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Aim: This study investigated if a process-oriented training for health professionals will influence women's use and reasons for using a nipple shield, the baby's weight, and the duration of breastfeeding. Materials and Methods: An intervention was performed for health professionals that included a process-oriented training program on breastfeeding support. Primiparas living in either the intervention municipality or in a control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with those for the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, at 3 months, and at 9 months postpartum. Results: The mothers' use of nipple shields related to the finding that if the women had a higher body mass index in the beginning of the pregnancy, the babies had difficulty in grasping over the nipple, and the mothers had pain or wound on the nipple. For the mothers in the IG group, there was no significant difference if they had used nipple shields or not in relation to breastfeeding duration. In contrast, the mothers in the control groups had a significant shorter breastfeeding duration if they had used nipple shields. In the IG, there were no significant difference between the use of nipple shields and the babies' weights at 3 or 9 months. The babies of women in the CGB who used nipple shields had a significantly lower weight at 3 months than the babies of those who did not use nipple shields (p=0.02). Conclusions: A process-oriented training in breastfeeding counseling prolongs the duration of breastfeeding for women with breastfeeding problems, where the problems are remedied by the use of nipple shields.

Vid MS och ALS förekommer depressioner i olika nyanser, vilket är viktigt för sjuksköterskan att fånga upp tidigt och ge den omvårdnad individen behöver samt att minska lidandet. För att detta skall kunna uppnås är det viktigt att den som är sjuk känner trygghet och tillit i sin relation till sjuksköterskan. Syftet med studien var att beskriva människors upplevelser av olika symtom i samband med depression som förekommer vid MS och ALS. För att fånga upp människors upplevelser av symtom i samband med depression användes en kvalitativ metod. Data samlades in genom åtta självbiografier som var skrivna på svenska av både kvinnor och män. En kvalitativ metod enligt Dahlberg användes för att tolka dessa data. Resultatet presenterades i varje sjukdom för sig i kategorier och underkategorier. Kategorier i MS var trötthet, förnekelse, skam, rädsla och tankar på döden. Kategorierna i ALS var, de gråter ut sin sorg, att tära på varandra, att behöva ta emot hjälp och tankar på döden. Resultatet visade skillnad i depressioner mellan dessa två sjukdomar. Vid MS är depressionerna djupare och längre då sjukdomen går i skov, medan det i ALS förändras från att vara djupa depressioner i samband med diagnos, till något positivt då de har kort tid kvar i livet., When having MS and ALS there is also prevalence of depression of varying degree. This is important for the nurse to detect early in order to give the individual the right amount of care, to minimise suffering. In order to achieve this; it is important that the patient feels trust and security in the relation with the nurse. The aim of this study was to describe people's experiences of various symptoms associated with depression in MS and ALS, through the use of autobiographies. A qualitative method was used to gather the individual's experience of depression. Data was collected from eight autobiographies written in Swedish by both women and men. To interpret the data, a qualitative method, according to Dahlberg, was used. The results was separately for the two diseases, and was categorised and sub-categorised. The categories for MS were fatigue, denial, shame, fear and thoughts of death. The categories for ALS was, crying out grief, absume eachothers energy, help dependency and thoughts of death. The results showed differences in the state of depression between the two diseases. For MS, the depression goes deeper and for a longer duration, since the disease progresses in relapse. For ALS, the condition changes from deep depression when diagnosed to somewhat more positive when there are only little time left in life.