Orientador: Jose Paulo Cabral de Vasconcellos / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T23:02:33Z (GMT). No. of bitstreams: 1 Okanobo_Andre_M.pdf: 2897473 bytes, checksum: 5bad5928ff037c8396c72781f5829cc1 (MD5) Previous issue date: 2014 / Resumo: Avaliação da qualidade de Vida dos Pacientes Antes e Após Realização de Transplante Penetrante de Córnea. OBJETIVO Verificar o impacto do transplante de córnea sobre a qualidade de vida dos indivíduos submetidos à cirurgia no serviço de Oftalmologia HC-UNICAMP no período de outubro de 2005 a outubro de 2006. METODO: O estudo foi aprovado pelo comitê de ética e pesquisa da FCM-UNICAMP. Foram inclusos indivíduos com indicação de transplante de córnea do ambulatório de Doenças Externas da Oftalmologia do HC UNICAMP no período de outubro de 2005 a outubro de 2006 e que aceitaram em participar do estudo. Foram incluídos 32 indivíduos. Os critérios de exclusão foram transplante tectônico, indivíduos com déficit visual importante causado por outra afecção ocular além das alterações corneanas. Realizou-se exame oftalmológico assim como aspectos demográficos e história ocular dos pacientes incluídos no estudo. Métodos objetivos como claridade do transplante e melhor acuidade visual corrigida e método subjetivo, a qualidade de vida, através do questionário SF-36 adaptado. RESULTADOS: Houve diferença significativa de satisfação entre gêneros com maior escore no sexo masculino (p = 0.0319). No método objetivo como a acuidade visual corrigida teve aumento significativo do olho transplantado (p<0.0001); A AV média antes do transplante era de 0,98 ± 0,1 logMAR e após 0,48 ± 0.38 logMAR. Quanto o escore de qualidade de vida (SF-36), método subjetivo, após o transplante houve um aumento significativo (p<0.0001). O escore do SF-36 antes do transplante foi de 49,11% ± 19,28 (média ± DP) e após o transplante de 71, 98% ± 24,28 (média ± DP) com uma melhora de 22, 87% (p<0.0001).Os indivíduos mais satisfeitos foram aqueles que tiveram a pontuação mais alta no SF-36 (r = 0.60; P = 0.0002). A satisfação parece não estar correlacionada com a melhora da AVCC no olho transplantado (r = 0.3186; P = 0.0755). Ocorreu uma fraca correlação entre a melhora da AVCC no olho transplantado e a melhora do SF-36 (r=0.28382; p=0.1154). Não houve diferença significativa do SF-36 nos indivíduos com visão baixa nos dois olhos quando comparado com os pacientes com visão boa em um dos olhos (p=0.2998 ) CONCLUSÃO: O transplante penetrante de córnea proporcionou melhora na pontuação dos métodos subjetivo e objetivos. Os indivíduos com maior satisfação foram melhor avaliados através do método subjetivo (SF-36). Não houve diferença significativa na qualidade de vida dos indivíduos com pior acuidade visual no olho contralateral quando comparado com os indivíduos com boa visão no olho contralateral, mas análise de um maior número de indivíduos é necessária / Abstract: Purpose: To assess and measures the patient satisfaction before and after penetrating keratoplasty. Methods: The study of approved by the ethics committee of FCM-UNICAMP. Data were collected from 32 patients who underwent penetrating keratoplasty (PK) between October 2005 and October 2006. Demographic, ocular history, objective treatment outcome measures such as clarity of the graft and best-corrected visual acuity (BCVA) of both eyes were collected prospectively. In addition to assessment of quality of life were obtained by an interview before the PK and after at least one year of postoperative. Results: The average age of subjects was 42 ± 22 (mean ± SD) years and 68.75 % were women. On average, men were most satisfied. BCVA was 0,98 ± 0,1 logMAR before and 0,48 ± 0.38 logMAR after PK showing a significant improvement on BCVA (P < 0.0001). SF-36 score was 49.11% ± 19.28% before and 71.98% ± 24.28% after PK showing a significant improvement after the PK (p< 0.0001). The most satisfied patients where those who had a better score on SF-36 (r = 0.60; p = 0.0002). Satisfaction seems not to be correlated to improvement in BCVA at the transplanted eye (r = 0.3186; p = 0.0755). There was weak correlation between improvement in BCVA on the transplanted eye and improvement of SF-36 score (r = 0.28382; p=0.1154). There was no significant improvement in SF-36 in patients with worse BCVA in the other eye (p = 0.2998). Conclusions: Penetrating keratoplasty has a positive effect on objective and subjective outcome measures. Patient satisfaction is better predicted by subjective outcomes. There is no significant difference in quality of life in patients with worse BCVA in the contralateral eye when compared to eye with good BCVA in the contralateral eye, but analysis of a larger number of patients is necessary to confirm that / Mestrado / Oftalmologia / Mestre em Ciências Médicas

As the age increases, the physical fitness of seniors decreases. This shows the fragility of their body. Managing everyday activities becomes increasingly more difficult for them. Result of this is reduced self-sufficiency of the seniors, which leads to reduced mobility and to the greater loss of muscle mass and higher dependence on professional care. Aging is accompanied by loss of muscle mass and muscle strength - sarcopenia. This is one of the main causes of geriatric fragility. Sarcopenia presents a serious health problem with both social and economic consequences. The term sarcopenia (from Greek words sarx - meaning flesh referring to muscle and penia - loss) was first used in 1989 by Irwin Rosenberg to describe the loss of muscle mass accompanying aging. Exactly defining the term sarcopenia has helped explain this gradual loss of muscle mass. Three objectives were set in the thesis. The first objective was to find out whether sarcopenia reduces the quality of life in the elderly. The second goal was to determine, which quality of life tests are suitable for testing sarcopenia and the last one was whether the SARC - F questionnaire predicts sarcopenia.Quantitative research was used for the empirical part of this work. Data collection was performed using a method of a questionnaire. These were standardized questionnaires aimed at assessing sarcopenia and quality of life. The research was carried out with a total of 77 respondents with sarcopenia and respondents without sarcopenia. The quantitative part of the research was statistically processed using the MS Excel computer program.

This diploma thesis deals with the issue of life quality of patients taking home parenteral nutrition. Its intention is to present the achieved life quality scores in the individual domains of physical and mental health in comparison with general population and to point out the differences in what dimensions the life quality of these patients is particularly affected. The theoretical section describes the present situation of the issue of home parenteral nutrition in the CR and the system of the care about the patients. The chapter about indications and contraindications to HPN is elaborated in more detail. The possibilities of the long-term vascular accesses, the care about them are also mentioned here, and particularly the role of a nurse in patient education in transferring parenteral nutrition to the domestic environment. The problems with long-term parenteral nutrition resulting from mechanic, metabolic and septic complications are also outlined. Parenteral nutrition failure is the most serious problem, which is why a chapter on small intestine transplantation as the last resort to save a patient with combined failure of intestine and nutrition is included. The second part of the theoretical section describes the life quality. I wanted to define the nature of this unambiguously graspable a term, determinants affecting life quality are also mentioned here. The possibilities of life quality measurement and assessment and particularly the follow-up use of the obtained data are mostly summarized here. Goals and hypotheses: Two goals were set to meet the main purpose of the thesis: Goal 1: To find whether the life quality of patients on HPN differs from that of the general public. Goal 2: To find the spheres in which the life quality of patients on HPN is mostly affected. A zero hypothesis was set to achieve the goals: Life quality of patients on HPN does not differ from that of the general public. There is no statistically significant difference between men and women. Eight alternative hypotheses to each life quality domain followed: H1: Patients on HPN show lower life quality score compared to the general public in the sphere of physical functions. H2: Patients on HPN show lower life quality score compared to the general public in the sphere of physical roles' limitation. H3: Patients on HPN show lower life quality score compared to the general public in the sphere of emotional roles' limitation. H4: Patients on HPN show lower life quality score compared to the general public in the sphere of emotional limitation of social functions. H5: Patients on HPN show lower life quality score compared to the general public in the sphere of pain. H6: Patients on HPN show lower life quality score compared to the general public in the sphere of general mental health. H7: Patients on HPN show lower life quality score compared to the general public in the sphere of vitality. H8: Patients on HPN show lower life quality score compared to the general public in the sphere of general health perception. A quantitative method of collected data analysis was applied to the research implementation. The research was based on the standardized questionnaire SF-36 supplemented with questions dealing with identification of respondents, time consumption of their treatment and their consequent satisfaction at the beginning. The questionnaire was distributed to patients using home parenteral nutrition in specialized nutrition centres of the Thomayer Faculty Hospital in Prague, Faculty hospitals in Brno and Hradec Králové and also by electronic means through the website of the citizen association Life without Intestine. The obtained data were statistically evaluated and processed into illustrative tables and graphs.Detailed mapping of the problems of life quality and highlighting of the neglected spheres of life quality of patients using HPN are the outputs of the thesis. The results will be presented to the members of the workgroup for HPN within their.

This dissertation concerning the theme "A comparison of the Contact and HRQOL concept in clients of nursing/old people´s homes" consists of a theoretical and practical part. The theoretical part firstly defines in detail the concept of the quality of life and the quality of life related to health (HRQoL ? health related quality of life). It also describes various methods of its evaluation. The next charter deals with the problems of aging and changes which arise with increasing age and are associated with a deteriorating health condition, as well as with situations and circumstances which may reset in a chase in the perception of the quality of life. The dissertation takes a closer look at the stay of elderly in some institutions for the elderly. The theoretical part compares the results obtained from elderly clients in an old people?s home using standardised SF-36 and Contact questionnaires. The SF-36 questionnaire is designed to measure the quality of life related to health and the Contact questionnaire serves to ascertain the frequency of contact between family and friends ant he elderly client. Data from both questionnaires were evaluated statistically and drawn up in the form of tables and graphs. This research showed a reduced perception of the quality of life of clients living in old people?s homes compared with the standard European population. In most domains of the quality of life there was no significant difference between clients with various frequency of contact with family and friends, and no difference was found n the evaluation of the quality of life between men and women.

Made available in DSpace on 2016-01-26T12:51:16Z (GMT). No. of bitstreams: 1 marielza_dissert_parte 1.pdf: 600568 bytes, checksum: 0107e3e73118e6ec5de58894e7163c10 (MD5) Previous issue date: 2004-04-27 / Technological improvements in dialysis have contributed for the increased survival of chronic renal patients, however, undergoing dialysis treatment for an indeterminate time might interfere in the quality of life of these patients. This study was aimed at evaluating the quality of life of chronic renal patients undergoing hemodialysis and identifying the activities that might have a negative impact on their quality of life. This is a descriptive and exploratory study, including 125 chronic renal patients undergoing hemodialysis (74 men and 51 women), mean age 53.1±14.6 years, mean time on hemodialysis 28.5±23 months. The generic SF-36 quality of life questionnaire and a semi-structured interview were used as data collection instruments. Data was subject to a descriptive statistical analysis, the chi-squared test, Pearson s correlation coefficient and the proportion comparison test, with a significance level of 5%. The results showed impaired quality of life of the patients, with lower scores for physical aspects dimensions (32.3±11.3), emotional aspects (46.1±16.3) and vitality (48.7±7.3). Quality of life variables regarding genders did not have a significant difference. There was a negative correlation between time on hemodialysis and physical component (r=-0.75, p<0.001), indicating that the longer the time on hemodialysis the lower are the scores found for this component and there was no significant correlation between time on hemodialysis and mental component (r=-0.29). Physical and recreational activities were the most affected in the global sample and in the sample stratified by gender. There was a negative correlation between time on hemodialysis and daily activities: work (p=0.0014), domestic activities (p=0.0014) and practical activities (0.0459). Data have shown impairment in several of the analyzed quality of life aspects in chronic renal patients undergoing hemodialysis and have pointed out that daily physical and recreational activities were the most affected ones. Our results have allowed the conclusion that there were no evidences of statistically significant differences in quality of life compared to gender; time on hemodialysis correlated with quality of life and daily activities had a negative correlation with physical component and work, domestic and practical activities. These results are important predictive factors to improve quality of life parameters in these patients. / Os avanços tecnológicos na área de diálise contribuíram para o aumento da sobrevida dos renais crônicos, entretanto, a permanência por tempo indeterminado em tratamento dialítico pode interferir na qualidade de vida destes pacientes. Este estudo teve como objetivo avaliar a qualidade de vida de pacientes renais crônicos em tratamento de hemodiálise e identificar as atividades cotidianas, que podem comprometer na qualidade de vida. Trata-se de estudo descritivo e exploratório, onde foram pesquisados 125 pacientes renais crônicos em tratamento de hemodiálise (74 homens e 51 mulheres), com média de idade 53,114,6 anos, tempo médio de hemodiálise de 28,523 meses. Utilizou como instrumentos de coleta de dados o questionário genérico de qualidade de vida SF-36 e a entrevista semi-estruturada. Os dados foram submetidos a análise estatística descritiva, o teste qui-quadrado, o coeficiente de correlação de Pearson e o teste de comparação de proporções, efetuados ao nível de 5% de significância. Os resultados constataram prejuízo na qualidade de vida dos pacientes, demostrando menores escores nos domínios dos aspectos fisicos (32 3+11 3), aspectos emocionais (46,11 6,3) e vitalidade (48,77,3). As variáveis de qualidade de vida em relação ao sexo não apresentou diferença significante. Verificou-se correlação negativa entre tempo de hemodiálise e componente físico (r = -0,75, p< 0,001), indicando que quanto maior o tempo de hemodiálise mais baixos são os valores encontrados deste componente e não houve correlação sígnificante entre tempo de hemodiálise e componente mental (r = -0,29). As atividades corporais e recreativas foram as mais comprometidas tanto na amostra global quanto na estratificada por sexo. Observou-se correlação negativa entre tempo de hemodiálise e as atividades cotidianas: trabalho (p=0,001 4), atividades domésticas (p= 0,0014) e atividades práticas (0,0459). Nota de Resumo Os dados evidenciaram o comprometimento em vários domíníos analisados da qualidade de vida dos renais crônicos em hemodiálise e identificaram que as atividades cotidianas corporais e recreativas foram as mais afetadas. Os resultados permitiram concluir: que não houve evidências de diferença estatisticamente significantes da qualidade de vida em relação ao sexo; houve diferença estatisticamente significante quanto as atividades cotidianas; o tempo de hemodiálise correlacionado com a qualidade de vida e atividades cotidianas apresentou correlação negativa no componente físico e nas atividades do trabalho, domestica e prática respectivamente Estes valores são importantes fatores preditivos para a melhora dos parâmetros de qualidade de vida destes pacientes.

I want to present a prospective evaluation of one-year results in patients undergoing total hip arthroplasty from a minimally invasive antero-lateral approach (THA MIS-AL). And I want also to compare, by means of biochemical markers, the operative invasiveness of standard total hip replacement with that of the minimally invasive anterolateral (MIS-AL) approach.At one year after surgery we evaluated the quality of life by 60 patients using SF-36 questionaire and we compared the results with standard anterolateral approach and regional standard.