Dissertations / Theses on the topic 'Dementia Patients Care Case studies'
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Johnson, Roxanna H. "Experiences of dementia care workers in nursing homes : an exploratory study comparing Canada, Scotland, and the United States." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21884.
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This comparative research explores the work experiences of dementia care workers in nursing homes. The aim of this study is to understand concepts central to care and to gain insights from the care workers‟ perspectives. A comparative framework and symbolic interactionist approach is used to analyse data collected using ethnographic methods from 59 dementia care workers in Canada, Scotland, and the United States. The fieldwork settings are institutionalised; dominated by for-profit ownership; and provide care for a resident population with high cognitive and physical needs. The comparative findings underscore the importance of work conditions that provide care workers with sufficient resources to do their job and enough time to complete their work. The absence of these critical components creates stressful work conditions for the care workers. The lack of time, staff and supplies such as towels, wash cloths, and continence products do not allow the residents‟ choices in their care and disregard their dignity and rights. The inability to deliver care for the residents according to the guaranteed government care standards often result in the violation of human rights for the care workers and residents. The care workers are unable to supply the quality of care they know the residents need and are capable of providing given better circumstances. There are frequently not enough care workers, resources, or time to meet the level of care that relevant standards mandate or the care workers know is possible. The analysis reveals that care workers struggle to provide more than basic physical care and are seldom able to meet essential social care needs for the residents. Unwritten rules are implemented in each setting that include separating people with dementia, placing these residents out of view of the public, not allowing the residents access to go outside, and not providing them with engaging and meaningful interactions. While policies are frequently developed with good intentions, many are counter-productive without dementia knowledge. This comparative research reveals care practices and routines share strong similarities across the fieldwork sites while the care worker characteristics as a workforce vary the most between countries. Some differences involve the training required, average age, pay and mode of dress or appearances. Too often researchers frame stress issues for care workers as problems with attitudes, motivation, training and incentives. Yet, the broader social structures and conditions that set the context in which these problems have their origins are commonly ignored. Good working conditions for care workers are precursors to good care for the residents. This thesis concludes with recommendations for practice, research and policy development.
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Paulsson, Petra, and Madeleine Perman. "Sjuksköterskors erfarenhet av att vårda patienter med demenssjukdom : En litteraturbaserad studie." Thesis, Högskolan Väst, Avdelningen för omvårdnad - grundnivå, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-14267.
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Background: Today, 160,000 people with dementia live in Sweden. With increasing age, the risk of suffering from dementia is higher. Many of those who seek hospital care and other healthcare facilities have dementia in addition to other disorders. Caring for people with dementia demands that the nurse has the knowledge and skills required to be able to provide adequate and safe care. Aim: The aim of this study is to describe nurse´s experiences in taking care of patients with dementia disease. Method: A literature-based study was performed, analyzing ten qualitative articles Results: The results consist of two main themes with four subthemes each. The first theme is nurses experience of barriers to good dementia care with four subthemes, the organization as an obstacle, lack of time, lack of knowledge, education and experience, non-adapted care environment. The second main theme was nurse's experience with conditions to good dementia care with four sub-themes, working in teams, working person-centered, knowledge of dementia diseases and caring environment. These highlight nurses experience to care for people with dementia. Conclusion: To care for patients with dementia, according to the result, time and knowledge are mainly required. Working person-centered gives the patient quality of care. Building a relationship with the patient and learning how to interpret signals takes time but is necessary for good care and good working environment. Resources are needed from management in form of time, staffing and knowledge development
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Furlini, Linda. "Living with chronic dementia from the caregiver perspective : a case for educational support." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=85161.
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Caregiving for two parents affected by chronic dementia was the original impetus for this study. My negative experiences led to a quest for insight and solutions through volunteer, professional and academic pursuits. It culminated in this exploration of caregivers' experiences and their decision-making to expose the educational support they need. Caregivers tend to be family members, and overwhelmingly women. Studies from various disciplines confirm that caregivers need educational support to make decisions. Yet, little is known about what type of educational support they need and how it is to be provided. Caregivers' voices are seldom included in research and they are frequently blamed for the problems they confront. This qualitative study honours caregivers' voices. Through in-depth semi-structured interviews, the perspectives of five women form my primary source of data. Personal documentation, archival materials, and interviews with experts in the field supplement these data. To analyze the data two complementary analytic approaches are used: categorization and contextualization. A categorization approach organizes the data into conceptual themes. These themes include activities of multitasking, being locked into a state of heightened alert, interpreting the disease, and managing care. These activities reveal physical and psychological suffering. Contextualization approaches situate the dilemmas the women face in particular contexts. These dilemmas highlight their lack of authority. The analyses indicate that the women engage in a wide range of decision-making and that they need both similar and specific types of educational support. These types of support include (1) lessening their burdens and their frustrations of decision-making; (2) facilitating ethical decision-making; (3) providing information about medical treatments; and (4) assisting with the access to and with the assessment of suitable resources. Overall, caregiving is a ve
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Nowik, Iwona. "Sjuksköterskors erfarenhet av samtal med närstående till personer med demenssjukdom vid övergången till sen palliativ fas : en kvalitativ studie." Thesis, Sophiahemmet Högskola, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2696.
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Demens är en obotlig sjukdom som leder till döden. En stor andel personer som bor i permanenta särskilda boendeformer i Sverige lider av demenssjukdom. Det ligger ett stort ansvar för omvårdnaden av personer med demenssjukdom på sjuksköterskan, som bland annat informerar och samtalar med närstående när livet hos den demenssjuke närmar sig slutet. Identifiering av hinder och förutsättningar för genomförande av dessa samtal bidrar till en bättre förståelse och utveckling av detta område. Syftet med denna studie var att belysa sjuksköterskors erfarenheter av att samtala med närstående till personer med demenssjukdom i samband med övergången till sen palliativ fas på särskilda boenden.En kvalitativ studie med semistrukturerade intervjuer genomfördes, där sju sjuksköterskor som arbetade vid demensenheter inkluderades. Data analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultatet utgörs av 8 kategorier: vårdplanering, personcentrerad vård, information och kommunikation, kunskap och utbildning, övergång till sen palliativ fas, teamarbete, LCP och att dö hemma.Denna studie påvisar hinder som kan uppstå i genomförande av brytpunktsamtal med närstående till personer med demenssjukdom. Några av dem är bristande kunskaper om demenssjukdomar hos närstående, brist på tidig planering av vården vid den sista tiden och osäkerhet bland sjuksköterskorna kring att hantera svåra samtal. Vidare presenteras förbättringsförslag som kan öka tryggheten och säkerheten i vården och på så sätt kan förbättra situationen för sjuksköterskor vid brytpunktssamtal. De två viktigaste förbättringsförslagen är dels att skapa en bättre kontinuitet i omvårdnadsarbetet och dels att organisera kontinuerliga utbildningar för att höja kompetensen hos omvårdnadspersonalen.Dementia is an incurable disease that leads to death. A large proportion of people living in nursing homes in Sweden have dementia. Nurses have a great responsibility for the care of people with dementia since they, among other things, carry out informative communication with the family when the resident approaches the end of life. Identification of barriers and facilitators for such communication could lead to a better understanding and development of this matter. The purpose of this study was to illuminate nurses’ experiences of conversations with families of people with dementia in the transition to end-of-life care in nursing homes.A qualitative study with semi-structured interviews was conducted, where seven nurses, working in nursing homes specialized in dementia, were included. A qualitative content analysis with an inductive approach was performed. The result consists of 8 categories: planning of care, person-centred care, information and communication, knowledge and education, transition to end-of-life care, teamwork, LCP and to die home.This study identified challenges that might hinder breakpoint communication with families of people with dementia. Some of them are families’ lack of knowledge about dementia, lack of early planning of end-of-life care and uncertainties among nurses on how to handle difficult conversations. Furthermore, improvement suggestions are presented that can increase the safety in care and improve the situation for the nurses in breakpoint communication. The two most important suggestions are the creation of a better continuity in the nursing and to organize continuous educations to increase the competence among staff.Keywords:
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Kelly, Fiona. "Well-being and expression of self in dementia : interactions in long-term wards and creative sessions." Thesis, University of Stirling, 2007. http://hdl.handle.net/1893/207.
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This is a multi-method ethnographic study, grounded in symbolic interactionism and social constructionism, which seeks to explore the social worlds of people with dementia in institutional long-term care. Carried out over six months, it uses non-participant observation, Dementia Care Mapping, video-recording, focused conversations and extensive fieldnotes to document types of interactions that fourteen people with dementia received in everyday ward life and during weekly creative sessions facilitated by occupational therapy (OT) staff. Using Kitwood’s (1997) work on person-centred care and Sabat’s (2001) work on selfhood (Selfs 1-3) it identifies their responses to such interactions in terms of their well or ill-being and expressions of Self. The study shows that everyday staff interactions with participants, while sometimes positive, were more often limited in their potential for maintaining or increasing well-being. Sometimes staff interactions were abusive; causing participant ill-being. Participants expressed Selfs 1-3 verbally and visually, although some of these expressions were subtle, fleeting and fragile. During creative sessions, OT staff engaged in sustained positive interactions, raising participant well-being and facilitating Self-expression; a fragile expression of Self could become a robust expression of Self, a past Self could be reclaimed and a desired Self co-constructed. My findings suggest that, in their interactions during creative sessions, OT staff generally recognised and supported Self of participants, raising well-being. However, ward staff did not fully recognise and therefore could not support Self in their interactions with participants, resulting in participant ill-being. This is a crucial finding, which could partially explain the differences in interaction types I observed, and the corresponding differences in participant well-being and Self-expression. This thesis argues for integrating the selfhood and person-centred approaches into an innovative staff-training programme, in order to bring about transformational change in practice. This might encourage care staff to reach out, recognise and respond to aspects of Self as they carry out care; promoting more positive ways of interacting with their patients, increasing patient well-being and fostering staff satisfaction.
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Choy, Yin-san Catherine. "An exploratory study on anticipatory grieving : case studies of spouses of terminally ill patients /." [Hong Kong : University of Hong Kong], 1987. http://sunzi.lib.hku.hk/hkuto/record.jsp?B12341575.
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Scheldeman, Griet. "Performing diabetes : balancing between 'patients' and 'carers', bodies and pumps, Scotland and beyond." Thesis, University of St Andrews, 2006. http://hdl.handle.net/10023/11085.
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This study is about young people (age 11-16) with diabetes. Based on fieldwork in a paediatric diabetes centre in Scotland, it describes the ways diabetes is lived and done by young people, their health carers and insulin pumps. This enactment is contrasted with other ways of doing diabetes, as observed on short fieldwork trips to paediatric centres in Brussels, Gothenburg and Boston. I explore the dynamics of diabetes care on two levels. I consider the interaction between health carers and patients. Comparative data from various paediatric centres make apparent how culturally and socially informed approaches towards adolescence, health and illness shape both care practices and patients' experiences, resulting in different medical outcomes. Concretely in the Scottish centre, a non-hierarchical holistic care approach by health carers emphasizing quality of life over health, informs the young people's perspective on diabetes. Being a free adolescent takes priority over managing diabetes, with the results of ill health and possible future complications. The existing dynamics in this care framework change as a third actor enters the scene: the insulin pump, a pager-sized technological device continuously attached to the body. I explore the balancing act between young people and their pumps. As the adolescents actively engage with their pumps not to search for better health but rather to pursue a better quality of life, the guiding question becomes: how can a technological device for insulin injection double as a tool towards a desired identity and a different illness? This work then, can be read as a concrete case study of how a uniform technological device is embedded and used in a specific cultural and social context. It can also be read as an argument for a re-orientation of paediatric diabetes care in the Scottish centre: care centred on collaboration and inclusion rather than focused on merely containing underlying conflict (between adults and adolescents, diabetes and life, health and quality of life). Centres in Brussels, Gothenburg and Boston, and the insulin pump concretely, show how collaboration can lead to good health and quality of life. To leave us to wonder: is 'doing diabetes differently' synonymous with 'doing a different diabetes'?
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Choy, Yin-san Catherine, and 蔡妍珊. "An exploratory study on anticipatory grieving: case studies of spouses of terminally ill patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1987. http://hub.hku.hk/bib/B31247799.
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Rees, Christopher Lewis. "An examination of patients' responses to framework breaks in psychotherapy in an institutional context." Thesis, Rhodes University, 1998. http://hdl.handle.net/10962/d1002551.
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This study examines the workings of the ground rules which make up the framework of psychotherapy, in an institutional context, by analysing transcripts of twelve audio taped sessions of therapy conducted in a psychiatric hospital. The breaks in the ground rules of the sessions are noted and the patients' responses to these breaks are analysed using Langs's (1982, 1988) method for decoding patients' material, suitably modified for use as a hermeneutic research method. Although all of the ground rules are broken in the institutional context, only one of the ten ground rules appears to be essentially affected by this particular institutional context. Other ground rules are broken out of choice of technique or through error. The institutional context has a structural impact only on the ground rule requiring a one to one relationship with privacy and confidentiality and this ground rule is transgressed in a number of ways in all twelve sessions examined in this study. However the patients' responses to this breach only occur in ways predicted by communicative theory when the break in the ground rule involves actual entry into the therapy space by another person. Other contraventions to this ground rule that do not involve such an entry do not elicit the predicted patient responses. The many other ground rule breaks occurring in the institutional context evoke the predicted responses in the patients' material. In the study, no therapist interventions are found to comply with the communicative therapy requirements for sound interventions; concomitantly it was found that no therapist interventions receive the required derivative validation. The results indicate that it is possible to conduct therapy of a substantially secure frame variety in this institutional context with minimum effort on the part of therapists and given proper training and supervision of therapists in the techniques of communicative psychotherapy. Furthermore the results lend weight to the importance of the communicative methodology for listening to patients' material in psychotherapy in an institutional context. However, further rigorous study of competently performed therapy, executed within the context of a secure frame within an institutional context, is needed in order to demonstrate the benefits of the communicative psychotherapy interventions and interpretations in this context.
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Ataie, Jutta Elisabeth. ""Who Would Have Thought, With a Diagnosis Like This, I Would be Happy?": Portraits of Perceived Strengths and Resources in Early-Stage Dementia." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1107.
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This study used photovoice methodology to explore how people with early-stage dementia use their perceived strength and resources to cope with the illness. Purposive sampling was used to recruit participants. Thirteen women and seven men age 57 to 90 (mean 73.4) with MMSE scores ranging from 20 to 28 (mean 25.6) participated in the project. Participants were provided with a disposable camera and invited to take photographs relevant to their well-being. The photographs provided the means for participants to take the lead in dialogue sessions about their coping response.
Grounded theory analysis revealed that initially, early-stage dementia precipitated a disruption in well-being. For the participants in this study, learning to live with the illness was an ongoing, continually shifting process of adjustment, where the participants moved from a familiar sense of well-being to an alternative sense of well-being. In this process the participants used a variety of strengths and resources ranging from those that supported them in reconstructing identity, regaining control, and rebuilding relationships to those that assisted them in reestablishing a healthy lifestyle and restoring meaning and purpose. Striving toward well-being while acknowledging the inconceivable notion of losing one's cognitive abilities was the central strength that the participants brought to this process. It captured the paradox the participants faced in living with early-stage dementia, which was to relegate the illness to the background of their lives while managing its symptoms in the foreground.
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Lee, Christopher. "The significance of Christian hope in cancer care : an exploration of the theme of hope in patients with cancer at a major cancer centre." Thesis, University of Wales Trinity Saint David, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683009.
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Waterfall, A. Christine. "Needs of caregivers of stroke survivors." Virtual Press, 2002. http://liblink.bsu.edu/uhtbin/catkey/1246469.
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Stroke is a medical event that has serious consequences for the survivor, his family, and society. Stroke is the third leading cause of death in the United States, and two-thirds of stroke survivors are permanently disabled with one-half of these survivors considered severely impaired. The economic burden from stroke is estimated to be $30 billion annually in health care costs and lost productivity.This study described the needs of 35 caregivers of stroke survivors within 24 hours of discharge to home from an acute care "safety net" teaching hospital in Indiana and how well those needs were met. Two subscales, (a) the Need for Information and (b) Patient Care Needs, of the Home Caregiver Need Survey were used. The theoretical framework for this study was the Neuman Systems Model.The stroke survivors were over 50 years old (77.1 %), half were African-American and half were Caucasian, and about a quarter were minimally impaired (25.8%) and less than a quarter were very impaired (22.9%) cognitively and/or physically upon discharge to home. Their caregivers were their children (48.6%) or spouses (28.6%), half of whom worked full-time outside the home. Most (85.7%) caregivers were female, in good health, and with no experience (81.8%) in caring for patients at home.School of Nursing
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Alshammari, Muna A. B. J. M. "The role of nurses in diabetes care and the impact of the different approaches of nurses' role on patients percieved quality of nursing care : two case studies from the UK and Kuwait." Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/49796/.
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Type 2 diabetes (T2D) is considered as a global major health problem, which requires healthcare systems to find solutions to meet the needs of the great numbers of people with T2D. One key to these solutions is nurses who undertake the provision of diabetes care. Nursing care in T2D varies across countries as a result of differences in healthcare systems, the way in which they are organised and other factors relating to nursing practice. The UK and Kuwait are two countries which have high incidences of T2D but differing health care delivery models, which has raised the need to understand the different roles of nurses in providing T2D care in these two countries’ healthcare systems. Key aims of this research were: (1) to investigate the actual roles undertaken by nurses in T2D care; (2) to investigate the extent to which these different roles affect perceived quality of nursing care; (3) to investigate the guidelines of diabetes care in the UK and Kuwait; and (4) to evaluate if nurses are delivering care based on these guidelines. This study investigated two cases in the UK and Kuwait regarding nursing roles in T2D care and how they affect the perceived quality of nursing care. In order to understand the phenomenon, a multiple case study design was employed involving multiple sources of information including documents review, non-participant observations, and semi-structured interviews with nurses and their patients with T2D. The diabetes clinic sites for this study were Nottingham University Hospitals (NUH) Trust in the UK and the Ministry of Health (MoH) hospitals in Kuwait. A thematic approach was utilised as a framework for the within-case and cross-case analyses. The findings of the study showed that nurses are motivated and competent to provide optimum care to achieve patient satisfaction, which is a significant sign of quality of nursing care. The nurse-led system in the UK and the physician-led system in Kuwait indicate different approaches in T2D care. In the UK, the nurse’s part in T2D care has been extended and advanced, making the role comparable to a physician's role. For instance, the status of 'nurse consultant' and 'nurse prescriber', allows the nurse to coordinate and lead diabetes care. In Kuwait, nurses contribute significantly to T2D diabetes care; however, their role is not officially recognised as they are not titled ‘diabetes nurse’ despite the fact they follow physician-established guidelines. Findings from this research further showed that the role of a diabetes nurse in Kuwait lacks clarity, as evidenced by the lack of any published statements specifying their roles according to their specialisation, experience and qualifications. This absence of what nurses are supposed to be doing or a lack of a statement relating to the guideline-informed role of nurses has therefore resulted in an undervaluation and lack of support for this role in Kuwait. The results of this study enhanced understanding of the roles nurses play within T2D care in both the UK and Kuwait. The information gathered also provides better understanding about nurses’ guideline-informed roles and their actual roles in T2D care and therefore that data determines how the differences in the roles of nurses might impact on patients' perceived quality of nursing care.
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Skinner, Kerry. "The quality of life of three men with autism spectrum disorders living in a group home: a case study." Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/2192.
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Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2009.This thesis focused on three adults with Autistic Spectrum Disorder (ASD) who are living in a group home in Cape Town. The purpose of this exploratory study was to explore and describe the three occupants' perceived quality of life and their experiences of living in the group home. The group home was established in 2005 as a pioneering project by Autism Western Cape, a regional non-profit organisation (NGO). It is designed for adults with high-functioning ASD who require low care. In this interpretative study, a multiple case study method of enquiry was used. The Personal Wellbeing Index – Intellectual Disability (PWI-ID), as developed by Cummins and Lau (2005), was used as the primary subjective outcome measure of quality of life. In addition, the study made use of participant observations undertaken during two semi-structured interviews with each participant and two focus group interviews. All three participants felt that they had enjoyed a higher level of quality of life, especially in the domain of 'personal relationships', since their arrival at the group home. However, they expressed a desire for more independence; a higher income; female companionship and better security at the home. These suggestions have been made available to the relevant sponsors of the housing project.
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Erickson, Jeanne. "The education experiences of eight American adolescents in cancer survivorship." Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:e366e072-075d-4f9f-8a02-308c09d8728e.
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The aim of this thesis is to understand the experiences of eight American high school students who have been diagnosed with cancer. By increasing understanding of the challenges that adolescents in cancer survivorship experience, better support can be identified. The experience of cancer survivorship influences the physical, psychological, and social experiences of patients. As the survival rate of childhood cancers continues to increase, death becomes less likely making the need to maintain educational engagement during survivorship increasingly important. The research questions for this study were designed to address two main gaps in the current field of research. The first research question aims to address how the physical and psychological effects of cancer and treatment impact the participants' engagement with school. The second research question aims to understand the role that school plays for adolescents in cancer survivorship, including how participants experienced supplemental education during and after cancer treatment. This study uses a qualitative research methodology to address the research questions utilizing primarily semi-structured interviews and an adjusted version of the Adolescent Coping Scale. When used in combination with the interviews, the scale provides a picture of what the participants experienced and how they have been able to cope with the challenges they have faced. Interpretive phenomenological analysis was used to provide structure to the interview analysis. The results of this study show that fatigue and a compromised immune system have an impact on school attendance more than other physical effects during cancer treatment. As a result, adolescents are most at-risk of experiencing challenges in educational engagement during treatment. The results of this study also show that the feeling of uncertainty throughout cancer survivorship promotes fear and the feeling of a loss of control. Once treatment ends, fear of relapse is common. Physical and psychological effects were felt to improve as time passed. Another key result of this study is that the cancer experience results in a shift in perspective that becomes incorporated into the formation of identity. Participants feel different from peers as a result of the physical and psychological effects of the cancer experience. The results from the Adolescent Coping Scale indicate that school achievement, relapse and the worsening of physical side effects, and being treated different by peers were common concerns for the participants regarding their school, illness, and social concerns, respectively. Lastly, the participants view supplemental education as successful if it meets their personal academic and physical needs, is implemented consistently, and helps them to feel emotionally supported and socially connected. However, more research is needed that focuses on the implementation of policy at the state and district levels to discern whether this is a common challenge unique to this population of students with a physical or medical disability. The sample available for this research topic is not only limited to an extremely small population, but they are also a highly guarded population, making access for recruitment challenging. However, while generalization is difficult with a study of this size, the evidence collected on the participants' experiences during and after treatment provides valuable data on aspects of supplemental education implementation.
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Le, Roux Rhonddie. ""Acts of disclosing" : an enthnographic investigation of HIV/AIDS disclosure grounded in the experiences of those living with HIV/AIDS accessing Paarl Hospice House seeking treatment." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/16610.
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Thesis (MPhil)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: Paarl, in the Western Cape, has been identified as one of the 15 national sites where antiretroviral treatment (ARVs) would be made available to people living with HIV/AIDS. Paarl Hospice initiated a support group for people to deal with this disease in 2003. Since February 2004 Paarl Hospice has been recruiting people from the surrounding informal settlements for ARVs. By means of participant observation I explored how HIV/AIDS-related disclosure experiences unfolded in places, spaces and events associated with the support group in the context of factors enabling and preventing people from accessing Hospice House. I did this by considering the insights drawn from an anthropological approach. I found the meanings of disclosure in the majority of studies to be limited and restricted. Available studies approached disclosure in a top-down fashion by regarding the definition of disclosure as the announcement of HIV-positivity at the time of diagnosis only. These studies have not considered social differences relating to disclosure neither did they focus on the actual process of disclosure. By means of a constructivist approach to grounded theory I seek to broaden the definition of disclosure to account for the range of ways in which disclosure practices take place. I found that disclosure could not be separated from the situational context in which it occurs and that it can only be understood in relation to the circumstances and relationships in which it takes place. In this study, disclosure was an ongoing process, situated somewhere between active, public announcement of an HIV-status and complete secrecy and somewhere between voluntary and involuntary revealing of the disease.
AFRIKAANSE OPSOMMING: Paarl in die Wes-Kaap is geïdentifiseer as een van die 15 nasionale areas waar antiretrovirale medikasie beskikbaar gestel sou word aan mense wat leef met MIV/VIGS. Paarl Hospice het gedurende 2003 ʼn ondersteuningsgroep geїnisieer om aan MIV/VIGS aandag te gee. Sedert Februarie 2004 is Paarl Hospice in die proses om mense te werf uit die omliggende informele behuisingsgebiede vir antiretrovirale behandeling. Met behulp van antropologiese insigte en deelnemende waarneming kon ek nagaan hoe verskillende maniere van MIV/VIGS-verwante bekendmaking ontvou in plekke, ruimtes en gebeurtenisse wat verband hou met die ondersteuningsgroep. MIV/VIGSverwante bekendmaking is ondersoek te midde van inhiberende en fasiliterende faktore wat mense verhoed of aanhelp om Paarl Hospice te besoek. Ek het bevind dat die definisie van bekendmaking in die meeste navorsing gebrekkig is. Beskikbare navorsing het bekendmaking volgens ‘n bo-na-onder-wyse benader as die openbare bekendmaking van ‘n MIV-status na afloop van diagnose alleenlik. Met behulp van ‘n konstruktiewe benadering van die begronde teorie het ek gepoog om die definisie van bekendmaking uit te bou om sodoende die verskeidenheid maniere waarop bekendmaking plaasvind te akkommodeer. Ek het vasgestel dat bekendmaking onlosmaakbaar deel is van die situasionele konteks waarin dit plaasvind en dat dit slegs begryp kan word in verband tot die verhoudings en omstandighede waarin dit plaasvind. In hierdie studie was bekendmaking ʼn voortdurende proses, gesitueer tussen aktiewe openbare bekendmaking en volledige geheimhouding van ʼn MIVstatus, asook tussen volkome vrywillige en onvrywillige bekendmaking van ʼn MIVstatus.
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Cheng, So-fong Nancy, and 鄭素芳. "The use of Minuchin's structural approach in an exploratory studyof the impact of stroke on families." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1985. http://hub.hku.hk/bib/B31247465.
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王善萍. "未成年住院患者疾病模式及住院費用研究 : 南方某三甲醫院個案分析." Thesis, University of Macau, 2012. http://umaclib3.umac.mo/record=b2590336.
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McConnell-Barker, Michelle. "Comparison of restraint practices for persons with dementia residing in and outside special care units in British Columbia." Thesis, 2000. http://hdl.handle.net/2429/10694.
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The excessive use of chemical and physical restraints in intermediate care facilities has
been a subject of study since the early eighties, and has produced several explanations for why
restraint use continues to be practiced. One of the primary reasons often cited is that restraints
are used to control "problematic behavior" commonly exhibited by a person suffering from
dementia.
The focus of the proposed project is to analyze whether restraint practices for residents
with moderate to severe dementia differ between Special Care Units and integrated units within
long term care facilities. The main objective of the study is to demonstrate whether seniors with
dementia residing in Special Care Units will be less likely to encounter physical and chemical
restraints than demented residents living within an integrated facility. This objective explores
the assumption that Special Care Units were designed to meet the needs of residents with
dementia, and therefore, care providers should be more accepting of deviant behaviours.
The findings revealed that the more severe the level of memory impairment the more likely
a resident would be placed in a Special Care Unit. Once located in these Special Care Units,
residents were more likely to experience physical and chemical restraints than their counterparts
in integrated care units.
20
Lee, Youjung 1977. "Korean American dementia caregivers' attitude toward caregiving: the role of culture." Thesis, 2007. http://hdl.handle.net/2152/3786.
Full textAbstract:
The purpose of this study was to explore how Korean American caregivers view dementia caregiving and analyze the role of culture in their attitude toward caregiving. Demographic characteristics, stressor factors, social support factors, and cultural factors were examined in the model. Stressor factors were measured by care receivers' problem behaviors, duration of caregiving, and amount of caregiving. Social support factors were composed of the amount of social support and the quality of social support. Cultural factors included level of acculturation, years in the U.S., filial piety, and familism. The study compared a group of spouse caregivers with a group of children providing care in order to investigate the differences in their attitude toward caregiving. In addition, the interaction effect between social support and acculturation on dementia caregiver's attitude toward caregiving was examined. Eighty five Korean American dementia caregivers participated in the survey through a convenience sampling method. Among the Korean American dementia caregivers, child caregivers showed a more positive attitude toward caregiving then spouse caregivers. The effects of social support on caregivers' attitude toward caregiving did not vary with the level of acculturation. Hierarchical multiple regression analysis indicated that, among the study factors including stressor factors, social support factors, and cultural factors, only social support factors contributed significantly to Korean American dementia caregivers' positive attitude toward caregiving. Among the predictors of Korean American dementia caregivers' attitude toward caregivng, the amount of caregiving per day was the most significant variable, followed by the quality of social support and care receivers' problem behaviors. Higher levels of daily caregiving and higher quality of social support were positively related to positive attitude toward caregiving. A higher level of care receivers' problem behaviors was negatively related to positive attitude toward caregiving. Comparison of the beta coefficients from the spouse caregiver group and nonspouse caregiver group revealed that there was a discrepancy of predictors of Korean American caregivers' attitude toward caregiving between the two caregiving groups. The model had a better fit for immigrant spouse caregiver groups indicated by significantly different R² from spouse caregivers and non-spouse caregivers, 85% and 33%, respectively. The results of this study imply the importance of incorporating cultural diversity in social policy. Because of the salient findings in this study, inclusion of content on increasing and enhancing quality of social support is recommended for social work practice with Korean American dementia caregivers.
21
Schaper, Anna Sophie. "Deskriptive Studie zur zahnärztlichen Betreuung und Versorgung demenzkranker Patienten im Raum Göttingen." Doctoral thesis, 2020. http://hdl.handle.net/21.11130/00-1735-0000-0005-143E-0.
Full text
22
McIntosh, C. J., J. L. Westbrook, R. Sheldrick, Claire A. Surr, and D. J. Hare. "The feasibility of Dementia Care Mapping (DCM) on a neurorehabilitation ward." 2012. http://hdl.handle.net/10454/6971.
Full textAbstract:
Person-centred care (PCC) is recommended when working with patients with neurological difficulties. Despite this, to date there has been no appropriate methodology for assessing or developing PCC in neurorehabilitation settings. Dementia Care Mapping (DCM) is a well-established tool for assessing and developing PCC in dementia settings and the current study investigated the feasibility of applying DCM on an acute neurorehabilitation ward. DCM procedure and coding required minor adaptations for use in this setting and further recommended adaptations were subsequently identified. It was found that the DCM coding system was generally suitable and could identify strengths, weaknesses and areas for development in ward care. Q-methodology identified that staff views endorsed the feasibility of using DCM in neurorehabilitation, with staff reporting that they found DCM useful and relevant to their work. DCM could be further developed for this setting by amendments to the behaviour coding system, concept and coding of person-centred care, and a population-specific manual. DCM is a promising methodology to develop and promote PCC in neurorehabilitation.
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TSOU, JUI-YU, and 鄒瑞玉. "Research on Therapy and Care of Dementia Patients :A Case Study of Two Elderly Care Institutions,Taoyuan City." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/c457an.
Full textAbstract:
碩士元智大學
社會暨政策科學學系
107
This research concerns dementia patient treatment and care, focusing on veteran elderlies with similar living conditions and cultural backgrounds registered at a residential institution specializing in Dementia caregiving service and a Day care center, both in Taoyuan City. This study is qualitative, using literature analysis, actual participatory observation and in-depth interviews as methods to understand the impact that medical treatment and lifecare service have on the disease process of dementia patients and identify the suitability of occupational therapy intervention in the patients' everyday lives. Recently, as the national population aged, the number of dementia patients also rose, which have caused considerable difficulty for families in giving care to their members and also financial stress. In order to allow dementia patients to receive proper medical attention and adequate lifecare service, the Administrative Yuan launched a "10-Year Long-Term Care Plan 2.0", including dementia patients into targeted populations as a response to a range of caregiving issues related to dementia (Ministry of Health and Welfare 2016). This study found that dementia patients can receive occupational therapy through non-medicated means to improve the patents' degenerative limbs, and also applies to other patients with different diseases. There are however uncertain factors, such as dementia patients' willingness to participate and their physical conditions. The learning care type such as non-medicated therapy sessions can extend cognitive functions. When dementia patients receive proper medical care and lifecare, their quality of life improves, and the duration of long-term care is dramatically reduced and lowers the intensity of human labor and social cost.
24
Capstick, Andrea. "Ex Memoria: In Eva's case - some memories fade - others keep returning." 2007. http://hdl.handle.net/10454/5644.
Full textAbstract:
yesEx Memoria is a short film - just 15 minutes long - which focuses on the experience of Eva, a woman with dementia living in a nursing home. The film - which is the result of a collaboration between Bradford Dementia Group (BDG), writer/director Josh Appignanesi, and producer Mia Bays - attempts to show how life might be experienced from Eva's point of view, in her 'version of reality'. In this article I will outline the background to the making of Ex Memoria, explain how the film is being used on the Dementia Studies courses provided by BDG, and - without giving away too much of the story for people who haven't yet seen the film - summarise some of the responses to it.
25
羅慈縈. "Apriori Algorithm for Care Targets from Different Types of Dementia Patients – A Case of Medical Center in Taiwan." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/85d43w.
Full textAbstract:
碩士國立彰化師範大學
企業管理學系
107
With the population transition, an aged society has made elderly care more important. Dementia is a problem faced nowadays. It is one of the leading causes of elderly persons’ inability to live independently that requires long-term medical cares. Different types of medical cares are required because of the type of dementia, the course of disease, and the length of time. Dementia of onset to death will continue for several years. It will aggravate the condition as time goes on, but it lacks an integrated approach to care. Dementia patients will not only have dementia but will be accompanied by other chronic diseases. Therefore, a cross-disciplinary care integration is also needed. This study uses Apriori algorithm and the dementia database from a medical center in central Taiwan. The main purpose is to find the care targets that are suitable for most dementia patients. In addition, by analyzing and discussing the relationship between dementia and care targets, a group of dementia care plans can be formed. The input variables of Apriori algorithm in this study include four demographic variables and fifteen care targets with the support, confidence, and lift are set up to be 10%, 90%, and greater than 1, respectively. There are 1759 association rules found, and these rules can be further organized into four groups: the prerequisite five care targets, the care targets needed by different types of dementia, the care targets needed by different CDR scores, and the correlation between specific care targets. The results show that the majority of patients need five care: care (3) appropriate activities, care (9) regular outpatient follow-up treatment, care (12) introduction and referral of social resources, care (13) referral to family support groups and care skills training, and care (15) disease tracking and health education for dementia and BPSD. Other care targets can be added based on the condition of dementia. Medical and care institutions can refer to these results to develop care plans for dementia patients to provide better medical care and improve the quality of care. Keywords: data mining, apriori algorithm, dementia, dementia care, care plan
26
Hsu, Yun-Ying, and 許昀螢. "Using Decision Trees to Identify Care Target Combinations for Different Dementia Patients – A Case Study in A Medical Center in Central Taiwan." Thesis, 2017. http://ndltd.ncl.edu.tw/handle/8q9dam.
Full textAbstract:
碩士國立彰化師範大學
企業管理學系
105
In recent years, the global population structure has moved towards aging, and dementia is one of the related diseases. Accordingt to the Taiwan Alzheimer`s Disease Association statistics, one of every 12 people in Taiwan is suffering from dementia. It is urgent to face the aging problem. The purpose of this study is to identify what types of care targets are required for each type of dementia patients. Thus, fifteen care targets along with two demographic variables are the input variables, while the type of dementia is the target. The data are from the patients with dementia provided by a medical center in central Taiwan. By applying classification and regression tree, C5.0, and CHAID, different care targets might be required for family members or health care workers in order to take great care of different types of dementia patients.The results show that 22, 26, and 16 rules are generated by classification and regression tree, C5.0, and CHAID, respectively. In the evaluation of the three algorithms, the predictive models of C5.0 and CHAID were superior to CART in others with tumor results, and CART and C5.0 outperformed CHAID in mixed dementia. In addition, the performance ranking in vascular dementia was CART > C5.0 > CHAID. Finally, C5.0 performed the best followed by CART and CHAID in Alzheimer's disease.
27
Mohammadi, Nooredin. "A hermeneutic phenomenological inquiry into the lived experience of Muslim patients in Australian hospitals." 2008. http://hdl.handle.net/2440/47562.
Full textAbstract:
In the past few years, many people with an Islamic background have settled in Australia. Within the health care context, this means that health care providers must modify the care provided to ensure it meets the needs of this culturally diverse population. Little nursing research has focused on understanding the perceptions and experiences of Muslim people within health care systems, particularly in Australia. This study provided an opportunity to explore, and document the experience of the hospitalisation for Islamic people and thereby advance the available information upon which important nursing care decisions that relate to this group can be more informatively made. This study aims to explore and interpret the lived experience of thirteen Muslim patients who had been hospitalised in an Australian hospital. The hermeneutic phenomenology of Heidegger (1967/1996), the philosophical hermeneutics of Gadamer (1989), and the ideas of van Manen (1990/1996) underpin this study. The meaning and understanding of the everyday experience of Muslim patient in a non-Islamic hospital is achieved through interpretation of the participants’ stories. Data were generated using unstructured audio-taped interviews from participants. The interviews were transcribed verbatim and analysed, then interpreted using phenomenological methods. The two themes to emerge from the participants’ experiences are: Being-thrown-into-an-un-everyday-world and living-Islam-in-the-un-everyday-world. The theme of Being-thrown-into-an-un-everyday-world arose from the sub-themes of the awareness of self and Being an outsider. The theme living-Islam-in-the-un-everyday-world was drawn from the three sub-themes of Being the same and different, hindrances to being Muslim, and adapting-to-the-un-everyday-world. The findings of this study provide an insight into the experience of Muslims being cared for in Australian hospitals. It is hoped that this interpretation will make a significant contribution to the care of Muslim patients by having health professionals consider how this group could be cared for in a culturally sensitive manner. It is not intended as a prescription for care but draws the reader to reflect on aspects of the Muslim faith and how this may impact on individuals experience when in hospital. The scope of this study and the dearth of available research in this area conclude that much more research needs to be undertaken.http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1317115
Thesis(Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008
28
Mohammadi, Nooredin. "A hermeneutic phenomenological inquiry into the lived experience of Muslim patients in Australian hospitals." Thesis, 2008. http://hdl.handle.net/2440/47562.
Full textAbstract:
In the past few years, many people with an Islamic background have settled in Australia. Within the health care context, this means that health care providers must modify the care provided to ensure it meets the needs of this culturally diverse population. Little nursing research has focused on understanding the perceptions and experiences of Muslim people within health care systems, particularly in Australia. This study provided an opportunity to explore, and document the experience of the hospitalisation for Islamic people and thereby advance the available information upon which important nursing care decisions that relate to this group can be more informatively made.
This study aims to explore and interpret the lived experience of thirteen Muslim patients who had been hospitalised in an Australian hospital. The hermeneutic phenomenology of Heidegger (1967/1996), the philosophical hermeneutics of Gadamer (1989), and the ideas of van Manen (1990/1996) underpin this study. The meaning and understanding of the everyday experience of Muslim patient in a non-Islamic hospital is achieved through interpretation of the participants’ stories. Data were generated using unstructured audio-taped interviews from participants. The interviews were transcribed verbatim and analysed, then interpreted using phenomenological methods.
The two themes to emerge from the participants’ experiences are: Being-thrown-into-an-un-everyday-world and living-Islam-in-the-un-everyday-world. The theme of Being-thrown-into-an-un-everyday-world arose from the sub-themes of the awareness of self and Being an outsider. The theme living-Islam-in-the-un-everyday-world was drawn from the three sub-themes of Being the same and different, hindrances to being Muslim, and adapting-to-the-un-everyday-world. The findings of this study provide an insight into the experience of Muslims being cared for in Australian hospitals. It is hoped that this interpretation will make a significant contribution to the care of Muslim patients by having health professionals consider how this group could be cared for in a culturally sensitive manner. It is not intended as a prescription for care but draws the reader to reflect on aspects of the Muslim faith and how this may impact on individuals experience when in hospital. The scope of this study and the dearth of available research in this area conclude that much more research needs to be undertaken.Thesis(Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008
29
Chang, Yu-Jui, and 張祐瑞. "An Research for the Influence of Environmental Design on the improvement of Problems Behaviorof Demented Patients -- By a Case of Special Care Unit for Dementia." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/50938795529240410282.
Full textAbstract:
碩士國立雲林科技大學
空間設計系碩士班
92
According to the stastistic data announced by the ministry of Interior, there are fifty thousand demented patients demanding special care , the population has been up to 3 percentage of aging population. Caregivings for demented elders are recognized as urgent problems in Taiwan. Behavior problems occur frequently in demented patients and represent one of the most difficult items in their care. Behavior problems inducing caregiver burnout, so that strategies for caregiving were widely discussed in the past year. Except for clinical drug, caregiver attitude and therapy program, environmental factors probably play major role in decreasing the frequency of behavior problems. Based on this concept, a growing number of special care units for demented elders with a specially designed environment has been established in many advanced countries. This research is focused on SCU in Taiwan as an object, the methodology includes the use of instrument to measure the behavior problems of demented patients, and the observation visiting to discuss the environment effect correlationship on decrease in the Problems Behavior of dementia. In this research, the nine people of loses a wisdom sickness in dementia and the carry person are processing question behavior evaluation after into the protection environment for three months, six months and nine months this three level, and the result according to “t” examination to analyze around cross-reference the question behavior have difference of the frequency﹔And have to depth visit all the carry person and observe the patient’s behavior situation in order to discuss the patient live in the process to affect the question behavior reduction to have the reason﹔Finally uses the linearity to examine correlation elements of the question behavior reduction. From the study results, we can find Problems Behavior was significantly affected with Environmental Design, by use of instrument to measure the behavior problems of demented patients and observation visiting. The most helpful to decrease in Problems Behavior are Arrangement for Living Space, Construction of Memory-Reminding Setting, The Use of Building Material and Equipment. Although Planning on Wandering Space and Identification elements for Orientation were insignificant in measure, both of them affect the dementia patient’s Problems Behavior to have decrement. This could confirm that are benefit to improvement of Problems Behavior of Demented Patients.
30
Freeman, Rachel Johanna. "Social workers’ perceptions of their role in providing palliative care to patients with life-limiting illnesses : a qualitative study among social workers in primary care settings in Namibia." Thesis, 2017. http://hdl.handle.net/10500/24340.
Full textAbstract:
This study explored social workers’ perceptions of their role in providing palliative care to patients with life-limiting illnesses in six hospitals across Namibia. A qualitative grounded theory approach was use in which in-depth interviews were conduct with twenty (20) social workers. Several key findings are presented: First, the emerging constructivist grounded theory of social workers’ multi-dimensional roles in providing palliative include identities of advocate, assessor, broker, counsellor, educator, facilitator, patient liaison, mediator, discharge planner and manager of in-country referrals. Second, several participants’ uncertainties of what palliative care entails offered insight that they are in need of palliative care education and training. Third, healthcare professionals do not understand the role of the social workers and therefore social workers receive inadequate support from them. Fourth, there is a lack of in-service training and continuous education in palliative care. Fifth, there are inadequate practice opportunities in palliative care for undergraduate social work students. Finally, the well-being of social workers is another concern with limited debriefing opportunities available. Further research needs to be conducted and policy guidelines established to identify ways to improve the field of palliative care social work. In achieving this, formal education and palliative care practice opportunities for social workers need to be established, providing continuing education and establishing a Centre of Excellence on palliative care provision. This study argues that the social work profession is well positioned to draw upon its values, culture and experiences (particularly from their clients) to get involved in creating a constructivist grounded theory of social workers’ roles in providing palliative care.Sociology
D. Phil. (Sociology)
31
Chiu, Yi-Ru, and 邱奕儒. "Multilingual mhealth platform for case studies of long-term care at home: Taking patients with brain trauma as an example." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/2x5a46.
Full textAbstract:
碩士國立陽明大學
生物醫學資訊研究所
107
In recent years, the rapid development of science and technology, for the medical system, advanced equipment has also brought a lot of benefits to people, the combination of information technology remote care model is a good example, and is widely used in chronic diseases and elderly patients, such as illness tracking and home care. As the population structure gradually enters into the society of young children and the elderly, as well as the changes in the current economic structure and lifestyle and the development of medical care technology, the problem of caring for the elderly has emerged. According to the 2018 survey by the Ministry of Health and Welfare of Taiwan, 17.23% and 10.74% of people aged 55 to 64 and over 65 have patients in need of home care. According to statistics, there are 730,000 elderly people in need of foreign caregivers in Taiwan in 2018. However, there is a shortage of native foreign caregivers. There are only about 12,000 native caregivers, accounting for only 4 percent of foreign caregivers. In the large number of foreign caregivers, southeast Asian countries dominated, Indonesia led, followed by the Philippines, Vietnam and Thailand. And the proportion has increased significantly every year since the government opened its door to the outside world. According to a survey by the Department of Labor at the end of 2018, the number of foreign workers working in nursing care in Taiwan has reached 256,173. Therefore, it is a trend to integrate mobile medical care services into handheld mobile devices, and to integrate care information and foreign languages. This study through smart phones build multilingual mhealth platform used in home care, provide another assist platform for foreign caregivers, foreign caregivers can take advantage of this App easily upload the daily physiological values. And the case of Health care practitioners can use this App at any time to catch on the status of the case through the statistical charts. To improve the quality of care at home by establishing a communication platform between Health care practitioners, family members and foreign caregivers.
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Nkosi, Zama Portia. "Patients' experiences at mobile health clinics : a case study of the KwaMachi in KwaZulu-Natal." Thesis, 2013. http://hdl.handle.net/10413/11283.
Full textAbstract:
Primary health care remains at the top of the government’s agenda. To address the issues of
inequity, the Department of Health adopted mobile health clinics to ensure that the places that
are hard to reach have access to primary health care. Without good health people do not have
means to enjoy other aspect such as education and employment.
Apartheid policies implemented by the old regime resulted in many rural areas in South
Africa remaining underdeveloped and underserviced. Hence, the introduction of mobile
health clinic ensured that the population in rural areas have access to health care. Unlike fixed
clinics, there are no specific sets of guidelines set up for the operations of mobile health
clinic. This include, displaying health posters at mobile health clinics, providing patients with
safe drinking water at the mobile site. With more and more mobile health clinics being added
to the rural population there should be established scope of services to for rural population.
This will ensure equality of service delivery between the mobile health clinics and fixed
clinics. Thus, guaranteeing its acceptability to the users.
Using qualitative methods the study explored the experiences of patients at the mobile health
clinic. Following the health equity model the study explored what the community of
KwaMachi use the mobile health clinic for and the experiences of individual when accessing
health care at the mobile health clinic.
The findings suggest that patients have both positive and negative experiences at the mobile
health clinic. The majority of respondents commented that mobile health clinic offered them
an entry point to the South African national health system. They also pointed out the services
offered are limited. Hence, providing a range of primary health care services will ensure the
maximisation of positive experiences at the mobile health clinic and this is likely to
contribute positively to the morbidity and mortality rates in rural areas in South Africa.Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2013.
33
Moyana, Watson. "The utilisation of the continuum of care for treatment of persons with a substance use disorder : service providers’ and service users’ experiences and perceptions." Diss., 2019. http://hdl.handle.net/10500/25591.
Full textAbstract:
In South Africa, substance use, abuse and dependency is twice the world norm. To address this trend, the continuum of care guides legislative prescriptions for the treatment of a substance use disorder. This study aimed to address the lack of a description of the utilisation thereof in literature and recent research findings. A qualitative approach was followed and purposive sampling was employed to collect data from both service providers and users of services. Tesch’s framework for qualitative data analysis (Creswell, 2014:218) was used to identify themes, sub-themes and categories, while the data was compared with existing literature on the identified themes. The trustworthiness of the findings was enhanced by the verification of the data through aspects of credibility/authenticity, transformability, dependability and conformability (Schurink, Fouché and de Vos, 2011:397). Informed consent, confidentiality , non-compensation, debriefing of participants, and the management of information were considered to ensure ethical practice.Social Work
M.A.(S.S.)
34
"Executive information systems (EIS): its roles in decision making on patients' discharge in intensive care unit." Chinese University of Hong Kong, 1995. http://library.cuhk.edu.hk/record=b5888309.
Full textAbstract:
by Chow Wai-hung.Thesis (M.B.A.)--Chinese University of Hong Kong, 1995.
Includes bibliographical references (leaves 56-57).
ABSTRACT --- p.ii
TABLE OF CONTENTS --- p.iv
LIST OF FIGURES --- p.vi
LIST OF TABLES --- p.vii
ACKNOWLEDGMENT --- p.viii
Chapter
Chapter I. --- INTRODUCTION --- p.1
Intensive Care Services --- p.1
Clinician as an Information Processor --- p.2
Executive Information System (EIS) for Intensive Care Services --- p.7
Scope of the Study --- p.7
The Organization of the Remaining Report --- p.8
Chapter II. --- LITERATURE REVIEW --- p.9
Sickness Scoring Systems --- p.9
Executive Information Systems (EIS) --- p.15
Information Requirements Determination for EIS --- p.17
Future Direction of EIS in Intensive Care --- p.20
Chapter III. --- RESEARCH METHODOLOGY --- p.22
Survey by Mailed Questionnaire --- p.23
Personal Interview --- p.24
Subjects Selection --- p.26
Analysis --- p.27
Chapter IV. --- RESULTS AND FINDINGS --- p.28
Part 1 - Questionnaires --- p.29
Part 2 - Interviews --- p.31
Chapter V. --- ANALYSIS AND DISCUSSION --- p.44
Analysis of Results and Findings --- p.44
Evaluation on Information Requirements Determination for an EIS --- p.50
Chapter VI. --- CONCLUSION --- p.52
Chapter VII. --- FUTURE DIRECTION OF DECISION SUPPORT IN CRITICAL CARE --- p.54
REFERENCES --- p.56
INTERVIEWS --- p.59
APPENDIX --- p.60
Chapter 1. --- A Sample of Hospital Information System Requirement Survey Questionnaire --- p.61
Chapter 2. --- Samples of Visual Display --- p.67
Chapter 3. --- A Sample of Format of a Structured Report --- p.70
35
Singh, Vikesh. "The knowledge of nurses on multidrug resistant tuberculosis at primary health care facilities in the Nelson Mandela Metropolitan." Diss., 2014. http://hdl.handle.net/10500/18451.
Full textAbstract:
Decentralisation of the multidrug resistant tuberculosis (MDR TB) programme to primary health care (PHC) facilities in the Nelson Mandela Metropolitan was implemented in order to improve the effectiveness of MDR TB services. This study explored the knowledge gaps of nurses at PHC facilities as regards MDR TB. A quantitative, cross-sectional descriptive study was conducted; data was collected using a structured questionnaire. Non-probability sampling was applied in this study. A convenient sampling technique was used and 25 of the 42 facilities were selected. Thirty-two respondents completed the questionnaire with a response rate of 64%. Descriptive statistics were used to describe the data. Only 38% of the nurses had been trained on MDR TB. Overall scores were high with a mean knowledge score of 61%. However there were knowledge gaps regarding side effects of MDR TB medication. This study revealed gaps in knowledge of certain areas of MDR TB managementHealth Studies
M.A. (Public Health)
36
Šuláková, Dagmar. "Etapy sociální práce s klientem s Alzheimrovou nemocí." Master's thesis, 2017. http://www.nusl.cz/ntk/nusl-358140.
Full textAbstract:
In this thesis, "Stages of social work with clients with Alzheimer's disease", I focused on the analysis of the most effective stages of social work. I found out that most respondents prefer a domestic informal care, corresponding to the stages of provided social work and unconditional acceptance of the patient. The sick person requires a sensitive holistic approach, accepting his individuality and ensuring dignity in all stages of the disease. The thesis was structured on the theoretical part, based on the findings of scientific literature dealing with the symptomatology and processes of Alzheimer's disease, characterized by basic treatment and care approaches. The theoretical part is followed by an own joint investigation, divided in a qualitative and a quantitative approach. The qualitative approach is based on a detailed case study which uses the methods of observation and interviews. Anonymous questionnaires were used for the quantitative method. The obtained data were summarized and analyzed. Due to the lack of data I concluded that the considered results can be obtained as irrelevant.
37
Sethuntsa, Molelekeng. "The development of a therapeutic approach for the treatment of individuals with Prader-Willi syndrome and their primary caregivers." Thesis, 2017. http://hdl.handle.net/10500/23826.
Full textAbstract:
Prader-Willi syndrome (PWS) is a genetic disorder resulting from a mutation of chromosome 15. It can manifest in physiological characteristics, cognitive impairment, behavioural problems, and sometimes also psychiatric disturbances. Taking care of an individual with PWS has a detrimental impact on the primary caregiver and also affects others around them. This considered, the current study aimed to learn more about the experiences and challenges of individuals diagnosed with PWS and their primary caregivers, in Gauteng and North-West Provinces, South Africa. Purposive sampling was used to select five families which then participated in the study. Qualitative research was used to conduct the study. As it was also crucial to generate a comprehensive understanding of participant experiences, collective instrumental case studies were used ̶ making use of participatory action research, ethnography and elements of auto-ethnography. Data were gathered by conducting semi-structured interviews, which were then analysed using thematic analysis. The data were organized around certain topics and common themes which emerged in each case study and the findings were then integrated with the literature which had been extensively reviewed. Based on these experiences and challenges, interventions were suggested that addressed the challenges and needs of the PWS individuals, their caregivers and families, and those around them (including school teachers). The main findings confirmed that not all individuals diagnosed with PWS manifest all the physiological characteristics, psychiatric disturbances and behavioural problems which have been documented in the literature. Furthermore, the symptoms vary in severity from one individual to the next. Cognitive impairment was, however, common to all individuals in the study. The findings also suggest that having a child diagnosed with PWS has a significantly negative impact on the primary caregiver, and taking care of PWS children is emotionally overwhelming and time-consuming. The use of a client-centred approach, implementing behaviour therapy techniques and doing psycho-education, all proved to be effective in managing some of these behaviours displayed by the individual patients and the challenges experienced by primary caregivers.Psychology
Ph. D. (Psychology)
38
McKeown, Shari I. "Playing with dolls : use of simulation technology in the Thompson Rivers University respiratory therapy program." 2011. http://hdl.handle.net/10170/446.
Full textAbstract:
This descriptive case study examines the use of medical simulation technology in the three-year Thompson Rivers University respiratory therapy training program. Qualitative analysis of data gathered from 78 participants through interviews, observations, and discussion groups reveal a wide variety of low- intermediate- and high-fidelity technologies used for education and evaluation. Deliberate practice is the predominant learning theory informing the use of simulation for safe and ethical training in competencies that would otherwise pose significant risk to patients. Recommendations include enhancements of the existing technology with psychological and environmental fidelity, and for optimal curriculum placement of high-fidelity simulators at hospital sites for student development of critical thinking and team training. Further research into learning with high-fidelity simulation specifically within the context of a student respiratory therapist as an embedded hospital team member is needed.
Keywords: respiratory therapy, patient simulation, critical thinking, learning, critical care, deliberate practice
39
Nunes, Susana Sofia da Costa. "Quedas em internamento hospitalar: causas, consequências e custos: estudo de caso numa unidade hospitalar de Lisboa, EPE." Master's thesis, 2015. http://hdl.handle.net/10437/6632.
Full textAbstract:
Orientação: Ana Lúcia RomãoNos últimos 30 anos, os custos com a saúde têm vindo a aumentar significativamente. As quedas de doentes são episódios frequentes nos internamentos de qualquer UH, que podem originar lesões, hospitalizações mais prolongadas, atraso na reabilitação e aumento de custos para a UH. A presente investigação teve por objetivo analisar quais as causas, consequências e custos de episódios de quedas notificadas com lesão, de doentes internados numa UH de Lisboa, EPE. Utilizou-se uma abordagem quantitativa, do tipo correlacional-preditivo-transversal, através de uma análise retrospetiva de 153 notificações de incidentes de quedas com lesão, durante o ano de 2013. A grande maioria dos doentes tinha idade compreendida num intervalo de 71 a 85 anos, sendo a média da idade de 72 anos. O principal motivo que os levou a cair foi a busca da satisfação das suas necessidades fisiológicas (47,7%), com probabilidade de ter sido provocada pelo estado de saúde do doente (67,3%), com maior incidência de escoriações e hematomas (em igual número 28,1%). No geral, os casos de quedas com um nível de lesão moderado e grave são os que representam um maior valor médio dos custos, em que as lesões graves de origem ortopédica acarretaram maiores custos para UH.
In the last 30 years, healthcare costs have increased significantly, contributing widely to the growth of public expenses. Patient falls are frequent episodes throughout the period of stay in any UH, which can lead to injuries, longer hospitalizations, delays in rehabilitation and increased costs to the UH. This research aimed to analyze causes, consequences and costs of reported fall events which lead to injuries in a UH of Lisbon, EPE. The study is based on a predictive, transversal and cross-sectional approach, through a retrospective analysis of 153 fall incident reports that lead to injuries during the year of 2013. The vast majority of patients were between 71 and 85 years old, with an average of 72 years old. The main reason that led them to fall was the fulfilment of their physiological needs (47.7%), likely caused by the patient's health condition (67.3%), with a higher incidence of bruises and hematomas (both 28.1%). Overall, falls with moderate and severe levels of injury are the cases that origin higher average costs, whereas serious orthopaedic injuries lead to higher costs for the UH.
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Viviers, Linde Juana. "The different voices of chronic illness." Diss., 2005. http://hdl.handle.net/10500/1247.
Full textAbstract:
This study aimed at exploring chronic illness from both the perspectives of the patient, living with the illness and the professional, treating the illness.
The epistemological framework is social constructionism. Qualitative research was selected as the research approach. Three in-depth interviews with three patients, suffering with a chronic illness were conducted, as well as three interviews with professionals, who had experience with patients diagnosed with chronic illnesses. Thematic analysis was the method used for the analysis of data.
The stories of the participants were reconstructed in terms of themes. A comparative analysis for both participants groups was done, and linked to the relevant literature
This study created an understanding of the complexity of chronic illness. The themes identified, highlighted the importance of the patient-professional relationship, specifically in the context of chronic illness.Psychology
M.A. (Clinical Psychology)
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Lekubu, Gloria Stephinah Sebaetseng. "Exploring the experiences of adult offenders living with HIV on pre-antiretroviral therapy program at the Losperfontein Correctional Centre." Diss., 2016. http://hdl.handle.net/10500/22274.
Full textAbstract:
Text in EnglishThe aim of the study was to explore the experiences of adult offenders living with HIV (OLWHIV) not qualifying for antiretroviral therapy (ART). Such offenders are put on the pre-antiretroviral therapy (pre-ART) program after HIV diagnosis. Follow up of OLWHIV is done every six months to ensure prompt treatment. Research objectives include exploration of experiences of OLWHIV on the pre-ART program, the accessibility of the program and the challenges thereof. An exploratory, qualitative study with face-to-face interviews was conducted. Purposive sampling of the eight participants was done to conduct the study. Seven out of eight participants accessed the pre-ART program well but had little knowledge of the pre-ART program. Furthermore, participants experienced little support from partners and health care workers. The study showed institutional constraints such as poor diet, shortage of staff and humiliation from Correctional officers. Participants portrayed commitment in the support group irrespective of the challenges experienced. The study further showed that the self-care theory could enhance the pre-ART program but that institutional constraints deterred the progress. Participants made recommendations such as strengthening of partnerships for support groups, good diet, and an increase of staff capacity. Overall study recommendations include implementation of universal test and treat and mixed methods for future studies.
Sociology
M.A. (Social Behaviour Studies in HIV/AIDS)
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Brito, Tânia Raquel Mendes Amaral de. "Qualidade em saúde: satisfação do utente com o serviço de urgências do Hospital de Santa Maria." Master's thesis, 2015. http://hdl.handle.net/10437/6633.
Full textAbstract:
Orientação: Vasco ReisIntrodução: Medir a qualidade dos serviços de saúde através da avaliação da satisfação dos utentes é indispensável para uma gestão adequada dos recursos, sobretudo no contexto socioeconómico atual. Esta avaliação também promove a centralidade do cidadão no sistema de saúde e é essencial para o desenvolvimento e aperfeiçoamento dos serviços de saúde. São objetivos principais deste estudo mensurar o índice de satisfação dos utentes com o Serviço de Urgências (SU) do Hospital Santa Maria (HSM) e identificar a influência de diversas variáveis como o género, idade, situação atual, habilitações literárias e estado de saúde. Métodos: Realizou-se um estudo transversal de natureza quantitativa, não experimental, descritivo-correlacional, envolvendo uma amostra de 155 indivíduos, destes 52,3% eram do género feminino, 54,8% pertencem ao grupo etário correspondente às idades compreendidas entre os 35 e os 64 anos, 38,1% encontram-se empregados, contudo a percentagem de desempregados situa-se imediatamente a seguir sendo de 26,5% e 34,8% têm ensino superior. Por fim, é de salientar que 43,2% dos inquiridos considera que tem um estado de saúde bom e 29,7% muito bom. O questionário utilizado foi o “Instrumento de medida de satisfação dos utentes nos Hospitais EPE e SA (Urgências)”. Este questionário avalia a satisfação em 11 dimensões: imagem, tempo de espera, instalações, médicos, enfermeiros, exames e tratamentos, família, qualidade global apercebida, resolução das reclamações, satisfação e lealdade; através de uma escala de Likert de 10 pontos. Resultados: As dimensões que obtiveram resultados mais altos são as relacionadas com os profissionais de saúde – médicos, 7.55 pontos; enfermeiros, 7,77 pontos e exames e tratamentos, 7,5 pontos, em média. Por outro lado, o tempo de espera e a capacidade de resolução de uma reclamação obtiveram o score mais baixo e próximo dos 5 pontos. Contudo, salienta-se que todas as avaliações foram positivas. Conclusões: A amostra analisada permite constatar a existência de um elevado nível de satisfação com o SU do HSM.
Introduction: Measuring the quality of Health services by assessing the patient satisfaction is essential for an appropriate management of resources, especially in the current socio-economic context. This review also promotes the centrality of the patient in the Health system and is essential for the development and improvement of Health services. The primary purposes of this study are measure the satisfaction level of the users of the emergency department of the Hospital Stoanta Maria and identify the influence of several variables such as gender, age, current status, educational qualifications and Health status. Methods: This study is descriptive and correlational, quantitative and not experimental. Includes 155 subjects: 52,3% are female, 54,8% have 35-64 years old, 38,1% are employed, however th percentage of unemployed is situated immediately after being and 34,8% have higher education. Finally, is noted that 43,2% of respondents belive it has a good Health and 29,7% has a very good Health. The questionnaire used was the “Instrumento de Medida de Satisfação dos Utentes nos Hospitais EPE e SA (Urgências)”. This questionnaire includes eleven dimensions: picture, waiting time, facilities, doctors, nurses, tests and treatments, family, perceived overall quality and resolution of complaits, satisfaction and loyalty; using a Likert scale of ten points. Results: The dimensions obtained higher results are related to Health professionals – doctors, 7,55 points; nurses, 7,77 points and tests and treatment, 7,5 points, on average. On the other hand, the delay time and the capacity of resolution a complaint obtained the lowest score, around 5 points. However, it is noted that all evaluations were positive. Conclusions: The sample concerned allows us to verify the existence of a high level of satisfaction with the emergency service of Hospital Santa Maria.