Bakgrund: Distriktssköterskan har en betydande roll i hemsjukvården med fördjupade kunskaper i omvårdnad och folkhälsa. Den äldre befolkningen utgör en allt större grupp i samhället och åldrandet i kombination med flera samtidiga sjukdomar ökar risken för att drabbas av psykisk ohälsa. Psykisk ohälsa orsakar ett stort lidande och nedsatt livskvalitet hos många äldre personer. Syfte: Att belysa distriktssköterskans erfarenheter av att bedriva omvårdnad av vårdtagare med psykisk ohälsa i hemsjukvården, samt vilka faktorer som påverkar omvårdnaden. Metod: En kvalitativ metod med induktiv ansats genomfördes med semistrukturerade intervjuer. Resultat: I den hälsofrämjande omvårdnaden ingick att identifiera psykisk ohälsa, att utveckla förtroendefulla relationer, ge socialt stöd, arbeta som ställföreträdare och att balansera omvårdnadsbehov mot en komplex problematik. Samarbete med andra vårdinstanser, handledning och utbildning, och riktlinjer och rutiner påverkade omvårdnaden. Slutsats: Distriktssköterskan i hemsjukvården bedriver hälsofrämjande omvårdnad av vårdtagare med psykisk ohälsa. Genom att inge en känsla av meningsfullhet, begriplighet och hanterbarhet har distriktssköterskan möjlighet att stödja vårdtagaren till att hantera sin livssituation. För att uppnå en helhetssyn i omvårdnaden är samarbete mellan olika vårdinstanser av betydelse. Hälso- och sjukvården och distriktssköterskan bör vara uppmärksam på sambandet mellan multisjuklighet och social isolering som riskfaktorer för psykisk ohälsa hos äldre. Forskning om hur psykisk ohälsa hos äldre kan förebyggas med preventiv omvårdnad är därför av vikt. / Background: The district nurse has a significant role in home care with in-depth knowledge of nursing and public health. The elderly population is an even larger group in society and aging in combination with multimorbidity increases the risk of suffering from mental illness. Mental illness causes a great deal of suffering and impaired quality of life in many elderly people. Purpose: To shed light on the district nurse's experience of providing nursing care to patients with mental illness in home care, as well as the factors that affect the nursing care. Method: A qualitative method with inductive approach was conducted with semi-structured interviews. Results: The health promotion included identifying mental illness, developing trusting relationships, providing social support, working as a substitute, and balancing nursing needs against a complex problem. Collaboration with other healthcare professionals, supervision and education, and guidelines and routines affected the nursing care. Conclusion: The district nurse in home care conducts health-promoting nursing for patients with mental illness. By providing a sense of meaningfulness, comprehensibility and manageability, the district nurse has the opportunity to support the patient to manage his or her lifesituation. In order to achieve a holistic view in nursing, collaboration between different healthcare professionals is important. Health care and the district nurse should be aware of the link between multimorbidity and social isolation as risk factors for mental illness. Research on preventive nursing for how mental illness in the elderly should be prevented is important. / <p>Datum för godkännande: 2019-11-05</p>

The aim of this literature review was to illuminate children's experiences and stories of parents with mental illnesses. This thesis also aimed to look into how the parent-child relationship is influenced by the parents mental illness. A search was conducted through various databases, and a total of 17 articles were reviewed. The method for analysis was a qualitative thematic content analysis and the results are based on the patterns and themes that were identified. The results show that these children are continuously excluded by their parents and often take responsibility for the parents' condition. Children are also forced to take on responsibility beyond their years, and develop strategies to compensate for the parents' shortcomings. These strategies also support the child's development of resilience. The children also experience overwhelmingly negative emotions as a result of their circumstances, as well as the on-going stigmatization regarding mental illness. Children of parents with mental illnesses are thus more at risk of developing a mental illness; though not all do. The results also show that the children's resilience determines their ability to process and adapt to the surrounding hardships. The authors´conclusion was that the primary obstacle to overcome is the lacking inclusion and communication of children to parents with mental illnesses; that way appropriate strategies and support can be provided and alleviate the situation.

SAMMANFATTNING Bakgrund   Psykisk ohälsa och sömnproblem är stora folkhälsoproblem idag både i Sverige och globalt. Dessa två faktorer har en dubbelriktad verkan där personer med psykisk ohälsa ofta även besväras av sömnproblem. Sömnproblem har negativa konsekvenser både för den psykiska och fysiska hälsan men får trots detta ofta låg prioritet vid behandling av patienter med både psykisk ohälsa och sömnproblem. Syfte  Syftet är att belysa omvårdnadsåtgärder som beskrivs att kunna förbättra sömnen hos personer med psykisk ohälsa.  Metod  En icke-systematisk litteraturöversikt gjordes baserad på 15 stycken vetenskapliga artiklar. Samtliga inkluderade artiklar var av kvantitativ metod. Litteratursökningen genomfördes i databaserna CINAHL och PubMed. Artiklarnas kvalitet granskades med hjälp av Sophiahemmets bedömningsunderlag för vetenskaplig kvalitetsgranskning och klassificering. Sedan gjordes en integrativ dataanalys av artiklarna där de olika datakällorna kombinerades och analyserades som en helhet. Resultat Fyra stycken teman och 12 subteman på sömnfrämjande åtgärder hittades. Teman på sömnfrämjande åtgärder funna i de analyserade artiklarna är KBT, sömnhygien, mindfulness och alternativa metoder såsom aromaterapi och musik. Resultaten visar generellt en positiv effekt av riktad behandling mot sömnproblem och med det ofta även en positiv effekt på den mentala hälsan hos personen.  Slutsats Flertalet alternativ till sömnfrämjande åtgärder med måttligt till god effekt på sömnproblem hittades i resultatet och detta har även ofta en positiv inverkan på personens mentala hälsa. Det finns dock bristande tillgänglighet till denna typ av vård vilket visar på en förbättringspotential. Hur tillgängligheten kan förbättras är ett ämne för vidare studier men våra resultat pekar mot att sjuksköterskor skulle kunna ha en nyckelroll i detta. / ABSTRACT Background Mental health issues and sleep problems are big health issues in society today both in Sweden and globally around the world.  These two factors of mental health issues and sleep problems often correlate. Sleepi problems have a negative impact on both mental and physical health but is despite this not prioritized when treating patients with both mental health issues and sleep problem Aim The aim was to highlight nursing care that can help improve sleep for people with mental health issues.  Method A non-systematic literature review was made based on 15 different articles. All of the included articles used quantitative research methods.  The literature search was made using the databases CINAHL and PubMed. Furthermore, chosen articles were quality reviewed using the Sophiahemmet assessment basis for quality evaluation and classification. After this an integrative data analysis was made of the articles where the different data sets were combined and analyzed as a whole. Results Four themes and 12 sub themes were found with working practices for sleep-improvement. These themes that were found in the analyzed articles were cognitive-behavioural therapy, sleep hygiene, mindfulness and alternative methods such as aromatherapy and music therapy. The results show a positive outcome and improvement for sleep problems when using focused treatment and the results also indicate an improved mental health.  Conclusions There are several different methods available which can give moderate to good impact on sleep problems. When sleep improves in most cases the mental health also improves. All methods are not available in all places and there is a potential for improvement of nursing care for persons with mental health issues and sleep problems.

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<div><div><div><p>Objectives: Previous research suggests an association between working alliance, the collaborative and affective bond between patient and therapist, and improved therapeutic treatment outcomes within treatment of severe mental illness (SMI). However, little is known about the mechanisms through which working alliance improves outcomes in this population. Through investigating key elements of recovery within SMI, two possible mediators—patient activation and hope—appear particularly relevant to the relationship between working alliance and improved treatment outcomes. The current study aimed to examine patient activation and hope as potential mediators in the relationship between working alliance and improved depression in individuals with SMI. Additionally, the current study investigated whether or not the patient’s evaluation of which provider is most important to their recovery significantly moderated the relationship between working alliance and patient activation/hope.</p><p>Methods: The current study was a secondary analysis of longitudinal (baseline, 6-month, and 12-month) data comparing two interventions aimed at reducing treatment provider burnout in community mental health settings primarily serving individuals with SMI. Participants (maximum N for analyses = 346) completed measures of working alliance with a linked provider on their treatment team, patient activation, hope, and depression at baseline, 6 months, and 12 months. Using moderated mediation analysis, 6-month patient activation and 6-month hope were examined as mediators in the relationship between baseline working alliance and 12-month improved depression (change score between 12-month and baseline depression). Additionally, whether or not the patient deemed their linked provider as most important to their recovery was tested as a moderator in the relationship between baseline working alliance and 6-month patient activation/hope.</p><p>Results: Overall, the current study’s hypothesized model was not supported. Baseline working alliance did not significantly predict improved depression 12 months later. Further, both patient activation and hope measured at month 6 in the study did not significantly mediate the relationship between working alliance quality at baseline and improved depression at month 12. Additionally, whether or not the patient believed their linked provider was most important to their recovery did not significantly moderate the relationship between baseline working alliance and 6-month patient activation or 6-month hope. However, results indicate that better quality working alliance at baseline did significantly predict higher patient activation at 6 months. Lastly, the current study found a significant positive correlation between importance of provider and baseline working alliance.</p></div></div></div><div><div><div><p>Discussion: Results suggest that improvement in depression may not be a key SMI treatment outcome that relates to working alliance, patient activation, and hope. Further, fostering a positive working alliance (e.g., collaboratively developing goals/tasks in-session) may increase patient’s ability, willingness, and confidence in managing their own mental health care. Additionally, a positive working alliance may also contribute to how important the patient believes the provider is to their recovery. However, those that have seen their provider for longer (e.g., more chronically ill) may be less active in managing their own mental health care. Limitations and possible future directions are discussed.</p></div></div></div>

Endometriosis is a common chronic disease that effects approximately 10–15% of the women in today’s society. However, there is a lack of research that examines if endometriosis produces pathological changes in the skeleton. This thesis addresses the association between the osteological discipline and endometriosis.The primary purpose of this thesis is to test a hypothesis which was created during a previous paper. In order to test the hypothesis, it’s fundamental to analyze female pelvises and to see if endometriosis is detectable in the skeleton and leaves pathological changes in the shape of discoloration. The source material includes 39 female pelvic bones that are available at the medical history museum in Uppsala, Sweden. The collection includes 22 pelvic bones from individuals of Swedish descent and 17 pelvic bones from individuals of diverse foreign descent. This thesis also focuses on mental illness in association with endometriosis among historical women.                                                                                      The analysis of pelvic bones showed that 8 of them had pathological changes in the shape of discoloration. The analysis also demonstrated how women, in today’s- and historical society, was affected mentally and socially. The discussion includes how the skeleton is affected by endometriosis and how osteologist can trace the disease if it isn’t visible in the skeleton. The discussion also includes how historical women was mentally affected by the disease and if we can reach the mental illness through modern women. The study also demonstrates how women was affected economically.Currently, there is not enough research in order to prove the hypothesis about pathological changes in the shape of discoloration. We need more research to further investigate the hypothesis. To continue further investigation of the hypothesis, we need to examine modern patients diagnosed with endometriosis.

Bakgrund: Hjärtinfarkt är ett allvarligt hälsotillstånd förenat med en ökad mortalitetsrisk. Sjukdomen ger upphov till fysiska symtom som kan bidra till en mängd olika känslomässiga reaktioner, som för den drabbade kan innebära psykisk lidande vilket kan ha negativ påverkan på dennes tillvaro.    Syfte: Syftet med denna litteraturöversikt var att undersöka personers upplevelser av psykisk ohälsa efter en hjärtinfarkt.  Metod: En allmän litteraturöversikt baserad på tio kvalitativa originalartiklar utvalda från databaserna PubMed och CINAHL. Utvalda artiklar kvalitetsgranskades, varav artiklar av medelhög eller hög kvalitet inkluderades. Artiklarna lästes igenom, bearbetades och analyserades, därefter skapades teman och kategorier.  Resultat:  Efter hjärtinfarkten upplevde personerna rädsla för att dö, förenat med oro eller stress över en ytterligare infarkt. Därav uppmärksammade personer symtom som kunde indikera på en ny hjärtinfarkt. Faktorer som kunde förvärra känslor av oro och stress var oönskad ensamhet, brist på stöd, fysiska begränsningar och otillräcklig information från sjukhuset. Sjukdomen gav upphov till olika negativa känslor som depression, mental utmattning, fatigue, ilska, skam, skuld, kontrollförlust och identitetsförlust. Psykisk ohälsa hade negativ inverkan på personers vardag, relationer samt förmåga till livsstilsförändring, acceptans och återhämtning.   Slutsats: Litteraturöversiktens resultat bekräftar att upplevelser av psykisk ohälsa förekommer hos personer efter en hjärtinfarkt. Personer beskrev en mängd olika negativa känslor i varierad grad, vilket indikerar på att allas upplevelser är individuella. Då psykisk ohälsa orsakar ett personligt lidande har sjuksköterskan ett ansvar i att främja välmående samt förebygga psykisk ohälsa hos alla människor på ett individuellt plan. / Background: Myocardial infarction is a serious health condition, associated with an increased mortality risk. The disease involves physical symptoms that can cause a variety of different emotional reactions, which for the affected person can result in mental suffering and a negatively impacted existence.  Aim: The aim of this literature review was to explore persons’ experiences of mental illness post myocardial infarction.  Method: A literature review based on ten qualitative original articles selected from the PubMed and CINAHL databases. The elected articles were quality audited, of which those of medium or high quality were included. The articles were then read through, processed and analysed, thereafter themes and categories were constructed.  Results: Post myocardial infarction, the individuals experienced fear of dying combined with anxiety or stress over another myocardial infarction. Hence, they noticed symptoms that could indicate another myocardial infarction. Components that could aggravate feelings of anxiety and stress were undesirable loneliness, lack of support, physical limitations and poor information from the hospital. The disease allowed for negative emotions to rise, such as depression, mental exhaustion, fatigue, anger, shame, guilt, loss of control and loss of identity. Mental illness had a negative impact on their everyday lives, relationships and abilities to make lifestyle changes, accept and recover.  Conclusion: The literature review resulted in confirmation that myocardial infarction can lead to experiences of mental illness. The individuals described a variety of negative emotions to varying degrees, which indicates that every individuals experience is personal. Since mental illness generates a personal suffering, the nurse has a responsibility to further benefit well-being, and prevent mental illness for all people on an individual level.

In the United States, stigma surrounding mental illness is ever present. With a large misrepresentation from the media, those suffering with mental illnesses, like eating disorders, often face different types of social rejection. Due to the stigma surrounding mental illness, and eating disorders, the disclosure of such an illness to another person can result in a negative impression of the sender. There is little research looking at how mental illness disclosures can affect the formation of a romantic relationship, specifically from the perspective of the receiver of a disclosure. Looking specifically at the format of mobile dating apps, this study looks at how a receiver’s initial attraction to a person changes, based on the presence of an eating disorder disclosure. Results found a correlation between stigma and attraction, however, disclosure type had no effect on attraction, or stigma.

Bakgrund: Psykisk ohälsa är ett samlingsnamn för psykiska tillstånd som orsakar lidande och innebär vissa svårigheter att fungera i vardagslivet. Tonåren är en tid av såväl psykiska som fysiska förändringar och gör därför tonåren till en sårbar period för psykisk ohälsa. Cirka tio procent av tonåringarna har så omfattande psykiska problem att det påverkar den dagliga livsföringen. Skolsköterskan är en av de första att träffa tonåringar med psykisk ohälsa och utgör därför en viktig del av tonåringens välbefinnande.  Syfte: Syftet var att undersöka skolsköterskors erfarenheter av att arbeta med tonåringar med psykisk ohälsa.  Metod: En litteraturöversikt med integrerad analys. Litteratursökning utfördes i tre databaser; Cinahl, PubMed och PsycINFO. Totalt tolv kvalitativa artiklar analyserades och inkluderades i litteraturöversikten. Alla inkluderade artiklar kvalitetsgranskades med hjälp av en kvalitetsgranskningsmall.  Resultat: Fyra kategorier framkom i analysen; Saknar verktyg och kunskap om psykisk ohälsa, Tidsbrist och arbetsbelastning, Vikten av teamarbete och Meningsfullt arbete men känslomässigt tärande. Resultatet visade att skolsköterskorna efterfrågade verktyg och mer kunskap om tonåringars psykiska ohälsa. Vidare upplevde skolsköterskorna tidsbrist och att de inte alltid kunde vara så tillgängliga för tonåringarna som de önskade. Teamarbetet med övriga professioner och externa aktörer kunde bli bättre då skolsköterskorna inte alltid kände sig accepterade i sin yrkesroll. Även om skolsköterskorna upplevde arbetet som känslomässigt tärande så kände de ändå att deras arbete var meningsfullt för den enskilde tonåringen.  Slutsats: Skolsköterskorna saknade kunskap, verktyg och resurser i arbetet med tonåringar med psykisk ohälsa. De upplevde att tidsbristen försvårar det förebyggande arbetet för psykisk ohälsa och att de inte alltid kände sig accepterade av andra professioner. Det är av stor vikt att skolsköterskan i klinisk praxis kan erbjudas mer kunskap, tid och resurser för att jobba förebyggande mot psykisk ohälsa. / Background: Mental illness is an overall term for mental conditions that cause suffering and involve certain difficulties in functioning in everyday life. Adolescence is a time of both mental and physical change and therefore makes adolescence a vulnerable period for mental illness. About ten percent of teenagers have such extensive mental health problems that it affects their daily life. The school nurse is one of the first to meet teenagers with mental illness and therefore forms an important part of the teenager's well-being.  Aim: The aim was to investigate school nurses' experiences of working with adolescents with mental illness.  Design: A literature review with integrated analysis. Literature search was performed in three databases; Cinahl, PubMed and PsycINFO. A total of twelve qualitative articles were analyzed and included in the literature review. All included items were quality reviewed using a quality review template.    Results: Four categories emerged in the analysis; Lacks tools and knowledge about mental illness, Lack of time and workload, The importance of teamwork and Meaningful work but emotionally consuming. The results indicated that school nurses need tools and more knowledge about teenagers' mental illness. Furthermore, school nurses experienced a lack of time and that they could not always be as accessible to the teenagers as they wanted. The teamwork with other professions and external actors could be better as the school nurses did not always feel accepted in their professional role. Even though the school nurses experienced the work as emotionally consuming, they still felt that their work was meaningful to the individual teenager.  Conclusion: School nurses lack knowledge, tools and resources in working with adolescents with mental illness. They experience that the lack of time complicates the preventive work for mental illness and that they do not always feel accepted by other professions. It is of great importance that the school nurse in clinical practice can be offered more knowledge, time and resources to work preventively against mental illness.