The diagnosis of HIV is a life-changing event that requires people to deal with the disease, as well as cope with HIV stigma. Both people living with HIV or AIDS (PLHA) and their close family members (CFM) are stigmatized, but CFM also stigmatizes PLHA. This interaction affects the relationship between PLHA and their CFM. The aim of this study was to evaluate the effect of a comprehensive community-based HIV stigma reduction intervention on PLHA and their CFM as well as to explore and describe their experiences during and after the intervention. A holistic multiple case study design as well as a qualitative description approach was used. The study was conducted in both an urban and a rural setting. Purposive sampling was used for the PLHA and snowball sampling for the CFM. The case record for the case study consisted of several sources. In-depth-interviews were used to explore their experiences. The data was analysed using open coding and text document analysis. Both groups gained a richer understanding of HIV stigma and coping with it. The relationships enriched by PLHA feeling more supported and CFM realizing how they stigmatized and that they should be more supportive. Leadership was activated through the project. Bringing PLHA and CFM together during an intervention, proved to be affective, Recommendations focus on the inclusion of HIV-related stigma reduction awareness interventions in the curriculum of student nurses and the implementation thereof in the community, through community based nursing. It would be of benefit if the programme could also be offered as a workshop to traditional healers in the community. Nurses in clinics working with PLHA should invite PLHA and CFM to participate in groups to support each other in reducing HIV-related stigma and share problem-solving coping strategies. The researcher believes that the results of the current study have important implications for further research in HIV-related stigma reduction interventions in other countries and demographic groups. It has the potential to be used for long-term monitoring studies of HIV stigma reduction interventions and the change over time. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013

The diagnosis of HIV is a life-changing event that requires people to deal with the disease, as well as cope with HIV stigma. Both people living with HIV or AIDS (PLHA) and their close family members (CFM) are stigmatized, but CFM also stigmatizes PLHA. This interaction affects the relationship between PLHA and their CFM. The aim of this study was to evaluate the effect of a comprehensive community-based HIV stigma reduction intervention on PLHA and their CFM as well as to explore and describe their experiences during and after the intervention. A holistic multiple case study design as well as a qualitative description approach was used. The study was conducted in both an urban and a rural setting. Purposive sampling was used for the PLHA and snowball sampling for the CFM. The case record for the case study consisted of several sources. In-depth-interviews were used to explore their experiences. The data was analysed using open coding and text document analysis. Both groups gained a richer understanding of HIV stigma and coping with it. The relationships enriched by PLHA feeling more supported and CFM realizing how they stigmatized and that they should be more supportive. Leadership was activated through the project. Bringing PLHA and CFM together during an intervention, proved to be affective, Recommendations focus on the inclusion of HIV-related stigma reduction awareness interventions in the curriculum of student nurses and the implementation thereof in the community, through community based nursing. It would be of benefit if the programme could also be offered as a workshop to traditional healers in the community. Nurses in clinics working with PLHA should invite PLHA and CFM to participate in groups to support each other in reducing HIV-related stigma and share problem-solving coping strategies. The researcher believes that the results of the current study have important implications for further research in HIV-related stigma reduction interventions in other countries and demographic groups. It has the potential to be used for long-term monitoring studies of HIV stigma reduction interventions and the change over time. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013

Bakgrund: Stroke är en av de vanligaste orsakerna till funktionsnedsättningar och död i Sverige. De flesta som fått en stroke blir beroende av stöd från sina anhöriga. Anhöriga bör delta i vården av den som fått stroke för att underlätta i deras tillvaro. Syfte: Att beskriva upplevelsen av att vara anhörig till en människa som har fått stroke. Metod: En litteraturstudie med tio kvalitativa vetenskapliga artiklar med beskrivande syntes. Resultat: Först kände de anhöriga en osäkerhet över situationen, en känsla av kaos uppstod och de var oroliga inför framtiden. Sedan kände de anhöriga sig ensamma i tillvaron, de upplevde brist i stödet från hälso- och sjukvården samt obehag över det stora ansvaret som nu följde. De anhöriga började sedan acceptera framtiden, de kände tacksamhet över sin livssituation och de började omprioritera sitt liv. Slutsats: Genom att låta sjuksköterskor ta del av de anhörigas upplevelser kan de ge bättre och mer anpassad information och stöd individuellt till de anhöriga. Detta skulle ge patienten ett bättre stöd och minska onödigt lidande. / Background: In Sweden, Stroke is one of the most common causes to disability and death. Stroke can provide serious consequences and most of patients need to be helped by their close family members. It is important for close family members to be involved in the care of patients who have had a stroke to facilitate the life. Aim: To describe the experience of being a close family member of a person who has had a stroke. Method: A literature review based on ten qualitative scientific articles with descriptive synthesis. Result: At first, close family members felt the uncertainty of the situation because of a sense of chaos and worries about future. At second, they felt loneliness in life because they experienced a lack of support from health care and overwhelming responsibility that followed. Lastly, the family members accepted the future because they felt gratitude for their lives and they began to re-prioritize their life. Conclusion: By allowing nurses to take more knowledge of the family members' experience, they can understand why it is important to provide better and more detailed and individual support to the family members. This would give the patient a better support and reduce unnecessary suffering.

Syftet med studien är att beskriva forskningen som finns avseende informationsflöde, erfarenheter och upplevelser av anhöriga som grupp när en närstående drabbas av en allvarlig, livsomvälvande eller livshotande olycka eller katastrof. Studien har gjorts genom en scopingreview där fem databaser har genomsökts för att få en överblick av relevant forskning. Resultat påvisar vikten att information kring deras närstående når anhöriga i ett tidigt skede för att minska onödig stress. I arbetet med anhöriga visar det sig att socialarbetare bör ha en plats i krishanteringsarbetet då de ofta har utbildning och erfarenheter av att jobba emotionellt och stärkande. När en allvarlig olycka eller katastrof sker har det visat sig att även anhöriga påverkas. När anhöriga inte har förmågan att på egen hand ta sig igenom krisen bör det finnas krisinterventioner att sätta in. Interventionen bör vara individuellt anpassad och kan därmed behövas långsiktigt. / The purpose of this paper is to examine the needs close family and relatives have of information and support when a serious accident or disaster occurs. This was done through a scoping review. Five databases were searched to summarize relevant research. The results indicate how important it is with information to close family and relatives in an early stage to minimize their negative stress. Social workers should have a given place with the trauma team since they usually have the training and skills to work emotionally and supportive with people. When a severe accident or disaster occurs, it is proven that close family and relatives are also affected. A crisis intervention should be available when they don’t have the resources to cope with the crisis on their own. Crisis interventions should be individually adapted and might be needed fora long time.

Bakgrund: Ett patientfokuserat vårdande innebär att även patientens närstående inkluderas i vården. Vilka som är närstående definieras av patienten och vilka hen väljer ut som viktiga personer i sitt liv. Närstående ser sig som viktiga informationskällor till individer som lever med psykisk ohälsa. Studier visar att hela deras tillvaro förändras och att hela familjen påverkas när någon insjuknar i psykisk ohälsa. Det är därmed av vikt att vårdpersonalen gör de närstående delaktiga i den vuxenpsykiatriska vården. Syfte: Syftet med denna studien är att undersöka vårdpersonalens upplevelse av att inkludera närstående inom vuxenpsykiatrisk öppenvård.  Metod: En kvalitativ studie är gjord och semistrukturerade intervjuer har genomförts med vårdpersonal som arbetar inom vuxenpsykiatrisk öppenvård. Vårdpersonalen bestod av sju specialistsjuksköterskor inom psykiatrisk vård, två sjuksköterskor och sex skötare. Insamlad data analyserades med en kvalitativ innehållsanalys.  Resultat: Vårdpersonalen uttryckte att det är av vikt att medvetandegöra och skapa en förståelse för närståendes situation, med en god relation upplevdes omvårdnadsarbetet betydligt lättare när det gäller att stödja patienten på rätt sätt. Vårdpersonalen uppmärksammade även närståendes behov av stöd och information. Det upplevdes även finnas en del utmaningar när det kom till att inkludera närstående i den vuxenpsykiatriska öppenvården.  Slutsats: Ett samarbete mellan patient, närstående och vårdpersonal underlättas om de närstående inkluderas i den vuxenpsykiatriska öppenvården. Studien kan användas som inspiration för utveckling av närståendearbete inom såväl psykiatrisk som somatisk vård. För att närståendearbetet ska kunna utvecklas vore det gynnsamt om stöd kom från verksamheten så att ett samarbete med närstående kan prioriteras på organisationsnivå. / Background: A patient-focused care means that the patient's relatives are also included in the care. Those who are related are defined by the patient and who choose them as important persons in their life. Related parties see themselves as important sources of information for individuals living with mental illness. Studies show that their entire life is changing and that the whole family is affected when someone falls ill in mental illness. It is therefore important that the healthcare staff participate in the adolescent psychiatric care. Aim: The aim of this study is to investigate the healthcare staff's experience of including close relatives in adult psychiatric outpatient care. Methodology: A qualitative study is done and semi-structured interviews have been conducted with healthcare professionals working in adult psychiatric outpatient care. The healthcare staff consisted of seven specialist nurses in psychiatric care, two general nurses and six caregivers. Collected data was analyzed with a qualitative content analysis. Result: The healthcare staff stated that it is important to raise awareness and create an understanding of the situation of close relatives, with a good relationship, the nursing work was felt much easier when it came to supporting the patient in the right way. The healthcare staff also noticed the relatives' need for support and information. There were also some challenges encountered when it came to including relatives in the adult psychiatric outpatient care. Conclusion: Collaboration between the patient, related persons and healthcare staff is facilitated if the related parties are included in the adult psychiatric outpatient care. The study can be used as inspiration for the development of close family work in both psychiatric and somatic care. In order for the related party work to be able to develop, it would be beneficial if support came from the business so that cooperation with related parties can be prioritized at the organizational level.

Introduction : Les personnes ayant eu un accident vasculaire cérébral léger (AVCL) sont autonomes pour l’accomplissement des activités de la vie quotidienne de base, mais peuvent présenter des déficits subtils pour l’accomplissement d’activités complexes qui ne sont pas dépistés durant l’hospitalisation. Le retour à domicile parmi les proches est souvent le moment où certaines difficultés apparaissent. L’objectif de cette étude est d’explorer la perception des proches de leur qualité de vie, trois mois après le retour à domicile de la personne ayant eu l’AVCL. Méthodologie : Cette étude qualitative repose sur un paradigme constructiviste. Des entrevues individuelles semi-dirigées ont été menées à l’aide d’un guide d’entrevue, auprès de proches de personnes ayant eu un premier AVCL trois mois auparavant. Une transcription du contenu des entrevues a été faite sous forme de verbatim, suivie d’une analyse de contenu. Résultats : Huit entrevues ont été complétées (âge moyen 56,9 ans – ratio hommes/femmes de 2/6). Six thèmes ont été identifiés : personne ayant eu l’AVCL, vie quotidienne, relation conjugale, récidive, santé et services. L’AVCL engendre plusieurs incapacités (personne ayant eu l’AVCL) et les proches interrogés rapportent une augmentation de leurs tâches quotidiennes ce qui limite leurs activités personnelles (vie quotidienne). Ils mentionnent également devoir passer du rôle de conjoint à celui de parent, ce qui modifie la dynamique de couple (relation conjugale). Les proches se disent anxieux face au risque de récidive (récidive) et certains présentent des malaises physiques comme des maux de tête et un manque d’énergie (santé). Les proches affirment n’avoir accès à aucun service et que le seul soutien dont ils bénéficie est celui de leur entourage (services). Conclusion : Le retour à domicile de la personne AVCL engendre diverses conséquences sur le quotidien des proches, ce qui affecte leur qualité de vie. / Introduction: Mild stroke clients are often independent in basic activities of daily living but may present subtle deficits that impact on complex activities and roles. The purpose of this study was to explore the perceived quality of life of close family members three months after the stroke client was discharged home. Method: Qualitative design based on a constructivist paradigm. Interviews were conducted with family members of mild stroke clients three months after discharge. An interview guide was used and the audio content was transcribed, followed by a content analysis. Results: Eight interviews were conducted (mean age 56.9 ± 9.2 years; men=2/8). Six essential themes emerged from the data. According to participants, mild stroke clients present sequelae that interfere with complex tasks (patient), increasing the burden on other family members who have to limit their personal activities (daily living). Spouses reported sometimes acting like a parent, which caused tensions in the relationship (conjugal relationship). Anxiety is related to the risk of stroke recurrence (relapse) and some family members present physical symptoms and a lack of energy (health). However, family members do not have access to services despite support from their relatives (services). Conclusion: The results of this exploratory study strongly suggest that even a ‘mild’ stroke has an impact on the daily lives of close family members and affects their quality of life.

Introduction : Les personnes ayant eu un accident vasculaire cérébral léger (AVCL) sont autonomes pour l’accomplissement des activités de la vie quotidienne de base, mais peuvent présenter des déficits subtils pour l’accomplissement d’activités complexes qui ne sont pas dépistés durant l’hospitalisation. Le retour à domicile parmi les proches est souvent le moment où certaines difficultés apparaissent. L’objectif de cette étude est d’explorer la perception des proches de leur qualité de vie, trois mois après le retour à domicile de la personne ayant eu l’AVCL. Méthodologie : Cette étude qualitative repose sur un paradigme constructiviste. Des entrevues individuelles semi-dirigées ont été menées à l’aide d’un guide d’entrevue, auprès de proches de personnes ayant eu un premier AVCL trois mois auparavant. Une transcription du contenu des entrevues a été faite sous forme de verbatim, suivie d’une analyse de contenu. Résultats : Huit entrevues ont été complétées (âge moyen 56,9 ans – ratio hommes/femmes de 2/6). Six thèmes ont été identifiés : personne ayant eu l’AVCL, vie quotidienne, relation conjugale, récidive, santé et services. L’AVCL engendre plusieurs incapacités (personne ayant eu l’AVCL) et les proches interrogés rapportent une augmentation de leurs tâches quotidiennes ce qui limite leurs activités personnelles (vie quotidienne). Ils mentionnent également devoir passer du rôle de conjoint à celui de parent, ce qui modifie la dynamique de couple (relation conjugale). Les proches se disent anxieux face au risque de récidive (récidive) et certains présentent des malaises physiques comme des maux de tête et un manque d’énergie (santé). Les proches affirment n’avoir accès à aucun service et que le seul soutien dont ils bénéficie est celui de leur entourage (services). Conclusion : Le retour à domicile de la personne AVCL engendre diverses conséquences sur le quotidien des proches, ce qui affecte leur qualité de vie. / Introduction: Mild stroke clients are often independent in basic activities of daily living but may present subtle deficits that impact on complex activities and roles. The purpose of this study was to explore the perceived quality of life of close family members three months after the stroke client was discharged home. Method: Qualitative design based on a constructivist paradigm. Interviews were conducted with family members of mild stroke clients three months after discharge. An interview guide was used and the audio content was transcribed, followed by a content analysis. Results: Eight interviews were conducted (mean age 56.9 ± 9.2 years; men=2/8). Six essential themes emerged from the data. According to participants, mild stroke clients present sequelae that interfere with complex tasks (patient), increasing the burden on other family members who have to limit their personal activities (daily living). Spouses reported sometimes acting like a parent, which caused tensions in the relationship (conjugal relationship). Anxiety is related to the risk of stroke recurrence (relapse) and some family members present physical symptoms and a lack of energy (health). However, family members do not have access to services despite support from their relatives (services). Conclusion: The results of this exploratory study strongly suggest that even a ‘mild’ stroke has an impact on the daily lives of close family members and affects their quality of life.