<p>The prehospital management of patients with acute myocardial infarction (AMI)now includes 12-lead electrocardiogram transmission directly from the ambulance to hospital.If the ECG shows ST-elevated myocardial infarction the patient should be transported directlyto a hospital with capability for percutaneous coronary intervention (PCI).                                               Aim: The aim of this study was to describe how ambulance nurses experienced the prehospital management of patients with AMI who are transported by ambulance directly to hospital for PCI.                                                Method: Semi structured interviews were conducted with eight ambulance nurses. Data were analysed using qualitative content analysis. The categories that emerged were: Use ofcompetence, Responsibility and Insufficiency. Result: The result showed that the ambulance nurses felt secure when they cared for patients transported directly to PCI. The nurses assessed the patient and decided how he or she should be cared for. The contact with doctors was considered good. However the nurses discussed the noisy environment in ambulances and bad connection in the cellular phone network as a source of insecurity when prescriptions were given to them. They would like to have a written prescription as a text message from the doctor. The nurses also felt that they had the sole responsibility for the patient.                      Conclusions: The capability of working alone, ability to act in complex situations andspecialist knowledge in order to assess the patient correctly is important. Prescriptions should be verified with a text message to the ambulance from prescribing doctor.</p> / <p>Prehospital omvårdnad av patienter med akut hjärtinfarkt innefattar numera att 12-avledningsleds elektrokardiogram (EKG) sänds från ambulansen till sjukhus. Om EKG visar ST-höjningsinfarkt skall patienten transporteras direkt till sjukhus med möjlighet att utföra perkutan coronar intervention.          Syfte: Syftet med studien var att beskriva hur sjuksköterskor i ambulans upplever den prehospitala omvårdnaden av patienter med akut hjärtinfarkt som transporterats med ambulans direkt till sjukhus för perkutan coronar intervention (PCI).                                                                            Metod: Semistrukturerade intervjuer genomfördes med åtta sjuksköterskor inom ambulansverksamheten. Kvalitativ innehållsanalys valdes för att analysera data och utmynnade i tre kategorier: Kompetensnyttjande, Ansvarstagande och Otillräcklighet.                                                  Resultat: Resultatet visade att sjuksköterskorna upplevde trygghet i uppdraget att omhänderta patienter med hjärtinfarkt som transporteras direkt till PCI. Sjuksköterskorna bedömde patientens tillstånd och tog ställning till hur den fortsatta omvårdnaden skulle utformas. Kontakten med mottagande läkare upplevdes mycket bra. Något som upplevdes som mindre positivt var dels den bullriga miljö som förekom i några ambulansmodeller, samt när det var dålig mottagning i mobiltelefonnätet. Båda dessa störningsmoment upplevdes som en källa till osäkerhet när det gällde läkemedelsordinationer från mottagande läkare. Det fanns önskemålom att dessa ordinationer borde verifieras med ett textmeddelande till ambulansen. Vidare visade resultatet att sjuksköterskorna kunde uppleva ensamhet med omvårdnadsansvaret för patienten.    Slutsatser: Vikten av att kunna arbeta ensam, ha handlingsberedskap i komplexa situationer och specialistkunskaper för att kunna göra korrekta bedömningar är av stor betydelse. Läkemedelsordinationer till sjuksköterskan ska verifieras genom att ordinerande läkare skickar ordinationen skriftligt via textmeddelande till ambulansen.</p>

<p>Syftet med studien var att undersöka hur manliga elitfotbollspelare (1) upplever stress under sin rehabilitering samt (2) vilka typer av strategier de använder sig av för att minska den upplevda stressen under sin rehabilitering. Elitfotbollspelarna (N=11) med en medelålder på 22 år besvarade en semistrukturerad intervjuguide gällande stress och coping under rehabilitering. Intervjuerna analyserades genom tematisk innehållsanalys. Resultatet visade att elitfotbollspelare upplever störst press och stress från sig själva och att det sociala nätverket är en viktig del för att handskas med upplevd stress. Resultatet visade även att positiv inställning är en viktig komponent för att få ett bra rehabiliteringsutfall. Resultatet från studien diskuterades i relation till relevant litteratur samt fyra utvalda teorier som tar upp de centrala begreppen i studien.</p> / <p>The purpose of this study was to examine how male elite soccer players (1) experience stress during their rehabilitation, and (2) what types of coping strategies they use to reduce the perceived stress during their rehabilitation. Elite soccer players (N = 11) with a mean age of 22 years responded to a constructed interview guide about current stress and coping during rehabilitationperiod. The interviews were analyzed by qualitative content analysis. The results showed that elite soccer players are experiencing the greatest pressure from themselves and to the social network is an important part to deal with the resulting pressure. The results also showed that positive attitudes are an important part leading to adaptive rehabilitation outcome. Results of the study were discussed in relation to relevant literature, and four selected theories that address the key concepts in the study</p>

<p></p><p>BAKGRUND: Antalet multisjuka äldre personer ökar och ett omfattande vårdbehov kan skönjas. Vårdens organisation och hur den fylls med innehåll påverkar relationen till patienten. Ledarskapsstilen påverkar upplevd arbetstillfredsställelse och den kultur som vårdpersonalen skapar tillsammans avgör livskvalitet och vårdandets kvalitet för patienten. SYFTE: Syftet med studien är att utifrån semistrukturerad observation beskriva arbetsinnehållet och ledarskap för en första linjens chef inom kommunal äldreomsorg. METOD: En fallstudie, a single case study, med semistrukturerad observation av en första linjens chef inom kommunal äldreomsorg. Studien hade en deskriptiv design med en kvalitativ ansats. Observatörens nedskrivna texter analyserades med latent innehållsanalys. RESULTAT: Utförande av arbetsuppgifter hade genomgående karaktär av ledarskap. Administration och organisering av arbete var en stor del av arbetsuppgifterna och övervägande var oplanerade. Ansvarstagande, problemlösning, bekräftelse, tjänstvillighet och organisering av arbete där personlighet, kunskap och yrkeserfarenhet påverkade ledarskapet och informantens upplevelse av utförandet av arbetsuppgifter. SLUTSATS: En första linjens chefs arbetsuppgifter är mångfacetterande och spänner sig över kvalificerat arbete där specifik utbildning krävs och till att serva boende och däremellan ge direktiv och organisera för att få arbetet utfört samt medverka vid möten med ledning och chefsgrupp. En dialog som exempelvis öppet informerar om förändringar och varför samt att medarbetare accepterar och samarbetar för att underlätta arbetet där perspektivet utgår från den boende vilket skulle påverka vårdkulturen i positiv riktning och öka möjligheten till en kreativ och livsbejakande miljö kring den boende.</p>

<p>Our aim with this study is to investigate whether or not Utbildningsradions - which is a public broadcasting agency - educational programmes reproduce the existing gender patterns of the female and male genders. We have chosen to analyse two educational programmes, Home Farm Twins and Rena rama forntiden.</p><p>We use a social constructionist theory regarding the construction and reproduction of gender and the method we have chosen to use is a qualitative content analysis to study the educational programmes.</p><p>Our conclusion is that in the case of Home Farm Twins, it reproduces the current stereotypes that exist in society. Rena rama forntiden on the other hand does not, the program has got a clear gender perspective in regards to its content. Though it can be said that in some ways it does not reflect upon the gender patterns that exist in society today, to a satisfactionary extent.</p><p>Utbildningsradion does not achieve its policy concerning Home Farm Twins, but on the other hand it shows that in the case of Rena rama forntiden they do own up to the standards regarding cultural diversity and creative aim.</p>

The general aim of this thesis was to study the transition process from dependency towards anatomy and psychological empowerment among teenagers with type 1 diabetes. Thirty-two teenagers (18 female/14 male) aged 13-17 took part in conversational interviews. The interviews followed a semi-structured question guide. Data comprised 31 tape recorded interviews (one informant did not want to be tape recorded). The research design was based on a phenomenological and life world perspective including two different analysis methods. The transition towards autonomy among teenagers with type 1 diabetes was elucidated in a phenomenological approach (paper I). Through the teenagers’ narratives about their daily life experiences with type 1 diabetes there emerged the over-riding theme “Hovering between individual actions and support of others”. This theme illustrates the main problem related to diabetes management - duality in dependence and independence. The themes “growth through individual self-reliance” and “growth through confirmation of others” seem to facilitate the transition process from dependency towards autonomy. Experiences of the Empowerment Education Programme (EEP) were studied by a qualitative content analysis (paper II). From the teenagers’ descriptions the over-riding theme was formulated as “Sense of community”, and this covered the categories of social fellow feeling, collaborative learning, and community of interests. A synthesis of the findings illustrates that individual self-reliance, confirmation of others, and sense of community are closely related to individual inner resources, trust in others, and the feeling of belonging, which are all suggested as specific goals of empowerment and fulfilment of psychological empowerment. A model was created to explain the relation between psychological empowerment and growth through individual self-reliance, confirmation of others, and sense of community. Professional nursing care might start from the unique situation and context the individual experiences and exists in. Social meetings with like-minded youth were highly appreciated among the teenagers. The teenagers showed their willingness to transform themselves towards becoming more independent in self-management, and the teenage years may be the right period to empower and coach the teenagers towards autonomy and prepare them for adulthood living with type 1 diabetes.

Abstract Authors: Mikael Gustafsson &amp; Kristofer von Wachenfeldt Title: With help from people and cattle; to recover from mental illness in a rural environment [translated title] Supervisor: Kent-Inge Perseius Purpose: The aim of this study was to examine feelings of recovery from mental illness in the perspective of individuals participating in Nymålen; a rural- situated facility focusing on recreation- and work- related interventions. The study took place outside of Oskarshamn, Sweden. The study focused on if, and in that case how, Nymålen contributes to recovery from mental illness. We were also interested in which factors affecting the recovery-process, as expressed by the participants themselves. Method: Eight individuals from Nymålen participated in individually performed semi- structured interviews. The collected data was then coded and categorized to enable further analysis by using Qualitative content analysis inspired by Graneheim &amp; Lundman (2003). Latent themes that described the underlying meaning of the material were then extracted, using an analysis inspired by Robert K. Merton’s (1967) thesis on manifest and latent functions. Results: The findings of this study suggest that Nymålen in some ways contributes to feelings of recovery from mental illness. Nymålens environment including animals, a feeling of non- demanding chores, perceptive personnel and a positive interaction between the participants were the expressed main factors contributing to recovery from mental illness. Factors interrupting the recovery process were also detected, mainly an unhealthy feeling of competition between the participants, the lack of personnel and feelings of neglect from other psychiatric institutions. Keywords: Recovery, Mental illness, Animals, Rural, Rehabilitation, Qualitative content analysis

 BAKGRUND: Antalet multisjuka äldre personer ökar och ett omfattande vårdbehov kan skönjas. Vårdens organisation och hur den fylls med innehåll påverkar relationen till patienten. Ledarskapsstilen påverkar upplevd arbetstillfredsställelse och den kultur som vårdpersonalen skapar tillsammans avgör livskvalitet och vårdandets kvalitet för patienten. SYFTE: Syftet med studien är att utifrån semistrukturerad observation beskriva arbetsinnehållet och ledarskap för en första linjens chef inom kommunal äldreomsorg. METOD: En fallstudie, a single case study, med semistrukturerad observation av en första linjens chef inom kommunal äldreomsorg. Studien hade en deskriptiv design med en kvalitativ ansats. Observatörens nedskrivna texter analyserades med latent innehållsanalys. RESULTAT: Utförande av arbetsuppgifter hade genomgående karaktär av ledarskap. Administration och organisering av arbete var en stor del av arbetsuppgifterna och övervägande var oplanerade. Ansvarstagande, problemlösning, bekräftelse, tjänstvillighet och organisering av arbete där personlighet, kunskap och yrkeserfarenhet påverkade ledarskapet och informantens upplevelse av utförandet av arbetsuppgifter. SLUTSATS: En första linjens chefs arbetsuppgifter är mångfacetterande och spänner sig över kvalificerat arbete där specifik utbildning krävs och till att serva boende och däremellan ge direktiv och organisera för att få arbetet utfört samt medverka vid möten med ledning och chefsgrupp. En dialog som exempelvis öppet informerar om förändringar och varför samt att medarbetare accepterar och samarbetar för att underlätta arbetet där perspektivet utgår från den boende vilket skulle påverka vårdkulturen i positiv riktning och öka möjligheten till en kreativ och livsbejakande miljö kring den boende.

Inom rättspsykiatrin vårdas många patienter med samsjuklighet missbruk/beroende. Patientgruppen är heterogen med komplexa och specifika vårdbehov. Vårdare är de som tillbringar mest tid med dessa patienter. Studiens syfte var att beskriva vårdares erfarenheter av att vårda patienter som lider av allvarlig psykisk störning med samsjuklighet missbruk/beroende, inom rättspsykiatrisk vård. Tio sjuksköterskor och tio skötare som arbetade på en rättspsykiatrisk regionvårdsklinik intervjuades och materialet bearbetades med kvalitativ innehållsanalys. Intervjuer gjordes med stöd av en semistrukturerad intervjuguide. Ur analysen framkom 14 subkategorier som bildade fyra kategorier; samverkan, skapa funktionellt vardagsliv, finnas kvar över tid och kunskap/kompetens. Resultatet visade att vårdares samverkan med patienter och övriga yrkeskategorier gav vårdprocessen en helhetssyn. Goda vårdrelationer kunde hjälpa patienter att bryta förnekelse av missbruksproblem. Individanpassade aktiviteter och praktisk färdighetsträning var betydelsefullt i patienters rehabilitering. Vårdprocessen kunde inte forceras och motivationsarbetet var centralt. Klinisk erfarenhet, livserfarenhet, teoretisk kunskap kombinerat med en trygg och stabil personlighet, var den kompetens som enligt vårdare behövdes för att vårda dessa patienter. Inom kunskapsområdet missbruk/beroende upplevde vårdare behov av teoretisk komplettering. / Many psychiatric patients with comorbidity of addiction /dependence are treating in forensic mental health. The patient group is heterogenic with complex and specific health needs. Nursing care staffs are those who spent the most time with these patients. The aim of this study was to describe caregivers' experiences of caring for patients suffering from severe mental disorder with comorbidity of addiction /dependence, in psychiatric care. Ten registered nurses and ten licensed mental nurses who worked at a forensic psychiatric clinic were interviewed, and the material was processed with content analysis. Interviews were conducted with support of a semi-structured interview guide. From the analysis revealed 14 subcategories to form four categories: collaboration, create functional everyday life, persist over time and knowledge / skills. The results showed that nursing care staff´s interaction with patients and other health care professionals gave a holistic approach. Good health care relationships could help patients to break the denial of substance abuse problems. Individualized activities and practical skill training was important in patients' rehabilitation. Nursing process could not be rushed and motivational work was crucial. Clinical experience, life experience, theoretical knowledge combined with a secure and stable personality, were the skills as nursing care staff´s needed to care for these patients. In the area of knowledge abuse/dependence experienced nurses need theoretical completion.

Our aim with this study is to investigate whether or not Utbildningsradions - which is a public broadcasting agency - educational programmes reproduce the existing gender patterns of the female and male genders. We have chosen to analyse two educational programmes, Home Farm Twins and Rena rama forntiden. We use a social constructionist theory regarding the construction and reproduction of gender and the method we have chosen to use is a qualitative content analysis to study the educational programmes. Our conclusion is that in the case of Home Farm Twins, it reproduces the current stereotypes that exist in society. Rena rama forntiden on the other hand does not, the program has got a clear gender perspective in regards to its content. Though it can be said that in some ways it does not reflect upon the gender patterns that exist in society today, to a satisfactionary extent. Utbildningsradion does not achieve its policy concerning Home Farm Twins, but on the other hand it shows that in the case of Rena rama forntiden they do own up to the standards regarding cultural diversity and creative aim.

The aim of this thesis was to investigate what an intervention comprising systematic discussion groups meant in the context of conflicts and cooperation between social care staff and nursing staff, over a period of 7–15 months. The intervention was carried out in four experimental dwellings in special types of housing for elderly and disabled people and in comparison with four similar reference dwellings. Results are based on 27 interviews prior to the intervention and 29 after. The interviewees were managers, registered nurses, enrolled nurses and care assistants and concerned their experiences regarding problematic situations that occurred in their everyday work. The questionnaires (before n=84 and after intervention n=93) used were: sense of coherence, job-satisfaction and burnout and were aimed at investigating staff experiences of working climate and the influence of the intervention. The issues were investigated both before and after the intervention. Observations were used to determine whether they could provide further knowledge about the intervention and thus extend our understanding of the marginal differences in the complementary studies. The phenomenological hermeneutic interpretation of the narratives in the interviews shows that the intervention was important to the experiences of being in problematic situations. The results before the intervention and in reference dwellings are equivalent and elucidate staff members' struggle to retain their self-esteem and to be confirmed by their colleagues. The experimental dwellings narratives show a change from rejecting to confirming communication among colleagues. Moreover, subtle changes are present which point to an emotional closeness where attempts have been made to understand colleagues' perspective and reactions where the residents are the central concern in the narratives. An analysis of the content of the interviews after intervention shows equivalent changes in experimental dwellings and reference dwellings. The analysis shows that the staff's view of problematic situations had been softened and that they viewed their colleagues as less of a hindrances. There were no mentions made of the previously indicated conflicts between social and nursing staff. The results also show that staff members are not afraid to stand by their own ideas of how they should act in various situations. The staff experience of the working climate was positive both before and after the intervention and no significant differences could be seen. What stands out from the observation study is that the groups have different cultures and thus different prerequisites for the intervention. In two of four groups the intervention seemed to give rise to positive meanings regarding the staffs´ understanding of each other, necessary for their successful cooperation, but when the groups are in the ”basic assumption phase” other additional strategies are probably also needed. The marginal differences shown in the other complementary studies can be understood in terms of two of the four groups not perceiving the intervention to any large extent. When the internal group processes are of great importance it is essential to pay attention to culture of the staff groups before the intervention is implemented.