Дисертації: "Qualitative patient interviews"

1

Collier, Sarah E. "Perspectives from Adolescents with Secondary Mitochondrial Disease." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1491317275179069.

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Gäfvert, Matilda, and Caroline Laursen. "Home Care in Thailand A Qualitative Study of Patients‟ Experience of Being Cared in Their Own Home." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20243.

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This study is sponsored by Minor Field Study (MFS) scholarships from the University of Borås, funded by the Swedish International Development Cooperation Agency (SIDA). Thailand is a densely populated developing country situated in Asia. The relatives are the most important social network in Thailand. People all over the world, including Thai people are in need of aftercare when they have left the hospital. In Thailand this care mostly executed by relatives.There is not much research done that shows the patient‟s perspective of home care in Thailand so it is important to do this study. The aim of the study is to illuminate the Thai patients‟ perspective of being cared in their own home. The qualitative interviews were made with six patients at a hospital in Bangkok. The authors had one in beforehand-prepared question, but had to put in some stimulating questions in all of the interviews. To describe and analyze the result the authors did qualitative content analysis. The criteria to take part in this study were that the interviewees were Thai, over 25 years old and had experiences of being cared in their own home, by relatives or by professionals.The result is presented with meanings units, codes, sub-categories, categories and content areas. The content areas are; the patient does not experience any problems with home care and the patient experience problems with home care. The categories are good experiences and naturally and hard experiences. The authors then made sub-categories and named them; safety, family as caregiver is expected, solidarity, grateful, sense of guilt, insecure and hard to be dependent.The authors found out that all the interviewees experienced home care as something naturally, when it is a part of life to be cared by your relatives in Thailand. This expression fits in under the first content area, but some of the interviewees also expressed feelings that fit in under the opposite content area. In the end of the study the authors discusses different choices that they have done, and the consequences that followed with them, in a discussion of the method. Even the use of an interpreter is discussed in this part. In the discussion of the result the authors discusses the most interesting parts of the result and verify this with references from scientific articles. One thing that the authors found out was that home care in Thailand can be expressed with both positive and negative experiences from the same person.
Program: Sjuksköterskeutbildning

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Crispin, Vivianne. "Information exchange between patients and nurses during routine nursing care in ward settings : a qualitative multiple case study." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21158.

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Aim: This study explores what type of information patients and nurses share with, or provide to, each other, and whether or not the information received was relevant and sufficient for their needs. Background: Information exchange, as part of shared decision-making, is advocated in policy and practice throughout the healthcare sector. Much of the literature on information exchange relates to one-to-one consultations with consultants or GPs. To date, no studies have explored information exchange between patients and nurses in ward settings. Nursing literature on patients’ information needs focuses on one-way information provision from nurses to patients, rather than on two-way information exchange between patients and nurses. Methods: Interactions between patients and nurses were observed and audio-recorded using a remotely controlled audio-recording system. Semi-structured individual face-to-face interviews were then conducted to clarify and add to the observation data. A multiple case study design was used for this study: each case comprised one patient, the nurses caring for that patient, and the interactions between them. A pilot study was undertaken to inform the methods for recruitment and data collection for the main study. Results: The pilot study comprised five cases (patients n=5, nurses n=3). Changes to the recruitment strategy for the main study included surgical patients being invited to participate in the same way as medical patients. There were no difficulties with the data collection methods. The main study comprised nineteen cases (patients n=19, nurses n=22). Information exchange seemed unfamiliar to ward-based nurses. The findings show that information exchange may not be a one-off event but a complex series of interactions. Patients did not distinguish between clinical and non-clinical information in the same way as nurses. Primary reasons for patients’ hospital admission were not discussed and nurses did not share information about nursing interventions. The relevance for patients and nurses differed; patients generally wanted information for reducing anxiety and socialization; nurses wanted information for assessment and care planning. In terms of sufficiency, observation sessions highlighted that insufficient information was provided, often due to lost opportunities and paternalistic practice. However, the majority of patients and nurses perceived that they had exchanged sufficient information. Conclusion: This multiple case study provides insights into the type, relevance and sufficiency of information for patients and nurses in ward settings. In ward settings, information exchange as conceptualised by Charles et al. (1997 and 1999) may be difficult to achieve due to the complexity of patient/nurse interactions. Therefore, there are implications for policy makers as policies are not context specific. However, information exchange may be helpful for reducing patients’ anxieties. The concepts of shared decision-making and information exchange are not part of ward-based cultures and philosophies, which suggests implications for patient and nurse education. Research on information exchange between patients and nurses in other ward contexts may contribute to further understanding of information exchange in ward settings.

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Siqueira, Anna Carolina Arena. "Os significados atribuídos às LER/DORT na relação médico-paciente: um estudo entre médicos peritos do INSS/SP e pacientes portadores de LER/DORT usuários do CEREST/SP." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-11032008-142450/.

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O presente trabalho objetivou a apreensão dos significados e concepções acerca do adoecimento pelas LER/DORT, para médicos peritos do INSS/SP e portadores de LER/DORT do CEREST/SP. Para tanto, foi empregada metodologia qualitativa, utilizando-se como instrumento de coleta de dados a entrevista em profundidade, com roteiros distintos para médicos peritos e portadores de LER/DORT. Foram entrevistados três médicos peritos, todos do sexo masculino, com idades entre 50 e 65 anos e mais de 10 anos de experiência em perícias médicas e, no outro pólo da investigação, participaram do estudo seis portadores de LER/DORT, pacientes do serviço de atendimento ambulatorial do CEREST/SP, sendo cinco do sexo feminino e um do sexo masculino, com idades entre 35 e 55 anos, todos empregados no setor de serviços e em afastamento pelo INSS. Ao material coletado foi aplicada análise de conteúdo temática da qual foram extraídos três eixos temáticos mais abrangentes: os sujeitos de pesquisa, o trabalho e a relação médico-paciente em contexto de perícia médica. Foi possível apreender que a relação médico-paciente que se estabelece entre peritos e portadores de LER/DORT é peculiar já que, a perícia consiste em ambiente de consulta médica permeado pelo julgamento da lei previdenciária. Nesse contexto, ocorre o embate entre portadores de LER/DORT, que levam ao momento da perícia a expectativa do atendimento direcionado à assistência e do reconhecimento de sua condição, e médicos peritos, cuja atuação está direcionada à determinação da capacidade para o trabalho e limitada por normas institucionais, fator de tolhimento ao exercício de sua autonomia profissional.
The present work has aimed at the comprehension of meanings and conceptions concerning RSI illnesses to INSS/SP medical examiners and RSI patients from CEREST/SP. In order to achieve that, the qualitative methodology was chosen making use of thorough questioning as an instrument of data collection, having distinct scripts to medical examiners and RSI patients. Three medical examiners were interviewed, all male, ranging from 50 to 65 years old, having at least 10 years of experience as professionals in the area. On the other side of the investigation, six patients with RSI from the ambulatory care CEREST/SP were interviewed, 5 female and 1 male, ranging from 35 to 55 years old, all employees to the service sector on leave of absence by the INSS. Thematic content analysis was applied to the collected material, from which three main thematic axes were extracted: the subjects to this study, the work and the doctor-patient relation regarding medical examination. It has been possible to comprehend that the relation doctor-patient established among examiners and patients with RSI is peculiar, since the examination takes place in a doctor\'s office environment permeated by the judgment of the social security law. Within this context, there is a hassle among RSI patients, who take to the moment of their examination their apprehension directed to the assistance and recognition of their condition, and medical examiners, whose expertise is directed to the establishment of the work capability limited by institutional rules, what is a restricting factor in the exercise of their professional autonomy.

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Small, Nicola. "Patient empowerment in long-term conditions : development and validation of a new measure." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/patient-empowerment-in-longterm-conditions-development-and-validation-of-a-new-measure(b85db41b-5898-4c51-a180-78439eb94ea7).html.

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Background: Patient empowerment is viewed as a priority by policy makers, patients and practitioners worldwide. Although there are a number of measures available, none have been developed specifically for patients in the UK with long-term conditions. It is the aim of this study to report the development and preliminary validation of an empowerment instrument for patients with long-term conditions in primary care.Methods: The study involved three methods. Firstly, a systematic review was conducted to identify existing empowerment instruments, and to describe, compare and appraise their content and quality. The results supported the need for a new instrument. Item content of existing instruments helped support development of the new instrument. Secondly, empowerment was explored in patients with long-term conditions and primary care practitioners using qualitative methods, to explore its meaning and the factors that support or hinder empowerment. This led to the development of a conceptual model to support instrument development. Thirdly, a new instrument for measuring empowerment in patients with long-term conditions in primary care was developed. A cross-sectional survey of patients was conducted to collect preliminary data on acceptability, reliability and validity, using pre-specified hypotheses based on existing theoretical and empirical work. Results: Nine instruments meeting review inclusion criteria were identified. Only one instrument was developed to measure empowerment in long-term conditions in the context of primary care, and that was judged to be insufficient in terms of content and purpose. Five dimensions (‘identity’, ‘knowledge and understanding’, ‘personal control’, personal decision-making’, and ‘enabling other patients’) of empowerment were identified through published literature and the qualitative work and incorporated into a preliminary version of the new instrument. A postal survey achieved 197 responses (response rate 33%). Almost half of the sample reported circulatory, diabetic or musculoskeletal conditions. Exploratory factor analysis suggested a three factor solution (‘identity’, ‘knowledge and understanding’ and ‘enabling’). Two dimensions of empowerment (‘identity’ and ‘enabling’) and total empowerment showed acceptable levels of internal consistency. The measure showed relationships with external measures (including quality of chronic illness care, self-efficacy and educational qualifications) that were generally supportive of its construct validity.Conclusion: Initial analyses suggest that the new measure meets basic psychometric criteria and has potential for the measurement of patient empowerment in long-term conditions in primary care. The scale may have a role in research on quality of care for long-term conditions, and could function as a patient-reported outcome measure. However, further validation is required before more extensive use of the measure.

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Koehn, Amy R. "To report or not report : a qualitative study of nurses' decisions in error reporting." Thesis, Indiana University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3665927.

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This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses' decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit's expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses' experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates.

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Nordin, Cecilia, and Elin Eklund. "Women's trust in maternal health care : A qualitative interview study about nurses' experiences within primary health care in Ghana." Thesis, Röda Korsets Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2255.

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Background: In Ghana, many women die every year due to preventable causes related to pregnancy and child birth. Several national strategies have been made to improve women’s access to essential maternal health care. Still there is a significant inequality in the number of women attending to maternal health care in between different parts of the country. An important determinant that affects women’s utilization of the subsidized maternal health care is the quality of health care, including the health providers’ attitudes to their patients. Aim: The aim of this study was to describe nurses’ experiences of interacting with women in a maternal health care context within primary care in Ghana. Method: Five qualitative semi-structured interviews were conducted at three different primary health care clinics. Content analysis was used to analyse the data. Results: Three main-themes, patient compliance, building trust and nursing strategies and ten sub-themes were identified. Conclusion: Although the nurses expressed a desire to have more women attend maternal health care, they seemed unaware of how their own behaviour might contribute to the current underutilization. A hierarchical power imbalance within the nurse-patient interactions, where the patients were perceived and treated as subordinate passive receivers of the nurses’ expertise, was identified. The nurses’ lack of critical approach towards their own actions might be at the source of this underutilization. Suggestion for further research: The authors recommend further studies to explore nurses’ ability to allow self-reflective critical thinking and also how implementation of a more patient-centred approach in Ghana would affect the quality of health care.
Bakgrund: Varje år dör många kvinnor i Ghana på grund av förebyggbara komplikationer relaterade till graviditet och förlossning. Flera nationella strategier har genomförts i syfte att ge fler kvinnor tillgång till nödvändig mödrahälsovård. Trots det råder en signifikant skillnad i andel kvinnor som söker mödrahälsovård mellan olika delar av landet. En viktig faktor som påverkar utnyttjandet av den subventionerade mödrahälsovården är vårdkvaliteten, inklusive vårdpersonalens bemötande. Syfte: Syftet med denna studie var att beskriva sjuksköterskors erfarenheter av bemötande av kvinnor i en mödrahälsovårdskontext inom primärvården i Ghana. Metod: Fem kvalitativa semistrukturerade intervjuer genomfördes vid tre olika primärvårdskliniker. Innehållsanalys användes for att analysera insamlad data. Resultat: Tre huvudteman, patientföljsamhet, bygga förtroende och omvårdnadsstrategier och tio underteman hittades i resultatet. Slutsats: Trots att sjuksköterskorna uttryckte en vilja att få fler kvinnor att nyttja tillgänglig mödrahälsovård så verkade de omedvetna om hur deras eget agerande skulle kunna bidra till att kvinnorna väljer att inte söka vård. En hierarkisk maktobalans inom sjuksköterskornas vårdrelation med patienterna framträdde genom intervjuerna, där patienterna sågs och bemöttes som underordnade, passiva mottagare av sjuksköterskornas expertis. Sjuksköterskornas brist på kritiskt förhållningssätt till egna insatser kan göra att de oavsiktligt arbetar emot sina egna mål. Förslag på fortsatta studier: Ytterligare studier för att utforska sjuksköterskors förmåga att tillämpa kritiskt tänkande rekommenderas samt vilken nytta det skulle vara för kvaliteten på omvårdnaden om ett mer patientcentrerat förhållningssätt implementerades inom vården i Ghana.

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Lindbom, Alexandra, and Frida Mårtensson. "Amputation av en extremitet : upplevelsen av att förlora en kroppsdel." Thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-17696.

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Bakgrund: Att förlora ett ben innebär en påfrestning på livet och livskvalitén sänks. Amputation betyder att skadad vävnad och skelett avlägsnas och det kan bero på trauma, cirkulatorisk svikt eller infektioner. Syfte: Var att beskriva upplevelsen av att ha förlorat en nedre extremitet genom amputation. Metod: Allmän litteraturöversikt användes för att sammanställa och skapa en översikt över befintlig forskning. Analysmodellen var induktiv utifrån Fribergs trestegsmodell. Resultat: Fem huvudkategorier med tillhörande underkategorier sammanställdes. De fem huvudkategorierna var; upplevelser av hur livet förändrats och hur andra ser på en själv, upplevelsen av information och stöd från sjukvården, hjälpmedel som hinder eller möjlighet till självständighet, att behöva socialt stöd på vägen mot ett nytt liv och positivt tänkande – en nyckelfaktor. Diskussion: Litteraturstudien visade att behovet av information var av stor vikt under hela amputationsprocessen, de amputerade upplevde att det var lite information som gavs ut och det skulle vara relevant att ge ut information både muntligt och skriftligt. Litteraturstudien visade också att protesen spelade en stor roll för synen på framtiden. Många såg den som nyckeln tillbaka till det tidigare livet och till ökad självständighet. Vidare föreslås mer forskning med kvalitativt tillvägagångssätt avseende de psykiska aspekterna hos såväl de amputerade som deras anhöriga.

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Persson, Evelina, and Emmie Lindgren. "Nurses´ experiences when caring for patients infected with malaria in Tanzania : A qualitative interview study." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-47551.

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Background: Malaria is one of the mosquito-transmitted diseases that is killing millions of people every year, with the highest prevalence in Africa. In Tanzania, more than 90 percent of the inhabitants are at risk of being infected with malaria. The malaria parasite Plasmodium falciparum does not obtain specific symptoms and differential diagnoses can make it difficult to diagnose malaria. If malaria gets developed into a severe stage, it can affect organs and eventually cause death. Nurses have the role to educate inhabitants on how to prevent malaria. Purpose: The aim of this study was to describe nurses ́ experiences when caring for patients infected with malaria in Tanzania. Method: Study with a qualitative approach. A content analysis with a manifest structure was carried out, based on individual semi-structured in-depth interviews with nurses. Result: Nurses found it difficult to differentiate malaria from other diseases, like typhoid or meningitis. Nurses focused mostly on patients’ physical by working with medical treatment and education about malaria prevention. Conclusion: This study highlighted the importance for nurses of being educated about malaria and knowing how to assess its condition as it can be a mortal disease.

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Car, Josip. "Exploring notions of patient-doctor partnership in South Asian and European people with asthma : qualitative interview study." Thesis, Imperial College London, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.423182.

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11

Torbjörnsson, Eva, and Sandra Kollberg. "The lived experience in patients with screening-diagnosed Abdominal Aortic Aneurysm (AAA). : A qualitative interview study." Thesis, Umeå universitet, Institutionen för omvårdnad, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-61626.

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Kollberg, S. Torbjörnsson, E. (2012). The lived experience in patients with screening-diagnosed abdominal aortic aneurysm (AAA). ABSTRACT The aim of this study was to describe the patients’ experiences of living with the knowledge of having an abdominal aortic aneurysm (AAA) that was found during screening. Eleven patients from two different screening centers, with initially measured aneurysms of 40-46 mm, were invited to participate in the interview study. Three of the men declined to participate, so in total eight men were interviewed. The interviews were analyzed by qualitative content analysis. Four categories were identified: the informant’s reasons for taking part in the screening program for abdominal aortic aneurysm, the experience of the screening, the experience of living with their abdominal aortic aneurysm and the thoughts on the present screening program. The result showed that the men joined the screening program (SCP) with very little knowledge of both aneurysms and the purpose of the screening. In connection with the ultrasound the men became upset over the information about them having an AAA. After they had received information about the diagnose from the vascular surgeon , all of the men felt soothed and understood that despite of their aneurysm, they could continue to live their life as they used to do. The men didn’t believe that the AAA affected their lives, though most of them had made changes in their way of living. The result of this interview study shows that the men experience a lack of information between the ultrasound and the appointment with the physician. It could be of interest to investigate if an aortic nurse with the same function as the breast nurse in the mammography screening could be the solution of this problem. Keywords: Abdominal Aortic Aneurysm, screening, information
Kollberg, S. Torbjörnsson, E. (2012). The lived experience in patients with screening-diagnosed abdominal aortic aneurysm (AAA). SAMMANFATTNING Syftet med den här studien var att beskriva patienternas upplevelse av att leva med kunskapen av att ha en förstorad kroppspulsåder som är hittat via screening. Elva patienter från två olika screeningcenter, med en ursprunglig diameter på sin aorta uppmätt till 40 – 46 mm, bjöds in för deltagande i studien. Tre avböjde att delta, så totalt utfördes åtta intervjuer. Intervjuerna analyserades med kvalitativ innehållsanalys. Fyra kategorier identifierades: Informanternas anledning till att delta i screeningprogrammet, upplevelsen av screeningen, upplevelsen av att leva med AAA och patienternas tankar om det nuvarande screeningprogrammet. Resultatet visade att männen deltog i screeningsprogrammet (SCP) med en begränsad kunskap både om vad aneurysm är och vad syftet med screeningen är. I samband med ultraljudsundersökningen blev männen upprörda över beskedet att de har ett förstorat aneurysm, men efter besöket hos en kärlkirurg som gav information om diagnosen blev de lugnade och förstod att det går bra att fortsätta leva som vanligt trots deras diagnos. Männen i studien tyckte inte att diagnosen påverkade de i deras dagliga liv, trots att många av dem hade genomfört förändringar. Resultatet av den här studien visar att männen upplever en brist i informationen mellan ultraljudsundersökningen och besöket hos läkaren. Det skulle vara intressant att se om en aortasjuksköterska, med samma funktion som en bröstsjuksköterska inom mammografiscreeningen har, skulle kunna vara en lösning på problemet. Nyckelord: Abdominellt aorta aneurysm, screening, information Abstraktet är justerat efter instruktioner i Journal of Vascular Nursing

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Ekenberg, Marie. "Swedish diabetes patients’ experiences of using GLP-1 receptor agonists (GLP-1 RAs) : A qualitative interview study." Thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-434750.

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Background: The world prevalence of diabetes mellitus in 2019 was 8.3%, out of which 85-90% have type 2 diabetes mellitus (T2DM). Numerous drugs for treating T2DM are approved, and one of the newer classes of drugs are GLP-1 receptor agonists (GLP-1 RAs). In Sweden during 2015 to 2019, the number of patients using GLP-1 RAs has increased by 280%. Despite this, few studies have explored the experiences of patients using these drugs. Aim: The aim of this study was to gain knowledge about how patients diagnosed with T2DM experience and understand their treatment with GLP-1 RAs in Sweden. Methods: Individual semi-structural interviews were conducted with seven patients and three persons from the healthcare staff during October and November 2020 in Region Uppsala, Sweden. The data was analyzed qualitatively with systematic text condensation. Results: The four main findings were: 1) Both patients with great effect and less effect were satisfied with treatment and preferred GLP-1 RAs compared to their other treatments, 2) GLP-1 RAs may have an impact on lifestyle by effect on appetite and hunger and through the stability in glucose level, more freedom, 3) The preferred administration frequency depended on how easy it was to remember taking the drug, 4) Patients mostly understood their treatment as well as they wanted to, but regular initiation follow-ups and more explanations of decisions could increase treatment motivation and reduce anxiety.The healthcare staff confirmed these experiences by patients but assumed patients preferred weekly administrations compared to daily administrations. Conclusions: Patients’ experiences of using GLP-1 RAs were positive and they described GLP-1 RAs as the best T2DM treatment they had.

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Elias, Robert. "How decisions about renal replacement therapy are made : a qualitative study using interviews with patients and health care workers." Thesis, St George's, University of London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.530509.

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Viksveen, Petter. "Can self-reported depression be helped by homeopaths? : a pragmatic cohort randomised controlled trial with qualitative interviews with patients." Thesis, University of Sheffield, 2015. http://etheses.whiterose.ac.uk/11875/.

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Introduction: Depression is a common health problem. Some patients seek help from homeopaths as a complement or an alternative to conventional treatment. This may be due to reluctance to using or insufficient effect of “talking therapies” or antidepressants, or side-effects of such drugs. Insufficient evidence exists to determine whether homeopathy is acceptable, effective and safe. Aims: To evaluate the effectiveness of offering adjunctive treatment by homeopaths to patients with self-reported moderate to severe depression, and assess acceptability and safety. Methods: A pragmatic cohort multiple randomised controlled trial design was used. One third who fulfilled inclusion criteria were randomly selected to be offered a course of treatment by a homeopath. The primary outcome was the Patient Health Questionnaire (PHQ-9), 6 months post-randomisation. An intention-to-treat analysis compared “Offer” and “No offer” groups. An instrumental-variables-analysis (IV) assessed effects of received treatment. Safety was assessed through patients’/practitioners’ reports. Qualitative interviews were used to learn about patients’ experiences. Results: The full sample (n=566) was recruited. One third (n= 185) were randomly selected to the “Offer group” were offered treatment by a homeopath, 40% (n=74/185) accepted the offer of treatment. Four-hundred-and-fifty-eight (81%) responded to the 6 month questionnaire. At 6 months, the “Offer” group (ITT-analysis) reported lower PHQ-9 scores (mean 1.4, 95% CI 0.2, 2.5) compared to the “No offer” group (p=0.019), with a small effect size (d=0.30). Secondary analyses showed similar results. IV-analysis showed 2.6 points (95% CI 0.5, 4.7, p=0.018) lower depression scores for those who received treatment by a homeopath (medium effect size, d=0.57). Although 14 adverse events were possibly linked to the intervention, most were mild, none were life-threatening and all were transient. Themes developed from 46 qualitative interviews with 33 patients regarding their experiences included feeling listened to, supported and accepted during consultations, and as a result, opening up and coming to realisations. Some patients described improvement in their mood, wellbeing, energy and physical symptoms, others experienced little or no change, or felt worse. Conclusion: These preliminary (6 month) results suggest that treatment provided by homeopaths for patients with self-reported depression is acceptable. The effect size (d=0.30) is comparable to “talking therapies”; however, wide confidence intervals preclude firm conclusions from being drawn. There was no evidence that treatment by a homeopath was unsafe. Analysis of 12-month results is now required.

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Kimani, Kellen Njeri. "The experiences of patients living and dying with advanced heart failure in Kenya : a qualitative serial interview study." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/29564.

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Background The number of people in Sub-Saharan Africa dying of heart failure is increasing. However, little is known about their experiences and needs. In Kenya, palliative care services are available for some people with cancer and HIV/AIDS, but these services may not be configured to meet the needs of patients dying with heart failure. Aims and objectives This study aimed to explore the experiences of patients living and dying with heart failure in Kenya. Specifically, it sought to understand how patients describe their illness experience, their experience of receiving treatment and care, and their perspectives on how their care could be improved. Methods Twenty patients admitted and diagnosed with advanced heart failure were purposively recruited from a rural district hospital. Serial in-depth interviews were conducted with patients at 0, 3 and 6 months after recruitment. Bereavement interviews were carried out with carers. All interviews were conducted and recorded in the local language of Kiswahili, transcribed into English and analysed thematically with the assistance of Nvivo software. Results Forty-four interviews were conducted. Three significant phases were identified in patients’ experience (i) coming to a diagnosis, (ii) living with heart failure and (iii) dying with heart failure. Before receiving the diagnosis of heart failure, many patients were mistakenly misdiagnosed with common serious infectious conditions such as pneumonia, tuberculosis, and malaria. Once treatment commenced and physical symptoms abated, many patients were hopeful of a full recovery, unaware that there would be a progressive deterioration in their health. Social relationships were a source of encouragement but were strained by the accumulating cost of care. Patients particularly those who were younger, felt anxious or depressed when symptoms failed to improve with treatment. Uncertainty was prevalent and underlay patients’ experiences from the time of diagnosis to the end of life. Very few patients spoke about the possibility of death believing that life and death are in the hand of God. Majority of patients had poor understanding of their illness and expressed a need for more information and better communication with health professionals. Conclusion Patients with advanced heart failure in Kenya have significant unmet physical, psychological, social, spiritual, financial, and information needs. Patients’ narratives pointed to how they could benefit from a holistic approach aimed at catering for their multidimensional wellbeing. There is need to improve patients access to information and support better communication with health professionals. Chronic disease management aimed at (i) early identification of patients (ii) improving treatment and care guidelines and (iii) promoting primary and secondary prevention to identify, treat and control common risk factors for heart failure is needed.

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Al, Shemeili Saeed Khamis. "Exploring structures and processes of medicines management in elderly hospitalised patients in the United Arab Emirates." Thesis, Robert Gordon University, 2015. http://hdl.handle.net/10059/1370.

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Given the complexity of medicines use in elderly patients, structures and processes of medicines management are key to deriving best outcomes. This research was conducted in hospitals in the United Arab Emirates (UAE) and focused on the patient journey from admission to discharge. The overall aim was to explore the structures and processes of medicines management in elderly hospitalised patients in the UAE, conducted in three phases. Phase 1. Following a review of systematic reviews of aspects of medicines management (e.g. reconciliation), this phase focused on a specific, emerging tool (the Drug Burden Index (DBI)) relating to anticholinergic/sedative agents, which are problematic in the elderly. The aim was to critically appraise, synthesize and present evidence of DBI use. The review protocol was registered with the Joanna Briggs Institute and conducted according to best accepted practice. The key finding was the lack of evidence of DBI use prospectively to identify potentially inappropriate prescribing. Phase 2. Phase 2 employed a qualitative phenomenological design to explore health professionals’ views and experiences of medicines management. Semi-structured interviews were conducted with 27 professionals and analysed using Normalization Process Theory (NPT) and the Theoretical Domains Framework (TDF). Findings revealed little evidence of coherence, cognitive participation, collective action and reflexive monitoring (NPT). TDF domains dominant were: professional role, identity; beliefs about capabilities; beliefs about consequences; environmental context, resources; and knowledge. Phase 3. The Delphi technique in phase 3 aimed to determine consensus around medicines management using an expert panel of policy makers, educators and lead health professionals. Phase 1 and 2 findings were used in construction of validated statements. A high level of consensus (≥70% strongly agree/agree) was obtained for statements other than those for targeting medicines management (rather than all elderly admissions) and tasks linked to professions (rather than trained staff). Overall, this research has generated original findings focused on the entire inpatient hospital journey, particularly the need to more clearly define, refine and agree on healthcare structures and processes across the entire patient journey from admission to discharge. The use of the NPT and TDF has highlighted those individual practitioners and organisational issues which require consideration.

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Eder, Karen. "Patienten mit "Diabetischem Fuss" in der Allgemeinarztpraxis, Veränderungen von Epidemiologie und Behandlungskonzepten 1992 - 1999 sowie eine qualitative Inhaltsanalyse von zehn Interviews mit Patienten mit Diabetischem Fuss /." [S.l.] : [s.n.], 2003. http://deposit.ddb.de/cgi-bin/dokserv?idn=968396097.

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Brinck, Anna Gerda Sieglinde Lieselotte [Verfasser]. "Betreuung übergewichtiger Patienten in der Hausarztpraxis : eine qualitative Analyse von Interviews mit Hausärzten aus Berlin und Brandenburg / Anna Gerda Sieglinde Lieselotte Brinck." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2012. http://d-nb.info/1029849471/34.

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Zheng, Qi. "BARRIERS TO EYE CARE AMONG PATIENTS WITH DIABETES IN THE GREATER NEW HAVEN AREA." Yale University, 2010. http://ymtdl.med.yale.edu/theses/available/etd-03222010-151332/.

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This study aims to identify the perceived barriers to eye care and to evaluate concerns about vision and eye care among patients with diabetes in the greater New Haven area. A qualitative study applying one-on-one semi-structured interviews and non-participatory observations was conducted to identify the factors that deter diabetics from seeking eye care. Patients were recruited at the Yale Primary Care Center, Diabetes Center and Eye Center, who met the following criteria: 1) have been diagnosed with type 1 or type 2 diabetes and 2) have been referred to an eye center for dilated eye exam and/or treatment. All interviews and discussions were recorded and transcribed. The transcripts were then analyzed to detect recurrent themes. Data collection continued until no new themes emerged. This study showed that lack of awareness and lack of adequate referral to regular diabetic eye exam were viewed as the most common barriers. Many patients had limited awareness that diabetes could affect the eye or lead to blindness. Patients had little knowledge of diabetic retinopathy, or the significance of early screening and intervention. Primary care providers usually emphasized diet and blood sugar control to prevent future complications; diabetic eye care education was not often prioritized. Other barriers included cost, lack of insurance, immobility due to diabetic complications, reluctance to receive medical intervention, and distrust of the services. A strong family history of diabetes and blindness due to diabetes contributed to the awareness of diabetic retinopathy, and as a result motivated patients to seek regular eye care. Raising the awareness of diabetic retinopathy and the risk of vision loss, offering more diabetic eye care education, tracking the status of patients eye exam attendance, and providing adequate eye exam referral to a patient friendly eye clinic may encourage diabetics to attend regular eye exams.

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Lungaro-Mifsud, Stephen. "A home physiotherapy service for stroke patients in Malta : constraints and recommendations : the process of setting up a home physiotherapy service for hospitalised stroke patients within the public health system in Malta : new knowledge contributing to a strategy document." Thesis, University of Bradford, 2009. http://hdl.handle.net/10454/4327.

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Home physiotherapy is a valid service option for the patient who was recently discharged from hospital after sustaining a stroke, as it enhances functional independence in friendly and familiar surroundings, as opposed to an outpatient clinic (Bader 2008). The aim of this study was to investigate the system responses to the planning and implementation of a home physiotherapy service as an innovation within the Maltese Public Health Service, uncovering barriers or constraints that influenced the introduction and development of state-run home physiotherapy in Malta. Method A qualitative approach was used for this research. A case study design was selected because it possessed contextual, descriptive and heuristic characteristics. Study participants planned and implemented the service using the available resources. Policy makers, physiotherapists, stroke patients and caregivers contributed to the study through their responses to, and experiences of, this service innovation. It was both an exploration and an opportunity to learn about service innovation from a Maltese perspective. A group of stakeholders were interviewed during the planning stage (Phase 1) of the home physiotherapy service. The main purpose of these interviews was to inform the design of the service. Another group of participants was interviewed in the active service stage (Phase 2) - at the beginning and at the end. The purpose here was to gather data from their direct experiences with home physiotherapy. Documents relevant to home rehabilitation were accessed and analysed hermeneutically. These included newspaper media, as it was considered a sensitive instrument to understand social context (Catalán Matamoros 2007; Davis 1990). Findings and discussion Data analysis identified categories of findings such as 'barriers to the implementation of a new service', 'attitudes to home physiotherapy' and 'fragmented rehabilitation service'. The category components were discussed and linked to the hermeneutical analysis of documents, offering a deeper understanding of the categories within the local context, and revealing a reinforcement of establishment-based health care. Conclusion The findings of this study provided an insight into the constraints that would appear if home physiotherapy, indeed home rehabilitation, were introduced by the Maltese Public Health Service. This research had an impact on the state physiotherapy services. Recommendations to help mitigate the constraints in an overarching manner were offered at the end of the thesis. To the international reader with experience in organised home physiotherapy, this study gives a glimpse into how issues that would seem trivial and obvious at first glance become significant challenges - challenges that the uninitiated would need to overcome.

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Berglund, Linnea, and Siri Fjellman. "Registered nurses' experiences of working with indigenous patients in remote areas in Amazonas, Peru : a qualitative interview study at health clinics in Loreto region." Thesis, Sophiahemmet Högskola, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3374.

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Background In remote areas of the Peruvian Amazon there is a high burden of communicable diseases, limited access to health care and a low distribution of registered nurses. Registered nurses are working with indigenous patients in the area, where traditional medicine and practice is common. In order to strengthen the relation between western and traditional practices, intercultural health has been implemented within the public health care. Aim The aim was to describe registered nurses’ experiences of working with indigenous patients in remote health care settings in Loreto region, Peruvian Amazon. Method A qualitative field study with semi-structured interviews was conducted at four health clinics in Maynas and Mariscal Ramón Castilla province. A qualitative content analysis was used when analyzing the data. Findings Three categories were identified in the analysis; Working environment in a remote area, Providing health care for indigenous patients and Including intercultural health in nursing practice. The participants’ daily work with few colleagues and high demand in remote clinics was described. Experiences of working with intercultural health, as well as opportunities and challenges of working with indigenous patients was found. Conclusion The registered nurses work in an area with a high workload, limited resources and geographic isolation. Intercultural implementations were shown to improve intercultural relations, autonomy and health. Challenges between registered nurses and indigenous patients related to communication and different cultures were described. In order to improve the situation and reach the UN Sustainable Development Goals, infrastructural and socio-economic improvements, more resources and health professionals are necessary.

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Carlsson, Eva. "Communication about eating difficulties after stroke : from the perspectives of patients and professionals in health care." Doctoral thesis, Örebro universitet, Hälsoakademin, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-2712.

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Stroke is one of the major causes of eating difficulties (EDs). It is one of the leading causes of death and disability and one of the most important factors contributing to health-care costs. There is a clear association between EDs after stroke and undernutrition, where studies have shown that structured screening of eating function among stroke patients can predict nutritional problems as well as need for subsequent institutional care. Reliable and valid instruments that can identify EDs exist, but there is lack of knowledge on how persons experience living with EDs after stroke. Stroke unit care is evidence-based and grounded in multidisciplinary collaboration and continuity of care. The overall aim of this thesis is to explore and describe EDs after stroke as represented by health care professionals in patient records (PRs) and transferred information, and as described by persons living with EDs after stroke. An additional aim is to explore methodological aspects related to the inclusion of persons with EDs and communication impairment in research studies. Both quantitative and qualitative methods were used. Two studies used descriptive designs (I, II), one an explorative design (III) and one applied a methodological discussion (IV). In one of the studies PR data were used (I), in another study data were derived from three sources: PRs, screening of patients and interviews with nurses (II). Persons with EDs after stroke participated in Study III while literature, empirical data and researchers' experiences served as the data in study IV. Data were analysed by categorisation of phrases (I), content analysis (II) and descriptive statistics (I, II), by qualitative analysis (III) and by processing of literature and empirical findings in two research groups (IV). The main findings from the studies on representation of stroke care in PRs (I, II) showed that, despite that >50% of patients in Study I and all patients in Study II had EDs, there were few signs of multidisciplinary collaboration dealing with this problem. Unsystematic screening for swallowing difficulties was routine, whereas screening for nutritional risk and EDs was lacking (I, II). Multidisciplinary discharge summaries proved to have low quality and entailed little information on patients' eating ability (I). The two EDs most frequently documented were swallowing and lack of energy to complete a meal (I,II). EDs were described in vague terms (I, II). In Study II, all patients had swallowing difficulties and most patients had lack of energy to complete a meal. The electronic information transfer tool held information on eating ability for most patients (II), but the nursing staff in residential home care perceived deficiencies in that information, even identifying several EDs not reported at discharge (II). Experiences from persons living with EDs after stroke were presented in one main theme: Striving to live a normal life, including three sub-themes: Abandoned to learn on one's own (little support from health care professionals to learn to handle eating), Experiencing losses (loss of eating functions and loss of valued activities) and Feeling dependent in mealtime situations (III). One major finding from the methodological exploration (IV) is that creative approaches and suitable methods for inclusion of participants with EDs and communication impairment into qualitative studies can be found in the fields of aphasiology and learning disabilities. Another major finding from Study IV is that researchers need good communication skills as well as knowledge in neuropsychology. A general conclusion is that screening for EDs should be routine in stroke care and that a multidisciplinary terminology to express EDs must be developed to provide accurate information transfer. Health care professionals need to enhance their knowledge in nutrition and provide support to stroke patients with EDs with the goal that they can eat and perform meal-related activities in accordance with their habits before the stroke. To gain access to the experiences of persons with EDs and communication impairment researchers need to test participatory approaches when planning for inclusion of those persons.

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Gustavsson, Madeleine, and Katarina Wall. "Intrahospital transport av kritiskt sjuka patienter : Intensivvårdssjuksköterskans erfarenhet ur ett patientsäkerhetsperspektiv - en fokusgruppstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-81653.

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Bakgrund: De intrahospitala transporterna av kritiskt sjuka patienter ökar på grund av en alltmer avancerad intensivsjukvård. Transporterna är ofta associerade med komplikationsrisker och kan därmed även påverka patientsäkerheten, trots detta saknas det idag studier om intensivvårds-sjuksköterskans erfarenhet ur ett patientsäkerhetsperspektiv. Syfte: Syftet med studien var att belysa intensivvårdssjuksköterskans erfarenhet av en patientsäker intrahospital transport för kritiskt sjuka patienter som vårdas på en intensivvårdsavdelning. Metod: Studien utfördes genom semi-strukturerade fokusgruppsintervjuer med kvalitativ induktiv design. Under tre intervjuer samlades data in med hjälp av totalt tretton intensivvårds-sjuksköterskor. Insamlat material analyserades med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre kategorier; förberedelsens betydelse för patientsäker intrahospital transport, kommunikationens betydelse för patientsäker intrahospital transport samt yttre faktorer som kan påverka patientsäkerheten. Slutsats: För att förbättra patientsäkerheten rekommenderar författarna att arbeta med och uppdatera checklistor, förespråka god kommunikation samt använda sig av teamövningar. Den nya kunskapen skulle ur ett patient- och samhällsperspektiv kunna ge en ökad insikt och förståelse inför det preventiva arbetet med att motverka vårdskador samt minska onödigt lidande hos patienterna samt även kunna vara användbart ur ett utbildnings-perspektiv. Vidare forskning avseende samarbetets betydelse vid intrahospitala transporter samt att få ökad kunskap om olika förbättringsområden avseende den tekniska utrustningen, vore också önskvärt.
Background: The intrahospital transport of critically ill patients is increasing due to gradually advanced intensive care. Transports are often associated with complication risks and can thus also affect patient safety. Despite this, studies on the experience of the intensive care nurse from a patient safety perspective are lacking. Aim: The aim of the study was to highlight the intensive care nurse's experience of a patient-safe intrahospital transport for critically ill patients who are cared for in an intensive care unit. Method: The study was carried out through semi-structured focus group interviews with qualitative inductive design. During three interviews, data were collected using a total of thirteen intensive care nurses. The collected material was analyzed with a qualitative content analysis. Results: The analysis resulted in three categories; the importance of the preparation for patient-safe intrahospital transport, the importance of communication for patient-safe intrahospital transport and external factors that can affect patient safety. Conclusions: In order to improve patient safety, the authors recommend working with and updating checklists, advocating good communication and using team exercises. The new knowledge could, from a patient and societal perspective, provide an increased insight and understanding of the preventive work to counteract health injuries and reduce unnecessary suffering in patients and also be useful from an educational perspective. Further research on the importance of cooperation in intrahospital transport and to gain more knowledge about different areas of improvement regarding the technical equipment would also be desirable.

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Leopoldson, Carolina, and Madeleine Johansson. "Det ni vet ─ vet jag också det? : Patienters upplevelser av delaktighet vid akut inskrivning på kirurgisk vårdavdelning." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-296345.

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Bakgrund: År 2015 infördes Patientlagen (SFS 2014:821) som slår fast att hälso- och sjukvården ska ge patienterna möjlighet att bli delaktiga i sin vård. Studier visar att patientdelaktighet kan förbättra kvaliteten på vården och har en betydelsefull del i att uppnå en säker vård för patienterna. På kirurgisk vårdavdelning inkommer patienter dygnet runt och är beroende av sjuksköterskan för att göras delaktiga i sin vård. Syfte: Att beskriva hur patienter som skrivs in akut upplever delaktighet gällande information och planering i samband med inskrivning av sjuksköterska på kirurgisk vårdavdelning. Metod: Kvalitativ studie med semistrukturerade intervjuer (15 deltagare). Datan analyserades med latent kvalitativ innehållsanalys enligt Graneheim och Lundman (2004). Huvudresultat: Patienter upplevde att det var viktigt att få information om sin vård och planering vid inskrivning på kirurgisk vårdavdelning. Både positiva och negativa upplevelser vid inskrivningen framkom och orsaken till detta grundades i sjuksköterskans bemötande. Vårdrelationen var viktig för att känna sig trygg i en utsatt situation och var förutsättning för att uppleva delaktighet. Patienterna berättade att delaktighet vid inskrivningen var att bli lyssnad på och att få en individuellt anpassad information. Slutsats: Patientdelaktighet vid inskrivning på kirurgisk vårdavdelning förutsätter att sjuksköterskan bjuder in patienten till delaktighet samt ger information på ett individanpassat sätt. Delaktighet är viktigt för att minska fel i vården, bedriva en lagstadgad vård och för tryggheten hos patienterna. För att klara lagkraven på vården behöver både patienter och vårdpersonal utbildning inom ämnet för att skapa en gemensam syn på vad delaktighet i vården innebär.
Background: In 2015 a new patient-law was launched in Sweden. It states that healthcare should give the patients possibility to participate in their own care. Studies have shown that patient participation can improve the quality of care and reduce adverse events in healthcare. In surgical wards patients are admitted every hour of the day and they are dependent on the registered nurse to get involved in their care. Aim: To describe how patients admitted from the emergency department experience their participation during the enrollment with the nurse in the surgical ward with a specific focus on information and planning of the care. Methods: A qualitative study based on semi-structured interviews (n=15 participants). Data was analysed with content analysis according to Granheim and Lundman (2004). Results: The study showed that during the enrollment at the surgical ward patients experienced information about the care and the plan as important. Both positive and negative experiences during the enrollment were shown in the result. The reason was based on the nurses caring or uncaring relationship with the patient. The nurse-patient relationship was important for the patient to feel safe in an exposed situation and was a prerequiesite for participation. Patients talked about participation at the enrollment and pointed out that being listened to and personalized information as the most important. Conclusion: Patient participation at enrollment at the surgical ward requires the nurse to invite the patient to take part and gives information in a personalized manner. Participation is important to reduce errors in care, carry on a statutory care and to the safety for patients. To manage the requirements of the patientlaw, both patients and staff needs education about the subject to create a mutual vision of what participation in care is.

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Ramström, Mathias, and Elin Svensson. "Vårdrelationen med patienter med självskadebeteende." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-34600.

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Bakgrund: Självskadebeteende är ett växande samhällsproblem. Ibland brister sjuksköterskors bemötande av patienter med självskadebeteende inom somatisk vård. Problem: Patienter med självskadebeteende som vårdas inom somatisk vård riskerar att inte få den vårdrelation med sjuksköterskan som det finns behov av. Syfte: Att utforska sjuksköterskors erfarenheter gällande deras vårdrelation med patienter med självskadebeteende. Metod: Empirisk intervjustudie med fem sjuksköterskor inom en somatisk vårdavdelning på ett länssjukhus i Sverige. Materialet analyserades med kvalitativ innehållsanalys. Resultat: Innehållsanalysen resulterade i två kategorier, betydelsen av sjuksköterskornas bemötande i vårdrelationen med patienter med självskadebeteende samt brist på tillit i vårdrelationen med patienter med självskadebeteende. Sex underkategorier identifierades utifrån dessa två kategorier. I sjuksköterskornas bemötande ansågs det avgörande för vårdrelationens utveckling att bekräfta patienten, visa intresse och skapa förtroende. Brist på tillit i vårdrelationen skapade känslor som misstro, osäkerhet och brist på motivation hos sjuksköterskorna. Slutsats: Sjuksköterskornas bemötande i vårdrelationen med patienter med självskadebeteende är av betydelse för hur vårdrelationen utvecklas. Tillit är en väsentlig del i vårdrelationen mellan sjuksköterskor och patienter med självskadebeteende och det är av betydelse för vårdrelationen att den är ömsesidig.
Background: Deliberate self-harm has become an increasing problem in society. Nurses sometimes express negative attitudes towards patients who self-harm in somatic care settings. Problem: While being treated in somatic care settings, a patient who self-harm may not get the caring relationship with the nurse that is needed. Aim: To explore nurses’ experiences regarding their caring relationship with patients who self-harm. Method: Interview with five nurses within a somatic nursing ward in Sweden. The material was analyzed with qualitative content analysis. Result: The content analysis resulted in two categories, the meaning of nurses’ attitude in the caring relationship with patients who self-harm and lack of trust in the caring relationship between nurses and patients who self-harm. Six subcategories were identified based on these two categories. Within the nurses’ attitude it was considered crucial for the development of the caring relationship to acknowledge the patient, show interest, and create reliance. Lack of trust in the caring relationship brought feelings of mistrust, insecurity and lack of motivation. Conclusions: Nurses’ attitude in the caring relationship with patients who self-harm has meaning in developing the caring relationship, trust is essential between nurses and patients who self-harm and it is important that the trust is mutual.

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Linnea, Cimmerbeck. "Vårdpersonals upplevelse av skam hos patienter med anorexia nervosa : - En kvalitativ intervjustudie." Thesis, Linnéuniversitetet, Institutionen för psykologi (PSY), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-104087.

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Several studies have shown that patients with anorexia nervosa (AN) have elevated levels of shame. To the researcher's knowledge there was a lack of research concerning how healthcare professionals experienced shame in their patients with AN when the study was conducted. Against this background, the purpose of the present study was to contribute to a deeper insight into how healthcare professionals experienced shame in patients with AN, which was investigated through the research question: How do healthcare professionals experience shame in patients with anorexia nervosa? Based on a qualitative method and a phenomenological approach, the research question was investigated through semi-structured interviews with seven participants. The material was analyzed using thematic analysis. The analysis generated the overarching theme of self-contempt and the themes: shame against the anorexic voice, shame against their self and the impossible choice between the shame-loyalties, and seven sub-themes. Healthcare professional´s experience is in line with previous studies on patients, which have shown that shame plays a central role in AN. Further research is encouraged to investigate whether psychoeducation about shame as well as targeted treatment interventions for shame could be helpful in treating patients with AN.
Flera studier har påvisat att patienter med anorexia nervosa (AN) har förhöjda nivåer av skam. Till författarens vetskap, saknades vid studiens genomförande, forskning om hur vårdpersonal upplevde skam hos sina patienter med AN. Föreliggande studies syfte var mot bakgrund av detta att bidra till en djupare insyn i hur vårdpersonal upplevde skam hos patienter med AN, vilket undersöktes genom frågeställningen: Hur upplever vårdpersonal skam hos patienter med anorexia nervosa? Utifrån en kvalitativ metod och en fenomenologisk ansats undersöktes frågeställningen genom semistrukturerade intervjuer med sju deltagare. Materialet analyserades med hjälp av tematisk analys. I analysen skapades det överordnade temat självförakt och temana: skam mot den anorektiska rösten, skam mot sitt ”jag” och det omöjliga valet mellan skamlojaliteterna, samt sju underteman. Vårdpersonals upplevelse ligger i linje med tidigare studier på patienter, vilka har påvisat att skam spelar en central roll vid AN. Framtida forskning uppmuntras undersöka huruvida psykoedukation om skam samt riktade behandlingsinsatser för skam kan vara hjälpsamt vid behandling av patienter med AN.

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Nilsson, Åsa. "Towards a shared understanding : Exploring encounters in hospital care from the perspectives of nurses and patients." Licentiate thesis, Luleå tekniska universitet, Omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-63355.

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The overall aim of this licentiate thesis was to describe encounters in hospital care from the perspectives of nurses and patients. It focuses specifically on nurses’ views of shortcomings in patient-care encounters in one hospital (I) and the meanings of participation in hospital care as narrated by patients (II). Three focus group discussions with 15 registered nurses were conducted, and data were analyzed using thematic content analysis (I). Narrative interviews were conducted with 15 patients in hospital care, and the interviews were analyzed with a phenomenological hermeneutic interpretation (II). This licentiate thesis shows that a shared understanding is considered as central for both the nurses and the patients in the hospital-care encounter. The nurses demonstrate the need to understand, to create space, and also to be available for vulnerable patients. The patients describe the need to be understood and to understand their own situations. This thesis suggests that positive encounters in hospital care imply that nurses need to take responsibility for creating a mutual dialogue where the patient experiences himself or herself as a co-creator in a trustful context. When nurses acknowledge and confirm the vulnerability of their patients, it becomes possible to support them to participate in an active manner. A well-functioning team, as well as a coherent environment, is, in this thesis, understood as a precondition for positive hospitalcare encounters.

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Lilja, Fanny, and Madelene Tornerhjelm. "Cultural Competence in Care of Patients from Diverse Cultural Backgrounds : Experiences of Nursing Students in Gauteng Province, South Africa." Thesis, Blekinge Tekniska Högskola, Institutionen för hälsa, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-16308.

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Background: The society is rapidly changing in a demographic matter. As a result of this nurses are required to be equipped with the right skills and knowledge to approach a more diverse patient group. Hence, the health care is dependent on cultural competent nurses, without them the health care is vulnerable. Previous studies show that nurses are faced with great challenges when it comes to encounters with patients from different cultural backgrounds and that they lack the essential cultural knowledge which effects the quality and standard of care. This means high demands on the nursing curricula to integrate guidelines for cultural competence and educate future nurses in order to make them more prepared for their future profession. Aim: To explore nursing students experiences of practicing cultural competence in care of patients from diverse cultural backgrounds, a qualitative study in Gauteng province, South Africa. Method: The chosen method was qualitative. Eight individual semi-structured interviews were conducted and analyzed with inspiration from Burnard’s (1996) four-step content analysis. Findings: The findings showed the main-category: beneficial components in cultural competent care, with three sub-categories: positive attitudes and adapting of care, gaining knowledge from cultural encounters with patients and existing contextual insights of own culture and other cultures. The beneficial components included the positive attitudes of the participants and their ability to adapt the care around cultural challenges. Gaining knowledge from cultural encounters with patients and having existing contextual insights of own culture facilitated the encounters with patients. Findings also showed the main-category: barriers in providing a cultural competent care with three sub-categories: disrupted communication, limited levels of cultural knowledge and lack of trust. Disrupted communication was mostly due to the language barrier, a huge problem as important information was left out and the system of getting interpreters faulted. The limited levels of cultural knowledge were based on limited knowledge about different cultures. Lack of trust originated from patients’ strong cultural belief while disbelieving in the westernized health care which resulted in a non-trusting relationship between health care personnel and patients. Conclusion: There were several barriers as well as facilitators, though the barriers were more dominating in character. Therefore, more education is needed so nursing students feel empowered and more secure when encountering patients from different cultures. Continuing education is also needed for registered nurses as well as prospective and further research is required in order to obtain the best resources for implementation of cultural competence.

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Brandén, Persson Caroline, and Signe Lennartsdotter. "Ambulanssjuksköterskans upplevelse av att hänvisa patienter till annat färdsätt än ambulans : En kvalitativ intervjustudie." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-21485.

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Det är en utmaning för ambulansorganisationen att möta det akuta vårdbehovet som förekommer i vårt skiftande samhälle. Det ställs ett ökat krav på ambulanssjuksköterskans bedömningsförmåga, för att vägleda patienten till fortsatt vård inom olika vårdnivåer på ett patientsäkert vis. Ambulanstransporter som ej är befogade är ett betydande problem. Inom Västra Götalandsregionen hänvisar ambulanssjuksköterskan patienter till alternativa färdsätt med vårdkedjan SAMBand. Målet är att frigöra ambulansresurser på ett patientsäkert sätt samt öka tillgängligheten av ambulansresurser i samhället. Syftet med denna studie är att beskriva ambulanssjuksköterskans upplevelse av att hänvisa patienten till ett alternativt färdsätt med hjälp av vårdkedjan SAMBand. En kvalitativ intervjustudie genomfördes på tre ambulansstationer i glesbygden inom SÄS. Bekvämlighetsurval användes för att rekrytera och intervjua ambulanssjuksköterskor. Antalet deltagare var 10 ambulanssjuksköterskor där yrkeserfarenheten sträckte sig mellan 6 till 28 år. Datamaterialet analyserades med kvalitativ innehållsanalys. Resultatet visade att ambulanssjuksköterskan beskriver en så kallad magkänsla och erfarenhet som viktiga vid hänvisning till alternativt färdsätt. Möjligheten att hänvisa till vårdcentraler i underlaget SAMBand saknades, ett ökat mandat att neka patienter önskades. Frustration förekommer när ambulanssjuksköterskorna blev tvungna att transportera patienter utan vårdbehov. Ambulanssjuksköterskornas erfarenhet spelar en betydelsefull roll vid patientbedömningen, vilket kunde betraktas som både positivt och negativt. Möjligheten om att neka patienter ambulanstransport som sista utväg bör vidare undersökas för att istället hänvisa till SAMBand. Det ses en fördel för både patienten och ambulansorganisationen av att inkludera vårdcentraler i SAMBand samt att underlaget bör tydliggöras.

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Lindqvist, Anna, and Mikaela Viksell. "Kunskap,frågor och svar om egenvårdsråd gällande kost till patienter med kolorektal cancersjukdom : En intervjustudie med sjuksköterskor på kirurgisk vårdavdelning." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-354656.

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Bakgrund: Aktuell forskning lyfter kostens betydelse för tillfrisknande vid kolorektal cancersjukdom och föreslår kostbehandling som ett kompletterande behandlingsalternativ. Trots detta finns osäkerhet hos både patienter och sjuksköterskor om egenvårdsråd gällande kost vid utskrivning från kirurgisk vårdavdelning. Syfte: Syftet var att, från ett sjuksköterskeperspektiv, beskriva vilka egenvårdsråd om kost patienter som behandlas för kolorektal cancersjukdom efterfrågar och får inför utskrivning från kirurgisk vårdavdelning. Ett annat syfte var att beskriva vilken kunskap sjuksköterskor har för att ge egenvårdsråd om kost. Metodbeskrivning: En deskriptiv kvalitativ intervjustudie med semistrukturerade intervjuer med sjuksköterskor (n=11) på kirurgisk vårdavdelning genomfördes. Konventionell innehållsanalys användes vid dataanalys. Huvudresultat: En vanligt förekommande fråga från patienter med kolorektal cancersjukdom var om något i kosten bör uteslutas relaterat till diagnos. Patienterna rekommenderades att återgå till normal kosthållning och uppmanades att anpassa intaget efter tarmfunktion. Sjuksköterskornas rekommendationer baserades ofta på vilka frågor patienterna själva ställde. Gällande sjuksköterskors kunskap om egenvårdsråd om kost beskriver sjuksköterskorna ett ökat kunskapsbehov. Sjuksköterskorna hänvisade till andra professioner vid kostrådgivning samt en avsaknad av rutin för kostrådgivning framkom. Slutsats: Vaga och generella egenvårdsråd om kost till patienter med kolorektal cancersjukdom har identifierats. Sjuksköterskor tenderar att lämna över ansvar om kostråd till andra professioner och rutinerna för hur egenvårdsråd om kost skall ges är oklara, vilket bidrar till att en evidensbaserad kirurgisk omvårdnad inte uppnås. Ett angeläget behov finns således för rutinutveckling och förbättrad kunskap i ämnet hos sjuksköterskor, för att säkerställa att patienter får ta del av viktig information för tillfrisknande och att förutsättningar för en god egenvård skapas.
Background: The importance of a nutritional diet in the recovery of patients with colorectal cancer disease is acknowledged in current research, with nutritional therapies recommended as a complementary treatment option. Despite this, it has been recognized that many nurses and patients experiencing uncertainty regarding evidence based dietary advice at the point of discharge from the surgical departments. Aim: Firstly, it sets out to describe, from a nurse perspective, what dietary advice patients with colorectal cancer asks for and receives at the point of discharge from the surgical care department. Secondly it aims to describe what knowledge nurses possess in providing dietary advice. Method: A descriptive qualitative interview study was conducted, involving semi-structured interviews with nurses within a surgical care department (n=11). Conventional content analysis was used in data analysis. Results: A common question from patients was if something should be excluded in their diet following their diagnosis. Patients were advised to return to their normal diets and were encouraged to adjust their food intake in accordance with their intestinal function. Recommendations given by nurses were often led by the questions asked by the patients themselves. The nurses described a need for increased knowledge and education to sufficiently advice patients in the effective dietary self-management following discharge. Nurses referred to other professions in dietary advice and a lack of routine for dietary advice emerged. Conclusion: Discharge dietary self-management advise for patients with colorectal cancer disease has been identified as vague and impersonal. It has been suggested that nurses are prone to delegate the responsibility for dietary advices to other professions. This is further complicated by no current clear guidance on what constitutes effective dietary self-management, thus hindering evidence-based practice. Subsequently, there is an urgent need for further developed protocols and improved knowledge among nurses to ensure optimal dietary self-management for patients with a view to increase effective recovery and general wellbeing.

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Helmersson, Katarina, and Ingrid Järpfält-Svensson. "ALS : Upplevelser av att leva med ALS." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-19346.

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Amyotrofisk lateralskleros, ALS, är en obotlig sjukdom som klassas som en neurologisk sjukdom där de motoriska nervcellerna i hjärnan, hjärnstammen och ryggmärgen förtvinar. Sjukdomen kan ha ett hastigt förlopp vilket gör att patienterna är i behov av många hjälpinsatser. Syftet med studien är att öka kunskapen hos sjuksköterskor genom att belysa patienters upplevelser av att leva med ALS. För att beskriva dessa har en kvalitativ innehållsanalys använts. Med hjälp av denna modell fördjupas förståelsen av patienternas upplevelser, erfarenheter och förväntningar av sjukdomen. Följande huvudteman framkom: omgivningens betydelse, existentiella tankar och behov och strategier att hantera sin sjukdom. Faktorer som var betydelsefulla för patienterna var relationer med familj och vänner och att kunna få bibehålla sin integritet och värdighet. Det är viktigt att sjuksköterskor på bästa sätt ökar sin kunskap om patienternas upplevelser för att kunna ge en god omvårdnad under deras sista tid i livet.
Program: Fristående kurs

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Lindgren, Sara, and Rebecca Sundin. "The Tanzanian nurses’ experiences of caring for patients with life threatening conditions at a hospital in a small community : A qualitative interview study with nurses at a hospital in Bagamoyo, Tanzania." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-5344.

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Background: Tanzania is a low-income country where many people struggle to afford health care. Previous research on emergency health care in Tanzania shows that there are limited resources when it comes to both education in emergency care and acute care equipment. Furthermore, there is limited information concerning experiences from nurses working with emergency care under these conditions. Aim: The aim of this study was to examine the Tanzanian nurses’ experience of caring for patients with life threatening conditions at a hospital in a small community. Method: The study has a qualitative design with a semi-structured interview method where six registered nurses with experience of caring for patients who suffers from life threatening conditions at the Bagamoyo District Hospital in Tanzania were interviewed. The interview transcriptions where analyzed with a qualitative content analysis method described by Granheim and Lundman (2004). Results: The result shows that the nurses works in an environment where recourses are limited and how they have found alternative ways to provide care under the given circumstances. It reveals how the nurses’ cope with these situations, their emotional challenges and how they manage feelings that comes from caring for patients with life threatening conditions under the prevailing circumstances. Discussion: The result was discussed in relation to Roy’s adaption theory where the main focus was on the human being and its ability to adapt in order to maintain health and quality of life while interacting with a changing environment.
Bakgrund: Tanzania är ett utvecklingsland där många människor har svårt att bekosta sjukvård. Tidigare forskning rörande akutsjukvård i Tanzania visar att det finns en brist på utbildning och utrustning inom akutsjukvården. Det finns få studier som undersöker sjuksköterskans erfarenheter från att arbeta med akutsjukvård under de bristande förhållandena. Utifrån detta väcktes ett intresse för att utforska sjuksköterskans upplevelser utav att vårda patienter i livshotande tillstånd under dessa bristfälliga förhållanden. Syfte: Syftet med studien var att utforska den Tanzanianska sjuksköterskans upplevelser av att vårda patienter i livshotande tillstånd på ett sjukhus i ett litet samhälle. Metod: Studien har en kvalitativ utformning med semistrukturerade intervjuer. Intervjuer hölls med sex sjuksköterskor som arbetar på Bagamoyo District Hospital i Tanzania med erfarenhet av att vårda patienter i livshotande tillstånd. Intervjuerna transkriberades och bearbetades enligt en kvalitativ innehållsanalys som beskriven utav Granheim och Lundman (2004). Resultat: Resultatet visade att sjuksköterskorna arbetar i en miljö där resurser saknas och hur de funnit alternativa vägar för att kunna ge omvårdnad trots detta. Resultatet visar också att sjuksköterskorna ställs inför känslomässiga utmaningar och hur de hanterar känslorna som uppkommer då de vårdar patienter i livshotande tillstånd under bristfälliga förhållanden. Diskussion: Resultatet diskuterades i relation till Roys adaptionsteori med tyngdpunkt på människan och dess förmåga att adaptera för att upprätthålla hälsa och livskvalitet i en föränderlig miljö.

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MONTÁN, MALIN. "God omvårdnad av emotionellt instabilt personlighetsstörda patienter på en slutenpsykiatrisk avdelning enligt vårdare." Thesis, Mittuniversitetet, Institutionen för hälsovetenskap, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-9411.

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Syftet med denna studie var att belysa vilka omvårdnadsåtgärder vårdpersonal på en slutenpsykiatrisk avdelning angav vara av betydelse för patienter med emotionellt instabil personlighetsstörning (EIP). Metod För att svara på syftet i denna studie valdes metoden kvalitativ innehållsanalys av halvstrukturerade intervjuer med 6 vårdare som arbetade på slutenpsykiatriskavdelning med speciell inriktning mot vård av personer med EIP. Resultat Genom innehållsanalys av intervjuerna framkom tre teman med tillhörande subteman. Tema 1: Att hantera utåtagerande symptom, subteman: Att hantera splitting, Att hantera ångest, utspel och självskada. Tema 2: Att arbeta tillsammans för att nå omvårdnadsmål, subteman: Enhetligt förhållningssätt, Struktur i omvårdnaden. Tema 3: Att bygga upp en individ, subteman: Att skapa en tillitsfull relation, Att rusta patienten för utskrivning, Tid som en faktor i omvårdnaden, Att vara tillgänglig för patienterna, Självförtroendets del i ökad hälsa, En inre trygghet är en grund för positiv utveckling, Omvårdnaden utförs i ett medmänskligt samspel. Slutsats Som svar på denna studies syfte att belysa vilka omvårdnadsåtgärder vårdpersonalen på en slutenpsykiatrisk avdelning angav vara av betydelse för patienter med emotionellt instabil personlighetsstörning, är svaret de subteman som framkom genom analysen.
The Ame of this study was to investigate what the caregivers of an in-patient ward would say was important for the care of patients diagnosed with borderline personality disorder (BPD). The Method that was used was qualitative content analysis of face-to-face semi structured interviews with six caregivers of an in-patient ward that was specialized in caring for BPD patients. The Result of the content analysis emerged into three themes with subthemes. Theme number one was: To handle symptoms, the subthemes were To handle splitting, To handle acting out behaviors, anguish and self mutilations. Theme number two was: Working together to reach care-giving goals, the subthemes where: Unanimous attitudes, Structured care-giving. Theme number three was: To strengthen a person, the subthemes where: To create trust in the care-relationship , To prepare the patient for the transcription, Recovery takes time, To be available, Incising self-confidence for grater health, An inner confidence as a ground for personal grout. The care is set in an interpersonal relationship. The Conclusion was that the subthemes reflected what was important in the care of patients diagnosed with BPD.

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Arvidsson, Jennie, and Emelie Selström. "Anestesi- och intensivvårdssjuksköterskors upplevelser av överrapportering av postoperativa patienter." Thesis, Luleå tekniska universitet, Omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-69401.

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Bakgrund: Runt om i världen och på svenska sjukhus och , överrapporteras dagligen flertaletpostoperativa patienter mellan anestesi-och intensivvårdssjuksköterskor. Vad somkommunicerats har stor betydelse för patienternas fortsatta vård och sjuksköterskornasupplevelse av överrapportering. Bristande överrapportering kan få konsekvenser som sämrevårdkvalité och ökad risk för komplikationer för patienterna. Syfte: Att beskriva anestesi-ochintensivvårdssjuksköterskors upplevelser av överrapportering av postoperativa patienter. Metod:Intervjuer genomfördes i form av fokusgrupper, en med anestesisjuksköterskor och en medintensivvårdssjuksköterskor. Materialet analyserades enligt kvalitativ innehållsanalys. Resultat:Fem huvudkategorier: Behov av att dubbelkolla och dubbeldokumentera, att inte veta vilkeninformation som är relevant och sakna förståelse för varandra, att den postoperativaavdelningen är rörig och orsakar störningar i överrapportering, attoperationssjuksköterskornas överrapportering är viktig och behov av att överrapportera vidpatienterna och upprätthålla fullständig sekretess. Slutsats: Tydliga rutiner behövs gällande vadpostoperativ överrapportering ska innehålla, samt utveckling av samarbete mellan de som deltar iöverrapportering. Behov av att kunna genomföra överrapportering vid patienterna men ändåupprätthålla sekretess var ett komplext område. Operationssjuksköterskans deltagande iöverrapportering var ett av de största förbättringsområden som framkom denna studie.

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Gertsson, Anette. "ETT ROFYLLT SLUT : Sjuksköterskors upplevelser kring palliativ sedering hos patienter med lungcancer." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-28566.

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Bakgrund: När patienter med lungcancer befinner sig i den sena fasen med palliativ vård i livets slutskede är det inte ovanligt att de på grund av outhärdlig smärta och/eller ångest och oro har ett behov av att få sedering som behandlingsform. Det kan dock finnas en risk att patienterna inte alltid får tillräcklig lindring i samband med detta lidande. För att lindra lidandet hos dessa patienter är det viktigt att sjuksköterskan är väl förtrogen med denna behandlingsform. Därtill krävs en uppmärksamhet gällande patientens behov av behandlingsformen. Syfte: Syftet var att beskriva sjuksköterskors upplevelser kring sedering som behandlingsform vid vård i livets slutskede hos patienter med lungcancer. Metod: Studien utgick från en hermeneutisk vetenskapsteoretisk grund och utgjordes av åtta intervjuer. Analysen genomfördes med hjälp av en kvalitativ manifest och latent innehållsanalys. Resultat: Temat "Att få känna tillit och stöd i situationen" baseras på följande kategorier: lidandets betydelse, jobbiga situationers betydelse, arbetsklimatets betydelse, vårdplaneringens betydelse och den upplevda erfarenhetens betydelse. Slutsats: Det måste finnas ett kollegialt stöd och möjlighet till reflektionsstunder för att sjuksköterskor ska orka arbeta med palliativ sedering för patienter med lungcancer i livets slutskede. Stöd och en tydlig struktur att arbeta efter ger trygga sjuksköterskor.
Background: When patient with lung cancer is in the late phase of palliative terminal care it is not unusual for them because of horrible pain and/or worry and anxiety have need to have sedation as a treatment. There may be a risk that patient do not always get enough relief in the connection with this suffering. In order to alleviate the suffering of these patients, it is important that the nurse is familiar with this form of treatment. This requires an awareness regarding the need for treatment form. Aim: The aim was to describe nurses experiences about sedation as a treatment in care of patient with lung cancer in the end of the life. Method: The study was based on a hermeneutic epistemological basis and consisted of eight interviews. The analysis was conducted using a qualitative manifest and latent content analysis. Results: The theme "to feel confident and support in the situation" is based on following categories: suffering significant, difficult situations importance, working climate importance, care planning importance and the perceived importance of experience. Conclusion: There must be a collegial support and possibility for reflection moments that nurses have the energy to work with palliative sedation for patients with lung cancer at the end of life. Support and a clear sture to work after giving confident nurses.

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Pettersson, Emma. "Patientens upplevelse av svårläkta bensår : En kvalitativ intervjustudie." Thesis, Högskolan Dalarna, Omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:du-25439.

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Syfte: Syftet med studien var att studera den äldre patientens upplevelse av att leva med svårläkta bensår och vad denne anser bidrar till eller förhindrar en positiv syn på sin tillvaro. Metod: Studien innehåller intervjuer med äldre personer drabbade av svårläkta bensår. En kvalitativ innehållsanalys genomfördes. Resultat: Resultatet visar att informanterna upplever smärta, oro för försämring, ångest och att den långsamma sårläkningen är påfrestande. Enligt informanterna krävs det deltagande vid sociala sammankomster och aktiviteter samt att hålla kontakt med vänner och anhöriga för att bibehålla en positiv syn på sin tillvaro. Livskvaliteten upplevs som relativt god. Liksom synen på tillvaron påverkas också den upplevda livskvaliteten av den egna situationen och då positivt genom att känna sig delaktig i ett socialt sammanhang och negativ genom förlust av självständighet. Samtliga informanter har en positiv upplevelse av den erhållna sjukvården, de tror på kontinuitet för ett bra behandlingsresultat och känsla av trygghet. Slutsats: Svårläkta bensår påverkar den äldre människan på olika områden i livet, fysiskt, psykisk och existentiellt. De äldre patienterna behöver hälso- och sjukvården samt ett socialt nätverk för att bibehålla en positiv livssyn.
Aim: The aim of this study was to study the older patient's experience of living with chronic leg ulcers and what he or she considers to contribute to or impede a positive outlook on their lives. Method: The study includes interviews with elderly people suffering from chronic leg ulcers. A content analysis was performed. Results: The result shows that the informants are experiencing pain, concerns about worsening, anxiety, and that the slow wound healing are stressful. According to informants, it requires attendance at social gatherings and activities and to keep in touch with friends and loved ones to maintain a positive outlook on their lives. The quality of life is perceived as relatively good. The perception of life and the perceived quality of life effects positively by feeling involved in a social context and negatively through the loss of independence. All respondents have a positive experience of the obtained medical care, they believe in the continuity for good treatment results and sense of security. Conlusion: Slow-healing leg ulcers affects older people in different areas of life, physical, psychological and existential. The older patients need health care and a social network to maintain a positive outlook on life.

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Östlund, Gunnel. "Promoting return to work : lay experiences after sickness absence with musculoskeletal diagnoses." Doctoral thesis, Linköpings universitet, Socialmedicin och folkhälsovetenskap, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-26344.

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Introduction: Musculoskeletal disorders constitute the greatest cause of sickness absence from work. Despite research and efforts at rehabilitation, sickness absence due to these disorders has not decreased, but has instead increased, particularly in women. Clients’ perceptions of care and rehabilitation, i.e. knowledge generated from a lay perspective, is a neglected area of research. This thesis deals with lay experiences of rehabilitation following sickness absence due to back, neck or shoulder problems, termed musculoskeletal disorders (MSD). Aim: The overall aim was to examine hindering and promoting processes in rehabilitation after sickness absence due to MSD from a lay perspective. Specific aims were to study how lay persons experience rehabilitation agents and rehabilitation activities (paper I), how they describe themselves and their experience in relation to work (paper II), the significance of the private arena regarding return to work (paper III), and how clients who have experienced sickness absence due to MSD perceive contact with rehabilitation agents (paper IV). Method: The study population in the four papers is part of a cohort of persons living in the same municipality and who in 1985 were aged 25-34 years and were sick-listed due to back, neck or shoulder diagnoses for 28 days or more, n=213. During 1995, 148 persons in the cohort responded to a questionnaire, and in 1997-1998, 20 of these persons were interviewed concerning their experiences with rehabilitation. In papers I, II and III the qualitative method of Grounded Theory was used with a focus on creating an empirically-based theory concerning the area under study. Data collection was strategic and analysis of the tape-recorded interviews was done on a continual basis. How previously sick-listed persons experienced contact with professional rehabilitation agents in t he health care sector and social insurance office was investigated in paper IV. Factor analysis and multiple regression analysis were used to analyse the data in this study. Results: The interview study shed light on lay persons’ experiences with medical, social and work-related measures in rehabilitation, their perceptions of rehabilitation actors and family members in relation to rehabilitation, and their self-presentations. The descriptions of lay persons concerned three arenas, the health care arena, the occupational arena, and the private arena. Dilemmas and difficulties in these arenas were described, such as handling the duty to work, experiencing domestic strain, and the experience of lacking socioemotional support from significant persons during the rehabilitation process. In paper I some ideal types of rehabilitation agents emerged from the interviewees’ descriptions concerning the health care arena, and we called these the routine bureaucrat, the empathic administrator, the distant technician, and the professional mentor. The latter agent was requested and was described as a person who could provide socioemotional support, who had professional competence, and who could function as a unifying link during the rehabilitation process. The results from paper II showed that in their self-presentations, the interviewees expressed having a duty to work and that there were differences in how they handled this sense of duty. The selfpresentations contained descriptions of work as a part of personal identity and could be summarised in the following ideal types: the work manic, the workhorse, the workaholic and the relaxed worker. The latter used a strategy that can be considered to promote rehabilitation in that the individual himself/herself had control over his/her work and worked in accordance with his/her own needs rather than those of others. Paper III focused on the private arena. Different patterns were found in the experiences of men and women. Women related that their responsibility for the home and domestic work seldom left any time for themselves, including any time for rehabilitation. Men more often reported having time for themselves that could be used for leisure activities and rehabilitation. Some of the women said that they lacked socioemotional support from their partner and that they had a great deal of responsibility for housework, which seemed to be a hindrance in returning to work after sickness absence. Furthermore, these women, like most of the men, had little education, which could make finding other work alternatives more difficult. Based on the interviews, a hypothesis was developed regarding domestic strain that is related to the distribution of domestic work, the distribution of responsibility for the home, and the quality of the marital relationship. Paper IV dealt with clients’ perceptions of contact with rehabilitation agents in health care and the social insurance office. Three latent dimensions were found in the respondents’ ratings of these contacts: supportive treatment, distant treatment, and empowering treatment. Sex, disability pension status, mental health and diagnostic group were significantly related to how these dimensionswere rated. Women perceived the treatment from both types of rehabilitation agents as more supportive than men. Contact with the social insurance offices were rated higher by persons with disability pensions than by those who had returned to work. Men rated their contact with rehabilitation agents at social insurance offices high on the dimension of distant treatment. Respondents with mental health problems rated the contact as distant for both types of rehabilitation agents, but contact with health care was also scored low on the supportive dimension. Finally, respondents with neck/shoulder diagnoses rated contact with rehabilitation agents in health care as more empowering than was done by persons with back diagnoses. Conclusions: From a lay perspective rehabilitation following sickness absence due to MSD occured in three arenas, the health care arena, the occupational arena and the private arena, where the quality of relationships both with rehabilitation agents, persons at work and in one’s private life was described as important regarding the rehabilitation process. This thesis also showed that both sex and health were important factors regarding how lay persons’ perceived contacts with rehabilitation agents during the rehabilitation process following sickness absence due to MSD.

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Samuelson, Kajsa, and Frida Lidén. "”Love and patience is most important” : A qualitative interview study about the views and experiences from physical therapists working with orphan children diagnosed with cerebral palsy in Ho Chi Minh City, Vietnam." Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-411357.

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Background: Cerebral palsy (CP) is a diagnosis found worldwide. Literature indicates the importance of teaching families how to support the child. Orphan children are an exposed group and if the child also is diagnosed with CP the child is even more exposed. A literature search on how the lack of social support from close family, for example a child being orphan, affects the physical therapy intervention for CP showed no results. Purpose: The purpose of this bachelor thesis was to investigate views and experiences from physical therapists at “The Center of Rehabilitation and Support For Children With Disabilities”, Ho Chi Minh City, about their work with orphan children diagnosed with CP. Method: A qualitative interview study with physical therapists working with orphan children diagnosed with CP. The data was collected through five semi-structured interviews. Summary of result: The result was divided into four categories and 14 subcategories. The treatment for the orphan children was motor skill oriented and included a psychosocial view. “Love” was very important in physical therapy treatment, as a substitute for social support from close family. The participants had examples of obstacles and experiences on ways to overcome lack of social support. Conclusion: The most prominent views and experiences from the physical therapists were to love the orphan children as their own and act in their professional roles in ways that compensate for strong social support. There is a need for more research in this area.
Bakgrund: Cerebral pares (CP) är en diagnos som finns över hela världen. Litteratur och riktlinjer anger vikten av att lära familjer hur man kan stödja barnet. Föräldralösa barn är en utsatt grupp och om barnet också är diagnostiserat med CP är barnet ännu mer utsatt. En litteratursökning om hur bristen på socialt stöd, till exempel ett barn som är föräldralöst, påverkar fysioterapeutisk behandling för CP visade inga resultat. Syftet: Syftet med denna kandidatuppsats var att intervjua fysioterapeuter vid ”The Center for Rehabilitation and Support For Children with Disabilities” i Vietnam, Ho Chi Minh City, om erfarenheter av deras arbete med föräldralösa barn som har fått diagnosen CP. Metod: En kvalitativ intervjustudie med fysioterapeuter som arbetade med föräldralösa barn diagnostiserade med CP. Datan samlades in genom fem semistrukturerade intervjuer. Sammanfattning av resultatet: Resultatet delades in i fyra kategorier och 14 subkategorier. Behandlingen för de föräldralösa barnen var motorisk färdighetsorienterad och inkluderade ett psykosocialt perspektiv. ”Kärlek” var mycket viktigt i fysioterapibehandlingen, som en ersättning för bristen av socialt stöd från nära familj. Deltagarna hade exempel på hinder som uppkom men också erfarenheter av sätt att övervinna bristen på socialt stöd. Slutsats: De mest framstående erfarenheterna från fysioterapeuterna var att älska de föräldralösa barnen som sina egna och agera som ett starkt socialt stöd. Det finns ett behov av ytterligare forskning inom detta område.

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Povozhaev, Lea M. "Addiction Rhetoric: Conceptual Metaphors in Conversational Illness Narratives." Kent State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=kent1406720653.

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Broman, Niroshani, and Lundbäck Elin Svensson. "Möte med depression - En intervjustudie om sjuksköterskors uppfattningar om och förhållningssätt till depression hos patienter i primärvården." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25804.

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Bakgrund: Depression är en folkhälsosjukdom i Sverige. Den kan uttryckas i både fysiska och psykiska symtom. Sjuksköterskan har en roll i att upptäcka och identifiera dessa. Syfte: Att undersöka sjuksköterskors uppfattningar om och förhållningssätt till depression och/eller depressionssymtom hos patienter inom primärvården. Metod: En intervjuundersökning med sex sjuksköterskor som arbetar på vårdcentraler i Sverige. Kvalitativ innehållsanalys användes som analysmetod. Resultat: Depression och/eller depressionssymtom var ett ämne som innebar utmaningar och låg utanför sjuksköterskans egentliga arbetsområde, även om de hade en viktig roll i det initiala skedet. Sjuksköterskans arbete med problematiken upplevdes ha utökats i takt med en utveckling av primärvården. Den psykiska hälsan och ohälsan upplevdes ha fått ett större utrymme och patienter ansågs ha en medvetenhet om sin egen psykiska hälsa och ohälsa. Behov av större tillgång till psykolog och kurator, mer tid för patienter och vidare utbildning av sjuksköterskor uttrycktes tydligt.
Background: Depression is a public health disease in the Swedish population. The symptoms can be both physical and psychical. The nurse plays an important role within the discovery and identification of depression and/or depressive symptoms. Aim: To examine nurses’ attitudes and comprehension of depression in primary care. Method: A qualitative study with semi-structured interviews was made, with six nurses employed at different public health centers in Sweden. Manifest content analysis was used. Result: Depression and/or depressive symptoms were experienced as an area that withheld challenge and were outside of the nurses’ main responsibility. The nurse played an important role in the initial process. The psychic health had been given a larger room within the primary care. The nurses´ tasks had increased as the development of the primary care had proceeded. There was an experienced need of more psychologists and counselors, as well as more time with patients and an education of nurses.

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Blommé, Nina. "Patienters erfarenheter av att delta i forskning : En litteraturöversikt." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-4774.

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Bakgrund: Forskning- och utvecklingsarbete är något som bedrivs på många håll inom hälso- och sjukvården. Detta innebär att många patienter som söker vård och behandling kan komma att tillfrågas om att delta i forskning. En person som är sjuk, och i behov av vård, kan uppleva att man i patientrollen hamnar i en beroendeställning i förhållande till vårdpersonalen. Patienten är den hjälpsökande och vårdpersonalen är de som på grund av kunskap och förmåga att hjälpa patienten har en starkare ställning. Att vara patient och medverka i forskning kan innebära att patienten får ökad uppmärksamhet men patienten kan också uppleva att beroendeställningen gentemot vårdpersonalen förstärks. Syfte: Syftet var att beskriva patienters erfarenheter av att delta i forskning. Metod: En litteraturöversikt har gjorts där tio vetenskapliga, kvalitativa artiklar, med begränsning vuxna patienter, har utgjort grunden till resultatet. Resultat: Resultatet presenteras i fyra kategorier, vilka är; Överväganden inför beslut om att delta i forskning, Meningsfullhet av att delta i forskning, Upplevelse av hinder i samband med forskning samt Från känslan av stöd – till känslan av övergivenhet. Diskussion: Resultatet har diskuterats i relation till livsvärldsperspektivet enligt Dahlberg och Segesten. Tre aspekter av resultatet kommer särskilt att diskuteras: Barriärer för ett forskningsdeltagande kontra viljan att delta, Beroendeställningen till vårdpersonal -en riskfaktor för både patienten och forskningen samt Patientens delaktighet och autonomi i samband med beslutsfattande om att delta i forskning.
Background: Research and development is conducted in many areas of health care. This means that many patients seeking care and treatment may be asked to participate in research. A person who is ill and in need of care can experience him/herself, in the role of patient, ending up in a position of dependence in relation to health care professionals. The patient is seeking help and health care staff are those who by virtue of knowledge and ability to help patients have a stronger position. Being a patient and participating in research may thus imply receiving increasing attention, but also inferiority or dependency. Aim: The aim was to describe patients’ experiences of participating in research. Method: A literature review was performed based on results from ten qualitative articles, limited to adult patients with experience of participating in research. Results: The results are presented in four categories; exploring the decision to participate in research, Meaningfulness of participating in research, Perception of barriers related to research and from the feeling of support – to the feeling of abandonment. Discussion: The result has been discussed in relation to the life-world perspective according to Dahlberg and Segesten. Three main aspects of the results will be discussed; Barriers for participating in clinical trials versus willingness to participate, dependency on health care professionals – a risk factor both for the patient and the research trial, and the patient’s autonomy and participation in the decision-making about research.

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Gagner, Björn, and Tim Zander. "Tanken är att vi ska få ner luft i patienten, och det är snabbt. : En kvalitativ intervjustudie kring sjuksköterskan i ambulansens upplevelse av luftvägshantering och stöd." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-102554.

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Introduktion: Adekvat andning är grundläggande för liv. Att kunna utföra luftvägshantering är därför en kunskap sjuksköterskan måste besitta. I regionen där studien genomförts kan anestesisjuksköterskeresurs medfölja ambulans vid larm om andnings- eller luftvägsproblematik. Denna resurs har tidigare nyttjats per automatik från larmcentral, men har nu övergått till att nyttjas först på ambulanspersonalens begäran. Hur denna förändring upplevs av sjuksköterskan i ambulansen är tidigare inte undersökt. Syfte: Belysa sjuksköterskan i ambulansens upplevelse av luftvägshantering samt upplevelsen av stöd från anestesisjuksköterskan prehospitalt. Metod: Kvalitativ intervjustudie som analyserades med induktiv innehållsanalys. Femton semistrukturerade intervjuer genomfördes på en ambulansavdelning i södra Sverige. Deltagarna var sjuksköterskor aktivt verksamma inom ambulanssjukvården. Resultat: Sjuksköterskan i ambulansen upplevde generellt trygghet i luftvägshantering efter som det övas frekvent. Anestesisjuksköterskans stöd var dock viktigt vid avancerad luftvägshantering. Rutinförändringen, gällande att anestesisjuksköterska endast medföljde på ambulanspersonalens begäran, upplevdes av sjuksköterskan i ambulansen som positivt. Detta skapade fler tillfällen att få möjlighet till luftvägshantering vilket i sin tur skapade ökad trygghet. En annan positiv upplevelse av rutinförändringen var att anestesisjuksköterskeresursen nu kunde nyttjas när den verkligen behövdes. Få tillfällen för samövning mellan anestesisjuksköterskan och sjuksköterskan i ambulansen upplevdes av sjuksköterskan i ambulansen ej ge personlig kännedom för anestesisjuksköterskan, vilket i sin tur påverkade teamkänslan. Deltagarna menade även att det ofta var ”extra händer” som efterfrågades istället för viss kompetens. Slutsats: Luftvägshantering kräver regelbunden övning för att upprätthålla kompetens och känsla av trygghet. Anestesisjuksköterskan bör dock fortsatt finnas att tillgå som stöd vid avancerad luftvägshantering. Rätt resurs ska användas vid rätt tillfälle, vilket sjuksköterskan i ambulansens ansvarar för att så sker. För att möjliggöra en god teamkänsla inom vårdteamet krävs samövning och personlig kännedom.
Introduction: Adequate breathing is essential for life. Being able to perform airway management is therefore a knowledge the nurse must possess. Within the prehospital care in the region the study is carried out there is an anesthesia nurse resource in the event of respiratory problems. This resource has previously been used automatically from dispatch, but now this resource is only used on request from the ambulance staff. How this change is experienced by the nurse in the ambulance has not been investigated earlier. Purpose: Illuminate the nurse in the ambulance’s experience of airway management and the experience of support from the anesthesia nurse prehospital. Method: Qualitative interview study that was analysed with inductive content analysis. Fifteen semi-structured interviews were conducted in an ambulance department in southern Sweden. The participants were nurses with an active employment in ambulance care. Result: The nurse in the ambulance generally felt comfortable in airway management as it was frequently practiced. However, the support of the anesthesia nurse was important in advanced airway management. The routine change, regarding the fact that the anesthesia nurse was only included at the request of the ambulance staff, was perceived by the nurse in the ambulance as positive. This created more opportunities for airway management, which in return increased confidence. Another positive experience of the routine change was that the anesthesia nurse resource could now be used when it was really needed. Few opportunities for joint practice between the anesthesia nurse and the nurse in the ambulance were experienced by the nurse in the ambulance as not giving personal knowledge to the anesthesia nurse, which in return affected the team spirit. The participants also said that it was often ”extra hands” that they requested instead of certain skills. Conclusion: Airway management requires regular practice to maintain competence and confidence. However, the anesthesia nurse should continue to be available, as support for advanced airway management. The correct resource must be used in the right situation, which the nurse in the ambulance is responsible for ensuring. To enable a good team spirit within the care team, joint practice and personal knowledge are required.

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Glantz, Patrik, and Antonia Johansson. "Ambulanssjuksköterskans upplevelser av att hänvisa patienter till annan vårdnivå när inget behov av ambulanstransport föreligger." Thesis, Luleå tekniska universitet, Omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-64319.

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Bakgrund: Riksrevisionens statistik visar på en allt högre belastning på ambulanssjukvården i landet, detta har medfört att flera regioner infört rutiner för ambulanssjuksköterskan att bedöma det aktuella vårdbehovet hos patienterna för att hänvisa till rätt vårdnivå om det inte föreligger transportbehov med ambulans. Syfte: Syftet med studien var att undersöka ambulanssjuksköterskors upplevelser av att hänvisa patienter till annan vårdnivå när inget behov av ambulanstransport föreligger. Metod: Två kvalitativa fokusgruppsintervjuer genomfördes på två ambulansstationer inom Region Norrbotten. Ett ändamålsenligt urval användes för att rekrytera ambulanssjuksköterskor. Deltagarna var mellan 33 och 48 år och yrkeserfarenheten sträckte sig mellan 8 och 20 år. Data analyserades med en kvalitativ innehållsanalys. Resultat: Analysen resulterade i fyra huvudkategorier: Erfarenheter, magkänsla och bemötande gav förutsättningar för bedömning, Att välja vårdnivå var tidskrävande men värt arbetsinsatsen, Patienter som transporteras utan vårdbehov skapar frustration, En förändring kräver information, utbildning och stöd i beslut. Resultatet visade att ambulanssjuksköterskorna använde sig av intuition tillsammans med de befintliga rutinerna och kände sig då trygga med att bedöma och hänvisa patienterna till en annan vårdnivå. De saknade möjligheten till stöd av ambulansläkare för att underlätta vid bedömning och beslut. Ambulanssjuksköterskorna upplevde det som en begränsning att inte privata vårdgivare var anslutna till rutinen för att hänvisa patienter. Frustration uppstod när de var tvungna att transportera patienter utan vårdbehov. Slutsats: För att kunna optimera akutsjukvårdens resurser så behöver rutiner ses över så att samtliga hälsocentraler i regionen ingår i “vårdstigen”. En ambulansläkare bör omgående rekryteras som ett stöd i ambulanssjuksköterskornas dagliga arbete och vid hänvisning av patienter till annan vårdnivå.

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44

Palmryd, Lena. "Sjuksköterskors uppfattning om hantering av sekretess i relation till patienters omvårdnadshandlingar på en postoperativ avdelning - En intervjustudie med kvalitatitv insats. : Nursing´s preception of the management of cinfidentiality in relation to patient´s nursing documents in a post-operative department - an interview study with qualitative efforts." Thesis, Mittuniversitetet, Avdelningen för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-30806.

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McIntosh, Michele Janet. "Participants' perspectives of risk inherent in unstructured qualitative interviews." 2009. http://repository.library.ualberta.ca/dspace/handle/10048/820.

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Thesis (Ph.D.)--University of Alberta, 2009.
A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Faculty of Nursing. Title from pdf file main screen (viewed on November 15, 2009). Includes bibliographical references.

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Patchick, E., Maria Horne, A. Vail, and A. Bowen. "Development of a patient-reported outcome measure (PROM) for post-stroke cognitive rehabilitation: using qualitative interviews to inform design and content." 2015. http://hdl.handle.net/10454/7372.

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no
Background Improving cognition is service users' top research priority for life after stroke, and future research should include outcomes that they deem important. Patient perspectives on outcomes are collected using patient-reported outcome measures (PROMs). There is currently no patient-centred PROM specific for cognitive rehabilitation trials. Objective Inform PROM development by exploring stroke survivor perspectives on the important, measurable impacts of persisting post-stroke cognitive problems. Design Qualitative semi-structured interviews in participants' homes. Participants Purposive sample of 16 cognitively impaired stroke survivors at least six months post-stroke. Methods Interviews used a schedule and communication aids developed through patient consultation. Interviews were transcribed verbatim with non-verbal communication recorded using field notes. Data were analysed using a framework approach to find commonalities to shape the focus and content of an outcome measure. Results Participants identified important impacts of their ‘invisible’ cognitive problems, outside of other stroke-related impairments. Cognitive problems exacerbated emotional issues and vice versa. Changes in self-identity and social participation were prominent. Impact was not spoken about in terms of frequency but rather in terms of the negative affect associated with problems; terms like ‘bothered’ and ‘frustration’ were often used. Conclusions The results support the development of a PROM specifically designed to address the impact of cognitive problems. It should: include items addressing a comprehensive range of cognitive skills; ask questions about mood, self-identity and social participation; use accessible wording that respondents understand and endorse; measure impact rather than frequency; and explore perceived impact on carers.

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Stanners, Melinda Nicole. "An exploration of the prevalence, diagnosis and treatment of depression in patients with multiple chronic conditions." Thesis, 2013. http://hdl.handle.net/2440/82543.

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Introduction: The likelihood of developing two or more chronic illnesses (‘multimorbidity’) increases with age. Depression is common with chronic physical illness, but may not be detected or treated in multimorbid patients. This thesis is comprised of a series of related studies designed to explore the prevalence, diagnosis and management of depression in patients with multiple chronic conditions using an explanatory mixed methods design. Data and participants were sourced from a multidisciplinary outpatient clinic in metropolitan Adelaide. Study One: Clinic Database Analysis. The study estimated the prevalence of a) depression diagnoses and b) depressive symptoms using the Geriatric Depression Scale (GDS) in an outpatient clinic population, exploring agreement between clinician diagnoses of depression and GDS scores. Doctor-diagnosed depression was recorded for 15% of patients. Based on GDS scores, 50% of patients reported threshold-level depression symptoms, although many had no corresponding depression diagnosis. This suggests that whilst many multimorbid patients experience depressive symptoms, these may not be detected. Study Two: Comparing the GDS, HADS and CIDI. Study Two compared GDS scores with Hospital Anxiety and Depression Scale (HADS) scores and Composite International Diagnostic Interview (CIDI) diagnoses. The GDS identified more depression-positive cases than the HADS and the CIDI, but the CIDI failed to detect severe depressive symptoms in several patients. During the study, concerns arose relating to the use of the CIDI with older multimorbid patients; consequently, the study was terminated early. Study Three: Patient Symptom Priority Scale. The Patient Symptom Priority Scale was developed to explore patient perceptions of symptom burden and functional impact, and piloted in the clinic. Patients described more physical symptoms than emotional symptoms. Age correlated positively with chronic illness and physical symptom counts, and negatively with psychological symptom impact. Geriatric Depression Scale scores correlated with all psychological variables. Study Four: GP experiences of depression diagnosis and management with multimorbid patients. Semi-structured interviews were conducted with GPs who had referred patients to the clinic, to explore GP perceptions of depression diagnosis and treatment with multimorbid patients and generate a grounded theory model reflecting the role of multimorbidity in their practice. Multimorbidity generated increased time to determine symptom causation and build relationship with the patient. GPs offered medical and social depression interventions. Study Five: Experiences of depression diagnosis and treatment amongst multimorbid patients. To explore the patient perspective, further qualitative interviews were undertaken with multimorbid clinic patients who had been diagnosed with depression. Thematic analysis revealed common diagnosis and treatment experiences amongst these multimorbid patients with depression. All patients attributed depression onset to the loss of their normal life, with stigma emerging as an underlying influence in patient decisions about treatment. Conclusion: This is the first study to compare depression symptoms with depression diagnoses in a multimorbid population, and found that many patients experience threshold-level depression symptoms that are not being addressed. General practitioners are aware of contextual factors, and try to address them, but also make assumptions about their patients that may not be accurate. This may account for the number of patients still suffering. The findings suggest that a thorough symptom profile is necessary for effective detection and treatment of depression in this vulnerable population.
Thesis (Ph.D) -- University of Adelaide, School of Medicine, 2013

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Tomlinson, Justine, Jonathan Silcock, H. Smith, K. Karban, and Beth Fylan. "Post-discharge medicines management: the experiences, perceptions and roles of older people and their family carers." 2020. http://hdl.handle.net/10454/18541.

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Yes
Multiple changes are made to older patients' medicines during hospital admission, which can sometimes cause confusion and anxiety. This results in problems with post-discharge medicines management, for example medicines taken incorrectly, which can lead to harm, hospital readmission and reduced quality of life. To explore the experiences of older patients and their family carers as they enacted post-discharge medicines management. Semi-structured interviews took place in participants' homes, approximately two weeks after hospital discharge. Data analysis used the Framework method. Recruitment took place during admission to one of two large teaching hospitals in North England. Twenty-seven participants aged 75 plus who lived with long-term conditions and polypharmacy, and nine family carers, were interviewed. Three core themes emerged: impact of the transition, safety strategies and medicines management role. Conversations between participants and health-care professionals about medicines changes often lacked detail, which disrupted some participants' knowledge and medicines management capabilities. Participants used multiple strategies to support post-discharge medicines management, such as creating administration checklists, seeking advice or supporting primary care through prompts to ensure medicines were supplied on time. The level to which they engaged with these activities varied. Participants experienced gaps in their post-discharge medicines management, which they had to bridge through implementing their own strategies or by enlisting support from others. Areas for improvement were identified, mainly through better communication about medicines changes and wider involvement of patients and family carers in their medicines-related care during the hospital-to-home transition.
This work was supported by the National Institute for Health Research (NIHR) Yorkshire and Humber Patient Safety Translational Research Centre (NIHR Yorkshire and Humber PSTRC). This independent research is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0317-20010).

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Mackintosh, Carolyn. "Making patients better: a qualitative descriptive study of Registered Nurses reasons for working in surgical areas." 2007. http://hdl.handle.net/10454/4102.

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No
Little is known about the career decisions qualified nurses make, although it is clear that some areas of practice are more popular than others. This qualitative descriptive study considers one common area, surgery, and explores the motivation for decisions made by Registered Nurses (RNs) to work in this area. A sample of 16 RNs working within surgical areas participated in semi-structured interviews, using a thematic interview schedule. Findings were analysed using the framework suggested by Morse and Field. Analysis of findings indicates that all participants actively chose to work within surgery and that this was because of the pace and turnover of surgical work, personal satisfaction at the recovery of patients; the close links between this type of work; and participants' original aims when first entering nursing and participants' preference of surgery to other areas of nursing work. Participants actively rejected working in areas where patients were likely to suffer from chronic long-term conditions where recovery was unlikely and felt that these areas were likely to be depressing and unrewarding. These findings suggest that participants actively chose to work with 'healthy' patients in preference to those who may be considered 'ill', and this is closely linked to the identified need of participants to be able to 'make patients better'. Participants were reluctant to work in areas where they would be unlikely to achieve this aim.

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Garrity, Brigid. "Patient and family experiences with peri-operative care for spinal fusion surgery." Thesis, 2018. https://hdl.handle.net/2144/31155.

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Children with medical complexity (CMC) require increased number and length of hospitalizations, and increased need for care coordination.1-3 Many complex children with neuromuscular diseases have scoliosis, or a deformity of the spine. Often, scoliosis in these patients affects multiple organ systems and requires spinal fusion surgery to repair the deformity and decrease the likelihood of further organ damage.4,5 While it is well-known that spinal fusion surgery is costly and a high-risk procedure, little research has evaluated the perioperative process of spinal fusion patients. Furthermore, few care pathways exist for medically complex patients undergoing spinal fusions.6 This study examines the pre-, peri-, and post-operative experiences of families of patients undergoing spinal fusion surgery at Boston Children’s Hospital. Providers, organization, leadership and teamwork, and overall outcomes are assessed by this qualitative study. Initial data suggest that a pathway improving coordination and communication, especially among interactions with the surgical coordinator, should be implemented to improve scheduling of surgery and appointments throughout the perioperative process

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Дисертації з теми "Qualitative patient interviews"

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