BAKGRUND: Mer än var tionde kvinna drabbas av bröstcancer under sin livstid, vilken är den vanligaste cancertyp som drabbar flest kvinnor. Trots den höga incidensen har antalet friskförklarade ökat de senaste åren. Kvinnor med bröstcancer får en förändrad självbild efter diagnos och behandling, vilket generellt skapar specifika omvårdnadsbehov. Det är viktigt att hantera dessa konsekvenser av bröstcancer, då de är starkt sammankopplade med livskvaliteten. Detta medför ett ökat behov av holistisk omvårdnad med fokus på livskvalitet.  SYFTE: Att belysa sjuksköterskans stödjande roll i omvårdnaden av patienter med bröstcancer. METOD: Undersökningen genomfördes som en litteraturöversikt och utgår från artiklar baserade på kvalitativa studier. RESULTAT: Bröstcancerpatienter i olika stadier, från diagnos till efter avslutad behandling, uttrycker att sjuksköterskan varit en viktig resurs genom hela vårdprocessen. Framför allt betonas hantering av information, stöd och kompetenta sjuksköterskor. Sjuksköterskan har förmedlat emotionellt stöd, hjälpt till att navigera i systemet som omger vårdprocessen, varit kompetent, varit kunnig inom cancervård samt har förmedlat information.  SLUTSATS: Litteraturstudien visar att sjuksköterskor i de flesta fall möter bröstcancerpatienter i deras behov av stöd, information, kliniska färdigheter samt kunskap om hur systemet i hälso- och sjukvården fungerar. Det framkommer att de flesta patienter och närstående är nöjda med vården och att de har känt förtroende för sjuksköterskan. För att ett salutogent hälsoperspektiv ska kunna råda behöver de här patienterna inte bara hjälp med den fysiska vården relaterad till bröstcancer utan detta förutsätter vård i ett holistiskt perspektiv. / BACKGROUND: More than one in ten women get diagnosed with breast cancer during their lifetime. Breast cancer is currently the most common type of cancer amongst women. Despite the high incidence the number of women who are declared healthy in recent years, increase. Women with breast cancer experience an altered self-image after diagnosis and treatment which generally creates specific nursing-needs. It is important to handle these impacts of breast cancer since they are strongly connected with life quality. This increases the need of holistic nursing with a quality of life focus. PURPOSE: To highlight the nurse´s supportive role in the care of patients with breast cancer. METHOD: The survey was conducted as a literature review and based on qualitative studies. RESULT: Breast cancer patients at various stages, from diagnosis to after completed treatment express that the nurse has been an important resource throughout the care process. In particular, they emphasize managing information, being supportive and is knowledgeable. The nurse has conveyed emotional support, helped to navigate in the system surrounding the care process, owned skills and knowledge in cancer care and that supplied information. CONSLUSION: The literature review show that nurses in the majority of cases meet patients in their needs for support, information, clinical skills and knowledge of how the system of health care functions. It appears that most patients and their relatives are satisfied with the care and they have trusted the nurses. To be able to provide care with a salutogenic perspective in interest, the patients not only need physical care, they need care with a holistic perspective.

<p>Today patients are more aware of their rights regarding their own care. They are more informed, more engaged and have more and individual requirements, which leads to increased demands for information and participation increases. The Health Act sets out the patients´ right to participation. Participation increases patient satisfaction with care, promotes healing and increases adherence to health care advise. The patient doesn´t always experience participation in their own care to the extent they wish, which suggests that nurse’s does not always succeed in getting the patient involved. The purpose of this study is to describe factors that are important for patient participation in nursing care in a nurse- and patient perspective. Nine research articles were analyzed with qualitative content analysis. The analysis resulted in two themes: health care relationships and communication. Through various acts of nursing care, patients experienced themselves as being seen and confirmed. Patients experienced a sense of security and trust, which is the essence of a trusting relationship, which in turn is the basis for caring and patient participation in their own care. Patient participation requires a sophisticated interaction between nurse and patient, a quest of a safe relationship that can lead the patient to see themselves seen and confirmed.</p><p> </p><p> </p><p> </p><p>Keywords: patient participation, nurse-patient relationship, nurse, care</p>

Today patients are more aware of their rights regarding their own care. They are more informed, more engaged and have more and individual requirements, which leads to increased demands for information and participation increases. The Health Act sets out the patients´ right to participation. Participation increases patient satisfaction with care, promotes healing and increases adherence to health care advise. The patient doesn´t always experience participation in their own care to the extent they wish, which suggests that nurse’s does not always succeed in getting the patient involved. The purpose of this study is to describe factors that are important for patient participation in nursing care in a nurse- and patient perspective. Nine research articles were analyzed with qualitative content analysis. The analysis resulted in two themes: health care relationships and communication. Through various acts of nursing care, patients experienced themselves as being seen and confirmed. Patients experienced a sense of security and trust, which is the essence of a trusting relationship, which in turn is the basis for caring and patient participation in their own care. Patient participation requires a sophisticated interaction between nurse and patient, a quest of a safe relationship that can lead the patient to see themselves seen and confirmed.       Keywords: patient participation, nurse-patient relationship, nurse, care

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A lesÃo medular ocasiona diversas dificuldades ou necessidades de ajuda na realizaÃÃo das mais diferentes atividades da vida diÃria nas pessoas acometidas. Ao proporcionar um cuidado de enfermagem para ajudar a pessoa portadora de lesÃo medular, se obtÃm um exemplo de reflexÃo acerca da qualificaÃÃo da prÃtica profissional, promoÃÃo da saÃde e melhoria do bem-estar destas pessoas. Contrariando a tendÃncia de nÃo valorizar o uso de teorias de enfermagem, objetivou-se analisar a aplicabilidade da Teoria de Enfermagem ClÃnica de Ernestine Wiedenbach na identificaÃÃo da necessidade de ajuda Ãs pessoas com paraplegia. Trata-se de um estudo exploratÃrio, descritivo e de natureza qualitativa que permite uma compreensÃo da experiÃncia humana subjetiva da vida destes seres. Os sujeitos pesquisados perfizeram um total de nove pessoas com paraplegia atravÃs de triagem realizada seguindo critÃrios de inclusÃo. O lÃcus foi o domicÃlio, uma vez que à um ambiente que promove maior privacidade e confiabilidade para a coleta de informaÃÃes. Os instrumentos escolhidos foram um formulÃrio estruturado constando dados socioeconÃmicos, de identificaÃÃo do sujeito da pesquisa e especÃficos sobre a lesÃo medular e uma entrevista semi-estruturada que abordou questÃes sobre o significado de ajuda, quais necessidades de ajuda enfrentam estes sujeitos, qual ajuda necessÃria pretendem receber, de quem estÃo recebendo ajuda e se algum enfermeiro o havia ajudado. A entrevista foi gravada respeitando-se todos os critÃrios Ãticos de pesquisa com seres humanos e os dados foram posteriormente transcritos e agrupados em categorias seguindo a abordagem metodolÃgica de Bardin da anÃlise de conteÃdo dos relatos. Assim, foram criadas quatro categorias: 1- A percepÃÃo do que à ajuda pelos portadores de paraplegia e o cuidado de enfermagem; 2- A identificaÃÃo das necessidades de ajuda; 3- Ofertando a ajuda: os significados e 4- A ajuda esperada pelos portadores de paraplegia. Os dados demonstraram que os portadores de paraplegia entendem a ajuda como, cooperaÃÃo, incentivo, motivaÃÃo, apoio ou atà mesmo uma forma de preconceito ou exclusÃo. Quanto Ãs necessidades de ajuda, as identificadas foram: Acessibilidade; Preconceito que percebem das pessoas; Sentimento de impotÃncia diante das dificuldades; Higiene Pessoal e Ãntima; Privacidade na execuÃÃo de cuidados de higiene Ãntima; InfecÃÃo urinÃria; Cateterismo vesical; Medo; Dor neuropÃtica; Espasticidade; Problemas financeiros; Falta de emprego; Uso de medicaÃÃes orais; e Falta de adaptaÃÃo no domicÃlio. Quanto à ajuda que recebem foram apontados a dos amigos e da famÃlia. Ao serem perguntados se algum enfermeiro ofertou alguma ajuda no percurso de sua condiÃÃo de paraplegia obteve-se como resposta os profissionais do centro de reabilitaÃÃo. AlÃm disso, foi proposto um plano de cuidados para a prÃxis de enfermeiros no cuidado domiciliar a pessoas com paraplegia. Considera-se que este estudo trouxe uma grande contribuiÃÃo cientÃfica visto que comprovou a eficÃcia da Teoria de Wiedenbach para a implementaÃÃo de cuidados de enfermagem direcionados a pessoas com lesÃo medular e ainda elaborou um modelo de processo de enfermagem voltado para portadores de paraplegia, podendo ser executado no prÃprio domicÃlio, corroborando com a proposta de promoÃÃo da saÃde, reintegraÃÃo e suporte sÃcio-espiritual do cuidar humanizado preconizado pela ciÃncia da Enfermagem.

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2015-11-23T17:13:54Z No. of bitstreams: 1 Beloní Gabe Leal_.pdf: 2118279 bytes, checksum: 946f5888dcf7ac8a1ed76613ae36b86b (MD5) / Made available in DSpace on 2015-11-23T17:13:54Z (GMT). No. of bitstreams: 1 Beloní Gabe Leal_.pdf: 2118279 bytes, checksum: 946f5888dcf7ac8a1ed76613ae36b86b (MD5) Previous issue date: 2015-09-30 / Nenhuma / Este estudo aborda as representações sociais (RS) de saúde e doença na perspectiva dos profissionais de enfermagem que trabalham no turno da noite. As RS refletem o modo como indivíduos, grupos e sujeitos sociais constroem seu conhecimento a partir de sua inscrição social e cultural. O objetivo foi elaborar ações de educação em saúde, para os profissionais de enfermagem do turno da noite, a partir de suas representações sociais de saúde e doença, relacionadas ao trabalho noturno. O estudo foi realizado à luz das RS, com base na teoria do núcleo central. O campo de estudo foi uma instituição hospitalar da rede privada, localizada em Porto Alegre/RS. Participaram 100 profissionais de enfermagem que exercem atividades no turno da noite. A coleta deu-se por meio de questionário com questões estímulos. Para a análise das evocações, utilizou-se o software Ensemble de Programmes Permettant l’Analyse des Evocations. Seguiu-se a Resolução nº. 466/2012. As RS dos profissionais de enfermagem do noturno acerca do pré-plantão foram constituídas por atributos que representam a necessidade de organização prévia, bem antes de iniciar a jornada de trabalho. Também evocaram o esforço para superar o cansaço e a sonolência, exigindo um ritmo de alerta e maior concentração no trabalho. No pós-plantão emergiram evocações relacionadas ao cansaço, ao sono e à necessidade de descanso, representando a longa jornada de trabalho noturno com 12 horas consecutivas. As RS do plantão noturno, relacionadas à saúde foram constituídas por vocábulos como alimentação, dores, insônia, obesidade, sedentarismo e sono, que indicam o plantão noturno como espaço de “não saúde”. As RS relacionadas à doença foram constituídas pelas evocações: dores, ansiedade, depressão, insônia, hipertensão, obesidade e varizes. Esse mesmo grupo evoca vocábulos que representam a preocupação em prevenir essas doenças ou outras e suas causas. As RS do plantão noturno relacionadas à vida social e familiar foram constituídas por evocações que determinaram a falta de tempo, a ausência e a saudade, apontando que o trabalho à noite pode dificultar as relações sociais e familiares, com desencontros, ausências em comemorações e em momentos de lazer junto com a família. As RS dos profissionais de enfermagem acerca do pré e pós-plantão noturno relacionadas à sua saúde, à doença e à sua vida social guiaram e respaldaram a proposta de intervenção deste estudo, pautada nos princípios de educação em saúde e de promoção da saúde. Ações de educação em saúde foram constituídas em três dimensões do cuidado: elaboradas para os profissionais de enfermagem, para a gestão assistencial e para a instituição. Considera-se que o conjunto de ações de educação em saúde pode contribuir para a qualificação das condições do trabalho noturno dos profissionais de enfermagem. / This essay will discuss the social representations (SR) of health and illness on the perspective of nurses that work on the night shift. The SR reflect the way individuals, groups and social personas make up their knowledgement by taking as reference their own social and cultural contexts. The objective of this essay was to create actions on health education for nurses that work in the night shift, taking as a starting point their social representations on night shift work schedule.The study was focused on SR and based on the central nucleus theory. A private hospital located in Porto Alegre/RS was used as field of study. One hundred nurse professionals from the night shift took part of the study. A questionnaire containing stimulus questions was used for data collection. The software Ensemble de Programmes Permettant l’Analyse des Evocations was used to analyse the evoked words. The essay was done in conformity with the Resolution 446/2012. Night shift nurses’ SR concerning the moment before their duties were constituted by attributes that represent their necessity of previous organization. The effort to keep themselves awake and rested was evoked as well, once their shift requires them to be much more aware and concentrated on their tasks than those of the morning shift. The participants also claimed about being tired, sleepy and needed of resting on the post shift period, reflections of their working journey of 12 hours in a roll. The night shift SR related to health were composed by words such as: food, pain, insomnia, obesity, sedentary lifestyle and sleepiness – what points the night shift as a non healthy environment. The SR related to illness were composed by the words: pain, anxiety, depression, insomnia, hypertension, obesity and varicose veins. This same group evokes words that represent their worrying on preventing those illness or similar ones and its causes. The SR related to their personal lives were composed by evocations such as lack of time, absence and longing, what points the night shift as an obstacle for the maintenance of social and parental relationships, once night shift workers can’t always be present on family’s parties and friends hangouts. The SR related to the period before and after the night shift, to workers’ health, to illness and to workers’ personal lives, guided and endorsed this study’s intervention proposal, based on health education and health promotion principles. Health education actions were composed based on three caring dimensions: towards the nurses, towards the care management and towards the institution. A series of actions of health education can contribute for the better qualification of night shift workers environment.

Syftet med denna systematiska litteraturstudie var att beskriva patienters upplevelse av livskvalitet samt sjuksköterskans omvårdnadsåtgärder i samband med cytostatikabehandling vid cancersjukdom. För att besvara studiens syfte har sökning efter artiklar (n=17) genomförts i databaserna Blackwell Synergy samt Elin@Dalarna. Följande sökord har använts i olika kombinationer; cancer, patients, experience, nurse care, quality of life, scale, instrument, chemotherapy och care. Resultatet visade att cytostatikabehandlingen hade både positiv och negativ inverkan på patienternas livskvalitet. Livskvaliteten ökade då symtom lindrades. Försämrad livskvalitet var alltid associerad till biverkningar av cytostatikabehandlingen. De vanligaste biverkningarna som inverkade på livskvaliteten var illamående och kräkningar, fatigue, hårförlust samt neutropeni. Biverkningarna påverkade patienternas livskvalitet negativt då de försämrade deras välmående samt förändrade deras situation i vardagslivet. Information och undervisning var viktiga omvårdnadsåtgärder för att förbereda patienterna inför behandlingen och för att underlätta deras situation under behandlingstiden. Även att få stöd från sjuksköterskan ansågs vara viktigt under behandlingstiden.

It is inconceivable for only one person to take care of ill people in a health care. To achieve the aim which is in particular maintenance of the highest life quality of specimens in health or in disease, is important mutual cooperation of professionals in the branch, where every single ensure care for a patient on the basis of his own knowledge and skills. It is about team co-operation, where every single member of the team has his own obligations, but also rights and authority. The term multisiciplinary care means co-operation of more scientific branches. Hemodialysis patients'nursing care is about team of professionals, who are fully involved in satisfying patients' needs. This co-operation enables primarily the unitary communication, reduction of patient's issue analysis, unified and consecutive nursing care, complete documentation and quality evaluation of provided nursing care of these patients. The aim of the dissertation was to chart multidicsiplinary care's issues at hemodialysis, on the basis of available literature. The dissertation is based on theoretically processed topic by the method of documents' content analysis and method of review and synthesis. Information is obtained from domestic but also foreign science books, scientific magazines, and internet sources. Findings from the 42nd international conference EDTNA/ERCA, which topic was Innovation of renal care through multi-professional leadership, which took place in Malmö, Sweden, from 31st of August to 3rd of September 2013, also contributed. The dissertation is divided into three basic chapters. The first part is focused on team characteristic. There are definitions, types, features, building, composition, roles, conflicts within a team and elemental description of multidisciplinary co-operation. The second chapter deals with a history and hemodialysis as a medical extracorporal method. The third, and the broadest section, is focused on multidisciplinary co-operation at the centre of hemodialysis. It is divided into several sub-chapters. In each of them the information descend from general field to concrete needs of hemodialysed patient and continue to the description of each member of a multidisciplinary team. The result is comprehensive view on provision of multidisciplinary care in the centres of hemodialysis. The output of the dissertation is a draft of the nursing care algorithm within the purview of multidisciplinary care at the centres of hemodialysis. Multidisciplinary care is necessary requirement for assumption of effective, high quality and continuous medical and nursing care at all the centres.

While providing nursing care, in exceptional cases it is necessary to use restrictive measures to calm down a patient by applying physical restraints. However, since these are methods that seriously interfere with the patient´s personal liberty, it is necessary to observe certain principles in such a way that the methods minimize the risk of various complications, which may be both mental and physical, but also legal. Therefore, the indication for the use of these measures is especially the patient´s behavior that involves significant imminent danger or harm to the patient and others. The aim of our study was to determine what is the most frequent indication for putting the patient to a net bed enclosure in traumatological and psychiatric wards, to find out whether nurses have at their disposal the standards developed in relation to restraints, to find out what nurses regard as advantages and disadvantages in placing patients into net bed enclosures, to identify how nurses see the public´s attitude to the issue of the use of bed net enclosures and to determine the public opinion on the use of net bed enclosures. It can be seen from the results that over several years the approach to this issue of both the public and the medical management has changed and there is a readiness to use physical restraints or net bed enclosures properly and in accordance with human rights and human dignity. This thesis may be used as a theoretical basis for training students of non-medical disciplines or in training nurses on the issue related to the restraints. Furthermore, it could be used as a guide for the public to get the notion how the restraints and net bed enclosures are being used, how much attention is being paid to human dignity and personal liberty. This thesis also provides an overview of how the issue has evolved over time and what level it has reached at present. The issue of net bed enclosures and restraints in general is very "sensitive". Over the past ten years this issue has undergone many changes, has aroused indignation, but also understanding. Forms of restraints will certainly be the subject of a lot of negative or positive discussions in the future. It is important that nurses consider the patients, in which restraints have been applied, as their partners, that they meet all their needs and do their best to provide comfort taking into consideration their individualities.

Bakgrund: Eksem är en vanlig hudsjukdom och ofta ett kroniskt tillstånd som påverkar mer än bara huden. Sömnsvårigheter, klåda och torr hud är symtom av eksem och dessa påverkar patientens livskvalité. Patienter uttrycker ett behov av bättre stöd från vården, fungerande behandling och utökade kunskaper i eksemvård utanför specialistvården.Syfte: Att beskriva vad sjuksköterskan kan bidra med till den samlade vården för att förbättra livskvalitén för patienten inom öppen- och slutenvård.Metod: Studien genomfördes som en litteraturöversikt. Resultatet baseras på 17 vetenskapliga artiklar ifrån sju olika länder, varav tio kvantitativa, fem kvalitativa och två mixade metodartiklar. Databaserna CINAHL, PubMed och Web of Science användes.Resultat: Det framkom tre kategorier som speglar sjuksköterskans omvårdnads insatser: Utbildning, Psykosocialt stöd, Planering och behandling. Underkategorier som presenteras är Utbildning om eksem, Individanpassning, Workshop, Stödja resurser, Kontinuitet och lättillgänglighet, Engagera och involvera, Omvårdnadsplanering, Förbättringsarbete. Litteraturöversikten visar en förbättring i livskvalité och kliniska resultat när sjuksköterskan var involverad och hade ett ökat ansvar för patienten.Slutsats: Sjuksköterskan har en betydande roll i patientens eksemvård. Sjuksköterskan bidrog med individuellt anpassad information och utbildningsinsatser och en ökad förståelse för patientens situation vilket bidrog till en bättre eksemvård. Digitala verktyg visade sig vara användbara för patienten och sjuksköterskan, de var även resurseffektiva. Behandling baserad på en helhetssyn och evidens behövs för att tillgodose patientens behov. Den grundutbildade sjuksköterskan behöver få ökade kunskaper för att kunna bidra med god och säker eksemvård inom öppen- och slutenvården. / Background: Eczema is a common skin disease and often a chronic condition that affects more than just the skin. Difficulty sleeping, itching and dry skin are symptoms of eczema which affects the patient's quality of life. Patients express a need for better support from care, effective treatment and increased knowledge in eczema care outside of specialist care.Purpose: To describe what the nurse can contribute with in care to improve the quality of life for the patient in outpatient and inpatient care.Method: The study was conducted as a literature review. The result is based on 17 scientific articles from seven different countries, of which ten are quantitative, five qualitative and two mixed method articles where included. CINAHL, PubMed and Web of Science databases were used.Results: There are three categories that reflect the nurse's nursing measures: Education, Psychosocial support, Planning and treatment. Subcategories that are presented are Education about eczema, Individual adaptation, Workshop, Supporting resources, Continuity and easy accessibility, Engaging and involving, Nursing planning, Improvement work. The literature review shows an improvement in quality of life and clinical outcomes when the nurse was involved and had an increased responsibility for the patient.Conclusion: The nurse has a significant role in the patient's eczema care. The nurse contributed with individually tailored information, educational efforts and an increased understanding of the patient's situation, which contributed to better eczema care. Digital tools proved to be useful for both the patient, the nurse and they were also resource efficient. Treatment based on a holistic view and evidence are needed to meet the patient's needs. The nurse needs to gain increased knowledge to be able to contribute with good and safe eczema care in outpatient and inpatient care.

Bakgrund: Urinläckage är en vanligt förekommande komplikation efter behandling av prostatacancer, som är den vanligaste cancerformen i Sverige. Det finns flera olika behandlingsalternativ där kunskap om risken för komplikationer behövs för att öka patienternas delaktighet inför behandlingsvalet. Syfte: Att jämföra skillnad i självrapporterad förekomst och självgraderad omfattning av urinläckage mellan män med prostatacancer som genomgått yttre strålbehandling enskilt eller yttre strålbehandling i kombination med kirurgi. Metod: En jämförande tvärsnittsstudie som hämtat data från en tidigare datainsamling på fyra olika strålbehandlingskliniker där deltagarna besvarat enkäter. I föreliggande studie analyserades svaren på utvald studiespecifik fråga gällande urinläckage. Huvudresultat: Det förelåg inte någon signifikant skillnad varken gällande självrapporterad förekomst eller självgraderad omfattning av urinläckage mellan män med prostatacancer som genomgått yttre strålbehandling enskilt eller yttre strålbehandling i kombination med kirurgi. Slutsats: Trots icke signifikant skillnad gällande förekomst och omfattning av urinläckage ansågs resultatet betydelsefullt för sjuksköterskans omvårdnadsarbete och patientens delaktighet. / Background: Urinary leakage is a common complication after treatment for prostate cancer, which is the most common form of cancer in Sweden. There are several different treatment options where knowledge of the risk of complications is needed to increase patients' participation infront of treatment choice. Aim: To compare the difference in self-reported occurrence and self-rated extent of urinary leakage between men with prostate cancer who received external radiotherapy only or external radiotherapy combined with surgery. Method:A comparative cross-sectional study where data has been selected from a previous data collection at four different radiotherapy clinics where the participants answered questionnaires. In the present study, the answers to selected study-specific questions regarding urine leakage were analysed. Main results: There was no significant difference in either self-reported occurrence or self-rated extent of urinary leakage between men with prostate cancer who received external radiotherapy only or external radiotherapy combined with surgery. Conclusion: Despite a non-significant difference regarding the occurrence and extent of urine leakage, the result was considered important for the nursing care and the patient’s participation.