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Introduktion: När ett barn diagnostiseras med cancer, oavsett ålder, ökar barnets behov av föräldrarnas stöd och trygghet. Därför är föräldrarnas delaktighet i vården betydelsefull och något som bör uppmuntras och stödjas av samtlig vårdpersonal. Omvårdnaden av svårt sjuka barn ställer höga krav på sjukvården och som sjuksköterska är det viktigt att arbeta familjecentrerat för att möta och tillgodose hela familjens behov. Familjecentrerad omvårdnad innebär att varje familj ska betraktas som unik och att vården ska anpassas efter familjens behov och situation. Syfte: Syftet var att beskriva hur föräldrar till barn med cancer upplever möjligheter och hinder i den familjecentrerade omvårdnaden vid långvarig sjukhusvistelse. Metod: En litteraturöversikt med deskriptiv design baserad på 13 kvalitativa artiklar. Artiklarna kvalitetsgranskades med SBU bedömningsmall för kvalitativ metodik. Databearbetningen av litteraturstudien utfördes enligt Popenoe et al. (2021) beskrivning av allmän litteraturstudie. Resultat: I resultatanalysen framkom fyra kategorier; relation, kunskap, delaktighet och information. Under respektive kategori utformades underkategorier vilka beskrev möjligheter och hinder med familjecentrerad omvårdnad.  Slutsats: Föräldrars upplevelser av möjligheter och hinder i den familjecentrerade omvårdnaden är mångfacetterade. En god vårdrelation, erfaren och kompetent vårdpersonal, främjad delaktighet och tillgodosett behov av information var möjligheter i den familjecentrerade omvårdnaden. Detta ställer krav på vårdpersonalens närvaro, engagemang samt deras förmåga att kommunicera och anpassa omvårdnaden - aspekter som annars utgjorde hinder för den familjecentrerade omvårdnaden. / Background: When a child is diagnosed with cancer, regardless of age, the child's need for parental support and security increases. Therefore, parents' participation in care is important and something that should be encouraged and supported by the staff. Nursing ill children places high demands on healthcare and as a nurse it is important to work family-centered to meet and satisfy the needs of the family. Family-centered care means that each family is considered unique, and that care must be adapted to the specific needs and situation. Aim: The aim was to describe how parents of children with cancer experience opportunities and obstacles in family-centered care during long-term hospital stay. Method: A literature review with descriptive design based on 13 qualitative articles. The articles were quality reviewed using the SBU assessment template for qualitative methodology. Data was analyzed using Popenoe et al. (2021) description of general literature review. Results: In the results analysis, four categories emerged; relationship, knowledge, participation and information. Under each category, subcategories were created which described possibilities and barriers for family-centered care. Conclusion: Parents' experiences of opportunities and obstacles in family-centered care are multifaceted. A good nursing relationship, experienced nursing staff, promoted participation and satisfied need for information were opportunities in family-centered nursing. This places demands on the care staff's presence, commitment and their ability to communicate and adapt the care - aspects that otherwise constituted obstacles for the family center regarding care.

BACKGROUND: People survive repeated health crises that used to be fatal and, at times, treatment intended to prolong life, prolongs death instead. Many people die in hospitals although they say they prefer to die at home. At the same time, research identifies multiple ways the American healthcare system is ill equipped to serve patients at the end of life. Presently, 20% of Americans die in Intensive Care Units (ICU), thus ICUs represent an important setting for learning about end-of-life care and death in America today. PURPOSE: To explore the nature of ICU care as perceived by family members, this qualitative study analyzed 693 reports from surveys mailed to family members of patients who died in the ICU of a major Boston hospital between 2009 and 2015. The study focused on experiences of received services as reported in responses to the survey’s three open-ended questions regarding helpful and unhelpful aspects of care surrounding the patient’s death. Family member experiences with social work services were also explored. METHODS: Data were assessed using the Family-centered Care (FCC) model, an emerging framework for provision of best practices in hospital settings. This framework emphasizes that patients, families, and health care providers work in partnership to set treatment goals. Since FCC has been correlated with better outcomes, one research objective here was to explore the extent to which family members’ experiences reflected the presence of FCC. The study also assessed family members’ experiences that fell outside the realm of FCC. Using NVivo software, analysis was guided by Braun and Clarke’s (2012) six-phase thematic analysis approach. FINDINGS AND IMPLICATIONS: Family members described numerous positive experiences. Deaths were humane and the delivery of FCC was evident. An in-depth data analysis provided illuminating details of FCC and explicated over 47 themes important to families’ ICU experiences. Families reported that they received emotional support, were well-informed, and were treated with respect. Findings suggest that FCC is possible in an ICU setting, supporting the use of FCC in ICU care and suggesting that it could profoundly improve the quality of end-of-life care. Responses concerning the role of social work were limited.

Bakgrund  Prognosen för barncancer är idag god och ca 80 procent av barn överlever sin diagnos även om en stor del drabbas av sena komplikationer. Familjecentrerad vård är ett begrepp som ser familjen som en enhet snarare än den individuella familjemedlemmen som genomgår behandling. Vidare har tidigare forskning visat på ett samband mellan måendet hos barn som undergår behandling och deras föräldrars mående då de är barnets primära stöd under behandlingen. Trots tidigare forskningsresultat är familjecentrerad vård inte fullt utnyttjat inom vård och missar potentiellt de positiva effekter det skulle kunna innebära för familjer med barn som undergår behandling för sjukdomar som cancer.       Syfte   Att beskriva föräldrars erfarenheter av att ha ett barn med cancer.   Metod Studien baserades på en icke-systematisk litteraturstudie av 19 artiklar. Artikelsökningen har genomförts i de tre vetenskapliga databaserna PubMed, CINAHL samt PsychInfo. Integrerad analys har utförts. De inkluderade artiklarna har genomgått en kvalitetsgranskning med Sophiahemmets Högskolas bedömningsunderlag för att säkerställa kvalitet och tillförlitlighet.      Resultat Resultaten antyder att det finns ett flertal olika stöd som föräldrar skulle kunna erhålla för att förbättra deras mående när deras barn har cancer. Att behålla sitt sociala liv samt ett relativt normalt arbetsliv var kopplade till positiva effekter på föräldrars mående. Majoriteten av artiklarna var samstämmiga kring att känslor kopplade till att vara förälder till ett barn med cancer inkluderade posttraumatiska stressymtom, depression, ångest och känslor av tappad kontroll över sin livssituation.    Slutsats Ett flertal olika stöd föreslås förbättra föräldrars mående. Stöd i form av kunskap och samtal mellan vårdpersonal och föräldrar ökar samt ger möjlighet att behålla ett socialt liv, den personliga sfären och relativt normalt arbetsliv föreslås också ha positiva effekter. / Background The prognosis for children's cancer is generally good and approximately 80 percent of children survive their diagnosis though many children are affected by late complications. Family centered care is a body of literature suggesting viewing the family as one unit, rather than focusing caregiving on the individual patient in need of physical care. Furthermore, previous research has shown that the mental health of children receiving care is connected to the mental health of their parents. This is mainly explained by the parental role of primary support to the child undergoing care, the mental health of the parent affecting the ability to provide the support needed for the child. Despite previous research findings, family centered care is underutilized within health care, potentially not realizing positive effects for families with children undergoing treatment for diseases such as cancer.   Aim To describe the experiences of parents to children undergoing treatment for cancer.   Method    The study was conducted using a non-systematic literature study of 19 articles. The article search has been conducted in the three scientific databases PubMed, CINAHL and PsychInfo. Integrated analysis has been performed. The included articles have been assessed with Sophiahemmet Universities assessment basis to ensure quality and reliability.     Results The results suggest that there are a number of different kinds of support that parents could receive in order to improve their mental well being during the treatment of their child. Maintaining a social life as well as the ability to keep working on a relatively normal level were suggested to contribute to parents’ well being. Furthermore the majority of the included articles were consistent on that feelings experienced as a parent of a cold with cancer were post traumatic stress symptoms, depression, anxiety and a feeling of loss of control of their life situation.      Conclusions  Several types of support could be offered to parents to improve their mental health. Support in knowledge about the disease and its treatment as well as support to maintain a social life, retaining the personal sphere and a relatively normal working life are all suggested to have a positive effect.

Bakgrund: Globalt uppskattas 55 miljoner vara i behov av palliativ vård. I Sverige erhåller cirka 60 000 människor palliativ vård. Syftet med den palliativa vården är att symtomlindra och bibehålla god livskvalitet. Det är av vikt att sjuksköterskan undersöker närståendes upplevelser av palliativ vård för att kunna bemöta och ge ett gott stöd. Syfte: Syftet var att beskriva närståendes upplevelser av palliativ vård i livets slutskede. Metod: En kvalitativ litteraturöversikt med induktiv ansats där 14 artiklar analyserades till resultatet. Resultat: Två teman och sex subteman identifierades. Temat behov av att känna trygghet med tillhörande subteman; Att få tillräcklig information, att ha en god relation till vårdteamet och att befinna sig i en trygg miljö. Temat behov av att känna stöd med tillhörande subteman; att känna sig trygg i vårdarrollen, att få vara inkluderad, att få stöd i att hantera dödens närvaro.    Slutsats: Närstående upplevde vikten av att känna trygghet och att få stöd. En meningsfull relation och tillräcklig information ansågs vara avgörande för att skapa känslan av trygghet. Behovet av att erhålla stöd från vårdpersonalen upplevdes vara viktigt för att få möjligheten att vara involverad och att ha ett inflytande inom vårdförloppet. Familjecentrerad vård återspeglades i resultatet genom att de centrala aspekterna framkom i sjuksköterskans och vårdteamets bemötande med närstående. / Background: Globally 55 million people are estimated to be in need of palliative care. In Sweden, approximately 60,000 people receive palliative care. The purpose of palliative care is to relieve symptoms and maintain a good quality of life. It is important that the nurse examines relatives' experiences of palliative care in order to be able to encounter relatives and provide good support. Aim: The aim was to describe relatives' experiences of palliative care at the end of life. Method: A qualitative literature review with an inductive approach where 14 articles were analyzed for the result. Result: Two themes and six subthemes were identified. The theme of need to feel secure with associated subthemes; to receive sufficient information, to have a good relationship with the care team and to be in a safe environment. The theme of need to feel supported with associated subthemes; to feel safe in the caregiver role, to be included and to be supported in dealing with the presence of death.  Conclusion: Relatives experienced the importance of feeling safe and receiving support. A meaningful relationship and sufficient information were considered crucial to creating a sense of security. The need to receive support from the care staff was felt to be important in order to have the opportunity to be involved and to have an influence within the care process. Family-centered care was reflected in the results by the fact that the central aspects emerged in the nurse’s and care team’s encounter with relatives.

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Bakgrund: Barnsjukvården bedrivs idag på ett sätt som inkluderar hela familjen i omvårdnaden. Det är viktigt att öka förståelsen för de känslor och behov som föräldrar till sjuka barn upplever vid de tillfällen då deras barn vistas på sjukhus, eftersom sjuksköterskan som omvårdnadsansvarig ska kunna möta och tillgodose dessa behov. Syfte: Att genom en litteraturstudie undersöka föräldrars behov och upplevelser av deras barns sjukhusvistelse. Artiklar söktes i databaserna CINAHL och PubMed och analyserades enligt Graneheim & Lundmans kvalitativa innehållsanalys. Tre teman identifierades relaterat till föräldrars behov: Miljö, Psykosocialt och Kommunikation. Fyra teman identifierades relaterat till upplevelser: Miljö, Psykosocialt, Kommunikation och Relationer. Resultat: Det framkom att föräldrar upplevde sjukhusvistelse som påfrestande. Miljön upplevdes främmande och annorlunda och i denna var föräldrar sårbara och känsliga. Föräldrar hade ett uttalat behov av att vara nära sitt barn och ville att sjuksköterskan skulle vara ärlig och omsorgsfull i omvårdnaden. De hade behov av en personlig relation med sjuksköterskan och behövde vägledning och stöd i beslut. Föräldrar behövde uppmuntras för att inte tappa hoppet i situationer som kändes hopplösa och sökte bekräftelse när dem upplevde skuldkänslor för barnets sjukdom. Vad föräldrar behöver varierarde beroende på förutsättningar och situation, men den generella uppfattningen var att dem upplevde sina behov otillfredsställda. / Background: Child health care in Sweden is currently carried out in a way that includes the whole family, therefore it’s important to increase understanding of the feelings and needs that parents of hospitalized children experience to enable the nurse to meet and satisfy these needs. Aim: Thru a literature review examine parents' needs and experiences of their child's hospitalization. Articles were searched in the databases CINAHL and PubMed, and analysed according to Graneheim & Lund 's qualitative content analysis. Three themes were identified related to parents' needs: Environment, Psychosocial and Communication. Four themes were identified related to the experiences: Environment, Psychosocial, Communication and Relationships. Result: Parents experienced hospitalization as strenuous. The environment felt strange and different and parents were vulnerable and sensitive. Parents had a need to be near their child and wanted the nurse to be honest and diligent in his or her care. They had need for a personal relationship with the nurse, guidance and support. Parents needed to be encouraged not to lose hope in situations that seemed hopeless, and sought confirmation when they experienced feelings of guilt for their child's illness. What parents need varied depending on circumstances and situation, but the general opinion was that they felt their needs were unmet.

Background: Every year, hundreds of children are diagnosed with cancer. This affects the whole child's family, which means that the nurse during the child's cancer care must be there to support the whole family. The parent needs to feel involved in the child's care and have a trusting relationship with the nurse. As a parent, you have to go through a great deal of suffering, which requires the nurse to adapt her support to the needs of the parent and the child. Aim: The purpose of this study was to shed light on how a parent with a child with cancer experiences the nurse's support during and after cancer care. Method: A literature-based study was conducted. Ten qualitative articles were selected and analyzed, based on Friberg's analysis step model. This participates in three categories and a total of eight subcategories. Results: The results showed that the nurse's support was an important factor in an attempt to reduce the parent's suffering. This support could be divided into three categories: Cooperation between nurse and parent, parent's need for support and accessibility and communication. Conclusion: Pediatric cancer affects the whole child's family, and the parent is in great need of support to deal with their suffering and at the same time support their child. During their child’scancer care, the parent goes through many feelings of no longer recognizing their own child, as well as being helpless in their parenting role. By the nurse working in an empathetic and inclusive way where there is an opportunity to build meaningful and strengthening relationships between the parent and the nurse and that the parent's needs are also met, the parent's suffering can be reduced with the help of the nurse's support.

Bakgrund I Sverige drabbas tusentals människor av hjärtstopp årligen, och dessa omhändertas inom akutsjukvården. Den vanligaste orsaken till hjärtstopp är hjärtinfarkt. För att rädda deras liv genomförs hjärt- och lungräddning (HLR). Ett perspektiv till situationen är de närstående och deras närvaro under HLR. Personalen upplever bland annat att de närstående kan vara i vägen och ett stressmoment. Däremot upplever de också att de kan stärka bandet mellan varandra när de närvarar. Den teoretiska utgångspunkten för studien var familjecentrerad vård och det syftar till att involvera de närstående och även ge dessa omvårdnad. Syftet var att belysa närståendes upplevelse av att ha närvarat vid HLR inom akutsjukvården och hur detta har påverkat de närstående efteråt. Metod Studien har genomförts som en icke-systematisk litteraturöversikt med systematisk sökmetod. Totalt har 15 artiklar inkluderats varav 10 var kvalitativa och fem var kvantitativa. De analyserades med en integrerad innehållsanalys. Resultatet fick fyra huvudkategorier vilka var Känslor under hjärt- och lungräddning, Delaktighet, Information samt Livet efter. Ur dessa har 10 underkategorier tagits fram. Dessa var Trygghet, förståelse, negativa känslor, vårdpersonalens roll, närståendes roll, valmöjlighet, tydlig information, bristen på information, positiva känslor efter samt negativa känslor efter. Studien kom fram till att det under HLR finns många känslor både positiva och negativa och att de närstående upplevde att stöd från vårdpersonalen var viktigt. Dessutom framkom det att informationen var en central del för att minska ångest och öka känslan av trygghet och hopp. Slutsatserna från studien är att de närstående upplever många känslor när de bevittnar HLR, de kan vara positiva eller negativa känslor. Dessutom önskar de närstående att de får stöd och att de önskar få valmöjligheten att vara delaktiga. Även efter situationen känner de många känslor. / Background In Sweden, thousands of people suffer from cardiac arrest every year, and these are dealt with in emergency medical care. The most common cause of cardiac arrest is heart attack. To save their lives, cardiopulmonary resuscitation (CPR) is performed. One perspective to the situation is the relatives and their presence during CPR. The staff experiences, among other things, that the relatives can be in the way and are a moment of stress. However, they also feel that they can strengthen the bond between the staff and the relatives when they attend. The theoretical framework for the study was family-centered care which aims to involve the next of kin and also provide them with care. The aim was to shed light on the relatives' experience of having been present during CPR in emergency healthcare and how this has affected the relatives afterwards. Method The study has been carried out as a non-systematic literature review with a systematic search method. A total of 15 articles have been included, of which 10 were qualitative and five were quantitative. They were analyzed using an integrated content analysis. Results The results received four main categories, which were Feelings during cardiopulmonary resuscitation, Participation, Information and Life after. From these, 10 subcategories have been developed. These were Safety, understanding, negative feelings, the role of the care staff, the role of relatives, choice, clear information, the lack of information, positive feelings after and negative feelings after. The study concluded that during CPR there are many emotions, both positive and negative, and that the relatives felt that the support of the healthcare staff was important. In addition, it emerged that the information was a central part of reducing anxiety and increasing the feeling of security and hope. The Conclusions from the study is that the relatives experience many emotions when they witness CPR, they can be positive or negative emotions. In addition, the relatives wish that they receive support and that they wish to be given the choice to participate. Even after the situation, they feel many emotions that will affect them.