No description available.

No description available.

Bakgrund: Tidigare forskning visade på att sjuksköterskor tenderade att ha en negativ bild av missbrukare, samtidigt som de uttryckte att de ändå gav god omvårdnad. Missbrukspatienterna ansågs ha ett stort eget ansvar för sin sjukdom. De negativa attityderna sågs ofta som direkt orsakade av kunskapsbrist. Syfte: Syftet med denna studie var att beskriva hur några sjuksköterskor uppfattade mötet med missbrukare på en akutmottagning i en svensk storstad. Metod: Intervjustudie med kvalitativ ansats, där det manifesta innehållet analyserades. Resultat: Kunskapsbrist inom området beroendelära ansågs vara en faktor som påverkade mötet negativt. Sjuksköterskorna visade respekt för patienten och poängterade vikten av att ha empatisk förmåga. Patientgruppen ansågs generellt som svårhanterlig på grund av ovilja att samarbeta och de hotfulla situationer som ibland uppkom i samband med alkohol och narkotikapåverkan. Hopplöshet infann sig inför det faktum att sjuksköterskan försökte göra allt för denna patientgrupp, men inte såg några framsteg. Slutsats: Sjuksköterskorna hade en generellt sett positiv uppfattning av mötet och de viktigaste delarna för att skapa ett gott möte var kunskap, empati och respekt. Utbredd kunskapsbrist inom beroendelära var ett hinder för att skapa ett bra möte. / Background: Previous research showed that nurses tended to hold a negative image of substance abusers, but they still provided good care for the group. Substance abusers held a great responsibility for their own illness. The negative attitudes were often seen as directly caused by lack of knowledge. Aim: To describe how some nurses perceived the meeting with substance abusers at an emergency room in a Swedish city. Method: Interview-study with a qualitative approach, where the analysis was conducted with content analysis on the manifest contents. Result: Lack of knowledge about addiction affected the meeting in a negative way. The nurse showed respect for the patient and empathized the need for empathetic ability in nursing. Overall substance abusers were seen as an unwieldy group due to their inability to cooperate and the threatening situations which sometimes occurred. The fact that the nurse tried to do everything in her power to help the patient, but didn't see any progress generated feelings of hopelessness. Conclusion: The nurses had an overall positive perception of the meeting and the most important components to create a good meeting were knowledge, empathy and respect. Lack of knowledge about addiction was a hindrance for creating a good meeting.

Bakgrund Förutfattade meningar mot vårdpersonal är ett fenomen inom vården, särskilt mot manliga sjuksköterskor, som är en minoritet inom sjuksköterskeyrket. Tidigare forskning har fokuserat på specifika problemsituationer som uppstår i yrket för manliga sjuksköterskor, samhällets syn på manliga sjuksköterskor och att manliga sjuksköterskor priviligierats i arbetsgruppen. I litteraturen nämns ofta olika förutfattade meningar om manliga sjuksköterskor, trots att det saknas forskning med fokus på manliga sjuksköterskors egna upplevelser av förutfattade meningar mot dem. Syfte Syftet med studien är att belysa vilka förutfattade meningar som manliga sjuksköterskor upplever finns mot dem. Metod Litteraturstudie i form av en beskrivande metasyntes. Resultat Manliga sjuksköterskor upplever flera förutfattade meningar som presenteras i fyra teman: “accepteras inte som sjuksköterskor”, “muskler, lyfthjälp och tekniskkompetens”, “antas vara homosexuella” och “antas ha sexuella avsikter motpatienter”. Slutsats Upplevda förutfattade meningar kan påverka manliga sjuksköterskors syn på sig själv och yrkesrollen samt patientmötet och omvårdnaden. Dessa förutfattade meningar kan skapa konflikter och missnöje på arbetsplatsen vilket kan störa patientmötet och vårdrelationen. Klinisk Betydelse Genom att belysa förutfattade meningar som manliga sjuksköterskor upplever kan åtgärder vidtas för att motverka dem som påverkar vårdarbetet negativt. / Background Preconceptions against health care workers is a phenomenon in health care, especially against male nurses, who are a minority within the nursing profession. Previous research has focused on specific problematic situations that arise in the profession for male nurses, society's view of male nurses and the fact that male nurses are privileged in the workgroup. Literature often mentions various preconceptions about male nurses, despite the lack of research focusing on male nurses' own experiences of prejudice against them. Purpose The purpose of this study is to shed light on the preconceptions that male nurses are experiences towards themselves. Method Literature review in the form of a descriptive meta-synthesis. Results Male nurses experience several preconceptions which are presented in four key concepts: "not accepted as nurses", "muscles, lift assistance and technical skills", "are assumed to be gay" and "are assumed to have sexual intentions towards patients". Conclusion Experienced preconceptions can affect male nurses' view of themselves and the professional role, meeting the patient and nursing care. These preconceptions can create conflicts and grievances in the workplace which can disrupt the nurse-patient relationship. Clinical Significance By shedding light on the preconceptions that male nurses are experiencing measures can be taken to reduce the ones that affect nursing work negatively.

Uterine Fibroids, medically termed uterine leiomyoma, are benign tumors of smooth muscle cells that grow in the uterus. While they are the most common pelvic neoplasm in women and fewer than 1 percent of fibroids develop into cancer, uterine fibroids can cause infertility, adverse pregnancy outcomes, and greatly affect one’s quality of life. Black women have been disproportionately affected by fibroids; when compared to white women, Black women are: 2-3 times more likely to have fibroids, diagnosed at a younger age, more likely to have 7 or more fibroids, more likely to have more severe and more troublesome symptoms (anemia, severe pelvic pain, constipation, and stomach aches), and have twice as many hysterectomies due to fibroids. Black women’s disproportionate affliction with uterine fibroids is particularly concerning given the historical medical injustices associated with Black women’s bodies and reproductive rights from slavery to present day. By placing Black women at the center of analysis and using a Black feminist epistemological framework, this study aims to make a unique contribution to medical sociology as well as literature on the theoretical and practical management of sickness and wellness among Black women in the United States. Using qualitative interviews and grounded theory methodology, the study examined how Black women frame the condition of having uterine fibroids. Specifically, the study investigated a) how Black women conceptualize having fibroids, b) how Black women’s conceptualizations of fibroids affect their feelings about selves or their lifestyles, c) the mechanisms, if any, by which Black women deal with uterine fibroids, d) how their multiple race, class, and gender identities affect their illness experiences and types of treatment that they seek, and e) how conventional and complementary/alternative medicine shapes Black women’s experiences with fibroids. Conceptualizations about fibroids are rooted in the race-gendered histories of Black women and the unique stressors that they face. Through interactions with doctors and among peers, Black women resist the unbearable burden of uterine fibroids through various coping strategies, but generally “keep it moving”. They avoid invasive surgeries through patient agency by being advocates for their medical treatment, self-researching, dialoguing with others, and directing doctor-patient interactions.

Bakgrund: Att beröra någon annan ger känslor och känslouttryck hos både individen som utför handlingen och mottagaren. Mellanmänsklig beröring är ett uttryck för kärlek eller tillgivenhet inom familjer och även i andra miljöer. I kliniska sammanhang är beröring viktigt p.g.a. den lugnande effekt och emotionella påverkan som sker. Att lägga handen på någon som lider kan skapa trygghet. Inom omvårdnad är beröring det viktigaste av alla icke-verbala beteenden. Beröring lugnar, tryggar, ger värme och stimulerar patienten. Syfte: Syftet med denna studie var att beskriva patienters och sjuksköterskors erfarenheter av expressiv beröring. Metod: Litteraturöversikt innehållande 10 vetenskapliga artiklar varav nio kvalitativa och en kvantitativ. Artiklar söktes i databaserna CINAHL, MEDLINE samt manuell sökning i Google scholar. Resultat: Beröring var ett centralt behov för patienter. Vid beröring kände de sig sedda som individer. Sjuksköterskorna hade ett behov av att beröra patienter och att bli berörda. Sjuksköterskor använde beröring för att anknyta emotionellt. Sjuksköterskor och patienter hade behov av att beröra och att bli berörda på ett sätt som passade dem och beröringen gjorde att patienterna och sjuksköterskorna fick en samhörighet på ett djupare existentiellt plan. Det fanns skillnader i hur kvinnor och män uppfattade beröring. En god relation var avgörande för hur beröringen uppfattades. Slutsats: Sjuksköterskorna ser expressiv beröring som något positivt medan patienternas uppfattningar varierar stort. Relationen med sjuksköterskan som utför beröringen är avgörande för hur beröringen uppfattas. Detta visar på nödvändigheten i att stämma av med patienten vid fysisk kontakt och att anpassa beröringen individuellt. Klinisk betydelse: Att vara medveten om hur beröring används gör att sjuksköterskor kan skapa goda vårdrelationer från första ögonblicket och snabbt undvika missförstånd. / Background: Touching provides emotional expression to both parties involved. Human touch is an expression of love or affection within families and other environments. Expressive touch in a clinical context is important due to its calming and emotional effect. Laying a hand on a suffering individual can provide comfort. Touch is the most important non-verbal behavior in caring. Touching calms comforts and stimulates the patient. Aim: The aim of the study was to describe patient´s and nurse´s experiences of expressive touch. Method: A literature review of 10 scientific articles consisting of nine was qualitative and one was quantitative. Articles were found using the databases CINAHL, MEDLINE and manually searched in Google scholar. Result: Touch was a central need for patients. When they were touched, they felt that they were seen as individuals. Nurses also had the need to touch and to be touched by the patients. Nurses used touch to connect emotionally with patients. The touch made nurse´s and patient´s feel solidarity on a deeper existential level. There was a difference in perceptions of touch between men and women. A good nurse patient relationship was crucial to how the touch was perceived. Conclusion: The nurses see expressive touch as something positive whilst the patient's perceptions vary. The nurse patient relationship is crucial to how the touch is perceived. This shows the necessity of checking with the patient while engaging in physical contact and to adapt the touch to the individual. Clinical significance: Being aware of how expressive touch should be used enables nurses to establish good nurse patient relationships and quickly avoid misinterpretations.

Bakgrund: Forskningen har visat att humor är ett socialt fenomen som kan ses som ett universellt språk. Den har visat sig påverka en rad faktorer positivt, däribland vårdmiljön, relationen mellan sjuksköterska och patient samt patientens hälsa. Humor är inte enbart positivt i en vårdkontext, däremot finns det tillfällen då den bör undvikas. Syfte: Syftet är att belysa användandet av humor i mötet mellan sjuksköterska och patient.Metod: Examensarbetet är en litteraturöversikt där tio vetenskapliga artiklar valts ut, skillnader och likheter har identifierats och slutligen sammanställts. Resultat: Resultatet består av tre huvudteman: Humorns inverkan på avdelningens vårdatmosfär, interaktion mellan sjuksköterska och patient samt humorns effekter. Under huvudtemat interaktion mellan sjuksköterska och patient hittades två underkategorier: kommunikation mellan sjuksköterska och patient samt förlorade tillfällen till humor. I huvudtemat humorns effekter hittades underkategorierna: humor som strategi samt humor som lindring. Diskussion: I resultatdiskussionen följer en diskussion där resultatet implementeras i Travelbees omvårdnadsteori, Human-to-Human Relationship Theory, men också hur ny forskning förhåller sig till resultatet. Travelbees omvårdnadsteori med dess faser kan användas genomgående i resultatet, vilket också ny forskning till stor del visar. Sammantaget bör sjuksköterskan använda sig av humor i en större utsträckning än vad som är fallet idag. / Background: Research has revealed that humor is a social phenomenon that can be seen as a universal language. It has been shown to affect a number of factors in a positive way including the care environment, the relationship between nurse and patient as well as the patient's health. Humor is not only positive in a nursing context, hence there are times when it should be avoided. Objective: The purpose is to illustrate the use of humor in the meeting between nurse and patient.Method: This bachelor thesis is a literature review where ten scientific articles have been selected, similarities and differences are identified and finally compiled. Results: The result consists of three main themes: The impact of humor on the department's care atmosphere, the interaction between nurse and patient and the effects of humor. Under the main theme of interaction between nurse and patient, two sub-categories were identified: communication between nurse and patient as well as lost opportunities for humor. The main theme of humor effects were identified under the categories: humor as strategy and humor as relief. Discussion: In the resultdicussion a debate will follow in which the results are implemented in Travelbees nursing theory, Human- to- Human Relationship Theory, but also how new research relates to the result. Travelbees nursing theory with its phases can be used consistently in the result, which new research also largely shows. Overall, the nurse should use humor, to a greater extent than is the case today.

The recent expansion of general practitioner (GP) out of hours cooperatives indicates that many British GPs see this as the solution to managing out of hours work, particularly the 'problem' of 'inappropriate' demand. This thesis investigates the highly contentious subject of 'inappropriateness' of demand for out of hours GP services for children under five, and develops a methodology that allows for a reconceptualisation of the issues involved based on the beliefs, assumptions and practices of all those concerned, rather than locating the 'problem' within the province of parents alone, or within the doctor-patient relationship as a bounded system. Using a predominantly sociological and anthropological conceptual framework, the thesis draws on a synthesis of views and practice, bringing those of professionals and parents together with fieldwork observations based in the primary care centre setting. It suggests that contrary to talk about management of the 'problem' in technical, bureaucratic and medical terms, this becomes a moral issue in practice. Scientific or organisational imperatives disguise largely moral proscriptions and examples illustrate ways in which moral and emotional dimensions embedded within these social relations can conflict with particular forms of rationality. The analysis shows how organisational initiatives that fail to take account of such moral frameworks can produce unexpected and unintended consequences. The thesis illustrates the value of what is described as a dialogic process, taking account of the fluidity between voices, layers of time and space, and interchange between researcher, participants, and future audiences. The play of these issues in the rapid and extensive growth of cooperatives is discussed in the wider context of the rhetoric of consumerism and shifts in interprofessional practices and relationships. Negotiation of 'appropriate' supply of and demand for out of hours services has had a major impact on government initiatives for primary care as a whole. Thus key elements in the formation of cooperatives, originally targeted at a more narrow conceptualisation of problems, can be seen as expressing a deeper impetus for change, and serving as vehicles for more fundamental and rapid development.

This study examines the way people use online resources within their personal healthcare practices to better understand how individuals manage their health issues in the age of the Internet. It specifically addresses the extent to which the Internet is used as an information database and associated patterns of use, whether the Internet represents a source of support or enables a supportive encounter and the implications of using the Internet as part of the health management across relationships with medical professionals and oneself. Using a sequential mixed methods design, the data was gathered within a larger multidisciplinary research project conducted in East York, Ontario. An initial quantitative analysis of 350 surveys describes Internet usage. The qualitative analysis of the 86 follow-up interviews of people recounting their personal health management processes demonstrated the importance of social networks, subjective health status and Internet user-style. The facile ability to engage with health information is transforming definitions and experiences of health and relationships with medical professionals. Examining medical encounters mindful of the aspects of trust, power, knowledge and privilege reveals an evolution to the doctor-patient relationship brought about by both information and personal empowerment. Using the Internet reinforces primary relationships and points to the development of new relationships that are sought at moments of meaningful life events or circumstances. New types of connections are being built across the Internet based on shared experiences, health concerns and health identities. Applying Actor Network Theory furthers an understanding of how search engines and online resources can emerge as actors in health information seeking and health management processes. Internet use is now a part of everyday life and is no longer limited to affluent early adopters as the gaps between those with access diminish in urban Canada. While its use is becoming intrinsically linked to health management it is not a panacea for improving health outcomes. As the populations’ collective health knowledge increases, so does the presumption that health management is a personal imperative. This notion that the achievement of good health is an individual responsibility or the theory of Healthism, frames the interpretation of the large percentage of the sample indicating they are striving to become healthier. Social workers need to acknowledge the place of the Internet within its practice and to balance the emphasis on individualized health management with the perspective that health outcomes reflect community mores. It is important for social workers to treat the Internet as a medium of relationships and for social workers to become knowledgeable about what these connections can provide in terms of support and information and what the limitations and risks of these relationships can be.

This study examines the way people use online resources within their personal healthcare practices to better understand how individuals manage their health issues in the age of the Internet. It specifically addresses the extent to which the Internet is used as an information database and associated patterns of use, whether the Internet represents a source of support or enables a supportive encounter and the implications of using the Internet as part of the health management across relationships with medical professionals and oneself. Using a sequential mixed methods design, the data was gathered within a larger multidisciplinary research project conducted in East York, Ontario. An initial quantitative analysis of 350 surveys describes Internet usage. The qualitative analysis of the 86 follow-up interviews of people recounting their personal health management processes demonstrated the importance of social networks, subjective health status and Internet user-style. The facile ability to engage with health information is transforming definitions and experiences of health and relationships with medical professionals. Examining medical encounters mindful of the aspects of trust, power, knowledge and privilege reveals an evolution to the doctor-patient relationship brought about by both information and personal empowerment. Using the Internet reinforces primary relationships and points to the development of new relationships that are sought at moments of meaningful life events or circumstances. New types of connections are being built across the Internet based on shared experiences, health concerns and health identities. Applying Actor Network Theory furthers an understanding of how search engines and online resources can emerge as actors in health information seeking and health management processes. Internet use is now a part of everyday life and is no longer limited to affluent early adopters as the gaps between those with access diminish in urban Canada. While its use is becoming intrinsically linked to health management it is not a panacea for improving health outcomes. As the populations’ collective health knowledge increases, so does the presumption that health management is a personal imperative. This notion that the achievement of good health is an individual responsibility or the theory of Healthism, frames the interpretation of the large percentage of the sample indicating they are striving to become healthier. Social workers need to acknowledge the place of the Internet within its practice and to balance the emphasis on individualized health management with the perspective that health outcomes reflect community mores. It is important for social workers to treat the Internet as a medium of relationships and for social workers to become knowledgeable about what these connections can provide in terms of support and information and what the limitations and risks of these relationships can be.