Bakgrund: Trycksår är en komplikation som bidrar till ökat lidande för patienter, därav behövs en strukturerad behandlingsstrategi för trycksår. Efter forskning inom ämnesområdet har det blivit konstaterat att nutritionen har en påverkan på sårläkningsprocessen. Nutritionens betydelse för specifikt trycksårsläkning har det även gjorts forskning på, men än idag finns det kunskapsluckor. I nuläget finns etablerade, preventiva åtgärder att tillgå för sjuksköterskor, men tydliga riktlinjer och specifika orala nutritiva åtgärder saknas för trycksårsbehandling vid befintliga trycksår. Legitimerade sjuksköterskor förväntas ha kunskap om sambandet mellan nutrition och hälsa. Av relevans för sjuksköterskors yrkeskompetens och omvårdnadsarbete behövs orala nutritiva åtgärders effekt på läkningsprocessen vid befintliga trycksår belysas. Syfte: Att sammanställa vilken effekt orala nutritiva åtgärder har på sårläkningsprocessen vid befintliga trycksår. Metod: En litteraturstudie som inkluderar 15 vetenskapliga artiklar med kvantitativ ansats. Resultat: De vetenskapliga artiklarnas resultat och statistiska signifikans presenterades och sammanställdes under tre teman: effekten av orala näringstillskott berikad med arginin, effekten av orala näringstillskott berikad med övriga nutrienter och biverkningar. Konklusion: Litteraturstudien påvisade att orala nutritiva åtgärder hade en främjande effekt för sårläkningsprocessen vid trycksår. Det fanns olika näringstillskott som bedömdes gynna trycksårsläkningen men näringstillskott berikad med arginin uppvisade ha bäst effekt. / Background: Pressure ulcers are complications that contribute to increased suffering for patients, therefore is a structured treatment much needed. After research in the subject area it has been concluded that nutrition has an important role in the wound healing process. The importance of nutrition for specifically pressure ulcers has also been researched on, but still to this day there are knowledge gaps. There are currently preventive actions established for nurses, but not clear guidelines nor specific oral nutritional interventions for existing pressure ulcers. Registered nurses are expected to have knowledge of the connection between nutrition and health. Therefore, it’s essential to compile oral nutritional interventions effect on the healing process of existing pressure ulcer. Aim: To compile oral nutritional interventions’ effect on the healing process in existing pressure ulcers. Method: A literature review based on 15 scientific, quantitative studies. Results: The scientific studies’ result and statistical significance was presented and categorised into three categories: the effect of oral nutritional supplements enriched with arginine, the effect of oral nutritional supplement enriched with other nutrients and side effects. Conclusion: This literature review showed that oral nutritional interventions had a favourable effect on the healing of pressure ulcers. Various nutrition supplements were deemed to favour the healing of pressure ulcers, but especially supplements enriched with arginine.

<p>This thesis analyse how life-histories are expressed and reformulated in connection to a life crisis of ill health. The study is based on ten interviews with people who in connection with ill health have made use of treatments within both orthodox medicine and complementary medicine and who have also developed various forms of self-treatment. The overall aim is, with a point of departure in the concepts health, healing and trust, to analyse narratives as a practice through which the respondents create identity and a life-context. The signifi cance of constructing the (auto)biography of the healing narrative – a form of narrative and performative act – runs as the main thread through the thesis. This act makes up the practice that is recurrently discussed in several of the thesis’ chapters and is synonymously termed the telling of healing narratives or or to narrate health and healing. The analysis of the narrative’s The analysis of the narrative’s healing main themes is mirrored in the order of the chapters. The study is broadly thematic and structured as a generalised healing process beginning with upheaval, continuing with crisis and social drama, and further to the endeavour of expressing values and judgements in a public context.</p><p>The interview themes of self-treatment and alternative treatment have occasioned the investigation into what an ethno-medical perspective can bring to analyses of people’s experiences of ill health in an everyday medical context. One of the points of having the concept ethno-medicine as a starting point is that every practice or narrative formation is ascribed with a potential for interpretation in its creation of knowledge. Another chapter deals with two themes of identity and life-history construction in the practice of healing narratives – the need for a chronology and reappraised perspectives on body, health and lifestyle. Healing narratives can be understood as a genre of life-historical narratives where life is often described as a linear course of events. A model by the anthropologist Victor Turner on the course and content of social drama is used as a comment to analyses of three respondents’ narratives in another chapter. A drama can be understood as a tragic course of events, based on an accident or an upsetting incident that roughly revolves around event/crisis, chaos and the striving for restoration. The concept of other journals is then used to make visible the everyday medical administrative practice and refers to the documentation used in the form of collected documents, written notes, and diaries. As an unexpected part of healing processes, the necessity of familiarising oneself with rules, laws and health insurance systems in order to be able to claim one’s rights is brought forward.</p><p>The social transformation process of various care practices in society makes up both a context and a commonly occurring theme in the narratives that the thesis is based upon. A modern health culture that gains strength from loosely composed social movements exerts infl uence on all levels of society. With an increased individual responsibility, the need grows to fi nd one’s own healing strategies and to create one’s own life-history in narratives that mirror this transformation in an everyday context. Healing narratives can be seen as a form of evaluation of health-care practices where experiences of treatment and notions of health and cure and healing are concretised.</p>

This thesis analyse how life-histories are expressed and reformulated in connection to a life crisis of ill health. The study is based on ten interviews with people who in connection with ill health have made use of treatments within both orthodox medicine and complementary medicine and who have also developed various forms of self-treatment. The overall aim is, with a point of departure in the concepts health, healing and trust, to analyse narratives as a practice through which the respondents create identity and a life-context. The signifi cance of constructing the (auto)biography of the healing narrative – a form of narrative and performative act – runs as the main thread through the thesis. This act makes up the practice that is recurrently discussed in several of the thesis’ chapters and is synonymously termed the telling of healing narratives or or to narrate health and healing. The analysis of the narrative’s The analysis of the narrative’s healing main themes is mirrored in the order of the chapters. The study is broadly thematic and structured as a generalised healing process beginning with upheaval, continuing with crisis and social drama, and further to the endeavour of expressing values and judgements in a public context. The interview themes of self-treatment and alternative treatment have occasioned the investigation into what an ethno-medical perspective can bring to analyses of people’s experiences of ill health in an everyday medical context. One of the points of having the concept ethno-medicine as a starting point is that every practice or narrative formation is ascribed with a potential for interpretation in its creation of knowledge. Another chapter deals with two themes of identity and life-history construction in the practice of healing narratives – the need for a chronology and reappraised perspectives on body, health and lifestyle. Healing narratives can be understood as a genre of life-historical narratives where life is often described as a linear course of events. A model by the anthropologist Victor Turner on the course and content of social drama is used as a comment to analyses of three respondents’ narratives in another chapter. A drama can be understood as a tragic course of events, based on an accident or an upsetting incident that roughly revolves around event/crisis, chaos and the striving for restoration. The concept of other journals is then used to make visible the everyday medical administrative practice and refers to the documentation used in the form of collected documents, written notes, and diaries. As an unexpected part of healing processes, the necessity of familiarising oneself with rules, laws and health insurance systems in order to be able to claim one’s rights is brought forward. The social transformation process of various care practices in society makes up both a context and a commonly occurring theme in the narratives that the thesis is based upon. A modern health culture that gains strength from loosely composed social movements exerts infl uence on all levels of society. With an increased individual responsibility, the need grows to fi nd one’s own healing strategies and to create one’s own life-history in narratives that mirror this transformation in an everyday context. Healing narratives can be seen as a form of evaluation of health-care practices where experiences of treatment and notions of health and cure and healing are concretised.

Afrikaans text / Hierdie studie bied vanuit 'n ekosistemiese benadering 'n verduideliking van die lewenswereld van die volwasse persoon wat as kind gemolesteer is. Enkele uitgangspunte van die ekosistemiese benadering word bespreek wat dien as vertrekpunt waarvolgens die navorser konstruksies oor die as kind gemolesteerde volwassene konstrueer. Daar word gefokus op die langtermyneffekte van die kindermolestering met spesifieke verwysing na die effek op die • fisiese gedrag van die volwassene; • die aard van die seksuele verhoudings van die volwassene; en • die aard van die interpersoonlike verhoudings van die volwassene. Tydens hierdie bespreking word die oorlewingstrategiee, wat die volwassene aanwend om met die l angtermyneffekte te oorl eef, duidel i k belig. Die he l i ngsproses waardeur 'n vol wassene vol gens sy of haar ei e pas beweeg ten einde die effek van die molestering te verwerk, word volledig bespreek. Die teorie is toegepas in die navorsing om die uitwerking van die kindermolestering op volwassenes te beskryf asook enkele gebeure (events) van die helingsproses waardeur 'n volwassene beweeg het. Gevolgtrekkings en aanbevelings word geformuleer ten einde die bruikbaarheid van hierdie studie in die praktyk aan te dui. / In this study the world of the adult survivor of sexua 1 abuse is described in terms of the eco-systemic approach, as well as certain constructions within the approach. These constructions served as a base on which the researcher construed further constructions of the adult survivor of sexual abuse. The study focuses on the 1 ong term effects of the child abuse with specific reference to the effect on • the physical behaviour of the adult; • the nature of the sexual relationships of the adult; and • the nature of the interpersonal relationships of the adult. The strategies of the adult in surviving with these long term effects are also highlighted in the discussion. The healing process through which the adult survivor passes in healing the sexual trauma according to his or her own pace, is fully discussed. In the empirical research the theory is applied to describe the effect of sexual abuse on the lives of adults as well as on certain events of the healing process. Conclusions and recommendations are formulated to indicate the usefulness of this study for the field. / Social Work / D.Phil. (Maatskaplike Werk)

Afrikaans text / Hierdie studie bied vanuit 'n ekosistemiese benadering 'n verduideliking van die lewenswereld van die volwasse persoon wat as kind gemolesteer is. Enkele uitgangspunte van die ekosistemiese benadering word bespreek wat dien as vertrekpunt waarvolgens die navorser konstruksies oor die as kind gemolesteerde volwassene konstrueer. Daar word gefokus op die langtermyneffekte van die kindermolestering met spesifieke verwysing na die effek op die • fisiese gedrag van die volwassene; • die aard van die seksuele verhoudings van die volwassene; en • die aard van die interpersoonlike verhoudings van die volwassene. Tydens hierdie bespreking word die oorlewingstrategiee, wat die volwassene aanwend om met die l angtermyneffekte te oorl eef, duidel i k belig. Die he l i ngsproses waardeur 'n vol wassene vol gens sy of haar ei e pas beweeg ten einde die effek van die molestering te verwerk, word volledig bespreek. Die teorie is toegepas in die navorsing om die uitwerking van die kindermolestering op volwassenes te beskryf asook enkele gebeure (events) van die helingsproses waardeur 'n volwassene beweeg het. Gevolgtrekkings en aanbevelings word geformuleer ten einde die bruikbaarheid van hierdie studie in die praktyk aan te dui. / In this study the world of the adult survivor of sexua 1 abuse is described in terms of the eco-systemic approach, as well as certain constructions within the approach. These constructions served as a base on which the researcher construed further constructions of the adult survivor of sexual abuse. The study focuses on the 1 ong term effects of the child abuse with specific reference to the effect on • the physical behaviour of the adult; • the nature of the sexual relationships of the adult; and • the nature of the interpersonal relationships of the adult. The strategies of the adult in surviving with these long term effects are also highlighted in the discussion. The healing process through which the adult survivor passes in healing the sexual trauma according to his or her own pace, is fully discussed. In the empirical research the theory is applied to describe the effect of sexual abuse on the lives of adults as well as on certain events of the healing process. Conclusions and recommendations are formulated to indicate the usefulness of this study for the field. / Social Work / D.Phil. (Maatskaplike Werk)