Background: The definition of urinary incontinence is involuntary loss of urine that is objectively detectable and results in a social and hygienic inconvenience for the individual. There are different types and causes of urinary incontinence and the symptoms often occur more frequently with higher age. Women are affected to a greater extent than men. Urinary incontinence may affect everyday life and lead to changes in quality of life. Aim: To illuminate women's experiences of living with urinary incontinence. Method: A literature study was conducted using qualitative analysis through five steps. An analysis of ten qualitative articles was carried out. Results: Four main themes emerged, a suffering in everyday life, perceived body perception, feelings about sexuality and hope and despair. The results showed that living with urinary incontinence affected everyday life activities. The women felt limited and learned to cope through different strategies. Urinary incontinence affected the women's body image and could result in less confidence and the feeling of powerlessness. The complex situation sometimes leads to negative sexual effects. Women lived with the hope to recover but at the same time there were feelings of despair for what the future would hold for them. Conclusion: Women suffering from urinary incontinence experience restrictions in their everyday life, in physical, mental and social aspects. It creates a feeling of loss of control. And many women suffer in silence without seeking help. Urinary incontinence has a negative effect on their quality of life.

Bakgrund: Alla människor i alla åldrar har rätt till att uppnå god hälsa och välbefinnande. Sexualitet beskrivs som en central aspekt för kvinnor i klimakteriet då god sexuell hälsa kan öka kvinnors livskvalité. Dock är det vanligt med menopausala symtom och sexuell dysfunktion bland kvinnor under och efter klimakteriet vilket har en negativ inverkan på kvinnornas sexualitet och sexuella välbefinnande. För att säkerställa hälsosamma liv och främja välbefinnande för dessa kvinnor behövs tillgång till en god sexuell hälsovård. Syfte: Syftet med denna metasyntes var att undersöka hur kvinnor upplever sin sexualitet under och efter klimakteriet. Metod: Kvalitativ metasyntes med en meta-etnografisk analysmetod. Databaser som inkluderats var CINAHL, PsycInfo, PubMed och Web of science. Efter kvalitetsgranskning återstod 13 artiklar som representerar metasyntesens resultat. Resultat: Fyra huvudteman har identifierats, Lust, Kroppsbildens förändring och betydelse, Yttre faktorer och ”Job as a wife”. I resultatet har även sju underteman identifierats, Symtom, Lustens transition, Acceptans, Strategier och kommunikation, Intimitet, Information och Adaptation. Slutsats: Metasyntesens resultat visade att klimakteriet medförde förändringar som ofta hade inverkan på kvinnors upplevelse av deras kroppsbild och sexuella lust. Till följd av minskad lust undvek kvinnor sexuella aktiviteter vilket hade en negativ inverkan på deras välbefinnande och relationer. Yttre faktorer påverkade även kvinnornas sexualitet. Partnerns roll och handlingar påverkade kvinnornas upplevelse av sin sexualitet vilket medförde att kvinnan adapterade sina sexuella behov efter partnerns behov och funktion. Klinisk tillämpbarhet: Resultaten av metasyntesen kan framför allt användas av barnmorskor men även av annan vårdpersonal för att öka kunskapen om hur kvinnor upplever sin sexualitet under och efter klimakteriet för att bättre kunna bemöta och tillhandahålla med information till dessa kvinnor. Förslagsvis kan barnmorskan göra det möjligt för kvinnor att mötas för diskussion och lyfta fram frågor, erfarenheter och upplevelser rörande sexualitet och sexuell hälsa. / Backgound: All people of all ages have the right to achieve good health and well-being. Sexuality is described as a central aspect for women during menopause as good sexual health can increase women's quality of life. However, menopausal symptoms and sexual dysfunction are common among women during and after menopause, which have negative impact on women's sexuality and sexual well-being. To ensure healthy lives and promote well-being for these women, access to good sexual health care is needed. Aim: The purpose of this metasynthesis was to investigate how women experience their sexuality during and after menopause. Method: Qualitative metasynthesis with a meta-ethnographic analysis method. Databases included were CINAHL, PsycInfo, PubMed och Web of science. After quality review, 13 articles remained to represent the results of the metasynthesis. Result: Four main themes have been identified, Lust, Change in body image and its significance, External factors and "Job as a wife". The result also identified seven sub-themes, Symptoms, Transition of Lust, Acceptance, Strategies and Communication, Intimacy, Information and Adaptation. Conclusion: The results of the meta-synthesis showed that menopause brought changes that had an impact on women's experience of their body image and sexual desire. As a result of decreased desire, women avoided sexual activities, which had a negative impact on their well-being and relationships. External factors also affected women's sexuality. The partner's role and actions influenced the women's experience of their sexuality, which meant that the woman often adapted her sexual needs to the partner's needs and function. Clinical implications: The results of the metasynthesis can primarily be used by midwives but also by other healthcare professionals to increase knowledge about how women experience their sexuality during and after menopause in order to better respond and provide information to these women. As a suggestion, the midwife can make it possible for women to meet for discussion and highlight questions and experiences concerning sexuality and sexual health.

Introduktion: Cirka 33 700 kvinnor genomgår abort i Sverige varje år. Det finns två huvudsakliga metoder för abort: medicinsk abort och kirurgisk abort. Kvinnor som genomgår en abort kan uppleva både fysiska och psykiska besvär, där de kan behöva stöd från sjukvårdspersonal.  Syfte: Syftet med litteraturstudien var att beskriva kvinnors upplevelse av att genomgå en abort.  Metod: En beskrivande litteraturstudie baserad på 13 vetenskapliga artiklar med kvalitativ ansats.  Resultat: Resultatet visade att kvinnors upplevelser varierade. En del kvinnor var nöjda med vården och upplevde att de fick tillräckligt med information samt blev bemötta med respekt. En del kvinnor upplevde stigmatisering och diskriminering från vårdpersonalen. Det väckte negativa känslor hos kvinnor såsom sorg och skam. Beslutet att göra abort varierade. Kvinnor upplevde känsla av stolthet och var bekväma med sina beslut, eller upplevde sorg och hade ingen att vända sig till samt blev chockade över att ha avslutat graviditeten.  Slutsats: Kvinnor upplevde blandade känslor i samband med abort, såsom skuld, stolthet, oro och ensamhet. Därför är det viktigt att sjukvårdspersonal har djupare förståelse för abortprocessen för att kunna minska lidande hos kvinnor och därmed negativa vårdupplevelser. / Introduction: Approximately 33,700 women undergo abortions in Sweden every year. There are two main methods of abortion: medical and surgical. Women who undergo an abortion may experience both physical and mental discomfort, where they may need support from healthcare professionals.  Aim: The purpose of the literature study was to describe women's experience of undergoing an abortion. Method: A descriptive literature review based on 13 scientific articles with a qualitative approach. Results: The results showed that women's experiences varied. Some women were satisfied with the care and felt that they received enough information and were treated with respect. Some women experienced stigma and discrimination from the healthcare staff. It evoked negative feelings in women such as sadness and shame. The decision to have an abortion varied. Women experienced feelings of pride and were comfortable with their decisions, or experienced grief and had no one to turn to and were shocked to have terminated the pregnancy. Conclusion: Women experienced mixed feelings associated with abortion, such as guilt, pride, anxiety and loneliness. Therefore, it is important for healthcare professionals to have a deeper understanding of the abortion process to be able to reduce the suffering of women and thus negative care experiences.

Bakgrund: Våld i nära relationer mot kvinnor är ett tilltagande globalt folkhälsoproblem där var tredje kvinna världen över någon gång har upplevt våld i en nära relation. Våldet kan visa sig som psykiskt, fysiskt och sexuellt våld som medför allvarliga konsekvenser för de utsatta kvinnorna. Hälso- och sjukvårdspersonalen har en viktig roll i bemötandet med våldsutsatta kvinnor och bär en nyckelroll i att skapa en förtroendefull relation med patienten.  Syfte: Syftet var att belysa hur kvinnor som utsatts för våld i nära relation upplever bemötande från hälso- och sjukvårdpersonalen.   Metod: Denna litteraturöversikt grundades av tio kvalitativa originalartiklar. Artiklarna inhämtades via databaserna Cinahl Complete och PubMed. Data analyserades enligt Fribergs analyssteg.   Resultat: I denna litteraturöversikt identifierades fem huvudteman: Bli tagen på allvar, Vikten av tillit, Empati, Säkerhet och Betydelsen av stöd. När hälso- och sjukvårdspersonalens bemötande upplevdes som negativt upplevde de våldsutsatta kvinnorna känslor av ensamhet, skam, att de inte blev tagna på allvar och skuldbelagde sig själva. Sammanfattning: Resultatet visar att våldsutsatta kvinnorna i nära relationer hade övervägande negativa erfarenheter av bemötandet från hälso-och sjukvårdspersonalen. De upplevde att hälso- och sjukvårdspersonalen saknade empati och kunskap i att både ställa frågan om våld i nära relationer och att besitta kunskap i vilka stöd och resurser som fanns att hänvisa till. / Background: Intimate partner violence is a global increasing public health problem where one in three women in the world has experienced violence from their partner during their lifetime. The violence includes different types among others psychological, physical and sexual violence and has severe consequences for the woman. Healthcare professionals has an important role in the treatment of women subjected to intimate partner violence and plays a key role in stablishing a trusting relationship with the patient. Aim: The purpose of this literature review is to shed light on the experience of women who are subjected to intimate partner violence encountering healthcare professionals. Method: A literature review based on results extracted from ten qualitative articles and the articels were collected from the databases Cinahl complete and PubMed. Data was analyzed based on Fribergs four analysing steps.   Results: Four themes were identified in this literature review: The importance of trust, Be taken seriously, Empathy, Safety, and The importance of support. Women who have been exposed to intimate partner violence experienced feelings of loneliness, shame, not being taken seriously and blamed themselves when the treatment of the health care professionals was perecived as negative. Summary: Women who are subjected to intimate partner violence had predominantly negative experiences encountering healthcare professionals. They felt that the healthcare professionals lacked empathy and knowledge in both asking the question about being exposed to violence, providing support and referral to available resources where these women could get help.

Globally, in low and middle-income countries 4 out of every 10 pregnancies is reported to be unintended. Having an unintended pregnancy increases the risk of maternal and infant morbidity and mortality, preterm birth, low birth weight, and decreases rates of breast-feeding. The United States (U.S.) consistently has some of the highest rates of preterm birth, infant and maternal mortality of all high-income countries and 45% of all pregnancies in the U.S. are reported to be unintended. The etiology of these outcomes and their relationship to pregnancy intention are complex and multifactorial, but we know this disproportionately effects women living in poverty both in the U.S. and globally. When couples have the knowledge, access, and power to decide when and whether to become pregnant they are more likely to seek preconception care, thus increasing the likelihood of planned pregnancies leading to improved maternal and child health outcomes. Primary prevention strategies to improve maternal/child health outcomes in the U.S. include sexual and reproductive health considerations such as increasing access to birth control. Globally, strategies include expanding access, as well as focusing on the empowerment of women and improving gender social norms. Focusing on community level norms and individual empowerment can lead to greater reproductive autonomy, which in turn leads to an increase in the uptake of birth control and family planning. This broader consideration of multiple levels of power or autonomy is often lacking in approaches taken in the U.S. More information is needed about the social context and determinants of pregnancy intention in our communities, particularly of women living in poverty. The purposes of this dissertation were to 1) to describe reproductive autonomy and family planning challenges in a population of marginalized Ecuadorian women; 2) develop a conceptual framework of reproductive autonomy from the global literature; 3) to validate a shortened form of an interpersonal violence scale used in a study of low-income pregnant women in Kentucky; and finally 4) to investigate the association between pregnancy intention and individual, interpersonal and community factors of impoverished women living in Kentucky. The qualitative study of women in Ecuador identified barriers and facilitators to family planning in a low-resource community. The major themes that emerged were that women’s autonomy was limited by men, shame was ‘keeping women quiet’, systems failed women, and as women aged they were able to build resilience in spite of these challenges. Many reported reproductive coercion, gender-based violence, and regret. Those who could leave unsupportive partners and found social support were more effective at planning their pregnancies. Evidence supports these themes are relatively common in the global literature, particularly of women living in poverty. The comprehensive review of these findings was used to develop a conceptual framework of reproductive autonomy. The Socio-Ecological Model was used to organize the data based on individual, interpersonal or community level determinants of pregnancy intention and reproductive autonomy. This new conceptual model, called the Power and Reproductive Autonomy (PARA) model, was used as a guide to analyze multiple levels of data in a secondary analysis of pregnant women living in poverty in Kentucky. Prior to this secondary analysis study, a measure used in the parent study needed to be validated. A short form of the Women’s Experience with Battering (WEB) scale was found to be psychometrically valid to measure of the impact of intimate partner violence for this population. Findings from the secondary analysis included high rates of unintended pregnancy (66%), and women with unintended pregnancy were more likely to report exposure to interpersonal violence, poor social support, and anxiety at the bivariate level. At the community (county) level those with an unintended pregnancy were more likely to live in counties with fewer social associations, and in rural communities. None of the access, gender equity, income inequality, or violence variables were correlated to pregnancy intention. In the final multilevel model, controlling for demographic variables, only being unmarried and answering the question in English were significant predictors of unintended pregnancy. The rate of social associations in a county was marginally significant with pregnancy intention, in that the presence of social associations appeared to decrease the likelihood of unintended pregnancy. Operationalizing the PARA framework to examine predictors of unintended pregnancy in Kentucky proved to not yield expected results; county level variables related to access, gender equity, and violence were not found to be significantly correlated. Women answering the question in Spanish had significantly higher rates of planned pregnancy, which is a new finding. Having opportunities for social engagement also seemed to be a protective factor in preventing unintended pregnancies. Limitations of cross-sectional data also make it a challenge to capture cumulative life stressors which could contribute to poor reproductive autonomy. Future studies may yield a greater understanding of the social context of pregnancy intention if more interpersonal data related specifically to reproductive autonomy are in the model, such as reproductive coercion, relationship power, communication, and contraceptive decision making. Additionally, further examination of structures or systems that provide economic opportunities in the community is a promising area of reproductive autonomy and pregnancy intention research.

Syfte: Litteraturstudien syftar till att studera äldre kvinnor som utsatts för våld i nära relationer med utgångspunkt från kvinnornas perspektiv. Studien syftar till att lyfta fram hur äldre kvinnor påverkas, vad de uttrycker för behov av stöd, hur de beskriver problematiken med att lämna ett våldsamt förhållande samt förövarens påverkan på kvinnan.   Metod: I studien granskas 13 artiklar. Studien är en kvalitativ litteraturstudie med tematisk analys. Resultat: Studien resulterar i 3 huvudteman med 2 underteman vardera. Huvudtemana behandlar: (1) behov av stöd, (2) förövarens påverkan, och (3) känslor av skam och skuld.  Slutsats: Kvinnorna uttrycker ett behov av anpassade formella insatser samt berättar att de finner stor hjälp i stödgrupper. Kvinnornas förövare kontrollerar genom isolation och skrämsel. Kvinnorna upplever skuld och skam över deras situation samt tar på sig ansvar för våldet vilket påverkar deras psykiska mående. / Aim: This literature study aims to study older women who are exposed to IPV told from the women’s perspective. The study wants to highlight how older women are affected, what kind of support they want, difficulties in leaving and the perpetrator’s impact. Method: The design is a qualitative literature study using thematic analysis on 13 articles.  Results: The study resulted in 3 main themes with 2 sub-themes each. The main themes highlights: (1) the need for support, (2) the perpetrator’s impact, and (3) the shame and guilt. Conclusion: The women express a need for adapted formal support and express that they find great help in support groups. The women's perpetrators control them through isolation and intimidation. The women experience guilt and shame over their situation and take on responsibility for the violence which affects their mental health.