Bakgrund: Primär dysmenorré, svår menstruationssmärta utan sjukdomsrelaterad bakomliggande orsak, är det vanligaste gynekologiska besväret för unga kvinnor. Idag fokuseras behandlingen av menstruationssmärta på läkemedel. Det har dock visats att kvinnor även använder sig av ickefarmakologiska metoder för att lindra sin smärta. Syftet med denna litteraturöversikt var att undersöka om det finns evidens för att följande ickefarmakologiska behandlingsmetoder kan lindra primär dysmenorré: akupunktur, akupressur, kostvanor och kostterapi, massage, transkutan elektrisk nervstimulering (TENS), värme samt örtterapi. Metod: Sökningar genomfördes i databaserna AMED, CINAHL, Cochrane Library samt Pubmed. På grund av få artikelträffar och låg kvalitet hos artiklarna exkluderades massage och värme. Totalt inkluderades 18 engelskspråkiga artiklar, publicerade mellan år 1999-2009, vilka redovisade resultat från sammanlagt 92 studier. Sammanlagt 23 studier undersökte akupunktur, 11 undersökte akupressur, 46 undersökte örtterapi, 3 undersökte kostterapi och kostvanor samt 9 undersökte TENS. Kvalitetsgranskning genomfördes enligt en mall från Forsberg & Wengström (2008). Resultat: Det finns evidens för att akupressur, TENS och örtterapi lindrar primär dysmenorré. Vilka specifika akupunkter och örter som har en smärtlindande effekt är dock oklart. Sjuksköterskan kan ge råd till patienter med primär dysmenorré att prova TENS för att lindra sina menstruationssmärtor. / Background: Primary dysmenorrhea, menstrual pain without disease-related underlying reason, is the most common gynaecological discomfort for young women. Today the treatment regime for menstrual pain is focused on pharmacologic treatments. However, it has been observed that women also use non-pharmacologic methods to ease their pain. The objective for this literature review was to determine if there is evidence for the following non- pharmacologic treatment-methods to ease primary dysmenorrhea: acupuncture, acupressure, dietary habits and dietary therapies, massage, transcutaneous electrical nerve stimulation (TENS), heat and herbal therapy. Method: Searches were performed in databases AMED, CINAHL, Cochrane Library and PubMed. Because of a small number of search-results and low quality of the articles massage and heat was excluded. A total of 18 English-speaking articles published between 1999-2009 were identified. They reviewed results from 92 studies. Altogether 23 studies reviewed acupuncture, 11 acupressure, 46 herbal therapy, 3 dietary therapies and dietary habits and 9 TENS. Quality assessment was performed according to a template from Forsberg & Wengström (2008). Results: There is evidence that acupressure, TENS and herbal therapy ease primary dysmenorrhea. Which specific acupoints and herbs that are pain relieving could not be concluded. The nurse can give advice to patients with primary dysmenorrhea to test TENS to ease their menstrual pain.

Methods to improve self-care and clinical management of heart failure are required, especially in light of the anticipated increase in heart failure prevalence and associated high costs. Remote patient monitoring (RPM) has been shown to improve heart failure outcomes, but the feasibility and efficacy of mobile phone-based RPM systems are still unknown. The main objectives of this research were to investigate the optimal design of a mobile phone-based RPM system, and to determine the effects of the system on self-care, clinical management, and health outcomes. A mobile phone-based RPM system was first developed using a user-centric design process. It was then evaluated with a six-month randomized controlled trial consisting of 100 patients attending a heart function clinic. The quality of life improved only for the intervention group, but both intervention and control groups improved with respect to self-care, heart function, and heart failure prognosis. The clinic was determined to be a confounder. Patients who were enrolled into the clinic for less than six months showed significantly greater improvements (six months is required for patients to stabilize from medication optimization). Therefore, a subgroup analysis using data from the 63 patients who were enrolled into the clinic for over six months at time of recruitment was performed. The results from the subgroup analysis indicated that the RPM system improved self-care, heart function, and heart failure prognosis at statistically significant and clinically meaningful levels. These improvements were found to be a result of enhanced self-care knowledge and practices, as well as enhanced clinical management enabled by the system. No differences in mortality or hospital admissions were found between groups, but the trial was underpowered to detect changes in these outcome measures. In summary, mobile phone-based RPM was found to be a feasible and effective tool to help improve heart failure management and outcomes.

Methods to improve self-care and clinical management of heart failure are required, especially in light of the anticipated increase in heart failure prevalence and associated high costs. Remote patient monitoring (RPM) has been shown to improve heart failure outcomes, but the feasibility and efficacy of mobile phone-based RPM systems are still unknown. The main objectives of this research were to investigate the optimal design of a mobile phone-based RPM system, and to determine the effects of the system on self-care, clinical management, and health outcomes. A mobile phone-based RPM system was first developed using a user-centric design process. It was then evaluated with a six-month randomized controlled trial consisting of 100 patients attending a heart function clinic. The quality of life improved only for the intervention group, but both intervention and control groups improved with respect to self-care, heart function, and heart failure prognosis. The clinic was determined to be a confounder. Patients who were enrolled into the clinic for less than six months showed significantly greater improvements (six months is required for patients to stabilize from medication optimization). Therefore, a subgroup analysis using data from the 63 patients who were enrolled into the clinic for over six months at time of recruitment was performed. The results from the subgroup analysis indicated that the RPM system improved self-care, heart function, and heart failure prognosis at statistically significant and clinically meaningful levels. These improvements were found to be a result of enhanced self-care knowledge and practices, as well as enhanced clinical management enabled by the system. No differences in mortality or hospital admissions were found between groups, but the trial was underpowered to detect changes in these outcome measures. In summary, mobile phone-based RPM was found to be a feasible and effective tool to help improve heart failure management and outcomes.

School of Nursing

Personer som drabbas av kronisk njursjukdom och startar behandling med hemodialys får en förändrad livssituation. Kärlaccess är en förutsättning för behandling och är personens framtida livlina. Sjuksköterskans uppgift är att ge stöd och stärka personens förmåga att uppleva hälsa trots sjukdom. Möjlighet att nå delaktighet och ökad egenvård är olika för varje enskild person och sjuksköterskan behöver bred kunskap för att möta detta behov. Syftet med studien, som utfördes som en litteraturöversikt, var att utifrån patientperspektivet belysa erfarenheter av hur kärlaccess kan påverka hälsan hos personer i hemodialys. Resultatet visade att tillit till sjuksköterskan och till sig själv, kunskap om sig själv och sin sjukdom, viljan att inte känna sig annorlunda och stöd från personer i sin omgivning påverkade hälsan. Tillit till sjuksköterskan behövs för att, trots rädsla vid placering av nålar, kunna vara delaktig i behandling. Stöd och kunskap har betydelse för personens väg mot egenvård. Mer forskning är önskvärd inom området för att belysa upplevelser hos personer med dialys och kärlaccessens betydelse för självständig behandling. / The life situation changes for individuals suffering from Chronic Kidney Disease who starts treatment with Hemodialysis. A vascular access is a prerequisite and is the individual’s future lifeline. The nurse’s task is to support and reinforce the individual’s ability to experience health despite disease. The possibility to achieve involvement and increased self-care varies for each individual and the nurse requires extensive knowledge to meet this need. The study was carried out as a literature overview. The purpose was, from a patient perspective, to highlight experience of how vascular access can influence the health of people with hemodialysis.The result showed that trust in the nurse and themselves, knowledge about themselves and their illness, willingness not to feel different and support from the people around them influenced the health. Trust in the nurse is needed to facilitate involvement in the treatment, despite fear when inserting the needles. Support and knowledge is of value in order for the individual towards self-care. More research on this subject is desirable to highlight the experiences of individuals in dialysis and the significance of the vascular access in order to achieve independent treatment.

Thesis (Ph. D.)--University of Missouri--Columbia, 2001. / "December 2001." Typescript. Vita. Includes bibliographical references (leaves 228-243). Also available on the Internet.

Thesis (Psy. D.)--Rutgers University, 2009. / "Graduate Program in Clinical Psychology." Includes bibliographic references (p. 101-104).

Includes bibliographical references.

No description available.

The purpose of this study is to test a theory-based intervention program to reverse excess disability of nursing homes elders in Taiwan. The program called the Self-Care Self-Efficacy Enhancement Program (SCSEEP) was derived from Social Cognitive Theory and Theory of Conformity with Nature. The program was tested by an experimental, two-group, pre-post design with forty-two qualified subjects, recruited from the two nursing homes located in the southern Taiwan. The subjects were randomly assigned to one of the two groups: the experimental group (n = 21) and the comparison group (n = 21). Subjects in the experimental group, who were aged from 73.8 to 94.7, received the SCSEEP. Subjects in the comparison group, who were aged from 71.2 to 95.6, received six-week social visits. Statistical data analysis showed that the following pair-variables were positively correlated: 1) life satisfaction and self-esteem, 2) life satisfaction and motivation, 3) self-esteem and motivation in health behavior, 4) self-esteem and levels of BADL performance, and 5) motivation in health behavior and levels of BADL performance. It also was found that elders receiving the SCSEEP significantly improved in most self-care abilities, after controlling for baseline BADL performance. However, the SCSEEP did not significantly affect elders' life satisfaction, self-esteem, and motivation in health behavior. This study provides a theory-based caring model for Chinese nursing home elders in improving their BADL performance if SCSEEP is provided.