Background: As a result of the changes in support for adults with Intellectual Disabilities (ID) and the increasing emphasis on independent living within the community, individuals commonly live in their own homes with support provided by voluntary or private services. As a result, support staff play a huge role in the lives of adults with ID and are often the mediators of interventions aimed at reducing distress or the occurrence of challenging behaviour. Issues relating to the well-being of support staff and how they manage behaviours that challenge services are central to the quality of the lives of adults with ID. Method: A systematic review was carried out regarding interventions aimed at reducing stress felt by staff supporting adults with ID, with the aim of informing the clinical practice of psychologists that work with such staff groups. An empirical study employing the qualitative methodology of grounded theory was also conducted to explore the experiences of staff working with clinical psychologists outside of their organisation in the development of support guidelines aimed at reducing challenging behaviour. Results: Findings from the Systematic Review highlighted the lack of high quality intervention studies aimed at reducing stress in staff. Some tentative support was found for interventions based on Acceptance and Commitment Therapy and those taking a more practical problem-solving approach. The empirical study resulted in a tentative model within which the role of expectations was highlighted as key to staff’s experiences of working with professionals. Conclusion: Further research is required in order to identify the most effective ways to reduce stress experienced by staff working with adults with ID. The constructed theoretical model suggests ways in which psychologists can understand the experience of staff and has implications for their practice.

Background: Communication is key to expressing oneself and, in healthcare, communication may be compromised due to different limitations. In dementia care, relatives often take on the role of caregivers for their loved one and thereby adopt a role of advocacy. With this role communication with healthcare staff becomes a necessity. However, certain factors affect the way communication is perceived. Since nurses in Sweden have laws and ethical codes as well as a description of competence to follow to ensure that health is promoted and good care given, the knowledge of communication factors is a necessity. Aim: The aim of this study was to describe the factors affecting the communication between healthcare staff and caregivers in dementia care. Method: The chosen method was literature review and nine scientific articles from 2012-2022 were analysed. Results: The analysis resulted in the following themes and subthemes: Affected perception with the subthemes Frustration, stress and concern, Language barriers.Staff qualifications and commitment with the subthemes Lack of competence, Inadequate information, Staff presence and display of interest. Availability with the subthemes Support and correct information, Teamwork, Cooperation and participation and Good competence. Conclusion: The results showed that communication with caregivers was affected by lack of staff and knowledge in dementia care. When staff were unavailable, caregivers experienced that they were left out and kept uninformed. This caused them to feel frustrated and stressed and affected their communication skills. To prevent this, staff need to gain more knowledge in dementia care, should make themselves available and be able to provide accurate and timelyinformation.

Hand hygiene is generally considered to be the most important measure that can be applied to prevent the spread of healthcare-associated infection (HAI). Continuous emphasis on this intervention has lead to the widespread opinion that HAI rates can be greatly reduced by increased hand hygiene compliance alone. However, this assumes that the effectiveness of hand hygiene is not constrained by other factors and that improved compliance in excess of a given level, in itself, will result in a commensurate reduction in the incidence of HAI. However, several researchers have found the law of diminishing returns to apply to hand hygiene, with the greatest benefits occurring in the first 20% or so of compliance, and others have demonstrated that poor cohorting of nursing staff profoundly influences the effectiveness of hand hygiene measures. Collectively, these findings raise intriguing questions about the extent to which increasing compliance alone can further reduce rates of HAI. In order to investigate these issues further, we constructed a deterministic Ross-Macdonald model and applied it to a hypothetical general medical ward. In this model the transmission of staphylococcal infection was assumed to occur after contact with the transiently colonized hands of HCWs, who, in turn, acquire contamination only by touching colonized patients. The aim of the study was to evaluate the impact of imperfect hand cleansing on the transmission of staphylococcal infection and to identify, whether there is a limit, above which further hand hygiene compliance is unlikely to be of benefit. The model demonstrated that if transmission is solely via the hands of HCWs, it should, under most circumstances, be possible to prevent outbreaks of staphylococcal infection from occurring at a hand cleansing frequencies <50%, even with imperfect hand hygiene. The analysis also indicated that the relationship between hand cleansing efficacy and frequency is not linear - as efficacy decreases, so the hand cleansing frequency required to ensure R0<1 increases disproportionately. Although our study confirmed hand hygiene to be an effective control measure, it demonstrated that the law of diminishing returns applies, with the greatest benefit derived from the first 20% or so of compliance. Indeed, our analysis suggests that there is little benefit to be accrued from very high levels of hand cleansing and that in most situations compliance >40% should be enough to prevent outbreaks of staphylococcal infection occurring, if transmission is solely via the hands of HCWs. Furthermore we identified a non-linear relationship between hand cleansing efficacy and frequency, suggesting that it is important to maximise the efficacy of the hand cleansing process.

Bakgrund: Endometrios är en sjukdom där livmoderslemhinnan förekommer på andra platser än i livmoderhålan. Den ektopiska vävnaden följer menstruationscykeln och blöder därför som livmoderslemhinnan vanligtvis gör vid menstruation. Detta kan leda till inflammationer och smärtsamma sammanväxningar i bukhålan. Kvinnorna kan i och med detta få lov att utstå mycket lidande. Sjuksköterskans kommunikativa förmåga är en viktig del i strävan mot att lindra lidande. Syfte: Att undersöka kvinnors upplevelser av att leva med endometrios samt hur de upplever vårdpersonalens bemötande. Metod: Studien genomfördes som en litteraturöversikt. Databaser CINAHL, PubMED och PsycINFO användes för att söka vetenskapliga artiklar. Tio vetenskapliga artiklar var av kvalitativ ansats, två vetenskapliga artiklar var av kvantitativ ansats och en vetenskaplig artikel var av mixad design. Resultat: Tre domäner identifierades utifrån studierna: Sjukdomens inverkan på livet, Vårdpersonalens bemötande och Positiva aspekter i samband med sjukdomen. Kvinnornas symtom togs sällan på allvar. Kvinnorna antog att deras symtom och smärtor var “normala”. Endometriosen påverkade livet negativt, såväl kärleksrelationer samt arbetsliv och ekonomi påverkades av sjukdomen. Många kvinnor använde sig av egenvård för att hantera sin sjukdom, dock kände sig en del kvinnor stressade då de inte klarade av att leva upp till livsstilsförändringarna. Kvinnorna beskrev att de ofta kände sig avfärdade av vårdpersonal då de sökte vård. Många blev misstrodda och deras symtom klassades som psykosomatiska. Slutsats: Kvinnorna ansåg att bemötandet de fick av vårdpersonalen var bristfälligt och att deras symtom blev normaliserade. Sjuksköterskor behöver bli medvetna om kvinnornas situation för att kunna bekräfta deras upplevelser. / Background: Endometriosis is the presence of endometrial glands and stroma outside the endometrial cavity. The ectopic tissue follows the menstrual cycle and therefor bleeds during menstruation. This might lead to inflammation and painful adhensions in the pelvic cavity. The women may have to endure a great deal of suffering because of this. The nurses’ communication skill is an important part in the striving to alleviate the suffering. Aim: The aim of this study was to investigate womens experiences of living with endometriosis and how they experience the healthcare staffs treatment. Method: The study was made as a literature review. Following databases were used to search scientific articles: CINAHL, PubMED and Psyc INFO. Ten scientific articles were of qualitative approach and three scientific articles were of quantitative approach. Result: Three categories were identified from the articles: The disease´s impact on life, The healthcare staffs treatment and Positive aspects in relation to the disease. The womens symptoms were rarely taken seriously. The women assumed that their symptoms and pain were ”normal”. The endometriosis affected their lives negative, both love relationships and also work and economics were affected by the disease. A lot of women used selfmanagement to handle their disease, however some women felt stressed out when they didn’t manage to live up to the lifestyle changes. The women described that they often felt dismissed by healthcare staff when they sought treatment. Many were disbelieved and their symptoms were classified as psychological. Conclusion: The women felt that the treatment they´ve got from the healthcare staff were inadequate and that their symptoms were normalized. Nurses need to become aware of the womens situation to be able to acknowledge their experience.

Self-injury in correctional facilities is an increasing problem. Healthcare staff are tasked with responding to and treating self-injurious inmates. Research concerning the perceptions of prison self-injury depended on the experiences of professional healthcare staff and showed that specialized training reduced anxiety and altered perceptions. The perceptions of nonprofessional healthcare staff regarding inmate self-injury have not been studied. The purpose of this research was to understand the perceptions of inmate self-injury maintained by untrained healthcare staff through evaluation of their expressed experiences with self-injuring inmates. The research was based on the humanistic nursing theory. A phenomenological approach guided interviews of 8 healthcare staff having direct contact with inmates who self-injure. Participants had a past or present employment status with a State of Georgia Department of Corrections North Region correctional facility. Data were reviewed and coded to best reflect what it means to be a nonprofessionally trained healthcare member responding to inmate self-injury. Nonprofessional healthcare staff perceived that various experiences affected their level of ease and certainty, they operated as preservers of life and active listeners, felt that other healthcare staff held negative opinions, and were very helpful and supporting. Staff perceived that challenges prevented their success in managing self-injury. Last, nonprofessional staff perceived themselves as very helpful and therapeutic. This study promotes social change by encouraging staff to share knowledge, experience, and practical help with each other while building cohesive and collaborative relationships.

<p>Syfte med litteraturstudien var att beskriva bemötande av äldre människor inom vården utifrån de äldre vårdtagarnas, vårdgivarnas, observatörernas/anhörigas perspektiv. I en av dessa tre perspektiv representerade anhöriga tillsammans med observatörerna ett gemensamt perspektiv. En litteraturstudie gjordes och sexton vetenskapliga artiklar granskades och analyserades. Joyce Travelbee’s omsorgsteori (Interaktionsteori) var den teoretiska referensramen för studien. Resultatet visade att vårdgivarnas tillvaratagande av den äldre vårdtagarens autonomi bidrog påtagligt till upplevelsen av bemötandet, vårdtagarna uttryckte denna aspekt tydligast. Personalbrist var ett inbyggt fel i organisationen som påverkade bemötande. Alla tre perspektiv uttryckte detta problem tydligt. Vårdgivarnas egen förmåga att organisera och prioritera var av betydelse för upplevelsen av bemötande. Bemötandet påverkades när den äldre vårdtagarens önskemål nedprioriterades för rutiner. Nivån på vårdgivarnas empatiska förmåga påverkade upplevelsen av bemötandets kvalitet på olika sätt. Vården upplevdes som trygg när vårdgivare hade hög empatisk förmåga. Sammanfattningsvis var upplevelsen av bemötande att det var en förmåga till lyhördhet och en vilja att kommunicera, utförandet av dessa var i sin tur beroende av tid, personliga värderingar och invant beteende.</p>

Syfte med litteraturstudien var att beskriva bemötande av äldre människor inom vården utifrån de äldre vårdtagarnas, vårdgivarnas, observatörernas/anhörigas perspektiv. I en av dessa tre perspektiv representerade anhöriga tillsammans med observatörerna ett gemensamt perspektiv. En litteraturstudie gjordes och sexton vetenskapliga artiklar granskades och analyserades. Joyce Travelbee’s omsorgsteori (Interaktionsteori) var den teoretiska referensramen för studien. Resultatet visade att vårdgivarnas tillvaratagande av den äldre vårdtagarens autonomi bidrog påtagligt till upplevelsen av bemötandet, vårdtagarna uttryckte denna aspekt tydligast. Personalbrist var ett inbyggt fel i organisationen som påverkade bemötande. Alla tre perspektiv uttryckte detta problem tydligt. Vårdgivarnas egen förmåga att organisera och prioritera var av betydelse för upplevelsen av bemötande. Bemötandet påverkades när den äldre vårdtagarens önskemål nedprioriterades för rutiner. Nivån på vårdgivarnas empatiska förmåga påverkade upplevelsen av bemötandets kvalitet på olika sätt. Vården upplevdes som trygg när vårdgivare hade hög empatisk förmåga. Sammanfattningsvis var upplevelsen av bemötande att det var en förmåga till lyhördhet och en vilja att kommunicera, utförandet av dessa var i sin tur beroende av tid, personliga värderingar och invant beteende.

The study aims at evaluation of significance of the use of working hours of healthcare staff for effectiveness of nursing process in X divisions of Neurosurgery Hospital, Kaunas University of Medicine. The conception of nursery, the organization of caregiver's individual working place and subordination, also the effectiveness of working hours are discussed in the study. Aim of the study. to analyze the use of working hours of healthcare staff and effectiveness of nursing process as well as to give recommendations for the improvement of work organization in X divisions of Neurosurgery Hospital, Kaunas University of Medicine. Methods. There are two stages of the research: a) questionnaire survey for demographic and work characteristics of healthcare staff: b) individual autophotography of working hours for time expenditure of working hours to be registered. The questionnaire and the individual record of autophotography of working hours were made according to EUROSTAT 2004 methodical recommendations and the study of literature about effectiveness working hours. Results. 65 nurses of general practice were questioned during the research of working hours. The major part of them (70,77%) had college education, others (29,23%) had higher university and non-university education. More than a half of respondents 46 (70,77%) had work experience of 10 years in hospital. Time expenditure of working hours of healthcare staff was classified into 5 groups: frequency and duration of... [to full text]

Amning, amningskomplikationer, stöd och råd vid amning är en del av den sexuella och reproduktiva hälsan och ingår i barnmorskans kompetensområde.Det finns mycket forskning som beskriver nyblivna föräldrars upplevelse av amningsstöd men inte lika mycket forskning på hur vårdpersonalen upplever amningsstödet som ges till gravida och nyblivna föräldrar. Syftet med denna studie var att undersöka vårdpersonals upplevelser av amningsstöd till gravida och nyblivna föräldrar.Studien utfördes genom en kvalitativ metod utifrån en induktiv ansats. Data hämtades från intervjuer med semistrukturerade frågor i 11 fokusgrupper. All data bearbetades genom kvalitativ, induktiv innehållsanalys.Resultatet i studien visade att vårdpersonal upplever amningsstödet de ger som en viktig del i deras arbete. Amningsstödet hade brister och en betydande brist uppgavs vara kontinuiteten av amningsstöd genom hela vårdkedjan.Informanterna ansåg att amningsstödet borde förbättras och många förslag nämndes för att främja amningen hos nyblivna föräldrar och barn.Denna studie kan öka medvetenheten av den egna och kollegornas upplevelse av amningsstöd vilket kan leda till ett bättre samarbete mellan enheterna och en bättre kommunikation samt förändringar i organisationen som gynnar och främjar amningen. / Providing support and advice during lactation and breastfeeding complications are parts of the sexual and reproductive health.There are much research that describes new parents' experience of breastfeeding support, but not as much research that describes health professionals´ experiences of breastfeeding support that is given to pregnant and new parents. The purpose of this study was to investigate the health professionals´ experiences of breastfeeding support to pregnant and new parents.The study was conducted through a qualitative method based on an inductive approach.Data was collected from interviews with semi- structured questions in 11 focus groups. All data were processed by qualitative and inductive content analysis.The results of the study showed that healthcare professionals are experiencing breastfeeding support as an important part of their work.Breastfeeding support had flaws and a significant deficiency was reported to be continuity of breastfeeding support throughout the continuum of care.The informants felt that breastfeeding support should be improved and many suggestions were mentioned to promote breastfeeding among new parents and children.This study may highlight work professionals knowledge about their own and co-worker’s experiences of breastfeeding support which could lead to better cooperation and communication between units to promote and support breastfeeding.

The goal of the presented study is to assess patient safety during nursing care from two different points of view. The first view represented the opinions of the staff working in direct contact with patients, and the second view represented the management`s opinions of activities leading to quality improvement and care safety. The combination of a quantitative and qualitative study was used to meet the purpose of the thesis. The quantitative part used standardized questionnaires called The Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ), and Systems of Quality Improvement in European Hospitals designed for quality managers and coordinators within the project called Deepening of our Understanding of Quality Improvement in Europe (DUQuE) while this part was complemented by a qualitative study using a semi-structured dialogue. The sample consisted of 427 respondents (331 non-medical healthcare professionals working in direct contact with patients and 96 non-medical healthcare managers. The study using the HSOPSC tool showed that the respondents did not perceive patient safety at their workplace as problematic. They did not expect that patient safety would be put at risk during information handovers and patient transfers. Similarly, the management`s activities leading to patient safety improvement were assessed positively, which is one of key elements of ensuring safety culture. Higher attention should be paid to team cooperation across hospital wards, which influences the care coordination, and also to the personnel measures that influence the management of workload and development of errors. It was studied using the DUQUeE tool which sources and methods were the most common for quality improvement and care safety. Clinical audits and monitoring of work of individual staff nurses were mentioned as the most common systematic activities. Improvement efforts should be focused on the area of supporting information technologies and training dealing with internal peer review, and further projects of quality improvement. The sample of the qualitative study consisted of 9 respondents ? managers responsible for the coordination of quality improvement activities. The qualitative study used a semistructured dialogue, and complemented the quantitative study by the information on the ways of putting some areas into practice. Among others, it was found out that the range and quality of evaluated results corresponded with the absence of training in particular methods at the level of management of non-medical healthcare professions. This thesis has produced both theoretical and practical benefits. The practical benefit includes the recommendation of a suitable combination of testing methods for hospital self-assessments within the concept of safe care. The involvement of staff nurses and management will contribute to more effective promotion of safety and the whole process of continuous improvement, and repeated assessments will enable monitoring of the effect of safety measures. In the theoretical area, this study can extend the approach to management education since it provides various innovative views of safety problems and care quality.