Bakgrund: I Afrika är behovet av palliativ vård stort efter utbredning av HIV, samt cancer och andra sjukdomar. Den palliativa vården avser att öka livskvalitet en hos patienter och närstående, lindra lidande och behandla smärta. World Health Organization startade ett projekt för att utveckla palliativ vård i Afrika, ett projekt som önskar utveckla synen på palliativ vård, integrera den i vårdprogram och förbättra möjligheten till läkemedelstillgångar och utbildning. Sjuksköterskan är en central figur inom den palliativa vården och relationen är betydelsefull för patienten. För sjuksköterskan är mötet med den palliativa patienten både smärtsamt och stressfullt, och väcker starka känslor.Syfte: Beskriva sjuksköterskors upplevelse av palliativ vård i Tanzania.Metod: En empirisk studie och datainsamling i form av semistrukturerade intervjuer genomfördes med åtta sjuksköterskor i Tanzania.

The focus in this paper was on managers in the middle position in the care of the elderly and people with disabilities. The aim was to develop knowledge about the conditions of work among managers in the middle position and what they characterized as good leadership and which strategies they used in their work. The empirical data consisted of nine qualitative interviews with managers in the middle position in the municipality of Halmstad.The frameworks that mainly limited the middle managers' discretion were laws, political regulations and most of all it was the allocated budget. Their discretion was found closer to the operation such as working methods, recruitment and changes in job schedules. The middle managers spent the majority of their working hours with personnel administrative work and that they often had to prioritise among their tasks.

Nursing care of persons having dementia diseases affecting the frontal lobes, sets special demands on the staff, but the knowledge about how to best tailor nursing care is sparse. The aim of the study was to illuminate possibilities and difficulties in nursing care of persons having dementia diseases with frontal lobe dysfunction and was carried out as a descriptive, qualitative study, based on a review of medical records and interviews with nursing staff (n=10) that was analysed with qualitative content analysis. The difficulties were related to the patients lack of inhibition and judgement, anxiety, agitation, reduced ability to care for physical needs, egocentrism, imbalance between rest and activity, and depressed mood. The possibilities were seen in relation to the nursing staffs professional encounter, characterised by being distinct and consequent, being a step ahead, being flexible and catch the moment, being calm and create a positive atmosphere, being close and trusting and being and doing together. To receive continuous feedback and support was a prerequisite for the staffs? engagement.

The level of help and support given to elderly people over the age of 65 has been regulated by two separate laws; 1-the Act concerning Support and Service for Persons with Certain Functional Impairments (LSS) and 2- Act of Social Services (SoL). Recent changes in the legislation could cause local authorities to deal with these issues in different ways. The aim of this study was to examine and evaluate possible differences in the level of support for the elderly, dependant on which of the two laws was used in the decision process.The questions raised in this paper are· What are the major differences in the purposes of the two legislations?· How will the decisions be influenced dependant on what law is used? Do the decisionmakers identify the difference between the quality levels "good" and "fair"?· How is the process of care organised and managed within each of these legislations and how is the personnel used?· Are there differences in quality regarding freedom of choice, your own right to decide, influence, comprehensive view and continuity in the efforts given?· What development can you see in these fields of care.As a method I have used a case study involving four big cities in Scania. The most interesting and essential knowledge in the study was obtained from qualitative interviews with eleven decision-makers in the four communities.The result of this study indicates that there are more similarities than differences in the purposes of these laws.

Shivering är ett fenomen som uppstår hos patienterna postoperativt. Det innebär att patienten har okontrollerbara muskelskälvningar som gör att patienten darrar, skälver eller huttrar i mer än 15 sekunder. Shivering påverkar kroppen negativt, men är också obehagligt och ett onödigt lidande för patienten. I takt med den tekniska utvecklingen utarbetas nya operationstekniker och idag utförs flera operationer med laparoskopisk teknik. Pilotstudiens syfte var att undersöka före-komsten av postoperativ shivering hos patienter som opererats med laparoskopisk teknik.

ABSTRACTPressure ulcers are a serious health damage that causes great suffering, prolonged hospital stays and increased health care costs. Patients undergoing surgery are at high risk of developing pressure ulcers and it is the operating theatre nurse responsibility to protect against health damage through nursing. There are little research made in the area of perioperative pressure ulcer prevention. In order to investigate perioperative pressure ulcer preventive care measures that are described in the litterature and to answer the question how the operating theater nurse can protect the patient, a pilot study of a systematic literature review was carried out. Data base searches were conducted in PubMed and Cinahl from where ten articles were selected and examined for their quality and content.

Background: There might be a risk that family members experience limited possibilities to act, participate and influence the end of life care for the elderly in the nursing home. For family members it could be the first time they face death which can imply a lot of questions and existential needs. Aim: The aim of this study was to examine the needs of family members in the patient terminal care in a nursing home. Research methods: The study implemented a qualitative approach and data was collected through four interviews and through a literature review were 17 articles were selected. The results were processed and analysed with a qualitative content analysis and two main categories, participation and assurance with subcategories were identified.

The Purpose of the study was to highlight the primary care managers' perception of the barriers and opportunities in the implementation of the national guidelines for harmful drinking and alcohol abuse in KalmarCounty. The data was collected by questionnaires which were directed to all primary care managers in the county. The response rate was low, 40%. The data collection was complemented at a later stage with a non-response analysis. To analyze the results implementation theory with following terms were used: wants to, understand and know.

SAMMANFATTNING                                                                                             Syftet med interventionsstudien var att undersöka om ROAG (revised oral assessment guide) munbedömningsinstrument förbättrade sjuksköterskor bedömning av cancerpatienters munhälsa på en palliativ vårdenhet.Metoden hade en kvasiexperimentell design med en journalgranskning före och efter en intervention. Interventionen bestod av en kortare utbildning av munhälsa samt införandet av ROAG munbedömningsinstrumentet.Resultatet visade att både bedömningar och åtgärder av munhälsan har ökat statistiskt signifikant jämfört med före interventionen på den palliativa vårdenheten, resultatet visar också att det inte alltid finns rätt koppling mellan symtom och åtgärd.Slutsats ROAG munbedömningsinstrument är ett bra verktyg för sjuksköterskor att använda för att bedöma munhälsan på en palliativ vårdenhet, men det räcker inte bara med ROAG munbedömningsinstrument utan det behövs kontinuerlig utbildning för att förbättra bedömningar och åtgärder ..

Background: Examinations with the intent to assess neurological functions and level of conciousness are common in neurocritical care, but the effect on the patient is not entirely researched.Aim: The purpose of this study was to describe the patient?s situation at the neurological wake-up test concerning the environment, nursing interventions and the possibility given the patient to become awake, and if these conditions affect the outcome of the wake-up test.Methods: A quantitative observational study took place at a neurocritical care unit, where 20 patients were observed from interruption of sedation to the neurological assessment, which was performed by a neurosurgeon or a specialized critical care registered nurse. Nursing interventions, environmental factors and physiological parameters were documented.Result: Twelve intervention varieties to control patients? physiological parameters were used. CPP > 80 mmHg was found in 90 % of observations.

The aim of the study was to describe the oral health development among patients at the Public Dental Care clinic in Bromölla who made an agreement regarding Healthy Dental Care during the years 2001 and 2004, compared with patients who did not made such an agreement. The study material was obtained from dental journals in total at 150 patients. Data regarding age, sex, health status, tobacco use, plaque- and gingivitis values, pocket depht, initial- and manifest caries, risk assessments, preventive measures by dental personel and acute dental care between year 2001 and 2004 was obtained from dental results. Almost twice as many man made an agreement compared to women. Tobacco use was higher in control group both 2001 and 2004.

More people are likely to be diagnosed with cancer and the number of people living with cancer is expected to increase, which means that patients live longer with cancer and different treatments. All patients in Sweden should have access to a nurse navigator to facilitate the cancer trajectory. The purpose of this literature review was to delineate patients' experiences of the care given by the nurse navigator. The result is based upon twelve scientific articles included in this review. The results show that the experiences of the patients can be divided into four different categories: emotional support- being present and offering supportive talks, support for physical symptoms- counseling and relief from symptoms due to illness and treatments, educational support- receiving information and knowledge about the disease and cancer trajectory and coordination support- collaboration with other healthcare professionals involved in patients´care.

The purpose of this report was to investigate what characterizes a good psychosocialwork environment, and whether it may have impact on a vessel's safe voyage. Thisreport is proposed to increase the understanding of what creates a good psychosocialwork environment and its potential effect on safety at sea. In order to find out thesuccess factors for a good work environment group interviews were conducted in socalledunstructured focus groups. During these conversations, the participants discussedfreely by the question "what is a good psychosocial work environment for you?? Thesuccess factors were thereafter applied on selected accident reports, to investigate theextent to which they were represented and taken into account.The results of the study show three categories of factors: colleagues, communicationand competence, where colleagues are the main contribution to a good psychosocialwork environment.

Background: Borderline personality disorder is a psychiatric diagnosis that one to two percent of the population and at least every fourth patient that have received treatment at a psychiatric clinic has been diagnosed with. BPD is most common in women between teenage and early adulthood. Purpose: The aim of this literature study was to emphasize the nursing care of patients diagnosed with BPD within different perspectives. Method: A literature study was conducted to get a deeper understanding for the nursing care of patients with BPD. The search for pertinent articles, answering to the aim of the study, was done in different databases.

Background: Heart failure is a complex condition which means that the hearts capacity topump blood is reduced. The aim of this study was to investigate how patients with heartfailure considered their knowledge and the information they received about their disease andself-care.Method: Patients suffering from heart failure, hospitalized at section 30 E (n=13), andpatients visiting the nurse led heart failure clinic (n=4) at Akademiska sjukhuset in Uppsala,were requested to participate in the study. The patients answered questions about knowledgeand information concerning self-care and their disease. Data were analyzed using SPSS 15.0.Results: The patients valued their knowledge about the disease as lower than their knowledgeabout self-care. The study showed that all the patients found the information they hadreceived about their self-care better than the information they had received about theirdisease.