Bakgrund: Tidigare forskning visar att patienter uttrycker ett behov av att sjuksköterskor är tillgängliga och stöttar dem under deras svåra tid vid palliativ vård i livets slutskede. Det framgår även att anhöriga upplever att de får ta en stor roll i vårdandet av patienter och är därför i behov av att sjuksköterskor bekräftar dem samt är stöttande. Syfte: Att beskriva sjuksköterskors upplevelser inom palliativ vård i livets slutskede. Metod: En systematisk litteraturstudie med en beskrivande syntes. Tolv kvalitativa artiklar analyserades och är presenterade i examensarbetets resultat. Resultat: Efter analys framkom två teman: Upplevelsen av att bli involverad och Uppleva hinder för god palliativ vård. Utifrån dessa två teman identifierades totalt fyra subtema. Slutsats: Sjuksköterskor som arbetade nära patienter som erhöll palliativ vård i livets slutskede upplevde att de blev berörda samt ville lindra patienters lidande. Begränsad tid skapade frustration och en hjälplöshet hos sjuksköterskor. När den egna kunskapen brister av att arbeta inom palliativ vård i livets slutskede uppkom en osäkerhet hos sjuksköterskor, av att inte kunna hjälpa patienter och deras anhöriga tillräckligt mycket. Genom sina möten med patienter uttryckte sjuksköterskor en tacksamhet över livet och insåg hur skört det är, vilket skapade reflektion kring döden. / Background: Previous research has shown that patients express a need for nurses to be available and support them during their difficult time in end-of-life palliative care. It also appears that relatives feel that they get to play an important role in the care of the patient and are therefore in need of nurses’ validation and support. Aim: To describe nurses' experiences in palliative care at the end of life. Method: A systematic literature study with a descriptive synthesis. Twelve qualitative articles were analyzed and are presented in the results. Results: After analysis, two themes emerged: The experience of becoming involved and experiencing obstacles to good palliative care. From these two themes, a total of four subthemes were identified. Conclusion: Nurses who worked close to patients who received palliative care at the end of life felt affected for them and wanted to alleviate the patients suffering. Limited time led to frustration and a sense of helplessness among the nurses. Those who lacked experience working in palliative care at the end of life, were uncertain if they provided sufficient help to the patients and their relatives. Their encounters with patients gave the nurses an appreciation for life and how fragile it is, which led to reflections on death

Background: End-of-life palliative care is provided to individuals who have a progressive and incurable disease or injury. The meaning of palliative care is to promote quality of life and to alleviate the relief of patients but also those close to them. Previous research shows that patients in palliative care have a limited everyday life and that they become more dependent on nurses, which in turn leads to reduced autonomy. There was also a lack of communication among nurses and relatives. Method: Systematic literature study with a descriptive summary, 13 care science articles were analysed, all of which have a qualitative approach. Aim: The aim of the thesis is to describe nurses' experiences of caring for patients at the end of life. Results: The analysis revealed two themes; experiences of challenges in care and experiences of being present in care. The first theme included three subthemes; to understand the importance of communication, to experience a lack of knowledge and experience and to be affected emotionally, which was about the communication difficulty and challenges those nurses encountered. The second theme in turn included two subthemes; to experience the care as rewarding and meaningful and to promote good relationships in the care, which were about how nurses were personally affected in the care of patients at the end of life and in the treatment of relatives. Conclusion: The nurse experienced gratitude in caring for the patient at the end of life. The nurse experienced the care as rewarding and satisfying when they promoted good relationships with the patient and relatives. However, the nurse experienced challenges in care due to lack of knowledge and experience. This led to the nurse experiencing an obstacle to meeting the patient's needs.

The purpose of this study was to set up equivalent groups of conventional and experimental classes in English in order to test both groups with certain standardized tests before and after a definite period of instruction, and to evaluate the relative efficiency of the two teaching methods in light of the statistical evidence.

This study represents a survey of selected eighth-grade students of San Joaquin County and the measurement of their ability and achievement in certain aspects of the Language Arts program of the elementary school.

Bakgrund: Amyotrofisk lateral skleros är en terminal progressiv sjukdom där motoriska nervceller i hjärnan, hjärnstammen och ryggmärgen bryts ner och dör. Musklerna blir därmed understimulerade och förtvinar vilket leder till förlamning. Majoriteten av personerna som insjuknar i amyotrofisk lateral skleros avlider inom fem år. Cirka 10-20 procent lever längre än tio år från sjukdomsdebut. Att diagnostiseras med amyotrofisk lateral skleros innebär en chock och en omfattande livsomställning. Då det inte finns något botemedel är det viktigt att patienten erbjuds individanpassad omvårdnad samt psykosocialt och existentiellt stöd för att lindra symtom och stärka patientens livskvalitet. Syfte: Syftet var att beskriva patienters upplevelser av att leva med Amyotrofisk Lateral Skleros. Metod: Litteraturstudie baserad på befintlig forskning inom området. Tio vårdvetenskapliga artiklar hämtade från databaserna CINAHL Complete och MEDLINE har använts och tillvägagångssättet har utförts enligt Fribergs metod. Resultat: I resultatet framträdde tre teman och fyra subteman som beskrev olika aspekter av att leva med amyotrofisk lateral skleros. De teman som identifierades var: livet faller samman med subtemana förlust av förmågor och förlust av mening, att bygga upp livet på nytt med subtemana acceptans och anpassning och finna mening samt beslut kring vård. Att leva med amyotrofisk lateral skleros innebar sorg, osäkerhet och rädsla samt en känsla av att livet förlorat mening. Sjukdomens progression innebar ett ständigt beslutsfattande kring vård. Familjens delaktighet i vårdbesluten var betydelsefull men gav även upphov till pliktkänslor. Förlusten av fysiska förmågor medförde både rädsla för att helt förlora kontrollen i livet och bli beroende av andra samt rädsla inför döden. Trots detta var det möjligt för deltagarna att acceptera och anpassa sig till sjukdomen samt att hitta ny mening i livet och uppleva livskvalitet. Diskussion: Resultatet diskuterades utifrån ytterligare forskning samt Callista Roys adaptionsmodell som berör människans förmåga till anpassning. De delar som lyftes fram och diskuterades var acceptans, anpassning, autonomi och pliktkänsla. / Background: Amyotrophic Lateral Sclerosis is a terminal progressive disease in which themotor neurons in the brain, brainstem and spinal cord breaks down and dies. As a result of this the muscles becomes under stimulated and atrophies which leads to paralysis. The majority of persons suffering from Amyotrophic Lateral Sclerosis die within five years. Between 10-20 percent live longer than ten years from the onset of the disease. Being diagnosed with Amyotrophic Lateral Sclerosis causes a shock and leads to a sweeping life change. Since there is no cure, it is important that people with Amyotrophic Lateral Sclerosis are offered individualized care as well as psychosocial and existential support in order to relieve symptoms and strengthen the patient’s quality of life. Aim: The aim was to describe patients’ experiences of living with Amyotrophic Lateral Sclerosis. Method: Literature study based on existing research in the field. Ten articles on care science have been used from the databases CINAHL Complete and MEDLINE. The procedure has been carried out according to Friberg's method. Results: The result featured three themes and four subthemes that described different aspects of living with Amyotrophic Lateral Sclerosis. The themes that were identified were: life falls apart with subthemes loss of abilities and loss of meaning, rebuilding life with subthemes acceptance and adaptation and finding meaning and decisions about care. Living with Amyotrophic Lateral Sclerosis meant grief, insecurity and fear as well as a feeling that life had lost meaning. The progression of the disease led to a constant decision-making process regarding care. The family's participation in health care decisions was meaningful, but also caused feelings of duty. The loss of physical abilities led to fear of completely losing control in life and becoming dependent on others but also fear of death itself. Despite this, the participants were able to accept and adapt to the disease allowing them to find new meaning and experience quality of life. Discussion: The results were discussed on the basis of further research and Callista Roy's adaptation model, which is about people's ability to adapt. The parts highlighted in the discussion were acceptance, adaption, autonomy and feelings of duty.

Orientador: Kelly Cristiane Henschel Pobbe de Carvalho / Banca: Thiago Alves Valente / Banca: Diana Navas / Resumo: Esta dissertação é resultado de uma investigação realizada com alunos do Ensino Fundamental - Séries Finais (9ºano), em uma escola pública estadual, acerca da leitura de crônicas, sobretudo, aquelas já consagradas pelos grandes escritores da literatura brasileira e perpetuadas no suporte livro. Assim, buscou-se refletir se o gênero crônica pode contribuir na formação do leitor estético, uma vez que, este gênero, tem sido explorado nos diferentes materiais didáticos que circulam na esfera escolar como o Currículo Oficial do Estado de São Paulo, o livro didático, além de outros materiais que contemplam o ensino da leitura. Para tanto, são apresentadas algumas reflexões sobre os pressupostos teóricos que norteiam esta investigação, como: a metodologia, a concepção de linguagem, de leitura, de leitor, a concepção de tipos e gêneros textuais, o ensino de literatura e as estratégias que envolvem o desenvolvimento da compreensão leitora. A base teórica para esta pesquisa vem, principalmente, da concepção dialógica da linguagem proposta por Bakhtin (1997, 2006), bem como da concepção sociointeracionista proposta por Vygotsky (1991, 1994), além das contribuições da Teoria da Estética da Recepção, mais especificamente, o Método Recepcional, preconizado por Bordini e Aguiar (1993). Para o desenvolvimento desta investigação, a metodologia qualitativa de caráter interpretativista foi utilizada, por meio da aplicação dos procedimentos previstos na pesquisa narrativa. Buscou-se, ainda, refl... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This work is the result of an investigation conducted with 9th year Elementary School students from a public institution in São Paulo State, about reading chronicles, especially those already established by the great writers of Brazilian literature and perpetuated in the books. So we decided to consider if the text genre chronicle can contribute to the formation of the aesthetic reader, since this genre has been explored in different teaching materials used in the school, like the support materials of the Currículo do Estado de São Paulo, the textbooks, as well as other materials that include the teaching of reading. For this reason, we present some reflections on the theoretical assumptions that guide this research, such as the methodology, the conception of language, of reading, of reader, of text types and genres, the teaching of literature and the strategies involving the development of reading comprehension. The theoretical basis for this research comes mainly from the dialogical conception of language proposed by Bakhtin (1997, 2006) and from the sociointeractionist concepton proposed by Vygotsky (1991, 1994), besides the contributions of the Reception Aesthetic Theory, more specifically the Recepcional Method suggested by Bordini and Aguiar (1993). In order to develop this investigation, it was used the qualitative methodology of interpretative character, applying the procedures provided in the narrative research. It was also proposed a reflection on what concerns the reading of chronicles, if this work, based on the theoretical principles described, could assure to the students the development of reading comprehension, as well as the expansion of their horizons of expectation / Mestre

Sometimes students struggle to interpret literary texts because some of these texts do not lend themselves to the deduction of the interpretative processes with which they are familiar, but the same is not true when students pull interpretations from songs. Is it possible that students’ familiarity with songs might enable them to connect a song with a book and aid interpretation that way? This study attempted to explore the possibility of bridging songs to literary texts in my Community College English classroom, to ascertain if or how the use of song can support or extend students’ interpretive strategies across different types of texts. I investigated how songs might work as a bridge to other texts, like novels, and, if the students use songs as texts, to what extent do the students develop and hone their interpretative skills? Because of this, how might including songs as texts in English writing or English Literature curriculum contribute to the enhancement of students’ writing? The students’ responses disclosed that the songs appealed to their cognition and memories and helped them to interpret and write about the novels they read. Moreover, the students’ responses revealed that pairing or matching songs with novels strengthened interpretation of the book in a plethora of ways, such as meta-message deduction, applying contexts, applying comparisons, and examining thematic correlations. When a novel is bridged or paired with a song, interpretation can also be derived by examining different perspectives, characterizations, personal connections, and life experiences. Exploring emotional connections as well as signs and symbolism can also enable interpretation. Another way to deduce interpretation, according to the students, is to locate a reoccurring issue or thread in a song and transfer the analysis from the song to the novel. However, although a few students might not use songs to interpret literary texts, they might still be able to recognize that the possibility exists to grasp meaning that way.

Bakgrund: Studier har visat att hälso- och sjukvårdspersonal har ett stigmatiserande förhållningssätt gentemot personer med schizofreni. Syfte: Att beskriva hur personer med schizofreni upplever relationen till hälso- och sjukvårdspersonal inom den psykiatriska vården. Metod: Arbetet har en beskrivande design med litteraturöversikt med systematisk ansats och baseras på åtta kvalitativa originalartiklar. Resultat: Det framkom sex kategorier: Kommunikation, diskriminering och stigmatisering, närvaro och tillgänglighet, tvång och ofrihet, delaktighet och meningsfullhet, och säkerhet och trygghet. Resultatet visar att patienterna upplevde goda och dåliga relationer till hälso-och sjukvårdspersonalen. De beskrev att en god relation upplevdes då det fanns god kommunikation, förtroende, delaktighet och trygghet. Dåliga relation upplevdes vid tvång, hot och dålig kommunikation mellan patient och hälso- och sjukvårdspersonal.   Slutsats: En god relation är fundamentalt viktig för patientens välbefinnande och vård. Det behövs mer undervisning till hälso- och sjukvårdspersonal om hur de bör bemöta personer med schizofreni. Vidare forsknings behövs dock då det var svårt att finna artiklar inom samma ämne som var från de närmsta tio åren. / Background: Studies have shown that health personnel have a stigmatizing approach towards people with schizophrenia. Aim: To describe how people with schizophrenia experience the relation to health personnel within psychiatric care. Method: This study has a descriptive design with a literature review with a systematic approach, and is based on eight qualitative original articles. Results: Six categories were identified: Communication, discrimination, presence and availability, coercion and lack of freedom, participation and meaningfulness and safety and security. The results show that patients experience both good and bad relations to health personnel. Good relations took place when patients experienced good communication, trust, participation and security. Bad relations took place when patients experienced coercion, threats and bad communication. Conclusion: A good relation is fundamentally important for the patient’s wellbeing and care. More education on how health personnel establish a good relation with patients with schizophrenia is necessary. However, further research is needed on the subject, since articles published within the past ten years were difficult to find.

Bakgrund: Njurtransplantation är en behandling mot kronisk njursvikt och är den vanligaste formen av organtransplantation. Det är däremot ingen botande behandling. För att undvika avstötning av den nya njuren följer en livslång behandling med immunhämmande medicinering. Syfte: Syftet med studien var att beskriva personers erfarenheter av att leva med en transplanterad njure.  Metod: Nio kvalitativa empiriska artiklar valdes ut från databaserna CINAHL, PsycINFO och Pubmed. En kvalitativ innehållsanalys genomfördes.  Resultat: Följande tre huvudkategorier identifierades i analysen: Att vara fri men samtidigt begränsad, Att uppleva motstridiga känslor samt Att genomgå en personlig utveckling i relation till omgivningen. Ytterligare sju subkategorier identifierades.  Konklusion: Denna litteraturstudie lyfter den komplexa livssituationen efter en njurtransplantation där personerna upplever en paradox mellan hälsa och ohälsa samt frihet och begränsningar. En insikt i personernas levda erfarenheter är betydelsefullt för mötet med denna patientgrupp. Ensamhet, oro och att inte känna sig förstådd kan underlättas genom sjuksköterskeledda interventioner för en bättre anpassning till det nya livet. / Background: Kidney transplantation is a treatment for chronic kidney disease, and it is the most common form of organ graft replacement. However, it is not a curative treatment. Kidney transplants require a lifelong regimen of immunosuppressive medication to avoid rejection.  Aim: The objective of this study was to describe the lived experiences of kidney transplant recipients. Methods: Nine qualitative empirical articles were chosen from the databases CINAHL, PsycINFO, and Pubmed. A qualitative content analysis was used to analyze the chosen articles.  Results: The following three categories were identified: Liberty with limitations, To experience conflicting emotions and Personal development in relation to the environment. An additional seven subcategories were identified.  Conclusion: This literature study illustrates the complexity of life for those having undergone a kidney transplant; individuals experienced a paradox between health and illness, as well as between freedom and limitation. The study provides insight into patients’ experience, which is notably important for the treatment of this particular patient group. Isolation, anxiety, and feelings of being misunderstood could be helped through interventional nursing that stresses adapting to new life changes.

Bakgrund: Akutsjukvård ges till någon som blivit akut sjuk eller skadad, vården ska dessutom leva upp till samhällets krav på god och säker vård. Idag arbetar både grund- och specialistutbildade sjuksköterskor på Sveriges akutmottagningar. Teamarbete är en viktig framgångsfaktor för att öka effektiviteten av vården. Syfte: Syftet med studien var att belysa vårdpersonals erfarenheter av och reflektioner kring teamarbete inom akutsjukvård.  Metod: En litteraturstudie baserad på åtta kvalitativa studier. Artikelsökningen genomfördes i PubMed och Cinahl. Artiklarna har granskats, analyserats och sammanställts.    Resultat: Litteraturstudiens resultat presenteras i tre kategorier och åtta underkategorier; Behovet av en formell struktur: Vikten av god kommunikation, Vikten av tydliga roller och Vikten av en ledare. Hinder för ett optimalt teamarbete: Oerfarna teammedlemmar och Arbete under stress. Möjligheter som främjar teamarbetet: Skapa goda relationer, Stötta och hjälpa varandra och Utbildning och träning.  Konklusion: Fungerande teamarbete är vitalt för patientsäkerheten. Sjuksköterskor har en betydande roll i teamet samt påverkar utfallet av teamarbetet och vården. Det behövs kontinuerlig träning och utbildning i teamarbete samt riktlinjer över hur teamarbete ska bedrivas. / Background: Emergency care is given to someone who has been acutely ill or injured, the care must also live up to society’s demands for good and safe care. In Sweden both registered- and specialist nurses work in the emergency department. Teamwork is an important factor to increase efficiency of care.  Aim: The aim of this study was to illuminate health personnel’s experiences of and reflections on teamwork in the emergency medical services.  Methods: A literature study based on eight qualitative studies. Search for articles was conducted in the databases PubMed and Cinahl. Articles have been reviewed, analyzed and complied.  Results: Results of the literature study are presented in three categories and eight subcategories; Need of a formal structure: Importance of good communication, Importance of clear roles and Importance of a leader. Obstacles to optimal teamwork: Inexperienced team members and Working during stress. Options that promotes teamwork: Create good relationships, Support and help each other and Education and training.  Conclusion: Functional teamwork is vital for patient safety. Nurses have a significant role in the team and influence the outcome of teamwork and care. Continuous training and education are required as well as guidelines on how teamwork should be conducted.