<p>I Sverige lever idag ungefär 150 000 personer med en demenssjukdom och det är vanligt att personen uppvisar ett agiterat beteende. Antalet som drabbas av en demenssjukdom ökar i takt med att människan lever längre. Syftet med litteraturstudien var att belysa beröring som omvårdnadsintervention vid demensrelaterad agitation. Studien genomfördes utifrån Polit och Beck’s (2008) riktlinjer för litteraturstudier och bygger på elva granskade artiklar. Via databaserna Cinahl, PubMed, PsykInfo samt AMED har data insamlats. Litteraturstudiens resultat visar på en minskning av agitationsbeteende hos studiedeltagarna, under tiden när massage ges, under interventionsperioden samt i ett fåtal fall även en tid efter att interventionen är avslutad. Beröring har även visats ge en motsatt effekt hos personerna, där agitationen istället ökade. Resultaten redovisas under två huvudkategorier: <em>Betydelsen av beröring under intervention och <em>Betydelsen av beröring efter avslutad intervention. Vidare redovisas resultat i underkategorierna <em>Handmassage och <em>Taktil massage. </em></em></em></em></p>

I Sverige lever idag ungefär 150 000 personer med en demenssjukdom och det är vanligt att personen uppvisar ett agiterat beteende. Antalet som drabbas av en demenssjukdom ökar i takt med att människan lever längre. Syftet med litteraturstudien var att belysa beröring som omvårdnadsintervention vid demensrelaterad agitation. Studien genomfördes utifrån Polit och Beck’s (2008) riktlinjer för litteraturstudier och bygger på elva granskade artiklar. Via databaserna Cinahl, PubMed, PsykInfo samt AMED har data insamlats. Litteraturstudiens resultat visar på en minskning av agitationsbeteende hos studiedeltagarna, under tiden när massage ges, under interventionsperioden samt i ett fåtal fall även en tid efter att interventionen är avslutad. Beröring har även visats ge en motsatt effekt hos personerna, där agitationen istället ökade. Resultaten redovisas under två huvudkategorier: Betydelsen av beröring under intervention och Betydelsen av beröring efter avslutad intervention. Vidare redovisas resultat i underkategorierna Handmassage och Taktil massage.

Introduktion: Omvårdnad är operationssjuksköterskans huvudområde. Operationssjuksköterskan ska förebygga skador och komplikationer som kan uppstå vid en operation. En sådan komplikation kan vara kompartmentsyndrom. Kompartmentsyndrom är en ovanlig komplikation men kan leda till allvarliga skador. Det är därför viktigt att operationssjuksköterskan beaktar det i sitt arbete. Syfte: Detta arbete syftar till att belysa operationssjuksköterskans erfarenheter av att arbeta med att förebygga kompartmentsyndrom i den perioperativa omvårdnaden. Metod: En kvalitativ ansats tillämpades och data samlades in via intervjuer. Insamlade data analyserades genom kvalitativ innehållsanalys. I arbetet deltog 11 operationssjuksköterskor, tio kvinnor och en man, som arbetade på fyra olika operationsavdelningar vid två olika sjukhus. Resultat: I den kvalitativa innehållsanalysen av texten framkom två kategorier, Att arbeta förebyggande samt Att handla på osäker grund. I den förstnämnda kategorin beskrevs hur operationssjuksköterskorna genomförde en individuell riskbedömning, var noggranna i positioneringen och utförde lägesändring samt massage av patientens ben för att förebygga kompartmentsyndrom. I den andra kategorin, Att handla på osäker grund, beskrevs en osäkerhet i den perioperativa omvårdnaden kring kompartmentsyndrom. Det belystes en osäkerhet runt ämnet, omvårdnadsinterventionerna ifrågasattes och en brist på vetenskaplig evidens framkom. Konklusion: Det fanns brister i riktlinjer och rutiner gällande omvårdnad kring kompartmentsyndrom. Det fanns även en brist i att implementera ny kunskap i operationssjuksköterskans omvårdnad för att kunna arbeta evidensbaserat. / Introduction: Nursing is the main area for the operating room (OR) nurse. The OR nurse will prevent injuries and complications that can occur during surgery. One such complication can be compartment syndrome. Compartment syndrome is a rare complication but can lead to serious injuries. It is therefore important that the OR nurse take this in consideration in their work. Aim: This essay aims to highlight the OR nurse's experiences of working with the prevention of compartment syndrome in the perioperative nursing. Method: A qualitative approach was applied and the data were collected through interviews. Collected data were analyzed by qualitative content analysis. The essay enrolled 11 OR nurses, ten women and one man, who worked in four different surgical wards at two different hospitals. Result: After a qualitative content analysis of the data were conducted two categories emerged, Preventive work and To act on uncertain foundations. The first category described how the OR nurse undertook an individual risk assessment, was accurate in positioning and performed a change in position and massage of the patient’s leg to prevent compartment syndrome. The second category, To act on uncertain foundations, described an uncertainty in the perioperative care regarding compartment syndrome. It highlighted an uncertainty around the topic, nursing interventions were questioned and a lack of scientific evidence emerged. Conclusion: There were a lack of guidelines and recommendations regarding care about compartment syndrome. There was also a lack of implementing new knowledge in nursing to provide an evidence-based practice.

Aim of the Study The aim of this study was to determine if the nursing interventions of patient education and multidisciplinary coordination of care were able to improve pain control in the cancer patient in an acute hospital setting. Background of the Study The role of the nurse in cancer pain management has been defined as being that of an educator, coordinator of care and advocate. A nurse with adequate knowledge of pain and its application to the cancer population and functioning in the role as defined is believed to be able to overcome many of the barriers that exist in implementing adequate analgesia and improve pain management in cancer patients. Design of the Study A randomized experimental control group design was utilized. The study comprised 3 experimental groups and one control group incorporating pre and post testing. The Intervention of the Study Experimental group one: subjects received education regarding their pain management which was tailored to meet their specific needs. Experimental group two: subjects underwent a pain assessment and construction of a care plan which was communicated verbally to the treating medical and nursing team and followed up with a written report which was documented in the history and sent to the treating medical physician. Experimental group three: subjects received the combined interventions administered to groups one and two. Control group four: subjects were assessed and all information was record in the same manner as for the experimental groups. The control group received their usual care during the study and their pain scores were measured at the same time intervals as the three experimental groups. Instrumentation The Wisconsin Brief Pain Questionnaire was used for the assessment of all subjects. The McGill Pain Questionnaire was used as the outcome measure following intervention. Data Analysis A one-way analysis of variance was used to detect the differences between the intervention groups and the control group. T-Tests were used to detect the differences between the groups incorporating a Bonferroni adjustment for frequent T tests. Results The main effect demonstrated a significant difference between the treatment groups and control at a significance level of 0.002. T-Tests showed no significant difference between control and communication groups and no significant difference between education and combined groups. A significant difference was detected between education and control and between combined and control. Conclusions Nursing interventions of patient education, coordination of care and advocacy can significantly improve cancer pain management. Intervention was tailored to meet the specific patient needs based on findings from the assessment and was dependent upon an adequate knowledge base. The nursing intervention of education was the most powerful of the three intervention types and its success was in tailoring to each individual. However, it is believed that with further recognition of the role of the nurse as coordinator of care will lead to greater improvements in cancer pain management.

Psykisk ohälsa bland adolescenter i åldern 10–19 år ökar och det finns flera olika orsaker till att de drabbas av psykisk ohälsa. Orsaker som till exempel önskan av kroppslig förändring, press kring att passa in, utforskande av sexuell identitet, ökad tillgänglighet och användande av internet kan leda till psykisk ohälsa. Depression är en av de ledande orsakerna till att psykisk ohälsa ökar bland adolescenter. Syftet var att undersöka hur adolescenter med depression upplever sjuksköterskans omvårdnadsåtgärder och behandlingar. För att besvara syftet genomfördes en litteraturstudie med artikelsökningar i tre olika databaser. Det resulterade i tre huvudkategorier: Omvårdnadsåtgärden träning upplevdes stärka självbilden, Omvårdnadsåtgärden medverkan upplevdes skapa trygghet och den tredje kategorin Behandlingar med fokus på förändring av tankar och känslor upplevdes ge insikt. Det är viktigt att besitta kunskap om adolescenters upplevelser av sjuksköterskans omvårdnadsåtgärder och behandlingar för depression eftersom det ger en inblick i hur det tas emot av adolescenter. / Mental illness among adolescents aged 10-19 years increases and there are several reasons why they suffer from it. Causes such as the desire of body change, increased accessibility and internet usage, pressure to fit in and exploration of sexual identity can affect the mental health. Depression is one of the leading causes of mental illness progression among adolescents. The purpose was to investigate how adolescents with depression experience nursing interventions and treatments. To answer the purpose, a literature study was conducted with article searches in three different databases. The result led to three main categories in this study: The nursing intervention physical activity as exercise was perceived to improve self-esteem, The nursing intervention participation was perceived to create a sense of security and the third category Treatments with focus on changes in thoughts and emotions was perceived to give insight. It is important to understand the adolescents’ experience of nursing interventions and treatment for depression because it gives an awareness into how they receive it.

Este estudo objetivou identificar os diagnósticos que as enfermeiras reconhecem como: 1) mais freqüentes em sua prática clínica; 2) mais difíceis de serem formulados; 3) mais difíceis para propor intervenções e 4) verificar as associações entre a freqüência de diagnósticos, a dificuldade para formular diagnósticos e a dificuldade para propor intervenções. Os 155 diagnósticos de enfermagem (DE) estudados foram divididos, compondo três questionários. A estimativa de freqüência, a dificuldade de formulação, e a dificuldade para propor intervenções para cada diagnóstico foram indicadas em escala tipo Likert de 5 pontos. O alfa de Chronbach variou de 0,90 a 097 entre os 3 tipos de questionários. Cada tipo de questionário foi respondido por 49 enfermeiras do Hospital Universitário da Universidade de São Paulo, totalizando 147 enfermeiras (97% = sexo feminino, idade média=35,1±8,3 anos; tempo médio de formadas=11,1 ±7,8 anos). Considerando os totais de DE em cada tipo de questionário, os escores médios de freqüência variaram de 2,2 a 2,3, os de dificuldade para formular variaram de 2,5 a 2,6, e os de dificuldade para propor intervenções de 2,9 a 3,0. Considerando cada diagnóstico, escores médios =3 foram definidos como altos para as três variáveis do estudo: freqüência, dificuldade para formular e dificuldade para propor intervenções. Entre as enfermeiras que cuidam predominantemente de adultos, 40 DE foram de alta freqüência, 59 foram de alta dificuldade para formular e 90 de alta dificuldade para a proposição de intervenções. Entre as enfermeiras que cuidam de pacientes pediátricos e de obstetrícia, 22 DE foram de alta freqüência, 67 de alta dificuldade de formulação e 82 de alta dificuldade para propor intervenções. Houve correlações significativas entre as variáveis dificuldade para formular os diagnósticos e dificuldade para propor intervenções de enfermagem nos 3 questionários (Pearson, coeficientes entre 0,75 e 0,83, p=0,000). / This study aimed to identify which diagnoses nurses estimate as: 1) the most frequent in their clinical practice; 2) the most difficult to formulate; 3) the most difficulty to propose interventions for and 4) to verify the associations among the nursing diagnoses (ND) frequency, the difficulty to state ND, and the difficulty to propose interventions The 155 nursing diagnoses (ND) studied were divided to compound 3 questionnaires. Frequency, difficulty to state, and difficulty to propose interventions for each ND were indicated in 5-point Likert scales. The Chronbach\'s alpha varied from 0.90 to 0.97 among the 3 questionnaires. Each questionnaire was answered by 49 nurses of the University Hospital of the University of São Paulo, totaling 147 nurses (97% female; mean age=35.1±8.3 years; mean years after bachelor´s degree=1.1±7.8). Considering the total of ND in each questionnaire, the mean scores of frequency varied from 2.2 to 2.3; the mean scores of difficulty to state ND, between 2.5 and 2.6; and the mean scores of difficulty to propose interventions, between 2,9 and 3.0. Considering each diagnosis, mean scores =3 were defined as high ones for the three variables: frequency, difficulty to state, and difficulty to propose interventions. Forty ND were high frequency ND among nurses who care of adult patients; 59 were ND of high difficulty to state; and 90 were ND of high difficulty to propose interventions for. For nurses caring of pediatrics and obstetrics\' patients, there were 22 high frequency ND, 67 ND of high difficulty to state; and 82 of high difficulty to propose interventions for. There were significant positive correlations between the variables: difficulty to state ND and difficulty to propose interventions for the 3 questionnaires (Pearson test, coefficients between 0.75 and 0.83, p=0.000).

Early childhood caries (ECC) is the most common chronic disease condition in childhood and involves the presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled teeth in children under 72 months of age (American Academy of Pediatric Dentistry, 2010a). ECC is a multifactorial disease that is preventable and requires intervention by the nurse. When teeth are discolored and damaged by dental caries, children may be reluctant to smile, have difficulty talking, miss school, or be unable to focus on studies due to dental pain. This "state of the science" article reviews the literature to determine the risk factors for ECC, assess the prevention strategies, and apply that information to enhance nursing practice. Computerized searches from MEDLINE, CINAHL, and the Cochrane Library were used.

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The use of noninvasive positive pressure ventilation (NPPV) in acute care settings has drastically increased within the past 20 years. Research has indicated that NPPV is equally as effective as traditional mechanical ventilation(MV) in treating acute exacerbations of chronic pulmonary obstructive disease (COPD) and cardiogenic pulmonary edema. Furthermore, the risk of complication from NPPV is much lower than MV, in terms of ventilator-associated pneumonia and sepsis. It is imperative for the nurse to understand the various indications, interfaces, and potential complications associated with NPPV use. In addition to treating acute exacerbations of COPD and cardiogenic pulmonary edema, NPPV has been used for prevention of reintubation, palliative care, and status asthmaticus. Furthermore, NPPV could be delivered through various interfaces, such as nasal, facial, and helmet. Each of these interfaces could eventually cause complications for the patient, such as skin ulceration and sepsis. However, there is limited amount of research available discussing the role of the nurse in caring for the patient with NPPV. There are no standardized guidelines established to assist the nurse in this care, in terms of interface selection, prevention of complications, and staffing patterns. Several recommendations are presented at the end of this thesis to guide future nursing research, education, and clinical practice, such as exploring the role of oral care and education for NPPV patients.