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Background: During 2014 over 200 different languages were spoken in Sweden, and by the end of 2017 approximately 20 % of the population was foreign born. 110 000 healthcare injuries, many of them due to failure in communication were reported by the nursing association (2017). The evident language barriers create a lack of trust and confidence between patient and nurse. To overcome the identified language barriers interpreters have become a necessary tool in order to exchange information and create a trusting relationship between patients and nurses.

Aim: To explore the nurses experiences and perceptions of existing language barriers and the use of interpreters within healthcare.

Method: A literature review of fifteen scientific articles. These were identified in the databases PubMed and Cinahl through searches for relevant articles with appropriate keywords.

Results: Nurses consider language barriers to be the biggest obstacle to good communication, which often lead to misunderstandings and misinterpretations. The identified problem of communication is experienced as time consuming and the nurses perceive more planning to be needed when dealing with patients with a different mother tongue. Furthermore, it presents a severe challenge to maintain good care and establish an understanding of the patient’s story. Nurses prefer to use an interpreter on site, however interpreters by phone are more accessible. More than one underlying cause is linked to nurse’s skepticism to use interpreters. To mention one many nurses doubt the accuracy of the interpretation. Moreover, nurses acknowledge their need of further training and education in the use of interpreters.

Conclusion: The result identified is based upon nurse’s first hand experiences of language barriers and the use of interpreters. The literature review has provided insightful knowledge and increased the understanding of language barriers and the use of interpreters in health care. The research will be an asset in future careers and provide help in overcoming set problem.

Background.  Older people currently constitute the largest patient group visiting emergency departments worldwide and are often accompanied by carers and/or relatives. The aging part of the population is increasing which leads to a greater strain on the health care system. While emergency departments offer acute care services to the general population, they are not well suited for the particular needs of older people and their relatives. Being aware of the issues older people and their relatives face during visits to the emergency department can help to deliver better suited care for this growing part of the population.  Aim. The aim of this literature review is to investigate older peoples’ and relatives’ experiences of visiting emergency departments.  Methods. The method of this study is a literature review of 14 articles from Australia, Europe, North America and South America. The databases used to find the articles were CINAHL and PubMed. Results. Results were divided into positive and negative themes. The six negative themes that emerged were: Lack of communication; Lack of patient involvement; Long waiting times; Lack of attentiveness; Inadequate physical environment and inadequate management of needs and symptoms. The positive theme that emerged was that emergency departments as reliable and easily accessible health care facilities. Conclusions. Older people and their relatives see their emergency department experience as mostly negative, exposing a need for better communication practices, positive person-centred interactions between health care staff and patients as well as their relatives and changes to the physical environment and health care system of the emergency department.

Background:Palliative care is about relieving the suffering of patients with incurable diseaseand meeting their physical, psychosocial and existential needs to promote the patient's quality of life. Palliative care should be built on four cornerstones: symptom relief, cooperation, communication and support for relatives. The care staff must have enough knowledge about palliative care in order to perform the practical nursing care to the patients in the palliative phase.Aim: The aim of this study is to describe adult patients' experience in connection with palliative care.Method: The literature review contains 17 scientific articles with qualitative, quantitative and mixed methods. The data search was performed in the databases CINAHL and PubMed.Results: The result showed six categories that are knowledge of palliative care, loss of self-esteem and vulnerability, existential support, empathy and sympathy, feelings of security and communication and self-determination. The results showed that several patients missing knowledge about palliative care and those patients have different perceptions of palliative care, for example, some patients believe that palliative care means the end of life while other patients describe that palliative care for them is more than the end of life. For example, patients express that it is a supportive care to improve their quality of life.Conclusion: Patients need more knowledge about palliative care and therefore it is important that care staff offer information to patients. This is important for patients to be well informed about their care. To increase patient participation and knowledge of palliative care, it is important that there is good communication between patients and care staff.

Background The increasing migration in Sweden increases the demands on nurses to meet and care for patients with a different cultural background. Culture is a decisive factor that affects the patient, and the nurse needs to take this into account with the help of cultural competence. Having cultural competence means that the nurse has knowledge and understanding of the patient's culture and adapts care to the patient's cultural background. The patients feel that cultural and linguistic differences between them and the nurses affect the care and reduce the quality of care.

Aim The purpose of the literature review is to explore the nurse's experiences of caring for patients with a different cultural background.

Method The method for the work is a structured literature study with elements of the methodology used in systematic reviews. It consists of 14 qualitative articles collected from the databases CINAHL, PubMed and PsycInfo. The articles were analysed using Friberg's analysis model in three steps and the quality of the articles was reviewed using Ulrika Nilsson's review template.

Results The results were presented in three main categories: experiences of communication; cultural differences and cultural competence and its strategies for improving the care of patients with different cultural backgrounds. The results showed that language differences made patient care more difficult, that the nurses faced discrimination and that a lack of cultural competence caused feelings of uncertainty and fear.

Conclusions The nurses experienced challenges that included cultural differences, language differences, lack of cultural competence and meeting and being met by patients. Despite these challenges, the nurses were able to navigate different situations and use different strategies to overcome the challenges.

OBJECTIVE: To explore maternal near miss and death after emergency cesarean delivery in Somaliland, including the impact of the prerequisite for family consent.

METHODS: A facility-based, mixed-methods study was conducted to assess all maternal near misses and deaths recorded at a referral hospital that provided services to women from all regions of Somaliland. The data sources comprised a quantitative prospective cross-sectional study using the WHO near-miss tool (performed from August 1 to December 31, 2015) and qualitative interviews with 17 healthcare providers working at the referral hospital who were in direct contact with the women in labor (performed from January 15 to March 15, 2015).

RESULTS: Of the 138 maternal near misses and deaths recorded, 50 (36%) were associated with emergency cesarean delivery. The most frequent maternal complication was severe pre-eclampsia (n=17; 34%), and the most frequent underlying causes were hypertensive disorders (n=31; 62%) and obstetric hemorrhage (n=15; 30%). Healthcare providers were often prevented from performing emergency cesarean delivery until the required consent had been received from the woman's extended family.

CONCLUSION: Maternity care in Somaliland must be improved, and the issue of legal authority for consent examined, to ensure both safe and timely provision of emergency cesarean delivery. This article is protected by copyright. All rights reserved.

Humanitarian programming in fragile economies often use unconditional cash transfers (UCTs) to offset food insecurity. However, there is an increasing focus on using cash transfers to boost household incomes beyond the short-term through micro-enterprise start-up and growth. This paper conducts a randomised control trial to measure the impact of three different sizes of business grants against UCT in Somalia. We find that giving the same amount of money as a lump sum business grant results in higher likelihood of business ownership and income compared with UCT in the short run (3-4 months after the transfers). However, the impacts are larger and persist 3 years later only for those who received larger amount of grants. The results indicate our 'medium'-sized grant being more cost-effective. © 2022 The Author(s).

BackgroundType 2 diabetes is a disease that is constantly increasing and leads to many complications. Self-care is a major part of treatment, requiring patients to have the insight and ability to perform the self-care measures in order to live with type 2 diabetes, which can be challenging for many patients. Therefore, the nurse has a great part in the treatment of type 2 diabetes as these patients need a lot of education about the disease.

AimTo describe patients ' experience of self-care in newly diagnosed Type 2 diabetes.

MethodThe study is a literature review that answers a purpose with the help of scientific articles. The databases PubMed and CINAHL were used to find the articles. Results in this literature review were based on Eleven articles published between 2014–2024.

ResultsThe results of the study came to three main categories, disease acceptance, challenges to change in living habits and self-care promoting factors. Disease acceptance had a major impact in how patients engaged in the self-care interventions, and challenges lead to lackof self-care. Health care support was considered important in patients with type 2 diabetes.

ConclusionsThe results of the literature study showed that the patients experienced that self-care as newly diagnosed type 2 diabetes was challenging. This because of the disease required great effort from the patients and knowledge in order to be able to live with the disease. Processing the emotional reactions associated with the disease had a major impact on how the patients followed the self-care measures. Support was important for patients as it promoted patient self-care.

Background: Eighteen of Sweden's population suffers from long-term pain. The unmeasured data in the presence is not known. Among the older population, 54% of women and 38% prevalence of men, have long-term pain. The pain affects several factors, everything from inferior well-being and physical fatigue, to the impact on social life and work. The costs for society are estimated to cost SEK 87.5 billion annually in direct and indirect costs. Complementary and alternative medicine is a collective term for treatments that are not part of the traditional medical treatment. Examples of treatments include massage, acupuncture, transcutaneous electrical nerve stimulation (TENS), cognitive behavioral therapy (KBT) and meditation/yoga. Aim: To describe patients' experiences and the positive effect of alternative and complementary medicine of long-term pain. Method: A literature review based on 14 scientific articles with qualitative or quantitative approach. Searches have been conducted in CINAHL and PubMed. Results: Three main themes emerged in the result, which was increased wellbeing, pain relief and increased mobility. The studies indicate that the patients experienced good pain relief and increased quality of life both physically and mentally during treatment with complementary and alternative medicine. Patients who have not achieved pain relief through traditional care, experienced good pain relief with complementary and alternative medicine. Conclusion:  Complementary and alternative medicine can be an alternative to traditional treatment and sometimes even a first alternative for several reasons, among other things to avoid side effects from drugs.

Background Due to various circumstances, more and more people are forced to flee their countries of origin, which leads to more and more countries becoming multicultural. A multicultural society is in turn reflected in health care. Nurses are faced with great challenges in the care of patients who have other cultural backgrounds. Therefore, it is important that nurses are culturally competent and able to communicate with patients who do not share the same language and culture.

AimThe purpose was to describe the nurse's experiences of transcultural nursing among adult patients.

MethodA literature review based on 15 scientific articles was conducted. The collection of data was done by using databases PubMed and CINAHL

ResultsThe results of the study showed that nurses face several challenges in the field of transcultural nursing which include lack of cultural competence, communication barriers, prejudices, and individual values. It became clear that sufficient cultural competence, effective communication, respect, and a welcoming attitude are significant and decisive factors in being able to provide meaningful and dignified care to patients with a different cultural background.

ConclusionsNurses face challenges in caring for patients from different cultural backgrounds, which can lead to uncertainty and misunderstanding. To ensure quality care, nurses need to increase their knowledge of transcultural nursing and develop effective communication strategies.

Background: Subacromial pain is a common problem within sports. Exercise is the treatment of choice with subacromial pain. However, there is a lack of consensus regarding optimal exercise, doses and load. The shoulder dislocation exercise can be seen on social media as an effective treatment on subacromialpain, but without scientific backing.

Purpose: To investigate the effect on mobility, activity limitations, general shoulder health and pain of the shoulder dislocation exercise on adult recreational powerlifters with subacromial pain.

Method: A single subject study with A-B design were conducted on five individuals with subacromial pain syndrome who regularly trains powerlifting. Baseline phase (A) consisted of three measurements sessions for one week. Outcome measures for mobility was Apley’s scratch test; grade of activity limitation was evaluated with PSFS, pain was evaluated with number of positive provocation tests and the general shoulder health by the SRQ-S. The intervention phase (B) was during six weeks, performing the intervention three times a week split into three sets of ten repetitions. The results were analyzed using the 2SDband method and presented narratively for each participant.

Results: Four of five participants significantly improved their mobility. Four offive participants clinically significantly improved their self-assessed activity limitations. No one improved their general shoulder health, but all five participants decreased number of positive provocation tests for subacromial pain.

Conclusion: The shoulder dislocation exercise seems to improve mobility, activity limitations and number of positive provocation tests for subacromial pain, but not the general shoulder health in the population of adult recreationally powerlifters with subacromial pain. 

Introduction: Diabetes Mellitus is a chronic disease that is linked to suffering

and lack of quality of life. Self-care is essential to reduce the negative

consequences. Less than half of all patients achieve good self-care. Some of the

reasons are limited knowledge of diabetes and poor self-care compliance. The

introduction of ICT in diabetes care was started to improve clinical outcomes and

quality of life for patients with diabetes type 2. Aim: To describe how information

and communication technology can promote self-care in distance for patients with

diabetes mellitus type 2. Methods: Literature study, in which the articles were

searched in CINAHL, PubMed and Web of Science. Articles included were 15

articles with a quantitative, qualitative and mixed method. Results: The results

showed that information and communication technology such as internet,

computer and mobile phone-based self-care program promoted self-care in patients

with diabetes type 2 by increasing knowledge, awareness, motivation and

improving lifestyle change. Conclusion: Information and communication

technology can facilitate the daily challenges for patients with type 2 diabetes

because it covers the knowledge gap and increases patient awareness and

motivation for self-care.

Parenthood can be defined by the contradiction that it is one of the most satisfying yet stressful experiences in life. Many parents experience stress during parenthood, and some to the extent that they display symptoms of parental burnout. Nevertheless, research on parental burnout is scant and many studies have only examined the condition in Western settings. The aim of this study was to examine parental burnout among Somali mothers in Mogadishu, Somalia, and its association with certain psychological, psychosocial, and sociodemographic factors. In this cross-sectional study, questionnaire data were collected through the measurements Parental Burnout Assessment and Patient Health Questionnaire 9, as well as through social and demographic questions. A total of 882 Somali mothers in Mogadishu participated. The analysis methods used were univariate, bivariate, and multiple linear regression analysis. The results revealed that the mean parental burnout score was low in the sample. Additionally, a significant association was found between higher levels of parental burnout and higher levels of depression, perceived lack of social support, being unmarried, having a low monthly household income, and when the youngest child was of school-age.

This study aimed to investigate the patterns of sick leave, as well as factors associated with sick leave due to COVID-19 during one year after the COVID-19 diagnosis, and sex-related aspects on sick leave. This nationwide study involved 11,902 individuals who received sickness benefits for COVID-19 during the first wave of the pandemic. Data from three Swedish registries were analyzed for sick leave that commenced between March 1 and August 31, 2020, with a follow-up period of 12 months. Sick leave due to COVID-19 was counted as the number of days with sickness benefits and required to include at least one registered COVID-19 diagnosis. The median duration of sick leave was 35 days, and 347 (2.9%) individuals continued their sick leave during the entire follow-up period. Furthermore, 1 year later, the cumulative incidence of sick leave was slightly higher in males (3.5%) compared to females (2.7%). Older age, being single with no children, diagnosed with the virus, medium income level, history of sick leave, and need for inpatient care were significantly associated with a higher duration of sick leave due to COVID-19, both in the total population and when stratified by sex. These results indicated that three out of 100 (3%) patients were still on sick leave 1 year after their COVID-19 diagnosis. Aspects regarding the importance of sick leave duration differed between males and females and comprised sociodemographic characteristics and need for inpatient care. The results indicated the complexity of sick leave due to COVID-19.

Background Intimate partner violence is a global and serious problem and about a quarter of the world’s women over the age of 15 have at some point been exposed physically and/or psychologically by a male partner. The consequences of the violence can manifest themselves in both physical and psychological symptoms. The nurse should possess knowledge of intimate partner violence to pay attention to the signs and to offer adequate care.

Aim To describe nurses’ experiences of meeting women exposed to intimate partner violence.

Method The design of this literature review is a structured literature study with elements of the methodology used in systematic reviews and is based on 12 scientific articles from the PubMed and CINAHL databases that were published between 2015-2023. The dataanalysis is carried out according to Friberg's five-step analysis for qualitative research.

Results The results from the analysis are presented in four main categories with ten associated subcategories.: Talking about the violence, The importance of care and society, Emotional reactions and Knowledge and experience.

Conclusions Meeting patients exposed to intimate partner violence is challenging work. A personcentered approach is the basis for handling and identifying women exposed to intimate partner violence. There is a lack of clear guidelines in the workplace and the cooperation between different authorities/institutions is insufficient, as well as societal support for a woman who has been subjected to violence. To increase the knowledge of nurses, more and continuous education is needed.

Background: Dementia is an umbrella term for illnesses that cause cognitive impairment. A person centered approach is the foundation of caring for people with dementia. The relatives to admitted patients with dementia experience the care as generally good, but with room for improvement. Aim: This literature review aims to illustrate RNs experiences in caring for persons with dementia in an inpatient hospital setting. Method: This literature review was made with a methodology similar to ones used in systematic reviews. The search engines PubMed, CINAHL and APA PsycInfo were used and the chosen articles were checked for quality according to a template for qualitative research. The results were analyzed using Fribergs five steps for qualitative analysis. Results: A large number of RNs experienced challenges in the care of PwD. Organisational pressure and a lack of interprofessional co-operation led to an increase in the use of psychotropic drugs, as the stressful environment increased the rate of responsive behaviours in PwD. Distraction was common for RNs to use to counter responsive behaviours. RNs also used person centred communication to facilitate a good relationship. Conclusions: Experienced factors like lack of time and lack of knowledge was experienced as contributing to nurses having difficulties performing person centred care. This can resultin a reduced wellbeing for people with dementia when they are in need of care.

Background: Florence Nightingale (1820 - 1910) was a major advocate for the importance of environment for optimal patient recovery. The modern healthcare environment typically consists of two components, one physical and one psychosocial, where both parts are considered crucial for the patient’s return to health. This is particularly important to bear in mind in the postoperative context and with the experience of postoperative pain, which varies from patient to patient. Nurses are responsible for providing postoperative pain relief, chiefly by nursing, utilizing the health care environment and administering pharmacological painkillers.Aim: The purpose of the study is to describe the importance of the health care environment in relieving newly operated patients postoperative pain.Method: A literature review with qualitative design. The results of the study are based on 15 scientific articles that have been quality reviewed. The scientific articles were searched on CINAHL, PubMed, Web of Science and via manual search.Results: The literature review identified physical care environment with subcategories; patient room and contact with the external environment. In the category psychosocial care environment subcategories; sense of control, relationships and music as distraction as pain-relieving alternatives.Conclusion: The physical and psychosocial health care environment act as a distractive element on the patient and/or have a relieving effect on the postoperative pain.

Background Lipoedema has a prevalence of seven to eleven percent of adult women in Western countries, yet the condition remains largely unknown by both society and health professionals who often mistake it for obesity. Women with lipedema go through anaverage interval of eighteen years between the onset of symptoms and diagnosis where they experience exacerbation of various symptoms without knowing the cause or mistaking it for obesity. As lipedema is a chronic disease, it affects the lives of women with lipedema not only through disease-related symptoms, but also through fat-related stigma.

Aim The purpose of the literature review is to investigate women´s experiences of living with lipedema.

Method A literature search was conducted on the Cinahl and PubMed databases, resulting in ten scientific articles. These articles were quality reviewed using Ulrika Nilsson's review template and analysed using the analysis model of Forsberg & Wengström.

Results Results show that women’s experiences can be grouped into two main categories: to be a Stranger in one's own body which were divided into three subcategories, Bodily Changes, Pain and Mental Illness. The other main category, Stigmatisation, was divided into two subcategories: Shame and Lack of care.

Conclusions Experiences with lipedema are revealed to be potentially damaging to both physical as well as psychological health due to lack of information, reduced number of effective treatments and stigmatization coming from both healthcare actors as well as society. Wrong diagnosing, lack of information, misdiagnosis and ineffective treatments then leads these women to ineffective interventions and unnecessary suffering. Further research is needed to increase knowledge about diagnoses and treatments for lipoedema to increase the quality of life of women with lipoedema. 

Syfte

Syftet var att ta reda på vad elitaktiva inom längdskidor anser vara en bra idrotts- och träningsmiljö.

Metod

Metoden som används är uppdelad i två olika ansatser. Den första ansatsen är inom den kvantitativa forskningen och utformades som en enkätstudie, där längdskidåkare har fått svara på frågor om sin träningsmiljö. Den andra delen av uppsatsen är utformad som en kvalitativ studie med semistrukturerade intervjufrågor baserat på ett mindre urval av de som svarat på enkäten. Detta skedde efter att resultatet av den kvantitativa studien blivit analyserat, för att utforma en intervjumall från enkätsvaren, i syfte att försöka få en djupare förståelse av detta problemområde.

Resultat

Resultatet visar att det finns en stor komplexitet i uppfattningen om vad som anses vara en bra träningsmiljö för längdskidåkare. Dock kan det urskiljas att vissa faktorer som viktigare än andra, till exempel vikten av att ha träningskamrater och god sparring för att kunna utvecklas. Värdet av att ha en tränare ansågs också viktigt. Resultaten visar även hur den elitaktive upplever sin träningsmiljö i dag och vad som efterfrågas.

Slutsatser

Det framkom tydligt att bristen på hjälp upplevs stor bland seniorer inom längdskidor. Att steget mellan junior och eventuellt gå på ett skidgymnasium, till att bli senior upplevs alldeles för stort, att det inte finns tillräcklig stödfunktioner, skolor eller träningsgrupper att tillgå som senior.

Syfte: Syftet var att beskriva patienters upplevelse att vänta på organtransplantation.

Metod: Studien genomfördes som en litteraturöversikt. Artiklarna har sökts i databaserna CINAHL, PubMed och Scopus. 15 artiklar valdes ut till resultatet, 3 artiklar hade kvantitativ ansats och 12 kvalitativ ansats.

Resultat: 3 huvudkategorier presenteras i resultatet: Begränsningar innebar att vara bunden av teknisk apparatur och förhålla sig till en ny livsstil. Tiden fick nytt perspektiv och patienter upplevde att de alltid behövde vara beredda. Patienterna möttes av falskt alarm och upplevde väntan som oviss. Det fanns behov av stöd från anhöriga, patienter i samma situation och stöd från vårdpersonal. Tydlig och rak kommunikation var viktig för patienterna. Sjuksköterskan behövde finnas till hands. Trots oro fanns en känsla av en andra chans i livet.

Slutsats: Patienter som väntar på en organtransplantation upplever att sjuksköterskan behöver vara tillgänglig, ha tydlig kommunikation, ge anpassad information utifrån individuella önskemål samt accepterar och förstår vikten av anhörigas närvaro och stöd så att varje patients enskilda behov kan bemötas.

BACKGROUND: Most women within reproductive ages living in Low- and Middle-Income Countries, have limited or no access to education on sexual and reproductive health and contraception, yet about 1.9 billon women in LMICs own a mobile phone. The exposure to digital health services has the potential to contribute to improving awareness, influencing positive perceptions, beliefs and promoting SRH and contraception.AIM: To explore user views and perceptions on the Grace Health’s (a digital health service) ability to improve awareness on sexual reproductive health and contraception among Ghanaian, Nigerian and Kenyan women aged 18-35.METHODOLOGY: A qualitative design using phenomenography to interview women remotely on women’s perception of digital health services through their own experience with using the Grace health chat bot and app. Also, their views were sought on how other women are gaining awareness and impacts on sexual reproductive health and contraception from the digital health services.RESULTS: Seven categories on digital health services emerged, with key findings presented as Safe days, ovulation as contraception, impacts on SRH, Avoiding or seeking pregnancy and influence on perception.CONCLUSION: This qualitative study gives insight for research community, public health professionals, app designers, health care providers, stakeholders and civil society organisations in making decisions regarding the use of digital health service as strategic, innovative instruments for interventions in major key indicators of Sexual Reproductive Health and Rights.

Objective: Explore general practitioners’ (GPs’) views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases.

Design: Qualitative content analysis of five focus-group discussions.

Setting: Primary health care centers in the Region of Västra Götaland and Dalarna County, Sweden.

Subjects: 29 GPs.

Main outcome measures: GPs’ views and experiences of care managers for patients with depression.

Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases.

Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members’ roles must be clear.

Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.

Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.

Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.

Background: Cancers can affect both sexes at any age and it is estimated that at least one in three people will be diagnosed with cancer at some point in their lives. In the diagnosis of cancer, the care can have two orientations, curative or palliative. When curative care no longer is possible, the care is transferred to palliative care, which means that the focus is primarily on symptom relief, promoting quality of life and well-being. People may have different wishes and goals at the end of life and in order for the quality of life to be promoted, the individual wishes should be taken into account. Quality of life is individual and includes the factors that affect the individual and is a subjective assessment of the individual's social, emotional, material and physical well-being.Aim: To describe factors that can affect the quality of life of patiens with cancer in a late stage of palliative care from a patient perspective.Method: The study is conducted as a literature review based on 15 quantitative and 7 qualitative scientific articles. Data searches have been performed in the CINAHL and PubMed databases.Results: The results showed that there are 6 main categories that make up the factors that affect the quality of life, these are background factors, social factors, palliative care environment, psychological factors, physical factors and existential factors.Conclusion: Younger individuals experience a poorer quality of life than older people. Where the individual is cared for and the care environment was an important factor in promoting a good quality of life at the end of life. Depression and anxiety were factors that negatively affected the individual. The physical symptoms such as pain were strongly associated with poorer quality of life.

Background

Each year approximately 1 percent of Sweden’s population dies, which corresponds to approximately 90 000 people. Of these, about 36 percent dies while living in special housing. Pain is a common symptom in older people receiving end-of-life care. Identifying pain and alleviating pain thus becomes central and an important part of the work of the nurse responsible for care.

Aim

The aim is to describe nurses’ experiences of identifying pain and using nursing interventions for pain relief in older people living in special housing at the end of life.

Method

The method used is a qualitative interview study with and inductive approach. Semistructured interviews have been used for the collection of data were nurses with at least one year of experience of working in special housing for people older than 65 years of age in end-of-life care were included as informants. Content analysis was done according to a method described by Graneheim and Lundman (2004).

Results

The result of the study is presented with four categories; Relationship central for end-oflife care, Identifying pain is difficult, Nursing interventions alleviate pain and A qualified team promotes nursing. All categories are presented with associated subcategories.

Conclusions

The results of the study show that knowledge of the person made person-centered care possible and increased the possibility to individualize nursing interventions and made it easier to identify pain in older people. Nursing staff lacked knowledge about identifying pain and alleviating pain with nursing interventions. It was nurses who had the responsibility to tutor, and competence supply the team however the results show that nurses does not follow guidelines regarding estimation instruments when identifying pain and neither do they have satisfactory knowledge of the four dimensions of pain.

Aim: The aim of this literature review was to, from a patient point of view, identify factors within the specialized palliative care that constituted good care from the.Method: A systematic literature review was undertaken. Fifteen articles were reviewed. Thirteen of these were qualitative and two were quantitative.Results: Four categories were identified: self determination, capability of the nurse, nursing relations and maintaining dignity.The patients self determination was a central part of nursing. Delegating control and self determination from a patient to a nurse is also a form of self determination.Capable nurses instill trust and gave patients the opportunity of more alternatives when it came to choices concerning the care of the patient.A good relation with the nurse could give the patient a feeling of being important and being a part of something bigger, despite lack of family or friends. Important factors regarding patient-nurse relations were continuity and nurse accessibility.Maintaining dignity included being seen as the human being that the patient was before the terminal illness was diagnosed.Conclusion: Patients noted several factors as important for good palliative care. These could be summarized as self determination, nurse capability, nursing relations and maintaining dignity.

Background: People suffering from mental illness experience stigma in differentcontexts. There are various factors that affected by stigma in people suffering frommental illness, which also leads to experiences of discrimination in them. Stigma isa common problem in today's society, which has consequences in people sufferingfrom mental illness.Aim: The purpose of this study is to describe factors related to the stigma of as wellas these consequences for people suffering from mental illness outside psychiatry.Method: The thesis carried out as a literature review where 15 scientific articlessearched based on the purpose, which then analyzed and compiled into the results.The articles were of both qualitative, quantitative design and a mixed method. TheCINAHL and PsycINFO databases used as search engines.Result: The result consists of four main categories. “Quality of life” describes theconsequences of stigma on quality of life. “Cultural and socio-demographic factors”which discuss the impact of cultural perspectives on stigma and the link betweenstigma and educational attainment are described. “Social distancing,” points outfactors that cause people suffering from mental illness to withdraw from socialsituations. "Family" there describes the family as a source of stigma.Conclusion: Stigma affects the quality of life of people suffering from mentalillness. Furthermore, lack of access and level of education can increase the risk ofstigma. Stigma also leads to social distancing in people suffering from mentalillness. In addition, the family of people suffering from mental illness considered animportant source of stigma, which means that they avoid talking about mental illnessin the family.

Parkinson’s disease (PD) is a degenerative, progressive disorder of the central nervous system that mainly affects motor control. The aim of this study was to develop data-driven methods and test their clinimetric properties to detect and quantify PD motor states using motion sensor data from leg agility tests. Nineteen PD patients were recruited in a levodopa single dose challenge study. PD patients performed leg agility tasks while wearing motion sensors on their lower extremities. Clinical evaluation of video recordings was performed by three movement disorder specialists who used four items from the motor section of the Unified PD Rating Scale (UPDRS), the treatment response scale (TRS) and a dyskinesia score. Using the sensor data, spatiotemporal features were calculated and relevant features were selected by feature selection. Machine learning methods like support vector machines (SVM), decision trees and linear regression, using 10-fold cross validation were trained to predict motor states of the patients. SVM showed the best convergence validity with correlation coefficients of 0.81 to TRS, 0.83 to UPDRS #31 (body bradykinesia and hypokinesia), 0.78 to SUMUPDRS (the sum of the UPDRS items: #26-leg agility, #27-arising from chair and #29-gait), and 0.67 to dyskinesia. Additionally, the SVM-based scores had similar test-retest reliability in relation to clinical ratings. The SVM-based scores were less responsive to treatment effects than the clinical scores, particularly with regards to dyskinesia. In conclusion, the results from this study indicate that using motion sensors during leg agility tests may lead to valid and reliable objective measures of PD motor symptoms.

Syftet var att undersöka vilka egenvårdsråd och effekterna av dessa som finns beskrivna i litteraturen vid NAFLD samt hur följsamheten av dessa beskrivs. Studien utfördes som en litteraturöversikt som inkluderade 16 artiklar, alla med kvantitativ ansats. Resultatet visade att livsstilsförändringar i form av fysisk aktivitet och ändrade matvanor var det bästa sättet för att minska NAFLD. Viktminskning hade en god effekt på NAFLD och även små viktminskningar reducerade mängden fett i levern. Det framkom även att fysisk aktivitet utan viktminskning var effektivt för att reducera mängden fett i levern. Vidare visade det sig att följsamheten ökade med individuellt utformade program och kontinuerlig stöttning. Förutsättningar för att uppnå livsstilsförändringar ökade med realistiskt uppsatta mål.

Background: The first year of life is critical for sleep development, and the quality of sleep affects both the physical and neurological development. The sleep of infants constitutes a common cause of worry among new parents, which can lead to modifications in recommended sleep arrangements to promote both parents’ and infants’ wellbeing. Aim: To investigate parents’ experience and description of preterm (<37 weeks of pregnancy) and full-term infants’ sleeping habits at one and six months of age. Method: This was a quantitative study with a longitudinal design consisting of 923 parents to 504 infants born during 2020/2021 who received care in either the maternity- or neonatal ward in Sweden. Data was collected from questionnaires and was analyzed using descriptive statistics, Mann-Whitney U test and Cohen’s d. Results: Fathers and parents with a low educational level experienced the infant’s sleep less problematic compared to mothers and parents with a high educational level at both one and six months of age. Over time there was no difference related to educational level. One moth post-partum, parents to preterm infants experienced that the sleeping habits were more of a problem compared to parents to full term infants. Parents to breastfed infants experienced the sleeping habits as more problematic at six months of age, and co-sleeping was common during the infants’ first month of life. Conclusions: Parents’ experience of infants’ sleeping habits is affected by various factors in the immediate home environment. Hence there is a need for individualized support and interventions for new parents regarding infants’ sleep environment.

Background: Dementia impairs cognitive functions, such as memory and

speech, changing a person’s life forever. Providing person-centred care to these

persons intend to retain their identities, dignity and autonomy. Such care demands

time, devotion and good knowledge of the caring nurse. Dementia is expected to

increase in the future and therefore nurses will have to face new challenges.

Aim: To describe nurses’ experience of providing person-centred care for people

with dementia.

Method: A literature review of 15 articles, published between 2009-2016, that

have been read and analysed through content-analysis.

Results: Nurses experience a positive change in their attitudes, when providing

person-centred care to people with dementia, as they gained better understanding

of their patients’ dignity and integrity. Education, training and support from

management were seen as key factors for providing up-to-date care. Time was

viewed as a hindrance for person-centred care, and often led to nurses prioritizing

other routines. Two common outcomes of person-centred care were increased

satisfaction as well as emotional burnout.

Conclusion: Since dementia is increasing and nurses find person-centred care

time-consuming, there is a risk of such care becoming poor. To prevent this nurses

need good leadership and education.

Suicides by drowning have received limited attention by researchers. A recent finding that almost one-third of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.

Bakgrund: Förlossningsrädsla är vanligt förekommande och drabbar cirka 20 procent av alla gravida.Barnmorskan på barnmorskemottagningen möter de gravida med förlossningsrädsla i sitt arbete och har ettviktigt uppdrag i att identifiera förlossningsrädsla. I Sverige finns idag inget gemensamt och standardiserat sättatt mäta förlossningsrädsla inom klinisk vård. Fear of Birth Scale (FOBS) är emellertid ett validerat sätt attscreena för förlossningsrädsla som används inom flera regioner.Syfte: Syftet var att undersöka barnmorskor på barnmorskemottagningars erfarenheter av att använda Fear ofBirth Scale (FOBS) för att mäta förlossningsrädsla.Metod: En kvalitativ intervjustudie med induktiv ansats valdes för studiens genomförande. Totalt intervjuadesåtta barnmorskor som arbetade på barnmorskemottagningar i fem olika regioner i Sverige.Resultat: Resultatet utmynnade i två teman; Att mäta och vägleda rätt samt Dialogen som verktyg förskattning. Temat Att mäta och vägleda rätt omfattade fyra subteman; Tidpunkter och insatser, Konkretmätskala tydliggör, Dynamiken en utmaning samt Strategier vid språkbarriärer. Temat Dialogen som verktygför skattning omfattade två subteman; Öppet samtal i fokus samt Att tolka och anpassa i situationen.Slutsats: FOBS har bidragit till att sätta ämnet förlossningsrädsla på agendan hos barnmorskan på BMM.Under rätt förutsättningar kan FOBS bidra till att underlätta barnmorskans arbete med att identifiera ochbedöma förlossningsrädsla, men tid och fortbildning krävs.Klinisk tillämpbarhet: Identifiering och stöd vid förlossningsrädsla ingår i mödrahälsovårdens omfattandeuppdrag. Med rätt förutsättningar kan FOBS vara ett användbart hjälpmedel för att hitta och inleda en dialogom förlossningsrädsla, som är ett komplext ämne där vissa grupper särskilt sårbara och har ett stort stödbehov

Background: In today's society, depression is considered a world problem. A reduced desire for life, low self-esteem, tiredness and low energy are a few of the symptoms that a person with depression and depressive symptoms suffer from. The use of physical activity in various forms is recommended as a treatment for depression and depressive symptoms in elderly people. Person-centered care aims to ensure that the individual's own experience of health is in focus which increases the well-being of a person suffering from depression or depressive symptoms.Purpose: The purpose of the literature review is to investigate the effect of physical activity in elderly people with depression and depressive symptoms.Method: The degree project was carried out as a literature review. 14 articles were searched in the PubMed and CINAHL databases with keywords designed from the purpose. The articles were reviewed based on Dalarna University's review template and compiled based on different quality grades. Articles with medium and high quality were included. The results were categorised and compiled based on similarities and differences that emerged from the analysis.Results: The results of the literature review are shown to have an effect in depression and depressive symptoms in elderly people. Being physically active through an assigned individual exercise program, training in groups or in the form of yoga was shown to be able to positively affect the depressive symptoms and depression. The intensity of exercise and frequency may have an impact on the effect of depressive symptoms or depression.Conclusion: The effect of physical activity in various forms has been shown to reduce depressive symptoms in elderly people.

BACKGROUND: Children in need of special support often display delays in time processing ability, affecting everyday functioning. MyTime is an intervention programme for systematic training of time processing ability. To support preschool children's development of time processing ability and everyday functioning, it is necessary to include their perspectives of the MyTime intervention programme. A previous study shows that MyTime is feasible with children in the preschool setting and shows positive effects on time processing ability for older children in special schools. Yet, there is a lack of knowledge regarding how preschool children experience the intervention programme and how they understand its meaning. The aim of this study was to explore the experiences and the meaning of using MyTime from the perspective of children with informal needs of special support (INS) 5-6 years of age in the preschool context.

METHODS: To explore the children's perspectives, video-recorded interviews with 21 children were analysed hermeneutically. To facilitate the interview situation with the children in need of special support, the Talking Mats© was used. Both body and spoken languages were analysed.

RESULTS: The results reveal children as active participants, willing to share their experiences of using the MyTime intervention in the preschool context. The conceptualization of the children's experiences and expressions uncovers their meaning of using the MyTime intervention as to know and to understand time by doing.

CONCLUSIONS: When children are given the opportunity to use concrete tools to understand and measure time, they experience themselves as active participants involved and engaged in the intervention. They reveal meaningful experiences to be able to manage time that facilitate their everyday functioning and participation in the preschool context.

OBJECTIVE: To capture care providers' perceptions of defibulated immigrant women's sexual and reproductive health, illuminated by their experiences as care providers for these women.

METHODS: Individual interview study with 13 care providers at Swedish healthcare facilities: six gynaecologists and seven midwives caring for defibulated immigrant women, analysed with a phenomenographic method.

FINDINGS: One of the care providers' perceptions of women who had been defibulated was that they had an altered genital function, meaning a wider introitus, improved vaginal intercourse, and more ease urinating and menstruating. The care providers also perceived that women who were defibulated had to balance their wellbeing, struggling between a positive self-image and handling their emotions. Existing in-between cultural values led to a fear of being excluded while at the same time having a desire to be included in the new culture.

CONCLUSION: Defibulation affects women's sexual and reproductive health and calls for a holistic perspective when providing services, individualized according to the woman's care needs. Support and counselling, should include information about defibulation already during the adolescent years to promote sexual and reproductive health and well-being.

Background: One of the most important qualities in the nursing profession is to establish a dialogue with patients to learn more about the patient's current situation. The purpose of this study is to study the stressors that affect communication between nurses and patients. Stressrelated to work causes poor physical and mental health and affects the nurses' work environment. A good nurse always tries to improve the relationship with the patients so that it is easier to get to the basic problem. A well performed communication contributes to patients feeling involved and given the opportunity to convey their experience. Aim: To clarify stress factors that affect communication between nurses and patients in inpatient care. Method: A structured literature review with elements of the methodology used in systematic literature reviews. The result contained 15 scientific articles and was taken from Psycinfo, PubMed and Cinahl. Results: Understaffing increases the nurse's workload, which minimizes the ability to see the patient's needs. Time pressure will cause the nurses to not have time to complete their work tasks, which in turn burdens their colleagues. Cultural and language barriers are one of the stressors that hinder communication between patients and nurses. Conclusions: Lack of experienced nurses increases the nurse's work-related stress, which in turn reduces the ability to see patients' needs. Documentation and understaffing creates a stressful work environment, and this leads to an increased workload. Lack of time minimizes communication between nurses and patients, which leads to a lack of nursing. Cultural differences could mean that nurses do not communicate with patients as much due to the fear of insulting the patients' culture.

Background: The prostate is a gland located under the male bladder and surrounding the urethra. Prostate cancer is the most common form of cancer in Sweden among men. A common treatment is radical prostatectomy, which means removal of the prostate gland. One of the side effects of this treatment is erectile dysfunction, which affects over half of men after the procedure. Men's sexuality is intimately linked to the social context and can be influenced by both physiological and psychosocial factors

Aim: To describe men's experience of sexuality after radical prostatectomy.

Method: Meta-ethnography was chosen as the analysis method to answer the purpose of the meta-synthesis. PubMed, CINAHL and PsykINFO were used for data collection. The quality of the articles was assessed according to the Joanna Briggs review template. The results of the meta-synthesis are based on 15 scientific articles.

Results: The result consists of three main categories that emerged during the analysis of the articles: The first main category is the experience of sexual life, which includes the subcategory Lack of support and the subcategory Restrictions on sexual activity. The second main category is Impact on psychosocial well-being and perceived emotions followed by the sub-category Life transitions and changes, impact on quality of life and the sub-category Redefining sexuality. The third main category is Changed Identity which is followed by the sub-category Loss of Confidence, Masculinity and Masculinity.

Conclusion: Men experienced negative changes in their sexual scripts, influenced by traditional masculinity norms. For that reason, it is of great importance that this patient group receives adequate support after the operation and sexual counseling in order to promote sexual health, sexuality and to minimize negative side effects on quality of life and men's perception of masculinity and masculinity. Clinical applicability: This study may contribute to an increased insight, knowledge and understanding of men who have undergone radical prostatectomy. Which can further help midwives manage the treatment of these patients. Improved insight and understanding of the problem can promote high-quality person-centred care, reduce hospital stays and increase patients' trust in health care. 

Background: Stroke is a collective name for conditions that occur when the oxygen supply to the brain are disturbed as a result of a blockage or cerebral haemorrhage. The condition affects 15 million people annually making stroke one of the foremost the cause of death in the world. Stroke can contribute to major injuries which can be life changing for the person and the family. The nurse has an important role in providing support and care to the patient and informing and supporting relatives through this change.Aim: To describe family caregivers experience of life after strokeMethod: A literature review where 14 qualitative articles have been analyzed, the articles are taken from the databases Psycinfo, PubMed and CINAHL.Results: Three main categories were developed in the results. The categories was changed relationships and roles within the family, An everyday life with limitations and the consequences of a life in change..Conclusion: The literature review showed that relatives felt that life changed significantly after a family member's stroke diagnosis. The changed life situation made it difficult for relatives to restore a balance in everyday life. Through careful planning before hospital discharge, the nurse can identify which support measures are relevant for the family to have a functioning everyday life. The nurse should also be aware of the need for physical and emotional support in the meeting with relatives. The nurse can offer training, workshops or other forums where relatives can talk and meet families in similar situations. This can thus increase the nurse's ability to promote the health and well-being of relatives.

OBJECTIVES: Comparing language-supported group antenatal care (gANC) and standard antenatal care (sANC) for Somali-born women in Sweden, measuring overall ratings of care and emotional well-being, and testing the feasibility of the outcome measures.

DESIGN: A quasi-experimental trial with one intervention and one historical control group, nested in an intervention development and feasibility study.

SETTING: Midwifery-led antenatal care clinic in a mid-sized Swedish town.

PARTICIPANTS: Pregnant Somali-born women (<25 gestational weeks); 64 women in gANC and 81 in sANC.

INTERVENTION: Language-supported gANC (2017-2019). Participants were offered seven 60-minute group sessions with other Somali-born women led by one to two midwives, in addition to 15-30 min individual appointments with their designated midwife.

OUTCOMES: Primary outcomes were women's overall ratings of antenatal care and emotional well-being (Edinburgh Postnatal Depression Scale (EPDS)) in gestational week ≥35 and 2 months post partum. Secondary outcomes were specific care experiences, information received, social support, knowledge of pregnancy danger signs and obstetric outcomes.

RESULTS: Recruitment and retention of participants were challenging. Of eligible women, 39.3% (n=106) declined to participate. No relevant differences regarding overall ratings of antenatal care between the groups were detected (late pregnancy OR 1.42, 95% CI 0.50 to 4.16 and 6-8 weeks post partum OR 2.71, 95% CI 0.88 to 9.41). The reduction in mean EPDS score was greater in the intervention group when adjusting for differences at baseline (mean difference -1.89; 95% CI -3.73 to -0.07). Women in gANC were happier with received pregnancy and birth information, for example, caesarean section where 94.9% (n=37) believed the information was sufficient compared with 17.5% (n=7) in standard care (p<0.001) in late pregnancy.

CONCLUSIONS: This evaluation suggests potential for language-supported gANC to improve knowledge acquisition among pregnant Somali-born women with residence in Sweden ˂10 years. An adequately powered randomised trial is needed to evaluate the effectiveness of the intervention.

TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03879200).

BACKGROUND: Language supported group antenatal care (gANC) for Somali-born women was implemented in a Swedish public ANC clinic. The women were offered seven 60-min sessions, facilitated by midwives and starting with a presentation of a selected topic, with an additional 15-min individual appointment before or after. The aim of this study was to assess the feasibility for participants and midwives of implementing The Hooyo ("mother" in Somali) gANC intervention, including implementation, mechanisms of impact and contextual factors.

METHODS: A process evaluation was performed, using The Medical Research Council (MRC) guidelines for evaluating complex interventions as a framework. A range of qualitative and quantitative data sources were used including observations (n = 9), complementary, in-depth and key-informant interviews (women n = 6, midwives n = 4, interpreters and research assistants n = 3) and questionnaire data (women n = 44; midwives n = 8).

RESULTS: Language-supported gANC offered more comprehensive ANC that seemed to correspond to existing needs of the participants and could address knowledge gaps related to pregnancy, birth and the Swedish health care system. The majority of women thought listening to other pregnant women was valuable (91%), felt comfortable in the group (98%) and supported by the other women (79%), and they said that gANC suited them (79%). The intervention seemed to enhance knowledge and cultural understanding among midwives, thus contributing to more women-centred care. The intervention was not successful at involving partners in ANC.

CONCLUSIONS: The Hooyo gANC intervention was acceptable to the Somali women and to midwives, but did not lead to greater participation by fathers-to-be. The main mechanisms of impact were more comprehensive ANC and enhanced mutual cultural understanding. The position of women was strengthened in the groups, and the way in which the midwives expanded their understanding of the participants and their narratives was promising. To be feasible at a large scale, gANC might require further adaptations and the "othering" of women in risk groups should be avoided.

TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov (Identifier: NCT03879200).

OBJECTIVE: To explore Somali-born parents' experiences of antenatal care in Sweden, antenatal care midwives´ experiences of caring for Somali-born parents, and their respective ideas about group antenatal care for Somali-born parents.

DESIGN: Eight focus group discussions with 2-8 participants in each were conducted, three with Somali-born mothers, two with fathers and three with antenatal care midwives. The transcribed text was analysed using Attride-Stirling´s tool "Thematic networks".

SETTING: Two towns in mid-Sweden and a suburb of the capital city of Sweden.

PARTICIPANTS: Mothers (n = 16), fathers (n = 13) and midwives (n = 7) were recruited using purposeful sampling.

FINDINGS: Somali-born mothers and fathers in Sweden were content with many aspects of antenatal care, but they also faced barriers. Challenges in the midwife-parent encounter related to tailoring of care to individual needs, dealing with stereotypes, addressing varied levels of health literacy, overcoming communication barriers and enabling partner involvement. Health system challenges related to accessibility of care, limited resources, and the need for clear, but flexible routines and supportive structures for parent education. Midwives confirmed these challenges and tried to address them but sometimes lacked the support, resources and tools to do so. Mothers, fathers and midwives thought that language-supported group antenatal care might help to improve communication, provide mutual support and enable better dialogue, but they were concerned that group care should still allow privacy when needed and not stereotype families according to their country of birth.

KEY CONCLUSIONS: ANC interventions targeting inequalities between migrants and non-migrants may benefit from embracing a person-centred approach, as a means to counteract stereotypes, misunderstandings and prejudice. Group antenatal care has the potential to provide a platform for person-centred care and has other potential benefits in providing high-quality antenatal care for sub-groups that tend to receive less or poor quality care. Further research on how to address stereotypes and implicit bias in maternity care in the Swedish context is needed.

Background: Pain is a major problem in nursing homes. Dementia is a disease that causes humans lose their ability to communicate their pain to their surroundings. People with dementia express their pain through behavioral changes because they can’t verbalize their pain experiences. As a consequence of this leads to that dementia patients are not receiving adequate pain management.

Aim: The aim of this study is to explore how nurses identify pain in dementia patients in nursing homes.

Method: The study was conducted as a literature survey. In total, 15 articles were used in this study that consists of both quantitative and qualitative approaches. Articles have been sought in the databases Cinhal and PubMed.

Results: The results of this study shows that according to nurses is pain identification among dementia patients an extreme challenge and requires more knowledge. Patients with mild to moderate dementia can self-report their pain to a certain extent. The most useful clues to discovering pain among dementia patients who are limited in their speaking skills is to observe facial expressions, body language and behavior changes.

Conclusion: The authors conclude that it is important to create and develop a relationship between caregivers and demented patients. This is to get to know the patient and knowing his usual habits and behavior changes as to facilitate the identification of pain

Background:

Extensive demands are placed on midwives in their professional role. The midwifery education is obligated to answer to these professional requirements. ountry specific, feasible and acceptable accreditation toolkit for institution/collages/universities is, therefore, relevant to develop.

Objective:

The objective was to map the existing situation of the midwifery education sites in Dhaka division and to explore acceptable and feasible requirements to be included in an accreditation toolkit for Bangladesh.

Methods:

A questionnaire study with open and closed response alternatives was used.

Results

: Six nursing diploma institute and one nursing college were included in the mapping. The theory in relation to practice (theory/practice) in the education was 40%/60% for 5 institution/colleges and 50%/50% for one institute. Both qualitative open questions and closed questions based on ICM Global standards revealed that the acceptable and feasible requirements for a nationwide accreditation tool for midwifery educations needs clearly written admission and student policies, supportive staffs and formally prepared and globally oriented competent unbiased teachers who maintain their standard by participating in professional development activities.

Conclusion:

Implementing globally standard accreditation tool for educating and training competent midwives is not a far-fetched idea in the context of Bangladesh. The clinical applicability of this essay lies in the fact that competent midwives can profoundly provide suggestions for improvements of midwifery educations with support of an accreditation tool.

Background:

Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is achieved through the use of contraceptive methods and the treatment of infertility. It secures the well-being and autonomy of women while supporting the health and development of the communities. A midwife can support people having family planning facilities and thus reduce maternal and neonatal mortality and morbidity and unnecessary interventions, and improve psychosocial and public health.

Objective:

The objective of the study was to assess the knowledge, attitudes, and perceptions towards family planning among future midwives in Bangladesh.

Methods:

A cross-sectional study was conducted among final year midwifery students (n=141) of 16 public midwifery nursing institutes and colleges of Bangladesh. A structured questionnaire was used and data analyzed by descriptive statistics in Excel.

Results:

Almost all respondents agreed on the statement that women should be treated with respect when seeking family planning services. One third disagreed or strongly disagreed that unmarried women should abstain rather than use family planning. Almost half of the respondents disagreed or strongly disagreed that women should be free to choose if and when they want to become a pregnant. Majority of the respondents had inadequate knowledge about effectiveness regarding different FP methods and misconceptions regarding hormonal family planning methods.

Conclusion:

This study showed that diverse attitudes related to family planning and women’s right to access family planning services exist among future midwives. The study also found misconceptions regarding side effects of family planning methods and inadequate knowledge regarding effectiveness and appropriateness of different family planning methods.

Clinical implications:

To increase knowledge, midwifery curriculum should have a special emphasis on the effectiveness of different contraceptive methods and effects of hormonal contraceptives, and particularly the link to clinical practice. Value clarification training can be a way to address attitudes in relation to family planning. Further qualitative research should be conducted to gain a deeper understanding of midwifery students’ attitudes and perceptions.

INTRODUCTION: The aim of this study was to explore midwives' and assistant nurses' experiences of providing extra support to non-Swedish-speaking migrants by offering individual language-supported visits to the labor ward during pregnancy.

METHODS: Semi-structured interviews were conducted with six guides, midwives or assistant nurses, working in the INFÖR (Individuell förlossningsförberedelse) project at Södertälje hospital in Sweden. INFOR includes a two-hour individual language-supported visit at the labor ward, for non-Swedish speaking pregnant women and their partners. An inductive thematic analysis was conducted.

RESULTS: The guides described INFOR as being a bridge and creating safety, achieved by meeting with women and providing practical information. The guides felt that they fulfilled an important purpose, they were dedicated and adapted to the women's individual needs. Providing extra language-assisted support to migrant pregnant women was developing and enriching, but the guides highlighted some barriers. Communicating via an interpreter was a challenge and the women were in need of more and extended meetings. The guides wished that INFOR could become a standard part of antenatal care, but the model needs to be further developed, and a better system for recruitment must be introduced.

CONCLUSIONS: The guides experienced that the INFOR model is valuable in creating safety to pregnant migrant women before birth. The model is appreciated by the expectant couples, midwives and assistant nurses, and could be implemented as standard care. However, it is important to adapt the visits to the women's and their families' needs and goals, and structure needs to be developed before implementation.

INTRODUCTION: The European Union faces challenges related to migration, cultural diversity and health. Immigration to Sweden has increased and a third of all women giving birth were born outside Sweden. A higher risk for negative pregnancy outcomes is seen among foreign-born women and one of the explanations given is inadequate communication. Midwives in Sweden have responsibility for normal birth. This study aimed to investigate labor ward midwives' experiences of caring for and communicating with women who do not speak and understand the Swedish language.

METHODS: A questionnaire based on the Migrant Friendly Hospital questionnaire was distributed to all 46 midwives working on the Södertälje Hospital labor and postpartum ward in 2018 and 32 completed it (70%).

RESULTS: Most of the midwives thought communication and giving support to non-Swedish speaking women during birth was difficult or very difficult (n=31; 97%). The quality of the professional interpreters' work was reported as good or very good by most of the midwives (n=31; 97%). However, the most common resource for facilitating communication during labor was an adult relative (always/often: n=25; 83%). Increased availability was the most common response for improving the interpreter service (n=22; 69%), as well as increasing the number of languages available for interpreter services (n=8; 25%).

CONCLUSIONS: When women are giving birth, it is of the highest priority to improve communication between midwives and non-Swedish-speaking women. Better strategies for improving communication must be implemented in order to comply adequately with Swedish law and achieve equitable care of high quality for all, regardless of linguistic background.

Background:

High demands are placed on midwives in their professional role. The midwifery education is obligated to answer to these professional requirements. Country specific, feasible and acceptable requirement accreditation toolkit for institution/collages/universities to achieve is therefore relevant to develop. This study is part of a survey mapping 25 midwifery education sites in seven divisions in Bangladesh. This is to provide a baseline assessment for possible requirement for the ongoing development of an accreditation toolkit for institutes and collages providing midwifery education.

Objective:

The objective was twofold. First, to map five midwifery education sites in Dhaka and Mymensingh divisions as a baseline in the process of developing an accreditation toolkit in Bangladesh. Secondly, to explore nursing instructors’ suggestions of acceptable and feasible requirements for an accreditation toolkit for midwifery education in Bangladesh.

Methods:

The design was a questionnaire study. The total number of participants was 36. Data was collected through a semi-structured questionnaire with both open and closed response options, which were analyzed through essentially non-parametric statistics and systematic text condensation.

Results

: The mapping showed that the students enrolled at the midwifery programs were young, being lectured by comparably few faculty members compared to the number of students, a faculty with an extensive experience of nursing but with less experience in midwifery. Suggestions for the development of an accreditation toolkit were that the assessor should be Bangladeshi, and that posts for clinical teachers and mentors should be one assessment criteria. Further findings showed that 40 normal births were less important to achieve in core competences for midwifery students than other requirements related to midwifery skills.

Conclusion:

An accreditation tool can" close the gap" between the curricula in text and implementation of the same. Mapping of existing education sites amongst partners provides a potential for development of a Bangladeshi national and a global midwifery education accreditation toolkit. The clinical applicability of this essay lies in a development of an accreditation tool that can support institutes to achieve the goal that a Midwifery Diploma curriculum is being implemented that support student’s learning, and the goal that the students will become "Midwives" according to global standards and ICM definition.