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Syfte: Syftet med denna studie var att sammanställa patienters upplevelser av att leva med Multipel Skleros (MS) samt att undersöka vilka omvårdnadsbehov patienter med MS har. Metod: Uppsatsen har genomförts som en systematisk litteraturstudie. Inklusionskriterier var att artiklarna skulle vara vetenskapligt granskade och inte äldre än fem år. Sammanlagt har 17 stycken artiklar använts till resultatet, av dessa var nio stycken kvantitativa studier och åtta stycken kvalitativa studier. Resultat: Trötthet och depression var de mest besvärliga och immobiliserande symptomen för personer med MS. Sjukdomen inverkade negativt på sexlivet. Symptom som inkontinens och urinträngningar upplevdes som ett stort problem, men själv-kateterisering ledde till färre urinvägsproblem. Smärta fanns hos hälften av MS-patienterna, av dem upplevde 70,5 % neurogen smärta. Balanssvårigheter var det största problemet gällande rörligheten, och ovissheten om hur symptomen varierar från dag till dag upplevdes frustrerande. En stor del upplevde att andra människor har svårt att förstå deras situation och ta den på allvar. Kvaliteten på information och kommunikation mellan patienterna och vårdpersonalen hade stor betydelse. Delaktighet i planeringen av sin vård var av stor vikt för patienterna med MS.

Root Cause Analysis (RCA) är en metodik som kan användas vid problemlösning för att gå till botten av en problemsituation och lösa ut de grundläggande orsakerna bakom problematiken. Problemet med RCA är att denna metod har främst undersökts och använts i sammanhang då ett problem med fysisk händelse, ett praktiskt symptom, har inträffat. En enligt studenterna förbisedd del av denna forskning berör problem där symptomet inte kan kopplas till en fysisk händelse – ett administrativt symptom. Syftet med denna studie är att tillämpa RCA på ett problem med administrativt symptom för att sedan ställa detta resultat i relation till andra studier med praktiska respektive administrativa symptom. Därefter gör studenterna bedömningen huruvida RCA är en lämplig metodik vid tillämpningen av ett administrativt symptom eller inte.   Denna studie har genomförts på Volvo Cars Body Components (VCBC) i Olofström där det undersökta problemet med administrativt symptom har varit VCBCs materialdifferenser på produktionsmaterialet plåt. Utifrån denna studie framkom sex rotorsaker bakom VCBCs problematik, vilka alla oberoende av varandra gav upphov till problematiken. Denna trend kunde uppvisas i annan studie med administrativt symptom, men kunde inte uppvisas i någon studie då ett praktiskt symptom studerats. En slutsats av denna studie visar på att skillnaden mellan ett problem med ett praktiskt respektive administrativt symptom ligger i själva ursprunget till den grundläggande rotorsaken. I fall med praktiska symptom kan denna direkt hänvisas till en mänsklig faktor som ursprung till problematiken, en trend som inte framgår i de fall då ett administrativt symptom undersökts. Det är också studenternas slutsats att RCA är en lämplig metodik att använda vid problem med administrativa symptom. / Root Cause Analysis (RCA) is a method that can be used in problem solving to get to the bottom of a problem situation and solving the root causes behind the problems. The problem of RCA is that this method has mainly been studied and used in contexts where a problem with the physical event, a practical symptom occurred. According to the students, an overlooked part of this research addresses problems where the symptom cannot be linked to a natural event – an administrative symptom. The purpose of this study is to apply RCA to a problem with an administrative symptom in order to then set the result in relation to other studies with practical and administrative symptoms. Thereafter the students will do the assessment whether RCA is a suitable methodology to apply on an administrative symptom or not.   This study was conducted at Volvo Cars Body Components (VCBC) in Olofström where the investigated problem with an administrative symptom has been VCBCs material differences in the production material sheet. Based on this study six root causes were revealed to be behind VCBCs problems, where all, independent of each other, gave rise to problem. This trend could be presented in another study with administrative symptom, but could not be produced in any study where a practical symptoms was studied. One conclusion of this study show that the difference between a problem with a practical respectively administrative symptom lies in the very origin of the fundamental root cause. In cases of practical symptoms, this may actually refer to a human factor as the origin of the problem, a trend which is not clear in cases where an administrative symptom is investigated. It is also the student's conclusion that RCA is an appropriate methodology to use in case of problems with the administrative symptoms

SAMMANFATTNING Varje år insjuknar ca 1200 personer i Sverige med primär hjärntumör (Socialstyrelsen, 2014). En hjärntumör får ofta en stor inverkan på livssituationen för patienten och dennes närstående. Att identifiera och undervisa patient och närstående att hantera symtom och biverkningar för att kunna sätta in hjälpinsatser i rätt tid är en stor del av omvårdnadsarbetet för att förbättra den hälsorelaterade livskvaliteten under och efter sjukdomsperioden (Cahill & Armstrong, 2011). PROM är en förkortning av Patient Reported Outcome Measure, som översätts till patientrapporterade utfallsmått på svenska. PROM innefattar patientens egen skattning av sjukdomssymptom, funktionsförmåga och hälsorelaterad livskvalitet. Att använda frågeformulär med PROM är ett strukturerat sätt för både symtomintervention och uppföljning av vården (Nilsson, 2014). Syftet var att sammanställa frågeformulär framtagna eller modifierade för att mäta patientrapporterade utfallsmått hos vuxna patienter med primär hjärntumör. Litteraturöversikt valdes som metod och litteratursökning gjordes i databaserna PubMed och Cinahl. I resultatet presenterades sju frågeformulär framtagna eller modifierade och validerade för patienter med hjärntumör. Frågeformulären användes i olika syften som symtomintervention, uppföljning av vården eller utfallsmått i kliniska studier. Slutsatsen var att de två vanligast förekommande frågeformulären för patienter med hjärntumör var livskvalitetsformulären EORTC QLQ-C30 med hjärntumörmodulen BN20 och FACT-Br.

This qualitative descriptive study described the prodromal symptoms of older individuals, age 65 and above, experiencing acute coronary syndrome (ACS). Review of the literature establishes that older adults experiencing precursor symptoms of ACS are a high-risk group, one that experiences disparities in hospital emergency departments (EDs) and decreased ACS survival. Identification of early symptoms predictive of ACS may influence a patient's willingness to seek medical treatment and necessitate early, accurate diagnosis and treatment. The purpose of this study was to describe older individual's prodromal symptoms patterns and symptom experiences including perceptions, interpretations, and treatment seeking decisions. This study compared and contrasted symptom patterns of ACS among groups of older adult participants, age 65+ based upon age, gender, and other demographic characteristics (previous myocardial infarction, race, ethnicity, regular exercise, insurance, and comorbidity). Three specific aims were addressed in this study. Specific Aim 1 Explore the prodromal symptom patterns as perceived by the older individual encountering ACS. Specific Aim 2 Explore the older individual's interpretation of the prodromal symptom patterns encountering ACS. Specific Aim 3 Explore the treatment decision making processes used by older individuals when experiencing and interpreting prodromal symptom patterns in ACS. Participants included patients newly diagnosed with ACS and ≥ 65 years of age. For the qualitative description, participants (n=20) were recruited and a chart audit was conducted. Demographic information and data were obtained from the admitting ED history and physical, and discharge summary. Additionally, face-to-face semi-structured interviews were conducted with each participant. Content and matrix analyses were used to address the study aims. Research findings from this study elucidated early symptom indicators of myocardial ischemia/infarction (MI), which may be used for screening or developing ACS assessment guidelines specific to geriatric patients.

No description available.

The Neuropsychological Symptom Inventory (Dean, 1982) was developed to examine the neuropsychological symptomology presented by patients. It consists of 17 items that assess family/medical history that are responded to on a true/false format. In addition, there are 100 items which assess cognitive, emotional-social, sensory-perceptual, and behavioral symptomology, which are to be responded to on a Likert scale from 1 to 4.The present study investigated the validation of the Neuropsychological Symptom Inventory (NSI) (Dean, 1982). In a series of investigations the construct validity, internal consistency, and test-retest reliability of the NSI were examined. Such procedures were considered essential to investigate the utility of the NSI.The subjects numbered 826, for the factor analysis study and the internal consistency analysis, which consisted of college students from introductory psychology classes, and patients seen in both outpatient and inpatient settings. Additionally, there were 132 subjects who participated in the study for test-retest.Utilizing a varimax rotation, a four factor solution was obtained for the NSI, accounting for 47.9 % of the total variance. The results demonstrated high internal consistency for the NSI, with an overall Alpha coefficient of .967. In addition, moderate test-retest estimates were found, ranging from .3365 for Factor 3 to .6223 for Factor 4.These results showed strong psychometric properties for the NSI and suggest its use as a viable alternative to currently available measures. Results are discussed in terms of a need for further refinement of the NSI. / Department of Educational Psychology

The purpose of the study was to investigate the perceived anxiety experienced by coronary care nurses working eight- and 12-hour work shifts. It was hypothesized that length of shift work affects the before- and after-shift anxiety for nurses working eight or 12-hour work shifts. Anxiety differences between the eight- and 12-hour work shifts were examined as well as differences between the before- and after-shift anxiety for each length of shift.Thirty-two (32) coronary care nurses from a general medical and surgical hospital in the Midwest volunteered to participate in the research. The sample consisted of all females (18 Registered Nurses, nine Licensed Practical Nurses, three charge nurses, a supervisory nurse, and a rehabilitation nurse). The nurses had voluntarily selected the eight- or 12-hour length of shift work and understood that they would be committed to work that shift for one year. Twelve nurses worked the eight-hour shift; 20 nurses chose the new 12-hour shift.The State Anxiety Inventory (SAI) was used to measure the nurses' before- and after-shift anxiety. Baseline data were collected from the nurses prior to the initiation of the 12-hour shift. The Box-Jenkins Time Series Analysis was used to analyze the daily before- and after-shift anxiety scores and to establish a forecasted trend for both the eight- and 12-hour shifts.The first finding was that the before-shift anxiety scores for the eight-hour workers declined, while the anxiety scores for the 12-hour workers increased, following the implementation of the 12-hour shift. The same trend was forecast for the after-shift anxiety scores. The eight-hour nurses' after-shift anxiety scores declined while the 12-hour nurses' anxiety scores increased. A transfer function was conducted for both the eight-hour and 12-hour before- and after-shift anxiety scores. No predictive trend could be established for the eight-hour anxiety scores; however, the 12-hour after-shift anxiety scores were found to be consistently higher than before-shift anxiety scores. / Department of Educational Psychology

Bakgrund: Benign prostatahyperplasi påverkar åldrande män över hela världen och en fjärdedel av alla män beräknas ha symptom till följd av sjukdomen. Vid uppkomst av symptom drabbas mannens nedre urinvägar vilket kan leda till bland annat nedre urinvägssymptom, sexuell dysfunktion och psykiska besvär vilket kan antas påverka livskvalitén. Som referensram valdes livskvalité med utgångspunkt i Världshälsoorganisationens definition och Sprangers och Schwartz modell om response shift. Syfte: Att belysa livskvalitén hos män med symptomgivande benign prostatahyperplasi. Metod: Litteraturstudie med induktiv ansats. Resultat: Resultatet visade att livskvalitén påverkas negativt av symptomen vid benign prostatahyperplasi. Graden av påverkan berodde på vilket symptom samt symptomets allvarlighetsgrad. De mest framträdande och återkommande symptomen var nocturi, akut blåstömning, smärta samt sexuell dysfunktion. Slutsats: I resultatet framkom att benign prostatahyperplasi påverkade livskvalitén negativt. Dock saknades kvalitativ forskning för att beskriva hur livskvalitén påverkades. För att få en tydlig bild av att se hur livskvalitén förändras över tid kan modellen om response shift användas och därmed kan vården på ett bra sätt främja livskvalitén hos personer drabbade av benign prostatahyperplasi.

Submitted by Haroudo Xavier Filho (haroudo.xavierfo@ufpe.br) on 2016-07-01T14:48:51Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - ALEX BRUNO SOARES.pdf: 8182673 bytes, checksum: a1b0d71f1ed56ef8997cc9047c27db27 (MD5) / Made available in DSpace on 2016-07-01T14:48:51Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - ALEX BRUNO SOARES.pdf: 8182673 bytes, checksum: a1b0d71f1ed56ef8997cc9047c27db27 (MD5) Previous issue date: 2016-03-14 / O sulco vocal é definido como uma depressão longitudinal na prega vocal paralela à sua borda livre. Sua característica vocal mais marcante é a soprosidade da voz, que decorre de um fechamento incompleto da glote. Outro parâmetro vocal seria a aspereza, pela diminuição da vibração da onda mucosa na prega vocal. Aspectos acústicos vocais, como a frequência de voz, jitter e shimmer podem estar alterados também em indivíduos com sulco vocal. Os estudos de avaliação de voz em indivíduos com sulco vocal, em geral, selecionam uma população sintomática, excluindo-se possíveis indivíduos com sulco que não apresentam queixa vocal. Assim, torna-se necessário estudar esta população assintomática para se obter uma melhor caracterização vocal desta entidade. O objetivo deste estudo foi caracterizar a voz de indivíduos adultos assintomáticos com sulco vocal. Buscou-se comparar as características perceptivo-auditivas, acústicas e autoperceptivas da voz entre indivíduos com laringe com modelo anatômico padrão de prega vocal e com sulco vocal. Foram avaliados 26 indivíduos adultos, 13 com sulco vocal, e 13 indivíduos sem sulco vocal. Todos os participantes foram submetidos à microlaringoscopia de suspensão, autoavaliação da voz, avaliação perceptivo-auditiva da voz e avaliação acústica. Entre os indivíduos com sulco vocal, 78% dos sulcos vocais eram do tipo I, 22% eram sulcos do tipo II. Na avaliação perceptivo-auditiva, houve piores escores em indivíduos portadores de sulco vocal, com diferença estatisticamente significante em relação ao grupo controle, nos parâmetros grau global de disfonia e rugosidade, ambos em grau discreto. Na autoavaliação da voz e na avaliação acústica não foi encontrada diferença estatisticamente significante entre os dois grupos. Conclui-se que indivíduos sem queixas de voz portadores de sulco vocal do tipo I podem apresentar alterações discretas na qualidade vocal, com característica de rugosidade. A alteração de voz nesses casos não causa impacto em sua qualidade de vida. / The sulcus vocalis is defined as a longitudinal depression in parallel vocal fold to the free edge. Its most striking feature is the vocal blowing voice, which stems from an incomplete closure of the glottis. Another vocal parameter would be the roughness, the reduction of the mucosal wave vibration of the vocal folds. vocal acoustic aspects such as the frequency of voice jitter and shimmer can also be altered in patients with vocal fold. Voice evaluation studies in patients with sulcus generally select a symptomatic population, excluding possible groove carriers that do not have vocal complaints. Thus, it becomes necessary to study this asymptomatic population to obtain a better characterization of this voice entity. The aim of this study was to characterize the voice of adults with asymptomatic sulcus. We sought to compare the auditory perception characteristics, acoustic and voice self-perceptual among individuals with larynx with standard anatomical model of vocal fold and sulcus. We evaluated 26 adult subjects, 13 with sulcus, and 13 individuals without sulcus. All participants underwent suspension microlaryngoscopy, voice self-assessment, perceptual evaluation of voice and acoustic evaluation. Among individuals with sulcus, 78% of vocal grooves were type I, 22% were furrows type II. In the perceptual assessment, there was worse scores in individuals with sulcus, with statistically significant difference from the control group, the parameters overall degree of dysphonia and roughness, both in mild. In the self-assessment of voice and acoustic analysis revealed no statistically significant difference between the two groups. Individuals without voice complaints carriers sulcus type I may have subtle changes in vocal quality roughness feature. Changing voice in these cases, no impact on their quality of life.