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Epidemiological studies of Oral Health, development and influencing factors in the county of Dalarna, Sweden 1983–2013Edman, Kristina January 2016 (has links)
The aim of this thesis is to describe the development of oral health and possible associations with socioeconomic and socio-behavioural factors, in an adult population over a period of 30 years. A further aim is to describe attitudes to, and demands of dental care, and the impact of oral conditions on quality of life. The study sample consisted of 787-1158 individuals, aged between 35-85 years, randomly selected from Dalarna’s population register in 1982, 2002, 2007 and 2012. The studies were carried out in 1983, 2003, 2008 and 2013, and the participants responded to a questionnaire and a clinical examination of oral status. There has been a substantial improvement in oral status in regard to the mean number of teeth, intact teeth, and less removable dentures over this period of 30 years. The proportion of individuals with alveolar bone loss decreased significantly between 1983 and 2008, but increased significantly between 2008 and 2013. Smoking was the overall strongest factor associated with alveolar bone loss, after adjustment for socioeconomic and socio-behaviour factors, age and number of teeth. Calculus, visible on radiographs, increased significantly between 2003 and 2013. The proportion of individuals with manifest caries declined significantly between 1983 and 2008, but seems to level out between 2008 and 2013. Socioeconomic and socio-behaviour factors were significantly associated with manifest caries. Preventive treatment, meeting the same caregiver as on previous visits, and information about treatment cost was reported to a significantly lower degree as important in 2013, compared with 2003 and 2008, and booking time for treatment was reported as more difficult in 2013, compared with earlier years. Regular recalls was reported as less important in 2013, compared with 2008. A third of the respondents reported oral impact on daily performance and irregular dental visits, limited economy for dental care, less than 20 remaining teeth, manifest caries and temporomandibular disorder were significantly associated with oral impact on daily performance.
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Hälsorelaterad livskvalitet bland ungdomar i Västerås : En kvantitativ undersökning baserad på Liv och Hälsa Ung 2014Paulsson, Linnea January 2016 (has links)
Bakgrund: Folkhälsan i Sverige blir allt bättre men trots detta ökar skillnaderna i hälsa mellan olika grupper. En individs hälsa i ungdomsåren påverkar hälsan resten av livet och detta är en av anledningarna att folkhälsoinsatser är prioriterade till barn och ungdomar. En individs livskvalitet förändras beroende på olika faktorer runtomkring. För att undersöka ungdomars livskvalitet krävs det att mätinstrumenten som används är validerade till målgruppen. Syfte: Studien syftar dels till att psykometriskt utvärdera och anpassa mätinstrumentet Minneapolis-Manchester Quality of Life Instrument – Adolescent Form (MMQL) till en svensk ungdomspopulation, dels till att beskriva livskvaliteten bland unga och analysera ojämlikheter utifrån klassiska bakgrundsfaktorer. Metod: En kvantitativ ansats med tvärsnittsdesign användes i studien. Datamaterial från Liv och Hälsa Ung 2014 användes och avgränsades till årskurs 9 på grundskolan och årskurs 2 på gymnasiet i Västerås. Resultat: Faktoranalysen resulterade i en modell av mätinstrumentet MMQL bestående av sju faktorer innehållande 33 frågor. Den interna reliabiliteten av instrumentet undersöktes genom Cronbach’s Alpha vilket visade goda resultat. Ungdomarnas hälsorelaterade livskvalitet är generellt sett god och i nivå med vad andra internationella studier visat. Dock finns det betydande skillnader mellan grupper; tjejer har sämre livskvalitet än killar, de äldre ungdomarna sämre än de yngre och de med låg familjeekonomi har sämre livskvalitet än de med hög familjeekonomi. Slutsats: Den anpassade versionen av MMQL visade goda psykometriska egenskaper i en svensk ungdomskontext. Ungdomarnas livskvalitet är god och i nivå med andra internationella studier men fördelningen av livskvalitet är inte jämlik. / Background: Public health in Sweden is getting better, however, there are increasing differences in health between different groups of society. An individual’s health during adolescence continuously affects the health for life and is one reason why public health interventions are prioritized among children and adolescents. An individual’s quality of life change depending on various factors, which contributes to a better or worse quality of life. To examine young people’s quality of life it requires that the instrument that is being used is validated to the targets group. Aim: The study aims to both evaluate the psychometric properties and adapt the Minneapolis-Manchester Quality of Life Instrument – Adolescent Form (MMQL) instrument to a Swedish youth population, as well as to describe the quality of life amongst young people and analyzes inequalities based on classical background factors. Method: A quantitative approach to the cross-sectional design was used in the study. Data and material from Liv och Hälsa Ung 2014 was used but restricted to the 9th grade in elementary school and grade 2 in upper secondary schools in Västerås. Results: The factor analysis resulted in a 7-factor model of the measure instrument MMQL containing 33 questions. The internal reliability of the instrument was assessed by Cronbach’s Alpha, which showed good results. In regards to the distribution of health-related quality of life statistically significant differences were found between genders as well as between age groups. Conclusion: The customized version of MMQL showed good psychometric properties in the context of Swedish youth. Young people’s quality of life in Västerås is good and on par with other international studies, however, the distribution of quality of life is not equal.
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An evaluation of a health status measure and two health utility measures in patients with inflammatory polyarthritisHarrison, Mark James January 2008 (has links)
Background: The ability to measure health and the value of improving or declining health is crucial to the evaluation of health care interventions. Many generic and disease specific health status measures exist for use in patients with rheumatoid arthritis (RA). The Overall Status in Rheumatoid Arthritis (OSRA) measure is a new and simple measure with early evidence of construct validity. Generic health profiles with attached utility weights such as the EuroQol EQ-5D and the SF-6D (calculated from the Medical Outcome Study 36-item short-form health survey) allow the quantification of a patient's health relative to perfect health and death, and can be used to estimate quality adjusted life years (QALYs). The EQ-5D is extensively used in RA, but has potential limitations. The SF-6D appears to have potential, but needs further evaluation. The aim of this thesis was to assess the validity and responsiveness of the EQ5D, SF-6D and OSRA in UK RA patients, and compare the performance and implications of the use of the EQ-5D and SF-6D.Methods and subjects: Patient data were obtained from three sources; the Steroids in Very Early Arthritis (STIVEA) (n=256) and British Rheumatoid arthritis Outcome Study Group (BROSG) (n=466) randomised controlled trials, and the British Society for Rheumatology Biologics Register (BSRBR) (n=129). The data used included lifestyle and demographic factors, disease activity (DAS28), functional disability (HAQ), X-rays to assess erosive damage, the EQ-5D and the SF-6D. The OSRA was collected only in the BROSG trial. Visual analogue scales (VAS) of pain and fatigue were collected in BROSG and STIVEA. Construct validity was tested by correlating the EQ-5D, SF-6D and OSRA with a range of outcome measures for RA. Responsiveness to change was assessed using minimum important differences (MID), effect size (ES) and standardised response means (SRM), and compared using ratios. EQ-5D profiles placing arthritis patients in utility states 'worse than death' (negative scores) were described and assessed using linear and logistic regression. The implications of using the EQ-5D and SF-6D in economic evaluation were compared by cost-effectiveness analyses of the BROSG trial. Results: The correlation of the EQ-5D and SF-6D was moderate to high (0.67). Both measures had moderate to high correlations with disease activity, physical function, joint damage and fatigue. The OSRA Activity (OSRA-A) and Damage (OSRA-D) correlated strongly with measures of related aspects of disease. The EQ-5D, SF-6D and OSRA discriminated between known differences in health status across groups defined by social deprivation and disease activity. The EQ-5D MID was 0.04 for improvement and 0.10 for deterioration. The SF-6D MID was 0.04 in both directions. The SF-6D was more responsive to improvement (EQ-5D: SF-6D ES ratio 0.78-0.88) and the EQ-5D more responsive to deterioration (ES ratio 1.14) in health. The OSRA-A was the most sensitive disease specific measure in the BROSG trial, and the OSRA-D was more responsive than the HAQ. The factors associated with being in a 'worse than death' health state were male gender, the HAQ, SF-36 mental composite scale, pain VAS, and erythrocyte sedimentation rate (a marker of inflammation). Pain was the predominant factor and was scored at the most extreme level in every worse than death profile. The cost-effectiveness analyses (BROSG trial), found net quality adjusted life years (QALYs) were greater for the EQ-5D (0.07) than the SF-6D (0.05), but had higher variance than the SF-6D. Conclusions: The EQ-5D and SF-6D appear valid and responsive to changes in health in RA, but measure subtly different aspects of health. There are issues with both measures, and cost-effectiveness conclusions of a study could differ according to which measure was used. The EQ-5D may be more likely to demonstrate that an intervention is cost effective than the SF-6D, due to its larger mean change in response to change in health status. The OSRA is valid for use in RA and its responsiveness suggests potential for inclusion in clinical trials.
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Personer med Parkinsons sjukdom och deras skattning av sin hälsorelaterade livskvalitet : En litteraturöversikt / People with Parkinson´s disease and their assessment of their health-related quality of life : A litterature reviewPersson, Frida, Vensjö, Sara January 2017 (has links)
Bakgrund: Parkinsons sjukdom [eng. Parkinson´s Disease - PD] är en neurologisk och progressiv sjukdom, med motoriska och icke motoriska symtom. Forskning visar att personer med PD ofta är oroliga för hur sjukdomen kommer att påverka deras hälsorelaterade livskvalitet [eng. Health Related Quality of Life - HRQoL], och de tenderar att skatta sin HRQoL sämre än övrig befolkning. HRQoL beskrivs som innebörden av hur hälsan påverkar livskvaliteten [eng. Quality of Life - QoL] och är viktig att ta hänsyn till i omvårdnadsarbetet. Syfte: Att beskriva personer med Parkinsons sjukdom och deras skattning av sin hälsorelaterade livskvalitet. Metod: En litteraturöversikt bestående av tolv vetenskapliga artiklar med kvantitativ design och deduktiv ansats analyserades enligt Fribergs trestegsmodell. Artiklar där HRQoL mäts med PDQ-39SI inkluderades. Resultat: Flera olika faktorer var negativt relaterade med HRQoL såsom längre sjukdomstid, tidig sjukdomsdebut och hög grad av symtom. Vissa behandlingar hade en positiv effekt på HRQoL såsom behandling med infusion av levodopa, följsamhetsterapi av läkemedelsbehandling, fysisk aktivitet och djup hjärnstimulering. Slutsats: Denna litteraturöversikt har bidragit med kunskap om hur olika faktorer påverkar HRQoL vid PD. Kunskapen kan hjälpa sjuksköterskor att bemöta denna patientgrupp, då flera faktorer har en negativ påverkan på HRQoL. / Main title: People with Parkinson's disease and their assessment of their health-related quality of life. Subtitle: A literature review Background: PD is a neurological and progressive disease, with motor and non-motor symptoms. Research shows that people with PD are often worried about how the disease will affect their QoL and they tend to estimate their HRQoL poorer than other parts of the population. The HRQoL is described as the meaning of how health affects the QoL and is important to take into account in nursing work. Aim: To describe people with Parkinson's disease and their assessment of their health-related quality of life. Method: A literature review consisting twelve scientific articles with quantitative approaches was analyzed according to Friberg's three-dimensional model. Articles where the HRQoL is measured with PDQ-39SI was included. Results: Several different factors were negatively related to the HRQoL such as longer illness, an early disease outcome and a high degree of symptoms. Some treatments had a positive effect on the HRQoL such as treatment with levodopa infusion, drug therapy compliance, physical activity and deep brain stimulation. Conclusion: This literature review has contributed with knowledge of how different factors affect the HRQoL in PD. Knowledge can help nurses to respond to this patient group, as several factors have a negative impact on the HRQoL.
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Epidemiological aspects of microscopic colitisWickbom, Anna January 2017 (has links)
Microscopic colitis (MC) constitutes the main entities collagenous colitis (CC) and lymphocytic colitis (LC), diseases that are relatively recently described (in 1976 and 1989, respectively). The aims of this thesis were to study the epidemiology of MC, to describe how these diseases affect patients in terms of symptom burden and health-related quality of life (HRQoL), to study potential risk factors such as familial factors, childhood circumstances, educational level, marital status, smoking and comorbidity, and to describe a cohort of patients with ulcerative colitis (UC) or Crohn’s disease (CD) and subsequent MC, and vice versa. During 1999–2008 in Sweden, the mean annual incidence of MC was 10.2 per 105 inhabitants, compared with 5.2 per 105 inhabitants for CC, and 5.0 per 105 inhabitants for LC. The prevalence of MC on 31 December 2008 was 123 per 105 inhabitants. Women appeared to be especially affected – the female:male ratio was 3.6:1 in CC and 4.6:1 in LC. Patients’ HRQoL is impaired both in active CC and in LC. Patients with CC in clinical remission have persisting symptoms: abdominal pain, fatigue, arthralgia and myalgia; LC patients in remission have persistent fatigue compared with controls. This illustrates that the longterm outcome is different in CC compared with LC. Microscopic colitis is associated with a family history of MC, indicating that familial factors may play a role in the pathogenesis of this disease. We confirm earlier reports that smoking is a risk factor in MC. In the present study population, CC was associated with rheumatic disease and previous appendicectomy. Moreover, CC and LC were associated with thyroid disease and coeliac disease and, interestingly, with a history of UC. Most patients with UC or CD and subsequent MC, or vice versa, had UC or CD first and later developed MC. The majority had extensive UC and later onset of CC. Microscopic colitis should be considered in patients with UC or CD if there is onset of chronic watery diarrhoea without endoscopic relapse of mucosal inflammation.
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Cytostatikabehandling vid bröstcancer: Faktorer vården kan bidra med för att kvinnornas upplevelser ska bli mer positiva.Nyberg, Sara, Gebreyesus, Luchia January 2017 (has links)
Bakgrund: Cytostatikabehandling är vanligt inslag vid behandling av bröstcancer och kan medföra en lång tid av kämpande mot både sjukdomen, behandlingen och andra svåra upplevelser. Cytostatikabehandling är förknippat med exempelvis diverse biverkningar som kan påverka bröstcancer patienterna. Syfte: Att undersöka underlättande hjälpmedel, som inte inkluderar materiella saker som proteser, kryckor och rullstolar, utan andra medel som vården kan bidra med för att skapa en mera positivare upplevelse av behandlingen samt att undersöka de psykiska upplevelser hos kvinnor med bröstcancer som genomgått cytostatikabehandling. Ett annat syfte var att ta reda på hur kvinnans syn på livet, alltså livskvalitén, påverkas. Metod: Litteraturstudie med hjälp av systematiska översikter, kvalitativa- och kvantitativa artiklar. Resultat:Olika hjälpmedel som hälso- och sjukvården kan implementera eller använda i större utsträckning för att hjälpa bröstcancer patienterna vid cytostatikabehandlingen. Mycket tyngd ligger på fysisk, psykiskt och socialt stöd, utbildning för personal- och patienter och information från hälso- och sjukvårdens sida. Denna studie visar dessutom att kvinnorna genomgår fyra faser under cytostatikabehandlingen i och med det får hälso- och sjukvården får en ökad förståelse om den psykologiska processen och kan hjälp lättare erbjudas. Psykiska upplevelser är starkt kopplat till uppkomna biverkningar och det finns kompletterande behandlingar som exempelvis guidade bildspråk, vilket underlättade upplevelsen av cytostatikabehandlingen. Att livskvalitén förändras är i de flesta fall relaterat till själva behandlingen och negativa biverkningar som uppkommer exempelvis ångest, depression och en allmän känsla av att vara mindre nöjd med sitt liv. Genom användande av olika behandlingsalternativ och kritiska åtgärdsstrategier kan biverkningarna reduceras och livskvalitén förbättras. Slutsats: Hälso- och sjukvårdpersonalen kan genom förbättrade insatser hjälpa bröstcancer patienterna under behandlingsperioden. / Introduction: Chemotherapy is a common element in the treatment of breast cancer and can lead to a long period of struggling against the disease, the treatment and other difficult experiences. Chemotherapy is also associated with, for example, various side effects that can affect the breast cancer patients. Purpose: To investigate tools, that doesn’t include material things such as prostheses, crutches or wheelchairs, other average that can contribute to creating a more positive experience of the treatment and to investigate the physical experiences of women with breast cancer undergoing chemotherapy. Another aim was to find out how the women feels about their lives, their quality of life, is being affected. Method: Literature study using systematic reviews, qualitative- and quantitative articles. Results: Different tools that healthcare can implement or use in a greater extent during the chemotherapy treatment to help the patients. Much emphasis is on physical, psychological and social support, training for staff and patients and information from the health care side. This study also shows that women undergoes four phases during chemotherapy and this leads to that health care gets a better understanding of the psychological process and can much easier offer assistance.Physical experiences are strongly linked to the side effects and there are complementary therapies such as guided imagery, which reduced the experience of chemotherapy. The quality of life changes are in most cases related to the treatment and adverse side effects that arise such as anxiety, depression and a general feeling of being less satisfied with their lives. By using different treatments and critical intervention strategies, the side effects can be reduced and the quality of life improves. Conclusion: The healthcare staff can through different enhanced efforts help breast cancer patients during the treatment period.
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Kvalita života jedinců po transplantaci ledvin a možnosti jejího ovlivnění různými formami intervence / Quality of life in renal transplant recipients and the possibilities of its affecting through different forms of interventionKrálová, Helena January 2011 (has links)
Title: Quality of life in renal transplant recipients and the possibilities of its affecting through different forms of intervention. Aims: 1) To evaluate quality of life in renal transplant recipients and compare it with that of the general population. 2) To analyze effects of a 6 months controlled intervention exercise program, special diet, combination of special diet and exercise program and control group on the health related quality of life and to compare results between groups. Methods: We studied a composite group of 21 patients (mean age 58,4 9,34 years) after renal transplantation. Patients were randomly divided into four groups, each group had different program, as described above. The assessment of the quality of life was performed twice, before and after six months of a regular intervention program. We used standardized questionnaires KDQOL-SFTM . We have also assessed the importance of individual dimensions of quality of life with questionnaire WHOQOL - 100. Results were analyzed using descriptive statistics, non-parametric Wilcoxon signed-rank test and non-parametric Kruskal Wallis test. Statistically significance was considered on p ≤ 0,05. Results: After the pre-test and evaluation of the quality of life we assessed, that from 8 dimensions there were 5 lower after the...
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Avaliação de qualidade de vida relacionada à saúde de pacientes submetidos ao transplante de células tronco hematopoéticas / Evaluation of Health-Related Quality of Life of patients submitted to Hematopoietic Stem Cell TransplantationSantos, Carla Libralli Tostes dos 09 September 2010 (has links)
O transplante de células tronco hematopoéticas(TCTH) consiste na infusão intravenosa de células tronco hematopoéticas, destinadas a restabelecer a função medular e imune em pacientes com uma série de doenças malignas e não malignas, herdadas ou adquiridas, sendo considerado um procedimento de alta complexidade, alto custo financeiro e alta morbi-mortalidade . O sucesso do TCTH resultou em um grande número de pacientes sobreviventes livres de doença, trazendo como grande questão colocada pelos candidatos a essa terapêutica como será sua qualidade de vida após o procedimento. O objetivo desse estudo longitudinal consistiu em avaliar a qualidade de vida relacionada à saúde (QVRS) de pacientes submetidos ao TCTH autólogo e alogênico em três momentos distintos: no pré, após 30 e 180 dias pós TCTH e correlacionar com dados clínicos e sócio-demográficos. Para a coleta de dados foram utilizados dois questionários: o primeiro para obtenção de dados clínicos e sócio-demográficos, e o segundo uma escala específica traduzida e validada para o português o Functional Assessment Cancer Therapy (FACT-BMT). A amostra inicial foi constituída por 30 pacientes, 26 avaliados nos três momentos. O conjunto de resultados permitiu visualizar um impacto positivo da QVRS em pacientes com neoplasias e doenças hematológicas submetidos ao TCTH, ao final dos seis meses pós TCTH, apesar de algumas funções se apresentarem mais prejudicadas como a função física, funcional e preocupações adicionais com 30 dias pós TCTH, houve melhora nos escores do FACT-BMT em todos os componentes quando comparado ao do pré TCTH, especialmente nos aspectos físicos, emocionais e relacionamento com o médico.Conhecer essas implicações auxiliam a equipe interdisciplinar e o paciente na decisão de submeter-se a esse procedimento e auxiliam no planejamento de uma assistência que visa a melhora da QVRS desses pacientes. / The Hematopoietic Stem Cells Transplantation (HSCT) consists of infusing stem cells intravenously, aiming to reestablish the spinal cord and immune functions in patients with a series of, inherent or acquired, malignant and nonmalignant diseases. It is considered a highly complex procedure, with high financial costs and morbidity and mortality. The HSCT success resulted in a large number of patients who survived and were healed, which in turn lead potential candidates to question how good quality of life can be after the procedure. This study evaluates the Health- Related Quality of Life (HRQoL) of patients submitted to the autologous and allogenic HSCT in three different points in time: before, 30 and 180 days after the HSCT and correlated clinical and socio-demographic data. Two questionnaires were used for data collection: the first addressed clinical and socio-demographic data and the second was the Functional Assessment Cancer Therapy (FACT-BMT) translated and validated to Portuguese. The initial sample was composed of 30 patients; 26 were evaluated in the three points. The set of results indicated a positive impact on HRQoL in patients with neoplasias and hematologic diseases six months after the HSCT. Despite the fact there were additional concerns and some functions, such as physical and functional, were affected 30 days after the HSCT, the FACT-BMT scores improved in all components reaching levels above those pre HSCT, especially in physical and emotional aspects and relationship with the physician. Knowledge concerning these implications helps patients to decide whether to submit to the procedure and the interdisciplinary team to plan care with a view to improve the HRQoL of these patients.
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Percepção do cuidador na qualidade de vida relacionado à saúde bucal de crianças e adolescentes com transtorno do espectro autista / Caregiver perception on quality of life related to the oral health of children and Teenagers with autism spectrum disorderSotelo, Ruth Monica Carranza 04 July 2018 (has links)
Os objetivos deste estudo de corte transversal, analítico e descritivo, foram: 1) Avaliar a percepção dos pais e/ou cuidadores em relação a qualidade de vida (QVRSB) relacionada à saúde e à saúde bucal de crianças e adolescentes com diagnóstico do TEA. 2) Avaliar se a condição bucal das crianças e adolescentes com diagnóstico do TEA pode interferir na QVRSB e QVRS. Material e métodos: Este estudo transversal contou com a participação de 74 crianças e adolescentes com TEA cadastrados no CAPE (Centro de atendimento a Pacientes Especiais) / FOUSP, entre 2017 e 2018, com idades entre 5 e 18 anos (9,81± 3,70).A Saúde bucal foi caracterizada por meio da avaliação do Índice de sangramento gengival (ISG), Índice de placa (IP), Índice de dentes cariados, perdidos e obturados ceo-d/(CPO-D), Índice de defeito de desenvolvimento do esmalte dentário (DDE), Anomalias dentárias (AD), Hábitos parafuncionais e a Escala comportamental de Venham. Para avaliação da QVRS e QVRSB foi selecionado o instrumento Peds QL® 4.0 - relato dos pais/responsáveis e PedsQL®Escala bucal - relato de crianças pais/responsáveis, uttilizamos a análise de Regressão de Poison. Resultados: as variáveis explanatórias que atuaram negativamente determinado uma pior QVRSB foram: aglomeração domiciliar maior ou igual à 4 pessoas, 3 ou mais filhos, presença de ceo-d/CPO-D maior que zero e e protesto generalizado durante atendimento odontológico. Maior comprometimento emocional esteve associado à renda familiar menor que 2 salários mínimos, ceo-d/CPO-D maior que dois e protesto moderado durante o atendimento odontológico. A piora na atividade escolar esteve associada ao maior número de filhos (3 ou mais filhos) e protesto generalizado durante o atendimento odontológico. Houve associação entre capacidade física e idade da criança, aglomeração familiar e protesto generalizado durante o atendimento odontológico, sendo que valores maiores dessas variáveis determinaram efeito negativo na capacidade física. Houve associação entre construto social e algumas variáveis explanatórias clínicas. Observamos que a pior interação social estava associada com maior CEOd/ CPO-D e protesto intenso durante o atendimento odontológico. Conclusão: De acordo com a percepção dos pais/responsáveis houve impacto negativo reduzido tanto na QVRS, como na QVRSB das crianças/adolescentes com TEA. O construto emocional e o de saúde bucal foram os mais associados às variáveis socioeconômicas e clínicas. / The objectives of this cross-sectional, analytical and descriptive study were: 1) To evaluate the perception of parent sand / or caregivers regarding quality of life (HRQoL) related the health and oral health of children and teenagers diagnosed with Austism Spectrum Disorder (ASD) 2) Evaluateif oral condition of children and adolescents diagnosed with ASD interfere with HRQoL and HRQoL. Material and methods:This cross-sectional study comprised 74 children and teenagers with ASD, enrolled in the CAPE (Special Patient Care Center) / FOUSP between years 2017 and 2018, aged between 5 and 18 years (9.81 ± 3 , 70). Oral health was characterized by evaluation of gingival bleeding index, plaque index, ceo-d /CPO-D, enamel development defect index (DDE). To evaluate behavior durind dental care, the Vehan\'s Behavioral Scale was used. For the evaluation of the HRQoL and QRSRS, the Peds QL® 4.0 instrument - parent / guardian reportand PedsQL® Oral Scale - parent / guardian report were used. Poison Regression analysis was performed to identify possible associations amongs planatory variables. Results:The explanatory variables that negatively worsed OHRQoL were house hold agglomeration greater than or equalto 4 people, 3 or more children, presence of CEO-d/CPO-D greater than 2 and wides pread protest during dental treatment. Highe remotion alimpairment was associated with family income less than 2 minimun wages, CEO-d/CPO-D higher than 2 and moderate protest dudring dental care. The worsening of school activity was associated with higher number of children (3 or more) and wides pread protest during dental care. There wasan association between physical capacity and age of children, family agglomeration and generalized protest during dental care. A higher value of these variables was associated with a negative effect on physical activity. There was also an association between social constructand some clinical explanatory variables. The worse the social interaction, higher the CEO-d/CPO-D and intense protest during dental care. Conclusion: According to the perception of parents there was a reduced negative impact in both HRQoL and OHRQoLof children/adolescents with ASD. The emotional and oral health construcs were the most associated with socioeconomic and clinical variables.
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Äldres hälsorelaterade livskvalité efter sepsis : En litteraturöversikt / Health-related quality of life in elderly people after sepsis : A literature reviewLange rosén, Cecilia, Nyberg, Frida January 2019 (has links)
Bakgrund: Sepsis är en sjukdom där bakterier tar sig ut i blodbanan och frisätter substanser som rubbar den normala funktionen i våra organ. Sepsis delas in i tre svårighetsgrader: sepsis, svår sepsis och septisk chock. Globalt insjuknar över 35 miljoner människor per år i sepsis och hög ålder är en stor riskfaktor. Äldre individer som överlever en svår sepsis ses ha en ökad sjuklighet och dödlighet efter infektionen och löper därmed större risk för nedsatt hälsorelaterad livskvalité. Syfte: Syftet var att sammanställa kunskap om äldre patienters kvarstående problem med hälsorelaterade livskvalité efter att ha vårdats för sepsis på sjukhus. Metod: Studiedesignen för detta examensarbete var en litteraturöversikt innehållande 11 kvantitativa studier med svar på efterfrågat syfte. Sökning gjordes i CINAHL och PubMed med datumbegränsning från 2008–2018. Inkluderade artiklar har granskats med GRADE och presenteras med rubriker och underrubriker i resultatdelen. Resultat: Huvudkategorierna fysisk hälsa, kognitiv påverkan på hälsa och social hälsa härleddes till temat hälsorelaterad livskvalité. Sepsisinfektionen kunde kopplas till försämringar av fysiska, sociala och kognitiva attribut som kvarstår långt efter patienten var medicinskt färdigbehandlad. Slutsats: Forskning visar att försämrad hälsorelaterad livskvalité kvarstår långt efter utskrivning, mer forskning behövs inom området för att stötta dessa individer. Nyckelord: Hälsorelaterad livskvalité, livskvalitet, omvårdnad, sepsis, överlevnad. / Background: Sepsis is a disease where bacteria get into the bloodstream and release substances that rub the normal function in our organs. Sepsis is divided into three severities: sepsis, severe sepsis and septic shock. Globally, more than 35 million people worldwide suffer from sepsis and high age is a major risk factor. Older individuals who survive a severe sepsis are seen to have increased morbidity and mortality after infection and thus run higher risk of impaired health-related quality of life. Aim: The aim was to summarize knowledge of older patients' remaining problems with health-related quality of life after being taken care of after hospitalization. Method: The study design for this project was a literature review containing 11 quantitative studies in response to the aim. Search was made in CINAHL and PubMed with data limitation from 2008-2018. Included articles have been examined with GRADE and are presented with headings and subheadings in the result section. Result: The headings of physical health, cognitive impact on health and social health were derived from the theme of health-related quality of life. The sepsis infection could be associated with physical, social and cognitive impairment disorders that persisted long after the patient was medically discharged. Conclusion: Research shows that deteriorating health-related quality of life persists long after discharge, and more research is needed in the area to support these individuals. Keywords: Health-related quality of life, nursing, sepsis, survival quality of life
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