Background: Over 40 million people around the world suffer from incurable illness or injury each year and need palliative care. The patient experience of end-of-life care needs to be illustrated, to make the healthcare better. There is little knowledge about the social, psychological, and existential dimensions of palliative care. Therefore, it is of relevance that the nurse has knowledge about the patient’s experiences, to be able to offer a better care.  Aim: The aim of this study was to describe adult patients’ experiences of palliative care.  Method: The study was based on a literature study, that had a qualitative approach. Ten scientific articles were searched and selected from databases Cinahl and PubMed, with inclusion criteria's adults, English language, year 2012-2022. The articles were analysed using Friberg’s (2017) five steps process.  Results: Three major themes emerged: safety and its impact, the significance of the relationship to healthcare staff, and the impact of palliative care. The patients expressed the value of a good communication with the healthcare staff, to enable feeling safe, seen and understood. Patients better understanding of palliative care resulted in feeling secure. And through receiving practical help, they maintained autonomy and self-determination.  Conclusion: This study emphasized that patients' experiences of receiving palliative care is important to uptain a good quality of life. Whereas person-centered care, good communication skills, and good quality of care are central parts.

Bakgrund: Att leva med hjärtsvikt innebär att leva med en allvarlig kronisk sjukdom, vilket ställer höga krav på patienten. Konsekvensen av låg följsamhet kan bli att symptomen förvärras vilket i sin tur leder till sjukhusvistelse. För att förbättra följsamheten hos dessa patienter behöver alternativa strategier lyftas fram. Som bakgrund till detta tar studien upp hjärtsvikt och dess behandling, hälsolitteracitet som begrepp och användningsområde, låg följsamhet och låg hälsolitteracitet samt sjuksköterskans omvårdnadsperspektiv. Syfte: Syftet med litteraturstudien var att undersöka upplevda orsaker till låg följsamhet hos patienter med hjärtsvikt. Metod: Studien genomfördes som en litteraturstudie med kvalitativ ansats, inriktad på patienter med hjärtsvikt och deras perspektiv. Databassökning genomfördes med blocksökningar i CINAHL och PubMed. 12 artiklar granskades med en granskningsmall för kvalitativa artiklar, utformad av SBU. En enkel form av innehållsanalys enligt Forsberg och Wengström, användes vid analysförfarandet. Resultat: Patienter upplevde sig ha svårt att förstå sin sjukdom, de kände att stort ansvar lades på dem, saknade stöd, fick bristfällig information och upplevde otydlig kommunikation med hälso- och sjukvården. De hade även svårt att ändra vanor och upplevde sig gå miste om sociala situationer till följd av känslan av den begränsning som rekommendationerna medförde. Detta ledde i sin tur till låg följsamhet. Resultatet presenterades i fyra teman: att inte förstå sin sjukdom, upplevelse av bristande stöd, upplevelse av bristande kommunikation och information och upplevelse av bristande välbefinnande. Slutsats: Resultatet visade på de svårigheter som patienter upplever i att leva med hjärtsvikt. De fyra teman diskuterades utifrån hälsolitteracitet, sjuksköterskans omvårdnadsperspektiv och personcentrerad vård. Studien lyfte fram patienters perspektiv av orsaker till låg följsamhet men även hur sjuksköterskan skulle kunna påverka patienter till ökad följsamhet. Ett personcentrerat perspektiv och kunskap om hälsolitteracitet lyfts fram som alternativa sätt att nå patienter med låg följsamhet. / Background: To live with heart failure means living with a severe cronic disease, this requires a lot of the patients. The consequence of low compliance can result in worsened symptoms which leads to hospitalization. To improve patients’ compliance alternative strategies needs to be highlighted. The background in this study contains four parts: heart failure and its treatment, health literacy as a concept and its usability, low compliance and low health literacy, and a nursing perspective. Aim: The aim was to explore perceived reasons for low compliance in patients with heart failure. Method: The study was conducted as a literature review with a qualitative approach, with a focus on patients with a heart failure and their perspective. The database search was performed with searches in CINAHL and PubMed. 12 articles were reviewed with a template by SBU. A simple form of content analysis was used for analysing the articles. Result: Patients experienced that it was difficult to understand their disease, they felt a large responsibility were imposed on them, they experienced a lack of support, inadequate information and experienced inexplicit communication with the health care. Patients also experienced difficulty changing habits and to miss out on social occasions because of the limitations the recommendations imposed. All this led to low compliance. The results were presented in four themes: to not understand one’s disease, experience of a lack of support, experience of inadequate communication and information, and experience of insufficient wellbeing. Conclusion: The results show the difficulties that patients experience when living with heart failure. The four themes were discussed from a health literacy perspective, a nursing perspective and patient-centered care. The study highlights the patient perspective on reasons for low compliance but also how the nurse can influence patients to increase their compliance. Health literacy and patient-centered care are discussed as alternative ways to reach patients with low compliance.

In the last decade, many first-episode psychosis programs have been developed in the United States and elsewhere. First-episode psychosis typically affects adolescents and young adults. These programs, therefore, emphasize early intervention to alter long-term consequences and address specific needs of the affected population. Open Dialogue, which has shown promise in Finnish studies, is one such program that is gaining popularity outside of Finland. The program emphasizes active involvement of family and collaborative decision making. The three studies in this dissertation elucidate how Open Dialogue can contribute to current treatment options and describe considerations in adaptation and implementation of Open Dialogue in the United States. The Promoting Action on Research Implementation in Health Services (PARiHS) framework describing the role of evidence, context, and facilitation in successful implementation provides the theoretical basis for these studies. Study One is a systematic scoping review of the literature describing first-episode psychosis programs. Study Two is a qualitative study of stakeholder experiences in a pilot study of the Open Dialogue model in the United States. It examines perceived usefulness, contextual support, and factors facilitating participation. Study Three examines organizational characteristics that supported implementation at the agency where the program was piloted in the United States. The scoping review of first-episode psychosis programs indicates a need for further research regarding their long-term benefits, optimal duration and intensity, and critical components. Family intervention appears to be beneficial, suggesting that the Open Dialogue approach to family support might be a valuable addition warranting further investigation. Stakeholders involved in the Open Dialogue pilot identified several unique and beneficial features of the approach, focusing particularly on the value of family involvement, transparency, respectfulness, and collaborative nature of the approach. The compatibility of the Open Dialogue model with agency values, strong leadership support and vision, alongside organizational capacity to deliver the services emerge as critical factors in successful implementation of the model in the pilot study. As per the PARiHS framework, contextual factors, particularly funding of this model of services in the United States healthcare environment are key determinants to address for the future implementation of Open Dialogue in the United States. / 2019-12-31T00:00:00Z

Background: 1,3 billion people in the world suffer from hypertension, and it is considered a leading global risk factor for death and disability. Patients who are diagnosed with this condition are recommended to undergo lifestyle changes to reduce the incidence of secondary diseases. Aim: The aim of this study was to describe patients experience of lifestyle changes to promote health in hypertension. Method: An analysis method with a foundation in qualitative research was used to contibrute to evidence-based nursing. The authors utilized Friberg’s methodology of qualitative studies. This litterature-based study incorporates 10 qualitative articles. Results: This study found that patients encounter diverse barriers and factors in their experiences with lifestyle changes, Two themes emerged; 1: ‘Insight into the complexity of lifestyle changes’. Subthemes that emerged in this theme was; ‘Barriers and challenges’, and ‘Social and psykosocial factors’. 2: ‘Breaking old patterns and navigating through challenges’. Subthemes was; ‘Motivation’, Strategies and insights’, and ‘Finding support in one’s enviroment’. Conclusion:It is crucial for nurses to possess the necessary competence to structure person- centered lifestyle changes in consultation with patients and their specific conditions. Increased knowledge and education on this subject would likely enhance patients health, preserve their dignity and have a preventive effect against further complications

Pancreatic cancer is a form of severe neoplasm with a swift disease progression and a high rate of mortality. It is the 12th leading cause of death globally for all cancer-related mortalities. Diagnosis is often late in the disease progression due to the late manifestation of symptoms which limits curative treatment options, resulting in primary palliative treatments. Patients experience a broad variety of symptoms that affect their physical and mental health causing a tremendous symptom burden. Therefore, the aim of this study was to describe the patient’s experience of living with pancreatic cancer. A literature review of qualitative and quantitative research articles was conducted to answer the purpose of this study. Data was collected through Cinahl, PsycINFO and PubMed and generated eleven articles which were analyzed, nine qualitative and two quantitative. The results were presented in two categories living in uncertainty which presented the patients emotions associated with getting the diagnosis together with unmeet informational needs and living with an unwell body which presented the physical bodily changes. This study concluded that pancreatic cancer has a significant impact on both the patients’ physical and mental health. Furthermore, there was a correlation between physical and psychological symptoms that all affected the patients' state of well-being. Moreover, patients experienced a lack of sufficient information concerning the disease. Therefore, it is of utmost importance that the patient is seen as a whole entity by the healthcare personnel to meet the individual care needs that arise from the illness.

Background: The population is growing, which places higher demands on palliative care and the need for knowledge development in nursing. Suffering is a big part of living with a terminal illness and relive suffering is part of the nurses' area of responsibility. It is of value for nurses to get insight into the patients' world of life, to provide individual palliative nursing measures. The aim in nursing is to promote quality of life through person-centered care. Aim: The aim of this study was to describe adult patients' experiences of suffering and alleviation in palliative care. Method: The study was based on a qualitative literature study, with six scientific articles. The articles were selected from the databases Cinahl and PsycInfo, with delimitations for Peer- Reviewed, adults, English language and published between 2013-2023. To analyze the articles, the five-step model of Friberg (2017) was used. Results: Three themes emerged from the analyses: Emotional suffering, Physical suffering and Close to death. This study showed patients different and similar experiences of suffering and alleviated suffering at the end of life. Reliving experiences was based on preparation for death, be treated with respect and compassion, be seen and heard, discuss thoughts about life and death and maintain the activities of importance. Conclusion: By providing compassionate care, active listening, and being genuinely interested in the patients' wellbeing, increased patients' experience of life quality and gave them a sense of relief. The care measures should be individually tailored due to every patient’s unique needs. It is therefore important for nurses to have a knowledge of how suffering could appear and choose fitting palliative care measures to reach the goal of relieved suffering

Bakgrund Sedan en tid tillbaka har webbåtkomst av patientjournalen utvecklats och blivit möjlig för patienterna såväl i Sverige som i flera länder globalt. Sedan tillgången till journalen underlättats för patienterna tar allt fler chansen att läsa i sina journaler. Med bakgrund av detta undersöks patienternas upplevelser och erfarenheter av att läsa sina journaler i denna litteraturstudie.  Syfte Syftet var att belysa vuxna patienters upplevelser av att läsa journalen vid kontakt med hälso- och sjukvården. Metod En icke-systematisk litteraturöversikt genomfördes genom att samla in data och granska 17 vetenskapliga originalartiklar. Artiklarna innefattar varierande typer av studiedesign. Författarna granskade de utvalda originalartiklarna efter Sophiahemmets Högskolas bedömningsunderlag för kvalitetsgranskning, för att sedan analysera artiklarna genom en integrerad analysmetod. Utefter detta presenterades resultatet uppdelat efter tre teman som författarna fann under analysen.  Resultat Genom granskningen upptäcktes tre huvudteman. De teman som upptäcktes då patienternas upplevelser av att läsa sina journaler undersöktes var: Patienternas upplevelse av: patientdelaktighet, av att inhämta, tolka och förstå journalinformation och personcentrering. Under dessa huvudkategorier sågs ett antal subteman. Dessa subteman innefattade patienternas upplevelser av eller kring deltagande, kommunikation, medicinsk terminologi, förståelse, tekniska svårigheter, reaktioner och känslor, partnerskapet, egenmakt och egenvård. Slutsats Enligt studien var patienterna till stor del positiva över tillgången till patientjournalen och ville läsa sina journalanteckningar. Skillnader fanns mellan olika grupper av patienter när det kom till vilka som tyckte sig ha mest nytta av att läsa journalerna. Patienterna upplevde språkbruket och den medicinska terminologin som används i journalen som svårt att förstå. Enligt studien kan en ökad personcentrering och patientdelaktighet, vid och kring journalföringen, leda till positiva erfarenheter hos patienterna såväl som det kan ge minskade risker inom vården. En ökad personcentrering vid journalföring kan även bidra till att stärka patienternas möjligheter till ett högre mått av hälsolitteracitet. / Background For some time now, web access to the medical records has developed and become possible for patients both in Sweden and in several countries globally. Since access to medical records has been made easier for patients, more and more people are taking the chance to read their medical records. Against this background, the patients attitudes and experiences of reading their medical records are examined in this litteraturestudy. Aim The aim was to shed light on adult patients' experience of reading their medical record when in contact with the health care system. Method The authors created a non-systematic literature review by collecting data and reviewing 17 scientific articles. The articles included were of various types. The authors reviewed the selected articles according to Sophiahemmet University's assessment document for quality review and then analyzed the articles through an integrated analysis method. Following this, the results were presented divided according to three themes that the authors found during the analysis. Results Through the review, three main themes were discovered. The themes that were discovered when the patients' experiences of reading their medical records were examined were: The patients' experience of: patient participation, of obtaining, interpreting and understanding medical record information and person-centeredness. Under these main categories, several sub-themes were seen. These sub-themes included the patients' experiences of or around participation, communication, medical terminology, understanding, technical difficulties, reactions and feelings, the partnership, empowerment and self-care. Conclusions According to the study, patients for the most part had positive experiences while reading their medical records and wanted to continue doing so. There were differences between groups of patients when it came to who found that they had the most benefit from reading the medical records. The patients found the language and medical terminology used in the medical record difficult to understand. According to the study, increased person-centredness and patient participation in record keeping can lead to increased positive experiences for patients as well as reduced risks in care. An increased person-centredness in recordkeeping can also contribute to strengthening patients' opportunities for a higher measure of health literacy.

Bakgrund: Syftet med palliativ vård är att förbättra livskvalitet och minska lidandeför patienter och anhöriga. För att en god palliativ vård av hög kvalitet ska kunna gesbehöver ett personcentrerat förhållningssätt tillämpas av sjuksköterskor som har encentral roll inom palliativ vård. Syfte: Syftet med studien var att belysasjuksköterskans upplevelser av att arbeta personcentrerat vid palliativ vård. Metod: Litteraturstudie med induktiv ansats. Sökningar utfördes i databaserna: PsycINFO,CINAHL och PubMed vilket resulterade i nio vetenskapliga artiklar. Resultat: Litteraturstudien resulterade i fyra huvudkategorier: betydelsen av helhetssynen,betydelsen av relationer, betydelsen av smärt- och symtomlindring, betydelsen avupplevda barriärer. En helhetssyn av människan som vårdas är viktig för att ge enpersoncentrerad vård. Helhetssynen bör innefatta individuella val, behov ochönskningar. Relationen mellan sjuksköterskan och patienten ska prioriteras samtidigtsom sjuksköterskan ska ha en relation med de anhöriga. En optimal smärtlindring kanadministreras om sjuksköterskan lär känna patienten och får en helhetsbild. Konklusion: Kategorierna innefattar beskrivningar av sjuksköterskors upplevelser avatt vårda patienter som är palliativa och samtidigt främja personcentrerad vård. / Background: The purpose of palliative care is to improve quality of life and decrease suffering for patients and relatives. To implement a good palliative care with high quality, there is a need for a person-centered approach from nurses who have a central role in palliative care. Aim: The aim of the study was to illuminate experiences of nurses working with person-centered care during palliative care. Method: A literature review with an inductive approach. The searches were performed in the databases: PsycINFO, CINAHL and PubMed which resulted in nine scientific articles. Result: The litterature review resulted in four main categories: importance of the holistic view, importance of relationships, importance of pain and symptom relieving, importance of experienced barriers. An holistic view of people who are receiving care is important in order to give person-centered care. The holistic view should include individual options, needs and desires. The relationship between the nurse and the patient should prioritise as well as the nurse needs to have a relationship with the relatives. Optimal pain and symptoms relief can administrate when the nurse gets to know the patient with a overall picture. Conclusion: The categories include description of nurses’ experience caring for palliative patients and at the same time implement person-centered care.

Bakgrund: Astma är en vanlig förekommande folksjukdom som drabbar individer i alla åldrar. Det finns olika typer av astma och de vanligaste typerna är den allergiska och den icke allergiska formen av astma. Sjukdomen orsakar förträningar och inflammationer i luftvägarna, vilket försvårar andningen. Symtom som fås vid astma uppvisas genom andnöd, hosta, nattlig dyspnè och tryck över bröstet. Syfte: Syftet var att beskriva vuxna personers erfarenheter av att leva med astma. Metod: En allmän litteraturöversikt genomfördes med elva kvalitativa artiklar som grund. Databaserna Cinahl och Pubmed tillämpades. De elva artiklarna kvalitetsgranskades i enligt med Fribergs metod och analyserades tematiskt. Resultat: Erfarenheten av att leva med astma resulterade i dessa två huvudteman: Att anpassa sig till livet med astma och Vårdpersonalens betydelse för personer med astmas erfarenheten av sjukdomen. I den första huvudteman inkluderas de fyra subteman; Upplevelser av fysiska förändringar, Upplevelsen av emotionella förändringar, Svårigheter med anpassning och Användbara strategier vid anpassning. Slutsats: Att leva med astma medförde livsstilsförändringar i form av fysiska och emotionella begränsningar. Graden av anpassning skiljdes åt beroende på faktorer såsom kulturella antaganden, grundhållning och stöd från anhörig. En allmän syn på astma som mild framfördes existera i samhället. Brister i vårdandet var påtagliga och framfördes påverka delaktigheten. Denna litteraturöversikt har belyst ytterligare om den avgörande roll som sjuksköterskor har när det gäller att inneha ett personcentrerad vårdande och aktivt engagemang vid vård av personer med astma. / Background: Asthma is a common prevalent condition affecting individuals of all ages. There are different types of asthma, with the most common being allergic and non-allergic forms. This disease causes constriction and inflammation in the airways, which makes breathing difficult. Symptoms of asthma include shortness of breath, coughing, nocturnal dyspnea, and chest tightness. Aim: The aim was to describe adults' experiences of living with asthma. Method: A general literature review was carried out with eleven qualitative articles as a basis. Databases Cinahl and Pubmed were applied. The eleven articles were quality checked in accordance with the Friberg method and thematically analyzed. Results: The experience of living with asthma resulted in these two main themes: to adapt life with asthma and the impact of healthcare professionals on the experience of individuals with asthma. In the first main theme, the four subthemes are included: experiences of physical changes, experiences of emotional changes, difficulties with adaptation and useful strategies for adaptation. Conclusions: Living with asthma led to lifestyle changes involving physical and emotional limitations. The extent of adaptation varied based on factors such as cultural beliefs, attitude, and support from relatives. There was a prevalent societal perception of asthma as a mild condition. Observable deficiencies in care were noted to impact involvement. This literature review has further illuminated the crucial role that nurses play in providing person-centered care and active engagement in the treatment of individuals with asthma.

Bakgrund: Hjärtsvikt är en folksjukdom som ökar kraftigt vid stigande ålder och kräver ökade behov av hälso- och sjukvårdsinsatser. För att bibehålla hälsan och inte belasta sjukvården kan interventioner av egenvård förebygga, underhålla och hantera den kroniska hjärtsvikten. Även livsstilsförändringar är viktiga bitar i egenvårdsinterventionen för att minska risken för sjukdomsförsämring. För att kunna sköta sin egenvård på ett optimalt sätt behövs utbildning och kunskap om effektiva interventioner som stärker förmågan att utföra egenvård. Syftet: Syftet var att belysa interventioner som kan förbättra egenvård hos personer med hjärtsvikt. Metod: En litteraturstudie valdes som metod. Sökningarna i omvårdnadsdatabaserna CINAHL och PubMed genererade totalt 16 omvårdnadsvetenskapliga artiklar publicerade mellan 2013 och 2023 som svarade på studiens syfte. Artiklarna kvalitetsgranskades och analyserades genom integrerad analys. Resultat: Olika typer av interventioner kan förbättra egenvården hos personer med hjärtsvikt. Resultatet sorterades in i tre kategorier. Utbildningsintervention som stärker kunskap, Interventioner med teknisk support och socialt stöd och Interventioner med olika samtalstekniker.   Slutsats: Studien visar på hur strukturerade insatser av egenvårdsinterventioner stärker egenvårdsbeteendet för att förebygga, hanterar och underhåller hjärtsviktssymtom vilken inverkan på hur personen behåller hälsan. Personens självkännedom kan förbättras genom individanpassad information och utbildningsprogram för att öka kunskapen på ett sätt som passar bäst utifrån sina resurser och behov. Därför har personcentrerad vård en central roll när det gäller att stärka egenvård och delaktighet hos personer med hjärtsvikt. / Background: Heart failure is a common disease that increases sharply with increasing age and requires additional needs for health care interventions. In order to maintain health and avoid burdening the healthcare system, self-care interventions can prevent, maintain and manage chronic heart failure. Lifestyle changes are also important compondents of the self-care intervention to reduce the risk of disease worsening. In order to manage self-care in an optimal way, education and knowledge about effective interventions that strengthen the ability to perform self-care are needed. Purpose: The aim was to highlight interventions that can improve self-care in people with heart failure. Method: A literature study was chosen as the method. The searches in the nursing databases CINAHL and PubMed generated a total of 16 nursing science articles published between 2013 and 2023 that responded to the study objective. The articles are quality checked and analyzed through integrated analysis. Results: Different types of interventions can improve self-care in people with heart failure. The results were sorted into three categories. Educational intervention that strengthens knowledge, Interventions with technical support and social support and Interventions with different conversation techniques. Conclusion: The study shows how structured interventions focusing on self-care  strengthens self-care behaviours to prevent, manage and maintain heart failure symptoms which impact on how the person maintains their health. A person's self-awareness can be improved through individually tailored information and training programs to increase knowledge in a way that best suits their resources and needs. Therefore, person-centered care has a central role when it comes to strengthening self-care and participation in people with heart failure.