Bakgrund: I Sverige har antalet invånare med utländsk bakgrund ökat de senaste åren vilket medför att hälso- och sjukvården vårdar allt fler patienter som inte kan det svenska språket. Informationsutbytet mellan patienten och sjuksköterskan är en viktig del av vårdandet. Arbetet inom hemsjukvården kan vara utmanande då allt fler patienter vårdas hemma, och sjuksköterskor ska kunna leva upp till de krav som ställs på att ge alla patienter god vård på lika villkor. Språkliga hinder kan vara en utmaning för sjuksköterskor i mötet med patienter. När kommunikationen inte fungerar på grund av språkbarriärer riskerar patientens vård att drabbas negativt. Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenheter av språkbarriärer vid mötet med patienter i hemsjukvården. Metod: Studien genomfördes med en kvalitativ induktiv ansats med åtta semistrukturerade intervjuer. Tre distriktssköterskor, en specialistsjuksköterska inom vård av äldre samt fyra sjuksköterskor deltog. Datainsamlingen analyserades utifrån en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier och tio underkategorier. Sjuksköterskorna använde sig ofta av olika strategier för kommunikation, genom kroppsspråket samt anhöriga och vårdpersonal som tolkar. Vidare upplevde sjuksköterskorna utmaningar i vårdarbetet vid språkbarriärer, där mer tid avsattes för patienterna. Även förutsättningar för god vårdrelation samt bedömning försvårades vid språkbarriärer. Sjuksköterskorna upplevde även skillnader i vårdmötet när ett gemensamt språk saknas, där kunskapen om olika kulturer upplevdes bristande. Språkbarriärer påverkade även sjuksköterskornas arbetsbelastning samt patienters förväntningar på hemsjukvården. Slutsats: Det krävs en fungerade kommunikation för att skapa en god vårdrelation. Att använda auktoriserad tolk är inte alltid optimalt inom hemsjukvårdens verksamhet då det krävs mer planering. Ofta tolkar anhöriga och kollegor istället. Det upplevdes ta mer tid att vårda patienter som inte talar svenska, önskemål fanns om att verksamheten anställer fler sjuksköterskor. Bristande kunskap om olika kulturer upplevdes, mer utbildning inom kulturella skillnader var önskvärt för att vårdrelationen med patienten kan förbättras. Förväntningarna på hemsjukvården upplevs höga från patienter som inte talar svenska, genom lättillgänglig skriftlig information på olika språk om hemsjukvårdens verksamhet kan rätt information nås ut till patienterna. / Background: In Sweden the number of residents with a foreign background has increased, and as a result it is becoming more common in the health care to care for patients who cannot speak the Swedish language. The exchange of information between the patient and the nurse is an fundamental part of the care. The work within home care can be challenging as more patients are cared for at home and nurses must be able to live up to the requirements that are set, for all patients to receive good care on equal terms. Linguistic barriers can be a challenge for nurses when meeting patients. When the communication does not work due to language barriers, the patient's care risks being affected negatively. Aim: The aim of the study was to describe nurses' experiences of language barriers when meeting patients in home care. Method: The study was conducted with a qualitative inductive approach with eight semi-structured interviews. Three district nurses, one specialist nurse in the care of the elderly and four nurses participated. The data collection was analyzed based on a qualitative content analysis. Results: The analysis resulted in three main categories and ten subcategories. The nurses often used different strategies for communication, through the body language, and relatives and nursing staff as interpreters. Furthermore, the nurses experienced challenges in the health care by language barriers, where increased time was spent for the patients. Prerequisites to establish a good care relationship and nursing assessment were more difficult due to language barriers. The nurses also experienced differences in health care meeting when a common language is missing, where the knowledge of cultural differences was felt to be lacking. Language barriers also affected the nurses' workload and patients' expectations of home care. Conclusion: A well-functioning communication is required to create a good care relationship. Using an authorized interpreter is not optimal within the home care, as more planning is required. Instead relatives and colleagues are used as interpreters. It was perceived to take more time to care for patients who do not speak Swedish, therefor there was a wish that more nurses should be hired. Lack of knowledge in cultures was experienced, more education in cultural differences was desirable to improve the care relationship. The expectations of home care were high from patients who dont speak Swedish, through easily accessible information about home care in different languages can the right information reached to the patients.

Este estudo foi de natureza qualitativa e utilizou como referencial teórico o Interacionismo simbólico e metodológico a Teoria Fundamentada em Dados. Objetivou-se desenvolver um modelo de cuidado espiritual para os pacientes e seus familiares no enfrentamento de situações de adoecimento. O estudo foi realizado em Hospital Universitário do sul do Brasil, com seis enfermeiras e quatro técnicas de enfermagem, com um ano ou mais de experiência na área de atuação e que estavam exercendo suas atividades. Para coleta dos dados utilizou-se uma entrevista semiestruturada do tipo intensivo e um grupo de expertise, com quatro participantes para validação do Modelo, no período de março a maio de 2016. Os preceitos éticos foram seguidos e obtidas as assinaturas de todas as participantes no Termo de Consentimento Livre e Esclarecido. A coleta e análise dos dados ocorreram de forma concomitante de acordo com o método. Na análise dos dados aplicaram-se as etapas da Teoria Fundamentada em Dados que prevê a codificação inicial, focalizada, axial e teórica. Os significados, pressupostos, ações e resultantes identificados a partir das experiências e vivências das participantes no cuidado aos pacientes e seus familiares foram descritas nas categorias Situando a espiritualidade no seu viver e as subcategorias “Reconhecendo a espiritualidade como uma necessidade e complemento” e “Caminhando na espiritualidade”. Exercitando a espiritualidade na vida e as subcategorias “Praticando a espiritualidade ao seu modo”, “Percebendo a espiritualidade como uma opção de vida”, “Respeitando as crenças do outro”, “Encontrando a espiritualidade na maneira de agir e pensar”. Percebendo o papel da equipe de enfermagem no cuidado espiritual e as subcategorias “Advogando os direitos do paciente e em prol da profissão”, “Conversando sobre espiritualidade”, “Preparando a equipe de enfermagem”, “Cuidando no processo e morte e morrer”, “Limitando o cuidado pelas crenças pessoais, organizacionais e religiosas”. Identificando as manifestações das necessidades espirituais e as subcategorias “Identificando as formas de enfrentamento do sofrimento” e “Acontecendo: o momento de atender as necessidades”. Colocando a espiritualidade como prioridade no cuidado e as subcategorias “Acolhendo os pacientes e familiares”, “Utilizando práticas integrativas”, “Rezando com o paciente”, “Confortando por meio da espiritualidade” e “Continuando a acreditar todos os dias”. A integração destas categorias possibilitou identificar a categoria central Ressignificando o adoecimento e o desenvolvimento do modelo de cuidado espiritual. Além disso, foi desenvolvida uma versão prática do modelo. O estudo originou uma compreensão e interpretação conceitual e prática sobre o tema espiritualidade na enfermagem e foram delineadas as conexões entre a equipe de enfermagem e os pacientes e familiares no momento do cuidado espiritual. / This study was a qualitative approach, which used the theoretical symbolic interactionism and the Grounded Theory as methodological benchmarks. The purpose was to develop a spiritual model of care for patients and their relatives when confronting situations of illness. The study was conducted in a University Hospital in the south of Brazil and involved six nurses and four certified nurse practitioner, whose had one year or over of experience in the operating area and were performing their activities. In order to collect data, we used semi-structured interviews of intensive type and an expertise group, composed of four participants, with sights to validate the Model, during the period between March and May 2016. The ethical precepts were followed, and then we obtained the signatures of all participants in the Free and Informed Consent Form. The collection and analysis of data took place concomitantly in line with the method. When analyzing data, we applied the steps of the Grounded Theory, which foresees the initial, focused, axial and theoretical coding. The meanings, assumptions, actions and outcomes identified from the experiences and backgrounds of the participants in the care of patients and their relatives were described in the categories “Situating the spirituality in your daily life” and the subcategories “Recognizing the spirituality as a need and complement” and “Walking in the spirituality”. “Exercising the spirituality in life” and the subcategories “Practicing the spirituality in my own way”, “Perceiving the spirituality as a life choice”, “Respecting the beliefs of others”, Finding the spirituality in the way of acting and thinking”. “Perceiving the role of the nursing team in the spiritual care” and the subcategories “Advocating the patient’s rights and for the promotion of the profession”, “Talking about spirituality”, “Preparing the nursing team”, “Caring for in the process of death and dying”, “Limiting care through the personal, organizational and religious beliefs”. “Identifying the manifestations of the spiritual needs” and the subcategories “Identifying the ways of confronting the suffering” and “Happening: the time to meet the needs”. “Placing the spirituality as a priority in the care” and the subcategories “Welcoming the patients and relatives”, “Using integrative practices”, “Praying together with the patient”, “Comforting through the spirituality” and “Continuing to believe every day”. The integration of these categories has enabled us to identify the central category “Resignifying the illness”, as well as to develop a spiritual care model. In addition, we have developed a practical version of the model. The study gave rise to a practical and conceptual understanding and interpretation about the issue of spirituality in nursing, and then we drew up the connections between the nursing team and the patients and their relatives at the time of the spiritual care.

Bakgrund: Vård i livets slutskede bygger på att lindra lidande samt förbättra livskvaliteten för patienten, vilket är en del av sjuksköterskors grundläggande ansvarsområden och ingår i den personcentrerade vården. Beroende på vilket stadie i sjukdomen patienten befinner sig i påverkas vilka vårdinsatser som behövs. Sjuksköterskor ställs inför stora utmaningar och har en definitiv roll i omvårdnaden av patienten i livets slutskede.Syfte: Att sammanställa kunskap om sjuksköterskors upplevelser och erfarenheter av vård i livets slutskede på sjukhus.Metod: En litteraturöversikt som sammanställer både kvalitativa och kvantitativa artiklar från databaserna PubMed och CINAHL.Resultat: Resultatet baseras på vetenskapliga artiklar från olika delar i världen. Uppsatsförfattarna har valt att dela in resultatet i huvudkategorier: Känslomässiga reaktioner hos sjuksköterskor, Tids- och resursbrist för att stödja patienten i livets slutskede, Påverkbara aspekter i vårdmiljön, Kommunikation mellan sjuksköterskor och patienten och Behov av kunskap och utbildning i palliativ vård. Sjuksköterskor upplever blandade känslor och delade meningar om att vårda patienter i livets slutskede och möta deras behov i slutet av livet vilket beror på sjuksköterskors yrkeserfarenhet.Slutsats: Sjuksköterskor upplever känslomässiga reaktioner, tids-och resursbrist, brist på utbildning samt olika nivåer av erfarenheter vilket är faktorer som försvårar deras arbete av vård i livets slutskede. Detta gav känslor av otillräcklighet. Sjuksköterskor upplevde även att kommunikationen var svår vilket oftast grundade sig i att sjuksköterskorna kände sig otrygga i sina roller i arbetet med patienter i livets slutskede medan sjuksköterskor med längre erfarenhet och de som hade högre kunskap inte hade några svårigheter att möta dessa patienter. / Background: End of life care based on relieving suffering and improving the quality of life for the patient´s, which is the nurses basic responsibilities, which are part of the person centered care. Depending on the stage of the disease the patient is in, the helath care needs are affected. The nurse´s faces major challenges and has a definite role in nursing care in the final end of life.Aim: To compile the nurse's experiences about palliative care in hospitalsMethod: A literature review which compiles qualitative and quantitative articles from databases PubMed and CINAHL.Results: The result is based on scientific articles from various parts of the world. The authors have chosen to divide the results into main categories: Emotional responses in nurses, Time and resource shortages to support end-life patients, Impactable aspects of the health environment, Communication between nurses and patients and the need for knowledge and training in palliative care. Nurses experience mixed feelings and shared opinions about caring for patients in the end of life and meeting their needs at the end of life, which is due to the nurse's professional experienceConclusion: Nurses experience emotional responses, lack of time and resources, lack of education, and different levels of experience are factors that complicate their work of care at the end of life, which gave feelings of inadequacy. Nurses also felt that communication was difficult, which was mostly based on the fact that nurses felt insecure in their role in working with patients in the final stages of life while nurses with longer experience and those with higher knowledge had no difficulty in meeting these patients.

Este estudo foi de natureza qualitativa e utilizou como referencial teórico o Interacionismo simbólico e metodológico a Teoria Fundamentada em Dados. Objetivou-se desenvolver um modelo de cuidado espiritual para os pacientes e seus familiares no enfrentamento de situações de adoecimento. O estudo foi realizado em Hospital Universitário do sul do Brasil, com seis enfermeiras e quatro técnicas de enfermagem, com um ano ou mais de experiência na área de atuação e que estavam exercendo suas atividades. Para coleta dos dados utilizou-se uma entrevista semiestruturada do tipo intensivo e um grupo de expertise, com quatro participantes para validação do Modelo, no período de março a maio de 2016. Os preceitos éticos foram seguidos e obtidas as assinaturas de todas as participantes no Termo de Consentimento Livre e Esclarecido. A coleta e análise dos dados ocorreram de forma concomitante de acordo com o método. Na análise dos dados aplicaram-se as etapas da Teoria Fundamentada em Dados que prevê a codificação inicial, focalizada, axial e teórica. Os significados, pressupostos, ações e resultantes identificados a partir das experiências e vivências das participantes no cuidado aos pacientes e seus familiares foram descritas nas categorias Situando a espiritualidade no seu viver e as subcategorias “Reconhecendo a espiritualidade como uma necessidade e complemento” e “Caminhando na espiritualidade”. Exercitando a espiritualidade na vida e as subcategorias “Praticando a espiritualidade ao seu modo”, “Percebendo a espiritualidade como uma opção de vida”, “Respeitando as crenças do outro”, “Encontrando a espiritualidade na maneira de agir e pensar”. Percebendo o papel da equipe de enfermagem no cuidado espiritual e as subcategorias “Advogando os direitos do paciente e em prol da profissão”, “Conversando sobre espiritualidade”, “Preparando a equipe de enfermagem”, “Cuidando no processo e morte e morrer”, “Limitando o cuidado pelas crenças pessoais, organizacionais e religiosas”. Identificando as manifestações das necessidades espirituais e as subcategorias “Identificando as formas de enfrentamento do sofrimento” e “Acontecendo: o momento de atender as necessidades”. Colocando a espiritualidade como prioridade no cuidado e as subcategorias “Acolhendo os pacientes e familiares”, “Utilizando práticas integrativas”, “Rezando com o paciente”, “Confortando por meio da espiritualidade” e “Continuando a acreditar todos os dias”. A integração destas categorias possibilitou identificar a categoria central Ressignificando o adoecimento e o desenvolvimento do modelo de cuidado espiritual. Além disso, foi desenvolvida uma versão prática do modelo. O estudo originou uma compreensão e interpretação conceitual e prática sobre o tema espiritualidade na enfermagem e foram delineadas as conexões entre a equipe de enfermagem e os pacientes e familiares no momento do cuidado espiritual. / This study was a qualitative approach, which used the theoretical symbolic interactionism and the Grounded Theory as methodological benchmarks. The purpose was to develop a spiritual model of care for patients and their relatives when confronting situations of illness. The study was conducted in a University Hospital in the south of Brazil and involved six nurses and four certified nurse practitioner, whose had one year or over of experience in the operating area and were performing their activities. In order to collect data, we used semi-structured interviews of intensive type and an expertise group, composed of four participants, with sights to validate the Model, during the period between March and May 2016. The ethical precepts were followed, and then we obtained the signatures of all participants in the Free and Informed Consent Form. The collection and analysis of data took place concomitantly in line with the method. When analyzing data, we applied the steps of the Grounded Theory, which foresees the initial, focused, axial and theoretical coding. The meanings, assumptions, actions and outcomes identified from the experiences and backgrounds of the participants in the care of patients and their relatives were described in the categories “Situating the spirituality in your daily life” and the subcategories “Recognizing the spirituality as a need and complement” and “Walking in the spirituality”. “Exercising the spirituality in life” and the subcategories “Practicing the spirituality in my own way”, “Perceiving the spirituality as a life choice”, “Respecting the beliefs of others”, Finding the spirituality in the way of acting and thinking”. “Perceiving the role of the nursing team in the spiritual care” and the subcategories “Advocating the patient’s rights and for the promotion of the profession”, “Talking about spirituality”, “Preparing the nursing team”, “Caring for in the process of death and dying”, “Limiting care through the personal, organizational and religious beliefs”. “Identifying the manifestations of the spiritual needs” and the subcategories “Identifying the ways of confronting the suffering” and “Happening: the time to meet the needs”. “Placing the spirituality as a priority in the care” and the subcategories “Welcoming the patients and relatives”, “Using integrative practices”, “Praying together with the patient”, “Comforting through the spirituality” and “Continuing to believe every day”. The integration of these categories has enabled us to identify the central category “Resignifying the illness”, as well as to develop a spiritual care model. In addition, we have developed a practical version of the model. The study gave rise to a practical and conceptual understanding and interpretation about the issue of spirituality in nursing, and then we drew up the connections between the nursing team and the patients and their relatives at the time of the spiritual care.

Background: Cancer in the head and neck region is an unusual form of cancer. The treatment for this cancer can cause permanent damage to vital functions. Nurses' have expressed frustration about feeling insufficient to accommodate the patients' needs. Patients' with head and neck cancer are reported to have low quality of life. Aim Describe patients' experiences of undergoing treatment of cancer in the head and/or neck region. Method: A qualitative systematic literature review with descriptive approach of qualitative articles. Result: Undergoing treatment for cancer in the head and neck region created challenges for the patients'. Many patients' have had experienced that the time between the diagnose and treatment went fast. The treatment caused side effects that led to constraints in daily life and many created a new identity because they did not recognize themselves in the same way as before the diagnose. Patients became dependent to the medical care and made them omitted to others. They had to handle a new life situation, and to manage that, the patients created strategies. Conclusion: The treatment provided side effects that affected the everyday lives of the patients. The side effects impacted on patients both physically, psychologically, socially and existentially. More knowledge is needed in order to improve the health care for patients with head and neck cancer.

Bakgrund: Enligt den nya patientlagen ska patientens delaktighet i sin egen vård utökas och förstärkas ytterligare. Som en del i detta arbete så har personcentrerad vård införts i flera svenska regioner och landsting. Positiva effekter av personcentrerad vård har kunnat bevisas både hos patienter och vårdgivare. Syfte: Att beskriva vilka faktorer som kan försvåra möjligheterna för sjuksköterskor att ge personcentrerad vård. Metod: Examensarbetet genomfördes som en litteraturöversikt. Tio vetenskapliga artiklar publicerade mellan 2010-2016 ingick i studien. Artiklarna söktes i databaserna CINAHL och PubMed samt genom fritextsökning i Google Scholar. Resultat: Det visade sig finnas flera teman med tillhörande faktorer som kunde försvåra möjligheten för sjuksköterskor att ge en personcentrerad vård. Framträdande faktorer var bland andra sjuksköterskans förhållningssätt och syn på sin profession och på patienten, bristande patientdelaktighet, bristande teamarbete och kommunikation, svagt stöd från organisation och ledning, undermålig miljö och utbildning samt hög arbetsbelastning. Slutsats: Flera faktorer som kunde försvåra för sjuksköterskan att ge personcentrerad vård framkom, där vissa upplevdes som mer avgörande än andra. För att sjuksköterskor ska kunna ge patienten en vård baserad på patientdelaktighet så är det av stor betydelse att medvetenheten om dessa försvårande faktorer ökar. Genom att redan under sjuksköterskeutbildningen arbeta med ett personcentrerat förhållningssätt så ökar sannolikheten för att implementeringen av personcentrerad vård inom svensk hälso- och sjukvård skall lyckas. / Background: According to the new patient law, patients' involvement in their own care will be expanded and strengthened further. As part of this work, personcentred care has been introduced in several Swedish regions and county councils. Positive effects of person-centred care have been proven to exist for both patients and healthcare providers. Aim: To describe factors that can complicate the ability for nurses to provide person-centred care. Methods: The thesis project was conducted as a literature review. Ten scientific articles published between 2010-2016 were included in the study. The articles were searched in the CINAHL and PubMed databases, as well as through Google Scholar free text search. Results: There were several themes with associated factors that could complicate the possibility for nurses to provide a person-centred care. Prominent factors include the attitude of the nurse and his or her view of the profession and the patient, lack of patient participation, lack of teamwork and communication, weak support from organization and management, poor environment and education, and high workload. Conclusion: Several factors that could make it difficult for the nurse to provide person-centred care were discovered, some of which were perceived to be more crucial than others. In order for nurses to be able to provide care based on patient participation, it is very important that awareness of these aggravating factors is increased. By working with a person-centred approach already during nursing education, the likelihood of successful implementation of person-centred care in Swedish healthcare increases

Bakgrund: Diabetes typ 1 och typ 2 ökar hos den äldre befolkningen vilket ställer krav på ökad kunskap och kompetens hos sjuksköterskor inom kommunal hälso- och sjukvården. Det finns sparsamt med forskning som belyser sjuksköterskors erfarenheter av att vårda patienter med diabetes inom kommunal hälso- och sjukvård. Som specialistsjuksköterska inom diabetesvård ingår det att bedriva utvecklingsarbete och att utbilda andra yrkeskategorier. För att kunna ge rätt stöd är det viktigt att lyfta fram sjuksköterskors erfarenheter av att vårda patienter med diabetes under jourtid. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda patienter med diabetes inom kommunal hälso- och sjukvård under jourtid. Metod: Kvalitativ intervjustudie med induktiv ansats där tio allmänsjuksköterskor intervjuades semistrukturerat. Intervjuerna transkriberades och analyserades med kvalitativ innehållsanalys. Resultat: Resultatet presenteras i två kategorier med tre underkategorier vardera. Att vara Trygg med underkategorierna Patientkänndom, Stöd från kollegor och Kunskap och Att känna Ansvar med underkategorierna Ansvar för delegering och omvårdnadspersonalens kunskap, Ansvar för och vikten av dokumentation och Att lämna över ansvar. Slutsats: Studiens resultat visar att sjuksköterskorna kände ett stort ansvar både i sina bedömningar i diabetesfrågor och i att leda och vara ett stöd för omvårdnadspersonalen. Sjuksköterskorna upplevde att de hade bristande kunskap och kände en osäkerhet i arbetet. Deras största stöd i detta var en grundlig journal och stöd från kollegor. För att känna sig trygga i arbetet med diabetes önskade de mer utbildning. / Background: Diabetes type 1 and type 2 increases in the elderly population and puts a demand on increased knowledge and qualification on nurses within the municipal health care. Little research illustrates nurses' experiences of caring for patients with diabetes in municipal health care. Working as a specialist nurse in diabetes care includes development work and educating other professions. In order to provide the right support, it is important to highlight nurses' experiences of caring for patients with diabetes during on call time. Aim: Nurses' experiences in caring for patients with diabetes within municipal health care during "on call time" Method: Qualitative interview study with inductive approach where ten registered nurses were interviewed semi-structured. The interviews were transcribed and analyzed with qualitative content analysis. Results: The result is presented in two categories with three sub-categories each. Being Secure with the sub-categories Patient knowledge, Support from colleagues and Knowledge and Feeling Responsible with the sub-categories Responsibility for delegating and the assistant nurses' knowledge, Responsibility and the importance of documentation and To hand over responsibility. Conclusion: The result showed that nurses felt a great responsibility both in their assessments in diabetes questions and in leading and being a support to the assistant nurses. The nurses felt they lacked in knowledge and felt an insecurity in their work. Their biggest support were a thorough journal and support from colleagues. To feel secure in their work with diabetes they wanted more education.

Background: The daily nursing work includes managing of peripheral intravenous catheter, PIVC. It is the most widely used medical device and often the cause of healthcare associated infections. The most common procedure for inpatients care and used to provide fluid, medication, nutrition, or blood products. Aim: Describe nurses practice of use and management of PIVC. Method: Literature study based on 10 scientific articles worldwide. Results: Presents two themes: “Preparation and inplacement” and “Maintenance and aftercare”. Conclusion: The authors concluded that there were consistent shortcomings in the nursing of PIVC management. The aspects that the study data could demonstrate as factors for lack of care were stress, finances/availability of materials, and knowledge. / Bakgrund: I det dagliga omvårdnadsarbetet ingår hantering av perifer venkateter, PVK. Det är den mest använda medicintekniska produkten och ofta orsak till vårdrelaterade infektioner. Det vanligaste ingreppet för patienter som vårdas i slutenvården och används för att ge vätska, läkemedel, näring eller blodprodukter. Syfte: Beskriva sjuksköterskors hantering av PVK. Metod: Litterarutstudie baserad på 10 vetenskapliga artiklar världen runt. Resultat: Redovisar två teman: ”Förberedande och insättning” och ”Underhåll och eftervård” Slutsats: Författarna kom fram till att det fanns genomgående brister inom omvårdnaden av PVK hantering. De aspekter som studiens data kunde påvisa som faktorer för bristande omvårdnaden var stress, ekonomi/tillgänglighet till material, samt kunskap.

Bakgrund: Kronisk smärta är ett hälsoproblem med en negativ påverkan på människors livskvalité. En av sjuksköterskornas kärnkompetenser är personcentrerad vård vilket visar ha ett positivt inflytande på kvalitén på patientens omvårdnad. Syfte:Att belysa sjuksköterskans erfarenheter av personcentrerad vård vid kronisk smärta. Metod: En allmän litteraturstudie vilket resulterade i nio resultatartiklar. Resultat:Presenteras i två kategorier: Relationen mellan sjuksköterskan och patienten är betydelsefull för personcentrerad vård och Hinder för personcentrerad vård med treunderkategorier: Sjuksköterskans bristande förtroende till patienten med kronisk smärta, Sjuksköterskans bristande kunskap om kronisk smärta och Samarbetshinder mellan sjuksköterska och patient för effektiv smärtbehandling vid kronisk smärta. Konklusion: Personcentrerad vård skapar en relation mellan sjuksköterskan och patienten som är viktig för att skapa en gynnsam vård kring kronisk smärta, vilket bidrar till positiva förändringar i patientens livsstil samt smärthantering. Sjuksköterskornas förtroendebrist och kunskapsbrist bidrar till en begränsning för patientens smärtbehandling. Sjuksköterskor behöver smärtutbildning för att förbättra attityder kring smärttillstånd vilket kan bidra till en god omvårdnadsprocess. / Background: Chronic pain is a health problem that negatively impacts people's quality of life. One of the nurses' core competencies is person-centered care, which shows that they positively influence the quality of the patient's nursing. Purpose: To shed light on the nurse's experiences of person-centered care for chronic pain. Method: A general literature study which resulted in nine result articles. Results:Presented in two categories: The relationship between the nurse and the patient is important for person-centered care and Barriers to person-centered care with threesubcategories: The nurse's lack of trust in the patient with chronic pain, The nurse's lack of knowledge chronic pain and Barriers to cooperation between nurse and patient to effective pain treatment in chronic pain. Conclusion: Person-centered care creates a relationship between the nurse and the patient that is important for creating favorable care for chronic pain, which contributes to positive changes in the patient's lifestyle and pain management. The nurses' lack of trust and knowledge contributes to limiting the patient's pain treatment. Nurses need pain training to improve attitudes about pain conditions, which contributes to a good nursing process.

Bakgrund: Konfusion är ett övergående akut förvirringstillstånd som många patienter med höftfraktur drabbas av varje år efter att de genomgått en operation. De främsta orsakerna är det kirurgiska traumat, anestesin, smärta, sömnbrist, läkemedel och stress. Kvinnor är mest drabbade av konfusion men det kan vara en skrämmande upplevelse oavsett vem som drabbas. Syfte: Syftet med studien var att studera hur patienter som genomgått höftoperation kan undgå att drabbas av konfusion, genom att studera vad sjuksköterskor behöver för att uppnå god beredskap att förebygga eller lindra konfusion. Metod: Detta arbete är en litteraturöversikt som grundar sig på 11 kvantitativa vetenskapliga originalartiklar. Litteratursökningen genomfördes på databaserna PubMed, PsycInfo samt CINAHL. Samtliga studier kvalitetsgranskades med Fribergs (2017) granskningsmall för kvantitativa studier. Resultat: Artiklarnas resultat sammanställdes i två tabeller, en för vardera av de frågeställningar som kompletterade litteraturöversiktens syfte. I resultatet framkom det att sjuksköterskor saknade kompetensen att i kliniken identifiera tecken på konfusion hos patienterna. Sjuksköterskor utbildade i konfusion hade lägre konfusionsincidenter bland sina patienter. Hade patienten haft konfusion tidigare var detta viktig information för personal som sköter vården postoperativt. Det var också en fördel om kompletterande kompetenser, till exempel i form av geriatriksjuksköterskor, fysioterapeuter och arbetsterapeuter, kunde finnas tillgängliga vid behov. Patienter som fick lyssna på lugn klassisk musik fick en bättre utveckling på den kognitiva funktionen. Slutsats: Studiens resultat visar att det behövs mer kunskap, instrument och verktyg för sjuksköterskor för att förebygga, identifiera och behandla konfusion tidigt. En god kompetens, snabb identifiering och information till patientens andra vårdgivare kan leda till bättre vård för patienten och en bättre arbetsmiljö för sjuksköterskan. / Background: Delirium is a transient acute state of confusion that thousands of hip fracture patients suffer from each year after undergoing surgery. The main causes are surgical trauma, anesthesia, pain, lack of sleep, medication and stress. Women are most affected by delirium but it can be a scary experience no matter who is affected. Aim: The aim of the study was to study how patients who have undergone hip surgery can avoid being affected by delirium, by studying what nurses need to achieve good readiness to prevent or alleviate delirium. Method: This work is a literature review based on 11 quantitative scientific original articles. The literature search was performed on the databases PubMed, PsycInfo and CINAHL. All studies were quality reviewed with Friberg’s (2017) review template for quantitative studies. Result: The results of the articles were compiled in two tables, one for each of the questions that complemented the purpose of the literature review. The results showed that nurses lacked the competence to identify signs of delirium in the patients in the clinic. Nurses trained in delirium had lower delirium incidents among their patients. If the patient had had delirium before, this was important information for staff who provide care postoperatively. It was also an advantage if complementary competencies, for example in the form of geriatric nurses, physiotherapists and occupational therapists, could be available if needed. Patients who were allowed to listen to calm classical music had a better development of cognitive function. Conclusion: The results of the study show that more knowledge, instruments and tools are needed for nurses to prevent, identify and treat delirium early. Good competence, quick identification and information to the patient's other care providers can lead to better care for the patient and a better working environment for the nurse.