Bakgrund: Stroke är en av vanligaste folksjukdomen i Sverige. Stroke är ett samlingsbegrepp för hjärnblödning och hjärninfarkt. Sjukdomen påverkar alla aspekter av livet, även anhöriga. I sjuksköterskans yrkesroll ingår att bidra med goda stöd och information till anhöriga samt etablera en relation som bygger på förtroende. Syfte: Att beskriva upplevelsen av att vara anhörig till en person som drabbas av stroke. Metod: En litteraturöversikt baserad på elva kvalitativa artiklar genomfördes enligt Fribergs metodbeskrivning. Sökning skedde genom databaserna CinahL och PubMed med sökord ”Stroke” Family” ”Caregivers” och ”Experience”. Analysarbetet resulterade i ett huvudtema ”Livet är förändrat” med fyra tillhörande subteman ”ett förändrat vardagsliv”, ”ett förändrat ansvarstagande”, ”ett förändrat Personligt liv” och ”ett förändrat hälsotisstånd”. Resultat: Resultaten visade att anhöriga upplevde förändringar i vardagsrutiner och hälsotisstånd. Utöver att de hade ett nytt ansvar som påverkade deras sociala liv. Anhöriga upplevde en känsla av oro, ansträngning att hålla samtidigt olika roller, upplevelse av isolering och förluster av sociala kontakter. Sammanfattning: Litteraturöversikt visade att anhöriga är i behov av hjälp och stöd. Anhörigas hälsa påverkas i stor utsträckning av de olika livsförändring och den nya vårdande rollen de antar. Därför bör sjukvårdspersonalen hitta strategier för att ge anhöriga det stöd som de behöver för att kunna känna sig trygga i den ny livssituation. / Background: Strokes is one of the most common endemic diseases in Sweden. Stroke is a collective term for cerebral hemorrhage and cardiac infarctions. The disease affects all aspects of life, as well as family members. The role of the nurse includes contributing with support and information to family members and establishing a relation that builds on trust. Aim: To describe the experience of being a family member to a person that has been affected by a stroke. Method: A literature review based on eleven qualitative articles was conducted according to Fribergs method description. The searches were made through the databases CinahL and Pubmed with the keywords” Stroke” Family”,” Caregivers” and” Experience”. The analysis work resulted in a main theme “Life is changed” and four sub-themes “a changed everyday life”, “a changed responsibility taking”, “a changed personal life” and “a changed state of health. Results: The results showed that family members experienced changes in daytoday routines and state of health. They had new responsibilities that affected their social lives. Family members also experienced feelings of worry, weariness to continuously hold different roles, experience of isolation and loss of social contacts. Conclusion: The literature review shows that relatives are in great need of help and support. The health of relatives is affected to a great extent by the different changes to their day to day lives which a stroke and the new caretaker role brings. Therefor the health care system needs to give relatives the support they need to be able to feel safe in their new life situation.

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Introduction and background: Family-centred care in the intensive care unit has increased steadily over the past three decades, based on the premise that the illness and health of an individual family member affects the whole family unit. Although widely researched there are still inconsistencies in implementing family-centred care, which influences the ability to transfer research findings into practice. Research has shown that recognising the role of family members in the critical care environment should be considered an essential component to caring for the critically ill patient. Although recommendations have been made for the implementation of familycentred care, it is not feasible for all recommendations to be adopted by nurses and healthcare professionals in a single ICU. Nurses and healthcare professionals need to customise strategies to an individual intensive care unit to improve family-centred care. Aim: The aim of the study was to explore and describe nurses, healthcare professionals and family members’ perceptions of family-centred care in the intensive care unit. Research design and methods: A quali-quanti research design was used. Participants included nurses, healthcare professionals and family members in the intensive care unit of a private hospital in Gauteng, South Africa. There were a total of sixty (60) participants who took part in the study. Nurses were selected using stratified random sampling, healthcare professionals were selected using total population sampling and family members were selected using purposive, maximum variation and convenience sampling. Data was collected over a period of one month by means of structured interviews using an associative group analysis technique. Participants were asked to write down free word associations in relation to the stimulus word “family-centred care” in order to explore and describe their perceptions of family-centred care in the intensive care unit as it is currently, as it could be in the “ideal world” and any gaps that exist around these perceptions. Results: Five themes were derived from the data: communication, environment, continuum of feelings, reflections and spiritual care. Conclusion: The implementation of family-centred care should involve all stakeholders in the intensive care unit in order to address inconsistencies in perceptions around family-centred care. Keywords: Associative group analysis, intensive care unit, family-centred care, healthcare professionals, nurses, perceptions, stakeholders / Dissertation (MNur)--University of Pretoria, 2019. / Nursing Science / MNur (Clinical) / Unrestricted

Background: Palliative care is aimed at relieving care, not curative care. Pediatric palliative carediffers from palliative care aimed at adults as the degree of maturity and insight of the child is crucial. Nurses working in pediatric palliative care find it emotionally difficult to support relatives. Aim: The aim was to investigate relatives' experiences of pediatric palliative care. Method: Literature study with a qualitative approach where data has been analyzed through Braun and Clarke's thematic analysis. The result is based on twelve articles. Results: Three themes were identified: need for support from the care team, to be the child's lawyer and a changed life situation. Relatives feel the need for supportive care with experienced healthcare professionals. During the pediatric palliative care, relatives feel the need to be the child's lawyer andclaim to know the child best. Relatives experience challenging emotions during the care period, which makes the situation more difficult. Summary: Lack of knowledge of caregivers affects the performance of an adapted care. This affects relatives' trust in the caregivers, which creates frustration among both relatives and caregivers. The frustration needs to be met with an understanding of the family's needs to adapt the care, which reduces relatives' feelings of being overlooked. The nurse is responsible for showing consideration forrelatives and therefore needs care in accordance with family-focused care. / Bakgrund: Palliativ vård syftar till lindrande vård, inte kurativ. Den pediatriska palliativa vården skiljer sig från den palliativa vården riktad till vuxna då mognadsgrad och insikt hos barnet är avgörande. Sjuksköterskor som arbetar med pediatrisk palliativ vård upplever det emotionellt svårt att stödja anhöriga. Syfte: Syftet var att undersöka anhörigas upplevelser av pediatrisk palliativ vård. Metod: Litteraturstudie med kvalitativ ansats där data har analyserats genom Braun och Clarkes tematiska analys. Resultatet är baserat på tolv artiklar. Resultat: Tre teman identifierades: Behov av stöd från vårdteamet, att vara barnets advokat och en förändrad livssituation. Anhöriga upplever behov av en stöttande vård med erfaren vårdpersonal. Under den pediatriska palliativa vården känner anhöriga behovet att vara barnets advokat samt påstår att dem känner barnet bäst. Anhöriga upplever utmanande känslor under vården vilket görsituationen svårare. Slutsats: Brist på kunskap hos vårdgivare påverkar utförandet av en anpassad vård. Detta påverkaranhörigas tillit till vårdgivarna vilket skapar en frustration hos både anhöriga och vårdgivare. Frustrationen behöver bemötas med förståelse för familjens behov för att anpassa omvårdnaden, vilket minskar anhörigas känslor av att bli förbisedda. Sjuksköterskan ansvarar för att visa hänsyn tillanhöriga och behöver därför vårda i enlighet med familjefokuserad omvårdnad.

Background: Sudden cardiac arrest is the third most common cause of death in Europe. The nurse has a significant role in the work of the resuscitation team. It is often the nurse who is the first among the medical staff to discover cardiac arrest. In the last two decades, research has shown the importance of family presence during resuscitation (FPDR), it can for example aid the family members in their grieving process as well as allow them to support the patient. Family presence is routine if the patient is a child, but not if the patient is an adult. Aim: The aim was to map the nurse's experiences and perceptions of NBHLR in adult patients in hospital wards. Method: A literature review with qualitative content analysis based on research-based on both qualitative and quantitative data on thirteen original articles. Two themes and subthemes emerged in the result. Results: The research in this area showed no clear explanations for why CPR is not used more frequently for adult patients. Education or lack of education, for example, did not have a significant impact on the use of NBHLR. Several of the nurses were worried about how the family members would be affected by attending CPR. Conclusion: More research and knowledge are needed regarding NBHLR. An important area of research could be to find out more in detail about why NBHLR works well in some cases and what would convince the nurse to invite family members to attend.

Thesis (Ph.D.(Psychology)) -- University of Limpopo, 2020 / Suicide is one of the major global public health challenges, with evidence showing that an interplay of multiple factors leads to someone taking their life. While suicide is often a solitary act, its impact on other people is far-reaching. When someone commits suicide, family and friends are almost always left behind to grieve, trying to understand the reasons for the suicide and having to learn to continue with their lives. Because suicide happens within families, its impact on the remaining members is of paramount importance. Understanding the impact of suicide on the surviving family members is a critical step in determining how to assist survivors. The study comprised eleven (11) participants who were all nuclear family members bereaved by suicide in the Capricorn District of Limpopo Province, South Africa. They were all from the Sepedi-speaking ethnic group. Data was collected through in-depth, semi structured, individual face-to-face interviews. Data analysis was done through the use of Hycner’s phenomenological explication process. The following themes were extracted from the participants’ case studies: knowledge of suicide; causes of suicide; methods used in the act; the impact of suicide on the family; prevention of suicide; coping strategies; grief following suicide and grief following other causes of death; concerns about the topic of suicide; and, suggestions in terms of support for suicide bereaved families. The current study reveals that there is still a lot of secrecy around psychological problems which lead people to suicide with the survivors not knowing who or what to blame. It is also evident from the findings that suicide bereaved people tended to be psychologically disturbed, less likeable and more blameworthy than non-suicidally bereaved. The psychological impact experienced includes depression, self-blame, aggression, suicidal ideations and also resulting in hospitalisation for some. Suicide can lead to longer and more complicated grief reactions because family members cannot share their experiences or thoughts, particularly the feelings of guilt that they are struggling with. The stigma from society does not make it any easier for survivors to deal with their grief, leading them to isolate themselves with fear of being judged. Based on the study findings, a culturally informed psychological model of suicide bereavement was developed to explain the lived experiences of African family v members bereaved by suicide. The model incorporates some ideas from Bowen’s structural family theory and the Afrocentric theory. This model proposes that suicide may cause a break-up within the family system and that cultural beliefs may be unfavourable in some instances. For instance, in this study, it was found that some Africans still believe that suicide is a taboo and a curse, which contradicts the psychological importance of viewing the victim’s body by family members. Being unable to view the deceased causes complications in the bereavement process, which leads to psychological problems. It further proposes that African culture is broad and still follows the norms and values in most situations, while these norms and values also play a role in the outcome of the bereavement process. These norms and values may lead to a breakdown of the family structure, leaving them with conflicts or complicated grief, leading to more psychological problems.

Thesis (MPH.) -- University of Limpopo, 2019 / Background- care of the mentally ill by family members is done with little or no supervision by skilled health workers. Therefore, the purpose of the study was to investigate the experiences of family members of patients living with mental illness in the Capricorn District of Limpopo Province in South Africa. Objective- to explore and describe the experiences of family members caring for patients living with mental illness. Methods- A qualitative, descriptive and exploratory design was used. Non-probability sampling of the purposive and convenient type was used to explore and describe the experiences of family members of patients living with mental illness in the Capricorn District. Data were collected from fifteen family members caring for MHCUs, by using open-ended semi-structured face-to-face interviews. Data were audio recorded and observations were done during interviews. Trustworthiness was ensured by applying credibility, transferability, confirmability and dependability. Data were analysed using Tech’s open-coding method. Results- family members experience disruptive behaviour from MHCUs and they also have to adapt to new routines that are at times unfavourable. As a result, the family members’ health and quality of life are affected, thus making them susceptible to having mental illness and other medical conditions as well. Conclusion- There is a need for family members caring for persons living with mental illness to be given emotional and social support. community projects such as support groups for family members caring for MHCUs and goal directed standard operations procedures at the Psychiatric Ward – specifically designed and implemented for family members caring for MHCUs, are recommended.

Indiana University-Purdue University Indianapolis (IUPUI) / Human papillomaviruses (HPVs) are one of the most common causes of sexually transmitted disease in the world. HPVs are divided into high-risk (HR) or low-risk (LR) types based on their oncogenic potential. HPVs 16 and 18 are considered HR types and can cause cervical cancer. HPVs 6 and 11 are classified as LR and are associated with condyloma acuminata (genital warts). Viral proteins of both HR and LR HPVs must be able to facilitate a replication competent environment. The E7 proteins of LR and HR HPVs are responsible for maintenance of S-phase activity in infected cells. HR E7 proteins target all pRb family members (pRb, p107 and p130) for degradation. LR E7 does not target pRb or p107 for degradation, but does target p130 for degradation. Immunohistochemistry experiments on HPV 6 infected patient biopsies of condyloma acuminata showed that detection of p130 was decreased in the presence of the whole HPV 6 genome. Further, the effect of HR HPV 16 E7 and LR HPV 6 E7 on p130 intracellular localization and half-life was examined. Experiments were performed using human foreskin keratinocytes transduced with HPV 6 E7, HPV 16 E7 or parental vector. Nuclear/cytoplasmic fractionation and immunofluorescence showed that, in contrast to control and HPV 6 E7-expressing cells, a greater amount of p130 was present in the cytoplasm in the viii presence of HPV 16 E7. The half-life of p130, relative to control cells, was decreased in the cytoplasm in the presence of HPV 6 E7 or HPV 16 E7, but only decreased by HPV 6 E7 in the nucleus. Inhibition of proteasomal degradation extended the half-life of p130, regardless of intracellular localization. Experiments were also conducted to detect E7-binding partners. Cyclin C and cullin 5 were identified as proteins capable of binding to both HPV 6 E7 and HPV 16 E7. Preliminary experiments showed that decreasing protein levels of p600, a binding partner of both HPV 6 E7 and HPV 16 E7, by RNA interference might affect p130 stability. Elucidating the mechanisms of p130 degradation may identify potential targets for preventing degradation of p130 and allowing restoration of cell cycle control.

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