Sammanfattning Bakgrund: Tidigare forskning visar att personer med allvarlig psykisk ohälsa är mindre fysiskt aktiva än resterande befolkning. De är som grupp i riskzonen för drabbas av fysiska hälsoproblem samt att dö i förtid av somatiska sjukdomar. Vårdpersonal har observerat samband mellan fysisk aktivitet och mindre besvär av symtom och lägre läkemedelsbehov. Utbudet av forskning som svarar på hur fysisk aktivitet kan upplevas främja återhämtning hos personer med allvarlig psykisk ohälsa är däremot begränsat.  Syfte: Syftet med studien är att med utgångspunkt i tidigare forskning beskriva hur personer med allvarlig psykisk ohälsa erfar att fysisk aktivitet främjar återhämtning. Metod: Metasyntes, en induktiv och kvalitativ analysmetod. Resultat: Utifrån analysen presenteras fyra teman Att få en starkare tro på sig själv och framtiden, Att uppleva mening och gemenskap, Att få struktur i livet och Att kontrollera och minska psykiska symtom som i sin tur tillsammans ledde fram till nyckelmetaforen en positiv spiral. Slutsats: Sjuksköterskan, eller vårdaren, kan genom att stödja patienten till fysisk aktivitet främja såväl allians som en start som ger fart åt patientens återhämtningsprocess. Nyckelord: allvarlig psykisk ohälsa, fysisk aktivitet, gemenskap, mening, patienters upplevelse, positiv spiral, återhämtning / abstract Background: Previous research shows that people with severe mental illness are less physically active than the remaining population. As a group, they are in risk of physical problems and premature death. Health professionals have observed a connection between physical activity and less discomfort caused by symptoms as well as a lower need of medical treatment. The amount of available research regarding experiences of physical activity and what it means for recovery amongst people with severe mental illness is limited. Aim: The aim of the study based on previous research is to describe how people with serious mental illness experience that physical activity promotes recovery. Method: Metasynthesis, an inductive and qualitative method of analysis. Results: the analysis provided four themes To have a stronger belief in oneself and the future, To experience meaning and community, To get structure in life and To control and reduce mental symtoms wich in turn together led to the key metaphor as a positive spiral. Conclusion: The nurse, or the caregiver, can, through supporting the patient to physical activity, promote both an alliance and a start that gives momentum to the patient's recovery process. Keywords: severe mental illness, physical activity, community, meaning, patient experience, positive spiral, recovery

Bakgrund: En stor del av vårdskadorna i Sverige beror på undvikbara händelser i samband med kirurgiska ingrepp och årligen anmäls hundratals lex Maria anmälningar till Inspektionen för vård och omsorg för utredning. Riskerna i den intraoperativ vården är väl kända, men kunskapen om avvikelserna som faktiskt inträffat är liten. Syfte: Studiens syfte var att beskriva inrapporterade allvarliga avvikelser som uppstått under intraoperativ vård och lett till lex Maria anmälningar. Metod: En kvantitativ innehållsanalys av 173 lex Maria anmälningar som skett under intraoperativ vård. Pearson’s korrelationsanalys utfördes för att studera statistiska samband mellan variabler. Resultat: Vid analys av lex Maria anmälningarna framkom 11 kategorier som beskriver vilken typ av händelse som lett till allvarlig vårdskada eller risk för allvarlig vårdskada. De 11 kategorierna är; Operation utförd på fel sätt 17,71 %, oavsiktlig vävnadsskada 15,43 %, fel läkemedelshantering 12,57 %, kvarglömt material 11,43 %, felhantering av medicintekniska produkter 9,14 %, operation av fel område 6,86 %, felpositionering 6,29 %, förväxlad anatomi 5,71 %, brist i patientövervakning 5,14 %, kommunikationsbrister 5,14 % och fel på medicinteknisk produkt 4,57 %. Det framkom att stor del av patienterna behövt genomgå ytterligare ingrepp, fått en skadad kroppsfunktion och fått ett ökat vårdbehov, till följd av händelsen. Slutsats: Det förekommer flera risker som hotar patientsäkerheten under den intraoperativa vården och dessvärre var det en stor del av anmälningarna där patienter drabbats av allvarliga vårdskador. Resultatet kan bidra till medvetenhet om de omständighet som leder till en kirurgisk vårdskada. / Background: A large part of the healthcare injuries in Sweden are due to adverse events in surgical settings, and hundreds of adverse events (lex Maria) are reported annually to the Swedish healthcare authority for investigation. The risks in intraoperative care are well known, but knowledge of the adverse events that actually occurred is small. Aim: The aim of the study was to describe reported serious adverse events that occurred during intraoperative care and led to lex Maria reports. Method: A quantitative content analysis of 173 lex Maria reports that took place during intraoperative care. Pearson’s correlation analysis was performed to study statistic correlation between variables. Results: In the analysis of the lex Maria reports, 11 categories emerged that describe the type of event that led to serious care injury or risk of serious care injury. The 11 categories are; Surgery performed incorrectly 17,71 %, unintentional tissue damage 15,43 %, incorrect drug management 12,57 %, retained foreign objects 11,43 %, incorrect management of medical devices 9,14 %, wrong site surgery 6,86 %, incorrect positioning 6,29 %, mixed up anatomy 5,71 %, lack of patient monitoring 5,14 %, communication deficiencies 5,14 % and errors in medical device 4,57 %. It was also found that a large proportion of patients needed further surgical intervention, received an impaired bodily function and had an increased need of care as a result of the events. Conclusion: There are several risks that threaten patient safety during intraoperative care and unfortunately a large proportion of patients suffered health care injuries. The result can contribute to awareness of the circumstances that lead to a surgical care injury.

Background: The Swedish penal code has viewed self-induced temporary insanity, caused by intoxication, depending on which Sociology of Punishment is currently active. Starting from a lenient view of drug-induced insanity in the Middle Ages towards a harsher penal climate today.  Aims: This thesis aims to investigate how the Courts of Appeals views self-induced temporary insanity. Specifically, the investigation highlights how the courts navigate between the conflicting rationalities governing criminal intent on the one hand and drug abuse on the other. Results: A thematic analysis using NVivo showed that the Court of Appeals verdicts are inconsistent regarding sentencing when addiction is involved. The results also show a lack of knowledge about addiction as an illness within the Court of Appeals and that the courts sentence substance abusers much harder than others with temporary insanity. The thesis concludes that the Rule of Law is at risk when inconsistent verdicts are commonplace.

The aim of this qualitative study was to explore hospital-counselors view on collaboration in thedischarge-process from inpatient psychiatric care regarding individuals with comorbidity in form ofserious mental illness and substance abuse. Six hospital-counselors from different psychiatric in-patient wards in Stockholms county participated in the study. All participants had a degree in socialwork and five of them had earlier experience working in the municipality as social workers. Theresearch process was conducted using qualitative interviews, further applying a systemic view oncollaboration which consisted of three levels: structural-, organizational- and individual, which wasbased on the core concepts of integrated care and person-centered care. The results showed that thehospital-counselors acted as a “link” between the health care, municipality, and patient duringcollaboration. Collaboration itself was described as a process involving different actors andorganizations within the two main principal sectors. The complexity of the differences in economicinterests, view on support needs and responsibilities regarding treatment and further care seemed to becentral aspects influencing collaboration. Although the results largely confirm previous research, it hasbrought attention to specific claims on what facilitates collaboration and what undermines it.