The aim of this study was to describe the meaning of individual care according to Newborn Individualized Developmental Care and Assessment programs (NIDCAP) to the early born child. The care around the early born child has shown a big importance. NIDCAP incorporates many care aspects that give structure for an individual tailored care. A fast care planning within three days and night after the birth according to NIDCAP has a positive effect for the cognitive development. The early child has showed that the surroundings environment has an important role for their development. To support the early born child´s development thus the brain can mature in its rate to achieve self-check and to handle it sensory rise to respect the early born child on the basis of their maturity's degree is the goal of NIDCAP model. Through reducing sounds and light levels on the incubator room has it been seen that the early born child can few a better control on its new life. It is important that the nurse makes the parents believe on them self and to actively attend the care, that they dare to be alone with the child. Focus on individual care according to NIDCAP model is to support the parents to understand the early born child's neurodevelopment. If the nurse creates a good relationship with the parents, creates a better condition to developing parent role.

Syfte. Undersöka användningen av kängurumetoden hos extremt för tidigt födda barn. Bakgrund. Kängurumetoden (KM) är en evidensbaserad metod som innebär att barnet bärs hud mot hud på förälderns bröst i upprätt ställning. Metoden har många fördelar för det för tidigt födda barnet och har visat sig vara effektiv för att skapa starka band föräldrar och barn emellan. Forskning visar att det är en säker vårdmetod även för extremt för tidigt födda barn.   Design. En retrospektiv explorativ journalgranskningsstudie med både kvantitativ och kvalitativ ansats. Journaler granskades för de 49 extremt för tidigt födda barn vårdade vid Norrlands universitetssjukhus mellan oktober 2011 och oktober 2013. Metod. Statistiska beräkningar gjordes med icke parametrisk korrelation enligt Spearman och Wilcoxon signed ranks test. I den kvalitativa delen utfördes textanalys av journalanteckningar. Resultat. Medianålder vid kängurudebuten var fyra dagar. De flesta barn kängurudebuterade med mamman, och pappor utövade känguruvård i mindre utsträckning än mammor. Ju tidigare barnet var fött, desto längre dröjde kängurudebuten, men känguruvård har förekommit så tidigt som dag fyra hos de mest för tidigt födda barnen. Slutsats. Neonatalvården har mycket att vinna på om vårdpersonalen lyckas hjälpa föräldrar i allmänhet, och pappor i synnerhet, till att tidigt våga närma sig och känguruvårda sina extremt för tidigt födda barn. Med utbildning och träning för personal och stöd till föräldrarna, kan KM användas i större utsträckning för de extremt för tidigt födda barnen. Kliniska implikationer. Resultaten av denna studie bidrar till insikter och djupare kunskap om användningen av KM för extremt för tidigt födda barn. Resultatet kan användas för att identifiera utvecklingsmöjligheter men även för att utvärdera framtida förbättringsarbete. Kunskapen om och tron på vinsterna med KM kan rädda liv. / Aims. To study the use of the KMC for extremely preterm infants. Background. Kangaroo-Mother care (KMC) is an evidence-based method that involves carrying the infant skin to skin on the parent’s chest in an upright position. The method brings many benefits for the preterm infant and has proven to be effective for creating strong bonds between parents and infants. Research shows that KMC is a safe method even for extremely preterm infants. Design. A retrospective exploratory medical records review using both quantitative and qualitative approach. Medical records were reviewed for the 49 extremely preterm infants cared for at Norrland’s University Hospital between October 2011 and October 2013. Methods. Statistical analysis were made by non-parametric correlation by Spearman and Wilcoxon´s signed ranks test. In the qualitative part text analysis of medical records was performed. Results. KMC onset was in a median age of four days after birth. The kangaroo onset was most often with the mother, and fathers performed less KMC than mothers. The more preterm the infant was born, the later kangaroo onset, but KMC has occurred as early as day four for the most preterm infants. Conclusion. Neonatal care has much to gain if nursing staff succeed in helping parents in general, and fathers in particular, to an early KMC onset. With education and training for staff and support to the parents, KMC can be used for the extremely preterm infants to a greater extent. Relevance to clinical practice. The results of this study contribute to the understanding and deeper knowledge about the use of KMC for extremely preterm infants. The result can be used to identify needs for development, but also to evaluate future improvements. Knowledge of and belief in the benefits of KMC can save lives.

Bakgrund: Sjuksköterskor på neonatalavdelningar arbetar ofta i nära relation med föräldrar till för tidigt födda barn. Föräldrars delaktighet i omvårdnaden av sitt barn kan påverka förälderns psykiska hälsa, anknytning till barnet samt påverka barnets välmående och möjlighet till utveckling. Syfte: Beskriva barnsjuksköterskors upplevelser av att optimera föräldrars delaktighet i omvårdnaden av sitt för tidigt födda barn. Metod: Kvalitativ studie med induktiv ansats. Genom ett bekvämlighetsurval rekryterades åtta kvinnliga barnsjuksköterskor vid två jämförbara neonatalavdelningar i södra Sverige att delta vid semistrukturerade intervjuer. Intervjuerna bearbetades genom en kvalitativ innehållsanalys. Resultat: Studiens resultat presenteras utifrån två kategorier med nio underkategorier: 1) Svårigheter, innefattande fem underkategorier: Föräldrars olika medverkan i omvårndaden, Föräldrars reaktioner, Kommunikationssvårigheter, Relationen föräldrar-barnsjuksköterska samt Organisatoriska hinder 2) Framgångsfaktorer innefattande fyra underkategorier: Gynnad anknytning, Samspel mellan föräldrar och barn, Professionellt bemötande samt Utbildning till föräldrar och personal. Diskussion/Slutsats: Föräldrars insatser i omvårdnaden av sitt barn, barnsjuksköterskornas sätt att involvera dem och samspelet mellan båda parter leder till att föräldrars delaktighet kan optimeras eller missgynnas. Föräldrars rädslor är ett hinder för optimerad delaktighet som behöver uppmärksammas och ges utökade resurser för att hantera. Fortbildning till vårdpersonal på neonatalavdelningar skulle kunna förbättra barnsjuksköterskornas professionalitet i bemötande och omhändertagande av rädda och oförberedda föräldrar. / Background: Nurses working on neonatal wards often work closely to parents of premature born babies. Parents’ participation in the care of their baby can affect their mental health, their connection to the baby and influence the well-being and opportunities for development for the child. Aim: To describe pediatric nurses’ experiences of optimizing the participation of parents in the care of their premature born babies. Method: A qualitative study was conducted. Eight female pediatric nurses from two comparable neonatal wards in Southern Sweden were interviewed with semi-structured questions. A qualitative content analysis was conducted. Findings: The result of the study was represented by two categories and nine subcategories: 1) Challenges, containing five subcategories: Variation in parent participation, Parental reactions, Communication issues, Relationship between the parents and the pediatric nurse and Organizational obstacles 2) Factors for progress, containing four subcategories: Favored attachment, Interaction between parents and the child, Professional treatment, and Education of parents and staff. Conclusion: Parental contributions in the care of their newborn, the pediatric nurses’ ways of involving the parents and the interaction between the two can determine if the parental involvement becomes optimized or is disadvantaged. Parents fear represent one of many obstacles for optimized participation and could be given further attention and increased resources. Educating the pediatric staff could also improve the quality of care when working with parents reactions and fear in the unthought-of situation.

Babies born prematurely are deprived of normal sensorimotor stimulation when placed in an artificial environment, the incubator. The aim of this project was to design a series of products that could promote the baby’s emotional and neurological development, and to facilitate parental bonding.  The products designed in this project has a theoretical basis on the research available today on cognitive and emotional development in children born prematurely. They were developed in close cooperation with a group of parents and nurses in a neonatal intensive care unit. Presence is a product collection for developmental care, consisting of a mattress, a figure and a necklace. The mattress has vibration sensors that transfer the mother’s heart beat and speakers with recorded heartbeat and her voice. The figure in silicone is designed for sensorimotor stimulation and can be together with the child in the incubator. The figure wears a cloth with mother’s scent. The cloth can be worn by parent in a necklace made of silicone.

Studien vill undersöka hur tidigt förebyggande arbete idag ser ut i samhället, samt hur det skulle kunna utvecklas. Syftet med studien är att undersöka det tidigt förebyggande arbetet med barn, samt om en implementering av socionomen på BVC skulle kunna utveckla det förebyggande arbetet som idag finns. Med en kvalitativ ansats och induktiv syn genomförs studien med semistrukturerade intervjuer. En generell strategi har använts för att komma fram till den empiri som samlats in, genom fyra semistrukturerade intervjuer och en översikt av forskning inom området. Problemperspektivet ligger till grund för bearbetning samt kodning av studiens genomförda intervjuer. Den teorin som studien använder sig av under kodning samt analys är utvecklingsekologin. Från teorin används tre av teorins system, som är mikro-, exo- och makrosystemet. Studien når slutsatser utifrån systemen som är: Mikroslutsats: Tidigt förebyggande arbete måste tas på större allvar och ske i större utsträckning. Exoslutsats: Det tvärprofessionella teamet bör finnas, med socionomen, för att utföra tidigt förebyggande arbete av god kvalité. Makroslutsats: Att satsa på tidigt förebyggande arbete kommer att minska höga kostnader i framtiden. / This study wants to identify how the early prevention work looks in the society as well as how it could be developed. The purpose with this study is to exam the early prevention work for children, also if an implementation of a social worker in the children health care could develop the early prevention work that exist today. The study has a qualitative approach and an inductive view. A general strategy has been used to reach the empirics, that is gathered through four semi structed interviews and a review of current research in the field. The problem perspective is a foundation for processing and coding the interviews in the study. The study uses the bioecological model as the theory to process the coding and analysis of the interview empirics. From the theory three of the systems are used, micro-, exo and macrosystems. The study reaches conclusions from the systems that are: Micro conclusion: Early prevention work must be taken more seriously and occur in a greater extent. Exo conclusion: The interprofessional team should exist, along with the social worker, to perform early prevention work of good quality. Macro conclusion: To focus on early prevention will reduce high costs in the future.

The aim of the paper was to identify tendencies in the type of descriptions, categories, and identities that the doctors at the mental hospital Stockholm’s hospital gave to the mentally ill patients. The time period was chosen for a few specific reasons, one being Bror Gadelius, then chief physician at the mental hospital and his ambitions for a humanistic care of the mentally ill. The other reason is that this period has been forgotten in Swedish history of mental health care as it fell between the 18th and 19th century ‘surveillance and control’, and on the other hand a period of electrical treatments, lobotomies,and sterilisations to ‘treat’ mental illness and fix society during 1930-1950. In the paper, two theories are used to be able to discern tendencies and different attitudes from the doctors in the patient records. The first is the intersectional perspective with some main categories such as Gender, Class, Body, and Sexuality, but also smaller categories that I discovered during the research. These are somewhat abstract yet self-explanatory: Curable/Incurable, meaning whether the attitude in the records suggests that there was any chance for the patient to get well. Talking/Not talking, where the patient's ability or unwillingness to talk to the doctor changes how the patient is described, and finally Docile/Resistant, which means that the patient is described according to how they behave in accordance with the norms of the mental hospital. The second theory is about objective medicine, which developed with the natural sciences, and the need to be scientifically accurate and to be able to define what disease is, what it looks like and its dimensions. However, when objective medicine developed, it was based on a subjective basis, and therefore being ill meant being 'ugly' and not conforming to societal norms. The two theories work well together because they both highlight historically changing meanings within patients' categories and given identities. Although these are two major theories, the paper is still a micro-historical study, I wanted to get up close to the source material and thoroughly examine the different ways in which patients could be described in the mental hospital. And I believe that it is possible, even with a small study of ten patient records, to provide some nuances of how the doctors viewed the mentally ill patients in the early 20th century.

In cases where children and youths are in need of support from various activities in order to have their needs met, authorities shall collaborate towards the common goal: the child’s best interests. The concept lacks an unambiguous definition and professionals should make decisions adjusted to the child’s individual needs. Within the Mobile team, which is an interprofessional form of collaboration between the school and social services, the different professional groups could be characterized by different perspectives. This may lead to different interpretations which can pose a challenge to agree on a joint decision for the child’s best interests. The study is based on a qualitative approach through semi-structured interviews with six professionals within a mobile team. The theories used to analyze the empirical material is collaboration theory and theory about discretion in decision making. Several noteworthy results were find. The mobile team work early and preventive both generally and with more concrete interventions for the child’s best interests. The work within collaboration can be divided into resourse-, information- and knowledge exchange which creates the opportunity to get at better overall picture of the child. Further, to work for the child’s best interests the mobile team focuses on school, spare time and family, as different areas that are important for the child. Their approach is also characterized by understanding and supporting individual needs. Finally, there are factors that need to be considered to fulfil a successful collaboration. For example, the professionals must be aware of each other’s duties, roles, activities and regulatory systems.