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Bakgrund: Endometrios är en vanlig gynekologisk sjukdom som drabbar var tionde fertil kvinna i Sverige och än idag finns oklarheter kring sjukdomens uppkomst. Sjukdomen innebär att livmoderslemhinnan är lokaliserad på andra ställen än i livmodern vilket yttrar sig i olika symtom där smärta är vanligast. Endometrios är associerad med försämrad livskvalitet som kan påverka kvinnan både fysiskt och emotionellt. Syfte: Syftet var att undersöka kvinnors upplevelser av att leva med endometrios. Metod: En beskrivande litteraturstudie där 12 kvalitativa originalartiklar från databaserna PubMed och CINAHL inkluderades. Resultat: Kvinnorna rapporterade att de påverkades fysiskt av endometrios där smärta, i olika former som exempelvis bäckensmärta, dyspareuni och dysmenorré, var det vanligaste upplevda symtomet. Smärtans varaktighet var individuell och kunde vara allt från några dagar till konstant smärta. Kvinnornas emotionella välmående påverkades negativt där de upplevde känslor av hjälplöshet, ilska, ångest och brist på kontroll av deras liv, samt negativ påverkan på självförtroendet och självkänslan. Kvinnornas sociala relationer, arbete, utbildning samt sociala aktiviteter påverkades främst negativt av sjukdomen, då kvinnorna inte kunde delta och prestera på grund av symtom av sjukdomen. Endometrios visade även ha en existentiell påverkan där vissa kvinnor påverkades positivt där de fann en mening med livet, medan andra påverkades negativt och upplevde självmordstankar. Slutsats: Endometrios påverkar olika aspekter av kvinnors liv där sjukdomen främst påverkar kvinnors fysiska, emotionella, sociala och existentiella hälsa negativt och en försämrad livskvalitet hos kvinnorna. Ett behov av vidare kvalitativ forskning behövs för att synliggöra endometrios, öka kunskapen om sjukdomen samt utveckla diagnostik och behandlingsmetoder för att hjälpa kvinnorna att uppnå en förbättrad livskvalitet. / Background: Endometriosis is a common gynecological disease which affects every tenth fertile woman in Sweden and still today there are uncertainties about the origin of the disease. Endometriosis means that endometrium is located on other places than in the womb which manifests itself in various symptoms where pain is the most common. The disease is associated with impaired quality of life which can affect the woman both physically and emotionally. Aim: The aim was to examine women’s experiences of living with endometriosis. Method: A descriptive literature study including twelve qualitative original articles from the databases PubMed and CINAHL.   Results: The women reported that they got affected by endometriosis physically where pain, in different shapes such as pelvic pain, dyspareunia and dysmenorrhea, were the most experienced symptom. The duration of the pain was individually but could last from a few days to constantly pain. The women’s emotionally wellbeing was affected negative where feelings of hopelessness, anger, anxiety and lack of control of their life’s, and also a negative affect on their self-confidence and self-esteem. The women’s social relationships, work, education and social activities where mainly affected negative by the disease, because the women could not participate and perform because of the disease. Endometriosis also showed to have an existential affect where some women were positively affected because they found a meaning of life, where others were negatively affected and experienced suicidal thoughts. Conclusion: Endometriosis affects different aspects of women’s life where the disease mainly affects women’s physical, emotional, social and existential health negatively and an impaired quality of life. A need for further qualitative research is needed to make endometriosis more visible, increase the knowledge about the disease and develop diagnostics and treatment methods to help the women achieve an improved quality of life.

Background: Breast cancer is today the most common cancer among women in the world. For many women, a breast cancer diagnosis means a constant fear, stress, physical changes and low self-esteem that negatively affect their lives. The responsibility of the health service includes informing and supporting these people throughout the course of the disease. This literature study contributes to more knowledge about women's experiences of living with breast cancer. Aim: The aim was to describe women's experiences of living with breast cancer. Method: This literature study was conducted with qualitative articles. A total of 9 scientific articles were included. Results: The results were compiled into two categories. The first category is "women's experience of the body" which has under the category "body perception" and "emotional". Second category "women's need for support during and after treatment" which has under the category "insufficient support of care staff" and "increased need for support to protect mental illness and suffering in women". Conclusion: In order to prevent women with breast cancer from feeling unwell, increased knowledge and emotional support is required from both health care professionals and relatives. / Bakgrund: Bröstcancer är idag den vanligaste cancersjukdomen bland kvinnor i världen. En bröstcancerdiagnos innebär för många kvinnor en konstant rädsla, stress, fysiska förändringar och dåligt självförtroende som påverkar deras liv negativt. Hälso- och sjukvårdens ansvar ingår att informera och stötta dessa personer under hela sjukdomsförloppet. Denna litteraturstudie bidrar till mer kunskap om kvinnors erfarenheter av att leva med bröstcancer. Syfte: Syftet var att beskriva kvinnorserfarenheter att leva med bröstcancer. Metod: Denna litteraturstudie genomfördes med kvalitativa artiklar. Totalt inkluderades 9 vetenskapliga artiklar. Resultat: Resultatet sammanställdes i två kategorier. Första kategorin är ”kvinnors upplevelse av kroppen” som har under kategorin ”kroppsuppfattning” och ”emotionellt”. Andra kategorin ”kvinnors behov av stöd under och efter behandling” som har under kategori ”otillräckligt stöd av vårdpersonal” och ”ökat behov av stöd för att förhindra psykisk ohälsa och lidande hos kvinnor”. Slutsats: För att kunna motverka att kvinnor med bröstcancer inte ska må dåligt krävs ökad kunskap och emotionellt stöd av både hälso- och sjukvårdspersonal och anhöriga.

Ghana, a low-income developing country in sub-Saharan Africa is experiencing low maternal health service utilization and high rates of maternal mortality, especially in the rural areas. The Talensi-Nabdam District is one of the poorest and most remote districts in Ghana. The reproductive health status of women in the most remote communities in this District is poor. Dialogue about women’s reproductive health care needs in Ghana have been influenced by health care authorities, professionals, researchers and experts’ perceptions. The purpose of this ethnographic research was to explore rural Ghanaian women’s experiences of seeking reproductive health care from their own perspectives. The study was based on data collected from participant observations, unstructured face-to-face interviews and focus group discussions. A total of 27 women of varying socio-demographic backgrounds participated in the study. Interviews were conducted at locations of the women’s choice and in women’s local dialect. Data were translated and transcribed verbatim, and analyzed thematically. Four major themes emerged from the findings: submitting to the voices of family, women’s experiences of receiving nursing care, the community of gossip, and gaining voice. The findings of this study have implications for nursing practice, education and nursing inquiry. Awareness of barriers that rural women encounter in meeting their reproductive health care needs among health care providers is important in facilitating positive health care seeking behaviours. Nurse educators should orient themselves to the challenges to meeting women’s health care needs, and include in culturally sensitive approaches in nursing education programs. Further research is needed to investigate strategies that will enhance women’s reproductive health care seeking behaviours in rural settings and to focus on women’s perspectives in particular. In addition, research is needed to examine nurses’ perspectives on factors that influence quality care delivery to address women’s reproductive health issues.

Ghana, a low-income developing country in sub-Saharan Africa is experiencing low maternal health service utilization and high rates of maternal mortality, especially in the rural areas. The Talensi-Nabdam District is one of the poorest and most remote districts in Ghana. The reproductive health status of women in the most remote communities in this District is poor. Dialogue about women’s reproductive health care needs in Ghana have been influenced by health care authorities, professionals, researchers and experts’ perceptions. The purpose of this ethnographic research was to explore rural Ghanaian women’s experiences of seeking reproductive health care from their own perspectives. The study was based on data collected from participant observations, unstructured face-to-face interviews and focus group discussions. A total of 27 women of varying socio-demographic backgrounds participated in the study. Interviews were conducted at locations of the women’s choice and in women’s local dialect. Data were translated and transcribed verbatim, and analyzed thematically. Four major themes emerged from the findings: submitting to the voices of family, women’s experiences of receiving nursing care, the community of gossip, and gaining voice. The findings of this study have implications for nursing practice, education and nursing inquiry. Awareness of barriers that rural women encounter in meeting their reproductive health care needs among health care providers is important in facilitating positive health care seeking behaviours. Nurse educators should orient themselves to the challenges to meeting women’s health care needs, and include in culturally sensitive approaches in nursing education programs. Further research is needed to investigate strategies that will enhance women’s reproductive health care seeking behaviours in rural settings and to focus on women’s perspectives in particular. In addition, research is needed to examine nurses’ perspectives on factors that influence quality care delivery to address women’s reproductive health issues.

Ghana, a low-income developing country in sub-Saharan Africa is experiencing low maternal health service utilization and high rates of maternal mortality, especially in the rural areas. The Talensi-Nabdam District is one of the poorest and most remote districts in Ghana. The reproductive health status of women in the most remote communities in this District is poor. Dialogue about women’s reproductive health care needs in Ghana have been influenced by health care authorities, professionals, researchers and experts’ perceptions. The purpose of this ethnographic research was to explore rural Ghanaian women’s experiences of seeking reproductive health care from their own perspectives. The study was based on data collected from participant observations, unstructured face-to-face interviews and focus group discussions. A total of 27 women of varying socio-demographic backgrounds participated in the study. Interviews were conducted at locations of the women’s choice and in women’s local dialect. Data were translated and transcribed verbatim, and analyzed thematically. Four major themes emerged from the findings: submitting to the voices of family, women’s experiences of receiving nursing care, the community of gossip, and gaining voice. The findings of this study have implications for nursing practice, education and nursing inquiry. Awareness of barriers that rural women encounter in meeting their reproductive health care needs among health care providers is important in facilitating positive health care seeking behaviours. Nurse educators should orient themselves to the challenges to meeting women’s health care needs, and include in culturally sensitive approaches in nursing education programs. Further research is needed to investigate strategies that will enhance women’s reproductive health care seeking behaviours in rural settings and to focus on women’s perspectives in particular. In addition, research is needed to examine nurses’ perspectives on factors that influence quality care delivery to address women’s reproductive health issues. / Health and Social Development, Faculty of (Okanagan) / Nursing, School of (Okanagan) / Graduate

The diploma thesis conceptualizes an experience of women with assisted reproduction and services offered in fertility clinics. The assisted reproduction is a medical method treating infertility. The scientific progress and the usage of new reproductive technologies bring up broad possibilities in reproduction. Regarding the biological explanation of human's life, the biomedicine discourse represents a dominant approach in reproduction and claims control over a conception of a new life. Women undergoing the assisted reproduction, which is offered in case of infertility, face new challenges related to social, economic, ethical, and legal issues. The major goal of this thesis is the analysis of an experience of women with assisted reproduction in state-funded and private fertility clinics while applying a feminist critical reading. Qualitative research is based on semi-structured interviews with women who have turned to medical experts for help and underwent the assisted reproduction or other reproductive methods to increase a chance of conception. Key words: assisted reproduction, reproduction, women's experience, reproductive medicine, fertility, gender, poststructuralism

Bakgrund Ungefär 200 miljoner kvinnor i 30 olika länder har blivit utsatta för könsstympning världen över. Prevalensen för ingreppet är vanligt förekommande i länder inom Afrika och Asien. På grund av den rådande globaliseringen kommer tillståndet vara något som hälso- och sjukvården i höginkomstländer kommer komma i kontakt med i allt större utsträckning. Könsstympningen delas in i fyra olika kategorier och kan ge både fysiska, psykiska och sociala efterföljder. Det är genom hälso- och sjukvården som nya fall av kvinnor som genomgått ingreppet upptäcks och det är därför viktigt att vårdpersonal har kunskap om ingreppet och dess konsekvenser. Syfte Syftet var att belysa kvinnors upplevelser av könsstympning. Metod Föreliggande studie är en icke-systematisk litteraturöversikt. De sammanslagna sökningarna resulterade i 618 träffar som gav artiklar av kvalitativ och kvantitativ studiedesign. Artiklarna söktes i databaserna PubMed och CINAHL med relevanta sökord och avgränsningar utifrån exklusions- och inklusionskriterier. Sökorden som användes var “circumcision, female”, “circumcision, female/psychology”, “female genital mutilation”, “perception”, “culture”, “universal healthcare”, “psychological trauma”, “experiences” och “beliefs”. Artiklarna analyserades i sin tur genom en integrerad analys. Resultat Resultatet visade på att kvinnorna upplever fysiska, psykologiska och sociala konsekvenser av ingreppet. De fysiska konsekvenserna var enbart negativa. De psykologiska konsekvenserna var till största delen negativa, med positiva inslag. De sociala konsekvenserna kunde vara positiva förutsatt att kvinnan var bosatt i ett land där ingreppet praktiseras. Vidare framkom att vårdpersonal uppfattas som antingen okunniga, okänsliga, eller osäkra vid vårdmötet. Slutsats De fysiska, psykologiska och sociala konsekvenser som kvinnlig könsstympning leder till är mångfaldiga och komplexa. Då kvinnans upplevelser av könsstympningen i hög grad visades variera ställs det höga krav på vårdens förmåga att anpassa bemötandet därefter. God kompetens hos sjukvårdspersonal inom behandling, kommunikation och kulturella skillnader samt kunskap om ingreppets konsekvenser är av stor vikt för att kunna bidra till ökad hälsa hos dessa kvinnor. / Background  Approximately 200 million women in 30 different countries has been subjected to female genital mutilation worldwide. The prevalence of the procedure is common in countries in Africa and Asia. Due to the current globalization, it will also be something that healthcare professionals in high-income countries will encounter to an increasing extent. The procedure is categorized into four different types which all may cause physical, psychological and social consequences. It is through health care that new cases of women who have undergone the procedure are discovered, which is why it is of high importance that healthcare staff have knowledge of the procedure and its consequences. Aim  The aim was to illustrate women´s experiences of genital mutilation. Method  The present study is a non-systematic literature review. The combined searches resulted in 618 hits that presented articles of qualitative and quantitative study design. The articles were searched in the databases PubMed and CINAHL with relevant keywords and delimitations based on exclusion and inclusion criteria. The keywords used were “circumcision, female”, “circumcision, female/psychology”, “female genital mutilation”, “perception”, “culture”, “universal healthcare”, “psychological trauma”, “experiences” and “beliefs”. The articles were analyzed through an integrated analysis. Result  The results showed that women experienced physical, psychological and social consequences of the genital mutilation. The physical consequences were only negative. The psychological consequences were mostly negative, with positive elements. The social consequences could be positive given that the women were living in a country whereas the procedure is commonly practiced. Furthermore, it emerged that care staff are perceived as either ignorant, insensitive, or insecure at the care meeting. Conclusion  The physical, psychological and social consequences which the procedure leads to are nuanced and complex. With the knowledge that women's experiences can vary greatly there is a demand on the healthcare´s ability to adapt its treatments accordingly. The treatment, communication and cultural competence of the care staff, as well as knowledge about all the consequences of the procedure, are therefore of great importance in order to be able to contribute to increased health in these women.

Introduktion: Våld mot kvinnor är ett utbrett folkhälsoproblem och utgör ett allvarligt hot mot kvinnors fysiska såväl psykiska hälsa. Hälso- och sjukvårdspersonal har ett ansvar att identifiera våldet samt ha kompetens att hjälpa kvinnorna.  Syfte: Syftet var att undersöka hur kvinnor som utsatts för våld i nära relation upplever bemötandet av hälso- och sjukvårdspersonal. Metod: Deskriptiv design med litteraturöversikt som metod. Studierna som användes i denna litteraturöversikt var kvalitativa. Resultat: Temat upplevelser av vårdtillfället presenterades med tre kategorier. Tidsaspekten framförde att tiden påverkade kvinnornas upplevelser av mötet. Frågan om våldet redogjorde att kvinnorna kände sig värdefulla när personalen frågade om våldet men att frågan sällan ställdes. I personalens åtgärder framförde flera kvinnor att personalens åtgärder fokuserade på annat än våldet. Temat intryck och påverkan av bemötandet presenterades med tre kategorier. I det goda mötet framförde kvinnorna att de kände sig trygga, trodda på och bekräftade av personalen. De upplevde även att personal bemötte dem med empati. Det bristfälliga mötet redogjorde att flera kvinnor upplevde att de inte togs på allvar, blev förminskade och ifrågasatta. De upplevde även att personalen saknade empati i bemötandet. I kategorin skuldbeläggande framfördes det att flera kvinnor kände sig skuldbelagda av personalen när de berättade om sin våldsutsatthet. Slutsats: Kvinnorna upplevde både goda och bristfälliga bemötanden av hälso- och sjukvårdspersonal. Kvinnorna uttryckte i många fall att de inte fick den hjälp de var i behov av. Ökad kunskap hos hälso- och sjukvårdspersonal gällande våld i nära relation samt kommunikation skulle kunna utveckla det bristfälliga bemötandet. / Introduction: Violence against women is a widespread public health problem and constitutes a serious threat towards women's physical as well as mental health. Healthcare personnel have a responsibility to identify the violence and to have knowledge in how to help the women.  Purpose: The aim of this study was to explore how women exposed to intimate partner violence experience encounters with healthcare personnel.  Method: Descriptive design with literature review as method. In this literature review the included studies were qualitative. Results: The theme experiences of the care occasion was presented with three categories. The time aspect stated that time affected the women's experiences of the meeting. The question about the violence expressed that the women felt valuable when the healthcare personnel asked about the violence but that the question rarely was asked. Provided care reported that several women experienced that the healthcare personnel focused on providing care against other issues than the violence. The second theme, the impact and effect of the encounters, was presented with three categories. The good encounter stated the women felt safe, believed and confirmed by the healthcare personnel. They also felt that they were encountered with empathy. The inadequate encounter expressed that several women felt that they were not taken seriously, felt diminished and questioned. They also felt that the staff lacked empathy in their encounter. Blaming stated that several women felt blamed by the healthcare personnel when they told them about their exposure to violence. Conclusion: The women experienced both good and inadequate encounters by healthcare personnel. In many cases the women expressed that they did not receive the help they needed. Increased knowledge among healthcare providers regarding intimate partner violence and communication would improve the inadequate encounters.

Bakgrund Endometrios är en kronisk och inflammatorisk sjukdom som drabbar ungefär var tionde kvinna i fertil ålder. Vanliga symptom är smärta, rikliga blödningar samt infertilitet och genomsnittstiden för att få en diagnos är sju till åtta år. Ojämställdhet mellan kvinnor och män har lett till att vårdens kunskap om sjukdomar som främst drabbar kvinnor är lägre än kunskapen om de sjukdomar som män i större utsträckning drabbas av och att kvinnor får färre vårdinsatser än män. Denna ojämlikhet och kunskapsbrist är en orsak till att diagnostisering av endometrios är fördröjd. Syfte ​Syftet var att beskriva kvinnors upplevelser av att leva med endometrios​. Metod ​​​En litteraturöversikt med elva inkluderande artiklar från fyra kontinenter, publicerade under åren 2010–2023. Resultatet granskades, sammanställdes systematiskt och en kvalitetsgranskning efter Fribergs mall gjordes. Resultat I resultatet identifierades tre huvudkategorier: Upplevelsen av symptom, Upplevelsen av ovisshet, kunskap och okunskap samt Upplevelsen av fertiliteten med relaterade underkategorier: Smärta, blödningar, relationer och arbete samt (O)kunskap hos vårdpersonal, (O)kunskap hos omgivningen, Ovisshet och (O)kunskap hos kvinnan.​ Sammanfattning ​Symptomen kvinnorna upplever normaliseras ofta av samhället när kvinnor med endometrios i själva verket upplever att sjukdomen har negativ inverkan på deras livskvalitet. Mer kunskap behövs för att kunna hjälpa dessa kvinnor och framtida generationer. Sjuksköterskans roll är en viktig del av utvecklingen av omvårdnaden för dessa kvinnor.​ / Background Endometriosis is a chronic and inflammatory disease that affects approximately one in ten women of childbearing age. Common symptoms are pain, heavy bleeding and infertility, and the average time to get a diagnosis is seven to eight years. Inequality between women and men has led to health care's knowledge of diseases that mainly affect women being lower than knowledge of the diseases that men are affected by to a greater extent, and that women receive fewer care interventions than men. This inequality and lack of knowledge  is one reason why the diagnosis of endometriosis is delayed.​ Aim The aim was to describe women’s experiences of living with endometriosis.​ Method A literature review including eleven articles, from four continents, published between the years: 2010–2023. The results were systematically reviewed and compiled. A Quality Review was made according to Friberg's template. Results The results identified three main categories: The experience of symptoms, the experience of the uncertainty, knowledge and ignorance and also the experience of fertility. The subcategories were: pain, bleeding, relationships, employment  and the ignorance by health personnel, ignorance by others and the uncertainty in the woman.​ Summary ​The symptoms women experience are often normalized by society, meanwhile women with endometriosis experience that the disease has a negative impact on their quality of life. More knowledge is needed to be able to help these women and future generations. The nurse's role is an important part of the development of care for these women.​