Sjuksköterskor har lång erfarenhet av att möta och vårda multisjuka äldre som lever och lider av långvarig smärta. Smärtan kan visas som symtom orsakad av otillräckligt eller ej adekvat behandling. Det resulterar i en gradvis funktionsnedsättning både fysiskt och psykiskt hos multisjuka äldre. Därför är det av stor vikt att undersöka samt få mer kunskap om hur sjuksköterskor upplever att vårda multisjuka äldre med långvarig smärta. Syftet är att beskriva hur sjuksköterskor upplever att vårda multisjuka äldre med långvarig smärta. Studien har genomförts med en kvalitativ forskningsdesign. Åtta sjuksköterskor deltog och bidrog med sin kunskap och erfarenhet. Materialet som insamlades analyserades med induktiv innehållsanalys. Analysen av sjuksköterskors upplevelse resulterade i tre kategorier; Se hela människan, Lindra smärtan samt Kunskap och kompetens. Kategorierna var i sin tur uppbyggda av totalt sju subkategorier. I diskussionen diskuteras vikten av att ha kunskap om vad individuell anpassning innebär samt en strukturerad smärtlindring som bidrar till att minska patientens lidande. Det är av största vikt är att uppnå en ökning av patientens livskvalité genom förbättring av fysisk och psykisk hälsa. Som blivande specialistsjuksköteror med inriktning Vård av Äldre kan denna kunskap bidra till ett vårdande förhållningssätt, vilket innebär att stötta och hjälpa patienten med att öka sin livskvalitet. / Background: Nurses have for many years cared for multi-sick elderly people whom are suffering from long-term pain. The pain may appear as symptoms caused by inadequate treatment. This results in a gradual impairment of both physical and mental health of the multi-ill elderly. Therefore, it is of great importance to investigate and gain more knowledge about how nurses perceive caring for multi-ill elderly people with long-term pain. Aim: The purpose is to describe how nurses experience caring for multi-sick elderly people with long-term pain. Method: The study has a qualitative inductive approach to elucidate nurses' experience, knowledge and attitude. Data was collected using three phases, eight nurses participated and contributed with their knowledge and experience. The data collected was analyzed by means of qualitative content analysis. Results: The analysis of nurses' experiences resulted in three categories; see the entire person, pain relief, knowledge and competence. The categories were made up by seven subcategories. Conclusion: The importance of having knowledge of what individual adaptation means and having a structured adequate pain relief that helps to reduce the patient's suffering. It is important to achieve an increase in the patient's quality of life through improvement of physical and mental health. As future specialist nurses with a focus on Care for the Elderly, this knowledge can contribute to a way of working that is based on an attitude which means to support and help the patient to increase their quality of life.

Bakgrund: Äldres behov av vård kommer att öka med en åldrande befolkning och fler kommer att drabbas av svårläkta sår. För att möta det stigande vårdbehovet behövs digitala verktyg vid sårbehandling, som kan bidra till trygghet, tillgänglighet och att vårdens resurser används effektivt. Specialistsjuksköterskor har ett utökat ansvar vid utveckling och implementering av digitala verktyg. Genom digitala verktyg ska vård ges utifrån individens behov men det är en utmaning att utveckla verktyg som är personcentrerade. Idag finns det verksamheter i Sverige som arbetar med sårbehandling via appen OneWound. Syfte: Att undersöka sjuksköterskors erfarenheter av appen OneWound vid sårbehandling. Metod: Kvalitativ intervjustudie med induktiv ansats som analyserades med kvalitativ innehållsanalys, vilket mynnade ut i tre kategorier och åtta subkategorier. Resultat: Sjuksköterskorna utvecklades i sin profession genom teoretisk kunskap och användning av OneWound. Sjuksköterskorna kunde möta hinder vid implementering, vilket påverkade användningen. Påverkningsfaktorer beskrevs som personliga egenskaper, tekniska problem och brist på rutiner i verksamheten. Genom användning av OneWound med möjlighet till konsultation av sårexperter upplevde sjuksköterskorna trygghet, arbetsglädje och stöd viaappens funktioner samt vinster på individ- och samhällsnivå som bidrog till hållbar vård och en känsla av att erbjuda en vård av hög kvalité. Slutsats: OneWound tillfredsställde sjuksköterskornas behov av ny kunskap, struktur, och stöd vid sårbehandling. Utifrån ett omvårdnadsperspektiv ger studiens resultat en inblick i de utmaningar som finns vid sårbehandling och de positiva effekter som OneWound bidrar till. Forskning behövs för att utforska patientperspektivet samt hur OneWound erfars i förhållande till traditionell specialistkontakt vid svårläkta sår. / Background: The elderly’s need for care will increase with an aging population and more will suffer from wounds that are hard-to-heal. To meet the rising need for care, digital tools are needed in wound care, which can contribute to safety, accessibility and efficient use of care resources. Specialist nurses have an increased responsibility for the development and implementation of digital tools. Through digital tools, care must be provided based on the individual’s needs. However, it is a challenge to develop tools that are person-centered. Today, there are healthcare providers in Sweden that work with wound care via the OneWound app. Aim: To investigate nurses’ experiences of the OneWound app in wound care. Method: Qualitative interview study with an inductive approach that was analyzed with qualitative content analysis, which resulted in three categories and eight subcategories. Results: The nurses developed in their profession through theoretical knowledge and use of the OneWound app. The nurses faced obstacles during implementation. Impact factors were described as personal characteristics, technical problems and lack of routines. Through the use of OneWound with the possibility to consult wound experts, nurses felt safe, experienced job satisfaction and support through the app's functions as well as gains at the individual and community level that contributed to sustainable care and a sense of offering high quality care.  Conclusion: OneWound satisfied the nurses' need for new knowledge, structure, and support in wound treatment. From a nursing perspective, the results of the study provide an insight into the challenges that exist in wound treatment and the positive effects that the OneWound app contributes to. Further research is needed to explore the patient perspective and how OneWound is experienced in relation to traditional specialist contact when facing hard-to-heal wounds.

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Orientador: Luís Cuadrado Martin / Resumo: O conhecimento sobre qualquer patologia pode ser facilmente encontrado na internet, mas dificilmente encontra-se alguma ferramenta que faça a análise e o raciocínio entre os dados de um paciente e se obtenha o diagnóstico mais provável. Em nosso cotidiano, em virtude de uma maior demanda na área da saúde, existe uma necessidade crescente de diagnósticos médicos rápidos e precisos. Em virtude disso, foi elaborado um Sistema de Apoio à Decisão Médica com o intuito de otimizar e agilizar de forma confiável os diagnósticos médicos. A ideia é dar qualidade e agilidade à prática médica, adotando a tecnologia como ferramenta básica: “Quem tem mais informação, tem melhores condições para escolher e tomar decisões”. Na construção deste sistema, foram utilizados um banco de dados relacional (MySQL) e aplicadas técnicas de inteligência artificial, tais como: a construção de Árvores de Decisão, Aprendizado não supervisionado e a utilização das Redes de Bayes (onde estão envolvidos domínios de conhecimento com significativo grau de incerteza, como é o caso da área médica). Através da união destas técnicas, são feitas a seleção e classificação das doenças mais prováveis, onde as mesmas podem ser examinadas com mais detalhes pelo médico, garantindo assim uma maior segurança na escolha dos possíveis diagnósticos. Visando uma maior abrangência e rapidez na disseminação do conhecimento humano, o sistema foi disponibilizado via internet (www.danton.med.br). Para a concepção do projeto foi reali... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The knowledge about any pathology can be easily found on the internet, but it is difficult to find any tool that makes the analysis and reasoning between the data of a patient and obtain the most probable diagnosis. In our daily lives, due to a greater demand in the health area, there is a growing need for fast and accurate medical diagnoses. As a result, a Medical Decision Support System was developed in order to reliably optimize and streamline medical diagnostics. The idea is to give quality and agility to medical practice, adopting technology as a basic tool: “Who has more information, has better conditions to choose and make decisions”. In the construction of this system, a relational database (MySQL) was used and artificial intelligence techniques were applied, such as: the construction of Decision Trees, Unsupervised Learning and the use of Bayes Networks (where knowledge domains are involved with significant degree of uncertainty, as is the case in the medical field). Through the union of these techniques, the selection and classification of the most probable diseases are made, where they can be examined in more detail by the doctor, thus ensuring greater security in the choice of possible diagnoses. Aiming at a greater scope and speed in the dissemination of human knowledge, the system was made available via internet (www.danton.med.br). To design the project, a prospective, randomized, crossover and open study was carried out; in which 3 groups of doctors (called gr... (Complete abstract click electronic access below) / Doutor

Bakgrund: Personer med bipolärt syndrom utgör en stor riskgrupp för suicid. Sjuksköterskor arbetar aktivt, på olika sätt, med att förebygga suicidal problematik. Detta arbete är svårt och komplext, men kan underlättas genom att ha en gemensam plan vid försämring. Personerna med bipolärt syndrom lägger stor vikt i att ha en fast sjuksköterskekontakt, ha någon att prata med. Syfte: Syftet med studien var att beskriva specialistsjuksköterskors erfarenheter av suicidprevention för vuxna personer med bipolärt syndrom, inom psykiatrisk öppenvård. Metod: Metoden som användes  i denna studie var en kvalitativ innehållsanalys. En semistrukturerad intervjuguide användes för att inhämta data. Data insamlades med hjälp av intervjuer. Resultat: I resultatet framkommer fyra kategorier och sammanlagt tio subkategorier. Följande huvudkategorier redovisas i resultatdelen; att vara närvarande och uppmärksam i stunden, att sträva efter en hållbar relation, att hänga med i svängarna och att skapa balans i vardagen. Slutsatser: Det suicidpreventiva arbetet för personer med bipolärt syndrom är svårt och ofta krävande. Detta beror mycket på syndromets komplexitet och det skiftande måendet. Stora krav ställs på sjuksköterskans arbete att skapa en relation, men också att involvera anhöriga i vården. Förebyggande åtgärder är viktiga ytterst signifikant för att förhindra suicid. Det gäller att motivera och belysa de aspekter i personens livsvärld som faktiskt fungerar, i främjandet av personens återhämtning. / Background: People with bipolar syndrome are a major risk group for suicide. Nurses work actively, in various ways, to prevent suicidal problems. This work is difficult and complex, but can be facilitated by having a common plan for deterioration. The people with bipolar syndrome attach great importance to having a permanent nurse contact, having someone to talk to. Objective: The aim of the study was to describe the specialist nurses' experiences of suicide prevention for adults with bipolar syndrome, in open psychiatric care. Method: The method used in this study was a qualitative content analysis. A semi-structured questionnaire was used to collect data. Data were collected using interviews. Result: The result shows four categories and a total of ten sub-categories. The following main categories are reported in the results section; to be present and attentive at in the moment, to strive for a sustainable relationship, to keep up with the turns and to create balance in everyday life. Conclusions: The suicide prevention work for people with bipolar syndrome is difficult and often demanding. This is very much due to the complexity of the syndrome and the changing mood. Great demands are placed on the nurse's work to create a relationship, but also to involve relatives in the care. Preventive measures are e extremely significant in preventing suicide. It is about motivating and highlighting the aspects of the person's life world that actually work, in promoting the person's recovery.

(English) The aim of this diploma thesis is to assess the current state of the educational structure of staff in university libraries on a research sample of university libraries, which are members of the Association of Libraries of Czech Universities. In the introduction, the thesis presents a brief historical excursion into the development of the position of the university librarian. At present, greater demands are placed on the skills and knowledge of the university librarian. The librarian can obtain them by starting school, retraining courses, or lifelong learning. The legislation does not yet specify the requirements of the professional competence for work as a librarian in the library. The practical part deals with the analysis of the educational structure of staff and the management of university libraries. I am interested in their attitude to further education and also what they would appreciate in this area. Data collection is ensured via a combination of a questionnaire survey and subsequent interviews, which complete the results of the questionnaires. Chosen research methods were intended for both groups. The conclusion of the thesis evaluates all findings and offers possible solutions to the problems existing in the field of further education.

Bakgrund: Ordet kejsarsnitt kommer från latin och innebär att barnets tas ut genom livmoderväggen med ett snitt långt ner på buken. Det föds närmare 200 000 barn om året i Sverige och av dessa är 17,3 procent förlösta genom kejsarsnitt. Tidigare forskning beskriver vikten av en fungerande och tydlig kommunikation i operationsteamet kring patienten, för att patientsäkerheten ska uppfyllas och en säker vård ska kunna bedrivas vid ett akut kejsarsnitt. Syfte: Att beskriva operationsteamets erfarenheter av kommunikation under ett akut kejsarsnitt. Metod: En kvalitativ studie där data inhämtades via 14 stycken frågeformulär utformade enligt critical incident technique. Data analyserades enligt en kvalitativ innehållsanalys och redovisas genom tabell, citat och löpande text. Resultat: Kommunikation är viktigt vid akuta kejsarsnitt, men beroende på vilka som ingår i operationsteamet och vilken erfarenhet de har med sig kan kommunikationen vara mer eller mindre uttalad. Aspekter, förutom yrkeserfarenhet, för en välfungerande kommunikation är tid, samarbete och rutiner. Slutsats: I resultatet framkommer att kommunikationen tar sig olika uttryck i olika team, där rutiner och yrkeserfarenhet påverkar hur man kommunicerar. En fungerande kommunikation behöver operationsteamet arbeta aktivt med, då det medför ett positivt teamarbete, bra stämning på sal och en säker vård. / Background: The word caesarean section is Latin and means that the baby is delivered through the uterine wall with an incision far down on the abdomen. Nearly 200,000 babies are born each year in Sweden and of these, 17.3 per cent are delivered by caesarean section. Previous literature describes the importance of clear and well-established communication in the surgical team responsible for the patient, so that patient safety standards are met, and safe care can be provided in an emergency caesarean section. Aim of the study: To describe the operating team's experiences of communication during an emergency caesarean section. Methodology: A qualitative study where data were collected via 14 questionnaires designed according to the critical incident technique and data were analyzed according to a qualitative content analysis and reported by table, citation and running text. Results: Communication is important in acute caesarean sections, though depending on who is part of the surgical team and what experience they have, the quality of the communication can vary. Elements, besides professional experience, for a well-functioning communication were time, attitude, and clarity. Conclusion: The result shows that the communication patterns varies depending on whom is a part of the team, where routines and professional experience form the communication. The operating team needs to work actively with a functioning communication as it is important for a positive team work, a good atmosphere in the ward and safe care.

(English) The aim of this diploma thesis is to assess the current state of the educational structure of staff in university libraries on a research sample of university libraries, which are members of the Association of Libraries of Czech Universities. In the introduction, the thesis presents a brief historical excursion into the development of the position of the university librarian. At present, greater demands are placed on the skills and knowledge of the university librarian. The librarian can obtain them by starting school, retraining courses, or lifelong learning. The legislation does not yet specify the requirements of the professional competence for work as a librarian in the library. The practical part deals with the analysis of the educational structure of staff and the management of university libraries. I am interested in their attitude to further education and also what they would appreciate in this area. Data collection is ensured via a combination of a questionnaire survey and subsequent interviews, which complete the results of the questionnaires. Chosen research methods were intended for both groups. The conclusion of the thesis evaluates all findings and offers possible solutions to the problems existing in the field of further education.

The topic of this diploma thesis is the qualification and personality profile of the job title - methodology specialist in the social services in the Czech Republic. The theoretical part of this work describes the quality of social services because their setting, evaluation and management are in the spotlight during last few decades. This work deals with the law on social services and with social services quality standards which are the benchmark of quality for these services. The job title methodology specialist in social services is described in detail in the chapter describing social services workers. Conclusion of the theoretical part of this work highlights the importance of human resources for the organization and the importance of the job title description. The practical part of this work is aimed on mapping of competency and personality profile of the job title of current methodology specialists in social services. There are used qualitative research methods specifically semi structured interviews with employees who work in this position. The analysis of gained information gives answers to research questions and creates a picture of competency and personal profile of methodology specialist in the social services field. Key words: Quality, social services, methodology specialist, quality...

Joint appointments in the health sector in South Africa are made to serve both service and academic functions in one post. Typically the employing organisations are unequal, as one of them is the paying organisation while the other is the academic employer. This practice has been in existence for decades, and is ruled by expediency rather than being based on values. Joint employees experience role confusion, job confusion, dual loyalty confusion and being managed according to the rules of two organisations. This suboptimal situation leads to lower-than-expected performance in the eyes of both employing organisations. In this study the knowledge and problem areas of joint appointments were explored. The first part of the study consisted of a questionnaire analysis of the knowledge and view of problems as expressed by joint staff as well as by human resources (HR) practitioners. Group discussions, as well as the major part of the study, namely, interviews with senior management staff of both organisations were then conducted. In order to complete the study, an analysis was made of values that might inform on the problem. Joint staff members were found to have limited knowledge of the work requirements of a joint employee, and expressed concern about loyalty and role confusion. When the values were discussed with senior management staff, some values were identified as informing on possible solutions such as joint establishment of vision, joint objectives, respect for all components of the job, as well as generic values, including honesty, transparency, fairness, diversity and others. A framework is suggested commenting on the potential place for a values-based approach. From this a model is proposed by means of which a values-based process can be initiated by a top-level agreement meeting (“meeting of the minds”) of both employers that may lead to a single joint vision and set of objectives. From this agreement a policymaking joint body can establish the rules, while application and implementation are monitored by local joint management committees. / Dissertation (MCom)--University of Pretoria, 2011. / Human Resource Management / unrestricted