Bakgrund: Långvarig smärta är vanligt förekommande i Sveriges befolkning. Smärtupplevelsen är individuell och påverkas av många dimensioner i livet. Långvarig smärta är svår att bedöma och lindra, den kan skapa ett lidande. Att lindra lidande och främja hälsa hos dessa personer är en viktig men inte alla gånger lätt uppgift för sjuksköterskan. Därför är det nödvändigt med insikter i hur det är att leva med långvarig smärta. Syfte: Syftet med studien var att beskriva upplevelsen av att leva med långvarig smärta. Metod: En litteraturstudie har använts. Studien baseras på tio kvalitativa artiklar som granskats och analyserats med influens av Forsberg och Wengström (2013) samt Friberg (2012). Det vetenskapliga underlaget är hämtat ur databaserna CINAHL och PubMed och är publicerat år 2000-2013. Resultat: Tre huvudteman med subteman representerar resultatet. Första huvudtemat, Känsla av att livet är begränsat, beskriver de negativa förändringar som smärtan leder till, gällande fysiska, psykiska och sociala aspekter. Andra huvudtemat, Strävan efter att bemästra den långvariga smärtan, visar hur varierande strategier används för att bemästra den långvariga smärtan. I tredje huvudtemat, Kampen för att bli betrodd i sitt lidande, framträder smärtans osynlighet som problematisk, misstro i kontakt med närstående och vårdgivare förekommer. Diskussion: Resultatet knyts an till Erikssons omvårdnadsteori om lidande. Sjukdomslidande, livslidande och vårdlidande diskuteras. Försök att lindra, liksom anpassningen av livsmönster och förmågan till försoning belyses. Ensamhet och avskildhet diskuteras samt vikten av att få tid och rum att lida. Omgivningens roll i lidandet samt hur vårdlidande kan lindras berörs även. / Background: Chronic pain is common in the Swedish population. The pain experience is individual and influenced by the many dimensions of life. Chronic pain is difficult to cure and relieve, it causes suffering. To relieve suffering and promote health for these people is an important but not always easy task for the nurse. Therefore, it is necessary to have insight in the experiences related to living with chronic pain. Aim: The aim of this study was to describe the experience of living with chronic pain. Methods: A literature review was used. The study is based on ten qualitative articles that have been investigated and analyzed with influence by Forsberg and Wengström (2013) and Friberg (2012). The scientific evidence is from the databases CINAHL and PubMed and is published year 2000-2013. Results: Three main themes with subthemes represent the result. The first main theme, Feeling that life is limited, describes the negative changes that the pain creates concerning physical, psychological and social aspects. The second main theme, Efforts to overcome the chronic pain, shows that varying strategies are used to overcome the chronic pain. In the third main theme, The struggle to be trusted in their suffering, the invisible pain appears as problematic, suspicion in touch with both family and caregivers occur. Discussions: The result is related to Eriksson´s nursing theory of suffering. The suffering of illness, the suffering of life and the suffering of care is discussed. Attempts to relieve pain as well as adaptation of life patterns and the ability of reconciliation are illuminated. Loneliness and separation is discussed as well as the importance of having time and space to suffer. The role of the fellow people in the suffering, and how the suffering of care may be eased is mentioned as well.

Bakgrund: I Sverige insjuknar cirka 25 000 personer i en demenssjukdom årligen. Symtomen har ofta ett smygande förlopp och kan till en början vara svåra att koppla till demenssjukdom. Demenssjukdom har beskrivits som “de anhörigas sjukdom” vilket antyder att sjukdomen inte bara påverkar den som drabbats utan även de anhöriga och deras livssituation. Syfte: Att beskriva anhörigas erfarenheter av att leva tillsammans med en person med demenssjukdom i det gemensamma hemmet. Metod: En systematisk litteraturstudie med kvalitativ innehållsanalys. Sökning av artiklar utfördes i CINAHL, PubMed och PsycInfo och resulterade i elva kvalitetsgranskade vetenskapliga studier. Resultat: Anhörigas erfarenheter är att äktenskapet successivt förändras och de anhöriga intar en ny roll som innebär större ansvar och erfars ofta som en börda. Att få minskad tid för sig själv eller möjlighet att medverka i sociala tillställningar leder ofta till isolering och olika känslomässiga reaktioner. Utbytet med partnern minskar ju längre sjukdomen fortskrider och sociala kontakter förloras vilket leder till en känsla av ensamhet och förlust. Slutsats: Livet för den anhöriga förändras på många olika sätt och de egna behoven nedprioriteras vilket kan leda till att den anhöriga drabbas av ohälsa. Det är viktigt att sjuksköterskor och annan vårdpersonal försöker förstå den situation anhöriga befinner sig för att kunna erbjuda rätt hjälp och stöd.

Background: Myocardial infarction is one of the most common diseases that cause death in the world. The diagnosis has an immediate impact on the person's life. It's important that nurses are aware of the paramount importance of their role as caregivers and also as their role in monitoring the patient after discharge from hospital. Aim: The aim of the study was to describe patients' experiences after myocardial infarction. Method: In order to understand patients' experiences following myocardial infarction and to contribute to evidence-based nursing, present study was a literature study based on qualitative research. Analysis was conducted according to Friberg's five-step analysis method, which gave four themes and eight subthemes. Results: The result shows that patients had experience of physical and mental changes after myocardial infarction. They felt a loss of energy and strength and experienced fatigue, which limited them in everyday life. Getting support from healthcare professionals was considered important to implement the lifestyle changes that were recommended and to get a pleased recovery. Patients' relatives were also considered important during recovery as they constituted support for the patient and helped them to see a bright future. Conclusion: It´s important that nurses maintain continuous contact with patients after discharge from hospital in order to make a good support system and to encourage the patients for a healthy living.

Background: Obesity has exploaded in the last decades and an ongoing increase is to be seen. The disease is rated as a huge epidemia of times and has developed to an economic social problem. Today more people die from obesity and it´s complications than from nutritional diseases and malnutrition. Gastric Bypass has proved to enable a new life including an improved health and quality of life but has also been critized for being a quick solution not resulting in a long term perspective weight loss. Aim: The aim of this study was to describe people´s experiences from going through Gastric Bypass surgery. Method: The method used was a literature study based on qualitative research. The articles were analysed according to Fribergs five step model and resulted in three main themes and nine sub-themes. Results: The main themes were- The last way out, The battle against oneself and On a new adventure. In order to be able to support these people keeping their new life style and weight reduction the nurse must have insight in people´s experiences of having undergone a Gastric Bypass surgery. Conclusion: The result showed that Gastric Bypass can be a last alternative for hope about a better future and a chance to an improved health and quality of life. Though the surgery has to be combined with individually created coping strategies and a genuine, strong will to make a change in order to become a successful action in a long term perspective.

Philosophiae Doctor - PhD / Digital storytelling is a workshop-based practice, originally developed by the Californiabased nonprofit StoryCenter, in which people create short, first-person digital video narratives based on stories from their own lives. The practice has been adopted around the world as a participatory research method, as a pedagogical tool, as a community-based reflective arts practice and as medium for advocacy. It is associated with a loosely connected global movement linked by genealogy and a set of ethical commitments to the significance of all life stories and to the power of listening as a creative and political act.

South African society has been a ected either directly or indirectly by some degree of trauma. Therefore the presence of a trauma unit within a hospital created the ideal opportunity for novice trauma counsellors to have practical experience. The present research is an exploratory study, designed in accordance with ethno- graphic principles in order to understand the psychological e ects of trauma on novice trauma counsellors. It focuses on themes that reverberate throughout the participants narratives. Vicarious trauma and compassion fatigue are two such e ects that were explored in this study. Research into compassion fatigue and vi- carious trauma span over several decades and researchers have moved from merely describing the symptoms of secondary traumatic stress to explaining it in terms of models that highlight the role of various factors that contribute vicarious trauma or compassion fatigue. This study concludes with recommendations to counter the e ects of experiencing secondary trauma. / (M.A. (Clinical Psychology))

Syftet med denna undersökning är att beskriva hur närstående till en familjemedlem som lever med HIV/AIDS upplever att deras egen hälsa påverkas av detta, hur de hanterar sin livssituation och vilka förväntningar de har från samhällets håll när det gäller bemötanden och behandlingar. Sex anhöriga till en HIV-positiv deltog i studien. En kvalitativ induktiv metod användes och datainsamlingen genomfördes med hjälp av semistrukturerade intervjuer för att låta de närstående relativt fritt berätta om sina upplevelser. Intervjuerna spelades in och transkriberades för att sedan analyseras med hjälp av en manifest innehållsanalys resulterande i tre kategorier. De tre kategorier är upplevd hälsa, coping och förväntningarna. I resultatet framkom det att de närstående upplever att deras hälsa påverkas av att de lever med någon som har HIV/AIDS. De behöver mobilisera sina inre resurser och ta stöd från deras sociala nätverk för att kunna hantera sin livssituation. Slutsatsen blev den att en ökad allmänkunskap om HIV/AIDS behövs, särskilt för att utveckla insatser riktade till just de anhöriga till smittade. Det är av vikt att även deras röster hörs samt att deras inre och yttre resurser uppmärksammas och stärks. Interventioner för HIV-infekerade borde också gynna deras familjer. / The purpose of this study is to describe to what extent the family members of someone who is HIV/AIDS positive feel that their health is also affected by this, how they cope with this circumstance land what expectations they have regarding how they hope to be received and treated in society as a whole. 6 family members of an HIV/AIDS positive individual participated in the study. A qualitative inductive method was used for the study and the data collection was carried out using semi-structured interviews so as to allow the family members to relatively freely share of their experiences. The interviews were transcribed and then analyzed using a manifest content analysis, resulting in the three categories: perceived health, coping and expectations. The results show that the family members feel that their health is also affected by their relation to someone who is HIV/AIDS positive. They need to mobilize their internal resources and seek support from their social networks to be able manage their day-to-day lives. It was also concluded that a general increased in knowledge concerning HIV/AIDS is needed, especially with the goal of developing effective interventions specifically aimed at the family members of the HIV infected. It is important that their voices are heard and that their internal and external resources are both recognized and strengthened. Interventions for HIV positive individuals should also benefit the lives of their families.

A evolução tecnológica e a inovação dos recursos médicos tornaram crescentes e impulsionaram a busca por procedimentos realizados pela Medicina no Brasil e, como consequência, o número de erros médicos também aumentou. O erro médico advém de uma conduta inadequada, capaz de produzir dano à vida ou agravo à saúde do seu paciente, por ação ou omissão do profissional médico, mediante a imperícia, imprudência ou negligência. Essa situação tem se tornado cada vez mais comum nos cenários nacional e internacional. No Brasil, não se tem uma dimensão exata do número de pessoas acometidas pelo erro médico, como também, não se têm pesquisas aprofundadas envolvendo a subjetividade e o sofrimento das vítimas na literatura nacional. O objetivo desta tese foi investigar o sentido dado pelas vítimas de erro médico a essa sua condição existencial e também analisar o sofrimento psíquico implicado nesse processo, à luz da perspectiva fenomenológico-existencial e das contribuições de Walter Benjamin. Foi conduzida uma entrevista semiestruturada com uma questão inicial disparadora, realizada com 12 pessoas vítimas de erro médico. Os dados foram tratados a partir da análise de sentido. Pôde-se observar, dentre outros aspectos, que as vítimas inicialmente demoram para acreditar no que estão vivenciando, ficando perplexas e indignadas diante do erro médico do qual foram vítimas. Verificou-se que algumas souberam por outros profissionais da ocorrência do erro, e nenhum dos médicos que cometeu o erro foi o responsável pelo suporte e condução da correção. Assumir que errou foi pouco visto nos 1 É preciso destacar que esta pesquisa não tem o propósito e nem a finalidade de gerar conflito de interesse. discursos e atitudes dos médicos envolvidos. Os sentimentos de ódio, raiva e desespero tomam conta da vivência das vítimas. A rotina de vida se modifica, e as vítimas se tornam, muitas vezes, dependentes e impossibilitadas de continuar com suas responsabilidades e afazeres. As narrativas das vítimas indicaram que cada indivíduo tem seu modo subjetivo de enfrentar e reagir ao erro, e o sofrimento é um elemento peculiar a esse processo. O conceito de erro médico, formulado pelas vítimas, apresenta uma conotação negativa e representa uma atuação profissional sem qualidade, retratando a realidade do contexto sanitário que o País vive, sem respeito e consideração pelo paciente. Sobre o julgamento dos casos, as vítimas destacaram a demora na deliberação do processo e sentiram-se surpresas quanto às brandas punições aplicadas aos médicos condenados. Com base nas reflexões, é possível apontar que o estigma do erro médico tem uma forte ligação com os juízos de valores e culturais impostos no País, o que dificulta a sua aceitação tanto para a vítima quanto para o profissional. A relação médico e paciente tem se mostrado desgastada, sem haver o respeito e consideração à individualidade da pessoa como paciente, distanciando o médico de uma prática humanizada e dos aspectos bioéticos. As narrativas permitem um pensar sobre o sofrimento psíquico das vítimas e ajudam a compreender melhor os aspectos emocionais, comportamentais e sociais de uma vítima de erro médico no Brasil. A partir das análises, identificou-se a necessidade de um olhar mais cauteloso e atento da Psicologia para o cuidado à saúde mental dos envolvidos no erro / The technological evolution and the innovation of medical resources increased and boosted the search for medical procedures in Brazil, and, as a consequence, the number of medical errors has also raised. The medical error results from an inadequate procedure than can either damage the patient´s life or worsen his/her health, and that follows an action or omission of the doctor, because of his/her malpractice, imprudence or negligence. Such a situation has become more and more common both in the national and in the international scene. In Brazil, there is not an exact dimension of the number of people affected by medical errors, nor there is depth research about the victims´ subjectivity and suffering in the national literature. The aim of this thesis was to investigate the meaning the victims of medical errors give to their current existential condition, as well as to analyze the psychic suffering involved in such a process, in the light of the phenomenological-existential perspective and of Walter Benjamin´s contributions. We conducted a semi-structured interview in which there was an initial triggering question with 12 people who were victims of medical error. The data were treated from the analysis of meaning. Among other aspects, we could observe that first it takes a long time for the victims to believe what they are experiencing. They are astonished and indignant as they stand before the error they fell victims to. We found out that some of the victims were informed by other professionals of the occurrence of the error, and that none of the doctors who made the error became responsible for supporting and performing the correction. To assume the error was something that was hardly verified in the speech and attitudes of the doctors involved in the error. Hate, anger and despair are experienced by the victims. The daily routine changes, and a lot of times the victims become dependent and incapable of taking over their previous responsibility and tasks. The victims´ narratives show that each individual has his/her subjective way to face and react to the error, and suffering is a peculiar element of such a process. The victims´ concept of medical error has a negative connotation, and it stands for professional performance without any quality, which portrays the reality of the country´s health context, without any respect or consideration for the patient. As for the judgement of the cases, the victims highlighted the slow process of deliberation, and they were surprised with the light punishment inflicted on the doctors condemned. From our study, we can state that the medical error stigma is strongly tied with the country´s culture and value judgements, which makes it more difficult for the victim and the professional to accept it. The relation between doctor and patient has worn out, without any respect or consideration for the patient´s individuality, which distances the doctor from a humanized practice and bioethical issues. The narratives let us think about the victims´ psychic suffering, and they help us understand better the emotional, social and behavior issues of a victim of medical error in Brazil. From the analyses undertaken, it was identified the need for a more cautious and attentive look of Psychology to the mental health care of the people involved in the error

Bakgrund: Organtransplantation är ett livräddande ingrepp som genomförs när inga andra behandlingsalternativ finns. Patienten står inför en livslång behandling med immunsänkande läkemedel för att minska risken för avstötning. Det är en emotionellt krävande upplevelse för patienterna och deras familjer som gör att de är i behov av stöd av sjuksköterskan. Syfte: Syftet var att beskriva patienters emotionella upplevelser före och efter organtransplantation. Metod: En litteraturstudie som baseras på kvalitativa omvårdnadsvetenskapliga artiklar. Resultat: Fyra kategorier identifierades, Tacksamhet och skuld på samma gång, Upplevelse av stöd, Känslomässig berg- och dalbana och Oro med tillhörande underkategorier. Slutsats: Organtransplantation var överlag en omtumlande upplevelse som var unik för varje patient. Sjuksköterskan behöver mer kunskap för att bidra till god vård då patienters upplevelser före och efter organtransplantation är relativt outforskat. Nyckelord: Livserfarenhet, mottagare, organtransplantation, patient, upplevelse. / Background: Organ transplantation is a life-saving intervention that is carried out when no other treatment options exist. The patient is facing a lifelong treatment with immunosuppressive drugs to reduce the risk of rejection. It is an emotionally demanding experience for the patients and their families are in need of support from the nurse. Aim: The purpose was to describe patients' emotional experiences before and after organ transplantation. Method: A literature study based on qualitative nursing science articles. Result: Four categories were identified, Gratitude and guilt at the same time, Experience of support, Emotional roller coaster and Concern with associated subcategories. Conclusion: Organ transplantation was generally a tumultuous experience unique to each patient. The nurse needs more knowledge to contribute to good care since patients' experiences before and after organ transplantation are relatively unexplored. Keywords: Life experience, recipient, organ transplantation, patient, experience.

The objectives of the study were to examine the Life Experience curriculum, level 3-4, in terms of the teachers, students and problems encountered in the course presentation at the adult school of the North Eastern Regional Non-formal Education Centre: Tools used in the study are :- (1) questionnaires seeking the expectations of the twenty-seven centre staff (2) questionnaires seeking attitudes and desires of eighty-two students in the classes studied (3) observation of four Life-Experience classes (4) interviews with five teachers of Life-Experience classes and thirty-one students. Important findings include the following :- Both student attendance and staff enthusiasm were high, The syllabus was seen as suitable in length and level of difficulty by both staff and students, even though the level of performance (as measured by examination) varied widely across courses and between students. Students asked for a flexible component to meet localised needs as well as the core curriculum. The objectives of the classes were for students who had had no chance to continue their formal studies to gain knowledge, attitudes, skills and culture needed for their daily occupation. Students requested more information on foreign geography, biographies on important Thai figures, and the economic and political situation in Thailand. Skills which were learnt and applied included food preservation, house maintenance, hygiene, use of legal procedures such as traffic controls and loans, family planning and Buddhist moral codes. Attitudes which it was considered appropriate to develop were symbolised by the 'Knit-pen man' who is a good citizen, rational problem solver, diligent, patient and a supporter of national goals. Changes requested by students for the courses included more time for class discussion, a wide range of textbooks to be available, and field trips to broaden their experience. Changes indicated by staff and student responses were a greater emphasis on changes in behaviour with regard to food preparation and hygiene, more thorough and reflexive evaluation to develop adequate levels of knowledge, allowance for the considerable personal difficulties of the adult students attending classes, and supply of a greater range of teaching resources.