Syftet med studien var att undersöka skolsköterskors inställning till gymnasieungdomars övervikt. Studien genomfördes med hjälp av två fokusgruppsintervjuer. Den första gruppen bestod av tre skolsköterskor och den andra av fem. Data har analyserats med kvalitativ innehållsanalys. De tre kategorier som kom fram var övervikt som hälsoproblem, bedömning och diagnostik och hälsofrämjande åtgärder vilket visade att många skolsköterskor uppfattade sig ha större problem med anorexia bland eleverna jämfört med övervikt. Ofta hade ungdomarna fått fetma innan skolsköterskorna ansåg sig reagera på övervikten. Skolsköterskorna uppfattade en skillnad i övervikt hos ungdomarna mellan olika gymnasieprogram. De ansåg också att övervikt kan vara svårt att tala om och att problemet kunde vara svårt att åtgärda på grund av att tiden inte räcker till. Skolsköterskorna menade att de hade en god förståelse för hur övervikt uppstår och hur problemet kan åtgärdas. Slutsatsen är att skolsköterskorna inte uppfattade övervikt som ett stort problem bland skolungdomar. De menade att problemet är litet i jämförelse med andra hälsoproblem. När övervikten betraktas i relation till andra problem kan det finnas en risk att problemet underskattas. För att klargöra detta behövs dock ytterligare undersökningar. / The aim of the study was to investigate the school nurses' attitudes towards overweight among teenagers. The study was conducted using two focus group interviews. The first group consisted of three school nurses and the other of five. Data was analyzed using qualitative content analysis. Three categories appeared: overweight as a health problem; assessment and diagnosis; and health promotion. It showed that many nurses perceived the greater problem was anorexia among students compared to obesity. Often the young people had become obese before school nurses reacted to their overweight condition. The school nurses perceived that there is a difference between high school programs in percentage of adolescents who are overweight. They also found that overweight can be difficult to talk about. The problem could be difficult to deal with because of insufficient time. The school nurses felt that they had a good understanding of how obesity occurs and the measures to be taken. The conclusion is that school nurses did not perceive obesity as a major problem among schoolchildren. They argued that the problem is small in comparison to other health problems. When weight is considered in relation to other problems, there may be a risk that the overweight is underestimated. However, to clarify this, further studies are needed.

Background: Sexuality, defined as love, intimacy and sex, is a part of patients’ overall health and concerns the quality of life. Patients have needs and wishes to discuss how the treatment and diagnosis might affect their sexual functioning as a number of medical conditions also can lead to sexual difficulties. Research has shown that nurses do not meet the patients’ need to discuss sexual matters. Aim: To describe nurses’ approach towards discussing sexuality with patients. Method: A literature review described by Friberg (2012) was conducted. The result of three qualitative and eight quantitative studies was summarized and then organized into groups depending on the similarities and differences. Results: The results outlined in four themes; The talk not taking place, Hindering factors, Promoting factors and Organizational factors. Nurses were knowledgeable in regards to how treatment and diagnosis affected patient sexuality. Even though they recognized the importance of sexuality for patients and felt responsible, nurses did avoid conversation about sexuality. Hindering factors stated by the nurses were lack of competency, considering sexuality as a private and taboo subject and feeling uncomfortable talking about sexual issues. Factors promoting conversation about sexuality were amongst others work experience and education. The organization may affect whether the nurses bring up the subject or not. Discussion: Despite that the society today is more open towards sexuality, the taboo of sexuality remains a fact in health care. A trusting and caring relationship between nurse and patient described by among others Travelbee could open up a permissive atmosphere, overcome taboos and facilitate discussions on sensitive issue. Models of sexual communication such as the PLISSIT-model could be used.

Bakgrund: Sverige tar emot många asylsökande vilket har medfört att arbetsbelastningen för distriktssköterskor inom primärvården har ökat. Några av de svårigheter som distriktssköterskan ställs inför när det gäller omvårdnaden och omhändertagandet kring asylsökande är bland annat, att bemöta dem med vänlighet och respekt och att försöka lindra deras lidande. Syfte: Syftet med studien var att beskriva asylsökandes upplevelser av bemötande från distriktssköterskor och övrig vårdpersonal på en flyktinghälsa och vårdcentral. Metod:Kvalitativ design med en induktiv ansats valdes till denna studie. Semistrukturerade intervjuer utfördes med hjälp av professionell telefontolk med 12 asylsökande. Materialet analyserades med kvalitativ innehållsanalys med fokus på det latenta innehållet. Resultat: Bemötande har många dimensioner som kan ge upphov till många olika känslor. Asylsökande har i vårdmötet upplevt bemötande som orsakat dem otrygghet och vårdlidande men även bemötande som har gett dem trygghet och känslan av att vara betydelsefulla som människor. Slutsats: Upplevelser kring varje vårdmöte är individuella och unika. Vårdlidande kan uppstå genom att asylsökande upplever otrygghet i det vårdande mötet. Om asylsökande däremot upplever trygghet i vårdmötet kan deras lidande lindras. / Background: Sweden receives many asylum seekers which implies that the workload of district nurses in primary care has increased. Some of the difficulties that the district nurse face when it comes to the nursing care and the specific care of asylum seekers is, among other things, to treat them with kindness and respect and to try to lessen their suffering. Purpose: The purpose of this study was to describe the asylum seekers' experiences of nurse-patient encounters with the district nurses and other health professionals at a refugee health clinic and health center. Method: Qualitative design with an inductive approach was chosen for this study. Semi-structured interviews were conducted with the help of professional telephone interpreters’ with 12 asylum seekers. The material was analyzed using qualitative content analysis focusing the latent content. Results: Treatment (nurse-patient encounters) have many dimensions that can cause many different feelings. Asylum seekers have in the health care encounter experienced treatment that caused them a sence of insecurity and suffering due to care but also the nursing staffs’ attitude has given them increased confidence and a feeling of being an important person. Conclusion: Experiences of each nurse-patient encounter is individual and unique. Care suffering can be caused by that asylum seekers are experiencing a sence of insecurity in the encounter with health care. But if they experience security in the encounter with health care staff, their suffering lessened.

A literature search was carried out on the role of the Community Psychiatric Nurse (CPN) in counselling within the Primary Health Care Team (PHCT) which highlighted a lack of theoretical knowledge for the psycho-social issues and that CPNs were not trained to provide counselling. The aim of this thesis was centred around the role in counselling the CPNs in Mid-Surrey Health District had in PHCTs, and whether General Practitioners (GPs) perceived CPNs as CPNs or counsellors. Two hypotheses were devised at the beginning of the study and a methodology was pursued in proving or disproving these hypotheses. Results indicated that CPNs were aware of the meaning of the term ‘counselling’ and that all but one felt they had not enough knowledge to carry out more in depth counselling/psychotherapeutic interventions. They all felt that counselling training was inherent to their work as CPNs within the PHCT. This therefore supported the hypothesis that CPN counselling in the PHCT needs to be trained. The GPs result was that they were unaware of qualifications held by CPNs or counsellors. They felt that CPN was invaluable and it would be an advantage if CPNs had counselling training. However, some felt that CPNs needed to retrain the ‘multipurpose’ aspect of their work. From the results it was apparent that there was a misperception of the role of CPN and counsellor as some GPs felt that CPNs were already counsellors. However, the result was inconclusive in proving or disproving the hypothesis. Most GPs introduced the CPN as a CPN and not as a counsellor, although some GPs believed that CPNs were also trained in counselling. It is argued that although these findings indicate that CPNs need counselling training and counselling was perceived as an important part of their work, in depth counselling training was not regarded as necessary to carry out their work as CPN.

The primary purpose of this study was to describe relationships between the concepts of caring behaviors of nurses, adolescent hopefulness and adolescent health care outcomes. The secondary purpose was to test and refine instruments developed to index those concepts. The conceptual framework used for the study was derived from two sources: an existential theory of nursing, Humanistic Nursing, as developed by Paterson and Zderad (1976). and a set of inductive studies on nurse-adolescent patient interactions (Hinds, 1983). A longitudinal, descriptive-correlational design having three data collection points was used. The study sample consisted of 25 adolescents (x age 15.6 years) receiving inpatient treatment for substance abuse. The data collection points occurred at 24-48 hours after admission (T₁), 96-120 hours before discharge (T₂), and 4-5 weeks after discharge (T₃). Adolescents completed visual analogue instruments and responded to a set of open-ended questions indexing the study concepts. Instrumentation data were analyzed using descriptive and correlational statistics and tests of significance for change. Qualitative data resu1ting from the interviews were content analyzed. Findings included statistically significant positive relationships between the concepts of caring behaviors of nurses and adolescent hopefulness at T₁, and T₂. Secondly, the relationship between adolescent hopefulness and adolescent health care outcomes was statistically significant at T₃. The concepts of caring behaviors of nurses and adolescent hopefulness changed significantly in a positive direction from T₁ to T₂. Content analysis findings indicated the concept of adolescent hopefulness was qualitatively different at each of the data collection points. Findings provide support for the theorized link between nurse-patient relationships and positive patient change. The purposeful use of a caring self for positive patient change represents the blend of art and science that defines the nursing profession.

No description available.

No description available.

No description available.

The central contention of this thesis is that story as an aid to learning, particularly student nurses' own stories of practice, is not being used to its full potential in nurse education. The dominant tendencies in nurse education are briefly outlined; the first, a ‘top- down’, managerialist approach, which is theory-focused, and where ‘reflection-on-action’ from an essentially theoretical perspective, with assessment strategies related to extrinsic criteria, is predominant; and the second, a ‘bottom-up’ approach, focused on practice itself as a resource for learning, with ‘reflection-in-action’ (moment-to-moment decision-making) as its major pedagogic strategy. This thesis argues that these approaches are too often treated in isolation from one another, but that for nurse education to be effective, professional practice must unite the two, and that story is an imaginative and stimulating method by which this can be achieved. The thesis outlines the ways in which story has been explored in the literature, but the emphasis is on the ‘humanness’ of stories and the varied and diverse roles they could play in the development of nurse education. This discussion of the unique contribution that story can make to nurse education is placed in the context of two major theories of learning: constructivist and social constructivist, with particular emphasis on the seminal work of Schon. The research methodology adopted is that of narrative, and data were provided by student nurses’ written stories and learning accounts of practice, and notes taken during focus groups. The data were supplemented by the use of my own stories of experience of clinical practice. In all, 55 students’ written stories and learning accounts were collected, and then analysed using a three stage approach: first, reading the stories and learning accounts; second, a two- part analysis using content analysis and analysis of form; and third, a structured presentation of findings. Therefore, whilst accepting that direct learning from story is difficult to demonstrate, the evidence presented in this thesis illustrates the different ways in which stories can be an aid to student learning from practice, particularly by encouraging students to differentiate and structure clinical experiences that might otherwise remain undifferentiated and unstructured, and acknowledge and identify the tacit nature of their learning in practice and develop strategies for making it explicit. The evidence presented in this thesis supports the contention that inclusion in the curriculum of students’ stories of clinical practice can contribute towards the transformation of nurse education.

The migration of nurses is stimulating international debate around globalisation, ethics, and the effects on health systems. This thesis examines this phenomenon through nurses trained in Nepal who migrate to the UK. Since 2000, increasing numbers of Nepali nurses have started crossing national borders to participate in the global healthcare market, particularly in the affluent west. By using qualitative multisited research and in-depth interviews with key stakeholders in both Nepal and the UK, this thesis explores why nurses aspire to migrate, how they fulfil these aspirations, and their experience of living and working in the UK. The thesis begins by examining the historical development of nurse training in Nepal, particularly from the mid 1950s. This period saw profound socio-political transformations, including in the position of women in Nepali society and in the perception of nursing in Nepal. Previously, many families were very reluctant to send their daughters into nursing. By the late 1990s, middle-class women and their families were increasingly attracted to nursing, both as a vocation and as a means to migrate. The thesis explores the rise of private training colleges to meet the increased demand for nurse training, and the new businesses that have grown up around the profession to facilitate nurse recruitment and migration. Around one thousand nurses have migrated to the UK since 2000, and the second part of the thesis presents their experiences of the migration process and of working and settling in the UK. Nurses have faced complex bureaucratic and professional hurdles, particularly after UK nurse registration and work-permit policies changed in 2006. The thesis also highlights how highly qualified nurses with many years of work experience in Nepal have become increasingly deskilled in UK. Frequently sent to rural nursing-homes by recruiting agencies, they create and join new diasporic support networks. Further, many have left their loved ones behind, and experience homesickness and the pain of family separation. Often, they plan for their husbands and children to join them after several years, and the research explores this and the issues faced by their families, as they relocate and adapt to life in the UK. Finally, the thesis makes some important policy recommendations. For Nepal, these relate to greater regulation of nurse training and the brokering of nurses abroad. In the UK, they relate to increasing the flexibility of registration and visa regulations to assist in supporting Nepali nurses' work choices, and to value and utilise their professional skills in the UK better.