Background: Registered nurses in the emergency department are exposed to a high workload, and the work environment is stressful. Frequent reports of burnout in the health care profession are a fact, and nurses are a particularly vulnerable group. Aim: The aim of this study was to investigate registered nurses’ experiences of work-related stress in the emergency department. Method: A literature review including 13 quantitative and qualitative studies was conducted. The databases CINAHL and Pubmed were used to find relevant research for this study’s intended purpose. The authors read all the studies multiple times to gain understanding and to find connections between the results. Results: The findings in this study revealed three main themes: the feeling of inadequacy, not having control and, finally, the deterioration of their health. The nurses conveyed that they were not capable of performing optimal care due to a lack of recourses paired with a high workload. The feeling of endangering the patients' safety because of the nurses' stress was recurring. The nurses described multiple coping mechanisms to handle stressful situations at emergency departments, but none that really worked. Conclusion: The nurses in the emergency department feel that work-related stress has a negative impact on their mental and physical health. Feelings such as powerlessness, guilt towards the patients and shame were common. Most nurses described that they were not satisfied with the quality of the care they provided. All nurses expressed the need for more resources to manage stress and to provide appropriate patient-safe care.

Background: Stroke is a global health problem and one of the most common causes of death and disability in Sweden. In the event of an ischemic stroke, parts of the brain tissue lose circulation due to thrombosis, embolism or brain hemorrhage leading to brain damage. Due to brain injury, the stroke affected patient may have neurological impairments and will find themselves in a sudden elevated need of care. The patient may be affected somatically as well as cognitively with difficulties regarding, among other things, mobilization, speech and language as a result. The nurse is responsible for the care among all hospitalized patients.  Aim: The aim of this literature based study was to describe the experiences of stroke-affected patients of nurse’s care in stroke units. Method: The chosen method was a literature study based on the analysis of qualitative scientific articles. Results: The results showed that patients appreciated nurses who took time to acknowledge them, listen to them and who were involved in their rehabilitation. Due to lack of communication, active listening and initiative to make conversations with the patients, the person-centered care failed on many occasions. Conclusion: Updated knowledge about person-centered care needs to be implemented to reduce the asymmetric care relationship between patient and nurse to promote patients' health and well-being.

ABSTRACT Background: Today there are about 150 000 people in Sweden with dementia and every year, about 25 000 people develop dementia. A dementia disease results in impaired cognitive abilities, leading to increased nursing needs. Dementia care should be based on person-centered care, which is a central concept in the nursing profession. Purpose: To describe the nurses’ experiences of caring for older people with dementia. Method: A systematic literature study with qualitative approach and descriptive synthesis where twelve articles have been included. Results: The analysis resulted in two themes and five subthemes. The first theme is Furtherance conditions with the subthemes; The importance of getting to know the elderly, The impact of the healthcare environment and The importance of education. The second theme is Challenging aspects with the subthemes; Difficulties in treatment and Lack of resources. Conclusion: Nurses’ feelings of satisfaction were experienced when the conditions for conducting person-centered care were present. The elderly`s life story, an adapted healthcare environment and increased knowledge through education promoted care of the elderly person with dementia. Nurses experienced challenges due to difficulties in managing the elderly`s behavior, lack of time and staff in dementia care.

Background The emergency department is intended for people with acute illness or injuries. In the acute phase and in urgent situations, the focus of the healthcare staff is not always on attendance and respectful treatment or care. Instead, quick handling and strict schedules are prioritized. As a result, communication and information fail and the patients' basic needs are overlooked. Consequently, the healthcare staff might be perceived as indifferent and rude. This uncaring encounter leaves the patients feeling vulnerable, abandoned and disrespected. The absence of communication and respectful treatment may have adverse effects on the patients' well-being. Aim The aim of this study was to describe patients' experiences of treatment in emergency departments. Method A literary study was made using 9 articles with a qualitative approach. Results Two themes were identified: the patients' experiences of being noticed in emergency departments and the patients' experiences of the meaning of communication in emergency departments. The themes had two subthemes each: not to be seen, to feel confirmed, lack of information and the importance of communication in health care. Conclusion The absence of caring encounters and lack of information contributes to negative experiences in the emergency departments and is the cause of great suffering in patients. / Denna studie hade som syfte att undersöka patienters upplevelser av bemötande när de sökte vård på akutmottagningar. Resultatet visade att patienter hade svårigheter i att tala om varför de sökte vård, då personalen upplevdes som ifrågasättande och nonchalanta. Patienterna kände sig bortglömda i väntrummet då det var långa väntetider samt att de inte informerades tillräckligt. Detta resulterade i att känslor av otrygghet, rädsla och oro belystes. De patienter som däremot informerades, uppmärksammades av personalen samt där personalen bjöd in patienten till delaktighet i sitt vårdbesök, upplevde ett gott bemötande. Denna studie visar att patienter upplevde brister i bemötandet på akutmottagningar och att personcentrerad vård värderades högt av patienterna för att känna en trygghet till vården. Att inte bli respektfullt bemött resulterar i ett onödigt lidande för patienten. Vården som bedrivs på akutmottagningen är inriktad på allvarliga skador och åkommor, där personalen har som ansvar att bedöma, sortera och prioritera så att de allvarligaste skadorna hanteras först. En del av sjuksköterskan ansvar på akutmottagningen är att uppmärksamma patientens psykosociala behov, likaledes är hennes ansvar att prioritera patienters fysiska behov. Studiens resultat påvisade att patienter upplevde brister kring dessa ansvarsområden. Patienter som sökte vård på akutmottagningen upplevde ångest och oro då de saknade kunskap om sitt förändrade hälsotillstånd och var beroende av kontinuerlig information. För att ge patienten en positiv upplevelse av sitt besök så kan personcentrerad vård vara en ingång. Personcentrerad vård innebär en kärnkompetens för sjuksköterskor och belyser vikten av att tillsammans med patienten bilda en relation och ett partnerskap för att patienten ska kunna uppleva delaktighet i sin egen vård. Genom delaktighet kan patienten på ett bättre sätt hantera och begripa sin situation. Den metod som använts är en litteraturstudie. Kvalitativ forskning har granskats för att skapa en överblick av tidigare forskningsresultat kring detta ämne. Studiens syfte var att undersöka patienters upplevelser och därför valdes kvalitativ forskning, då denna forskningsmetod rekommenderas för granskningar av upplevelser.

Bakgrund: Bukspottkörtelcancer är en av de dödligaste formerna av cancer. Det kan vara av värde för sjuksköterskor att inneha kunskap om hur patienter med bukspottkörtelcancer upplever sin sjukdom, för att kunna planera en personcentrerad omvårdnad. Syfte: Syftet med studien var att belysa upplevelser hos patienter med bukspottkörtelcancer. Metod: En litteraturstudie med induktiv ansats och kritisk granskning av nio vetenskapliga artiklar utfördes. Resultat: I resultatet framkom tre kategorier: Fysisk påverkan till följd av sjukdom eller behandling, Psykisk påverkan till följd av sjukdom eller behandling samt Betydelsen av kommunikation med vårdpersonal. Resultatet visade att patienter med bukspottkörtelcancer led av fysiska och psykiska symtom. Symtomen påverkade deras sociala och vardagliga aktiviteter. Resultatet visade även att patienter med bukspottkörtelcancer var i behov av information och kommunikation med vårdpersonal. Slutsats: Studien kan bidra med kunskap om hur patienter med bukspottkörtelcancer upplever sin sjukdom på en fysisk och psykisk samt kommunikativ nivå. Ytterligare forskning kring hur patienter med bukspottkörtelcancer upplever sin sjukdom kan hjälpa sjuksköterskor att känna sig trygga med att arbeta med denna patientgrupp. Förslag på vidare forskning är att studera sambandet mellan personcentrerad vård i relation till patienter med bukspottkörtelcancer. / Background: Pancreatic cancer is one of the deadliest forms of cancer. It may be valuable for nurses to have knowledge of how patients with pancreatic cancer experience their disease, in order to be able to plan a person-centered care. Purpose: The aim of the study was to explore experiences in patients with pancreatic cancer. Method: A literature study with inductive structure and review of nine scientific articles was conducted. Result: The result revealed three categories: Physical impact as a result of illness or treatment, psychological impact as a result of illness or treatment and Importance of communication with healthcare professionals. The results showed that patients with pancreatic cancer suffered from physical and psychological symptoms. The symptoms affected their social and everyday activities. The results also showed that patients with pancreatic cancer were in need of information and communication with healthcare professionals. Conclusion: This study can contribute with knowledge about how patients with pancreatic cancer experience their disease on a physical, psychological and communicative level. Further research on how patients with pancreatic cancer experience their disease can help nurses feel safe working with this type of patients. Suggestion for further research is to study the relationship between person-centered care in connection to patients with pancreatic cancer.

Family-centered care (FCC) is considered the gold standard for care delivery in the Neonatal Intensive Care Unit (NICU). However, there are challenges with the implementation of FCC in practice and there is limited literature about how to tailor this approach for specialized NICU populations. To explore FCC for surgical neonates in the NICU, the concept was explored using Roger’s evolutionary concept analysis. Results illustrate that FCC in the NICU is a philosophy or care, rather than a set of interventions. The subsequent cross-sectional descriptive exploratory study showed that the surgical infants in our sample (n=11) received a limited amount of skin-to-skin care (median 0 mins/day) and parents reported challenges to being involved in their infant’s care. This thesis supports the challenges with the implementation of FCC in practice and both the need to consider multiple perspectives and the need for broader systemic change in order to support a FCC philosophy.

Digital technologies are becoming increasingly common tools in our daily lives. We use it for finding information, but also to communicate with people all over the world. With a vision to strengthen Swedish healthcare's digital resources, Sweden has made major efforts in this area. Improved living conditions have changed the demographic situation as people grow older, which in turn places higher demands on healthcare efficiency. Being able to meet these demands has made digitalization of healthcare increasingly important, but also demonstrating new challenges such as participation, transparency and usability. The purpose of this study has been to investigate if communicative tools can be created to facilitate nurses work with person-centred care and to enhance patients' positive experiences of their own care. The study is based on interviews and observations with nurses working within orthopaedic sections and employees working in facility management as well as administration within the hospital. The results show that digital solutions can be effective tools for enhancing person-centered care, but with automated solutions the physical encounter between nurses and patients can be reduced. The concepts that have been developed are two mobile applications. They were developed with the intention to make it easier for nurses to document and communicate patients' activity and care plans.

Kangaroo care (KC) is a cost-efficient method to increase infant-parent bonding and neonatal health outcomes worldwide. Despite evidence supporting KC in critically ill infants, nursing perceptions regarding patient safety and interrupted work flow continued to impede practice in the local high-tech neonatal intensive care unit (NICU). Their current policy failed to address the 2-person transfer method recommended for safe practice. In addition, both staff and parents lacked training and education regarding the benefits and feasibility of KC. This doctoral project aimed to decrease practice barriers and promote earlier and more frequent KC by developing and integrating an evidence-based clinical pathway within a multifaceted champion-based simulated educational training program for NICU staff and parents. Published outcomes and generated organizational data for program synthesis connected the gap in practice. Kolcaba's comfort theory served as the guiding framework to ensure a partnership in care. This quasi-experimental quantitative study used the generalized liner model for data analysis. Study findings indicated that KC occurred 2.4 more times after the intervention compared to before (p = 0.001). Descriptive data revealed that KC episodes for intubated patients nearly doubled after implementation (11.1% from 6.2%). Post-survey scores for nursing knowledge and comfort level also improved after the intervention. Although earlier KC practice was non-conclusive (p = 0.082), future trials should control groups for day of life since admission. Disseminating the KC pathway can have a positive social change on family-centered care by increasing NICU nurses' knowledge, comfort, and adoption of this evidence-based practice as an expected routine standard of care.

Many researchers have suggested positive patient-health provider relationships can positively impact patient outcomes. A few focused explicitly on bariatric weight loss surgery (BWLS) professional-patient interactions. This study is significant because BWLS is a recommended tool to combat obesity. The purpose of this study was to analyze the perceptions of BWLS education nurses regarding their patient encounters. This mixed methods research study used an online survey combining quantitative Likert scale questions and open-ended qualitative questions, with social cognitive theory as the theoretical foundation. These explored viewpoints relate to their patient relations expressed by a health professional. Health professional beliefs incorporated into patient interactions has merit within BWLS continuum from presurgery requirements, to the procedure, and post-surgery lifestyle. Many respondents are employed in obesity services programs and received 'snowballs' from other contacted health professionals. The analyzed written response word clouds favor patient-focused care. Participation reluctance by not answering or skipping short answer perspective questions was a quantitative trend. Data revealed survey specific noticeable qualitative tendencies favorable toward patient-centered care and patient health accountability. The anticipated positive social change is a better understanding of issues surrounding the choice for and against BWLS and improved healthcare and health professional-patient communications.

Schools of nursing educators are faced with redesigning nursing education to meet the complexity of implementing communication and patient- centered care to improve patient safety. This qualitative case study addressed the problem that teaching communication and patient- centered care were not threaded throughout curriculum, which left many new graduates nurses unprepared. The purpose of this study was to understand classroom experiences of new graduate nurses to meet performance outcomes. The research questions focused on understanding the classroom experiences of new graduates' of a nursing program by assessing the two concepts and how to address preparatory practices. The target populations were new graduates' of nursing programs who had been working in a hospital for less than 1 year and are registered nurses. Emergent themes regarding the new graduates classroom experiences strengths and areas of improvements were extracted from the 10 participants interview questions, and practice experiences from the journal recordings were manually coded, validated , triangulated, and member checked with eight themes that emerged from face-to-face interviews, theoretical frameworks, and the current literature. The researcher determined that the new graduates' nurses were self-motivated to implement communication and patient centered care, however incorporating the two concepts in the class instructions would be a safer preparatory experience. This study may contribute to positive social change through raising awareness regarding the overall standard of nursing education, which may lead to a reevaluation of nursing curricula and teaching strategies so that new graduate nurses may master the complexity of clinical practices resulting in positive performance outcomes