The overall aim of this thesis was to study palliative end-of-life care outside specialist palliative care settings, from an organizational perspective and from professionals’ and relatives’ experiences. In Study I 174 individuals were identified retrospectively from nursing records and palliative care identification forms as being in a palliative phase. Data were analyzed with descriptive and analytic statistical methods. In Study II a total of nine nurses working in primary home care, community care, and hospitals were interviewed. Phenomenological methodology was used to analyze data. In Study III 17 enrolled nurses, who worked in community or primary care and in a sitting service organization, participated in four focus group interviews. Data were analyzed with qualitative content analysis. In Study IV seven relatives from four families were interviewed twice. They had each cared in the private home for a dying family member who had received sitting service. Direct interpretation and categorical aggregation were used to analyze data. The results highlight challenges in palliative care, vulnerable situations, and a need of support (I–IV). Individuals’ needs for both palliative care and sitting service were identified, including those of a smaller part of the population who actually received the sitting service. (I). Registered nurses’ responsibilities included care at the same time for individuals in both palliative and curative phases. This created vulnerable situations for the nurses, since their ambitions concerning the care did not correspond to available resources (II). The enrolled nurses’ task was to manage ongoing life and dying in different care settings, to meet individual needs and still provide equivalent care. Despite experiences of vulnerable situations, they felt safe (III). Relatives experienced care situations differently, related to differences in families, the illness trajectory, the need for support, and the support offered. Without sufficient support, vulnerable situations occurred, which made the relatives feel insecure (IV). Thus, care situations in palliative end-of-life care can be experienced in different ways, with different levels of vulnerability. One implication of the research might be to suggest that professional caregivers, to supplement the relatives’ own resources with support tailored to the individual’s and the family’s needs

An exploratory, descriptive qualitative design was used to describe and explore how the students experienced their clinical accompaniment in a specific programme. The researcher conducted a tape recorded interview to a 14 individual students, who voluntarily agreed to participate in the study, transcription followed, then data analysis was done following the steps as described by De Vos, Srydom, Fouché and Delport (2005:334) citing Creswell (1998:142) where open coding leads to themes and subthemes. From the findings of this study it was discovered that the students experienced dissatisfaction in terms of their development of clinical skills to competence as they were not given an opportunity due to negative circumstances around their training. Recommendations were made to improve clinical accompaniment of student nurses for all involved so that the student nurses acquire clinical skills, knowledge and values. / Health Studies / M.A. (Health Studies)

An exploratory, descriptive qualitative design was used to describe and explore how the students experienced their clinical accompaniment in a specific programme. The researcher conducted a tape recorded interview to a 14 individual students, who voluntarily agreed to participate in the study, transcription followed, then data analysis was done following the steps as described by De Vos, Srydom, Fouché and Delport (2005:334) citing Creswell (1998:142) where open coding leads to themes and subthemes. From the findings of this study it was discovered that the students experienced dissatisfaction in terms of their development of clinical skills to competence as they were not given an opportunity due to negative circumstances around their training. Recommendations were made to improve clinical accompaniment of student nurses for all involved so that the student nurses acquire clinical skills, knowledge and values. / Health Studies / M.A. (Health Studies)

<p>The aim of the study has been to gain an increased understanding of the sense of participation and influence that the enrolled nurses, working with home-help services within the purchaser – provider model, feel and how this participation and influence affect them. Five enrolled nurses in three of Stockholm's districts related their experiences of participation and influence at work in the qualitative interviews that were conducted. The result was then analyzed with the help of two theories, Karasek's and Theorell´s Demand- Control Model and Antonovsky's theory regarding ”a Sense of Coherence (SOC)”. The analyzes show that the enrolled nurses have a low sense of participation and influence regarding decisions relating to their work situation. Decisions that affect the enrolled nurses are made by politicians, directors, and care managers of the city districts (biståndshandläggare). On the other hand, the enrolled nurses felt strong support from their peers at work. They could socialize and discuss issues with them. The analyzes show that without their peer support, they would have a lower sense of participation and influence. Furthermore the analyzes show that the interview subjects possess knowledge and competence that they are unable to make use of in their work.</p>

The aim of the study has been to gain an increased understanding of the sense of participation and influence that the enrolled nurses, working with home-help services within the purchaser – provider model, feel and how this participation and influence affect them. Five enrolled nurses in three of Stockholm's districts related their experiences of participation and influence at work in the qualitative interviews that were conducted. The result was then analyzed with the help of two theories, Karasek's and Theorell´s Demand- Control Model and Antonovsky's theory regarding ”a Sense of Coherence (SOC)”. The analyzes show that the enrolled nurses have a low sense of participation and influence regarding decisions relating to their work situation. Decisions that affect the enrolled nurses are made by politicians, directors, and care managers of the city districts (biståndshandläggare). On the other hand, the enrolled nurses felt strong support from their peers at work. They could socialize and discuss issues with them. The analyzes show that without their peer support, they would have a lower sense of participation and influence. Furthermore the analyzes show that the interview subjects possess knowledge and competence that they are unable to make use of in their work.

En stor andel av alla sjukskrivningar i Sverige beror på psykisk ohälsa. Kvinnor inom kontaktyrken löper störst risk att drabbas. Konflikter på arbetsplatsen är en anledning till psykisk ohälsa. Syftet med denna kvalitativa studie är att undersöka hur kvinnliga undersköterskor upplever konflikter i arbetsgrupp utifrån fyra perspektiv: arbetsgrupp, genus, makt och socialt utbyte. Med hjälp av semistrukturerade intervjuer har vi intervjuat tio undersköterskor i en mindre ort i Västra Götaland. Resultatet visar att informanterna upplever att konflikter har en negativ inverkan på undersköterskornas arbetssituation. Informanterna upplever även att konflikter uppstår på grund av olika personlighetstyper som inte harmoniserar med varandra, olika arbetssätt samt undvikande från arbetsuppgifter. Majoriteten av informanterna upplever att de agerar på ett medlande eller undvikande sätt i konflikter. De upplever även att konflikternas uttryckssätt beror på genusstrukturer. Exempelvis upplever informanterna att de hellre väljer att prata bakom ryggen på varandra än att reda ut konflikterna. De upplever att det är ett genusrelaterat beteende att prata bakom ryggen på varandra. Informanterna vittnar även om upplevelsen att det lätt uppstår en maktobalans bland nyanställd personal och mer etablerad personal. Slutligen visar studien resultat att informanterna upplever att chefens beteende är av stor vikt för personalens välmående. Sammanfattningsvis tyder resultaten på att undersköterskornas konflikter på arbetsplatsen är komplexa och kan te sig på olika sätt. Att konflikterna är varierande i sin uttrycksform kan bero på att det är en kvinnodominerad arbetsplats med en hög arbetsbelastning. / A majority of the individuals on sick leave in Sweden is due to mental illness and women working in healthcare is at high risk. A common reason due to psychological health related sickness is conflicts in the workplace. The purpose of this qualitative study is to examine female enrolled nurse’s experiences of conflicts in workgroups. Four perspectives are taken in to account – work group, gender, power and social exchange theory. The empirical samplings were collected via semi-structured interviews with ten enrolled nurses attending from a smaller city in the Västra Götaland region. The result shows that conflicts have a negative impact regarding the workplace situation in general. The conflicts arise due to differences in personality type, different approaches to how to get the job done and also evading of work duties. The result also show that a majority of the informants consider their conflict management strategies characterized by meddling or avoiding. They also consider the conflicts means of expression originating from gender structures. For example, the informants prefer to talk behind each other’s backs rather than solve the conflicts immediately. They consider this originating from gender related behavior. Further on a power imbalance tend to occur between enrolled nurses who is newly hired and/or with less professional experience and those who has a lot of professional experience and has been at the workplace for a longer time. The head manager’s behavior toward conflicts is of great importance regarding the enrolled nurse’s wellbeing in the workplace. In summary the results show that the conflicts in the workplace is complex and appear differently. A reason behind this could be the fact that the enrolled nurse’s work place is both female dominated and characterized by a heavy workload.

The aim of the study was to gain an understanding on the experiences of enrolled nurses with regard to caring for people living with HIV and AIDS in one of the rural hospital in Vhembe district, in order to make recommendations for guiding and supporting those enrolled nurses. This study followed qualitative approach using interpretative phenomenological analysis design. Data were collected from 11 purposively selected participants using semi structured interviews. Data were analysed using interpretative phenomenological analysis framework for data analysis. Three super-ordinate themes emerged from data analysis namely: resources, support and impact of working with HIV positive patients. The study revealed that enrolled nurses are failing to provide proper care to people living with HIV and AIDS due to inadequate resources and lack of support. This situation has negative impact on the health of enrolled nurses providing care to people living with HIV and AIDS. Recommendations are put forth to improve resources, enhance support and for mitigating impacts experienced by enrolled nurses when caring for people living with HIV and AIDS at a rural hospital in Vhembe district of Limpopo province. / Health Studies / M.P.H.