Extremt prematura barn behöver ofta medicinsk vård dygnet runt, vanligtvis på en neonatal intensivvårdsavdelning (neo-IVA). Miljön på neo-IVA bör erbjuda utvecklingsstödjande vård som stödjer sömn och stabila fysiologiska parametrar. Den medicinska utrustningen och vårdbehandlingen på neo-IVA kan dock leda till negativa effekter för barnen. Prematura barn är känsliga för alla stimuli, såsom höga ljud och stark belysning. De måste skyddas samt vårdas på ett sätt så deras utveckling gynnas. Syftet var att beskriva de faktorer i vårdmiljön inom neonatal intensivvård som främjar de prematura barnens utveckling. Data analyserades enligt Whittemore och Knafls beskrivning. Resultatet presenteras i följande kategorier: icke farmakologiska metoder som främjar barnens utveckling, förutsättningar för att ge barnen en god sömn, miljöns påverkan på barnens beteendemönster, barnens vårdtid påverkas av olika miljöer och miljöns påverkan på barnens fysiologiska parametrar. Resultaten visar att position, beröring, musik, ljud och ljus påverkar hur barnen känner och utvecklas och bidrar med kunskaper om en vårdmiljö som är mer fördelaktig när det gäller barnens vård och utveckling. I diskussionen reflekteras områden som hur personal på neo-IVA kan ge bättre vård för prematura barn med minskat lidande och möjlighet till god utveckling som följd. / Extreme premature infants often require around the clock medical care, typically provided in neonatal intensive care units (NICUs). As such, the environment at NICU should offer developmentally supportive care that supports sleep and stable physiological parameters. However, the medical equipment and procedures in the NICUs can lead to negative effects on infants. Premature infants are sensitive to all stimuli, such as loud noises and bright lighting. They must be protected and cared for in such a way that benefits their development. The purpose was to describe the factors in the care environment in neonatal intensive care that promote the development of premature infants. Data were analyzed according to Whittemore and Knafl's description. The results are presented in the following categories: non-pharmacological methods that promote infant development, conditions for giving infants sufficient sleep, the environment's impact on infants' behavioral patterns, infants' care time affected by different environments and the environment's impact on infants' physiological parameters. The results show that body position, touch, music, sound and light affect how infants feel and develop and contribute with knowledge about a care environment that is more beneficial when it comes to the infant’s care and development. The discussion reflects areas such as how staff at NICU can provide better care for premature infants with reduced suffering and the opportunity for good development as a result.

Graft-versus-host disease (GvHD) is a frequent, and often life-threatening, complication after an allogeneic, hematopoietic stem cell transplantation (allo-SCT). It can appear in an acute or a chronic form and presents different grades of severity. Particularly, the severe forms of GvHD are often responsible for a change of the curative intent for allo-SCT into a palliative goal of care. For this non-systematic review, we conducted a focused literature search in the MEDLINE database via PubMed to examine whether patients with severe forms of GvHD might have special needs and burdens from a supportive and palliative care perspective. To draw a comprehensive picture of this patient group, we included findings on quality of life (QoL) and physical symptoms and function as well as psychological and spiritual well-being. In most domains, patients with severe forms of GvHD showed greater impairment and a higher symptom burden compared to patients with milder forms of GvHD. However, we could not identify any studies that specifically investigated patients with severe forms of GvHD. Further research in this field is necessary to guarantee the highest standard of care for this very special patient group.

PhD (Health Sciences) / Department of Advanced Nursing Science / Disability is the most painful experience for the mother and relatives when a child is born. This is because every parent expects a normal child once a woman conceives. For a mother to be able to cope with their children they need to be supported emotionally, psychologically and physically by the family members, community, and health care professionals and other support service providers.The overall purpose of the study was to develop a model to support mothers of children with intellectual disabilities in selected institutions of Limpopo Province.An exploratory sequential mixed method was employed which includes both qualitative and quantitative approaches to guide the study.Population was all mothers of children with intellectual disabilitiesand health care professionals from the selected institutions where the research was conducted. Health care professionals were purposively selected whereas mothers were conveniently selected. The study was carried out in two phases i.e Phase1(a & b) and Phase 2. Qualitative results were used to build a subsequent quantitative phase. In Phase 1a,a qualitative approach was employed using descriptive and exploratory designs. Qualitative data was collected through individual interviews.Data analyses were done utilising Tesch’s open coding method.In Phase 1b was quantitative approach wherein a cross-sectional descriptive design was used.Questionnaireswere developed and data were collected from the health care professionals in the selected study areas.Data analyses were done using the Statistical Package for the Social Sciences (SPSS) version 24 and the level of statistical difference being set at p<0,05.In Phase 2, concept analysis, model development and validation of the model were performed. Themes and sub- themes were identified from the analysed data. Current study revealed that some mothers were fully supported and some were not supported at all by both the family, friends, relatives, community members and health care professionals. Hence continuous support was seen to be very crucial to them.The study recommendations include: open communication, social, psychological and emotional support, combined available support services, access to special schools and formulation of support groups. / NRF