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Dissertations / Theses on the topic 'COPD, disease, nursing care, patient'

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1

Zakrisson, Ann-Britt. "Management of patients with chronic obstructive pulmonary disease in primary health care : a study of a nurse-led multidisciplinary programme of pulmonary rehabilitation." Doctoral thesis, Örebro universitet, Hälsoakademin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-15732.

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The aim of this thesis was to modify and evaluate effects, as well as todescribe experiences of a nurse-led multidisciplinary programme of pulmonaryrehabilitation in primary health care for patients with chronicobstructive pulmonary disease (COPD) and their next of kin.Interviews were performed with 12 COPD nurses about their experiencesof patient education (I). Forty-nine patients participated in the interventiongroup and 54 in the control group in a quasi-experimentalstudy which investigated the effects of the programme on functional capacity,quality of life and exacerbation frequency during one year (II).Interviews were performed related to the experiences of 20 patients whohad participated in the six-week programme (III) and the experiences of20 next of kin to the patients that had participated (IV).The results showed that COPD nurses fluctuated between security andinsecurity in patient education and were in need of support, time, structureand collaboration to develop their patient education (I). In Study IIthere were no differences between the groups with regard to functionalcapacity and quality of life, but the number of exacerbations decreased inthe intervention group and increased in the control group (II). The patientsin study III had allowed themselves to live at their own pace followingthe programme but a constant fear was present in spite of the programme(III). Next of kin in Study IV had a life that remained overshadowedby illness but there were positive outcomes of the programme aslong as two years afterwards. The next of kin also had constant fear,however (IV).In conclusion, the six week programme brought about results in changingeveryday life. Nevertheless, all lived in the shadow of fear and uncertaintyin spite of the programme. More research is needed to address therequirements of COPD nurses, patients and next of kin.
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Hodson, Matthew. "Development of a patient reported experience measure in chronic obstructive pulmonary disease (COPD)." Thesis, University of Portsmouth, 2014. https://researchportal.port.ac.uk/portal/en/theses/development-of-a-patient-reported-experience-measure-in-chronic-obstructive-pulmonary-disease-copd(c7bf6540-155f-4245-b764-daa61ea6f73a).html.

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The experience of patients living with chronic obstructive pulmonary disease (COPD) and their views on the quality of healthcare they receive is not currently captured in patient reported measures. Aim: To develop and validate a patient reported experience measure to assess experiences of living with COPD and perceived quality of healthcare provision. Method: Previous work with 83 COPD patients identified 38 items for inclusion in a patient reported experience measure. These, together with the COPD Assessment Test and Hospital Anxiety and Depression Scale were administered to patients with COPD. Items demonstrating significant gender or age bias (p<0.05), floor or ceiling effects (set at 40%), missing data >15%, or high item to item correlations (r>0.8) were removed. Rasch analysis was applied to the remaining items. Results: 174 patients (Mean age 71 years, SD 9; 91 female; Mean Forced Expiratory Volume1 59%, SD 21.9) were studied. 29 items were removed, providing a 9-item unidimensional scale (chi-square p=0.33) with a wide scaling range (logits from -0.1 to +0.2). These cover experiences of living with COPD (e.g. I feel that I am in control of my condition) and health care (e.g. I am concerned that my GP won't listen to my point of view). Internal consistency was good (PSI= 0.77) and correlations between the COPD PREM-9, COPD Assessment Test and Hospital Anxiety and Depression Scale were moderate (r=0.42 and r=0.30, respectively). Conclusions: The COPD PREM-9 demonstrated good internal reliability and showed a wide scaling range suggesting, regardless of severity, people with COPD can have good or bad experiences. There were low to moderate correlations with the COPD Assessment Test and Hospital Anxiety and Depression Scale, which suggests the PREM COPD-9 is measuring a different concept. The COPD PREM-9 may be a useful measure of quality of care that complements measures of health status and mood.
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Jones, Sharon Scardina. "Evaluating a Discharge Bundle for Chronic Obstructive Pulmonary Disease." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4861.

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Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the leading causes of hospital readmissions within 30 days. Frequent readmissions negatively affect hospital reimbursements and patient outcomes. Creative strategies, such as COPD care bundles, have been shown to reduce readmission rates according to existing studies. A COPD discharge bundle was developed and implemented at 1 community hospital in response to an identified problem with COPD readmissions. Evaluation of this quality improvement initiative was the purpose of this project study. The practice-focused question was: Have 30-day readmission rates changed following the implementation of a COPD discharge bundle prior to transitioning from hospital to home? The framework selected for this project was the model for improvement. Sources of evidence included existing hospital data to evaluate the change in readmissions. The chi-square test of independence was used to assess the difference in frequency of 30-day readmissions. Pre and post-bundle implementation comparisons of readmission rates showed a decrease for 3 out of the 4 groups compared; these results were not statistically significant. Analysis of the post-bundle intervention groups revealed lower 30-day readmissions for individuals who were bundle compliant versus noncompliant and for those who spoke with a pharmacist within 48 hours of discharge opposed to those who did not; these results were statistically significant. Continued use of the bundle and maintaining the role of the pharmacist was recommended. Reduction of readmissions within 30-days has positive social implications for hospitals through financial gains and for the COPD population by improving overall health outcomes.
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Askratni, Josette. "A Chronic Obstructive Pulmonary Disease Self-Management Packet to Reduce 30-Day Readmissions." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4709.

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Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's evidence-based practice model was used to guide practice change. The U.S. Prevention Service Task Force's level of evidence hierarchy was chosen to categorize the strengths and weaknesses of the evidence referenced for this project. Postdevelopment surveys using the Likert scale were distributed to the facility's COPD committee, and a 70% response rate of strongly agreed to all questions was achieved. There were no adverse responses, and the packet was approved unanimously. Based on the positive responses, the packet will be easily adapted and beneficial in practice. The recommendation is to pilot the packet on the medical-surgical unit and follow-up postdischarge with phone calls to ascertain patients' perspective of the packet. Utilization of the education packet will lead to positive social change by affording the stakeholders self-management awareness and positive outcome measures including reducing the COPD 30-day readmission rate, curtailing economic strains, and promoting positive patient-centered relationships.
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Fuseya, Yoshinori. "Perspectives on End-of-Life Treatment among Patients with COPD: A Multicenter, Cross-sectional Study in Japan." Kyoto University, 2020. http://hdl.handle.net/2433/252978.

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Newman, Linda C. "Maintaining self integrity in the care of AIDS patients : a grounded theory approach." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/834521.

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The purpose of the study was to explore barriers hospital nurses perceive in the care of AIDS or HIV positive patients. According to the Center for Disease Control, the total number of AIDS cases reported in the United States as of December 1991 was 206,392. The Center for Disease Control reported of the known AIDS cases in the United States 59% have resulted in death.A grounded theory approach was used in the study of sixteen nurses working with AIDS patients in a medical surgical area of the hospital. Results of the study showed nurses had a need to maintain self integrity. All barriers found as a result of the study related to the nurses need to maintain self integrity. Barriers found as a result of the study include the following: fear of contagion, family concerns, fear of the unknown, issues in confidentiality, issues in universal precautions, and emotional and spiritual aspects.
School of Nursing
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7

Prieto, Roseanne. "Preventing Progression of End Stage Renal Disease: A Systematic Review of Patient-Provider Communication in Primary Care." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/612943.

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Background: Chronic kidney disease (CKD) affects approximately 26 million individuals in the United States and is a top priority in the objectives for Healthy People 2020. Despite efforts to improve awareness, discussion of CKD is often minimal or ineffective in the primary care setting. This leads to a lack of patient awareness and knowledge of self-care skills to prevent or slow progression of the disease. A lack of communication of has been attributed to the provider's lack of confidence and knowledge to discuss CKD and to avoid unnecessary stress. Purpose: The purpose of the DNP project is to provide a systematic review of patient-provider communication processes used to influence self-management or behavioral change in primary care and propose a tool to enhance communication and slow progression of CKD. Methods: A systematic review was conducted following the method guidelines of the Cochrane Collaboration. Six electronic databases were searched. Inclusion criteria were adult humans, primary research studies, systematic and literature reviews, focus on communication of self-management or behavioral change strategies, primary outcomes of improving self-management and/or patient outcomes and availability of full-text online or by request. Outcomes: Of the 5765 articles initially identified, 28 studies met inclusion criteria. The studies revealed a lack of evidence directed towards CKD and communication was not directly addressed in a majority of the studies. Interventions most successful in improving patient outcomes were individualized, elicited collaboration or interaction with the patient and provider, were motivational or encouraging and aided in barrier identification and problem solving. A communication tool was developed from the evidence in order to stimulate more meaningful conversation between the patient and provider.
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Cheung, Mei-ying Josephine, and 張美盈. "Taking care of pediatric SARS patient in isolation ward: a phenomenological view." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B45011606.

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9

Österlund, Efraimsson Eva. "Communication in Smoking Cessation and Self-management : a study at Nurse-led COPD-clinics in Primary Health Care." Doctoral thesis, Högskolan Dalarna, Omvårdnad, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:du-5307.

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ABSTRACTThe general aim of this thesis was to investigate behavioral change communication at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary health care, focusing on communication in self-management and smoking cessation for patients with COPD.Designs: Observational, prospective observational and experimental designs were used.Methods: To explore and describe the structure and content of self-management education and smoking cessation communication, consultations between patients (n=30) and nurses (n=7) were videotaped and analyzed with three instruments: Consulting Map (CM), the Motivational Interviewing Treatment Integrity (MITI) scale and the Client Language Assessment in Motivational Interviewing (CLAMI). To examine the effects of structured self-management education, patients with COPD (n=52) were randomized in an intervention and a control group. Patients’ quality of life (QoL), knowledge about COPD and smoking cessation were examined with a questionnaire on knowledge about COPD and smoking habits and with St. George’s Respiratory Questionnaire, addressing QoL. Results: The findings from the videotaped consultations showed that communication about the reasons for consultation mainly concerned medical and physical problems and (to a certain extent) patients´ perceptions. Two consultations ended with shared understanding, but none of the patients received an individual treatment-plan. In the smoking cessation communication the nurses did only to a small extent evoke patients’ reasons for change, fostered collaboration and supported patients’ autonomy. The nurses provided a lot of information (42%), asked closed (21%) rather than open questions (3%), made simpler (14%) rather than complex (2%) reflections and used MI non-adherent (16%) rather than MI-adherent (5%) behavior. Most of the patients’ utterances in the communication were neutral either toward or away from smoking cessation (59%), utterances about reason (desire, ability and need) were 40%, taking steps 1% and commitment to stop smoking 0%. The number of patients who stopped smoking, and patients’ knowledge about the disease and their QoL, was increased by structured self-management education and smoking cessation in collaboration between the patient, nurse and physician and, when necessary, a physiotherapist, a dietician, an occupational therapist and/or a medical social worker.Conclusion The communication at nurse-led COPD clinics rarely involved the patients in shared understanding and responsibility and concerned patients’ fears, worries and problems only to a limited extent. The results also showed that nurses had difficulties in attaining proficiency in behavioral change communication. Structured self-management education showed positive effects on patients’ perceived QoL, on the number of patients who quit smoking and on patients’ knowledge about COPD.
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Landim, Camila Aparecida Pinheiro. "Adaptação cultural para o Brasil e Portugal do instrumento Patient Assessment of Chronic Illness Care (PACIC)." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-17042013-144940/.

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O Patient Assessment of Chronic Illness Care (PACIC) é o único instrumento disponível na literatura científica para avaliação da qualidade do cuidado sobre os elementos do Modelo de Cuidados Crônicos, na perspectiva da pessoa com condição crônica. No contexto cultural do Brasil e de Portugal, não há instrumentos para avaliar essa dimensão de cuidado no diabetes mellitus (DM), considerada como uma importante condição crônica, em decorrência da sua prevalência e mortalidade mundial. Trata-se de um estudo metodológico com o objetivo de realizar a adaptação cultural para o Brasil e Portugal do instrumento PACIC. Constituído por 20 itens, o PACIC possui cinco domínios: Participação Ativa do Paciente no Tratamento, Modelo do Sistema de Cuidado/Modelo para a Prática, Estabelecimento de Metas/Adaptação, Resolução de Problemas/Contexto e Seguimento/Coordenação. O processo de adaptação cultural seguiu as etapas preconizadas pela literatura: Tradução, Comitê de Especialistas, Retrotradução (Back-Translation), Pré-Teste e Entrevista Cognitiva. O estudo foi realizado em ambulatório de endocrinologia, de uma unidade básica distrital de saúde no município de Ribeirão Preto, São Paulo, Brasil e de um hospital público e de ensino na cidade do Porto, Portugal. Os dados foram obtidos por meio da entrevista dirigida, nos meses de novembro (Brasil) e maio (Portugal) de 2012. Mediante os critérios de seleção, a população do estudo foi constituída por 50 pessoas brasileiras e 50 pessoas portuguesas, perfazendo um total de 100 pessoas com DM. Para a coleta de dados foi utilizado os instrumentos Impressão Geral e Específica do Projeto DISABKIDS ® . Para apresentação dos resultados utilizou-se análise descritiva, por meio de quadros e tabelas. Os resultados encontrados foram satisfatórios, demonstrando que o instrumento foi considerado muito bom pela maioria da população do estudo, com questões fáceis de entender e categorias de respostas não difíceis de serem utilizadas. Somado a isso, 92% (Brasil) e 86% (Portugal) dos participantes declararam que os itens do instrumento são muito relevantes para o diabetes mellitus, como condição de saúde. Visando a maneira como os 20 itens do instrumento avaliado foram formulados, a maioria mostrou-se de fácil compreensão, apenas quatro (6, 10, 12 e 16) foram adaptados culturalmente no Brasil e um (19) em Portugal. Conclui-se que o estudo resultou em um instrumento adaptado culturalmente e compreensível para o Brasil e Portugal. Há necessidade de prosseguir com a avaliação das propriedades psicométricas para o estudo de validação do instrumento adaptado em ambos os contextos culturais.
The Patient Assessment of Chronic Illness Care (PACIC) is the only instrument available in the scientific literature to assess the quality of care for the elements of Chronic Care Model from the perspectives of individuals with chronic diseases. In the Brazilian cultural context, there is no instrument to evaluate this dimension in the care provided for diabetes mellitus (DM) patients, which is considered an important chronic condition due to its prevalence and mortality worldwide, nor is there one in the Portuguese cultural context. This methodological study\'s objective was to perform the cultural adaptation of the PACIC instrument for both Brazil and Portugal. It comprises 20 items and five domains: Patient Activation, Delivery System Design/Practice Design, Goal-Setting/Tailoring, Problem-Solving/Context and Follow- up/Coordination. The cultural adaptation process followed the steps recommended by the literature: Forward Translation, Expert Panel, Back-Translation, Pre-testing, and Cognitive Interviewing. The study was conducted in the endocrinology outpatient clinic of a primary health unit in the city of Ribeirão Preto, SP, Brazil and in a public university hospital in the city of Porto, Portugal. Data were obtained through focused interviews in November (Brazil) and in May (Portugal), 2012. A total of 50 Brazilian and 50 Portuguese individuals met the inclusion criteria, totaling 100 individuals with DM. The instruments General and Specific Impression of DISABKIDS ® Project were used to collect data. Descriptive analysis was used and the results are presented in tables. The results were satisfactory, showing the instrument was considered very good by most of the study\'s population. Questions were considered to be easy to understand and the answer categories were also easy to use. Additionally, 92% (Brazil) and 86% (Portugal) of the participants reported the instrument\'s items are very relevant for DM as a health condition. Due to the way the instrument\'s 20 items were developed, most were easy to understand and only four (6, 10, 12 and 16) were culturally adapted for Brazil and only one (19) was culturally adapted for Portugal. The conclusion was an instrument culturally adapted and easy to understand both in Brazil and Portugal. There is a need to assess its psychometric properties to validate the adapted instrument for both cultural contexts.
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Omar, Mohamed Zamzam, and Muya Wanja Shellomith. "Att leva med kronisk obstruktiv sjukdom (KOL) : en litteraturstudie." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-8899.

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Gillespie, Cynthia Ann. "Evaluating an Educational Initiative for Postsurgical Vascular Patients." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6432.

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The educational medium GetWellNetWork (GWNW) in a large magnet teaching facility offered few educational videos specific to vascular patients with a focus on leg elevation after lower extremity bypass surgery. Supplying patient-specific education has the potential for providing cost-effective nursing care to vascular patients and improving hospital reimbursement. Guided by the interactive care model, a storyboard was developed using best-practice evidence for vascular postoperative patients that could lead to the development of a video to address the educational needs of vascular patients upon discharge. The practice focused question asked if a video addressing the importance of leg elevation would improve patients’ use of in-house educational videos and stakeholder satisfaction. A vascular physician (n = 1) and nursing staff (n = 9) provided feedback on the appropriateness of the evidence-based educational content for the storyboard by completing a 9-item, open-ended survey. Survey results supported development of the video and revealed positive feedback on storyboard content and that staff with 1–3 years’ experience or 15+ years’ experience had an increased understanding of the importance of evidence-based guidelines for leg elevation for vascular patients. The feedback will be used to develop a vascular-patient-specific educational video. Encouraging patients to view the video on leg elevation has the potential to improve cost effectiveness of patient care and hospital reimbursement, prevent hospital readmission that could lead to patient and caregiver hardships associated with readmission, and improve the health outcomes for postoperative vascular patients.
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McManus, Lisa Sullivan. "The Patient-Centered Medical Home and Diabetes Mellitus Outcomes: A Systematic Review." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3310.

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Ineffectively managed chronic diseases such as diabetes mellitus (DM) increase overall health care expenditures and negatively affects health outcomes such as exacerbations, functional decline, disability, and death. The purpose of this systematic review (SR) was to review the DM outcomes reported by patient-centered medical homes (PCMHs). The goal was to determine how care coordination and evidence-based clinical management impacted financial and health outcomes. The SR followed the Cochrane protocol and complied with the PRISMA evidence-based minimum set for reporting. Overall, DM management in the PCMH demonstrated statistically significant completion rates for essential screenings and preventive care, including HgA1c (p = 0.0013), lipid management (p
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Silva, Viviane Martins da. "Characterization of nursing diagnoses in children with congenital heart disease: Study at a specialized hospital in diseases cardiopulmonary." Universidade Federal do CearÃ, 2007. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=1050.

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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
Os cuidados de enfermagem para crianÃas com cardiopatia congÃnita devem ser estabelecidos e executados tÃo logo se suspeite do diagnÃstico de defeito cardÃaco congÃnito, voltados sempre para a detecÃÃo precoce de sinais de descompensaÃÃo e manutenÃÃo de condiÃÃes Ãtimas para a cirurgia. Objetivou-se caracterizar o quadro de diagnÃsticos de enfermagem apresentados por crianÃas com cardiopatias congÃnitas. Estudo de natureza observacional, longitudinal desenvolvido nos meses de julho a novembro de 2004. A amostra foi composta por 45 crianÃas internadas em um hospital da rede pÃblica do municÃpio de Fortaleza-CearÃ. Para a coleta, foram utilizados entrevista e exame clÃnico de enfermagem. As crianÃas foram acompanhadas durante quinze dias de internamento desde a data de sua admissÃo. No perÃodo efetivaram-se seis avaliaÃÃes diagnÃsticas com intervalo de 48 horas. O processo de elaboraÃÃo e inferÃncia dos diagnÃsticos e problemas colaborativos seguiu as etapas de coleta, interpretaÃÃo / agrupamento das informaÃÃes e nomeaÃÃo de categorias. Foram encontrados 22 diagnÃsticos de enfermagem, 34 fatores relacionados e 13 problemas colaborativos diferentes nas 270 avaliaÃÃes realizadas. Observou-se associaÃÃo estatisticamente significante entre os diagnÃsticos Troca de gases prejudicada, PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade, Crescimento e desenvolvimento retardados e PerfusÃo tissular ineficaz. Estes diagnÃsticos apresentaram associaÃÃo com os fatores relacionados: DesequilÃbrio da ventilaÃÃo-perfusÃo, HiperventilaÃÃo, ReduÃÃo mecÃnica do fluxo sangÃÃneo, SecreÃÃes brÃnquicas e SecreÃÃes retidas. Os diagnÃsticos IntolerÃncia à atividade e Crescimento e desenvolvimento retardados mostraram associaÃÃo com o sexo feminino. Nos diagnÃsticos Troca de gases prejudicada, PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade, Crescimento e desenvolvimento retardados e DÃbito cardÃaco diminuÃdo, identificaram-se diferenÃas de mÃdia de sobrevida entre crianÃas atà 4 meses e acima de 4 meses. Os diagnÃsticos Troca de gases prejudicada, PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade e Risco para infecÃÃo ocorreram precocemente no perÃodo de internamento. Entre os diagnÃsticos, seis evidenciaram maiores oscilaÃÃes em suas trajetÃrias de ocorrÃncia no tempo: PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade, DesobstruÃÃo ineficaz das vias aÃreas, Hipertermia, PadrÃo de sono perturbado e Risco para intolerÃncia à atividade. Foram construÃdos cinco modelos paramÃtricos no domÃnio tempo, com vistas a predizer a ocorrÃncia desses diagnÃsticos de enfermagem. O ajustamento das equaÃÃes para os diagnÃsticos PadrÃo de sono perturbado e Hipertermia denotou grande dispersÃo entre os dados e a linha de tendÃncia, indicando que, alÃm do tempo, outras variÃveis determinam a proporÃÃo de crianÃas que manifestarÃo esses diagnÃsticos. Considera-se a importÃncia de se realizar pesquisas de caracterizaÃÃo do quadro de diagnÃsticos para determinaÃÃo das necessidades de assistÃncia de enfermagem à crianÃa cardiopata. O conhecimento da evoluÃÃo temporal das respostas do indivÃduo pode direcionar os cuidados de enfermagem para as reais necessidades do cliente, facilitando, assim, a escolha de intervenÃÃes mais adequadas
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Romero, Massú Nicole, and Moa Vållberg. "Ett komplext vårdande : -Sjuksköterskors erfarenheter av att vårda personer med diabetes." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-48760.

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Sammanfattning Bakgrund: Personer som drabbats av diabetes har ökat under de senaste decennierna. Fler sjuksköterskor kommer behöva evidensbaserad kunskap om hur de vårdar dessa personer på bästa sätt. Tidigare forskning visade patienters- och anhörigas erfarenheter av diabetessjukdomen samt diabetesvården. Då återstod frågan vad sjuksköterskor hade för erfarenheter av att vårda personer med diabetes. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda personer som drabbats av diabetes. Metod: Systematisk litteraturstudie med beskrivande syntes enligt Evans (2002) med en induktiv ansats. Resultat: Sjuksköterskors erfarenheter beskrevs i två teman med fyra tillhörande subteman. Första temat var att vårda utifrån den unika människan med subteman, att stötta patienten till egenvård samt att arbeta med en komplex vård kring patienten. Andra temat var att inte ha förutsättningar för att ge god vård med subteman, att inte ha tid och kompetens samt att generalisera och inneha en maktposition. Slutsats: För att vårda den växande populationen av personer med diabetes på bästa möjliga sätt, visade detta examensarbete bland annat att sjuksköterskor bör beakta patienters självbestämmanderätt, samt att sjuksköterskor bör vårda mer personcentrerat.
Abstract Background: Number of people affected by diabetes has increased during the past decades. Numerous nurses will be needing evidence-based knowledge of how to care for these people in the best way. Previous research has shown patients 'and relatives' experiences of diabetes and diabetes care. The question of what experiences nurses had of caring for diabetics remained. Aim: To describe nurses’ experiences of caring for people who suffer from diabetes. Method: Systematic literature study with descriptive synthesis according to Evans (2002) with an inductive approach. Results: Nurses' experiences were described in two themes with four subthemes. The first theme was to care for the unique human, with subthemes, to support the patient to self-care and to work with a complex care around the patient. The second theme was not to have the conditions to provide good care with subthemes, not to have time and competence a long with to generalize and hold a power position. Conclusion: To facilitate the best care for the growing population of diabetics, this degree project showed, for instance, that nurses should both consider patients' self-determination rights and apply more person-centred care.

Sjuksköterskeprogrammet

Kurs: Examensarbete i vårdvetenskap med inriktning mot omvårdnad.

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Rova, Elin, and Henny Wiippa. "Patienters upplevelser av vården från beskedet om obotlig sjukdom till palliativ vård i livets slutskede : Patients experiences of healthcare from the information of incurable disease to palliative care in the end of life." Thesis, Luleå tekniska universitet, Omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-73811.

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Obotlig sjukdom kan beskrivas som kronisk och progressiv sjukdom där det inte finns någon rimlig möjlighet att svara på behandling och den förväntade livslängden är oviss. Den palliativa vården handlar om ett förhållningssätt med målet att förbättra livskvaliteten hos patienter och deras närstående som drabbats av livshotande sjukdom. Detta skapas genom ett välfungerande teamsamarbete mellan läkare, sjuksköterskor och undersköterskor. Syfte: Syftet med litteraturstudien var att beskriva patienters upplevelser av vården från besked om obotlig sjukdom till palliativ vård i livets slutskede. Metod: Författarna till denna studie använde en kvalitativ manifest innehållsanalys som analysmetod och tio vetenskapliga artiklar ingick i resultatet. Analysen resulterade i fem kategorier: att få tydlig information; att vara rädd; att drabbas av olika symtom; att framtiden är oviss; att närstående och en religiös tro var av betydelse. Resultat: Det framkommer att patienter började se livet från ett annat perspektiv i och med vetskapen om att sjukdomen inte gick att bota. Patienter som befann sig i livets slutskede gick igenom stora förändringar som krävde insatser från hälso- och sjukvården. Slutsats: Sjuksköterskor kan med hjälp av transitionsteori hjälpa patienter att hantera, bearbeta och acceptera den förändrade situationen. Ytterligare kunskap om vården från obotlig sjukdom till palliativ vård kan förbättra kommunikationen och informationen till patienter.
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Bygg, Erika, and Ellinor Morelius. "KOL-patienters nutrition och sjuksköterskans omvårdnadsåtgärder : en litteraturöversikt." Thesis, Högskolan Dalarna, Omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:du-30232.

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Bakgrund: Malnutrition är vanligt hos patienter med kroniskt obstruktiv lungsjukdom (KOL). Malnutrition hos patienter med KOL kan orsaka nedsatt immunförsvar, ökad dyspné, minskad livskvalité samt att KOL-sjukdomen riskerar att öka i allvarlighetsgrad samt ha ett snabbare sjukdomsförlopp. År 2030 bedöms KOL vara den tredje vanligaste sjukdomen i världen. Därför är det viktigt som sjuksköterska att ha kunskap i vilka omvårdnadsåtgärder som kan användas vid malnutrition hos KOL-patienter. Syfte: Syftet med denna litteraturöversikt var att sammanställa KOL-patienters upplevda problem vid nutrition samt vilka omvårdnadsåtgärder sjuksköterskan kan vidta vid malnutrition. Metod: Litteraturöversikt baserad på 15 vetenskapliga artiklar. Resultat: Det fanns många olika problem som KOL-patienter upplevde i samband med nutrition. Dessa faktorer kunde vara både fysiska och psykiska. Sjuksköterskan kunde som omvårdnadsåtgärd upprätta kontakt med dietist för individuella råd och åtgärder till patienten. Som sjuksköterska var den stödjande samt kunskapsförmedlande rollen viktig, likväl att ge egenvårdsråd utifrån patientens önskemål samt förutsättningar. Slutsats: Den problematik som KOL-patienter upplevde i relation till nutrition var individuell. Nutrition hos KOL-patienter var ett komplext område då det innefattade både fysiska och psykiska bekymmer. Det är viktigt att sjuksköterskan arbetar personcentrerat vid vård av KOL-patienter då patienterna upplever olika problemområden i samband med nutrition, detta för att ge en god och säker vård.
Background: Malnutrition is common in patients with chronic obstructive pulmonary disease (COPD). Malnutrition in patients with COPD can cause impaired immune system, increased dyspnoea, decreased quality of life, and the COPD risk being increased in severity as well as having a faster disease course. In 2030, COPD is estimated to be the third most common disease in the world. Therefore, it is important as a nurse to have knowledge of which nurse care can be used in malnutrition in COPD patients. Aim: The aim of this literature review was to compile COPD patients' perceived problems with nutrition and what nurse care the nurse can take in malnutrition. Method: A literature review based on 15 scientific articles. Results: There were problems that occur for COPD patients that were caused according to their nutrition. These conditions could be both physical and psychological. The nurse could seek advice from a dietician to be informed of the best solution regarding nutritional needs of the patient. As a nurse it was important to pass on knowledge and give support to the patient whilst also advising on selfcare according to the patient's current condition and preferences. Conclusion: The variety of nutritional problems COPD patients face were highly individual and are therefore a complex subject as the effects are both physical and psychological. In general, the nurse should work closely with the patient as there can be nutrition related problems and in doing so, ensures appropriate and safe care.
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18

Mörsin, Erik, and Alexander Ohlsson. "Faktorer som påverkar patienters följsamhet till behandling vid hjärt-och kärlsjukdomar." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25400.

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Bakgrund: Trots att hälso-och sjukvården varit framgångsrik i att behandla hjärt-och kärlsjukdomar de senaste decennierna, utgör kardiovaskulära sjukdomar fortfarande den vanligaste dödsorsaken i Sverige. Samtidigt visar forskningen att mellan en tredjedel till hälften av patienterna inte följer den ordinerade behandlingen som syftar till att minska riskfaktorerna eller behandla symptom. Låg följsamhet är därmed en ofta förbisedd riskfaktor som leder till försämrad hälsa, ökad vårdtyngd och ökade kostnader för vården. Syfte: Att belysa vilka faktorer som påverkar patienters följsamhet till behandling vid hjärtkärlsjukdom. Metod: Studien utformades som en allmän litteraturstudie, med empirin hämtad från Databaserna CINAHL och PubMed. Tio artiklar valdes ut och granskades med hjälp av SBU:s granskningsmall för kvalitativa studier. Analysen gjordes sedan genom en enkel innehållsanalys. Resultat: Det framkom två teman, sex kategorier och 14 underkategorier som på olika sätt beskrev faktorer till följsamhet. Faktorerna delades upp i inre faktorer som rörde patienters tankar, känslor och handlingar, samt yttre faktorer som rörde de aspekter som påverkade patienterna utifrån. Slutsats: Resultatet visade att patienters redogörelser för faktorer till följsamhet var flera och komplexa. En stor del av faktorerna låg bortom patientens kontroll, bland annat visade det sig att relationen mellan vårdare och patient var betydelsefull. Vidare visade resultatet att faktorerna uppvisade en variation mellan patienter, således är det väsentligt att sjuksköterskor arbetar personcentrerat för att kunna optimera patienters följsamhet.
Background: Although health care has been successful in treating cardiovascular diseases in recent decades, cardiovascular disease still remains the most common cause of death in Sweden. Simultaneously, research shows that approximately one third to half of the patients do not follow the prescribed treatment, aimed at reducing the risk factors or treating symptoms. Therefore, low adherence is a frequently overlooked risk factor which ultimately leads to impaired health, increased healthcare strain and increased costs. Purpose: To highlight the factors affecting patients’ adherence to cardiovascular disease treatment. Method: The study was designed as a literature review, with studies gathered from the CINAHL and PubMed databases. Ten qualitative articles were selected and examined using the SBU's qualitative study review template. The analysis was then conducted using content analysis. Findings: Two themes, six categories and 14 subcategories which in different ways describe factors that influence patient adherence emerged during the analysis. The factors were divided into inward factors, concerning patient thoughts, emotions and actions, and outward factors concerning external factors that influenced the patient. Conclusion: The results showed factors to adherence were numerous and complex. A large proportion of the factors were beyond the control of the patient, and the relationship between carers and patients proved significant. Furthermore, the results displayed that the factors showed a variation between patients, therefore it is essential that nurses work person-centered to optimize patients’ adherence.
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Giang, Winny, and Carl-Ragnar Karlsson. "Isoleringsvård : Systematisk litteraturstudie om patienters upplevelser vid smittsam sjukdom." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-38535.

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Bakgrund: Smittsamma sjukdomar är ett ökande problem för världen med ständig utveckling av bland annat antibiotikaresistenta bakterier, vilket kan göra att patienter med smittsam sjukdom blir komplicerade att vårda. För att minska smittspridning vårdas patienter i isolering, vilket kan medföra negativa upplevelser. Problem: När patienter vårdas i isolering blir de begränsade i sin livssituation. Deras möjlighet till att socialisera och interagera med andra människor försvåras, vilket kan ge upphov till ohälsa och eventuellt lidande. Isoleringsvård innebär även tillämpning av skydds- och försiktighetsåtgärder som orsakar ökad arbetsbelastning för sjukvårdspersonal, vilket kan leda till sämre omvårdnadskvalitet för patienter som vårdas i isolering. Syfte: Beskriva patienters upplevelser av isoleringsvård vid smittsam sjukdom. Metod: Kvalitativ systematisk litteraturstudie med beskrivande syntes, där tio analyserade vetenskapliga artiklar användes i resultatet. Resultat: Det framkom både negativa och positiva upplevelser hos patienter som vårdas i isolering. Dessa delades in i två övergripande teman; Vårdas i ensamhet med tre tillhörande subteman och Behov av att förstå med två tillhörande subteman. Slutsats: Sjukvårdspersonal behöver anpassa den vård som ges med hänsyn till patienters omvårdnadsbehov. Genom att sjukvårdspersonal får utökade kunskaper om patienters positiva och negativa upplevelser av isoleringsvård kan sjukvårdspersonal anpassa vårdandet.
Background: Communicable diseases is an increasing problem world-wide due to the ongoing increase of antibiotic-resistant bacteria, which makes the diseases hard to treat. Patients are forcibly being treated in isolation due to the risk of spreading the infection to other people, this can cause negative experiences for these patients. Problem: Patients who are being treated in isolation are forced into a limited situation in their lives. Their possibilities of socializing and interacting with other people are reduced which could cause unhealthiness and suffering. Isolation care means that healthcare professionals have to apply precautionary methods with protective equipment when treating these patients. This could cause an increased workload for healthcare professionals and lead to poor quality of care for patients in isolation. Aim: To describe patients’ experience of isolation care due to communicable diseases. Method: A systematic review with a descriptive synthesis, and ten articles were analyzed for the result. Result: Both negative and positive experiences were identified of patient treated in isolation. These experiences were divided into two major themes; To receive care in loneliness with three included sub-themes and The need to understand with two included sub-themes. Conclusion: Healthcare professionals have to adapt the care to the needs of the unique patient. If healthcare professionals had more knowledge of caring for patients in isolation some of the negative experiences could be eliminated and lead to better quality of care.
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20

Chin, Elizabeth D. "Symptom Experience and Treatment Delay during Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Dissertation." eScholarship@UMMS, 2012. https://escholarship.umassmed.edu/gsn_diss/30.

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Chronic obstructive pulmonary disease (COPD) is a major health problem in the United States. Acute exacerbations of COPD are primarily responsible for the physical, psychological and economic burden of this disease. Early identification and treatment of exacerbations is important to improve patient and healthcare outcomes. Little is known about how patients with COPD recognize an impending exacerbation and subsequently decide to seek treatment. The purpose of this qualitative descriptive study was to explore and describe symptom recognition and treatment delay in individuals experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD). Leventhal’s Common Sense Model of illness representation undergirded this study. Using semi-structured interviews, adults hospitalized with an acute exacerbation of COPD were asked to describe their symptom experience and self care behaviors, including treatment seeking, in the days to weeks prior to hospitalization. Data analysis revealed one main theme: Recognizing, responding and reacting to change, and six subthemes: Something’s coming, Here we go again, Seeking urgent treatment, Riding it out, Not in charge anymore and My last day that richly described the COPD exacerbation experience. The study revealed that patients experience an illness prodrome prior to exacerbation and have a recurrent exacerbation symptom pattern that was self-recognized. Treatment seeking was most influenced by the speed and acuity of exacerbation onset, severity of breathlessness, fears of death, nature of patient-provider relationship and the perception of stigmatization during prior healthcare encounters. These findings are important for the development of interventions to improve patient recognition and management of COPD exacerbations in the future.
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21

Shekastehbad, Aysin, and Saija-Marisa Stenman. "Patienters upplevelser av hjärtrehabilitering vid kranskärlsjukdom : En litteraturöversikt." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-7524.

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Hjärtrehabilitering är ett program som ger bästa möjliga medicinska, fysiska och psykiska förutsättningar för patienter som har drabbats av kranskärlssjukdom, Den förbättrar livskvaliteten hos dessa patienter till en optimal individuell funktionsnivå. Syftet med denna studie var att belysa upplevelser av hjärtrehabilitering hos patienter med kranskärlssjukdom. En litteraturöversikt baserad på elva artiklar, tio av kvalitativ och en kvantitativ design hämtade från tre databaser Cinahl Complete, PubMed och PsycINFO. Artiklarna granskades enligt Friberg (2017) och därefter sammanställdes resultat i form av fyra tema. Vid analysen av de valda artiklarna har fyra huvudteman inklusive några underteman identifierats: Psykologiska upplevelser av hjärtrehabiliteringen. Upplevelser av stöd och motivation. Upplevelser av sjuksköterskans roll. Upplevelser av förhinder att delta i hjärtrehabilitering. Resultatet från denna litteraturöversikt har diskuterats utifrån Dorothea Orems egenvårdsteori. Patienterna hade en positiv inställning till hjärtrehabilitering men de flesta upplevde förhinder i någon form. Brist på information kan förbättras genom att vårdpersonalen har rätt kunskap och ger stöd. För att underlätta svårigheter av livsstilsförändringar kan sjuksköterskan använda motiverande samtal utifrån patientens individuella behov för att utveckla egenvårdskapaciteten hos patienten.
Cardio rehabilitation is a programme which provides best possible medical, physical and mental conditions for patients who have suffered from cardiovascular disease. It improves quality of life for these patients to an optimal individual functioning level. The aim of this study was to highlight experiences from cardiac rehabilitation of patients with coronary artery disease. This study was carried out by a literature review method. Eleven articles, ten of qualitatative and of quantitative design identified in three databases: Cinahl Complete, PubMed och PsycINFO. Articles were reviewed according to Friberg (2017) and then the result was compiled in the form of four themes. In the analysis of the selected articles, four main themes, including some sub-themes, have been identified: Phsycological experiences of cardiac rehabilitation, Experiences of support and motivation, Experiences of nurses’ role and Experiences facing difficulties attending cardic rehabilitation program. Results from this literature review have been discussed related to Dorothea Orem's self-care theory. The patients had a positive attitude towards cardiac rehabilitation but most experienced some form of obstruction. Lack of information can be improved by the health care professions having the right knowledge and providing support. In order to facilitate difficulties in lifestyle changes, the nurse can use motivational talks based on the patient's individual need to develop self-care capacity in the patient.
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22

Skapur, Amira, and Billeskalns Lovisa Åhlin. "Palliativ vård av personer med mycket svår KOL inom hemsjukvården - En intervjustudie ur sjuksköterskors perspektiv." Thesis, Umeå universitet, Institutionen för omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-122032.

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Abstrakt: Okontrollerade symptom och upprepade sjukhusinläggningar kännetecknar den sista tiden i livet hos en del patienter med mycket svår KOL. Trots att det finns en växande insikt att tidig integration av palliativ vård förbättrar patientens symtombehandling och livskvalitet, dör majoriteten av patienter med KOL utan tillgång till palliativ vård. Sjuksköterskor i hemsjukvården har en central roll när det gäller att identifiera och hantera patienternas palliativa vårdbehov. Syfte: Syftet med denna studie är att belysa hur sjuksköterskor i hemsjukvården upplever den palliativa vården av patienter med mycket svår KOL. Metod: Kvalitativ studie där 11 semistrukturerade intervjuer bearbetats med kvalitativ innehållsanalys. Resultat: Insamlat datamaterial resulterade i tre kategorier som påvisar förutsättningar för god palliativ vård i hemmet: 1) Personella och organisatoriska resurser i hemsjuk- och primärvården där stora brister i samarbetet med primärvården samt bristande resurserna för god vård i hemmet noteras. 2) Planering och kommunikation där bristande kommunikation med patienten och mellan olika vårdinsatser samt planering kring patientens vård poängteras. 3) Kunskap där ett behov av att utöka kunskapen om KOL och palliativ vård hos alla yrkeskategorier uppmärksammas. Konklusion: Patienter med mycket svår KOL får ofta en god palliativ vård i livets absoluta slutskede. Resultatet visar dock att patientens vård under de sista månaderna i livet ofta upplevs som oklar och diffus, vilket pekar på att palliativ vård behöver integreras tidigare i vården av patienter med mycket svår KOL. I kommunikations- och planeringsprocessen med patienten har sjuksköterskor en samordnande roll som behöver specificeras och utrustas med de erforderliga personella och organisatoriska resurserna, kunskaperna och befogenheterna.
Abstract: Uncontrolled symptoms and repeated hospitalizations characterize the last period of life in some patients with very severe COPD. Although there is a growing recognition that early integration of palliative care improves the treatment of patient's symptoms and quality of life, the majority of patients with COPD dies without access to palliative care. Nurses in home care have a central role in identifying and managing patients' palliative care needs. Aim: The purpose of this study is to examine how nurses in home care and in nursing homes experience palliative care of patients with severe COPD. Method: Qualitative study in which 11 semi-structured interviews processed using qualitative content analysis. Results: Collected data resulted in three categories that indicate conditions for good palliative care in the home: 1) Human and organizational resources in home- and primary care, where serious deficits within primary care and resources for good home care is noted. 2) Planning and communication, where the lack of communication with the patient and between different health care institutions as well as care planning is emphasized. 3) Knowledge, where a need to improve knowledge of COPD and palliative care for all care professions is recognized. Conclusion: The result shows that the patient's care during the last months of life is often perceived as vague and diffuse, suggesting that palliative care needs to be integrated earlier in the care of patients with very severe COPD. In the communication process and care planning with patients, nurses have a coordinating role that needs to be specified and equipped with the requisite human and organizational resources, skills and competences.
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23

Reynolds, Carol A. (Carol Ann). "Attitudes of Nursing Faculty Toward Patients With AIDS and Patients With a Homosexual Lifestyle." Thesis, University of North Texas, 1991. https://digital.library.unt.edu/ark:/67531/metadc332811/.

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The purposes of this study were (1) to determine whether patients with AIDS are stigmatized by nursing faculty, (2) to determine whether practicing homosexuals are stigmatized by nursing faculty, (3) to determine whether faculty attitudes toward AIDS patients are influenced by the patients' sexual preference, and (4) to determine whether faculty attitudes toward practicing homosexual patients are influenced by the patients' disease. This study is a modified replication of studies by Kelly et al.
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24

Al-Khamees, Inas, and Mary Bilal. "Att leva med ALS : En litteraturstudie ur patienters perspektiv." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-52375.

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Bakgrund: Amyotrofisk lateralskleros, ALS, är en fortskridande motorneuronsjukdom som drabbar och bryter ner nervceller som styr skelettmuskulaturen. Sjukdomen orsakar stort lidande för patienter och kan vara snabbt fortskridande och oförutsägbar. Sjuksköterskor upplever att patienter med ALS behöver få adekvat information och stöd för att lindra lidande. Detta sker genom att sjuksköterskor är respektfulla och lyhörda på patientberättelsen. Närstående har också en stödjande funktion i patienters kamp mot sjukdomen genom att vara närvaro i vardagen. Syfte: Att beskriva patienters upplevelser av att leva med ALS.  Metod: En kvalitativ litteraturstudie baserad på tretton kvalitativa artiklar. Resultat: Två teman och fem subteman identifierades. Det första temat var en förändrad livssituation genom att uppleva rädsla för framtiden, att vara begränsad i vardagen och att vara beroende av omgivningen. Det andra temat var att anpassa sig till en ny tillvaro genom att leva med acceptans i nuet och att finna mening trots sjukdomen.  Slutsats: Patienter med ALS upplever en förändrad livssituation på grund av sjukdomen. Detta krävs en medvetenhet och kunskap om patienters upplevelser hos sjuksköterskor vilken kan bidra till bättre vård och öka anpassning för patienter i livet. Nyckelord: Kvalitativ, Motorneuronsjukdom, Palliativ vård, Patienters perspektiv, Upplevelser.
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Fernández, Sánchez Montserrat. "Self-management for Type 2 Diabetes Mellitus Patients in Mexico - Nurses' perspective : A qualitative study." Thesis, Hälsohögskolan, Jönköping University, HHJ, Avd. för omvårdnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-48478.

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Bakgrund: Diabetes Mellitus Typ 2 är en kronisk sjukdom som ger allvarliga långsiktiga skador. En av hörnstenarna för att kontrollera sjukdomen är patientens egenvård.  För att genomföra behandlingen måste patienterna förstå vilken betydelse de har för sjukdomen.    Syfte: Syftet med denna studie är att beskriva Mexikaner sjuksköterskornas upplevelse om deras bidrag till kännedom om egenvård hos patienter med Diabetes Mellitus Typ 2 i Mexiko.   Metod: En kvalitativ design med semi-strukturerade intervjuer och en innehållanalys användes i denna studie.    Resultat: Deltagarna upplever att egenvård är av stor betydelse vid behandling av  Diabetes Mellitus typ 2. Patienterna behöver kunskap och utbildning, och sjuksköterskorna är medvetna om att de är ansvariga för undervisningen. Däremot på grund av tidsbrist,  otillräcklig personal samt överbelastning av patienter kan inte utbildning av patienter ske. Enligt deltagarna är patienternas engagemang och familjestöd  faktorer som påverkar patienternas egenvård.   Slutsats: Deltagarna upplever att egenvård är viktigt för Diabetes Mellitus typ 2. Patienten och sjuksköterskorna har en viktigt roll vid egenvård. En personcentrerad vård kan hjälpa sjuksköterskor att tillgodose patienternas behov.
Background: Type 2 Diabetes Mellitus is a chronic disease that produces serious long-term complications. The self-management of the patient has become the cornerstones to control the disease.  To carry out treatment, patients must understand the role they play at this.        Aim: This study aims to describe the Mexican nurses’ perception of their contribution  to the knowledge of self-management in patients with T2DM in Mexico.   Method: A qualitative approach with semi-structured survey and a content analysis was used in this study.   Result: The participants perception is that self-management is of great importance in the treatment of T2DM. However,  patients need education and knowledge,  and the nurses are aware that they are responsible for  that education. Nevertheless,  the lack of time, inadequate nurse staffing and overwhelming number of patients, are causes that are not allowing them to  educate the patients. According to the participants, the engagement of the patients and family support are factors affecting the patients’ self-management.    Conclusions: The participants perception is that self-management is crucial for T2DM patients and the nurses have an important role in it. The use of a Person-Center Cared approach can help the nurses meet the needs of the patients.
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Gebrim, Cyanéa Ferreira Lima. "Implantação do consultório de enfermagem para seguimento ambulatorial de pacientes em pós-operatório de doença arterial obstrutiva periférica." Universidade Federal de Goiás, 2017. http://repositorio.bc.ufg.br/tede/handle/tede/7982.

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AIM: to analyse the process of the implementation of nursing office for output follow-up of postoperative patientes of peripheral obstructive arterial disease, according to the structure, process and outcome indicators. METHOD: an uncontrolled, prospective intervention study conducted from 2013 to 2016 at the outpatient clinic of a university hospital in the Brazilian Midwest. Patients admitted to the nursing office for ambulatory follow-up in the postoperative period of peripheral obstructive arterial disease participated in the study. Two instruments were used to collect the data, the first to verify the sociodemographic profile and the second to measure the Patient Satisfaction index with the quality of nursing care. For statistical analysis, we used: absolute frequencies, median, mean and standard deviation, Raw Scale with logistic binary regression, Pearson correlation coefficient. RESULTS: the structure comprised: situational diagnosis, partnerships, training of the executing team and acquisition of physical and material resources. In the process, the methodology used for the care was the systematization of nursing care and as an outcome of the implementation of nursing office, the level of satisfaction of the patients with the nursing care was evaluated. A total of 39 patients, 51,3% male, mean age 63 years, 71.8% retired, 66.7% diabetic, 84.6% hypertensive, 71.8% dyslipidemic, 51.3% smoker, 84.9% sedentary. A total of 303 nursing consultations were performed, of which 80% of the patients evaluated were discharged and 15% needed rehospitalization. Nursing care reached an index of positivity (>80%) considered safe and of quality, and a high level of the patient satisfaction (mean: 4,195 and median 4). Five postoperative complications emerged: 53,9% surgical site infection, 10,3% amputations, 7,7% pain, 2,6% sepsis and 2,6% deaths. Statistically (p<0,05) more satisfied patients with nursing care were those that presented normal nutritional status (p=0,049), who assessed their health as poor or normal (p=0,020) and did not use anti-hypertensives (p=0,031). The Pearson Coefficients showed significant correlation, with an increasing association (r>0,0) between the technical-professional, educational and nurse's confidence domains. CONCLUSION: the structure of the nursing office, signaled important indicators in relation to the nursing practice, as a systematized service model for the follow-up of patients in the postoperative period of peripheral obstructive arterial disease, positively reflecting the improvement of the patients’ health. It emphasizes the early identification of some complications and the promotion of the quality of care with the lesion, in addition to narrowing the bond between the team and the patient. It impacted on the level of patient satisfation regarding the assistance provided by the nursing office team, in the outpatient follow-up of patients in the postoperative period of peripheral obstructive arterial disease.
OBJETIVO: analisar o processo de implantação do consultório de enfermagem para seguimento ambulatorial de pacientes em pós-operatório de doença arterial obstrutiva periférica, segundo os indicadores de estrutura, processo e resultado. MÉTODO: estudo de intervenção não controlado, prospectivo, realizado de 2013 a 2016, no ambulatório de um hospital universitário do Centro-Oeste brasileiro. Participaram do estudo pacientes admitidos no consultório de enfermagem para seguimento ambulatorial no pós-operatório de doença arterial obstrutiva periférica. Para a coleta dos dados, foram utilizados dois instrumentos, sendo o primeiro para verificar o perfil sociodemográfico, e o segundo para medir o índice de satisfação do paciente com a qualidade do cuidado de enfermagem. Para análise estatística, utilizaram-se frequências absolutas, mediana, média e desvio padrão, Raw Scale com regressão binária logística, coeficiente de correlação de Pearson. RESULTADOS: a estrutura compreendeu: diagnóstico situacional, parcerias, capacitação da equipe executora e aquisição de recursos físicos e materiais. No processo, a metodologia utilizada para o atendimento foi a sistematização da assistência de enfermagem, e como resultado da implantação do consultório, avaliou-se o nível de satisfação dos pacientes com os cuidados de enfermagem. Participaram 39 pacientes, 51,3% do sexo masculino, com média de idade de 63 anos, 71,8% aposentados, 66,7% diabéticos, 84,6% hipertensos, 71,8% dislipidêmicos, 51,3% tabagistas, 84,9% sedentários. Foram realizadas 303 consultas de enfermagem, das quais 80% dos pacientes avaliados receberam alta, e 15% necessitaram de reinternação. O cuidado de enfermagem alcançou índice de positividade (>80%) considerado seguro e de qualidade e alto nível de satisfação dos pacientes (média: 4,195 e mediana 4). Em meio às complicações pós-operatórias identificadas emergiram cinco: 53,9% infecções do sítio cirúrgico, 10,3% amputações, 7,7% dores, 2,6% sepses e 2,6% óbitos. Os pacientes estatisticamente (p<0,05) mais satisfeitos com os cuidados de enfermagem foram os que apresentaram estado nutricional normal (p=0,049), que autoavaliaram sua saúde como ruim ou regular (p=0,020) e que não faziam uso de anti-hipertensivos (p=0,031). Os Coeficientes de Pearson mostraram correlação significativa com associação crescente (r>0,0) entre os domínios Técnico-profissional, Educacional e Confiança do enfermeiro. CONCLUSÃO: a estruturação do consultório de enfermagem sinalizou indicadores importantes em relação ao consultório de enfermagem, como modelo de serviço sistematizado para o seguimento dos pacientes em pós-operatório de doença arterial obstrutiva periférica, refletindo positivamente na melhoria da saúde dos pacientes. Destacaram-se a identificação precoce de algumas complicações e a promoção da qualidade do cuidado com a lesão, além de estreitar o vínculo entre a equipe e o paciente. Impactou, no nível de satisfação dos pacientes em relação, a assistência prestada pela equipe do consultório de enfermagem, no seguimento ambulatorial de pacientes em pós-operatório de doença arterial obstrutiva periférica.
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27

Simpson, Anna Catherine. "Negotiating Uncertainty: Advance care planning in advanced chronic obstructive pulmonary disease (COPD)." 2012. http://hdl.handle.net/10222/15015.

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Physical and psychosocial symptoms in advanced chronic obstructive pulmonary disease (COPD) are cumulative and profound; global financial and human costs are huge. COPD in late stages runs an unpredictable downward course of increasing, potentially fatal exacerbations. Nevertheless many physicians avoid advance care planning in this context, a choice that tends to promote last minute crisis decision-making. To explore a more ethically sound proactive approach to end-of-life care decision-making I conducted a qualitative study informed by the question: “What is required for meaningful and effective advance care planning in the context of advanced COPD?” Fifteen participants (eight patients with advanced COPD plus seven intimate others) participated in two in-home advance care planning discussions that incorporated patient-centred care principles. Session transcripts were analyzed using "interpretive description." Despite initial wariness, participants were able to discuss their care-related hopes and preferences and reported that the process was a positive one. Interpretation of the positive feedback suggested participants experienced the process as a chance to: a) talk with an attentive clinician, b) learn, c) consider care-related goals and preferences, and, d) have intimate others hear about these goals/preferences. Interpretation of the process that led to this positive assessment is described in terms of a thematic network. The overarching global theme of this network was "advance care planning as collaborative care," which involved three organizing themes--partnering, negotiating ambiguity, and being a resource--and a cluster of basic themes related to each of these. The "collaborative care" approach is discussed as a guide to advance care planning in advanced COPD. Like other advance care planning models, the study approach included a skilled clinician facilitator, provision of targeted information, and attention to readiness. There were four new elements: focus on caring, engaging hope, facilitator reflective praxis, and contextual sensitivity. While potentially enhancing the "care" dimension in advance care planning, the study approach may incidentally improve resource allocation and satisfaction with outcomes. Done well it may enhance decision-making and care planning, and, just as importantly, be experienced as care itself at a time and by those often neglected in this regard.
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28

Fitzsimmons, D. A., J. Thompson, C. L. Bentley, and Gail Mountain. "Comparison of patient perceptions of Telehealth-supported and specialist nursing interventions for early stage COPD: a qualitative study." 2016. http://hdl.handle.net/10454/11039.

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Yes
Background: The increasing prevalence and associated cost of treating Chronic Obstructive Pulmonary Disease (COPD) is unsustainable, and focus is needed on self-management and prevention of hospital admissions. Telehealth monitoring of patients’ vital signs allows clinicians to prioritise their workload and enables patients to take more responsibility for their health. This paper reports the results of a qualitative study embedded within a feasibility and pilot Randomised Controlled Trial (RCT) of Telehealth-supported care within a community-based COPD supported-discharge service. The aim of the study was to qualitatively explore the experiences of patients with COPD who had received either a Telehealth-supported or a specialist nursing intervention following their discharge from hospital after an admission for a COPD exacerbation. Methods: Patients were invited to either participate in semi-structured interviews or to complete a semi-structured self-administered questionnaire on completion of the intervention. Nine patients were interviewed (67 % female) and seventeen patients completed the questionnaires. In addition, three clinicians responsible for the delivery of both interventions were interviewed to obtain their perspectives on the new services. Results: Seven underlying themes emerged from the patient interviews and were further explored in the questionnaires: (1) patient demographics; (2) information received by the participants; (3) installation of the Telehealth technology; (4) Telehealth service functionality; (5) visits; (6) service withdrawal; and (7) service perceptions. Recipients of both services reported feelings of safety derived from the delivery of an integrated, community-based service. Conclusions: Although recipients of the Telehealth service received 50 % fewer home visits from the clinicians than recipients of a more traditional community-based nursing intervention, the patients were enthusiastic about the service, with some describing it as the best service they had ever received. This suggests that a Telehealth intervention is an acceptable alternative to a more traditional home nursing visit model for monitoring community-based patients with COPD following their discharge from hospital.
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29

"Patient participation in end-stage renal disease care: a grounded theory approach." 1999. http://library.cuhk.edu.hk/record=b5889986.

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by Tong Lai Wah, Christina.
Thesis (M.Phil.)--Chinese University of Hong Kong, 1999.
Includes bibliographical references (leaves 101-112).
Abstracts in English and Chinese.
Title Page --- p.i
Authorization Page --- p.ii
Signature Page --- p.iii
Acknowledgements --- p.iv
Table of Contents --- p.v-viii
List of Figures --- p.ix
List of Tables --- p.x
List of Append --- p.ix xi
Title Page --- p.xii
Abstract --- p.xiii
Chapter 1 --- Introduction --- p.14-15
Chapter 2 --- Literature Review --- p.16-24
Chapter 2.1 --- Introduction
Chapter 2.2 --- End-stage renal disease
Chapter 2.3 --- Continuous ambulatory peritoneal dialysis
Chapter 2.4 --- Patient participation
Chapter 2.4.1 --- Definition of participation
Chapter 2.4.2 --- Benefits of participation
Chapter 2.4.3 --- Problems of patient participation
Chapter 2.4.4 --- Application of patient participation
Chapter 2.5 --- Conclusion
Chapter 3 --- Methodology --- p.25-43
Chapter 3.1 --- Introduction
Chapter 3.2 --- Overview of grounded theory
Chapter 3.3 --- Procedures
Chapter 3.3.1 --- Data generation
Chapter - --- Sampling
Chapter - --- Data gathering
Chapter - --- Data recording
Chapter 3.3.2 --- Data analysis
Chapter - --- Open coding
Chapter - --- Constant comparative analysis
Chapter - --- Categorization
Chapter - --- Axial coding
Chapter - --- Theoretical sensitivity
Chapter - --- Memoing
Chapter 3.3.3 --- Theory construction
Chapter - --- Core category
Chapter 3.4 --- Method application
Chapter 3.4.1 --- Data collection
Chapter - --- Sampling
Chapter - --- Interview
Chapter - --- Recording
Chapter 3.4.2 --- Data analysis
Chapter - --- Open coding
Chapter - --- Constant comparative analysis
Chapter - --- Categorization and Axial coding
Chapter - --- Theoretical sensitivity
Chapter - --- Memoing
Chapter 3.4.3 --- Theoretical construction
Chapter - --- Concept formation
Chapter - --- Concept development
Chapter 3.5 --- Credibility & Trustworthiness
Chapter 3.6 --- Conclusion
Chapter 4 --- Findings --- p.44-72
Chapter 4.1 --- Introduction
Chapter 4.2 --- Core category: Integrative Restructuring
Chapter 4.3 --- Emotional Labour
Chapter 4.3.1 --- Entering the active zone
Chapter (a) --- Conditions to go into active zone
Chapter (b) --- Outcomes of emotional labour
Chapter (c) --- Strategies used for emotional labour
Chapter - --- Letting go of emotions
Chapter - --- Aligning cognitive consistency
Chapter - --- Maximizing ego
Chapter - --- Locating self
Chapter - --- Boosting power
Chapter i. --- Active control
Chapter ii. --- Building positive expectancies
Chapter iii. --- Covariance to positive expectancies
Chapter 4.3.2 --- Retreating into comfort zone
Chapter (a) --- Contexts of comfort zone
Chapter (b) --- Conditions to build comfort zone
Chapter (c) --- Strategies used within comfort zone
Chapter - --- Defending
Chapter - --- Relinquishing
Chapter - --- Anchoring
Chapter 4.3.3 --- Migrating between the two zones
Chapter (a) --- Conditions to initiate the move
Chapter (b) --- Covariance to the movement
Chapter (c) --- Strategies to make progress
Chapter 4.4 --- Conclusion
Chapter 5 --- Discussion --- p.73-92
Chapter 5.1 --- Introduction
Chapter 5.2 --- Theoretical framework
Chapter 5.3 --- Core category: Integrative Restructuring
Chapter 5.4 --- Variables affecting the move to active zone
Chapter 5.4.1 --- Preparations
Chapter 5.4.2 --- Support
Chapter (a) --- Source of support
Chapter (b) --- Context of support
Chapter (c) --- Effects of support
Chapter (i) --- Effects upon support-seekers
Chapter (ii) --- Supporter's reaction to support-giving relationship
Chapter 5.4.3 --- Commitment
Chapter (a) --- Perception of the situation
Chapter (b) --- Cultural influences
Chapter 5.4.4 --- Control
Chapter 5.5 --- Conclusion
Chapter 6 --- Concluding Chapter --- p.93-100
Chapter 6.1 --- Limitations
Chapter 6.2 --- Implications
Chapter 6.2.1 --- Practice
Chapter 6.2.2 --- Research
Chapter 6.2.3 --- Teaching
Chapter 6.2.4 --- Policy Making
Chapter 6.2.5 --- Summary
Chapter 6.3 --- Future research
Chapter 6.4 --- Reflections upon the study
Chapter 6.5 --- Conclusion
References --- p.101-112
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30

Huang, Syuan-Syuan, and 黃璿璇. "Nursing Experience Care for Chronic Foot Ulcer in a Diabetic Patient with Hemodialysis Combining Peripheral Arterial Occlusive Disease." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/48852300697260411602.

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碩士
中臺科技大學
醫療暨健康產業管理系碩士班
103
Motivation: Given the increasing cases of diabetes and more than ninety percent of cases undergoing hemodialysis treatment, witnessed similar cases without access to adequate care and amputation was the fate of one of the selected case studies outpatient hemodialysis patients with diabetes cum, this is motivated this study. Objective: This study explored a middle-aged male patients undergoing hemodialysis and the combined cases of peripheral arterial occlusive disease cases in the face of chronic foot ulcers. This study was aimed at the promotion cases resilience and achieved partial self-care, and thus enhance the quality of life and reduce re-admission situations. Also we hope to be a case of sharing this experience nursing, clinical nursing staff to provide care for similar cases of reference to enhance the quality of clinical care. Research Methods: Gordon eleven functional health status assessment of the case, establish the case of health problems, including self-care deficit, anxiety and hopelessness for the future, the risk of wound infection, lack of knowledge of other psychological, physical and social impact of the course; Therefore, this study Watson caring theory care concept, so the case can be brave enough to face the trauma of losing limbs, regain hope in life. Conclusion: Foot care diabetes education, in addition to improving patient compliance, increase self-care capabilities, in order prevent the risk of foot ulcers and amputations, and may reduce the burden on families and reduce the economic impact of family , thus improving the quality of life of patients and reduce medical costs.
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31

Oupra, R., University of Western Sydney, College of Health and Science, and School of Nursing. "The effect of a nurse led supportive educative learning program for family caregivers (SELF) on outcomes for stroke survivors and the family carers in Thailand." 2007. http://handle.uws.edu.au:8081/1959.7/13996.

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Complications due to stroke account for a significant proportion of admissions to medical wards in Thailand. Unlike western countries where community rehabilitation programs have been established to provide services following the acute stage of stroke recovery, there is no stroke rehabilitation team in the community and family care givers are the primary source of ongoing care and support. This research was a comparative study with concurrent controls, using a two-group pre-test and post test design. The aims of this study were to develop and implement a nurse led supportive educative learning program for care givers of stroke survivors, and to evaluate outcomes for patients and their carers. The study demonstrated that providing education and support to the family caregiver of stroke survivors does benefit both the survivors and caregiver by empower carers to make decisions about the care they provide which has a follow on effect of reducing care stress and burden. It is recommended that programs to provide carers with skills and knowledge to assume an active and therapeutic role in the management of family members who suffer a stroke be established and appropriately supported. Furthermore, implementing this research in other regions of Thailand is recommended.
Doctor of Philosophy (PhD)
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32

Chokani-Namame, Nellie Monteliwa. "Acute Coronary Syndromes patients' characteristics : optimising outcomes in the pre-hospital phase of care." Diss., 2005. http://hdl.handle.net/10500/757.

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Timely management in pre-hospital emergency care enhances the chances of patients' survival or clinical outcomes of an Acute Coronary Syndrome (ACS). In Botswana nurses serve in the frontline of pre-hospital emergency services as the initial recipients of the emergency reports and situations. Knowledge of the patient's characteristics will assist the nurses as well as the family/others to understand the patient's responses during an ACS situation and therefore enable prompt patient assessment and facilitation of early access to appropriate care. Patient and family involvement in care during cardiac emergencies also influences the patient outcomes. This is a non-experimental, quantitative, exploratory and descriptive study, designed to explore and describe the characteristics of patients with the experience of an ACS, and the available resources during the pre-hospital phase of emergency care, with the aim of improving patients' clinical outcomes. The results indicated that optimal care by nurses is essential in the chain of care influencing patients' chances of surviving ACS.
Health Studies
M.A. (Health Studies)
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33

Mbatha, Fatima Phumzile. "Patient and family experience of a cerebrovascular accident: a phenomenological inquiry." Diss., 2004. http://hdl.handle.net/10500/1416.

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34

PÍŠOVÁ, Leona. "Rizika v ošetřovatelské péči u akutních forem ischemické choroby srdeční." Master's thesis, 2014. http://www.nusl.cz/ntk/nusl-174603.

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Diploma thesis entitled Healthcare Risks in Acute Forms of Coronary Heart Disease is divided into a theoretical and a practical part. The theoretical part is divided into parts dealing with medicinal aspects, risk management and nursing care. The medicinal part defines the term coronary heart disease and describes its acute forms. The nursing care part describes how to care about a patient with acute CHD. It also points out the risky spheres in caring about a patient with acute CHD and describes possibilities of education provided by a nurse before discharging a patient to home care. The next part lists examples of diagnoses according to NANDA II that a nurse determines in patients with acute CHD. The research was performed with nurses from the cardiology department of the České Budějovice Hospital. Twelve nurses participated in the research in the qualitative research form based on semi structured interview. Three aims were set for the diploma thesis. The first aim was to find out whether nurses knew the risks that might occur in nursing care of acute CHD forms. The next aim of the thesis was to find out how nurses prevent the risks in nursing care of acute CHD forms. And the third aim was to find and compare differences in knowledge and skills between nurses from a Cardiac Intensive Care Unit and those from a standard cardiology department in nursing care of acute CHD forms. Six research questions were based on the aims. 1: Do nurses know the risks that might occur in nursing care of acute CHD forms? 2: Do nurses know complications that might arise from the risks in nursing care of acute CHD forms? 3: Do nurses know how to proceed in a situation when a mere risk changes into a real problem? 4: Do nurses from the Cardiac Intensive Care Unit (CICU) know how to proceed against the risks in acute CHD forms better than the nurses from the cardiology ward (CW)? 5: Are the CICU nurses able to prevent the risks better than the CW nurses? 6: Are the CICU nurses better aware of the risks that might occur in nursing care of acute CHD forms? I have managed to find answers to the research questions and thus to fulfil the aims set for the diploma thesis. It was found in the research, particularly by comparison of the knowledge and skills of the nurses from the Cardiac Intensive Care Unit and those from the standard cardiology ward that the knowledge among the nurses from both the stations is comparable. Only the results of the standard cardiology ward nurses and their answers suggest that they try to concentrate on patient's psychological condition apart from provision of nursing care. The following conclusions were finally drawn from the research questions set for the research: Nurses are aware of the risks that might occur in nursing care of acute CHD forms. Nurses are aware of the complications that might arise from the risks in nursing care of acute CHD forms. Nurses know how to proceed in a situation when a mere risk changes into a real problem. Nurses from the Cardiac Intensive Care Unit know how to proceed against the risks in acute CHD forms better than the nurses from the standard cardiology ward. Nurses from the Cardiac Intensive Care Unit are able to prevent the risks better than the standard cardiology ward nurses. Nurses from the Cardiac Intensive Care Unit do not know the risks that might occur in nursing care of acute CHD forms better than the nurses from the standard cardiology ward. Study material for secondary and tertiary students summarizing how to care about a patient with acute CHD was prepared as a result of the thesis, with regard to the research with the nurses, who personally faced the patients with acute CHD and are experienced in the care both with and without complications.
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35

Ježková, Kateřina. "Alzheimerova choroba a prostředí intenzivní péče." Master's thesis, 2015. http://www.nusl.cz/ntk/nusl-335244.

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Introduction: The thesis "Alzheimer's disease and department of intensive care" deals with the specifics and difficulties of nursing care for patients with this chronic and degenerative disease in intensive care units (ICUs). The number of patients with Alzheimer's disease is constantly growing and caring for them in such specific wards is extremely demanding. The purpose of this thesis was to map the most problematic areas in the care provided and propose their solution. Methods and results: The empirical part presents the results of a conducted qualitative research which took place in the form of interviews with 10 general nurses who have experience with such patients. Following a word-for-word transcription of the obtained interviews, the results are summarized in a final discussion. They show that when caring for a patient with dementia, general nurses see the main problems in his decreased ability to cooperate, behavioral changes, which often appear as a result of environment change, and difficult communication. They consider the patient's confusion, his negativism, and the inability to find the right words to be communication barriers. This results in enormous demands on the caring staff's patience. The interviewed general nurses however approach patients with dementia generally positively...
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36

Mametja, Victoria Lesetja. "Problems experienced by professional nurses caring for HIV/AIDS patients in public hospitals of Polokwane Municipality, Limpopo Province." Thesis, 2013. http://hdl.handle.net/10386/973.

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Thesis (M. Cur.)-- University of Limpopo, 2013
Background: The growing human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) pandemic continues to make a serious impact on all countries throughout the world. Globally, countries have responded to the HIV/AIDS pandemic by investing millions of dollars to help fight the disease, but the impact of HIV/AIDS is even greater in developing countries of Sub-Saharan Africa, including South Africa. Aims: The aims of this study were to describe the perceived problems experienced by professional nurses who provide health care to patients living with HIV/AIDS in public hospitals of Polokwane municipality, Limpopo Province and to identify guidelines to support these professional nurses. Study method: A qualitative, descriptive and contextual method was used in this study. Semi-structured, one-to-one interviews were conducted with professional nurses who participated voluntarily in the study. Tesch’s open-coding method was used for data analysis. Results: Professional nurses who provided care to people living with HIV/AIDS at Polokwane Hospital expressed feelings of frustrations and work overload, treatment delay, lack of knowledge on HIV/AIDS, lack of support systems, poor prognosis and patients presenting with confusion and mental disturbances. Conclusion and recommendations: Despite the fact that the professional nurses expressed negative experiences as they carried out their daily activities, and they still continued rendering care to HIV/AIDS patients, notwithstanding the obstacles they encountered. Recommendations were made with regard to nursing practice and nursing education, staff support by vii management, education and counselling for relatives, reaching out to the relatives and community, and further research.
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37

Bam, Nokwanda. "Exploring the lived experiences of nurses caring for the terminally ill patients with AIDS in selected wards in a level one district hospital in KwaZulu-Natal." Thesis, 2012. http://hdl.handle.net/10413/11118.

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Title: Exploring the lived experiences of nurses caring for the terminally ill patients with AIDS in selected wards in a level one district hospital. Aim: The purpose of this study was to explore and describe the experiences of nurses caring for dying patients with AIDS in the context of palliative care. Methodology: The study explored the meaning of caring and terminal illness and the lived experiences of nurses in the context of AIDS in palliative care. A constructivist paradigm underpinned this study. A qualitative research approach was used and Giorgi’s five steps of analysis were aligned to the Husserlian phenomenology method to make sense of the data. Individual in-depth interviews were conducted with ten of the operational nurses who were caring for patients suffering from AIDS in the palliative care wards of a level one state-aided district hospital. These included professional nurses, enrolled nurses and enrolled nursing assistants. The interviews were audio-taped. Findings: The findings of the study were presented and discussed according to the two categories that emerged during the data analysis, namely, conceptualization of the core concepts of caring and terminal illness and the experiences of caring in the context of palliative care. Each of these categories had themes and sub-themes that were presented and discussed. The conceptualization of the core terms influenced the nurses’ actions, behaviors and opinions as they described their experiences of taking care of terminally ill patients who suffered from AIDS. The nurses’ lived experiences were conceptualized into three main themes: the social networking that enabled the nurses to collaborate with colleagues in the interdisciplinary teams and share knowledge, skills and support within the palliative care team to optimize patient outcomes; factors hindering the nurses abilities to provide quality care to their patients and the internal and external mechanisms that enabled the nurses to provide care within palliative care contexts despite the encountered challenges. Conclusion: Nurses are exposed to increasing work-load in the context of HIV/AIDS, particularly in the care of terminally ill patients suffering from AIDS as they deal with complex emotional aspects of the diseases. Routine exposure to suffering and death accustom the nurses to dealing with death, resulting in situations where they display lack of care and respect for the terminal patients. Therefore, the antecedents that alter the nurses’ level of caring augmented by the emotionally taxing contexts are an agenda that needs to be addressed in order to achieve emotional work through improved nurse-patient relationships.
Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2012.
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38

Mammbona, Avhatakali Allga. "Experiences of enrolled nurses towards caring for people living with HIV and AIDS." Diss., 2017. http://hdl.handle.net/10500/23446.

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The aim of the study was to gain an understanding on the experiences of enrolled nurses with regard to caring for people living with HIV and AIDS in one of the rural hospital in Vhembe district, in order to make recommendations for guiding and supporting those enrolled nurses. This study followed qualitative approach using interpretative phenomenological analysis design. Data were collected from 11 purposively selected participants using semi structured interviews. Data were analysed using interpretative phenomenological analysis framework for data analysis. Three super-ordinate themes emerged from data analysis namely: resources, support and impact of working with HIV positive patients. The study revealed that enrolled nurses are failing to provide proper care to people living with HIV and AIDS due to inadequate resources and lack of support. This situation has negative impact on the health of enrolled nurses providing care to people living with HIV and AIDS. Recommendations are put forth to improve resources, enhance support and for mitigating impacts experienced by enrolled nurses when caring for people living with HIV and AIDS at a rural hospital in Vhembe district of Limpopo province.
Health Studies
M.P.H.
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39

KAČÍRKOVÁ, Michala. "Jednostranná nefrektomie z pohledu pacienta." Master's thesis, 2012. http://www.nusl.cz/ntk/nusl-138004.

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The subject of the diploma thesis is unilateral nephrectomy from the point of view of the patient. The work is divided into a theoretical and practical part. The theoretical part focuses on kidney diseases, the nephrectomy problems from the patient's as well as the nurse´s perspective, and further on the role of nurses. . The second part is research. The research was realized in urological departments in selected hospitals of South Bohemia. For the research was selected qualitative research was conducted through semi-structured interview with two sets of research. The first experimental group consisted of 10 patients after nephrectomy, five respondents after classical open nephrectomy and five after laparoscopic nephrectomy. The second experimental group consisted of 10 nurses working in the urology department of the bed. This thesis diploma was focused on the experiences (feelings) or if at how the patient perceives surgical removal of the kidney. We wanted to know how is the issue seen from the perspective of a patient who is in the hospital experiencing a number of concerns and negative emotions. We also investigated whether a different view of nurses and patients on the issue exists. We have identified three objectives and six esearch questions for this work. The first objective was to determine how the patient perceives urological unilateral nephrectomy. The second objective was to determine what are the most common fears which faces the urology patient before and after surgery. The third objective was to determine what proportion of the nurse to patient information. The first research question was how the patient perceives urological unilateral nephrectomy. The second research question was, how urological patient after unilateral nephrectomy perceive their body image. The third research question was, what are the most common concerns of the patient before surgery. Further, patients who often address their concerns. The fifth research question was how the nurse involved in patient awareness. The last research question was, how often nurse informs the patient. The results of the diploma thesis can serve to nurses when working with urological patients and for the improvement of the nursing care for them. We have created an information map that can serve to patients as an assistant, through which they can prepare themselves for the entire course of hospitalization.
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MACH, Rostislav. "Komplexní přístup poskytovatele zdravotnické záchranné služby k transportu pacienta s vysoce nakažlivou nemocí." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-398916.

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In the thesis "Comprehensive approach of emergency medical services provider to a highly-contagious patient transportation" we concentrated on nursing care and aspects of transportation administered by operating paramedics, all in cases that public health authorities suspect to be related to a highly - contagious disease and transportation in isolated transportation vehicle is mandated. The theoretical part of the thesis defines the key concepts of highly - contagious disease, it describes individual causal agents of contagious diseases and their ways of transmission to humans. For description of contagious diseases were chosen those with high morbidity, lethality and interpersonal transmission. We mention the danger of biological agents misuse, ways of protection against contagious diseases and types of decontamination procedures. We describe different means of personal protection used by biohazard team members and even environmental factors affecting the work of paramedics using personal protective agents. Further on, we bring to attention legal aspects and inner policies related to aforementioned issues including analysis of procedure logistics of emergency services teams dealing with emergencies with suspicion of highly - contagious disease. Research in practical part of the thesis concentrates on aims related to optimizing nursing care for patients suspected of suffering from a highly - contagious disease, when securing them in the transportation vehicle, furthermore, we examine the impact of personal protective agents used by paramedics when transporting the patient, and we also analyze environmental factors inside the ambulance vehicle and isolated personal transportation vehicle. All of these aims were researched with the help of planned experiments and the resulting findings are based on the outcomes of these experiments.
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SALOTOVÁ, Jana. "Náročnost práce sester o pacienty s Alzheimerovou chorobou." Master's thesis, 2011. http://www.nusl.cz/ntk/nusl-55644.

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This diploma work focuses on demanding and important task of nurses care of patients suffering from Alzheimer's disease. The problems of Alzheimer's disease represent socially serious and very important subject at present due to the fact that our generation is growing old, which will obviously result in increasing frequency of Alzheimer?s disease occurrence. This diploma work is divided in two parts: theoretical part and practical part. In the theoretical part there are causes, signs and symptoms, diagnosis and therapy of Alzheimer?s disease. Furthermore there is a conceptual framework of nursing care applied to the patients suffering from Alzheimer?s disease according to nursing model by Virginia Henderson. In addition to it burn out syndrome is mentioned here because due to the syndrome the nursing personnel is exposed to extreme psychic and physical load. The Alzheimer Programme Plan in the Czech Republic is presented in order to get better idea about activities in our country. In the practical part of this diploma work we laid down the following three objectives. The first objective was to ascertain exacting character of nursing work of the nurses taking care of the patients suffering from Alzheimer?s disease. The second objective was to ascertain what is considered by nurses to be the most problematic area within the range of nursing care of the aforementioned patients suffering from Alzheimer?s disease and the third objective of our research was to ascertain the contribution of specialised Alzheimer centres. The above-specified objectives have been fulfilled. In addition to it another research questions have been defined as follows: what is the level of exacting character of nursing work of the nurses taking care of the patients suffering from Alzheimer?s disease, what do the nurses see as the most problematic area within the range of nursing care of the aforementioned patients suffering from Alzheimer?s disease within the range of nursing care, what is the contribution of specialised Alzheimer centres and what nursing care should be provided in the specialised Alzheimer centres. The research questions have been answered. For the purpose of the development of this diploma work a qualitative examination has been used. Data acquisition and collection have been performed by applying the method of non-standard structured interview. The research work took place in Psychiatric Ward of the Hospital of České Budějovice a.s. (Joint stock company), in Alzheimer Centre named Loucký Mlýn near the town of Vodňany and in Alzheimer Centre in the town of Písek, and in Home of Old People in the village of Dobrá Voda. The answers of the interviewed nurses have been worked out in the form of sixteen case reports and subsequently category matrices (tables) containing the most important data were created from the aforementioned reports. The examination took place in the time period from March 2011 to June 2011. The results of our work could serve as a feedback for hospitals and sanatoria first of all for those where the examinations took place. Furthermore the results may be used for keeping public informed about the possibilities of helping patients suffering from Alzheimer?s disease e.g. in the form of information booklet.
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