Bakgrund: Hjärtsvikt drabbar många personer såväl i Sverige som internationellt. Information är grundläggande för hantering av sjukdomen samt för att förebygga negativa följder. Som teoretisk utgångspunkt användes KASAM, känslan av sammanhang. Syfte: Att beskriva hjärtsviktspatienters erfarenheter av information. Metod: En litteraturöversikt med tolv kvalitativa artiklar har gjorts. Artiklarna har analyserats med Fribergs femstegsmodell. Resultat: I litteraturöversiktens resultat framkommer två teman, "Tillfredsställelse med information" samt "Former för information". Hjärtsviktspatienter hade skilda erfarenheter gällande information. Vissa patienter hade upplevt att informationen var tillfredsställande och tillräcklig medan andra upplevde informationen som bristande. Informationen som gavs upplevdes ofta vara i behov av anpassning utifrån patientens förutsättningar. Patienter hade erfarenheter av aspekter som såväl hindrade som underlättade information. I vissa fall använde patienter andra källor utöver vården för att hitta information. Slutsatser: För att omvårdnaden kring hjärtsviktspatienter ska bli tillgodosedd krävs att sjuksköterskan tar sig tid och ger anpassad information till patienterna. Sjuksköterskan bör se till att anpassa informationen utifrån patienternas förutsättningar, önskemål, resurser och behov. Litteröversikten visar att det finns rum för förbättring angående givning av information till hjärtsviktspatienter. / Background: Heart failure affect many people both in Sweden and internationally. Information is key to managing the illness and preventing negative consequences. KASAM (SOC), sense of coherence, was used as the theoretical starting point. Aim: To describe heart failure patients' experiences of information. Method: With Friberg's five step model as the analytic method, a literature review was conducted on twelve qualitative studies about heart failure patients' experiences of information. Result: The literature review's result shows two themes, "Satisfaction with Information" and "Forms of Information". Heart failure patients had different experiences concerning information. Some patients experienced the information as satisfactory and sufficient while others experience the information as lacking. The information that was given was often experienced as in need of adaptation to fit the patient's situation.  Patients had experiences of aspects that both hindered and facilitated information. In some cases, patients used sources other than the health care to find additional information. Conclusion: In nursing of heart failure patients the nurse has to take time to inform and to adapt information to the patients. The nurse should make sure to adapt the information after the patients' condition, wishes, resources and needs. The literature review shows that there's room for improvement concerning information given to heart failure patients.

No description available.

Bakgrund: Urininkontinens är ett tabubelagt ämne som påverkar kvinnor negativt både fysiskt, psykiskt och socialt. Syfte: Att beskriva kvinnors upplevelser av att leva med urininkontinens. Metod: En litteraturöversikt gjordes. Kvalitativa artiklar bearbetades och analyserades med Fribergs femstegsmodell. Cinahl och Medline användes för att få fram artiklarna som svarade på syftet. Resultat: Av de 10 kvalitativa artiklarna som valdes växte två huvudkategorier fram: en känsla av maktlöshet och en del av livet. Den första huvudkategorin utvecklades av två subkategorier: frustration och skam. Den andra huvudkategorin bildades utan subkategorier beroende på att innehållet inte kunde särskiljas. Kvinnor upplevde begräsningar i vardagslivet. Upplevelser som är kopplade till urininkontinens var skam, ångest, rädsla, oro och genants. Många kvinnor accepterade sin urininkontinens och såg det som en del av livet. Slutsats: Kvinnor upplevde att urininkontinens påverkade vardagslivet negativt. Urininkontinens var förenat med skamkänslor och ett lidande i tystnad. För att sjuksköterskan ska kunna bemöta kvinnor med urininkontinens på ett professionellt sätt, bör hen ha omfattande kunskap i ämnet. Ett gott bemötande ledde till att kvinnor upplevde att de kunde hantera och bibehålla egenvårdskapaciteten. / Background: Urinary incontinence is a taboo subject that affect women negatively on physical, psychological and social. The aim: To describe women’s experience of living with urinary incontinence. Methods: A literature review was made. Qualitative articles were processed and analyzed by Fribergs five steps model. Cinahl and Medline was used to get the articles who answered the aim. Result: 10 qualitative articles was chosen to consist of two main categories: feelings of powerlessness and part of life. The first category developed from two subcategories: frustration and shame. The second category emerged without any subcategory since the content can’t be separated.  Women experienced limits in their daily life. Experiences that was connected to urinary incontinence was shame, anxiety, fear, worry and embarrassment. Many women accepted their urinary incontinence and saw it as part of life. Conclusion: Women experience that urinary incontinence affected negatively on their daily life. Women suffered in silent and urinary incontinence is associated with feelings of shame. In order for the nurses to meet women with urinary incontinence in professional way, nurses should have knowledge of the subject. A good meeting can lead to women’s experience of be able to handle the urinary incontinence and preserve self-management.

Bakgrund: Närstående till patienter med psykisk ohälsa och patienter med psykisk ohälsa upplever att det är svårt att få god vård. Bristande kommunikation var en del som gjorde vårdandet sämre. Patienter upplever sig kränkta eller diskriminerade av vården. Syfte: Att beskriva sjuksköterskors upplevelser av att vårda patienter med psykisk ohälsa. Metod: Systematisk litteraturstudie enligt Evans (2002), där 12 kvalitativa vårdvetenskapliga artiklar har analyserats med en beskrivande ansats. Resultat: Sjuksköterskor upplevde att kommunikation var viktigt inom vårdandet, även relationer var viktiga, både till patienter och till patienters närstående. Att upprätthålla en god relation och god kommunikation var delar sjuksköterskor upplevde som svåra, om det inte lyckades kunde sjuksköterskor uppleva att de misslyckats med vårdandet. Slutsats: Sjuksköterskor upplevde att kommunikation och att skapa en relation är viktigt mellan sjuksköterskor och patienter för att vårdandet ska ge förutsättningar för en god vård. Lyckades in en relation skapas upplevde sjuksköterskor ofta att vårdandet misslyckades. Viktigt var även att närstående som ville vara delaktiga i vårdandet tilläts vara involverade för det kunde gynna vårdandet. Bemötandet sjuksköterskor ger kan således ses som en grundläggande del som behöver förbättras för att vårdandet ska upplevas bättre för alla involverade parter. / Background: Relatives to patients with mental illness and patients with mental illness experience that it’s hard to get proper healthcare. Lack of communication was a part of the issues that made the healthcare worse. Patients expressed being discriminated against by the healthcare. Aim: To explore nurse’s experiences of working with mental health patients. Method: Systematic literature review with a descriptive synthesis following Evans (2002), twelve qualitative research articles were analysed with an inductive approach. Result: Nurses experienced that communication was an important part of the care, relations were also an important part for the healthcare, both to patients and to relatives of the patient. If this didn’t occur nurses would experience that the healthcare had failed. Conclusion: Nurses experienced that communication and creating relationships between patients was monumental for the outcome to be good. Did this not succeed, nurses felt that they’d failed. It was also important that relatives of the patient could get involved in the healthcare, since it could benefit the recovery of the patient. How nurses treated both patients and relatives were then a good start in getting improvements for how the treatment could be improved for everyone.

This study determined how stakeholders of heritage attractions apply strategic management for their business planning and development. A conceptual framework for strategic heritage planning was created and applied within the case of Plovdiv, Bulgaria. The framework provided a new way of interpreting whether effective strategies were used within the heritage management sector. In addition to offering a lens to view policy planning, the framework led to a stakeholder analysis determining who was governing the heritage sites within thecity. The literature review revealed that studies about planning for heritage are neither prescriptive nor descriptive. Instead, they commonly reviewed challenges in planning with valuation, policy learning, implementation and maintenance for safeguarding sites. The new conceptual framework was created based on the gaps, challenges, issues and recommendations presented in the literature for heritage preservation. Each stage is operational and can be used as a guide for good practice or as an audit instrument. Critical realism was the most appropriate research approach because the study was practical and investigated how stakeholders process policy planning in the heritage sector. This study used purely qualitative methods and considered the stakeholders' experiences to give meaning to the situation. Purposive sampling was used and the questions created for the semi-structured interviews focused on stakeholder involvement throughout the phases of the framework. Accordingly, the Interview questions focused on assessment, creation and implementation of policy. Nine stakeholders were interviewed who were directly involved in the policy planning for heritage in Plovdiv. Document analysis was also used assessing the planning strategies highlighted in the Municipal Policy Document for Plovdiv 2014-2020.In terms of the strategic planning and development process of the heritage sites, the findings revealed that managers pay more attention to the assessment and 3 creation phases rather than the implementation phase. With regards to stakeholder involvement, the research showed that few of them were involved at certain stages of the process due to the hierarchy of governance. Academic andmanagerial recommendations are further discussed in the study.

Understanding conceptual models of business domains is a key skill for practitioners tasked with systems analysis and design. Research in this field predominantly uses experiments with specific user proxy cohorts to examine factors that explain how well different types of conceptual models can be comprehended by model viewers. However, the results from these studies are difficult to compare. One key difficulty rests in the unsystematic and fluctuating consideration of model viewer characteristics (MVCs) to date. In this paper, we review MVCs used in prominent prior studies on conceptual model comprehension. We then design an empirical review of the influence of MVCS through a global, cross-sectional experimental study in which over 500 student and practitioner users were asked to answer comprehension questions about a prominent type of conceptual model - BPMN process models. As an experimental treatment, we used good versus bad layout in order to increase the variance of performance. Our results show MVC to be a multi-dimensional construct. Moreover, process model comprehension is related in different ways to different traits of the MVC construct. Based on these findings, we offer guidance for experimental designs in this area of research and provide implications for the study of MVCs.

Domestic violence is often experienced as a crisis period, and it may impact children’s well-being, everyday functioning and development. To promote these minors’ resilience, social intervention is extremely important. The support and responses attributed to these children are not always adequate for their needs and interests. Considering children’s perspectives on social intervention is crucial to improve and to provide complete social work responses. A systematic literature review was conducted, aiming to analyze how children exposed to domestic violence characterize the barriers and facilitators of social intervention. Through two databases, 8 articles were found, related to adolescents’ perspectives on social intervention in situations of domestic violence. The participants were children aged 12-18 years, who were witnesses of violence between parents or who suffered abuses from one/both parent(s). Findings demonstrated the main factors of social intervention that children recognized as being negative and unhelpful (barriers), and as being positive and helpful (facilitators). The identified barriers were lateness, mistrust, lack of child perspective, passivity, lack of value, malice, boredom, and inaccessibility. On the other hand, the established facilitators were protection, trust, child perspective, active listening, value, accessibility, sympathy, sharing, and information. Implications for social workers are provided, centered on specialized trainings and guidance, and on the use of appropriate methods when intervening with children. Also, the necessity to expand the quantity of research related to the child’s perspective on social intervention is highlighted.

Bakgrund: Behandling mot bröstcancer medför olika biverkningar för kvinnor, bland annat torra slemhinnor, klåda och smärta vid samlag, samt deformation av ett eller båda brösten. Sammantaget kan dessa biverkningar inverka på kvinnors upplevelse av sin sexualitet. Mer kunskap krävs kring kvinnors upplevelser av sin sexualitet, för att utifrån det kunna ge god vård och stärka kvinnors sexuella hälsa. Syfte: Syftet med studien är att beskriva kvinnors upplevelser av sin sexualitet under och efter avslutad bröstcancerbehandling. Metod: En litteraturöversikt som är baserad på tre kvantitativa och sex kvalitativa vetenskapliga artiklar. Resultat: Kvinnorna upplevde förändring av sin kroppsbild samt sin sexualitet under och efter bröstcancerbehandling. Ångest och depression var vanligt relaterat till viktuppgång. Det fanns dock kvinnor som upplevde förändring i en positiv riktning. Oro fanns över att inte vara tillräcklig i sin sexuella relation med sin partner. Brist på information gällande behandlingar och dess biverkningar, upplevdes av kvinnorna. Diskussion: Kvinnor upplever både fysiska och psykiska besvär vid bröstcancer. Kvinnor behöver mer information innan, under och efter behandling för bröstcancer. Det är viktigt att sjuksköterskor fångar upp varje kvinna för att kunna ge en individanpassad omvårdnad. Konklusion: Kommunikation mellan sjuksköterskor, kvinnor och deras partner kan stärka kvinnor i sin sexuella hälsa. / Background: Treatment against breast cancer can cause women various side effects, including dry mucous membranes, itching, as well as deformation of one or both breasts. All in all these side effects can affect women´s experience of their sexuality and create a suffering for them. More knowledge is needed about women´s experience of their sexuality, so the nurses can provide good care and strengthen the sexual health of women. Aim: The aim of this study is to describe women´s experience of their sexuality during and after treatment of breast cancer. Method: A literature review based on three quantitative and six qualitative studies. Result: Change in body image and sexuality during or after breast cancer treatment, were a common experience among women. Anxiety and depression was common related to weight gain. However, there were women who experienced change in a positive direction after breast cancer. Concern about being insufficient in their sexual relationships with their partner was found. Women experienced lack of information about treatments and their side effects. Discussion: Both physical and mental disorders were experienced by women with breast cancer. Women needed more information before, during, and after treatment for breast cancer. In order to provide personalized care, nurse´s need to see the whole woman and meet her individual needs of caring. Conclusion: Communication both between nurses, women and their partners could strengthen women in their sexual health.

BAKGRUND: Det råder idag brist på sjuksköterskor i Sverige, denna brist förväntas öka under de kommande åren till följd av en ökad befolkning i landet. Enligt en undersökning av Statistiska Centralbyrånstatistik från 2014 arbetar en av tio legitimerade sjuksköterskor inte inom vården och en av de största anledningarna till detta är stress. Ett tämligen nbytt begrepp i Sverige, Compassion Fatigue, är ett tillstånd av sekundär traumatisk stress som drabbar personer i vårdgivande roller. Detta tillstånd är relativt outforskat inom svensk sjukvård. SYFTE: Syftet var att belysa faktorer som kan bidra till utvecklandet av compassion fatigue bland sjuksköterskor. METOD: En litteraturöversikt enligt Fribergs metod som baserades på sju studier av kvantitativ metod, två studier av kvalitativ metod och en studie som använt mixad metod. RESULTAT: Resultatet presenteras utifrån fem huvudkategorier: Demografiska faktorer (ålder, kön och civilstånd); Miljörelaterade faktorer (betydelsen av ledarskap, arbetsbelastning och personalomsättning); Yrkesrelaterade faktorer (utbildningsnivå, yrkeserfarenhet, arbetstid och avdelning); Coping (hälsosamma och ohälsosamma hanteringsstrategier); Bekräftelse och stöd (från kollegor, ledning och anhöriga). DISKUSSION:I diskussionen uppmärksammasidentifieras bristen av kunskap om compassion fatigue, bland såväl sjuksköterskor som ledning, som ett betydelsefullt bifynd vilket kan vara en bakomliggande orsak till utvecklandet. Utbildning och stödjande åtgärder kan utformas baserade på Watsons teori om mänsklig omsorg för att förebygga utvecklandet av Compassion Fatigue. / BACKGROUND: There is currently a shortage of nursing staff in Sweden. Following on from a population increase, this shortage is expected to increase in upcoming years. According to 2014 statistics, one out of ten licensed nurses do not work within a healthcare setting, and one of the main contributing factors to this is stress. Stress is also the main reason for sick leave among nurses. A fairly new concept in Sweden, Compassion Fatigue, is a condition of secondary traumatic stress, which affects healthcare professionals. This condition is relatively unexplored in Sweden. AIM: The aim of this literature review was to shed light onhighlight factors that may impact on the development of compassion fatigue among nurses. METHOD: A literature review according to Friberg’s method which was based on seven quantitative studies, two qualitative studies and one study of mixed methods. RESULTS: The results are presented based on five main categories: Demographic factors (age, gender and marital status); Environmental factors (importance of leadership, work load and staff turnover); Occupational factors (level of education, professional experience, working hours and department); Coping (healthy and unhealthy management strategies); Acknowledgement and support (from colleagues, management and relatives). DISCUSSION: A lack of knowledge about Compassion Fatigue among nurses as well as management is the main reason for its developtment. Education and supportive measures, based on Watson’s theory of human caring, can be used to prevent Compassion Fatigue.

Submitted by Michelle Catarina Pires (catarinamcatarinap@gmail.com) on 2016-04-01T20:02:30Z No. of bitstreams: 1 dissertação mestrado 29022016.pdf: 3459720 bytes, checksum: d104cdf26cd66a64c36361ef64f249d8 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-04-05T19:37:59Z (GMT) No. of bitstreams: 1 pires_mc_me_bot.pdf: 3459720 bytes, checksum: d104cdf26cd66a64c36361ef64f249d8 (MD5) / Made available in DSpace on 2016-04-05T19:37:59Z (GMT). No. of bitstreams: 1 pires_mc_me_bot.pdf: 3459720 bytes, checksum: d104cdf26cd66a64c36361ef64f249d8 (MD5) Previous issue date: 2016-02-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Há vinte e cinco anos, o primeiro caso de síndrome da infusão do propofol foi descrito e, até hoje, são ainda desconhecida às verdadeiras razões para seu desenvolvimento. O objetivo desta revisão sistemática e meta-análise proporcional é avaliar os fatores contribuintes, sinais clínicos e taxa de mortalidade relacionada à ocorrência da síndrome da infusão do propofol. Métodos: Revisão sistemática da literatura e meta-análise proporcional de relatos e série de casos de pacientes com síndrome da infusão do propofol. A meta-análise foi realizada avaliando o desfecho morte associada com dose (< 240mg/Kg versus ≥ 240mg/Kg) ou tempo de infusão (< 48h contra ≥ 48h) usando um modelo de efeito randômico. Os intervalos de confiança de 95% também foram calculados. Resultados: Foram incluídos 59 relatos e série de casos com um total de 75 pacientes. Acidose metabólica e doenças cardíacas foram associadas com aumento das taxas de mortalidade. Houve uma diferença estatisticamente significante favorecendo a dose total propofol inferior a 240mg/Kg 31% (IC 95% 16% a 49%) em comparação com ≥ 240mg/Kg 66% (lC 95% 52% a 79%) na redução das taxas de mortalidade. Houve também uma proporção estatisticamente maior de morte no período de administração de propofol ≥ 48h 64% (IC de 95% 51% a 76%) em comparação com < 48h 20% (IC 95% 14% a 48%). Conclusão: Estes dados sugerem que tanto a acidose metabólica, quanto os distúrbios cardíacos podem ser preditores da mortalidade em pacientes com síndrome da infusão do propofol. Além disso, os dados mostraram que período de administração e dose maiores de propofol resultam nas taxas de mortalidade mais elevadas entre os pacientes com síndrome da infusão do propofol. / Twenty-five years ago the first case of propofol infusion syndrome was described and, until today, it is yet unknown the true reasons for it’s develop. The aim of this systematic review and proportional meta-analysis is to evaluate the contributing factors, clinical signs and mortality rate related to the occurrence of the propofol infusion syndrome. Methods: Literature review and proporcional meta-analysis of both, reports and case series of all patients with propofol infusion syndrome undergoing either general surgey or ICU. The meta-analysis was performed on death associated with either dose (< 240mg/Kg versus ≥ 240 mg/Kg) or infusion time (< 48h versus ≥ 48h) using a radom-effect model. The 95% confidential intervals were also calculed. Results: 59 studies were included with a total of 75 patients. Metabolic acidosis and cardiac disorders were associated with increase rates of mortality. There was a statistically significance difference favoring propofol total dose less than 240mg/Kg 31% (CI 95% 16% to 49%) compared to ≥ 240mg/Kg 66% (CI 95% 52% to 79%) in the reduction of mortality rates. There was also a statistically higher proportion of death in the infusion propofol period ≥ 48h 64% (CI 95% 51% to 76%) compared to < 48h 29% (CI 95% 14% to 48%). Conclusion: These data suggests that both metabolic acidosis and cardiac disorders might be predictors of the development of mortality in patients with propofol infusion syndrome. Furthermore, our data showed that higher infusion period and dose of propofol results in higher mortality rates among those patients with propofol infusion syndrome.