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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Der Verlauf der Lebensqualität von Brustkrebspatientinnen in Abhängigkeit von Patientinnenmerkmalen und psychoonkologischem Angebot / The development of quality of life of breast cancer patients depending on patient characteristics and psycho-oncological support

Badtke, Anika 26 September 2016 (has links)
Die psychoonkologische Betreuung von Brustkrebspatientinnen spielt eine wichtige Rolle in der multimodalen Therapie des Mammakarzinoms. Als Hauptziele werden mit dieser eine Verbesserung der Lebensqualität und die Reduktion von Angst und Depression angestrebt. Ziel der vorliegenden Untersuchung war es, die Wirksamkeit eines neu-eingeführten screeninggestützten psychoonkologischen Behandlungspfades zu überprüfen. Weiterhin wurde der Verlauf der Lebensqualität der Patientinnen verfolgt und wichtige Einflussfaktoren identifiziert. 213 Brustkrebspatientinnen im Alter von 26-88 wurden untersucht. Standardisierte Messungen zur Lebensqualität (EORTC-QLQ-C30), zu Angst und Depressivität (HADS), zur Krankheitsbewältigung (MAC) und zu psychosozialen Belastungen (Checkliste psychosozialer Belastungen) wurden zu drei verschiedenen Zeitpunkten erfasst: null, sechs und 12 Monate nach Diagnosestellung. Die Interventionskohorte (110 Patientinnen) nahm an einem neu eingeführten Screening-basierten psychoonkologischen Behandlungspfad teil. Die Kontrollgruppe (103 Patientinnen) erhielt unsystematisch eine weitgehend flächendeckende psychoonkologische Betreuung. Signifikante Lebensqualitätsunterschiede der Kohorten fanden sich nach sechs Monaten entgegen unserer Erwartungen nicht. Nicht-Unterlegenheit des neuen psychoonkologischen Pfades konnte nachgewiesen werden. Aufgrund der fehlenden Wirksamkeit des psychoonkologischen Behandlungspfades konnte nicht gezeigt werden, dass Patientinnen mit initial hoher psychischer Belastung und Frauen mit gering ausgeprägtem Kampfgeist besonders vom psychoonkologischen Behandlungspfad profitierten. Negativer Vorhersagewert für die gesundheitsbezogene Lebensqualität nach 6 Monaten war ein hoher Ausgangs-HADS-Wert. Als positiven Prädiktor stellte sich ein geringer Ausgangs-Fighting-Spirit-Wert heraus - nicht wie initial vermutet - ein hoher. Im Gesamtkollektiv konnte im Verlauf eine stärkere Lebensqualitätsverbesserung der initial psychisch Belasteten und der Patientinnen mit viel Kampfgeist beobachtet werden. Dies ist wahrscheinlich auf verschiedene Faktoren zurückzuführen. Zum einen können die psychoonkologischen Interventionen beigetragen haben, zum anderen könnte das klinische Phänomen der Spontanremission dank einer erfolgreichen Krank-heitsverarbeitung eine Rolle gespielt haben. Das Verstreichen der Zeit und damit auch der Neben- und Nachwirkungen der operativen und der adjuvanten Therapien sind auch nicht zu vernachlässigen. Das Alter, das Vorliegen einer F-Diagnose, psychosoziale Belastungen, die Art der Krankheitsbewältigung, die jeweils erhaltene Therapie sowie persönliche Ressourcen wurden als Einflussfaktoren auf die Lebensqualität identifiziert. Unabhängiger wichtigster Vorhersagewert der Lebensqualität nach 6 Monaten war die Ausgangslebensqualität. Außerdem waren jüngere Patientinnen initial psychisch belasteter als ältere. Die untersuchten Mammakarzinompatientinnen erreichten eine geringere gesundheitsbezogene Lebensqualität im Vergleich zu Frauen der gesunden deutschen Normalbevölkerung. Die einheitliche Schaffung eines strukturierten und qualitätsgesicherten Angebotes für eine psychoonkologische Betreuung inklusive Screening psychischer Belastungen für Mammakarzinompatientinnen in den Brustzentren wäre hilfreich, um die gesundheitsbezogene Lebensqualität zu verbessern und psychischen Disstress zu reduzieren. Weitere Untersuchungen im Zeitverlauf und im Vergleich zu Kontrollgruppen zur Wirksamkeit psychoonkologischer Interventionen und deren Einfluss auf Lebensqualität und psychische Belastungen sind wünschenswert.
12

Perfil epidemiológico de mulheres com câncer de colo do útero atendidas em um hospital do interior paulista / Epidemiological profile of women with cervical cancer treated at a hospital in the interior of São Paulo State

Favaro, Caroline Ribeiro Pereira 17 February 2017 (has links)
O câncer de colo do útero (CCU) é considerado problema de saúde pública no Brasil, por exercer papel importante na morbimortalidade das mulheres. Os principais fatores de risco para o desenvolvimento do CCU estão relacionados às condições socioeconômicas, ambientais e aos hábitos de vida, que incluem: início precoce da atividade sexual, pluralidade de parceiros sexuais, tabagismo, hábitos inadequados de higiene, uso prolongado de contraceptivos orais e a não-realização de exame preventivo de citologia oncótica. A infecção pelo papiloma vírus humano (HPV) leva a alterações que podem, com o passar do tempo, evoluir para o CCU. Este estudo teve como objetivo caracterizar o perfil epidemiológico das mulheres com CCU atendidas no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, da Universidade de São Paulo (HCFMRP-USP), no período de janeiro de 2000 a dezembro de 2013. Trata-se de um estudo retrospectivo, longitudinal e baseado em dados do Registro Hospitalar de Câncer (RHC). O RHC é um banco de dados que fornece informações às organizações nacionais, caracterizando os diversos tipos de câncer, auxiliando na formulação da Política Nacional de Atenção Oncológica. Foram analisados os dados de 906 mulheres entre 18 e 95 anos e a faixa etária predominante foi de 31 a 60 anos (58,9%); 10,81% eram analfabetas e 68,6% possuíam ensino fundamental. O tipo celular mais incidente (40,8%) foi o carcinoma escamocelular e o estádio clínico 0 foi o mais observado (39,6%). Quanto à procedência, observou-se que 86,1% das mulheres eram da Divisão Regional de Saúde-XIII, à qual pertence a cidade de Ribeirão Preto (40,55%). O cruzamento entre escolaridade e estadiamento clínico apontou que, no estádio 0, dos 39,62% dos casos, 34,76% possuíam ensino fundamental ou médio, o que demonstrou influência da escolaridade na detecção do CCU em estádio inicial. Os casos diagnosticados em estádios avançados (III e IV) foram responsáveis pelo maior número de óbitos, sendo que, das 145 mulheres em estádio III, 87 foram a óbito e, das 80 mulheres diagnosticadas em estádio IV, 67 faleceram, enquanto, das 359 mulheres em estádio 0, apenas 14 foram a óbito. No presente estudo, a sobrevida em cinco anos para as mulheres acometidas pelo CCU foi de 56,5%. Os resultados alcançados corroboram com os encontrados nas produções científicas atuais, demonstrando a importância do rastreamento e diagnóstico precoce, a fim de diminuir a mortalidade causada pelo CCU em estádios avançados. Também apontam a necessidade de ações de educação em saúde como um meio para a prevenção do CCU. Ações educativas e preventivas devem ser desenvolvidas de forma contínua na vida das mulheres e o enfermeiro, como membro da equipe de saúde, tem papel fundamental, informando as mulheres quanto às medidas de prevenção da doença e a importância do rastreamento, desmistificando culturas enraizadas e também conscientizando essas mulheres sobre o seu papel de sujeitos responsáveis por sua saúde / Cervical cancer (UCC) is considered a public health problem in Brazil, since it plays an important role in the morbidity and mortality of women. The main risk factors for UCC development are related to socioeconomic, environmental and lifestyle conditions, which include: early sexual initiation, plurality of sexual partners, smoking, inadequate hygiene habits, prolonged use of oral contraceptives and The non-accomplishment of preventive examination of oncotic cytology. Infection caused by human papillomavirus (HPV) leads to changes that may, over time, progress to UCC. The objective of this study was to characterize the epidemiological profile of women with UCC treated at the Hospital das Clínicas of the Medical School of Ribeirão Preto, University of São Paulo (HCFMRP-USP), from January 2000 to December 2013. This is a retrospective longitudinal study based on data from the Hospital Registry of Cancer (RHC). The RHC is a database that provides information to national organizations, characterizing the different types of cancer, helping in the formulation of the National Cancer Care Policy. Data from 906 women between 18 and 95 years of age were analyzed, and the predominant age group was 31 to 60 years (58.9%); 10.81% were illiterate and 68.6% had primary education. The most incident cell type (40.8%) was squamous cell carcinoma and clinical stage 0 was the most observed (39.6%). Regarding the origin, it was observed that 86.1% of the women were from the Regional Health Division- XIII, to which the city of Ribeirão Preto belongs (40.55%). The intersection between schooling and clinical staging showed that, in stage 0, of the 39.62% of the cases, 34.76% had primary or secondary education, which demonstrated the influence of schooling in the detection of UCC in the initial stage. The cases diagnosed in advanced stages (III and IV) were responsible for the highest number of deaths, and, of the 145 women in stage III, 87 died, and, of the 80 women diagnosed in stage IV, 67 died, while, of 359 women in stage 0, only 14 died. In the present study, the five-year survival rate for women with UCC was 56.5%. The results obtained corroborate with those found in current scientific production, demonstrating the importance of screening and early diagnosis, in order to reduce the mortality caused by UCC in advanced stages. They also point out the need of health education actions as a means to prevent UCC. Educational and preventive actions should be continuously developed in the lives of women and the nurse, as a member of the health team, plays a fundamental role, informing women about the disease prevention measures and the importance of screening, demystifying rooted cultures and also making these women aware of their role as responsible subjects for their health
13

Ethical reasoning among experienced registered nurses in relation to communication with severely ill patients disclosing personal knowledge

Jansson, Lilian January 1993 (has links)
Personal knowledge was disclosed amongst a group of experienced registered nurses in relation to feeding severely ill patients with cancer and dementia (I,II,III), communicating with severely demented patients (IV,V), and receiving group supervision (VI). Principled ethics did not seem an adequate model for describing the ethical reasoning of experienced RNs. For the twenty RNs working in oncological care the question of whether or not to accept active euthanasia was the most urgent. The twenty RNs working in dementia care emphasized the difficulty they had in understanding the meaning of communicative cues in severely demented patients. Both groups of nurses saw themselves as advocates for their patients and seemed to reason mainly in accordance with the Golden Rule. Through a phenomenological hermeneutic analysis of video recordings of two RNs' interaction with each of four severely demented patients, it was possible to interpret the patients' vague and unclear communicative cues. But observations based on an assessment of facial muscle movements showed that it was very difficult (the FACS). Group supervision based on a narrative framework was carried out in order to support nurses working in dementia care. Interviews with the fifteen RNs showed that they experienced recognition and reassurance of worth, an increased repertoire of actions, gained new perspectives, an increased awareness of their professional role, and interdependence. It is proposed that the care of severely ill patients can be improved by the use of a narrative approach both as regards understanding patients and encouraging RNs to develop their clinical knowledge through reflecting on their own and their coworkers' narrations about care. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1993, härtill 6 uppsatser.</p> / digitalisering@umu
14

Distress, Emotional reactivity and Fatigue following Breast Cancer : A Theoretical Approach and a Randomised Intervention Study

Rissanen, Ritva January 2014 (has links)
Aim: Overall aims were to evaluate a stress management intervention with a stepped care approach among women with breast cancer and to explore distress, emotional reactivity and fatigue, both using a theoretical approach and self-reported assessment. Methods: A total of 821 women were approached, 372 women rejected participation, 23 women failed to return the questionnaire and one died, hence, 425 patients (52%) accepted participation. Study I evaluated the cognitive processing model with the aid of an untreated patient group, including 189 women according to the main study protocol. Sixty-six of these women were ineligible for the intervention, as they did not report clinical levels of distress. The remaining 123 women were eligible but they declined participation. Study II explored the validation of the ELSS and emotional reactivity among women with breast cancer. The population comprised of all 425 women (breast cancer sample) and 176 women randomly selected from the PAR register (random women sample). Studies III and IV evaluated the intervention and included all 425 women. Main findings: Study I: avoidance does not mediate the relationship between intrusion and later psychological distress in an early stage breast cancer population. Study II: the ELSS has acceptable validity and reliability. The factor structure of the ELSS was similar in both samples and correlated well with the STAQ (gold standard). Younger age was the only variable associated with emotional reactivity at the start of curative treatment. Studies III and IV: a stepped care approach did not reduce the number of women who require a more extensive treatment at three-months post-diagnosis. Both intervention groups (group/individual) reduced their levels of distress, but there were no significant differences between them. Only about half of the women who were randomised in the second step of the intervention accepted participation. Conclusions: The present thesis provides information regarding distress, emotional reactivity and fatigue among women with breast cancer. A majority of women with early stage breast cancer seem to process the trauma of a cancer diagnosis in a satisfactory way but may experience some emotional reactivity, and younger women may experience more emotional distress. The results also highlight the need for validated measures and carefully planned psychosocial interventions.
15

Artumo reikšmė vertybių kaitai onkologinės ligos patyrimo metu / The meaning of closeness for the changing values in patients‘ suffering from oncological illnesses

Višinskytė, Asta 24 July 2014 (has links)
Darbo tikslas buvo: sukurti grindžiamąją teoriją, kuri atskleistų pagrindinį gyvenimo konsteksto rūpestį ir kokią reikšmę jis turi vertybių kaitai vėžio ligos patyrimo metu. Tikslui pasiekti iškelti darbo uždaviniai: 1. Atskleisti pagrindinį gyvenimo konteksto rūpestį, išryškėjantį onkologinės ligos patyrimo metu; 2. Įvardinti esminę kategoriją, pagrindines subkategorijas ir kategorijas, paaiškinančias išryškėjusio pagrindinio gyvenimo konteksto rūpesčio reikšmę vertybių kaitai onkologinės ligos patyrimo metu; 3. Palyginti žmonių, kurių artimasis sirgo/serga onkologine liga, ir žmonių, kurie patys sirgo/serga onkologine liga, gautus rezultatus; 4. Išnagrinėti onkologine liga sirgusių/sergančių žmonių galimas vertybių ir Havighurst asmenybės raidos teorijos akcentuojamų raidos užduočių sąsajas. Tyrimo duomenims surinkti buvo naudotas pusiau struktūruotas interviu su šešiais žmonėmis, kurių artimasis serga/sirgo onkologine liga, kalbėta apie artimųjų patirtį, ir su keturiais žmonėmis, kurie patys serga/sirgo onkologine liga. Analizuojant tyrimo duomenis, buvo remiamasi autorių Straus ir Corbin grindžiamiosios teorijos duomenų analizės principais. Tyrime išryškėjo pagrindinis gyvenimo konteksto rūpestis – artumas. Individualių interviu metu su šešiais respondentais, kurie pasakojo apie savo artimo žmogaus onkologinės ligos patirtį, išryškėjo su artumu susijusios pagrindinės penkios gyvenimo konteksto sritys: santykis su šeima, socialiniai santykiai, laisvalaikis, asmeninės... [toliau žr. visą tekstą] / The aim of this thesis: to develop a grounded theory to reveal the main concern in life context and the role it plays in the changing values suffering from oncological disease. The following tasks were identified: 1. To reveal the main concern in life context which elucidates in suffering from oncological disease; 2. To name the fundamental category, main sub-categories and categories explaining the significance of the main concern in life context for the changing values in suffering from oncological disease; 3. To compare the results of people who have / had relatives with oncological disease and people who themselves had an oncological disease; 4. To analyse potential links between the values of people who have / had an oncological disease and developmental tasks emphasised in the Havighurst‘s theory of personality development. The data for the research was collected by a partially structured interview with six people who are relatives of current or former cancer patients by speaking about the experience of their close ones and with four people who themselves had an oncological disease. The principles of Strauss and Corbin ground theory analysis were used to analyse the research data. The main concern in life that is closeness became apparent whilst suffering from oncological disease. The individual interviews with six respondents who shared the experience of an oncological disease of their close ones revealed five main categories in life context related with closeness:... [to full text]
16

Perceptions of pain intensity, site and relief a comparative study of cancer patients and their nurses : a research report submitted in partial fulfillment ... /

McCarthy, Megan L. January 1985 (has links)
Thesis (M.S.)--University of Michigan, 1985.
17

Perceptions of pain intensity, site and relief a comparative study of cancer patients and their nurses : a research report submitted in partial fulfillment ... /

McCarthy, Megan L. January 1985 (has links)
Thesis (M.S.)--University of Michigan, 1985.
18

Perfil epidemiológico de mulheres com câncer de colo do útero atendidas em um hospital do interior paulista / Epidemiological profile of women with cervical cancer treated at a hospital in the interior of São Paulo State

Caroline Ribeiro Pereira Favaro 17 February 2017 (has links)
O câncer de colo do útero (CCU) é considerado problema de saúde pública no Brasil, por exercer papel importante na morbimortalidade das mulheres. Os principais fatores de risco para o desenvolvimento do CCU estão relacionados às condições socioeconômicas, ambientais e aos hábitos de vida, que incluem: início precoce da atividade sexual, pluralidade de parceiros sexuais, tabagismo, hábitos inadequados de higiene, uso prolongado de contraceptivos orais e a não-realização de exame preventivo de citologia oncótica. A infecção pelo papiloma vírus humano (HPV) leva a alterações que podem, com o passar do tempo, evoluir para o CCU. Este estudo teve como objetivo caracterizar o perfil epidemiológico das mulheres com CCU atendidas no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, da Universidade de São Paulo (HCFMRP-USP), no período de janeiro de 2000 a dezembro de 2013. Trata-se de um estudo retrospectivo, longitudinal e baseado em dados do Registro Hospitalar de Câncer (RHC). O RHC é um banco de dados que fornece informações às organizações nacionais, caracterizando os diversos tipos de câncer, auxiliando na formulação da Política Nacional de Atenção Oncológica. Foram analisados os dados de 906 mulheres entre 18 e 95 anos e a faixa etária predominante foi de 31 a 60 anos (58,9%); 10,81% eram analfabetas e 68,6% possuíam ensino fundamental. O tipo celular mais incidente (40,8%) foi o carcinoma escamocelular e o estádio clínico 0 foi o mais observado (39,6%). Quanto à procedência, observou-se que 86,1% das mulheres eram da Divisão Regional de Saúde-XIII, à qual pertence a cidade de Ribeirão Preto (40,55%). O cruzamento entre escolaridade e estadiamento clínico apontou que, no estádio 0, dos 39,62% dos casos, 34,76% possuíam ensino fundamental ou médio, o que demonstrou influência da escolaridade na detecção do CCU em estádio inicial. Os casos diagnosticados em estádios avançados (III e IV) foram responsáveis pelo maior número de óbitos, sendo que, das 145 mulheres em estádio III, 87 foram a óbito e, das 80 mulheres diagnosticadas em estádio IV, 67 faleceram, enquanto, das 359 mulheres em estádio 0, apenas 14 foram a óbito. No presente estudo, a sobrevida em cinco anos para as mulheres acometidas pelo CCU foi de 56,5%. Os resultados alcançados corroboram com os encontrados nas produções científicas atuais, demonstrando a importância do rastreamento e diagnóstico precoce, a fim de diminuir a mortalidade causada pelo CCU em estádios avançados. Também apontam a necessidade de ações de educação em saúde como um meio para a prevenção do CCU. Ações educativas e preventivas devem ser desenvolvidas de forma contínua na vida das mulheres e o enfermeiro, como membro da equipe de saúde, tem papel fundamental, informando as mulheres quanto às medidas de prevenção da doença e a importância do rastreamento, desmistificando culturas enraizadas e também conscientizando essas mulheres sobre o seu papel de sujeitos responsáveis por sua saúde / Cervical cancer (UCC) is considered a public health problem in Brazil, since it plays an important role in the morbidity and mortality of women. The main risk factors for UCC development are related to socioeconomic, environmental and lifestyle conditions, which include: early sexual initiation, plurality of sexual partners, smoking, inadequate hygiene habits, prolonged use of oral contraceptives and The non-accomplishment of preventive examination of oncotic cytology. Infection caused by human papillomavirus (HPV) leads to changes that may, over time, progress to UCC. The objective of this study was to characterize the epidemiological profile of women with UCC treated at the Hospital das Clínicas of the Medical School of Ribeirão Preto, University of São Paulo (HCFMRP-USP), from January 2000 to December 2013. This is a retrospective longitudinal study based on data from the Hospital Registry of Cancer (RHC). The RHC is a database that provides information to national organizations, characterizing the different types of cancer, helping in the formulation of the National Cancer Care Policy. Data from 906 women between 18 and 95 years of age were analyzed, and the predominant age group was 31 to 60 years (58.9%); 10.81% were illiterate and 68.6% had primary education. The most incident cell type (40.8%) was squamous cell carcinoma and clinical stage 0 was the most observed (39.6%). Regarding the origin, it was observed that 86.1% of the women were from the Regional Health Division- XIII, to which the city of Ribeirão Preto belongs (40.55%). The intersection between schooling and clinical staging showed that, in stage 0, of the 39.62% of the cases, 34.76% had primary or secondary education, which demonstrated the influence of schooling in the detection of UCC in the initial stage. The cases diagnosed in advanced stages (III and IV) were responsible for the highest number of deaths, and, of the 145 women in stage III, 87 died, and, of the 80 women diagnosed in stage IV, 67 died, while, of 359 women in stage 0, only 14 died. In the present study, the five-year survival rate for women with UCC was 56.5%. The results obtained corroborate with those found in current scientific production, demonstrating the importance of screening and early diagnosis, in order to reduce the mortality caused by UCC in advanced stages. They also point out the need of health education actions as a means to prevent UCC. Educational and preventive actions should be continuously developed in the lives of women and the nurse, as a member of the health team, plays a fundamental role, informing women about the disease prevention measures and the importance of screening, demystifying rooted cultures and also making these women aware of their role as responsible subjects for their health
19

Sendo familiar de pessoa em tratamento de câncer

Esteves, Júlia de Almeida 14 December 2016 (has links)
Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-07-11T19:36:35Z No. of bitstreams: 1 juliadealmeidaesteves.pdf: 1079418 bytes, checksum: c79ca18054c0d228f181db182ae70af3 (MD5) / Rejected by Adriana Oliveira (adriana.oliveira@ufjf.edu.br), reason: Tirar hífen do título on 2017-08-08T15:41:08Z (GMT) / Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-08-08T15:51:37Z No. of bitstreams: 1 juliadealmeidaesteves.pdf: 1079418 bytes, checksum: c79ca18054c0d228f181db182ae70af3 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-09T11:49:10Z (GMT) No. of bitstreams: 1 juliadealmeidaesteves.pdf: 1079418 bytes, checksum: c79ca18054c0d228f181db182ae70af3 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-09T11:49:47Z (GMT) No. of bitstreams: 1 juliadealmeidaesteves.pdf: 1079418 bytes, checksum: c79ca18054c0d228f181db182ae70af3 (MD5) / Made available in DSpace on 2017-08-09T11:49:47Z (GMT). No. of bitstreams: 1 juliadealmeidaesteves.pdf: 1079418 bytes, checksum: c79ca18054c0d228f181db182ae70af3 (MD5) Previous issue date: 2016-12-14 / O câncer é um grave problema de saúde pública no Brasil e no mundo, por sua alta incidência, mortalidade e por comprometer a saúde e a qualidade de vida do ser humano, ocupando o segundo lugar nas causas de morte por doença no país, segundo o Sistema de Informação sobre Mortalidade (SIM). Este estudo se propôs a responder à questão norteadora: Como é para o familiar vivenciar o processo do tratamento de pessoa próxima contra o câncer? Objetivou-se desvelar o ser-aífamiliar de pessoa em tratamento de câncer. A pesquisa, de natureza qualitativa, foi norteada pela fenomenologia, alicerçada no pensamento teórico-metodológico e filosófico de Martin Heidegger. Foram participantes, dezesseis familiares, entrevistados em encontros mediados pela empatia e redução de pressupostos, ocorridos entre os meses de setembro e dezembro de 2015. A compreensão vaga e mediana permitiu a elaboração do fio condutor de análise. A hermenêutica possibilitou a interpretação do ser-aí-familiar-de-pessoa-em-tratamento-de-câncer que se mostrou imersa na cotidianidade, agindo na impessoalidade, impropriedade e inautenticidade. Não se compreende como um ser de possibilidades, posto que se mostra no modo do falatório, ambiguidade, curiosidade, decadência e ocupação do estado de saúde do outro. Revela que o familiar cuida da pessoa em tratamento de câncer, mas se esquece de cuidar de si mesmo apresentando problemas psicológicos, emocionais e até mesmo de saúde, decorrentes da sobrecarga do acompanhando de seu familiar em tratamento. Ocupam-se da vida e do estado de saúde do outro, colocando essa como sua prioridade no momento. Percebe-se a fragilidade do familiar em lidar com a situação de doença do outro. Assim, uma abordagem multiprofissional para atender as demandas do familiar, por meio do cuidado psicológico, social, assistência e orientação sobre a situação do outro, se mostra necessária. A partir dos sentidos desvelados nessa pesquisa, evidencia-se a importância de se discutir um novo modo de cuidado autêntico a esse familiar que acompanha a pessoa em tratamento de câncer. Pois, o mesmo se mostrou deficiente ou inexistente pela equipe de saúde. Os familiares necessitam de acompanhamento para exercer os cuidados ao outro e para cuidarem de si de maneira autentica. / Cancer is a serious public health problem in Brazil and the world, due to its high incidence, mortality and by compromising health and quality of life of the human being, occupying second place in causes of death by disease in the country, according to the Mortality Information System (MIS). This study aims to answer the guiding question: How is it for the family member to experience the treatment process of a person close against cancer? The aim was to unveil the being-familiar of person in cancer treatment. The research, of a qualitative nature, was guided by phenomenology, based on theoretical-methodological and philosophical thinking of Martin Heidegger. Sixteen family members were enrolled in the study, interviewed in meetings mediated by empathy and reduction of assumptions, occurring between the months of September and December of 2015. The vague and medium understanding allowed the elaboration of conducting wire of analysis. Hermeneutics enabled the interpretation of being-familiar-of-person-in-treatment-of-cancer, who was immersed in everyday life, acting in impersonality, impropriety and inauthenticity. It is not understood as a being of possibilities, since it is shown in speech mode, ambiguity, curiosity, decadence and occupation of the state of health of the other. It reveals that the family cares for the person in cancer treatment, but he forgets to take care of himself presenting psychological problems, emotional and even health, due to the overload of the follow-up of their family member under treatment. They deal with the life and state of health of the other, putting this as your priority at the moment. One perceives the fragility of the relative in dealing with the illness situation of the other. Thus, a multiprofessional approach to meet the demands of the family, through psychological, social, assistance and guidance on the situation of the other, it proves necessary. From the senses unveiled in this research, evidence of the importance of discussing a new format of authentic care to this familiar which accompanies the person in cancer treatment. Because the same was shown deficient or non-existent by the health team. Family members need follow-up to exercise care for the other and to take care of themselves authentically and individually.
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Epidémiologie clinique des tumeurs primitives du système nerveux central et en particulier des gliomes / Clinical epidemiology of primary tumors of the central nervous system and gliomas specifically

Zouaoui, Sonia 16 February 2015 (has links)
Les gliomes ont des conséquences dévastatrices. La morbidité et la mortalité sont élevées. Les gliomes représentent un groupe hétérogène complexe d'entités pathologiques et aucune cause n'a été identifiée pour la majorité des gliomes. Les données épidémiologiques varient d'une étude à l'autre. Le nombre de chaque sous-type histologique est trop petit, même pour un grand centre de neurochirurgie, pour permettre une bonne recherche sur chaque sous-type de gliome. Les spécificités oncologiques et cliniques (épilepsie, troubles cognitifs, troubles moteurs, etc.) nécessitent une prise en charge et une analyse spécifique. De plus, il est important de recueillir et d'enregistrer tous les nouveaux cas et le suivi sur une grande région ou un pays entier pour permettre des études fondamentales et cliniques de qualité. En effet, les études en population sont la seule façon de connaitre l'impact en pratique des différentes thérapeutiques effectuées. Les sociétés françaises impliquées en neuro-oncologie (Société Française de Neurochirurgie, Société Française de Neuropathologie, Association des Neuro-Oncologues d'Expression Française) ont récemment créé le Recensement national histologique des tumeurs primitives du système nerveux central (RnhTPSNC) ou French Brain Tumor DataBase (FBTDB) en anglais. L'objectif principal du RnhTPSNC est d'enregistrer de manière prospective tous les cas incidents de tumeur primitive du système nerveux central (TPSNC), en France, pour lesquels le diagnostic histologique est confirmé (1-3). Les objectifs à long terme du RnhTPSNC sont de créer un registre histologique et un réseau national pour : (1) réaliser des études épidémiologiques, (2) mettre en place une base de données pour favoriser toute étude clinique ou fondamentale à grande échelle, (3) permettre l'évaluation des pratiques médicales d'une région ou du pays tout entier, (4) harmoniser et optimiser la prise en charge médicale des patients atteints de TPSNC. La présente étudiante en thèse, Sonia Zouaoui, concentrera son travail sur les gliomes. D'abord, elle devra recueillir les données des patients, puis analyser les facteurs pronostiques, la survie et les prises en charges oncologiques. Deuxièmement, elle participera à l'étude de la répartition géographique des principaux types de gliomes et à la recherche de facteurs de causaux. Troisièmement, elle procédera à un inventaire du matériel cryopréservé disponible pour la réalisation d'études translationnelles. / Gliomas have devastating consequences. Morbidity and mortality are high. Gliomas represent a complex heterogeneous group of pathologic entities and no underlying cause has been identified for the majority of them. Epidemiologic data vary from study to study. The number of each histological subtype is too small, even for a big neurosurgical center, to allow a good research on each subtype of glioma. Oncological and clinical specificities (epilepsy, cognitive disorders, motor impairments, etc) require a specific care and analysis. Indeed, we need to collect and record all new cases and follow up in large area, to allow good basic and clinical studies. Furthermore, population study is the only way to know what clinicians do to the patients, and make possible evaluating the medical care. The French societies involved in Neuro-Oncology (Société Française de Neurochirurgie, Société Française de Neuropathologie, Association des Neuro-Oncologues d'Expression Française) have recently created the French Brain Tumor DataBase (FBTDB). The main objective of the FBTDB is to prospectively record all primary central nervous system tumors (PCNST), in France, for which histological diagnosis is available (1-3). The long-term goals of the FBTDB are to create a histological national registry and a national network to (1) perform epidemiological studies, (2) implement a new database and use it for setting up both clinical and basic research protocols, (3) allow the evaluation of the medical practices of an area or of the entire country, and (4) harmonize the healthcare of patients affected by PCNST at the higher level. The present PhD student, Sonia Zouaoui, will focus her work on gliomas. First, she will collect data, and will analyze prognostic factors, survival and oncological patterns of care for patients with newly diagnosed glioma in France. Secondly, she will participate in the study of geographical distribution of the main types of glioma and in search of causal factors. Thirdly, she will conduct an inventory of cryopreserved material available for translational research.

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