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Otillräcklig aktivitet har blivit ett stort folkhälsoproblem i världen. Många människor är otillräckligt aktiva och ju mer stillasittande personerna är desto högre risk har de att drabbas av sjukdom. Syftet med studien var att undersöka vad som orsakar en otillräcklig fysisk aktivitet hos personer i åldern 40-75 år. Studien genomfördes som en integrativ litteraturstudie som hanterar både kvantitativ och kvalitativ forskning. Resultatet grundar sig på tolv artiklar och presenteras under fem teman: beteendemässiga faktorer, konkurrerande krav, upplevda hinder, situationsspecifika aspekter och personliga faktorer. Inställningen till fysisk aktivitet grundar sig bland annat på personernas uppväxt och tidigare erfarenheter. Många saknar kunskap om aktiviteternas positiva effekt på hälsan och vid avsaknad av uppmuntran och stöd riskerar personerna att bli otillräckligt aktiva. Orsaker till otillräckligt aktivitet var bland annat bristen på tid som istället ägnades åt familj och arbete samt bristande tillgänglighet till träningsanläggningar. Personer som tidigare har upplevt positiva hälsoeffekter och får stöd har lättare att genomföra en hälsoförändring. Stödet kan utgöras av hälsosamtal som kan inge trygghet hos personen och öka sannolikheten att en förändring genomförs. För att kunna motivera till hälsoförändring är det viktigt att distriktssköterskor har kunskap om vad som orsakar att människor är otillräckligt aktiva. / Insufficiently activity has become a major public health problem throughout the world. Many people are insufficiently active and the more sedentary individuals are, the higher risk that they will suffer from a disease. The aim of this study was to investigate the causes of an inadequate physical activity among people aged 40-75 years. The study was conducted as an integrative literature review that handles both qualitative and quantitative research. The results are based on twelve articles and presented under five themes: behavioral factors, competing demands, perceived barriers, situational aspects and personal factors. Attitudes towards physical activity are based on people's upbringing and past experiences. Many lack knowledge about the positive effects of physical activity and, when coupled with a lack of encouragement and support, there is a risk that people will be insufficiently active. One of the primary reasons for insufficient activity was lack of time which was otherwise devoted to family and work. People who have experienced health benefits and receive support have an easier time implementing a healthy change in their level of physical activity. This support can take the form of health talks which foster a sense of security for the person and increase the likelihood that a positive change is implemented. To motivate improved health, it is important that district nurses have a good background  knowledge as to the common reasons why people are insufficiently active.

The purpose of this research was to examine and describe the relationships among health status, marital status, income level, education level, age, and body mass index (BMI) with the added influence of spirituality on the health promotion behaviors of African American women, living in South Florida. The sample consisted of 137 women, 18 to 64 years of age, who were born in the United States and whose parents were born in the United States. Each participant completed a demographic questionnaire, the Health-Promoting Lifestyle Profile II (HPLP II), the Short Form-36 Health survey (SF-36), and the Spiritual Well-Being Scale (SWBS). Descriptive and inferential statistics with an alpha level of .05 were used for data analysis. Statistically significant findings were (1) a positive relationship between health promotion behaviors and formal education, (2) a positive relationship between health promotion behaviors and spirituality (existential well-being), and (3) a negative relationship between health promotion behaviors and number of children. In the regression model, the five sets of variables together accounted for 25.5% of the variance in overall health promotion behaviors of African American women F (15, 121) = 2.768, p < .01. The health promotion behaviors of African American women were not significantly affected by health status, marital status or BMI. Of the five demographic variables entered in the model, only number of children and education made statistically significant, unique contributions to health promotion behaviors. A sense of life satisfaction and purpose (existential well-being) made an additional, statistically significant, unique contribution to health promotion behaviors among African American women. The unique contribution of religious well-being was trivial. Therefore, formal education, number of children, and spirituality (existential well-being) may be used as predictors of health promotion behaviors among African American women, based on the results of this study. Culturally appropriate and relevant interventions used to encourage and educate African American women to increase physical activity, and decrease caloric intake are critical to mitigate the high rate of morbidity and mortality that African American women experience from CVD.

Problem and significance: Adherence to health-promoting behaviors in a diabetes self-care regimen is essential for individuals with diabetes and can assist providers and individuals with diabetes management. The purpose of this research was to explore the relationship between personal factors (age, length of diabetes diagnosis, perceived health status, weight), perceived barriers to action (number of barrier days), interpersonal influences (social support), situational influences (depressive symptoms), and patient adherence to health-promoting behaviors (blood glucose monitoring, diet, and exercise) and health outcomes ( A1c and body mass index) in a diabetes self-care regimen. Methods: A descriptive correlational analysis was performed using baseline data from the National Health and Nutrition Examination Survey (NHANES) [2007-2008]. Constructs from the Health Promotion Model were used to predict health-promoting behaviors and health outcomes in diabetes self-management. The 713 participants with diabetes were primarily Black or Hispanic (57.5%), older ( M 62.2 years, SD 12.9), and married or living with a partner (56.2%). Approximately half of the participants were female (50.8%); 59% were obese. Results: The longer the time since diagnosis and the more barrier days experienced per month, the more frequently blood glucose monitoring was performed (R2 = .076, R2adj = .060, F (6, 363) = 4.875, p < .001). The greater the body weight, the more likely participants were to implement diet management behaviors (R2 = .097, R2adj = .081, F (7, 413) = 6.209, p < .001). The younger the age and the higher perceived health status, the more minutes per week were spent in exercise (R2 = .054, R2adj = .038, F (7, 412) = 3.307, p < .01). The older the age and the shorter time since diagnosis, the lower the A1c levels (R2 = .054, R2adj = .044, F (6, 568) = 5.391, p < .001). The younger the age, the more barrier days per month and the more diet management behaviors reported, the higher the BMI (R2 = .149, R2adj = .140, F (6, 581) = 16.764, p < .001). Findings indicate that treatment measures, not preventative, are being practiced, and that predictors of behaviors and outcomes are multifaceted and require further investigation.

Några bidragande faktorer till övervikt och fetma är levnadsvanor som innefattar inaktivitet och felaktiga kostvanor. Personer med övervikt och fetma kan få hjälp från primärvården att påverka vikten till det bättre. Syfte med studien var att undersöka vilka erfarenheter personer med övervikt och fetma har av samtal om levnadsvanor med distriktssköterskan. Studien genomfördes som integrativ litteraturstudie vilket ger djupare förståelse för ett visst fenomen inom hälso-och sjukvården. Litteraturstudiens resultat baseras på 16 vetenskapliga artiklar. I analysen framkom fyra kategorier: Betydelsen av att bli motiverad, betydelsen av egen inställning till samtal om levnadsvanor, betydelsen av distriktssköterskans kommunikativa förmåga, betydelsen av distriktssköterskans kunskap och kompetens. Distriktssköterskans kommunaktion var avgörande för hur patienten upplevde samtalet om levnadsvanor. När distriktssköterskan tillsammans med patienten satte upp mål och råden individanpassades motiverades patienten att ändra levnadsvanor. Patienternas motivation minskade när de upplevde att råden de fått var generella. Vissa patienter upplevde att distriktssköterskan inte hade tillräckligt med kunskap för att hantera övervikt och fetma. Kategorierna visar sig överensstämma med Penders hälsofrämjande arbetsmodell som förklaringsmodell för förståelse för patientens motivation till ändrade levnadsvanor. / Some factors that contribute to overweight and obesity are lifestyle related and comprise a lack of physical activity and poor nutrition. Overweight and obese individuals may seek medical attention and acquire advice on how to lose their weight. The purpose of this study was to look into the experiences of the overweight and obese patients pertaining to lifestyle conversations with the district nurse. The study was conducted as an integrative literature overview, which enables a better understanding of a certain phenomenon within medical service. The results consist of sixteen scientific articles. The analysis reveals four categories: the significance of becoming motivated, the significance of one’s own attitude towards conversations about lifestyle, the significance of the district nurse’s communicative skills and the district nurse’s knowledge and competence. The communicative skills of the district nurse played a pivotal role in how the conversations about lifestyle were perceived by the patients. When the district nurse and the patient set individual goals together, the patient appeared more motivated to make a lifestyle change. On the other hand, the motivation of the patient decreased when the advice received was too generalized. Moreover, some patients believed that the district nurse was not adequately knowledgeable to deal with overweight and obesity. The categories correlate with Pender's health-promoting model as an explanation of patients' motivation in changing their lifestyles.

Influensa är en vanligt förekommande sjukdom i hela världen. Äldre över 65 år är en riskgrupp där det föreligger ökad risk för komplikationer, sjuklighet och dödlighet till följd av insjuknande i influensa. Forskning visar att det mest effektiva sättet att skydda sig mot sjukdomen är genom vaccination. Vaccinationstäckningen för influensa bland äldre personer är låg och behöver öka. Syftet med litteraturstudien var att undersöka vad som påverkar äldre i deras val om att motta eller avböja influensavaccination. Studien genomfördes som en integrativ litteraturstudie där resultatet baserades på 18 artiklar. Fem kategorier identifierades: uppfattningen om effekt och biverkningar, tillgänglighet och kostnader, kunskap och brist på kunskap, omgivningens påverkan och preventivt hälsobeteende. Litteraturstudien bidrar med förståelse och kunskap om vad som kan påverka äldre i valet om att motta eller avböja influensavaccination som distriktssköterskan sedan kan använda i arbetet för att främja ett ökat vaccinationsupptag. Dock behövs vidare forskning kring vilka insatser äldre upplever att distriktssköterskan kan bidra med för att äldre personer skall kunna ta välgrundade beslut om influensavaccination. / Influenza is a common disease throughout the world. Older people over the age of 65 are a risk group in which there is an increased risk of complications, morbidity and mortality as a result of infected influenza. Research shows that the most effective way of protecting against the disease is by vaccination. The vaccination cover for influenza among elderly people is low and needs to increase. The purpose of the literature study was to investigate what affects elderly people in their choices to receive or reject influenza vaccination. The study was conducted as an integrative literature study based on 18 articles. Five categories were identified: perception of effects and side effects, availability and costs of the vaccine, knowledge and lack of knowledge, environmental impact and preventive health behavior. The literature study contributes with understanding and knowledge of what can affect elderly in their choices to receive or reject influenza vaccination that the district nurse can use in the work to promote an increased vaccination intake. However, research is needed on what efforts elderly people believe that the district nurse can contribute with to making informed decisions about influenza vaccination.

Humant papillomvirus är ett mycket vanligt förekommande sexuellt överförbart virus som kan orsaka allvarliga sjukdomar såsom livmoderhalscancer. I Sverige vaccineras flickor i årskurs 5 – 6, vars vårdnadshavare har gett sitt skriftliga samtycke, mot humant papillomavirus via skolsköterskan. Vaccinet har minskat förekomsten av livmoderhalscancer. För att minska antalet dödsfall i denna sjukdom är det av stor vikt att uppnå hög vaccinationstäckning hos flickor före tonåren. Syftet med litteraturstudien var att belysa orsaker till att vårdnadshavare avböjer vaccination mot humant papillomvirus till sina döttrar. Studien genomfördes som en litteraturstudie med integrativ ansats. Resultatet baserades på 19 artiklar. Orsakerna till att vårdnadshavarna avböjer att vaccinera sina döttrar mot humant papillomvirus resulterade i sex teman: oro för vaccinets säkerhet; bristande kunskap; otillräcklig information; otydliga rekommendationer; värderingar och övertygelser; misstro gentemot myndigheter. Skolsköterskor bör utbildas och fördjupa sin kunskap om humant papillomvirus och om vaccinet för att förmå framföra korrekt och adekvat information. Detta kan minska vårdnadshavarnas oro, vilket i sin tur kan leda till att täckningsgraden ökar och folkhälsan förbättras. / Human papillomavirus is a very common sexually transmitted virus that can cause serious diseases such as cervical cancer. In Sweden, vaccination against human papillomavirus is administered by the school nurse to girls in grades 5 – 6 whose parents have given their written consent. The vaccine has shown to reduce the incidence of cervical cancer. In order to reduce the number of deaths in this disease it is very important to achieve high vaccination coverage in adolescent girls. The purpose of the literature study was to highlight the reasons why parents decline human papillomavirus vaccination for their daughters. The study was conducted as a literature study with an integrative approach. The result was based on 19 articles. The reasons why parents decline vaccination for their daughters resulted in six themes: concern about the safety of the vaccine; lack of knowledge; insufficient information; unclear recommendations; values and beliefs; distrust of authorities. School nurses should receive further education and improve their knowledge about human papillomavirus and the vaccination in order to provide accurate and adequate information. This can reduce parents’ concerns, which in turn can increase coverage and improve public health.

Chronic obstructive pulmonary disease (COPD) has a severe impact on quality of life (QOL). Using the Health Promotion Model as a guide, a cross-sectional, correlational design was used to describe relationships among individual characteristics and experiences (age, gender, race, severity of illness, resilience), behavior-specific cognitions and affect (self-efficacy, barriers, social support), behavioral outcomes (health promoting lifestyle), and QOL in this patient population. One hundred and twenty participants were recruited from three clinics at Virginia Commonwealth University Health System. In addition to a demographic survey, participants completed a 151-item questionnaire incorporating measures resilience, severity of illness, self-efficacy, and barriers to a health-promoting lifestyle, social support, lifestyle, and QOL. Spirometric evaluation of lung function and the 6-minute walking test were also completed. Structural equation modeling was used to determine the effect of nine independent variables on QOL.Participants were white (51.2%), female (63.6%), and approximately 60.5 years old. Severity of illness, characterized by symptoms and functional capacity, suggested they were not severely ill (mean = 3.18, S.D.= 2.69). They were somewhat resilient (mean = 136.01, S.D.= 23.01), had adequate social support (mean = 68.10, S.D.= 19.95), were uncertain about their competency (self-efficacy) to manage their health (mean = 24.91, S.D.= 4.92), sometimes experienced barriers (mean = 33.33, S.D.= 9.02), and sometimes included attributes of a healthy lifestyle in their lives (mean = 123.93, S.D.= 25.22). Their QOL was fair to poor (mean = 6.10, S.D.= 2.39).A series of analyses using structural equation modeling was conducted. The first model that was tested did not fit the data χ2(df = 13)= 67.989,p = 0.000, GFI = 0.895, CFI = 0.781, RMSEA = 0.189). Next, modification indices were use to reexamine for fit. Using the recommended modifications, a good fit model was obtained χ2(df = 9)=5.016, p = 0.833, GFI = 0.992, CFI = 1.0, RMSEA = 0.0); however, non-significant paths were present. An alternative model was tested and fit the data very well χ2(df=18)= 10.011, p = 0.932, GFI = 0.981, CFI = 1.0, RMSEA = 0.0). The independent variables explained about 45.1% of the variance in health-promoting lifestyle. All the variables explained 45.3% of variance in QOL. The most significant predictor of a healthy lifestyle was social support (0.383) and the most significant predictor of QOL was self-efficacy (0.364). The findings confirmed the utility of the HPM.

Lietuvoje vis daugiau atliekama kepenų transplantacijų. Šiuo metu pacientų išgyvenimas didėja, todėl atsiranda problema, kad slaugytojams, trūksta žinių ir informacijos apie fizinės ir emocinės sveikatos problemas kylančias pacientams, kuriems yra atlikta kepenų transplantacija. Gastroenterologijos skyriaus slaugytojų, kurios slaugo pacientus po atliktos kepenų transplantacijos, vienas iš slaugos tikslų yra skatinti pacientus dalyvauti slaugoje bei siekti sveikatą skatinančio elgesio. Atlikus tyrimą bus išsiaiškinta, kokios fizinės ir emocinės sveikatos problemos kyla pacientams, kuriems atlikta kepenų transplantacija. Suprasdami ir žinodami šiems pacientams kylančias problemas, slaugytojai galės geriau planuoti slaugą, pasitelkti į pagalbą kitus specialistus. Darbo tikslas – atskleisti, kokia yra pacientų, kuriems atlikta kepenų transplantacija, fizinė ir emocinė sveikata. Šiam tikslui pasiekti buvo pasirinktas atlikti kokybinis tyrimas. Kokybinio tyrimo klausimas: Kokia yra pacientų, kuriems atlikta kepenų transplantacija, fizinė ir emocinė sveikata? Tyrimo objektas – pacientų, kuriems atlikta kepenų transplantacija, fizinė ir emocinė sveikata. Tyrimo priemonė – pusiau struktūruotas interviu. Tyrimo dalyviai – pacientai, kuriems atlikta kepenų transplantacija ne mažiau kaip prieš du mėnesius. Tyrimo rezultatai atskleidė, kad: 1. Pacientams po atliktos kepenų transplantacijos iškilo naujų fizinės sveikatos problemų susijusių su atsiradusiu cukriniu diabetu, padidėjusiu... [toliau žr. visą tekstą] / Every year more and more liver transplantations are performed in Lithuania.these days more Patients trial these operations and this creates a problem that nursing staff lacks informatikon about physical and emotional healtcare problems that these Patients face. One of the tasks for nursing staff of Gastroenterology divisions is to encourage Patients to participate in the nursing process and to promote Health-improving behavior. The research aims to help explaining what physical and emotional healthcare problems Patients face after liver transplantation. By knowing and understanding these problems nursing staff will have more tools in nursing planning and also will be able to ask for a timely help by other specialists. Goal of this thesis is to examine physical and emotional Health of Patients after liver transplantation. Qualitative method was chosed to implement this research. Key question of the research is: what is the physical and emotional Health of Patients after liver transplantation? Object of the research is physical and emotional Health of Patients after liver transplantation. Tool of the research is semi-structured interview. Respondents of the research are Patients who experienced liver transplantation not more than two month ago. Results of the research are the following: 1. Patients after liver transplantation face new physical healthcare problems related to diabetes, increased arterial blood presure, special diet, physical activity, smoking and consunning... [to full text]

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