Bakgrund: Hjärtsvikt är en av de vanligaste folksjukdomarna som drabbar båda könen, men främst äldre människor. Vid hjärtsvikt krävs optimal behandling och bra egenvård i form av patientutbildning för förbättrad livskvalitet. Egenvård kräver patientutbildning i syfte att stärka patientens förmåga att lindra effekten av sin hjärtsvikt. Syfte: Syftet är att beskriva vad som hindrar att genomföra egenvård och vad som påverkar livskvaliteten hos patienter med hjärtsvikt. Metod: Det här arbetet är en litteraturöversikt. Fjorton vetenskapliga artiklar med olika metoder hämtades i databaserna CINAHL, Pub och PsycINFO. Artiklarna lästes igenom och utmynnade i huvudkategorier och underkategorier. Resultat: Resultatet visar brist på egenvårdutbildning medför brist på kunskap, ekonomiska begränsningar och brist på förtroende. Ensamboende och brist på förtroende och multisjuklighet. Fysiska förändringar sker på grund av kliniska symtom och dessa komponenter utgör hinder för egenvård, vilket försämrar livskvalitet. Symtomen från hjärtsvikt har negativ inverkan på dagliga och sociala aktiviteter. Kognitiva förändringar i samband med hjärtsvikt leder till försämrad koncentrationsförmåga och dåligt minne. Diskussion: Minskad egenvård relaterade till fler besök till sjukhuset. Kliniska symtom på hjärtsvikt var det som mest påverkade patienternas livskvalitet och hindrade dem från att fortsätta leva som tidigare. Nedsatt fysisk förmåga försvårade för patienterna att kunna fortsätta jobba som tidigare, vara social eller bibehålla sina tidigare hobbyer. / Background: Heart failure is one of the most common diseases that affect both sexes, but mainly elderly people. In heart failure requires optimal treatment and good self-care in the form of patient education to improve quality of life. Self-care requires patient education in order to enhance the patient's ability to mitigate the effects of its failure. Aim: The purpose is to describe what prevents implement self-care and what affects the quality of life in patients with heart failure Method: This work is a literature review. Fourteen scientific papers with different methods was picked in the databases CINAHL, PsycINFO and Pub. The articles were read through and resulted in major categories and subcategories. Results: The results show a lack of self-care education means lack of knowledge, financial constraints and lack of confidence. Living alone and lack of trust and multimorbidity. Physical changes happen because of clinical symptoms and these components constitute barriers to self-care, which impairs the quality of life. Symptoms of heart failure have a negative impact on daily and social activities. Cognitive changes associated with heart failure leads to impaired concentration and poor memory. Discussion: Reduced self-care related to more visits to the hospital. Clinical symptoms of heart failure was the most affected patients' quality of life and prevented them from continuing to live as before. Reduced physical ability it difficult for patients to be able to continue working as before, be social or maintain their previous hobbies.

SYMPTOM CLUSTERS IN LUNG CANCER PATIENTS By Debra Rattican, PhD, RN A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Major Director: Debra E. Lyon, PhD. Professor and Chair Family and Community Health Nursing The purpose of the study was to examine selected relationships among symptoms common to individuals with lung cancer. The specific aims were: 1) To examine the relationship between the symptoms of dyspnea and anxiety in patients with lung cancer. 2) To examine the relationships among the symptoms of dyspnea, anxiety, and symptom cluster components (depressive symptoms, fatigue, pain) in patients with lung cancer. 3) To examine the correlation between functional ability and quality of life in patients with lung cancer. 4) To explore the relationships among the symptoms of dyspnea, anxiety, and symptom cluster components (depressive symptoms, fatigue, pain) in patients with lung cancer and patients’ functional ability. 5) To explore the relationships among the symptoms of dyspnea, anxiety, and symptom cluster components (depressive symptoms, fatigue, pain) in patients with lung cancer and patients’ quality of life. Data were gathered through online survey and analyzed using descriptive, correlation, principal component analysis, exploratory factor analysis, and forward stepwise regression techniques. A strong positive correlation was found between dyspnea and anxiety (both anxiety in general and anxiety at the time the survey was completed. While results of this study cannot provide conclusive evidence of the existence of a symptom cluster composed of depressive symptoms, fatigue, and pain, the results are consistent with other studies in this area. Significant positive correlations among these three symptoms indicate that this is a possible symptom cluster experienced by lung cancer patients in general. This study provides preliminary data on how these symptoms are related and how they affect functional ability, or the ability to perform routine activities of daily living (ADLS) and instrumental activities of daily living (IADLS), and quality of life in patients with lung cancer. Further study is needed on to better understand the symptom experience of these individuals in order to develop robust interventions targeting effective symptom management.

Annotation: Master thesis "Psychosocial effects of tinnitus" is based on a general approach to this phenomenon as a disease of civilization. The symptom that tinnitus represents is underestimated in Czech Republic as well as treatment possibilities and the impact of tinnitus itself on person's life and his/hers surroundings. It can have devastating consequences. Coping with tinnitus can be very difficult if not impossible and in the end it can lead to suicidal attempt. Similar negative effects as on affected person can tinnitus have on his/hers closest surroundings which could not understand him/her.

Cette recherche de thèse porte sur le travail réalisé avec des sujets demandant une prise en charge en médecine procréative. Nous envisageons la question du travail collaboratif entre psychanalyse et médecine dans le champ de l’assistance médicale à la procréation, sur la base de deux approches. La première, historique, porte sur l’évolution de la représentation culturelle de l’infertilité, et la seconde, clinique, d’inspiration psychanalytique, a été construite sur la base de notre expérience au sein d'un centre d’assistance médicale à la procréation et dans un cabinet privé. Nos hypothèses visent à montrer comment les pré-conceptions médicales et psychologiques barrent le dialogue entre le sujet demandant une prise en charge et celui qui l’accueille. À cet effet, nous envisagerons le processus d’objectivation subi par le concept de désir d’enfant, de plus en plus assimilé à celui de projet d’enfant, et nous abordons aussi les difficultés que l’infertilité pose aux hommes dans une époque où elle commence à être conçue comme une maladie du couple et non pas comme une maladie des femmes. À partir d’une mise à jour de la notion d’infertilité, telle qu’elle est comprise par la médecine et par la loi, et de la reprise des théorisations freudiennes autour du symptôme et de la pratique clinique, nous chercherons à montrer la valeur d’une perspective qui n’assume pas d’emblée que toute demande de prise en charge en médecine procréative est une demande d’enfant à la médecine. / This research focuses on work with subjects requiring care in medically assisted procreation. Based on two approaches: an historical one, on the evolution of the cultural representation of infertility. The other clinical, from a psychoanalytic perspective, developed working in a center of assisted reproduction and in private practice. Our work addresses the question of collaborative work between psychoanalysis and medicine in the field of reproductive medicine. Our hypotheses are intended to show how medical and psychological preconceptions difficult the dialogue between the subject requiring care and those who receive him. To this end we will consider the process of objectification suffered in the concept of desire for a child, now assimilated to that of the project of a child. We also address the challenges that infertility imposes on men when it begins to be seen as a couple’s disease and not only as women’s disease. From an update of the notion of infertility, as it is comprised now by medicine and law, and the recovering of Freudian theories about the symptom and clinical practice, we intend to show the value of a perspective that does not automatically assume the demand for care in reproductive medicine as a demand of a child to medicine.

No description available.

Title: Dysmenorrhea and its possible treatment by physiotherapy Objectives: The aim of this thesis has been to assess the effect of simple feet exercises along with the practice of pelvic floor activation and relaxation on women struggling with dysmenorrhea. Subsequently, it also deals with the issue of whether the pelvic floor treat- ment per rectum together with the exercises is more effective than just plain exercising. Methods: This research has been based on an experiment. This thesis includes both a the- oretical part and a practical part. The methods used for the practical part are as follows: questionnaire (specifically Menstrual Symptom Questionnaire), simple feet exercises, ex- ercises used for the activation and relaxation of the pelvic floor as well as the pelvic floor treatment per rectum and final processing of the gathered data into statistics. Results: The menstrual cycle of every woman is completely individual and every woman perceives it quite differently. The result of the research was that simple feet exercises along with the practice of pelvic floor activation, relaxation and the pelvic floor treatment per rectum help women struggling with dysmenorrhea. We didn't discover any data that confirms whether the pelvic floor treatment per rectum, together with the exercises, is more...

<p>Validerat; 20151026 (global_studentproject_submitter)</p>

SAMMANFATTNING Bakgrund: I en åldrande befolkning ökar prevalensen av hjärtsvikt. När det kommer till behandling av sjukdomen läggs mycket ansvar på patienten när det gäller symtomlindring. Strategier för att kunna kontrollera symtomen kan innebära en omfattande livsstilsförändring, vilket i sin tur kan skapa en mängd olika känslor för patienten.  Syfte: Syftet med denna studie var att beskriva patienters upplevelser av att leva med hjärtsvikt. Metod: En deskriptiv, systematisk litteraturstudie genomfördes. Tolv kvalitativa artiklar användes, och materialet analyserades genom kodning och teman. Databasen som användes var PubMed. Den teoretiska referensramen som tillämpades var livsvärldsperspektivet.    Resultat: Tre kategorier med tolv underkategorier identifierades. Patienter upplevde olika typer av begränsningar i det dagliga livet, både fysiska och emotionella. Andnöd och trötthet var en central fysisk upplevelse. Ensamhet, isolering och förändrade roller inom familjen rapporterades. Upplevelser av skuld, skam och känslan av att utgöra en börda gentemot familjen framkom. Vidare rapporterades olika former av anpassning till ett nytt liv, som till exempel förändringar i kost, alkoholkonsumtion och fysisk aktivitet. Positiv attityd och spiritualitet visades vara strategier för att hantera sitt tillstånd. Sjukhuset upplevdes vara den säkraste platsen för rehabilitering och hantering av symtom. Vidare framkom dock upplevelser av brister inom sjukvården gällande empati, kontinuitet och förmedlande av information. Familj och vänner upplevdes vara en viktig resurs gällande fysiskt och emotionellt stöd samt motivation.  Slutsats: Patienter med hjärtsvikt upplevde olika typer av begränsningar i det dagliga livet relaterat till sjukdomen, brister inom sjukvården samt behov av stöd. Sjukvården behöver ta dessa upplevelser i beaktande i mötet med patienten för att kunna individanpassa omvårdnad och egenvårdsrekommendationer. Vidare kan detta ge ett ökat oberoende och därmed en ökad livskvalitet för patienten. / ABSTRACT Background: In an ageing population the prevalence of heart failure is rising. When it comes to treating the disease, a lot of responsibility lies with the patient in terms of symptom management. Strategies to control symptoms may mean a significant change of life style which in turn can cause a range of emotions.  Objective: The objective for this study was to describe the experience of patients living with heart failure.  Methods: A descriptive systematic literature review was conducted. Twelve qualitative studies were used, and the material was analyzed by making codes and themes. The database that was used was PubMed. The theoretical framework that guided this study was theperspective of life world. Results: Three categories with twelve subcategories were identified. Patients experienced different types of limitations in their daily life, both physical and emotional. Central physical experiences were breathlessness and fatigue. Loneliness, isolation and changing roles within the family was also reported. Experiences of guilt, shame and a sense of being a burden towards the family emerged. Furthermore, various forms of adaptation were reported, such as changes in diet, alcohol consumption and physical activity. Positive attitude and spirituality proved to be strategies used to cope with the condition. The hospital was considered the safest place for rehabilitation and management of symptoms. Moreover, the hospital environment proved to lack in empathy, continuity and in conveying information. Family and friends were important resources regarding both physical and emotional support and motivation. Conclusions: Heart failure patients experience different types of limitations related to the disease in their daily life, shortcomings in health care, and need of support. The health care system needs to take these experiences into consideration when meeting the patient in order to personalize the care and self-care recommendations to increase independency and with that increase overall life quality for the patient.

A recuperação e a restauração florestal de ecossistemas degradados podem não acontecer das maneiras desejadas, se houver carência nutricional ou suprimento inadequado de nutrientes às plantas no estádio inicial de desenvolvimento de espécies florestais nativas. O objetivo da presente investigação foi avaliar os efeitos da deficiência de nutrientes nas plantas na fase inicial de desenvolvimento das espécies florestais nativas Schinus terebinthifolius Raddi (aroeira-pimenteira), Cordia superba Cham. (baba-de-boi) e Cariniana estrellensis (Raddi) Kintze (jequitibá-branco). Foram observadas as alterações ultra-estruturais e teciduais das células do mesofilo das folhas, foi descrita a sintomatologia visual de deficiência nutricional, foram feitas as determinações de teores de macro e micronutrientes, das taxas de assimilação de gás carbônico e de transpiração, e as mensurações da altura e da produção de biomassa. O experimento foi conduzido em casa de vegetação, em blocos ao acaso, com três repetições e treze tratamentos para cada espécie, empregando a técnica de diagnose por subtração (-N, -P, -K, -Ca, -Mg, -S, -B, -Cu, -Fe, -Mn, -Mo, -Zn), sendo que em um dos tratamentos, as espécies nativas foram cultivadas em solução nutritiva completa, com todos os macros e micronutrientes. Durante o experimento e em sua análise, foi observada a seqüência de eventos que motivaram os sintomas de deficiência e a diminuição na produção de biomassa. Sabe-se que falta de um nutriente provoca alteração molecular, o que alterou as ultraestruturas celulares das folhas que foram observadas por microscopia. Essas modificações celulares provocaram alterações no tecido vegetal que induziram nas plantas os sintomas visuais específicos de cada nutriente que foram descritos. Como efeito fisiológico da deficiência nutricional, de forma geral, constataram-se diminuições nas taxas de fotossíntese e de transpiração e, por conseguinte, na produção de biomassa. Estes resultados claramente evidenciam o fato de que projetos de implantação de florestas ou de recuperação e restauração de ecossistemas degradados por meio do plantio das três espécies florestais nativas, em solos que necessitem de suplementação nutricional, poderão ter seu sucesso comprometido se não houver complementação nutricional / The recovery and forest restoration of degraded ecosystems may not be occur as desired if there is a nutritional deficiency or an inadequate supply of nutrients in the initial phase development of native forest species. The objective of this research was to evaluate the macronutrient and micronutrient deficiency effects on Brazilian native species young plants: Schinus terebinthifolius Raddi, Cordia superba Cham. and Cariniana estrellensis (Raddi) Kintze. Ultrastructural and tissue of the mesophyll cells of leaves changes were observed by microscopy, the visual symptom of nutritional deficiencies were described, the nutrient contents were analyzed, the carbon assimilation and transpiration rates were measured, the plant heights and the biomass production were measured. The experiment was carried on a greenhouse in a randomized block design with three replications and thirteen treatments for each species, using the technique of diagnosis by subtraction (-N, -P, -K, -Ca, -Mg, -S, -B, - Cu, -Fe, -Mn, -Mo, -Zn) and in one of the treatments the species were grown in a nutrient solution with all macro and micronutrients. It was observed, during the experiment and its analysis, a sequence of events that caused the visual symptoms and decreased the biomass production. It is known that the nutrient deficiency causes molecular alterations, which consequently led the changes in cellular ultrastructure of the leaves and they were observed by microcopy. These cellular changes caused modifications in the foliar tissue, and the plants showed specific visual symptoms of each nutrient, which they were described. As physiological effect of nutritional deficiency, in general decreases the photosynthesis and transpiration taxes, and consequently the biomass production were decreased. These results clearly project that forest implantation or recovery and restoration of damaged ecosystems by planting the three native species in soils that require nutritional supplementation may have its success compromised if there is no a nutritional supplementation

Bakgrund:  Symtomkontroll är en viktig del i den palliativa vården. Sjuksköterskan har en central roll i denna vård. Fokus inom tidigare forskning har legat på smärthantering och därför gjordes denna litteraturöversikt som belyser vikten av hantering av illamående i palliativ vård.  Syfte: Att undersöka förekomsten av illamående hos palliativa patienter samt sammanställa sjuksköterskans kunskap kring hantering av dessa patienters illamående inom hälso- och sjukvård.  Metod: Litteraturöversikt som inkluderar 16 artiklar.  Resultat: Förekomsten av illamående hos palliativa patienter i litteraturöversikten var mellan 7-40 %. Resultatet visar att sjuksköterskor tycker att de har god kunskap för att kunna symtomskatta, behandla och utvärdera behandling av illamående i palliativ vård. Det visade även en skillnad av sjuksköterskors upplevda kunskap kring palliativ vård beroende på arbetslivserfarenhet.  Det framkom i resultatet att symtomskattning inte alltid utfördes och att validerade skattningsinstrument för illamående inte alltid användes. En del palliativa patienter är medicinskt underbehandlade och utvärdering av behandling av illamående förekom inte alltid hos palliativa patienter i hälso- och sjukvården. Resultatet visade även på skillnader i hantering av illamående utifrån kön och ålder.  Konklusion: Sjuksköterskorna hade mer kunskap om symtomhantering desto mer erfarenhet de hade. Det behövs mer utbildning för att hantera illamående, både på grundnivå inom sjuksköterskeprogrammet men även fortsatt utbildning på arbetsplatserna. Det behövs mer forskning inom detta för att identifiera mer exakt vilken kunskap sjuksköterskor saknar. Det behövs även mer forskning för att undersöka hur sjuksköterskan fastställer illamåendets orsak. / Background: Symptom management is an important part in palliative care. Nurses have a central role in this care. Previous research highlights pain management, this literature review aims to shed light on the importance of nausea management in palliative care.  Aim: To examine the prevalence of nausea in palliative patients and to compile nurses’ knowledge about management of these patient’s nausea in healthcare.  Method: A literature review based on 16 articles.  Result: Prevalence of nausea in palliative patients in the literature review was between 7-40%. The result shows that nurses rate their knowledge high when it comes to symptom estimation, treating symptoms and evaluate treatment of nausea in palliative care. Nurses knowledge of palliative care differed depending on their work experience. It also showed that symptom estimation doesn’t always occur and validated tools to estimate nausea are not always used. Some palliative care patients are medically undertreated for nausea and evaluation of nausea-treatment isn’t always done. The result also showed discrepancies of treatment between gender and age.  Conclusion: Nurses’ had more knowledge about symptom management the more work experience they had. There is a need for further education in how to manage nausea both in nursing school and at the workplace. Additional research is needed to identify exactly what knowledge nurses’ lack. There is also a need for research that examines how nurses determines the cause of nausea.