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<p>Diss. (sammanfattning) Umeå : Umeå universitet, 2002</p> / digitalisering@umu

<p>Syftet med denna litteraturstudie var att enligt vetenskapliga studier, publicerade mellan år 2002 och 2007, beskriva omvårdnad av patienter med kronisk hjärtsvikt. Metoden som användes var en litteraturstudie med beskrivande design. Information hämtades från databaserna Medline, Academic Search Elite och Cochrane Library, samt ur Vård i Nordens webbarkiv. Sökorden som användes var ”chronic heart failure” och ”nursing”. Totalt inkluderades 22 studier i denna litteraturstudie. Ur studierna kunde fem inriktningar inom omvårdnaden av patienter med hjärtsvikt identifieras. Dessa var omvårdnad genom patientutbildning, telefonrådgivning, fysisk träning, hemsjukvård och hjärtsviktsmottagning. Resultatet visade på ett positivt samband mellan fysisk träning och ökad livskvalitet hos patienter med hjärtsvikt i samtliga studier som undersökte dessa två variabler. Majoriteten av studierna som undersökte effekten av telefonrådgivning till patienter med hjärtsvikt fann att antalet inläggningar på sjukhus hade minskat efter att patienterna under en period fått telefonrådgivning. I de studier som granskats låg fokus till stor del på att stärka patienternas egenvård. Två inriktningar inom omvårdnaden av patienter med hjärtsvikt utmärkte sig som de mest effektiva metoderna. Dessa var fysisk träning och telefonrådgivning.</p> / <p> </p><p>The aim of this literature study was to describe the care of patients with chronic heart failure according to scientific studies published between the years 2002 and 2007. A descriptive design was used. Information was gathered from the following databases: Medline, Academic Search Elite and Cochrane Library. Vård i Norden webb archive was also used for collecting articles. Keywords used in the search were "chronic heart failure" and "nursing". A total of 22 articles were included in this study. The articles in this study showed five different themes in the care of patients with heart failure, these were: patient education, telephone care, physical exercise, home-based care and heart failure clinics. The result showed a positive correlation between physical exercise and quality of life, this was found in every article covering these two variables. Most studies concerning telephone care found that the number of hospital readmissions decreased after an intervention based on telephone care. In the included studies a lot of focus was on strengthening patient's ability to self care. In this study physical exercise and telephone care were the most effective methods of care for patients with heart failure.</p>

Syftet med denna litteraturstudie var att enligt vetenskapliga studier, publicerade mellan år 2002 och 2007, beskriva omvårdnad av patienter med kronisk hjärtsvikt. Metoden som användes var en litteraturstudie med beskrivande design. Information hämtades från databaserna Medline, Academic Search Elite och Cochrane Library, samt ur Vård i Nordens webbarkiv. Sökorden som användes var ”chronic heart failure” och ”nursing”. Totalt inkluderades 22 studier i denna litteraturstudie. Ur studierna kunde fem inriktningar inom omvårdnaden av patienter med hjärtsvikt identifieras. Dessa var omvårdnad genom patientutbildning, telefonrådgivning, fysisk träning, hemsjukvård och hjärtsviktsmottagning. Resultatet visade på ett positivt samband mellan fysisk träning och ökad livskvalitet hos patienter med hjärtsvikt i samtliga studier som undersökte dessa två variabler. Majoriteten av studierna som undersökte effekten av telefonrådgivning till patienter med hjärtsvikt fann att antalet inläggningar på sjukhus hade minskat efter att patienterna under en period fått telefonrådgivning. I de studier som granskats låg fokus till stor del på att stärka patienternas egenvård. Två inriktningar inom omvårdnaden av patienter med hjärtsvikt utmärkte sig som de mest effektiva metoderna. Dessa var fysisk träning och telefonrådgivning. / The aim of this literature study was to describe the care of patients with chronic heart failure according to scientific studies published between the years 2002 and 2007. A descriptive design was used. Information was gathered from the following databases: Medline, Academic Search Elite and Cochrane Library. Vård i Norden webb archive was also used for collecting articles. Keywords used in the search were "chronic heart failure" and "nursing". A total of 22 articles were included in this study. The articles in this study showed five different themes in the care of patients with heart failure, these were: patient education, telephone care, physical exercise, home-based care and heart failure clinics. The result showed a positive correlation between physical exercise and quality of life, this was found in every article covering these two variables. Most studies concerning telephone care found that the number of hospital readmissions decreased after an intervention based on telephone care. In the included studies a lot of focus was on strengthening patient's ability to self care. In this study physical exercise and telephone care were the most effective methods of care for patients with heart failure.

Omvårdnadsforskningen har ökat i takt med att fler sjuksköterskor har en akademisk utbildning. Studier på området har fokuserat på i vilken omfattning sjuksköterskor använder sig av evidensbaserad forskning samt vilka barriärer som finns för användandet. Resultaten är entydiga om att det är svårt att integrera forskningsresultat i det kliniska arbetet. Följden av detta kan bli att kunskap inte når ut i det kliniska omvårdnadsarbetet. Syftet med litteraturstudien var att beskriva omvårdnadsforskningens integrering i det kliniska omvårdnadsarbetet. En systematisk litteraturstudie med integrativ metod genomfördes. I resultatet framkom olika möjligheter till integrering av forskning i klinisk verksamhet. Ett öppet klimat med gemensamma mål för integrering av omvårdnadsforskning samt ett tydligt ledarskap som ger resurser i form av ekonomi, utbildning och tid. För att integreringen av forskning i det kliniska arbetet ska öka behövs ett samarbete mellan universitet/ högskolor och klinisk verksamhet så att sjuksköterskor kan få det stöd som behövs för att utveckla den omvårdnad som ges till patienten. I litteraturen finns få empiriska studier i ämnet varför det vore av intresse att fortsätta utforska detta område. / Nursing research has increased as more nurses have a university education. Studies in this area have focused on the extent to which nurses use evidence-based research as well as the barriers that exist for their use. The results are clear that it is difficult to integrate research findings into clinical practice. The consequence of this may be that knowledge does not reach the clinical nursing practice. The purpose of this study was to describe nursing research integration in clinical nursing. A systematic study with integrative approach was implemented. The result shows various possibilities for the integration of research into clinical practice. An open climate with common goals for the integration of nursing research and clear leadership that provides resources in terms of finance, education and time. For the integration of research into clinical practice will increase the need for collaboration between universities / colleges and clinical practice so that nurses can get the support needed to develop the care given to the patient. In the literature, there are few empirical studies on the subject why it would be of interest to continue exploring this area.

This thesis evaluates experiences, effects, and costs of abdominal massage for people with constipation. The thesis comprises four papers: Paper I is a literature review of health economic analysis of nursing practice. Paper II and III is a prospective randomized controlled trial that evaluates abdominal massage in terms of effects and costs. Paper IV uses a qualitative approach to illuminate the experiences of receiving abdominal massage. Paper II and III included 60 participants who were constipated in accordance with Rome II criteria. Paper IV included nine participants. Paper I investigated the application of economic evaluation in studies of nursing practice. Systematic database searches were performed and gave nearly 600 papers that were screened and 115 studies were relevant according to stipulated inclusion criteria. The result showed that there was a trend of increased publications from the year 2000. Few studies reported the health economic methods used and the perspective of the economic analysis. There was a large variability in number of included cost items. Because the methodological weaknesses in many studies, it was difficult to use some studies as ground for discussion of resource distribution. Paper II investigates the effects of abdominal massage on gastrointestinal function and laxative intake on persons with constipation. The questionnaire Gastrointestinal Symptom Rating Scale (GSRS) was used and data were analyzed using multiple linear regression. The results showed that after eight weeks of abdominal massage the intervention group experienced significantly fewer gastrointestinal symptoms and had significantly more bowel evacuation compared with the control group. There were no differences in laxative intake. Paper III evaluated the change in health-related quality of life (HRQoL) for people with constipation when receiving abdominal massage and estimates the cost-effectiveness of two alternative implementation scenarios: 1) abdominal massage given by enrolled nurses in a department; and 2) participants giving themselves abdominal massage after receiving training in self-massage. Both scenarios imply that all participants received abdominal massage for eight weeks and those who found the treatment effective continued to receive treatment for eight more weeks. EQ-5D was used to assess HRQoL and for calculating QALY. The intervention group had after eight weeks of abdominal massage significantly higher HRQoL assessed with EQ-5D VAS compared with the control group. No significant differences were assessed with the EQ-5D index. Abdominal massage is initially expensive, but for those who respond favourably abdominal massage can be a cost-effective long-term treatment. Paper IV examines the experiences of receiving abdominal massage when having constipation. Four themes were formulated: being on one’s guard, becoming embraced by safe hands, feeling touch to body and mind, and being in a fragile state. Receiving abdominal massage was described as comfortable and lead to decreased problems with constipation. The improvement was described as easily disturbed and it was associated with demands to continue massage to maintain the new state. Conclusion: Abdominal massage is a pleasant treatment that provides significantly fewer gastrointestinal symptoms and increased health-related quality of life. As a long- term treatment, abdominal massage can be a cost-effective treatment.