Tesi sul tema "Patient Handling"
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1
Holman, Grady Talley Thomas Robert Evans. "Patient handling restrictions & conditions". Auburn, Ala., 2007. http://repo.lib.auburn.edu/2007%20Fall%20Dissertations/Holman_Grady_7.pdf.
Testo completo
2
Waymouth, Andrew David. "Low effort patient handling devices". Thesis, University of Canterbury. Mechanical, 2014. http://hdl.handle.net/10092/10093.
Testo completoAbstract (sommario):
With an aging population there is a growing need to assist people with disabilities. Particularly crucial is assisting people who cannot stand between positions necessary for everyday living, such as from a wheelchair to the toilet. It is unsafe to transfer people with direct manual techniques, thus a patient handling device is required.
To reduce the burden on the healthcare system it is beneficial for disabled people to be cared for in-home. Many in-home caregivers may be physically impaired, thus patient handling devices for this use must require as little effort as possible.
This thesis found that existing manual patient handling devices contained significant weaknesses when used for in-home care and there is potential to improve upon them. Expert interviews, computer modelling and physical models were used to develop a novel patient handling device which addresses these identified weaknesses. A reduction in the number of operator tasks, operation time and operation force was achieved.
A method of supporting the patient solely by their upper body is required by the novel patient handling device, though an acceptable way of incorporating this has yet to be achieved. Testing of an upper body enclosure support revealed that a person may be supported by their lower thorax without substantial clamping or physical effort from the patient. Such a support has potential to be developed into an acceptable solution. Further development and testing in variable conditions encountered during practical patient handling is required.
3
Amini, Pay Noura. "Patient handling activities by informal caregivers: Informal caregiver’s biomechanical loads during patient repositioning". The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1563462946325851.
Testo completo
4
Fray, Mike. "A comprehensive evaluation of outcomes from patient handling interventions". Thesis, Loughborough University, 2010. https://dspace.lboro.ac.uk/2134/6322.
Testo completoAbstract (sommario):
Assisting less able people to move in a healthcare setting is a very common occurrence but carries risks to staff and patients. The scientific study of patient handling activities and interventions to help reduce musculoskeletal disorders in the workplace is a relatively new but growing area. Recent literature reviews have identified two key factors, the lack of high quality studies and the lack of strong links between patient handling interventions and reduced musculoskeletal injury. This study has systematically reviewed the available literature and investigated the potential outcome measures used to show benefits of improved patient handling. A wide range of outcomes has been identified concentrated on the benefits to staff, patients and organisations. No methods were identified to compare different benefits, outcomes or intervention strategies. This study used mixed methods to develop a tool to compare the results of all types of interventions: a. Focus group studies in four EU countries recorded a priority list of the 12 most important outcomes from patient handling interventions b. The most suitable method for examining the 12 outcomes was identified c. The Intervention Evaluation Tool (IET) was developed as a single measurement tool d. The IET was translated and used in four EU countries to evaluate its usability and its usefulness to patient handling practitioners The EU trials and subsequent expert review have given favourable feedback for the IET. The IET creates 12 outcome evaluations with detail and differentiation, and an overall performance score to assist an organisation to target its future interventions. The method can be used to compare interventions, and the performance between organisations and countries across the EU. Though the IET needs more field trials and validity testing it is hoped that a wider application may be to create a benchmarking method that can assist in the improvement of patient handling systems across Europe.
5
Kahn, Julie. "Biomechanics of Patient Handling Slings Associated with Spinal Cord Injuries". Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4702.
Testo completoAbstract (sommario):
Pressure ulcers and related skin integrity threats are a significant problem in current transfer/transport systems used for spinal cord injury patients. To understand this problem twenty-three different slings with varying type, material, and features were analyzed in hopes to identify at-risk areas for skin integrity threats such as pressure ulcers. Population samples included non-disabled (otherwise referred to as "healthy") volunteers as well as SCI patients from the James A. Haley Veterans Hospital. High resolution pressure interface mapping was utilized to directly measure the interface pressures between the patient and sling interface. Overall results provide relevant feedback on the systems used and to suggest a particular type of sling that might reduce and possibly minimize skin integrity threats as well as extend safe patient handling guidelines with sling use. It was found that the highest interface pressures convened along the seams of the sling, regardless of manufacturer or type.
6
Muriti, Andrew John Safety Science Faculty of Science UNSW. "A biomechanical analysis of patient handling techniques and equipment in a remote setting". Awarded by:University of New South Wales. Safety Science, 2005. http://handle.unsw.edu.au/1959.4/22002.
Testo completoAbstract (sommario):
Remote area staff performing manual patient handling tasks in the absence of patient lifting hoists available in most health care settings are at an elevated risk of musculoskeletal injuries. The objective of this project was to identify the patient handling methods that have the lowest risk of injury. The patient handling task of lifting a patient from floor to a chair or wheelchair is a common task performed in a remote health care setting. The task was performed utilising three methods, these being: (1) heads/tails lift, (2) use of two Blue MEDesign?? slings and (3) use of a drawsheet. The task of the heads/tails lift was broken down into two distinctly separate subtasks: lifting from the (1) head and (2) tail ends of the patient load. These techniques were selected based on criteria including current practice, durability, portability, accessibility, ease of storage and cost to supply. Postural data were obtained using a Vicon 370 three - dimensional motion measurement and analysis system in the Biomechanics & Gait laboratory at the University of New South Wales. Forty reflective markers were placed on the subject to obtain the following joint angles: ankle, knee, hip, torso, shoulder, elbow, and wrist. The raw data were converted into the respective joint angles (Y, X, Z) for further analysis. The postural data was analysed using the University of Michigan???s Three-Dimensional Static Strength Prediction Program (3D SSPP) and the relative risk of injury was based on the following three values: (1) a threshold value of 3,400 N for compression force, (2) a threshold value of 500 N for shear force, and (3) population strength capability data. The effects on changes to the anthropometric data was estimated and analysed using the in-built anthropometric data contained within the 3D SSPP program for 6 separate lifter scenarios, these being male and female 5th, 50th and 95th percentiles. Changes to the patient load were estimated and analysed using the same computer software. Estimated compressive and shear forces were found to be lower with the drawsheet and tail component of the heads/tails lift in comparison to the use of the Blue MEDesign?? straps and head component of the heads/tails lift. The results obtained for the strength capability aspect of each of the lifts indicated a higher percentage of the population capable of both the drawsheet and tail end of the heads/tails lift. The relative risk of back injury for the lifters is distributed more evenly with the drawsheet lift as opposed to the heads/tails (tail) lift where risk is disproportionate with the heavier end being lifted. The use of lifter anthropometrics does not appear to be a realistic variable to base assumptions on which group of the population are capable of safely performing this task in a remote setting. This study advocates the use of the drawsheet lift in a remote setting based on the author???s experience and the biomechanical results obtained in this study. The drawsheet lift is both more accessible and provides a more acceptable risk when more than two patient handlers are involved, in comparison to the other lifts utilised lifting patients from floor to a chair.
7
Doire, Terry L. "Evaluating the Knowledge and Attitudes of Orthopedic Nurses Regarding the Use of SPHM Algorithms as a Standard of Care". NSUWorks, 2019. https://nsuworks.nova.edu/hpd_con_stuetd/63.
Testo completoAbstract (sommario):
Background: Healthcare workers are ranked among one of the top occupations for musculoskeletal disorder (MSD) injuries that affect the muscles, the bones, the nervous system and due to repetitive motion tasks (Centers for Disease Control and Prevention, 2017). Numerous high-risk patient handling tasks such as lifting, transferring, ambulating and repositioning of patients cause injuries that can be prevented when evidence-based solutions are used for safe patient handling and mobility (SPHM) tasks.
Purpose: The purpose of this quality improvement project was to evaluate the knowledge and attitudes of orthopedic nurses regarding the use of SPHM algorithms as the standard of care when transferring patients.
Theoretical Framework. Lewin’s Theory of Change
Methods. A quasi-experimental pretest-post-test design was utilized in this evidenced-based practice project. Results. Descriptive statistics that evaluated pre and post questionnaires of the orthopedic nurses noted nurses displayed behavioral and attitudinal intent to use the SPHM algorithms as the standard of care to improve patient outcomes by decreasing falls. Although the behavioral beliefs and attitudes reflected acknowledgement of SPHM skills and knowledge, nursing did not improve in their documentation of SPH fall risk as two separate tools were required on each patient.
Conclusions: SPHM evidenced-based standards do guide staff to critically examine how to safely transfer and mobilize a patient. Patient fall rates did decrease during educational sessions, prompting the need for on-going education of all staff on the unit that transfers patients. The findings from this quality project may encourage future practice approaches to use of the safe patient handling (SPH) fall risk assessment tool for all patients to prevent patient falls.
8
Torres, Noris II. "Effects of Training in Modifying Work Methods and Behaviors During Common Patient Handling Activities". Thesis, Virginia Tech, 1998. http://hdl.handle.net/10919/35528.
Testo completoAbstract (sommario):
In a 1994 survey, on incidence rates of musculoskeletal
injuries among private industries within the U.S, nurses
ranked first nationally. Patient handling tasks are
considered to be a precipitating factor in the development
of many musculoskeletal injuries. For many decades
personnel training has been an intervention widely used for
the nursing back problem. Inconsistency regarding the
effectiveness of many personnel training programs, lack of
controlled research among existing studies, and a primary
focus only on long term reduction of injury rates makes the
interpretation of the success of personnel training programs
a difficult one. This study is based on the assumption
that, if a training program is to be effective as a means
of reducing musculoskeletal injuries, it must first modify
worker behaviors and biomechanical stresses to a measurable
degree.
This research investigated the effects of training
(Video and Lecture/Practice) on modifying working behaviors
and biomechanical stress. Two tasks were examined
(wheelchair to bed and lift up in bed) with two types of
assistance (one-person or two-person) and two levels of
patient's dependence (semi-dependent or dependent).
Changes in behaviors were examined immediately following
training (1-2 days delay) and after a short period of time
(4-6 weeks) and evaluated using the criteria of subjective
ratings of exertion, and postural and biomechanical
measures. Results indicated that training led to several
significant changes in the knee, hip, elbow and torso
angles, whole body, shoulders and low back RPE, shear forces
and shoulder moments. No differences were observed in
these measures after a short period of time, suggesting
retention of the information presented during the training
programs. Results as a whole suggest that training can
positively affect the working postures and biomechanical
stress during common patient handling tasks. All the
postural changes and biomechanical measures were
advantageous in terms of reducing musculoskeletal stress.
It was also found that after a short period of time
(4-6 weeks) still retained the information presented
during the training programs. Training using a
combination of lecture and practice in some cases achieved
better results than Video-based training.
Master of Science
9
Callison, Myrna. "Identification, Evaluation and Control of Physically Demanding Patient-Handling Tasks in an Acute Care Facility". Diss., Virginia Tech, 2007. http://hdl.handle.net/10919/26561.
Testo completoAbstract (sommario):
Work-related musculoskeletal disorders (WMSDs) are prevalent among health care workers worldwide and underreporting among nurses may mask the true impact of these injuries. Nursing staff are consistently among the top 10 occupations at risk for experiencing WMSDs and patient-handling tasks are the precipitating event in the majority of back injuries experienced among nursing staff.
Existing research has focused on patient-handling issues within long-term care facilities, and identifying physically demanding patient-handling tasks. The first study in this dissertation (Chapter 3) was conducted to determine whether nurses in acute care facilities are exposed to the same hazards as their cohorts in long-term care. The aim was to identify the top 10 patient-handling tasks being conducted and to rank these tasks by perceived physical demand. This two-phase study consisted of a procedural task analysis of patient-handling activities, and a questionnaire to identify the characteristics of the study population and obtain a ranking of physically demanding patient-handling tasks. All nurses providing direct inpatient care were recruited to participate in both phases of this study. Compared to long-term care facilities, in which the majority of tasks have been shown to be associated with performance of ADL tasks, the most frequently observed tasks in the acute care facility were repositioning tasks. Therefore, it is important to determine the patient-handling demands and needs that are unique to each type of healthcare facility. Generalizing across facilities or units may lead to incorrect assumptions and conclusions about physical demands being placed on nurses.
A laboratory simulation was used for the second study (Chapter 4). The top four physically demanding patient-handling tasks (taken from Chapter 3) were simulated to determine the effect of an assistive device and assistance from another person. Sixteen nurse volunteers were recruited and provided perceptual responses regarding exertion and injury risk. Nurses perceived that assistance decreased their physical exertion and injury risk; however they consistently perceived exertion to be relatively higher than their injury risk.
The aim of the third study (Chapter 5) was to determine the level of agreement between and within different expert groups. Three groups of participants were involved, with different levels of ergonomics expertise (i.e. researchers, consultants, and graduate students). These groups viewed digitized video clips from the laboratory simulation (Chapter 4) and provided ratings of perceived exertion, perceived injury risk and common WMSD risk factors (effort, posture, and speed). The major finding from this study was that poor agreement existed between nurses and the other expert groups (researchers, consultants and students).
The current research laid the groundwork for measuring the magnitude of physical exposure to injury risk in the patient-handling environment. The research supports earlier evidence that suggests nurses underreport their discomfort and injury, which, in turn, contributes to increased exposure and risk. This knowledge will enable practitioners to focus interventions and designs on those factors in the work environment that contribute significantly to increased exposure and thereby more effectively reduce WMSD risk.Ph. D.
10
Behnam, Sarah. "Optimization of Using Devices Helping Patient Handling at Hospitals by Developing a Supply Chain Model". Thesis, KTH, Industriell produktion, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-102527.
Testo completoAbstract (sommario):
Each year, thousands of nurses and other health care workers are injured from manually lifting patients. A few decades ago managers were mostly focusing on minimizing direct manufacturing costs but because of the competitive markets nowadays managers should also focus on indirect costs. In this situation the importance of supply chain networks and facility location problems becomes more visible. The need of sophisticated and applicable facility location models is vital and that’s because of indirect manufacturing costs (such as transportation, inventory, procurement & etc.) are considered in supply chain network and facility location models. Literature review is used to develop a model at hospitals in order to get a cost effective model for maximum availability of the products used in patient handling by minimizing the supply chain cost of automated patient handling. The products used for patient handling at hospitals are so expensive and they need to be arranged by a supply chain model to be used at maximum efficiency.
11
Westhoff, Oneida Dugarte. "Development of an instrumented mannequin for training of caregivers in safe patient handling and movement". [Tampa, Fla.] : University of South Florida, 2004. http://purl.fcla.edu/fcla/etd/SFE0000236.
Testo completo
12
Nagavarapu, Shasank. "Measuring Biomechanical Loads on the spine during Patient Lifting Sling Application and Removal: Assessing the effects of Work Method, Patient Weight and Bed Height". The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1440270675.
Testo completo
13
Rombach, Ines. "The handling, analysis and reporting of missing data in patient reported outcome measures for randomised controlled trials". Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:1d038192-69ca-4d34-9974-1bc092466dee.
Testo completoAbstract (sommario):
Missing data is a potential source of bias in the results of randomised controlled trials (RCTs), which can have a negative impact on guidance derived from them, and ultimately patient care. This thesis aims to improve the understanding, handling, analysis and reporting of missing data in patient reported outcome measures (PROMs) for RCTs. A review of the literature provided evidence of discrepancies between recommended methodology and current practice in the handling and reporting of missing data. Particularly, missed opportunities to minimise missing data, the use of inappropriate analytical methods and lack of sensitivity analyses were noted. Missing data patterns were examined and found to vary between PROMs as well as across RCTs. Separate analyses illustrated difficulties in predicting missing data, resulting in uncertainty about assumed underlying missing data mechanisms. Simulation work was used to assess the comparative performance of statistical approaches for handling missing available in standard statistical software. Multiple imputation (MI) at either the item, subscale or composite score level was considered for missing PROMs data at a single follow-up time point. The choice of an MI approach depended on a multitude of factors, with MI at the item level being more beneficial than its alternatives for high proportions of item missingness. The approaches performed similarly for high proportions of unit-nonresponse; however, convergence issues were observed for MI at the item level. Maximum likelihood (ML), MI and inverse probability weighting (IPW) were evaluated for handling missing longitudinal PROMs data. MI was less biased than ML when additional post-randomisation data were available, while IPW introduced more bias compared to both ML and MI. A case study was used to explore approaches to sensitivity analyses to assess the impact of missing data. It was found that trial results could be susceptible to varying assumptions about missing data, and the importance of interpreting the results in this context was reiterated. This thesis provides researchers with guidance for the handling and reporting of missing PROMs data in order to decrease bias arising from missing data in RCTs.
14
Jersenius, Ylva, e Erika Möller. "A medical device for spinal motion restriction : Development of a device for safe and efficient patient handling". Thesis, Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-80042.
Testo completoAbstract (sommario):
Prehospital emergency care is facing a paradigm shift. Spinal motion restriction (SMR) is a way to treat trauma patients with symptoms of spinal injury. It was earlier entitled as ‘routine SMR’, and included spine board and cervical collar. During the 2000s, it has been noted that there is a lack of scientific evidence that proves the benefits with ‘routine SMR’. This led an expert group to the development of the national guidelines, that were published in 2019. The national guidelines can be described as ‘selective SMR’, where the cervical collar and spine board is excluded. It means that the SMR shall be adapted to the patient and not the equipment. Furthermore, the patient should be involved as much as possible in the treatment. This master thesis has been conducted at the Luleå University of Technology (LTU), in collaboration with AB Germa. The objective was to enable paramedics (the users in this project) to provide trauma patients with safe and efficient SMR by improving the usability of available or future products for SMR. Therefore, the project aim was to deliver a conceptual suggestion with feedback from the users. Furthermore, a mapping with experienced problems was delivered, and a review of the available medical devices with recommendations on how the future product development of medical devices for SMR could head in a user-centred direction. The theoretical framework included both ergonomics, including anthropometry and anatomy, and semiotics to involve both the physical and cognitive aspects of good usability, as a complement to the contextual immersion to be able to develop a thought through conceptual suggestion. The contextual immersion involved contact with Sweden’s 21 regions, and 16 paramedics. Through visits, interviews, and observations information was gathered about available medical devices for SMR, and challenges that paramedics are facing with them where mapped. This was compiled in a user need specification, which formed the basis for the idea generation. The ideation resulted in over 200 ideas. Iterative feedback sessions together with the users generated five concepts, that by further feedback, and iterative work converged into one final concept. The project delivers a vest with vacuum technology that enables paramedics to perform safe and efficient SMR of trauma patients with various anatomy. The concept has the flexibility of a KED and the adaptability of a vacuum mattress. It enables ’selective SMR’ in confined spaces, and facilitates the patient to be more involved in the treatment. The project has generated insights about ’selective SMR’, and the meaning of it for future product development. Generally, we are moving towards medical devices for SMR that does not restrict movement as strictly as before. Many products in ambulance care have not been updated for a long time, and there is no doubt that there is a need for it.Inom prehospital akutsjukvård pågår just nu ett paradigmskifte. Spinal rörelsebegränsning (SRB) är ett sätt att vårda patienter som varit utsatta för trauma och som uppvisar symtom på spinal skada. Det benämndes till en början som ’rutinmässig SRB’ och inkluderade användning av spineboard och nackkrage. Under 2000-talet visade det sig finnas en avsaknad av vetenskapliga bevis som talade för fördelarna med ’rutinmässig SRB’, vilket ledde till att nackkrage och spineboard exkluderades. Det här föranledde en expertgrupp att ta fram nya nationella riktlinjer som publicerades 2019. De nationella riktlinjerna kan beskrivas som ’selektiv SRB’, vilket handlar om att SRB ska anpassas utifrån patientens tillstånd och inte efter utrustningen. Patienten ska även involveras så mycket som möjligt i omhändertagandet. Det här examensarbetet har utförts vid Luleå Tekniska Universitet (LTU), tillsammans med AB Germa. Syftet var att underlätta för ambulanssjukvårdare (användarna i det här projektet) att utföra säker och effektiv SRB på traumapatienter, genom att förbättra användbarheten hos befintliga eller framtida produkter för SRB. Målet var därför att leverera ett konceptuellt förslag med feedback från användarna. Utöver detta skulle en kartläggning av dagens utrustning och problem med dessa undersökas, med rekommendationer om hur den framtida utvecklingen kan gå mot en mer användarcentrerad riktning. För att få med de fysiska såväl som de kognitiva aspekterna av en god användbarhet så inkluderades både ergonomi, inkluderande antropometri och anatomi, samt semiotik i den teoretiska referensramen. Det här användes som ett komplement till den kontextuella undersökningen för att försäkra sig om att det framtagna konceptet var väl genomtänkt. Den kontextuella undersökningen inkluderade kontakt med Sveriges 21 regioner och 16 ambulanssjukvårdare. Genom besök, intervjuer och observationer samlades information om dagens utrustning för SRB, som utgjorde underlag för en kartläggning av de upplevda problemen. Allt sammanställdes som användarbehov i en lista. Det här kom att ligga till grund för den kommande idégenereingen, som resulterade i över 200 idéer. Iterativa feedbacksessioner tillsammans med användarna resulterade i fem koncept, som genom ännu mer feedback och iterativt arbete resulterade i ett slutgiltigt koncept. Projektet levererar en väst med vakuumteknologi som möjliggör för användarna att utföra säker och effektiv SRB på traumapatienter med varierande anatomi. Konceptet har smidigheten av en KED och följsamheten av en vakuummadrass. Den möjliggör ’selektiv SRB’ i trånga utrymmen och underlättar för patienten att vara deltagande i omhändertagandet. Projektet har också levererat insikter om vad ’selektiv SRB’ kan innebära för framtida produktutveckling. Det har visat sig att trenden går mot att utrustningen inte ska rörelsebegränsa lika mycket som den gjort tidigare. Många produkter inom ambulansen har inte uppdaterats på länge och det finns inga tvivel om att det finns ett behov för detta.
15
Grimaud, Theta A. "Safe patient handling and movement device training: a hands-on continuing education program for occupational therapy practitioners". Thesis, Boston University, 2012. https://hdl.handle.net/2144/12403.
Testo completoAbstract (sommario):
Thesis (O.T.D.)--Boston University
PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.Healthcare workers are reported to have a higher rate of work-related injuries than workers in private industry and most these injuries have been attributed to client handling tasks (BLS, 2009). Client handling tasks for all healthcare workers can include tasks such as: transfers, bed mobility, activities of daily living (ADL), sitting and standing balance training, ambulation/gait, wound care, lymphedema care and splinting. Research on the nursing profession indicates at least 12% of nurses are injured during client handling tasks and that at least 12% of nursing staff will leave client care or the profession because of an injury or fear of an injury (ANA, 20 12). Occupational therapists are conducting research to understand the injury rates of occupational therapy practitioners and the impact on the profession. The current research appears to mirror the nursing profession's findings. At least 12% of occupational therapy practitioners are injured during client care tasks and at least 12% will leave client care or the profession because of an injury or out of fear of an injury (Campo & Darragh, 2010; Darragh, et al., 2009; & Rice, et al., 2011). The nursing profession has found that the use of safe patient handling and movement (SPHM) devices and techniques can reduce the incidents of client care related injuries among nursing staff (ANA, 2012). However, the use of SPHM devices has been primarily limited to surface to surface transfers and rarely used for therapeutic purposes. In fact, research indicates that therapy practitioners, for many reasons, currently do not believe that SPHM is appropriate for therapeutic interventions (Campo & Darragh, 2010; & Darragh, Campo, & Olson, 2009). This research also indicates therapy practitioner beliefs that the SPHM providers have not met the needs of therapy practitioners to use the devices therapeutically. The Program is a face-to-face hands-on continuing education program designed to help occupational therapy practitioners investigate the causes and impacts of client care related injuries, problem-solve alternative direct care options and practice therapeutic use of SPHM devices and techniques.
16
Larson, Robert Eugene. "Saving Our Backs: Reducing Low Back Forces, Investigating Pain, and Observing Multifidus". BYU ScholarsArchive, 2020. https://scholarsarchive.byu.edu/etd/8608.
Testo completoAbstract (sommario):
BACKGROUND: Healthcare workers are among the most injured workers in the United States. This is due to the high rate of patient handling. The low back is the most injured in this population. This study observed biomechanical factors and how these factors affect low back and ground reaction forces. This study further investigated pain and its relationship to low back force, multifidus cross-sectional area, and multifidus activation in healthcare workers. METHODS: The 45 participants included 10 healthy subjects in the preliminary study and 35 active healthcare workers in the main study. Subjects filled out the VAS to determine current pain level. Ultrasound images of the multifidus muscles were taken. The participants were fitted with reflective markers and surface EMG sensors. A series of patient transfers at various bed heights using three different transfer devices was undertaken. The transfer devices included a Cotton sheet, a Skil-Care™ Transfer Sling, and an AirPal® device. RESULTS: There was a downward trend in resultant low back force when comparing lower bed heights to higher. Therefore, the highest bed position was determined to be optimal. There were significant differences in low back force between self-chosen and optimal bed heights among healthcare workers. There was no significant difference between peak low back or ground reaction forces between pain and nonpain groups. There was a significant difference in multifidus cross-sectional area between these groups at S1, a trend toward significance at L5, and no difference at L4. There was a trend toward significance when comparing multifidus activation between these groups as recorded by surface EMG. CONCLUSIONS: Healthcare workers should choose higher bed heights and appropriate equipment to reduce low back force and those who have smaller multifidus have more pain.
17
Moberg, Anne-May. "Från lag till handling : En fallstudie av hur lagkravet om patientsäkerhetsberättelse nyttiggjordes i Stockholms läns landsting". Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-21511.
Testo completoAbstract (sommario):
Bakgrund: Enligt patientsäkerhetslagen 2010:659 ska vårdgivare årligen skriva en patientsäkerhetsberättelse. Granskning av 76 patientsäkerhetsberättelser i Stockholms läns landsting (SLL) visade bristande kunskap om hur den skrivs och bristfällig förståelse för patientsäkerhet, främst bland mindre vårdgivare. Hälso- och sjukvårdsadministratörer kunde inte besvara vårdgivarnas frågor om patientsäkerhetsberättelsen, varför ett förbättringsprojekt initierades för att skapa stödmaterial samt nyttiggöra patientsäkerhetsberättelsen. Syfte: Att belysa hur ett statligt styrinitiativ hanterades i praktiken i SLL och vilka erfarenheter som kunde knytas till praktikprojektet i hälso-och sjukvårdsadministrationen, hos vårdgivare och i interaktionen dem emellan samt om insatserna bidrog till ökad förståelse för patientsäkerhet. Metod: Studien var en deskriptiv fallstudie. Datainsamlingen bestod av intervjuer med vårdgivare och hälso-och sjukvårdsadministratörer och dokumentanalys. Analyserna var kvalitativ och kvantitativ innehållsanalys. Resultat: I uppföljning av vårdgivare nyttiggjordes patientsäkerhetsberättelsen med stöd av mall och manual. Interaktionen mellan vårdgivare och hälso- och sjukvårdsadministratör gick från kontroll till dialog. Lärande, och i viss mån förståelse för patientsäkerhet, ökade. Slutsats: Genom att vara proaktiv och bereda stöd för vårdgivare att fullfölja sitt åtagande avseende patientsäkerhetsberättelse kunde flera vårdgivare bli varse sitt ansvar och skyldigheter. Förbättringsprojektet genomfördes med stöd av förbättringskunskap och hög delaktighet, ett arbetssätt som rekommenderas. Fortsatt forskning av styrningens effekter föreslås.Background: Caregivers shall according to the patient safety act 2010:659 annually write a patient safety declaration. Review of 76 patient safety declarations in Stockholm County Council (SCC), Sweden, showed a lack of knowledge about how to write and inadequate understanding of patient safety, particularly among smaller caregivers. Healthcare administrators could not answer caregivers’ questions on the patient safety declaration, why an improvement project was initiated to create support and to make the patient safety declaration useful. Aim: To illustrate how a state steering initiative was handled in practice in the SCC and the experiences associated with the improvement project in health care administration, among caregivers and the interaction between them, and whether the efforts contributed to increased understanding of patient safety. Method: The study was a descriptive case study. The data collection was interviews of caregivers and healthcare administrators and document analysis. The analysies performed were qualitative and quantitative content analysis. Results: The patient safety declaration was made useful in the follow up process of caregivers with support of a template and a manual. The interaction between caregivers and healthcare administrators went from monitoring to dialogue. Learning increased and also understanding of patient safety to some degree. Conclusion: By being proactive and prepare support for caregivers to fulfill their commitment on patient safety declarations, several caregivers became aware of their responsibilities and obligations. The improvement project was accomplished with improvement knowledge and high level of participation, an approach that is recommended. Further research on the steering effects is suggested.
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Latha, Sampath Shakti. "Comprehensive Understanding of Injuries in Hospitals through Nursing Staff Interviews and Hospital Injury Records". University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1544101088645945.
Testo completo
19
Freiberg, Alice, Maria Girbig, Ulrike Euler, Julia Scharfe, Albert Nienhaus, Sonja Freitag e Andreas Seidler. "Influence of the Kinaesthetics care conception during patient handling on the development of musculoskeletal complaints and diseases - A scoping review". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-217822.
Testo completoAbstract (sommario):
The Kinaesthetics care conception is a nursing approach for patient handling which aims to prevent work-related complaints and diseases. The evidence about the influence of Kinaesthetics on musculoskeletal disorders among persons who handle patients is unclear to date. The purposes of the scoping review are to gain insight into the current state of research regarding the clinical effectiveness of Kinaesthetics (in terms of perceived exertion and musculoskeletal complaints) among persons who handle patients and to identify potential research gaps. A scoping review was conducted. The search strategy comprised a systematic search in electronic databases (MEDLINE, EMBASE, AMED, CINAHL), a hand search, a fast forward search (Web of Science) and a Google scholar-search. The review process was carried out independently by two reviewers. Methodological quality was assessed for all studies using three methodological main categories (reporting quality, internal validity, external validity). Thirteen studies with different study designs were included. Seven studies investigated musculoskeletal complaints and nine studies the perceived exertion of nursing staff. Most studies were of very low methodology. Most studies reported a decrease of musculoskeletal complaints and perceived exertion due to Kinaesthetics. In conclusion, there is only little evidence of very low quality about the effectiveness of Kinaesthetics. Out of the studies it could be assumed that Kinaesthetics may decrease the patient handling related perceived exertion and musculoskeletal pain of persons who handle patients. But an overestimation of these results is likely, due to inadequate methodology of included studies. As a result, no clear recommendations about the effectiveness of the Kinaesthetics care conception can be made yet. Since a research gap was shown, further high quality intervention studies are necessary for clarifying the effectiveness of Kinaesthetics.
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Freiberg, Alice, Maria Girbig, Ulrike Euler, Julia Scharfe, Albert Nienhaus, Sonja Freitag e Andreas Seidler. "Influence of the Kinaesthetics care conception during patient handling on the development of musculoskeletal complaints and diseases - A scoping review". BioMed Central, 2016. https://tud.qucosa.de/id/qucosa%3A30133.
Testo completoAbstract (sommario):
The Kinaesthetics care conception is a nursing approach for patient handling which aims to prevent work-related complaints and diseases. The evidence about the influence of Kinaesthetics on musculoskeletal disorders among persons who handle patients is unclear to date. The purposes of the scoping review are to gain insight into the current state of research regarding the clinical effectiveness of Kinaesthetics (in terms of perceived exertion and musculoskeletal complaints) among persons who handle patients and to identify potential research gaps. A scoping review was conducted. The search strategy comprised a systematic search in electronic databases (MEDLINE, EMBASE, AMED, CINAHL), a hand search, a fast forward search (Web of Science) and a Google scholar-search. The review process was carried out independently by two reviewers. Methodological quality was assessed for all studies using three methodological main categories (reporting quality, internal validity, external validity). Thirteen studies with different study designs were included. Seven studies investigated musculoskeletal complaints and nine studies the perceived exertion of nursing staff. Most studies were of very low methodology. Most studies reported a decrease of musculoskeletal complaints and perceived exertion due to Kinaesthetics. In conclusion, there is only little evidence of very low quality about the effectiveness of Kinaesthetics. Out of the studies it could be assumed that Kinaesthetics may decrease the patient handling related perceived exertion and musculoskeletal pain of persons who handle patients. But an overestimation of these results is likely, due to inadequate methodology of included studies. As a result, no clear recommendations about the effectiveness of the Kinaesthetics care conception can be made yet. Since a research gap was shown, further high quality intervention studies are necessary for clarifying the effectiveness of Kinaesthetics.
21
Söderberg, Johan. "Sources of preanalytical error in primary health care : implications for patient safety". Doctoral thesis, Umeå universitet, Klinisk kemi, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-21256.
Testo completoAbstract (sommario):
Background Venous blood tests constitute an important part in the diagnosis and treatment of patients. However, test results are often viewed as objective values rather than the end result of a complex process. This has clinical importance since most errors arise before the sample reaches the laboratory. Such preanalytical errors affect patient safety and are often due to human mistakes in the collection and handling of the sample. The preanalytical performance of venous blood testing in primary health care, where the majority of the patients contact with care occurs, has not previously been reported. Aims To investigate venous blood sampling practices and the prevalence of haemolysed blood samples in primary health care. Methods A questionnaire investigated the collection and handling of venous blood samples in primary health care centres in two county councils and in two hospital clinical laboratories. Haemolysis index was used to evaluate the prevalence of haemolysed blood samples sent from primary health care centres, nursing homes and a hospital emergency department. Results and discussion The results indicate that recommended preanalytical procedures were not always followed in the surveyed primary health care centres. For example, only 54% reported to always use name and Swedish identification number, and 5% to use photo-ID, the two recommended means for patient identification. Only 12% reported to always label the test tubes prior to blood collection. This increases the possibility of sample mix-up. As few as 6% reported to always allow the patient to rest at least 15 minutes before blood collection, desirable for a correct test result. Only 31% reported to have filed an incident report regarding venous blood sampling, indicating underreporting of incidents in the preanalytical phase. Major differences in the prevalence of haemolysed blood samples were found. For example, samples collected in the primary health care centre with the highest prevalence of haemolysed samples were six times (95% CI 4.0 to 9.2) more often haemolysed compared to the centre with the lowest prevalence. The significant variation in haemolysed samples is likely to reflect varying preanalytical conditions. Conclusions This thesis indicates that the preanalytical procedure in primary health care is associated with an increased risk of errors with consequences for patient safety and care. Monitoring of haemolysis index could be a valuable tool for estimating preanalytical sample quality. Further studies and interventions aimed at the preanalytical phase in primary health care are clearly needed.
22
Häggström, Fredrik, e Jane Lundgren. "OMVÅRDNADSPERSONALENS OMHÄNDERTAGANDE AV SUICIDALA PATIENTER : Vårdpersonalens upplevelse av att vårda patienter som utfört en suicidal handling samt samarbetet mellan psykiatrisk och intensivvårdsavdelning omkring dessa patienter.-en kvalitativ intervjustudie". Thesis, Mid Sweden University, Department of Health Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-8762.
Testo completoAbstract (sommario):
Introduktion: Suicidala patienter är en patientgrupp som väckte känslomässigt engagemang hos vårdpersonalen. För att kedjan av vårdinsatser mellan den somatiska och psykiatriska vården skulle fungera optimalt behövdes ett väl utvecklat samarbete. Syfte: Syftet med studien är att belysa vårdpersonalens upplevelse av att vårda en patient som utfört en suicidal handling samt samarbetet mellan psykiatrisk och intensivvårdsavdelning vid vård av dessa patienter. Metod: Studien gjordes med en kvalitativ metod med intervjuer i fem fokusgrupper där resultatet tolkades med hjälp av en manifest innehållsanalys. Resultat: Studien visade att vårdpersonalen upplevde den suicidala patienten som en komplext och resurskrävande patientgrupp. Resultatet visade även att man önskade ett mer utarbetat samarbete runt dessa patienter mellan intensivvården och psykiatrin. Diskussion: Resultatet tyder på att för att patienter som utfört en suicidal handling ska kunna få ett bra omhändertagande och om attityderna angående denna patient grupp skall kunna förändras inom vården så bör man se över samarbetet mellan de aktuella avdelningarna. Slutsats: Det krävs tydligare riktlinjer för hur samarbetet ska se ut mellan avdelningarna detta tillsammans med handledning och utbildning då kan vårdpersonalens osäkerhet minskas och vårdpersonalen kan se varandra som en resurs att använda när situationen kräver detta.
Introduction: Patients who attempted suicide is a group of patients that arouse many feelings for the caregivers. To optimize the cooperation between the psyciatric and intensive care units needs a developing cooperation. Aim: The aim of this study is to highlight the caregivers experience of caring a patient who attempted suicide act and the cooperation between psyhiatric and intensive care units for theese patients. Method: The study was made as an empirical study with five focus groups where the result interpret with a manifesto contents analysis. Result: The result of this stydy shows that the caregivers feels that the suicide patient is a complex and demanding group of patient's. The result even shows that the nursing staff wish a more prepare cooperation between psyciatric and intensive care unit's. Discussion: The author's of this study concider that for the patients who had made a suicid attempt should have a good tempory costady and the negative attitudes for this type of patient group demands a increase bethween the current units. Conclusion: It requires a straighter guidelines for the cooperation between the units togheteher with education and supervision for the caregivers can the insecure behavior reduse and cooperation growe when the situation needs that.
23
McClean, Kim. "Does accurate data, identifying obese patients impact nurse safety and hospital finances?" Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2021. https://ro.ecu.edu.au/theses/2462.
Testo completoAbstract (sommario):
Healthcare staff who manage obese patients are at increased risk of sustaining patient handling injuries, and this risk is anticipated to intensify as projected Australian obesity rates increase to 42% by the year 2035 and obese patients admitted to hospitals also increase. High cost burdens to healthcare organisations will result due to increased funding requirements for bariatric risk management solutions and growing costs of workers’ compensation claims of injured staff. Five (5) studies explored if identification of obese patients impacts the safety of nurses and other healthcare staff who manage obese patients and investigated the accuracy of obesity data recorded in hospital data systems. Additionally, financial impacts to hospitals relating to obesity data accuracy was also examined. Very little research currently exists on these risks.
A literature review was conducted which investigated risks to healthcare staff and organisations that manage obese patients. Availability of obesity data to mitigate risks was also explored. Thirty (30) studies were included in the review, which identified high risks of injury to healthcare staff and high liability and financial risks to healthcare organisations. Availability of obesity data within clinically captured information was also verified.
A pilot study successfully investigated accuracy of obesity data in the Western Australian Country Health Service (WACHS), and factors potentially impacting completeness of obesity data recording and accuracy of obesity coding. The methodology and data used in the pilot study was expanded to examine 590 patient records, and poor completeness of obesity data recording and coding accuracy was determined.
Financial implications to hospitals due to inaccurate obesity data were also examined. Eighty five (85) records of inaccurate obesity data were identified and corrected, and adjusted Diagnosis Related Groups, National Weighted Activity Units and Activity Based Funding were examined. Estimated annual lost funding opportunities of A$2.23 million due to obesity coding inaccuracy was calculated.
Finally, an intervention to improve completeness of obesity recording and data accuracy was conducted at a WACHS hospital site over a 1 year timeframe. The intervention outcomes demonstrated improved obesity recording and coding, including increases in weight and height recording, BMI recording, obesity coding, and sensitivity.
The 5 completed studies illustrate the risks to healthcare staff and organisations that manage obese patients, and the ability to use accurate obesity data to mitigate risks and improve hospital finances. Obesity data recording and coding has been demonstrated to be inaccurate, however improvement programs will enhance obesity data recording and accuracy which will positively impact safety of hospital workers and hospital finances.
24
Henriksson, Ivan, e Johannes Österberg. "Beröring inom omvårdnad : Patienters och sjuksköterskors erfarenheter av expressiv beröring : En litteraturöversikt". Thesis, Röda Korsets Högskola, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-1095.
Testo completoAbstract (sommario):
Bakgrund: Att beröra någon annan ger känslor och känslouttryck hos både individen som utför handlingen och mottagaren. Mellanmänsklig beröring är ett uttryck för kärlek eller tillgivenhet inom familjer och även i andra miljöer. I kliniska sammanhang är beröring viktigt p.g.a. den lugnande effekt och emotionella påverkan som sker. Att lägga handen på någon som lider kan skapa trygghet. Inom omvårdnad är beröring det viktigaste av alla icke-verbala beteenden. Beröring lugnar, tryggar, ger värme och stimulerar patienten. Syfte: Syftet med denna studie var att beskriva patienters och sjuksköterskors erfarenheter av expressiv beröring. Metod: Litteraturöversikt innehållande 10 vetenskapliga artiklar varav nio kvalitativa och en kvantitativ. Artiklar söktes i databaserna CINAHL, MEDLINE samt manuell sökning i Google scholar. Resultat: Beröring var ett centralt behov för patienter. Vid beröring kände de sig sedda som individer. Sjuksköterskorna hade ett behov av att beröra patienter och att bli berörda. Sjuksköterskor använde beröring för att anknyta emotionellt. Sjuksköterskor och patienter hade behov av att beröra och att bli berörda på ett sätt som passade dem och beröringen gjorde att patienterna och sjuksköterskorna fick en samhörighet på ett djupare existentiellt plan. Det fanns skillnader i hur kvinnor och män uppfattade beröring. En god relation var avgörande för hur beröringen uppfattades. Slutsats: Sjuksköterskorna ser expressiv beröring som något positivt medan patienternas uppfattningar varierar stort. Relationen med sjuksköterskan som utför beröringen är avgörande för hur beröringen uppfattas. Detta visar på nödvändigheten i att stämma av med patienten vid fysisk kontakt och att anpassa beröringen individuellt. Klinisk betydelse: Att vara medveten om hur beröring används gör att sjuksköterskor kan skapa goda vårdrelationer från första ögonblicket och snabbt undvika missförstånd.Background: Touching provides emotional expression to both parties involved. Human touch is an expression of love or affection within families and other environments. Expressive touch in a clinical context is important due to its calming and emotional effect. Laying a hand on a suffering individual can provide comfort. Touch is the most important non-verbal behavior in caring. Touching calms comforts and stimulates the patient. Aim: The aim of the study was to describe patient´s and nurse´s experiences of expressive touch. Method: A literature review of 10 scientific articles consisting of nine was qualitative and one was quantitative. Articles were found using the databases CINAHL, MEDLINE and manually searched in Google scholar. Result: Touch was a central need for patients. When they were touched, they felt that they were seen as individuals. Nurses also had the need to touch and to be touched by the patients. Nurses used touch to connect emotionally with patients. The touch made nurse´s and patient´s feel solidarity on a deeper existential level. There was a difference in perceptions of touch between men and women. A good nurse patient relationship was crucial to how the touch was perceived. Conclusion: The nurses see expressive touch as something positive whilst the patient's perceptions vary. The nurse patient relationship is crucial to how the touch is perceived. This shows the necessity of checking with the patient while engaging in physical contact and to adapt the touch to the individual. Clinical significance: Being aware of how expressive touch should be used enables nurses to establish good nurse patient relationships and quickly avoid misinterpretations.
25
Saathoff, April Marie. "Improving the Nursing Practice Environment With Point of Care Specimen Collection". ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3832.
Testo completoAbstract (sommario):
Specimen collection and identification errors are a significant problem in healthcare, contributing to incorrect diagnoses, delayed care, lack of essential treatments, patient injury or death, increased length of stay and increased healthcare costs, and decreased patient satisfaction. The purpose of the project was to evaluate the implementation of specimen collection technology with barcode scanning and bedside label printing in the maternal child health division of a community teaching hospital. The project was driven from Donabedian's quality framework for healthcare implementations, indicating that evaluating the quality of health care can be drawn from the categories of structure, process, and outcomes. The project featured a quantitative analysis with a pretest-posttest design. Mislabeled specimen rates and collection turnaround times were generated from laboratory quality data and measured before, during, and after implementation of specimen collection technology. Data analysis using an independent samples t test in SPSS 17.0 compared the changes in the mean scores of specimen collection turnaround times and mislabeled specimen rates. Mislabeled specimen percentages in all areas decreased from 0.0250% preimplementation to 0.0023% postimplementation with a p value less than 0.001. Collection turnaround times greater than 60 minutes decreased following implementation of specimen collection technology by 22% with a p value less than 0.001. The implementation of specimen collection technology has positive implications for social change, including the expectation that as technology is proven to significantly improve the safety and quality of laboratory collections, there will be a mandate for implementation of safer collection processes in healthcare.
26
Tran, Grace My-Linh. "Assistive Intervention in the Characterization of Muscle Activity During Bed Rising and Assessment of Self-Perceived Recovery Measures for Abdominal Surgery Patients in Postoperative Care". Thesis, Virginia Tech, 2004. http://hdl.handle.net/10919/10115.
Testo completoAbstract (sommario):
Previous literature has indicated that nursing personnel face the second highest rate of occupational injury and illness. Assistive equipment, such as lift and transfer aids, has helped lower work task demands and reduce back stress on patient handlers. However, limited attention has been paid to the safety, comfort and dignity of the patient in postoperative care. Research on the efficacy of self-transfer aids for patients who require limited or no assistance by nursing personnel is insufficient. Ratings of comfort and security have only been evaluated for nursing home residents in a pilot field study, in which residents rated assistive devices as generally equal to or more secure and comfortable than manual transfer methods.
The first study reports the laboratory evaluation of bed rising with the use of two self-transfer aids and bed rising unassisted. The objective was to determine muscle activity during bed rising tasks with and without the use of a bed assistive device using surface electromyography (EMG). Twenty male (n = 9; age, 33.7 ± 8.0 years) and female (n = 11; age, 34.5 ± 23.9 years) participants, with normal body mass index (BMI) ranging from 18.4 to 24.9, took part in the study. Mean and peak activity was recorded from three abdominal muscle sites. The results indicated bed rising with the use of a self-transfer device significantly reduced muscle activity compared to bed rising unassisted. Anchoring the devices at a higher height and elevating the torso further reduced muscle activity. Although no differences were observed between devices using EMG, results from the usability survey and final ranking indicated favorable ratings for the ABNOSTRAINTM prototype compared to the Bed Pull-up.
A second study was conducted to determine the efficacy of a bed assistive device in a patient population. The objective was to compare self-perceived recovery measures and usage of pain medication between patients in the control (n = 8; age, 34.0 ± 6.3years) and device (n = 7; 40.7 ± 12.4) groups. A total of fifteen female participants undergoing either abdominal hysterectomy (n = 6) or Cesarean-section (n = 9) procedures were recruited for the study. Both groups completed a total of twelve questionnaires over a five-week recovery period. Responses to self-perceived recovery measures were significantly different. In general, the device group reported higher levels of energy, less pain interference, lower perceived pain, less reliance on pain medication and returned to activities of daily living faster than the control group.
The results from the study provide clinicians or other practitioners information on the benefits of bed assistive devices for patients during postoperative recovery. Age and surgery differences should be considered when suggesting bed movement patterns with assistive intervention.Master of Science
27
Weston, Eric Brian. "Evaluation of Risk to the Lumbar Spine and Shoulders During Simulated Wheelchair Pushing". The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1480535340490527.
Testo completo
28
Strömklint, Theo, e Mia Wilhelmsson. "Integritet och säkerhet inom den digitaliserade sjukvården. : Med perspektiv utifrån patientdatalagen". Thesis, Högskolan i Halmstad, Sektionen för Informationsvetenskap, Data– och Elektroteknik (IDE), 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-18978.
Testo completoAbstract (sommario):
The digitization of patient data and medical records used by the healthcare-industry in Sweden is rapidly developing. However; developing and changing things in this field is not an easy task because of the circumstances surrounding it. Digital systems intended to process, and hold, sensitive personal data, such as medical journals, must be developed with laws, confidentiality, integrity and availability in mind to secure that none of this data gets compromised. A complicating factor in regards to this is the fast rate of development within IT in contrast to the much slower bureaucratic process of the justice system. This means that laws and regulations oftentimes aren’t up to date with the newest available technology. With the purpose of establishing set regulations on how patient data should be properly handled the Swedish government enacted the Patient Data Act (sv. Patientdatalagen, SFS 2008:355) on the 1:st of July 2008. This act doesn’t only touch on safeguarding patient data but also deals with: A possibility for healthcare-providers to take part of other provider’s journals (a system for distribution and sharing of patient data). The patients given right to at any time deny access of their data to any given healthcare-provider and/or specific personnel. The possibility for patients to take part of follow-up information regarding access to their data and see, among other things, who’s accessed their files, at what time and which changes were made. In addition to the Patient Data Act the Swedish National Board of Health and Welfare and the Data Inspection Board inaugurated regulations regarding the handling of information and journal keeping of the healthcare-industry (SOSFS 2008:14). This legislative act concerns business organizational issues regarding healthcare-providers responsibilities involving handling of sensitive data. The legislation also sets requirements for routines when following up on logs, methods for authentication etc. In addition to enacted laws and applied technical solutions there is the aspect, and importance, of education of healthcare-personnel. A key component to secure information handling is a security conscious, well-educated staff. This thesis describes the complexity and existing issues between the development of IT and currently enacted laws and regulations regarding healthcare and electronic journal keeping. It also discusses approaches to these issues and the target objective of future technical and administrative implementations. In addition to the presentation of contemporary circumstances in the area the report also deals with proposed solutions to the aforementioned issues. It highlights the areas that are considered critical, and currently non-prioritized, with regards to patient integrity.
29
Park, Sanghyun. "Investigating the Impacts of Barriers and Facilitators Affecting the Adoption of Lifting Devices in Health Care Facilities". The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1431086115.
Testo completo
30
Menzel, Nancy Nivison. "Manual Handling Workload and Musculoskeletal Discomfort in Nursing Personnel". [Tampa, Fla. : s.n.], 2001. http://purl.fcla.edu/fcla/etd/SFE0000020.
Testo completo
31
Garrett, Claire Anne. "Assessing the renal handling of a dietary protein load in patients managed for nephroblastoma". Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/95936.
Testo completoAbstract (sommario):
Thesis (MNutr)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Introduction and purpose The aim of the study was to determine the renal handling of a once-off bolus dietary protein load in patients treated for nephroblastoma. Patients who have been managed for nephroblastoma always have suboptimal amounts of kidney tissue as a result of their medical management which includes nephrectomies, chemotherapy and or radiotherapy. Little data are available indicating the extent of renal impairment expected in such patients as a result of their disease and management. The study was to determine whether the use of regular screening tests such as serum urea, creatinine and urine microalbumin, in conjunction with a dietary protein load could help detect early progressive deterioration of kidney function in nephroblastoma patients. Methodology The study was a quantitative non-randomised intervention study in which patients served as their own control before and after a protein load. Thirty-four participants were included in the study. Each participant was provided with a supplemental protein drink providing 2 g/kg body weight of protein. Serum creatinine, urea and urine microalbumin were assessed at baseline and four hours after the intervention. These pre- and post intervention biochemical values were then analysed together with descriptive data relating to the participants, such as age, stage of nephroblastoma, aspects of medical management and the period of time since they had been treated for nephroblastoma, and statistical relationships were assessed. Data were collected from May 2010 to November 2010. Results Descriptive statistics indicated that the mean [± Standard deviation (SD)] age of the population was 92 (± 55) months, the mean age at diagnosis was 41 (± 27) months and the mean age from the diagnosis to the time of the study was 51 (± 53) months. There was a statistically significant increase (p = 0.00) in serum urea post intervention; however, no significant difference was noted between pre- and post intervention serum creatinine and urine microalbumin values. The stages of nephroblastoma failed to show a statistical correlation with the response to the dietary protein bolus load in terms of the difference in pre- and post intervention biochemical data. No statistical correlation was found between post-pubescence and response to the protein load. Similiarly, no statistical correlation could be demonstrated for a longer period between the diagnosis and the time of this study, on the one hand, and the prevalence of high values in the biochemical data, on the other. Conclusion The study was unable to demonstrate statistically that participants managed for nephroblastoma had poor renal handling of a once-off dietary protein load in terms of the objectives specified. The study had limitations including a small population with even smaller subgroups of participants, therefore results of the study need to be interpreted in context to the size of the population.
AFRIKAANSE OPSOMMING: Doel Die doel van die studie was om die renale hantering van ’n eenmalige bolus dieetproteïenlading by pasiënte wat vir nefroblastoom behandel word, te bepaal. Pasiënte wat vir nefroblastoom behandel word, het altyd ‘n subopitmale hoeveelheid nierweefsel as gevolg van hulle mediese behandeling wat nefrektomies, chemoterapie en / of radioterapie insluit. Min data is beskikbaar omtrent die omvang van die nierbelemmering wat in sulke pasiënte verwag word as gevolg van hulle siekte en behandeling. Die studie is uitgevoer om te bepaal of die gebruik van gereelde siftingstoetse soos serum-ureum, kreatinien en mikroalbuminurie, in samewerking met ‘n dieetproteïenlading, kan help om vroeë progressiewe agteruitgang van nierfunksie in nefroblastoom pasiënte, op te spoor. Metodologie Die studie was ‘n kwantitatiewe nie-ewekansige intervensie studie waar pasiënte as hul eie kontrole gedien het voor en na ‘n proteïenlading. Altesaam 34 deelnemers is by die studie betrek. Elke deelnemer het ’n proteïenaanvullingsdrankie ontvang wat 2 gram proteïen per kilogram liggaamsgewig voorsien het. Serumkreatinien, serum-ureum en mikro-albuminurie is op die basislyn sowel as vier uur na die intervensie gemeet. Hierdie biochemiese waardes voor en na die intervensie is daarna saam met beskrywende data van die deelnemers – soos ouderdom, stadium van nefroblastoom, aspekte van mediese behandeling en tydsverloop sedert behandeling vir nefroblastoom – ontleed. Statistiese verwantskappe is vervolgens beoordeel. Data is vanaf Mei 2010 tot November 2010 ingesamel. Resultate Beskrywende statistieke het op ’n gemiddelde [± Standaard afwyking (SA)] populasie-ouderdom van 92 (± 55) maande, ’n gemiddelde diagnose-ouderdom van 41(± 27) maande en ’n gemiddelde ouderdom van 51(± 53) maande vanaf diagnose tot en met die studie gedui. Ná die intervensie is ’n statisties beduidende toename (p = 0.00) in serum-ureum opgemerk, hoewel daar geen beduidende verskil in serumkreatinien en mikro-albuminurie waardes, voor en na behandeling, was nie. Biochemiese data voor en na die intervensie het geen statistiese verwantskap tussen die stadium van nefroblastoom en die reaksie op die dieetproteïenlading getoon nie. Boonop is geen statistiese verwantskap opgemerk tussen post-pubesensie en die reaksie op die proteïenlading, of tussen ’n langer tydsverloop tussen die diagnose en die studie en die voorkoms van hoë waardes in die biochemiese data nie. Gevolgtrekking Wat die studie-doelwitte betref, kon die navorsing nie statisties bewys dat deelnemers wat vir nefroblastoom behandel word, swak renale hantering van ’n eenmalige dieetproteïenlading toon nie. Die beperkinge van die studie sluit ‘n klein populasie met selfs kleiner subgroepe in; die resultate van die studie moet derhalwe in die konteks van die grootte van die populasie, geÏnterpreteer word.
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Wang, Jing. "Genetic and functional analysis of pathways regulating sodium handling in patients with low renin hypertension". Thesis, University of Cambridge, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.611982.
Testo completo
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Stangarlin, Lize. "FERRAMENTA PARA IMPLEMENTAÇÃO DOS REQUISITOS HIGIÊNICO-SANITÁRIOS EM SERVIÇOS DE NUTRIÇÃO E DIETÉTICA HOSPITALAR". Universidade Federal de Santa Maria, 2014. http://repositorio.ufsm.br/handle/1/3393.
Testo completoAbstract (sommario):
The goal of this study was to develop a quality tool for Nutrition and Dietetics Hospital Services and evaluate the hygienic sanitary conditions of these places before and after the implementation of this tool, according to the view of the internal and external auditor. Also, to evaluate the satisfaction of the internal auditors regarding the tool, check the hygienic sanitary conditions of the hands of manipulators and surfaces in contact with food after improvements and training and evaluate the satisfactionf the patients regarding the meals served after implementation of the tool. This research was divided in three studies (1 - preparation and implementation of the tool; 2 - Review of the hygienic sanitary conditions of the hands and contact surfaces; 3 - evaluation of the satisfaction of patients regarding the meals served). The sample was composed by 15 Nutrition and Dietetics Hospital Services. To establish the quality tool, we used the requirements of the laws and regulations of Brazil. The tool is composed by four support instruments, divided in: 1 - Evaluation and quality planning; 2 - A guide for the development of the Manual of Best Practices; 3 - A guide for the development of Standard Operating Procedures and Instrument; 4 - A guide for the development of the Essential Operational Controls. After the development of the tool, we performed an initial evaluation of the hygienic sanitary requirements at each site through the application of the Instrument 1 by the internal and external auditor. The technician responsible for the Nutrition and Dietetics Hospital Services was considered the internal auditor and the external auditor was a professional with experience in the food area, which evaluated all the locations. After the implementation, the internal auditors received the results of the external auditor and other instruments of the tool, and the deadline of one year for the implementation was stipulated. At the end of the deadline, the internal and external auditors applied again the instrument 1. Then, the internal auditors completed a questionnaire to evaluate their satisfaction regarding the quality tool. The evaluation of the hygienic sanitary conditions of the hands and contact surfaces was divided into two stages. First, we evaluated the requirements of hygiene and microbiological analyzes on hands and contact surfaces. Then, the locations received the results and recommendations of adequacy, which were asked to be fulfilled in two months. After this, the local that showed improvements participated in the second stage, with training and new collection of microbiological analyzes. To evaluate the satisfaction of the patients regarding the meals served, we prepared a questionnaire with classifications sucha as: Great; Fair and Poor. In the evaluation of the internal auditors, the instruments were considered Great. After the implementation of the tool there was significant increase in the percentage of overall suitability and
requirements, both in the evaluation of the internal external auditor. It was found that in the percentage of overall suitability, before the application of the tool, there was a statistically significant difference in the evaluation between the auditors, and this fact was not observed after the application of the tool. In the evaluation of the meals served, it was found that in the overall average, the requirements were considered Great. It is concluded that the quality tool was effective in adjusting the criteria for the hygienic sanitary control in Nutrition and Dietetics Hospital Services, according to the view of the internal and external auditors and helped in the understanding of the internal auditors, provided a more critical view of the requirements and decreased differences between evaluators. It is seen that the hygienic sanitary conditions of the hands and contact surfaces got better. After the improvement, the patients were satisfied with the meals served due to the implementation of the tool.O objetivo foi elaborar uma ferramenta de qualidade para Serviços de Nutrição e Dietética Hospitalar e avaliar as condições higiênico-sanitárias desses locais, antes e após a implementação desta ferramenta, na visão do auditor interno e externo. Avaliar a satisfação dos auditores internos, quanto à ferramenta. Verificar as condições higiênico-sanitárias das mãos dos manipuladores e superfícies em contato com os alimentos, após melhorias e capacitação e avaliar a satisfação dos pacientes quanto às refeições servidas, após implementação da ferramenta. Esta pesquisa foi dividida em três estudos (1- elaboração e implementação da ferramenta; 2 avaliação das condições higiênico-sanitárias das mãos e superfícies de contato; 3 avaliação da satisação dos pacientes, quanto as refeições servidas). A amostra foi composta por 15 Serviços de Nutrição e Dietética Hospitalar. Para a elaboração da ferramenta de qualidade utilizou-se os requisitos das legislações e normas do Brasil. A ferramenta foi composta por quatro instrumentos de apoio, sendo divididos em Instrumento 1 Avaliação e planejamento da qualidade; Instrumento 2 Roteiro para elaboração do Manual de Boas Práticas; Instrumento 3 - Roteiro para elaboração dos Procedimentos Operacionais Padronizados e Instrumento 4 Roteiro para elaboração dos Controles Operacionais Essenciais. Após a elaboração da ferramenta, realizou-se a avaliação inicial dos requisitos higiênico-sanitários em cada local, através da aplicação do Instrumento 1, pelo auditor interno e externo. O responsável técnico do Serviço de Nutrição e Dietética Hospitalar foi considerado o auditor interno, e o auditor externo um profissional com experiência na área de alimentos, que avaliou todos locais. Após aplicação, os auditores internos receberam os resultados da avaliação do auditor externo e os demais instrumentos da ferramenta, sendo estipulado o prazo de um ano para sua implementação. No final do prazo, o auditor interno e externo aplicaram novamente o instrumento 1. Após, os auditores internos preencheram um questionário para avaliar sua satisfação quanto à ferramenta de qualidade. A avaliação das condições higiênico-sanitárias das mãos e superfícies em contato foi dividida em duas etapas. Primeiramente, realizou-se avaliação dos requisitos de higienização e análises microbiológicas nas mãos e superfície em contato. Após, os locais receberam os resultados e recomendações de adequação, sendo estipulados dois meses para adequar-se. Posteriormente, os locais que realizaram as melhorias, participaram da segunda etapa, sendo realizada capacitação e nova coleta das análises microbiológicas. Para avaliar a satisfação dos pacientes quanto às refeições servidas, elaborou-se um questionário, sendo classificadas como: Ótimo; Regular e Ruim. Na avaliação dos auditores internos, os instrumentos foram considerados Ótimos. Após a implementação da ferramenta houve um aumento significativo no percentual de adequação geral e dos requisitos, tanto na avaliação do auditor interno e externo. Verificou-se que no percentual de adequação geral, antes da aplicação da ferramenta, houve diferença estatisticamente significativa na avaliação entre os auditores, sendo esse fato não constatado, após a aplicação da ferramenta. Na avaliação das refeições servidas, constatou-se que na média geral, os requisitos foram considerados Ótimo. Conclui-se que a ferramenta de qualidade foi eficiente na adequação dos critérios para o controle higiênico-sanitário em Serviços de Nutrição e Dietética Hospitalar, na visão dos auditores interno e externo e auxiliou no conhecimento dos auditores internos, proporcionou uma visão mais crítica dos requisitos e diminuiu as divergências entre os avaliadores. Constata-se que as condições higiênico-sanitárias das mãos e superfície em contato, melhoraram após as melhorias da lista avaliação e capacitação e pacientes encontraram-se satisfeitos com as refeições servidas, após a implementação da ferramenta.
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Keen, Andrew. "Handling consultations in which distressing information is given : the effects of an interactive teaching programme on the performance of fifth year medical students and junior house officers". Thesis, University of Aberdeen, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368838.
Testo completoAbstract (sommario):
Technological advances mean that medical education bodies can now teach doctors in training using sophisticated engineering systems. Clearly, it is important to establish the efficacy of such innovative educational methods. This study was undertaken primarily to determine whether or not an interactive computerised teaching programme could train medical students and junior house officers to impart effectively distressing information. Subjects were fifth year medical undergraduates at the University of Aberdeen during the 1997/98 academic year. Subjects were separated into two groups. One group had access to the teaching programme during their final undergraduate year, whilst the other did not. Subjects conducted simulated interviews toward the end of their fifth year at medical school and toward the end of their pre-registration year. All subjects were assessed on one of three cases. Subjects were assessed on the same case at both assessment points. All interviews were videotaped. Performances were scored independently by two raters. Subjects rated their own performances. Of 132 medical undergraduates, 94 (71%) conducted interviews toward the end of their fifth year. Of the 63 who could participate one year later, 45 (71%) conducted a second assessment interview. The interaction teaching programme did not improve subjects' ability to give bad news at either test point. Regarding subjects' ratings, at the undergraduate test point, the two significant differences favoured those subjects given access to the teaching programme. At the postgraduate assessment point, the four significant differences favoured those subjects not given access to the teaching programme. Analyses indicated that the skills of doctors in training could be reliably evaluated using three ten-minute interviews. Subjects were poor at evaluating their own communication skills. Those who gave bad news more frequently as junior house officers performed at a similar level to those who gave bad news less frequently. The implications for medical education are discussed.
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Gourdin-Petit, Le Manac'h Audrey. "Interaction entre les parcours de soins et les parcours professionnels des lombalgiques. : Rôle de la coordination des acteurs de soins et de la prévention. Low back pain, intervertebral disc and occupational diseases Recommandations de bonnes pratiques pour la surveillance me´dico-professionnelle du risque lombaire pour les travailleurs expose´s a` des manipulations de charges Pre‑employment examination for low back risk in workers exposed to manual handling of loads: French guidelines French good practice guidelines for medical and occupational surveillance of the low back pain risk among workers exposed to manual handling of loads. Pre-return-to-work medical consultation for low back pain workers. Good practice recommendations Chronic low-back pain, chronic disability at work, chronic management issues". Thesis, Angers, 2015. http://www.theses.fr/2015ANGE0092.
Testo completoAbstract (sommario):
La lombalgie est un problème majeur de santé publique et de santé au travail dans les pays industrialisés. La chronicité de la lombalgie et l’incapacité qui en découle sont potentiellement sources d’altération de la qualité de vie, de rupture des parcours professionnels, voire de désinsertion socioprofessionnelle. La première partie de ce travail situe la problématique de la pathologie rachidienne en lien avec l’activité professionnelle et de sa reconnaissance sociale. L’évolution vers la chronicité de la lombalgie ainsi que la restriction de participation sociale et professionnelle s’inscrivent dans un modèle dynamique faisant intervenir des facteurs liés à l’individu, au système de soins et de prévention, au travail, et au système de compensation financière. La nécessité de l’intégration de tous ces éléments pour la prise en charge médicale et la surveillance médico-professionnelle des travailleurs lombalgiques est développée à travers l’exposé des recommandations de bonne pratique. Les recommandations pour la visite de pré-reprise soulignent notamment l’intérêt de la coordination des acteurs médicaux, sociaux et du travail pour le retour/maintien en emploi et la lutte contre la désinsertion professionnelle des travailleurs lombalgiques. Enfin, les stratégies proposées aux travailleurs lombalgiques qui ont montré leur efficacité associent un réentraînement physique intensif, une approche cognitivo-comportementale, une action en milieu de travail et la coordination des acteurs du retour au travail. Cependant, la mise en place de ces interventions complexes présente un certain nombre de limites et notre équipe tente de développer des stratégies hiérarchisées et plus largement applicablesLow back pain is a major public and occupational health issue in industrialized countries. Chronic low back pain and resulting disability are potential sources of impaired quality of life, breaking career and even socio-professional exclusion. The first part of this work places the issue of the back intervertebral disc disease related to work and its social recognition.The low back pain chronicity and the social and professional restriction of participation are part of a dynamic model involving factors related to the individual, to the prevention and care system, to work, and to the financial compensation system. The need for integration of all these elements for medical care, prevention and medical and occupational surveillance of low back pain workers is developed through the presentation of recommendations for good practice. Recommendations for pre-return-to-work medical examination especially emphasize the benefit of coordinating medical, social and occupational actors for the return to / retention at work and the fight against occupational exclusion of low back pain workers. Finally, the offered to low back pain workers strategies which have shown their effectiveness in reducing the duration of sick leave combine an intensive physical rehabilitation, a cognitive-behavioral approach, a workplace intervention and the coordination of return to work actors. However, the implementation of these complex interventions has a great number of limitations
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Norder, Sanna, e Susanne Pettersson. "Attityder gentemot patienter med självskadebeteende : - En litteraturöversikt över akutsjuksköterskors tankar, känslor och handlingar". Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1830.
Testo completoAbstract (sommario):
Bakgrund: Patienter som vårdas på grund av självskadebeteende inom slutenvården har ökat sedan 1990- talet. Det första mötet dessa patienter har med sjukvården är ofta på akutmottagningar, som främst är utformade för att effektivt vårda patienter som är fysiskt sjuka. Patienter som med självskadebeteende har ofta svårt att kommunicera sina känslor till andra. Samtidigt som de upplever att de bemöts negativt av sjuksköterskor i vården. Attityder hos sjuksköterskor påverkar omvårdnaden genom hur de tänker, känner och handlar gentemot patienten. Syfte: Syftet med detta examensarbete är att beskriva akutsjuksköterskors attityder gentemot patienter med ett självskadebeteende. Metod: En allmän litteraturöversikt baserad på 9 vetenskapliga studier varav 6 var kvantitativa och 3 kvalitativa. Studierna valdes ut genom kritisk granskning och utifrån urvalskriterier. De översattes från engelska till svenska och analyserades utifrån attitydbegreppets tre komponter; tankar, känslor och handlingar. Resultat: Resultatet presenterar utifrån följande teman och rubriker: Tankar: sjuksköterskors tankar om självskadebeteende, uppfattningar om att vårda patienter med självskadebeteende, brist på kunskap och kompetens i omvårdnaden av patienter som skadar sig själva. Känslor: starka känslor framkallas i vårdandet av patienter som skadar sig själva, faktorer som påverkar känslorna gentemot patienter med självskadebeteende. Handlingar: patienter med självskadebeteende bortprioriteras på akutmottagningen, brister riktlinjer och bedömningar i vården av patienter med självskadebeteende. Diskussion: Hur tankar, känslor och handlingar hör samman diskuteras utifrån Orlandos interaktionsteori. Att utbildning påverkar attityderna positivt diskuteras, samt en problematisering kring det medicinska fokus som finns på akutmottagningen. Vidare diskuteras praktiska implikationer och vidare forskning.Background: The numbers of patients that are treated for self-harm in inpatient care have increased since 1990's. The first meeting these patients have with healthcare often take place in the emergency department, which is primarily designed to efficiently care for patients who are physically ill. Patients who engage in self-harm have often difficulties communicating their feelings to others. These patients experience that they are negatively treated by nurses in health care. The attitude of nurses is affecting care by the way they think, feel and act towards the patient Aim: The aim of this literature review is to describe emergency nurses' attitude towards patients with self-injurious behavior. Methods: A general literature review based on 9 scientific studies, of which 6 were quantitative and 3 qualitative studies. The studies were selected through critical review and selection criteria. They were translated from English to Swedish and analyzed by the three components of the attitude concept; thoughts, feelings and actions. Results: The results is presented on the following themes and headlines: Thoughts: nurses thoughts about self-injurious behavior, views of caring for patients with self-injurious behavior, lack of knowledge and skills in the care of patients who harm themselves. Emotions: strong feelings are evoked in the care of patients who harm themselves, factors that affect the feelings towards patients with self-injurious behavior. Actions: Patients who engage in self-harm are deprioritized in the emergency department, deficits in assessment and guidelines regarding the care of patients with self-injurious behavior. Discussion: How thoughts, feelings and actions are associated is discussed based on Orlando's interaction theory. That education affects attitudes positively is discussed as well the problematisation of the medical focus that exists in the emergency department. Furthermore, we discuss practical implications and further research.
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Gren, Susanne, e Kristiansson Karin Tell. "Handlingar som kan stärka och möjliggöra utförandet av egenvård hos patienter med hjärtsvikt". Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3749.
Testo completoAbstract (sommario):
Bakgrund Hjärtsvikt är den vanligaste orsaken till att personer över 65 år läggs in på sjukhus och orsakar ofta stort lidande med sänkt livskvalitet som följd. Hjärtsvikt uppstår när hjärtats pumpförmåga inte försörjer vävnaderna i kroppen med tillräcklig mängd blod. Dödligheten är hög men går att förebygga genom egenvård som görs för att bibehålla eller förbättra hälsan som till exempel god nattsömn, hygien, hälsosam kost och motion. Genom att stärka och möjliggöra egenvården är det lättare för patienter att leva med kronisk sjukdom. Syfte Syftet var att belysa vad som stärker och möjliggör utförandet av egenvård hos patienter med hjärtsvikt. Metod Studien är en litteraturöversikt som baserades på 15 artiklar. Dessa återfanns i databaserna CINAHL och PubMed och var publicerade mellan åren 2011–2019. Artiklarna analyserades genom integrerad analys samt kvalitetsgranskades och sorterades i kategorier efter huvudsakligt innehåll. Resultat I resultatet framkom att patienter med hjärtsvikt kunde bibehålla livskvaliteten med olika handlingar och med motivation att utföra egenvård. Patienterna blev stärkta när de kände sig inkluderade i vården och delaktiga i besluten kring sin sjukdom. Stöttning från sjukvård och närstående gav upplevelsen av både frihet och autonomi. Slutsats Vård och omsorg samt tekniska hjälpmedel behöver anpassas efter patientens unika behov och kunskap. Andra omständigheter som kan motivera patienter med hjärtsvikt är hens grundinställning till livet, sociala nätverk samt förmågan att acceptera sjukdomen och den nya livssituationen.Background Heart failure is the most common cause for people over the age of 65 being admitted to hospitals and often causes great suffering with a reduced quality of life. Heart failure occurs when the heart's pumping capacity does not supply the tissues of the body with sufficient blood. Mortality is high but can be prevented through self-care that is done to maintain or to improve health such as good night's sleep, hygiene, healthy diet, and exercise. By strengthening and enabling self-care, it is easier for patients to live with chronic illness. Aim The aim was to illustrate what strengthens and enables self-care in patients with heart failure. Method The study is a literature review that was based on 15 articles. These were found in the databases CINAHL and PubMed and were published between the years 2011-2019. The articles were analyzed through integrated analysis, quality checked and sorted into categories according to main content. Results The results showed that patients with heart failure could maintain the quality of life with different actions and motivation to perform self-care. Patients were strengthened when they felt included in the care and became involved in decisions about their disease. Support from healthcare and informal caregivers provided an experience of both freedom and autonomy. Conclusions Care as well as technical aids need to be adapted to the patient's unique needs and knowledge. Other circumstances that can motivate patients with heart failure include the patient's basic attitude to life, social networks, and the ability to accept the disease and the new life situation.
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Muna, Azinwi Phina [Verfasser], e Dobromir [Akademischer Betreuer] Dobrev. "Alterations of cellular electrophysiology and Ca2+-handling in patients with different forms of atrial fibrillation / Azinwi Phina Muna geb. Khan ; Betreuer: Dobromir Dobrev". Duisburg, 2019. http://d-nb.info/1193648408/34.
Testo completo
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Eklund, Emelie, e Anna Möller. "Sjuksköterskans möte på akutmottagning med patienter utsatta för våld i nära relation : en litteraturstudie". Thesis, Sophiahemmet Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-4028.
Testo completoAbstract (sommario):
Våld i nära relationer är idag ett stort samhällsproblem och akutmottagningar är vanligen den första och enda kontakten den utsatta personen har med sjukvården. Det är viktigt att sjuksköterskor på akutmottagningar identifierar denna patientgrupp för att kunna erbjuda stöd och eventuellt förhindra ytterligare och mer allvarliga skador samt bråd död. Syftet med studien var att beskriva sjuksköterskors erfarenheter av att identifiera och handlägga patienter som utsatts för våld i nära relationer på akutmottagning. Metoden som användes för att besvara syftet var en allmän litteraturöversikt med strukturerad ansats. Datainsamling skedde i databaserna Cinahl, PubMed, PsycInfo samt SweMed. Vid sökning i databaserna användes årsintervallet 2010 till 2020. Som analysmetod valdes integrerad analys då det möjliggjorde att olika metodologier användes. Resultatet består av femton vetenskapliga artiklar. Resultatet belyser både hinder, möjligheter samt känslomässiga erfarenheter kring identifiering och handläggning av patienter som utsatts för våld i nära relationer. Påverkansfaktorer som framkom i resultat var tidsbrist, brister i akutmottagningens miljö, bristande kunskaper om handläggning och identifiering av våld i nära relationer, teamarbete, träning och erfarenheter, trygg vårdmiljö och sjuksköterskans ansvar, personliga erfarenheter och professionella erfarenheter. Slutsatsen påvisar att dessa olika faktorer möjliggör och hindrar identifiering och handläggning i våld i nära relation. Utbildningsinsatser i ämnet skulle kunna medföra förändringar i attityder, kunskap samt bidra till en ökad förståelse för de våldsutsatta patienterna i nära relation. Det skulle också kunna leda till att riktlinjer utvecklas och förbättras för att medföra en bättre och säkrare vård för denna patientgrupp samt en eventuellt bättre arbetsmiljö för hälso- och sjukvårdspersonal på akutmottagning.Violence in close relationships is today a major societal problem and emergency department are usually the first and only contact the vulnerable person has with healthcare. It is important that nurses in emergency departments identify this patient group in order to be able to offer support and possibly prevent further and more serious injuries and sudden death. The aim of the study was to describe nurses' experiences of identifying and treating patients who have been subjected to violence in close relationships in the emergency department. The method used to answer the purpose was general literature review. Data collection took place in Cinahl, PubMed, PsycInfo samt SweMed. When searching the databases, the annual interval 2010 to 2020 was used. Integrated analysis was chosen as the analysis method as it made it possible to use different methodologies.The result consists of fifteen scientific articles. The results shed light on both obstacles, opportunities and emotional experiences regarding the identification and handling of patients who have been subjected to violence in close relationships. Influencing factors that emerged in the results were lack of time, shortcomings in the emergency room environment, lack of knowledge about handling and identification of violence in close relationships, teamwork, training and experiences, safe care environment and the nurse's responsibility. The conclusion shows that these various factors enable and hinder identification and handling of violence in close relationships. Educational initiatives in the subject could lead to changes in attitudes, knowledge and contribute to an increased understanding of the abused patients in close relationships. It could also lead to guidelines being developed and improved to lead to better and safer care for this patient group as well as a possibly better working environment for health care staff in the emergency department.
40
Möller, Anna, e Emelie Eklund. "Sjuksköterskans möte på akutmottagning med patienter utsatta för våld i nära relation : en litteraturstudie". Thesis, Sophiahemmet Högskola, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-4028.
Testo completoAbstract (sommario):
Våld i nära relationer är idag ett stort samhällsproblem och akutmottagningar är vanligen den första och enda kontakten den utsatta personen har med sjukvården. Det är viktigt att sjuksköterskor på akutmottagningar identifierar denna patientgrupp för att kunna erbjuda stöd och eventuellt förhindra ytterligare och mer allvarliga skador samt bråd död. Syftet med studien var att beskriva sjuksköterskors erfarenheter av att identifiera och handlägga patienter som utsatts för våld i nära relationer på akutmottagning. Metoden som användes för att besvara syftet var en allmän litteraturöversikt med strukturerad ansats. Datainsamling skedde i databaserna Cinahl, PubMed, PsycInfo samt SweMed. Vid sökning i databaserna användes årsintervallet 2010 till 2020. Som analysmetod valdes integrerad analys då det möjliggjorde att olika metodologier användes. Resultatet består av femton vetenskapliga artiklar. Resultatet belyser både hinder, möjligheter samt känslomässiga erfarenheter kring identifiering och handläggning av patienter som utsatts för våld i nära relationer. Påverkansfaktorer som framkom i resultat var tidsbrist, brister i akutmottagningens miljö, bristande kunskaper om handläggning och identifiering av våld i nära relationer, teamarbete, träning och erfarenheter, trygg vårdmiljö och sjuksköterskans ansvar, personliga erfarenheter och professionella erfarenheter. Slutsatsen påvisar att dessa olika faktorer möjliggör och hindrar identifiering och handläggning i våld i nära relation. Utbildningsinsatser i ämnet skulle kunna medföra förändringar i attityder, kunskap samt bidra till en ökad förståelse för de våldsutsatta patienterna i nära relation. Det skulle också kunna leda till att riktlinjer utvecklas och förbättras för att medföra en bättre och säkrare vård för denna patientgrupp samt en eventuellt bättre arbetsmiljö för hälso- och sjukvårdspersonal på akutmottagning.Violence in close relationships is today a major societal problem and emergency department are usually the first and only contact the vulnerable person has with healthcare. It is important that nurses in emergency departments identify this patient group in order to be able to offer support and possibly prevent further and more serious injuries and sudden death. The aim of the study was to describe nurses' experiences of identifying and treating patients who have been subjected to violence in close relationships in the emergency department. The method used to answer the purpose was general literature review. Data collection took place in Cinahl, PubMed, PsycInfo samt SweMed. When searching the databases, the annual interval 2010 to 2020 was used. Integrated analysis was chosen as the analysis method as it made it possible to use different methodologies.The result consists of fifteen scientific articles. The results shed light on both obstacles, opportunities and emotional experiences regarding the identification and handling of patients who have been subjected to violence in close relationships. Influencing factors that emerged in the results were lack of time, shortcomings in the emergency room environment, lack of knowledge about handling and identification of violence in close relationships, teamwork, training and experiences, safe care environment and the nurse's responsibility. The conclusion shows that these various factors enable and hinder identification and handling of violence in close relationships. Educational initiatives in the subject could lead to changes in attitudes, knowledge and contribute to an increased understanding of the abused patients in close relationships. It could also lead to guidelines being developed and improved to lead to better and safer care for this patient group as well as a possibly better working environment for health care staff in the emergency department.
41
Grunditz, Mauritz, e Daniel Johansson. "Ambulanssjuksköterskors upplevelser av att vårda patienter med suicidala tankar och handlingar : en strävan mot prehospital suicidprevention". Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-17319.
Testo completoAbstract (sommario):
Patienter med suicidala tankar och handlingar är en skör patientgrupp som är sårbara på grund av sitt sjukdomstillstånd. Omvårdnaden av dessa patienter är en stor utmaning för ambulanssjuksköterskan som många gånger är patientens första kontakt med vården i det akuta skedet. Vårdandet kräver ett stort personligt engagemang och kan spela stor roll för att förhindra suicid och påverka patientens framtida liv och välbefinnande. Denna studies syfte var att belysa ambulanssjuksköterskors upplevelser av att vårda patienter med suicidala tankar och handlingar. Kvalitativa djupintervjuer av åtta ambulanssjuksköterskor genomfördes. Dessa analyserades med kvalitativ innehållsanalys. Analysen resulterade i sexton underkategorier och fyra huvudkategorier. Huvudkategorierna var: Främjande av vårdrelation, Byggande av tryggt vårdrum, Känslomässig påfrestning samt Värdering av patientens önskan att dö. Resultatet visar två tydliga områden i vården av patienter med suicidala tankar och handlingar. Den ena upplevelsen var relaterad till bemötandet och omhändertagandet av patienten för att få fram information om patientens intention med sin handling. Den andra upplevelsen var relaterad till vårdarens egna känslomässiga påfrestning efter att ha vårdat en suicidal patient. Studien visar hur komplicerad och svår vården av suicidnära patienter är och att det ställs höga krav på ambulanssjuksköterskorna som vårdar dessa patienter. Efterfrågan på ökade utbildningsinsatser till ambulanssjuksköterskor gällande patientkategorin samt framtagande av behandlingsriktlinjer/bedömningsinstrument är något som studien påvisar.Program: Specialistsjuksköterskeutbildning med inriktning mot ambulanssjukvård
42
Palm, Bonita, e Emilia Sundberg. "Att skapa en god vårdrelation : En litteraturstudie om patienters erfarenheter av vårdrelationen med sjuksköterskan". Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-2191.
Testo completoAbstract (sommario):
Bakgrund: Vårdrelationen tycks ha stor betydelse för patientens välbefinnande och många faktorer kan påverka utvecklingen av relationen i en positiv riktning. Relationen ses främst som ett medel för att uppnå omvårdnadsmålen, men kan även utgöra ett mål i sig. Tidigare forskning fokuserar på när och hur vårdrelationen innebär ett vårdande för patienten. Studier som har ett helhetsperspektiv och en generell utgångspunkt i patienters preferenser avseende hur sjuksköterskan kan utveckla en god vårdrelation är få. För att kunna utveckla goda vård- relationer till sina patienter behöver sjuksköterskor förstå de faktorer som patienter upplever som betydelsefulla i den goda vårdrelationen. Syfte: Att beskriva faktorer som ur ett patientperspektiv har betydelse för en god vårdrelation mellan patient och sjuksköterska. Metod: För att få fördjupad kunskap om de faktorer patienter finner betydelsefulla för att en god vårdrelation ska utvecklas genomfördes en litteraturstudie av vårdvetenskapliga artiklar om patienters erfarenheter av vårdrelationen. Resultat: Studien resulterade i sex teman som beskriver patienternas förväntningar på sjuk- sköterskans kunskaper, egenskaper och handlingar inom ramen för den goda vårdrelationen. Patienterna värdesätter fysisk närvaro vid omvårdnaden, ett medmänskligt och respektfullt bemötande, att sjuksköterskan är professionell och förtroendeingivande, har ett personcent- rerat engagemang samt kommunikationsförmåga. Av sjätte temat framgår att patienten, och inte bara sjuksköterskan, lägger ner stora ansträngningar på att en vårdrelation ska utvecklas. Diskussion: Patienter vill bli sedda och respekterade som unika individer, med sina behov och förutsättningar. De vill möta en sjuksköterska som är intresserad och engagerad, inte bara i patienten som person, utan även i sin profession och utvecklingen av den, för att uppnå patientens främsta mål – nämligen förbättrad hälsa. Patienterna vill uppleva symmetri i engagemanget för relationen och utifrån detta gemensamt arbeta mot ökat välbefinnande. Resultatet har många beröringspunkter med Travelbees teori om mellanmänskliga relationer.
43
Lundberg, Amanda. "Skattad hanteringsförmåga och hälsorelaterad livskvalitet hos närstående till patienter med kronisk hjärtsvikt och stroke : - En jämförande studie". Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-17294.
Testo completoAbstract (sommario):
Syftet med studien var att jämföra skattad hanteringsförmåga och hälsorelateradlivskvalitet hos närstående till personer med kronisk hjärtsvikt och stroke. Ett annat syfte var också att studera om samband fanns mellan hanteringsförmågaoch hälsorelaterad livskvalitet. Metod: En komparativ och korrelativdesign med kvantitativ ansats användes. För att mäta hanteringsförmåga ochhälsorelaterad livskvalitet användes Jalowiec Coping Scale (JCS) och Shortform- 36 (SF- 36). Urvalsgruppen för studien var närstående till patienter med kronisk hjärtsvikt och stroke (n = 46). Resultatet visade att båda närstående grupperna använde mer optimistisk-, självtillit och konfrontativ stil. Närstående till patienter med stroke skattar sitt psykiska välbefinnande högre än närstående till patienter med kronisk hjärtsvikt(p=0,024). Det framkom flera låga och moderata negativa statistiska signifikanta samband mellan hälsorelaterad livskvalitet och hanteringsförmåga. De psykiska skalorna (SF-36) hade fler statistiska samband med coping stilar(JCS) än de fysiska skalorna. Konklusionen visade att närstående till patienter med kronisk hjärtsvikt skattar sin hälsorelaterade livskvalitet lägre på den psykiska välbefinnande än närstående till patienter med stroke. Generellt var att lägre användning av copingstilar hade mer samband med högre skattad hälsorelaterad livskvalitet.The aims of the study were to compare handling ability and health-related quality of life in next of kin to patients with chronic heart failure and stroke, as well as study correlations between handling ability and health-related quality of life. Method: A comparative and correlative design with quantitative approach was used. To measure handling ability and health-related quality Jalowiec Coping Scale (JCS) and Short Form-36 (SF-36) were used. The study group was next of kin to patients with chronic heart failure and stroke (n = 46). The results showed that both groups use most optimistic, self- reliant and confrontative coping styles. Next of kin to patients with stroke estimated mental health significantly higher than next of kin to patients with chronic heart failure (p = 0.024). There were several significant negative low-and moderate correlations between health-related quality of life and handling ability. In SF-36, the mental scales were more significantly associated with coping strategies (JCS) than the physical scales. Conclusions: Next of kin to patients with chronic heart failure rated health-related quality of life lower in the scale mental health than next of patients with stroke. Lower use of coping styles were more associated with higher health- related quality of life.
Att leva med långvarig ohälsa- hanteringsförmåga/resurser och upplevd livskvalitet
44
Lindell, Gabrielle. "Intensivvårdssjuksköterskors upplevelser av att vårda patienter som i självdestruktivt syfte överdoserat läkemedel". Thesis, Luleå tekniska universitet, Omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-65224.
Testo completoAbstract (sommario):
Självdestruktiva handlingar innebär att medvetet tillfoga sig skada. Hos personer som avsiktligt självskadar sig är suicidtankar vanligt förekommande men syftet kan vara ångestlindring och uttryck för psykiskt illabefinnande. Mellan 2005-2014 vårdades 77371 personer inom slutenvård på grund av avsiktlig självdestruktiv handling och risken för suicid är höjd efter en självdestruktiv handling. Syftet med denna studie var att undersöka intensivvårdssjuksköterskans upplevelse av att vårda patienter som avsiktligt överdoserat läkemedel i självdestruktivt syfte. Fem kvalitativa intervjuer med semistrukturerad intervjuguide analyserades med innehållsanalys och materialet utmynnade i fem kategorier samlade under ett tema: Att vilja men inte alltid kunna. Kategorierna var: Att känna hjälplöshet i den psykiatriska omvårdnaden, Att ha kännedom om patientens sammanhang, Att prioritera bort samtal, Att attityder påverkar samarbetet med kollegor, Att ha behov av samverkan och stöd från psykiatrin. Studien visade att upplevelsen av att vårda patienter som överdoserat läkemedel i självdestruktivt syfte påverkades av patientens bakgrund, social kontext och livssituation. Bakgrund i missbruk, låg ålder och kvinnligt kön medförde att handlingen upplevdes mer impulsartad. Upplevelsen av att vårda var komplex och intensivvårdssjuksköterskan kände sympati, frustration och otillräcklighet i omvårdnaden av patienten. Samarbetet på intensivvårdsavdelningen påverkades av attityder inom personalgruppen där intensivvårdssjuksköterskan kände sig ensam ansvarig för samtal kring självdestruktivitet och mående. Det förelåg svårigheter i det multiprofessionella teamarbetet samt i förmågan att uppnå holistisk och personcentrad vård. Intensivvårdssjuksköterskorna upplevde att samarbetet med psykiatrin var bristfälligt och hade negativ påverkan på upplevelsen. Intensivvårdssjuksköterskans upplevelse var att slitas mellan sympati och frustration. Den moraliska stressen kan leda till att patienten får bristfällig omvårdnad och risken för framtida suicid kan öka.
45
Neves, Ana Margarida Lopes das. "Efeitos da formação na prevenção de lesões músculo-esqueléticas da coluna lombar nos profissionais de saúde : revisão sistemática". Master's thesis, Universidade Nova de Lisboa. Escola Nacional de Saúde Pública, 2012. http://hdl.handle.net/10362/9708.
Testo completoAbstract (sommario):
RESUMO - A morbilidade associada às lesões músculo-esqueléticas da coluna lombar é estimada em 0,8 milhões de DALYS em todo o mundo, constituindo-se a maior causa de absentismo ao trabalho, o que induz uma enorme perda económica. Os profissionais de saúde são um grupo vulnerável a ocorrência de lesões-músculo-esqueléticas ligadas ao trabalho (LMELT), nomeadamente aqueles que mobilizam os doentes no seu dia-a-dia.
Perante a frequente perspetiva da imutabilidade da situação de trabalho, a pressão organizacional na prestação de cuidados e o reduzido número de recursos humanos, subsiste a implementação de programas centrados na formação dos profissionais de saúde sobre técnicas e mobilização de doentes, com o intuito de prevenir as LMELT inerentes a esta atividade.
O objetivo do estudo é analisar as principais intervenções descritas na bibliografia no que respeita ao impacto da formação dos profissionais de saúde sobre mobilização de doentes, nomeadamente enfermeiros, de modo a contribuir para a prevenção de LMELT ao nível da coluna vertebral.
Realizou-se uma revisão sistemática segundo a metodologia do Prisma Statement® nas bases de dados PubMed, Web of Science, B-On, JSTOR, Science, Nature, Scielo e IndeX, no período de 1998-2011, em Português, Inglês e Francês. Foram identificados 79 artigos. Após triagem e avaliação da qualidade dos estudos foram selecionados 11.
Verificou-se que não existe evidência científica que suporte o investimento em programas centrados na formação/informação dos profissionais de saúde acerca das técnicas de mobilização de doentes com o intuito de prevenir as lesões músculo-esqueléticas da coluna lombar. Constatou-se que os programas de intervenção multifatorial, apoiados na componente sistémica e integrada, permitem compreender as relações entre o trabalhador, o trabalho e os efeitos sobre a saúde, de forma a implementar medidas eficazes para a prevenção de LMELT.ABSTRACT - Morbidity from lumbar spine musculoskeletal disorders is estimated to be around 0.8 million DALYS worldwide and is the main cause of absenteeism from work, causing high economic and social losses. Healthcare professionals are one of the most vulnerable groups to work-related musculoskeletal disorders (WRMSD), namely those moving and handling patients everyday. Facing the frequent perspective of unchanging working conditions, organisational pressure on healthcare and the lack of human resources, programmes focused on training healthcare professionals in patient mobilisation techniques are implemented in order to prevent WRMSD associated with this activity. The aim of this study was to focus on the main interventions described in the bibliography concerning the impact of healthcare professional training on patient handling, more specifically nurses, with regard to helping to prevent WRMSD of the lumbar spine. A systematic review was conducted according to the Prisma Statement® method based on data from PubMed, Web of Science, B-On, JSTOR, Science, Nature, Scielo and IndeX, between 1998 and 2011, in Portuguese, English and French. 79 articles were found and after screening and assessing the quality of the studies, 11 were selected and analysed. There is no scientific evidence to warrant investment in programmes focused on healthcare professional training/information on patient mobilization techniques to prevent musculoskeletal disorders of the lumbar spine. Multifactorial intervention programmes based on systemic and integrative components allow us to understand the relationship between workers, their work and health-related issues and how to implement efficient WRMSD prevention measures.
46
Linde, Nina. "Allt är inte hopplöst; det finns fortfarande hopp : en litteraturöversikt om upplevelser av hopp och hopplöshet hos självmordsnära patienter och deras möte med vården". Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-3912.
Testo completoAbstract (sommario):
Background: Suicidal individuals are vulnerable patients in need of a caring relationship. A caring relationship should be based on a real presence were the patient's needs are in focus. Yet research has shown that suicidal patients experience caring that exacerbate their suicidial problems and hopelessness. Aim: To describe the experiences of hope and hopelessness in suicidal patients and their encounter with health care. Methods: In a literature review, in accordance with Friberg (2012) eight scientific papers have used, analyzed and scrutinized to answer the purpose of a new whole. Results: Two main themes emerged in the results with related subcategories. Experiences of hopegiving acts with sub-themes: The significance of a caring relationship, the significance of a strong social network and the significance of feelings of hopefulness. The second main theme that emerged was: Experiences of acts connected to hopelessness with subthemes: The significance of a non-confirmatory caring relationship and the significance of feelings of hopelessness. Discussions: It is found that suicidal patients experience care that lead to feelings of despair. Nursing theorist Rosemarie Rizzo Parse Human Becoming theory has been used as a basis for discussion in this literature review where a deepening of the results derived from the concept of a real presence. A real presence is all about the nurse's ability to share the lived situations of individuals and families in which hope can be expressed and shared.Bakgrund: Självmordsnära individer är utsatta patienter i behov av en vårdande relation. En vårdande relation ska baseras på en verklig närvaro där patientens behov står i fokus. Forskning har dock visat att självmordsnära patienter upplever vårdande som förvärrar deras självmordsproblematik och hopplöshetskänslor. Syfte: Att beskriva upplevelser av hopp och hopplöshet hos självmordsnära patienter och deras möte med vården. Metod: I en litteraturöversikt i enlighet med Friberg (2012) har åtta vetenskapliga artiklar använts, analyserats och granskats för att besvara syftet i en ny helhet. Resultat: Två huvudteman framkom i resultatet med tillhörande subkategorier. Upplevelser av hoppingivande handlingar med underteman: Betydelsen av en vårdande relation, betydelsen av ett starkt socialt nätverk och betydelsen av känslor av hoppfullhet. Det andra huvudtemat som framkom är: Upplevelser av handlingar förknippade med hopplöshet med underteman: Betydelsen av en icke-bekräftande vårdrelation och betydelsen av känslor av hopplöshet. Diskussion: Det framkommer att självmordsnära patienter upplever vård som leder till både känslor av hopp och hopplöshet. Omvårdnadsteoretikern Rosemarie Rizzo Parse Human becoming teori har använts som underlag för diskussionen i denna litteraturöversikt där en fördjupning av resultatet härletts till konceptet verklig närvaro. En verklig närvaro handlar om sjuksköterskans förmåga att dela levda situationer med individer och anhöriga i vilka hopp kan uttryckas och delas.
47
Nkhebenyane, Jane Sebolelo. "Microbial hazards associated with food preparation in Central South African HIV/Aids hospices". Thesis, Bloemfontein : Central University of Technology, Free State, 2010. http://hdl.handle.net/11462/135.
Testo completoAbstract (sommario):
Thesis (M. Tech.) -- Central University of Technology, Free State, 2010South Africa currently faces one of the highest HIV prevalence rates in the world. As this prevalence rises, the strain placed on its hospitals is likely to increase due to the shortage of beds. The devastating effects of HIV/AIDS initiated the establishment of a hospice which is a non-governmental organisation whose goal is the provision of care for terminally ill patients, either in their homes, in hospitals or in a hospice’s own in-patients wards. Part of the hospice’s mission is to offer palliative care without charge to anyone who requires it. The basic elements of hospice care include pain and symptom management, provision of support to the bereaving family and promoting a peaceful and dignified death. This also includes the provision of cooked foods to the patients using the kitchen facilities of the hospices for this activity. It is well known that the kitchen is particularly important in the spread of infectious disease in the domestic environment due to many activities that occur in this particular setting. Food and water safety is especially important to the persons infected with the human immunodeficiency virus (HIV) or with immunodeficiency syndrome (AIDS).It is estimated that food-borne pathogens (disease–causing agents) are responsible for 76 million illnesses, some resulting in death, in the United States alone every year. In one study of patients with AIDS, two-thirds had diarrhoeal disease and in two-thirds of these, the following enteric pathogens were identified: Salmonella, Shigella, Listeria, Yersnia, Cryptosporidium, Entamoeba histolylica and Campylobacter sp. In an epidemiological study of patients with HIV infection a close association was found between consumption of raw or partially cooked fish and antimicrobial-resistant Mycobacterium avium complex. Antibiotic resistance in food-borne pathogens has become a reality and this poses a serious threat to the medical fraternity since it diminishes the effectiveness of treatment. This study was undertaken to determine the prevalence of foodborne pathogens including bio aerosols isolated from the kitchen surfaces and food handler’s before and after cooking. The antibiotic resistance of the isolated pathogens was further determined to assess their impact on treatment. The following microbiota were isolated: Total viable counts (TVC), Coliforms, Escherichia coli, Staphylococcus aureus, Pseudomonas and presumptive Salmonella. The hospices had high counts of E.coli and S.aureus on the cutting boards for the breakfast session compared to the traditional home based kitchens. It was speculated that this could have originated from crosscontamination via the foodhandler’s hands and the food served. It is evident from the results that hospices lack a management system regarding the prevalence of E. coli as it was present on the cutting boards throughout the food preparation sessions. Gram negative organisms (coliform and P. aeruginosa) were in particular both resistant to oxacillin and this pose a great challenge in this particular setting. This can be addressed by putting emphasis on hygiene as a strategy per se for reducing antibiotic resistance.
48
Trollvik, Anne. "Barn med astma og deres foreldre : læring, deltakelse og samarbeid". Doctoral thesis, Nordic School of Public Health NHV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3750.
Testo completoAbstract (sommario):
Bakgrunn og hensikt: Astma er den hyppigste kroniske sykdommen i barnealderen, den påfører barn og familierpersonlige og sosiale påkjenninger samtutgjør et betydelig folkehelseproblem. For å handtere hverdagen trenger barna og foreldrene kunnskap. Det overgripende målet med avhandlingen er å utvikle læringstilbud til barn og foreldre der den pedagogiske tilnærmingen tar utgangspunkt i barns, foreldres og helsepersonells vurderinger om hva som er viktig å lære. Metode: Avhandlingen inkluderer 5 studier (I–V) ut fra 2 prosjekter som forgikk på en barneavdeling i Norge, i 1995–1998 og 2004–2007. I studie I og IIble hermeneutisk fenomenologi brukt der 9 foreldre deltok i dypintervju. I studie IIIble innholdsanalyse brukt i et aksjonsforsknings prosjekt, handlings-orientert forskningssamarbeid, der 90 personer deltok. I studie IV ble hermeneutisk fenomenologi brukt der 15 barn i alderen 7–10 år tegnet og deltok i dypintervju. I studie V ble innholdsanalyse brukt der samhandlingen mellom 3 barn og 2 helsepersonellble observerti et læringstilbud. Resultateneviser at både barn med astma og foreldrene erfarte engstelse og redsel i hverdagen (I,IV). Foreldrene uttrykte følelser av usikkerhet,hjelpeløshet og skyld (I). Barna var redde for forverrelser av astmaenog hvordan sykdommenpåvirket kroppen. De brukte mange forskjellige ord når de beskrev astma.De kjente astma i hele kroppenogsituasjonenkunne endre seg raskt fra vanliglek til at all energi var borte. Barna var redde for å bli utestengt fra lek og aktivitet, og opplevde det som et dilemma om de skulle fortelle om astmaen til andre eller holde det hemmelig(V). Både barn og foreldre erfarte det å dele erfaringer i gruppe som betydningsfullt (II, V). Barnas perspektiv og deltakelse ble ivaretatt gjennom intervensjonsfasen, mens barneperspektivet ble ivaretatt av voksne gjennom hele prosjekt 2 (III). I læringstilbudet kjente barna seg trygge, var aktive, lærte av hverandre og satte ord på egne følelser(IV). Fortellinger og bilder fungerte godt i pedagogisk tilnærming til barn. Barnas egne tegninger var et godt redskap for å kommunisere med barn og for å få tilgang til deres livsverden(V). Konklusjon: Denne avhandlingen viser at for å støtte barn og foreldre til å handtere astma i hverdagen, er det viktig at helsepersonell legger tilrette for læring ved å utforme læringstilbud som tar utgangspunkt i deres perspektiver. Det at barna selv er aktive, at deres egne erfaringer brukes og verdsettes i dialogen, viser et nedenfraperspektiv som er en god kilde til empowerment-prosesser. Slike prosesser styrker barna i troen på egne krefter og gir dem handlekompetanse. Læringsprosessene som er beskrevet i meningsfull læringvil styrke barnas begripelighet, handterbarhet og meningsfullhet og derved styrke barnas Sense of Coherence (SOC). Ved styrket SOC vil barna i større grad mestre utfordringer i livet og derved oppnå bedre helse og livskvalitetBackground and aim: Asthma is the most common chronic childhood disease,many children and families are personally and socially affected which makes asthma a public health problem. The overall aim of this thesis was to develop an asthma education programme for children with asthma and their parents, where the pedagogic approach takeschildren’s, parents’and health care personnel’s experiences and views as a starting point. Methods: This thesis includes 5 studies (I–V) from 2 projects performed in a paediatric ward in Norway in 1995–1998 and 2004–2007. In studies I and IIa hermeneutic phenomenological approach was used, in which 9 parents participated in qualitative research interviews. In study III, 90 persons participated in a co-operative inquiry. Data were analysed by content analysis. Study IV used a hermeneutic phenomenological approach: 15 children (7–10 years of age) participated in qualitative research interviews. In study V, 3 children and 2 health care personnel participated in an observational study. Content analysis was used in the analysis. The results showed that both the children and the parents experienced fear in their experiences of asthma in everyday life (I, IV). The parents expressed feelings of uncertainty, helplessness and guilt (I). The children experienced fear of exacerbations and how the asthma affected their bodies. They used many different words when they described how asthma affected them. They felt asthma in their whole body,and the condition could change quickly. The fear of being ostracised concerned all aspects of the children’s livesand they related a dilemma of keeping the asthma secret or being open about it (V). Sharing experiences in group settings was experienced as meaningful to both children and parents (II, V). The adult’s child perspectives were taken into account throughout the project, while the children’sown perspectives were taken into account during the period of intervention (III). During the asthma education programmethe children actively participated and learned from each other. As the pictures and stories were related to their experiences made it easier for them to express their own feelings. Drawings were a good way toinitiate a dialogue with the children and to get access to their lifeworld (V). Conclusion: This thesis shows that in order to support children and parents to cope with asthma, it is crucial to build on their perspectives in learning processes. Active involvement of the children shows a bottom-up perspective that can lead to confidence in their own strength and empowerment. Overall, this approach corresponds to an educational approach and learning theory that takes meaningful learning into account. Meaningful learning strengthens children’s comprehensibility, manageability and meaningfulness and their Sense of Coherence (SOC). A strong SOC leads to better health and a better quality of life
49
Reichert, Paul. "Patient handling ergonomics". Thesis, 2004. http://library1.njit.edu/etd/fromwebvoyage.cfm?id=njit-etd2004-011.
Testo completo
50
Cheng, Yu-Sheng, e 鄭又升. "Patient Handling Methods and Musculoskeletal Disorders among Nurses". Thesis, 2012. http://ndltd.ncl.edu.tw/handle/27344937724036132427.
Testo completoAbstract (sommario):
碩士國立臺灣大學
職能治療研究所
100
Nurses have one of the highest prevalence of musculoskeletal disorders （MSDs） among all the occupations and healthcare practitioners, resulting in nursing shortage and decreasing the quality of healthcare. The main cause of musculoskeletal injuries in nurses is showed to be patient handling. Patient handling can be carried out in different methods and may have varied risks for musculoskeletal system. However, previous research to compare the risks of MSDs by different patient handling methods was mostly done in laboratory context. Until now few studies examined nurses'' patient handling methods in working situation and its impact on MSDs. Thus, the purposes of this study include: 1) To survey MSDs (prevalence, affected body parts, pain intensity, and functional impact on work) among nurses in Taiwan. 2) To examined patient handling tasks (frequency, perceived exertion, and patient handling methods such as types of assistive technology and number of executors) executed by hospital nurses in Taiwan. 3) To identify potential risk factors including demographic and workplace characteristics and variables of patient handling tasks for number of prevalent body parts among hospital nurses in Taiwan. The results may provide the strategies for preventing MSDs among nurses in Taiwan. In this cross-sectional study, a questionnaire survey was carried out among nurses in one medical center, four metropolitan hospitals and belonging nursing homes in northern Taiwan. A self-reported questionnaire was used to investigate 1) demographic and workplace characteristics. 2) MSDs of neck, shoulder, upper back, lower back, elbow, wrist/hand, hip, knee, ankle/foot. 3) Nurses'' performance of 10 patient handling tasks. Questionnaires were distributed by nursing stations, and 470 valid questionnaires were collected. The 6-month prevalence of MSDs at any body parts was 88.3%, and half of the participants reported at least MSDs of four body parts. Lower back (77.2%）, neck (64.2%）and shoulder (58.7%） were the most prevalent body parts. Nurses with wrist/hand complaints had the highest proportion (21.6%) of severe functional impact on work and absence from work due to MSDs, followed by nurses with lower back complaint s (20%). There''s a significant difference of MSDs prevalence of shoulder, upper back, wrist/hand, and ankle/foot among different wards. In general, surgical, intensive care, and long-term care units had higher prevalence of MSDs, contrary to internal medical and emergency units. The prevalence of lower back MSDs is high among all units, and up to 92~95.7% in neurosurgical and neurology units, implicating the common issue of lower back pain. All surveyed patient handling tasks were executed by at least 60% of nurses in Taiwan. Four patient handling tasks in bed (moving in the bed, turning or rolling over in bed, from lying to sitting in bed, from bed to bed）were performed by at least 90% of surveyed nurses, and these four tasks were with the highest frequency and patient handling burden (defined as frequency multiply by scores of perceived exertion）. In addition, "from bed to chair/wheelchair with patients unable to sit up " and "up from floor" were two tasks that had the highest perceived exertion and highest perceived extent to cause MSDs. These six tasks mentioned above had high priority to pay attention for. In average, nurses in Taiwan preferred to use transfer equipment in four out of ten patient handling tasks, and the other tasks were mostly carried out manually. Four tasks in bed had the highest proportion to use transfer equipment, ranging from 55.4% to 93.8%. The equipment most often used was bed sheets, slide boards/ slippery sheets, and electric beds. Ordinal regression analysis showed that older age, married, graduate school, certain wards (long-term care, surgical, intensive care), higher patient handling burden, and higher loads due to manual patient handling were the risk factors for more body parts with MSDs. In conclusion, the burden and methods of patient handling were both risk factors for MSDs among nurses in Taiwan. Appropriate transfer equipment and education on how to properly handle patients is needed to decrease the burden of patient handling and its unhealthy impact on MSDs among nurses.