Background: The number of people with a stoma increases for every year. Various diseases and causes can lead to an ileostomy, whether it is temporary or permanent. The nurse has a responsibility for patients with ileostomy by providing high quality nursing care, education and information. Aim: The aim was to highlight patient’s experiences with having an ileostomy. Method: The implementation of the literature study took place with an inductive approach. Result articles with both qualitative and quantitative methods were used to form the result. Various themes were formed which were divided into categories. Results: The result formed three categories that highlighted patients' experiences of an ileostomy: “The impact of ostomy on physical well-being”, “The impact of ostomy on psychological well-being” and “The impact of ostomy on social well-being”. The ileostomy had a major impact on patients' lives and the ability to adapt to it could look different from individual to individual. The patients felt that it was important to have emotional support from relatives and healthcare professionals. Conclusion: Patients with an ileostomy need constant follow-up by healthcare professionals. Support and information can help patients manage and adapt easier to their ileostomy.

With an aging population here is also an increase in dementia. World Health Organisation estimates that in 2016, there were 47,5 million people with dementia and the number of incidents doubles every 20 years. The nurse meets people with dementia in different care situations. People with dementia are a particularly vulnerable group with special health care needs that require person-centered care. The aim was to describe personcentred care for dementia from a nurse perspective. A literature study was conducted using articles relevant to the subject,  then eleven qualitative articles responded with the purpose. The result revealed three themes: The need of the time, relations importance and need for knowledge. The results emphasize the personal characteristics of the nurse was important to create a relationship of trust and training in person-centered care was required to create a commitment. The result was imbued by the need for knowledge and relations important that nurses may face in different care situations. In order to care for people with dementia in a person-centered approach, more research on the subject, and more time and training in person-centered dementia care in nursing is needed.

Palliative care is something most nurses are dealing with during their working lives. The purpose of this study was to illuminate the experiences of nursing care from a patient perspective. Nine articles were selected for review, from the articles six themes revealed: Experiences of; nursing relationships, communication and information, the care environment, symptom control, accessibility and self-determination. The result showed that a relationship of trust and communication created good nursing care. Lack of communication could also occur. A good nurse was perceived as someone who listened and had broad knowledge. Patients wanted to be involved in their care and treatment.

People with dementia is a category of patients that nurses often meet. The disease affects the cognitive functions and because of that there may appear frequent ethical difficulties in nursing. Therefore the purpose of this study was to highlight the causes of ethical difficulties within professional nursing care of patients with dementia. The study was conducted as a literature review and the results consisted of five themes: lack of knowledge, lack of time and resources, restricted physical care environment, threatened autonomy, dignity and integrity and lack of communication. Health personnel’s lack of knowledge about dementia caused difficulties in identifying the various symptoms and because of that perform a professional nursing care. As a consequence of lack of time and resources, the patients were limited more than necessary. In a hospital environment patients were at risk of becoming over-stimulated due to stimuli from many directions. Since dementia may affect the ability to communicate, there were difficulties in preserving patients autonomy, dignity and integrity. The conclusion is that good knowledge about the disease is required and an adaption of the physical and psychological environment. More research is needed about the impact of time and lack of resources regarding patients with dementia, because of today’s great savings and staff reductions in health care. There is a lack of health personnel with knowledge about dementia and educations have to be developed to meet the needs that arise in the organizations.

Bakgrund: Även om kaströrelsen i detalj skiljer sig mellan olika idrotter så är den biomekaniska funktionen i grunden densamma. Inom alla kastrelaterade idrotter återkommer den så kallade accelerationsfasen, här har det visat sig att inåtrotationen i axelleden har en hög korrelation med bollhastighet i kaströrelsen. Axelledens inåtrotatorer har alltså en viktig funktion för ett effektivt kast. En funktionell uppvärmning av dessa strukturer optimerar prestationsförmågan och minskar skaderisken. Kan träningsredskapet Activation Grip (AG) effektivisera uppvärmningen av den övre extremiteten hos kastidrottare?

Syfte: Att undersöka och jämföra hur muskelaktiviteten i m. pectoralis major (PM), m. deltoideus anterior (DA), m. flexor carpi raidalis (FCR) och m. extensor digitoris communis (EDC) påverkas vid inåtrotation i axelleden med och utan träningsredskapet AG. Studien syftar även till att utvärdera AG som produkt.

Metod: Muskelaktiviteten i PM, DA, FCR och EDC registrerades med hjälp av elektromyografi (sEMG) hos 18 aktiva idrottare inom överarmskastrelaterade idrotter (ålder 23,7 ± 5,7) vid inåtrotation i axelleden med maximal hastighet, jämfört med samma rörelse med AG och 30% belastning.

Resultat: Resultatet visade på en signifikant högre muskelaktivering (p < 0.05) i DA, FCR, EDC under inåtrotationen med maximal hastighet. Hos PM sågs ingen signifikant skillnad i muskelaktivitet. AG fick över lag positiv respons från testdeltagarna. 

Konklusion: Med resultatet i beaktande så skulle AG kunna kombineras tillsammans med andra uppvärmningsövningar för att få specifik aktivering i önskad muskulatur. Vidare studier gällande rörelse, motstånd och hastighet för att effektivisera användningen av AG bör göras. Även om AG fick positiv respons så bör produkten utvecklas ytterligare.

Purpose:

The aim of the study was to explore and gain an understanding of patients' views on their periodontal conditions, their perceived impact of periodontitis on daily life, as well as their attitudes to oral health and expectations of treatment.

Materials and Methods:

The study subjects were patients with chronic periodontitis, who had been referred to a specialist clinic. The constant comparative method for grounded theory was used to collect and analyse the data. Audiotaped, open-ended interviews were conducted after periodontal examination, but before treatment. The interviews were transcribed verbatim and consecutively analysed in hierarchical coding processes and continued until saturation was reached (n = 17). In the analysis, a conceptual model that outlined the steps involved in the diagnosis of periodontitis was generated. The core concept of the model, keeping up appearance and self-esteem, was related to the following four additional categories and their dimensions; doing what you have to do trying to live up to the norm, suddenly having a shameful and disabling disease, feeling deserted and in the hands of an authority, and investing all in a treatment with an unpredictable outcome.

Results:

The results illustrated that subjects diagnosed with chronic periodontitis felt ashamed and were willing to invest all they had in terms of time, effort and financial resources to become healthy and to maintain their self-esteem. However, they perceived a low degree of control over treatment decisions and treatment outcome.

Conclusions:

The results demonstrate the vulnerability of patients diagnosed with chronic periodontitis and emphasise the importance of communication in dentistry.

In Sweden every year about 3000 patients are affected by sudden cardiac arrest in a hospital setting. Sudden cardiac arrest is one of the most stressful situations for hospital staff to handle. Earlier research has mainly focused on the medical and biophysical aspects of cardiac resuscitation. The subjective experience and feelings of those performing the resuscitation are seldom described. The aim of the study was to describe the nurse an esthetists’ experience of participation in sudden cardiac arrest resuscitation in a hospital setting. Data collection was done through focus group interviews involving five participants and indepth interviews with two participants. Data analysis was systematically performed according to Graneheim & Lundmans qualitative content analysis. The result showed three categories with respective subcategories. The following categories emerged: The given role, Teamwork and Reflection related to cardiac arrest. The given role was perceived as safe, satisfying and filled with demands. A defined leadership and good communication were described as important factors in ensuring clear direction, goals and teamwork.         

The participants experienced a need for feedback and felt debriefing was of the utmost importance. This study can lead to future areas of improvement including further discussion and follow up of sudden cardiac arrest in hospital settings. Further research in this area and across professional borders is needed.

Everyone can be the victim of a cardiac arrest and each year in Sweden alone about 15000 people suffer from cardiac arrest. Being the victim of a cardiac arrest is a traumatic experience that affects the individual in different ways. An increased knowledge about the patient´s experiences is the best way to be able to give professional nursing care and to meet the patient in their life-world. The aim of the study was to highlight the patient´s experiences of surviving a cardiac arrest. A literature study was done comprised of ten scientific articles. Two main themes were identified: Life is turned upside down and Re-evaluation of one’s existence. Seven sub-categories were mentioned: resuscitation; insecurity, fear and anxiety; amnesia; tiredness and weakness; vulnerability; to overcome and get a new outlook on life. These patients are in need of extensive support to be able to participate in the health care and nursing process needed in order to return to a well-functioning life. Further qualitative research in this area would be needed primarily for patients without ICD treatment. Expansion of knowledge about patients experiences and life-world can enable nurses to meet and help this patient group with individual evidence based nursing care in a clinical setting.

Background: Worldwide integration is increasing and this creates a language barrier that creates communication problems in health care. It is a challenge to integrate immigrant communities into existing health services and language barriers is the biggest challenge to meet the healthcare needs of the immigrant population. Lack of communication is an obstacle to a good care relationship. In addition, communication is considered a challenge when two different languages are involved, especially when interpreters do not exist. Purpose: The aim was to expose nurse's experiences of communication with relatives who do not speak the same language. Method: A literature review with an inductive approach. Results: The study is based on nine scientific articles that resulted in two categories: Language barriers affect health care and Language barriers require resources. The nurse's experience of language barriers was negative and the use of interpreters in health care was considered to have their good and bad functions. However, the nurse was in need of additional resources. Conclusion: The results of the literature study clearly appeared about nurses' negative experiences of language barriers. This was also seen as a hindrance because communication could not be effectively conducted with relatives who did not speak the same language. Instead, nurses had to use simplified language, non-verbal communication and use family members to help them interpret instead of authorized interpreters. The result also showed that the use of interpreters in health care had their good and bad sides between nurses and relatives who did not speak the same language. It is important that the nurse adapts communication to the conditions of relatives. More research is needed on how nurses can support relatives who do not speak the same language.

Introduktion: Frukt och grönsaksintaget har minskat i både rika och fattiga länder. Konsekvenserna av ett för lågt intag kan vara övervikt och fetma som i sin tur kan leda till hjärt- och kärl sjukdomar, cancer och diabetes typ 2. Det har visat sig att det finns flera olika faktorer i hemmet som gör att det har blivit ett minskat intag. I tidigare forskning finns det tydliga samband mellan familjen och ett minskat intag av frukt och grönsaker hos barn och ungdomar. Syfte: Syftet med studien var att undersöka vilka faktorer i familjen som påverkar barn och ungdomars intag av frukt och grönsaker. Metod: Metoden som användes var en litteraturstudie och de databaser som användes vid databassökning var Ebsco och Pubmed. Resultat: De tre faktorer som hade störst betydelse för frukt och grönsaksintaget var: Socioekonomisk status, Matkultur och Föräldrars som förebilder. En låg socioekonomisk status visade på ett mindre intag av frukt och grönsaker. I familjer med låg socioekonomisk var tillgängligheten och kunskapen om frukt och grönt lägre hos familjerna. Tidigare gjorda interventioner visar att det finns metoder för att öka intaget hos barn och ungdomar. Implikationer: Genom att höja kunskapen om betydelsen av frukt och grönsaker går det att förbygga problem med framtida hälsa.

Forskning visar på att bristande utveckling och kunskap preventivt inom existentiell hälsa möjligtvis påverkar ökningen av ett sämre hälsotillstånd och ohälsosam livsstil. Vikten av att utveckla kunskap inom existentiell hälsa men även att arbeta ur ett promotivt synsätt kan vara nödvändigt att effektivisera och framföra. Följande studie har därför fokuserat på att utveckla kunskapen om sjundedagsadventisters välbefinnande som nödvändigtvis kan effektivisera forskningsområdet, främst i Europa, där endast ringa forskning kring sjundedagsadventister och hälsa föreligger. Generellt förekommer mer kvantitativ forskning kring sjundedagsadventister och hälsa vilket leder till att få kvalitativa studier har tillämpats. Med hänsyn till detta är syftet med denna studie att belysa hur religionens betydelse stärker välbefinnandet hos sjundedagsadventister. En kvalitativ forskningsdesign med kvalitativ innehållsanalys tillämpades i form av semistrukturerade individuella intervjuer. Urvalet av deltagare innefattade medlemmar över 18 år från sjundedagsadventistiska kyrkan. Teorierna som tillämpades och kopplades samman i studien var Parks meningsskapande system och Van Deurzens teori. Resultatet från studien utformades av fyra huvudkategorier i form av hälsobudskapet, meningsfullhet, gemenskap och återhämtning. Slutsatsen i studien inkluderar och bekräftar tidigare studiers forskningsresultat kopplat till religionens betydelse på hälsan. Denna studie kan stå till grund för fortsatt kvalitativ forskning kopplat till sjundedagsadventister och välbefinnande men även generell forskning kopplat till religion och hälsa

BACKGROUND: A healthy Nordic diet (ND), a diet based on foods originating from the Nordic countries, improves blood lipid profile and insulin sensitivity and lowers blood pressure and body weight in hypercholesterolemic subjects.

OBJECTIVE: To describe and compare food and nutrient composition of the ND in relation to the intake of a Swedish reference population (SRP) and the recommended intake (RI) and average requirement (AR), as described by the Nordic nutrition recommendations (NNR).

DESIGN: The analyses were based on an estimate of actual food and nutrient intake of 44 men and women (mean age 53±8 years, BMI 26±3), representing an intervention arm receiving ND for 6 weeks.

RESULTS: The main difference between ND and SRP was the higher intake of plant foods, fish, egg and vegetable fat and a lower intake of meat products, dairy products, sweets and desserts and alcoholic beverages during ND (p<0.001 for all food groups). Intake of cereals and seeds was similar between ND and SRP (p>0.3). The relative intake of protein, fat and carbohydrates during ND was in accordance with RI. Intake of all vitamins and minerals was above AR, whereas sodium intake was below RI.

CONCLUSIONS: When compared with the food intake of an SRP, ND is primarily a plant-based diet. ND represents a balanced food intake that meets the current RI and AR of NNR 2004 and has a dietary pattern that is associated with decreased morbidity and mortality.

© 2012 Viola Adamsson et al.

Objective:

The aim of this study was to investigate the effects of a healthy Nordic diet (ND) on cardiovascular risk factors.

Design and subjects:

In a randomizedcontrolled trial (NORDIET) conducted in Sweden, 88 mildly hypercholesterolaemic subjects were randomly assigned to an ad libitum ND or control diet (subjects' usual Western diet) for 6 weeks. Participants in the ND group were provided with all meals and foods. Primary outcome measurements were low-density lipoprotein (LDL) cholesterol, and secondary outcomes were blood pressure (BP) and insulin sensitivity (fasting insulin and homeostatic model assessment-insulin resistance). The ND was rich in high-fibre plant foods, fruits, berries, vegetables, whole grains, rapeseed oil, nuts, fish and low-fat milk products, but low in salt, added sugars and saturated fats.

Results:

The ND contained 27%, 52%, 19% and 2% of energy from fat, carbohydrate, protein and alcohol, respectively. In total, 86 of 88 subjects randomly assigned to diet completed the study. Compared with controls, there was a decrease in plasma cholesterol (-16%, P < 0.001), LDL cholesterol (-21%, P < 0.001), high-density lipoprotein (HDL) cholesterol (-5%, P < 0.01), LDL/HDL (-14%, P < 0.01) and apolipoprotein (apo)B/apoA1 (-1%, P < 0.05) in the ND group. The ND reduced insulin (-9%, P = 0.01) and systolic BP by -6.6 ± 13.2 mmHg (-5%, P < 0.05) compared with the control diet. Despite the ad libitum nature of the ND, body weight decreased after 6 weeks in the ND compared with the control group (-4%, P < 0.001). After adjustment for weight change, the significant differences between groups remained for blood lipids, but not for insulin sensitivity or BP. There were no significant differences in diastolic BP or triglyceride or glucose concentrations.

Conclusions:

A healthy ND improves blood lipid profile and insulin sensitivity and lowers blood pressure at clinically relevant levels in hypercholesterolaemic subjects. © 2010 The Association for the Publication of the Journal of Internal Medicine.

Background: Apart from lipid-lowering drugs, dietary changes can also reduce plasma LDL-C concentrations. No studies have been conducted to investigate the clinical effects of a diet with traditional foods originating from the Nordic countries. Method: In a randomised, controlled parallel-group intervention study 88 mildly hypercholesterolemic men and women were randomized to either an ad libitum Nordic diet (ND) or a control diet (CD) for 6 weeks. All meals and foods were provided to the participants in the ND group. Primary outcome measure was LDL-cholesterol, and secondary outcomes were blood pressure, plasma insulin and glucose concentrations. The ND was a high-fibre diet rich in plant foods (fruit, berries, vegetables, root vegetables, whole grain cereals and legumes), vegetable fats (rapeseed oil and nuts) and fatty fish, low-fat milk products, but low in salt, added sugars, saturated fats and red meats. Result: 86 subjects completed the study. Distribution of carbohydrates, fat and protein (E%) in ND was 54, 27, 19, respectively. ND lowered plasma total cholesterol 0.98±0.75 mmol/l (-16%), LDL-C by 0.83±0.67 mmol/l (-21%), HDL-C 0.08±0.23 mmol/l (-5%), including reduced LDL/HDL ratio by -0.42±0.57 (-14%) (all p<0.01 versus controls). Insulin concentrations decreased by 0.51± 2.25 (-9%, p=0.01) and systolic blood pressure by 7±13 mmHg (-5%, P<0.01) compared to controls. Despite diets were eaten ad libitum, body weight decreased by 3.0 kg in the ND (P<0.001). No significant differences were found for diastolic blood pressure, triglycerides or plasma glucose. Conclusion: A Nordic diet improves blood lipid profile, and insulin sensitivity as well as lowering blood pressure to a clinically significant extent in hypercholesterolemic subjects.

Sjuksköterskor som vårdar cancersjuka barn har höga krav på sig. De ska fungera som ett stöd till både patienten och till patientens anhöriga. Barnen de vårdar är även sjukare än andra barn. De många kraven sjuksköterskan har på sig kan leda till stress. Syftet med litteraturstudien var att beskriva hur vårdandet av cancersjuka barn kan påverka sjuksköterskan med avseende på upplevelse av stress. Studien genomfördes med systematiska sökningar baserat på problemformuleringen och syftet. Relevant forskning inom området identifierades, granskades och analyserades. I resultatet framkom fyra kategorier: sjuksköterskan arbetar i en krävande miljö, ökad kompetens bidrar till hanterbar stress, känslomässigt engagemang innebär ökad risk för utbrändhet och sjuksköterskan behöver strategier för att hantera stress. Resultatet visar att det fanns ett flertal orsaker som bidrog till att sjuksköterskorna upplevde arbetsrelaterad stress. Orsakerna var tidsbrist, personalbrist och känslomässiga engagemang i sina patienter och deras anhöriga. Stöd och reflektion framkom som sätt att minska stressen för sjuksköterskorna. Bristen på tid bidrog till att det var svårt för sjuksköterskorna att finna tid till reflektion. Vidare forskning kring sjuksköterskans upplevelse av vårdandet av cancersjuka barn kan leda till en bättre arbetsmiljö och minskad arbetsrelaterad stress.

Background: Children's pain is complex and in order to achieve adequate pain management experience is required. It is important to treat pain as it is a threat to the child's health and untreated pain can lead to severe complications. Pain is a subjective experience and in order to achieve a positive pain management, the child must be asked about the pain. Aim: The aim was to describe children's experiences of pain management and pain treatment at care facilities. Method: A general literature study with a structured search method in which nine articles were examined using the five steps of content analysis. Results: Presented in four categories: being involved and receive information is important, successful pharmacological pain treatment contributes to positive experiences, the importance of distraction, to obtain support and feeling safe is central with the subcategories: from the parents, caring from the nurse. Conclusion: Children experience that security is a central part of the pain treatment which is created with the help of information, participation, distraction and through the presence of the parents. To achieve positive experiences of pain management the nurses need to administrate fast and adequate pharmacological treatment combined with distraction adapted to each individual child. Treatment of pain requires constant development and updating of guidelines where children's subjective experience of pain should be central to the successful development of pain treatment.

I dagens samhälle är ständig utveckling och förnyelse viktiga överlevnadsvillkor för företag inte minst inom branschen företagshälsovård. Konkurrensen ökar och företagen måste ständigt se till att ligga i framkant och det har allt oftare konstaterats att den viktigaste tillgången är att utveckla de anställdas kompetens. Syftet med studien är att studera personals uppfattningar kring kompetensutvecklingen inom företagshälsans olika yrkesgrupper samt att genom den identifiera hur gynnsamma förhållanden för lärande kan skapas. För att få svar på syftet har vi använt oss av kvalitativa intervjuer som datainsamlingsmetod. Sammanlagt genomfördes sex intervjuer där fem olika yrkesgrupper representerades och företagets Vd. Studien har en fenemenografisk ansats som medför dataanalysmetod som består av sju steg. Eftersom vi var ute efter variationer av yrkesgruppernas olika uppfattningar var den fenemenografiska ansatsen mest optimal.

I resultatet framkommer det ett flertal uppfattningar kring kompetensutveckling, lärandestrategier och hur gynnsamma förhållanden för lärande kan skapas. Vidare finns det gemensamma uppfattningar om att yrkesgrupperna har ett stort handlingsutrymme och att det är nödvändigt för att arbetet ska fungera. En av studiens slutsatser är att tid för reflektion är viktigt för gynnsamma förhållanden. Genom att få mer tid att kunna reflektera över det som har skett tror vi medför ett mer kreativt tänkande och en utveckling av kompetens. En annan intressant slutsats som framkom är att varje yrkesgrupp är i behov av den konsultativa kompetensen och att den aldrig är färdigutvecklad.

Pregnancy and childbirth are in most cases a normal life event. Over the past decades the rate of instrumental birth and caesarean sections has increased at the expense of normal birth. Despite more interventions no difference is seen in the maternal or perinatal morbidity or mortality. The midwife’s work encompasses the normal pregnancy and labour. The aim of this study was to describe how the midwife can promote normal birth. The study was conducted as a literature study in which 13 scientific articles, with both quantitative and qualitative approach, were analyzed. Three categories emerged that explained how the midwife promotes normal birth. The midwife creates through closeness a positive relationship to the woman and gives guidance. By using herself as a source of knowledge, the midwife’s senses, experiences from previous labours and formal knowledge, contribute to make correct decisions. The midwife supports and confirms the normalcy, from the woman’s individual needs, and thereby creates a safe environment for the woman that prevents her from unnecessary interventions. As there is a medical culture within the maternity care, the midwife’s work with normal birth needs to be strengthened. Since the organization has an impact on the midwife’s promoting work, further research is needed in this area.

Despite the majority of all pregnancies are assessed as normal, the interventions during labourprocess increase, where caesarean section without medical reason is one part. One reason may be that care for women with uncomplicated pregnancy is conducted at the same level as a complicated pregnancy. A caesarean section may result in increased risk of health problem for both the woman and the child. The midwife´s work encompasses the normal, uncomplicated pregnancy and labour. The midwife also has the possibility within the working range to promote women’s health. The aim of this study was to gain an increased understanding of how midwives promote the normal labourprocess. A non-participation observational study, of a total of four midwives in duty at a labour ward, was conducted at two hospitals. Grounded Theory was used for data collection and analysis. As a result emerged the core category to act as a pilot with four subcategories. The midwife primarily creates and anchors a relationship with the woman. Through the different stages of labour, the midwife assesses, facilitates and confirms the labourprocess individually, concerning the woman´s needs. The categories together form a model that describes what the midwife performs; in verbal and silent communication and in acting or refraining from acting, to promote a normal birth. There is a need for further research about what in the midwife´s management that promotes the normal birth. It is also essential with research at an organizational level since it has an impact on how the midwife promotes normal birth.    

Problem: The professions in health care are highly physically and especially mentally stressful jobs where time pressure and work rate continues to increase. Purpose: The purpose of this study was to illuminate stressors that may affect nursing outcomes. Method: The study was a literature review, 17 articles (3 qualitative and 14 quantitative) and a thesis which met the study's purpose was reviewed and analysed. Results and conclusion: Many factors and causes of ill health can today be found in the work environment and its increasingly greater demands on the individual. Each individual is unique and therefor affected differently by the same situations. The stressful experience and how each person handles the situation depends on all the factors in her/his whole life-world. It becomes clear that regardless of the situation, no one is doing well during long-term stress. The factors considered to contribute to the deterioration of quality of care includes lack of time, heavy workload, staff shortages, poor working conditions and reorganizations. These together and also separately, result in that nurses´ experiences of stress and dissatisfaction with their work, which may affect quality of patient care. Implication: Further research should focus on how nurses can influence the factors which leads to stress and a poor work environment and decrased quality of care.

Idag ska det finnas digitala inslag i ämnet idrott och hälsa och skolan har generellt blivit mer digitaliserad. Det kan vara svårt att veta hur digitala verktyg kan implementeras i idrottsundervisningen, varför det ska användas och vad det egentligen medför till ämnet som är praktiskt inriktat. I dagens samhälle är det viktigt med digital kompetens både för lärare och elever, vilket kräver tid och kunskap. Syftet var att belysa digitaliseringen i skolan. Delmålen med studien var att undersöka digitaliseringens påverkan i ämnet idrott och hälsa samt hur digitala verktyg används i undervisningen under olika former. Studien genomfördes på olika skolor i Västra Sverige där tio idrottslärare med olika erfarenheter, kön och ålder intervjuades. Frågorna som behandlades i studien var hur digitala hjälpmedel och verktyg användes under lektionerna inom idrott och hälsa, varför digitala verktyg används för elevernas lärande inom idrott och hälsa samt vilka hinder digitaliseringen kan medföra i ämnet idrott och hälsa. Det som främst framkom i studien var att digitala verktyg inte används i alla moment utan främst i momenten dans, orientering och redskapsgymnastik. Det används även för att skapa ett formativt lärande och bedömningsunderlag. Hinder digitaliseringen medför var att det bidrar till stillasittande, mer skärmtid och mer arbete för idrottslärarna. 

This study aimed to establish Egyptian women's attitudes and beliefs about female genital cutting (FGC) or mutilation by applying a questionnaire module about violence to a subsample of 5249 married women from a total of 19 474 women who participated in the 2005 Egypt Demographic Health Survey. Women were interviewed to determine if they had been exposed to marital violence in the year prior to the survey, their attitudes and beliefs about FGC, and if they physically abused their children. The association of beliefs about FGC with maternal physical abuse was examined, adjusting for exposure to marital violence and other socio-demographic variables. Of the women surveyed 16.4% and 3.4% had been exposed to physical and sexual violence, respectively, during the year prior to the survey. Around 76% of the women surveyed intended to continue the FGC practice, and 69.8% had slapped or hit their children during the year prior to the survey. Holding positive beliefs about the practice of FGC or intending to continue it was associated with maternal physical abuse and this has significant implications for health and welfare workers in Egypt and for society in general.

Aim: To investigate agreement between: (1) expected reasons and actual reasons for admission of people with dementia according to informal caregivers; (2) scores on measurement instruments prior to admission and the actual reasons for admission according to informal caregivers.

Background: Timely admission of people with dementia is a crucial issue. Information is highly warranted on whether informal caregivers are capable of prior identification of causes of admission and, can thus be considered a reliable prospective source on causes of admission.

Design: A cohort study among informal caregivers of people with dementia who made a transition to institutional long-term care.

Methods: Qualitative data on the expected and actual reasons for admission were collected via open-ended questions at baseline and follow-up. Furthermore, at baseline, data were collected using measurement instruments to measure pre-admission characteristics. Interviews took place between November 2010-April 2012. After categorizing the answers, the agreement between the expected and actual reasons was calculated. Furthermore, bivariate associations were calculated between the actual reasons for admission and scores on corresponding measurement instruments.

Results/Findings: For most informal caregivers, there was agreement between their statements on the expected reason and the actual reason for admission. A third of the caregivers showed no conformity. Bivariate associations showed that there is also agreement between the actual reasons for admission and scores on corresponding measurement instruments.

Conclusion: Informal caregivers can be considered reliable sources of information regarding what causes the admission of a person with dementia. Professional care should anticipate informal caregivers' statements and collaborate with them to strive for timely and appropriate admission. © 2014 John Wiley & Sons Ltd.

Individuals with autism spectrum disorder (ASD) tend to have a limited capacity for social interactions, communications, and usually show hyper or hypo reactions to sensory stimuli. Time spent in health facilities can therefore be extra stressful. Since music is used for therapy or pain relief in cancer treatment and dementia care for example, it would be interesting to further explore the effects of music. The aim of this literature review was to investigate how individuals with ASD are affected by music. Eleven literature articles were analyzed and as a result, four themes emerged: physical, social, emotional influence and also focus and coping. Anxiety, mood, and social interactions were affected in a positive way by music or music therapy. Physical reactions in the brain were seen in regions underlying music perception and emotional processing. The nurse’s goal is person-centered care, and the knowledge of the effects of music and the possibility to use music in clinical practice, could make working with ASD patients easier. Future research on this subject could provide further knowledge and result in guidelines and routines for an easy use of music in the care of individuals with ASD.

Den moderna sjukvårdens avancerade resurser räddar många liv, men kan också leda till ett utdraget och plågsamt döende. I ett fåtal länder i världen är eutanasi och läkarassisterat självmord ett val för den som drabbats av en obotlig sjukdom som leder till döden. Syftet med denna studie är att beskriva obotligt sjuka patienters uppfattningar om dödshjälp. En litteraturstudie genomfördes och relevanta sökord som motsvarade syftet användes vid artikelsökning. Vid bearbetning av data framkom tre olika kategorier med subkategorier som motsvarade de olika uppfattningarna. Resultatet visar att positiva uppfattningar till dödshjälp kan bero på patientens egna syn på värdighet, självbestämmande och hopp, medan negativa uppfattningar till dödshjälp kan bero på rädsla eller religion. Även kommunikation med vårdpersonal kan påverka patienters uppfattningar om dödshjälp. För att möta obotlig sjuka patienters behov den sista tiden i livet behövs det kunskap om alla sorters tankar patienten kan ha, detta gäller även tankar om dödshjälp. Vidare forskning inom området dödshjälp behövs för att möta alla utmaningar som det innebär när patienter önskar hjälp med att dö.

Although it is advocated that end-users are engaged in developing evidence-based injury prevention training to enhance the implementation, this rarely happens. The € Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT)' uses an ecological participatory design incorporating the perspectives of multiple stakeholders throughout the project. Within the I-PROTECT project, the current study aimed to describe the development of holistic injury prevention training specifically for youth handball players through using knowledge from both end-users (coaches and players) and researchers/handball experts. Employing action evaluation within participatory action research, the cyclical development process included three phases: research team preparation, handball expert-based preparation and end-user evaluation to develop injury prevention training incorporating both physical and psychological perspectives. To grow the knowledge of the interdisciplinary research team, rethinking was conducted within and between phases based on participants' contributions. Researchers and end-users cocreated examples of handball-specific exercises, including injury prevention physical principles (movement technique for upper and lower extremities, respectively, and muscle strength) combined with psychological aspects (increase end-user motivation, task focus and body awareness) to integrate into warm-up and skills training within handball practice. A cyclical development process that engaged researchers/handball experts and end-users to cocreate evidence-based, theory-informed and context-specific injury prevention training specifically for youth handball players generated a first pilot version of exercises including physical principles combined with psychological aspects to be integrated within handball practice. © 2022 BMJ Publishing Group. All rights reserved. © 2022 BMJ Publishing Group. All rights reserved.

Living with ADHD can lead to a number of problems for the individuals receiving the

diagnosis. Social- and psychological difficulties and other mental illnesses like

depression and anxiety are all conditions that can occur when individuals are

diagnosed with ADHD. Based on these facts it is urgent to examine young adult’s

own experiences of what it means to live with an ADHD diagnosis to find ways to

reduce the risks following the diagnosis. This study’s aim turns focus on young adults

with ADHD, and the purpose is to increase the knowledge in what’s important after

receiving a diagnosis from a nursing perspective. Four young women who all had

received their diagnosis during the past year were recruited to the study. The

informants were randomized from a children's psychiatric registry in Region Halland

.

The informants were contacted by phone and asked to participate in the study. Before

the interviews started they were asked to fill in a consent form. The findings from

your study clearly show a correlation between ADHD and other troubles in young

adults everyday life. The majority of the informants describe feelings of exclusion

with multiple failures in adaption as a result. Receiving a diagnosis contributed to get

an explanation for their troubles, not only for themselves but to their environment as

well. The result of the study also show the group's fear of changing health care

contact mainly concerning the transition from child psychiatry for adult psychiatry.

The study shows a high prevalence of trouble among individuals who have ADHD

but also what an enormous personal profit it may mean getting diagnosis when the

support can be individually adjusted. The study is based on only four informants and

the result is therefore not possible to generalize on a larger group, however, the study

can be used as background for a larger study with more informants. The current state

of scientific knowledge in the field today are insufficient and most facts are based on

individuals own experiences. We hope that our findings can contribute to further

research that can benefit the nursing care for the patients.

Background: Palliative care could be described on the four foundations which are symptom relief, cooperation, communication, and support for close relatives. Palliative care is split into two different phases where the last phase is end of life care and the main goal is to relieve suffering and improve quality of life. Nurses have a major role in supporting patients at the end-of-life care. Nursing patients at the end of their life can provide different experiences for nurses. Aim: The aim of this study was to explore nurses’ emotional experience of caring for patients in end-of-life care. Method: The chosen method was a literature review of ten qualitative scientific articles with aim to explore the current state of knowledge. Result: Several different main- and subcategories emerged in the results: The experience related to the nurse as a person: feeling of inadequacy and futility and the feeling of meaningfulness. The experience related to nursing as a professional: The need for knowledge and experience and need for teamwork and planning. Caring for patients in the end of their life can be stressful and can evoke different emotions. The feelings can be one's own thoughts about death but also feelings from the patient, relatives, and colleagues. Nurses highlighted the importance of knowledge and experience in the implementation of palliative care as well as in future care. Lack of knowledge, time and resources can affect the quality of care in a negative way by causing for example, stress or other emotional strain. Conclusion: Caring for patients in palliative care is complex and requires knowledge, experience and more research. Care at the end of life is very time consuming and becomes a big challenge for the nurses who work with patients at the end of their life, where the workload is high and the lack of time is a fact. This can contribute to feelings of guilt and inadequacy in nurses.

The aim of this paper is to investigate the feasibility of using the Dynamic Time Warping (DTW) method to measure motor states in advanced Parkinson's disease (PD). Data were collected from 19 PD patients who experimented leg agility motor tests with motion sensors on their ankles once before and multiple times after an administration of 150% of their normal daily dose of medication. Experiments of 22 healthy controls were included. Three movement disorder specialists rated the motor states of the patients according to Treatment Response Scale (TRS) using recorded videos of the experiments. A DTW-based motor state distance score (DDS) was constructed using the acceleration and gyroscope signals collected during leg agility motor tests. Mean DDS showed similar trends to mean TRS scores across the test occasions. Mean DDS was able to differentiate between PD patients at Off and On motor states. DDS was able to classify the motor state changes with good accuracy (82%). The PD patients who showed more response to medication were selected using the TRS scale, and the most related DTW-based features to their TRS scores were investigated. There were individual DTW-based features identified for each patient. In conclusion, the DTW method can provide information about motor states of advanced PD patients which can be used in the development of methods for automatic motor scoring of PD. © 2020 Somayeh Aghanavesi et al.

Parent participation in the nursing care of their children in hospital haven´t always been obvious. Not until after the Second World War children´s need of their parents in hospitals were elucidated by researchers within psychology and nursing. Despite continued development of parent participation within children’s nursing care there is still deficiencies in that area. The aim of the study was to describe parent’s perception of participation in the nursing care of their children in hospital. The result shows parental perceptions of participation in the nursing care of children in hospital based on twelve scientific articles. The result includes four categories of participation which elucidate parental perceptions of; being present, information, decision-making, practical nursing care. The conclusion describes parent’s positive and negative perceptions of participation. Suggestions on further national studies within the area and in relation to the gender perspective are given. The futures care development with education on the subject could be national guidelines, Standardized Care Plan and e-hälsa.

Objectives: To describe chronic kidney disease (CKD) regarding treatment rates, comorbidities, usage of CKD International Classification of Diseases (ICD) diagnosis, mortality, hospitalisation, evaluate healthcare utilisation and screening for CKD in relation to new nationwide CKD guidelines.

Design: Population-based observational study.

Setting: Healthcare registry data of patients in Southwest Sweden.

Participants: A total cohort of 65 959 individuals aged >18 years of which 20 488 met the criteria for CKD (cohort 1) and 45 470 at risk of CKD (cohort 2).

Primary and secondary outcome measures: Data were analysed with regards to prevalence, screening rates of blood pressure, glucose, estimated glomerular filtration rate (eGFR), Urinary-albumin-creatinine ratio (UACR) and usage of ICD-codes for CKD. Mortality and hospitalisation were analysed with logistic regression models.

Results: Of the CKD cohort, 18% had CKD ICD-diagnosis and were followed annually for blood pressure (79%), glucose testing (76%), eGFR (65%), UACR (24%). UACR follow-up was two times as common in hypertensive and cardiovascular versus diabetes patients with CKD with a similar pattern in those at risk of CKD. Statin and renin-angiotensin-aldosterone inhibitor appeared in 34% and 43%, respectively. Mortality OR at CKD stage 5 was 1.23 (CI 0.68 to 0.87), diabetes 1.20 (CI 1.04 to 1.38), hypertension 1.63 (CI 1.42 to 1.88), atherosclerotic cardiovascular disease (ASCVD) 1.84 (CI 1.62 to 2.09) associated with highest mortality risk. Hospitalisation OR in CKD stage 5 was 1.96 (CI 1.40 to 2.76), diabetes 1.15 (CI 1.06 to 1.25), hypertension 1.23 (CI 1.13 to 1.33) and ASCVD 1.52 (CI 1.41 to 1.64).

Conclusions: The gap between patients with CKD by definition versus those diagnosed as such was large. Compared with recommendations patients with CKD have suboptimal follow-up and treatment with renin-angiotensin-aldosterone system inhibitor and statins. Hypertension, diabetes and ASCVD were associated with increased mortality and hospitalisation. Improved screening and diagnosis of CKD, identification and management of risk factors and kidney protective treatment could affect clinical and economic outcomes. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Background: Individuals with type 2 diabetes (T2D) are at increased risk of developing cardiovascular disease (CVD) which necessitates monitoring of risk factors and appropriate pharmacotherapy. This study aimed to identify factors predicting emergency department visits, hospitalizations, and mortality among T2D patients after being newly diagnosed with CVD.

Methods: In a retrospective observational study conducted in Region Halland, individuals aged > 40 years with T2D diagnosed between 2011 and 2019, and a new diagnosis of CVD between 2016 and 2019, were followed for one year from the date of CVD diagnosis. The first encounter for CVD diagnosis was categorized as inpatient-, outpatient-, primary-, or emergency department care. Follow-up included laboratory tests, blood pressure, pharmacotherapies, and healthcare utilization. Hazard ratios (HR) in two Cox regression analyses determined relative risks for emergency visits/hospitalization and mortality, adjusting for age, sex, glucose regulation, lipid levels, kidney function, blood pressure, pharmacotherapy, and healthcare utilization.

Results: The study included a total of 1759 T2D individuals who received a new CVD diagnosis, with 67% diagnosed during inpatient care. The average hospitalization stay was 6.5 days, and primary care follow-up averaged 10.1 visits. Patients with CVD diagnosed in primary care had a HR 0.52 (confidence interval [CI] 0.35–0.77) for emergency department visits/hospitalization, but age had a HR 1.02 (CI 1.00-1.03). Pharmacotherapy with insulin, DPP4-inhibitors, aldosterone antagonists, and beta-blockers had a raised HR. Highest mortality risk was observed when CVD was diagnosed inpatient care, systolic blood pressure < 100 mm Hg and elevated HbA1c. Age had a HR 1.05 (CI 1.03–1.08), eGFR < 30 ml/min HR 1.46 (CI 1.01–2.11), and LDL-Cholesterol > 2,5 h 1.46 (CI 1.01–2.11) and associated with increased mortality risk. Pharmacotherapy with metformin had a HR 0.41 (CI 0.28–0.62), statins a HR 0.39 (CI 0.27–0.57), and a primary care follow-up < 30 days a HR 0.53 (CI 0.37–0.77) and associated with lower mortality risk.

Conclusions: T2D individuals who had a new diagnosis of CVD were predominantly diagnosed when hospitalized, while follow-up typically occurred in primary care. Identifying factors that predict risks of mortality and hospitalization should be a focus of follow-up care, underscoring the critical role of primary care in the effective management of T2D and CVD. © The Author(s) 2024.

Statistics show an increase in ransomware activity in recent years. The increase is mainly due to the ongoing Covid-19 pandemic. Cybercriminals take advantage of the fact that hospitals worldwide are overloaded with caring for seriously ill patients in Covid-19 and perform ransomware attacks.

This thesis examines how Swedish hospitals experience and handle the increased threat of ransomware. The bachelor’s thesis consists of a literature study and some in-depth interviews. The literature study is investigating ransomware as a phenomenon and finding out why it is a successful method for cybercriminals to use in digital extortion.

The purpose is also to investigate how Swedish hospitals relate to the fact that the healthcare sector has become an attractive target for cyber-attacks. The interview study examines the hospitals' IT security to determine whether they are sufficiently resistant to ransomware attacks. The interview results are discussed and analyzed against the background of the literature. The conclusion of this analysis is the basis for the proposed countermeasure.

The results show that the hospitals surveyed have suitable IT security. The most central security mechanisms for the hospitals are their backup and recovery routines in the fight against ransomware. The discussion in this work combines the results from the literature and interview studies carried out. Based on the discussion, the conclusion is that the hospitals surveyed have good security and meet most of the recommendations published by Swedish authorities. Still, there is room for some improvement which is indicated.

Minorities risk being excluded from society and discriminated in different ways. Transexuals is a group who is exposed to these risks not only in society but also in medical attendance. The purpose of this literature review was to elucidate factors affecting the meeting between health professionals and transsexual patients. Transsexuals had difficulty in finding health professionals who respected their gender identity. This resulted in that health care was made inacces-sible. Furthermore this group of patients experienced disinterest from the professionals and this resulted in a lack of their health care needs. When professionals showed respect and empathy for the transsexual, combined with awareness and competence, the treatment was optimal. Discrimination and transphobia against this group of patients were due to inadequate skills, morals and different individual set of values. General health problems of this group of patients were assumed being caused by the patients transsexuali-ty.

A significant factor was to address the transsexuals by the right pronouns as an impaired quality of care was experienced when wrong pronouns were used during a heath care meeting. The heteronomous view within health care excluded the transsexuals from investigations, treatments and health care availability.

Lack of prior research has resulted in poorly trained professionals regarding transsexuality. This deficiency occurred both in primary and institutional care. Recent knowledge is based on clinical experience and to a less extent of scientific evidence. This has resulted in that nursing students had an inadequate formal education regarding transgender issues.

I sjuksköterskans hälsofrämjande arbete krävs kunskap om hälsorisker och förmåga att se till patientens behov, såväl de fysiska, psykiska och sociala. Övervikt och fetma är idag ett av samhällets största problem, och har en komplex uppkomstmekanism. Möjligheten till en varaktig viktreducering påverkas av en rad olika faktorer. För att övergå till den hälsosamma livsstil som krävs för en varaktig viktnedgång, behövs en beteendeförändring. Syftet med denna litteraturstudie var att undersöka hur psykologiska och psykosociala faktorer påverkar överviktiga individers möjlighet till en varaktig viktnedgång. I resultatet framkom två huvudteman: Motivation och mål samt Livsstilsförändring. Individer har varierande förmåga till självkontroll, egenvård och följsamhet, samt olika tillgång till stödfunktioner i samhället. Motivation och mål har en central roll. Hur personer reagerar på utmaningar och svårigheter är också högst individuellt och avgörande för en varaktig viktnedgång. En ökad kunskap genom utbildning och forskning rörande psykologiska och psykosociala faktorer kan underlätta sjuksköterskans möjlighet till individanpassad vård och förbättra motivationsstrategier för livsstilsförändringar. Mer kunskap kan även leda till ett förbättrat bemötande och omvårdnad. 

Poor Mental health in adolescence has become more prevalent over the past decades. Differences between gender and age in mental health are apparent where girls rate their mental health lower than boys. Socioeconomic status has proven to be a determinant for poor mental health, however in detecting poor mental health, the use of solely objective measures may not suffice. The aim of this cross-sectional study was to explore different aspects of socioeconomic status and their association with school children’s mental health. The data was obtained from the 2009/10 HBSC survey in Sweden. A sample of 4449 students aged 11 and 15 was included. Binary logistic regression with odds ratio (OR) and 95% confidence intervals (95%CI) was used to estimate the associations between the different aspects of SES and mental health outcomes. The relationship between poor mental health and low subjective economic status was significant while no such relationship was found in the other SES-measures. The use of subjective economic status may be a more reliable determinant for poor mental health than objective and relative measures. Future studies should focus on developing targeted interventions, also on the understanding of socioeconomic status in childhood.

The aim of this thesis was to explore social capital and inequalities in mental health among young adolescents in Sweden. This is a compilation thesis comprising four studies. Studies I and II are quantitative studies of crosssectional data from the Swedish Health Behaviour in School-aged Children survey. The aim of Study I was to investigate socioeconomic inequalities in health using both a subjective and an objective measure of socioeconomic status among Swedish adolescents. The findings showed that subjective socioeconomic status robustly and independently predicted mental health problems, poor life satisfaction and poor general health perception. The association between objective socioeconomic status and mental health was weakened, and even reversed, when subjective socioeconomic status was accounted for in regression models. A Latent Profile Analysis was applied in Study II with the aim of identifying distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles. The findings showed that five distinct profiles best represented the data for 11 and 15-year olds, while a four-profile model was optimal for 13-year olds. Significant inequalities were identified between profiles when these were examined in terms of mental health problems and life satisfaction. The design of Study III was a qualitative semi-structured interview study. The aim was to explore social capital from the perspective of adolescents in relation to mental health. Adolescents spoke of having access to a safe space, feeling connected to others and predictability as important aspects of social relationships and networks in relation to mental health. The aim of Study IV was to identify and evaluate the design and psychometric properties of instruments for assessing social capital specifically developed and validated for self-reporting among adolescents (10-19 years). The design was a systematic review, in which 20 instruments were identified. The results revealed a lack of instruments that covered both the multidimensionality of social capital and contextual relevance in relation to adolescents. The conclusion from this thesis is that social capital may be useful for identifying vulnerable individuals and for differentiating between the natural imbalance of adolescence and what may lead to serious illness. Longitudinal research and refinement of the operationalization of the concept are, however, needed to enhance the understanding of these findings.

Background: The increase in adolescents reporting mental health problems presents a major public health challenge. The complex association between mental health and social capital motivates further investigation of social capital as a crucial aspect in shaping adolescents' help-seeking knowledge, attitudes, and behaviours. Aim: This protocol presents a project that aims to investigate social capital in relation to help-seeking and mental health in close collaboration with adolescents and key stakeholders in the school setting, in the southern part of Sweden. Methods: A mixed-method design with three interconnected work packages (WP) will be undertaken with an emphasis on co-production where adolescents are involved throughout the process. WP1 is a development and validation of two questionnaire instruments for assessing social capital and help-seeking in adolescence. WP2 is a longitudinal quantitative study involving 1,500 adolescents from two regions representing rural and suburban/urban settings. Adolescents aged 15 will be asked to complete questionnaires concerning social capital, mental health, and help-seeking in a baseline and one-year follow-up, allowing for investigation of the role of social capital for help-seeking. WP3 is designed to elucidate experiences and knowledge of adolescents and key stakeholders via collaborative World Café workshops. These will be held along the project to evolve the generated knowledge and maximize it's applicability during and after the project is finalized. Conclusion: The results are expected to further the understanding of the relationship between adolescents' social capital, mental health, and help-seeking, to contribute to a deeper understanding of the mechanisms behind the paradoxical help-seeking patterns among adolescents today and to narrow the gap between research and practice to produce sustainable and efficient strategies, which may facilitate help-seeking and improve the mental health of adolescents within existing organizational structures. Copyright © 2024 Ahlborg, Morgan, Svedberg, Nygren, Eriksson and Westberg.

The social environment that adolescents interact in has undoubtedly changed over the past decades. The latent constructs of social capital that have been described in theory may be universal, but it is necessary to reveal sociocultural specific pathways and manifestation in order to validly operationalize social capital for adolescents. There is a call for qualitative data to enhance our understanding of social capital for adolescents today and the specific sociocultural context they live in. The aim of this study was to explore social capital from the perspective of adolescents in relation to mental health. Twenty-three semi-structured interviews were conducted in a school setting with a sample of adolescents aged 11 and 15 years. Qualitative content analysis was applied, and analysis remained on a manifest level. From having adolescents describe their social relations and networks in relation to mental health, three main categories were formed: accessing a safe space, with sub-categories of trusting enough to share, having someone close to you, and being part of an inclusive and honest environment; feeling connected to others, with sub-categories of hanging out and having things in common; and maintaining control, with sub-categories of deciding for yourself, dealing with change, and having social skills. Having access to a safe space is vital for adolescents’ mental health, by providing resources such as mutual trust, honesty, and unconditional access. Feeling connected to others is important in close relationships and reveals the glue that holds networks together, but also links to sociability in a wider sense. Predictability in adolescents’ social relationships and networks, influenced by internal and external factors, may be a resource of increasing importance in todays’ society and an interesting subject for intervention and future research on social capital and adolescent mental health. © 2023 by the authors.

Aim: The aim of this integrative review was to investigate how resilience has been researched and explore experiences of resilience, in children of parents with mental illness or alcohol or substance misuse. Design: An integrative review. Method: The search included three major electronic databases, PubMed, Scopus and PsycINFO with the aim of identifying peer-reviewed studies where the concept of resilience was explored as resilience, coping, adaptation or protective factors. Results: Out of 4016 studies, 14 were included after meeting predetermined criteria and methodological quality evaluation. The findings are presented in five categories: characteristics of the studies, operationalization and interpretation of resilience, individual resources, family resources and resources outside the family. Patient or public contribution: Resilience in children of parents with mental illness or substance misuse refers to coping strategies, protective factors and absence of symptoms or risk behaviour despite being exposed to risk. We suggest a three-level approach for mapping of resilience resources in the target group: the individual level, family level and outside of the family that includes both non-professionals and professionals. The use of disengagement or avoidance strategies implies poor resilience but may be necessary in absence of support, as acts of self-preservation during chaotic periods or harmful situations. © 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.

There is a great heterogeneity in the conceptualization and operationalization of social capital in empirical research targeting adolescents. There has not yet been an attempt to systematically map and psychometrically evaluate the existing instruments for measuring social capital that have been developed and validated for adolescent samples. The aim of this systematic review was to identify and evaluate the design and psychometric properties of self-reported instruments for social capital, specifically developed and validated for use among adolescents. The design of this study was a systematic review guided by the COSMIN methodology for systematic reviews of Patient Reported Outcome Measures. The search included six electronic databases and no time frame was applied. Twenty studies were identified as describing the development and validation of a social capital instrument for adolescent samples. The results reveal common denominators, but also great variation in the design and validation of the instruments. Adolescents were only involved in the development procedures of four instruments. There is a lack of social capital instruments that cover both the multidimensionality of social capital and contextual relevance in relation to adolescents. Careful examination of instruments should thus precede a decision when designing studies and further instrument development involving the target group is encouraged. © 2022 by the authors.

Background

Recent reports of increasing prevalence of frequent health complaints and mental health problems among adolescents call for directing more attention on determinants of adolescent health. The relationship between health and social capital has gained increased attention since the early 2000’s and research at review level confirms the importance of social capital for health outcomes, despite methodological heterogeneity. The aim of this study was to identify distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles.

Method

Cross-sectional data from the Swedish Health Behaviour of School-aged Children 2013/14 was used for this study. The analytical sample consisted of 7,804 adolescents aged 11-, 13- and 15-years. Items representing sense of belonging and emotional support were assessed in three contexts; family, school and among peers. Latent profile analyses (LPA) were run to determine social capital profiles. Health outcomes included frequent health complaints and life satisfaction, while socioeconomic status and genders were included as predictors.

Results

The results show that five distinct profiles best represent the data for 11- and 15-year olds, while a four-profile model was optimal for 13-year olds. Some profiles were recurrent between age groups but unique profiles were also found. Health outcomes were significantly different between profiles depending on levels of social capital in the different contexts.

Conclusions

This study provides novel insight into how social capital co-occurs among adolescents within the contexts of family, school and peers and how this translates into differences in health outcomes. The national representativeness of the sample increases the implications of the results and contributes to meaningful insights that help explain the interactions of social capital in multiple contexts, complementing what is previously known about the relationship with adolescent health. © 2019 Ahlborg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Background

Socioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents.

Method

Cross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders.

Results

Subjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68).

Conclusions

The level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries. ©  The Author(s). 2017

The purpose of this research was to psychometrically evaluate the Dyadic Adjustment Scale (DAS), modified for use with new, first-time parents by extending the items of communication, sensuality, and sexuality. A total of 820 Swedish respondents, 6 months after the birth of their first child, participated in the study. Psychometric evaluation was conducted with factor analysis. The obtained factor structure was tested with multitrait analysis program. Thirty-three itemswere found to fit into a five-factor solution, explaining 50% of the total variance. Descriptive data revealed thatmost new parentswere satisfied with their intimate relationship in general, but dissatisfied with their sexual lives. Themodified DAS, now called the Quality of Dyadic Relationship Instrument includes 33 items and seems to be a useful, updated measurement for assessing quality of the intimate relationship in new first-time parents.

Although HIV is a well-known disease and millions of people worldwide are affected, it is still one of the world's most stigmatized diseases. Stigmatization causes the disease to be associated with both prejudice and shame, affecting the people who suffer from the disease annually. The purpose of this qualitative literature study was to highlight patients' experiences of getting an HIV diagnosis. The results of the literature study were based on nine scientific articles that resulted in the following six themes: Experiences of shock, experiences of anger and guilt, experiences in fear of dying, experiences of difficulty whit disclosure to friends and family, experiences of acceptance, and experiences of the diagnosis as a positive turning point. In the results, it was clear that the diagnosis raised many strong emotions and that the people who are affected are in urgent need of assistance and support from healthcare professionals to handle the diagnosis. Hence, it is important that nurses get an insight into the experiences regarding an HIV diagnosis and receive more education in the subject so that the right information can be given.

Background: Pre-exhausting a synergist prior to a compound exercise has been shown to alter the firing patterns in the muscles during the exercise. Pre-exhausting a muscle is done by exercising a muscle group to fatigue with a single joint exercise prior to an exercise.

Aim: The purpose of this study was to further investigate the effects of pre-exhausting the triceps brachii prior to performing a bench press, measuring the EMG activity in pectoralis major, triceps brachii and deltoid anterior.

Methods: 30 participants, men (n=15) and women (n=15), performed two different protocols (T1 and T2) while the muscle activity was measured with surface EMG. Electrodes were placed on pectoralis major, triceps brachii and deltoid anterior. Maximum voluntary isometric contraction (MVIC) was performed prior to performing protocols in order to get reference values.

Results: Pectoralis major and deltoid anterior activation was significantly higher when preexhausting triceps brachii before bench press compared to no PRE, but no significant increase was seen in triceps brachii (p=0.000, p=.0009 and p=0.405 respectively) MVIC expressed in percentages and mean values ± standard deviation during protocol T1 for pectoralis major 45.3(±12.4), triceps brachii 56.28(±15.9) and deltoid anterior 63.45(±31.4) and during protocol T2 pectoralis major 56.41(±18.4), triceps brachii 58.49(±20.07) and deltoid anterior 71.65(±42.7).

Conclusion: These results suggest that pre-exhausting a synergist prior to a compound exercise may change the muscle activity in the involved muscles. This can be used in a practical sense to develop weak points in the muscles by changing the activation pattern in the muscles hence being able to target specific muscles better.

Abstract                                      The management of postoperative pain is insufficient despite increased knowledge of the physiology of pain and the development of new pharmacological guidelines. Postoperative pain left untreated can lead to delayed mobilization and secondary complications such as deep venous thrombosis, pulmonary embolism, cardiac infarction, stroke and pneumonia. The outcome is increased mental and physical disability for the patient and increased costs for the society. The nurse anesthesist has a crucial role in postoperative pain management before and during anesthesia and needs to work preventively to secure sufficient analgesia for the patient. The aim of this study was to enlighten the nurse anesthesist’s strategies to prevent postoperative pain after general anesthesia. Semi-structured interviews with four nurse anesthetists at a hospital in the Southwest of Sweden were analyzed with qualitative content analysis. The nurse anesthesists strived to individualize pain management. The effect of the atmosphere created at the preoperative meeting with the patient, the character of the planned procedure and the usage of other methods of pain management all affected peroperative planning of dosage of intravenous analgesics. By using multimodality analgesia in patients who have surgery under general anesthesia postoperative pain could be prevented and hence contribute to reduced patient disability and faster postoperative recovery.  Furthermore, the in-hospital care time can be reduced which could mean socioeconomic benefits.

Döden angår oss alla och vår kulturella bakgrund har stor betydelse för hur vi möter den. Palliativ vård fokuserar på att ge stöd och lindring till döende patienter för att öka deras livskvalitet. Av Sveriges invånare har var sjätte utländsk bakgrund och detta ställer andra och delvis nya krav på sjukvården. Syftet med studien var att belysa faktorer som påverkar sjuksköterskans palliativa omvårdnad till patienter från andra kulturer. Studien är en litteraturöversikt där tolv artiklar analyserats utifrån syftet. I resultatet finns många olika faktorer som påverkar sjuksköterskans omvårdnadsarbete av palliativa patienter i en mångkulturell vårdsituation. Resultatet delades upp i tre huvudkategorier:

kulturell kommunikation, kulturell medvetenhet/kunskap och kulturella skillnader/behov. För att kunna ge patienter med annan kulturell bakgrund en palliativ omvårdnad med hög kvalitet behövs medvetenhet och kunskap hos sjuksköterskan om deras specifika behov. Utvidgad utbildning och diskussion behövs i ämnet och svenska empiriska studier som belyser dessa patienter och anhörigas behov. Det är nödvändigt att både den specialiserade palliativa vården och övrig vård tar del i både forskning och utbildning, eftersom palliativa patienter från andra kulturer finns inom de flesta specialiteter.

Coronary artery bypass is for the patient a major event leading to many questions and concerns. Previous research has shown that patients who have undergone coronary artery bypass have great needs of information. Our aim of this study was to describe information before and after a coronary artery bypass. The study was done as a literature review. The results of the study were distributed into three categories, information methods, information content and the various factors that affect patient information. Information was given in writing, orally, by video, by Internet or by a patient previously undergoing a coronary artery surgery, usually in combination with each other. What the patient wanted the information should contain varied from person to person depending on what stage the patient was, pre- or postoperatively. Several factors emerged that were relevant. It was important for the patients that the staff took the time to listen and respond to questions and concerns. Patients with small social networks had a greater need for information than others with larger social network. Another important thing was that patients could easily get in touch with competent personnel both before surgery and after discharge. The conclusion of the result was that the information should be individualized based on each patient's needs. Continued research is needed to develop good patient information on patients' experience of different types of information means, and to develop contact with patients who have previously done a coronary artery bypass.