No description available.

Kognitiva sjukdomar är ett samlingsnamn för olika sjukdomar som framför allt påverkar en persons kognitiva funktioner men även till exempel kroppen och personens beteenden. Omkring 55 miljoner personer i världen beräknas ha en kognitiv sjukdom och i Sverige är siffran mellan 130 000–150 000. En stor andel av dessa bor hemma och ofta finns anhöriga som tar ett stort ansvar kring vården. Att vara anhörigvårdare kan upplevas som givande men det är ofta sammankopplat med en hög nivå av stress. Syftet med den här studien är att beskriva anhörigas upplevelser av att vårda en person med kognitiv sjukdom. Metoden för att svara på syftet är en allmän litteraturstudie, där data från 15 vetenskapliga artiklar analyserats och sammanställts. Resultatet delas in i två teman med tillhörande subteman: ”En omkullkastad tillvaro” och ”Att behöva anpassa sig till livsförändringen”. Slutsatsen blir att situationen som den anhörige hamnar i när en närstående får en kognitiv sjukdom ofta är mycket påfrestande. Det påverkar de flesta delar av livet, så som exempelvis vardagen, den egna hälsan, relationer och så vidare. Det finns ofta ett behov av stöd, både från människor i ens närhet och insatser från samhället. Den anhöriga behöver hitta strategier för att hantera den nya livssituationen för att motverka sådant som en låg upplevd livskvalitet och psykisk ohälsa. / Neurocognitive disorders are a group of different disorders that mainly affect a person ́s cognitive functions, but also domains as the physical body and the person ́s behavior. An estimated number of 55 million persons globally are diagnosed with some kind of neurocognitive disorder and the number in Sweden is among 130 000–150 000. The majority of the persons with a neurocognitive disorder live at home and in many cases they have a family member or friend who is responsible for the caregiving, an informal caregiver. The role of the informal caregiver can be rewarding, but it often comes with a high level of strain. The aim of this study is to describe the informal caregiver ́s experience of taking care of a person with neurocognitive disorder. The method that is used is a general literature review that contains data from 15 scientific papers. The data has been analyzed and compiled. The result was categorized in two themes and sub-themes: ”When life is turned upside down” and ”Having to adapt to the life change”. The conclusion is that the situation of being an informal caregiver is very stressful. It affects almost all aspects of one ́s life, including the everyday life, one ́s own health and relationships. The informal caregiver is in need of support from family and friends as well as formal support. The informal caregiver must find constructive coping strategies to deal with the new situation to avoid mental illness or low level of perceived quality of life.

Bakgrund: Prevalens och incidens av demensdiagnoser skiljer sig mellan världsregioner men förväntas öka i samband med befolkningens åldrande och tillväxt. I västerländska länder förväntas demensdiagnoser ligga mer stabilt givet längre livslängd, högre socioekonomisk status och utbildning. Personer med demens får succesivt försämrade kognitiva- och funktionella funktioner samt beteendeförändringar vilket i första hand är en utmaning för en sammanboende partner. Syfte: Syftet är att belysa erfarenheter hos informella vårdgivare som lever i en parrelation med en person med demens Metod: Allmän litteraturöversikt med sökning i databaserna PubMed och CINAHL inkluderade tio vetenskapliga originalartiklar. Data analyserades enligt Graneheim och Lundmans kvalitativa innehållsanalys. Resultat: Studien resulterade i två kategorier: Anta en ny roll som informell vårdgivare och Den nya relationen. Fem subkategorier: Ta över ansvaret i omvårdnaden, sakna externt stöd, utmaningar och beslutsfattande i vardagen, kärlekens förändringar och sorg och oro inför framtiden.   Slutsats: Partners upplevde svårigheter att vara informella vårdgivare och bristen på stöd och information från hälso-och sjukvården försvårar detta ytterligare. Det behövs vidare forskning om positiva aspekter och fördelar med fortsatt sammanboende för partners där den ena har demens. / Background: Prevalence and incidence of dementia differ in the world but are expected to increase with population aging and growth. In Western countries, dementia is expected to be more stable given longer life expectancy, higher socioeconomic status, education. People with dementia gradually experience deteriorating cognitive and functional functions as well as behavioral changes, which is primarily a challenge for a cohabiting partner. Aim: The aim is to illustrate the experiences of informal caregivers who live in a relationship with a person with dementia Methods: General literature review of ten original scientific articles, analyzed using qualitative content analysis according to Graneheim and Lundman. Results: Two categories: Taking on a new role as informal caregiver and The new relationship. Five subcategories: Overtaking the responsibility in nursing, lack of external support, challenges and decision-making in everyday life, the changes of love and sadness and worry about the future. Conclusions: Partners experienced difficulties in being informal caregivers, a lack of support and information from the health care service which made their situation even more difficult. The benefits and positive factors of continued cohabitation with a partner following a dementia diagnosis needs further research.

In Sweden as well as internationally, the demographic development is moving towards an increasingly older population. At the same time the risk for dementia increases with age. This implies a future increased need for care and support for the elderly and for those diagnosed with dementia. Currently, family members already take a substantial responsibility for their relatives´ care and support, which can impose both physical and psychological burdens on the caregivers. The purpose of this study is therefore to explore the experience of informal caregiving. This is achieved through a thematic analysis of three authors´narratives of their relationship with a parent with dementia. The results indicating that informal caregiving is demanding and exhausting while the satisfaction with the relationship provides a sense of purpose, which influence the experience of caregiving. Furthermore, an effective communication and positive interactions with care professionals facilitate the process. Continued research is necessary to assess the specific support that adult children of parents with dementia require.

Stroke är den tredje vanligaste dödsorsaken i Sverige och risken för att insjukna ökar med stigande ålder. Vid stroke har personen drabbats antingen av en infarkt eller av en blödning i hjärnan. Restsymtomen efter en stroke kan uttrycka sig på olika vis. Vanligaste symtomen är domningar eller förlamningar i ansikte, armar och ben. Rehabilitering efter en stroke kan ta lång tid och efter sjukhusvistelsen är det ofta närstående som tar det största ansvaret för omvårdnaden av personen som drabbats av stroke. Syfte med studien var att undersöka närståendes upplevelser och erfarenheter av att vårda en person som drabbats av stroke. Litteraturöversikten genomfördes genom kritisk granskning och analys av kvalitativa och kvantitativa vårdvetenskapliga artiklar, enligt analysmodellen av Friberg (2006). Litteratursökningen gjordes i databaserna Cinahl och Pubmed. I resultatet framträdde två huvudteman : Förändrad livsvärld och Upplevelser och erfarenhet med hälso- och sjukvårdspersonal. Resultatet visade att närstående upplevde en stor livsförändring där rutiner och livsmönster ändrades och anpassades efter personen som drabbats av stroke. Det gjorde att närstående upplevde att det inte fanns tid för egna intressen. Närstående upplevde både psykisk- och fysisk ohälsa som stress, depression, ångest, högt blodtryck, magsmärtor och sömnsvårigheter. Många närstående upplevde att informationen från hälso- och sjukvårdspersonalen var otillräcklig. Det medförde att närstående kände sig osäkra på att vårda den som drabbats av stroke. Sjuksköterskor har möjlighet att påverka närståendes upplevelser genom att bemöta dem på ett respektfullt och lyhört sätt. Det handlar också om att de kan identifiera informationsbehovet för att ge adekvat information som kan stilla närståendes oro. / Program: Sjuksköterskeutbildning

Background and Objectives: Alterations in the habitual sleep/wake patterns of women with breast cancer and their informal caregivers may be concurrently exacerbated and co-vary during the patient’s treatment. The current study set out to longitudinally ex-plore sleep-wake patterns of patient-caregiver dyads in the context of adjuvant chemotherapy (CTh) for breast cancer. Taking into consideration the complexity of mechanisms interfering with a care dyad’s sleep, diverse sleep-impairing factors were also investigated. Design and Methods: Descriptive, observational, repeated-measures dyadic study. Forty eight newly diagnosed women receiving outpatient adjuvant CTh for early stage breast cancer (stage I-IIIA) and their nominated primary informal caregiver completed self-reported sleep measures at pre-treatment (week prior to CTh), post-CTh cycle 1, post-CThC4, and approximately 30 days after the end of CTh (total of =6 cycles received). Additional data on the dyads’ sleep hygiene practices (SH), patient physical burden, caregiving burden (CRACB), psychological burden (PSYCH), nocturnal sleep disturbances (SDSTRB), and maladaptive coping strategies were collected at each assessment point. Results: Prior to CTh, 65% of dyads consisted of at least one poor sleeper, a rate further increasing to approximately 88% at CThC4. Multivariate hierarchical linear modelling revealed curvilinear trajectories for most dyads’ sleep/wake parameters that nevertheless reached significance (p<.05) for patients only. In both groups, sleep/wake impairment reached its peak at mid-treatment (CThC4); yet, patients consistently reported significantly more sleep problems than their carers. Partial convergence also emerged as suggested by positive correlations and no between-groups differences in daily disturbance, daytime napping duration, total sleep time, and overall sleep/wake impairment at pre-treatment. At CThC4, rates of change in sleep latency and daytime napping duration were also similar. In exploratory analyses, increased CRACB, poor SH, and SDSTRB consistently predicted poorer outcomes in the dyad members’ own sleep-wake patterns. Cross-partner effects most frequently emerged with regard to the dyads’ PSYCH, as well as for CRACB. Among the most interesting findings, increased patient PSYCH adversely affected caregiver perceived sleep quality and daytime napping. Reversely, increased CRACB was related to worse patient sleep quality, reduced sleep time, and difficulty to fall asleep. Some links might be suggested for own poor sleep hygiene and worse partner outcomes on daytime functioning, sleep efficiency, or wake after sleep onset. Conclusions and Future Implications: This is one of the first studies to show that a dyadic approach in the assessment of sleep/wake patterns in patients with breast cancer and their informal carers is a promising method to enhance exploration of potentially concurrent sleep/wake-impairment and associations with sleep-impairing factors that may co-vary in dyad members. Replication of the current findings in future dyadic sleep research is warranted. Meanwhile, clinicians will need to engage in concurrent systematic and ongoing sleep assessments that synthesise and contrast data to establish a care dyad’s level of sleep quality.

Objectives. The aim of this thesis was to study the prognosis, health care utilization and health situation in stroke patients, and informal caregiver burden during the first post-stroke year. Material and methods. 390 patients, 65 years or older, discharged from hospital after a stroke, were followed with repeated patient interviews, patient record and register data, and hospital staff and informal caregiver questionnaires. Results. Prognosis assessments performed by hospital staff at discharge regarding the course of events during the following year were highly accurate and were mainly influenced by the patient’s pre- and post-morbid state. The risk of dying or having a new stroke decreased rapidly during the early post-morbid phase. Health care utilization, in hospitals as well as in primary health care, and municipal social service support was considerably higher after the stroke than before, but the utilization of services was lower than previously reported. Health problem prevalence according to interview and record scrutiny was modest, peaked early after discharge and then declined. Support from informal caregivers increased significantly after discharge and remained high during the first post-stroke year. The support given was mainly determined by patient functional ability, distance to patient, relation to patient, municipal social service support provided, and patient sex. The informal caregivers reported considerable strain and burden, with significantly higher levels of anxiety and depression than the stroke patients. Moreover, there was a parallel between the patient’s and the caregiver’s situation regarding anxiety, emotional and social situation, and home, social and outdoor activities. Conclusion. Hospital staff prognosis assessments of patient outcomes during the next year were highly accurate. Risk of recurrence and mortality, and health problem prevalence was high in the early post-stroke period, and than declined. Health care utilization and municipality social support increased over time. Informal caregivers reported considerable strain and burden.

Bakgrund: Minst var tredje person kommer under sin livstid att få en cancerdiagnos. Närstående till dessa personer kommer att spela en central roll i vårdandet. Att som närstående vårda beskrivs ofta som en stressande situation med psykiska och fysiska påfrestningar. Dessa påfrestningar hos närstående kan göra att de riskerar att drabbas av ohälsa. Hur dessa personer väljer att hantera situationen är individuellt och det är varje individs ansvar att se över sin hälsa och skapa strategier för att hantera dessa påfrestande situationer för att främja hälsan.   Syfte: Syftet med denna studie var att beskriva vilka copingstrategier närstående som vårdar patienter med cancersjukdom använder för att bevara den psykosociala hälsan.   Metod: En litteraturöversikt där artiklarna analyserades enligt en analysmodell av Friberg (2012). Artiklar lästes igenom, med fokus på resultat, för att kunna identifiera nyckelfynd. Varje artikels resultat sammanställdes och relaterades till varandra för att få fram nya teman. Orems egenvårdsteori användes vid resultatdiskussionen.   Resultat: Resultatet presenteras i fem huvudteman; Vårdgivande och coping, Kognitiva copingstrategier, Normaliserande copingstrategier, Instrumentella copingstrategier och Psykosociala faktorer. Copingstrategier som framkom var omdirigering av tankar, positivt tänkande, tro, hopp, acceptans, upprätthålla rutiner, stark fasad, jämförelse, stöd och information. Andra områden som framkommer i resultatet är hur närstående utvecklar copingstrategier och förutsättningar för att uppleva stöd, vinster med vårdgivande och coping samt relationen till hälso- och sjukvården.   Slutsats: Resultatet visar en variation på användandet av copingstrategier samt skillnader och likheter i förhållande till dessa. Den enskilda individens erfarenheter och kunskaper spelar också roll vid utveckling av dessa. Copingstrategier tycktes även vara knutna till individens personliga resurser samt egna färdigheter. / Background: At least every third person will be diagnosed with cancer during his/hers lifetime. Relatives, familymembers and friends to these persons will play a central role in caring. Being a care giving relative, a family member or a friend to a person diagnosed with cancer, is often described as a stressful situation with both mental and physical strain. These strains in close relationships may lead to poor health. How each caregiver chooses to handle the situation is individual and he/she has a responsibility to self-assess health and create strategies to promote these stressful health situations.   Aim: The purpose of the study was to describe which coping strategies relatives, familymembers or friends who care for patients with cancer disease use to maintain psychosocial health.   Method: A literature review where the articles were evaluated with an analysis model according to Friberg (2012). Articles were read trough, focusing on results, to identify key findings. The results of each article were compiled and related to each other in order to develop new themes. Orem's self-care theory was applied to the resultdiscussion.   Result: The results were presented in five main themes; Caregiving and coping, Cognitive coping strategies, Normalizing coping strategies, Instrumental coping strategies and Psychosocial factors. Coping strategies that emerged were redirecting thoughts, positive thinking, faith, hope, acceptance, maintaining routines, strong facade, comparison, support, and information. Other areas found in the results are how relatives, familymembers or friends develop coping strategies and conditions for experiencing support, benefits with care and coping and the relationship with healthcare professionals.   Conclusion: The results show a variation in the use of coping strategies as well as differences and similarities in relation to these. Individual's experiences and knowledge play a part in the development of these copingstrategies. Which coping strategies individuals choose also seemed to be linked to their personal resources as well as own skills.

Det är vida känt att psykisk ohälsa är ett aktuellt och ökande problem. Däremot finns det en grupp människor som är starkt knutna till detta fenomen, men som inte uppmärksammas - de anhöriga. Denna kvalitativa och fenomenologiska studie ämnar att skildra hur det är att vara anhörig/informell vårdgivare till någon med psykisk ohälsa, vilka förväntningar de har på sig, samt hur de upplever samhällets stöd. Utifrån teorin om roller och stigma intervjuades tio anhöriga runt om i Sverige för att besvara studiens syfte och frågeställningar. Under analysen uppstod sju teman: upplevelse av vardag, att stötta den närstående, påverkan på den anhörige, roll, eget stöd, omgivningens bemötande och nöjdhet med stöd. Resultatet åskådliggjorde att deras vardag begränsas och att de kunde uppleva oro, skam/skuld, utmattning och bristande aptit. Vidare tar de mycket ansvar och stöttar sina närstående genom samtal och fysisk närvaro. Bemötandet från omgivningen var mestadels positivt, men även negativt. De anhöriga hade också flera självhjälpsstrategier, varav några fick stöd från vänner och/eller sökte hjälp av vården. Det samhälleliga stödet var både bra och dåligt. Slutsatsen är att det är mycket jobbigt att vara anhörig och vården behöver göra mer för dem än vad de gör nu. / It is widely known that mental illness is a current and growing problem. There is however a group of people who are strongly connected to this phenomenon that do not receive enough attention - the relatives. This qualitative and phenomenological study aims to describe what it is like to be a relative/informal caregiver to someone with a mental illness, which expectations they have on them and how they perceive the support from society. Ten relatives from Sweden were interviewed to answer the purpose of the study and the research questions. During the analysis seven themes emerged: experience of the situation, to support the dependant, impact on the relative, role, own support, the treatment from others and satisfaction with the support. The result revealed that the relatives’ every-day life becomes restricted and that they could experience worry, shame/guilt, exhaustion and a loss of appetite. They also take a lot of responsibility and support their dependants through dialogues and being there. The treatment from others is mostly positive but it can also be negative. The relatives also have several self-help strategies, where some get support from friends and/or seeks help from the health care. The social support is both satisfactory and dissatisfactory. The conclusion is that it is very burdensome to be a relative, and that the healthcare should do more for them than they are currently doing.

The aim of this thesis is to inform in detail about the latest clinical and nursing practice trends concerning the needs of patients in vegetative state and their carers. It also deals with relations in the system of long-term nursing care, providing medical and social services and rehabilitation. It also tries to point out the most pressing problems of the current situation of patients in vegetative state and their families, especially in terms of patient discharge to home care and availability of services specified for this target group. The latest findings and proven methods will be summarized in a simple and understandable form, which will serve as a guide both for health professionals and caregivers.For this thesis the Review and synthesis method will be used. The overview of current knowledge and studies in the field of care for patients in vegetative state will be synthesized and focused on home care with recommendations for practice and indications of weak spots.Long-term follow-up nursing and rehabilitative care is necessary for these patients. A special chapter is focused on the specific needs of patients in vegetative state and appropriate nursing care, rehabilitation and release issues. The fundamental part is the consistency of formal and informal care, caregiver preparation for their future role and related socio-economic issues. In conclusion the legal and ethical aspects of the whole field are mentioned regarding medical and nursing care of patients in vegetative state.In line with the objective of this thesis a manual will be created for potential informal carers on how to care for their loved ones, where to go in the case of emergency and what steps to take during the intermediate stage of institutional and home care. The results can be used for further exploration and as an additional source of information for health professionals.