Background One of the main demands on Swedish and global health care in general is to meet the patient?s need for safety. By general health care law this also comprises district nurses? field of responsibility. Although there are numerous studies describing the concept of safety and its different shapes, no research could be found exploring how safety is, or supposed to be, mediated by district nurses? in a Swedish context.

BackgroundResearch shows that the majority of patients feel anxiety before and during anesthesia. It has been shown in several studies that preoperative anxiety may cause adverse effects in the postoperative course. Nurse anesthetists have a key role in creating a safe environment and the opportunity to use different interventions to reduce the degree of anxiety.AimThe aim of the study was to examine which interventions may reduce anxiety in adult patients before and during both general, local and regional anesthesia.DesignSystematic literature review with a quantitative approach.ResultsSeveral studies indicate that gabapentin and pregabalin can reduce anxiety before and during anesthesia. The anxiety reducing effect appeared to be dose dependent. The naturopathic drugs Citrus aurantium blossom and Passiflora incarnata Linneaus were found to reduce anxiety before anesthesia.

Background:  Heart failure is a multidimensional phenomenon with high mortality. Heart failure is treated with angiotensin converting enzyme (ACE) - inhibitors or angiotensin receptor blockers (ARBs) that counteract neurohormonal stimuli that occur in heart failure, as well as providing vessel dilatation, which reduces symptoms and the need for hospitalization and increases survival. Despite this, only about 50% of heart failure patients survive 6 years after diagnosis with drug therapy, and as heart failure is increasing globally, due to improved care and treatment and increasing life expectancy of the population, there is a great need for new drugs such as LCZ696 that acts by dual inhibition of the renin - angiotensin - aldosterone system and neprilysin inhibition.Objective: The aim of this literature study was to evaluate the efficacy of current treatment and possible future treatments on mortality and morbidity in heart failure patients.Results: The examined articles show that treatment with ACE inhibitors in patients with symptomatic heart failure reduces the risk of total mortality by 16% over 3.5 years, reduces all-cause mortality or hospitalization due to heart failure with NNT (number needed to treat) = 10.4 over 3.5 years and increases median survival by 9.2 months over 12.1 years in patients with asymptomatic heart failure. Treatments with high-dose ACE inhibitors reduce mortality and hospitalization because of cardiovascular causes and hospitalizations from any cause by NNT = 30 over 3 years. Beta-blockers reduce sudden death and total mortality and cardiac death or non - fatal myocardial infarction with NNT = 38 and NNT = 23, respectively, over 12 months.

Background: Since the end of the 1990`s the self-harm among adolescents have increased. Research is needed on how to improve the ability to care for these patients. That is why it is important to investigate how patients who self-harm and the next of kin are encountered by the caregivers.Aim: The aim of this study was to illuminate the experiences of encounters with caregivers at self-harm.Method: The study was based on narratives, which in this case means analysis of autobiographies. Five autobiographies were analyzed in accordance with a description by Dahlborg-Lyckhage. Four of these were written by self-harmers and one by a next of kin.Results: Three themes and twelve subthemes emerged which describe both negative and positive experiences of encounters with caregivers.

The main purpose of this thesis was to examine the collection management at five different hospital libraries´ children and youth?s section to discern different roles of the collections. We made qualitative interviews with five hospital librarians. The purpose was also to see how the collection development affected the different roles of the collections. We used two theories.

Background: Suicidal individuals are vulnerable patients in need of a caring relationship. A caring relationship should be based on a real presence were the patient's needs are in focus. Yet research has shown that suicidal patients experience caring that exacerbate their suicidial problems and hopelessness.Aim: To describe the experiences of hope and hopelessness in suicidal patients and their encounter with health care.Methods: In a literature review, in accordance with Friberg (2012) eight scientific papers have used, analyzed and scrutinized to answer the purpose of a new whole.Results: Two main themes emerged in the results with related subcategories. Experiences of hopegiving acts with sub-themes: The significance of  a caring relationship, the significance of a strong social network and the significance of feelings of hopefulness. The second main theme that emerged was: Experiences of acts connected to hopelessness with subthemes: The significance of a non-confirmatory caring relationship and the significance of feelings of hopelessness.Discussions: It is found that suicidal patients experience care that lead to feelings of despair.

Shorter hospital stays increases the need for well functioning post hospital aftercare. Persons close to the patient are often involved in the aftercare and need information about self-care. This need is frequently not satisfied. The aim of this study was to investigate if the next-of-kin of patients cared for at the thoracic clinic at Uppsala University hospital, have received information about self-care and how they perceive the information they have been given. METHOD: To investigate this, questionnaires were sent out by mail.

The 1st of January 2009 a new goal was set for the emergency care in Stockholms läns landsting. This new goal stated that 70 per cent of the patients shall not spend more than four hours in the hospital when requesting emergency care. The processes in the emergency room at Södersjukhuset do not cope with this new goal. The authors studied the reasons for this and made suggestions based on the findings. The conclusions were that the emergency room should place doctors much earlier in the emergency care process or implement a system where specialists act as tutors to non-specialized doctors.

Background: Type 2-diabetes is now a public health problem, which constitutes 85-90 percent of diabetes care. The district nurse´s role in treating a diabetic (/person with diabetes) does not only comprise pure medical treatment but also support, advice and training to the individual. In our profession as nurses, we have found that medical knowledge in patients with Typ 2-diabetes is not always enough to obtain changes in lifestyles.Aim: The purpose of this study was to investigate the illness perceptions in patients with Type 2-diabetes and their impact on health behavior.Method: This qualitative study used grounded theory as a method. Results: The informants described in the interviews, their perceptions of living with Type 2-diabetes. The analysis revealed the main category periodic health behavior built up on and related to five categories developed in data: preventive health awareness, guilt, confidence in medical treatment, motivational problems and periods of insight.Conclusion: This study contributes to understanding of patients with Type 2 - diabetes their beliefs about illness and how it affects everyday lives.Keywords: Believes, District nurses, Groundey Theory, Illness perception, Type 2-diabetes.

SAMMANFATTNINGBakgrund: Fo?r att patientsa?kerheten ska kunna garanteras vid en utskrivning fra?n slutenva?rden till kommunen a?r det viktigt att ra?tt information ges mellan instanserna. Det finns dock problem med kommunikationen vilket kan fa? olyckliga konsekvenser.Syfte: Att beskriva en patients utskrivning, fra?n slutenva?rd till kommunal omsorg, ur kommunsjuksko?terskors perspektiv.Metod: En kvalitativ metod med en explorativ design har anva?nts fo?r att besvara studiens syfte. Grundutbildande och specialistutbildade sjuksko?terskor fra?n fyra olika kommuner intervjuades till studien.

The aim of this study was to increase the knowledge about and deepen our understanding for people who are treated with dialysis in aspects of quality of life and coping strategies. The research questions were: How does the scientific literature describe quality of life and coping strategies from people?s perspective who are treated with dialysis? How does dialysis affect patients and their lives? How/what can the nurses do for people who are treated with dialysis to keep or improve their quality of life. The result is based on eight scientific articles and after interpretation of the result we found six themes that describes how patients have to restructure their lives to a new normal life, how they adapt to a life with dialysis treatment, how dialysis affect their physical condition, witch meaning does the family and others have, how they keep their self-esteem in relation to the dependence of dialysis treatment and which factors are associated with a long life with dialysis..

When a person arrives at the emergency ward at the Uppsala University Hospital with his or her symptoms he or she explains the problems and then a priority process starts. The staff evaluate at which emergency level the patient is located in a model called Triage. The Triage model helps to decide the priority need and is based upon templates which point out in which of the 5 categories a patient is to be placed, to eliminate any future risk regarding his or her health. A lower triage level means lower priority but implies better health when the evaluation takes place. To obtain optimal effect of the Triage model the evaluation of symptoms must be reproducible so that patients with the same symptoms are placed at the same triage level regardless of whom among the staff conducts the evaluation. The purpose of the study was to see if the resources are allocated based on priority level of the patients.

Introduction: Balance between the essential nutritive substances is important for aperson to maintain health. The surgical patient can be stricken with conditions, whichhave a negative impact on this balance and can lead to malnutrition. Working as a nurseit is important to identify patients that are malnourished or is in the risk zone ofmalnourishment since 30 % of all patients in hospitals are malnourished.Aim: The aim of this study was to examine the compliance to the guidelines fornutritional assessment and parenteral nutrition on a surgical ward. Also whether thenutritional treatment/-support was reported to the next caregivers if the patient wasmalnourished or was in the risk zone of malnourishment at the time of discharge.Method: 80 patients enrolled on the ward in the beginning of year 2011 were included.Audit of patient records was made according to the hospital guidelines for nutrition andparenteral nutrition and followed a study specific protocol.Results: The examination of the case records showed that the guidelines for nutritionwere partly complied with. Nutritional treatment/-support was reported to the nextcaregivers when needed.

Physiotherapists treat people with different views of the world and medical beliefs, which require a good understanding of cultural differences. One way to achieve cultural understanding is through self-reflection in a new context. During five weeks the authors, two physiotherapy students, completed a clinical practice at the rehabilitation center Pina Palmera, Zipolite, Oaxaca, Mexico. At the beginning of the period a critical incident was chosen, when the head physiotherapist for the ward Cuidados Especiales intended to sell jewellery to the authors during a treatment of a patient. The authors have by using the reflection framework "Framework to guide reflective process", and Interpretive Phenomenological Analysis (IPA) for analysis, discussed different ways of communication, adherence, education, and self-reflection and critical thinking.

The purposes of litteratur review were to describe patients experiences of living with HIV/AIDS and and their expectations when in contact with care/healthcare. As theoretical frame has Antonovsky, A (1991) salutogenic model, sense of coherence been used. After analyzing the content of the litterature it resulted in 5 categories of experiences and 3 categories regarding expectations. The categories that regards experiences were, to feel frustration and dependance, to switch between hope and despair and suicidal thoughts, to be able to cope with the changing self and to feel social support. The categories that regards expectations were, to feel proffessionalism/competence, to get caring treatment and feeling secure, to feel engagement/individuality in caring.