Bakgrund: Sepsis ?r ett livshotande tillst?nd med h?g global d?dlighet, som kr?ver snabb identifiering och behandling. Sjuksk?terskor p? akutmottagningen har en central roll i att uppt?cka tidiga tecken p? sepsis. Utmaningen ligger i symtomens ospecifika karakt?r, vilket g?r sjuksk?terskans strategier och kliniska bed?mning avg?rande f?r patientens ?verlevnad. Syfte: Syftet ?r att unders?ka vilka strategier sjuksk?terskan anv?nder sig av vid identifiering av tidiga tecken p? sepsis p? akutmottagningen.

Bakgrunden beskrivs utifrån ett globalt och svenskt perspektiv hur levnadsvanor påverkar människors hälsa negativt. Den vanligaste ohälsosamma levnadsvanan är övervikt och den ökar globalt samtidigt kan övervikt leda till sjukdomar. Vidare beskrivs motiverande samtal (MI) och vårdande samtal som kan vara en del i behandlingen vid livsstilsförändringar. Problemformuleringen beskriver sjuksköterskans roll i arbetet med patienters livsstilförändringar. Syftet är att belysa patienters upplevelser av motiverande samtal vid livsstilsförändringar.

Cancer is one of the most feared diseases in veterinary medicine today, and the incidence is higher than ever due to the fact that our companion animals live longer then they did ten to twenty years ago. Cancer is also one of the most common causes of mortality in older companion animals. This literature review will be about two of the currently most common form of cancer treatment of companion animals in Swedish animal hospitals, chemotherapy and radiation therapy. There will also be a section of general nursing care for cancer patients. The section of chemotherapy will describe the indications for choosing chemotherapy, the way to administrate chemotherapeutic drugs, describe specific chemotherapeutic drugs, potential side effects of chemotherapy, and how to handle and store chemotherapeutic drugs safely. The section of radiation therapy will describe the current devices for delivering radiation therapy, describe the indications for choosing radiation therapy and describe potential side effects that radiation therapy may cause.

The main objective of this study is to divide a number of colorectal cancer cases into subgroups based on their molecular features using cluster analysis. The data used is supplied by a research group at Pathology, the Department of Medical Biosciences, Umeå University, and consists, after some preparation, of 455 observations which is a larger data set than many similar studies. The molecular variables that the clustering is based on are CIMP (CpG Island Methylator Phenotype), MSI (Micro Satellite Instability), BRAF- and KRAS-mutations. These are categorical variables and consequently the clustering method used is PAM (Partitioning Around Medoids) which is particularly useful with data on diverse variable level. The final analysis results in four subgroups that are represented by different combinations of attributes on the aforementioned variables.

Background: More focus has been placed towards autonomy when it comes to care and in special towards palliative care. The purpose with palliative care is to relieve and support at the end of the life. When the patient has difficulties to communicate to those around him due to his illness it is hard to preserve the patients right of self-determination. It is very important to consider the patient as autonomous during the course of the illness. Different alternatives have been developed to preserve the patient?s autonomy such as dedicate a deputy or plan the care of the patient in advance.Aim: The aim of this study was to describe, from an ethical point of view, how the patient?s autonomy could preserved at palliative care.Method: A general literature study where 11 scientific articles have been analysed from a qualitative checklist whereof the result has been discussed based on the principles of ethics.

SAMMANFATTNINGBakgrund: Diabetes är en sjukdom, där patienten med diabetes dagligen fattar beslut gällande sin sjukdom. Genom empowerment kan patienten upptäcka och använda sin egen inneboende förmåga att kontrollera sin diabetes, vilket skapar förutsättningar för en mer individanpassad egenvård.Syfte: Litteraturstudiens syfte var att beskriva hur empowerment kan främjas i omvårdnaden av den vuxna patienten med diabetes.Metod: Den metod som användes var en systematisk litteraturstudie med beskrivande design. Sökningar har gjorts i databaserna Cinahl, Medline och Medline PubMed, med sökorden diabetes, empowerment, nursing och caring.Resultat: För att arbeta empowermentfrämjande krävs en förändring av sjuksköterskans yrkesroll där också patientens egen kunskap om att leva med diabetes erkänns. Att vara en god lyssnare, förmedla kunskap om diabetessjukdomen, vara öppen och lyhörd för varje patients individuella behov och uppmuntra patienten att själv finna lösningar på egenvårdsproblem är viktiga delar för sjuksköterskan och övrig sjukvårdspersonal att arbeta med.Slutsats: För att sjuksköterskans yrkesroll ska kunna förändras och nya arbetsmetoder utvecklas är tid, stöd, utbildning och handledning till både sjuksköterskorna själva och den övriga personalen som arbetar runt patienten av betydelse..

Background: Physological abuse consists of threats, harassment, humiliation, telling off, refuse to talk, social isolation, abandonment as well as attitudes that lead to a feeling of insecurity and desperation. Institutional elder abuse is very elusive and an overall picture is still considered missing.Aim: The purpose of this essay was to review psychological abuse within the elderly care.Method: This essay is based on a literature study with systematic search.Result: This article review led to main categories and the result of the study is presented after these. The first ones gives a picture of the kind of psychological abuse that occured within the the elderly care. The second one deals with the possible explanations for psychological abuse within elderly care. The result showed that verbal assault was the most common form of psychological abuse against elderly.

Background:An increasing number of patients with an oncology diagnose will be seen in the future. The oncology care is complex and in great need of nurses with a high level of competence. There is a lack of previous research in the specialist oncology nurses competence and therefore knowledge of their skills can reveal an understanding of their competence.Aim:The aim of the study was to describe the competence of the specialist oncology nurse.Method:Four oncology nurses and two directors of oncology care were interviewed. The interview text was analyzed using qualitative content analysis.Results:The result showed that the oncology nurses had developed six different competences within different areas. These competence areas were assertiveness, patient-centered care, ethical and moral-, pedagogical-, to lead and develop- and theoretical competence.

Background: In studies about Romani people?s health, it becomes clear that the Romani inseveral countries have a poor health and avoid seeking health care.Objective: The purpose of this study was to explore Romani men's experiences of treatmentin the Swedish health care.Method: A qualitative interview study was conducted with respondents about theirexperiences in individual interviews. Seven male Romanis were elected with a purposefulsample. A content analysis by systematic text condensation on the data obtained was made asdescribed by Granheim & Lundman (2004).Results: The summed up impressions of the responses was perceived to be good, however,many men believe that the information is inadequate. Staff at the emergency department inUppsala should listen more to patients.

The aim of this study was to examine young men born between 1990-1995 with anorectal malformations (ARM) whom have undergone the new PSARP-operation starting in 1990, and how they experience their psychosocial and sexual health. The study also examines how they cope with their life situation and what their experience is of the health care and how they were responded to through out the years. This study is a qualitative research and consists seven semi- structured interviews with young men between sixteen and twenty years old. The analyses of this material resulted in three themes around which the study centers: psychosocial health, sexual health and the medical establishment and the informants thoughts about the proposition of counseling for themselves and other individuals born with ARM. The study shows that these young men have a good psychosocial health and a likely reason for that is good parental relationships and close friendships.

The purpose of this article is to explore the technologies of government that are created within gender disorder assessments as an institution. I have done so by utilizing Norman Faircloughs discourse analysing instrument ?communicative action?, which focus on the social institution as relational.The material is strategically chosen by gathering texts from the Swedish state, the psychiatric clinics, NGO:s and by performing interviews with transsexual patients.When analysing the communication of the main agents, I have concluded that practices highly are a result of repeating text and speech inside the institution. The psychiatric assessments can also be seen as an illustration in changes in how citizens are governed in advanced liberal societies, where the role of the state has been gradually reduced in favour of other agents.I consider that the change illustrates an ?acting at a distance?-mentality where the patient is introduced to participate in the definition of the care in what I call ?negotiation as a technology?.

Background: Research shows that the nurse?s presence has a great significance for the relationship between patient and nurse. By this, the nurse can gain a greater understanding for the patient?s situation and thus have an opportunity to influence the patient?s health processes.Problem: Today?s focus on the technology and lack of time in healthcare can create a stress which can make it more difficult for the nurse to prove presence to the patient.Aim: To describe patients? experiences of the nurse?s presence in healthcare.Method: A qualitative approach, where Evans descriptive synthesis has been used. Eleven previously published qualitative, caring science, articles has been used in the synthesis.Results: The synthesis revealed two themes.

Alzheimers sjukdom är mycket vanligt förekommande sett ur både ett internationellt och nationellt perspektiv. Ungefär 90 000 personer har diagnosen Alzheimers i Sverige. För att sjuksköterskan ska kunna ge god och adekvat vård behöver patientens upplevelse av sjukdomen uppmärksammas. Syftet med denna studie var att belysa patientens upplevelse av första fasen vid Alzheimers sjukdom. Studien genomfördes som en litteraturöversikt där tolv vetenskapliga artiklar bearbetades och analyserades för att sedan utgöra resultatet.

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.

Background: More focus has been placed towards autonomy when it comes to care and in special towards palliative care. The purpose with palliative care is to relieve and support at the end of the life. When the patient has difficulties to communicate to those around him due to his illness it is hard to preserve the patients right of self-determination. It is very important to consider the patient as autonomous during the course of the illness. Different alternatives have been developed to preserve the patient?s autonomy such as dedicate a deputy or plan the care of the patient in advance.