O cenário competitivo da indústria da moda, no qual se insere a indústria calçadista, configura ciclos curtos e rápidos de produção e comercialização característicos do modelo fast fashion, porém, a crescente preocupação com aspectos sociais e ambientais tem despertado o interesse da sociedade por uma mudança de postura frente a estas questões. O posicionamento de marcas com foco na preservação ambiental pode viabilizar melhorias em produtos que ainda são projetados e manufaturados de forma convencional, ou resultar em inovações significativas no desenvolvimento de produtos ambientalmente amigáveis. A proposta do estudo foi realizar um diagnóstico do cenário atual do design de calçados ambientalmente orientado, identificando as práticas utilizadas nos processos de design que colaboram na redução do impacto ambiental do final de vida útil dos calçados. Para melhor compreender os fatos, o estudo foi subdividido em quatro etapas. A primeira etapa contempla a revisão de literatura; a segunda etapa é resultado de pesquisa desk; na terceira etapa, realizou-se levantamento de dados por interrogação direta de pessoas através de entrevistas em diferentes amostras; e na quarta etapa realizadas as análises e interpretação dos resultados. A pesquisa básica, de abordagem qualitativa e objetivos exploratórios, utilizou-se de amostras não-probabilísticas definidas conforme os critérios estabelecidos para cada fase Os resultados alcançados apontam que, mesmo com tecnologia e informação globalizada, na prática, pouco é feito em design e produção de calçados em prol da redução de impactos ambientais. Incluem-se nessa realidade clusters tradicionais de produção, como o do Vale dos Sinos no Rio Grande do Sul, Brasil, sendo as iniciativas calçadistas que levam em consideração o cuidado com o meio ambiente, ainda, restritas e isoladas representando nichos distintos. A indústria calçadista segue aos moldes tradicionais de produção e percebe-se que, quando há uma mudança, esta é impulsionada, principalmente, por legislações ou acidentes ambientais gerados por seus dejetos, ou então são empresas que surgem com foco em desenvolver produtos ambientalmente orientados para nichos de mercado. Desta forma, na maior parte do desenvolvimento os designers reproduzem o sistema de criação rápida, obedecendo ao contexto de coleções e preços cada vez mais enxutos. O conhecimento sobre o assunto ainda é pouco explorado e, por consequência, falta articulação entre os atores da cadeia para uma mobilização efetiva na busca por soluções para o desenvolvimento sustentável do setor. / The competitive landscape of the fashion industry, which includes the footwear industry, sets up short and fast production and marketing cycles characteristic of the fast fashion model, but the growing concern with social and environmental aspects has aroused society's interest in a change position on these issues. The positioning of brands focused on environmental preservation can enable improvements in products that are still designed and manufactured in a conventional way, or result in significant innovations in the development of environmentally friendly products. The purpose of the study was to carry out a diagnosis of the current scenario of environmentally oriented footwear design, identifying the practices used in the design processes that collaborate in reducing the environmental impact of the end of the shoe life. To better understand the facts, the study was subdivided into four stages. The first stage contemplates the literature review; the second stage is the result of desk research; in the third stage, data were collected by direct interrogation of people through interviews in different samples; and in the fourth stage, the analyzes and interpretation of the results were carried out. The basic research, with a qualitative approach and exploratory objectives, was used of non-probabilistic samples defined according to the established criteria for each phase. The results show that, even with technology and globalized information, in practice little is done in the design and production of footwear in favor of reducing environmental impacts Traditional clusters of production, such as Vale dos Sinos in the Rio Grande do Sul, Brazil, are included in this reality. Footwear initiatives that take into account the care for the environment are still restricted and isolated, representing different niches. The footwear industry follows the traditional patterns of production and it is noticed that when there is a change, this is mainly driven by environmental laws or accidents generated by their waste, or else they are companies that are focused on developing environmentally oriented products for niche markets. In this way, in most of the development, the designers reproduce the system of fast creation, obeying to the context of collections and prices more and leaner. The knowledge about the subject is still little explored and, as a consequence, there is a lack of articulation between the actors in the chain for an effective mobilization in search of solutions for the sustainable development of the sector.

Introduction: In order for us to create a society where we live good lives until death, we must dare to talk about the end of life. Relatives are an important part of the palliative care and it is important that they get support for managing the situation and their sorrow The Aim of this study was to investigate professionals’ dialogue with relatives of patients who are in palliative care. My chosen method was qualitative analysis through semistructured interviews with professionals’ in palliative care. To analyze the empirical data, I used the symbolic interactionism. Results show that body language, treatment and team collaboration are important and crucial aspects of the conversations between professionals and relatives. The study has confirmed that the different professions work on the same goal and have a similar approach to palliative care. In the conversation with relatives, it is important to speak truthfully, prepare and let the family's feelings and thoughts take place

Bakgrund: Sjuksköterskan har många olika arbetsuppgifter och att vårda döende patienter, är något som en del sjuksköterskor kommer att träffa på någon gång under sin karriär. Att vårda döende patienter påverkar sjuksköterskan, särskilt de som inte har varit med om detta tidigare. Syfte: Syftet med denna studie var att sammanställa tidigare kvalitativa empiriska studier om hur sjuksköterskan upplever och hanterar mötet med döende patienter. Metod: En litteraturstudie utfördes med tio kvalitativa empiriska intervjustudier som beskriver sjuksköterskans perspektiv på att vårda döende patienter. Datan insamlades genom databaserna CINAHL och PubMed och de relevanta artiklarna granskades av en mall från statens beredning för medicinsk utvärdering (SBU). De valda artiklarna till resultatet analyserades genom datakategorisering. Resultat: Fyra teman identifierades; Att känna emotionell stress, Att använda copingstrategier, Existentiella tankar hos sjuksköterskan och En önskan att vara expert. Under temat “Att använda copingstrategier”, uppkom fyra subteman; Att ha någon att prata med, Att skydda sig själv, att kunna koppla av och Att ha en andlig tro. Konklusion: Sjuksköterskan upplever att arbetet med att vårda döende patienter är påfrestande. De känner sig stressade i mötet med dessa patienter och det kunde ibland leda till utbrändhet. Detta var mer frekvent hos oerfarna sjuksköterskor. Därför har många sjuksköterskor nyttjat olika copingstrategier, som; stöd från familj, kollegor och vänner, andlig tro, gränssättning och genom att sjuksköterskan utvecklade sina kompetenser inom vård av döende patienter. Detta minskade risken för emotionell stress. / Background: Caring for patients in the final stage of life, is something that some nurses will encounter at some time during their career. This has certain effects on nurses who have not previously been involved in this type of situation. Aim: The purpose of this study is to compile previous qualitative empirical studies on how the nurse experience and manage the meeting with dying patients. Methods: A litterature review was conducted with ten qualitative emperical interviews that described the nurse´s perspective of caring for patients in the final stages of life. The data was collected through the databases: CINAHL and PubMed. The relevant articles were reviewed by Swedish agency for health technology assessment and assessment of social services. The selected articles were analysed by data categorization. Results: Four themes were identified; To feel compassion fatigue, Taking on coping strategies, Existential thoughts of the nurse & Wishing on becoming an expert. Under the theme of “Taking on coping strategies”, four subthemes emerged; To have someone to talk to, To be able to protect yourselves, To be able to relax and To having spiritual beliefs. Conclusion: Nurses experience that caring for patients in the final stage is stressful and could sometimes lead to burnout. This was more common with inexperienced nurses. Therefore, many nurses used coping strategies, such as; support from family, colleagues and friends, spiritual beliefs, boundaries and developing nurses skills in care of the final stage of life. This reduced the risk of developing compassion fatigue.

INTRODUCTION: Older patients with AML (> 60 years) often receive intensive EOL care including hospitalizations and chemotherapy close to death. Intensive EOL care has been shown to increase emotional and financial burdens for patients and families, while often not aligning with patients’ preferences. However, factors associated with the intensity of EOL care in this population are unknown. OBJECTIVES: There is a need to better understand the factors associated with intense EOL care, in hopes of providing more informed, high-quality EOL care in line with patient preferences and decreasing burdens associated with unnecessary healthcare. We aim to describe the associations between the intensity of EOL care, patient demographics, and baseline psychological distress in older patients with AML. METHODS: We conducted a secondary analysis of two supportive care studies including 168 deceased older patients with AML. We assessed patients’ demographics, quality of life (QOL) [Functional Assessment Cancer Therapy-Leukemia], and anxiety and depression symptoms [Hospital Anxiety and Depression Scale (HADS); Patient Health Questionnaire (PHQ-9)] at the time of diagnosis. We used multivariate logistic regression models to examine the association among demographic factors, patient-reported outcomes, and the following EOL care outcomes abstracted from the electronic health record: 1) hospitalizations in the last 7 days of life; 2) receipt of chemotherapy in the last 30 days of life; and 3) hospice utilization. RESULTS: The median age of the cohort was 69 (range 20-100), and the majority were males (63.7% 107/168). Overall, 66.7% (110/165) of patients were hospitalized in the last 7 days of life, 51.8% (71/137) received chemotherapy in the last 30 days of life, and 40.7% (70/168) utilized hospice services. In multivariate models, higher education (OR = 1.54, SE=0.24, P=0.006), and elevated depression symptoms [PHQ-9: OR=1.09, SE=0.04, P=0.028] at the time of diagnosis were associated with higher odds of being hospitalized in the last 7 days of life. In contrast, higher QOL at diagnosis [OR=0.98, SE=0.01, P=0.009] was associated with lower odds of being hospitalized in the last 7 days of life. Depression symptoms at the time of diagnosis as measured by the HADS was the only factor associated with the receipt of chemotherapy in the last 30 days of life [HADS-Depression: OR=1.10, SE=0.05, P=0.042]. Patients factors were not associated with hospice utilization. CONCLUSIONS: Older patients with AML who are more educated and report elevated depression symptoms and lower QOL at the time of diagnosis were more likely to receive intensive EOL care. These findings identify a population at the time of diagnosis of AML who are at higher risk for hospitalizations and chemotherapy use at the EOL and who may benefit from targeted supportive care interventions.

Bakgrund: Årligen är cirka 20 miljoner barn världen över i behov av någon form av omvårdnad i livets slutskede. All vård av barn skall vara utformad så att särskild hänsyn tas till barnets bästa. Sjuksköterskans uppgifter vid vård i livets slutskede är att lindra lidande, tillgodose familjens behov samt att bemöta familjerna med respekt, värdighet, medkänsla och med hänsyn till patientens integritet. Syfte: Syftet var att beskriva sjuksköterskors upplevelser av att vårda barn i livets slutskede. Metod: Studien genomfördes som en litteraturstudie med induktiv ansats. Tio resultatartiklar inhämtades och bearbetades i en innehållsanalys. Resultat: Analysen resulterade i tre huvudteman med tillhörande underteman. Huvudtemana var: positiva och negativa känslor, kommunikativa utmaningar och behov av stöd och utbildning. Sjuksköterskorna betonade att arbetet med barn i livets slutskede gav såväl positiva som negativa känslor. Flera sjuksköterskor upplevde brist på tillräcklig utbildning och stöd. Konklusion: Sjuksköterskornas upplevelser visade att omvårdnaden av barn i livets slutskede kunde vara givande, trots tuffa och sorgfyllda situationer. För att förbättra sjuksköterskornas upplevelser är det av stor vikt med en ökad kunskap och utbildning, specifikt inom kommunikation, samt förbättrade möjligheter till stöd på en organisatorisk nivå. / Background: Every year approximately 20 million children worldwide are in need of some form of end-of-life care. All care involving children must be designed so that the best interest of the child is considered. The nurse’s responsibilities in end-of-lifecare are to alleviate suffering, fulfill the family’s needs and approach them with respect, dignity, compassion and integrity. Aim: The aim was to describe nurses’ experiences of caring for children at the end of life. Method: The study was conducted as a literature study with an inductive approach. Ten result articles were selected and examined using content analysis. Result: The analysis resulted in three main themes with associated sub-themes. The main themes were: positive and negative emotions, communicative challenges and a need for support and education. The nurses emphasized that end-of-life care of children induced both positive and negative emotions. Several nurses experienced a lack of knowledge and support. Conclusion: The nurses’ experiences showed that caring for children at the end of life could be rewarding, despite the sorrow and tough situations. To improve the nurses’ experiences, it is imperative to increase their knowledge and education, specifically regarding communication, and improving the opportunities for support at an organizational level.

Background: End-of-life palliative care is provided to individuals who have a progressive and incurable disease or injury. The meaning of palliative care is to promote quality of life and to alleviate the relief of patients but also those close to them. Previous research shows that patients in palliative care have a limited everyday life and that they become more dependent on nurses, which in turn leads to reduced autonomy. There was also a lack of communication among nurses and relatives. Method: Systematic literature study with a descriptive summary, 13 care science articles were analysed, all of which have a qualitative approach. Aim: The aim of the thesis is to describe nurses' experiences of caring for patients at the end of life. Results: The analysis revealed two themes; experiences of challenges in care and experiences of being present in care. The first theme included three subthemes; to understand the importance of communication, to experience a lack of knowledge and experience and to be affected emotionally, which was about the communication difficulty and challenges those nurses encountered. The second theme in turn included two subthemes; to experience the care as rewarding and meaningful and to promote good relationships in the care, which were about how nurses were personally affected in the care of patients at the end of life and in the treatment of relatives. Conclusion: The nurse experienced gratitude in caring for the patient at the end of life. The nurse experienced the care as rewarding and satisfying when they promoted good relationships with the patient and relatives. However, the nurse experienced challenges in care due to lack of knowledge and experience. This led to the nurse experiencing an obstacle to meeting the patient's needs.

Sammanfattning Bakgrund: Vård i livets slutskede är krävande för såväl familj som sjuksköterskor, men många sjuksköterskor erfar trots det att de får någonting tillbaka av att vårda de döende. Cancersjukdomar är vanligt och både överlevnaden och prognosen skiftar mycket beroende på vilken typ av cancer en person blir diagnostiserad med. Det är därmed viktigt att sjuksköterskor har kunskap och förståelse om grundläggande palliativ vård samt vård i livets slutskede för att kunna erbjuda den bästa vården för såväl patient som dennes anhöriga. Syfte: Syftet var att beskriva sjuksköterskors erfarenheter i vårdandet av patienter med cancer i livets slutskede på sjukhus. Metod: Examenarbetet utgick enligt en systematisk litteraturstudie med beskrivande syntes. Resultat: Utifrån 11 artiklar analys framkom två tema: Etiska utmaningar i vårdandet och sjuksköterskans utveckling. Dessa innefattar fem subteman som beskriver sjuksköterskors erfarenheter att vårda i livets slutskede. Slutsatser: Det framkom att sjuksköterskor blir utmanade av känslomässig involvering med patienter, tidsbrist, mängden information sjuksköterskor bör ge sina patienter samt att kunna vara i ett existentiellt samtal. Sjuksköterskorna erfor att de har utvecklats mycket av att vårda patienter i livets slutskede, både personligt och professionellt. Däremot erfor sjuksköterskorna också att de saknade kunskap i att ge vård i livets slutskede. / Background: To give care in the end of life is a demanding process for both family members and nurses, but the nurses experiences that in spite this, they gain a lot in return to care for the dying. Cancer is common and the survival and prognosis differs depending on what type of cancer a person is diagnosed with. It is therefore important for the nurse to have knowledge and understanding in basic palliative care and end-of-life care to be able to offer the very best care for both the patient and their family. Aim: This study describes the experiences that nurses have in the care of patients with cancer in end-of-life care in a hospital. Methods: A systematic literature study with descriptive synthesis was used. Results: After 11 articles were analyzed two themes emerged: Ethical challenges in caring and nurses’ development. These include five subthemes that describes the nurses experience in end-of-life care. Conclusions: Results showed that nurses were challenged by the emotional involvements with their patients, the lack of time, how much information to give their patients and how to be in existential conversations with their patients. The nurses experienced that they developed a lot by caring for patients in the end of life. However, the nurses experienced that they lacked knowledge in providing end-of-life care

No description available.

Bakgrund: Palliativ vård innebär att främja livskvalité och att lindra lidande för patienter som vårdas vid livets slutskede. Lindra smärta och symptom är två viktiga mål för att patienten ska kunna uppleva ett välbefinnande trots sin svåra sjukdom. Omvårdnaden för den döende patienten bör vara personcentrerad, en vårdmodell som kallas de 6:sn underlättar och främjar en personcentrerad vård. Syfte: Att belysa sjuksköterskors erfarenheter av att vårda patienter i ett palliativt skede inom sluten somatisk vård. Metod: Den metod som användes i studien var en litteraturbaserad metod bestående av nio kvalitativa artiklar. Resultat: Ur analysen framkommer tre huvudteman; bygga nära relationer, samarbete mellan inblandade aktörer och emotionellt påfrestande, med sju underteman. Konklusion: Den kommunikativa förmågan hos sjuksköterskan är en kärnpunkt för god omvårdnad inom den palliativa vården, kontinuerlig övning och utbildning skapar goda förutsättningar för hög kommunikativ förmåga. Att möta patienter i livets slutskede är emotionellt påfrestande, tid och kontinuitet för varje patient skapar goda förutsättningar för sjuksköterskan att möta dessa känslor på professionellt sätt. / Background: Palliative care means supporting life quality and preventing suffering to patients in care in the end of life. Relieving pain and symptoms are two important aims for the patient to experience a wellbeing despite a severe disease. The care for the dying patient should be person centred, a model of care I used to simplify a person centred care and it`s called the 6:sn. Purpose: To illustrate nurses’ experiences of caring patients in a palliative phase within closed somatic care. Method: The used method in this study is a literature review consisting nine qualitative articles. Result: Three main themes are emerged from the analysis; build close relationships, cooperation between actors involved and emotional stress, with seven subthemes. Conclusion: The nurse’s ability to communicate is the main point for good care in the palliative care. Frequent practice and education creates good qualifications for having a well developed communicative skill. To meet patients in the end of life is an emotionally trying, time and continuity to each patient creates a good basis for the nurse to meet these feelings in a professional way.

This capstone project examined social workers’ knowledge, values, and beliefs as related to the concept of cultural humility to determine how hospice care professionals treat patients’ cultural preferences and traditions with respect and sensitivity at the end of life; as such practices have the ability to improve the hospice experience. Research questions addressed in the study (a) how social workers in Nevada define cultural humility in the context of hospice social work practice, (b) the values or principles hospice social workers in Nevada consider most important in providing culturally appropriate care to hospice patients, and (c) the ways hospice social workers in Nevada implemented a cultural humility stance within their practice. To obtain data for this project, connections with the local hospice care community were used to recruit interested individuals directly involved in service delivery through a convenience sampling method. Participant data was collected via a focus group with 9 participants, which was then recorded, transcribed, and analyzed. The method of analysis was thematic exploration and estimation of the prevalence of identified themes. Five major themes were identified through analyses: (a) individualized culture, (b) respect for others, (c) team-oriented approach, (d) implementation of cultural humility, (e) lack of formal training and integration of hands-on experience. Findings contribute to the generic hospice services knowledge base, working in synergy with previous research findings to help encourage future research studies on this topic.