Dissertationen: „Medical intervention or comfort care“

1

Chen, Yen-Yuan. „The Influence of Two Different Do-Not-Resuscitate Orders on the Outcomes of Patients in a Medical Intensive Care Unit“. Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1224664388.

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2

Elfarawi, Hunaydah. „Alobar Holoprosencephaly: Parental Perspectives on Prenatal Decision-making, Prenatal Provider Prognostication, and Quality of Life“. University of Cincinnati / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1617108856885634.

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3

Walker, Annette Clare, of Western Sydney Nepean University und Faculty of Nursing and Health Studies. „Nurse and patient work: comfort and the medical-surgical patient“. THESIS_FNHS_XXX_Walker_ A.xml, 1996. http://handle.uws.edu.au:8081/1959.7/286.

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This grounded theory study investigates the experiences and perceptions of comfort and discomfort of hospital patients admitted for medical-surgical conditions, with a focus on the post-accute stage of hospitalisation. In-depth post-discharge interviews were conducted with seventeen English speaking adults who had been admitted to nine Australian hospitals. A substantive theory of finding comfort and of managing discomfort was generated. Processes of self-talk (anticipating, interpreting, accepting, making allowances and maintaining perspective) and self-care (self-help and seeking help, which involved accommodating to the level and type of help available through deferring, avoiding, persisting or desisting) were used to find comfort and to manage discomfort. The study has implications for nursign practice, management, research and education. Existing practice in the areas of assessment, communication, individualised care planning and the management of discomfort need to be strengthened if nursing care is to make a difference for this category of patient. The study revealed that integrated caring by nurses perceived by informants as 'experts', contributed most to the experience of finding comfort and managing discomfort in this group of informants
Doctor of Philosophy (PhD)

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Badger, James Mark. „Nurses' experiences of moving from cure-oriented to comfort-oriented care in the medical intensive care unit setting /“. View online ; access limited to URI, 2003. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3115620.

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5

Crawford, Kathryn J. „Assessment of noise in a medical intensive care unit“. Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/2061.

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Exposure to noise in hospital intensive care units (ICUs) can disrupt patients’ sleep and delay their recovery. In this intervention study, noise levels were measured in eight patient rooms of a medical ICU (MICU) every minute with sound level meters for eight weeks before and after an intervention. Implemented over six weeks, the intervention was designed to educate nurses and other staff members to reduce noise levels through behavior modification, including instituting a “quiet time” in the afternoons, encouraging patients to keep televisions off or at lower volumes, and speaking more quietly during conversations. Sound equivalent levels (Leq) were calculated from one-minute measurements for each hour in each room. These hourly Leq (Leq-H) values were compared by pod (group of rooms within the MICU), room position (in proximity to a central nurses’ station), occupancy status, and time of day. Days with more than ten hours of one-minute noise levels above 60 dBA were flagged as the loudest time periods and compared to MICU activity logs. The intervention was ineffective with Leq-H values always above World Health Organization guidelines for ICUs (35 dBA in day; 30 dBA at night) before and after the intervention. Leq-H values frequently exceeded more modest project goals during the day regardless of the intervention (50% of Leq-H > 55 dBA both pre- and post-intervention) and at night (68% and 62% of Leq-H > 50 dBA pre- and post-intervention). Statistical analysis of the Leq-H suggests a general source is contributing to the high baseline noise in the MICU, most likely the heating, ventilation, and air-conditioning (HVAC) system. Our analysis of one-minute data indicated that high noise was often associated with high-volume respiratory-support devices. We concluded that our intervention focusing on administrative controls (e.g., education and training) was not enough to reduce noise in the MICU but that an intervention designed with engineering controls (e.g., shielding, substitution) would be more effective.

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6

Chung, Yuk-lan Ida. „A systematic review on integrated care pathway for children who need surgical intervention /“. View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B36396886.

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7

Osborne, Michelle. „EXPLORATION OF THE RELATIONSHIP BETWEEN PAIN INTENSITY, COMFORT LEVEL AND PATIENT SATISFACTION AMONG ORTHOPEDIC PATIENTS FOLLOWING KNEE SURGERY ON POSTOPERATIVE DAY ONE“. Case Western Reserve University Doctor of Nursing Practice / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=casednp1430142885.

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8

Chung, Yuk-lan Ida, und 鍾玉蘭. „A systematic review on integrated care pathway for children who need surgical intervention“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B45011758.

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9

Doll, Richard P. „Continuity of care : a study of alternate forms of intervention“. Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26246.

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The aim of this study is to determine the effect of two approaches of social work intervention, a continuity approach, and a team approach, upon the three dependent variables of subject satisfaction, control, and mood. In order to determine differences in outcome, subjects were administered psychological tests to determine changes in their reported sense of control and mood (hopelessness) in relation to their response to the diagnosis and treatment of cancer. At follow-up, subjects also completed a questionnaire designed to determine their satisfaction with social work services received. The amount of time spent in contact with social workers was also assessed at this time. The analysis of the relationship between these variables revealed that there were no statistically significant differences between the study groups; subjects were equally satisfied with the two approaches in social work intervention, and there were no major differences between the reported changes in mood and control by the subjects in the study groups.
Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate

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Johal, Kirandeep Kaur. „Psychological Well being of Residents in Senior Care Homes Case work Intervention“. Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-45511.

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ABSTRACTINTRODUCTION: Aging is an unstoppable phenomenon which starts fromconception to last until death. During person’s life goes through certain changes suchas biological, psychological, sociological, and environmental. From all periods of life, Old age is one of important part of person’s life when psychological and sociologicalrelations drifts. It can be defined by three ways (1) chronology, (2) shift in socialstatus, and (3) change in capacity. In a nutshell, aging is a dynamic process that leadsto physical and mental shifts. The change cannot be stopped or reversed, but it may bedelayed by aiding older people in continuing to live their existing lifestyles. AIM: For Nordic countries, aging population is the most pressing challenge incontemporary period. The aim is to assess the psychological wellbeing of old agepeople staying in care home or institution care. METHODS AND ANALYSIS: By using scooping methodology and old age peopleage limit 65 to 84 yrs took data from secondary validated sources in which explainabout good and very good health countries such as Sweden and Norway and Finlandwith lower percentage of good health in both genders and also how decrease mortalityrate increase the dependency ratio in these countries. CONCLUSION: In Nordic countries, Government provide numerous facilities fortheir residents such as home care, institution care for their well being. But even aftergood care, old people suffer from psychological problems such as loneliness, depression and suicide. The conclusion of this study include some interventions whichcan improve their mental as social health such lifelong learning participation , activeaging policies to stay active at their own capacity, identify the vulnerable groups anduse compensatory strategies to stay active and participate in social activities.This ideais not only explain the individual's right and responsibility to remain active, but alsothe government's responsibility to create an age-friendly social system andcommunity environment. Moreover, I focus on quality of health care provided toresidents and also on emotional well being of old people.

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Medabesh, Ali Mohemmed M. „Customer comfort as a marketing construct in healthcare“. University of Western Australia. Dept. of Information Management and Marketing, 2009. http://theses.library.uwa.edu.au/adt-WU2009.0068.

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Customer comfort is an important factor in developing and maintaining relationships between customers and service providers. For example, it plays essential roles in selecting service provider. In spite of its importance, the concept of comfort has not been fully explained in the service marketing literature. Although, comfort has been discussed as a fundamental element in healthcare, its role in developing and maintaining customer relationships has not been fully explored in the boarder marketing literature. The present study focuses on the concept of comfort (physical and psychological) as a crucial factor in marketing health care services, particularly in Saudi private hospitals This thesis examines a number of the antecedents and consequences of physical and psychological aspects of comfort in the marketing arena. Antecedents investigated included: functional and technical dimensions of service quality, the environmental and social aspects of hospital life and service costs (monetary and non-monetary). Patients satisfaction was the consequence of customer comfort explored in this thesis. When the relationships between the physical and psychological aspects of comfort and their antecedents were examined, it was concluded that a number of these constructs were shown to have positive effects in the concept of comfort in Saudi private hospitals. For example, the construct of functional service quality appears to have a positive effect in the perception of psychological comfort. The construct of technical service quality, such as staff behaviours, also tends to have a positive effect in the perception of psychological comfort. The social and environmental aspects of hospital life stood out as the only construct that has a positive effect in the perception of physical comfort. While the monetary and non-monetary costs of the service were VII found to have no effect in the perceptions of both physical and psychological comfort. In testing the consequence of the physical and psychological aspects of comfort, it was found that psychological comfort tends to have a positive effect in satisfaction. Finally, the findings showed that the technical dimension of service quality appears to have significant effects in the perceptions of both psychological comfort and satisfaction. This implies that the technical dimension of service quality tends to promote psychological comfort and satisfaction for Saudi patients. The perception of physical and psychological comfort in Saudi private hospitals is also influenced by the roles of the Islamic religion which is based on the holy Quran and Sunnah of Profit Mohammed (peace be upon Him). In addition to the basic dimensions of comfort, these roles can be used to shape the perceptions of the concept of comfort. It may be useful for Saudi private hospitals to direct their efforts towards promoting patients comfort and satisfaction by providing healthcare quality experience that focuses on the functional and technical dimensions of healthcare services, the environmental and social aspects of hospitals and the costs of their services. Data has been collected using an established questionnaire to examine the relationship between comfort, service quality, hospital life and costs.

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Esmaily, Hamideh Mohammadzadeh. „Outcome-based continuing medical education an intervention to improve rational prescribing /“. Stockholm : Karolinska institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-710-8/.

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13

Shelby, Rebecca Ann. „Understanding the effectiveness of interventions for cancer patients a study of patient characteristics and intervention evaluations /“. Columbus, Ohio : Ohio State University, 2006. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1148322580.

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Woodward, Nakia J. „A Mixed Methods Analysis of a Library Based Handheld Intervention with Rural Primary Care Clinicians“. Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/8818.

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15

Forsberg, Lars. „Hazardous or harmful alcohol use in emergency care : early detection, motivation to change and brief intervention /“. Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-547-6.

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16

Groessl, Erik J. „Participation and empowerment : factors related to positive outcomes in a health intervention with older people with osteoarthritis /“. Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 1999. http://wwwlib.umi.com/cr/ucsd/fullcit?p9952668.

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17

McGee, Deborah Socha. „In search of patient communication competence : a test of an intervention to improve communication in the primary-care medical interview /“. The Ohio State University, 1996. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487936356160687.

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18

Front, Sofia. „Self-Care Education in Oral Health : An intervention study among dental nurse students in Danang, Vietnam“. Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Oral hälsa, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-44660.

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Aim:The aim of the thesis was to study the effect of a self-care education in oral health for a group of dental nurse students in Danang, Vietnam. Methods: A quantitative intervention study was performed consisting of 53 selected participants, who were clinically examined to measure the dental biofilm and gingival inflammation. The intervention was a self-care education session where both information and instruction about the materials and methods of self-care in toothbrush technique and interdental cleaning were included. Results: The self-care education in oral health proved to have an effect on the students' oral hygiene. There was a statistically significant difference between the first and the second examination of the gingival inflammation. No statistically significant difference was found between the first and second examination of dental plaque but plaque score of buccal, lingual and distal surfaces significantly decreased before the second examination.The results did not show any significant difference between the group from the rural area and the group from the urban area. Conclusion:The result of the study shows that the self-care education in oral health had a positive impact on the participant´s oral hygiene. It would be beneficial to develop a self-care educational program for the population in Vietnam to improve the oral hygiene.Through knowledge and information about good self-care habits and its positive effects, more people can achieve a better and healthier oral health as a result.
Syfte:Syftet med studien var att studera effekten av en given egenvårdsutbildning i oral hälsa för en grupp dental nurse studenter i Danang, Vietnam. Metod:En kvantitativ interventionsstudie utfördes, bestående av 53 utvalda deltagare som undersöktes kliniskt för att mäta dental biofilm och gingival inflammation. Interventionen var en egenvårdsutbildning där information och instruktion i material och metoder för egenvård i tandborstteknik och approximal rengöring inkluderades. Resultat:Egenvårdsutbildningen i oral hälsa visade sig ha effekt på studenternas munhygien. Det var en statistiskt signifikant skillnad mellan den första och den andra undersökningen av gingival inflammation. Ingen statistiskt signifikant skillnad uppnåddes mellan den första och andra undersökningen av dentalt plack. Dock sjönk plackförekomsten på de buccala, linguala och distala ytorna avsevärt innan den andra undersökningen. Resultaten visade inte någon signifikant skillnad mellan gruppen från landsbygd eller gruppen från tätort. Slutsats:Resultatet av studien visar att egenvårdsutbildningen haft en positiv inverkan på deltagarens munhygien. Det skulle vara fördelaktigt att utveckla ett egenvårdsprogram för befolkningen i Vietnam för att allmänt förbättra den orala hygienen. Genom kunskap och information om goda egenvårdsvanor och dess positiva effekter kan fler människor uppnå en bättre och hälsosammare oral hälsa.

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Miesner, Michael T. „Mental Health Referral in Primary Care: Influence of a Screening Instrument and a Brief Educational Intervention“. Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etd/2398.

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Although less than half of all patients with mental disorders seek mental health treatment per se, approximately 80% of all people will visit their primary care physician (PCPs) within a year (Strosahl, 1998). However, it is not well understood how to best handle patients presenting with mental health issues in primary care practices. The purpose of this project was to implement an intervention involving a screening measure for anxiety and mood disorders in a primary care setting to increase the volume of anxiety and mood disorder screening, to increase the accuracy of disorder detection, and to also enhance PCPs patterns of referral to mental health professionals (MHPs). Though starting with a quantitative design, difficulties encountered throughout the project eventually led to a largely qualitative analysis, which did yield useful information. A pilot project demonstrated anxiety and mood disorders were commonly noted in patients’ medical charts (46%), but also found referrals were rarely made for mental health services (7%), despite colocation of a licensed psychologist and licensed clinical social worker within the practice. This indicated that services available to provide comprehensive integrated total health care may not be have been used to their full potential. In the main project, 59 participants from a family medicine clinic and 20 PCPs from that clinic participated. The My Mood Monitor (M3) was administered to the patients and became part of their Electronic Medical Records (EMR). The M3 screens for anxiety, depression, and bipolar disorders within primary care settings. In 2 separate noon conferences, PCPs were trained on diagnostic criteria for anxiety disorders and mood disorders, interpretation of M3 results, and the internal Mental Health Professional referral process. The project was hampered by a full-scale switch from paper-based medical records to an EMR and accompanying lack of user experience with EMR functions, lack of efficient transfer of M3 results into the EMR, and an unforeseen switch of psychologists mid-way through the study. However, results were obtained that showed relatively low levels of PCP review of M3 results, potentially high rates of anxiety disorders and mood disorders within the setting, relatively high levels of PCP knowledge of diagnostic criteria for anxiety and mood disorders, and that patients may not prefer a ‘warm handoff’ model of mental health referral. These findings are couched within a number of important caveats, but future directions for research were clearly implied.

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Abo, Yasuyo. „The need for social work intervention for the elderly patients and their family members“. CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2789.

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Contends that poor discharge planning for elderly patients in American hospitals is the result of reduced lengths of stay which do not give medical social workers adequate time to assess patients' needs. A survey methodology was used to assess social service and community resource needs of hospitalized elderly patients and their family members at Riverside Community Hospital in California. Argues that the results of the survey can be used to improve discharge planning and lead to a more client-centered practice in hospitals.

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McCall, MacBain Marcy C. „Yoga as a complex intervention and its development for health-related quality of life in adult cancer“. Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:c7259cbe-b6c0-42f8-b893-79306cdccdfa.

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The aim of this thesis was to develop yoga as a complex intervention in health care for the improvement of health-related quality of life (HRQoL) in adult cancer. As the Indian tradition of practising yoga increases in popularity worldwide, populations in the West are beginning to see yoga as an opportunity to prevent and treat health conditions. The Medical Research Council’s framework has provided a methodology to address a paucity of coherent evidence for the myriad of unsupported health claims made by yoga enthusiasts. The thesis structure included a step-by-step approach to investigate biomedical theories of how yoga might work to improve health, to synthesise evidence of yoga interventions, to model their process and outcomes, and to test evaluation procedures in the context of a randomised controlled trial (RCT). The results of a bibliometric analysis indicated an overall increase in the publication rate of yoga research in health care, and in 2005 this research began to focus on cancer. A component analysis, semi-structured patient interviews (n=10) and oncologist surveys (n=29) were successively designed, implemented and analysed to advance a model of yoga intervention specific to adult cancer. The cumulative results were applied to design three yoga interventions randomly allocated to men and women receiving treatment for cancer (n=15). Outcomes of the feasibility study demonstrated that yoga intervention is appropriate for adult patients and can be administered safely in a clinical setting. In its conclusion, this thesis produces evidence-based support for the optimisation of yoga intervention in the context of a large-scale RCT for HRQoL in adult cancer, and it provides recommendations to improve research methodology and reporting of complex interventions in health care.

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Dannecker, Achim, Martin Radzuweit, Carolin Stupp, Birgit Wenke und Ulrike Lechner. „Community INVADE - Eine Community als Intervention“. Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-143352.

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23

Trinks, Anna. „Alcohol prevention in emergency care : Drinking patterns among patients and the impact of a computerized intervention in a Swedish Emergency department“. Doctoral thesis, Linköpings universitet, Socialmedicin och folkhälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-72333.

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The aim of this thesis was to generate knowledge about alcohol consumption among patients in a Swedish ED, the reach and effectiveness of a computerized brief intervention delivered in the ED, and factors that are associated with reduced alcohol consumption 6 months after the ED visit. The results from the studies show that alcohol consumption was higher among patients who were injured than patients who were not injured. Injury patients had a higher weekly consumption, drank more frequently and drank higher typical quantities than non-injury patients. Patients who were categorized as acute drinkers had higher weekly alcohol consumption and were more frequently engaged in heavy episodic drinking (HED) than non-acute drinkers. Among the patients who took part in the computerized test, more than 15% stated that they were at the preparation stage or actively motivated to change their alcohol consumption. Of the patients who were categorized as acute drinkers, 34% were at the action or preparation stage. Among patients who were categorized as risky drinkers, 48% became non-risky drinkers at follow-up. The relative change in average weekly consumption among risky drinkers was 30% and the relative change in HED occasions per month was 37% from baseline to follow-up. Motivated to reduce alcohol consumption at baseline, influenced by just visiting the ED, considering the alcohol-related feedback information and impact from a health care provider are independent predictors for reduced alcohol consumption.

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Dannecker, Achim, Martin Radzuweit, Carolin Stupp, Birgit Wenke und Ulrike Lechner. „Community INVADE - Eine Community als Intervention“. Technische Universität Dresden, 2011. https://tud.qucosa.de/id/qucosa%3A28060.

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Murphy, Janet Ann. „Parental Perceptions of Articulation Intervention Services Received at Portland State University“. PDXScholar, 1996. https://pdxscholar.library.pdx.edu/open_access_etds/5161.

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Now more than ever, speech clinicians are being required to justify the effectiveness of their work by showing results. There are different ways to measure outcomes. For example, outcomes may be measured by testing to determine if change has occurred regarding clinical goals, or by comparing the cost of the treatment to the benefit of the treatment to determine if the treatment was economically sound. Another type of measure is subjective outcomes, such as client satisfaction. Subjective outcomes are difficult to define and measure and few studies of this type have been reported in the literature. Because clinical outcome is dependent, at least to some extent, on client satisfaction (Williams, 1994), and because few studies have been reported in the literature regarding client satisfaction with speech and language services, this area became the focus of the current study. This study sought to answer the following questions: (a) Did the parents think their child benefrtted from the articulation intervention services received at the clinic? and (b) What were parents' attitudes regarding the clinical atmosphere and staff? The Consumer Satisfaction Measure of the American SpeechLanguage- Hearing Association (ASHA) was used in this study because it is broad in scope and contains statements relating to the research questions of the current study. Answers to the research questions were derived from the responses to the survey that was mailed to the parents of 86 children who had received articulation services from the PSU Speech and Hearing Clinic. Ninety-five percent of the parental responses regarding whether parents felt that their children benefited from services obtained at the PSU Speech and Hearing Clinic were positive, indicating that parents were satisfied with the services received. Ninety-one percent of the parental responses regarding parent's attitudes toward the clinical atmosphere and staff were positive. It appears that parents hold favorable views regarding the clinical atmosphere and staff and that they were satisfied with the services their children received at the PSU Speech and Hearing Clinic.

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Abascal, Liana B. „The effect of depression and adherence in a dietary and physical activity intervention for overweight and obese adults“. Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2008. http://wwwlib.umi.com/cr/ucsd/fullcit?p3307359.

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Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2008.
Title from first page of PDF file (viewed July 11, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 67-76).

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Ehrenberg, Anna. „In pursuit of the common thread : Nursing content in patient records with special reference to nursing home care“. Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-495.

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The purpose of this thesis was to study different aspects of nursing content in patient records with special reference to nursing home care. The thesis focused on the content, comprehensiveness, accuracy and auditing of records, as well as the practice and perceptions of nurses in relation to recording. A national sample of nurses was asked to complete a questionnaire. The effects on recording and nurses' practice and perceptions in nursing homes following educational intervention were studied. Accuracy was examined through record reviews and interviews with nurses and patients. A literature review of record auditing methods was performed and findings from this search were applied in the assessment of a set of records.

The results indicate that the VIPS model, as a structure for nursing recording, is widespread and shows validity across various areas in Swedish health care. After the educational intervention program, documentation in nursing home care improved significantly in the study group concerning notes on nursing history, nursing status, nursing diagnoses, interventions and discharge notes. Systematic and comprehensive assessment grounded in research-based criteria were not used in the records. Accuracy varied considerably and was significantly better for some areas in the study group. After intervention, the nurses in the study group indicated that they recorded assessments of patients with greater frequency, showed greater satisfaction with their documentation and spent less time on oral reports. Procedures in auditing patient records were found to encompass four approaches: formal structure, process comprehensiveness, knowledge based and accuracy.

In conclusion, the evidence suggests that there are serious flaws in the nursing content of nursing home records though improvements can be achieved through educational means. Presently, there are serious limitations in using the patient record as the sole source of data for care delivery, quality assessment and evaluation of care.

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Rosenfeld, Mark. „Whiplash-associated disorders from a physical therapy and health-economic perspective : a study of an active physical therapy involvement and intervention for the treatment of acute whiplash-associated disorders and an analysis of its costs and consequenses /“. Göteborg : Institute of Neuroscience and Physiology, Division of Physical Therapy, Sahlgrenska Academy at Göteborg University, 2006. http://hdl.handle.net/2077/711.

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Atkins, Kristi Laurine. „Early Intervention Referral Outcomes for Children at Increased Risk of Experiencing Developmental Delays“. PDXScholar, 2019. https://pdxscholar.library.pdx.edu/open_access_etds/5100.

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Research has shown that children born low birth weight (i.e., ≤2500 grams) and/or premature (i.e., birth prior to 37 weeks gestation) are at increased risk of experiencing developmental delays, as well as long-standing executive functioning and academic challenges. Despite these well-known risks, children born low birth weight are under-enrolled nationally in Part C Early Intervention (EI) services intended to support developmentally vulnerable children. Little is known regarding why EI enrollment is low in this high risk population, especially given children born LBW are readily identifiable as at increased risk of delays at birth. This study explored EI referral outcomes from a high risk infant follow up program serving children with complex early medical histories that place them at increased risk of experiencing developmental delays to determine how many children referred to EI were ultimately evaluated and enrolled in the program. This explanatory sequential mixed methods study included a quantitative phase characterizing the EI referral outcome and a qualitative phase consisting of interviews with families to explore the parent/caregiver's experience of the EI referral process. Data analysis included descriptive statistics to characterize the sample and Pearson Chi Square and independent samples t-tests to investigate child characteristics associated with successful referral. Qualitative interviews were transcribed and coded for themes in an iterative and cyclical fashion. Results indicate that only 62% of the children who were referred for EI services were evaluated by the program, with about the same percentage of those evaluated being found eligible (67%). Of those who were not found eligible, about a third of children should have qualified based on previous testing and/or medical conditions. However, these qualifying medical conditions were often not clearly documented on the referral form, and not all forms included documentation of the scores from developmental testing. There were also a significant number (71%) of Oregon children referred to EI but never evaluated who were likely to have qualified based on medical history and/or results from developmental testing. There were several key themes identified following analysis of the qualitative interviews. Most critically, the parent/caregiver's perception of the need for the EI referral was identified as an essential factor in facilitating a successful connection to EI. Other key themes included the need to honor the many different demands placed on the caregivers of these high risk children, as well as the necessity of providing clear explanation of the purpose of both the visit to the high risk infant follow up program and the EI referral. The Chronic Care Model is used as a framework for discussing implications for practice.

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Ågren, Susanna. „Supportive care for patients with heart failure and their partners : A descriptive and interventional study“. Doctoral thesis, Linköpings universitet, Omvårdnad, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-56232.

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Background: Having the support of a partner is essential for both health related quality of life and survival in heart failure patients. However, caring for a patient with heart failure may affect the health related quality of life, well‐being and cause a burden for the partner. The partner is expected to be responsible for the care, which may have consequences for the heart failure patient’s long‐term health and well‐being. Further research to determine health related quality of life, well‐being, caregiver burden and needs of partners is warranted as well as studies evaluating interventions targeting patient‐partner dyads. Aim: The overall aim was to describe how the life situation of patient‐partner dyads was influenced by heart failure and to determine the effects of an intervention of follow‐up with education and psychosocial support for patient‐partner dyads. Design and methods: The thesis is based on three quantitative studies and one qualitative study. The first two studies were descriptive and included 135 dyads (patient‐partner) (I, II) and the randomised intervention study included a total of 155 dyads (IV). The qualitative study had a grounded theory approach. Thirteen partners were interviewed and data analysed using constant comparative method (III). Results: Caregiver burden was perceived as moderate in 30% of the partners and the rest experienced a low caregiver burden. The patients’ physical component score of SF‐36, partners’ mental component score of SF‐36 and perceived control explained 39% of the caregiver burden (I). Patients had lower health related quality of life compared to their partners in all dimensions except in the mental health domain of SF‐36 and lower qualityadjusted life year weights compared to their partners. Mental health scores were lower in partners compared to age and gender‐matched references. All other health related quality of life scores and the quality‐adjusted life year weights were comparable between the partners and the reference group. Patients had more depressive symptoms than their partners. There was no difference in the level of perceived control or knowledge about chronic heart failure between patients and partners (II). During grounded theory analysis confirmation was identified as describing the core category of the partners’ individual needs. The core category theoretically binds together three underlying subcategories: security, rest for mind and body, and inner strength. Confirmation facilitated acceptance and improvement of mental and physical health among partners (III). At the three month follow‐up the dyad‐intervention had improved perceived control in patients, but not in the partners. There were no other significant differences in the control and intervention group with regard to the dyads’ health related quality of life and symptoms of depression. There were also no differences in the patients’ self‐care behaviour and partners’ experiences of caregiver burden (IV). Conclusions and implications: Partners to patients with chronic heart failure are at risk of decreased mental well‐being. One third of the partners experienced a moderate caregiver burden and was therefore at a higher risk of poor mental health and decreased perceived control. During short‐term follow‐up the intervention with education and psychosocial support to dyads (patient‐partner) improved the level of perceived control in the chronic heart failure patient group. By identifying partnersʹ needs for security, rest for mind and body, and inner strength, healthcare professionals can confirm these needs throughout the caring process, from the critical care period and throughout rehabilitation at home. Interventions targeting dyads have been limited in previous research. Partners need to be prepared regarding the disease process, the daily regimen, hopes for the future and responsible care providers. They also need to be confirmed because they are vital to the patients’ recovery. Further, the effects of the intervention study should also include a long‐term follow‐up as well as an evaluation of the health‐economic perspective including direct and indirect costs of care.

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Mattheus, Charl. „Managerial Intervention Strategies to Reduce Patient No-Show Rates“. Thesis, Walden University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10284622.

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High patient no-show rates increase health care costs, decrease healthcare access, and reduce the clinical efficiency and productivity of health care facilities. The purpose of this exploratory qualitative single case study was to explore and analyze the managerial intervention strategies healthcare administrators use to reduce patient no-show rates. The targeted research population was active American College of Healthcare Executives (ACHE), Hawaii-Pacific Chapter healthcare administrative members with operational and supervisory experience addressing administrative patient no-show interventions. The conceptual framework was the theory of planned behavior. Semistructured interviews were conducted with 4 healthcare administrators, and appointment cancellation policy documents were reviewed. Interpretations of the data were subjected to member checking to ensure the trustworthiness of the findings. Based on the methodological triangulation of the data collected, 5 common themes emerged after the data analysis: reform appointment cancellation policies, use text message appointment reminders, improve patient accessibility, fill patient no-show slots immediately, and create organizational and administrative efficiencies. Sharing the findings of this study may help healthcare administrators to improve patient health care accessibility, organizational performance and the social well-being of their communities.

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Ahmad, Shahjehan. „Investigating the Effects of a Pre‐ and Post‐Discharge Intervention on Access to Care and 30‐Day Readmission Rates of CHF Patients at the Phoenix VA Medical Center“. Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/603587.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
Significance: Cardiovascular disease represents the single most costly and common cause of hospitalizations in the US. More alarmingly, congestive heart failure (CHF) represents the largest cause of preventable hospitalizations. The 30‐day readmission rate after a hospitalization for CHF is an increasingly important measure of quality in the management of this chronic condition. Interventions targeted at CHF patients after discharge should address access to care and early follow‐up, and should be investigated as a means of decreasing 30‐day readmissions and improving patient outcomes. The Phoenix VAMC created a new early‐follow up clinic in 2011, and this study was the first investigation of outcomes from the intervention. Methods: Patients were selected who were admitted to the Phoenix VAMC with a primary diagnosis of heart failure (ICD‐9: 428.x). Patients referred to the early follow‐up clinic by their primary medicine team were our cohort of interest; patients which underwent standard care and served as our controls. A retrospective chart review was done to assess health status, compliance with the intervention, and 30‐day outcomes, the patient level outcomes. We also compared patients in two time periods, before and after the intervention was implemented, the hospital level outcome. Statistical analysis of this cohort study was done by identifying the relative risk of readmission and death. The RE‐AIM framework was used to determine the hospital‐level impact of the intervention. Results: 275 patients were divided into 116 control patients and 159 intervention patients. The RR of readmission in those referred to the clinic was 1.57 (p=0.09), and mortality was 0.78 (p=0.05). In those patients who were discharged in the post‐intervention time period, the RR of readmission was 0.57 (p=0.036) and 30d mortality was 0.72 (p=0.015). Time to follow‐up was reduced from 15 to 9 days (p<0.01) from the early time period to the late one. Conclusions: The use of care transition interventions have the potential to address issues of rehospitalization, especially in chronic diseases. Establishing a model which improves patient outcomes will have many long‐term benefits for our healthcare system. This intervention decreased mortality and increased readmissions on a patient level, while decreasing both mortality and readmissions on a hospital level, though other factors may be involved.

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Anderson, Deborah Ellen. „Parental Perceptions of the Efficacy of Clinical Intervention for Speech-Language Disorders at Portland State University's Speech and Language Clinic“. PDXScholar, 1996. https://pdxscholar.library.pdx.edu/open_access_etds/4932.

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The purpose of this study was to investigate the survey as a method of assessing client satisfaction with clinical services and to then assess parental satisfaction of clinical services at Portland State University's language clinic using the survey method. The survey asked questions regarding the parents' perceived benefits from the clinic, their perception of the skills of the clinicians who served their children, and the parents' perception of the clinical atmosphere. Eighty-five Consumer Satisfaction Surveys were mailed to 81 parents of children receiving services at Portland State University Speech-Language Clinic between the years 1987 and 1994. Eleven surveys were returned, all containing a signed consent letter, representing a 13% rate. Determining the cause behind the poor response rate for this particular survey was not difficult. No surveys were returned from the years 1987 through 1989. The highest percentage of return was from the year 1994 (38% ), indicating that higher response rates were achieved if the client was polled within 1 year of using clinical services. To further substantiate this conclusion, two of the parents contacted by telephone refused to participate in the survey, and gave length of time as the reason behind their refusal. The overall response to the survey was positive, indicating a high rate of satisfaction among the survey respondents with the services provided at the Portland State University Speech-Language clinic.

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Sundberg, Catharina, und Marica Jarvén. „Information och individuellet omhändertagande av bröstcancer-patienter“. Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24565.

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I Sverige drabbas ca 6 800 kvinnor av bröstcancer varje år. Onkologiska kliniken på universitetssjukhuset MAS i Malmö tar årligen emot cirka 230 bröstcancer-patienter för strål- och/eller cytostatikabehandling. Efter det första uppföljande läkarbesöket känner sig patienten ofta ensam och övergiven och fortsätter att ha ett stort behov av information. En empirisk kontrollstudie med kvantitativ ansats gjordes med syfte att undersöka om ett riktat informationssamtal med rådgivande onkologisjuksköterska, kunde öka kvinnliga bröstcancerpatienters trygghet och välbefinnande. Studiegruppen erhöll ett informationssamtal med sjuksköterska och båda grupperna fick besvara en enkät. Resultatet visade att studiegruppen i större omfattning visste när och till vilken sjuksköterska de skulle ringa. De motionerade mer och mådde fysiskt och psykiskt bättre. Båda grupperna kände sig väl omhändertagna och nöjda med råden de fick.
In Sweden about 6800 females are affected by breast cancer each year. The oncology clinic at MAS hospital in Malmö accepts approximately 230 breast cancer patients for radiation treatments and / or chemotherapy. Proceeding the initial doctors appointment the patients frequently feel abandoned and isolated and continue to require a large amount of information. An empirical study with quantitative attempts was conducted to investigate if directed information with a consultation nurse, could increase the female breast cancer patient’s comfort and wellbeing. Two groups were formed out of which a trial group had an information session with an oncology consultation nurse, and both groups had to complete a questionnaire. The results proved that the trial group to a greater extent knew when to call, and which nurse to contact. They exercised more and felt better both physically and emotionally. Both groups felt well looked after and were satisfied with the advice provided.

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McClure, Anne Carey. „Ritualized Futility via Clinical Momentum at the End of Life in the Intensive Care Unit:An Ethical Inquiry into Moral Distress in Nurses as a Response to a Culturally MediatedHealthcare System Failure“. The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1587082543896911.

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Durandt, Nicola Estelle. „Outcome of a home-visiting intervention to improve social withdrawal assessed with the m-ADBB in six-month old infants in Khayelitsha, Cape Town : a cluster randomised controlled trial“. Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/96009.

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Thesis (MSc)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Pregnant women living in South African peri-urban settlements face many challenges for their health and the health of their infants. Current health care services face many constraints and are not able to meet all the needs of pregnant mothers. Home-visiting programmes implemented by community health workers can alleviate these constraints. The current RCT assessed the effectiveness of the Philani Plus Intervention Program that addressed HIV, alcohol, maternal and child nutrition and mental health. The effectiveness of the intervention was assessed by measuring infant social withdrawal behaviour using the modified Alarm Distress Baby Scale (m- ADBB). A total of 681 cases were randomised into control (N=330) and intervention groups (N=351) and assessed using the m-ADBB. A cut-off score of two and above was used to determined significant social withdrawal behaviour. Data was analysed using descriptive statistics and cross-tabulation initially, followed by analysis of variance and multilevel modelling. Results indicated a prevalence of 46.7% of social withdrawal behaviour; however, no significant differences between groups were found. The current prevalence was substantially higher in comparison to the only other published study using the m-ADBB. Furthermore, the prevalence rate was also significantly higher compared to the majority of other studies using the original Alarm distress Baby Scale (ADBB). The high prevalence of social withdrawal behaviour found in this study indicates an increased risk for suboptimal infant development. Further research regarding social withdrawal behaviour and the casual mechanisms associated with the development of such behaviour is needed. Furthermore, validation of the m-ADBB in different settings is needed.
AFRIKAANSE OPSOMMING: Swanger vroue wat in Suid-Afrikaanse buitestedelike nedersettings woon staar baie uitdagings in die gesig met betrekking tot hul gesondheid en die gesondheid van hul babas. Huidige gesondheidsdienste is baie beperk en is nie in staat om in al die behoeftes van swanger moeders te voorsien nie. Huis-besoek programme wat deur gemeenskaplike gesondheidswerkers geïmplementeer word, kan hierdie beperkings verlig. Die huidige RCT het die effektiwiteit van die Philani Plus Intervensie Program wat MIV, alkohol, voeding en geestelike gesondheid aanspreek, geassesseer. Die effektiwiteit van die intervensie is geassesseer deur sosiale onttrekkingsgedrag met behulp van die gewysigde Alarm Nood Baba Skaal (m-ADBB) te meet. ‘n Totaal van 681 gevalle is lukraak in kontrole (N = 330) en intervensie groepe (N = 351) verdeel en geëvalueer volgens die m-ADBB. 'n Afsnypunt van twee en hoër is gebruik om beduidende sosiale onttrekkingsgedrag te bepaal. Data is aanvanklik ontleed met behulp van beskrywende statistiek en kruis-tabulering, gevolg deur analise van variansie en multi-modelle. Resultate toon 'n 46,7%-voorkoms van sosiale onttrekkingsgedrag, maar het egter geen beduidende verskille tussen groepe getoon nie. Die huidige voorkoms was aansienlik hoër in vergelyking met die enigste ander gepubliseerde studie wat gebruik gemaak het van die m- ADBB. Verder was die voorkomssyfer ook aansienlik hoër in vergelyking met die meerderheid van die ander studies wat gebruik gemaak het van die oorspronklike Alarm Nood Baba Skaal (ADBB). Die hoë voorkoms van sosiale onttrekkingsgedrag dui op 'n verhoogde risiko vir suboptimale baba ontwikkeling. Verdere navorsing oor sosiale onttrekkingsgedrag en die meganismes wat verband hou met die ontwikkeling van sulke gedrag, is nodig. Verder word die bekragtiging van die m-ADBB in verskillende instellings benodig.

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Karlsson, Elisabeth. „Ungdomars attityder till oral hälsa och upplevelse av att ha fått ta del av en beteendevetenskaplig intervention samt dess effekt på munhygienbeteende“. Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Oral hälsa, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-36555.

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Syfte: Pröva en integrerad metod av den transteoretiska modellen och begreppet känsla av sammanhang hos ungdomar gällande munhygienbeteende och upplevelse av intervention och reflektioner kring oral hälsa. Metod: Studien utfördes med en mixad metod. Urvalet bestod av 20 ungdomar där 11 valde att delta. Deltagarna randomiserades till två grupper där experimentgrupp vid base-line fick ta del av den beteendevetenskapliga interventionen och kontrollgrupp av en mer traditionell tandvårdsbehandling. Plack och gingivit mättes vid base-line och efter en månad. Experimentgrupp intervjuades vid uppföljning om upplevelse av att ha fått ta del av intervention och inställningar till oral hälsa. Statistiska analyser av kvantitativa data gjordes för att räkna ut skillnader inom respektive grupper samt mellan dem gällande plack och gingivit. Dataanalysen utfördes med deskriptiv statistik och icke-parametriska test. En kvalitativ innehållsanalys gjordes av intervjuerna och sedan jämfördes kvantitativa och kvalitativa resultat och presenterades i en metaslutsats. Resultat: Mellan base-line och en-månads uppföljning minskade plack och gingivit signifikant hos experimentgruppen. I jämförelse mellan grupperna minskade plack och gingivit mer hos experimentgrupp än kontrollgrupp. Frågeställningen kring deltagarnas upplevelse av interventionen resulterade i huvudkategorierna ”positivt bemötande” och ”begriplig och motiverande kunskap”, med fyra underkategorier. Frågeställningen om reflektioner kring oral hälsa resulterade i ”oral hälsa ur en social kontext” och ”munnens betydelse för att fungera och se bra ut” också med fyra underkategorier. Slutsats: Den integrerade beteendevetenskapliga interventionen gav ett bättre resultat på munhygienbeteende hos deltagarna än den mer traditionella tandvårdsbehandlingen. Upplevelsen av att ha tagit del av interventionen var positiv vilket stärker interventionens användbarhet. Mer forskning behövs för att utreda nyttan och användbarheten av interventionen inom tandvården.

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Stonestreet, John Ryan. „A Confession of Miraculous Mythological Epistemology for Health Communication“. Ohio University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1412942733.

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Stange, Dorit [Verfasser], und Dorothee [Akademischer Betreuer] Dartsch. „Effects of a structured medical management intervention aimed at reducing medication complexity during hospitalization in inpatient and subsequent outpatient care : a controlled trial under routine clinical conditions in chronically ill patients / Dorit Stange. Betreuer: Dorothee Dartsch“. Hamburg : Staats- und Universitätsbibliothek Hamburg, 2012. http://d-nb.info/102757307X/34.

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Lucas, D. Pulane. „Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital“. VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/2996.

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Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs.

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Tolaj, Suana. „KRISREAKTIONER OCH KRISHANTERING BLAND VÅRDPERSONALEN“. Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26757.

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Att nästan varje dag konfronteras genom sitt yrke med t ex tragedier, allvarligt skadade eller dödfall upplevs olika av oss alla. Syftet med föreliggande studie var att beskriva krisreaktioner samt möjligheten till krishantering hos vårdpersonalen efter traumavård vid en akutmottagning. En enkät användes för datainsamling. Resultatet visar att personalen upplever krisreaktioner i samband med omhändertagandet av skadade barn samt yngre patienter och vid omhändertagandet av deras anhöriga. Möjlighet till krishantering finns på arbetsplatsen men alla är inte nöjda. Förslag på förbättring av krishanteringen handlar om bl a återkommande formell krishantering.
To almost daily be confronted at work by tragedies, seriously hurt people or death is something that we all experience in different ways. The aim of this study was to describe crisis reactions and the possibility of crisis interventions after trauma care among the nursing staff at one emergency department. A questionnaire was used to collect data. The result shows that the nursing staff experience crisis reactions when taking care of hurt children and younger patients, and when taking care of there relatives. There is possibility to crisis interventions at the workplace but not everybody is satisfied with it. Among other things, the nursing staff proposed recurring formal crisis interventions as an improvement.

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Liljeroos, Maria. „Caring needs in patient-partner dyads affected by heart failure : An evaluation of the long-term effects of a dyadic psycho-educational intervention“. Doctoral thesis, Linköpings universitet, Avdelningen för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-133182.

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Introduction: As medical treatment has improved, patients with heart failure (HF) now live longer and care mostly takes place at home with partners providing the main assistance. Taking care of an ill or disabled individual imposes a well-documented burden on the partner’s healthrelated quality of life. The awareness of partners’ burdensome situation is increasing, but few interventions have targeted the needs of patientpartner dyads with HF. The results have been inconclusive and give no clear guidance on how interventional programmes should be designed to improve both patient and partner outcomes. Aim: The overall aim of this thesis was to evaluate the effects of a psychoeducational intervention delivered to patient-partner dyads with HF during long-term follow-up, and to explore the dyads’ perceived caring needs. Methods: The thesis is based on four papers that used both quantitative and qualitative data. Study I and II used a randomized controlled design with a follow-up assessment after 24 months including 155 patientpartner dyads. The control group received care as usual. The intervention group received care as usual, and in addition they participated in the nurse-led psycho-educational intervention. Data was collected using questionnaires before and 24 months after the intervention, in order to determine the long-term effects on patients and partners regarding health related quality of life, perceived control, symptoms of depression and partners’ caregiver burden (I, II). A conceptual health promotion model inspired the intervention. To describe how the model was applied, a qualitative approach analysing nurses’ documentation of the sessions with 71 dyads in the intervention group (III) was used. Study IV has an explorative design. To further explore the dyads’ perceived caring needs, focus groups interviews with 19 patient-partner dyads with heart failure (IV) were performed. Results: The intervention did not have any significant effect on physical or mental health- related quality of life, depressive symptoms, or perceived control over the heart failure among the dyads (I) or caregiver burden in the partners (II) after 24 months. Furthermore, time to first event did not differ significantly between the dyads in the intervention group and the control group (I, II). As for the partners, both the intervention and control group reported decreased physical health between the baseline assessment and the 24-month follow-up (I). The intervention was composed of three components; 1) cognitive 2) supportive, and 3) behavioural component. The analysis of the nurses’ documentation confirmed the coverage of all the components and the analysis revealed a vide range of caring needs among the dyads (III). The dyads described a need to learn about HF to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital and both the patient and the partner need to be present at the clinic visits. Meeting others who are in the same situation and sharing the burden in nurse-led group sessions was proposed as an opportunity to support each other and others (IV). Conclusions: Over the 24-month follow-up period, the intervention had a neutral effect on health- related quality of life, depressive symptoms and perceived control over the HF among the dyads, and on partners’ caregiver burden. Considering the fact that partners serve as a critical extension of the formal healthcare system, and that both patients and partners ask for more support, it will become crucial to find new ways to support dyads affected by heart failure. This thesis may be viewed as a first step in trying to understand dyads’ perceived caring needs, and it can serve as a guide in clinical work and when designing new dyadic interventions.

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Edwards, Timothy Robin. „A prospective observational study to investigate the effect of prehospital airway management strategies on mortality and morbidity of patients who experience return of spontaneous circulation post cardiac arrest and are transferred directly to regional Heart Attack Centres by the Ambulance Service“. Thesis, University of Hertfordshire, 2017. http://hdl.handle.net/2299/19508.

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Introduction: The most appropriate airway management technique for use by paramedics in out-of-hospital cardiac arrest is yet to be determined and evidence relating to the influence of airway management strategy on outcome remains equivocal. In cases where return of spontaneous circulation (ROSC) occurs following out-of-hospital cardiac arrest, patients may undergo direct transfer to a specialist heart attack centre (HAC) where the post resuscitation 12 lead ECG demonstrates evidence of ST elevation myocardial infarction. To date, no studies have investigated the role of airway management strategy on outcomes in this sub-set of patients. The AMICABLE (Airway Management In Cardiac Arrest, Basic, Laryngeal mask airway, Endotracheal intubation) study therefore sought to investigate the influence of prehospital airway management strategy on outcomes in patients transferred by the ambulance service directly to a HAC post ROSC. Methods: Adults with ROSC post out-of-hospital cardiac arrest who met local criteria for transfer to a HAC were identified prospectively. Ambulance records were reviewed to determine prehospital airway management approach and collect physiological and demographic data. HAC notes were obtained to determine in-hospital course and quantify neurological outcome via the Cerebral Performance Category (CPC) scale. Neurologically intact survivors were contacted post discharge to assess quality of life via the SF-36 health survey. Statistical analyses were performed via Chi-square, Mann Whitney U test, odds ratios, and binomial logistic regression. Results: A total of 220 patients were recruited between August 2013 and August 2014, with complete outcome data available for 209. The age of patients ranged from 22-96 years and 71.3% were male (n=149). Airway management was undertaken using a supraglottic airway (SGA) in 72.7% of cases (n=152) with the remainder undergoing endotracheal intubation (ETI). There was no significant difference in the proportion of patients with good neurological outcome (CPC 1&2) between the SGA and ETI groups (p=.286). Similarly, binomial logistic regression incorporating factors known to influence outcome demonstrated no significant difference between the SGA and ETI groups (Adjusted OR 0.725, 95% CI 0.337-1.561). Clinical and demographic variables associated with good neurological outcome included the presence of a shockable rhythm (p < .001), exposure to angiography (p < .001), younger age (p < .001) and shorter time to ROSC (p < .001). Due to an inadequate response rate (25.4%, n=15) analysis of SF36 data was limited to descriptive statistics. Limitations: The study only included patients who achieved ROSC and met the criteria for direct transfer to a HAC. Results are therefore not generalisable to more heterogenous resuscitation populations. Accuracy of clinical decision making and ECG interpretation were not assessed and therefore some patients included in the study may have been inappropriately transferred to a HAC. The low SF-36 survey response rate limited the level of neurological outcome analysis that could be undertaken. Conclusion: In this study, there was no significant difference in the proportion of good neurological outcomes in patients managed with SGA versus ETI during cardiac arrest. Further research incorporating randomised controlled trials is required to provide more definitive evidence in relation to the optimal airway management strategy in out-of-hospital cardiac arrest.

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Mendonça, João Guilherme Rodrigues [UNESP]. „Mulher e criança: ambivalência de dois mundos ditados por especialistas em artigos de revistas destinados ao grande público entre os anos de 1940 a 1950“. Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/101325.

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Ce travail se propose a comprendre, analyser et interpréter les textes en forme de articles, produits en sessions destinées à mères dans les magazines dirigés au grand public entre les années 1940 à 1950. Les magazines que contiennent des sessions dans cette periode discriminée sont trois: Fon Fon, Allons lire et La Cigale. La thèse c’est divisée en deux blocs avec des sessions differentes. Le premier bloc représente la première partie de la thèse dans la quelle on voit l’admission théorique sur le but de recherche. Le deuxième bloc, qui représente la deuxième partie de la thèse, presente l’exploration du but de recherche à partir des magazines Fon Fon, Allons lire et La Cigale, pendant la periode de 1940 à 1950. L’ensemble des articles qui compose les sessions de ces magazines configurent la source documentaire, composée de 213 articles où je décrits et j’analyse les informations , les descriptions et les représentations de la femme mère, caractérisée par les experts, qui leur écrivaient dans ces sessions spécifiques destinées à mères par l’exercice de la maternité. La recherche démontre que les experts que s’ont dédié plus fréquemment dans la publication de textes et de messages à les femmes mères ont été les médecins.Ceux-ci exercent une vraie éducation de la femme pour la fonction de la maternité; ils ont entré dans l’histoire familière , en intervenant et en engendrant des normes por la routine de la éducation du fils, en engendrant une athmosfère de faute, de dilution, de l’autonomie parentale,à travers de l’imposition de la puissance de la connaissance spécialisée, en disqualifiant les traditions familières et des endroits, en disqualifiant les parents, les parents et en cherchant prendre les espaces des laïques et des orientations des personnes plus vieilles et plus proximes de la famille. Une police... (Résumé complet accès életronique cidessous)
O presente trabalho se propôs a compreender, analisar e interpretar os textos em forma de artigos, produzidos em seções destinadas às mães em revistas voltadas ao grande público entre os anos de 1940 a 1950. As revistas que mantêm seções nesse período discriminado são: Fon Fon, Vamos Ler e A Cigarra. A tese está dividida em dois blocos de diferentes seções. O primeiro bloco retrata a primeira parte da tese, onde se evidencia o aporte teórico sobre o objeto de pesquisa; o segundo bloco representa a segunda parte da tese, que retrata a exploração do objeto de pesquisa a partir das revistas Fon Fon, Vamos Ler e A Cigarra, compreendendo o período de 1940 a 1950. O conjunto dos artigos que compõe as seções dessas revistas, configuram a fonte documental, composta de 213 artigos em que descrevo e analiso as informações, descrições e representações da mulher mãe, caracterizada pelos especialistas, que escreviam a elas, nessas seções específicas destinadas às mães, para o exercício da maternidade. A pesquisa revela que os especialistas que mais frequentemente se dedicaram na editoração de textos e mensagens às mulheres mães foram os médicos. Estes exercem uma verdadeira educação da mulher, visando a função da maternidade; adentram na história familiar, interferindo e fundamentando normas para a rotina da criação do filho, criando uma atmosfera de culpa, diluição da autonomia parental, através da imposição do poder do conhecimento especializado, descredenciando as tradições familiares e locais; desacreditando os pais, os parentes e procurando tomar os espaços dos leigos e das orientações das pessoas mais velhas e próximas da família. Uma autêntica polícia das famílias se instala. Será preciso, então, que essa mulher, que faz parte da elite e representa...
The present work proposed to understand and interpret the articles destined to mothers in magazines to the public between 1940 and 1950. The magazines that keep articles in this period itemized are three: Fon Fon, Vamos Ler e a Cigarra. The Work is divided in two blocks of different sessions. The first block pictures the first part of the work highlights the theoretical input about the research from the magazines Fon Fon, Vamos Ler e a Cigarra between 1940 and 1950. The ensemble of these magazines articles, are the documentary source, consist in 230 articles in which I write and analyze the information, descriptions, and representations of woman mother, characterized by experts, who wrote to them, in those magazines which had session aimed to mothers. The research shows that the experts who frequently dedicated writing the articles where doctors. They had a major influence in the exercise of being a mother for those women, going into familiar history, intervening and making rules of how bring up a child, creating an atmosphere of guilty, dilating the parents autonomy ,throw the knowledge expert’s power, putting family tradition behide, disbelieving the parents and looking to take off elderly and near friends orientation . Installing a family police. Is there a need for this up class mother, who represents the magazine’s aim public ,to learn how to be a mother and take care of your own child with expert doctors now because before were de nannies, slaves, milk mothers and so on. The doctor did not believe that it was a natural mother s feeling, the concept of a child insert in a family also didn’t exist in the doctors view. This was the concept that was proposed by the articles published by those magazines Fon Fon, Vamos Ler e a Cigarra. In the end the expert writers dedicated to the up a class mothers governance, left... (Complete abstract click electronic access below)

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Nnajiofor, Chinyere Fidelia. „HIV/AIDS-Related Stigma and Discrimination Toward Women Living With HIV/AIDS in Enugu, Nigeria“. Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10143549.

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HIV/AIDS-related stigma and discrimination (S&D), lack of social support, poverty, and gender inequalities have been identified as factors in the increased prevalence rate of HIV transmission in Enugu, Nigeria, especially among women ages 15 to 49 years. Despite the funding of reduction programs, HIV/AIDS-related S&D remain a major driving force in the increased rate of new HIV cases in Enugu. This study addressed a perceived need for behavioral change intervention approaches that span all societal factors to reduce the HIV infection rate in Enugu Nigeria. The study was guided by Goffman’s (1963) social S&D theory. The sample was composed of 132 women living with HIV/AIDS WLWHA ages 21 to 54 years, purposefully sampled from the 4 HIV and AIDS comprehensive initiatives care centers in Enugu, Nigeria. Fifteen WLWHA were interviewed and 114 participated in an online survey. The descriptive statistics and a multiple linear regression analysis and comparison revealed a convergent significant relationship between the S&D determinants (social, political, psychological, environmental, and cultural) and HIV/AIDS-related S&D towards WLWHA in Enugu F (4,109) = 45.09, p <.001). It also revealed that the cultural determinant of S&D was a significant predictor of HIV/AIDS-related S&D towards WLWHA in Enugu (? = 0.81, p < 0.001). The implications for positive social change include providing public health professionals evidence-based data to inform policy change, plan and to implement programs that will change societal attitudes and mobilize broad-based community actions to eradicate HIV/AIDS–related S&D toward WLWHA in Enugu, Nigeria, and in Sub-Saharan African Countries.

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Mendonça, João Guilherme Rodrigues. „Mulher e criança : ambivalência de dois mundos ditados por especialistas em artigos de revistas destinados ao grande público entre os anos de 1940 a 1950 /“. Araraquara : [s.n.], 2011. http://hdl.handle.net/11449/101325.

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Orientador: Paulo Rennes Marçal Ribeiro
Banca: Eladio Sebastián Heredero
Banca: Ari Fernando Maia
Banca: Fátima Elizabeth Denari
Banca: Fábio Tadeu Reina
Resumo: O presente trabalho se propôs a compreender, analisar e interpretar os textos em forma de artigos, produzidos em seções destinadas às mães em revistas voltadas ao grande público entre os anos de 1940 a 1950. As revistas que mantêm seções nesse período discriminado são: Fon Fon, Vamos Ler e A Cigarra. A tese está dividida em dois blocos de diferentes seções. O primeiro bloco retrata a primeira parte da tese, onde se evidencia o aporte teórico sobre o objeto de pesquisa; o segundo bloco representa a segunda parte da tese, que retrata a exploração do objeto de pesquisa a partir das revistas Fon Fon, Vamos Ler e A Cigarra, compreendendo o período de 1940 a 1950. O conjunto dos artigos que compõe as seções dessas revistas, configuram a fonte documental, composta de 213 artigos em que descrevo e analiso as informações, descrições e representações da mulher mãe, caracterizada pelos especialistas, que escreviam a elas, nessas seções específicas destinadas às mães, para o exercício da maternidade. A pesquisa revela que os especialistas que mais frequentemente se dedicaram na editoração de textos e mensagens às mulheres mães foram os médicos. Estes exercem uma verdadeira educação da mulher, visando a função da maternidade; adentram na história familiar, interferindo e fundamentando normas para a rotina da criação do filho, criando uma atmosfera de culpa, diluição da autonomia parental, através da imposição do poder do conhecimento especializado, descredenciando as tradições familiares e locais; desacreditando os pais, os parentes e procurando tomar os espaços dos leigos e das orientações das pessoas mais velhas e próximas da família. Uma autêntica polícia das famílias se instala. Será preciso, então, que essa mulher, que faz parte da elite e representa... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The present work proposed to understand and interpret the articles destined to mothers in magazines to the public between 1940 and 1950. The magazines that keep articles in this period itemized are three: Fon Fon, Vamos Ler e a Cigarra. The Work is divided in two blocks of different sessions. The first block pictures the first part of the work highlights the theoretical input about the research from the magazines Fon Fon, Vamos Ler e a Cigarra between 1940 and 1950. The ensemble of these magazines articles, are the documentary source, consist in 230 articles in which I write and analyze the information, descriptions, and representations of woman mother, characterized by experts, who wrote to them, in those magazines which had session aimed to mothers. The research shows that the experts who frequently dedicated writing the articles where doctors. They had a major influence in the exercise of being a mother for those women, going into familiar history, intervening and making rules of how bring up a child, creating an atmosphere of guilty, dilating the parents autonomy ,throw the knowledge expert's power, putting family tradition behide, disbelieving the parents and looking to take off elderly and near friends orientation . Installing a family police. Is there a need for this up class mother, who represents the magazine's aim public ,to learn how to be a mother and take care of your own child with expert doctors now because before were de nannies, slaves, milk mothers and so on. The doctor did not believe that it was a natural mother s feeling, the concept of a child insert in a family also didn't exist in the doctors view. This was the concept that was proposed by the articles published by those magazines Fon Fon, Vamos Ler e a Cigarra. In the end the expert writers dedicated to the up a class mothers governance, left... (Complete abstract click electronic access below)
Résumè: Ce travail se propose a comprendre, analyser et interpréter les textes en forme de articles, produits en sessions destinées à mères dans les magazines dirigés au grand public entre les années 1940 à 1950. Les magazines que contiennent des sessions dans cette periode discriminée sont trois: Fon Fon, Allons lire et La Cigale. La thèse c'est divisée en deux blocs avec des sessions differentes. Le premier bloc représente la première partie de la thèse dans la quelle on voit l'admission théorique sur le but de recherche. Le deuxième bloc, qui représente la deuxième partie de la thèse, presente l'exploration du but de recherche à partir des magazines Fon Fon, Allons lire et La Cigale, pendant la periode de 1940 à 1950. L'ensemble des articles qui compose les sessions de ces magazines configurent la source documentaire, composée de 213 articles où je décrits et j'analyse les informations , les descriptions et les représentations de la femme mère, caractérisée par les experts, qui leur écrivaient dans ces sessions spécifiques destinées à mères par l'exercice de la maternité. La recherche démontre que les experts que s'ont dédié plus fréquemment dans la publication de textes et de messages à les femmes mères ont été les médecins.Ceux-ci exercent une vraie éducation de la femme pour la fonction de la maternité; ils ont entré dans l'histoire familière , en intervenant et en engendrant des normes por la routine de la éducation du fils, en engendrant une athmosfère de faute, de dilution, de l'autonomie parentale,à travers de l'imposition de la puissance de la connaissance spécialisée, en disqualifiant les traditions familières et des endroits, en disqualifiant les parents, les parents et en cherchant prendre les espaces des laïques et des orientations des personnes plus vieilles et plus proximes de la famille. Une police... (Résumé complet accès életronique cidessous)
Doutor

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Henriksson, Martin. „Cost-effectiveness and Value of Further Research of Treatment Strategies for Cardiovascular Disease“. Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9788.

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48

Olanrewaju, Folawiyo S., Ayotola Falodun, Muhammed Jawla, Patricia Vanhook und Stacey McKenzie. „Hepatitis C Virus Screening in Federally Qualified Health Centers in Rural Appalachia“. Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/90.

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The prevalence of Hepatitis C Virus (HCV) in the US is estimated at 3.5 million with 18,153 deaths in 2016. It is the most common bloodborne infection, with a higher age-adjusted mortality rate than Hepatitis B Virus or Human Immunodeficiency Virus. Without treatment, nearly 1.1 million people will die from HCV by 2060. About 41,200 new cases of HCV were reported in 41 states in the US in 2016. The reported cases of acute HCV in 2016 is 2.3 per 100,000 in Tennessee, which is more than twice the national goal set by Healthy People 2020. This is a descriptive study to ascertain the HCV prevalence and usefulness of screening in medical outreach settings (MO) compared to indigent healthcare clinics (IHC) in northeast Tennessee. This study period was from April 2017 – February 2019. Participants (n=250), were adults, who engaged in routine, opt-out HCV testing at 4 IHC and 3 MO sites in the Tri-Cities, TN region. During the screening, demographic information- age, gender, race- were collected and the de-identified data were analyzed using Statistical Analysis System (SAS 9.3) to perform a descriptive analysis. Also, several discrete Chi-Square tests of independence between the demographic variables, screening locations, and HCV antibody prevalence was conducted. A total of 250 clients were screened for HCV. The majority of clients screened were non-Hispanic whites 228 (91.20%); females 136 (54.40%); young adults 131 (52.40%) and at IHC clinics 187 (74.80%). Screening showed HCV antibody prevalence of 14.8%. The majority of positive cases were non-Hispanic whites 36 (97.30%; P=0.1561); females 19 (51.35%; P=0.6867) and young adults 23 (62.16%; P=0.286). The prevalence at the IHC clinics and MO settings were 36 (97.30%; P=0.0006) and 1(2.70%) respectively. This analysis shows the higher yield of targeted HCV screening at IHC clinics. Focused HCV screening is critical in the era of opioid epidemic, particularly when direct-acting antiviral agents (DAAs) which offer a Sustained Virologic Response (SVR) rate of more than 90% are available. The use of case control or cohort study designs to establish causality is recommended for improving focused HCV screening.

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Pinto, Sara Maria Oliveira. „Comfort in palliative care: development and evaluation of a complex nursing intervention“. Tese, 2017. https://repositorio-aberto.up.pt/handle/10216/105622.

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50

Pinto, Sara Maria Oliveira. „Comfort in palliative care: development and evaluation of a complex nursing intervention“. Doctoral thesis, 2017. https://repositorio-aberto.up.pt/handle/10216/105622.

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