• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 211
  • 107
  • 37
  • 15
  • 11
  • 9
  • 6
  • 5
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • 3
  • Tagged with
  • 455
  • 455
  • 420
  • 419
  • 190
  • 190
  • 181
  • 176
  • 97
  • 76
  • 62
  • 41
  • 41
  • 38
  • 38
  • 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.
331

Efeitos do alongamento da musculatura respiratória com a técnica de alongamento passivo e contração-relaxamento na mecânica ventilatória e capacidade funcional de pacientes com doença pulmonar obstrutiva crônica / Effects of respiratory muscle stretching with passive and hold-relax techniques on ventilatory mechanics and functional capacity in patients with chronic obstructive pulmonary disease

Juliano Takashi Wada 13 February 2015 (has links)
Os pacientes com doença pulmonar obstrutiva crônica (DPOC), devido à obstrução brônquica e redução da retração elástica pulmonar apresentam o aumento do recrutamento da musculatura respiratória, predispondo à incoordenação toracoabdominal, aumentando o trabalho respiratório, provocando fadiga e dispnéia. O alongamento dos músculos respiratórios (AMR) poderia diminuir a atividade muscular, melhorar a sua capacidade contrátil e a mobilidade da caixa torácica otimizando a ventilação pulmonar, entretanto, estes efeitos nos músculos respiratórios permanecem desconhecidos. Objetivo: Avaliar os efeitos da adição do AMR associados à reabilitação pulmonar na mecânica ventilatória, na capacidade funcional e na atividade muscular em pacientes com DPOC. Método: Estudo randomizado e controlado incluiu 30 pacientes com DPOC que foram distribuídos aleatoriamente para os grupos: tratado (GT, n = 15) e controle (GC, n = 15). Todos os pacientes foram submetidos a 24 sessões de treinamento aeróbico duas vezes por semana. Além disso, o GT recebeu AMR e o GC recebeu o alongamento dos membros superiores e inferiores, antes dos exercícios aeróbicos. Foram avaliados: teste da capacidade funcional (teste de caminhada de 6 minutos, TC6), mecânica toracoabdominal (pletismografia optoeletrônica, POE) e atividade muscular respiratória (eletromiografia de superfície, EMG) durante o exercício. Os dados representam a variação (delta)=pós- - pré-avaliação, foi utilizado o teste t para comparar os grupos e o nível de significância foi fixado em 5%. Resultados: O GT apresentou o aumento da capacidade funcional (25,14m +) com a redução da sensação de dispneia após o TC6 (p < 0,01), quando comparado ao GC. Provavelmente está relacionado com a melhora do volume da caixa torácica (p < 0,01), capacidade ventilatória (p < 0,01) com o aumento do volume e da contribuição do compartimento abdominal (p < 0,01). Observamos também no GT a redução da atividade muscular (p < 0,01) com maior eficiência ventilatória (p < 0,006). Conclusão: Nossos resultados sugerem que a adição do AMR no treinamento aeróbio aumenta a capacidade funcional com diminuição da dispneia, melhora a eficácia da contração muscular e da capacidade ventilatória devido à maior participação do compartimento abdominal em pacientes com DPOC / Chronic obstructive pulmonary disease (COPD) patients due to bronchial obstruction and reduced lung elastic recoil present increased in the recruitment of respiratory muscles, predisposing an thoracoabdominal incoordination, major breathing work, causing fatigue and dyspnea. The respiratory muscles stretching (RMS) could decrease the muscle activity and improve their contractile capacity, chest wall mobility and optimize the pulmonary ventilation, however, this effect remains unknown. Objective: To evaluate the effects of adding the RMS associated with pulmonary rehabilitation in ventilatory mechanics, functional capacity and muscle activity in patients with COPD. Method: Randomized and controlled trial, enrolled 30 COPD patients who were randomly allocated into treatment (TG, n = 15) and control (CG, n = 15) groups. All patients underwent 24 sessions of aerobic training twice a week. In Addition, TG received RMS and CG received upper and lower limb stretching before aerobic exercises. Were evaluated: functional capacity (6-minute walking distance test, 6MWDT), thoracoabdominal mechanics (optoelectronic plethysmography, OEP) and respiratory muscle activity (surface electromyography, EMG) during exercise. The data represents the change (delta) = post- - pre-evaluation, a t-test was used to compare the groups, and the significance level was set at 5%. Results: TG showed improvement in the functional capacity (25,14m +) with decrease of the dyspnea sensation after the 6MWDT (p < 0.01), compared with CG. Probably is related with increased of chest wall volume (p < 0.01), ventilatory capacity (p < 0.01), volume and the contribution of the abdominal compartment (p < 0.01). We also observed in the TG, a reduction of respiratory muscle activity (p < 0,01) and the ratio between volume displaced (p < 0,006). Conclusion: Our results suggest that the addition of RMS to aerobic training increases the functional capacity with dyspnea reduction, improvement of efficacy of respiratory muscle contraction and ventilatory capacity due to higher participation of the abdominal compartment in patients with COPD
332

Estudo do padrão respiratório, movimentação toracoabdominal e ventilação em pacientes portadores de doença pulmonar obstrutiva crônica durante respiração diafragmática / Study of respiratory pattern, thoracoabdominal motion and ventilation in patients with chronic obstructive pulmonary disease during diaphragmatic breathing

Marcelo Fernandes 11 January 2008 (has links)
Introdução: A respiração diafragmática (RD) é uma técnica que integra um conjunto de ações de auto-cuidado no programa de reabilitação pulmonar com objetivo de melhorar a mecânica ventilatória e reduzir a dispnéia em pacientes com doença pulmonar obstrutiva crônica (DPOC). No entanto, questiona-se sua indicação e seus efeitos. Nesse contexto avaliamos o efeito da RD no padrão respiratório, movimento toracoabdominal e ventilação em pacientes com DPOC. Método: Foram estudados 44 indivíduos entre 45 e 75 anos conforme o grau de obstrução da via aérea (VEF1), divididos em grupos controle, DPOC moderado e DPOC grave. Avaliou-se padrão respiratório, movimento toracoabdominal e ventilação por meio de sistemas de pletismografia respiratória por indutância (Respitrace) e análise metabólica de gases (MGC) durante 10 minutos. Após quatro minutos de respiração tranqüila os indivíduos realizavam dois minutos de respiração diafragmática e novamente, quatro de respiração tranqüila. Dispnéia foi avaliada antes, durante e após a RD (escala de Borg modificada). Mobilidade diafragmática foi avaliada utilizando radiografias de tórax. Resultados: Verificou-se aumento do volume corrente e redução da freqüência respiratória durante a RD a partir da elevação do fluxo inspiratório médio e do tempo inspiratório. Houve maior participação do compartimento abdominal com o grupo moderado apresentando incoordenação. A ventilação pulmonar se elevou em associação à redução na ventilação em espaço morto, no equivalente ventilatório para o gás carbônico, e elevação da saturação periférica de oxigênio. Mobilidade diafragmática, ausência de dispnéia, menor grau de hipoxemia e movimento toracoabdominal coordenado associaram-se ao melhor desempenho da RD. Conclusões: A respiração diafragmática é capaz de promover melhora no padrão respiratório e eficiência ventilatória sem conduzir a dispnéia naqueles pacientes com sistema muscular respiratório preservado. / Introduction: Diaphragmatic breathing (DB) is a technique which is part of a set of self-care actions in the lung rehabilitation program for the purpose of improving the ventilatory mechanical and reducing dyspnea. There are doubts, however, as to its effects and recommended use. In this context we assessed the effect of the DB on respiratory pattern, thoracoabdominal motion and ventilation in patients with chronic pulmonary obstructive disease (COPD). Method: Forty-four subjects aged between 45 and 75 years were studied according to the degree of obstruction of the airway (FEV1). This group was subdivided into three: a control group and two others, respectively, of moderate and severe COPD. Their breathing pattern, thoracoabdominal motion and ventilation by means of respiratory inductive plethysmograph (Respitrace) and metabolic analysis of gases (MGC) systems were assessed during ten minutes. After four minutes of quiet breathing, the subjects would perform two minutes of the DB and four other minutes of quiet breathing. Dyspnea was assessed before, during and after diaphragmatic breathing (modified Borg scale). Diaphragmatic mobility was assessed by thoracic radiography. Results: An increase in tidal volume and a reduction in breathing frequency were found during DB as from the rise in mean inspiratory flow and inspiratory time. There was greater participation of the abdominal compartment with the moderate group presenting asynchronous motion. The pulmonary ventilation increased together with the reduction of the ventilation in the dead space and of the ventilatory equivalent for carbonic gas, with the increase in arterial oxygen saturation. Diaphragmatic mobility, absence of dyspnea, minor degree of hypoxemia and coordinated thoracoabdominal motion were associated with the better DB performance. Conclusions: Diaphragmatic breathing is capable of promoting an improvement in the breathing pattern and ventilatory efficiency without provoking dyspnea in patients whose muscular respiratory system has been preserved.
333

Impact des cytokines de la famille IL-20 sur l’épithélium respiratoire en conditions infectieuses et dans un contexte de broncho-pneumopathie chronique obstructive / Impact of IL-20 family cytokines on respiratory epithelium in infectious conditions and in the context of Chronic Obstructive Pulmonary Disease

Barada, Olivia 25 October 2018 (has links)
La Broncho-Pneumopathie Chronique Obstructive (BPCO) est une maladie pulmonaire inflammatoire consécutive à l'exposition chronique à la pollution atmosphérique et surtout au tabagisme dans environ 90% des cas. Cette maladie se caractérise par une obstruction des bronches due à une hypersécrétion de mucus, une hypertrophie des muscles lisses, ainsi qu’une destruction de la paroi des alvéoles respiratoires amenant le patient à l’emphysème. Le stress induit par la fumée de cigarette provoque une activation de la barrière épithéliale pulmonaire associée à une altération de la réponse immunitaire responsable d’une susceptibilité accrue aux infections pulmonaires. De ce fait, les patients atteints de cette maladie développent des exacerbations principalement liées à ces infections bactériennes en particulier à Non-Typable Haemophilus influenza (NTHi) et Streptoccocus pneumoniae (Sp).La cytokine IL-22 est un acteur très important des défenses antibactériennes et du maintien de la barrière épithéliale. Cette cytokine appartient à la grande famille de l’IL-10, et à la sous-famille des cytokines IL-20 composée de l’IL-19, l’IL-20 et l’IL-24. L’IL-22 se lie au récepteur formé par les sous-unités IL-10Rb et IL-22Ra, tandis que les cytokines IL-19, IL-20 et IL-24 utilisent deux récepteurs associant l’IL-20Rb avec l’IL-20Ra ou l’IL-22Ra. Il a été démontré que les cytokines de la famille IL-20 (IL-19, IL-20, IL-24) agissent sur la clairance bactérienne au cours d’une infection cutanée par Staphylococcus aureus (Myles et al., 2013), en inhibant la production des cytokines IL-17 et IL-22. De plus, des précédents travaux au laboratoire, ont montré un défaut de l’expression des cytokines IL-17 et IL-22 qui participaient à la susceptibilité à l’infection chez les souris atteintes de BPCO (Pichavant et al., 2015). Enfin, nos données actuelles montrent que l'exposition à la fumée de cigarette augmente l'expression des cytokines de la famille IL-20 et que l'inhibition de cette voie permet de bloquer le développement d'épisodes d'exacerbation chez des souris BPCO.L'objectif de cette thèse est de préciser le rôle des cytokines IL-20 dans la réponse à l'infection bactérienne (Sp, NTHi) tant dans un contexte physiologique qu'au cours d’un contexte mimant la BPCO. Pour cela, nous nous focaliserons sur le rôle de l’épithélium pulmonaire tant dans la production que dans la fonction de ces cytokines en contexte infectieux.Pour répondre à ces questions, nous avons analysé l’expression des cytokines IL-20 par l’épithélium pulmonaire in vitro et ex vivo dans un modèle murin mimant l’exacerbation de la BPCO ainsi que dans des biopsies pulmonaires de patients fumeurs atteints ou non de BPCO. Dans un second temps nous avons évalué la modulation par un anticorps bloquant le récepteur des cytokines IL-20 (anti-IL-20Rb) au cours de la réponse anti-infectieuse de l'épithélium dans nos modèles in vivo (souris infectées par Sp) et in vitro (cellules épithéliales de trachées murines). Nous avons en parallèle évalué l'implication des cytokines IL-20 dans la réparation épithéliale.L’ensemble des résultats acquis au cours de la thèse nous a permis de démontrer l'implication des cytokines IL-20 et de préciser leur rôle sur l’épithélium pulmonaire au cours de l'infection bactérienne ainsi que dans la pathologie de la BPCO. De plus, les résultats obtenus avec l’anticorps neutralisant anti-IL-20Rb dans ces contextes d’infections et de BPCO, font de celui-ci une potentielle piste thérapeutique pour le traitement des lésions dues à l’infection. / Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory lung disease due to chronic exposure to air pollution and especially to cigarette smoke exposure in approximately 90% of the cases. This disease is characterized by obstruction of the bronchi due to hypersecretion of mucus, hypertrophy of the smooth muscles, and destruction of the alveolar wall leading the patient to emphysema. The stress induced by cigarette smoke exposure causes activation of resident cells including pulmonary epithelial cells and an alteration of the immune system responsible for an increased susceptibility to pulmonary infections. As a result, patients with this disease develop exacerbations especially du to Non-Typable Haemophilus influenza (NTHi) and Streptoccocus pneumoniae (Sp).The IL-22 cytokine plays a key role in antibacterial defenses and maintenance of the epithelial barrier. This cytokine belongs to the large IL-10 family, and to the IL-20 cytokine subfamily also including IL-19, IL-20 and IL-24. IL-22 binds to the receptor formed by the IL-10Rb and IL-22Ra subunits, while the IL-19, IL-20 and IL-24 cytokines binds to IL-20Rb associated with either IL-20Ra or IL-22Ra subunits. IL-20 cytokines (IL-19, IL-20, IL-24) have been shown to impair bacterial clearance during cutaneous infection with Staphylococcus aureus (Myles et al., 2013), by inhibiting the production of IL-17 and IL-22 cytokines. In addition, previous work in the laboratory showed a defect in the expression of IL-17 and IL-22 cytokines contributing to the susceptibility to infection in COPD mice (Pichavant et al., 2015). In fact, our current data show that exposure to cigarette smoke increases cytokine expression of the IL-20 family and that inhibition of this pathway blocks the development of exacerbation episodes in COPD mice.The aim of this thesis is to clarify the role of IL-20 cytokines in the response to bacterial infections (Sp, NTHi) both in a physiological context and in a context mimicking COPD. To do so, we will focus on the role of pulmonary epithelium both in the production and function of these cytokines in infectious context.To answer these questions, we analyzed the expression of IL-20 cytokines by pulmonary epithelium in vitro and ex vivo in a mouse model mimicking the COPD exacerbation as well as in pulmonary biopsies of smokers and non-smokers patients and of COPD patients. In a second step we evaluated the modulation by an IL-20 receptor blocking antibody (anti-IL-20Rb) of the anti-infectious response in our in vitro (murine tracheal epithelial cells) and in vivo models (Sp-infected mice). In parallel, we evaluated the involvement of IL-20 cytokines in the epithelial repair.All the results acquired during the thesis allowed us to demonstrate the expression of IL-20 cytokines and to demonstrate their role on the pulmonary epithelium during bacterial infection as well as in COPD. In addition, the results obtained with the anti-IL-20Rb neutralizing antibody in these contexts of infections and COPD, suggests a potential therapeutic application for respiratory infection.
334

Distriktssköterskans erfarenheter av kroniskt obstruktiv lungsjukdom i primärvården : En kvalitativ intervjustudie / District nurse´s experience of chronic obstructive pulmonary disease in primary care : A qualitative interview study

Sundström, Johanna, Vestlin, Magdalena January 2020 (has links)
Bakgrund: Sjukdomen KOL kan orsaka begränsningar i det dagliga livet för varje enskild individ. Primärvården är en viktig aktör i omhändertagandet av patienter, där omvårdnaden vid KOL är av stor vikt för patienters hälsa. Syfte: Att beskriva distriktsköterskors/sjuksköterskors erfarenheter av att handha patienter med KOL i primärvården Metod: Intervjustudie av kvalitativ design. Åtta individuella intervjuer med distriktssköterskor/sjuksköterskor inom astma/KOL genomfördes. Data analyserades med hjälp av en kvalitativ innehållsanalys med induktiv ansats. Resultat: Distriktssköterskors/sjuksköterskors beskrivningar av erfarenheter av att handha patienter med KOL i primärvården resulterade i tre kategorier: ”Att samverka med andra professioner”, ”Att stödja egenvården” och ”Att möta hinder i arbetet på astma/KOL mottagningen”. Åtta underkategorier framkom: Viktigt att inte känna sig ensam, Olika tillgänglighet till olika professioner, Att stödja patienten till ökad kunskap och förståelse kring sin sjukdom, Att stödja patienten till rökavvänjning, Avståndet har betydelse, Tiden räcker inte till, Många saknar en överskådlig individuell behandlingsplan och Brister i kommunikationen. Konklusion: Distriktssköterskan/sjuksköterskan har en samordnande roll på astma/KOL mottagning i primärvården där interprofessionell samverkan beskrivs som en viktig förutsättning för god omvårdnad. Distriktssköterskan/sjuksköterskan har en betydelsefull roll i omvårdnaden i att stödja patienter med KOL till ökad kunskap och förståelse kring sin sjukdom. / Background: The disease COPD can cause limitations in the daily life of each individual. Primary care plays an important role in the caring of patients, where nursing at COPD is of great importance for patients' health Aim: To describe district nurses / nurses' experiences of managing patients with COPD in primary care Method: Interview study of qualitative design. Eight individual interviews with district nurses / nurses in asthma / COPD were conducted. Data was analyzed using a qualitative content analysis with an inductive approach. Results: District nurses / nurses' descriptions of experiences of managing patients with COPD in primary care resulted in three categories: “Collaborating with other professions”, “Supporting self-care” and “Facing barriers with work at asthma / COPD reception”. Eight subcategories emerged: Important not to feel alone, Different accessibility to different professions, Supporting the patient for increased knowledge and understanding of their illness, Supporting the patient for smoking cessation, Distance is important, Time is insufficient, Many lack a clear individual treatment plan and deficiencies in communication. Conclusion: The district nurse / nurse has a coordinating role on asthma / COPD in primary care where interprofessional collaboration is described as an important prerequisite for good nursing. The district nurse / nurse has a significant role in nursing while supporting patients with COPD to increase knowledge and understanding of their illness.
335

Patientens upplevelse av att leva med KOL med fokus på palliativ vård: en litteraturöversikt / Experience of symptom and need of support with emphasis on palliative care in patients with COPD – a literature review from the patient´s perspective

Andersson, Emilie, Vestman, Sandra January 2020 (has links)
Bakgrund: Personer med en kronisk obstruktiv lungsjukdom kan ha många besvärande symtom. Andnöd är ett betydande symtom som ofta påverkar personernas liv avsevärt och försämrar livskvalitén. Tidigare forskning visar på att personer med en kronisk obstruktiv lungsjukdom inte får palliativ vård i samma utsträckning som personer med andra luftvägssjukdomar. Det kan vara betydande kunskap för sjuksköterskan att förstå patientens upplevelse av att leva med sjukdomen för att kunna bemöta dessa personer på bästa sätt. Syfte: Syftet var att beskriva symtom och utmaningar, utifrån patientens perspektiv, med fokus på palliativ vård hos personer med kronisk obstruktiv lungsjukdom.  Metod: En litteraturöversikt grundat på 15 vetenskapliga artiklar. Resultat: De huvudteman som kunde utkristallisera sig från dataanalysen var; fysiska symtom, psykiska symtom, hantering av det dagliga livet, information och kommunikation och existentiella utmaningar. Det mest genomgående betydande symtomet i artiklarna var det fysiska symtomet andnöd. Flertalet artiklar konstaterade att deltagarna önskade mer information om sin sjukdom, prognos och vård vid livets slut. De flesta var positiva till att inleda samtal om palliativ vård i ett tidigt skede i sjukdomen.  Slutsats: Att få personer med KOL får palliativa insatser kan bero på att sjukdomsprognosen är så pass oviss att man inte vet när man ska börja ha samtal om den sista tiden i livet. Denna litteraturöversikt visar på att palliativ vård välkomnas av personer med KOL i ett tidigt skede i sjukdomen då de lättare kan acceptera sin situation och besvärliga symtom. / Background: People with chronic obstructive pulmonary disease have several severe symptoms. Shortness of breath is a significant symptom that affects people´s lives considerably and impairs their quality of life. Previous research shows that people with chronic obstructive pulmonary disease do not receive palliative care to the same extent as other. It is important knowledge for the nurse to understand the patients´ experiences of living with the disease to treat these people in the best possible way.  Aim: The aim was to describe the symptoms and challenges, through patient´s perspective, with emphasis on palliative care in people with chronic obstructive pulmonary disease. Method: A literature review based on 15 scientific articles. Results: The main themes from the data analysis were physical symptoms, psychological symptoms, management of daily life, information and communication and existential support. The most consistently significant symptom in the articles was the physical symptom shortness of breath. Several articles stated that participants wanted more information about their illness, prognosis and care at the end of their lives. Most people were positive about initiating conversations about palliative care at an early stage of the disease. Conclusion: Chronic obstructive pulmonary disease (COPD) affects the person with many troublesome symptoms, regardless of what phase you are in the disease progression. This literature review shows that palliative care is welcomed by people with COPD at an early stage in the disease, because they can more readily accept their situation.
336

Advance Care Planning in Home Health: A Review of the Literature

Bigger, Sharon, Haddad, Lisa 01 December 2019 (has links)
The purpose of this article is to synthesize the evidence on advance care planning (ACP), determine what is applicable to the home health (HH) setting, and find where gaps in knowledge may exist. An integrative review methodology was chosen. Although there is ample literature on the topic of ACP, most research has been conducted in the acute care, outpatient, and general community settings. There is limited literature regarding ACP with patients living with chronic cardiovascular and pulmonary illnesses, who comprise the majority of the HH population. Some literature has been published regarding the interprofessional team's role in ACP in the HH setting. A gap in knowledge exists regarding ACP in HH, and recommendations for future research are provided.
337

Anhörigas upplevelse av att vårda en närstående med KOL : En litteraturstudie / Relatives' Experiences of Caring for a Close Relative with COPD : A literature review

Fleischer, Matilda, Neubert, Jaqueline January 2021 (has links)
Bakgrund: Kroniskt obstruktiv lungsjukdom (KOL) orsakar inflammerade celler i luftrör och lungvävnad. Personer med KOL upplever att kroppen inte orkar och känner sig begränsade i vardagen. Syfte: Belysa anhörigas upplevelser att vårda en närstående med kroniskt obstruktiv lungsjukdom. Metod: Kvalitativa literaturstudier baserade på intervjuer av anhöriga till personer med kroniskt obstruktiv lungsjukdom. Resultat: Tolv artiklar användes, 183 personer deltog, 25 till 90 år. Artiklar från Sverige, Kanada, Portugal, Danmark, USA, Norge, Island, Nordirland England. Anhöriga till personer med KOL upplever stress, hopplöshet, oro och trötthet. Oron är kopplad till den närstående med KOL och deras försämring av sjukdom. Både anhöriga och närstående upplever brist på utbildning och kunskap från sjukvården. Slutsats: Att vårda en närstående tar mycket energi, för att hushållssysslor och omvårdnadsysslor tar långt tid och tar mycket kraft i vardagen. Vid försämring av den närståendes tillstånd upplever anhöriga en kraftig oro vilket ger en nedsatt omvårdnad till den närstående. Bristen av kontakt till sjukvården gör att anhöriga inte kan få tips och råd om den närståendes sjukdomsutveckling. Det framkommer även att anhöriga behöver stöd från sjukvården för att bibehålla en positiv roll som informell vårdare. / Background: Chronic obstructive pulmonary disease (COPD) causes inflamed cells in the trachea and lung tissue. People with COPD experience less body strength and feel limited in everyday life. Purpose: To shed light on relatives’ experiences of caring for related parties with chronic obstructive pulmonary disease. Method: Quantitative interview-based literature study of relatives experiences. Results: Includes twelve articles, 183 participants in age 25-90. Articles originate from Sweden, Canada, Portugal, Denmark, USA, Norway, Iceland, and Northern Ireland England. Relatives caring for related parties with COPD experience stress, hopelessness, anxiety, and fatigue. Anxiety is linked to worsening of the related parties COPD condition. Both parties experience lack of education from healthcare services. Conclusion: Caring for a close relative takes a lot of energy, because household chores and nursing chores take a long time. Furthermore, it takes a lot of energy in everyday life. In the event that the close relative condition deteriorates, experience the related caretaker severe anxiety, which results in reduced care of the close relative. Lack of healthcare contact can limit advice of the close relatives' illness development. It also emerged that relatives’ need support from healthcare services to maintain a positive role as an informal caretaker.
338

Depression, Anxiety, and Utilization of Mental Healthcare Services Among Individuals with Chronic Obstructive Pulmonary Disease

Neifert, Heather Y. 29 April 2022 (has links)
No description available.
339

Symptom Experience and Treatment Delay during Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Dissertation

Chin, Elizabeth D. 21 August 2012 (has links)
Chronic obstructive pulmonary disease (COPD) is a major health problem in the United States. Acute exacerbations of COPD are primarily responsible for the physical, psychological and economic burden of this disease. Early identification and treatment of exacerbations is important to improve patient and healthcare outcomes. Little is known about how patients with COPD recognize an impending exacerbation and subsequently decide to seek treatment. The purpose of this qualitative descriptive study was to explore and describe symptom recognition and treatment delay in individuals experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD). Leventhal’s Common Sense Model of illness representation undergirded this study. Using semi-structured interviews, adults hospitalized with an acute exacerbation of COPD were asked to describe their symptom experience and self care behaviors, including treatment seeking, in the days to weeks prior to hospitalization. Data analysis revealed one main theme: Recognizing, responding and reacting to change, and six subthemes: Something’s coming, Here we go again, Seeking urgent treatment, Riding it out, Not in charge anymore and My last day that richly described the COPD exacerbation experience. The study revealed that patients experience an illness prodrome prior to exacerbation and have a recurrent exacerbation symptom pattern that was self-recognized. Treatment seeking was most influenced by the speed and acuity of exacerbation onset, severity of breathlessness, fears of death, nature of patient-provider relationship and the perception of stigmatization during prior healthcare encounters. These findings are important for the development of interventions to improve patient recognition and management of COPD exacerbations in the future.
340

Factores asociados al auto-reporte de Asma/EPOC diagnosticado luego del ingreso a un Establecimiento Penitenciario según el Censo Nacional Penitenciario, Perú 2016 / Factors associated with self-reported Asthma/COPD diagnosed after internment among People Deprived of Liberty using the Peruvian Nationwide Penitentiary Census, 2016

Medina Perea, Gabriela, Polar Trinidad, Marcos 01 February 2022 (has links)
Introducción: Las personas privadas de la libertad (PPL) pertenecen a una población vulnerable con mayor carga de enfermedad que la población general, entre ellas enfermedades respiratorias como Asma y/o EPOC. Este estudio evaluó qué factores sociodemográficos y clínicos se asocian al auto-reporte de Asma/EPOC diagnosticado en Establecimientos Penitenciarios (EP). Métodos: Estudio transversal analítico que incluyó PPLs ≥18 años de 66 diferentes EPs del Perú que participaron en el Censo Nacional Penitenciario 2016. La variable de estudio fue auto-reporte de Asma/EPOC diagnosticada por un profesional de salud luego de ingresar al EP. Se realizaron análisis descriptivo, bivariado, y se obtuvieron razones de prevalencia crudas y ajustadas (RPa) mediante regresión de Poisson multinivel, colocando los EP en el primer nivel. Resultados: Se evalúo 76180 PPL con una mediana de edad de 34 años y 94.2% eran hombres. La prevalencia de Asma/EPOC fue 2.27%. Factores asociados a mayor prevalencia fueron edad (RPa 1.03 por cada año; IC95% 1.03-1.04), sexo femenino (RPa 1.40; IC95% 1.18-1.67), fumar diario respecto a no fumar (RPa 1.22; IC95% 1.02-1.47), tener VIH/SIDA (RPa 1.55; IC95% 1.06-2.27), y tener Tuberculosis (RPa 4.27; IC95% 3.48-5.22). Tener formación secundaria se asoció a menos probabilidad de Asma/EPOC (RPa 0.80; IC95% 0.71-0.90) así como educación superior (RPa 0.75; IC95% 0.62-0.91), respecto a aquellos que no tenían educación. Conclusiones: Tener mayor edad, ser de sexo femenino, fumar diario, tener VIH/SIDA, y haber tenido o tener tuberculosis se asociaron a mayor probabilidad de tener Asma y/o EPOC diagnosticado por un personal de salud luego de ingresar al EP, mientras que tener un mayor nivel educativo se asoció a una menor probabilidad. Esto podría servir para identificar población en riesgo cuando ingresan al EP. / Introduction: People Deprived of Liberty (PDL) belong to a vulnerable population with higher burden of disease than general population, including respiratory diseases such as asthma and/or COPD. This study evaluated which sociodemographic and clinical factors are associated with self-reported asthma/COPD diagnosed in Penitentiary Establishments (PE). Methods: Cross-sectional study that included PDLs ≥18 years old from 66 different PEs in Peru that participated in the Nationwide Penitentiary Census 2016. The outcome variable was self-reported asthma/COPD diagnosed by a health professional after entering a PE. Descriptive, bivariate analyzes were carried out; and crude and adjusted prevalence ratios (aPR) were obtained by multilevel Poisson regression, placing PE as first level. Results: 76180 PDLs were evaluated with a median age of 34 years old, and 94.2% were men. The prevalence of Asthma/COPD was 2.27%. Factors associated with higher prevalence were age (aPR 1.03 for each year; 95% CI 1.03-1.04), female sex (aPR 1.40; 95% CI 1.18-1.67), daily smoking compared to not smoking (aPR 1.22; 95% CI 1.02-1.47) , having HIV/AIDS (aPR 1.55; 95% CI 1.06-2.27), and having past/current Tuberculosis (aPR 4.27; 95% CI 3.48-5.22). Having high school was associated with lower probability of Asthma/COPD (aPR 0.80; 95% CI 0.71-0.90) as well as higher education (aPR 0.75; 95% CI 0.62-0.91), compared to those who had no education. Conclusions: Being older, being female, smoking daily, having HIV/AIDS, and having or having had tuberculosis were associated with a greater probability of developing asthma and/or COPD diagnosed by health personnel after entering the penitentiary; while having a higher educational level was associated with a lower probability. This could serve to identify populations at risk when they enter a PE. / Tesis

Page generated in 0.0396 seconds