Sexual assault is a global public health and human rights challenge which cuts across all social classes. According to a literature review based on 50 studies from around the world, between 10% and 50% of women have experienced some act of physical violence while one in every four women experience sexual violence by an intimate partner at some point in their lives. In an emergency unit in the North West, South Africa there are policies, guidelines and procedures in place with regard to the management of the rape survivors after the incident which focus on a medical orientated approach. The views of female rape survivors on their management are neglected; therefore management is not patient-centred. The main objective of the study was to explore and describe the views of the female rape survivors regarding the management they received in emergency unit to enable the health care professionals to move towards a more patient-centred approach in the management these patients. Appreciative Inquiry was used a research methodology. A qualitative design using purposive sampling was used to select the participants. Unstructured interviews were conducted with 10 female rape survivors and Tesch steps were used to analyse the data. Three main themes were identified, namely 1) therapeutic environment, 2) optimal healthcare received and 3) excellence in service delivery. With regard to the disease orientated management received the female rape survivors found it to be good. The participants voiced that it is important that female rape survivors should have an opportunity to attend group therapy following the rape incident so that they are able to support each other. / Dissertation (MCur)--University of Pretoria, 2014. / lk2014 / Nursing Science / MCur / Unrestricted

Dentists have traditionally been the sole gatekeepers to the delivery of primary care dental services. Direct Access, a measure that allows Dental Care Professionals to see patients without a referral from a Dentist, is a fundamental change to this long-standing principle. This thesis systematically explores the attitudes of stakeholders across the micro, meso and macro levels of dentistry towards Direct Access in two distinct health care systems, the Netherlands and the UK.Direct Access was introduced in the Netherlands in 2006 and subsequently introduced in the UK in 2013. This study uses a qualitative approach to explore the attitudes towards the introduction of Direct Access in both of these states. It presents the results of semi-structured interviews with 74 participants (individually or as part of a group) including Students, Dental Care Professionals and Dentists at the micro-level, representatives of Professional Associations, Insurers and Dental Schools at the meso-level and Policy Makers at the macro-level. The results of this study show a significant range of attitudes towards Direct Access, but reveal a degree of consensus within individual stakeholder groups towards the reform’s introduction and impact. Dental Care Professionals interpret the introduction of Direct Access as recognition of their capabilities and expect it to primarily benefit patients through access to care and expertise. Dentists were more likely to view the introduction of Direct Access in terms of competition or professional persecution, with the impacts considered from a professional or financial viewpoint. Policy Makers saw potential for Direct Access to realign dental workforces and services to contemporary care needs. Attitudes at the meso level demonstrated the greatest variety and were more influenced by the idiosyncrasies of their respective health care system. In comparing the attitudes towards Direct Access in the Netherlands and the UK there were several differences, such as in the support of the Direct Access by Principal Dentists, however many of these can be explained by differences in healthcare funding and the time difference between the two reforms. Despite these differences stakeholders in both states felt that while Direct Access had the potential to create significant impacts on a range of issues (including professional competition, patient access to care, the reduction of care costs to patients and the state, the redistribution of dental tasks and the remodelling of the dental workforce) it was unlikely to do so in either the Netherlands or the UK. Flaws in the Direct Access regulations, legal obstructions to crucial procedures and imbalances in street-level professional power were perceived to obstruct Direct Access. Rather than revolutionising dental services Direct Access has been implemented selectively in the interest of dental practices.

Bakgrund: Antalet personer som drabbas av demenssjukdom förväntas öka i takt med att populationens livslängd blir allt längre. Demenssjukdomar skapar förändringar i hjärnan som gör att patienterna har svårigheter att samtala, tolka sin verklighet och minnessvårigheter. Vårdpersonalen förväntas ge en god och säker omvårdnad till varje enskild patient. Delaktighet anses vara en grundförutsättning för den personcentrerade vården, där vårdpersonalen har en viktig uppgift i att göra patienterna delaktiga genom att ge vård som är tillrättalagd efter patientens specifika behov. Syfte: Syftet var att beskriva vårdpersonals upplevelser av att vårda patienter med demenssjukdomar. Metod: En litteraturöversikt med kvalitativ ansats baserad på tolv vetenskapliga artiklar. Resultat: Ur analysen framkom fyra teman och fjorton underteman. Huvudtemana var: Kommunikation – en utmaning för vårdpersonal, Andliga och existentiella frågor – en utmaning för vårdpersonal, Kunskap och erfarenhet bygger bra vårdpersonal, och Den känslomässiga vårdpersonalen. Konklusion: Kommunikationsproblem, tidsbrist och brist på utbildning leder till att vårdpersonalen känner en känsla av otillräcklighet i samband med vården av patienter med demenssjukdom. Vårdpersonalens välbefinnande förbättras genom att de känner stöd från kollegor, chefer och ett öppet arbetsklimat. / Background: The number of people afflicted with dementia is expected to increase due to the longer life expectancy of the population. Dementias create changes in the brain causing the patients to have difficulties speaking, interpreting their reality and remembering. Health professionals are expected to provide each patient with good and safe care. Involvement is considered a prerequisite for the person-centred care, where the nurses have an important task in making the patients involved by providing care personalised after the patients’ specific needs. Aim: The aim was to describe health professionals’ experiences of caring for patients with dementia. Method: A literature review with a qualitative approach based on twelve scientific articles. Results: From the analysis four main themes and fourteen subthemes emerged. The main themes were: Communication – A Challenge for Health Professionals, Spiritual and Existential Questions – A Challenge for Health Professionals, Knowledge and Experience Makes Good Health Professionals, Anxiety of Prioritising and The Emotional Health Professionals. Conclusion: Communication problems, lack of time and lack of education leads to nurses having a feeling of insufficiency regarding their care of patients with dementia. The nurses’ well-being is improved by them feeling supported by colleagues, bosses and an open working climate.

The main topic of Master's Thesis is the analysis of recruitment in the company KPMG Czech Republic, regarding to specifically experienced employees in the department Management Consulting. The thesis consists of two integrated parts; the theoretical part covers basic terms and pieces of knowledge in area of recruiting employees and the practical part introduces at first the company KPMG Czech Republic and the department Management Consulting. The analysis is focused on identifying external and internal conditions of recruiting experienced employees in the department of company and on assessing process as well as current methods of recruitment. On the base of findings and in consideration of the latest trends, there are set out suggestions on how is possible to optimize recruiting experienced professionals from external sources in the department Management Consulting.

Bakgrund: Studier visar att mobiltelefoner används i operationsrummen både för tjänsterelaterat och privat bruk och det beskrivs för- och nackdelar relaterat till mobiltelefonanvändning inom sjukvården. Syftet: Var att beskriva och kartlägga användning av tjänstetelefoner och personalens privata mobiltelefoner i operationsrummen. Metod: Kvantitativ ansats, designen är en beskrivande tvärsnittsstudie med 40 strukturerade observationer i operationsrummen samt en enkätundersökning, som besvarades av 33 personer. Deltagarna var  anestesisjuksköterskor, läkare, operationssjuksköterskor och undersköterskor. Data analyserades deskriptivt i SPSS. Resultat: Observationerna i operationsrummen visade att av 477 telefonanvändningar var 287 (60,2 %) privata mobiltelefoner och 190 (39,8 %) tjänstetelefoner. Följsamheten till basalhandhygien riktlinjer före och efter telefonanvändning, n=477, var 93 (19,4 %) respektive 103 (21,5 %). Av enkäten framgick att 9 (27,2%) av deltagarna dagligen upplevde att användning av privata mobiltelefoner störde teammedlemmar i operationsrummen. Åtta (24, 2%) av deltagarna upplevde dagligen, 7 (21,7%) varje vecka, att medarbetare blev mindre koncentrerade på grund av användning av privata mobiltelefoner. Konklusion: Ökad följsamhet till basal handhygien, utformning av riktlinjer angående användning av privata mobiltelefoner i operationsrummen samt en diskussion angående vad som är etiskt riktigt i förhållande till patienterna kan anses som väsentligt. Ytterligare studier behövs för fortsatt kartläggning av användning och hantering av mobiltelefoner i operationsrummen. / Background: Studies show that mobile phones are used in the operating rooms for both service-related and private use, and the advantages and disadvantages associated with the use of mobile phones in the healthcare sector are described. Purpose: To describe and map the use of service phones and staff's private mobile phones in the operating rooms. Method: Quantitative approach, the design is a descriptive crosssectional study with 40 structured observations in the operating rooms and a questionnaire survey, which was answered by 33 people. The participants were anesthetic nurses, anesthesiologists, operating room nurses and assistant nurses. Data was analyzed descriptively in SPSS. Result: The observations in the operating rooms showed that of 477 phone uses, 287 (60.2%) were private mobile phones and 190 (39.8%) service phones. The adherence to basal hygiene guidelines before and after telephone use, n = 477, was 93 (19.4%) and 103 (21.5%), respectively. The survey showed that 9 (27.2%) of the participants experienced daily that the use of private mobile phones disturbed team members in the operating rooms. Eight (24, 2%) of participants experienced daily, 7 (21.7%) weekly, employees became less concentrated due to the use of private cell phones. Conclusion: Increased compliance with basic hand hygiene, designing guidelines regarding the use of private mobile phones in the operating rooms and a discussion regarding what is ethically correct in relation to the patients can be considered essential. Further studies are needed for continued examination of the use and management of mobile phones in the operating rooms.

Background: Endometriosis is a hormonal reactive syndrome affecting women of reproductive age. The cause of endometriosis is unknown, but known symptoms include dysmenorrhea and infertility. Symptoms can amount to emotional and psychosociological disorders/issues such as depression and isolation which can result in limited ability to work and lead a normal daily life. Aim: To describe women with endometriosis experiences of reception from healthcare professionals. Method: Descriptive literature study. Main Result: The experience of normalization and distrust in symptoms as well as the lack of adequate information and support from healthcare professionals were reoccurring themes in the results of this study. Accounts from the included studies within this thesis portrayed women’s experiences of confusion, anxiety, anger, and frustration as a consequence of perceived unsatisfactory reception from healthcare professionals due to inadequate support and information. Women experienced difficulties in feeling understood and taken seriously by healthcare professionals. However, in cases where women in the aforementioned studies were met with understanding as well as pertinent information and support was appreciation expressed. Conclusion: The results presented in this study concluded that knowledge of endometriosis was perceived as partially inadequate. Regarding reception, it seems of importance that healthcare professionals portray qualities such as empathy and understanding as a reflection of women’s needs occasionally depicted in this study’s results. Studies reviewed in this paper, whose participants described their experiences of reception by healthcare professional in relation to endometriosis, exemplify the importance that healthcare professionals, in addition to the ability to provide good communication, also possess the ability to communicate empathy and understanding towards patients. / Bakgrund: Endometrios är en hormonreaktiv sjukdom som drabbar främst kvinnor i reproduktiv ålder. Dess orsak är okänd men effekter av sjukdomen kan innefatta fysiska symtom såsom dysmenorré, dyspareuni, menorragi och infertilitet. Detta kan ge upphov till emotionella och psykosociala besvär som depression och isolering vilket kan resultera i begränsad förmåga till sysselsättning. Syfte: Att beskriva kvinnor med endometrios erfarenheter och upplevelser av bemötande från vårdpersonal. Metod: Deskriptiv litteraturstudie. Huvudresultat: Genom analys av resultaten av de inkluderade studierna var upplevelser av normalisering, misstro, bristfällig information och stöd hos kvinnor i mötet med vårdpersonal återkommande teman. Kvinnor upplevde att det bristande bemötandet resulterade i känslor såsom förvirring, oro, ilska, och frustration. Kvinnor med endometrios upplevde svårigheter att känna sig förstådd och att symtomen skulle tas på allvar av vårdpersonalen. Hos de deltagande kvinnor som bemötts med förståelse, information, och stöd av vårdpersonal uttrycktes uppskattning för detta. Slutsats: Resultaten i föreliggande litteraturstudie tyder på att kunskapen om sjukdomen inom vården varit delvis upplevts som bristfällig. Gällande bemötande förfaller det utifrån föreliggande litteraturstudies resultat vara betydelsefullt att vårdgivare uppvisar den typ av förståelse och empati som kvinnorna i studien stundvis uttryckt behov av. Alla studier som granskats i detta litteraturstudie vars deltagare själva beskrivit sina erfarenheter av bemötande från vårdpersonal exemplifierar betydelsen av att vårdpersonalen, förutom att vara påläst även besitter förmågan av god kommunikation, empati och förståelse i mötet med patienter med endometrios.

Bakgrund: Det finns ett flertal lagrum i Sverige som reglerar ungas rätt tilldelaktighet i beslut som rör dem själva. Det är en grundläggande rättighet och ettcentralt uttryck för att visa respekt för ungas status som självständiga subjekt. Detär inte alltid möjligt för unga att införliva delaktighet på egen hand utan de är oftaberoende av professionella. Professionellas uppfattningar om ungas rätt tilldelaktighet kan dock utgöra ett hinder för dess införlivning.Syfte: Syftet med studien var att undersöka professionellas upplevelser av ungasdelaktighet i samhällsvård och vilken betydelse det har för vården.Metod: En litteraturöversikt med en induktiv ansats har använts i studien. Detinsamlade materialet har antagit en kvalitativ ansats och är baserat på 11vetenskapliga artiklar från databaserna Psycinfo och Sociological abstract.Artiklarna har analyserats genom en tematisk analys.Resultat: 6 teman identifierades i studien: "Betydelsen avdeltagande", ”Förutsättningar hos unga", "Förutsättningar hos professionella","Skydd av unga", "Relationers påverkan på delaktighet" och "Utmaningar ochframtida behov ”.Diskussion: Resultatet visar på att professionella uppfattar ungas delaktighet somen viktig aspekt i praktiken. Samtidigt finner de utmaningar i att införliva det. Deupplever ett behov av mer kunskap inom området och ett bättre välfärdssystem. / Background: There are several different laws in Sweden governing youngpeople’s rights to participate in decisions that concerns themselves. It is afundamental right and an expression of showing respect for young people’s statusas independent subjects. It is not always possible for young people to incorporatetheir participation on their own as they often depend on professionals. Theprofessionals’ perceptions of young people’s right to participation may be anobstacle to its incorporation.Aim: The aim of this study was to explore professionals’ experiences of youngpeople’s participation in social care.Method: A literature review with an inductive approach has been used for thestudy. The collected material has adopted a qualitative approach and is based on11 articles found in databases Psycinfo and Sociological Abstracts. The articleshave been analyzed through a thematic analysis.Results: 6 themes were identified in the study: ”The importance ofparticipation”, ”Conditions for young people”, ”Conditions forprofessionals”, ”Protection of young people”, ” Impact of relationships onparticipation” and ”Challenges and future needs”.Discussion: The results show that professionals consider participation to be animportant aspect of their practice. At the same time, they find challenges inincorporating it. They experience a need for more knowledge in the area and abetter welfare system.

Bakgrund: Möjligheten för anhöriga att närvara vid återupplivningsförsök är ett omdiskuterat ämne och rutinerna kring detta skiljer sig åt beroende länders olika riktlinjer kring ämnet. Det finns ett större antal kvantitativa studier som behandlar upplevelser av anhörigas närvaro vid återupplivningsförsök. Däremot finns det inte lika många kvalitativa studier som berör ämnet. Därför kan det vara relevant att studera dessa kvalitativa studier närmare och belysa de anhörigas upplevelser i relation till sjukvårdspersonalens.Syfte: Syftet med denna litteraturstudie var att belysa både anhörigas och sjukvårdspersonalens upplevelser av att anhörigas närvaro vid ett återupplivningsförsök på en närstående.Metod: En litteraturstudie baserad på tio kvalitativa artiklar som belyser både sjukvårdspersonalens och de anhörigas perspektiv. Artikelsökningen genomfördes i databaserna PubMed och CINAHL.Resultat: Fyra huvudkategorier med två underkategorier vardera identifierades. Delaktighet; Aktivt deltagande och Insyn och stöd, Information och kommunikation; God kommunikation och Bristande kommunikation, Trauma; Oro för familjen och Risker, Förutsättningar; personal- och platsbrist och Personalens upplevelse av utsatthet.Slutsats: I resultatet framkom både positiva och negativa effekter av att anhöriga närvarar vid ett återupplivningsförsök på en närstående. Möjligheten att ha fått vara närvarande kunde underlätta sorgearbetet för familjen och hjälpa dessa att acceptera situationens utfall. Närvaron kunde även ge familjen en chans att agera stöd åt patienten. De största orosmomenten för sjukvårdspersonalen handlade om hur familjens beteende eventuellt kunde påverka arbetet med patienten samt eventuella negativa effekter för familjens psykiska hälsa i framtiden. / Background: The opportunity for families to be present during resuscitation is a well discussed subject. The routines regarding family witnessed resuscitation (FWR) depends on the national guidelines. Research has been conducted regarding experiences of FWR. The majority of this previous research used quantitative methods. Therefore, it ́s relevant to further explore the existing qualitative research regarding FWR.Aim: The aim of this study was to illuminate families ́ and health care professionals ́ experiences of FWR.Method: A literature review based on ten qualitative articles obtained from PubMed and CINAHL.Results: Four main categories with two subcategories each were identified. Participation; Active participation and Transparent & support, Information and communication; Good communication and Lack of communication, Trauma; Concerns for the family and Risks, Conditions; Lack of staff and space and The staff ́s sense of exposure.Conclusion: The result that emerged showed both positive and negative effects of FWR. The opportunity to be present could help the family accept the outcome of the procedure and help to ease the grieving process. Family ́s presence could also function as a source of support for the patient. The health care professionals ́ biggest concerns were about the family's behavior and how it possibly could affect the situation in a negative way and also the risk of negative effects on the family ́s psychic health in the future.

The purpose of this study is to lift and highlight the problem battered gay men face when they seek help for domestic violence in partner relationship. One thing that can make it more difficult to seek help can be because the accepted sexual norm in society is the heterosexual orientation. The study has a qualitative approach, which contain four semi structured interviews with professionals who works in the domestic violence field. The material from the interviews have been analyzed and seven themes appeared during the process, Exclusion, authority/organization, professionals, heterosexual norm and other stereotypes, cooperating, marketing and availability. Research shows that homosexual men does not have the same availability for seeking help due to society’s heterosexual norm. Gay men are afraid not to be taken seriously in the meeting with professionals due to the masculinity and heterosexual stereotypes. Not all domestic violence shelters and crisis center welcomes victims with a homosexual orientation. Organizations who welcomes all different sexual orientations aren’t good at marketing themselves which makes it hard for LGBT people to know where they can seek help without the fear of not be taken seriously. My data shows a need of raising the subject about homosexual men’s vulnerability when seeking help for domestic violence and include every sexual orientation in organizations marketing ads. The conclusion of the report is the need of raising competence among professionals due to different sexual orientations and the following vulnerabilities. Also, be norm critical in the professional role about sexuality and masculinity. So, everyone no matter what sexual orientation easily accessible help when victims have been exposed for domestic violence.

This paper is written in a collaboration with the Swedish Police in Landskrona.Based on their request to know more about the decreasing crime rates inLandskrona the purpose of the study is to highlight and create knowledge aboutpossible explanations for these changes. The study consists of semi-structuredinterviews with different stakeholders from the Police, Municipality and theCounty Administrative Board. These individuals’ perceptions are used in order todiscover what is happening in Landskrona. During the examined ten-year period ithas been possible to distinguish a downward trend in terms of reported crimes inLandskrona. The result shows several possible explanations to this trend but, themost consistent findings are; effective collaboration mainly between the Policeand the municipality, various investments toward youths both social andeducational and huge investments in urban development. These investments areused as possible explanations for the changes in reported crime in Landskrona andperceived to play a pivotal role when it comes to understand the decreasing crimerates.