Background: Family caregivers represent a critical component in the management of the health of older adults. The inclusion of family caregivers during transitions occurring between hospital and community settings has been previously considered. However, the experience of family caregivers during transitions occurring within the same setting remains unclear. The purpose of this study was to describe the experiences of family caregivers during transitions occurring within an acute care setting. Method: A qualitative description study was conducted. Semi-structured interviews were conducted with 10 family caregivers. Interviews were audio-recorded and occurred in person or over the telephone. Analysis included coding of interview data and the development of overarching themes. Findings: In this study, family caregivers reported the following themes. These themes included: "a lack of central brain during hospitalization," "muddling through transitions alone" and "wariness towards the care delivery system. The environmental influence of the hospital setting influenced family caregivers' view of the care provided by healthcare professionals and the transitions occurring between different units. Furthermore, half of the family caregiver participants (n=5) identified as having a background in healthcare. Healthcare professionals as family caregivers (HCP-FCs) reported unique experiences from other non-healthcare family caregivers. Interviews and field notes from HCP-FC participants were analyzed separately following the same procedures as the larger study. Three themes emerged including, "seeking inclusion," "insider perspectives," and "role struggle." Conclusion: Experiences of HCP-FCs and family caregivers during hospitalization of older adults have the potential to influence perceptions regarding transitional events occurring within acute care settings. Additionally, family caregivers' and HCP-FCs' perceptions of care coordination among healthcare professionals had the potential to negatively influence perceptions of transitions occurring within the acute care setting.

Syftet med studien var att utforska och beskriva arbetsterapeuters erfarenheter av samarbete med närstående i rehabiliteringen av personer med stroke. Studien antog en kvalitativ induktiv ansats för att fokusera på deltagarnas beskrivningar. Ändamålsenligt urval skedde utifrån kriterier. Tio deltagare ingick i studien. Data samlades in via semistrukturerade intervjuer med öppna frågor och analyserades med kvalitativ innehållsanalys. Analysen resulterade i fyra kategorier: Möta den närstående i en förändrad livssituation; Finna rehabiliteringsåtgärder som främjar ett fortsatt engagemang i aktiviteter; Hantera utmaningar; Resurser för att återskapa en tillfredsställande vardag. Studiens resultat visade att arbetsterapeuternas samarbete med närstående i rehabiliteringen av personer med stroke fokuserade främst på aktiviteterna för personen med stroke. Närståendes aktiviteter beaktades i en viss mån i rehabiliteringsprocessen, däremot var arbetsterapeutiska åtgärder för deras aktiviteter begränsad och omfattade främst rådgivning. Vidare ur ett rehabiliteringsperspektiv visade resultatet att närståendes engagemang skapade förutsättningar för en kontinuerlig rehabilitering och att uppnå goda resultat, samtidigt som höga förväntningar, krisreaktioner och kulturella skillnader var utmanade. Resultatet av denna studie kan bidra till ökade kunskaper om hur arbetsterapeuter samarbetar med närstående i rehabiliteringen av personer med stroke och kan vara användbar vid utveckling av rehabiliteringsinsatser i ett familjecentrerat perspektiv inom arbetsterapi. / The aim of the study was to explore and describe occupational therapists' experiences of collaboration with family caregivers in the rehabilitation of people with stroke. The study adopted a qualitative inductive approach in order to focus on the participants' descriptions. A purposeful selection took place based on criteria. Ten participants were included in the study. Data were collected through semistructured open-ended interviews and were analyzed by qualitative content analysis. The analysis resulted in four main categories: Meeting the family caregiver in a changed life situation; Identify rehabilitation interventions that promotes a continued engagement in activities; Managing challenges; Resources to recreate a satisfying everyday life. The study results showed that occupational therapists' collaboration with family caregivers in the rehabilitation of people with stroke primarily focused on the occupations for the person with stroke. Family caregivers occupations were considered to a certain extent in the rehabilitation process, however occupational therapy interventions for their occupations were limited and mainly included counseling. Furthermore, from a rehabilitation perspective, the result showed that family caregivers involvement creates the conditions for continuous rehabilitation and achieving good results while high expectations, crisis and cultural differences are challenging. The result of this study can contribute to increased knowledge of how occupational therapists collaborate with family caregivers in the rehabilitation of people with stroke and may be useful in the development of rehabilitation interventions in a family-centered approach within occupational therapy.

Taking care of seniors with dementia in the home environment can prove itself difficult not only for the individuals burdened with the main caretaking, but it is also challenging for their close family relationships. There is usually some way of sharing the care in the families, where more family members are put into a caregiver's position. Based on the semistructured interviews with the family caregivers this paper describes the alterations of the family relationships and the forms of support between the family members, as well as the common conflicts and rejections. The issue is being described from the point of view of the caregivers with a direct, actual and long-time experience in the home caregiving. Also the data of the interviews has been shortly compared to the information retrieved from the anxiety, depression and burden inquiries, all collected among the respondents. Powered by TCPDF (www.tcpdf.org)

Bakgrund: Behovet av palliativ vård i världen är beräknat till 40 miljoner människor varje år. Palliativ vård ska förbättra livskvaliteten, lindra lidande samt se döden som en naturlig del av livet. Anhörigvårdare spelar ofta stor roll för personer med obotlig sjukdom, vilket gör att de är en viktig tillgång i palliativ vård. Syfte: Syftet med litteraturstudien var att beskriva anhörigvårdares upplevelser av att ge palliativ vård till en familjemedlem med cancer. Metod: En litteraturstudie baserad på nio kvalitativa studier framsökta i databaserna Cinahl och PubMed.  Resultat: Tre kategorier och sju subkategorier fastställdes med grund i litteraturstudiens resultat. Huvudkategorierna var: Sätta sitt eget liv på paus, Samverkan med vårdpersonal och En värdefull sista tid.  Konklusion: Anhörigvårdare behöver stöd från vårdpersonal för att inte lämnas ensamma med ansvaret över vårdandet av sin familjemedlem. Ansvarsfördelningen mellan anhörigvårdare och vårdpersonal behöver därmed tydliggöras. Stöd från vårdpersonal behövs också för att anhörigvårdare ska känna trygghet i vårdandet, samt få individuellt anpassad information och kommunikation. / Background: 40 million people are in need of palliative care each year worldwide. Palliative care should improve quality of life and relieve suffering. Family caregivers are often important for people with incurable disease, which makes them an important asset in palliative care.  Aim: The aim was to describe family caregivers’ experiences of providing palliative care to a family member with cancer. Methods: A literature study based on nine qualitative studies found in two databases: Cinahl and PubMed. Results: Three main categories were defined from the results of the literature study: Putting their own life on pause, Cooperation with healthcare professionals and A valuable last time. Conclusion: Family caregivers need support from healthcare professionals in order not to be left alone with the responsibility for the care of the family member. The distribution 0f responsibility between family caregivers and healthcare professionals also needs to be clarified. The support from healthcare professionals is also needed for family caregivers to feel secure in caring for the family member. Family caregivers also need individually adapted information and communication.

Bakgrund: HIV är en kronisk sjukdom som drabbar människor i helavärlden. Sjukdomen är förknippad med skam, skuldkänslor och utsatthet. Både den sjuka personen och de närstående är fysiskt och psykiskt utsatta. Studier har visat att närstående till patienter med kronisk sjukdom blir åsidosatta. I dagens samhälle har det blivit vanligare att närstående vårdar – därmed är det viktigt att deras upplevelser beaktas för att de ska kunna erbjudas rätt stöd. Sjuksköterskan har ett ansvar att inkludera och stödja de närstående för att de ska kunna upprätthålla sin roll som vårdare. Syfte: Syftet var att belysa närståendes upplevelser av att vårda en person med HIV. Metod: En litteraturöversikt som består av tio vetenskapliga artiklar används. Artiklarna genomsökts i tre olika databaser. Artiklarna är både kvalitativa och mixad metod. Innehållsanalys gjordes enligt Friberg. Resultat: I resultatet framkom olika kategorier och subkategorier; De närståendes känslor med subkategorierna Rädsla, Frustration, Hopp och hopplöshet samt Närståendes positiva upplevelser av att vårda; Konsekvenser för närstående som vårdar med subkategorierna Stress, Vårdbörda och ansvar samt stigmatisering. De övriga huvudkategorierna är Kunskap och brist på kunskap samt Stöd och brist på stöd. Diskussion: Resultatdiskussionen tar upp hur stigmat får olika konsekvenser för de närstående i samband med vårdandet av en person med HIV. Utgångspunkter tas framförallt ifrån Erikssons caritativa teori med fokus på begreppen hälsa och lidande. Även kunskap och brist på kunskap för de närstående är av central betydelse gällande sjukdomen. Detta diskuteras utifrån de närståendes förutsättningar för att vårda en person med HIV. / Bakgrund: HIV is a chronic disease that affects people worldwide and is associated with shame, guilt and vulnerability. Both the person with an HIV and the related are physically and psychologically exposed. Studies have shown that relatives of the patients with chronic diseases are often neglected. In today's society, it has become more common for relatives to care - so it is important that their experiences are taken into consideration in order to be offered the right support. The nurse has a responsibility to include and support the related persons in order to maintain their role as carers. Aim: The aim of this literature study was to highlight the family caregivers’ experiences of caring for a person who has HIV. Method: A literature review consisting of ten scientific articles found in three different databases. The articles have both qualitative and mixed design. The content analysis was conducted according to Friberg. Results: The results exposed different categories and subcategories; The emotions of the family caregivers with the subcategories Fear, Frustration, Hope and hopelessness as well as the family caregivers’ positive experiences of caring; Consequences that family caregivers faced during caring for relatives with the subcategories Stress, Care burden and Responsibility as well as Stigmatization. The other main categories are Knowledge and lack of knowledge as well as support and luck of support. Discussion: The outcome discussion explains how stigmatism has different consequences for the relatives in association with the care of a person with HIV. The premises are primarily taken from Eriksson's caritative theory, focusing on the concepts of health and suffering. Knowledge and lack of knowledge for the relatives are also discussed based on the family caregiver’s conditions to care for the person who has HIV.

Alzheimer's Disease and Related Disorders (ADRD) are a major public health problems. Major sources of care provision are family members in the community and these ADRD caregivers encounter a variety of stressor. Currently there continues to be a need to develop and test Internet based interventions designed to reduce stress for caregivers for persons with ADRD. The web-based Structured Written Emotional Expressions (SWEE) was developed to manage ADRD caregivers stress related to caregiving experiences through writing about their thoughts and feelings. However, differences between provided services by researchers (the web-based SWEE) and the desired services of ADRD caregivers could be a barrier to ADRD caregivers' acceptance and use of the web-based SWEE. The purpose of this study was to assess the acceptability of implementing a web-based nursing intervention for ADRD caregivers and to describe participants' experiences in using the website to understand ADRD caregivers' website usage. An experimental design was used to determine whether the web-based SWEE helped to manage ADRD caregivers' stress through writing interventions. In addition, the UTAUT model was employed for a theoretical framework to explain and predict the web-based SWEE usage behavior by ADRD caregivers. The Finding Meaning Through Caregiving Scale (FMTCS) was used to evaluate finding-meaning related to caregiving experiences as a mediator between performance expectancy and behavioral intention to use in the UTAUT model. Furthermore, the web-based research methods were assessed throughout the web-based SWEE implementing process. Both web-based and paper-based methods were used for recruiting potential participants. Most people who contacted the researcher were recruited by the web-based method. Structural Equation Modeling (SEM) was used for test ADRD caregivers' acceptability of the web-based SWEE and direct content analysis was used for describing participants' experiences in using the web-based SWEE. Fifty people completed the study out of the 90 people who enrolled. Of these 50 participants, 31 completed the study as intended and on schedule. The research showed a good model fit with a Chi-square value (df=43) of 57.191 (p>0.05). The findings showed that performance expectancy had a significant effect on participants' behavioral intention to use (β=0.620, p<0.01) and that effort expectancy also affected the behavioral intention to use the web-based SWEE (β=0.293, p<0.01). Performance expectancy showed stronger effects than effort expectancy. This model explained 52% of variance in behavioral intention to use. However, the effects of facilitating conditions on actual usage and effects of behavioral intention to use on actual usage were not supported by this research. The finding-meaning measure did not show a significant mediating effect on the relationship between performance expectancy and behavioral intention to use. Findings suggested that recruitment methods which use the Internet were an effective way to find potential study participants. Regardless of the topic, the writing intervention helped ADRD caregivers to express stress related to caregiving experiences. In addition, the perceived usefulness of this nursing intervention (performance expectancy) and the perceived ease of use (effort expectancy) were two important constructs which predicted and explained the acceptance of the web-based SWEE by ADRD caregivers. Finally, even though the UATAUT model was only partially supported by a good model fit, this study's findings showed the potential of the UTAUT model for providing health consumer information systems in nursing.

African Americans suffer disproportionately higher incidence of congestive heart failure (CHF) at an earlier age of onset and with more rapid progression compared to other races. Due to this escalating prevalence of CHF within the African American population and the lack of culturally responsive support for the caregiving role, African American family caregivers of adult CHF patients face greater challenges and suffer increased caregiver burden, stress, depression, and financial strain compared to European American caregivers. The purpose of this project was to conduct a systematic literature review to find the recommendations that target African American family caregivers of adult CHF patients. The Joanna Briggs Institute model for systematic review (JBIM-SR), and the caregiver stress theory proposed by Tsai, guided this project. A review of multiple databases yielded 118,078 articles. After removal of duplicates and exclusion of articles not consistent with the purpose of the review, 1 article was selected. A second reviewer completed an independent search of the databases using the same exclusion/inclusion criteria and identified the same review. The selected article was analyzed and graded using the JBIM-SR grading tools. Family Heart Failure Home Care, a telephone coaching intervention adapted to the cultural preferences of the African American family caregivers of adult CHF patients, was suggested as an effective culturally sensitive intervention. Results of this project can promote positive social change by improving the care and well-being of the African American community. Nurses at the project site can use the findings to provide evidence-based care to the African American family caregivers of adult CHF patients.

Bakgrund: Den äldre populationen är växande i Sverige och anhörigvårdarnas insatser ökar i omfattning. Detta innebär förändringar i anhörigvårdarnas livssituation och kan upplevas både positivt och negativt. För att få ett väl fungerande vård- och omsorgssystem är det viktigt att få en övergripande bild av anhörigvårdarnas erfarenheter. Detta för att kunna främja och bibehålla deras livskvalitet. Syfte: Syftet med studien är att studera äldre anhörigvårdares erfarenheter av att vårda en närstående. Metod: Litteraturstudie som är baserad på 9 vetenskapliga artiklar. Både kvalitativa och kvantitativa artiklar har använts och dessa har granskats och analyserats. Kriterierna för urvalet var att de skulle innefatta människor över 60 års ålder, vara publicerade efter 2001 samt skrivna i industriländer som kan passa in på Sveriges sjukvård. Resultat: Resultatet beskriver anhörigvårdarnas erfarenhet av att vårda en närstående som en förändring som påverkar även deras livssituation. Studien presenteras i två kategorier med sju underkategorier: Anhörigvårdarens livssituation och Den viktiga interaktionen med omvärlden. Diskussion: Erfarenheterna av att vara anhörigvårdare var av olika karaktär och påverkades av yttre och inre faktorer. Där en del anhörigvårdare kände en förlust av egen tid upplevde andra en ökad samhörighet med den närstående. Att bemästra sin roll som anhörigvårdare verkade till stor del grunda sig i personens inneboende egenskaper, även det sociala nätverk anhörigvårdaren hade upplevdes betydelsefullt. Benner och Wrubels omsorgsteori låg till grund för diskussionen och vissa begrepp förankrades: omsorg, person, situation, kontext, stress, bemästrande, livscykel, hälsa (välbefinnande) och ohälsa.

Background: Each year approximately 30 000 people suffer from stroke in Sweden, often with substantial mental and physical consequences. Those who suffered from stroke handled the situation by mourning what they had lost and by accepting their changed body and life situation. For those who provide care for people who has suffered a stroke help and support was required. The caring science perspective was based upon caring and suffering. Aim: The purpose of this study was to describe family caregivers’ experiences of caring for persons who had suffered a stroke. Method: The method consisted of a systematic review with a descriptive synthesis and an inductive approach. Results: The analysis resulted in four major themes: alienation, dependency, change and control. Alienation was based on feelings of isolation and abandonment. Through the need for support from others and a new responsibility dependence was experienced. Change involved both a change of roles and the loss of independence. Lack of control resulted in feelings of uncertainty. In order to regain control methods to manage the life situation was used. Conclusions: Family caregivers experienced the caring for the person who had suffered a stroke as a responsibility that was forced upon them and the lack of support from the health care services contributed to negative experiences. By using coping strategies to manage the life situation family caregivers accepted the new life situation.

Sammanfattning/Abstract Bakgrund: Många patienter väljer i dag att vårdas hemma under sin sista tid i livet istället för som tidigare på sjukhus eller ett boende. Den palliativa hemsjukvården blir därför alltmer utbredd vilket samtidigt innebär att allt större krav ställs på de närstående som då ofta intar en vårdande roll.  Syfte: Syftet är att beskriva hur närstående upplever sin vårdande roll i den palliativa hemsjukvården. Metod: En litteraturstudie baserad på tio resultatartiklar som består av både kvalitativa och kvantitativa studier där vi kom fram till tre teman som handlade om den närståendes upplevelser av den vårdande rollen, närståendes vårdande roll och den sjuke och närståendes vårdande  roll och sjuksköterskan.  Resultat: Många närstående fann både fördelar och nackdelar med den vårdande rollen och att den innebär en stor omställning. Många närstående kände sig mer eller mindre tvingade att ta över den vårdande rollen.Tillräcklig information och en god kommunikation ansågs av de närstående som en mycket viktig faktor.   Diskussion: Att vårda en svårt sjuk anhörig är ofta en belastning. Detta kräver att vårdpersonalen är medvetna om de närståendes svåra situation och upplevelsen av denna. Det är även viktigt att uppmärksamma närståendes behov av information och att ha en bra kommunikation för att vi som sjuksköterskor ska kunna stödja de närstående i deras vårdande roll. Nyckelord: Anhörig vårdare, vårdande roll, palliativ vård, döende patienter, vård i livets slut Keywords: Family caregivers, caring role, palliative care, terminally ill, end of life care