Este estudo objetiva analisar as representações sociais da aids produzidas por enfermeiras atuantes em dois níveis distintos de atenção aos sujeitos que vivem com HIV/Aids e suas implicações para o cuidado desenvolvido por esse grupo profissional. Trata-se de um estudo exploratório-descritivo, pautado na abordagem qualitativa, orientado pela Teoria das Representações Sociais, em sua abordagem processual. Os sujeitos do estudo foram enfermeiras, atuantes em instituições públicas de saúde da cidade do Rio de Janeiro, sendo 10 da rede hospitalar e 9 da rede básica. A coleta de dados deu-se por meio de um roteiro de entrevista semi-estruturada e um questionário de caracterização. Para a análise dos dados foi utilizada a técnica de análise lexical, realizada pelo software Alceste 4.10. Na análise do grupo total de sujeitos foram definidas seis categorias: "Memórias sócio profissionais de enfermeiras sobre o HIV/Aids", abordando os atores sociais atingidos pela aids no passado e na atualidade, as memórias das enfermeiras sobre aids e os estereótipos presentes em cada período; "O cuidado relacionado à autoproteção ao HIV/Aids", referindo-se as medidas de proteção ao HIV/Aids adotadas pelas enfermeiras tanto em suas vidas profissionais quanto pessoais; "Dimensões práticas do atendimento e do cuidado", destacando elementos do cotidiano assistencial, com ênfase nas diferentes formas de compreensão do cuidado; "As famílias atingidas pela aids", com conteúdos relativos às vivências das enfermeiras em situações da aids no contexto familiar; "As políticas públicas e instituicionais e a aids", relativa as percepções das enfermeiras sobre as políticas de saúde; "O tratamento medicamentoso do HIV/Aids", com conteúdos relativos às dificuldades percebidas para a adesão ao tratamento medicamentoso por parte dos sujeitos com HIV/Aids. A análise cruzada da variável nível de atenção permitiu observar que a representação da aids no grupo de enfermeiras da rede hospitalar encontra-se ancorada em elementos negativos relativos ao passado, embora apontem também para novos elementos representacionais no presente; enquanto as enfermeiras de rede básica representam a aids a partir de elementos relativos à prática assistencial cotidiana. A representação da aids para o grupo de enfermeiras estudado abarca elementos tais como: sentimento de insegurança em relação ao próprio parceiro, devido a situações que vivenciam, imagem dos sujeitos que vivem com HIV/Aids em transição devido às mudanças ocorridas no perfil epidemiológico; atitudes distintas no campo profissional, relacionadas às formas de contágio e persistência de identificação dos sujeitos que vivem com HIV/Aids como vítimas ou culpados. Apesar de afirmarem inexistir diferenças no cuidado de enfermagem às pessoas que vivem com o HIV/Aids quando comparado ao cuidado aos sujeitos com outras patologias, enfatizam a necessidade de maior cautela devido ao risco de contágio em relação aos primeiros, caracterizando uma contradição no discurso. Conclui-se que existem diferenças nas representações sociais das enfermeiras de acordo com o nível de atenção no qual atuam e que há repercussões singulares na forma que o cuidado de enfermagem é desenvolvido, a partir dessas representações. / This study intends to analyze social representations of AIDS produced by nurses working in two distinct levels of care for individuals living with HIV/AIDS and its implications for nursing care developed by these professionals. This is an exploratory descriptive study, based on a qualitative approach, guided by the theory of social representation as procedural approach. The study participants were nurses working in public health institutions in the city of Rio de Janeiro, 10 of them on the hospital network and 9 of them on basic network. Data collection was performed by a roadmap for semi-structured interviews and a characterization questionnaire. Lexical Analysis technique was used, performed by the software Alceste 4.10. In the analysis of the general group, six categories of analysis emerged: "Social-Professional memories of nurses about HIV/AIDS", addressing social actors affected by AIDS in the past and at present, the memories of the nurses about AIDS and the stereotypes; "The care related to self-protection from HIV/AIDS", referring to the protective procedures adopted by nurses in their lives both professionally and personally against HIV/AIDS, "Practical Dimensions of treatment and nursing care, bringing elements of daily care, especially for different forms of understanding care; "Families affected by AIDS," with content relating to the experiences of nurses with AIDS cases in the family context, "Public, institutional policies and AIDS", with contents relating to how policies health are perceived by nurses, "Drug treatment of HIV/AIDS", with content related to perceived difficulties in adherence to drug treatment by individuals with HIV/AIDS. The analysis of the variable "area of attention" permitted to observe that the representation of AIDS among nurses working at hospital network is anchored in negative elements related to the past, although it also points to new representational elements at present; basic network nurses represent AIDS from elements related to daily nursing care. It was possible to see that the representation of AIDS among the nursing staff studied encompasses elements such as feelings of insecurity about their own partner, because the situations they experience, transition in images of the subjects living with HIV/AIDS, due to changes in their epidemiological profile, different attitudes in the professional field related to forms of contagion and persistence on identification of individuals living with HIV/AIDS as victims or perpetrators. Despite claiming nonexistence of differences in nursing care for people living with HIV/AIDS care in relation to any other client, nurses emphasize the need for greater caution due to the risk of contagion, thus presenting a contradiction in their speech. Its possible to conclude that there are differences in social representations of nurses according to the level of attention to individuals who live with HIV/AIDS and that there are unique repercussions in the way nursing care is developed from these representations.

Kunskap om vårdmiljöns betydelse för patienten och dennes delaktighet i utformningen av miljön främjar välbefinnande hos patienten. I en personcentrerad omvårdnad är miljö en viktig komponent i människans läkeprocess. Syftet med denna studie var att beskriva upplevelsen av den fysiska och psykosociala vårdmiljön för kvinnor som opererades på dagkirurgisk avdelning på grund av bröstcancer från inskrivning till omedelbart innan sedering. Metoden var en kvalitativ, semistrukturerad intervjustudie. Strategiskt urval användes för att rekrytera informanter och åtta personer deltog. Kvalitativ innehållsanalys valdes för att utföra analys på intervjumaterialet. Studiens resultat visade att informanterna hade en positiv upplevelse av vårdmiljön på avdelningen. Beskrivningar av upplevelsen av den fysiska vårdmiljön på avdelningen varierade men var generellt positiv. Ren och trevlig miljö var betydelsefullt för informanternas upplevelse. En hemlik känsla upplevdes. Eget rum uppskattades högt av informanterna vilket förknippades med integritet. Det förekom dock upplevelser av brister i hur integriteten bevaras på grund av vårdmiljöns utformning, i synnerhet i det gemensamma väntrummet. Informanterna upplevde professionalism och kompetens hos personalen vilket skapade en känsla av trygghet och förtroende. Personalens goda arbetssätt och bemötande skapade en känsla av harmoni och trygghet vilket upplevdes som lugnande. Slutsatsen är att vårdmiljön på avdelningen påverkade informanternas upplevelse generellt positivt. Även om upplevelsen av den fysiska miljön på avdelningen inte beskrevs vara optimal vägde upplevelsen av den psykosociala vårdmiljön och det goda bemötandet upp informanternas helhetsupplevelse. / Knowledge about the importance of nursing environment and patients’ participation in its design promote patients’ well-being. In person centred care, environment is an important component of the human healing process. The aim of this study was to describe the experience of the physical and psychosocial nursing environment in women who underwent day surgery due to breast cancer from registration to immediately before sedation. The method used was qualitative semi structured interview study. Strategic selection was used to recruit informants where eight patients participated. Qualitative content analysis was chosen to analyse the data. The results showed that the informants had a positive experience of the nursing environment at the department. Described experiences in the physical nursing environment varied but were generally positive. Clean and friendly environment was important for the informants’ experience. A “just like home” experience was described. Having a private room was highly appreciated by the informants, which they associated with experienced integrity. However, there were experiences of deficiencies in how integrity was preserved in the common waiting room due to its design. Experienced professionalism and skills in the nursing staff resulted in a sense of security and trust. The nursing staff’s good working methods and patient treatment created a sense of harmony and security that was experienced as calming. In conclusion, the department’s nursing environment affected the informants' experience generally positive. Although the experience of the physical nursing environment was described as not optimal, experience of the psychosocial nursing environment and good patient treatment outweighed the informants' overall experience.

Abstract The goals: The goal of the present thesis is to describe the principles of safe identification of patients by a nurse and the application of the medicines with higher risk rate. Another goal is to define procedures for prevention of a confusion of an intervention, a location or a patient at the operation theatre and to characterize the hand hygiene procedures in healthcare. The next goal was to describe a programme of prevention and reduction of falls and decubiti in hospitalized patients. The last goal focuses on the oral and telephonic prescription of medicines, on the reporting of patient examination results, and on the procedure of patient handover. Eight research questions were set in relation to these goals. Methodology: A qualitative research method based on in-depth interviews was chosen to reach the goals of the thesis. The intentional choice method was chosen for the selection of the communication partners. The research was performed in three selected hospitals of the South Bohemia Region. 20 communication partners participated in the anonymous questioning. The in-depth interviews were performed with a head nurse, with a quality manager, with perioperative nurses, with nurses from a neurology department and an after-care department. Scientific contributions of the thesis: The research deals with the current safety problems of hospitalized patients. The scientific results of the research are intended for both, specialist and the general public. The research study could serve to hospital managements as a stimulus for the improvement of the safety in the healthcare provision system. The achieved findings and conclusions: Hospitalization always brings some risk to a patient. From the point of view of the minimizing of adverse events and damage to a patient healthcare staff need to identify a patient safely, to apply risky medicines in safe manners, to prevent adverse events in operations, to adhere to the hand hygiene and the barrier nursing techniques. The healthcare staff also have to proceed correctly in the oral or telephonic prescription of medicines, in reporting of patient examination results, and in the patient handover procedures. It is in also the interest of the healthcare staff to minimize the risk of falls and to prevent the occurrence of decubiti in hospitalized patients.

Gastrostomy is one of the access routes enabling enteral nutrition support to children with eating disorders. It is a method of choice in situations where real assumption of enteral feeding by a nasogastric probe longer than six weeks exists and with undamaged functional digestive system. The possibility to perform enteral feeding outside health care facilities is the most advantageous aspect of gastrostomy for children and their parents. Optimum nursing care is one of the main preconditions of long term functional gastrostomy. This why suitable education of parents and their children in the nutrition support method is necessary. The aim of the work was to map awareness of the issues of gastrostomy in children patients among parents and to propose a unified educational programme aimed at easier insight into the issues. Qualitative research method was applied to the problems. The techniques of study of healthcare documentation and semi standardized interviews with respondents in their home environment were used for data collection. The results of the healthcare documentation studies, which defined the sample of the children with applied gastrostomy, were processed into graphic form for better transparency. The interviews with the respondents in the form of audio recording were transposed into written form and quantified by means of tables enabling the research conclusion to be drawn. The research results showed that practical training of gastrostomy treatment and awareness of possible complications and their solution was the weak point of the education. The above results have confirmed the necessity to elaborate a unique educational programme related to the issues of feeding tube insertion, the care for gastrostomy, support of food, medicines, and possible related complications in terms of learning the ability to prevent complications, identify and solve them.

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No. of bitstreams: 1 ramos_msm_me_bot.pdf: 1201718 bytes, checksum: 3e156114145adaf97a008a17d305b960 (MD5) Previous issue date: 2018-08-28 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / No contexto da prática assistencial hospitalar, percebe-se a despreocupação de se escolher o método de descontaminação, conforme o potencial de risco do material (não-crítico, semicrítico, crítico) em disseminar patógenos e, consequentemente, infecções cruzadas, empregado em cuidados de higiene de pacientes acamados. A contento, indiscriminadamente, bacias de banho têm sido submetidas à desinfecção de baixo nível, com álcool 70% p/v, aplicado por toda extensão por 30 segundos, após limpeza manual com água corrente e detergente neutro seguida de secagem. Contudo, há literatura recomendando para procedimentos de desinfecção intermediários e de baixo nível em superfícies lisas que o tempo de exposição ao álcool etílico ou isopropílico seja ≥ 60 segundos, nas concentrações de 60 a 90% p/v. Objetivo geral. Avaliar a eficácia do álcool 80% p/v, aplicado por 30 e 60 segundos, no processamento manual de bacias de banho inoxidáveis, após limpeza com água corrente e detergente neutro. Método. Estudo experimental randomizado, com delineamento anterior-posterior, unicego, realizado em centro único (Hospital Público do Estado de São Paulo), em unidade de internação, com média de 150 banhos mensais. Com poder de 80% e confiabilidade de 95%, estimou-se amostra mínima de 50 bacias igualmente distribuídas aleatoriamente em dois grupos: 25 no grupo 30s e 25 no grupo 60s, utilizando-se teste de proporções pareado (dois momentos). Testes microbiológicos antes e após às intervenções foram realizados para os dois grupos. O grupo 30s passou pela intervenção após esfregaço do álcool 80% p/v por 30 segundos e no grupo 60s por esfregaço do mesmo desinfetante por 60 segundos, conforme procedimento operacional padrão proposto. Resultados. Verificou-se eficácia relativa do álcool etílico 80% p/v na descontaminação manual no reuso de bacias de banho inoxidáveis, mesmo elevada de 60% para 64%, quando ampliado o tempo de aplicação de 30 para 60 segundos, após submetê-las à limpeza com água corrente e detergente neutro. Apesar de redução considerável de microrganismos hospitalares, após esfregaço de 30s (5,8 vezes), quanto no de 60s (8,3 vezes), a ação do desinfetante não foi suficiente para descontaminar 36% das bacias, elevando-se para 44% quando o tempo de intervenção foi 30s. Observou-se em ambos grupos maior prevalência de sobrevida de bactérias gram-negativas não fermentadoras, com destaque à Pseudomonas aeruginosa que, apesar de não apresentarem resistência múltipla, 14 cepas foram resistentes à carbapenases, sendo 11 ao imepenen e três ao meropenen. Conclusões. Bacias de banho no leito inoxidáveis descontaminadas para reuso com álcool 80% p/v após limpeza com água corrente e detergente neutro apresentam risco de infecção para pacientes, podendo desempenhar papel de fômites, incluindo cepas importantes para a vigilância, como possíveis produtoras de espectro estendido-beta lactamase (ESBL) e Klebsiella pneumoniae (KPC), Enterococcus Resistente à Vancomicina (VRE) e multirresistentes (resistente a um ou mais antimicrobianos de três ou mais classes). Produto. Relatório final de pesquisa enviado à Agência Nacional de Vigilância Sanitária (ANVISA) brasileira e à Comissão de Controle de Infecção Relacionada à Assistência à Saúde (CCIRAS) local, recomendando bacias de banho inoxidáveis reusáveis como materiais semicríticos, demandando desinfecção de alto nível ou substitui-las por banho no leito descartável. ABSTRACT Introduction. In the hospital care practice context, the lack of concern for choosing the decontamination method, according to the risk potential of the material (non-critical, semi critical, critical) in disseminating pathogens and, consequently, cross-infection, used in hygiene of bedridden patients. Indiscriminately, bath bowls have been subjected to low level disinfection with 70% w/v alcohol, applied for 30 seconds at all times, after manual cleaning with running water and neutral detergent followed by drying. However, there is a literature recommending for intermediate and low-level disinfection procedures on smooth surfaces that the time of exposure to ethyl or isopropyl alcohol is ≥60 seconds at concentrations of 60 to 90% w/v. General objective. To evaluate the efficacy of 80% w / v alcohol, applied for 30 and 60 seconds, in the manual processing of stainless bath bowls, after cleaning. General objective. To evaluate the efficacy of 80% w/v alcohol, applied for 30 and 60 seconds, in the manual processing of stainless bath bowls, after cleaning with running water and neutral detergent. Method. A randomized experimental study, with an anterior-posterior design, single-blind, performed in a single center (Public Hospital of the State of São Paulo), in an inpatient unit, with an average of 150 monthly baths. With 80% power and 95% reliability, a minimum sample of 50 basins was randomly distributed in two groups: 25 in the 30s group and 25 in the 60s group, using a paired proportions test (two moments). Microbiological tests before and after the interventions were performed for both groups. The 30s group underwent the intervention after 80% w/v alcohol smear for 30 seconds and in the 60s group by smearing the same disinfectant for 60 seconds, according to the proposed standard operating procedure. Results. Relative efficacy of 80% w/v ethyl alcohol in manual decontamination in the reuse of stainless bath basins, even from 60% to 64%, was verified when the application time was extended from 30 to 60 seconds, after subjecting them to cleaning with running water and neutral detergent. Despite a considerable reduction of hospital microorganisms, after 30s (5.8 times) and 60s (8.3 times) smear, the action of the disinfectant was not sufficient to decontaminate 36% of the basins, rising to 44% when the intervention time was 30s. A higher prevalence of non-fermenting gram-negative bacteria was observed in both groups, especially Pseudomonas aeruginosa, which, despite not having multiple resistance, 14 strains were resistant to carbapenases, 11 being imepenen and 3 being meropenen. Conclusions. 80% w / v alcohol reuse baths after cleaning with running water and neutral detergent present a risk of infection for patients, and may play a role of fomites, including strains important for surveillance, as possible producers of extended spectrum (ESBL) and Klebsiella pneumoniae (KPC), Vancomycin Resistant Enterococcus (VRE) and multiresistant (resistant to one or more antimicrobials of three or more classes). Product. Final research report sent to the Brazilian National Health Surveillance Agency (ANVISA) and the local Health Care-Related Infection Control Commission (CCIRAS), recommending reusable stainless bath basins as semi-critical materials, requiring high level disinfection or replacing them, by bathing them in the disposable bed. / Introduction. In the hospital care practice context, the lack of concern for choosing the decontamination method, according to the risk potential of the material (non-critical, semi critical, critical) in disseminating pathogens and, consequently, cross-infection, used in hygiene of bedridden patients. Indiscriminately, bath bowls have been subjected to low level disinfection with 70% w/v alcohol, applied for 30 seconds at all times, after manual cleaning with running water and neutral detergent followed by drying. However, there is a literature recommending for intermediate and low-level disinfection procedures on smooth surfaces that the time of exposure to ethyl or isopropyl alcohol is ≥60 seconds at concentrations of 60 to 90% w/v. General objective. To evaluate the efficacy of 80% w / v alcohol, applied for 30 and 60 seconds, in the manual processing of stainless bath bowls, after cleaning. General objective. To evaluate the efficacy of 80% w/v alcohol, applied for 30 and 60 seconds, in the manual processing of stainless bath bowls, after cleaning with running water and neutral detergent. Method. A randomized experimental study, with an anterior-posterior design, single-blind, performed in a single center (Public Hospital of the State of São Paulo), in an inpatient unit, with an average of 150 monthly baths. With 80% power and 95% reliability, a minimum sample of 50 basins was randomly distributed in two groups: 25 in the 30s group and 25 in the 60s group, using a paired proportions test (two moments). Microbiological tests before and after the interventions were performed for both groups. The 30s group underwent the intervention after 80% w/v alcohol smear for 30 seconds and in the 60s group by smearing the same disinfectant for 60 seconds, according to the proposed standard operating procedure. Results. Relative efficacy of 80% w/v ethyl alcohol in manual decontamination in the reuse of stainless bath basins, even from 60% to 64%, was verified when the application time was extended from 30 to 60 seconds, after subjecting them to cleaning with running water and neutral detergent. Despite a considerable reduction of hospital microorganisms, after 30s (5.8 times) and 60s (8.3 times) smear, the action of the disinfectant was not sufficient to decontaminate 36% of the basins, rising to 44% when the intervention time was 30s. A higher prevalence of non-fermenting gram-negative bacteria was observed in both groups, especially Pseudomonas aeruginosa, which, despite not having multiple resistance, 14 strains were resistant to carbapenases, 11 being imepenen and 3 being meropenen. Conclusions. 80% w / v alcohol reuse baths after cleaning with running water and neutral detergent present a risk of infection for patients, and may play a role of fomites, including strains important for surveillance, as possible producers of extended spectrum (ESBL) and Klebsiella pneumoniae (KPC), Vancomycin Resistant Enterococcus (VRE) and multiresistant (resistant to one or more antimicrobials of three or more classes). Product. Final research report sent to the Brazilian National Health Surveillance Agency (ANVISA) and the local Health Care-Related Infection Control Commission (CCIRAS), recommending reusable stainless bath basins as semi-critical materials, requiring high level disinfection or replacing them, by bathing them in the disposable bed. / FAPESP: 2426902

Introduktion: Smärta är en subjektiv känsla som endast den som upplever smärtan kan beskriva, men är något som nästan alla som genomgår ett kirurgiskt ingrepp upplever. Det finns olika typer av smärta och olika sätt att analysera och behandla den på. Bristfällig postoperativ smärtbehandling kan leda till svåra komplikationer och kan medföra stora kostnader för samhället och lidande för patienter. Syfte: I den här studien var syftet att med hjälp av vetenskaplig litteratur beskriva patienters upplevelser av postoperativ smärtlindring. Metod: Studien är gjord som en litteraturstudie med tio vetenskapliga artiklar vilka granskades med hjälp av innehållsanalys. Artiklar söktes via sökmotorerna PubMed och CINAHL. Resultat: Resultatet visade att patienter som var välinformerade om den postoperativa smärtbehandlingen både muntligt och skriftligt före och efter operationen, upplevde att de var mer nöjda med sin postoperativa smärtbehandling. Dessa patienter kände sig tryggare i att tillkalla sjukvårdspersonalen vid smärta och de upplevde att de var förberedda på postoperativ smärta redan innan operationen. Patienterna uppgav att ett bra bemötande från sjukvårdspersonalen hade en positiv inverkan på deras smärtupplevelse. Patienterna lyfte också fram aspekter som kunde förvärra patienternas upplevelse och beskrev då svårigheter att förmedla sin smärta, bristfällig information, ett dåligt bemötande med mera. Slutsats: Majoriteten patienter var nöjda med den postoperativa smärthandlingen men det fanns faktorer som påverkar upplevelsen till det sämre. För att förbättra möjligheten till en god postoperativ smärtbehandling är det viktigt att utveckla en arbetsmiljö för sjukvårdspersonal som tillåter ett gott bemötande och en tydlig kommunikation med patienter både före och efter operation. / Introduction: Pain is a complex and subjective experience, it is hard for any other else than the patient to understand it. All patients that undergo surgery will experience some sort of postoperative pain and therefore it is important to understand what pain is and what the patient goes through. Insufficient pain management could lead to postoperative complications that could be life threatening and increases the cost to society. Aim: The aim of this study was to examine the patient’s experiences of postoperative pain management. Methods: This study used a descriptive literature review. The searches were performed in the databases PubMed and CINAHL. Results: Results show that patients who were well-informed both pre- and postoperatively about the pain management were the most satisfied with their experience. Good communication and good treatment heightened the well-being of patients. Negative aspects could be communication difficulties and troubles describing the pain, lack of information and overstrained staff. Conclusion: The majority of patients were satisfied with their postoperative pain management but there were different things that had a negative influence on their experience. Improvements can be made, especially in the staffs’ individual behavior and in the organization as such.

Background: More than 200 million females worldwide live with some form of female genital mutilation [FGM]. While reinforcing social and cultural values for those, to whom the practice is normative, FGM also envelops psychological as well as physical lifelong consequences. Aim: This literature study aimed to describe women's experiences of living with female genital mutilation from a physical, psychological, social and cultural perspective. Method: A literature study was performed through collecting and analysing ten qualitative articles. The data consisted of narratives of migrant women that had undergone FGM and lived in Western societies. The analysis was performed according to Friberg's five-step-model. Results: Feelings of honour and shame were expressed in connection to FGM. FGM was understood to fortify belonging to cultural identities and establish social acceptance linked to cultural ideals of femininity. Emotional and physical pain made women feel incompleteness, challenging their social relationships, including sexual intimacy. Additionally, it was noted that healthcare professionals lack specific knowledge needed while caring for those women, leaving them hesitant in further seeking healthcare. Women's perception of FGM changed after migration. They experienced larger control over their lives but also insecurity towards the discontinuation of the practice. Conclusion: FGM and its implications were complex and resulted in consequences that affect women's life. Greater knowledge and understanding of FGM were identified as necessary on the healthcare system, strengthening and furthering the required support and information for women's health.

Bakgrund Endokardit är dagsläget en relativt sällsynt infektionssjukdom som drabbar hjärtat och framförallt hjärtklaffarna. I Sverige drabbas årligen cirka 500 personer och överlevnaden med adekvat behandling ligger på cirka 80-90%. Endokardit är ett komplext sjukdomstillstånd med ofta kräver expertis från många olika specialister. Vårdtiden är lång och inte sällan med olika former av komplikationer som följd. Syftet med studien var att beskriva omvårdnaden av patienter med endokardit från ett sjuksköterskeperspektiv.Metoden som användes var en kvalitativ metod med beskrivande design. Intervjuer med strategiskt ändamålsurval som använt sig av inklusions- och exklusions kriterier har genomförts. Sex sjuksköterskor från olika bakgrund, kön och arbetsplatser deltog i studien. Datan som framkom analyserades genom manifest innehållsanalys med till viss del latenta inslag.Resultatet visar informanternas beskrivning av omvårdnad kring patienter med endokardit ur ett sjuksköterskeperspektiv. Detta ses i resultatets tre huvud kategorier: Patientens förutsättningar, organisationens förutsättningar, sjuksköterskans förutsättningar. Alla kategorierna påvisar hur komplex omvårdnad kring denna patientgrupp är utifrån ett sjuksköterskeperspektiv. Slutsats av studien visar att begreppet omvårdnad är ett svårtolkat begrepp även för erfarna sjuksköterskor. Patienter med ett tidigare missbruk är en speciellt sårbar grupp att hantera, där behöver arbetet ske med tanke på deras missbruk samtidigt som behandlingen av endokardit fortgår. Hur väl omvårdnadsmässigt infektionsavdelningar i Mellansverige tar hand om och behandlar patienter med endokardit beror till stor del på vilka resurser sjukhuset har samt hur stor erfarenhet de sjuksköterskor som arbetar där har av att vårda patienter med endokardit. / Background endocarditis is a relatively uncommon diagnosis compared to other infectious diseases. Endocarditis affects the heart muscle but is mainly situated in the heart valves. In Sweden today about 500 persons are affected annually, with adequate treatment and care the survival rate is high within 80-90% of all cases. Endocarditis is a complex disease that requires treatment and care from multiple specialists, the time spent in hospital is long compared to other diseases and is often prolonged by complications of the treatment.The Aim of the study was to describe the caring of patients with endocarditis from a nurse’s perspective.The method used was a qualitative analysis using descriptive design, with the use of strategic purposeful sampling with help of inclusion and exclusions criterias. Six Nurses from different backgrounds, genders and workplaces participated in the interview study. The data analysis was conducted using manifest content analysis with some grade of latent analysis included.The Result showed how the informants of the study described caring for patients with endocarditis from a nurses point of view. This is explained by the three major categories: Patients conditions, The Organisations prerequisite and the Nursing staffs experienced and educational level. They all tell about the complexity of caring for patients with endocarditis.The Conclusion of the study showed that Nursing care and the term caring itself are terms that are somewhat hard to grasp because of their wide meaning in the Nursing community. Patients with predeveloped addiction to some sort of drug is a special group of patients to handle, especially when they are infected by endocarditis. Since they have to be cared for in their addiction as well as their infection. How well nurses on infections wards in Sweden care for patients affected by endocarditis depends a lot on what other resources the hospital has and on the experienced level of the nurses working there.

Home and outpatient nursing care about children suffering cystic fibrosis Cystic fibrosis is a serious autosomally recessive disease in European population. The disease affects lungs and the digestive system. Complex medical procedures have started to develop recently which improve the prognosis. Surrounding factors are also very important age, infection, nutrition, quality of medical and nursing care and above all, quality of home nursing care. CF is treatable today, nevertheless even with maximum care, using all available methods and processes, which modern medicine offers, it is unfortunately not curable. The task for modern medicine is mainly to reduce problems caused by this disease and to prevent worsening the problems. Care about breathing tubes is very important, as well as good nutrition, repression of infection and inflammation and treating complications. Nursing care about a child suffering cystic fibrosis is a topic including many problems it includes medicine, mental and social aspects. Parents and a team of specialists from an ambulance of cystic fibrosis are very important and their role of taking care about a diseased child is irreplaceable. The specialists, using their professional knowledge, help the parents to take care about the child well and at the same time react positively to the child´s needs. Their role of educating the parents and whole family is also irreplaceable. The mother or parents need someone to demonstrate specialized care of the child and to be able to try it themselves. They need support. In case the mother or parents and medical staff manage to cooperate well, we can reach requested results and satisfaction can be found on both sides.

This thesis focuses mainly on threats to the safety of nursing personnel. These include a high risk of injury when positioning and the risk of developing musculoskeletal disorders,which can lead to a long-term sickness of the member of the medical staff. The theoretical part is divided into four parts. The first part describes in particular the need for safety and security, as well as factors that have an influence on this human need.Attention is focused also on ensuring safety while providing nursing care, especially when positioning patients. In connection with safety during this activity, a section in this thesis is devoted to the kinaesthetic mobilization, which offers a slightly different view of the positioning and patient handling. In the last chapter of the theoretical part, findings concerning the prevention of damage to health nurses in providing nursing care are summarized. The thesis has three objectives that were formulated as follows. Objective 1: Determine whether nurses use kinaesthetic principles during a patient handling. Objective 2: Determine whether nurses, in their opinion, have enough equipment to ensure safety during patient handling and positioning. Objective 3: Map the causes of the use of inconsiderate patient positioning techniques. Based on these objectives, the research question and three hypotheses were set. Research question: What are the possibilities for improving patient handling and positioning within the nursing process? Hypothesis 1: The use of kinaesthetic depends on the type of department. Hypothesis 2: Nurses use bad positioning techniques despite their knowledge that they can harm their health and also patient's. Hypothesis 3: Lack of time is the most common cause of the use of the inconsiderate method of positioning. In order to fulfil the objectives, a quantitative research, for which we choose the questionnaire method of data collection, was conducted. The questionnaires were designed for nurses working in the department of surgery, internal medicine and the department of aftercare. The survey was carried out in 7 hospitals of South Bohemia. In total, 340 questionnaires were distributed into these hospitals.The final research sample, therefore, consisted of 209 completed questionnaires. The rate of return was 61%. The obtained data were processed and analysed using Microsoft Excel 2013, then analysed statistically using the chi-square test. The results were processed into graphs. Based on the results, we can conclude that the hypothesis 1 is confirmed. We found that kinaesthetic is used most in aftercare departments. On the contrary, surgery departments use it the least. This is probably due to a different composition of patients on these wards.Hypothesis 2 was, for testing purposes, divided into two working hypotheses. H2a: 60 % nurses know that classical principles of positioning can damage their health. This hypothesis has been disproved. A corollary is HA: Knowledge of nurses about the risk of an injury is not 60%. The research has also revealed that almost three quarters (74 %) of the nurses know that positioning can damage their health. The second part of the hypothesis 2, i.e. H2b: 60 % nurses know that the classical principles of positioning can damage the health of the patient, has also been refuted, and thus applies HA: Knowledge of nurses about the risk of an injury to the patient is not 60%. The results of the survey showed that only 24 % nurses consider the classic method of positioning a risk to patient's health. Hypothesis 3 was, through our research survey, refuted. Sisters see the most frequent reason for using the inconsiderate positioning procedure in the lack of staff.We managed to answer the research question by analysing literature in the theoretical part and performing the survey in the practical part of this thesis.An output of this thesis will be an expert article published in a professional journal and a presentation at a professional conference