Sammanfattning Bakgrund: Diabetes förekommer hos 3-4 procent av Sveriges befolkning. Uppkomsten av diabetes är ofta relaterad till livsstil. Hur människor upplever att få diagnosen påverkar synen på sjukdom och framtid. Människor som får sjukdomen är i behov av stöd från vårdpersonal. Syfte: Beskriva vuxnas upplevelser av stöd efter att ha fått diagnosen diabetes mellitus. Metod: Systematisk litteraturstudie, där 8 stycken vetenskapliga artiklar granskades. Resultat: Analys av artiklar resulterade i fyra olika kategorier: bemötande, hantera negativa känslor, lära genom utbildning och accepterande/anpassning. Diskussion: Det fanns kunskapsbrist om sjukdomen bland diabetespatienter. Utbildning med stöd och ett bra bemötande från vårdpersonal kan förebygga kunskapsbrist. Slutsats: Vuxna som får diagnosen diabetes mellitus behöver ha stöd från vårdpersonal och anhöriga. Patienter behöver ha kunskap om diabetes för att egenvårds-kapacitet ska kunna utvecklas. Nyckelord: Diabetes, stöd, upplevelse, utbildning Abstract Background: Diabetes occurs in 3-4 per cent in the Swedish population. Diabetes is often related to the lifestyle. How people experience to receive the diagnosis affects the view of illness and future. People who get the illness need support from caregivers. Aim: Describe adults experience of support after they have received the diagnose diabetes mellitus. Method: A systematic literature review, there eight scientific articles were revised. Result: The analyse resulted in four different categories: treatment, manage negative feelings, learn by education and accepting/adaptation. Discussion: The findings showed that a lack of knowledge existed of the illness among diabetes patients. Education with support and a good treatment from the caregivers could prevent a lack of knowledge. Conclusion: Adults who receive the diagnose diabetes mellitus need support from caregivers and the next of kin. Patients need knowledge about diabetes too know how to develop self care capacity. Keywords: Diabetes, education, experience, support

Bakgrund: Att drabbas av en hjärtinfarkt är en hotfull och skrämmande upplevelse som kan påverka upplevelsen av livskvalitet för många kvinnor. Enligt Siri Naess definition av livskvalitet ska personen ha en grundstämning av gjädje, självkänsla, samhörighet och vara aktiv för att uppleva en god livskvalitet. Syfte: Syftet var att beskriva kvinnors upplevelser efter en hjärtinfarkt med fokus på livskvalitet. Metod: En allmän litteraturstudie genomfördes, vilken bygger på vetenskapliga artiklar framtagna genom databaserad litteratursökning. Dessa kvalitetsgranskades och en artikelöversikt sammanställdes. Resultat: Fyra huvudkategorier formulerades utifrån Siri Naess definition av livskvalitet: upplevelser relaterade till grundstämning av glädje, upplevelser relaterade till självkänsla, upplevelser relaterade till samhörighet och upplevelser relaterade till aktivitet. Kvinnornas upplevelser av livskvalitet påverkades efter hjärtinfarkten. De upptogs av existentiella tankar och känslor samt inverkade på deras grundstämning av glädje. Slutsats: Som sjuksköterska är det betydelsefullt att veta att kvinnorna är i behov av att samtala om sina existentiella tankar och känslor. Förutom det medicinska, livsstilsförändringar och rehabilitering så vore det önskvärt om sjuksköterskan gavs möjlighet att utgöra stöd inom alla områden som berör kvinnornas livskvalitet.

Abstract Background: When an acute illness or trauma occurs, life becomes disorganised and shattered for the critically ill person and his/her family members. The family members are confronted with thoughts about life and death which can cause stress and anxiety. How the family members cope with the crisis is individual and depending on personality and earlier experiences. Aim: The purpose of this literary review was to illustrate the family members´ experiences when dealing with a critically ill family member. Method: A literary review was made based on fifteen qualitative and quantitative scientific articles and a literary book. Findings: The analysis of the articles resulted in two main categories; security and insecurity. Information, involvement and wellbeing were the three subcategories which together lead to family members´ feeling of security. The feeling of insecurity was caused by negative experiences such as a lack of information, exclusion and discomfort. Conclusion: Nurses need to improve their knowledge and understanding in order to guide and support family members dealing with a life crisis. The result of the literary review made it apparent that all hospital personal are important for family members to feel security. The nurse however is a key employee of the hospital staff in order to offer a holistic family nursing.

Most of the stoma-operated persons must work themselves through difficult feelings. The task for the nurse is to deliver a care that promotes as much independence as possible. The aim of this literature review was to illuminate how the self-care agencies affect the well-being for the persons who are operated for stoma. A systematic literature study was done based on eleven scientific studies. Three categories, which describe how self-care agencies affect the physical, psychological and social well-being, are presented in the result. When a person who is operated for a stoma has problems to handle their self-care the caregivers need to offer a care that strengthens the self-care agency of the person. Most of these persons learn by time to handle bodily problems to achieve a physical well-being. However, a lot of persons experience larger difficulties to handle feelings such as fear, anxiety and reduced sexual self-confidence. If the caregivers become more conscious about how they can help persons to handle this problems the total well-being will increase. The caregivers must be aware on that this is a slow process and that their treatment and availability play an important part in achieving this.

Background: In Sweden around 6500 women suffer each year from breast cancer and during lifetime every tenth women is affected. Mastectomy (removal of part of or the whole breast) is carried out mostly in purpose to remove malign tumours or in prophylactic purpose. The breast can be rebuilt through breast reconstruction. Method: The result analysis was based on nine articles. A Manifest content analysis was used and data from the articles where divided into themes and patterns, on the basis of these categories were created. Aim: The aim of this study was to describe women’s experience of quality of life which has undergone breast reconstruction after mastectomy. Results: The result is presented in categories: psychic, social, physical, body image and sexual. After breast reconstruction women can suffer from psychological, social, physical, body image and sexual dysfunctions. Women’s quality of life after breast reconstruction varies. Women should in right time receive support from medical staff. Body image, body reality and self-image are affected by illness. A good body image can improve self-confidence which can improve quality of life. Conclusion: Participations and awareness can be linked to good quality of life after breast reconstruction. Therefore information is an important foundation stone in the care.

År 2004 avled 190 barn i åldrarna 5 - 14 år i Sverige av en sjukdom som krävde palliativ vård. När dessa barn insjuknade berördes även de närstående. Syftet med denna litteraturstudie var att belysa de närståendes behov av stöd när ett barn vårdades palliativt. Studien genomfördes som en allmän litteratur studie och aktuell forskning från år 2000 - 2007 granskades och analyserades. Resultatet visade att närstående hade behov av empati, ärlighet och förståelse. Behov av delaktighet i omvårdnaden, det vill säga stöd att utföra en uppgift eller sköta omvårdnaden av sitt barn. Behov av information, kommunikation och undervisning, att den information som gavs var korrekt, individanpassad och utförlig. Behov av tillit till sin egen förmåga, hjälpte de närstående att känna att de beslut och de uppfattningar som de hade kring den aktuella situationen var korrekta. Stöd till de närstående är en av sjuksköterskans främsta uppgifter i den palliativa vården av barn. Trots kunskapen om de behov som finns och den forskning som gjorts upplever de närstående fortfarande vissa brister i stödet. Ytterligare forskning inom området behövs för att ge kunskap om varför stödet uteblir eller inte når fram till de närstående.

Background: Every year about 4600 nurses are examined in Sweden. The work as a nurse is responsible and she is often working under time pressure. Aim: To describe nurse’s understandings about her professional role during her first year after the examination. Method: Systematic literature review, where 10 scientific articles were examined. Findings: Five categories were found: To be alone with the responsibility; To have insufficient knowledge in nursing; to experience time pressure; to develop a profession and become a member of the team; To feel satisfaction by being a nurse. Discussion: Newly examined nurses require support from experienced nurses during their first year. Time pressure caused stressful situations. To little time with each patients were frustrating for them. Conclusion: An important issue is to have support from a preceptor during the first year or to participate in a trainee program.

Malnutrition is a common problem for patients with cancer that leads to anxiety and frustration for the whole family. Patients with palliative cancer disease treated at home are entitled to an adequate nutrition treatment suited to individual needs. Aim: The aim of the literature review was to describe how cancer patients experience their nutriment situation before and after the introduction of parental nutrition and the experience of getting home parental nutrition. Methods: A literature study was carried out where qualitative and quantitative articles were examined. Findings: Five qualitative and five quantitative articles were examined. Four categories were created; patients experiences of their nutriment situation before the introduction of parental nutrition, mental experiences receiving parental nutrition at home, physical experiences receiving parental nutrition at home, patients experiences in general receiving parental nutrition at home. Conclusion: Through the parental nutrition treatment at home patients felt that the physical condition improved and the physiological symptoms were decreased. Even though family life was affected patients strived for a normal life. More studies are needed on the role of the nurse in the palliative care regarding nutritional treatment and how her support affects the patient’s positive experience.

Bakgrund: Hjärtinfarkt är den vanligaste dödsorsaken bland kvinnor i världen. Män och kvinnor har i regel inte samma symtom, kvinnor får oftast ont i höger skuldra, känner illamående samt åtstramning vid käkarna. Eftersom hjärtat är starkt förknippat med livet upplever många kvinnor olika känslomässiga upplevelser. Syfte: Syftet var att beskriva kvinnors upplevelser av vardagslivet efter hjärtinfarkt. Metod: En allmän litteraturstudie som grundades på kvalitativa vetenskapliga artiklar gjordes. Resultatet baserades på elva artiklar som söktes fram via elektroniska databaser och därefter granskades och analyserades. Resultat: Det som framkom var att kvinnorna upplevde kroppsliga förändringar, inverkan på det sociala livet och känslomässiga upplevelser. Kvinnorna upplevde symtom även efter hjärtinfarkten och det sociala nätverket var en viktig del i återhämtningsprocessen. Rädsla var en återkommande upplevelse, bland annat upplevde de rädsla för döden, framtiden samt för återinsjuknande. Diskussion: Information och samtalsstöd är viktiga faktorer som hade kunnat underlätta återhämtningsprocessen för kvinnorna. Sådana åtgärder är en del i sjuksköterskans ansvarsområde. Slutsats: Existentiella behov förbises ofta i sjukvården, därför är det viktigt att uppmärksamma detta. Background: Myocardial infarction is the most common cause of death among women in the world. Men and women are not having the same symptom, women are more likely to have pain in their right shoulder, feeling nausea as well as discomfort in the jaw. Because the heart is associated with life many women experience emotional experiences. Aim: The aim was to describe women’s experiences of daily life after myocardial infarction. Method: A common literature review based on qualitative scientific articles was made. The result were based on eleven articles which was searched and retrieved in electronic databases, examined and analysed. Results: The women’s experiences were related to bodily changes, influences on the social life and emotional experiences. The women experienced symptoms even after the myocardial infarction and the social network was an important part in the recovery process. Fear was a recurrent feeling, they experienced fear of death, for the future and relapse. Discussion: Information and conversation support is important to make the recovery process easier for the women. This is a part of the nurse’s responsibility. Conclusion: Existential needs are often overlooked in the medical care, that’s why it is important to notice this.

Elective joint surgery increases for every year and the operations are associated with postoperative pain. Postoperative pain is a well known phenomenon and pain physiology and analgesics are well known by caregivers, but the significance of the interaction between patient and caregiver is not illuminated. There are still patients experiencing unnecessary postoperative pain. Among patients in elective surgery, 25% runs a risk for underestimated pain. The aim of the study was to describe patient’s experiences of nursing interaction in the context of postoperative pain during hospitalisation after going through knee- or hiparthropasty. This study was constructed on a qualitative phenomenological research method of Amadeo Giorgio (1985). The sample contains 11 patients undergoing knee- or hiparthroplasty. The informers were interviewed in their own home and the interviews were taped and analyzed. The result indicates that pain relief is depending on interactive communication. All the patients who experienced intense pain also experienced deficient communication. Pain caused by anxiety or social relations runs a risk for underestimation by the caregivers. The patients who experienced a faithful relation also experienced satisfying pain relief. Holistic view is limited in orthopaedic care and effect on pain by socialpsychologic reasons has hitherto not been reported. The caregivers need to obtain a trustful relation to the patients to minimize pain. The nursing care for postoperative pain can be developed and this study might contribute to development of quality in post surgical orthopaedic care.