Patients' independence of a nurse for the administration of subcutaneous anti-TNF therapy: A phenomenographic study

Rheumatology nursing supports patients to manage their lives and live as independently as possible without pain, stiffness and functional restrictions. When conventional drugs fail to delay the development of the rheumatic disease, the patient may require biological treatment such as self-administered subcutaneous anti-tumour necrosis factor (TNF) therapy. It is therefore important that the patient perspective focuses on the life-changing situation caused by the administration of regular subcutaneous injections. The aim of this study was to describe variations in how patients with rheumatic diseases experience their independence of a nurse for administration of subcutaneous anti-TNF therapy. The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Four ways of understanding the patients' experience of their subcutaneous anti-TNF therapy and independence of a nurse emerged: the struggling patient; the learning patient; the participating patient; the independent patient. Achieving independence of a nurse for subcutaneous anti-TNF injections can be understood by the patients in different ways. In their strive for independence, patients progress by learning about and participating in drug treatment, after which they experience that the injections make them independent

Stress in women's daily life before and after a myocardial infarction: a qualitative analysis.

Background: Little is known about women's perceptions of their daily life before and after a myocardial infarction (MI), especially with regard to stress, which is a risk factor for coronary heart disease (CHD). Aim: To describe and explore women's perceptions of stress before and after an MI. Method: Two interviews with women who suffered an MI, the first at the hospital (n = 20) and the second 4-10 months after the MI (n = 14), were analysed using a phenomenographic approach. Findings: The stress emanated either from within themselves (personal traits) or as an effect of their immediate surroundings. The period before the MI was stressful due to the different roles they had to maintain in their private and professional lives. They lost control over their daily life. After hospital discharge they both wanted and needed support, as they were terrified when they returned home. They did not know how much they could do and neither did their relatives, while little or no support was provided by the healthcare professionals. Conclusions: To prevent CHD in daily life and avoid reinforcing stress, it is important to place greater emphasis on stress as an important risk factor. An understanding of this phenomenon can assist primary healthcare, coronary care unit (CCU) and rehabilitation nurses in supporting these women as well as their partners to adapt their daily lives both before and after an MI. It is essential to formulate and implement individualised treatment plans and to provide support groups for women

Women's descriptions of symptoms and delay reasons in seeking medical care at the time of a first myocardial infarction: A qualitative study.

Background Coronary heart disease (CHD) is a major cause of mortality in women. Women have also been identified as late presenters in seeking medical care. Aim The aim of this study was to explore and describe women's symptoms and the reasons for delay in seeking medical care at the time of the first myocardial infarction (MI). Methods The study had an explorative and descriptive design based on content analysis approach. Nineteen women were interviewed at the hospital 2 or 3 days after hospitalisation. Results The result showed that the women had difficulties interpreting, understanding and linking the symptoms to CHD. They tried to handle the discomfort and even the chest pain, rather then ask for professional help. The women had problems with making the final decision. Conclusion Women need to be made aware of the clinical symptoms of CHD, in order to understand the consequences of delay in seeking medical care following an MI

Subjective evaluation of user experience in interactive 3D-visualization in a medical context

New display technologies enable the usage of 3D-visualization in a medical context. Even though user performance seems to be enhanced with respect to 2D thanks to the addition of recreated depth cues, human factors, and more particularly visual comfort and visual fatigue can still be a bridle to the widespread use of these systems. This study aimed at evaluating and comparing two different 3D visualization systems (a market stereoscopic display, and a state-of-the-art multi-view display) in terms of quality of experience (QoE), in the context of interactive medical visualization. An adapted methodology was designed in order to subjectively evaluate the experience of users. 14 medical doctors and 15 medical students took part in the experiment. After solving different tasks using the 3D reconstruction of a phantom object, they were asked to judge their quality of the experience, according to specific features. They were also asked to give their opinion about the influence of 3D-systems on their work conditions. Results suggest that medical doctors are opened to 3D-visualization techniques and are confident concerning their beneficial influence on their work. However, visual comfort and visual fatigue are still an issue of 3D-displays. Results obtained with the multi-view display suggest that the use of continuous horizontal parallax might be the future response to these current limitations