Thesis (M.S.)--Brigham Young University. Dept. of Geography. / Electronic thesis. Also available in print ed.

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Enfermagem, 2016. / Submitted by Albânia Cézar de Melo (albania@bce.unb.br) on 2016-10-06T15:34:06Z No. of bitstreams: 1 2016_MariaLuizaRêgoBezerra.pdf: 1954020 bytes, checksum: 2f06b2b2ad954008a895cc7e7409751d (MD5) / Approved for entry into archive by Raquel Viana(raquelviana@bce.unb.br) on 2016-11-21T13:59:51Z (GMT) No. of bitstreams: 1 2016_MariaLuizaRêgoBezerra.pdf: 1954020 bytes, checksum: 2f06b2b2ad954008a895cc7e7409751d (MD5) / Made available in DSpace on 2016-11-21T13:59:51Z (GMT). No. of bitstreams: 1 2016_MariaLuizaRêgoBezerra.pdf: 1954020 bytes, checksum: 2f06b2b2ad954008a895cc7e7409751d (MD5) / Este estudo objetivou analisar o perfil diagnóstico de enfermagem de usuários acometidos pela hanseníase, em um hospital de ensino do Distrito Federal, conforme a Taxonomia II da NANDA-I, à luz do construto de autocuidado de Orem. Estudo descritivo, quantitativo de delineamento transversal, realizado entre os meses de janeiro a março de 2016, e contemplou uma amostra por conveniência de 40 indivíduos acometidos pela hanseníase atendidos em um ambulatório especializado em hanseníase. A maioria dos participantes era homens (26; 65%), com idade entre 56-66 anos (14; 35%), de cor parda (24; 60%), estado civil casado (18; 45%), religião católica (55%; 22) e nível de instrução ensino fundamental completo (9; 23%). A renda familiar mais referida foi a correspondente de até 1 salário mínimo (16; 40%). Aposento por idade foi a ocupação mais ocorrente nos participantes do estudo (7; 18%) e 68% (27) dos mesmos apresentaram como condicionantes de saneamento básico e acesso à saúde água tratada, rede de esgoto, rua asfaltada e televisão. No que concerne a procedência a maioria dos indivíduos era de regiões administrativas do Distrito Federal como: Planaltina (20%; 8), Riacho Fundo I (3; 8%), São Sebastião (3; 8%) e Santa Maria (2%; 5); os demais corresponderam ao Plano Piloto (2;5%) e a outros estados como Goiás (45%; 18), Minas Gerais (3; 8%) e Piauí (1; 3%). Dezoito (45%) dos participantes da pesquisa foram caracterizados com outras formas clínicas, tendo igual referência para as baciloscopias de raspado intradérmico com resultado positivo e não informado (16; 40%). Poliquimioterapia (PQT) de 6 a 12 meses (18; 45%), classificação operacional (40; 100%) e PQT comum (26; 65%) foram os achados em relação ao tratamento poliqmuioterápico. A maioria dos indivíduos era caso novo de hanseníase (29; 73%), com uma cicatriz de BCG (19; 48%) e com o sintoma mais referido neuralgia de membros (8; 20%). Foram listados no estudo 637 diagnósticos de enfermagem, sendo ao todo 37 rótulos diagnósticos evidenciados, dos quais 44,6% (284) foram com foco no problema, 49% (309) diagnósticos de risco ou vulnerabilidade e apenas 7 % (44) enquadraram-se na classificação de promoção da saúde. Com frequência acima de 50% estão os seguintes diagnósticos: Dor crônica (40; 100%), Proteção ineficaz (40; 100%), Risco de constipação (40; 100%) , Risco de função hepática prejudicada (40; 100%), Risco de lesão (40; 100%), Risco de lesão térmica (40; 100%), Risco de infecção (40; 100%), Risco de baixa autoestima situacional (38; 95%), Estilo de vida sedentário (34; 85%), Conhecimento deficiente (33; 83%), Atividade de recreação deficiente (29; 73%), Distúrbio na imagem corporal (29; 73%), Risco de olho seco (26; 65%), Disposição para processos familiares melhorados (26; 65%) e Fadiga (26; 65%). Os diagnósticos de enfermagem Integridade da pele prejudicada (17; 43%), Integridade tissular prejudicada (4; 10%) e Risco de integridade da pele prejudicada (19; 48%) também foram destacados e discutidos no estudo diante da relevância, dado ao acometimento cutâneo da hanseníase. Em suma evidenciou-se a relevância dos diagnósticos de enfermagem para o planejamento, implementação e avaliação do processo de cuidar em enfermagem à luz da Teoria do Autocuidado de Orem em indivíduos acometidos pela hanseníase. ________________________________________________________________________________________________ ABSTRACT / This study was intended to analyze the nursing diagnosis profile of users affected by leprosy, in a teaching hospital of the Federal District, according to NANDA-I Taxonomy II, based on the Orem’s construct of self-care. This is a descriptive and quantitative study, with a cross-sectional design, performed between the months of January and March 2016, which encompassed a convenience sample of 40 individuals affected by leprosy and assisted in an outpatient clinic specialized in leprosy. Most participants were men (26; 65%), aged between 56 and 66 years (14; 35%), with brown color (24; 60%), married (18; 45%), Catholics (55%; 22) and with a schooling level equivalent to the complete elementary school (9; 23%). The most referred family income was the one corresponding to up to one minimum wage (16; 40%). Retirement due to age was the most recurrent occupation in the study participants (7; 18%), and 68% (27) of them reported conditions such as basic sanitation and access to health, treated water, sewage system, paved street and television. Concerning the origin, most individuals were from administrative regions of the Federal District such as: Planaltina (20%; 8), Riacho Fundo I (3; 8%), São Sebastião (3; 8%) and Santa Maria (2%; 5). The others corresponded to the Plano Piloto (2;5%) and other Brazilian states such as Goiás (45%; 18), Minas Gerais (3; 8%) and Piauí (1; 3%). Eighteen (45%) of the research participants were characterized with other clinical forms, with equal reference to skin smears of intradermal scraping with positive result and unanswered (16; 40%). Multidrug therapy (MDT) from 6 to 12 months (18; 45%), operational classification (40; 100%) and common MDT (26; 65%) were the findings with respect to the polychemotherapic treatment. Most individuals were new cases of leprosy (29; 73%), with a BCG scar (19; 48%), and the most referred symptom was the neuralgia in members (8; 20%). The study listed 637 nursing diagnoses, and to all 37 labels evidenced diagnostics, of which 44.6% (284) were Focused on the problem, 49% (309) Vulnerability diagnoses, and only 7% (44) framed, in Health promotion classification. Often above 50 % are the following diagnoses: Chronic pain (40; 100%), Ineffective protection (40; 100%), Risk for constipation (40; 100%), Risk for impaired liver function (40; 100%), Risk for injury and Risk for thermal injury (40; 100%), Risk for infection (40; 100%), Risk for situational low self-esteem (38; 95%), Sedentary lifestyle (34; 85%); Knowledge deficit (33; 83%), Deficit in recreational activities (29; 73%), Disturbed body image (29; 73%), Risk for dry eye (26; 65%), Willingness to improved family processes (26; 65%) and Fatigue (26; 65%) were the most frequent nursing diagnoses displayed. Impaired skin integrity (17; 43%), Impaired tissue integrity (4; 10%) and Risk for impaired skin integrity (19; 48%) were also emphasized and discussed in the study because of the relevance given to the cutaneous involvement of leprosy. In summary, it has highlighted the relevance of the nursing diagnoses for the planning, implementation and assessment of the process of caring for in nursing on the basis of the nursing theory “Orem’s Theory of Self-Care” in individuals affected by leprosy. ____________________________________________________________________ RESUMEN / Este estudio tuvo como objetivo analizar el perfil de diagnóstico de enfermería de usuarios afectados por la lepra, en un hospital de enseñanza del Distrito Federal, de acuerdo con la Taxonomía II de la NANDA, a la luz del constructo de autoatención de Orem. Estudio descriptivo y cuantitativo, con diseño transversal, efectuado entre los meses de enero y marzo de 2016, que incluyó un muestreo por conveniencia de 40 individuos afectados por la lepra atendidos en un dispensario médico especializado en lepra. La mayoría de los participantes eran hombres (26; 65%), con edades entre 56 y 66 años (14; 35%), de color pardo (24; 60%), casados (18; 45%), católicos (55%; 22) y con nivel de escolaridad equivalente a la enseñanza fundamental completa (9; 23%). El ingreso familiar más referido fue aquel que corresponde hasta 1 salario mínimo (16; 40%). La jubilación por edad fue la ocupación más recurrente en los participantes del estudio (7; 18%), y 68% (27) de ellos presentaron condiciones tales como saneamiento ambiental y acceso a la salud, agua tratada, red de alcantarillado, calle asfaltada y television. En relación con al origen, la mayoría de los individuos provenían de regiones administrativas del Distrito Federal como Planaltina (20%; 8), Riacho Fundo I (3; 8%), São Sebastião (3; 8%) y Santa Maria (2%; 5). Los remanecientes correspondieron al Plano Piloto (2;5%) y otros estados brasileños como Goiás (45%; 18), Minas Gerais (3; 8%) y Piauí (1; 3%). Dieciocho (45%) de los participantes de la investigación se caracterizaron con otras formas clínicas, teniendo referencia igual para las baciloscopias de rascado intradérmico con resultado positivo y no informado (16; 40%). Poliquimioterapia (PQT) de 6 a 12 meses (18; 45%), clasificación operacional (40; 100%) y PQT común (26; 65%) fueron los hallazgos con respecto al tratamiento poliquimioterápico. La mayoría de los individuos eran nuevos casos de lepra (29; 73%), con una cicatriz de BCG (19; 48%), y el síntoma más referido fue la neuralgia de las extremidades (8; 20%). Fueron listados 637 duagnósticos de enfermería , y todo el 37 etiquetas evidenciaron diagnósticos , de los cuales el 44,6 % ( 284 ) se han centrado en el problema , el 49% (309) diagnósticos de riesgo o vulnerabilidad , y sólo el 7 % ( 44 ) enmarcados , en la clasificación de promoción de la salud . A menudo por encima del 50 % son los siguientes diagnósticos: Dolor crónico (40; 100%), Protección ineficaz (40; 100%), Riesgo de estreñimiento (40; 100%), Riesgo de deterioro de la función hepática (40; 100% ), Riesgo de lesión y Riesgo de lesión térmica (40; 100%), Riesgo de infección (40; 100%), Riesgo de baja autoestima situacional (38; 95%), Estilo de vida sedentario (34; 85%); Déficit de conocimientos (33; 83%), Déficit de actividades recreativas (29, 73%), Alteración de la imagen corporal (29; 73%), Riesgo de ojo seco (26; 65%), Disposición para mejorar los procesos familiares (26; 65%) y Fatiga (26; 65%) fueron los más frecuentes diagnósticos de enfermería señalados. Deterioro de la integridad de la piel (17; 43%), Integridad tisular prejudicada (4; 10%) y Riesgo de deterioro de la integridad de la piel (19; 48%) también fueron señalados y discutidos en el estudio delante de la relevancia asignada a la afección cutánea de la lepra. Resumiendo, hemos subrayado la relevancia de los diagnósticos de enfermería para el planeamiento, implementación y evaluación del proceso de atención de enfermería a la luz de la teoría de enfermería “Teoría de la Autoatención de Orem” en los individuos afectados por la lepra.

Bakgrund Vi sover drygt en tredjedel av våra liv och vår hälsa är starkt beroende av en god sömn. Begreppet sömnstörning kan beskrivas som sömn med bristande kvantitet eller kvalitet som varar under en längre period. I åldersgruppen 16 och 24 år har problemen ökat stadigt. Omvårdnadsteoretikern Dorotea Orem bygger sin teori på att människan vill och har förmåga att göra förnuftiga bedömningar och handla i enlighet med dessa och att sjuksköterskans roll är att hjälpa en person att planera och genomföra aktiviteter som hör till det dagliga livet med avsikt att förbättra, återställa och bevara hälsa/friskhet samt förebygga ohälsa/sjukdom. Syfte Syftet var att beskriva hur omvårdnad kan organiseras för att stödja egenvårdsförmågan hos en ung person med sömnbesvär utifrån Orems egenvårdsteori. Metod Metod som valdes för arbetet var litteraturöversikt. Forskningsartiklar söktes under november 2016 i databaserna CINAHL, PubMed och PsychINFO. Sökorden som användes var adolescent, dyssomnias, sömnstörninga, nursing, nursing care, self care, sleep, sleep deprivation, sleep hygiene, sleep initiation and maintenance disorders och young adult. Resultatet bygger på 16 artiklar. Databearbetning skedde utefter Orems teoretiska modell om egenvård. Material sorterades i teman efter egenvård, egenvårdsbehov och egenvårdskrav. Resultat Egenvårdsförmågan kan förbättras utifrån tre huvudfynd: sömnhygien, kognitiv beteendeterapi och utbildning/information. Slutsats Genom att utbilda ungdomen i sömnhygien eller kongnitiv beteendeterapi kan egenvårdsförmågan öka. Kombineras dessa åtgärder kan den sömnfrämjande effekten öka. Sjuksköterskan bör utbilda, ge rådgivning och stödja ungdomen till att uppnå bästa möjliga egenvårdskapacitet.

Bakgrund: Anhöriga är personer inom familjen eller en nära släkting som stödjer eller vårdar en närstående, som i detta sammanhang syftar till patienten. Tidigare forskning beskriver att sjuksköterskan upplever att de ger olika sorters stöd till anhöriga och patienten under ett cancerförlopp vilket kan vara utmanande. Patienten upplever delvis ett bristande stöd från sjuksköterskan men stödet från anhöriga upplevs betydelsefullt. Syfte: Att beskriva anhörigas upplevelser av att stödja en närstående under förloppet av en cancersjukdom. Metod: En kvalitativ, manifest innehållsanalys av bloggar med induktiv ansats. Resultat: Tre kategorier presenteras: Finna livsglädje, Återkommande behov och Känslomässiga utmaningar. Anhöriga upplever att det är av vikt att bibehålla livsglädje och ta vara på tiden med den närstående. De beskriver också att det finns en längtan efter att något skulle förändras, läggas till eller tas bort för att kunna utstå situationen. Trots detta präglades vardagen av utmaningar. De anhöriga upplevde en inre stress och en otillräcklighet. Slutsats: För att bibehålla en positiv livshållning var det viktigt att anhörigas behov tillfredsställdes. Om dessa behov inte tillfredsställdes uppstod ett lidande som kunde göra det svårt att orka vara ett stöd för den närstående. Kunskapen kan vara ett utvecklingsbidrag för sjuksköterskans arbete. / Background: A family member is a person within the family or a relative who supports or care for a close relative, which in this context refers to the patient. Previous research describes that by the nurse experiences they provide various support to family members and patients during the course of a cancer disease, but it was expressed as challenging. The patient experiences a partially lack of support from the nurse, but support from family members is felt to be significant. Aim: To describe family members’ experience of supporting a close relative during the course of a cancer disease. Method: A qualitative, manifest content analysis of blogs with an inductive approach. Findings: Three categories are presented: Find life joy, Recurrent needs and Emotional challenges. It is important to maintain a positive lifestyle and seize the time. There is a longing for change, to add or remove something to cope with the situation. Regardless, everyday life is characterized by suffering. They experience an internal stress and an inadequacy. Conclusion: It was important that the needs of the family members were satisfied. If they were not, suffering made it difficult remain the energy to be a support for the close relative. This knowledge can be developmental for the nurses’ work.

Abstrakt Bakgrund: Typ 2 diabetes är en livsstilssjukdom som ökar både i Sverige och globalt. Egenvården är en viktig del i behandlingen av sjukdomen och är en livslång uppgift. Sjuksköterskan har en viktig roll i att, genom stöd, undervisning och vägledning, motivera och stärka personens egenvårdskapacitet. För att bättre förstå personens behov i egenvården är det betydelsefullt att sjuksköterskan får ta del av personers erfarenheter av egenvård vid typ 2 diabetes. Syfte: Syftet med denna litteraturstudie var att belysa personers erfarenheter av egenvård vid typ 2 diabetes. Metod: Litteraturstudie baserad på tolv kvalitativa artiklar. Artiklarna söktes i databaserna Cinahl och PubMed. Artiklarna kvalitetsgranskades och analyserades och kategorier och underkategorier identifierades.  Resultat: Resultatet kategoriserades i fyra kategorier och elva underkategorier. Dagligt liv med underkategorier kost, fysisk aktivitet, läkemedelsbehandling och blodsockerkontroll. Stöd; socialt stöd, stöd i samband med sociala sammankomster, familjen som stöd och tron som stöd. Psykiska aspekter; motivationens betydelse för egenvård och känslor i samband med egenvård. Kunskap/information; kunskap och förståelse och behov av diabetesutbildning. Konklusion: Erfarenheter av egenvård varierar från person till person. Att kunna stödja och motivera personen till egenvård ställer stora krav på sjuksköterskans omvårdnadskapacitet. Mycket talar för att Orems egenvårdsteori är användbar i sjuksköterskans arbete med detta.  Nyckelord: Typ 2 diabetes, egenvård, Orem, patientperspektiv, omvårdnad.

Bakgrund: Diabetes är en global folksjukdom som drabbar ett stort antal människor. Sjukdomen är kronisk och kan leda till allvarliga komplikationer som amputation. Sjuksköterskan behöver förståelse för hur en amputation påverkar patientens upplevelser av hälsa och livskvalitet. Syfte: Syftet var att belysa patienters upplevelser och livskvalitet till följd av att leva med amputation som komplikation av diabetes. Metod: En litteraturöversikt genomfördes där resultatet baseras på 13 vetenskapliga artiklar. Dessa söktes fram i databaserna CINAHL Complete och PubMed. Resultat: Resultatet hanterade patienternaserfarenheter av en amputation. Patienternas känslor vid förlusten av en kroppsdel och hur den nya situationen kunde accepteras belystes. Livskvaliteten påverkades av amputationen och kunde förbättras eller försämras jämfört med innan amputation. Behovet av stöd från vård och närstående belystes för att patientens syn på livskvalitet och hälsa ska vara positiv, trots amputation. Slutsats: Amputation leder till en stor fysisk och psykisk påverkan på patientens upplevelse av sin sjukdom och livskvalitet. Beroende på patientens syn på sin förmåga och jämfört med upplevelsen av fotsår som leder till amputation kan ingreppet leda till försämrad eller förbättrad upplevelse av livskvalitet. Patientens egna förmågor och resurser styr hur vården planeras, genomförs och utvärderas. / Background: Diabetes is a global illness that affects a great number of people worldwide. The disease is chronic and can develop into serious complications such as amputaion. The nurses need understanding of how an amputation affects the patients’ experience of health and quality of life. Aim: The aim in this study was to illustrate patients’ experience and quality of life when living with a diabetes-related amputated extremity. Method: A literature review was made where the results are based on 13 scientific articles. These were taken from the databases CINAHL Complete and PubMed. Results: The results described patients’ experience of an amputation. The patients’ feelings of dealing with a lost extremity and how this new situation was accepted was described. Patients’ experience of quality of life was illustrated and was improved or impaired compared to before the amputation. The need for support from health services and relatives were illustrated for the patients’ view on quality of life and health to be positive, despite the amputation. Conclusion: Amputation leads to a great physical and psychological impact on the patients’ experience of their disease and quality of life. Depending on the patients’ view of their ability and compared to the experience of foot ulcers leading up to amputation, the procedure can lead to reduced or increased experienced quality of life. The patients’ own abilities and resources control the planning, implementation and evaluation of self-care.

Orem, Utah, is a rapidly growing city that is changing from rural to urban land uses. A present inventory of land is important in determining the land use characteristics of the city, the degree of development, and future use of land. A field survey was made of the city and the resultant land use information was computerized for data analysis.Although Orem City is rapidly changing to urban uses, the city is still largely undeveloped, especially when compared to major urban centers. Agriculture is still the most dominant use of land comprising almost thirty-nine percent of the city. Approximately forty percent of Orem is developed, and land occupied by single family dwellings is the dominant use of developed land. Because of urban sprawl and reduction of agricultural land in Orem, a land use plan for the future is vital. It should include re-classification of zoned land in the city, and steps to control growth and preserve open space.

Bakgrund: Diabetes mellitus typ 2 är den mest ökande och livshotande metaboliska sjukdomen i världen. I Sverige var 468 402 patienter diagnostiserade med sjukdomen år 2022. Patienten har ett stort ansvar för att utföra egenvård och genomföra nödvändiga livsstilsförändringar för att förebygga sjukdomsrelaterade komplikationer. Exempel är att förändra kost- och motionsvanor. Syftet: Att beskriva sjuksköterskors erfarenheter av egenvård hos patienter med diabetes mellitus typ 2. Metod: Litteraturöversikten som genomfördes hade en kvalitativ ansats. I studien inkluderades 12 kvalitativa vetenskapliga studier. Analysen av studierna genomfördes i enlighet med de fem steg som Friberg (2022a) rekommenderar. Resultat: Vid analys av studierna som ingick i materialet identifierades tre teman och sex subteman. Tema Utmaningar i att stödja till egenvård med subtema Hinder för egenvård och Kulturella värderingar och religiösa övertygelsers påverkan. Tema Betydelsen av kommunikation med subtema Att övertyga betydelsen av egenvård och Att skapa relation med patienterna. Tema Kunskapens betydelse med subtema Kunskapsbrist hos patienterna och Patientens behov av utbildning. Slutsats: I ett mångkulturellt samhälle är det viktigt att öka kulturella kompetenser bland sjuksköterskor för att kunna stödja personer med diabetes typ 2 till genomförandet av egenvård. Kommunikationen mellan sjuksköterskor och patienter bör anpassas efter de behov och förutsättningar individen har, där en god relation är central. Dessutom behövs strategier utvecklas för att öka patienternas kunskap om sjukdomen. / Background: Diabetes mellitus type 2 is the most increasing and life-threatening metabolic disease in the world. In Sweden, 468,402 patients were diagnosed with the disease in 2022.The patient has a great responsibility for performing self-care and implementing the necessary lifestyle changes to prevent disease-related complications. Examples are changing diet and exercise habits. Purpose: To describe nurses' experiences of self-care in patients with diabetes mellitus type 2. Method: The literature review conducted had a qualitative approach. The study included 12 qualitative scientific studies. The analysis of the studies was done according to the five steps Friberg (2022a) recommends. Results: When analyzing the studies included three themes and six subthemes were identified. The theme, Challenges in supporting self-care with subtheme, Obstacles to self-care and Influence of cultural values and religious beliefs. The theme, Importance of communication, with subtheme Convincing the importance of self-care and Creating a relationship with the patients. The theme, Importance of knowledge with subtheme Lack of knowledge in patientsand Patient's need for education. Conclusion: In a multicultural society, it is important to increase cultural competence among nurses to support people with type 2 diabetes to implement self-care. Communication between nurses and patients should be adapted to the needs and conditions of the individual, where a good relationship is central. In addition, strategies need to be developed to increase patients' knowledge of the disease.

Bakgrund: Mer än en miljard människor har diagnosen hypertoni och sjukdomen är den främsta orsaken till kardiovaskulära sjukdomar. Förstahandsvalet vid behandling är åtgärder relaterade till levnadsvanor. Har inte åtgärderna tillräcklig effekt kan läkemedel vara nödvändigt. Ökad insikt i patientperspektivet kan ge bättre möjligheter att stödja patienter med hypertoni. Syfte: Syftet var att beskriva patienters upplevelser av egenvård vid hypertoni. Metod: Litteraturöversikten innefattade tolv studier med kvalitativ ansats och analyserades utifrån Fribergs modell. Analysen genererade två teman och sex subteman som speglade olika upplevelser av egenvård. Resultat: Resultatet speglade två olika sidor av egenvård. Barriärer påvisade utmaningar med egenvård där oro och bristande motivation uttrycktes. Även bristande stöd från hälso- och sjukvårdspersonal och implementerandet av egenvård i vardagen upplevdes utmanande. Möjligheter uttrycktes som upplevd kontroll och motivation till att förbättra hälsan med hjälp av egenvård. Slutsats: Upplevelserna skilde sig åt vilket speglar egenvårdens omfattning. Den enskilt viktigaste faktorn vid egenvård var graden av motivation där sjuksköterskans ansvar är att skapa eller stärka drivkraften. Individuella resurser påverkade patienternas förmåga till att leva hälsosamt och individanpassade råd gavpatienterna förutsättningar att bedriva en god egenvård. / Background: More than a billion people around the world have been diagnosed with hypertension and the disease is the primary cause of cardiovascular diseases. The primary choice of treatment are actions related to lifestyle. If the actions are insufficient, medication can be necessary. Increased insight into the patient´s perspective can give more possibilities to help patients with hypertension. Aim: The aim was to describe the patient´s experiences of self-care in hypertension. Method: The literature review included twelve studies with a qualitative method and the analysis model used was Friberg's model. The analysis generated two themes and six sub-themes which reflected different experiences of self-care. Results: The result reflected two different sides of self-care. Barriers expressed challenges with self-care were anxiety and lack of motivation were expressed, but also lack of support from health-care professionals and implementation of self-care in everyday life. Possibilities were expressed as experienced control and motivation to improve health with self-care. Conclusion: The experiences differed which reflected the extent of self-care. The most important factor in self-care proved to be the individuals degree of motivation where the nurse´s responsibility is to create or strengthen the motivation. Individual resources affected the patient´s capacity to a healthy living and individualized advice give conditions to manage self-care.

Made available in DSpace on 2014-07-29T15:04:47Z (GMT). No. of bitstreams: 1 Dissertacao Maria Auxiliadora Gomes de Mello.pdf: 607048 bytes, checksum: 5fbc949c78852566850928bda527f423 (MD5) Previous issue date: 2007-02-23 / The nursery role next to people with acute spinal cord injury is of great reaching, and it requires knowledge from the professionals faced to the features of that population. The nursing diagnosis (ND) knowledge that occurs on that group of people can help on more efficient introducing of nursing systems. Facing the exposed above, it emerges the need of knowing the diagnosis profile of that population. It is about a descriptive study of the quantitative approaching and aims: 1 - to analyze the nursing diagnosis profile of North American Nursing Diagnosis Association (NANDA), identified next to acute spinal cord injury carriers using Orem Model. 2 To analyze the relation of identified nursing diagnosis numbers with the variables: age, sex, income, marital status and level of scholarship of the person with acute spinal cord injury, etiology, level and extent of the injury, lead time of the injury, existence of a daycare, sex and degree of kinship of the daycare. 3 to analyze the relation of the identified nursing diagnosis with those variables. To the data collection, it was made interviews, physical exam and consulting to the patient files. In the ND developing it was realized the process of rational thought process proposed by Helland and the Taxonomy II of NANDA. 30 patients with acute spinal cord injury participated on the sample, independent from the gender, attended in the ambulatory of triage of a rehabilitation center of Goiás state, from November 2005 to December 2006, who agreed to take part in the research signing the informed consent , 73.3% of the patients were male, the medium age was 32.6 years old (± 10,29). The average time of the injury was 162 days (±369,9), 28 of the cases presented traumatic injury, and 16 presented complete spinal cord injury. From these ones, 16.7% were not literate. The familiar income varied from 0 to 5 minimum wages. 61 different nursing diagnoses were found, with a sum of 734 happenings, and the average was 24.46 ND per person. The most affected requirement of universal long term care was the one about prevention of dangerous to the life function and to the well- being of humans, with 20 ND and 318 happenings. The number of identified nursing diagnosis didn t present any link with the variables age, sex, income, marital status and scholarship of the person with acute spinal cord injury, etiology, level and extent of the injury, lead time of the injury, existence of the daycare, sex and degree of kinship of the daycare, to the studied sample. The variables with highest number of association with ND were: level of the injury that presented association statistically meaningful with ND impaired walking (p = 0.009); useless control of the therapeutic regime (p = 0.034); lack of care about feeding (p = 0.0006); lack of care about oral hygiene (p = 0.004); impaired physical mobility (p = 0.034); ineffective protection (p = 0.014); and risk for impaired home maintenance (p = 0.015), and the variable extent of the injury that presented association statistically meaningful with ND impaired walking (p = 0.007); sexual dysfunction (p = 0.005), intestinal incontinent (p = 0.033); total urinary incontinent (p = 0.0006); infection (p= 0.024); tissue integrity impaired (p = 0.16); ineffective protection (p = 0.0004); risk for peripheral neurovascular dysfunction (p = 0.002) and risk for musculoskeletal inactivity (p = 0.015). We hope the results of this research can contribute to the grounding of professional practice and to a better nursing assistance to acute spinal cord injury patients. / A atuação do enfermeiro junto a pessoas com lesão medular é de grande abrangência, e requer dos profissionais conhecimentos voltados às características dessa população. O conhecimento dos Diagnósticos de Enfermagem (DE) que ocorrem nesse grupo de pessoas poderá auxiliar na implementação de sistemas de enfermagem mais eficazes. Frente ao exposto, emerge a necessidade conhecer o perfil diagnóstico dessa população. Trata-se de um estudo descritivo de abordagem quantitativa e teve como objetivos: 1-Analisar o perfil de diagnósticos de enfermagem da North American Nursing Diagnosis Association (NANDA) identificados junto a portadores de lesão medular usando o Modelo de Orem. 2-Analisar a relação do número de diagnósticos de enfermagem identificados, com as variáveis: idade, sexo, renda, estado civil e escolaridade da pessoa com lesão medular, etiologia, nível e grau da lesão, tempo decorrido da lesão, existência de cuidador, sexo e grau de parentesco do cuidador. 3 Analisar a relação dos diagnósticos de enfermagem identificados, com essas variáveis. Para a coleta de dados foram realizadas entrevistas, exame físico e consulta ao prontuário. Na elaboração dos DE foi realizado o processo de raciocínio diagnóstico proposto por Helland e a Taxonomia II da NANDA Participaram da amostra 30 pacientes com LM, independente do gênero, atendidos no ambulatório de triagem de um centro de reabilitação do estado de Goiás, entre Novembro de 2005 a Dezembro de 2006, que concordaram em participar da pesquisa assinando o termo de consentimento livre e esclarecido, sendo 73,3 % do sexo masculino, média de idade de 32,6 anos (± 10,29). O tempo médio de lesão foi de 162 dias (±369,9). A lesão foi traumática em 28 dos casos, 16 apresentaram lesões completas da medula espinhal. Destes, 16,7 % não eram alfabetizados. A renda familiar variou de zero até 5 SM. Foram identificados 61 diferentes diagnósticos de enfermagem, com um total de 734 ocorrências, sendo a média de 24,46 DE por pessoa. O requisito de autocuidado universal mais afetado, foi o de prevenção de perigos para a vida funcionamento e bem-estar humanos, com 20 DE e 318 ocorrências. O número de diagnósticos de enfermagem identificados não apresentou associação com as variáveis idade, sexo, renda, estado civil e escolaridade da pessoa com lesão medular, etiologia, nível e grau da lesão, tempo decorrido da lesão, existência de cuidador, sexo e grau de parentesco do cuidador, para a amostra estudada. As variáveis com maior número de associação com os DE foram: nível da lesão que apresentou associação estatisticamente significativa com os DE deambulação prejudicada (p = 0,009); controle ineficaz do regime terapêutico (p = 0,034); déficit no autocuidado para alimentação (p= 0,0006); déficit no autocuidado para higiene oral (p = 0,004); mobilidade física prejudicada (p = 0,034); proteção ineficaz (0,014) e risco de manutenção do lar prejudicada (0,015)., e a variável grau da lesão que apresentou associação estatisticamente significativa com os DE deambulação prejudicada (p = 0,007); disfunção sexual (p= 0,005), incontinência intestinal (p = 0,033); incontinência urinária total (p = 0,0006); infecção (p = 0,024); integridade tissular prejudicada (p=0,16); proteção ineficaz (p = 0,0004); risco de disfunção neurovascular periférica (p = 0,002) e risco de síndrome do desuso (p = 0,015). Esperamos que os resultados desta pesquisa possam contribuir para fundamentação da prática profissional e para a melhor assistência de enfermagem aos portadores de lesão medular