Background: Family caregivers represent a critical component in the management of the health of older adults. The inclusion of family caregivers during transitions occurring between hospital and community settings has been previously considered. However, the experience of family caregivers during transitions occurring within the same setting remains unclear. The purpose of this study was to describe the experiences of family caregivers during transitions occurring within an acute care setting. Method: A qualitative description study was conducted. Semi-structured interviews were conducted with 10 family caregivers. Interviews were audio-recorded and occurred in person or over the telephone. Analysis included coding of interview data and the development of overarching themes. Findings: In this study, family caregivers reported the following themes. These themes included: "a lack of central brain during hospitalization," "muddling through transitions alone" and "wariness towards the care delivery system. The environmental influence of the hospital setting influenced family caregivers' view of the care provided by healthcare professionals and the transitions occurring between different units. Furthermore, half of the family caregiver participants (n=5) identified as having a background in healthcare. Healthcare professionals as family caregivers (HCP-FCs) reported unique experiences from other non-healthcare family caregivers. Interviews and field notes from HCP-FC participants were analyzed separately following the same procedures as the larger study. Three themes emerged including, "seeking inclusion," "insider perspectives," and "role struggle." Conclusion: Experiences of HCP-FCs and family caregivers during hospitalization of older adults have the potential to influence perceptions regarding transitional events occurring within acute care settings. Additionally, family caregivers' and HCP-FCs' perceptions of care coordination among healthcare professionals had the potential to negatively influence perceptions of transitions occurring within the acute care setting.

Bakgrund: Sjuksköterskor i allmänt upplever det svårt att smärtlindra patienter eftersom smärta är en subjektiv företeelse. Sjuksköterskor belyser att det råder en brist på kunskap och riktlinjer vid hantering av smärtlindring. Sjuksköterskor som möter patienter med drogberoende som befinner sig i smärta anser att det är stressfullt och komplicerat. Detta på grund av att sjuksköterskorna upplevde det vara förenat med inre konflikter och moraliska dilemman. Syfte: Syftet var att beskriva patienters upplevelser av vårdpersonalens bemötande när patienterna upplever smärta som samtidigt är beroende av droger Metod: En litteraturöversikt baserad på tio vårdvetenskapliga artiklar gjordes. Artiklarna har analyserats enligt Fribergs (2012) analysmetod där författarna sökte efter likheter och skillnader av ett fenomen som sedan skapade resultatets teman. Resultat: Resultatet presenteras i två huvudteman. I det första temat: Hinder i vårdpersonalens bemötande uppkom det fem subteman. I dessa subteman beskrivs det om hur patienter upplever ett negativt bemötande ifrån vårdpersonalen. I det andra huvudtemat: Förutsättningar för bemötandet uppkom ett subtema. Det subtemat beskriver hur patienter med ett drogberoende upplever en god vårdrelation och hur den skapas. Diskussion: Författarna har diskuterat resultatets huvudfynd i förhållande till litteraturöversiktens bakgrund, författarnas synpunkter samt med Katie Erikssons caritativa teori som referensram. / Background: Nurses in general find it difficult to provide patients with pain relief because pain is a subjective phenomenon. Nurses emphasize that there is a lack of knowledge and guidelines for the handling of pain. Nurses who encounter drug dependent patients in pain find it to be stressful and complicated. The reason for this is that the nurses felt that it was fraught with their own inner conflicts and moral dilemmas. Aim: The aim of this study was to describe patient experiences of health care professionals treatment when the patient experiences pain and when they are at the same time addicted to drugs. Method: A literature review based on ten scientific articles was made. The articles was analysed with Fribergs (2012) method where the authors searched for similarities and differences out of a phenomenon that created the results themes. Results: The results of this litterature review are presented in two main themes. In the first main theme – Obstruct in the health care professionals treatment the authors could find five sub themes. These sub themes highlights how patients experience negative treatment from the health care professionals. In the second main theme: Preconditions in the treatment the authors could find one sub theme. This sub theme highlights how patients with drug addiction experience a caring relationship and how it can evolve. Discussion: The authors have discussed the results main findings in relation to the literature review background, the authors aspects and with Katie Erikssons “caritative” theory used as a theoretical framework

The Numeric Rating Scale (NRS) is suitable in postoperative settings, yet, the implementation has shown varying results. This has raised issues about the pain scales contribution to the identifying and understanding of pain. The aim of this thesis was to describe the clinical utility of patients’ self-rated postoperative pain after major surgery from a healthcare professional perspective. The aim of study I and II was to describe healthcare professionals’ perceptions of the use of pain scales, and to through considering critical incidents describe care experiences and actions taken by healthcare professionals’ when assessing pain. Participants in study I (N=25) and II (N=24) were enrolled- registered nurses and physicians with clinical experiences of pain scales. The aims of study III and IV were to determine the clinical applicability of NRS mode- and maximum- measures, and the NRS mode- and median measures at rest and during activity based on patients self-rated pain. The aim in study IV was additionally to determine the number of NRS ratings needed for the calculation of these measures. The number of surgical and orthopedic patients who completed study III were: n=157 and study IV: n=479. Study I and II confirmed earlier findings of patients’ self-reported pain scores as a facilitator in the understanding of their postoperative pain. Organizational routines, documentation devices, clinical competence, continuity in care, collaborative actions, time, and individual routines were healthcare related factors affecting the use of pain scales (I, II). Patient-related facilitating factors were patients’ ability and willingness to communicate pain, while disability and unwillingness to communicate or inconsistency in verbal communication with observed behaviors were barriers (II). Time and multidimensional communication approaches could bridge these barriers (I, II). Study III and IV showed acceptable reliability for the mode, median and maximum measures. Rank correlations for individual median scores, based on four ratings, versus patients’ retrospective self-rated average pain, were moderate and strengthened with increased numbers of ratings. The Svensson method showed an individual variation within the expected outcome and a significant systematic group change towards a higher level of reported retrospective pain. The calculated pain measures, particularly concerning pain at rest, generally were lower than patients’ recall of pain. The findings described beneficial effects of patient self-reported pain, however present healthcare did not fully support the utilization of pain scales. Because of the simple measurement characteristics, the use of daily NRS average pain measures, patients’ pain can be followed until resolved. The measures could additionally become important patient reported outcome measures and thus constitute new motivators to increase the utilization of pain scales.

Bakgrund  Varje år är ca 1,2 miljoner barn i världen i behov av palliativ vård. Barn har fler tillstånd än vuxna som kan komma att kräva den här typen av vård. De centrala arbetsuppgifterna för vårdpersonal som arbetar med palliativ vård av barn är att skapa förutsättningar för god livskvalitet och lindra lidandet, samt skapa förutsättningar för att involvera familjemedlemmar i vården. Syfte Syftet med litteraturstudien är att beskriva vårdpersonals erfarenheter av att vårda barn i palliativt skede. Metod En litteraturstudie som inkluderade åtta vetenskapliga artiklar av kvalitativ ansats sammanställdes. Sökningarna genomfördes i följande databaser: Cinahl, PubMed och Scopus. Granskning, analys och sammanställning av artiklarnas resultat genomfördes enligt modell av Friberg. Resultat Analysen resulterade i följande tre huvudkategorier; att sträva efter god omvårdnad, att stöta på organisatoriska hinder och att uppleva emotionella prövningar. Slutsats Vårdpersonal strävar efter god omvårdnad genom att involvera och skapa goda relationer till barn och familjer. Organisatoriska hinder påverkar vården negativt och försvårar vårdpersonals möjligheter att arbeta personcentrerat. Det är viktigt att vårdpersonal ges förutsättningar att arbeta enligt ett personcentrerat förhållningssätt då det kan generera i ökad vårdkvalitet.

Although a growing number of scholars suggest that the construction of identity is an important form of institutional work, the complex interactions between identities and institutions remain under-explored. In particular, few studies consider how the affective aspects of identities may inform institutional work. This thesis examines the experiences of lawyers who volunteered to create and support a legal charity. As these volunteers grew to more than twenty thousand over fifteen years, the charity gradually centralized charitable work across law firms for the first time. In this way, it transformed the institution of pro bono work within the English legal profession. Drawing on this case study, this thesis employs a grounded theory methodology to generate a conceptual framework that connects emotion work, identity work and institutional work. This framework suggests that some professionals work to re-assert and ‘remember’ aspects of their traditional identities that compete with some contemporary demands. This can prompt identity contradictions that inspire reflection on professional practices. This identity work may also encourage professionals to evoke emotions of guilt that can imbue contradictions with enough significance to create a purpose for remedial institutional work. When enabled by meso-level processes, such micro-level work can reinvigorate traditional practices and accomplish institutional change.

Bakgrund: Smärta är en av de vanligaste orsakerna till varför patienter uppsöker vård. Akut smärta beskrivs som subjektiv och individuell vilket styrker nödvändigheten av ökad kunskap och förståelse för akut smärta och patienters olika upplevelser av den.  Detta skulle kunna generera i en bättre omvårdnad, där utvecklingen från akut smärta till en kronisk långvarig smärta samt ett lidande för patienten skulle kunna minimeras. Syfte: Syftet var att beskriva patienters upplevelse av akut smärta och vårdpersonalens betydelse i samband med den. Metod: En litteraturöversikt som baseras på 13 artiklar, sju kvalitativa och sex kvantitativa. Resultat: Fyra teman identifierades; "Vikten av adekvat smärtbehandling", "Vårdpersonalens kompetens inger trygghet", "Att underkasta sig vårdpersonalen" samt "Betydelsen av kommunikation och information". Konklusion: Akut smärta är fortfarande ett stort problem och alldeles för många patienter lider av akut smärta. Vårdpersonalen har stor betydelse för dessa patienters upplevelse då det kan lindra smärtan och förebygga onödigt lidande. För att förbättra vården för patienter med akut smärta behövs en ökad förståelse och kunskap för deras subjektiva upplevelser men även betydelsen av hur sjuksköterskan agerar, behandlar och utvärderar är viktig. / Background: Pain is one of the most common reasons why patients seek healthcare. Acute pain is described as subjective and individual, which proves the need for greater knowledge and understanding of the acute pain and the patient's different experiences of it. This could generate in a better care, where the development of acute pain to chronic prolonged pain and the suffering of the patient could be minimized. Aim: The aim was to describe the patients’ experience of acute pain and the significance of health care professionals associated with it. Method: A literature review based on 13 articles, seven qualitative and six quantitative.   Results: Four themes where identified; "The importance of adequate pain management",”To submit to the health care professionals”, “How the health care professionals’ competence incites a sense of safety” and ”The significance of communication and information”. Conclusion: Acute pain is still a major problem and too many patients suffers from it. The health care professionals have a great importance for these patients’ experience since they can ease the pain and prevent unnecessary suffering. To improve care for patients with acute pain, a greater understanding and knowledge of their subjective experiences is required but also the significance of how the nurse act, treats and evaluates should be of importance.

The concept of understanding one’s origin or existence spans across almost every sphere of social science; despite its popularity, there is still a lack of research exploring identity in the work setting of developing countries. This thesis aims to contribute to understanding identity processes of workers in developing countries through the lenses of social identity and post-colonialism. The rationale for using these areas lies in the perceived nature of identity processes for people in developing countries by taking into account historical and cultural influences; for social identity (Tajfel & Turner, 1979), the “prototype” and “cohesion, solidarity and harmony” and for post-colonialism (Sen, 2006; Ekeh, 1975; Ekanola, 2006; Mizuno & Okazawa, 2009), “power”, the “dialectics of the colonized mind” and “social formations”. This thesis takes a socio-psychological approach, which is based on a qualitative research method; in particular, 47 in-depth interviews with professionals from the oil and gas sector of Nigeria form a key aspect of the research method. Findings reveal that social identity theory can be used to interpret the propensity of Nigerians to identify with groups. The thesis finds that social identity captures the importance attached to group identification through an understanding of the drivers and benefits of harmony to the self-concept in the chosen context. However the thesis also finds that social identity but does not cater for other integral aspects of identity processes, such as power and identity struggle. The thesis finds that by addressing the perception of perpetuated colonialism produced by the persistent domination of foreign workers in senior roles and their interaction with indigenous workers, post-colonial theory adequately covers issues of power and struggle. In summary, the thesis finds that the integration of social identity theory and post-colonial theory facilitates a more holistic interpretation of identity processes in regions like Nigeria. Hence this thesis contributes to the literature on identity processes in the work setting of a developing country.

The topic of this thesis focuses on various legal professions within the Czech Republic, such as attorneys, notaries, bailiffs and judges. These occupations are often associated with civil judiciary process. The purpose of this thesis is to define the foundations of their legal status, including the scope of their activities, and how they differ. Additionally, the thesis focuses on the role of individual professions. Firstly, important elements, such as confidentiality, independence, autonomy or responsibility will be analyzed. Secondly, the thesis will address significant problems in defining the role of the legal profession. Finally, the thesis will include several challenges lawyers face in the 21st century, for example, the provision of legal services by non-professionals. Powered by TCPDF (www.tcpdf.org)

Bakgrund: Depression är en folksjukdom som orsakar stort lidande för dem som drabbas och deras närstående. Sjukdomen underdiagnosiseras på grund av samsjuklighet med fysiska sjukdomar. Ökad kunskap om depression krävs för att kunna främja ett bra bemötande av patient från vårdpersonal. Syfte: Syftet med studien var att beskriva hur patienten med depression upplever bemötande från vårdpersonal. Metod: En litteraturöversikt baserad på tio vetenskapliga artiklar som analyserades i enlighet med Friberg. Tio kvalitativa studier hämtades från CINAHL, PsycINFO och PubMed. Som en teoretisk utgångpunkt användes Rosemarie Rizzo Parses omvårdnadsteori. Resultat: Resultatet presenterades i två teman och sex underteman. Det första huvudtemat är relation till vårdpersonalen med tre underteman: delaktighet, information, delaktighet och behandling och tillgänglig vård. Det andra huvudtemat är interaktion med vårdpersonal med tre undertemat: kommunikation, upplevelse att bli lyssnad på och kompetent och närvarande personal. Diskussion: Resultat diskuteras utifrån Rosemarie Rizzo Parses teori och även tio vetenskapliga artiklar, med syfte att visa att deprimerade patienter som känner brist på tillit, engagemang från vårdpersonalen samt brist av god behandling och kontinuitet haft dåligt erfarenheter av bemötande med vårdpersonal. Det krävs en ömsesidig relation mellan patienter och vårdpersonal för att patienterna kunna ha en bra upplevelse med vårdpersonalen. / Background: Depression is a common disease that causes great suffering for patients and their relatives. The disease is often under diagnosed because of comorbidity with physical disorders. Increased knowledge about depression is needed to a good response between patients and health care professionals. Aim: The aim of this study was to describe how the patient with depression experiences treatment from healthcare professionals. Method: A literature review based on ten scientific articles that were analyzed in accordance with Friberg (2012). Ten qualitative studies were retrieved from the database CINAHL, PsycINFO and PubMed. As a theoretical base used Rosemarie Rizzo Parse's theory. Results: The result demonstrates two main themes and the six sub-themes. The first main theme highlights the relationship with the nursing staff with three sub-themes: participation, information, treatment and care available. The second main theme is the interaction with health care professionals with three sub-themes: communication, experience to be listened to and competent and present staff. Discussion: The results discussed from Rosemarie Rizzo Parse's theory, and also additional ten scientific articles, with the aim to show that depressed patients who feel a lack trust, commitment from health care professionals and continuity had bad experiences of treatment with health care professionals. The needed a mutual relationship between patients and health care professionals in order to patients to have a good experience with health care professionals.

Background: Abortion continues to be stigmatized in Ghana even though Ghana has one of the most liberal abortion laws in West Africa. This stigmatization discourages women from having safe abortion and discourages the health care professionals to provide services for abortion. The recruitment of healthcare providers is therefore marginalized, isolated and difficult. Aim: The aim of the study is to describe the healthcare professionals’ experiences of working with the abortion care in Ghana. Method: Five qualitative, semi-structured interviews were conducted with healthcare professionals working at two different governmentally owned hospitals in Ghana. The findings were analysed with qualitative content analysis. Results: Four main themes emerged in this study describing healthcare professionals’ experiences of working with abortion care in Ghana; Context, Nursing care, Challenges and Saving lives. The healthcare professionals work is stigmatized and challenging but the best part of their profession was helping adolescents, families and saving lives. Conclusion: To save lives, enhance the working situation for the healthcare professionals and to reduce stigma, education and better working environment is necessary. / Bakgrund: Abort fortsätter att vara stigmatiserat i Ghana trots att Ghana har en av de mest liberala abortlagarna i Väst Afrika. Stigman avskräcker kvinnor från säker abort och hindrar hälso- sjukvårdspersonalen att tillhandahålla tjänsten för abort. Anställingen av hälso-sjukvårdspersonalen är därför marginaliserad, begränsad och svår. Syfte: Att beskriva hälso-sjukvårdspersonalens erfarenheter av att arbeta med abortvården i Ghana. Metod: Fem kvalitativa, semi-strukturerade intervjuer utfördes med hälso-sjukvårdspersonal från två olika sjukhus i Ghana. Kvalitativ innehållsanalys användes för att analysera insamlad data. Resultat: Hälso-sjukvårdspersonalens erfarenheter och åsikter om att arbeta med abortvård beskrevs med fem huvudteman: Kontext, Omvårdnad, Utmaningar och Rädda liv. Hälso-sjukvårdspersonalens arbete är stigmatiserat och utmanande men den bästa delen av deras profession var att hjälpa ungdomar, familjer och att rädda liv. Slutsats: För att kunna rädda liv, förbättra arbetssituationen för hälsosjukvårdspersonalen och för att minska stigman är utbildning och bättre arbetsmiljö nödvändigt.