Hemodialysis induces various symptoms in many patients. However, the type of dialysis symptoms induced and how they contribute to recovery time remains unclear. This study aims to understand patient experiences reporting dialysis recovery time and associated symptoms using three separate novel instruments developed for this study. We conducted a 13-week prospective cohort study in prevalent in-center hemodialysis patients and measured their recovery time using three instruments. Instrument A inquired how long it took to recover from the last dialysis treatment. Instrument B inquired recovery time from last treatment for each of 10 specified symptoms and Instrument C included symptom severity to Instrument B. Each instrument was used for each dialysis treatment for one week. We compared patient response and distribution of recovery time found with each instrument using mixed-effects logistic regression models. 118 participants were recruited from two centres of which 914 (86%) of 1062 expected responses were completed. Recovery time using instrument A resulted in more participants identifying some recovery time from dialysis (83 to 86%) as compared with Instrument B (66 to 80%, p = 0.001) and Instrument C (69 to 73%, p <0.001). The third visit of the week was associated with fewer patients reporting recovery time (p = 0.036). However, Instrument B (p = 0.016) and Instrument C (p < 0.001) showed a longer recovery time compared to the distribution of recovery time of Instrument A. Lack of energy was the most common symptom following dialysis (69 to 77% of all patients). Recovery time with Instrument A was a significant predictor of kidney-specific component scores and mental component score as measured by the Kidney Disease Quality of Life-36 instrument. Recovery time is complex, and includes different symptoms that vary in duration. Attempts to reduce recovery time may impact specific symptoms differentially. / Thesis / Master of Science (MSc)

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published_or_final_version / Comparative Asian Studies / Master / Master of Arts

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Background: The current studies aimed to explore the effects of different variants of multiple sclerosis (MS) on social cognitive skills such as emotion perception, theory of mind (ToM) and empathy. Various aspects of empathy were measured using newly developed video paradigm that generated reliable and consistent responses in study participants. Further, the relationships between social cognition abilities and cognitive functioning, MS severity, mood and age were explored. The final aim was to establish whether difficulties in social cognition predicted restricted social participation and reduced quality of life in MS. Methods: This research measured multi-domain emotion perception, ToM and empathy using more ecologically valid measures than previous studies in participants with relapsing-remitting MS (n = 30), chronic progressive MS (n = 26) and matched healthy controls (n = 31). Executive functioning was measured using verbal fluency, whereas speed of processing was tested with the Digit Symbol Coding Task. Self-report measures were administered to assess of empathy, social participation, MS severity and mood. Results: Both MS groups presented with impairments in emotion perception and ToM but not in empathy. Cognitive functioning was associated with some measures of emotion perception and ToM. Reduced quality of life was inconsistently predicted by personal distress only and some aspects of emotion perception in individuals with MS. No aspects of social cognition were found to be a significant predictor of restricted social engagement in MS. Conclusion: Both MS samples demonstrated similar emotion perception and ToM impairments and no significant empathy impairment, though those with progressive MS reported poorer social participation. Lower levels of emotion perception and personal distress predicted some aspects of quality of life. Since the pattern of these results proved to be inconsistent, it is important to interpret the findings with caution, and to further explore socio-emotional functioning in MS.

Bakgrund: Under perioden 1980 till 2014 har prevalensen av fetma i världen mer än fördubblats. Samhällets utveckling ses ha en negativ inverkan då konsumtionen av kaloririk mat har ökat samtidigt som graden av fysisk aktivitet har minskat. Fetma klassas som en folksjukdom och kan leda till följdsjukdomar som t.ex. hjärt- och kärlsjukdomar, diabetes typ 2 och cancer.   Syfte: Syftet med litteraturstudien var att beskriva vuxna personer med fetmas upplevelse av livskvalitet samt undersöka vilken kvalitet artiklarna hade med fokus på datainsamlingsmetod.   Metod: En litteraturstudie med deskriptiv design som innefattar 12 artiklar, varav tio med kvantitativ ansats och två med kvalitativ ansats.   Huvudresultat: Fetma är ett tillstånd som setts påverka livskvalitén negativt, dessutom har en prevalensökning av psykisk ohälsa i form av ångest och depression setts. Personer med fetma upplevde oftare att de blev diskriminerade och stigmatiserade för sin vikt än normalviktiga och diskriminering påverkade deras psykiska välmående, livskvalitet och livstillfredsställelse negativt. Personer med fetma upplevde sig begränsade i sin vardag samt att deras sociala relationer påverkades negativt, bland annat i form av försämrat stöd från sin omgivning och social isolering.   Slutsatser: Forskning visar att livskvaliteten påverkas negativt hos personer med fetma. De upplever också diskriminering, stigmatisering och påverkan på sociala relationer oftare, och drabbas i större utsträckning av ångest och depressioner än normalviktiga. Genom respektfullt bemötande, förståelse och omtanke kan risken för diskriminering och stigmatisering minskas, och deras autonomi och tilltro till hälso- och sjukvården stärkas. / Background: During the period of 1980 to 2014, the global prevalence of obesity has more than doubled. The societal development is seen to have a negative influence on obesity since the consumption of caloric food has increased while the degree of physical activity has decreased. Obesity is classified as an endemic disease and can cause sequelae such as coronary-artery disease, type 2 diabetes and cancer.   Aim: The aim of the literature study was to describe obese adults' experience of quality of life and to examine the articles' quality with focus on their data collection method.   Method: A literature study with a descriptive design comprised of 12 articles, ten of which has a quantitative design and two whom have a qualitative design.   Main results: Obesity is a condition which is seen to negatively impact quality of life. A prevalence increase in psychiatric illness in the form of anxiety and depression has also been observed. Persons with obesity experienced discrimination and stigmatization more often than normal weight individuals, and discrimination negatively impacted their psychiatric well-being, quality of life and life satisfaction. They also experienced restrictions in their daily lives and a negative impact on their social relationships, including less support from their surroundings and social isolation.   Conclusions: Research shows that the quality of life is negatively affected in obese persons. They experience discrimination, stigmatization and impacted social relationships more often, and are affected in greater occurrence by anxiety and depression than those with normal weight. Through respectful treatment, understanding and consideration the risk of discrimination and stigmatization can be diminished, and their autonomy and trust for the healthcare service be strengthened.

Livskvalitet är en subjektiv upplevelse och det är av stor vikt att sjuksköterskor är medvetna om patienters individuella upplevelse av livskvalitet. En litteraturgenomgång visar att befintlig vetenskaplig litteratur inom humanvetenskapen och vårdvetenskapen är otillräcklig i upplevelsen av jaget i relation till livskvalitet i vårdandet. Syftet med studien är att utforska begreppet livskvalitet i vårdandet. Studien genomfördes som en litteraturstudie med åtta vetenskapliga artiklar, där alla vetenskapliga artiklar var kvalitativa och belyste livskvalitet i vårdandet. I resultatet framkom det ett övergripande teman frid och frihet, med två huvudkategorier livskvalitet – jagets mening samt livskvalitet – jagets livsmening. Resultatet visar att livskvalitet i vårdandet är en omfattande del i att uppnå frid och frihet. Viktiga aspekter för att uppleva livskvalitet i vårdandet är mellanmänskliga relationer, roller, identitet, autonomi, tillfredsställelse och meningsfullhet. Utan någon eller flera av ovanstående aspekter har människan närmare till avsaknad av livskvalitet. Essensen i livskvalitet är att det är en subjektiv och individuell upplevelse som behöver belysas i samtal mellan sjuksköterskor och patienter för att gynna det goda vårdandet. För att sjuksköterskor skall kunna ordinera oberoende omvårdnadsåtgärder i relation till livskvalitet krävs evidensbaserad kunskap om patienters subjektiva upplevelse av livskvalitet

published_or_final_version / Community Medicine / Master / Master of Public Health