Bakgrund: Varje år insjuknar ungefär 7000 personer i bröstcancer i Sverige, vilket innebär att 15-20 kvinnor om dagen får en bröstcancerdiagnos och att var tionde kvinna utvecklar bröstcancer under sin livstid. Mötena mellan dessa kvinnor och sjuksköterskan blir viktiga för upplevelsen av hela sjukdomsförloppet. Syfte: Syftet var att belysa hur kvinnor som lever med bröstcancer upplever mötet med sjuksköterskan. Metod: Studien var en allmän litteraturstudie som baserades på ett systematiskt urval av vetenskapliga artiklar, där elva artiklar har kvalitetsgranskats och analyserat. Resultat: Resultatet visade att bröstcancerdrabbade kvinnor upplevde trygghet, stöd och att de blev sedda, vilket kategoriserades som vårdande möten. De kunde även uppleva otrygghet, bristande stöd samt att de inte blev sedda. Detta benämndes icke-vårdande möten. Diskussion: Vikten av reflektion i det dagliga arbetet för att få till de vårdande mötena med patienten diskuterades. Även vikten av att tydliggöra sjuksköterskans ansvarsområden i utbildningen lyftes fram. Slutsats: Det finns ett fortsatt behov av att sprida kunskapen om kvinnors upplevelser av mötet med sjuksköterskan. Den förståelse för patientens situation som studien ger bör appliceras på alla patienter oavsett sjukdom, vilket kan leda till vårdande möten i alla vårdsituationer. / Background: Each year approximately 7000 people is diagnosed with breast cancer in Sweden, which means that 15-20 women a day get a breast cancer diagnosis and that one out of ten women develop breast cancer during their lifetime. The meetings between these women and the nurse will be important for the experience of the entire course of the disease. Aim: The aim was to highlight how women with breast cancer experience the meeting with the nurse. Method: The study was a literature review that was based on a systematic selection of scholarly articles, in which eleven articles have been quality reviewed and analyzed. Results: The results showed that women with breast cancer experienced security, support and being seen, which was categorized as caring encounters. The women also experienced insecurity, not being supported and not being seen. This was categorized as uncaring encounters. Discussion: The importance of reflection on a daily basis to get to the caring encounters with the patient was discussed. The importance of clarifying the responsibilities of the nurse in the education was also highlighted. Conclusion: There is a further need to raise awareness of women's experiences of the meeting with the nurse. The understanding of the patient's situation that this study gives should be applied to all patients regardless of disease, which can lead to caring encounters in all care settings.

<p>Information ska ses som en integrerad del i god omvårdnad av den patient som befinner sig i det akuta skedet av en hjärtinfarkt och är en förutsättning för en god vård. Sjuksköterskans bemötande och kommunikation är en viktig del i omvårdnaden av patienten. Det är av betydelse att sjuksköterskan har en förmåga att förmedla kunskap, förståelse under de stressade förhållanden som ibland kan råda på en akutmottagning. På så sätt ges förutsättningar för att patienten att kunna vara delaktig och ha inflytande över sin egen vård och behandling. Syftet med studien är att belysa informationens betydelse för patienten i den akuta fasen av en hjärtinfarkt. Metoden som använts är en litteraturstudie och resultatet består av 12 artiklar, 10 kvalitativa och 2 kvantitativa. I resultatet finns fem kategorier: patientens upplevelse av information, sjuksköterskans roll vid information, kommunikation mellan sjuksköterska och patient, sjuksköterskans stöd till patienten samt patientens oro och rädsla. Resultatet i litteraturstudien belyser att bra information som talas i klartext minskar patientens oro, reducerar ångest och ökar patientens förståelse för sin sjukdom. Patienter som får relevant och individuell information känner även tillfredställelse med vården och upplever ökat välbefinnande.</p> / <p>Information should be seen as an integrated part in caring for patients´ that suffer from acute myocardial infarction. The nurse´s support and communication is an important part in caring for the patient. It is of significance that the nurse has an ability to provide knowledge and understanding under busy conditions in the emergency ward. In that way the patient can participate and have ability to take part in their own care and treatment.The aim with the study is to elucidate the information's importance for the patient at the acute phase of his myocardial infarction. The method that has been used is a literature study and the result comprizes in 12 articles, 10 qualitative and 2 quantitative. In the result, five categories has shown. These are: The patient´s experience of the information, the nurse´s roll when giving information, communication between the nurse and the patient, the nurses support to the patient and the patient´s anxiety and fear. The result in the literature study shows that good information in plain language reduces the patient´s worries and anxiety and increases the patient´s understanding of his/her condition. Patients who are given relevant and individual information feel satisfaction with the care and experience an increased well-being.</p>

Background: Animals are used in several health care areas and have been shown to promote many aspects of patients’ health. Animals have potential for use in nurses’ health promotion work. Nurses need a deeper understanding of the importance and health-promoting properties of animal-assisted therapy. Aim: The aim was to describe the importance of animal assisted therapy for patients’ health. Methods: A literature review was conducted based on ten nursing science studies with both qualitative and quantitative approaches, which were selected after critical review. Only articles that corresponded to the purpose of the literature review were included. The authors read the selected articles thoroughly and compared the similarities and differences in the articles’ results. The results were compiled in different categories. Results: The results show that animal-assisted therapy has a positive impact on three categories: bodily health, psychological well-being and social interplay. Bodily health includes physical activity and physical presence. Psychological well-being includes emotions and self-perceived health and well-being. Social interplay includes the interaction with animals and other people. Discussions: The strengths of the literature review that are discussed in the methodological discussion are the chosen databases, the combination of quantitative and qualitative articles, the quality assessment of articles and the articles’ geographical spread. One weakness that is discussed is the possibility of misinterpretation in the analysis of the quantitative results. The results are discussed in relation to Eriksson's (1989) theory of nursing "tend, play, learn”. “Play” is the part of Eriksson's theory that emerges most clearly in the results. “Learning” also plays a distinct role in the outcome but “tending” does not emerge quite as clear. The result also has a strong connection to the nursing metaparadigm “health”. / Bakgrund: Djur används i flera områden i sjukvården och har visat sig främja många aspekter av hälsa för patienter. Djur kan med fördel användas i sjuksköterskans hälsofrämjande arbete. Sjuksköterskor behöver en bredare insikt i den djurassisterade omvårdnadens betydelse för patienter och dess hälsofrämjande egenskaper. Syfte: Syftet var att beskriva den djurassisterade omvårdnadens betydelse för patienters hälsa. Metod: En litteraturöversikt genomfördes baserad på tio vetenskapliga studier med både kvalitativa och kvantitativa ansatser, vilka valdes ut efter kritisk granskning. Endast artiklar som svarade mot litteraturöversiktens syfte inkluderades. Författarna läste de utvalda artiklarna grundligt och jämförde likheter och skillnader i deras resultat. Resultaten sammanställdes i olika kategorier. Resultat: Resultatet visar att djurassisterad omvårdnad har en positiv inverkan på tre kategorier: kroppslig hälsa, psykiskt välbefinnande samt socialt samspel. Den kroppsliga hälsan omfattar bland annat fysisk aktivitet och fysisk närvaro. Den psykiska välbefinnandet innefattar känslor samt självupplevd hälsa och välbefinnande. Det sociala samspelet inrymmer interaktion med djuret och andra människor. Diskussion: Litteraturöversiktens styrkor som diskuteras i metoddiskussionen är använda databaser, kombinationen av kvantitativa och kvalitativa resultatartiklar, kvalitetsgranskning av artiklarna samt artiklarnas geografiska spridning. Svagheter som diskuteras är risken för feltolkning vid analys av och begränsad djupförståelse i de kvantitativa resultaten. I resultatdiskussionen relateras resultatet till Erikssons (1989) omvårdnadsteori “ansa, leka, lära”. Lekandet är den del av Erikssons teori som framträder tydligast. Även lärandet spelar en tydlig roll i resultatet men ansandet framträder ej lika tydligt. Resultatet har även en stark anknytning till konsensusbegreppet hälsa.

The dissertation thesis deals with the issue of violence during mutual contact of a patient and a nurse in the Czech Republic. Its main aim is to map violence which appears only during mutual contact between general nurses and patients. The secondary aims were to identify the most common problems in these situations, and to find possibilities to solve them. The aims were tested by four hypotheses and one research question. Mixed design - a combination of quantitative methods, qualitative in-depth interviews, and ex-post evaluation of my own teaching method - was used in this research. The quantitative sample included 896 respondents (500 general nurses, 92 doctors, 151 paramedics, 25 ambulance drivers, 60 physiotherapists, 18 safety workers and 50 auxiliary health care workers). Qualitative research is based on ten in-depth interviews with nurses (from various departments including outpatient care and emergency pre-hospital care) who have experienced a violent incident (analyzed by coding according to Glaser and Strauss). Unlike quantitative research, in-depth interviews are carried out on a smaller sample of respondents. Originally, there were 50 interviews carried out, but some attributes were being repeated, thus only 10 interviews were chosen to show the most important aspects. Ex-post evaluation included evaluation of practical training of 550 non-medical health care workers (general nurses, porters, auxiliary workers) in 14 workshops that were organized during 11 months. The total number of non-medical health care workers in the project was 550. After 12 months, 239 questionnaires were returned (42 % response rate). The first hypothesis, that both female and male health care workers alike experience violence in providing nursing care in the Czech Republic, was verified. The second hypothesis proved that general nurses in the Czech Republic are the professional group that is most exposed to verbal violence. Violence in health care in the Czech Republic is thus mostly a problem of nursing care. The third hypothesis proved that nurses with secondary education are exposed to violence more often than nurses with tertiary education. Qualitative analysis discovered a new dimension of violence in nursing - nurses' behaviour adds significantly to conflict escalation and is one of the causes of violence. The fourth hypothesis proved that it is possible to prepare nurses for dealing with a violent patient and prevent violence by choosing the correct style of communication.

This thesis focuses on the fluid replacement therapies and the use of blood products in intensive care which is part of the daily routine for the mutidisciplinary team on intensive care including the intensive care nursing staff. These therapies span wide array of functions, including but not limited to fluid status management, electrolyte replacement and optimisation, therapeutic purposes and the delivery of nutritional requirements. The administration of blood products is vital in modern day medicine, partyicularly in the intensive care setting, and although there has been significant improvements in the standard of safety it is not completely without risk. The role of the intensive care nurse is vital not only in the preparation and administraton of blood products but also to watch for potential complications and side effects that may arise. They are also responsible for meticulous care of venous access ports as these are frequently used in the intensive care setting and must be well looked after to ensure patency and to prevent infection. This thesis is divided into parts in an attempt to cover the main issues surrounding fluid managemnet and the administration of blood products. The first part aims to summarise the relevant physiology underlying fluid balance, transfusion medicine and homeostasis. Next, based on reviewing the current literature, we aim to describe the current terminology approaches to fluid management and summarise the most commonly used products. The following sections are written with a focus on nursing care the tasks involved and their responsibilities and an overview of the possible complications that may arise with fluid replacement strategies. The important aspects of transfusion medicine are described by first defining the available blood products commonly used on intensive care followed by the basic principles underpinning the indications for their usage. We go on further to highlight the possible complications of these respective therapies and what nursing staff should be vigilant for when involved in the care of patients receiving blood products. We also address the role of the nurse in the care of the patient in hypovolemic shock. This encompasses the principles and therapies previously described in an acute setting. We describe the principles of management of such patients together with the clinical implications and practical considerations that need to be taken into account. We also focus on the particular responsibilities of the nurse in the care of such patients on intensive care. At the end of this thesis we summarised the safe concept of intravenous therapy. The second aim of this paper was based on the literature search to summarise and compare modern trends in fluid management.

Nursing care of restless and aggressive patients, despite the unstoppable progress, can hardly do without the use of restrictive measures in all cases. In order to provide quality nursing care and to ensure the patient´s safety even with the application of restrictive measures, it is necessary to determine the level of professional quality, or the introduction of nursing standards at all wards where restrictive measures are used. The aim of this thesis was to verify if the restrictive measures in psychiatric inpatient units and inpatient wards of other medical disciplines are being used in accordance with the standard of nursing care of patients who are restrained in bed, and analyze the current standards of nursing care determining the use of restrictive measures. Another objective was to find out nurses´ attitudes to application of restrictive measures and to survey their feelings while applying restrictive measures. On the base of the objectives hypotheses were formulated with regard to data in literature and my own clinical practice, which also includes the use of restrictive measures. The nursing research was conducted through a questionnaire at the wards where restrictive measures are applied. The respondents were nurses working in these units. The results provided clear evidence that not only worldwide, throughout Europe, but also within medical facilities of the Czech Republic, the care of psychiatric patients is inconsistent in terms of restrictive measures, and therefore, standardization of this care is highly desirable. A component part of this thesis is the created Standard of nursing care for application of restrictive measures in medical inpatient facilities, which will be used in practice in České Budějovice Hospital, Inc.

Forskning har visat att empati är betydelsefullt i sjuksköterske-patient-relationen. Då empatisk förmåga tränas under sjuksköterskeutbildningar är mätning av empatinivåerna av betydelse för utbildningens kvalitet. Syftet med studien var att med hjälp av enkäter och intervju undersöka empatinivåerna på andra terminen, sjätte terminen och hos specialiststudenterna på en svensk sjuksköterskeutbildning. Grundstudenterna i termin sex hade signifikant högre empati än grundstudenterna i termin två och specialiststudenterna. Distriktsjuksköterskestudenter hade signifikant högre empati än anestesi- och intensivvårdssjuksköterskestudenter, medan intensivvårdssjuksköterskestudenter hade signifikant lägre empati än barnmorske- och psykiatristudenter. Specialiststudenterna tyckte empati var det viktigaste i mötet med patienten, följt av professionell hållning, kommunikation, allians och tid. En empatiforskare övervägde stress, erfarenhet och desillusion som möjliga förklaringar till empatiskillnaderna mellan termin två, termin sex och specialiststudenterna, medan skillnader i teknikfokus, identifikationsmöjligheter och interaktion, förmodades vara orsaker till empatiskillnaderna mellan specialistutbildningarna. Studiens styrka var metoden då analysarbetet genomfördes med både kvantitativ och kvalitativ. En svaghet var det låga antalet manliga deltagare. Då stress påverkar empatimätningar, föreslås att i framtida studier undersöka empati under mindre påfrestande förhållanden.

Följande uppsats är en begreppsanalys med syftet att studera och beskriva innebörden av begreppet ”partnerskap” ur ett vårdvetenskapligt perspektiv. Begreppsanalysen gjordes för att bidra till en djupare kunskap och förståelse samt tydlig innebörd av begreppet inom hälso- och sjukvård. Metoden som användes var granskning av ordböcker, synonymordböcker och vetenskapliga artiklar där karaktäristiska, förutsättningar och konsekvenser av begreppet beskrevs. Genom att studera de vetenskapliga artiklarna fick vi en djupare förståelse för innebörden av begreppet i relation till kontext. Tre fallbeskrivningar utformades som illustration och förtydliga resultatet. I analysen identifierades fyra framträdande attribut av begreppet, patienten som ansvarstagande partner, förutsättningar för partnerskap, delta i beslutfattande och delad makt. Resultatet visar att partnerskap inom hälso- och sjukvård innebär ett delat ansvar mellan patient och vårdgivare, och vården måste anpassas efter båda parters respektive mål, expertis, och resurser. Partnerskapet skall förstås som en djupare relation av jämlika parter med ett gemensamt ansvarstagande och åtagande för de handlingar som ingår i partnerskapet. Parterna utbyter kunskap, expertis, teknik, erfarenheter, finansiella och emotionella resurser, för att bidra till att målen uppfylls. I diskussionen visar vi att begreppet används inom skilda områden och med liknande betydelse. Partnerskap i Hälso- och sjukvården bygger på ett samarbete mellan vårdgivare och patient där patientens berättelse är utgångspunkten. Detta påvisas i fallbeskrivningar och innebär att sjuksköterskan ansvarar att förvalta berättelsen och att bjuda in till delaktighet.

Attention should be paid to pharmacotherapy in the orthopedic department mainly because patients at this department make up a risky group, they are older and often tend to use more types of drugs at the same time. Nursing at the orthopedic department is both mentally and physically demanding. Nurses administer medication to patients throughout the whole day, that is why lack of certain medication may occur in this department, the same way they would with all routine procedures. Be it conscious or unconscious. The thesis sets its objective to map out the issue of pharmacotherapy in the orthopedic department. Further, to map out factors that may influence the origin of complications when administering medication to patients in the orthopedic deartment, and suggest improvements in the process of pharmacotherapy in the orthopedic department. A qualitative research via participant observation and semi-structured interviews carried out with the nurses and patients of the orthopedic department, was used. The results of this survey prove that nurses do have basic theoretical knowledge in the area of pharmacotherapy. At the same time certain shortcomings were discovered, i.e. this theoretical knowledge is not being applied in practice. Most surprising were the results in the area of patient identification before administering medication, this step not always being abode by the nurses as a part of medical error prevention. Quite on the contrary, it can be said, based on the results, that nurses do have excellent knowledge and skills in pain reduction. This is proven by both participant observation and the happiness of patients themselves. Partial results have been presented at a seminar in the orthopedic department, and they have been passed on to the management of this department. The resulting shortcomings have been used as aid material. The diploma thesis was written so as to serve as material of information to beginner or existing nurses at the orthopedic department as well.

No description available.