Palliativ vård syftar till att främja livskvalitet för personer med livshotande sjukdom och deras närstående. Patientens fysiska, psykosociala och andliga problem ska lindras. Dessutom ska närstående stöttas genom sjukdomstiden och det sorgearbete som följer. Den palliativa vården vilar på de fyra hörnstenarna symtomlindring, kommunikation, teamarbete och närstående. Närstående har en naturlig roll inom den palliativa vården och deras behov ska uppmärksammas. EAPC’s definition av palliativ sedering beskriver en kontrollerad sänkning av medvetandet för att lindra svårbehandlade symtom. Sjuksköterskans ansvarsområde vid palliativ sedering innebär bland annat att värna patientens välbefinnande men även att informera och stötta närstående under döendeprocessen. Kunskap om hur närståendes erfarenheter vid palliativ sedering behövs för att deras behov ska kunna synliggöras och tillmötesgås.       Syftet med denna studie var att belysa närståendes erfarenheter av palliativ sedering inom palliativ vård. Metoden som valdes var systematisk litteraturstudie. Inklusionskriterierna var att artiklarna skulle vara peer reviewed, skrivna på engelska och inte äldre än 15 år Litteratursökningar i databaserna PubMed, CINAHL, PsychINFO och MEDLINE resulterade i 12 inkluderade artiklar, samtliga etiskt godkända och kvalitetsgranskade. Data analyserades sedan med innehållsanalys.   Resultatet består av de fyra kategorierna symtomlindring, kommunikation, teamarbete och närstående. Närstående upplevde själva lindring då patientens lidande lindrades. De plågades av det faktum att de inte längre kunde kommunicera med patienten efter att sedering påbörjats. Även om de samtyckt till den palliativa sederingen funderade de i efterhand på vem den gynnat. Den emotionella påverkan hos närstående var stor och de upplevde mycket oro.   Slutsatsen av denna studie är att de flesta närstående är nöjda med den palliativa sederingen men situationen är mycket påfrestande för dem. De tar svåra beslut och upplever mycket oro och lidande. Kommunikation med och stöd från vårdpersonal är därför viktigt. Sårbara närstående bör identifieras och erbjudas ytterligare stöd. / Palliative care aims to improve the quality of life for people with terminal diseases and their relatives. Physical, psychosocial and spiritual problems of the patient shall be prevented and relieved. Additionally, relatives should be supported throughout the illness and the mourning that follows. Palliative care rests upon the four cornerstones symptom relief, communication, team work and relatives. Relatives have a natural role within palliative care and their needs should be payed attention to. EAPC’s definition of palliative sedation describes a controlled decrease of consciousness to relieve intractable symptoms. The nurses responsibility during palliative sedation includes protecting the patients well-being, as well as informing and supporting relatives during the dying process. Knowledge about relatives’ experiences during palliativ sedation is required in order for their needs to be made visible and accomodated.    The aim of this study was to illuminate the relatives’ experiences of palliative sedation within palliative care.    The systematic review method that was utilized in this study. The inclusion criterion was that the articles were to be peer reviewed, written in English and not more than 15 years old. The serches for articles were conducted in the databases PubMed, CINAHL, PsychINFO and MEDLINE. It resulted in 12 included studies, all of which had an ethical approval and were quality controlled. Data was then analyzed with content analysis.   The result consists of the four categories symptom relief, communication, team work and relatives. Relatives experienced relief when the patiens suffering was alleviated. They suffered because they could no longer communicate with the patient after sedation had started. Even though they had given their consent to the palliative sedation, afterward they thought about who it had favoured. The emotional impact on the relatives was great and they experienced a lot of anxiety.   In conclusion, most relatives are pleased with the palliative sedation but the situation is very distressing for them. They make difficult decisions and experience a lot of anxiety and suffering. The communication with and support from health professionals is therefor vital. Vulnerable relatives should be identified and offered additional support.

This thesis deals with rights and responsibilities of nurses at performance of medical profession. The theoretical part summarizes basic terms regarding the given issue.The first aim of this thesis was to map fields of rights and responsibilities of nurses at performance of their medical profession. The second aim was to evaluate an area of respecting the rights and responsibilities of nurses at performance of medical profession. The next step was to determine five research questions processed in detail in the practical part of the thesis.For answering these research questions four hypotheses were determined. These were also processed in the practical part of the work.The research was done by qualitative quantitative method. Research for the qualitative part was done according to the structured interview by open questions. Research for the quantitative part was done by a method of enquiry using an anonymous questionnaire. Research set for the qualitative part consisted of head nurses of medical institutes of Southern and Western region of the Czech Republic. The results of the research of qualitative and quantitative part are processed in detail in a practical part of the thesis. The interviews carried out with respondents in the qualitative part were rewritten and every answer was subsequently processed into schemes for clear arrangement. The results of quantitative part were statistically elaborated in SPSS program into tables.Each hypothesis was statistically proved. The results of the research could help to reveal the gaps in the field of rights and responsibilities of nurses at performance of medical profession. They can be used not only by lead management of medical organization for motivation and support of nurses but also for quality improvement in the fields of rights and responsibilities of nurses and other medics.

Background: About 17 million people die of cardiovascular disease in the world each year, of which almost 25% are sudden cardiac death. Cardiovascular disease deaths are a global public health problem. Although cardiovascular disease mortality has decreased in recent years, cardiovascular disease is still the dominant cause of death in Europe for both men and women. Coronary heart disease is one of the common types of Cardiovascular diseases that can in some untreated cases lead to heart attack. Changes in mortality are explained by changes in lifestyle such increased physical activity, healthy diet and improvement in treatment strategies. Physical inactivity is one of the many risk factors for coronary heart disease. The disease can be prevented by för instance engaging in physical activities. Aim: The purpose of the study was to describe what factors affect nurses' work in motivating cardiac and coronary heart disease patients to physical activity. Method /Design: A literature review was conducted based on both qualitative and quantitative articles. Results: Three main themes and seven sub themes were identified; Nurses 'approach, nurses' knowledge and external factors. Increasing the nurse's knowledge and skills, communication and attitudes, person-centred work, health education, use of various tools as well as lack of time and resources in the behaviour change process played an important role in nurses health promotion work in motivating patients with cardiac and coronary heart disease to physical activity. Conclusion: Nurses' encourage health promotion by motivating patients with coronary heart disease to physical activity and lifestyle change on various factors. It has been found that these factors have both positive and negative effects on the patient's behaviour change process. Nurses' knowledge, nurses’ approach and other external factors are of great importance for directly affecting the patient's process of lifestyle change. / Cirka 17 miljoner personer dör i hjärt-kärlsjukdomar i världen varje år, varav nästan 25% är plötslig hjärtdöd. Dödsfall i hjärt-kärlsjukdomar är ett globalt folkhälsoproblem. Trots att dödlighet i hjärt-kärlsjukdomar har minskat de senaste åren är hjärt-kärlsjukdomar fortfarande den dominerande dödsorsaken i Europa för både män och kvinnor. Kranskärlsjukdomar är en av de vanliga typerna av hjärt-kärlsjukdomar som kan vid obehandlade fall leda till hjärtinfarkt. Förändringar i dödlighet förklaras av förändringar i levnadsvanor såsom ökad fysisk aktivitet, hälsosam kost och förbättring i behandlingsstrategier. Fysisk inaktivitet är en av många riskfaktorer för kranskärlssjukdomar. Den är relaterade till livsstil som går att påverka.

Bakgrund: Barns grundläggande språkkunskaper utvecklas under förskoleåldern (2-6år) och de befinner sig under denna period i ett språkfönster då språkutvecklingen är inne i en gynnsam fas. Upptäcks barn med språksvårigheter och får rätt insatser under denna period förbättras förutsättningarna för barnets fortsatta språkutveckling. Det är barnhälsovården och BHV-sjuksköterskans ansvar att upptäcka barn med atypisk språkutveckling, detta arbete sker genom upprepade språkbedömningar och språkscreeningar under tiden då barnet deltar i barnhälsovårdens verksamhet (0-6år). Syfte: Syftet med studien var att beskriva BHV-sjuksköterskors erfarenheter av att arbeta med barns språkutveckling inom barnhälsovården. Metod: En induktiv ansats valdes där datamaterialet analyserades med kvalitativ innehållsanalys. Åtta intervjuer genomfördes med BHV-sjuksköterskor. Resultat: Ur analysen av datamaterialet framträdde tre kategorier såsom; upptäcker barn med atypisk språkutveckling, samarbetar med föräldrar och använder evidensbaserat screeningsverktyg med sex tillhörande underkategorier. Konklusion: I studien framkommer att BHV-sjuksköterskorna upplever ett stort ansvar i att upptäcka barn med atypisk språkutveckling. Detta för att barn med språksvårigheter får bättre förutsättningar om insatser startar i tidig ålder. Föräldrar upplevs sakna förståelse för barnets språkutveckling och vilken betydelse språket har för barnet. BHV-sjuksköterskorna försöker skapa kunskap och förståelse för barnets språkutveckling hos föräldrarna då de har en central roll i barnets utveckling. / Background: Children's basic language skills develop during the preschool age (2-6 years) and are at this time in a positive progress of language development. If children with language difficulties are detected and gets the right support during this period of time it improves the conditions for the child’s language development. It is the Child health care nurse’s responsibility to identify children with deviant language development. Aim:  The aim of the study was to describe Child health care nurses´ experience of working with children´s language development in Child health centre. Method: An inductive approach was chosen where data was analyzed using qualitative content analysis. Eight interviews were conducted with Child health care nurses. Results:  Three categories emerged from the analysis; detects children with deviant language development, collaborates with parents and use evidence-based screening instrument with six subcategories included.   Conclusion: It emerges from the study that Child health care nurses´ experience a major responsibility to detecting children with deviant language development. This is because children with language difficulties get better prerequisites if insertion starts at early age.  Child health care nurses perceive lack of understanding from parents regarding the child´s language development and the importance of language for the child.