Bakgrund: Vid gynekologisk cancer involveras organ som är relaterade till kvinnlighet och sexualliv. Sjukdomen och behandlingen kan innebära en negativ inverkan på kvinnans sexuella hälsa vilket är en viktig del av livet och kan ha en stor påverkan på livskvalitén. I sjuksköterskans profession ingår att främja och bevara patientens hälsa och därmed sexuell hälsa. Syfte: Syftet var att belysa kvinnors upplevelser av sexuell hälsa vid gynekologisk cancer. Metod: En litteraturstudie med en kvalitativ ansats baserad på en analys av 10 artiklar genomfördes. Resultat: Kvinnor drabbade av gynekologisk cancer upplevde att sjukdomen och dess behandlingar hade påverkan på den sexuella hälsa. Sex teman identifierades, varav brist på information var det mest framträdande. Slutsats: Kvinnor drabbade av gynekologisk cancer upplevde flera hinder för att uppnå en tillfredsställande sexuell hälsa. Det främsta hindret och den gemensamma nämnaren, var bristen på information om hur behandlingar och dess biverkningar påverkade den sexuella hälsan, vilket medförde onödigt lidande och försämrad livskvalité. Klinisk betydelse: En ökad förståelse av kvinnornas upplevelser kan hjälpa sjuksköterskor att tillgodose en omvårdnad innefattande flera aspekter av sjukdomen, såsom sexuell hälsa. På grund av ämnets känsliga natur behöver det lyftas i grundutbildningen för sjuksköterskor, så att studenterna skall bli bekanta med och känna sig bekväma med ämnet så att det ska bli en naturlig del i den kliniska omvårdnaden. PLISSIT-modellen bör implementeras som ett verktyg för sjuksköterskor att använda vid samtal med patienter om sexuell hälsa. / Background: Gynecological cancer involves organs related to femininity and sexual life. The disease and treatment can have a negative impact on the woman's sexual health, which is an important part of life and can have a major impact on quality of life. The nurse´s profession includes promoting and preserving the health of the patient and thus the sexual health. Aim: The aim of this study was to highlight women's experiences of sexual health in gynecological cancer. Method: A literature review was conducted with a qualitative approach based on an analysis of 10 articles. Results: Women suffering from gynecological cancer experienced that the disease and its treatments had an impact on their sexual health. Six themes were identified of which, lack of information was the most prominent. Conclusion: Women with gynecological cancer experienced several obstacles to achieve satisfactory sexual health. The main obstacle and the common denominator was the lack of information on which impact treatments and their side effects had on sexual health, causing unnecessary suffering and impaired quality of life. Clinical suggestions: An increased understanding of women´s experiences can help nurses to meet the care, such as sexual health. Because of the sensitive nature of the topic, the authors consider that it needs to be emphasized in the nursing education, for students to become familiar with and feel comfortable with the topic to become an integrated part of clinical care. The PLISSIT-model should be implemented as an instrument for nurses to use in conversations with patients about sexual health.

Background: An estimated 125 million women live with Female Genital Mutilation (FGM) worldwide. Despite it being internationally recognized as a human rights violation. FGM is still practiced in approximately 29 countries, most of them in Africa and the Middle East. FGM has no health benefits, whereas there are short and long terms negative consequences that can cause physical and psychological problems. Aim: To describe the experiences of women who live with FGM and their subsequent interactions with healthcare providers in countries where FGM is not a tradition. Method: A literature study based on ten studies with a qualitative research design. Results: Five main themes were found; Knowledge of FGM, Language Barriers, The Gender of Healthcare Provider, Interactions with Healthcare Provider and On Display. Conclusion: Patients had difficulties due to the language barriers. There was a preference for female healthcare providers. Patients were affected by interactions with healthcare providers as well as lack of knowledge. Patients also had their genitals put on display for others. Clinical significance: With increasing migration, it is important that healthcare providers do not judge, but instead treat and care for these women with respect and empathy. / Bakgrund: Runt 125 miljoner kvinnor i världen idag är könsstympade, även fast det är internationellt erkänt som ett brott mot de mänskliga rättigheterna. Trots detta praktiseras könstympning fortfarande i cirka 29 länder, mestadels i Afrika och i Mellanöstern. Det finns inga hälsovinster för kvinnor som är könsstympade, däremot medför det kort- och långsiktiga negativa konsekvenser som kan leda till fysiska och psykiska problem. Syfte: Att beskriva könsstympade kvinnors erfarenheter av vårdpersonal i länder där det inte finns någon tradition av könsstympning. Metod: En litteraturstudie baserad på tio studier med kvalitativ ansats. Resultat: Fem huvudteman framkom och beskrevs; Kunskap om könstympning, Språksvårigheter, genus av personal, samspelet med vårdgivare och att den könsstympade kvinnan kände sig uttittad av vårdpersonalen. Slutsats: Patienterna hade svårt att kommunicera med sjukvårdspersonalen. Patienterna föredrog kvinnlig sjukvårdspersonal. Interaktionen med sjukvårdspersonalen påverkade patientens relation till vården. Patienterna kände sig uttittade av sjukvårdpersonalen. Patienterna upplevde att vårdpersonalen hade kunskapsbrister om FGM. Klinisk betydelse: Med ökad migration är det nödvändigt att vårdpersonalen ger en respektfull vård och visar empati för de könstympade kvinnorna.

BAKGRUND: Det råder oklarhet i vilken utsträckning patienter drabbade av cancer får information om cancerbehandlingens potentiella inverkan på fertiliteten och fertilitetsbevarande åtgärder. SYFTE: Att beskriva erfarenheter av information avseende fertilitet och fertilitetsbevarande åtgärder inför cancerbehandling hos patienter drabbade av cancer i fertil ålder. METOD: Litteraturöversikt av kvalitativ och kvantitativ forskning. RESULTAT: Sju teman identifierades: (1) Information till kvinnor om behandlingens potentiella inverkan på fertiliteten. (2) Rådgivning om fertilitetsbevarande åtgärder. (3) Brist på empowerment som en konsekvens av otillräcklig information. (4) Varför fick jag ingen information och varför erbjöds inte fertilitetsbevarande åtgärder? (5) Informationen varierar kopplat till kön, ålder och sexuell läggning. (6) Förlust av fertilitet kan ge nedsatt livskvalitet och påverka kvinnans syn på sin identitet. (7) Patienterna vill ha mer information och stöd. SLUTSATS: Patienter drabbade av cancer i fertil ålder får inte tillräckligt med information om cancerbehandlingens potentiella risker för fertiliteten. Kvinnor får mindre information än män och löper större risk att äventyra sin fertilitet. Vårdpersonalen behöver vara lyhörda för patientens behov och bör delge patienten adekvat information för att möjliggöra empowerment och öka livskvalité hos dessa patienter. / BACKGROUND: There is uncertainty as to what extent patients with cancer receive information about cancer treatment's potential effects on fertility and fertility preservation. PURPOSE: To describe the experience about information regarding fertility and fertility preservation prior to cancer treatment in patients with cancer of reproductive age. METHODS: Literature review of qualitative and quantitative research. RESULTS: Seven themes were identified: (1) Information to women about the treatment's potential effects on fertility. (2) Counseling in infertility preservation. (3) Lack of empowerment as a consequence of insufficient information. (4) Why didn’t I receive any information and whywasn’t I offered fertility preservation? (5) Information varies related to sex, age and sexual orientation. (6) Loss of fertility may impair quality of life and affect a woman's view of her identity. (7) Patients want more information and support. CONCLUSIONS: Patients with cancer in reproductive age, may not be enough informed about the cancer treatment´s potential risks on fertility. Women receive less information than men and are more likely to jeopardize their fertility. Health professionals need to be sensitive to the patient's needs and should inform the patient with adequate information to enable empowerment and to increasing the quality of life in these patients.

BACKGROUND: The child mortality is relatively high in a middle income country such as Ghana. Great achievements have been accomplished in order to reduce the under five mortality rate, likewise reach the millennium development goal to reduce child mortality. The nurses´ role to carry the capacity to face these challenges becomes a great part of their work. AIM: The aim of the study was to illuminate the experiences of nurses caring for ill children in Ghana and to gain a better understanding of the Ghanese perspective of important factors in pediatric care. METHOD: A qualitative method with semi structured interviews was performed. Five interviews were conducted with nurses at one pediatric ward in Ghana. The data was analysed using content analysis, Halldorsdottir´s theory was used as a raster throughout the paper. RESULTS: Two categories were identified and represent the results, Qualities and Strengths and Obstacles. The categories were found to be encompassed by nine subcategories, Feelings, Improvisation, Attitudes, Empowerment, Collaboration, Workload, Difficulties in the Nurse-Patient relationship, Contradictory experiences and Environmental challenges. CONCLUSION: The findings in this study suggest that the nursing care is largely affected by different factors in the nurses’ daily work. This can result in both a positive and negative impact on the nurse, patient and their relationship. CLINICAL RELEVANCE: Describing how nurses experience work in pediatric nursing care can contribute with a better knowledge of important factors in global nursing. / BAKGRUND: Barnadödligheten är relativt hög i ett medelinkomstland som Ghana. Stora framsteg har gjorts för att minska dödligheten, likaså uppnå millenniemålet att minska barnadödligheten. Sjuksköterskornas roll att inneha kapaciteten för att bemöta dessa utmaningar blir en stor del av deras arbete. SYFTE: Syftet med studien var att belysa sjuksköterskors erfarenheter av att vårda sjuka barn i Ghana, samt att få en bättre förståelse av viktiga faktorer i pediatrisk omvårdnad från ett ghanesiskt perspektiv. METOD: En kvalitativ metod med semi strukturerade intervjuer utfördes. Fem intervjuer utfördes med sjuksköterskor på en pediatrisk avdelning i Ghana. Datan analyserades genom en innehållsanalys och Halldorsdottirs teroi användes som ett raster löpande genom rapporten. RESULTAT: Två kateorier identifierades och representerar resultatet Kvalitéer och Styrkor samt Hinder. Kategorierna omfattas av nio subkategorier, Känslor, Improvisation, Attityder, Empowerment, Samarbete, Arbetsbörda, Svårigheter i sjusköterske- och patientrelationen, Paradoxala upplevelser samt Hinder i miljön. SLUTSATS: Resultatet i den här studien föreslår att omvårdnaden till stor del påverkas av olika faktorer i sjuksköterskans dagliga arbete. Detta kan resultera i både en positiv och negativ påverkan för sjuksköterskan, patienten och deras relation. KLINISK BETYDELSE: Genom att beskriva hur sjuksköterskor upplever arbetet inom pedriatitisk vård kan detta bidra till större kunskap om viktiga faktorer inom omvårdnad globalt.

Bakgrund: 2014 anlände drygt 80.000 flyktingar till Sverige. Dessa individer kan ha varit med om traumatiska händelser vilket i sin tur kan ha bidragit till sämre psykisk hälsa i form av depression, posttraumatisk stressyndrom och psykos. Sjuksköterskor som möter flyktingar med psykisk ohälsa upplever olika svårigheter vid omvårdnad av flyktingar. För att sjuksköterskorna ska kunna optimera vården behövs större förståelse för deras upplevelser av denna patientgrupp med psykisk ohälsa. Syfte: Syftet med studien är att beskriva sjuksköterskors upplevelser att vårda flyktingar med psykisk ohälsa. Metod: En studie med empirisk ansats i form av kvalitativa intervjuer med fem sjuksköterskor inom en psykiatrisk verksamhet. All data analyserades med hjälp av en innehållsanalys. Resultat: Det var flertalet olika upplevelser som synliggjordes i resultatet, vilka utmynnade i fem teman: "upplevelser att tillgodose flyktingars behov", "upplevelser av kompetensutveckling", "upplevelser av kulturkrock", "upplevelser av maktlöshet" samt "upplevelser av medlidande för flyktingen". Slutsats: Två av de fem dimensionerna av sjuksköterskors upplevelser är nya i förhållande till tidigare studiers fynd. Dessa upplevelser är maktlöshet och medlidande som är viktiga att beaktas i sjuksköterskors arbete inom psykiatrisk vård. Medlidandet hos sjuksköterskorna i studien bidrog till en ökad påfrestande belastning, både under och utanför arbetstid. Professionell handledning och utbildning är väsentliga för att underlätta sjuksköterskans vård av flyktingar med psykisk ohälsa. Fortsatt forskning: För att minimera upplevelse av exempelvis maktlöshet måste vidare forskning på nationell och internationell nivå på detta område utvecklas. Detta genom att undersöka på djupet vilka situationer som orsakar upplevelse av maktslöshet och medlidande hos sjuksköterskor inom psykiatrisk vård. / Background: In 2014 about 80,000 refugees arrived to Sweden. Most of these individuals have experienced traumatic events, which contributed to mental illness, example of these diagnosis are depression, PTSD and psychosis. Registrered nurses who take care of this group of patients facing some difficulties in their caring. To optimize the caring there is a essential need of comprehensive for the nurse´s experiences of refugees with mental illness. Aim: The aim of the study is to describe the experiences of registred nurses to care of refugees with mental illness. Method: A study with a empirical approach, qualitative interviews with five registrered nurses in a psychiatric clinic. All data were analysed through a content analysis. Results: The results demonstrated five different experiences of the nurses: "experiences of caring of the refugees, "experiences of the need of skills development", "experiences of culture clash", "experiences of powerless" and "experiences of compassion". Conclusion: Two of five dimensions of experiences are new compare to earlier studies´ approaches: experience of powerlessness and experiences of compassion among the nurses in psychiatric care. Compassion of the nurses contributed to a tension in their own mental health. A professional supervision by the employer is necessary to facilitate the nurses´ care of the refugees. Further research: To minimize the experiences, for example powerlessness, the research should exspand on national and international basis.

Syfte: Att beskriva ambulanssjuksköterskors upplevelser av att omhänderta barn i en masskadehändelse med fokus på triage. Bakgrund: Att omhänderta barn vid en stor olycka/allvarlig händelse eller katastrof har beskrivits som påfrestande. Framförallt upplever sjuksköterskor känslomässiga hinder när de ska prioritera och triagera barn. Att vara oförberedd på vad som kommer att ske kan påverka det professionella skyddet och omhändertagandet. Metod: En kvalitativ ansats med tre fokusgrupper användes. En innehållsanalys gjordes av fokusgruppsintervjuerna med sex deltagare i varje grupp varav 16 deltagare var ambulanssjuksköterskor och två var sjuksköterskor, sex var kvinnor och 12 män. Resultat: Resultatet består av tre kategorier: Svårigheter i situationen, Otillräcklighet och Omställning. I de tre kategorierna framkom 10 underkategorier. Det som framkom var att sjuksköterskor riskerar att bli kvar hos ett barn under själva triageringen, situationen ansågs som ovanlig och skapade osäkerhet, kommunikationen är av stor betydelse samt att sjuksköterskor upplever en bristande kunskap och utbildning när det gäller barn vid masskadehändelse. Slutsats: Sjuksköterskor upplever omhändertagandet av barn på större skadeplatser som annorlunda och avvikande samt att de känner sig otrygga och oförberedda inför situationen.  Eftersom att omhänderta barn på skadeplats är ovanliga händelser är det viktigt med tid för reflektion. Ett öppet klimat på arbetsplatsen som främjar reflektion och eftertanke kan bidra till ett bättre och mer effektivt omhändertagande på skadeplats och sjuksköterskor som kan känna en större trygghet vid omhändertagandet av barn. / Aim: The purpose of this study was to describe the ambulance nurses’ experiences of disposal for children in a mass casualty event focusing on triage. Background: The care for children in a disaster/major event has been described as strenuous. Particularly in the case prioritization and triage of children experiencing ambulance nurses emotional obstacles. Being unprepared for what will occur can affect the professional protection and care. Method: A qualitative approach with three focus groups were used. A content analysis was made of the focusgroupintervjus. With six participants in each group which 16 participants was ambulance nurses and two were nurses, six were women and 12 were men. Results: The result consists of three categories: Difficulties in the situation, Inadequacy and Conversion. In these three categories, 10 subcategories emerged. What was shown was that the ambulance nurses risked getting stuck with one children during the triage ring, the situation was considered unusual and created uncertainty, communication is of great importance and the nurses experiencing a lack of awareness and education when it came to children at mass casualty event. Conclusion: Nurses experience the care of children on larger damage sites as different and divergent, and they feel insecure and unprepared for the situation. Because to take care of children at the scene are rare events, it is important to have time for reflection. An open climate in the workplace that promotes reflection and consideration can contribute to a better and more efficient care at the scene and nurses who may feel more secure in the care of children.

Background: Fibromyalgia is a chronic disease that is difficult to treat and diagnose. The illness is of unknown etiology. The majority of the ill is women. Aim: The aim of this study was to describe women ́s experiences of living with long term pain associated with fibromyalgia. Method: A literature -based study was performed. The database Cinahl was used in the search process. This study includes 11 qualitative articles that have been analysed by a review template. The analysis resulted in two categories "experiences of a changed me" and "experiences of social life" with six subcategories. Results: The consequences of fibromyalgia were that the family life, spare time, social life and working life changed in different ways. The articles also showed that women with fibromyalgia did not receive the understanding they needed from their families or the environment. Conclusion: Women with fibromyalgia feel that they do not get understanding from the outside world. It is important that health care professionals understand and acknowledge these individuals' subjective experiences so that they can give professional care and support.

Published Article / The aim of the study on which this article is based was to reflect on the learning experiences of students during integrated management of childhood illness (IMCI) training in an undergraduate programme. IMCI is a set of guidelines that was established by the World Health Organisation (WHO) for cost-effective quality care for children younger than five to prevent diseases and death (WHO, 2004). Skilled primary healthcare workers are required to provide quality care at first contact with these children. The IMCI package was presented as an integral part of the second-year module that focuses on primary healthcare. In order to improve the quality of health services and refocus the health system on primary health-care (South Africa Department of Health, 2010), students have to demonstrate that they have achieved competence. According to Killen (2000:188), competence is a holistic term and focuses on knowledge, skills and values instead of competencies, which refer to specific capabilities. Primary health-care workers who act competently will integrate foundational IMCI knowledge with skills and values as well as with the ability to verify their decisions (Killen, 2000:188). Aqualitative, exploratory and descriptive research design was used to investigate the IMCI learning experiences. Such experiences are one of the indications whether training has been successful and how it can be improved (Suski, 2004:222). Data was collected by means of nominal-group technique (NGT) interviews with second-year nursing students of the training school who complied with the criteria for inclusion. NGT interviews were used effectively to evaluate clinical interaction, education and training.The findings reflected the different emotions experienced during teaching and learning as having been positive, negative or neutral. The consideration of negative emotions will assist with the improvement of IMCI teaching and learning, but all these findings can be useful for other higher-education institutions that present or plan to present IMCI training.

There is a growing recognition that removal of an eye may cause a significant impact on a person's body image and her or his role in society; and may evoke a variety of emotional responses. The loss of an eye does not only signal disfigurement, it also means a loss of a body part and a vital sense; that of sight. Without vision, individuals have difficulty communicating. The emotional responses to this loss many a times, go unrecognized as the doctors and nurses who are in close contact with the patient at this time are not necessarily prepared to provide emotional care. This study seeks to address this gap by identifying the emotional impact of loss of an eye and sight on people's lives and the implication it has for health care workers, especially nurses. The eliciting of the different feelings and experiences of these patients can provide information for the formulation and design of protocols for holistic health care management. A non-experimental exploratory and descriptive design was used to conduct In-depth conversational interviews with seven purposively selected participants who had enucleation or evisceration between 2000 and 2005. Information-rich data yielded findings that clearly stressed the need for greater sensitization to the problem. All the participants expressed shock at the final diagnosis of enucleation or evisceration even if this was on their request. Patients wanted to know about the operation and its outcome, the prosthesis, how will it look like and its fit. Findings indicate that answers to these questions were not provided. Patients were not adequately emotionally prepared pre-operatively and were therefore not appropriately cared for post-operatively. Families were not satisfactorily involved and as such were not in a position to provide emotional support that the patients needed The recommendation was that a study to explore the health care team's knowledge in the psychological and emotional management of patients in crisis should be conducted as a benchmark for further training. / Health Studies / M.A. (Health Studies)

Bakgrund: I Sverige slutar ungefär 12-13 % av alla kända graviditeter med missfall. De flesta sker innan graviditetsvecka 13 och räknas därmed som tidiga. Många kvinnor upplever att vårdpersonalen inte ger dem det stöd de behöver. Detta kan bero på bristfällig kunskap om den känslomässiga processen vid tidiga missfall. Syfte: Syftet med denna litteraturstudie var att beskriva kvinnors upplevelser i samband med tidiga missfall. Metod: I litteraturstudien har 10 kvalitativa empiriska studier sammanställts och analyserats utifrån Fribergs analysmetod, inspirerad av beskrivande syntes. Artikelsökning utfördes i databaserna Cinahl, Pubmed och SweMed+. Resultat: Upplevelserna vid tidiga missfall innefattar psykiska, existentiella och sociala aspekter samt omvårdnadsrelaterade upplevelser. Missfallet upplevs ofta som en oväntad förlust vilket kan medföra reaktioner som sorg, ifrågasättande av den egna identiteten och skuldkänslor. Många kvinnor känner sig missförstådda av sina anhöriga och att vårdpersonalen inte uppmärksammar deras känslor, upplevelser och behov. Slutsats: Litteraturstudiens resultat visar att kvinnor vill bli bemötta med respekt och förståelse vid tidiga missfall. För att förbättra omvårdnaden av dessa kvinnor krävs personcentrerad omvårdnad som uppmärksammar deras individuella behov, utbildning bland vårdpersonalen samt ytterligare forskning inom området. / Background: About 12-13 % of all recognised pregnancies in Sweden end in a miscarriage. The majority of these occur before gestational week 13 and are therefore classified as early. Many women experience inadequate support from the nursing staff. This could be related to a limited knowledge about the emotional process subsequent to early miscarriages. Aim: The aim of this study was to describe women’s experiences associated with early miscarriages. Methods: In this literature study 10 empirical studies were compiled and analysed with Friberg’s method of analysis, inspired by descriptive synthesis. Article search was performed in the Cinahl, PubMed and SweMed+ databases. Results: The experiences of early miscarriages include psychological, existential and social aspects and experiences connected to nursing care. The miscarriage is often perceived as an unexpected bereavement that can bring about reactions such as grief, questioning of one’s identity and guilt. Many women feel misunderstood by their friends and families and that the nursing staff does not recognize their feelings, experiences and needs. Conclusion: The result of the literature study shows that women want to be met with respect and understanding during the time of early miscarriage. Person centred care that recognise the women’s individual needs, education among the staff and further research in this area is needed to improve the nursing care of these women.