Dissertations / Theses: 'Family centred care discourse'

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Sye, Jill. "A fine balance." Click here to access this resource online, 2008. http://hdl.handle.net/10292/387.

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The aim of this study is to analyse the discourses drawn upon by community paediatric nurses in relation to children’s rights to health. The philosophy of Michel Foucault has been used to underpin the analysis of the interviews and exemplars of five experienced community nurses, revealing conflicting power relationships and discourses. Rights are formalised morality and so from a children’s rights perspective, discourses reflect both the moral and ethical positions of the nurses. Children are constructed as developing human beings whose moral status gradually changes and who, through a lack of developmental autonomy, entrust their decision-making to their representatives (parents and caregivers) as their trustees. Rights are correlative with the obligations and duties toward children by both families and society. Society constructs legislative and politically organised structures to govern raising children because children are an intrinsic social concern. Whilst representing society’s interest in children’s rights to health, nurses in the home act as a conduit for multiple governing structures. The nurses in this study construct their “truths” and knowledge about children’s health rights from nursing, medicine, law, education, and social policy. However, the values of individual parents can conflict with universal values for children’s health and wellbeing. Therefore representing society positions nurses as “agents of the state”, a role that potentially holds power over parents and children and leads to the epithet of “the health police”. Within the institution of the family, and in the privacy of the home, there are also mechanisms of power that can resist the mechanisms of the state and its representatives. Therefore the discourse “it takes a village to raise a child” competes with the “my home is my castle” discourse. Nurses negotiate a fine balance between these power relations. Nurses are challenged with using power productively to promote children’s rights whilst respecting the role of parents and families. I argue that children’s rights are central to the moral and ethical work of nurses but that such work is often obscured and invisible. I propose that children’s community nurses are excellent at negotiating networking and connecting at a micro level, but need to create a more sophisticated and cohesive entity at a macro level to become fully political children’s rights advocates.

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Toms, Gill. "Applications of family-centred care in clinical practice." Thesis, Bangor University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540738.

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Senabye, Juliet Sejosennye. "Family centred care in an intensive care unit in Botswana : the views of families." Diss., University of Pretoria, 2018. http://hdl.handle.net/2263/65856.

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Family-centred care (FCC) is a model of care that is focused on promoting collaboration through engagement of nurses and families in information sharing and decision making. This experience is common for families with patients admitted in the intensive care unit (ICU). Disruption of the social system usually manifests in the form of depression, fear and/or anger. Families need to be supported and involved in patient care and decision making, in order to reduce complaints, improve patient outcomes, and hence promote family-centred care. AIM The aim of the study was to describe the views of families regarding FCC and collaboratively develop strategies to enhance FCC in the general ICU in Botswana. Research Design The researcher used a qualitative, contextual, explorative and descriptive research design in order to explore and describe the lived views of families with patients admitted in the ICU regarding FCC. Methodology Ten family members of patients admitted in the ICU were purposively selected and data was collected by means of one-on-one interviews. The data-collection instrument was an Appreciative Inquiry semi-structured and open-ended interview guide. Findings The following main themes emerged: 1) workplace culture 2) compassion and 3) counselling. Conclusion Supporting and involving families in the care of the critically ill family member may improve family satisfaction, reduce complaints and ultimately lead to positive health outcomes for the patient.
Dissertation (MCur Nursing Science)--University of Pretoria, 2018.
Nursing Science
MCur Nursing Science
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Yuennan, Choosak. "The nature of family-centred care in Thailand : a case study." Thesis, University of East Anglia, 2015. https://ueaeprints.uea.ac.uk/59197/.

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Thalassemia is a long-term condition that is highly prevalent in children in northern Thailand and the management of this disease requires a strong input from families. Family-centred care is a key philosophy in the nursing care of children and their families, especially as parents play a key role in the health and well-being of a child. However, the concept of family-centred care is a western one and there is limited literature on its use in Thailand. The aim of this study is to explore the characteristics of family-centred care in one hospital in Thailand and the factors that influence the nature of the nursing care. Using a qualitative case study approach, data was collected by non-participant observations, semi-structured interviews of five families, four nurses, a medical doctor and a Buddhist monk and the analysis of documentation in 2010. The data was initially analysed deductively using a recognised framework of family-centred care and this was followed by a thematic inductive analysis. The results showed that all the elements of the framework of family-centred care existed in varying degrees although the concept was not recognised as shaping the nature of this care. The nature of this care was influenced by three factors: the family, the hospital and Thai culture with its strong religious traditions. These factors were incorporated into a model of family-centred care that could be applied to other institutions in Thailand. This study has shown that the family-centred care model is practiced but it requires a strong commitment and input from healthcare professionals. Strengthening and formalising the use of this concept can be a very useful strategy to ensure that the needs of the child and family are recognised, valued and met.

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Ohene, Lillian. "Family centred care for children in Ghana hospitalised through road traffic accident." Thesis, De Montfort University, 2017. http://hdl.handle.net/2086/16366.

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Road traffic accident (RTA) is one of the leading causes of injuries and hospitalisation of children in Ghana. The sudden hospitalisation of the injured child is associated with anxieties and stressful episodes for the affected families. Family Centred Care (FCC) is a concept in paediatric nursing, which forms the basis of care for sick children and their families. FCC as a product of social constructs differs in cultures and context, despite the universal principles underpinning the concept. There is a perceived lack of knowledge of the concept in childcare practice in Ghana. This study explored the perspectives of FCC among health professionals and parents of children hospitalised through RTA in Ghana. The study adopted a qualitative approach, underpinned by a constructivist grounded theory methodology. Data was generated through in-depth individual interviews using a semi-structured technique. Participants consisted of twenty-four professionals and nineteen parents. Data were analysed using a constant comparative approach and two core categories emerged. Parental presence emerged from parents’ perspective, which generated four sub-categories. These include; managing emotions, negotiating the system, parental care roles, and challenges encountered. The professionals’ interviews generated family involvement; its sub-categories are parental involvement, communication, setting boundaries and support for family involvement. The emerging model of parental presence and family involvement for the care of the injured child in the hospital is the first of its kind in Ghana. The dimensions of negotiating the care system, which includes parents negotiating their social status with the professionals, also, demonstrating their usefulness in the hospital and establishing acquaintances with persons with influential powers within the socio-cultural context of Ghana forms part of key findings and the contribution to knowledge. The outcome of discussing the findings within the existing literature was projected using the Force Field Analysis as a conceptual framework for family involvement in the medico-cultural context of Ghana. The study recommends that institutional policies should reflect family involvement practice evidenced by clear written protocols for the involvement of parents/family in the care of the in-patient child.

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Pretorius, Rachele Lara. "Perceptions of stakeholders on family-centred care in the intensive care unit: an associative group analysis." Diss., University of Pretoria, 2019. http://hdl.handle.net/2263/73769.

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Introduction and background: Family-centred care in the intensive care unit has increased steadily over the past three decades, based on the premise that the illness and health of an individual family member affects the whole family unit. Although widely researched there are still inconsistencies in implementing family-centred care, which influences the ability to transfer research findings into practice. Research has shown that recognising the role of family members in the critical care environment should be considered an essential component to caring for the critically ill patient. Although recommendations have been made for the implementation of familycentred care, it is not feasible for all recommendations to be adopted by nurses and healthcare professionals in a single ICU. Nurses and healthcare professionals need to customise strategies to an individual intensive care unit to improve family-centred care. Aim: The aim of the study was to explore and describe nurses, healthcare professionals and family members’ perceptions of family-centred care in the intensive care unit. Research design and methods: A quali-quanti research design was used. Participants included nurses, healthcare professionals and family members in the intensive care unit of a private hospital in Gauteng, South Africa. There were a total of sixty (60) participants who took part in the study. Nurses were selected using stratified random sampling, healthcare professionals were selected using total population sampling and family members were selected using purposive, maximum variation and convenience sampling. Data was collected over a period of one month by means of structured interviews using an associative group analysis technique. Participants were asked to write down free word associations in relation to the stimulus word “family-centred care” in order to explore and describe their perceptions of family-centred care in the intensive care unit as it is currently, as it could be in the “ideal world” and any gaps that exist around these perceptions. Results: Five themes were derived from the data: communication, environment, continuum of feelings, reflections and spiritual care. Conclusion: The implementation of family-centred care should involve all stakeholders in the intensive care unit in order to address inconsistencies in perceptions around family-centred care. Keywords: Associative group analysis, intensive care unit, family-centred care, healthcare professionals, nurses, perceptions, stakeholders
Dissertation (MNur)--University of Pretoria, 2019.
Nursing Science
MNur (Clinical)
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Wilson, Sally B. "Family Centred Care: A Descriptive Study of the Situation in Rural Western Australia." Curtin University of Technology, School of Nursing and Midwifery, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=15170.

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Family centred care is a concept espoused to be fundamental to achieving excellence in paediatric nursing. Although it is recognised that family centred care includes the child's rights to self determination the focus of this study is parental participation in the decision making and care of their hospitalised child at a partnership level. This is based on negotiation and requires frequent, effective communication between parents and nurses and for each to respect the other's knowledge and appreciate the other has something to offer in the relationship which will benefit the child. The purpose of this study was to identify whether family centred care was occurring in paediatric settings in rural Western Australia and explored parents' and nurses' perceptions of the concept. A questionnaire was designed based on the literature and common themes identified from focus groups. Convenience sampling was used and 15 rural hospitals facilitated participation of 243 parents who had a child under ten years of age hospitalised and 108 nurses who cared for children. Exploratory factor analysis identified four subscales from the parents' questionnaire and three subscales from the nurses' questionnaire which measured separate concepts of family centred care. Descriptive statistics were generated for each subscale, and independent t-tests, ANOVA and correlations were examined between independent variables and subscales of family centred care. There was a statistically significant difference in scores for parents' perceptions of `child friendly environment' between regional and district hospitals. Those parents who did not have social support scored a statistically significantly lower mean score for `respect as parent'. Nurses in district hospitals generated statistically significantly higher mean scores for `family focussed hospital' than those who worked in regional hospitals.
Parents and nurses both perceived that parents wanted to continue parenting their hospitalised child, however parents wanted to provide more nursing care than was perceived by nurses. Nurses' perceptions of delivering family centred care were greater than the perceptions of parents receiving it, however they were consistent in items that were scored low. Nurses did ask parents about the amount of participation they wanted in their child's care on admission however, it was not done on a regular basis. Parents perceived that nurses were unaware of other things that parents needed to attend to while their child was hospitalised and therefore did not enable parents to attend to these needs. More frequent negotiation of roles between parents and nurses by communicating each shift, or at least daily, could narrow the gap between differing perceptions in care provision and also enable parents to attend to their other roles thereby reducing their levels of physical and emotional stress.

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Puiras, Tuija. "A family-centred case management approach in long-term health care for children, parents' perceptions of care." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0024/MQ33433.pdf.

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Archibong, Uduak Emmanuel. "Promoting family-centred care through primary nursing practice in Nigeria : an action research project." Thesis, University of Hull, 1995. http://hydra.hull.ac.uk/resources/hull:11269.

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The context of the family in developing countries, especially in Nigeria, is very wide and embraces the immediate as well as the extended family members. The involvement of the family in health care can not be over-emphasised in the Nigerian society where every family member assumes the role of his/her brother's keeper. The expectations of and the role of the Nigerian extended family system in the health care of its members, the problem of incompatibility of the nursing process with the Nigerian nursing organisational pattern, which is predominantly functional nursing, and the increased call for the improvement of the quality of nursing care in Nigeria informed this study. The 'outsider' model of action research project using an 'insider' was undertaken to promote family-centred care through the introduction of primary nursing in Nigeria. The project involved introduction and evaluation of change in a model ward in a Nigerian hospital. The change was implemented in phases. A 37-bed medical-surgical ward in a 400-bed tertiary health institution formed the nucleus site for the change. Twenty-eight nursing staff (25 trained and 3 untrained), all patients and their families in the model ward and others took part in the change. In the pre-change evaluation study, 10 patients and 8 family members were assessed, while 8 patients and 6 family members were involved in the post-change evaluation. Data collection was carried out before and after the introduction of the change through observation, review of records, interview and self-report questionnaire. Measures used in the study included: QUALPACS, nurse-patient and nurse-family interaction sheets, modified Riser satisfaction questionnaire for patient and family satisfaction, questionnaire to determine the focus of nursing care and questionnaire to assess the practice of primary nursing in the model ward. Families and patients were supportive of the change, nurses were receptive of the change, hospital administration was helpful and other health care practitioners were neutral about the change. Other wards in the hospital and other hospitals expressed willingness to join in the change. After the introduction of primary nursing into the model ward, there appeared to be (1) marked improvement in the quality of nursing care received by the patients, (2) higher levels of family and patient satisfaction with nursing care, (3) an increase in the frequency of nurse-patient and nurse-family interactions, (4) improvement in the level of patient and family involvement in interactions and (5) an increase in the number of nurse-patient and nurse-family interactions in which supportive nursing activities were involved. Despite the study limitations, further research and replication studies are suggested to enable the spread of family-centred nursing care into other hospitals. Possibilities for continuity measures, outcomes for nursing staff and other health care practitioners have been raised as necessary variables for future evaluative studies. The need for more long term studies on primary nursing, and an in-depth study to ascertain the association between presence of family at patient's beside while the patient is under care and the level of patient satisfaction with nursing care have been implicated from this study.

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Van, Rhyn Gabieba. "Caregivers’ experiences with implementing asthma management guidelines for children who attend a hospital in the Western Cape." University of the Western Cape, 2013. http://hdl.handle.net/11394/4832.

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>Magister Scientiae - MSc
Asthma education aims to reduce exacerbations by helping the patient or the caregivers to recognize early warning signs and act accordingly. However, a number of studies have indicated that childhood asthma morbidity is still rising. The goal of this research study is to explore the caregivers’ experiences of implementing the asthma education guidelines. The question to be answered by this research is: “How do caregivers experience the implementation of the guidelines for preventing an asthma attack?” Caregivers attending the asthma clinic at Red Cross War Memorial Children Hospital, Rondebosch were the study population who participated in this qualitative study. Purposive sampling was applied for recruiting participants to the study. A semi-structured, open –ended interview schedule was used to collect data from individuals during semi-structured, in-depth interviews. The data was analysed according to the guidelines of Creswell (2009). The results showed that care-givers found the education programme useful. They also reported that the education programme were offered at their level and was easy to understand. Care-givers indicated that the programme should continue because they learnt every time they attended and found that the practical demonstrations were particularly useful.

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Tersing, Linda, and Mariann Lindgren. "Mödrars upplevelser av att amma det för tidigt födda barnet på en neonatalavdelning : En litteraturstudie." Thesis, Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-4809.

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Background: About five percent of the infants being born in Sweden are cared for in a neonatal unit because of their prematurity. Breastfeeding and breast milk is considered to be the best nutrition for infants in general and for premature infants in particular. The premature infant, depending on how premature, may not be able to breastfeed effectively due to their immaturity. Stress, anxiety and fatigue are factors that affect breast milk production in a negative direction and these feelings are common in the neonatal unit. Aim: To illuminate mothers’ experiences of breastfeeding the premature infant in the neonatal unit. Method: A literature review of eight studies with a qualitative research approach, published between the year 2000 and 2012 was conducted. The studies have been analysed through a content analysis. Result: The findings showed that mothers perceived breastfeeding as a marker of motherhood and they felt guilt and began to question themselves as good mothers if it did not work. The mothers experienced lack of understanding, from the staff, concerning difficulties with breastfeeding, moreover the nurses where the ones who decided when and for how long the mothers should breastfeed. It also appeared that excessively focus on breastfeeding and breast milk by the staff resulted in objectification and the mothers would rather see breastfeeding as a natural process. Some mothers felt support and encouragement from the staff, while some mothers felt that the staff was constant present, which resulted in insecurity. Conclusion: Breastfeeding support for mothers of premature infants during their hospital stay is not satisfying and nurses’ actions have a major impact on mothers’ experiences. Therefore, nurses need to pay attention to mother’s individual needs of support and be aware of how her actions affect the mothers. Nurses also need to strength the mothers in their parent role so that they believe in their own ability to make breastfeeding work.

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Lillie, Alison Kate. "'The missing discourse' : how does the family history of cancer affect the care needs of palliative care patients?" Thesis, University of Birmingham, 2009. http://etheses.bham.ac.uk//id/eprint/293/.

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There is increasing scientific understanding and growing public awareness of the influence of genetics on the development of cancer. It is known that up to ten percent of cancers are associated with a genetic predisposition. This study asks ‘How does the family history of cancer affect the care needs of palliative care patients?’ in this context. This question is addressed using the principles of phenomenology to explore the meaning of a family history of cancer for palliative care patients and nurses. Data was collected through recorded, semi-structured interviews with purposively sampled participants. The information obtained was analyzed using Miles and Huberman’s (1994) framework, where data is displayed, reduced, and conclusions drawn. Emergent themes were organized around Van Manen’s (1990) schema for existential reflection, which considers the relationship between phenomena and four universal themes: lived-body, lived-relationship, lived-time and lived-space. Findings describe how the physical, social, emotional and cultural dimensions of care are modified when viewed through the genetic lens. Patients’ poor understanding of cancer and novice nursing practice (Benner 1984) were barriers to appropriately meeting the needs of this patient group. A new approach to the care of palliative patients with a family history of cancer is proposed.

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Bernling, Sigrid, and Nadire Kucukcelik. "Medias konstruktioner av flyktingar och hur dessa kan påverka distriktssköterskor i deras möte med flyktingar." Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-11718.

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I den uppsatsen analyseras medias konstruktioner av flyktingar genom diskursanalys. År 2015 kom ett ökat antal flyktingar till Sverige vilket skrevs om i media. Syftet med studien var att undersöka mediers konstruktioner och diskurser av flyktingar då dessa diskurser kan komma att påverka distriktssköterskor i möten med flyktingar. Det är av vikt att diskutera hur det kan ta sig uttryck och om det hindrar ett välfungerande möte mellan distriktssköterskor och flyktingar. Att möta flyktingar bör ske utifrån ett personcentrerat synsätt där hänsyn tas till patientens subjektiva upplevelser, det vill säga patientens berättelse om sin upplevelse. Personcentrerad vård värdesätter patientens berättelse och sätter hens upplevelse av denna i centrum. En personcentrerad vård bygger på en medveten etik kring vårdhandlingar, en god relation och ett gott förhållningssätt till patienteter. Det är nödvändigt att öka kunskap och förståelse hos vårdpersonal som möter flyktingar i sitt arbete som distriktssköterskor gör. Utgångspunkten för personcentrerad vård är att människor ska bemötas som fria och värdiga personer. Kärnan i personcentrerad vård är partnerskap mellan vårdpersonal och patienten och dess anhöriga. Partnerskap innebär gemensamt beslut om hälsoplan. Hälso- och sjukvårdslagen (1982:763) grundas utifrån en humanistisk människosyn. Detta innebär att människan har rätt att medverka och bestämma över sig. Distriktssköterskan bör ha en medvetenhet kring sin egen människosyn då de kan komma att styra ens handlingar. Data för studien hämtades från tre olika dagstidningar; Dagens Nyheter, Sydsvenskan och Svenska Dagbladet och deras publiceringar under september, oktober och november, 2015. Artiklarna söktes fram via Mediearkivet. Totalt analyserades 4022 artiklar som innehöll begreppet flykting. I analysarbetet användes AntcConc som är ett datorprogram som gör det möjligt att sortera större mängd text. Det framkom att flyktingar i media konstrueras som en homogen grupp vilket vi anser kan leda till en negativ påverkan på läsaren och därmed på distriktssköterskor i mötet med flyktingar. Att arbeta utifrån ett personcentrerat förhållningssätt i mötet med dessa patienter innebär att aktivt försöka se bakom den konstruerade flyktingen och istället se människan i sin helhet. Fyra diskurser utifrån 13 konstruktioner identifierades. De fyra diskurserna var: krisdiskurs, hjälplöshetsdiskurs, politisk diskurs och ekonomisk diskurs. Vården och mötet kan utifrån vad som framkommit av innehållet i diskurserna bli begränsande och negativ för patienten. Det i sin tur kan skapa enskilt lidande för patienterna i fråga men också på sikt ge en ökad belastning för vården. Det är därför viktigt att belysa ämnet så att en god och jämlik vård kan ges.
In 2015, the increased number of refugees arriving in Sweden was covered in media. Public health nurses may in their encounter with immigrants be influenced by discourses arising from medial constructions of refugees. The aim of this study was to examine mass medial constructions of and discourses about refugees, since preconceptions can influence district nurses in encounters with these persons. It is a matter of importance to discuss how this can manifest itself, in order to make public health nurses encounters with refugees as well-functioning as possible. Person-centred care has been uses as a theoretical frame of reference in this study. A qualitative approach was chosen. The methods used were corpus analysis and discourse analysis. Data was collected from three daily newspapers: Dagens Nyheter, Sydsvenskan and Svenska Dagbladet, published in September, October and November 2015. During this time the concept refugee occurred in 4022 articles. The result shows that refugees in media are contoured as a homogenous group. Four discourses based on thirteen constructions were identified. The four discourses were a crisis discourse, a helplessness discourse, a political discourse, and an economical discourse. From the discourses, it is assumed that public health nurses reading of medial texts about refugees influences their view, and therefore their care, of refugees. Hence, it is important to illuminate the constructions of refugees in media

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Kruse, Erika, and Camilla Forsgren. "Informationens betydelse vid intensivvård : Vad påverkar och samspelar med närståendes helhetsintryck?" Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-353131.

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Bakgrund: Närstående till en person som vårdas på en intensivvårdsavdelning fyller en viktig funktion för dennas sjukdomsförlopp, utfall och rehabilitering. Närstående har själva behov under denna tid och det är viktigt att även dessa tillgodoses av sjuksköterskor. Behovet av information har i många studier påvisats vara det mest betydelsefulla för närstående. Syfte: Syftet med studien var att undersöka sambandet mellan närståendes uppfattning om information korrelerat till deras uppfattning om bemötande, förtroende, stöd och delaktighet. Vidare var syftet att belysa närståendes upplevelser av omhändertagandet på en intensivvårdsavdelning. Metod: Studien var en enkätundersökning med mixad metod. Resultat: 206 enkäter skickades ut och 47 % (n=97) av respondenterna valde att delta. Resultatet visade att det fanns svaga till starka samband mellan information och bemötande/förtroende/stöd/delaktighet. Starkast samband sågs mellan variablerna information och förtroende samt mellan information och delaktighet. Respondenternas upplevelser resulterade i två teman; information och bemötande. Närstående upplevde att information var fundamentalt inom intensivvården och den önskades vara ärlig, tydlig och ges kontinuerligt. Respondenterna upplevde att bemötandet de fått under intensivvårdtiden både varit positivt och negativt. Slutsats: Positiva korrelationer har påvisats mellan information och bemötande, förtroende, stöd och delaktighet. Studien belyser även att närståendes upplevelse av omhändertagandet kan påverkas både positivt och negativt av information och bemötande. Kännedom om detta samt med hjälp av en familjefokuserad omvårdnad kan möjliggöra för intensivvårdssjuksköterskan att främja närståendes upplevelse och uppfattning under vårdtiden.
Background: Relatives to a person who is cared for in a critical care unit fill an important function for the patient’s disease progression, outcome and rehabilitation. Relatives themselves have needs during this period and it is important that also their needs are met by nurses. The need to receive information has been shown to be the most meaningful to relatives. Aim: The aim of the study was to examine whether relatives’ perception of information correlated with their perception of treatment, trust, support and participation. Furthermore, the aim was to highlight the way in which relative’s experience care at a critical care unit. Method: The study was conducted as a mixed method survey. Results: 206 surveys were sent out and 47% (n=97) of the respondents chose to participate. The result indicated that there are weak to strong correlation between information and treatment/trust/support/participation. The strongest correlation was observed between the variables information and trust, as well as information and participation. The respondents’ experiences resulted in two themes; information and treatment. Relatives perceived information as fundamental within critical care and preferred it to be honest, clear and continuous. The respondents had experienced the treatment they received during the critical care period as both positive and negative. Conclusion: Positive correlations has been found between information and treatment, trust, support and participation. The study also highlight that a relative’s experience of the care is impacted both positively and negatively by information and treatment. Knowledge about this and with help from a family focused care can make it possible for critical care nurses to encourage relative’s experience and perception about the time of care.

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Tong, Allison. "Towards consumer-centred health care and health research in nephrology understanding patient and family caregiver experiences and perspectives in chronic kidney disease /." Faculty of Medicine, 2008. http://hdl.handle.net/2123/4024.

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Doctor of Philosophy (PhD)
Healthcare services and health research aim to improve the physical and psychosocial well being of consumers, and to offer responsive services needed and valued by them. Research in chronic kidney disease (CKD) has predominantly focused on investigating biomedical aspects and evaluating technological or pharmacological treatment interventions to improve medical management. While research into assessing patients’ and caregivers’ quality of life, and symptom burden, is growing minimal attention has been given to gaining a broad and in-depth understanding about the experiences, psychosocial issues and needs of patients and their caregivers. These need to be considered when planning and delivering patient-centred care and health research across the whole trajectory of CKD. The studies that form the major part of this thesis explore the perspectives, needs and experiences of CKD patients and their caregivers, within a broad and multidimensional framework encompassing aspects of the nature of the health and illness experiences and consumer perspectives. In Chapter 2, to understand what is known about parental experiences of caring for a child with CKD, the relevant qualitative literature was systematically reviewed and synthesized. Three inter-related clusters were identified: intrapersonal, interpersonal and external experiences. In Chapter 3, to gain a more detailed and broader understanding of this topic, in-depth interviews were conducted with parents of 20 children with CKD and 4 major themes were identified: absorbing the clinical environment, medicalising parenting, disrupting family norms, and coping strategies and support structures. In Chapter 4, to assess the effectiveness of support interventions for caregivers of patients with CKD, a systematic review was conducted which identified only three eligible studies that assessed only the effect of educational material on caregiver knowledge, not other domains. In Chapter 5, to describe and compare the broad range and depth of experiences and perspectives from predialysis, dialysis and transplantation patients, data from patient focus groups were analysed. The 5 themes that emerged from this data were: personal meaning of CKD, managing and monitoring health, lifestyle consequences, family impact, and informal structures. In Chapter 6, the focus groups were also used to elicit research priorities and identify reasons that patients used to develop their research priorities. A patient focused research agenda was elicited for CKD and 5 reasons that patients used to develop their research priorities were identified: normalisation of life, altruism, economic efficiency, personal concerns and clinical outcomes. During the focus groups, participants repeatedly expressed frustration about the poor public profile, and lack of community-based information on CKD prevention. So in Chapter 7, to assess how Australian news media covered prevention and early detection of CKD, I analysed television and newspaper stories that referred to CKD prevention or early detection. Kidney disease in general, and particularly the prevention and early detection of CKD, received virtually no media attention. When mentioned, it was mainly in the context of transplantation and donor stories, and seldom prevention or early detection, which appears largely unnewsworthy in its current form. At best, CKD received peripheral mention as a secondary concern in diabetes and obesity news stories which focused on lifestyle solutions. In Chapter 8, to develop a checklist for explicit and comprehensive reporting of qualitative studies (in-depth interviews and focus groups), I performed a comprehensive search in relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: 1) research team and reflexivity, 2) study design, and 3) data analysis and reporting. The overarching purpose of these studies was to gain a better understanding about the needs, experiences and perspectives of CKD patients and their caregivers. The findings describe the permanent, profound and pervasive impact of CKD on the lives of patients and caregivers across the whole illness trajectory. A more detailed and broader understanding about patient and caregiver perspectives, as presented in this thesis, can support a move towards advancing patient-centred healthcare and research in CKD.

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Kyratsis, Ioannis. "Diffusion and adoption of complex health innovations : the case of family medicine-centred primary health care reforms in five European transition countries." Thesis, Imperial College London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517632.

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Eriksson, Rebecca, Nellie Karlsson, and Felicia Åsberg. "När minnet utmanar livet : Anhörigas upplevelser av att vårda en person med demenssjukdom." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-39866.

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Bakgrund: Demenssjukdomar är vanligt förekommande i Sverige och prevalensen beräknas öka. Många personer med demenssjukdom bor kvar i hemmet och anhöriga tar ett stort ansvar för vården av dessa personer. Att vara anhörigvårdare till en person med demenssjukdom innebär påfrestningar både fysiskt, psykiskt och socialt.Syfte: Att beskriva anhörigas upplevelser av att vårda en person med demenssjukdom. Metod: Litteraturöversikt med induktiv ansats baserad på 15 vetenskapliga artiklar med kvalitativ design, som har analyserats med Fribergs femstegsmodell. Resultat: I resultatet framkom huvudkategorierna: En förändrad livssituation, Att acceptera förändringen samt Anhörigas behov. Det framkom även åtta subkategorier: Förändrade roller i relationen, Förändrat socialt liv, En förändrad framtid, Förändrade känslor, Att acceptera rollen, Att känna meningsfullhet, Behov av egentid samt Behov av stöd.Slutsats: Anhöriga är i behov av stöd från hälso-sjukvården. Sjuksköterskan har en nyckelroll i att stödja anhöriga vilket kräver goda kunskaper om demenssjukdomar och om anhörigas upplevelser av att vårda en person med demenssjukdom.
Background: Dementia are common in Sweden and the prevalence is expected to increase. Many people with dementia live in their homes and relatives are responsible for the care of these people. Being a caregiver for a person with dementia causes great pressures both physically, psychologically and socially. Aim: To describe relatives experiences of caring for a person with dementia. Method: Literature review with inductive approach based on 15 scientific articles with qualitative design, which has been analysed with Friberg's five-step model. Findings: In the results, the main categories were: A changed life situation, To accept the change and Relatives needs. There were eight subcategories: Changed Role in Relationship, A changed social life, A changed future, Emotional attendance, Accepting the role, Feeling meaningful, Need to be for themselves, and Need for support. Conclusion: Relatives are in need of support from the health care. The nurse has a key role in supporting the relatives, which requires good knowledge of dementia and relatives' experiences of caring for a person with dementia.

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Rydberg, Elin, and Velander Linda Öjkvist. "Universella och riktade hembesök inom barnhälsovården : Sjuksköterskors erfarenheter." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-44305.

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Bakgrund: Barnhälsovården (BHV) genomför universella insatser till alla barn och deras föräldrar och riktade insatser till de familjer som har särskilda behov. Hembesök är en arbetsmetod som används av BHV-sjuksköterskan och kan göras av olika orsaker. Dels som en del av de universella insatserna, dels som en riktad insats till familjer i behov av extra stöd. Syfte: Beskriva sjuksköterskors erfarenheter av att arbeta med universella och riktade hembesök inom barnhälsovården. Metod: En kvalitativ studie. Femton specialistsjuksköterskor inom BHV intervjuades. Innehållsanalys med induktiv ansats har använts som analysmetod. Resultat: BHV-sjuksköterskorna har positiva erfarenheter av hembesök som en användbar arbetsmetod både universellt och riktat, men att det är tidskrävande med hembesök. BHV-sjuksköterskornas erfarenheter visar att hembesök ger goda förutsättningar för att kunna etablera en god vårdrelation med familjen. BHV-sjuksköterskorna upplever att både barnen och föräldrarna är tryggare i hemmiljön. Föräldrarna vågar öppna sig mer och det underlättar för BHV-sjuksköterskan att bedöma barnets hälsa när barnet är tryggare. Samarbete med andra professioner vid hembesök upplevs i vissa situationer som ett bra stöd. Slutsats: Barnet och föräldrarna upplevs tryggare i hemmet än på mottagningen och hembesök ger därför goda förutsättningar för att bygga upp en förtroendefull vårdrelation med familjen. Universella hembesök ger BHV-sjuksköterskorna möjlighet att identifiera familjer med behov av riktat stöd och riktade hembesök kan vidare bidra till att alla familjer får en ökad möjlighet till likvärdig hälsa.
Background: The Child Health Care (CHC) offer universal interventions to all children and their parents, as well as targeted intervention for families with specific needs. One method used by the CHC-nurse is home visits and they can be performed for different reasons. Partly as a component of the universal support, partly as a targeted intervention to families in need of extra support. Purpose: To describe nurses experiences working with universal as well as targeted home visits in Child Health Care. Method: A qualitative study. Fifteen specialist nurses were interviewed, and content analysis has been used to analyse the interviews. Results: The CHC-nurses find home visits as a positive and useful method, both for universal and targeted purpose. However, it is a time-consuming method. Their experiences show that the method facilitate caring relation with the family. The nurses experience that both children and their parents are much safer in their home environment. The parents dare to open up more and it makes it easier for the Child Health Care Nurses to assess the child’s health and development. Cooperation with other professions when making home visits can be supportive in certain situations. Conclusion: The child and the parents are seemingly more at ease at home than at the clinic. As a consequence, home visits lead to good opportunities to establish a caring and trustful relation with the family. Universal home visits offer the possibility to identify families in need of more targeted support. Targeted home visits can contribute to promote every families the opportunity to access equal health.

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Landervik, Malin. "Sjuksköterskans upplevelser av det enskilda samtalet med den icke-födande föräldern i barnhälsovården : En kvalitativ intervjustudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-42304.

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Bakgrund: Barnhälsovården finns till för att främja alla barns hälsa, allsidiga utveckling och välbefinnande. Sjuksköterskans uppdrag inom barnhälsovården är att tidigt grundlägga god kontakt med båda föräldrarna till det nyfödda barnet samt främja båda föräldrarnas delaktighet i omvårdnaden av barnet. Som stöd för främjande av en jämställd vård infördes år 2018 ett enskilt samtal även med den ickefödande föräldern i det nationella barnhälsovårdsprogrammet. Syfte: Att undersöka hur sjuksköterskor inom barnhälsovården upplever det enskilda samtalet med den icke-födande föräldern. Metod: Studien genomfördes med kvalitativa intervjuer med stöd av semistrukturerad intervjuguide. Data analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Fyra kategorier och tio underkategorier framkom i analysen. Följande kategorier presenteras: (i) Bättre kontakt med den icke-födande föräldern, (ii) Stort intresse för samtalet, (iii) Att kunna stärka föräldern i sin nya roll, och (iv) Att bekräfta betydelsen av att båda föräldrarna är lika viktiga. Konklusion: Införandet av det enskilda samtalet för den icke-födande föräldern har gjort att BVCsköterskan får möjlighet att grundlägga en bättre relation till den icke-födande föräldern och på så sätt utforma ett stöd som innebär en jämställd vård till hela familjen.
Background: The Child Health Care’s (CHC) aim is to enable all children's right to health, versatile development and wellbeing. It is important that the CHC-nurse early in the care of the newborn child develops a good relationship with both parents to create better possibilities for good health for the entire family. As a support for the CHC-nurses to be able to present an equal care for both parents a one on one conversation with the father/non-birth parent is offered when the newborn is about 3- 5 months old. Aim: The aim was to study the CHC-nurse’s experiences of the one on one conversation with the non-birth parent. Method: The study was conducted with a qualitative descriptive method including semi-structured interviews and qualitative content analysis. Result: The result is presented in the following categories: Better contact with the non-birth parent, Great interest for the conversation, To be able to support the parent in their new situation, To confirm the relevance of both parents being equally important. Conclusion: The introduction of the one on one conversation with the non-birth parent has increased the possibilities for the CHCnurse to found a better relationship with the non-birth parent. This increases the chances to offer equal care for the entire family.

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Becker, Regina. "Beratung von pflegenden Angehörigen : eine queer-feministische Diskursanalyse /." Kassel : Kassel Univ. Press, 2008. http://d-nb.info/989149358/04.

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Rioux-Dubois, Annie. "L'intégration et la négociation du rôle de l'infirmière praticienne en soins de santé primaires en contexte de collaboration interprofessionnelle." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/38717.

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La prestation coordonnée de soins de santé primaires (SSP) a été éprouvée comme améliorant la qualité et l’accès des soins prodigués aux Canadiens. Plusieurs études ont notamment confirmé les avantages des infirmières praticiennes (IP) et des modèles interprofessionnels en SSP pour le système de santé. Les écrits suggèrent toutefois que l’intégration des IP en SSP est jalonnée de tensions et restructurations en raison d’une confusion supposée de leur rôle. À ce jour, les recherches ont principalement ciblé les barrières et facilitateurs de l’intégration du rôle des IP. Une analyse critique des dynamiques socioprofessionnelles et politiques de l’intégration des IP n’a toutefois pas encore été réalisée. Une ethnographie critique combinant la Théorie de l’acteur-réseau et les concepts foucaldiens de discours, savoir et pouvoir a permis l’examen des interactions sémiotiques caractérisant certains milieux de SSP. Différents modèles interprofessionnels de SSP (2 centres de santé communautaire, 2 équipes de santé familiale et 2 cliniques dirigées par les IP) ont été investis. Les données issues d’entrevues semi-dirigées avec des IP (n=23), d’observations directes de milieux et de rencontres interprofessionnelles, et d’analyse documentaire ont été soumises à une analyse thématique puis une analyse critique de discours. Les résultats montrent que la valeur morale des IP, les finalités organisationnelles des milieux de SSP, les normes de pratique, la collaboration interprofessionnelle et la prise en charge des patients disposent les IP à la négociation de leur rôle et à certains enjeux socioprofessionnels et politiques qui génèrent plusieurs contrecoups: pluralisme de leurs rôles professionnels, dissonance identitaire, sentiments d’incompétence et d’incertitude, glissements discursifs dans leurs propres discours, et divers états émotionnels et souffrances. Ces contrecoups commandent diverses stratégies d’adaptation et de résistance permettant aux IP de gérer ces tensions. Plusieurs entités non-humaines (inscription des clientèles, discours de soutien aux médecins et espaces physiques) émergent comme acteurs agissant sur l’intégration et la négociation du rôle des IP en SSP. Cette étude permet de décrire le processus de traduction du rôle de l’IP en SSP qui problématise certains discours tenus pour acquis en SSP. Elle permet également de proposer une nouvelle définition de l’intégration du rôle des IP en SSP.

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Achiampong, Julie. "A literature review of research into what family caregivers do in support of their loved one with Dementia, and research examining links between perceptions of continuity and the levels of person-centred care people give to their spouse with Dementia." Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/3162/.

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The following work has been completed as part of the Birmingham University Clinical Psychology Doctorate. Volume One contains three research papers: a literature review on work exploring care-giving approaches in family carers of people with dementia; an empirical paper exploring the link between perceptions of continuity in spouses caring for someone with dementia and person-centred care; and an executive summary of the empirical paper. Volume Two contains the following clinical practice reports (CPR) completed whilst on placements within the NHS. The models CPR describes the assessment, Cognitive-Behavioural and Psychodynamic formulation of a twenty-year old young man with a diagnosis of Somatoform Disorder. The service evaluation CPR is a qualitative exploration of staff experiences and needs in the use of Cognitive Behavioural Approaches in Community Mental Health Teams. The Single Case CPR describes and evaluates an intervention for visual neglect conducted with a 55 year-old man. The Case study CPR presents cognitive-behavioural therapy work conducted with a teenage girl with appearance-related social anxiety. The abstract for the Clinical Presentation CPR is included and this described work with a 79 year old man in a general hospital, referred for low mood.

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Ndlovu, Mathoto Sinnah. "Parent's views of family centred care in a South African academic Hospital in Gauteng." Thesis, 2017. https://hdl.handle.net/10539/24655.

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Introduction Admission of a child in hospital is a stressful situation for the child, parents and family. According to the American National Centre for Family/Professional Development (2009) Family Centred Care is important as this can improve patient and family outcomes, improve the patient’s and family’s experience, increase patient and family satisfaction, build on child and family strengths, increase professional satisfaction, decrease health care costs, and lead to more effective use of health care resources. Hence, there is a need for Family Centred Care and this should be standard practice in health care institutions. While Family Centred Care is known to be beneficial, the approach has not received specific attention in most hospitals in South Africa. Little is also known about the parental views on family centred care in the South African context. Purpose and objectives The purpose of the study was to describe parents’ views on Family Centred Care in two general paediatric medical wards of an academic hospital with a view to develop to improve Family Centred Care in the future. The objectives are to describe parents’ views regarding Family Centred Care with the use of Family Centred Care Scale and to compare parents’ views in the two paediatric medical wards. Method This study was conducted using a quantitative design with a descriptive, cross sectional, non-experimental survey, using a researcher-administered assessment validated tool entitled Family Centred Care Scale (FCCS) with a 5-point Likert scale (Curley, Hunsberger, and Harris, 2013). The total population N=161 parents of the total sum of children’s parents admitted in the two medical wards of a particular month were asked to participate in the survey if they met the inclusion criteria. Results The results from the matched p scores (p<0.05) from the importance and consistency subscales show that the parents expectations of the nurses’ actions are being fulfilled with regard to Family Centred care. The match scores were all above 50% however, the item “nurses help me feel welcomed” rated the lowest. This could be because of the rigid vi and short visiting hours. There was no statistically difference in the match scores of Ward A and Ward B. Conclusion There is general satisfaction of family-centred care in the two paediatric wards from the respondents. The respondents from both wards in the study did not differ significantly in terms of family-centred care views, as portrayed by the Family-Centred Care Scale. There is a need to replicate this study on parents whose children have been discharged but meanwhile attention to the rigid visiting hours appears to be warranted.
GR2018

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Brown, Devon. "The lived experience of family-centred care by primary caregivers of critically ill children in the pediatric intensive care unit." 2012. http://hdl.handle.net/1993/5111.

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The unexpected admission of a child to the pediatric intensive care unit (PICU) creates feelings of uncertainty, distress, and fear and is a devastating experience for primary caregivers. Health care providers must address primary caregivers` concerns to enhance primary caregivers’ coping abilities. While a family-centred approach to care can assist in diminishing uneasy feelings experienced by primary caregivers, this philosophy of care is not consistently used in everyday practice. The PICU is a unique area of care that focuses on restoring the health of critically ill children with the use of machines and equipment. However, the use of technology for life sustaining measures creates additional responsibilities for health care providers, potentially compromising the quality of patient care. There is evidence to support that the involvement of the primary caregiver in the care of the critically child can address the gap that commonly exists between technology and holistic patient care. Furthermore, involvement in care increases primary caregivers’ satisfaction with the care their child receives and may also improve patient outcomes. Most importantly, the involvement of primary caregivers in the care of the critically ill child encompasses a family-centred approach to care. By increasing health care provider’s awareness of family-centred care within the PICU, primary caregiver’s needs may be more effectively addressed during this devastating and vulnerable time. Health care providers are key players in the promotion of family-centred care in the PICU; however, they are often faced with multiple challenges and barriers. Increasing health care providers’ awareness around the components of family-centred care can facilitate its implementation into practice by understanding how primary care givers define and experience ii family-centred care. Accordingly, a qualitative study guided by the philosophy of hermeneutic phenomenology was conducted to elicit a detailed description of the lived experience of family-centred care from the perspective of the primary caregiver. Participants in this study consisted of those primary caregivers who had previously had a child admitted to the PICU. Participants were recruited from a large mid-western hospital. In total nine primary caregivers ranging in age from 33 to 44 years with the mean age being 37 years participated in the study. Nine of the participants were mothers and two were fathers. All participants took part in semi-structured, open-ended interviews. A total of nine interviews were conducted with two of the interviews involving both parents. Demographic data and field notes were recorded. All field notes and interview data were transcribed. The transcripts were reviewed repeatedly for significant statements in an attempt to find meaning and understanding through themes. The data analysis revealed the essence of the lived experience of family-centred care to be being present. Three themes communicated the essence and included: (a) physical presence, (b) participation in care and, (c) advocating. Three themes from the data emerged around how primary caregivers defined family-centred care and included: (a) collaboration, (b) being updated and, (c) continuity of care. Finally, primary caregivers identified four conditions that needed to be in place to experience family-centred in the PICU which included: (a) being present for rounds, (b) caring behaviours, (c) feeling welcomed and, (d) support. The findings from this study may be used to guide policy around family-centred care and improve on, or bring new insights around interventions related to family-centred care. Future recommendation for nursing practice, education and research are presented.

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Dimitris, MICHELLE. "PREDICTORS OF UP-TO-DATE COLORECTAL CANCER SCREENING AND PATIENT-CENTRED CARE IN FAMILY HEALTH TEAM PRIMARY CARE PRACTICES." Thesis, 2012. http://hdl.handle.net/1974/7550.

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Introduction: The Family Health Team (FHT) is an Ontario-based initiative that aims to provide primary care through multidisciplinary teams of healthcare professionals. Little is known about variability between and within teams, and whether certain organizational characteristics are associated with quality of patient care. Objectives: (1) To describe FHT-level organizational characteristics for seven FHTs in Southeastern Ontario. (2) To examine the role of physician-level organizational characteristics in predicting: (a) Up-to-date colorectal cancer screening and (b) episodic patient-centredness for patients within seven FHTs in Southeastern Ontario. Methods: This study employed linked datasets obtained from surveys of seven FHTs, 115 health care providers (including 41 family physicians) and 998 patients, as well as a chart abstraction. Statistical analyses included performing subject-specific multilevel multivariate modeling. Results: (1) FHTs varied on characteristics including length of time of practice operation, number of patients, existence of personnel policies, team makeup and team climate. (2) (a) Patient uptake of colorectal cancer screening was associated with average duration of regular routine visit OR=0.88 per minute (95% CI 0.83-0.94), patient gender male OR=2.00 (95% CI 1.22-3.28), general checkup in past 2 years OR=9.03 (95% CI 5.18-15.73), travel time less than or equal to 20 minutes OR=1.53 (95% CI 0.94-2.48), and usually see regular provider OR=0.40 (95% CI 0.19–0.87). Patient uptake or physician recommendation of colorectal cancer screening demonstrated similar associations, with the absence of travel time and the addition of team climate (family physician and nurses) OR=5.88 (95% CI 0.98-35.24), patient occupational status employed vs. retired OR=0.49 (95% CI 0.23–1.02), patient occupational status not employed vs. retired OR=0.42 (95% CI 0.16–1.13), and patient smoking status never vs. ever OR=0.59 (95% CI 0.37–0.96). (b) Episodic patient-centredness was associated with patient born in Canada 0.1119 (95% CI -0.0040-0.2278), seeing regular healthcare provider today 0.1449 (95% CI 0.0426-0.2472), physician-patient gender concordance 0.1019 (95% CI 0.0128-0.1910), and appointment length 0.006929 (95% CI 0.003554-0.010304). Discussion: Further research is needed to examine predictors of the quality of patient care at the practice, physician and patient levels.
Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2012-09-27 15:21:12.794

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Tatterton, Michael J., and C. Walker. "The prevalence of nonprescription cannabinoid-based medicines in British children's hospices: results of a national survey." 2019. http://hdl.handle.net/10454/18243.

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No
Background: Almost 50,000 children and young people are affected by life-limiting conditions in the United Kingdom, around a third of which use children's hospices. Anecdotal evidence suggests that cannabinoid-based medicines (CBMs), specifically cannabis oil (CO), are being used by families with increasing frequency to manage distressing symptoms. The use of most nonprescription CBMs in the United Kingdom remains illegal. Objective: The objective of the study was to identify the prevalence of CO use by families who use children's hospices in the United Kingdom, and the approaches taken by those services to manage it. Design: An electronic survey was sent to each of the 54 children's hospices in the United Kingdom between May and July 2018, comprising 10 questions. Results: Forty children's hospices from across the four countries of the United Kingdom responded to the survey, representing 74% of British children's hospices. About 87.5% of hospices knew of children who use CO therapeutically. Sixty-nine percent of those hospices have received requests to administer CO during an episode of care. Approaches by organizations around CO management varied across the sectors, including arrangements for storage, administration, and recording of its use. Hospices highlighted how the lack of available guidance made decision making more challenging. Only a third of responding organizations routinely questioned families about the use of cannabis when prescribing medicines. Conclusion: CO is used extensively by children who use children's hospices. Despite recognizing the use of CO, many hospices are unable to support it. There is a need for clear guidelines on how hospices should approach the care needs of children, allowing hospices to meet the needs of children who use CO, and families in a safe, consistent, and relevant way, safeguarding all children, families, and professionals within the organization.

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Tatterton, Michael J., A. Honour, J. Lyon, L. Kirkby, M. Newbegin, and J. Webster. "Sources of emotional challenge for practitioners delivering family centred care after the death of child: an inductive thematic analysis." 2021. http://hdl.handle.net/10454/18496.

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Yes
Care after the death of a child and support of their bereaved family is an important element of the services offered by children’s hospices in the United Kingdom. The study aims to explore the emotional challenges of those delivering care to families of children in hospice cool rooms. An internet-based questionnaire was sent to all practitioners to explore their perspectives of providing care to bereaved families whilst the child’s body was in the hospice, as well as caring for a child’s body after death. In total, 94.9% (n=56) of staff responded. Two key themes were identified that represent the emotional challenges perceived by staff: the impact of deterioration of a child’s body; and witnessing the acute grief of families. Practitioners seek to provide care that recognises the importance of family and demonstrates family-centred care, as well as supporting families to deal with the changes that occur after death. Organisations can support practitioners to deliver care in cool rooms by providing training and education on anticipating and managing the pathophysiological changes that occur after death as well as training in grief and loss, and how to support a bereaved family.

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Romaniuk, Daria K. "The parent-nurse relationship in family-centred care of the hospitalized child with cancer : the parents' perspective." 1994. http://hdl.handle.net/1993/18426.

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Chalifour, Emma E. ""Can I see my Daddy?": child and adult family members as visitors in the adult intensive care unit." Thesis, 2020. http://hdl.handle.net/1828/12534.

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The purpose of this qualitative study was to supply preliminary insights into improving the support of visiting families with children who are minors during the intensive care unit stay (ICU) of an adult family member. Hospitals often restrict children from visiting in ICUs; however, a review of the literature revealed that despite the prevalence of this policy, there has been little research into whether visiting is harmful or supportive (Liu et al., 2013; Manici & Ghillani, 2018). Although family-centred care (FCC) is considered beneficial for adult family members (Davidson et al., 2012; Eggenberger & Nelms, 2007), there is little evidence that policymakers have considered the involvement of children during an ICU stay (Knutsson & Bergbom, 2007). In this study, seven families shared their experiences of the critical illness of a loved one. Using a constructionist lens, this study explored the interaction between the gathered stories and the policies and practices associated with child and adult family members visiting adult critical care contexts in British Columbia (BC), Canada. This study found that the involvement of children in a family illness event is important and that tailoring involvement to the individual preferences of the child, and their family, is crucial. While navigating an ICU stay, families may benefit from a collaborative approach between the child, their caregiver/s, and a member of the ICU team. The goal of this research is that it will resonate with its readers and move people to deeper curiosity and further study. This exploratory study led to a list of seven preliminary recommendations that could inform the interdisciplinary policies and practices associated with supporting child and adult family members as visitors in an ICU. Further research is needed to explore the experiences of families with children more fully, and to understand the systems that need to be in place to support them during the critical illness of a loved one.
Graduate
2021-12-16

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Tatterton, Michael J., and C. Walshe. "Understanding the bereavement experience of grandparents following the death of a grandchild from a life-limiting condition: A meta-ethnography." 2018. http://hdl.handle.net/10454/18237.

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yes
To increase understanding of grandparental grief following the death of a grandchild from a life-limiting condition. Meta-ethnography. Academic Search Complete CINHAL, Embase, psycINFO, PubMed and Web of Science, supplemented by manual search strategies (in 2015, updated 2018). Studies were appraised and synthesized using the principles of meta-ethnography. Three superordinate themes were identified: 'influence of the relationship with their grandchild', 'influence of the relationship with the grandchild's family' and 'pain'. The simultaneous, multigenerational position of grandparents meant individuals experience emotional pain from witnessing the experience of family members. Many factors that contribute to the bereavement experience of grandparents are outside of their control. The roles, positions, and support needs of grandparents need to be acknowledged to better meet their needs as parents, grandparents, and individuals who have experienced a child death.
Hospice UK, RCN Foundation

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Yun, Tae-Young. "Family Members, Not Workers." Doctoral thesis, 2012. http://hdl.handle.net/11858/00-1735-0000-002E-E5CA-8.

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Tatterton, Michael J., and J. A. Lyon. "‘I no longer feel alone’: meeting the needs of bereaved grandparents through a children’s hospice support group." 2020. http://hdl.handle.net/10454/18216.

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yes
Background: Children’s hospices provide a range of family-centred care services, including bereavement support. Not all hospices provide specific services for grandparents. Aim: To explore how a hospice-based bereavement support group supported grandparents in their grief following the death of a grandchild. Methods: Grandparents attending a group were invited to complete an anonymous questionnaire. Questionnaires from eight groups, run between 2015 and 2019 were collated and interpreted to identify themes. Findings: 121 grandparents attended the groups; 113 returned the questionnaires (93% response). Three central themes were identified: environment and space, being with people who understand, and the opportunity to hear the stories of others. Grandparents valued hearing the stories of others, providing an opportunity to reflect on the experience of others. Conclusion: Grandparents felt supported and validated by the group. The facilitated sessions increased coping and resilience of participants, enabling grandparents to support their partner, adult children and surviving grandchildren more effectively.
The full text will be available at the end of the embargo

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MacLeod, Suzanne. "From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times." Thesis, 2014. http://hdl.handle.net/1828/5213.

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As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive.
Graduate
0452
0680
0351
macsuz@shaw.ca

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Archibong, Uduak E. "Evaluating the Impact of Primary Nursing Practice on the Quality of Nursing Care: A Nigerian Study." 1999. http://hdl.handle.net/10454/3230.

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No
This paper is abstracted from an action research project on promoting family-centred care in Nigeria through the practice of Nigerian Primary Nursing (NMPN). This article will present results of comparative evaluation of the impact of primary nursing on the quality of care received by patients in a 37-bedded acute medical-surgical, mixed sex ward in a specialist hospital in eastern Nigeria. A total of 44 nurses' interactions with 10 patients in the pre-NMPN period and 58 nurses' interactions with eight patients in the post-NMPN period were assessed using QUALPACS (Quality Patient Care Scale.). Results showed a significant improvement in the quality of nursing care with primary nursing practice. The greatest improvement in quality of nursing appeared to be in the elements that address the individual needs of the patient, while the smallest improvements were in the area of physical care--elements of routine, technical nursing care. Implications of the study and recommendations for further studies are made.

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Phillips-Beck, Wanda. "Development of a framework of improved childbirth care for First Nation women in Manitoba: A First Nation family centred approach." 2010. http://hdl.handle.net/1993/3985.

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This paper reports on a qualitative exploratory study focusing on the childbirth experiences of women and their families from a northern isolated community in Manitoba - who had to leave or were about to leave home to give birth. Perspectives from critical medical anthropology, cultural relativism and human ecological theory provided the theoretical foundation for this study. This study utilized ethnographic approaches to explore the perspectives of the women, their families and “significant others” and how they have been affected by policies, practices and structures at all levels of their environment in an attempt to gain a better understanding of the type of support and services that could potentially improve this experience. Presently, women from northern, rural and/or isolated communities leave home from a period of a few days up to 10 weeks to deliver their babies in an urban tertiary centre. They stay in boarding homes with others who have left home to obtain medical care, or with family and friends. During this period of time the women often do not access prenatal support or services within the regional health authority, other than medical care from a primary care provider (whom they may not have seen prior in their pregnancy) or to receive specialized medical intervention and monitoring. The boarding homes where they often stay do not offer any prenatal support or outreach services and are not conducive to housing women so close to delivering a baby. The women spoke of their experiences of giving birth marred by memories of fear, anger, frustration, tears and longing for family. They also spoke of a renewed sense of hope and excitement at the opportunity to share their ideas about possible ways that their experience could be improved. This paper breathed life into their thoughts and brought their ideas together to develop a new vision towards a system of supportive childbirth care for First Nation women in Manitoba, and more specifically, for women who are medically evacuated from the north to deliver their babies in urban Manitoba. For the Faculty of Medicine, it is a Master’s thesis, but for me and the many women and residents of Berens River, it is an opportunity for First Nation women to participate in shaping policy and influencing the direction for care and services that is created for them. It is important to acknowledge that evacuation and temporary relocation for birth is not an issue unique to First Nation women, it impacts hundreds of other northern and rural Métis and non-First Nation women every year. However, their experience is not included in this study. This paper suggests immediate and interim solutions for women who must leave home to give birth, albeit, the ultimate aim is to return birthing services closer to home.

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Knutson, Shannon. "The Missing Link: Explorations of Wellness when a Family Member Resides in Long-Term Care." Thesis, 2012. http://hdl.handle.net/10012/6754.

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With the aging of our population and the higher risk of chronic illness and disability with age, more and more family members may be faced with the experience of having a relative transition into a long-term care (LTC) home. This reality necessitates greater understanding of family care partner needs to ensure wellness throughout their caring career. Using participatory action research, notions of wellness were explored for family partners in care with relatives residing in LTC homes. Using two LTC homes from a privately owned company called Specialty Care, ten family members were interviewed, followed by one focus group at each of the two LTC homes. Three major themes were revealed, each with several sub themes: (1) understanding wellness amidst challenges to keep a sense of wellness in life; (2) self-appraisal: becoming aware of personal beliefs and perceptions that influence wellness; and (3) assessing LTC homes and their influence on the experience of wellness. We not only revealed more about wellness and how it is experienced in the caring context, we also discovered leisure’s role in maintaining wellness and how embedded leisure’s influence is on the various aspects of wellness that family partners in care experience. Relationship-centred care is a framework we used to guide this study. It highlights the importance of family member needs, along with the needs of the residents and staff. With our enhanced understanding of family care partner needs, recommendations were made to the Specialty Care communities so they can work together to ensure optimal wellness is maintained for all parties, including family partners in care.

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Jamal, Sherin. "Needs, preferences and decision-making regarding long-term residential care: South Asian older adults' and family caregivers' perspectives." Thesis, 2021. http://hdl.handle.net/1828/12862.

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The aging Canadian population is becoming increasingly ethno-culturally diverse primarily due to immigration. This, together with research indicating increased likelihood of long-term residential care (LTRC) use at older ages and challenges in providing these services, prompt important questions about whether LTRC services are prepared to provide culturally responsive and competent care to immigrant and ethno-cultural minority older adults (EMOA). This ethnographic study, informed by a critical theoretical perspective, explored these questions from the perspectives of South Asian older adults (SAOAs) and their family caregivers (FCGs). In-depth interviews with 18 SAOAs in LTRC, assisted living and those at home, their FCGs, and seven key informants from LTRC and the South Asian (SA) community (n=43) were undertaken. These interviews, in addition to 220 hours of participant observation in two LTRC facilities, provided information regarding the needs, preferences, experiences and situation of SAOAs in LTRC as well as how SA families make decisions regarding the use of such services. A select review of provincial policy, residential care regulation, health authority and facility documents, exposed taken-for-granted assumptions in how care and services are provided and the sociopolitical context of LTRC provision. Study findings suggest that LTRC services are challenged to meet the needs of immigrant and EMOA and reflect unequal and inequitable care, illuminated by the differential impact of macro-policies and resource-constrained LTRC environments on SAOAs and their families and on the ability of existing LTRC services to provide person-centred care. This inequity in service provision has implications for immigrant and EMOA and their family members in light of findings that the decision to move to LTRC is essentially a (non) decision influenced by a range of social structural factors that interact to necessitate the move to LTRC. Study findings revealed the salience of socio-economic status and economic resources in particular, in the (non) decision for LTRC placement. The findings from this study along with demographic shifts in the aging Canadian population call for LTRC service providers and policy makers to actively prepare for increasing ethno-culturally diverse resident populations and point to the need for equity informed approaches to the care of older adults.
Graduate
2022-03-31

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MULAČOVÁ, Romana. "Integrace rodičů do péče o kriticky nemocné dítě." Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-110118.

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Nowadays the parental presence in the pediatric intensive care units (PICU) is quite common. Building a fellowship between parents and health care staff and high quality parents' integration into the care is a very demanding process. First of all, the success of this process largely depends upon the nurse. It is the very nurse who leads, educates, supports and also professionally integrates parents into their child's care. In addition, critically ill child's care in cooperation with parents is complicated by a high parental stress level, child's serious condition and high professional and technical requirements posed to the nurse. The graduation thesis concentrates on the parents' integration into the care of a critically ill child from the nurse's point of view. The goal of this thesis was to describe the general conditions of parents' integration into the critically ill child's care and to map the actual state of the cooperation within the nurse ? parent ? critically ill child relation from the nurse's point of view. Other goals included the analysis of nurse's feeling of readiness for work with parents of critically ill children, and elaboration of a booklet concerning the initial introduction of an intensive care and resuscitation unit for infants and older children for better parents' awareness. In the research part of the thesis a qualitative research was used. The data collection technique was a semi-standardized interview. A research sample was represented by seven nurses working in the sphere of the critically ill children care in four selected hospitals in the Czech Republic. The study took place in the period starting May 2011 till July 2011. The research results revealed that the parental integration conditions are not quite optimal. First of all, in this sphere the nurses pointed to a limited accommodation capacity for parents, lack of supporting services and unsatisfactory site layout of the intensive care units. The nurses expressed their readiness to the closer cooperation with critically ill children's parents in the basic nursing sphere, mostly, thereafter, in the sphere of hygiene care. The parental cooperation in the special-care sphere was accepted rather negatively by the respondents. As the research results show, most of the nurses consider the work with parents psychologically very demanding and during their school education they had never been prepared for it by anybody. Findings flowing from the research results gave birth to the information booklet that is a basic informational and educational material for parents of children admitted to the intensive and resuscitation care unit for older children and infants in Hradec Králové University Teaching Hospital. It also represents a detailed instruction for a similar material for other facilities of this type and, last but not least, it facilitates the whole process of initial parents' education for nurses. This graduation thesis can also assist in the education of children's nurses, help students and nurses working with critically ill children's parents understand the "Family-centered care" principles and their practical introduction.

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Inoue, Chiho Sunakawa. "Virtual "ie" household : transnational family interactions in Japan and the United States." Thesis, 2012. http://hdl.handle.net/2152/ETD-UT-2012-05-5158.

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This dissertation explores the impact of technology on social life. Focusing on webcam-mediated audio-visual conversations between Japanese families in the United States and their extended family members in Japan, I examine how technology participates in creating an interactional space for the families to manage intra- and intergenerational relationships. Combining ethnography with turn-by-turn analyses of naturally occurring webcam interactions, I specifically investigate how cultural, discursive, and family practices are transformed in innovative ways and how families adapt to the emerging mediated space. Looking at how interactional activities are coordinated across spaces, I show that webcam interactions constitute a new type of shared living space in which multigenerational family relationships are created and managed. I call this emerging space the virtual ie (‘house’ and ‘stem-family system’). In this virtually conjoined space, children, parents, and grandparents are visually familiarized with each other’s households and socialized to each other’s virtual presence. Even though the ie is no longer a juridical unit of co-residence, my goal is to discuss the significance of the ie in understanding how transnational Japanese families can dwell in a shared living space created by webcam interactions. My analyses demonstrate how webcam encounters create a stage for participants to perform various identities in interactions. Learning to talk and participate in such webcam interactions, children are socialized to their ie belongings and identities. Additionally, even though far-flung children do not provide physical and daily care for their parents in Japan, they actively take care of elder parents’ media environments. I demonstrate that what I call media care practices add another context for adult children living abroad to carry out their filial responsibilities. I also show that the management of webcam visual fields creates a type of social field that reflects local understandings of social positioning in ie structures. How participants decide to display themselves to others by manipulating the webcam’s visual fields provides a new way to demonstrate various social relationships and responsibilities over long distances. From this perspective, a virtual ie is not merely a reflection of an ideological understanding of Japanese families, but an interactional achievement facilitated by webcams.
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Brander, ROSEMARY. "Collaborative care relations: Examining perspectives for application and change within a Canadian hospital." Thesis, 2012. http://hdl.handle.net/1974/7288.

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Collaborative care is a philosophy which guides the work of interdisciplinary teams and patients and their families internationally. It has been demonstrated to improve quality of care, safety, and patient and staff satisfaction, yet applying this philosophy still requires much investigation. This thesis describes processes of change directed towards a vision to enhance collaborative care relationships with patients and families within one hospital site of a non-acute academic health science centre in Ontario, Canada. By building focused conversations around existing patient and family centred education and using an initial conceptual framework of customer service, healthcare providers, mid- and senior level leaders shared their perspectives, negotiated meanings and created innovations to enhance collaborative relationships within the organization. Based within the critical paradigm, a critical collaborative ethnography was constructed with the use of sequential and mixed research methodologies. The ethnography evolved over three phases in a step-wise and additive design during the three year period of study. Phase 1 examined the perspectives of healthcare providers in an exploratory case study which contributed to mid-level leaders’ discussions in Phase 2. Cumulative findings from Phases 1 and 2 were brought to discussions with senior leaders in Phase 3. Members of a participative action research team assisted with research design and study processes. Shared meanings and innovative change ideas were developed and captured through the use of semi-structured focus groups and interviews, survey, participant observation and inductive analysis. A conceptual framework of ‘partners-in-care’ emerged and was used to assist participants to make sense of the values and factors important in their work with respect to collaborative relationships. The research processes facilitated the development of many innovations to enhance collaborative practice within the hospital. The organization was described by the research as undergoing directed change to enhance collaborative care as evidenced through participant self-reports, observed initiatives and the ethnographic descriptions.
Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2012-06-25 15:06:24.687

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Smythe, A., P. Bentham, C. Jenkins, and Jan R. Oyebode. "The experiences of staff in a specialist mental health service in relation to development of skills for the provision of person centred care for people with dementia." 2013. http://hdl.handle.net/10454/9272.

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No
It is estimated that 820,000 people in the UK have dementia. Dementia costs the UK 17 billion a year and in the next 30 years this will treble to over pound50 billion a year. There is a need to raise competence of staff delivering care to people living with dementia across health, social and voluntary sector provision. Effective education and training will build capacity and improve staff knowledge. However, at present not enough is known about the experiences of staff involved in gaining the skills, knowledge and attitudes required to support provision of high quality care for people with dementia. This study was conducted within a large National Health Service Trust in the UK serving an urban, ethnically mixed population, in collaboration with a local university. The trust responded to government policy by seeking to identify staff training needs. The aim was to explore the experiences of staff working within a specialist mental health service in relation to development of skills for the provision of person-centred care for people with dementia. To achieve this, staff roles, experiences of dementia training and the ways in which staff feel they learn were explored through focus group interviews. Relatives' views of staff competencies necessary for effective care provision were also explored to supplement the data from staff. A total of 70 staff and 16 family carers participated and data were subjected to inductive thematic analysis. Five themes emerged: competency-based skills, beliefs, enablers and barriers and ways of learning. Findings suggested participants felt that skills for person-centred care were innate and could not be taught, while effective ways of learning were identified as learning by doing, learning from each other and learning from experience.

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Phiri, Lesego Margaret. "Assessment of the needs of critically ill / injured patients' famalies in an accident and emergency unit." Diss., 2010. http://hdl.handle.net/2263/26551.

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The critical illness/injury of a family member warranting an admission to an A&E unit can predispose a family to psychological and physiological needs. The patient-centred-care approach rendered in an A&E unit focuses on the patient as a priority, resulting in the family’s needs being neglected during a crisis situation. Based on the Family Resilience Framework, the aim of this study was to assess the needs of the families of the critically ill/injured patients in an A&E unit. Based on the identified needs, recommendations were made with regard to a family-centred-care approach as a relevant resilience-based strategy suitable to these families. The research adopted a quantitative, non-experimental, exploratory and descriptive design. A purposive convenience sample of 100 participants was recruited over a period of four months. The data were collected by means of a structured interview schedule. The study revealed that the five main domains of family needs identified by the respondents as very important was, in order of priority, the need for communication, support, meaning, comfort and proximity. The findings supported the need to initiate and foster a family-centred-care approach in the A&E unit, which could guide the nurse practitioners in supporting the affected families, which in turn could enable these families to become resilient. Copyright
Dissertation (MCur)--University of Pretoria, 2010.
Nursing Science
unrestricted

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Královec, Jiří. "Charta práv dětí v nemocnici ("EACH Charter") jako nástroj posilování a ochrany etických aspektů pediatrické hospitalizace." Master's thesis, 2020. http://www.nusl.cz/ntk/nusl-448716.

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The Charter of rights of children in hospital (the EACH Charter) is an international document authored by the European Association for Children in Hospital (EACH) in the eighties of the twentieth century. The Charter can be perceived as a response to the fact that a child's stay in hospital - and paediatric hospital as an institution - is strongly influenced and formed by economical, technological and administrative aspects prevailing over the ethical ones. The Charter highlights specific situations where the health care profession - by neglecting children's needs and ignoring and/or tolerating avoidable suffering - becomes unethical. The aim of my thesis is to scrutinize the ethical appeal of the EACH Charter and to explore the Charter's ethical implications for contemporary paediatric practice in the Czech Republic.

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Dahan, Sonia. "Parents ressources en néonatologie : évaluations d'expériences locales et perspectives de développement de pratiques partenariales innovantes." Thèse, 2019. http://hdl.handle.net/1866/22803.

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Botha, Carolina Stephanusina. "Reconstructing rainbows in a remarried family : narratives of a diverse group of female adolescents 'doing family' after divorce." Thesis, 2003. http://hdl.handle.net/10500/986.

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This research journey investigated the ways in which (1) the lives of adolescents have been influenced by parental divorce and subsequent remarriage, (2) exploring the relationships participants have with biological, nonresidential fathers and (3) to collaboratively present ways of doing family in alternative. Four adolescent girls took part in group conversations where they could were empowered to have their voices heard in a society where they are usually marginalized and silenced. As a result of these conversations a family game, FunFam, was developed that aimed to assist families in expanding communication within the family. Normalizing prescriptive discourses about divorce and remarriage were deconstructed to offer participants the opportunity to re-author their stories about their families. The second part of the research journey explored the problem-saturated stories that these four participants had with their biological, nonresidential fathers. They deconstructed the discourses that influenced this relationship and redefined the relationship to suit their expectations and wishes.
Practical Theology
M.Th.

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46

Chibamba, Fortune Michelo. "The role of community-based organisations in response to the HIV/AIDS in Botswana : the case of Gabane Community Home Based Care Organisation." Diss., 2011. http://hdl.handle.net/10500/4796.

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This study examines the role of Community Based-Organisations (CBOs) in the response to HIV/AIDS as a development challenge drawing examples from the Gabane Community Home-Based Care CBO in Botswana. The study adopted qualitative methods of research and used group discussions, relative unstructured interviews, direct observation and literature review as methods of data collection. The study found out that HIV/AIDS is indeed a development problem and that it can be dealt with using some existing development approaches such as the sustainable livelihoods approaches. The study further identified specific roles that CBOs play in the response to HIV/AIDS. It also revealed the potential that CBOs have in achieving development. In addition, the study identified and outlined challenges that CBOs face in responding to HIV/AIDS. Key recommendations are that CBOs must integrate poverty reduction interventions in their activities. They must also form coalitions and strengthen their capacity to sustain their activities and manage partnerships.
Development Studies

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Van, Pevenage Isabelle. "De l'aide au lien : des enfants adultes nous parlent de leurs parents âgés." Thèse, 2011. http://hdl.handle.net/1866/5905.

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Cette thèse s’intéresse aux parents âgés et à l’implication de leurs enfants adultes lorsque le besoin d’aide se fait sentir. Plus précisément, il s’agit ici de comprendre la signification que les enfants adultes attribuent à ce qu’ils considèrent comme un besoin d’aide de la part de leur parent âgé. Elle s’inscrit à la croisée de trois champs sociologiques : le vieillissement, les relations et solidarités familiales, les aides aux personnes âgées dépendantes. La démarche a consisté, d’une part, à repérer dans le récit que nous livrent des enfants adultes à propos de leurs parents, les significations accordées de part et d’autre à ce qui peut apparaître, ou non, comme un besoin d’aide ; d’autre part, à approfondir la réflexion sur l’évolution complexe du lien entre les parents âgés et leurs enfants, dès lors que la frontière entre ce que l’on appelle « autonomie » et « dépendance » apparaît éminemment subjective. Trois questions spécifiques sont posées. Premièrement, comment les enfants conçoivent-ils l’autonomie de leur parent ? Comment parlent-ils de cette autonomie ? Deuxièmement, en quoi les types d’aide apportés aux parents considérés comme « autonomes » diffèrent-ils de ceux apportés aux parents considérés « en perte d’autonomie » ? Troisièmement, dans quelle mesure la proximité résidentielle entre les parents âgés et leurs enfants répond-elle à un type de besoin spécifique et/ou traduit-elle un type de lien particulier entre ceux-ci ? La méthodologie privilégiée est celle de l’analyse de discours. Les résultats mettent en évidence trois éléments. Premièrement, le caractère éminemment subjectif des notions d’aide et de besoin d’aide, lorsqu’ils s’inscrivent dans une relation parent âgé / enfant adulte, en particulier dès que ce parent âgé apparaît comme étant potentiellement en perte d’autonomie. Deuxièmement, la grande plasticité de cette notion d’autonomie que l’on invoque, ou non, lorsqu’il est question d’apporter de l’aide au parent âgé : on n’aide pas forcément moins un parent considéré comme autonome qu’un autre étiqueté comme étant en perte d’autonomie. Troisièmement, l’imbrication étroite des statuts de fils/filles d’une part, et d’aidant(e), d’autre part, faisant en sorte qu’il est difficile de démêler les différents ordres de motivation qui interviennent tant dans les discours que dans les pratiques d’adultes « aidant » leur parent âgé.
This thesis studies elderly parents and the involvement of their adult children whenever help is needed. More precisely, the goal has been to understand the signification attributed, by the adult children, to what they consider to be a need of their parents. The study stands at the crossroads of three sociological fields: aging, family relationship and family solidarity, and care provided to the dependent elderly. The process consisted in extracting from the children’s discourse, the diversity of significations attributed to the sense of need, on both parts. Also, the complex evolution of the bond between the elderly parents and their children will be questioned, for it is hard to clearly distinguish autonomy from dependence. Three specific questions will be asked. Firstly, how do children perceive the autonomy of their parents? How do they express their point of view? Secondly, to what extent is the care brought to «autonomous» parents differing from that brought to parents with «decreasing autonomy»? Lastly, in what measure does residential proximity play a role; does it respond to a specific need and/or does it demonstrate a specific type of relationship? The methodology employed in this study consisted in discourse analysis. The results shed light on three elements. Firstly, the eminently subjective understandings of the notion of help/need, when having to care about elderly parents, especially when they are losing autonomy. Secondly, the great plasticity of the notion of parental autonomy, spoken or not, in the case that care need be offered to one's parents: more care is not necessarily brought to more dependent parents. Thirdly, the major implications of the double status of child and carer make it complicated to bring out the numerous motivations that intervene when a child decides to help.

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Moola, Sabihah. "Communication dynamics in producing effective patient care : a case study at Stanger Hospital’s diabetes clinic in Kwazulu-Natal, South Africa." Thesis, 2015. http://hdl.handle.net/10500/20679.

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Abstract:

Text in English
Interactive health communication between the health-care professional (HCP) and patient relationship for diabetes health-care positively contributes to patient-centred care. Hence individual patient concerns are addressed and catered for in the medical system. The purpose of this study was to analyse in-depth how HCP-patient relationships and HCP-HCP teamwork dynamics positively contribute to effective diabetes patient care and treatment adherence. Different health communication models and theories were reviewed and a conceptual framework was developed from the literature. A qualitative case study approach was used to collect data at Stanger Hospital’s diabetes clinic. Data was collected using three different methods, namely in-depth interviews with HCPs and patients individually, observations conducted at the clinic analysing both the HCPs and patients, and finally, documentation that emerged as a third data collection method where patient files and diabetes educational material were analysed at the clinic. Triangulation by means of the three methods ensured that reliable, valid and credible data was collected in the field. Diabetes health-care and treatment management are affected by the social context/social system which includes family and culture. These social factors are acknowledged as core in the literature. However, a single comprehensive health communication model did not exist solely in this regard. The data indicated that at the Stanger Hospital’s diabetes clinic, patient-centred (individual tailor-made treatment plans) care was only implemented after patients had defaulted treatment for reasons linked to their social circumstances. The findings of the study indicate that teamwork was favoured in the HCP-HCP relationship at the diabetes clinic, and that this made a positive contribution to effective diabetes patient care. HCPs were overburdened at the clinic since patient numbers were high and there were staff shortages. The patients’ empirical data indicated that interactive communication positively contributed to their medical concerns being catered for at the diabetes clinic, but this tended to occur only after non-adherence. Patients required care and support from HCPs in order to learn to accept diabetes and manage their illness.
Sociology
D. Litt. et Phil. (Sociology)

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Dissertations / Theses on the topic 'Family centred care discourse'

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