Bakgrund: Tidigare forskning visar att patienter uttrycker ett behov av att sjuksköterskor är tillgängliga och stöttar dem under deras svåra tid vid palliativ vård i livets slutskede. Det framgår även att anhöriga upplever att de får ta en stor roll i vårdandet av patienter och är därför i behov av att sjuksköterskor bekräftar dem samt är stöttande. Syfte: Att beskriva sjuksköterskors upplevelser inom palliativ vård i livets slutskede. Metod: En systematisk litteraturstudie med en beskrivande syntes. Tolv kvalitativa artiklar analyserades och är presenterade i examensarbetets resultat. Resultat: Efter analys framkom två teman: Upplevelsen av att bli involverad och Uppleva hinder för god palliativ vård. Utifrån dessa två teman identifierades totalt fyra subtema. Slutsats: Sjuksköterskor som arbetade nära patienter som erhöll palliativ vård i livets slutskede upplevde att de blev berörda samt ville lindra patienters lidande. Begränsad tid skapade frustration och en hjälplöshet hos sjuksköterskor. När den egna kunskapen brister av att arbeta inom palliativ vård i livets slutskede uppkom en osäkerhet hos sjuksköterskor, av att inte kunna hjälpa patienter och deras anhöriga tillräckligt mycket. Genom sina möten med patienter uttryckte sjuksköterskor en tacksamhet över livet och insåg hur skört det är, vilket skapade reflektion kring döden. / Background: Previous research has shown that patients express a need for nurses to be available and support them during their difficult time in end-of-life palliative care. It also appears that relatives feel that they get to play an important role in the care of the patient and are therefore in need of nurses’ validation and support. Aim: To describe nurses' experiences in palliative care at the end of life. Method: A systematic literature study with a descriptive synthesis. Twelve qualitative articles were analyzed and are presented in the results. Results: After analysis, two themes emerged: The experience of becoming involved and experiencing obstacles to good palliative care. From these two themes, a total of four subthemes were identified. Conclusion: Nurses who worked close to patients who received palliative care at the end of life felt affected for them and wanted to alleviate the patients suffering. Limited time led to frustration and a sense of helplessness among the nurses. Those who lacked experience working in palliative care at the end of life, were uncertain if they provided sufficient help to the patients and their relatives. Their encounters with patients gave the nurses an appreciation for life and how fragile it is, which led to reflections on death

No description available.

A modified ascending thin layer chromatographic technique has been developed which resolves the major phospholipid and neutral lipid classes of five common fluids and tissues. A one-half milliliter sample is extracted with n-butanol:diisopropylether (40:60 by volume, cholesteryl acetate = 100 ng/ul) for thirty minutes and the organic phase is spotted onto a thin layer chromatography plate and carried through three successive chromatographic developments. The lipids are then visualized either by charring with ammonium bisulfate or staining with phosphomolybdic acid. The use of cholesteryl acetate as an internal standard enables quantitation of the phospholipids and neutral lipid classes. This method may be a very valuable, new technique for research and clinical laboratories.

Bakgrund: Sex miljoner människor globalt avlider till följd av trauman årligen. De vanligaste orsakerna är trafikrelaterade skador, suicid, dråp och fallskador. Ett fysiskt trauma inträffar vanligen oväntat där den drabbade har behov av fysisk och psykisk hjälp. Det är betydande att en vårdrelation etableras mellan vårdpersonal och patient för att patienten ska kunna göras delaktig i sin vård. Personcentrerad vård är viktigt vid det initiala mötet och sedan fortlöpande genom vårdkedjan. Fysiska trauman orsakar belastning på vård och samhälle samtidigt som det medför stort lidande för patienten. Syfte: Syftet var att beskriva patienters erfarenheter av vårdpersonals omvårdnad efter fysiskt trauma.  Metod: Litteraturstudie med beskrivande design. Elva kvalitativa originalartiklar som belyser patienters erfarenheter identifierades genom artikelsökning i databaserna PubMed och CINAHL. Kvalitetsgranskningen genomfördes utifrån Statens beredning för medicinsk och social utvärdering (SBU:s) granskningsmall. Artiklarna ansågs vara av medel eller hög kvalitet.  Resultat: Patienters erfarenheter av vårdpersonalens omvårdnad efter fysiskt trauma, besvarades av tre teman, vilka var: ha stort informationsbehov, vilja kommunicera med vårdpersonal samt önska vara delaktig i sin vård. Patienternas erfarenheter varierade angående om informationen var tillräcklig, om kommunikationen var god och om patienterna fick möjligheten att vara delaktiga i sin egen vård.  Slutsats: Det stora informationsbehovet, viljan att kommunicera med vårdpersonal och önskan om att vara delaktig var framträdande i hur patienterna erfor vårdpersonalens omvårdnad efter fysiskt trauma. Studiens resultat redovisar patienters perspektiv. Dessa erfarenheter är värda att hörsammas av vårdpersonal som möter patienter drabbade av fysiskt trauma, för att öka vårdpersonalens förståelse för erfarenheterna av omvårdnaden hos patienterna. / Background: Six million people globally die as a result of trauma annually. The most common causes are traffic-related injuries, suicide, homicide, and fall injuries. A physical trauma usually occurs unexpectedly where the patient needs physical and psychological help. It is important that a nurse-patient relationship is established between healthcare professionals and patients in order for the patient to be able to participate in their care. Person-centered care is important at the initial meeting and then continuously throughout the care continuity. Physical trauma causes a strain on healthcare and society, while at the same time causing great suffering for the patient. Aim: To describe trauma patients' experiences of nursing care after physical trauma.  Method: Literature study with a descriptive design. Eleven qualitative original articles highlighting patients' experiences were identified through article searches in databases PubMed and CINAHL. The quality review was carried out using the State's preparation for medical and social evaluation (SBU's) review template. The articles were considered to be of medium or high quality.  Results: Patients' experiences of nursing care after physical trauma were answered by three themes, which were: having a great need for information, wanting to communicate with healthcare professionals, and wanting to be involved in their care. The patients' experiences varied regarding whether the information was sufficient, whether the communication was good, and whether the patients were given the opportunity to participate in their care. Conclusion: The great need for information, the desire to communicate with healthcare staff and the desire to be involved were crucial in how the patients experienced the nursing staff's care after physical trauma. The results of the study report patients' perspectives. These experiences are worth listening to by healthcare professionals who encounter patients affected by physical trauma, in order to increase healthcare professionals' understanding of patients' nursing experiences.

No description available.

Admissions processes for health professions programs result in students entering these programs academically homogeneous. Yet some students have great difficulty with the programs. Research has shown a limited ability of traditional academic indicators to predict successful outcomes for health professions education. The purpose of this study was to examine the relationship between learning motivation and academic outcomes for students in health professions programs. The Modified Archer Health Professions Motivation Scale (MAHPMS) and a demographic survey were administered at orientation to 131 medical and 29 physician assistant students at the University of North Texas Health Science Center in the fall of 2005. At the end of the semester, the same version of the MAHPMS was administered, and final course grades and semester averages were collected. Descriptive statistics were analyzed for all the study variables. Analysis of variance was utilized to examine within subjects and between subjects differences for the learning motivation scores among programs and demographic categories. Linear regression analyses were used to determine the relationship between learning motivation scores and end-of-semester grades. And finally, logistic regression was performed to explore the ability of the motivation scores to predict academically high-risk students. Approximately three-fourths of the students indicated a preference for mastery learning and an internal locus of control. For the PA students, alienation to learning and performance goal scores statistically related to semester grades, and alienation to learning scores predicted high-risk academic performance almost 90% of the time. For the medical students, mastery goal scores statistically related to semester grades, but no motivation score predicted high-risk performance. External locus of control scores predicted high-risk performance 81% of the time for the total group of students at the end of the semester. Students in this study exhibited learning motivation preferences similar to those of other health professions students reported in the literature. The findings of this study agreed with the literature on achievement motivation theory and raised questions regarding the effect of health professions curricula on student learning goals. Similar studies, measuring larger samples longitudinally need to be conducted in order to further validate or elucidate the results of this study.

Background: Muscular strengthening activity (MSA) has been shown to be inversely associated with insulin resistance (IR). The associations between quartiles of the homeostatic model assessment of insulin resistance (HOMA-IR) and self-reported MSA in a nationally representative sample of euglycemic U.S. adults were examined. Methods: Sample included adult participants (≥20 years of age [n=2,543]) from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). HOMA-IR was categorized into quartiles based on every 25th percentile. No MSA was the dependent variable. Results: Following adjustment for covariates, those with HOMA-IR values in third (p Conclusions: Having a higher HOMA-IR value is associated with greater odds of reporting no MSA in euglycemic U.S. adults.

<p>Alla har någon gång mot sin vilja fått en störande tanke på hjärnan. En skrämmande bild eller en känsla av att någonting är fel.</p><p>I den här artikelserien möter du personer vars tankar och beteenden inte stannat vid vanlig skrockfullhet – de har skenat iväg och blivit ett hinder för normalt umgänge med andra människor.</p><p>Läs om livet som tvångssjuk.</p>

Praktisering av brukermedvirkning krever at sykepleierne ser på brukerne som likeverdige partnere. Det bryter med det tradisjonelle sykepleier–pasientforholdet og krever andre arbeidsmetoder og holdninger. For å kunne få til en slik endring forutsetter det at sykepleierne har nødvendig kunnskap og forståelse for brukermedvirkning og den bakenforliggende ideologien. Hensikt: Hensikten med studiet var å studere sykepleiernes teoretiske forståelse av begrepet brukermedvirkning og kartlegge hvordan sykepleierne selv opplever at de praktiserte brukermedvirkning i kommunens omsorgstjeneste. Metode: Det har blitt gjennomført en kvalitativ studie med halvstrukturerte intervjuer. Analysemetode var meningsfortettning og meningskategorisering etter beskrivelse av Kvale. Studien har 20 respondentern fra sykehjem og hjemmetjenesten i en stor norsk kommune. Resultater: Sykepleiernes kunnskap om brukermedvirkning var i stor grad situasjonsbestemt. Den ble beskrevet ut fra pasientene de selv arbeider med, situasjonene og konteksten. Det ble knyttet usikkerhet til den teoretiske forståelse av begrepet. Brukermedvirkning blir i hovedsak beskrevet som samråd og må forstås som symbolsk deltagelse der pasientenes deltar og gir uttrykker behov eller gir råd uten at de har reell innflytelse eller myndighet. Langt færre beskrev brukermedvirkning som brukerinnflytelse i form av partnerskap der pasienten gis anledning til å ta avgjørelse og oppleve kontroll.I hvilken grad brukermedvirkning praktiseres avhenger av avveininger i tjenesteutforming, institusjonelle forhold og strukturelle rammer. Sykepleiere opplevde ved håndtering av meningsforskjeller mellom pasient og pårørende en lojalitet overfor pasienten samtidig som de viser forståelse overfor pårørende. Konklusjon: Sykepleiernes forståelse av brukermedvirkning handler i stor grad om symbolsk deltagelse fordi de gis mulighet til å uttrykke ønsker men ikke fatte endelig avgjørelse. Implementering av brukermedvirkning på systemnivå og en kombinasjonen av teoretisk kunnskap og refleksjon over praksis, vil kunne styrke bevisstheten og vektleggingen av brukermedvirkning. / The practice of user participation requires nurses to regard users as equal partners. It breaks with the traditional nurse-patient relationship and demands different working methods and attitudes. Achieving such a change requires nurses to have the necessary knowledge and understanding of user participation and the ideology behind it. Objective: This study aimed to investigate nurses’ understanding and practice of user participation in the municipal care service. Method: We implemented a qualitative study by conducting semi-structured interviews with 20 respondents from nursing homes and home care services in a major Norwegian municipality.Analysis involved consolidating and categorizing the subjects’ intent, as described by Kvale. Results: The nurses’ knowledge of user participation was situational (i.e., they based their descriptions on current patients, situations, and context). Their theoretical understanding of the concept was uncertain. Most described user participation as a consultation that must be understood as symbolic participation, where the patients express their needs or give advice without having any real influence or authority. Far fewer nurses described user participation as user influence in the form of a partnership, where patients are given the opportunity to make decisions and experience control. The extent to which nurses practice user participation depends on trade-offs among services, institutional situations, and structural frameworks. When faced with differing opinions between patients and their relatives, nurses experienced loyalty toward their patients and simultaneously showed empathy for the relatives. Conclusion: Nurses’ understanding of user participation largely deals with symbolic participation because it enables patients to express desires without making any final decisions. Implementing user participation at the system level and combining theoretical knowledge and reflection in practice would strengthen awareness and focus attention on user participation / <p>ISBN 978-91-85721-73-3</p>

Bakgrunn: Kontroll og overvåking av institusjonservervede infeksjoner (sykehusinfeksjoner) ble regulert i lov og forskrift i 1996. Helseinstitusjoner ble pålagt å ha infeksjonskontrollprogram. Hensikt: Å beskrive i hvilken utstrekning sykehjem i Akerhus fylke fulgte lovverket med å ha infeksjonskontrollprogram, inkludert infeksjonsforebyggende- og overvåkende tiltak. Metode: To tverrsnittsundersøkelser ble gjennomført i sykehjem i Akershus fylke i 2001 og 2005. En spørreundersøkelse ble utformet i 2001 for å kartlegge infeksjonskontrollprogram, inkludert lovverk, retningslinjer, ansattes helse og opplæring. I 2005 ble spørreundersøkelsen utvidet til å inkludere retningslinjer for meticillin resistente Staphylococcus aureus (MRSA), isolering, samarbeid med mikrobiolgoisk laboratorie og vaksinering. Spørreskjemaet ble sendt til institusjonssjef ved hvert sykehjem i fylket. I tillegg kontrollerte vi om institusjonene deltok i nasjonale prevalens registreringer og om de hadde erfaring med beboere med MRSA ved å benytte Nasjonale Folkehelseinstitutt sin database. Resultater: Antallet sykehjem som hadde etablert infeksjonskontrollprogram hadde steget fra 24 (48%) i 2001 til 45 (80%) i 2005 (Relativ risiko (RR)=1.6, 95% Konfidens interall (KI): 1.2-2.3). Det var en økning i kjennskap til fylkets lokale infeksjonskontrollprogram (RR=1.5, 95% KI: 1.1-2.1). Institusjonssjef vurderte det svært viktig å ha et infeksjonkontrollprogram (gjennomsnitt=6.2, variasjonsbredde 6.0-6.5 på en skala fra 1 til 7). Konklusjon: Det har vært økende oppmerksomhet på infeksjonskontroll og overvåking i sykehjem i Akershus fylke, Norge. Nasjonalt lovverk og gjentatte nasjonale prevalensregistreringer av institusjonservervede infeksjoner kan ha bidratt til dette / Background:In 1996, regulations regarding control and prevention of healthcare-associated infections in all healthcare institutions were implemented in Norway. It became mandatory for all healthcare facilities to have an infection control program. Objective: To describe to what extent long-term care facilities (LTCFs) in Akershus County have implemented infection control programs including guidelines and surveillance. Methods: A repeated, cross-sectional survey was performed among the LTCFs in Akershus County in 2001 and in 2005. A questionnaire was developed in 2001 investigating infection control programs including regulatory issues, guidelines, occupational health and training. In 2005, the questionnaire was expanded to include additional questions regarding policies and guidelines on methicillin-resistant Staphylococcus aureus (MRSA), isolation containment, collaboration with the microbiology laboratory and immunization policies. The questionnaire was sent to the head managing nurse of each LTCF in the county. Additionally, we searched for participation of LTCFs in the national prevalence surveys on healthcare-associated infections and for MRSA positive cases in the databases of Norwegian Institute of Public Health. Results: The number of LTCFs with an infection control program increased from 24 (48%) in 2001 to 45 (80%) in 2005 (Relative risk (RR) =1.6, 95% Confidence interval (CI): 1.2-2.3). There was an increasing knowledge about the county’s infection control program (RR=1.5, 95% CI: 1.1-2.1). The LTCF’s head managing nurses perceived having an infection control program as important (mean=6.2, range 6.0-6.5 on a scale of 1 to 7). Conclusion: There has been an increased attention towards infection control in LTCFs in Akershus County, Norway. National regulations and repeated national prevalence surveys on healthcare-associated infections may have contributed to this improvement. / <p>ISBN 978-91-85721-19-1</p>