Bakgrund: Allt fler insjuknar i diabetes varje år och för att minska risken för komplikationer av sjukdomen är egenvård nödvändigt. Sjuksköterskor har en viktig roll i att stötta patienter och kompensera bristande egenvårdskapacitet. Intresset för detta ämne väcktes då författarna uppfattat svårigheter hos patienter att sköta sin egenvård och de ville därför identifiera verktyg för att kunna stötta dessa individer. Syfte: Belysa patienters erfarenhet av faktorer som hindrar eller främjar egenvård vid diabetes typ 2. Metod: Litteraturöversikt där resultatet baseras på 13 vetenskapliga artiklar hämtade från databaserna Cinahl Complete, Academic Search Complete, PubMed och Nursing & Allied Health Database. Kvalitativa studier har varit i fokus för litteraturöversikten. Matriser har använts för att sammanställa resultatartiklarna som sedan har analyserats och tematiserats. Resultat: Flertalet faktorer framkom som kunde vara till hjälp eller förhindra individernas egenvård. Dessa presenteras i två huvudteman; hindrande faktorer för egenvården och främjande faktorer för egenvården. Egenvård vid diabetes typ 2 påverkades av både inre och yttre förhållanden. Brist på motivation och förståelse för egenvården var ett återkommande problem. Under huvudtemat främjande faktorer visas bland annat hur coping, compliance och self-efficacy kunde påverka egenvården positivt. Diskussion: Det framkom att individens självkänsla och sinnesstämning påverkar egenvårdskapaciteten och möjligheten till förändring. Sjuksköterskor behöver få möjlighet att förbättra sina kunskaper om livsstilsförändring och diabetesråd för att bättre kunna stötta dessa patienter och själva få en större förståelse. Resultatet har delvis diskuterats utifrån Orems omvårdnadsteori om egenvård. / Background: Diabetes is an increasing problem and self-care is of great importance to prevent complications. Nurses have an important role in supporting or compensating in areas that the patient is not sufficient enough to self-manage. The interest in this topic originated in several clinical encounters with patients showing self-care deficits and tools for supporting these patients are in demand. Aim: The aim of this literature review is to illuminate patients’ experiences of barriers and promoters of self-care in type 2 diabetes. Method: Literature review. The result is based on 13 scholarly articles. The articles were identified from searching the databases Cinahl Complete, Academic Search Complete, PubMed and Nursing & Allied Health Database. This literature review focused on qualitative studies. A matrix method was used in compiling the results. The results were then analyzed and categorized. Results: Many factors affect individuals' ability of self-care. These are presented in the main themes: "Barriers" and "Promotors". Both internal and external factors influence a persons’ ability of self-care. A recurrent problem and barrier were lack of motivation and understanding of the importance of self-care. Coping, compliance and self-efficacy have a positive influence on self-care as demonstrated in the promotors theme. Discussion: Self-image and a persons’ emotional state affect his or hers self-care capacity and ability to change habits. Nurses need opportunities to improve their knowledge and understanding about lifestyle and diabetes counselling in order to help these patients. The results of this literature review were partially discussed using Dorothea Orem's "Self-care nursing deficit theory".

Bakgrund: Att leva med långvarig sjukdom innebär förluster för individen och krav på anpassning. En viktig del i sjuksköterskans arbete med att stärka hälsa hos personer i behov av vård är att stötta lärande. En viktig del i lärande är interaktion och delaktighet. Som vårdvetenskaplig utgångspunkt har Dorothea Orems “Teori om omvårdnadssystem” använts och denna teori beskriver interaktionen mellan sjuksköterskan och de personer hon vårdar. Syfte: Syftet var att nå kunskap om hur sjuksköterskan kan arbeta med lärande i grupp hos personer med långvarig sjukdom utifrån Dorothea Orems ”Teori om omvårdnadssystem”. Metod: En litteraturöversikt har genomförts där tio kvantitativa studier har sammanställts genom analys med Dorothea Orems “Teori om omvårdnadssystem” som utgångspunkt. Resultat: Resultatet visar hur de olika programmen i studierna arbetat med lärande i grupp bland personer med långvarig sjukdom, där det framkommer skillnader och likheter i deltagarnas och sjuksköterskans roller. Likheter fanns i programmens fokus på interaktion mellan deltagarna såväl som på sjuksköterskans faciliterande roll. En viktig skillnad fanns i utsträckningen av deltagarnas påverkan på innehållet i gruppträffarna, där vissa program lät deltagarnas behov och intresse styra medan vissa program i förväg hade bestämt innehållet. Diskussion: I resultatdiskussionen argumenteras för att människans egenidentifierade lärandebehov bör styra lärandet. Lärandet bör främja utvecklandet av självstyrning hos personen. Resultatet visar att deltagarna i interaktionen mellan varandra har inneboende resurser som används för att främja individens och andras lärande. I metoddiskussionen uppmärksammas styrkor och svagheter kring val av metod för denna litteraturöversikt. / Background: Living with long term illness means losses for the individual and demands for adaptation. An important part of the nurse's work on strengthening the health of people in need of care is to support learning. An important part of learning is interaction and participation. As a nursing-science basis Dorothea Orem’s "Theory of nursing system" has been used and this theory describes the interaction between the nurse and the person she cares for. Aim: The purpose was to gain knowledge about how nurses can work with learning in a group of persons with long-term illness with basis in Dorothea Orem’s "Theory of nursing systems." Method: A literature review was carried out where ten quantitative studies have been compiled through analysis with Dorothea Orem’s "theory of nursing system" as a basis. Results: The results how how the various programs of the studies worked with learning in a group among people with long-term illness, where similarities and differences in the roles of the participants and the nurses emerged. Similarities were found in the programs focus on the interaction between participants as well as on the facilitating role of the nurse. An important difference was revealed in the extent of participants' influence on the content of the group sessions, where some programs let participants' needs and interests guide while some programs previously had determined the content. Discussions: In the discussion of the results it is argued that man's self-identified learning needs should direct learning. Learning should encourage the development of the person’s self-direction. The results show that participants in the interaction between each other have inherent resources used to promote learning among themselves and others. Strengths and weaknesses regarding the chosen method for this literature review are highlighted in the method discussion.

Summaries in Afrikaans and English / Die doelwitte van hierdie studie is om een van die teoriee wat by opleidingsinstellings gedoseer word, in die gemeenskapgesondheidpraktyk op tienergesinne toe te pas en om 'n strategie te ontwikkel wat sodanige toepassing vir verpleegkundiges aanvaarbaar maak. Orem se selfsorgtekortteorie is gevolglik op gevallestudies by 'n Gemeenskapgesondheidskliniek van 'n stadsgesondheidsafdeling toegepas. Persoonlike onderhoudvoering is as navorsingstegniek gebruik om probleme te identif iseer, behoeftes te bepaal en selfsorgtekorte aan te spreek. Data is gemeet aan die hand van UNICEF se GOBI FFFF en die PKK se vyf konsepte, die verpleegproses en OREM SE KONSTRUKTE. Evaluasie toon dat Orem se selfsorgteorie 'n instrument bied om selfsorgvermoens te evalueer, die verpleegkundige te rig om tekorte te identifiseer en verpleegsorg te beplan sodat interdissiplinere konsultasie verminder en professionele verpleegkundiges beter aangewend word, hulpbronne en fasiliteite maksimaal benut word en elke indiwidu as selfsorgagent ontwikkel word. / The objective of this study is to apply one of the theories taught at training institutions to teenage families in the community health practice and to develop a strategy to make such application acceptable to nurses. Orem' s self-care deficiency theory was consequently applied to case studies at a community clinic of a Municipal Health Department. Personal interviews were mainly used as research technique to identify problems, determine needs and address self-care deficiencies. Data was evaluated according to UNICEF' s GOBI FFFF, the "PKK" 's five concepts, the nursing process and OREM's Constructs. Evaluation has proved that Orem' s theory offers an instrument to evaluate self-care abilities and guide the nurse in identifying deficiencies and planning nursing care in order to reduce multidisciplinary consultation, which results in professional nurses being employed appropriately, resources being utilised to the maximum and each individual developing into a complete self-care agent. / Health Studies / M.A. (Verpleegkunde)

Bakgrund: Diabetes typ 2 är en kronisk sjukdom och en av de sjukdomar som ökar kraftigasti världen. Behandlingen består av att patienten gör flera olika livsstilsförändringar i form avegenvård. Sjuksköterskor har en viktig roll i att stödja, motivera och undervisa patienten idetta och det är därför viktigt att sjuksköterskor ökar sin kunskap om hur patienter uppleveregenvård. Syfte: Beskriva patientens upplevelse av egenvård vid diabetes typ 2. Metod: Enlitteraturöversikt som baseras på 15 kvalitativa artiklar och en kvantitativ artikel. Desystematiska sökningarna gjordes i databaserna PubMed och Cinahl. Resultat: I dennalitteraturöversikt framkom flera faktorer som både främjar och hindrar utförandet avegenvård. Dessa presenteras under två huvudkategorier och sju underkategorier. Faktorersom upplevdes främja egenvården var att patienten hade en god relation till sjukvården, enhög egenvårdskapacitet samt kunskap och stöd från familj. Faktorer som upplevdes hindraen god egenvården var brist på kunskap, information och motivation men även bristandestöd från familj och vänner. Diskussion: Patienter med diabetes typ 2 har olika upplevelseroch behov av egenvård. Det är viktigt att sjuksköterskan i samråd med patienten identifierarstrategier som förbättrar patientens egenvårdsförmåga. Sjuksköterskan bör ge patientenadekvat information samt stötta och motivera patienten till att utföra en god egenvård.Slutsats: Det är betydelsefullt att sjuksköterskan har kunskap om patienters upplevelse avegenvård för att kunna stärka patientens egenvårdskapacitet samt öka patientens compliancetill behandling och på så sätt kunna bedriva en effektiv och god vård. / <p>Godkännande datum: 2018-11-06</p>

Theory Stroke, a cerebrovascular disease, causes severe disability and failure of self-sufficiency for nearly of half of the patients. Nursing focuses on respecting the individuality of each patient, supports the return and consolidation of a good health, promotes self-sufficiency and searches for the needs of the patient. Conceptual model of D. E. Orem assumes the ability of each human to take care of self. Although partially, or not capable of self-care at all, it is necessary to fill up the deficit by nursing care. Objectives The first objective was to state the options to how to fill up the deficit of self-care by patienst after stroke. The second objective was to determine, whether the patient´s living environment has an impact the development of self-care. Research questions Q1: Does the home environment stimulate the acceleration of the return of self-care ability by patients after a stroke? Q2 : Does the respondent perceive the issue of own disability equaly as the surrounding? Q3 : Is it more beneficial for the patient to perform self-care with deficiency, or to receive perfect execution of it by others? Q4 : Does the patient perceive the subsequent therapy (physiotherapy, occupational therapy) as a faster way to return to sufficient self-care? The research part of the thesis was carried out by a qualitative survey, conducted as a individual semi-structured thematic interviews with respondents devided into two groups. One group consisted of patients after a stroke and a second group of caregivers. Total of 8 patients, 4 males and 4 females, were interviewed. The research was completed in three sessions, each at intervals of four to six weeks. The information received were processed by open coding method, analytical induction development of technology showdown and narrative analysis. Results Using data received from interviews with respondents it was possible to answer all the research questions. The first research question examined was, whether the home environment stimulates the acceleration of the return of self-care ability by patients after a stroke. According to interviews and objective evaluation, the domestic environment has improved overall condition and faster return to individual self-care. Although, aftercare provided enough nursing and rehabilitative care, patient very much appreciated mental stimulation given by the home environment. The second research question focused on whether the respondent perceives own disability equaly as the surrounding. The interviews showed most of the patients perceive their health and subsequent disabilities better than its surroundings. The third research question examined whether it is more beneficial for the patient to perform self-care with deficiency, or to receive perfect execution of it by others. The results indicated more benefits by performing own self-care, even with mistakes that encourage practising, thereby repeating and consolidating manners. Most of the respondents refused any help. The fourth research question focused on patient´s perception of the subsequent therapy (physiotherapy, occupational therapy) as a faster way to return to sufficient self-care. The interviews showed that the respondents did not realize the importance of aftercare, considered it to be routine and as a part of the treatment. Yet, increased physiotherapy activities results into a quicker adjustment of self-sufficiency. Conclusion The temporal evolution of self-sufficiency of patients after a stroke and the attitudes of caregivers are described in this thesis. The results are presented in a form of mental map. This might be used by the patients after stroke, nursing staff or official home caregivers and informal caregivers, as well.

This thesis deals with the issue of patients after the amputation of the lower limb. Loss of the lower limb means a great change for the patient, not only in understanding the integrity of one's own body, one's own health, but also from a functional point of view. The theoretical part of the thesis presents the latest available knowledge about lower limb amputation and postoperative care for patients with this diagnosis. It also deals with self-care, based on Dorotheus Orem's theory of self-care deficit. The aim of the work was to determine the level of self-care of patients after amputation of the lower limb using some aspects of D. E. Orem's model. To find out in what systems D.E. Orem's nurses support patients after the amputation of the lower limb in self-care and how to help nurses care for these patients. The research part of the thesis was realized through a qualitative research survey. The technique of data collection was a semi-structured interview with patients with amputation of the lower limb and nurses who provide nursing care for such ill persons. The theoretical basis for the interview was the DE Oremové model, which was complemented by the ADL (Activity Daily Living), IADL (Instrumental Activities of Daily Living Scale) and the analogue range of pain in the group of respondents - patients. The data obtained were processed in the form of transcripts of the interviews, which are supplemented by evaluation of individual scales. The output of the diploma thesis is a set of recommended measures and a proposal of a comprehensive information material on the amputation of the lower limb for patients, which the nurses should be available to their departments.

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem, 2015. / Submitted by Fernanda Percia França (fernandafranca@bce.unb.br) on 2016-02-11T15:39:13Z No. of bitstreams: 1 2015_LucyanaBertosodeVasconcelosFreire.pdf: 2395688 bytes, checksum: b6d9c2b7591d46a5648558877cbc730d (MD5) / Approved for entry into archive by Raquel Viana(raquelviana@bce.unb.br) on 2016-02-12T18:10:54Z (GMT) No. of bitstreams: 1 2015_LucyanaBertosodeVasconcelosFreire.pdf: 2395688 bytes, checksum: b6d9c2b7591d46a5648558877cbc730d (MD5) / Made available in DSpace on 2016-02-12T18:10:55Z (GMT). No. of bitstreams: 1 2015_LucyanaBertosodeVasconcelosFreire.pdf: 2395688 bytes, checksum: b6d9c2b7591d46a5648558877cbc730d (MD5) / INTRODUÇÃO: Os avanços ocorridos na área de Nefrologia, especificamente no âmbito das terapias renais substitutivas, trouxeram grandes alterações na estratégia até então utilizada na assistência aos usuários com doença crônica. Nesse contexto, a diálise peritoneal (DP) se apresenta como uma modalidade alternativa de tratamento essencialmente domiciliar e coloca em evidência outras demandas de atenção como a orientação sistematizada, o autocuidado e a participação de outros atores na unidade de cuidado, como a figura do cuidador, com vistas ao desenvolvimento de competências de cuidado de dependente e à melhoria na assistência de enfermagem para esse sistema usuário-cuidador. A Teoria do Déficit de Autocuidado de Enfermagem (TDACE), de Dorothea Orem, tem sido aplicada em diversos contextos no Brasil e no mundo e o presente estudo discute o autocuidado e o cuidado de dependente da TDACE em usuários com doença renal submetidos à diálise peritoneal domiciliar. OBJETIVOS: Analisar o autocuidado e o cuidado de dependente em usuários submetidos à diálise peritoneal ambulatorial contínua (DPAC). MÉTODO: Trata-se de um estudo descritivo-exploratório, transversal, com abordagem qualitativa. O Estudo foi realizado em um hospital de ensino de Brasília - DF. Participaram do estudo os usuários do programa de DPAC e seus respectivos cuidadores. Os critérios de inclusão adotados para os usuários foram: diagnóstico de doença renal crônica dialítica, no mínimo noventa dias de ingresso no programa de DP, ambos os sexos, independente de faixa etária. Foram excluídos os usuários com lesão renal aguda, em regime de internação e em condições clínicas que impossibilitavam a participação. Como critérios de inclusão para os cuidadores, foram considerados: estar exercendo o papel de cuidador há mais de três meses em relação à DP e ter recebido o treinamento em DP pela equipe do Centro de Diálise. Os dados foram coletados por meio de entrevista e análise documental. O Estudo foi dividido em Estudo I e Estudo II. No primeiro estudo, foi estruturado instrumento adaptado para a coleta de dados e utilizados três instrumentos validados: Índice de Katz, Escala de Lawton e Escala de ZBI. No Estudo II, foi aplicado o instrumento elaborado no estudo I em usuários de DPAC e em seus cuidadores. RESULTADOS: Os usuários eram 64,7% mulheres, 35,3% homens, com predomínio do grupo etário de 30 a 45 anos e 14 a 29 anos. 47% tinham o ensino fundamental incompleto. Constatou-se que 70,6% dos usuários possuíam cuidador. Entre os cuidadores, 78,6% eram mulheres, 50% no grupo etário entre 30 a 40 anos, 42,9% entre 41 a 50 anos e 35,7% com ensino superior completo. Em relação ao grau de parentesco, 42,9% eram filhos e 78,6% residiam com os usuários. Foram identificados e definidos os indicadores empíricos do autocuidado e do cuidado de dependente em usuários de DPAC. Os fatores que interferem nos requisitos universais foram identificados na demanda de autocuidado universal relacionado à alimentação, eliminação, atividade e repouso, solidão e interação social e promoção da saúde. A aplicação do índice de Katz (grau de funcionalidade) e a Escala de Lawton (grau de dependência) permitiram identificar o déficit de autocuidado para a demanda de atividade e repouso e de solidão e interação social. Em relação ao desvio de desenvolvimento, 23,5% dos participantes possuíam este requisito alterado em função da faixa etária e do diagnóstico da DRC. O déficit de cuidado de dependente relacionado à capacidade psicoemocional foi identificado em 57,1% dos cuidadores, com manifestação de tristeza. A sobrecarga de cuidador foi classificada de moderada a severa em 28,6% dos cuidadores de acordo com a escala de ZBI. Apenas 14,3% dos cuidadores relataram não compreender o funcionamento da diálise peritoneal. Quanto à capacidade física, 78,6% relataram cansaço, indisposição e falta de energia após a função de cuidador. A identificação dos déficits de autocuidado e de cuidado de dependente possibilitaram elaborar os diagnósticos, os sistemas e as intervenções de enfermagem e esquematizar um modelo descritivo de unidade de cuidado de dependente ao usuário de DPAC. CONCLUSÃO: A Teoria de Orem em usuários de DPAC e em seus cuidadores apresenta-se como caminho producente para sistematizar a consulta de enfermagem e para avaliação e orientação das reais necessidades de cuidados de enfermagem no contexto da DP com vistas ao desenvolvimento das capacidades de autocuidado e de cuidado de dependente dos usuários renais. ______________________________________________________________________________________________ ABSTRACT / INTRODUCTION: Advances made in the area of Nephrology, specifically in the context of renal replacement therapies brought major changes for the strategy until then used in assisting users with chronic disease. In this context, peritoneal dialysis (PD) is presented as an alternative form of essential home care treatment and puts in evidence other attention demands such as: systematic orientation, self-care and other people's participation in the care unit, like the caregiver, with a view to develop dependent care skills and to improve nursing care in the user-caregiver system. Dorothea Orem's self-care deficit nursing theory (TDACE), has been used in various contexts within Brazil and worldwide and this study discusses the self-care and TDACE dependent care in users with kidney disease undergoing domiciliary peritoneal dialysis. OBJECTIVES: to analyze self-care and the dependent care in users undergoing continuous ambulatory peritoneal dialysis (CAPD). METHOD: This is a descriptive, exploratory and transversal study, with a qualitative approach. The study was conducted at a teaching hospital in Brasília-DF. Users of DPAC program and their caregivers participated in the study. The adopted inclusion criteria applied were: dialytic chronic kidney disease diagnosis (DRC), minimum of 90 days of entry into the DP program, both sexes, regardless of age. Users with acute kidney injury, in detention regime, and the users who were in impossible clinic conditions to participate were all excluded. The criteria for the inclusion of caregivers were: the practice of caregiver activity for more than three months in relation to DP, and the obtaining of DP training from the dialysis center staff. Interview and documents analysis were used for data collecting. The study was divided into Study I and Study II. In the first study, an adapted data collection instrument was structured, and three validate instruments were used: Katz Index, Lawton Scale and ZBI Scale. In Study II, the instrument used in study I was applied in DPAC users and in their caregivers. RESULTS: Among the group users 64, 7% were women and 35, 3% were men, with predominant age range groups at 30-45 years old and at 14-29 years old. 47% of them didn't complete elementary school graduation. It was found that 70.6% of users had caregivers. Among the caregivers, 78.6% were women, 50% in the age group of 30-40 years-old, 42.9% in the age group of 41-50 years-old and 35.7% have a complete higher education. In relation to the degree of kinship, 42.9% were their kids and 78,6 lived with users. Empirical indicators of self-care and dependent care were identified and defined in DPAC uses. Factors that interfere in universal requirements were identified in the self-care universal demands, in relation to food supply, elimination, activity and rest, loneliness, and social interaction and health promotion. The application of Katz index (degree of functionality) and the Lawton Scale (degree of dependence) helped to identify the self-care deficit on demands for activity and rest, loneliness and social interaction. In relation to the development deviation, 23.5% of participants had it modified, depending on the age and on the DRC diagnosis. The dependent deficit care, in relation to psycho-emotional capacity, was identified in 57.1% of caregivers with sadness demonstration. According to ZBI scale, a caregiver burden was classified as moderate to severe by 28.6% of caregivers. Only 14.3% of caregivers reported not to understand how does peritoneal dialysis work. About physical capacity, 78.6% reported fatigue symptoms, malaise, and lack or energy after a caregiver work. The identification of the self-care deficits and dependent care enabled the preparation for diagnosis, systems, and nursing interventions, and lay out a descriptive dependent care unit model to the DPAC users. CONCLUSION: Orem's theory application to DPAC users and to their caregivers means a productive way to systematize nursing consultation and also to the assessment and orientation of the real nursing care needs in the DP context with a view to the development of self-care capabilities and renal users dependent care. ______________________________________________________________________________________________ RESUMEN / INTRODUCCIÓN: Los avances ocurridos en Nefrología, de manera específica en el ámbito de las terapias renales sustitutivas, han traído grandes cambios en la estrategia utilizada, hasta ahora, en la asistencia a los usuarios con enfermedad crónica. Asi, la diálisis peritoneal (DP) se presenta como una modalidad alternativa de tratamiento esencialmente domiciliar y evidencia otras demandas de atención, como la orientación sistematizada, el autocuidado y la participación de otros actores en la unidad de cuidado, por ejemplo el cuidador, con vistas a desarrollar competencias de cuidado del dependiente y la mejoría en la asistencia de enfermería para este sistema usuario y cuidador. La Teoría Enfermera del Déficit de Autocuidado, de Dorothea Orem, ha sido aplicada en diversos contextos en Brasil y el mundo. Esta disertación discute el autocuidado y el cuidado del dependiente de la teoría de Orem em usuarios con enfermedad renal sometido a diálisis peritoneal domiciliar. OBJETIVOS: Analisar el autocuidado y el cuidado de dependiente en usuarios sometidos a díalisis peritoneal ambulatoria continua (DPAC). MÉTODO: Es un estudio descriptivo y exploratorio de corte transversal de abordaje cualitativo. Fue realizado en un hospital de enseñanza de Brasilia- DF. Han participado los usuarios del programa de DPAC y sus respectivos cuidadores. Los criterios de inclusión adoptados fueron: diagnóstico de enfermedad renal crónica (ERC) dialítica, con al menos noventa días de ingreso en el programa DP, los dos sexos, independiente del grupo de edad. Fueron eliminados los usuarios con lesión renal aguda, en régimen de internación y en condiciones clínicas que imposibilitaban la participación. Como criterios de inclusión para los cuidadores, fueron considerados: exercer el papel de cuidador por más de tres meses en relación a DP y que hubiera recebido entrenamiento en DP por el Centro de Diálisis. Los datos fueron recolectados por medio de una cita y análisis documental (historia clínica). El estudio ha sido dividido en Estudio I y Estudio II. En el primero, fue estructurado un instrumento adaptado de recolección de datos y se utilizaron tres instrumentos: Índice de Katz, Escala de Lawton y Escala de ZBI. En el Estudio II se aplicó un instrumento elaborado en el Estudio I en usuarios de DPAC y en sus cuidadores. RESULTADOS: Los usuarios eran 64,7% mujeres, 35,3% varones, con predominio de edad entre 30 a 45 años y 14 a 29 años. 47% tenía la enseñanza básica incompleta. Se ha constatado que 70,6% de los usuarios tenían cuidador. Entre los cuidadores, 78,6% eran mujeres, 50% en el grupo de edad entre 30 a 40 años, 42,9% entre 41 a 50 años y 35,7% con grado superior. En relación a la familia, 42,9% eran hijos y 78,6% vivian con los usuarios. Fueron identificados y definidos los indicadores empíricos de autocuidado y del cuidado de dependiente en usuarios de DPAC. Los fatores que interfieren en los requisitos universales fueron identificados en la demanda de autocuidado universal relacionado a la alimentación, eliminación, actividad y descanso, soledad e interación social y promoción de la salud. La aplicación del Índice de Katz (grado de funcionalidad) y la Escala de Lawton (grado de dependencia) han permitido identificar el déficit de autocuidado para la demanda de actividad y descanso y de soledad e interación social. En relación al desvío de desarrollo,23,5% de los participantes tenían este requisito cambiado en función del grupo de edad y del diagnóstico de ERC. El déficit de cuidado del dependiente relacionado a la capacidad psicoemocional fue identificado en 57,1% de los cuidadores, con manifestación de tristeza. La sobrecarga del cuidador fue clasificada de moderada a severa em 28,6% de los cuidadores, según la escala de ZBI. Solamente 14,3% de los cuidadores relataron no comprender el funcionamiento de la diálisis peritoneal. De acuerdo con la capacidad física, 78,6% relataron cansancio, indisposición y falta de energía después de la función de cuidador. La identificación de los déficits de autocuidado y del cuidado del dependiente posibilitaron elaborar los diagnósticos, los sistemas y las intervenciones de enfermería y esquematizar um modelo descritivo de unidad de cuidado del dependiente al usuario de DPAC. CONCLUSIÓN: La teoría de Orem en usuarios de DPAC y en sus cuidadores se presenta como un camino para sistematizar la consulta de enfermería y para evaluación y orientación de las necesidades reales de cuidados de enfermería en el contexto de la Diálisis Peritoneal, a fines de desarrollar las capacidades de autocuidado y de cuidado de dependiente de los usuarios renales.

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, 2006. / Submitted by Thaíza da Silva Santos (thaiza28@hotmail.com) on 2009-10-05T21:34:58Z No. of bitstreams: 1 2006_Maria Madalena Guimarães Rodrigues.pdf: 650737 bytes, checksum: 62801ec661d41279e4b4d43cf80aff96 (MD5) / Approved for entry into archive by Luanna Maia(luanna@bce.unb.br) on 2009-10-06T16:10:02Z (GMT) No. of bitstreams: 1 2006_Maria Madalena Guimarães Rodrigues.pdf: 650737 bytes, checksum: 62801ec661d41279e4b4d43cf80aff96 (MD5) / Made available in DSpace on 2009-10-06T16:10:02Z (GMT). No. of bitstreams: 1 2006_Maria Madalena Guimarães Rodrigues.pdf: 650737 bytes, checksum: 62801ec661d41279e4b4d43cf80aff96 (MD5) Previous issue date: 2006-07-24 / A aplicação da Teoria de Orem na prática de enfermagem em oncologia pediátrica proporciona ao enfermeiro a oportunidade de planejar as suas ações a partir da identificação das demandas de autocuidado, permitindo a participação das crianças/adolescentes e familiares no processo de tratamento, bem como no enfrentamento da situação. A realização desta pesquisa teve por objetivo analisar as necessidades/demandas para o autocuidado em crianças/adolescentes com câncer com base na Teoria do Autocuidado de Orem, a fim de contribuir para o enfrentamento do evento pela família e pela criança/adolescente, assim como obter elementos para sistematizar a atenção de enfermagem nas instituições de saúde. O estudo foi realizado em um hospital público de nível quaternário do Distrito Federal, Hospital de Apoio de Brasília. A metodologia empregada tem abordagem qualitativa com um estudo do tipo exploratório-descritivo. O estudo possibilitou identificar e caracterizar as demandas de autocuidado em crianças/adolescentes com câncer gerando informações que podem subsidiar o profissional no planejamento do cuidado e na definição do diagnóstico de enfermagem e, sobretudo, nas orientações a essas crianças/adolescentes e seus familiares, durante a consulta de enfermagem. ____________________________________________________________________________________ ABSTRACT / The application of the Selfcare Theory prays in the practical one of nursing in pediatric oncology provides to the nurse the chance to plan its actions from the identification of the demands of, allowing the participation of the familiar children/adolescents and in the treatment process, as well as the confrontation of the situation. The accomplishment of this research had for objective to analyze needs/demands for selfcare in children/adolescents with cancer on the basis of the Selfcare Theory one of prays, similar to contribute for the confrontation of the event for the family and the child/adolescent, as well as getting elements systemize the attention of nursing in the health institutions. The study was performed in a public hospital of quartenary level of the Distrito Federal, Hospital de Apoio de Brasilia. The employed methodology has qualitative boarding with a study of the type exploratory-description. The study made possible to identify and characterize the selfcare demands in children/adolescents with cancer generating information that can subsidize the professional in the planning of the care and the definition of the nursing diagnosis and, over all, in the guides to children/adolescents and its familiar ones, during the nursing consultation.

Malignt melanom är en av de tio vanligaste cancerformerna. Insjuknandet har ökat på grund av ändrade sol- och resvanor. Utvecklingen beror främst på UV-strålningen från solen samt ökad användning av solarier. Idag är det främst de yngre kvinnorna som insjuknar. Det gäller att diagnostisera malignt melanom i ett tidigt stadie, då det ger en bättre förutsättning för överlevnaden. Sjuksköterskor ska arbeta preventivt mot ohälsa och ge information om riskfyllt beteende för att förebygga sjukdom och skada. Med tanke på detta var syftet med litteraturstudien att kartlägga riskfaktorer för malignt melanom som grund för sjuksköterskans preventiva arbete. Orems egenvårdsteori ligger till grund för studien. Litteraturstudien är baserad på elva vetenskapliga artiklar och resultatet presenteras i fem huvudteman: socioekonomiskt status, livsstilsfaktorer, sjukvårdspersonalens brister, patienternas kunskap och attityder samt individuella faktorer. Hög socioekonomisk position hade samband med ökat insjuknande och högre överlevnad. Högt intag av grönsaker, frukt och fisk hade skyddande effekt. Sjukvårdspersonalen hade bristande kommunikation om risker och för lite tid för att förmedla information om sjukdomen. Solarier användes mer bland yngre, trots att de hade vetskapen om att solarier ökade utvecklingen. Individuella faktorer såsom exempelvis ljus hud, fler fräknar och antal solbrännor under barndomen associerades med ökad utveckling av malignt melanom.Nyckelord: Kommunikation, kost, livsstil, malignt melanom, Orem, prevention, socioekonomiskt status, UV-strålning. / Malignant Melanoma is one of the ten most common cancer diseases. The disease has increased due to changed sun and travel habits. The development depends on UV-radiation from the sun and increasing use of sunbeds. Today it’s the younger women who are most affected. Malignant Melanoma has to be diagnosed in an early stage because it’s prerequisite with a better survival. The nurse should work preventive against illness and give information about risky behaviour so that diseases and injuries are obviated. Taking this into consideration the aim of this literature review was to determine risk factors for Malignant Melanoma that can be used by the nurse in the preventive work. Orem’s Self-Care Deficit Theory of Nursing underlies this study. The study was based on eleven scientific articles and the result was presented in five main themes: socioeconomic status, lifestyle, lack in the medical service, patient’s knowledge and attitude and individual factors. High socioeconomic position was associated with more illness and higher survival. A high intake of vegetable, fruit and fish had a protective effect. There was a lack in the medical service about risk communication and little information was given about the disease. It was the younger individuals who used sunbeds, even though they had knowledge about the relation between sunbed use and the development of Malignant Melanoma. Examples for individual factors which were associated with a higher development for Malignant Melanoma was fair skin, freckles and the quantity of sunburns during the childhood.Keywords: Communication, diet, lifestyle, Malignant Melanoma, Orem, prevention, socioeconomic status, UV-radiation.

Syftet med studien är att undersöka vilka effekter kontakten med sällskapsdjur har för äldre personers hälsa och välbefinnande. Metoden var en litteraturstudie där tio artiklar granskades. Studien visar att djurs närvaro har ett flertal positiva effekter framförallt i vården av äldre med Alzheimers sjukdom. Dessa uppvisade en högre grad av socialisering och en lägre grad av beteendestörningar i närvaron av djur. Även friska äldre påverkades positivt av relationen med djur då det gällde sociala kontakter och graden av fysisk aktivitet. Slutsatsen är att djurterapi är en intervention som har stor potential att fylla ett behov hos äldre människor som annars är svårt att tillgodose. / The purpose of this study was to examine what effects the presence of animals has on the health and wellbeing of elderly persons. The method used was to review ten articles. The study shows that pets have several positive effects, primarily in the care for elderly with Alzheimer’s disease. These individuals showed a higher degree of socialization and a lower degree of agitated behaviours in the presence of animals. Healthy elderly were also influenced in a positive way by the relation with animals in regards to socialization and the degree of physical activity. The conclusion is that pet-therapy is an intervention that has a great potential to fulfil a need in elderly people that is otherwise hard to provide for.