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Dissertations / Theses on the topic 'Patient experience'
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1
Avlijas, Tanja. "A Concept Analysis of the Patient Experience in Acute Care." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39715.
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Background: Patient experience has become an essential quality indicator in healthcare.
Purpose: The purpose of this thesis was to conduct a concept analysis of the patient experience.
Methods: Walker and Avant’s methodology served as the framework for this concept analysis.
Data were retrieved from seven databases and one search engine. The literature search used keywords related to "patient experience" and included articles published at any time up until March 2018. A total of 257 articles and organizational websites were included in the analysis after meeting the inclusion criteria.
Results: Twenty attributes were found to define the patient experience: communication, respect for patients, information/education, patient-centered care, comfort/pain, discharge from hospital, hospital environment, professionalism/trust, clinical care/staff competency, access to care, global ratings, medication, transitions/continuity, emotional dimension, outcomes, hospital processes, safety/security, interdisciplinary team, social dimension, and patient dependent features.
Conclusion: The results of this study will guide and clarify the critical concepts towards an explicit definition of the patient experience.
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Oi, Katsuya. "Understanding the Role of Patient Activation in the Association between Patient Socio-Economic Demographics and Patient Experience." PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/467.
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This study focuses on the association between patient characteristics, which include both demographic and contextual factors, and patients' experiences with health care. The pre-existing literature provides rich information about patients' various demographics related to patient experience. Despite the abundance of empirical evidence showing that patients' demographics do affect how they perceive their health care. However, there is little to no empirical knowledge explaining the significance of such factors. As the existing literature points out the need for taking into contextual factors such as patient's beliefs, attitudes, skills that are pertinent to dealing with health care, my study proposes patient activation as such a contextual factor that explains the association between patient demographics and patient experience. Findings suggest that patient activation is a strong predictor of two patient experience measures: patients' rating of doctor-patient communication and their self-reported difficulties in getting needed care. However, it is also observed that the mediating effects of patient activation vary by the two dimensions of patient experiences. Though this study demonstrates that promoting patient activation may be able to normalize how patients report the quality of doctor-patient interaction, further research is needed to address access to care issues.
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Ghazali, R. J. "Patient satisfaction : the Malaysian experience." Thesis, Swansea University, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.637051.
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The problem of scarce resources and escalating cost of health care has made the Malaysian governments to think about the corporatization of public hospitals. It is vital to understand the current situation before embarking on such a big project. The fundamental aim of the research was to assess the level of patient satisfaction in seven hospitals. In referral hospitals, only medical, surgical, orthopaedic, obstetric and gynaecology wards were selected. In non-referral hospitals, the wards selected were limited to male and female wards. Inpatients were given self-administered questionnaires after selection based on a set of inclusion and exclusion criteria. As for the staff, the same questionnaires were given to doctors, nurses and attendants who were working during that time. SERVQUAL, which was developed by Parasuraman, Zeithami and Berry, was used as a tool for measuring satisfaction. Apart from SERVQUAL, the questionnaires also include a session on respondent requests. Respondents were asked to list and prioritise five important things that they want from the hospital services. In this study the rate of patient satisfaction was low in all the seven hospitals. None of the hospitals had a patient satisfaction score greater than 45%. However in all the hospitals, the levels of dissatisfaction were only mild. In terms of SERVQUAL, patients and staff were least dissatisfied in the dimension of Empathy. Meanwhile, the greatest level of patient dissatisfaction was in the dimension of Responsiveness. For staff, the greatest level of dissatisfaction was Tangibles. Staff perceived that hospital equipment was not up-to-date. Patients understand that being a public hospital, it could only provide facilities to a certain extent. However they expect the staff to respond promptly to their needs. This study also has proven the hypothesis: The patient satisfaction will deteriorate if staff knowledge about patient requests/expectations decreases.
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Salmon, Pauline Adora. "Improving the Patient Experience with Communication." ScholarWorks, 2020. https://scholarworks.waldenu.edu/dissertations/7839.
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A quality patient experience is one of the highest priorities for hospitals as patients and families are looking to healthcare providers to meet their demands for quality service. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures the extent to which providers effectively communicate pertinent information such as communication about medications. On a 20-bed intermediate care unit, the HCAHPS item scores relating to nurse communication and communication about medicine were inconsistent and, on most occasions, were below the comparison benchmark of the 50th percentile when compared to other like hospitals. The purpose of this quality improvement project guided by the patient-centered care model, needs based theory, and adult learning theory, was to test the impact of an educational module for nurses on best practices for teaching patients about medications. Thirty nurses consented to participate in the teach-back sessions. Results of the pre- and posttest, evaluating the nurses' knowledge and attitude about teach-back, were analyzed using the Wilcoxon Signed Ranks test and findings showed an improvement in knowledge scores (z = -2.833, p = .005). However, no statistically significant changes occurred in nurse attitudes toward teach-back. A comparison of descriptive HCAHPS scores on communication about medications and nurse communication showed that scores improved from a low of 58% top box to 74% after the teach-back education. These findings indicated that using teach-back could enhance communication about medications. Effectively communicating pertinent health information using teach-back may have significant consequences for nurse-patient-family engagement contributing to positive social change.
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Marshall, L. "Healthcare environment design and patient experience." Thesis, Canterbury Christ Church University, 2018. http://create.canterbury.ac.uk/17671/.
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The design of healthcare environments has been shown to produce positive effects for patient outcomes, particularly in mental healthcare. However, relatively little is known about patient experience of design within physical healthcare environments. In this study, fourteen cancer patients were interviewed about their experiences of using a newly built cancer centre that incorporates art and design. Grounded theory methodology provided a framework for the analysis of results and the construction of a theoretical model which represents a first attempt at explaining the relationship between healthcare environments and patients with respect to emotional wellbeing. Results show that central aspects of this particular healthcare environment – orientation, physical aspects of design, and atmosphere – were not like a hospital and these led to diverse patient experiences depending on the individual context, in other words the personal histories and preferences that patients brought. Implications for research and clinical practice, including the benefits of drawing upon helpful aspects of environments as part of a holistic approach to treatment, are discussed.
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Fuller, Valerie J., and Valerie J. Fuller. "The Patient Experience of Postoperative Delirium." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/625719.
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Background: Postoperative delirium (POD) is a common neurocognitive disorder in patients undergoing surgical procedures. Delirium is a disorder that is poorly understood, frequently unrecognized and associated with numerous adverse outcomes including longer hospital stays, significantly higher costs and increased morbidity and mortality. While there has been a great deal of research on proposed etiologies, risk factors and outcomes of delirium, few studies have explored the patient’s subjective experience of the phenomenon.
Purpose: The purpose of this qualitative descriptive research was to investigate the patient experience of postoperative delirium and measure the distress associated with the experience. The Delirium Symptoms Experience Model (DSEM) provided the theoretical framework in which to understand the postoperative delirium experience. The three specific aims used to guide the investigation were: 1) Identify patient age, gender, race, type and length of surgery, past medical and surgical history, length of admission, delirium subtype (if known), and medications (including anesthetic agents) used in the perioperative period to better characterize the sample and provide context for the qualitative findings; 2) Describe the postoperative patients’ experience of being and feeling delirious; and, 3) Measure the distress associated with the recall of delirium using the Delirium Experience Questionnaire (DEQ)
Methods: Ten participants ranging in age from 33-75 years (mean = 66.2 years of age) who experienced postoperative delirium were interviewed. Patients were screened for persistent delirium or cognitive impairment as assessed with the Confusion Assessment Method and the Mini-Cog™ Instruments.
Results: Three organizing themes emerged from the content analysis: 1) Altered Perceptions of Reality; 2) Stuck in the Confusion; and, 3) Seeking Reality. The analysis of the quantitative measures and descriptive data demonstrated a high rate of psychological distress associated with delirium recall with 80% participants reporting it caused severe to very severe distress. The anesthetic drug propofol was the common medication prescribed in the perioperative period and given to all ten participants.
Conclusion: Understanding this phenomenon from the patients’ perspective may provide a better understanding of the delirium experience and aid in the development of interventions and treatments to improve care and reduce suffering.
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Karlsson, Terese. "Improvements within patient experience during MRI." Thesis, KTH, Människa och Kommunikation, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-209939.
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MRI is one of the biggest and most growing imaging techniques. Even though itis one of the most harmless technologies a big portion of the patients experienceanxiety during the exam. By improving the patient experience unnecessary psychologicalstress for the patient can be prevented, the patient movement wouldthen decrease and therefore the imaging can be improved without changing thetechnique. Participant observations at four dierent MRI departments werecompleted with six interviews with radiographers and technical MRI personnelin order to get insight in the work around an MRI exam and the problemsthat patients experience. The data collection resulted in three improvementareas: the atmosphere of the waiting room, the atmosphere of the MRI roomand the headset used by the patient during the MRI exam. These improvementareas were paired up with solution suggestions which were then controlled andcommented by one MRI specialist, one MRI developer and one radiographer tovalidate the suggestions. The conclusion was that there is already much doneto improve the environment in the MRI room, even though more can be done.The waiting room, on the other hand ,has not been an object for studies orfor improvements before. Therefore more calculation about how big of a protit could be, to improving the atmosphere in the waiting room, should be doneso one knows how much resources one can be put into that improvement area.Lastly there are potential solutions for how to create a much better headset butbecause the generated solutions in this area are so technically challenging moreresearch has to be done before it can be realised.MR är en av de största och mest växande medicinsk bildgivande teknikerna som finns. Även om tekniken är helt ofarlig är det många patienter som lider av ångest kopplad till undersökningen. Genom att förbättra patientens upplevelse kan man förbygga den ångesten, då kommer också patienten kunna ligga mera still under undersökningen och därför kommer bilderna kunna förbättras utan att ändra tekniken.Datainsamlingen bestod av deltagande observationer på fyra olika röntgenavdelningar tillsammans med sex stycken intervjuer med både röntgensköterskor och personal som jobbar med MR-tekniken. Detta för att få en inblick i jobbet runt en MR undersökning och problemtiken som patienterna upplever. Datainsamlingen resulterade i tre olika förbättringsområden: väntrummet, undersökningsrummet och headsetet som patienten använder under MR-undersökningen. Dessa förbättringsområden parades ihop med förbättringsförs-lag och validerades sedan med en MR speciallist, en utvecklare och en röntgensköterska.Slutsatsen var att det idag görs mycket för att förbättre miljön i undersökningsrummet, även om mycket mer kan göras. Väntrummet, och andra sidan, har inte varit föremål för varken studier eller förbättringar och därför behöver uträkningar göras på hur stor vinst det skulle vara med en förbättrad miljö där för att veta hur mycket resurser som kan läggas på det. Till sist kan det konstateras att det finns potentiella lösningar för hur ett bättre headset skulle kunna skapas, men eftersom de förslagen som genererats i den här studien är så tekniskt avancerade behövs mer forskning för att kunna realisera lösningarna.
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DeAdder, Dawna Nadine. "The illness experience of patients following a myocardial infarction : implications for patient education." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/29706.
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This study used the research method of phenomenology to elicit the patient's perspective of the illness experience following a myocardial infarction (MI). The purpose of studying this experience was to gain an understanding of what it meant to men and women to have a MI, what the learning needs were following a MI, and how these learning needs were met. It was proposed that patients would view the illness experience differently from health professionals, thus the patients would identify different learning needs. Anderson's (1985) adaptation of Kleinman's health care system framework was used to conceptualize this problem.
Three males and two females, ranging in age from 42 to 77 years, participated in the study. Data were collected through 11 in-depth interviews. From analysis of this data significant statements were extracted to provide a description of the phenomenon under study.
The findings of this study suggest that health professionals and patients do view the MI experience from different perspectives. The emphasis of the patients on understanding the MI experience from the reality of their world is reflected in their attempts to rationalize the occurrence of the MI and their desires to know more about
their own MI, prognosis, and treatment. In order to plan patient education that will assist post-MI patients in their recovery health professionals must assess patients individually for their: (1) beliefs regarding risk factors and causes of MI; (2) desire for Information; (3) preference for method of instruction; and, (4) preference for timing of education.Applied Science, Faculty of
Nursing, School of
Graduate
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Johansson, Sofia, and Emelie Mörk. "Patientens upplevelse av omvårdnad vid ortopediska skador." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-294953.
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SAMMANFATTNING Bakgrund Den ortopediska skadan kan för patienten vara en mycket smärtsam process och orsaka långvarigt lidande. Detta ställer höga krav på sjuksköterskans kompetens som utifrån patientens individuella behov måste tillämpa en god personcentrerad omvårdnad. Syfte Syftet med denna litteraturstudie är att undersöka patientens upplevelse av omvårdnadsåtgärder vid ortopediska skador, samt få en ökad förståelse för betydelsen av personcentrerad omvårdnad vid dessa åtgärder. Metod Då författarna valde att använda redan publicerad forskning användes litteraturstudie som metod. Artiklarna söktes fram i databaserna Cinahl och Pubmed med sökorden orthopaedic, patient, experience, interview. Efter noggrann granskning och värdering av artiklarna inkluderades totalt elva artiklar. Resultat I resultatet redovisas fyra kategorier; information, stöd från vårdpersonal, främja delaktighet och smärtlindring, som för patienten fick en stor betydelse för upplevelsen av omvårdnadsåtgärder vid ortopediska skador. Slutsats Denna studies resultat visar att det utifrån patienternas upplevelser finns ett behov av förbättring. Följaktligen kan vårdpersonalen förbättra sitt utförande av ortopediska omvårdnadsåtgärder, och därmed tillämpa en personcentrerad omvårdnad. Nyckelord: orthopedic, patient, experience, nursing.ABSTRACT Background The orthopaedic injury can be a painful experience and cause long-time suffering. This put up for high requirements for the nurse who needs to apply a person-centered care. The aim The aim of the study was to investigate the patient´s experience of provided care when having an orthopedic injury. The second purpose was to obtain knowledge about the meaning of person-centered care. Method A Literature review was used as method though the writers wanted to use already published material. The search of the articles was made in the databases Cinahl and PubMed with the words orthopedic, patient, experience interview. After examining the articles a total of 11 articles were included. Result The results revealed four categories; information, support from the medical staff, participation and alleviation of pain. These categories had a big impact of the patient´s experience of the provided care they were given. Conclusion In this study the result showed that the patients’ experiences found a need of improvement in the work of the nursing-staff. Therefore the nursing-staff can improve their orthopedic care and apply a person-centered care. Keywords: orthopedic, patient, experience, nursing.
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Wahl, Grendi Heidi. "Measuring Patient Experience in Hospital Maternity Care." Thesis, KTH, Skolan för elektroteknik och datavetenskap (EECS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-281290.
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This thesis concerns Patient Experience (PX), in hospital maternity care in Sweden. The focus lies in the development of a measure to describe the current state of PX. The thesis uses a semi-sequential mixed-methods study design; exploration of the patient journey, through qualitative methods, informs the adaptation of an existing maternity care experience survey instrument. The resulting survey instrument is tried in a pilot study and renders a composite measure of PX. Part of the analysis is dedicated to understanding the e!ect of information and communication in PX; Exploratory Factor Analysis is used to test the model and attempt an answer. The results show that it is possible to describe PX using the proposed survey instrument. The composite measure preserves di!erences in perceptions better than an arithmetic average of two discrete VAS-1 type measurements, and is more appropriate when measuring attitudes, and opinions using Likert-type measures. A three component solution describes 65.44% of the total sample variance. Determining to what degree PX is influenced by information and communication remains di"cult to quantify, but these initial results indicate that the manner of the attending sta! during aftercare and the respondent’s mastery of information during discharge are important dimensions of patients’ total PX (ANOVA R .695, R Square .483). The model’s three components are almost entirely built from items that address interpersonal skills and information assimilation. These correspond to two of the three Service Quality Dimensions, namely Interaction Quality and Outcome Quality. Most important of the three is the component “Chemistry in aftercare”. The predictive strength of the model shows merit under the context of the study and could advise further e!orts to develop measurements for PX in maternity care in a Swedish hospital setting. Lastly, this study contextualises Service Design in hospital maternity healthcare; the study therefore o!ers ample opportunity for innovation.Arbetet handlar om Patientupplevelse (PU), i förlossningsvården i Sverige. Fokus ligger på utvecklingen av ett mätvärde att beskriva den nuvarande patientupplevelsen. Arbetet använder kvalitativa och kvantitativa metoder (mixed-methods), i en semi-sekventiell design; utforskning av patientresan ligger till grund för anpassningen av ett existerande mätinstrument. Det nya mätinstrumentet testas i en pilotstudie och ger ett kompositmätvärde av PU. En del av analysen ägnas åt att förstå vilken e!ekt information och kommunikation har på PU; Explorativ faktoranalys används för ändamålet. Resultaten visar att det är möjligt att beskriva PU genom det föreslagna mätinstrumentet. Det resulterande kompositvärdet är bättre på att beskriva skillnader i uppfattning än ett medelvärde av två diskreta variabler av VAS-1 typen, och är också lämpligare när attityder och åsikter mäts med hjälp av Likert-skalor. En trekomponentslösning beskriver 65.44% av den totala stickprovsvariansen. Att avgöra hur mycket PU påverkas av information och kommunikation förblir svårt att kvantifiera, men dessa inledande resultat visar att patientbemötande under eftervårdstiden och patientens förmåga att bemästra information under utskrivningen är viktiga dimensioner av patienters totala PU (ANOVA R .695, R Square .483). Modellens tre komponenter är nästan uteslutande uppbyggda av variabler som fångar upp personliga relationer och assimilering av information. Dessa motsvarar två av de tre dimensionerna i Servicekvalitetsmodellen, nämligen Interaktionskvalitet och Utfallskvalitet. Viktigaste komponenten är Personlig kemi under eftervården. Modellens förutsägningsstyrka visar förtjänst under studiens kontext och kunde informera framtida ansträngningar att utveckla mätvärden för förlossningsvården inom svensk sjukhusmiljö. Till sist kan nämnas att studien kontextualiserar Service Design inom förlossningsvården; studien erbjuder därför omfattande möjligheter för innovation.
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Bockover, Spencer R. "Cancer Patient Experience Using Integrative Health Techniques." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7477.
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Objective:
From a patient-centered perspective, this study sought to explore cancer patient experiences using integrative health techniques, while undergoing or after having completed conventional cancer therapy.
Methods:
Recruitment and data collection both occurred within the Supportive Care Medicine Department of a comprehensive cancer center in the southeastern United States. The primary collection method was semi-structured interviews, of which 13 were conducted.
Results:
Patients using integrative therapies experienced a variety of physical and mental/emotional benefits from their chosen therapy, such as management of lymphedema and nerve damage, increased mobility, and improved self-confidence.
Conclusion:
Integrative therapies can provide many benefits to patients in mitigating treatment side effects and other cancer related symptoms. CAM practitioners themselves played an important role in post-treatment cancer support; both by acting as a health educator and by administrating the therapy itself.
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Beattie, Michelle. "Measuring the patient experience of hospital quality of care." Thesis, University of Stirling, 2016. http://hdl.handle.net/1893/23410.
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The primary motivation of this PhD by publication has been the apparent disconnect between the metrics of hospital quality of care at national and board level and patients’ experiences. Exploration of the gap led to the realisation of two key points. Firstly, the concept of healthcare quality continually evolves. Secondly, the NHS Scotland Measurement Framework does not include a measure of patient experience at the microsystem level (e.g. hospital ward). This is needed to counterbalance easier to obtain metrics of quality (e.g. waiting times). Resource tends to follow measurement. Papers 1 and 2 were exploratory, investigating theoretical and practical aspects of measuring quality of hospital care at the clinical microsystem level. With the associated Chapters, they highlighted both the necessity and the possibility of measuring the patient experience at the micro level of the healthcare system. They also drew attention to the inadequacy of “satisfaction” as a metric, leading to closer examination of “experience” as the decisive metric. This required the development of a systematic review protocol (Paper Three), then a systematic review (Paper Four). The review (Paper Four) examined the utility (validity, reliability, cost efficiency, acceptability and educational impact) of questionnaires to measure the patient experience of hospital quality of care, with a newly devised matrix tool. Findings highlighted a gap for an instrument with high utility for use at the clinical microsystem level of healthcare. Paper Five presents the development and preliminary psychometric testing of such an instrument; the Care Experience Feedback Improvement Tool (CEFIT). The thesis provides, as well as the matrix tool and CEFIT, theoretical and methodological contributions in the field of healthcare quality. It contributes to an aspiration that the patient’s voice can be heard and acknowledged, in order to direct improvements in the quality of hospital care.
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Wilkinson, Katherine. "Cardiac pacemakers in paediatric patients : a qualitative study of patient and parental experience." Thesis, University of Leeds, 2010. http://etheses.whiterose.ac.uk/1366/.
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The aim of the study was to explore the experience of having a pacemaker as a child or young person and the experience of their parent in caring for them. Due to lack of research, very little is known about the impact that having a pacemaker has on children and their parents. However, evidence from the adult literature and clinicians’ observations revealed that problems with adjustment can occur. Clinicians have also noted interesting differences in adjustment between families, with some coping well and others experiencing more difficulty. Both children and parents were interviewed because of the importance of systemic influences on children. Also, the literature suggests generational transmission of anxieties and coping styles between parents and children often takes place. Given the exploratory nature of the study, a qualitative methodology was employed. Eight participants were interviewed (four parent‐child dyads). All the child participants were aged between 11 and 16 years and had been fitted with a pacemaker. Data were subjected to Interpretative Phenomenological Analysis. The child and parent group data were analysed separately. Three main themes emerged from the child group analysis: identity, coping with having a pacemaker and medicalisation of life. Five main themes emerged from the parent group analysis: guilt, adjustment as a process over time, coping with having a child with a pacemaker, the battle for control and my perception of my child. Each of the main themes consisted of several subthemes further illustrating the complexity of the participants’ experience. Overall it appeared that despite feelings of threat and anxiety at times, participants used a variety of coping methods to help them adjust to the presence of the pacemaker in their lives. The findings are discussed within the wider literature and clinical implications highlighted.
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Smith, Cheryl. "Patients’ Perceptions of Patient-Centered Care and the Hospital Experience Pre- and Post-Discharge." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etd/3388.
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Florence Nightingale used the principles of patient-centered care as the foundation for nursing practice. Today, patient-centered care delivery is part of the healthcare reform process that extends interprofessionally throughout all settings of healthcare in the United States (U.S.). Patient satisfaction measurement is one primary determinant of effective patient-centered care. The standardized Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and methods is a nation-wide tool used to measure patient satisfaction. However, this method of patient satisfaction assessment relies on recollections of patients’ hospital experiences and requires accurate memory and recall. This study sought to examine the effect of the memory-experience gap on patients’ perceptions of their hospital experiences and address this research question: Are there any statistical differences between in-hospital and two-week post-discharge perceptions of patient-centered care as measured with HCAHPS patient satisfaction ratings on (a) the composite scores for communication with nurses, communication with physicians, communication about medicines, pain management, staff responsiveness, (b) the individual scores for the hospital environment’s cleanliness and quietness, and the inclusion of patient and family preferences in the plan of care, and (c) the overall global rating score? The design was a non-experimental, prospective, descriptive correlational study. The setting was a 255-bed regional hospital that serves individuals from eight surrounding rural counties in southern middle Tennessee. The case-mix contained diverse individuals with multiple economic, environmental, physical, social and spiritual dynamics. A convenience sample of 82 adult patients ages 26 - 93 represented mainly Caucasian females with mostly cardiovascular and respiratory illnesses who had a minimum one-day stay.
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Sinnott, Patricia A. "Pharmacists' illness experience and the pharmacist-patient relationship." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ29338.pdf.
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Alexander, Janet. "Patient reflections on the experience of pain management." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0017/MQ52870.pdf.
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Singh, Jeshika. "Development of a descriptive system for patient experience." Thesis, Brunel University, 2018. http://bura.brunel.ac.uk/handle/2438/16385.
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Efficient allocation of public resources requires identification, measurement and quantification of costs and benefits of alternative programs. Patient reported outcomes (PROs) are routinely incorporated into economic evaluations of health technologies, but patient experience is often overlooked. This thesis aims to develop a descriptive system for patient experience that can be valued and used to inform economic evaluation. The generation and selection of items is key in the development of any PRO measure. The thesis provides a contemporary overview of recommended methods and those actually used by instrument developers. Frequently a staged approach is used to establish dimensions first, using exploratory factor analysis, followed by item selection using item response theory (IRT), Rasch or structural equation modelling (SEM). I demonstrate the use of different methods for item selection and its underlying mechanics, followed by comparison of the methods. An existing patient dataset, the Inpatient survey (2014) that collected information on nearly 70 aspects of healthcare delivery from NHS users was used. Logistic regression analyses were applied with respondents' rating of overall patient experience specified as dependent variable. Advanced statistical analyses focussed mostly on patients who had an operation or procedure. Latent construct or dimensions were derived and measurement model was confirmed using confirmatory factor analysis. IRT and factor analysis were employed in each one-factor model for item selection. Regression analyses identified many significant variables but most overlapped conceptually. An 11 and 8 factor model for patients with A&E and planned admissions respectively was determined. A generalised partial credit model and a factor analysis model identified different items to include in each dimension. Broadly the items identified by different methods related to respect, comfort and clear communication to patients. This thesis presents descriptive systems for patient experience that is amenable to valuation. It also demonstrates that different patient experience instruments are generated based on patient population used and item selection technique adopted.
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Aoki, Takuya. "Social Isolation and Patient Experience in Older Adults." Kyoto University, 2019. http://hdl.handle.net/2433/242366.
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Andersson, Emma. "Patient Experiences after Undergoing Bariatric Surgery." Thesis, Blekinge Tekniska Högskola, Institutionen för hälsa, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-754.
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Background: Overweight and obesity has increased worldwide and is a leading cause of preventable death. This has led to the quantity of bariatric surgical procedures in Sweden increasing. Research has identified significant medical benefits such as long-term weight loss, improved risk factors and significant reduction of mortality resulting from the surgery, however research focusing on the experiences of patients has not been undertaken to the same degree. The increasing incidence of overweight and obesity suggest that this patient group will continue to increase each year. Knowledge about the experience of bariatric surgery, including the challenges it represents from the patients’ perspective, is essential for nurses in order to provide the best possible care. Aim: The aim of the study was to investigate the patient’s experiences after undergoing bariatric surgery beyond the initial post-operative period of 6 months. Method: This study has been conducted as a literature review of nine qualitative scientific nursing articles. The data was analysed by conducting a manifest content analysis. Result: The results found that experiences after bariatric surgery beyond the initial post-operative period were both positive and negative. How the individuals adapted to the changes the surgery entailed was found to be a strong factor in determining the nature of the experience. Two main categories emerged from the data; ‘Enforced Structure’ and ‘A Complete Transformation’. Conclusion: Undergoing bariatric surgery results in extensive and complex changes for this patient group to adapt to. Exploring their experiences has allowed factors for successful and challenging adaption to these changes to be identified. Nursing professionals can use this knowledge to help guide bariatric patients towards a successful adaption to the multitude of changes that surgery encompasses.
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Lastra, Åsa. "Patienternas upplevelser av ronden på en kirurgisk akutvårdsavdelning." Thesis, University of Skövde, School of Life Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-2833.
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Ronden på en kirurgisk akutvårdsavdelning är en central del i vårdprocessen för patient och personal. Ronden sker dagligen och mötet mellan patient, läkare, sjuksköterska och undersköterska sker på kort tid och det sker snabba beslut. Syftet var att undersöka patientens upplevelse av ronden på en kirurgisk akut vårdsavdelning. Med utgångspunkt från detta så valdes det en kvalitativ metod med fenomenologisk ansats och intervjuer som datainsamlings metod. Efter analys av totalt 11 patienters upplevelser av ronden kom det fram tre kategorier med tillhörande underkategorier i resultatet. Kategorin tid och rum har underkategorierna mångfaldens, tidens och placeringens betydelse, kategorin interaktion har bemötandets, rummets och erfarenhetens betydelse och kategorin delaktighet har informationens betydelse, självbestämmande och känsla av stöd. Informanternas upplevelser av ronden betonade att det var många deltagare, att mötet var kort och snabbt, deltagarnas placering på rummet och delgivande av information hade en betydelse. Dock ett bra bemötande från personalen, att känna sig delaktig, att känna ett stöd från sjuksköterskan, känsla av förtroende och tidigare negativa upplevelser gav en positiv upplevelse av ronden.
Round on a surgical emergency ward is a central part of the care process for patients and staff. Round take place daily and the meeting between patient, doctors and other staff take place briefly and decisions are taken rapidly. The purpose was to examine the patient's experience of rounds on a surgical emergency ward. A qualitative and the phenomenon illogical approach were chosen with the interviews. After the analysis of the 11 patients' experiences of rounds show three categories and related subcategories which are labelled as time and room such as diversity, time and posting importance. Further more interaction such as importance of treatment, the space and experience and also participation such as the importance of information, self-determination and sense of support. The results show that the participants thought that there were various participants involved in the rounds, the meetings were short and brief, and the participants' presence in the room and the given information affected their experiences. However, a good treatment from the staff, sense of participation, a sense of support, a sense of confidence and previous experience gave participants positive experiences.
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Grifone, Rose. "Personal investment : five physicians' core experience of relating with patients /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ56231.pdf.
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Newton, Alana. "Disengagement from patient relationships: nurses' experience in acute care." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/680.
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Nursing is uniquely demanding work and occupational stress in the nursing profession has been well-documented. Many theories of stress-related disruptions among helping professionals have been proposed. Although these theories differ slightly in their origin of stress, they share similarities in nurses’ response to the patient relationship. Depersonalization, withdrawal, and avoidance all serve to create relational distance between the nurse and the patient. Despite the prevalence of these responses, there are not any theories on the nurses’ process of disengagement from patient relationships. Using Strauss and Corbin’s (1990) grounded theory method, this study explored acute care nurses’ experience of disengagement in patient relationships. The purpose of the study was to develop a mid-range theory of nurses’ process of disengagement from patient relationships as it occurred in acute care. Through purposive and theoretical sampling, 12 acute care nurses participated in open-ended individual interviews. The process of open, axial and selective coding discovered seven categories related to nurses’ experience of disengagement from patient relationships. These categories were emotional experience, behavioural expression, environmental influences, relational distance, professional identity and work spillover. Although these categories were exclusive, conceptual elements were interwoven into more than one category. The categories were interrelated around the core category, ‘Doing and Being’, and the process of nurses’ disengagement from patient relationships was delineated. Participants in the study experienced dissonance when they were unable to act in accordance to their caring beliefs. Conditions in the work environment, such as the lack of time, the culture of productivity and patient characteristics influenced and promoted their process of disengagement. Disengagement was manifested in the nurse-patient relationship by decreased eye contact, increased physical distance and increased task focused behaviour. These behaviours increased relational distance between the nurse and the patient. Nurses’ experience of dissonance had the potential to foster feelings of professional dissatisfaction and alienation from self, leading to increased turnover behaviour and depression. Implications and recommendations for practice and future research are discussed.
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Green, Rachel. "Patient and professional views and experience of oral precancer." Thesis, University of Newcastle upon Tyne, 2013. http://hdl.handle.net/10443/2270.
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Oral precancer (OPC) is a collective term for a number of disorders that may precede oral cancer. Treatment is aimed at preventing malignant transformation however, this is complicated by a lack of robust evidence concerning both treatment effectiveness and future cancer risk. Uncertainties surrounding prognosis and treatment options might be expected to impact on a patient’s experience of their disease, as well as creating challenges for their management. The aim of this research was to explore the experience of OPC through the eyes of the patient and clinician to assess the impact of living with oral precancer and enable the identification of opportunities to improve outcomes. The project comprised two qualitative studies, each employing semi-structured interviews. 28 patients with OPC, were recruited for study A, while 11 Oral and Maxillofacial Consultants were involved in study B. Data collection and analysis was iterative, following the principles of the ‘constant comparative’ method (Glaser 1965). Data collection stopped when data saturation was achieved. The data were analysed using thematic analysis. The results indicated that during the diagnosis and management of OPC, clinicians were faced with challenges. These included: communicating a diagnosis, (particularly in terms of terminology), conveying risk meaningfully, meeting patients’ additional information needs, encouraging behaviour change and making treatment decisions. The patient data indicated that for some, OPC represents a devastating diagnosis leading to feelings of fear and uncertainty impacting significantly on the individual’s life. In addition, analysis also allowed a disease journey to be mapped and directly related to the findings from the clinician group thereby indicating opportunities where changes in practice may improve patient care. These points included: the diagnosis, where understanding terminology and comprehending risk were problematic, following a diagnosis, where meeting information needs was a challenge and during the management and review stages when treatment decisions were made and carried out.
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Ajaj, Shaban Al-Furgani. "Improving patient confidentiality systems in Libya using UK experience." Thesis, University of Gloucestershire, 2012. http://eprints.glos.ac.uk/1104/.
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Patient confidentiality has received much attention in recent years because of the rise in the number of confidentiality breach incidents and the need to improve the provision of health services in general. Patient confidentiality is defined as the patients‟ right to the protection of their personal medical information within health institutions under normal conditions. While literature on the protection of patient confidentiality exists, there is little or no attempt made to use a theoretical model to represent this, and hence, with which to appraise the practice of patient confidentiality in health care systems. The main aim of this research study is to contribute to the development of a model for the protection of patient confidentiality in Libya, using experience and evidence from elsewhere, and also to suggest means to improve confidentiality through the application of lessons from the UK health service. The standpoint taken is a pragmatic one, as the focus is on the utility of the proposed model. There are two principal strands to the research: one concerns the views of experts as to factors that influence patient confidentiality. The second major one is the development of a System Dynamics Model to present the flow of patient data and the places where breaches of confidentiality are likely to occur. These two strands are then considered jointly to provide a basis for conclusions and recommendations of particular relevance in Libya (and perhaps more generally). The data used to identify the main factors that affect the practice of patient confidentiality were collected using two stages: literature review and expert surveys. The first iteration requesting views was sent to experts from Libya, Europe and elsewhere in the field of patient confidentiality, to establish a set of factors that might influence the practice of patient confidentiality. A second iteration followed with selected respondents to rank the relative importance of elements of contributing to two factors, trust and ethics, that were identified in the first expert letter survey. The results from the expert letters indicated that the main factors that influence the practice of patient confidentiality, especially in Libya, were trust, ethics, regulation and technology. The results from the interviews and the focus group showed that the findings of the current research had ecological validity. This is based on the Libyan participants‟ views, which strongly supported the research results as having the potential to improve Libyan patient confidentiality systems by learning from the UK experience. The responses were used to inform the insights obtained from the UK NHS model of patient confidentiality of 2003, which was developed into an innovative simulation using Systems Dynamics Modelling (SDM). Quantitative data to populate the model was drawn from NHS statistics. The model was „validated‟ through personal interviews and a focus group with individuals who had experience in the practice of patient confidentiality in the Libyan health service. The results of the running of the SDM model were also compared to known data to provide a check on validity. The proposed SDM model of patient confidentiality was shown to have ecological validity though the views of medical staff and medical records managers in two major general UK hospitals. The premise was that breaches of patient confidentiality could occur either from (i) human error when dealing with patient medical data within the national health services by staff such as frontline medical staff, doctors and nurses, or (ii) at locations of safe-keeping of patient notes, where medical records managers and others store patient medical data on IT systems, with varying dynamics and volume. The results obtained from the developed model of patient confidentiality are encouraging; they may assist health service managers to minimize breaches of patient confidentiality occurrences. Therefore, the current study proposes a framework and recommendations that can help to improve the protection of patient confidentiality systems in the Libyan health service and assist in delivering a good quality of health care.
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Ober, Jay Kyle. "Student Nurses’ Experience of Learning with Human Patient Simulation." eScholarship@UMMS, 2009. https://escholarship.umassmed.edu/gsn_diss/15.
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Human patient simulation (HPS) has been used for over 40 years in medical education. A human patient simulator is a life-like, anatomically correct, computer driven mannequin with physiologic responses that mimic real patients. Since the introduction of computerized HPS in 2000, its use by medical and nursing students has grown exponentially. Approximately 500 nursing schools are using human patient simulators in nursing education. Researchers have suggested that using HPS can assist in reducing the gaps between theory and practice by improving critical thinking, decision making and patient outcomes. An increase in recognition of medical errors has dictated the need to improve education by allowing students and clinicians to learn in an environment that permits errors and do not put real patients in danger.
However, there is a dearth of research on the benefits, advantages and disadvantages of HPS as well as the learning experiences of students who used HPS in their nursing education. Therefore, the purpose of this qualitative study was to describe and analyze the learning experience of baccalaureate nursing students who used HPS during their education. Focus group interviews with HPS students were recorded and transcribed for content analysis in NVIVO, a qualitative analysis software program. The results of the analysis were categorized into four major themes: Structure, Environment, Instructor and Learning. The findings revealed that HPS students felt that structure was critical to optimize learning opportunities. Students wanted to be properly oriented to the environment of the HPS sessions, and they felt that the lack of realism of the simulators did not negatively affect their learning. Students wanted knowledgeable and competent instructors who had good interpersonal communication and interaction skills. Last, students expressed that there were benefits from acting as both the nurse and the observer during HPS. The opportunity to make mistakes without harming a patient and to experience different types of nurse-to-nurse reports were viewed as positive.
The findings of the study suggested that further research about student perceptions of HPS learning experiences could provide valuable information for educators and policymakers to improve the implementation of HPS in nursing and medical education.
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Thomas, Ashley Nicole. "Patient Experience of Cultural Competency in a Hospital Setting." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1505183/.
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Anthropological research conducted in a local Texas hospital provides data to analyze cultural competency. Increasing health equity is a key aspect of cultural competency literature, hospital, and national goals. Examining the local context allows for the analysis of how one hospital can affect public health in the area by using patient-centered care. Using observational and interview data to create the ideal of the patient journey shows how patient families experience cultural competency. Overall, the patient families felt they experienced culturally competent healthcare, however from the hospital structure perspective there could more goals to attain.
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Björklund, Victor, and Johan Sving. "Att vara patient på akutmottagningen : En beskrivande litteraturstudie." Thesis, Högskolan i Gävle, Medicin- och vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-29494.
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Bakgrund: Akutmottagningen är en plats dit människor söker sig vid akuta besvär, de har öppet dygnet runt, det finns inga schemalagda besök och väntetiderna är långa. Kommunikation är en viktig faktor på en akutmottagning då det används för att leverera omvårdnad och för att samarbeta. Sjuksköterskan på en akutmottagning har en hög arbetsbelastning och besitter breda kunskaper för att leverera vård till de varierande sjukdomarna som förekommer. Man vet att vara patient på ett sjukhus kan innebära ett förlorat egenvärde och hopplöshet däremot finns det lite studier på hur det är att vara patient på en akutmottagning.
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Gustafsson, Maria. "Patient experience surrounding service failure in Swedish public healthcare: a qualitative study of patient perceptions." Thesis, Internationella Handelshögskolan, Högskolan i Jönköping, IHH, Företagsekonomi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-45198.
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Background: Swedish healthcare is frequently claimed to be top class. A view not only communicated by politicians and the media, but also shared by an average citizen - for decades. Certain statistical indicators seem to support this: Sweden historically scores very high in life expectancy, stroke and cancer survival and infant mortality. At the same time, it is being reported that Swedish healthcare is suffering from a number of problems. While statistics looks reassuring, it focuses on results rather than processes, and does not take patient perceptions into account. Patient perspective seems to be somewhat overlooked in general in favour of more operations-focused research. Purpose: The purpose of this study is to address the shortage of relevant literature and describe patient experience surrounding service failure in the fairly unique institutional context of Swedish public healthcare. Patient experience will include patient perceptions on service failure and recovery, as well as patient expectations and post-failure responses. Method: The study employed a qualitative approach with 13 semi-structured interviews. Conclusion: The study located reasons for service failure, which are fairly consistent with both previous research on this matter and the reported struggles of Swedish healthcare. It was also found that service recovery is not a common occurrence. Determinants for patient expectations and variability in patient post-failure responses were also uncovered.
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Schirg, Glenn Richard. "Determining the patient satisfaction factors for hospital room service & the association of room service with the overall satisfaction with the hospital experience." Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007schirgg.pdf.
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Karlsson, Camilla, and Jenny Wedin. "Patienters erfarenheter av delaktighet på akutmottagning i samband med vård och behandling : en litteraturöversikt." Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3633.
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På akutmottagningen sker korta möten med ett stort antal patienter. Dessa möten präglas av snabba beslut och akuta åtgärder samtidigt som stunden med väntan och ovisshet kan vara lång för patienten. Delaktighet i vården är en rättighet för patienten och en skyldighet för den som utför vård och omvårdnad. Forskning visar att patientdelaktighet har många positiva fördelar, både för patienten och sjukvården. Patienten ska så långt det är möjligt göras delaktig i sin egen vård. Syftet var att beskriva patienters erfarenheter av delaktighet i samband med vård och behandling på akutmottagning. Metoden som användes var en allmän litteraturstudie. Datainsamlingen utfördes i PubMed, CINAHL, PsycINFO, MedLine och genom manuella sökningar. Femton empiriska originalartiklar inkluderades totalt. Dessa granskades för att sedan analyseras genom integrerad analys. Resultatet delades in i fyra huvudkategorier: möjlig delaktighet i vårdmötet, omgivningens påverkan i mötet, betydelse av skade- och sjukdomstillståndet samt tillit till vården. Patienterna hade både positiva och negativa erfarenheter av delaktighet i samband med vård och behandling på akutmottagning. Patienterna upplevde att möjligheten till delaktighet bland annat främjades av ett samspel med vårdpersonalen som präglades av ett gott bemötande, bekräftelse och användandet av ett begripligt språk, tydlig information, att bli tilltalad som en person och inte ett sjukdomstillstånd samt ett förtroende till akutsjukvården. Skade- och sjukdomstillståndets allvarlighetsgrad kunde både vara ett hinder och en möjlighet för delaktighet medans akutmottagningens miljö endast ansågs vara ett hinder för delaktighet, enligt patienterna. Slutsatsen var att det fanns en önskan om och ett behov av delaktighet hos patienter som söker sig till en akutmottagning. Patientdelaktighet har både individ- och samhälleliga vinster. Fler studier behövs för att öka förståelsen hos akutsjuksköterskan om patienternas erfarenheter för att kunna utveckla och förbättra vården.At the emergency department several short meetings take place and these are characterized by quick decisions and urgent actions. For the individual patients, however, the moment of waiting and uncertainty can be long. Patient participation is a right for the patient and an obligation for healthcare professionals. Research shows that patient participation has many positive benefits, both for the patient and the health care system. As far as possible, the patients should be involved in their own care. The aim was to describe patients’ experiences of patient participation in connection with care and treatment in the emergency department. The chosen method was a general literature study, where article searches were performed in PubMed, CINAHL, PsycINFO, MedLine and through manual searches. Fifteen empirical original articles were included. These were reviewed and then analyzed through integrated analysis. The result was divided into four categories: possible participation in the care interaction, the environments impact on the meeting, the importance of the state of injury and illness and trust in the healthcare. The patients had both positive and negative experiences of patient participation in connection with care and treatment at the emergency department. Patients experienced that the possibility of participation was promoted by interaction with the health care staff, which was characterized by a good encounter, confirmation and the use of an understandable language, clear information, be addressed as a person and not a medical condition and a trust in emergency medical care. The severity of the injury or the illness could both be an obstacle and an opportunity for participation while the emergency department environment only was considered as an obstacle for participation, according to the patients. The conclusion was that patients in the emergency department got a desire and a need for participation. Patient participation has both individual- and social benefits. More studies are needed to gain better understanding about patients’ experiences in order to develop and improve care.
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Olin, Nathalie, and Renée Roos. "När magen krympte : patientupplevelser före och efter överviktskirurgi." Thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-12812.
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Bakgrund: Överviktsoperationer ökar i snabb takt runt om i världen i samband med en eskalerande fetmaepidemi. En överviktsoperation innebär stora förändringar i livet och ställer krav på att sjukvårdspersonal är kunniga om dessa förändringar ur patientens perspektiv. Syfte: Syftet med litteraturstudien var att belysa patienters upplevelser före och efter överviktskirurgi. Metod: 13 vetenskapliga artiklar granskades och analyserades. Sammanställningen resulterade i ett tema och fem presenterade underkategorier. Resultat: Överviktskirurgi blev en sista chans till ett bättre liv för patienterna. De hade förväntningar på ett förändrat liv, som i många fall till stor besvikelse inte blev bättre. Patienterna upplevde att den mentala hälsan blev åsidosatt vid överviktskirurgi, varav de önskade att vårdpersonalen la mer fokus på just detta. Slutsats: Då överviktskirurgi är en livsomvälvande process är det viktigt att sjuksköterskan har förståelse för patientens hela upplevelse, även den känslomässiga.Background: The number of bariatric surgeries performed globally is increasing in relation to an escalating obesity epidemic. Bariatric surgery leads to life-changing processes and put demands on health care staff to have knowledge about these changes from the patients’ perspective. Purpose: The purpose of the literature review was to illuminate patients’ experiences before and after bariatric surgery. Method: Thirteen scientific articles were reviewed and analysed. The combination resulted in a theme and five presented subcategories. Results: Bariatric surgery became the last chance to a better life for the patients. They had expectations of a changed life, which in many cases to great disappointment didn’t became better. The patients experienced that the mental health was disacknowledged while going through bariatric surgery and was something they wished that the health care staff had focused more on. Conclusion: Bariatric surgery is a life-changing process, why it’s important for the nurse to understand the experiences of the patient, even the emotional experience.
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Antonsson, Lisa, and Carolina Gustavsson. "Livet efter organtransplantation : En litteraturbaserad studie om patienters upplevelser." Thesis, Högskolan Väst, Avd för vårdvetenskap på grundnivå, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-8163.
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Background: For patients with end-stage organ failure receiving an organ is lifesaving. To be transplanted means a big change and adjustment in life with lifelong medication. The ambition for these patients is to go back and live as normal of life as possible. Aim: The aim of this study was to describe patients experiences of being organ transplanted. Method: The method used was a literature-based study based on qualitative scientific articles. A total of 9articles were analyzed with a qualitative content analysis. Result: After analysis 5 categories emerged; indebted, limitations in daily life, fear of organ rejection, concerns about medicine and a positive attitude to life. It showed that patient´s experiences of being organ transplanted are individual and unique. Some experiences are harder to deal with than others. Conclusion: Patients describe both negative as well as positive experiences of being transplanted. They express a need for more knowledge about their condition and a need that health care staff enhance their knowledge and understanding about their unique situation.
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Rådén, Emelie, and Jenny Wallenius. "Hur patienter med hiv upplever bemötandet från vårdpersonal." Thesis, Högskolan Väst, Avd för vårdvetenskap på grundnivå, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-6326.
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Background: During the 1980s, the fear of HIV spread over the world. Health professionals'attitudes to patients with HIV, was negatively impacted because of their fear to be infected.Patients with HIV have therefore,during disease history's first two decades, experienced stigma and discrimination in the response from health professionals. Because of the increasing knowledge of HIV it is of interest to study patients' contemporary experiences of the encounter with health professionals. Aim:To explore how patients with HIV experiencing the meeting with health professionals. Method:Literature study with seven qualitative and three quantitative articles. Results:Two themes were found; to be discriminated and to be powerless and extradited. To be discriminated describes that patients in several cases been treated differently than others, by health professionals.To be powerless and extradited describes that patients are not allowed tobe involved in their care and they have distrust to health care providers.Conclusion:Patients with HIV experience discrimination, excessive precautions and ignorance which cause a care suffering. It is important that the nurse is aware of the deficiencies in the treatment to work towards a good care relationship.There is a great need for further research regarding to explore how patients with HIV experiencing the treatment from health professionals.
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Körle, Anna, and Lars Jensen. "Patienters upplevelser av postoperativ smärta och smärtlindring : En litteraturöversikt." Thesis, Högskolan Väst, Avdelningen för omvårdnad - grundnivå, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-12796.
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Background: Approximately 2,8 million surgical procedures were performed in Sweden 2016. After surgery, patients experienced different degrees of postoperative pain. Under treated postoperative pain created great suffering for patients, delayed the recovery after surgery and could increase the risk of complications. Therefore, it is of importance to explore and describe patients’ experiences regarding pain in conjunction with surgery, in order to improve postoperative pain relief from a nursing perspective. Aim: To describe how patients experience postoperative pain and pain relief. Method: A literature review was conducted in which four qualitative studies and three quantitative studies were included. The studies were subjected to assurance of quality and Friberg’s three-step analysis was used. Results: Two categories and eight subcategories emerged. The two categories were (1) The time before surgery and (2) The time after surgery. The categories illustrated how patients experienced postoperative pain and pain relief before and after surgical procedures. Conclusion: Patients had previous experiences, expectations, knowledge and beliefs about postoperative pain and pain relief that affected their experiences before surgery. After the procedure, patients' difficulty in communicating, their participation, the attitudes of healthcare professionals and the degree of attendance of the nurse were important experiences related to postoperative pain and pain relief.
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Rogerson, Lynne Joanne. "Clinician and patient perceptions and experience of novel gynaecological procedures." Thesis, University of Leeds, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.415603.
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Sinfield, Paul. "Developing a measure of patient experience of prostate cancer care." Thesis, University of Leicester, 2010. http://hdl.handle.net/2381/8935.
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Some of the published articles from Appendix 14 have been removed from the electronic copy of this thesis due to copyright restrictions. The unabridged version can be consulted at the David Wilson Library, University of Leicester.
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Hartwell, Heather. "Patient experience, nutritional uptake and satisfaction with hospital food services." Thesis, Bournemouth University, 2004. http://eprints.bournemouth.ac.uk/405/.
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It has been recognised that hospital food service could be improved, with malnutrition a particular concern. The problem of patients obtaining adequate nutrition in hospital is complex with many constraints at ward level. The hypothesis of this study is that patients able to see and smell the food on offer and with potential for greater server empathy, will achieve better nutritional status and increased meal satisfaction. Data were collected from two wards, Women's Health and Orthopaedic, (n=62) over two, three-day consecutive periods. Firstly, for a pre-ordered, plated meal service and secondly, nine months later, for a trolley service offering choice at the point of consumption. Food was weighed before and after the meal. Questionnaires were administered and interviews conducted with patients (n= 614) to evaluate patient acceptability of both catering systems and other pertinent data. The research methodology also involved collecting observational data during mealtimes. Focus groups were conducted with ward staff, and patients together with their visitors while open ended interviews were conducted with the catering manager, facilities manager, chief dietitian, orthopaedic ward dietitian and chief pharmacist. This was to enhance and validate information already gathered. Results show that nutritional intake was not dependent on the catering system and that possibly in hospital; unlike other `eating out' situations there are barriers to `complete nutrition'1. A theoretical model of patient experience and satisfaction with hospital food service is presented, reflecting data gathered during the case study. Texture and temperature of food were shown to be critical factors impinging on patient satisfaction and the trolley system of delivery is the preferred style of service. Service predisposition demonstrates little significance with patient satisfaction towards the overall meal experience. This research indicates that nutritionally, the method of meal delivery is immaterial but patients do prefer choice at the point of consumption. 1 A term used to define the provision of a healthy nutritionally balanced diet which meets and satisfies both physiological and psychological requirements.
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Woodward, Catherine Emily. "Limb reconstruction : distress, appearance concerns, social support and patient experience." Thesis, University of East London, 2011. http://roar.uel.ac.uk/3717/.
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Limb reconstruction is an orthopaedic surgical technique designed to treat severe fractures, including fractures that have failed to heal using conventional methods, and congenital deformities. The existing research suggests high levels of distress among patients, and that the appearance of the external fixation device is a possible factor contributing to distress, but the psychological contribution to this research is scarce. The overall aim of this mixed methods study was to gain a better understanding of the experience of limb reconstruction patients. In particular, the quantitative study aimed to investigate levels of psychological distress in adults undergoing limb reconstruction, and to examine variables that correlate with distress. A crosssectional sample of patients completed measures of psychological distress, appearance concern, social support, and pain. The purpose of the qualitative part of the study was to gain an in-depth understanding of the experience of adults undergoing limb reconstruction via external fixation device (EFD). Semi structured interviews were conducted with current patients, and were analysed using Interpretative Phenomenological Analysis. Self-reported levels of psychological distress were high. Appearance concern was higher among younger, female patients. Patients described feelings of vulnerability, and a fear of falling following their accidents. Patients' identity was called into question and there were psychological consequences when treatment was longer than expected. The results are considered in relation to relevant literature and the implications for intervention are discussed.
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Bader, Kathryn E. "Transforming the pain experience of surgical patients through shared decision-making." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Thesis/Spring2009/K_Bader_052909.pdf.
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Wisener, Kim. "Therapeutic experience in retrospect : examination of non-specific factors in therapy." Thesis, Canberra, ACT : The Australian National University, 1991. http://hdl.handle.net/1885/141480.
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Diamond-Brown, Lauren Ashley. "Contingent Care: Obstetricians' Lived Experience and Interpretations of Decision-Making in Childbirth." Thesis, Boston College, 2017. http://hdl.handle.net/2345/bc-ir:107585.
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Thesis advisor: Sharlene N. Hesse-BiberThis dissertation seeks to understand obstetricians’ lived experience of decision-making in childbirth and investigate how the organizational context within which obstetricians work influences how they make treatment decisions. Understanding how obstetricians make decisions in childbirth is important because maternity care in the United States is in crisis. Our system is failing women on multiple accounts: between 1990 and 2013, maternal mortality more than doubled in the United States, and is higher than most other high-income countries. Furthermore, women continue to suffer from abusive practices by maternity care providers who dismiss their concerns and sometimes outright refuse to honor their self-determination in childbirth. Today multiple stakeholders acknowledge a need for maternity care reform; this creates new challenges for health care policy and opportunities for social science research. Obstetrician-gynecologists provide the majority of maternity care to American women, and this dissertation examines their lived experience of decision-making in birth and analyzes how a range of social forces affect this process. To investigate this phenomenon I performed 50 in-depth interviews with obstetricians from Massachusetts, Louisiana and Vermont about how they make patient care decisions in birth. The specific research questions and analysis for each chapter evolved through an iterative process that combined analytical grounded theory and template analysis. I present this in a three-article format. In article one I show how shift-work models of labor and delivery pose challenges to using a patient-centered approach to decision-making. Obstetricians either work shifts in labor and delivery or they work on-call for their patients’ births. The current thinking is that shifts are good because they allow work-life balance for doctors, reduce fatigue, and reduce convenience-based decisions. Shift work models assume that doctors and patients are interchangeable because doctors will follow protocols and standards of care produced by medical professional organizations. I argue shift work does not work in practice the way it does in theory. I explain how there are not standards for many decisions in birth, instead these decisions are characterized by medical uncertainty. In these cases, doctors rely on patient-centered approaches to make decisions. But shift work limits doctors’ ability to use patient-centered approaches. I found that shift-work models of hospital care do not provide doctors the opportunity to get to know their patients and understand their preferences. In practices that do not depend on shift work, the doctor patient relationship is far less fragmented and doctors tend to experience less conflict with their patients and are less likely to rely on stereotypes that reproduce social inequality. In article two I examine obstetricians’ understandings of convenience as a motivation in decision-making. Anecdotal evidence suggests that obstetricians sometimes make clinical care decisions less out of concern for their patients and more out of concern for their own time and schedule. This may be a particular problem in on-call models. In this paper I show doctors’ stories match anecdotal evidence: Some obstetricians make clinical decisions in birth based partially on their own convenience. Yet others actively resist the temptation of convenience, even in on-call care. A key dimension of this difference lies in doctors’ understandings of the nature of time in labor and the safety of interventions. Some doctors have a faster-the-better approach to birth and believe the routine use of interventions is the best way to practice in labor and delivery. These doctors frame their own convenience as legitimate because it overlaps with the idea that speeding up the labor is inherently good. Alternatively, other doctors believe time in labor is productive, and that interventions should be used judiciously because they increase risk of harm. These doctors cannot easily legitimize convenience because it conflicts with the reduction of interventions as a key dimension of this philosophy. I argue that because shift work poses serious challenges to patient-centered care, cultural change is a better avenue for reducing births of convenience. Article three addresses an ongoing question in medical sociology about whether physicians maintain control over their clinical work amidst challenges to their authority. Patient empowerment and standardization are two movements that sociologists have theorized in terms of weakening of doctors’ clinical discretion. I uncover how obstetricians draw on the conflicting nature of these approaches strategically to maintain their power in the face of a threat. Standards and patient empowerment act as countervailing powers; they drew on one to off set the challenge to their authority posed by the other
Thesis (PhD) — Boston College, 2017
Submitted to: Boston College. Graduate School of Arts and Sciences
Discipline: Sociology
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Johansson, Mikaela, and Emeli Örneskog. "Att leva med tarmstomi : en litteraturstudie." Thesis, Kristianstad University College, School of Health and Society, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-5927.
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Bakgrund: En stomi är en konstgjord öppning för att avleda avföring genom bukväggen. Att acceptera stomin och sin nya livssituation kan vara en komplicerad process för patienten. Syfte: Syftet med litteraturstudien var att beskriva patienters upplevelser av att leva med tarmstomi. Metod: Studien utformades som en allmän litteraturstudie baserad på elva vetenskapliga artiklar, varav åtta var av kvalitativ ansats och tre av kvantitativ. Resultat: Det framkom att stomiopererade patienter upplevde fysiska, emotionella och sociala förändringar som påverkade det dagliga livet. Negativa känslor och upplevelser dominerade bland stomibärarna, vilket gjorde anpassningen till stomin besvärlig. Trots svårigheter upplevde stomibärarna ändå en tacksamhet över sina stomier eftersom de slapp tidigare lidande. Diskussion: För att stomibärarna ska kunna förbereda sig på hur livet med en stomi kommer att se ut bör de få mer information både inför och efter stomioperationen. Informationen bör vara anpassad efter stomibärarens behov. Genom att stomibärarna får samtalsstöd kan de få hjälp med att övervinna sina psykiska hinder och anpassa sig till livet med stomi, samt få ökat välbefinnande. Slutsats: Om stomibärarna får mer hjälp i sitt dagliga liv och om vårdpersonalen stöttar dem, skulle fler uppleva positiva erfarenheter av sina stomier.
Background: An ostomy is an artificial opening to drain faeces through the abdominal wall. Accepting the ostomy and the new life situation is a complicated process for the patient. Aim: The aim of this study was to describe patient's experiences of living with an ostomy. Method: The study was designed as a literature review based on eleven scientific articles, of which eight had a qualitative approach and three, a quantitative. Results: The findings of the review indicate that ostomypatients experienced physical, emotional and social changes which affected patient's daily life. Negative feelings and experiences dominated, which made adjustment to the ostomy difficult. The patients experienced gratefulness to their ostomies because they avoided previous suffering, despite difficulties in their daily lives. Discussion: The patients need more information both before and after a stoma surgery to prepare for the life with an ostomy. The information should be adapted for patient's needs. They can overcome their psychological problems if they participate in support groups. The patients can then adapt to their ostomies and increase their wellbeing. Conclusion: If ostomypatients get more support from nursing staff in their daily lives, many of them would have positive experiences of their ostomies.
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Amanbaeva, Asel, and Bernadetta Swierszcz. "Att vårdas för MRSA : En litteraturöversikt om patienters upplevelser av MRSA-vård." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-3923.
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Bakgrund: Meticillinresistenta Staphylococcus aureus (MRSA) ökar drastiskt inom sjukvården både i Sverige och i hela världen. Bakterien sprids vanligast från patient till patient via vårdpersonal då restriktioner om basala hygienrutiner inte följs. Att bli smittad med MRSA kan leda till svåra konsekvenser för patienter i form av infektioner i operationssår, i implanterade proteser, på hjärtklaffar, i lungorna och på hjärnhinnor. Patienter med MRSA vårdas i isolering för att förebygga att MRSA sprids vidare, vilket kan orsaka lidande hos patienter. Syfte: Denna uppsats syftar till att beskriva patienters upplevelser av MRSA-vård. Metod: Nio vetenskapliga kvalitativa artiklar ligger till grund för denna litteraturöversikt. Artiklarna har analyserats och sammanställts och nya teman uppkom efter de likheter som framkom i deras resultatdelar. Resultat: Resultatet visar att vårdandet förändrades efter MRSA-diagnos. Detta redovisas efter följande i sex teman och två subteman: Patienters kunskap om MRSA, Upplevelser av att bli smittad med MRSA, Patienters upplevelser av personalens kunskap och information, Upplevelser av personalens bemötande, Isolering med två subteman: Negativa upplevelser av isolering och Positiva upplevelser av isolering samt Oro för framtid. Diskussion: Resultatet diskuteras utifrån Katie Erikssons teori om den lidande människan som teoretisk utgångspunkt och utifrån patientens perspektiv. Vårdpersonalen kan påverka hur vårdandet upplevs. Brister i kunskap om MRSA hos vårdpersonalen, deras bemötande och följsamheten till hygienrutiner orsakar vårdlidande hos patienter med MRSA. Sjuksköterskans roll är att förebygga/lindra lidandet hos patienter.Background: Methicillin-resistant Staphylococcus aureus (MRSA) is increasing drastically in healthcare both in Sweden and worldwide. The bacteria is spread most commonly from patient to patient by health-care professionals when restrictions on basic hygiene is not followed. Becoming infected with MRSA can lead to severe consequences for the patients in terms of surgical site infection, the implanted prostheses, the heart valves, lungs, the meninges. Patients with MRSA are cared for in isolation to prevent MRSA from spreading further, which could cause distress in patients. Aim: This paper aims to describe patients' experiences of MRSA care. Methods: Nine scientific qualitative articles form the basis of this literature review. The articles were analyzed and compiled, and new themes emerged after the similarities that emerged from their performance parts. Results: The result shows that caring changed after MRSA diagnosis. This is recognized by the following six themes and two subthemes: Patients' knowledge about MRSA, Experiences of becoming infected with MRSA, Patients experiences of staff knowledge and information, experiences of treatment by staff, isolation with two subthemes: Negative experiences of isolation and positive experiences of isolation and Concerns for the future. Discussions: The results are discussed from the patient's perspective, with Katie Erikson's theory of the suffering person as a theoretical base. The nursing staff can affect how caring is experienced. Deficiencies in knowledge of MRSA in health care staff, their attitude and adherence to hygiene causes health suffering in patients with MRSA. The nurse's role is to prevent / alleviate the suffering of patients.
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Gustafson, Elisabeth, and Anna-Karin Lyreborg. "Det är som att åka berg och dalbana : Patientens erfarenheter av den palliativa vården." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-12004.
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Julihn, Charlotta, and Shilan Eliassi. "Patienters erfarenheter av att drabbas av stroke : En litteraturstudie." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-12320.
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Bakgrund: Stroke är ett sjukdomstillstånd som skadar hjärnvävnaden. Tillståndet innebär stora konsekvenser för de drabbade. De patienter som drabbats av stroke känner oftast skam och förtvivlan med en förlorad livsglädje som resultat. Idag upptar sjukdomsgruppen flest antal vårdplatser på sjukhusen runtom i Sverige. Med ökad kunskap i omhändertagande i kombination med stöttning för patienten efter insjuknandet, kan känslan av förlorad livskvalitet minskas markant. Syftet: Syfte med denna studie var att belysa patienters erfarenheter av att drabbas av stroke. Metod: En litteraturbaserad studie där 12 kvalitativa artiklar har analyserats. Resultat: Ur analysen av datamaterialet framträdde tre kategorier: Tappat kontrollen över sin kropp, Hamnar i beroendeställning och Återfå ett liv som självständig med åtta underkategorier. Slutsats: Studien bidrar med kunskap om patienters erfarenheter efter att ha drabbats av en stroke. Det kan vara omtumlande känslor att bearbeta för dessa patienter. Behovet av stöd är nödvändigt för att patienterna ska finna livskvalité. Motivation, hopp och uppmuntran stärker patientens självförtroende och leder till ett ökat välbefinnande. Genom en ökad förståelse för patientens upplevelser efter insjuknandet kan sjuksköterskan främja patientens hälsa och välbefinnande.
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Nordström, Moa, and Maria Söderlund. "Patienters upplevelser av att leva med sjukdom i ett palliativt skede : En litteraturstudie." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-22865.
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Bakgrund: Begreppet palliativ vård definieras som ett förhållningssätt där det centrala målet är att förbättra patienters och anhörigas livskvalitet. Behovet av palliativ vård är stort då allt fler blir äldre. Sjuksköterskor kan möta patienter i palliativa skeden inom olika vårdsammanhang och upplever att kunskapen är otillräcklig. Syfte: Syftet var att beskriva patienters upplevelser av att leva med sjukdom i ett palliativt skede, samt att beskriva de valda artiklars undersökningsgrupper. Metod: Litteraturstudie med en beskrivande design innefattande 13 artiklar med kvalitativ ansats från databaserna CINAHL och MEDLINE via PubMed. Huvudresultat: Att leva i ett palliativt skede upplevdes av många patienter som en kamp och ett lidande. De önskade att få fortsätta leva ett så normalt liv som möjligt och bibehålla självständigheten. Att inte längre kunna ta hand om sig själv upplevdes skapa ett stort beroende av andra och resulterade i en känsla av att vara en börda för familjen. Det var meningsfullt att spendera tid med familjen samt att få stöd. Vissa patienter upplevde en acceptans av livets slut och önskade att få dö fridfullt. Slutsatser: De upplevelser som patienterna förmedlade i det palliativa skedet kan tyda på ett stort behov av att erhålla stöd på olika sätt, samt att självständighet och familjen spelar en viktig roll i patienternas livssituation. För att patienterna ska få bevara upplevelsen av att vara självständig och få en så god omvårdnad som möjligt, bör sjuksköterskan kommunicera och stödja patienterna samt sträva efter att de får uppleva delaktighet i den egna vården.Background: The concept of palliative care is defined as an approach where the key objective is to improve the quality of life for patients and their relatives. The need for palliative care is substantial as more people are getting older. Nurses can meet patients in palliative stages in different health care settings and experience the knowledge as inadequate. Aim: The aim was to describe patients experience of living with disease in a palliative stage, and to describe the selected articles study groups. Method: Litterature review with a descriptive design including 13 articles with a qualitative approach, from the databases CINAHL and MEDLINE via PubMed. Main results: To live in a palliative stage was experienced by many patients like a struggle and suffering. They wanted to live their lives as normally as possible and to maintain their independence. To no longer being able to take care of themselves perceived to create a dependence on others and resulted in a feeling of being a burden to the family. It was meaningful to spend time with family and to receive support. Some patients experienced an acceptance of life ending and wished to die peacefully. Conclusions: The experiences that patients mediated in the palliative stage may indicate a great need to be supported in different ways, and that independence and the family plays an important role in patients' lives. To ensure that patients are preserving the experience of being independent and get as good care as possible, the nurse should communicate and support patients and strive to get the experience involvement in their own care.
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Nygårdh, Elisabeth. "Behandlares upplevelser när en patient begår suicid." Thesis, Ersta Sköndal högskola, S:t Lukas utbildningsinstitut, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1764.
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Inom psykiatrisk verksamhet händer det att patienter tar sitt liv under pågående behandling eller i direkt anslutning till en behandlingsperiod. Enligt patientsäkerhetsförordningen måste dessa händelser rapporteras och utredas. Syftet med patientsäkerhetsförordningen är att den ska främja hög patientsäkerhet inom hälso- och sjukvård genom att minska antalet vårdskador, oavsett om bristerna beror på systemfel eller på att vårdpersonal begått misstag. Fokus är således på ett patientperspektiv, därför känns det angeläget att studera upplevelser som väcks hos olika grupper av vårdgivare när en patient begår suicid. Frågeställningar: Behandlares upplevelser när en patient gör suicid. Metod: En kvalitativ intervju på fenomenologisk grund genomfördes med fem vårdgivare i psykiatrisk verksamhet, två sjuksköterskor med steg 1 utbildning och tre skötare. Resultat: Upplevelser hos vårdgivare som är med om en patients suicid kännetecknas av chock, traumatisk stress och sorg. Det väcks också tankar som rör den egna professionen och i en del fall oro för följder av beslut som i efterhand kan bedömas vara felaktiga. Diskussion: När vårdgivare intervjuas om sina upplevelser efter en patients suicid, berättas om olika reaktioner som inte uppmärksammats nämnvärt. Det känns därför angeläget att belysa de upplevelser av chock, sorg och traumatisk karaktär som är vanliga.
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Halls, S. "Understanding the patient experience of stiffness, and developing a stiffness patient-recorded outcome measure, in rheumatoid arthritis." Thesis, University of the West of England, Bristol, 2016. http://eprints.uwe.ac.uk/29181/.
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Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease. Stiffness is a major symptom of RA which is commonly reported by patients, affects patients’ daily life, and is relevant to patients in relation to fluctuating aspects of RA such as flare and low disease activity. Morning stiffness is also frequently used as an outcome measure both clinically and in research. Despite the relevance and uses of stiffness, it remains poorly understood and was omitted from the RA core set because of poor measurement properties. A pragmatic, mixed methods approach was used to better understand the patient experience of stiffness in people with RA and to develop and test a new RA stiffness patient reported outcome measure (PROM). It involved a systematic literature review, semi-structured interviews, focus groups, cognitive interviews, the development of appropriate candidate items to characterise stiffness and multivariate analysis of a survey using these items. The systematic literature review found that current stiffness assessment is based on items that capture the duration or severity of morning stiffness. However, items were often poorly defined, highly variable in wording and format, had limited measurement property evidence and had not been developed according to current standards including collaboration with patients. Overall, there was no evidence regarding the most appropriate way to assess stiffness in RA, indicating the need for a new measure developed according to best practice PROM guidelines. Semi-structured interviews with RA patients provided an improved understanding of their experience of stiffness, demonstrated its relevance to patients and enabled the development of a conceptual model. These data also highlighted inconsistencies between current stiffness assessment and the patient perspective of this symptom. Focus groups with RA patients reinforced the stiffness conceptual model in a new sample, using a different method of data collection. They also provided information specifically addressing stiffness assessment from the patient perspective, including a number of concepts for measurement instrument development. These patient-driven concepts and qualitative data were tempered with measurement theory to develop a conceptually sound yet practically appropriate preliminary set of items for a new RA stiffness PROM. Preliminary items were reviewed and modified by RA patients in cognitive interviews. Following refinement, 45 candidate items (39 new items and 6 traditional stiffness items) were taken forward to a postal survey to develop and test the structure of a new RA stiffness PROM. Analysis of the survey responses involved rigorous statistical testing including a series of iterative principal component analyses (undertaken initially with two different approaches), balancing Cronbach’s alpha for internal consistency, bootstrapping for stability, and expert judgement for clinical appropriateness. The emergent structure was the Rheumatoid Arthritis Stiffness (RAST) questionnaire with 21 items in 3-components capturing ‘stiffness severity’, ‘physical impact’ and ‘psychosocial impact’. The initial qualitative work enhanced its content validity and statistical testing for appropriate relationships with other measures of disease demonstrated good construct validity. These results provide support for RAST as an appropriate tool for use in future stiffness assessment. The development of the RAST is important in recognising stiffness as a relevant patient symptom and is a significant step towards standardised stiffness assessment. Further testing in a fresh population will generate additional evidence of reliability and sensitivity to change to support its use. The RAST provides a measure for use in new investigations of disease mechanisms and response to therapy.
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Somerville, Jacqueline Gannon. "Development and Psychometric Evaluation of Patients' Perception of Feeling Known by Their Nurses (PPFKN) Scale." Thesis, Boston College, 2009. http://hdl.handle.net/2345/662.
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Thesis advisor: Dorothy JonesThe importance of the nurse-patient relationship to the overall well- being of the person has been explored extensively by nurses. What is largely missing from this knowledge developed to date is the patient's perspective. The purpose of this study was to develop a reliable and valid measure of patients' perceptions of feeling known by their nurses during an acute, surgical, hospital admission. The development of the PPFKN Scale was guided by Newman's theoretical framework of Health as Expanding Consciousness (1994) and data from a qualitative descriptive study conducted in 2003 (Somerville). The current investigation focused on the development and psychometric testing of the PPFKN Scale. The four themes that emerged from the earlier qualitative study were used to guide the development of the 85-item scale. This scale was exposed to a panel of nurse experts to establish inter-rater agreement and content validity, item understandability and readability. The revised scale was piloted with five participants who had experienced an inpatient, surgical admission to determine content validity, item readability and understandability. The revised 77-item scale was then administered to 327 surgical inpatients across seven general care units at a large academic urban medical center. A sample size of 296 completed surveys was analyzed. A four-component solution was devised using Principal Components Analysis with Varimax rotation. This four-component solution accounted for 63.3% variance, with a total scale Cronbach's alpha coefficient of 0.99. A component loading cut-off was set at 0.3 and items not loading at this value on the expected component were dropped. This process resulted in a reliable and valid 48 item PPFKN Scale with four components and a total scale Cronbach's alpha coefficient of 0.98
Thesis (PhD) — Boston College, 2009
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Abrahamsson, Fanny, and Björklund Sara Elmersson. "När smärtan är ständigt närvarande : En litteraturstudie om upplevelsen av att leva med långvarig smärta." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-2215.
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Bakgrund: Långvarig smärta är vanligt förekommande i Sveriges befolkning. Smärtupplevelsen är individuell och påverkas av många dimensioner i livet. Långvarig smärta är svår att bedöma och lindra, den kan skapa ett lidande. Att lindra lidande och främja hälsa hos dessa personer är en viktig men inte alla gånger lätt uppgift för sjuksköterskan. Därför är det nödvändigt med insikter i hur det är att leva med långvarig smärta. Syfte: Syftet med studien var att beskriva upplevelsen av att leva med långvarig smärta. Metod: En litteraturstudie har använts. Studien baseras på tio kvalitativa artiklar som granskats och analyserats med influens av Forsberg och Wengström (2013) samt Friberg (2012). Det vetenskapliga underlaget är hämtat ur databaserna CINAHL och PubMed och är publicerat år 2000-2013. Resultat: Tre huvudteman med subteman representerar resultatet. Första huvudtemat, Känsla av att livet är begränsat, beskriver de negativa förändringar som smärtan leder till, gällande fysiska, psykiska och sociala aspekter. Andra huvudtemat, Strävan efter att bemästra den långvariga smärtan, visar hur varierande strategier används för att bemästra den långvariga smärtan. I tredje huvudtemat, Kampen för att bli betrodd i sitt lidande, framträder smärtans osynlighet som problematisk, misstro i kontakt med närstående och vårdgivare förekommer. Diskussion: Resultatet knyts an till Erikssons omvårdnadsteori om lidande. Sjukdomslidande, livslidande och vårdlidande diskuteras. Försök att lindra, liksom anpassningen av livsmönster och förmågan till försoning belyses. Ensamhet och avskildhet diskuteras samt vikten av att få tid och rum att lida. Omgivningens roll i lidandet samt hur vårdlidande kan lindras berörs även.Background: Chronic pain is common in the Swedish population. The pain experience is individual and influenced by the many dimensions of life. Chronic pain is difficult to cure and relieve, it causes suffering. To relieve suffering and promote health for these people is an important but not always easy task for the nurse. Therefore, it is necessary to have insight in the experiences related to living with chronic pain. Aim: The aim of this study was to describe the experience of living with chronic pain. Methods: A literature review was used. The study is based on ten qualitative articles that have been investigated and analyzed with influence by Forsberg and Wengström (2013) and Friberg (2012). The scientific evidence is from the databases CINAHL and PubMed and is published year 2000-2013. Results: Three main themes with subthemes represent the result. The first main theme, Feeling that life is limited, describes the negative changes that the pain creates concerning physical, psychological and social aspects. The second main theme, Efforts to overcome the chronic pain, shows that varying strategies are used to overcome the chronic pain. In the third main theme, The struggle to be trusted in their suffering, the invisible pain appears as problematic, suspicion in touch with both family and caregivers occur. Discussions: The result is related to Eriksson´s nursing theory of suffering. The suffering of illness, the suffering of life and the suffering of care is discussed. Attempts to relieve pain as well as adaptation of life patterns and the ability of reconciliation are illuminated. Loneliness and separation is discussed as well as the importance of having time and space to suffer. The role of the fellow people in the suffering, and how the suffering of care may be eased is mentioned as well.