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<p>In nursing education the clinical component comprises an important part of the students&rsquo / training. Clinical teaching and learning happens in simulated as well as real world settings. First&ndash / year students spend the first quarter of their first year developing clinical skills in the skills laboratory. In the second-term they are placed in real service settings. This study was aimed at exploring the experiences of first year nursing students of the University of the Western Cape (UWC) during their first clinical placement in the hospital. A qualitative phenomenological exploratory study design was used and a purposive sample of twelve nursing students was selected to participate in the study. The research question was &ldquo / Describe your experiences during your first placement in hospital?&rdquo / Written informed consent was given by every participant and ethical approval was obtained from the relevant UWC structures. In-depth, face-to-face interviews were conducted, audio taped and transcribed verbatim. Transcripts were coded and sub-categories, categories, and themes were extracted during the data analysis process. Trustworthiness of the data collection and data analysis processes were ensured. Many of the first year nursing students described theirexperience in hospital as being stressful. However, the first placement in hospital allowed them to work with real patients and provided them an opportunity to develop a variety of clinical skills. Even though the hospital environment was unfamiliar and the ward staff unwelcoming, the patients&rsquo / acknowledged and valued their contribution to patient care. Students tend to seek support from family members and lecturers. It is recommended that first year nursing students be prepared adequately for their first placement in hospital as well as to&nbsp / provide practical and emotional support to students during their hospital placement</p>

Vara förälder till ett barn som är inneliggande på ett sjukhus är komplicerat, svårt och upplevs olika av föräldrar. Isolering kan orsaka stress och leda till kontroll-, informations- och kommunikationsbehov. Syftet med studien var att beskriva föräldrars upplevelser av att vistas i isoleringsrum vid vård av sina barn på sjukhus. Studien har en deskriptiv kvalitativ design. Resultatet visade att föräldrarna kände sig besvärliga och var rädda för att störa när de behövde be om hjälp. Vikten av att personalen såg föräldrarna framkom och brister fanns gällande information och kommunikation. Information kring avlastning, planering och sysselsättning saknades. Isoleringsrummen beskrevs som sterila och saknade värme och hemtrevnad. Sysselsättning bidrog till att underlätta isoleringen men föräldrarna tyckte ändå det var svårt att underhålla barnen. Föräldrarna kände sig instängda då de inte kunde lämna rummet vilket bidrog till oro och tankar kring barnets hälsa. Avlastningen som föräldrarna fick varierade och stöd var betydelsefullt. Vidare forskning om avlastningens betydelse samt hur personalen kan förändra föräldrars upplevelse av att känna sig besvärliga skulle kunna vara till nytta för föräldrar, barn och personal och frambringa nya rutiner. / To be a parent of a child who is being cared for in hospital is complicated and difficult and affects each parent differently. Isolation can cause stress to the parents and lead to a further need for control, information and communication. The purpose of this study was to describe how parents experienced staying in a hospital isolation room with their children when the children were being cared for in hospital. The study has a descriptive qualitative design. The study showed that the parents felt awkward and worried about asking for help when they needed it. The parents placed an importance on being seen by the staff and there was a lack of information and communication. There was no information available about how to receive help, the planning process and also how to keep oneself occupied. The isolation rooms were described as sterile, cold and lacking a homely feel. Having something to do made the isolation easier to cope with however the parents still found it difficult to keep the children entertained. The parents felt trapped when they were not able to leave the room which resulted in a constant focus on the health of the child and this in turn led to an increased anxiety level. The level of help given to the parents varied and support was considered important. Further research into the importance of help available for parents, as well as how staff members could change the awkwardness parents feel, would be useful for parents, children and staff members, and may encourage new routines.

With the global trend of transnational migration, a huge influx of highly skilled immigrants has been influencing Canadian society and economy. However, there is little literature that illuminates highly skilled migrants’ workplace experiences and their identities in terms of second language acquisition. This multiple case study explores three highly skilled Korean immigrants’ experiences, focusing on the interplay of their language learning, identity, and workplace communities. Grounded in the notion of “imagined communities” (Kano & Norton, 2003) and the theory of “communities of practice” (Lave & Wenger, 1991), this study analyzes the process of how highly skilled migrants have constructed their imagined workplace communities. By revealing the multiple dynamic negotiations co-constructed by the workplace contexts and the individuals, this study shows the interlocked relationship between second language learning, identity, and the given community. This study also argues the importance of membership and positive social arrangements in a community for language learning.

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Sjuksköterskor upplever stora krav och stor belastning i sitt dagliga arbete, dels från patienter, dels från kollegor och dels från sig själva vilket gör att de ofta känner sig otillräckliga. Den stora fysiska och psykiska belastningen leder till att sjuksköterskor känner oro över kvaliteten på vården vilket ger upphov till moralisk stress. Sjuksköterskor upplever moralisk stress i högre grad än andra professioner och är en betydande orsak till att sjuksköterskor avslutar sin anställning. I tidigare forskning har få studier moralisk stress som huvudsyfte. Därför syftar denna allmänna litteraturstudie till att undersöka närmare vad sjuksköterskan upplever i sin moraliska stress. Syftet var att beskriva sjuksköterskans upplevelser av moralisk stress. För att besvara syftet valdes 13 kvalitativa vetenskapliga artiklar ut. I resultatet framkom sex kategorier: Maktlöshet, Frustration, Vånda, Ilska, Självtvivel och Skuld. Maktlöshet har en betydande roll och många av de andra känslorna bottnar i maktlösheten. Maktlöshet beror framförallt på att sjuksköterskan inte känner sig delaktig i beslutsfattandet kring patienten. För att minska sjuksköterskans moraliska stress kan samverkan mellan professioner främjas. Vidare svensk forskning kan behövas för att identifiera om moralisk stress är en bidragande orsak till rådande sjuksköterskebrist. / Nurses are experiencing huge demands and big loads in their daily work, both from patients and from colleagues and from themselves so that they often feel inadequate. This great physical and psychological workload means that nurses are concerned about the quality of care which gives rise to the moral distress. Nurses are experiencing this moral distress at greater extent than other professions and is a major reason why nurses quit their jobs. In previous research, few studies have moral distress as their main purpose. Therefore this general literature review intends to look more closely at what the nurse is experiencing in his or her moral distress. The purpose was to describe the nurse's experiences of moral distress. For this purpose, 13 qualitative research articles were selected and the results revealed six categories: Powerlessness, Frustration, Agony, Anger, Self-doubt and Guilt. Powerlessness has a significant role and contributed to many of the other emotions listed. Powerlessness is mainly due to the nurse not feeling involved in decision-making regarding the patient. To reduce the nurse's moral distress collaboration between professions could be encouraged. Further Swedish research could be needed to identify whether moral distress is a contributing factor to the current nursing shortage.

Bakgrund: Hjärtsvikt är ett vanligt förekommande tillstånd som ger symtom som andfåddhet, trötthet och hjärtklappningar. Hjärtsvikt kan orsakas av flera olika anledningar där ischemisk hjärtsjukdom och hypertoni är vanligast förekommande. För att ange graden av hjärtsvikt används funktionsklassificering enligt New York Heart Associaton Functional Classification (NYHA I-IV). Lidande kan uppstå vid sjukdom där sjukdomslidande, livslidande och vårdlidande är tre olika former. Egenvård är en viktig faktor för att vidhålla hälsa och välbefinnande. Patienter med hjärtsvikt har vanligen regelbunden kontakt med sjukvården. Syfte: Att beskriva patienters upplevelser av att leva med hjärtsvikt. Metod: Litteraturbaserad studie som är baserad på 13 vetenskapliga artiklar. Resultat: Patienter upplevde fysiska och psykiska begränsningar i det dagliga livet. De var tvungna att hitta nya sätt att leva och deras sociala roll förminskades. Patienterna upplevde ibland vården negativ, de beskrev brist på information och stöd. Framtiden var osäker för patienterna. En del patienter upplevde att de hade framtidstro och andra var redo att dö. Konklusion: Hjärtsviktens nedbrytande effekter orsakar att patienternas sociala roller förminskas, de dagliga aktiviteterna blir svårare att genomföra och framtidstron minskas. Det är viktigt att stärka patientens tilltro till sig själv. Sjuksköterskor har ett ansvar i att lindra lidande och stärka patienternas förmåga till att bedriva egenvård. / Background: Heart failure is a common condition that causes symptoms like shortness of breath, fatigue and palpitations. Heart failure can be caused by several reasons which ischemic heart disease and hypertension are the most common. To specify the degree of heart failure, New York Heart Associaton Functional Classification (NYHA I-IV), is used. Suffering can occur during illness. Suffering of disease, suffering of life and suffering of care are three varieties of suffering. Self-care is an important factor in order to maintain health and wellbeing. Patients with heart failure usually have regular contact with medical services. Aim: To describe patients' experiences of living with heart failure. Method: A literature-based study that is based on 13 scientific articles. Results: Patients experienced physical and mental limitations in daily life. They had to change the way of life and their social role was diminished. Patients sometimes experienced care negatives, they described the lack of information and support. The future was experienced uncertain for the patients. Conclusion: Patients' social roles are reduced, daily activities become more difficult to implement and confidence is reduced. It is important to strengthen the patient's self-confidence. Nurses have a responsibility to reduce suffering and enhance patients' ability to engage in self-care.

Introduction: Past studies have indicated that nursing support reduces parental stress and anxiety during a child’s NICU hospitalisation and therefore fosters the parents’ abilities to cope with the difficulties they are facing. The importance of parental support has been emphasised in numerous studies in Western countries, however the nursing support which is responsive to the parents may vary between different cultures. The cultural norms of medical and nursing care environments can affect parental stress-related experiences as well as nursing roles in the NICUs across different countries. The aims of this study are, first, to compare the medical and nursing care environments of the two NICUs. Second, the study establishes any similarities and differences in sources of parental stress in the two NICUs. Third, the study illustrates the underlying philosophy of Doane and Varcoe’s (2005) relational approach to family nursing and highlights the importance of relational inquiry in the process of determining the parental support which best responds to individual families’ needs in the NICU. Methods: This study analyses the nursing roles that support parents of children hospitalised in a Neonatal Intensive Care Unit (NICU). It is a cross-cultural comparison between two NICUs, one in Christchurch, New Zealand and the other in Tokyo, Japan, with both quantitative and qualitative components. Thirty-one families participated voluntarily in the study from each NICU (n=121). The three main sources of data were a NICU staff interview, parental interview, and parental questionnaire using the Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU) (Miles, 2002). A thematic analysis was used in order to examine parental comments. Results: The differences between the two NICUs in terms of the NICU care environment, including NICU regulations and routine nursing care, were identified by the staff interviews, highlighting the contrasting dominant ideologies of individualism and collectivism reflected in each culture. The three sources of parental stress, measured by PSS: NICU: Sights and Sounds; Baby’s Appearance and Behaviour; the Parental Role Alteration, were examined. The sources most responsible for parental stress differed between the four groups of parents. Overall, The Tokyo parents seemed to be most concerned about the infant’s condition. The Christchurch parents, however, perceived the change in parental role to be most stressful. Additionally, only the Tokyo fathers experienced stress in association with Sights and Sounds more often than other areas of stress. The infant’s medical/nursing care requirements, oxygen therapy and/or tube feeding, were associated with a high degree of stress for each of the parents’ groups except that of the Christchurch fathers. There was a positive relationship between parental NICU visiting and stress level among the Tokyo parents while this was not the case for the Christchurch parents. The infants’ and parental characteristics were found to be associated with stress level for the Tokyo mothers and Christchurch fathers only. The thematic analysis of interview data revealed three key themes of NICU parental experiences: Uncertainty, NICU contexts and Communication with staff. These themes were identical between the two NICUs. Discussion: This study highlighted the influence of the norms of each NICU, particularly the NICU regulations and nursing care on parental stress-related experiences, and the importance of reflecting upon these norms to critique those professional beliefs which may hamper parental coping abilities. The areas of parental support needing attention were different between the two NICUs. These areas were: the establishment of oral feeding, and infants’ nursing care-related decision-making for the Christchurch NICU whilst parental information/involvement in the early stage of hospitalisation, the influence of visiting regulations, and importing Western-based NICU intervention for the Tokyo NICU. In providing these areas of parental support, the importance of effective, meaningful communication between parents and staff was equally evident in the two NICU settings. In the light of the relational approach to family nursing, this study demonstrated that how nurses communicate with families is not universal: one way to reach across the differences is to listen to parents, and this, it is clear, is crucial to the role of nurses in NICU settings.

Bakgrund: ADHD är idag en vanlig funktionsnedsättning hos barn. Störningen påverkar dock inte enbart barnet utan också dess familj negativt. Föräldrarnas välbefinnande står även i relation med barnets välbefinnande. Denna störning innebär dock en försämrad livskvalité hos föräldrarna. Med familjecentrerad omvårdnad, socialt och professionellt stöd kan sjuksköterskan hjälpa föräldrar i deras krävande livssituation.Syftet: Syfte med denna studie var att belysa föräldrars erfarenheter av att leva med ett barn som har ADHD diagnos.Metod: En litteraturbaserad studie där 10 kvalitativa artiklar har analyserats.Resultat: Ur analysen av datamaterialet framkom två huvudkategorier: bemötande från omgivningen och svårt att ta beslut om medicinsk behandling med sju underkategorier.Slutsats: Denna studies resultat bidrar med kunskap om föräldrars erfarenheter av att leva med barn som har ADHD. Detta kan vara påfrestande på grund av de bemötanden som uppkommer med omgivningen. Föräldrar har även svårt att acceptera barnets diagnos och behandling. Behov av stöd har dock betydelse för avgörandet av att behandla barnet med medicin. Stödgrupper samt utbildning till föräldrarna förbättrar föräldrarnas välbefinnande.