Reprint from: Allergology International 55(1), 2006, p.59-65

Bakgrund: Personer som blir föremål för hjärttransplantation är mycket sjuka och det finns ingen annan behandling att tillgå. När hjärttransplantationen är genomförd krävs livsstilsförändringar och livslång och kontinuerlig behandling av immunosuppressiva läkemedel. En transplantation är en svårbegriplig händelse som väcker mångskiftande känslor. Syfte: Beskriva vuxna personers upplevelser efter en hjärttransplantation. Metod: En allmän litteraturstudie genomfördes. Resultat: I resultatet framkom fyra subkategorier: Känslor om det transplanterade hjärtat och donatorn, det psykiska lidandet, andligt och socialt stöd och framtidstro. Därefter bildades huvudkategorin: Livet som den hjärttransplanterade. Diskussion: Livet efter en hjärttransplantation är en komplicerad situation. Det kan vara en svårighet att anpassa sig till det donerade hjärtat. Det är därför viktigt med en god vårdrelation för att stötta och inge positiva aspekter till upplevd hälsa, detta har diskuterats utifrån Antonovskys teori KASAM. Slutsats: En god kontakt inbjuder till frågor om problem och funderingar kring sin hälsa vilket leder till trygghet och ökad kunskap. / Background: A person who are subject to heart transplantation is very ill and there is no other treatment available. When the heart transplantation is made lifestyle changes and life-long and continuous treatment of immunosuppressive drugs requires. A transplant is an obscure event that brings diverse emotions. Aim: To describe adults’ experiences after a heart transplantation. Method: A literature review was conducted. Results: In the result four subcategories appared: Emotion on the transplanted heart and the donor, the psychological suffering, spiritual and social support and belief in the future. Subsequently formed the main category: Life as the heart transplant. Discussion: Life after a heart transplant is a complex situation. It can be a difficulty to adapt to the donated heart. It is therefore important, but good health care relationship to support and inspire positive aspects of perceived health, this has been discussed on the basis of Antonovsky theory of Sense of Coherence. Conclusion: A good contact to invite questions about their health problems leading to security and increased knowledge.

Past research advocates the need for long-term care (LTC) facilities to adopt a person-centred model of care to optimize residents quality of life. The construct of quality of life in LTC has been defined by satisfaction with a set of domains identified by Kane and colleagues (2003). One goal of this study was to determine which domain is the most predictive of overall well-being among LTC residents in a rural setting. Based on past research and on Deci and Ryans (1985; 1991) self-determination theory, satisfaction with autonomy was predicted to emerge as most predictive of overall well-being. The present study also examined the relation between resident quality of life and well-being, and the degree of routinization (i.e., adherence to a rigid, inflexible daily schedule) within the LTC environment. Routinization is conceptually at odds with a person-centred model of care, yet its relation to the well-being of care recipients had not been examined prior. One hundred and ninety-eight residents from 15 LTC facilities in rural Saskatchewan participated in individual interviews to measure their satisfaction with 11 quality of life domains (Kane et al., 2003), and their overall well-being (using the Memorial University of Newfoundland Scale of Happiness; MUNSH; Kozma & Stones, 1980). One hundred and thirty-one staff from the 15 facilities completed a questionnaire designed to assess routinization within the LTC environment. Contrary to predictions, autonomy failed to emerge as a significant predictor of overall well-being among sample residents. The domain of meaningful activity received residents lowest satisfaction rating of the 11 domains, and also accounted for the most unique variance in overall well-being. Routinization was negatively related to resident quality of life, with staff rating routinization higher in facilities which residents reported lower satisfaction with quality of life. Results provide focus for improving the quality of life of LTC residents, and point to areas for further study.

A long-term care resident sits in front of a TV. With the push of a remote control button she instantly sees and visits with her children and grandchildren over 500 miles away. She last saw them on her 80th birthday, four years ago. She and her family are participants in a social action inquiry that explores video conferencing in order to understand the value of technology enhanced face-to-face interaction in a long-term care home. <p>This research, designed as a compassionate response to the serious problems of isolation, loneliness, helplessness, and boredom in long-term care, set out to determine what video conferencing can mean to long-term care residents and to the people they connect with. The study queried possibilities for improving the quality of social interactions of residents in long-term care facilities with family members living at some considerable distance from them. It involved setup of technical equipment, then three residents in a long-term care facility in western Canada were introduced to the practice of video conferencing with their families. Each conferencing event was supported with volunteers for a three-four month exploration period. <p>The research was intended to contribute to knowledge about learning in later life, to promote a way of increasing communication between the elderly and younger generations, and to address issues associated with elderly long-term care residents access to video conferencing technology. <p>Data collected through memory logs, observations, and interviews indicates that all study participants, including residents, family, and volunteers, responded favourably to the video conferencing experience. This study supports the claims that video conferencing can increase the frequency of contact between long-term residents and family members, and that the quality of this contact is enhanced through the visual presence and engagement of participants, through use of video conferencing technology. The video conferencing enabled family members separated by distance and unable to visit frequently to take on a "regular visitor role" and for residents to go visiting. The visually enhanced communication / visits transformed the otherwise limited audio interaction of phone calls or no interaction into socially substantive experiences of connectedness, inclusion about which residents reported feeling excited and connected with something to look forward to. <p>This suggests video conferencing could contribute to a good quality of life for residents. Future communications infrastructures should seriously consider inclusion strategies and availability of effective applications to long-term care residents.

Although the concept of quality of life (QOL) has become increasingly popular in the past few decades in a number of fields of research, few studies have specifically examined QOL for high-functioning individuals with autism spectrum disorders. Several studies have found that objectively measured outcomes for adults with high-functioning autism (HFA) and Asperger's syndrome (AS) tend to be poor in terms of employment, relationships, mental health, and independence. However, it has been recently suggested that in order to obtain a more accurate depiction of overall QOL, subjective impressions must be examined as well. Recent research has found that the most significant predictor variable of QOL for high-functioning individuals with autism spectrum disorders is the discrepancy between support needed and formal support provided. The current study examined 15 formal support variables and their relationships to subjective QOL scores on the WHOQOL-BREF, in 4 domains (physical health, psychological health, environment, and social relationships) as well as overall QOL. A total of 33 participants completed a questionnaire that included items designed to obtain information on demographics and formal support. Participants also completed the WHOQOL-BREF in order to obtain overall QOL scores along with QOL domain scores. Significant negative correlations were found between Environmental QOL scores and the accessing of a social worker as well as the accessing of social groups. Significant negative correlations were also found between Social QOL scores and the accessing of a psychiatrist and a single-item overall QOL score and the accessing of counselling or psychotherapy. All correlations between formal support factors and QOL scores showed lower QOL scores for those individuals who accessed the supports. The results of standard multiple regression analyses revealed a significant model that accounted for 49% of the total variance in the amount of total supports accessed as well as two other significant models predicting Social QOL and Environmental QOL.

Syftet med föreliggande litteraturstudie var att beskriva hur personer som genomgått amputation upplever sin livskvalitet. Den deskriptiva litteraturstudien baserades på 14 vetenskapliga artiklar med både kvantitativ och kvalitativ ansats. Litteratursökningarna utfördes i databaserna Medline (via PubMed) samt CINAHL. Huvudresultatet visade att amputation påverkade individerna utifrån ett fysiskt, psykisk och socialt perspektiv. Vanliga faktorer som påverkade livskvaliteten negativt var smärta och svårigheter med mobiliseringen. Ångest, depression och minskad självkänsla var förekommande psykiska problem. Svårigheter i att anpassa sig till den nya identiteten och social isolering var vanligt förekommande problem. Användandet av protes gjorde att känslan av att vara normal, och den fysiska förmågan att klara av aktiviteter i det dagliga livet, återkom. Den sociala anpassningen och relationer till familj och omgivning blev negativt förändrad efter amputationen. Individerna lärde sig att anpassa sig i sociala situationer vilket lindrade negativa känslor och osäkerhet. Sociala relationer upplevdes som viktiga för att få stöd och uppmuntran i rehabiliteringen samt minimera negativa känslor. Litteraturstudiens slutsats belyste vikten av att sjuksköterskan har kunskap om vanligt förekommande komplikationer som kan påverka livskvaliteten, detta för att kunna bearbeta eventuella problem innan de uppstår. / The aim of the literature review was to describe how people who have undergone amputation perceive their quality of life. The descriptive literature study was based on 14 scientific articles with both quantitative and qualitative approach. The literature searches were carried out in the databases Medline (via PubMed) and CINAHL. The main results showed that amputation affected individuals from a physical, mental and social perspective. Common factors that affected the quality of life negatively were pain and difficulty with the mobilization. Anxiety, depression and decreased self-esteem were common mental health problems. Difficulties in adjusting to the new identity and social isolation were common problems. The use of prosthesis gave the feeling of being normal and the physical ability to handle activities in daily life. The social adjustment and relationships with family and personal surroundings was negatively changed after the amputation. The individuals learned to adapt in social situations which eased the negative emotions and uncertainty. Social relationships were experienced as important for support and encouragement in the rehabilitation and minimize the negative emotions. The conclusion highlighted the importance of the nurse's knowledge about common complications that can affect quality of life, in order to deal with problems before they occur.

Background: Quality of life is a concept of individual meaning which is perceived differently depending on the person experiencing it. To have a chronic disease in the lung, such as asthma, has an effect on the quality of life. Asthma affects people of all ages. It is a disease that causes a constriction in the patients’ airways which leads to a feeling of suffocation which in turn produces a feeling of anxiety. Aim: The purpose is to illuminate which factors affect the quality of life in adult patients with asthma. Method: This is a literary review based on ten articles, both quantitative and qualitative, from four different continents. The articles were found in the databases Cinahl, PubMed, Medline and Academic Search Premier. Results: There were many factors affecting the quality of life in patients with asthma. Six categories emerged from the analysis; demographic factors, physical difficulties, treatment and environment and the inner were mental difficulties and knowledge and communication. Discussion: The most prominent factor in relation to quality of life was the existence of non-wanted symptoms. The symptoms the patients experienced were among other things caused by a lack of knowledge. Dorothea Orems "theory of self-care" was used in parts of the discussion and it was revealed that barriers to knowledge were for the patient an obstacle to self-care. / Bakgrund: Livskvalitet är ett koncept som har en individuell prägel och som kan betyda olika för olika personer. Att vara drabbad av en kronisk sjukdom i lungorna, såsom astma, har en påverkan på livskvaliteten. Astma drabbar människor i alla åldrar och är en sjukdom som gör att patienten får en sammandragning i luftvägarna, vilket leder till en ångestskapande känsla av att kvävas. Syfte: Syftet är att belysa vilka faktorer som påverkar livskvaliteten hos vuxna patienter med astma. Metod: Denna studie är gjord i form av en litteraturöversikt baserad på tio artiklar från fyra världsdelar. Artiklarna är av både kvalitativ och kvantitativ metod och funna i databaserna Cinahl, PubMed, Medline samt Academic Search Premier. Resultat: Det är många faktorer som påverkar livskvaliteten hos patienter med astma. Analysen resulterade i sex kategorier; demografiska faktorer, fysiska besvär, behandling, miljö, psykiska besvär samt kunskap och kommunikation. Diskussion: Den faktor som framkom som tydligast i förhållande till livskvaliteten var förekomsten av icke önskade symptom. Dessa symptom som patienterna upplevde hade bland annat en orsak i de kunskapsbrister som fanns. Dorothea Orems ´Teori om egenvård´ användes som underlag i delar av diskussionen och det framgick att kunskapsbrister hos patienten var ett förekommande hinder till egenvård.

Patienter med förmaksflimmer är en grupp vars symtom ofta underskattas. Symtomen påminner om de som uppkommer vid en hjärtinfarkt med bröstsmärta, hjärtklappning, andnöd och trötthet. Syftet med studien var att belysa hur det kan vara att leva med förmaksflimmer. En litteraturstudie utfördes där vetenskapliga artiklar analyserades och sammanställdes. Resultatet visade att patienternas livskvalitet var kraftigt nedsatt och även anhöriga påverkades. En ökning av ångest och depression sågs vid uppföljning sex och tolv månader efter fastställd diagnos. Informationen och omvårdnaden var bristfällig och ett kunskapsbehov identifierades. Evidensbaserade riktlinjer för omvårdnad och information har utarbetats för denna patientgrupp, men resultatet visade att det inte fanns några utarbetade vårdprogram att tillgå i Sverige. Baskunskaper i omvårdnaden saknades hos personalen som vårdade patienterna. Här ses ett stort behov av omvårdnadsforskning inom området. Ett ökat samarbete mellan forskare och kliniskt verksamma sjuksköterskor behövs för att nya rön ska kunna implementeras i den dagliga vården. / Patients with atrial fibrillation is a group whose symptoms are often underestimated. Symptoms are similar to those arising from a heart attack with chest pain, palpitations, shortness of breath and fatigue. The purpose of this study was to illustrate how it can be to live with atrial fibrillation. A literature review was conducted in which scientific articles were analyzed and summarized. The results showed that patients' quality of life was dramatically reduced and even relatives were affected. An increase in anxiety and depression were seen at follow-up six and twelve months after the established diagnosis. The information and care was poor and the knowledge needs were identified. Evidence-based guidelines for care and information has been prepared for this group of patients, but the result showed that there were no prepared programs of care available in Sweden. Basic knowledge of nursing was missing the nursing staff who cared for the patients. Seen here is a great need for nursing research in the field. Increased cooperation between academics and clinical nurses is needed so that new findings could be implemented in the daily care.

Huvud- och halscancer drabbar i Sverige varje år cirka 1200 män och kvinnor. Behandling sker främst genom strålbehandling och kirurgi. Både sjukdom och behandling kan ge svåra och många gånger bestående men som patienten måste lära sig leva med. Syftet med denna studie var att belysa patienternas upplevelser och erfarenheter efter avslutad behandling för huvud- och halscancer. Arbetet utfördes som en litteraturstudie där tio vetenskapliga artiklar analyserades. Resultatet visar att familj och vänner nu sätts i första rummet, det visar också på svårigheter hos de som är ensamma. Socialt ätande och förändrat utseende är två faktorer som inverkar på patienternas liv, och att de tar till olika strategier för att inte låta biverkningar och oro för sjukdom begränsa livsrummet. Patienterna upplever, trots sjukdom och biverkningar, ett stort mått av livskvalitet. Mycket kraft och energi läggs dagligen på att fungera så normalt som möjligt tillsammans med sig själv och sin omgivning. Utbildning i kommunikation och bemötande för att rusta sjuksköterskor att möta dessa patienters unika behov torde höja kvaliteten på omvårdnaden. Ytterligare forskning behövs och då främst med kvalitativ ansats för att belysa patienternas personliga upplevelser. / InSwedenthere are about 1200 new cases of head and neckcancer reported every year. The main treatments are radiotherapy and surgery. Both illness and treatment causes the patients bad sequele that they have to adjust to. The aim of this study was to obtain what head and neck cancer patients experience are after they completed treatment for head and neckcancer. The study was carried out as a literature study where ten research articles were analyzed. The results show that family and friends are what the patients value most and it also shows that it could be difficult for them who are alone. Social eating and changed appearance are two factors that have impact on the patients´ life, and that the patients embrace different strategies to prevent side effects and anxiety over illness to impact negatively in their life space. Despite this, patients do experience a good quality of life. It is a high level of power and energy these patients mobilize every day in order to live as normal as possible with themselves and among the rest of the world. Education in communication and treatment behavior for nurses to meet these patients´ unique needs could contribute to improve the nursing quality. Further research is needed, especially qualitative research, to highlight patients´ personal experiences.

Aim: The aim of present study was to determine the frequency of taste and smell disorders occuring in patients receiving chemotherapy for cancer. Methods: The study was of an empirical cross sectional quantitative descriptive design. During one month, consecutive cancer patients at outpatient units in two Swedish hospitals were asked to participate in the study by completing a questionnaire that had been developed previously for a similar study. All participants had undergone at least 1 cycle of intravenous chemotherapy or  a minimum of seven days of oral chemotherapy. Results: A total of 102 patients completed the questionnaire. Results show that 55 % experienced taste disorders and  42 % experienced smell disorders. Both disorders are more common in women than in men. Of patients with taste disorders 47 % reported that it  impacted on their daily life to some degree and of patients with smell disorders the corresponding number was 33%. Patients with smell disorders reported a smaller degree of impact on their daily life than did patients with taste disorders. Conclusion: Both taste and smell disorders are common in cancer patients treated within chemotherapy. More research into factors that might eliminate or dimnish these problems is needed.