Background: Rooming house residents have high rates of morbidity and mortality, yet little is known about why this disparity in health exists. Research Question: How are rooming houses linked to health? Case: Social exclusion of rooming house residents in downtown Ottawa, bounded by the neighborhood, and Ottawa’s political policies at the time of data collection (September 2019-June 2020). Methodology: A single embedded descriptive case study was informed by multiple sources of evidence, and involved a community advisory group (CAG). Rooming house residents took photos, participated in a community walk-about with participant observations and attended a focus group. Two additional focus groups were conducted; one with fellow rooming house residents, another with the CAG. Interviews with rooming house front-line service providers and a secondary data set of homeless service measures also informed the case. Findings: 1. Rooming house residents (n=10) took 112 photos, and (n=8) took part in a focus group where two broad themes emerged: Housing is health care, and just managing today. 2. Interviews with front-line service providers (n=11) focused on two themes: There are many costs to living in a rooming house, and rooming house front-line service providers wear many hats. 3. Between a sample of sheltered homeless (n = 60) and rooming house residents (n=52), there was no difference found for several health indicators, including frequency of care received in the emergency room, hospitalization as an inpatient, and if substance use made it difficult to stay or afford housing. Focus groups with rooming house residents who did not take photos (n=10) and the GAG (n=6) contributed to persona co-creation revealing financial and contextual factors affecting the health of rooming house residents. Conclusion: The shared spaces of rooming houses create a tension between offering community and creating a risk environment. The negative health consequences to living in a rooming house are mitigated by the many roles that rooming house front-line service providers play in filling gaps. This study suggests the need to definitively position rooming house residents on the housing continuum in order to ensure equitable distribution of resources to optimize the health of this vulnerable population.

Bakgrund: Omvårdnad är ett ord som kan ha flera olika betydelser, det kan vara ett verb som något man utövar eller en synonym med kunskap som något som erhålls. Syfte: Syftet med studien var att beskriva vad sjuksköterskor och undersköterskor ansåg inbegripas av begreppet omvårdnad och “god omvårdnad” samt vad för arbetsuppgifter de olika yrkeskategorierna utförde inom ramen för omvårdnad. Metod:Individuella intervjuer av tre sjuksköterskor och fyra undersköterskor. Innehållet analyserades med hjälp av kvalitativ innehållsanalys. Fem teman och 21 kategorier framkom. Resultat: Respondenterna uttryckte att den basala omvårdnaden hade en central roll inom begreppet omvårdnad. Vid diskussion om vad god omvårdnad innebar framhävde de flesta att ett gott bemötande var avgörande, att utföra arbetsuppgifter med omtanke och respekt. Att bedriva personcentrerad vård ansågs även ge god omvårdnad. Förutom basal omvårdnad och bemötande framkom det att medicinsk teknik var en stor del av arbetet inom omvårdnaden och att samarbete var en viktig del. Det rådde få meningsskiljaktigheter angående sjuksköterskans respektive undersköterskans arbetsuppgifter. Slutsats: Sjuksköterskorna och undersköterskorna som intervjuats har till stor del en samlad bild utav vad begreppet omvårdnad innebär. Det fokuserades mest på basal omvårdnad och gott bemötande vilket båda är två viktiga och centrala delar inom omvårdnaden. Att det inte fanns många meningsskiljaktigheter mellan undersköterskorna och sjuksköterskan kan ses som ett resultat av en tydlig arbetsfördelning. / Background: Nursing is a word that can have several meanings, it can be a verb or be synonymous with knowledge. Aim: The aim with this study was to describe what registered nurses (RN) and certified nursing assistant (CNA) perceived by the expressions nursing  and “qualitative nursing ” and what tasks at work these two different professions performed within the limits of nursing. Method: Qualitative interview study with individual interviews with three RN's and four CNA's. The content was analyzed through qualitative content analysis. Five themes and 21 categories arose. Results: The respondents expressed that the basal nursing care had a central role within the concept; nursing. At discussions about what good nursing meant, it was brought forth that a good interaction was decisive, to perform work related tasks with consideration and respect. To exercise person centered care was also considered to be good nursing. Besides basal nursing care and interactions it became apparent that medical technique is a big part of the job within nursing and that cooperation is an important part as well. There were few differences in opinions concerning RN respectively CNA job tasks. Conclusion: RN's and CNA's that were interviewed have the same general idea about what the concept nursing implies. It mainly focused on basal nursing care and good interactions, which were both considered as important parts within nursing. It can be seen that the lack of differences in opinion between CNA's and RN's is brought forth by a clear division of work between the two.

Sammanfattning Bakgrund: Mödrar har ammat i alla tider mer eller mindre. Attityder från familj och rådande kultur kan göra modern ambivalent till att amma sitt barn. Problem kan uppstå, som kan leda till att modern avstår från att amma. Det finns många fördelar med att amma både för barnet och för modern. Sjuksköterskan kan främja amning och bidra till att mödrar i större utsträckning får stöd att amma sina barn.                                                            Syfte: Att beskriva ammande mödrars erfarenheter av stöd i samband med amning samt att beskriva de valda artiklarnas undersökningsgrupp.                    Metod: En beskrivande litteraturstudie baserad på tio vetenskapliga artiklar. Artiklarna hämtades från databaserna MedLine/PubMed och Cinahl via högskolan i Gävle.  Resultat: Resultatet i litteraturstudien beskriver mödrars erfarenheter av amningsstöd i olika situationer, både positivt och negativt. De olika teman som framkom var, Blandade reaktioner innan förlossning, Efterfrågan av expertstöd och socialt stöd, Få ett bra bemötande, Osäkerhet och frustration, samt Uppskattning och missnöje av praktiska tips. Mödrar upplevde förberedelser för amning som användbart, men att amning inte alltid presenterades på ett realistiskt och ärligt sätt. Både förstföderskor och omföderskor önskade professionellt stöd. Om vårdpersonalen svarade på den enskilda moderns behov, värderades stödjande och icke-dömande som positivt amningsstöd. Motsägelsefulla budskap skapade förvirring och osäkerhet. Praktiskt stöd uppskattades särskilt i början. Hårdhänt vårdpersonal vid det praktiska stödet gjorde att mödrar kände sig missnöjda. Mödrarna i litteraturstudien var i olika åldrar, både förstföderskor och omföderskor som hade fött vaginalt eller med kejsarsnitt. Tre världsdelar fanns representerade som Europa, Oceanien och Nordamerika.                                                        Slutsats: Vikten av professionellt bra amningsstöd är en förutsättning för att fler mödrar ska känna sig tryggare vid amning. En bra förberedelse, praktiskt stöd och att informationen presenteras på ett realistiskt, ärligt, konsekvent sätt samt är baserat på mamman som individ gör kanske att fler mödrar ammar sina barn. Detta kan leda till att fler mödrar och barn kan ta del av det fördelar som amning innebär.  Nyckelord: Amning, problem, stöd, hälso- och sjukvårdspersonal, kvalitativ, omvårdnad. / Abstract Background: Mothers are breastfeeding at all times more or less. Attitudes from family and current culture can make mother ambivalent to breastfeeding their child. Problems may arise which may result in the mother refraining from breastfeeding. There are many benefits of breastfeeding both for the child and for the mother. The nurse can promote breastfeeding and contribute until mothers get more support to breastfeeding their children.                  Aim: To describe breastfeeding mothers experiences of breastfeeding support and to describe the selected articles study-group.                                       Method: A descriptive literature review based on ten scientific articles. The articles were retrieved from databases Med Line/PubMed and Cinahl through the University of Gävle.  Results: The outcome of the literature study describes mothers' experiences of breastfeeding support in different situations, both positive and negative. The different themes that emerged was, Mixed pre-delivery reactions, Demand for expert support and social support, and Get a good deal of attention, Insecurity and frustration, as well as Appreciation and dissatisfaction with practical tips. Mothers experienced preparations for breastfeeding as useful, but breastfeeding was not always presented in a realistic and honest way. Both prim parous and multiparous desired professional support. If the healthcare staff was responding to the needs of the single mother, evaluated supportive and non-judging as positive breastfeeding support. Contradictory messages created confusion and uncertainty. Practical support was especially appreciated initially. Hard-hearted healthcare professionals in the practical support made mothers feel dissatisfied.The mother´s in the literature study was of different ages, both prim parous and multiparous, who had born vaginally or with caesarean sections. Three continents were represented as Europe, Oceania and North America.                                                                                                                     Conclusion: The importance of professionally good breastfeeding support is a prerequisite for more mothers to feel safer when breastfeeding. A good preparation, practical support and that the information presented in a realistic, honest, consistent way and is based on the mother as an individual way make more mother´s breastfeed their children. This can lead to more mothers and children taking advantage of the benefits that breastfeeding involves.     Keywords: Breastfeeding, problems, support, health care- professionals, qualitative,nursing.