Studiens syfte var att bedöma omvårdnadsbehov hos patienter som vårdas på en medicinsk vårdavdelning och hur dessa kan beskrivas med hjälp av omvårdnadsdiagnoser enligt North American Nursing Diagnosis Association [NANDA]. NANDA är en internationell sjuksköterskesammanslutning som har skapat ett system med standardiserade omvårdnadsdiagnoser vilka inte finns översatta till svenska. Alla diagnoser är underbyggda av forskning och delas i domäner och klasser. Omvårdnadsdiagnoserna identifieras hos patienten genom karaktäristiska kännetecken, relaterade faktorer och riskfaktorer. Studien var en deskriptiv, kvantitativ studie med empirisk metod och kvalitativ ansats, där 25 patienter deltog. Datainsamlingen bestod i att samla information om patienternas omvårdnadsbehov genom att läsa journaler och intervjua patienter. Omvårdnadsbehoven sammanställdes och omvårdnadsdiagnoser enligt NANDA identifierades. Omvårdnadsdiagnoserna jämfördes med patienternas bakgrundsfaktorer. Författarna fann att patienternas omvårdnadsbehov kunde beskrivas med hjälp av standardiserade omvårdnadsdiagnoser enligt NANDA. Dessa upplevdes som säkrare och lättare att använda än att formulera omvårdnadsdiagnoser i fri text enligt Carnevalis modell. En brist hos NANDA var att det fanns omvårdnadsbehov som inte kunde beskrivas. De vanligaste omvårdnadsdiagnoserna var risk för fall, sömnsvårigheter och akut smärta. Hög ålder, att vara kvinna, underviktig, ha fetma och många medicinska bidiagnoser bidrog till ett högt antal omvårdnadsdiagnoser. NANDAs omvårdnadsdiagnoser reflekterade den vårdtyngd som bedömdes med KATZ index.

Syfte:Beskriva sjuksköterskors uppfattning och upplevelser av att använda omvårdnadsdiagnoser i det kliniska arbetet med fokus på användande av kännetecken och relaterade faktorer. Metod:En deskriptiv intervjustudie med kvalitativ design. Datainsamlingen har skett genom semistrukturerade intervjuer med tio sjuksköterskor som arbetar på två akutmedicinska enheter. Det insamlade materialet har efter utskriften genomgått en manifest kvalitativ innehållsanalys med induktiv ansats. Resultat: Informanterna kom i sitt dagliga arbete i kontakt med och arbetade utifrån omvårdnadsdiagnoser främst i standardvårdplaner men också i individuella vårdplaner. Alla var positivt inställda till att använda vårdplaner och omvårdnadsdiagnoser. Den struktur som arbetet med vårdplaner och omvårdnadsdiagnoser gav till dokumentationen upplevdes som positiv för den medförde tydlighet och en gemensam grund att arbeta utifrån. Medvetenheten om de kriterier och relaterade faktorer som idag finns i den elektroniska patientjournalen var låg. Diskussioner om omvårdnadsdokumentation eller omvårdnadsdiagnoser var inte vanligt förekommande på enheterna. Slutsats: Det finns en omedvetenhet på de studerade enheterna om hur man på ett optimalt sätt kan använda vårdplaner med omvårdnadsdiagnoser. Idag används kliniska kännetecken och relaterande faktorer inte i någon större utsträckning vilket gör att kvalitén och jämförbarheten på omvårdnadsdiagnoserna varierar.

In a theoretical part of the paper, the main focus is on characteristics and terminology of premature babies, breastfeeding, classification systems NANDA International, NIC and NOC, about also management which is an integral part of nursing process. Both quantitative and qualitative researches were used to obtain and process all data. In quantitative method was used a method of document was used, content analysis and quasiexperiment. Results of quantitative research were processed in SPSS software, version 16.0 Statistical Package for Social Sciences, where a method of nonparametric correlation was used. A pen and paper interview with open questions was used in qualitative section of research. Before the research itself, a deputy of nursing care in hospital Nemocnice České Budějovice, a.s. was addressed. The research was implemented between February 2013 and April 2013. First research cluster consisted of nine mothers and eleven premature babies in which two of the mothers had twins. Basic criteria for entering the research, was a necessary hospitalization of both the mother and the child, which the hospital Nemocnice České Budějovice, a. s. offers. The major criterion was an initiated lactation. Second research sample consisted of nurses working at Stanice intermediární péče II. (IMP II ? rooming) of Nemocnice České Budějovice a. s. First of goals was to create files from classification systems NANDA International, NIC, NOC for development and support of breastfeeding for premature babies. The main goal of this work was to create a comprehensive documentation mediated by classification systems NANDA International, NIC, NOC for growth and support of premature babies. The theoretical content of the paper itself was used to create documentation and its usage in praxis. It was not mentioned to create new, but to apply already well known, verified and proven classification systems, which can make not only breastfeeding, but also the daily routine of a nurse more efficient. The suggested documentation solves the issues of breastfeeding of premature babies to help mothers, but also to increase a professional prestige of nurses. Documentation was compiled to include all the necessary information needed for the correct nursing process method. Significant part of documentation is a preliminary case history of mother and child, which offered valuable information. Further attribute were nursing diagnoses dealing with breastfeeding issues of premature babies and intervention realized during hospitalization. It was necessary to address each entry concerned with premature babies individually, based on complex evaluation of overall condition. Many pieces of knowledge from specialized literature on the topic of premature babies and personal experience of doc. PhDr. Mária Bolendovičová, PhD. were used to create the documentation. Second aim of the study was verification of selected specimens on clinical praxis. Third aim was to monitor nurses in Stanice intermediární péče II. (IMP II ? rooming) and their attitude to usage of classification systems NANDA International, NIC and NOC. Based on interviews with nurses it was proven that nurses have better knowledge of NANDA Internationals classification systems than knowledge of NIC and NOC. Final documentation was tested in the perspective of medical staff and its exploitability in clinical praxis. It was found that nurses sense the classification systems NANDA International, NIC and NOC as an appropriate tool, but only with more staff present to work on station. From statements of nurses was clear that establishing a diagnoses is a responsibility of each nurse taking part in nursing process.

Bakgrund: Sexualitet spelar stor roll för hälsa och välbefinnande och då en sjukdom är färdigbehandlad kan sexuell dysfunktion finnas kvar som en följd av den tidigare sjukdomen. Sexuell dysfunktion innebär att sexualiteten inte fungerar tillfredsställande och kan vara upplevda, förväntade eller negativa förändringar. Sexualitet har visat sig vara något som sjuksköterskor har svårt att prata med patienter om och som följd dokumenteras det lite i ämnet. Syfte: Syftet var att beskriva sexuell dysfunktion vid olika somatiska sjukdomstillstånd. Metod: En litteraturstudie med deskriptiv design och systematisk sökning gjordes och 14 kvantitativa artiklar inkluderades i litteraturstudien. Deduktiv metod användes vid sortering av data. De valda rubrikerna var NANDA:s kännetecken för omvårdnadsdiagnosen Oro över egen sexualitet. Resultat: Litteraturstudiens huvudfynd var hur vanligt förekommande sexuell dysfunktion faktiskt var. Män beskrev erektil dysfunktion, ejakulationsproblem samt impotens och kvinnor beskrev orgasmproblematik och försämrad partnerrelation. Både män och kvinnor beskrev minskad sexuell lust, könsdrift, upphetsning och tillfredställelse. De beskrev även smärta vid sexuell aktivitet. Sexuell dysfunktion beskrevs bero på patienternas hälsotillstånd. Slutsats: Det pratas och dokumenteras för lite om sexualitet inom hälso-och sjukvården baserat på förekomsten av sexuell dysfunktion. Genom att uppmärksamma patientens sexuella dysfunktion kan patienten få hjälp att återställa hälsa och öka välbefinnandet.

Biosphere reserves have evolved out of a responsibility to resolve conflict by reconciling the needs of humans with the need to maintain ecological integrity and biodiversity. Participatory approaches to planning and management are seen as key to linking conservation and sustainable development. The purpose of this research was to investigate participation in planning and management activities in the Nanda Devi Biosphere Reserve (NDBR) located in Uttaranchal, India. Eco-development and microplanning have emerged in India as two government-initiated mechanisms allowing greater opportunity for other sectors to have a role in conservation-related planning and management activities. Although there has been progress in the application of participatory processes, the two case studies in this research illustrate the need to bolster civic and private sector participation in planning and management of the NDBR. One important and positive outcome of the participatory processes that were applied was that relationships had improved between the sectors. / February 2007

Biosphere reserves have evolved out of a responsibility to resolve conflict by reconciling the needs of humans with the need to maintain ecological integrity and biodiversity. Participatory approaches to planning and management are seen as key to linking conservation and sustainable development. The purpose of this research was to investigate participation in planning and management activities in the Nanda Devi Biosphere Reserve (NDBR) located in Uttaranchal, India. Eco-development and microplanning have emerged in India as two government-initiated mechanisms allowing greater opportunity for other sectors to have a role in conservation-related planning and management activities. Although there has been progress in the application of participatory processes, the two case studies in this research illustrate the need to bolster civic and private sector participation in planning and management of the NDBR. One important and positive outcome of the participatory processes that were applied was that relationships had improved between the sectors.

Biosphere reserves have evolved out of a responsibility to resolve conflict by reconciling the needs of humans with the need to maintain ecological integrity and biodiversity. Participatory approaches to planning and management are seen as key to linking conservation and sustainable development. The purpose of this research was to investigate participation in planning and management activities in the Nanda Devi Biosphere Reserve (NDBR) located in Uttaranchal, India. Eco-development and microplanning have emerged in India as two government-initiated mechanisms allowing greater opportunity for other sectors to have a role in conservation-related planning and management activities. Although there has been progress in the application of participatory processes, the two case studies in this research illustrate the need to bolster civic and private sector participation in planning and management of the NDBR. One important and positive outcome of the participatory processes that were applied was that relationships had improved between the sectors.

Background: Road traffic accidents are on the rise in low income countries and have a large socioeconomic impact on Uganda. In Uganda, the nurse-patient ratio is 50-100 patients per nurse which is higher than in Sweden, and the patients’ next-of-kin are involved to assist with nursing care. Victims of road traffic accidents demand a lot of nursing care but contextual limitations give patients different opportunities for recovery. A common nursing language, as NANDA and NIC, aim to make communication more efficient; ease work for the staff and make the care better for the patients. Setting: The study was conducted at Mulago Hospital in Kampala, Uganda. Method: Participant observation was used when observing the nursing care of 24 patients. Field notes were analyzed using manifest content analysis. Aim: The aim of this study was to identify the nursing panorama of patients with musculoskeletal injuries in their context. Result: The ratio between the ten most common diagnosis and interventions showed to be 222:59. The diagnostic span and the range of interventions varied according to if staff or next-of-kin performed the nursing of the patients. Conclusion: Using NANDA and NIC, revealed the next-of-kin in the study being responsible for nursing diagnoses and interventions.

Background: Lifestyle related non-communicable diseases are now the biggest cause of death and burden of disease in Thailand. NANDA is an evidence- based classification system of nursing diagnosis. Aim: The purpose of the study was to identify and describe the nursing needs of a patient group from a low socio-economic background located in an urban primary health-care setting in Thailand by using NANDA. Method: The study is a structured observation study with a quantitative approach. The study was conducted at a health- center in Bangkok, Thailand. Result: 42 different NANDA diagnoses were identified in the observed group. In total 609 nursing diagnoses were distributed among 96 patients of which 76 were women. The most frequent nursing need diagnosis found was; Imbalanced nutrition; more than body requirement. The most frequent nursing risk diagnosis identified was: Risk for decreased cardiac tissue perfusion. Conclusion: The nursing needs observed in the patient group were mainly related to non- communicable diseases. The disease panorama observed in the patient group coherent with findings in international modern research. Significant relationships and patterns between nursing needs could be identified which strengthens the idea of using an instrument such as NANDA. In conducting the study it was evident that some nursing problems did not match with any diagnosis in the NANDA taxonomy. Clinical impact: The study shows the nursing needs among a patient group with low-socio economic backgrounds in an urban primary health care setting in Bangkok. NANDA is a good tool to systematize nursing care in the nursing profession. It can be beneficial for students in similar situations to use a tool like NANDA to categorize their assessments and impressions. / Bakgrund: Livsstil relaterade icke-smittsamma sjukdomar är numera den största dödsorsaken och sjukdomsbördan i Thailand. NANDA är en evidensbaserad klassificeringssystem av omvårdnad diagnos. Syfte: Syftet med studien var att beskriva och identifiera omvårdnadsbehov hos en patientgrupp med låg socioekonomisk bakgrund inom primärvården i Bangkok genom att använda NANDA. Metod: Studien är en strukturerad observationsstudie med en kvantitativ ansats. Studien genomfördes på en primärvårsinstans i Bangkok. Resultat: 42 olika NANDA diagnoser identifierades i den observerade gruppen. Totalt fördelades 609 diagnoser på 96 patienter, varav 76 var kvinnor. Vanligaste omvårdnadnadsdiagnosen var Obalanserad kost, mer än kroppsbehovet. Den vanligaste omvårdnads riskdiagnosen identifierad var Risk för minskad hjärtvävnads perfusion. Slutsats: Omvårdnads behovet i den observerade patient gruppen var främst relaterat till icke smittsamma livsstilsrelaterade sjukdomar. Sjukdomspanoramat i den observerade patientgruppen var i överensstämmelse med resultat i internationell modern forskning. Att använda NANDA visade sig vara använbart för att organisera och systematisera observationer och data oavsett sammanhang. Signifikanta samband och mönster mellan olika omvårdnadsbehov kunde identifieras. Ett antal identifierade omvårdnadproblem matchade inte med någon diagnos i NANDA taxonomin. Klinisk betydelse: Studien visar på omvårdnadsbehovet hos en patientgrupp med låg socioekonomisk bakgrund i en urban primärvårdsinstans i Bangkok. NANDA är ett bra verktyg för att systematisera omvårdnad i sjuksköterskeyrket. Det kan vara fördelaktigt för studenter i liknande situationer att använda ett verktyg som NANDA att kategorisera sina bedömningar och intryck.

This thesis focuses on the issue of nursing care for adolescent boys who have undergone phimosis surgery. The nursing care is then evaluated according to the NANDA, NIC and NOC classification systems. The theoretical part deals with topics such as adolescence, phimosisa disease of the external genitalia of a man, preoperative and postoperative care for boys with phimosis, and the classification taxonomy of the NANDA, NIC and NOC classification systems, which represent the comprehensive standardized, but still evolving, nursing language. Available Czech and foreign literary sources were used for the compilation of the theoretical part of the stated subject. The empirical part of the thesis was processed using qualitative and quantitative research methods: content analyzes, modelling, thought experiment, structured and semi-structured interviews, and qualitative data analysis. Four objectives were defined. The way adolescent boys perceive and experience the bio-psycho-social aspects of the problems that the pre-op and post-op period brings, has been assessed using the NANDA, NIC and NOC classification systems. There were 46.66% of respondents with higher education, 53.34% of respondents with secondary education, and eight adolescent boys who had received phimosis surgery, all of whom contributed to the assessment. It was found that adolescent boys initially addressed their physician regarding the phimosis problem, because they had a sense of trust and anonymity, but also to some degree because of necessity. It is surprising that young men with this type of personal problem rather speak to their mothers. When it comes to peer relationships, the boys confide the problem to their peers, but they do not ask them for help in this area. The boys named the internet as the main source of information. The following assessments were made using the Fehring methods for determining the weighted scores. Out of 13 nursing diagnoses within the NNN classification systems there were 112 major and minor characteristics (41.18%) selected by the university educated respondents, 80 major and minor characteristics (29,41%) selected by by the secondary school educated respondents, and nine major and minor characteristics (3.31%) were selected by the adolescent boys. Out of the 15 nursing interventions published in the Nursing Interventions Classification (NIC), 203 major and minor characteristics (55.31%) were chosen by the university educated respondents and 235 major and minor characteristics (64.03%) were chosen by the secondary school educated respondents. Out of the 11 expected nursing outcomes published in the Nursing Outcomes Classification (NOC), 39 major and minor characteristics (15.42%) were selected by the university educated respondents, while 34 major and minor characteristics (13.44%) were selected by the secondary school educated respondents. By implementing the NANDA, NIC and NOC classification systems in nursing care one can expect to find solutions that help the professionals in nursing care to apply the nursing process effectively, and that allow nursing care to focus more on the individual needs of patients and to be improved in all areas.