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Diabetes mellitus belongs to diseases frequently occurring in childhood and adulthood. Insufficient knowledge of this disease and an unsatisfactory compensation for diabetes leads to development of late complications that have a negative impact on one's, as well as the family's, life and create an economic problem for society as a whole. The thesis focuses on the main characteristics of the disease, symptoms, diagnosis and treatment. Complications of the disease, including advice for patients themselves and their prevention are described in more detail. Social aspects (work inclusion of a diabetic, invalidity and reduced work capacity, driving of motor vehicles) are also emphasised. The research part containing 18 questions aims to find out to what extent the Czech public is informed about the problematic areas of this disease. It also assesses the feasibility of obtaining information from individuals of different ages and places of residence (city vs. village) regarding diabetes. These hypotheses were stated within the scope of the research: 1. Individuals older than 50 years of age are better informed about diabetes than individuals of a younger age. 1. Individuals living in a city have a better access to information concerning diabetes than individuals living in a village. The data was obtained from questionnaire research, in which respondents older than 18 years of age participated. The data collection took place in Bechyně Spa Ltd. 58 % of the resultant questionnaires were completed by women and 42 % by men.

Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished

Indiana University-Purdue University Indianapolis (IUPUI) / Diabetes is a significant health problem in the United States which disproportionately affects Native Americans. Despite many new prevention and intervention programs, there has been a prolific increase in the incidence of diabetes among Native Americans. The purpose of this qualitative study was to explore the experience of Coeur d’Alene tribal members living with type 2 diabetes using a Heideggerian hermeneutic framework. Participants were recruited through the local diabetes educator at the tribal clinic using purposive and snowball sampling. Individual interviews were conducted with ten Coeur d’Alene tribal members whom had type 2 diabetes and were willing to share their stories of about living with diabetes. Participants ranged in age from 26-86. Interviews lasted from 25-90 minutes and focused on gathering stories about their daily life with their diabetes, and barriers and supports to their diabetes self-management. These became the data for hermeneutic interpretations. Individual transcripts were read and reread for initial themes. Next, comparisons between and across transcripts were done through interpretive emersion into the texts. Emerging themes and patterns were brought before a group of qualitative nurse researchers and doctoral students as a means of cross-checking and validating interpretations. Perseverance was the overarching pattern in the stories of living with diabetes in the world of Schitsu’umsh. The four themes that emerged under the umbrella of perseverance were valuing tribal traditions, being inattentively caring, struggling with disease burdens, and experiencing tensions in patient-provider relations. Living with diabetes in the world of the Schitsu’umsh was always a tenuous balancing act. There was an ever present dialectic tension between strengths and barriers underlying their daily struggles for balance. By increasing our understanding of Native American experiences of living with diabetes, collaborative partnerships can be developed with the tribes to address these barriers to diabetes self-management and to develop culturally relevant diabetes education programs. There is also a need to address cultural competence by the health care community and to work at eliminating biases and prejudice in our healthcare system. This work brings new cultural understandings of what it means to live with diabetes in one Native American group.

Within a defined geographical area, all patients, 192 in total, with insulin- dependent diabetes of at least 2 years' duration and free from long-term diabetic complications were identified. Their experiences of the influence of the disease on daily living, tedium, and smoking habits were evaluated using a questionnaire and related to metabolic control. A case-referent study concerning smoking habits among 25 patients with good, and 25 with poor metabolic control was performed. The influence of mentruation on metabolic control was studied among 20 diabetic women and 20 healthy controls. Coping strategies and their outcomes were studied among 20 patients, using the interview technique. Among those with unsatifactory metabolic and/or emotional outcomes, plans for nursing intervention were agreed on, using diagnostic reasoning. Only a minority of the patients reported that the disease caused them considerable problems in their daily lives. The greatest problems occurred in connection with regularity in daily life, diet management, and exercise. Patients with good metabolic control (HbAic&lt;6.7) had a higher number of hypo-glycemic cornata (7 vs 1, p&lt;0.001). Patients with poor metabolic control (HbAic&gt;9.0) reported more often that they were smokers (pcO.Ol) and the women fertile aged in this group more often reported problems with metabolic control during menstruation (p&lt;0.05). Twenty-nine (18%) were defined as suffering from tedium. There was a higher proportion (NS) of high tedium scores among patients in both good and poor metabolic control groups than in those with intermediate metabolic control. Sixty (31%) of the patients were smokers, prevalence of smoking increased significantly with increasing HbAic- levels (17.5% among patients with the best metabolic control, 47.5% among those with the worst metabolic control). In the case referent study exposure to smoking was found to be significantly more common among those with poor control (odds ratio 6.0). No systematic change in metabolic control during the menstrual cycle could be found. Problem-solving coping strategy based on the monitoring of blood glucose in combination with sensitivity to signs of actual blood glucose level and logical reasoning, was found to have the best coping outcome, both regarding metabolic control and well-being. The results are summarized in a model for diagnostic reasoning in nursing. / <p>S. 1-46: sammanfattning, s. 47-117: 6 uppsatser</p> / digitalisering@umu