Bakgrund: HBV och HCV tillhör gruppen blodburna smittor, och är ett världshälsoproblem. Enligt smittskyddslagen klassas de som allmänfarliga sjukdomar, och det finns även kliniska riktlinjer och förhållningsregler gällande omvårdnad av dessa patienter. Att arbeta som sjuksköterska utgör en risk för att smittas av bland annat blodburna virus i vården av infekterade patienter. Vid kroniska sjukdomar förekommer ofta stigmatisering, i form av fördomar och negativt bemötande. Personer smittade med HBV och HCV är två patientgrupper som kan råka ut för detta. Syfte: Syftet med denna litteraturstudie är att undersöka om kunskaper och attityder påverkar sjuksköterskor och sjuksköterskestuderande i vården av HBV- och HCV-patienter.Metod: En litteraturstudie där tio kvantitativa vetenskapliga artiklar valdes ut och därefter granskades, analyserades och sammanställdes.Resultat: I några av artiklarna syntes ett starkt samband mellan kunskap och attityder. Det vill säga, desto mer kunskap de hade, desto positivare attityd visades. Viljan att behandla patienter skiljdes åt beroende på hur de hade smittats med infektionen. Även trodde sig många behöva extra infektionsskydd vid omvårdnad av dessa patienter. / Background: HBV and HCV belong to the group of blood-borne infections, and are a global health problem. According to Smittskyddslagen they are both classified as diseases generally known to be dangerous to the public. There are also clinical guidelines and instructions regarding the care of these patients. Working as a nurse poses a risk of contracting blood-borne viruses in the care of infected patients. People with chronic diseases are sometimes exposed to stigmatization, in the form of prejudices and negative approaches. People infected with HBV and HCV are two groups of patients who may experience this.Aim: The aim of this study is to investigate whether knowledge and attitudes are affecting nurses and nursing students in the care of HBV and HCV patients.Method: A literature review where ten quantitative scientific articles were selected, reviewed, analyzed and summarized.Results: In some of the articles a strong correlation between knowledge and attitudes appeared. That is, the more the knowledgeable they were, the more positive attitudes they showed. The desire to treat patients could be differentiated, depending on how the patients had contracted the infection. Several nurses and nursing students thought it was necessary to use extra infection control, for example double gloves, when caring for these patients.

Bakgrund: Runt om i världen lever det idag flera miljarder människor med olika blodsmittor. Det finns omkring 34 miljoner individer som bär på HIV-viruset, två miljarder människor som har hepatit B medan det uppskattningsvis finns 130 – 170 miljoner människor i världen som är drabbade av kronisk hepatit C. Med tanke på den höga prevalensen förekommer denna patientgrupp inom olika delar av vården, där det då även kan förekomma en exponering av smittförande blod. Syfte: Syftet med denna studie är att belysa grundutbildade sjuksköterskors upplevelse av att vårda patienter med känd blodsmitta på kirurgiska vårdavdelningar. Metod: En empirisk studie med kvalitativ ansats, där intervjuer med en semistrukturerad intervjuguide och en del slutna frågor användes. Datan analyserades med hjälp Burnards innehållsanalys. Resultat: Sjuksköterskorna menar att patientens beteende, situationens karaktär och arbetsklimatet är av betydelse för hur de upplever vårdandet av patienter med känd blodsmitta. I situationer då någonting oväntat händer och risken för exponering av smittat blod drastiskt ökar upplever en del av sjuksköterskorna en viss rädsla. De upplever att erfarenhet ger trygghet bland annat genom att de drar lärdom från patienterna och att erfarenheten av att möta patienter med blodsmitta gör dem tryggare i rollen som vårdare. Majoriteten av sjuksköterskorna upplever dock att de inte har tillräcklig kunskap om olika blodsmittor, men menar att detta inte påverkar deras upplevelse. Slutsats: Studien har visat att det finns flera faktorer som påverkar sjuksköterskornas upplevelse av att vårda patienter med känd blodsmitta, men att de i de flesta tillfällena inte upplever vårdandet som annorlunda än det av övriga patienter. Trots att de i vissa situationer kan uppleva ett visst obehag så menar de att alla människor, oavsett sjukdom, har rätt till samma vård. / Background: Around the world today there are billions of people living with different types of blood infections. Approximately 34 million are carriers of the HIV-virus, two billion are infected with hepatitis B and approximately 130 – 170 million people are living with a chronic infection of hepatitis C. Considering the high prevalence, these patients are present in all different sections of the health care system, adding a risk of exposure to infected blood. Aim: The aim of this study is to illuminate registered nurses’ experiences when caring for patients with known blood infections in surgery departments. Method: An empirically structured interview study with a qualitative approach, using a semi-structured interview guide with additional closed-ended questions. The data was analyzed by using a content analysis method by Burnard. Results: According to the nurses the patients’ behavior, the nature of the situation and the work climate impacts on their experience of caring for patients with known blood infections. In situations where something unexpected occurs and the risk of exposure to infected blood is highly increased, some of the nurses experience a certain amount of fear. They perceive they achieve safety through the experience of caring for, and gaining knowledge from, these patients. Their experience of meeting these patients helps them become more confident in their role as caregivers. The majority of the nurses also feel they lack sufficient knowledge of blood infections, however they argue this does not have an effect on their experiences. Conclusions: This study has shown that there are several factors affecting the nurses’ experiences of caring for patients with known blood infections, but, in most cases, they do not perceive these experiences as different from that of any other patient. Even though some nurses experience a certain amount of discomfort in unexpected situations, they argue that all humans, regardless of the disease, have the right to equal health care.

Introduction: Hepatitis B is a highly contagious infection. Basic knowledge about hepatitis B is necessary; with more knowledge people take preventive actions against hepatitis B, such as using stick proof cannulas. In Thailand an expected number of 8-20% of the population are currently carriers of the HBV infection.   Aim: The aim of the study was to investigate the knowledge about hepatitis B and the attitudes towards the vaccination among Thai university students.   Method: A cross-sectional study with a quantitative method was used. 280 students participated in the study, and the response rate was 93.9 %. The data was analysed using SPSS Statistics 20.   Result: Both genders had poor knowledge about hepatitis B, however 91.1 % of the students had heard about hepatitis B. About half of the students (55.4 %) knew correctly that hepatitis B is sexually transmitted and 40.0 % of the students knew that hepatitis B could cause liver cancer. There was no significant difference in knowledge between the genders. The attitudes towards the vaccine were satisfactory between both genders, 89.3 % of the students knew that healthy people need the vaccination and 81.1 % believed that they would receive the vaccination. However, only 43.6 % knew that the vaccination could be free or low cost through certain programs. There was a significant difference (p-value = 0.042) between the genders; the male students had a more positive attitude towards the vaccine than the female students.   Conclusion: The results from the Thai students showed that more information about the Hepatitis infection is needed to raise awareness among this certain group of people. Information about how it is transmitted is essential to improve the public health. It is also important to improve the individual's self-care, to encourage them to receive the vaccination. From a nursing point of view improving the knowledge about HBV and a positive attitude towards the vaccine in the prolonging contribute to improve the public health by getting a lower rate of cases with HBV.

Humant immunbristvirus (HIV), hepatit B och C är blodsmittor som finns världen över. Dessa tre sjukdomar anses som allmänfarliga och som anmälningspliktiga sjukdomar. Livet med en smittsam blodsjukdom kan vara påfrestande för en patient, både fysiskt och psykiskt. Syftet med denna litteraturstudie var att beskriva patienters upplevelse av att leva med en smittsam blodsjukdom. Studien är en allmän litteraturstudie, där kvalitativ forskning användes för att få fram resultatet. Resultatet består av tre teman och sju subteman. De teman som skapades var: rädsla, känslan av att vara osedd och känslan av att vara sedd. Livet med en smittsam blodsjukdom kan vara påfrestande för en patient. Rädslan för sjukdomens konsekvenser är stor. Socialt stöd från anhöriga och sin omgivning har stor påverkan på patientens liv. Brist på socialt stöd kan bidra till att patienten drar sig undan, tar till alternativa hjälpmedel såsom alkohol och narkotika samt till att patienten utvecklar depression. Som vårdpersonal är det viktigt att se patienten bakom den smittsamma blodsjukdomen, då patienter ibland upplever mötet med sjukvården som något negativt. Vårdpersonalen som är rädda för sjukdomen, är även rädda för att bli smittade. Det bidrar till att patienten känner sig dömd och väljer att avstå från behandlingar. / Human immunodeficiency virus (HIV), hepatitis b and c are contagious blood diseases that exists worldwide. These three diseases are considered to be generally dangerous and as a notifiable disease. Living with a contagious blood disease can be stressful to patients both physically and mentally. The purpose of this literature study was to describe patients' experience of living with contagious blood diseases. The study is a general literature study, where qualitative research was used to produce the result. The result consists of three themes and seven different subthemes. That resulted in the creation of three themes: fear, the feeling of being unseen and the feeling of being seen. Living with a contagious blood disease can be stressful to a patient. There is a great fear for the consequence of the disease. Getting social support from relatives and their social environment has a major impact on the patient's life. The lack of social support can make the patient avoid social contact. Patients’ take alternative means such as alcohol, drugs and the patient can develop depression. As a formal caregiver it is important to see the person behind the infection, as the patient experience the meeting with formal caregivers as negative. The formal caregivers are afraid of the disease and to be infected. The patient feels judged and chooses to avoid treatment.

Made available in DSpace on 2014-07-29T15:04:35Z (GMT). No. of bitstreams: 1 Grecia Carolina Pessoni.pdf: 1074052 bytes, checksum: 1a6c39b31bb8fa1188db36c9d804d866 (MD5) Previous issue date: 2010-04-05 / In order to investigate the seroepidemiological profile of hepatitis B virus (HBV) infection among female inmates from the Metropolitan Region of Goiânia, 148 women were interviewed on sociodemographic and risk factors for HBV. After, blood samples were collected for the detection of HBsAg, anti-HBs and anti-HBc by enzyme linked immunosorbent assay (ELISA). The majority of women had less than 36 years of age (77.1%), less than nine years of education (69.8%) and family income less than two Brazilian minimum wage (65.2%). Almost half (46.6%) of female inmates reported stable relationships. An overall HBV prevalence of 18.9% was found. One (0.7%) woman was HBsAg-positive. The anti-HBc was detected in 27 (18.2%) women, being 25/27 associated to anti-HBs, and 2/27 alone. In only 36 (24.3%) female inmates the anti-HBs isolated was detected, suggesting previous hepatitis B vaccination. The analysis of risk factors showed that age over 35 years, less than ten years of education, sexual partner in the prison , and previous STD were independently associated to HBV markers. The results of this study highlight the need for action to prevent the hepatitis B in the prison environment, including health education and immunization against hepatitis B. / Com o objetivo de investigar o perfil soroepidemiológico da infecção pelo vírus da hepatite B (HBV) em reeducandas da Regional Metropolitana de Goiás, 148 mulheres foram entrevistadas sobre dados sócio-demográficos e fatores de risco para a infecção pelo HBV. A seguir, foram coletadas amostras sanguíneas para a detecção dos marcadores HBsAg, anti-HBs e anti-HBc pelo ensaio imunoenzimático (ELISA). A maioria possuía menos de 36 anos de idade (77,1%), tempo de estudo inferior a nove anos (69,8%) e renda familiar de até um salário mínimo (65,2%). Praticamente a metade (46,6%) referiu relacionamento estável. Do total de reeducandas, verificou-se uma prevalência global de 18,9% para os marcadores da infecção pelo HBV. Uma (0,7%) reeducanda apresentou positividade para o HBsAg. O marcador anti-HBc foi detectado em 27(18,2%) mulheres, sendo que em 2/27 isoladamente e, em 25/27 associado ao anti-HBs. Em somente 36 (24,3%) reeducandas detectou-se positividade isolada para o anticorpo anti-HBs, sugerindo vacinação prévia contra o vírus da hepatite B. A análise dos fatores de risco mostrou que idade acima de 35 anos; escolaridade inferior a 10 anos, parceiro na agência prisional e antecedentes de DST foram independentemente associados aos marcadores de exposição ao HBV. Os resultados deste estudo evidenciam a necessidade de ações de prevenção da hepatite B no ambiente carcerário, incluindo educação em saúde e vacinação contra hepatite B.

Bakgrund: De tre vanligaste blodburna smittor som vårdpersonalen träffar på är humant immunbristvirus (HIV), hepatit C samt hepatit B. Dessa sjukdomar sprider sig via blodprodukter och medför en risk att vårdpersonalen kan bli smittade i sitt arbete. Risk för stigmatisering hos vårdpersonalen finns då sjukdomarna ofta förknippas med homosexualitet och intravenöst drogmissbruk. Risken är att patienter upplever sig diskriminerade av vårdpersonalen och att det påverkar omvårdnaden. Syfte: Syftet var att undersöka vårdpersonalens attityd mot patienter med blodburen smitta samt patienters upplevelse av vården och omvårdnaden. Metod: En litteraturstudie bestående av sex kvantitativa artiklar, fyra kvalitativa artiklar samt två mix-metod artiklar där det gjordes en induktiv analys av artiklarna för att tolka resultatet. Resultat: Det existerar en stigmatiserande attityd hos viss vårdpersonal mot patienter med blodburen smitta. En del i vårdpersonalen känner även av en viss rädsla mot patienterna med blodburen smitta, då rädslan grundar sig i att själva bli smittade. Rädslan och den stigmatiserande attityden påverkar vårdpersonalens vilja samt trygghet att vårda patienter med blodburen smitta. Patienter upplever och känner sig diskriminerade av vårdpersonal som har en stigmatiserande attityden samt visar rädsla gentemot dem. Patienterna har då större risk att undvika vården. Det som patienter upplever bra är när de får träffa samma personal som de kan lära känna och som vet deras historia. Slutsats: Viss vårdpersonal har en stigmatiserande attityd och rädsla mot patienter med blodburen smitta och detta grundar sig i vårdpersonalens okunskap och låga utbildning. Patienter märker av och känner sig diskriminerade av vårdpersonal som visar rädsla samt en stigmatiserande attityd mot dem. Detta påverkar patienters vård då patienter undviker vården eller inte får samma vård av vårdpersonalen på grund av sin sjukdom. / Background: The three most common blood-borne pathogens that the healthcare professional encounters are human immunodeficiency virus (HIV), hepatitis C and hepatitis B. These pathogens spread through blood products and there is a risk that the healthcare staff gets infected in their work. There is a risk of stigma among healthcare professionals as the pathogens are often associated with homosexuality and intravenous drug abuse. At the same time, the risk is that patients feel discriminated by the healthcare staff and that it affects their care. Purpose: The aim was to investigate the attitudes of the healthcare professionals towards patients with blood-borne pathogens as well as patients' experience of their care and nursing. Method: A literature study was based on six quantitative articles, four qualitative articles and two mix-method articles in which an inductive analysis of the articles was performed to interpret the results. Result: There is a stigmatizing attitude among healthcare professionals towards patients with bloodborne infection. Some of the healthcare staff also feel a certain fear of the patients with blood-borne infection and the fear is based on being infected themselves. Fear and stigmatizing attitudes affect the will of the healthcare staff and the safety of caring for patients with blood-borne infection. Patients experience and feel discriminated against by healthcare professionals who have a stigmatizing attitude and fear of them. Patients are then at greater risk of avoiding care. What patients feel good about is when they get to meet the same staff they can get to know and that knows their history. Conclusion: Some healthcare professionals have a stigmatizing attitude and fear of patients with blood-borne infection and this is based on the healthcare staff's knowledge and low education. Patients notice and feel discriminated against by healthcare professionals who display fear as well as a stigmatizing attitude towards them. This affects patients' care as patients avoid the care or do not receive the same care from the care staff due to their illness. Keywords: Blood-Borne Pathogens, healthcare professionals, patient, HIV, hepatitis B & hepatits C.

Title: Nurse’s experience of spreading awareness about self-care regarding Hepatitis B in Bali, Indonesia: A qualitative study. Background: Three to seven percent of the population has Hepatitis B (HBV) in Indonesia and six percent in Bali. Patients who apply self-care are more likely to achieve health. Self-care is about hygiene and eating habits where the healthcare provider should support the patient. Dorothea Orem’s theory about self-care is about the relationship between patients’ self-care abilities and needs for nursing support.  Aim: Describe nurses’ perception and experiences of informing patients about self-care regarding HBV in Bali, Indonesia. Method: Qualitative design, with semi-structured interviews with an inductive approach. Ten nurses have been interviewed at three hospitals and clinics in Bali.  Result: Three main findings, 1. Perception and experience of what information needed for a patient about self-care, 2. The nurses’ perception and experience of informing patients about transmission, 3. The nurses’ perception and experience of who is responsible for informing about vaccination for HBV. The result is presented in themes and subthemes. Conclusion: The nurses' experiences of informing patients about self-care regarding HBV, include hygiene, sexual contact, transmission, and vaccination. Their experiences differ in certain themes. However, nurses share their thoughts about self-care, even if their work experience differs. / Titel: Sjuksköterskans erfarenhet av att sprida medvetenhet om egenvård angående Hepatit B i Bali, Indonesien: En kvalitativ studie. Bakgrund: I Indonesien har tre till sju procent av befolkningen Hepatit B (HBV), samt sex procent på Bali. Patienter som tillämpar egenvård är mer benägna att uppnå hälsa. Egenvård handlar om att patienten tar hand om sina matvanor, hygien och medicinering, där vårdgivaren ska stötta och motivera patienten. Dorothea Orem’s teori om egenvård handlar om relationen mellan patienternas egenvårdsförmåga och behov av omvårdnadsstöd.   Syfte: Beskriva sjuksköterskors uppfattning och erfarenhet av att informera patienter om egenvård angående HBV i Bali, Indonesien.  Metod: Kvalitativ design, med semi strukturerade intervjuer och en induktiv ansats. Tio sjuksköterskor har intervjuats på tre sjukhus och kliniker på Bali.Resultat: Tre huvudfynd, 1. Uppfattning och erfarenhet om vilken information som behövs om egenvård, 2. Sjuksköterskornas uppfattning och erfarenhet av att informera patienter om smittspridning, 3. Sjuksköterskornas uppfattning och erfarenhet av vem som ansvarar för att informera om vaccination mot HBV. Resultat presenteras i teman och underteman. Slutsats: Sjuksköterskornas erfarenheter att informera patienter om egenvård kring HBV innefattar hygien, sexuell kontakt, smittvägar och vaccination. Deras erfarenheter skiljer sig åt i vissa teman. Sjuksköterskorna delar de flesta åsikter om egenvård även om deras arbetslivserfarenhet skiljer sig åt.