Intramuscular injections to cats can generate strong reactions in some individuals while reactions of the same extent, according to the author, not always are recognized when using the subcutaneous route. The reactions are probably caused by fear, stress and/or pain. When the injection can generate pain one has to take that into account, which can be a limitation in treatment. It is well known that injections generate pain, but knowledge about the cause and processes of the injection-associated pain is limited. This is mainly due to the difficulty in finding objects to study pain on, high cost of use of laboratory animals and difficulty to obtain objective measurements. Although there is evidence that there may be a local muscle injury by intramuscular injection, it is not always that the extent of damage is related to the pain experienced. Facts about the causes of injection-associated pain have been studied in a literature review.

SammanfattningBakgrund: Långvarig smärta är en individuell upplevelse och kan orsakas av skador eller sjukdomar, och är ihållande mer än tre månader. Detta kan innebära att det blir svårt att klara av sina vardagliga aktiviteter då funktionsförmågan kan försämras, vilket kan medföra ett lidande för individen.Syfte: Syfte med studien var att belysa individers upplevelser av långvarig smärta.Metod: En systematisk litteratur studie genomfördes och 14 kvalitativa studier kvalitetsgranskades utifrån Forsberg och Wengströms (2013) checklista för kvalitativa studier. Artiklar analyserades enligt Axelssons (2012) metod som innebär att gå från helhet till delar och till slut komma fram till en ny helhet, detta resulterade sedermera i sex teman.Resultat: Att leva med långvarig smärta kunde påverka och begränsa individens liv både fysiskt, psykiskt och socialt. Smärtan gjorde att individerna försökte anpassa sin vardag genom att hitta strategier för att hantera sin smärta. En del beskrev bristande förståelse från både anhöriga och vårdpersonal.Slutsats: Genom att lyssna och vara lyhörda kan sjuksköterskor öka sin förståelse för hur individer upplever långvarig smärta.

Bakgrund: Smärta är ett flerdimensionellt fenomen och ett vanligt problem inom äldrevården. Smärtbehandling finns att tillgå, trots detta är smärta underbehandlat hos äldre patienter.Syftet: Syftet med studien är att belysa hur sjuksköterskor bedömer fysisk smärta i omvårdnad av äldre patienter.Metod: Litteraturöversikt med kvalitativ ansats har använts. Datamaterialet bestod av fem kvantitativa och fyra kvalitativa vetenskapliga artiklar.Resultat: Det framkom tre huvudkategorier: smärtbedömningsprocesser, smärtbedömningsmetoder och smärtbedömningsredskap. Ur huvudkategorierna urskildes sex underkategorier: smärtidentifiering, smärtbedömningssvårigheter, kommunikation med patienterna för att bedöma smärta, smärtobservation, smärtbedömningsinstrument och dokumentation.Slutsatser: För att göra en smärtbedömning behövs en god relation till patienten, närstående och övrig personal där kommunikation har central roll. Sjuksköterskan måste tro på patientens egen skattning och smärtupplevelse..

Bakgrund: Smärta och smärtbehandling är en viktig del i sjuksköterskans yrkesutövning. Det är därför viktigt att ha kunskap om olika behandlingsmetoder för att på ett individanpassat sätt främja en god omvårdnad. Cannabis har länge använts i medicinskt syfte bland annat för att hantera smärta. En adekvat smärtlindring är av betydelse för patientens livskvalitet.Syfte: Att beskriva hur patienters livskvalitet påverkas av att använda cannabispreparat som analgetika vid långvariga smärttillstånd.Metod: Litteraturstudie med systematiska sökningar valdes som metod. Sökningarna utfördes i databaserna PubMed, CINAHL och PsycInfo, även manuella sökningar genomfördes.Resultat: Resultatet är baserat på 21 vetenskapliga artiklar med olika ansatser.

Background: Vacuum assisted closure, VAC, is a method which can benefit wound closure. There are not many reliable studies about the effects of VAC in different types of wounds. Previous studies have shown that patients have experienced pain during dressing changes.Aim: The aim of the study was to survey in what kind of wounds the vascular surgery ward have been using VAC, to study the treatment process of VAC and how it has been documented and also to investigate if patients with VAC experienced pain during dressing changes.Method: The patients were chosen from a ledger, which contained 77 patients that had been treated with VAC on the vascular surgery ward. Data were collected with a journal survey protocol.Results: The result is based on 67 patients with a total of 79 wounds. VAC was shown to have a good effect on wound healing and infected surgical wounds were the most commonly wound category undergoing treatment with VAC.

Syfte: Syftet med denna studie är att bland patienter med långvarig smärta, som är remitterade till en smärtmottagning, undersöka förväntningar avseende det första besöket, i vilken utsträckning patienterna anser att dessa uppfylldes samt att undersöka vilka förväntningar patienterna har på den fortsatta vården och kontakten med Smärtmottagningen. Metod: En empirisk studie med kvalitativ deduktiv ansats. Datainsamling skedde genom att tio personer intervjuades på Smärtmottagningen efter deras första besök. Materialet bearbetades med manifest innehållsanalys. Resultat: Patienter vid Smärtmottagningen hade i olika stor utsträckning förväntningar inför det första besöket och den fortsatta vården.

This is an examinaton of welfare officers and patients experiences of a course in mindfulnessbased stressreduction in primary care. The authors used a qualitative method and a phenomenological hermeneutics scientific philosophical position. The analys of the data appeared by using three theoretical perspectives; cognitive, coping and Antonovskys Sence of Coherence. The purpose was to get a deeper understanding of what mindfulness is, how a course in mindfulnessbased stressreduction can be arranged and how it is comprehended by the welfare officers and previous participators of the course. To get an opinion of the issue the authors wanted to know the welfare officers intention of the course, to which patients they provide the course, what the participators thought about their situation before and after the attendence and if they had assimilated the knowledge and if so how it was applicable.

Abstract Chronic heart failure is a common disease in elderly, and is the most common reason for hospitalization in patients over 65 years of age. Research on the elderly and heart failure often focus on treatment strategies, less research is available on patients' own experiences of living with chronic heart failure. The purpose of this interview study, was to gain more knowledge about patients´ own experiences of living with chronic heart failure. Nine patients were interviewed and the text was transcribed verbatim and it was then analyzed with a phenomenological hermeneutical method. From the analysis, three main themes emerged.

Background: Many Swedish inhabitants origin from different countries with different cultures that may show pain in other ways than Swedes. The Swedish law stress that nursing care should be done individually according to the patient's capabilities and needs. Aim and Method: The aim of this study was to describe nurses´ experiences of encounters with patients from other cultures with pain, and also their next of kin. Qualitative interviews were carried out with seven nurses. The interviews were analysed with the starting point in Giger and Davidhizars Transcultural Assessment Model and the six phenomena: communication, space, social organisation, time, environmental control and biological diversity.

The purpose of this study was to investigate women's experiences of pain, bleeding,to discover the fetus, hospitalization associated with medical abortion at home and toexplore differences in experiences between different groups of women, as age orprevious childbirth. The study was conducted at two gynecological clinics in Uppsalaand in Stockholm. A questionnaire was distributed and analyzed using a quantitativeanalysis method. The response rate was 30 %. Most women were satisfied with thepain relief given to them from the hospital.

Musculoskeletal disorders (MSD) are common in individuals with computer based work. Thecurrently known risk factors for these disorders is in the literature derived to physical,organizational and individual factors. A recent survey of three working groups at a companyin Stockholm explored that more than 50% of the employees had neck and shoulder problems.Aim: The study aims to create a better understanding for the current musculoskeletalproblems at the company. Such an understanding is created by examining the physical,organizational and individual risk factors in the workplace and the result can provide a goodbasis for intervention proposals.Method: In order to answer the aim of the study the authors chosed to use both qualitativeand quantitative methods of data collection through interviews and questionnaire survey. Theinterview and questionnaire was designed to create both a specific and comprehensive pictureof the physical, organizational and individual risk factors having a bearing effect on theexisting MSD problem.Result: Seven categories were compiled from interviews, which largely deals with the factthat high demands can lead to behaviors that may pose a significant risk for the occurrence ofMSD.

Smärta förekommer inom all sjukvård och är ett komplext problem, speciellt inom intensiv- och postoperativ vård då patienten ofta inte själv kan beskriva sin smärta eftersom patienten ofta är medvetslös eller är sederad. För att bedöma smärta finns olika verktyg, men för de som inte själv kan beskriva sin smärta är detta en svårighet. Syftet med studien var att undersöka reliabilitet och validitet på smärtbedömningsformulär inom intensiv- och postoperativ vård. Metoden vi använde oss av var en kvantitativ litteraturstudie för att besvara vårt syfte. Databaser som använts är CINAHL, PubMed och SweMed+, med sökorden nurse*, pain scale, pain assessment, pain measurement, questionnaire, postoperative och intenisive care.

This study deals with the complex phenomenon of occupational health. There is knowledge of how a good work environment should look like, but despite this, many employees experiences ill health in the workplace mainly in the form of neck and back pain. This study is a case study conducted in a high-risk workplace. The overall purpose was to describe and analyze the health situation of a specific company with neck and back problems. Mainly, eight interviews had been used as the data collection method, but additional observations had also been implemented.

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease. The disease is the fourth leading cause of death and more than 5 percent of the adult population worldwide is affected.The aim of this study was to investigate the association between periodontitis and COPD.Search for material for the literature review was done in the medical database PubMed where the keywords were: "Chronic obstructive pulmonary disease" and "Periodontal health or periodontal disease". The result is based on twelve studies that were extracted and analyzed. The studies have investigated pocket depth, attachment loss, plaque index, bleeding on probing and bone loss. Ten studies compared a COPD group with a healthy control group, one study compared two COPD groups and one study examined a COPD group and a group with other lung diseases.Most studies found that people with COPD had a higher incidence of pocket depth, attachment loss, plaque index, bleeding on probing and bone loss.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: A vegetarian diet, a possible treatment complement for relief of symptoms ofrheumatoid arthritis? A systematic review.Author: Alexandra Ahlsén and Caroline ForsbergSupervisor: Mette AxelsenExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012Background: Rheumatoid arthritis (RA) is a chronic remitting polyarthritis that is relapsing.Symptoms are inflammation of the joints with pain, stiffness and degradation of joint tissue.In some cases, also other parts of the body are involved. The treatment consists ofmedications to reduce pain, inflammation and degradation of joint tissue. Today, the offerednutritional treatment is primarily focused on meeting energy requirements and nutrient needs.The diet has also been discussed as symptomatic treatment, and one of the factors believed toinfluence the symptoms is meat.Objective: To assess the evidence as to whether a vegetarian diet affects the symptoms ofrheumatoid arthritis, and if so, to suggest how it can be implemented in practical dieteticswork.Search strategy The databases used in the literature search was PubMed, Scopus, and AMED.The search words used were: "rheumatiod arthritis", "vegetarian", "vegan", "diet", "meat" and"animal protein".Selection criteria: Studies investigating a vegetarian diet on the symptoms of RA wereincluded. Only RCT, clinical trial, controlled clinical trial, human studies and original articlesin English or Swedish were included.