The purpose of this literature review is to investigate the most effective forms of self-care that patients can perform to reduce swelling caused by lymphedema. Lymphedema may occur secondary to lymph node trauma, which makes it difficult for lymph fluid to leave an extremity. Even though lymphedema is more recognized as a side effect of breast cancer treatment, it can also be the result of many other ailments or treatments and can be present in any part of the body. By knowing which therapies are most effective, nurses and other health care professionals can educate patients to help ease the burden caused by this debilitating condition. This thesis discusses the results of clinical trials that studied different methods of self-care including exercises, bandaging, compression garments, sequential compression devices, and performing manual lymphatic drainage. The conclusion derived from the review of multiple studies is that participating in a combination of multiple therapies is the most effective means of lymphedema management and should be considered the ideal standard of care.

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Thesis (Ph. D.)--University of Virginia, 2008. / Includes bibliographical references. Also available online through Digital Dissertations.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Bakgrund: Utvecklingen av intensivvården har under de senaste åren lett till att antalet personer som överlever intensivvården har ökat. Över hälften av alla överlevare drabbas av olika komplikationer i efterförloppet som kräver behandling och rehabilitering. Kunskapen om detta är av betydelse för sjuksköterskan för att förstå vikten av personcentrerad vård efter intensivvårdsbehandling. Syfte: Syftet med litteraturstudien var att sammanställa intensivvårdsbehandlade patienters upplevelser av efterförloppet. Metod: En kvalitativ litteraturstudie med induktivt förhållningssätt. Databaserna PubMed, Cinahl och SveMed+ användes för att ta fram material för studien. En kvalitetsgranskning av studierna utfördes med SBU:s granskningsmall för kvalitativa studier. Resultat: Resultatet redovisas utifrån sex kategorier: fysisk, psykisk och kognitiv påverkan, en lång återhämtningsprocess, behov av stöd från närstående, behov av omvårdnad, behov av hanteringsstrategier och förändringar av livet. Konklusion: Studiens resultat skildrar de intensivvårdsbehandlade patienternas olika upplevelser i efterförloppet. Patienterna upplevde att deras behov inte blev tillgodosedda samt att tillgången till och kvaliteten på den uppföljande vården var begränsad. De upplevde även en brist på information om vad tiden efter intensivvårdsbehandlingen skulle innebära. Den uppföljande vården har utvecklats under den senaste tiden, men behöver fortsatt utveckling för att kunna tillgodose behoven hos denna patientgrupp. / Background: The development of intensive care during the latest years have led to increasing numbers of ICU survivors. More than half of all survivors are affected by different complications after intensive care treatment that needs treatment and rehabilitation. This knowledge is of meaning for the nurse to understand the importance of person-centred care after intensive care treatment. Aim: The aim of the study was to compile patients’ experiences of recovery after intensive care treatment. Method: A literature review with a qualitative approach was used. Literature searches were performed in the databases PubMed, Cinahl and SveMed+. The quality of the selected studies was assessed using SBU’s review tamplet for qualitative studies. Results: The results are reported based on six categories: physical, mental, and cognitive impact, a long recovery-process, need for support from family and friends, need for care, need for coping strategies and changes in life. Conclusion: The results of the study describes the patients´ different experiences during the recovery from intensive care treatment. The patients experienced that their needs weren´t fullfilled and that the availability and quality of the follow-up care was limited. They also experienced that there was a lack of information about the recovery. The follow-up care has developed during the recent years, but it needs further development to be able to meet the needs of this group of patients.

The COVID-19 pandemic affected regular health care for patients with chronic diseases. However, the impact of the pandemic on primary care for patients with coronary artery disease (CAD) who are enrolled in a structured disease management program (DMP) in Germany is not clear. We investigated whether the pandemic affected primary care and health outcomes of DMP-CAD patients (n = 750) by using a questionnaire assessing patients’ utilization of medical care, CAD symptoms, as well as health behavior and mental health since March 2020. We found that out of concern about getting infected with COVID-19, 9.1% of the patients did not consult a medical practitioner despite having CAD symptoms. Perceived own influence on infection risk was lower and anxiety was higher in these patients compared to symptomatic CAD patients who consulted a physician. Among the patients who reported chest pain lasting longer than 30 min, one third did not consult a medical practitioner subsequently. These patients were generally more worried about COVID-19. Patients with at least one worsening CAD symptom (chest pain, dyspnea, perspiration, or nausea without apparent reason) since the pandemic showed more depressive symptoms, higher anxiety scores, and were less likely to consult a doctor despite having CAD symptoms out of fear of infection. Our results provide evidence that the majority of patients received sufficient medical care during the COVID-19 pandemic in Germany. However, one in ten patients could be considered particularly at risk for medical undersupply and adverse health outcomes. The perceived infection risk with COVID-19 might have facilitated the decision not to consult a medical doctor.

Thesis (MEd(Psych))-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: The background experiences of adolescents removed from their families and placed in residential care are often characterised by trauma, abuse and neglect, resulting in significant psychological and developmental implications. However, as a result of their negative past experiences, many of these individuals view other people, including helping professionals, with mistrust or apprehension, influencing their openness to and thus the effectiveness of traditional psychotherapeutic interventions. Equine Assisted Psychotherapy (EAP) is explored within this study as an alternative non-invasive approach which aims to meet the emotional and developmental needs of vulnerable and difficult-to-reach adolescents. Innate characteristics of horses seem to encourage individuals to engage fully in the psychotherapeutic process making them well-suited to the role of co-therapist within the therapeutic team. This study aimed to explore the experiences of adolescents living within residential care who had participated in an EAP program for approximately eight months, and the affects their participation had within their lives. A qualitative study founded within the interpretive paradigm was used to gain insight into the research questions. Participants were selected using purposive and convenient sampling techniques. Following this, data was obtained through semi-structured interviews, the researcher’s reflective journal, and a focus group discussion. Inductive data segmentation and reassembling techniques were utilised to analyse the data. The findings were integrated and presented as a case study. The research findings indicated that the participants experienced various learning and development opportunities through their participation in EAP. They were able to establish connections which led to improved psychological, social, and physical well-being. The implicit integration of the Circle of Courage principles of mastery, belonging, generosity and independence within the EAP process was also explored and documented for the first time within this text. The findings were related to resilience theory in order to depict EAP as a psychotherapeutic approach which serves to foster resilience for vulnerable adolescents, namely those placed within residential care in this study. / AFRIKAANSE OPSOMMING: Die agtergrond ervaringe van adolessente wat verwyder is uit hul ouerhuise en in residensiële sorg geplaas is, word dikwels gekenmerk deur trauma, mishandeling en verwaarlosing, met beduidende gepaardgaande sielkundige - en ontwikkelingsimplikasies. Voortvloeiend uit hul negatiewe ervaringe van die verlede, is dit moeilik vir sommige van hierdie individue om ander mense, en dit sluit professionele mense in die hulp-professies in, te vertrou en sonder bedugtheid te benader. Dit beïnvloed hul openlikheid en dus die effektiwiteit van tradisionele psigoterapeutiese intervensies. Perd-ondersteunde psigoterapie (Equine Assisted Psychotherapy, EAP) word ondersoek in hierdie studie as ‘n alternatiewe, nie-indringende benadering, waarvan die doel is om die emosionele - en ontwikkelingsbehoeftes van weerlose en moeilik-bereikbare adolessente mee aan te spreek. Dit wil voorkom asof ingebore eienskappe van perde individue aanmoedig om ten volle deel te neem aan die psigoterapeutiese proses, en dit maak die perde baie geskik om as hulp-terapeute op te tree binne die terapeutiese span. Hierdie studie beoog om die ervaringe van adolessente in residensiële sorg, en wat vir agt maande deelgeneem het aan ‘n EAP program, te ondersoek, sowel as die effek wat hierdie deelname op hul lewens gehad het. ‘n Kwalitatiewe studie gebaseer op die interpretatiewe paradigma is gebruik om insig te verkry in die navorsingsvrae. Deelnemers is geselekteer deur doelgerigte - en gerieflikheidstegnieke te gebruik. Hierna is data verkry deur semi-gestruktureerde onderhoude, die navorser se reflektiewe joernaal en ‘n fokusgroep onderhoud. Induktiewe data segmentasie en hersamestellingstegnieke is gebruik om die data te analiseer. Die bevindinge is geïntegreer en aangebied as ‘n gevallestudie. Die bevindige van die studie dui aan dat die deelnemers verskeie leer- en ontwikkelingsgeleenthede ervaar het deur hul deelname aan EAP. Hulle was in staat om konneksies te maak wat bygedra het tot sielkundige, sosiale en fisiese welsyn. The research findings indicated that the participants experienced various learning and development opportunities through their participation in EAP. Die implisiete integrasie van die beginsels van die ‘Circle of Courage’, naamlik bemeestering, behoort aan, ruimhartigheid en onafhanklikheid, is binne die EAP proses ondersoek en vir die eerste keer in hierdie teks gedokumenteer. Die bevindinge is vergelyk met veerkragtigheid teorie om EAP as ‘n psigoterapeutiese benadering te beskryf wat veerkragtigheid aanmoedig by weerlose adolessente, naamlik dié wat in residensiële sorg geplaas is en aan hierdie studie deelgeneem het.

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