Bakgrund: Tuberkulos är en allvarlig och luftburen infektionssjukdom som varje år skördar ca två miljoner människoliv. Sjukdomen går att behandla men behandlingstiden är lång och biverkningarna efter medicineringen är svåra. Att ge omvårdnad till en patient med tuberkulos kräver därför kunskap om riskfaktorer som att avbryta behandling i förtid. Sjuksköterskor behöver också kunskap om smittöverföring för att förhindra smittspridning men också för att sudda ut eventuella rädslor som kan komma påverka bemötande och behandling. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda patienter med aktiv tuberkulos på sjukhus.  Metod: En litteraturöversikt där sökningen efter artiklar som svarade till syftet utfördes i fyra olika databaser. Resultatet blev åtta vetenskapligt granskade artiklar som analyserades och sammanställdes i tre olika teman. Resultat: Tre teman identifierades där rubrikerna blev: Att känna rädsla för smittöverföring, att känna sig otillräcklig och att känna sig utsatt. Resultatet visade att rädslan för smittöverföring berodde på resursbrister av skyddsmaterial samt kunskapsbrister om tuberkulos som sjukdom. I temat om att känna sig otillräcklig var majoriteten av sjuksköterskorna överens om att känna tidsbrist med patienterna och dess anhöriga. Att inte kunna stötta och motivera patienterna under deras långa behandlingstid gjorde att många patienter avbröt sina behandlingar i förtid för att senare insjukna igen men då med ett svårare sjukdomsförlopp. Utsattheten som sjuksköterskorna kände i sista temat handlade om långa arbetspass och den långa exponeringstiden ihop med patienter som vårdades för aktiv tuberkulos. Diskussion: Sjukhusen där sjuksköterskorna i redovisat resultat arbetade gav inte sjuksköterskorna rätt förutsättningar till att vårda patienterna med aktiv tuberkulos efter WHO rekommendationer och ICN:s riktlinjer. Sjukhusen riskerade därför att sprida smittan vidare samt vara en bidragande faktor till en ökning av den multiresistenta varianten av tuberkulos. Eriksons identitetsteori appliceras här på patienterna då samspelet mellan dessa och sjuksköterskorna kan vara avgörande för en fullgången och lyckad behandling. / Background: Tuberculosis is a serious and airborne infectious disease that annually harvests about two million human lives. The disease can be treated but the time of the treatment is long and the side effects after medication are sometimes difficult for the patient to handle. Providing nursing to a patient with tuberculosis therefore requires knowledge of risk factors such as interrupting treatment. Nurses also need knowledge about transmission to prevent infection spread, but also to erase fears that may affect the treatment. Aim: To describe nurses' experiences of caring for patients with active tuberculosis in hospitals. Method: A literature review in which the search for articles that corresponded to the purpose was performed in four different databases. The result was eight scientifically reviewed articles analyzed and compiled in three different themes. Results: Three themes were identified where the headings became: To feel fear of transmission of infection, to feel insufficient and to feel vulnerable. The results showed that the fear of transmission of infection was to resource deficiencies of protective materials and knowledge of tuberculosis as a disease. In the sense of feeling insufficient, the majority of nurses agreed to feel a shortage of time with the patients and their relatives. Being unable to support and motivate patients during their lengthy treatment meant that many patients discontinued their treatments prematurely to later recuperate but then with a more severe course of illness. The vulnerability experienced by the nurses in the last theme was about the long exposure time with patients treated for active tuberculosis. Discussion: The hospitals where nurses in reported results worked, did not give nurses the right conditions to care for patients with active tuberculosis following WHO recommendations and ICN guidelines. The hospitals therefore risked spreading the infection as well as contributing to an increase in the MDR variant of tuberculosis. Erikson's identity theory is applied on the patients since the interaction between the patients and nurses can be crucial for a successful treatment.

Background: Diabetes is one of Sweden's national diseases. Around 7000 children live with type 1 diabetes in Sweden today. The diagnosis requires planning of everyday life and revaluation of routines which places great demands on the family. Aim: The aim of this study was to describe parents and siblings' experiences of living with a child or young adult diagnosed with type 1 diabetes. Method: The study was designed as a literature-based study to contribute to evidence-based nursing based on analysis of qualitative research to reach a deeper understanding of families' experiences. An analysis of thirteen qualitative articles resulted in four main themes and ten subthemes. Results: The results of the study showed that the whole family is affected when a child gets diabetes. That the child was diagnosed was a shock that caused many feelings with both parents and siblings. There was a constant concern for complications in both the long and short term, resulting in a fear to hand over responsibility, causing a huge pressure on parents who could feel isolated. Conclusion: The families experienced strong feelings when the child was diagnosed. The families needed support from the healthcare professionals to be able to handle the disease.

Det blir allt vanligare med människor som vårdas palliativt i hemmet. I och med det blir det vanligare att närstående är en del av vårdprocessen. Närstående ställs då inför en helt ny roll gentemot den anhörige. De upplever svårigheter med att bibehålla ett normalt familjeliv då hemmet mer och mer börjar likna ett sjukhus, samtidigt som de vet att de inte skulle klara sig utan hjälpmedlen. Upplevelsen för närstående att ha en döende familjemedlem är påfrestande. Den närstående är inte längre bara en familjemedlem eller vän utan någon som den sjuke är beroende av. För att kunna axla denna roll behöver den närstående stöttning från sjuksköterskan, vänner och familj.   För att sjuksköterskan ska kunna ge det stöd närstående behöver är det viktigt att få en uppfattning om den närståendes upplevelse av den palliativa vården i hemmet. För att ta reda på detta valdes en litteraturstudie till examensarbetet. 12 kvalitativa artiklar analyserades till resultatet vilket mynnade ut i tre teman, att ta ansvar i vårdandet, att ha behov av stöd och att möta döden.  Resultatet visar att de närstående känner ett ansvar i vårdandet. Vissa uttrycker att de inte har något val, de sätter sig själva åt sidan för att kunna uppfylla löftet att vårda den sjuke. Andra känner att det är en självklarhet. De tycker att det är en naturlig del av livet och en möjlighet att få vara nära sin älskade på slutet. Det är viktigt med stöd från sjukvårdspersonal, vänner och familj för de närstående. Brist på stöd gör att närstående känner sig övergivna. Det är lätt att den närstående blir isolerad och bunden till hemmet under vårdtiden och för att klara av det krävs det stöd från utomstående. Närstående tycker att det var svårt att prata om döden, speciellt med den sjuke. De upplever att det är lättare att diskutera döden och sjukdomen med sjuksköterskan för att inte oroa den sjuke i onödan. De känner sig ständigt konfronterande med döden men de uppskattar att de kan vara närvarande och där för den sjuke på slutet. / Background: In recent years, it has become increasingly common for patients to choose to end their life at home. Relatives often wants to fulfill the wishes of the sick person, but are often poorly prepared to act as caregivers and experience lack of continuity, insufficient information and poor treatment. The experience of relatives having a dying family member is stressful. Aim: The aim of this study was to describe the experiences of relatives in palliative homecare.  Method: A literature based study with 12 qualitative articles were performed using the Friberg method of analysis. Results: The result showed that some relatives felt that taking care of their family member where a matter of course and others felt that they had no choice. It was important for the relatives to have support from healthcare professionals, family and friends. Lack of support made them feel abandoned. It was difficult to talk about death with the dying family member and relatives expressed that it was easier to talk to the nurse about it.  Conclusion: Death was constantly present, despite that death was hard to talk about with the sick person. It was also hard for the relative to be responsible for someone else and they felt that they were isolated in their own home. The relatives felt therefore the need to be supported by the nurse. They needed to be able to talk to the nurse and feel safe to fulfill the feeling of support.

En litteraturbaserad studie som belyser patienters erfarenheter av omhändertagandet i samband med trauma, där patienternas utsatthet framkommer på ett tydligt sätt. En litteraturöversikt med studier utförda i Sverige, England och USA.       Patienterna betonar vikten av sjuksköterskans empatiska förhållningssätt i mötet och vid den fysiska omvårdnaden. Trygghet uppstår när sjuksköterskan är vänlig, visar engagemang och bemöter patienten med respekt. Patienterna beskriver att de känner sig väl omhändertagna när sjuksköterskan vårdar dem ömt, samtidigt som de beskriver känslor av utsatthet och obehag vid fysiska undersökningar. Organisationen på sjukhuset påverkar patienternas erfarenheter av omhändertagandet. Patienterna upplever en tillfredställande vård när traumateamet har en god sammanhållning, skicklighet och kompetens. Vid en god kommunikation mellan sjuksköterskan och patienten upplevs känslor av förtroende och tillit. Patienterna vill få information om vad som händer och det är betydelsefullt att sjuksköterskan aktivt lyssnar på patientens enskilda behov och önskemål. Sjuksköterskan beskrivs som viktig då patienten behöver stöttning i att hantera sin nya situation och att kunna se en hoppfull framtid efter den traumatiska händelsen. Studiens resultat belyser att patienterna är i behov av stöd efter den traumatiska händelsen.       Dagens sjukvård har ekonomiska utmaningar och svårigheter som personalbrist vilket kan emellertid hindra ett optimalt omhändertagande av den sjuka och skadade patienten. En ökad kunskap hos sjuksköterskan och vårdorganisationen om att patienterna är i behov av stöd efter den traumatiska händelsen, kan bidra till en mer individanpassad och tillfredställande vård för patienten. / Background: Trauma is a common cause of death and disability and an event that can lead to a major suffering for the patient. To be exposed to trauma entails both physical and mental stress. Some patients expressed feelings such as guilt and hopelessness and had difficulty seeing the meaning of life after the accident, when the patient´s lifeworld was changed. Aim: The aim of this study was to illuminate patients' experiences of trauma care. Method: A literature review based on a content analysis of nine qualitative and three quantitative studies.  Results: The result revealed that patients needed support after the traumatic event. The findings were three main themes; Professional support from the nurse, Support of a functioning organization, Support of a good communication. Conclusion: The traumatic event turned out to be very emotional for the patients and they needed professional support after the accident. The nurse had a significant role and supportive function in the trauma care of the patient and could help the patient to feel safe in the situation and look hopefully on life again by means of an empathetic approach.

The psychology service programme was implemented at the Kalafong Paediatric HIV Clinic. The students from the Department of Psychology from the University of Pretoria were involved. The aim of the study was to explore, explain and describe the experiences of the personnel at the Clinic during the implementation of the programme in terms of an interpretive narrative framework. A qualitative research design was used. The primary source of data collection was through interviews. Interpreting experience took place at Reissman’s five levels of representation and Labov’s six elements for data reduction and interpretation were used. The emerged interpretive categories were presented as questions. The study found that the multidisciplinary team identified the need for psychological intervention, more so during the time when some of the adolescent patients had discovered that they were HIV positive. The patients were struggling to cope with the reality of accepting the diagnosis. The study noted the challenges that were experienced during the implementation, as well as the highlights. Availability of the psychology students seemed to be the greatest challenge as well as the issue of arranging psychological consultations to coincide with the same date for other consultations among other challenges. This study exhibited a mutual feeling that the implementation of the psychology service programme was a good initiative and ought to be continued at the Clinic. / Dissertation (MA)--University of Pretoria, 2013. / gm2014 / Psychology / unrestricted

Class of 2014 Abstract / Specific Aims: The final year of the Doctor of Pharmacy program at the University of Arizona is comprised of seven 6-week Advanced Pharmacy Practice Experiences (APPEs). Students evaluate rotations via voluntary anonymous, web-based assessments at the end of each rotation. The purpose of this study was to evaluate an original and a modified assessment tool using pharmacy student focus groups to determine if student feedback via the assessment tools accurately reflected opinions of rotation content and preceptor performance. Methods: Two moderators conducted tape-recorded focus groups with fourth-year pharmacy students using 10 standardized prompts. The first focus group included 5 students from the class of 2013. Based on data from that session, the assessment tool was modified. The second focus group included 5 students from the class of 2014 to evaluate the outcome of these modifications. Session transcripts and notes were used to construct thematic analysis tables and draw conclusions. Main Results: Focus group data revealed feedback via both assessment tools was not completely honest because of concerns about anonymity. The Class of 2013 felt limited by evaluating only their primary preceptor. The Class of 2014 stated that some revisions to the evaluation tool, such as item-specific comment boxes and separate evaluative sections for rotation site, preceptor, and rotation experience were helpful; however, they found the assessment tool lengthy, leading to survey fatigue. Conclusion: Student feedback from either assessment tool was not completely reflective of true attitudes of rotation experiences. Continued improvements to the tool and its delivery may provide more accurate feedback for quality improvement purposes.

Class of 2016 Abstract / Objectives: (1) To assess preceptors’ attitudes regarding the usefulness of the web-based assessments in evaluating rotation students. (2) To determine which assessment tool (original versus modified) provides more in-depth feedback for the evaluation of students. Subjects: Preceptors for 4th year students completing their Advanced Pharmacy Practice Experiences (APPE) in a variety of pharmacy settings. Methods: Electronic surveys anonymously collected ratings of preceptor attitudes toward the original and modified APPE assessment tools. Data on the usefulness, strengths, and limitations of both tools were analyzed through thematic analysis. Results: Surveys assessing preceptor attitudes towards the original assessment tool (46 responses) and modified assessment tool (29 responses) were collected and analyzed. Similar representation was seen across all rotation settings, with an average of 7 years of precepting experience. Preceptor attitudes were more positive towards the modified tool. More preceptors “strongly agreed” or “agreed” that they were able to effectively evaluate students with the modified tool compared to the original tool (83% vs. 63%). Additionally, more preceptors “strongly agreed” or “agreed” that the modified tool incorporated all necessary competencies (79% vs. 48%) and aided student growth by addressing deficits compared to the original tool (73% vs. 50%). Conclusions: APPE preceptors perceived both the original and modified assessment tools as effective, favoring their brevity and ease of use. However, preceptor attitudes were more positive towards the modified tool. The methods utilized in this study can be implemented again for future updates of the APPE assessment tool.

Background: With an increased understanding of dialysis-treated patients' experiences of waiting for a kidney transplant, the nurses can adjust their care based on patient's individual needs. A changed life situation that requires regular treatment and limiting the patient in their daily life makes it important that the nurse understands the patient's mood and is there to support. Aim: The aim of this study was to highlight the experiences of dialysis-treated patients waiting for a kidney transplant. Method: A literature study based on qualitative research. Friberg ́s five-step model was used for analyze of the articles and results in three main themes and six sub- themes. Results: This result showed that dialysis-treated patients awaiting a kidney transplant experienced both physical and mental barriers and stress. They experienced limitations in daily life as loss of freedom and financial difficulties. The patients' feelings oscillate between hope and uncertainty like an emotional roller coaster and they find support in their relatives, healthcare professionals or in their religion. Conclusion: The experiences of waiting for a kidney transplant are relatively similar, but strategies to get trough this process varies. Common for all patients were that it was a demanding and stressful time. Therefore it is important that nurses pay attention and adapt the care for each individual.

Magister Curationis - MCur / In nursing education the clinical component comprises an important part of the students’ training. Clinical teaching and learning happens in simulated as well as real world settings. First–year students spend the first quarter of their first year developing clinical skills in the skills laboratory. In the second-term they are placed in real service settings. This study was aimed at exploring the experiences of first year nursing students of the University of the Western Cape (UWC) during their first clinical placement in the hospital. A qualitative phenomenological exploratory study design was used and a purposive sample of twelve nursing students was selected to participate in the study. The research question was “Describe your experiences during your first placement in hospital?” Written informed consent was given by every participant and ethical approval was obtained from the relevant UWC structures. In-depth, face-to-face interviews were conducted, audio taped and transcribed verbatim. Transcripts were coded and sub-categories, categories, and themes were extracted during the data analysis process. Trustworthiness of the data collection and data analysis processes were ensured. Many of the first year nursing students described their experience in hospital as being stressful. However, the first placement in hospital allowed them to work with real patients and provided them an opportunity to develop a variety of clinical skills. Even though the hospital environment was unfamiliar and the ward staff unwelcoming, the patients’ acknowledged and valued their contribution to patient care. Students tend to seek support from family members and lecturers. It is recommended that first year nursing students be prepared adequately for their first placement in hospital as well as to provide practical and emotional support to students during their hospital placement. / South Africa

Magister Curationis - MCur / In nursing education the clinical component comprises an important part of the students’ training. Clinical teaching and learning happens in simulated as well as real world settings. First–year students spend the first quarter of their first year developing clinical skills in the skills laboratory. In the second-term they are placed in real service settings. This study was aimed at exploring the experiences of first year nursing students of the University of the Western Cape (UWC) during their first clinical placement in the hospital. A qualitative phenomenological exploratory study design was used and a purposive sample of twelve nursing students was selected to participate in the study. The research question was “Describe your experiences during your first placement in hospital?” Written informed consent was given by every participant and ethical approval was obtained from the relevant UWC structures. In-depth, face-to-face interviews were conducted, audio taped and transcribed verbatim. Transcripts were coded and sub-categories, categories, and themes were extracted during the data analysis process. Trustworthiness of the data collection and data analysis processes were ensured. Many of the first year nursing students described their experience in hospital as being stressful. However, the first placement in hospital allowed them to work with real patients and provided them an opportunity to develop a variety of clinical skills. Even though the hospital environment was unfamiliar and the ward staff unwelcoming, the patients’ acknowledged and valued their contribution to patient care. Students tend to seek support from family members and lecturers. It is recommended that first year nursing students be prepared adequately for their first placement in hospital as well as to provide practical and emotional support to students during their hospital placement