The purpose of this study was to explore the relationship between self-motivation and action control (decision implementation) as dispositional determinants of adherence to exercise programs at a worksite setting. Past studies have shown self-motivation to be a good measure of individual difference between those who persist in exercise behavior and those who do not. Theorists have suggested that individuals with a high action orientation are more likely to maintain and enact their intentions than those with a high state orientation. This study attempted to objectively test the theories by determining whether or not "regular" exercisers are more likely to demonstrate a high action control orientation and /or self-motivation than "irregular" exercisers. An attempt was also made to determine whether or not action control might be a stronger exercise adherence predictor than self-motivation.Eighty five hospital employees who were members of the wellness center at Ball Memorial Hospital, completed a demographic questionnaire, the Self-Motivation Inventory, and the Action Control Scale. Correlational analysis data indicated "regular" exercisers were more likely to demonstrate self-motivation than "irregular" exercisers. However, multiple regression analysis indicated that neither action control nor self-motivation accounted for more than 7% of the total variance. Further study is recommended. / Institute for Wellness

With the decreasing length of hospitalization for the Coronary Artery Bypass Graft (CABG) patient population, it is becoming increasingly difficult to provide patients with necessary education. The purpose of this study was to examine patients' perceptions of the importance of patient teaching information, and how realistic they perceive it is to learn the information following CABG surgery. Patients' learning and understanding are increased when the information is perceived as important.The findings of this study indicated that CABG patients rated the areas of medication, diet and activity information as the most important to learn during the early recovery period. The patients indicated that it was less realistic to learn in the areas of anatomy and physiology, risk factors, medications, diet, activity, post surgical care, psychological factors, and other pertinent information during the early recovery period. The information gained from this study could be used to enhance educational content for patients who have undertaken CABG surgeries. / School of Nursing

Coronary Artery Bypass Graft(CABG) Surgery increases blood flow to the endangered myocardium but does not slow the process of atherosclerosis. The only way to slow the process of coronary artery disease is to acknowledge the risk factors present and minimize or totally eliminate them from an individual's lifestyle. Men and women respond differently to stress and lifestyle modifications. The purpose of this study was to determine if there was a difference between genders in compliance to a heart healthy lifestyle pre and post CABG surgery.Thirty men and thirty women who had CABG surgery at least one year earlier were interviewed to assess coronary artery disease risk. The procedure for the protection of human subjects were followed. The instrument used was the RISKO Heart Hazard Appraisal Tool. This instrument was developed in 1985 by the American Heart Association and scored individuals on systolic blood pressure, weight, serum cholesterol level and cigarette smoking habits. Pre-operative records were also reviewed using the same tool to assess individuals preoperative risk. The research design used was 2 x 2 repeated measures. Data were analyzed using 2 x 2 repeated measures analysis of variance (ANOVA).Two findings were discovered. First there was a statistically significant difference between men and women (F=5.82 p=0.019) with men scoring lower RISKO scores than women, indicating lower risk and better compliance to a heart healthy lifestyle, both pre- and postoperatively. Second there was a significant difference between preand postoperative RISKO scores in the total population (F=8.77 p=0.004). Postoperative RISKO scores were lower indicating an improvement in heart healthy lifestyle. There was no statistically significant difference between genders in the difference of pre- and postoperative RISKO scores (F=2.56 p<.115). The significance of this study was that it looked specifically at gender differences and assessed disparities in cardiovascular risk factors and the impact of surgery on men and women.This study found that overall, men had lower RISKO scores than women. Both genders also had improved RISKO scores postoperatively from preoperatively. No statistically significant difference between genders of the RISKO scores from preoperatively to postoperatively was found. Education needs to continue to play a big part in the cardiac rehabilitation process for both genders and specifically women need to become the target of further research and education to improve compliance to a heart healthy lifestyle. / School of Nursing

Bakgrund: Diabetes typ 1 är en vanlig kronisk sjukdom som oftast drabbar barn. Sverige är ett av de länder som har högst incidens av diabetes typ 1 i världen. Diabetes typ 1 är en sjukdom där egenvården anses vara livsavgörande. Då sjukdomen drabbar barn spelar föräldrars delaktighet i egenvården en central roll. Syfte: Syftet med denna studie är att beskriva föräldrars upplevelse av delaktigheten i vården av sitt barn med diabetes typ 1. Metod: Studien är en allmän litteraturstudie, baserad på 10 kvalitativa artiklar. Resultat: Resultatet visade att föräldrar bar ett stort ansvar i vårdandet kring barnet som har diabetes typ 1. Föräldrars upplevelser kring delaktigheten i vårdandet av sitt sjuka barn bestod i olika känslor, tankar och förändringar. Resultatet redovisas i tre kategorier känslomässiga reaktioner, vårdandets påverkan på vardagen och en ny värld. Slutsats: Det är viktigt att belysa föräldrars upplevelser då detta kan bidra till utveckling av den familjefokuserade omvårdnaden. Genom detta kan sjuksköterskan hjälpa familjer att uppnå en god och säker vård för familjerna med barn som har diabetes typ 1. Av studiens resultat dras slutsatsen att det som sjuksköterska är viktigt att söka förståelse för familjens perspektiv. Vilket författarna ser inom detta område vara att förstå relationen mellan barns sjukdom och föräldrars upplevelser. Klinisk Betydelse: En ökad kunskap hos sjuksköterskor i ämnet, bidrar till en bättre vård där familjefokuserad omvårdnad uppmärksammas i större uträkning. / Background: Diabetes type 1 is one of the most common chronic illness effecting children. Sweden is one of the countries in the world with the highest incident of diabetes type 1. Diabetes type 1 is a disease when self-care plays a life effecting part. As the disease often affects children the parents’ participation in the self-care play a central part. Aim: The aim of this study is to describe parents’ experience of participating in nursing for their child with diabetes type 1. Method: This study is regular literatures study, based on 10 qualitative articles. Results: The result shows that parents’ carried a huge responsibility regarding nursing for the child with diabetes type 1. Parents’ experience regarding participating in nursing for their child consisted in different feelings, thoughts and changes. The result is presented in three categories emotional reactions, nursing affecting the everyday life and a new world. Conclusions: It’s important to highlight parents experience as it can contribute to developing family nursing. Through this the nurse can help the family to achieve a god and safe care for the family having a child with diabetes type 1. The result off this study concludes the important of seeking understanding for the patients’ perspective, by the nurse. Which the author of this study sees, in its context meaning understanding the relationship between children’s disease and parents’ experience. Relevance to clinical practice: Increased knowledge by the nurse in the subject will contribute to better care, where family nursing is in larger computation.

Hjärtsvikt är en folksjukdom som förekommer hos omkring 2 % av befolkningen. Hos den äldre befolkningen är det ett vanligt tillstånd och bland personer över 65 år lider 6-10 % av hjärtsvikt. Hjärtsvikt är ett allvarligt tillstånd med hög dödlighet, sjuklighet och nedsatt livskvalitet. Trötthet (fatigue) är ett av symtomen som diagnosen oftast grundar sig på. Fatigue har en central betydelse för patienternas begränsningar i sin funktionsförmåga. Syftet med litteraturstudien var att belysa upplevelsen av fatigue hos patienter med kronisk hjärtsvikt.  Litteraturstudiens resultat baseras på 13 vetenskapliga artiklar. Resultatet visade att fatigue upplevs som ett av de svåraste symtomen vid hjärtsvikt. Patienterna begränsas framförallt fysiskt men även otrygghet och osäkerhet var vanliga upplevelser. Patienterna för en aktiv kamp mot fatigue och de genomför många ändringar för att bibehålla så hög grad av egenvård och oberoende som möjligt. Fatigue resulterar ändå i ökat beroende och ändrat socialt liv. Sjuksköterskor både i grundutbildningen och i klinisk verksamhet behöver en större förståelse för hur patienter upplever fatigue, hur det begränsar vardagen och hur patienterna oroas på grund av fatigue. Sjuksköterskan behöver den här kunskapen för att kunna utföra individanpassad omvårdnad som kan hjälpa patienterna till ökad egenvård. / Heart failure is a widespread disease that occurs in about 2% of the population. Among the older population, it is a common condition. Among individuals over 65 years, 6-10% suffers from chronic heart failure. Heart failure is a serious condition with high mortality, morbidity and impaired quality of life. Tiredness (fatigue) is one of the symptoms that the diagnosis is usually based on. Fatigue is of central importance for patients' limitations in their capacity to function. The purpose of the literature review was to highlight the experience of fatigue in patients with chronic heart failure.  The literature review results are based on 13 scientific papers. The results showed that fatigue was experienced as one of the most severe symptoms of heart failure. Patients were limited especially physically but also insecurity and uncertainty were common experiences. Patients fought against fatigue and implemented many changes in order to maintain as much self-care and independence as possible. Fatigue resulted in increased dependency and changed the social life. Nurses, both in basic training and in clinical practice, need a greater understanding of how patients experience fatigue, how it restricts daily life and how patients are worried because of fatigue. The nurse needs this knowledge in order to perform personalized care to help patients to better self-care.

The purpose of this study was to explore whether and in what ways an intensive eight-week Mindfulness-Based Symptom Management (MBSM) program might shape the therapeutic experiences of therapists. I used a hermeneutic phenomenological approach to interview and develop in-depth descriptions of four therapists’ experiences in relation to mindfulness and their therapeutic practices. The data collection consisted of: (1) a telephone screening interview; (2) pre-mindfulness training interview; (3) post-mindfulness training interview; (4) field notes based on my observations, subjective experiences, and beginning analyses; (5) and member-checks to verify the accuracy of my interpretations of participants’ interview responses. The results pointed to several common themes indicating the changes therapists described after participating in the mindfulness program. Themes denoting the reported changes were organized into three categories: (1) personal relationship with mindfulness; (2) relationship between mindfulness and therapeutic experiences; and (3) mindfulness-oriented interventions performed in therapy. The findings indicated that mindfulness training is associated with the enhancement of important relational attitudes and skills of therapists, including more acceptance of where clients are at, more presence in therapy, increased capacity to listen, openness and curiosity, and more compassion and empathy. In addition, mindfulness training may be linked to improved reflexive abilities, which has implications for more intentional and ethical decision-making in therapy. Further, the findings also indicated that mindfulness training may be linked to improvements in emotion regulation by decreasing stress, increasing feelings of relaxation and calmness, improving awareness of negative emotional and cognitive states as well as the ability to interrupt these negative cycles. As such, this study pointed to several potential benefits for the inclusion of mindfulness training in therapists’ self-care practices as well as in therapist education.

While much is known about the long-term effects of childhood sexual abuse (CSA) on women in adulthood, little is currently known about their self-care efforts. Given the paucity of research on self-care for survivors, particularly those who are also mothers, and the potential importance of self-care for both themselves and their children, the main goal of the present study was to explore these women’s perceptions and practices of self-care. A grounded theory approach was chosen for this exploration as it provided a sensitive and open-ended methodology which garnered an in-depth understanding of self-care for survivor mothers. The current study combined classic grounded theory (GT) research methods with photovoice methods to explore self-care from the perspective of CSA survivor mothers. Analyses of interview and photograph data from 14 survivor mothers resulted in an original basic social process for understanding how these women care for themselves, feel better, and engage in healing in the context of past violence and trauma. Complex interactive behavioural patterns were identified that recreated a whole self out of damaged fragments; these were conceptualized as “reconstituting a damaged self”. This basic social process was comprised of three main stages, including: emotional de-paining, safetying, and authenticating and returning to self. Several substages within each of these main stages were also identified. Findings were discussed in relation to four theoretical frameworks. Future research directions and clinical implications for this neglected population were suggested. Reconstituting a damaged self can be a long process for sexual abuse survivor mothers involving taking small safe steps, for the most part, on one’s own.

Heart failure is the most common reason to hospitalization among persons over 65 years old. Self-care is an important part in the treatment of heart failure, but poor information and knowledge limits the ability of self-care and increases the risk of admission to hospital. The aim of the study was to investigate what information patients with heart failure describes that they receive from health care personal, how information is perceived, who provides the information, and on what occasions it is given. The aim was also to investigate whether patients' perception of knowledge about heart failure increased after hospitalization. The study is cross-sectional study with a descriptive design. A consecutive selection was used. A questionnaire was filled in by 28 participants. The study has shown that patients with heart failure largely experience information about heart failure inadequate. At firsthand the participants had been informed about swelling legs, dyspnea and increased weight. The information was highly described as comprehensible and individualized. Only one third of the participants described that they have been informed by a nurse. A few of the participants experienced increased knowledge about heart failure after the hospitalization. The information that is given to patients with heart failure is highly experienced as individualized and comprehensible but is given in insufficient extend, as the result demonstrate that many patients with heart failure completely lack information. A routine for heart failure caretaking that include information is required. / Hjärtsvikt är den vanligaste orsaken till inläggning på sjukhus hos personer över 65 år. Egenvård är en viktig del i behandlingen av hjärtsvikt, men bristande information och kunskap begränsar möjligheten till egenvård och därmed ökar risken för inläggning på sjukhus. Syftet med studien var att undersöka vilken information patienter med diagnosen hjärtsvikt beskriver att de får från vårdpersonal, på vilket sätt informationen upplevs, vem som ger informationen samt vid vilka tillfällen den ges. Syftet var också att undersöka om patientens upplevda kunskap om hjärtsvikt ökat efter vårdtillfället. Studien är en tvärsnittsstudie med deskriptiv design och genomförd som en enkätstudie med konsekutivt urval (N= 28). Studien visade att hjärtsviktpatienter i stor utsträckning upplever information om hjärtsvikt från vårdpersonal som otillräcklig. I första hand har deltagarna upplevt att de informerats om bensvullnad, andfåddhet, viktuppgång. Informationen upplevdes i hög grad lättförståelig och individuellt anpassad. Endast en tredjedel av deltagarna beskrev att de fått information av en sjuksköterska. Ett fåtal av deltagarna upplevde att kunskaperna om hjärtsvikt ökat efter vårdtillfället. Den information som ges till hjärtsviktspatienter upplevs till stor grad som individuellt anpassad och lättförståelig men informationen sker i bristande omfattning då resultatet visar att många patienter helt saknar information. Det behövs en rutin för omhändertagande av hjärtsviktspatienter som innefattar information.

Susirgus lėtiniais artritais, žymiai pablogėja ligonio gyvenimo kokybė, savirūpa, atsiranda informacijos apie ligą bei jos gydymą poreikis. Tai ypač tampa aktualu pacientams, kuriems taikoma biologinė terapija, kai su liga kovoti nebepadeda įprastas medikamentinis gydymas. Tikslas – ištirti sergančių lėtiniais artritais gyvenimo kokybę, savirūpą ir žinias taikant biologinę terapiją. Uždaviniai: 1) ištirti ir palyginti sergančių lėtiniais artritais gyvenimo kokybę prieš biologinę terapiją ir jos pokyčius po 4 mėn.; 2) ištirti ir palyginti sergančių lėtiniais artritais savirūpą prieš biologinę terapiją ir praėjus 4 mėn. po jos taikymo; 3) įvertinti sergančių lėtiniais artritais žinias apie biologinę terapiją prieš jos taikymą ir praėjus 4 mėn. po jos taikymo. Tyrimo metodai – 2013 m. vasario - spalio mėn. atlikta anoniminė anketinė apklausa. Tyrime dalyvavo LSMU reumatologijos skyriaus pacientai, sergantys lėtiniais artritais: reumatoidiniu artritu, ankiloziniu spondilitu, psoriaziniu artritu, kurie atitiko atrankos kriterijus biologinei terapijai. Tyrimui naudotas ,,SF-36’’ gyvenimo kokybės klausimynas, kasdieninės veiklos klausimynas (HAQ) bei autorės papildomai kurti klausimai. Respondentams buvo pateiktos anketos prieš biologinę terapiją ir po jos, praėjus 4 mėn. Gautas Lietuvos Sveikatos mokslų universiteto Medicinos akademijos Bioetikos centro leidimas 2013-02-07, Nr. BEK - KS(M)-241 tyrimo atlikimui. Rezultatai: analizuojant bendrai gyvenimo kokybės fizinę ir psichinę... [toliau žr. visą tekstą] / In case of the diagnosis with chronic arthritis, patients’ quality of life and self-care start to deteriorate significantly, the need of information about the disease and its treatment arises. It becomes relevant in particular to patients, treated with biological therapy as traditional treatment with drugs is ineffective. The aim – to research the quality of life, self-care and knowledge of chronic arthritis patients treated with biological therapy. Tasks: 1) to research and to compare the quality of life of patients with chronic arthritis prior to biological therapy and its changes in 4 months period, 2) to research and to compare self-care of patients with chronic arthritis prior to biological therapy and after the period of 4 months treatment, 3) to evaluate the knowledge of patients with chronic arthritis about biological therapy prior to its treatment and after 4 months. The research methods – from February till October, 2013 an anonymous questionnaire was conducted. Patients, diagnosed with chronic arthritis such as: rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, corresponding the selection criteria for biological therapy from Rheumatology department at LUHS, partipated in the research. ,,SF-36“ the life quality questionnaire, the health assesment questionnaire ( HAQ) as well as extra questions, made by the author, were applied in the research. Respondents were provided with the questionnaire forms prior to biological therapy and... [to full text]

Children with autism can have a variety of feeding challenges and there is a paucity of research on the strategies that are effective in addressing these challenges. This study used constructivist grounded theory methodology to determine the process used by mothers to feed their children with autism spectrum disorder. It included 11 mothers of 12 children between the ages of four and eleven years old who had feeding challenges. The feeding challenges went beyond picky eating and mothers used unique strategies and approaches in addressing these feeding challenges based on their beliefs. The data indicated that there is a need to use a deliberate, individualized approach when feeding children with ASD, based on the individual childs needs and the family beliefs. Achieving a Tenuous Balance emerged as the core process, as mothers attempted to maintain or improve their childs feeding amidst changing expectations, environments, and life events.