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Little is known about the recovery of patients after pneumonectomy and the impact of the surgery on the lifestyle of young, employed, ex-smokers and their families. This study was conducted to address this knowledge deficit, and gather information that would help health professionals to be able to assist people facing pneumonectomy. A qualitative study using van Manens methodological approach to interpretive phenomenology was chosen, in order to capture a full and rich understanding and meaning of the phenomenon that patients live. The names, age, operation, histological cell type, stage of disease, and disease free status of potential participants were obtained from a Lung Cancer Surgical Database after obtaining ethical approval for the study. Nine participants (three females and six males) met the inclusion criteria and gave informed consent for the study. Data collection comprised of open-ended interviews that were audiotaped, then transcribed verbatim into hard data. Data interpretation was based on the selective reading approach of van Manen from which six thematic statements arose. These are living the discomforts of treatment and recovery, discovering new limitations on myself; functional and emotional, my reliance on support, my financial security is threatened, my survival is at threat, and I wish I had known more. The study found that each participant had a unique experience of recovery and consequently the degree of recovery attained varied between participants. They all had a very strong desire to survive lung cancer and considered the risks of major surgery and loosing a lung to be insignificant compared to the certainty of loosing their life if they did not undergo surgery. This study provided a glimpse of what it was like for a group of patients to live the experience of life after a pneumonectomy and it provides a basis from which nurses can explore further the experiences of patients who are subjected to lung cancer surgery.

Little is known about the recovery of patients after pneumonectomy and the impact of the surgery on the lifestyle of young, employed, ex-smokers and their families. This study was conducted to address this knowledge deficit, and gather information that would help health professionals to be able to assist people facing pneumonectomy. A qualitative study using van Manens methodological approach to interpretive phenomenology was chosen, in order to capture a full and rich understanding and meaning of the phenomenon that patients live. The names, age, operation, histological cell type, stage of disease, and disease free status of potential participants were obtained from a Lung Cancer Surgical Database after obtaining ethical approval for the study. Nine participants (three females and six males) met the inclusion criteria and gave informed consent for the study. Data collection comprised of open-ended interviews that were audiotaped, then transcribed verbatim into hard data. Data interpretation was based on the selective reading approach of van Manen from which six thematic statements arose. These are living the discomforts of treatment and recovery, discovering new limitations on myself; functional and emotional, my reliance on support, my financial security is threatened, my survival is at threat, and I wish I had known more. The study found that each participant had a unique experience of recovery and consequently the degree of recovery attained varied between participants. They all had a very strong desire to survive lung cancer and considered the risks of major surgery and loosing a lung to be insignificant compared to the certainty of loosing their life if they did not undergo surgery. This study provided a glimpse of what it was like for a group of patients to live the experience of life after a pneumonectomy and it provides a basis from which nurses can explore further the experiences of patients who are subjected to lung cancer surgery.

The number of OIF and OEF veterans who are choosing to pursue post-secondary education is increasing due in part to increased financial scholastic benefits earned as part of their military service. Veterans are not returning from combat unharmed however, and many are presenting with newly experienced difficulties that may impact their academic careers. This includes for example, PTSD, TBI, depression, and anxiety. This study examined the impact of a veterans only college course entitled Life After War: Post-deployment Issues taught at a large Midwestern University. The class includes the instruction of scholastic skills, education on the natural consequences of post-deployment issues, as well as discussion of commonly reported transition issues. Participants of the study were OIF and/or OEF veterans who were currently pursuing post-secondary education and were enrolled in the Life After War college course. Participants completed self-report measures at the beginning and the end of the semester. Change in the areas of self-reported symptoms of anxiety, depression, PTSD, and help-seeking attitudes were examined over time. Demographics and other background information were obtained from each student to provide a framework for understanding the potential impact of the course. Results revealed several major findings including a pattern of likely under-reporting of symptoms by participants in the study, an increase in self-report symptoms from pre to post-test, a higher self-report of symptoms and difficulties from those participants who did not return for post-testing and finally, a higher level of negative help-seeking attitudes and beliefs among those who did not return for follow-up testing. Implications and future considerations for working with student veterans are addressed.

Thesis (PhD)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Despite the high prevalence of chronic kidney disease, renal narratives are under-reported. Much of what is written on kidney failure is written by health care professionals for health care professionals and about patients. While medical experts and health care practitioners have one type of knowledge, their patients have another type of knowledge acquired through their experience of their own condition. From within the disability and patients’ rights movements urgent calls have been made for the authentic voices of disabled people and patients to be heard without the mediation of professional lenses. In response to this my dissertation combines personal and academic writing to explore my own experience of end-stage renal disease, dialysis, transplantation and the life after transplant. I have used autoethnography as a methodology. Autoethnography is a relatively new, somewhat postmodern form of inquiry that developed from the reflexive turn in anthropology and narrative studies in the latter part of the twentieth century. It is very useful in writing about the experience of illness and reflecting on illness narratives because, in autoethnographic writing, the observer and observed, the narrator and narrated, insider and outsider are the same person. This allows scope for exploring the problematics of representation and for finding alternatives to already existing ways of telling certain stories. Engaging with autoethnography’s postmodern aspects has allowed me to conceptualize experiences that, until I undertook this research, I have never been able to articulate, because the traditional (static) illness narrative forms did not speak to my experience or my understanding of my condition. The central issue in my dissertation lies in the question: How do I tell the story of chronic illness once I have had an organ transplant? Flowing from this are a number of sub-issues: Can my story change? How do I describe myself: The well, the ill, the impaired, the disabled, the afflicted? Do I describe myself living in no man’s land? In my narrative, do I oscillate between being well and ill, or do I occupy another territory entirely? And if I do, what is it? My study shows that writing the story (or stories) of chronic kidney disease is complex, nuanced and dynamic and that, far from being an extended liminal experience, kidney disease is littoral. This distinction is important in coming to narrative terms with an identity that is not damaged so much as different. Through this I hope to demonstrate to both outsiders and insiders, who often submit to narratives that are forced on them, that more satisfying alternatives can be found. / AFRIKAANSE OPSOMMING: Ondanks die hoë voorkomssyfer van chroniese nierkwale word nierverhale nie genoeg aangemeld nie. Die meerderheid van dit wat oor nierversaking geskryf word, word deur gesondheidsorgdeskundiges vir gesondheidsorgdeskundiges en oor pasiënte geskryf. Terwyl mediese deskundiges en gesondheidsorgpraktisyns een soort kennis het, het hulle pasiënte ’n ander soort kennis op grond van hulle ervaring van hulle eie toestande. Van binne die gestremdheid en pasiënteregte-bewegings het ’n dringende oproep weerklink vir die outentieke stemme van mense met gestremdhede en pasiënte om gehoor te word sonder die tussenkoms van professionele perspektiewe. In reaksie hierop kombineer my verhandeling persoonlike en akademiese beskrywings om my eie ervaring van eindstadium- nierkwale, dialise, oorplanting en die lewe na oorplanting te verken. Ek het outo-etnografie as metodologie gebruik. Outo-etnografie is ’n relatief nuwe, ietwat postmoderne vorm van ondersoek wat in die tweede deel van die twintigste eeu uit die refleksiewe wending in antropologie en narratiewe studies ontwikkel het. Dit is baie bruikbaar wanneer oor die belewenis van siekte en besinning oor siekte-narratiewe geskryf word aangesien die waarnemer en die waargeneemde, die verteller en dit wat vertel word, die ingewyde en die buitestander in outo-etnografiese skryfwerk dieselfde persoon is. Dit laat meer ruimte vir verkenning van die problematiek van voorstelling en vir die opspoor van alternatiewe vir reeds bestaande wyses om sekere stories te vertel. My bemoeienis met postmoderne aspekte van outo-etnografie het dit vir my moontlik gemaak om ervaringe wat ek tot en met hierdie navorsing nooit kon artikuleer nie, te konseptualiseer, aangesien die tradisionele (statiese) vorme van siekte-narratiewe nie tot my ervaring of my begrip van my toestand gespreek het nie. ‘Hoe vertel ek die storie van chroniese siekte nadat ek ’n orgaanoorplanting gehad het?’ is ’n sentrale vraagstuk in my verhandeling. Hieruit spruit ’n aantal newevraagstukke voort: Kan my storie verander? Hoe beskryf ek myself: Die gesonde persoon, die sieke, die verswakte, die gestremde, die aangetaste? Hoe beskryf ek myself wat in ’n niemandsland woon? Fluktueer ek in my narratief tussen gesond wees en siek wees of betrek ek ’n geheel ander gebied? En indien wel, wat is dit? My studie toon dat, om die storie (of stories) van chroniese niersiekte te skryf, kompleks, genuanseerd en dinamies is en dat niersiekte glad nie ’n uitgebreide liminale ervaring is nie, maar eerder littoraal is. Dit is belangrik wanneer daar tot ’n narratiewe verstandhouding gekom moet word met ’n identiteit wat nie soseer beskadig is nie, maar eerder anders. Hierdeur hoop ek om aan beide buitestanders en ingewydes, wat dikwels voor narratiewe wat op hulle afgedwing word, moet buig, te wys dat daar meer bevredigende alternatiewe gekry kan word.

This thesis deals with the topic of afterlife in the evangelical imagination. It aims to find out the space for consolation (after the death of a youth) in the evangelical afterlife imaginations. The theoretical part deals with issues of death and afterlife in anthropological and biblical context. The thesis also defines the concepts of funeral and consolation. In the analytical part the thesis introduces four evangelical pastors who were interviewed regarding the funeral of a youth and specific topic of funeral at which the pastor is emotionally interested. Furthermore, the analytical part deals with the topics of personal attitudes towards death, the manner of dealing with it, images of afterlife and the ways of consolation. Using qualitative research methodology the thesis analyzes the research question of how particular evangelical pastors cope with the death of a youth in the context of the doctrine. Powered by TCPDF (www.tcpdf.org)

Syfte: Syftet med litteraturstudien var att belysa vuxna anhörigas upplevelser av livet efter att en närstående drabbats av stroke och fått bestående funktionshinder. Metod: Studien genomfördes som en litteraturstudie, 16 vetenskapliga artiklar granskades och sammanställdes sedan utifrån perspektiven fysiskt, psykiskt och socialt. Huvudresultat: Litteraturstudiens resultat visar att anhöriga till strokedrabbade påverkades ur ett fysiskt, psykiskt och socialt perspektiv. De kände sig utmattade till följd av det ökade ansvaret som stroken förde med sig. Deras liv vändes upp och ner och många var missnöjda med vården och dess bemötande. Anhöriga upplevde brist på information och kände att de saknade kunskap om området. Känslor som oro, frustration, sorg, nedstämdhet och skuldkänslor beskrevs. De anhöriga kände sig tvingade att hålla tillbaka sina känslor och de uppgav att stöd från familj, vänner och personal var viktigt och gav dem styrka. Kvinnliga anhöriga visade sig vara mer utsatta än manliga. Anhöriga kände tacksamhet för att den strokedrabbade överlevt. De upplevde brist på egentid, stagnerade framtidsplaner och många kände sig socialt isolerade. De förändrade rollerna som stroken innebar upplevdes som påfrestande. Slutsats: Kunskap om hur anhöriga upplever livet efter en närståendes stroke kan ge vägledning i sjuksköterskans arbete med att stödja och informera anhöriga. / Purpose: The purpose of this study was to illuminate the adult relatives experiences of life after a close person suffered a stroke and become permanently disabled. Method: The study was conducted as a literature review, 16 research articles were examined and then compiled from a physically, mentally and socially perspective. Main results: The literature study shows that relatives of stroke survivors were affected from a physical, mental and social perspective. They felt fatigued as a result of the increased responsibility that the stroke resulted in. Their lives were turned upside down and many were dissatisfied with the care and treatment. Family members felt a lack of information and felt they lacked knowledge of the area. Feelings of anxiety, frustration, grief, depression and guilt were described. The relatives felt compelled to hold back their emotions and they indicated that support from family, friends and staff was important and gave them strength. Female relatives were found to be more vulnerable than male relatives. Relatives felt gratitude for the survival of the stroke victim. They experienced lack of own time, stagnated plans of the future and experienced being socially isolated. The changed roles was experienced as stressful. Conclusion: Knowledge about how family members experience life after a stroke of a close one, may give guidance to the nurse in the work of supporting and informing relatives.

Bakgrund: Antalet individer som lever med ett transplanterat organ ökar. Transplantation innebär att ersätta ett sviktande organ med ett friskt fungerande organ från en donator. En transplantation innebär en förändring av livet. Sjuksköterskan har ansvar för undervisning och stöd för patienten samt etablering av en fortsatt vårdkontakt. Syfte: Syftet var att beskriva patientens upplevelse av att leva med ett transplanterat organ. Metod: En litteraturöversikt har genomförts och grundats på tio kvalitativa artiklar från olika databaser som besvarar syftet. Analysen av artiklarna ledde till subteman och teman som presenteras i litteraturöversiktens resultatdel. Litteraturöversikten har begränsats till att enbart innefatta transplantation av organen hjärta, lungor, lever och njurar. Resultat: Resultatet presenteras i fyra teman och fem subteman. De fyra teman är En förändrad kropp, Leva med konsekvenserna av medicinering, En emotionell berg- och dalbana och Att leva vidare. Patienterna upplevde en kroppslig förändring samt paradoxala känslor kring transplantationen. Hinder och möjligheter upplevde de transplanterade i återhämtningsprocessen samt konsekvenser som de var tvungna att leva med. I resultatet framkom vilken betydande roll sjuksköterskan, sjukvården och närstående har för patienten. Att genomgå en transplantation innebär en anpassning till en ny situation med livsstilsförändringar. Diskussion: I resultatdiskussionen används Husserls livsvärldsteori som teoretisk referensram. Patienterna upplevde en förändrad livsvärld och ett behov av att anpassa sig till det nya livet som ett transplanterat organ medförde. / Background: The number of individuals living with a transplanted organ is increasing. A transplant involves replacing a failing organ with a healthy functioning organ from a donor. A transplant involves a change of life. The nurse is responsible to educate and to support the patient and the establishment of a continuing care contact. Aim: The aim was to describe the patient´s experience of living with a transplanted organ. Method: A literature review has been conducted based on ten articles from different databases that will give answers the aim of the essay. The analysis of the articles led to subthemes and themes which are presented in this literature review result section. This literature review has been limited to only include the transplantation of organs heart, lungs, liver and kidneys. Results: The result are presented in four teams and five subthemes. The four themes are A changed body, Live with the consequences of medication, An emotional roller coaster and Live on. Patients experienced a bodily change and also paradoxical emotions related to the transplantation. The patients experienced obstacles and opportunities during the recovery process and also had to live with other consequences of the transplant. The results showed that the nurse, the health care received and close relatives played a significant role for the patient. A transplantation is an adaption to a new situation with lifestyle changes. Discussion: In the result discussion Husserl’s life-theory is used as a theoretical framework. Patient experienced a great change and needed to adapt to a new life, which the transplanted organ caused.

Bakgrund: Stroke är en av de största folksjukdomar. År 2018 drabbades cirka 25 500 individer och närmare 6 200 avled av sjukdomen i Sverige. Kvarstående symtom som förekommer vid stroke, beroende på vilken sidan av hjärnhalvan som blir drabbat inverkar på patienten fysiskt  och psykiskt, vilken i sin tur påverkas patienten socialt. Sjuksköterskan i detta fall har ett stort ansvar att ta hänsyn till patientens tillstånd och omvårdnadsbehov efter en stroke.   Syfte: Syftet med denna litteraturstudie var att beskriva personers upplevelse av livet efter en stroke. Metod: En beskrivande litteraturstudie som inkluderar 15 vetenskapliga artiklar med både kvalitativ och kvantitativ ansats. Databasen Medline via PubMed tillämpades för att söka fram artiklarna. Huvudresultat: Efter en stroke kan det uppkomma flertal kvarstående symtom, vilket kan påverka personernas fysiska, psykiska, samt sociala liv. Funktionshinder var den vanligaste kvarvarande symtom till personernas förändrade liv. Flera av dem upplevde en känsla av rädsla, oro, skuldkänslor, depression, förändrad självbild och självkänsla. Alla dessa omständigheter ledde till att drabbade personerna självmedvetet isolerade sig, vilket påverkade deras sociala nätverk. Trots dessa faktorer upplevde  de drabbade personerna ett hopp av att återhämtning skulle uppnås så småningom. Slutsats: Personer som drabbats av stroke beskrev upplevelser av olika psykiska, fysiska och sociala hinder till följd av en stroke. Trots dessa faktorer upplevde personerna ett hopp, motivation och positiva känslor. För sjuksköterskan är det viktigt att ha en tillräcklig kunskap om allt som gäller stroke för att kunna tillgodose personers omvårdnadsbehov, vilket hjälper de att kunna förstå, hantera tillståndet samt återhämta sig utan större svårigheter. / Background: Stroke is a widespread disease that affected approximately 25 500 people in 2018 and nearly 6 200 died of the disease in Sweden. Remaining symptoms that occur at stroke, depending on which side of the brain that been affected, effects the patient physically and psychically, which in turn affects the patient socially. The nurse in this case has a great responsibility to take  a deference about patient's condition and nursings needs after the stroke. Aim: The aim with this literature study was to describe person’s experience of the life after a stroke.  Method: A descriptive literature study that includes 15 scientific articles with both qvalitativ and qvantitativ sample. The Medline database via PubMed was used to search for the articles. Results: Persons who affected of stroke described experiences about their physically changes, psychically changes, and sociallity life changes. The functional obstacle created for example fear, depression, anxiety, debt feeling, changes of self-image and self-feeling. All of these circumstances led the affected individuals to self-isolate themselves, which affected their social network. Despite these factors, the affected person’s experienced a hope that recovery would eventually be achieved. Conclusion: The persons who affected of stroke described experiences of various psychically and sociality obstacles as result of a stroke. Despite these factors, persons experienced a hope, motivation and positive emotions. For the nurse it’s important to have sufficient knowledge about everything that concerns stroke, to be able to cater for person’s nursing needs, which help them to understand, manage the condition and recover themselves without any major difficulties.

No description available.