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Wu, Xi Vivien. „Holistic clinical assessment for undergraduate nursing students“. Doctoral thesis, Högskolan i Jönköping, Hälsohögskolan, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-29937.
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A major focus in nursing education is on the judgement of clinical performance, and it is a complex process due to the diverse nature of nursing practice. Difficulties in the development of valid and reliable assessment measures in nursing competency continue to pose a challenge in nursing education. A holistic approach in the assessment of competency comprises knowledge, skills and professional attitudes, wherein the notion of competency incorporates professional judgement and management skills in the clinical situation. Therefore, the thesis aims to develop a holistic clinical assessment tool with a reasonable level of validity and reliability to meet the needs of clinical education. The conceptual framework underlying this research is formed by establishing a theoretical connection between the practice of learning, and of pedagogy and assessment. This research consists of five studies. In Study I, a systematic review was conducted to explore the current assessment practices and tools for nursing undergraduates. In Studies II, III and IV, a qualitative approach with focus group discussions was adopted to explore the views of final-year undergraduate nursing students, preceptors, clinical nurse leaders and academics on the clinical assessment. Based on the multiple perspectives, it therefore addresses concerns in clinical assessment. In Study V, a holistic clinical assessment tool was developed, for which a psychometric testing was conducted. The systematic review indicated that limited studies adequately evaluate the psychometric properties of the assessment instrument. The qualitative studies have raised an awareness of professional and educational issues in relation to clinical assessment. Workload, time, availability of resources, adequate preparation of preceptors, and availability of valid and reliable clinical assessment tools were deemed to influence the quality of students’ clinical learning and assessment. In addition, the presence of support systems and formal educational programs for preceptors influenced their preparation and self-confidence. Nursing leaderships in hospitals and educational institutions have a joint responsibility in shaping the holistic clinical learning environment and making holistic clinical assessment for students. The involvement of all stakeholders in the development of a valid and reliable assessment tool for clinical competency is also essential to the process. The Holistic Clinical Assessment Tool (HCAT) was developed by the author based on the systematic review, qualitative findings and the core competencies of registered nurse from the professional nursing boards. The HCAT consists of 4 domains and 36 assessment items. Furthermore, testing of the psychometric properties indicated that the HCAT has satisfactory content validity, construct validity, internal consistency and test-retest reliability. In conclusion, the HCAT is meritorious in that it carries the potential to be used as a valid measure to evaluate clinical competency in nursing students, and provide specific and ongoing feedback to enhance the students’ holistic clinical learning experience. The HCAT not only functions as a tool for self-reflection for the students, but also guides the preceptors in clinical teaching and assessment. In addition, the HCAT can be used for peer-assessment and feedback. It is imperative that the clinical and academic institutions establish various levels of ongoing support for both students and preceptors in the process of clinical assessment.
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Avino, Karen M. „Integrating holistic nursing at the University of Delaware“. Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 152 p, 2008. http://proquest.umi.com/pqdweb?did=1597615941&sid=2&Fmt=2&clientId=8331&RQT=309&VName=PQD.
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Bridgen, Annette Frances. „A heuristic journey of discovery : exploring the positive influence of the natural environment on the human spirit : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Master of Nursing /“. ResearchArchive@Victoria e-Thesis, 2007. http://hdl.handle.net/10063/168.
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Craven, Molly K., Rachel L. Thelen, Lydia Elliot und Janice Lazear. „Provoked Ulvodynia: A Holistic Treatment Approach“. Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7084.
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Provoked vulvodynia (PVD) is a disorder characterized by intense vulvar pain, most often reported as raw, burning, or stinging tissue. Current treatment options for PVD are insufficient and narrow in focus, as they predominantly address the physical pain associated with the disorder. Current publications regarding cognitive behavioral therapy and mindfulness treatment indicate that both therapies are highly effective. Mindfulness and cognitive behavioral therapies are noninvasive, efficacious long term, and provide a comprehensive biopsychosocial approach. The aim of this study is to educate nurse practitioners regarding these treatment options, which manage the physical as well as psychosocial aspects of PVD.
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Cotter, Angela Jane Elise. „Wounded nurses Holism and nurses' experiences of being ill /“. Thesis, Online version, 1990. http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.280765.
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Naegle, Madeline, Lynne Dunphy, Patricia M. Vanhook und Kathleen Delaney. „Opioid Misuse Epidemic: Addressing Opioid Prescribing and Organization Initiatives for Holistic, Safe, and Compassionate Care“. Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7416.
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The U.S. Centers for Disease Control (CDC) (2016a) state that the misuse and illicit use of prescription analgesic drugs and use of heroin have skyrocketed to epidemic proportions. Former Surgeon General Vivek Murtha’s report, Facing Addiction in America (2016) notes that 12.5 million Americans use opioid pain relievers in ways other than those intended by prescription (USHHS, 2016). Notably, about 61% of the US drug overdose deaths in 2014 involved an opiate (Rudd, Seth, David, & Scholl, 2016). To address the opioid crisis requires the coordinated responses of all health care providers. Multiple disci- plines and professional nursing organizations have recommended strategies and published policy state- ments. Efforts to stem the opioid crisis include the development of provider education and dissemination of opioid prescribing guidelines, protocols for adher- ence to these guidelines, effective use of non-opioid treatment modalities for chronic pain, and initiatives to increase access to opioid addiction treatment. Nursing leadership in these initiatives must be broad based and unequivocal in order to engage all levels of the nursing workforce and to promote collaboration among organizations and agencies.
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Armah, Deborah. „Development of guidelines for holistic healthcare interventions for women with infertility in Ghana“. Thesis, University of Pretoria, 2019. http://hdl.handle.net/2263/76440.
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In her thesis, Development of guidelines for holistic healthcare interventions for women diagnosed with infertility in Ghana, the promovenda was guided by the philosophy of pragmatism and conducted the research in three phases. Phase I reviewed literature on existing holistic healthcare interventions for infertility in the global context. Phase II included focus group discussions with women with infertility and application of a nominal group technique with healthcare providers. Phase III used an e-Delphi technique to obtain consensus from independent experts. The focus group findings indicated that women with infertility experienced various unmet psychological, social and spiritual healthcare needs. Based on these needs, a group of healthcare providers proposed holistic healthcare interventions for women with infertility. The guidelines, which incorporated the proposed interventions and findings from literature, were refined by a panel of international experts. The research could improve the quality of life for women with infertility if implemented by healthcare providers in Ghana.Thesis (PhD) - University of Pretoria, 2019.
Nursing Science
PhD
Unrestricted
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Ogbuji, Victoria Ngozi. „Improving Spiritual Care in Preoperative Nursing“. ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7246.
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Spirituality and nursing have been intertwined from the beginning of the profession; however, there is little evidence that clearly defines spiritual nursing care and no standardized practices that can be included in the routine preoperative plan of care for patients undergoing invasive surgical procedures. The purpose of this project was to conduct a systematic review of the literature to define spiritual care and identify specific spiritual nursing care interventions. The biopsychosocial model, Narayanasamy's transcultural care practice model, and Watson's theory of human caring provided the theoretical framework for the project. MEDLINE, PubMed, Wiley online library, SCIENCE, WOS, Cochrane, and SciELO databases were searched for the literature review. Keywords and phrases used included spirituality, spiritual nursing care, holistic health practices, inpatient, hospital, and preoperative care. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) II tool was used for data analysis. Interventions found in the literature to be supportive of spirituality included healing presence; providing effective communication; praying with the patient and family or facilitating other religious rituals; using the therapeutic self to be with the patient; listening to and exploring the patients' spiritual perspectives; and showing support and empathy through patient-centered caring, nurturing spirituality, and creating a healing environment. Employing these nursing actions might promote positive social change by contributing to a sense of well-being as patients find meaning and purpose in their illness and life overall, which will promote improved surgical outcomes and better patient satisfaction with care.
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Paech, Susan Elisabeth, und spaech@vtown com au. „TOTALLY DIFFERENT: AN ETHNOGRAPHIC ACCOUNT OF INTELLECTUAL DISABILITY NURSING“. Flinders University. Medicine, 2007. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20090918.161221.
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This study adopted an ethnographic approach to examine the role of the Registered Nurse (RN) in the intellectual disability sector. The research setting (The Centre) is a residential facility for clients with intellectual disability in the northern suburbs of Adelaide that opened in 1971 and was similar to a hospital with the same hierarchy of nursing. Mental deficiency nurse training was conducted there until the 1990s but that qualification is no longer recognised. The Centre is under the umbrella of a large state disability organisation that is in the process of moving clients of the service from institutions (the Centre) to community living options such as group homes.
The cessation of mental deficiency nurse training and the introduction of deinstitutionalisation were considered to impact on client health and in the late 1990s a 24 hour nursing service was commenced. There was strong anecdotal evidence the service should be evaluated. A review of the literature found some research had been conducted in overseas countries with a focus on deinstitutionalisation but with a paucity of interest in the role of the RN, particularly in Australia.
Ethnography, first used in anthropology as a way of describing different cultures, was chosen as the research methodology because the researcher wanted to discover how the culture influenced the role of the RN. The researcher is an RN employed in the area. As an ethnographer and participant observer, the researcher became the data collection instrument. The entire culture is considered to be the sample in ethnography and data took the form of hundreds of hours of field note entries and interview transcripts.
Following analysis, the findings were presented in themes answering the research question which was in two parts. The first from the perspective of the nurse, client and other health care professionals, what constitutes intellectual disability nursing? and secondly what are the every day rituals, norms and patterns within the disability culture that shape and influence disability nursing for the Registered Nurse?.
Caring for the client who is institutionalised, The RN in the disability sector having certain qualities, Working within a different paradigm, Having to assume responsibility for large numbers of unregulated workers, Having to work alongside many professional groups and Having different educational needs are themes which describe the role. Themes describe the diversity of the role and in describing the registered intellectual disability nurse as different the role is compared with that of the nurse in other settings. The current research revealed there is a need for more health related education for unregulated workers and specific intellectual disability education for registered and enrolled nurses.
Themes that answer the second part of the research question are hierarchical structure, the Registered Nurse's position and role confusion. The non-nursing management at the top of the hierarchical ladder was found to significantly limit the role of the RN who was afforded no opportunity for leadership. Confusion over the RN's role and indeed individual workers' roles was observed at all levels. Findings suggest much stronger nursing leadership is required to provide advocacy and holistic care for the client and education for the carer. An outcome of the current research was the development of a model for intellectual disability nursing (see Table 8-1).
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Afolayan, Joel Adeleke. „A model for the integration of spiritual care into the nursing curriculum in Nigeria“. University of the Western Cape, 2018. http://hdl.handle.net/11394/6166.
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Philosophiae Doctor - PhD (Nursing)Man is a bio-psycho-social-spiritual being, and his needs are informed by all these elements. The need for spiritual care in nursing education and practice is no longer a new concept in developed countries, nor even in some developing countries. However, in Nigeria, there is no consistent evidence of how spirituality is taught within the nursing curriculum nor how it is practised. The literature review also confirms that no existing set of rules or models for integrating spiritual care into the curriculum of nursing exists in the country. If nursing care is to be holistic, concerted attention must be paid to spiritual care, and to the training of nurses so that they can provide spiritual care within the context of holistic care for patients in the healthcare system. The main purpose of this academic work was to develop a model for the integration of spiritual care-giving into the nursing curriculum. This cross-sectional study used adapted modified Intervention Mapping (IM) strategies with a mixed method approach, to collect in-depth information.
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Davison, Graydon, University of Western Sydney, College of Law and Business und School of Management. „Innovative practice in the process of patient management in palliative care“. THESIS_CLAB_MAN_Davison_G.xml, 2005. http://handle.uws.edu.au:8081/1959.7/498.
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This thesis examines the management of multidisciplinary teams in a highly innovative environment through a study of multidisciplinary patient care teams in palliative care. It investigates management that enables spontaneous innovation where necessary, yet maintains discipline and compliance with legislation, regulation and policy. To assist the explanation a model of palliative care multidisciplinary team management and operation is developed, building on work described in the continuous innovation and organisational configuration literatures. This thesis describes innovative practices as focusing on changing the organisation’s social potential, when necessary, in order to match changes in an individual patient’s situation. A definition of innovation suitable to this environment is developed here, adapted from the innovation literature. A definition of social potential suitable to this environment is also developed, based primarily in the literature of the socialisation of organisations. In palliative care organisations, care is delivered to the patient and any group of people supporting the patient during the end of life process. Care provided to these supporters, referred to in this thesis as patient-based carers, can extend beyond the death of the patient. Palliative care is more than symptom management during the dying process and can involve an interaction lasting weeks or months between the organisation and patients and patient-based carers. A patient’s situation is described at many levels and involves a number of aspects of the patient’s condition and life; for example medical, social, psychosocial, spiritual and physical. In palliative care, patients and patient-based carers are the major sources of information about their situation and changes to it. This makes them active participants in the care team, although some patients and patient-based carers choose not to take this role. Every patient and every group of patient-based carers creates individualised situations when progressing through their end of life processes, requiring individualised care from teams that can change the membership mix to suit the situation. Palliative care professionals can be members of multiple individual patient care teams simultaneously and teams can include heads of discipline (managers). Multidisciplinary palliative care teams can be managed from inside or outside the team, as the situation requires. Uncertainty pervades this environment and the response is flexibility based in learning and understanding. From the model developed of the management of innovation in the palliative care environment implications for the management of multidisciplinary teams in a highly innovative environment are drawn.Doctor of Philosophy (PhD)
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Berglund, Malin, und Maria Kostecka. „Patientcentrerad vård och helhetssyn i vården - skiljer sig begreppen? : En litteraturstudie“. Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-142806.
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SAMMANFATTNING Begrepp som patientcentrerad vård och helhetssyn i vården verkar användas av olika yrkeskategorier, inom hälso- och sjukvård, vilket kan ur kvalitetssynpunkt kan resultera i oklarheter inom den kliniska verksamheten. Syfte: Syftet med studien var att ta reda på vilka likheter och skillnader begreppen patientcentrerad vård och helhetssyn i vården har i den vetenskapliga litteraturen. Begreppen söktes i databaserna CINAHL och PubMed. Metod: Den metod som används för att jämföra begreppen byggde på Segestens begreppsanalysmodell. Resultat: Det som främst skiljer begreppet helhetssyn i vården från patientcentrerad vård är den andliga dimensionens centrala roll. Resultatet visar även att ett patientcentrerat arbetssätt förbättrar ekonomiska resultat. Det är främst sjuksköterskor som använder sig av helhetssyn i vården. Patientcentrerad vård verkar användas främst av läkare men begreppet förekommer även bland sjuksköterskor. Det gemensamma för begreppen då det gäller karaktäristika, förutsättningar och konsekvenser, är det som definieras i kraven på god vård enligt hälso- och sjukvårdslagen. Slutsats: sjukvårdspersonalens arbetssätt och syn på patienten utifrån patientcentrerad vård och helhetssyn i vården värnar om patientens bästa. Det som skiljer begreppen kan bero på vilken yrkesgrupp som undersökts i respektive studie. Studier av begreppet patientcentrerad vård uppfattas vara mer genomförda på läkargruppen samtidigt som helhetssyn i vården tycks vara mer förekommande då det gäller sjuksköterskegruppen. Fler studier behövs för att identifiera användningen av dessa begrepp och om deras betydelse i den kliniska verksamheten.SUMMARY Concepts such as patient-centered care and holistic care seem to be used by different professions in healthcare. Looking upon these concepts from the aspect of quality, ambiguities can arise in clinical practice. Objective: The purpose of this study was to compare the similarities and differences between the concepts of patientcentered care and holistic care as they are presented in scientific literature. The terms were searched for in the databases CINAHL and PubMed. Method: The method used to compare the concepts was based on Segesten concept analysis model. Results: what differentiates the concept of holistic care of the patient-centered care is the central role of spiritual dimension. The results also show that a patient-centered care improves economic results. The term holistic health care seems to be used primarily by nurses, while patient-centered care seems to be used primarly by physicians, even though the term does occur among nurses. Conclusion: both patient-centered care and holistic care seem to have the same goal, that of preserving the patient`s best interests. What distinguishes the concepts may depend on the profession which was examined in each study. Research studies on patient-centered care have been carried out primarily on physicians, while studies on the holistic approach in health care have focused on nurses. More studies are needed to identify the use of these concepts and their importance in clinical practice. Nyckelord: Patient-centeredness, patient-centered care, holistic care, holistic nursing.
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Ward, Beverly S. „Attitudes and Beliefs of Registered Retired and Registry Nurses Regarding Holistic Spiritual Care“. ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1949.
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The purpose of holistic spiritual care is to assess and provide for the spiritual needs of patients. Current literature indicates that holistic spiritual care is important to the healthcare of patients. Researchers suggest that nurses who practice holistic spiritual care are more aware of the attributes of caring, respect, and emotional support. This project study addressed a problem at the research site reported by local community nurses and holistic spiritual care experts of nurses not practicing holistic spiritual care. Mezirow's transformational learning theory was used as the theoretical foundation for this qualitative study, which was designed to examine the attitudes and beliefs of nurses about practicing holistic spiritual care. The study's participants were comprised of a mixed-gender convenience sample of 21 local registered nurses, aged 22 to 64, who were retired or who worked for a registry, and were recruited on Facebook to participate in a qualitative online questionnaire. Hand and computerized open coding and thematic analysis were used to analyze the data. Participants indicated that they believed practicing spiritual care nursing was beneficial as it could improve patient outcomes. The themes that emerged from the data included personal insecurities of nurses, little support, and lack of training in practicing spiritual holistic care. These findings were used to develop a 3-day workshop series designed to increase awareness and improve understanding of the benefits of holistic spiritual care of nurses, nurse educators, nurse leaders, and administrators. This study promotes positive social change by providing healthcare stakeholders at the local site with better understandings of the benefits of holistic spiritual care programs.
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Bäcklund, Anna-Lena, Susanne Näslund und Hylander Annika Torebrink. „Uttryck för lidande inom omvårdnad“. Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-23648.
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Lidande är en naturlig och oundviklig del av det mänskliga livet. En av de mest centrala uppgifterna inom vården innebär att lindra lidande. Därmed är det aktuellt att undersöka områdets kunskapsposition. Syftet var att beskriva lidande i omvårdnadStudien genomfördes som en litteraturstudie där 15 vetenskapliga artiklar utgjorde underlaget för resultatet. Resultatet i denna studie delades in i sex tema inom omvårdnad: ”Existentiellt lidande”, ”Livslidande”, ”Sjukdomslidande”, ”Vårdlidande”, ”Den vårdande personalens upplevelser av lidande” och ”Socioemotionellt lidande”. Studien visar att forskning i nutid på många sätt beskriver uttryck för patientens lidande i liknande former som det lidande som beskrivits i forskning tidigare. Utöver detta framkommer även beskrivningar av lindrande av lidande inom omvårdnad. Det framkommer att fokus i vården tenderar att ligga främst på att behandla fysiska symptom. En helhetssyn, där även existentiella, psykologiska, kulturella och sociala dimensioner uppmärksammas, är nödvändig för att förbättra patientens hälsa och minska patientens lidande.För att kunna möta patienten i lidandet krävs medvetenhet hos sjuksköterskan kring egna upplevelser av lidande. Fortsatt forskning samt belysning av området i sjuksköterskeprogrammet är betydelsefullt.Suffering is a natural and inevitable part of human life. One of the central parts in health care is to alleviate suffering. Consequently, the present knowledge state is of importance to follow up. The aim of this study was to describe suffering in nursing. The study was conducted as a literature review were 15 scientific articles were the basis for the results. The result of this literaturereview was divided into six themes in nursing: "Existential suffering", "Suffering in life", “Suffering in illness", "Suffering in care", "Socioemotional suffering" and ”Perceptions of suffering in nursing staff." Expressions of suffering of the patient are found to be found similar in recent studies compared to the suffering described in research further back. Recent studies additionally indicate other expressions of suffering and approaches to alleviate suffering in nursing. It emerges that the focus in care tends to be primarily focused on treatment of physical symptoms. A holistic focus, with awareness of existential, psychological, cultural and social dimensions, is necessary to promote health and to alleviate suffering. To respond to the patient in its suffering, awareness of the nurse’s own experiences of suffering is required. Further research and illumination of the subject in the nursing program is of importance.
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Philip, Neena S. „Exploring holistic nurse manager roles with new patient satisfaction dimensions and expectations“. Thesis, University of Phoenix, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3648302.
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The health care environment is transforming with new demands and expectations to improve patient outcomes including patient satisfaction. Health care organizations expect front line nurse managers to improve patient quality and satisfaction without a clear direction or meaningful understanding of the holistic role, functions, and competencies required to achieve organizational goals. The purpose of the qualitative transcendental phenomenological study was to explore the lived experiences and perceptions of the holistic and changing nature of the projected contemporary nurse manager’s roles, skills, practices, and dimensions aligned with the expectations for improving patient satisfaction. The exploration of the lived experiences and perceptions among 21 study participants, and data analysis using the modified van Kaam approach, led to the formulation of eight major themes that explained the nature of the experience with the phenomenon. The eight essential themes that encompass the context of the new contemporary and holistic role of the nurse manager to improve patient satisfaction include the following; (a) new expectations, (b) building a patient caring culture, (c) leader rounding, (d) healthy working environment, (e) staff engagement and empowerment, (f) change agent for continuous quality improvement, (g) impact of organization focus and culture, (h) challenges: sustainability of initiatives; lack of interdepartmental and interdisciplinary teamwork. The new proposed nurse manager role in transformation conceptual model aligns nurse manager contemporary and holistic role with transforming cultures for improved patient outcomes. The study findings are significant to health care organization, leaders, policy makers, and educators, in creating new patient caring and healthy working cultures for improved patient satisfaction.
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Berglund, Anna-Lena. „A holistic view of urinary stress incontinence in women“. Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 1995. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96892.
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The present study group consists of 45 women with genuine stress incontinence who were selected for surgical treatment and randomized either to retropubic urethrocystopexy (n=30) or pubococcygeal repair (n=15). The preoperative assessment included medical history, gynecological examination, urine analysis and culture, residual urine, pad test, frequency-continence charts, water urethrocystoscopy, continence test and cystometry with analysis of micturition. Moreover, five semistructured interviews were performed with the women and two with their partner. The following questionnaires were used measuring a) personality characteristics: Karolinska Scales of Personality (KSP), Eysenck Personality Inventory (EPI), b) depression: Beck Depression Inventory (BDI) and c) social support: Interview Schedule for Social Interaction (ISSI). The results have shown that there was no difference in the subjective cure rate between the two surgical methods (73% vs. 80 % respectively). The bladder volume had increased in both groups and the intravesical pressure of the bladder filled to maximum had increased in the pubococcygeal repair group. Other urodynamic variables were unchanged by the operation. Pad tests have demonstrated that 67 % of the women in the urethrocystopexy group and 47 % in the pubococcygeal repair group ceased to leak urine. Postoperatively, 63 % of the women in the urethrocystopexy group needed high doses of analgesics compared with only 33 % in the pubococcygeal repair group. Among the women experiencing severe to very severe pain dysphoric subjects were overrepresented. Postoperative residual urine was a minor nursing problem in both groups. Women with SUI of long duration scored significantly higher than controls on the KSP scales of somatic anxiety, psychic anxiety, psychasthenia, suspicion and on the EPI lie-scale. There was no significant difference in sexual activity before and after surgery. One or two sexual dysfunctions within the desire, excitement, orgasmic and resolution phase were reported by the majority of women both before and after surgical intervention. The cured women reported a higher level of overall activities before surgery than the improved (i.e. not cured) women, whereas post surgery both the cured and the improved women obtained about the same level of activities. Regarding social support, no differences between the cured or improved women occured as concerns attachment. The cured women showed a higher degree of adequacy of social integration compared with the improved women. In order to delineate predictive factors for the surgical outcome the following variables were investigated: age of patient, duration of urine leakage, parity, personality, psychological and social factors. The following predictors of the outcome of surgical treatment emerged: duration of stress incontinence, neuroticism and age of patient. The results of the present study indicate the ecessity of a multidisciplinary approach to the treatment and nursing of women with SUI.Diss. (sammanfattning) Umeå : Umeå universitet, 1995
digitalisering@umu
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Schafer, Maureen Lucy. „Assessing Soldiers' Wellness Holistically: An Evaluation of Instruments Applicable to Primary Care“. Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/228180.
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Increasingly, experts recommend that military primary care clinics consider implementing delivery of care based on models of holistic wellness. Several wellness measurement tools exist, but none of these has been applied to a military primary care clinic. In this study, the psychometric testing of two holistic wellness measurement instruments was carried out for possible use with soldiers in primary care clinics. The instruments tested were the Perceived Wellness Model (Adams, Bezner, & Steinhardt, 1998) and the Optimal Living Profile (Renger et al., 2000). Both instruments appear suitable for use in future studies for measuring wellness in Cadet Soldiers. The measures provided by these instruments provide important data that professionals can use to assist young Soldiers in their multidimensional wellness development.
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Davison, Graydon. „Innovative practice in the process of patient management in palliative care“. Thesis, View Thesis, 2005. http://handle.uws.edu.au:8081/1959.7/498.
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This thesis examines the management of multidisciplinary teams in a highly innovative environment through a study of multidisciplinary patient care teams in palliative care. It investigates management that enables spontaneous innovation where necessary, yet maintains discipline and compliance with legislation, regulation and policy. To assist the explanation a model of palliative care multidisciplinary team management and operation is developed, building on work described in the continuous innovation and organisational configuration literatures. This thesis describes innovative practices as focusing on changing the organisation’s social potential, when necessary, in order to match changes in an individual patient’s situation. A definition of innovation suitable to this environment is developed here, adapted from the innovation literature. A definition of social potential suitable to this environment is also developed, based primarily in the literature of the socialisation of organisations. In palliative care organisations, care is delivered to the patient and any group of people supporting the patient during the end of life process. Care provided to these supporters, referred to in this thesis as patient-based carers, can extend beyond the death of the patient. Palliative care is more than symptom management during the dying process and can involve an interaction lasting weeks or months between the organisation and patients and patient-based carers. A patient’s situation is described at many levels and involves a number of aspects of the patient’s condition and life; for example medical, social, psychosocial, spiritual and physical. In palliative care, patients and patient-based carers are the major sources of information about their situation and changes to it. This makes them active participants in the care team, although some patients and patient-based carers choose not to take this role. Every patient and every group of patient-based carers creates individualised situations when progressing through their end of life processes, requiring individualised care from teams that can change the membership mix to suit the situation. Palliative care professionals can be members of multiple individual patient care teams simultaneously and teams can include heads of discipline (managers). Multidisciplinary palliative care teams can be managed from inside or outside the team, as the situation requires. Uncertainty pervades this environment and the response is flexibility based in learning and understanding. From the model developed of the management of innovation in the palliative care environment implications for the management of multidisciplinary teams in a highly innovative environment are drawn.
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Gunnar, Ulrika, und Sahra Lindman. „Att leva med venösa bensår : en kvalitativ intervjustudie om patienters upplevelser“. Thesis, University of Skövde, School of Life Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-3505.
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I Sverige lider ca 50 000 personer av bensår vilket definieras som ”sår på ben och/eller fot nedom knät som ej läkt på 6 veckor”, ungefär hälften av dessa är venösa bensår. De flesta som drabbas av bensår är 65 år eller äldre. Syftet med denna studie var att beskriva patienters upplevelse av att leva med venösa bensår. Studien är baserad på en kvalitativ metod med en induktiv ansats. Data samlades in genom intervjuer från sex patienter och analyserades sedan med hjälp av innehållsanalys. Resultatet baseras på två kategorier; begränsat och bundet liv samt önskan att bli sedd. Dessa kategorier bildade temat; att vara hel men ändå inte. Utifrån denna studie kan personal som vårdar och behandlar bensårspatienter få ökad kunskap om hur patienter upplever att det är att leva med venösa bensår. Med hänsyn till detta vore det önskvärt att effektiva och välstrukturerade vårdrutiner utarbetas för att uppnå helhetssyn inom vården och behandlingen av bensårspatienter.
Approximately 50 000 people in Sweden are suffering from leg ulcers which is defined as "wounds on the legs and/or foot below the knee, which is not healed in 6 weeks", about half of them are venous leg ulcers. Most people who suffer from leg ulcers are 65 years or older. The purpose of this study was to describe patients' experiences of living with venous leg ulcers. The study is based on a qualitative method with an inductive approach. Data were collected through interviews from six patients and analyzed with help of content analyzing. The results are based on two different categories: limited and restricted life, and desire to be seen. These categories formed the theme; to be whole but still not. Based on this study, staff who care for and treat leg ulcer patients can increase knowledge about how patients feel it is to live with venous leg ulcers. Given this, it would be desirable that there are effective and well-structured care practices designed to achieve holistic healthcare and treatment of patients with leg ulcers.
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Lea, Dorothy University of Ballarat. „Spiritual awareness of professional nurses in the western region of Victoria: Investigation of a significant component of holistic heath care“. University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12789.
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A desire to more fully understand the impact of altered states of spiritual health on the general health of patients has been a focus of recent research activity. Studies have explored the meaning of spirituality held by patients and nurses, the spiritual needs of patients, and methods of providing spiritual care in nursing. However, few studies have investigated nurses’ own spiritual health and the significance this may have on the provision of holistic nursing care. The aim of this study, therefore, was to inform nursing regarding the spiritual health of nurses and the influence that nurses’ own spiritual health has on their ability to provide holistic nursing care to their patients. The study was conducted in two phases using both quantitative and qualitative methodologies. Phase one consisted of a survey of Division 1 nurses currently employed in the Grampians region of Victoria to describe key dimensions of their spiritual health. This survey provided biographical data and, through the use of the “Shalom Measure of Spiritual Health”, discovered the ideal of spiritual health held by nurses as well as the nurses’ perception of patient needs pertaining to the achievement of spiritual health. Phase two utilised Naturalistic Inquiry to further explore the meaning of spirituality and spiritual health held by nurses, and the methods of achieving these for nurses and patients. The findings revealed that although nurses perceive the spiritual dimension of patient care to be important, they feel ill-equipped to provide this aspect of care. In addition, the major support for nurses, who themselves experience spiritual distress whilst at work, comes from colleagues. Further, prevailing health care systems in place do not always lend themselves to holistic approaches to care. This study identifies the need for nurse education to redress the clearly inadequate preparation nurses are given for this aspect of their role. Health care policy-makers and administrators also have a responsibility to consider all dimensions of care when designing and implementing health care guidelines and systems.Master of Nursing
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Farias, Francisca SÃnia de Andrade Braga. „FormaÃÃo holÃstica do enfermeiro:realidade e desafios“. Universidade Federal do CearÃ, 2005. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=340.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorO estudo trata da necessidade de rever os princÃpios que embasam e dÃo vida à cultura dos cursos de graduaÃÃo dos futuros profissionais de enfermagem. As questÃes norteadores foram: Jà que cobramos dos nossos discentes um cuidar holÃstico para os pacientes, serà que estamos oferecendo esta formaÃÃo nos cursos de graduaÃÃo? Como vem sendo trabalhada esta formaÃÃo no currÃculo de graduaÃÃo? A tese que defendemos à que a formaÃÃo do enfermeiro à holÃstica se contemplar o tripà equilÃbrio, inclusÃo e conexÃo, bases fundamentais para a educaÃÃo holÃstica. Este estudo tem como objetivo maior investigar as evidÃncias que caracterizam a abordagem holÃstica na formaÃÃo do enfermeiro. Para alcanÃÃ-lo, optamos por um estudo exploratÃrio e descritivo, realizado nos cursos de graduaÃÃo de enfermagem das cinco instituiÃÃes de ensino superior (IES) do Estado do Cearà nas cidades de Fortaleza, Crato e Sobral, onde os dados foram coletados por meio de questionÃrios aplicados no perÃodo de setembro a dezembro de 2003. As bases da construÃÃo dos questionÃrios foram a abordagem holÃstica e a ResoluÃÃo CNE/CES n 3, de 7/11/2001, artigo 3Â, parÃgrafo 1 das Diretrizes Curriculares Nacionais para o Curso de GraduaÃÃo em Enfermagem. A amostra foi composta por 124 concludentes dos cinco cursos de enfermagem, representando 71,3% da populaÃÃo original de 177 graduandos. Consideramos somente os concludentes pelo fato de jà terem acumulado os conhecimentos e experiÃncias oferecidas pelos cursos. Fizeram ainda parte da nossa amostra as cinco coordenadoras dos cursos. Os dados foram analisados utilizando-se o software Statistical Package for the Social Sciences, estando apresentados em tabelas, figuras e nas falas dos componentes da amostra pesquisada. Utilizamos como referencial central o canadense J. P. Miller. Segundo percebemos, o currÃculo obedece ao que à preconizado pela lei. O aluno recebe uma visÃo geral do que estabelecem as diretrizes curriculares; mas, quando relacionamos as respostas afirmativas dos itens sim/nÃo dos questionÃrios Ãs suas justificativas, observamos a insatisfaÃÃo do aluno no respeitante Ãs experiÃncias de aprendizagem. Aqui jà podemos perceber a dificuldade do processo ensino-aprendizagem em conectar teoria e prÃtica, as experiÃncias vivenciadas com os conhecimentos adquiridos anteriormente, enfim, o sentido de sua formaÃÃo. Embora o sim prevaleÃa em todas as respostas, evidenciando uma formaÃÃo coerente conforme preconizado, as falas mostram que a formaÃÃo à fragmentada, tecnicista, e nÃo atende Ãs necessidades da populaÃÃo. Prepondera ainda a transmissÃo de conhecimentos e um discurso desconectado da prÃtica. Daà considerarmos que estamos formando nossos discentes ainda dentro de uma base atomista tendente ao pragmatismo. Como enfatizam as coordenadoras dos cursos a respeito da formaÃÃo holÃstica do enfermeiro, se reconhece a necessidade da formaÃÃo holÃstica, mas hà dificuldades e limitaÃÃes; se incentivam, proporcionam oportunidades, mas estas palavras nÃo traduzem algo de concreto, de real. A partir dos resultados obtidos, esboÃamos sugestÃes para serem revistos os valores que fundamentam a educaÃÃo holÃstica, principalmente a partir da preparaÃÃo de formadores e professores, no tratamento das experiÃncias de ensino-aprendizagem que devem se revestir de significado humano em todas as suas dimensÃes e na preocupaÃÃo em construir a cultura para a vivÃncia holÃstica na formaÃÃo do enfermeiro. Esta vivÃncia deve estar centrada num enfoque transdisciplinar expresso pelo conceito da conectividade entre os fatores envolvidos no processo ensinar-aprender-cuidar.
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Lea, Dorothy. „Spiritual awareness of professional nurses in the western region of Victoria: Investigation of a significant component of holistic heath care“. Thesis, University of Ballarat, 2005. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/40615.
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A desire to more fully understand the impact of altered states of spiritual health on the general health of patients has been a focus of recent research activity. Studies have explored the meaning of spirituality held by patients and nurses, the spiritual needs of patients, and methods of providing spiritual care in nursing. However, few studies have investigated nurses’ own spiritual health and the significance this may have on the provision of holistic nursing care. The aim of this study, therefore, was to inform nursing regarding the spiritual health of nurses and the influence that nurses’ own spiritual health has on their ability to provide holistic nursing care to their patients. The study was conducted in two phases using both quantitative and qualitative methodologies. Phase one consisted of a survey of Division 1 nurses currently employed in the Grampians region of Victoria to describe key dimensions of their spiritual health. This survey provided biographical data and, through the use of the “Shalom Measure of Spiritual Health”, discovered the ideal of spiritual health held by nurses as well as the nurses’ perception of patient needs pertaining to the achievement of spiritual health. Phase two utilised Naturalistic Inquiry to further explore the meaning of spirituality and spiritual health held by nurses, and the methods of achieving these for nurses and patients. The findings revealed that although nurses perceive the spiritual dimension of patient care to be important, they feel ill-equipped to provide this aspect of care. In addition, the major support for nurses, who themselves experience spiritual distress whilst at work, comes from colleagues. Further, prevailing health care systems in place do not always lend themselves to holistic approaches to care. This study identifies the need for nurse education to redress the clearly inadequate preparation nurses are given for this aspect of their role. Health care policy-makers and administrators also have a responsibility to consider all dimensions of care when designing and implementing health care guidelines and systems.Master of Nursing
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Lea, Dorothy. „Spiritual awareness of professional nurses in the western region of Victoria: Investigation of a significant component of holistic heath care“. University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/14624.
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A desire to more fully understand the impact of altered states of spiritual health on the general health of patients has been a focus of recent research activity. Studies have explored the meaning of spirituality held by patients and nurses, the spiritual needs of patients, and methods of providing spiritual care in nursing. However, few studies have investigated nurses’ own spiritual health and the significance this may have on the provision of holistic nursing care. The aim of this study, therefore, was to inform nursing regarding the spiritual health of nurses and the influence that nurses’ own spiritual health has on their ability to provide holistic nursing care to their patients. The study was conducted in two phases using both quantitative and qualitative methodologies. Phase one consisted of a survey of Division 1 nurses currently employed in the Grampians region of Victoria to describe key dimensions of their spiritual health. This survey provided biographical data and, through the use of the “Shalom Measure of Spiritual Health”, discovered the ideal of spiritual health held by nurses as well as the nurses’ perception of patient needs pertaining to the achievement of spiritual health. Phase two utilised Naturalistic Inquiry to further explore the meaning of spirituality and spiritual health held by nurses, and the methods of achieving these for nurses and patients. The findings revealed that although nurses perceive the spiritual dimension of patient care to be important, they feel ill-equipped to provide this aspect of care. In addition, the major support for nurses, who themselves experience spiritual distress whilst at work, comes from colleagues. Further, prevailing health care systems in place do not always lend themselves to holistic approaches to care. This study identifies the need for nurse education to redress the clearly inadequate preparation nurses are given for this aspect of their role. Health care policy-makers and administrators also have a responsibility to consider all dimensions of care when designing and implementing health care guidelines and systems.Master of Nursing
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Ayon, Mary Alice. „The Effects of Holistic Coping Strategies on Perceived Stress and Absenteeism in Hospital Nurses“. ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/49.
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The demanding work environments of professional nurses often contribute to high levels of stress that impact their professional practice and well-being. Although there is a significant amount of research regarding stress and absenteeism, a gap in the literature exists about the effects of holistic coping strategies on nurses' perceived stress and absenteeism. Based on the biopsychosocial model, the purpose of this quantitative study was to investigate effects of holistic coping strategies on perceived stress and absenteeism in 128 hospital nurses. An online cross-sectional survey design used the Perceived Stress Scale-10 to measure nurses' perceptions of stress. The independent grouping variable was self-reported use of meditation, massage, or exercise. Absenteeism data were collected using nurses' attendance records provided by the hospital nursing administration office. Multiple linear regression analysis and t tests were significant for increased absenteeism with the use of meditation, but showed no change in absenteeism with massage or exercise. There was no significant relationship found between use of massage, meditation, or exercise, and perceived stress. Consideration of these findings may be of interest to hospital administrators in addressing perceived stress and absenteeism in nursing personnel. Positive social change is achieved for society, community, and the individual by preventing burnout and by addressing the financial and attendance issues related to nurse shortages in hospitals.
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Davison, Graydon. „Innovative practice in the process of patient management in palliative care“. View Thesis, 2005. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20051025.104715/index.html.
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SOUZA, Marcus Antonio de. „A influência da fé no processo saúde-doença sob a percepção de líderes religiosos cristãos“. Universidade Federal de Goiás, 2009. http://repositorio.bc.ufg.br/tede/handle/tde/688.
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Previous issue date: 2009-03-30Expressions of faith, reverence in divinity, religious movements, have always been part of human history, affecting over time the social organizations, political and cultural civilizations. These practices also interfered in ways to understand and take care of health. Human beings, in their context of health and disease if appropriate of all the resources and knowledge available in the search for relief and cure of diseases. The general aim of this study was to investigate the influence of faith in the individual in the health-disease process, from the point of view of religious leaders. We investigated the perceptions of religious leaders Catholics, Protestants and Spiritist about the concepts of health and disease, about the influence of faith in the health-disease process and the resources and practices adopted by them when they are sought by people seeking help for problems health. This is a work with a qualitative approach developed in the municipality of Trinidad-GO. Participated in the survey two priests, two shepherds and two presidents of kardecist houses spiritists. The individual interview was used for data collection and the words were recorded, transcribed and then analyzed using the method of interpretation of meanings. The study was approved by an ethics committee, as recommended by the Resolution 196/96 of the National Health Councilor. The data were organized on four categories: a) The understanding of humanbeing and health, which discussed the entirety of the person and harmony between the spiritual and biopsicosociais aspects to have health. b) Multidimensional perceptions about disease, which were discussed different perceptions about the origin and forms of manifestation of disease, social inequalities and consensus as to negligence in care for the body c) Resources and practices used to benefit health, which were detected as resource a prayer, oil, water, salt and how practices adopted by the leaders, the reception, guidance, referrals and blessings d) The influence of the religious leader and the faith in the context health and disease of the person, evidenced that people seeking the means to religious and spiritual comfort find health care, brotherhood, love and affection. The leader encourages the hope and faith in God. It concluded among other things, that the faith of the person in a state of suffering influence in the process of recovery and healing and the maintenance of health. The science needs to get closer to religion in order to broaden the knowledge and ways of understanding and care of human beings.
Manifestações de fé, reverências a Divindades, movimentos religiosos, sempre fizeram parte da história da humanidade, influenciando ao longo do tempo as organizações sociais, políticas e culturais das civilizações. Essas práticas também influenciaram nos modos de entender e cuidar da saúde. O ser humano, em seu contexto de saúde e doença se apropria de todos os recursos e saberes disponíveis na busca de alívio e cura de doenças. O objetivo geral deste estudo foi investigar a influência da fé do indivíduo no processo saúde-doença, a partir do ponto de vista de líderes religiosos. Foram investigadas as percepções de líderes religiosos católicos, protestantes e espíritas sobre os conceitos de saúde e de doença; sobre a influência da fé no processo saúde-doença e sobre os recursos e práticas por eles adotadas quando são procurados por pessoas que buscam ajuda para problemas de saúde. Estudo com abordagem qualitativa desenvolvido no município de Trindade GO, do qual participaram padres, pastores e dirigentes de casas espíritas Kardecistas. A entrevista individual foi utilizada para a coleta dos dados e as falas foram gravadas, transcritas e posteriormente analisadas usando-se o método de Interpretação de Sentidos. O trabalho foi aprovado por um Comitê de Ética, tal como recomenda a Resolução 196/96 do Conselho Nacional de Saúde. Os dados foram organizados em quatro categorias: a) Os entendimentos sobre ser humano e saúde, na qual se discutiu a integralidade da pessoa e a harmonia entre os aspectos biopsicosociais e espirituais para se ter saúde. b) Percepções multidimensionais sobre doença, onde foram abordadas diferentes percepções quanto à origem e formas de manifestação das doenças, as desigualdades sociais e o consenso quanto à negligência em relação aos cuidados com o corpo c) Recursos e práticas utilizadas em benefício da saúde, onde foram detectados como recursos a oração, o óleo, a água, o sal e como práticas adotadas pelos líderes, o acolhimento, as orientações, encaminhamentos e bênçãos; d) A influência do líder religioso e da fé no contexto saúde-doença da pessoa, evidenciou que as pessoas que buscam o meio religioso para conforto espiritual e saúde encontram atenção, fraternidade, carinho e amor. O líder instiga a esperança e a fé em Deus. Concluiu-se entre outros aspectos, que a fé da pessoa em situação de sofrimento influencia de maneira importante no seu processo de recuperação e cura, bem como na manutenção da saúde. A ciência precisa se aproximar da religião de modo a ampliar os conhecimentos e as formas de entender e cuidar do ser humano.
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Olin, Josefine, und Hanna Tunér. „Sjuksköterskans användande av sin kompetens inom Rättspsykiatrisk slutenvård“. Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-54102.
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Bakgrund: Sjuksköterskan inom den rättspsykiatriska vården ser sitt arbete som mångfacetterat. I tidigare forskning framkommer de förväntade kompetenserna hos sjuksköterskan inom rättspsykiatri och även kompetensbeskrivningen beskriver vilka kompetenser sjuksköterskan förväntas besitta. Syfte: Syftet är att utifrån ett sjuksköterskeperspektiv beskriva användandet av sjuksköterskans kompetens inom rättspsykiatrisk slutenvård. Metod: Datainsamlingen skedde genom semistrukturerade intervjuer med nio sjuksköterskor på en rättspsykiatrisk klinik i Mellansverige. Analysen har genomförts med en kvalitativ innehållsanalys och har induktiv ansats. Resultat: I resultatet framkom sjuksköterskans användning av sin kompetens och hur verksamheten tar tillvara på denna kompetens. Det resulterade i fyra kategorier: Att ha ett helhetsperspektiv, att ha kunskaper som inte efterfrågas, att behöva driva sin egen utveckling samt att ha behov av varandra för gemensam utveckling. Slutsats: Sjuksköterskan får till viss del använda sin kompetens, men för att sjuksköterskan ska uppleva att dennes kompetens används och tas tillvara i högre grad är det av vikt att låta sjuksköterskans omvårdnadskompetens ta större plats.Background: Nurses in forensic psychiatric care see their work as multifaceted. In previous research, the expected competencies of the nurse in forensic psychiatry emerge, and the competency description also describes which competencies the nurse is expected to possess.Aim: The aim is to describe the use of the nurse's competence in forensic psychiatric inpatient care from a nurse's perspective. Method: Data collection took place through semi- structured interviews with nine nurses at a forensic psychiatric clinic in central Sweden. The analysis has been carried out with a qualitative content analysis and has an inductive approach. Results: The result showed the nurse's use of the competence and how the workplace makes use of this competence. It resulted in four categories: To have a holistic perspective, to have knowledge that is not requested, a need to drive their own progress and having a need for each other to improve. Conclusion: The nurse may, to a certain extent, use her competence. But in order for the nurse to feel that his or her competence is used and utilized to a greater degree, it is important to allow the nurse's nursing competence to take greater place.
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Hermansson, Carolin, und Peter Lindberg. „Sjuksköterskans upplevelse av att vårda patienter vid livets slut i hemmiljö“. Thesis, Röda Korsets Högskola, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-50.
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Bakgrund: Att vårdas hemma vid livets slut blir allt vanligare. De senaste 10-15 åren har behovet av avancerade vårdinsatser i hemmet alltjämt ökat och möjligheterna att vårda patienter med komplicerade sjukdomstillstånd har blivit mer möjliga. Detta har medfört att kraven på de såväl medicinska som de specifikt omvårdnadsmässiga åtgärderna har växt. Syfte: Syftet med denna studie var att belysa ASIH- sjuksköterskors upplevelse av att vårda patienter i hemmet vid livets slut. Metod: Studien har en kvalitativ och deskriptiv ansats. Två sjuksköterskor från en ASIH:enhet i Stockholm intervjuades. En innehållsanalys gjordes sedan för att analysera det insamlade materialet. Resultat: Tretton subkategorier kunde urskiljas ur dessa bildades fem kategorier. Kunskap och erfarenhet grund till god omvårdnad, Närståendes betydelse i vården, Kommunikation och förståelse mellan patient och sjuksköterska, Ta seden dit man kommer och Personal cost of caring. Slutsats: Sjuksköterskan inom ASIH bär ett stort ansvar då det gäller symtomlindring. Det kan gälla smärta såväl som oro och ångest. Vikten av att ha en helhetssyn som innefattar både patient och närstående beskrevs som viktiga. Ett fungerande samspel mellan sjuksköterska, patient och närstående är en förutsättning för god omvårdnad.Background: To be cared for at home at the end of life is becoming more common. The last 10-15 years, the need for advanced care in the home has increased and the possibility to treat patients with complex medical conditions has become more possible. This has led to higher medical demands and to higher demands concerning specific nursing activities. Aim/Objective: The purpose of this study was to illuminate the ASIH-nurses' experience of treating patients at home at the end of life. Design: The study has a qualitative and descriptive approach. Two nurses from one ASIH unit in Stockholm were interviewed. A content analysis was then used to analyze the material. Result: Thirteen subcategories could be distinguished those formed five categories. Knowledge and experience due to good care, Significant others and their part in the caringprocess, Communication and understanding between patient and nurse, To adapt to customs and Personal cost of caring. Findings: The nurse within the advanced homecare facility bears a great responsibility when it comes to symptom relief. It may be relief of pain as well as anxiety. The importance of having a holistic approach that includes both patient and relatives were described as important. A good interaction between nurses, patients and relatives is a prerequisite for good care.
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Lagerquist, Maud. „Sångens betydelse i det vårdande mötet med den äldre människan : en litteraturstudie“. Thesis, Röda Korsets Högskola, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-24.
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Studien ville visa på sångens möjligheter i vårdandet. Med en växande äldre population i västvärlden, blir sökandet efter nya evidenta och effektiva vårdinterventioner viktiga. Sången tar med hela människan i vårdandet på människans villkor. En kvalitativ litteraturstudie genomfördes med tio vetenskapliga artiklar till grund. Innehållsanalysen resulterade i tre teman; Sången skänker medgång i samverkan, Sången genererar förhöjd livskvalitet samt Sången tangerar patientens livsvärld. Resultatet visar på att individen känner sig betydelsefull och delaktig i omvårdnaden. Sången är en evident och lättillgänglig omvårdnadsintervention som tar med hela människan på hennes villkor. Sången värnar samtidigt om människans värdighet, vilket kan leda till lindrande av hennes lidande. Människan sjunger från vaggan till graven i alla kulturer och formas där av sångens betydelse. Sången ryms i minnet, och styr människan att visa påverkan vid sångaktivitet. Detta leder ofta vidare till en djupare samvaro med ökad samverkan.The study wanted to show the song possibilities in caregiving situations. With a growing elderly population in the western world, the searches for new and effective health interventions are important. The study shows that the use of song in caregiving is an evident and accessible care intervention for reaching the older person. Using the song in caregiving is an evident and accessible approach which includes the whole person on her condition. A qualitative literature study was conducted based on ten scientific articles. Content analysis resulted in three themes; the song brings success in collaboration, the song generates an increased quality of life and the song touches the patient's life world. The result shows that the individual feel involved, significant and protected in her dignity, which is a relief in suffering. Humans sing from the cradle to the grave in all cultures and it is in young years that she is formed of the songs meaning. The song fits in memory, and directs man to show the influence of singing activity. This often leads to a deeper understanding and increased interaction.
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Paskausky, Anna L. „Expert Nurses' Conceptualization of Healing“. Thesis, Boston College, 2015. http://hdl.handle.net/2345/bc-ir:104563.
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Thesis advisor: Callista RoyDespite the concept of healing being central to nursing, there has been a lack of conceptual clarity. This study sought to understand how expert nurses in practice conceptualize healing and how this conceptualization affects their practice. The sample consisted of 50 practicing nurses from multiple practice settings in an academic health system in Western Massachusetts. The study used a mixed method design using an electronic adaptation of the Delphi method. Findings from the study suggested a high level of consensus about the concept of healing in nursing. Qualitative data from the open-ended questions of Round 1 were coded into items about healing on subsequent quantitative surveys in Rounds 2 and 3. Participants ranked their level of agreement or disagreement with these statements. Ultimately, 49 statements met the a priori criteria for consensus as to what healing means from a nursing perspective. The overarching themes of statements were comprised of Nursing Actions to Promote Healing, Theoretical Understanding of Healing, Nurse Attributes to Promote Healing, Other Factors that Promote Healing, Types of Healing and Assessment of Healing. This study adds to the literature an exclusively nursing perspective on healing. The nursing-specific concept of healing synthesized from the data could be described as progression towards wholeness, with subjective and objective outcomes, promoted by the actions of nurses. The clarification of the concept of healing can inform research to create measurements for healing. It also can improve practice by articulating an existent conceptual framework, allowing nurses and administrators to better promote healing both directly and indirectly. Lastly, the results of this study offer students a simple yet accurate way of prioritizing nursing interventions
Thesis (PhD) — Boston College, 2015
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Nuñez, Helena Maria Fekete. „Terapias alternativas/complementares: o saber e o fazer das enfermeiras do distrito administrativo 71 - Santo Amaro-São Paulo“. Universidade de São Paulo, 2002. http://www.teses.usp.br/teses/disponiveis/7/7137/tde-25022008-104413/.
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Um novo paradigma - Holístico - vem revolucionando diversos campos do saber, especificamente na área da saúde, integrando os aspectos físicos, psíquicos, sociais e espirituais do ser humano e oferecendo fundamentos para o conhecimento e aplicação das terapias alternativas/ complementares (TA/C). Considerando a importância do enfermeiro no desenvolvimento das ações integrais da saúde, a autora fez um estudo exploratório prospectivo, com o objetivo de verificar o saber e o fazer das enfermeiras que atuam nas unidades municipais de Saúde do Distrito Administrativo 71 Santo Amaro - São Paulo, frente às TA/C. Aplicou questionário semi-estruturado, no período de junho a agosto de 2001, para todos os 18 enfermeiros, lotados em nove Unidades de Saúde. Numa abordagem quanti-qualitativa, analisou o perfil das enfermeiras e mostrou fatores que influenciam o saber e o fazer em terapias alternativas/ complementares; também apontou que existe uma grande aceitação e credibilidade por parte dos enfermeiros (89%), porém o escasso conhecimento do respaldo legal (22,2%) e cursos ou especializações nesta área (5,5%) restringem a sua prática. Cerca da metade dos enfermeiros (44,4%) busca para si mesma alguma prática, porém apenas 11,1% as aplica nos usuários/ clientes das unidades de saúde. A autora desvendou as percepções dos enfermeiros quanto à conceituação, facilidades e dificuldades institucionais e pessoais relativas às práticas, e considerou que há necessidade de se buscar novos saberes como opções de assistência à promoção da saúde da populaçãoA new paradigm - Holistic - is revolutionizing many fields of knowledge and, specifically at the health area, is integrating the physical, psychological, social and spiritual aspects of human being, offering foundations for the alternative or complementary therapies knowledge. Considering the nurse\'s importance for the development of health integral actions the author made an exploratory study aiming to identify the knowledge and action of the nurses that work at São Paulo\'s 71st Administrative District - Santo Amaro, regarding the alternative and complementary therapies submitting semi-structured questionnaries on July and August, 2001 to all eighteen nurses that worked at nine healthcare units. In a quantitative and qualitative approach the nurse\'s profile was analyzed and the factors that have influence on the knowledge and the doing on alternative or complementary therapies were showed. It also indicated that there\'s a great acceptance and credibility toward these techniques by the nurses (89%), but the little knowledge of legal support (22,2%) and specific courses or training available in this field (5,5%) limits its usage. Around half of the nurses (44,4%) searches for themselves some application but only 11,1% will be applying them on the users or clients at the healthcare units. The author unveiled the nurse\'s perception toward the conceptuae evolution, institutional and personal support and difficulties related to these practices and concluded that there\'s a need to search for additional knowledge to expand new assistential options for the population\'s health promotion
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Gran, Gabriella, und Robin Nilsson. „Vårdandet vid utskrivning : En systematisk litteraturstudie utifrån patienters upplevelser“. Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-42543.
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Bakgrund: Utskrivningen från slutenvården till hemmet är ett sårbart moment för patienter som övergår mellan två olika miljöer. Tidigare forskning visar att sjuksköterskor upplever utskrivningen som otydlig. Sjuksköterskor ser inte alltid utskrivningen som ett vårdande tillfälle eller upplever att det inte finns möjlighet att vårda. Det är oklart hur patienter påverkas av sjuksköterskans perspektiv på utskrivningen. Syfte: Att beskriva patienters upplevelser av vårdandet vid utskrivning. Metod: En systematisk litteraturstudie med deskriptiv design och analys av 13 kvalitativa vårdvetenskapliga artiklar. Resultat: Vårdrelationen vid utskrivning brister och patienter känner sig utelämnade. De upplever att deras behov inte blir uppmärksammade och att de blir utskickade. Patienter upplever att informationen är otillräcklig och att de inte får hjälp att förstå den. De vet inte vad de har att förvänta sig och blir oroliga. Omfattande information anses vara betryggande. Slutsats: Sjuksköterskor behöver förbättra sitt helhetsperspektiv på patienterna vid utskrivning. Mer uppdaterad kunskap angående vårdande relationer behövs för att synliggöra patientens behov och kunna utföra vårdande handlingar.
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Bengtsson, Tilda, und Julia Wallin. „Sjuksköterskans bedömning av venösa bensår i hemsjukvården“. Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-39613.
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Bakgrund: Venösa bensår är ingen sjukdom utan ett symtom som orsakas av bakomliggande faktorer. Det är framförallt äldre personer som har en ökad risk för sårbildning. Sjuksköterskan är ansvarig för att utföra en bedömning av såret inför val av behandling. Syfte: Att beskriva sjuksköterskors bedömning av venösa bensår hos patienter inom hemsjukvården. Metod: Studien är en kvalitativ intervjustudie med induktiv ansats. Data samlades in genom sex semistrukturerade intervjuer. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier: Sjuksköterskans tillvägagångssätt vid bedömning, sjuksköterskan och patienten tillsammans i en bedömning, sjuksköterskans behov av erfarenhet, stöd och utveckling i bedömning. Sårets egenskaper och fastställande av bakomliggande orsak var av stor betydelse. Likaså poängterades vikten av att göra en helhetsbedömning av patienten, vilket visade sig både ha positiva och negativa sidor relaterat till patientens hemmiljö. Kontinuerlig utbildning och stöd från kollegor ansågs vara till stor hjälp vid bedömning av patienter med venösa bensår. Slutsats: Det konstaterades att bedömningen av venösa bensår upplevs svår, innehåller flera moment samt att praktiken inte alltid stämmer överens med teorin. För att försäkra att patienten får de bästa förutsättningarna till en god sårläkning bör sjuksköterskan se till hela människan och varje patients enskilda behov.Titel: Nurse's assessment of venous leg ulcers in home based care Background: Venous leg ulcers is not an illness, but a symptom caused by underlying factors. It is mostly elderly people which have an increased risk for ulceration. The nurse is responsible for making the assessment of the ulcer, before choice of treatment. Aim: To describe nurse's assessment of venous leg ulcers in patients within home based care. Method: The study is qualitative interview study with an inductive approach. Data was collected through six semi- structured interviews. The material was analysed with qualitative content analysis. Results: The analysis resulted in three categories: Nurses approach to assessment, the nurse and the patient together in an assessment, nurses needs for experience, support and development in assessment. The ulcer's characteristics and determination of underlying cause were of great importance. Similarly, the importance of making a comprehensive assessment of the patient was emphasized, which proved to have both positive and negative sides related to the patient's home environment. Continuous education and support from colleagues were of great help in assessing patients with venous ulcers. Conclusion: It was confirmed that the assessment of venous leg ulcers is experienced complex, containing several moments, and that practice and theory are not always consistent. To ensure that the patient gets the best prerequisites for good wound healing, the nurse should look after the entire person and patient's individual needs.
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Klason, Pamela, und Evelyne Lorene Lundqvist. „Patienters(18+) upplevelse av andlig omvårdnad inom somatisk slutenvård : en integrativ litteraturöversikt“. Thesis, Högskolan Kristianstad, Fakulteten för hälsovetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-20243.
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Bakgrund: Att ge andlig omvårdnad ligger i sjuksköterskans ansvar. Trots alltmer forskning som visar att en tillfredställande andlig omvårdnad har positiv inverkan på hälsa, har detta dock ofta försummats inom vården. Begreppet andlighet kan ha olika betydelser och behöver därför uppfattas i sin bredd. Syfte: Beskriva vuxna patienters (18+) upplevelse av andlig omvårdnad inom somatisk slutenvård. Metod: En integrativ översikt bestående av nio kvalitativa originalartiklar från USA, Singapore, Kanada, Nederländerna, Iran och Australien. Data samlades genom CINAHL, Medline och manuell sökning. Analys gjordes efter inspiration av Friberg och Whittemore och Knafl analysmodeller. Resultat: Andlig omvårdnad kunde av patienterna upplevas positiv, negativ eller obefintlig beroende på olika faktorer. Patienterna i studien upplevde andlig omvårdnad genom att få möjlighet till uttryck av sin andlighet, genom att få möjlighet till relationer, genom att få ha sin värdighet i behåll och genom sjuksköterskans närvaro. Andlig omvårdnad ska utföras utifrån en personcentrerad vård eftersom uttryck av andlighet kan variera mellan individer. Slutsats: För att kunna prata om andlig omvårdnad behöver både personalen och patienter ha förståelse för vad andlighet kan innebära. Sjuksköterskan behöver få kunskap och verktyg för att lätt kunna införa andlig omvårdnad i sitt arbete och känna sig trygg med att utföra en holistisk vård dvs att se hela människan. Detta skulle resulterar i mer tillfreställda patienter.
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GOITOM, TESFU, und YOHANA BERHANE HAILE. „ATT GE PERSONCENTRERAD VÅRD : UTIFRÅN SJUKSKÖTERSKORS PERSPEKTIV“. Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-53562.
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Background: Person-centred care is a care model that favors the whole person to be seen, not only the disease. Caring person-centred means giving time and listening the patient about their health problems. This promotes the patients’ involvement in their care and that the care is based on the patients’ story. Patients and relatives experience that receiving insufficient time and information about the patient’s state of health makes person-centred care downgraded. Aim: To describe nurses' experiences of providing person-centred care. Method: Qualitative literature study with descriptive synthesis where eleven caring science articles used for result analysis. Results: Nurses experienced that the relationship with patients and the right conditions for person-centred care were basics for caring person-centred. Seeing the person behind the patient and motivating patients’ participation enabled a person-centred approach. Collaborating with colleagues, devoting more time to patients and personal conditions were both an opportunity and an obstacle to provide a person-centred caring. Conclusion: Seeing the person behind the patient and making patients involved is central in caring person-centred. It also requires the right conditions such as extra time, knowledge and functional cooperation for providing appropriate person-centred care.Bakgrund: Personcentrerad vård är en vård som möjliggör att hela personen ses, inte bara sjukdomen. Att vårda personcentrerat innebär att ge tid till och lyssna på patienter om sitt hälsoproblem. Detta leder till patientdelaktighet och till att vården utgår från patientensberättelsen. Patienter och anhöriga upplever att de inte får tillräcklig med tid och information om patientens hälsotillstånd, vilket gör att personcentrerad vård kan bli nedprioriterad. Syfte: Att beskriva sjuksköterskors erfarenheter av att ge personcentrerad vård. Metod: En kvalitativ litteraturstudie med beskrivande syntes där elva vårdvetenskapliga artiklar användes till resultatanalys. Resultat: Sjuksköterskor erfor att relationen till patienter och rätt förutsättningar för personcentrerad vård var grunden till att kunna ge personcentrerad vård. Att se personen bakom patienten och motivera patientdeltagande i sin egen vård möjliggjorde personcentrerat arbetssätt. Att samarbeta med kollegor, ägna mer tid till patienter och personliga förutsättningar var både möjlighet och hinder för att vårda utifrån personcentrerat arbetssätt. Slutsats: Att se personen bakom patienten och göra patienter delaktiga i sin vård är centralt för att kunna vårda personcentrerat. Det krävs även rätt förutsättningar så som mer tid, kunskap och fungerande samarbete för att kunna ge adekvat personcentrerad vård.
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Karlsson, Linda, und Ida Sundqvist. „Dold under draperingen : En intervjustudie om operationssjuksköterskans förhållningssätt till hela människan under arbetet i operationssåret“. Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-102275.
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Bakgrund: Under ett kirurgiskt ingrepp är patienten många gånger sövd och täckt av draperingsmaterial. Operationssjuksköterskan har spetskompetens gällande omvårdnaden kring patienten i samband med kirurgiska ingrepp. I den högteknologiska operationsmiljön blir operationssjuksköterskans arbete fokuserat till det kirurgiska såret under operationen. I denna situation riskerar patienten att uppfattas som ett objekt och inte som en unik människa. Syfte: Studiens syfte var att undersöka operationssjuksköterskans förhållningssätt till hela människan under arbetet i operationssåret. Metod: Studien genomfördes som en kvalitativ intervjustudie med induktiv ansats och elva operationssjuksköterskor från två olika sjukhus i södra Sverige intervjuades med semistrukturerade intervjufrågor. Datamaterialet analyserades med latent innehållsanalys i enlighet med Erlingsson och Brysiewicz (2017). Resultat: Det genomgående temat i resultatet var Se människan under draperingen.Operationssjuksköterskorna beskrev att noggrant förarbete och förtroendefullt samarbete med kollegor var en förutsättning för att utföra sitt arbete i operationssåret. De var ständigt vaksamma på förändringar kring patienten och försvarade patienten och den utsatta kroppen under operationen. Även under arbetet i operationssåret var operationssjuksköterskorna medvetna om hela människan som låg under draperingen och operationssjuksköterskans fokus i operationssåret tar avstamp i intresse för patienten och det bästa operationsresultatet. Slutsats: Operationssjuksköterskorna är ständigt medvetna om hela patienten under arbetet i operationssåret. Deras patientfokus och drivkraft att göra det bästa för patienten, även i situationer då de måste ägna operationssåret all uppmärksamhet, genererar en god vård för patienten i samband med operation och ger en positiv bild av operationssjuksköterskans yrke.Background: During a surgical procedure, the patient is often anesthetized and covered with draping material. The operating theatre nurse has expertise regarding the care of the patient in connection to surgical procedures. In the technological environment, the operating theatre nurse's work is focused on the surgical wound, during the operation. In this situation, there is a risk that the view of the patient will change from being a person into an object, and will not be seen as a human being. Objective:This study aims to investigate the operating theatre nurse’s attitude towards the whole picture of the human being during the work in the surgical wound. Method: The study was conducted with a qualitative interview method with an inductive approach, and eleven operating theatre nurses from two different hospitals in southern Sweden were interviewed with semi-structured interview questions. The data material was analyzed with latent content analysis in accordance with Erlingsson and Brysiewicz (2017). Result: The recurring theme in the result was See the human being beneath the draping. The operating theatre nurses described that careful preparation and trust in colleagues were a prerequisite in performing their work in the surgical wound. They were constantly alert to changes around the patient, and guarded the patient and the exposed body during the operation. Even during the work in the surgical wound, the operating theatre nurses were aware of the patient who was beneath the draping and the focus in the surgical wound was due to the concern of the patient, and the best surgical result. Conclusion: The operating theatre nurses are constantly aware of the whole person when they focus during the work in the surgical wound. Their patient focus is to do what is best for the patient. Even in situations when attention must be paid to the work in the wound, it is always due to the concern of the patient and gives a positive image of the profession of the operating theatre nurse.
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Souza, Allison Marlene. „Introducing the Health Coach Method of Motivational Interviewing to Medical Assistants to Improve the Patient Care Approach“. ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3414.
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The emerging health care culture of accountability for patient outcomes compounds problems for already overwhelmed clinicians struggling to fit everything entailed in complicated office visits into 15-minute appointments. Unprocessed frustrations tempt clinicians to use ineffective and outdated methods for trying to get their patients to comply or adhere to their care plans, undermining effective health care management. The intention of this project was to evaluate whether educating medical assistants in the health coaching method of motivational interviewing can improve the patient care approach while simultaneously assisting clinicians struggling with insufficient time. Several individual scheduling conflicts limited the target population into two primary care medical assistants and two auxiliary primary care office staff who voluntarily chose to learn the new approach. Guided by the adult learning theory, an educational lecture project was designed to capture the spirit of motivational interviewing through basic descriptions and strategies that will assist learners to focus on person-centered conversation skills, helping to balance both the needs of the patient and clinician. Following the education, participants filled out an anonymous post-lecture evaluation questionnaire to provide immediate feedback about learner understanding. Responses indicated the project met its stated objectives, and results showed the versatility of the motivational interviewing method which can be learned and effectively applied by health care workers from a wide range of professional backgrounds. Motivational interviewing is an innovative approach that utilizes therapeutic communication to promote behavior changes that lead to improved health of our communities and country.
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Rocha, Tatiana Ibrahim de Serpa Pinto. „A inserção das tecnologias gerenciais na práxis dos enfermeiros do Hospital Universitário Sul Fluminense: um estudo de campo“. Universidade Federal Fluminense, 2008. https://app.uff.br/riuff/handle/1/1444.
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Tatiana Ibrahim de Serpa Pinto Rocha.pdf: 653236 bytes, checksum: 3f12cf84347ed66912cd8107722cc769 (MD5)Made available in DSpace on 2016-02-02T16:10:09Z (GMT). No. of bitstreams: 1 Tatiana Ibrahim de Serpa Pinto Rocha.pdf: 653236 bytes, checksum: 3f12cf84347ed66912cd8107722cc769 (MD5) Previous issue date: 2008
Empresa de Ônibus e Turismo Pedro Antônio LTDA
Mestrado Profissional em Enfermagem Assistencial
O processo de trabalho do (a) enfermeiro(a) é construído por saberes originários de diferentes matrizes científicas e configuram uma atividade centrada no cuidado com articulação no campo da administração. No exercício da função, o (a) enfermeiro (a) utiliza uma série de saberes que podemos chamar de tecnologias. Tecnologias que são empregadas no trabalho do enfermeiro nos diferentes momentos da produção. Este estudo tem como objetivo, analisar o processo de trabalho do (a) enfermeiro (a), buscando identificar o uso das tecnologias no gerenciamento e no cuidado em saúde. Trata-se de um estudo descritivo com abordagem qualitativa. Como campo de estudo foi escolhido o Hospital Universitário Sul Fluminense, no Município de Vassouras. Os dados foram coletados através de entrevista temática com enfermeiros do hospital e observação participante. A análise dos dados se deu por meio da triangulação associada ao método hermenêutico dialético. Os resultados mostraram a utilização de diferentes ferramentas tecnológicas no gerenciamento do cuidado em que a fusão da função gerencial com a assistencial é uma constante. Nesse processo, destacamos o saber da teoria clássica da administração, como elemento presente em grande parte da produção naquele hospital. Apontamos, como conclusão, a importância de novos dispositivos para a descentralização do trabalho e a recuperação da centralidade no usuário
The working process of the nurse is constituted by facts derived from different scientific matrixes and configures an activity centered in the care, with an articulation in the administration field. In the realization of his function, the nurse uses a series of knowledge that we can call technologies. Technologies that are used in the work of the nurse on the different moments of the production. This study has as objective analyze the working process of the nurse, trying to identify the use of the technologies in the management and in the care in health. It‟s a descriptive study with qualitative approach. The Hospital Universitário Sul Fluminense, in Vassouras, was selected as the study field. The data were collected through a theme interview with the nurses of the hospital and participated observation. The analysis of the data was done by triangulation combined with the Hermeneutic-Dialectical Method. The results showed the utilization of different technological tools in the management of the care, in which the fusion of the management and care functions is a constant. In this process, we give emphasis to the knowledge of the administration classic theory, as an element present in a great part of the production in that hospital. We point out as a conclusion, the importance of new ways to the decentralization of work and the re-acquire of the users‟ centrality
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Larsson, Daniel, und David Sundström. „Genus inverkan på personcentrerad vård“. Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-27625.
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Bakgrund: Utifrån erfarenheter och teoretisk kunskap har sjuksköterskestudenter uppmärksammat hur stereotyper kring kön finns starkt närvarande i sjukvården. Vården är dominerad av kvinnor men styrs av maktstrukturer utifrån patriarkala hierarkier. Problem: Kan förutfattade meningar om vad som är manligt och kvinnligt bli ett hinder för personcentrerad vård? Förminskas patienten från att vara en individ till att bli en generalisering utifrån genusnormer? Kan sjukvården bortse från fördomsfulla vårdkulturer gällande könsstereotyper i mötet med patienten? Syfte: Att beskriva hur sjuksköterskor upplever att genus påverkar den personcentrerade vården. Metod: Examensarbetet är en empirisk intervjustudie som använder en kvalitativ manifest innehållsanalys av obearbetat material. Urvalet består av sjuksköterskor inom svensk somatisk vård. Resultat: Vårdares och patienters kön har stark inverkan på vårdens utformning samtidigt som det florerar uppfattningar hos sjuksköterskor att en förutsättningslös attityd kan överbrygga könets betydelse. Slutsats: Genus måste belysas starkare, både i forskning och klinisk praxis då genus har en direkt och indirekt inverkan på den personcentrerade vårdens kvalitet. Sjukvården måste bli bättre på att medvetandegöra genus då rådande genusnormer ofta är osynliga och måste belysas kontinuerligt för att inte åter bli osynliga och genom detta orsaka diskriminering och vårdlidande.Background: Experience and theoretical knowledge made nursing students aware that gender stereotypes are present in health care. Health care is dominated by women but controlled by patriarchal hierarchies. Problem: Can prejudice on masculinity and femininity hinder person-centered care? Is the patient being reduced from being an individual to becoming a generalization of gender norms? Is it possible for health care systems to ignore the impact of prejudiced gender cultures and still give patients qualitative treatment? Aim: To describe registered nurses experiences of how gender affects person-centered care. Method: An empirical interview study with a qualitative manifest content analysis of unprocessed data. The selection comprises registered nurses in Swedish somatic health care. Result: The gender of health care personnel and patients strongly affects the formation of health care relationships. Simultaneously there is preconception among nurses that an unbiased attitude can overlap the consequences of gender. Conclusion: Gender needs to be illuminated, in scientific research but also in practice. The health care system needs to develop its awareness of gender because prevailing gender norms are often invisible and need to be continuously illuminated in order to prevent gender bias, discrimination and care suffering.
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Drabo, Koiné Maxime. „Offrir une réponse aux besoins médicaux et psychosociaux des patients tuberculeux au Burkina Faso: quelles stratégies adopter ?“ Doctoral thesis, Universite Libre de Bruxelles, 2008. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/210412.
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Résumé exécutifIntroduction.
La prise en charge (PEC) des malades de tuberculose a été confiée à des institutions spécialisées et réduite aux seuls aspects biomédicaux du problème. En associant une revue de littérature sur les dimensions du problème posé par la tuberculose et un état des lieux sur la prise de charge de la tuberculose, les besoins non couverts par les centres de diagnostic et de traitement (CDTs) ont été identifiés dans trois districts sanitaires (DS) ruraux du Burkina Faso. Le recueil des évidences sur les interventions à même de corriger ces insuffisances (dans la littérature), associé à l’expérience des acteurs sur le terrain ont conduit à la mise en place d’un dispositif de soins. Ce dispositif intègre i) la décentralisation de la prise en charge des malades des CDTs vers les centres de santé de 1er échelon (CS), ii) l’organisation d’un soutien psychosocial au profit des malades en traitement et iii) la mise en contribution de personnes ressources pour offrir un soutien socioéconomique aux malades. Le présent travail s’intéresse à la conception et le test du dispositif au cours d’une phase pilote.
La question générale de recherche était de savoir si un tel dispositif pouvait améliorer significativement non seulement les résultats biomédicaux, mais aussi le confort physique, psychologique et matériel des malades pendant leur traitement. Trois hypothèses, faisant référence aux interventions clé du dispositif de soins, ont guidé l’investigation de cette question :
i) Une décentralisation du diagnostic, de l’administration des médicaments et du suivi du traitement de la tuberculose, des CDT vers les CS va contribuer à réduire pour les malades la distance à parcourir et accroitre de ce fait le taux de dépistage.
ii) Un soutien psychosocial va renforcer l’estime de soi des patients tuberculeux et réduire la stigmatisation ressentie par eux. Elle contribuera à améliorer le confort psychologique des malades ainsi que les résultats de traitement.
iii) Un soutien socioéconomique bien coordonné va résoudre les besoins de base des patients tuberculeux (transport, nourriture, habillement, etc.). Il va contribuer à améliorer les conditions de vie des malades ainsi que les résultats de traitement.
Le contenu du présent document comprend cinq parties. La première propose une introduction, la démarche générale et le contexte où le test du dispositif a été mis en place. La seconde présente les dimensions du problème posé par la tuberculose, un état des lieux sur l’offre actuelle de soins et les interventions potentiellement efficaces pour combler les besoins non couverts. La troisième partie décrit comment le dispositif de soin a été conçu et modélisé. La quatrième partie décrit le processus d’implantation et le fonctionnement du dispositif. Enfin, la dernière partie propose une discussion générale et quelques leçons apprises.
Première partie :Introduction, contexte et approche méthodologique générale.
Dans un chapitre introductif, nous mettons en exergue les défis que représente la promotion de la santé, le centre d’intérêt de la thèse, l’énoncé de la question de recherche et le cheminement méthodologique. Le cheminement utilisé est emprunté au modèle proposé par Campbell et Loeb pour la mise en œuvre et l’évaluation des interventions complexes. Il comporte quatre phases :i) la phase de modélisation, ii) la phase pilote, iii) la phase d’expérimentation définitive et iv) la phase d’implantation à long terme. La conception-modélisation et le test du dispositif de soins au cours d’une phase pilote ont fait l’objet du présent travail.
Le second chapitre présente le site de l’expérience. Six districts sanitaires ruraux sont répartis en un site d’intervention (3 districts couvrant un total de 8 453 km2 avec une population de 726 651 habitants en 2005) et en un site contrôle (3 autres districts couvrant un total de 9636 km2 avec une population de 719946). Les 2 sites partagent les mêmes réalités concernant l’organisation des soins en deux échelons (centres de santé de 1er échelon et hôpitaux de référence), la couverture en infrastructures (avec un rayon moyen de couverture par CS d’environ 6 kilomètres), l’organisation de la prise en charge de la tuberculose et les résultats du contrôle de cette maladie. La fréquentation des services de soins curatifs est considérée faible dans les 2 sites, comme dans les autres DS ruraux du pays. Elle se justifierait par les barrières financières, les pesanteurs socioculturelles, les perceptions négatives des populations vis à vis des services de santé et l’absence de système performant pour la prise en charge des urgences et des indigents.
Dans le troisième chapitre, un cadre général d’analyse de l’implantation du dispositif et de l’évaluation de son efficacité est proposé. Des précisions sont données à propos des centres d’intérêt, du but final de l’expérience et des méthodes utilisées pour vérifier les hypothèses de recherche. Une étude du processus d’implantation sert à analyser les interactions entre les acteurs et à identifier les obstacles rencontrés de même que les insuffisances du dispositif. Une étude quasi expérimentale sert à évaluer l’efficacité du dispositif.
Deuxième partie :Phase théorique.
Dans le quatrième chapitre, les insuffisances de l’offre de soins par les CDTs sont décrites et une revue de littérature sur les dimensions du problème posé par la tuberculose est présentée. Les 3 interventions susceptibles de couvrir les lacunes de l’offre actuelle de soins sont alors identifiées.
Troisième partie :Phase de modélisation du dispositif de soins.
Dans un cinquième chapitre, le processus de modélisation du dispositif est décrit. Une simulation du fonctionnement du dispositif permet de prévoir les effets directs et indirects. Les outils de documentation et d’évaluation du dispositif sont présentés.
Quatrième partie :Développement de la phase pilote.
Cette partie se compose de 4 chapitres qui sont: la présentation des interventions, des résultats intermédiaires, des interactions entre ces interventions et le système de santé. L’évaluation des effets observés termine cette partie.
Le sixième chapitre présente la manière dont le dispositif a été mis en place et son fonctionnement. En partant d’une démarche standardisée, obtenue après une concertation entre les différents acteurs (professionnels de santé et personnes issues du milieu de vie des malades), trois interventions ont été implantées dans les districts d’intervention. Il s’agit de la décentralisation du diagnostic et du traitement de la tuberculose dans 24 CS (8 / district), la mise en place de sessions de groupes de parole dans chaque CDT au profit des malades et la mise en place d’un comité de soutien dont les membres sont issus de l’environnement socioculturel des malades.
Le septième chapitre présente les résultats intermédiaires de chaque intervention.
Le huitième chapitre an\
Doctorat en Sciences médicales
info:eu-repo/semantics/nonPublished
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Lindskog, Caroline, und Jenny Persson. „Kvinnors upplevelse av sexualitet under och efter bröstcancerbehandling : En litteraturstudie“. Thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-29020.
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Bakgrund: Bröstcancer är kvinnans vanligaste cancersjukdom. Behandlingen kan innehålla flera metoder som kirurgi, strålbehandling, cytostatika och hormoner. Sexualitet är ett viktigt grundbehov som har betydelse för livskvalitén. Bröstcancerbehandlingen ger många biverkningar som kan påverka upplevelsen av sexualitet. För att sjuksköterskan ska kunna bedriva god omvårdnad av hela människan behöver hon ha kännedom om hur upplevelsen av sexualitet kan förändras under och efter bröstcancerbehandling. Syfte: Syftet var att beskriva hur kvinnor upplever sin sexualitet under och efter bröstcancerbehandling. Metod: Litteraturstudie med beskrivande design. Databassökning i Medline, CINAHL och PsycINFO. Elva artiklar granskades och valdes till studien. Resultat: Kvinnorna upplevde framförallt negativa men även positiva förändringar i sexualiteten. Att känna sig annorlunda samt mindre attraktiv och kvinnlig påverkade kroppsbilden negativt. Förändringar som minskad sexuell lust, upphetsning och njutning orsakade en minskad frekvens av samlag. Den sexuella njutningen minskade främst på grund av smärtsamt samlag vid minskad lubrikation. Förändringarna i den sexuella relationen orsakade känslor av oro, ångest, frustration, skuld och förslust. De positiva förändringarna var främst ökad intimitet och närhet i parrelationen. De sexuella förändringarna beskrevs som oväntade och chockerande på grund av informationsbrist. Slutsats: Kvinnan kan under och efter bröstcancerbehandling uppleva en stor förändring i sin sexualitet, som ofta är negativ. Informationsbristen är särskilt oroande då ökad information ger kvinnan större möjlighet att anpassa sig till förändringarna. För att bedriva holistisk vård behöver sjuksköterskan kunskap om sexuella förändringar som kan uppstå samt tillgång till bra verktyg för att samtala och informera om sexualitet. Ämnet sexualitet borde ha en självklar plats i sjuksköterskeprogrammet.
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Lankell, Louise, und Lisa Rådström. „Sjuksköterskors och undersköterskors upplevelse av att vårda den existentiella dimensionen hos vuxna patienter i palliativt skede : En litteraturöversikt“. Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-15832.
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Palliativ vård syftar till att möta dimensionerna kropp, själ och ande/existens hos patienter i palliativt skede och att lindra det lidande som kan uppkomma inom dimensionerna. Tidigare forskning visar att den andliga/existentiella dimensionen hos patienten är svårare att som vårdare möta än de kroppsliga och själsliga dimensionerna. De existentiella behoven hos patienter i palliativt skede riskerar därför att inte bli tillgodosedda. Sjuksköterskor och undersköterskor är de vårdare som oftast arbetar nära denna patientgrupp. Syftet med denna studie är därför att undersöka hur sjuksköterskor och undersköterskor upplever att vårda den existentiella dimensionen hos vuxna patienter i palliativt skede. Uppsatsen är en litteraturöversikt som baseras på 13 vetenskapliga artiklar som är analyserade efter Fribergs analysmodell. I vårt resultat presenteras de kategorier och underkategorier som har identifierats efter analys av litteraturen (se tabell 3). Huvudkategorier är; känslor inför att möta det existentiella, ett berikande arbete, en känsla av otillräcklighet och upplevelsen av ansvar. Resultatet visar att upplevelsen av att vårda den existentiella dimensionen kan vara både negativ och positiv. Faktorer som kan påverka upplevelsen är den egna kompetensen, vem som bär ansvaret för den existentiella vården, samt kulturella och religiösa skillnader mellan vårdare och patient. I diskussionen belyses att sjuksköterskor och undersköterskor riskerar att få psykosocial ohälsa av att ge existentiell vård om det inte finns förutsättningar för kompetensutveckling och stöd, samt förmåga att sätta gränser. Ytterligare aspekter som diskuteras är hur kulturen påverkar synen på existentiell vård och sjuksköterskans roll och ansvar att vårda den existentiella dimensionen hos patienter i palliativt skede i relation till hållbar utveckling.
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Olofsson, Viktoria, und Tanja Pekkala. „Husdjurets inverkan på den holistiska hälsan hos äldre personer : En integrerad översikt“. Thesis, Luleå tekniska universitet, Institutionen för hälsovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-78554.
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För att möta behov hos äldre personer kan alternativa hälsofrämjande åtgärder, såsom djurassisterade interventioner, vara en god idé. Syftet med studien var att sammanställa kunskap om hur olika interventioner med husdjur inverkar på den holistiska hälsan hos äldre personer. För att besvara syftet formulerades fyra frågeställningar om vilken inverkan husdjuret kan ha på de fyra dimensionerna av hälsa. En integrerad översikt genomfördes, där systematiska litteratursökningar och manuella sökningar resulterade i nitton artiklar som granskades och analyserades. Resultatet visade att husdjuret kunde främja de olika dimensionerna av hälsa hos äldre på olika sätt. Denna integrerade översikt bidrar till en kunskap om vad hälsa kan handla om och hur husdjuret inverkar på den. Olika djurassisterade interventioner verkar ha en möjlighet att fylla äldre personers unika behov som kanske annars är svåra att tillgodose.
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Tjale, Adele Agatha. „A framework for holistic nursing care in paediatric nursing“. Thesis, 2008. http://hdl.handle.net/10539/4650.
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ABSTRACT
Emphasis on humanistic values and personal experience in nursing has led to the popularisation of holistic nursing approach to nursing care. Although holistic nursing care as a construct is widely discussed in nursing literature. Contextual clinical application has been difficult, in the absence of guiding conceptual framework and guidelines that directs nursing practice. In this study, the purpose was to examine the meaning of holistic nursing care and develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing in academic hospitals. To achieve this aim, qualitative methodological perspectives were employed based on careful selection of the population, sampling, collection and analysis of data and trustworthiness. To enable the accomplishment of the purpose, the study objectives were formulated into two phases. Phase one objective enabled the identification of the characteristics of the concept holistic nursing care through concept analysis and by obtaining the emic viewpoints of the paediatric nurses working in academic hospitals. A philosophical inquiry was employed using Rodgers’ evolutionary method of concept analysis. To elucidate the concept holistic nursing care a qualitative, interpretive, explorative and contextual research design was employed. Holistic nursing care was interpreted as whole care fostering person-centred and family-centred care. The results confirm the current discourse in nursing literature with respect to “person-centred”, “family-centred care” as opposed to “patient-centred care”. The emphasis is on recognition of the need to transform current linguistic ontology from “patient care” towards the provision of “whole-person” care. Participants’ interpreted
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holistic nursing care as whole care directed towards a unique and complex human being. The dynamic, which is the driving force for the achievement of whole care, is established through enabling goal-directed nurse-family relationships.
One of the key finding is the prominence of spirituality and the inclusion of spirituality in different aspects of child nursing. The dependency of individual nurses to spiritual sources for personal strength and support was recognised and acknowledged. Knowledge of disease, person and “know how” are necessary for the acomplishment of ethically, safe person-centred whole care.
Attributes of holistic nursing care yielded two dimensions; whole person and mind-body-spirit dimension. The decriptors of whole person include physical, mental, emotional, spirit and spitual being. Spirituality is the predominant antecedent. Holistic nursing care is initiated by the recognition of the individual, in need of health care, as a spiritual being with mind-body-spirit dimension. Spirituaity is an ever-present force pervading all human experience. Complimentary alternative medicine (CAM) was identified as a surrogate term. The connection of CAM with holistic nursing care is the focus of therapetic interventions that are directed to the mind-body-spirit domain. The emphasis is on health rather than curing. Preventative therapeutic interventions are desingned to meet the needs of the whole-person. Caution is advocated in the use of CAM therapies in child nursing, as CAM efficacy has not been sufficiently investigated in child health care.
The conceptual framework is presented as unique contribution to nursing. The framework may be introduced at undergraduate teaching of child and family nursing care and in specialists’ paediatric nurse education. Recognition of the human being as a whole person with mind-body-spirit dimension is not restricted to a child or family care. Therefore, the
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framework is presented as a fundamental structure that can be used generally to all intervention activities in relation to human–human interactions. Its use may be broadened to any therapeutic environments. The framework may be tested in adult nursing in variety of settings in health care. There is a potential to expand and transfer certain elements of the framework to other discipline beyond nursing: in doctor-patient relationships, manager-employee relationships, and person-to-person interactions. Perhaps the South African Nursing Council, as the regulating body responsible for developing the educational framework of nursing education in this country may adopt this framework in line with their philosophy of nursing to articulate with their intended goal of providing holistic nursing care for the people of this nation. Adoption of the framework may require a shift from the current “patient-centred care” towards “person-centred care”.
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Deuell, Sharon Christine. „Spirituality and connectedness a phenomenological study : a research proposal submitted in partial fulfillment ... Master of Science (Psychiatric-Mental Health Nursing) /“. 1992. http://catalog.hathitrust.org/api/volumes/oclc/68796244.html.
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Murray, Barbara June. „Feng shui: implications of selected principles for holistic nursing care of the open heart patient“. Diss., 2001. http://hdl.handle.net/10500/1047.
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This qualitative study sought to explore the Hong Kong Chinese patient's perceptions of an Intensive Care experience and their views on the introduction of feng shui principles focussing on sleep orientations, dietary management and exercise regimes. The study explored the background of feng shui as an authentic traditional Chinese belief. It also explores if incorporating these feng shui principles into the health care setting would provide a positive effect for open-heart patients in an Intensive Care Unit at the Hong Kong Adventist Hospital in Hong Kong.
The major inference drawn from this study is that Chinese patients seek culturally related experiences from the health care setting. The Chinese informants showed strong belief patterns in traditional practices of feng shui, however, practiced these within the confines of their homes as these experiences were denied to them in the hospital setting.Health Studies
M.A. (Nursing Science)
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Huynh, Le-hong, und 黃張麗虹. „A STUDY OF THE PERCEPTIONS ON HOLISTIC NURSING CARE BETWEEN NURSES AND PATIENTS IN VIETNAM“. Thesis, 2010. http://ndltd.ncl.edu.tw/handle/55934797743516486363.
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碩士美和技術學院
健康照護研究所
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Holistic nursing care model was the most common and effective model in nursing care. The Ministry of Health of Vietnam has promulgated the regulations on holistic nursing care as a part of hospitals’ regulation in 1997. This study is a description – survey oriented research. It investigates the current status on holistic nursing care and explores perception on holistic nursing care between nurses and patients. The aim of the study was to identify (1) the relationship between holistic nursing care and nurses characteristics; (2) the relationship between holistic nursing care and patients characteristics; and (3) the perception on holistic nursing care between the nurses and patients. The study adopted questionnaire in data collection. A convenience sample was 238 nurses, who are nurses taking care of patients at medical departments and 420 patients with level II patients who are being treated at medical departments. The Statistical Package for Social Sciences (SPSS) for Windows (version 13) was used to analyze the data. The results indicated that there were significant differences in perceptions on holistic nursing care between nurses and patients. The mean score of nurses’ perception was higher than patients’ perception. The results suggested that the patient was unsatisfied with nursing care on holistic nursing care. The main reasons were lacking medical equipment and devices; lacking beds for the patient to lie down; lacking facilities serving for the patient’s daily living activities; and lacking a board of indicating hospital policies, regulations, and health information for patients and their families; limiting health education for patients and referring to social organizations to support the patient care. In addition, nurses need to explain procedures clearly and frequently monitor the patient.
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BICANOVÁ, Michaela. „Rehabilitační ošetřování jako součást holistického ošetřovatelství“. Master's thesis, 2007. http://www.nusl.cz/ntk/nusl-85743.
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The graduation thesis deals rehabilitative nursing as a part holistic nursing. The main idea of the theoretical part was mainly to give summary of nursing theory, whole rehabilitative system and each section and methods of rehabilitative nursing. The questionnaire given to general nurses was used for assignment of necessary dates in quintitative reserch. Explorational segment was aimed at education, traning and nursing standards of rehabilitative nursing, its knowledge and perform in use. It can be said at last than even though all hypotheses were proved, the nurses´answers were not always truly convincing.
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Dhamani, Khairunnisa. „Tanzanian nurses' understanding of spirituality and practice of spiritual care“. Phd thesis, 2010. http://hdl.handle.net/10048/1608.
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Spirituality is an integral part of a persons wholeness and therefore has an effect on and plays an important role in health and illness. Nurses are required by national and international nursing bodies as well as hospital accreditation agencies, to identify patients spiritual needs and intervene by integrating spiritual care into their nursing care. However, to date, no nursing studies have described Tanzanian nurses experiences of spirituality and spiritual care. The qualitative method of interpretive description was used. A purposive sample of fifteen registered nurses who were engaged in direct clinical practice at one of the private not-for-profit hospitals in Dar es Salaam, Tanzania was drawn. In-depth interviews using open-ended questions were carried out, tape-recorded, and transcribed verbatim. The data collection and analysis occurred concurrently. The transcripts were coded using inductive analysis. Themes related to spirituality and spiritual care that emerged from data were: meaning of spirituality, meaning of spiritual care, recognition of spiritual needs, interventions to respond to spiritual needs, challenges addressing spiritual care, and factors positively influencing the provision of spiritual care. Several recommendations for enhancing spiritual caregiving practices were given by participants. The findings from this study offer a basis for assessment, planning, and intervention strategies that nurses can apply in integrating spiritual care in clinical practice.
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Moran, Gayle. „Holistic and self-care theory documentation in family planning nursing practice a research report submitted in partial fulfillment ... /“. 1987. http://catalog.hathitrust.org/api/volumes/oclc/68787949.html.
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