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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Resilience and well-being in palliative care staff

Ablett, Janice R. January 2006 (has links)
Although working with cancer patients is considered inherently stressful, palliative care staff experience similar levels of psychological distress and lower levels of burnout than staff working in other specialties. There are few empirical studies in palliative care to explain this. Since working in a stressful job does not inevitably lead to psychological distress, the antecedent factors that promote resilience and maintain a sense of well-being are worthy of study. This thesis reviews two theoretical perspectives from the broader psychological literature, the personality constructs of hardiness and sense of coherence, which may promote resilience. It then outlines a qualitative study that used interpretative phenomenological analysis (IPA) to describe hospice nurses' experiences of work. During the analysis, themes emerged relating to the underlying interpersonal factors that influenced the nurses' decisions to begin and continue working in palliative care, and their attitudes towards life and work. These themes were compared with the theoretical personality constructs of hardiness and sense of coherence, and this comparison highlighted many similarities. The nurses showed high levels of commitment, and imputed a sense of meaning and purpose to their work. An area of divergence was their response to change, and this is discussed in relation to hardiness and sense of coherence. It is suggested that increasing our understanding of resilience in palliative care has implications for individual staff wellbeing, and for staff training and support, which, in turn, may also impact on the quality of patient care provided.
2

Avaliação da qualidade de vida e sobrevida de pacientes com câncer avançado na terapêutica paliativa

Visentin, Angelita January 2016 (has links)
Orientadora: Profª. Drª. Maria de Fátima Mantovani / Coorientadora: Profª. Drª. Luciana Puchalski Kalinke / Tese (doutorado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem. Defesa: Curitiba, 29/11/2016 / Inclui referências : f. 119-136 / Resumo: O objetivo deste estudo foi avaliar a qualidade de vida (QV) e sobrevida de pacientes com câncer avançado na terapêutia paliativa. Pesquisa longitudinal e analítica com 124 pacientes adultos que iniciaram a terapêutica paliativa para o câncer avançado em uma Instituição de Referência no Atendimento Oncológico em Curitiba/Paraná. A coleta de dados ocorreu entre os dias 02 de janeiro de 2015 e 30 de junho de 2016 utilizando quatro instrumentos: caracterização socioeconômica; avaliação de dor por faces; e questionários European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core15 PAL (EORTC QLQ-C15- PAL) e o Functional Assessment of Cancer Therapy Questionnaire Core 14 (FACITPAL- 14) a cada 3 meses até um ano após a inclusão do último paciente. A análise dos dados ocorreu por métodos estatísticos. No perfil socioeconômico e clínico a população feminina foi de 60,5%, 68,5% branca, 48,4% casada, 72,6% de religião católica e com renda entre 1 a 2 salários mínimos. Outrossim, 45,2% não tabagistas, 75% não etilistas e 92% apresenta Performance Status 1 e 2. O diagnóstico do câncer primário prevalente foi o de mama, com tratamento prévio de quimioterapia e radioterapia e os locais de metástase foram pulmão/mediastino/brônquios e linfonodos. Na análise do questionário EORTC QLQ-C15-PAL para todos os pacientes, observa-se que o escore de saúde global foi maior nas avaliações quatro (68,6), cinco (63,9) e seis (61,7). No questionário FACIT-PAL-14, o domínio social e familiar apresentou diferença estatística entre as avaliações para todos os pacientes. Os maiores escores foram apresentados na primeira avaliação para todos os domínios: físico (6,48), social e familiar (2,50), emocional e espiritual (12,15) e paliativo (9,08). O questionário de Dor por Faces apresentou a maior média na terceira avaliação para os dois grupos comparados. No que tange ao comparativo entre óbitos e não-óbitos observa-se significâncias para o questionário EORTC QLQC15- PAL nos domínios saúde global (p=0,032), funcionamento físico (p=0,016), fadiga (p=0,014) e dor (p=0,013) para a primeira avaliação e todos os domínios avaliados na sexta avaliação foram significantes. Para o mesmo comparativo para o questionário FACIT-PAL-14, o domínio físico e o emocional e espiritual apresentaram-se significativos na primeira avaliação sendo p=0,038 e p=0,025 respectivamente. Em relação a sexta avaliação, todos os domínios apresentaram significância estatística. Na avaliação do questionário de Dor por Faces, houve diferença significativa (p=0,004) entre os 37 pacientes que concluíram as seis avaliações. Os dados deste estudo demonstraram que os pacientes que têm melhor percepção de QV, ao iniciar a terapêutica paliativa, tiveram maior sobrevida. Na última avaliação, os escores para saúde global foram de 67,7 para os pacientes vivos e 23,3 para os pacientes que foram a óbito no estudo. A utilização de instrumentos para avaliar a QV de pacientes na terapêutica paliativa permite identificar os domínios afetados e direcionar o processo de enfermagem às necessidades individuais de saúde. Palavras-chave: Neoplasias. Qualidade de vida. Cuidados paliativos. Enfermagem oncológica. Questionários. Sobrevida. / Abstract: The objective this study was evaluate the quality of life and survival of patients with advanced câncer in the palliative therapy. Analytic,longitudinal and quantative research with 124 adult patients that initiated the palliative therapy to an advanced câncer in an Referral Institution on the Oncology Attendance in Curitiba. The data collect happened between January 2nd of 2015 and June 30th of 2016 using four isntruments: Socioeconomic caracterization;pain evaluation by faces;and the questionaries of the European Organization fo Research and Treatment of Cancer Quality -of-life Questionnaire Core 15 PAL (EO RTC QLQ-C15-PAL) and the Functional Assessment of Cancer Therapy Questionnaire Core 14(FACIT-PAL14) every three months for one year after inclusion of the last patient. The data analysis was done by statistical methods. At The clinical and socioeconomic profile were the female population 60,5%, 68,5% White,48,4% married,72,6% Catholic with an income of 1 or 2 minimum wages. Furthermore 45%2 non smoking, 75% nonalcoholic and 92% shows Performance Status 1 and 2. The diagnosis of the prevalent primary cancer was breast with a previous chemotherapy and radiotherapy and the metastasis place were lung/mediastinum/bronchi and lymph nodes.In the analysis of the questionary EORTC QLQ-C15PAL to all the patients it is observed that the global health escore was higher in the evaluations four (68,6%) five (63,9) and six (61,7). In the questionary FACIT-PAL-14,the family and social domain showed statistic difference amongst the evaluation for all the patients.The highest escores were presented in the first evaluation for the physical domain (6,48), social and Family domain (2,50) spiritual and emotional domain (12,15) and palliative domain (9,08). The Questionary of Pain by Faces presented the highest average in the thrid evaluation for the two compared groups. In reference of the comparison between deaths and non deaths it is observed the meaningfulness for the questionary EORTCQLQ-C15-PAL in the global health domain (p=0,032), physical functioning (p=0,016) fatigue (p=0,014) and pain (p=0,013) for the first evaluation and all the evaluated domain in the sixth evaluation were meaningful. For the comparative between deaths and non deaths, for the questionary FACIT-PAL 14 the physical domain and the spiritual and emotional appeared significant in the first evaluation being p=0,038 and p=0,025 respectively. In relation to the sixth evaluation all the domain presented statistical significance. In the evaluation of the Pain by Faces there was a significant difference (P=0,004) amongst the 37 patients that concluded the evaluations. The data in this study showed that patients that have better QV perception, when starting palliative therapy, had a longer survival.In the last evaluation the escores for global health were 67,7 for the alive patients and 23,3 for the patients that died during the study. The use of instruments to evaluate the QoL of patients in palliative therapy allows to identify the affected domains and direct the nursing process to individual health needs.

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