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Background: Nowadays people more often are surviving intensive care, which makes it important to increase the knowledge about the experiences. Illusions, nightmares and unreal experiences are common and often linger for quite some time. Aim: The aim of the study was to illuminate patients' experiences after intensive care. Method: A literature-based study of 16 qualitative studies was conducted Results: A lot of the patients have difficulties moving on, and are haunted by their experience. Memories from the hospital stay are often hazy, and evokes a sense of lacking a part of their life story. There is a need to understand in order to move on. Despite of this, some of the patients manage to find happiness. They find a new meaning in life, and learn to look at things from a brighter side. Conclusion: To process the experience, there seems to be a need of further support. Also, patients need to receive more information about what to expect after discharge.

PhD, Faculty of Health Sciences, University of the Witwatersrand / The aim of the study was to explore the practice of antiretroviral (ARV) therapy services, specifically regarding the patients’ issues and experiences, as well as the experiences of the health care providers rendering these services. Qualitative research methods were used, including a metasynthesis of qualitative research articles on human immunodeficiency virus (HIV) positive patients on ARV therapy, and phenomenological methods of inquiry. The study objectives were to conduct a metasynthesis of qualitative research on HIV-positive people on ARV therapy; to investigate the experiences of HIV-positive people who are on ARV therapy; to identify the constraints faced by HIV-positive people receiving ARV therapy; and to explore adherence to ARV therapy. The study was conducted in eThekwini district in KwaZulu Natal (KZN) province. The district was chosen considering the number of clinics rolling out ARV therapy. Three institutions initiating ARV therapy participated in the study; one urban, one semi-urban and one rural clinic, to ensure representation of each type. Participants were recruited from two initiating hospitals and one Community Health Centre providing ARV therapy. The metasynthesis revealed a shared set of four themes viz.: 1. Acceptance of, and coping with, HIV positive status 2. Social support and disclosure 3. Experiences and beliefs about HIV medication and health care 4. Provider relationships and health system factors Qualitative analyses of interviews with clients indicated their experiences and concerns, and were summarized in these themes: 1. Life before and after knowing HIV status 2. Initiating and continuing ARV therapy 3. Adherence to, and side effects of, the ARV therapy treatment 4. Social support for people on ARV treatment vi 5. Positive outcomes of being on ARV treatment 6. Improving access to ARV treatment services Analyses of in-depth interviews with health care providers specified their experiences, and were categorized into three themes viz.: 1. Establishing and maintaining a good client-provider relationship 2. Facilitators of and adherence to ARV treatment 3. Barriers to access to treatment

Bakgrund: Enligt World Health Organization [WHO] är övervikt och fetma ett växande hälsoproblem med global påverkan. Livsstilsförändringar som kostomläggning, beteendeterapi och ökad fysisk aktivitet är viktiga verktyg för att hjälpa patienterna att uppnå en viktnedgång men idag är viktoperationer den mest effektiva metoden mot fetma.  Syfte: Belysa patienters erfarenheter i det dagliga livet efter genomgången viktoperation. Metod: Nio steg av Polit och Beck (2016) har använts för att göra forskningsprocessen tydlig och överskådlig. Använda databaser i sökningen: CINAHL och PubMED. I resultat ingår åtta artiklar. Resultat: Viktoperation påverkar och förändrar patientens liv och erbjuder dessa ett nytt matsmältningssystem som kan upplevas både positivt och negativt. Tre kategorier framkom i studie: Fysiska och fysiologiska förändringar, psykiska processen och sociala ändringar. Från dessa kategorier tillkom underkategorierna: Kroppsförändringar och dess effekt på hälsan och intimitet, förändrad relation till mat postoperativt, motion och kondition, känslomässiga reaktioner och självkänslan, samhällets influenser och familjestöd efter viktoperation. Slutsats: Patienterna förmedlade både positiva och negativa erfarenheter av en viktoperation som påverkade deras nya sätt att leva och gav dem en ny framtid.

Background: Organ transplantation is seen as a treatment to save lives. There are great differences in the transplantation process between different countries. Patients have previously described the process of organ transplantation as restrictive and emotionally draining with an overhanging fear of death before transplant. Aim: The aim of this study was to describe patients’ experiences of waiting for organ transplantation.  Method: This literature-based study was conducted with analysis of qualitative research to gain knowledge about the patients’ experiences. Analysis of the eleven articles was performed by using Friberg’s five-step method. Results: Two main themes and six subthemes emerged from the analysis. The main themes The need for support and information highlighted the patients need for support and adequate information from both family and health care professionals. This was seen as a way to handle the uncertainty that the waiting time could bring. The other main theme The time on the waiting list described that waiting for an organ transplantation could bring restrictions to their daily life. Patients described the time on the waiting list as uncertain and many thoughts about the donor arose. Also, hope about their future was prominent throughout the time on the waiting list. At times this hope could turn to despair. Conclusion: Waiting for an organ transplantation is a multifaceted experience. Support from family was considered crucial and therefore should be included when possible. Nurses are responsible for giving enough and appropriate information and support to the patients during their wait.

Introduktion: En av de vanligaste dödsorsakerna i Europa är hjärtstopp. Vid ett hjärtstopp slutar hjärtat att pumpa blod och syrebrist uppstår. En livsviktig intervention är hjärt- och lungräddning. Chanserna att överleva ett hjärtstopp har ökat, trots detta har de som överlevt ofta både fysiska och psykiska nedsättningar. Depression och ångest är vanligt förekommande för de som överlevt ett hjärtstopp. Konsekvenserna påverkar överlevarnas livskvalitet och den psykosociala hälsan försämras. Det är viktigt att sjuksköterskan har kompetens inom området för att kunna ge hjärtstoppsöverlevare personcentrerad omvårdnad.  Syfte: Syftet var att beskriva vilka upplevelser patienter har efter att ha överlevt ett hjärtstopp. Metod: Arbetet hade en beskrivande design med en allmän litteraturöversikt som metod. Tolv kvalitativa artiklar valdes ut som undersökte patienters upplevelser av att ha överlevt ett hjärtstopp. Resultat: I resultatet framkom tio subkategorier och fem kategorier: Konsekvenser av ett hjärtstopp; Det nya normala; Individuella behov; Att omvärdera livet; Tacksamhet. Hjärtstoppsöverlevarna upplevde konsekvenser efter hjärtstoppet, vilket hade en stor påverkan på livet. Det nya normala beskriver sökandet efter en ny identitet samt information om hjärtstoppet. Överlevarna hade individuella behov rörande information om händelsen, rehabilitering och stöd från omgivningen. Existentiella tankar om livet, döden samt ny livsstil tas upp i att omvärdera livet. Tacksamhet utgick från överlevarnas tacksamhet angående deras nya chans i livet.  Slutsats: Patienter som har överlevt ett hjärtstopp har både positiva och negativa upplevelser. Utmaningar som patienterna möter under återhämtningsprocessen är individuella, men gemensamt för majoriteten är de existentiella tankarna som uppstår samt en känsla av tacksamhet. / Introduction: One of the most common causes of death in Europe is cardiac arrest. During a cardiac arrest (CA), the heart stops pumping blood and oxygen deficiency occurs. A vital intervention is cardiopulmonary resuscitation. The chances of surviving a cardiac arrest have increased, but those who survive often have both physical and mental impairments. Depression and anxiety are common after CA. The consequences affect the quality of life and psychosocial health deteriorates. It is important that the nurse has expertise in the field in order to provide CA survivors with personcentered care. Aim: The aim was to describe the experiences patients have after surviving a CA. Method: A descriptive design with a general literature review was applied. Twelve qualitative articles were selected that examined patients experiences of having survived a CA. Result: The result revealed ten subcategories and five categories: Consequences of a CA; The new normal; Individual needs; To re-evaluate life; Gratitude. The survivors experienced consequences after the CA, which had a major impact on life. The new normal describes the search of a new identity and information about the CA. The survivors had individual needs regarding information about the incident, rehabilitation and support. Existential thoughts about life, death and new lifestyles are addressed in re-evaluating life. Gratitude was based on the survivors gratitude for their new chance at life. Conclusion: Patients who survived CA have both positive and negative experiences. Challenges during the recovery process are individual, but common to the majority are the existential thoughts that arise and a feeling of gratitude.

Background: The history of transplantation goes back a long time and has been the last resort as a treatment to save a person's life. The availability of organs does not correspond to the need, there are also limited studies on how the patient's health processes are affected during the waiting time for a new organ. Aim: The aim of this study was to describe patientexperiences of waiting for an organ transplant. Method: This literature-based study was based on qualitative research to describe patient experiences of managing the waiting time for an organ transplant. 11 articles were analyzed according to Friberg's (2017) five step model. Results: The article analysis resulted in two main themes and six sub-themes. The main theme New Challenges highlighted that the patients are in need for both support and information during the time that they are waiting for an organ transplant. The second main theme, Emotional stress highlighted what feelings the patient can endure during the waiting time for a transplantation. The feelings of both hope and uncertainty are described by the patients. Conclusion: When nurses take responsibility for the caring and the six areas of competence, which means that patients who are on the waiting list for an organ transplant have their nursing needs met.

Background: Polycystic ovary syndrome (PCOS) affects 6-10% of women and has a range of impacts on women’s reproductive, psychological, metabolic, and cardiovascular health. A lifelong condition, symptoms of PCOS may start in adolescence and extend into post-menopause. Despite being such a pervasive disorder, with significant burden of disease for some women, it may be underrecognized within the medical and general communities. Recent studies suggest that women with PCOS may not be diagnosed early or receive appropriate guidance and information from physicians. Little is known about women’s experiences in Canada. This thesis explores experiences with diagnosis and management in Canada and assesses the barriers and facilitators women face while seeking care for their condition. Methods: Research questions were addressed using a multi-methods approach. Participants were recruited from online PCOS groups on Facebook, Reddit, and stand-alone PCOS forums. An online questionnaire measured participants’ time to diagnosis, number of doctors seen, and satisfaction with information provided. Descriptive statistics, Chi-square tests, Fisher’s exact tests, and Spearman’s rank correlations assessed characteristics of the sample and correlations between demographic factors and satisfaction measures. Twenty-five follow-up interviews were held over the phone to elicit greater richness of experiences. Qualitative data were analyzed using thematic analysis and the interpretive description framework. Results: The e-survey was completed by 296 women aged 18-60 with a self-reported diagnosis of PCOS. Approximately a third (34%) of respondents waited for more than 2 years before attaining a diagnosis and 41% saw 3 or more doctors. Most participants were dissatisfied with the information provided to them about PCOS (66%). Many did not receive any information about lifestyle management (42%) or medical therapy (28%). Barriers to diagnosis and management included lack of knowledge and/or concern in physicians. Women received insufficient information about PCOS implications (including mental health) at the diagnosis and subsequent visits. Few participants had physicians who were involved with PCOS management. Peri- and post-menopausal women especially lacked support and medical information on how to manage symptoms. Facilitators to diagnosis and management included self-education, self-advocation, and social support. Women identified a need for greater PCOS awareness in primary care physicians and the general community. Few women had heard of PCOS prior to their diagnosis. Conclusion: This thesis found delays to diagnoses and dissatisfaction in women around the care and information they received from doctors. Perceived lack of knowledge and engagement in physicians resulted in most barriers to diagnosis and management. Few participants had physicians whom they could rely upon for information and guidance. Greater awareness of PCOS is needed in the medical community, particularly in primary care. Women and girls may benefit from greater PCOS awareness early in life in health class at the elementary and/or secondary levels.

Bakgrund: Plötslig oväntat hjärtstopp står för 15–20% av dödsfallen i västvärlden. Att drabbas av ett hjärtstopp innebär ett akut tillstånd för personen och kräver omedelbara åtgärder. De senaste decennierna syns en tydlig trend i att allt fler överlever hjärtstopp, detta på grund av ökad kunskap om hjärt- och lungräddning samt förbättrad sjukvård. Att överleva ett hjärtstopp innebär ofta fysiska, psykiska och existentiella svårigheter och det är viktigt att sjuksköterskan har god kunskap och kompetens inom detta område för att kunna ge hjärtstoppsöverlevare en personcentrerad och bra vård.  Syfte: Att belysa personers upplevelser av att överleva ett hjärtstopp.  Metod: En litteraturstudie med kvalitativ design baserad på 9 kvalitativa studier från PubMed och CINAHL. Studierna analyserades med Fribergs femstegsmodell.  Resultat: I resultatet visade på två huvudkategorier: Att lära sig leva ett förändrat liv och betydelsen av information och stöd samt sju underkategorier. I resultatet framkom upplevelser av kaos, förvirring och minnesproblem vid uppvaknandet. Kroppsförändringar och psykiska svårigheter medförde att överlevarna var tvungna att anpassa sig till ett nytt liv. Rehabiliteringen var varierande och många önskade ett ökat stöd. Familjens roll blev central i återhämtningsprocessen.  Konklusion: Litteraturstudien betonar behovet av stöd för hjärtstoppsöverlevares fysiska, psykiska och existentiella utmaningar. Stödgrupper och anhöriga är väsentliga, och bristen på generella rutiner för rehabilitering och uppföljning riskerar att missa viktiga symtom. God vård kräver förståelse från sjuksköterskor och annan personal för överlevarens specifika utmaningar. / Background: Sudden cardiac arrest accounts for 15–20% of deaths in the Western world. Improved knowledge of cardiopulmonary resuscitation (CPR) and improvements in healthcare have increased survival rates. However, surviving a cardiac arrest often entails physical, psychological, and existential challenges. Nurses need comprehensive knowledge to provide person-centered care to survivors.  Aim: To illuminate individuals experiences of surviving a cardiac arrest.  Methods: A literature review based on nine qualitative studies from PubMed and CINAHL. The studies were analyzed with Friberg’s five-step model.  Results: Two main categories emerged: "Learning to live a changed life" and "The importance of information and support," with seven subcategories. The result showed that experiences of chaos, confusion, and memory issues emerged upon awakening. Survivors had to adapt to new lives due to physical and psychological changes. Rehabilitation experiences varied, emphasizing the desire for increased support. Family played a central role in the recovery process.  Conclusion: The literature review emphasizes the need for support for cardiac arrest survivors, acknowledging their physical, psychological, and existential challenges. Support groups and family involvement are crucial, and the absence of standardized rehabilitation and follow-up procedures may overlook significant symptoms. Providing effective care requires healthcare professionals, including nurses, to comprehend the specific challenges faced by survivors.