The study included two groups of participants: research (case) and control groups. The data on the QOL and the most frequently symptoms as well as sense of coherence was evaluated comparing the differences between research and control groups. Patients by age were homogenic in both groups (Table 2). Table 2. Socio-demographic characteristics of research and control groups. Socio-demographic characteristics Research group (n=84) Control group(n=82) p value Age (years)Mean (SD) 70.46 (5.93) 69.50 (5.29) 0.27 Education n (%)Primary school8 years education12 years educationCollage educationUniversity education 20 (23.7 %)14 (16.7 %)14 (16.7 %)13 (15.5 %)23 (27.4 %) 19 (23.2 %) 7 (8.5 %)11 (13.4 %)23 (28.1 %)22 (26.8 %) 0.13 Marital status n (%)Married/Live with partnerSingle/widower 72 (85.7 %)12 (14.3 %) 74 (90.2 %) 8 (9.8 %) 0.86 Religion n (%)BelieverLibertine 58 (69 %)26 (31 %) 63 (76.8 %)19 (23.2 %) 0.12 The place of residence n (%)CityRural areas 67 (79.8%)17 (20.2%) 59 (72.0 %)23 (28.0 %) 0.89 Overall, 29.8 % of patients were indicated with the mild pain and 30.0 % of patients – with moderate and severe pain (Figure 3). The urine incontinency symptom was determined only for three patients in the last stage of research and it is not demonstrated in the picture thoroughly. Fatigue was the most frequently indicated and most intensive symptom (82.1 % - 89.3 %) of patients in the research group throughout all three stages of research. It tended to be increasing the entire... [to full text]

The general aim of the present thesis was to develop a theory on caring and uncaring encounters within nursing and health care from the patient's perspective. Results of an analysis of two phenomenological studies (paper I), as well as research findings from five other phenomenological studies (papers II-VI), were used to develop the theory. Caring and uncaring can be conceptualized on a continuum symbolizing five basic modes of being with another, which, for example, involves a neutral mode of being with another, where the individual is perceived as neither caring nor uncanng. There are two major metaphors in the theory, that of the bridge, symbolizing the openness in communication and the connectedness experienced by the recipient of care in an encounter perceived as caring. The other metaphor is the wall, which symbolizes negative or no communication, detachment and lack of a caring connection, experienced by the recipient in an encounter perceived as uncaring. In the theory the importance of professional caring within nursing and health care is proposed, essentially involving competence, caring, and connection. The above-mentioned 'bridge' is developed through mutual trust and the development of a connection between the professional and the recipient. This connection is a combination of professional intimacy and a comfortable distance of respect and compassion -- professional distance. On the other hand, uncaring involves perceived indifference and incompetence, creating distrust, disconnection and the above-mentioned 'wall' of negative or no communication. The recipient of professional caring is influenced positively. Theconsequences, which are an increased sense of well-being and health, can be summarized as empowerment. Uncaring, however, has the negative consequences of decreased sense of well-being and health, which can be summarized as discouragement. Empowerment and discouragement in this context are defined as subjective experiences of the recipients of care. The importance of seeing the recipient in his or her inner and outer contexts is emphasized in the theory. The inner context involves perceived needs, expectations, previous experiences and sense of self, which in the perspective of the recipient of nursing can be summarized as both a sense of vulnerability and the need for professional caring. The perceived hospital environment comprises the recipient's outer context. It is concluded that nurses and other health professionals can, by theirprofessional caring or lack of it, be powerful sources of empowerment ordiscouragement to those whom they are pledged to serve. / <p>Papers, included in the Ph.D. thesis, are not registered and included in the posts from 1999 and backwards.</p><p>The following papers included in the Ph.D. Thesis are removed due to copyright restrictions.</p><p>Paper I: Halldirsdottir, S. l 991. Five basic modes of being with another. In Gaut, D.A., &amp; Leininger, M.M., (eds) <em>Caring: The compassionate healer</em>. NationalLeague for Nursing, New York, 37-49.</p><p>Paper II: Halldirsdottir, S. &amp; Hamrin, E. 1997. Caring and uncaring encounters'vvithin nursing and health care: From the cancer patient's perspective. <em>Cancer Nursing</em> April, 20(2):120-128.</p><p>Paper III: Halldirsdottir, S. &amp; Hamrin, E. 1996b. Experiencing existentialchanges: The lived experience ofhaving cancer. <em>Cancer Nursing</em>, 19(1), 29-36.</p><p>Paper IV: Halldirsdottir, S. &amp; Karlsd6ttir, S.I. 1996a. Empowerment ordiscouragement: Women's experience of caring and uncaring encounters during childbirth. <em>Health Care for Women lnternational</em>, 17( 4).</p><p>Paper V: Halldirsdottir, S. &amp; Karlsdottir, S.I. i 996b. Journeying through labourand delivery: Perceptions of women who have given birth. <em>Midwifery</em> 12(2).</p><p>Paper VI: Halldirsdottir, S. 1996a. The lived experience of health: Aphenomenological case study. (on the day of the defence date the status of this article was <em>Submitted</em>. <strong>Published later:</strong> Halldorsdottir, S. 2000. Feeling empowered: A phenomenological case study of the lived experience of health.  In B. Fridlund and C. Hildingh (eds),  <em>Qualitative methods in the service of health </em>(pp. 82-96).  Lund: Studentlitteratur.</p>

Diss. (sammanfattning) Umeå : Univ., 2008. / Härtill 5 uppsatser.

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 1992. / Typescript. Includes bibliographical references (leaves 112-117).

Thesis (M.S.)--University of Michigan, 1985. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1985. / eContent provider-neutral record in process. Description based on print version record.

Thesis (Ph.D.) -- McMaster University, 2001. / Includes bibliographical references (leaves 197-209). Also available via World Wide Web.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 151-159). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Bakgrund: Barnmisshandel är ett omfattande problem i Sverige och världen. Trots höga anmälningssiffror är det varje år en omfattande underrapportering av barnmisshandel och misstanke om misshandel mot barn. Forskning visar att misshandel av barn har negativ prospektiv inverkan på barns mående och hälsa. Att barn far illa förbises alltför ofta av sjuksköterskor och annan vårdpersonal på grund av bristande kompetens och kännedom inom ämnet.   Syfte: Att, utifrån svenska vårdprogram, riktlinjer och handlingsplaner, belysa vad som beskrivs gällande bemötande av barn som far illa.   Metod: Litteraturstudie där resultatet baserades på 19 dokument från olika regioner och landsting i Sverige, samt 1 nationellt dokument från Socialstyrelsen.   Resultat: Att bemöta barn som far illa kräver kompetens, närvaro och en professionell medvetenhet. Barn berättar sällan själva om sin utsatthet och därför åligger det dem som jobbar med barnen att våga fråga om våld och utsatthet för att kunna upptäcka barn som far illa. Barnets rätt till ett åldersorienterat bemötande, som utgår ifrån barnets mognad och ålder, skall alltid kombineras med att bemöta barnet med respekt och integritet. Detta blir särskilt viktigt om barnet utsatts för någon form av våld eller övergrepp. Att vårdpersonal är lyhörd och tar barns berättelser på allvar är essentiellt i bemötandet av barn och vårdpersonal skall alltid utgå ifrån att det som barnet berättar om är sant.  Konklusion: Ett gott bemötande av barn som far illa bygger på en rad olika aspekter som sjuksköterskor skall kunna förväntas följa. Parallellt med resultatet framkom dock yttring om stora brister i evidensunderlaget. Även en kunskapslucka gällande bemötande av barn som far illa har kunnat konstateras. / Background: Child abuse is a widespread problem in Sweden and the world. Every year there is a substantial under-reporting of child abuse and suspected abuse against children. Research shows that child abuse has a negative prospective impact on children's health. Signals and signs that a child is abused are far too often overlooked by nurses and other healthcare professionals due to lack of expertise and knowledge on the subject. Aim: To elucidate the context of personal treatment towards abused children, based on Swedish health care programmes, guidelines and action plans. Method: Literature review based on 20 Swedish regional and national health care programmes and guidelines. Findings: Encountering abused children requires expertise, presence and professional awareness. Children rarely speak out spontaneously about their vulnerability and therefore it is essential that those who work with children dare to ask about violence and vulnerability in order to detect child abuse. The child's right to an age oriented treatment, which is based on the child's maturity and age, should always be combined with the child’s right to respect and integrity. This is especially important if the is child a victim of any form of violence or abuse. Health professionals must be sensitive and keen and take children's stories seriously, and they must always be on the assumption of what the child says is true. Conclusion: A good personal treatment of children experiencing child abuse is based on a variety of aspects that nurses should be expected to follow. Major gaps of evidence and references were revealed parallelly with the results. Furthermore, a gap of knowledge was identified regarding personal treatment of abused children.

Submitted by TAIS LOPES SARANHOLI null (tais_saranholi@hotmail.com) on 2018-04-01T23:50:13Z No. of bitstreams: 1 Dissertação Corrigida - Taís Lopes Saranholi.pdf: 1261504 bytes, checksum: 32fecb89036e2d7e01d4d5a14bb736f5 (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2018-04-02T19:38:29Z (GMT) No. of bitstreams: 1 saranholi_tl_me_bot.pdf: 1261504 bytes, checksum: 32fecb89036e2d7e01d4d5a14bb736f5 (MD5) / Made available in DSpace on 2018-04-02T19:38:29Z (GMT). No. of bitstreams: 1 saranholi_tl_me_bot.pdf: 1261504 bytes, checksum: 32fecb89036e2d7e01d4d5a14bb736f5 (MD5) Previous issue date: 2018-02-22 / Introdução: As lesões por pressão (LP) são áreas de lesões localizadas na pele, geralmente sobre uma proeminência óssea, resultantes da pressão prolongada dos tecidos moles contra a superfície externa e estão frequentemente presentes nas unidades críticas de internação, portanto predizer quais os pacientes mais vulneráveis a este problema é fundamental. Existem diversas escalas de avaliação, que podem auxiliar no diagnóstico de um grupo de risco para LP. A Escala de Braden (EB) é um instrumento norte-americano para identificar o risco para o desenvolvimento de LP, sendo amplamente utilizada em diversos pacientes tanto no serviço de saúde quanto no domicílio. A escala CALCULATE foi desenvolvida especialmente para a utilização nos pacientes das unidades de terapia intensiva (UTIs), a partir de suas condições, resultando no risco alto ou muito alto para o desenvolvimento da LP. Objetivos: Comparar a acurácia da EB e da CALCULATE para predizer o risco de lesão por pressão em pacientes internados em uma unidade de terapia intensiva e compará-las. Método: Estudo tipo coorte prospectivo e analítico. Realizado inicialmente concordância interpessoal da EB e da escala CALCULATE. Após isto, a coleta de dados foi realizada nos pacientes internados em uma UTI de adultos de um hospital público de referência, dentro dos critérios de inclusão, até surgimento da LP estágio 1, alta da UTI ou óbito. Foram coletadas dados referentes as características demográficas, clínicas, escores das EB e CALCULATE (nas primeiras 24h da internação e após a cada 48 horas), medidas preventivas adotadas e características das LP nos casos que desenvolveram este agravo. A concordância interpessoal entre os escores pelos enfermeiros foi avaliada pelo coeficiente de correlação intraclasse e o desempenho das escalas quanto à predição de LP foi realizado por meio da curva ROC e cálculo da área sob a curva, sendo considerado desempenho satisfatório quando a área sob a curva for maior do que 0,7. Resultados: Ambas as escalas foram reprodutíveis na concordância interpessoal realizada inicialmente. Foram incluídos 100 participantes, sendo 62% sexo masculino, média de idade de 59 anos (DP±17,4), com tempo médio de internação de 7 dias (DP±5,2). As medidas preventivas adotadas foram mudança de decúbito a cada 2 horas (99%) e hidratação da pele (100%). Apenas para alguns pacientes (39%) foi utilizado colchão tipo piramidal. Houve 37 LP em 35 participantes. O local que mais ocorreu LP foi na região sacral. A maioria das lesões foram de estágio 1 (24%). Como intervenção pós LP foi realizado a intensificação da mudança de decúbito. Outros desfechos dos participantes foram: 45 altas e 20 óbitos. O desempenho da CALCULATE quanto a predição de LP foi melhor do que a EB, com área sob a curva de 0,74 (IC 95% 0,64 - 0,83) e 0,61 (IC 95% 0,50 - 0,72) respectivamente. Conclusão: A escala CALCULATE apresentou melhor acurácia na predição de LP nos pacientes adultos da UTI, quando comparada com a EB. / Introduction: Pressure lesions (LP) are lesion areas located on the skin, usually on a prominent bone, resulting from prolonged soft tissue pressure against the external surface and are frequently present in the critical units of hospitalization, thus predicting which patients are most vulnerable to this problem is fundamental. There are several scales of evaluation, which may help in the diagnosis of a risk group for LP. The Braden Scale (EB) is an American instrument to identify the risk factor for the development of LP, and is widely used in several patients, both in the health service and at home. The CALCULATE scale was specially developed for use in patients of intensive care units (ICUs), from their conditions resulting in high or very high risk for the development of LP. Objectives: To compare the accuracy of EB and CALCULATE to predict the risk of pressure injury in patients admitted to an intensive care unit and to compare them. Method: Prospective and analytical cohort study. Interpersonal agreement of the EB and the CALCULATE scale was initially performed. After this, the data collection was performed in patients admitted to an adult ICU of a public reference hospital, within the inclusion criteria, until the appearance of category 1 LP, discharge from the ICU or death. The demographic, clinical, EB and CALCULATE scores were collected (in the first 24 hours of hospitalization and after every 48 hours), preventive measures adopted and characteristics of LP in the cases that developed this illness. The interpersonal agreement between the scores by the nurses was evaluated by the intraclass correlation coefficient and the performance of the scales as for the LP prediction was performed by means of the ROC curve and the calculation of the area under the curve, being considered a satisfactory performance when the area under the curve is greater than 0.7. Results: Both scales were reproducible in the interpersonal agreement performed initially. A total of 100 participants were included, 62% male, mean age 59 years (SD ± 17.4), with an average length of hospital stay of 7 days (SD ± 5.2). The preventive measures adopted were change of position every 2 hours (99%) and skin hydration (100%). Only a few patients (39%) used a pyramidal type mattress. There were 37 LPs in 35 participants. The place that most occurred LP was in the sacral region. The majority of injuries were category 1 (24%). As a post-LP intervention, the change in decubitus was intensified. Other outcomes of the participants were: 45 high and 20 deaths. The performance of CALCULATE in predicting LP was better than EB, with area under the curve of 0.74 (CI 95% 0.64 - 0.83) and 0.61 (CI 95% 0.50 - 0.72) respectively. Conclusion: The CALCULATE scale presented better accuracy in LP prediction in adult ICU patients, when compared to EB