Made available in DSpace on 2014-06-11T19:28:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-07-02Bitstream added on 2014-06-13T18:35:10Z : No. of bitstreams: 1 000739913.pdf: 3500532 bytes, checksum: d1f5204e156e6108ea196d3ebbee589a (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A perda do bulbo ocular compromete não só a estética, mas também a tonicidade muscular da região facial do paciente, uma vez que com a ausência do globo ocular os músculos orbiculares dos olhos podem sofrer atrofia. Desse modo, o objetivo do presente estudo foi verificar a atividade elétrica dos músculos orbiculares, antes e após a instalação de próteses oculares em pacientes que foram submetidos à enucleação unilateral do bulbo ocular. Foram selecionados, por meio de anamnese e exame clínico, 12 pacientes voluntários com indicação de prótese. O sinal eletromiográfico foi realizado com o auxílio do eletromiógrafo, em quatro situações clínicas: Repouso (R), Abertura e Fechamento Normal das Pálpebras (AFN), Abertura e Fechamento Rápido das Pálpebras (AFR) e Apertamento (A). Esses registros foram realizados antes da instalação da prótese ocular, e após 7, 30 e 60 dias da instalação e uso da mesma. Os mesmos ensaios foram realizados no músculo orbicular do olho sadio do paciente, resultados que serviram como controle do estudo. Os dados obtidos foram submetidos à análise estatística pelo programa SPSS (p<0.05) e o t-teste foi utilizado para comparar os músculos superior e inferior por período de tratamento (inicial, 7, 14, 30 e 60 dias), para as quatro condições clínicas. Nas quatro condições clínicas avaliadas foi verificado diferença estatisticamente significativa em relação ao período inicial e após 7 dias da instalação da prótese. O fascículo superior do músculo orbicular do olho apresentou maiores valores de atividade elétrica em relação ao fascículo inferior em todas as situações clínicas avaliadas. Os menores valores de atividade elétrica foram observados durante o período inicial para a condição de repouso (OS 8.418 / OI 5.933) e os maiores após 60 dias na condição... / The eye loss besides affecting patient’s aesthetics, it compromises the muscle tone of the facial region owing to the atrophy of orbicular muscles. Thus, although the use of ocular prosthesis does not return patient’s vision, it fills the anophtalmic cavity restoring the cosmetic and muscle tone. The aim of this present study was to evaluate the electrical activity of orbicular muscles before and after ocular prosthesis insertion of patients who underwent unilateral enucleation of eyeball. The electrical activity of the orbicular muscles was assessed through the Myosystem BR1 electromyograph in four clinical situations: (1) rest, (2) normal opening and closing of the eyelid, (3) fast opening and closing of the eyelids, and (4) clenching. The electrodes were placed in the fascicles of upper (UO) and lower (LO) orbicular muscles. Electromyographic examinations were performed before and after 7, 14, 30 and 60 days of prosthesis insertion. T-test (p<.05) was used to compare the upper and lower orbicular muscles for each period of evaluation in all clinical conditions. A total of 12 patients of both genders were treated and they aged from 42 to 80 years. Several factors were the cause of anophthalmia and the trauma during job accident was the main reason. A statistical significant difference in the electromyographic data was observed for all four clinical conditions when comparing the baseline with the 7-day prosthesis insertion periods. The UO exhibited higher values of electrical activity than LO for all clinical situations. The lowest electrical activity was noted for the baseline period during the rest condition (UO 8.418 /LO 5.933), while the greatest one after 60 days of prosthesis insertion during clenching (UO 131.504 / LO 117.123). After ocular prosthesis insertion, a significant increase in the electrical activity values of the orbicular muscles was observed.

Orientador: Daniela Micheline dos Santos / Co-orientador: Marcelo Coelho Goiato / Banca: Eduardo Piza Pellizzer / Banca: Aldiéris Alves Pesqueira / Resumo: A perda do bulbo ocular compromete não só a estética, mas também a tonicidade muscular da região facial do paciente, uma vez que com a ausência do globo ocular os músculos orbiculares dos olhos podem sofrer atrofia. Desse modo, o objetivo do presente estudo foi verificar a atividade elétrica dos músculos orbiculares, antes e após a instalação de próteses oculares em pacientes que foram submetidos à enucleação unilateral do bulbo ocular. Foram selecionados, por meio de anamnese e exame clínico, 12 pacientes voluntários com indicação de prótese. O sinal eletromiográfico foi realizado com o auxílio do eletromiógrafo, em quatro situações clínicas: Repouso (R), Abertura e Fechamento Normal das Pálpebras (AFN), Abertura e Fechamento Rápido das Pálpebras (AFR) e Apertamento (A). Esses registros foram realizados antes da instalação da prótese ocular, e após 7, 30 e 60 dias da instalação e uso da mesma. Os mesmos ensaios foram realizados no músculo orbicular do olho sadio do paciente, resultados que serviram como controle do estudo. Os dados obtidos foram submetidos à análise estatística pelo programa SPSS (p<0.05) e o t-teste foi utilizado para comparar os músculos superior e inferior por período de tratamento (inicial, 7, 14, 30 e 60 dias), para as quatro condições clínicas. Nas quatro condições clínicas avaliadas foi verificado diferença estatisticamente significativa em relação ao período inicial e após 7 dias da instalação da prótese. O fascículo superior do músculo orbicular do olho apresentou maiores valores de atividade elétrica em relação ao fascículo inferior em todas as situações clínicas avaliadas. Os menores valores de atividade elétrica foram observados durante o período inicial para a condição de repouso (OS 8.418 / OI 5.933) e os maiores após 60 dias na condição... / Abstract: The eye loss besides affecting patient's aesthetics, it compromises the muscle tone of the facial region owing to the atrophy of orbicular muscles. Thus, although the use of ocular prosthesis does not return patient's vision, it fills the anophtalmic cavity restoring the cosmetic and muscle tone. The aim of this present study was to evaluate the electrical activity of orbicular muscles before and after ocular prosthesis insertion of patients who underwent unilateral enucleation of eyeball. The electrical activity of the orbicular muscles was assessed through the Myosystem BR1 electromyograph in four clinical situations: (1) rest, (2) normal opening and closing of the eyelid, (3) fast opening and closing of the eyelids, and (4) clenching. The electrodes were placed in the fascicles of upper (UO) and lower (LO) orbicular muscles. Electromyographic examinations were performed before and after 7, 14, 30 and 60 days of prosthesis insertion. T-test (p<.05) was used to compare the upper and lower orbicular muscles for each period of evaluation in all clinical conditions. A total of 12 patients of both genders were treated and they aged from 42 to 80 years. Several factors were the cause of anophthalmia and the trauma during job accident was the main reason. A statistical significant difference in the electromyographic data was observed for all four clinical conditions when comparing the baseline with the 7-day prosthesis insertion periods. The UO exhibited higher values of electrical activity than LO for all clinical situations. The lowest electrical activity was noted for the baseline period during the rest condition (UO 8.418 /LO 5.933), while the greatest one after 60 days of prosthesis insertion during clenching (UO 131.504 / LO 117.123). After ocular prosthesis insertion, a significant increase in the electrical activity values of the orbicular muscles was observed. / Mestre

There is a growing recognition that removal of an eye may cause a significant impact on a person's body image and her or his role in society; and may evoke a variety of emotional responses. The loss of an eye does not only signal disfigurement, it also means a loss of a body part and a vital sense; that of sight. Without vision, individuals have difficulty communicating. The emotional responses to this loss many a times, go unrecognized as the doctors and nurses who are in close contact with the patient at this time are not necessarily prepared to provide emotional care. This study seeks to address this gap by identifying the emotional impact of loss of an eye and sight on people's lives and the implication it has for health care workers, especially nurses. The eliciting of the different feelings and experiences of these patients can provide information for the formulation and design of protocols for holistic health care management. A non-experimental exploratory and descriptive design was used to conduct In-depth conversational interviews with seven purposively selected participants who had enucleation or evisceration between 2000 and 2005. Information-rich data yielded findings that clearly stressed the need for greater sensitization to the problem. All the participants expressed shock at the final diagnosis of enucleation or evisceration even if this was on their request. Patients wanted to know about the operation and its outcome, the prosthesis, how will it look like and its fit. Findings indicate that answers to these questions were not provided. Patients were not adequately emotionally prepared pre-operatively and were therefore not appropriately cared for post-operatively. Families were not satisfactorily involved and as such were not in a position to provide emotional support that the patients needed The recommendation was that a study to explore the health care team's knowledge in the psychological and emotional management of patients in crisis should be conducted as a benchmark for further training. / Health Studies / M.A. (Health Studies)

There is a growing recognition that removal of an eye may cause a significant impact on a person's body image and her or his role in society; and may evoke a variety of emotional responses. The loss of an eye does not only signal disfigurement, it also means a loss of a body part and a vital sense; that of sight. Without vision, individuals have difficulty communicating. The emotional responses to this loss many a times, go unrecognized as the doctors and nurses who are in close contact with the patient at this time are not necessarily prepared to provide emotional care. This study seeks to address this gap by identifying the emotional impact of loss of an eye and sight on people's lives and the implication it has for health care workers, especially nurses. The eliciting of the different feelings and experiences of these patients can provide information for the formulation and design of protocols for holistic health care management. A non-experimental exploratory and descriptive design was used to conduct In-depth conversational interviews with seven purposively selected participants who had enucleation or evisceration between 2000 and 2005. Information-rich data yielded findings that clearly stressed the need for greater sensitization to the problem. All the participants expressed shock at the final diagnosis of enucleation or evisceration even if this was on their request. Patients wanted to know about the operation and its outcome, the prosthesis, how will it look like and its fit. Findings indicate that answers to these questions were not provided. Patients were not adequately emotionally prepared pre-operatively and were therefore not appropriately cared for post-operatively. Families were not satisfactorily involved and as such were not in a position to provide emotional support that the patients needed The recommendation was that a study to explore the health care team's knowledge in the psychological and emotional management of patients in crisis should be conducted as a benchmark for further training. / Health Studies / M.A. (Health Studies)

En ögonamputation innebär en livslång begränsning av synfunktionen vilket kan förväntas påverka livskvaliteten. Syftet var att identifiera faktorer som påverkade livskvalitet på lång sikt efter en ögonamputation i vuxen ålder samt att beskriva hur livskvaliteten påverkades. Metod: Litteraturstudien följde niostegsmodellen av Polit och Beck (2017). Artiklarnas relevans bedömdes i tre urvalssteg: 1. Huruvida titel/ sammanfattningen matchade syftet. 2. Huruvida artiklarna i sin helhet matchade syftet samt in- och exklusionskriterierna. 3. Kvalitets­bedömning. Databearbetning: Faktorer som påverkade livskvalitet hos ögonamputerade protesbärare sorterades efter likheter och olikheter. Kategorier formulerades och tre karakteristiska teman identifierades bland dessa. Resultatet baserades på sju artiklar. Bland faktorerna som påverkade livskvalitet efter en ögonamputation identifierades tre teman ’Slutgiltig fysisk förändring’, ’Psykiska och känslomässiga påfrestningar’ samt ’Socialt undvikande beteende’. Temat ’Slutgiltig fysisk förändring’ tilldelades kategorierna ’Två blir ett: Enögdheten &amp; monokulärt seende’ och ’Ett camouflerat operationsärr: Ögonhåla &amp; protes’. ’Bearbetning av ögonförlusten’, ’Psykologiska problem’ samt ’Utmattning’ var de tre kategorierna tillhörande temat ’Psykiska och känslomässiga påfrestningar’. Temat ’Socialt undvikande beteende’ tillhörde kategorierna: ’Upplevd begränsad funktionsduglighet’ och ’Osäkerhet i mellanmänskliga relationer’. Slutsatsen: Studien sammanfattar kunskapsläget kring faktorer som påverkar livskvalitet efter en ögonamputation på lång sikt. Kunskap som behövs för att kunna optimera rehabiliteringsprocessen, ge god omvårdnad samt förhindra utanförskap. / Amputation of an eye results in life-long limitations of eye sight function which can be expected to affect quality of life (QoL). The aim of this study was to identify factors having long-term effects on QoL after amputation of an eye in adult patients and to describe in which way QoL was affected. Method: A litterature review following nine steps according to Polit and Beck (2017) was performed. Selection of relevant scientific articles was done in three steps: Evalutating relevance according to 1. title and abstract, 2. Article as a whole concidering aim of the review and criteria for in- and ex-clusion. 3. Study quality. Data analysis: Factors affecting QoL due to eye-amputation and wearing of an artificial eye were sorted according to similarities and differences. That way different categories were formed and among those main themes were identified. The result was based on seven articles. The three main themes that could be identified among factors influencing QoL after amputation of an eye were: ’Definitive physical changes’, ’Mental and emotional strains’ and ’Social avoidance’. Characteristic categories for the theme ’Definitive physical changes’ were ’Two become one: Monocularism &amp; monocular sight’ and ’A camouflaged operation scar: Eye socket &amp; prosthesis’. ’Processing the loss of an eye’, ’Psychological problems’ and ’Fatigue’ were three categories belonging to the theme ’Mental and emotional strains’.  The theme ’Social avoidance’ included categories like ’Experienced limited functioning’ and ’Uncertainty in interpersonal relationsships’. Conclusions: The review tries to sum up available ’recent’ research on factors with long-term effect on QoL after amputation of an eye. Knowledge which is necessary to improve rehabilitation- and caring-interventions as well as to prevent alienation in such patients

Thesis (M.S.)--Uniformed Services University of the Health Sciences, 2005. / Typescript (photocopy).