Bakgrund: Palliativ vård i livets slutskede bör så långt som möjligt verka för att personen får dö på den plats som överensstämmer med uttryckt önskan, i närvaro av för den sjuka personen betydelsefulla personer. De flesta som drabbats av en allvarlig obotlig sjukdom önskar att få vårdas och dö i sitt eget hem. Trots det dör de flesta på sjukhus. Syfte: Att beskriva sjuksköterskans erfarenheter av varför den palliativa vården i hemmet avbryts.  Metod: Kvalitativa intervjuer genomfördes med 11 sjuksköterskor verksamma i palliativ hemsjukvård. Materialet analyserades med induktiv innehållsanalys.  Resultat: Vid analysen bildades tre kategorier. Förändrade förutsättningar, som innebär att personen som är sjuk och närstående behöver uppleva trygghet, orka och vara införstådda i situationen. Hemmet blir arbetsplats. Att skapa plats för vård och ha flera, ibland okända personer i hemmet kan vara svårt av integritetsskäl. Vårdens otillräcklighet innefattar kompetens och tillgänglighet inom hemsjukvården, men också organisationens struktur och samverkan med andra vårdgivare.  Slutsats: Ska personer i palliativ vård kunna kvarstanna i hemmet behövs mycket resurser och stöd från hemsjukvård och läkare. Orsakerna till att personer i palliativ vård lämnar sina hem är att de söker mer vård och stöd. Det borde vara av intresse att stärka hemsjukvårdens förutsättningar. / Background: Palliative end of life care should facilitate for sick persons to die in a place complied with expressed desire, in presence of significant people. Most people affected by serious incurable diseases, wish to be cared for and die at home. Despite this, most people die in hospitals. Aim: To describe nurses' experiences of why palliative care in the home gets interrupted. Methods: Qualitative interviews were conducted with 11 nurses in palliative care. The material was analyzed with inductive content analysis. Results: The analysis formed three categories. Changed conditions, meaning that the person and the relatives need to experience security, have strength and need to be aware. The home becomes a workplace. To create room for care and have multiple, sometimes unknown people present, can affect the privacy. Inadequacy of care includes skills and availability within the care, but also the organization's structure and collaboration with other health care providers. Conclusion: If people in palliative care should be able to remain at home, much resources and support are needed from home care and physicians. The reason that people in palliative care leave their homes is that they are seeking for more care and support. It should be of interest to strengthen home care conditions.

El Perú está ubicado en una zona sísmica alta debido a que se encuentra en el Cinturón de Fuego del Pacífico; en la cual, se produjeron varios eventos sísmicos de gran magnitud que generaron consecuencias catastróficas. Además de ello, hace más de 200 años no ocurre un terremoto cerca de la capital peruana. Por otro lado, los centros educativos deben servir como lugares de refugio ante cualquier catástrofe. Por ese motivo, es importante evaluar que módulos o pabellones escolares públicos son aptos para soportar un sismo importante. En base a ello, la presente tesis evalúa la vulnerabilidad sísmica mediante un método cualitativo, que fue usado en varios países para determinar la vulnerabilidad de las estructuras, y otro método cuantitativo, basado en la filosofía de la norma peruana sismoresistente E0.30. La metodología cualitativa, Índice de vulnerabilidad del FEMA P-154, emplea cartillas de evaluación visual rápida de la vulnerabilidad sísmica para cualquier edificación, en este caso instituciones educativas públicas, es muy útil al tener una data extensa. De la misma manera, la metodología cuantitativa evalúa según la distorsión los posibles efectos que puede tener una estructura después de un sismo severo. El distrito de Villa María del Triunfo fue seleccionado para emplear esta metodología por ser un lugar con poco mantenimiento de colegios y para mostrar que módulos o pabellones son seguros para que los pobladores de dicho lugar se refugien. / Peru is located in a high seismic zone due to the Pacific Ring of Fire; in which, several seismic events of great magnitude generated catastrophic consequences. In addition to this, more than 200 years ago doesn’t happen a mayor earthquake near the Peruvian capital. On the other hand, according to world politics, schools must serve as places of refuge to face any catastrophe. For this reason, it is important to evaluate which modules of public-school are able to withstand an important earthquake. Based on this, this thesis evaluates the seismic vulnerability by means of a qualitative method, which was used in several countries to determine the vulnerability of the structures, and another quantitative method, based on the philosophy of the norma peruana seismoresistente E0.30. The qualitative methodology, FEMA Vulnerability Index P-154, uses quick visual assessment sheets of seismic vulnerability for any building, in this case public educational institutions, is very efficient when a very extensive data is required. In the same way, the quantitative methodology evaluates, according to the distortion, the possible effects that a structure can suffer after a several earthquake. The district of Villa María del Triunfo was selected to use this methodology for being a place with little maintenance of schools and to show what modules or pavilions are safe for people to take refuge. / Tesis

<p>Happiness research is advancing as an academic discipline as well as on the political agenda. An aspect, largely ignored in the field, is what impact an individual’s construction of the good life has on his or her subjective well-being. The purpose of this paper was to investigate how people in different situations in life and with different backgrounds construct the idea of a good life and the importance these constructions may have in explaining subjective well-being. Despite the differences between themselves, the respondents’ constructions of the good life were shown to have a lot in common. Some factors in the good life were shared by the respondents, such as relations to other people, access to food, water and housing, whereas in other aspects, such as money and time, the constructions of the good life differed quite a lot from one another. When evaluating their own lives the respondents used quite different criteria mostly corresponding to their idea of the good life. If this is a general pattern, possible to replicate in other studies, one may in the future be able to draw the conclusion that the construction of the good life has an effect on our subjective well-being.</p>

No description available.

<p>Den psykiska ohälsan ökar mest i storstadsområdena, men ökar i alla regioner och i samtliga sociala grupper. Andelen stressrelaterade sjukskrivningar ökar, främst bland unga människor och kvinnor. Utmattningssyndrom tycks mest förekomma i s k välfärdsyrken; service, vård, skola och myndighetsutövande. Vid sekelskiftet 1900 uppvisades likartade symtom med fysisk och mental trötthet. Syftet var att beskriva hur personer med utmattningssyndrom upplever sin livssituation och effekterna av akupressurbehandling. Studien är kvalitativ, inspirerad av fenomenologi. Datainsamling har skett genom halvstrukturerade intervjuer med åtta kvinnor. Variation eftersträvades i urvalet. Genom analysen utkristalliserades sex huvudkategorier: symtombild – när orken tryter, emotioner vid utmattningsyndrom, det sociala samspelet, arbete – på gott och ont, vård och socialt skyddsnät samt akupressur och vägen tillbaka till livet. Resultatet visar att livssituationen kraftigt påverkas av sjukdomen. Sjukskrivningslängd liksom bemötande från arbetsgivare, sjukvård och försäkringskassa varierar. Såväl yrkesliv, familjeliv som socialt liv störs. Känslor av skam, skuld och värdelöshet är vanliga. Stöd från familjer, vänner och myndigheter påverkar rehabiliteringen i positiv riktning. Informanterna anser att akupressurbehandlingarna varit det som mest bidragit till att de återfått hälsan. Ytterligare studier av akupressurens effekter vid utmattningssyndrom behöver göras.</p> / <p>Mental disorders are increasing in all areas and in all social groups. Stress disorders are increasing, mostly among young people and women. Stress causes physical and mental illness. Employees in the service sector, the education field and in authorities are vulnerable groups. In 1900 there was also a physical and mental exhaustion. The aim of the study is to describe how burnout persons experience their life and the effects of acupressure treatment. It is a qualitative study, inspired by phenomenology. Data acquisition has been made through semi structured interviews with eight women. The analysis gave six main categories; symptoms – total fatigue, burnout emotions, social context, work – for good or for worse, care and social protection, acupressure and the way back to life. The result shows strongly influenced living conditions. Time on sick-leave, treatment from employers, health care system and regional social insurance offices vary. Working life, family life and social life are disrupted. Shame, guilt and feeling worthless are common feelings. Support from family, friends and authorities is essential for rehabilitation. The informants declare that acupressure has been essential for their recovery. Further studies of acupressure and burnout are needed.</p>

<p>Syftet med denna deskriptiva kvalitativa intervjustudie var att beskriva barns upplevelser av lustgasbehandling. Urvalet består av sex barn i åldern sex till fjorton år som behandlats med lustgas vid procedursmärta, akut eller planerat, på barnsjukhusets akutmottagning eller allmänna specialistmottagning. Intervjuerna analyserades med kvalitativ innehållsanalys. Alla barnen upplevde annorlunda kroppskänslor eller abstrakta känslor som inte nödvändigtvis var obehagliga under lustgasbehandlingen. Samtidigt som flera av barnen beskrev en typ av frånvaro var de flesta medvetna om omgivningen och till viss del händelseförloppet. Vidare framkom att hörsel- och synintryck kunde förvrängas där ljud ibland förstärktes och kunde störa och påverka fokuseringen. Olika grader av smärta beskrevs. I barnens egen sammanfattning uttryckte fyra av barnen positiva upplevelser. Fem av barnen var positiva till att få lustgasbehandling igen om så behövdes medan ett barn svarade "kanske" och önskade i så fall en mindre mängd lustgas nästa gång. Behandlingen kan ytterligare utvecklas genom kombination med andra smärtstillande läkemedel.</p> / <p>The aim of this descriptive, qualitative interview study was to describe children´s experiences of treatment with nitrous oxide. The sample consists of six children aged six to fourteen who were treated with nitrous oxide for procedural pain, acute or planned, in the emergency room or special surgery of the Children´s hospital. The interviews were analyzed by qualitative content analysis. All children experienced different feelings in the body or intangible feelings that were not necessarily unpleasant during the treatment with nitrous oxide. Although some of the children described some kind of absence, most of them were aware of the surroundings and to some part what happened during the treatment. Further it appeared that hearing and sight impressions could be distorted and sounds were sometimes amplified and could disturb and affect the focusing. Varying degrees of pain were described. In their own summary four of the children expressed positive experiences. Five of the children were positive to receive nitrous oxide in the future if needed, while one child answered "perhaps" and in that case wanted less amount of nitrous oxide next time. The treatment could be developed further by combining with other analgesics.</p>

<p><em>Background: </em>An increasing number of operations on children are performed as day surgery and this experience of health care may affect future hospital stays.<em> </em>The aim of this qualitative study was to describe children´s experiences in connection with day surgery.<em> Method:</em> Ten children aged six to fifteen who had gone through general anesthesia at examinations or surgery were interviewed and the content was analyzed by systematic text condensation. <em>Result: </em>The core category <em>“From uncertainty to relief with newly </em><em>acquired</em><em> experience”</em> could summarize the result of this interview study.<em> </em>In the category <em>“Uncertainty creates </em><em>insecurity</em><em>” </em>all children expressed varying levels of anxiety for the anesthesia. The main causes for the worry were insufficient information or lacking experience from similar health care situation. <em>"The concrete experience different from the qualm”</em> describes that the discomfort the children expressed were different or slighter than expected. The anesthetization was easy and quick while the awakening was described as more unpleasant. In the category <em>“Good nursing care creates security and trust”</em> the children appreciated the staff and their way of informing and giving care<em>. </em>Many expressed an ease that the procedure had passed and would experience less anxiety before a possible future anesthesia;<em> “Relieved and strengthened through experience”. Conclusion: </em>The interviewed children had surprisingly little knowledge in advance of what would happen during the day and not to mention the procedure of anesthesia. Unpleasant experiences were described even during moments where it was not expected. To reduce the anxiety and discomfort the information in connection with day surgery needs to be substantially improved in this age group<em>. </em></p> / <p><em>Bakgrund: </em>Allt fler operationer på barn utförs polikliniskt och denna erfarenhet av sjukhusvård kan påverka upplevelsen vid framtida vårdtillfällen. Syftet med denna kvalitativa studie var att beskriva barns upplevelser i samband med dagkirurgi.<em> Metod</em>: Tio barn sex till femton år som genomgått sövning i samband med undersökning eller operation intervjuades och innehållet analyserades med systematisk textkondensering. <em>Resultat: </em>Temat <em>”Från ovisshet till lättnad med nyvunnen erfarenhet” </em>kan sammanfatta resultatet av intervjustudien. I kategorin <em>”Ovisshet skapar otrygghet” </em>uttrycktes oro i varierande grad inför sövningen vilken främst orsakades av otillräcklig information eller saknad erfarenhet av liknande sjukvårdssituation. <em>”Den konkreta upplevelsen annorlunda än farhågan” </em>beskriver att obehagen barnen berättade om var annorlunda eller lindrigare än förväntat. Nedsövningen gick lätt och snabbt medan uppvaknandet beskrevs som mera obehagligt. Under kategorin <em>”God omvårdnad skapar trygghet och tillit”</em> gav barnen positiva omdömen om personalen och deras sätt att informera och ge omvårdnad. Många uttryckte en lättnad över att ingreppet var genomfört och uppgav att de skulle känna mindre oro inför en möjlig framtida sövning; <em>”Lättade och stärkta av erfarenheten”.</em> <em>Slutsats: </em>De intervjuade barnen hade överraskande lite kunskap i förväg om vad som skulle hända under dagen och inte minst narkosproceduren. Obehag upplevdes även under moment där det ej förväntades. För att minska oro och obehag behöver informationen i samband dagkirurgi förbättras avsevärt till denna åldersgrupp.</p>

Background: An increasing number of operations on children are performed as day surgery and this experience of health care may affect future hospital stays. The aim of this qualitative study was to describe children´s experiences in connection with day surgery. Method: Ten children aged six to fifteen who had gone through general anesthesia at examinations or surgery were interviewed and the content was analyzed by systematic text condensation. Result: The core category “From uncertainty to relief with newly acquired experience” could summarize the result of this interview study. In the category “Uncertainty creates insecurity” all children expressed varying levels of anxiety for the anesthesia. The main causes for the worry were insufficient information or lacking experience from similar health care situation. "The concrete experience different from the qualm” describes that the discomfort the children expressed were different or slighter than expected. The anesthetization was easy and quick while the awakening was described as more unpleasant. In the category “Good nursing care creates security and trust” the children appreciated the staff and their way of informing and giving care. Many expressed an ease that the procedure had passed and would experience less anxiety before a possible future anesthesia; “Relieved and strengthened through experience”. Conclusion: The interviewed children had surprisingly little knowledge in advance of what would happen during the day and not to mention the procedure of anesthesia. Unpleasant experiences were described even during moments where it was not expected. To reduce the anxiety and discomfort the information in connection with day surgery needs to be substantially improved in this age group. / Bakgrund: Allt fler operationer på barn utförs polikliniskt och denna erfarenhet av sjukhusvård kan påverka upplevelsen vid framtida vårdtillfällen. Syftet med denna kvalitativa studie var att beskriva barns upplevelser i samband med dagkirurgi. Metod: Tio barn sex till femton år som genomgått sövning i samband med undersökning eller operation intervjuades och innehållet analyserades med systematisk textkondensering. Resultat: Temat ”Från ovisshet till lättnad med nyvunnen erfarenhet” kan sammanfatta resultatet av intervjustudien. I kategorin ”Ovisshet skapar otrygghet” uttrycktes oro i varierande grad inför sövningen vilken främst orsakades av otillräcklig information eller saknad erfarenhet av liknande sjukvårdssituation. ”Den konkreta upplevelsen annorlunda än farhågan” beskriver att obehagen barnen berättade om var annorlunda eller lindrigare än förväntat. Nedsövningen gick lätt och snabbt medan uppvaknandet beskrevs som mera obehagligt. Under kategorin ”God omvårdnad skapar trygghet och tillit” gav barnen positiva omdömen om personalen och deras sätt att informera och ge omvårdnad. Många uttryckte en lättnad över att ingreppet var genomfört och uppgav att de skulle känna mindre oro inför en möjlig framtida sövning; ”Lättade och stärkta av erfarenheten”. Slutsats: De intervjuade barnen hade överraskande lite kunskap i förväg om vad som skulle hända under dagen och inte minst narkosproceduren. Obehag upplevdes även under moment där det ej förväntades. För att minska oro och obehag behöver informationen i samband dagkirurgi förbättras avsevärt till denna åldersgrupp.

Happiness research is advancing as an academic discipline as well as on the political agenda. An aspect, largely ignored in the field, is what impact an individual’s construction of the good life has on his or her subjective well-being. The purpose of this paper was to investigate how people in different situations in life and with different backgrounds construct the idea of a good life and the importance these constructions may have in explaining subjective well-being. Despite the differences between themselves, the respondents’ constructions of the good life were shown to have a lot in common. Some factors in the good life were shared by the respondents, such as relations to other people, access to food, water and housing, whereas in other aspects, such as money and time, the constructions of the good life differed quite a lot from one another. When evaluating their own lives the respondents used quite different criteria mostly corresponding to their idea of the good life. If this is a general pattern, possible to replicate in other studies, one may in the future be able to draw the conclusion that the construction of the good life has an effect on our subjective well-being.

No description available.