Bakgrund: Uppkomsten till migrän är inte klarlagd och därav har barriärer uppkommit som försvårar behandling och omvårdnad. Barn och ungdomar är en utsatt grupp då deras utveckling kan påverkas både fysiskt, emotionellt, socialt och i skolan. Syfte: Att beskriva hur livskvalitet hos barn och ungdomar påverkas av migrän. Metod: I denna allmänna litteraturstudie har tio empiriska studier granskats med avseende på kvalitet och innehåll gällande domänerna i livskvalitet. Litteratursökning har genomförts i  EBSCO Discovery Service och CINAHL Complete. Resultat: Migrän påverkar barn och ungdomars livskvalitet negativt både fysiskt, emotionellt, socialt och i skolan. Smärtan har en inverkan på deras dagliga aktiviteter samt ger dem en känsla av oro, nedstämdhet och ångest. Även deras sömn påverkas. Migränen gör det svårt att komma överens och hålla jämna steg med familj och vänner, både i skolan och på fritiden. Slutsats: Studien bidrar med kunskap om hur barn och ungdomars livskvalitet påverkas av migrän. Kunskap hos allmänheten överensstämmer inte med hur barn och ungdomar upplever migrän. Vidare forskning behövs därav beträffande bemötande/behandling av barn och ungdomar med migrän. / Background: The origin of migraine is unclear and therefore barriers which complicate treatment and nursing have arisen. Children and adolescents is a vulnerable group because their development may be affected physically, emotionally, socially and in school. Aim: To describe how the quality of life in children and adolescents is affected by migraine. Method: In this general literature study have ten empirical studies been examined in terms of quality and content of existing domains of quality of life. The literature search has been made in EBSCO Discovery Service and CINAHL Complete. Results: Migraine affects children’s and adolescents’ quality of life negatively both physically, emotionally, socially and in school. The pain has an impact on their daily activities as well as giving them a sense of worry, depression and anxiety. Even sleep is affected. Migraine makes it difficult to get along and keep up with family and friends, both at school and in leisure. Conclusion: This study contributes to knowledge about how children’s and adolescents’ quality of life is affected by migraine. Knowledge in general does not conform with children’s and adolescents’ experience of migraine. Further research is needed regarding the attitudes/treatment towards migraine.

This qualitative study explored the use of Reiki in improving the quality of life of people living with HIV (PLWH). A purposive sample of seven participants consented to the study. Reiki attunement, self healing and data collection were done over a six-month period. An idiographic approach was used. The participants were interviewed, then underwent Reiki attunement, performed self healing for 21-30 days and were interviewed again. Responses suggest that Reiki therapy had positive outcomes. Illnessspecific symptom relief, increased levels of energy, improved sleeping patterns, decreased anxiety and depression, spiritual awakening and a better ability to handle stressful situations were reported. Reiki therapy enabled the participants to reappraise living with HIV, deal with anger, depression and self-blame. These positive changes led to some of them seeking employment, leaving destructive personal relationships and reconnecting with family members. The researcher strongly recommends further research in this area. / Sociology / (M.A. (Social Behavioural Studies HIV/AIDS))

BACKGROUND:Neurogenic detrusor overactivity (NDO) leads to impaired health-related quality of life (HRQoL), productivity, and greater healthcare resource burden. The humanistic and economic burden may be more apparent in NDO patients with urinary incontinence (UI). The objective of this study was to compare the HRQoL, productivity, and health resource use (HRU) between continent and incontinent NDO patients.METHODS:A retrospective database analysis was conducted using the Adelphi Overactive Bladder (OAB)/UI Disease Specific Programme, a multi-national, cross-sectional survey reported from both patients' and physicians' perspectives. The population for this analysis included NDO patients with or without UI. General and disease-specific HRQoL were assessed using the EuroQoL-5D (EQ-5D), Incontinence Quality of Life questionnaire (I-QOL), and the Overactive Bladder Questionnaire (OAB-q). Productivity and daily activity impairment were measured using the Work Productivity and Activity Impairment (WPAI) questionnaire. HRU indicators included OAB-related surgery, OAB-related hospitalizations, incontinence pad usage, switching anticholinergics used for OAB due to inadequate response or adverse effects, and OAB-related physician visits. Bivariate analyses, multivariate ordinary least squares (OLS) regression analyses and published minimal clinically important differences (MCID) were used to assess relationships between incontinent status and the aforementioned outcome measures.RESULTS:A total of 324 NDO patients with or without urinary incontinence were included, averaging 54years of age (SD 16), of whom 43.8 percent were male. Bivariate analyses detected no significant relationship between incontinent status and HRU variables. Regression analyses revealed that incontinent patients had clinically and statistically lower disease-specific HRQoL and greater impairment in daily activities as compared to continent patients. On average, incontinent patients scored 10 points lower on the I-QOL total score, 9 points lower on the OAB-q HRQoL score, 15 points higher on OAB-q symptom severity, and experienced 8.2 percent higher activity impairment due to their bladder condition (all p <0.001).CONCLUSIONS:Incontinent NDO patients experience significantly lower HRQoL and activity impairment as compared to continent NDO patients.

Within recent literature, internal locus of control (LOC) has been correlated with self-efficacy and improved coping after injury. Service connection (SC) has been linked to well-being after trauma. Level of injury has been associated with physical ability and limitations. This study examines how depression and QOL are associated with LOC and SC for veterans diagnosed with spinal cord injury (SCI). It was hypothesized that internal LOC and SC would correlate with higher QOL and decreased depression. Participants included 58 veterans, 30 diagnosed with paraplegia and 28 with quadriplegia. Measures included a demographics questionnaire, the Rotter's Internal-External Scale of LOC, the Diener's Satisfaction with Life Scale, and the Center for Epidemiological Studies - Depression Scale. Medical records were reviewed for SC. Generalized linear model regressions were run using LOC, SC and level of injury to estimate QOL and depression. Locus of control was a significant predictor of QOL, F=2.961, p=.045, while SC approached significance at F=2.082, p=.077. Locus of control approached significance as a predictor for depression, F=1.977, p=.083 level. Level of injury was not a significant factor for either outcome variable. Follow-up analyses including time since injury (TSI) indicated that the interaction of LOC and TSI was a significant predictor for QOL, F=5.320, p=0.013, and the interaction of SC and TSI was a significant predictor for depression, F=9.800, p=0.002. A significant correlation was found between depression and QOL, r=-.472, p=.000. A significant correlation was found between LOC and TSI, r=-.277, p=.018. Results indicate that internal LOC, SC, and increased TSI are positively associated with improved QOL and lower depression. The negative correlation between LOC and TSI indicates that LOC may be a mutable personality factor that adjusts from being external to internal to improve coping after disability, or those with an internal LOC are more consistent with treatment over time. The negative correlation between depression and QOL indicates that participants endorsing depression perceive having a lower QOL. These findings have important implications for health psychology, as they indicate that increasing internal LOC and access to health care over time can promote lower depression and higher QOL for SCI patients.

Syfte: Syftet med litteraturöversikten var att sammanställa aktuell forskning som beskriver hur det är att leva med Amyotrofisk Lateral Skleros (ALS). Metod: Vetenskapliga artiklar söktes i databaserna CINAHL och PubMed. Tolv artiklar med kvalitativ ansats valdes ut och kvalitetsgranskades enligt granskningsmall för kvalitativa studier. Huvudresultat: Resultatet visade att de som drabbades av ALS, en obotlig sjukdom, och deras närstående utsattes för stora psykologiska påfrestningar. Det fanns en rädsla och oro över att förlora kroppsfunktioner utan förvarning och detta medförde att patienter med ALS kände sig som fångar i den egna kroppen. Självförtroende och självkänsla rubbades negativt och bidrog till stunder av isolering, uppgivenhet och frustration. För att hantera sin livssituation använde sig patienter med ALS av olika strategier och livsstilsförändringar för att underlätta och möjliggöra ett oberoende i vardagen. Känslor av skuld och skam över familjens lidande i samband med sjukdomen ALS kunde bli en börda att bära för patienter med ALS och dessa känslor kunde generera till ett ökat kontrollbehov av omgivningen. Patienter med ALS hade kvar en känsla av hopp inför framtiden. Slutsats: Litteraturöversikten kan öka förståelsen hos sjuksköterskan och de närstående hur det är att leva med sjukdomen ALS och därmed skapa bättre individuella förutsättningar för god omvårdnad och god omsorg för patienter med ALS.

This thesis portfolio examines attitudes to ageing in older adults, and explores the impact that attitudes to ageing have on mental health status and quality of life. Attitudes to ageing are becoming more widely measured in older adults, particularly with the ageing population but also due the recent development of the Attitudes to Ageing Questionnaire. There is growing evidence to suggest a relationship between attitudes to ageing and mental health status in older adults. However, no study has explored the association between attitudes to ageing and quality of life in older adults, incorporating the Attitudes to Ageing Questionnaire and the World Health Organisation Quality of Life measures. Firstly a systematic search of studies exploring the relationship between attitudes to ageing and mental health in older adults (≥55 years) was undertaken. All potentially relevant studies were screened against inclusion and exclusion criteria. Variables related to attitudes to ageing, ageism, age stereotypes, depression and anxiety were considered in this review. Twelve papers met inclusion criteria for the systematic review. The setting, culture and measures incorporated varied across the studies. A negative attitude to ageing was associated with poorer mental health status in older adults across all 12 studies. The second part of this portfolio was an international cross-sectional analysis of attitudes to ageing and quality of life in older adults (≥57 years). Correlation and regression analyses explored the relationship between attitudes to ageing and QOL and investigated the impact of socio-demographic variables, depression and attitudes to ageing on two quality of life measures. The two constructs were positively related; a more positive attitude to ageing was associated with a better quality of life. Further, positive attitudes to ageing was a significant predictor of a better QOL. The sample was then divided into two age groups (57-79 years and 80+ years) and attitudes to ageing and quality of life ratings were compared. Results revealed more negative ratings in attitudes to ageing and quality of life in the over 80 year old age group. Correlation and regression analyses were then explored across both age groups. More positive attitudes to ageing was a significant predictor of better quality of life across both age groups. Overall, the two studies in this thesis portfolio highlight the need to better recognise and target older adults’ negative attitudes to ageing. Appropriate psychological interventions could be provided to challenge negative attitudes and promote attitude change in an attempt to improve mental health difficulties and quality of life in older adults. Continued use of the Attitudes to Ageing Questionnaire and quality of life psychometric measures in clinical practice and research is encouraged.

Hintergrund: Der Zweite Weltkrieg und die damit verbundenen traumatischen Ereignisse können auch Jahrzehnte später bei der ehemaligen Kriegsgeneration Deutschlands mit langfristigen und schwerwiegenden gesundheitlichen Folgen einhergehen. Insbesondere die Erforschung von Langzeitverläufen traumatisierender Erlebnisse befindet sich noch in ihren Anfängen. Ziele: Es werden die Auswirkungen traumatischer Erfahrungen und posttraumatischer Belas-tungssymptomatik auf die heutige gesundheitsbezogene Lebensqualität der älteren Bevölkerung Deutschlands (bis 1948 geboren) untersucht. Die Zusammenhänge werden unter dem Einfluss komorbider Depressivität, somatischer Symptome und körperlicher Erkrankungen analysiert. Material und Methoden: Diese Arbeit untersucht die physische und psychische gesund-heitsbezogene Lebensqualität (SF12v2-Fragebogen zur gesundheitsbezogenen Lebensqua-lität), traumatische Erfahrungen (Traumaliste des M-CIDI), Posttraumatische Belastungsstörung (PTBS) entsprechend des DSM-IV, partielle PTBS (Posttraumatic Diagnostic Scale, PDS), körperliche Erkrankungen (Multimorbiditätsfragebogen), Depressions- und Somatisierungssymptomatik (Patient Health Questionnaire, PHQ-D) in einer repräsentativen Stichprobe der 60-85 jährigen Bevölkerung Deutschlands (N = 1659) mit Hilfe von Selbstbeurteilungsverfahren. Ergebnisse: Personen mit traumatischen Erfahrungen in der Lebensgeschichte berichten eine niedrigere Lebensqualität als Personen ohne traumatische Erfahrungen. Zudem findet sich mit steigender Anzahl der traumatischen Erfahrungen eine niedrigere physische und psychische Lebensqualität. Auch haben Personen mit einer Vollbild- oder partiellen PTBS eine niedrigere körperliche und psychische gesundheitsbezogene Lebensqualität. Beeinträchtigungen in der physischen gesundheitsbezogenen Lebensqualität werden hauptsächlich durch komorbide depressive und somatische Symptome und körperliche Erkrankungen erklärt. Auf die Beeinträchtigungen der psychischen gesundheitsbezogenen Lebensqualität haben sowohl traumatische Erfahrungen und posttraumatische Belastungssymptomatik als auch komorbide Depressions- und Somatisierungssymptomatik Einfluss. Die PTBS führt sowohl bei kategorialer als auch bei dimensionaler Betrachtung zur Beeinträchtigung der gesundheitsbezogenen Lebensqualität; stärkster Einfluss wird auf die psychische Dimension genommen. Schlussfolgerung: Selbst nach Jahrzehnten können potentiell traumatisierende Erlebnisse in der Folge mit erheblichen körperlichen und psychosozialen Beeinträchtigungen einhergehen. Im Umgang mit Älteren sollten neu auftretende oder zunehmende gesundheitliche Beschwerden immer vor dem Hintergrund der historisch-biographischen Perspektive betrachtet werden. Dabei sollte auch subsyndromalen Störungsbildern genügend Beachtung zukommen. Dem Einsatz von Messinstrumenten zur Erfassung der Lebensqualität in der Diagnostik und zur Verlaufsbeurteilung sollte mehr Bedeutung beigemessen werden.

Background: Multiple sclerosis (MS) is a chronic neurological autoimmune disease. The disease affects most young people between 20-40 years of age, mainly women. There are about 2.5 million people worldwide are affected by MS. The most common symptoms that a patient with MS suffers from are the fatigue (tiredness), pain, depression, sleep disturbance, balance disorder, dizziness, palsies (paralysis) and heat intolerance. There are also other physical and mental dysfunctions. Aim: The purpose of this study was to describe patients' experiences of MS disease symptoms and the nurse's possible role in disease progression. Method: A literature study based on nine scientific articles. Articles were searched in the databases CINAHL and PubMed in the fall 2015th.   Results: This study showed how the experiences of the symptoms for patients with MS affected their health, social life and quality of life in a negative way. The study also showed that nurses have an important informative, supportive and integrated role for the patient and family, during the course of the disease. Conclusions: MS disease affects the sufferer's life in a negative way, both physically and mentally. The disease usually means that the patient is facing uncertain and unpredictable future, and suffers unpleasant symptoms. These experiences involve not only a part of the body but the whole person. The assistance of the care and especially the nurse is of great importance to facilitate the patient's situation and help the patient to preserve their quality of life as good as possible. The nurses’ informative and caring role is a great support to patients with MS. Better understanding of patients' experience can be valuable for a better communication and care.

published_or_final_version / Urban Planning / Master / Master of Science in Urban Planning

published_or_final_version / Dentistry / Master / Master of Dental Surgery