Bakgrund: Det är viktigt att känna sig delaktig i en familj och alla individer i familjen påverkar varandra, både positivt och negativt. Syskon betyder ofta mycket för varandra även om relationen inte alltid är positiv. När ett barn blir sjukt påverkas hela familjen. Det sjuka barnet får mer fokus och syskonet kan känna sig åsidosatt. Som teoretisk referensram till arbetet användes systemteori med fokus på familjecentrerad omvårdnad. Enligt teorin ses familjen som en helhet där alla delar, föräldrar, barnen och syskon, är beroende av varandra för att fungera på bästa sätt. Enligt familjecentrerad omvårdnad ska alla i familjen få komma till tals och bli uppmärksammade. Vården behöver uppmärksamma behoven hos hela familjen för att kunna ge bästa omvårdnad för alla inblandade. Syfte: Studiens syfte var att ta reda på vilka upplevelser och behov av stöd som syskon till sjuka barn har samt undersöka vad vården kan göra för syskonet. Metod: Metoden var litteraturstudie baserad på kvalitativa originalartiklar. Resultat: Föräldrar och syskon har ibland olika perspektiv och olika uppfattning om hur sjukdomen påverkar familjen. Syskon känner sig ofta åsidosatta. Syskon vill ha information och vill vara delaktiga i vården. Att ge information om sjukdomen ger trygghet till syskonet. Information, stödsamtal och gruppträffar har visat positivt resultat för syskon genom förbättrad empati, större förståelse för sjukdomen samt att de kan hantera och uttrycka sina känslor bättre. Familjestödjare har sett positiva resultat av att syskonet fått uppmärksamhet och höras. Slutsats: Syskon behöver involveras mer i vården av det sjuka barnet och de vill bli informerade. Det behövs en vårdplan tidigt i vårdförloppet för hela familjen. Vårdpersonal skall bekräfta syskonets tankar och visa att de lyssnar. Det behövs fler studier som väger in syskonets egna upplevelser och känslor. / Background: It is important to be a part of a family and all individuals in the family are affected of each other, both positively and negatively. Siblings often mean a lot to each other, even if the relationship isn´t always positive. When a child becomes ill, the entire family is affected. The ill child gets more focus and the sibling may feel overlooked. As a theoretical reference framework for the study, a system-theoretical model was used focusing on family-centered care. According to this theory, the family is seen as a whole where all parts are dependent on each other to have the family to work at its best. According to family-centered care, everyone in the family should be heard and get attention. Healthcare professionals should be able to detect the needs of the whole family to provide the best care for all involved. Aim: The aim of this study was to examine what experiences and needs siblings have when there is a sick child in the family and to examine what healthcare professionals can provide for the sibling. Method: The method was a literature study based on qualitative original articles. Results: Parents and siblings sometimes have different perspectives and different views of how the disease affects the family. Siblings often feel excluded. Siblings want to be informed and wants to be involved in the nursing. Providing information about the disease leads to a feeling of safety for the sibling. Information, support talks and group sessions have shown positive results for siblings by improved empathy, greater understanding of the disease, and better expressing of their feelings. Family support workers have seen positive results of the sibling after given more support and meetings. Conclusion: Siblings need to be more involved in the care of the sick child and they want to have more knowledge about the disease. A care plan is needed early in the process for the whole family. Healthcare professionals should confirm the sibling and show them that they are listening to them. More studies are required where sibling’s own experiences and feelings are heard.

Bakgrund Vaccinets funktion i att begränsa och eliminera virusbaserade sjukdomar är vetenskapligt bevisat och dess inverkan på samhället sedan införseln av ett nationellt barnvaccinationsprogram har varit otvivelaktig. I och med vaccinationsprogrammets framgång har rädslan och förståelsen för hur farliga barnsjukdomarna var minskat. Något som kan leda till att rädslan inte längre leder till en skyddande aktion såsom vaccinering. Syfte Syftet med denna studie var att undersöka informationens betydelse för föräldrars beslut att avstå från att vaccinera sitt barn eller låta vaccinera barnet. Metod Litteraturstudie baserad på elva vetenskapliga originalartiklar publicerade mellan år 2004-2018. Artikelsökning skedde i databaserna CINAHL, PubMed och SveMed+. Granskning av originalartiklar genomfördes enligt kvalitetsgranskningsmallar. I studien har the Health Belief Model samt familjecentrerad vård använts som teoretiska referensramar. Resultat Information är av yttersta vikt vid ett beslut om vaccination. Vårdgivare är viktiga i informationsgivandet. Det framkom att föräldrar vill ha neutral information med både för- och nackdelar. Föräldrar uppgav att de inhämtar information från internet, vetenskapliga studier eller vänner och familj. Information kan ges i muntligt eller skriftlig form. Muntlig information kan ske antingen genom faktagivning eller diskussion.   Slutsats Informationen har en betydande roll i beslutsprocessen hos föräldrar som ska vaccinera sitt barn. Föräldrar får information från vården, men de söker även information på egen hand för att komplettera informationen. Informationen från vården behöver anpassas efter personerna i fråga. Utifrån tydlig information som berör ämnet på ett trovärdigt sätt kan sjuksköterskan visa på vaccinationsprogrammets centrala roll i att minimera risker och maximera fördelar för barnet. / Backgrund Since the introduction of a national childhood vaccination programme, the vaccine's role in limiting and eliminating virus-based diseases have been scientifically proven and its impact on society has been undeniable. With the success of the vaccination programme, the fear of how dangerous childhood diseases have been diminished. This could lead to the fear no longer acting as a strong enough reason to vaccinate.  Aim The aim of the study was to investigate how significant information is to parents when deciding whether to refrain or receive vaccination for their child. Method The literature review is based on eleven scientific original articles published between the years 2004-2018. The article search took place in the CINAHL, PubMed and SveMed+ databases. Original articles were reviewed using quality review templates. The theoretical framework for this study was based on the Health Belief Model and Family Centred Nursing. Result Information is of utmost importance when deciding to vaccinate. Caregivers are important in the provision of information. It appeared that parents want neutral information with both pros and cons. Parents stated that they gather information from the internet, scientific studies or friends and family. Information may be given in oral or written form. Oral information may be given through both the presentation of facts or discussion.  Conclusion Information has a significant role in the decision-making process of parents to vaccinate their child. Parents receive information from healthcare, but they also seek information on their own to supplement the information. The information from healthcare needs to be adapted to the persons in question. Given that fair and direct information is provided, that relates to the subject in a credible way, the nurse can demonstrate the central role of the vaccination program in minimizing the risks and maximizing benefits to the child.

Heart failure is a growing public health problem associated with significant morbidity and mortality. Family support positively affects outcomes for the person with heart failure while also leading to caregiver burden. Registered nurses have a key role in supporting and meeting the needs of family caregivers. The overall aim was to explore the situation and needs of family caregivers to a person with heart failure, and explore requisites and ways of supporting and involving family caregivers in heart failure nursing care. Two interview studies, one web survey study and one intervention study were conducted between 2012 and 2017. A total of 22 family caregivers, eight persons with heart failure and 331 registered nurses participated in the studies. Family caregivers' daily life was characterized by worry, uncertainty and relational incongruence but salutogenic behaviours restored new strength and motivation to care. Family caregivers experienced that their caregiving was taken for granted by health care professionals. Family caregivers expressed a need for a permanent health care contact and more involvement in the planning and implementation of their near one’s health care together with health care professionals. Registered nurses acknowledged family caregivers’ burden, lack of knowledge and relational incongruence. A registered nurse was suggested as a permanent health care contact to improve continuity and security. Registered nurses neither acknowledged family caregivers as a resource nor their need for involvement. Registered nurses working in primary health care centres, in nurse-led heart failure clinics, with district nurse specialization, with education in cardiac nursing care held the most supportive attitudes toward family involvement in heart failure nursing care. Family health conversations via telephone in nurse-led heart failure clinics were found to successfully support and involve families. The conversations enhanced nurse-family relationship and relations within the family. They also provided registered nurses with new, relevant knowledge and understanding about the family as a whole. Family health conversations via telephone were feasible to both families and registered nurses, although fewer and shorter conversations were preferred by registered nurses. This thesis highlights the divergence between family caregivers’ experiences and needs, and registered nurses’ perceptions about family caregivers’ situation and attitudes toward the importance of family involvement. It adds to the knowledge on the importance to acknowledge family caregivers as a resource and to support and involve them in heart failure nursing care. One feasible and successful way is to conduct Family health conversations via telephone in nurse-led heart failure clinics.