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Bakgrund: När sjukdomen inte längre kan botas, blir fokus för vården att främja välbefinnandet under livets sista skede. Palliativ vård syftar till att lindra symtom och minska lidande. Sjuksköterskans roll är en grundläggande del i den palliativa vården och innefattar partnerskap, lyssnande på patientberättelsen och dokumentation av patientjournal och hälsoplan. Personcentrerad omvårdnad är utgångspunkten när sjuksköterskor ska vårda palliativa patienter i livets slutskede.   Syfte: Att belysa sjuksköterskors erfarenheter av att vårda patienter palliativt i hemmet under livets slutskede.  Metod: En litteraturöversikt med kvalitativ design. Analys enligt Fribergs fem steg (2022) tillämpades på 12 artiklar.    Resultat: Resultatet utgår från två teman meningsfullt samspel (att vara i mötet med patienten, att vara i mötet med närstående) och samverkande vård (vårda i team, hemmet som vårdmiljö, tillgång av resurser). Den teoretiska referensramen som tillämpades i litteraturöversikten var personcentrerad vård.    Slutsats: En effektiv kommunikation och samarbeta mellan de olika medlemmarna i teamet inklusive olika professioner, närstående och patienten har en viktig roll för att uppnå en personcentrerad vård. Den miljön och de resurser som sjuksköterskorna har tillgång till under den palliativa vården har även en påverkan på vårdandets kvalité. / Background: When the disease is no longer curable, the focus of care shifts towards promoting well-being during the final stages of life. Palliative care aims to alleviate symptoms and reduce suffering. The nurse's role is a fundamental part of palliative care, involving partnership, listening to the patient's narrative, and documenting the patient's chart and care plan. Person-centered nursing is the foundation when nurses provide care for palliative patients at the end of life.   Aim: To highlight the nurses experiences in providing palliative care to patients at the end of life in the home setting.   Method: A literature review with a qualitative design. Analysis according to Friberg's five-step method (2022) was applied to 12 articles   Results: The result is based on two themes: meaningful interaction (being in the encounter with the patient, being in the encounter with family members) and collaborative care (caring within a team, the home as a care environment, availability of resources). The theoretical framework applied in the literature review was person-centered care.   Conclusion: Effective communication and collaboration among various team members, including different professions, family members, and the patient, play a crucial role in achieving person-centered care. The environment and resources available to nurses during palliative care also impact the quality of care provided.

Bakgrund: Det är 25% av världens befolkning som drabbas av stroke någon gång under sin livstid. Stroke är ett samlingsnamn för minskad eller avsaknad av blodtillförsel till hjärnan. Patienter som drabbas av stroke får i stor utsträckning nedsatta kognitiva och motoriska funktioner. Detta leder till att sjuksköterskor får ett mer omfattande omvårdnadsarbete.Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av att vårda patienter med stroke.Metod: En litteraturöversikt med kvalitativ metod och induktiv ansats. Till resultatet användes 13 artiklar. Artikelsökningar gjordes i databaserna Cinahl, Medline och Psycinfo. Fribergs femstegsmodell användes i dataanalysen.Resultat: Tre teman och åtta subteman sammanställdes. Litteraturöversiktens huvudteman var utmaningar i organisationen, utmaningar i vårdmötet och relationens betydelse. Subteman som identifierades var personalbrist, tidsbrist och resursbrist, brist på utbildning, kommunikationssvårigheter, patientens inställning till vård, kognitiva problem, inkludera patientens närstående och samarbetssvårigheter.Slutsats: Brist på utbildning, tid och resurser är något som sjuksköterskor har erfarenhet i vård av strokepatienter. Patientens inställning till vård kan vara en utmaning för sjuksköterskor. Afasi, dysfagi och kognitiva problem är en faktor som försvårar sjuksköterskors arbete utifrån ett personcentrerat förhållningssätt.Involvering av anhöriga är väsentligt för en god personcentrerad vård men kan vara utmanande för sjuksköterskor. / Background: 25% of the world's population suffer from stroke at some point during their lifetime. Stroke is a collective name for reduced or restricted blood stream to the brain. It includes ischemic stroke and hemorrhagic stroke. Patients who suffer from stroke often get reduced cognitive impairment and physical disabilities. This leads to extensive work for the nurse.Aim: The aim was to describe the nurse's experiences of caring for patients with stroke.Method: A literature review with quality method with inductive approach. In the result 13 articles were selected. The article research was conducted in Cinahl, Medline and Psycinfo. Fribergs five steps model was used for the data analysis.Result: Three themes were found and eight subthemes. Three themes were compiled as well as eight subthemes. Challenges in the organization, challenges in the care meeting and the importance of the relationship were the main themes. The subthemes that were identified were lack of staff and lack of resources, lack of time, lack of education, communicating disabilities, cognitive impairments, the patient's attitude to health care, include the patient's relatives and cooperation difficulties.Conclusion: When caring for stroke patients nurses experienced that they had lack of education, time and resources. The patient's opinions about their healthcare could be challenging for the nurse. Aphasia, dysphagia and cognitive impairment are factors that complicates the nurse's work based on a person-centered approach. Relative involvement is essential for good person-centered care but can be challenging for the nurse.

Bakgrund: Barnsjukvården bedrivs idag på ett sätt som inkluderar hela familjen i omvårdnaden. Det är viktigt att öka förståelsen för de känslor och behov som föräldrar till sjuka barn upplever vid de tillfällen då deras barn vistas på sjukhus, eftersom sjuksköterskan som omvårdnadsansvarig ska kunna möta och tillgodose dessa behov. Syfte: Att genom en litteraturstudie undersöka föräldrars behov och upplevelser av deras barns sjukhusvistelse. Artiklar söktes i databaserna CINAHL och PubMed och analyserades enligt Graneheim & Lundmans kvalitativa innehållsanalys. Tre teman identifierades relaterat till föräldrars behov: Miljö, Psykosocialt och Kommunikation. Fyra teman identifierades relaterat till upplevelser: Miljö, Psykosocialt, Kommunikation och Relationer. Resultat: Det framkom att föräldrar upplevde sjukhusvistelse som påfrestande. Miljön upplevdes främmande och annorlunda och i denna var föräldrar sårbara och känsliga. Föräldrar hade ett uttalat behov av att vara nära sitt barn och ville att sjuksköterskan skulle vara ärlig och omsorgsfull i omvårdnaden. De hade behov av en personlig relation med sjuksköterskan och behövde vägledning och stöd i beslut. Föräldrar behövde uppmuntras för att inte tappa hoppet i situationer som kändes hopplösa och sökte bekräftelse när dem upplevde skuldkänslor för barnets sjukdom. Vad föräldrar behöver varierarde beroende på förutsättningar och situation, men den generella uppfattningen var att dem upplevde sina behov otillfredsställda. / Background: Child health care in Sweden is currently carried out in a way that includes the whole family, therefore it’s important to increase understanding of the feelings and needs that parents of hospitalized children experience to enable the nurse to meet and satisfy these needs. Aim: Thru a literature review examine parents' needs and experiences of their child's hospitalization. Articles were searched in the databases CINAHL and PubMed, and analysed according to Graneheim & Lund 's qualitative content analysis. Three themes were identified related to parents' needs: Environment, Psychosocial and Communication. Four themes were identified related to the experiences: Environment, Psychosocial, Communication and Relationships. Result: Parents experienced hospitalization as strenuous. The environment felt strange and different and parents were vulnerable and sensitive. Parents had a need to be near their child and wanted the nurse to be honest and diligent in his or her care. They had need for a personal relationship with the nurse, guidance and support. Parents needed to be encouraged not to lose hope in situations that seemed hopeless, and sought confirmation when they experienced feelings of guilt for their child's illness. What parents need varied depending on circumstances and situation, but the general opinion was that they felt their needs were unmet.

Background: Person-centered care is one of the nurse's core competencies where the nurse's role is to enable the patient's care based on participation and self-determination. According to research, person-centered care has positive effects such as higher quality of life, reduced cost and satisfaction in both patients and care staff. Despite this, the implementation of personcentered care is slow, which is most often referred to various obstructive factors such as lack of time and shortcomings in the work environment. Aim: The aim of the study was to investigate how nurses describe their experiences of person-centered care in psychiatric outpatient care. Method: The study was done with a qualitative design and the data collection took place through semi-structured interviews of eleven nurses at a psychiatric outpatient clinic. These interviews analyzed by inductive content analysis. Results: The overall category Person-centered care - opportunities and challenges shows that nurses' experiences of person-centered care are complex. The results of this study are presented through four subcategories. 1. With patient in focus. 2. Collaboration as a prerequisite for Participation. 3.To adapt and strive for good communication. 4. Organizational work and knowledge. Conclusion: Joint responsibility is required to provide person-centered care. Nurses cannot provide person-centered care on their own, but greater organizational change work is needed. On the other hand, specialist nurses in psychiatric care, with their in-depth care scientific knowledge, must be able to lead the nursing work based on the person-centered approach. Suggestions for further research: This study is important as it sheds light on knowledgegaps based on the nurses' previous experiences, while at the same time it sheds light on the specialist nurse's opportunities to develop person-centered care. Finally, more knowledge is requested in person-centered care, including communication, collaboration, participation and documentation with a focus on care plans.

<p><strong>Objective: </strong>The objective of this thesis is to identify the approaches to patient-centered care provision currently employed by clinicians and to identify patient perspectives of patient-centeredness in relation to pain and disability following distal radius fracture. This thesis includes a scoping review of patient-centered care frameworks and models, as well as a prospective cohort study.</p> <p><strong>Rationale: </strong>Patient-centered care provision has been linked with positive health outcomes, improved patient satisfaction, and reduced health costs. A uniform approach to patient-centered care in rehabilitation has yet to be developed primarily due to the breadth and scope of practice. Understanding current approaches to patient-centered care and patient perspectives on this care can serve as a foundation to future discussions on the development of a rehabilitation-specific approach to patient-centered care provision.</p> <p><strong>Data sources: </strong>Frameworks and models of patient-centered care provision were located via electronic database searches. The extracted frameworks and models were compared based on how they described strategies on achieving the three tenets of patient-centered care: communication, partnership, and health promotion. A prospective cohort study provided patient perspectives on patient-centeredness, pain, and disability following distal radius fracture at baseline and at three months post distal radius fracture in 129 patients.</p> <p><strong>Methods: </strong>Frameworks and models on patient-centered care provision were extracted from articles and placed in data summary tables for comparison and review. Information on how these frameworks and models described strategies for communication, partnership, and health promotion was collated and reviewed. The patients’ perceptions of patient-centeredness, pain, and disability were determined from responses to the Patient Perceptions of Patient-Centeredness Questionnaire and the Patient Rated Wrist Evaluation. Outcome measure responses were analyzed to measure change over time (Wilcoxon Rank Sum and T-Test analyses) and to identify relationships (Pearson correlations).</p> <p><strong>Results: </strong>The scoping review found 19 articles, from which 25 patient-centered care frameworks or models were identified. All frameworks and models reported strategies on achieving effective communication, partnership, and health promotion. The prospective cohort study revealed significant correlations between patient perspectives of patient-centeredness and pain and disability following distal radius fracture. This suggests that positive experiences with patient-centered care provision are correlated with reduction in pain and improvement in function following an acute orthopaedic injury.</p> <p><strong>Implications: </strong>Until a rehabilitation-specific approach to patient-centered care provision is developed, rehabilitation clinicians can be confident that selection of one of the currently employed frameworks or models of patient-centered care will reflect the three tenets of patient-centered care provision. Adopting one of these patient-centered approaches to care provision likely will result in positive health outcomes.</p> / Master of Science Rehabilitation Science (MSc)