Bakgrund: Globalt drabbas 30 miljoner människor varje år av sepsis varav ca 5 miljoner människor dör. Forskning har fokuserat på överlevnad och den kunskapen har gjort att fler överlever. En tredjedel av de personer som överlevt sepsis drabbas av restsymtom och en sjättedel får kvarstående men för livet. Livskvalitet är en subjektiv upplevelse av välbefinnande och är beroende av flera faktorer. Hälso- och sjukvården ska bedriva personcentrerad omvårdnad och se patienten i sin helhet. Syfte: Syftet var att beskriva livskvalitet hos patienter som överlevt sepsis. Metod: Studien har genomförts som en litteraturöversikt och rymmer 18 artiklar. Datainsamling har skett i databaserna Cinahl Complete, PubMed samt PsycINFO. Resultat: Totalt 17 kvantitativa artiklar och en kvalitativ artikel inkluderades i litteraturöversikten. Resultatet visar att personer som överlevt sepsis blir påverkade inom fyra domäner; fysisk-, kognitiv-, psykisk- och social livskvalitet. Diskussion: Personer som överlever sepsis har ökad risk för fysisk, kognitiv, psykisk och social påverkan på livskvaliteten och söker i stor utsträckning vård. Det är viktigt att sjuksköterskan har kunskap kring de restsymtom som personerna kan drabbas av, en förståelse för det den gått igenom och en uppfattning om hur detta kan påverka deras livskvalitet.

OBJECTIVE: Implementation of patient-reported outcome measures for patients with palliative care needs is characterized by both enablers and barriers. The ways in which healthcare professionals experience the use of assessment tools is important. Our aims were to explore factors contributing to or hindering patients with palliative care needs in assessing their symptoms with the Integrated Palliative Care Outcome Scale (IPOS) and to explore healthcare professionals' experiences of the use of IPOS in acute care settings.

METHOD: Data were collected as a part of the evaluation of the feasibility of an implementation strategy for introducing IPOS. Data from three participating acute care units were included. We used descriptive and analytical statistics; a qualitative content analysis was also performed.ResultA total of 309 patients were eligible to be offered assessment of symptoms with IPOS. Of these 69 (22%) had completed IPOS. A significant positive association was found between healthcare professionals' participation in training sessions and completed IPOS. The experiences of IPOS were split into two categories: "IPOS acting as a facilitator" and "barriers to the use of IPOS." The use of IPOS was described as contributing to person-centered care of patients with palliative care needs and inspiration to improved routines. Healthcare professionals' feelings of uncertainty about how to approach severely ill patients and their family members appear to have hindered their use of IPOS.Significance of resultsWe found an association between healthcare professionals' participation in training sessions and patients who completed IPOS, indicating the need for a high degree of attendance at the training to achieve successful implementation. The healthcare professionals expressed feelings of insecurity concerning the use of IPOS indicating a need for further education and clinical support in its use of IPOS. Nevertheless, use of IPOS was considered to contribute to improved care of patients with palliative care needs.

Background: Limited data are available on body composition (BC) and physical function in healthy adults >80 y, potentially hampering development of reference values. We aimed to study 1) BC and physical function and 2) changes in hand-grip strength over a 4-year period in a community dwelling elderly Swedish population.

Methods: Apparently healthy, community-dwelling men (n=51) and women (n=51) aged >83y were measured by Sit to Stand-test, hand grip strength, body height, body weight and BC using a Bioimpedance Spectroscopy (Impedimed). The study was approved by the Regional Ethical Review Board in Gothenburg as an addition to Elderly Persons in the Risk Zone (T176-12).

Results: Mean age 86.5 y, no age difference between sexes. Men and women performed equally well at the Sit to Stand-test. Men were significantly stronger with a mean HGS of 34.1 kg compared to women of 19.5 kg. 15 % had a BMI below 22 kg/m2. According to skeletal muscle index (SMI) 64 % were assessed as having severe sarcopenia (Cruz-Jentoft et al 2010).

Conclusion: In this healthy elderly population BC and physical function was well preserved compared to previous studies, although many were classified as sarcopenic according to current cut-offs. Results from this study can be used as reference values for healthy community-dwelling elderly in high age.

The link between sleep and Body Mass Index (BMI) is poorly understood and existing literature on the topic is contradictory. Aim: To investigate the association between Body Mass Index [BMI] and sleep habits in adolescents in Sweden. Methods: This cross-sectional study uses data obtained from the self-reported questionnaires of 1518 (50.7% female) 13- to 15 year-olds in southern Sweden. Questions were on sleep and lifestyle habits and general demographics including height and weight. Multiple logistic regression analysis was used to analyze sleep duration, bedtime and rising time, controlling for covariates. Results: The only sleep related variable associated with overweight/obesity was sleep duration on weekends, where longer sleep duration decreased the likelihood of being overweight or obese. Conclusion: This study found that longer sleep duration during weekends was associated with not being overweight. Modifying sleep habits in adolescents is a potential target for obesity intervention and this information is particularly well-suited for school nurses to disseminate to students and their parents.

Stroke is a life changing event for both stroke survivor and the family caregiver. After the acute care at the hospital, the stroke survivors are discharged with many disabilities and the family members are supposed to take care of them at home and continue treatment and rehabilitation. The new role of ‘informal caregiver’ give rise many problems and difficulties for them and in order to identify those, exploring their experience on providing informal care was needed. An explorative descriptive study with qualitative approach was conducted with the participation of 10 family caregivers who were providing informal care to their stroke survivors treated at the stroke unit of the National hospital Sri Lanka. Data were collected through in-depth interviews. Qualitative analysis of data, resulted in an overriding theme; ‘Caring with love, against all odds’ along with four main categories ‘Life alterations’, ‘Lack of resources’, ‘Compassionate care’ and ‘Coping strategies’. Increased workload, physical problems and restricted social life were highlighted within the life alterations and knowledge and financial deficits were the resources family caregivers mainly lacked. Findings of the study emphasized the importance of further assessments and strategies to address burning issues of stroke family caregivers in order to promote the health and well-being of both stroke survivors and their families.

RATIONALE: Anorexia or lack of appetite is common in chronic obstructive pulmonary disease (COPD) and may be caused or augmented by several symptoms affecting appetite and eating. We aimed to investigate and quantify the extent of nutrition impact symptoms (NIS) in patients with COPD and to explore relationships between NIS and fat free mass depletion.

METHODS: The results in this cross-sectional study are based on 169 COPD patients (62 % females). Body composition was assessed using bioelectrical impedance spectroscopy and the patients reported NIS by two newly developed questionnaires; Eating Symptoms Questionnaire (ESQ) and Disease Related Appetite Questionnaire (DRAQ).

RESULTS: Symptoms with the highest prevalence were dry mouth (71%), stomach ache (39%), pain or aches affecting appetite (36%) and constipation (35%). Problems with diarrhoea and feeling affected by smells were more severe among women compared to men (p<0.05). Thirty-six percent of the patients were depleted (FFMI < 15 kg/m² for women and FFMI < 16 kg/m² for men). Depleted patients had more NIS (p<0.05), and also rated appetite and taste of food as worse compared to non-depleted (p < 0.05).

CONCLUSION: Nutrition impact symptoms are common in patients with COPD and depleted patients have more severe symptoms. To investigate how these symptoms are best prevented and/or managed and if NIS prevention/treatment can affect development of malnutrition in patients with COPD is a challenge for the future.

Inledning: Flertal barn spenderar mycket tid på förskolan i Sverige, vilket innebär att de äter flera mål mat där om dagen. Barnen har rätt till att uttrycka sina åsikter och de vuxna ska ta det i beaktande. Maten och måltiderna är en central del av deras tillvaro på förskolan och därför viktiga att få påverka och ha inflytande över. Syfte: Hur kan barn göras delaktiga i att utveckla och förbättra mellanmålsalternativen på förskolan? Material och metod: En kvalitativ studie med 5-6 åriga barn har gjorts, där barnen har ritat och diskuterat sitt favoritmellanmål i fokusgrupper. Sedan har ett sensoriskt gillandetest gjorts på nyutvecklade mellanmål där recepten grundar sig på barnens favoritmellanmål. Resultat: När barnen uttrycker vad ett gott mellanmål är så är det främst smaken de utgår ifrån och till viss del utseendet. Favoritmellanmålet är pannkakor och de mest omtyckta smakerna är jordgubbe, vanilj och banan. Det sensoriska gillandetestet visade att barnen kunde bedöma mellanmålen med hjälp av smileys. Slutsats: Ett gott mellanmål för barnen smakar bra och ser tilltalande ut. Barn kan göras delaktiga genom att på olika sätt uttrycka sig via olika visuella metoder och tycka till om mellanmålen genom att använda smileys. Dock kan det finnas utmaningar och svårigheter med att göra barnen delaktiga då det kan vara svårt att tolka och få fram deras idéer och synpunkter samt att barnens önskningar inte alltid överensstämmer med hur näringsinnehållet bör vara, men genom att använda flera visuella metoder kan de uttrycka sina åsikter och göras delaktiga.

Background: Limited data are available on body composition (BC) and physical function in healthy adults >80 y, potentially hampering development of reference values. We aimed to study 1) BC and physical function and 2) changes in hand-grip strength over a 4-year period in a community dwelling elderly Swedish population.

Methods: Apparently healthy, community-dwelling men (n=51) and women (n=51) aged >83y were measured by Sit to Stand-test, hand grip strength, body height, body weight and BC using a Bioimpedance Spectroscopy (Impedimed). The study was approved by the Regional Ethical Review Board in Gothenburg as an addition to Elderly Persons in the Risk Zone (T176-12).

Results: Mean age 86.5 y, no age difference between sexes. Men and women performed equally well at the Sit to Stand-test. Men were significantly stronger with a mean HGS of 34.1 kg compared to women of 19.5 kg. 15 % had a BMI below 22 kg/m2. According to skeletal muscle index (SMI) 64 % were assessed as having severe sarcopenia (Cruz-Jentoft et al 2010).

Conclusion: In this healthy elderly population BC and physical function was well preserved compared to previous studies, although many were classified as sarcopenic according to current cut-offs. Results from this study can be used as reference values for healthy community-dwelling elderly in high age.

Background: Longevity increases worldwide but there are few studies on body composition and hand grip strength inpopulations over 80 years. Given high prevalence of chronic disease and functional disability in octogenarians, it may be difficult todistinguish effects of ageing from those imposed by disease. The European Consensus definition of sarcopenia recommends usingboth low muscle mass and function for diagnosis.

Objectives: Examine body composition and hand grip strength in a selected groupof community-dwelling older adults with high level of functional independence. In addition, longitudinal changes in handgripstrength were examined using previously collected data.

Design: Cross-sectional body composition and hand grip strength witha four year retrospective analysis on previously assessed hand grip strength.

Setting: Measurements were conducted by homevisits.

Participants: 102 community-dwelling 83-96 year-olds, 50 % women.

Measurements: Hand grip strength was registered bya dynamometer and body composition analysis using bioimpedance spectroscopy.

Results: According to European Consensusdefinition, only 6/102 had normal muscle mass - no men, although 78 % of men and 40 % of women had normal muscle strength.Since previously collected data four years earlier, men had lost strength (p<0.001), while women had not (p=0.202).

Conclusions: Subject characteristics and health status support well-preserved body energy, protein stores and muscle strength. Low musclemass was much more prevalent than low muscle strength. Results may give an indication of what constitutes a healthy bodycomposition in oldest old and could serve as a starting point for reference values on healthy body composition in octogenarians.