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Bakgrund. Barns smärta kan orsaka oro och ångest, vilket även kan öka föräldrars stressnivå och förtroende för hälso- och sjukvård. Inom slutenvård visar forskning att mindre än en tredjedel barn fått adekvat smärtlindring. Smärtlindring inom barnhälsovård är värdefull kunskap, med tanke på det stora antal barn som vaccineras via Sveriges vaccinationsprogram. Syftet med litteraturstudien var att beskriva effekter av bröstmjölk och glukoslösning som smärtlindringsmetoder vid procedurrelaterad smärta hos barn 1–24 månader, enligt den vetenskapliga litteraturen. Metod. Designen var deskriptiv med kvantitativ ansats och gjordes i form av en litteraturstudie. Studiens resultat grundades på 18 kvantitativa artiklar från databaserna PubMed och Cinahl. Huvudresultat. I de 18 studier som ingick i resultatet undersökte sex effekt av bröstmjölk, vilka alla hade signifikant effekt mot procedurrelaterad smärta. Detta oberoende av administrering. Av de tio artiklar som undersökt effekten av glukoslösning visade tre studier signifikant effekt mot procedurrelaterad smärta. I de två studier som studerat glukoslösning och bröstmjölk, visade en att bröstmjölk hade signifikant bättre smärtstillande effekt än glukoslösning. I den andra studien jämfördes inte interventionsgrupperna, utan huruvida effekten var jämlik, vilket den visade sig vara. Slutsats. Resultatet visar att bröstmjölk som smärtlindringsmetod för barn 1–24 månader inför smärtsamma procedurer, var effektiv och enkel och kan motverka vårdlidande. Glukoslösning visade varierande effekt som smärtlindringsmetod. I studien som jämfört de två, var bröstmjölk mer effektiv. Vidare forskning, med fler studier kan bättre säkerställa vad som är mest optimalt Background. Children's pain, in connection with care procedures, is contrary to several legal regulations and guidelines for the professional practice of district nurses. Children's pain can cause worry and anxiety and can also increase parents' stress level and trust in health care. Inpatient care-research shows that less than a third of children receive adequate pain relief. Pain relief in child health care is valuable knowledge, given the large number of children who are vaccinated via Sweden's vaccination program. The purpose of the literature study was to describe the effects of breast milk and glucose solution as pain relief methods for procedure-related pain in children 1–24 months, according to the scientific literature. Method. The design was descriptive with a quantitative approach and was done in the form of a literature study. The study's results were based on 18 quantitative articles from the databases PubMed and Cinahl. Main results. In the 18 studies included in the results, six investigated the effect of breast milk, which all had a significant effect on procedure-related pain, independent of administration. Of the ten articles investigating glucose solution, three showed a significant effect against procedure-related pain. In the two studies that studied glucose solution and breast milk, one showed that breast milk had a significantly better pain-relieving effect than glucose solution. Conclusion. The results show that, as a pain relief method for children 1–24 months before painful procedures, breast milk was effective, simple and can counteract care suffering. Glucose solution showed variable efficacy as a pain relief method. In the study comparing the two, breast milk was more effective. Further research, with more studies can better ensure what’s most optimal.

Aim: The overall aim of the thesis is to examine how young adults experiences life living with existential concerns and how well-being is enabled when living with existential concerns. Approach and method: A reflective lifeworld research (RLR) approach guided this dissertation’s methodological approach. Lifeworld interviews were performed in all four studies and analyses were conducted according to RLR principles: bridled attitude, openness, and compliance to the studies’ different phenomena. Study I describes healthcare professionals’ experiences of conversations with young adults experiencing existential concerns. Eleven lifeworld interviews (seven individual-, two pair- and two group interviews) were conducted with seventeen healthcare professionals from various fields. Data was analysed via phenomenological-based thematic meaning analysis. Studies II and III describes young adults’ experiences of existential concerns from the perspective of young women and young men; nine women (study II) and eight men (study III) participated. All interviews were individual lifeworld interviews. Study IV describes young adults’ experiences of enabling wellbeing in a life with existential concerns. Seventeen adults (same participants as study II and III) participated and all interviews were individual lifeworld interviews. Studies II, III, and IV were analysed by phenomenological analysis. Main results: The results show that the lives of young adults with existential concerns are significantly affected by these concerns. Existential concerns awaken vulnerability, characterized by feeling lost in life and living near a bottomless darkness in which life may seem unbearable. In such a vulnerable existence, there is a desire to find a place to rest, thereby enabling wellbeing. For young adults, vulnerability means having the courage to expose their life situation and innermost thoughts. In encounters with others, there is a risk of being condemned, neglected, identified as weak, or rejected. In a caring relationship between young adults and healthcare professionals, both young adults and healthcare professionals’ vulnerability to life’s fragility evokes. Courage means daring to expose one’s vulnerability and sharing one’s life story. Courage also means that healthcare professionals dare to remain in the caring relationship and listen to the young adult’s life story, no matter how dire or dark it seems. In order for the life story to stand out, a mutual invitation between young adults and healthcare professionals is required. The results show that the prerequisites for a caring relationship involve mutual vulnerability, courage, and invitation to reflect on life’s challenges. In a genuinely caring relationship, through existential confirmation, entails finding a place to rest that enables wellbeing when experiencing existential concerns as a young adult. Conclusion: The thesis contributes knowledge relating to how young adults experience life with existential concerns and, in turn, how wellbeing is enabled through the experiences of young adults and healthcare professionals. Existential concern is a complex phenomenon, involving vulnerability, courage, and the invitation to enable wellbeing. From a lifeworld theoretical perspective, we see an openness to existential dimensions in young adults’ life stories, providing guidance to caregivers in enabling young adults to find a place where they can be vulnerable and have an opportunity to recover. Disputationen sänds via videolänk, förinformation se kalendariet på hb.se/forskning.

Introduction Young men may struggle in life with challenges of various concerns about their identity and who they want to be in life. Many health issues arise from social norms and wider societal determinations and for today’s young men, following such norms poses a risk of losing oneself. An essential part of health are connected to the existential dimensions in life and concerns who you are, and how well you know and understand yourself. However; little is known about what it means for young men to live a life with existential concerns. Purpose and method The purpose of this phenomenological study, based on reflective lifeworld research (RLR), is to describe young men’s experiences of living with existential concerns for which they have sought support. Eight lifeworld interviews were conducted. Results The results essentially show that young men living with existential concerns describe their situations as living close to a bottomless darkness. This is further described according to four constituents: enduring everyday life, striving for a solution, hearing an inner self-critical voice, and wearing a hard shell. Conclusion We conclude that strengthening young men’s health processes requires healthcare professionals to create an atmosphere where young men feel safe talking about existential concerns without feeling exposed and vulnerable.

Purpose: The aim of this study is to describe young women’s (16–25 years old) experiences of living with existential concerns for which they have sought support from healthcare professionals, teachers, family, or friends, among others. Methods: This phenomenological study is based on a reflective lifeworld research (RLR) approach. Nine young women were interviewed about their experience of living with existential concerns. Results: The results show the essential meaning of the phenomenon of “existential concerns” that can be described as living a life that is marked in a profound way by a feeling of being lost in an unknown terrain. To further understand the essential meaning, four constituents are described: the unpredictable body, longing for comprehension, playing a game, and longing to share one’s vulnerability. Conclusions: Young women with existential concerns are vulnerable, as they are profoundly influenced by these concerns. They have to navigate through daily life while trying to fit in and to make their situation comprehensible. These young women have a longing to share their existential concerns with a trustworthy person, while at the same time they fear revealing their existential concerns and risking being rejected by others. A lifeworld-led, caring science approach, intertwined with the results of the present study, has the potential to direct caring practice.

Background: Previous studies have shown that pressure ulcers are common in hospitalized patients. These wounds give rise to suffering and lower quality of life in the affected patients. Objective: To identify the shortcomings in documentation and risk assessment. Method: The study was descriptive-explorative. A journal review was made on records documented during October, November and December 2017. Data was collected in an excel document and was described descriptively. Results: Of the 50 journals that were included, three (6%) pressure ulcers were on entry. Less than half of the records (46%) had notes that actions planned against pressure ulcers were begun or implemented. None of the 42 journals with measures documented had evaluation of set goals and actions. 37 (74%) had a risk assessment made with Norton. 42 records (84%) had preventions and eight (16%) had none at all. 32 (64%) had both preventions and a full Norton assessment. Three records (6%) lacked both preventions and Norton assessment. In four (6%) of the records, pressure ulcers encountered during the care period. One of these records had a Norton assessment. All of these had preventions planned. Conclusion: There is a lack of whether or not actions taken at risk of pressure ulcers are implemented. It is unclear whether or not initiated measures have been initiated. Most often, a complete risk assessment is also lacking as a basis for being able to insert relevant measures and see the importance of their implementation. There is an increased need of education regarding documentation of pressure ulcer. Keywords: pressure ulcer, risk, prevention & control, nursing records, documentation

Bakgrund I Sverige ökar invandringen för varje år. Det medför en ökning av antalet individer med ursprung från andra länder och kulturer än Sverige. Denna ökade mångfald ställer nya krav på hälso- och sjukvården. Sverige har lagstiftat alla människors rätt till likvärdig vård. I mötet mellan patient och personal är kommunikationen viktig, och förekomsten av språkbarriärer kan leda till svårigheter att bedöma hälsotillstånd och utforma adekvat vård. Syfte Syftet med studien var att beskriva patienters upplevelse av mötet med personal inom svensk hälso- och sjukvård när ett gemensamt språk saknas. Metod Utifrån en kvalitativ forskningsmetod intervjuades nio personer med icke-svenskt ursprung som varit i kontakt med svensk hälso- och sjukvård där det i mötet med hälso- och sjukvårdspersonalen saknats ett gemensamt språk. Åtta intervjuer inkluderades i resultatet. En semistrukturerad intervjuguide användes och materialet analyserades med hjälp av kvalitativ innehållsanalys. Resultat I resultatet formulerades tre kategorier som svarade på syftet. Kategorierna var ”Förstå och göra sig förstådd”, “Tillämpa strategier för kommunikationen” och “Personalens attityd och förhållningssätt”. Förståelse för systemet och kunskap om hur man söker kontakt med vården hade betydelse för hur mötet upplevdes. Personalens vilja att förstå och deras positiva attityd hade stor inverkan på hur patienten upplevde mötet Slutsats Förmågan att kommunicera har stor betydelse för upplevelsen av mötet och påverkas av språkförståelse, kulturell medvetenhet, förståelse för sjukvårdssystemet, tillgång till tolk samt personalens attityd. Då språkbarriärer kan resultera i att patienten inte känner sig delaktig är det viktigt att personalen besitter kunskap och strategier för att kunna arbeta personcentrerat.