The dynamic action of footbridge users in different forms of activity (especially during walking andrunning) may cause an excessive vibration of the footbridge deck and may disturb the comfort of use of the structure. Thedynamic susceptibility of the footbridges varies depending on the construction material used to build the footbridge andthe typical construction solutions (construction details) resulting from the construction material used. The paper presentsthe basic dynamic characteristics of timber footbridges of various structural solutions, collected during dynamic field testsof these structures. The obtained results indicate relatively high dynamic resistance of timber footbridges to the dynamicloads generated by users under normal conditions of use. In addition, the results show that in the case of timberfootbridges, it is possible to consider changing the requirements of international standards defining the range of naturalfrequencies sensitive to the dynamic impact of users. In the case of timber footbridges, characterized by a relatively highself-weight (compared to steel footbridges), high stiffness and high damping, it is possible to consider changing therequirements for performing forced vibration analyses only for structures with fundamental vertical vibration frequency f_v <= 3.0 Hz instead of the currently defined f_v <= 5.0 Hz.

Background: More seriously ill people are cared for in their own home, which puts higher demands on the staff working in home healthcare. Patients have good experience of home health care because they have the opportunity to receive the care they need at home when they can ́t get to a care unit. In home healthcare, several professionals work in teams with a person-centred approach. The team includes district nurse/registered nurse, occupational therapist, physiotherapist, nursing assistant, coordinator, head of unit for home care and case worker. 

Aim: The purpose of the study is to describe district nurses experiences of teamwork in home health care.Method: The method used was a qualitative interviewstudy with an inductive approach. Eight semi-structured interviews of district nurses were carried out individually and then analyzed with a qualitative content analysis according to Graneheim & Lundman (2004). 

Results: The results show that there are several different types of meetings between the team members. Communication is important for teamwork. There is a lack of consensus in the team where the team members have distance between each other. Working together by each other's side in the team promotes good team collaboration. 

Conclusion: When the team works together towards common goals, home health care works at its very best. The team needs to have a person-centred approach and make the patient more involved in the team. The team members need to develop good relationships and create an understanding of each other in order to increase the quality of care. 

I såväl läroplan som kunskapskriterier i gymnasieskolan ställs krav på att muntlig förmåga ska utvecklas och bedömas. Samtidigt finns en stor grupp elever med svårigheter att uppfylla just dessa krav. Detta kan av olika anledningar anses problematiskt, inte minst utifrån ett demokratiskt perspektiv och att det därför finns ett behov av att lyfta fram och hantera just fenomenet talängslan. En integrerad förståelse av specialpedagogik, inkludering och talängslan kan betraktas som grundläggande för att främja en demokratisk skolmiljö där varje elev ges möjlighet att utveckla sina kommunikativa förmågor och delta i samhällsdebatten. Syftet med denna studie är därför att genom ökad förståelse för elevers självupplevda talängslan bidra med kunskap om hur ett specialpedagogiskt arbete skulle kunna utformas för att möta och hjälpa dessa elever. Studien är kvalitativ och narrativa semistrukturerade intervjuer har använts. Tio elever på en gymnasieskola i södra Sverige har intervjuats. Utifrån en innehållsanalys har teman tillhörande studiens frågeställningar identifierats. Dessa teman är: Föreställningar, Skottglugg och Reaktioner, Förändring, Undvikande, Trygghetsskapande samt Förståelse. Narrativ teori samt symbolisk interaktionism har använts för att förstå resultat och analys. Resultatet av studien visar att upplevelsen av talängslan styrs av olika föreställningar kring talsituationen som i sin tur leder till reaktioner. Eleverna agerar antingen genom att på olika sätt undvika situationen eller genom försök att göra den tryggare. Betydelsen av omgivningens förståelse lyfts också som centralt för det pedagogiska bemötandet. Resultat och analys mot bakgrund av teorier och tidigare forskning har utgjort grunden för att en modell vid namn Trygg Talare utarbetats. Syftet med modellen är att lyfta fram olika aspekter av hur arbetet med talängslan utifrån ett specialpedagogiskt synsätt skulle kunna hanteras i en skolkontext. Detta med förhoppningen att stötta och vägleda skolor i arbetet med dessa elever. Modellen omfattar stegen identifiering, kartläggning, ledning och stimulans och extra anpassningar samt utvärdering. Det sistnämnda steget har illustrativt hamnat utanför modellen då fokus utifrån ett relationellt perspektiv bör ligga på de andra stegen. 

Bakgrund: Palliativ vård är en helhetsvård som ges till patienter vid livets slutskede med syftet att ge bästa möjliga vård och lindra lidande. I takt med att den åldrande befolkningen ökar så ökar även den palliativa vården som ges i hemmet. Tidigare forskning visar att distriktssköterskor som vårdar äldre patienter med palliativa behov i hemmet upplever vårdandet som krävande och komplex. 

Syftet: Syftet med studien var att beskriva distriktssköterskors upplevelser av att vårda äldre patienter med palliativa behov i hemmet. 

Metod: En kvalitativ intervjustudie med induktiv ansats användes i studien. Semistrukturerade intervjuer genomfördes med åtta distriktssköterskor i en kommun i södra Sverige. Insamlade data analyserades med en kvalitativ innehållsanalys av Graneheim och Lundman (2004). 

Resultat: Analysen resulterade i fyra kategorier; en meningsfull och viktig roll, utmaningar och möjligheter med palliativ vård i hemmet, upplevelsen av teamsamverkan inom palliativ vård och betydelsen av egen kompetens och erfarenhet. 

Slutsats: Distriktssköterskor upplever att arbetet med palliativ vård är givande och meningsfullt både på ett personligt och professionellt plan. Trots detta är arbetet med palliativ vård i hemmet utmanande och krävande på grund av olika utmaningar såsom tidsbrist. Distriktssköterskor bär ett stort ansvar för genomförandet av en god palliativ vård och även ett ansvar att utbilda vårdpersonal. Viktiga faktorer för en god palliativa vård är teamsamverkan, betydelsen av egen erfarenhet och kunskap inom ämnet. 

Curling härstammar från Skottland och spåras tillbaka till 1500-talet. Curlingen kom till Sverige i mitten av 1800-talet och Svenska Curlingförbundet bildades i början av 1900-talet. Curlingsporten , som traditionellt förknippas med äldre vuxna, ölmagar, cigarettrökning och sällskaplighet, har gått in i en tid där dominerande diskurser främjar en strikt diet, lite alkohol, ingen rökning och konstant fysisk aktivitet som ett sätt att "åldras väl " inom sporten. Marknadsföring inom curling har blivit ett stort problem idag. Det här är en sport som ofta är okänd för allmänheten, men det finns många som älskar att spela det. Vidare kan man även se att bristen på information som ges till intresserade curlingfans är ett problem. 

Syftet med studien är att undersöka hur curlingen ser ut i dagsläget. Mer specifikt hur marknadsföringen ser ut, men även vilka konsumentgrupper som i dagsläget förknippas med eller utövar sporten. 

Resultatet i studien visar att det finns utvecklingsmöjligheter när det kommer till marknadsföring och konsumentgrupper inom curling. Dels arbete med sociala medier och vad som ska visas på dessa men även hur man ska locka fler ungdomar till sporten då den domineras av äldre individer. 

Denna studie utgår från förskolan vilken saknar tradition när det gäller att ha tillgång till specialpedagog. Frånvaron av professionen i såväl skollag som läroplan får konsekvensen att det blir den omgivande kontexten som påverkar konstruktionen av den specialpedagogiska yrkesrollen i förskolan. Syftet med studien är att bidra till en ökad kunskap om gestaltningar av specialpedagogens roll i förskoleutvecklande systematiskt kvalitetsarbete. Studien bygger på sex stycken kvalitativa intervjuer med rektorer. Forskning som framställs i studien belyser den specialpedagogiska rollen ur såväl utifrån- som inifrånperspektiv samt det systematiska kvalitetsarbetet i förskolan. Det dramaturgiska perspektivet användes för att analysera de olika roller, fasader och scener som konstrueras om det systematiska kvalitetsarbetet och specialpedagogen i rektorernas beskrivningar. Gestaltningen som konstrueras i resultatet belyser betydelsen av rektorns insikt och förståelse för specialpedagogens förmågor. I analysen blir det tydligt att både det systematiska kvalitetsarbetet och specialpedagogens roll blir olika beroende på betraktarens utgångspunkt. Frånvaron av en rollbeskrivning gör professionen mottagligare för omgivningens tolkningar såväl inom som utanför den egna organisationen eller om den ska finnas i förskolan och i så fall på vilken nivå. Om tillgång till specialpedagog saknas skulle det kunna få till följd att utbildningen inte blir likvärdig och tillgänglig för alla barn, att verksamheten går miste om en viktig samtalspart för rektorer, pedagoger och vårdnadshavare samt att utvecklingen av utbildningen kan utebli.

Under 1900-talets andra hälft genomfördes två genomgripande reformer inom skolområdet, re-formen om grundskola respektive reformen om en decentralisering av skolans styrning. Dessa båda reformer utgör samtidigt varandras motsatser vad gäller reformernas respektive innehåll och argumentation. Även reformprocesserna skiljer sig åt, vilket illustrerar hur utredningsväsendet och statens beslutsprocesser förändrades från slutet av 1950-talet till slutet av 1980-talet. Jag kommer att i denna inledning ägna visst utrymme åt dessa båda reformer, eftersom Maktutred-ningen från 1990, som står i fokus för föreliggande studie, blev en viktig vattendelare för två helt olika sätt se på styrningen av svensk skola, liksom på innebörden av begreppet ”en likvärdig skola”. I grunden handlar brottet, som det kom till uttryck i Maktutredningen (SOU 1990:44), om två olika sätt att förstå begreppet demokrati.

Background: The professional role of the district nurse has a long history, and the competence description is extensive and sets great demands, at the same time it includes much of what is in the competence description for nurses. How the tasks are separated between the roles can be difficult to define and varies depending on the workplace. Studying and becoming a specialist nurse and changing titles can be a multifaceted adjustment for many nurses.

Aim: The study examined the district nurse´s experience of her new professional role when returning to the same workplace after completing district nursing training. 

Method: The study was conducted using a qualitative method with an inductive approach. Semi-structured interviews were conducted with eleven district nurses who were employed at health centers in south-eastern Sweden. The material was analyzed using a qualitative content analysis. 

Results: The analysis resulted in three categories with seven subcategories. The categories were: A new title, where the new title entailed conflicting feelings and the experience of how the district nurses were valued. Professional development, a clear sense of independence, and a new approach towards patients emerged. A contradictory specialist competence, there were conflicting descriptions of how the district nurses had the same tasks as the nurses but still had specific areas of responsibility. 

Conclusion: Returning to the same workplace after completing district nurse training can be experienced in many ways. How the workplace is structured, and the distribution of tasks affects how much change the district nurse experiences when she returns. Colleagues´ reactions and expectations of the new title make them both proud and troubled. Having the education paid for makes the experience more positive and contributes to feeling valued. 

In this thesis, we tackle a significant optimization challenge within Vehicular Ad Hoc Networks (VANETs) by employing a simulated annealing approach. We focus on developing an efficient Vehicle Routing Problem (VRP) algorithm to sift through numerous potential solutions and identify the best one.

Our VANET scenario revolves around four distinct vehicles traversing four unique routes. The primary objective is to minimize the total distance covered by these vehicles while ensuring that they visit all designated waypoints. We implement this problem using MATLAB to establish initial routes for each simulation uniquely.

Simulated annealing proves to be a valuable tool in optimizing VANETs. The gradual cooling process reduces the likelihood of accepting suboptimal solutions over time, allowing the algorithm to escape local optima and converge towards nearly optimal solutions.

Regarding routing protocol parameter configuration, simulated annealing is the technique of choice for identifying the most influential parameters. It evaluates the cost and creates new routes based on neighboring nodes, calculating the cost function for these new routes. Starting from an initial configuration, the algorithm iteratively refines it by introducing random changes, retaining only those that enhance the objective function. Our objective function defines the Quality of Service (QoS) and communication efficiency of the routing protocol. The gradual reduction in the acceptance of less favorable configurations over time is called the annealing schedule, enabling the algorithm to escape local optima and approach nearly optimal designs.

Visual Learning Analytics (VLA) tools (such as dashboards) serve as a centralized hub for monitoring and analyzing educational data. Dashboards can assist teachers in data-informed pedagogical decision-making and/or students in following their own learning progress. However, the design of VLA tools should include features of trust in order to make analytics overt among its users. In this study, we propose a framework for the development of VLA tools from beginning to end that describes how we intend to develop the digital and technical infrastructure in our project for teachers. With that aim, we offer one scenario describing how data is managed, transferred, analyzed, and visualized by teachers. The suggested framework intends to make it easier for developers to understand the various steps involved in co-designing and developing a reliable VLA tool and to comprehend the importance of the teacher’s participation in design. VLA tools developed based on the proposed framework have the potential to assist teachers in understanding and analyzing educational data, monitoring students’ learning paths based on their learning outcomes and activities, simplifying regular tasks, and giving teachers more time to support teaching/learning and growth.

PurposeIt is important to understand why some workers prolong their working life even though they are entitled to statutory pension benefits. This paper aims to investigate whether senior workers are motivated by external factors such as pay and social expectations (extrinsic motivation) or are primarily motivated by internal factors such as job satisfaction (intrinsic motivation). This is a central question for policymakers and social partners when it comes to the design of public pension systems and work organisation.

Design/methodology/approachThis study uses a combined longitudinal administrative data and an own-designed postal survey to ask individuals aged 65–76 years to describe their work motivation. Based on the answers, this study constructs an index of autonomous motivation (AM) where a value of zero implies only extrinsic motivation and a value of one implies only intrinsic motivation. The values between zero and one thus imply various grades of AM, where higher values signal motivation that is more autonomous and hence a higher degree of intrinsic work motivation.

FindingsThe results of the statistical analysis show that the extent of intrinsic motivation is higher among senior workers who retired aged 65 years or older compared to those who retired at 65 years or younger. In addition, this study found that the degree of intrinsic work motivation among senior workers decreases when they face economic and financial constraints. It also found that intrinsic motivation is more prevalent among high-skilled workers.

Research limitations/implicationsThis study shows that individuals who continue to work after 65 are mostly motivated by the satisfaction they derive from their job. Job satisfaction is strongly related to skill level, job quality, job content and job autonomy. Results indicate that job quality and commitment to work are essential elements for motivating seniors to postpone retirement.

Originality/valueThis study contributes to this literature by applying a multidisciplinary approach from organisational psychology and labour economics that considers the potential importance of intrinsic motivation to work after standard retirement age. The authors think that this approach enhances the understanding of the mechanisms behind the lengthening of working life. Finally, this study suggests a simple, but efficient way of empirically measuring the extent of intrinsic motivation among workers.

The climate impact from the construction and property sector has in recent years been adriving cause of emissions of greenhouse gases, which is a challenge for society. InSweden, the climate impact caused by the construction and real estate sector in 2020 hasbeen estimated at approximately 9.8 million tonnes of carbon dioxide equivalents, whichcorresponds to 21% of Sweden's climate impact. Sweden is a country that constantlyworks to reduce the climate impact from new buildings and as a result the governmenthas introduced requirements for climate declarations for newly constructed buildings.Climate declarations must cover a building's product stage (module A1 – A3), transport(A4), construction waste and energy consumption on the construction site (A5).

The thesis has been carried out with the help of the 3D modeling program Revit,Boverket's climate database and SundaHus's database. Revit was used to calculatematerial quantities to be included in the climate declaration. Boverket's and SundaHus'sdatabase was used to collect the material's climate data.

In the climate declaration, the total climate impact is reported, which corresponds to 545𝑘𝑔𝐶𝑂2𝑒/𝑚2𝐵𝑇𝐴. The result of the climate impact covers the modules concerning theconstruction phase, i.e. A1 – A5 where product stage A1 – A3 has amounted to 492,transport 28, construction waste 15 and energy 10 in 𝑘𝑔𝐶𝑂2𝑒/𝑚2𝐵𝑇𝐴.

The climate declaration act contributes to increased competence and understanding withinthe construction and property sector for how different materials affect the climate.Currently, there are no limit values to refer to when calculating the climate impact andtherefore it is difficult to assess the result. The calculations made reflect the estimatedvalue of hospitals supported by the standard values, which are estimated values regardingdiesel and heating oil at the construction site.

In Sweden, the growing influence of the radical right have turned cultural

institutions into political symbols in an emerging ‘culture war’ (Harding,

2021). Carlsson, Hanell & Hansson (2022) show how digital forums and social

media play a significant part in orchestrating the ideologically laden conflicts

and confrontations that public libraries are currently facing. This prompts an

investigation of the digital environments where supporters of radical right-wing

ideas interact, share thoughts, construct collective identities, and coordinate

actions towards libraries. In this explorative pilot study, we use selected

methods on a small dataset to test viable methods and approaches.

In the aftermath of natural disasters, providing temporary housing to displaced people is essential to alleviate human suffering. However, in some cases, the chosen post-disaster temporary housing strategy may not be suitable for the local conditions, which can worsen the negative impacts, particularly when decision-makers need to change their original plan due to the uncertainty of post-disaster conditions. As most temporary housing design strategies have their weaknesses, the best approach is the one that matches the specific circumstances of each scenario. This thesis proposes design strategies, including prefabricated and modular units, foldable units, upgradable units, grid and linear expansion, and passive energy units, to determine the most appropriate policy to minimize conflicts between local requirements and temporary housing characteristics while maximizing the comfort and sustainability of temporary housing design. The strategies were analyzed based on their strength and weaknesses by following the previous research, and their implementation possibilities on recently occurred natural disasters, e.g., Turkey's earthquake in 2023, were also evaluated. It was found that all strategies except for grid and linear expansion might be suitable for the studied natural disaster.

Studying the consequences of variation in individual life-histories is vital for our understanding of the evolution of animal societies. In this thesis, I study the ecology and consequences of group living on growth, survival, reproduction, and the gut microbiome of the Damaraland mole-rat (Fukomys damarensis), a subterranean cooperatively breeding mammal. For this, I used data and faecal samples collected from a long-term study population in the Kalahari Desert, South Africa.

I explored the effects of group size and group composition on individuals’ growth and survival. While large group size had no clear advantages for either growth or survival, individuals within groups biased to their own sex grew more slowly. The number of recruits increased modestly with group size, but experimentally created pairs showed the same reproductive success as established groups. Further, single individuals exhibited high survival rates and good body condition. Combined, these results suggest that mole-rats delay dispersal to maximise their own fitness, and that group living has costs and benefits for all group members.

I also investigated the effects of individual life-histories and group affiliation on the gut microbiome. This work shows that individuals bring the gut microbiome from their birth group when they disperse, and that group members have more similar gut microbiomes. When dispersed individuals start to reproduce in their new groups, they subsequently transfer this microbiome to their offspring, resulting in higher similarity between offspring with common descent of breeders. This pattern could arise from shared early life environment of breeders or through genetic relatedness of breeders. To separate the effects of these factors, I used a cross-foster experiment of captive animals, which showed that group members have more similar gut microbiomes, regardless of host relatedness.

My thesis gives deepened insights into the ecology of the Damaraland mole-rat. It shows how variation in the social environment of group living species affects their life-histories, their fitness, and beyond that extended phenotypic traits such as the gut microbiome composition.

Acute myeloid leukemia (AML) is a hematopoietic malignancy with poor survivalrate and limited therapeutic options. Targeted treatment of other types ofcancer, for instance chronic myeloid leukemia (CML) and breast cancer, has seensignificant progress. However, when it comes to AML, the outcome is poor witha five-year relative survival of only 20 - 30%. Over the last four years, the FDA hasapproved nine new drugs for AML patients in the United States. Unfortunately,the median overall survival of AML patients is still fairly low. For patients aged 70 years and older, the median overall survival is only about 10 months. Even forchildren with AML, the overall 5-year survival rate is 65 - 70%. A major cause oftreatment failure is the development of treatment-induced drug resistance. Thedevelopment of somatic mutations is one of the most common mechanisms ofdrug resistance.

In AML, mutations in the FMS-like tyrosine kinase 3 (FLT3) gene are oftenpresent, with an incidence rate of ∼30% of cases. Most of these mutations areinternal tandem duplications (ITD), present in approximately 25% of the patients.Patients with a high FLT3-ITD burden often relapse after chemotherapy. Inpatients with FLT3-ITD mutations, FLT3 has become a promising drug target fortherapy. In the past few years, FLT3 inhibitors have led to clinical progress, butthere are still some significant problems with their usage. Among these, drugresistance is urgent to overcome.

This thesis mainly focuses on exploring different treatment regimens to over-come drug resistance in human FLT3+ AML cells as a model for the disease.Initially, a drug rotation protocol between two inhibitors which have differentresistance profiles was tested. However, the results were not satisfying. Combi-nation therapy between a FLT3 inhibitor and another inhibitor was adopted. Thisstrategy exhibited significant synergy and, more importantly, could postponethe emergence of drug resistance. In further experiments, we examined somenewly-developed small molecular compounds, and it turned out some of themhad excellent inhibitory activity against established drug-resistant AML cell lines.In parallel, we have also studied the cause of resistance in these cells and haveidentified resistance mutations that have not been described before. Finally, westudied whether FLT3 inhibitors were likely to be synergistic with azacitidine, ahypomethylating agent approved for AML treatment. Such combinations did notdisplay a clear synergistic effect on AML cells, though one combination may bepromising. Overall, our studies provided a better understanding of the resistancemechanisms by which FLT3-ITD cells overcome therapy and valuable informationabout the efficacy of novel inhibitors that are not currently in clinical use, and oncombination therapies. To this end, the results will enable to further facilitatethe rational development of new strategies to overcome drug resistance in FLT3+AML.

Background:  Health care is in constant development. Reorganization leads to more responsibility for primary health care. Nurses are expected to work based on evidence, stay up-to-date and have competence to be able to perform their work. Nurses competency has a greater impact on patient safety then the issue of staffing.

Aim: The aim is to chart nurses competency development in primary health care; value of, impact on patient safety and time. 

Method: A non-experimental, cross-sectional study with a web survey. The results were presented with descriptive statistics in text, tables and figures.  Data were analyzed in the statistical program IBM SPSS statistics version 29. The analysis methods Spearman bivariate correlation and Mann-Whitney U-test was used and presented with descriptive statistics in text, tables and figures. The significance level was p <0.05. Nurses who worked at a regional primary health care center in southern Sweden were included in the study.

Results: The nurses generally had no time for competence development and were generally not satisfied. They considered that it was reasonable to have more time for competence development that the existing time. Many respondents read or studied in their spare time and some due to non-existent time at work. Nurses value their own competence and that of their nursing colleagues. All nurses considered that the nurse's competence affects patient safety.

Conclusion: Scheduled time for competence development for nurses should be prioritized in primary health care. It requires competent nurses to provide good and safe care. Nurses need competence development to increase job satisfaction and for sustainable development in health care.

Background: In Sweden one of three suffer from cancer only two of three survive. More women than men suffer from cancer because of genetic and unhealthy determinations. Worry, fear and anxiety are common reactions notified of a cancer diagnosis and during the treatment of cancer. It can affect the persons suffering from the disease and their life. Primary care has a coordinating role and will have more responsibility in the future reagarding cancer care. Due to this, that the district nurse must have increased knowledge about patients with cancer in terms of worry, fear and anxiety. 

Aim: The aim was to illuminate women's experiences under treatment of cancer.

Method: The study has a qualitative design and the data collection was based on eight autobiographical written by women. The study has been analyzed using a narrative thematic analysis. The analysis was performed on a manifest and a latent level.

Results: The eight women's experiences of worry, fear and anxiety under treatment of cancer was described in three themes and nine categories. The themes that emerged were: The constant oscillation between safety and rough distress, The importance of making the most of the time and The changes on personal levels. It appears that the feelings oscillated between loneliness under the treatment of cancer and safeness from loved ones. The women found strategies to handle the side effects under the treatment of cancer that affected their personal levels. The women could find vitality despite suffering from the disease and suffering from life. 

Conclusion: Women who were under treatment of cancer experienced anxiety over the treatment's long term effects and the risk of relapses. Loneliness, worrying, anxiety and identity crises were common in the result. District nurses, therefore, need to be conscious about the patients' experiences when interacting and treating cancer patients. Through an ethical approach, equal care can be applied and strengthen the dignity for women suffering from cancer.  

Bakgrund: En amputation är ett livsförändrande ingrepp som orsakar ett stort lidande och påverkar individens livsvärld och levda kropp. Amputationer av nedre extremiteter till följd av vaskulära komplikationer förväntas öka internationellt. Därmed behövs mer forskning för att skapa en bredare förståelse om ingreppets påverkan samt vilka behov dessa individer har avseende psykiska, fysiska samt sociala aspekter. Med en ökad förståelse och kunskap om vilka utmaningar som möter dessa patienter kan sjuksköterskan på ett personcentrerat sätt bemöta och vägleda till en bättre livskvalitet och hälsa.

Syfte: Att beskriva patienters upplevelser i samband med amputation av nedre extremiteter till följd av vaskulära komplikationer.

Metod: Totalt 10 artiklar med kvalitativ design kvalitetsgranskades och analyserades enligt Fribergs modell i fem steg.

Resultat: Förlusten av en extremitet observerades vara ett multidimensionellt fenomen som innefattade påverkan på individen både fysiskt och emotionellt, men även socialt och ekonomiskt. Fem övergripande teman framkom: Att möta vården, Att vara i behov av stöd, Att bära på inre konflikter, Att övervinna hinder samt Att återta makten över sitt liv. Resultatet belyser denna patientkategoris upplevelser av en förändrad identitet, en förändrad kropp samt hur detta påverkar deras behov av autonomi och självbestämmande.

Slutsats: Patientens upplevelse av mötet med vården kan förbättras via stöttning, samtal, information samt uppmuntran för att uppnå en mer skräddarsydd personcentrerad vård, med stort fokus på delaktighet och att detta sker på patientens egna premisser.