The public health care sector has come under increasing pressure to cut down costs, maximize productivity and satisfy patients' needs during the 1990s and onwards. As a way of "getting more for less" quality management has been introduced. Originating in the private manufacturing industry, quality management has a strong focus on productivity and efficiency, aspects which are measured in quantitative terms. However, there are strong concerns that quality management is a means of speeding up the marketization of public health care by introducing core values much different from the ethic and medical norms that traditionally underpin health care organizations.This essay focuses on how quality management has been introduced to, and transformed by, public health care. A theoretical framework based on new institutionalism is constructed, and translation theories are used as a way of illustrating how the medical institutional environment, in fact, changes the concept of quality management.

The aim with our paper has been to get a picture of which factors one of the heterogeneous group that we've chosen of old persons, 75-90 years, in Scania, in south Sweden, have experienced to be of importance for their life quality today and what they wish to preserve of their actual life style when they eventually shall use the elderly care. Also how their individual life course has influenced their experience of the quality of life.We found this subject interesting as the group of old people in the society is constantly increasing and when the group becomes bigger, then greater demands will be put on the elderly care. We have proceeded from a standpoint that all people are unique individuals and that people become what they are from their life histories and from the choices they have made during their life. We have used the life course theory that says that one should see the individual in his/her wholeness and the whole life history of a person in order to understand him/her. We have also studied earlier research concerning the different determinants of the life quality.

Background: During the 1980s, the fear of HIV spread over the world. Health professionals'attitudes to patients with HIV, was negatively impacted because of their fear to be infected.Patients with HIV have therefore,during disease history's first two decades, experienced stigma and discrimination in the response from health professionals. Because of the increasing knowledge of HIV it is of interest to study patients' contemporary experiences of the encounter with health professionals. Aim:To explore how patients with HIV experiencing the meeting with health professionals. Method:Literature study with seven qualitative and three quantitative articles.

The digitization in the Swedish health care sector is rapidly growing. This study investigates whether the digitalization in health care has led to higher quality and an increased value for patients. Interviews with staff in various health care professional categories were conducted to qualitatively study how the implementation of digitization is perceived in practice by those directly involved. Furthermore, an observation was made, where a doctor was followed duringa workday to study the different digitalization software tools that are being used. Previous studies and other relevant literature accompanied the study of digitalization in health care. Organizational theories were compared with the practical organization management at the studied health care organization, as well as their dependence on other authorities and companies.

Today patients are more aware of their rights regarding their own care. They are more informed, more engaged and have more and individual requirements, which leads to increased demands for information and participation increases. The Health Act sets out the patients´ right to participation. Participation increases patient satisfaction with care, promotes healing and increases adherence to health care advise. The patient doesn´t always experience participation in their own care to the extent they wish, which suggests that nurse?s does not always succeed in getting the patient involved.

Background: Ill-health related to unhealthy lifestyle is increasing and despite existing knowledge about healthy lifestyle it is difficult to change behaviour. Counselling in the primary health care is often superficial and without critical elements for behaviour change. Aim: The aim of this paper to elucidate interventions for change of lifestyle with respect diet and physical activity. Method: A literature review was carried out and ten scientific articles were analyzed and compiled in two main categories: design of these interventions and participation in them. Results: Education, decision making, goal setting, feedback, social support and follow-up were identified as critical elements for behaviour change.

Children are a group of patients that require special knowledge from the anesthesia staff, both general and specific. Theoretical knowledge and practical experience is necessary to adequately care for the child as it anatomically, physiologically and mentally may differ from adult patients.A growing problem in the pediatric population is overweight and obesity. From a stagnation in the early 2000s the prevalence of overweight and obesity among children in the world are again increasing.The purpose of this study was to examine peri-operative care of overweight and obese children.Systematic searches were done in PubMed, CINAHL and Scopus. After the quality audit according to SBU, twelve articles were included for analysis.Results suggest that overweight and obese children have a higher risk of respiratory peri-operative complications. The risk of hospital admission after outpatient surgery was also greater in this group as well as higher costs for health care.Overweight and obese children are complex subjects with more frequent peri-operative risk factors than normal-weight children.

The personnel policy program for the employees in studied municipality includes guidelines for the working environment, saying that health promoting activities is offered to all employees.                              Objective: To investigate how these activities were used and how the staff perceived the activities offered. The aim was also to find out how well the information about current health promotion efforts reached the staff.Method: A qualitative approach was used in the form of interviews. The sample consisted of municipal employees from seven different work sites.  A total of 12 women aged 32-52 years participated. The interviews were recorded and a hermeneutic theory was used to interpret the results.Results: The results showed that most informants used some form of fitness activity. In most cases health care-time was used for anything from walking to organized workouts. The great barrier was lack of information and lack of trained and dedicated health motivators. In several cases, informants had no knowledge about what a health motivator is supposed to do. The informants own suggestions for health promotion interventions included stress management and foot care.Conclusion: The survey showed that respondents were poorly informed about which wellness activities the municipality offered. The result could also be interpreted as a communication gap between the local authority, health motivators and the employees. A request for group activities was detected.  .

Studies in Sweden have shown that the districtnurses had no time for health promotion. The Swedish government also indicate that there is a lack of health promotion and preventive care in Sweden. The purpose of this study was to describe into which extent the districtnurses in the middle and southwest area of Region Skåne worked with preventive care in their profession and into which extent they documented their achievement. The inquiry was answered by 45 districtnurses about background, present situation, preventive care, secondary prevention, tertiary prevention, health promotion and documentation. Results of this study shows that the districtnurses worked mostly with tertiary prevention.

The aim of this study was to map out the quality of the treatment in the forensic outpatient care unity in Malmoe from a patient point of view. This target group, seriously mentally disordered law-offenders, has been neglected in the scientific research. This investigation will hopefully contribute to a positive change in this subject. To achieve a good understanding of this field a methodological triangulation was conducted which included an observational study, a pilotstudy and semistructured interviews. 14 patients and 10 staff members were interviewed.

The purpose of the literature review was to illuminate how family are responded to in health care and their experiences with a sick person in the palliative care. Ten articles dealing with the questions have been used. The questions emphasized how family experienced the response from people working within health care, their own situations and if they felt they were sufficiently informed. The results were presented from out in the questions in two themes families positive and negative experiences. The results show that for the families to have positive experiences of the respons, the situation and the information given, the working within health care have to make families feel part of the palliative care, to the extent they wish to participate..

Background: Contracting asexually transmitted disease is strongly associated with stigmaand shame. Stigma associated with these diseases has a significant impact on self-image andpropensityto seek care. Despitehigh incidencethere is a generallack of awareness about therisks and theeffectsthatthese diseases have on both mental and physical health. Health carepersonnel are experiencing difficulties to meet and care for these patients. Aim: The aim ofthis studyisto describe patients'experiences of health care after they were diagnosed with asexually transmitted disease.

The purpose of this paper is to investigate how social workers, working in a management position in the health care system, perceive the encounter of the medical and social perspective. With seven qualitative interviews, the study tries to conclude whether or not social workers are accepted at managerial positions within the health care sector. The social worker is, as a manager in health care, a leader but at the same time in a professional alienation from the medical caregivers. Organizations in the health care sector are often multi professional and have their own long standing tradition, history and culture. The results show that the conditions for social workers, working in a management position in health care appear to be agreeable.

Background: Mental illness is a growing public health problem which can cause significant disabilities and lead to poor quality of life. As primary care nurses often are the first to encounter these patients they need knowledge to be able to respond appropriately to this group.Aim: The aim was to describe how the sufferer of mental illness experiences the introduction to primary care. Method: The literature review was based on the results of 11 scientific articles which were analyzed with the inspiration of a metasynthesis method.Results: Four categories emerged: the experience of being treated like a human being, the importance of a therapeutic space, the experience of time and availability as well as the importance of competent personnel and the importance of continuity. Patients described different aspects deemed important when encountering nursing staff. Conclusion: Patients experienced that they received good care when they felt listened to and seen as individuals with their own thoughts and feelings.

Abstract:Background: Socialstyrelsen statistics show that breastfeeding continues to decline. Previous research some mother experiencing breastfeeding difficulties and their lack of knowledge and understanding of breastfeeding. Support to mothers varies depending on their individual needs. Factors affecting the choice are the support of health care nurses and the social network. Aim: The aim of this study was to describe health care nurse experiences of giving support to mother who are breastfeeding.