Bakgrund: Andelen äldre personer ökar i världen från år till år. Vi kan räkna med att behovet av vård från allt fler äldre också ökar i Sverige. Ju äldre populationen blir ju större risk att få olika hälsoproblem. Det är därför av vikt att förstå den problematik som äldre har och behovet av nutrition. Nutritionen är av stor vikt för livskvalitet och välmående och lika viktig som någon annan medicinsk behandling. Undernäring skapar stora problem för individen och för sjukvården. Syftet med denna studie är att beskriva sjuksköterskors erfarenheter av vad som påverkar nutritionen vid vård av äldre inom slutenvården. Metod: Studien är en kvalitativ intervjustudie med induktiv ansats. Intervjudata analyserades med hjälp av kvalitativ innehållsanalys. Resultatet visar att det finns fyra aspekter som påverkar nutritionen inom slutenvården - sjukdomstillstånd och behandling har betydelse för nutritionen, miljön har betydelse för nutritionen, ansvarsfördelning och arbetssituation samt utbildning och klinisk erfarenhet. Konklusion: Studien indikerade att nutritionsproblematiken grundade sig i en resursfråga. Sjuksköterskorna uppgav att problematiken hade kunnat lösas via anställning av mer personal för att därmed underlätta den enskildes arbetsbörda. Många av de tillfrågade sjuksköterskorna uppgav att de ofta känner sig nödsakade att prioritera bort nutritionen för att hinna med sina övriga arbetsuppgifter. Vidare uppgav många av dem att de upplever sina nutritionskunskaper som bristfälliga tillsammans med en önskan om mer utbildning i ämnet som de anser vara av vikt. / Background: The proportion of older people is increasing each year worldwide. We can expect the need of care from a growing number as well in Sweden. The older the population gets, the greater the risk of various health problems. It is therefore important to understand the problems that older people have and the need for nutrition. The nutrition is of great importance to the quality of life and well-being, and as important as any other medical treatment. Malnutrition causes major problems for the individual and for health care. The aim of this study is to describe nurses' experiences of what affects the nutrition in the care of older people in inpatient care. Method: A qualitative empirical study with an inductive approach. Interview data were analyzed using qualitative content analysis. Results: The result shows that there are four aspects that affect the nutrition in inpatient care - health status and treatment are important for the nutrition, the environment affects the nutrition, responsibility and working conditions, education and clinical experience. Conclusion: The study indicated that the nutrition problem is based on a resource issue. The nurses narrated that the problem could have been solved by hiring more staff and thereby facilitate the individual's workload. Many of the surveyed nurses said that they often felt compelled to prioritize away the nutrition to keep up with their other duties. Furthermore, many of them felt that their nutrition knowledge flawed along with a desire for more education in the subject they deem important.

Bakgrund: När det konstaterats att livsförlängande behandling inte längre är meningsfullt övergår vårdandet till den senare fasen, livets slutskede. Livets slutskede innebär att döden är ofrånkomlig inom en snar framtid och målet med behandling är då att lindra lidande. God palliativ vård bygger på de fyra hörnstenarna symtomlindring, multiprofessionellt samarbete, relation och kommunikation samt stöd till närstående. Tillsammans med ett personcentrerat förhållningssätt kan de fyra hörnstenarna tillämpas av all vårdpersonal i syfte att tillföra patienter ett förbättrat välmående och ökad livskvalitet i livets slut. Syfte: Syftet med denna litteraturöversikt var att beskriva hur patienter som befinner sig i livets slutskede upplever omvårdnaden på sjukhus. Metod: Vald design till uppsatsen var litteraturöversikt och 15 vetenskapliga artiklar ligger till grund för resultatet. Vid artikelsökningen användes databaserna Public Medline [PubMed] och Cumulative Index to Nursing and Allied Health Literature [CINAHL Complete]. Resultatet sammanställdes genom en integrerad analys. Resultat: Resultatet delades upp i huvudkategorier som beskrev patienters upplevelse av sjukhusmiljön, mötet med sjuksköterskan, symtomlindring samt existentiella behov. Tillsammans med underkategorier visar resultatet att patienter som befann sig i livets slutskede över lag var nöjda även om brister kunde pekas ut. De brister som fanns handlade om hur patienter upplevde sjukhusmiljön där exempelvis flerbäddssalar påverkade livskvaliteten på ett negativt sätt. Patienter beskrev även hur sjukvårdspersonal på sjukhuset upplevdes som stressade och oengagerade vilket bidrog till att patienterna kände sig som en belastning. Slutsats: Kunskap om palliativ omvårdnad på sjukhus till de patienter som befinner sig i livets slutskede är, baserat på resultatet i denna uppsats, ett viktigt ämne att belysa. Med en ökad medellivslängd samt ny forskning och teknik för livsuppehållande åtgärder kommer behovet av palliativ omvårdnad efterfrågas i allt större utsträckning. Brist på kunskapen att förmedla god omvårdnad till människor i livets slutskede medför ett försämrat välmående och nedsatt livskvalitet för patienter i det sena palliativa skedet. / Background: When it has been established that life-prolonging treatment is no longer meaningful, care goes to the latter phase, the final stage of life. The final stage of life means that death is inevitable in the near future and the goal of treatment is to alleviate the suffering. Good palliative care is based on the four cornerstones of symptom relief, multi-professional collaboration, relationship and communication, and support for close relatives. Together with a person-centered approach, the four cornerstones can be applied by all health care professionals with the aim of providing patients with improved well-being and improved quality of life at the final stage. Aim: The purpose of this literature review was to describe how patients who are at the final stage of life experience nursing care in hospitals. Method: The chosen design for the essay was a literature review and 15 scientific articles which form the basis for the result. In the article search, the databases Public Medline [PubMed] and the Cumulative Index to Nursing and Allied Health Literature [CINAHL Complete] were used. The result was compiled by an integrated analysis. Results: The results were divided into main categories that described the patients' experience of the hospital environment, the meeting with the nurse, symptom relief, and existential needs. Together with the subcategories, the results show that the patients who were in the final stages of life were generally satisfied, although deficiencies could be identified. The shortcomings that could be pointed out were about how the patients experienced the hospital environment where, for example, multi-bed rooms negatively affected their quality of life. The patients also described how they experienced the hospital staff being stressed and disengaged, which contributed to the patient feeling like a burden. Conclusions: Knowledge about palliative care in hospitals for patients at the final stage of life is, based on the results of this paper, an important topic to elucidate. With an increased life expectancy as well as new research and technology for life-sustaining measures, the need for palliative care will be increasingly demanded. Lack of knowledge to convey good care to people at the final stage of life results in impaired well-being and reduced quality of life for patients who are in the late palliative stage.

Bakgrund  Sömn är ett grundläggande behov hos människan då det utgör en viktig del av den fysiska och psykiska återhämtningen. En bristande sömn har visat sig kunna ge en rad olika följder, kortsiktiga såväl som långsiktiga. Bland annat kan immunförsvaret påverkas negativt av otillräcklig sömn. Intag av alkohol, nikotin och koffein samt brist på motion är exempel på faktorer som kan försämra förutsättningarna för god sömn. Forskning har visat att patienters sömn kan påverkas av att vara inlagd på sjukhus. Syfte Syftet med litteraturöversikten var att beskriva patienters upplevelser av sömn på sjukhus. Metod Detta arbete är utformat som en icke-systematisk litteraturöversikt. Översikten grundades på 17 vetenskapliga originalartiklar, som alla inhämtats via databaserna PubMed och CINAHL. Både artiklar utförda med kvalitativ- och kvantitativ metod inkluderades. Samtliga artiklar genomgick en kvalitetsgranskning och endast artiklar som bedömdes ha hög- och medelhög kvalitet inkluderades. Materialet analyserades utifrån en integrerad analys och sorterades med hjälp av färgkodning. Resultatet av litteraturöversiktenredovisades utifrån fyra huvudkategorier med tillhörande subkategorier, som alla identifierades under dataanalysprocessen.  Resultat Resultatet visade att patienters upplevelser av sömn på sjukhus var varierande. Patienter upplevde generellt att sömnen påverkades av sjukhusvistelsen och i många fall uppgavs en störd och försämrad sömn. Bland annat påverkades sömnen av faktorer i vårdmiljön samt av olika psykologiska- och fysiologiska faktorer. Olika ljud, nattliga omvårdnadsåtgärder och stark smärta var tre huvudsakliga faktorer som upplevdes påverka sömnen negativt. Slutsats Denna litteraturstudie visade att sjuksköterskan och annan vårdpersonal utgjorde en central del av de faktorer som patienter framförallt upplevde som sömnstörande. Genom att sjuksköterskan tar del av patienters upplevelser, kan insikt ges kring vilka sömnfrämjande åtgärder som potentiellt kan behöva vidtas för att i förlängningen öka patientens välmående och hälsa. Sjuksköterskan har sammanfattningsvis potential att förbättra patienters möjlighet till god sömn på sjukhus. / Background Sleep is a basic human need as it is an important part of the physical and mental recovery. A lack of sleep has been shown to have a number of different consequences, in short-term as well as long-term. Among other things, the immune system can be affected by insufficient sleep. Consumption of alcohol, nicotine and caffeine as well as lack of exercise are examples of factors that can impair the conditions for good sleep. Research has shown that patients' sleep can be affected by being hospitalized. Aim The aim of this literature review was to describe patients' experiences of sleep in hospitals. Method This study is designed as a non-systematic literature review. The study was based on 17 original scientific articles, all obtained from the databases PubMed and CINAHL. Both articles made with qualitative and quantitative methods were included. All articles underwent a quality review and only articles that were judged to be of high and medium quality were included. The material was analyzed based on an integrated analysis and sorted into categories using color coding. The results of this literature review were presented using four main categories with associated subcategories, all of which were identified during the data analysis process. Results The results showed that patients' experiences of sleep in hospital were varied. Patients generally experienced that sleep was affected by hospitalization and in many cases a disturbed and impaired sleep was reported. Among other things, sleep was affected by factors in the care environment as well as by various psychological and physiological factors. Different sounds, nocturnal nursing care and strong pain were three main factors that were perceived to affect sleep negatively. Conclusions This literature review showed that the nurse and other healthcare staff were a central part of the factors that patients mainly experienced as sleep disruptive. By taking part in patients' experiences, the nurse can be aware of what sleep promotion measures may potentially need to be taken to increase the patient's well-being and health in the long run. In summary, the nurse has the potential to improve patients' chances of good sleep in hospitals.

No description available.

Exposure to abuse, neglect, and familial dysfunction in childhood is connected to long-term negative effects on mental and physical health in adulthood. Current research of adverse childhood experience is overwhelmingly focused on community samples. Those populations that tend to experience a greater number of adversities (e.g., high-risk forensic populations) are largely overlooked. Studies investigating differential risk factors and outcomes among those in high-risk populations could indicate environmental 2015 Appalachian Student Research Forum Page 107 responsiveness to experiences of abuse, neglect, and household dysfunction in early development. A pilot study was conducted to investigate the prevalence and severity of childhood trauma, maltreatment, and familial dysfunction using the Adverse Childhood Experience (ACE) survey in a sample of forensic mental health offenders. Participants were randomly selected forensic inpatients (n = 185) from a maximum- and intermediate-security psychiatric facility. The sample is predominantly male (81.0%) and majority Caucasian (56.0%), African American (40.0%), and Hispanic (2.0%) with a mean age of 42.5 (SD=13.2). Approximately 29.0% of the current forensic sample has experienced 4 or more adversities in childhood (e.g., intrafamilial sexual abuse). This is a significantly higher percentage compared to the Center for Disease Control community norms of 12.5% indicating that a greater number of childhood adversities were experienced by the current sample of forensic mental health inpatients than in the general population. Additionally, significant percentages of diagnosed mental health disorders have been revealed. Diagnosed mental disorders in the current sample include, but are not limited to: psychotic disorders (59.0%), intellectual disability or cognitive developmental disorders (57.3%), mood disorders (45.0%), impulse disorders (22.2%), and post-traumatic stress disorder (13.0%). Comprehension of type, severity, and length of exposure to adversities, environmental responsiveness to abuse, maltreatment and familial dysfunction, and the onset and severity of mental and behavioral health outcomes are needed to better inform treatment, intervention, and rehabilitation of forensic psychiatric inpatient populations.

Sömnen har vitala effekter på hjärnfunktion såväl som många andra av människans kroppsorgan. Av denna anledning så kan sömnbrist orsaka och leda till allvarliga fysiologiska konsekvenser. Studier visar att patienters sömn, dess varaktighet och kvalitet äventyras vid sjukhusinläggningar. För att minska denna risk är det viktigt att sjuksköterskan har goda kunskaper om sömn. Detta möjliggör för sjukvårdspersonal att kunna vidta viktiga åtgärder i de fall där patientens sömnmönster rubbas. / Sleep has vital effects on brain functions as well as many other of the human organs. For this reason, sleep deprivation can cause and lead to serious physiological consequences. Studies show that patients sleep, and its continuity and quality is placed at risk when being hospitalized. To reduce this risk, it is important for nurses to have a basic knowledge about sleep. This enables healthcare professionals to be able to take important actions in cases where patients sleep patterns are disturbed.

Introduction: People with Parkinson's disease require individualised medication regimens to achieve symptomatic control whilst managing complications of the treatments and the underlying disease. Patients should continue to receive their individualised regimen when they are admitted to hospital but studies have highlighted that this may not happen. There is a paucity of research about patients' perceptions of the management of anti-parkinsonian medicines during a hospital admission and the aim of this study was to explore the perceptions of Parkinson's disease patients admitted to Leeds Teaching Hospitals about the management of their anti-parkinsonian medications.Method: Grounded theory methodology was used to allow detailed exploration of patients' perceptions and to generate theory about this under-researched area. Face to face, semi-structured interviews were conducted with 13 Parkinson's disease patients during their hospital admission, fully transcribed and analysed using the constant comparative approach. Results: Categories contributing to the core category of 'patient anxiety' were identified as 'maintaining usual medication routine', 'access to anti-parkinsonian medications', 'accuracy and consistency', 'trust in healthcare professionals' and 'staff knowledge about Parkinson's disease'. Strategies used to manage the anxiety were related to the categories 'utilising expertise' in Parkinson's disease and 'patient involvement' in their care. Discussion: The theory suggests that some patients have negative perceptions about the management of their medicines during a hospital admission. Areas for practice development are presented along with areas for future research. Conclusion: This study provides new insight into the perceptions of patients with Parkinson's disease about the management of their medicines during a hospital admission.

Background: The etiology of pulmonary disease is complex and influenced by various factors, resulting in a significant public health issue, with 16 million Americans living with chronic obstructive pulmonary disease (COPD) and 24 million with asthma, and cases are on the rise. The purpose of this study was to explore demographic, health status, and lifestyle behaviors with pulmonary disease so patterns of risk can be understood and inform interventions. Methods: This cross-sectional study utilized the National Inpatient Sample Data from 2019 (NIS 2019). The predictor variables consisted of: demographics (age (18+), sex, race), health status (obesity, depression, diabetes), lifestyle behaviors (smoking, alcohol use, and aspirin use), and the outcome variable was pulmonary disease. To ensure accuracy, the data was weighted by the variable discharge weight (DISCWT), and chi-square analyses and ANOVA tests were conducted to determine the independence of categorical and numerical predictor variables. Descriptive statistics were conducted for all variables, simple and multiple logistic regression analyses were performed to identify factors that contribute to the likelihood of having pulmonary disease. Results: The sample of the NIS 2019 data included 6,043,654 cases of which, 22.65% of inpatients had pulmonary disease. The collective sample demographic characteristics were: mean age of 58.4 years, and more than half of inpatients were females (57.05% compared to 42.95% males). In terms of health, 17.75% of the sample were obese, 28.8% had diabetes, and 14.25% were depressed. Within the collective sample, 16.8% of inpatients reported smoking, 9.09% drank alcohol, and 14.51% consumed aspirin (long-term (current) use of aspirin). Results of the multivariate statistical analyses reveal that individuals who were obese were 68.3% more likely to have pulmonary disease compared to non-obese patients (aOR = 1.683, CI 1.679-1.686, pConclusion: Results of our study provide important insights between pulmonary disease and associated risk patterns. As pulmonary symptoms have risen in the wake of the COVID-19 pandemic, there is an urgent public health need to explore disruption of risk pathways to avoid overwhelming fragile global healthcare systems.

No description available.

Introduction: People with Parkinson's disease require individualised medication regimens to achieve symptomatic control whilst managing complications of the treatments and the underlying disease. Patients should continue to receive their individualised regimen when they are admitted to hospital but studies have highlighted that this may not happen. There is a paucity of research about patients' perceptions of the management of antiparkinsonian medicines during a hospital admission and the aim of this study was to explore the perceptions of Parkinson's disease patients admitted to Leeds Teaching Hospitals about the management of their antiparkinsonian medications.Method: Grounded theory methodology was used to allow detailed exploration of patients' perceptions and to generate theory about this under-researched area. Face to face, semi-structured interviews were conducted with 13 Parkinson's disease patients during their hospital admission, fully transcribed and analysed using the constant comparative approach. Results: Categories contributing to the core category of 'patient anxiety' were identified as 'maintaining usual medication routine', 'access to antiparkinsonian medications', 'accuracy and consistency', 'trust in healthcare professionals' and 'staff knowledge about Parkinson's disease'. Strategies used to manage the anxiety were related to the categories 'utilising expertise' in Parkinson's disease and 'patient involvement' in their care. Discussion: The theory suggests that some patients have negative perceptions about the management of their medicines during a hospital admission. Areas for practice development are presented along with areas for future research. Conclusion: This study provides new insight into the perceptions of patients with Parkinson's disease about the management of their medicines during a hospital admission.