Skolidrott och fysiska aktiviteter har visat sig ge olika hälsorelaterade fördelar. Fördelar som kan komma till användning för att må bättre och klara av skolgången. Dock är det inte alla målgrupper av elever som har förutsättningar för att tillgodogöra sig idrottsundervisning. Detta arbete har därför utgått från syftet att undersöka vuxna rörelsehindrades upplevelser av idrottsundervisningen i den svenska grundskolan genom en intervjustudie. För att besvara mitt syfte, användes två stycken frågeställningar. Vilka faktorer hindrar personer med rörelsehinder att deltaga i idrottsundervisningen samt om det förekommer faktorer som möjliggör ett tillgodogörande av idrottsundervisningen. Resultatet har visat sig att den fysiska otillgängligheten inte bara inverkar på individernas möjlighet att idrotta utan även möjligheten att ingå i en gemenskap med andra klasskamrater, vilket även påverkar den psykiska hälsan. Skolans representanter har även visat tecken för oförståelse kring undervisningen av elever med funktionshinder. När det gäller möjliggörande faktorer, har det visat sig att olika stödinsatser kan vara viktigt för att individer med rörelsehinder ska kunna tillgodogöra sig idrottsundervisning, exempelvis assistans. Det har även framkommit att individer med rörelsehinder får komma på egna lösningar för att deltaga i idrottsundervisningen i grundskolan. / School sports and physical activities have been shown to provide different health-related benefits. Benefits that involves the ability to feel better and complete the schooling process. However, its not all groups of students who have the prerequisites for using physical education. This work has therefore been based on the purpose of investigating adults with physical disabilities and their experience of intramural sports in Swedish elementary school through an interview study. To answer my purpose, two questions were used. What factors prevent students with physical disabilities to participate in physical education and whether there are factors that allows for the possibilities to participate in physical education. The result has been shown that physical inaccessibility not only affects the ability of individuals to participate in sporting activities but also the possibility of joining a social community with other classmates, which also affects the mental health. There have also been forms of insufficient knowledge about the disability area from school representatives. As far as possible factors are concerned, it has been found that various support interventions may be important for some individuals with physical disabilities to gain access to physical education. For example, assistance. It has also been found that individuals with physical disabilities usually have their own solutions in order to participate in physical education in elementary school.

Background: Critical Care Nurses have previously noted obstacles in caring for dying patients. Obstacles noted by nurses working in more urban settings have been reported. What is not known is the obstacles to providing end-of-life (EOL) care as perceived by nurses working in Critical Access Hospitals (CAHs). Objective: To determine the stories/experiences related to obstacles in providing EOL care as reported by nurses working in CAHs. Methods: This was an exploratory, cross-sectional study. Previous quantitative data has been reported. Documentation of the qualitative stories/experiences of nurses working in CAHs related to obstacles to providing EOL care for dying patients and their families. Results: Sixty-four CAH nurses provided 96 categorizable responses. Two major categories emerged related to either Family, Physician, & Ancillary staff issues or Nursing, Environment, Protocols, and Miscellaneous issues. Issues related to family behaviors included families insisting on futile care, disagreeing about DNR/DNI orders, issues with out-of-town family members, or even family members who suggested to the nurse to hasten the death of their family member. Physician behaviors related to providing false hope, dishonest communication, continuing futile treatments, or not ordering pain medications. Nursing issues included not having enough time to provide EOL care, already knowing the patient/family, or actions of compassion for the dying patient and family. Conclusion: Family issues continue to be obstacles to providing EOL care for nurses regardless of urban or rural setting. Physician behaviors are also consistent regardless of setting. Education of family members regarding issues with EOL care in ICUs is challenging because it is likely the families first experience with ICU terminology and technology. Further research into EOL care in CAHs is needed.

Background: Critical care nurses (CCNs) provide end-of-life (EOL) care for critically ill patients. CCNs face many obstacles while trying to provide quality EOL care. Some research has been published focusing on obstacles CCNs face while trying to provide quality EOL care; however, research focusing on family behavior obstacles is limited.Objective: To determine if magnitude scores (obstacle item size x obstacle item frequency of occurrence) have changed since previous magnitude score data were first gathered in 1999.Methods: A random geographically dispersed sample of 2,000 members of the American Association of Critical-Care Nurses (AACN) was surveyed. Responses from quantitative Likert- type items were statistically analyzed for mean and standard deviation for size of obstacle and how frequently each item occurred. Current data were then compared to similar data gathered in 1999.Results: Six items’ magnitude scores significantly increased over time. Four of the six items related to issues with families including families not accepting poor prognosis, interfamily fighting about continuing or stopping life-support, families requesting life-sustaining measures contrary to the patients’ wishes and, families not understanding the term “life-saving” measures. Two other items included nurses knowing patients’ poor prognosis before families knows and unit visiting hours that were too liberal.Seven items significantly decreased in magnitude score over time, including two items specifically related to physician behavior such as physicians who would not let patients die from the disease process or physicians who avoid talking to family members. Other items which significantly decreased were poor design of units, visiting hours that were too restrictive, no available support personnel, and when the nurse’s opinion regarding direction of care was not valued or considered.Conclusions: EOL care obstacles emphasized in 1999 are still valid and pertinent. Based on magnitude scores, some EOL obstacles related to families increased significantly, whereas, obstacles related to ICU environment and physicians have significantly decreased. Based on this information, recommendations for areas of improvement include improved EOL education for families and nurses.

Background: Domestic violence occurs in many forms and is a public health problem all over the world. Many women described the importance of how they are received by nurses when they seek medical care for the violence. Trust, empathy and a feeling of safety were things women described as mostly valuable. Feelings of not being listened to or even trusted were on top of the list of negative experiences. Aim: The aim was to highlight nurses’ experiences of meeting women exposed to domestic violence. Method: A litterature review was implemented, which included analysis of 12 scientific articles, whence seven qualitative, four quantitative and one mixed method. Results: Nurses mentioned difficulties understanding the women due to cultural- and linguistical differences. Enabling factors to get women to talk about the violence were feelings of trust and safety, as well as routine screening. Conclusion: Encouraging victims of domestic violence to talk about their experience, requires trust and safety. Cultural- and linguistical differences constitutes the main obstacles to achieve this. Appreciation of the women’s situation, as well as the culture they come from, needs to improve and this requires further education.

No description available.

Bakgrund: Trycksår betraktas idag som en nosokomial skada som har en direkt påverkan på den drabbande så väl fysiskt och psykiskt. Utöver det personliga lidandet inbegriper trycksår även betydande resursutnyttjande ur en pur ekonomisk synpunkt men även som en personal belastande fenomen. Evidensen pekar på att ca 95% av samtliga trycksår kan förebyggas vid implementering av evidensbaserade riskbedömningsinstrument och åtgärder. Ändock råder det diskrepans mellan planerade och utförda åtgärder. Syfte: Syftet med studien var att beskriva sjuksköterskors kunskap och upplevda hinder vid förebyggande av trycksår.   Metod: En litteraturstudie genomfördes. Artikelsökningen har i första hand gjorts i databaser Cinahl och PubMed men också en manuell sökning har genomförts. Tematiskananlys användes för att analysera artiklarnas innehåll. Artiklar hade betydande geografisk spridning, var på engelska och i fulltext, original, peer-reviewed samt etiskt godkända.  Resultat: Tio artiklar mötte inklusionskriterier och ingår i studien. Två huvudteman identifierades; sjuksköterskan och arbetsmiljöperspektiv. Första temat hade två subteman kunskap och attityd och arbetsmiljöperspektivet hade tre subteman; personalbrist, tidsbrist samt patienten.   Sjuksköterskor har varierande kunskapsnivåer dock pekar evidensen på att variationerna har liten eller ingen betydelse för utförandet av preventiva åtgärder. Nio artiklar redogjorde för god attityd relaterad till trycksårsprevention.  God attityd har större betydelse än kunskap men likväl begränsad och har endast modest betydelse för implementering av trycksårsförebyggande åtgärder. Personalbrist, tidsbrist och patienten själv framträder som betydande hinder för utförande av preventiva åtgärder.   Slutsats: Denna studie indikerar att kunskap relaterade till trycksårsprevention har stor variation bland sjuksköterskor med såväl gott som dålig kunskap, men också att det generellt sett råder god attityd. Dock har både kunskap och attityd en sekundär betydelseför preventivt arbete emedan de upplevda hindren utgör den största barriären för evidensbaserat preventionsarbete.  Därmed kan det vara önskvärt att ytterligare undersöka om varför kunskap relaterad till trycksår inte tillämpas. / Background: Today pressure ulcers are considered as a nosocomial damage that has a direct impact on the affected person physically as well as psychologically. In addition to personal suffering, pressure ulcers also include significant resource utilization from a purely economic point of view but also as a staff-burdening phenomenon. The evidence indicates that about 95% of all pressure ulcers can be avoided by implementing the evidence-based risk assessment instruments and measures. Nevertheless, there is a discrepancy between planned and implemented measures. Lack of consensus regarding risk assessment and implementation of preventive measures is an another prominent problem.  Aim: The aim of this study was to describe nurses' knowledge and perceived barriers in the prevention of pressure ulcers.  Methods: A literature review was conducted. The article search was primarily done in the databases Cinahl and PubMed but also a manuel search has carried out. Thematic analysis was used to analyse the content of the articles. Articles had significant geographical spread, were in English and in full text, original, peer-reviewed and ethically approved. Results: Ten articles met the inclusion criteria and are included in the study. Two main themes were identified; nurse and work environment perspectives. The first theme had two sub-themes: knowledge and attitude and the work environment perspective had three subthemes: staff shortages, lack of time and the patient.  Nurses have varying levels of knowledge, however, the evidence indicates that the variations have little or no bearing on the performance of preventive measures. Nine articles outlined good attitudes related to pressure ulcer prevention. However, the effects of good attitude are greater than knowledge, but nevertheless they are limited and have only modest significance for the implementation of pressure ulcer prevention measures. Staff shortages, lack of time and the patient himself appear to be significant obstacles to the execution of preventive measures.   Conclusions: This study indicates that knowledge about pressure ulcer prevention among nurses varied, with both good and poor knowledge represented, but also that there is generally a good attitude. However, both knowledge and attitude are of secondary importance to preventive work, as the perceived obstacles constitute the biggest barrier to evidence-based prevention work.  Thus, it may be desirable to further investigate why knowledge related to pressure ulcers is not applied.

Bakgrund: Diabetes typ 2 är den vanligaste formen av diabetes. Cirka 5 procent av Sveriges vuxna befolkning hade diabetes år 2018. Diabetes typ 2 kräver omfattande livsstil förändring och egenvårdinsats. Många personer med sjukdomen ser sin livskvalité minska drastiskt med tiden. Komplikationer som kan följa sjukdomen och de förebyggande insatser från sjukvården innebär betydande direkta och indirekta kostnader för samhället. Sjukdomen är till stor del livsstilsrelaterad och orsakas bland annat av fysisk inaktivitet och ohälsosamma kostvanor även om ärftligheten också spelar stor roll. Den rekommenderade förändringen vid ohälsosamma levnadsvanor kräver en stor insats av egenvård från individen själv och stöd från omgivningen och hälso- och sjukvården. Syfte: Syftet var att beskriva personers upplevelser av hinder för att utföra egenvård vid Diabetes typ 2. Metod: En litteraturöversikt baserad på vetenskapliga artiklar med kvalitativ design Resultat: Resultaten i denna studie identifierade faktorer som påverkar egenvårdsförmågan hos personer som har Diabetes typ 2. Faktorerna som identifierades var individers motivation och förmåga, stöd från ens familj och vänner, materiella förutsättningar och ekonomiska förhållanden, närvaron av en stödjande infrastruktur i hälso- och sjukvården och rådande kulturella normer. Sammanfattning: För att förbättra egenvården bör huvudfokus vara att förändra individens kunskap, attityder och beteende. Detta kan uppnås genom egenvårdsutbildning, kontinuitet i den kliniska vården, personligt stöd och utveckling av hälsosystem. Det är också viktigt att utbilda vårdpersonal så att de kan effektivt stödja egenvårdsinsatser. / Background: Type 2 diabetes is the most common form of diabetes. Approximately 5 percent of Sweden's adult population had diabetes in 2018. Type 2 diabetes requires extensive lifestyle changes and self-care efforts. Many people with the disease see their quality of life decrease drastically over time. Complications that may follow the disease and the preventive measures from healthcare involve significant direct and indirect costs to society. The disease is largely lifestyle-related and is caused by, among other things, physical inactivity and unhealthy eating habits, although heredity also plays a major role. The recommended change in unhealthy living habits requires a great deal of self-care from the individual and support from the environment and health care. Aim: The aim of this study was to describe people's experiences of obstacles to performing self-care in type 2 diabetes. Method: A literature review based on scientific articles with qualitative design Resultat: The results of this study identified factors that affect the self-care ability of people with type 2 diabetes. The factors identified were individuals' motivation and ability, support from one's family and friends, financial conditions, the presence of a supportive health care infrastructure and prevailing cultural norms. Summary: To improve self-care, the main focus should be on changing the individual's knowledge, attitudes and behavior. This can be achieved through self-care education, continuity in clinical care, personal support and development of health systems. It is also important to train healthcare professionals so that they can effectively support self-care initiatives.

No description available.

The wars in some Middle Eastern countries have played an essential role in increasingthe number of immigrants to Sweden in recent years. Some of these immigrants hadean entrepreneurial background in their home country. As former entrepreneurs, theyhave been seeking for opportunities since their arrival in Sweden in order to open theirown business. Our research focuses on the obstacles encountered by seven immigrants from theMiddle East with an entrepreneurial background after their stay in Sweden for at leastfive years, the measures they have taken and are taking to overcome these obstacles,and identifying their views and suggestions for needs. Alternatively, the solutionsneeded for them to overcome these obstacles and start their business. The researchaccording to the qualitative method, the research is conducted based on using the lifestory as a kind of semi-structured interviews to collect empirical data and to obtainwhat is unique in each story. The research was analyzed utilizing thematic analysisand interpretation of the interviewees' explanations. As for the strategies they undertook to overcome these obstacles, they were traditionaland similar to those undertaken by former immigrant entrepreneurs, such as ethnicentrepreneurship and networks, or new, such as early communication with businesssupport organizations, work, training and volunteer, and they showed great flexibilityto adapt and overcome obstacles. Their proposed needs were centred around teachingthe Swedish language and work culture during training or work, working with Swedish entrepreneurs, government support, tax cuts and government encouragementfor them, in addition to the need for effective support when establishing the companyand after incorporation, real analysis of the needs and increased police interest inimmigrant areas and facilitating their access to resources, suppliers and customers.Our group has shown great flexibility to adapt and overcome obstacles and be awareof the majority of obstacles that may arise as a result of ethnic entrepreneurship.

Background: The Critical Access Hospitals (CAHs) system was developed to bring health care to rural populations. Although CAHs lack equipment and resources, CAH nurses still provide end-of-life (EOL) care to critically-ill and dying patients. Objectives: To determine the largest and smallest ranked obstacles and helpful behaviors to providing EOL care to rural patients as perceived by CAH nurses. Also, to determine how CAH nurses' perceptions of obstacles and helpful behaviors to providing EOL care compare to that of their urban counterparts. Methods: A cross-sectional, nationally representative sample of nurses working in 39 CAHs were sent a questionnaire. Nurse participants were asked to rate obstacle and helpful behavior item sizes to providing EOL care to critically-ill patients. Current data were analyzed and compared with previously collected data obtained from urban-working critical care nurses. Results: Seven of the top 10 largest obstacle items were related directly to family behaviors and attitudes such as families not understanding what lifesaving measures entail and intra-family disagreements about life support. Largest helpful behavior items ranked in the top 10 included interventions which the nurse controls and items that impacted nurses having adequate time to deliver EOL care. The majority of the top 10 largest obstacle and helpful behavior items from the 2015 study, as ranked by urban critical care nurses, remained in the top 10 for the current study. Obstacle and helpful behavior items unique to CAHs such as a lack of resources and the nurse knowing the patient or patient's family fell below the top 10 largest items in ranking. Conclusion: As perceived by nurse participants, obstacles and helpful behaviors to providing EOL care remain similar despite location (rural versus urban). CAH nurses are accustomed to working without typical resources found in urban hospitals and therefore did not perceive resource deficits to be among the largest-ranked obstacles to providing EOL care. Family behaviors and attitudes remain the most dominant obstacle noted by nurses.