy, (3) Acupressure, (4) Creams and (5) Other methods. These five themes have been shown to be effective in relieving uremic pruritus. Conclusion: In conclusion, aromatherapy, thermal therapy, acupressure, creams and other methods have been shown to be working in treating uremic pruritus. By applying these nursing interventions can it further contribute to better quality of sleep and quality of life for patients that are suffering from uremic pruritus. Furthermore, are nursing interventions cost-effective alternatives to medical treatment.