Bakgrund: Den psykiska ohälsan ökar i Sverige. Det innebär förändringar inom den prehospitala sjukvården. Ambulanssjuksköterskans arbete riktas ofta initialt mot akuta somatiska problem, men att vårda patienter med psykosomatisk bröstsmärta till följd av ångest är också en viktig del av omvårdnadsarbetet. Detta medför stor potentiell patientnytta då obehandlad, svår ångest indirekt kan bli livshotande med hänseende till suicidrisken. För att öka kunskapen om psykosomatisk bröstsmärta finns det ett behov av att beforska området. Syfte: Att beskriva sjuksköterskors upplevelser av mötet med patienter med psykosomatisk bröstsmärta prehospitalt. Metod: Åtta sjuksköterskor varav sex vidareutbildade inom ambulanssjukvård rekryterades från tre olika ambulansstationer i Norrland. Datan insamlades genom individuella semistrukturerade intervjuer och analyserades genom en kvalitativ innehållsanalys med induktiv ansats. Resultat: Vald analysmetod resulterade i tre huvudkategorier: Samtalet har en viktig roll i mötet, Bedömningen av allvarlighetsgrad är utmanande i mötet, och Ett per- soncentrerat förhållningssätt är viktigt i mötet, med sex tillhörande underkategorier som svarar på syftet. Slutsats: Psykisk ohälsa ses vara ett fullvärdigt problem inom den prehospitala sjukvården. Sjuksköterskor inom prehospital sjukvård utesluter i första hand somatisk orsak, men ser samtalet som ett naturligt nästa steg i bemötandet och behandlingen av patienter som söker vård för psykosomatisk bröstsmärta. Samtalet i kombination med ett personcentrerat förhållningssätt anses vara de bästa verktygen i bemötandet.

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Bakgrund: Yrket sjuksköterska har bland personalen präglats av kvinnodominans och själva yrkestiteln i sig har en feminin ändelse. När män i större utsträckning väljer att utbilda sig till sjuksköterskor så uppstår nya situationer som inte förekommit tidigare när det bara funnits kvinnlig personal att förhålla sig till. Syfte: Att undersöka och beskriva manliga sjuksköterskors erfarenhet av att vårda och bemöta kvinnliga patienter i nära vårdsituationer inom den somatiska vården, samt kvinnliga patienters emotionella erfarenhet av att ha blivit vårdade av manliga sjuksköterskor. Metod: Studien bedrevs som en litteraturstudie med sökningar i databaser för omvårdnadsforskning. Både kvalitativa och kvantitativa granskningsmallar användes vid kvalitetsgranskning. En beprövad innehållsanalysmodell användes till att finna gemensamma teman ur artiklarna som till skulle bli resultatet. Resultat: Studien visade att manliga sjuksköterskor ofta är rädda för att bli anklagade för sexuella olägenheter av kvinnliga patienter. För att undvika missförstånd och tvetydigheter använde manliga sjuksköterskor sig av olika strategier som hjälp till att klara av att utföra intim vård. Intima samtal kunde enligt den manliga sjuksköterskan upplevas som lika intimt som intimberöring. Ur ett patientperspektiv framkom det att yngre kvinnliga patienter önskade att få vård av samma kön, medan äldre kvinnliga patienter inte hade samma preferenser för könet på sjuksköterskan som utförde vården. Beröring av intim karaktär var något som kunde väcka starka känslor hos den kvinnliga patienten. / Background: Nursing has traditionally been predominantly staffed by women and the work title itself has had a female connotation. When men to a larger degree enter nursing, new situations arise which didn’t before when the patients only had female staff to take into consideration. Aim: To investigate and describe the experience of nurses who are male in their care and treatment of women patients in intimate care situations in a hospital setting, as we as the emotional experience of the women clients of having been cared for by nurses who are male. Method: The study was carried out as a literature review through searches in databases containing nursing sciences. Both qualitative and quantitative review templates were used to carry out the quality review. A proven method for content analysis was used to find common themes in the articles, which eventually formed the basis for the result. Result: The study found that male nurses often were afraid of being accused of improprieties by the female patients. In order to avoid misunderstandings, male nurses used different strategies in order to be able to perform intimate care. Conversations of an intimate nature were seen as an equally sensitive matter to the male nurses. From a patient perspective it was discovered that younger female patients preferred to be cared for by nurses of the same gender, while older female patients did not specify the same preference. Intimate touch was something that could evoke strong feelings in the female patient.

Bakgrund: Psykisk ohälsa hos befolkningen har ökat och personer med psykisk och fysisk samsjuklighet har en ökad risk att dö upp till 20 år tidigare på grund av fysiska sjukdomar. Det förekommer stigmatiserande attityder mot dessa patienter inom vården och på grund av sin psykiska ohälsa blir de bemötta annorlunda och riskerar att bli utan god somatisk vård. Syfte: Att beskriva sjuksköterskors upplevelser av att vårda patienter med psykisk ohälsa inom somatisk vård. Metod: En allmän litteraturstudie med beskrivande syntes av 12 kvalitativa artiklar. Resultat: 3 teman och 7 subteman framkom. Första temat beskriver känslor som uppstod i mötet med patienter, andra temat lyfter kompetens av att vårda patienter med psykisk ohälsa och tredje temat hur vårdmiljön påverkade möjligheten till god vård för dessa patienter. Slutsats: Sjuksköterskor upplevde svårigheter att utföra god vård till patienter med psykisk ohälsa under samtliga teman. Sjuksköterskor hade en önskan att utveckla sin kompetens för att kunna hjälpa dessa patienter. Trots orsaker på arbetsplatsen som sjuksköterskor själva har svårt att ändra på, försökte sjuksköterskor anpassa sig och tillgodose de behov som patienter med psykisk ohälsa hade. / Background: Population with mental illness has increased and people with mental and physical comorbidity have an increased risk of dying up to 20 years earlier due to physical diseases. There are stigmatizing attitudes towards these patients in health care and because of their mental illness they are treated differently and risk being without good somatic care. Aim: To describe nurses' experiences of caring for patients with mental illness in somatic care. Method: General literature review with descriptive synthesis of 12 qualitative articles. Results: 3 themes and 7 subthemes emerged. First theme describes feelings that arose in the meeting with patients, second theme highlights the competence of caring for patients with mental illness and the third theme how care environment affected the possibility of good care for these patients. Conclusion: Nurses experienced difficulties in providing good care to patients with mental illness under all themes. Nurses had a desire to develop their skills to be able to help these patients. Despite causes in the workplace that nurses themselves found difficult to change, nurses tried to adapt and meet the needs of patients with mental illness.

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Thesis (M.A. (Nursing Science)) -- University of Limpopo, 2016 / The purpose of the study was to develop a protocol to enhance patient satisfaction with regard to nursing care at Health Centres and to determine factors leading to patient dissatisfaction. A quantitative, descriptive and cross-sectional research design was used for this study. The population of the study for the two Health Centres was: Agincourt Health Centre= 5697 while Thulamahashe Health Centres= 5696. Systemic random sampling method was used to select 400 respondents from each Health Centre. Data were collected through self-developed questionnaire. The questionnaire was pre-tested at Cunningmoore clinic. Reliability was ensured through conducting of a pre-test. Validity was ensured through undertaking extensive literature review. The questionnaire was also given to the supervisor for content validity. Data analysis was done through descriptive and inferential statistics using SPSS version 22 programme of data analysis. The findings indicated that factors leading to patient dissatisfaction with regard to nursing are: long waiting time, poor communication and information between nurses and patients, shortage of nurses, poor service and environmental condition and shortage of treatment (medication). The study recommends that waiting time should be reduced to less than 3 hours, shortage of nurses should be addressed, workshops and inservice training should be implemented and treatment should be monitored.

No / The National Health Service (NHS) in England must improve productivity by 6% per annum if projected savings of £21 billion are to be attained by 2014, while simultaneously improving or at least maintaining the quality of care (Department of Health (DH), 2009; 2010a). Given that staff costs represent 60% of the current NHS budget, it is likely that both the number and composition of the 1.7 million strong workforce will need to be changed to meet these targets. In the Department of Health's draft Structural Reform Plan (2010b), the emphasis is on shifting resources to promote better healthcare outcomes, to which end a review of working practices and role relationship must take place, with increased delivery of services by community nurses.

The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses. The study sought to determine which departments were referring patients and which patients were being referred. The completeness and appropriateness of the referrals were also studied. The major inferences drawn from this study are that health care workers have a poor concept of what information the psychiatric units needs and about the scope and function of the unit. The poor feedback from the psychiatric unit to the referral source is indicative of the poor communication amongst the health care team members. / Health Studies / M.A. (Advanced Nursing Sciences)

This thesis explores the potential of visual information and communication technologies (ICTs) for collaboration in emergency care. The thesis consists of four studies exploring future technology, 3D telepresence technology for medical consultation (3DMC), from several different methodological and analytical perspectives. Together the studies provide a broad view of the potential benefits, risks and implications of using visual technologies for collaboration in emergency care. The results show that paramedic-physician collaboration via 3DMC might have some benefits for patient care, both in the immediate patient care situation and beyond, for example, when coordinating transport and resources; improving understanding between different actors; and in developing paramedic competence and confidence in their skills. However, collaboration is heavily impacted by physicians’ and paramedics’ respective work practices which are situated in very different physical, professional and organizational contexts. Adding a visual dimension to this collaboration presents unique challenges for the overall design, development, implementation, and appropriation process. Thus, the thesis emphasizes the importance of understanding both the individual users as well as the complex overall image which, although often neglected or ignored, is crucial to understand when developing and introducing new technology that is successful and justified in the overall context while also being useful and meaningful for the individual users. / <p>Academic dissertation for the Degree of Doctor of Philosophy in Library and Information Science at the University of Gothenburg and the University of Borås to be publicly defended on Thursday 19 September 2013 at 13:15 in the auditorium at Simonsland, University of Borås, Skaraborgsvägen 3, Borås.</p>

Some innovations are termed ‘disruptive’, a designation that is normally applied to technology; examples include computers, digital cameras, and mobile phones. The term can also be applied to groups of workers, particularly if they are able to offer specific technical capabilities within a market at lower cost, but broadly equal and effective to that offered by traditional products or services. Paramedics could be described in this way and are a newly professionalised group, with distinctive capabilities in terms of responding to the needs of not just the acutely ill and injured, but increasingly those patients with undifferentiated non-life- threatening conditions, which increasingly make up the bulk of 999 call demand. The key to their transition from an artisan, skilled worker to professional status is the acquisition of certain ‘hallmarks’. Perhaps the most important of these is the completion of more prolonged education that affords the opportunity to graduate with enhanced decision-making and other clinical skills in order to meet the needs of the full spectrum of patients in the pre-hospital setting. Paramedics were surveyed to determine how they rated their ‘traditional’ preparation and to establish what their attitudes were to a more educationally based approach. Paramedics themselves proved to be realistic regarding shortcomings in established training and education systems, while also being strongly motivated to learn more within a higher education setting, particularly if this additional effort would result in being able to offer a wider range of care to their patients. During the study, major changes in the health care environment and the role of the Ambulance Service took place, leading to a requirement to undertake a second phase of research. This took the form of ‘Horizon Scanning’ in an attempt to detect ‘signals’, themes and trends in relation to newly emerging ‘competitors’ to the paramedic role. These included nursing, new practitioners and most critically, the rapidly emerging medical sub-speciality of pre-hospital care, staffed by medical personnel on a pattern found specifically in some European countries, sometimes termed the ‘Franco-German’ model/System (FGM/S). Hitherto, the model of provision in the UK had followed the ‘Anglo-American’ model/System (AAM/S), approach, with paramedics providing direct patient care in the field and medical staff largely involved in medical oversight, teaching, clinical governance and other higher level roles. As part of this research, the evidence base for change was examined and consideration given to the factors that might help clarify what the likely situation could be in 2030 in respect of ambulance services, pre-hospital care and paramedics. This future is uncertain, but factors have been identified that would militate in favour of one or other model prevailing, with close links established between educational preparation, system design, career structure and the continuance of the professionalisation process favouring paramedic progression. However, other factors, most specifically professional power, the absence of a clear evidence base and an apparent reluctance to clearly acknowledge this in some respects, lead to the conclusion that the future of pre-hospital care remains uncertain and contested, but also potentially amenable to a well-directed influencing strategy.