Background For patients in need for psychiatric care who refuse treatment, coercive care might be necessary due to The Law of Psychiatric Compulsory Care, LPT. The purpose of this law is to make sure the patient later on will be able to increase autonomy. The most frequent patients in coercive care suffer from psychosis, heavy depression or having high risk of committing suicide. One of the most important tasks in the nurse profession is to increase patients’ autonomy. Therefore having ethical judgment is necessary to know when to use paternalism. To take note of patients’ experiences may increase awareness, making care more patient-centered. Aim To describe patients’ experiences of coercive care and coercive interventions in psychiatric care. Method A literature review has been conducted in order to compile what is currently known about the topic at hand. The result is based on ten scientific articles with findings responding to the aim of this study. The articles have been analyzed by identifying similarities and differences that have synthesized to a new whole.   Result The literature review yielded a profound view of patients’ experiences when being in coercive care. Three main themes were found to cover the phenomenon. Those were Coercive Care - limits and possibilities, The care relationship is fundamental and From abuse to life saving. Discussion The result has been discussed using the theory about Care Suffering, as described by Katie Eriksson. This theory is applicable on the context of interest. The findings has also been discussed using earlier studies concerning coercive care, as well as studies emphasizing the perspective of the nurse’s using coercive restraint. Key words Coercive care, coercive interventions, psychiatric care, patients’ experiences.

Palliativ omvårdnad är något de flesta sjuksköterskor kommer i kontakt med under sitt yrkesverksamma liv. Syftet med litteraturstudien var att belysa upplevelser i omvårdnaden ur ett patientperspektiv.  Nio artiklar valdes för granskning, ur artiklarnas resultat framkom sex teman: Upplevelser av; omvårdnadsrelationer, kommunikation och information, vårdmiljön, symtomkontroll, tillgänglighet och självbestämmande. I resultatet framkom att en förtroendefull relation och kommunikation skapade god omvårdnad. Brister i kommunikationen kunde även förekomma. En bra sjuksköterska upplevdes som någon som lyssnade och hade bred kunskap. Patienter ville vara delaktiga i sin vård och behandling. / Palliative care is something most nurses are dealing with during their working lives. The purpose of this study was to illuminate the experiences of nursing care from a patient perspective. Nine articles were selected for review, from the articles six themes revealed: Experiences of; nursing relationships, communication and information, the care environment, symptom control, accessibility and self-determination. The result showed that a relationship of trust and communication created good nursing care. Lack of communication could also occur. A good nurse was perceived as someone who listened and had broad knowledge. Patients wanted to be involved in their care and treatment.

Bakgrund: I Sverige drabbas varje år cirka 30 000 personer av stroke och en tredjedel av dem får tydliga funktionsnedsättningar. Även livet för familj och andra närstående till den drabbade kan påverkas. Problem: Tidigare forskning visar att sjuksköterskor kan ha svårt att ta del av patienters upplevelser när de drabbats av funktionsnedsättning efter en stroke. Detta är något som kan påverka sjuksköterskans vårdande. Syfte: Att beskriva de drabbades upplevelser av att leva med funktionsnedsättning efter en stroke. Metod: En kvalitativ litteraturstudie av vårdvetenskapliga artiklar med Evans beskrivande syntes som analysmetod. Resultat: Upplevelser som kom fram delades in i tre stora teman och var kopplade till den förändrade kroppen, det förändrade jaget och den förändrade framtiden. Underteman var kopplade till kontroll och avsaknad av kontroll av kroppen, ett nytt jag och en ny roll, förlust av självständighet samt återhämtning och positiva tankar om framtiden. Slutsats: Att leva med funktionsnedsättning efter en stroke är något som påverkar den drabbade både kroppsligt, själsligt och andligt och det blir en omställning till ett nytt liv. Sjuksköterskan bör bli medveten om dessa upplevelser för att göra vården för dessa patienter så bra som möjligt. / Background: In Sweden aproximately 30 000 people suffers a stroke every year and a third of the victims are also affected by disabilty. The life of families and relatives of the victim is also affected. Problem: Previous research shows that nurses may find it difficult to take part of patients’ experiences when they are affected by disabilty after a stroke. This may be something that can affect the nursing care. Aim: To describe the victims’ experiences of living with disabilty after a stroke. Method: A qualitative literature review based on scientific articles with a descriptive synthesis by Evans as the method of analysis. Result: The experiences that came upp were divided into three different themes which were linked to the changed body, the changed self and the changed future. The subthemes were linked to the control and the lack of control of the body, a new self and a new role, loss of independence, recovery and positive thoughts about the future. Conclusion: Living with disabilities after a stroke is something that affects the victim both physically, mentally and spiritually and it will be a life changing event. Nurses should be aware of these experiences to make the nursing care as good as possible.

The purpose of this mixed method study was to determine the extent of physical problems, rehabilitation needs, and cancer rehabilitation experiences after breast cancer treatment. Women diagnosed with breast cancer were surveyed to examine physical morbidities, disability, and quality of life. An interpretive descriptive approach was used in the conduction of a focus group. The percentage of women experiencing physical problems after breast cancer treatment was high, physical disability was low and there was a moderately high quality of life. Despite the high report of physical problems, less than half received physical rehabilitation. Themes from the focus group data were difficulty in finding clear/consistent information, financial issues and the need for integration of cancer rehabilitation services. This research adds to the better understanding of cancer rehabilitation needs and practices and may be used to improve the delivery of cancer rehabilitation services to address the physical needs of breast cancer survivors.

This study focuses on investigating the psychological needs of orphans affected by HIV/AIDS and how these learners can be supported in order to cope effectively with the challenges posed by the HIV/AIDS pandemic. The study needed to understand the psychological well being of learners affected or orphaned by HIV/AIDS, their general performance at school, the nature and extent of social support they get from their families, communities and societies and their physical well being. Suggestions for an ecosystemic theoretical framework to be infused in all psycho-social support programmes geared to strengthen the psycho-social well-being of AIDS orphans were made. Orphans are affected by the HIV/AIDS pandemic emotionally, physically, spiritually and socially. Affected learners have fewer opportunities for schooling and education, may suffer from malnutrition. They are themselves often highly vulnerable to HIV infection and are at higher risk of developing psychological problems. In this study, a case study design was followed. Interviews were conducted with a sample of participants including orphaned learners living in a child-headed household, class-educator, an aunt and a health worker in Soweto. The researcher recruited participants by means of snowball sampling. Results revealed that learners orphaned by HIV/AIDS suffer emotional trauma and grief, illness and stress. They have scholastic problems, suffer stigmatization and discrimination, miss out on educational opportunities and experience poverty. This is an indication of a need for social support. It is for this reason that an ecosystemic support programme which schools can adopt and adapt in order to develop the psychological and social resilience of learners affected and orphaned by the HIV/AIDS pandemic is proposed. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2006.

This study focuses on investigating the psychological needs of orphans affected by HIV/AIDS and how these learners can be supported in order to cope effectively with the challenges posed by the HIV/AIDS pandemic. The study needed to understand the psychological well being of learners affected or orphaned by HIV/AIDS, their general performance at school, the nature and extent of social support they get from their families, communities and societies and their physical well being. Suggestions for an ecosystemic theoretical framework to be infused in all psycho-social support programmes geared to strengthen the psycho-social well-being of AIDS orphans were made. Orphans are affected by the HIV/AIDS pandemic emotionally, physically, spiritually and socially. Affected learners have fewer opportunities for schooling and education, may suffer from malnutrition. They are themselves often highly vulnerable to HIV infection and are at higher risk of developing psychological problems. In this study, a case study design was followed. Interviews were conducted with a sample of participants including orphaned learners living in a child-headed household, class-educator, an aunt and a health worker in Soweto. The researcher recruited participants by means of snowball sampling. Results revealed that learners orphaned by HIV/AIDS suffer emotional trauma and grief, illness and stress. They have scholastic problems, suffer stigmatization and discrimination, miss out on educational opportunities and experience poverty. This is an indication of a need for social support. It is for this reason that an ecosystemic support programme which schools can adopt and adapt in order to develop the psychological and social resilience of learners affected and orphaned by the HIV/AIDS pandemic is proposed. / Thesis (M.Ed.)--North-West University, Vaal Triangle Campus, 2006.

När patienten önskar att få avsluta sitt liv i hemmet krävs det att den avancerade vården också flyttas till hemmet. Distriktssköterskor har övergripande omvårdnadsansvar inom palliativ hemsjukvård och kan uppleva etiska, moraliska och kommunikativa svårigheter. För en god palliativ omvårdnad krävs det att distriktssköterskor är engagerade, har erfarenhet och har avancerad kompetens inom palliativ vård. Syftet med denna studie är att belysa distriktssköterskors erfarenheter av att vårda patienter i livets slutskede inom palliativ hemsjukvård. Nio distriktssköterskor intervjuades. För att analysera data användes en kvalitativ innehållsanalys med induktiv ansats. Analysen resulterade i fyra teman med tillhörande åtta underteman. Teman benämns; Kunna samarbeta och samverka i vården, Kunna vårda anhöriga, Kunna hantera negativa känslor och Skapa en god vårdmiljö. Slutsatsen blev att, ett bra teamarbete är viktigt för distriktssköterskor men att ha olika vårdaktörer kan försvåra vårdarbetet. Det är viktigt för distriktssköterskor att kunna möta anhöriga och ta emot sorg då sorgen kunde komma som missnöje. Detta kan påverka vårdpersonalen negativt. Det är viktigt att distriktssköterskor får stöd vid känsla av otillräcklighet och känslomässiga reaktioner. Fortsatt forskning kan riktas ur anhörigas synvinkel för att kunna förstå anhörigas reaktioner. / When the patient wishes to die at their own home requires that the advanced care also moved to their home. District nurses have primary care responsibilities in palliative home care and may experience ethical, moral and communicative difficulties. For a good palliative care requires that district nurses is involved, have the experience and have advanced skills in palliative care. The purpose of this study is to illuminate district nurses' experiences of caring for patients in the final stage in palliative home care. Nine district nurses were interviewed. To analyze the data, a qualitative content analysis with an inductive approach was applied. The analysis resulted in four main themes with its eight sub- themes. Main themes titled; Being able to collaborate and cooperate in care, Being able to care for relatives, Being able to manage negative emotions and Able to create a good care environment. The conclusion was that, a good teamwork is important for district nurses but having different care providers can complicate caring. It is important for district nurses to meet relatives and receive grief when grief could come as dissatisfaction. This could affect the nursing staff negatively. It is important that district nurses are supported in the sense of inadequacy and emotional reactions. Further research may be aimed at relatives ' point of view in order to understand family members' reactions.

Det är inte ovanligt förekommande att ambulanspersonal råkar ut för hot och våldshändelser och enligt statistiken är detta ett problem som ökar hela tiden. Enligt Arbetsmiljöverket står vård och omsorgssektorn för 60 % av samtliga anmälningar inom hot och våldskategorin. Syftet med denna studie var att beskriva ambulanssjuksköterskans upplevelser och hantering kring hot och våld i det dagliga arbetet. Metod: Studien genomfördes som en kvalitativ intervjustudie där fem intervjuer med ambulanssjuksköterskor genomfördes. Ur resultatet framkom ett generellt tema; utsatt för hot och våld, med fem tillhörande kategorier; otrygg miljö, säkerhetstänkande, förebyggande strategier, avledande strategier och känslomässig hantering. Vidare påvisade resultatet att hot och våldssituationer inte enbart handlar om verbala hot eller våldshandlingar. Även situationer som upplevdes obehagliga, medförde en känsla av oro eller otrygghet. Det framkom ett antal olika situationer som kunde resultera i hot eller våld och som upplevdes som påfrestande för ambulanspersonalen. Vidare visade det sig att hanteringen för dessa situationer var många och personalen var nöjda med de handlingsplaner som fanns att tillgå, det var också vanligt att ambulanspersonalen själva utarbetade en beredskapsplan utifrån det givna tillfället där hot och våld kunde tänkas förekomma för att kunna hantera en eventuell våldsam situation. Vikten av att ha förebyggande strategier lyftes upp och betonades som särskilt viktig. Känslorna efter att ha blivit utsatt för hot eller våld kom ofta i efterhand och därav ansågs det viktigt med tid för eftertanke och reflektion. / It is not an uncommon occurrence that paramedics encounter threats and incidents of violence. According to statistics, this is a problem that is increasing over time. According to Arbetsmiljöverket the healthcare sector stands for 60 % of all notifications in the threats and violence category. The purpose of this study was to describe the ambulance nurse´s experiences of threats and violence in their daily work and how these situations are handled. Method: The study was performed as a qualitative interview study in which five interviews with ambulance nurses was conducted. The outcome of the result revealed a general theme; subjected to threats and violence, with five related categories: unsafe environment, safety awareness, prevention strategies, diversionary strategies, and emotional management. Additionally the results demonstrate that threats and violent situations are not only about verbal threats or acts of violence. Even situations that were experienced unpleasant, resulting in a feeling of anxiety or insecurity. It revealed a number of different situations that could result in threats or violence and this were perceived as stressful for the ambulance crew. Furthermore, strategies to manage these situations were many and the staff were satisfied with the contingency plan that was available, it was also common for paramedics themselves drew up a contingency plan based on the given time where threats and violence could be anticipated for such terms to face a possible violent situation. The importance of preventative work was lifted up and was emphasized as particularly important. Feelings after having been exposed to threats or violence often came afterwards and therefore it was considered important time for thought and reflection.

The purpose of this research was to identify the contributors to optimal sexual experiences. At present, there is a lack of clinical knowledge, research knowledge and in-depth public discourse concerning the nature of healthy sexuality. The theoretical and research literature in this area has focused almost exclusively on defining and conceptualizing sexual dysfunctions with little attention paid to either normal or satisfactory experiences. Very little theory exists on the nature and components of optimal sexuality. To date, no empirical investigations have been done to determine the contributors to optimal sexual experiences. In order to identify the contributors to optimal sexual experiences, semi-structured interviews were conducted with 12 individuals who reported having experienced “great sex”. A phenomenologically-oriented content analysis was performed on interview transcripts to determine the contributors to optimal sexual experiences. Analysis led to the identification of seven major contributors, two pathways towards optimal sexual experiences and two minor contributors. The major contributors included developmental contributors, individual qualities overall, individual qualities in-the moment, skills, relationship qualities overall, relationship qualities in-the-moment and environmental, situational and preparatory contributors. Each of these larger themes was also characterized by a variety of more specific themes. The two pathways that led to optimal sexual experiences included individual qualities that facilitated relationship qualities and relationship qualities that facilitated individual qualities. Finally, the minor contributors consisted of personal proclivities and miscellaneous contributors. Noteworthy findings of this investigation are discussed and then compared and contrasted with existing research and theory. The implications of this work for the general public, sex therapy, sex education, theory and research are considered as well as the strengths and limitations of this study.

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.