Bakgrund: I sjuksköterskans profession ingår att främja hälsa, förebygga sjukdom, återställa hälsa och lindra lidande. En hjärtinfarkt är en omtumlande händelse och flera tusen drabbas varje år, för en sådan kris saknar ofta människor beredskap. En hjärtinfarkt kan ge plötslig, svår smärta samt ångest och orsakas av stopp i ett kranskärl, vilket leder till syrebrist i hjärtat. Anhöriga kände ett stort ansvar och saknade information från sjukvården. De kände även en oro att deras närstående skulle drabbas av ännu en hjärtinfarkt. Syfte: Att beskriva kvinnor och mäns erfarenheter efter en hjärtinfarkt.  Metod: Resultatet av denna litteraturstudie utgjordes av tio kvalitativa artiklar identifierade i databasen PubMed.     Huvudresultat: Det framkom att flera konsekvenser upplevdes efter hjärtinfarkten, såsom utmattning, ångest, oro och rädsla för att drabbas igen, vilket gav begränsningar i livet. Efter hjärtinfarkten kunde livet präglas av en rädsla att anstränga det sjuka hjärtat och minskad tro på hjärtats förmåga. Vidare framkom behovet av mer information från sjukvården. Närstående visade sig ha stor betydelse för tillfrisknandet samt möjligheten att få träffa andra i samma situation. Hjärtinfarkten var för många en väckarklocka som gav insikt om det viktiga i livet och kunde motivera till livsstilsförändringar. Slutsats: Hjärtinfarkten medförde många konsekvenser. Trots en rädsla att anstränga det sjuka hjärtat kunde händelsen motivera till livsstilsförändring. Anhöriga var ett stort stöd i tillfrisknandet, dock fanns en önskan om mer stöd och information från sjukvården. Denna litteraturstudie kan ge vårdpersonalen ökad förståelse för erfarenheter efter en hjärtinfarkt samt bidra med kunskap om hur eftervården kan utformas. / Background: The nursing profession includes promoting health, preventing disease, restoring health and relieving suffering. A heart attack is a dizzying event and several thousand are affected every year, because such a crisis often leaves people unprepared. A heart attack can cause sudden, severe pain and anxiety and is caused by a blockage in a coronary artery, which leads to a lack of oxygen in the heart. Relatives felt a great responsibility and lacked information from the health service. They also felt a concern that their loved ones would suffer another heart attack.Aim: To describe women's and men's experiences after a heart attack.Method: The results of this literature review consisted of ten qualitative articles identified in the PubMed database.Main results: It turned out that several consequences were experienced after the heart attack, such as fatigue, anxiety, worry and fear of being hit again, which gave limitations in life. After the heart attack, life could be marked by a fear of straining the diseased heart and diminished belief in the heart's ability. Furthermore, the need for more information from the health service emerged. Relatives proved to be of great importance for recovery and the opportunity to meet others in the same situation. For many, the heart attack was an alarm clock that provided insight into the important things in life and could motivate them to make lifestyle changes.Conclusion: The heart attack had many consequences. Despite a fear of straining the sick heart, the event could motivate a lifestyle change. Relatives were a great support in the recovery, however, there was a desire for more support and information from the health care. This literature study can give the care staff an increased understanding of experiences after a heart attack and contribute with knowledge of how aftercare can be designed.

Bakgrund: Svenska Hjärt-Lungräddningsregistret rapporterade år 2019 att 1532 personer överlevt hjärtstopp. Vid en sådan händelse är larmning, hjärt- och lungräddning samt tidig strömstöt från hjärtstartare viktig för ökad chans till överlevnad. De sjuksköterskor som ställs inför dessa situationer har en betydande roll i mötet med dessa patienter och deras anhöriga. Syfte: Att beskriva personers erfarenheter av att överleva hjärtstopp under de första 6 åren efter händelsen.Metod: En beskrivande litteraturstudie med en tematisk analysmetod baserad på 12 vetenskapliga artiklar. Huvudresultat: Resultatet av denna litteraturstudie visade förändringar och utmaningar både fysiskt, psykiskt samt emotionellt. Överlevarna uttryckte en stor tacksamhet till en andra chans i livet, men även ångest och oro för att våga lita på sin kropp igen. De beskrev minnesförluster efter händelsen där många av dem hade behov av att fylla dessa minnesluckor. Det var en stor omställning att gå från tryggheten på sjukhuset med all personal, till att behöva klara sig själv när det var dags att åka hem. Väl hemma var det en utmaning att vänja sig vid ett nytt liv och finna sin nya identitet. Slutsats: Att uppleva ett hjärtstopp väckte många känslor kring liv och död. Hjärtstoppet gav överlevarna en påminnelse om att livet är skört samt en känsla av tacksamhet för en andra chans i livet. Händelsen efterlämnar mycket ångest och rädslor inför framtiden samt en känsla av att inte vara densamma varken fysiskt eller psykiskt. Med bättre stöd för de komplikationer som hjärtstoppsöverlevarna drabbats av, kan den individuella livskvalitén samt upplevda hälsan öka. / Background: The Swedish Heart- and Lung register reported in 2019 that 1532 people survived cardiac arrest. In such an occurrence, early warning, cardiopulmonary resuscitation (CPR) and early electric chock from defibrillation are important for increasing the chance of survival. The nurses who face these situations have a significant role in meeting these patients and their relatives. Aim: To describe people's experiences after surviving a cardiac arrest during the first 6 years after the occurrence.Method: A descriptive literature review with a thematic analysis method based on 12 scientific articles. Main Result: The result of this review showed changes and challenges both physically, mentally, and emotionally. Cardiac arrest survivors expressed gratitude for a second chance in life, but also anxiety and worry about trusting their body again. They describe memory loss after the occurrence where many of them felt the need to fill these memory gaps. It was a big change to go from the safety of the hospital with all the staff, to having to take care of themselves when it was time to go home. Once they were home, it was a challenge to get used to a new life and find their new identity. Conclusion: Experiencing a cardiac arrest evokes many feelings about life and death. The cardiac arrest reminded the survivors that life is fragile, and gave a feeling of gratitude for a second chance at life. The event leaves a lot of anxiety and fears for the future as well as a feeling of not being the same, either physically or mentally. With better support for the complications suffered by cardiac arrest survivors, the individual quality of life and perceived health can increase.

Receiving a breast cancer (BC) diagnosis generates significant physical and psychological stress that may persist months, years, or even decades beyond treatment completion. Such chronic stress can severely alter the biological systems of BC survivors (BCS). Yet, little is known about the impact and associated variables of these long-term physiological sequelae. Considering that the number of BCS continues to grow each year, it is imperative to assess the extent to which a BC experience impacts human physiological mechanisms by examining the secretion patterns of associated stress- and immune-related biomarkers and by exploring the behavioural, physical, and psychological variables implicated in these dysregulations. Such research is of particular importance in order to guide cancer survivorship care and develop interventions promoting optimal health outcomes in BCS. This research program sought to address this through three inter-related studies. Study One was a quasi-experimental design study examining both the diurnal and reactive concentration patterns of secretory immunoglobulin A (SIgA) in a sample of women with (n = 22) and without a prior history of BC (n = 26). SIgA concentration patterns were contrasted to concentration patterns of cortisol and salivary alpha-amylase (sAA) in the same individuals (complementary to two previously published studies). Participants supplied saliva samples at five time points on two consecutive typical days (for diurnal data) and at seven time points before, during, and after an acute laboratory stressor (for reactive data). Results reveled no evidence of uncharacteristic SIgA diurnal or reactive concentration patterns, suggesting a normal and well-functioning immunological SIgA system in BCS on average 4.6 years post-diagnosis. Study One acted as a summary article allowing readers to grasp the "big picture" of long-term physiological dysregulations in BCS as a whole. Building on this, Study Two, which used the same dataset as Study One, aimed to determine whether physical activity (PA) could mitigate the adverse physiological effects of a BC experience in BCS (n = 25), as indexed by their cortisol concentration patterns. Participants self-reported their PA frequency and engaged in the same cortisol assay protocol reported in Study One. Results indicated no statistically significant differences in diurnal and reactive cortisol patterns between low- and high-PA groups. A trend that PA might not have the same effect on women with and without a history of BC was noted. Important limitations to Study Two included the small sample size and the lack of sensitivity and objectivity of the PA measure. To address Study Two’s limitations and to consider a wider range of modifiable variables that could contribute to the physiological dysregulations observed in BCS, Study Three aimed to assess the predictive value of six behavioural, physical, and psychological variables on the physiological effects of a BC experience, as indexed by cortisol (n = 192) and C-reactive protein (CRP; n = 168) levels over the first 1.5 year post-treatment. CRP, a biomarker that had not been considered so far in this research program, allowed to assess systemic inflammation in BCS post-treatment. Study Three also aimed to describe naturally occurring changes in cortisol and CRP levels and assess whether they changed in tandem. Data were drawn from 201 BCS who provided capillary blood and saliva samples at approximately 3.5 months post-treatment and again 3, 6, 9, and 12 months later. At each time point, participants also completed self-report questionnaires and wore an accelerometer for seven consecutive days. Multilevel modeling analyses revealed no significant change over time for cortisol levels post-treatment and a non-linear trajectory of change for CRP levels which was not predicted by cortisol levels. Associations between cortisol and sedentary time as well as associations between CRP and PA, body mass index, and health- and cancer-related stress were found. Collectively, these three inter-related studies uniquely add to the literature by describing long-term physiological trajectories of stress- and immune-related biomarkers in BCS. This research program attempts to gain a better understanding of the underlying mechanisms that tie behavioural, physical, and psychological variables and biomarker secretion to a BC experience. It also offers opportunities to identify women at greater risk of physiological dysregulations following a BC experience. This represents an important step towards the development of tailored interventions targeting specific BCS that most warrant them. With the number of BCS climbing each year, cancer survivorship needs to be a priority in research and efforts to better understand, monitor, and mitigate the physiological consequences of a BC experience are critical.

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A thesis submitted to the Faculty of Arts in fulfilment of the requirements for the degree of Doctor in Community Psychology in the Department of Psychology at the University Of Zululand, South Africa, 2015 / The incidence of rape in South Africa is high. A total of 50 481 rape cases were reported in 2010. Rape trauma is exacerbated by the fact that the country has a limited number of professionally trained therapists to attend to survivors. Most survivors end up looking for assistance from their churches, and therefore claim to be healed spiritually. This study was conducted in the Nkangala district of South Africa because of the high incidence of reported rape cases. While it is estimated that one woman is raped in every five minutes in this district, there are only three psychologists employed by the government to attend to a population of 1 020 592. As a result of the scarcity of health care professionals, survivors end up looking for assistance from their churches. South Africa is a country in which spirituality is clearly important. Seventy five percent of the population claim to be Christian and twenty percent claim allegiance to other religions In-depth interviews were conducted with eight female rape survivors between the ages of 18 and 40yrs, who considered themselves to have experienced spiritual healing. Content analysis indicated that spiritual healing approximated psychotherapeutic interventions in the provision of unconditional positive regard, empathy, congregational support and respect. Survivors strongly believed that their healing occurred as a result of prayer, reading Holy Scriptures, church support and spiritual guidance, which gave them strength to forgive perpetrators and move on with their lives. / Department of Health Mpumalanga Province

Indiana University-Purdue University Indianapolis (IUPUI) / Up to 75% of the more than 3.5 million breast cancer survivors (BCS) living in the United States report cognitive dysfunction. However, little is known about cognitive dysfunction among older BCS, who may be at greater risk. Therefore, the purpose of this dissertation was to characterize cognitive dysfunction in older BCS. Specific aims included: (1) synthesize the literature regarding cognitive dysfunction in older BCS; and (2) examine the relationships between a) objective cognitive function (immediate memory, delayed memory, attention, executive function-working memory, verbal fluency) and subjective cognitive function (attention); b) demographic factors, medical factors, treatment factors, and cancer-related symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and cognitive function; and c) comorbidity and cognitive function and physical functioning, and quality of life (QoL) in older BCS. In an integrative review, to address aim 1, 12 studies were identified. Up to 41% of older BCS showed objective cognitive dysfunction on neuropsychological assessment, up to 64% reported subjective cognitive dysfunction concerns pre-treatment, and 50% incurred cognitive decline from pre- to post-treatment. Cognitive dysfunction was associated with older age, multiple comorbidities, chemotherapy, sleep disturbance, neuropsychological symptom cluster, frailty, and poorer QoL. To address aim 2, data were leveraged from a large, nationwide, QoL in younger versus older BCS study (PI: Champion), which included 335 older BCS who were ≥60 years of age, had breast cancer (stage I-IIIa), received chemotherapy, and were 3-8 years post-diagnosis without recurrence. Findings included up to 19% of older BCS had mild-moderate objective cognitive dysfunction on at least one neuropsychological assessment, with 26% reporting poor-moderate subjective attention function. BCS, who were older, had less education and more depressive symptoms had greater cognitive dysfunction. Objective attention and executive function-working memory significantly and positively correlated with subjective attention. In turn, subjective cognitive dysfunction and increased number of comorbidities were related to poorer physical functioning. Subjective cognitive dysfunction was also related to poorer QoL. The findings from this study highlights the prevalence and complexity of cognitive dysfunction in older BCS. Further research is needed to better understand the intersection of aging, cancer, comorbidities and cognitive dysfunction and the negative implications in older BCS.

Over one third of breast cancer survivors report “fear of recurrence” as the primary concern after diagnosis and treatment. Behavior changes such as exercise and weight loss post cancer may reduce recurrence risk. How perceived recurrence risk affects behavior change is unknown. We evaluated this association in the Breast Cancer Survivorship Study, a cross-sectional study of 301 breast cancer survivors. Data on perceived recurrence risk (local and distant) and health behavior change (alcohol, exercise, nutrition, smoking, sun exposure, supplement use, weight) were assessed by mailed questionnaire. Multivariable logistic regressions were used to evaluate associations between perceived recurrence risk and health behavior change, and multinomial logistic regression to assess direction of change. 47.6% of women perceived their local recurrence risk <10%, while 36.3% perceived distant between 10-30%. Participants mean age was 60 years and had predominantly early stage cancer. Over 90% of women reported making a behavior change. Significant associations were found between higher perceived recurrence risk and behavior changes of nutrition (OR 3.1, 95% CI 1.6-6.3) and sun exposure (OR 2.5, 95% CI 1.2- 5.0). Exploratory direction of change analyses found women with higher perceived recurrence risk were more likely to make positive changes in nutrition (OR 4.0, 95% CI 1.9-8.2) and sun exposure (OR 2.5, 95% CI 1.2-5.2). Overall, we found trends that women are likely to make specific behavior changes as their perceived recurrence risk increases. Findings provide a baseline for future research to identify survivors more likely to make behavior changes that affect their long term health.

No description available.

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / The occurrence of colorectal cancer among those over the age of 50 is decreasing; conversely, the rate of diagnosis for those under 50 years old is increasing. While medical researchers scramble to identify the cause for this increase, young onset colorectal cancer (YOCC) patients and survivors are left to navigate a new normal. This new normal often includes awkward and troublesome concerns such as scarring, colostomy bags, and bowel problems. Contrary to those diagnosed with colorectal cancer later in life, those that are diagnosed at a younger age are forced to deal with these issues for many years. The purpose of this exploratory study was to identify privacy issues surrounding YOCC. Because of the significant increase in diagnoses, YOCC is now being researched independently from colorectal cancer in general. The topic of privacy has been researched in academic disciplines, including medicine. Privacy issues surrounding cancer have been researched, as well. Yet, the topic of privacy concerns facing YOCC patients/survivors has been overlooked. It is important to identify privacy concerns specific to YOCC patients/survivors as the information could help health care providers, communication scholars, and caregivers. Patient narratives were analyzed employing thematic analysis to identify privacy concerns of YOCC patients/survivors through the lens of Communication Privacy Management theory (CPM theory). Results indicated that participants discussed disclosure of their YOCC journey as a process. Within this disclosure process, YOCC patients/survivors identified specific privacy issues that influenced the way they disclosed or concealed information specific to their illness. There is a growing need for more research into the YOCC community due to the increase in diagnosis rates and their unique privacy concerns. Potential topics for future research include the impact of COVID-19, patient desire to help others, social media influence on disclosure, how patient disclosure could impact provider training, dating with YOCC, and specific demographic research.