A quality patient experience is one of the highest priorities for hospitals as patients and families are looking to healthcare providers to meet their demands for quality service. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures the extent to which providers effectively communicate pertinent information such as communication about medications. On a 20-bed intermediate care unit, the HCAHPS item scores relating to nurse communication and communication about medicine were inconsistent and, on most occasions, were below the comparison benchmark of the 50th percentile when compared to other like hospitals. The purpose of this quality improvement project guided by the patient-centered care model, needs based theory, and adult learning theory, was to test the impact of an educational module for nurses on best practices for teaching patients about medications. Thirty nurses consented to participate in the teach-back sessions. Results of the pre- and posttest, evaluating the nurses' knowledge and attitude about teach-back, were analyzed using the Wilcoxon Signed Ranks test and findings showed an improvement in knowledge scores (z = -2.833, p = .005). However, no statistically significant changes occurred in nurse attitudes toward teach-back. A comparison of descriptive HCAHPS scores on communication about medications and nurse communication showed that scores improved from a low of 58% top box to 74% after the teach-back education. These findings indicated that using teach-back could enhance communication about medications. Effectively communicating pertinent health information using teach-back may have significant consequences for nurse-patient-family engagement contributing to positive social change.

Master of Public Health - MPH / Background: HIV remains a global concern. Consequently, global institutions such as the World Health Organisation (WHO) and United Nations Programme on HIV and AIDS (UNAIDS) continue to work towards ending HIV/AIDS by facilitating innovative strategies to improve service delivery of antiretroviral therapy (ART). In 2016 WHO issued the ‘test and treat’ policy recommendation in line with the UNAIDS 2020, 90-90-90 target of reaching 90% people to know their HIV status, get 90% of these on ART treatment and to have 90% of those on treatment virally suppressed. Differentiated Care Models (DCMs) has been put in place for all stakeholders, from global, institutes, government departments and civil society to improve patient access to treatment and retention in care. While various evaluation studies have shown that DCMs improve the retention in care and adherence to medication behaviours of patients on ART, little is known about the patients’ experiences and preferences. The aim of the current study was to explore and compare the experiences of patients in three DCMs (Facility Adherence Clubs [FAC], Community Adherence Club [CAC] and Quick Pharmacy Pick-up [QPUP]) in a community health care facility in a township in Cape Town, South Africa. Methods: An exploratory qualitative study design was used. Data were collected through semi-structured interviews (12) and focus group discussions (6) with purposively selected participants from six DCMs. Thematic analysis was done using Atlas.ti version 8.0. Results: Patients found DCMs easily accessible and convenient and presented positive experiences in relation to the National Health Services (NHS) patients experience principles. FACs and CAC presented attributes of patient-centeredness as prescribed by the NHI. We found that the QPUP model fell short on attributes of patient-centeredness such as coordination and integration of care, information sharing, communication and education, and emotional/psychological support. Conclusions: The principles of DCMs acknowledge the diversity and preference of PLHIV in addressing the barriers they face in accessing ART while empowering these patients to self-manage their disease. Understanding the experiences of patients using DCMs could improve our understanding of how DCMs promote self-management among PLHIV (or not) and some of the challenges faced by the patients using these care models. This understanding could inform strategies to tailor ART delivery services that suit the patients’ needs and enhance their abilities to achieve optimal retention in care and viral suppression.

Purpose: The purpose of this Qualitative Descriptive study was to describe the experience of hospitalized adults during the pandemic who did not have COVID-19. Specific Aims: The specific aims of the study were to: Describe the hospital experience, including but not limited to, interactions with hospital staff, visitation, isolation, physical and emotional stressors, and the environment. Identify perceived comfort needs during hospitalization and perceptions of the nurse’s role in providing comforting interventions. Examine the ability to achieve physical, psychospiritual, sociocultural, and environmental comfort during hospitalization despite the required infection control measures. Framework: This study was guided by Kolcaba’s Theory of Comfort (1994). Design: This was a qualitative descriptive study. Semi-structured interviews were conducted. Interview questions focused on the overall hospital experience, the nurse’s role in their experience, comfort needs, and the experience of having comfort needs met during the hospitalization. Results: Twenty participants took part in this study. Conventional content analysis revealed five main themes. The themes are: I don’t expect the hospital to be comfortable, I was always tense, Wanting human connection, Communication is important, and Nurses are busy. Conclusion: The findings identified a need for targeting education, research, and policy development to improve patient comfort (physical, psycho-spiritual, sociocultural, and environmental). This is important as we look toward improving the overall patient experience during hospitalization.

Bakgrund Målet med intensivvård är att uppnå det bästa medicinska samt omvårdnadsmässiga resultatetutan komplikationer. Det har tidigare varit standard att djupt sedera patienter som erhållermekanisk ventilation. Intensivvårdspatienter kan idag vårdas på en intensivvårdsavdelningmed lättare sedering än tidigare vilket bidrar till kortare vårdtid på intensivvårdsavdelning samt minskad respiratortid för patienter. En lätt sedering underlättar för patienter och sjuksköterskan att kommunicera samt bygga en relation till varandra vilket bidrar till enbättre vård för patienter. Syfte Att undersöka patienters upplevelse av att vara intuberade samt lätt sederade på en intensivvårdsavdelning utifrån perspektivet vårdlidande. Metod En litteraturöversikt med systematisk ansats användes för att söka, kritiskt granska samtsammanställa data från tidigare genomförda studier. Totalt inkluderades 19 vetenskapligaartiklar som kvalitetsgranskades med hjälp av SBU:s granskningsmall för kvalitativa studier. Analysen gjordes utifrån Katie Erikssons teori om vårdlidande. Resultat Resultatet redogjordes utifrån fyra förutbestämda kategorier; Kränkning av patientersvärdighet, fördömelse och straff, makt och utebliven vård samt en femte kategori; Lindratvårdlidande. 10 subkategorier framkom ur resultatet som svarade på syftet. Slutsats Vårt resultat visar att vårdlidande är konstant närvarande. Brister i kommunikation, delaktighet och känslan av maktlöshet fortsätter att skapa vårdlidande för patienter. Närvaro av familj och att bli sedd som en individ framkom vara viktigt för patienter för att minska vårdlidandet. Ökad kunskap och förståelse kring ämnet gör att behov kan förutses och tillgodoses, vilket resulterar i minskat vårdlidande och ökad komfort för patienter. Intensivvårdssjuksköterskan kan genom att vara lyhörd för patienters individuella behov tillsammans med standardiserade omvårdnadsrutiner minska vårdlidandet. / Background The goal with intensive care is to achieve the best medical and nursing care result without complications. It has previously been standard to deeply sedate mechanically ventilated patients. Intensive care patients can today receive care with lighter sedation than ever before which results in shorter time spent on a ventilator and at the intensive care unit. A lighter sedation helps patient and nurse to communicate and build a relationship with each other which leads to a better care for the patient. Aim To explore the patient experience of being intubated and lightly sedated in an intensive care unit from the perspective of suffering from care. Method A literary review with a systematic approach was used to search, critically analyse and comprise data from previous studies. In total 19 articles were included, and quality checked with SBU template for qualitative research. The analysis was based on Katie Ericsson’s theory of suffering from care. Result The findings emerged from four previously decided categories: Violation of patient's dignity, condemnation and punishment, control, lack of care and a fifth category that emergedduring the process, relived suffering. 10 subcategories were created from the result and answer the aim of the literary review. Conclusion The result show that suffering from care is constantly present. Lack of communication, participation and the feeling of being powerless continues to create suffering from care for patients. Having family present and being seen as an individual were helpful in easing the suffering of care. Greater knowledge and understanding about the subject makes it possible to foresee and fore fill needs, which would result in less suffering of care and a higher level of comfort for the patients. The intensive care nurse can trough being responsive for the patients individual needs, together with standardised care actions decrease the suffering of care.

INTRODUKTION: Ett personcentrerat arbetssätt med god kommunikation främjar patientsäkerheten och stärker patientens egen roll i sin vård. Bedsiderapportering (BSR) syftar till att öka patientsäkerheten, patientdeltagande och skapar förutsättningar för personcentrerad vård.   SYFTE: Syftet med arbetet var att undersöka upplevelser av BSR ur både patient- och sjuksköterskeperspektiv på somatiska vårdavdelningar inom vuxenvården.   METOD: Arbetet har en beskrivande design med litteraturöversikt som metod. Sökning efter artiklar gjordes i databaserna CIINAHL och PubMed. Kvalitetsanalys genomfördes med SBUs granskningsmall Bedömning av studier med kvalitativ metodik. Resultatanalys skedde med Fribergs (2022) femstegsmodell.    RESULTAT: Sjuksköterskor och patienter var enade om att BSR ökade patientdelaktigheten, förbättrade relationen mellan patient och sjuksköterska och ökade patientsäkerheten. Vidare var båda parterna ense om att sekretessen kunde vara ett problem, särskilt på delade rum eller då anhöriga deltar.   SLUTSATS: BSR visade sig ha många fördelar ur både sjuksköterske- och patientperspektiv. Främst ökar patientdelaktigheten i vården vid användning av BSR. / INTRODUCTION: A person- centered approach with adequate promotes patient safety and strengthens the patients’ own involvement in their care. Bedside report (BSR) is supposed to enhance patient safety, patient involvement and creates opportunities for person centered care.    AIM: The aim of this study was to explore the experiences of nurses and patients related to BSR in somatic adult hospital wards.    METHOD: This essay has a descriptive design using literature review as a method. A search for articles was made in the databases CINAHL and PubMed. Quality analysis was made with SBU’s template ”assessment of studies with a qualitative method”. Result analysis was made with Fribergs (2022) five- step model.    RESULTS: Nurses and patient agreed that BSR promoted patient involvement, created a better relationship between nurse and patient and enhanced patient safety. Both parties agreed that confidentiality could be a concern, especially when BSR took place in a multiple- patient room or when visitors were around.    CONCLUSION: BSR had a lot of benefits for both nurses and patients, especially when it comes to patient involvement.

Bakgrund: Det är cirka 40 miljoner människor i världen som är i behov av palliativa vårdinsatser och i Sverige anses 70 000 – 75 000 personer vara i behov av det årligen. Vården baseras på holistisk vård som grundas på de fyra hörnstenarna, vilket sjuksköterskan bör förhålla sig till. Patienters åsikter anses värdefulla för en god palliativ vård. Syfte: Syftet med litteraturöversikten är att belysa vuxna patienters erfarenheter av palliativ vård.  Metod: Metoden som har används är en allmän litteraturöversikt. Tio kvalitativa vetenskapliga artiklar har bidragit till resultatet. Åtta artiklar är från PubMed och Cinahl Complete, två genom sekundärsökning. Artiklarna analyserades enligt rekommenderade analyssteg.  Resultat: Fyra huvudteman med tillhörande underteman framkom: (1) Holistisk vård med undertema Upplevelser av holistisk vård och Livskvalitet trots obotlig sjukdom, (2) Upplevelser av palliativa teamet med undertema Upplevelser av sjuksköterskor och Upplevelser av brister under vårdtiden, (3) Vikten av information och kunskap samt (4) Dialog vid livets slut med undertema Avsked av närstående och Önskningar vid livets slut. Sammanfattning: Palliativ vård upplevdes generellt positivt av patienter utifrån detta resultat. Värdig vård ansågs vara genom holistisk vård och tid. För att hantera och acceptera sin situation angav patienterna att information om tillstånd och behandling var viktigt, likaså samtal om livets slut. Palliativa vården och vårdteamet hade en viktig roll för patienter med obotlig sjukdom. / Background: There are about 40 million people in the world who are in need of palliative care and in Sweden 70,000 - 75,000 people are considered to be in need of it annually. The care is based on holistic care which is founded in the four cornerstones, which the nurse should relate to. Patients opinions are considered valuable for good palliative care.  Aim: The purpose of the literature review is to explain adult patients experiences of palliative care.  Method: The used method is for a general literature review. Ten qualitative articles have contributed to the result. Eight articles from PubMed and Cinahl Complete, two through a secondary search. The articles were analyzed according to recommended analysis steps. Results: Four main themes with associated sub-themes emerged. (1) Holistic care with the sub-theme Experiences of holistic care and Quality of life despite incurable disease, (2) Experiences of the palliative care team with the sub-theme Experiences of nurses and Experiences of deficiencies during the care period, (3) The importance of information and knowledge and (4) Dialogue at the end of life with subtheme Farewell to relatives and Wishes at the end of life. Summary: Experiences of palliative care were generally experienced positively by patients based on this result. Nurses' abilities to care holistically and provide time were perceived by patients as dignified care. To handle and accept their situation, the patients indicated that information about the condition and treatment was important, as well as conversations about the end of life. Palliative care and the care team also had an important role for patients living with an incurable disease.

Introduktion: Endometrios är en kronisk sjukdom som drabbar ungefär 10 procent av flickor ochkvinnor i fertil ålder. Tidigare forskning tyder på att hälso- och sjukvården saknar adekvat kunskapvilket i kombination med sjukdomens många olika symtom försvårar diagnostisering ochbehandling. Detta kan resultera i ett bemötande från vårdpersonal som leder till nedsatthälsorelaterad livskvalitet och välbefinnande för kvinnorna. Syftet: var att beskriva hur kvinnor med endometrios upplever bemötandet inom hälso- ochsjukvården. Metodbeskrivning: En empirisk studie med enkät som metod. Deskriptiv statistik ochinnehållsanalys användes för att sammanställa och analysera insamlad data. Resultat: Totalt 34 kvinnor ingick i studien. Följande fem kategorier framkom: Vårdpersonalensförhållningssätt; Vårdpersonalens kommunikation; Vårdpersonalens kunskap; Vårdmötet; Tid är enfaktor för patientdelaktighet. Resultatet visar både positiva och negativa aspekter gällande hurkvinnor med endometrios upplevde bemötandet inom hälso- och sjukvården. Slutsats: Studien synliggjorde förbättrings- och utvecklingsmöjligheter för vårdpersonal gällandebemötandet av kvinnor med endometrios. Likvärdig kunskap och bättre kommunikation mellanvårdpersonal har betydelse för bemötandet. Hänsyn behöver tas till kvinnors subjektiva upplevelserav sjukdomen, behandling och smärtlindring. Tid är avgörande för kvinnornas delaktighet i denegna vården. / Introduction: Endometriosis is a chronic disease that affects about 10 percent of women of childbearing age. Prior research suggests that healthcare services lack adequate knowledge of thedisease, which, in combination with the wide range of symptoms of the disease, makes diagnosisand treatment difficult. This can result in a response from healthcare professional that may lead toreduced quality of life and wellbeing for women. Aim: The aim was to describe how women with endometriosis perceive how women diagnosedwith endometriosis experience their encount with healthcare. Methods: An empirical study facilitated through the questionnaire method. Descriptive statisticsand content analysis were used to compile and analyze collected data. Results: A total of 34 women participated. Five categories emerged, including: Attitude ofhealthcare professionals; Communication of healthcare professionals; Knowledge of healthcareprofessionals; Encounters with healthcare professionals; Time as a factor of patient participation.The results show both positive and negative aspects regarding how women with endometriosisexperienced their encount with healthcare. Conclusion: The study highlighted opportunities forimprovement and development for healthcare professional regarding the encounting of women withendometriosis. Equivalent knowledge and better communication between healthcare professionalare important for the encounting. Women's subjective experiences of the disease, treatment and painrelief need to be taken into account. Time is crucial for women's participation in their own care.

Bakgrund Långvarig smärta är ett utbrett problem med konsekvenser på både individ- och samhällsnivå. Personer med långvariga smärttillstånd är ofta fysiskt inaktiva till följd av smärta, trots att fysisk aktivitet har kända positiva effekter på både smärta och den övriga hälsan. Fysisk aktivitet kan utföras i form av egenvård, bland annat som en del i omvårdnaden. För att motverka konsekvenserna av fysisk inaktivitet och för att främja en god hälsa, behövs fler studier om personers upplevelser av fysisk aktivitet vid långvarig smärta. Syfte Syftet var att belysa personers upplevelser av fysisk aktivitet vid långvarig smärta. Metod Denna icke-systematiska litteraturöversikt baserades på 15 vetenskapliga artiklar med kvalitativ design, vilka inhämtades från databaserna PubMed och CINAHL. Därefter granskades artiklarna avseende kvalitet utifrån Sophiahemmet Högskolas granskningsmall och artiklarnas innehåll analyserades utifrån en metod beskriven av Friberg, varpå tre huvudkategorier utformades. Resultat I resultatet beskrevs en variation av upplevelser av fysisk aktivitet. Dessa var bland annat ökad smärta alternativt en positiv inverkan på smärtan, smärthanteringen och den allmänna hälsan, såväl fysiskt som psykosocialt. Upplägget av fysisk aktivitet upplevdes även ha påverkan på utförandet av det och genomgående beskrevs vikten av motivation och stöd, samt betydelsen av att ha personens situation och sammanhang i åtanke. Slutsats Varierade upplevelser av fysisk aktivitet vid långvarig smärta beskrevs, där motivation, stöd från andra samt information och kunskap upplevdes vara några av de viktigaste aspekterna i att få den fysiska aktiviteten att fungera. Resultatet visade sammanfattningsvis på att personcentrering och individanpassning i omvårdnaden utgjorde grunden för ett lyckat utförande och vidmakthållande av den fysiska aktiviteten. / Background Chronic pain is a widespread problem, with consequences on both an individual and societal level. People with chronic pain conditions are often physically inactive due to pain, even though physical activity has known positive effects on both pain, and health in general. Physical activity can be performed in the form of self-care, as a part of nursing care. To counteract the consequences of physical inactivity, and to promote good health, more studies about people’s experiences of physical activity when living with chronic pain are required. Aim The aim was to illustrate people’s experiences of physical activity when living with chronic pain.                                             Method This non-systematic literature review was based on 15 scientific articles with a qualitative design, which were obtained from the databases PubMed and CINAHL. The quality of the articles was reviewed using the assessment basis by Sophiahemmet University, and each article was analyzed by a method for content analysis described by Friberg, whereupon three main categories were formulated. Results A variation of experiences of physical activity was described. Some of these were increased pain or positive effects on pain, pain management, and health in general, both physically and psychosocially. People also experienced that the arrangement of physical activity affected their performance. The importance of motivation and support, as well as having the individual’s situation and context in mind, was also constantly described. Conclusions Varying experiences of physical activity when living with chronic pain were described, where motivation, support from others, information, and knowledge were perceived to be some of the most important aspects in making the physical activity function. As a summary, the results showed that person-centered care, and individual adaptation in nursing-care, formed the basis of successful performance and maintenance of physical activity.

No description available.

Pain is a symptom that occurs in many diseases and in emergency care is a common symptom that affects a patient's psychosocial and physical needs. An accurate assessment of a patient’s pain may be difficult to obtain due to the subjective nature of pain and the patient’s inability to accurately express the pain they are experiencing. Nurses can support their patients’ experience by facilitating an increased understanding of pain and pain management. Therefore, patients’ individual needs revealed in the initial intake should dictate the management and decrease of their pain. The aim of this study was to describe adult patients' acute pain management experiences while in the emergency department. The method used in this study was a literature review with a systematic approach. The searches were performed in the databases PubMed and CINAHL, which after a quality evaluation resulted in 16 articles that were included in the review. These articles were analyzed in an integrated analysis that resulted in two main categories and five subcategories. The results showed two main categories that affected the patient’s pain management and satisfaction. These categories were “Caring encounters” and “Pain management”. The patients appreciated when the nurse’s caring encounters recognized their suffering and showed empathy. This could be achieved, among other things, through sufficient information and inclusion in their care. Another factor that affected the patient's experience was the combination of wait time for pain medication to be administered and communication of the patient’s pain relief expectations. With less time for administration and sufficient communication with the nurse, patients' experience of pain treatment was better. This literature review concludes that how the nurse treats their patient directly impacts the patient’s pain management and satisfaction in regard to their pain experience. Confirmation, information and inclusion were important to the patients. Patients who received some kind of pain treatment experienced higher levels of satisfaction with their pain situation. Patients’ knowledge and information of pain treatment further elevated levels of satisfaction / Smärta är ett symtom som förekommer vid många sjukdomstillstånd och inom akutsjukvården är det ett vanligt symtom som påverkar patientens psykosociala och fysiska behov. Att göra en smärtskattning kan vara svårt då smärta är en personlig upplevelse och att patienter inte alltid kan uttrycka sin smärta utan kan behöva hjälp av sjuksköterskan för att kommunicera upplevelser samt behov som smärtan framkallar. Sjuksköterskan kan här stödja patienten i dennes situation genom att underlätta förståelsen för smärtan och hanteringen av smärtan. Patientens individuella behov bör därför ligga i fokus i det initiala mötet som lägger grunden för att möjliggöra hantering och minskad smärta för patienten. Syftet var att beskriva vuxna patienters upplevelse av smärthantering på akutmottagning vid akut smärta. Metoden som används i studien är en litteraturöversikt med systematisk ansats. Sökningarna genomfördes i databaserna PubMed och CINAHL vilket efter kvalitetsgranskning resulterade i att 16 vetenskapliga artiklar inkluderades i studien. Dessa artiklar analyserades genom en integrerad analys som resulterade i två huvudkategorier och fem underkategorier. Resultatet beskrev två huvudkategorier som påverkade patientens smärthantering och tillfredsställelse. Dessa kategorier var “Bemötande” och “Smärtbehandling”. Patienterna uppskattade när sjuksköterskans bemötande bekräftade deras lidande och visade empati för deras situation. Detta kunde bland annat uppnås via tillräcklig information och delaktighet i sin vård. En annan faktor som påverkade patientens upplevelse var väntetiden till administrerade läkemedel mot smärta och att samtidigt informeras kring vilka förväntningar som patienten kan ha på sin smärtbehandling. Vid kortare tid till administrering och tillräcklig information var patienternas upplevelse av smärtbehandlingen bättre. Slutsatsen av denna litteraturöversikt visar på att hur patienten blir bemött i sin smärtsituation påverkar patienters smärthantering och tillfredsställelse i sin smärtsituation. Bekräftelse, information och delaktighet var viktigt för patienterna. Patienter som fick någon form av smärtstillande hade högre tillfredsställelse av sin smärtsituation. Tillfredsställelsen höjdes också av kunskap och information om smärtbehandlingen.