<p>The district nurses' duties with all organisational changes, above all during the last 20 years, have been changed. Economy and listing governs which visits that to be prioritized. The aim with this study was to examine what district nurses in the primary care in Uppsala län has for view about their occupational role. The method was qualitative and the selection comprized ten district nurses in Uppsala län that were interviewed individually on the basis of a semi structured interview guide that the authors the actual created. In the wide analysis of the results could a theme, <em>As a rubber screw in a shrinking hole</em> and three central categories be discerned, <em>Occupational role</em>, <em>Diversity</em> and <em>Organisation. </em>The district nurses enjoy with work and their choice of profession despite higher demand, stress and low staffing. They experience that the profession role have become unclear and others professions has poor knowledge about which competence they hold. They have an interest of working preventive and a holistic view when thinking about nursing care among children and adults. The feeling of not be needed as a profession, not to become seen with the competence that they possesses, is experienced very frustrating and the obvious role the district nurse earlier had in the primary health care and society seem to fade increasingly. The district nurses description of their profession role can compared as a rubber screw which reflects the flexibility but also the resistance against increasingly healthcare. The shrinking hole symbolize the majority organization changes as forced the district nurses to priority other duties than public health work and a decreased sphere of activity. <em> </em></p>

<p>To sort, is the meaning of the word “triage”. Triage is used at emergency departments to facilitate prioritization of patients according to the urgency of the chief complaint.<em> </em>The aim of this study was to investigate how the nurses experience the triage model at the emergency department at Uppsala university hospital.</p><p>Twelve nurses were interviewed. The mean age was 40 years and the mean work experience was three years and four months. An interview guide was used, consisting of questions about triage, collaboration and work situation.</p><p>The nurses perceived that triage supports assessment and prioritization of patients. Different triage models were used depending on the nurses’ level of triage-education, which was perceived as problematic. The nurses perceived safety when triage was performed together with the physician. The level of collaboration, between the nurses and the physicians, was experienced to be person-dependent. The importance of good communication between nurses and physicians were highlighted.</p><p>Triage supports the assessment and prioritization of patients.<strong> </strong>A standardized triage model would increase the quality of care. The collaboration between nurses and physicians could be improved if they receive the same information and education about triage. Improved communication will facilitate the collaboration. Physicians should participate in the triage process.</p>

<p>The purpose of this study was to investigate registered nurses experiences about the current model for triage at the emergency department at Uppsala University Hospital. The study is descriptive with qualitative approach. The data collection was made in the form of semi structured interviews. The interviews took place at the emergency department. The sample consisted of eight registered nurses with varying work experience of emergency care. The interviews were transcribed and analyzed. The content analysis resulted in 14 categories and four themes.</p><p>The main result contains both positive and negative experiences concerning registered nurses situation when working with team triage. Team triage has improved the work in many aspects: it runs more smoothly and inspires to a good working climate. At the same time the informants experienced the lack of guidelines on how team triage should be conducted. Working in team has improved the cooperation with the physicians. An important factor to this is good communication. However, numerous of the informants felt that they were of no use when working in team. It was also a lack of interest from the physicians of working in team with registered nurses. Further research is required on this topic to develop and improve the way to work with team triage.</p>

<p>The purpose of this study was to explore nurses' experiences of obstructed airways in the prehospital work.</p><p>A qualitative interview study with a descriptive and explorative design was used. The sample consisted of nine registered nurses whereof three were women and six were men, with or without further education and varying length of experience in the ambulance service.</p><p>Prehospital personnel builds up a vast plan of action based on the emergency information provided by SOS. Simple methods for managing obstructed airways were stated often enough. Problems with obstructed airways are considered so unusual that it never becomes a routine. Several factors affect the identification and managing of obstructed airways, both external factors and the different patient categories are considered important. The study found that the bystanders rarely perceived to be performing actions for the creation of a free airway. While obstructed airways perceived to be stressful for ambulance nurses, however, they are not worried to face such a situation. For the coping of what has happened during an emergency, ambulance crew talk through the whole situation of what could have been done better or if something could be done differently. Many factors affect the identification and managing of obstructed airways in prehospital nurses' work. While obstructed airways perceived to be stressful for ambulance nurses they are not concerned to face such a situation. The tools and techniques available for managing airways are usually considered to be adequate and well-functioning</p>

<p>The study aimed to evaluate the information and training the stoma therapist at Uppsala University Hospital has given to patients who have recently undergone stoma surgery. The study was a descriptive cross-sectional study using qualitative and quantitative design. A total of 22 patients who completely or partially took care of their stomas and recently had undergone stoma surgery participated by answering a questionnaire. At discharge most of them experienced they were relatively well-informed but they wanted more information. Before the revisit they weren’t especially safe or comfortable. The participants felt they were better informed and more safe and comfortable three weeks to six months after surgery. Whether the patients had undergone a planned or acute surgery did not influence how wellinformed, safe and comfortable in stoma management they were. No differences were found regarding how safe and comfortable in stoma management the patients were related to how long time ago they underwent the operation. Patients wanted additional information about diet, intestinal function and stoma care and more practice in changing stoma materials. Recently operated stoma patients need information and training until they feel sufficiently well-informed, safe and comfortable in order to better manage their stoma at home after discharge.</p> / <p>Studien syftade till att utvärdera den information och utbildning som stomiterapeuten vid Akademiska sjukhuset har gett till patienter som nyligen genomgått en stomioperation. Studien var en deskriptiv tvärsnittsstudie med såväl kvalitativ som kvantitativ design. Sammanlagt 22 patienter som helt eller delvis skötte sin stomi och nyligen genomgått en stomioperation deltog i studien genom att svara på ett frågeformulär. Vid utskrivning upplevde de flesta av deltagarna att de var relativt välinformerade men de önskade mer information. Innan återbesöket var de varken särskilt säkra eller trygga med stomiskötseln. Patienterna upplevde att de var mer välinformerade, trygga och säkra tre veckor till sex månader efter operation. Huruvida de hade genomgått en planerad eller akut operation påverkade inte hur välinformerade, trygga och säkra på stomiskötseln de var. Det kunde inte heller påvisas någon skillnad mellan hur trygga och säkra på stomiskötseln patienterna var relaterat till hur länge sedan de genomgick operationen. Patienterna önskade ytterligare träning på att byta stomimaterial samt mer information kring kost, tarmens funktion samt stomiskötsel innan utskrivning. Nyopererade stomipatienter skulle behöva information och utbildning tills de känner sig tillräckligt välinformerade, trygga och säkra för att bättre kunna sköta sin stomi i hemmet efter utskrivning.</p>

The purpose of this study was to compare the health profiles of women seeking residential treatment for substance abuse with women in the community. These 2 data sets consisted of a total of 621 participants. An additional aim of the present study was to examine whether these health profiles differ between the monosubstance abusing and polysubstance abusing women within the treatment group. There were a total of 257 participants in this group. All analyses controlled for the effects of age, insurance, marital status, employment and race/ethnicity. Binary logistic regressions were used to compare between and within the specified groups on the following variables: asthma, dyslipidemia, diabetes, Hepatitis B vaccination, HIV testing, hypertension, Pap smear testing, mental health problems, overweight/obesity and smoking. A follow-up analyses examined whether differences in the variables could be explained by the effects of specific control variables. Results suggested that differences in four outcomes might be explained by a single or smaller number of specific control variables. The overall results revealed that age was one of the strongest predictors of differences between the treatment and community group. When we controlled for age, marital status, low socioeconomic status (insurance, employment) and ethnicity we found that only two variables were significantly different. Women in residential showed significantly more smoking and mental health symptoms than were found in the community sample. There were no significant differences in the health profiles of polysubstance substance abusing than were found in monosubstance abusing women. The findings of the present study indicate that women seeking treatment are individuals with similar health disorders and health maintaining behaviors as the general population of women. However, women seeking treatment have significant increases in mental health disorders and smoking. Older age was related to increases in the odds of having dyslipidemia, diabetes, hypertension, and decreases in the odds of being immunized for Hepatitis B, tested for HIV, and having a Pap test in the last year. Due to anticipated-age related disorders, screening for dyslipidemia, diabetes, and hypertension should be provided for older women seeking admission to treatment. Substance abuse treatment centers for women should provide for mental health services and offer smoking cessation.

Maltreatment affected an estimated 794,000 children in the 50 States, the District of Columbia, and Puerto Rico in 2007 (United States Department of Health and Human Services [USDHHS], 2009). The purpose of this study was to examine the risk factors of young maternal age, parents' marital status, multiple birth, preterm birth, birth defects/disability, low economic status, and parental substance abuse related to suspected maltreatment of children 3 years of age or younger from the prospective of pediatric nurse practitioners (PNPs). A cross-sectional survey design, using the Tailored Design Method, was used in this study. A convenience sample consisting of the National Association of Pediatric Nurse Practitioners (NAPNAP) email registry was used for this study with a response rate of 11%. The respondents represented all regions of the United States. Seventy-nine percent of the PNP's (n=363) who completed the survey had suspected child abuse or neglect within the last year in a child three years of age or younger compared to 21% of PNPs (n=96) who did not suspect child maltreatment within the past year. The prevalence of suspected child maltreatment in the study population was 2.35%. According to the model examining child risk factors and abuse, the log of the odds of a child being abused was negatively related to preterm birth (p = .036) and birth defects/disability (p = .001). Multiple birth was positively related but not significant (p = .359). There were no statistically significant child risk factors found in the logistical regression for neglect (preterm birth, p = .180; multiple births, p = .938; birth defects/disabilities, p = .234). When examining the abuse and neglect groups together, the log of the odds of a child being abused and neglected was negatively related to birth defects/disabilities (p = .030). Preterm birth (p = .364) and multiple birth (p = .298) were positively related to the abuse and neglect group but were not significant. According to the model examining parental risk factors and abuse, the log of the odds of a child being abused due to a parent characteristic was negatively related to low economic status, with the proxy being WIC eligibility (p = .001) and a history of substance abuse (p = .031). The regression for abuse indicated a positive, yet insignificant, relationship with young maternal age (p = .129) and single marital status (p = .816). The logistic regression for neglect indicated a positive significant relationship with a substance abuse history (p = .012). The regression for neglect indicated positive but insignificant relationships for young maternal age (p = .693), marital status (p = .343), and WIC eligibility (p = .106). There were no statistically significant parental risk factors found in the logistical regression for abuse and neglect together (young maternal age, p = .263; marital status, p = .523; WIC eligibility, p = .131; substance abuse, p = .985). Findings indicated that child maltreatment is suspected by PNPs in primary care settings, and that PNPs recognize signs and symptoms of abuse and neglect.

Syftet med denna studie var att beskriva vilka faktorer som kan påverka sjuksköterskans möjligheter att handleda sjuksköterskestudenter under deras verksamhetsförlagda utbildning. Sjuksköterskan handleder studenter dagligen i klinisk praktik. Sjuksköterskan ska kunna hantera sitt arbete och samtidigt vara handledare för studenter. Studien är en litteraturstudie med en beskrivande design i vilken fjorton artiklar granskats. Resultatet visade att i tio av de fjorton artiklarna togs negativt påverkande faktorer upp såsom hög arbetsbelastning och otillräcklig avsatt tid för lärande och återkoppling med studenten i den kliniska miljön. Positiva faktorer var att få stöd från kollegor och från Högskolan. I elva artiklar framkom att högre vetenskaplig utbildning och utbildning i handledning underlättar för handledare att kunna ge studenter en stimulerande klinisk praktik. I sex av de fjorton artiklarna visade resultatet behovet för Högskolan att ha en god samordning med handledare och ge information om studenters kunskap och uppsatta mål med verksamhetsförlagd utbildning. / The purpose of this study was to describe the factors that may affect nurses' ability in supervision of  nursing students during their clinical training. Nurse´s precepts students in daily clinical practice. The nurse should be able to manage their work as well as being preceptor for students. The study is a literature review with a descriptive design in which fourteen articles were reviewed. The results showed that in ten of the fourteen articles negative factors were described as high workload and insufficient time allocated for learning and feedback to the student in the clinical environment. Positive factors were described as received support from colleagues and from the School of Nursing. It appeared in eleven articles that factors such as higher scientific education and a training in supervision facilitated the preceptoring nurses  in their task to give students a stimulating clinical practice. In six of the fourteen articles results showed a need for the School of Nursing to have a good coordination with the preceptor and to provide information on students' knowledge and goals of the clinical training.

Övervikt och fetma är ett stort hälsoproblem i hela världen och associeras många gånger till social diskriminering. Under de senaste 35 åren har övervikt och fetma ökat i Sverige och kostar sjukvården tre miljarder varje år. Patienter med övervikt kan känna sig otrygga samt kan känna ett obehag att söka vård på grund av rädsla för stereotypa attityder från sjukvårdspersonal. Syftet var att identifiera och beskriva forskning om sjuksköterskors och sjuksköterskestudenters attityder gentemot vuxna patienter med övervikt/fetma. En litteraturstudie har gjorts för att sammanställa vad forskningen påvisar. Sammanlagt har 9 artiklar, både kvalitativa och kvantitativa analyserats och valts ut. Artiklarnas resultat delades in i likheter och olikheter. Därefter utvecklades resultatet till fem olika områden/attityder. Resultatet visade att det finns delade meningar om attityder då vissa studier visade olika resultat. Attityder som sjuksköterskor kan ha är att patienter kan vara lata, oattraktiva, långsamma och sällan uttrycker sina riktiga känslor har påvisats. Sjuksköterskestudenter visade sig ha mindre negativa attityder än sjuksköterskor. Sjuksköterskors BMI kan ha en betydelse för vilka attityder och fördomar hon eller han har i mötet med patienten. På grund av ett ojämt och motsägelsefullt resultat är det svårt att dra en slutsats om sjuksköterskors och sjuksköterskestudenters attityder. / Overweight and obesity is a major health problem worldwide and many times associated to social discrimination. Over the past 35 years, overweight and obesity has increased in Sweden and costs the healthcare three billion crowns each year. Patients with obesity can feel insecure and discomfort to seek treatment because of fear of stereotypical attitudes from health professionals. The aim was to identify and describe research on nurses and nursing students´ attitudes towards adult patients who are overweight/obese. A literature review was used to compile what the research shows. A total of nine articles, both qualitative and quantitative studies was selected and analyzed. Results of all articles were divided into similarities and differences. Thereafter five different areas were developed from the result. The results showed that there are differing views on attitudes when some studies showed different results. That the patients can be lazy, unappealing, slow and rarely express their true feelings are some of the attitudes that have been found. Nursing students were found to have less negative attitudes than nurses. The nurse BMI may have significance for the attitudes and prejudices that she or he has in the meeting with the patient. Because of uneven and contradictory results, it is difficult to draw a conclusion about nurses and nursing students.

Patienter med annan kulturell bakgrund är sårbara på grund av bristande kunskaper i det nya landets språk vilket leder till kommunikationssvårigheter. Inte bara i Sverige utan i hela världen är kommunikationsbarriärer den vanligaste barriären mellan en sjuksköterska och denna patientgrupp. Bakgrund: Kommunikation har grundläggande betydelse för kvalitén av omvårdnad inom patientvården. En sjuksköterska ska vara medveten om att språkbarriärer spelar en viktig roll i patienters vårdvistelse samt kan vara ett hinder när dessa patienter söker sjukvård. Syfte: Studiens syfte är att beskriva vilka faktorer som påverkar kommunikationen mellan patient med annan etnicitet och sjuksköterska, ur ett patientperspektiv. Metod: En litteraturöversikt är genomförts. Resultat: Resultatet visade på tre olika teman: bristande språkkunskaper, tolk/familjemedlemmar och kultur som viktiga faktorer av betydelse för kommunikationen mellan patient och sjuksköterska. Resultatet visade att patienter upplevde kommunikationen med sjuksköterska var avgörande för en god vård. När språkbarriärer uppstod kunde personalen ordna en auktoriserad tolk, men även detta kunde innebära problem som dialektskillnader. / Patients with different ethnicity can be vulnerable due to lack of knowledge of the language in the new country which causes communication difficulties. This problem is an international phenomenon and often contributes to communication problems when these groups of patients meet with the nurses in the health care system. Background: The result of the communication has great impact on the quality of care in the healthcare. A nurse must be aware of the effects the language barriers have on a patient while he/she is under care, and this barriers become an obstacle to get in touch with the healthcare. If the communication between a nurse and patients with different ethnicity hindered, it can lead to for example depression at the patient. Aim: The study’s aim is to describe the factors that influence the immigrant patient’s communication with nurse, from the patient's perspective. Method: A literature review is designed to answer the study’s purpose. Result: The result showed that there have been found three different themes, lack of language skills, interpreter/family and culture. The results showed that patients experienced the communication with the nurse to be decisive about their overall ratings of good or bad care. When language barriers arose the staff could arrange for a certified interpreter, but even this could be problematic as dialect differences.