Diss. (sammanfattning) Stockholm : Karolinska institutet, 2010.

Thesis (Ph. D.)--University of Massachusetts Worcester and University of Massachusetts Amherst, 2002. / Title from opening page (viewed Oct. 10, 2007). "February 2002, Collaborative PhD in Nursing Program, Worcester and Amherst." Includes bibliographical references (p. 86-97).

One of the most important areas of society-wide tasks influencing the health of the whole population is child care. It includes care of children with a hemangioma. Hemangiomas are the most common benign (not malignant) vascular tumours of a child age. This benign tumour may be present as early as at birth or appear in the first weeks of life. It is usually located on or under the skin surface but may also affect internal organs. Although a hemangioma may affect any body part, it is mostly located on the head and neck. A hemangioma is diagnosed in a tenth of new-born children. Hemangiomas typically appear at neonatal age or infancy. The objectives of the diploma thesis "Nurse's Roles in Care of a Child Patient with a Hemangioma" are to examine the roles of nurses in care of a child patient with a hemangioma, as seen by parents (mothers) of the children, and to identify which of the roles is the most important for the parents (mothers). It has also been ascertained whether nurses deal with any problems while providing this care and whether occurrence of a hemangioma in a child has any influence on the child's family. It has also been ascertained whether any complications are encountered in the treatment of children with a hemangioma. A qualitative research was used for data processing. Several methods of data collection were used. The researcher used a case history according to the model of Virginia Henderson, semi-structured interview with mothers of patients, data content analysis and secret participant observation during outpatient checks. The last method used was a survey aimed at nurses who took care of children with a hemangioma, asking them whether they dealt with any problems and complications in such children. The first research set consisted of ten child patients who were selected on purpose on the basis of pre-set criteria. The first criterion was presence of a hemangioma; five patients were hospitalised with a hemangioma and underwent a treatment with propranolol, while the other five patients with a hemangioma underwent only a conservative treatment. Last but the most important criterion was that mothers of patients with a hemangioma granted their consent to the research. These mothers formed the second research set and underwent a semi-structured interview focused on their personal experience with a hemangioma and on the work of nurses as seen by mothers. The last research set consisted of ten nurses who were also selected on purpose on the basis of a very important criterion, which was care of child patients with a hemangioma. This thesis may be of a benefit not only for professionals who are in contact with children with a hemangioma but may also serve to deepen general knowledge of other healthcare professionals who may encounter this disease either in their professional or private life. Based on the information acquired for the diploma thesis, was prepared for nurses and will be presented at professional workshops.

Bakgrund: Vård av god kvalité innebär vård där sjuksköterskan känner medlidande med patienten och upplever inre tillfredställelse av att göra det. Det är sjuksköterskor och patienter eniga om. Sjuksköterskor som inte lyckas uppleva compassion satisfaction kan hamna i ett tillstånd som heter compassion fatigue vilket är ett tillstånd som har sin grund i höga påfrestningar som uppstår i arbetet. Syfte: Att beskriva sjuksköterskors erfarenheter av att hitta kraft av att vårda. Metod: En allmän litteraturöversikt genomfördes på två kvantitativa artiklar och elva kvalitativa artiklar. Analysen genomfördes enligt Friberg. Resultat: Resultatet visade på flera olika faktorer som leder till känslan av glädje och motivation i yrket som sjuksköterska. Fyra olika kategorier uppenbarades: mellanmänsklig bekräftelse, moralisk tillfredställelse, existentiell tillfredställelse, professionellt erkännande och utveckling. Kategorierna beskriver källor till tillfredställande och till kraft att fortsätta inom professionen. Exempel på dessa faktorer är: att få chans att göra skillnad för patienten, att kunna vara autonom och att få bekräftelse från arbetskollegor och ledningen. Slutsats: Sjuksköterskor kan finna kraft i att vårda dock finns det även sjuksköterskor som inte lyckas uppleva compassion satisfaction. Mer kunskap om compassion satisfaction kan gynna sjuksköterskor i framtiden. / Background: Good quality care means nursing with compassion and experiencing inner satisfaction of doing so. Nurses and patients are in agreement on that. Nurses who fail to experience compassion satisfaction can end up in a state called compassion fatigue which is a condition that is due to the high stresses that arise at work. Aim: To describe nurses' experiences of achieving a sense of power through care. Method: A general literature review was conducted on two quantitative articles and eleven qualitative articles. The analysis was conducted according to Friberg Result: The results showed different factors that bring forth a sense of joy and motivation in the nursing profession. Four different categories were revealed: interpersonal confirmation, moral satisfaction, existential satisfaction, professional recognition and development. The categories describe different sources of satisfaction and the empowering elements that supports retention in the profession.  Examples of factors are: a chance to make a difference for the patient, being able to be autonomous and getting confirmation from colleagues and the management. Conclusions: Nurses can find power in caring, however, there are also nurses who fail to experience compassion satisfaction. More knowledge about compassion satisfaction can benefit nurses in the future.

Orientadores: Marcia Regina Nozawa, Antonieta Keiko Kakuda Shimo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T18:38:16Z (GMT). No. of bitstreams: 1 Queiroz_PatriciaHelenaBreno_M.pdf: 1894359 bytes, checksum: d8f1ad64ea2907d6afbda72ac0feff14 (MD5) Previous issue date: 2008 / Resumo: Esta tese envolveu estudos com 287 mulheres, 69 não menopausadas e 218 pós-menopausadas; destas 84 em e 124 sem terapia de reposição hormonal (TRH), todas atendidas em hospitais públicos da Universidade Estadual de Campinas, Estado de São Paulo. As voluntárias foram recrutadas junto aos ambulatórios de dislipidemias (n=193), do Hospital das Clínicas Unicamp, e do ambulatório de menopausa (n=94), do CAISM/Unicamp. Seu intervalo de idades foi de 20 a 82 anos. As pós-menopausadas apresentavam idade acima de 40 anos e amenorréia por período superior a um ano. O grupo em terapia de reposição hormonal foi subdividido de acordo com o tipo de TRH em 2 subgrupos: pacientes em uso de estrógenos isoladamente (0.625mg/dia, n=48) ou pacientes em reposição hormonal combinada com acetato de medroxiprogesterona, (2,5mg/dia, 10% e 5mg/dia, 90%, n=36), por no mínimo um ano. Caracterizaram a metodologia a definição da menopausa, através do preenchimento de questionário sobre o tempo de amenorréia natural, a determinação do uso e tipo de terapia de reposição hormonal por meio de entrevistas, seguidas de exame médico clínico. Foi objetivo a determinação dos efeitos do uso da terapia de reposição hormonal oral no período pós-menopausal, estrogênica ou estrogênica associada à progestágenos sobre diversos marcadores séricos de oxidação no plasma. Como evento ponto-final da aterosclerose precoce determinou-se os efeitos da menopausa e da menopausa tratada com reposição hormonal sobre a aterosclerose precoce carotidiana e sua regulação metabólica. A abordagem de efeitos metabólicos da TRH foi realizada com a determinação após uso da terapia de reposição hormonal oral das atividades de proteínas reguladoras do metabolismo das lipoproteínas plasmáticas: a lípase hepática, a lipoproteína lipase, a proteína de transferência de colesteril-éster e a proteína de transferência de fosfolípides. Foram analisados também os seguintes parâmetros: colesterol, não HDL colesterol (NHDLcol), colesterol de lipoproteínas de alta densidade (HDLcol), colesterol de lipoproteínas de baixa densidade (LDLcol), triglicérides (TG), apolipoproteínas (AI e B 100), lipoproteína (a) Lp(a), autoanticorpos anti-LDL oxidada, anticorpos anti-epítopos proteicos da apolipoproteína B oxidada (anti-D, anti-D2 e anti-A); atividades das proteínas de transferência de colesteril-éster (CETP) e de fosfolípides (PLTP), da lipase hepática (LH), da lipoproteína lipase (LPL), a atividade séricas da catalase, determinação do nitrato, substâncias reativas ao ácido tiobarbitúrico (TBARS) e PCR séricos. O parâmetro radiológico medido foi o espessamento íntimo-médio da camada carotídiana (EIM) das artérias carótidas comuns direita e esquerda (ultra-sonografia Doppler). A análise estatística dos dados foi realizada através do programa SAS. Procedeu-se à correções para idade e IMC, quando indicado. A analise de regressão linear múltipla foi utilizada para acessar a influência dos diversos parâmetros bioquímicos e antropométricos sobre a EIM carotídea. Foram observados vários efeitos bioquímicos e antropométricos pró-aterogênicos da menopausa: aumento do EIM, do IMC, da medida da cintura e títulos de autoanticorpos anti-LDL oxidada e anti-D. A terapia de reposição hormonal apresentou efeitos modificadores benéficos reduzindo a lipase hepática (maior magnitude com a terapia conjugada), aumento de HDLcol, redução de autoanticorpos anti-D2 e aumento da concentração da catalase, (maior magnitude na terapia combinada). Outros marcadores de estresse oxidativo os nitratos, as substancias reativas ao ácido tiobarbitúrico e os lipoperóxidos não se modificaram com a TRH. Nas análises multivariadas a TRH conjugada e estrogênica modulou a EIM através de três fatores: via triglicérides, CETP (negativo) e lipoperóxidos (ao contrário do grupo sem TRH, com sete fatores de regulação); a terapia estrogênica atuou apenas via TG. Houve influência positiva do tratamento sobre a regulação positiva pela PCR a qual desapareceu. Este estudo reitera o risco aumentado para a doença cardiovascular (DCV) pelo aumento de um conjunto de fatores de risco na mulher em pós-menopausa, fato já demonstrado em estudos prévios. A TRH foi benéfica do ponto de vista de melhora do perfil de lípides. Modificou favoravelmente a lípase hepática aumentando o colesterol da HDL, lipoproteína anti-aterogênica. A redução de autoanticorpos contra a oxidação apoproteica B100 e o aumento da atividade sérica da catalase demonstram capacidade antioxidante maior e dredução do estersse oxidativo plasmático. Não menos importante e apesar do efeito ter sido insuficiente amostra populacional para alterar a EIM, a TRH modificou a modulação da aterosclerose precoce no sentido de maior ateroproteção / Abstract: This thesis was composed of studies conducted on 287 women: pre menopausal (69) and post (218); the last with (n=84, WHRT) and without (n=134, WTRT) hormone replacement therapy (HRT), attended at the UNICAMP university hospitals, São Paulo state. The volunteers were recruited from Hospital de Clínicas (n=193) and CAISM hospital (n=94). They aged from 20 to 82 years (y). Postmenopausal women were 40y old and above and presented amenorrhea for at least 1 year. WHRT women were subdivided in 2 groups: one using conjugated estrogens (0.625mg/day, n=48) or estrogen associated with medroxyprogesterone acetate (2.5, 10% of all or 5mg/day 90% of all, n=36). The methodology was characterized by the menopause definition and through questionnaires and a clinical exam. The objective of this study was to verify if HRT, estrogenic or combined, modified plasmatic oxidative markers. The end-point for atherosclerosis was the measurement of common carotid intima-media thickness (IMT), as well as its metabolic regulation. The study also dtermined the activities of several proteins of lipid metabolism: lipoprotein lipase, hepatic lipase, cholesteryl ester and phospholipid transfer protein under HRT estrogenic or combined. ELISA, nephelometric, enzymatic and radiometric methods were used to determine several parameters: cholesterol, non HDL cholesterol (NHDLchol), HDL-cholesterol, LDL-cholesterol triglycerides (TG), apolipoproteins (AI e B 100), lipoprotein (a), Lp(a), autoantibodies against oxidized LDL, epitopes of oxidized apolipoprotein B100 (anti-D, anti-D2 e anti-A); activities of CETP, PLTP, HL LH and LPL, catalase, nitrates, TBARS, lipid peroxides, CRP. The radiologic common carotid intima-media thickness was done by Doppler ultrasound. The data were analyzed by the SAS statistical package. Multiple linear regression analyses were used to assess the influence of diverse biochemical markers on carotid IMT. In this study several postmenopausal anthropometric and biochemical effects were pro-atherogenic: increases in IMT, BMI (body mass index), WC (waist circumference), antibodies against oxidized LDL and anti-apoD antibodies titers. HRT showed beneficial actions, decreasing HL activity, reducing anti-D2 antibody titers, increasing HDLchol and catalase activity. The nitrate concentration, TBARS and hydroperoxides showed no changes with HRT. HRT improved the women¿s lipid profiles but not ApoAI and B100. decreased hepatic lipase and increased HDLchol, an anti-atherogenic lipoprotein, reduced anti-D2 and increased catalase activity. Although HRT was insufficient to modify IMT, the multivariate analysis demonstrated that conjugated and estrogen HRT modulated IMT through triglycerides concentration, CETP (negative) and lipid peroxides a situation differently from non-treated women that presented 7 modulators; under estrogenic treatment only TG regulated IMT. As well the hormone treatment influenced favorably excluding the effects positive of CRP. This study reinforces the higher risk of CAD in post-menopausal women and the beneficial action of HRT by improving lipid profiles. It changed favorably HL, HDL-cholesterol, decreased antibodies against oxidized apoB100 and increased catalase activity indicating reduced oxidative stress; not less important are the results showing that HRT although not changing carotid IMT, modified beneficially the relationship of precocious atherosclerosis and its modulators suggesting an atheroprotective action / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

Background: It's a fundamental principal to protect children's rights. Through legislation, child abuse has been prohibited in many countries. Nurses working with children has a frontline role in identifying and reporting suspected or known child abuse. Mandatory reporting is one of the nurse's duty, reluctancy to report can lead to misconduct but it also leads to children suffering. Aim: The purpose of this degree project was to identify factors preventing nurses from mandatory reporting of children in health care. Method: A literature study based on using and analysing nine qualitative articles. Results: Three themes emerged in the result. The first theme was knowledge deficit, with two subthemes which were the need of education of signs and symptoms and the other subtheme was insufficient experiences. The second theme was nurses strained work environment with three subthemes. The first subtheme was the lack of routines, the second one miss information and the third one lack of cooperation and communication. The third theme consists of two subthemes, which were the lack of emotional support and the experience of fear. The results showed that nurses due to different factors relinquished from mandatory reporting.  Conclusion: The results highlighted that education and training was needed among nurses to gain knowledge on how to safeguard children and establish mandatory reporting. Thus, support from colleagues and managers agencies dealing with child safety was highly valued by nurses. Implementation of education, training and support could improve the cooperation in protecting children.

Lidande utgör ett hot mot hela människan som ej kan undflys. Patientens lidande påverkar vårdaren. Det skapar ett eget lidande i sjuksköterskan som inte kan lindra patientens lidande eller till och med orsakar ytterligare lidande. Också anhörigas lidande påverkar intensivvårdssjuksköterskan. Syftet med uppsatsen var att beskriva hur intensivvårdssjuksköterskor upplevde att vårda patienter med svårt lidande. En deskriptiv, semistrukturerad intervjuundersökning genomfördes med tre intensivvårdssjuksköterskor och tolkades medelst innehållsanalys. Resultat: Temat Lidandet genomsyrar sjuksköterskans värld identifierades och handlade om hur sjuksköterskan måste hantera sitt eget lidande likväl som patientens och anhörigas. Temat var uppbyggt av tre kategorier. Lidandets former beskrev det lidande informanterna mötte på intensivvårdsavdelningen. Lidandets samspel beskrev hur positiva och negativa känslor väcktes i samarbetet med lidande patienter, anhöriga och kollegor. Att göra den andres lidande till sitt eget beskrev sjuksköterskans personliga, ofta negativa, känsloupplevelser som aktualiserades vid mötet med stort lidande. / Suffering is an unavoidable threat to the individual as a whole. Suffering of patient and relatives affects the nurse, and creates a personal suffering when incapable of relieving the patients suffering, or inflicting even more. The purpose of this study was to describe how ICU nurses experienced caring for suffering patients. A descriptive, semi-structured interview study was conducted on ICU nurses and interpreted by content analysis. Result: The theme Suffering permeates the nurse’s world was identified and described how the suffering of patient, relatives and self had to be handled by the nurse. The theme consisted of three categories. The manifestation of suffering described how suffering in the ICU is perceived. The interaction of suffering described how cooperating with suffering patients, relatives and colleagues caused negative and positive emotions. Integrating suffering of the other described often negative personal emotions of the nurse evoked when encountering suffering. / <p>2010 felaktigt årtal titelsida</p>

Bakgrund: Den vanligaste kroniska sjukdomen bland äldre människor i hela världen är demens. Vård och omsorg på ett boende för människor med demens kräver kompetens och erfarenhet. Dessutom är sjuksköterskans uppdrag att vara en ledare inom omvårdnad och hälso- och sjukvård. Syfte: Arbetets syfte är att belysa sjuksköterskans ledarskap på boende för personer med demens.Metod: En kvalitativ litteraturstudie innehållande tio studier med kvalitativ ansats. Databaserna PubMed, CINAHL, SveMed+ användes för sökning av vetenskapliga artiklar. Artiklarnas kvalitet granskades med hjälp av modifierad SBU:s (2018) granskningsmall. Analysen av samtliga vetenskapliga artiklar utgick utifrån Forsbergs och Wengströms (2013) beskrivning av innehållsanalys.Resultat: Sjuksköterskans ledarskap är ett komplext mångbottnat fenomen. Tio huvudkategorier identifierades inom ämnet: handledning och styrning, kunskap, etik, undervisning, kommunikation, teamarbete, hinder, stöd, vårdkvalitet och vårdmiljö.Konklusion: Mer uppmärksamhet till sjuksköterskans ledarskap behövs. Fördjupad kunskap inom ledarskap är nödvändig för succesivt arbete och sjuksköterskans status. / Background: In the world dementia is the most common chronic disease among older people. Competence and experience are essential for providing care and ward in residential facilities for people with dementia. Nurses mission is to be a leader in nursing and healthcare.Aim: The aim of this paper is to describe nurse’s leadership in nursing home for people with dementia.Method: A qualitative literature review consisting ten research articles with qualitative approach. PubMed, CINAHL and SveMed+ databases were used for research. Articles were quality reviewed according to modified SBU’s quality template. Content analysis as described by Forsbergs and Wengströms (2013) was used for analysis. Result: Nurse’s leadership is a complex, multicomponent phenomena. Ten main categories of the subject were identified: coaching and guiding, skills, ethics, education, communication, teamwork, obstacles, support, quality of care and care environment.Conclusion: More attention is needed for nurse’s leadership. More research on nurse’s leadership, deeper knowledge in this area is needed for successful work and increasing of nurse’s status.

Bakgrund: Redan 1824 rapporterades det om hot och våld på akutmottagningen. Sjuksköterskor bedriver omvårdnadsarbete i en utsatt arbetsmiljö där hot och våld är vanligt förekommande och arbetet på akutmottagning står inför stora utmaningar. Syfte: Syftet med litteraturstudien var att beskriva sjuksköterskors upplevelser av hot och våld på akutmottagningen. Metod: En litteraturstudie som utgår ifrån Polit och Beck (2017) nio steg. Databaserna Cinahl och Pubmed användes för att identifiera relevanta artiklar som kunde besvara studiens syfte. 12 artiklar återstod efter kvalitetsgranskningen som genomfördes utefter Polit och Beck (2017) granskningsmallar, dessa artiklar användes för utformning av litteraturstudiens resultat. Resultat: Resultatet presenteras utifrån fyra olika kategorier: Att känna sig utsatt, att känna sig hindrad i att kunna utföra god omvårdnad, negativ emotionell påverkan som försämrar hälsan och att känna behov av stöd. Slutsats: Sjuksköterskorna kände sig utsatta, sårbara och utlämnade och patientsäkerheten äventyrades då utförandet av god omvårdnad försvårades. Emotionell påverkan ledde till försämrad hälsa för sjuksköterskan och betydelsen av stöd blev påtagligt speciellt då stödet från organisationen upplevdes bristande.

SAMMANFATTNING Bakgrund   Idag finns det runt 43 000 personer i Sverige som lever med stomi och sedan 2006 har antalet patienter ökat i alla regioner och landsting. Operationen förändrade patientens livssituation och dess upplevelse om den nya vardagen efter stomioperationen påverkade individens livskvalitet. Sjuksköterskans roll i möten med denna patientgrupp är att lindra deras lidande och främja deras livskvalitet. Patienters förändrade välbefinnande och livskvalitet efter stomioperationen ställer krav på sjuksköterskans kapacitet till att främja livskvaliteten.    Syfte Syftet var att beskriva utmaningar, livskvalitet hos patienter efter stomioperation samt behov av stöd av sjuksköterskan.  Metod Denna litteraturöversikt grundar sig på 15 vetenskapliga artiklar, både kvalitativa och kvantitativa studier. Databassökningen genomfördes i databaserna PubMed och CINAHL. De inkluderade artiklarna kvalitetsgranskades enligt Sophiahemmets bedömningstabell och analyserades med stöd av Integrerade analys. Resultat I studien framkom tre kategorier vilka ansågs viktiga för att beskriva patientens utmaningar, livskvalitet hos patienter efter stomioperation samt behov av sjuksköterskans stöd.  Slutsats Sammanfattningsvis visar resultatet att patienter som får stomi upplever negativ i större utsträckning som har sämre inverkan på deras livskvalitet. Sjuksköterska stöd genom rådgivning, stomiutbildning och egenvård kan minska problem och komplikationer i vardagen som har bättre inverkan på livskvalitet. / ABSTRACT Background Today, there are around 43,000 people in Sweden living with an ostomy and since 2006 the number of patients has been increased in all over the country. Changing the patient's life situation and their experience of the new everyday life after the ostomy operation affects the individual's quality of life. The nurse's role in meetings with this group of patients is to alleviate their suffering and promote their quality of life. Patients' changed well-being and quality of life after the ostomy operation lies demand on the nurse's capacity to promote quality of life. Aim The purpose was to describe challenges, quality of life in patients after ostomy surgery and the need for support from the nurse. Method This literature review is based on 15 scientific articles, both qualitative and quantitative studies. The database search was carried out in the databases PubMed and CINAHL. The included articles were peer-reviewed according to Sophiahemmet's assessment table and analyzed with support from Integrated analysis. Results The study identified three categories that were considered important to describe the patient's challenges, the quality of life of patients after ostomy surgery and the need for nurse support. Conclusions In summary, the results show that patients who have an ostomy experience negatively to a greater extent that have a lower impact on their quality of life. Nurse support through counseling, ostomy education and self-care can reduce problems and complications in everyday life that have a better impact on quality of life.