Sammanfattning Syfte: Syftet är att beskriva hur individer som överlevt ett hjärtstopp samt individer som överlevt ett hjärtstopp och erhållit en ICD upplever sin livskvalitet utifrån ett fysiskt, psykiskt och socialt perspektiv. Vidare var syftet också att beskriva kvaliteten på de ingående artiklarna avseende undersökningsgrupp. Metod: Beskrivande litteraturstudie med 12 ingående resultatartiklar. Sökningar gjordes i databaserna Cinahl, PubMed och PsychINFO. Huvudresultat: Upplevelsen av livskvalitet påverkas ur flera aspekter hos individer som drabbats av hjärtstopp. Den fysiska förmågan var försämrad och med en för många uttalad trötthet försvårades det dagliga livet för dessa individer. Många upplevde oro och ångest och detta tillsammans med depression var en betydlig bidragande del till en minskad upplevelse av livskvalitet. Slutsats: Upplevelsen av livskvalitet är individuell och många upplever en sämre livskvalitet efter hjärtstoppet medan andra upplever att livet är lika bra som innan eller bättre efter hjärtstoppet. Sjuksköterskan har i sitt arbete ett stort ansvar att se till den enskilda individen och förmedla information, kunskap och hopp. / Abstract Aim: To describe how individuals who have survived a cardiac arrest, and individuals who have survived a cardiac arrest and received an ICD perceive their quality of life from a physical, psychological and social perspective. Furthermore, the aim was also to describe the quality of the included articles relating to the investigation group.Methods: Descriptive literature review study of 12 articles detailed results. Searches were made in the databases Cinahl, PubMed and PsychInfo. Main results: The perception of quality of life is affected by several aspects in individuals suffering from cardiac arrest. The physical ability was impaired and many experienced an extreme fatigue hampered the daily lives of these individuals. Many felt anxiety and this along with depression was a significant contributing factor to a reduced perceived quality of life. Conclusion: The experience of life is individual and many experience a poorer quality of life after cardiac arrest, while others feel that life is as good as before or even better after the arrest. The nurse has a large responsibility to the individual and to convey information, knowledge and hope.

ABSTRACT Background: People with colorectal cancer undergoing rectum amputation get a permanent colostomy, which affects the social life. It may be valuable for health care what these people experience living with colostomy in order to provide the greatest possible support. Objective: The aim of this study is to describe how people who received a colostomy experience their daily lives and the support they have received from the health services.Method: Qualitative interview study with six people, with a descriptive phenomenological approach.Results: The analysis of the interviews about how it's like to live with a colostomy resulted in three themes: 1) Living with a colostomy gives an uncertainty that affect the social life, 2) Physical and psychological impact of getting a colostomy and 3) Support for health care and relatives.Conclusion: Subjects had a positive attitude towards life, which contributed to that they could adjust to living with a colostomy and feel a meaningfulness of life. The study shows that all the interviewed people overall were satisfied with the information provided by the healthcare personnel. It was good with both oral and written information and very appreciated with repeated information. One aspect that could be improved was the information given aboute the closure of anus during surgery and the following complications. This was the most painful experience among the interviewed people. Special nurses in surgery should take more responsibility for that the information reaches the patients and also that a follow-up take place.

Canadians are worried about the future of the health care system, and provincial governments are questioning the ability of the existing system to support Canadians health care needs in the 21st Century(Industry Canada, 2011). Health care providers and system administrators are both driving and experiencing a paradigm shift; moving away from paternalism and toward an egalitarian approach. In order to practice patient centredness, health care providers must prioritize patient needs; provide information regarding treatments while taking patient preferences into account (Romanow, 2002). While there is a growing body of literature regarding patient centredness, there is scant information from the patient perspective. If the most effective and acceptable health services are those that realize the expectations of the users, this is an important area of study. Using phenomenological research methods and the theory of planned behaviour as a theoretical framework, the purpose of the study was to explore the influence of beliefs, attitudes and experiences on behaviour from the perspective of patients in primary health care or stroke rehabilitation. A second purpose was to explore the degree to which beliefs, attitudes and behaviour were similar between clinical contexts. The theory of planned behaviour was unsuitable for understanding peoples’ beliefs, attitudes and behaviour about being a patient. Being a patient was not a single, observable behaviour, but rather a set of contextually dependent strategies patients’ directed at a particular goal. The goal for each participant group was different; rehabilitation patients focused on the specific goal of recovery and discharge, while PHC patients focused on a broader goal of accessing and receiving best health care possible. These goals were reflected in their respective approaches to accessing health care services, an experience they described as socially oriented, governed and reinforced. Although patients described themselves as actively engaged, they did not approach each interaction with health care with a set of behavioural beliefs about being a patient. During the course of their participation, patients identified, developed and adopted strategies to assist in achieving the target; and evaluated those strategies more positively.

Canadians are worried about the future of the health care system, and provincial governments are questioning the ability of the existing system to support Canadians health care needs in the 21st Century(Industry Canada, 2011). Health care providers and system administrators are both driving and experiencing a paradigm shift; moving away from paternalism and toward an egalitarian approach. In order to practice patient centredness, health care providers must prioritize patient needs; provide information regarding treatments while taking patient preferences into account (Romanow, 2002). While there is a growing body of literature regarding patient centredness, there is scant information from the patient perspective. If the most effective and acceptable health services are those that realize the expectations of the users, this is an important area of study. Using phenomenological research methods and the theory of planned behaviour as a theoretical framework, the purpose of the study was to explore the influence of beliefs, attitudes and experiences on behaviour from the perspective of patients in primary health care or stroke rehabilitation. A second purpose was to explore the degree to which beliefs, attitudes and behaviour were similar between clinical contexts. The theory of planned behaviour was unsuitable for understanding peoples’ beliefs, attitudes and behaviour about being a patient. Being a patient was not a single, observable behaviour, but rather a set of contextually dependent strategies patients’ directed at a particular goal. The goal for each participant group was different; rehabilitation patients focused on the specific goal of recovery and discharge, while PHC patients focused on a broader goal of accessing and receiving best health care possible. These goals were reflected in their respective approaches to accessing health care services, an experience they described as socially oriented, governed and reinforced. Although patients described themselves as actively engaged, they did not approach each interaction with health care with a set of behavioural beliefs about being a patient. During the course of their participation, patients identified, developed and adopted strategies to assist in achieving the target; and evaluated those strategies more positively.

Sammanfattning   Bakgrund: Cancer är en av de vanligaste folksjukdomarna i Sverige. Vid cancer sker en okontrollerad mutation av cellerna som leder till tumörbildningar. Sjukdomen förändrar den drabbades liv och kan ge sociala, emotionella och existentiella konsekvenser.   Metod: Författarna har genomfört en deskriptiv litteratur studie med 22 artiklar från olika länder med syftet att beskriva cancerpatienters upplevelser av existentiell smärta.   Resultat: Studiens resultat är presenterat i två teman: Lidande som berör kropp, psyke och socialt liv med subteman: Fysiskt, psykiskt och socialt lidande och Spirituellt lidande med subteman: Tankar kring andlighet, Att uppleva acceptans, Att fina mening och Att känna hopp. Teman och subteman beskriver patientens upplevelser av existentiell smärta vid cancer. Fysiska lidandet uttrycktes i form av trötthet och andra biverkningar från cancerbehandlingen. Den fysiska nedsättningen ledde till psykiskt och socialt lidande som var uttryckt i form av ångest, skuld, skam, isolering, oro, tankar kring döden och depression. Dessa upplevelser ledde till en oförutsägbar framtid där mening, hopp och acceptans var viktigt att uppnå för att kunna hantera sin situation och minska det spirituella lidandet.    Slutsats: Det är viktigt att sjuksköterskor fokuserar på alla dimensioner vid vårdandet av patienten som fysiskt, socialt, psykiskt och existentiellt för att ge så god omvårdnad som möjligt. Patienterna tyckte att existentiella smärtan behöver mer uppmärksamhet och att det ingår i sjuksköterskans ansvar att kunna hjälpa patienterna med sina existentiella frågor och behov. Miljö, god relation, lyhördhet leder till bra samtal som hjälper patienterna att skapa hopp, acceptans, mening som i sin tur kan leda till lindring av den existentiella smärtan. / Abstract   Background: Cancer is one of the most common diseases in Sweden, where there is an uncontrolled mutation of cells that lead to tumour formation. The disease alters the patient`s life and can cause social, emotional and spiritual consequences.   Method: A descriptive literature review, with 22 articles from different countries, with the aim to describe cancer patient`s experiences of existential pain was performed.   Results: The study results are presented in two themes: Suffering that affects the body, psyche and social life with subthemes: physical, psychological and social suffering and Spiritual suffering with subthemes:Thoughts on spirituality, to experience acceptance, to find meaning and hope. Themes and subthemes are describing patient`s experiences of existential pain in cancer. Physical suffering was expressed in the form of fatigue and other side effects from cancer treatment. The physical impairment leading to mental and social suffering that was expressed in the form of anxiety, guilt, shame, isolation, anxiety, thoughts about death and depression. These experiences led to an unpredictable future where meaning, hope, and acceptance was important to achieve to be able to handle the situation and reduce the spiritual suffering.   Conclusion: It is important that nurses focus on all dimensions in the care as physically, socially, psychologically, existentially to provide as good care as possible. The patients felt that existential pain needs more attention and that it is the nurse's responsibility to help patients with their existential questions and needs. Environment, good relationship, responsiveness and lead to good conversation that helps patients to create hope, acceptance, meaning, that leads to relief of the existential pain.

Background Anorexia nervosa is a growing problem in society and it is most common among women. It is a complex disease that affects both the mental and the physical health. The disease expresses itself differently from person to person, therefore, treatment should be individualized. Nurses need to gain insight into how patients feel about the treatment in order to understand their experience. Previous studies use statistical research to evaluate treatment. This study focuses on describing patients' concrete experiences during care and treatment for anorexia nervosa. Aim The aim is to highlight women's experiences of care and treatment for anorexia nervosa at hospital wards. Method The study was based on qualitative articles containing interviews. Nine articles were analysed according to Friberg's (2012) qualitative content analyse for literature-based studies. Results Four themes and twelve subthemes emerged from the analyse. The findings of the results are characterized by feeling isolated, not being seen, feeling trust and taking one step at the time. The quality of care affects the outcome of the treatment. Conclusion Nursing patients with anorexia nervosa is a complex task and skilled staff is required. The whole patient should be treated, both physically and mentally. When treating only the physical the underlying problem still exist and relapse is inevitable. Every individual is different and everyone has different problems. Individualized care is therefore required for the best treatment results.

Purpose Over half a million Australians (561,413) speak limited English, with 29 per cent of those being aged over 65 years (ABS 2006). Little research has been conducted into the acute hospital experience of elderly patients with limited English proficiency. This thesis examines, in an acute hospital setting, the subjective experience of a consecutive convenience sample of 258 elderly acute or emergency patients from nine language groups, who prefer to speak a language other than English. Method Trained bilingual staff investigated communication methods used by hospital staff with participants in a multilingual telephone survey (MTS). Information for validation was obtained from a medical records audit (MRA). Hospital statistical information was linked with MTS and MRA data. The agreement between the MTS and the MRA was analysed using descriptive and inferential statistics. A score, the 'Communication Complexity Score' (CCS), was developed to reflect patient clinical complexity, and the association between this score and interpreter usage was assessed. Seven language-specific focus groups were conducted to identify factors associated with a positive, a negative, or a very negative experience. Constructivist grounded theory was used to analyse the discourse in the focus groups. Results Thirty-one per cent of patients reported using professional interpreters. Concordance was present between the MTS and MRA. A positive association was found between clinical complexity and interpreter usage. The CCS had good psychometric properties. Many patients reported positive experiences; however, a theme of powerlessness was identified. Language barriers, poor patient and family involvement, staff shortages or incompetence, and inattention to cultural mores were all factors associated with negative experiences. Some patients discounted their negative experiences and were reluctant to assert their healthcare rights. An explanatory construct for this phenomenon, the 'Happy Migrant Effect,' was developed. Contributing factors for this effect include: powerlessness; positive assessment of Australian healthcare compared with the patient's country of origin; patriotism; cultural norms proscribing acceptance; politeness; desire for social acceptability; self-denigration for not learning English; and fear of reprisals following complaint. Conclusion This research has important implications for healthcare policy and service delivery associated with the quality of care and safety of patients with limited English.

Bakgrund: Trakeostomi erhålls av patienter som behöver en fri luftväg, både i akut skede och under en längre tid. Trots att trakeostomin är en viktig livsuppehållande åtgärd, medföljer risker. Kommunikation ligger till grund för god personcentrerad omvårdnad, som är en av sjuksköterskans kärnkompetenser. Personcentrerad omvårdnad lyfter fram patientens styrkor, tillgångar och involverar personen i sin omvårdnad. Syfte: Syftet var att undersöka patientens upplevelse av omvårdnad kring sin trakeostomi. Metod: En allmän litteraturstudie genomfördes i databaserna CINAHL, PubMed och Psycinfo. Resultat: Att ha en trakeostomi uppfattades som en känslomässigt påfrestande upplevelse. Trakeostomin påverkade patientens förmåga att kunna tala, vilket uppfattades som fysiskt och psykiskt påfrestande. Behovet av innehållsrik information, tålamod och närvaro från sjuksköterskan var viktiga delar för att skapa trygghet och lugn hos patienten. Att involvera patienten i sin omvårdnad medförde gynnsamma förutsättningar för den personcentrerade omvårdnaden och skapade tillit i vårdrelationen. Slutsats: Föreliggande studie visar att trakeostomerade patienter upplevde obehag som kunde förebyggas genom personcentrerad omvårdnad. Personcentrerad vård uppnåddes när patienten involverades, fick innehållsrik information och gavs tålamod i den icke-verbala kommunikationen. / Background: The tracheostomy enables a clear airway for those who need it, both in emergent situations and when needed for a longer time. Although this is a lifeprolonging intervention, tracheostomy is accompanied with risks. Communication has a pivotal role for person centered care, which is one of the nurse’s core competence. Person centered care highlight the patient’s strengths, assets and involves the patient in their care. Aim: Hence the aim of this study was to analyze the patient’s experience of their nursing care around the tracheostomy. Method: A general literature study was conducted in the databases CINAHL, PubMed and Psycinfo. Results: The tracheostomy was perceived as emotionally challenging. The tracheostomy affected the patient’s ability to speak, which was physically and mentally challenging for the patient. The need for comprehensive information and patience from the nurse was important to create a sense of security and calmness in the patients. To involve the patient in their care brought favorable conditions for the person centered care and created trust in the nurse. Conclusions: This study shows that tracheostomized patients experience discomfort that can be prevented by person-centered care, comprehensive information and having patience during the non-verbal communication with the patient.

Inom forskningen ligger fokus till stor del på hur sjukvårdspersonalen upplever bemötandet i kontakten med patienterna. För att förstå patienternas upplevelse behöver deras perspektiv undersökas. En utsatt grupp är patienter med cancer, eftersom det är en livshotande sjukdom som väcker existentiella frågor. / In today's science most of the research is based on how healthcare providers experience the communication with their patients. To be able to understand the patients’ point of view, their experience needs to be further investigated. One group that is more vulnerable than others are the patients with cancer, since their disease is life-threatening and therefore leads to existential questions.

Background: Surgeries history stretches far back in time. Stoma operations started being successfully in the 19th century. In the 1950s, a standard treatment for stoma operations was developed which still is being used today. The reason for getting a stoma may be due to various things such as illness or trauma. Getting a stoma can lead to a changed body perception and can affect the individual's experience of health and suffering. It´s up to the nurse to be able to approach these patients and their experiences in the best professional way. Aim: The aim of the study was to describe patients experiences of living with a stoma. Method: This study has been conducted as a qualitative litterature review. An analysis of eleven qualitative articles was carried out. Results: Three themes explaining the patient's experience of living with a stoma where identified as: the patient's path to acceptance, the patient's obstacles to the way of acceptance and the continued life with a stoma. Eight sub-themes: teaching and information, social support, an inner process, complications and leakage, uncertainty and concern, changed body perception, daily constraints, adaptation to a new life situation, where discovered. Conclusion: The experience of living with a stoma varies from person to person. There are factors that can affect the patient's life with a stoma. There are both positive and negative experiences that create an overall picture.