Representação social da qualidade de vida de jovens vivendo com HIV: uma contribuição para a enfermagem / Social representation of the quality of living of youngsters' living with HIV: a contribution to Nursing

O presente estudo teve como objetivo geral analisar as representações sociais da qualidade de vida para jovens que vivem com HIV. Trata-se de um estudo descritivo, com abordagem qualitativa, orientado pela Teoria de Representações Sociais. Os sujeitos estudados foram 24 jovens que vivem com HIV, em tratamento em cinco serviços de atendimento especializado, localizados nos municípios do Rio de Janeiro, Macaé e Rio das Ostras. A coleta de dados se deu através da aplicação de um questionário de caracterização socioeconômica e de práticas, além de entrevistas semiestruturadas. A análise estatística descritiva do questionário foi realizada com o uso do software Excel e a análise das entrevistas foi realizada com a técnica de análise lexical, apoiada pelo software IRAMUTEQ. O perfil do grupo estudado se caracterizou por sexo masculino (66,7%), faixa etária entre 21 e 24 anos (54,1%), com nível médio completo ou superior incompleto (50,0%), referem estar empregados (50,0%), com tempo de diagnóstico igual ou menor a 4 anos (66,6%), com tempo de uso da terapia antirretroviral menor ou igual a 6 meses (45,4%), e percebem a própria saúde como boa/muito boa (50,0%). Após a análise inferencial, o corpus composto pelo total de entrevistas recebeu o nome de "Representação social e as práticas de promoção da QV de jovens que vivem com HIV", que deu origem a dois subcorpus: o primeiro intitulado "Representações Sociais da QV e seus aspectos preditores", que engloba a classe 1 (23,6%) intitulada "A multidimensionalidade da qualidade de vida no contexto do HIV/aids"; a classe 4 (19,6%) "Redes de apoio familiar e social para a qualidade de vida dos jovens"; e a classe 5 (21,4%) "O impacto do diagnóstico na qualidade de vida dos jovens". O segundo bloco textual foi denominado "Políticas de controle e acompanhamento do HIV/aids e a influencia na qualidade de vida", e contempla as classes 2 (12,2%) "A influência do atendimento dos serviços de saúde na qualidade de vida dos jovens"; e 3 (23,1%) "A terapia antirretroviral e a influencia na qualidade de vida dos jovens. Os resultados demonstram que a representação social da qualidade de vida está ancorada na saúde e no bem-estar, comporta uma dimensão imagética da terapia antirretroviral, considerada essencial para a manutenção da saúde e da QV. Conclui-se que o estigma e o preconceito são os principais fatores que exercem influência negativa sobre a QV dos participantes, exigindo ações de cuidado psicossocial e relacional que possam superar ou neutralizar tais expressões.

This study aimed at analyzing social representations of the quality of living concerning youngsters. It is a descriptive study with qualitative approach under the light of the Social Representations theoretical framework. The subjects studied comprised 24 youngsters living with HIV, undergoing treatment at five expert care service centers located at the municipalities of Rio de Janeiro, Macaé, and Rio das Ostras in the state of Rio de Janeiro, Brazil. Data were collected by means of a social class social practice-based questionnaire, in addition to semistructured interviews. The statistical analysis describing the questionnaire was conducted on the basis of the Excel software and the analysis of the interviews was conducted on the basis of lexical analysis on the IRAMUTEC software. The profile of the group concerned was characterized by males (66.7%), ranging between 21 and 24 years of age (54.1%), either finished high school or begun college (50.0%), having a job (50.0%), on a diagnosis for 4 years or less (66.6%), on antiretroviral therapy for 6 months or less (45.4%), and regarding their own health as good/very good (50%). After inferential analysis, the corpus comprehended by the total number of interviews was named "Social representations and higher quality of living promoting practices concerning youngsters living with HIV". Two subcorpus came out as "Social Representations of quality of living and their predicting aspects", comprehending class 1 (23.6%) entitled "Quality of living multidimensionality within the HIV context"; class 4 (19.6%) "Family and social support networks for the youngsters' quality of living"; and class 5 (21.4%) "Diagnosis impact on the youngsters' quality of living". The second textual set was named "HIV control and follow-up policies and impact on quality of living", and it contemplates classes 2 (12.2%) "Impact of health care services on the youngsters' quality of living"; and 3 (23.1%) "Antiretroviral therapy and its impact on the youngsters' quality of living". Results showed that the social representations of quality of living are rooted in health and wellbeing, holds an imagetic dimension of the antiretroviral therapy, regarded as essential to sustaining both health standards and quality of living. Conclusions show that stigma and prejudice are core issues to the negative impact on the participants' quality living. That requires, therefore, psychosocial and relational care actions, which may either overcome or offset those expressions.

Repurcussions of Concurrent Chemoradiotherapy for Head and Neck Cancers

Cancer is a potentially lethal disorder with abnormal cell growth and metastasis, warranting multimodal treatment owing to its diversity and complexity. Head and neck cancers are physically and emotionally devastating disease, with profound impact on the most fundamental activities of the subjects’ daily life such as the ability to speak, breathe, eat, drink, and socialize. The side-effects of radiotherapy and chemotherapy get superimposed on the existing problems and cause new problems resulting in significant morbidity and suffering. Methods: This Prospective Observational study was conducted at the Department of ENT, Southern Railway Headquarters Hospital, Chennai, India. All subjects were evaluated for toxicities using RTOG/EORTC toxicity criteria and Common Toxicity Criteria (CTC). Results: Hypopharynx was the most common site of malignancy observed (31.6 %). Pain (90%) and appetite loss (84.2%) secondary to Mucositis and Xerostomia were the most predominant, serious and lasting adverse effects noted. Subjects also experienced markedly altered smell (63%) and taste (78%). Skin changes and alopecia was observed in all the subjects. Overall treatment duration was prolonged in 78.9% owing to severe toxicities, which necessitated withholding of last few cycles of chemotherapy. Conclusion: Subjects receiving concurrent Chemo-Radiotherapy experience a substantial number of treatment related adverse events, which had considerable effect on their Quality of life.

Analysis on effect of extended care on quality of life and viral load of elderly patients with AIDS / 国际检验医学杂志

Objective To study effect of extended care on quality of life of elderly patients with AIDS and effect on virus load ,so as to provide theory gist for care of AIDS .Methods A total of 80 cases of elderly patients with AIDS diagnosed and treated in our hospital since March 2014 to March 2016 were selected as the subjects of study ,and all patients were treated with highly active an-tiretroviral therapy and other conventional treatment .And 40 cases of patients provided with conventional treatment on the base of highly active antiretroviral therapy were set as control group ,while the other 40 cases of patients provided with extended care were set as observation group .Patients in two groups were evaluated for quality of life via HARRT before and after care ,and two care methods were compared for effect on treatment compliance .Levels of subgroups of T lymphocytes CD4+ before care ,in 3 moths and 6 months after care was examined ,while virus load of HIV was detected via polymerase chain reaction (PCR) .Results The score of HARRT in observation group after care was improved compared with that before care .The treatment compliance of observation group was 95 .00% ,which was significantly higher than 72 .50% in control group(P<0 .05) .The levels of CD4+ in observation group after treating 3 moths and 6 months were dramatically higher than that in the control group(P<0 .05) .After receiving treat-ment ,the proportion of patients with total blood virus load lower than 50 copies/L in observation group was 80 .00% ,which was significantly higher than 62 .50% in control group(P<0 .05) .Conclusion Basic treatment combined with extended care for elderly patients with AIDS could improve quality of life ,treatment compliance and immune functionsignificantly ,so as to assist control for virus load .

Analysis on effect of extended care on quality of life and viral load of elderly patients with AIDS / 国际检验医学杂志

Objective To study effect of extended care on quality of life of elderly patients with AIDS and effect on virus load ,so as to provide theory gist for care of AIDS .Methods A total of 80 cases of elderly patients with AIDS diagnosed and treated in our hospital since March 2014 to March 2016 were selected as the subjects of study ,and all patients were treated with highly active an-tiretroviral therapy and other conventional treatment .And 40 cases of patients provided with conventional treatment on the base of highly active antiretroviral therapy were set as control group ,while the other 40 cases of patients provided with extended care were set as observation group .Patients in two groups were evaluated for quality of life via HARRT before and after care ,and two care methods were compared for effect on treatment compliance .Levels of subgroups of T lymphocytes CD4+ before care ,in 3 moths and 6 months after care was examined ,while virus load of HIV was detected via polymerase chain reaction (PCR) .Results The score of HARRT in observation group after care was improved compared with that before care .The treatment compliance of observation group was 95 .00% ,which was significantly higher than 72 .50% in control group(P<0 .05) .The levels of CD4+ in observation group after treating 3 moths and 6 months were dramatically higher than that in the control group(P<0 .05) .After receiving treat-ment ,the proportion of patients with total blood virus load lower than 50 copies/L in observation group was 80 .00% ,which was significantly higher than 62 .50% in control group(P<0 .05) .Conclusion Basic treatment combined with extended care for elderly patients with AIDS could improve quality of life ,treatment compliance and immune functionsignificantly ,so as to assist control for virus load .

Investigation on living quality of patients after orthotopic cardiac transplantation / 中华器官移植杂志

Objective To investigate living quality of patients after orthotopic cardiac transplantation and to provide scientific evidence for specific strategy of therapy and improvement of living quality of patients with cardiac transplantation. Methods SF-36 and the social support questionnaire were used to analyze living quality of 79 patients who received orthotopic cardiac transplantation in the Department of Cardiovascular surgery of Affiliated Union Hospital of Fujian Medical University. The mode of SF-36 was from the investigative numerical value of residents in Sichuan province. Description, t-test and Spearman correlation analysis were used to study the related factors. Results Compared with a reference general population, the heart transplant recipients showed a significantly worse living quality score on all domains of the SF-36 scales (P＜0. 05), except the domain of somatic pain. Among the patients after cardiac transplantation, living quality was more significantly improved in ＞2-year survival group than that in ＜one-year survival group (P＜0. 05),except the domain of somatic pain. The relationships between the social support and living quality were analyzed,and it was found that as compared with a reference general population, the heart transplant recipients showed significantly lower scores on all domains of the social support questionnaire (P＜0. 01 ). The total social support scores were positively related to mental health related living quality (P＜0.05, r = 0.223 - 0.710), except the domain of somatic pain. Conclusion Compared with a general population, heart transplant recipients demonstrated a significantly worsened living quality. But evidence showed the living quality can be improved gradually with the prolongation of the survival time after heart transplantation. Social support was related to the living quality of heart transplantation patients. Improvement of availability on social support will probably improve living quality.