Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) är en komplex sjukdom av okänd etologi. ME/CFS syns inte på utsidan men leder till funktionsnedsättning i varierande grad. Okunskapen om sjukdomen är stor vilket leder till att många får diagnos i ett sent skede eller en felaktig diagnos. ME/CFS innebär en etisk utmaning för forskningen, samhället och inte minst för sjukvården, då evidens för både omvårdnad och behandling fortfarande saknas. Syftet var att undersöka personers erfarenheter av att leva med ME/CFS. I databearbetningen framkom tre kategorier: möte med vården, påverkan på vardagen samt anpassning till livssituationen. I resultatet påvisas erfarenheter från personer med ME/CFS och hur de upplever bemötandet med vården och den okunskap som råder. Det framkommer att sjukdomen påverkar identitet, relationer och aktivitetsförmåga. Resultatet visar även hur livet förändras samt vilka strategier som krävs för att hantera vardagen när förutsättningarna i livet förändras. För att möta omvårdnadsbehovet hos personer med ME/CFS krävs mer forskning och utbildning för vårdpersonal. / Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex disease of unknown etiology. Although ME/CFS is not visible on the outside, it leads to disability in varying degrees. There is a lack of knowledge regarding the disease, which often leads to a delayed or incorrect diagnosis. ME/CFS represents an ethical challenge for research, society and especially for healthcare professionals since no evidence-based nursing or treatment are available. The aim was to investigate people’s experiences with ME/CFS. Three categories emerged in the data analysis: meeting with the health care, impact on daily life and adaption to the new life situation. The result shows experiences of people with ME/CFS and how they feel they are treated by the healthcare system and the lack of knowledge that exists. It appears that the disease affects identity, relationships and abilities in physical activity. The result also shows how life changes and what strategies are required to manage everyday life when the conditions in life change. To meet the nursing needs of people with ME/CFS, more research on the subject, as well as education for healthcare professionals, are necessary.

Nessa dissertação foi realizada uma scoping review com objetivo de buscar na literatura o que existe, até o presente momento, para explicar a relação entre o metabolismo mitocondrial com a síndrome da fadiga crônica (SFC). A SFC se apresenta de forma diferente para cada indivíduo, o que torna complexo seu entendimento, uma vez que não foram identificados biomarcadores específicos para auxiliar em um diagnóstico definitivo que favoreça uma intervenção adequada e tratamentos mais eficazes. Diferentes mecanismos biológicos são estudados, sendo que alterações no metabolismo mitocondrial têm sido foco de pesquisas recentes. Tais alterações podem ser a causa de fadiga severa e estudos sobre SFC mostraram que entre os principais indicadores da disfunção mitocondrial, envolvidos com a menor produção de ATP, está o comprometimento das vias de fosforilação oxidativa. O método utilizado nessa revisão, scoping review, é utilizado para investigar conceitos-chave subjacentes a uma nova área de pesquisa, bem como esclarecer definições de trabalhos, analisando o título e resumo de artigos para seleciona-los. Como critérios de inclusão ficaram determinados: (1) estudos clínicos que registram pacientes adultos (>= 18 anos de idade); (2) mostram uma relação entre questões do metabolismo e bioenergética mitocondrial com síndrome da fadiga crônica; (3) são escritos em português, inglês ou espanhol; (4) artigos publicados nos últimos 10 anos. E de exclusão: (1) utilizaram modelos animai; (2) relatos de casos, editoriais, cartas, revisões de literatura, resumos e dissertações de reuniões; (3) literatura cinzenta. Entre os descritores comuns, utilizados para realizar a busca nas bases de dados estão: mitochondria OR mitochondrial, fatigue, bioenergy OR bioenergetic OR energy metabolism. O estudo foi guiado pela seguinte questão: \"\"Alterações no metabolismo energético mitocondrial estão relacionados com a origem e prevalência da síndrome da fadiga crônica?\". Após utilizar a estratégia de busca, específica para cada uma das quatro bases de dados (PubMed, EMBASE, SCOPUS e Web of Science), foram encontrados 228 artigos, os quais foram exportados para o software Rayyan QCRI e removidos aqueles que se encontravam em duplicata. Este software permitiu que dois revisores executassem, de forma independente, a leitura dos títulos e resumos de 150 artigos e 27 foram selecionados para a leitura na íntegra, por atenderem aos critérios supracitados. Dentre esses últimos, apenas 10 relatavam alterações no metabolismo mitocondrial relacionadas à SFC. As alterações compreendem modificações nas vias de transporte mitocondrial e na cadeia respiratória; mutações no DNA mitocondrial e, até mesmo, disfunções energéticas em células do sistema imune, como as natural-killer. Foram encontrados dados de pesquisas em diversas áreas clínicas, tais como: cardiologia, oncologia e distúrbios musculares, os quais podem colaborar para trazer luz às causas biológicas dessa síndrome. Desta forma, tornou-se ainda mais evidente a conexão entre distúrbios na bioenergética mitocondrial, como uma menor capacidade de transporte de oxigênio por meio das vias de transporte, ou até mesmo, a insuficiência mitocondrial para produção de ATP, com a SFC. De acordo com os estudos que compuseram a amostra final desta revisão (n=10), o metabolismo mitocondrial e suas principais atividades, como a produção e transporte de ATP, são um alvo potencial para auxiliar na compreensão de incógnitas existentes sobre a SFC. Esses resultados são promissores para a enfermagem, sobretudo na área da ciência dos sintomas, com impacto na qualidade de vida e no manejo personalizado de sintomas em diferentes condições crônicas, especialmente na SFC / In this dissertation a scoping review was carried out with the objective of searching in the literature what exists to date to explain the relationship between mitochondrial metabolism and chronic fatigue syndrome (CFS). SFC presents itself differently for each individual, which makes complex their understanding, since no specific biomarkers were identified to aid in a definitive diagnosis that favors an appropriate intervention and more effective treatments. Different biological mechanisms are studied, and changes in mitochondrial metabolism have been the focus of recent research. Such alterations may be the cause of severe fatigue and studies on CFS have shown that among the main indicators of mitochondrial dysfunction, involved in the lower production of ATP, is the involvement of oxidative phosphorylation pathways. The method used in this review, scoping review, is used to investigate key concepts underlying a new research area, as well as clarifying definitions of papers, analyzing the title and abstract articles to select them. As inclusion criteria were determined: (1) clinical studies that register adult patients (>= 18 years of age); (2) show a relationship between metabolism and bioenergetic mitochondrial issues with chronic fatigue syndrome; (3) written in Portuguese, English or Spanish; (4) articles published in the last 10 years. The exclusion criteria: (1) used animal models; (2) case reports, editorials, letters, literature reviews, abstracts and dissertations; (3) gray literature. Among the common descriptors used to perform the search in the databases are: mitochondria OR mitochondrial, fatigue, bioenergy OR bioenergetic OR energy metabolism. The study was guided by the following question: \"\" Changes in mitochondrial energy metabolism are related to the origin and prevalence of chronic fatigue syndrome? \". After using the search strategy, specific to each of the four databases (PubMed, EMBASE, SCOPUS and Web of Science), 228 articles were found, which were exported to the Rayyan QCRI software and removed from those that were in duplicate. This software allowed two reviewers to independently perform the reading of the titles and abstracts of 150 articles and 27 were selected for reading in full, because they meet the aforementioned criteria. Among the latter, only 10 reported changes in mitochondrial metabolism related to CFS. The changes comprise modifications in mitochondrial transport pathways and respiratory chain; mutations in mitochondrial DNA, and even energy dysfunctions in cells of the immune system, such as natural killer. Research data have been found in several clinical areas, such as: cardiology, oncology and muscular disorders, which can collaborate to bring light to the biological causes of this syndrome. Thus, the connection between disturbances in mitochondrial bioenergetics, such as reduced oxygen transport capacity, or even mitochondrial insufficiency for ATP production, with CFS became even more evident. According to the studies that compose the final sample of this review (n = 10), mitochondrial metabolism and its main activities, such as the production and transport of ATP, are a potential target to aid in the understanding of existing unknowns about CFS. These results are promising for nursing, especially in the area of symptom science, with an impact on quality of life and personalized management of symptoms in different chronic conditions, especially CFS

This research is the exploration of the lived experience of tertiary students in Australia with the medical condition usually known as ME/CFS (Myalgic Encephalomyelitis /Chronic Fatigue Syndrome) seeking to explore issues of equity and human rights from the perspective of the Disability Discrimination Act 1992. Students feel that their difficulties are not caused just by the illness itself but by the failure of the tertiary institutions to understand the effects of this illness on them, the student, especially within the areas of accommodations and assessments. Their lived experiences are studied to ascertain if their experiences differ from those of other tertiary students. Forty participants came from every state and territory of Australia and twenty -four of Australia's universities as well as eight Technical and Further Education/Open Training Education Network (TAFE/OTEN) colleges are represented. The selection of the chosen methodology, Critical Ethnography from a Habermasian perspective, has been circumscribed by the medical condition which placed limitations on methodology and also data gathering methods. Non-structured stories, in which the participants wrote of their lived experience as students, were considered the most appropriate source of data. These were transmitted by electronic mail (with some by postal mail) to the researcher. A short questionnaire provided a participant background to the stories and was also collated for a composite overview of the participants. The stories are analysed in a number of ways: six selected stories are retold and the issues arising from these stories have been weighed against the remainder of the stories. Four intertwined themes were constructed from the issues raised in each story. Apparent infringements of the Disability Discrimination Act (1992) which impact on quality of life, human rights and equity are found. No accommodations are being made by the academic institutions for the cognitive dysfunctions and learning difficulties. Students are stigmatised and lack credibility to negotiate appropriate academic accommodations. A possible means of improving the ability of students to negotiate appropriate accommodations is explored. Finally the researcher reflects on her own involvement in the research as an 'insider' researcher.

<p>The purpose with this work is to describe the language that is built around the chronic fatigue syndrome (CFS) in Sweden. Our questions are: What does the professional field look like; who writes, about what and for which kind of readers? How do they describe the expressions and the upcoming of CFS? For which reasons can CFS be considered as a medical diagnosis/illness? How can CFS be understood from a social perspective? Our theoretical starting point is a social constructive theory and also Karin Johannisson's theory about medicalization and Foucault’s theory about power. We have from a literature-exposition of Swedish articles from 1989 to 2006, done a social constructive discourse analysis with help from Laclau & Mouffe's discourse theory, and Fairclough's model of social practices. In our textual analysis we found three dominating discourses: A medical discourse, a social/cultural discourse and a general/popular discourse. Our results showed that the dominating professional category is doctors and those who have medical direction within their work. In most cases they wrote articles that searched for medical explanations of CFS and their common factor was that they looked at CFS as an illness. The articles that had a social constructive, anthropological, idea historical or religious perspective to CFS was in a minority and they often defined the phenomenon as an expression of different kind of public elements and were often critical to medicalization.</p>

The purpose with this work is to describe the language that is built around the chronic fatigue syndrome (CFS) in Sweden. Our questions are: What does the professional field look like; who writes, about what and for which kind of readers? How do they describe the expressions and the upcoming of CFS? For which reasons can CFS be considered as a medical diagnosis/illness? How can CFS be understood from a social perspective? Our theoretical starting point is a social constructive theory and also Karin Johannisson's theory about medicalization and Foucault’s theory about power. We have from a literature-exposition of Swedish articles from 1989 to 2006, done a social constructive discourse analysis with help from Laclau &amp; Mouffe's discourse theory, and Fairclough's model of social practices. In our textual analysis we found three dominating discourses: A medical discourse, a social/cultural discourse and a general/popular discourse. Our results showed that the dominating professional category is doctors and those who have medical direction within their work. In most cases they wrote articles that searched for medical explanations of CFS and their common factor was that they looked at CFS as an illness. The articles that had a social constructive, anthropological, idea historical or religious perspective to CFS was in a minority and they often defined the phenomenon as an expression of different kind of public elements and were often critical to medicalization.

Bakgrund: Folkhälsoproblemet stress har bara ökat under senare år och flertalet sjukdomar uppkommer ur stress. Det finns olika stresshanteringsmetoder, men den kinesiska medicinen som stresshantering är inte så vanligt än. Hur kan den kinesiska medicinen påverka stressen hos individen? Syfte: Vilken metod inom den traditionella kinesiska medicinen(TCM) kan hjälpa mot stressrelaterade sjukdomar? Metod: En litteraturstudie genomfördes med tio utvalda artiklar som analyserades och sammanställdes till en rapport. Resultat: Akupunktur, akupressur, qigong har visat sig vara bra redskap till stresshantering. Bara positiv resultat har uppmäts och då det är ofarligt för alla att utöva, så de flesta personer kan medverka. Vidare forskning måste dock göras, för att undersöka om det är motionen som visar de positiva resultaten eller om det är de olika metoderna i sig. Slutsats: Kinesisk medicin kan rekommenderas att använda till att förebygga folkhälsoproblemet stress och för att förhindra stressrelaterade sjukdomar. / Background: The public health problem stress has only increased in recent years and several diseases are arisen from stress. There are various stress management techniques but the Chinese medicine is in the stress field not widely used yet. How can Chinese medicine affect stress in individuals? Purpose: What method within the Traditional Chinese medicine (TCM) can help against stress related diseases? Methods: A literature review was conducted with ten selected articles that was analysed and compiled into a report. Results: Acupuncture, acupressure, qigong and tai chi have proved to be good tools for stress management. Only positive results have been measured and it is safe for everyone to practice, so the most people can do it. Further research must be done to investigate if there is the exercise that shows the positive results or whether it is the different Chinese methods. Conclusion: Chinese medicine can be recommended to use in preventing the public health problem stress and to prevent stress related illnesses.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Thesis (Master of Science (Hons.) Social Ecology) -- University of Western Sydney, Hawkesbury, 1994. / "A dissertation submitted in fulfilment of the requirements for the degree of Master of Science (Honours) in Social Ecology in the University of Western Sydney - Hawkesbury" Bibliography : leaves 288-300.

Purpose: The aim of the systematic review was to address whether psychological interventions were able to reduce fatigue severity or the impact of fatigue in individuals with Multiple Sclerosis. The empirical study aimed to evaluate the effectiveness of a CBT based self-help workbook at reducing perceived impact of fatigue in a clinical sample of MS patients. Methods: A systematic search of the literature was carried out between the years 1980 and February 2015 to review whether psychological interventions were effective for fatigue management in Multiple Sclerosis. A randomised controlled trial examined the effectiveness of a CBT-based self-help workbook for the reduction of fatigue impact in MS. Participants were randomly allocated to one of three groups treatment as usual (TAU), pure self-help (PSH) or guided self-help (GSH). Results: Eleven studies were included in the systematic review, which indicated that CBT based interventions aiming to reduce fatigue or depression were most effective at reducing the severity of fatigue. Impact of fatigue can be reduced through mindfulness, CBT, motivational interviewing and to a lesser extent acceptance and commitment therapy. The empirical study did not find any significant differences between groups, however satisfaction with the workbook was high. Conclusions: The review suggests that there is a clear role for psychological interventions in fatigue management in MS, although further robust research into different therapeutic modalities is needed. From the empirical study it appears that the low level CBT-based intervention for fatigue in MS was not effective at reducing the perceived impact of fatigue. This study reflects an inclusive, clinical sample, recruited from a specialist rehabilitation unit, with high levels of multidisciplinary input which may have diluted any potential effect of the workbook. Objectives: The aim of the systematic review was to address whether psychological interventions are able to reduce fatigue severity or the impact of fatigue in individuals with Multiple Sclerosis Data sources: A search was conducted of: Psychinfo, Medline, Embase, CINAHL between 1980 and February 2015. Review methods: All studies were evaluated against a set of quality criteria by author (KG) with a proportion of studies being independently reviewed by author (DP) to ensure reliability of ratings. Results: Eleven studies were included in the review. CBT based interventions with a focus on fatigue management and depression appear to significantly reduce fatigue severity with medium to large effect. Significant reductions in fatigue impact can be found from mindfulness groups, motivational interviewing and CBT. Effect sizes for CBT interventions ranged from negligible to medium. For the mindfulness and motivational interviewing interventions effect sizes were not able to be calculated. The acceptance and commitment therapy intervention did not find a significant reduction in fatigue but found a medium effect for the intervention. Conclusions: There is a clear role for psychological interventions in the reduction of fatigue management but more high quality research needs to be carried out.

This post-positivist research study explored the possible relationship between Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) and the presence of underlying psychological and emotional issues. An exploratory design with naturalistic methods of inquiry was utilized to investigate whether the presence, or absence, of these issues had any impact on the overall disease process.