Patients with haematological diseases are entitled to supportive care. Considering organisational and technological development, support in the form of caring communication provided through the web is today a possible alternative. The aim of this thesis was to examine the usefulness and importance of a web-based counselling service to patients with haematological diseases. The basis for the thesis was a development project funded by the Swedish Cancer Society, which provided an opportunity to offer patients communication with a nurse through a web-based counselling service. Four studies were performed from a patient perspective. Study I had a cross-sectional design, measuring occurrence of anxiety and depression, and these variables’ associations to mastery, social support, and insomnia among patients with haematological diseases. Study II was a qualitative content analysis focusing on conditions for provision and use of the web-based counselling service. Study III used a qualitative hermeneutical approach to focus on patients’ experiences of using the counselling service. Study IV was a qualitative deductive analysis examining how communication within the web-based counselling service can be caring in accordance to caring theory. The results revealed that females of 30-49 years of age are vulnerable to experiencing anxiety. Low sense of mastery and support are associated with anxiety and/or depression. Being able to self-identify the need for support as well as appreciate the written medium are necessary conditions for the web-based counselling service to be used. The counselling service must also be part of a comprehensive range of supportive activities and web-based services to be useful. The main importance of the communication is that the patient’s influence on the communication is strengthened, and that the constant access to individual medical and caring assessment can imply a sense of safety. When patients share their innermost concerns and search for support, nursing compassion and competence can substantiate in explicit written responses. A conclusion is that there is a caring potential in communication within a web-based counselling service. To make this form of communication possible, nurses should take possession of and ensure that this medium for communication is offered to patients. Nurses should also increase their knowledge of caring communication in writing and how this possibly can impact patients.

Patients with haematological diseases are entitled to supportive care. Considering organisational and technological development, support in the form of caring communication provided through the web is today a possible alternative. The aim of this thesis was to examine the usefulness and importance of a web-based counselling service to patients with haematological diseases. The basis for the thesis was a development project funded by the Swedish Cancer Society, which provided an opportunity to offer patients communication with a nurse through a web-based counselling service. Four studies were performed from a patient perspective. Study I had a cross-sectional design, measuring occurrence of anxiety and depression, and these variables’ associations to mastery, social support, and insomnia among patients with haematological diseases. Study II was a qualitative content analysis focusing on conditions for provision and use of the web-based counselling service. Study III used a qualitative hermeneutical approach to focus on patients’ experiences of using the counselling service. Study IV was a qualitative deductive analysis examining how communication within the web-based counselling service can be caring in accordance to caring theory. The results revealed that females of 30-49 years of age are vulnerable to experiencing anxiety. Low sense of mastery and support are associated with anxiety and/or depression. Being able to self-identify the need for support as well as appreciate the written medium are necessary conditions for the web-based counselling service to be used. The counselling service must also be part of a comprehensive range of supportive activities and web-based services to be useful. The main importance of the communication is that the patient’s influence on the communication is strengthened, and that the constant access to individual medical and caring assessment can imply a sense of safety. When patients share their innermost concerns and search for support, nursing compassion and competence can substantiate in explicit written responses. A conclusion is that there is a caring potential in communication within a web-based counselling service. To make this form of communication possible, nurses should take possession of and ensure that this medium for communication is offered to patients. Nurses should also increase their knowledge of caring communication in writing and how this possibly can impact patients.

Background: Type II diabetics with co-morbidity in depression run a greater risk of suffering from sequelae. Lack of knowledge about the symptoms of depression, lack of routine for depression screening and the stigmatization of depression can affect the possibility of getting help. Depression causes suffering and impaired self-care ability.  Purpose: To describe experiences and interventions related to health promotion nursing in type II diabetes and contemporary depression. The following issues were dealt with:1. What experiences do these patients, and their nurses describe?2. What health promotion interventions have been described and tested for these patients?  Method: General literature study consisting of 7 quantitative, 2 qualitative and 1 mixed-method study.  Results: Based on the results of the Patient and nurses' experiences questionnaire, categories were identified; Depression can be difficult to identify, Approach to depression, Caregiver's need for Insight into the patient's perspective and conditions. Based on the question Health promoting interventions, categories were identified; Multifaceted efforts, Promote self-care skills and Broad competence in care.  Conclusion: Health-promoting interventions for patients with co-morbidity in diabetes type II and depression should be based on collaboration between nurse and patient where the interventions are based on the patient's needs. Nurses need psychiatric competence and insight into health-promoting methods, for example caring communication in the care of the patient category.

No description available.

Bakgrund: Sexuell hälsa innebär bland annat ett fysiskt, emotionellt, mentalt tillstånd och socialt välbefinnande i relation till sexualitet. Attityder till äldres sexuella hälsa har förändrats och de äldre tillåts njuta av sin sexualitet. Positiva och negativa aspekter gällande äldre människors sexuella hälsa pekar på att skillnader finns mellan män och kvinnor. Syfte: Att undersöka hur distriktssköterskor uppfattar att samtala om sexuell hälsa med äldre människor på vårdcentral. Metod: Metoden i denna studie är kvalitativ med en fenomenografisk ansats. Data samlades genom individuella intervjuer med öppna frågor. Resultat: Resultatet visade sju beskrivningskategorier: Det är ett känsligt ämne att samtala om, Det är inte en rutin att samtala om sexuell hälsa, Att ha en förutfattad mening i mötet med de äldre, Det är ett relevant ämne att samtala om, Brist på kunskap i ämnet, Att samtala med män och kvinnor skiljer sig åt och Dessa samtal är mer relevanta vid läkarbesök. Efter resultatet presenteras ett utfallsrum. Konklusion: Slutsatsen är att sexuell hälsa är ett känsligt ämne att samtala om. Det behövs fler rutiner för distriktssköterskor på vårdcentral och möjlighet till utbildning för att utöka kunskapen inom detta ämne. / Background: Sexual health consists of physical, emotional, mental and social well-being in relation to sexuality. Attitudes towards elderly’s sexual health have changed, and elder are allowed take pleasure in their sexuality. Positive and negative aspects concerning elderly people’s sexual health suggests that there are differences between men and women. Purpose: To investigate how district nurses perceive their dialogues about sexual health with elderlies. Method: The method in this study is of qualitative character through a phenomenographical approach. Data was collected during individual interviews with open-ended questions. Result: The results revealed seven categories of description; It is a sensitive topic to discuss, It is not of routine to talk about sexual health, Preconceptions when meeting elderlies, It is a relevant subject to talk about, Insufficient knowledge regarding the subject, Dialogues with men and women differ and these dialogues are more relevant during visits to physicians. After the result, an outcome space is presented. Conclusion: The conclusion labels sexual health as a sensitive speech topic. There is a need for additional routines for district nurses at health centers along with the possibility to extend the knowledge in this field.

Urininkontinens är ett folkhälsoproblem och förekomsten ökar med stigande ålder. Tidigare forskning visar att äldre kvinnor upplever urininkontinens som skamligt samt ser tillståndet som en oundviklig del av naturligt åldrande. Urininkontinens upplevs besvärande att prata om vilket medför att få äldre kvinnor söker vård. Distriktssköterskan har med sin kompetens om urininkontinens samt vårdande samtal möjlighet att möta den äldre kvinnans livsvärld. Syftet var att belysa äldre kvinnors erfarenheter av att leva med urininkontinens. En systematisk litteraturöversikt med induktiv ansats genomfördes och tio kvalitativa artiklar analyserades enligt Popeone, Langius-Eklöf, Stenwall och Jervaeus (2021) analysmetod. Analysen resulterade i en huvudkategori och fyra kategorier med två till tre underkategorier. Huvudkategorin var stigmatiseringen kring urininkontinens tycks påverka äldre kvinnors livsvärld och kategorierna följande: samspel av känslor kring urininkontinens, betydelsen av påverkan på det dagliga livet, betydelsen av hälso- och sjukvårdens agerande samt strategier för att hantera urininkontinens. Ur resultatet framkom det att urininkontinens är stigmatiserat och påverkar den äldre kvinnans livsvärld, främst genom en förändrad självbild och isolering. Resultatet visar vidare att vården både kan ge stöd och orsaka lidande beroende på bemötande. Sammanfattningsvis kan det konstateras att genom ett vårdande samtal med livsvärlden i fokus kan distriktssköterskan möta den äldre kvinnan ur ett holistiskt perspektiv, vilket kan leda till att värdighet och autonomi bevaras samtidigt som stöd erbjuds. Översikten kan vara av värde för fortsatt reflektion hos distriktssköterskor som möter äldre kvinnor med urininkontinens. / : Urinary incontinence is a public health problem, and the incidence increases with age. Previous research shows that older women experience urinary incontinence as shameful and see the condition as an inevitable part of natural aging. The condition is therefore perceived as troublesome to talk about, which means that few older women seek care. With the expertise in urinary incontinence and caring communication, the district nurse can meet the older women’s lifeworld. The aim was to shed light on older women's experiences of living with urinary incontinence. A systematic literature review with an inductive approach was carried out and ten qualitative articles were analyzed according to Popeone, Langius-Eklöf, Stenwall and Jervaeus (2021) analysis method. The analysis resulted in one main category and four categories with two to three subcategories. The main category was the stigma surrounding urinary incontinence seems to affect the life world of older women and the categories were as follows: interplay of feelings around urinary incontinence, the importance of the impact on daily life, the importance of the healthcare system's actions and strategies for managing urinary incontinence. The results showed that urinary incontinence is stigmatized and affects the older woman's lifeworld, mainly through a changed self-image and isolation. Healthcare can both provide support and cause suffering depending on the treatment. In summary, it can be stated that through a caring conversation with the life world in focus, the district nurse can meet the older woman from a holistic perspective, which can lead to dignity and autonomy being preserved while offering support. The results may be of value for continued reflection by district nurses who meet older women with urinary incontinence.

Bakgrund: Den psykiska ohälsan ökar stadigt i Sverige. Genom folkhälsomyndighetens mätningar 2016 visade resultatet att 16 procent av befolkning lider av psykisk ohälsa. Det har framkommit att genom samtal med sjuksköterska kan den som lider av psykisk ohälsa få stöd och kraft till att egna förmågor stärks. En förutsättning för att kunna ge en god vård är att skapa en god vårdrelation mellan vårdare och patient. Syfte: Syftet med denna studie är att belysa vad sjuksköterskor inom psykiatrisk öppenvård upplever som vårdande i samtal med patient. Metod: Tio semistrukturerade intervjuer har genomförts och dessa har analyserats med en kvalitativ innehållsanalys. Resultat: Resultatet redovisas i tre kategorierna; Att känna engagemang för patienten, som belyser vikten av att lyssna och hörsamma patientens berättelse och förstå patienten utifrån dennes livsvärld. Det framkom att ett syfte för samtalet ses som viktigt. Vidare beaktades respekten för patientens integritet och förmågan att anpassa samtalen utifrån varje enskild individ. Skapa och fördjupa relationen, handlar om att trygghet och tillit i vårdrelationen är en förutsättning för ett vårdande samtal. Vidare uttrycks att en stadigvarande kontakt är gynnsamt för relationen och samtalen. Utrymme för utveckling, belyser vikten av patientens önskemål i samtalet, och samtalet som möjlighet till förändring. Slutsats: Studien visar på att sjuksköterskor upplever det vårdande samtalet som betydelsefullt. För att lyckas med detta behövs insyn i det vårdande samtalets betydelse och att det får ta tid att lära känna patienten. Utifrån studien kan slutsatsen dras att sjuksköterskorna har en god värdegrund med patienten i fokus. / Background: Psychological ill health is steadily increasing in Sweden. By the Public Health Authority's measurements in 2016, the result showed that 16 percent of the population suffered from mental health. It has been found that through talks with a nurse, the person suffering from mental health can get support and power to strengthen his / her own abilities. A prerequisite for being able to provide a good care is to create a good care relationship between caregivers and patients. Purpose: The purpose of this study is to highlight what nurses in psychiatric outpatients experience as carers in conversation with patients. Method: Ten semi- structured interviews have been conducted and these have been analyzed with a qualitative content analysis. Results: The result is presented in three categories; To feel commitment to the patient, describing the importance of listening and hearing the patient's story and understanding the patient based on his life. It is described that a purpose of the caring communication is considered important. Respect for the patient's integrity and the ability to adapt the conversation from each individual is described. Create and deepen the relationship, be sure that safety and trust in the care relationship is a prerequisite for a caring communication. It is expressed that a constant contact is favorable to the relationship and the conversation. Space for development highlights the importance of the patient's wishes in the conversation. As well as the conversation as a possibility of change. Conclusion: The study shows that nurses experience the caring communication as significant. In order to succeed, insight into the importance of caring communication needs to be taken and that it may take time to get to know the patient. Based on the study, the conclusion can be drawn that nurses have a good value base with the patient in focus.