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.

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.

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.

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.

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...

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.

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.

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

O câncer de pulmão é uma doença maligna que acomete principalmente a população de adultos e idosos na faixa etária dos 40 aos 80 anos. Sua principal causa continua sendo o tabagismo, e sua sobrevida varia com o estadiamento da doença no momento do diagnóstico e sua alta taxa de mortalidade está associada ao diagnóstico tardio da doença, o que limita as opções de tratamento curativo. A Qualidade de Vida Relacionada à Saúde (QVRS) de sujeitos com câncer de pulmão é influenciada por múltiplos fatores, incluindo sintomas, capacidade funcional, estratégias de enfrentamento e rede social de suporte, dentre outros. Entretanto, ainda falta esclarecer o impacto da fadiga na QVRS de pessoas com câncer de pulmão avançado. O objetivo deste estudo é avaliar a QVRS e a fadiga de sujeitos com diagnóstico de câncer de pulmão em cuidados paliativos e identificar a relação entre a presença de fadiga e percepção da QVRS desta população. Trata-se de um estudo transversal e com abordagem quantitativa, correlacional, com uma casuística composta por 120 sujeitos, sendo 60 com câncer de pulmão em cuidados paliativos (grupo de estudo) e 60 sem diagnóstico oncológico (grupo controle). Durante a coleta de dados foram aplicadas as escalas: Karnofsky Performance Scale (KPS), o Critério de Classificação Econômica Brasil (CCEB - versão 2014), a Escala de Fadiga de Piper - revisada e a European Organization for Research in the Treatment of Cancer Questionnaire-core 30 (EORTC- QLQ-C30), com seu módulo específico para câncer de pulmão - o Quality of Life Questionnaire Lung Cancer 13 (QLQ-LC13). Para a análise dos resultados foi realizada estatística descritiva (Mediana, Mínimo e Máximo e 1º e 3º quartil) e testes não paramétricos de Mann-Whitney e Kruskal-Wallis para a comparação entre os grupos e variáveis. Os resultados indicaram que houve significância estatística na comparação entre os grupos para as escalas funcionais, de sintomas e dificuldades financeiras do EORTC QLQ-C30 e para os sintomas associados ao câncer e/ou decorrentes do seu tratamento avaliados pelo módulo QLQ-LC13, bem como para a presença de fadiga. A fadiga foi identificada como o sintoma mais frequente nessa população, relacionada com capacidade funcional reduzida (avaliada pelo KPS) e pior percepção da QVRS. Portanto, sujeitos com diagnóstico de câncer de pulmão em cuidados paliativos apresentam maior carga do sintoma fadiga em comparação com a população em geral e quanto maior a fadiga e de outros sintomas, maior o comprometimento da QVRS dos sujeitos com câncer de pulmão em cuidados paliativos. Este estudo traz contribuições relevantes à Saúde Pública por meio da investigação da relação entre doenças crônicas oncológicas e qualidade de vida relacionada à saúde, para o tratamento sujeitos com câncer de pulmão em cuidados paliativos e que apresentam a fadiga como fator limitante para a realização de suas atividades diárias bem como para os diversos profissionais que atuam na atenção à pessoa com uma condição oncológica em cuidados paliativos / Lung cancer is a malignant disease that mostly affects adults aged between 40 to 80 years old. The main cause of lung cancer is smoking and the survival varies according with the disease stage at the moment of the diagnosis and the high lung cancer mortality rate is related to a late diagnosis, which limits the curative treatment options.. Health Related Quality of Life (HRQoL) of people who have lung cancer is influenced by multiple factors including symptoms, functional capacity, coping strategies and social support networking, among others. However, there is still a need for clarify the impact of fatigue on HRQoL of people with advanced lung cancer. The purpose of this study was to evaluate HRQoL and fatigue of subjects diagnosed with lung cancer in palliative care and identify the relationship between the presence of fatigue and perception of hrqol in this population. this is a cross-sectional, quantitative and correlational approach in which sample was composed of 120 subjects, 60 of them with lung cancer in palliative care (study group) and the others 60 without cancer diagnosis (control group). During data collection were applied the scales: Karnofsky Performance Scale (KPS), Brazil Criterion of Economic Classification (CCEB - version 2014), the Piper Fatigue Scale - Revised and the European Organization for Research in the Treatment of Cancer Questionnaire-Core 30 (EORTC-QLQ-C30), with its specific module for lung cancer - the Quality of Life Questionnaire lung Cancer 13 (QLQ-LC13). For data analysis it was performed descriptive statistics (median, Minimum and Maximum and 1st and 3rd quartile) and two non-parametric statistical tests -- Mann Whitney and Kruskal-Wallis. for comparison between groups and variables. The results indicated significant statistical differences when comparing the groups for the functional and symptoms scales, for the financial difficulties of EORTC QLQ-C30 and symptoms related to and/or resulting from lung cancer and its treatment evaluated by QLQ-LC13 module and for fatigue presence. Fatigue was identified as the most frequent symptom in this population, it\'s related to reduced functional capacity (assessed by KPS) and worse perception of HRQoL. Therefore, subjects diagnosed with lung cancer in palliative care have a higher burden of fatigue compared to general population and the greater fatigue and other symptoms, the greater HRQOL impairment of lung cancer patients in palliative care. This study provides important contributions to public health by investigating the relationship between chronic diseases and oncology HRQoL, to treatment of lung cancer people in palliative care who have fatigue as a limiting factor to carrying on their daily activities and to health professionals who works with oncologic palliative care

A Hipertensão Arterial Sistêmica (HAS) é uma doença crônica não transmissível com etiologia multifatorial e uma das principais causas de doenças cardiovasculares que são responsáveis pela maioria das mortes mundiais. Por ser tratar de uma doença de alta prevalência e na maioria das vezes assintomática, a adesão do hipertenso ao tratamento tem uma representação muito baixa, o que requer a intervenção educacional dos profissionais da saúde no tratamento, na prevenção das complicações e na manutenção da vida. A qualidade de vida relacionada à saúde (QVRS) dos indivíduos com hipertensão arterial é menor comparada com a população geral. A avaliação dos fatores que influenciam na QVRS dos hipertensos pode servir de subsídios no planejamento de estratégias de tratamento mais eficazes para essa população. Objetivos: Caracterizar os indivíduos com hipertensão arterial participantes do grupo de convivência educativa segundo as variáveis: sócio-demográficas e econômica; hábitos de vida (atividade física, tabagismo, consumo de bebida alcoólica); dados relacionados a HAS(co-morbidades, uso de medicamentos anti-hipertensivos, controle dos níveis pressóricos, tempo de progressão da HAS) e tempo de participação nas atividades educativas em grupo, comparar a QVRS entre hipertensos participantes do grupo de convivência educativa com as variáveis sócio-demográficas, econômicas e clínicas e avaliar a contribuição do grupo de convivência na qualidade de vida dos hipertensos. Material e Métodos: Foi realizado um estudo descritivo do tipo transversal com 131 sujeitos com idade superior a 18 anos e diagnóstico de hipertensão arterial, residentes no município de Sacramento-MG, cadastrados no grupo de convivência no período mínimo de um ano anterior a data da entrevista. Os instrumentos utilizados para a coleta de dados foram: instrumento para caracterização da população quanto aos dados clínicos e sóciodemográficos e econômicos e o Medical Outcomes Short-Form Health Survey (SF-36) para avaliação da QVRS. Resultados: Dos pacientes, 98 eram mulheres e 33 homens, a maioria idosa 88(67,2%), com predomínio na faixa etária de 60 a 69 anos 43(32,8%) e ganham igual ou menos que um salário mínimo por mês 88(67,2%). As dimensões do SF-36 que obtiveram menores escores foram: vitalidade (64,4) e dor (70,3), enquanto as dimensões que apresentaram maiores escores foram: aspectos sociais (86,7) e capacidade funcional (79,4). Os fatores que apresentaram relação com a variação dos escores médios e correlação das dimensões do SF-36 foram: renda, atividade física, número de morbidades, diabetes, obesidade. A participação no grupo apresentou relação estatisticamente significante apenas no domínio saúde mental. Conclusão: Clinicamente os resultados mostraram relevância para intervenções educativas pela equipe de saúde. Os enfermeiros como elementos constituintes destas equipes devem estar presentes e ativos em todas as etapas desse trabalho, desde o planejamento, execução e avaliação colaborando na busca de meios efetivos que vão de encontro com a melhoria da qualidade de vida dessa população. / Arterial Hypertension is a non-transmissible chronic disease with multifactorial etiology and it is one of the main causes of cardiovascular diseases which are the leading cause of death in the world. Since the disease is characterized as having a high prevalence rate and in most cases it is asymptomatic, the treatment adherence rate is low, therefore requiring educational intervention from health professionals during the treatment in order to prevent complications and to keep the patient alive. Health-related quality of life (HRQoL) in patients with high blood pressure is reduced when compared to the general population. The evaluation of factors influencing on the HRQoL of high blood pressure patients point to the strategic planning of more efficient treatments to this population. Aims: Characterize the high blood pressure patients participating in the educational gathering group according to the following variables: socio-demographics and economics; lifestyles (physical activity, smoking, drinking); data related to systemic arterial hypertension (comorbidity, use of antidepressive drugs, blood pressure rate control, systemic arterial hypertension progression rate) and participation time in educational group activities, comparison of HRQoL among the group participating patients with the socio-demographical, economical and clinical variables and evaluate the contribution of the group to the quality of life of the participating patients. Methods and Materials: It was performed a descriptive cross-sectional study with 131 individuals over 18 years of age who suffered from high blood pressure. The patients lived in the city of Sacramento ? MG and had been participating in the gathering group for at least one year prior to the interview. The following tools were used to collect the data: Tools to characterize the population according to clinical, socio-demographical and economical data; Medical Outcomes Short-Form Health Survey (SF-36) to evaluate HRQoL. Results: From the total of 131 patients, 98 were female and 33 were male. Most of them (88 patients or 67.2%) were in an advanced age ranging from 60 to 69 years old (43 patients or 32.8%) and earned minimal wage or less (88 patients or 67.2%). The SF-36 dimensions with the lowest scores were: Vitality (64.4) and pain (70.3), whereas the dimensions with the highest scores were: Social functioning (86.7) and functional status (79.4). The factors presenting relation to the average score variation and dimension correlation in the SF-36 were: Income; physical activity; death rate; diabetes, obesity. The participation in the group was statiscally significant relation only to the mental health dimension. Conclusion: The results clinically showed the relevance of educational interventions performed by the health team. The nurses, as part of this team, must be present and active in all the stages of this work, planning, performing and searching for effective methods that lead to the improvement of life quality for this population.