Bakgrund: Globalt sett är arbetsrelaterad stress ett stort problem. Hälso- och sjukvårdsbranschen är den mest drabbade och detta kan medföra konsekvenser både för sjuksköterskors hälsa samt vårdkvaliteten. Det finns ett behov av att öka förståelsen och fastställa faktorer som bidrar till arbetsrelaterad stress hos sjuksköterskor.  Syfte: Syftet var att beskriva sjuksköterskors erfarenhet av arbetsrelaterad stress inom sjukhusvård. Metod: En litteraturstudie baserad på åtta kvalitativa intervjustudier. Databassökning gjordes i Cinahl och PubMed. Analysen genomfördes utifrån femstegsmodellen av Friberg. Resultat: Analysen resulterade i tre huvudkategorier och sex underkategorier. Huvudkategorierna var: organisatorisk struktur, relationer och professionen.  Konklusion: Personalbrist, tidsbrist, höga krav samt bristande kompetens var några faktorer som framkom och detta visar på att faktorerna som leder till arbetsrelaterad stress i viss utsträckning påverkas av varandra. Enligt krav-kontrolloch stödmodellen är det viktigt att sjuksköterskor känner en balans mellan krav och kompetens vilket talar för att kompetensutveckling bör prioriteras på arbetsplatsen. / Background: Globally, occupational stress is a major problem. The healthcare sector is the most affected and this can have an impact on both the health of nurses and the quality of care. There is a need to increase understanding and identify factors that contribute to work-related stress among nurses.  Aim: The aim was to describe nurses' experiences of work-related stress in hospital care. Methods: A literature review based on eight qualitative interview studies. Database searches were conducted in Cinahl and PubMed. The analysis was conducted using the five-stage model by Friberg. Results: The analysis resulted in three main categories and six sub-categories. The main categories were: organizational structure, relationships and the profession. Conclusion: Lack of staff, lack of time, high demands and lack of skills were some of the factors that emerged and this indicates that the factors leading to occupational stress are to some extent influenced by each other. According to the demand-control and support model, it is important for nurses to feel a balance between demands and competence, which suggests that competence development should be a priority in the workplace.

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Introduction: Contemporary hospital settings are a challenging learning and working environment for healthcare professionals. The challenges are largely related to the increasing need for healthcare caused by an ageing population, a lack of personnel resources, and demands for time efficiency. Therefore, it is of interest to study how individuals and teams learn during these working conditions. Nurses are especially exposed when entering working life, why this profession has been of interest to explore further in this thesis. Furthermore, the interprofessional team is significant in providing qualitative care at the hospital wards, which could be affected by the lack of nurses and demands for efficiency. Aim: To explore work integrated learning from an individual nurse and interprofessional team learning perspective in a contemporary hospital ward setting. Methodology: Two qualitative approaches were used in this thesis. Study I was a qualitative content analysis based on individual interviews with 10 nurses within hospital ward care. Study II was an insider action research project (IAR) within a specific hospital ward. Data from the project in Study II were analyzed using the cycle of expansive learning. Results: Study I showed that, during their early working life, newly graduated nurses learned their profession by developing and using different learning strategies. Their initial strategy was to learn how to perform daily tasks as safely and effectively as possible. However, in learning how to provide qualitative care, the nurses realized the importance of participating in bedside care to gain clinical experience. Opportunities to learn from clinical experiences and reflection were essential for developing as a new nurse. Study II explored work integrated learning in an interprofessional ward team. The learning process resulted in the establishment of a digital planning board to illustrate the patients’ recovery process during their stay at the ward. This board opened an opportunity to learn about core values and goals for discharge, but also contributed to boundary awareness between the professionals, which was important for collaboration to improve patient safety in daily work. Discussion: The results reveal that work-integrated learning was manifested in an interdependency between the professionals and the health-care organization. The interdependency was multifaceted as the professionals were dependent on each other to learn as individuals in relation to each other, and to develop their joint work processes. The professionals were also dependent on the organizational prerequisites to learn. This result shows the need for the professionals to develop their own learning strategies to manage daily work, which was associated with the professional’s motivation in leading their own professional development towards qualitative and safe care. Conclusion: The results of this thesis reveal that the professions within a hospital ward setting are largely dependent on each other to create conditions for work integrated learning. The individuals and the team both had strong determination, will, and desire to learn to provide patients with care that was as qualitative and safe as possible. The quality of work-integrated learning was found to be related to the professions’ awareness of boundaries, knowledge, and responsibilities related to each other within the interprofessional team. / Denna studie har utforskat det arbetsintegrerade lärandet hos nyutbildade sjuksköterskor och hos ett interprofessionellt team, i en sjukhusavdelningsmiljö. Resultatet visade att organisatoriska förutsättningar såsom brist på personal, högt vårdflöde samt uppgiftsväxling, tvingar de nyutbildade sjuksköterskornas att anta strategier som gör att det måste förlita sig på andrahandsinformation för bedömning av patienters status. Även om det patientnära arbete uttrycks som väsentligt för att lär sig yrket, tvingas de nyutbildade ofta att prioritera administrativa uppgifter och därmed missas väsentligt information viktig för lärande och för att kunna hantera arbetet säkert och kvalitativt. Organisatoriska förutsättningar riskerar därmed också att ”förlänga” lärandet mot ett expert-kunnande. Resultat visa dock att det finns en styrka i att hitta sina egna vägar att ta sig fram i en svår lärandemiljö, där den professionelles ”jävlar anamma”, engagemang och motivation för att lära, påverkar både riktning och innehåll i lärandet. Resultatet visar att hos både den enskilda sjuksköterskan och hos teamarbetets medlemmar fanns ett driv, vilja och önskan att lära för att kunna ge patienterna en så god och säker vård som möjligt. Det arbetsintegrerade lärandet visade sig också vara relaterat till professionernas medvetenhet om hur deras egna professionella gränser, kunskap och ansvar förhöll sig till övriga medarbetare i teamet. Att skapa ett medvetande om professionella gränser inom teamet innebar att utveckla kunskap om varandras professionella ansvar och bidrag till vårdteamet som helhet samt vilka värderingar och målsättningar som kunde leda teamets arbete framåt. Undersköterskans roll för sjuksköterskans och vårdteamets arbetsintegrerade lärande var central. Att tydliggöra gränser mellan professionerna kräver ett gediget arbete som tar tid, motivation och uthållighet hos både individer och ledning. Ett arbete som kan vara svårt att åstadkomma i vardagsarbetet och därför kräver särskilda insatser men kan ha avgörande beredelse för vårdkvalitén och patientsäkerheten. Sammanfattningsvis kan denna uppsats bidra med fördjupad kunskap om arbetsintegrerat lärande i dagens sjukhusvård. Inom sjukhusvården, där effektivitetskrav dagligen måste balanseras gentemot bristande resurser, kan sjukhusavdelningar lärandemiljö ifrågasättas. Strategiska lärandestrategier krävs för att kunna säkerställa ett kvalitativt arbetsintegrerat lärande för nyutbildade sjuksköterskor och för teamet. / <p>Paper  B is not included in the electronic version. </p>

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A three-day food intake was recorded for 100 elderly patients who were subsequently interviewed to determine the relationship of income level, educational level completed, and sex of the person with the nutrient intakes of these patients. Three-day caloric and nutrient intakes were recorded and compared to the 1974 Reconmended Daily Allowances (RDA). Mean intake for a three-day period of seven nutrients showed patient averages met at least 100 percent of the RDA for all nutrients except calcium. The females had a mean intake of ninety-six percent of the RDA for calcium. The patients with the lower incomes had dietary patterns that were less adequate than the patterns for those with higher incomes, and these patients ate more carbohydrate and less protein than did the patients with higher income. Nutrient intake was increased for the patients as their level of education increased. There were no significant differences in the nutrient intakes between sexes. The males had a higher nutrient intake and had a higher percentage of protein in their diets than did the females, however, the differences were slight. It was concluded from the above results that certain beneficial changes in the study menu could be made. Especially important areas such as calcium and fat intake may need modification at some time in the future as more light is shed on these areas. / Master of Science

Bakgrund Bristande handhygien hos hälso-och sjukvårdspersonal bidrar till smittspridning och ökade kostnader för hälso-och sjukvården. Hälso- och sjukvårdspersonalen har en avgörande roll i att minska smittspridningen med hjälp av noggrant genomförd handhygien. Trots att kunskap i ämnet finns så brister handhygienen och patienterna beroende av sjukvård drabbas av vårdskador i samband med vård och behandling. Syfte Syftet är att beskriva faktorer som påverkar vårdpersonalens följsamhet av hygienrutiner på sjukhus. Metod En litteraturöversikt har genomförts med 13 vetenskapliga artiklar som publicerats under tidsperioden 2012–2024 i databaserna CINAHL och PubMed. Resultat I litteraturöversiktens resultats del kunde tre huvudkategorier hittas: verksamhetsfaktorer, arbetsfaktorer och personliga faktorer. Utifrån dessa tre huvudkategorier kunde åtta underkategorier identifieras. Kategorierna präglas av alltifrån personliga faktorer som glömska och preferenser. Till organisationsfaktorer där bland annat resursbrist och bristande rutiner beskrivs. Slutsats Det breda spektrumet av påverkande faktorer kan förebyggas och åtgärdas genom kunskap och strukturimplementering. På så vis skulle följsamheten till hygienrutiner öka och patientsäkerheten främjas. / Background Insufficient hand hygiene in healthcare contributes to the spread of infection and increased costs for the healthcare system. Healthcare professionals have a decisive role in reducing the spread of infection with the help of carefully implemented hand hygiene, even though there is knowledge on the subject, hand hygiene is lacking and patients dependent on medical care suffer from health care related injuries. Aim The aim is to describe factors that influence healthcare staff's adherence to hygiene routines in hospitals. Method A literature review has been carried out with 13 scientific articles published during theperiod 2012–2024 in the databases CINAHL and PubMed. Results In the results section of the literature review, three main categories could be found: institutional factors, work factors and personal factors. Based on these three main categories, eight subcategories could be identified. The categories are characterized by everything from personal factors such as forgetfulness and preferences. To organizational factors where,among other things, lack of resources and inadequate routines are described. Conclusions The broad spectrum of factors can be prevented and solved with knowledge and implementation of structures. With that the adherence to hygiene routines could increase and the patient safety would be promoted.

Yes / Purpose The 999 ambulance call handler is critical in responding to emergency patient treatment; however, the call handlers are often a hidden component of the healthcare workforce and an under-researched group. The objective of this study is to understand stress triggers experienced by 999 ambulance call handlers that could lead to burnout and examine personal and organisational mechanisms and strategies which reduced the risk of burnout. Design/methodology/approach A single interview case study approach applying qualitative methods was undertaken. Participants were identified through a purposive sample of 999 ambulance call handlers with the Yorkshire Ambulance Service National Health Service Trust (UK). Participants were interviewed via telephone between July 2019 and September 2019. Findings In total, 18 staff participated in this study. Societal factors including public incivility and media representation and organisational factors, such as a demanding environment, lack of appreciation and career progression, training issues and protocols were key stressors. Organisational well-being services were helpful for some, but for others lacked accessibility and appropriateness. Positive public feedback and speaking with peers bolstered well-being. 999 ambulance call handlers suggested that sufficient breaks, co-design or feeding back on training and protocols and creating more informal opportunities to discuss ongoing everyday stressors as methods to reduce stress and burnout. Originality/value This paper explores a previously under researched area on stressors and potential burnout in 999 call handlers. This paper highlights the need for improved organisational support services and appropriate public and sector peer recognition of the role of ambulance 999 ambulance call handlers. / This research was funded by the University of Bradford Research Development Fund. This research was supported by Yorkshire Ambulance Service NHS Trust, and the National Institute for Health Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC).

published_or_final_version / Social Work / Master / Master of Social Work