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Furniss, Stephanie. "Characteristics of Patients Using a Patient Portal via Mobile Technology." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1492468236459889.
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Cochrane, Janine. "Exploring transformative engagement of managers, clinical staff and patients." Thesis, Middlesex University, 2015. http://eprints.mdx.ac.uk/18505/.
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Policy directives and the new NHS constitution require managers and leaders to adopt strategies that motivate and encourage teams to work collaboratively with staff and patients. These innovative ways of working are seen as a means of improving the quality and coordination of patient care, thus impacting on the patients’ experience. Despite this focus, the evidence of what constitutes and therefore what can deliver effective collaboration between managers, staff and patients is sparse. This study identifies a conceptual model of effective management strategies and behaviours that will assist in achieving partnership and collaborative working. This research is based in the real world which is complex and uncertain. The study uses an explorative framework and gains insight from a number of different perspectives. The methodological approach is a qualitative case study. Data was collected from an NHS Trust based in Wales and a District Health Board in New Zealand. Data was collected through document analysis and semi-structured interviews. The findings support a move from a managerialist approach (where managers are target driven, transactional and administer activity) to a more reflexive, egalitarian, transformational approach that can be adapted to cope with complex environments and function successfully in the zone of chaos (where problems are ill defined and messy). The ability of a middle manager to interpret context and operate a balanced approach would appear to be key to navigating a constantly changing and negotiated environment. This study supports adoption of a servant leadership model and proposes guidance for middle managers undertaking change. The guidance proposed is a move away from the dominant doctrine of managerialism and describes the principles for working collaboratively with front-line staff in the NHS and the New Zealand health system.
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McConnell, Angela H. "Influence of Patient Engagement Protocol on Health Outcomes and Medication Adherence of Patients with Metabolic Syndrome." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2741.
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August 2016
Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following training, patient disease biometrics and medication adherence were monitored for approximately four months. Due to a diminished sample size in the completer data set, an intention to treat (ITT) data set was created with baseline values brought forward. In the ITT set, BMI decreased significantly (p=0.005, d=0.18) with each group over time: (IM: 32.9 -± 7.3 Kg/m2 to 31.6 -± 6.8 Kg/m2) and (UC: 32.1 -± 6.7 to 31.5 -± 6.3 Kg/m2). However, there were no statistically significant differences between these two groups' measures. In the completer set, BMI decreased significantly (p < 0.05, d=0.18) over time with the IM group, but not the UC group: (IM: 35.14 -± 7.9 Kg/m2 to 33.65* -± 7.62 Kg/m2) and (UC: 32.4 -± 6.62 Kg/m2 and (32.4 -± 6.5 Kg/m2); indicating a possible relationship between the intervention training (IM) and improved health outcomes. Thus, providers are assisting patients with important lifestyle choices to better manage MetS, potentially leading to social change around improved patient health care behaviors and advancement in providers' patient centered practices.
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Smith, Cheryl. "Patients’ Perceptions of Patient-Centered Care and the Hospital Experience Pre- and Post-Discharge." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etd/3388.
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Florence Nightingale used the principles of patient-centered care as the foundation for nursing practice. Today, patient-centered care delivery is part of the healthcare reform process that extends interprofessionally throughout all settings of healthcare in the United States (U.S.). Patient satisfaction measurement is one primary determinant of effective patient-centered care. The standardized Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and methods is a nation-wide tool used to measure patient satisfaction. However, this method of patient satisfaction assessment relies on recollections of patients’ hospital experiences and requires accurate memory and recall. This study sought to examine the effect of the memory-experience gap on patients’ perceptions of their hospital experiences and address this research question: Are there any statistical differences between in-hospital and two-week post-discharge perceptions of patient-centered care as measured with HCAHPS patient satisfaction ratings on (a) the composite scores for communication with nurses, communication with physicians, communication about medicines, pain management, staff responsiveness, (b) the individual scores for the hospital environment’s cleanliness and quietness, and the inclusion of patient and family preferences in the plan of care, and (c) the overall global rating score? The design was a non-experimental, prospective, descriptive correlational study. The setting was a 255-bed regional hospital that serves individuals from eight surrounding rural counties in southern middle Tennessee. The case-mix contained diverse individuals with multiple economic, environmental, physical, social and spiritual dynamics. A convenience sample of 82 adult patients ages 26 - 93 represented mainly Caucasian females with mostly cardiovascular and respiratory illnesses who had a minimum one-day stay.
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Vittatoe, Danielle S. "Determining Patient Activation Levels among Patients who are Receiving Rehabilitation Services in a Rehabilitation or Long-Term Care Facility." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/251.
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Research shows that one of the major contributors for an extended stay in a long-term care facility is lack of knowledge regarding goals for rehabilitation after being discharged from an acute care facility. It is important to determine patients’ levels of engagement because individuals who are actively involved in discharge planning and rehabilitation goals are able to manage their ongoing care more effectively, which results in increased quality of life. The data was collected using a survey method and the instrument used was the Patient Activation Measure or PAM which is a highly accurate and reliable tool. The 22 question survey was used to determine the level of patient activation among patients who are currently receiving rehabilitation services at a rehabilitation or long-term care facility. Determining the level of engagement in patients receiving rehabilitation services will provide health care providers insight into the how willing patients are to be engaged in their own care. A total of 11 surveys were completed by patients varying age, gender, and length of stay. Each patient was currently receiving rehabilitation services at National Healthcare Corporation of Johnson City or John M. Reed Health and Rehabilitation Facility in Limestone.
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Gilbert, Hannah. "Rallying resources : strategies of therapeutic engagement among patients living with HIV in Senegal." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=79769.
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In recent years there has been a worldwide recognition of the disparity of HIV treatment available in the West and in Sub-Saharan Africa. The West African nation of Senegal was early to implement measures that allowed for the distribution of highly effective anti-HIV therapy known as Antiretroviral (ARV) therapy to a limited number of patients. This thesis explores how patients living in Senegal who are infected with HIV have engaged in various negotiations to obtain access to treatment and other resources to meet the needs posed by their infection. These negotiations are framed by various historically embedded notions of how to engage relationships in the search for care. Strategies are also shaped by the biopolitically-laden discourse that guides the distribution of ARV therapy. This thesis traces the structure, evolution, and effects of patients' strategic negotiations in response to the introduction of this therapeutic technology.
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Alcala, Ann-Marie. "Managerial Strategies for Improving Employee Engagement: A Single Case Study." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4192.
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In 2013, 1% of Medicare reimbursements were withheld from U.S. hospitals, with a
proposed cap of 2% in 2017 for redistribution to those hospitals that improve overall care and patient satisfaction. The purpose of this single case study was to explore the engagement strategies that some hospital middle managers used to improve employee performance to increase patient satisfaction. The sample included 4 health care middle managers in 1 hospital in northeast Connecticut. The conceptual framework that grounded this study was Kahn's personal engagement theory. Data were collected via semistructured interviews, participant observations, and review of hospital and public government documents. The process of member checking and methodological triangulation contributed to the study validity. The data were analyzed using Yin's 5-step method of analysis. Themes that emerged from the study were the importance of the role of the manager in fostering employee engagement, implementing explicit communication techniques, assisting employees in role performance, promoting employee wellbeing, commitment to patient care and satisfaction, and providing employees with rewards and recognition. Although this was a single case study, health care managers from other hospitals could benefit from the results of this study. The implications for social change include the potential for hospital managers to implement strategies to improve employees' engagement, thus improving patients' care and satisfaction, and the overall health and wellness of individuals in the community.
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Hoff, David. "L'information et la communication autour des maladies respiratoires. De la recherche d'information du malade à la construction sociale d'un champ." Thesis, Université de Lorraine, 2012. http://www.theses.fr/2012LORR0370/document.
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Durant les années 80, la prise en charge des personnes insuffisantes respiratoires a bénéficié d'avancées techniques qui ont permis aux malades, auparavant contraints de rester à l'hôpital, de pouvoir retourner chez eux. Les patients ont alors dû faire face à des problèmes auxquels ils n'étaient pas toujours préparés. Atteints d'une pathologie qu'ils ne connaissaient pas, ces derniers ont dû devenir plus autonomes en matière de recherche d'information, de gestion des crises de la maladie et d'utilisation des traitements. Ils devaient comprendre et construire une représentation de leur maladie, très souvent inconnue par leur entourage et par eux-mêmes. Il leur a fallu également affronter le regard des autres et lutter contre la stigmatisation. Progressivement, les patients se sont réunis et ont créé des associations dans le but de faire face ensemble à ces problématiques. Ces associations départementales ou régionales se sont rapidement fédérées pour former une organisation d'échelle nationale, la Fédération Française des Associations et Amicales de malades Insuffisants ou handicapés Respiratoires (FFAAIR). Progressivement, ce mouvement a permis à des agents d'acquérir la légitimité de représenter les malades et de participer avec les professionnels de santé à la construction d'un nouveau champ social. Ces transformations ont été accompagnées et rendues possibles par l'émergence d'une nouvelle forme d'engagement socio-discursif associatifDuring the 1980's, the management and treatment of people suffering from respiratory failure has been improved by new technical developments enabling patients to return home instead of staying in hospital. These patients were thus confronted by certain issues that they were not necessarily prepared for. Diagnosed with a pathology that they did not know, they had to become more self-reliant in terms of information research, health crisis management and the use of medical treatment. They had to understand and build a representation of their disease, a disease often unknown to their family/social circle as well as themselves. They also had to face the regard of others and to fight against stigmatization. The patients thus joined together and created associations in order to address, together, such problems. These departmental or regional associations soon became an organization on a national scale, the Fédération Française des Associations et Amicales de malades Insuffisants ou handicaps Respiratoires (FFAAIR). Progressively, this movement enabled agents to gain legitimacy in representing patients and, together with health professionals, take part in the construction of a new social field. Such transformations were supported and made possible by the emergence of a new form of socio-discursive associative commitment
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Alquait, Abdulrahman. "Determinants of cardiac rehabilitation engagement, uptake and adherence in the percutaneous coronary intervention patients." Thesis, University of York, 2018. http://etheses.whiterose.ac.uk/19918/.
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Purpose: Despite the proven benefits of cardiac rehabilitation (CR) it remains underutilised in the percutaneous coronary intervention (PCI) cohort in many healthcare systems. The objective of this thesis is to contribute to the growing area of CR research by systematically reviewing CR utilisation determinants in the literature then validate those determinants against routinely collected clinical data. Methods: A systematic review was conducted to identify CR utilisation determinants in the literature. Data from the UK National Audit of Cardiac Rehabilitation (NACR) for patients who underwent PCI in 2013 to 2016 was retrieved. Three hierarchical logistic regression models were constructed, using multiple imputation as appropriate, to assess the impact of the identified determinants on CR engagement, uptake and adherence. To account for mode of CR delivery on adherence rates, an online survey was administered to 296 CR programmes across the UK. Results: During the study period, a total of 149,597 cardiac events were recorded in the NACR dataset. Out of this cohort 70,303 (47%) patients underwent a PCI procedure and a total of 59,807 PCI patients were eligible to receive CR. From the CR eligible cohort, 38,246 (63.9%) patients engaged in CR then 28,263 (73.9%) started and finally 22,173 (78.5%) patients completed the programme. The constructed logistic regression models revealed 19 determinants of CR engagement, 23 determinants of CR uptake and 13 determinants of CR adherence. A total of 167 programmes (56.4%) responded to the survey and the results showed that 104 (62.3%) programmes are delivering CR in group- and home based settings while 61 programmes deliver CR in group-based setting only. The Pearson Chi-square test revealed no significant association between mode of CR delivery and adherence rate (p = 0.53, OR: 0.93, 95% CI: 0.87 to 1.01). Conclusion: This thesis revealed that current CR programmes are not attractive to those who are most deprived, diabetic and smokers. The research has also shown that CR utilisation is not a single patient decision but is also related to service level factors, over which healthcare systems have more direct control.
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Mousley, Perdita. "Dangerous and severe personality disordered patients' engagement in education : extent, rationale and developmental impacts." Thesis, University of Lincoln, 2015. http://eprints.lincoln.ac.uk/19486/.
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This thesis explores the extent of rationales for developmental impacts of personality disordered offenders’ engagement in education. The study investigates the educational experiences of a sample of twelve personality disordered offenders receiving interventions in a high secure hospital unit. Engaging offenders in education in prison is challenging as many offenders have apprehensions, apprehensions about joining education which stem from previous negative educational experiences. Many offenders share a common profile, they come from disadvantaged backgrounds, fail to engage at school and leave education with low levels of attainment and poor personal and social skills. Lack of skills and qualifications often leads to a pattern of repeat offending. The combination of previous experiences, offending histories and mental disorder pose particular problems for personality disordered offenders in relation to their engagement in education. A qualitative case study research method is employed to understand the educational experiences of the twelve participants, which are compared to existing theories on offender education. The findings of this research reveal that in addition to previous learning experiences, emotional, behavioural and social difficulties create barriers to learning. In particular mental health issues are found to negatively influence personality disordered offenders’ engagement in education. Although there are barriers that negatively impact on learning other factors are identified as encouraging engagement in education. The reason why individuals start education is not necessarily the reason why they continue. Therefore factors that initially engage offenders in education as well as factors that maintain offenders’ continued engagement in education are explored. Whilst there are some interrelating factors that engage offenders in initial and continued education additional factors are also realised. Engaging personality disordered offenders in education is important as education has the power to enrich, change and develop people (Meek et al, 2012). The findings determine that as well as developing academically, the outcomes of personality disordered offenders’ continued engagement in education are increased social skills and self-awareness, the greatest agent for change. The final conclusions indicate that personality disordered offenders’ engagement in education can be explained through the concept of ‘gradualness’.
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Salwan, A., Nicholas E. Hagemeier, Karilynn Dowling, Kelly N. Foster, J. Arnold, Arsham Alamian, and Robert P. Pack. "Community Pharmacist Engagement in Co-Dispensing Naloxone to Patients at Risk for Opioid Overdose." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/5427.
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Bowersox, Nicholas W. "Treatment Attrition and Relapse Readmission in Psychiatric Inpatients: Predictors of Treatment Engagement and Psychiatric Relapse." [Milwaukee, Wis.] : e-Publications@Marquette, 2009. http://epublications.marquette.edu/dissertations_mu/18.
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Oriowo, Oluremi Omolara. "Improving Patient and Caregiver Engagement During the Transition of Care to Improve Health Outcomes in Patients 65 Years and Older with Heart Failure." Xavier University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1512646682649032.
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Balabanovic, Janet. "Negotiating disconnection : a grounded theory study of therapeutic engagement of patients with 'medically unexplained symptoms'." Thesis, London Metropolitan University, 2017. http://repository.londonmet.ac.uk/1248/.
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"Medically unexplained symptoms" or "MUS" is a term used to reference a poorly understood phenomenon in which patients experience subjectively compelling and distressing somatic symptoms which are not explained by underlying physical pathology. The literature on MUS is replete with controversy regarding the diagnosis and classification of this problem. A dualistic diagnostic system that seeks to classify disorders as either “physical” or “mental” disenfranchises patients with MUS who are so firmly at the intersection, causing problems that reverberate throughout the system. Effective treatment of MUS has been impeded by a complex array of barriers, including structural problems in the health system, lack of consensus over MUS aetiology, lack of effective therapies, and a shortage of suitably trained therapists. A pluralistic review of the clinical literature highlights that no single, universally accepted, and empirically supported model of MUS currently prevails. Furthermore, issues with patient engagement have been consistently highlighted as a problem. Despite this, few exploratory studies on treatment have been conducted so at present, relatively little is understood about either therapists’ or patients’ experiences of therapy for MUS. This research has used a constructivist grounded theory approach to explore the process of therapeutic engagement based on depth interviews with specialist clinicians who work with the most complex patients with MUS in primary care. Through a process of constant comparison the analysis identified how multiple interacting layers of disconnections (systemic, interpersonal and intra-psychic) impede engagement. The research introduces a new theoretical framework “negotiating disconnection” that conceptualises the process of engagement in terms of a series of stages: “drawing in” (negotiating systemic disconnection), “meeting patients where they’re at” (connecting in the disconnection) and “nudging forward” (cultivating new connections), and illustrates how the different stages of engagement are negotiated by clinicians. The model shows that it is critical for mental health clinicians to engage the medical system and collaborate closely with GPs in order to engage these patients. However, it also points to some of the challenges that may be encountered doing this, reflecting the complexities of organisational and cultural change. At a clinical practitioner level, the model illustrates the importance of adopting a flexible, pluralistic and integrative approach that is person and process-led. The model emphasises the importance of clinicians and doctors, who must both embrace a holistic (biopsychosocial) stance towards MUS and to be sensitively attuned to its complex phenomenology. Implications for service structure, psychological therapy provision, training and future research are discussed, as well as implications for Counselling Psychology.
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MENICHETTI, DELOR JULIA PAOLA. "PATIENT ENGAGEMENT SUPPORT FOR OLDER ADULTS: DEVELOPMENT AND IMPLEMENTATION OF AN INTERVENTION IN AN INTEGRATED-CARE CONTEXT." Doctoral thesis, Università Cattolica del Sacro Cuore, 2018. http://hdl.handle.net/10280/39107.
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Obiettivo: Accrescere la conoscenza relativa a come supportare il coinvolgimento attivo dei pazienti anziani, descrivendo i contenuti di interventi per il coinvolgimento attivo con pazienti anziani attualmente presenti sul panorama scientifico, sviluppando un nuovo intervento e studiando le prime fasi della sua implementazione.
Metodo: Nel primo studio, in risposta al primo obiettivo, è stata condotta una analisi sistematica della letteratura scientifica sul tema. Il secondo studio ha visto la conduzione di focus groups con professionisti sanitari e interviste individuali a pazienti anziani per raffinare e validare qualitativamente un nuovo intervento per il coinvolgimento attivo. Nel terzo studio, si è studiata l’implementazione iniziale dell’intervento in un contesto italiano di cure integrate attraverso una ricerca partecipativa.
Risultati: Il principale risultato del primo studio è stato la sbilanciata attenzione tra i 35 interventi per il coinvolgimento attivo presenti in letteratura per le componenti emotive a favore di quelle educative e comportamentali. È sulla base dei risultati del primo studio e di un modello teorico che è stata sviluppata una prima bozza di intervento. Nel secondo studio, la prospettiva di professionisti sanitari e pazienti anziani ha fornito indicazioni per modificare l’intervento e renderlo potenzialmente implementabile nella pratica clinica. L’intervento che è risultato consiste di almeno due incontri mensili individuali, più un set personalizzato di esercizi riflessivi per il paziente da compilare in autonomia a casa. Infine, il terzo studio ha osservato come le diverse pratiche educative presenti nei diversi setting – ospedaliero, ambulatoriale, territoriale - di un contesto di cura integrato hanno generato diverse, specifiche, difficoltà per l’implementazione. Un certo sforzo di flessibilità e personalizzazione dei contenuti e delle procedure dell’intervento è stato dunque richiesto.
Implicazioni: L’intervento sviluppato mostra potenzialità nel supportare il coinvolgimento attivo dei pazienti anziani, ma necessita di ulteriori studi relativi all’implementabilità sul lungo termine e alla sua efficacia.Aim: To contribute knowledge about how patient engagement support can be provided to older adults, by describing the contents of interventions aimed at patient engagement for older adults, developing a patient engagement intervention, and studying its early-stage implementation. Methods: In study 1, a systematic review of the literature was performed. In study 2, a qualitative study with focus groups involving healthcare professionals and individual interviews to older adults was conducted to develop the intervention. In study 3, a qualitative study of a participatory process was accomplished to explore the early-stage implementation of the intervention in one integrated-care organization. Results: The main finding of study 1 was that the emotional dimension was less used than the educational and behavioural dimensions among the 35 patient engagement interventions for older adults. The findings from the study 1 were used, together with a theory of patient engagement, to develop a draft of an individual patient engagement intervention for older adults (PHEinAction). In the study 2, the views of healthcare professionals and older adults were used to refine and finally endorse it. The final version of PHEinAction consisted of at least two face-to-face one hour individual sessions one month apart, plus a set of personalized home-based exercises aimed to facilitate a range of emotional, behavioural, cognitive changes for patient engagement. Finally, the study 3 observed how the existing patient education practice of inpatient, outpatient and territorial settings differently challenged the implementation. A certain degree of flexibility of PHEinAction’s contents and procedures was required to address these challenges. Implications: PHEinAction shows promise as an intervention to improve patient engagement in older adults. However, more research is needed, especially focusing on long-term implementation studies and evaluation of effects with experimental studies.
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Normand, Claire. "Conscience du trouble chez le malade psychiatrique (insight, attente et engagement therapeutiques, compliance au traitement) : échantillon de 61 cas, dont 52 deprimes, hospitalisés volontairement en psychiatrie." Bordeaux 2, 1994. http://www.theses.fr/1994BOR23061.
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"Objectif : la difficulté de prendre conscience de son trouble est souvent évoquée chez les patients psychiatriques. Les auteurs anglo-saxons ont étudié "l'insight", essentiellement chez les psychotiques, et ont montré sa multi-dimentionnalité, sans consensus quant à sa définition et son évaluation. Notre thèse a cherché a évalué la conscience du trouble ("insight") chez des sujets déprimés, ses relations avec le type de dépression, la sévérité de la pathologie et les données anamnestiques. Méthode : 61 sujets, hospitalisés volontairement, dont 52 déprimés, ont été évalués à l'aide d'un questionnaire personnel sur la conscience du trouble, l'attente et l'engagement thérapeutiques et la compliance au traitement, à l'entrée et à la sortie de l'hospitalisation. Prallèlement, ils ont été cotés à des échelles d'évaluation standardisée de l'humeur, de l'anxiété et des fonctions cognitives. Résultats : la conscience du trouble (CT) à l'entrée était proportionnelle au degré d'anxiété des patients. CT et attente thérapeutique étaient positivement liées entre elles, et à l'évaluation des fonctions cognitives. La CT était meilleure, quand des sujets possédaient une bonne conscience de leur troubles antérieurs, et une bonne conscience des troubles d'autrui. La CT était inversement corrélée au nombre total d'hospitalisations psychiatriques antérieures. Une tentative de suicide récente était associée à une différence de prise de conscience du trouble au cours de l'hospitalisation. Type et sévérité de la dépression étaient indépendants des scores de la CT. La CT à l'entrée ne permettait pas de prédire l'amélioration thérapeutique. Conclusion : les patients déprimés n'avaient pas tous une bonne conscience de leur trouble, celle-ci étant essentiellement reliée aux données amamnestiques. Elle a été évaluée à partir d'un questionnaire personnel, d'une bonne cohérence interne. La conscience du trouble, sans définition ni évaluation consensuelles, reste un phénomène complexe et multidimensionnel. "
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Kidwai, Asif. "Technology Acceptance and Compliance in Obstructive Sleep Apnea Patients." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5209.
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The focus of this study is the problem of declining trend in obstructive sleep apnea (OSA) patient compliance. Studies reported improved compliance in patients with chronic diseases due to technology-based interventions. However, researchers have not investigated the advantages of technology to improve the compliance of OSA patients in detail. The specific problem was the lack of engagement between patients and healthcare managers, resulting in low compliance within OSA patients. The purpose of this qualitative study was to evaluate how technology-based interventions can improve OSA patient engagement with the healthcare managers resulting in improved compliance with treatment procedures. In this study, the technology acceptance model was used as the instrument in evaluating the information collected through interviews with 20 healthcare managers about their attitudes toward usage, perceived usefulness, and perceived ease of use. The transcribed interviews were open-coded using the RQDA library in R Studio. In general, results from this study indicated that the healthcare managers showed a positive attitude towards the use of technology for patient engagement and expressed that the technology is useful for patient engagement and is easier to use. However, they identified technology-related and patient-related challenges in implementing technology for patient engagement. Further, the respondents identified process-related and patient-related opportunities in using technology for patient engagement. Results from this study have practice and policy implications by enabling healthcare managers to devise better compliance plans for OSA patient management. The findings could have a social benefit by helping healthcare managers to implement technology-based interventions to better achieve a higher compliance resulting in better patient health at lower costs.
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Nordin, Elin. "Power and Patients : An ethnological study of access to maternity care in rural Sweden." Thesis, Umeå universitet, Institutionen för kultur- och medievetenskaper, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-155339.
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In february 2017 the maternity ward in Sollefteå was shut down. The citizens of the surrounding area, Ådalen, thus have more than two hours - with private transportation on narrow roads without phone connection - to the nearest maternity ward. The shutdown is a result of various developments in society, connected to larger structures of power that present these changes as natural and inevitable. This qualitative study explores the relationship between individual and structure by examining the area of Ådalen and its inhabitants’ access to maternity care. The emphasis lay on power dynamics within - and between - different structures and how these come to influence people’s everyday life. With ethnographic material collected through in depth-interviews and observations, the impact of these power structures are exemplified and discussed from the perspectives of a few individuals. The relevant structures are examined through three norms; a male norm, a neoliberal norm and an urban norm. The analysis problematize how the norms, through the conceptions of women, rurality and human values they reproduce, influence access to maternity care and limit the agency of the study’s participants. The analysis is based on power theories of both Foucault and Bourdieu. Foucault’s theories of subject and resistance are used to examine structural exercise of power and the informants’ collective actions and experiences. While Bourdieu’s theories of habitus, capital and field are used to analyze the informants’ individual perceptions of power. The power structures discussed are tied together by an intersectional framework, which enables a broader analysis of how these structures cooperate and strengthen each other. The study shows the complexity of power where the local movements challenge prevailing structures through mobilization and resistance.I februari 2017 stängdes Sollefteå BB. Invånarna i det omgivande området, Ådalen, har därmed över två timmars bilfärd - med privat transport på smala vägar utan telefontäckning - till närmaste förlossningsvård. Nedstängningen av Sollefteå BB kan förstås som en konsekvens av olika samhälleliga förändringar, vilka är kopplade till större maktstrukturer som får denna utveckling att framstå som naturlig och oundviklig. Denna kvalitativa studie utforskar relationen mellan individ och struktur genom att undersöka Ådalen och dess invånares tillgång till förlossningsvård. Fokus ligger på makt-dynamiken inom, liksom mellan, olika strukturer och hur dessa påverkar människors villkor. Maktstrukturerna exemplifieras och diskuteras utifrån ett antal individers perspektiv, med etnografiskt material insamlat genom djupintervjuer och observationer. De för studien relevanta strukturerna undersöks genom tre normer; en manlig norm, en neoliberal norm och en urban norm. Utifrån dessa normer diskuteras hur informanterna relaterar till makt i kontexten av nedstängningen av Sollefteå BB. Analysen problematiserar hur de olika normerna genom den uppfattning om kvinnor, landsbygd och mänskliga värden som reproduceras påverkar tillgången till förlossningsvård, liksom handlingsutrymmet för studiens deltagare. Analysen utgår från teorier om makt av både Foucault och Bourdieu. Foucaults teorier om bl. a. subjekt och motmakt används för att analysera strukturellt maktutövande och informanternas kollektiva handlingar och upplevelser. Medan Bourdieus teorier om habitus, kapital och fält används för att förstå informanternas individuella erfarenheter av och uppfattningar om makt. De maktstrukturer som diskuteras knyts samman genom ett övergripande intersektionellt ramverk, vilket möjliggör en bredare analys av hur dessa strukturer samarbetar och stärker varandra. Studien visar en komplex bild av makt och maktutövning där de lokala rörelserna i Ådalen utmanar rådande maktstrukturer genom mobilisering och motstånd.
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Khan, Nagina B. "Self help for depression in primary care mental health services : the key influences on the engagement of patients with guided self help." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.495738.
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The aim of the study was to identify predictors of (a) successful engagement with self management for patients with depression and (b) successful outcome of treatment. A number of Key issues were highlighted, which could impact on the success of self help in primary care. These included the importance of issues of control and social functioning among patients with depression, the need to ensure that the context of primary care is viewed as a suitable location for mental health care.
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Rogers, Lindsey Claire. "An exploratory study of quality of life, identity and engagement in patients with renal disease participating in a resistance exercise intervention during treatment." Thesis, University of Leicester, 2013. http://hdl.handle.net/2381/28271.
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A narrative review of quantitative studies was conducted to critically appraise and synthesise the current evidence for resistance exercise as a way to improve the psychosocial well-being of older adults. Fifteen articles, which met the inclusion criteria, were retrieved. The data were synthesized and critiqued according to methodological features. The results suggest that resistance exercise can significantly improve the psychosocial well-being of older adults and may be particularly effective for clinically unwell older adults. However, a cautious interpretation should be made when analysing the results, due to the diversity of resistance exercise used. Suggestions for future research were considered. A mixed-method approach combing both quantitative and qualitative methods was adopted for the empirical paper. Twenty-three participants were recruited through a larger study, a randomised controlled eight-week trial comparing resistance training with a treatment-as-usual group. Questionnaires were used to analyse the effect of exercise on quality of life and mental health of older adults. Results showed no significant differences between the groups. Interviews were conducted post intervention with nine participants who had been allocated to the resistance exercise group. Interview transcripts were analysed using thematic analysis. Six main themes were created to describe the participants’ experience: adjustment to illness; capabilities/limitations of body/ability; maintaining life’s qualities; impact of exercise; undertaking a research programme and being a helper. The analysis suggests that resistance exercise can improve mood, bodily confidence, social contact with others and generate routine and purpose. The findings also suggest that those who are not effectively supported may not continue with their exercise routine.
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Bennett, Stephanie. "Concept Mapping with Patients, Parents, Clinicians, and Researchers to Understand the Perception of Engagement and Value in a Learning Network: A Mixed Methods Study." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1592170772908631.
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Damaskinidou, Katina. "The application of grief family therapy for the prevention of relapse in psychiatric patients : a study of engagement and changes in the expressed emotion of relatives." Thesis, St George's, University of London, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435826.
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Paskell, Rachel Grace. "Military culture and psychosocial factors associated with motivation for, and engagement in, rehabilitation after musculoskeletal injury : a feasibility study with male British military and civilian physiotherapy patients." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698972.
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Engagement in rehabilitation, such as physiotherapy, is critical to enhanced outcomes from musculoskeletal injuries (MIs) and has been found to be related to psychosocial factors, including increased personal control, higher levels of autonomous-motivation and more problem-focused type coping strategies in sports populations. However, this has not been empirically studied in British military groups, despite MIs being the most common reason for medical discharge from the British armed forces. Military personnel are thought to cope with injury within the context of a 'military culture' that is not found in civilians. This study tested a concept of military culture being related to greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation; lower levels of emotion-focused coping strategies; a greater use of problem-focused coping strategies and better engagement in rehabilitation. Data from self-report questionnaires and physiotherapist ratings of engagement in rehabilitation, provided by two groups, was compared. Group one consisted of 16 serving male military personnel and group two of 22 committed sports men; all had MIs sustained within the past 6 months, for which they were having physiotherapy. The sports group were found to show statistically significant greater adherence to masculine norms, and use of problem-focused and emotion-focused coping strategies. No significant differences were found between the groups on perceived personal control, autonomous motivation nor engagement in rehabilitation. A military culture defined by greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation and a greater use of problem-focused coping strategies has therefore not been supported by this study. However, only sufficient power was achieved for the analysis of emotional-focused coping strategies so caution must be taken when interpreting these results. Clinical and research implications are discussed with recommendations for further work with methodological lessons learnt.
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Parron, Audrey. "Le passage à l'âge adulte des jeunes souffrant de troubles psychiques : enjeux d'autonomisation dans la prise en charge du handicap psychique entre dépendance et engagement des jeunes usagers/patients." Phd thesis, Université Toulouse le Mirail - Toulouse II, 2011. http://tel.archives-ouvertes.fr/tel-00681834.
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La jeunesse est communément considérée comme une période de transition d'une situation de dépendance familiale à une situation d'autonomie et qui se réalise selon différentes étapes de décohabitation familiale, d'indépendance financière par l'emploi et par la création de sa propre cellule familiale.Cette thèse a l'ambition de décrire des passages à l'âge adulte de jeunes souffrant de troubles psychiques. Dans un contexte où les parcours individuels sont de plus en plus marqués par une exigence d'autonomie, ce temps particulier du parcours de vie est un moment critique où les tensions liées aux relations de dépendance propres à l'enfance d'un côté et au travail de gestion collective de la maladie de l'autre se heurtent aux difficultés d'avoir accès à l'activité salariale et à l'indépendance financière. Avec une approche qualitative et longitudinale, l'objectif de cette recherche est de comprendre la construction collective de ce passage dans une situation de troubles et/ou de handicap psychique à travers ses enjeux individuels (empowerment, expérience et gestion des troubles, participation sociale et accès aux ressources, définition d'un projet), relationnels (travail collectif de gestion de la trajectoire de la maladie, travail de care, travail d'accompagnement) et institutionnels (définition du handicap psychique, dispositifs d'accompagnement, autonomie comme règle institutionnelle, place des usagers/patients dans les différents services psychiatriques, sanitaires, médico-sociaux, judiciaires ou sociaux).
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Hickey, Victoria. "Using a Novel Digital Token Economy Intervention to Improve Adherence to Self-care Behaviors in Hospitalized Pediatric Patients." Xavier University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1525349538790395.
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Morlock, Nicole Sarah. "Healthcare Administrator Strategies for Nurse Engagement to Increase Patient Care." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5907.
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Healthcare administrators can improve patient care and safety by stimulating nurse engagement as a means of improving internal relationships. The purpose of this case study was to explore engagement strategies that healthcare administrators use to stimulate nurse engagement. Data were collected using semistructured interviews with 4 healthcare administrators in a Missouri hospital setting. The engagement theory informed the conceptual framework of the study. Data were analyzed using Yin's 5-step process that included compiling, disassembling, reassembling, interpreting, and concluding. Analysis revealed 4 major themes: teamwork, nurse and administrator communication, nurse recognition, and nurse empowerment. Strategies were identified through the exploration and analysis of the 4 themes, and the major findings included healthcare administrators increase trust with nurses by forming teams, and administrators who increase communication are more likely to stimulate nurse engagement. The social change implication for this study was that findings of nurse engagement may lead to improved patient care and contribute to a positive patient experience, which benefit patients and their families. Improved patient care may lead to greater faith and credence in medical care benefiting citizens, practitioners, and healthcare administrators.
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Pavelka, Sarah. "The Relationship Between Hospital Leadership Activities and Clinical Quality Outcomes in Iowa." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2996.
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The Centers for Medicare and Medicaid Services have been working with hospital networks across the United States to improve health care through education and training on clinical best practices and leadership frameworks. Some organizations have failed to reach the high-quality standards of care expected and have adverse patient care outcomes. The purpose of the study was to determine the relationship between leadership actions, funding type, and clinical care outcomes in participating Partners for Patients hospital programs in Iowa. The secondary variable data were provided from a Partnership for Patients contractor, through the Centers for Medicare and Medicaid Services Organizational Assessment Tool. Multiple linear regression analyses were used to determine the relationship between the leadership actions, funding type, and the clinical quality outcomes of catheter-associated urinary tract infections, central line associated bloodstream infections, falls with injury, and venous thromboembolism. The findings demonstrated no statistically significant relationships between leadership actions, such as completing a leadership checklist, incident dashboard, and board involvement in decision making, and the specified clinical care outcomes. There was a statistically significant relationship between leadership actions of completing a root cause analysis for incidents, federal funding type, and the clinical quality outcomes of falls with injury and venous thromboembolism. The results of this study will be shared with Partnership for Patients program leadership to positively impact patient care. The results may be useful as organizations continue to implement best practices to reduce medical errors, save cost, and increase patient safety.
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Meyer, Melanie. "The Effects of Financial Literacy on Patient Engagement." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1727.
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Health care reform has caused consumers to learn more about what it means to have health insurance and its costs. Patient engagement, a critical component of health care reform, reflects provider and consumer attention to shared decision making between patient and physician. The problem addressed in this study is that although researchers have studied patient engagement, there has been insufficient exploration of the relationship between financial literacy and patient engagement, which could negatively impact health outcomes not only for patients or consumers but for society as a whole. The purpose of this quantitative research was to determine if a relationship exists between patient financial literacy and patient engagement, as measured by the patient activation measure. The potential effects of increased patient financial responsibility due to high deductible health plans, measured via an item inquiring about participants' deductible, as well as shared decision making between physician and patient were also evaluated as potential moderators between financial literacy and patient engagement. Theories used to provide conceptual context include Shim's cultural health capital theory and Bourbeau's (2008) self-management model. Two hierarchical linear multiple regression models were used to test the research hypotheses. While the research did not find a significant relationship between patient financial literacy and patient engagement, it did confirm the importance of mental health status and patient-physician shared decision making as important predictors of patient engagement. These findings provide a better understanding of financial literacy and specific financial behaviors in the context of healthcare environment today.
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Forward, Cortney D. "Involving Patient/Family Advisors and Advisory Councils with Patient and Family Engagement." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6326.
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Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and family engagement, their experiences from the advisor program, and what is most meaningful to them. A phenomenological design was employed with a purposeful sample of 19 interview respondents drawn from 5 different advisory councils. Data analysis consisted of interpretive phenomenological analysis and a detailed, in-depth account of participant experiences. Transcripts from semi structured face-to-face interviews were collected, coded, validated by member checking, and triangulated with emergent themes. Emergent themes included patient/family advisors' descriptions of patient and family engagement within the patient family advisory councils and organizational efforts most meaningful to patient/family advisors. The results of this study may help create social change by improving the standards and quality of patient and family engagement by preparing health care professionals to better meet the needs of health care consumers.
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Sperber, Jodi. "Patient Driven, Patient Centered Care| Examining Engagement within a Health Community Based on Twitter." Thesis, Brandeis Univ., The Heller School for Social Policy and Mgmt, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10010835.
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Today’s emerging patient centered health movement is focused not on a specific condition or demographic, but rather on shifting the balance of power and enabling access to information to drive decision-making in healthcare. This takes place through electronic health records as well as more generalized sources. The uptake of social media is contributing to an innovation in patient centered healthcare: information and support on a global scale is coming not only from the formal healthcare system, but also within online social networks. Today, through computer-mediated interactions, patients are not only seeking information, they are curating and sharing information. Subsequently, patients are also creating information, establishing a novel ecosystem of engagement that has the potential to disrupt the current healthcare system.
This dissertation explores an online health community, BCSM (which stands for “breast cancer social media”), established using Twitter, a largely public and searchable social media platform. Drawing primarily from social network theory, disruptive innovation, and ecological systems theory, this research identifies essential characteristics within the community that may inform future development and support for patient centered healthcare. To conduct this research, a blended approach of netnography – referring to the approach of ethnography applied to the study of online cultures and communities – and in-depth interviews with BCSM participants were employed.
Data collected via interviews and tweets using the hashtag #bcsm provide evidence of clinical support, emotional support, information sharing, and knowledge translation. Underpinning this activity is the opportunity to associate not only with peers, but also with individuals of varying roles (including patients, providers, advocates, researchers, and caregivers). As evidenced by the data collected, educational opportunities flow in both directions.
This work contributes to the larger corpus of health-related literature in the identification and naming of a significant community element that has seen little focused attention: cross-peer engagement, a term used to highlight the interaction amongst individuals of differing status, ability, or rank. This research also documents the formation of microspurs, defined as relationships that form as a result of community participation. These come in many forms and range from expanding a personal support network to participation in federal policy work. Findings suggest that the future of healthcare will not revolve around hospitals and bounded systems. Instead, patients will demand an expanded set of entry points for health information sharing, knowledge transfer, condition management, and general support.
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Gazza, Clément. "De la prise en charge à la (re)prise du pouvoir ? : la participation sportive comme révélateur des dynamiques de transformation de l'Association des Paralysés de France." Thesis, Montpellier, 2017. http://www.theses.fr/2017MONT4007/document.
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L’Association des Paralysés de France (APF), fondée en 1933, se présente à la fois comme organisation gestionnaire d’établissements et de services médicosociaux, et comme organisation représentative de « personnes en situation de handicap ». Oscillant entre « auto-organisation » et « organisation pour autrui » (Laville & Sainsaulieu, 2013), l’APF cherche à développer un « modèle participatif » (Ebersold, 2002) en impliquant ses adhérents et usagers dans les décisions individuelles et collectives.C’est dans ce contexte que la direction nationale de l’APF a pris la décision en 2013 de recruter un doctorant en convention industrielle de formation par la recherche (CIFRE) pour travailler spécifiquement sur l’organisation des activités physiques et sportives (APS). Pourtant, la demande sportive étant rarement formulée par les adhérents et usagers, il s’avère difficile d’envisager l’organisation des APS dans une forme de co-construction. La question centrale de cette recherche est alors de mieux comprendre la place donnée ou prise par les adhérents et usagers de l’APF dans les décisions concernant l’organisation des APS.À travers une observation participante au siège national, une immersion prolongée dans 10 « structures APF », 49 entretiens qualitatifs (23 salariés ou bénévoles, 26 adhérents ou usagers) et une recherche documentaire, nous avons adopté une démarche compréhensive visant à appréhender les représentations et croyances des différents acteurs, ainsi que leurs interactions.La participation sportive apparaît au final comme un révélateur des difficultés, pour les salariés et bénévoles de l’association comme pour ses adhérents et usagers, à passer d’un modèle de prise en charge à un modèle (re)donnant le pouvoir aux personnes ayant des incapacités (Oliver, 1987, Morris, 1997, 2001)The French Association of the Paralyzed (FAP), which was created in 1933, is both an administrator for social and health establishments and services and a representative organization of “disabled people”. Fluctuating between a “self-organization” and an “organization for others” (Laville & Sainsaulieu, 2013), the FPA is attempting to develop a “participatory model” (Ebersold, 2002) by involving its members and users in individual and collective decisions.In this context, the National Directorate of FPA decided to recruit a PhD student to carry out research specifically concerning the question of physical and sports activities. However, since sports demand is infrequent among members and users, it is difficult to consider the organization of physical activities from a co-construction perspective. The central issue is then to better understand the position which is either given or taken by the members and users of the FPA in the decision-making process in terms of physical and sport activities.Through a participant observation at the headquarters of the association, plus monographic studies of 10 FPA’s units, 49 in-depth interviews (23 employees or volunteers, and 26 members or users) and a documentary research, we adopted a comprehensive approach. Its aim was to grasp the beliefs and social representations of these actors, as well as their interactions.Finally, sport participation in the association seems to expose the difficulties for the employees or volunteers and for the members and users to move from the “model of care” to the “model of empowerment” (Oliver, 1990 ; Morris, 1997, 2001)
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Roberson, Kerrie L. "Patient and Family Engagement Initiative| A Quantitative Causal-Comparative Analysis." Thesis, University of Phoenix, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10615091.
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Patients and families play an important role at the bedside, and that is making sure the transition of care among providers is safe and effective. Bedside shift report (BSR), a type of patient and family engagement, is a process where patients, families, and health care providers work together as partners to improve the quality and safety of hospital care. In 2010, TJC developed and revised the standards for patient-centered care, which were designed to improve the safety and quality of care for patient and family involvement. The purpose of this quantitative descriptive study with a causal-comparative design was to compare two dependent variables of patient and nurse satisfaction from the pre-and post-implementation of BSR as a patient and family engagement strategy and determine if BSR resulted in a positive return on investment for a health care organization. This quantitative descriptive study employed Donabedian’s structure-process-outcome (SPO) approach model. This model is a foundation for modern health care quality measurement, studying the structures of process and outcome, and the means to an end of a relationship. The data analysis utilized both descriptive and inferential statistics. The mean and standard deviation were calculated on two dependent variables, nurse satisfaction and patient satisfaction. Both research questions were measured using Chi-square to compare the difference in the yearly data for patient satisfaction and nurse satisfaction pre-and post-implementation of BSR as a patient and family engagement strategy on a surgical unit. The dependent variable patient satisfaction is statistically significant and the dependent variable nurse satisfaction is not statistically significant. Each year, post-implementation BSR for both dependent variables had a positive trend.
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Martin, Rosemary. "The Impact of Engagement Strategies on the Reduction of Patient Falls." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4462.
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Despite the availability of many fall prevention measures, many patients fall in U.S. hospitals each year. Experts view patient fall rates as the measure that can be most affected by a nurse-led, evidence-based intervention. The purpose of this quality improvement project was to implement and evaluate the impact of patient engagement strategies on patient compliance to fall prevention education and the reduction of falls. The quality improvement framework used for this project was the Iowa Model. Interventions for this project included patient engagement strategies including the teach-back (TB) method and video-based fall prevention education paired with the project site's existing fall prevention program. A prospective quantitative design was used to answer the practice-focused question of whether the implementation of a falls protocol incorporating patient engagement strategies improves patient compliance with the fall prevention plan of care and reduces patient falls. A total of 58 patients were included in this project, conducted from July to October 2017. The results showed a 75% reduction in the fall rate compared to the same three month period in 2016. This finding suggests that reinforcement of oral and written instruction through video education follow-up and the use of the TB method to assess patient understanding are effective measures to reduce patient falls and increase patient compliance to the fall prevention plan of care. These patient engagement strategies can be replicated by nurses in similar acute care settings. Adoption of such evidence-based changes in nursing practice may improve patient safety and decrease harm in hospital settings as implications for positive social change.
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Jog, Chetan R. (Chetan Ravindra). "Healthcare technology, patient engagement and adherence : systems and business opportunity analysis." Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/76493.
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Thesis (S.M. in Management and Engineering)--Massachusetts Institute of Technology, Engineering Systems Division, System Design and Management Program, 2012.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 63-64).
In the current shift in the US healthcare system, lower cost, higher quality of care, access and safety are the main drivers that are effecting changes. Patient compliance with medication and technology enabled wellness and engagement programs play an important role in ensuring the cost and quality of care is reduced. In a recent study, the overall cost of poor medication adherence, measured in otherwise avoidable medical spending, is close to $310 billion annually, representing approximately 14% of total healthcare expenditures. There have been several studies analyzing the reasons for and impact of non-adherence and solutions to achieve increasing compliance. With the recent wave in healthcare technology, the scope of prescription medication adherence needs to be expanded to include patient engagement and their awareness towards lifestyle changes and managing their own health. This thesis engages in an analysis of these compliance issues and in understanding the relationships among the various stakeholders involved. It also analyses the several technology platforms and solutions from mobile health to "gamification" and social networks from a business, user and regulatory standpoint. It looks into how these newer health technologies helps the individual in adhering and realizing novel insights into their own patterns related to medication, lifestyle and general health. Further, working with a health technology startup catering to the behavioral care market, a real world application of a health technology product that utilizes technology based patient assessment, decision support and patient communication, will be evaluated to explore how it will help in delivering value to several stakeholders.
by Chetan R. Jog.
S.M.in Management and Engineering
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Washburn, Kimberly Dawn. "Effects of Authentic Leadership Style and Nurse Engagement on Patient Satisfaction." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4339.
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Ineffective leadership and disengaged nurses reduce the quality of care and patient satisfaction in healthcare organizations. Healthcare leaders can benefit from understanding the factors that improve leadership ability and nurse engagement to improve healthcare outcomes. The purpose of this correlational study was to examine the relationship between the demonstration of authentic leadership characteristics and nurse engagement. The study's population comprised acute care registered nurses in a rural hospital in central Washington State. Authentic leadership theory and engagement theory constituted the theoretical framework. Independent variables were the 4 constructs of authentic leadership theory, self-awareness, balanced information processing, relational transparency, and internalized moral perspective; the dependent variable was nurse engagement. Three hundred sixty-nine registered nurses received 2 pen and paper, Likert-type scale surveys, the Authentic Leadership Questionnaire, and Utrecht Worker Engagement Scale- 9 item, to complete for data collection. Data were analyzed using multiple linear regression. There was no relationship between the 4 constructs of authentic leadership and nurse engagement. The coefficient of determination demonstrated only 11% variation in nurse engagement related to the independent variables. Healthcare leaders face significant challenges. With a better understanding of the factors that lead to higher nurse engagement, leaders can increase both nurse and patient satisfaction, leading to better healthcare outcomes.
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Folke, Fredrik. "Patient Engagement and the Effectiveness of Behavioural Activation in Inpatient Psychiatry." Doctoral thesis, Uppsala universitet, Psykiatri, Akademiska sjukhuset, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-330960.
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Psychiatric inpatient services provide important care for individuals with serious mental health problems. Studies show that passivity and social disengagement prevail in inpatient settings, and the transition to outpatient care is associated with increased suicide risk. Behavioural Activation is an intervention that targets depression by increasing personally meaningful activities. Preliminary research shows that Behavioural Activation can be used in inpatient settings. The overall aim of this thesis was to evaluate the feasibility and effectiveness of Behavioural Activation for individuals in psychiatric inpatient settings, and in the transition between inpatient and outpatient care. Study I investigated inpatient activities and associated experiences. Study II was a pilot single-case experimental study of the feasibility and effectiveness of inpatient Behavioural Activation. Study III, was an interrupted time series evaluation of nursing-adapted Behavioural Activation across three wards. In Study IV Behavioural Activation in the transition from inpatient to outpatient care was compared to Supportive Therapy in a randomised controlled trial with 64 participants. The primary outcome was that of self-reported depressive symptoms and participants were followed up 12 months after treatment completion. Doing nothing was the most common inpatient activity, along with meal related activities. Passive and solitary activities were associated with negative distress and reward profiles. The preliminary evaluation of Behavioural Activation found high patient and staff satisfaction, and four of six participants showed improvement in depressive symptoms and functioning. After nursing-adapted Behavioural Activation was implemented on three wards, engagement increased. Avoidance decreased but later returned to baseline levels. Depressive symptoms and global clinical severity did not improve after nursing-adapted Behavioural Activations was introduced. The randomised controlled trial found that adding Behavioural Activation in the transition to outpatient care had a small, short-term, advantage over Supportive Therapy for self-reported depression. In conclusion, inpatient disengagement is associated with distress, and Behavioural Activation is a feasible intervention in inpatient settings that can be used by both trained therapists and nursing staff to increase patients’ treatment engagement. Behavioural Activation seems useful in targeting depressive symptoms in the transition from inpatient to outpatient care, a period associated with increased risk of suicide and clinical deterioration.
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Victoria, Lindsey N. "A Feasibility Analysis of a Pilot Study Comparing Prenatal Genetic Service Delivery Outcomes Using the Self-Determination Theory." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7982.
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Genetic counselors, along with the National Society of Genetic Counselors, desire evidence-based research and data assessing the value of genetic counseling in genetic service delivery. This pilot study was designed to gather data about genetic counseling outcomes as well as analyze the feasibility of a study looking at new genetic outcome measures in the prenatal setting. Implementation of the methods used for data collection were evaluated by analysis of the appropriateness, acceptability, feasibility, fidelity, and adoption of the research protocol at three sites. We found that there is a hierarchy between implementation outcomes and it may be necessary to satisfy one implementation outcome before the next one can be achieved. We also found that patient engagement is a key component to evaluating the success of methods used for data collection. These findings may be useful to individuals designing future research studies used to measure genetic counseling outcomes.
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Vendel, Malin, and Anna Wid. "Sjuksköterskors upplevelser av vad som är vårdande i samtal med patienter." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-71415.
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Bakgrund: Den psykiska ohälsan ökar stadigt i Sverige. Genom folkhälsomyndighetens mätningar 2016 visade resultatet att 16 procent av befolkning lider av psykisk ohälsa. Det har framkommit att genom samtal med sjuksköterska kan den som lider av psykisk ohälsa få stöd och kraft till att egna förmågor stärks. En förutsättning för att kunna ge en god vård är att skapa en god vårdrelation mellan vårdare och patient. Syfte: Syftet med denna studie är att belysa vad sjuksköterskor inom psykiatrisk öppenvård upplever som vårdande i samtal med patient. Metod: Tio semistrukturerade intervjuer har genomförts och dessa har analyserats med en kvalitativ innehållsanalys. Resultat: Resultatet redovisas i tre kategorierna; Att känna engagemang för patienten, som belyser vikten av att lyssna och hörsamma patientens berättelse och förstå patienten utifrån dennes livsvärld. Det framkom att ett syfte för samtalet ses som viktigt. Vidare beaktades respekten för patientens integritet och förmågan att anpassa samtalen utifrån varje enskild individ. Skapa och fördjupa relationen, handlar om att trygghet och tillit i vårdrelationen är en förutsättning för ett vårdande samtal. Vidare uttrycks att en stadigvarande kontakt är gynnsamt för relationen och samtalen. Utrymme för utveckling, belyser vikten av patientens önskemål i samtalet, och samtalet som möjlighet till förändring. Slutsats: Studien visar på att sjuksköterskor upplever det vårdande samtalet som betydelsefullt. För att lyckas med detta behövs insyn i det vårdande samtalets betydelse och att det får ta tid att lära känna patienten. Utifrån studien kan slutsatsen dras att sjuksköterskorna har en god värdegrund med patienten i fokus.Background: Psychological ill health is steadily increasing in Sweden. By the Public Health Authority's measurements in 2016, the result showed that 16 percent of the population suffered from mental health. It has been found that through talks with a nurse, the person suffering from mental health can get support and power to strengthen his / her own abilities. A prerequisite for being able to provide a good care is to create a good care relationship between caregivers and patients. Purpose: The purpose of this study is to highlight what nurses in psychiatric outpatients experience as carers in conversation with patients. Method: Ten semi- structured interviews have been conducted and these have been analyzed with a qualitative content analysis. Results: The result is presented in three categories; To feel commitment to the patient, describing the importance of listening and hearing the patient's story and understanding the patient based on his life. It is described that a purpose of the caring communication is considered important. Respect for the patient's integrity and the ability to adapt the conversation from each individual is described. Create and deepen the relationship, be sure that safety and trust in the care relationship is a prerequisite for a caring communication. It is expressed that a constant contact is favorable to the relationship and the conversation. Space for development highlights the importance of the patient's wishes in the conversation. As well as the conversation as a possibility of change. Conclusion: The study shows that nurses experience the caring communication as significant. In order to succeed, insight into the importance of caring communication needs to be taken and that it may take time to get to know the patient. Based on the study, the conclusion can be drawn that nurses have a good value base with the patient in focus.
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Simpson, Cheryl. "Quality Improvement Initiative About Patient Engagement With Clinicians in a Community Hospital." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4103.
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Chronic kidney disease (CKD) is a global health problem and efforts are needed to improve the care of individuals affected by the disease. A recent strategy for improving care within the healthcare system is patient engagement. Nurses and other health care clinicians can apply patient engagement into their clinical practice to improve the care they provide to their patients. Therefore, the purpose of this project was to increase the knowledge and awareness of patient engagement among clinicians who work with CKD patients. This quality improvement project used Lewin's force field analysis to analyze driving and restraining forces to help develop and implement strategies to develop an e-learning module. The project used practice-focused questions to determine if knowledge about patient engagement and the Shared End-Stage Renal Patients - Decision Making Tool could improve staff knowledge and awareness about patient engagement. A quantitative pretest, posttest approach was used to compare pretest scores to posttest scores after the e-learning module was viewed. Nine clinicians participated in the project study. Results showed that clinicians' knowledge and awareness about patient engagement increased from a mean pretest score of 5.22 to a mean posttest score of 6.22, (p = 0.08617). The sample of only 9 participants may have contributed to the lack of statistical significance after viewing the educational presentation. The e-learning module will provide positive social change as staff and students of renal programs learn about and apply the principles of patient engagement to their clinical practice.
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Halder, Anirban [Verfasser]. "Slow Engagements: Patient’s Perspective in Narratives of Chronic Illness / Anirban Halder." Mainz : Universitätsbibliothek Mainz, 2020. http://d-nb.info/1210964155/34.
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Foreman, Meagan. "Public Interest, Patient Engagement and the Transparency Initiative of the College of Physicians and Surgeons of Ontario." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37975.
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In recent years, patient-centredness has become a central focus in improving health care quality. In 2010, the Canadian Medical Association (CMA) launched a four-year action plan aimed at transforming Canada’s health care through a framework aimed at creating a culture of patient-centred care, accountability and responsibility. Several of Canada’s provincial governments proceeded to launch patient-centred action plans, including the Government of Ontario’s “Patients First” framework, which prioritizes patient engagement and increased transparency. As an example of how organizations are putting these values into practice, the College of Physicians and Surgeons of Ontario (CPSO)’s transparency initiative, which aims to make more physician-specific information available to the public in order to help patients make informed decisions about their health care, was examined. This thesis asks how physicians and members of the public feel that the transparency initiative aligns with the CPSO’s public interest mandate. Using discourse analysis, 226 responses by physicians, members of the public and organizations on a discussion forum in the Policy Consultations section of the CPSO’s website were analyzed in order to identify the main themes in arguments for or against increased transparency. The results show that physicians and members of the public tended to differ in their views on the purposes and probable outcomes of the CPSO’s transparency initiative. The majority of physicians worried about patients’ ability to accurately understand and utilize the information being provided to them, and the negative impact that this might have on individual physicians and on the physician-patient relationship more broadly. Most members of the public had a more positive outlook on the potential for transparency to build public trust, help patients become informed and engaged decision-makers and improve patient safety.
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Post, Kathryn E. "Understanding Patient Engagement in Breast Cancer Survivorship Care: A National Web-Based Survey." Thesis, Boston College, 2019. http://hdl.handle.net/2345/bc-ir:108398.
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Thesis advisor: Jane FlanaganBACKGROUND: Breast cancer survivors experience a range of needs in the post-treatment phase as they transition into survivorship and beyond. The transition to survivorship requires breast cancer survivors to actively engage in self-managing their care, but little is known about patient engagement into survivorship care and what factors may contribute to this. Information is needed to further explore patient engagement into survivorship care, what factors may contribute to it and which patients are more likely to engage in their care and thus be better equipped to self-manage during survivorship. PURPOSE: The purpose of this study was to explore how demographic/personal factors and survivorship outcomes are related to and may contribute to patient engagement in early stage breast cancer survivors. METHODS: A cross-sectional, web-based self-report national survey was conducted using measures assessing personal/demographic factors, survivorship outcomes: health-related quality of life (HRQOL), fear of cancer recurrence (FCR), cancer health literacy (CHL) and two measures of patient engagement (patient activation (PA) and knowing participation in change (KPC). There was one open-ended question regarding additional survivorship concerns, not addressed in the previous survey items. Participants were recruited using Dr. Susan Love’s Army of Women Research Foundation and Craigslist. Data were analyzed via bivariate associations and backwards linear regression modeling in SPSS. RESULTS: The final sample included 303 participants (301 females and 2 males) with a mean age of 50.70 years. The sample was predominantly White, non-Hispanic and equally dispersed across the United States. Patient engagement, as represented by PA and KPC, was significantly correlated with 13 predictor variables and there were 10 predictor variables that resulted in significant ANOVA relationships with PA and KPC. In both the KPC and PA regression models, HRQOL significantly predicted for patient engagement. In the KPC regression model, social support and level of education also significantly predicted for patient engagement and receipt of a survivorship care plan contributed unique variance to the model. The open-ended question response categories included: physical concerns, mental health concerns, financial toxicity, social support, body image concerns, other concerns or no concerns/none. CONCLUSIONS: This study provides preliminary evidence that personal/demographic factors and survivorship outcomes may contribute to patient engagement in breast cancer survivors. Using assessment tools that measure factors such as HRQOL, social support, education level and patient engagement may give providers some insight as to which survivors may be ready to engage in survivorship care and those that may need more resources and/or support. Additional studies are needed to replicate and validate these results. More research is needed aimed at maximizing patient-centered care, patient engagement and ultimately improving SC. Keywords: breast cancer survivor, survivorship, patient engagement, health-related quality of life, social support
Thesis (PhD) — Boston College, 2019
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Ogungbayi, CarolineE Jokotola. "Strategies for Patient Engagement in a Self-Management Program for Adults with Diabetes." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7174.
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Patients' lack of adherence to diabetes self-management education and support (DSMES) recommendations is a challenge for healthcare. One approach to addressing patient noncompliance with DSMES is through education of staff on current guidelines. In an outpatient facility in South Texas, staff training on current DSMES guidelines was recommended as one of the solutions to the problem of Type 2 diabetes mellitus (T2DM) complications observed among clinic patients. An educational module was created to increase staff knowledge on T2DM and to assist staff members in teaching patients to self-manage T2DM. The module was built on the self-management and health promotion models, as well as self-regulation, dual process, and social learning theories. The DSMES educational module created for clinic staff consisted of a lecture presentation on current diabetes information and management guidelines, and a pre and posttest survey based on 13 close-ended questions. The generated data were summarized and analyzed using McNemar's test for paired, binary data. Results revealed that the module was useful for clinic staff in updating their T2DM and DSMES knowledge. Improvement in staff expertise might lead to positive social changes related to improved patient self-care of diabetes and reduction in financial burden in the longer term.
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Campbell, Desiree. "An evaluation of patient engagement with diabetes out-patient services in an ethically diverse urban area in the UK." Thesis, City, University of London, 2018. http://openaccess.city.ac.uk/21477/.
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Diabetes has been described as an epidemic with a significant global burden of illness. This burden is associated with poorer engagement with services and the cost of managing avoidable complications. One outcome measure of engagement in the national health service (NHS) in the United Kingdom (UK) is attendance at appointments. The cost implications (direct and indirect) of non-attendance are significant, with empirical evidence consistently demonstrating higher than average non-attendance rates for out-patient appointments and education sessions by minority ethnic and socio-economically deprived individuals. A gap was identified whereby a comprehensive understanding of non-attendance which moves beyond clinical and technical aspects such as capacity and demand is still required. This thesis provides a fresh approach and granular understanding of patient engagement which can influence clinical care, service delivery and policy. The main research questions in this thesis were: 1. What are the predictors of out-patient attendance? 2. What are the barriers and enablers to attendance? To answer these questions, a retrospective geo-demographic trend analysis, critical narrative literature review of Community Health Worker (CHW) and peer support interventions and a research study were conducted. The case study is based on a dataset which comprised of 35,597 appointments. Its findings highlighted that factors such as age, gender, ethnicity, local geography and deprivation were significant predictors of out-patient attendance. A critical review of CHW and peer support interventions demonstrated that despite the heterogeneity of programme designs, duration of interventions, follow up and healthcare systems in which they were used, they were assessed to be both clinically and cost effective. There was limited evidence on the sustainability of these interventions due to a lack of longitudinal studies. The research element was conducted in two stages and utilised multi methods (focus groups, semi-structured interviews and questionnaires) to evaluate the barriers and facilitators to attendance. Key findings included the need for effective and on-going education, better alignment of health and social care due to the impact of the wider determinants of health but more interestingly, the influence of family on the concept of ownership for one's health by some individuals whose self-determination is limited by language and health literacy. The relationship between patient activation (knowledge, skills and confidence) and attendance was also evaluated. This evaluation demonstrated that the more activated individuals are, they are significantly more likely to attend appointments. However, to maximise care planning and operational effectiveness, activation should not be assessed in isolation. The findings of this thesis highlighted the influence of individual, organisational and structural factors on patients' engagement with out-patient services and the need for a synergistic approach involving service users, clinicians, organisations and policy makers to minimise patient dis-engagement with healthcare services.
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Salmon, Pauline Adora. "Improving the Patient Experience with Communication." ScholarWorks, 2020. https://scholarworks.waldenu.edu/dissertations/7839.
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A quality patient experience is one of the highest priorities for hospitals as patients and families are looking to healthcare providers to meet their demands for quality service. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures the extent to which providers effectively communicate pertinent information such as communication about medications. On a 20-bed intermediate care unit, the HCAHPS item scores relating to nurse communication and communication about medicine were inconsistent and, on most occasions, were below the comparison benchmark of the 50th percentile when compared to other like hospitals. The purpose of this quality improvement project guided by the patient-centered care model, needs based theory, and adult learning theory, was to test the impact of an educational module for nurses on best practices for teaching patients about medications. Thirty nurses consented to participate in the teach-back sessions. Results of the pre- and posttest, evaluating the nurses' knowledge and attitude about teach-back, were analyzed using the Wilcoxon Signed Ranks test and findings showed an improvement in knowledge scores (z = -2.833, p = .005). However, no statistically significant changes occurred in nurse attitudes toward teach-back. A comparison of descriptive HCAHPS scores on communication about medications and nurse communication showed that scores improved from a low of 58% top box to 74% after the teach-back education. These findings indicated that using teach-back could enhance communication about medications. Effectively communicating pertinent health information using teach-back may have significant consequences for nurse-patient-family engagement contributing to positive social change.
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LaRock-McMahon, Catherine. "Factors Influencing Emergency Registered Nurse Satisfaction and Engagement." Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10973779.
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Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg’s, Vroom’s, Yetton’s, Maslow’s, Benner’s, and Kahn’s motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and engagement elements using structured interviews of 21 ED nurses from three hospitals of varying sizes and capabilities and included three generational cohorts of Baby Boomer, Generation X, and Millennial RN. Interview analysis showed distinct similarities and differences in nurse satisfaction and work engagement with a consistency in job engagement with no distinct differences among generations. Distinct findings included persistent lack of staff resources, poor communication from leaders, and compassion fatigue among staff. Findings reflected strong interpersonal relationships, teamwork, autonomy, and a strong sense of accomplishment among nurses. Findings indicate that satisfied nurses have improved outcomes, produce happier customers, and feel a sense of accomplishment in the job performed. The positive social impact of this study is in providing guidance on retaining ED RN to provide adequate staffing levels for safe, quality healthcare.
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Andersson, Anna, and Ingela Nilsson. "Samtal i livets slut." Thesis, Högskolan Kristianstad, Sektionen för hälsa och samhälle, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-11806.
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Bakgrund: Samtal om övergången från en botande behandling till palliativ vård kan vara svårt. Sjuksköterskan har en central roll i omvårdnaden och att kommunicera med patienter är betydelsefullt för omvårdnaden av döende patienter. Livets slut är ett känsligt ämne att samtala om och lätt att undvika. Detta kan bero på bristande erfarenhet, utbildning, tidsbrist och rädsla inför ämnet. Syftet med studien var att beskriva sjuksköterskans upplevelse av samtal med vuxna patienter i livets slutskede. Metoden var en allmän litteraturstudie, som byggde på tretton artiklar. Resultatet visade upplevelser som påverkade sjuksköterskan i kommunikationen med patienter i livets slutskede. Till exempel rädslan att ta ifrån patienten hoppet, brist på utbildning, erfarenhet och tid. Dessa sammanställdes i tre teman; ärlighet, engagemang och verbal- ickeverbal kommunikation. Livets slut är något vi har behov av att prata om, men som är svårt. Diskussion: Det är viktigt att sjuksköterskan är trygg i yrkesrollen och vet sin egen inställning till döden. Det krävs god kunskap och tid för samtal med patienter i livets slutskede. Genom samtal kan rädslan minskas och tiden fram till livets slut kanske kännas mindre skrämmande för den döende.
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Barron, Alison Claire. "Attachment in psychological therapy : an exploratory study into patient and therapist attachment patterns and their relationship with early engagement and therapeutic alliance." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/16239.
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Background. Recent research into attachment theory has suggested it provides a useful framework for understanding the psychological therapeutic process. Clinical application of attachment theory has been a recent development in adult mental health research. Previous studies have focused on patient attachment styles and a systematic review of the literature highlights the limited research that explores both patient and clinician attachment patterns. The reported study aims to explore both patient and therapist attachment and the dyadic interaction on the therapeutic process, and, in particular, how attachment influences the early engagement and development of the therapeutic alliance. Methods. Patient participants and clinician participants completed a self-report measure of attachment prior to commencing a psychological intervention. Early engagement was measured through appointment attendance and independent therapeutic alliance ratings from patients and clinicians were completed after the third appointment. Correlations and regression analysis explored the extent to which patient and clinician attachment predicts early engagement and the therapeutic alliance. Results. Fifty-five patients and 38 clinician’s self-report attachment styles indicate greater security amongst clinicians. Patients presenting to mental health services reported higher levels of anxious and avoidant attachment patterns, which were predictive of greater psychological distress. Patient avoidant attachment was associated with poor engagement and both patient anxiety and avoidance attachment were predictive of therapeutic alliance. No relationship was found between therapist attachment and early engagement or therapeutic alliance, and there were no significant interactions between patient and therapist attachments patterns. Conclusions. Findings from the current study suggest that patient attachment style is predictive of reported psychological distress, early engagement and therapeutic alliance. Applying the principles of attachment theory to clinical practice could therefore provide greater insight into the interpersonal dynamics between patient and therapist and help inform services as to how to improve engagement and alliance with insecure patients. The strengths and weaknesses of the study are discussed, which highlights the need for further research with larger samples to build on the current limited findings.
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Eriksson, Caroline, and Wikström Pernilla. "Kommunikation mellan sjuksköterska och patient." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25790.
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Kommunikationen har stor betydelse inom sjukvården och det är många faktorer som kan påverka kommunikationen mellan sjuksköterska och patient. Syftet med denna litteratur-baserade studie var att ur ett patientperspektiv belysa faktorer som har betydelse för kommunikationen mellan sjuksköterskor och vuxna patienter med kontinuerlig kontakt med vården på sjukhus eller äldreboende. Metoden har varit en strukturerad litteraturba-serad studie baserad på Fribergs (2006) sju steg. Resultatet av de nio vetenskapliga artik-larna visar att patienternas upplevelser av kommunikationen påverkas av faktorer relate-rade till sjuksköterskornas personlighet, sjuksköterskornas profession, den individuella patienten samt miljö och organisation. Många patienter var över lag nöjda med kommu-nikationen till sjuksköterskorna. De patienter som inte var nöjda visade tydligt vad som var bra respektive dåligt med kommunikationen.Communication is of great importance within health care and many factors may affect thecommunication between nurse and patient. The aim of this literature based study was toemphasize some factors that are important for the communication between nurses andadult patients that are in continuous contact with the care within hospitals or homes for the elderly. The method has been a structured literature based study based on the seven steps of Friberg (2006). The result of the nine scientific articles shows that the patients´ experiences of the communication are affected by factors related to nurses´ personality,nurses´ profession, the individual patient and the environment and organisation. Manypatients were overall satisfied with the communication with the nurses´. The patients that were not satisfied clearly showed what was good and what was not good with the communication.
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Ainsworth, Thomas Christian. "The development of persuasive design theory to improve patient engagement with therapeutic exercises in people with rheumatoid arthritis." Thesis, University of Brighton, 2013. https://research.brighton.ac.uk/en/studentTheses/306fac62-e963-4e6f-abc5-fa31446e9483.
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This thesis presents the development of persuasive design theory to effect behaviour change amongst patients with Rheumatoid Arthritis (RA). Drawing on research from the disciplines of design, social psychology and healthcare, this study defines ‘persuasive design’ as an area of design research which seeks to change a person’s attitude or behaviour for the benefit of their health and in concordance with their own ambitions. The research aim is to support patient engagement with long-term therapeutic exercise recommendations specifically for the hand. This is achieved by identifying ‘designable factors’ ideas, objects, and environments (virtual and real), which are specific to people with RA and can be identified, examined, understood and selectively influenced to increase the ability and willingness of users to engage with long-term therapeutic exercise recommendations. The research explores existing motivations and interests, embedded within daily life activities that can be targeted to incorporate therapeutic exercise interventions. To achieve this a qualitative research methodology was adopted, consisting of photographic ‘cultural probe’ and ‘photo elicitation’ methods, which were utilised within a focus group setting.