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Personer med idiopatisk normaltryckshydrocefalus:deras förväntningar på behandling med shunt och syn på egen roll i rehabiliteringsprocessen-en intervjustudie
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2015 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Bakgrund: Det har i vissa fall varit märkbart att patienter med idiopatisk normaltrycks hydrocefalus (iNPH) upplever att förväntat shuntbehandlingsresultat inte uppnåtts och de rapporterar försämring vid den postoperativa uppföljningen trots att standardiserade tester inte visar i den riktningen. Det har också visat sig att rehabiliteringsinsatserna varierat för patienterna allt från strukturerade rehabiliteringsperioder på exempelvis geriatrisk rehabiliteringsenhet till i princip ingen rehabilitering alls.

Syfte: Att beskriva vilka förväntningar personer med iNPH har på behandling med shunt och hur de ser på sin egen roll i rehabiliteringsprocessen.

Metod: Kvalitativ, deskriptiv design med manifest och induktiv ansats. Datainsamlingen skedde genom semistrukturerade intervjuer med sju patienter med iNPH preoperativt.

Resultat: Det fanns en samstämmighet bland informanterna kring förväntningar på shuntbehandlingsresultatet. De rörde den symtomtriad (gång och balansstörning, överaktiv urinblåsa samt kognitiv nedsättning) som ofta finns vid iNPH. Varierade beskrivningar gavs på hur symtomen påverkade informanterna. Det fanns också en uppfattning bland informanterna att de hade ett eget ansvar i rehabiliteringsprocessen och förslag framkom på vad de själva kunde bidra med i processen men också olika hinder för att utöva fysisk aktivitet beskrevs.

Slutsats: Förväntningar på shuntbehandlingsresultat behöver diskuteras med patienten (ibland även anhörig) inför shuntbehandling redan vid beslut om operation men också då patienten läggs in för behandlingen. Rehabiliteringsprocessen behöver också diskuteras med patienten såväl före shuntoperation som tidigt postoperativt. Detta är troligtvis mycket viktigt för att uppnå ett så optimalt behandlingsresultat som möjligt.

Abstract [en]

Background: It has been noticeable that some patients with idiopathic normal pressure hydrocephalus (iNPH) find the expected result of shunt treatment not  achieved and they report detoriation at postoperative follow-up even though standardized tests do not show results in that direction. It has also been shown that rehabilitation possibilities for patients varied, ranging from structured rehabilitation periods, e.g. at geriatric rehabilitation units to basically no rehabilitation at all.

Objective: To describe what expectations patients with iNPH have on treatment with shunt and how they view their own role in the rehabilitation process.

Method: A quality, descriptive design with manifest and inductive approach. The data collection was done by semi-structured interviews with seven patients with iNPH preoperative.

Results: There was consensus among informants regarding the expectations on the result of shunt treatment. The expectations concerned the symptom triad (gait-and balance disturbance, urgency bladder and cognitive dysfunction) which often occurs in iNPH. Varied descriptions were given on how the symptoms had affected the informants. There was also an opinion among the informants that they had own responsibility for the rehabilitation process and suggestions were given on what they could contribute with in the process but also different obstacles for performing physical activities were described.

Conclusion: Expectations on shunt treatment results need to be discussed with the patient (sometimes together with a relative) prior to shunt treatment, already when the patient is offered a shunt operation and also on the day before operation when the patient is in the neurosurgery clinic. The rehabilitation process also needs to be discussed with the patient before the shuntoperation as well as early postoperative. This is probably very important in order to achieve as optimal treatment results as possible.

Place, publisher, year, edition, pages
2015. , 37 p.
Keyword [en]
Idiopathic normal pressure hydrocephalus, shunt treatment, expectations, rehabilitations process, patient role
Keyword [sv]
Idiopatisk normaltryckshydrocefalus, shuntbehandling, förväntningar, rehabiliteringsprocessen, patientroll.
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-267303OAI: oai:DiVA.org:uu-267303DiVA: diva2:872714
Subject / course
Caring Sciences
Educational program
Freestanding course
Supervisors
Examiners
Available from: 2015-11-20 Created: 2015-11-19 Last updated: 2015-11-20Bibliographically approved

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