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Theory Stroke, a cerebrovascular disease, causes severe disability and failure of self-sufficiency for nearly of half of the patients. Nursing focuses on respecting the individuality of each patient, supports the return and consolidation of a good health, promotes self-sufficiency and searches for the needs of the patient. Conceptual model of D. E. Orem assumes the ability of each human to take care of self. Although partially, or not capable of self-care at all, it is necessary to fill up the deficit by nursing care. Objectives The first objective was to state the options to how to fill up the deficit of self-care by patienst after stroke. The second objective was to determine, whether the patient´s living environment has an impact the development of self-care. Research questions Q1: Does the home environment stimulate the acceleration of the return of self-care ability by patients after a stroke? Q2 : Does the respondent perceive the issue of own disability equaly as the surrounding? Q3 : Is it more beneficial for the patient to perform self-care with deficiency, or to receive perfect execution of it by others? Q4 : Does the patient perceive the subsequent therapy (physiotherapy, occupational therapy) as a faster way to return to sufficient self-care? The research part of the thesis was carried out by a qualitative survey, conducted as a individual semi-structured thematic interviews with respondents devided into two groups. One group consisted of patients after a stroke and a second group of caregivers. Total of 8 patients, 4 males and 4 females, were interviewed. The research was completed in three sessions, each at intervals of four to six weeks. The information received were processed by open coding method, analytical induction development of technology showdown and narrative analysis. Results Using data received from interviews with respondents it was possible to answer all the research questions. The first research question examined was, whether the home environment stimulates the acceleration of the return of self-care ability by patients after a stroke. According to interviews and objective evaluation, the domestic environment has improved overall condition and faster return to individual self-care. Although, aftercare provided enough nursing and rehabilitative care, patient very much appreciated mental stimulation given by the home environment. The second research question focused on whether the respondent perceives own disability equaly as the surrounding. The interviews showed most of the patients perceive their health and subsequent disabilities better than its surroundings. The third research question examined whether it is more beneficial for the patient to perform self-care with deficiency, or to receive perfect execution of it by others. The results indicated more benefits by performing own self-care, even with mistakes that encourage practising, thereby repeating and consolidating manners. Most of the respondents refused any help. The fourth research question focused on patient´s perception of the subsequent therapy (physiotherapy, occupational therapy) as a faster way to return to sufficient self-care. The interviews showed that the respondents did not realize the importance of aftercare, considered it to be routine and as a part of the treatment. Yet, increased physiotherapy activities results into a quicker adjustment of self-sufficiency. Conclusion The temporal evolution of self-sufficiency of patients after a stroke and the attitudes of caregivers are described in this thesis. The results are presented in a form of mental map. This might be used by the patients after stroke, nursing staff or official home caregivers and informal caregivers, as well.

Bakgrund: Fysiska och kognitiva handikapp kan leda till minskad förmåga att klara sin munvård och risken att drabbas av ohälsa i munnen ökar. Omsorgspersonal har bristande kunskaper inom munhälsa och munvården prioriteras lägre än andra omvårdnadsåtgärder. Sjuksköterskan är ytterst ansvarig för omvårdnaden men det saknas studier om hur sjuksköterskor arbetar med munhälsa inom kommunal hälso- och sjukvård. Syftet med studien var att undersöka sjuksköterskors erfarenhet av att arbeta med munhälsa och munvård i kommunal hälso- och sjukvård. Metoden som användes var en kvalitativ innehållsanalys med induktiv ansats med en fokusgruppsintervju samt sju enskilda intervjuer. Resultat: Tre kategorier identifierades: Munhälsa är att främja hälsa, Arbetar med munhälsa vid egenvårdsbrist och Aktörer i omvårdnadssystemet. Slutsats: De intervjuade sjuksköterskorna ansåg att munhälsa är något självklart och att det är viktigt att värna om patientens egenvård och integritet. I arbetet med kvalitetsregister ökade sjuksköterskornas delaktighet i munhälsoarbetet men de arbetade främst med munhälsa först när ett problem uppstått. Stort fokus lades på munhälsa och munvård hos palliativa patienter medan arbetet med munhälsa kunde bli lidande hos patienter som till viss del sköter sig själva. För att förbättra munhälsan, hos patienter i den kommunala hemsjukvården, finns ett behov av ökad kunskap hos både omsorgspersonal och sjuksköterskor, bättre rutiner och ökat samarbete med tandvården. / Background: Physical and cognitive disabilities may affect patients’ ability to cope with oral health and increase the risk of suffering from illness in the mouth. Studies show that staff in municipality provided care have poor knowledge in oral health and that oral health is less prioritized than other nursing interventions. Registered Nurses (RN) have the ultimate responsibility for providing care but there are few studies that describe how nurses experience working with oral health. Aim: To examine the experience of RN’s with regards to oral health and oral care in municipal health care. Method: A qualitative content analysis with an inductive approach including one focus group discussion, with five RN’s participating, and seven patientual interviews. Results: Three categories were identified: Oral health promotes general health, Works with oral health when self-care deficit and Agents in the nursing system. Conclusion: The RN’s believed that oral health is self-evident and that it is important to safeguard the patient's self-care and integrity. When working in quality registers, the RN participation in oral health work increase, but they primarily work with oral health when a problem arises. Great focus was placed on oral health and oral care in palliative patients, but the work with oral health could be suffering in patients who to some extent manage themselves. To improve oral health, the study showed that there is a need for more education for health care workers providing municipality care and RN’s, there is also a need for better routines and better collaboration with the dental care.

Bakgrund: Diabetes mellitus är en kronisk sjukdom som allt fler personer världen över drabbas av. Studier har visat ett nära samband mellan livsstil och diabetes typ 2. Genom att ha en bra egenvårdsbehandling minskar personen med diabetes risken för senkomplikationer. Här har diabetessköterskan ett viktigt ansvar att arbeta både hälsofrämjande och sjukdomsförebyggande genom vägledning i egenvård. Syfte: Syftet med studien var att beskriva diabetessköterskans erfarenheter av att vägleda personer med diabetes i egenvård. Metod: Mellan januari och mars 2016 genomfördes 16 stycken semistrukturerade intervjuer med diabetessköterskor inom primärvården. Intervjuerna transkriberades och analyserades med kvalitativ innehållsanalys baserad på Elo och Kyngäs. Kategorier och underkategorier skapades sedan. Resultat: Innehållsanalysen har resulterat i tre kategorier; Grunden för engagemang, Kunskapsöverföring och Organisatoriska faktorer. Under respektive kategori finns 2-4 underkategorier. I resultatet kunde fyra huvudfynd ses vilka var; Diabetessköterskans möjlighet att skapa delaktighet, kunskapen hos både diabetessköterskan och personen med diabetes, grupputbildningarnas hälsofrämjande inverkan och teamets inverkan på vägledningen. Slutsats: Resultatet belyser vikten av att vägledningen bygger på kunskap och leder till ett ökat engagemang hos personen med diabetes. En väl fungerande kommunikation är avgörande för att nå de gemensamma målen samt att det finns ett fungerande team runt personen med diabetes som tillsammans arbetar mot samma mål. / Background: Diabetes mellitus is a chronic disease which affects more and more people around the world. Studies have shown a close relationship between lifestyle and diabetes type 2 and the importance of having a good self-care treatment to reduce the risk of complications. The diabetes nurse has an important responsibility to work with both health promotion and disease prevention through guidance in self-care. Purpose: The purpose of the study was to describe the diabetes nurse’s experiences of guiding people with diabetes in self-care. Method: 16 semi-structured interviews was performed during January – March 2016 with diabetes nurses who worked in primary care. The interviews were transcribed and analyzed using a qualitative content analysis. Result: The content analysis resulted in three categories; the ground for commitment, Knowledge transfer and Organizational conditions. The four main results in the study was: The diabetes nurse’s possibilities to create participation, knowledge that both the diabetes nurse and the person possessed,  group educations health promoting impacts and the team’s impact on guidance. Conclusion: The result highlights that guidance in self-care should be built on knowledge and lead to a higher level of engagement. A well-functioning communication is crucial to achieve common goals and that the team around the person with diabetes is working together towards the same goal.

Många kvinnor med typ 2-diabetes misslyckas med sin egenvård och komplikationer tillstöter. Denna studie sammanfattar ett antal forskningsresultat som beskriver kvinnors upplevelser av att leva med typ 2-diabetes. Syftet med litteraturstudien var att beskriva hur kvinnor med typ 2-diabetes upplever att leva med sin sjukdom.  Dessa upplevelser påverkar hur kvinnan kan sköta sin egenvård men också ge information om hur sjuksköterskan kan stödja kvinnan. Orems egenvårsteori kopplas till kvinnans egenvård och sjuksköterskans roll. Vidare var syftet även att granska artiklarnas kvalitet utifrån den metodologiska aspekten urvalsmetod. Denna studie utformades som en deskriptiv litteraturstudie baserade på tio artikar med kvalitativ ansats. Resultatet från dessa artiklar visade att upplevelserna kan delas in i fem olika kategorier. 1. Upplevelse av utmaningar med egenvården och livsstilsförändringar 2. Upplevelse att hantera sina känslor 3. Upplevelse av motivation och engagemang 4. Upplevelse av omgivningens stöd 5. Upplevelse av interaktion med vårdgivare Slutsatsen från studien är att kvinnor med typ 2-diabetes har många erfarenheter runt sin diagnos som påverkar hennes egenvårdskapacitet. Granskningen av artiklarnas kvalitet utifrån den metodologiska aspekten urvalsmetod visar att urvalet är kritiskt för resultatet. I alla studier som är baserade på urval bör urvalsmetod granskas kritiskt innan några slutsatser tas. / Many women with type 2 diabetes fail in their efforts with self care management. The consequence are medical complications. The purpose of this paper is to look at a number of research articles describing women’s experiences relating to their diabetes diagnosis. These experiences affect the woman's ability to self care but also guides the nurse in her profession on how to best support the woman. Orem's self care deficit theory is tied to the diabetic woman and her self care but also to the role of the nurse. There is also an analysis of the sampling methods used in each of the articles. This study was done as a descriptive litterature study based on ten qualitative research articles. The result from the analysis of the articles shows that the experiences of the diabetic women can be sorted into five categories. 1.     Self-care and lifestyle change 2.     Coping with ones own feelings and emotions 3.     Motivation and engagement 4.     The surrounding support  5.     The interaction with the caregiver/medical expertise. The conclusion that can be made from this study is that women with type 2 diabetes have a lot of emotional experiences relating to the diagnosis that affects their self care management. The analysis of the sampling methods used in each of the articles show that it is critical for the result how the sampling was done and care should be exercised before drawing any conclusions from the results.

The number of older persons is growing at a shocking rate. In spite of this reality, the South African health care sector does not prioritise older persons, causing their health to be poorly managed. Not only does poor health management affect the health of the older person, but also economic factors. This causes a high burden on the public health sector of South Africa, with specific reference to the Primary Health Care (PHC) clinics. PHC clinics in this country are not only overcrowded due to staff shortages, but also owing to the rapidly ageing population and the large number of younger persons affected by the high unemployment rate of South Africa. The above-mentioned factors keep the professional nurses in the clinic from spending time on proper physical examinations and provision of health education to older persons. This causes older persons to lack knowledge regarding self-care, potentially leading to unintentional self-neglect, which decreases their quality of life. Studies conducted on older persons concluded that the older person wants to be involved in health promotion, but needs the necessary knowledge to take care of him- or herself. Therefore, the researcher's overarching aim with this study was to develop guidelines to facilitate self-care amongst older persons. Such guidelines aim at constituting an indirect approach to promote the health of the older person. Health education on self-care should be conducted in self-care support groups, since community experience teaches that some older persons in the community do not apply self-care skills learned without some form of support. The aim with these guidelines is to decrease unintentional self-neglect by empowering the older person to make autonomous decisions regarding self-care, in order to increase quality of life. RESEARCH AIM AND OBJECTIVES In order to reach the overarching aim of this study, which comprises the development of guidelines to facilitate self-care amongst the older persons in the Potchefstroom district, the study firstly includes a literature review to understand self-care and related constructs from a theoretical perspective. Secondly, the Appraisal of self-care agency scale-A (ASA-A) and Exercise of self-care agency scale (ESCA) were used as questionnaires to assess the self-care of the selected older persons. Lastly, after determining the self-care of the older persons, the study investigates the relationship between these two questionnaires through correlational analysis. RESEARCH DESIGN A quantitative, descriptive, correlational and contextual design was used in this study to .reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand self-care and related constructs. Thereafter the researcher employed two structured questionnaires, the ASA-A and ESCA, were employed to collect data. The questionnaires were developed to measure self-care (self-care is determined by measuring the self-care agency). These questionnaires were based on Dorothea OrenYs self-care deficit theory of nursing, the same theory that this research study is based on. Minor adaptations were made to both the questionnaires prior to administration to the predominantly Setswana-speaking older population. The study formed part of the larger Multinational Prospective Urban and Rural Epidemiological study (PURE-SA study - ethical approval number 04M10). All the older persons identified in the peri-urban population of the PURE-SA study living in the Potchefstroom district and who were willing to participate were included in the sample. Trained fieldworkers assisted the researcher in data collection. Of the 198 older persons, 192 participated, accumulating to a 98% response rate. Lastly the researcher correlated the ASA-A and ESCA to determine their relationship as an added benefit to this research study. RESULTS The findings indicate that although the studied older population was of a lower socio-economic status with a lower literacy level, their overall self-care was relatively good. Seven self-care deficits were identified namely time management skills affecting self-care, energy deficit affecting self-care, sleep deprivation, lack of knowledge and ability to acquire knowledge with regard to health and self-care, lack of a rest, exercise and self-care programme, self-care deficit caused by physical deterioration and, lastly, the lack of performance of activities to prevent/decrease self-care deficits. These identified self-care deficits supported the development of guidelines to facilitate self-care amongst older persons, together with Menon's psychological health empowerment model, as well as an in-depth literature review on self-care and related constructs to understand self-care from a theoretical perspective. Furthermore, the study compared the ASA-A and ESCA questionnaires to determine the relationship between these questionnaires. The two questionnaires had a very good correlation with each other, conclusion that either of these two questionnaires could be used to measure self-care of a population. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

The number of older persons is growing at a shocking rate. In spite of this reality, the South African health care sector does not prioritise older persons, causing their health to be poorly managed. Not only does poor health management affect the health of the older person, but also economic factors. This causes a high burden on the public health sector of South Africa, with specific reference to the Primary Health Care (PHC) clinics. PHC clinics in this country are not only overcrowded due to staff shortages, but also owing to the rapidly ageing population and the large number of younger persons affected by the high unemployment rate of South Africa. The above-mentioned factors keep the professional nurses in the clinic from spending time on proper physical examinations and provision of health education to older persons. This causes older persons to lack knowledge regarding self-care, potentially leading to unintentional self-neglect, which decreases their quality of life. Studies conducted on older persons concluded that the older person wants to be involved in health promotion, but needs the necessary knowledge to take care of him- or herself. Therefore, the researcher's overarching aim with this study was to develop guidelines to facilitate self-care amongst older persons. Such guidelines aim at constituting an indirect approach to promote the health of the older person. Health education on self-care should be conducted in self-care support groups, since community experience teaches that some older persons in the community do not apply self-care skills learned without some form of support. The aim with these guidelines is to decrease unintentional self-neglect by empowering the older person to make autonomous decisions regarding self-care, in order to increase quality of life. RESEARCH AIM AND OBJECTIVES In order to reach the overarching aim of this study, which comprises the development of guidelines to facilitate self-care amongst the older persons in the Potchefstroom district, the study firstly includes a literature review to understand self-care and related constructs from a theoretical perspective. Secondly, the Appraisal of self-care agency scale-A (ASA-A) and Exercise of self-care agency scale (ESCA) were used as questionnaires to assess the self-care of the selected older persons. Lastly, after determining the self-care of the older persons, the study investigates the relationship between these two questionnaires through correlational analysis. RESEARCH DESIGN A quantitative, descriptive, correlational and contextual design was used in this study to .reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand self-care and related constructs. Thereafter the researcher employed two structured questionnaires, the ASA-A and ESCA, were employed to collect data. The questionnaires were developed to measure self-care (self-care is determined by measuring the self-care agency). These questionnaires were based on Dorothea OrenYs self-care deficit theory of nursing, the same theory that this research study is based on. Minor adaptations were made to both the questionnaires prior to administration to the predominantly Setswana-speaking older population. The study formed part of the larger Multinational Prospective Urban and Rural Epidemiological study (PURE-SA study - ethical approval number 04M10). All the older persons identified in the peri-urban population of the PURE-SA study living in the Potchefstroom district and who were willing to participate were included in the sample. Trained fieldworkers assisted the researcher in data collection. Of the 198 older persons, 192 participated, accumulating to a 98% response rate. Lastly the researcher correlated the ASA-A and ESCA to determine their relationship as an added benefit to this research study. RESULTS The findings indicate that although the studied older population was of a lower socio-economic status with a lower literacy level, their overall self-care was relatively good. Seven self-care deficits were identified namely time management skills affecting self-care, energy deficit affecting self-care, sleep deprivation, lack of knowledge and ability to acquire knowledge with regard to health and self-care, lack of a rest, exercise and self-care programme, self-care deficit caused by physical deterioration and, lastly, the lack of performance of activities to prevent/decrease self-care deficits. These identified self-care deficits supported the development of guidelines to facilitate self-care amongst older persons, together with Menon's psychological health empowerment model, as well as an in-depth literature review on self-care and related constructs to understand self-care from a theoretical perspective. Furthermore, the study compared the ASA-A and ESCA questionnaires to determine the relationship between these questionnaires. The two questionnaires had a very good correlation with each other, conclusion that either of these two questionnaires could be used to measure self-care of a population. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

Bakgrund: Hjärtsvikt är ett globalt hälsoproblem som ständigt ökar. Detta hälsoproblem påverkar patienters förmåga att kunna utföra dagliga aktiviteter samt utförandet av egenvård för att minska påverkan av symtomen. Orems egenvårdsteori användes som teoretisk utgångspunkt. Syfte: var att beskriva patienters upplevelser av daglig egenvård vid kronisk hjärtsvikt. Metod: I litteraturöversikten användes vetenskapliga artiklar med kvalitativ metod som analyserades enligt Fribergs (2017) analys. Resultat: Genom 13 vetenskapliga artiklar presenteras resultatet i tre huvudteman med respektive subteman: Emotionella utmaningar (förändrade känslor), Fysiska begränsningar (dyspné & fatigue), Stöd genom egenvård (resurser). Slutsats: Patienter upplevde att negativa känslor påverkade deras förmåga att utföra egenvård. Socialt stöd från familjen hade både positiv och negativ påverkan. Samtal med olika professioner var värdefullt för patienterna då de fick ökad kunskap om hjärtsvikt för att hantera sin egenvård. Kunskapsbrister hos vårdpersonalen resulterade till att behövlig information inte förmedlades till patienter med hjärtsvikt vilket kunde orsaka egenvårdsbrist. / Background: Heart failure is a global health problem that is constantly increasing. Symptoms of heart failure affects the performance in activities of daily living and the ability to perform self-care. Proper self-care can decrease symptoms, increase self-esteem and well-being. Orem's theory Self-care deficit nursing theory was used as a theoretical framework. Aim: was to describe chronic heart failure patients experiences of daily self-care. Method: The literature review had scientific articles with a qualitative method which was analyzed by Friberg's (2017).   Results: A total of 13 scientific articles were selected for the results and presented in three main categories with respective subcategories: Emotional challenges (changed emotions), Physical limitations (dyspnea & fatigue), Support through self-care (resources). Conclusion: Patients experienced that negative emotions affected their ability to perform self-care. Social support from the family had both a positive and negative impact. Conversations with various professions were valuable for patients as they gained increased knowledge about heart failure to manage their self-care. Inadequacy in healthcare staff resulted in incorrect information being communicated to patients with heart failure and causing inefficient self-care.

Thesis: The main contribution of D. Orem's self-care theory is that, using adequate methods, it leads the nurses to respect patients' own conception of self-care. Key words: Patient - nurse relationships, Self-Care Deficit Nursing Theory, D. E. Orem, human actions, respect for autonomy, NANDA taxonomy, non-compliance, responsibility. This dissertation thesis deals with the issues of a relationship between a patient and a healthcare worker, or more precisely a nurse, all from the point of view of patient self-care in the sense of deliberate action that is conducted by the patient for the purpose of sustaining their health and realizing their life plans. Ethical aspects of Orem's Self-Care Deficit Theory consist in the approach to a person that emphasizes the human nature of a human being that develops within the community - among other people, that becomes unique and that cares about their own being. Self-care deficit nursing theory is compared to NANDA taxonomy II with respect to a patient's autonomy. Both approaches to nursing care are studied from the point of view of their assumptions, theoretical basis, the diagnostic process, communication, personal competence of nurses and the aims of health care. Attention is also paid to the situations when a patient is not willing to take part in the...