Multiple sclerosis is a commonly diagnosed neurological disease that currently has no cure. Due to the significant physical and emotional impact that this disease has on the course of life, depressive symptoms frequently occurs among its sufferers. Many interventions have been developed and studied in an effort to reduce the depressive symptoms without the use of traditional antidepressant medications. This integrated literature review examines empirical evidence regarding non-pharmacologic interventions for depression published between 2003 and 2008. Cognitive behavioral therapy, complementary therapy, and support interventions were examined. Although no single intervention was shown to completely alleviate depressive symptoms, most interventions had a favorable impact.

The needs of the informal caregiver can be difficult to determine apart from those related to caring for the terminally ill loved one. Often, informal caregivers' individual needs are lost because of their day-to-day responsibility and care of their terminally ill loved one. The purpose of this project was to discover the characteristics of informal caregivers of the terminally ill. An integrated literature review was conducted using the Fineout-Overhalt, Melnyk, Stillwell, and Williamson's (2010) analytical approach to reviewing the evidence. The approach consisted of 7 levels for evaluating the hierachy of evidence. Inclusion criteria were studies limited from January 2004 to October 2015, English language, and full text. A total of 22 studies were reviewed and categorized according to 1 of the 7 hierachial levels, and findings related to the characteristics of informal caregivers were summarized at each appropriate level. Characteristics of informal caregivers were described regarding sociodemogrphics, such as age, gender, relationship with family members, financial status, and educational level. Characteristics of informal caregivers were discussed in relationship to the terminally ill loved one. The evidence did not concentrate on who the informal caregiver was without assessing their relationship to the terminally ill patient. It is recommended that a mixed-method approach be conducted to indentify characteristics of informal caregivers outside of their relationship with the terminally ill. Gaining a new perspective about the characteristics of informal caregivers for the terminally ill patient would help health care providers to more effectively meet their needs independent of the needs of the terminally ill loved one.

Introduktion: Befuktning vid mekanisk ventilation är nödvändigt för att inte skador skall uppstå i luftvägarna. Luften kan befuktas aktivt eller passivt och då tekniken ständigt utvecklas kan tidigare riktlinjer för vilken metod som är bäst behöva revideras. Syfte: Studiens syfte var att undersöka evidensen för användning av aktiv befuktning hos intuberade eller trakeostomerade patienter. Metod: I enlighet med Whittemore & Knafls metod utfördes en integrerad litteraturstudie. Litteratursökning gjordes i databaserna PubMed, CINAHL och Cochrane. Även en manuell sökning i referenslistor utfördes och ledde till att totalt 14 artiklar valdes ut, varav 13 var kvantitativa och 1 kvalitativ. Resultat: Analysen av de 14 artiklarna resulterade i fyra huvudkategorier med efterföljande underrubriker: Aktiv befuktnings påverkan på nosokomiala infektioner: Infektionsincidens och Infektionstyp; Aktiv befuktnings påverkan på luftvägsproblem: Ocklusionsproblemoch Sekretviskositet/sekretmängd; Aktiv befuktnings påverkan på mekanisk ventilation: Vårdtid med mekanisk ventilation och Påverkan på andningsarbete;Upplevelse av aktiv befuktning: Upplevd påverkan på hälsa och Negativ påverkanpå vårdmiljön. Konklusion: Denna studie var att aktiv befuktning har en viktigfunktion att fylla hos vissa patienter, men borde inte användas slentrianmässigt.Sjuksköterskan har en viktig roll i att hitta de patienter som är mest hjälpta av det. / Introduction: Humidification during mechanical ventilation is necessary to avoid damage in the airways. The air can be humidified actively or passively and since thetechnique is constant developing the guidelines for which of the alternative that’sthe best may need to be revised. Aim: The aim of the study was to examine the evidence of using active humidification in intubated patients or in patients withtracheostomy. Method: An integrated literature review according to Whittemore &Knafl was carried through. The literature search was done in the databases PubMed, CINAHL and Cochrane. A manual search in reference lists was also made and resulted in a total of 14 articles whereof 13 were quantitative and one was qualitative. Result: The analysis of the 14 articles led to four main categories with the following subcategories: Active humidifications influence on nosocomial infections: Infectionincidence and Infection type; Active humidifications influence on airway problems: Occlusion problems and Mucus viscosity/mucus volume; Active humidifications influence on mechanical ventilation: Time on mechanical ventilation and Influenceon respiratory work; Experience of active humidification: Experienced influence on health and Negative impact on hospital environment. Conclusion: The conclusion of this study was that active humidification is the better choice among certain patientgroups but should not be used routinely. The nurse plays an important role in finding the patients who can benefit the most of it.