En av de vanligaste biverkningarna som patienter med cancer får är cancerrelaterad fatigue (CRF). Symtomen på CRF kan vara trötthet, oro och utanförskap. Syftet med litteraturöversikten var att belysa hur patienter upplevde CRF. Litteraturöversikten är baserad på tio kvalitativa artiklar och för att hitta dessa artiklar användes databaserna Cinahl och PubMed. Studierna analyserades utifrån en femstegsmodell som resulterade i fyra huvudkategorier: Att känna sig helt utmattad, Att uppleva en inre kamp, Att inte känna igen sig själv och Att förlora sin plats i livet. Många av patienterna i studierna beskrev en känsla av kroppslig utmattning, minskad fysisk förmåga samt daglig trötthet, vilket ledde till att de inte hade någon energi kvar. Det blev viktigt att lära sig uppfatta och tolka kroppens signaler och passa på att göra saker de stunder som patienterna hade energi. När de inte orkade utföra dagliga aktiviteter bidrog det till utanförskap och att de blev beroende av andra. Patienterna upplevde också en inre stress och oro. Slutsatserna är att CRF är det mest nedslående symtomet vid cancer och för med sig konsekvenser för hela livet. Det behövs mer utbildning inom vården för att kunna tillgodose patienternas behov. / One of the most common side effects that cancer patients experience is cancer-related fatigue (CRF). The symptoms of CRF may be tierdness, anxiety and alienation. The aim of the literature review was to illustrate how patients experienced CRF. The literature review is based on ten qualitative articles and to found these articles the databases Cinahl and PubMed were used. Studies were analyzed by a five-stage model that resulted in four main categories: To feel completely exhausted, To experience an inner struggle, To not recognize yourself and To lose your place in life. Many of the patients in the studies described a feeling of physical exhaustion, reduced physical ability and daily tierdness which led to that they had no energy left. It was important to learn how to perceive and interpret the body's signals and take the opportunity to do things the moments that patients had energy. When they could not manage to perform daily activities it contributed to alienation and they became dependent on others. Patients also experienced an internal stress and anxiety. The conclusions are that CRF is the most depressing symptom of cancer and cause consequences for life. More education is needed in health care to meet patients' needs.

Bakgrund: Kroniska bensår definieras som sår som sitter på underbenen och/eller fötterna och läker väldigt långsamt. I Sverige lider ca 50 000 personer av bensår och det är främst äldre som drabbas. Vanligaste orsaken till bensår är cirkulatoriska rubbningar som arteriell rubbning och venös insufficiens. Syfte: Syftet med denna uppsats var att beskriva patienters upplevelser av att leva med bensår. Metod: Sökning och sammanställning av tidigare forskning. Resultat: Patienterna upplevde bland annat svårigheter med att utöva fysisk aktivitet och ville ha mer stöd från sjukvårdspersonal. Patienterna upplevde att lukt och vätska från såren försvårade umgänge med andra och orsakade skamkänsla och oro. Smärta var ett stort problem och en ständig påminnelse om bensåren. Relationen till sjuksköterskan och upplevelsen av omvårdnaden kändes ibland otillräcklig och patienten önskade större förståelse. Diskussion: I mötet med en patient som lider av en kronisk sjukdom är det viktigt att sjuksköterskan förstår hur patienten hanterar sin diagnos. Mer information och stöd från sjuksköterskan kan göra skillnad i patienternas copingstrategier. Slutsats: Resultatet visar tydligt att patienter med venösa bensår upplever stort lidande och att det som patienterna upplever vara jobbigast med bensåren är smärtan och de förändringar som de måste genomgå på grund av sjukdomen. Effektivisering av vården kan minska risken för nedstämdhet, öka chanserna för bättre följsamhet samt öka livskvaliteten. / Background: Chronic leg ulcers are defined as ulcers located on the lower legs and/or the feet and heal very slowly. In Sweden approximately 50 000 people suffer from leg ulcers and it is mainly elderly people who suffers. Most common cause of ulcers is circulatory disorders like arterial and venous insufficiency disorder. Aim: The aim of this study was to describe patients’ experiences of living with a leg ulcer. Method: Search and compilation of previous research. Results: Patients experienced particular difficulties in physical activity and wanted more support from health professionals. Patients experienced that the smell and exudate from the wounds complicated relations with others and caused a feeling of shame and anxiety. Pain was a major problem and a constant reminder of the leg ulcers. The relationship with the nurses and their knowledge felt sometimes inadequate and the patient desired a greater understanding. Discussion: In the meeting with a patient suffering from a chronic illness, it is important that nurses understand how patients manage their diagnosis. More information and support from the nurse can make a difference in how patients cope with their illness. Conclusion: The results clearly show that patients with venous leg ulcers experience great suffering and that what patients perceive to be hardest with having leg ulcers is the pain and the changes they must undergo because of the disease. Efficiency care can reduce the risk of depression, increase the chances of better compliance and increase quality of life.

Syfte: Sammanställa och granska studier gällande postoperativ behandling vid ruptur av ligament patella. Detta för att beskriva effekt och kvalitet på studier om postoperativ behandling. Metod: En beskrivande litteraturstudie valdes som design, med sökorden: patellar ligament, patellar tendon, rupture, knee injuries, surgery. Av totalt 1240 träffar valdes 13 relevanta artiklar publicerade mellan 1999-2013 efter sökningar i databaserna PubMed, PEDro, COCHRANE, SCOPUS, CINAHL, SPORTDiscus och AMED. Artiklarna kvalitetsgranskades enligt PEDro scale. Resultat: Två postoperativa behandlingar beskrevs, tidig och sen mobilisering. Antingen placeras knäleden i ett stabiliserande knäskydd som till en början låser knäleden i full extension eller så påbörjas tidig mobilisering av den opererade knäleden. Ingen signifikant skillnad påvisades mellan tidig och sen mobilisering vad gäller effekten på muskelstyrka, rörelseomfång och återgång till tidigare aktivitetsnivå. Vidare var kvaliteten på de granskade artiklarna genomgående låg (PEDro scale ≤ 5). Konklusion: Ytterligare forskning krävs för att fastställa vilken postoperativ behandling som ger bäst effekt. / Objective: Summarize and examine studies regarding postoperative treatment following rupture of the patellar ligament. Further the aim was to evaluate the effect of the postoperative treatment and the quality of the studies. Method: As design, a descriptive review was chosen, keywords: patellar ligament, patellar tendon, rupture, knee injuries, surgery. From a total of 1240 items, 13 relevant articles published 1999-2013 were selected after search in the databases PubMed, PEDro, COCHRANE, SCOPUS, CINAHL, SPORTDiscus and AMED. The articles were quality-graded according to PEDro scale. Results: Two postoperative treatments were described, early and delayed mobilization. There was no significant difference between them regarding the effect on muscle strength, range of motion and return to preinjury level of activity. The quality-graded articles had overall low quality (PEDro scale ≤ 5). Conclusion: Further researches are required to determine which postoperative treatment has the best effect.

Bakgrund: Missfall är en vanlig komplikation till graviditet. Upplevelsen är individuell och kan innebära ett behov av stöd. Det finns olika typer av stöd, emotionellt och kognitivt stöd. I Sverige är det vanligt att kvinnor som fått missfall blir inlagda på en gynekologisk avdelning vilket gör att sjuksköterskan möter dessa kvinnor. Syfte: Syftet var att beskriva kvinnors behov av stöd från sjuksköterskan vid missfall. Metod: En litteraturstudie innehållande tio kvalitativa och kvantitativa vetenskapliga originalartiklar gjordes. Artiklar söktes i databaserna Cinahl, PubMed och PsychInfo, därefter kvalitetsgranskades och analyserades de. Resultat: Ur analysen framkom det att kvinnor som vårdats för missfall hade behov av både emotionellt och kognitivt stöd. Några kvinnor fick behovet av stöd tillgodosett, andra var missnöjda med stödet. Slutsats: Sjuksköterskan bör se till att kvinnan känner sig sedd och förstådd i sin situation och vara medveten om att kvinnor upplever missfallet på olika sätt Därför kan stödet som kvinnorna behöver och efterfrågar vara olika. Sjuksköterskan bör bemöta med empati, detta för att kvinnan ska känna sig optimalt stöttad och återhämta sig bättre. / Background: Miscarriage is a common complication of pregnancy. The experience is individual and may imply a need for support. There are different types of support, emotional and cognitive support. In Sweden it is common that women who have had a miscarriage are admitted to a gynaecological ward which means that the nurse meets these women. Aim: The aim was to describe women's need of support from the nurse at miscarriage. Method: A literature review was made and was based on ten qualitative and quantitative original scientific articles. Articles were searched in the databases Cinahl, PubMed and PsychInfo. The articles were reviewed for quality and analyzed. Results: From the analysis it was found that women who received treatment for miscarriage had need of both emotional and cognitive support. Some women were satisfied with the support that was given to them others were dissatisfied with the support. Conclusion: Nurses should ensure that women feel seen and understood in their situation, and be aware that women experience miscarriage differently. Therefore, the support that women need and demand may vary. The nurse should respond with empathy, in order that the woman will feel optimally supported and recover better.

No description available.

Many patient-level barriers to more effective post-fracture osteoporosis (OP) management are associated with patients’ perceptions of their bone health and the link between their fracture and OP. These barriers could be addressed by interventions which account for the role of patients’ perceptions, such as those based on theories of behaviour change. This thesis had two objectives: to review the literature and determine whether these theories have been integrated in post-fracture OP management and to examine patients’ awareness of the OP-fracture link. The results showed that theories of behaviour change have not been integrated into post-fracture interventions, that most patients do not perceive the OP-fracture link even after a baseline intervention and that two baseline factors predict who is less likely to make the OP-fracture link at follow up. Based on these findings, modifications to current OP interventions were proposed and guidance that could help create new, patient-centered interventions was provided.

Many patient-level barriers to more effective post-fracture osteoporosis (OP) management are associated with patients’ perceptions of their bone health and the link between their fracture and OP. These barriers could be addressed by interventions which account for the role of patients’ perceptions, such as those based on theories of behaviour change. This thesis had two objectives: to review the literature and determine whether these theories have been integrated in post-fracture OP management and to examine patients’ awareness of the OP-fracture link. The results showed that theories of behaviour change have not been integrated into post-fracture interventions, that most patients do not perceive the OP-fracture link even after a baseline intervention and that two baseline factors predict who is less likely to make the OP-fracture link at follow up. Based on these findings, modifications to current OP interventions were proposed and guidance that could help create new, patient-centered interventions was provided.

Bakgrund: Varje år insjuknar ungefär 7000 personer i bröstcancer i Sverige, vilket innebär att 15-20 kvinnor om dagen får en bröstcancerdiagnos och att var tionde kvinna utvecklar bröstcancer under sin livstid. Mötena mellan dessa kvinnor och sjuksköterskan blir viktiga för upplevelsen av hela sjukdomsförloppet. Syfte: Syftet var att belysa hur kvinnor som lever med bröstcancer upplever mötet med sjuksköterskan. Metod: Studien var en allmän litteraturstudie som baserades på ett systematiskt urval av vetenskapliga artiklar, där elva artiklar har kvalitetsgranskats och analyserat. Resultat: Resultatet visade att bröstcancerdrabbade kvinnor upplevde trygghet, stöd och att de blev sedda, vilket kategoriserades som vårdande möten. De kunde även uppleva otrygghet, bristande stöd samt att de inte blev sedda. Detta benämndes icke-vårdande möten. Diskussion: Vikten av reflektion i det dagliga arbetet för att få till de vårdande mötena med patienten diskuterades. Även vikten av att tydliggöra sjuksköterskans ansvarsområden i utbildningen lyftes fram. Slutsats: Det finns ett fortsatt behov av att sprida kunskapen om kvinnors upplevelser av mötet med sjuksköterskan. Den förståelse för patientens situation som studien ger bör appliceras på alla patienter oavsett sjukdom, vilket kan leda till vårdande möten i alla vårdsituationer. / Background: Each year approximately 7000 people is diagnosed with breast cancer in Sweden, which means that 15-20 women a day get a breast cancer diagnosis and that one out of ten women develop breast cancer during their lifetime. The meetings between these women and the nurse will be important for the experience of the entire course of the disease. Aim: The aim was to highlight how women with breast cancer experience the meeting with the nurse. Method: The study was a literature review that was based on a systematic selection of scholarly articles, in which eleven articles have been quality reviewed and analyzed. Results: The results showed that women with breast cancer experienced security, support and being seen, which was categorized as caring encounters. The women also experienced insecurity, not being supported and not being seen. This was categorized as uncaring encounters. Discussion: The importance of reflection on a daily basis to get to the caring encounters with the patient was discussed. The importance of clarifying the responsibilities of the nurse in the education was also highlighted. Conclusion: There is a further need to raise awareness of women's experiences of the meeting with the nurse. The understanding of the patient's situation that this study gives should be applied to all patients regardless of disease, which can lead to caring encounters in all care settings.

Bakgrund: Idag beräknas minst 40 miljoner människor leva med den kroniska sjukdomen HIV. När HIV blev känt under 80-talet ansåg många att det endast var homosexuella eller personer som levde ett promiskuöst liv som smittades vilket gjorde att de smittade behandlades illa och frystes ut från samhället. Kunskapen inom området har ökat sedan dess, dock lever stigmatiseringen i samhället och inom vården kvar. Syfte: Att belysa hur personer med HIV upplever stigmatisering. Metod: Studien som gjorts är en allmän litteraturstudie baserad på 15 vetenskapliga artiklar. Resultat: Artiklarna analyserades och det framkom att personer med HIV upplever stigmatisering på flera sätt. Resultatet delades in i tre kategorier: Oro och rädsla inför att bli utsatt för stigmatisering, Diskriminering, utanförskap och befrielse samt Strategier för att kunna hantera stigmatiseringen. Diskussion: Stigmatisering i vårdrelaterade situationer leder till lidande hos personer som är HIV-smittade. Stigman bidrar även till att personerna med HIV får en djupare insikt i vad som är betydelsefullt i livet. Som sjuksköterska är det viktigt att känna till hur stigman inom vården upplevs samt vilka positiva effekter den kan ge, för att kunna utföra optimal omvårdnad. / Background: Today an estimated 40 million people are living with the chronic disease HIV. When HIV became known in the 80’s people thought that it was only homosexuals or people who lived a promiscuous lifestyle that were at risk of infection. As a result the infected were treated badly and became outcasts of society. Knowledge in this area has increased since then, however stigma in the community and in health care still remains. Aim: To illuminate how persons with HIV experience stigma. Method: The study is based on 15 qualitative, scientific articles. Results: The articles were analyzed and it was found that persons with HIV experience stigma in many ways. The findings resulted in three categories: Fear and anxiety about being exposed to stigma, Discrimination, exclusion and exemption and Strategies for managing stigma. Discussion: Stigma in health-related situations leads to suffering among persons with HIV infection. Stigma also makes them get a deeper insight into what is important in life. As a nurse it is important to know how people perceive stigma in health care, and that there might be a beneficial effect, in order to perform optimal care.

Children’s risk for overweight and obesity is particularly high in rural areas of the United States. Many health, psychosocial, and economic consequences are associated with childhood overweight and obesity, which concerns health researchers and professionals. But how and why might rural children be more at risk for being overweight and obese? This dissertation investigates childhood overweight and obesity in rural settings through three separate studies. First, a systematic literature review was conducted to identify determinants and mechanisms of childhood obesity-related behaviors that are specific to rural locations. The findings from the review show that lack of health resources and poverty within the rural environment may impact children’s social environment and individual factors. However, results are inconclusive and there continues to be a lack of studies focusing on linking environmental influence with individual factors. Second, a meta-analysis of current research evidence was conducted to assess the efficacy of rural interventions designed to reduce childhood overweight and obesity. Results showed that interventions have been efficacious yet modest, with a mean effect size of 0.18. Moderating variables were also examined. Mean intervention effect size was moderated by children’s age and intervention duration. Last, secondary data were used to examine the association between rural food stores and availability and affordability of fresh fruits and vegetables. A multilevel analytical approach was used to determine if rural location was associated with availability and affordability of fresh fruits and vegetables. After controlling for other variables, results showed that rural location was not associated with fruit and vegetable availability and affordability. The findings from this dissertation suggest that the area of rural childhood overweight and obesity remains understudied. More research is needed in order to understand the mechanisms of social ecological influences on diet, physical activity, and childhood overweight and obesity. This area of research, however, is rife with opportunities for public health education and promotion. Public health educators can help promote and advocate for environmental conditions that support healthy lifestyles.