Swedish healthcare has experienced increased economic pressure during the last decades and organizations have faced many changes. Managers and their roles in organizations have also been affected by the changes. Traditionally, managers in the healthcare sector are highly specialized doctors with a strong medical background. In the thesis, we study a big private healthcare company with an ambition to lead the development in the sector. In order to accomplish its goal, the company is trying to change the organization of managers.

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.

Background: Many women experience high levels of pain after caesarean birth. Adequate postoperative pain treatment is important for the mother to be able to breastfeed, take care of the infant and experience a positive birth. Objective: The overall aim is to study women?s experience of postoperative pain and pain relief after caesarean birth. Method: A quantitative retrospective survey.

Aim: The aim was to investigate the ambulance nurses experiences during a specific ambulance missions that led to usage of LUCAS ?.Method: Participating ambulance nurses were randomly assigned from a total sample group of 12 women and 39 men. Five women and five men participated. Qualitative interviews were conducted, where the Critical Incident Technique approach was used. Collected interviews were valued using qualitative content analysis.Result: Interview texts were divided into three domains, 10 subcategories could be identified which were sorted into three categories.

Inledning: Syftet med föreliggande studie var att testa interbedömarreliabiliteten för det i Sverige vanligaste triageinstrumentet Rapid Emergency Triage and Treatment System (RETTS). Instrumentet består av 42 kontaktorsaker (ESS) som kombinerat med mätta vitalparametrar, t.ex. blodtryck och puls, ger en triagefärg. För att kunna bedriva evidensbaserad omvårdnad krävs att instrument, skalor och metoder är valida och reliabla. Statens beredning för medicinsk utvärdering anser att RETTS saknar både validitets- och reliabilitetsdata.Metod: Två ESS från instrumentet valdes.

Urination is a biological need but the routines surrounding urination are culturally specific and ever changing. This makes the organization of public space an important part in deciding what actions are made possible for the people in it. This paper considers women?s public urination and the possibilities to merge the need to urinate and the construction of the female body as feminine.A number of texts that describe the construction of the female body and identity as both gendered and socially produced are analysed in relation to women?s experiences of incontinence. Incontinence as a medical diagnosis is by this becoming possible to question, and may be seen as one of several strategies used to manage both the organization of the public space and the expectations of the female body to be a docile body.The conclusion is that a woman who wants to enter public space has the following options when it comes to the need to urinate:To strive for the feminine ideal.

Objective: The purpose of the study is to explore and illustrate how ultrasound midwives and medical specialist in obstetrics and gynecology believe the information given to parents about the genetic soft markers should be handled.Design: A quantitative questionnaire study with cross-sectional design. Participants: 44 ultrasound midwives and 37 medical specialists in obstetrics and gynecology.Findings: Most of the participants would like to inform before the ultrasound starts that they will be looking for genetic softmarkers during the ultrasound. Likewise the majority wanted to inform the parents about possible increases in the risk for chromosomal abnormalities based on findings on the routine ultrasound. There was a difference in frequency between those who responded that they would like to inform before the ultrasound that they will be looking for genetic softmarkers and those who responded that they believe the future parents wants information before the examination.Key conclusions: It could help health care professionals in their role as information providers if there were common recommendations for the information to be given to future parents about genetic softmarkers in connection with the routine ultrasound.

Sedan oktober 2011 sköter Sjukvårdens Larmcentral, SvLC, utalarmeringen av akuta sjukdomsfall som inkommer vid 112-samtal. Samtidigt infördes ett nytt medicinskt beslutsstöd för de sjuksköterskor som tar emot de akuta samtalen. Då orsaken till buksmärta är komplext och svårt att identifiera hos patienterna valdes just detta tillstånd för granskning.Syfte: Att undersöka om det medicinska beslutsstödet för sjuksköterskorna på SvLC i Uppsala län är en tillförlitlig hjälp i identifieringen av patienter med akuta buksmärtor, samt att undersöka om det fanns ålder-eller könsskillnader.Metod: En empirisk kvantitativ studie med en retrospektiv journalgranskning. Sammanlagt 151 patienter som ringt ambulans på grund av buksmärta och som av larmcentralen prioriterats som livshotande (prioritet 1) eller brådskande (prioritet 2) har granskats.Resultat: SvLC´s initiala bedömningar stämde väl överens med de prehospitala bedömningar sjuksköterskan i ambulans gjorde. Hos prio1-gruppen hade 48 % diagnostiserats buksmärta UNS, det vill säga buksmärta utan närmare specifikation, och hos prio 2-gruppen var det 40 % som fått samma diagnos.

Arbetsuppgifterna på ett fartyg kan innefatta hård fysisk påfrestning samt arbete i mörker, påhög höjd och i slutna utrymmen vilket betyder att sjöfolk måste vara lämpliga för tjänstgöringen.De nationella reglerna för medicinsk lämplighet för sjöfolk skiljer sig trots att deninternationella standarden är densamma för alla. Syftet med denna rapport är att åskådliggöraskillnaderna mellan regelverken om läkarintyg för sjöfolk i de skandinaviska länderna ochundersöka historien bakom de svenska föreskrifterna.Vår slutsats är att det skulle gagna Sverige att återinföra Sjömansläkare, som troligtvis är merkompetenta än en icke specialiserad läkare vad gäller tjänstbarhetsbedömning för sjömän.Systemet med sjömansläkare är fortfarande i bruk och fungerar väl i både Danmark ochNorge.Slutligen sammanfattas rapporten av författarnas egna reflektioner kring ämnet i relation tillresultatet. Förslag till vidare forskning återfinns i slutet..

ABSTRACT Introduction: During the past 40 years the ambulance service in Sweden has evolved from mainly being a source of transport to today?s high-tech caring facilities that enable qualified care to start already in the patient?s home. This first level of care is now provided by registered nurses and registered nurses with specialist training in pre hospital care.At the same time as the care provided is becoming more advanced, results from studies demonstrate that the amount of dispatches to patients that lack the need for ambulance care and transport is increasing. Nurses in pre-hospital care possess the knowledge, training and authority to perform an initial assessment of patients and also treat patients according to local and national guidelines. After the treatment it would sometimes be possible for the patients to remain at home without having to use ambulance transport to an emergency department or in other cases find other means of transport to hospital.

Anafylaxi är en akut, oförutsedd, allergisk reaktion som kan uppkomma när som helst. Alla sjuksköterskor skall ha kunskap om anafylaxi, samt beredskap att ta hand om denna reaktion på ett korrekt sätt. I bakgrunden beskrivs den immunologiska mekanismen vid anafylaxi och allergi, symtom och behandling, samt det omvårdnadsvetenskapliga perspektivet. Syftet med denna litteraturöversikt var att identifiera och beskriva bidragande orsaker som ligger bakom osäkerheten kring anafylaxi och därmed ge en ökad kunskap om anafylaxi i sjuksköterskans professionella omhändertagande. Metoden som vi har använt oss av har varit litteraturstudie och sökning har skett via databaserna Pubmed, Cinahl och Scopus.

Varje år drabbas 30 000 svenskar av stroke, vilket innebär stora personliga omställningar och stora kostnader för samhället. Den mest effektiva behandlingen, trombolys, måste ges så snart som möjligt för att ha god effekt.  Samtidigt som det är av största vikt att ta reda på om patienten har några differentialdiagnoser som gör behandlingen riskfylld.Den här studien undersöker hur strokekedjan går till och vilka faktorer som påverkar beslutsfattandet. Studien är baserad på etnografiska fältstudier på fyra svenska sjukhus och materialet är analyserat med metoder från sammansatta kognitiva system och målorienterad design. Resultaten visar att trots olika organiserade strokekedjor på de olika sjukhusen är processerna desamma och direkt kommunikation är mest framgångsrik för att effektivt sprida information mellan dem. Neurologjouren är viktig roll som, liksom resten av aktörerna i strokekedjan, ständigt balanserar sitt beslutsfattande mellan effektivitet och grundlighet.

Featured adjuvant chemotherapy treatment in women with breast cancer can lead to pain. The aim of this study was to explore, the variety of perceptions and impact of adjuvantchemotherapy-induced pain in daily life, of some women newly diagnosed with breast cancer.Inclusion criteria were participating in an ongoing stress management projectand chemotherapy of (anthracycline/taxan) in doses of 75mg² or more. Exclusioncriteria were inability to understand and communicate in Swedish and mentalillness. After ethical approval of the sub study in September 2010, women wereconsecutively included through oral and written request. Phenomenologicalapproach was used in the eight interviews and data analysis.

ABSTRACTThe discussions about energy use have increased year by year everywhere in the society, and so also in the healthcare sector. But what is actually energy use in a hospital facility, and what affects it?The typical way today to express the energy use is in kWh/m2. The problem with a key performance indicator that is expressed as energy use in relation to a specific area is that it does not take into account the activity in the building. Even though the activity to a very high extent affects the energy use.

ABSTRACTThe discussions about energy use have increased year by year everywhere in the society, and so also in the healthcare sector. But what is actually energy use in a hospital facility, and what affects it?The typical way today to express the energy use is in kWh/m2. The problem with a key performance indicator that is expressed as energy use in relation to a specific area is that it does not take into account the activity in the building. Even though the activity to a very high extent affects the energy use.