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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.
11

Proxy Reliability of the 12-Item World Health Organization Disability Assessment Schedule II Among Adult Patients With Mental Disorders

Zhou, Wei, Liu, Qian, Yu, Yu, Xiao, Shuiyuan, Chen, Lizhang, Khoshnood, Kaveh, Zheng, Shimin 01 August 2020 (has links)
Purpose: Despite the wide usage of World Health Organization Disability Assessment Schedule II (WHODAS 2.0) in psychiatry research and clinical practice, there was limited knowledge on its proxy reliability among people with mental disorders. This paper aimed to compare the 12-item WHODAS 2.0 responses of adult patients with mental disorders to their family caregivers. Methods: In this study, 205 pairs of patients with mental disorders and primary family caregivers were consecutively recruited from one inpatient mental health department in a large hospital in China. All participants completed the 12-item version WHODAS 2.0 to assess patients’ functioning in the 30 days prior to the hospitalization. Measurement invariance, including configural, metric and scalar invariance, was tested across patient and proxy groups, using multi-group confirmatory factor analysis. Agreement between patients and proxies was examined by paired Wilcoxon tests and intraclass correlation coefficients (ICC). Subgroup analyses for proxy reliability were conducted within strata of proxy kinship and patient psychiatric diagnosis. Results: The 12-item WHODAS 2.0 achieved configural, metric and partial scalar invariance across patient and proxy groups. Unsatisfactory consistency was found for most items (ICC < 0.75, P < 0.05), especially for items on Cognition, Getting along, Life activities, and Participation in society (ICC < 0.4, P < 0.05). Spouses agreed with patients more often than parents (ICC ≥ 0.4, P < 0.05). The paired Wilcoxon tests found that impairment of patients with psychotic disorders tended to be overestimated by proxies while proxies tended to underestimate impairment of patients with mood disorders. Conclusion: Our study reveals inconsistency between self and proxy reports in the 12-item WHODAS 2.0 among adult patients with mental disorders. When proxy reports is needed, spouses are preferred than parents. We should be aware of proxies’ impairment overestimation among patients with psychotic disorders and underestimation among patients with mood disorders.
12

Upplevelser av omvårdnad vid epilepsi - patientens perspektiv : En allmän litteraturstudie / Experiences of nursing in epilepsy – the patient’s perspective : A general literature study

Flint, Helena, Nilsson, Lina January 2023 (has links)
Bakgrund: Epilepsi är en neurologisk sjukdom som drabbar människor över hela världen. Epilepsi påverkar livets alla aspekter och de begränsningar som sjukdomen medför kan resultera i försämrad livskvalitet. Syfte: Syftet var att belysa vuxna patienters upplevelser av omvårdnad vid epilepsi. Metod: En allmän litteraturstudie genomfördes och tolv vetenskapliga artiklar inkluderades. Resultat: Patienter med epilepsi upplevde omvårdnaden bristfällig gällande information och bemötande. Otydlig och otillräcklig information från vårdpersonal medförde svårigheter att hantera sin sjukdom. Patienter upplevde ett förminskande av känslor samt att vårdpersonal visade brist på empati och respekt vid bemötandet. Bemötandet från sjukvårdspersonal beskrevs som väsentligt då det lägger en grund för upplevelsen av omvårdnaden. Personcentrerade omvårdnadsåtgärder samt ett professionellt bemötande upplevdes öka hanterbarheten, stärka självbestämmandet och genererade i ökad livskvalitet. Konklusion: Det förelåg brister i omvårdnaden vid epilepsi och det framkom ett behov av ökad kunskap gällande personcentrerad vård. Genom att patienters upplevelser belystes ökade medvetenheten kring behov och resurser, vilket genererade i en förbättrad personcentrerad omvårdnad och förbättrad livskvalitet. / Background: Epilepsy is a neurological disease that affects people all over the world. Epilepsy affects all aspects of life and the limitation that the disease entails can result in an impaired quality of life. Purpose: The purpose was to elucidate adult patients experience of nursing care in epilepsy. Method: A general literature study was conducted and twelve scientific articles were included. Results: Patients with epilepsy perceive the nursing care as insufficient when it comes to information and treatment. Unclear and insufficient information from healthcare professionals means that patients with epilepsy experienced difficulties in managing their illness. Patients with epilepsy experience a diminution of emotions as well as an empathetic and disrespectful treatment. The treatment from healthcare professionals is described as essential as it laid a foundation for the experience of nursing. Person-centered care measures and professional treatment are perceived to increase manageability, strengthened self-determination and results in increased quality of life. Conclusions: There are shortcomings in nursing care in epilepsy and a need for improvement is identified regarding person-centered care. By highlighting patients’ experiences, awareness of needs and resources increases, which can generate improved person-centered care and improved quality of life for patients with epilepsy.
13

Human Rhinoviruses in Adult Patients in a Tertiary Care Hospital in Germany: Molecular Epidemiology and Clinical Significance

Golke, Philipp, Hönemann, Mario, Bergs, Sandra, Liebert, Uwe Gerd 09 May 2023 (has links)
Rhinoviruses (RVs) constitute a substantial public health burden. To evaluate their abundance and genetic diversity in adult patients, RV RNA in respiratory samples was assessed using real-time RT-PCR and the partial nucleic acid sequencing of viral genomes. Additionally, clinical data were retrieved from patient charts to determine the clinical significance of adult RV infections. In total, the respiratory specimens of 284 adult patients (18–90 years), collected from 2013 to 2017, were analyzed. Infections occurred throughout the entire year, with peaks occurring in fall and winter, and showed a remarkably high intra- and interseasonal diversity of RV genotypes. RV species were detected in the following ratios: 60.9% RV-A 173, 12.7% RV-B, and 26.4% RV-C. No correlations between RV species and underlying comorbidities such as asthma (p = 0.167), COPD (p = 0.312) or immunosuppression (p = 0.824) were found. However, 21.1% of the patients had co-infections with other pathogens, which were associated with a longer hospital stay (p = 0.024), LRTI (p < 0.001), and pneumonia (p = 0.01). Taken together, this study shows a pronounced genetic diversity of RV in adults and underlines the important role of co-infections. No correlation of specific RV species with a particular clinical presentation could be deduced.
14

Sjuksköterskors erfarenheter av att vårda vuxna patienter med maligna blodsjukdomar : En litteraturöversikt / Nurses’ experiences of caring for adult patients with malignant blood diseases : A literature Review

Österberg, Linn, Jansson, Elin January 2023 (has links)
Bakgrund Sjuksköterskans roll i vårdandet av patienter med maligna blodsjukdomar är utmanande då sjuksköterskan ska stötta patienten genom både diagnos och behandling. Personcentrerad omvårdnad gör att patienten lär sig om sjukdomen och blir delaktig i behandlingen. Syfte Syftet är att beskriva sjuksköterskors erfarenheter av att vårda vuxna patienter med maligna blodsjukdomar. Metod Arbetet utformades som en strukturerad litteraturöversikt med inslag av metodologi som används vid systematiska litteraturstudier, med fokus på sjuksköterskors erfarenheter. Databaserna CINAHL och PubMed användes och sju artiklar publicerade 2013–2023 sammanställdes. Resultat Sjuksköterskornas erfarenheter av att vårda patienter med maligna blodsjukdomar belystes via kategorierna Kommunikation och Utmaningar för sjuksköterskor samt underkategorierna Kommunikation mellan sjuksköterskor och patienter, Kommunikationinom vårdteamet, Emotionell påverkan, Överlevnadsvård och Palliativ vård vid maligna blodsjukdomar. Slutsats Sjuksköterskorna upplevde kommunikation som viktig del i vårdandet av patienter med maligna blodsjukdomar i relation mellan sjuksköterskor-patienter samt sjuksköterskor vårdteamet. Sjuksköterskorna upplevde även att det var lätt att bli emotionellt påverkad i arbetet. Hantering och utförande av överlevande- och palliativ vård var en utmaning för sjuksköterskorna som arbetade med patienter som har diagnostiserats med maligna blodsjukdomar. / Background Nurse's role in caring for patients with malignant blood disorders is challenging. Nurses must support the patient through a diagnosis and the course of treatment. Person-centred care means that the patient learns about the disease and becomes involved in thetreatment. Aim The aim is to describe nurses` experiences of caring for adult patients with malignant blood diseases. Method This review was made with a methodology similar to ones used in systematic reviews with a focus on nurses` experience. The databases CINAHL and PubMed were used. Seven articles were found. The included articles in the results were published between 2013–2023. Results Nurses' experiences of caring for patients with malignant blood diseases were highlighted by the categories Communication and Challenges for nurses and the subcategories Communication between nurses and patients, Communication within the care team, Emotional impact, Survival care and Palliative care for malignant blood diseases. Conclusions Nurses experienced communication as an important part in the care of patients with malignant blood diseases in the relationship between nurses-patients and the nurses-care team. Nurses also felt that it was easy to be emotionally affected at work. Management and delivery of survivorship and palliative care was a challenge for nurses working with patients diagnosed with blood malignancies.
15

Biomarkery časného poškození ledvin / Biomarkers of early renal injury

Fořtová, Magdaléna January 2018 (has links)
Aims: The thesis deals with the biomarkers of early renal injury, namely albuminuria and neutrophil gelatinase-associated lipocalin (NGAL). The aims in the case of albuminuria were the implementation of HPLC method, comparing HPLC with immunoturbidimetric (IT) method and monitoring the relationship to the diagnosis of diabetes mellitus. The aim of urinary NGAL (and eventually other markers) examination was to verify its reliability in the prediction of acute kidney injury (AKI). Methods: We investigated albuminuria in fresh urine samples in the groups of 636 diabetics and 456 nondiabetics using the HPLC method (Agilent 1200, Agilent Technologies, USA) and immunoturbidimetrically (Cobas Integra 400, Roche Diagnostics); we studied the correlations and relationships between albuminuria and glycated hemoglobin HbA1c. We investigated urinary NGAL by chemiluminescent microparticle immunoassay (Architect i4000, Abbott) in children's groups: 1) after renal transplantation (N = 15), 2) with acute or chronic kidney disease (N = 28); and in adult patient's groups: 1) after cardiac surgery (N = 10) and 2) post angiography (N = 41). Results: Albuminuria determined by HPLC was statistically significantly higher than albuminuria determined by IT. We excluded nonspecificity of the HPLC method. Results indicate...

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