Publikationer från Sophiahemmets Högskola
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Transgender individuals' experiences of healthcare encounters : A non-systematic literature review
No full textBakgrund: Transsexuella personer möter ofta utmaningar som könsdysfori, minoritetsstress och stigmatisering, vilka påverkar deras psykiska och fysiska hälsa. Trots att vården enligt lag ska vara jämlik och inkluderande visar forskning att bristande kunskap, heteronormativa normer och diskriminerande bemötande är vanliga problem. Syfte: Syftet var att beskriva transsexuella personers upplevelser av bemötande i hälso- och sjukvården. Metod: Litteraturöversikten var icke-systematisk och 11 artiklar valdes ut till resultatanalysen. Artiklarna var av kvalitativ, kvantitativ och multimetod design. De granskades av författarna i enlighet med Sophiahemmet Högskolas granskningsmall. Dessa analyserades av författarna, både tillsammans och enskilt. Resultat: Från analysen sammanställdes två huvudkategorier; Kommunikation och bemötande samt Upplevelser av respekt och erkännande. Studien visar att transsexuella personer ofta möter okunskap, diskriminering och stigmatisering inom hälso- och sjukvården, vilket tvingar dem att förespråka för sig själva och utbilda vårdpersonal om sina behov. Felköning, stereotypa antaganden och bristande respekt skapar känslomässig påfrestning och avskräcker många från att söka vård. Trots dessa utmaningar har vissa rapporterat om positiva erfarenheter med respektfullt bemötande och kompetent vård. Förbättringar kräver ökad utbildning om transfrågor, attitydförändringar och inkluderande vårdmiljöer där transsexuella personers identitet och autonomi respekteras. Detta skulle minska hindren och främja tryggare vård för transsexuella personer. Slutsats: Sammantaget visade resultatet att vården behöver förbättra sin kompetens och sina attityder gentemot transsexuella personer för att minska behovet av självförespråkande samt för att undvika diskriminering. Genom att utbilda hälso- och sjukvårdspersonal och normalisera transfrågor i vården kan många av dessa problem hanteras. Vidare forskning bör utforska vilka interventioner som är mest effektiva för att skapa hållbara förbättringar i bemötandet av transsexuella personer inom vården.Background: Transsexual people often face challenges such as gender dysphoria, minority stress and stigmatization, which affect their mental and physical health. Despite the fact that care according to law must be equal and inclusive, research shows that lack of knowledge, heteronormative norms and discriminatory treatment are common problems. Aim: The purpose was to describe transsexual peoples' experiences of reception and treatment in health care. Method: The literature study was non-systematic and 11 articles were selected for the result analysis. The articles were of qualitative, quantitative and of multimethod design, and were reviewed by both the authors in accordance with Sophiahemmet University’s review template. These articles were then analyzed by the authors, both together and individually. Results: From the analysis, two main categories emerged: Communication and treatment and Experiences of respect and recognition. The study highlights that transsexual individuals often face ignorance, discrimination, and stigma in health care, leading to self-advocacy and educating providers about their needs. Misgendering and lack of respect cause emotional stress and deter care-seeking. Despite these challenges, positive experiences with respectful and competent care were noted. Improvements require better education on trans-issues, attitudinal shifts, and inclusive care environments where trans-identities and their autonomy are respected. This would also reduce barriers and ensure safer care. Conclusions: Overall, the results show that health care needs to improve its skills and attitudes towards transsexual people in order to reduce the need for self-advocacy and to avoid discrimination. By educating health care professionals and normalizing transsexual issues in healthcare, many of these problems can be addressed. Further research should explore which interventions are most effective in creating sustainable improvements in the treatment of transgender people in healthcare
Perceived health effects in the respiratory system of inhaling fumes from e-cigarettes
No full textBakgrund: Brukandet av e-cigaretter är ett folkhälsoproblem. Antalet personer som använder e-cigaretter har ökat sedan 2010 och har i dagsläget uppnått 86 miljoner personer. Trots det stora antalet som brukar nikotinprodukter, i form av bland annat e-cigaretter, saknas det kunskap kring dess effekt på det respiratoriska systemet. Det finns därför en efterfrågan på att sammanställa aktuell forskning för att bidra med kunskap till hälso- och sjukvårdspersonal kring e-cigaretters påverkan på den respiratoriska hälsan, för att möjliggöra ett hälsofrämjande arbete. Syfte: Syftet var att belysa upplevda hälsoeffekter i det respiratoriska systemet hos vuxna som inhalerar nikotinprodukter samt belysa olika aspekter av att använda e-cigaretter. Metod: Detta arbete utgick från en icke-systematisk litteraturöversikt som grundades på tio vetenskapliga originalartiklar med kvantitativ ansats. Artiklarna inhämtades genom att sökord kombinerades i databaserna PubMed och CINAHL. Artiklarnas kvalitet har granskats med hjälp av Sophiahemmet Högskolas bedömningsunderlag, och har på så vis fått en vetenskaplig klassificering. Avslutningsvis sammanställdes och analyserades resultatet i form av en integrerad dataanalys. Resultat: Resultatet redogjorde för positiva likväl negativa upplevelser av den respiratoriska hälsan relaterat till användning av e-cigaretter, där det framkom att tidigare rökare upplevde en positiv effekt medan icke-rökare upplevde en försämrad respiratorisk hälsa. Slutsats: Denna litteraturöversikt tydde på att e-cigaretter inte bidrog till en förbättrad upplevd respiratorisk hälsa. Vad som däremot framkom var att ett kombinationsbruk av konventionella cigaretter och e-cigaretter gav flest komplikationer. Denna slutsats bidrar med kunskap för sjuksköterskeprofessionens hälsofrämjande- samt förebyggande arbete där sjuksköterskan har en central roll i att främja hälsa samt ge individanpassad information för en förbättrad folkhälsa.Background: The use of e-cigarettes is a public health problem. The amount of people using e-cigarettes has increased since 2010 and has today reached 86 million people. Despite the large amount of people using nicotine products, in the form of e-cigarettes, for instance, there is a lack of knowledge about its effect on the respiratory system. There is therefore a demand to gather current research to provide knowledge to healthcare professionals about the impact of e-cigarettes on respiratory health, and as a result, enable health promotion. Aim: The aim was to illustrate perceived health effects in the respiratory system in adults who inhale nicotine products and illustrate various aspects of using e-cigarettes. Method: This study was based on a non-systematic literature review established in ten original scientific articles with a quantitative approach. The articles were obtained by combining keywords in the databases PubMed and CINAHL. The articles’ quality was examined with Sophiahemmet University’s assessment basis and has thus received a scientific classification. Lastly, the result was compiled and analyzed in the form of an integrated data analysis. Results: The result presented both positive as well as negative experiences of respiratory health related to the use of e-cigarettes, where it was found that ex-smokers experienced a positive effect while non-smokers experienced a deterioration of their respiratory health. Conclusions: This literature review indicated that the use of e-cigarettes did not contribute to improved perceived respiratory health. On the other hand, the review indicated that a combined use of conventional cigarettes and e-cigarettes caused the most complications. This conclusion contributes knowledge for the nursing profession’s health promotion and preventive work, where the nurse has a central role in promoting health and providing individualized information for improved public health
People's experiences of music in relation to chronic pain : A non-systematic litterature review
No full textBakgrund Långvarig smärta är svårbehandlad. Smärtan är komplex då den påverkar personer biologiskt, psykologiskt och socialt. I Europa lever 19 procent av den vuxna befolkningen med långvarig smärta som allvarligt påverkar dagliga funktionen. Inom vården möter sjuksköterskan personer med långvarig smärta i olika vårdsammanhang och behöver kompetens för hur den ska hanteras för att minska lidande och främja hälsa. Sjuksköterskans arbete ska för att uppnå detta präglas av ett personcentrerat förhållningssätt, genom att använda alternativa behandlingar som musik. Syfte Syftet med studien var att beskriva personers upplevelser av musik i samband med långvarig smärta. Metod Studien genomfördes med en icke-systematisk litteraturöversikt där 10 vetenskapliga artiklar inkluderades. Databaserna PubMed, CINAHL och PsycInfo användes för sökning av artiklar med olika kombinationer av sökord. Sophiahemmet Högskolas bedömningsunderlag har använts för kvalitetsgranskning av samtliga artiklar som inkluderats i studiens resultat. En integrerad dataanalys användes för att sammanställa och analysera resultatet. Resultat I resultatet framkom tre huvudkategorier: Upplevelse av effekt på smärtan, Upplevelse av effekt på välmåendet och Upplevelse av effekt på det sociala livet. Resultatet visade att musik kunde ha effekt på minskad smärtintensitet, förbättrad smärthantering, lindring av depression och ångest och kunde ha god effekt på humör och sociala relationer. Slutsats Vid långvarig smärta sågs användandet av musik ha en effekt på minskad smärtupplevelse, förbättrat välmående och god effekt på det sociala livet. Det framkom att sjuksköterskan i sin professionella roll ska arbeta med personcentrerat förhållningssätt, för att lindra lidande och främja hälsa. Detta genom fördjupad kunskap kring hur sjuksköterskan kan använda den icke farmakologiska åtgärden musik, för att lindra långvarig smärta. Det finns en variation i musikens effekt på långvarig smärta. Därav krävs ett personcentrerat förhållningsätt för implementering.Background Chronic pain is difficult to treat. The pain is complex since it impacts individuals’ biology, psychology, and socially. In Europe, 19 percent of the adult population have chronic pain significantly affecting their daily functioning. Nurses encounter chronic pain in various healthcare settings and need competence to manage this to alleviate suffering and promote health. To achieve this, the nurse’s work should have a person-centered approach, incorporating alternative treatments as music. Aim The aim of the study was to describe people’s experiences of music in relation to chronic pain. Method The study was conducted using a non-systematic literature review, including 10 scientific articles. The databases PubMed, CINAHL, and PsycInfo were used to search for articles with various combinations of keywords. Sophiahemmet University's assessment tool was used to evaluate the quality of all articles included in the results of this study. An integrated data analysis was performed to compile and analyze the findings. Results The results revealed three main categories: The experience of pain, The perceived impact on well-being, and The perceived impact on social life. It showed that music can have an impact on reducing pain intensity, improve pain management, alleviate depression and anxiety and positively influence mood and social relationships. Conclusions In chronic pain music had an effect on reduced pain perception, improved well-being and a good effect was shown on the social life. It emerged that nurses, in their professional role, should adopt a person-centered approach to alleviate suffering and promote health. This requires deeper knowledge of how nurses can use the non-pharmacological intervention music to relieve chronic pain. There is a variation in the effectiveness of music on chronic pain, which underscores the need for a person-centered approach in its implementation
Implementing the Family Talk Intervention among families with a severely ill parent or child with palliative care needs : A longitudinal study of the perspectives of hospital social workers
No full textBACKGROUND: The Family Talk Intervention (FTI) is a psychosocial intervention supporting families where a family member has palliative care needs. This study aimed to evaluate how the Family Talk Intervention (FTI) was implemented over time from the perspective of hospital social workers (HSWs) in their everyday clinical practice among families with a severely ill parent or child in need of palliative care. METHODS: HSWs (n = 21) working in adult and children's care completed a 10-day education where they were trained to use FTI. The education was part of a multifaced implementation strategy involving educational outreach visits, facilitation, clinical implementation meetings, and audit and feedback. The HSWs were then expected to use FTI in their clinical practice to support families with dependent children. To assess if and how FTI was integrated into their daily practice, they were also asked to complete the Swedish version of the Normalization Process Theory Measure (S-NoMAD) on three occasions: on completion of the FTI-education, six months later, and one year later. For the longitudinal analysis of data, Friedman's test was used. RESULTS: The HSWs rated the use of FTI high after completing the FTI-education, indicating a positive attitude towards FTI. In the longitudinal analysis, statistically significant changes were seen for two questions in S-NoMAD, where the HSWs' ratings showed that the FTI became more familiar and normalized over time. Generally, the HSWs' ratings of S-NoMAD's main constructs were high and stable over time, indicating a positive view of FTI and its implementation. However, for the single questions, the ratings were slightly more negative to some contextual aspects, such as managerial support and resources. CONCLUSION: As results showed, HSW mainly rated different aspects of the implementation process as positive, both from the beginning, but also over time. Therefore, the intervention could be judged to have been implemented as a tool to support families when a parent or a child is severely ill. Contextual factors, involving managerial support and resources were rated lower, indicating the importance of those aspects when introducing interventions into healthcare. The result also indicates that the multifaced implementation strategy supported the HSW's everyday clinical practice. CLINICAL TRIAL REGISTRATION: clinicaltrials, nr, identifier (NCT05365919; 2022-03-04 and; NCT05020158 2021-05-11)
Chronic pain: people´s experiences of physical activity as treatment : A non-systematic literature review
No full textBakgrund Långvarig smärta är ett omfattande och komplext hälsoproblem som påverkar flera aspekter av individens liv, fysiskt, psykiskt och socialt. Detta hälsoproblem behandlas som bäst genom en kombination av icke-farmakologiska och farmakologiska insatser, multimodal behandling. Fysisk aktivitet som del av multimodala behandlingsprogram kan visa positiva effekter fysiologiskt och psykologiskt. Sjuksköterskan har en viktig roll i detta genom att stödja personer med långvarig smärta, främja hälsosamma levnadsvanor, ge råd och stärka patientens egen förmåga till egenvård. För att möjliggöra fysisk aktivitet som behandling behöver sjuksköterskan har god förståelse för patienters upplevelser av fysisk aktivitet i relation till sin smärta. Syfte Syftet med studien var att beskriva personers erfarenheter av att använda fysisk aktivitet som behandling vid långvarig smärta. Metod Den här studien använde sig av design i form av en icke-systematisk litteraturöversikt med ett systematiskt arbetssätt. Arbetet baserades på evidens från tio utvalda artiklar som följt det valda urvalet samt genomgått kvalitetsgranskning av författarna till det här arbetet. Insamlade data har analyserats och kategoriserats i huvud- och subkategorier utifrån en integrerad analys. Resultat Användning av fysisk aktivitet som behandling har visats ha god påverkan på smärtan såväl som på följder av smärtan. Fysisk aktivitet kan bidra till god effekt fysiskt, psykiskt och socialt. Personer med långvarig smärta kan uppleva det svårt att utföra fysisk aktivitet utifrån ett flertal identifierade barriärer såsom smärtans begränsning, praktiska och sociala hinder samt bristande motivation och kunskap. Det identifierades även faktorer som underlättade utförandet av fysisk aktivitet såsom socialt stöd, vilja och motivation samt hjälp och stöd från vårdgivare. Slutsats Personer med långvarig smärta beskriver goda erfarenheter av fysisk aktivitet som del av behandlingen. Patienter kan dock behöva stöd från sjuksköterskan då det finns barriärer som hindrar dem att utföra fysisk aktivitet. Background Chronic pain is a comprehensive and complex health problem that affects several aspects of the individual´s life, physically, psychologically, and socially. This health issue is best treated through a combination of pharmacological and non-pharmacological interventions, called a multimodal approach. Physical activity, as a treatment, has previously shown positive effects both physiologically and psychologically. Nurses play a vital role in supporting individuals with chronic pain by promoting healthy lifestyle habits, offering guidance, and strengthening the individual's capacity for self-care. To enable physical activity as a treatment, nurses require a thorough understanding of how patients experience physical activity in relation to their pain. Aim This study aimed to describe people's experiences of using physical activity as a treatment for chronic pain. Method The method used in this study is a non-systematic literature review with a systematic approach. This work is based on collected evidence from ten articles that have undergone quality control by the authors. The collected data has been analyzed and categorized into main and subcategories based on a model of integrated analysis. Results The use of physical activity as treatment for chronic pain has been shown to have a good impact on pain as well as on the consequences caused by the pain. Physical activity can have a positive effect on physical, mental, and social well-being. People with chronic pain may find it difficult to perform physical activity based on identified barriers, the limitations of pain, practical and social obstacles, and a lack of motivation and knowledge. Factors that facilitated physical activity performance were also identified, including social support, willingness, motivation, and help and support from caregivers. Conclusions People with chronic pain describe positive experiences of physical activity as part of their treatment.. However, patients may need support from the nurse as there are barriers that prevent them from engaging in physical activity.
Lifestyle behaviours and future healthcare utilisation for musculoskeletal pain in young adults : A cohort study of Norwegian university students with three-year follow-up
No full textBACKGROUND: It is unclear whether lifestyle behaviours influence use of healthcare for musculoskeletal pain in young adults. This study examined if lifestyle behaviours among college/university students were associated with future healthcare utilisation for musculoskeletal pain. METHODS: Data from the Students' Health and Wellbeing Study (SHoT2018) were linked with the Norwegian Registry for Primary Health Care, comprising 31,358 college/university students. We analysed associations of physical activity level, sleep duration, alcohol consumption, smoking, illicit drug use and cumulative adverse lifestyle behaviours with healthcare utilisation for musculoskeletal pain over the following three years, including 'any use', 'high use' and for back and neck pain specifically. RESULTS: High physical activity levels, compared to recommended levels, were associated with a higher risk of 'any' healthcare utilisation for musculoskeletal pain (females: RR 1.14, 99% CI [1.04-1.25]; males: RR 1.20, 99% CI [1.07-1.36]); below recommended physical activity levels were associated with a lower risk (females: RR 0.90, 99% CI [0.85-0.96]; males: RR 0.84, 99% CI [0.76-0.93]). Illicit drug use was associated with a lower risk of healthcare utilisation for neck pain in females (RR 0.77, 99% CI [0.62-0.97]). Four or more adverse lifestyle behaviours, compared to ≤ 1, were associated with a lower risk of high healthcare utilisation for musculoskeletal pain (females: RR 0.66, 99% CI [0.48-0.90]; males: RR 0.68, 99% CI [0.48-0.97]) and a lower risk of healthcare utilisation for neck pain in females (RR 0.63, 99% CI [0.41-0.97]). CONCLUSIONS: Associations between college/university students' lifestyle behaviours and healthcare utilisation for musculoskeletal pain were identified, but with some unexpected patterns. Future research should explore long-term effects of these behaviours on healthcare utilisation for musculoskeletal pain. SIGNIFICANCE: High levels of physical activity among college and university students were associated with a greater risk of seeking healthcare for musculoskeletal pain within the following three years. Illicit drug use was associated with a lower risk of seeking healthcare for neck pain in females. Surprisingly, the presence of many adverse lifestyle behaviours appeared to be associated with a lower risk of healthcare utilisation for musculoskeletal pain, particularly healthcare contacts for neck pain in females and repeated healthcare contacts for musculoskeletal pain in general
Refugees and asylum seekers' experiences of care meetings : A non-systematic literature review
No full textBakgrund I takt med att krig, förtryck och människorättsbrott tvingar allt fler människor på flykt, står flyktingar inför betydande utmaningar vid integrationen i nya samhällen. En särskilt kritisk aspekt är tillgången till hälso- och sjukvård. Trots att rätten till hälso- och sjukvård är erkänd som en grundläggande mänsklig rättighet enligt internationella konventioner, vittnar många flyktingar och asylsökande om svårigheter att få adekvat hjälp. Genom ökad förståelse för dessa erfarenheter kan vårdpersonal bidra till mer jämlika, tillgängliga och kulturellt anpassade vårdmöten som stärker patientens inflytande och rättigheter. Syfte Syftet med denna studie var att belysa flyktingar och asylsökandes upplevelser av vårdmöten. Metod Denna litteraturöversikt genomfördes som en icke-systematisk granskning av tio vetenskapliga originalartiklar. Artiklarna identifierades genom systematiska sökningar i databaserna PubMed och CINAHL, med hjälp av relevanta sökord anpassade till studiens syfte. Urvalet granskades och kvalitetsbedömdes i enlighet med Sophiahemmet Högskolas mall för vetenskaplig klassificering. Det insamlade materialet analyserades och presenterades genom en integrerad dataanalys. Resultat Studiens resultat genererade tre huvudkategorier: kommunikationsbarriärer, kulturell exkludering och strategisk vårdnavigering. Utifrån huvudkategorierna identifierades sex underkategorier: kommunikationshinder och tolkanvändning, patientens röst, förtroende och kulturell förståelse, utmaningen att få bli sedd som en person i sin kontext, diskriminering och normkrock i bemötandet, strategier för att navigera utmaningarna, och tyst anpassning och selektiv närvaro i vården. Slutsats Det krävs en djupare insikt och fortlöpande stödinsatser från hälso- och sjukvårdspersonal för att på ett mer adekvat sätt kunna möta de komplexa behov som flyktingar och asylsökande ofta har. Stöd och information bör individanpassas med hänsyn till språkliga, kulturella och existentiella förutsättningar. Brister i kommunikationen, begränsad tillgång till tolkresurser samt upplevelser av diskriminering riskerar att underminera tilliten till vården. För att möjliggöra en jämlik och personcentrerad vård krävs ett ökat fokus på kulturell lyhördhet, ett relationellt bemötande och en vårdmiljö där patienters inflytande och erkännande utgör grundläggande principer.Background As war, oppression, and human rights violations continue to force people to flee their home countries, refugees and asylum seekers face numerous challenges as they try to settle in new societies. One major challenge is gaining access to health and medical care. Even though access to healthcare is recognized as a basic human right in international agreements, many refugees and asylum seekers report difficulties in receiving adequate care. By listening to their stories and learning from their experiences, healthcare professionals can work toward creating more equitable, accessible, and culturally sensitive care. This, in turn, can help strengthen patients’ rights and ensure that everyone is treated with dignity and respect. Aim The aim of this study was to explore refugees’ and asylum seekers’ experiences of healthcare encounters. Method This literature review was conducted as a non-systematic examination of ten original scientific articles. The articles were identified through systematic searches in the PubMed and CINAHL databases, using selected keywords tailored to the aim of the study. The selection was reviewed and assessed for quality in accordance with Sophia Emmet University’s template for scientific classification. The collected material was analyzed and presented using an integrated data analysis. Results The results of the study identified three main categories: communication barriers, cultural exclusion, and strategic navigation of the healthcare system. Within these categories, six subcategories emerged: communication barriers and interpreter use, patient voice, trust and cultural understanding, the difficulty of being seen as a person within one’s social and cultural context, discrimination and clashes of norms in interactions, strategies for managing these challenges, and silent adaptation and selective participation in healthcare. Conclusions A more profound understanding, coupled with sustained support from healthcare professionals, is crucial to effectively addressing the complex needs frequently encountered by refugees and asylum seekers. Support and information must be individually adapted, taking into account linguistic, cultural, and existential factors. Communication barriers, insufficient access to interpreter services, and experiences of discrimination can significantly erode trust in the healthcare system. Promoting equitable and person-centred care requires heightened attention to cultural responsiveness, relational engagement, and the cultivation of care environments where patient agency and recognition are upheld as core principles
Optimizing physical fitness before colorectal cancer surgery (CANOPTIPHYS) : The effect of preoperative exercise on pre- and postoperative physical fitness in older people - A randomized controlled trial
No full textINTRODUCTION/OBJECTIVE: Surgery-induced losses in physical fitness may have detrimental consequences for patients with low reserve capacity at start. Our objective was to evaluate the effect of preoperative exercise on physical fitness in older patients with low physical fitness scheduled for colorectal cancer surgery. METHODS: In this randomized, controlled trial, patients ≥65 years of age, who were scheduled for colorectal cancer surgery were included if they had a low maximal walking speed. Exercise for 2 to 3 weeks before surgery was home-based, high-intensity, and partly supervised by a primary care physiotherapist. The intervention consisted of inspiratory muscle training, aerobic, and strength exercises. A control group underwent usual preoperative care. Physical fitness was assessed with the 6-min walk test (primary outcome), the 30-s chair stand test and maximal inspiratory pressure which estimates inspiratory muscle strength (secondary outcomes). The effect of preoperative exercise on these outcomes before and after surgery was analyzed with linear mixed-models for the 6-min walk test and maximal inspiratory pressure and with a non-parametric Friedman rank sum test for the 30-s chair stand test. To evaluate adherence, physical activity was measured and compared for both groups. RESULTS: A total of 52 participants were included. Analyses showed a statistically significant effect of preoperative exercise on postoperative inspiratory muscle strength. We did not find an effect of preoperative exercise on 6-min walk test or 30-s chair stand test performance. Regarding preoperative physical activity, the intervention group engaged more in high-intensity physical activity in relation to their total stepping time compared to the control group. CONCLUSIONS: Short-term exercise before colorectal cancer surgery can provide benefits in terms of increased postoperative inspiratory muscle strength in older patients with low physical fitness. While we could not demonstrate an effect of preoperative exercise on any other outcomes, these results should be interpreted with caution due to a small sample size. TRIAL REGISTRATION: Clinicaltrials.gov, identification number: NCT04878185, URL: Study Details | Optimizing Physical Function Before Cancer Surgery in Older People at Risk | ClinicalTrials.gov
Healthcare professionals´ perceptions of sexual health conversations with patients in a palliative stage : A literature review
No full textBakgrund: Palliativ vård fokuserar på att stödja individens värdighet och välbefinnande fram till livets slut, oavsett ålder eller diagnos. Syftet är att lindra lidande och bibehålla livskvalitet. Palliativt skede kan sträcka sig allt emellan flera år till endast några dagar. Sexuell hälsa är en del av den allmänna hälsan och ett livslångt välbefinnande. Sexlusten hos patienten kan minska och påverkas av sjukdom, behandlingar och olika symptom, vilket inte betyder att patienten har slutat ha behov av närhet och ömhet. Patienter uttrycker behov av att vårdpersonal lyfter frågan om sexuell hälsa och vårdpersonalen är medveten om patientens problem. Trots det undviker de flesta att nämna ämnet i samtalet. Genom samtal kan vårdpersonal ge stöd och hjälp till patienten kring frågor gällande sexuell hälsa. Syfte: Syftet med litteraturöversikten var att belysa vårdpersonals uppfattningar om vad som påverkar samtal kring sexuell hälsa med patienter i palliativt skede. Metod: En litteraturöversikt med kvalitativ design och induktiv ansats baserad på resultat från 13 vetenskapliga artiklar. En kvalitativ innehållsanalys enligt Lundman och Hällgren Graneheim (2017). Resultat: Resultatet bygger på fem kategorier och 12 underkategorier. De fem kategorierna är följande: “Normer som påverkade samtalet”, “Förhållanden inom organisationen som påverkade samtalet”, “Betydelsen av kompetens i samtalet”, “Demografiska förhållanden som påverkade samtalet” och “Vårdrelationens betydelse i samtalet”. Slutsats: Det finns flera hinder som försvårar för vårdpersonal att samtala om sexuell hälsa med patienter i palliativt skede. Vårdpersonalen ser en möjlig förändring för vissa hinder medan andra omständigheter är betydligt svårare att påverka. Implementering av personcentrerad vård på arbetsplatser där patienten, med sin livsberättelse, får en självklar plats i teamet kan medföra förändring. Betydelsefullt är fortsatt arbete, med att öka vårdpersonalens medvetenhet om deras ansvar och skyldigheter gentemot patienten i frågan kring sexuell hälsa. Background: Palliative care focuses on supporting the dignity and well-being of the individual until the end of life, regardless of age or diagnosis. The aim is to relieve suffering and maintain quality of life. The palliative stage can last anywhere from several years to just a few days. Sexual health is part of overall health and lifelong well-being. A patient's sexual desire can decrease and be affected by illness, treatments, and various symptoms, which does not mean that the patient has stopped needing closeness and tenderness. Patients express a need for healthcare professionals to raise the issue of sexual health and healthcare professionals are aware of the patient's problems. Despite this, most avoid mentioning the topic in conversation. Through conversations, healthcare professionals can provide support and assistance to the patient regarding issues related to sexual health. Aim: The purpose of the literature review was to shed light on healthcare professionals' perceptions of what influences conversations about sexual health with patients in the palliative stage. Method: A literature review with a qualitative design and inductive approach based on results from 13 scientific articles. A qualitative content analysis according to Lundman and Hällgren Graneheim (2017). Results: The results are based on five categories and 12 subcategories. The five categories are as follows: “Norms that influenced the conversation”, “Conditions within the organization that influenced the conversation”, “The importance of competence in the conversation”, “Demographic conditions that influenced the conversation” and “The importance of the care relationship in the conversation”. Conclusion: There are several barriers that make it difficult for healthcare professionals to discuss sexual health with patients in the palliative stage. Healthcare professionals see a possible change for some barriers, while other circumstances are much more difficult to influence. Implementing person-centered care in workplaces where the patient, with their life story, has an obvious place in the team can bring about change. Continued work to increase healthcare professionals' awareness of their responsibilities and obligations towards patients in matters of sexual health is important.
Association between physical function before radical cystectomy for urinary bladder cancer and recovery after discharge from hospital
No full textObjective This study aimed to evaluate the association between physical function before surgery and recovery measured as physical activity in daily life after discharge from the hospital. Material and methods In total, 105 patients undergoing robot-assisted radical cystectomy were included, based on preoperative and baseline measurements taken before the intervention from a randomised controlled trial. Physical function was assessed the day before surgery using Six-minute Walk test for functional capacity and 30-second chair stand test for lower body strength. Recovery was evaluated during the week after discharge by measuring daily physical activity, including daily steps, brisk walking, sedentary time, and sit-to-stand transitions, using an accelerometer (activPAL3 micro activity monitor). Multiple regression analysis was performed to evaluate the association, adjusting for age, sex, and American Society of Anaesthesiologists score. Results Analysis included 73 participants with valid measurements for both physical function and recovery. A significant positive association was observed between functional capacity and daily steps, with a 100-meter increase in walking distance associated with approximately 600 additional steps per day (95% CI: 0.53-11.29). The association between functional capacity and sit-to-stand transitions approached significance (β = 0.05; 95% CI: -0.001-0.09). No significant associations were observed between physical function and brisk walking or sedentary time, nor between lower body strength and any recovery outcomes. Conclusions Higher functional capacity is associated with higher recovery levels, as measured by physical activity after hospital discharge using activity monitors. The findings indicate that interventions aimed at improving physical function before robot-assisted radical cystectomy may enhance recovery. Keywords: Abdominal surgery, activity monitor, cancer rehabilitation, physiotherapy, recovery