Abstrakt Hjärtinfarkt är ett av de största hälsoproblemen i Sverige idag. Kvinnor drabbas i stor utsträckning av hjärtinfarkt men de riskeras att missas då den mesta evidensen utgår från ett manligt perspektiv och normer. Syftet med denna integrerade litteraturöversikt var att sammanställa kunskap inom omvårdnadsforskning om kvinnors erfarenheter  efter att ha drabbats av en första hjärtinfarkt. En integrerad litteraturöversikt enligt Whittemore och Knafl metod utfördes och granskades enligt SBU:s riktlinjer. Kvalitativa, kvantitativa och mix studier sammanställdes. Sökningen utfördes i databasen CINAHL. Resultatet visade att kvinnors symtom vid en första hjärtinfarkt särskildes sig från mäns symtom och riskerades att missas av vården på grund av kunskapsbrist. Kvinnor avvaktade att uppsöka vård på grund av ovisshet kring symtomens allvar. Sjuksköterskan behöver uppmärksamma prodromala symtom samt lyfta frågor kring sexuellt samliv. Ny evidens behövs för att få kunskap om kvinnors upplevelser av att drabbas av en första hjärtinfarkt.

Non-invasiv ventilation är en vanligt förekommande behandling för patienter som söker akutsjukvård med akut respiratorisk svikt. Behandlingen startas ofta på akutmottagningen och fortsätter därefter på intensiv-, intermediär- eller vanlig vårdavdelning. Behandlingen kan av patienter upplevas både intensiv och betungande och ett betydande problem är att patienten inte tolererar behandlingen.  Syftet var att beskriva patienters erfarenheter av non-invasiv ventilator vid akut respiratorisk svikt. Metoden var en allmän litteraturöversikt med systematiskt tillvägagångssätt. Systematiska sökningar utfördes i databaserna PubMed, CINAHL och PsychInfo. Sammanlagt inkluderades 15 kvalitativa och kvantitativa vetenskapliga artiklar publicerade mellan år 2012–2019 till litteraturöversikten. Inkluderade artiklar analyserades med en integrerad metod.  Analysen ledde fram till två huvudkategorier och sex underkategorier. Resultatet påvisade förekomst av både fysiska och psykiska aspekter. Sammanfattningsvis var erfarenheter av negativ art vanligast förekommande och kunde karakteriseras av symtom på ångest, smärta och klaustrofobi. Positiva upplevelser var upplevelser av förbättrat andningsarbete, känslor av hopp och säkerhet samt att få en chans till ett fortsatt liv. Resultatet visade även hur personalen påverkar patienters erfarenheter av non-invasiv ventilatorbehandling, där bristfällig delaktighet är en tydligt hämmande faktor och hög kunskapsgrad samt erfarenhet hos personalen en framstående främjande faktor.  Slutsatsen blev att patienter många gånger upplever en majoritet av negativa symtom samtidigt som de befinner sig i en särskilt utsatt och sårbar situation. Behandlingens utfall påverkas av patientens erfarenheter men med hjälp av ökade kunskaper och ett personcentrerat arbetssätt hos hälso- och sjukvårdspersonalen kan den non-invasiva ventilatorbehandlingen optimeras. / Non-invasive ventilation is a common treatment for patients seeking emergency care with acute respiratory failure. The treatment is often initiated at the emergency department and further continues in the intensive- or intermediate care unit, or on a regular ward. The treatment can be experienced by patients as intensive and burdensome, and a significant problem is that the patient can’t tolerate the treatment.   The aim was to describe patients’ experiences of non-invasive ventilation in acute respiratory failure. The method was a general literature review with a systematic approach. Systematic searches were carried out in the PubMed, CINAHL and PsychInfo databases. A total of 15 qualitative and quantitative articles published between the years 2012–2019 was included for the literature review. The included articles were analyzed in an integrated method.  The analysis led to two main categories and six subcategories. The results showed occurrences of both physical and psychological aspects. In summary, negative experiences were the most common and could be characterized by symptoms of anxiety, pain and claustrophobia. Positive experiences were experiences of improved work of breathing, feelings of hope and safety and to be given a chance to a continued life. The results also showed how healthcare personnel affect patients' experiences of non-invasive ventilation, where decreased participation was a clearly inhibiting factor and high levels of knowledge and experience in the personnel was an eminent promoting factor.  The conclusion was that patients often experience a majority of negative symptoms and at the same time being in a particularly vulnerable situation. Treatment outcomes are affected by patients' experiences, but with the use of increased knowledge and a person-centered approach by the healthcare personnel, the non-invasive ventilation treatment can be optimized.

Bakgrund: En amputation innebär ett avlägsnade av en kroppsdel. De flesta amputationer utförs i de nedre extremiteterna. I Sverige sker årligen ungefär 2250 amputationer i de nedre extremiteterna. Orsaken till amputation kan vara kärlsjukdomar, diabetes samt trauma. Sjuksköterskan har i sin profession en betydande roll i mötet med patienten. Syfte: Syftet var att beskriva patienters upplevelser efter amputation av nedre extremitet. Metod: En litteraturöversikt genomfördes utifrån Fribergs metodbeskrivning. Tio kvalitativa originalartiklar inhämtades via databaserna PubMed och Cinahl Complete. Primära sökord som användes var amputation, nedre extremitet och livsförändrade händelser med begränsningar såsom engelska och peer reviewed. Resultat: Fyra teman identifierades: Upplevelsen av psykiska och fysiska förändringar, Att uppleva rollförändring och förlust av självständighet, Förändrad kroppsuppfattning och känslan av sårbarhet samt Vägen tillbaka efter amputation. Resultatet visade att patienterna upplevde en förlust av självständighet vilket gav upphov till en känsla av att vara en börda för sin familj. Den fysiska förmågan försämrades vilket bidrog till att de inte kunde ta sig utanför hemmet. Detta resulterade i att de kände sig ensamma och isolerade. Slutsats: Patienter upplevde känslomässig chock och rädsla inför framtiden. Att inte kunna prestera till fullo, bidrog till en känsla av förlust av identitet och självständighet. Vikten av stöd från familj, vänner och vårdpersonal har en central betydelse för återhämtning efter amputation. Amputation innebär att patienten genomgår en övergång till en ny fas i livet, en transition. / Background: An amputation implies a removal of a body part. Most amputations transact at the lower extremities. In Sweden approximately 2250 lower extremity amputations are made a year. The causes of amputation may be vascular diseases, diabetes or trauma. The profession of a nurse has a major role in the relation to the patient. Aim: The aim was to investigate patients’ experiences after an amputation of lower extremity. Method: To approach the aim a literature review was performed by the method of Friberg. Ten qualitative original articles were collected by the databases PubMed and Cinahl Complete. Primary keywords were amputation, lower extremity and life change events. Limitations were English and peer reviewed. Results: Four themes were identified: Experience of psychological and physical changes, To experience changes of identity and loss of independents, Changes of self-perceptions and the feeling of being vulnerable and How to recover after an amputation. The result showed that the patients’ experienced a loss of independence which resulted in a feeling of being a burden. The physical ability was impaired and contributed to a feeling of being isolated and lonely. Conclusion: The patients’ experienced emotional shock and a fear for the future. Not being able to perform to the fullest produced a loss of identity and independence. Support from family, friends and healthcare professionals has a central value for the recovery. To be amputated results in a transitioning and a new phase in life.

No / Despite advances in technology and medicine, death itself remains an immutable certainty. Indeed, the acceptance and understanding of our mortality are among the enduring metaphysical challenges that have confronted human beings from the beginning of time. How have we sought to cope with the inevitability of our mortality? How do various cultural and social representations of mortality shape and influence the way in which we understand and approach death? To what extent do personal beliefs and convictions about the meaning of life or the notion of an afterlife affect how we perceive and experience the process of death and dying? Steve Paulson, executive producer and host of To the Best of Our Knowledge, moderated a discussion on death, dying, and what lies beyond that included psychologist Lani Leary, professor of philosophy and religion Jeffrey J. Kripal, and sociologist Allan Kellehear. The following is an edited transcript of the discussion that occurred February 5, 7:00-8:30 pm, at the New York Academy of Sciences in New York City.

A review of the literature on adjustment to widowhood and survivorship reveals gaps in qualitative and quantitative studies which explore anticipatory processes for this expectable life event. Studies focusing on men anticipating this time of life are rare to non-existent. This is a qualitative study on the anticipatory processes (cognitive, emotional and behavioral) of individuals and couples. The theoretical underpinnings for the study are drawn from symbolic interactionist ideas of how individuals settle on a personal and functional reality and from the ideas of Peter Berger and his associates on how the marital conversation stabilizes the individual's sense of the world. Fourteen long-married couples ages 50 to 80 were interviewed. They are Caucasian, middle and upper-middle class people, married from 29 to 49 years. The first part of the study examines the following: whether people have a prediction relative to which of the couple will probably die first; whether members of the couple hold the same prediction; what factors inform such a prediction, and how much discussion there is of this topic. It was found that about one-half of the informants have a stable prediction and that three couples held the same view. Three typologies, the CLEARS, those IN PROCESS and the VAGUES, were used to describe the prediction behavior of the 28 participants. Among the seven factors highlighted were the sense of one's genetic inheritance, belief in the “common wisdom" that husbands pre-decease their wives, and observations of one's own energy level relative to one's partner. The second part of the study explores the worries and concerns of men and women as they look forward to a time without the life partner. The study uncovers the actions they take at present and actions they believe they would take in the future to best perform daily routines and to deal with emotional and relationship needs. It was found that the men and women envision their futures differently, that men anticipate the likelihood of remarriage and tend to see remarriage as a pleasant coping strategy. Women show a disinclination to remarry emphasizing the trade-offs of marriage. Their strategies are more varied, and are more likely to be based on observations of widowed women throughout their lives. Finally, the participants' religious and philosophical attitudes, broad enough to encompass death and loneliness, are noted. / Ph. D.

Text in Afrikaans / Hoë werkloosheid het 'n permanente kenmerk van die moderne samelweing geword en daarom word daar huidiglik baie aandag geskenk aan die psigologiese impak van werkloosheid op die werklose persoon en sy gesin. Die teoretiese benadering van hierdie studie is dat werksverlies 'n stresvolle lewensgebeurtenis is waarvan die impak binne 'n sistemiese benadering bestudeer is. Die kwalitatiewe navorsingsmetode is gevolg. Die navorsingsresultate is verkry deur in-diepte onderhoude te voer met agt blanke getroude pare. Die resultate van die onderhoude is vergelyk met bestaande navorsing oor die impak van onwillekeurige werksverlies op die individu en sy gesin. Resultate dui daarop dat werksverlies 'n verpletterende ervaring is vir sommige pare terwyl dit in ander huwelikke lei tot groter intimiteit en persoonlike groei. Veranderlikes wat vir hierdie verskille verantwoordelik is, word geidentifiseer. Implikasies vir toekomstige navorsing word bespreek. / High unemployment has become a permanent feature of modern-day society. As a result there has been an increased interest in the psychological impact of involuntary job loss on the individual and his family. The theoretical appraoch of this study is that job loss is a stressful life event which is studies within the subsystem of the family. The research design is the qualitative method that was executed by conducting depth interviews with eight white couples. The results of the interviews were compared with those of previous research relating to the impact of involuntary job loss on the individual and his family. Results show that job loss is a devastating experience for some couples while other couples experience it as a opportunity for personal growth and increased intimacy in the relationship. Factors that account for these differences are identified. Implications for future research are discussed. / Psychology / M.A. (Sielkundige Navorsing)

Bakgrund- Prostatacancer är en av de vanligaste cancerformerna i Sverige och nästan 34 % av alla fall av cancer hos män är prostatacancer. Radikal prostatektomi är en behandling som innebär att hela prostatan och intilliggande körtlar tas bort. Prostatektomi kan ha negativ påverkan på livskvaliteten p.g.a. ingreppets komplikationer. Syfte- att belysa hur män upplever sin livskvalitet efter att ha genomgått en prostatektomi. Metod- En systematisk litteraturstudie. Artiklar har sökts fram i elektroniska databaser. Tio artiklar har granskats enligt kriterier för kvalitetsgranskning där nio kvalificerats och används i resultatet. Inspireras av kvalitativ analys och identifierat olika teman i texten. Vi kom fram till fyra kategorier som vi redovisar resultaten ifrån: fysiska, psykiska, sociala och omvårdnadsaspekter. Resultat- Sexualitet, relationer, männens upplevelse av självkänsla och kontroll över sin kropp samt informationsbrist var de viktigaste områdena där livskvaliteten påverkades negativt. Slutsats- Radikal prostatektomi innebar en stor förändrig för männens livskvalitet och deras liv. Vi tror att mer forskning behövs inom ämnesområdet för att få en djupare förståelse för hur männen upplever sin livskvalitet efter operationen.

Thesis (MSc (Physiological Sciences))--University of Stellenbosch, 2006. / Early adverse life events appear to increase the susceptibility of developing psychiatric disorders later in life. The molecular mechanisms involved in the development of pathological behaviour remain unclear. Dysregulation of the hypothalamic-pituitary-adrenal axis and alterations in neurotrophic factors have been implicated.

Thesis (MEd)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Even though dyspraxia is a fairly new and unknown disorder, especially in South Africa, a fair amount of research has been conducted on what this condition entails, its causes and symptoms, as well as the resources available to deal with children with dyspraxia. However, research on the emotions, frustrations and concerns of the parents of children with dyspraxia is not as readily available. Bronfenbrenner’s bio-ecological perspective was used as it identifies the family’s diferrent systems where-in it functions. This can possibly identify and bring to attention the existing support systems within the family’s community. The research methodology of this study is qualitative research within the interpretive paradigm. The researcher made use of two case studies as this research explored a specific phenomenon. Through purposive sampling, four parents of children with dyspraxia was identified as participants. The research question guiding this study explores the personal experiences of the parents regarding their children’s dyspraxia. Individual semi-structured interviews and reflective journals were used as methods of data collection. According to existing literature, parents of children with disorders experience their children’s disorders on an emotional, physical as well as social level. The data analysis have shown that parents of children with dyspraxia also experience their children’s condition on these three levels. From this study, it was concluded that parents’ knowledge of dyspraxia, their living environment, the measure of support and resources available, as well as the number of children in the family are all factors that influence their experiences across the three aforementioned levels. The research provides insight into the parents’ experiences and the importance of adequate support for parents, and should promote general awareness and acknowledgement of dyspraxia as a significant barrier in a child’s development. / AFRIKAANSE OPSOMMING: Alhoewel dispraksie veral in Suid-Afrika nog ’n betreklik nuwe en onbekende versteuring is, is daar al heelwat navorsing gedoen oor wat dié toestand behels, hoe dit ontstaan, met watter simptome dit gepaardgaan, en die beskikbare hulpbronne om ʼn kind met dispraksie te hanteer. Tog is navorsing oor die emosies, frustrasies en bekommernisse van die ouers van kinders met dispraksie nie ewe geredelik beskikbaar nie. Bronfenbrenner se bio-ekologiese teorie is gebruik, omdat dit die gesin se verskeie sisteme identifiseer waarbinne hulle funksioneer. Sodoende kan moontlike ondersteuning in die gesin se gemeenskap geïdentifiseer en bewerkstellig word. Die navorsingsmetodologie van hierdie studie is kwalitatiewe navorsing binne ʼn interpretatiewe paradigma. ʼn Spesifieke fenomeen is ondersoek en die navorser het gebruik gemaak van twee gevallestudies. Die deelnemers, soos geïdentifiseer deur ʼn doelgerigte steekproef, is vier ouers van kinders met dispraksie. Die navorsingsvraag wat hierdie studie lei handel oor die ouers se ervarings en persoonlike belewings rakende hul kinders se dispraksie. Individuele, semi-gestruktureerde onderhoude, sowel as reflektiewe joernale, is as metodes van data-insameling gebruik. Volgens bestaande literatuur beleef ouers van ʼn kind met ʼn versteuring hul kinders se toestand op ʼn emosionele, fisiese én sosiale vlak. Die data analise het gedui dat ook ouers van kinders met dispraksie hul kinders se toestand op hierdie drie vlakke ervaar. Die studie het ook daarop gedui dat ouers se kennis van dispraksie, die omgewing waar hulle woon, die mate van ondersteuning en hulpbronne waaroor hulle beskik, sowel as die getal kinders in die gesin, alles faktore is wat hul ervarings op voormelde drie vlakke beïnvloed. Die navorsing bied insig in die ouers se ervarings en die noodsaaklikheid van genoegsame ondersteuning vir ouers, en behoort algemene bewustheid en erkenning van dispraksie as ʼn hindernis vir ʼn kind se ontwikkeling te bevorder.

Previous research indicates that those with a history of abuse have an increased risk to experience subsequent traumatic events. This study utilized a convenience sample of undergraduate students to examine the reaction of those with a history of abuse to subsequent traumatic experiences. In addition, the study assessed the level of posttraumatic growth an individual experiences following childhood abuse. The level of posttraumatic growth was examined to determine if the growth allowed for participants to better handle successive traumas. Those with a history of abuse experienced higher levels of symptomology following a successive traumatic event. Results did not support the hypothesis that among those with a history of abuse, lower levels of posttraumatic growth would predict higher levels of symptoms following a later trauma. Implications and limitations of the study, as well as directions for future research are discussed.