Implementing Multifactorial Education Modules With Older Adults: Individualized And Interactive Fall Prevention Education, Salvador Chavez, Jocelle Flores, Rachelle Yambao

Dissertations, Masters Theses, Capstones, and Culminating Projects

Falls are a significant concern for community-dwelling older adults (OAs), with one in four OAs reporting a fall every year. Occupational therapy students collaborated with first responders of the Novato Fire District to identify gaps in fall prevention community outreach programs and found that many interventions lack an interactive or individualized approach. Based on the gap analysis and current literature, seven education modules were developed to address key risk factors including home safety hazards, polypharmacy, fear of falling, and strength and balance exercises. Thirty community-dwelling OAs participated in the education modules that were implemented at two senior community sites in …

The Duc Healthy Aging Website: Providing Online Occupation-Based Information, Haley Caruthers, Samantha Talavera, Jackeline Ulloa, Stephanie Vera

Dissertations, Masters Theses, Capstones, and Culminating Projects

Access to current, evidence-based health information is an important step to the promotion of health and wellness for all age groups, including OAs. Since the virtual world is easily accessible and is being used more frequently by OAs, an effective way to convey relevant up-to-date health information is through a website devoted to the dissemination of health promotion information tailored for OAs, including tips for integrating healthy habits into their lifestyle. Dominican University of California’s (DUC) Healthy Aging website, developed in May 2014, contains relevant and evidence-based research, including activities and local community based programs that promote healthy aging on …

Resilience And Social Support Among College Students With Disabilities, Rachita Sharma

Theses and Dissertations

Since the implementation of the Americans with Disabilities Act of 1990, individuals with disabilities have found enhanced opportunities in various areas of living. The numbers of students with disabilities in institutions of postsecondary education have also increased in the past few decades; however, despite this increase, the degree completion rates of students with disabilities continue to lag in comparison to their non-disabled peers in colleges and universities. As such, most universities currently have a designated office or department of disability accommodations designed to provide academic accommodations for students with disabilities. Nonetheless, current rehabilitation research is lacking in knowledge regarding interventions …

The Impact Of Timing Of Pornography Exposure On Mental Health, Life Satisfaction, And Sexual Behavior, Bonnie Young

Theses and Dissertations

As pornography has become more widespread, young people are being exposed to pornography at earlier ages. Research examining the relationship between timing of exposure to pornography and outcomes in adulthood of mental health, life satisfaction, sexual behavior and attitudes, and pornography viewing patterns is limited. This study focuses on the relationship between timing of exposure to pornography and individual outcomes in adulthood. Results indicate that earlier exposure to pornography may significantly influence mental health, life satisfaction, sexual behavior and attitudes, and pornography viewing patterns in adulthood. Implications of this study include greater awareness of the risks of early exposure to …

Congenital Abnormalities Of The Lower Airways And Lungs, Christopher M. Oermann

Presentations

Goals and Objectives. Participants will be able to: Describe the 5 stages of fetal lung development. Summarize the prenatal identification and management of congenital abnormalities of the lower airway and lung (CALAL). Explain the classification of CALAL. Compare the clinical characteristics, pathology and management of common CALAL. Discuss the long term prognosis of CALAL.

Student Self-Assessment Of Operative Dentistry Experiences : A Time Dependent Exercise In Best Practice Outcomes., Celine Joyce Cornelius Timothius

Electronic Theses and Dissertations

Purpose: The purpose of this project was to evaluate student self-assessment of operative dentistry experiences. Methods: First, a retrospective analysis of student self-assessment and faculty assessment grade sheets were evaluated for mean differences and correlations across time. Both preclinical (D2: n=120) and clinical (D3: n=120; D4: n=120) grades sheets were evaluated. Secondly, twenty-five (n=25) students from each of the D1, D2, D3 and D4 classes were asked to evaluate dentoform work. Twenty-five (n=25) operative calibrated faculty graded the same two dentoforms. Results: D2 student’s self-assessment scores were significantly higher than the faculty assessment scores (t-test; p0.05) and there was a …

Medicapt In The Democratic Republic Of The Congo: The Design, Development, And Deployment Of Mobile Technology To Document Forensic Evidence Of Sexual Violence, Karen Naimer, Widney Brown, Ranit Mishori

Genocide Studies and Prevention: An International Journal

This review essay provides an overview of the MediCapt app and the steps Physicians for Human Rights has taken to design, develop, and field-test the app in the Democratic Republic of the Congo. It also explores advocacy opportunities that the app’s emerging technology may facilitate down the road. This review essay also identifies the many challenges and questions that we have grappled with and lessons learned as we seek to deploy MediCapt in a low-resourced and politically unstable context and take it to scale beyond DRC. Finally, in sharing the details of this case study, we hope to emphasize both …

Fluorinated N,N'-Diarylureas As Novel Therapeutic Agents Against Cancer Stem Cells, Dasha E. Kenlan, Piotr G. Rychahou, Vitaliy M. Sviripa, Heidi L. Weiss, Chunming Liu, David S. Watt, B. Mark Evers

Markey Cancer Center Faculty Publications

Colorectal cancer is the second-leading cause of cancer-related mortality in the United States. More than 50% of patients with colorectal cancer will develop local recurrence or distant organ metastasis. Cancer stem cells play a major role in the survival and metastasis of cancer cells. In this study, we examined the effects of novel AMP-activated protein kinase (AMPK) activating compounds on colorectal cancer metastatic and stem cell lines as potential candidates for chemotherapy. We found that activation of AMPK by all fluorinated N,N-diarylureas (FND) compounds at micromolar levels significantly inhibited the cell-cycle progression and subsequent cellular proliferation. In addition, we demonstrated …

Incidence Of Cns Tumors In Appalachian Children, Bin Huang, Alice Luo, Eric B. Durbin, Ellen Lycan, Thomas Tucker, Quan Chen, Craig Horbinski, John L. Villano

Markey Cancer Center Faculty Publications

Determine whether the risk of astrocytomas in Appalachian children is higher than the national average. We compared the incidence of pediatric brain tumors in Appalachia versus non-Appalachia regions, covering years 2000–2011. The North American Association of Central Cancer Registries (NAACCR) collects population-based data from 55 cancer registries throughout U.S. and Canada. All invasive primary (i.e. non-metastatic tumors), with age at diagnosis 0–19 years old, were included. Nearly 27,000 and 2200 central nervous system (CNS) tumors from non-Appalachia and Appalachia, respectively comprise the cohorts. Age-adjusted incidence rates of each main brain tumor subtype were compared. The incidence rate of pediatric CNS …

Paracrine Regulation Of Melanocyte Genomic Stability: A Focus On Nucleotide Excision Repair, Stuart Gordon Jarrett, Katharine Marie Carter, John August D'Orazio

Markey Cancer Center Faculty Publications

UV radiation is a major environmental risk factor for the development of melanoma by causing DNA damage and mutations. Resistance to UV damage is largely determined by the capacity of melanocytes to respond to UV injury by repairing mutagenic photolesions. The nucleotide excision repair (NER) pathway is the major mechanism by which cells correct UV photodamage. This multistep process involves the basic steps of damage recognition, isolation, localized strand unwinding, assembly of a repair complex, excision of the damage‐containing strand 3′ and 5′ to the photolesion, synthesis of a sequence‐appropriate replacement strand, and finally ligation to restore continuity of genomic …

The External Globus Pallidus: Bidirectional Control Over Anxiety-Related Behavior Mediated By Crfr1, Albert J. Hunt Jr

Dissertations and Theses (Open Access)

Abstract

THE EXTERNAL GLOBUS PALLIDUS: BIDIRECTIONAL CONTROL OVER ANXIETY-RELATED BEHAVIOR MEDIATED BY CRFR1

Albert Lee Joseph Hunt, Jr., B.S.

Advisory Professor: Shane Cunha, Ph.D.

Corticotropin-releasing factor receptor 1 (CRFR1), the principle receptor responsible for the anxiogenic activity of the stress peptide CRF, is abundantly expressed in the external globus pallidus (GPe) raising the question whether activity in the GPe is altered in response to stress. I show that CRFR1 expressing neurons are of the “prototypic” subtype of GPe neurons. I provide evidence of novel circuits from CRF neurons in stress-responsive nuclei, including the paraventricular nucleus of the hypothalamus (PVN) and …

Visualizing The Dynamics Of Immune Surveillance In Brain Tumors By Intravital Multiphoton Microscopy, Felix Nwajei

Dissertations and Theses (Open Access)

Visualizing the dynamics of immune surveillance in brain tumors by intravital multiphoton microscopy

By

Felix I. Nwajei, MD

Supervisory Professor: Tomasz Zal, Ph.D.

Brain tumors (BTs) generally have a bad prognosis despite conventional treatment strategies. Immunotherapy is a relatively novel treatment approach that has shown benefit for durable treatment of melanoma, and is a promising candidate for different tumor types including BTs. Immunotherapeutic strategies work by exploiting and/or enhancing natural anti-tumor immune response, a process that is critically dependent on adaptive immunity, T cell infiltration and surveillance of tumor. However, little is known about the dynamics and regulation of T …

Biodegradable Polymeric Biomaterials In Different Forms For Long-Acting Contraception And Drug Delivery To The Eye And Brain, Dileep Reddy Janagam

Theses and Dissertations (ETD)

Efficacy of many of the new and existing therapeutics is often hampered by the lack of an effective and compliant method of delivery. Typically, drugs have poor water solubility, short half-lives, and low permeability across the biological membranes. The result is low bioavailability of the drugs at the target site and can cause toxicity and side effects at high doses. Often the conventional dosage forms fail to overcome these limitations. In the recent decades, biodegradable polymeric drug delivery systems have emerged as promising candidates to solve the challenges of poor solubility, low permeability and sustained release owing to the advantages …

Investigating The Role Of Dispatched In Hedgehog Ligand Transport And Delivery, William Bodeen

Theses and Dissertations (ETD)

During the development of all metazoans, the Hedgehog (Hh) signaling pathway provides instructional cues influencing a variety of cellular processes. The pathway ligand, Hh, is dually lipidated by cholesterol and palmitate, which effectively anchors the molecule to the lipid bilayer of the signal producing cell. To complicate the Hh pathway induction process, the Hh ligand is often produced at a significant distance from the cells it influences. Only one known conserved molecule, Dispatched (Disp), can alleviate the membrane tethering imparted by Hh lipidation. Underscoring the importance of Disp protein during development, knockout animals succumb to lethality at E9.5, an exact …

Therapeutic Effects Of Ormeloxifene In Cervical Cancer Carcinogenesis, Neeraj Chauhan

Theses and Dissertations (ETD)

Cervical cancer (CxCa) remains the fourth leading cause of cancer related deaths among women worldwide. Cervical cancer is mainly (~ 99.7%) derived from high risk Human papillomavirus (HR HPV). HPV E6/E7 are the two main oncoproteins that interfere with p53 and pRb (retinoblastoma) cell cycle regulatory proteins and hinder their efficacy of controlling cell growth. Additionally, PI3K-Akt is a cell survival pathway that is aberrantly expressed in cervical cancer cells. This pathway has a profound role in inhibiting mitochondrial intrinsic apoptotic signaling pathway. Advanced stage cervical cancer is difficult to treat and patients diagnosed with metastatic disease have a poor …

Role Of Dendritic Cells In Pathology Of Respiratory Syncytial Virus Infection In Neonates, Bishwas Shrestha

Theses and Dissertations (ETD)

Respiratory syncytial virus (RSV) is one of the leading causes of bronchiolitis in children. We have shown that neonatal mice respond to primary RSV infection with T helper type 2 (Th2) biased immune responses, which are enhanced following reinfection. Dendritic cells (DCs) including myeloid DCs (mDCs) and plasmacytoid DCs (pDCs) play important roles in driving host responses to RSV infection. mDCs present antigens to help Th cells differentiate, and pDCs protect against viral infection through type I interferons (IFNs). Despite data demonstrating importance of mDCs and pDCs in protection against RSV, it has not been studied in an age appropriate …

Discovery Of Natural Product-Based Antimycobacterial Agents Effective Against Non-Replicating Bacilli, Shajila Siricilla

Theses and Dissertations (ETD)

New antimycobacterial molecules that kill non-replicating Mycobacterium tuberculosis (Mtb) were identified by screening libraries of synthetic natural products. De novo screening of a 400-membered library of aurachin RE analogs resulted in discovery of UT-317 ((R)-20). UT-317 is a selective vitamin K2 biosynthesis (MenA) inhibitor that killed replicating and non-replicating Mtb at 2.31 μg/mL (MIC) and 0.85 μg/mL, respectively. A 50-membered library of capuramycin analogs was evaluated in their enzymatic inhibitory activities against translocase I (MraY/MurX) and prenyl-phosphate-GlcNAc-1-phosphate transferase (WecA). UT-01320 (45) is identified as a selective WecA inhibitor that kills both replicating and non-replicating Mtb at 1.50 μg/mL (MIC) and …

Psychometric Evaluation Of The Nursing Child Assessment Teaching (Ncat) Scale In Two Samples Of Mothers And Children, Samantha H. Ransone

Theses and Dissertations (ETD)

The mother-child relationship (MCR) has received an increasing amount of attention over the last several decades regarding its effect on long-term child development. Because the quality and quantity of interactions in the MCR have been established as important predictors of the child’s development, early identification of areas in the relationship requiring support and intervention is essential for promoting positive child outcomes. Observational assessment of the mother and child is considered best practice in evaluating maternal-child interaction (MCI). The Nursing Child Assessment Teaching (NCAT) scale is an instrument that has been used to quantify the quality of interaction in the MCR …

Decreasing Sedentary Behavior: Effects On Academic Performance, Meta-Cognition, And Sleep, June J. Pilcher, Drew M. Morris, Stewart A. Bryant, Paul A. Merritt, Hayley B. Feigl

Publications

There is growing interest in using activity workstations as a method of increasing light physical activity in normally sedentary environments. The current study (N = 117) compared the effects of studying in college students while slowly pedaling a stationary bike with a desktop with studying at traditional desks across 10 weeks in an academic semester. The students were assigned to study either on the stationary bike or at a traditional desk located in the campus library for a minimum of 2 h a week. During the 10 weeks, the students studied for tests or worked on other required academic …

Nutrient Content Of Human Breast Milk From Overweight And Normal Weight Caucasian Women Of Northeast Tennessee, Megan R. Kwon

Electronic Theses and Dissertations

Many factors influence the nutrient composition of breast milk (BRM) particularly within the fatty acids composition. In this study BRM between 2-14 weeks of lactation was collected from 44 Caucasian women (24 normal weight (NW, BMI 18.5-24.9kg/m²) and 20 overweight (OW, BMI >25.0kg/m²). BRM was subjected to proximate analysis and participants completed food frequency questionnaires (FFQ) to estimate fruit, vegetable, and fat intake. BMI differed between NW and OW groups, 22.03 vs 33.86kg/m² (p0.10) were identified for total calories (5,581.8 vs 5562.9cal/g), %fat (39.6 vs 43.9), or %protein (9.8 vs 8.9) for BRM in NW …

The Increasing Risk Of Vector-Borne Diseases: Mapping The Effects Of Climate Change And Human Population Density On Future Aedes Aegypti Habitats, Julie Obenauer

Electronic Theses and Dissertations

The Aedes aegypti mosquito is the vector for four infectious diseases of global concern – Yellow Fever, Dengue, Chikungunya, and Zikavirus. Previous attempts to model the expansion of the vector habitat due to global climate change have rarely included characteristics related to the human populations on which this mosquito is dependent. The purpose of this research was to determine whether the inclusion of human population density improves model performance while creating risk maps that can be used to determine where humans are most likely to be exposed to the vector in the future. The resulting model demonstrated that the inclusion …

Prevalence Of Communication Disorders In Children With Neonatal Abstinence Syndrome On School Speech-Language Pathology Caseloads: A National Survey, Brittany V. Ratliff

Electronic Theses and Dissertations

There is concern about the recently increasing number of infants born with Neonatal Abstinence Syndrome (NAS), yet little is known about its long-term neurodevelopmental effects. School-based speech-language pathologists (SLPs) are in a unique position to comment on potential long-term consequences of NAS because their caseloads include children with a variety of communication disorders and comorbidities. School-based SLPs across the United States (N = 258) responded to a survey about the presence of children with NAS on their caseloads and their perceptions of the children’s communication disorders and comorbidities. Results revealed that children with NAS currently are being treated by …

An Epidemiological Study Of Obesity Among Asian Americans In California, United States, Shaoqing Gong

Electronic Theses and Dissertations

Obesity has reached epidemic levels in the United States (U.S.). Despite an increasing number of studies on obesity, a very few have addressed this debilitating condition among Asian American adults. The overall objective of this study is to utilize the latest cycles of the California Health Interview Survey (CHIS) to better understand obesity and identify its correlates among Asian Americans. The study population comprised Asian American adults aged 18 years or older from the CHIS with data pooled from the 2013 and 2014 survey years. Obesity (≥27.5 kg/m²) was defined using the World Health Organization (WHO) Asian body …

Difference In Quality Of Life Between Group And Individual Exercise In A Faith-Based Sample, Everett Jackson Amburn

Electronic Theses and Dissertations

There is limited data on the quality of life of individuals who exercise in a group versus individuals who exercise alone. The purpose of this study was to determine if there is a difference in the quality life between adults who attend an exercise class and those who exercise alone. Using the WHOQOL-BREF, 27 adult females were surveyed in Central California at two Church of Latter Day Saints locations. Ten females were enrolled in a group exercise class while 17 were individual exercisers. The data was analyzed using a t-test for independent samples to determine if there is a …

Peanut Allergen Threshold Study (Pats): Novel Single-Dose Oral Food Challenge Study To Validate Eliciting Doses In Children With Peanut Allergy, Jonathan O'B. Hourihane, Katrina J. Allen, Wayne G. Shreffler, Gillian Dunngalvin, Julie A. Nordlee, Giovanni A. Zurzolo, Audrey Dunngalvin, Lyle C. Gurrin, Joseph L. Baumert, Steve L. Taylor

Department of Food Science and Technology: Faculty Publications

Background: Eliciting doses (EDs) of allergenic foods can be defined by the distribution of threshold doses for subjects within a specific population. The ED₀₅ is the dose that elicits a reaction in 5% of allergic subjects. The predicted ED₀₅ for peanut is 1.5 mg of peanut protein (6 mg of whole peanut).

Objective: We sought to validate the predicted peanut ED₀₅ (1.5 mg) with a novel single-dose challenge. Methods: Consecutive eligible children with peanut allergy in 3 centers were prospectively invited to participate, irrespective of previous reaction severity. Predetermined criteria for objective reactions were used …

Prevention Of Postpartum Haemorrhage By Community-Based Auxiliary Midwives In Hard-To-Reach Areas Of Myanmar: A Qualitative Inquiry Into Acceptability And Feasibility Of Task Shifting, Kyu Kyu Than, Yasmin Mohamed, Victoria Oliver, Theingi Myint, Thazin La, James G. Beeson, Stanley Luchters

Population Health, East Africa

Background: In Myanmar, postpartum haemorrhage is the leading cause of maternal mortality and contributes to around 30% of all maternal deaths. The World Health Organization recommends training and supporting auxiliary midwives to administer oral misoprostol for prevention of postpartum haemorrhage in resource-limited settings. However, use of misoprostol by auxiliary midwives has not formally been approved in Myanmar. Our study aimed to explore community and provider perspectives on the roles of auxiliary midwives and community-level provision of oral misoprostol by auxiliary midwives.

Methods: A qualitative inquiry was conducted in Ngape Township, Myanmar. A total of 15 focus group discussions with midwives, …

Epigenetic Age Acceleration Assessed With Human White-Matter Images, Karen Hodgson, Melanie A. Carless, Hemant Kulkarni, Joanne E. Curran, Emma Sprooten, Emma E. Knowles, Samuel R. Mathias, Harald H. H. Goring, Nailin Yao, Rene L. Olvera, Laura Almasy, Ravindranath Duggirala, John Blangero, David C. Glahn

School of Medicine Publications

The accurate estimation of age using methylation data has proved a useful and heritable biomarker, with acceleration in epigenetic age predicting a number of age-related phenotypes. Measures of white matter integrity in the brain are also heritable and highly sensitive to both normal and pathological aging processes across adulthood. We consider the phenotypic and genetic interrelationships between epigenetic age acceleration and white matter integrity in humans. Our goal was to investigate processes that underlie interindividual variability in age-related changes in the brain. Using blood taken from a Mexican-American extended pedigree sample (n = 628; age = 23.28-93.11 years), epigenetic …

A Variant Pfcrt Isoform Can Contribute To Plasmodium Falciparum Resistance To The First-Line Partner Drug Piperaquine, Satish K. Dhingra, Devasha Redhi, Jill M. Combrinck, Tomas Yeo, John Okombo, Philipp P. Henrich, Annie N. Cowell, Purva Gupta, Matthew L. Stegman, Jonathan M. Hoke, Roland A. Cooper, Elizabeth Winzeler, Sachel Mok, Timothy J. Egan, David A. Fidock

Biological Sciences Faculty Publications

Current efforts to reduce the global burden of malaria are threatened by the rapid spread throughout Asia of Plasmodium falciparum resistance to artemisinin-based combination therapies, which includes increasing rates of clinical failure with dihydroartemisinin plus piperaquine (PPQ) in Cambodia. Using zinc finger nuclease-based gene editing, we report that addition of the C101F mutation to the chloroquine (CQ) resistance-conferring PfCRT Dd2 isoform common to Asia can confer PPQ resistance to cultured parasites. Resistance was demonstrated as significantly higher PPQ concentrations causing 90% inhibition of parasite growth (IC₉₀) or 50% parasite killing (50% lethal dose [LD₅₀]). This mutation …

ภาวะโรคเรื้อรังร่วมหลายโรคในผู้สูงอายุ: สถานการณ์ ประเด็นท้าทาย และการจัดการดูแล, ศกุนตลา อนุเรือง

Journal of Nursing Research, Innovation, and Health

ภาวะโรคเรื้อรังร่วมหลายโรคเป็นภาวะที่พบได้บ่อยในผู้สูงอายุ มีความซับซ้อนทั้งด้านอาการ ความไม่สุขสบาย วิถีชีวิตเกี่ยวกับโรค ตลอดจนแนวทางการรักษา ซึ่งภาวะนี้เป็นสาเหตุในความสูญเสียทางด้านร่างกาย จิตใจ เศรษฐกิจ สังคม และอารมณ์ ทั้งในระดับตัวบุคคล ผู้ดูแล ครอบครัว และยังส่งผลกระทบในวงกว้าง คือ ระดับเศรษฐกิจของชาติได้อีกด้วย ในปัจจุบัน ภาวะโรคเรื้อรังร่วมหลายโรคในผู้สูงอายุจึงเป็นภาวะที่น่าสนใจและมีประเด็นความท้าทายทั้งในเชิงคลินิก และเชิงวิชาการ การเรียนรู้สถานการณ์ปัจจุบันประเด็นท้าทาย และแนวทางการจัดการดูแลภาวะโรคเรื้อรังร่วมหลายโรคในผู้สูงอายุ จึงเป็นสิ่งจำเป็นสำหรับบุคลากรทุกสหสาขาวิชาชีพในสถานบริการสุขภาพทุกระดับ พยาบาลวิชาชีพเป็นบุคลากรทางสุขภาพที่มีความใกล้ชิดกับผู้ป่วยและผู้ดูแล ซึ่งหากมีความเข้าใจในความหมาย สถานการณ์ และประเด็นท้าทายต่างๆ ที่เกิดขึ้น จะสามารถใช้เป็นพื้นฐานในการคิดต่อยอดเพื่อพัฒนาคุณภาพการดูแลที่มีประสิทธิภาพร่วมกับทีมผู้ดูแลจากสหสาขาวิชาชีพ สามารถลดความสูญเสียต่างๆ เช่น การสูญเสียปีสุขภาวะ และการสูญเสียชีวิตในผู้สูงอายุ ตลอดจนการคงไว้ซึ่งคุณภาพชีวิตของผู้สูงอายุที่มีภาวะโรคเรื้อรังร่วมหลายโรค นอกจากนี้ ยังสามารถพัฒนาคุณภาพการดูแลสำหรับผู้ดูแลที่มีความสำคัญเป็นอย่างยิ่ง ให้สามารถดูแลผู้สูงอายุที่มีภาวะโรคเรื้อรังร่วมหลายโรคได้อย่างมีประสิทธิภาพ สามารถลดความยุ่งยาก เหนื่อยล้าจากการดูแล อีกทั้งยังสามารถส่งเสริมภาวะสุขภาพทั้งด้านร่างกาย จิตใจ และคุณภาพชีวิตของผู้ดูแลได้อีกด้วย นอกจากนี้ ยังสามารถลดค่าใช้จ่ายของชาติในการดูแลผู้สูงอายุที่มีภาวะโรคเรื้อรังร่วมหลายโรคนี้ลงได้อีกด้วย

อาการนอนไม่หลับในผู้ป่วยที่มีหัวใจล้มเหลวเรื้อรัง, จรรยา ฉิมหลวง

Journal of Nursing Research, Innovation, and Health

การนอนหลับเป็นสิ่งจำเป็นอย่างยิ่งสำหรับผู้ป่วยหัวใจล้มเหลวเรื้อรัง ที่หัวใจไม่สามารถบีบเลือดไปเลี้ยงส่วนต่างๆ ของร่างกายได้อย่างเพียงพอ อย่างไรก็ตาม มีผู้ป่วยหัวใจล้มเหลวเรื้อรังจำนวนมากที่มีอาการนอนไม่หลับ โดยพบว่าผู้ป่วยหัวใจล้มเหลวเรื้อรังส่วนใหญ่จะพบอาการนอนไม่หลับทั้ง 3 อาการคือ อาการเริ่มต้นนอนหลับยาก การนอนหลับไม่ต่อเนื่อง และอาการตื่นเช้ากว่าปกติ ซึ่งอาการเหล่านี้จะส่งผลให้ผู้ป่วยมีอาการหัวใจเต้นผิดปกติ มีภาวะหัวใจล้มเหลวเพิ่มมากขึ้น และอาจเกิดภาวะแทรกซ้อนของระบบหัวใจและหลอดเลือด นอกจากนี้ อาการนอนไม่หลับยังส่งผลกระทบต่อความผาสุกทางจิตวิญญาณและคุณภาพชีวิตของผู้ป่วยเป็นอย่างมาก ดังนั้น พยาบาลจึงจำเป็นต้องเรียนรู้เกี่ยวกับปัจจัยโน้มนำและปัจจัยกระตุ้น ที่ทำให้เกิดอาการนอนไม่หลับ รวมถึง ปัจจัย ที่ทำให้อ าการนอนไมหลับยังคงอยู่อย่างถาวร เรียนรู้เกี่ยวกับการประเมินอาการนอนไม่หลับเพื่อให้สามารถประเมินอาการนอนไม่หลับได้อย่างครอบคลุมและเรียนรู้วิธีการจัดการอาการนอนไม่หลับโดยไม่ใช้ยานอนหลับในหลายรูปแบบ เช่น การให้ความรู้เรื่องสุขลักษณะการนอน การบำบัดทางความคิดรู้ การควบคุมการกระตุ้น การจำกัดการนอน การฝึกการผ่อนคลาย หรือการบำบัดโดยการใช้หลายวิธี ซึ่งการเรียนรู้เกี่ยวกับสิ่งเหล่านี้จะทำให้พยาบาลมีความรู้มีความเข้าใจ สามารถประเมินและให้การพยาบาลแก่ผู้ป่วยหัวใจล้มเหลวเรื้อรังที่มีความทุกข์ทรมานจากอาการนอนไม่หลับได้อย่างถูกต้องและเหมาะสม เพื่อให้ผู้ป่วยสามารถนอนหลับได้ดีขึ้น ส่งผลให้ผู้ป่วยมีคุณภาพชีวิตที่ดีขึ้นตามไปด้วย