Дисертації: "Quality of social care"

1

Momanyi, Kevin. "Enhancing quality in social care through economic analysis." Thesis, University of Aberdeen, 2019. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=240815.

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Population ageing has motivated policy makers around the world to focus on how best to organise health and social care services to meet an aniticipated growing demand on services. Two popular initiatives are reablement and telecare. Reablement is an approach within homecare that enables older individuals with social care needs to improve their functional performance and live independently. Telecare, on the other hand, involves use of devices to monitor individuals' health and safety, and provide response when needed. This thesis investigates the effectiveness of reablement and telecare by conducting a comprehensive review of the literature and undertaking three empirical studies. It is composed of six chapters. The first chapter presents a theoretical model that links the demand for reablement and telecare to various outcomes. The model is estimated using a strategy that controls for the effects of confounding variables and unobservable factors, and is general in the sense that it nests several other estimation strategies and study designs as special cases. The next chapter contains the literature review. Chapters 3, 4 and 5 present the three empirical studies. The first study investigates the effect of telecare on independent living at home; the second study determines the relationship between the use of telecare and admission to hospital, while the third study determines the relationship between telecare use and the length of stay in hospital. Chapter 6 concludes the thesis and provides some suggestions for further research. Unlike the results of the previous studies, the findings from this thesis suggest that the treatment effects are not homogenous across the poulation and also vary depending on the type of telecare device under consideration.

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2

Kocman, David. "Quality matters : re-formatting the boundaries of care in Czech social care policy." Thesis, University of Kent, 2013. https://kar.kent.ac.uk/47654/.

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This thesis deals with knowledge about the mechanics and effects of quality reforms in public service as advanced by critical policy studies. Critical policy studies have identified managerialism and marketization of public services as key conditions in introducing quality reforms. The argument has been built in opposition to proponents of quality who argue that marketization, when introduced to services, enhances their quality. In contrast, critical studies have shown that quality reforms have restructured organizational contexts of public services where quality acted mainly as a rhetorical figure, and where improvements remain dubious. The real effects of quality reforms, they argue, are increased control over practitioners’ labour process and de-professionalization. This thesis is a case study of a recent Czech social care reform. The Czech case is a case of a quality reform without marketization and managerialism, yet with a similar outcome in the form of managerialised care. As such, the Czech case offers an opportunity to further our knowledge about the mechanics of quality reforms provided we make a methodological step outside the analytics of managerialism. The thesis undertakes this methodological shift by drawing on Actor Network Theory. The question this thesis asks is how could managerialised care be achieved without either marketization or managerialism? Methodologically, the thesis argues that mapping social alliances among policy actors is necessary but in itself not sufficient to explain the outcome. The thesis traces the Czech quality reform from its inception as a policy project at the Ministry of Labour and Social Affairs to its circulation in social care sector. The Czech case shows how articulating quality service in quality standards re-organised care by extending (both conceptually and practically) its boundaries. Care traditionally understood as interactional bodywork was extended horizontally to include practices and forms outside the practitioner-client interaction (such as support planning), and it was extended vertically shifting the agency in care from an equipped practitioner to an equipped service. The contribution of the thesis is twofold. It shows that quality has gained a life in its own outside the managerialist causation model and may not necessarily follow in the footsteps of marketization and managerialism. Mainly, the thesis shows that quality is a complex shibboleth able to re-format the content of practitioner work rather than merely re-structure organizational contexts of public service provision.

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3

English, Christine. "Judging quality : parents' perspectives of the quality of their child's hospital care." Thesis, Northumbria University, 2017. http://nrl.northumbria.ac.uk/31608/.

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Background - UK healthcare has adopted various improvement strategies from business including using satisfaction surveys. However, the way patients form and express judgements of quality care can be more complex than customer purchases. Research in adult patient satisfaction has found capturing patient opinion challenging; however, adult service- user views continue to underpin quality care guidance across healthcare. Development of knowledge to include parental views of quality care is important to inform future guidance specific to children’s services. Methods - This study aimed to examine how parents determined the quality of care provided when their child was hospitalised, factors influencing perceptions of care and whether these judgements changed over time. Using a grounded theory approach, data were collected through a series of in-depth interviews (22) with nine parents following their child’s hospitalisation. Findings - The substantive grounded theory - Parenting in an alien hospital world: on guard and on behalf offers new perspectives on the complex psychosocial processes underlying parents’ quality judgements. When their child was hospitalised parents landed in an ‘alien’ world but continued to try 'to parent' (protect and advocate) their child. Parents' experiences were characterised by landing; moving from being' new parents' to 'old hands'; searching for and judging the 'clues' and facing dilemmas of how best to respond to professionals. Parents were found to use an escalating level of signals to prompt health professionals to respond to their queries and concerns Parents' personal lens altered through their transitional journey and this, together with their perception of professionals' power impacted on their chosen responses to professionals and their quality judgements. Parents held two views of care quality: ‘at the time’ and a final ‘on balance’ view. The final view recognised their own heightened emotions and reflected their current transition. Conclusions - Ultimately parents judge hospital care as high quality when they perceived health professionals acted as their allies in their parenting roles as protectors and advocates for their child in the alien hospital world. Health professionals could improve parents' experiences and quality judgements of care by early recognition and response to their 'signalling' and by explicitly acting as parental allies.

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4

Rapley, Mark Timothy John. "Quality of life : a critical approach." Thesis, Lancaster University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337125.

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5

Schultz, Rebecka A. "Staff Perceptions of Quality Interactions in Dementia Care." DigitalCommons@USU, 2019. https://digitalcommons.usu.edu/etd/7629.

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The national aging trend suggests that population of those aged 65 and older will reach 83.7 million by the year 2050. With increasing age comes the growing possibility of one getting some form of dementia. The Alzheimer’s Association expects the number of American’s with dementia to triple from the reported 5 million cases in 2014 by 2050. With a rise in this cognitively impaired population there is reason to look closely at the needs of persons with dementia living in residential facilities and whether or not they are being met. The main focus of residential facilities is to provide aid with physical needs. However, research shows that all people also have social and psychological needs that need to be met to have the highest quality of life possible. Other research shows that residents with dementia spend a majority of their days with little to no social interactions. This study aims to uncover what verbal and nonverbal behaviors, if any, Certified Nursing Assistants (CNAs) in residential care facilities find to be important when interacting with persons with dementia. This study includes the analysis of 11 interviews of CNAs from local facilities and home health companies. Analysis of their responses uncovered very few observable verbal and nonverbal behaviors were actually discussed. What was more apparent was that attitudes and internal behaviors participants considered important drove the use of good verbal and nonverbal communication. Five themes were uncovered. They were: Observable Verbal and Nonverbal Behaviors, Valuing Personhood, Get on Their [Cognitive and Reality] Level, Be a Friend, and Compassion. Excerpts from the interviews are included for examples of how these themes presented themselves.

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6

Aldousari, Abdulrahman. "Influence of national culture on the social construction of health care quality." Thesis, University of Surrey, 2015. http://epubs.surrey.ac.uk/807220/.

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The purpose of this study is to examine how national culture influences the social constructions of health care quality in the Kuwaiti primary care. Kuwait has a well- developed primary care system, offering a wide range of services in practices distributed throughout the nation, throughout the day, and on a walk-in basis. Despite its extended hours, relative comprehensiveness and affordability, the primary care service in Kuwait appears to be poorly received by the public. This study employed a qualitative research methodology to investigate how the elements of the Kuwaiti national culture shape the social constructions of health care quality. The study proposal was reviewed by the research ethics committees of the University of Surrey and KIMS, and a favourable ethical opinion was obtained. Participant information sheet were given to potential participants and consent obtained before data collection. Semi-structured interviews were conducted with 42 participants from various stakeholder groups. Data analysis identified three themes that represent the experiences of the various stakeholders’ relating to their social constructions of health care quality in primary care: (1) meanings of health, (2) attitudes towards primary care service, and (3) access to primary care. Within the identified themes, a number of sub-themes were identified, including: (a) the meaning of health, (b) responsibility for one’s health, (c) tensions in doctor-patient communication, (d) doctors feeling ‘undervalued’, (e) gender issues, (f) cultural suitability of primary care, (g) primary care work environment, (h) disproportionate distribution, (i) waiting times, and (j) institutional discrimination. The study found that the high-power distance element of national culture impacts the social constructions of health care quality. Perceptions of power differentials across social groups seem to contribute considerably to the social construction of health care quality. The contribution of this study is towards the body of knowledge on the cultural competence of health care provision in high-power distance cultures.

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7

Ekström, Anette. "Amning och vårdkvalitet = Breastfeeding and quality of care /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-240-3/.

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8

Putnam, Robin Irene Abell Ellen Elizabeth. "Social support and the quality of child care practices among participants in the Family Child Care Partnerships program." Auburn, Ala., 2006. http://repo.lib.auburn.edu/2006%20Fall/Theses/PUTNAM_ROBIN_48.pdf.

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9

Rababa, Majdi Mohammad. "SOCIAL SUPPORT, RELATIONSHIP QUALITY, AND SELF-CARE BEHAVIORS IN PATIENTS WITH HEART FAILURE." UKnowledge, 2018. https://uknowledge.uky.edu/nursing_etds/40.

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The purpose of this dissertation was to examine the associations among social support, gender, relationship quality, and self-care behaviors in patients with heart failure (HF). Specific aims were to: 1) compare the psychometric properties of the 12-item and the 9-item European Heart Failure Self-Care Behavior Scale (EHFScBS) when used to measure self-care behaviors in patients with HF in the United States; 2) determine whether gender moderated the association between perceived social support and daily sodium intake in patients with HF; and 3) determine whether a patient’s gender and relationship with the primary family caregiver (spousal or non-spousal) moderated the association between relationship quality and HF self-care. For the first specific aim, reliability and validity of the 12-item and the 9-item EHFScBS were compared by measures of internal consistency of reliability, item analysis, exploratory factor analysis, and hypothesis testing. The 12-item and the 9-item EHFScBS were valid and reliable when used to measure self-care behaviors in the United States. The 9-item EHFScBS was more homogenous with dimensions closer to the originally proposed dimensions when compared to the 12-item EHFScBS. The second specific aim was addressed by secondary analysis of data from The RICH Heart Program HF Registry. A hierarchical multiple regression model was used to determine whether gender moderated the association between social support and daily sodium intake. In our study, gender did not moderate the association between social support and daily sodium intake. The third specific aim was addressed using hierarchical multiple regression analyses to determine whether gender or relationship type moderated the association between relationship quality and HF self-care. Baseline data from an ongoing longitudinal, randomized controlled trial of a patient-caregiver dyadic intervention program were used in the analysis. Relationship quality was measured using the patient version of the Dyadic Relationship Scale, which consists of two subscales: positive dyadic interaction and negative dyadic strain. Heart failure self-care was measured using the 9-item EHFScBS. Positive dyadic interaction was associated with better HF self-care in female patients or patients with a non-spousal relationship with their family caregiver. This dissertation has fulfilled important gaps in the evidence base for the self-care of patients with HF. The findings from this dissertation provided evidence for the validity and reliability of the 9-item EHFScBS when used to measure HF self-care behaviors. It also provided recommendations for future research to measure directed social support to adopt a specific behavior, such as eating low sodium diet, instead of measuring the social support in general. It also emphasized the importance of examining the quality of the relationship between patients and their family caregivers. The findings also pointed to the need for interventions targeting the relationship quality to be tailored according to the patients’ gender or their relationship type with their family caregiver (spousal or non-spousal). A better understanding of how social factors can impact self-care behaviors in patients with HF is essential, as it gives researchers and healthcare providers the prospect of developing effective interventions to improve HF self-care.

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10

Lam, Yue-ban. "Pastoral care as a process indicator of quality schools." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21304816.

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11

Lo, Oi-sheung Anne. "A study of different perspectives on the quality of health care and its implication for medical social service /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13417496.

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12

Mngadi, Patricia Thuli. "Adolescent pregnancy and parenthood in Swaziland : quality of care, community support and health care service needs /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7140-725-2/.

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13

Walshe, Kieran. "The reliability and validity of adverse-event measures of the quality of health care." Thesis, University of Birmingham, 1998. http://etheses.bham.ac.uk//id/eprint/342/.

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The quality of healthcare is increasingly the subject of scrutiny by a range of stakeholders, including healthcare provider organisations, health professionals and their representative bodies, healthcare purchasers and funders, policy makers and national governments, patients and users of health services. The use of a variety of quality measures has become widespread in the healthcare systems of many developed countries, including the United Kingdom. The twin tasks of measuring and improving the quality of care - often termed quality assurance - have been addressed by new arrangements for professional accountability, new approaches to managing and comparing organisational performance, and new statutory and legal mechanisms. Adverse events in healthcare, which can be loosely defined as instances which indicate or may indicate that a patient has received poor quality care, offer an important opportunity for quality measurement and improvement. There is extensive evidence that adverse events are relatively common, that they can have serious and lasting impacts on patients, and that they represent a considerable cost to healthcare organisations. Equally importantly, evidence in healthcare and experience in other sectors suggests that adverse events offer an important insight into the strengths and weaknesses of healthcare processes, and an invaluable opportunity to bring about improvements in the quality of care. Adverse events have been used quite widely, particularly in the United States of America, as the basis of a number of measures of the quality of healthcare. However, these measures have rarely been developed and tested rigorously before they have entered widespread usage, and there has been considerable debate about their advantages and disadvantages. A series of empirical studies were undertaken, using data collected through the use of adverse-event measures of quality in a British acute hospital, aimed at investigating the validity and reliability of those measures. The results showed that the adverse-event measures being tested had moderate to good face, content and construct validity. Although their validity was capable of improvement, it was still clear that they were measuring meaningful and important dimensions of the quality of healthcare. However, the reliability of the measures being tested was more mixed. While experimental studies of interrater and intrarater reliability indicated that they had moderate to good reliability (though, again, it was capable of improvement) observational studies suggested that the reliability in actual use might be lower than that found during testing. This research concludes that adverse-event measures of quality are important measures of the quality of healthcare, which should be used in healthcare quality assurance with two main provisos. Firstly, the development of measures should be more rigorous, and should pay more attention to both validity and reliability issues. Secondly, the routine use of such measures should incorporate some element of ongoing reliability testing, in order to ensure that good reliability is maintained.

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14

Richardson, Annette. "Improving quality : assessment of risk, interventions and measuring improvement in critical care." Thesis, Northumbria University, 2018. http://nrl.northumbria.ac.uk/36239/.

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Introduction: My ten published papers focus on two domains of the quality agenda, patient safety and patient experience, concentrating on how quality improvement can reduce the occurrence of serious consequences of patient harm and poor patient experience. Aims: My goal was to design, test and discover how to make improvements in clinical practice in four areas: sleep deprivation, infection prevention, falls prevention and pressure ulcer prevention. Literature Review: There was limited evidence of successful strategies for change to improve quality. Common quality improvement challenges were within the complex critical care environment and an urgency to act without the focus on well-designed methods. Design and Methodology: A broad range of research methods was applied to evaluate the implementation of improvement interventions in critical care. These included: observational designs to uncover understanding on patient experience, activities and processes; before and after design; stepped cluster design and longitudinal time series design, utilised to increase confidence with attributable effect from the interventions. Results: My appraisal of my ten publications showed quality varied. Process and outcome measures were used to determine the success, and I received national and local recognition for some of my work. Discussion My three main knowledge contributions were: · practical ways to help nurses assess and improve patients’ sleep · risk assessment approaches · translation and implementation of improvement methodology in critical care. I discovered four cross-cutting themes which add to quality improvement knowledge and I developed an enhanced model for improvement. The four themes are: · clinical leadership at a programme and local level · using a bundle of technical and non-technical interventions · undertaking patient risk assessment to guide interventions · the value of data measurement and feedback Conclusions & Recommendations: My work has improved patient experience and patient safety knowledge. With further testing this knowledge could greatly benefit other areas of healthcare.

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15

Gage, LaToya Brown. "Perceived Quality of Care and Burnout in Psychiatric Caregivers Working With Offenders." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6022.

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Perceived quality of care and burnout affects psychiatric care workers profession-ally and physically. Psychiatric caregivers working in forensic facilities encounter negative changes with perceived quality of care and burnout when working with offender patients. Recognizing the variables that lead to burnout and perceived quality of care may assist professionals and organizations with the information needed to prevent burnout and poor perceived quality of care among psychiatric caregivers. Using self-efficacy theory as a framework, this correlational design examined whether years of experience, self-efficacy, and caseload complexity predict burnout and perceived quality of care. A total of 148 psychiatric caregiver participants completed questionnaires comprised of the Maslach Burnout Inventory-HSS, General Self-efficacy Scale, and Quality of Care Measures (staff-form), along with demographic questions. Multiple regression determined that self-efficacy and years of experience significantly predicted personal accomplishment, which is a subscale of burnout. However, self-efficacy did not predict of depersonalization or emotional exhaustion the other 2 subscales of burnout. Self-efficacy was also found to be a positive predictor of perceived quality of care. The research findings have the potential to influence social change by providing professionals and organizations a better under-standing of the factors that influence burnout and perceived quality of care when work-ing with offender patients. In relation, improvements in trainings, interventions, and strat-egies for positive employee well-being and increased patient care could possibly reduce burnout and increase perceived quality of care.

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16

Govender, Badroonesa. "The development of guidelines for social workers involved in early childhood development within the Department of Social Development." University of the Western Cape, 2016. http://hdl.handle.net/11394/4972.

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Philosophiae Doctor - PhD
Social workers employed by the Department of Social Development in South Africa are tasked with the provision of a broad spectrum of social services and may specialise in fields, such as welfare planning, which involves the capacity building, support and monitoring of welfare organisations. Early childhood development services fall in this category, as these services are monitored by social workers. Social workers employed by the Department of Social Development are the only group tasked with the mandate to capacitate, register partial care facilities and programmes, as well as monitor unregistered and registered facilities, on an on-going basis. Social workers adhere to these mandates amid many challenges. The aim of this study is to develop guidelines for social workers, who render services to Early Childhood Development (partial care) facilities. The objectives of this study are to explore the needs of social workers in the Early Childhood Development field in the Department of Social Development, identify challenges related to effective service delivery, explore the current methods of service delivery, develop guidelines and refined the draft guidelines, through a Delphi study. The Intervention Research design was used in this study, as it best suited the development of a tool; however, it was adapted to use only certain phases that were suitable for implementation for this study. The adaptation involved the use of the first four phases of the Intervention research method, combining of phase 1 and 2 to form a new phase 1 of the modified phases that linked to objectives one and two of the study. Therefore, this study only has three operational phases. A qualitative methodology was employed in this study to achieve the intended outcomes. Data collection occurred through semi-structured and telephonic interviews. Purposive sampling was used to select twenty (20) social workers from the Department of Social Development in the Western Cape and five (5) in the Eastern Cape. These participants engaged with Early Childhood Development facilities and interviews were conducted with them, while five (5) telephonic interviews were conducted with social workers in the Eastern Province. Conclusions from the analysed data were used to develop guidelines for DSD social workers within ECD settings. Two rounds of a Delphi study were employed to refine the proposed guidelines.

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17

Risman, Kelsey Lynn. "Individual Empathy, Person-Organization Fit, and Patient Care Quality: The Moderating Effect of Cohesion." University of Akron / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=akron1399477496.

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18

van, Leeuwen Karen, Judith E. Bosmans, Aaltje PD Jansen, Stacey E. Rand, Ann-Marie Towers, Nick Smith, Kamilla Razik, et al. "Dutch translation and cross-cultural validation of the Adult Social Care Outcomes Toolkit (ASCOT)." BioMed Central, 2015. http://dx.doi.org/10.1186/s12955-015-0249-x.

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Background: The Adult Social Care Outcomes Toolkit was developed to measure outcomes of social care in England. In this study, we translated the four level self-completion version (SCT-4) of the ASCOT for use in the Netherlands and performed a cross-cultural validation. Methods: The ASCOT SCT-4 was translated into Dutch following international guidelines, including two forward and back translations. The resulting version was pilot tested among frail older adults using think-aloud interviews. Furthermore, using a subsample of the Dutch ACT-study, we investigated test-retest reliability and construct validity and compared response distributions with data from a comparable English study. Results: The pilot tests showed that translated items were in general understood as intended, that most items were reliable, and that the response distributions of the Dutch translation and associations with other measures were comparable to the original English version. Based on the results of the pilot tests, some small modifications and a revision of the Dignity items were proposed for the final translation, which were approved by the ASCOT development team. The complete original English version and the final Dutch translation can be obtained after registration on the ASCOT website (http://www.pssru.ac.uk/ascot). Conclusions: This study provides preliminary evidence that the Dutch translation of the ASCOT is valid, reliable and comparable to the original English version. We recommend further research to confirm the validity of the modified Dutch ASCOT translation. (authors' abstract)

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19

Lam, Yue-ban, and 林遇品. "Pastoral care as a process indicator of quality schools." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31961010.

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20

Ratcliffe, Julie. "Valuing the benefits of health care technologies : a case study of liver transplantation." Thesis, Brunel University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311267.

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21

Prill, Hollie Rae. "The quality of the family day care setting and its effects on children's social and cognitive play behaviors." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1670.

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22

Brown, Madison McMurray. "Increasing the Quantity and Quality of Caregivers' Use of Social Reinforcement in a Large Residential Facility." Thesis, University of North Texas, 2018. https://digital.library.unt.edu/ark:/67531/metadc1404625/.

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Behavior-specific praise has been shown to increase rate of desired behaviors for individuals with intellectual and developmental disabilities, though it is rarely used by caregivers in residential facilities for adults with disabilities. Prompting in the form of tactile stimulation has been demonstrated to increase rate of behavior-specific praise delivered by teachers and caregivers. The purpose of the current study was to increase the quantity and quality of behavior-specific praise statements that were delivered by caregivers to individuals at a large residential facility for adults with disabilities. A tactile prompting device (Gymboss Interval Timer and Stopwatch) was provided to the caregivers and set to vibrate for one second at intervals of five minutes, for a total of six intervals. Instructions were provided to the caregivers to deliver behavior-specific praise statements, for appropriate behaviors, to their assigned clients every time a vibration occurred. Examples of behavior-specific praise statements were provided to the caregivers before each session, but no feedback was delivered during the prompting phase. Results indicated that a tactile prompting device was effective at increasing rate of behavior-specific praise statements delivered by caregivers in as little as one session.

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Witty, Willis J. "An exploratory case study of African American male nurses on leadership and quality of care." Thesis, University of Phoenix, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3731432.

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The purpose of this qualitative exploratory multiple-case study was to explore the lived experiences and the challenges African American male nurses faced in leadership roles and in providing quality care for minority patients. Participants included 15 African American male registered nurses (RNs) working in executive, administrative, and managerial leadership positions in Florida’s hospitals and other healthcare organizations. The participation criteria included being an African American male RN working in a leadership position in Florida with experiences in leadership and providing quality care for minority patients and at least 5 years of leadership experience. Participants completed in-depth face-to-face, digitally recorded interviews answering open-ended questions. Analysis of the interview data identified emerging themes and patterns using NVivo 10 qualitative data analysis software. Four major themes were identified: (a) specific leadership challenges associated with being an African American male leader, (b) general leadership challenges, (c) patient-level challenges limit the ability to provide quality care for minority patients, and (d) systemic challenges limit the ability to provide quality care for minority patients. Recommendations to healthcare leaders include a work environment free of gender segregation and racial discrimination, organizations adequately funded to deliver quality care, and strong leadership support for nurses and staff. Future studies should include additional geographic locations to increase the generalizability of findings to other populations.

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Barker, Wendy Vanessa. "Enhancing independence and the quality of life of older people through intermediate care : a mixed methods evaluation." Thesis, University of Hull, 2008. http://hydra.hull.ac.uk/resources/hull:6674.

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Cheung, Yun-ping Mary, and 張潤屛. "Patients' resources centre: from a ��marketingstrategy' to an enhancement of the quality of patient care." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B31964734.

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Pangilinan, John Simon. "IMPACT OF COMPASSION FATIGUE AND EMOTIONAL INTELLIGENCE ON THE QUALITY OF CARE IN SKILLED NURSING FACILITIES." CSUSB ScholarWorks, 2018. https://scholarworks.lib.csusb.edu/etd/648.

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Staff in skilled nursing facilities (SNF) can experience physical and emotional strain via caregiving. The purpose of this study was to educate staff on the harm of compassion fatigue and a lack of emotional intelligence and provide steps that can be taken by administration to improve the quality of care provided. It was hypothesized for staff that having low compassion fatigue and high emotional intelligence would result in a higher quality of care. The study design utilized a quantitative approach and a purposive sample from a SNF. Participants were provided with The Professional Quality of Life 5 Scale (ProQoL 5), Wong & Law Emotional Intelligence Scale (WLEIS), and survey data received from Department of Public Health. A Multiple Regression test analyzed the relationship between compassion fatigue and emotional intelligence on the quality of care provided by staff members. The results of this study indicated that staff’s compassion fatigue was not indicative of quality of care; however, Self-Emotional Appraisal, a subscale of WLEIS, was found to predict the quality of care. This study assisted with informing SNF staff in recognizing how managing their emotions could be a useful tool to improve the quality of care they provide. Lastly, SNF administration could implement policies, procedures, and in-services to ensure that all staff members are educated in identifying emotions and practicing self-care

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27

Trigg, Lisa. "Improving the quality of residential care for older people : a study of government approaches in England and Australia." Thesis, London School of Economics and Political Science (University of London), 2018. http://etheses.lse.ac.uk/3772/.

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Improving the quality of residential care for older people is a priority for many governments, but the relationship between government actions and high-quality provision is unclear. This qualitative research study uses the cases of England and Australia to examine and compare regulatory regimes for raising provider quality. It examines how understandings of quality in each country are linked to differences in the respective regulatory regimes; how and why these regimes have developed; how information on quality is used by each government to influence quality improvement; and how regulatory regimes influence providers to deliver quality. The study develops a new typology of three provider quality orientations (organisation-focused, consumer-directed, relationship-centred) to examine differences between the two regulatory regimes. The research draws on interviews conducted between January 2015 and April 2017 with 79 individuals from different stakeholder groups in England and Australia, and interviews with 24 individuals from five provider organisations in each country. These interviews highlighted greater differences between the two regimes than previous research suggests. For example, while each system includes a government role for inspecting or reviewing provider quality, there are differences around how quality is formally defined, the role and transparency of quality information, and how some provider quality behaviour is influenced by different policy interventions. Two important findings emerge from the study for policymakers and researchers. First, the importance of considering the broader historical and institutional context of the care sector overall, not simply the regulatory environment, as shown by the more welfare-oriented approach in England when compared to Australia’s highly consumerist approach. Second, the importance of considering the overall ‘regulatory space’ when designing policy interventions for quality. Policymakers should consider the effects and interaction of multiple policy interventions, the impact of funding mechanisms and the activity of multiple stakeholders, and not restrict attention to those policy interventions explicitly developed for quality improvement goals.

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Cheung, Yun-ping Mary. "Patients' resources centre : from a m̀arketing strategy' to an enhancement of the quality of patient care /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14023830.

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29

Santos, Michelle Florine. "A case study of supervisor-employee communication and the link to program quality." Scholarly Commons, 2007. https://scholarlycommons.pacific.edu/uop_etds/656.

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This case study investigated the quality of supervisor- employee communication and its impact on employee job satisfaction, self-esteem and trust, as well as the link to program quality in a center-based childcare setting. Three research questions guided the study with the purpose of examining communication as a means to improve job satisfaction, diminish staff turnover and strengthen program quality. Fifteen employees from a non-profit childcare center in San Joaquin County volunteered for the study. Data was collected from face to face and telephone interviews. Transcripts of the interviews revealed three themes- feedback, active listening and supervisor support. Responses were coded and categorized by theme, and then each theme was sorted into high quality supervisor communication responses and low quality supervisor communication responses. High quality supervisor communication was characterized by frequent and constructive feedback, self-motivation, openness and freedom to speak. The results of the study indicated high quality supervisor communication increased job satisfaction. Low quality supervisor communication was characterized by minimal feedback, the perception of favoritism, interference of work routine, low morale and increased absenteeism. The study found low quality supervisor communication hindered job satisfaction. The results of the study indicated that high quality communication between supervisor and employee had a positive impact on job performance, job satisfaction and organizational outcomes. Feedback, active listening and support were important communication behaviors sustaining job satisfaction. Passion for children proved to be intrinsic motivation to enhance program quality. Suggestions for developing program quality are provided.

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30

Neal, Margaret B. "Socialization and ideal expectations for the health professional role in the provision of quality terminal care for the urban elderly." PDXScholar, 1985. https://pdxscholar.library.pdx.edu/open_access_etds/332.

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This study investigates socialization and ideal expectations for the health professional role in the provision of quality terminal care. Guiding the research are role theory, socialization theory, and Talcott Parsons' (1951) pattern variables. The research was conducted in three phases. The first phase involved development of an analytical framework elaborating upon Parsons' five pattern variables, which were first conceptualized as dimensions describing the ways in which roles could vary. Specific indicators for each of the pattern variables were developed. Typologies characterizing (1) the medical, or conventional, model and (2) the holistic model (specifically, the hospice model) for the provision of health care based on these indicators then were developed. Using the analytical framework, the second and third phases consisted of: (1) a content analysis of the physician and nurse socialization literature to determine the role prescriptions learned by these health professionals; and (2) a content analysis of open-ended interviews with a group (N = 94) of terminally ill elderly patients (n = 17), family members (n = 38), and health professionals (n = 39) from 10 urban health care programs (five conventional and five hospice) to identify ideal role expectations for the health professional. Major findings were that: (1) Parsons' pattern variables, with elaboration, can provide a useful framework for role analysis; (2) physicians and nurses appear to be socialized to a number of role prescriptions consistent with the medical model, although there is evidence of conflicting socialization (to both models) for some role prescriptions; (3) respondents' expectations generally were consistent with those prescribed by the hospice model with some notable exceptions; (4) the role expectations of the three groups of respondents were more congruent than was expected, although subgroups' (conventional versus hospice) expectations tended to differ. Implications of the findings for: (1) role analysis; (2) socialization of health professionals to minimize role strain and conflict with patients and families; (3) continued implementation of conventional and hospice models for the provision of quality terminal care; (4) assessment of the quality of terminal care are explored; and (5) further research are explored.

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Uttjek, Margaretha. "Psoriasis care consumption and consequences of having psoriasis in everyday life." Doctoral thesis, Umeå : Umeå universitet, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-866.

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32

Thompson, Carl Anthony. "Quality : a multi-method exploration of the social construction of a contested concept in the National Health Service." Thesis, University of York, 1998. http://etheses.whiterose.ac.uk/13991/.

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33

Dodd, Catherine J. "Trends and predictors of quality, access, and cost in California's hospices. An examination of changes in quality in California's Medicare certified hospices from 2000--2005." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3261269.

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34

Lo, Oi-sheung Anne, and 羅愛嫦. "A study of different perspectives on the quality of health care and its implication for medical social service." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1992. http://hub.hku.hk/bib/B31249334.

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Jones, Abigail. "Delivering Quality Care: The Roles and Future of Midwives in Southern California." Scholarship @ Claremont, 2012. http://scholarship.claremont.edu/scripps_theses/88.

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The United States is ranked 27th in the world for maternal mortality, yet spends twice as much on maternity care services as countries with better maternal health indicators. Stuck in a technocratic and physician-dominated maternity care system, the U.S. depends on expensive technologies to control birth out of fear of pain and litigation, costing Americans billions of dollars and depriving women of the opportunity to have a transformative birth experience. Through an analysis of the medicalization of birth and the current biomedical model in birth, in conjunction with open-ended interviews with 5 hospital midwives and 3 homebirth midwives, the benefits and challenges of incorporating a midwifery model of care into our maternity services are explored. The midwifery model emphasizes that birth is not pathology and that psychosocial factors play a large role in birth outcomes. Basing their practice on collaboration, education, and support, midwives empower women, avoid unnecessary interventions, and offer a lower cost and higher quality care alternative. The current monopoly of women’s health services by physicians is unsustainable. Incorporating midwives into the maternity care team could provide a sustainable alternative with the caliber of maternity care services that U.S. women and families deserve.

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36

Brinson, Joseph Ray, and Luis Hernandez. "HUMAN SERVICE PROVIDERS’ PERCEPTION OF THE QUALITY OF CLIENT SERVICES PROVIDED AS RELATED TO THEIR LEVEL OF SELF-CARE." CSUSB ScholarWorks, 2014. https://scholarworks.lib.csusb.edu/etd/71.

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This study explored human service providers’ perception of the quality of client services provided as related to the providers’ level of self-care. We utilized a quantitative research approach to survey 54 human service providers from three Southern California agencies. An independent t-test was conducted to analyze the difference between participants’ perceptions of self-care by age, gender, and level of education. This study revealed a significant difference was found between gender and social care. Females are more likely to maintain an open, trusting relationship with someone who they can share their frustrations with, sustain balance in their life by pursing a variety of interests outside of work, and have a close relationship with someone who serves as a mentor and/or advisor. Also, a significant difference was found between gender and service delivery. When not meeting self-care needs, men felt that their service delivery was affected more so than women. Additionally, when stressed, males had more difficulty relating to clients than females. Due to the limitations of the study such as: sample size, sampling technique, validity and reliability of the questionnaire, these results cannot be generalized. For future research, it is recommended that similar studies are conducted on human service providers’ perception of the quality of client services provided as related to their level of self-care utilizing a larger sample size and a standardized instrument. It is also recommended that gender differences are studied within social work regarding self-care and its impact on job retention.

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37

Gethin-Jones, Stephen. "Does outcome-focused intervention for frail older people provide better quality care than current 'time and task' models?" Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/45266/.

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This thesis reports on a study of outcome-focused care for older people in one English local authority. The aim of the research was to examine whether altering the delivery of care to an outcome-focused model would improve service delivery and save money for the organisation in the long term. In order for this to be established, a longitudinal study was conducted over 18 months, utilising a mixed-method design. The sample consisted of 40 service users aged 65 years and over who all had critical and substantial care needs. The study also included interviews with and observations from social services staff responsible for the commissioning and delivery of care. The focus of this case study was to examine the impact of two models of home care delivery for older people, and how these two models impact on the older persons’ self-reported well-being. The research established that there was a greater improvement in well-being in the group receiving outcome-focused care, when compared with the comparison group receiving the traditional task-focused model. Managers’ and social workers’ perceptions were also that outcome-focused care improved service users’ sense of well-being, in comparison with those receiving task-focused care. The overall cost (service provision only) of providing the new style of intervention was 17% more than the traditional task-focused model. The main conclusion was that outcome-focused care allowed a meaningful relationship to be established between the home care worker and the service user, whereas the opportunity for such relationship building was limited in the traditional task-orientated model.

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Grubnic, Suzana. "The social construction of care pathways : a nursing management initiative towards operationalising continuous quality improvement in a children's hospital." Thesis, University of Derby, 2000. http://hdl.handle.net/10545/227118.

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The literature is dominated by prescriptive accounts of the application of Continuous Quality Improvement and care pathways in the acute hospital services sector. The authors assume that the organisation is a designed artefact (Scapens, Otley and Lister, 1984): goals can be achieved. This thesisr eports on the nature, processa nd consequenceso f a Nurse Manager introducing care pathways in a Children's Hospital It believes, in opposition to the conventional view, that the organisation is a culture. The actions and interactions of individuals and groups shape initiatives. This is within context and within time. The research investigation was conducted over a twenty-five month period, from February 1996 to April 1998. It was ethnographic in nature. Interviews were conducted with managers, nurses and doctors, formal meetings and activity in the Children's Emergency Department observed, and documentation collected. The findings are, however, presented from the nurses' perspective using their words. Files for newspaper clippings were created and maintained. The thesis contributes to the literature in three ways. In the main, it represents the first contextual and critical account of the implementation of care pathways than that believed to be contained in the literature. Further, it purposefully utilises for the first time two conceptualf rameworks in order to explicate the changep rocessesin the Children's Hospital. These are Watson's (1994) Strategic Exchange Perspective and Dawson's (1994) Processual Framework. It presents the descriptive part of the findings in the form of a narrative. The Nurse Manager established a project to multiskill experienced nurses in the diagnosis and treatment of minor conditions using care pathways as the vehicle. Her role changed during the process of implementation, but the project had little, if no, impact on power structures between and decision making of doctors and nurses

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Slayback, Benjamin G. "Spinal cord injury and surfing| A quality of life study." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527752.

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A spinal cord injury (SCI) can be debilitating and research is necessary to examine how patients' quality of life (QOL) can be improved through both psychological and physical remedies. This study's central research question was: Does participation in surfing improve perceptions of quality oflife in an individual with spinal cord injury? By interviewing eight individuals with SCis, the researcher attempted to assess, by means of a qualitative semi-structured interviews, whether participation in surfing activities had a positive impact on the respondents' perceived QOL. Respondents experienced improved QOL as a result of their participation in surfing with the Life Rolls On foundation because they felt supported, independent, relaxed, and exhilarated. Their perceived QOL was improved by the benefits of making friends and feeling like part of a community. It was hypothesized that respondents would report psychological benefits from recreational post-injury physical activities. These findings indicate support for the hypothesis.

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40

Fitzsimmons, Cynthia Richelle. "The value of relationship in long-term care an exploratory study /." Theological Research Exchange Network (TREN), 2008. http://www.tren.com/search.cfm?p088-0178.

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41

Goins, Semin. "Social Determinants of Health-Related Quality of Life Among African-American and Hispanic Adults." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1552657187400605.

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42

Pasmeny, Gloria A., and University of Lethbridge Faculty of Education. "Social support and quality of life in adults with severe and persistent mental illness." Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 2008, 2008. http://hdl.handle.net/10133/780.

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The current study investigated the relationship between social support and quality of life (QoL) as well as social support and community functioning among persons with severe and persistent mental illness (SPMI). Empirical data from Phase II of the Continuity of Mental Health Services (COMHS) Study of Alberta (Adair, Wild, Joyce, McDougall, Gordon, et al., 2003) were used to comprehensively examine these variables among a broad-based sample of 301 people with SPMI receiving a mix of inpatient, outpatient, and community services. Multiple measures administered in Phase II of the COMHS research program provided comprehensive data on QoL (i.e., disease-specific and generic QoL), functioning (i.e., community ability), and objective (OSS) and subjective (SSS) measures of social support. Higher ratings of both OSS and SSS were associated with better QoL and functioning at outcome. Participant ratings of objective dimensions of their own social support were shown to be most important in determining life quality and functioning at outcome. Of the two SSS variables, the one most predictive of life quality was the participants’ sense of the provision and receipt of social support. Clinician-rated OSS was a significant predictor of QoL only for participants who rated social support availability as poor. The results of this study may inform policy development, planning, and resource allocation for community treatment programs in Alberta and elsewhere, as there is widespread support both provincially and nationally for increasing community support services and decreasing the number and length of inpatient admissions (Kirby & Keon, 2006). A better understanding of the relative impact of social support variables is essential for further development of effective psychosocial rehabilitation programming.
xvii, 217 leaves ; 29 cm.

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Salamah, Seham. "The quality of life, social care and family relationships of older unmarried Saudi women living in Jeddah : a qualitative study." Thesis, University of Surrey, 2018. http://epubs.surrey.ac.uk/845801/.

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Changes in the Saudi family structure are having profound effects on the current cohort of older Saudi women. This is reflected in living arrangements whereby family patterns have been transformed from extended to nuclear ones. Previous social research has not examined the current situation of older Saudi women, with little known about their Quality of Life (QoL). This study explores the QoL of older unmarried Saudi women by analysing their family relationships, social lives and daily activities. It examines how family relationships, social integration, health and financial aspects are influenced by social policies and gender-related issues. The study is based on in-depth interviews with a purposive sample of 50 widowed, divorced and never-married women aged 60-75 in Jeddah, Saudi Arabia from a range of socio-economic classes; 25 lived alone and 25 lived in inter-generational households. Gender segregation was a decisive factor that adversely affected the QoL of interviewees. They were dependent on their family or maids socially, instrumentally, and some financially on the ‘Goodwill’ of their children or relatives. Older divorced women were particularly likely to experience financial and social problems. Lower class and many middle class older women who lived alone were dissatisfied and suffered from depression, isolation and loneliness, whereas higher class women living alone demonstrated greater autonomy, independence and life satisfaction. Most interviewees had poor health and multiple chronic diseases, such as diabetes and high blood pressure, which are linked to their socially and geographically restricted lives. Also, urbanization and associated cultural changes have adversely affected their QoL. Gender segregation driven by ultra-conservative patriarchy has resulted in the economic and social dependency and restricted lives of older unmarried Saudi women. State intervention is needed to improve the general situation of older women, such as establishing care homes, increasing social insurance income and providing medical insurance.

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Arias, Rosa, and Flora Irene Dharmaraj. "Levels of subjective quality of life among adults with psychotic disorders formerly in foster care: Compared to a matched sample." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3117.

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The purpose of this study was to explore whether or not adults with psychotic disorders, who were formerly in foster care, are more likely to report a lesser quality of life as compared to a matched sample with no history of foster care.

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Post, Kathryn E. "Understanding Patient Engagement in Breast Cancer Survivorship Care: A National Web-Based Survey." Thesis, Boston College, 2019. http://hdl.handle.net/2345/bc-ir:108398.

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Thesis advisor: Jane Flanagan
BACKGROUND: Breast cancer survivors experience a range of needs in the post-treatment phase as they transition into survivorship and beyond. The transition to survivorship requires breast cancer survivors to actively engage in self-managing their care, but little is known about patient engagement into survivorship care and what factors may contribute to this. Information is needed to further explore patient engagement into survivorship care, what factors may contribute to it and which patients are more likely to engage in their care and thus be better equipped to self-manage during survivorship. PURPOSE: The purpose of this study was to explore how demographic/personal factors and survivorship outcomes are related to and may contribute to patient engagement in early stage breast cancer survivors. METHODS: A cross-sectional, web-based self-report national survey was conducted using measures assessing personal/demographic factors, survivorship outcomes: health-related quality of life (HRQOL), fear of cancer recurrence (FCR), cancer health literacy (CHL) and two measures of patient engagement (patient activation (PA) and knowing participation in change (KPC). There was one open-ended question regarding additional survivorship concerns, not addressed in the previous survey items. Participants were recruited using Dr. Susan Love’s Army of Women Research Foundation and Craigslist. Data were analyzed via bivariate associations and backwards linear regression modeling in SPSS. RESULTS: The final sample included 303 participants (301 females and 2 males) with a mean age of 50.70 years. The sample was predominantly White, non-Hispanic and equally dispersed across the United States. Patient engagement, as represented by PA and KPC, was significantly correlated with 13 predictor variables and there were 10 predictor variables that resulted in significant ANOVA relationships with PA and KPC. In both the KPC and PA regression models, HRQOL significantly predicted for patient engagement. In the KPC regression model, social support and level of education also significantly predicted for patient engagement and receipt of a survivorship care plan contributed unique variance to the model. The open-ended question response categories included: physical concerns, mental health concerns, financial toxicity, social support, body image concerns, other concerns or no concerns/none. CONCLUSIONS: This study provides preliminary evidence that personal/demographic factors and survivorship outcomes may contribute to patient engagement in breast cancer survivors. Using assessment tools that measure factors such as HRQOL, social support, education level and patient engagement may give providers some insight as to which survivors may be ready to engage in survivorship care and those that may need more resources and/or support. Additional studies are needed to replicate and validate these results. More research is needed aimed at maximizing patient-centered care, patient engagement and ultimately improving SC. Keywords: breast cancer survivor, survivorship, patient engagement, health-related quality of life, social support
Thesis (PhD) — Boston College, 2019
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing

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46

Hasson, Henna. "Nursing Staff Competence, Psychosocial Work Environment and Quality of Elderly Care: Impact of an Educational Intervention." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis (AUU), 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7383.

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47

Fredin, Rebecca Layton. "Perceptions of quality of medical care among consumers with schizophrenia who have a comorbid medical illness." The Ohio State University, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=osu1330979750.

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48

Ding, Hua, and 丁華. "In the trend of "socializing social welfare" policy: a study on service quality and social capital in thesociety-run home for the aged in Beijing, China." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B39558952.

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49

Dobell, L. Gail. "The development and testing of an instrument to measure quality of home and community based long-term care delivery." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2008. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3311336.

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50

Olsson, Claudia. "Affordable high quality health carefor school children in India." Thesis, KTH, Hållbarhet och industriell dynamik, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-148950.

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Access to affordable high-quality health care solutions is a global challenge, especially in emerging markets where health care systems are the most resource constrained. The socio-economic benefits of investing in health care are considerable, especially in terms of improvement of life quality and economic development. This creates a strong demand for efficient health care delivery models with good health outcomes. In particular, health programs targeting children in their formative years can have a longlasting effect on the children’s and their families’ lives. In India, which has one of the highest burdens of disease in the world, many states lack adequate school health programs. To address this need, the NICE Foundation has developed a school health program that provides free health care to over 200,000 children. The NICE Foundation has experienced a great interest in their school health model and thus aims to expand their operations. This study analyses the characteristics of the school health program in order to identify future opportunities and to provide strategic advice for the expansion of the NICE Foundation School Health Program.
Tillgång till prisvärd och högkvalitativ sjukvård är en global utmaning, i synnerhet i tillväxtländer där sjukvårdssystemen är mycket resursbegränsade. De socio-ekonomiska fördelarna av att investera i sjukvård är avsevärda, med förbättrad livskvalitet och ekonomisk utveckling som följd. Det finns därför en stor efterfrågan på effektiva hälsomodeller som renderar goda hälsoresultat. Särskilt hälsoprogram som är inriktade på barn i deras formativa år har dokumenterats ge långtgående positiva effekter för individerna och samhället. I Indien, som har en av de högsta nivåerna av sjukdomsbörda i världen, saknar många av delstaterna skolhälsoprogram. För att addressera detta behov har NICE Foundation utvecklat ett skolhälsoprogram som i nuläget erbjuder gratis sjukvård för över 200 000 barn. NICE Foundation skolhälsomodell har fått mycket positiv respons och organisationen ämnar att expandera programmet. Denna studie analyserar NICE Foundation skolhälsomodell för att identifiera framtida möjligheter samt för att tillhandahålla strategiska råd för expansion.

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