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Background: It's a fundamental principal to protect children's rights. Through legislation, child abuse has been prohibited in many countries. Nurses working with children has a frontline role in identifying and reporting suspected or known child abuse. Mandatory reporting is one of the nurse's duty, reluctancy to report can lead to misconduct but it also leads to children suffering.
Aim: The purpose of this degree project was to identify factors preventing nurses from mandatory reporting of children in health care.
Method: A literature study based on using and analysing nine qualitative articles.
Results: Three themes emerged in the result. The first theme was knowledge deficit, with two subthemes which were the need of education of signs and symptoms and the other subtheme was insufficient experiences. The second theme was nurses strained work environment with three subthemes. The first subtheme was the lack of routines, the second one miss information and the third one lack of cooperation and communication. The third theme consists of two subthemes, which were the lack of emotional support and the experience of fear. The results showed that nurses due to different factors relinquished from mandatory reporting.
Conclusion: The results highlighted that education and training was needed among nurses to gain knowledge on how to safeguard children and establish mandatory reporting. Thus, support from colleagues and managers agencies dealing with child safety was highly valued by nurses. Implementation of education, training and support could improve the cooperation in protecting children.
Background: Fibromyalgia is a chronic disease that is difficult to treat and diagnose. The illness is of unknown etiology. The majority of the ill is women. Aim: The aim of this study was to describe women ́s experiences of living with long term pain associated with fibromyalgia. Method: A literature -based study was performed. The database Cinahl was used in the search process. This study includes 11 qualitative articles that have been analysed by a review template. The analysis resulted in two categories "experiences of a changed me" and "experiences of social life" with six subcategories. Results: The consequences of fibromyalgia were that the family life, spare time, social life and working life changed in different ways. The articles also showed that women with fibromyalgia did not receive the understanding they needed from their families or the environment. Conclusion: Women with fibromyalgia feel that they do not get understanding from the outside world. It is important that health care professionals understand and acknowledge these individuals' subjective experiences so that they can give professional care and support.
Background: Mental illness is defined differently depending on the context, ranging from symptoms of anxiety and depression to schizophrenia. Mental illness among the population has increased since 1990. A survey done by the Central Bureau of Statistics in Sweden (2006) shows that issues such as anxiety are more common now than before. Twenty-three percent of women aged 16-84 said they had experienced symptoms of anxiety. Thirteen percent of the men aged 16-64 said they had experienced the same. Pre-conceived notions often meet people with mental health issues and there is a stigma surrounding them and their situation.
Aim: The aim of the study was to examine how patients with mental illness experience their contact with health care professionals in health care.
Method: The study was designed as a literature based study. Eleven articles were analyzed, nine articles were found by a systematic search and two articles were found in an unsystematic search.
Results: This study showed two main themes and eight subthemes. The main themes were patients desire to have a good relationship and good interaction with health care professionals. The subthemes were patient confidence in health care professionals, a dedicated staff, patients desire to get person-centered care and to feel involved, to have good continuity in their health care and to have highly available health care professionals around them, to have a good dialogue, be actively listened to, competent health care professionals and being labeled.
Conclusion: The conclusion is that patients that lack trust, commitment from health care professionals or continuity had bad experiences with the health care system. Patients needed to have a mutual relationship with the health care staff to have a good experience with the health care system.
Background: Research have shown children to be a large patient group within the health care sector. Nurses, should therefore, have knowledge about how to individually adapt meetings so it will be a positive experience for the child, the parents, and for themselves. Historically, this has not been the case and created immense care suffering for several families.
Aim: The aim of this study was to illuminate nurses' experiences of meeting children and their parents within the health care sector.
Method: A method to contribute to evidence-based nursing with ground in analysis of qualitative research was performed. An analysis of nine scientific articles was carried out. The analysis resulted in three main themes and eight subthemes.
Results: The main themes were: "To see the child as an individual", "to built trust", and "knowledge and experience are crucial". Knowledge were fundamental for creating a positive meeting.
Conclusion: By individually adapting communication to the child and the parents, good conditions allowed for a trusting relationship to emerge. Time was needed to create a safe and trusting relationship. However, it did not always exist. With knowledge and experience the nurse could see the child as an individual and adapt the meeting to the child. It was the responsibility of the nurse to gain the necessary knowledge, and to reflect with colleagues was seen as an important source to attain new knowledge.
Background: Humour has been a part of mankind since ancient time and affects the human being in several ways. Communication is essential in creating a relationship and humour may improve the possibility that a nurse and a patient succeed in building a therapeutic relationship.
Aim: The aim of this literature review was to illuminate humour in the therapeutic relationship between nurse and patient.
Method: The method used was a literature review. Systematic searches were conducted in the databases Cinahl and PubMed where eight articles were found, a ninth article was found by a non-systematic search. The articles were then analyzed through Friberg's five-step model for literature reviews.
Results: Four themes occurred. Humour as a brick in building a bridge in the therapeutic relationship, Experiences and effects of humour in the therapeutic relationship, Barriers and fears when using humour in the therapeutic relationship and Gender and humour in the therapeutic relationship. The result suggests that humour is useful in building a therapeutic relationship and is being used frequently, yet there are times when nurses hesitate to use humour due to the lack of experience. There also occurred a difference in how humour is used due to the gender of the patient.
Conclusion: Humour is mainly a positive experience in the therapeutic relationship and should be used as it makes communication easier and makes it easier for nurses and patients to bond. The way using humour differs in gender must be considered by the nurse.
Background: Burns are a global problem and more people survive today. After a burn injury a long rehabilitation time can wait, both physical and psychological and little is known about the patients' experiences after a burn injury.
Aim: The aim of this study is to illuminate patients' experience of life after a burn injury.
Method: A method is used to contribute to evidence-based nursing, based on analysis of qualitative research. Data was collected from analyzing eleven scientific articles.
Results: Two themes with five sub-themes emerged. Results show that patients' experience increased vulnerability in relation to changes in the skin, the changed appearance and the mental stress. The feeling of pain, itching, stigmatization and anxiety are some of the experiences that create problems in everyday life. They also found that the experience of support and acceptance by the burned was part of the process of returning to life.
Conclusion: The result showed that suffering from a burn causes remaining problems after the injury. The patients needed support to be able to accept what happened and return to life.
Background: During the recent years a great amount of unaccompanied children have arrived to Sweden. They constitute a vulnerable group since they lack the protection of an adult. Previous research shows that they often have traumatic experiences and suffer from mental health problems. Nurses need to be aware of these issues to be able to provide good care for the asylum seeking children. Aim: The aim of this study was to describe the experiences of unaccompanied children seeking asylum. Method: A literature review based on the content of six qualitative studies, four quantitative studies and two studies of mixed method. Results: The findings revealed four main themes; Being a survivor, Almost in safety, Mental vulnerability and Creating a new life. The results show that the children have survived war and persecution and have had to leave their families to search for safety. They have a great fear of being sent back and express a need for support and encouragement. It also appears that many of the children feel lonely and isolated and that a significant part suffer from mental health problems such as Post Traumatic Stress Disorder, depression and anxiety. The children strive to create a new network and to succeed. Conclusion: To be able to help unaccompanied children with traumatic experiences and consequences thereof, it is important for the nurse to build a relation based on trust. It is useful for nurses to engage a life-world perspective, since it includes a holistic view of the children and their lived reality.
Background: Each year there are thousands of children abused in Sweden. This can result in lifelong consequences not only for the children, but also for the society. Verified statistics show an increasing number of child abuse in Sweden in recent years. As per Swedish law, nurses are required to report child abuse, but despite the law requirement the studies indicated that reporting is not always done.
Aim: The aim of this study was to describe nurses' experiences of reporting a suspected child abuse to social services.
Method: A method to contribute to evidence-based nursing based on analysis of qualitative research was performed to deepen understanding. An analysis of eight qualitative research articles was carried out. The analysis resulted in four main categories and nine sub categories.
Results: The main categories were: Worksite factors, barriers for not reporting, personal factors caused by the nurse, lack of or poor functioning cooperation with social services.
Conclusion: This study indicates, that nurses need experience, training, support and information and also clear guidelines and feedback from social services.
Background: Palliative care is an approach that aims to increase both the quality of life of patients and related parties, as far as possible, to relieve suffering and promote health at the end of life. Palliative care is based on teamwork, where relatives play an important role. Participation from related parties have a large significant role which is emotionally and physically exhausting. Communication and language is prerequisite understanding the experiences and realities of health and suffering.
Aim: The purpose of this study was to illuminate the relatives experiences of nurse communication, support and treatment in a palliative care in the home.
Method: The method is a systematic literature review of the basis of qualitative research, contributing to evidence-based nursing. A total of eight scientific articles have been used on studying closely related experiences.
Results: The results show that relatives were in need of support from the nurse to participate in care. As well as communication and response from the nurse was important in how relatives experienced support and how this contributed to a good quality of care. The results are divided into two main themes and seven sub-themes.
Conclusion: Inadequate communication and response from the nurse emerges and this led to the suffering and feeling of abandonment and disappointment among of the relatives. More research is needed on the basis of relatives perspectives because they became more involved in the care. Nurses need to increase their knowledge and understanding of communication and treatment of disease process and the dying process, as this can allow for better care. The relatives felt the support from the nurse as important.
Background: Anxiety is a common and unpleasant emotional state that affects many patients while waiting for surgery. Anxiety is described as an undesirable feeling of nervousness caused of a potential threat. It is an uncomfortable state of mind and can elicit physiological responses. Adequate nurse interventions that relieve anxiety improve the patient's condition, which lead to better recovery.
Aim: The purpose of this study was to describe the preoperative care, that can alleviate the patient's anxiety associated with surgery. Method: The method of study is a literature review of 12 scientific articles, of which 11 quantitative and one qualitative which cover nursing interventions that can alleviate preoperative anxiety. The search took place in the databases PubMed and Cinahl. This study was based on Friberg's model for the literature review.
Results: Result of the study presents three categories that contain different care interventions to alleviate the patient's preoperative anxiety: auditory, physical, and informational. Six care interventions are described in total. Music and aromatherapy proved to be simple and cost-effective care interventions. Acupuncture, hand massage and heating can be considered more expensive in comparison, because they require additional staff training, equipment and require more time. Person-centred information helps the patient to better understand the upcoming operation, which is seen as a way to promote and protect the patient's well-being. Conclusion: Nurses should understand that it is important to reduce preoperative anxiety in patients. It is equally important that nurses can balance patient care needs and appropriate nursing interventions for each patient. Through active listening and attention to non-verbal signals from patients, nurses understand better the patient's needs and can decide which care interventions can reduce anxiety.
Background: Occupational stress is a growing problem in caring professions, with consequences such as mental and physical ill health for the individual, which in turn can lead to increased long-term sick leave. Research shows that long-term sickness caused by mental illness can be associated with working conditions, where individuals who work in caring professions tend to be more vulnerable.
Aim: The aim with this study was to illuminate the social workers' experience of occupational stress within the unit of financial aid in the social service.
Method: A qualitative study was performed where six respondents participated in interviews. Content analysis was used to analyze the interviews.
Results: Three themes emerged during the analysis; to feel pressure in the work situation, to feel support and to feel wellbeing. The result shows that workload and lack of time were factors that caused stress at work. A promoting factor was colleagues at work. Social workers experienced the tasks at work as meaningful but could sometimes feel insufficient.
Conclusion: The findings of this study point out that social workers experience stress at work and it affects their physical and mental health. This study wants to increase knowledge of occupational stress which can be a profit for social workers in the financial aid. Prevention can help social workers to improve their health and wellbeing. New findings in this study point out that social workers highlights the absence from work as a contributing factor to experience stress at work.
Background: According to World Health Organization is palliative care a human right. The focus of palliative care is relieving suffering and having quality of life as the main goal. The nurse's role is to enable symptom control, to be a support for the patient and close relatives, as well as contributing to a good and worthy death. Although death is a part of life, strong feelings arise about death and the dying. Aim: The aim of this study was to describe nurse experiences of palliative care. Method: The method used was a literature study based on international qualitative research. Eleven articles were analyzed and resulted in four main themes and nine sub-themes. Results: The findings were four main themes; the profession, relationships, work environment and feelings as well as nine sub themes; experiences and knowledges, the patient, relatives, stress, support from colleagues, lack of support from colleagues, grief and impotency, satisfaction and mental strain. Conclusion: The nurse's experience of palliative care is individual and varies depending on, experience, interaction with colleagues and self-perception regarding individual values and existential questions.
Heart failure is one of the most common diagnoses in Swedish health care. Approximately 250 000 people in Sweden are estimated to have a heart failure and approximately 30 000 new patients are diagnosed every year. Heart failure is a serious illness with server symptoms and high mortality. The aim of this study was to illustrate patients with heart failures experiences of quality of life. The method that was used is a literature-based study of 12 qualitative articles that was based on their results. The included articles were published between 2003-2014. The majority of the participants were in the scale between NYHA-II-III. The result shows that patients with heart failure experienced symptom burden that limited their daily life. They described a constant struggle between the illness and the feeling of maintaining the roll they once had. The most important thing was to find strategies to maintain the quality in life and to have good spirit and positive thought. The result was presented in four themes: When the body sets limits, feelings taking over, captive in your own home and an uncertain future. The conclusion that can be drawn from the results of this study is that the experience of quality of life is highly individual and depends mostly on how the experience of the disease is being managed by the individual.
Burnout due to work-related stress is increasing in the society. Many studies concern the causes and effects of burnout, but rarely concern the experiences of those who are living with burnout. The aim of this study was to examine the experience of living with burnout. The concepts of health, suffering, burnout, stress and coping are briefly described in the background. The method that was used is a literature-based study with the analysis of qualitative research. This study is based on eight qualitative articles. Six themes emerged; Physical experiences, Psychological experiences and Existential experiences, Work experiences, Experiences of relations in private life and Experiences of demands and expectations. The results shows that burnout affects a person on many different levels. Dealing with burnout involves a range of varieties of symtoms, physical as well as psychological and social. Physical symtoms that appeared among the participants were for instance fatigue, brain fog, headache and palpitations. Social and relational problems as bad conscience, low self- esteem and feelings of inadequacy were experienced. Emotional disturbances and existential reflections were common amongst those who were suffering from burnout.
Background: People that suffer from stroke become a regular patient category in hospitals. A severe change in the patient's living situation occurs both physically, mentally and socially. A stroke can cause physical as well as cognitive impairments. When patients lose their physical ability it often leads to a sense of loss. The disability prevents the stroke survivors from living as before and they feel they are no longer in control of their lives.
Aim: To describe patient's experiences of performing activities of daily living after a stroke.
Method: Method of contributing to evidence-based nursing based on analysis of qualitative research.
Results: The result is described in two main themes: being physically limited and being psychosocially limited. Patients described traumatic and emotional experiences when they were not able to control their body and suddenly became dependent on nursing. Nurses have an important role in making the patient involved in nursing care to facilitate the patient's sense of dignity. The patients had difficulty processing their feelings after the stroke and they felt worried about the future. Social relations could be adversely affected when cognitive impairments prevented the patients and they felt sorrow when their future plans changed dramatically.
Conclusion: Patients affected by stroke were in an exposed situation. They perceived that their changed body affected them both emotionally and existentially and they had trouble accepting their functional difficulties. Everyday life became complex because of the complications after the stroke.
Background: Mental illness is a growing problem in society and is increasingly seen in younger people. Deliberate self-harm is seen as a complication of mental illness. Self-harm means that people intentionally injure themselves as a habit and with more or less severe de-gree, but with no intention to take their own life. Aim: The aim of the study is to illustrate parents' experiences of their child's deliberate self-harm behavior. Method: A literature-based study based on analysis of ten qualitative articles. Results: The results are presented in three main themes and ten subthemes. The first main theme is "A roller coaster of feelings", with three subthemes "First battle", "Feelings of guilt and shame" and "Anxiety and fear". The second main theme is "Parenthood and family rela-tionship" with four subthemes "Changing positions of power", "Parents in conflict", "Not being enough as a parent" and "A changed relationship". The last main theme is "Parents ex-perience of support" with three subthemes "The insufficient support", "Feeling seen" and "To get support from the surroundings". Conclusion: Health care professionals need to create a good relationship with both parents and patients, which can be done by meeting the parents' feelings and being responsive.
Background Colorectal cancer is the third most common form of cancer among men and women in Sweden. The disease is shown to have a higher incidence among older individuals. Recent studies showed that the individuals may ignore their symptoms. To make a choice in what treatment to go for individuals got support from family and friends. With the focus on getting through the treatment. Understanding the individual's experience of living with colorectal cancer is important for the nurse profession. The nurse roll is to inform, support, care for these individuals and give a person-centered care.
Aim The aim of this study was to describe individual's experience of living with colorectal cancer after completed treatment.
Method The method used in the study was designed by Friberg (2012) to contribute with evidenced based caring in qualitative science research. Eleven science articles were analyzed using Friberg (2012) five step method of analysis. The analysis resulted into three main themes and eight subthemes.
Results The results were formed into three main themed named: the uncontrollable body, becoming depended on the environment and a new view of life after treatment.
Conclusion To live with colorectal cancer after completed treatment, affects the individual life situation and quality of life. Therefore, it is important for the nurse to be aware of the disease and the effects of the trearment on the individual.
Background The UN Convention on the Rights of the Child, CRC, claims that children should be heard in decisions about themselves. Children also have the right to play. This need to be applied in healthcare environment. Swedish laws and guidelines for children's healthcare confirm this. What do children themselves propose as important support to participate? Aim The aim of this study was to describe children and young people's experience in healthcare environment. Method A literature-based study of nine qualitative academic articles was conducted. 556 children altogether were asked about their experience from healthcare environment. Results The result is presented by five themes: To be afraid and sad To feel comfort and safety To understand To be included in decisions To know the nurse Conclusion Children and young people in healthcare environment feel discomfort and insecurity. They need help with symptoms and fear. If the nurse is perceived as a "bad nurse", the child is exposed to feel helpless. A child need a certain amount of comfort, playing and contact with peers to be motivated to participate. When invited to ask questions and express their worries, they want to be involved. Children want to participate in decisions about themselves. The nurse has a key role to involve the child. Confidence is built through technical skills in achieving procedures, good communication and personal attributes, such as being helping, kind, friendly and humorous.
Background: Osteoarthrosis is considered the 11th most common disorder that causes the greatest disability and gradually decline the patient's quality of life. Studies have shown that 80% of the patients have different types of disabilities and 25% can not perform their daily activities. Aim: The purpose of this study was to describe patients' experiences of being stricken with knee osteoarthritis. Method: A literature-based study was chosen as the method that conduce to evidence-based nursing by analyzing qualitative research. The analysis resulted in three main themes and seven subthemes. Results: Three main themes were: "Daily challenges", "To relieve symptoms" and "To be cared". The main finding was that knee osteoarthritis considered to be the central focus in the patients' lives which caused physical and socio-economies limitations. This worsened their quality of life and mental well-being. Although surgery considered to be the only solution, the expectations regarding the outcome differed. Conclusion: It is important to treat knee osteoarthritis in early course of the disease to prevent limitations and other diseases. The patient's need information and support to manage their symptoms.
Background: Considering the increasing requirements and needs facing primary health care, the aspiration to use nurses as care providers has increased. This is done to improve the availability, effectiveness, and to dispense the available resources.
Aim: The purpose of this study is to illuminate the patient's experiences of meeting nurses as care providers in primary health care.
Method: Six qualitative, three quantitative, and one mixed method articles were analyzed to create a literature review.
Results: Generally, the patients were satisfied with meeting nurses as care providers in primary health care. The result showed that the patients described relationship, trust, participation, and communication with nurses as significant aspects to feel secure. That the nurses made time available, as well as were easy to contact, were also aspects that contributed to the patients feeling secure. Uncertainties regarding the nurse's role, competence, and not being able to choose level of care were aspects that affected the insecurity.
Conclusion: Nurses in primary health care have big opportunities to develop the meeting in a way that the patient feels secure in health care. Most patients experience great satisfaction with care provided by nurses. Considering the above facts, it seems possible to develop health care led by nurses.
Background: Every year 25 000- 30 000 people strikes with stroke. Out of these, at least every fifth is affected with aphasia. Affected with aphasia may cause an essential impact and change in the everyday life. The changes may also result in a suffering for the adult with aphasia. Therefore it's important that the nurse has adequate knowledge of what aphasia is and treats the person for whom it is, not for its illness. Aim: The aim of this study was to illuminate the adult's experience of aphasia's impact in the changed life after stroke. Method: A qualitative method to contribute to evidence-based nursing with a ground in analysis of qualitative research, was used to enable a deeper understanding of adult's experiences of aphasia. Ten qualitative articles were analysed, four themes and eight subthemes emerged. Results: The results showed that the adult with aphasia experienced a loss of the identity, loved ones and work. Aphasia also caused a change in the language ability that affected participation in social activities. All resulting in a suffering. To cope with the aphasia's difficulties, different strategies evolved. The adult with aphasia also described the social support to be important but also to accept what aphasia had contributed in the changed life. Conclusion: According to the results the language appeared to be a central part to whom we are. When the language ability no longer existed, a suffering emerged. Keywords: Aphasia, communication, patient's perspective, stroke, suffering.
Background: It is valuable that the patients experience a good encounter with the nurse at the emergency department. There are several factors that can influence the encounter and the patients' perception of the nurses and the surroundings at the emergency department. To not be seen as the person you are or not treated well, is a common reason why patients feel health suffering. It is the patients' experience of the circumstances which determines whether situations cause health suffering or not. Aim: The aim of this study was to describe patients' experiences of the encounter with the nurse at the emergency department.
Method: The method used in this study was a literature review, based on qualitative studies. Ten articles were analyzed according to Friberg's (2012) qualitative content analyze in five steps. Results: The researchers found five themes that specifically stood out when studies were researched. The themes were feelings of: participation, being seen, abandonment, being dependent and vulnerability. Conclusion: The experience of the encounter with the nurse at the emergency department differ from each patient. All patients want to meet a nurse who characterises kindness and warmth. The nurses are the ones who can control the outcome of the encounter at the emergency department.
Objectives We compare various aspects in the early chain of care among patients with haemorrhagic stroke and ischaemic stroke. Materials & methods The Emergency Medical Services (EMS) and nine emergency hospitals, each with a stroke unit, were included. All patients hospitalised with a first and a final diagnosis of stroke between 15 December 2010 and 15 April 2011 were included. The primary endpoint was the system delay (from call to the EMS until diagnosis). Secondary endpoints were: (i) use of the EMS, (ii) delay from symptom onset until call to the EMS; (iii) priority at the dispatch centre; (iv) priority by the EMS; and (v) suspicion of stroke by the EMS nurse and physician on admission to hospital. Results Of 1336 patients, 172 (13%) had a haemorrhagic stroke. The delay from call to the EMS until diagnosis was significantly shorter in haemorrhagic stroke. The patient's decision time was significantly shorter in haemorrhagic stroke. The priority level at the dispatch centre did not differ between the two groups, whereas the EMS nurse gave a significantly higher priority to patients with haemorrhage. There was no significant difference between groups with regard to the suspicion of stroke either by the EMS nurse or by the physician on admission to hospital. Conclusions Patients with a haemorrhagic stroke differed from other stroke patients with a more frequent and rapid activation of EMS.
Background: Studies indicate that both patients and nurses are positive to have relatives present at the cardiopulmonary resuscitation (CPR) situation. They see relatives as a resource and support, and also that the afterward crisis management may be facilitated. Routine should be created for the nurse to offer the relatives to attend and that it will become a natural part of CPR situation.
Aim: To illustrate the experiences of close relatives attending cardiopulmonary resuscitation.
Method: A literature study with qualitative approach. Seven articles were reviewed and analyzed according to content analysis method.
Results: We found that relatives appreciated and felt it was important to attend the CPR-situation. They found it easier to move on after the incident, especially if the patient died. They wanted to be sure that everything that could be done also was done. The feeling that their presence in some way protected their dear ones from danger and harm was also important. Honest information was considered essential and the relatives appreciated the efforts and care that the healthcare personal gave their relatives.
Conclusions: The vast majority of relatives to patients undergoing CPR choose to feel that it's important to be present at the CPR. Based on this knowledge, further work can lead to create routines concerning relatives' wishes to attend CPR situations.
Background: Self harm has increased among adolescents during the last years. Studies reveal nurses' attitudes as an issue. The need to investigate nurses' experience of patients who self-harm is very important to see what is missing. Relation between nurses and patients is a vital part of caring and studies show that very little research is done in this area.
Aim: The aim of this study is to overlook nurses' experience when they meet a patient that is self- harming.
Metod: A literature study with a mixed approach. Articles where chosen, read, reviewed and analysed to find similarities and differences in their result.
Results: The result came out with three main categories and seven sub categories. The first category is Difficult to understand self-injury which has two sub categories; Difficult to understand the behaviour and Difficult to understand the reason. The second category is Self- injury evokes emotions and has three sub categories; Anger, concern and anxiety, Empathy and conflicting emotions and Creates conflicts. The third category is The environmental impact on nursing care which has two sub categories; The meaning of time and Environmental influences and care.
Conclusion: The results show that nurses felt that they needed further education about self- harm, that many of them were negative or insecure while meeting patients and did not know what to say in fear of making the behaviour worse. Many nurses also considered it hard to understand self-harm and why someone would like to harm themselves.
Background: Hypertension is a common disease and over half of all deaths in cardiovascular disease are caused by complications of hypertension. The basis of the treatment is non-pharma-cological and includes lifestyle changes such as physical activity and diet change. Only few patients reach the treatment goal and are well treated, therefor it's important for the health care service to have a greater understanding on how patients experience implementing lifestyle changes in hypertension.
Aim: The aim of this study was to describe patient's experience of implementing lifestyle changes in hypertension.
Method: A qualitative-based literature study was used. Ten qualitative articles from PubMed, Cinahl and Proquest was analysed by the five-step method described by Friberg (2012).
Results: Two main themes emerged under the analyse process. The two main themes were: opportunities and barriers, with the sub themes: knowledge, attitude, social, comorbidity, time, society and economy.
Conclusion: Patients with hypertension experience opportunities and barriers to implement lifestyle changes in hypertension. Patients with good knowledge and a more positive attitude towards their disease had a greater opportunity to implement lifestyle changes in their life. The results also showed that patients had different recourses and assets that affect their possibility to follow and succeed with lifestyle changes. Therefore the nurse should work towards a person-centred care. This provided opportunities for each patient as an individual to obtain knowledge, motivation and good conditions to create and establish self-care.
Background: Dementia not only affects the individual patient, but also healthcare professionals and the relatives. It is an increasing incurable disease that affects the mind of the afflicted person. He or she will experience difficulties with either expressing oneself, recognizing daily things, performing tasks that he or she previously were able to managed or the ability to plan, initiate or complete various tasks.
Aim: The aim of this study was to illuminate experiences of being a relative of an older person afflicted of dementia.
Method: A literature based study was performed, analyzing 10 qualitative articles.
Results: The results consist of two main themes, relatives experiences of support, with two subthemes, support in the care relationship and support from others in the same situation. The second theme progression of the disease and its affects on relations and feelings, with three subthemes, the partners behavioral change, a new kind of relationship and impact of the disease on feelings. These highlight significant experiences the relatives go through in relation to the disease. Support was something that may be given in different ways and the need for support was necessary. The behavioral change that comes with the disease, results in a new form of relationship with the affected. Feelings of sadness, guilt and shame were constantly present.
Conclusion: The results shows that the relatives need support through the entire disease progression when the behavior of the affected changes and a new relationship is formed. When accepting the disease, the relatives found it easier to deal with life in general. Nurses need to have the means to respond to these relatives and to know how they experience their situation, to be able to support them in the best possible way.
Background: Breast cancer is the most common form of cancer among women in Sweden. The cancer diagnosis has under the past few years increased and are expected to increase even more in the future. As cancer diagnosis increases, the ability to survive a cancer disease becomes more apparent with the help of advanced treatments. Aim: The aim of this study was to describe women´s emotional reactions when receiving a breast cancer diagnosis. Metod: A literature-based study was performed in order to describe women´s experience about their emotional reactions towards a breast cancer diagnosis. To analyse the result of the 11 included articles, a five step qualitative analytical method was used. The analysis resulted in one major theme and five subthemes. Results: To receive a breast cancer diagnosis was a huge change in life that affected women´s emotional reactions in many different ways. The result showed that women was chocked, they denied the breast cancer diagnosis, felt anger and grief. The women also felt hopefulness to fight and conquer the breast cancer disease. Conclusion: According to the result this study showed that a breast cancer diagnosis transforms a women´s life, from a healthy life to a life in illness. A breast cancer diagnosis did not only bring out negative feelings like frustration and hopelessness. It´s also bring out positive feelings like relief and fighting spirit.
Background: Alzheimer's disease is the most common dementia disease and affects 60-70 percent of people suffering from a dementia disease. About 100 000 people in Sweden are diagnosed with Alzheimer's disease. Managing and taking care of a person who needs a lot of support and help means that life becomes completely different than before. Support from the surroundings are therefore very important for close relatives caring for a person with Alzheimer's Disease.
Aim: The aim of this study was to explore closely related persons' experience of caring for a person with Alzheimer's disease.
Method: The method to create evidence-based nursing based on analysis of qualitative research was used. Eleven articles were obtained through the databases Cinahl and PsycINFO. From the 11 articles three themes and eight sub-themes emerged.
Results: The results showed that close relatives experienced difficulties communicating with the person in Alzheimer's disease. They felt great fear and concern about the disease and its development. Relatives breached themselves to meet the person's need for care. The close relative felt that caring for Alzheimer's disease caused them to feel isolated. Relatives found strategies that made it easier for them to care for Alzheimer's disease.
Conclusion: It was stressful to care for a person with Alzheimer's disease and the close relatives were in great need of support. The nurse must be able to meet the close relatives' feelings of anxiety, guilt and shame, especially as a close relative caring for a person with Alzheimer's disease is not always voluntary.
Immigrants from the Middle East have higher prevalence and incidence of type 2 diabetes (T2D) compared with native Swedes. The aim of the study was to describe and understand health beliefs in relation to T2D as well as attitudes regarding participation in a screening process in a local group of Assyrian immigrants living in Sweden. A qualitative and quantitative method was chosen in which 43 individuals participated in a health check-up and 13 agreed to be interviewed. Interviews were conducted, anthropometric measurements and blood tests were collected, and an oral glucose tolerance test was performed. In total, 13 of the 43 participants were diagnosed with impaired glucose metabolism, 4 of these 13 had TD2. The interviewed participants perceived that screening was an opportunity to discover more about their health and to care for themselves and their families. Nevertheless, they were not necessarily committed to taking action as a consequence of the screening. Instead, they professed that their health was not solely in their own hands and that they felt safe that God would provide for them. Assyrians' background and religion affect their health beliefs and willingness to participate in screening for TD2.
Background: Dementia is a degenerative disease which effects the brains cognitive functions and there are several different types of dementia. A person who has dementia is likely to wander, shout, be aggressive, memory loss and poor perception of time. All of these symptoms affect the partner to the person with dementia. Every year over 25'000 persons gets dementia and many of these persons lives at home. The partner is often the one who takes care of the person with dementia.
Aim: The aim of this study was to investigate partners experiences of living with a person who has dementia. Method: The method used in this study was literature study and fifteen qualitative articles were analysed.
Results: Two main themes emerged: a changed relationship and to manage the situation.Dementia affects the relationship of a couple. There will be changes in the emotional relationship because the person who once was there disappears as the dementia deteriorates. At the same time there is a change in the roles. The chores that the person with dementia did earlier is now the partner's responsibility. To be able to take care of the person with dementia the partner had his or hers own resources.These resources could consist of practical and emotional strategies. Also external resources where available, such as support from family, friends, church or support groups. Conclusion: The conclusion is that the partner is doing everything in its power to keep the person with dementia at home as long as possible.
Background: Stress among ´nurses´ at the emergency department is a common problem. Emergency departments are often overcrowded and the lack of staff is a usual issue. The work pace in the emergency department is often high and dealing with stressful situations is often forgotten.
Aim: The aim of this study was to explore ´nurses´ experience of occupational stress in the emergency department.
Method: A literature review has been made of 7 qualitative and 7 quantitative articles. Articles were analyzed by searching for similarities and differences. The analyzed articles were published between 2008-2016.
Results: The results showed that ´nurses´ showed a high level of occupational stress due to high workload and lack of staff. The results also showed that consequenses of stress were fatigue syndrome and depression. The most effective coping strategy among ´nurses´ were a strong social support, and the use of debriefing.
Conclusion: To work as a ´nurse´ at the emergency department can be stressful. To be able to deal with stress effectively ´nurses´ need to be educated in coping strategies. Clear guidelines in the emergency department are an effective method in dealing with stress.
Background: Diabetes is one of Sweden's national diseases. Around 7000 children live with type 1 diabetes in Sweden today. The diagnosis requires planning of everyday life and revaluation of routines which places great demands on the family.
Aim: The aim of this study was to describe parents and siblings' experiences of living with a child or young adult diagnosed with type 1 diabetes.
Method: The study was designed as a literature-based study to contribute to evidence-based nursing based on analysis of qualitative research to reach a deeper understanding of families' experiences. An analysis of thirteen qualitative articles resulted in four main themes and ten subthemes.
Results: The results of the study showed that the whole family is affected when a child gets diabetes. That the child was diagnosed was a shock that caused many feelings with both parents and siblings. There was a constant concern for complications in both the long and short term, resulting in a fear to hand over responsibility, causing a huge pressure on parents who could feel isolated.
Conclusion: The families experienced strong feelings when the child was diagnosed. The families needed support from the healthcare professionals to be able to handle the disease.
Background: Diabetes is an incurable and chronic disease and a risk factor for both stroke and cardiovascular disease. Type 2 Diabetes mostly affect people over the age of 40 however, in recent years even a lot of younger people got this disease. Since every patient is a unique person with its own needs and conditions the experiences of how to live with this disease is an important acknowledge in the caring of these patients.
Aim: The aim with this study was to illuminate experiences of living with diabetes type 2.
Method: 10 articles has been analyzed by Friberg's five step model.
Results: The analysis resulted in three themes; The environmental impact, with sub team the feeling of shame, blame and grief; the need of support with sub themes support and information and information for self-care; and another life with sub themes lifestyle changes and self-care and fear of complications.
Conclusion: The results showed that the need for support and information about self-care was important to increase patient motivation. Lack of knowledge about the disease gave negative experiences such as difficulty in accepting the disease and also the feeling of guilt and shame occurred.
Background Parkinson's disease is a chronic progressive neurological disease. About 10 million people are living with the disease today, knowing that there is no cure. There are different types of pharmacological ways to slow down the development of the symptoms but little is known about people's experiences of living with the disease. Aim The aim of this study was to describe people's experiences of living with Parkinson's disease. Method A literaturebased study based on analysis of eleven qualitative scientific studies to get a deeper understanding of people's experiences. Result The analysis resulted in three themes with ten sub themes. The themes that emerged was Readjustment of life, Changed as a person and The body does not work properly. People suffering from Parkinson's disease experienced physical, mental, social and existential challenges which led to feelings of shame and isolation. It also affected their daily lives and relationships. Shame and anxiety was constantly present causing them to withdraw from others and made them worry about the future. Conclusion Due to the results the conclusion was that an early effort in psychological support, continuous follow-up and information is necessary to give the people the opportunity to manage their disease and to increase their quality of life
Background: Being close to a person who suffers from a disease can mean a burden, as these tends to disregard own needs in favor of the person who is sick. Aphasia is a disorder that affects communication skills and is one of the most common complications due to brain damage.
Aim: The main purpose of this literature study was to illuminate relatives experiences of living with a person with aphasia.
Method: Nine scientific articles were analyzed with a qualitative manifest content analysis which resulted in three themes with subthemes: Emotional reactions: The impact on well-being, Changing social and emotional relationships; A changed everyday life: Obstacles in communication, Decreased social interaction, Being able to handle everyday; Increased need for support: To get information about the aphasia; Deterioration of the economy and the need for financial support.
Result: It was revealed that relatives felt left aside in the care of their relative with aphasia, resulting in an increased need for information, support and relief.
Conclusion: Therefore conclusion was that relatives should be asked by nurses of how much involved in the care of their sick relative they want to be or can be and how much support they need to be able to handle that.
Background: Multiple sclerosis (MS) is a serious chronic disease that affects people all over the world. In Sweden about a thousand new patients every year got MS, and today there are approximately 17 500 people who have the diagnosis. As MS often arise in the prime time of life and is unpredictable this causes great difficulty for those individuals who are diagnosed and then forced to live with the disease. Aim: The aim of the study was to illuminate patients' experience of living with Multiple Sclerocis. Method: Method was a literature-based study, in which the analysis is based on qualitative studies. Results: The result showed that MS have a great influence in patients life and tell us how patients experience emotions fear, despair, uncertainty and hope in their everyday lives and emotions of fear. Conclusion: It is evident from the findings of this study that individuals living with MS face several challenges in life. It is valuable for nurses and people who work in health care to know how these patients experience their daily lives. This study will hopefully create awareness of the disease and how the patients feel.
Background: The way nurses encounter patients affects the whole nursing process. It can be influenced by several different factors. In Namibia the general health situation largely depends on socio-economic resources. The competence of the nurse and the way s/he responds to the needs of anxious patients is crucial in terms of how the patient experiences the nursing interventions. Aim: The aim of the study was to describe the ways in which Namibian nurses respond to anxious patients in the context of nurse-patient encounters. Method: This empirical qualitative study is based on three semi-structured interviews and six non-structured observations which were carried out in Namibia during the spring of 2017. These were analyzed with qualitative content analysis. Results: The results consist of three main categories and eight sub categories. Namibian nurses respond to anxious patients by "Conversation", "Calm behavior" and "Expression of compassion". The nurse should have the language skills to explain and talk with the patient. Nurses must not be stressed out, have patience, show empathy and respect. Conclusion: The degree to which the nurse was calm and able to show compassion in the conversations determined the quality of the nurse-patient encounter and the success of the information exchange between them
Background: Heart failure is a chronic disease that increases among the population, despite progress in research. Living with heart failure can cause suffering and impaired health due to physical limitations in daily life. Research indicates that patients experience of living with heart failure is paid too little attention in relation to the medical treatment itself.
Aim: The aim of this study was to describe patients' experiences of living with heart failure.
Method: This study is based on a method to contribute to evidence-based nursing with ground in analysis of qualitative research. Eleven qualitative articles were analyzed using Fribergsfive step model.
Results: Through the analysis three main themes and eight sub-themes were developed. The main themes were: The daily life changes, To be involved in your own care and Listen to your heart.
Conclusion: To be diagnosed with heart failure means a life change. Therefore, it is important that the nurse is aware of the physical, and psychological effects of the disease.
Background: In Sweden, around 30 men receives the diagnosis prostate cancer every day. Healthcare services need to understand how treatment for prostate cancer effects a man and his lifeworld. Prostate cancer is the most common type of cancer in Sweden, but insufficient treatment for men's well-being and sense of self after treatment is made.
Aim: To describe the experiences of men who is treated for prostate cancer.
Method: A literature overview was performed.
Results: Results show that men need support when diagnosed and treated for prostate cancer. Men were less likely to seek support and admit to themselves that they needed professional help. The treatment for prostate cancer had negative effects on the man's sense of self.
Conclusion: The importance of nurse's professionalism in treatment of men with prostate cancer. Nurses need to initiate conversations about the impact the treatment of prostate cancer had on the men's lifeworld.
Background: The increasing prevalence of mental illness among adolescents has become a burden to health care. Simultaneously the use of social media has become pervasive among adolescents. How does the increased use of social media affect the mental health among adolescents? Aim: The aim of this study is to investigate how the use of social media effects adolescents´ mental health. Method: Both qualitative and quantitative data was collected and used in a literature overview with the analysis method of Friberg through a descriptive summary of the area. Ten articles was used. Results: The use of social media can both promote and counteract the mental health among adolescents. Thus it can create a sense of context and connection it can also contribute to stress, impaired sleep quality, development of eating disorders and also to a lower selfesteem. Previously mental illness was shown to be fortified by the use of social media. Conclusion: The prevalence of mental illness was associated with a high usage of social media.
Background Nutrition plays an important role in the lives of all people, both for health and for illness. Malnutrition has a negative impact on the human body, especially in the case of illness, as both mortality and complications increase in this condition. The Nurse has the highest level of nursing responsibility for the patient, where nutrition is an important part. Aim The purpose of this literature review was to describe how nurses perceive their nursing responsibility for the patient's nutrition on a somatic ward. Method The research method was a literature review based on articles with both qualitative and quantitative stirring. Articles were analyzed according to Friberg (2012). Four themes submerged from the analysis: lack of knowledge, barriers to nutritional care, nurses' attitudes, and nursing role. Results The Nurse generally considered that the nutrition of the patients was within their area of responsibility, however, they felt that they did not have enough knowledge to meet the needs, both in terms of nutrition knowledge and the national assessment tools available. After receiving education in nutrition, the nurse felt safer in this role. Time and staff shortages in combination with competing tasks were considered barriers to effective nutrition care. Attitudes towards nutrition and shortcomings in collaboration between occupational categories were also considered as obstacles. Conclusion More knowledge is needed about nutrition along with a distinct accountability for nurses. Also a better working interdisciplinary between doctors, nurses and dietitians. Nurses also wanted better meal options and more flexible time for patients to eat.
Background: Admitting psychiatric patients against their will is a criticized form of care. Decisions stating that a patient needs to be hospitalized under coercion are based on their incapability to voluntarily participate in their care. Former patients reported that coercive care led to lower satisfaction with their care. Although most former patients experienced negative care, there where patients that understood their care. Previous studies stated a need to examine how patients experienced being under coercive care and subjected to coercive measures such as seclusion, mechanical restraint and forced medication.
Aim: This study aimed to illuminate adult psychiatric inpatients experiences of coercive care.
Method: A literature-based study based on analysis of ten qualitative scientific studies.
Results: 3 themes with 10 subthemes emerged from the analysis; interpersonal relationships, lack of influence while under coercive care and good coercion. The results showed that negative experiences of coercion were often linked to the actions of the mental health care staff. The relationship to the staff could contribute to their experiences being negative or positive. Patients also stated that they felt powerless and experienced loss of autonomy during coercive care. Good coercion was experienced when they felt seen and taken seriously.
Conclusion: Patients expressed both negative and positive experiences of coercion. Patients wished for better adjusted information and opportunities to participate. They also expressed the need for trusting and supportive relationships to the mental health care staff. This could lead to greater understanding for their coercive care.
Background: When a child is cared for in hospital, the child's well-being and ability to influence its own care must be taken into consideration. Children should not be separated from their parents unless the purpose is to protect the child. Children are entitled to a relative's presence and participation throughout the care period. The environment affects the child's experience of health and well-being during hospitalization. The presence of the family is of great importance and creates a well-being that gives the child security, harmony and an inner calm.
Aim: The aim of this study was to highlight nurses' experiences of family-centered care when a child is admitted to hospital.
Method: The method was a literature-based study that contributes to evidence-based care, eight scientific articles with qualitative data were analysed using Friberg's five-step model. The method was used to compile and analyse previous research into a new whole and to use the identified scientific knowledge into practically useful knowledge.
Results: Three main themes and ten subthemes were identified. The first theme describes the relationship between the nurse and the family. The subthemes were; The importance of the family, Creating a trusting relationship, Involving the family in the child's care, The family may hinder family-centration. The second theme describes the importance of communication. The subthemes were; Need for communicative skills, Nurses' retention of certain information, Cultural barriers. The third theme describes lack of resources preventing family-centration. The subthemes were; Insufficient material and infrastructural resources, Insufficient human resources and Lack of knowledge about family-centering.
Conclusion: Family's presence is of great importance to the child, that the nurse should be able to involve the family in the child's care and create a trusting relationship with the family. Nurses' approach is meaningful to how the family's participation in the child's care is perceived. The family can be seen as an obstacle or an advantage to the nurse's work. The nurses acknowledge that they need more knowledge about family-centered nursing in its entirety, and how to work with the family.
Background ADHD is a disability with symptoms like inattention, impulsivity and hyperactivity. The symptoms can make everyday life difficult for the adults with ADHD. In Sweden, 2,5% of the adult population is expected to have ADHD. Previously, the diagnosis has been noted as a disability that is only found in children. This has meant that many adults have not received the help they need.
Aim The aim of this study was to describe adults´ experiences of living with ADHD.
Method The method chosen for this study was to contribute to evidence-based nursing with ground in analysis of qualitative research. By using this method, experiences from adults living with ADHD could be described. Eight articles were analysed from which three main themes och ten sub themes arose.
Results The result showed that living with ADHD both is about handling a life with limitations and strengths caused by its symptoms. It also showed how the symptoms impact the everyday life and the experience of failure in both social life and work life. It is important for adults with ADHD to gain self awareness and awareness from others. It is also described how adapting the environment can help the adult with ADHD.
Conclusion It is important for adults with ADHD to get good knowledge about the diagnosis, to get support and that both healthcare professionals and relatives are well informed about the need and support.
Background: When a person needs heart transplantation it means that they are suffering from a serious heart failure, and in order to survive they need to undergo surgery for a new heart from a dead person. A lot of the patients don't know what to expect from the surgery and life after the transplantation but their fear of that will not overshadow the chance they have to take somebody's else's heart and begin to live a new life. The transplantation can be a difficult thing to understand and handle without help. It becomes very important for the nurse to have knowledge of the patients' experiences to adjust an individual care in the future.
Aim: The aim of the study was to describe patients' experiences of life after heart transplantation.
Method: A five-step model was used described by Friberg (2012) to contribute to evidence-based nursing with basis in analysis of qualitative research, for the analysis of ten scientific qualitative articles.
Results: The findings that emerged from the analysis shows that they can be applied to the nursing profession. The findings formed three themes: New life, Existential thoughts, and Spiritual aspects, with subthemes.
Conclusion: After the heart transplantation there is no guarantee that the patients wellbeing will improve. It is important that nurses have knowledge in this field so they can care for the patients' and help them to regain their physical and mental health.
Background: During trauma treatment lots of health personal are mobilized under a short timeframe. The focus lies upon the care of the patient which leads to reduced focus on the nursing care for the relatives. The relatives are in a difficult life situation and in a major need for nursing care. Aim: The aim of this study was to illuminate the nurses' care for the relatives of trauma patients. Method: This study is a literature review of eleven studies that involves relatives or nurses perceptions of the nursing care provided for the family-members of critically ill trauma patients. The studies were analyzed and categorized into themes and subthemes. Results: A total of three themes emerged. "Communications with the relatives", with subthemes the nurse gives information, nurses' behaviors and accessibility, taking the time to get to know the relatives. "Relatives involvement in care" with the subthemes involving the relatives in care, letting the relatives close to the patient. The last theme was "nurses provide care for the patient" without any subthemes. Conclusion: Information was crucial to the relatives. The nurse had to be calm and accessible to the relatives' needs and when he or she seemed stressed it was considered uncaring for the relatives. The relatives wanted to comfort themselves and the patient by being close to him or her. The subject needs more research especially with focus on what's being done for the relatives of trauma patients.
Background: Chronic obstructive pulmonary disease is a growing problem today around the world. People are getting diagnosed with COPD everyday and the number of cases is expected to increase in the future. It is important that the nurse can respond to people living with COPD and to understand the symptoms and living condition of these people in order to apply a good nursing care.
Aim: The aim of this study was to describe how quality of life is affected by chronic obstructive pulmonary disease (COPD).
Method: The method of this study is based on a qualitative and quantitative research according to Friberg (2006) and Friberg (2012). Nine articles was analyzed according to Fribergs five-step model and results divided in three main themes.
Results: The main themes were Symptom that limits everyday life, symptoms with a psychosocial impact and Relieving of symptoms that increases the quality of life.
Conclusion: The results showed that COPD affects the entire life. To combine different treatment options such as applying oxygen, special breathing techniques and to increase the physical activity, it is possible to increase quality of life in COPD.
Background: In Sweden last year 426 patients received a new kidney. As a patient you can be on a waiting list for a kidney transplantation between 1-3 years, sometimes longer. While waiting for a kidney transplantation dialysis is often required. Kidney transplantation is the renal replacement therapy of choice for more than 55 % of people with kidney failure. Despite improvements of quality of life in physical, social and psychological domains many factors influence life in a negative way.
Aim: The aim of this study was to describe patients' experiences after a kidney transplant.
Method: A literature-study was based on ten qualitative research articles.
Result: Our analysis of the result emerged in two themes; "Adaption from ill to health with side-effects" and "Difficulties to make friends with uncertainty". Patients experienced a wide range of emotions while trying to adjust to life after transplantation. It is a complex task to establish normality in the shadow of troublesome side-effects and the constant risk of rejection.
Conclusions: The kidney transplant patient often hovers between health and suffering. It is a big adjustment in life to try to live as a healthy person but along with side-effects and constant threat of graft rejection on the patients' mind. To learn to cope with the situation and move towards acceptance the patient also needs hope. The nurse must be attentive to what the patient experiences to be able to support the patient in the process of striving towards health.
Background: Diabetes type 2 is today a rapidly increasing global health problem, often caused by unhealthy lifestyle choices. Changing life after a chronic disease is both time-consuming and burdensome, especially when many felt that the life they had lived before was too valuable to give up.
Aim: The aim of this study was to illuminate experiences of living with diabetes type 2.
Method: A literature study was produced based on eleven qualitative scientific articles, which were analyzed by Friberg's five step analysis.
Results: The analysis resulted in two main themes, Imbalance in life and Balance in life with eight sub-themes; The inner battle, Loneliness, Life in denial, Lack of knowledge, The will to fight, The need for support, Finding acceptance in life and The importance of knowledge. These themes described the striving for balance in life when living with diabetes type 2.
Conclusion: The study showed that persons with type 2 diabetes experienced a mix of feelings which were highly affected by how their lives around them looked like. This meant that even though you might had learned and accepted to live with type 2 diabetes, it did not necessarily meant that life not will take a turnabout. It is important for the nurse to know that life with diabetes are changeable, and that they therefore have a significant role to support the person to find balance in life.


text:
This piece of note is from my personal experience.
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subset: commoncrawl


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I have the best hubby in the world @Zakesbantwini! This was the best surprise baby shower ever thank you @minniedlamini for organizing this! You're my MVP! Thank you @nonigasa @langamngoma for planning this and thank you to all my friends who came💙. No I'm not in labour😂😂. #Funtimes #BabyMadida
@minniedlamini thank you for organizing such a beautiful event! Love you my sister! You @Zakesbantwini and @NoniGasa are slick😜. Great surprise!💙 #BabyMadida Face: @bevthemakeupartist
As my water broke😂😜... #mannequinchallenge #babymadida @minniedlamini @nonigasa @mablerh @mrs_gigabyte @Zakithi_Mthembu @sthandik1 @bandile_xaba @cheriyasekasi 😂
"Who was she? And what did she do? She was herself. And she did it all.." Read all about it. I'm your cover star for the December issue of Destiny Magazine. Get yourself a copy @destinyconnect ❤ #AfricanQueen 👑#DestinyDecIssue #WhatAnHonourWhatAYear
Nothing and no one can get in the way of ones destiny. On the cover of the December issue of @destinyconnect. What a beautiful day and year❤. #DestinyDecIssue Outfit: @colourfashionlabel
"It was all a dream" I am beyond humbled to receive such an award. We've just signed an incredible deal for 2017 for Colour. As I enter this journey of being a new mom I can only hope my child, husband and family can be proud of me. I do it for them❤. 2016 thank you for being so good to me. Thank you @WED_SouthAfrica @ForbesWomanAfrica #WomenWOW-SA


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Persian painting is a stable centuries-old artistic tradition, with its own rules and principles of the painting.
Persian miniature was a book illustrations. Persian artists had developed a marvelous painting system, which is dominated by subtle decorative sense, and work is a model of understanding of how color and form can be combine to create a single rhythmic whole on a flat surface. Persian miniature – the beautiful, comfortable art , which does not encroach on the inner world of the viewer. With the great degree of certainty it can be argued that all the wealth of Persian culture brilliantly manifested in the first place in painting.


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Jen dogs are above others she puts her heart and soul into all of the dogs that she raises. When you go meet one of Jens pups you are meeting FAMILY !
Is this dog for sale? What breed and how old?
I was inquiring a African Mastiff Boerle. Do you have any in all black preferable a male? If you have any puppies or one at least a year in age.
Mysti looks just like Charlee in the face. I remember her as a puppy! She is just beautiful!
No pups now and none expected this year but I have some adults to place from 1 yr old to 4 years old. Call me if your interested. 3524274383


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I think that's a sad fact I have forgotten as I don't visit them often. The Sweater Friends had the pleasure to play a quaint location called The Woodshed this Saturday night. This is the first time we've played a bar. It was fun, the bartenders were nice and there music guy really liked us, my only complaint was the 10:00 start time. It's way too late to make for a good show. And we were only the first band, which meant by band etiquette rules, we had to stay for the band after us (they asked us to play). I was so tired Shad and I started talking about teleportation on the way home. We could have used it Saturday night.
Because I had 3 week days off this week from coverage, I had a really eventful week. Tuesday night a group of my girlfriends went to Britney. It was amazing. Thanks to Kelly at Chili's we missed half of the Pussy Cat Dolls show. I was a bit disappointed but the parts we did see were pretty good. I expected them to be stronger dancers though. Maybe they were tired. Then came Britney. As I'm sure many of you have read, her show is based off of her single Circus. She had all sorts of circus performers entertain before the show actually started, and then they participated all throughout the show. It was great. There was always so much going on and so much to look at. I think I could have ignored Britney for the entire show and still been super entertained.
Wednesday, I was able to wrap up a bunch of stuff around the house. Shad commented to me when I'm home during the day, it's like a scavenger hunt when he gets home to see what I've done. I put the guest room back together and decorated it a little bit, hung some shelves in the living room and painted a table and chair from the office. I then finished it all up with some tutoring. Pretty good day.
Thursday I did laundry and cleaned the bathrooms. Then I went and got my makeup done for our family pictures that afternoon. When I got up that morning, it was cloudy but I was hoping it was done raining for the day. I got home and gave Dublin a bath so he could be all clean and shiny for pictures. He actually climbed into the tub himself this time and sat down before I even had his stuff out. I wouldn't go so far to say he loves baths but he doesn't hate them either. After his bath I let him out to go to the bathroom. Unfortunately there was a bird in the yard. Dublin hates birds. He will try to chase a bird on the ground, in a tree and even on telephone poles. Luckily he's nowhere near fast or stealthy enough to come close to catching them. Maybe that's why he hates them. This particular bird was standing in the mud where the swing set used to be. So of course my nice clean puppy charged full force after the bird only to land empty handed in the mud. After his second bath for the day, I took him out in the back yard on a leash. At least one of us learned a lesson. Sadly all of this effort was in vain. As we were driving down to SLC, our photographer called to say it was raining and we would have to reschedule (again). We will get it this Wednesday, I'm sure.
Friday night we drove up to Maddox for dinner then went to the hot springs. We didn't last very long at the hot springs, it was still way too cold to go down the slide and the hot pools were overflowing with 13 year old scouts. Such is the hot springs on a Friday night.
Sunday after our late Saturday night, I was excited to get a nap. Shad took Dublin for a walk so I might get to sleep. They returned just as I was drifting off. Shoot. Shad of course laid down and was out in 5 seconds. Dublin laid down too but didn't go to sleep. Once again just as I was drifting off, Dublin had the uncontrollable urge to get up and lick my face and hair (I was laying on the floor). I resolved a nap just wasn't supposed to happen and watched leatherheads instead.


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I have been struggling with my hair because it's rebonded and now the roots are growing. I had a rebond one year ago and I had to accept the fact that my hair's naturally curly and that's what's made for me because I look much better with it. I had really frizzy hair when I was in elementary school so I did not hesitate to rebond it but then I realized that it did not suit me much because it was so limp and volumeless and it made my hair thinner and thinner as time comes so I stopped getting a rebond and instead, I'm growing it out. Everyday I get annoyed with my hair because it's thick, full of volume, long and it's really hot (Philippines is a tropical country, plus it's summer). I tied my hair up everyday in the past because it really feel uncomfortable down and it's really a mess. The problem is, my scalp hurts a lot because of the tight ponytails and heavy hair that my scalp should support. To end this problem, I had a haircut yesterday which made my hair so much easier to manage thus, ending my problems. I will grow out my curls and hopefully be proud and comfortable with it.
This is a photo of me yesterday when my hair was newly cut and my hair was blowdried to straighten my locks.
This one's taken today showing my natural waves. I achieved this by bunning my hair for about 4-10 hours? depending on your hair texture. I might post a tutorial if I have time.
Short hair? very comfty!


text: KIRKUS REVIEW O'Hara' is something of a problem for reviewers- more than the fact that he snarls at them from time to time. But he writes so calculably about people whom you might know, or at least recognize on the street, and a place, the Marquand country, in and around Gibbsville, Pennsylvania, that his virtues and limitations have by now been pretty well defined. The Lockwood Concern, a long, tenacious, dynastic account, is also a closed corporation. Founding father Moses built a wall around his house to protect himself from his neighbors because his life was threatened. A later Lockwood put up another wall--with spikes--on which a child was killed. But by this time the Lockwoods were sufficiently secure to remain unmolested. Actually the Lockwood men had one thing in common-- they made money and women with equal ease. For the most part this is George Lockwood's story-- he is the third generation-- and from the beginning is the focus of his father's ambition and tutelage through the right schools (St. Bartholomew's and Princeton). There's his marriage to the primly resistant Agnes and his concurrent affair with the girl he had first chosen; a more sophisticated, semi-detached second marriage at Agnes' death; the estrangement from his son, Bing; his acceptance of his daughter's self-destructive promiscuity; and the admission, just before his death, of his own loveless and unloved existence. This is of course one lack in O'Hara's novels-- they are unfeeling-- but they are also eminently professional, expertly readable and there are few writers who have recorded the social and sexual folkways of a certain group with such stereophonic fidelity. That's the O'Hara concern. Pub Date: Nov. 25th, 1965ISBN: 0881842176Page count: 432ppPublisher: Random HouseReview Posted Online: Oct. 3rd, 2011Kirkus Reviews Issue: Nov. 1st, 1965


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It's Okay to Not be Okay
Well, first of all, I kind of misled you. Whether you're a new mom or a seasoned mom, you're going to lose your shit, from time to time. What you do need to know, is that its' okay to not be okay! Speaking from a new mom's perspective, motherhood is just plain hard. When you add military life to the mix, you might as well send me to the loony bin. As much as it's rewarding and the joy your little ones bring you, some days, you just want to hide in the bathroom and drink your coffee before it gets cold. I'm here to tell you as chaotic as it can be in those moments of stress and being overwhelmed, there are some ways to help you from going crazy.
#1 Sleep!
As I write this, I am laughing because I know firsthand, how difficult it can be to find time to sleep, especially in the newborn stage. From week one till about three months, my daughter had colic. On top of colic, she also struggled with reflux for about the first six months of her life. The colic and reflux resulted in her crying for hours and hours on end. Cue the sleep deprivation! My husband and I had to take turns at being on "baby duty" just so we could try to squeeze in some sleep. Not to mention, in the first two weeks of her birth, we were in the process of moving. Picture this: an air mattress with a rock n' play beside it and a sleeping bag, upstairs, in an empty room. I had to wear earphones and blast white noise to drown out the crying when it was my turn to try and get some sleep. Man, that was rough! So, I know firsthand, its' easier said than done, but any chance you get in the newborn stage, try to sleep. Forget those dishes because it isn't as important as your well-being!
#2 Schedule "Me time"
Oh, I cannot emphasize enough, the importance of giving yourself a break! You AND your spouse need your own "me time". For my husband and I, we each take a few hours on the weekend to go out and doing something by ourselves. Examples of what you could do include getting your nails done, window shopping, reading a book at a coffee shop, go for a walk, etc. If you want to use that time to nap, DO IT! Have your significant other take the baby out for an hour or two while you catch up on some sleep. My husband likes to go play golf, rugby or play nerdy games at the game store. I find taking time for ourselves is not only important for us individually but for our marriage. Parenting in general is not easy but in the early months, its' especially trying, so remember to give yourself a break!
#3 Ask for Help
Whether you have a supportive spouse or if you're a single parent, ask for help! The saying goes, "It takes a village to raise a child" and with that, I concur. Please, don't try to be Super Mom and do everything yourself because it will break you down. I remember people brought us food whenever my daughter was born and I was forever grateful! A week after I had Madeline, the packers came to pack up our belongings, so we were without any proper furniture. One of my neighbors came to my rescue, and let me borrow a rocking chair, for the time being! I was also blessed my mom flew out to help us with the transition of parenthood. She cleaned, folded laundry, did dishes, made food, held my crying daughter so I could shower, and for that I am so thankful.
People are going to ask you if they can help, so instead of saying, "Oh, it's okay, don't worry about it!", please say yes! Ask them to do your dishes or fold that stack of laundry, do not feel guilty!!! You are not there to entertain them. They are there to help you!Remember that "me time"? Ask someone to watch your little one while you get away for an hour or two. It makes all the difference in the world to get a break and recharge!
#4 Exercise
Exercise is medicine for the body! You don't have to be a gym rat or in excellent physical condition to get started. After having a child, you most likely will not be in the best shape of your life (which is totally normal and to be expected), so take it slow! I highly recommend finding a gym that provides childcare. There are also many mom groups/businesses that offer child-friendly classes. I feel so much better after I workout and am just all around more happy!
#5 Find mom-friends
You can only talk about the color of your baby's poop or how often they eat, to your spouse, for so long. Sometimes, it's just easier to talk to a fellow mom friend. A mom friend understands what you're going through and can also give you advice (if you want it). Mom friends can get together for play dates and bond over how often you had to re-heat that coffee and change your blouse, that morning. We just get each other, its' that simple.
#6 Be Kind to Yourself
You are not the same woman you were before you gave birth. You feel different and may even look different. I'm here to remind you that all of that is normal and not to beat yourself up! Realize the miracle you created and the process your body went through to bring your baby into the world. Embrace those stretch marks. Don't try to fit into those pre-pregnancy jeans, right away. In fact, I highly suggest shopping for some outfits that fit you and your new body. About six months after I gave birth, I still wasn't quite fitting in my old jeans, so I went out and bought a new pair. There is nothing worse on your confidence than trying to squeeze into clothes that are too tight. Who says you have to be a certain size or weight? That number is just that, a number. So I got my new jeans and I felt great because I wasn't feeling the pressure (I put on myself) to fit into my old clothes right away. Don't get me wrong, there's nothing wrong with wanting to fit back into those jeans, just know it will probably take time but if it never happens, that's okay, too. Remember you're a different person now. Your body is different but it is beautiful! Be kind to yourself!
#7 Don't Doubt Yourself
In the beginning stages of motherhood, I often found myself questioning, "Am I doing something wrong?". This doubt is somewhat normal but do not let it control your thoughts. In the beginning, I would obsess over what I was doing or if my husband "wasn't doing something correctly" when in reality, I was just being a paranoid, controlling new mom (also totally normal!). As they say, "there is more than one way to cook a chicken", meaning there is more than one way to put a baby to sleep, to change their diaper, to feed them, etc. Don't obsess over everything being perfect, because, motherhood is far from it! Let people take over for your sometimes, even when you are screaming inside because they aren't changing the baby "right" (this was me). I soon realized that sometimes babies just cry. It doesn't mean I'm doing something "wrong". In those early "colic" days, when I was going crazy from the constant crying, I would say to myself "This is temporary". I would take a deep breath and repeat this mantra and it would significantly calm me down.
I hope these few tips on staying sane during that first year of motherhood are of some help to you, if not, just a reminder! Take care of yourself, physically and emotionally, and you will make it through! Also, remember, it's okay to lose it sometimes. I still do. However, these tips have significantly helped tone down my crazy! Ha! God bless Mamas! What is something you do to help yourself from losing it?


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Wings of a Butterfly
Devyn Lindström moved to Scranton for a new life. Ricky Olson moved to Scranton for his band, Motionless in White. Will they maintain a friendship or will a romance blossom?
- 2 Votes
The Vain Escape
Alex finds herself wandering some shady forest where she meets a group of other lost drifters
Changing the world
The Osaki 8
- 1 Vote
Toxic Valentine. (Fransykes)
"Show evil the up most respect," Or at least, that's kind of how they individually saw themselves, as evil. Oli for corrupting him, and Josh for dragging him into a whole new side of intimacy that he never had to see.
10.0 6 Votes
The Sound of Silence
Trauma can change people in the most horrific ways. Once you experience a trauma, it's hard to go back to the person you used to be. Rarely ever does it happen in fact.
10.0 6 Votes
Goodbye Agony
Ashley has a daughter...or had one. What happens when he sees a post on IG that might be from his daughter who he thought was long dead? Ashley and the rest of the band are best friends with MIW, PTV, MCR, SWS. BMTH, OM&M, and a couple others. Together, they find out what happened the night of Ashle
10.0 12 Votes
Run Away Before It's Too Late
Kathandria is in an orphanage. One day, someone she never expected to see comes to adopt someone.
Completed ✓
10.0 35 Votes
From Light Unto Darkness
The story of Zila *prequel to Rage, Rage Against the Dying of the Light*
10.0 7 Votes
Show Me What I Can't See


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A change of managers at Chelsea is nothing new. In the 15 years Roman Abramovich has owned the club, the Blues have had 12 different men in charge of team affairs on a permanent or temporary basis. The likelihood is that this will soon become 13 with Antonio Conte expected to depart in the coming weeks.
Presently, there is no glaringly obvious candidate to replace Conte and Chelsea supporters are widely divided over the suitability of the managers being linked to take on one of the most challenging jobs in football.
Fan concern at this latest hiatus is exacerbated by the fact that Abramovich is pressing ahead with plans to redevelop Stamford Bridge. It's expected the Blues will play at the Bridge for two more seasons and then move to temporary home for at least four years while the stadium is rebuilt. Where Chelsea will play their football during this period has yet to be decided. Wembley remains the most likely venue, but a ground-share with West Ham at the London Stadium is also being rumoured and it's believed that options to remain within the Borough of Hammersmith and Fulham are also being explored.
To make matters worse for supporters already troubled by these uncertainties, the Blues have come up short on the pitch this season. Premier League champions Manchester City have raised the bar and in the process, erased a number of records set by Chelsea in the Abramovich era. Manchester United, Tottenham and Liverpool also finished ahead in the table, meaning Champions League football will not be on the agenda for the 2018-2019 campaign.
What Chelsea fans crave right now is managerial stability and sight of a clearly defined football strategy that will enable the club to claw back the ground lost to rivals. When Jose Mourinho returned in 2013 for his second stint as boss, hope sprang eternal the Portuguese would go the distance and stay to build a dynasty that would overarch the stadium redevelopment that was announced during his tenure. Of course that didn't work out — boom soon turned to bust for Mourinho. When Conte was appointed and led Chelsea to the title in his first season, the same thought processes were applied — but then the Italian's world rapidly unravelled as well.
At face value it could be argued that supporters are worrying over nothing. Saturday sees Chelsea play Manchester United in the FA Cup final and with that comes the opportunity to win yet another trophy. Win or lose, Abramovich has huge cash reserves to throw at his expensive hobby.
Conte may well leave and, should he do so, the next man will come in and be given money to spend on new players — that's the way things have always worked at the Bridge under the Russian and the 14 major trophies won to date under his ownership make it hard to criticise the way success has been achieved.
Scratch beneath the lustrous veneer that this silverware represents, however, and there is little for fans to be enthusiastic about. Chelsea lack the director of football-style structure and stadium permanence their rivals now have in place. Yes the academy continues to deliver success, but that is also measured in trophies rather than progress — which in this case means players breaking through to the first team.
Right now nothing appears joined up. Abramovich, of course, has the financial resources to address this, but does he have the right kind of football wisdom? The next managerial appointment and the back office support that goes with it is potentially the most important in the club's entire history.
Get it right and Chelsea will soon be back in the groove and match-going supporters will ride out the stadium redevelopment and continue to part with their hard earned cash to follow the team. Get it wrong and the empty seats that were very much in evidence in the final home game of the season with Huddersfield will become increasingly noticeable and only get worse when the Blues move away from the Bridge.
Gazing at rows of empty seats at the Emirates when disgruntled Arsenal season ticket holders stayed away during the final troubled weeks of Arsene Wenger's managerial reign was a portent of things to come. Watching football is an expensive business and now as never before supporters need to feel that their club is doing the right thing by them.
Clearly conscious of this fact, Arsenal are being meticulous about appointing a successor to Wenger who was in charge of the team for 22 years. A long-term strategy is clearly in play, but they know they need to get the right man. Whether or not Abramovich is thinking along the same lines is a mystery — he should be though, because if two years down the line Chelsea find themselves without a manager once more it will only mean one thing — failure, and with it a long hard road might lie ahead.
Mark Worrall is one of ESPN FC's Chelsea bloggers. You can follow him on Twitter: @gate17marco


text: Nerds in Court has followed the lawsuit of Bethesda, creator of Elder Scrolls V: Skyrim, against Majong Studios since it was first filed. Majong Studios, creator of the popular Minecraft game, were sued over the title of their upcomingScrolls game. At one point, Majong Studios head Markus 'Notch' Persson offered to settle the lawsuit with a Quake deathmatch, but retracted upon reflection. Although the full details are unknown, Persson recently tweeted that a settlement was reached allowing Scrolls to go forward as planned with Bethesda owning the actual trademark, but Majong's title permitted. NiC wishes the best for Mr. Persson and gives him the 2011 Award for Most Entertaining Alternative Dispute Resolution Proposal.


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text:
Major Milk Campaign kicks off online
A large scale campaign has been launched in Cumbria highlighting to the whole UK the plight of the Dairy Industry
Ispeak4Daisy is a visual media campaign launched in Silloth on 30th March 2015. The purpose of this commercial campaign is to raise national consumer awareness being faced by Daisy who represents the British dairy industry and the crisis that is threatening her existence and sustainability in extremely difficult economic conditions. Since the campaign was launched on social media through Facebook and Youtube, the Facebook post has reached out to 117,907 people and the video has been viewed by more than 35,000 people in less than 48 hours.
This video is a short informative television ad which is focused on Daisy, a beautiful and elegant dairy cow, who lives at Kelsick House Farm in Abbeytown in West Cumbria.
The campaign has been initiated by Rozila Kana of Workington who commented saying:
"I felt that we, the public, need to speak for Daisy who represents the Dairy industry and helps look after the British countryside. It is hoped that this commercial will empower the British public to buy dairy products from retailers that pay fair prices to British dairy farmers and also encourage the British public to buy farming products sourced on British farms. Retailers should use correct food labels that clearly reflect country of source."
Windermere Councillor Ben Berry praised Rozila Kana for her hard work saying:
"Round here we care about our farmers and local economy, but often we aren't quite sure what we can do to help. Rozila has done a fantastic job here so I implore you to watch the video, like the campaign on Facebook and look for products with the Red Tractor badge."
The Youtube Video can be found here


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Child in autumn Park having fun playing , Walks in the fresh air
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