Bakgrund: Urinkateterns design har inte förändrats sedan 1930-talet. Detta trots att komplikationer relaterat till urinkatetern kan vara allvarliga och vanligt förekommande. För att förhindra komplikationer krävs det att kateterbärarna använder sig av egenvård. För en fungerande egenvård behöver kateterbärarna goda kunskaper om urinkatetrar, vilket är sjuksköterskans uppgift att förmedla.Syfte: Att beskriva personers upplevelse av att leva med kvarliggande urinkateter.Metod: Litteraturöversikt med kvalitativa studier. 11 artiklar gick igenom kvalitetsgranskningen till resultatet. Fribergs 5-stegs modell användes för att analysera datan.Resultat: Att leva med urinkateter kan innebära en stor lättnad och möjliggöra ett friare liv för personerna. Dock kan det också innebära precis tvärtom, att urinkatetern hindrar personerna på grund av mycket oro och, tidskrävande skötsel och en påverkad kroppsbild. Kateterbärarnas relationer till människor i sin närhet har ett stort inflytande över upplevelsen av att leva med urinkateter.Slutsatser: Många personer med urinkateter upplever en ständig oro över problem som kan komma att uppstå. Här råder ett glapp mellan sjukvårdens kunskap och utbud och kateterbärarnas upplevelse och efterfrågan. Sjukvården är tillsynes inte medvetna om kateterbärarnas verkliga upplevelse. Detta kräver vidare forskning för att utreda förbättringsmöjligheter inom hälso- och sjukvården. / Background: The urinary catheter design has not changed since the 1930's. This is thus that complications related to the urinary catheter can be serious and are common. To prevent these complications the catheter users need to use self-care. For self-care to be sufficient the catheter users need good knowledge about urinary catheters. It is the nurse's task to pass on this information.Aim: To describe the experience of living with an indwelling urinary catheter.Method: A literature study with qualitative studies. 11 articles went through the quality review process to the result. Fribergs 5-steps model was used to analyze the data.Result: To live with a urinary catheter can mean a huge relief and enable more freedom. Thus it can also mean the opposite, that the urinary catheter can revent people because it involves a lot of anxiety, time consuming care and affects the body image. Peoples relationships to others in their surroundings has a huge influence on the experience of living with a urinary catheter.Conclusion: Many people with urinary catheter experience a constant anxiety over possible problems. Here is a gap between what is known and offered from the health services and the catheter users experience and requests. The health services are not aware of the real experience of the catheter users. This needs more research to investigate the ability of improvement in the health system.

Introdução: A integridade do Sistema Venoso Central é uma condição fundamental para criar ou manter um acesso vascular eficiente para hemodiálise. A cateterização da veia subclávia é a principal responsável pelo desenvolvimento de obstruções nesses vasos. Porém, é preciso reavaliar a distribuição dessas lesões na atual época de priorização da cateterização da veia jugular interna. Objetivo: Avaliar a distribuição anatômica das obstruções no Sistema Venoso Central dos pacientes em hemodiálise com sinais clínicos de hipertensão venosa. Método e Material: foi realizado um estudo prospectivo de casos consecutivos no HC-FMUSP com duração de 2 anos. A amostra foi composta de 30 pacientes que estavam apresentando sinais clínicos de hipertensão venosa no membro superior portador de uma fístula arteriovenosa. Todos os doentes incluídos foram submetidos a uma angiografia do membro superior através da fístula como método diagnóstico. Coleta de dados e Procedimentos: antes da fistulografia, os pacientes encaminhados ao ambulatório de Nefrologia do HC-FMUSP foram submetidos a uma avaliação clínica com preenchimento de um questionário padronizado, aqueles que preencherão os critérios da pesquisa foram agendados para a realização do exame. Após o diagnostico as lesões foram classificadas conforme o tipo e localização. Análise Estatística: os dados foram expressos em proporção, média ou mediana e valores mínimos e máximos conforme apropriado. As variáveis foram apresentadas descritivamente em tabelas contendo freqüências absolutas (n) e relativas (%). As diferenças entre grupos foram testadas inicialmente com uso de análise univariada, com aplicação do teste t de Student ou do teste de Mann- Whitney. Resultados: nos 30 doentes avaliados foram diagnosticadas ao todo 30 lesões, sendo 20 na veia braquiocefálica, 9 na veia subclávia e 1 na veia cava superior. 70% dessas lesões estavam localizadas em veias intratorácicas. O tipo de lesão mais freqüente foi a oclusão, presente em 70% dos casos. 33% dos pacientes que desenvolveram lesões no Sistema Venoso Central tiveram antecedente de cateterização somente da veia jugular interna. Conclusão: Atualmente, no diagnostico das lesões obstrutivas do Sistema Venoso Central nos pacientes em hemodiálise é importante utilizar métodos diagnósticos que possam informar com precisão as condições dos vasos de localização intratorácica. / Introduction: Central Venous System integrity is a fundamental condition in order to create or maintain an efficient vascular access for dialysis. Subclavian vein catheterization is the foremost condition responsible for these vessels\' obstructions development. However, it is necessary to reappraise these wounds distribution as the current priorization is for catheterization of internal jugular vein. Objective: To evaluate anatomical obstructions distribution in the Central Venous System of patients under dialysis who present clinical signs of venous hypertension. Method and material: A prospective study of consecutive cases was carried out at HCFMUSP within a two years period. The sample was composed by 30 patients who showed up clinical signs of venous hypertension and were bearers of an artery-venous fistula in the upper member. All included patients were submitted to an angiography of the upper member through the fistula as a diagnosis approach. Fact-gathering and procedures: Prior to fistulography, patients were directed to the Nephrology outpatient clinic at HC-FMUSP and were submitted to a clinical evaluation, and filled in a pattern questionnaire. Those who fulfilled the research criteria were scheduled for the exam achievement. After diagnosed, all lesions were classified according to category and location. Statistical analysis: Facts were expressed in proportion, medium or average and minimum and maximum values according appropriate needs. Variables were presented descriptively in absolute tables containing frequencies (n) and relative values (%). Differences amid groups were initially quizzed using univariate analysis, with application of test t of Student or test of Mann-Whitney. Results: Among 30 evaluated patients a total 30 wounds were diagnosed, being 20 in brachiocephalic vein, 9 in subclavian vein and 1 in superior cava vein. 70% of these wounds were located within intratoracic veins. The most frequent lesion category was occlusion present in 70% of the cases. 33% of the patients who developed wounds in the Central Venous System had antecedent of catheterization only at internal jugular vein. Conclusion: Nowadays, in order to diagnose obstructive lesions within Central Venous System among patients on dialysis it is important to use diagnoses approaches which can accurately inform the conditions of intratoracic vessels location.

Introduktion: Vårdrelaterade infektioner och antibiotikaresistens är ett folkhälsoproblem. Kvarliggande urinvägskateter är en riskfaktor för att drabbas av vårdrelaterad urinvägsinfektion. Det finns en tydlig koppling mellan vårdrelaterad infektion, antibiotikaanvändning och antibiotikaresistens. På sjukhusronden har sjuksköterskan en nyckelroll i att förebygga vårdrelaterade infektioner. Syfte: Undersöka om införandet av ett rondkort har någon effekt på sjuksköterskornas upplevelse av sin delaktighet i patientens antibiotika- och urinvägskateterbehandling. Metod: En interventionsstudie utfördes på två vårdavdelningar på Norrlands universitetssjukhus, Umeå, Västerbotten. Interventionen bestod av en checklista, RondkortVLL, som utvecklades för sjuksköterskor att använda vid ronden. Interventionen pågick under fyra veckor. För att mäta deras upplevelse av delaktighet i patienternas antibiotika- och KAD-behandling fick de svara på en enkät före och efter interventionen. Svaren före och efter interventionen jämfördes med Mann Whitney-U test. Resultat: En signifikant förbättring på 1) dagligt ställningstagande till KAD-behandling och 2) sjuksköterskorna upplevde det naturligt att föra en dialog med läkaren om alternativ till urinvägskateter med mindre infektionsrisk. En ökad upplevelse av delaktighet angående patienternas antibiotikabehandling kunde ses på svaren efter interventionen men denna ökning var inte signifikant. Slutsats: Eftersom urvalet var litet och endast två avdelningar undersöktes är det svårt att dra några generella slutsatser. Resultatet tyder på att RondkortVLL har ökat sjuksköterskornas upplevelse av delaktighet i patienternas KAD-behandling och kan ha ökat sjuksköterskornas upplevelse av delaktighet i patienternas antibiotikabehandling. På grund av resultaten och betydelsen av att förebygga vårdrelaterade infektioner förordar vi en ökad klinisk användning av RondkortVLL. Vi hävdar att RondkortVLL kan vara effektivt som en daglig påminnelse, stärka sjuksköterskorna och medvetandegöra dem om deras betydelse i alla aspekter i patientens vård. / Introduction: Healthcare-associated infections and antibiotic resistance are public health problems. Indwelling catheters increase risk for urinary tract infections. There are connections among healthcare-associated infections, antibiotic use and antibiotic resistance. Nurses play a key role in infection control during hospital ward rounds. Aim: To investigate if a ward round checklist affects nursesʼ experiences of participation in patients’ antibiotica and indwelling catheter treatments. Method: An intervention study was conducted in two wards at Norrland University Hospital. The intervention was use of a checklist, RondkortVLL, that we developed for use by nurses at the ward round. The duration of the intervention was 1 month. The nurses answered a questionnaire about the use of antibiotica- and indwelling catheter before and after the intervention. Pre- and post-intervention responses were compared using the Mann Whitney-U test. Results: Significant improvements were found in 1) daily consideration of indwelling catheters and 2) the nurses feeling it was natural to conduct a dialogue with the physician about lower infection risk alternatives to indwelling catheters. While nurses tended to more often report the experience of participation in antibiotic treatment considerations post-intervention, this was not significant. Conclusion: Due to a small sample size and only two wards investigated it is difficult to generalize our results. However, our data indicate that RondkortVLL improved the nurses' experience of participation in patients' indwelling catheter treatments and may improve nursesʼ experiences of participation in a patient’s antibiotic treatment. Given these findings and the importance of infection prevention and control, we are pursuing greater clinical utilization of the RondkortVLL. We assert that RondkortVLL can be useful as a daily reminder, empower the nursesʼand raise awareness of their importance in all aspects of patient care.

Vascular access-related bloodstream infection (BSI) is frequent among patients undergoing hemodialysis increasing significantly their morbidity and mortality. Studies assessing centre- and patient-predictors of BSI have had inadequate sample size and follow-up time. The aims of this project are: to describe the incidence rates; and to determine patient- and centre-level predictors of BSI in a cohort of incident hemodialysis patients treated in teaching or community hospitals, and in First Nation dialysis units. The rates of BSI in our population were lower than those observed in other settings. Central venous catheters were the most important risk factor for BSI and their use in our study was much higher than recommended. Some variability in BSI rates was found among centres, but no centre-related variable was found to be associated with the risk of BSI. Effort to reduce catheter use in hemodialysis patients may significantly reduce the risk of BSI in this patient population.

Introdução: A integridade do Sistema Venoso Central é uma condição fundamental para criar ou manter um acesso vascular eficiente para hemodiálise. A cateterização da veia subclávia é a principal responsável pelo desenvolvimento de obstruções nesses vasos. Porém, é preciso reavaliar a distribuição dessas lesões na atual época de priorização da cateterização da veia jugular interna. Objetivo: Avaliar a distribuição anatômica das obstruções no Sistema Venoso Central dos pacientes em hemodiálise com sinais clínicos de hipertensão venosa. Método e Material: foi realizado um estudo prospectivo de casos consecutivos no HC-FMUSP com duração de 2 anos. A amostra foi composta de 30 pacientes que estavam apresentando sinais clínicos de hipertensão venosa no membro superior portador de uma fístula arteriovenosa. Todos os doentes incluídos foram submetidos a uma angiografia do membro superior através da fístula como método diagnóstico. Coleta de dados e Procedimentos: antes da fistulografia, os pacientes encaminhados ao ambulatório de Nefrologia do HC-FMUSP foram submetidos a uma avaliação clínica com preenchimento de um questionário padronizado, aqueles que preencherão os critérios da pesquisa foram agendados para a realização do exame. Após o diagnostico as lesões foram classificadas conforme o tipo e localização. Análise Estatística: os dados foram expressos em proporção, média ou mediana e valores mínimos e máximos conforme apropriado. As variáveis foram apresentadas descritivamente em tabelas contendo freqüências absolutas (n) e relativas (%). As diferenças entre grupos foram testadas inicialmente com uso de análise univariada, com aplicação do teste t de Student ou do teste de Mann- Whitney. Resultados: nos 30 doentes avaliados foram diagnosticadas ao todo 30 lesões, sendo 20 na veia braquiocefálica, 9 na veia subclávia e 1 na veia cava superior. 70% dessas lesões estavam localizadas em veias intratorácicas. O tipo de lesão mais freqüente foi a oclusão, presente em 70% dos casos. 33% dos pacientes que desenvolveram lesões no Sistema Venoso Central tiveram antecedente de cateterização somente da veia jugular interna. Conclusão: Atualmente, no diagnostico das lesões obstrutivas do Sistema Venoso Central nos pacientes em hemodiálise é importante utilizar métodos diagnósticos que possam informar com precisão as condições dos vasos de localização intratorácica. / Introduction: Central Venous System integrity is a fundamental condition in order to create or maintain an efficient vascular access for dialysis. Subclavian vein catheterization is the foremost condition responsible for these vessels\' obstructions development. However, it is necessary to reappraise these wounds distribution as the current priorization is for catheterization of internal jugular vein. Objective: To evaluate anatomical obstructions distribution in the Central Venous System of patients under dialysis who present clinical signs of venous hypertension. Method and material: A prospective study of consecutive cases was carried out at HCFMUSP within a two years period. The sample was composed by 30 patients who showed up clinical signs of venous hypertension and were bearers of an artery-venous fistula in the upper member. All included patients were submitted to an angiography of the upper member through the fistula as a diagnosis approach. Fact-gathering and procedures: Prior to fistulography, patients were directed to the Nephrology outpatient clinic at HC-FMUSP and were submitted to a clinical evaluation, and filled in a pattern questionnaire. Those who fulfilled the research criteria were scheduled for the exam achievement. After diagnosed, all lesions were classified according to category and location. Statistical analysis: Facts were expressed in proportion, medium or average and minimum and maximum values according appropriate needs. Variables were presented descriptively in absolute tables containing frequencies (n) and relative values (%). Differences amid groups were initially quizzed using univariate analysis, with application of test t of Student or test of Mann-Whitney. Results: Among 30 evaluated patients a total 30 wounds were diagnosed, being 20 in brachiocephalic vein, 9 in subclavian vein and 1 in superior cava vein. 70% of these wounds were located within intratoracic veins. The most frequent lesion category was occlusion present in 70% of the cases. 33% of the patients who developed wounds in the Central Venous System had antecedent of catheterization only at internal jugular vein. Conclusion: Nowadays, in order to diagnose obstructive lesions within Central Venous System among patients on dialysis it is important to use diagnoses approaches which can accurately inform the conditions of intratoracic vessels location.

No description available.

In this investigation key elements of the mysticism of Elizabeth of the Trinity (1880-1906) are compared and contrasted with the mysticism of the Eastern Orthodox Church, and as a result, the true nature of the relationship between their respective mysticism is elucidated. Key doctrines which exhibit a remarkable consonance are: the trinitarian foundation of their mysticism, the indwelling of the Trinity in the human soul, asceticism, desert spirituality, sacrificial love, liturgical spirituality, scriptural spirituality, deification and the doxological nature of their mysticism. Elements of divergence exist within the following: election and predestination, apophatic versus cataphatic mysticism, the Roman Catholic dogma of the immaculate conception of the virgin Mary, and the mode of God's presence in the human soul. Elizabeth's relevance for today is also considered, namely, her ecclesial mission which she now continues in heaven: to intercede for people seeking union with God and to draw people to interior recollection. / Christian Spirituality, Church History and Missiology / M.Th.

In this investigation key elements of the mysticism of Elizabeth of the Trinity (1880-1906) are compared and contrasted with the mysticism of the Eastern Orthodox Church, and as a result, the true nature of the relationship between their respective mysticism is elucidated. Key doctrines which exhibit a remarkable consonance are: the trinitarian foundation of their mysticism, the indwelling of the Trinity in the human soul, asceticism, desert spirituality, sacrificial love, liturgical spirituality, scriptural spirituality, deification and the doxological nature of their mysticism. Elements of divergence exist within the following: election and predestination, apophatic versus cataphatic mysticism, the Roman Catholic dogma of the immaculate conception of the virgin Mary, and the mode of God's presence in the human soul. Elizabeth's relevance for today is also considered, namely, her ecclesial mission which she now continues in heaven: to intercede for people seeking union with God and to draw people to interior recollection. / Christian Spirituality, Church History and Missiology / M.Th.