Bakgrund: Hjärtsvikt är en allvarlig och vanligt förekommande sjukdom samt en av de vanligaste orsakerna till sjukhusinläggning. Hjärtsvikt bidrar till en försämrad hälsa och livskvalitet. Egenvårdsåtgärder har en betydande roll för att främja patientens hälsa samt för att förebygga försämring av tillståndet. Brister i egenvård hos patienten beror till stor del på okunskap om hjärtsvikt och egenvårdsåtgärder. Syfte: Att beskriva vilka effekter patientutbildning har på egenvård och livskvalité hos patienter med hjärtsvikt, syftet var även att beskriva de ingående artiklarnas datainsamlingsmetoder. Metod: En deskriptiv litteraturstudie där 12 vetenskapliga artiklar från databasen Pubmed har inkluderats för att kunna svara på syfte och frågeställningar. Artiklarnas resultat och metod har analyserats och sammanställts under 6 kategorier. Resultat: Patientutbildning har visat sig ha positiva effekter både på egenvård och livskvalité. Det kunde ses förbättringar gällande medicinhantering, följsamhet vid medicinering och andra egenvårdsåtgärder så som att följa salt- och vätskerestriktioner, flertalet av patienterna var även mer positiva till livsstilsförändringar. När det kom till livskvalité förbättrades det fysiska, psykiska och sociala måendet, det kunde i en studie kopplas till att patienterna upplevde en större kontroll över sin situation. Den datainsamlingsmetod som var mest förekommande i de ingående artiklarna var enkäter och frågeformulär. Slutsats:Patientutbildning har visat sig ha goda effekter på livskvalité och egenvård. Olika typer av insatser kan påverka livskvalité och egenvård på olika sätt. Kunskapen om hjärtsvikt ökar vid patientutbildning vilket kan påverka inställning och motivation hos patienter med hjärtsvikt, det innebär bättre förutsättningar vid medicinering samt egenvårdsinsatser vilket leder till en bättre hälsa och en ökad livskvalité. / Background: Heart failure is a serious and common disease and one of the most common causes of hospitalization. Heart failure contributes to a deteriorating health and quality of life. Self-care measures will contribute a large and significant role in promoting the health of the patient and to prevent worsening of the condition. The shortcomings in self-care of the patient depend largely on the lack of knowledge in heart failure and the self-care process. Aim: To describe the effects of patient education on self-care and quality of life in patients with heart failure, the aim was also to describe the data collection methods of the included articles. Method: A descriptive literature study of 12 scientific articles from the database PubMed has been included in order to respond to aim and questions. The articles results and methods have been analyzed and compiled under 6 categories. Result: Patient education has been shown to have positive effects both in terms of self-care and quality of life. Improvements could be seen regarding medication management, compliance in medication and other self-care measures so as to comply with salt and fluid restriction. The majority of patients were also more positive about lifestyle changes. When it came to quality of life, improvements could be seen in the physical, mental and social well-being. It could, in one study, be linked to the patients experiences of a greater control over their situation. The data collection method that was the most prevalent in the included articles were surveys and questionnaires.   Conclusion:Patient education has been shown to have positive effects on quality of life and self-care. Different types of actions can affect quality of life and self-care in different ways. Knowledge of heart failure increases with patient education, which can affect attitude and motivation in patients with heart failure, it means better conditions for medication and self-care actions leading to a better health and an improved quality of life.

No description available.

Hjärtsvikt är ett sjukdomstillstånd som utmanar patienten både fysisk, psykisk och socialt och utgör idag den vanligaste diagnosen för patienter över 65 år. Därmed är det även den vanligaste inläggningsorsaken för patienter i denna åldersgrupp. Syftet med litteraturstudien var att belysa hur patienter som lever med hjärtsvikt upplever sin hälsa och egenvård. Metoden grundar sig på Polit och Beck (2012) genomförande av en litteraturstudie där en nio-stegsmodell använts som mall för utförandet av litteraturstudien. Sammanlagt elva vetenskapliga kvalitativa studier granskades efter sökningar i de elektroniska databaserna CINAHL och PubMed. De valda studierna kvalitetsgranskades, dataanalyserades och bearbetades vilket resulterade i tre kategorier. Resultatets tre huvudkategorier var fysisk upplevelse, psykisk upplevelse samt social upplevelse. Kategorierna består av patienters upplevelse av hälsa och egenvård. Slutsats Patienter som lever med hjärtsvikt världen över upplever hälsa och egenvård på olika sätt relaterat till hur och om egenvård utförs samt patientens inställning till sitt sjukdomstillstånd.

Venous leg ulceration has a high recurrence rate. Patients with healed or frequently recurring venous ulceration are required to perform self-care behaviours to prevent recurrence or promote healing, but many find these difficult to perform. Bandura’s self-efficacy theory is a widely used and robust behaviour change model and underpins many interventions designed to promote self-care in a variety of chronic conditions. By identifying areas where patients may experience difficulty in performing self-care, interventions can be developed to strengthen their self-efficacy beliefs in performing these activities successfully. There are currently a variety of self-efficacy scales available to measure self-efficacy in a variety of conditions; but not a disease-specific scale for use with venous ulcer patients. The aim of this study, therefore, was to develop a disease-specific, patient-focused self-efficacy scale for patients with healed venous leg ulceration. Phase 1 consisted of a qualitative design and used focus group methodology to generate an item pool for potential inclusion into the scale from the patients’ perspective. In phase 2, factor analysis using equamax orthogonal rotation methods was used to reduce the items from 60 to 30, resulting in 5 major domains: general self-care; daily self-care tasks; normal living; developing expertise and avoiding trauma. Preliminary reliability studies indicated that the developed scale, VeLUSET© has good internal consistency, with an overall Cronbach alpha of .929 and a strong test-re-test reliability. Furthermore, correlation with the General Self-Efficacy Scale demonstrated a strong positive relationship between the two scales. These results indicate that the VeLUSET©, although still in the early validation stages, is a reliable instrument to measure venous leg ulcer patients’ self-efficacy in performing self-care tasks within clinical practice. The development of this disease-specific tool has now filled a gap in the research on managing patients with healed venous leg ulceration.

Background: As psychosis is often a lifelong disorder, improved health-related quality of life (HRQoL) can be a relevant treatment goal. Persons with psychosis have significantly reduced physical health. Research has demonstrated a great excess of mortality due to cardiovascular diseases, as psychosis may lead to an inactive lifestyle and difficulties making healthy lifestyle choices. Metabolic side effects of second-generation antipsychotics are also common. Many are therefore affected by the metabolic syndrome. The overall situation calls for action by developing health promotion interventions suitable for this group. In recent years, there has been an increased interest in the physical health of persons with psychosis. However, efforts have not been optimally tailored to the needs of this group, and health care services have not done enough, despite being aware of the problem. Aim: The general aim of this thesis was to study HRQoL, and metabolic risk factors in persons with psychosis, and by a health promotion intervention and through the participants’ own perspective contribute to an improvement in lifestyle interventions. Methods: Study 1 had a cross-sectional cohort study design that was carried out in specialised psychiatric outpatient departments in Sweden. The patients (n=903) were diagnosed with a psychotic disorder and invited consecutively to participate. A prospective population-based study of public health in the south-east of Sweden (n=7238) served as reference group. Patients were assessed using psychiatric questionnaires, including the Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the EQ5D, both for patients and the population. Several other health status outcomes relevant to the metabolic syndrome were measured, together with lifestyle habits and clinical characteristics. Study II, III and IV were based on a lifestyle intervention for persons with psychosis. Study II was a longitudinal intervention study with a matched reference sample. The purpose of the lifestyle intervention  was to promote a healthier lifestyle by combining theoretical education with physical activities. The intervention group consisted of 42 participants. A matching procedure was made in which two individuals per participant were matched (n=84) into a reference group. The reference sample was matched for sex, BMI class, and being of as similar an age as possible. Socio-demographics were collected and metabolic risk factors relevant to the metabolic syndrome were measured. Symptom severity was measured using Clinical Global Impression (CGI), and HRQoL was assessed using EQ5D. Measurements were made at baseline and at a one-year follow-up. In study III, a qualitative exploratory study was conducted in order to explore prerequisites for a healthy lifestyle. Data were collected through individual interviews (n=40), using a semi-structured interview guide with participants who had undergone the lifestyle intervention. Data were collected 6–7 months after the intervention had been completed. Conventional content analysis was used. Study IV was also based on these 40 interviews and aimed to describe how persons with psychosis perceive participation in a lifestyle intervention. A phenomenographic analysis approach was used. Results/conclusions: Persons with psychosis are at great additional risk of physical comorbidity. Almost half of the patients met the criteria for metabolic syndrome. In addition, persons with psychosis had significantly lower HRQoL in all dimensions in the EQ5D, except for the pain/discomfort dimension. The only risk factor included in the metabolic syndrome that was associated with lower HRQoL was elevated blood pressure. Raised LDL-cholesterol was also related to lower HRQoL, together with low GAF, older age, high BMI, and female gender. The intervention study demonstrated that HRQoL was significantly improved in the intervention group when comparing EQ-VAS at baseline and at the one-year follow-up. It can be concluded that our intervention was not powerful enough to influence the metabolic factors to any greater extent. The key prerequisite for a healthy lifestyle seemed to be a wish to take part in the society and a longing to live like everybody else. However, many became stuck in a constant state of planning instead of taking action towards achieving a healthy lifestyle. Support by health care professionals is therefore also a prerequisite for a healthy lifestyle. This support should target the transition from thought to action and facilitate the participants’ ability to mirror themselves against healthy people in society by introducing activities they perceive that “common people” do. The challenge for health care professionals is to find a moderate intervention level that does not underestimate or overestimate the person’s capacity. This can facilitate continued participation, and participants can thereby find new social contacts and achieve health benefits.

No description available.

Bakgrund:Hjärtsvikt är en vanlig sjukdom i Sverige bland äldre människor. Sjukdomen påverkar patientens livskvalitet och kräver på grund av det en förändrad livsstil. Egenvård är en del av behandlingen av hjärtsvikt och för att patienten ska kunna utföra detta krävs ett engagemang och vilja att vårda sig själv. Sjuksköterskan har en viktig roll i egenvården då patienten behöver stöd i sin vård och information om sjukdomen. Syfte: Att beskriva patienters upplevelser av att leva med hjärtsvikt och hantera sin egenvård. Metod: En litteraturöversikt. Resultat: Resultatet presenteras i fyra huvudteman. Det första huvudtemat är diagnostisering av hjärtsvikt med två subteman, att acceptera sin diagnos och att förneka sin diagnos. Huvudtema två och tre är patientens upplevelse av egenvård och patientens upplevelse av fysisk aktivitet. Det fjärde huvudtemat är information och kunskap med två subteman, förstå innebörden och informationens betydelse. Diskussion: I diskussionen diskuterades litteraturöversiktens resultat som författarna kopplat till Orems och Erikssons omvårdnadsteori och konsensusbegreppet hälsa. Författarna argumenterade bland annat för ekonomin och genus betydelse för egenvård. / Background: Heart failure is a common disease among elderly people in Sweden. The disease affects the patient’s quality of life and requires a change of lifestyle. Self-care is a part of the treatment of heart failure and for the patient to be able to accomplish this requires a commitment and desire to care for himself. The nurse has a central role in patient’s self-care because the patient needs support in their self-care and information about the disease. Aim: To describe patients´ experiences of living with heart failure and manage their self-care. Method: A literature review Results: The result presents in four main themes. The first main theme is the diagnosis of heart failure and consists of two sub themes, to accept their diagnosis and to deny their diagnosis. The main theme two and three are the patients’ experiences of self-care and the patients’ experiences of physical activity. The last and fourth main theme is information and knowledge with two sub themes, is understand the meaning and the role of information. Discussion: In the discussion the authors discussed the results from the literature review related to Orems and Erikssons nursing theory, and the consensus concept of health. The authors argued for example for the economy and gender relevant to self-care.

Bakgrund: Diabetes mellitus typ 2 är en vanlig folksjukdom som innebär en stor börda för patienter. Kostförändringar har visats kunna förbättra patienters situation, men följsamheten av kostråd brister dock ofta och det tillhör sjuksköterskans roll att främja och stödja en effektiv egenvård bland patienter med diabetes. Syfte: Syftet av denna litteraturstudie är att undersöka utifrån patienters perspektiv vad som påverkar till en ökad samt minskad följsamhet av kostråd vid diabetes typ 2. Metod: Litteraturöversikten är baserad på 19 artiklar av både kvantitativa och kvalitativa ansats som valts ut från databaserna PubMed, Cinahl och PsycINFO. De valda artiklarna vetenskaplig kvalitet granskades med checklistor för kvasi-experimentella eller kvalitativa studier. De inkluderade artiklarnas resultat analyserades av båda författarna för att hitta faktorer som påverkar följsamhet av kostråd. Relevant data sorterades i teman beroende på likheter och skillnader. Resultat: Totalt identifierades sex teman som beskriver vad som kan ha betydelse för följsamheten till kostråd: (1) förhållningssätt till förändring, (2) sociala aspekter, (3) mental hälsa, (4) kultur, (5) kunskapsbrist och (6) socioekonomisk situation. Slutsats: Sjukdomsinsikt, self-efficacy och socialt stöd är väsentliga aspekter att beakta när sjuksköterskor vårdar patienter med diabetes, för att främja deras följsamhet till kostråd. Stödjande insatser borde bygga på individens egen förmåga att ändra sin kost genom att inkludera tidig och anpassad information, delaktighet av närstående samt empati gällande personens socioekonomiska, kulturella och psykiska förhållande. / Background: Prevalence of type 2 diabetes mellitus increases worldwide and represents a major disease burden. Effective self-care, including diet changes, has been shown to prevent complications and improve quality of life. However, adherence to diet therapy is often insufficient and it belongs to the nurse’s role to promote and support adequate self-care. Aim: The purpose of this study is to examine, from patients perspectives, what increases and decreases compliance to dietary advice for diabetes type 2. Method: The literature review is based on 19 articles of both quantitative and qualitative approaches, selected from the databases PubMed, CINAHL and PsycINFO. The scientific quality of the selected articles was assessed with checklists for quasi-experimental or qualitative studies. Both authors analyzed the results of the included articles, to identify factors that influence adherence to dietary advice. Relevant data were sorted into themes depending on similarities and differences. Results: Six themes were identified: (1) attitude to change, (2) social relations, (3) mental health, (4) culture, (5) lack of knowledge and (6) socio-economic condition. Conclusion: Disease insight, self-efficacy and social support are essential aspects to consider when nurses care for patients with diabetes, to promote their adherence to dietary advice. Supporting interventions should strengthen the individual's own capability to change their diet, by including early and tailored information, participation of family members and empathy regarding the person's socio-economic, cultural as well as their psychological condition.

Bakgrund: Alkoholkonsumtion bidrar till sjukdom, funktionsnedsättning och tidig död världen över. Behandlingsalternativ för den med problematiska alkoholvanor är främst medicinska- och/eller terapeutiska åtgärder. Återfall i det problematiska bruket är dock relativt vanligt. Det föreligger därför ett behov att fortsätta utveckla den vård som ges till personer inom alkoholvården. Fysisk aktivitet är en omvårdnadsåtgärd som sjuksköterskan kan använda för att främja hälsa och lindra sjukdom. Det finns inledande forskning kring den positiva effekt som fysisk aktivitet har för patienter med skadligt alkoholbruk och alkoholberoende men det saknas forskning kring huruvida åtgärden används i det kliniska arbetet. Syfte: Att beskriva sjuksköterskans uppfattningar och erfarenheter av fysisk aktivitet för patienter med skadligt alkoholbruk och alkoholberoende. Metod: Kvalitativ design där semistrukturerade intervjuer genomfördes med sju sjuksköterskor verksamma på mottagningar inom beroendevårdens öppenvård. Som analysmetod användes kvalitativ innehållsanalys. Resultat: Sjuksköterskorna beskrev fysisk aktivitet som en grundläggande del av hälsa och som en nödvändighet i patientens vardag. Fysisk aktivitet var ett sätt för patienten att bryta vanor förknippade med alkohol. Den fysiska aktiviteten ansågs lindra flera av de tillstånd som skadligt alkoholbruk och alkoholberoende för med sig, ökade patientens självkänsla och var ett sätt för patienten att självständigt påverka sin hälsa. Sjuksköterskorna sökte informera och motivera patienten till rätt nivå av fysisk aktivitet. Det saknas struktur för användandet i den kliniska vardagen och sjuksköterskorna efterfrågade praktiska möjligheter och bättre riktlinjer inom verksamheten för att underlätta främjandet av fysisk aktivitet hos patienterna. Diskussion: Resultatet diskuteras utifrån Orems egenvårdsteori samt relevant forskning. / Background: Alcohol consumption contributes to disease, disability and increased morbidity worldwide. Treatment options for those with problematic alcohol use are primarily medical- and/or therapeutic interventions. Relapse in the problematic behaviour is relatively common. There is therefore a need to continue to develop the care provided to people undergoing alcohol treatment. Physical activity is a nursing intervention that the nurse can use to promote healthy lifestyles and alleviate disease. There is preliminary research on the positive impact that physical activity have for patients with alcohol use disorders but no research is to be found on whether the intervention is used in the clinical practice. Aim: To describe nurses' perceptions and experiences of physical activity for patients with alcohol use disorders. Method: Qualitative design with semi-structured interviews was conducted with seven nurses working at outpatient dependence clinics. Qualitative content analysis was used to analyse the data. Results: The nurses described the physical activity as a fundamental element of health and as a necessity in the patient's everyday life. Physical activity was a way for the patient to break habits associated with alcohol. Physical activity was considered to decrease many of the comorbid conditions related to alcohol use, increased the patient's self-esteem and was a way for the patient to independently affect their health. The nurses searched to inform and motivate the patient to the right level of physical activity. There was a lack of structure in the everyday clinical practice and nurses demanded practical possibilities and better guidelines within the organization to facilitate the promotion of physical activity to patients. Discussions: The results are discussed from Orems self-care theory and relevant research.

Wellness dialogues in the United States consistently promote "mindfulness" and "meditation" in relation to self-care, but what do these terms really mean? This research project explores perceptions of mindfulness and meditation in the Claremont community, investigating how understandings of these terms are socially exchanged and reproduced. It also illuminates how these understandings have transformed from concepts influenced by a perceived "eastern-ness" to concepts whose cultural roots remain often undiscussed. Through this research, readers will better understand how Claremont community members conceptualize "mindfulness" and "meditation" and hopefully better access these practices with their perceived related health benefits.