Bakgrund: Globalt sett ökar debatten gällande vaccinationer inom såväl vården som samhället i stort. Årligen skapas även ett nytt influensavaccin anpassat för det virus som tros dominera under säsongen. Sjuksköterskor som arbetar i vården behöver även indirekt ta personlig ställning till om de vill vaccinera sig mot influensa.  Syfte: Syftet var att undersöka sjuksköterskans inställning till att vaccineras mot influensa. Metod: En kvalitativ metod tillämpades för att beskriva sjuksköterskornas upplevelser gällande vaccination. Databaserna Cinahl complete och Medline with full text användes för att hitta vetenskapliga artiklar som grund för litteraturöversikten. Totalt tio kvalitativa artiklar analyserades för att forma teman som svar på syftet. Resultat: Resultatet utgörs av fem teman: influensavaccin upplevdes som mindre viktigt, negativa erfarenheter av influensavaccination, autonomi och önskan om mer information.  Diskussion: Sjuksköterskorna hade en negativ inställning till influensavaccination samt att de uppgav deras egna kunskaper om sådan vaccination som bristfällig. Inom sjukvården är det av vikt att sjuksköterskor innehar evidensbaserade kunskaper för att kunna utbilda patienterna gällande influensa och influensavaccination. I enlighet med Jean Watsons holistiska beskrivning av sjuksköterskans arbete har även sjuksköterskan ett moraliskt ansvar att skydda och värna om patientens säkerhet gentemot sjukdomar och smittspridning. / Background: Globally, the debate regarding vaccinations in both healthcare and society is increasing. Each year, a new flu vaccine adapted for the virus that is believed to dominate during the season is also created. Nurses working in health care indirectly need to take a personal position on whether they want to vaccinate themselves or not against influenza. Aim: The aim was to describe nurse’s attitude towards being vaccinated against influenza.   Method: A qualitative method was used to describe the nurses' experiences regarding vaccination. The Cinahl complete and Medline with full text databases were used to find scientific articles as the basis for the literature review. A total of ten qualitative articles were analyzed to form themes in response to the purpose. Results: The result consists of five themes: influenza vaccine was perceived as less important, negative experiences of influenza vaccination, autonomy and the desire for more information. Discussion: The nurses had a negative attitude towards influenza vaccination and they stated their own knowledge about such vaccination as inadequate. In health care, it is important that nurses possess evidence-based knowledge in order to be able to educate patients regarding influenza and influenza vaccination. In accordance with Jean Watson's holistic description of the nurse's work, the nurse also has a moral responsibility to protect and guard the patient's safety against disease and spread of infection.

No description available.

Bakgrund: Arbetsrelaterad stress är ett växande problem inom vården, och de krav som ställs i förhållande till otillräckliga resurser skapar en hög arbetsbelastning vilket i sin tur kan leda till stress och ohälsa. Sjuksköterskans profession innebär ett stort ansvar då hon ska ge en god omvårdnad till alla som behöver och samtidigt agera arbetsledare samt organisera omvårdnadsarbetet. Den arbetsrelaterade stressen kan leda till konsekvenser som psykiska problem, nedsatt koncentrationsförmåga och svårigheter att sova. Syfte: Syftet var att undersöka arbetsrelaterad stress hos sjuksköterskor och dess möjliga påverkan på patientsäkerheten. Metod: En litteraturöversikt har genomförts. Resultatet är baserat på tolv kvalitativa och kvantitativa studier som valdes från databaserna PubMed och Cinahl Complete. Resultat: Litteraturöversikten resulterade i två huvudteman och fem underteman som beskriver de vanligaste arbetsrelaterade stressfaktorerna hos sjuksköterskor och hur dessa påverkar patienterna. De två huvudteman som framkom var: arbetsrelaterade stressfaktorer som påverkar sjuksköterskan och faktorer som påverkar patientsäkerheten. De fem underteman som framkom var arbetsbelastning, samarbete och arbetsledning, skiftarbete, sociala interaktionen, vårdskador- och längre vårdtider. Diskussion: Metoden diskuteras utifrån litteraturöversiktens styrkor och svagheter. Resultatet diskuteras under tre rubriker som utgår från Jean Watsons karativa faktorer: Inge tro och hopp, stödja, skydda och/eller förbättra den psykiska, fysiska, sociala och andliga miljön och att tillgodose mänskliga behov. Diskussionen förs i relation till Jean Watsons omvårdnadsteori, litteraturöversiktens bakgrund, författarnas egna reflektioner samt annan relevant forskning. Detta för att skapa en djupare förståelse för sjuksköterskans arbetsrelaterade stress och dess påverkan på patientsäkerheten. / Background: Occupational stress in healthcare is a growing issue, and the demands in relation to inadequate resources, creates a high workload which can lead to stress and illness. The nursing profession involves a big responsibility. As a nurse, you have to give good health care to everyone who needs it, and at the same time supervise and organize the nursing care. The occupational stress can lead to consequences such as psychological problems, reduced attention span and sleeping disorder. Aim: The aim of this study was to examine occupational stress among nurses and its possible impacts on patient safety. Method: A literature review was carried out and the result is based on twelve qualitative and quantitative studies which has been chosen from the databases PubMed and Cinahl Complete. Results: The literature review resulted in two main themes and five sub themes which describes the most common occupational stress factors among nurses and how these factors affect the patients. The two main themes that emerged were: Occupational stress factors which affects the nurse and Factors that affects patient safety. The five sub themes that emerged were: Workload, Cooperation and work management, Shift work, Social interactions and Healthcare detriment and longer hospital stays. Discussion: The method was discussed from the perspective of the strengths and weaknesses of the literature review. The result was discussed out of three of Jean Watsons carative factors: Generate hope and faith, Support, protect and/or improve the psychological, physical, social and spiritual environment and Cater to human needs. The discussion is conducted in relation to Jean Watsons care theory, the background of the literature review, the authors own reflections and other relevant researches. The purpose is to create a deeper understanding for the occupational stress among nurses and the effect on patient safety.

Bakgrund: Moralisk stress är ett begrepp som först kom att definieras av Jameton (1984) och anses uppstå när sjuksköterskor inte kan handla i enlighet med det de anser vara det rätta på grund av organisatoriska eller institutionella barriärer. Den legitimerade sjuksköterskan ansvarar för ett stort kunskaps- och arbetsområde som ska präglas av ett etiskt förhållningssätt och en personcentrerad vård. En inre konflikt uppstår när sjuksköterskan hindras att arbeta utifrån de rådande värdena, vilket ger upphov till känslor av moralisk stress. En större kunskap och förståelse inom problemområdet är nödvändig för att åstadkomma framtida förbättringar. Syfte: Syftet var att belysa moralisk stress hos sjuksköterskan. Metod: För att uppnå syftet har en litteraturöversikt genomförts. Sökningar efter relevanta artiklar i enlighet med den engelska översättningen av moralisk stress utfördes. Artiklar med kvalitativa och kvantitativa ansatser har använts. Resultat: Ur analysen urskildes tre olika huvudkategorier: bakomliggande orsaker till moralisk stress, konsekvenser av moralisk stress och strategier för hantering av moralisk stress. Diskussion: I resultatdiskussionen diskuteras moralisk stress hos sjuksköterskor utifrån Jean Watsons teori om mänsklig omsorg samt andra relevanta artiklar. Uppkomsten av moralisk stress hos sjuksköterskor diskuteras ur olika perspektiv. Skillnader i miljö och ledningens betydande roll avseende sjuksköterskors känslor av moralisk stress diskuteras vidare. Konsekvenser av moralisk stress hos sjuksköterskor diskuteras med betoning på patientsäkerhet och bemötandet av patienter. Medvetenheten kring moralisk stress hos sjuksköterskor behöver bli större. Ett fokus på moralisk stress hos sjuksköterskor kan med fördel lyftas redan under sjuksköterskeutbildningen. / Background: Moral stress is a term that was first defined by Jameton (1984) and is considered to occur when individuals are unable to act in accordance with what they consider to be right due to organizational or institutional barriers. The registered nurse is responsible for a large area of knowledge and work that needs to be characterized by an ethical approach and person-centered care. An internal conflict occurs when the nurse is prevented from working on the basis of these values, which causes feelings of moral stress. A greater knowledge and understanding of the problem area is necessary to achieve future improvements. Aim: The aim was to illustrate moral stress among the nurse. Method: To achieve this goal, a literature review has been conducted. Searches for relevant articles in accordance with the English translation of moral stress were performed. The databases Cinahl, PsycINFO and PubMed were used. Articles with qualitative and quantitative approaches have been used. Results: The analysis revealed three different main categories: underlying causes for moral stress, consequences of moral stress and strategies for managing moral stress. Discussion: In the result, moral stress is discussed among nurses based on Jean Watson's theory of human care and other relevant articles. The appearance of moral stress in nurses is discussed from different perspectives. Differences in the environment and management's significant role regarding nurses' feelings of moral stress are discussed further. The consequences of moral stress in nurses are discussed with emphasis on patient safety and the encounter of patients. Awareness about moral stress in nurses needs to be greater. A focus on moral stress in nurses should be emphasized during nursing education.

Bakgrund: Human immunodeficiency virus (HIV) är en kronisk sjukdom som successivt försämrar det mänskliga immunförsvaret. Det finns medicinsk behandling som leder till ökad livslängd. Detta innebär att antalet personer med HIV kommer att öka och hälso- och sjukvårdspersonal kommer att kunna möta dessa personer inom flera vårdkontexter än enbart i HIV-specifika sammanhang. HIV har varit en uppmärksammad sjukdom sedan 1980-talet och den diskriminering och stigmatisering som sjukdomen mötte då finns kvar idag, trots nationella och globala lagar och riktlinjer. Syfte: Syftet med denna litteraturöversikt var att beskriva hur personer med HIV upplever hälso- och sjukvårdspersonalens bemötande. Metod: Metoden för denna litteraturöversikt inkluderar tio vetenskapliga artiklar hämtade från databaserna CINAHL och PubMed. Av dessa var två kvantitativa och åtta kvalitativa. Följande sökord användes: nursing, healthcare, HIV, patient, experience, stigma, discrimination och isolation. Artiklarna granskades genom att identifiera meningsbärande begrepp, likheter och olikheter som sedan bildade resultatet. Resultat: Bemötandet av hälso- och sjukvårdspersonalen beskrevs av personer med HIV bestå av fördomar, stigmatisering och diskriminering. Det var inte ovanligt att vårdpersonalen undvek personer med HIV helt och hållet. Personer med HIV uttrycker starka åsikter om vikten av kontinuitet i vården och goda relationer till vårdpersonalen. Diskussion: Resultatet diskuterades utifrån Jean Watsons interaktionsteori samt konsensusbegreppen. I samband med detta jämfördes även hälso- och sjukvårdspersonalens bemötande mot personer med HIV med personer med Hepatit-C. / Background: Human immunodeficiency virus (HIV) is a chronic disease that progressively impairs the human immune system. Today, there are medical treatments that allow people with HIV to live longer than before. This means that the  number of people with HIV will increase and healthcare providers will be able to meet these people in several nursing context than just the HIV-specific context. HIV has been a noted disease since the 1980s and the discrimination and stigma that the disease met remains today, despite national and global laws and guidelines. Aim: The aim of this literature review was to describe how people with HIV are experiencing health care provider’s attitudes. Method: The method of this literature review included ten scientific articles found in the databases CINAHL and PubMed. Following search terms were used: nursing, healthcare, HIV, patient, experience, stigma, discrimination and isolation. Two articles were quantitative and eight were qualitative. These articles were examined by identifying meaningful concepts, similarities and differences that formed the result. Results: According to people with HIV the healthcare providers’ attitudes included prejudice, stigma and discrimination. It was not uncommon for caregivers to avoid people with HIV altogether. People with HIV expressed strong opinions about the importance of continuity of care and good relationships with caregivers. Discussions: The result of the literature review was discussed based on Jean Watson's interaction theory about the centre of caring in the healthcare encounter and the consensus concepts. The healthcare providers’ attitudes towards people with HIV were compared with people with Hepatitis-C.

Abstract The theme of this dissertation is the nursing care based on humanistic-altruistic values by model of Margaret Watson. Creating conceptual models and their designation in itself was a very important progress in the field of nursing. Conceptual models of nursing are some connection among philosophy, theory and practice. Conceptual model of M. J. Watson is unique in that it focuses on self-nurses, are also among the humanist conceptual models based on the principles of humanism respecting patient rights. Foreign authors talk about the content of the model as a return to the deep roots of professional nursing and values, such as helping others, empathy, trust, finding and meeting the needs of ill people. For practical application of established M. J. Watson there are 10 factors of humanistic care. In the area of research there was carried out questionnaire survey focused on awareness of selected conceptual models of interest in nursing education courses in the area of conceptual models. In addition the conceptual model was applied by M. J. Watson, in practice, for which interviews were used the original author designed and the nurses diaries. Qualitative results were processed by using a modified approach by Ritchie and Spencer. We set two objectives. To achieve the objective to inform nurses about the conceptual model of M. J. Watson was determined by six hypotheses. Hypothesis 1: Nurses are not informed about the conceptual model of M. J. Watson. This hypothesis was confirmed. Hypothesis 2: Nurses do not use M. J. Watson conceptual model for a care of their clients. This hypothesis was confirmed. Hypothesis 3: Nurses recognize an empathy as an important ability to nurse. This hypothesis was confirmed. Hypothesis 4: The interest of nurses in training courses in the area of conceptual models vary according to the length of experience. This hypothesis was confirmed. Hypothesis 5: The interest of nurses in training courses in the area of conceptual models vary according to their age. This hypothesis was not confirmed. Hypothesis 6: The interest of nurses in training courses in the area of conceptual models varies by their educational attainment. This hypothesis was not confirmed. To consider the surprising result that although the nurses admit a lack of information on conceptual models which prevails at the lack of interest in any course in this area. To gain the objective to find out what causes the changes of nursing care are based on a conceptual model of M. J. Watson for selected nurses and clients, we realized the practical application of the model. During our research we set goals to achieve more research questions which we work. Research question 1: Will nurses in implementing nursing care according to M. J. Watson indicate greater satisfaction with their work than before? Research question 2: Will the nurses recognize the increased benefits in the way of nursing care according to M. J. Watson compared to their normal practice? Research question 3: How does the nursing care according to M. J. Watson influence the clients? Research question 4: How nurses will evaluate the success factors of ten applications of humanistic care by M. J. Watson? Research question 5: What do nurses perceive negatively when applying the model of M. J. Watson in practice? We believe we have done this work to break the barrier of lack of information in the conceptual model of M. J. Watson in the country while we described how to return to the loving care in nursing. This model leads to a nurse wondered at herself, carried out their activities at the client with respect and the build confidence. Through the humanistic factors of ten to reach a tenderness in the nursing care.

Bakgrund: Palliativ sedering avser en avsiktlig sänkning av medvetandegraden hos en patient som befinner sig i livets slutskede och har outhärdliga symtom. Behandlingen ges av ett multiprofessionellt team där sjuksköterskornas uppgift är att iordningställa och administrera ordinerade läkemedel samt utvärdera effekt och upplevelse av behandlingen. Förutom de praktiska kraven som ställs på sjuksköterskorna medför palliativ sedering även krav på förmåga till reflektion och kritiskt såväl som etiskt tänkande. Syfte: Syftet med denna litteraturöversikt var att undersöka sjuksköterskors erfarenheter av palliativ sedering. Metod: En litteraturöversikt genomfördes och tio vetenskapliga artiklar valdes ut till analys efter litteratursökningar i databaserna CINAHL Complete och PubMed. Resultat: Tre teman med underteman identifierades. God palliativ vård inkluderade att ge palliativ sedering för att erbjuda patient, närstående och personal ett fridfullt avslut och för att uppfylla patientens önskningar. Palliativ sedering och eutanasi kunde vara svåra att skilja från varandra och sjuksköterskorna hade en känsla av att palliativ sedering påskyndande patientens död. Att arbeta i team var en viktig faktor för hur sjuksköterskor upplevde arbetet med palliativ sedering. Det underlättade om beslut om sedering togs gemensamt och olika former av stöd från teamet var betydelsefullt för sjuksköterskor under arbetet med palliativ sedering. Diskussion: Resultaten diskuterades utifrån Jean Watsons omvårdnadsteori om mänsklig omsorg och tre av hennes caritasprocesser Ett kärleksfullt och omsorgsfullt sinnelag, Utrymme för känslor och Hjälpsamma och tillitsfulla omsorgsrelationer. / Background: Palliative sedation refers to an intentional lowering of consciousness of a patient in the end of life who is suffering from unbearable symptoms. The care is performed by a multi-professional team where the nurses’ duties are to prepare, administer and evaluate prescribed pharmaceuticals. In addition to the practical skills required by the nurses, this treatment also requires ability to reflect as well as critical and ethical thinking. Aim: The aim of this literature review was to explore nurses’ experiences of palliative sedation. Method: A literature review was conducted and ten scientific articles were chosen for analysis. Literature searches were made in the databases CINAHL Complete and PubMed. Results: Three themes with subthemes were identified. Good palliative care included giving palliative sedation to offer patients, families and the staff a peaceful ending and to meet the patient’s wishes. Palliative sedation and euthanasia could be difficult to separate and there was a sense that palliative sedation hastened the patient’s death. Teamwork was an important factor for how nurses experienced working with palliative sedation. It was easier if the decision to sedate was taken jointly and support within the team was meaningful to nurses during their work with palliative sedation. Discussion: The results were discussed in relation to Jean Watson’s Theory of Human Caring and the three caritas processes The practice of loving kindness and equanimity, Promotion and acceptance of the expression of positive and negative feelings and Developing and sustaining a helping-trusting caring relationship.

The intent of this thesis was to examine compassion fatigue in nurses through analysis of research studies conducted within the past five years in an effort to identify predisposing factors to the experience of compassion fatigue. Individual and institutional factors were identified as well as current strategies to assist with management of compassion fatigue. Findings indicated that being new to practice, having a trait negative affect, being younger in age, having a history of exposure to trauma and working in high emotionally stressful units predisposed individuals to the experience of compassion fatigue. Institutional factors included a lack of managerial support, organizational commitment, group cohesion, work engagement and conflicting expectations of the nurse. Institutional interventions to assist in mitigating compassion fatigue include improving managerial support, developing group cohesion and communication and providing continuing education opportunities. Institutions can also assist by offering training in resiliency techniques such as negative thought pattern identification, meditation, peer-to-peer discussions, journaling about traumatic experiences, identification and maintenance of personal/professional boundaries and physical wellness through exercise and yoga. These proposed interventions address institutional accountability in health care worker wellness as defined by the quadruple aim. Such interventions also address use of Watson’s Caring Theory to emphasize the importance of nurse wellness as essential to creating caring nurse-patient relationships.