Bakgrund  Parkinsons sjukdom är en kronisk neurodegenerativ sjukdom som leder till gradvis försämring av både fysiska och psykiska funktioner. Orsakad av nedbrytning av dopaminproducerande nervceller, särskilt i en del av hjärnan som kallas substantia nigra, resulterar sjukdomen i rörelsestörningar, koncentrationssvårigheter, sömnproblem samt förändringar i både humör och kognitivt beteende. Behandlingen fokuserar på att lindra symtomen, främst genom att ersätta bristen på dopamin med medicinering och ibland djup hjärnstimulering. Sjuksköterskor spelar en viktig roll genom att erbjuda stödjande vård och utbildning till både patienter och deras anhöriga, med fokus på att främja välbefinnandet och självständigheten hos personer med Parkinsons sjukdom.  Syfte  Syftet var att belysa personers upplevelser av att leva med Parkinsons sjukdom.  Metod  En icke-systematisk litteraturöversikt där 14 vetenskapliga originalartiklar från databaserna PubMed och CINAHL inkluderades. Artiklarna bestod av både kvalitativa och kvantitativa ansatser. Artiklarna genomgick kvalitetsgranskning utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Resultatet sammanställdes med integrerad dataanalys för att besvara syftet.  Resultat  I sammanställningen av resultatet identifierades tre huvudkategorier: fysiska upplevelser, psykiska upplevelser och psykosociala upplevelser. Resultatet visade Parkinsons sjukdom påverkar primärt motoriska funktioner men har även betydande konsekvenser för personers psykiska och sociala välbefinnande. Dessutom presenteras strategier för att hantera sjukdomen och hur personer anpassar sig till livet med Parkinsons sjukdom.  Slutsats  Denna litteraturöversikt undersöker hur personer med Parkinsons sjukdom upplever sjukdomen och de utmaningar som tillkommer. Det framkommer att de möter fysiska, psykiska och psykosociala utmaningar, ofta med flera symtom samtidigt, såsom nedsatt fysisk funktion, kommunikationsproblem och isolering. Trots detta utvecklar de strategier för att hantera vardagen och upprätthålla livskvaliteten. Studien betonar vikten av att sjuksköterskor förstår dessa strategier för att kunna ge anpassat stöd och vård, samt att ökad medvetenhet och kunskap är avgörande för att erbjuda personcentrerad vård. / Background  Parkinson's disease is a chronic neurodegenerative condition characterized by the gradual deterioration of both physical and mental functions. Caused by the breakdown of dopamine-producing nerve cells, particularly in a region of the brain known as the substantia nigra, the disease manifests in motor disturbances, difficulties with concentration, sleep disturbances, and changes in mood and cognitive behavior. Treatment focuses on reducing symtoms, primarily by replacing the dopamine insufficiency through medication and occasionally deep brain stimulation. Nurses play a crucial role by providing supportive care and education to both patients and their families, with an emphasis on promoting the well-being and independence of individuals with Parkinson's disease.  Aim  The aim was to illuminate individuals' experiences of living with Parkinson's disease.  Method  A non-systematic literature review incorporating 14 scientific original articles from the databases PubMed and CINAHL was conducted. The articles include both qualitative and quantitative approaches. They underwent quality assessment based on the evaluation criteria provided by Sophiahemmet University College for scientific classification and quality. The findings were synthesized using integrated data analysis to address the aim.  Results  In the compilation of the results, three main categories were identified: physical experiences, psychological experiences, and psychosocial experiences. The findings revealed that Parkinson's disease primarily affects motor functions but also has significant implications for individuals' mental and social well-being. Additionally, strategies for managing the disease and how individuals adapt to life with Parkinson's disease are presented.  Conclusions  This literature review examines how individuals with Parkinson's disease experience the illness and the challenges that come with it. It reveals that they face physical, psychological, and psychosocial difficulties, often experiencing multiple symptoms simultaneously, such as reduced physical function, communication issues, and isolation. Despite these challenges, individuals develop strategies to manage daily life and maintain their quality of life. The study emphasizes the importance of nurses understanding these strategies to provide tailored support and care. Additionally, increased awareness and knowledge are crucial for delivering person-centered care.

Bakgrund: Anorexia nervosa är ett psykiatriskt tillstånd som påverkar det fysiska och psykiska välmåendet. Tillståndet är svårbehandlat på grund av låg sjukdomsinsikt hos patienter, och den allvarligaste komplikationen av sjukdomen innebär döden. Anorexia nervosa påverkar inte bara patienten som drabbas, men också patientens närstående och anhöriga. Sjukdomen kräver att sjuksköterskor besitter kunskap om hälsa som helhet och att de har ett personcentrerat förhållningssätt. Syfte: Att undersöka sjuksköterskors upplevelser i omvårdnaden av patienter med anorexia nervosa. Metod: Arbetet var en litteraturstudie som utformades efter Polit och Becks niostegsmodell. Tio artiklar analyserades enligt Elo och Kyngäs analysmetod. Resultat: Sex underkategorier framställdes som sedan sammanfattades i två kategorier: Etisk stress och skapande av vårdrelationer. Vidare utvecklades en huvudkategori: Utmaningar med personcentrerad omvårdnad. Slutsats: Litteraturstudien visade att sjuksköterskor upplever utmaningar i den personcentrerade omvårdnaden av patienter med anorexia nervosa. Dessa utmaningar relaterar till sjuksköterskors etiska stress och utmaningar i skapandet av vårdrelationer. Fortsatt forskning: Ytterligare forskning behövs om sjuksköterskors upplevelser av deras ansvar för omvårdnaden av patienter med anorexia nervosa samt vilka hälsofrämjande metoder som bör prioriteras i vården av dessa patienter. / Background: Anorexia nervosa is a psychiatric condition that affects the physical and mental well- being. The condition is tough to treat because of a low insight of the disease among patients, and the most serious complication is death. Anorexia nervosa does not only affect the patient, but family and friends of the patient too. The disease requires that nurses possess knowledge of health as a whole and that they have a person-centered approach. Aim: To investigate nurses’ experiences in caring for patients with anorexia nervosa.Method: The work was a literature study designed according to Polit and Beck's nine-step model. Ten articles were analyzed according to Elo and Kyngäs’ analysis method. Result: Six subcategories were developed that were summarized into two categories: Ethical stress and establishing care relationships. Furthermore, a main category was developed: Challenges with person- centered nursing. Conclusion: The literature study showed that nurses experience challenges in the person-centered care of patients with anorexia nervosa. These challenges relate to nurses' ethical stress and challenges in establishing caring relationships. Further research: Further research is required regarding nurses' experiences of their responsibility in caring for patients with anorexia nervosa and which health promoting methods should be prioritized in the care of these patients.

Bakgrund: Endometrios är en kronisk och inflammatorisk östrogenberoende sjukdom som drabbar var tionde kvinna i fertil ålder. Ur ett världsperspektiv motsvarar detta 190 miljoner kvinnor. Sjukdomen medför vanligen smärta i form av dyspareuni, dysmenorre och bäckensmärta men kan även orsaka psykisk ohälsa samt infertilitet. Försening av diagnossättning är standard vid endometrios och 5-7 år är den genomsnittliga tiden i Sverige. Eftersom att denna patientgrupp förekommer hos diverse vårdgivare är kompetens gällande ämnet nödvändig för att uppnå vård av god kvalitet. Syfte: Litteraturstudiens syfte var att sammanställa kvinnors upplevelser av endometriosrelaterad smärta. Metod: En litteraturstudie med kvalitativ ansats utfärdades där tio empiriska primärstudier inhämtades från databaserna Cinahl och Pubmed. En kvalitetsgranskning utfördes med utgångspunkt i SBU:s granskningsmall. Därefter genomfördes en analys som utmynnade i resultatet. Resultat: Fyra huvudkategorier och nio subkategorier identifierades. Huvudkategorierna benämns som följande: “Smärtans uttryck i kropp och sinne”, “Smärtans begränsningar i nutid och framtid”, “Konsekvenser av att inte erhålla adekvat vård” och “Smärtans påverkan på relationer”. Konklusion: Endometrios skapar en ensam tillvaro i många kvinnors fall. Smärtan resulterade i att kvinnorna isolerade sig och fick svårigheter att tillgodose sina dagliga behov samtidigt som omgivningen kunde bemöta dem med misstro. Personcentrerad vård är ett nödvändigt förhållningssätt inom vården av dessa kvinnor. Detta då patienten får möjlighet att delta i sin vård, bli tillgodosedd i sina psykosociala samt fysiska behov och vårdas ur ett helhetsperspektiv där samtliga livsaspekter beaktas. En multiprofessionell teamsamverkan med adekvata resurser ger goda förutsättningar för detta. Ett behov av ökad kunskap bland sjuksköterskor kan identifieras för att kunna förbättra vården för dessa kvinnor. / Background: Endometriosis is a chronic and inflammatory estrogen-dependent disease that affects one in ten women of childbearing age. From a world perspective, this corresponds to 190 million women. The disease frequently causes pain in the form of dyspareunia, dysmenorrhoea, and pelvic pain, as well as mental illness and infertility. Diagnostic delay is standard for endometriosis and 5-7 years is the average time for diagnosis in Sweden. Since this patient group occurs with various healthcare providers, competence regarding the subject is necessary for a care of good quality. Aim: This study aimed to compile women's experiences of endometriosis-related pain. Method: A literature study with a qualitative approach was issued where ten empirical primary studies were obtained from the databases Cinahl and Pubmed. A qualitative review was carried out based on SBU's review template. An analysis was later carried out which led to the result. Results: Four main categories and nine subcategories were identified. The main categories are named as followed: "Expressions of pain in body and mind", "Limitations of pain in the present and future", "Consequences of not receiving adequate care" and "The impact of pain on relationships”. Conclusion: Endometriosis creates a lonely existence for many women. The affected women expressed isolation and difficulties to meet their daily needs, related to the pain, while being treated with disbelief from their surroundings. Person-centered care is a necessary approach in the care of these women. This gives the patient an opportunity to participate in their care, have their psychosocial and physical needs met and to be cared for from a holistic perspective. A multi-professional team collaboration with adequate resources enables this. A need for increased knowledge among nurses can be identified in order to improve the care for these women.

SAMMANFATTNING Bakgrund: Ett barns död berör hela familjen, och utgör en svår upplevelse för föräldrarna, oavsett om dödsfallet är förväntat eller plötsligt. Familjecentrerad vård inkluderar hela familjen och innebär att sjuksköterskan stödjer föräldrarna i deras omsorgsroll och bekräftar föräldrarnas betydelse för barnets välbefinnande.   Syfte: Att beskriva föräldrars upplevelse av sorg samt vilka familjecentrerade omvårdnadsåtgärder som kan påverka deras förmåga att bearbeta sitt barns död     Metod: Kvalitativ litteraturstudie med induktiv ansats. Data bestående av 20 vetenskapliga artiklar samlades in och analyserades utifrån Evans metod, genom att nyckelfynd i artiklarna urskiljdes och sammanfogades i teman och subteman. Analysen av artiklarna resulterade i fyra teman, varav ett av temana delades upp i fyra subteman.   Resultat: Förlusten av deras barn framkallade en avgrundsdjup sorg hos föräldrarna. Genom att bygga upp en förtroendefull och god vårdrelation med föräldrarna kunde sjuksköterskan underlätta deras bearbetning av sorgen. Ett empatiskt bemötande samt ärlig och tydlig information från sjuksköterskan var grundläggande faktorer i att skapa en sådan relation, liksom att föräldrarna gavs stöd och en möjlighet till delaktighet i barnets omvårdnad. Föräldrarna uppskattade även att sjuksköterskan hjälpte till att skapa minnessaker efter barnet, som till exempel hand- och fotavtryck.   Slutsats: Vårdrelationen mellan sjuksköterskan och föräldrarna var bland det viktigaste för att hjälpa föräldrarna att hantera förlusten av och sorgen efter barnet. Bemötande, stöd, information och kommunikation samt delaktighet var faktorer som kunde stärka eller försvaga relationen, beroende på sättet de levererades på. / ABSTRACT Background:  The death of a child affects the whole family, and is a difficult experience for the parents, regardless of whether the death is expected or sudden. Family-centred care includes the whole family and means that the nurse supports the parents in their caring role and confirms the parents' importance to the child's well-being.    Objective:  To describe parents' experience of grief and which family-centered care interventions can affect their ability to process their child's death   Method: Qualitative literature review with an inductive approach. Data consisting of 20 scientific articles were collected and analyzed based on Evans' method, by distinguishing key findings in the articles and merging them into themes and subthemes. The analysis of the articles resulted in four themes, of which one of the themes was divided into four subthemes    Results: The loss of their child provoked an abysmal grief in the parents. By building up a trusting and good care relationship with the parents, the nurse was able to facilitate their processing of the grief. An empathetic approach and honest and clear information from the nurse were fundamental factors in creating such a relationship, as well as that the parents were given support and an opportunity to participate in the child's care. The parents also appreciated that the nurse helped to create memorabilia of the child, such as handprints and footprints.   Conclusion: The care relationship between the nurse and the parents was among the most important in helping the parents deal with the loss of and grief after the child. Approach, support, information and communication as well as participation were factors that could strengthen or weaken the relationship, depending on the way they were delivered.

Introduktion: Verksamhetsförlagd utbildning (VFU) är en viktig del av sjuksköterskeutbildningen och ger studenterna möjlighet att tillämpa teori till praktik. Relationen mellan student och handledare samt patientens medverkan spelar stor roll för studenters lärande och patienters upplevelser. Relationen mellan student och patient kan kopplas till Hildegard Peplau´s omvårdnadsteori “Interpersonel relations model” som beskriver olika roller som sjuksköterskan agerar efter. Syfte: Syftet var att undersöka patienters upplevelser av att vårdas av sjuksköterskestudenter  Metod: En litteraturöversikt med beskrivande design användes som metod. Resultatet baserades på tio kvalitativa vetenskapliga artiklar Resultat: Patienterna upplevde studenternas vård som både positiv och negativ. Avgörande för en positiv respektive negativ patientupplevelse var ofta patient-student relationen. En dålig patient-student relation innebar att patienterna upplevde studenterna som blyga, stressade, negativa samt att de hade brist på kunskap. Patient-student relation påverkades positivt då patienterna ansåg att studenterna var närvarande och intresserade. Resultatet visade att studenternas attityd spelade roll då studenterna som var osäkra hade negativ effekt på patienterna medan studenterna som var självsäkra istället hade en trygghetsingivande effekt. Vidare visade resultatet att aktivt deltagande och information var högt prioriterat hos patienterna när de vårdades av studenter. Flera patienter upplevde att de var med och bidrog till studenternas lärande och utveckling. Slutsats: Det fanns både positiva och negativa patientupplevelser från vården av sjuksköterskestudenter. Majoriteten av patientupplevelserna var positiva förutsatt att studenterna visade på kompetens, intresse, samt förmåga att etablera goda relationer. / Background: Clinical placement is an integral part of nursing education, providing students with the opportunity to apply theory to practice. The relationship between student and supervisor, as well as patient involvement, plays a significant role in student’s learning and patient’s experiences. The relationship between student and patient can be linked to Hildegard Peplau’s nursing theory, “Interpersonal Relations Model” which describes the various roles the nurse strives for. Aim: The aim was to study how patients experience being cared for by nursing students Method: A literature review with a descriptive design was used as a method. The result was based on ten qualitative scientific articles.  Result: The patients experienced the students' care as both positive and negative. The patient-student relationship was often crucial for a positive or negative patient experience. A poor patient-student relationship meant that the patients perceived the students as shy, stressed, negative, and lacking in knowledge. The patient-student relationship was positively influenced when the patients felt that the students were present and interested. The results showed that the students' attitude played a role, as students who were unsure had a negative effect on the patients, while those who were confident instead had a comforting effect. Furthermore, the results indicated that active participation and information were highly prioritized by the patients when they were cared for by students. Several patients felt that they were involved and contributed to the students' learning and development. Conclusion: There were both positive and negative patient experiences from the care provided by nursing students. The majority of patient experiences were positive provided that the students demonstrated competence, interest, and the ability to establish good relationships.

Background Palliative care is a form of care for patients suffering from incurable diseases. Palliative care helps the patient achieve the best possible quality of life both early and late in the course of the disease. Nurses have a responsibility to maintain a high quality of care that mitigates suffering and strengthens the patient's quality of life, as well as meeting the needs and support of the relatives. Problem Nurses play a crucial role and are the ones involved in how patients and family members experience palliative care. It is necessary that nurses' experiences are documented and presented to contribute to an increased understanding of how palliative care works in praxis. Purpose The purpose of the study was to create an overview of caring for patients who have palliative care need from the perspective of nurses. Method An overall literature survey was performed based on eight qualitative and two quantitative scientific articles. Results In the result, three central themes identified in the analysis could be distinguished. These were nurses' relation to patients, nurses' emotional influence and nurses' knowledge. Conclusion Nurses showed willingness to do good and develop close relationships with patients and relatives. Nurses were seeking knowledge to develop both professionally and personally.

The purpose of the study was to analyse if the two year upgrading programme done at Malawi College of Health Sciences attended by Nurse Midwife Technicians (NMTs) is able to improve the competencies, knowledge, skills and attitude of the graduates when providing comprehensive nursing and midwifery care. The main objectives of this study were • to determine the effectiveness of the Upgrading Diploma in Nursing and Midwifery programme in preparing the competencies of State Registered Nurse Midwifes (SRNMs) • to make recommendations on the training of Upgrading Diploma in Nursing and Midwifery programme The researcher used a quantitative, exploratory, descriptive design. A questionnaire with closed and open-ended questions was used to collect data from SRNMs who completed the upgrading programme. The findings indicated that the upgrading programme has a significant impact to improve the competencies of the NMTs to work as SRNMs. / Health Studies / M.A. (Health Studies)

Wang, Yue. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 108-120). / Abstract and some appendixes also in Chinese. / Chapter CHAPTER 1: --- INTRODUCTION --- p.1 / Chapter CHAPTER 2: --- LITERATURE REVIEW / Clinical decision making in nursing --- p.4 / Definition of clinical decision making --- p.4 / How nurses make clinical decisions --- p.6 / The analytical model --- p.7 / The intuitive model --- p.10 / Cognitive continumm theory --- p.13 / Factors influencing clincial decision making --- p.17 / Knowledge --- p.18 / Clinical experience --- p.19 / Internal factors --- p.21 / External factors --- p.23 / Autonomy in nurses' clinical decision making --- p.27 / Clinical decision making among Chinese nurses --- p.31 / Summary of literature review --- p.35 / Chapter CHAPTER 3: --- METHODOLOGY / Aims and objectives of the study --- p.37 / Research design --- p.37 / Setting and sample --- p.39 / The setting --- p.39 / The informants --- p.40 / Data collection procedures --- p.42 / Interview guide --- p.42 / Data collection method --- p.43 / Data analysis --- p.45 / Data preparation --- p.45 / Content analysis --- p.46 / Rigour of data --- p.47 / Validity --- p.48 / Reliability --- p.49 / Pilot study --- p.50 / Ethical consideration --- p.50 / Chapter CHAPTER 4: --- FINDING AND DISCUSSION / Introduction --- p.53 / Socio-demographic characteristics of informants --- p.53 / Categories identified from content analysis --- p.54 / Understanding of clinical decision making --- p.55 / Understanding about patien´tةs health condition --- p.56 / Making nursing judgment --- p.57 / Taking intervention --- p.58 / Problem solving --- p.59 / A participatory process --- p.60 / Involving the patient --- p.61 / Role of the family --- p.62 / Involvement of other staff --- p.63 / Autonomy in clinical decision making --- p.65 / Depending on doctoŕةs instruction --- p.66 / Making judgment about doctoŕةs order --- p.68 / Making decisions independently in emergency --- p.69 / Making decisions within scope of nursing practice --- p.70 / Attributes required in clinical decision making --- p.75 / Effective communication skill --- p.75 / Use of critical thinking --- p.76 / Role of knowledge in clinical decision making --- p.78 / Facilitating nurses to solve patien´tةs health problems --- p.78 / Facilitating nurses to make efficient and accurate judgment --- p.79 / Contributions of clinical experiences to clinical decision making --- p.80 / Using clinical experiences to identify patients' problems --- p.81 / Use of previous clinical experiences in clinical decision for intervention --- p.82 / Helping nurses solve patien´tةs problems effectively --- p.83 / Making judgment efficiently and effectively --- p.84 / Workplace environment --- p.86 / Workload --- p.86 / Workplace atmosphere --- p.87 / Similarities and differences of concept of clinical decision making between clinical nurses and nurse educators --- p.88 / Intuition --- p.89 / Making decisions based on evidence --- p.91 / Teamwork spirit --- p.93 / Nurséةs attitude to drug administration --- p.94 / Chinese tradition of respecting older people --- p.95 / Chapter CHAPTER 5: --- CONCLUSION / Study limitations --- p.100 / Sampling method --- p.100 / Use of interview --- p.101 / Issue of data saturation --- p.102 / Recommendation for further research --- p.103 / Implications for practice --- p.104 / Conclusion --- p.106 / REFERENCES --- p.108 / APPENDICES --- p.121

Diss. (sammanfattning)--Umeå : Umeå universitet, 2009. / Härtill 4 uppsatser. Även tryckt utgåva.

The purpose of the study was to analyse if the two year upgrading programme done at Malawi College of Health Sciences attended by Nurse Midwife Technicians (NMTs) is able to improve the competencies, knowledge, skills and attitude of the graduates when providing comprehensive nursing and midwifery care. The main objectives of this study were • to determine the effectiveness of the Upgrading Diploma in Nursing and Midwifery programme in preparing the competencies of State Registered Nurse Midwifes (SRNMs) • to make recommendations on the training of Upgrading Diploma in Nursing and Midwifery programme The researcher used a quantitative, exploratory, descriptive design. A questionnaire with closed and open-ended questions was used to collect data from SRNMs who completed the upgrading programme. The findings indicated that the upgrading programme has a significant impact to improve the competencies of the NMTs to work as SRNMs. / Health Studies / M.A. (Health Studies)