The sample (N=118) was mostly Lesbian (85.6%, n=101) with a mean age of 60.81 years (min=50, max=86, SD=7). Most (55.1%, n=65) lived with a partner, including 25.4% (n=30) being married. The education mean (=category 4.37, min=1, max=6, SD=1.123) was between Bachelor’s and Master’s degrees, 48.3% were employed full-time (n=57), 26.3% (n=31) retired, and the annual household income was $50,000 – $99,999 (mean=5.13; SD=1.392). They reported good health (mean=4.04; min=1, max=6, SD=0.789) with an overweight Body Mass Index (BMI mean=32.77; min=17.97, max=57.32, SD=8.03). Quality ratings showed: healthcare received was closest to very good (mean= 4.68; min=1, max=6, SD=1.205); care received from primary care provider was between very good and excellent (mean=4.54; min=1, max=6, SD=1.174); providers’ sensitivity/cultural competence for sexual orientation was closest to very good (mean=4.70; min=1, max=6, SD=1.182); providers’ sensitivity/cultural competence for race was between good to very good (mean=4.57; min=1, max=6, SD=1.178); and providers’ openness to hearing about/accepting sexual orientation was closest to very open (mean=3.77; min=1, max=5, SD=0.937). The majority (71.2% (n=84) experienced discrimination in the healthcare system—for being Black (64.4%, n=76), a woman (48.4%, n=57), overweight/obese (31.4%, n=54), or appearance (29.7%, n=35).Findings for performing 9 behaviors for healthy aging showed: 1-stages of change mean=4.283 (min=1.44, max=5, SD=0.663) was closest to action stage; 2-self-efficacy mean=5.171 (min=3, max=6, SD=0.703) was 80% confident; 3-knowledge mean = 5.811 (min=3.22, max=7, SD=0.916) was closest to a high level of knowledge; and, 4-motivation mean=5.57 (min=3.44, max=7, SD=0.935) was between moderate and high. They had moderately high: satisfaction with life (SWLS-3 mean=5.223, min=1.33, max=7, SD=1.272); overall life satisfaction (LSS-1, mean=7.50, min=2, max=10, SD=1.834); and harmony in life (mean=5.407; min=2, max=7, SD=1.184). Backwards stepwise regression, controlling for social desirability, indicated higher Satisfaction with Life (SWLS-3) was significantly predicted by: Higher harmony in life (B=0.714, p=0.000); Higher annual household income (B=0.155, p=0.004); Higher provider sensitivity/cultural competence to their patient being Black (B=0.208, p=0.002)—with 62.4% of variance explained (R2=0.615, adjusted R2=0.624; F=25.483, p=.000) by the model. Qualitative data amplified findings.

This study examined health-related quality of life (HRQoL) across weight categories in adolescents using both a general and a condition-specific measure sensitive to fatigue symptoms. Participants (N = 918) completed the Pediatric Quality of Life (PedsQL) Inventory and PedsQL Multidimensional Fatigue Scale measures. Actual height and weight were used to calculate body mass index for age and sex percentiles and assign weight categories. No interaction effects between total HRQoL and weight category and gender were found; however, main effects were found for both weight category and gender. Future research should examine the impact of using different measures to assess HRQoL outcomes across weight categories.

Lung cancer patients generally experience high levels of physical and psychological distress and decreased quality of life (QOL). Sense of coherence (SOC) has been conceptualized as a personality orientation reflecting the degree to which an individual perceives their world as comprehensible, manageable and meaningful. The present study investigated the associations of SOC with QOL in lung cancer. It also examined potential psychological mediators by which SOC may exert its influences on QOL. Fifty-six participants with non-small cell lung cancer were administered self-report assessments of SOC, QOL and psychological distress. Results revealed that SOC was positively associated with QOL and this relationship may be mediated by depressive symptoms. The current study supports the notion that SOC may be a protective factor with regard to psychological adjustment and QOL in cancer survivors.

Purpose. Psychological interventions are efficacious in reducing emotional distress for cancer patients. However, it is not clear whether psychological improvements are, in turn, related to improved health. A clinical trial tests whether a psychological intervention for cancer patients can do so, and also tests two routes to achieve better health: (a) reducing patients' Emotional Distress, and/or (b) enhancing their functional immunity. Methods. Post-surgery, 227 breast cancer patients were randomized to intervention or assessment only Study Arms. Conducted in small groups, intervention sessions were offered weekly for 4 months and followed by monthly sessions for 8 months. Measures included psychological (distress), biological (immune), and health outcomes (performance status and evaluations of patient's symptomatology, including toxicity from cancer treatment, lab values) collected at baseline, 4 months, and 12 months. Results. A path model revealed that intervention participation directly improved health (p < .05) at 12 months. These effects remained when statistically controlling for baseline levels of distress, immunity, and health as well as sociodemographic, disease, and cancer treatment variables. Regarding the mechanisms for achieving better health, support was found for an indirect effect of distress reduction. That is, by specifically lowering intervention patients' distress at 4 months, their health was improved at 12 months (p < .05). Although the intervention simultaneously improved patients' T-cell blastogenesis in response to phytohemagglutinin (PHA), the latter increases were unrelated to improved health. Conclusion. A convergence of biobehavioral effects and health improvements were observed. Behavioral change, rather than immunity change, was influential in achieving lower levels of symptomatology and higher functional status. Distress reduction is highlighted as an important mechanism by which health can be improved.

Background: The implantable cardioverter defibrillator (ICD) is the most effective treatment available for terminating potentially life-threatening ventricular tachycardia and ventricular fibrillation and reducing the risk of mortality. Despite its established health benefits, ICD therapy is accompanied by a unique array of patient and psychological factors meriting ample research attention. The purpose of this paper is to examine research trends and results regarding patient factors in cardiac and ICD research and to discuss key areas for future research. Hypothesis: An increase in articles associated with patient factors in cardiac and ICD research will be shown over time. Methods: The Medical Subject Heading (MeSH) system in PubMed was used to index articles under a range of psychosocial headings for both cardiovascular disease and ICDs to quantify the frequency of articles published across time, the journals most frequently utilized, the most productive institutions, and the most common areas of inquiry. Results: A significant positive relationship was revealed between patient factors in cardiac research (r = 0.96, p < 0.01) and ICD research (r = 0.88, p < 0.01) over time. Research is limited by the small number of investigations and institutions. Of the 178 articles on patient factors in ICD research, the most frequent areas of inquiry were psychosocial treatment (70.79%), anxiety (33.15%), quality of life (32.02%), and depression (29.78%). Conclusion: Future research examining positive adjustment is warranted, especially in light of increased prophylactic ICD implantation and possible decreased treatment burden associated with decreased shocks.

Subarachnoid hemorrhage (SAH) causes 5% of all strokes and is responsible for about 18,000 deaths per year in the United States (Aneurysmal Subarachnoid Hemorrhage, 2008). The incidence of SAH has been estimated at 6 to 8 per 100,000 persons per year (Linn, Rinkel, Algra, & van Gijn, 1996). In nearly 15% (range 5–34%) of patients with SAH, no source of hemorrhage can be identified via four-vessel cerebral angiography (Alen et al., 2003; Gupta et al., 2009), resulting in two major types of SAH: aneurysmal (ASAH) and nonaneurysmal (NASAH). Anecdotal evidence and contradictory research suggest that patients with NASAH experience some of the same health-related quality of life (HRQOL) issues as patients with ASAH. The purpose of this quantitative survey design study was to compare health-related quality of life (HRQOL) 1 to 3 years post-hemorrhage in patients who have experienced a NASAH to those who have experienced an ASAH. This is the first US study to specifically investigate HRQOL in NASAH and the second study comparing HRQOL outcomes between aneurysmal and nonaneurysmal subarachnoid hemorrhage patients. Our results are comparable to the first study by Hutter and Gilsbach, (1995), which also found that the two groups are much more similar than different. There were no significant differences between 28 of the 36 demographic and clinical characteristics examined in this study. Our study confirms previous findings that there is a significant impact on employment for both hemorrhage groups and an even greater inability to return to work for the NASAH patients. The nonaneurysmal group had more physical symptom complaints while the aneurysmal group had more emotional symptoms. Lastly, both groups had low levels of PTSD, and these levels did not differ significantly between groups. However, PTSD and social support were shown by regression analysis to impact HRQOL for both groups. We recommend that clinicians assess for PTSD in all subarachnoid hemorrhage patients and institute treatment early, which will decrease the negative effects on HRQOL. This may include offering psychological services or social work early in the hospital course to all SAH patients. Further research and policy changes are needed to assist in interventions that improve vocational reintegration after SAH. NASAH patients should no longer be referred to as having suffered a “benign hemorrhage.” They have had a life changing hemorrhage that may forever change their lives and impact their HRQOL.

Syftet med denna studie har varit att med en kvalitativ metod undersöka hur personer med fysiska funktionsnedsättningar upplever deras idrottsaktiviteter i förhållande till deras livskvalitet och delaktighet samt hur hinder och möjligheter i deras idrottsaktivitet kan upplevas. Genom att intervjua personer med fysiska funktionsnedsättningar som utövar idrott har det framkommit att faktorer som vänskap, familj och det sociala utbytet har en stor betydelse för denna målgrupp.Centrala begrepp som innanförskap, delaktighet och livskvalitet har framkommit utifrån den insamlade litteraturen och intervjupersonernas utsagor. Genom teorierna KASAM-känsla av sammanhang och livskvalitet och den tidigare forskning som presenteras i studien har dessa fungerat som en vägledning till resultatet av denna studie. / The intention of this essay has been to study with a qualitative method how people with physical disabilities emerged experience their sports activities. This in relation to their quality of life, participation and how obstacles or possibilites in their sports activities can be experienced. By interviewing people with physical disabilities who practice sports, it find out that factors such as friendship, family and social exchange are important for this group of people. Significant concepts such as introspection, participation and quality of life have emerged from the collected literature and from the interviewers’ answers. Through the theories KASAM-sense of context and quality of life together with the previous research, these have been a guide for the results of this study.

Bibliography: leaves 105-111. / HIV/AIDS poses a global medical epidemic threatening social and economic development in most developing countries. Sub-Saharan Africa currently bears the brunt of the epidemic with close to 30 million people infected with the disease. South Africa has the second fastest growing infection rates in the world as at December 2002. Currently no known cure for the disease exists. Interventions involve education and awareness programs and multiple therapy medical treatment. The aim of this thesis is to evaluate the perceptions and knowledge of participants at the Shell AIDS Champions workshop. The research used a triangulatory approach utilizing pre-test and post-test survey questionnaires group discussions, participant observation and semi-structured interviews. 22 participants from Shell Southern Africa and Easigas attended the workshop. Statistical techniques were applied to the questionnaire findings. Content analysis was used to analyse the qualitative data. Findings from the evaluation indicate that participant perceptions show agreement with current Shell policy on HIV/AIDS. The findings show that the major impact of the workshop was observed on the knowledge-based section of the evaluation. The results of the evaluation confirm that participant knowledge was increased through participation in the AIDS Champions workshop.

Bakgrund: Ett trycksår orsakar fysiskt, mentalt, emotionellt och socialt lidande för patienten. Även behandlingar som patienten behöver vara med om innefattar ett lidande och en rädsla för den smärta de upplever vid dessa. En rädsla för att såret inte ska läka och att få infektioner eller behöva amputera. Sjuksköterskan har en viktig uppgift vad gäller förebyggande åtgärder vid risk för trycksår, att ge en god omvårdnad och behandling. Detta trots att patienten upplever smärta vid omläggningen av såret. Syfte: Syftet med studien var att beskriva hur patienter som lever med svårläkta trycksår upplever sin situation och att kategorisera upplevelserna utifrån WHOQOL-instrumentets fyra dimensioner av livskvalitet. Metod: En litteraturstudie baserad på nio kvalitativa artiklar som kategoriserats utifrån WHOQOL-BREF:s fyra kategorier som referensram. Resultat: Patienter som lever med svårläkta trycksår upplever att deras liv påverkas på grund av fysiska, psykiska, sociala och miljörelaterade faktorer som smärta, oro/ångest, minskad social kontakt och att vara beroende av vården. Slutsats: Patienternas livskvalitet påverkas både fysiskt av att ha ett sår vilket gav konsekvenser för det psykiska välmåendet och den sociala kontakten. Detta beskrevs inte bara påverka patienterna själva utan även deras anhöriga och närstående. Mötet med vården beskrevs som påfrestande och med brist på förtroende vilket medförde att patienterna inte kände sig delaktiga. Klinisk betydelse: Uppsatsen vill visa att patienter påverkas på flera olika plan så som fysiskt, psykiskt och socialt och därmed vikten av att omvårdnadsåtgärder i form av att preventiva åtgärder vidtas för att förhindra att trycksår uppstår. Kunskap om förebyggande åtgärder finns beskrivna i PM/vårdprogram och behöver implementeras i undervisning och efterföljas inom vårdverksamheten. / Background: A pressure ulcer causes physical, mental, emotional and social suffering for the patient. Even treatments that the patient needs to go through includes a suffering and a fear of the pain they experience during treatment, but also a fear the wound won’t heal and to get infections or to have to amputate. Nurses have an important role in terms of prevention at risk for pressure ulcers, to give a good care and treatment. This despite the fact that the patient is experiencing pain during the bandaging. Purpose: The aim of this study was to describe how patients that are living with slow-healing pressure ulcers experience their situation and to categorize their experiences by using the four categories of the WHOQOL-instrument´s dimensions of quality of life. Method: A literature review based on nine qualitative articles with WHOQOL-BREF’s categories as reference. Results: Patients living with slow-healing wounds experience that their lives are effected because of physical, mental, social and environmental factors such as pain, worry/anxiety, reduced social contact and being dependent on the healthcare. Conclusion: The patients’ qualities of life are affected physically by having a wound, resulting in consequences for the mental health and the social contacts. This was described not only to affect the patients themselves but also their families and friends. Nursing care was described as distressing and with lack of confidence that led to that the patients didn’t feel involved. Clinical significance: This essay want to show that patients are affected on many levels such as physically, mentally and socially, and thereby the importance of nursing interventions through preventive measures to prevent pressure ulcers to occur. Knowledge of preventive measures are described in the PM/treatment programs and needs to be implemented in teaching and complied in the healthcare settings.

Fibromyalgia syndrome (FMS) is a debilitating condition that affects millions of individuals throughout the world. As of yet the specific etiology of this condition remains unknown and successful treatments remain in their infancy. Although several studies have focused on the emotional components of fibromyalgia, none have specifically addressed the issues of communication and anger that appear to be important among this patient population. The objectives of this study were to design a 4-week experimental group therapy treatment based on successful cognitive behavioral components and add anger management and communication components in an attempt to increase benefits to the overall well-being of patients. Subjects were 46 fibromyalgia patients recruited from physicians, chiropractors, and physical therapists as well as through newspaper, radio, and advertising through flyers. Patients who were accepted into the study were randomly assigned to either a treatment group or a wait-list control group, with the control group receiving the treatment in the month following the treatment group. Outcomes were assessed using a repeated measures analysis of variance with one within (time) and one-between subjects (group) factor. The five assessment measures utilized in this study were the Fibromyalgia Impact Questionnaire (FIQ), the Short-Form 36 (SF-36) Version 2, the Chronic Pain Self-Efficacy Survey (CPSS), the State Trait Anger Expression Inventory- 2 (ST AXI-2) and a communication inventory developed specifically for this intervention. Specific outcomes measured included change on fibromyalgia-specific symptoms and physical and emotional health-related status, improvement in communication, change in anger scores, and changes in levels of self-efficacy. Analysis of patient outcome data revealed that significant results were achieved in the areas of mental health and communication variables . In addition, several notable effect sizes were also found, particularly in the areas of vitality (-.97), mental health (-.76) and pain management (-1.17). Results demonstrated that a brief, cost-effective 4-week intervention can have a beneficial impact for FMS patients in the area of psychological function. Implications of these findings are discussed within the context of the existing literature on fibromyalgia treatment as well as in terms of possible limitations of the study as it was conducted.