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Developing interventions to improve parental and carer performance of temperature measurement, fever care and knowledge of feverish illness in childrenHernandez-Rodriguez, Jose P. January 2014 (has links)
<b>Background</b>: Fever is often the initial feature of infectious diseases, which remains a major cause of morbidity and an important cause of mortality in children in the UK, and is one of the most common reasons for children to be taken to a general practitioner. Febrile illness therefore places a considerable burden on children, their families and health care services. The initial disease identification and diagnostic challenge starts at home, with parents and carers differentiating children with suspected serious illness from the vast majority who have self-limiting or minor infections. This thesis aims to understand caregivers’ knowledge, beliefs and actions in the existence of a fever in comparison with NICE guideline advice, and suggests some recommendations to improve their knowledge and management of fever. <b>Method</b>: Four studies were conducted for this thesis. First, a systematic review of 47 studies, including 20,427 participants, was used to understand parents’ knowledge regarding interpretation of temperature measurements, actions to manage a fever, and their beliefs. Second, two focus group interviews in primary care, with 9 parents, were used to explore parental views and beliefs on the management of fever and temperature measurement. Third, a thermometer survey, with 123 thermometers, was used to assess the consistency of advice from information contained in commercially available thermometers, with respect to evidence-based guidelines for feverish illness in children. Fourth, a questionnaire survey, in primary care, with 309 participants, was used to find out carer knowledge of temperature measurement and fever management in children 5 years or younger. <b>Results</b>: Carer knowledge about normal body temperature and fever in children was poor: mild fever was misclassified by many as high. Understanding of what actually constitutes fever ranged widely; carers actively reduced mild fever with antipyretics, used non-recommended methods, and most learned to use a thermometer from its instructions. Most parents did not know what a fever was and believed that it was a harmful condition that may be linked to a more serious disease. Parents wanted to be provided with specific and practical information on the identification of fever and its management. Most of the thermometer information did not include guidance on fever management or thermometer use, did not take into account parental and carer interpretation of fever and disease, however, incorporated unnecessary referrals into health services. Thermometer cost had no influence on the quality of the information provided. <b>Conclusions</b>: The research presented in this thesis suggests that caregivers often lack basic knowledge on temperature measurement and fever care. The study proposes that a simple NICE guideline based educational intervention may help them to correctly take a temperature measurement while assessing other signs of illness, and allow them to provide appropriate management methods at home, and more importantly, seek further referral where necessary. This may help towards decreasing unnecessary attendances in primary and secondary care.
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Psykisk ohälsa hos vuxna samer : En litteraturöversikt / The mental ill-health of adult Sami : A literature reviewNyquist, Frida, Riedel, Noomi January 2020 (has links)
Bakgrund: Psykisk ohälsa är ett stort folkhälsoproblem världen över. Bland minoritetsbefolkningar är problematiken omfattande då upplevelser av diskriminering från samhällets sida bidrar till psykisk ohälsa. Den samiska befolkningen har under lång tid blivit hårt drabbad och på grund av de begränsningar i levnadsomständigheter som de inneburit har många haft svårt att kunna bibehålla och leva med en stark samisk identitet. Syfte: Syftet var att beskriva psykisk ohälsa hos vuxna samer i Sverige och Norge. Metod: Litteraturöversikt användes som metod där elva vetenskapliga artiklar inkluderades i resultatet. Databaser som användes var PubMed, DiVA och PsycINFO. Artikelsökningen utfördes även i DIVA som är ett öppet arkiv för bland annat forskningspublikationer. Artiklarna var av både kvalitativt och kvantitativt som analyserades enligt Fribergs fyra analyssteg. Resultat: Författarna fann tre huvudteman: identitet och livskvalitet, ångest och depression samt svårigheter i att söka vård. Resultatet gav en överblick av den komplexitet som den samiska identitet kan innebära och som många gånger gett och ger upphov till ångestrelaterad problematik. Vidare ger resultatet ett perspektiv över orsaker till hinder i att söka vård. Diskussion: Diskussionen delas upp i metod- och resultatdiskussion. Diskriminering samt olika typer av identitetskriser som många samer upplevt ökar risken för ångestproblematik diskuterades i resultatdiskussionen. Genom utbildning kring bemötandet av minoritetsgrupper inom sjukvården kan trygga vårdrelationer skapas vilket skapar större förutsättningar för samer att söka vård. Resultatet har även diskuterats utifrån Nordenfelts teori om hälsa, livskvalitet och värdighet. / Background: Mental ill-health is a major public health problem worldwide. Among minority populations, the problem is widespread as experiences of discrimination from society contribute to mental ill-health. The Sami population has for a long time been severely affected and because of the limitations of living conditions that this repression has meant, many have found it difficult to maintain and live with a strong Sami identity. Aim: The purpose was to describe mental illness in adult Sami in Sweden and Norway. Method: Literature review was used as a method where eleven scientific articles were included in the results. Databases used were PubMed, DiVA and PsycINFO. The article search was also carried out in DIVA, which is an open archive for example research publications. The articles were of both qualitative and quantitative analysis analyzed according to Friberg's four analysis steps Results: The authors found three main themes: identity and quality of life, anxiety and depression and difficulties in seeking care. The result gave an overview of the complexity that the Sami identity can entail and which many times have given and gives rise to anxiety-related problems. Furthermore, the result provides a perspective on the causes of obstacles in seeking care. Discussion: The discussion is divided into method and result discussions. Discrimination and various types of identity crises that many Sami people experience increase the risk of anxiety problems were discussed in the results discussion. By training about the treatment of minority groups within the healthcare sector, secure care relationships can be created, which creates greater conditions for the Sami to seek care. The results have also been discussed on the basis of Nordenfelt's theory of health, quality of life and dignity.
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"Att vara på tårna" : Anestesisjuksköterskans upplevelse av att anestesiinducera barnMelander, Matilda, Pilemyr, Matilda January 2023 (has links)
Bakgrund: Anestesiinduktion av barn kräver särskild kompetens hos anestesisjuksköterskan. Trygghet och tillit behöver skapas i mötet med barnet, vilket kan utgöra en utmaning om mötet är kort och intensivt. Barns förmåga att samarbeta och delta i förberedelser och vid anestesiinduktionen påverkas av barnets ålder och utvecklingsnivå. Bristande följsamhet och samarbetsvilja hos barnet kan leda till att tvång tillämpas i samband med induktionen, vilket kan väcka varierande tankar och känslor hos anestesisjuksköterskan. Tidigare forskning fokuserar främst på barn och föräldrars upplevelse av anestesiinduktionen. Genom att beskriva anestesisjuksköterskans upplevelse kan ett bredare perspektiv på fenomenet belysas och kunskapen inom barnanestesi fördjupas.Syfte: Syftet var att beskriva anestesisjuksköterskans upplevelse av att anestesiinducera barn.Metod: En kvalitativ metod med induktiv ansats har genomförts. Datainsamlingen bestod av semistrukturerade intervjuer och materialet analyserades enligt Graneheim och Lundmans (2004) kvalitativa innehållsanalys.Resultat: Analysen resulterade i fem huvudkategorier med 10 underkategorier som formade två övergripande teman: att skapa goda förutsättningar inför anestesiinduktionen vilket innefattade att etablera kontakt, anpassa förberedelser samt att samverka med föräldrarna. Det andra temat var att möta och hantera utmaningar vilket innefattade handlingsberedskap och professionell utmaning.Slutsats: Att anestesiinducera barn kan vara både stimulerande och utmanande. Goda förutsättningar inför anestesiinduktionen främjas av en tillitsfull relation med barnet och föräldrarna, där leken utgör ett viktigt verktyg för att skapa delaktighet och lärande. Genom handlingsberedskap och strategier kan oron för komplikationer minskas. Anestesiinducering av barn kan ge upphov till etiska dilemman samt innebära en yrkesmässig påfrestning hos anestesisjuksköterskan. / Background: Anaesthesia induction of children requires special skills of the anaesthetic nurse, both physiological and emotional. The anaesthetic nurse needs to create security and trust in the meeting with the child, which can pose a challenge if the meeting is short and intense. Children's ability to cooperate and participate in preparations and in connection with the anesthesia is affected by the child's age, level of development and unique conditions. Lack of adherence and willingness to cooperate in the child can lead to the application of coercion in connection with the induction, which provokes different thoughts and feelings in the anesthesia nurse. Previous research focuses primarily on children and parents' experience of anaesthesia. By describing the anesthesia nurse's experience, a broader perspective on the phenomenon can be highlighted and knowledge in pediatric anesthesia increased.Aim: The aim of the study was to describe the anesthesia nurse's experience of anesthetize children.Method: To answer the purpose of the study, a qualitative method with an inductive approach was used. The data collection consisted of semi-structured interviews with 12 informants and the material was analyzed according to Graneheim and Lundman's (2004) qualitative content analysis.Results: The analysis resulted in five main categories with ten subcategories that shaped two overarching themes. The first theme was to create good conditions for the anesthesia induction, which included establishing a contact, adapting preparations and collaborating with the parents. The second theme was to meet and manage challenges, which included readiness to act and handling a professional challenge.Conclusion: Anesthetizing children can be both stimulating and challenging. Good conditions can be created through preparation, play and the establishment of contact with the child and its parents. The worry of complications can be reduced through readiness to act and strategies. Anesthetizing children can give rise to ethical dilemmas as well as involve a professional strain on the anaesthetic nurse.
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