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Sammanfattning Titel: Patienters erfarenheter av kontakten med äldresköterskan i primärvården. Bakgrund: Andelen äldre människor i Sverige ökar eftersom vi lever längre. Med stigande ålder ökar mottagligheten för sjukdom. Både sjukdom och åldersförändringar kan ge funktionsnedsättningar men trots detta bor många äldre med hälso- och sjukvårdsbehov hemma utan inskrivning i den kommunala hemsjukvården. Syfte: Att belysa patienters erfarenheter av kontakten med äldresköterska inom primärvården. Metod: Studien utgår från en kvalitativ design med induktiv ansats. Fem patienter deltog enskilt i en semistrukturerad intervju. Dataanalysen genomfördes med kvalitativ manifest innehållsanalys. Resultat: De intervjuade upplevde att samtalet är den viktigaste erfarenheten av kontakten med äldresköterskan. Patienterna upplever att kontakten ger dem stöd och minskad oro i vardagen. Deras trygghet ökar genom den kontinuitet och tillgänglighet som äldresköterskan erbjuder. Slutsats: Det arbete som äldresköterskan utför bör lyftas fram och tillåtas utvecklas eftersom antalet äldre med vård- och omsorgsbehov ökar. / Abstract Titel: Patients' experiences of contact with elder nurses in primary health care. Background: The proportion of elderly people in Sweden will increase due to longer life span. With age susceptibility to disease increases. Both disease- and agerelated changes can cause impairments even though many elderly people with health needs live at home, without enrollment in the municipal home care. Objective: The aim was to illuminate patients´experiences of contact with the elder nurse in primary health care. Method: The study uses a qualitative design with inductive approach. Five patients participated individually in a semi-structured interview. Data analysis was performed by qualitative manifest content analysis. Results: The interviewees felt that the conversation is the most important experience of contact with the nurseproviding elder care. Patients feel that the contact give them support and reduced anxiety in daily life. Their safety is enhanced by the continuity and availability provided by the elder nurse. Conclusion: The work that elder nurse perform should be emphasized and allowed to evolve as the number om elderly people with health and care needs increase.

The thesis deals with specific nursing care for children with facial cleft anomalies. Facial clefts belong to frequent congenital anomalies with incidence of 1 : 500 in lively born children, which is why adequate care has to be provided to these children to honour the founder of Czech plastic surgery Prof. František Burian. Two goals were set in this thesis. The first goal was to elaborate a proposal of a nursing procedure for children with facial cleft. The other goal was to elaborate an educational programme for nurses and parents of children with facial cleft anomalies. Both the goals have been achieved. Two hypotheses were set in this thesis: Hypothesis No. 1 ?Nurses working at a specialized department are sufficiently informed on the care about children with facial cleft anomalies?. Hypothesis No. 2 ?Nurses working at maternity wards are sufficiently informed on the care about children with facial cleft anomalies?. Two research questions were also set before the research itself: Research question No. 1: How do nurses provide specific nursing care to children with facial cleft anomalies? Research question No. 2: What principles do nurses consider important for the care about children with facial cleft anomalies? The questionnaire, interview and observation methods were used for data collection. The questionnaire was based on information obtained from literature and was designed for ward nurses. The interview was prepared upon own experience from observation of nurses in the Královské Vinohrady University Hospital in the Centre for Cleft Anomalies Treatment and upon information from literature. 60 questionnaires were distributed in the České Budějovice Hospital in March 2011. There were 47 completed questionnaires suitable for processing. 11 questionnaires were distributed in the Královské Vinohrady University Hospital in March 2011. 9 completed questionnaires were used for processing. The research sample for the interview consisted of 11 nurses working in the Královské Vinohrady University Hospital, the Centre for Cleft Anomalies Treatment, the Paediatric ICU and the Paediatric ward. The results show that the nurses working at maternity wards are sufficiently informed. The results also show how nurses provide specific nursing care and what principles they consider important. We have elaborated educational programmes for parents and nurses within the set goals and upon the interviews with nurses, which may help improve the nursing care and particularly teach parents to care about their children with facial cleft properly.

The thesis is focused on a research and the evaluation of the nurse role during the invasive methods in chronic pain treatment and on a research the patient satisfaction and expectation with the nurses approach during the invasive methods in chronic pain treatment. The basis for the thesis processing is qualitative ? quantitative research carried out in the departments of pain treatment in four hospitals, in University Hospital Motol, University Hospital Brno, Hospital České Budějovice a.s., University Hospital PlzeňAlejSvobody. Qualitative research focuses on nurses working in the department of pain treatment using a method of questioning with the technique of non-standardized interview. Within qualitative research, we was looking for the answer to the research question: What is the nurse role during the invasive technique in chronic pain treatment? It was found, from the results of the interviews and their analysis, that nurses have within the invasive performance wide field of action and their role is changing in various stages of the entire performance. In all phases of the invasive performance, it´s essential the communication between the nurse and the patient. In the phase before the invasive performance and afterwards is the most dominated the educational role, except for the nursing role. Quantitative research using the questionnaire was intended for patients in the departments of pain treatment. The following predetermined hypothesis were verified using quantitative research: H1: Patients are satisfied with the nurses approach during the invasive techniques in pain treatment. H2: Patients with chronic pain during the invasive methods are expecting especially the empathetic approach from nurses. Evaluation of the questionnaires, which were voluntarily completed by patients, can be ended that both given hypothesis H1 and H2 have been confirmed and that the targets of qualitative researches have been met. The space for improvement can be found in the patient education before the invasive performance. Therefore We created educational material for patients. This educational material is not intended to replace the education conducted by nurses, it rather serves as a basis for the questions preparation that the patient will want to clarify before the invasive performance.

Increasing the education of nursing staff is a society-wide issue, influenced by continuous development of medicine and medical technologies. The provision of nursing care is rightly demanding. The only way to keep up with new trends is lifelong nursing education. Nursing education in a particular workplace primarily aims at addressing current problems of the department and nurses? needs. The theoretical part deals with the influence of education on the quality of nursing care. We present a structure of education of paramedical professions. We define and clarify terms such as pedagogy, didactics, education and learning. We deal with the specifics of education, didactic principles and principles of adult education. In addition, we specify instructional strategies for nursing staff. For the purposes of this thesis, four objectives were set. In the first one we wanted to find out what the system and process of nursing education in the department looks like. The research showed that educational events are held in all departments. The organizing departments mostly report irregular or monthly frequency. The aim of the second objective was to obtain an opinion on the effectiveness of education in the department. We found disparity between the views of ordinary nurses and head nurses. The third objective was to answer the question of whether the organized educational events are initiated by the nurses? requests. Based on the answers of head nurses and ordinary nurses, we found out that this is not always the case. The last objective was to determine whether nurses implement the knowledge and skills gained to routine nursing care. The questionnaires showed that ordinary nurses try to incorporate the knowledge and skills to routine nursing care. For the purposes of this thesis, the combination of qualitative and quantitative research was selected. In order to carry out the qualitative part of the research, the method of questioning, using the technique of semi-structured interview with open questions was chosen. For the issue of quantitative research, the method of questioning, using the questionnaire technique with closed and semi-closed questions was used. For qualitative research, we set two research questions. In the first research question we wanted to find out what impetus the management uses when planning education in the hospital and the department. We found out that most often it is initiated by head nurses and ward nurses. In the second research question, we examined what obstacles the management sees to the effectiveness of education and implementation of the knowledge and skills gained into practice. Head nurses identify a problem in the actual participation in education in the department. For quantitative research, we set five hypotheses. Hypothesis 1 was: Nursing education in the workplace is an activity organized by the management regardless of the ordinary nurses? requests. The hypothesis was not confirmed. Hypothesis 2 was: Management, unlike ordinary nurses, sees the effectiveness of education in the workplace positively. The hypothesis was not confirmed either. The third hypothesis was: Education is seen as a necessary, routine activity, not as motivating factor for improving the quality of nursing care. The hypothesis was not confirmed. The last hypothesis was: Implementation of the knowledge gained from the educational events into nursing care is monitored by the management. The hypothesis was not confirmed, the implementation of knowledge is monitored, but not to the extent we expected. When evaluating the results we came across other very interesting facts, which we believe deserve more attention. Finally, it is surprising that the organization of educational events does not reflect nurses? shifts. One of the reasons for this might be the fact that some head nurses do not prepare the plan and time schedule for nursing education. We tried to propose the time schedule of nurses education in deparments.

The aim of the thesis is to find out the conception of human dignity at medical staff. At nurses, in addition, with a hidden observation to verify to what extent they meet their statements in practice, whether for nurses a patient does not become only an object of relevant therapeutic and nursing acts. The empirical part of this thesis was processed in form of a qualitative research. The data collection technique was a non-standardised interview with nurses at standard in-patient departments, students of the nursery Master study programme, students of a higher nursing school and patients at a standard department. At nurses it was verified, using the technique of hidden observation, to what extent their actual behaviour in practice corresponds to the information mentioned in interviews. Therefore in their interviews we differentiated the mentioned and non-mentioned elements. The interviews were anonymous. They were recorded in writing because only in one case the respondent agreed for us to use a dictaphone. Collection of empirical data proceeded from June to August 2008. Unlike our expectations the research showed that respondents have no conception of human honour and have no complex conception of its keeping in practice. We categorised the rather poor information into five basic categories that covered 92% (intimacy, communication, individuality, empathy and equality of approach). Statements that we did not manage to categorise here create other 5 categories (worthy dying, consider seriously, pain calming, lege artis process and faith). Most often the respondents mentioned the following categories: intimacy (80.4 %), communication (76.8 %), individuality (60.7 %), empathy (39.3 %) and equality of approach (33.9 %). The hidden observation showed that most nurses (13 out of 16, i.e. 81 %) adhered to their fundamentals of keeping human dignity when working with ill people in a satisfactory way. The other 3 nurses made mistakes in all categories except keeping intimacy; here only one of them did wrong. Results of the thesis should contribute to improvement of quality of care and help to better respect for human dignity.

Little is known regarding registered nurse (RN) information management practice in long-term care (LTC) settings. This study identifies LTC RNs’ information management practice and needs, which are important for designing and implementing health information technology (HIT) in LTC settings. Methods: This descriptive qualitative study combines direct observations and semi-structured interviews, conducted at Alberta’s LTC facilities between May 2014 and August 2015. The constant comparative method of joint coding was used for data analysis. Results: Nine RNs from six nursing homes participated in the study. Based on the RNs’ existing information management system requirements, a graphic information flow model was constructed. Conclusion: This baseline study identified key components of LTC RNs’ information management system. The information flow model may assist HIT developers with future design and development of HIT solutions for LTCs, serve as a communication tool between RNs and developers to refine requirements and support further LTC HIT research. / Graduate

Several issues have impacted on district nursing practice and education within the UK, which can be conceptualised within four main areas: national policy; local organisational structures and practice; professional and disciplinary theory; and practice of individuals (Bergen and While 2005). However, there has been a lack of direction in district nursing in recent years within the UK, with a decline in the number of district nurses being educated (Queen’s Nursing Institute 2014a) and the educational standards supporting district nurse education being over 20 years out of date (Nursing and Midwifery Council 2001). In addition to this, the standards of education for pre-registration nursing (Nursing and Midwifery Council 2010) have supported a graduate workforce with an increasing focus on nursing in the community. This was identified as a consideration for me as an educator when examining the future educational requirements of nurses beyond the point of registration in the community, and became the focus of this study. Knowing in practice is a key concept within this thesis, that is, the particular awareness that underpins the being and doing of a district nurse in practice (Chinn and Kramer 2008). This study explores the unique knowing of district nursing in practice, and how this professional knowing is developed. Understanding the knowing of district nurses and how this is developed will contribute to future educational frameworks and ways of supporting professional development within community nursing practice. A question that is often asked is what makes district nurse knowing different from nursing in inpatient settings, and this emerges in this thesis. A qualitative study using an interpretative approach within a case study design was adopted using three Health Boards within Scotland as the cases. Within each Health Board area, interviews were undertaken with key informants and also, group interviews with district nurses were undertaken using photo elicitation as a focussing exercise. The data were analysed using framework analysis (Spencer et al. 2003). This approach illuminated a depth and breadth of knowing in district nurse practice and how this knowing is developed. The study findings depict the complexity of knowing in district nursing, acknowledging the advancing role of district nursing practice, where the context of care is an essential consideration. The unique knowing can be described as a landscape that the district nurse must travel: crossing a variety of socio-economic areas; entering the private space of individuals, and the public space of communities; as well as acknowledging professional practice; navigating the policy agenda while maintaining clinical person-centred care; and leading others across the terrain of interprofessional working. The unique knowing in practice that characterises the expertise of district nurses is a matrix of elements that incorporates different aspects of knowing that contribute to leadership, as suggested by Jackson et al. (2009). The participants in this study recognised that due to the complexity of the district nurse role, and its continuing advancements, that district nurse education needs to move to a Master's level preparation and it needs to continue to be supported by a suitably qualified practice teacher. Furthermore, the findings within this study demonstrate that the development of the unique knowing in district nurses does not happen in isolation and it is very complex. It consists of networks, conversations, engagement with policy, understanding of professional contexts, adhering to organisational boundaries, and interaction with complex and challenging situations. Theory and practice are mutually dependent on each other; change is inevitable and is unpredictable; and practices change by having experiences, therefore change is integral to practice. Consequently, it was concluded that the interdependent elements, which interact, develop the unique knowing of district nurses in practice. Finally this thesis makes recommendations and discusses future implications for policy, practice and research.

The concept of a missing nursing care in a nursing practice is a phenomenon that could endanger patients' safety in all cultures. This global deficit of a superior and comprehensive nursing care occurs in various departments of healthcare facilities. The theoretical part of this thesis deals with problematic aspects of the concept of a missing nursing care based on theoretical findings. Furthemore it summarises strategies used for ensuring that quality, safety and kompetence in a nursing care is met in relation to latest findings and the legislation. The research part presents outcomes of a conducted qualitative survey research focusing on nurses working in an Intensive Care Unit where a nursing care is directed towards the population of adult patients. Research Metodology: The data collection in the study is based on a semi-structured interview conducted on an actively working group of nine Intensive Care Unit nurses. Aim of the Study: The main objective of the thesis is to describe and analyse problematic aspects of the concept of a missing nursing care in an Intensive Care Unit, as well as to identify factors that affect occurrence of the given concept limited to the nursing staff in the Intensive Care Units. Research Results: The study analyses six categories in total, of which five categories...

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 4 uppsatser.