published_or_final_version / Community Medicine / Master / Master of Public Health

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

published_or_final_version / Mental Health / Master / Master of Social Sciences

ALS är en förkortning av Amyotrofisk lateral skleros. Nervceller som styr kroppensmuskulatur förtvinas och leder till förlamning. Till slut påverkas andningsmuskulaturen och man får svårigheter med andningen, vilket till sist leder till döden. Sjukdomen delas in i grupper och det skiljer sig åt i symptom och aggressivitet dock är utgången densamma. Överlevnaden är vanligtvis 3-5 år. Det bedrivs mycket medicinsk forskning men än så länge har man inte hittat botemedel. Orsaken är oklar men det finns vissa teorier. Behandlingen går ut på att lindra symtom och bromsa sjukdomförloppet. Syftet med denna studie är att belysa upplevelsen att leva med ALS.  Därför gjordes en litteraturstudie ur ett vårdvetenskapligt perspektiv, utifrån nio forskningsartiklar. Sökningar har gjorts i databaserna Cinahl, PubMed och Medline.I analysen framkom två teman: Förändrad livsvärld och Välbefinnande. Under Förändrad  livsvärd  framkommer  tre  underteman:  Lidande,  Skuld  och  skam  samt Vården av en anhörig. Under Välbefinnande hittades två underteman: Finna mening i livet och Konsten att leva i nuet. Studien visar att ALS skapar mycket lidande och existentiella funderingar både för patient och anhöriga. Den visar också att det är de anhöriga som står för den mesta vården och tar ett stort ansvar för patienten. Mitt i allt lidande kan man trots allt finna glädje och välbefinnande, vilket familj och vänner bidrar till.

Quality of life is a phrase that most people are familiar with, regardless of whether or not they can define it. Much research has been conducted across disciplines in an effort to explain the construct. As human service programs become more focused on outcomes, there is greater interest in measuring quality of life as an indicator of service quality and success. This study was designed to test whether or not quality of life differences exist between adults with developmental disabilities and the general population at an item, scale, and composite level. The quality of life dimensions that were tested included items related to well-being, community participation, access to services and human rights, and choice and decision-making. Differences were found in well-being and decision-making. Differences were also present in certain access items. The two groups also differed in overall quality of life with those with developmental disabilities having lower quality of life. A logistic regression model that was comprised of the life dimensions differentiated between the two groups with over 90% accuracy. Overall results indicate that adults with developmental disabilities are at a significant disadvantage with regard to quality of life in comparison with the general population.

Antidepressants are associated with sexual side effects (Clayton, Keller, & McGarvey, 2006). Sexual side effects are associated with non-compliance or discontinuance of antidepressants (Werneke, Northey, & Bhugra, 2006). Despite this, there are few empirically supported treatments for antidepressant side effects. However, in laboratory studies, exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants (Lorenz & Meston, 2012). I evaluated if exercise improves sexual functioning in women experiencing antidepressant-induced sexual side effects. Fifty-two women reporting antidepressant sexual side effects were followed for 3 weeks of sexual activity only. They were randomized to complete either three weeks of exercise immediately before sexual activity (3x/week) or 3 weeks of exercise separate from sexual activity (3x/week). At the end of the first exercise arm, participants crossed to the other. I measured sexual functioning, sexual satisfaction, depression and physical health. Completers showed modest improvements in sexual functioning and satisfaction. For women taking selective serotonin and norepinephrine reuptake inhibitors, exercising immediately before sexual activity was superior to exercise in general. As well as known effects in improved physical and psychological health, exercise may help improve sexual health and pleasure in women taking antidepressants. These findings have important implications for public health, as exercise is accessible, cheap, and does not add to burden of care. / text

Background: The Adult Social Care Outcomes Toolkit was developed to measure outcomes of social care in England. In this study, we translated the four level self-completion version (SCT-4) of the ASCOT for use in the Netherlands and performed a cross-cultural validation. Methods: The ASCOT SCT-4 was translated into Dutch following international guidelines, including two forward and back translations. The resulting version was pilot tested among frail older adults using think-aloud interviews. Furthermore, using a subsample of the Dutch ACT-study, we investigated test-retest reliability and construct validity and compared response distributions with data from a comparable English study. Results: The pilot tests showed that translated items were in general understood as intended, that most items were reliable, and that the response distributions of the Dutch translation and associations with other measures were comparable to the original English version. Based on the results of the pilot tests, some small modifications and a revision of the Dignity items were proposed for the final translation, which were approved by the ASCOT development team. The complete original English version and the final Dutch translation can be obtained after registration on the ASCOT website (http://www.pssru.ac.uk/ascot). Conclusions: This study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version. We recommend further research to confirm the validity of the modified Dutch ASCOT translation. (authors' abstract)

The purpose of this study was to test a theoretical model which predicted subjective well-being in patients who had been diagnosed with malignant melanoma. The theoretical model was developed from empirical findings based on a review of the literature in which health locus of control, social support and self-esteem were identified as significant predictors of well-being. The specific aim of this study was to examine the strength of the predicted relationships between selected psychosocial variables and subjective well-being. The study utilized a nonexperimental correlational design with a causal modeling approach. The convenience sample was composed of 75 individuals (x age = 52.5) who had been diagnosed with malignant melanoma. Subjects completed four instruments which measured the theoretical concepts under study. Two additional instruments were administered which indexed the variables of search for meaning and concern of recurrence. Descriptive statistics were used in examining the demographic and situational characteristics of the sample. Multiple regression techniques were utilized to empirically test the predicted theoretical relationships and to estimate predictive validity for the theoretical concepts. Graphic residual analysis was performed to assess for violations in the statistical and causal model assumptions. Study findings revealed that social support had a direct positive impact on self-esteem (B =.27, R² =.06) and that self-esteem had a direct positive impact on well-being (B =.49, R² =.37). The two demographic variables of employment and income were found to have a direct positive impact on well-being (B =.22 and B =.26, respectively), and resulted in a 10% increase in the total explained variance in well-being. The theoretical model, which was generated to predict subjective well-being in malignant melanoma patients, explained 47% of the total variance in well-being. Research into the variables which influence patient well-being during the cancer experience is vital if nursing is to implement therapeutic interventions which will promote an improved life quality. By intervening with nursing actions that focus on a positive self-esteem, a greater sense of well-being could be attained by individuals diagnosed with cancer.

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Background: Health-related quality of life (HRQL) outcomes have been increasingly used in phase III randomized controlled trials to characterize the benefits or risks of a cancer treatment. HRQL outcomes from clinical trials can also inform clinical practice in oncology settings. Previous qualitative research suggests that oncologists value HRQL outcomes but challenges to their clinical application exist. Little quantitative research has been conducted to examine these barriers. This study describes the opinions of oncologists toward HRQL outcomes, the ways in which HRQL outcomes can be presented, and the importance of suggested reporting standards for HRQL outcomes in clinical trials. It further examines the association between attitudinal and demographic factors associated with the self-reported current use and achievable use of HRQL outcomes in clinical practice. Methods: This study is a cross-sectional survey of oncologists. A web-based questionnaire was disseminated in Canada, United Kingdom, and Australia/New Zealand. The study included oncologist members of the NCIC Clinical Trials Group, the NCRI Clinical Studies Groups, and the Australasian Cancer Clinical Trials Groups. Respondents were asked to report their opinions toward HRQL outcomes and the factors associated with the use of these outcomes in clinical practice. Demographic characteristics were also collected. Chi-square tests were used to compare the proportion of responses between countries. Logistic regression was used to identify factors associated with the use of HRQL outcomes in clinical practice. Results: A total of 344 oncologists completed the survey. Most oncologists (65.9%) reported having a good knowledge of HRQL outcomes and 72% perceived HRQL outcomes to be useful. High current use of HRQL outcomes in clinical practice was associated with more medical practice experience; perceiving HRQL outcomes to be useful; perceiving HRQL measurements to be reliable; and reporting lack of understanding to rarely be a barrier to using HRQL outcomes. High achievable use of HRQL outcomes in clinical practice was associated with being a male oncologist, perceiving HRQL outcomes to be useful, and being an investigator in RCTs. Conclusions: Important factors associated with the use of HRQL outcomes in clinical practice were identified, highlighting the need for future research and education. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-09-30 12:56:09.362