Bakgrund: Hälsa som begrepp kan definieras på olika sätt där det gemensamma är att fler parametrar än endast avsaknad av sjukdom inkluderas. En individs hälsa påverkar den upplevda livskvaliteten och sambandet kallas hälsorelaterad livskvalitet. Covid-19 är en luftvägssjukdom som har förmåga att orsaka allvarlig sjukdom och död. Studier har visat att covid-19 kan leda till sänkt hälsorelaterad livskvalitet även efter tillfrisknande. Syfte: Målet med studien är att beskriva hälsorelaterad livskvalitet efter sjukhuskrävande covid-19 sex månader efter utskrivning och huruvida denna skiljer sig från en normalpopulation samt population med annan lungsjukdom. Metod: Studien inkluderar 38 patienter som vårdats på sjukhus för covid-19. Dessa har svarat på en EQ-5D-5L-enkät vilken mäter hälsorelaterad livskvalitet. Enkätsvaren redovisas med deskriptiv statistik och korrelationsanalyser har genomförts. Svaren på enkäten generar ett index (value set) vilket jämförs mot en normalpopulation och populationer med kroniskt obstruktiv lungsjukdom. Resultat: Studien visar att studiedeltagarna har lägre hälsorelaterad livskvalitet än en normalpopulation. Den faktor som har störst påverkan på utfallet är antalet sjukdomar individerna lever med. Tid på sjukhus och antal dagar i respirator har ingen statistisk signifikant påverkan på deltagarnas hälsorelaterade livskvalitet. Däremot ses en tendens till samband mellan längre vårdtid och lägre hälsorelaterad livskvalitet. Slutsats: Hälsorelaterad livskvalitet hos personer som vårdats på sjukhus för svår covid-19 är lägre än för en normalpopulation upp till sex månader efter utskrivning. Den hälsorelaterade livskvaliteten överensstämmer med en population som lever med kroniskt obstruktiv lungsjukdom. Vidare studier behövs för att studera långtidseffekterna av svår covid-19, särskilt i relation till kroniska sjukdomar.

Background: Open and closed fractures can be associated with posttraumatic or postoperative soft tissue defects caused by initial trauma, operative procedures, or infections. This study evaluated the postoperative outcomes in patients with open or closed lower leg fractures, related soft tissue defects, and subsequent flap coverage. Methods: We performed a retrospective single-center cohort study in a level 1 trauma center. We analyzed the patients treated from January 2012 through December 2017 and recorded demographics, treatment, and outcome data. The outcome data were measured via patient-reported Foot and Ankle Outcomes Scores (FAOS) and EQ-5D-5L scores. Results: We included 22 patients with complicated fractures (11 open and 11 closed) and subsequent soft tissue defects and flap coverages. The mean follow-up time was 41.2 months. Twenty-one patients developed infections, and necrosis at the site of surgery manifested in all closed fractures. Therefore, all patients needed soft tissue reconstructions. Preoperatively, 16 patients underwent arterial examinations via angiography and six underwent ultrasound examinations of the venous system. Ten patients had complications involving the flaps due to ischemia and consequent necrosis. The mean EQ-5D index was 0.62 ± 0.27, and EQ-5D VAS score was 57.7 ± 20.2. The mean FAOS was 60.7 ± 22.2; in particular, quality of life was 32.3 ± 28.8. The rate of returning to work in our patient group was 37.5% after 1 year. Conclusions: Distal tibial fractures often require revisions and soft tissue reconstruction. The evaluated patient population had poor outcomes in terms of function, quality of life, and return to work. Furthermore, patients suffering from flap ischemia have worse outcomes than those without flap ischemia.

Theoretical foundation Arterial disease which gradually leads to narrowing of artery, up to complete vascular closure and to subsequent manifestation of ischaemia is called ischaemic disease of the lower extremities (IDLE). We need to understand ischaemic disease of the lower extremities not only as a disease causing patients a range of difficulties and significantly impacting their life quality, but also as a very important indicator of overall cardiovascular condition of whole organism. Ischaemic disease of the lower extremities becomes more and more accepted as a chronic disease associated with a substantial cardiovascular risk. This disease causes primarily walking limitation by which it impacts daily activities and significantly decrease the life quality. Goal of the thesis: A goal was set for the thesis: Finding out in which areas the ischaemic disease of the lower extremities impacts the life quality. Hypotheses: 6 hypotheses were set for the thesis: H1: Patients with IDLE feel pain H2: Patients with IDLE are limited in moving H3: Patients with IDLE are limited socially H4: Patients with IDLE feel concern for their future H5: Patients with IDLE perceive their life quality as a low one. H6: Patients with IDLE are limited in the area of basic daily activities. Methodology: The research part of the thesis was implemented based on quantitative inquiry within the grant Project No. 120/2012/S ?Reflection of life quality in nursing?. For the empirical part of the thesis the quantitative method was used, the survey was carried out in form of questionnaires, more precisely a standardized questionnaire EQ-5D-5L, selected questions from a questionnaire WHOQOL 100 and specific non-standardized complementary questions for patients with ischaemic disease of the lower extremities. The survey was carried out by addressing practising physicians , doctors from specialized outpatient departments and inpatient wards. Nurses who were, along with the doctors, responsible for explaining the significance of the survey to the patients were an integral part to the data gathering process. The respondents were selected intentionally, the basic factor of selection was presence of the ischaemic disease of the lower extremities. The selection sample was designed using selective quota, the only quota being the age of respondent. Results: All results obtained were statistically processed in the SASD (Statistical Analysis of Social Data) software. The results were divided into three areas. Firstly results describing the structure of selection sample, secondly results depicted graphically and thirdly results processed using a descriptive statistics. The last two areas were then arranged according to the used questionnaire. The results provided us with information regarding patients' perceiving of pain, the difficulties in moving, the social area, the basic daily activities, the concerns for the future and subjective perceiving ot the life quality. Based on the results, the set hypotheses were evaluated as follows: H1: Patients with IDLE feel pain ? confirmed, H2: Patients with IDLE are limited in moving - confirmed, H3: Patients with IDLE are limited socially - confirmed, H4: Patients with IDLE feel concern for their future - confirmed, H5: Patients with IDLE perceive their life quality as a low one ? not confirmed, H6: Patients with IDLE are limited in the area of basic daily activities - confirmed. Conclusion: The thesis provides a comprehensive view on the areas impacting the life quality of patients with ischaemic disease of the lower extremities. In practice the results can facilitate the choice of effective intervention and improve communication with patients, especially due to the gained knowledge. The results will be published in journals and presented at conferences. The results could also be used as a foundation for another survey and as a studying material for students of nursing.