Tyrimo tikslas: įvertinti slaugos poreikį asmenims po klubo sąnario endoprotezavimo operacijos tolimuoju pooperaciniu laikotarpiu. Metodai. Tyrimas kiekybinis, atlikta anoniminė anketinė pacientų ir slaugytojų apklausa. Anketos pacientams dalintos gydymo įstaigoje, o pildomos namuose. Pacientams išdalintos 152 anketos. Bendruomenės slaugytojams anketos dalintos jų darbo vietoje ir pildomos iš karto. Viso slaugytojams išdalintos 220 anketų. Tyrimo duomenų statistinė analizė atlikta naudojant SPSS 17.0 programinį paketą. Rezultatai: Daugiau nei pusė pacientų savo būklę namuose vertina patenkinamai, daugumai (77 proc.) sunku nuvykti pas šeimos gydytoją, 15 proc. naudojosi slaugytojo teikiamomis slaugos paslaugomis namuose, pacientus namuose dažniausiai slaugo šeimos nariai (91proc.). Pacientams mažiausiai pakito fiziologinių poreikių tenkinimas. Pusė tiriamųjų pripažino (51 proc.), kad jautėsi priklausomi nuo kitų. Tyrimo pacientai dažnai norėtų iš slaugytojo bendravimo (26 proc.), pacientų mokymo (26 proc.), injekcijų į raumenis (21 proc.) ar į veną (26 proc.) paslaugų. Slaugytojų nuomone, pacientams vienodai svarbu patenkinti savimonės, vaidmens funkcijos bei abipusės (tarpusavio) priklausomybės poreikius. Tyrimo slaugytojai nurodo, kad jie dažnai įvertina paciento būklę namuose, aptaria slaugos tikslus (54proc.) ir sudaro slaugos planą (53 proc.). Priežastys trukdančios slaugytojui bendradarbiauti su pacientu namuose - per didelis darbo krūvis (83 proc.). Išvados: 1)... [toliau žr. visą tekstą] / The objective of the research: to evaluate the need of a care for the persons after hip replacement surgery in the remote postoperative period. Methods. The study is quantitative; anonymous questionnaire survey of patients and nurses has been conducted. The questionnaires were served to the patients at the medical institutions and they were filled at home. 152 questionnaires were distributed to the patients. The questionnaires were distributed to community nurses at their workplaces and filled immediately. In total 220 questionnaires were distributed to the nurses. The statistical analysis of research data was performed using SPSS 17.0 program package. Results: More than half of the patients evaluate their condition at home as satisfactory, the majority of them (77 percent) find difficulties to get to a family doctor, 15 percent used the home nursing services provided by the nurses, the patients at home are often being nursed by their family members (91 percent). Satisfaction of physiological needs is the least that changed to the patients. Half of the patients (51 percent) admitted they were feeling dependent on others. The patients of the research would often like to communicate with the nurses (26 percent), services of patients training (26 percent), injections to the muscles (21 percent) or vein (26 percent). The nurses believe that for the patients it is equally important to satisfy the needs of self-awareness, role function and reciprocal (mutual) dependence. The nurses... [to full text]

Introdução. Cuidar de uma pessoa com doença crônica pode afetar significativamente o bem-estar de quem cuida, assim como perturbar ou deteriorar sua saúde física e emocional, sua dinâmica familiar e social e seus recursos econômicos. Infelizmente na América Latina, o sistema de saúde não responde às demandas e necessidades dos cuidadores familiares. Dispor de evidências oriundas de pesquisas rigorosamente delineadas e conduzidas com cuidadores com o diagnóstico de Tensão do Papel Cuidador contribui para o desenvolvimento de intervenções para melhorar o bem estar e qualidade de vida dessa população. Objetivos. Desenvolver um programa de intervenção de enfermagem que promova a adaptação dos cuidadores familiares com tensão do papel de cuidador; determinar a efetividade de um programa de intervenção aplicado por telefone para promover a adaptação de cuidadores familiares colombianos e brasileiros com Tensão do Papel de Cuidador. Método. Para o primeiro objetivo proposto foi seguida a proposta do UK Medical Research Council para o desenvolvimento e avaliação de intervenções complexas. O programa de intervenção foi desenvolvido em três passos. No primeiro foi estabelecida a evidência existente sobre intervenções para cuidadores familiares. No segundo passo foi desenvolvida a concepção teórica do cuidador familiar visto como individuo adaptável e do programa de intervenção como estímulo contextual sob a perspectiva do modelo de Adaptação de Roy. No terceiro passo, foi modelada a primeira versão do programa de intervenção e refinada em um estudo piloto. Para atingir o segundo objetivo, foi realizado um ensaio clínico randomizado em que 208 cuidadores familiares (104 colombianos e 104 brasileiros) foram randomizados para cinco sessões de intervenção psicoeducativa aplicadas com uso de telefone (Grupo intervenção) ou o cuidado usual (Grupo controle). Na coleta de dados foram aplicados os instrumentos de caracterização do cuidador, do receptor de cuidados e do cuidado oferecido pelo cuidador, a escala de apoio social (MOS), a Escala de Tensão do Papel de Cuidador, a Escala de Bem-estar do Cuidador Familiar e a escala de avaliação da qualidade de vida WHOQol-Bref. Os participantes foram avaliados na linha de base e na 6ª e 9ª semanas de seguimento. As variáveis de desfecho foram analisadas por equações de estimação generalizada (EEG) considerando interação entre tempo e grupo. Resultados. Os dois grupos estudados apresentaram diminuição estatisticamente significante da tensão do papel ao longo do tempo (Fator tempo, p <0.01). Não houve diferenças significativas nos dois grupos ao nível das variáveis bem estar do cuidador familiar e qualidade de vida. Conclusão. O programa de intervenção aplicado com uso de telefone não foi efetivo para promover a adaptação de cuidadores familiares com tensão do papel de cuidador. Apesar dos achados deste estudo, a teoria da adaptação do cuidador familiar derivada do modelo conceptual proposto por Roy foi consistente para compreender o impacto do cuidado no cuidador familiar, além de proporcionar uma estrutura para testar a efetividade do programa. / Introduction. Caring for a person with chronic disease can significantly affect the well-being of carers, as well as disrupt or deteriorate their physical and emotional health, their family, social dynamics, and their economic resources. In Latin America, the health system does not respond to the demands and needs of familiar caregivers. Having evidence from research rigorously delineated and conducted to inform the care of caregivers with the diagnosis of caregiver role strain will contribute to the development of programs capable of meeting the needs and demands of this population. Objectives. To develop a nursing intervention program that promotes the adaptation of family caregivers with caregiver role strain; to determine the effectiveness of nursing interventions applied by telephone to promote adaptation of Colombian and Brazilian family caregivers with caregiver role strain. Method. For the first objective, the UK Medical Research Council guidelines for the development and evaluation of complex interventions were applied. The intervention program was developed in three main steps. In the first one we identified previously published data regarding interventions for family caregivers; in the second step we developed a theoretical understanding of caregiver seen an adaptive individual, and the intervention program was conceived as a contextual stimulus from the perspective of the Roy Adaptation Model. In the third step, a preliminary intervention program was modeled based on literature findings, and then it was refined in a pilot study. To achieve the second objective, a clinical trial with 208 family caregivers (104 Colombians and 104 Brazilians) randomized to five psychoeducational intervention sessions applied using telephone (intervention group) or usual care (control group) was conducted. During data collection, an instrument for caregiver, care receiver and care characteristics, the Social Support scale (MOS), the Caregiver Role Strain scale, the Caregiver Wellbeing scale, and the The World Health Organization Quality of Life (WHOQOL) scale were applied. The participants were assessed at baseline and at the 6th and 9th week of follow-up. The outcome variables were analyzed by generalized estimating equations (GEE) considering interaction between time and group. Results. The two groups had statistically significant decrease of the caregiver role strain over time (Time factor, p <0.01). There were no significant differences between groups for wellbeing of caregivers, neither for quality of life. Conclusion. The intervention program applied using telephone was not effective to promote adaptation of family caregivers with caregiver role strain. Despite the findings, the theory of adaptation of caregivers derived from the conceptual model proposed by Roy was consistent to understand the impact of care on family caregivers, as well as provided a framework to test the effectiveness of the program.

Bakgrund: Idag drabbas många av cancersjukdom men tack vare tidig upptäckt botas många. Under sjukdomstiden påverkas även patientens maka/make/partner av cancersjukdomen. Anhöriga som stöttar sin partner kan ha en ökad risk att drabbas av egna hälsorelaterade problem.  Syfte: Syftet var att belysa anhörigas upplevelser av att stötta en partner i kurativt skede av cancersjukdom.  Metod: Resultatet består av tolv vetenskapliga artiklar som analyserades och delades in i sju teman. Roys Adaptationsmodell har använts för att diskutera resultatet. Artiklarna samlades in via databaserna CINAHL och PUBMED med urvalet 2007-2017.   Resultat: Resultatet visade på att anhörigas behov blev åsidosatta under partnerns sjukdomstid.  Deras identitet påverkades då de anpassade tillvaron för att kunna fokusera på sin partners vård. Rollfördelningen i parrelationen förändrades och anhöriga fick ta mer ansvar. En för stor börda på de anhöriga kunde ha stor påverkan på deras hälsa men många anhöriga upplevde att de kom sin partner närmare under sjukdomstiden.                    Diskussion: De fyra anpassningslägena i Roys modell påverkar varandra och är svåra att separera. Detta visar på att det är viktigt att ha en helhetssyn på människan. Vi anser att det är viktigt att vården uppmärksammar anhörigas behov och situation och erbjuder stöd för att undvika framtida ohälsa. / Background: A large number of individuals are affected by cancer disease every year, but due to improved treatment and early discovery many are cured. The illness, also affect the patient´s significant other and may increase their risk of own health-related problems. Aim: The aim was to describe significant others´ experiences when supporting a partner in curative phase of cancer disease. Method: The results are based on twelve scientific articles and categorized in seven themes. The Roy Adaptation model was used to discuss the result. Data were collected from the CINAHL and PUBMED databases, including articles from the years 2007-2017. Results: The results show that significant others´ own needs were put aside during their partner´s illness. Their identities were affected as they were adapting their everyday life to be able to support their partner. A partner´s illness also changed the couple’s roles as the couples responsibility changed within the relationship. If the significant other experienced the support as burdensome their health could be negatively affected. Significant others´ experienced their relationship to their partner to improve during the illness. Discussion: The four adaptation modes by Roy are related to each other and are hard to distinguish and the holistic view of each person is important. We conclude that it is important that the health care system also acknowledges the significant other´s needs and situations and thereby provide support needed to elude future health issues.

老人居家照護是近來愈趨重視的議題，過去ㄧ直以來主要著重在老人生理狀態的偵測及相關居家醫療儀器的研究，但除了生理上訊號所顯現的不適之外，尚有其它的問題困擾著老人的生活。對於在老人身上所產生的許多不適，最直接的就是反映在老人的情緒上，若是能針對老人目前所處的環境狀態分析出造成老人情緒狀態轉變的因素，將有助於提升老人的生活品質。本研究所採用的替換調適模式之案例式推理，有別於一般案例式推理的應用，一般案例式推理需要對於應用領域的知識有相當了解才能達到有效地案例調適，因此在發展案例式推理的應用時，需要經過相當長的資訊收集，而替換調適模式運用一些已經存在的案例，從中萃取出案例間的關聯性，並藉由案例的不斷累積來自動化的調適案例庫中的知識，因此將使得推理的結果更符合老人過去的生活習性，因此能針對老人的情緒狀態找出形成的因素，而找出改變情緒的形成因素之後，將有機會的進一步解決老人目前所遭遇的生活難題，最終本研究期望能藉此達成提升老人生活品質的目的。 / e-Care for aging has become an increasingly important research topic in recent years. Most research focus on the detection of Physiological state or the study of the e-Care medical devices. Nevertheless, there are still other problems tormenting an aging’s life besides physiological discomfort detected from physiological signals. For instance, it is often the case that the discomfort comes from the aging's atypical mood status. In other words, causes behind the change of the aging’s mood status would help improve the quality of the aging’s life. Accordingly, this paper presents a substitution-based case adaptation CBR to analyze the causes of effecting the change of the aging’s mood status. Substitution-based case adaptation CBR differs from general CBR in lean adaptation knowledge required. Most existing CBR systems rely on an enormous amount of built-in adaptation knowledge in the form of adaptation rules (that require a deep analysis of the domain). Substitution-based case adaptation can make use of a limited number of cases to extract the relations between the cases and reach automatic adaptation. With the accumulation of cases in the case library, the result of inference fit in line with the habit of the aging’s life would be improved based on this automatic adaptation. The contribution of our method aims at reaching the e-Care goal of improving the aging’s life quality from the mental perspective.

Este trabalho apresenta dois artigos sobre a adaptação psicossocial de mães de crianças com TDAH. O primeiro corresponde a uma revisão de literatura sobre o TDAH, fundamentada no Modelo de Estresse e Adaptação Familiar. Foram identificadas limitações metodológicas (e.g. ausência de grupos controle e exame de co-morbidades). O segundo artigo investigou o estresse parental em mães de crianças com TDAH combinado (n=30), mães de crianças com TDAH e comorbidade com o Transtorno Opositor Desafiador (TOD) (n=30), e de crianças com desenvolvimento típico (n=30). Foram também investigadas possíveis correlações do estresse parental, com as estratégias de coping, apoio social e severidade do TDAH. Dentre outros fatores, os resultados indicaram que as mães das crianças com TDAH combinado e TDAH + TOD apresentaram mais estresse parental do que mães de crianças com desenvolvimento típico e que o apoio social, o coping auto-estima e médico atuaram como moderadores do estresse parental. / This paper present two articles about psychosocial adaptation’s mothers of the children with ADHD. The first is a literature review about ADHD, fundaments of the Stress and Family Adaptation Model. Were identified methodological limitations (e.g. absence of the control groups and examination of the co morbidity). The second article has investigated the parental stress in mothers of children with Attention Deficit / Hyperactivity Disorder (ADHD) (n=30), in mothers of children with co morbidity with the Oppositional Defiant Disorder (ODD) (n=30), and in mothers of children with typical development (n=30). In addition, possible correlations of parental stress with coping strategies, social support and ADHD severity have been investigated. The results indicated if mothers of children with ADHD and ADHD + ODD presented more parental stress than mothers of children with typical development. In addition, the social support, coping self-esteem and coping medical moderated the parental stress effect.

Este trabalho apresenta dois artigos sobre a adaptação psicossocial de mães de crianças com TDAH. O primeiro corresponde a uma revisão de literatura sobre o TDAH, fundamentada no Modelo de Estresse e Adaptação Familiar. Foram identificadas limitações metodológicas (e.g. ausência de grupos controle e exame de co-morbidades). O segundo artigo investigou o estresse parental em mães de crianças com TDAH combinado (n=30), mães de crianças com TDAH e comorbidade com o Transtorno Opositor Desafiador (TOD) (n=30), e de crianças com desenvolvimento típico (n=30). Foram também investigadas possíveis correlações do estresse parental, com as estratégias de coping, apoio social e severidade do TDAH. Dentre outros fatores, os resultados indicaram que as mães das crianças com TDAH combinado e TDAH + TOD apresentaram mais estresse parental do que mães de crianças com desenvolvimento típico e que o apoio social, o coping auto-estima e médico atuaram como moderadores do estresse parental. / This paper present two articles about psychosocial adaptation’s mothers of the children with ADHD. The first is a literature review about ADHD, fundaments of the Stress and Family Adaptation Model. Were identified methodological limitations (e.g. absence of the control groups and examination of the co morbidity). The second article has investigated the parental stress in mothers of children with Attention Deficit / Hyperactivity Disorder (ADHD) (n=30), in mothers of children with co morbidity with the Oppositional Defiant Disorder (ODD) (n=30), and in mothers of children with typical development (n=30). In addition, possible correlations of parental stress with coping strategies, social support and ADHD severity have been investigated. The results indicated if mothers of children with ADHD and ADHD + ODD presented more parental stress than mothers of children with typical development. In addition, the social support, coping self-esteem and coping medical moderated the parental stress effect.

Este trabalho apresenta dois artigos sobre a adaptação psicossocial de mães de crianças com TDAH. O primeiro corresponde a uma revisão de literatura sobre o TDAH, fundamentada no Modelo de Estresse e Adaptação Familiar. Foram identificadas limitações metodológicas (e.g. ausência de grupos controle e exame de co-morbidades). O segundo artigo investigou o estresse parental em mães de crianças com TDAH combinado (n=30), mães de crianças com TDAH e comorbidade com o Transtorno Opositor Desafiador (TOD) (n=30), e de crianças com desenvolvimento típico (n=30). Foram também investigadas possíveis correlações do estresse parental, com as estratégias de coping, apoio social e severidade do TDAH. Dentre outros fatores, os resultados indicaram que as mães das crianças com TDAH combinado e TDAH + TOD apresentaram mais estresse parental do que mães de crianças com desenvolvimento típico e que o apoio social, o coping auto-estima e médico atuaram como moderadores do estresse parental. / This paper present two articles about psychosocial adaptation’s mothers of the children with ADHD. The first is a literature review about ADHD, fundaments of the Stress and Family Adaptation Model. Were identified methodological limitations (e.g. absence of the control groups and examination of the co morbidity). The second article has investigated the parental stress in mothers of children with Attention Deficit / Hyperactivity Disorder (ADHD) (n=30), in mothers of children with co morbidity with the Oppositional Defiant Disorder (ODD) (n=30), and in mothers of children with typical development (n=30). In addition, possible correlations of parental stress with coping strategies, social support and ADHD severity have been investigated. The results indicated if mothers of children with ADHD and ADHD + ODD presented more parental stress than mothers of children with typical development. In addition, the social support, coping self-esteem and coping medical moderated the parental stress effect.

This master thesis deals with employee fluctuation in the selected manufacturing company. In its first part, it explains theoretical concepts associated with employee fluctuation, the ways to measure it, the most common reasons causing employees to leave, and associated costs to the company. The theoretical findings are used in the next part of the thesis to analyse and examine a particular situation in the selected company. The final part contains suggestions for improving identified problems to reduce fluctuation.

PURPOSE: The purpose of this feasibility study was to explore the use of a nurse-centered intervention, the Critical Caring Program, with family members of critically ill adults. The intervention was a series of therapeutic conversations with a family member, beginning in the ICU and following patient discharge from the ICU. FRAMEWORK: The Family Adjustment and Adaptation Response Model (Patterson, 1988) provided the conceptual framework; the intervention was adapted from the Calgary Family Assessment and Intervention Model. DESIGN: A randomized, controlled design with two groups (usual care and intervention) was used to assess the feasibility of the intervention. A convenience sample of 19 adult family members were recruited from an 18-bed ICU from October 2021–January 2022. RESULTS: 151 family members were screened for participation; 40 who were eligible and 19 were enrolled. Overall retention was 58% for the intervention group; 62% for the usual care group. Outcomes revealed no statistically significant differences between groups or changes within groups. The nurses viewed the training and conversations as positive but identified incorporating the visits into routine practice as challenging. CONCLUSION: The Calgary Family Intervention Model is a useful model for addressing families’ need for communication and support. Additional research is needed on incorporating therapeutic conversations into critical care nursing practice.

The purpose of this study was to determine how pain in PLHIV on community home based care programme was managed using the Roy adaptation model (RAM) as the theoretical framework. This study used a descriptive mixed method research design which allowed for the research topic to be investigated and described in terms of both narrative qualitative accounts and descriptive statistics. A sequential exploratory approach was adopted in which qualitative data collection was conducted in the initial phase followed by quantitative data collection. Ten qualitative interviews, guided by the components of the RAM were conducted in the initial phase and a structured interview schedule (questionnaire) partially based on the result of the qualitative phase and (which was also structured in accordance with the RAM) was administered to 120 respondents who met the inclusion criteria of being on CHBC. Convenience sampling was used to select study participants and respondents in both phases of the study. Peripheral neuropathy was the most common pain syndrome experienced by patients. More females suffered numbness/tingling sensation of toes, followed by chest pains than their male counterparts. Pain experienced was moderate to severe which was not treated effectively. The study findings could assist health care providers, policy makers and researchers to invest into improving pain management for PLHIV, strengthen education of patients and their primary caregivers on the causes of pain and modalities to employ for pain relief and implement palliative care guidelines for PLHIV. / Health Studies / D. Litt. et Phil. (Health Studies)