Bakgrund: Att leva med långvarig sjukdom innebär förluster för individen och krav på anpassning. En viktig del i sjuksköterskans arbete med att stärka hälsa hos personer i behov av vård är att stötta lärande. En viktig del i lärande är interaktion och delaktighet. Som vårdvetenskaplig utgångspunkt har Dorothea Orems “Teori om omvårdnadssystem” använts och denna teori beskriver interaktionen mellan sjuksköterskan och de personer hon vårdar. Syfte: Syftet var att nå kunskap om hur sjuksköterskan kan arbeta med lärande i grupp hos personer med långvarig sjukdom utifrån Dorothea Orems ”Teori om omvårdnadssystem”. Metod: En litteraturöversikt har genomförts där tio kvantitativa studier har sammanställts genom analys med Dorothea Orems “Teori om omvårdnadssystem” som utgångspunkt. Resultat: Resultatet visar hur de olika programmen i studierna arbetat med lärande i grupp bland personer med långvarig sjukdom, där det framkommer skillnader och likheter i deltagarnas och sjuksköterskans roller. Likheter fanns i programmens fokus på interaktion mellan deltagarna såväl som på sjuksköterskans faciliterande roll. En viktig skillnad fanns i utsträckningen av deltagarnas påverkan på innehållet i gruppträffarna, där vissa program lät deltagarnas behov och intresse styra medan vissa program i förväg hade bestämt innehållet. Diskussion: I resultatdiskussionen argumenteras för att människans egenidentifierade lärandebehov bör styra lärandet. Lärandet bör främja utvecklandet av självstyrning hos personen. Resultatet visar att deltagarna i interaktionen mellan varandra har inneboende resurser som används för att främja individens och andras lärande. I metoddiskussionen uppmärksammas styrkor och svagheter kring val av metod för denna litteraturöversikt. / Background: Living with long term illness means losses for the individual and demands for adaptation. An important part of the nurse's work on strengthening the health of people in need of care is to support learning. An important part of learning is interaction and participation. As a nursing-science basis Dorothea Orem’s "Theory of nursing system" has been used and this theory describes the interaction between the nurse and the person she cares for. Aim: The purpose was to gain knowledge about how nurses can work with learning in a group of persons with long-term illness with basis in Dorothea Orem’s "Theory of nursing systems." Method: A literature review was carried out where ten quantitative studies have been compiled through analysis with Dorothea Orem’s "theory of nursing system" as a basis. Results: The results how how the various programs of the studies worked with learning in a group among people with long-term illness, where similarities and differences in the roles of the participants and the nurses emerged. Similarities were found in the programs focus on the interaction between participants as well as on the facilitating role of the nurse. An important difference was revealed in the extent of participants' influence on the content of the group sessions, where some programs let participants' needs and interests guide while some programs previously had determined the content. Discussions: In the discussion of the results it is argued that man's self-identified learning needs should direct learning. Learning should encourage the development of the person’s self-direction. The results show that participants in the interaction between each other have inherent resources used to promote learning among themselves and others. Strengths and weaknesses regarding the chosen method for this literature review are highlighted in the method discussion.

A starting point for this thesis is that patients’ learning has not received sufficient attention and thus has not featured in the study programmes in the field of caring. Focus has instead been placed on patients being given information and advice about their illness and treatment, advice that they are then expected to comply with. Too little attention has been paid to the individual who lives with his/her illness and who should be considered to have significant experiences. The overall aim has been to analyze and describe the phenomenon of learning to live with long-term illness as well as to develop a didactic model that can help carers to support patients’ learning processes. The theoretical perspective in the thesis is lifeworld theory, which permeates ontological, epistemological and methodological standpoints and also the view on learning. The design and carrying out of the research is based on a reflective lifeworld approach. The empirical study consists of interviews with people who live with different types of long-term illnesses. The learning that follows life with a long-term illness is generated in such a way as to respond to the will to live the well-known everyday life. A greater understanding of the empirical results has been achieved by a lifeworld philosophical elucidation, with a particular focus on learning turning points and the importance of reflection. Based on the empirical results, the lifeworld philosophical elucidation and the caring science lifeworld didactics a didactic model has been formulated. This model is entitled: The challenge – to take charge of one’s life with long-term illness. The model contains four theses: 1) Confronting one’s life situation and challenging to make a change, 2) Positioning oneself at a distance when creating a new whole, 3) Developing self-consciousness and taking responsibility, 4) Making learning visible with the aim of providing development and balance in life. The results in the thesis show that a genuine learning is something that differs from the learning of information and that the learning must be supported at an existential level based on the sufferer’s situation and for a long period of time.

A starting point for this thesis is that patients’ learning has not received sufficient attention and thus has not featured in the study programmes in the field of caring. Focus has instead been placed on patients being given information and advice about their illness and treatment, advice that they are then expected to comply with. Too little attention has been paid to the individual who lives with his/her illness and who should be considered to have significant experiences. The overall aim has been to analyze and describe the phenomenon of learning to live with long-term illness as well as to develop a didactic model that can help carers to support patients’ learning processes. The theoretical perspective in the thesis is lifeworld theory, which permeates ontological, epistemological and methodological standpoints and also the view on learning. The design and carrying out of the research is based on a reflective lifeworld approach. The empirical study consists of interviews with people who live with different types of long-term illnesses. The learning that follows life with a long-term illness is generated in such a way as to respond to the will to live the well-known everyday life. A greater understanding of the empirical results has been achieved by a lifeworld philosophical elucidation, with a particular focus on learning turning points and the importance of reflection. Based on the empirical results, the lifeworld philosophical elucidation and the caring science lifeworld didactics a didactic model has been formulated. This model is entitled: The challenge – to take charge of one’s life with long-term illness. The model contains four theses: 1) Confronting one’s life situation and challenging to make a change, 2) Positioning oneself at a distance when creating a new whole, 3) Developing self-consciousness and taking responsibility, 4) Making learning visible with the aim of providing development and balance in life. The results in the thesis show that a genuine learning is something that differs from the learning of information and that the learning must be supported at an existential level based on the sufferer’s situation and for a long period of time.

While the healthy immigrant effect (HIE) has been seen throughout the western world in the adult population; research on the older population shows an inverse relationship between self-reported health and immigration status – i.e., in many instances, a health disadvantage for older immigrants. Explanations for this vary from a lack of selection into population, among older immigrants, to a duration effect; such that perceived health advantages seen in early life dissipate upon reaching older age. While these are the widely accepted reasons for the disappearance of the HIE among older people, not all mitigating factors have been examined in detail. This study aims to identify if there is an association between retirement and the healthy immigrant effect seen in Europe. It uses SHARE data for 27 European countries to examine self reported health (SRH) outcomes & presence of longterm illness’ (LTI) for population groups aged 55-74. The findings indicate the presence of a greater health disadvantage for retired immigrants (versus native-born retirees) as compared with those who are not retired. Additionally, better health outcomes (compared to native-born individuals) were seen for immigrants who retired late (after the age of 65) versus those who retired early. Retirement due to poor health was examined as an explanation for these findings, but it did not appear to affect the results, suggesting the observed patterns are most likely caused by an alternative factor relating to retirement. Further research is recommended to identify these factors.