Uticaj muzike na nivo anksioznosti oboljelih od karcinoma pluća tokom apliciranja hemoterapije

The impact of music on the anxiety level of patients with lung cancer after administration of chemotherapy

SAŽETAK

UVOD: Jedan od najučestalijih načina liječanja karcinoma pluća je hemoterapija. Hemoterapijski tretmani su veoma često agresivni, a supstance koje koriste su neselektivne i izazivaju niz neželjenjenih efekata. Pored fizičke težine, doživljaj neudobnosti može stvoriti poteškoće, emocionalni nemir i djelovati emocionalno traumatski. Opuštajuća ili „sedativ“ muzika, koju karakteriše spor tempo, ponavljajući ritam, blage konture, često se koristi kada se pokušava smanjiti anksioznost.

CILJ: Svrha ovog istraživanja je da se ispita terapijski uticaj muzike kao dio sestrinske intervencije, na nivo anksioznosti i razinu negativne reakcije kod bolesnika sa karcinomom pluća u toku apliciranja hemoterapije.

MATERIJAL I METODE: U ispitivanje su uključene dvije grupe, po 25 ispitanika(N-50). Svi ispitanici su zbog osnovnog tumorskog procesa na plućima primali hemoterapiju. Jedna grupa je u toku apliciranja hemoterapije slušala laganu muziku (ispitivana grupa), dok je druga grupa hemoterapiju primala u tišini (kontrolna grupa). Za objektiviziranje rezultata korištena je skala subjektivne ocjene(VAS), kojom su testirani: anksioznost, strah, briga, umor, udobnost i opuštenost. Ocjenjivanje se vršilo pomoću posebno dizajniranog upitnika za pred i post testiranje za obje grupe.

REZULTATI: Anksioznost koja je u obje grupe bila niža nakon hemoterapije, znatno manja je bila u grupi koja je slušala laganu muziku. Muzika nije značajno uticala na osjećaj umora i udobnosti. Na muziku su se značajno smanjili strah i briga, a povećao osjećaj opuštenosti.

ZAKLJUČAK: S obzirom da je muzika kao terapija neinvazivna i nefarmakološka metoda, jednostavna, jeftina a učinkovita, njena upotreba kao dio sestrinske intervencije može se preporučiti kao prikladan pristup za pacijente oboljele od karcinoma pluća tokom apliciranja hemoterapije.

KLJUČNE RIJEČI: karcinom pluća, hemoterapija, sestrinske intervencije, muzikoterapija

SUMMARY

INTRODUCTION:Chemotherapy is one of the most common treatments for lung cancer. Chemotherapy treatments are often very aggressive, and substances used are non-selective and can induce side effects. In addition to the physical weight, experience discomfort may create difficulties, emotional turmoil and act emotionally traumatic. Relaxing or “sedative” music, which is characterized by a slow tempo, repetitive rhythm, gentle contours, often used when trying to reduce anxiety.

AIM: The purpose of this study was to investigate the therapeutic effect of music as part of the nursing intervention, the level of anxiety and the level of adverse reactions in patients with lung cancer during chemotherapy administration.

MATERIALS AND METHODS: The study involved two groups of 25 subjects (N-50). All of them were due to primary tumor process in the lungs receiving chemotherapy. One group is in the course of administration of chemotherapy listened to soft music (study group), while the second group received chemotherapy in silence (control group). For objectifying results is used the visual analogue scale(VAS), which have been tested: anxiety, fear, worry, fatigue, comfort and relaxation. The evaluation was carried out using a specially designed questionnaire for pre and post test for both groups.

RESULTS: Anxiety, which is in both groups were lower after chemotherapy, significantly lower in the group who listened to soft music. Music had no significant effect on the feeling of fatigue and comfort. On the music were significantly reduced fear and concern, and increased sense of relaxation.

CONCLUSION: Considering that the music therapy as a non-invasive and non-pharmacological methods, simple, cheap and effective, its use as part of nursing interventions can be recommended as a suitable approach for patients suffering from lung cancer during the administration of chemotherapy.

KEY WORDS: Lung cancer, chemotherapy, nursing intervention, music therapy

Nastavi čitati Uticaj muzike na nivo anksioznosti oboljelih od karcinoma pluća tokom apliciranja hemoterapije

Prevencija anksioznosti i njen utjecaj na nivo bola kod oralno hirurške intervecije

Prevention of anxiety and its impact on the level of pain in oral surgery intervention

SAŽETAK

CILJ: U istraživanju je procjenjivana anksioznost vezana za hirurško ekstrahiranje impaktiranih trećih molara, pomoću dobijenih vrijednosti Corahovog upitnika dentalne anksioznosti i Spilbergovih koeficijenata aksioznost. Pearsonovim koeficijentima korelacija procjenjivana je povezanost navedenih parametara i njihov utjecaj na nivo bola kod hirurške extrakcije impaktiranog trećeg molara.

DIZAJN STUDIJE: U istraživanje je bio uključen 501 pacijent, muškog i ženskog pola, od 18-45 godina starosti, Nivo anksioznosti se procjenjivao upotrebom koeficijenata: DASR, X1 i X2 Prema protokolu Nakazata i autora(tab.1.), napravljene su grupe pacijenata na osnovu gradacije skorova anksoiznosti: na pacijente sa vrlo visokom, visokom, umjerenom, niskom i vrlo niskom anksioznosti. Na osnovu protokola Gedika i autora napravljene su i grupe prema dobnoj starosti pacijenata: od 18-20 godina, od 21-29 godina, od 30-39 godina i 40-45 godina. Mjerenje parametara: 1.dan.-DAS-R, X1 i X2; 2.dan- X1 i X2; 3.dan- X1,X2 i BOL.

REZULTATI: Vrijednosti mjerenih parametara: 1. dan mjerenja DASR=14,32; X1= 47,03; X2= 50,99 ; za 2.dan mjerenja X1= 46,014; X2= 50,11; za 3. dan mjerenja X1= 39,01; X2= 41,91 (tab.3,sl.9 i 10). Prosjećna vrijednost boli je 5,7.

KLJUČNE RIJEČI: prevencija, anksioznost, bol, ekstrakcija impaktiranih zuba

SUMMARY

THE OBJECTIVE: The study evaluated the anxiety related to the surgical extraction of impacted third molars, using the obtained values ​​Corah’s questionnaire dental anxiety and Spilberg’s coefficients anxiety. Pearson’s correlation coefficient evaluated the association mentioned parameters and their impact on the level of pain in the surgical extraction of impacted third molars.

STUDY DESIGN: The study included 501 patients, male and female, from 18 to 45 years of age, level of anxiety was assessed using coefficients: DASR, X1 and X2 According to the protocol to indicate the author (table 1)., Made the group of patients on the basis of graduation scores of anxiety: patients with a very high, high, moderate, low and very low anxiety. Based on the Gedik and authors protocol have been made and the group of patients by age: from 18 to 20 years, from 21 to 29 years, 30-39 years and 40-45 years. Measurement parameters: 1.dan.-DAS-R, X1 and X2; 2.dan- X 1 and X 2; 3.dan X1, X2 and BOL.

RESULTS: The values ​​of the measured parameters: Day 1 measurements DASR = 14.32; X1 = 47.03; X2 = 50.99; for Day 2 measurements X1 = 46,014; X2 = 50.11; for the third day of measurement X1 = 39.01; X2 = 41.91 (table 3, fig.9 and 10). Average value of pain was 5.7.

KEY WORDS: prevention, anxiety, pain, extraction of impacted teeth

Nastavi čitati Prevencija anksioznosti i njen utjecaj na nivo bola kod oralno hirurške intervecije

Postupci, prevencija i liječenje akutnog infarkta miokarda na klinici za kardiologiju klinike u Skopje u periodu 2012-2014.

Procedures, prevention and treatment of acute myocardial inarkt period of 2012-2014, the cardiology clinic in Skopje

Summary

INTRODUCTION: Acute myocardial infarction is an acute coronary ischemia leading to myocardial  necrosis.This disease is widespread in the world and as such is still a hot topic for processing. The benefit of its wide distribution and the fact that heart diseases are still the leading cause of death worldwide. 40% to 50% of deaths are due to heart disease. Macedonian practice shows that heart disease is present in a high percentage. Up to 60% of all deaths are attributed to this kind of disease. Survival in developed countries today is 95%.

PURPOSE: reduction of the clinical problem, the pathophysiological mechanism (decline of tissue, atherosclerosis), reduction of the symptoms (pain, dyspnea), complications (sudden death, thromboembolism, arrhythmia, heart failure progression) or new cardiovascular event, reducing the dependence of other people, increased efficiency, increased self-esteem.

MATERIALS AND METHODS: research activity is made using a statistically data JZUU Cardiology Clinic for three years and 2012. 2013. and 2014.

RESULTS: showed that the number of patients with coronary disease or acute myocardial infarction in emergency reviewed clinic- grow, and inversely proportional to age.

DISCUSSION: In 2012, there were 16,138 inspections in emergency clinic, of which 616 patients with MI.In 2013 performed 17 177 examinations of which 846 patients with me.In 2014 performed 19 423 examinations of which 1124 patients with MI. The patient with acute coronary disease or AIM (Acute Coronary Syndromes) is a medical emergency and require coordinated and efficient service from all members of the multidisciplinary team, especially on the initial assessment and treatment of these patients. In recent years there has been a real improvement of services for patients with coronary disease. Challenges remain for maximizing infrastructures and forces between them in order to deliver the best possible care to all who would benefit. The main objective is to reduce morbidity and mortality, and improvement in life expectancy, which in the course of life will have reduced exposure to risk factors related to lifestyle.

Key words: Acute coronary syndromes, stroke, coronary disease

Sažetak

UVOD: Infarkt miokarda je najteži oblik akutne ishemijske bolesti srca. U procesu nastaje potpuno začepljenje koronarne arterije što dovodi do nekroze miokarda zbog nedostatka krvi i hranljivih materija bogatih kiseonikom.

CILJ: ovog rada je utvrditi procedure za definiranje akutnog infarkta miokarda, različite faktore uzroka, sprečavanje i podizanje svijesti o faktorima rizika kod svakog pojedinca i borbi za smanjenje ili eliminaciju faktora rizika koi će biti opisani,,mozni komplikacii i najvažnije pravovremena dijagnoza i pravovremeno liječenje i sprovodzenje terapije.

MATERIJALI I METODE: Za istražovanje su korišteni statistički podaci JZUU Klinike za kardiologiju. Istraživanje je provedeno u period od tri godine i to: a 2012. 2013. i 2014. godine.

REZULTATI: pokazuju da je broj pacijenata sa koronarnom bolesti ili akutnim infarktom miokarda u stalnom porastu.

DISKUSIJA: U 2012. godini, obavljeno je 16.138 hitnih pregleda, od kojih je 616 pacijenata sa infarktom miokarda. U 2013 obavljeno 17. 177 pregleda od kojih 846 pacijenata sa infarktom miokarda, dok je u 2014 obavljeno 19. 423 pregleda od kojih 1124 pacijenata sa infarktom miokarda. Pacijent sa akutnom koronarnom bolesti ili AIM (akutnim koronarnim sindromom) je hitan slučaj i zahtijeva koordiniranu i kvalitetnu uslugu od svih članova multidisciplinarnog tima, posebno kada je u pitanju inicijalna procjena i liječenje ovih bolesnika.

ZAKLJUČAK: Cilj je smanjiti morbiditet i mortalitet, omogućiti poboljšanje životnog vijeka, te uticati na smanjenje faktorima rizika koji utiču na kvalitet života.

KLJUČNE RIJEČI: akutni koronarni sindrom, stemi, moždani udar, koronarna bolest.

Nastavi čitati Postupci, prevencija i liječenje akutnog infarkta miokarda na klinici za kardiologiju klinike u Skopje u periodu 2012-2014.

Uloga sestre u liječenju pacijenata sa koronarnom aretijskom bolesti

The role of the nurse in patients with coronary artery disease

Sažetak

Uvod: Koronarna bolest danas u razvijenim zemljama je jedan od najvećih uzroka smrti. Koronarna arterijska bolest je sužavanje koronarnih arterija uzrokovana arteriosklerozom, a proizlazi iz akumulacije masnih naslaga, plakova formiranih na unutrašnjoj površini zida koronarnih arterija. Taloženje masnih supstanci dovodi do sužavanja arterija i stenoza, što dovodi do smanjenog snadbijevanja srčanog mišića krvlju i kiseonikom. Tromb, također može dovesti do smanjenja u lumenu ili potpune okluzije (potpuno zatvaranje koronarnih arterija). Kada se radi o kompletnoj stenozi koronarnih arterija dovodi 100% od ishemije miokarda. Koronarna bolest može uzrokovati: akutni infarkt miokarda (sa ST elevacijom i bez-ST elevacijom), anginu pektoris (stabilna, nestabilna, vazospastična), akutni koronarni sindrom, hroničnu ishemijsku bolest srca, iznenadnu srčanu smrt, ishemiju miokarda bez simptoma.

Cilj rada: Ispitati liječenje bolesnika sa STEMI – hospitalizacija u jedinicama intenzivne njege gdje je EIN uz kontinuirano praćenje EKG, krvni pritisak, puls oksimetriju, i invazivne mjerenje centralnog venskog i arterijskog tlaka. Terapijski tretman sa anksiolitikom i analgetskom terapijom (morfin, diazepam), trombolitička terapija (fibrinolize, stent ili bypass), anti-trombocitna terapija, antikoagulansi (heparin), anti-ishemijska terapija (beta-blokatori, ACE inhibitori, nitrati, statini).

Materijali i medtode: Da bi se postigao ovaj cilj, korišteni se deskriptivni i statistički podaci iz Državnog zavoda za statistiku-Skopje i Klinici za kardiologiju – Skopje. Prikazani i sistematizirani napravljeni su razgovori, i na dobijenih informacijama izvučeni su zaključci.

Rezultati: Bolesti srca i krvnih sudova su u stalnom rastu. Smrtnost pacijenata kardiovaskularnih bolesti u Makedoniji je 55-58%.

Diskusija: Broj umrlih od bolesti krvotoka 1975. godine bio je kod 4.714 osoba. Dvadeset godina kasnije, broj slučajeva i smrtnih slučajeva gotovo udvostručio. U 1996- 8878 ljudi umrlo od bolesti srca. U 2003. godini taj broj je porastao na 10.185 osoba, a u 2005. godini bilo je 10.756 smrtnih slučajeva, dok je 2007. godine registrovano samo 11. 311 smrtnih slučajeva zbog kardiovaskularnih bolesti.

Zaključci: S obzirom na sve veći broj bolesti i smrtnosti posebno KAB treba obratiti posebnu pažnju na ranu prevenciji i eliminaciju faktora rizika za sprečavanje pojave KAB. Preventivne mjere treba sprovesti kod porodičnih ljekara i kardiologa kroz edukaciju, organizaciju i provedbu preventivnih mjera. Dugoročni ciljevi zaštite ne samo da se utiču na smanjenje mortaliteta i morbiditeta, nego i na poboljšanje kvaliteta života i smanjenje troškova i opterećenja sistema sekundarne zdravstvene zaštite.

Ključne riječi: koronarna bolest,koronarna arterijska bolest, STEMI.

Summary

Introduction: Coronary disease today in developed countries is one of the biggest causes death.Coronary artery disease is a narrowing of the coronary arteries due to atherosclerosis, resulting from the accumulation of fatty deposits, plaques formed on the inner surface of the wall of the coronary arteries. The deposition of fatty substances leads to narrowing of arteries and stenosis, resulting in reduced supply the heart muscle with blood and oxygen. Thrombus can also lead to a reduction in, or complete occlusion of the lumen (complete closure of the coronary arteries). When we complete coronary artery stenosis occurs 100% of myocardial ischemia. Coronary heart disease can cause acute myocardial infarction (with ST elevation and no-ST elevation), angina (stable, unstable, vasospastic), acute coronary syndrome, chronic ischemic heart disease, sudden cardiac death, myocardial ischemia without symptoms.

Aim: The treatment of patients with STEMI – hospitalization in intensive care units where the EIN with continuous monitoring of ECG, blood pressure, pulse oximetry, and invasive measurement of central venous and arterial pressure. The treatment with an anxiolytic and analgesic therapy (morphine, diazepam), thrombolytic therapy (fibrinolysis, stent or bypass), anti-platelet therapy, anticoagulants (heparin), an anti-ischemic therapy (beta-blockers, ACE inhibitors, nitrates, statins).

Materials and methods: In order to achieve this goal, used the descriptive and statistical data from the State Statistical Office Skopje and the Clinic for Cardiology – Skopje. Presented and systematized made the talks, and the obtained information drawn conclusions.

Results: The heart and blood vessels are growing steadily. The mortality rate of patients of cardiovascular disease in Macedonia is 55-58%.

Discussion: The number of deaths from circulatory diseases in 1975 was 4,714 people. Twenty years later, the number of cases and deaths has almost doubled. In 1996- 8878 people died of heart disease. In 2003, that number grew to 10,185 people in 2005, there were 10,756 deaths, and in 2007 he registered only 11 311 deaths due to cardiovascular disease.

Conclusion: In view of the increasing number of diseases and mortality especially CAD should pay particular attention to early prevention and elimination of risk factors to prevent the occurrence of CAD. Preventive measures should be implemented stem physicians and cardiologists through education, organization and implementation of preventive measures. Long-term goals of protection, not only to reduce the mortality and morbidity, but also to improve the quality of life and reduce the cost and burden the system of secondary health care.

Key words: coronary heart disease, coronary artery disease, STEMI.

Nastavi čitati Uloga sestre u liječenju pacijenata sa koronarnom aretijskom bolesti