Background: Postoperative delirium (POD) is a common neurocognitive disorder in patients undergoing surgical procedures. Delirium is a disorder that is poorly understood, frequently unrecognized and associated with numerous adverse outcomes including longer hospital stays, significantly higher costs and increased morbidity and mortality. While there has been a great deal of research on proposed etiologies, risk factors and outcomes of delirium, few studies have explored the patient’s subjective experience of the phenomenon. Purpose: The purpose of this qualitative descriptive research was to investigate the patient experience of postoperative delirium and measure the distress associated with the experience. The Delirium Symptoms Experience Model (DSEM) provided the theoretical framework in which to understand the postoperative delirium experience. The three specific aims used to guide the investigation were: 1) Identify patient age, gender, race, type and length of surgery, past medical and surgical history, length of admission, delirium subtype (if known), and medications (including anesthetic agents) used in the perioperative period to better characterize the sample and provide context for the qualitative findings; 2) Describe the postoperative patients’ experience of being and feeling delirious; and, 3) Measure the distress associated with the recall of delirium using the Delirium Experience Questionnaire (DEQ) Methods: Ten participants ranging in age from 33-75 years (mean = 66.2 years of age) who experienced postoperative delirium were interviewed. Patients were screened for persistent delirium or cognitive impairment as assessed with the Confusion Assessment Method and the Mini-Cog™ Instruments. Results: Three organizing themes emerged from the content analysis: 1) Altered Perceptions of Reality; 2) Stuck in the Confusion; and, 3) Seeking Reality. The analysis of the quantitative measures and descriptive data demonstrated a high rate of psychological distress associated with delirium recall with 80% participants reporting it caused severe to very severe distress. The anesthetic drug propofol was the common medication prescribed in the perioperative period and given to all ten participants. Conclusion: Understanding this phenomenon from the patients’ perspective may provide a better understanding of the delirium experience and aid in the development of interventions and treatments to improve care and reduce suffering.

Background: Chronic pain is a common and occurring disease that creates pain and suffering for many people. The painful experience is individually unique and is affected by many different factors. The insufficient knowledge regarding the assessment of chronic pain makes it difficult to abate the suffering from the individuals. Nurses´ perception and comprehension about chronic pain may hinder them from listening to the patient´s need. The nurse creates conditions for a functioning dialogue. An increased understanding from a patient´s point of view is necessary in order to comprehend the patient´s need. Aim: The aim is to highlight the experiences of people living with chronic pain. Method: This literature review is influenced by Friberg (2012). 12 qualitative scientific articles were obtained and analyzed from three different databases. Results: The result demonstrates two main categories with related sub-categories. The first category highlights how pain affects peoples´physical, emotional, social and existential aspects when the pain takes over. The latter describes how people manage the pain through strategies and acceptance. Discussion: The result is discussed from Armstrong´s symptoms experience model that demonstrates that people living with chronic pain gives meaning to their experience of pain in various ways, which may tend to give positive and negative impact in their daily life. Moreover, the result connects to Ericsson´s concepts regarding the Caring Science such as, suffering in illness, life, and healthcare. It also describes the theory of a person in suffering which can affect the individual as a whole. / Bakgrund: Långvarig smärta är vanligt förekommande och skapar ett lidande hos människor. Smärtupplevelsen är unik för varje individ och påverkas av många olika faktorer. Otillräcklig kunskap i bedömningen av långvarig smärta medför svårigheter i att lindra lidande. Sjuksköterskors föreställningar om smärta kan vara hinder för att lyssna på patienten. Sjuksköterskan skapar förutsättningar för en väl fungerande dialog. En ökad förståelse för patientens perspektiv är nödvändigt för att förstå patientens behov. Syfte: Syftet är att belysa människors upplevelser av att leva med långvarig smärta. Metod: Metoden är en litteraturöversikt influerad av Friberg (2012). 12 kvalitativa vetenskapliga artiklar inhämtade ur tre olika databaser har analyserats. Resultat: Resultatet presenterar två huvudkategorier med tillhörande underkategorier. Den första huvudkategorin: När smärtan tar över belyser hur smärta påverkar människor ur fysiska, psykiska, sociala och existentiella aspekter. Den andra huvudkategorin: Vägen till att kunna hantera smärtan uppmärksammar människors sätt att hantera smärtan genom strategier och acceptans. Diskussion: Resultatet diskuteras utifrån Armstrongs symtomupplevelsemodell som visar att människor ger mening åt smärtupplevelser på olika sätt, vilket kan medföra en positiv eller negativ inverkan i deras liv. Vidare knyts resultatet till Erikssons vårdvetenskapliga begrepp: sjukdomslidande, livslidande och vårdlidande samt teorin om den lidande människan som beskriver att smärtan kan påverka människan som helhet.