<p> Hypertension is a modifiable risk factor for cardiovascular disease. The current treatment options are drug therapy and lifestyle modifications. A promising lifestyle modification therapy for the management of hypertension is isometric exercise, as several studies have demonstrated that isometric handgrip (IHG) training reduces resting arterial blood pressure (ABP) (Peters et al., 2006; Taylor et al., 2003; Wiley et al., 1992). The purpose of the present investigation was two-fold: 1) to examine the effectiveness of IHG training in reducing resting ABP in newly diagnosed hypertensive patients, in comparison to matched controls receiving advice from a physician about lifestyle modifications; and 2) to examine markers of autonomic function, specifically, heart rate variability (HRV) to determine if changes in the autonomic nervous system (ANS) existed between the two groups of hypertensive adults.</p> <p> Resting blood pressure and heart rate were assessed with an automated acquisition system before, during and after the 6-week intervention period. Also, power spectral analysis of HRV was used to assess changes in modulation of the ANS. Participants in both groups (n=14) were given lifestyle modification recommendations regarding diet, exercise and stress reduction, while participants in the training group (n=8) also completed a bilateral IHG training protocol 3 times/week at 30% maximum voluntary contraction (MVC).</p> <p> Our results demonstrate that contrary to our hypothesis, isometric exercise in combination with lifestyle modification recommendations did not result in a reduction of resting ABP or change indices of HRV. Possible explanations for these results are that unlike previous IHG training, the present study was the first to use home-based training and the small sample size of this investigation would limit our ability to identify alterations in resting ABP or HRV.</p> / Thesis / Master of Science (MSc)

<p> Supervised isometric handgrip training (IHG) has been shown to lower blood pressure (BP) and therefore, may be an effective non-pharmacological treatment for hypertension. The present investigation examined the efficacy of unsupervised IHG to lower BP in patients who were recently diagnosed as hypertensive. Since the mechanisms responsible for attenuating BP remain unclear, this study also investigated the concurrent effects of IHG training on the autonomic nervous system (ANS) and arterial stiffness.</p> <p>Eight participants were randomized to the experimental group and the remaining six served as controls. Lifestyle modifications to lower BP were recommended for both groups. In addition, the experimental group completed IHG three times per week for six weeks. IHG consisted of four two-minute isometric contractions at 30% maximal voluntary contraction using alternate hands, each separated by a one-minute rest period. Pre- (PRE) and post-intervention (POST), BP was measured and the ANS was assessed by baroreceptor sensitivity (BRS) and both systolic and diastolic blood pressure variability (SBPV and DBPV) and arterial stiffness was evaluated by carotid-finger pulse wave velocity (PWV). All measures were assessed during a period of supine rest and during a 60° passive tilt.</p> <p> There were no significant changes in any BP measure from PRE to POST for either the experimental or control groups. There was a non-significant trend toward decreased heart rate (p = 0.065). BRS decreased from PRE to POST in both the experimental (10.7 ± 2.4 mm Hg to 9.7 ± 2.3 mm Hg) and control groups (8.6 ± 2.1 mm Hg to 7.6 ± 1.5 mm Hg), but there was no difference between groups. SBPV LF:HF was lower at POST than PRE in both experimental (6.8 ± 1.5 to 4.6 ± 1.1) and control (3.4 ± 1.9 to 2.3 ± 0.9), but there were no other differences in any other BPV variable. There were no significant changes in PWV.</p> <p> In conclusion, unsupervised IHG did not lower resting BP in newly diagnosed hypertensive patients, so there were no improvements in autonomic indices. There was a decrease in SBPV LF:HF indicating improved sympathovagal balance, but this was likely a result of lifestyle modification rather than IHG. Future studies are necessary to determine appropriate use of IHG as a treatment for hypertension and to verify the mechanisms responsible for BP attenuation with IHG.</p> / Thesis / Master of Science (MSc)

BakgrundTyp 2 diabetes är en sjukdom som ständigt ökar och leder till många komplikationer. Egenvård är en stor del i behandling, vilket kräver att patienterna har insikten och förmågan till att utföra egenvårdsåtgärderna för att kunna leva med typ 2 diabetes, vilket kan vara utmanande för många patienter. Därför har sjuksköterskan en stor del i behandling av typ 2 diabetes då dessa patienter behöver en hel del undervisning om sjukdomen. SyfteSyftet med studien är att beskriva patienternas upplevelse av egenvård vid nydiagnostiserad typ 2 diabetes. MetodStudien är en litteraturöversikt som besvarar ett syfte med hjälp av vetenskapliga artiklar. Databaserna PubMed och CINAHL användes för att hitta artiklarna. Resultat i denna litteraturöversikt grundades på elva artiklar som publicerades mellan 2014–2024. ResultatStudiens resultat framkom till tre huvudkategorier, sjukdomsacceptens, utmaningar för förändring i levnadsvanor och egenvårdfrämjande faktorer. Sjukdomsacceptansen hade en stor betydelse i hur patienterna engagerade sig i egenvårdsåtgärderna, och utmaningar leder till bristande egenvård. Stöd från hälso-och sjukvården ansågs viktigt hos patienter med typ 2 diabetes. SlutsatsLitteraturstudiens resultat visade att patienterna upplevde att egenvård som nydiagnostiserade typ 2 diabetes var utmanande. Detta på grund av sjukdomen krävde stora insatser från patienterna och kunskap för att kunna leva med sjukdomen. Att bearbeta de känslomässiga reaktioner som tillkommer med sjukdomen hade stort påverkande i hur patienterna följde egenvårdåtgärderna. Stöd var viktigt för patienterna då den främjade patienterna egenvård. / BackgroundType 2 diabetes is a disease that is constantly increasing and leads to many complications. Self-care is a major part of treatment, requiring patients to have the insight and ability to perform the self-care measures in order to live with type 2 diabetes, which can be challenging for many patients. Therefore, the nurse has a great part in the treatment of type 2 diabetes as these patients need a lot of education about the disease. AimTo describe patients ' experience of self-care in newly diagnosed Type 2 diabetes. MethodThe study is a literature review that answers a purpose with the help of scientific articles. The databases PubMed and CINAHL were used to find the articles. Results in this literature review were based on Eleven articles published between 2014–2024. ResultsThe results of the study came to three main categories, disease acceptance, challenges to change in living habits and self-care promoting factors. Disease acceptance had a major impact in how patients engaged in the self-care interventions, and challenges lead to lackof self-care. Health care support was considered important in patients with type 2 diabetes. ConclusionsThe results of the literature study showed that the patients experienced that self-care as newly diagnosed type 2 diabetes was challenging. This because of the disease required great effort from the patients and knowledge in order to be able to live with the disease. Processing the emotional reactions associated with the disease had a major impact on how the patients followed the self-care measures. Support was important for patients as it promoted patient self-care.

Reliable und valide Informationen zur Häufigkeit und zu Korrelaten von Depression in der Allgemeinbevölkerung sind eine Voraussetzung für eine wissenschaftlich fundierte Gesundheitsversorgung und für Präventionsmaßnahmen. Die Vielfalt an Definitionen und die klinische Heterogenität von „Depression“ stellt eine Herausforderung für das Gesundheitsmonitoring und für die epidemiologische Forschung dar. Dies spiegelt sich in der Vielzahl an Depressionsmaßen wider. Daran anknüpfend ist das Ziel dieser kumulativen Dissertation, die Häufigkeiten und soziodemographischen und gesundheitsbezogenen Korrelate – mit einem Schwerpunkt auf der somatischen Komorbidität – eines breiten Spektrums etablierter Depressionsmaße in der erwachsenen Allgemeinbevölkerung in Deutschland zu untersuchen: von aktueller psychischer Belastung, depressiver Symptomatik und einem depressiven Syndrom über eine selbstberichtete ärztliche Depressionsdiagnose bis hin zu einer klinischen Major Depression. Datenbasis für die vier Originalarbeiten der Dissertation sind die bundesweit repräsentativen Querschnittstudien „Gesundheit in Deutschland aktuell“ (GEDA, 18 Jahre und älter) und die „Studie zur Gesundheit Erwachsener in Deutschland“ (DEGS1, 19-79 Jahre) mit dem Modul Psychische Gesundheit (DEGS1-MH) des Robert Koch-Instituts (RKI). In Kapitel 1 werden Forschungshintergrund, Fragestellungen und Methoden der vier Originalarbeiten zusammengefasst und die Ergebnisse dargestellt. Es ergeben sich hohe Prävalenzen auf Basis aller Depressionsmaße. Zugleich wird deutlich, dass die jeweiligen Maße zu unterschiedlichen Prävalenzschätzungen führen und dass es nur moderate Schnittmengen der jeweils identifizierten Fallgruppen gibt. Weiterhin zeigt sich eine weitgehende, jedoch keine vollständige Übereinstimmung in assoziierten soziodemographischen und gesundheitsbezogenen Korrelaten. Dies betrifft auch die Assoziation mit chronischen somatischen Erkrankungen, für die sich teilweise unterschiedliche Muster zwischen den untersuchten Depressionsmaßen und zwischen den Altersgruppen zeigen. Es folgen eine synthetisierende Ergebnisdiskussion und die Ableitung von Implikationen für die epidemiologische Forschung, das Gesundheitsmonitoring und die klinische Praxis. Kapitel 2 enthält die vier Originalarbeiten der Dissertation.

In the United States, 397,000 children received foster care services in 2012. Some states successfully achieved permanent homes for children with diagnosed disabilities who exited care while others were less successful. Using change theory and social ecological theory as the foundations, the purpose of this study was to determine the impact that diagnosed disabilities had on permanent home placements among Pennsylvania's foster care children who were discharged and were between ages of 0 to 6 years in 2012. Hernandez's and Hodges's theory of change was used to evaluate the 1982 standards that license foster care agencies, while Stokol's ecological theory provided the framework to assess whether there were measurable increases in child welfare outcomes for permanent placements among children with diagnosed disabilities. Following a retrospective, nonexperimental, quantitative design, data were acquired from a purposive sample of 344 archived foster care files across the state. These data were analyzed using bivariate correlation procedures to evaluate the strength of the relationship between medically diagnosed conditions and permanent placement. The findings indicated a statistically significant association between medically diagnosed conditions and permanent placements (p=0.01). Additionally, length of stay in care was also found to be statistically associated with permanent placement (p=0.019). The theoretical constructs evaluation with a theory of change found the 1982 standards were outdated to authorize the licensing of foster care agencies; the social ecological theory identified evidence for change to achieve the intended goal. Findings of this study may provide guidance to policymakers in term of improving standards related to oversight and licensing foster care agencies in order to better support permanent placement of children with disabilities.

<p>Bakgrund: I dagens samhälle flödar information från många olika håll. Kunskap förmedlas till patienter och anhöriga av olika professioner utan samordning, vilket kan leda till missförstånd. För patienter med diabetes typ 2 är det viktigt att få information som kan förstås och som är relevant för deras sjukdom. Genom patientutbildning kan patienten sedan bedriva egenvård och ta kontroll över sjukdomen. Syfte: Syftet med studien var att se hur patienter med nydiagnostiserad typ 2 diabetes förstår egenvård efter besök hos diabetessköterskan. Metod: En empirisk, kvalitativ intervjustudie genomfördes och innehållet analyserades med kvalitativ innehållsanalys inspirerad av Graneheim och Lundman. Resultat: Det framkom under intervjuerna att ungefär hälften av deltagarna förväntade sig att drabbas av diabetes, då det fanns i släkten. Diabetes var naturligt att få vid en viss ålder, med eller utan egenvård. De flesta hade gjort förändring av kostvanor och rökning under de första månaderna efter diagnosen och fått bekräftat att egenvården gjort nytta. Många kände oro inför att inte orka fortsätta med de förändringar, men var ändå inte oroliga för framtiden. Andra hade fortsatt stor tillförsikt och visste att resultatet berodde på dem själv. Slutsats: Med eller utan tidig egenvård hade sjukdomen kommit ändå. Den första tiden efter diagnosen genomfördes förändringar och egenvården kändes viktig. När sedan känslan av att ”må bra” återkom, dalade motivationen. Med täta besök hos diabetessköterskan motiverades patienterna att fortsätta.</p> / <p>Background: In today's society, information flowing from many different directions. Knowledge communicated to patients and families of different professions, without coordination, which can lead to misunderstandings. For patients with diabetes type 2, it is important to get information that is understandable and relevant to their illness. Through patient education, the patient may then engage in self-care and take control of the disease. Aim: The purpose of this study was to see how patients with newly diagnosed type 2 diabetes understand self-care after visiting the nurse. Method: An empirical, qualitative interviews were carried out and contents were analyzed using qualitative content analysis inspired by Granheim and Lundman. Results: It emerged during the interviews that about half of the participants expected to suffer from diabetes, when there was a family history. Diabetes was natural to get at a certain age, with or without self-care. Most patients had made changes in diet and smoking during the first months after being diagnosed and confirmed that self-care was useful. Many felt concerned about not being able to continue with the changes, but was not worried about the future. Others had continued very confident and knew that the outcome depended on themselfs. Conclusion: With or without early self-care the disease would had come anyway. The first time after beeing diagnosed, change and self-care feelt important. When the sense of "feel good" reappeared, the motivation faded. With frequent visits to the nurse, the patients were motivated to continue.</p>

Bakgrund: I dagens samhälle flödar information från många olika håll. Kunskap förmedlas till patienter och anhöriga av olika professioner utan samordning, vilket kan leda till missförstånd. För patienter med diabetes typ 2 är det viktigt att få information som kan förstås och som är relevant för deras sjukdom. Genom patientutbildning kan patienten sedan bedriva egenvård och ta kontroll över sjukdomen. Syfte: Syftet med studien var att se hur patienter med nydiagnostiserad typ 2 diabetes förstår egenvård efter besök hos diabetessköterskan. Metod: En empirisk, kvalitativ intervjustudie genomfördes och innehållet analyserades med kvalitativ innehållsanalys inspirerad av Graneheim och Lundman. Resultat: Det framkom under intervjuerna att ungefär hälften av deltagarna förväntade sig att drabbas av diabetes, då det fanns i släkten. Diabetes var naturligt att få vid en viss ålder, med eller utan egenvård. De flesta hade gjort förändring av kostvanor och rökning under de första månaderna efter diagnosen och fått bekräftat att egenvården gjort nytta. Många kände oro inför att inte orka fortsätta med de förändringar, men var ändå inte oroliga för framtiden. Andra hade fortsatt stor tillförsikt och visste att resultatet berodde på dem själv. Slutsats: Med eller utan tidig egenvård hade sjukdomen kommit ändå. Den första tiden efter diagnosen genomfördes förändringar och egenvården kändes viktig. När sedan känslan av att ”må bra” återkom, dalade motivationen. Med täta besök hos diabetessköterskan motiverades patienterna att fortsätta. / Background: In today's society, information flowing from many different directions. Knowledge communicated to patients and families of different professions, without coordination, which can lead to misunderstandings. For patients with diabetes type 2, it is important to get information that is understandable and relevant to their illness. Through patient education, the patient may then engage in self-care and take control of the disease. Aim: The purpose of this study was to see how patients with newly diagnosed type 2 diabetes understand self-care after visiting the nurse. Method: An empirical, qualitative interviews were carried out and contents were analyzed using qualitative content analysis inspired by Granheim and Lundman. Results: It emerged during the interviews that about half of the participants expected to suffer from diabetes, when there was a family history. Diabetes was natural to get at a certain age, with or without self-care. Most patients had made changes in diet and smoking during the first months after being diagnosed and confirmed that self-care was useful. Many felt concerned about not being able to continue with the changes, but was not worried about the future. Others had continued very confident and knew that the outcome depended on themselfs. Conclusion: With or without early self-care the disease would had come anyway. The first time after beeing diagnosed, change and self-care feelt important. When the sense of "feel good" reappeared, the motivation faded. With frequent visits to the nurse, the patients were motivated to continue.

Bakgrund: Diabetes typ 2 utgör den vanligaste diabetesformen, och cirka 4 % av Sveriges befolkning uppskattades ha diabetes 2010, varav nästan 90 % av dessa utgjordes av diabetes typ 2. Sjuksköterskan har en viktig roll i att stödja och vägleda patienten utifrån dennes upplevelser och behov. Syfte: Att beskriva hur vuxna patienter upplever att diagnostiseras med diabetes typ 2. Metod: Denna studie är en litteraturstudie baserad på tidigare forskning kring diabetes typ 2, och kommer att fokusera på fenomen relaterat till patienters upplevelser av att få en diagnos. Författarna identifierade sex teman: Upplevelser och känslomässiga reaktioner vid diagnos, Information och kunskap, Lära sig leva med diabetes, Att förneka sin sjukdom, Eget ansvar och egenvård samt Syn på framtiden. Teoretisk referensram: Som teoretiskreferensram valdes  Afaf Meleis' Transitionsteori som bygger på tanken om att människor går igenom transitioner i livet av olika art. Resultat: Resultaten visade att deltagarna upplevde att få en diagnos som diabetes typ 2 på olika sätt beroende på hur deras liv sett ut tiden innan diagnos. Det framkom också att kunskapen kring diabetes varierade och att deltagarna hade olika behov av information och stöd vid tillfälle för diagnos. Diskussion: Att få en diagnos som diabetes typ 2 kan upplevas olika och vi har sett att det finns vissa faktorer som kan påverka upplevelsen. Faktorer som vi menar kan ha en inverkan är: den information och det stöd som ges vid diagnos, samt vilket bagage och vilken förförståelse personen i fråga har sedan tidigare. / Background: Type 2 Diabetes is the most common form of diabetes, and approximately 4 % of Sweden's population was estimated to have diabetes in 2010, and almost 90 % of these consisted of type 2 diabetes. The nurse has an important role in supporting and guiding the patient based on his experiences and needs. Aim: To describe how adult patients experience of being diagnosed with diabetes type two. Method: This study is a literature review based on previous research on type 2 diabetes, and the focus will be on the phenomenon related to patient experiences of being diagnosed with type 2 diabetes. The authors identified six themes: Experiences and emotional reactions at diagnosis, Information and knowledge, Learning to live with diabetes, To deny their illness, Personal responsibility and self-care and views of the future. Theoretical framework: The theoretical framework that was chosen for this study was Afaf Meleis' Transition Theory, which is based on the idea that people go through different transitions in life. Results: The results showed that patients experienced diagnosis of type 2 diabetes in different ways, depending on what their life looked like at the time before diagnosis. Findings also demonstrated that knowledge about diabetes varied among participants, and that they had different needs for information and support at the time of diagnosis. Discussion: To receive a diagnosis like type 2 diabetes, can be experienced in different ways, and we have seen that certain factors can have an impact on the experience. These factors that we have identified are: information and support at the time of diagnosis, and the baggage and pre-understanding the person have before diagnosis.

The purpose of this study was to explore the factors that contributed to the contraction of Tuberculosis (TB) amongst the patients who were newly diagnosed with TB at Katutura TB state hospital Windhoek, Namibia. Quantitative, descriptive research was conducted to explore the factors that contributed to contraction of TB among the newly diagnosed patients. Data was collected using questionnaires from 8th June 2016 to the 8th September 2016. The respondents were the newly diagnosed TB patients (n=40) admitted at Katutura TB state hospital. The findings revealed that there is a change in gender infection rate, men are now on the forefront, comprising 57.5% (n=23) of the sample surveyed. Furthermore, some other factors emerged on the study like TB stigma, poor nutrition, and lack of education. However, some factors are very controversial such as accommodation and sanitation as they need to be explored more to see their influence on TB infection rate / Health Studies / M.A. (Nursing Science)

Sammanfattning Bakgrund: Stroke är den tredje mest förekommande orsaken till dödsfall i Sverige. Risken att få stroke, är högre vid diabetes, högt blodtryck och rökning. Syfte: beskriva närståendes upplevelser av att leva med person som fått diagnosen stroke. Metod: Beskrivande litteraturstudie med granskning av 16 vetenskapliga artiklar. Huvudresultat: Närstående till person med diagnosen stroke upplevde en förändring av sin och sin partners livssituation. Från att just levt i ett partnerskap har relationen nu ändrats till att vara vårdare åt närstående person med diagnosen stroke. De närstående upplevde även att de har fått stor arbetsbelastning, var frustrerade över den situation som uppstått och kände även en stor oro för framtiden. Närstående upplevde även sin relation som mer omtänksam mot sin partner och såg att familjebanden stärktes efter att närstående fått diagnosen stroke. Deltagarna i de granskade studierna hade haft sin diagnos från 3 veckor till 3 år och i 15 av studierna intervjuades deltagarna och i en av studierna samlades informationen in via online inlägg. Slutsats: Stor oro och lite information från vården upplevdes hos de flesta närstående till person med stroke.  Denna studie skulle kunna öka förståelsen för närstående och även för den person som fått diagnosen stroke, då de har sin vårdkontakt. Sjuksköterskan behöver öka omvårdnaden för närstående och den person som fått diagnosen stroke. Det skulle underlätta i vardagen hos många familjer, då man får en ökad insikt i sjukdomen stroke och dess komplikationer.   Nyckelord: Dagligt liv, närstående, omvårdnad, person med diagnosen stroke. / Background: Stroke is the third most common cause of death in Sweden. The risk of stroke is higher in diabetes, high blood pressure and smoking. Purpose: Describe the perpetrators' experiences of living with a person who has been diagnosed with stroke. Method: Literature study based on evaluation of 16 scientific articles. Result: Proximity to a person diagnosed with stroke is experiencing a change in his / her partner's life situation. From just living in a partnership, the relationship has now changed to being a care provider of a related person diagnosed with stroke. The relatives also felt that they had a great workload, were frustrated by the situation that occurred and also felt a great deal of concern for the future. Relatives also experienced their relationship as more caring for their partner and saw that family ties were strengthened after relatives were diagnosed with stroke. The participants in the studies studied had been diagnosed from 3 weeks to 3 years and in 15 of the studies, participants were interviewed and in one of the studies the information was collected via online postings. Conclusion: Major concerns and some information from the health care system were experienced in most related persons to stroke.  This study could enhance understanding for close relatives and also for the person diagnosed with stroke, as they have their care contact. The nurse needs to increase the nursing care for close relatives and the person who has been diagnosed with stroke. This would facilitate the everyday life of many families, as you get an increased insight into the disease stroke and its complications.   Keywords: Daily life, diagnosed stroke, nursing, related person.