Background: Studies show that nurses' experiences of alleviating suffering in patients in palliative stage of illness place high demands on the nurse's knowledge and skills to be able to handle complex medical and psychosocial challenges. Aim: The aim of the literature review was to describe nurses' experiences of alleviating suffering in patients in palliative care. Method: The literature review is based on the results of ten scientific articles with a qualitative approach. The databases PubMed and Cinahl have been used to identify articles relevant to the purpose. The articles were quality reviewed based on SBU's template and analysed using Popenoe's criteria for data analysis. Results: Two categories were identified: A challenging task and the importance of good professional preconditions. Six subcategories were identified as follows: Difficulties in communication, Fears and uncertainty about symptom relief, Institutional related obstacles, Importance of knowledge and experience, Importance of getting to know the patient, and Importance of good teamwork. Conclusion: The result of the study highlights that nurses play a crucial role in alleviating suffering in palliative care but that they face a variety of challenges. With the right conditions and resources, nurses can succeed in providing the best possible relief of suffering. It is essential that nurses working in palliative care continue to be provided with the support and knowledge necessary to ensure that they can meet these challenges effectively.  

A survey targeting ASPHER members was launched in 2010/11, being a first initiative in improving ethics education in European Schools of Public Health. An 8-items questionnaire collected information on teaching of ethics in public health. A 52% response rate (43/82) revealed that almost all of the schools (95% out of 40 respondents with valid data) included the teaching of ethics in at least one of its programmes. They also expressed the need of support, (e.g.: a model curriculum (n=25), case studies (n=24)), which indicates further work to be met by the ASPHER Working Group on Ethics and Values in Public Health.

Bakgrund: Sverige har under åren utvecklats till ett multikulturellt land vilket innebär att nyexaminerade sjuksköterskor kommer att möta patienter från olika kulturella bakgrunder. Detta examensarbete kan användas som stöd för grundutbildade sjuksköterskor då det belyser hur andra sjuksköterskor har hanterat svårigheterna och utmaningarna som kan uppstå vid omvårdnad av palliativa patienter från olika kulturella bakgrunder.

Syfte Syftet med arbetet är att beskriva grundutbildade sjuksköterskors upplevelser av transkulturell omvårdnad inom palliativ vård.

Metod: Metasyntes användes som analysmetod för arbetet. Det är skrivet utifrån en kvalitativ litteraturöversikt och är baserad på totalt 10 kvalitativa artiklar.

Resultat: Resultatet för detta arbete valdes att presenteras utifrån tre huvudteman samt åtta subteman. Tema ett (1): Det som krävs för möjligheten till en god kommunikation vid transkulturell omvårdnad med tre (3) subteman: Verbal kommunikation, Beröring som kommunikationssätt samt Hjälp av tolk. Tema två (2): Kulturella skillnader med tre (3) subteman: Oro över att kränka patienten, Vikten av kunskap om kulturella skillnader samt Etiska dilemman. Tema tre (3): Sammarbete med familjen för personcentrerad vård med två (2) subteman: Medvetenhet om patienten som individ ochFamilj över autonomi

Slutsats: De grundutbildade sjuksköterskorna upplevde den verbala och icke-verbala kommunikationen som en svårighet vid transkulturell vård av palliativa patienter. Användning av tolk upplevdes inte alltid som positivt, och att ha kunskap om olika kulturer för att kunna ge personcentrerad omvårdnad sågs som viktigt.

Background: Research shows that patients prefer to be cared for and die at home. Caring for patients at the end of life in community settings places high demands on the knowledge and skills of community nurses to deal with complex medical and psychosocial challenges. Aim: The purpose of the literature review was to describe the nurse's experience of providing home-based end-of-life palliative care. Method: The literature review was based on the results of ten scientific articles with qualitative approaches. The databases PubMed and Cinahl were used to identify articles that met the study's inclusion criteria. The SBU template was used to review the articles. Results: Two categories were identified: Challenges at work, and Importance of a well-functioning organization. Six subcategories were identified and they were as follows: Feeling powerless, Feeling inadequate, Emotional and existential stress, Difficulties in collaboration within the team, The importance of a well-functioning organization, The importance of good relations with patients and relatives and the importance of support and structure in the work.Conclusion: The study findings suggest that nurses face a variety of challenges in caring for patients at the end of life at home. These included workplace stress, high demands, lack of control over tasks, not being seen, heard and respected, which could lead to feelings of inadequacy and difficulties in team collaboration. In order to offer good care to patients at the end of life in ordinary housing, it is important that the nurse receives good support, both from the organization and colleagues.

Children living with a parent with a mental illness can face difficulties. Parentalmental illness may influence the parents’ ability to cope with family life, where theparents’ awareness of their illness plays an important role. Family interventionsprovided by psychiatric and children’s social care services can be a way to supportthese children, making them feel less burdened, and improving the relationshipswithin the family. The aim of this thesis was to illuminate how children infamilies with a parent with a mental illness are supported in psychiatric and socialservices, especially by means of family interventions, and how families experiencethe support. Study I explored how professionals in adult psychiatric outpatient servicesdeal with children and families when a parent has a mental illness. The findingsshowed that professionals balanced between establishing, and maintaining,a relationship with the patient and fulfilling the legal obligations towards thepatient’s children. Asking the patient about their children could be experiencedas intrusive, and involving the patient’s family in the treatment could be seen asa dilemma, in relation to the patient. Efforts were made to enhance the familyperspective, and when the patient’s family and children joined the treatment thisrequired flexibility from the professional. Study II examined how professionals in children’s social care services experienceworking with children and families when a parent has a mental illness. The socialworkers’ objective was to identify the needs of the children. No specific attentionwas paid to families with parental mental illness; they were supported in thesame way as other families. When the parental mental illness became difficult tohandle both for the parent and the social worker, the latter had to set the child’sneeds aside in order to support the parent. Interagency collaboration seemed likea successful way to support these families, but difficult to achieve. Study III investigated if patients in psychiatric services that are also parentsof underage children, are provided with child-focused interventions or involvedin interagency collaboration between psychiatric and social services and childand adolescent psychiatry. The findings showed that only 12.9% of the patientsregistered as parents in Psykiatri Skåne had registered children under the ageof 18 years. One fourth of these patients had been provided with child-focusedinterventions in psychiatric service, and 13% of them were involved in interagencycollaboration. If a patient received child-focused interventions from the psychiatricservices, the likelihood of being involved in interagency collaboration was fivetimes greater as compared to patients receiving no child-focused intervention.Study IV explored how parents and their underage children who were supportedwith family interventions experienced these interventions. The results showedthat parents experiencing mental illness were eager to find support in explainingto and talking with their children about their mental illness, although the supportfrom the psychiatric service varied. Both children and other family membersappreciated being invited to family interventions. After such an intervention, theyexperienced the atmosphere in the family as less strained and found it easier tocommunicate with each other about difficulties. Unfortunately, the participatingpartners felt that they were left without support specifically targeted at them. The thesis showed that there is a gap between how professionals deal withquestions concerning these families and their support, and the parents’ and thefamilies’ needs to receive support in handling the parental mental illness in thefamily. The psychiatric and social services need to expand their approach andwork with the whole family, in order to meet the needs of the child and otherfamily members involved.

Purpose: Research has established that physical and psychological injury prevention training is effective in reducing injuries in youth team sports, but public health impact tends to be limited because such training is not widely, properly, or sustainably implemented. Insufficient involvement of end-users at the individual and organizational levels has been identified as a main barrier to implementation. Against this backdrop, the ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ project was initiated through dialogue between end-users and researchers with the goal of making injury prevention training an integral part of regular practice in youth handball through a series of studies. We have conducted studies within I-PROTECT and identified numerous barriers and facilitators, and address these determinants when designing the intervention.  

BackgroundInterventions that are co-created with end-users, and that are informed by behavior change or implementation theories, support implementation in real world settings. However, injury prevention programs for youth athletes have typically been developed by experts with no, or insufficiently described, end-user involvement and without guidance by theories. The aim of the current study was to describe the development of a holistic injury prevention intervention for youth handball targeting end-users at different levels, through using knowledge from end-users and researchers/experts and applying relevant behavior change and implementation theories.MethodsKnowledge from researchers/experts (sports medicine, sport psychology, handball, physical therapy, strength and conditioning (n = 14)) and end-users (coaches, players, club administrators, n = 16), and applying relevant implementation (Consolidated Framework for Implementation Research, CFIR), behavior change (Health Action Process Approach, HAPA) and motivational (Self-Determination Theory, SDT) theories, were used to co-design the intervention. Early end-users (coaches (n = 6), players (n = 3) and a club administrator (n = 1)) were interviewed for initial feedback.ResultsThe intervention consisted of end-user-targeted information and training that was made available in a specifically developed interactive mobile application with modules for players, coaches, club administrators, and caregivers. Information for all end-users included benefits and principles of physical and psychological injury prevention training, load-management, motivation, and communication. Information about implementation was developed for club administrators specifically. For coaches, training to do with their teams included handball-specific injury prevention exercises (legs, shoulders, core) combined with psychological aspects (motivation, task focus, body awareness) to integrate within warm-up and handball skills training. Training for players included handball-specific multi-joint strength, power, and explosive exercises (legs, shoulders, core) and sport psychology exercises (self-awareness, relaxation, being in the present moment, prevent and handle stress). To support self-management, adoption, and motivation, programs were provided, and players and coaches could change, add, progress the difficulty of exercises, and build their own programs. Initial feedback from early end-users was generally positive.ConclusionsUtilizing an approach where researchers/experts and end-users co-created injury prevention training specifically for youth handball, an intervention was generated that included information and holistic training targeting end-users at the individual (players, caregivers), team (coaches), and organizational (club administrators) levels.

Introduction Efficacy trials show that evidence-based injury prevention training reduces injuries in youth athletes but effectiveness, that is, outside the controlled setting, is lower and, consequently this training has had limited public health impact. Insufficient involvement of end-users at the individual and organisational levels is identified as a main barrier to successful implementation. The ‘Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)’ uses an ecological participatory design incorporating the perspectives of multiple stakeholders throughout the project. Within the I-PROTECT research project, the specific aim of this study is to investigate the implementation of the end-user-targeted I-PROTECT programme. 

Methods and analysis This pragmatic two-armed cluster randomised controlled trial is conducted collaboratively with the Swedish Handball Federation that has overall responsibility for handball in Sweden. Randomly selected clubs in Sweden offering handball for both female and male youth players are invited to participate. 18 clubs are randomised (stratified by club size) to intervention (I-PROTECT plus tailored implementation support) or control (injury prevention programme currently available through the Swedish Handball Federation). The anticipated total number of potential participants (players, coaches, club administrators, parents/guardians) is ~3500. The I-PROTECT programme includes end-user-targeted information and physical and psychological injury prevention training available in a specifically developed interactive mobile application. Implementation strategies were selected from the Expert Recommendations for Implementing Change discrete implementation strategy compilation, based on feedback from end-users. Implementation outcomes will be investigated at the endof the handball season using the Reach, Effectiveness, Adoption, Implementation and Maintenance implementation evaluation framework. A study-specific questionnaire, app downloads and/or workshops will be used to collect data.

Ethics and dissemination The Swedish Ethical Review Authority approved the study. Results will be disseminated in peer-reviewed scientific journals, as popular science articles, at international conferences and communicated via the Swedish Handball Federation. 

The inclusion of family members in the acute care of older persons with complex needs results in better coordination of care and reduces the frequency and/or duration of rehospitalisation. Therefore, healthcare professionals need a tool to assess the collaboration with family members on acute hospital wards. The aims were to test the psychometric properties of the Swedish version of the Family Collaboration Scale (FCS), to investigate family members' perception of collaboration with healthcare professionals on acute medical wards in Sweden and to compare the data with the corresponding Danish results. Three hundred and sixty family members of frail patients aged 65 or older from 13 acute medical wards answered the FCS questionnaire. In addition to descriptive statistics, psychometric methods were applied. The internal consistency of the Swedish version of the FCS was excellent, and confirmatory factor analysis revealed that its factor structure was equivalent to that of the original Danish FCS. The respondents' ratings indicated better perceived collaboration than in the Danish case. Older age than 60 was associated with worse collaboration with healthcare professionals regarding Influence on discharge than younger respondents. Those with compulsory and health or nursing education showed better collaboration. The Swedish version of the FCS should be further evaluated for its retest reliability and as an outcome measure in intervention studies.

AIMS: To describe and compare perceptions of collaboration between care providers on the part of three groups of Registered Nurses working in municipal care and having particular responsibility concerning the care of frail older people with intellectual disability (ID); and, furthermore, to investigate the presence of and compliance with guidelines for the coordination of care.

DESIGN: National survey study with cross-sectional design.

METHODS: Nurses (N = 110) with key positions concerning people with ID answered a national questionnaire about collaboration, guidelines and coordinated individual plans. Descriptive and comparative statistical analyses were applied.

RESULTS: The meetings on cooperation and coordination of interventions were attended most frequently by nurses, and least frequently by social workers. The nurses were overall satisfied with the collaboration but perceived shortcomings in the case of inpatient and outpatient psychiatric care. Only in about half of the meetings for making care plans participated the people with intellectual disability and next of kin.

Volt hockey is a team sport developed for persons with physical disabilities, but its influence on well-being is unknown. Elements of well-being have been described as positive emotions, engagement, relationships, meaning, and achievement constituting a theoretical framework referred to as PERMA. The purpose of this study was to describe how well-being according to PERMA is reflected in the experiences of playing volt hockey. Data were collected through focus group and individual interviews including 21 players. A deductive analysis was conducted using the elements in PERMA as preexisting main categories with an additional main category, named resources needed. Findings showed that all five elements constituting well-being according to PERMA were reflected in the experiences of playing volt hockey. In addition, players emphasized the importance of having the resources needed to play volt hockey. In conclusion, having the opportunity to enjoy playing volt hockey enabled the players to flourish and experience feelings of subjective well-being.

Volt hockey is a team sport developed for persons with physical disabilities. Because family members are important resources to enable sports participation, the purpose of this study was to illuminate experiences of volt hockey from family members’ perspectives. Focus group interviews were conducted, including 20 family members, and the verbatim transcripts were inductively analysed using reflexive thematic analysis. Family members saw the value of enabling participation in volt hockey, being an inclusive team sport that brings enjoyment and strengthens social relationships within, and outside of, the family. Trying to facilitate sport participation, the need for material resources and other actors was emphasised, such as personal assistance, funders, and healthcare professionals informing about the sport and the engagement of the volt hockey clubs. In conclusion, involvement in volt hockey is emotionally and socially rewarding for family members, but there is a need for additional enablers to allow the sport to grow. 

Circa 2% of the Swedish population suffer from heart failure, therefore there is a possibility that every nurse will at least once need to attend to this patient-group. Heart failure is a chronic condition where the heart function is reduced, this leads to life-long treatment with the patient being responsible for following self-care instructions and monitoring their symptoms. In order to provide the best possible care for patients with heart failure, it is necessary that nurses understand the patient’s perspective of their condition. Aim: The aim of the literature study was to illustrate patients’ experiences of how heart failure affects daily life. Method: The literature study was based on a qualitative study design. The database search was conducted in the databases PubMed and Cinahl. Twelve scientific articles were quality checked according to SBU’s review template. The data analysis was performed using Popenoe’s et al. method for analysing qualitative articles. Results: Three categories and eight subcategories emerged from the data analysis. The main categories were: Personal difficulties due to living with heart failure, Obstacles in daily life and Strategies to cope with living with heart failure. The patients were troubled by physical, psychological and existential difficulties. Because of the difficulties, the patients became hindered in physical, mental and social aspects of life. The physical and mental obstacles resulted in patients becoming dependent on others in their daily life. Finally, the results showed that patients created strategies to cope living with heart failure. Conclusion: The literature study’s result demonstrated that heart failure affects patients’ daily lives. Several aspects and dimensions of the patients’ daily lives were affected. If nurses were to gain a deeper understanding of patients' experiences of heart failure, then their professional practice could develop in a positive direction. 

Background: Approximately 75% of all women of childbearing age are affected by premenstrual symptoms. 15–20% have more distinct PMS, while 2–5% suffer from the more severe version PMDD. The most common symptoms are anger, irritability, anxiety, increased bloating, soreness in the breasts, headaches, joint/muscle pain and weight gain. Aim: The aim of the literature study was to investigate women's experiences of living with PMS and PMDD. Method: The thesis was carried out as a literature study with a qualitative study design. Ten scientific articles were compiled in order to answer the aim of the study. Results: For some women, PMS can mean years of monthly suffering, for others it's a sign of being a healthy woman. Women witnessed having to resort to different coping strategies to make everyday life work, the most common were personal time and self-monitoring. Many women experienced a negative societal image of PMS and how the premenstrual woman was perceived, these norms and ideals have been shown to have a harmful impact on their self-image and how they experience their premenstrual distress. Jean Watson (1985) highlights the importance of the nurse instilling faith and hope in the patient before the situation they find themselves in. In this way, the nurse can contribute to behavioral and attitudinal changes. Conclusion: Women feel that there is a societal ignorance that affects the extent to which they are comfortable speaking about their distress. This means that women do not receive the support and help they need to cope with everyday life, something that has a direct impact on their quality of life. Increased awareness and knowledge is fundamental in order for the nurse to provide adequate and person centered care for these women. 

Background: Healthcare-related infections (VRIs) compose a global patient safety risk. One third of all healthcare injuries in Sweden are healthcare-related infections. The most common VRI are urinary tract infections (UTI) and postoperative wound infections of varying severity, which account for about 50% of all VRIs in Sweden. The hands are the largest source of infection for diseases in health care and therefore it is important that the registered nurse works preventively and follows hand hygiene routines to reduce the risk of infections in health care. Aim: The purpose of this literature study is to describe the undergraduate nurses' experience of adherence to basic hygiene routines in inpatient care with a focus on hand hygiene. Method: This literature study used 10 qualitative scientific articles. The articles were taken from two databases PubMed and CINAHL focusing on nurses. Articles reviewed according to SBU guidelines and were analyzed to identify relevant articles that serve the aims of the study. Results: The results of the study have been compiled into four headings. The four headings were: knowledge and skills deficiencies, environmental and organizational factors, attitudes and social behavior technology. Conclusion: Nurses think that there is a shortage of hand hygiene products, staff and knowledge, which has a negative impact on compliance to hand hygiene.

Background: Sweden is today a multicultural society with a population where some have a mother tongue other than the official language. Among other things, this has led to language barriers arising, especially in healthcare. Aim: The aim of the study was to illustrate the nurse's experience of cross-cultural communication. Method: A literature review based on nine scientific articles with a qualitative approach and one with a mixed method. Results: The ten selected scientific articles answered the purpose of the literature study. The results were presented in six main themes: impact on the quality of care, the relationship between nurse and patient, communication without speaking the same language, bilingual nurses as interpreters, relatives as interpreters, and professional interpreters. The lack of communication between the nurse and the patient led to a lack of participation for the patient as the patient avoided communicating with the nurse and did not understand much of the information provided. Bilingual nurses had to often act as interpreters despite the lack of training in this area. Conclusion: The study shows that language barriers complicated the nurse's work and as a consequence also made the workaround nursing and patient-safe care more difficult. Both the nurse and the patient were affected by the language barriers that arose. One solution could therefore be for the nurse to expand her knowledge in communication to offer the patient safe care.

Background: Type 2 diabetes is a disease that is currently classified as an epidemic and is strongly linked to poor lifestyle habits. Treating the disease involves making lifestyle changes, such as dietary modifications. Through diet, many individuals can gain control over their blood sugar levels, resulting in clinical improvement. Purpose: To highlight the experiences of dietary changes among adult individuals with type 2 diabetes. Method: A qualitative literature study. Ten articles were identified and subjected to quality assessment using the SBU review template through structured searches using a PEO model via Pubmed and Cinahl. The results were then analyzed for the findings of the literature study. Results: Four main themes were identified: the need for knowledge, motivation, availability, and social contexts. Conclusion: Dietary changes are crucial in the treatment of type 2 diabetes and adherence to these changes depends heavily on personal factors in an individual’s life. Therefore, it’s important for nurses to provide effective person-centered care and it is necessary to have a holistic perspective in their supportive and health-promoting work.

Background: Covid-19 is an ongoing pandemic since the end of 2019. The virus has spread throughout the world. The lack of planning, resources and leadership has been an enormous problem during the pandemic. This has led to stress and pressure in the health care for the society. The nurses have been suffering physical and mental problems because of Covid-19.

Aim: The purpose of this literature study was to describe nurses' experiences of caring for patients with Covid-19.

Method: Only qualitative studies were used in the literature study. CINAHL, Psycinfo and PubMed were used as databases for data collection. With the help of inclusion and exclusion criteria, thirteen studies were found and selected for the result of the literature study. Each study that was found was assessed for quality which resulted in nine high quality studies and four medium quality studies.

Results: Two themes were found, and each theme had its own subthemes. The themes were “Physical and mental challenges” as well as “Experiences of the organization”.

Conclusion: The results showed that nurses who cared for patients with Covid-19 experienced negative emotions, experienced physical and mental challenges in relation to performing various nursing work. The nurses obtained experience and an extended knowledge around various nursing work, which was a positive experience for the nurses. Some nurses experienced a lack of support from the organizations and the government as well as a lack of clear guidelines and information regarding performing safe and person-centered care. After working together for a while, the nurses experienced a better team spirit as well as support from the society.

Keywords: Covid-19, Experiences, Nurse, Nursing, Pandemic.

Bakgrund: Multipel skleros är en kronisk och allvarlig sjukdom som successivtleder till fysisk funktionsnedsättning. Sjukdomen uppstår på grund avinflammation i det centrala nervsystemet. Det är den vanligaste orsaken tillrörelsehinder i Sverige. Orsaken är okänd och det finns inget botemedel. Studiervisar att behandlingen av MS är främst inriktad på symtomlindring. Det var därförbetydelsefullt att belysa personers upplevelser av att leva med MS för att kunnaförstå hur de uppfattar sjukdomen. Detta kan leda till en förbättrad ochpersoncentrerad vård där deras perspektiv är i centrum. Syfte med studien var attbelysa personer med MS och deras upplevelser av att leva med sin sjukdomMetod: En litteraturstudie baserad på elva studier med kvalitativ ansatsgenomfördes och data analyserades med innehållsanalys. Resultat: Tre temanidentifierades som var fysiska och psykisk påverkan, att hitta copingstrategier ochpåverkat socialt liv. De flesta av personerna blev fysisk begränsade i derasförmåga till rörlighet men även emotionellt påverkade. Självbilden blev påverkadoch kroppen kändes främmande. Familjeroller förändrades där majoriteten kändesig misslyckade i sina tidigare roller. Personerna upplevde att andra människorinte förstod sjukdomen och hade fördomar om den sjuka individen. På grund avbegränsningar blev det av vikt att planera vardagen för att orka och spara energi.De flesta fann hopp och var villiga att acceptera sjukdomen samt lära sig att levamed det. Konklusion: Symtom på MS varierar mycket och är känd för sinoförutsägbarhet. Det är viktigt som sjuksköterska att kunna identifiera personernasbehov av vård på ett personscentrerat sätt.

This thesis explores methods of co-design between designer and informal caregivers of disabled or chronically ill children in the design of a tool for the prevention and reduction of caregiver burden. Concluding that a platform based on the centralisation of healthcare (a factor previously unaccounted for), ease of communication between all parties (family members, healthcare providers, etc.) and task management is the most effective tool for caregivers to monitor their and the care recipient's health. Following established design parameters, from co-design dialogues, a visual prototype was designed as a platform/tool for collective effort and shared coordination that incentivises informed and enthusiastic commitment.

The purpose of the study was to investigate how the supporters' clubs of the SHL associations view the management of the supporters in order to further connect it to the commercial direction of the SHL-associations. To answer the purpose, two questions have arisen in the form of 1) How do the supporter clubs in the SHL feel that their respective ice hockey associations treat them? and 2) What similarities and differences are there between different SHL associations' handling of the supporters? Information collection took place through semi-structured interviews with respondents active in supporter clubs. The analysis method thematic analysis was used where three main themes in the form of 1) communication, 2) general supportership and 3) the relationship between the supporters' clubs and the association emerged. In the conducted analysis, the theoretical frameworks of McDonaldization and hegemony were followed with connections to the previous research and information gathering. Results that emerged during the study were that in order for the soft values of the supporters to be achieved, they need to feel heard and respected, which shows the importance of a functioning communication between the supporters' club and the SHL-associations. Furthermore, the result emerged that the supporter clubs that have a good communication and relationship with the SHL-associations have an increased understanding of the commercial decisions.

Bakgrund: Ungefär en tredjedel av de patienter som söker vård inom primärvården gör det på grund av psykisk ohälsa. Det är av vikt att primärvården är anpassad och bemannad för att hantera psykisk ohälsa eftersom primärvården ska vara ingången för all typ av ohälsa i befolkningen. Tidigare studier visar att sjuksköterskor i primärvården upplever en kunskapsbrist i psykiatri som kan riskera att bemötandet av patienter med psykisk ohälsa blir stigmatiserande. Rekryteringen av specialistsjuksköterskor i psykiatrisk vård i primärvården ter sig som en relativt ny företeelse. Det finns inga svenska studier som beskriver deras roll och funktion på vårdcentral eller deras upplevelse av arbetet i primärvård. Syfte: Att undersöka erfarenheterna hos specialistsjuksköterskor i psykiatrisk vård av arbetet på vårdcentral med patienter som söker vård för psykisk ohälsa. Metod: Specialistsjuksköterskor i psykiatrisk vård (N=11) vid nio vårdcentraler i Region Skånes regi intervjuades med semistrukturerade intervjuer. Dataanalysen genomfördes med kvalitativ innehållsanalys enligt Graneheim och Lundman (2004). Resultat: Analysen resulterade i fem kategorier: mötet med patienten med psykisk ohälsa, arbetar självständigt, värdesätter teamarbete, samverkar med specialistpsykiatrin, och besitter värdefull kompetens. Det latenta innehållet i kategorierna formulerades i temat “Unik roll där specialistkompetensen används”. Konklusion: De allra flesta intervjuade specialistsjuksköterskorna i psykiatrisk vård upplevde att de använde sin specialistkompetens i stor utsträckning och att det fanns ett stort behov av deras kompetens. De beskrev en mycket självständig roll med stort eget ansvar. Betydelsen av lång och bred erfarenhet, utöver specialistutbildningen och kunskap i samtalsmetodik, betonades.       

Background: Dementia is a chronic public disease that affects millions of people around the world. The disease causes severe cognitive impairment in, among other things, the ability to speak, the ability to act and the ability to communicate. People with dementia suffer from obstacles in their ability to communicate, both verbal and non-verbal communication, which leads to people having challenges in expressing themselves and taking in information from the environment. Impaired communication skills can challenge and affect nurses' main task, which is person-centered nursing. Aim: The aim of the study is to compile nurses' experience of communication with people with dementia. Method: The literature study was conducted with ten qualitative scientific articles. The articles were retrieved from two databases, Cinahl and PubMed, and have been reviewed based on SBU's quality review template. Result: Three main themes and five sub-themes are presented to answer the purpose of the study. The three main themes were Nurses' experiences of communication with patients with dementia, Adapted communication for people with dementia, Common language in the nurse-patient meeting. The results were then divided into four sub-themes: Body language, facial expressions and body contact, clear and clear communication, A white lie, the impact of the health care environment on communication and Mother tongue. Conclusion: Communication is thus central to being able to care for patients with dementia. It is the job of nurses to carry out nursing care, where communication plays a crucial role in the care of people with dementia.

Background: Prostate Cancer is one of the most common cancers among men with over 1,4 million incidents in the year 2020 worldwide. It’s significant that nurses understand lifestyle changes related to medical treatment and complications. By increasing this knowledge nurses can offer person-centered care and customized care to each patient's unique needs. There are many treatment options, and every treatment has its complications that can affect a man's life severely. Nurses play a crucial role in helping those men. It's crucial with person-centered-care to reduce suffering in patients.

Aim: The purpose of this literature review is to comprehensively map and synthesize the existing literature on men's experiences to live with prostate cancer

Methods: This literature study is based on twelve scientific articles with aqualitative approach. The articles were retrieved from two databases that specify in nursing and were analyzed using three steps which involves identifying the result and breaking it down into different aims until themes and subcategories submerge. The articles were evaluated for quality using SBU review temple.

Results: From the analysis two themes emerged: A changed self-image and Strategies to manage everyday life, and based on them six subcategories were identified.

Conclusion: Men living with prostate cancer suffer physically, mentally, and emotionally. Sexuality and body image are common concerns for prostate cancer patients. Information is of great importance, where the nurses play a decisive role. Men feel like they don't get enough support from the environment.

Background: Every year, approximately 90,000 people die in Sweden, and about 80% of them are considered to have been in need of end-of-life care. End-of-life care strives to provide care to patients in their last period of life focusing on  alleviating suffering but also promoting quality of life, both for the patient and their relatives. Family care means that relatives provide care to a relative with health condition deterioration, the relatives thus need to be offered support and experience participation from the care staff. The nurse should provide support to relatives in most cases and must be able to involve relatives in their work. Aim: The aim of this literature review. was to investigate how relatives experience endof-life care at home. Method: This literature review. was carried out using a qualitative method and built on ten scientific articles from the databases PubMed and CINAHL. The articles were quality checked using the Swedish Agency for Health Technology Assessment and Assessment of Social Services template, then analyzed using principles for content analysis. Findings: Two categories and seven subcategories were identified. The categories are named as: Being a part of the care and Aspects of the interaction with and between care staff. Conclusion: The results illustrated that the interaction between relatives and care staff played a major role in how the care was experienced by the relatives. In order for them to feel safe providing care and trust the care providers, good relationships and availability from the care staff were required. The relatives also stated a need for support and to be seen in order for them to have confidence in the care they were providing.

Alm, A & Eborn, S. Nurses’ experiences of caring for people with mental illness in somatic departments. A literature review. Degree Project in nursing 15 credit points, Malmö University: Faculty of Health and Society, Department of Care Science, 2023. Background: Since the mid-90s, the number of full-day psychiatric places has decreased sharply, which has resulted in more and more patients with mental illness seeking and being cared for in somatic wards. The nurses who work in the somatic departments are expected to use a person-centred approach to provide the best care possible. Aim: The aim is to highlight how nurses who work in somatic care experience the care of patients with mental illness. Method:A literature study based on 12 scientific articles with a qualitative approach. The databases Cinahl, PubMed and PsycInfo have been used for obtaining material. The analysis has been carried out according to Popenoe et al.'s systematic method for data analysis. The articles have been quality reviewed according to SBU's review template. Results: The following six categories were identified: 1) Limited care environment 2) The importance of support and cooperation 3) A time-consuming patient group 4) Experiences of inadequacy in care 5) The importance of communication 6) Try to meet the nursing need.Conclusion: The nurses felt that patients with mental illness are a resource-demanding patient group, which resulted in the nurses feeling the need to provide more care to them than the other somatic patients. The nurses also felt that the patients were using the system to their advantage, which resulted in a reluctance to care for the patients more than what was absolutely necessary.

In 2003, the Danish Football Association introduced a new club licensing system for its first-tier clubs. Among the criteria for the system was a requirement for clubs to play at a stadium with a minimum capacity of 10,000 spectators. This paper aims to understand how the Danish Football Association and the Danish league clubs have succeeded in their efforts to make their licensing criteria a public concern by standardizing them at a municipal level. It presents a case study examining how the policy process surrounding the decision of building a new stadium in the Danish village Hobro changed – in a peculiar way – what in institutional theory is understood as a (voluntary) standard into a directive for Mariagerfjord Municipality. The case is illustrative of policy processes regarding stadium funding in other parts of Denmark and most likely in other Scandinavian countries.

Background: An increasing number of patients survive critical illness due to medical advancements. Current research indicates that patients often find the acute phase of illness emotionally challenging, experiencing stress and uncertainty. It is known that critical illness and intensive care lead to physical consequences long after hospitalization, negatively impacting patients' recovery. With knowledge of patients' post-critical illness health experiences, nurses can tailor care to provide support for optimal recovery. Aim: To illuminate how patients' experiences of mental health are affected after critical illness. Method: A literature review based on twelve articles with a qualitative approach was analyzed using thematic content analysis. Results: Participants' experiences of mental health after critical illness are presented in five main categories: gratitude, vulnerability, worry and fear, fatigue, and identity changes. Conclusion: Participants' mental health experiences were influenced by gratitude for survival and the support received. However, vulnerability, worry, fatigue, and a need to reshape identity were common experiences leading participants to alter their self-perception and life perspectives. The importance of patients feeling understood and offered support from both healthcare and relatives has emerged and person-centered care and a holistic approach are highlighted as important factors in meeting the complex needs that arise after critical illness.

Athletes between the ages of 16-18 are increasingly migrating to other locations within Sweden with the ambition to continue their athletic careers in parallel with their secondary education, such as through a national sports high school [RIG]. However, migration among such young athletes represents an uncertain investment and is accompanied, from a migration perspective, by several challenges of adjustment, as well as psychological, psychosocial, and academic challenges. The RIG system is intended to ease this transition by offering a good education alongside athletic development. During Covid-19, the migration adjustment that RIG students are expected to make was made more difficult by several restrictions. While some studies have been conducted on the impact of the pandemic on both students and athletes, none have been conducted on individuals who are also pursuing dual careers and migrated during the pandemic, such as RIG students. Therefore, the present study aimed to examine RIG students' experiences and perceptions of the move and adjustment to a new environment during Covid-19, with the goal of understanding how the pandemic affected migration and how individuals were able to overcome the obstacles and challenges they faced. This was made possible by conducting a case study on RIG swimmers from Helsingborg and Jönköping. Five semi-structured interviews were conducted with RIG swimmers, which were later analyzed through a thematic analysis. Bourdieu's theoretical framework and concepts of capital, habitus, field, and illusio guided the thematic analysis and subsequent discussion. The results show that RIG swimmers experienced different difficulties in adapting based on the resources and previous conditions they possessed. Different types of capital ownership also meant different types of adaptations, which in the longer term affected motivation positively or negatively. All students, regardless of their capital ownership, experienced challenges in distance learning, discipline and routines, as well as a lack of community. The study therefore concludes that RIG students' adaptation depends on how much capital they possess within the new field and how strong a sense of illusio they have. In the longer term, the study highlights the importance of finding sustainable ways to support career opportunities for young athletes, even during a societal crisis such as Covid-19.

Background: There are several factors that affect women's sexual health, among those are biological and physiological wellbeing and gender. Furthermore gender is derived from society’s values that comes from history, politics, socio-economic prerequisites among other things. Previous studies have shown a lack of knowledge and a lack of follow-up of women’s sexual health the years after childbirth. The purpose of this study is to get a deeper understanding of women’s experiences of their sexual health the years after childbirth.

Aim: The aim of this study is to compile previous studies about women's experienced sexual health up til seven years after childbirth. This is done through the question “How do women experience their sexual health the years after childbirth?”

Method: This is a qualitative literature review that contains twelve articles. The inclusion criteria is previous healthy women with no pathological pregnancies, women who experienced episiotomy or cesarean section during childbirth. However, twins and spontaneous sphincter tears of the 3de or 4th degree have been excluded. This studies scope is limited to the first seven years after childbirth. The articles are written in swedish or english and published between 1960- 2020. Latent content analysis is used to analyse the material.

Result: Many women experience a loss in sexual health the years after childbirth. It depends on several different things such as physical changes, breast feeding, the impact of having a child, changes in relationships and how women experience the meeting with health care. All of this is presented through the four themes of our study.

Conclusion: There is a general loss in sexual health among women after childbirth and they wish for better support from health care professionals. To meet this demand healthcare professionals need more knowledge and to actually apply it. Furthermore, a deeper understanding how gender affects women’s sexual health is needed.

Background: Overweight and obesity are considered one of the biggesthealth problems of our time. Despite existing guidelines for preventive work, the increase continues and today affects more than 1.9 billion people worldwide, and entails an increased risk of developing sequelae such as diabetes, cancer and cardiovascular disease. The nurse has a central role in the nursing care, and the prevalence of the disease means that the registered nurse can meet this group of patients in different instances in the care chain. Aim: The purpose of the literature review was to illustrate the nurses' experiences of caring for overweight and obese adults with focus on promoting health. Method: The study was conducted as a literature review with a qualitative approach. With the databases Cinahl and Pubmed, twelve scientific articles were generated which were used to answer the purpose of the study in the result. Selected studies were reviewed using the SBU's review template and analyzed using metasynthesis. Result: The result highlighted the factors that influenced the nurse's work with the patient group. The factors led to the identification of three main themes: organization and collaboration in teams, knowledge and education, as well as attitudes and treatment. Based on the three main themes, another seven sub-themes could be identified, which enabled a deeper insight into how the nursing care was affected. Conclusion: Overweight and obesity are a complex health condition that can be caused by several different aspects. The complexity can result in that the nurse's knowledge is not sufficient, which places demands on well-functioning transcendence work between different professions. Attitudes and prejudices have a negative impact on the work, which leads to poorer care and increases the workload. More resources in the form of time, materials, training and guidelines are needed for the nurses to be able to offer good care to the group of patients.

Bakgrund: Årligen i Sverige uppskattas tio procent av patienterna drabbas av vårdskada. Inom hälso- och sjukvården är resursbrist och hög arbetsbelastning vanligt förekommande samtidigt som sjuksköterskan befinner sig i en arbetsmiljö med krav på att upprätthålla patientsäkerheten. Det är av vikt att den grundutbildade sjuksköterskan har förståelse för på vilket sätt arbetsmiljön påverkar patientsäkerheten för att kunna bedriva säker vård som tillgodoser patientens grundläggande behov. Syfte: Studiens syfte var att belysa hur sjuksköterskan erfar att arbetsmiljön påverkar patientsäkerheten.Metod: Litteraturstudien bygger på tolv vetenskapliga artiklar med kvalitativ ansats. Artiklarna är hämtade från databaserna Cinahl, PubMed och Psykinfo. Analysen har utgått från innehållsanalys och artiklarna har kvalitetsgranskats. Resultat: Fyra teman identifierades: Organisation och ledning, Fysisk och Psykisk påverkan, Bemanning och arbetsbelastning samt Teamarbete och kommunikation.Konklusion: Studien lyfter flera olika faktorer i sjuksköterskans arbetsmiljö som påverkar patientsäkerheten. Utmärkande var framförallt personalbrist och hög arbetsbelastning, vidare betonas att god kommunikation och fungerande teamarbete har positiv påverkan som bidrar till att sjuksköterskan kan tillgodose patientens grundläggande behov. För att förbättra sjuksköterskans arbetsmiljö och upprätthålla god och säker vård krävs åtgärder på såväl organisatorisk nivå som på individnivå. Litteraturstudien genererar en ökad förståelse för arbetsmiljöns betydelse för såväl sjuksköterskans personliga hälsa som patientens säkerhet. 

Background The number of people diagnosed with ADHD has increased steadily over the past 15 years. It has been shown that many have been diagnosed first as an adult. In recent years, research has shown the experience of a lower quality of life in adults with ADHD as well as several consequences of untreated ADHD such as divorce, increased risk of addiction, car accidents, accidental injuries, depression, anxiety, and suicide.

Aim The aim of the literature study was to compile experiences of ADHD in people who received the diagnosis in adulthood.

Method Literature review with qualitative design. Based on the perspective of adults with ADHD, a total of ten scientific articles from the PsycInfo and Cinahl databases were reviewed. Data were extracted, translated, condensed, coded and thematized based on basic content analysis.

Results The analysis of the results of the studies resulted in three main themes: ADHD affected life which describes the impact of ADHD, The significance of the diagnosis and the winding road talks about thoughts and feelings of being diagnosed, and Experiences of strategy, care and treatment which depicts the coping strategies of symptoms and difficulties as well as experiences of offered care.

Conclusion Experiences of symptoms and difficulties related to ADHD can differ greatly between people and gender. Something that has to be understood in order to enable work based on person-centred care. Stigma and negative experiences of healthcare are seen to be caused by lack of understanding and unawareness. Why the importance of attitude change in society is seen as crucial for good quality of life and to be treated well. One knowledge gap that was seen was women's experience of the cause of later diagnosis, here continued research is needed.

BACKGROUND: While a large body of research has focused on the challenges experienced by healthcare staff when providing sexual and reproductive health services, little attention has been paid to the ways healthcare providers navigate these challenges. This study examined healthcare providers' accounts of encounters when providing sexual and reproductive health (SRH) services to migrants in Southern Sweden. It sought to examine challenges and dilemmas experienced by healthcare providers, strategies used to navigate these challenges and dilemmas, and assumptions underlying participants' accounts.

METHODS: The data collection was conducted between September 2020 and March 2021. Qualitative thematic analysis was used to analyze thirty-one interviews with healthcare providers working in youth clinics and women healthcare clinics. The analysis was guided by a conceptual framework combining person-centered care approach, Foucault's concepts on power/knowledge, and theories to navigate diversity in healthcare setting: cultural competency and cultural humility.

RESULTS: Three themes were identified in the analysis: 1) Between person centeredness and cultural considerations; 2) Knowledge positions and patient involvement; and 3) beyond the dyadic interaction healthcare provider-patient. Some participants understood person-centered care as individualized care where the influence of culture on the encounter should be de-emphasized, whereas others tended to highlight this influence. Many participants viewed the influence of culture as primarily driven by migrants' cultural backgrounds, and as a source of challenges and dilemmas. Participants' strategies to navigate these perceived challenges and dilemmas included practicing cultural humility and seeking cultural competency. Knowledge positions also emerged as an important aspect of participants' accounts of encounters with migrants. Many participants experienced that migrant patients were lacking knowledge about the body and sexuality. This disadvantaged knowledge position affected migrant involvement in care. Additionally, the study shows how participants placed their experiences in a broader organizational and social context. Participants highlighted several organizational challenges to encountering migrants and discussed dilemmas stemming from the interplay between migrants' structural and individual disadvantages.

CONCLUSIONS: The study findings illuminate the complex links between person-centered care and two important dimensions of the encounters with migrants: culture and knowledge positions. They also shed the light on the organizational and structural challenges surrounding these encounters. These findings suggest that multilevel strategies are needed to improve the quality of encounters when providing SRH services to migrants. These strategies could include ensuring universal access to SRH services to migrants, adjusting the encounter duration when interpretation is needed, and providing necessary resources to healthcare providers to build their structural competency.

This thesis explores potential challenges to achieving sexual and reproductive health (SRH) equity in Sweden, focusing on young people with migration experience. It includes three qualitative studies, each addressing a specific aim. The findings of these studies are presented in four papers.

Study I is a policy analysis that aims to examine how migrants were represented in the discourses embedded within Swedish sexual and reproductive health and rights (SRHR)-related policies, and how migrants’ SRHR-related issues were framed and addressed within these discourses. To this end, 54 policy documents were critically examined and the results are presented in Paper I. The results show how migrants’ discursive representation in Swedish SRHR-related policies is often associated with the concept of vulnerability. Moreover, a discourse of otherness appears when discussing what is defined as honor-related violence and oppression. The results also indicate that framing migrants’ issues with regard to SRHR oscillates between two competing discourses. The first one tends to prioritize the structural level, as mainly reflected in adopting the human rights- based discourse, whereas the second tends to frame migrants’ SRHR issues and needs as individual issues requiring individual-level solutions.

Study II builds on interviews with 20 young people with migration experience. It aims to explore accounts of encounters of young people with migration experience with SRH services, and discourses on sexuality. The first part of the results is outlined in Paper II. It highlights how the interplay between participants’ negative perceptions of youth clinics, difficult access, and the perception of the irrelevancy of SRH services contributed to low service use. The first part of the results also shows how the experiences and attitudes toward school-based sexuality education differed substantially among participants, ranging from positive to less positive or negative. The second part of the results is presented in Paper III. It highlights the various constructions of sexuality in the participants’ discourses. Sexuality was constructed as a border marker that contributes to making a distinction between discursive constructions of mainstream Swedish society and ethnicized migrant communities. It was also constructed as a domain for negotiating risk, where sex was depicted as a risk associated with negative SRH outcomes. Finally, sexuality was constructed as a domain for negotiating sexual agency at the societal and interpersonal levels.

Study III is based on interviews with 31 healthcare providers. It aims to examine healthcare providers’ accounts of encounters with migrants when providing SRH services in Sweden. The results are presented in Paper IV. They illuminate the complex relations between person-centered care, culture, and knowledge positions that underlay the participants’ accounts. While some participants understood person-centered care as individualized care where the influence of culture on the encounter should be de-emphasized, others tended to highlight this influence. Participants related this influence to different perceived dilemmas and described strategies to navigate them. The main strategies involved practicing cultural humility (e.g., self-reflection, self-critique, and openness) and seeking cultural competency. Moreover, many participants experienced that migrant patients lacked knowledge about the body and sexuality. This disadvantaged knowledge position affected migrant involvement in care. The results also pointed to several organizational challenges as well as dilemmas stemming from the interplay between migrants’ structural and individual disadvantages.

The results of the three studies are integrated using a theoretical framework combining Fraser’s theory of justice and concepts of equity, othering, and belonging, along with a proposed concept of sexual-cultural citizenship. The thesis argues that the challenges to SRH equity highlighted in these studies represent forms of injustice stemming from either misrecognition, maldistribution, or misrepresentation, or an interplay of two or more of these dimensions of injustice. These challenges contribute to contesting the full sexual- cultural citizenship of young people with migration experience. 

Background

Previous research has shown that migrants in Sweden are disadvantaged in terms of sexual and reproductive health and rights (SRHR). SRHR policies might play a crucial role in shaping migrants’ SRHR outcomes. The purpose of the study was to critically examine: a) how migrants were represented in the discourses embedded within Swedish SRHR-related policies, and b) how migrants’ SRHR-related issues were framed and addressed within these discourses.

Methods

Critical discourse analysis (CDA) was used to analyze a total of 54 policy documents. Following Jäger’s approach to CDA, discourse strands and entanglements between different discourse strands were examined.

Results

Our findings consisted of three discourse strands: 1) “Emphasizing vulnerability”, 2) “Constructing otherness”, and 3) “Prioritizing the structural level or the individual level?”.

Migrants’ representation in Swedish SRHR-related policies is often associated with the concept of vulnerability, a concept that can hold negative connotations such as reinforcing social control, stigma, and disempowerment. Alongside the discourse of vulnerability, the discourse of otherness appears when framing migrants’ SRHR in relation to what is defined as honor-related violence and oppression. Furthermore, migrant SRHR issues are occasionally conceptualized as structural issues, as suggested by the human rights-based approach embraced by Swedish SRHR-related policies. Relevant structural factors, namely migration laws and regulations, are omitted when addressing, for example, human trafficking and HIV/AIDS.

Conclusions

We conclude that the dominant discourses favor depictions of migrants as vulnerable and as the Other. Moreover, despite the prevailing human rights-based discourse, structural factors are not always considered when framing and addressing migrants’ SRHR issues. This paper calls for a critical analysis of the concept of vulnerability in relation to migrants’ SRHR. It also highlights the importance of avoiding othering and paying attention to the structural factors when addressing migrants’ SRHR.

Although a growing body of literature has focused on the experience of young people with migration experience with Swedish sexual and reproductive health (SRH) services, there is a lack of deep qualitative exploration. The study aims to explore the encounters of young people with migration experience with SRH services and their understandings of factors that affect their use of these services. The findings of this study were drawn from 18 interviews conducted between October 2021 and May 2023 in Southern Sweden. A combination of convenient and snowball sampling strategies was used. Participants included in the study self-identified as Middle Eastern, migrated to Sweden, and were aged between 17 and 26. Data were analyzed using reflexive thematic analysis approach. Three themes were generated during the analysis. The first SRH services: dual perceptions and experiences shows how participants had ambivalent perceptions of SRH services, mainly the youth clinic. Some perceived the youth clinic as a stigmatized place associated with shame and SRH concerns like unwanted pregnancy and sexually transmitted infections, while others viewed the youth clinic as a safe space. The negative perceptions along with the difficulties with accessing the youth clinic contributed to low service use. The second Sexuality education: an eye-opener or a joke? reflects participants' both positive and negative experiences and attitudes when receiving sexuality education in schools. The third SRH information: beyond formal services and education captures participants' ways of accessing SRH information that go beyond information provided at the traditional SRH services and sexuality education in schools. These sources include the family, friends, and the internet. The study points to the need for multicomponent strategies to improve the accessibility of SRH services and draws attention to the importance of challenging norms related to Swedishness in sexuality education to foster the engagement of youth with migration experience and ensure their sexual citizenship.

Background: A pressure ulcer is an injury to the skin and underlying tissue that can occur after pressure or shear. Patients who suffer from pressure ulcers express that it causes great physical, psychological and social suffering. The nurse is responsible for the nursing work where pressure ulcer prevention is part of the preventive work and includes risk assessment, skin assessment and regular repositioning. Aim: The aim of the literature study was to shed light on nurses' experiences of pressure ulcer prevention in inpatient care. Method: Qualitative literature study based on 10 articles with a qualitative study design obtained from the databases Cinahl and Pubmed. The results of the selected articles were analyzed by conventional content analysis. Result: Through the content analysis, main categories and subcategories were crystallized from the results of the articles. The result was formed into two main categories: Care team and Work environment and six subcategories: Prevention, Communication, Nurse, Patient, Organizational factors and High workload. Conclusion: Nurses had experience that the care team and the caregiver's organizational responsibility had a decisive importance in the work with pressure ulcer prevention.

The aim of this study was to do a structured analysis of the literature on biomarkers for major depressive disorder (MDD) and how these biomarkers may be modulated by physical activity (PA). This with implications for future treatment of mild to moderate MDD with PA. The method was quantitative and followed guidelines for conducting a simplified meta-analysis. The study analyzed 37 randomized controlled trials (RCTs) that covered a total of 911 individuals doing PA. Articles on biomarkers that are previously well established in their relationship with MDD were collected in a structured way, following strict criteria. Results were achieved using statistical methods for calculating the average effect size (ES) and average mean difference (Δ%) for the biomarkers as a result of PA. BDNF showed an effect size of 0.81 ± 1.09 and an average mean difference of +61.7 ± 112.20 %. CRP showed an effect size of 0.35 ± 0.28 and an average mean difference of -18 ± 13.69 %. Cortisol showed an effect size of 0.09 ± 0.75 and an average mean difference of -2.9 ± 17.30 %. Serotonin showed an effect size of 0.39 ± 0.54 and an average mean difference of -11.53 ± 21.10 %. Testosterone showed an effect size of 0.59 ± 1.46 and an average mean difference of +6.50 ± 20.04 %. The conclusion was that PA had a large effect on BDNF and can be used as a diagnostic- and follow-up tool for patients with MDD treated with PA. PA has a small but consistent effect on CRP which therefore can be used in conjunction with other outcome measures to diagnose and follow up patients with MDD treated with PA. PA showed no effect on cortisol and can therefore be considered to be irrelevant as a diagnostic- and follow-up tool for patients with MDD treated with PA. PA had a small but relatively consistent effect on serotonin which therefore can be used in conjunction with other outcome measures to diagnose and follow up patients with MDD treated with PA. PA had a moderate and relatively inconsistent effect on testosterone which therefore can be used in conjunction with several other outcome measures to diagnose and follow up patients with MDD treated with PA. On the basis of these conclusions PA can be a valuable tool for improving some biomarkers for MDD (BDNF, CRP, serotonin & testosterone). Hopefully this study can provide a basis for further research as well as an addition to first line treatment for mild to moderate MDD with PA. 

Background: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students’ internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study. Objective: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students’ knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge? Methods: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study. Results: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019. Conclusions: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students’ attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students’ knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology.

Background: Attention deficit hyperactivity disorder (ADHD) belongs to the group of neuropsychiatric disorders. The core symptoms of adults with ADHD involve difficulties with attention with or without concomitant impulsivity and overactivity. The expressions and consequences of ADHD are characterized by what demands and expectations you have on yourself and what the current life situation looks like. ADHD can cause many worries and challenges in everyday life in different ways and cause physical, mental and social problems. In the meeting with this patient group, the nurse should perform individualized care with a holistic approach to meet the needs of these patients. Aim: The purpose of this literature study was to highlight how people with ADHD experience the impact of the neuropsychiatric impairment in adulthood. Method: A literature review with a qualitative approach. The articles are retrieved via the databases Cinahl and Psycinfo. The articles have been reviewed according to SBU: s review template for studies with qualitative methodology and the data analysis has been carried out according to Popenoe's recommendations. Result: The result is based on analysis of 12 qualitative articles. The analysis resulted in three main categories Feeling different, Comfort and support, Quality of life and six subcategories. Conclusion:The results showed that living with ADHD in adulthood can be both positive and negative. These people often have an increased comorbidity with experiences of exclusion and struggle with low self-esteem. Care and public knowledge of these people's experiences should be increased in order to provide person-centered care and thus avoid unnecessary suffering.

Background: Being constipated means physical and mental suffering that negatively affects the quality of life. Impaired fluid intake, low-fiber diet, immobilization, illness and medication are risk factors for constipation. Old age and female gender mean a further increased risk of being affected. The most common treatment methods for constipation are laxatives which can be difficult to balance as well as the invasive treatments enema and manual evacuation which for the elderly can be experienced as very stressful. Aim: The aim of the literature study was to shed light on non-invasive nursing measures for patients with constipation living in nursing homes aged 65 years and older. Method: This study was conducted as a literature review with a quantitative approach. Ten scientific articles were selected of which four were randomized trials and six were non-randomized trials. The studies underwent a quality review in which five articles were graded as grade I, which refers to high study quality, and five as grade II, which refers to medium-high study quality. Using the analysis, four themes were identified; healthy bacteria as a nursing measure, dietary supplements as a nursing measure, external influences as a nursing measure and individualized nursing measures which structured the results. Results: Nursing measures in the form of healthy bacteria, dietary supplements, external influences and individualized nursing resulted in a good therapeutic effect against constipation. Constipation-related symptoms decreased, quality of life improved and administration of laxatives, enemas and manual evacuation were reduced. Conclusion: The results of the literature review showed that non-invasive nursing measures exists that nurses can implement to treat constipation in nursing homes in Sweden. The nursing measures require acceptance, time and willingness from both patient and nursing staff for implementation.

Chemicals in cosmetics are dangerous for both humans and the environment. Multiple studies and reports estimate that Sweden will not reach its climate goals, in large part because of the usage of chemicals. The law meant to protect humans and nature against chemicals is flawed since it is based on a state of knowledge that is flawed. Mobile applications which are meant to increase awareness of chemical usage are flawed in scope, functionality and credibility.

The purpose of this study is to develop a mobile application which improves upon the flaws identified in existing mobile applications. The study uses design science research methodology, DSRM, to develop the artefact. DSRM is an iterative process with six steps where the development process is documented. The study is carried out with the company Consid AB which acts as stakeholders for the research project. The mobile application is evaluated in a descriptive method and analyzed by the authors of the study.

The results of the study show that the functional flaws identified from existing applications are possible to improve and that the developed application highlights chemicals with the flawed state of knowledge in mind.

Background: Nurses face many challenges in the nursing profession. One challenge is the ability to handle patient trauma and at the same time, as a nurse, process their trauma. With more awareness about how secondary traumatic stress shows itself in nurses and its aftermath, the stress can be identified in earlier stages. Aim: The aim of this literature review is to map how the aftermath of secondary traumatic stress show itself in nurses, described by nurses. Method: This study has been designed as a qualitative literature review with searches carried out in the databases CINAHL and PubMed. The mapping resulted in ten articles that were reviewed for their quality. Result: The metasynthesis of the identified articles resulted in seven subthemes, desire to leave nursing, providing insufficient care, teamwork, depersonalization, emotional distress, lack of resources and knowledge deficit. Conclusion: When the secondary traumatic stress overpowers the nurse, it may result in the nurse leaving its profession. Future research should thereby focus on methods that support the nurses exposed to secondary traumatic stress and lessen their feeling of exhaustion. Methods that help not only the nurses but also the patients they care for.