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Bakgrund Fibromyalgi är en kronisk smärtsjukdom som främst påverkar muskler och leder. Diagnosen kräver tre månaders smärta och minst elva ömma punkter på kroppen. Utöver smärtan kännetecknas sjukdomen av trötthet och sömnsvårigheter. Globalt lider 2-6 procent av fibromyalgi, och av dessa är 80-90 procentkvinnor. Orsakerna till sjukdomen är inte helt klara. Det krävs flera vårdbesök för att diagnostisera sjukdomen, vilket leder till olika behandlingar och tester för att hantera symtomen. Syfte Syftet är att belysa personers upplevelse av att leva med fibromyalgi. Metod I översikten användes Fribergs metodologiska ramverk (2022) för en systematisk litteraturöversikt. Det innebär att sammanfatta och analysera befintlig forskning inom ett specifikt område med noggrann granskning och vetenskaplig ansats för att belysa ett aktuellt problemkomplex. Resultat Resultatet lyfte fram smärta och trötthet som centrala hinder för arbetslivet och vardagsuppgifter. Dessa utlöste ofta depression och påverkade starkt den mentala hälsan. Utöver detta påverkade tillståndet även familjeliv och identitet negativt. Särskilt tydligt var stressen på arbetsplatsen och den ekonomiska osäkerheten. Tre huvudteman framkom, Fångad av smärta och trötthet, Kampen mot nedstämdhet och identitetsförändringar och Familjens roll och sociala utmaningar. Slutsatsen Personer drabbade av fibromyalgi lider av smärta, trötthet och psykisk påverkan, vilket påverkar arbete, identitet och familj. Det innebär att de behöver samhällets och hälso- och sjukvårdens stöd. / Background Fibromyalgia is a chronic pain condition that primarily affects muscles and joints. The diagnosis requires three months of pain and at least eleven tender points on the body. Apart from pain, the condition is characterized by fatigue and sleep disturbances. Globally, 2-6 percent suffer from fibromyalgia, with 80-90 percent of them being women. The causes of the disease are not entirely clear. Diagnosing the condition necessitates multiple healthcare visits, resulting in various treatments and tests to manage the symptoms. Aim To illuminate individuals' experiences of living with fibromyalgia. Method The study utilized Friberg's methodological framework (2022) for a systematic literature review. This involved summarizing and analyzing existing research in a specific area with meticulous scrutiny and a scientific approach to shed light on a current complex problem Results The results highlighted pain and fatigue as central obstacles in both work and daily tasks. These often triggered depression and significantly impacted mental health. Additionally, this condition negatively affected family life and identity. Particularly evident were workplace stress and financial insecurity. Three main themes emerged: Trapped by Pain and Fatigue, Struggle against Depression and Identity Changes, and the Role of Family and Social Challenges. Conclusion: Fibromyalgia patients suffer from pain, fatigue, and psychological impact, affecting work, identity, and family. They require support from society and healthcare.

Chronic pain is one of the most common health conditions, affecting nearly six million Canadian adults. Despite abundant research on chronic pain in general, there is limited knowledge on how racialized immigrant women experience living with chronic pain and how this relates to their broader social circumstances. The purpose of this qualitative, exploratory study is to understand living with chronic disabling pain as situated in and contextualized by the lived experiences of immigrant women residing in Ottawa, Ontario, and to explore the perspectives of the women's care partners as well as physicians providing care for chronic pain. Semi-structured interviews were conducted with 24 participants. The dissertation is guided by the social determinants of health framework and an intersectional lens. Four interconnected themes from the data analysis have been generated: (1) The trajectory and meaning of pain; (2) Reasons for pain and triggering factors; (3) Pain consequences; and (4) Coping and control. Findings indicate that chronic pain is a subjective, complex, biopsychosocial, and multidimensional phenomenon. Pain is a deeply personal experience linked with meaning. Results also highlight an association between the distribution of the social determinants of health during the life course and pain. Furthermore, the pain has profound, multidimensional impacts on the women and their families, and its treatment is a challenging task for health care professionals. In addition, the findings show that pain is often poorly recognized, underestimated, and inadequately managed. Finally, the results illustrate the perseverance and incredible resilience of the women and their carers. The findings provide several implications for policy, research, and practice.

Analytical Music Therapy (AMT) is an advanced model of music therapy practice in the United States. Inter Music Therapy (IMT) is one of four required training stages to becoming an analytical music therapist. IMT is an experiential process where two AMT trainees take turns being therapist and client to one another, while under the direct supervision of the AMT trainer. Music is an integral component throughout IMT. All clinical material addressed and processed in IMT is lived experience, rather than role-play. To date, there is limited research documenting the experience of IMT for the AMT trainee. This study describes the IMT experience for AMT trainees, reveals the most significant experiences of IMT, and identifies how IMT shapes the clinical skills of music therapists who experience it. Findings from this study may add value to the training of music therapists in general. This study implemented the qualitative interpretivist research approach of Transcendental Phenomenology to explore the lived experience of IMT from the perspective of persons who have participated in it. Six participants were interviewed, interviews were recorded and transcribed, and the data were analyzed in two phases. Phase one resulted in a synthesis for each participant. Syntheses are rich descriptions of each participant’s IMT experience. The final step in phase one resulted in a global distilled global essence describing what it is like to experience IMT. Phase two was a cross participant analysis resulting in six global themes, and some of these themes were further developed through sub-themes. The self-experience of IMT provided multiple learning opportunities for AMT trainees. IMT shaped AMT trainees’ clinical skills in the following ways: increased capacity for empathy, enhanced therapeutic presence, recognition of how personal material influenced the therapy session, further developed self-awareness, and expanded musical creativity. The supervisory process enhanced AMT trainees’ appreciation for supervision, and the value of trust in the therapy process. Log writing was instrumental to integrating learning. The following recommendations are suggested to strengthen music therapy training and supervision in general: opportunities for music making while in the role of self to increase self-awareness in training and supervision, with an emphasis on creativity; opportunities for live or recorded observation of clinical work in supervision (in academic settings and professional supervision); and training opportunities for music therapy supervisors along with improved clarity in the competency of music therapy supervisors. / Music Therapy

The treatment of eating disorders (EDs) presents many challenges. Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference may be partially due to the therapist's own vulnerabilities. Due to the personal connection to the work, countertransference towards ED clients may be pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists negotiate their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The present study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. The study was guided by the theoretical frameworks of social constructivism and symbolic interactionism, as well as the person-of-the-therapist clinical training philosophy. Using constructivist grounded theory methodology, semi-structured interviews (Mtime = 89 minutes) were conducted with 22 therapists with EDLE, who work with ED clients. Participants explored how they use and manage their EDLE during key tasks of treatment with their ED clients. Results revealed that therapists engaged in two, interconnected constellations of processes (systems) in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have implications for the EDLE literature, by providing novel ways therapists can use their EDLE. Findings also have implications for the POTT framework by exploring how POTT can be adapted for therapists who share lived experiences with their clients. A POTT-EDLE is proposed for training therapists with EDLE. / Doctor of Philosophy / The treatment of eating disorders (EDs) presents many challenges (e.g., frequent comorbidity, high rates of relapse, and the life-threatening nature of the disorder). Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference (e.g., worry, frustration, hopelessness) may be partially due to the therapist's own unresolved issues and vulnerabilities. Due to the personal and professional connections to the work, countertransference towards ED clients may be particularly pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists use and manage their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability and therapists with EDLE are working from a deficit. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. Interviews were conducted with 22 therapists with EDLE who work with ED clients. Results revealed that therapists engaged in two systems in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. The Central System and The Checks and Balances System work in tandem in order for the therapist to both use and manage their EDLE. Results describe the multiple processes informing these systems. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have clinical and training implications for how therapists with EDLE can use and manage their EDLE to inform their clinical work with ED clients.

Bakgrund: Postoperativt delirium (POD) är ett allvarligt tillstånd som kan bidra till betydande negativa konsekvenser på både individ- och samhällsnivå. Samtidigt visar forskning att sjuksköterskor saknar kunskaper om tillståndet och känner sig osäkra i omvårdnaden relaterat till dessa patienter. Att undersöka patienternas upplevelser av POD, kan bidra till ökade kunskaper om fenomenet och i sin tur en bättre omvårdnad. Syfte: Syftet med denna litteraturstudie var att beskriva patienters upplevelser av postoperativt delirium. Metod: Resultatet baserades på åtta kvalitativa studier. Artikelsökningarna genomfördes i databaserna Cinahl, Pubmed och Scopus. Analysen utfördes med inspiration från Fribergs femstegsmodell. Resultat: Från analysen framkom fem huvudkategorier: ’’De befann sig i en förvirrande värld’’, ’’De upplevde sig isolerade och maktlösa’’, ’’De upplevde en närvaro av döden’’, ’’De upplevde ett känslomässigt kaos’’ och ’’Visuella intryck påverkade upplevelsen av delirium både positivt och negativt” Konklusion: Litteraturstudiens resultat visade att upplevelsen av POD kunde vara skrämmande och medförde en känsla av maktlöshet. Sjuksköterskan samt anhöriga hade en betydande roll för tryggheten i upplevelsen. Det behövs vidare forskning om stöd i efterförloppet av POD och undersökningar om preoperativ information. / Background: Postoperative delirium (POD) is a serious condition that can contribute to significant negative consequences at both an individual and societal level. At the same time, research shows that nurses lack knowledge about the condition and feel uncertain in the caring for these patients. A survey about patients' experiences of POD can contribute to increased knowledge of the phenomenon and may result in better care. Aim: The aim of this study was to describe patients' experiences of postoperative delirium. Methods: The result was based on eight qualitative studies. The article searches were performed in the databases Cinahl, Pubmed and Scopus. The analysis was conducted with inspiration from Friberg's five-step model. Results: The analysis revealed five main categories: ''They were in a confusing world'', ''They felt isolated and powerless'', ''They experienced a presence of death'', ''They experienced emotional chaos'' and "Visual impressions influenced the experience of delirium both positively and negatively" Conclusion: The results of the literature study showed that the experience of POD could be frightening and entailed a feeling of powerlessness. The nurse and relatives had an important role in helping the patients feel safe. Further research is needed on support in the aftermath of POD and investigations on preoperative information.