Bakgrund: Telefonrådgivning är en växande verksamhet och utgör en stor del av distriktssköterskans arbete på vårdcentral. För vårdsökande innebär det att få råd, information och stöd för att öka tryggheten i vardagslivet. Det behövs ökad kunskap om äldres erfarenheter av telefonrådgivning för att bättre kunna förstå de vårdsökandes behov och för att vidare utveckla verksamheten. Syfte: Syftet är att beskriva äldre vårdsökandes erfarenheter av telefonrådgivning på vårdcentral. Metod: I studien har en kvalitativ deskriptiv design med induktiv ansats använts. Datainsamling har skett via tio intervjuer med äldre vårdsökare som har fått telefonrådgivning via vårdcentral och materialet analyserades med kvalitativ innehållsanalys. Resultat: I analysen framträdde två teman Få kontakt och Kommunikation.  I Få kontakt presenteras kategorierna: Telefonsystemet och Strategier för kontakt med tillhörande underkategorier. I Kommunikation presenteras kategorierna: Bemötande och Förutsättningar med tillhörande underkategorier. Slutsats: Telefonsystemet som används för att få kontakt kan ses både som en tillgång och ett hinder för kontakt. Äldre vårdsökande använder olika strategier för att underlätta kontakt med vårdcentral. Kommunikation mellan telefonsjuksköterskan och den äldre vårdsökanden kräver att det finns bra förutsättningar. Om kommunikationen dem emellan är god och den vårdsökande får vara i centrum blir vårdmötet tillfredsställande och den vårdsökande känner sig hjälpt. Om kommunikationen brister och den vårdsökande inte får vara i centrum kan vårdmötet bli otillfredsställande och leda till att vårdsökanden istället känner sig stjälpt. Slutsatsen är att telefonrådgivning på vårdcentralen kan både hjälpa och stjälpa den äldre vårdsökande. / Background: Telephone nursing is a large part of the nurse's work at the health center. The caller wants to get advice, information and support in everyday life. With this work we want to enhance the understanding of older people's experiences of telephone nursing at health center to further develop the telephone nursing from elderlies perspective. Aim: The aim is to describe the elderly caller’s experiences of telephone nursing at health center. Method: The study has a qualitative descriptive design with an inductive approach. Data was collected through 10 interviews with elderly callers who had received telephone nursing and the data was analyzed by a qualitative content analysis. Results: The analysis resulted in to two themes Get Contact and Communication. In Get Contact the following categories appeared: Phone system and Strategies for Contact with related subcategories. In term Communication the following categories appeared: Treatment and Conditions with related subcategories. Conclusion: The telephone system that is used for contact with the health center can be seen both as an asset and obstacle. Elderly callers use different strategies to facilitate the contact. It is important that there are good preconditions for the communication. If the communication between the nurse and elderly caller is good and the caller is in focus, the caller will feel helped and satisfied with the telephone meeting. If there is lack of communication and the caller is not in focus, the telephone meeting can be unsatisfied and lead to a feeling of being overturned.

Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.

Introduction: Hyperemesis gravidarum (HG) in pregnancy can cause severe and persistent vomiting, nausea, dehydration, vitamin and mineral deficiencies. The symptoms can have varying degrees of impact on women's physical, emotional, social, and marital lives and affect their quality of life. Some women voluntarily terminate their pregnancies due to HG. Despite the severe consequences, the etiology of this disorder remains unknown. HG is thought to be caused by a mixture of hormonal variables and genetics. Various therapies have been documented with varying degrees of efficacy. Nevertheless, there is a lack of research on the actual causes of the disease and effective medications, as well as a lack of research on patients' experiences with HG, its treatments, and its consequences. Aim: This thesis aims to examine women's own experiences of HG, with the following research questions: How do women experience HG in their daily lives? What kind of support do they have in coping? What kind of approach do they receive from the health care system? What medical interventions were offered to them? and how effective were they perceived? Method: The thesis adopts a qualitative approach. Some prominent women's groups on Facebook were used to spread the information about the study, and 20 women in Sweden who had suffered from HG during pregnancy and had given birth no more than four years ago were interviewed individually online via Zoom. The data was analyzed using the thematic analysis method by creating sub-themes and themes through coding. Findings: The analysis revealed two themes: 'Trapped in my own body' and 'Longing for optimal HG care'. The first theme described the women's daily lives, which were significantly affected by HG. Due to severe vomiting and nausea, many of them were bedridden for long periods and unable to take care of their children or do household chores. They had significant problems with eating food, drinking water, odors, and oral hygiene. Many were unable to work, and most were on long-term sick leave. Women relied on their partners and families to cope with HG. The disease was compounded by mental health problems such as isolation, loneliness, sadness, and even depression. The second theme revealed that medications and their perceived effects were experienced differently. No drug could completely cure the disease in every case, and HG treatments were not considered optimal by any woman. Medical facilities often lacked knowledge about the disease and the drugs available, and there were no functioning care plans. Lack of knowledge meant that most women in the early stages of pregnancy were not taken seriously by the health system, and it took a long time for many of them to receive appropriate treatment. Conclusion: HG was perceived by women as a severe disease that caused significant physical and psychological obstacles in life and made women feel imprisoned in their bodies. Their most considerable support in coping with this illness was their partners and family. Despite these severe problems, most received inadequate care at health facilities mainly due to ignorance of the disease. This study has highlighted a great need for clear organizational structures, a working care plan, and more knowledge of HG in all health departments. Evidence-based national and local guidelines are needed to improve the availability and quality of health care. Based on the women’s experiences, the findings of this study may provide essential insights for implementing such guidelines in clinical practice.

Bakgrund: Anorexia nervosa (AN) är en ätstörning där den drabbade försöker gå ner i vikt genom självsvält. Förvrängd kroppsuppfattning och ett starkt behov av kontroll över kropp och vikt är förekommande. Många som drabbas av AN avbryter sin behandling i förtid. Att sammanställa personers erfarenheter av att vårdas för AN på ätstörningskliniker kan bidra till viktig kunskap. Denna kunskap kan vara betydande vid utvecklingen av tillvägagångsätt för att stödja personer med AN.   Syfte: Syftet var att beskriva personers erfarenheter av att vårdas för anorexia nervosa på ätstörningskliniker. Metod: Åtta kvalitativa studier har granskats, analyserats och sammanställts i denna litteraturstudie. Databassökning genomfördes i Cinahl, PubMed och PsycInfo. Resultat: Analysen resulterade i två kategorier och sju underkategorier. De två följande kategorierna är ”Att behöva personcentrerad vård” och ”Att dela vardagen med andra personer med ätstörningar och behöva släppa kontrollen”. Konklusion: Litteraturstudien resultat visar att personer med AN upplever ett behov av personcentrerat vård. De beskriver även att vid delaktighet i sin vård ökas motivationen till fortsatt behandling. Med ett gott bemötande från vårdpersonalen kan goda relationer skapas. För att personer med AN ska uppleva att deras behov och önskemål tillgodoses kan det vara av betydelse att vårdpersonalen har kunskap om hur de kan tillämpa personcentrerad vård för personer med AN. / Background: Anorexia nervosa (AN) is an eating disorder in which the individual attempts to lose weight through self-starvation. Distorted body image and a strong need for control over body and weight are common characteristics. Many individuals who suffer from AN discontinue their treatment prematurely. Compiling people's experiences of being treated for AN in eating disorder clinics can contribute to valuable knowledge. This information can be significant in the development of approaches to support individuals with AN.  Aim: The aim of this study was to describe individuals' experiences of being treated for anorexia nervosa at a specialized clinic for eating disorders.  Methods: Eight qualitative studies were reviewed, analyzed, and compiled. A database search was conducted in CINAHL, PubMed, and PsycInfo.  Results: The analysis resulted in two main categories: "Requiring person-centered care" and "Sharing everyday life with others who have eating disorders and learning to let go of control." Conclusion: The results of the literature study indicate that individuals with anorexia nervosa (AN) express a need for person-centered care. They also report that active involvement in their care enhances motivation to sustain treatment. Establishing positive relationships is facilitated by effective treatment from the care staff. To ensure that the needs and preferences of individuals with AN are addressed, it is crucial for the care staff to possess knowledge on the application of person-centered care tailored to this population.