A quantitative, descriptive, explorative survey was conducted to explore and describe nurses’ perceptions of disclosure to children of their HIV positive status in Addis Ababa. 100 nurses working in six conveniently sampled health centres participated by completing a self-administered questionnaire. The findings revealed that the majority of participants were of the opinion that children have the right to know their HIV status, participate in their own treatment, and that disclosure contributes towards improved adherence. Forty-one of the participants said that it is nurses’ role to support caregivers in the disclosure process. But 56.3% felt they lacked the training to disclose to children that they are infected with HIV. Accordingly, it is recommended that relevant and applied training is required to equip nurses with the knowledge and skills to disclose to children their status. The importance of nurses’ proactive role in disclosure to children of their HIV status needs to be emphasised. / Health Studies

Allt fler människor i dagens samhälle lever och behandlas för en cancersjukdom. Det innebär att sjuksköterskan oftare kan komma att möta människor med olika cancersjukdomar inom sjukvården. Detta examensarbete kommer att beskriva vuxna människors upplevelser av att leva med en cancersjukdom. Nio vetenskapliga artiklar söktes fram via systematiska sökningar i databaserna Cinahl och PubMed, medan en artikel hittades osystematiskt. Dessa artiklar analyserades sedan genom att identifiera nyckelfynd som besvarade litteraturstudiens syfte. Med hjälp av dessa nyckelfynd kunde artiklarna sedan sammanställas till ett nytt resultat, vilket presenteras i denna uppsats. Resultatet påvisar att en cancersjukdom medför påfrestningar och förändringar i människans vardagliga liv. Framtiden upplevs som osäker men med stöd från familj, vänner och stödgrupper och känslan av hopp blir det lättare att kunna hantera sjukdomen. Resultatet visar också att cancersjukdomen medför att människan upplever sig som en börda, både för sig själv och sin omgivning. Relationer till familj och vänner sätts på prov. Det finns minskad ork till att utföra aktiviteter. Oro skapas över att samlivet förändras och de upplever även förändrat utseende på grund av håravfall. Med ökad kunskap om hur det är att leva med cancersjukdom får sjuksköterskan möjlighet till ökad förståelse för människan. Genom en ökad förståelse kan sjuksköterskan lyssna, ställa frågor och delge information på ett sätt som kan hjälpa människan att enklare kunna hantera sin vardag och livssituation. / Background Cancer is a growing problem in today ́s society. More people are diagnosed with the disease and the number of cases is expected to increase even more in the future. In order to be able to respond to people living with cancer and to apply a good nursing care, the nurse must know how these people experience their living conditions. Aim The aim of this study was to describe adults’ experiences of living with cancer. Method The method used was a literature study based on qualitative research according to Friberg (2012). The articles is analyzed according to Friberg ́s five-step model and results in three main themes and seven sub- themes. Results The main themes were- Changes in everyday life, Being a burden to themselves and their surroundings and To deal with an uncertain future. Conclusion The results showed that cancer disease changes the whole human life. The patients feel strain, both physically and mentally which changes everyday life in different ways and they live in a constant state of uncertainty.

ABSTRACT Study Aim and Objectives: The aim of the study was to explore what it means to have HIV/AIDS in Gaborone, Botswana. The study describes the demographic and socioeconomic circumstances of the participants. It also elicits and explores the experiences of people living with HIV/AIDS in Gaborone, Botswana. Methods Interviewees were purposely selected from a hospice, an NGO and a church that ministers to PLWHA. In depth interviews were conducted and recorded by audiotape. The interviews were conducted in Setswana and the interviewees responded to a statement, which essentially was, “Tell me about your life since you knew you had HIV/AIDS”. The audio recordings were transcribed into English. Care was taken to carry the Setswana way of speaking directly into English. A thematic analysis of the transcripts was made. A modified cut and paste method was used to gather the information into its various themes. Results There were 15 interviewees. Their average age was 35.3 years and on average, they had 1.6 children each. They were unemployed. The interviewees described a wide range of experiences, which were not necessarily experienced by all. Their narratives described the physical symptoms they suffered. They described stigma and discrimination that they went through. They gave accounts of psychological and emotional turmoil. Psychiatric problems were cited. They were very concerned that they could no longer support their children. They also worried about what would happen to their children when they died. As their disease progressed, they lost their jobs and were reduced to poverty. They could no longer support themselves and their dependents. They depended on relatives, friends, NGOs and government for relief. Relief from friends and relatives was often not available. They suffered hunger, as they could not satisfy their increased appetites after they started ARV drug therapy. Their relationships were disrupted when they got ill. Spouses and friends left and some relatives and friends stigmatised them. Interviewees were taken care of by relatives, friends, health professionals, NGOs, and social workers. In all these categories, there were good and bad care givers except the hospice and church, which were reported as good caregivers. Caregiver fatigue was described. Some interviewees found comfort in God. They believed that He knows what they are going through and will take care of them. The interviewees also found comfort and healing from the companionship of other PLWHA. The interviewees wanted to find jobs and work so that they could support themselves and their dependents. They wished government would train them and find them jobs. Conclusion The study confirmed the psycho-emotional problems and concern for children felt by PLWHA, that the literature revealed. It showed the physical problems they also suffer. The study revealed that interviewees lost jobs and became destitute. They could not satisfy their increased appetites after they started ARV drug therapy. Interviewees’ relationships were disrupted when they got ill. Spouses and friends left and some relatives did not treat them well. There were good and bad care givers in different categories. The African custom of botho/ubuntu seems to be succumbing to the onslaught of HIV/AIDS. The study showed that interviewees found comfort and support from family, friends, NGO’s and the church. They found God and other PLWHA especially valuable support systems. It was encouraging to notice that some interviewees felt that with time, stigmatisation of PLWHA is gradually subsiding.

ABSTRACT: Madwaleni Hospital is situated in a deeply rural area of the Eastern Cape Province of South Africa, serving a catchment population of approximately 262,300 within a 35 kilometer radius. An HIV programme was started in mid-2005 to try and address some of the HIV burden faced by the community. The pillars to the Madwaleni HIV programme comprise VCT (voluntary counselling and testing) and the HIV Wellness programme – a group of family-oriented services (including provision of antiretrovirals) offered to HIV positive individuals within the framework of local support groups meeting at the local hospital, community health center and primary health clinics. As at end August 2009, there are 3760 Wellness programmes members, of whom 1700 are on antiretrovirals. RESEARCH AIM: The purpose of this research was to obtain an in-depth understanding of individual’s perception of the success of the Madwaleni HIV Wellness Programme in the context of the individual needs in living with HIV.

A quantitative, descriptive, explorative survey was conducted to explore and describe nurses’ perceptions of disclosure to children of their HIV positive status in Addis Ababa. 100 nurses working in six conveniently sampled health centres participated by completing a self-administered questionnaire. The findings revealed that the majority of participants were of the opinion that children have the right to know their HIV status, participate in their own treatment, and that disclosure contributes towards improved adherence. Forty-one of the participants said that it is nurses’ role to support caregivers in the disclosure process. But 56.3% felt they lacked the training to disclose to children that they are infected with HIV. Accordingly, it is recommended that relevant and applied training is required to equip nurses with the knowledge and skills to disclose to children their status. The importance of nurses’ proactive role in disclosure to children of their HIV status needs to be emphasised. / Health Studies

INTRODUCTION: The rate of smoking is significantly higher among people living with HIV (PLWH) in comparison to the general population (CDC, 2017b; Humfleet et al., 2009). Tobacco use among PLWH heightens the risk for HIV-related symptoms and is a pertinent public health issue. Smokers living with HIV are also more likely to develop non-AIDS-related illness in comparison to non-smokers living with HIV. Smoking cessation interventions are desperately needed to cater towards PLWH. This warrants the need for patient-provider interactions in healthcare facilities regarding smoking cessation. AIM: To document rates of smoking and visitations to healthcare facilities among persons living with and without HIV in higher vs. lower-risk areas and to examine associations among healthcare visitations, stressors, and smoking in these sub-samples (i.e., PLWH in higher-risk areas, PLWH in lower-risk areas, people without HIV in higher-risk areas, people without HIV in lower-risk areas). METHODS: Secondary analyses were conducted using data from a network-based, HIV endemic study that was conducted in Metro Atlanta (Rothenberg, Dai, Adams & Heath, 2017). The study included 927 participants from 10 Atlanta zip codes (5 lower-risk and 5 higher-risk based on reported HIV cases). Participants provided information on their smoking status and healthcare visitations, as well as whether they had experienced several stressors (e.g., violence, homelessness, being threatened with a weapon, lack of transportation). Descriptive analyses and frequency distributions were conducted and presented on key variables. Logistic regression analyses were conducted to examine associations between key variables and smoking. RESULTS: Overall, the rate of smoking was quite high in this study. Seventy-four percent of the sample smoked, which is almost five times the smoking rate among the general adult U.S. population (CDC, 2016a). The smoking rate was strikingly high among PLWH in the higher-risk areas (95%). In unadjusted analyses, participants who were older, male, homeless, and do not drive their own car were more likely to smoke. In the adjusted analyses age, gender, and lack of transportation remained significant predictors of smoking. Visitations to healthcare facilities were not significantly associated with smoking or other variables in this study. DISCUSSION: Smoking appears quite common among PLWH, especially those living in higher-risk areas. This study provided important information on the extent to which persons living with and without HIV in higher and lower-risk areas of Atlanta are receiving healthcare services, as well as how demographic factors and stress relate to smoking in these sub-samples. Future research is needed to develop and disseminate effective smoking cessation programs among smokers living with HIV.

Background: Diabetes is a chronic metabolic disease and an increasing public health problem. Treatment of type 1 diabetes requires daily insulin injections. Young people living with diabetes may feel that they do not fit in among others of the same age. Aim: Illustrate young people's experiences of living with diabetes type 1. Method: This study was a qualitative literature-based study with an inductive approach. The result was based on 10 qualitative scientific articles. Result: The analysis resulted in three main themes and seven subthemes. The main themes were: To live in a process of adaptation, A buffet of challenges and How the social surroundings impact the life. Conclusion: The results showed that young people who lived with type 1 diabetes felt that they had to adapt their lives to the disease. For young people it was also important to become independent in their illness. It was obvious that living with type 1 diabetes was an experience of both physical and mental challenge, and the people in the studies expressed a desire to be normal and to be able to compare themselves with others. The social surroundings had a clear impact in many ways, though the support from the environment was perceived as valuable. / Diabetes typ 1 är en ständigt ökande folksjukdom som ofta drabbar unga människor. Diabetes typ 1 är en kronisk ämnesomsättningssjukdom som ställer krav på den unga individen och skapar utmaningar i vardagen. Unga som lever med diabetes påverkas av sin omgivning och är i behov av stöd på olika sätt. Diabetes innebär att individen ständigt har förhöjda blodsockernivåer, till följd av brist på insulin. Unga människor lever i en turbulent period av livet, och att leva med en kronisk sjukdom kan förhindra en utveckling av den egna identiteten. Egenvården upplevs som en viktig del på vägen mot självständighet hos de unga, och sjuksköterskan har en central del i att hjälpa den unga individen att främja hälsa. Syftet är att belysa unga människors upplevelse av att leva med diabetes typ 1. Tio kvalitativa vetenskapliga artiklar har använts som material i resultatet. Resultatet visar att sjukdomen kräver en anpassning av livet. Det är en dragkamp om ansvaret för sjukdomen mellan de unga och deras föräldrar, då självständighet anses viktigt av unga människor för att uppnå frihet, vilket relateras till begreppen livsvärld och hälsa. De unga upplevde både känslomässiga och praktiska utmaningar i livet med diabetes, vilket diskuteras i relation till livskvalitet. En önskan om att få vara normal och kunna jämföra sig med andra i samma ålder finns, eftersom det är en betydande del i de ungas sökande efter en egen identitet. De unga anser att omgivningen påverkar dem på olika sätt, stödet från vänner och familj upplevs som betydelsefullt.

Diabetes mellitus typ 1 är en autoimmun sjukdom, vilket innebär att immunsystemet ser betacellerna i bukspottskörteln som främmande och angriper dem. Cellerna kan då inte producera insulin längre, vilket är ett livsviktigt hormon för kroppen. I Sverige insjuknar cirka två barn varje dag i diabetes mellitus typ 1. Sjukdomen påverkar barnets vardag och kommer alltid vara en styrande del genom livet. Många barn oroar sig över hypoglykemi samt andra komplikationer som är relaterade till sjukdomen. Syftet med studien är att beskriva upplevelser av hur vardagen påverkats hos barn som är diagnostiserade med diabetes mellitus typ 1. Metoden är en sammanställning av empirisk data och baseras utifrån Axelssons (2012) modell. Studien innehåller 11 artiklar som består av både kvalitativa och kvantitativa ansatser. Examensarbetet fokuserar på barn i åldern 6-14 år och artiklarna i studien belyser upplevelsen av att leva med diabetes mellitus typ 1. Resultatet visade att barnen upplevde känslor av utanförskap och att de kände sig annorlunda jämfört med sina vänner. Familjen hade en betydelsefull roll för barnen och sjukdomen påverkade även omgivningen. Resultatet presenteras utifrån fyra huvudkategorier och tio subkategorier. I diskussionen belyser vi känslan av att vara barn och leva med en kronisk sjukdom, familjens betydelse samt att förlika sig med sjukdomen. En grundläggande aspekt som framkommer i diskussionen är även vikten av adekvat och individanpassad information efter barnets utvecklingsnivå.

Abstract Throughout history, many diseases have carried considerable stigma, including leprosy tuberculosis, cancer, mental illness and many STDs. Now HIV/AIDS is the topmost in the list of diseases that leads to devastating patient stigmatization. Despite international efforts to tackle HIV/AIDS, stigma and discrimination remain among the most poorly understood aspects of the epidemic. In the face of numerous intervention strategies, HIV/AIDS continues to spread and to pose a threat to the socio-economic transformation of South Africa. The broad objective of this study was to investigate how the stigmatisation of HIV-Positive women is made manifest and look at how successful the National Association of people living with HIV/AIDS (NAPWA) in South Africa has been in achieving their objectives and goals of changing the perceptions people have about HIV/AIDS and creating awareness about the debilitating effect stigmatisation has in the society, especially when it viciously targets HIV-positive women. A case study approach was used to examine the experiences of HIV/AIDS infected/affected women and NAPWA administrators. Methods used in the collection of data were self-administered questionnaires, participant observation and archival evidence in the form of documents. Through these methods, the study investigated ways in which the stigmatisation of HIV-positive women was made manifest, the role of NAPWA in fighting HIV/AIDS stigmatisation, how successful NAPWA has been in the fight against the stigmatisation of people infected and affected by HIV/AIDS in South Africa, challenges faced by NAPWA in the fight against HIV stigmatisation and discrimination, weaknesses of NAPWA and what impact all these have in the spread of HIV/AIDS. The research results show that HIV-positive women suffer stigmatisation and that; organisations of people living with HIV/AIDS (e.g. NAPWA-SA) play a major role in eradicating the stigma attached to HIV/AIDS. It also suggests that APWAs in effect help to reduce the spread of the disease and prolong the life span of those infected by it. All this not withstanding, the study also discovered that APWAs like NAPWA-SA need the support of government and stakeholders in South Africa to fully implement their strategies and programmes geared towards reducing stigma and the spread of HIV/AIDS.

Endometrios förekommer hos tio procent av kvinnorna i reproduktiv ålder och karakteriseras av att livmoderslemhinnan felaktigt växer utanför livmodern. Det är vanligt att det tar lång tid att få en diagnos och det påverkar kvinnorna både emotionellt och fysiskt. Sjukdomen är kronisk och trots att det finns många olika behandlingsformer är symtomen ofta svåra att bli av med. Att leva med endometrios är en subjektiv upplevelse och det är därför viktigt att sjuksköterskan ger individanpassad och adekvat vård. Kvinnornas situation behöver beaktas för att kunna lindra deras lidande. Syftet var att belysa kvinnors upplevelse av att leva med endometrios. Metoden för studien har varit en litteraturöversikt. Skillnader och likheter jämfördes i de tio resultatartiklarna. Artiklarna har varit av både kvantitativ och kvalitativ design och inhämtades från databaserna PubMed, Cinahl Complete och Academic Search Complete. Ur resultatet framkom fyra teman. Det första temat var Kvinnors välbefinnande med två subteman; Fysik välbefinnande och Psykiskt välbefinnande. Det andra temat var Ekonomiska svårigheter med följande subteman; Sjukfrånvaro och Arbete. Det tredje temat var Förlust av femininitet med två subteman; Sexuell hälsa och Infertilitet. Det fjärde och sista temat var Socialt med kommande två subteman; Relationer till närstående och Betydelsen av stöd. Upplevelsen av att leva med endometrios var förenat med otillräcklig hjälp mot smärta. Hälso- och sjukvården har ett ansvar att ta kvinnans upplevelse på allvar och se till varje unik situation. Det styrks även av Jean Watsons “Human caring science nursing paradigm” där sjuksköterskan behöver arbeta utifrån ett helhetsperspektiv. / Endometriosis occurs in ten percent of the women in reproductive age and is characterized by the endometrium incorrectly grows outside the uterus. It normally takes a long time to get a diagnose which affects the women both emotionally and physically. The disease is chronic and although there are many different therapies the symptoms are often difficult to get rid of. Living with endometriosis is a subjective experience and it is therefore important that the nurse provides personalized and adequate care. The women's situation needs to be considered to alleviate their suffering. The aim was to illuminate the women's experience of living with Endometriosis. The method of the study has been a literature review. Differences and similarities were compared in the ten results articles. The articles have been of both quantitative and qualitative design and were collected from databases PubMed, Cinahl Complete and Academic Search Complete. Four results emerged from the result. The first theme was Women's well-being with two subtemens; Physical well-being and mental well-being. The second theme was Economic difficulties with the following subtemes; Sick leave and work. The third theme was Loss of femininity with two subtemens; Sexual Health and Infertility. The fourth and last theme was Social with upcoming two subtemens; Relationships with related parties and the importance of support. The experience of living with endometriosis was associated with insufficient help against pain. Healthcare is responsible for taking the women's experience seriously and see to every unique situation. It is also reinforced by Jean Watson's "human caring science nursing paradigm" where the nurse needs to work from an overall perspective.