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1
Krainin, Penelope. "The influence of patient weight on patient-physician interaction and patient satisfaction." Full text available online (restricted access), 2001. http://images.lib.monash.edu.au/ts/theses/krainin.pdf.
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Irvine, Alastair D. J. "Time preferences and the patient-doctor interaction." Thesis, University of Aberdeen, 2018. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=238373.
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Patients' non-adherence to treatment is a widespread phenomenon in healthcare. Time preferences (how individuals value outcomes over time) are one cause for non-adherence. Using quasi-hyperbolic discounting, two options in the future are weighted consistently. However, when the early option becomes available the weighting changes. This creates the potential for non-adherence. The agency relationship that exists between patients and doctors implies hidden information. When the patient's time preferences are hidden from the doctor, the doctor must choose how to recommend treatments. Exploring how doctors make treatment decisions when time preferences are hidden from them, and how this impacts adherence, is therefore important. The first contribution of the thesis is to outline a model of the patient-doctor interaction incorporating quasi-hyperbolic discounting and hidden information. This shows that doctors should adapt to non-adherence when the probability a patient is present-biased is large enough. Secondly, a national survey of Scottish GPs explores whether doctors have different time preferences for themselves or their patients. Doctors do have the same private and professional time preferences, but value the health state differently between frames. Lastly, a laboratory experiment tests whether students in the role of a doctor adapt to non-adherence in the way predicted by the model. Students find the socially optimal level of treatment on average. Adaptation is stronger when using a performance payment, and results did not vary along demographic characteristics. The thesis highlights the importance of the patient-doctor interaction for generating nonadherence, not just patient preferences. It also shows that GPs' private time preferences may suitably substitute their preferences for patients. Finally, it points towards potential incentives for doctors to improve patient outcomes.
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Williams, Caroline M. A. "Nurse-patient interaction in an intensive care setting." Thesis, University of Brighton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273868.
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Ramsay, Michelle Clare. "Patient-ventilator interaction in domiciliary non-invasive ventilation." Thesis, King's College London (University of London), 2018. https://kclpure.kcl.ac.uk/portal/en/theses/patientventilator-interaction-in-domiciliary-noninvasive-ventilation(9b60bd3e-84b6-4605-96a8-22b4546b1e90).html.
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Introduction: Patient-ventilator asynchrony (PVA) can adversely affect the initiation of home mechanical ventilation (HMV). The aim was to quantify the prevalence of PVA during HMV and determine the relationships between PVA and adherence to therapy, respiratory muscle loading, nocturnal gas exchange, health-related quality of life measures and sleep quality. Method: A pilot randomised control trial was conducted to compare a physiological led set-up of HMV, using neural respiratory drive to optimise ventilator set-up, to an expert led set-up. Type and frequency of PVA were measured by surface parasternal muscle electromyography, thoraco-abdominal plethysmography and mask pressure during initiation of HMV and 3 months post therapy. Severe PVA was defined as affecting ≥10% of breaths. Results: 40 patients (25 male) were enrolled with an age of 58±17years and a body mass index(BMI) of 33±10kg/m2. Underlying diagnoses were neuromuscular ± chest wall disease (NMD-CWD,n=11), obesity-related chronic respiratory failure (ORRF,n=13) and chronic obstructive pulmonary disease (COPD, n=16). Overall, PVA affected 25.6(16.4-35.7)% breaths at initiation of HMV, with ineffective efforts as the predominant type of PVA affecting 10.9(4.6-23.7)% breaths. No difference was observed in the frequency of PVA between physician led and physiological led set-up of HMV at initiation or 3 months(28.4(17.4-37.6)%vs 25.6(14.0-30.4)%;p=0.6 and 22.4(13.3-37.1)%vs23.3(15.2-41.5)%;p=0.7,respectively). No correlations were observed between PVA and ventilator adherence(rs=0.02,p=0.90), nocturnal oxygen saturations(rs =0.04,p=0.85), nocturnal carbon dioxide levels(rs=0.15,p=0.41), respiratory muscle unloading(rs=0.06,p= 0.76), patient perception of ventilator synchronisation(rs=0.03,p=0.9) at 3 months of HMV therapy. 10 patients (7 male) underwent polysomnography assessment of sleep quality. No further correlations were observed between PVA during sleep and sleep efficiency (rs=-0.6,p=0.1), wake after sleep onset(rs=0.5,p= 0.2) or total sleep time(rs=-0.4,p= 0.3) at 3 months of HMV therapy. Conclusion: Severe PVA was identified in the majority of patients irrespective of pathophysiological disease. This was not associated with inappropriate delivery of effective ventilation. These data suggest that elimination of PVA may not be required to successfully set-up HMV.
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Potter, Margaret J. "Evaluating the efficacy of a program developed to optimise the physiotherapist-patient interaction." University of Western Australia. School of Human Movement and Exercise Science, 2003. http://theses.library.uwa.edu.au/adt-WU2004.0012.
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[Truncated abstract] This PhD project was comprised of three major studies. Study 1 utilised the Nominal Group Technique (NGT) to identify a typology of difficult patients in private practice physiotherapy and to determine strategies physiotherapists use and would like to improve, when dealing with such patients. Physiotherapists (n=37) also shared their expectations of patients and their perceptions of patient expectations of physiotherapy. Results showed that the two areas most difficult to manage were behavioural problems of patients followed by patient expectations. To assist in their interaction with difficult patients, physiotherapists identified communication skills and behaviour modification techniques as strategies they would most like to learn. While physiotherapists expressed the greatest number of expectations in the behavioural domain, identification of patient expectations was not elicited as a strategy to manage difficult patients. Results of this qualitative study contribute to the evolving literature relating to physiotherapist-patient interactions and form a useful basis for educational programs directed at improving the therapeutic relationship in private practice physiotherapy. Study 2 involved applying the NGT with separate groups of patients (n=26) to identify patient expectations of the qualities of a ‘good’ physiotherapist, and to ascertain the characteristics of good and bad experiences in private practice physiotherapy. Findings indicated that the qualities of a ‘good’ physiotherapist related to their communication ability, professional behaviour and organisational ability, and characteristics of the service provided. The most important expectations of patients were for example, symptomatic relief, self-management strategies and ‘hands on’ treatment; associated with the physical domain. When comparing equivalent groups from Study 1, with patient expectations, most patient groups identified that the most important expectations of physiotherapists would relate to patient behaviours such as; compliance, honesty, payment of their account, being punctual, cooperating, trusting and showing respect for their physiotherapist. However, physiotherapists’ rankings of the most important expectations held by patients were not congruent with patient rankings providing an explanation as to why problems may arise in the physiotherapistpatient interaction from the patient’s perspective. Based on the findings of Study 2 it was suggested that physiotherapists should actively seek to involve patients in their management. To do this effectively, physiotherapists would benefit from further training in communication skills to ensure that they can successfully adopt a patientcentred approach and to optimise the physiotherapist-patient interaction in private practice physiotherapy.
6
Munthe, Victor. "Implementing voice communication technology in patient applications." Thesis, Uppsala universitet, Institutionen för informationsteknologi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-417993.
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AstraZeneca as a biopharmaceutical company performs clinical trials on human volunteers every day. It is crucial that these participants complete the trial to maximise the medical learning from the trial but also to decrease the cost for AstraZeneca. Dropout's from clinical trials can not be eliminated but as a part of the work that AstraZeneca is doing to reduce dropouts, this thesis investigates the possibility to implement voice control into patient applications. The goal is to increase the usability of the systems used in clinical trials and in return reduce dropouts and increase medical knowledge. This thesis results in a discussion that can be used for future work on this topic. Opportunities that a voice-controlled system brings, together with its limitations are presented and results in a discussion regarding "data ownership". One of the main conclusions is that a voice-controlled system would bring a lot of positive features but that either the technology or the authorities are ready for such a system today. A suggested way forward can be to start trying clinical trials, where free-text responses are used for some questions, instead of fixed responses. This can help show the authorities the benefits of such a system and motivate them to open up for more technology.AstraZeneca är ett läkemedelsbolag som utför kliniska studier på frivilliga deltagare varje dag. Det är avgörande att deltagarna avslutar studien för att maximera utfallet av medicinsk kunskap men även ur ett kostnadsperspektiv. Den här rapporten undersöker möjligheten att implementera röststyrning i kliniska studier för patienter som en del i arbetet AstraZeneca gör för att minska avhoppen. Målet är att öka användbarheten av systemen som används i kliniska studier idag som i sin tur minskar antalet avhopp och bidrar mer till medicinsk kunskap. Rapporten resulterar i en diskussion som kan användas i ett fortsatt arbete inom ämnet. Möjligheterna som ett röststyrt system medför tillsammans med dess begränsningar presenteras och slutar i en diskussion kring ägandeskap av data. En tydlig slutsats som arbetet resulterar i är att implementationen av ett röststyrt system medför många positiva aspekter men att myndigheterna och teknologin inte har kommit lika långt. Ett föreslaget sätt att fortsätta är att börja testa kliniska studier med frågor där svaret består av fri text istället för svarsalternativ. Resultatet från studien kan då i sin tur användas i diskussion med myndigheterna för att visa på alla positiva följder som ett röststyrt system medför.
7
Ford, Sarah Theresa. "Analysing doctor-patient interactions in oncology : the development of the medical interaction process system (MIPS)." Thesis, University College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272373.
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Jangland, Eva. "The Patient–Health-professional Interaction in a Hospital Setting." Doctoral thesis, Uppsala universitet, Institutionen för kirurgiska vetenskaper, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-151420.
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The overall aim of the thesis was to describe patient−health-professional interactions in a hospital setting, with a specific focus on the surgical care unit. The thesis consists of four studies and includes both qualitative and quantitative studies. Content analysis and phenomenography were used in the qualitative studies; the quantitative study was an intervention study with a three-phase quasi-experimental design. The findings of study I showed that patient complaints to a local Patients’ Advisory Committee about negative interactions with health professionals most often concerned the perceived insufficiencies of information, respect, and empathy. The findings of study II showed that experiences of negative interactions with health professionals caused long-term consequences for individual patients and reduced patients’ confidence in upcoming consultations. The findings of the phenomenographic study (III) showed that surgical nurses understand an important part of their work in qualitatively different ways, which can be presented as a hierarchy of increasing complexity and comprehensiveness. In the most restricted understanding, surgical nurses focus on the work task, whereas in the others surgical nurses demonstrate increasing degrees of patient-centeredness. Finally, the results of study IV showed that an uncomplicated intervention that invited patients to express their daily questions and concerns in writing (using the ‘Tell-us card’) improved the patients’ perceptions of participation in their care in a surgical care unit. For further implementation of the Tell-us card to succeed, it needs to be prioritized and supported by leaders in ongoing quality improvement work. The value of a patient-focused interaction needs to be the subject of ongoing discussions in surgical care units. Patients’ stories of negative interactions could be used as a starting point for discussions in professional reflection sessions. It is important to discuss and become aware of different ways of understanding professional interactions and relationships with patients; these discussions could open up new areas of professional development. Providing patients an opportunity to ask their questions and express their concerns in writing, and using this information in the patient−health-professional interaction, could be an important step towards improved patient participation.
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Kuenne, Christoph W., Sabrina Adamczyk, Matthias Rass, Angelika C. Bullinger, and Kathrin M. Möslein. "IT-based Interaction Platforms to Foster Virtual Patient Communities." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-143583.
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Kuenne, Christoph W., Sabrina Adamczyk, Matthias Rass, Angelika C. Bullinger, and Kathrin M. Möslein. "IT-based Interaction Platforms to Foster Virtual Patient Communities." Technische Universität Dresden, 2011. https://tud.qucosa.de/id/qucosa%3A28075.
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Blais, Dawn Evelyn. "The nurses’ interpretation of the interaction between themselves and elderly, confused patients." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24411.
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Using symbolic interaction as a theoretical framework, the researcher explored the nurses' interpretation of their interactions with elderly, confused patients for the purposes of understanding nurses' behavior and of implementing more effective nurse-patient interactions. Qualitative data were collected during interviews with 18 registered nurses currently working either full-time or part-time in one of three extended care units.
Findings indicated that the nurses perceived specific patient behaviors, nurse behaviors, and external factors as influencing all phases of this interaction.
Six categories of patient behaviors emerged from the data. These categories are: (a) disruptive behaviors, (b) contextually inappropriate behaviors, (c) unintelligible behaviors, (d) memory-impaired behaviors, (e) unproductive repetitions, and (f) unpredictable fluctuations. These behaviors influenced the nurse-patient interaction by reducing the frequency with which nurses attached understandable meaning to patients' behavior, thereby reducing the effectiveness of and their satisfaction with the interaction.
The nurses' perceived that their behavior influenced the type, frequency, and duration of nurse-patient
communication, the degree to which the interaction was individualized and patient focused, and the extent of patient control during the interaction.
When patients influenced nursing behaviors in ways that reduced the frequency and person-oriented nature of the interaction, the nurses experienced the interaction as stressful and dissatisfying and subsequently withdrew to some degree.
External factors described as personal, interpersonal, and impersonal either facilitated or impeded the nurses' ability to assign understandable meaning to patients' behavior. The amount of understanding that occurred influenced the quality of care and communication and the amount of stress experienced by the nurse.
The findings suggest that geriatric nurses should focus their behavior on patients' psychosocial and emotional needs in addition to their physical needs. Nurses must be aware of the impact of behavior identified as confusion on the interaction. In response they must direct their caregiving and communication behaviors toward minimizing the impact of the reduced understanding that occurs during the interaction.Applied Science, Faculty of
Nursing, School of
Graduate
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Svensson, Staffan. "Medication adherence, side effects and patient-physician interaction in hypertension /." Göteborg : Department of Clinical Pharmacology, Institute of Internal Medicine, The Sahlgrenska Academy at Göteborg University, 2006. http://hdl.handle.net/2077/635.
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Ahmad, Naureen. "Between two worlds : a qualitative exploration of language, cultural and other barriers in diabetes consultations involving Pakistani patients." Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/4807.
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The AIMS of this study are to: (1) Explore the perceptions and experiences of diabetes consultations from the perspectives of Pakistani patients, health professionals and interpreters (when one was involved). (2) Identify the processes and mechanisms which hinder or foster effective communication between healthcare professionals and their patients. (3) Provide recommendations for ways in which communication can be improved between healthcare professionals and their Pakistani patients STUDY DESIGN: A prospective qualitative study was developed, comprising three sequential components; namely: In-depth interviews with patients prior to a diabetes consultation; observation of the consultation; and, in-depth interviews with patients, health professionals and interpreters (when one was involved) following the consultation. Data were collected in the form of 10 detailed case studies. Each case study involved a Pakistani patient with type 2 diabetes mellitus (T2DM), their practitioner (s) involved in the consultation and an interpreter (if one was used). SAMPLE: Five male and five female Pakistani with T2DM (aged 41-80 years), 12 practitioners (some patients consulted with two people) and three interpreters (two professional and one lay) were recruited through health services and personal contacts within Edinburgh’s Pakistani community. Individual case studies were thematically analysed before all the case studies were compared/contrasted to identify cross-cutting themes. FINDINGS: Alongside language, a range of barriers and issues were identified which impacted upon communication between patients and health professionals in the consultations observed. Because of previous experiences of attending consultations in the UK and also in Pakistan, patients tended to come to their diabetes consultations with limited expectations; namely, to have their medication reviewed and receive test results. Consequently, patients tended not to raise health concerns and other issues unless they perceived these to be directly relevant to the consultation. In some cases, this resulted in patients not disclosing important information relating to their diabetes management and led to health professionals making inappropriate treatment recommendations. The routine and predictable nature of these diabetes review consultations meant that patients could be passive, offer very little information and ‘get by’ in their consultations; for instance, by offering responses after guessing what the professional was asking. As a result, some health professionals were unaware of patients’ poor English and of how little they had understood during the consultation. Health professionals found it difficult to establish understanding and rapport with patients who adopted a passive role in their consultations. This hindered them from identifying, and appropriately addressing, gaps in patients’ diabetes knowledge and any concerns they may have had. Interpreters did not always address the language barrier and edited and misinterpreted information. This is partly because they struggled to interpret medical terminology. However, this research also revealed how interpreters can experience dilemmas and role conflicts by virtue of being members of the same closely-knit Pakistani community as the patients they interpret for. Some of the barriers identified during this study also arose because patients tended to see different professionals at every visit which discouraged patient-provider relationships from being established. CONCLUSION: Patients would benefit from receiving ‘continuity in care’ and education and training on how to use their consultations more effectively. Providers would also benefit from education and training on more effective ways to communicate with these patients.
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Alliex, Selma. "Process of nurse-patient interaction in the presence of technology." Curtin University of Technology, Australian Telecommunications Research Institute, 1998. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=11777.
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The purpose of this study was to develop a substantive theory or at least a set of theoretical propositions explaining the process of nurse-patient interaction in the presence of technology. This study was undertaken in Perth, Western Australia. The grounded theory method was chosen to undertake this research.The study's informants consisted of nurses. Theoretical sampling led to the inclusion of patients and patients' relatives. Purposive and theoretical sampling were used to choose the informants. Data were obtained using field observations and formal and informal interviews with nurses and post-discharge patients. Data analysis was conducted using the constant comparative method (Glaser and Strauss, 1967), writing memos and drawing a schema. The Ethnograph software package (Seidel, 1988) was used to organize and manage the data.The findings of the study indicated that nurses were stymied in their person-centered interactions with patients in the presence of technology. Nurses used the process of navigating the course of interaction to deal with this problem. The process of navigating the course of interaction consisted of three phases. These were the phases of embarking, steering and veering and disembarking. The action/interaction of the process occurred during the steering and veering phase and four specific strategies of interaction became evident in this research. These strategies of interaction were steadying, demurring, coasting and maximizing. The strategies of interaction used by nurses did not center on one type. There was rather a movement between strategies during and between interactions with patients in the presence of technology. This movement was termed oscillating connections. Conditions that modified the core process of navigating the course of interaction were also identified. The findings of the study provide an understanding of the problem ++encountered by nurses in their interaction with patients in the presence of technology and the process used by the nurses to deal with this problem.
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Tanguy, Marianna. "Client-counselor environment interaction using Holland's typology." Virtual Press, 1993. http://liblink.bsu.edu/uhtbin/catkey/862266.
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An ongoing therapeutic concern has been effectiveness of treatment (success and satisfaction). Mahalik and Kivlighan (1988) suggested that by examining the fit between type of counseling environment and personality type, reasons for satisfaction or dissatisfaction can be better understood. Research in this area, however, is limited. The present study examined the congruence between an individual's personality and the counseling environment, using Holland's model of personenvironment interaction to examine this relationship. This study also explored the underutilization of and dissatisfaction with counseling by certain Holland personality types and the congruence of clientcounselor environment interaction as an explanation of male underutilization of counseling.Ninety four students from Ball State University in Muncie, Indiana, participated in this study. Participants observed a videotape illustrating a particular counseling environment and completed four questionnaires: 1) the Self-Directed Search; 2) the Expectations About Counseling-Brief Form; 3) the Attitudes Toward Counseling; and 4) the Perception of Counseling Environment. The following hypotheses were tested: (hypothesis 1) Scores on Holland's typology will predict group membership (male and female). a) Artistic and Social scores will relate positively to female group membership. b) Realistic, Investigative, and Enterprising scores will relate positively to male group membership. (hypothesis 2) Scores on Holland's typology and gender will predict attitudes toward counseling. a) Realistic, Investigative, and Conventional scores will relate negatively to more favorable attitudes toward counseling. b) Social and Artistic scores will relate positively to more favorable attitudes toward counseling. c) Female status will relate positively to more favorable attitudes toward counseling. (hypothesis 3) Scores on Holland's typology and gender will predict perception of counseling environment. a) Realistic, Investigative, and Conventional scores and male status will relate positively to a more favorable perception of the Self-Help (more structured, less personally interactive) type counseling environment. b) Social and Artistic scores and female status will relate positively to a more favorable perception of the Social/Interactive (more abstract, more personally interactive) type counseling environment. Analyses included stepwise discriminant analysis predicting group membership, stepwise multiple regression analyses predicting gender, certain Holland types, and perception of counseling environment, and a 2 x 2 analysis of variance to analyze the interaction between gender and type of counseling environment.As expected, scores on Holland's typology predicted group membership. Results of the multiple regression analyses generally predicted attitudes toward counseling and perception of counseling environment. The interaction between gender and type of counseling environment was significant with females rating the Social/Interactive type counseling environment more positively than the Self-Help type counseling environment and males rating the Self-Help type counseling environment more positively than the Social/Interactive type of counseling environment. Implications of these findings and limitations and recommendations for future research are discussed.Department of Counseling Psychology and Guidance Services
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Deguet, Karen. "Measurement of patient interaction rates in general hospital psychiatric wards /." Title page, contents and abstract only, 1990. http://web4.library.adelaide.edu.au/theses/09SPS/09spsd321.pdf.
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Bucuroiu, Denisa Maria. "Emergent Social Interactions between a Hospital Patient and a Service Robot : A Research Through Design inquiry into the social dynamics of the interaction framework hospital patient, service robot, caregiver." Thesis, Malmö universitet, Institutionen för konst, kultur och kommunikation (K3), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-44276.
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The following documents a research through design inquiry into how socialites of a hospital environment are disrupted or improved by implementing a service robot. The robot, support for excessive work, represents a new intermediary between a patient and a caregiver. Robotic work routines appear as better, more efficient, and more affordable. Apart from other ethical and inclusive considerations given to this dialogue, the social values hidden in traditional workflows are of equal importance. This thesis attempts to generate constructive design research about emergent social norms and social dynamics caused by service robots’ implementation. The lessons learned are presented in a final research discussion. Further applied, the knowledge held common grounds with a rehabilitation robot developed by Blue Ocean Robotics.
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KARGBO, MORRIS Kensuke Abu. "Patient Information Sharing using a Socio-technical Approach." Doctoral thesis, Kyoto University, 2020. http://hdl.handle.net/2433/259071.
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付記する学位プログラム名: デザイン学大学院連携プログラム京都大学
0048
新制・課程博士
博士(情報学)
甲第22803号
情博第733号
新制||情||125(附属図書館)
京都大学大学院情報学研究科社会情報学専攻
(主査)教授 黒田 知宏, 教授 矢守 克也, 特定教授 川上 浩司
学位規則第4条第1項該当
Doctor of Informatics
Kyoto University
DFAM
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Finlay, Marike. "Dialogical strategiesstragetic dialogue : a discursive analysis of psychotherapeutic interaction." Thesis, McGill University, 1988. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=64079.
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Horton, Simon Malby Crofton. "A study of therapy for language impairment in aphasia : description and analysis of sessions in day-to-day practice." Thesis, City University London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268950.
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Dean, Patricia Sacht. "The physician-patient interaction as perceived by individuals with severe disabilities." Diss., The University of Arizona, 1993. http://hdl.handle.net/10150/186180.
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Very little has been written about the physician-patient interaction from the perspectives of individuals with severe disabilities. It has been reported that satisfaction with the physician-patient relationship can affect continuity of care and compliance with therapeutic regimens. While it is feasible that these issues could be of less consequence to the health of patients who are non-disabled, discontinuity of care or noncompliance with treatment plans could result in critical, life-threatening situations for individuals with severe disabilities. This study explored factors of the physician-patient interaction that are important from the perspective of individuals with severe disabilities. Research questions addressed the nature of the interaction, similarity with factors considered fundamental by individuals without disabilities, and whether there were factors important to individuals with severe disabilities that previously had not been reported in the patient satisfaction literature. The six individuals selected to participate in the study represented a range of disabilities that met the Rehabilitation Services Administration (RSA) criteria to be considered severe: blind, cerebral palsy, deaf, post-polio, spinal cord injured, and systemic lupus erythematosus. These participants also met all criteria as "key informants" for the purpose of qualitative research. A qualitative design was selected, employing two in-depth ethnographic interviews with each participant to elicit responses to focused, open-ended questions about the physician-patient interaction. The questions were patterned after those used in the development of the Smith-Falvo Patient-Doctor Interaction Scale (PDIS). Permission from the senior author was granted for "fair use" of the PDIS, and the related findings were used as comparison measures to responses of participants in this study. Findings of this research indicate that the interactional dynamics (eye contact, greeting, familiarity and evidence of respect) of first impressions for each individual in the physician-patient dyad influence to a large degree whether a satisfactory relationship can be established. In addition, participants with severe disabilities need to be considered by their physicians as equal partners in the management of their health care.
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Givan, Veronica L. "Parent/Patient Satisfaction and Physician/Nurse Interaction at a Children's Hospital." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7800.
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Walden University
College of Health Sciences
This is to certify that the doctoral dissertation by
Veronica Laviece Givan
has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.
Review Committee
Dr. Diana Naser, Committee Chairperson, Health Services Faculty
Dr. Nicoletta Alexander, Committee Member, Health Services Faculty
Dr. Michael Brunet, University Reviewer, Health Services Faculty
The Office of the Provost
Walden University
2019
Parent/patient satisfaction surveys are important tools used to measure quality of health care provided by physicians, nurses, and hospitals. Research has been conducted on patient satisfaction in adult settings; however, a gap exists in the research about pediatric patient satisfaction in relationship to nurse interactions and interactions with physicians in various clinical settings. The purpose of this descriptive quantitative study was to determine whether a significant difference exists in overall parent/patient satisfaction scores and interaction of patients with nurses, and physicians, as well as interaction with anesthesiologists in terms of pain management in the pediatric surgical service in comparison to the medical inpatient unit and intensive care unit. Watson's caring science theory served as the framework for this study. Research questions evaluated parent/patient satisfaction scores and tested interactions between the parent/patient and the physicians, nurses, and anesthesiologists in a children's hospital. A total of 675 parent/patient satisfaction surveys from a children's hospital were analyzed using an independent samples t test, Levene's test, and regression analysis. The data analysis revealed a significant difference between overall parent/patient satisfaction scores (p = .021) in the pediatric surgical service as compared with the medical unit and for the parent/patient satisfaction survey responses (p = .004) for the interaction with nurses and physicians in the pediatric surgical service as compared with intensive care units. The potential social change that could result from this study is that health care organizations should record patient experiences to facilitate and improve the quality of care, interactions with physicians and nurses, and clinical outcomes
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Guess, Winston. "Fluid-structure interaction modelling of a patient-specific arteriovenous access fistula." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/22840.
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This research forms part of an interdisciplinary project that aims to improve the detailed understanding of the haemodynamics and vascular mechanics in arteriovenous shunts that are required for haemodialysis treatments. A combination of new PCMRA imaging and computational modelling of in vivo blood flow aims to determine the haemodynamic conditions that may lead to the high failure rate of vascular access in these circumstances. This thesis focuses on developing a patient-specific fluid-structure interaction (FSI) model of a PC-MRA imaged arteriovenous fistula. The numerical FSI model is developed and simulated within the commercial multiphysics simulation package ANSYS® Academic Research, Release 16. The blood flow is modelled as a Newtonian fluid with the finite-volume method solver ANSYS® Fluent®. A pulsatile mass-flow boundary condition is applied at the artery inlet and a three-element Windkessel model at the artery and vein outlets. ANSYS® Mechanical™, a finite element method solver, is used to model the nonlinear behaviour of the vessel walls. The artery and vein walls are assumed to follow a third-order Yeoh model, and are differentiated by thickness and by material strength characteristics. The staggered FSI model is configured and executed in ANSYS® Workbench™, forming a semi-implicit coupling of the blood flow and vessel wall models. This work shows the effectiveness of combining a number of stabilisation techniques to simultaneously overcome the added-mass effect and optimise the efficiency of the overall model. The PC-MRA data, fluid model, and FSI model show almost identical flow features in the fistula; this applies in particular to a flow recirculation region in the vein that could potentially lead to fistula failure.
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Saubesty, Jorane. "Analyses multimodales de l'interaction patient-médecin en situation de formation à l'annonce d'un événement indésirable grave : modélisation en vue d'implémenter un outil de formation par la réalité virtuelle." Thesis, Aix-Marseille, 2018. http://www.theses.fr/2018AIXM0010.
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Le projet ANR ACORFORMed, dans lequel s’inscrit cette thèse, a pour objectif la création (par des informaticiens) d’un agent conversationnel animé « patient » comme outil de formation à l’annonce, par la simulation et à l’aide d’un environnement virtuel. A l’aide de la méthodologie issue des études de la gestuelle et des apports de la littérature sur l’organisation des interactions, nous tentons de répondre à la question suivante : quelle est l’organisation structurelle globale de l’interaction patient-médecin, lorsque ce dernier se forme à l’annonce d’un dommage associé aux soins ? Les analyses menées dans cette thèse nous permettent de décrire l’interaction patient/médecin lors de formations à l’annonce en proposant différentes phases composants l’interaction, ainsi que des précisions quant à leur découpage et leurs articulations. Elles constituent une base indispensable et utilisable par les informaticiens pour concevoir et implémenter un agent conversationnel « patient » crédible qui pourra être utilisé dans la formation des médecins. Située au coeur d’un projet interdisciplinaire, cette thèse en linguistique permet donc de transposer les pratiques interactionnelles des médecins en vue de l’implémentation d’un agent virtuel par des informaticiensThe ACORFORMed ANR project, in which this PhD project is integrated, aims at the creation (by computer scientists) of a "patient" animated conversational agent as a training tool for announcing, simulating and using a virtual environment. Using the methodology resulting from gestures studies and contributions of the literature on the organisation of interactions, we try to answer the following question: what is the overall structural organisation of the doctor/patient interaction, when this last is training to break the news of a damage associated with care? The analyses carried out in this thesis allow us to describe the doctor/patient interaction during training to break the news by proposing different phases that make up the interaction, as well as details about their division and their articulations. They are an indispensable and usable base for computer scientists to design and implement a credible "patient" conversational agent that can be used in physician training. Located at the heart of an interdisciplinary project, this thesis in linguistics makes it possible to transpose the interactional practices of physicians with a view to the implementation of a virtual agent by computer scientists
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Moore, John Oliver. "CollaboRhythm : new paradigms in doctor-patient interaction applied to HIV medication adherence." Thesis, Massachusetts Institute of Technology, 2009. http://hdl.handle.net/1721.1/55194.
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Thesis (S.M.)--Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2009.Cataloged from PDF version of thesis.
Includes bibliographical references (p. 74-78).
Despite astounding advances in medical knowledge and treatment in recent decades, health outcomes are disappointing and costs continue to rise. The traditional paternalistic and episodic approach to medical care is not meeting the needs of patients. CollaboRhythm is a technological platform that is being developed to enable a more modem collaborative and continuous approach to care by facilitating new paradigms in doctor-patient interaction. It asks the question: Can a system that allows patients to become active participants in their care, through data transparency, shared decision making, education, and new channels of communication, improve patient outcomes? To begin testing the principles of CollaboRhythm, a system to support medication adherence for Human Immunodeficiency Virus (HIV) infection was created. It includes custom applications on a patient cell phone and an interactive device for the home called a Chumby as well as a collaborative workstation in the clinician's office. The applications allow the reporting of medication adherence, viewing of adherence performance including a personalized and dynamic simulation of HIV, and sending of supportive video messages. The system is novel in that it abandons the typical alarm-based method of supporting adherence and instead focuses on a multifaceted approach to generating motivation through awareness, self-reflection, education, and social support. Transparency of data and new communication channels allow efficient and socially engaging collaboration in real-time. The HIV medication adherence system was evaluated in two stages.
(cont.) In the first stage, twelve patient interviews were conducted. The response to the principles of the system was positive with eleven of the twelve patients willing to share their adherence data with their clinician and all twelve agreeing that the HIV simulation and encouraging messages would motivate them to take their medications. Overall, eleven patients were interested in using the system. In the second stage, a one-month pilot deployment was conducted with four patients collaborating with an HIV medication adherence specialist. This stage also yielded encouraging results with three patients maintaining greater than 95% adherence all four patients confident that the system helped them improve their adherence. Important lessons were learned about its limitations, including ramifications of inaccurate reporting. The results from the HIV adherence study suggest that there is merit in the new paradigms in provider-patient interaction facilitated by CollaboRhythm and that some patients are receptive to the idea of becoming more active participants in their care. Evaluations at a larger scale and for a number of clinical scenarios are warranted.
by John O. Moore.
S.M.
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Kerner, Jan. "Patient specific computer modelling of bone changes around orthopaedic implants." Thesis, Imperial College London, 1999. http://hdl.handle.net/10044/1/7912.
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Nieminen, Cecilia, and Jelena Tomic. "Att vårdas i en flerbäddssal : En litteraturöversikt om patienters erfarenheter av att vårdas i en flerbäddssal." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-4275.
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Bakgrund: Att vårdas i en flerbäddssal med andra medpatienter kan medföra både positiva och negativa erfarenheter för patienter. När en människa intar rollen som patient hamnar hen i en situation där patientens avskildhet kan bli svår att bevara och värdigheten kan bli hotad. Syfte: Syftet var att beskriva patienters erfarenheter av att vårdas i en flerbäddssal med andra medpatienter. Metod: En litteraturöversikt baserad på tio vetenskapliga studier, varav nio var kvalitativa och en var både kvalitativ och kvantitativ. Studierna som erhölls ifrån databaserna CINAHL och PUBMED analyserades och sammanställdes. Resultat: Resultatet presenteras i fyra huvudteman och sju subteman. Det första huvudtemat benämns som Att vårdas i en flerbäddssal med tre subteman; Betydelsen av att ha sällskap av medpatienter, Stödjande samtal av medpatienter och Bevara självständighet och värdighet genom ett oberoende. Det andra huvudtemat benämns som Patienternas upplevelse av att vistas i en flerbäddssal med andra medpatienter med ett subtema; Att vårdas i en könsblandad flerbäddsal som ett hot mot värdigheten. Det tredje huvudtemat benämns som Patienters upplevelse av att höra och föra ett samtal i en flerbäddssal med ett subtema; Draperiernas betydelse för avskildhet i en flerbäddssal. Det fjärde huvudtemat benämns som Svårigheter med att bevara avskildhet i en flerbäddssal med ett subtema; Strategier för att vara avskild i en flerbäddssal. Diskussion: Diskussionen baseras på litteraturöversikten resultat, där författarna diskuterar resultatet utifrån livsvärldsbegreppet och konsensusbegreppet människa. I diskussionen lyfts de nämnda erfarenheter som förekom i resultatdelen och hur sjuksköterskan kan förhålla sig till och arbeta för att tillgodose patientens individuella behov.Background: Being cared for in multiple-bed hospital rooms with other fellow patients can have both positive and negative experiences for patients. When a person takes the role of patient harbors she/he in a situation where the patient's privacy can be difficult conserved and dignity can be threatened. Aim: The aim was to explore patients' experiences of being cared for in multiple-bed hospital room with other fellow patients. Method: A literature review based on ten scientific studies, of which nine was qualitative and one was both qualitative and quantitative. The studies were obtained from CINAHL and PUBMED which are then analyzed and compiled. Results: The results are presented in four main themes and seven subthemes. The first main theme is referred to as being cared for in a multiple-bed room with three subthemes: The importance of having the company of fellow patients, promoting conversations of fellow patients and preserve the autonomy and dignity towards the staff .The second main theme is referred to as patients' experience of staying in a multiple-bed room with other fellow patients with a subtema; Being cared for in a mixed-gender multiple-bed room as a threat to dignity. The third main theme is referred to as Patients' experience of hearing and having a conversation in a multiple-bed room with a subtema; The curtains importance of privacy in a multiple-bed room. The fourth main theme is referred to as Difficulties with preserving privacy in a multiple-bed room with a subtema; Strategies to be private in a multiple-bed room. Discussions: The discussion is based on the literature review results, which the authors discuss the results based on the life-world concept and consensus concept of human. The discussion highlighted those experiences that occurred in the results section and how the nurse can relate to and work to meet individual patient needs.
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Vingen, David, and Elias J. Andrews. "Usability in Patient-Oriented Drug Interaction Checkers : A Scandinavian Sampling and Heuristic Evaluation." Thesis, Linnéuniversitetet, Institutionen för informatik (IK), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-96600.
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Drug interactions are an important source of medical error. Studies have also shown it as a topic of particular interest to patients. To allow patients to participate in decision-making regarding their own health, they need to be empowered with information. This information must be provided through usable information systems. This thesis explored availability of drug interaction checkers in Scandinavia. It also explored the prevalence and characteristics of usability issues preventing patients from benefiting from these. Drug interaction checkers were sampled and described. Issue-based qualitative and quantitative data were gathered through heuristic evaluations. Patterns in the data were identified through descriptive statistics. Single-case and cross-case analyses explored emergent patterns in-depth. The findings were then interpreted side by side using a mixed-methods approach. The results showed the Scandinavian public faced with drug interaction checkers addressing healthcare professionals. They also showed a multitude of usability issues in these checkers. The issues were predominantly minor, but major issues were also identified in all but one of the checkers. Catastrophic usability issues were found in two of the checkers. These had the potential to lead patients to serious medical error. Results moreover showed the checkers lacking adaptive design, patient-oriented content, and a lack of adherence to basic design principles. A positive correlation was observed between system complexity and number of usability issues. This was suggested to result from lack of user-centered design approaches, or losing track of user goals while adding features over time. The result was a handful of generally professionally oriented drug interaction checkers known to be used by patients for their utility, but failing to accommodate them in terms of information and system quality. Empowering patients to participate in decision-making affecting their health asserts the need for developing patient-oriented information databases where these do not yet exist. These need to be presented through usable interfaces acknowledging patient behaviors.Läkemedelsinteraktioner är en viktig orsak till medicinska misstag. Tidigare studier har även identifierat läkemedelsinteraktioner som ett område av särskilt personligt intresse för patienter. För att patienter ska kunna vara delaktiga i beslutsfattande beträffande sin egen hälsa, måste de ges tillgång till information genom användbara informationssystem. Denna uppsatsen undersökte tillgänglighet av interaktionsgranskare för läkemedel för den skandinaviska publiken. Den undersökte också förekomst och karakteristiker av användbarhetsproblem som förhindrar patienter från att dra nytta av dessa interaktionsgranskarna. Tillgängliga interaktionsgranskare listades och beskrevs. Kvalitativa och kvantitativa data samlades in genom heuristiska utvärderingar. Mönster identifierades genom beskrivande statistik, medan kvalitativa enkelfalls- och tvärfallsanalyser undersökte frambrytande mönster på djupet. Resultat från kvantitativa och kvalitativa metoder tolkades sedan sida vid sida. Resultaten visade att skandinaviska patienter huvudsakligen möter interaktionsgranskare riktade mot professionell vårdpersonal. Resultaten påvisade också en stor mängd användbarhetsproblem i dessa granskarna. Problemen var oftast av mindre vikt, men även stora problem identifierades i alla utom en av granskarna. Katastrofala användbarhetsproblem hittades i två av granskarna. Dessa hade potential att leda patienter till allvarliga medicinska misstag. Resultaten visade dessutom att granskarna saknade adaptiv design, patientorienterat innehåll och efterlevnad av grundläggande designprinciper. En positiv korrelation observerades mellan systemkomplexitet och antal användbarhetsproblem. Detta föreslogs vara ett resultat av brist på användarcentrerad designmetod eller att man har tappat fokus på användarmål över tid medan funktioner har lagts till. Resultatet var en handfull huvudsakligen professionellt inriktade granskare för läkemedelsinteraktioner som används av patienter för deras nyttja, men som inte lyckas med att ta hänsyn till dem när det gäller informations- och systemkvalitet. För att patienter ska få möjlighet att delta i beslutsfattande som påverkar deras hälsa, finns behov av att utveckla patientorienterade informationsdatabaser där dessa ännu inte finns. Dessa måste erbjudas genom användbara gränssnitt som tillgodoser patienters beteenden.
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Rivers, Desiree Avia. "An examination of the relationship among patient factors, patient-physician interaction, and utilization of health services in adults with diabetes." [College Station, Tex. : Texas A&M University, 2007. http://hdl.handle.net/1969.1/ETD-TAMU-1324.
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Stoddart, Kathleen M. "A grounded theory study of patient/nurse interaction in a community practice setting." Thesis, University of Stirling, 2005. http://hdl.handle.net/1893/1844.
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This thesis is about patient/nurse interaction in a community practice. My aim is to advance sociologically informed understandings about patient/nurse interaction. The key areas of inquiry in my grounded theory study are: The meanings and understandings expressed in patient/nurse interaction. The influence of socio-cultural characteristics in patient/nurse interaction. My study was conducted in a community practice setting using the traditional discovery methodology of Glaser and Strauss (1967). The community practice setting is four health centres with social and geographical differences. The participants in the study are patients attending those health centres and practice nurses who work there. Research methods are observations, informal interviews and semi-structured interviews. Constant comparative analysis supports my research process. My substantive theory is constructed from the generation of two categories: Investment and Experience. The category of Investment relates to the social assets and resources brought to patient/nurse interaction. The category of Experience relates to the historically crafted meanings and understandings that individuals bring to patient/nurse interaction. Together, these categories contribute to understandings of patient/nurse interaction in a community practice setting. I argue in this thesis that the meanings and understandings that patients and nurses bring to interaction provide the social dimension that is quintessential and foundational in their relationship. I also argue that the social construction of reality of being a patient or a nurse is related to the socio-cultural characteristics that they bring to their performance in patient/nurse interaction. I show that performance as a patient or a nurse is initiated and achieved via processes of acting and reacting to each other in relation to socio-cultural characteristics. I demonstrate that the meanings and understandings patients and nurses generate from experiences beyond and including their situated need/care interaction are pivotal in the negotiation of their relationship. Empowerment plays a central role in processes of negotiation and is connected to the social construction of reality in patient/nurse interaction. My substantive theory contributes to understanding of patient/nurse interaction and raises the visibility of negotiation, empowerment, and the influential role of socio-cultural characteristics. The implications of my substantive theory relate to the involvement and participation of stakeholders in health care practice and delivery. In nurse education, the standards of proficiency for eligibility to register with the NMC should be revised to include the social dimension of patient/nurse interaction as a domain of practice. I conclude by arguing that sociologically informed understandings need to be expanded and applied in health care and nursing with contemporary social policy and current priorities for health in mind.
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Wang, Qian. "Patient-specific finite element modeling of biomechanical interaction in transcatheter aortic valve implantation." Diss., Georgia Institute of Technology, 2015. http://hdl.handle.net/1853/54849.
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Transcatheter aortic valve implantation (TAVI) is an effective alternative treatment option for patients with severe aortic stenosis, who are at a high risk for conventional surgical aortic valve replacement or considered inoperable. Despite the short- and mid-term survival benefits of TAVI, adverse clinical events, such as paravalvular leak, aortic rupture, and coronary occlusion, have been reported extensively. Many of these adverse events can be explained from the biomechanics perspective. Therefore, an in-depth understanding of biomechanical interaction between the device and native tissue is critical to the success of TAVI. The objective of this thesis was to investigate the biomechanics involved in the TAVI procedure using patient-specific finite element (FE) simulations. Patient-specific FE models of the aortic roots were reconstructed using pre-procedural multi-slice computed tomography images. The models incorporated aged human aortic material properties with material failure criteria obtained from mechanical tests, and realistic stent expansion methods. TAV deployment and tissue-device interaction were simulated; and the simulation results were compared to the clinical observations. Additionally, parametric studies were conducted to examine the influence of the model input on TAVI simulation results and subsequently the potential clinical complications such as paravalvular leak, annular rupture, and coronary artery occlusion. The methodology presented in this thesis could be potentially utilized to develop valuable pre-procedural planning tools to evaluate device performance for TAVI and eventually improve clinical outcomes.
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Tarrant, Carolyn Clare. "Continuity, trust and cooperation : a game theory perspective on the GP-patient interaction." Thesis, University of Leicester, 2006. http://hdl.handle.net/2381/847.
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There is evidence that personal continuity is associated with positive processes and outcomes, although much of the previous work has lacked a theoretical framework. This thesis aims to explore, and develop a model of, the relationship between continuity, trust and cooperation in primary care, based on existing principles from game theory. Hypotheses generated from a game theory perspective were tested through a questionnaire survey of 279 patients. A secondary qualitative analysis of two data sets – interviews with patients and GPs – was also carried out to explore experiences of trust and cooperation in primary care. The survey findings indicated that a history of positive interactions between a patient and a GP, and expectation of future interactions, were associated with higher trust, as was interpersonal care. Trust was found to be weakly associated with self-reported adherence to treatment. The analysis of patient interviews found that patients described relatively high levels of initial trust. Repeated interactions allowed initial trust in the GP to be validated, and allowed the patient to build their own reputation as cooperative. Over time, experience of consulting the same GP could lead to a reduction of uncertainty, and a move to a more stable, affective basis for trust. This was associated with increased willingness to disclose information, and to accept treatment or advice. Analysis of GP interviews explored GP views of patient trust, and identified mechanisms inherent in repeated interactions that could promote quality of care. The findings from the qualitative and quantitative work are drawn together in order to develop a model of trust and cooperation in primary care, informed by game theory principles. This thesis highlights the reciprocal and interdependent nature of the health professional-patient relationship, and the value of repeated interactions in promoting mutual trust and cooperation. The implications of this for policy are discussed.
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Klingert-Hall, Julie. "An exploration of a patient's use of her body within the transference relationship in intensive psychotherapy : towards allowing thoughts to become thinkable." Thesis, University of East London, 2015. http://repository.tavistockandportman.ac.uk/1126/.
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The thesis is an exploration of a patient’s use of her body in intensive psychoanalytic psychotherapy. The therapeutic encounter studied is between myself, a child and adolescent psychotherapist working in an NHS Child and Adolescent Mental Health Team,and a fifteen-year-old female diagnosed with depression. Pivotal sessions were examined: where significant shifts in the therapy were identified. These consisted of sessions where there was a transformation in anxiety; and the patient was able to verbalise what was otherwise being communicated in a bodily way. The analysis of the data using grounded theory highlighted the importance of visual communication in the therapeutic encounter. The analysis indicated that vision is the receptive point for the beginning of the containment process. The analysis of the data also highlighted that when the patient is communicating intense primitive anxieties, the therapist needs to receive and process the anxieties at a bodily level, when the patient is, perhaps for the first time, coming into contact with the feelings from which they have dissociated. The analysis of the data indicated that mirroring back emotional states that are congruent with those projected by the patient, makes thepatient aware of themselves in terms of the effect they have on others. This suggests the importance of the therapist’s non-verbal responses, which can be observed and introjected by the patient. The study contributes to the understanding of bodily communication in the therapeutic exchange. It raises interesting technical issues about when the therapist should receive and hold the patient’s projective identification at a bodily level and reflect back non- verbally that their communication has been received, and when to make a verbal interpretation. It also highligh ts the use of observation to gauge if the patient has been able to receive the therapist’s communication at a bodily level.
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Björnlund, Anders, and Martin Wejkner. "Humor i mötet mellan sjuksköterska och patient." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-4291.
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Bakgrund: Forskningen har visat att humor är ett socialt fenomen som kan ses som ett universellt språk. Den har visat sig påverka en rad faktorer positivt, däribland vårdmiljön, relationen mellan sjuksköterska och patient samt patientens hälsa. Humor är inte enbart positivt i en vårdkontext, däremot finns det tillfällen då den bör undvikas. Syfte: Syftet är att belysa användandet av humor i mötet mellan sjuksköterska och patient.Metod: Examensarbetet är en litteraturöversikt där tio vetenskapliga artiklar valts ut, skillnader och likheter har identifierats och slutligen sammanställts. Resultat: Resultatet består av tre huvudteman: Humorns inverkan på avdelningens vårdatmosfär, interaktion mellan sjuksköterska och patient samt humorns effekter. Under huvudtemat interaktion mellan sjuksköterska och patient hittades två underkategorier: kommunikation mellan sjuksköterska och patient samt förlorade tillfällen till humor. I huvudtemat humorns effekter hittades underkategorierna: humor som strategi samt humor som lindring. Diskussion: I resultatdiskussionen följer en diskussion där resultatet implementeras i Travelbees omvårdnadsteori, Human-to-Human Relationship Theory, men också hur ny forskning förhåller sig till resultatet. Travelbees omvårdnadsteori med dess faser kan användas genomgående i resultatet, vilket också ny forskning till stor del visar. Sammantaget bör sjuksköterskan använda sig av humor i en större utsträckning än vad som är fallet idag.Background: Research has revealed that humor is a social phenomenon that can be seen as a universal language. It has been shown to affect a number of factors in a positive way including the care environment, the relationship between nurse and patient as well as the patient's health. Humor is not only positive in a nursing context, hence there are times when it should be avoided. Objective: The purpose is to illustrate the use of humor in the meeting between nurse and patient.Method: This bachelor thesis is a literature review where ten scientific articles have been selected, similarities and differences are identified and finally compiled. Results: The result consists of three main themes: The impact of humor on the department's care atmosphere, the interaction between nurse and patient and the effects of humor. Under the main theme of interaction between nurse and patient, two sub-categories were identified: communication between nurse and patient as well as lost opportunities for humor. The main theme of humor effects were identified under the categories: humor as strategy and humor as relief. Discussion: In the resultdicussion a debate will follow in which the results are implemented in Travelbees nursing theory, Human- to- Human Relationship Theory, but also how new research relates to the result. Travelbees nursing theory with its phases can be used consistently in the result, which new research also largely shows. Overall, the nurse should use humor, to a greater extent than is the case today.
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Barthélémy, Sophie. "La gestion des affects dans la schizophrénie : entre intrapsychique et interaction." Aix-Marseille 1, 2006. http://www.theses.fr/2006AIX10087.
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Cette thèse se centre sur l'émergence de l'affect dans l'interaction. Elle se situe au croisement des courants psychanalytique (Resnik, 1999) et cognitivo-conversationnel (Bromberg & Trognon, 2004). Elle soutient une difficile gestion des affects chez le patient schizophrène, corrélée à des configurations conversationnelles spécifiques. L'évolution de la position conversationnelle en lien avec le vécu affectif va de pair avec la stabilisation de la maladie. À partir des entretiens cliniques de sujets schizophrènes (périodes stabilisée / aiguë), le traitement des données est fondé sur une étude psychodynamique, considérant les réactions contre-transférentielles du clinicien (Devereux, 1967) et sur une analyse cognitivo-conversationnelle (Trognon & Musiol, 2000). La recherche souligne les processus psychiques impliqués dans la gestion des affects, et permet de repérer leur contexte d'accomplissement dans l'interaction. La discussion avance une co-fondation entre intrapsychique et interaction.
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Bergsten, Ulrika, Stefan Bergman, Bengt Fridlund, and Barbro Arvidsson. ""Delivering knowledge and advice" : Healthcare providers' experiences of their interaction with patients' management of rheumatoid arthritis." Hälsohögskolan, Högskolan i Jönköping, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-16665.
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Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers' perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers' experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers' attitudes and patients' responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers' experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients' expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.
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Mellott, Karen. "Patient Ventilator Dyssynchrony: Types, Frequency and Patterns in Critically Ill Adults." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2084.
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Patient ventilator dyssynchrony (PVD) occurs frequently, but little is known about the types, frequency and patterns of PVD for longer than 30 minutes. Deeper levels of sedation are associated with PVD. Evaluation of ventilator graphics and the ability to identify PVD should assist clinicians to optimize patient ventilator interactions and promote earlier interventions. The purpose of this study was to identify the different types, frequency and patterns of PVD in critically ill adults and determine the effect of sedation level on PVD. Thirty medical and surgical ICU adult patients were enrolled; 27 were used for analysis. Pressure/time and flow/ time waveform data were collected using the Noninvasive Cardiac Output monitor for up to 90 minutes per subject. Blinded waveform analysis was performed. Sedation level was measured every 20 minutes. A Dyssynchrony Index (DI) and PVD Type Indices were used to describe PVD frequency. Lag analysis was used to detect associated patterns of PVD. PVD occurred during all phases of ventilated breaths and during each of the ventilatory modes used. Heretofore undocumented dyssynchrony in the form of patient gasp PVD, active triggers and combined PVDs were found. The most common type of PVD was Ineffective Trigger (63%), followed by Premature Termination-Flow (17%), Premature Termination (9%), Multiple Trigger (1%), Flow (0.87%) and Delayed Termination (0.09%). The overall frequency of dyssynchronous breaths in the sample was 23% of total breaths analyzed, however 93% of subjects experienced at least one incident of PVD. The overall median DI (Interquartile Range [IQR]) was 4% (1% - 9%) with Ineffective Trigger Index having the highest median index (1.78%). The high DI group (6 subjects, 22%) had a DI (IQR) of 61% (42% - 85%). Seventy seven percent of subjects experienced multiple types of PVD. Premature Termination was followed by Multiple Triggers starting at 3 seconds, but Delayed Termination was followed by Ineffective Triggers, starting at 30 seconds. Clinicians need to recognize PVD, since this is a critical step in evaluating patient ventilator interaction and providing subsequent intervention. PVD interpretation is complex requiring clinicians to clearly understand the operational function of ventilator modes and waveform alterations that occur.
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Capage, Laura C. "The role of therapist communication style in parent-child interaction therapy." Morgantown, W. Va. : [West Virginia University Libraries], 1999. http://etd.wvu.edu/templates/showETD.cfm?recnum=841.
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Thesis (Ph. D.)--West Virginia University, 1999.Title from document title page. Document formatted into pages; contains vii, 128 p. : ill. Includes abstract. Includes bibliographical references (p. 60-72).
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Park, Yujong. "Analyzing medical discourse the organization of doctor-patient interaction in Korean primary care settings /." Diss., Restricted to subscribing institutions, 2009. http://proquest.umi.com/pqdweb?did=1835448471&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Karlsson, Frida, and Viktor Wiklundh. "Kränkande bemötande från patienter : Har fysioterapeutens kön inverkan på bemötandet från patienten? - en enkätstudie." Thesis, Uppsala universitet, Fysioterapi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-337302.
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Bakgrund: Interaktion och bemötande är viktiga i vården. Hur en person uppfattar ett bemötande är individuellt och beror på tidigare erfarenheter och social status. Bio-psyko-sociala faktorer kan ha inverkan på interaktionen då patienters beteende kan påverkas av sjukdomstillstånd och tidigare erfarenheter. Syfte: Att undersöka hur fysioterapeuter som arbetar inom Akademiska sjukhuset och Uppsala kommun upplevde att de blivit kränkande bemötta av patienter utifrån sitt kön och om patientens sjukdomstillstånd och ålder har betydelse i bemötandet. Design och metod: En kvantitativ tvärsnittsstudie med en komparativ och deskriptiv design. Sammanlagt 84 fysioterapeuter från Akademiska sjukhuset och Uppsala kommun besvarade en egenkonstruerad webbenkät. Resultatet analyserades med beskrivande statistik, Chi-2 test och kvalitativ innehållsanalys. Resultat: En hög andel av fysioterapeuterna (83%) hade erfarenheter av kränkande bemötande och ingen signifikant skillnad sågs mellan könen eller arbetsplats gällande dessa erfarenheter. Störst andel av de manliga fysioterapeuterna rapporterade att de upplevt hot och våld från patienter medan kvinnliga fysioterapeuter uppgav att de fick utstå mer sexuella trakasserier. Patienter med smärta eller demens var de patientgrupper som flest fysioterapeuter upplevde sig blivit kränkande bemötta av. Konklusion: Kränkningar mot fysioterapeuter är vanligt förekommande oavsett kön. Patientens sjukdomstillstånd har stor betydelse vid kränkande beteende mot fysioterapeuten. Det är viktigt att uppmärksamma ämnet både i utbildning och inom yrkeslivet. Fler studier krävs för att styrka resultatet.Background: Interaction and communication are important in health care. How a person perceives a response is individual and depends on past experiences and social status. Bio-psycho-social factors can affect the interaction as patients' behavior is affected by disease states and previous experiences. Purpose: To investigate how physiotherapists working at Akademiska Sjukhuset and Uppsala municipality experienced how they were treated by patients based on their gender and if the patient's disease states and age can affect the interaction. Design and method: A quantitative cross-sectional study with a comparative and descriptive design. A total of 84 physiotherapists from Akademiska Sjukhuset and Uppsala municipality answered a self-designed web questionnaire survey. The result was analyzed with descriptive statistics, Chi-2 test and qualitative content analysis. Result: A high proportion of physiotherapists (83%) had experience of abusive treatment and no significant difference was seen between the sexes or the workplace regarding these experiences. Largest share of male physiotherapists reported that they experienced threats and violence from patients while female physiotherapists stated that they suffered more sexual harassment. Physiotherapists experienced the most abusive treatment of patients with pain or dementia. Conclusion: Violations against physiotherapists are commonplace regardless of gender. The patient's disease condition is of great importance in the case of offensive behavior against the physiotherapist. It´s important to pay attention to the subject both in education and in professional life. More studies are required to strengthen the results.
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Bergsten, Ulrika. "Patients' and healthcare providers' experiences of the cause, management and interaction in the care of rheumatoid arthritis." Doctoral thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-16740.
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Aim: The overall aim of this thesis was to explore and describe patients’ and healthcare providers’ experiences of the causes, management and interaction in the care of rheumatoid arthritis (RA). Method: The thesis is based on four studies. Studies I and II contain data from an epidemiologic project involving patients who were recently diagnosed with RA. The patients answered an open-ended question about their conception of the cause of their RA (Study I). Qualitative data from 38 patients were analysed using the phenomenographic approach in order to identify variation in conceptions. The results of Study I formed the basis for categorizing the conceptions of 785 patients in the search for patterns of background factors (Study II). Study III aimed to explore how patients experienced their management of RA in everyday life. Data were collected by interviews with 16 patients and analysed according to Grounded Theory (GT). In study IV, the aim was to explore healthcare providers’ experiences of their interaction with patients’ management of RA. Data were collected by interviews with 18 providers representing different professions and analysed using GT. Findings: Patients’ conceptions of the cause of their RA revealed new aspects from the patient perspective that can complement pathogenetic models. Two descriptive categories emerged: consequences beyond personal control and overloaded circumstances, which included six categories of conceptions (Study I). The most common conceptions of the cause of RA were unexpected effects of events followed by work and family-related stress (Study II). Background factors that influenced the conceptions of the cause were age, sex and educational level. Patient management of RA involved using personal resources together with grasping for support from others in their striving for a good life. When linking these aspects together, four ways of management emerged: mastering, struggling, relying and being resigned (Study III). Healthcare providers’ experiences of their interaction with patients’ management shed light upon the important issue of delivering knowledge and advice. The providers’ attitudes constituted one cornerstone and patients’ responses the other. The providers reported that the interaction led to different outcomes: completed delivery, adjusted delivery and failed delivery. Conclusions: The findings contribute new knowledge from both patients’ and healthcare providers’ perspectives, which could be used to develop a more person-centred approach in rheumatology care. Person-centred care involves taking patients’ beliefs and values into account in addition to creating a trusting relationship between patient and provider. A successful person-centred approach requires an organisation that supports the person-centred framework.
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Annmo, Linnea, and Frida Hållberg. "Blivande sjuksköterskors reflektioner angåendeett gott respektive ett sämre bemötande : En kvalitativ fokusgruppsintervjustudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-192493.
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Bakgrund: Som sjuksköterska består en stor del av arbetet i att bemöta människor. Det har visat sig att då bemötandet upplevs som sämre, så upplevs även övriga omvårdnaden som dålig. En förutsättning för att kunna ge ett gott bemötande är att ha reflekterat över begreppets innebörd och funderat på vilka faktorer som påverkar bemötandet så att det blir gott, respektive sämre. Syfte: Studiens syfte var att undersöka vad blivande sjuksköterskor i termin sex anser är ett gott/sämre bemötande samt orsakerna till varför bemötandet blir gott eller sämre. Metod: Tolv sjuksköterskestudenter intervjuades i fokusgrupper och kvalitativ innehållsanalys användes för att analysera data. Resultat: Sjuksköterskestudenterna betonade betydelsen av tid, respekt samt personliga ställningstaganden och egenskaper i ett bemötande. Exempel på olika orsaker som leder till ett gott bemötande både stämmer överens med de intervjuade sjuksköterskestudenterna och studerad litteratur, var vänlighet, hjälpsamhet, beröring och ögonkontakt. Dessutom framkom även en ”skyll-dig-själv”-attityd som en orsak till ett sämre bemötande, och som inte tidigare nämnts i varken litteratur eller forskning. Slutsats: Yttre omständigheter samt personliga egenskaper hos sjuksköterskan påverkar bemötandet. Dock behöver sjuksköterskestudenter en bättre förståelse för begreppet bemötande. Därför föreslås att rollspel och seminarium, angående bemötande, bör införas i sjuksköterskeutbildningen. Vidare forskning behöver göras för att undersöka hur patienter och yrkesutövande sjuksköterskor, reflekterar kring bemötandet, för att därmed kunna förtydliga rådande riktlinjer. Den ökade kunskapen anses kunna bidra till ökad vårdkvalitet, bättre arbetsmiljö samt ett ökat välmående för både sjuksköterska och patient.Background: Being a nurse means a lot of interacting with people. It has been found that when the interaction is perceived as bad, the other health care is perceived as bad. A prerequisite for being able to make a well interaction, you have to reflect the meaning and thoughts about the factors that can affect the interaction and make it good or worse. Aim: The aim of the study was to examine what the nursing students from last semester believe is a good / bad interaction, and the reasons why the interaction is better or worse. Methods: Twelve nursing students were interviewed in focus groups and qualitative content analysis was used to analyze the data. Results: Nursing students emphasized the importance of time, respect, empathy, personal standpoints and characteristics in an interaction. Examples of different causes that lead to good interaction is both consistent with the interviewed nursing students, and studied literature, was the friendliness, helpfulness, touch and eye contact. In addition, also revealed a "blame-yourself"-attitude as a cause of a worse interaction, and are not mentioned in either literature or research. Conclusion: External circumstances and personal characteristics affect the interaction. However, nursing students need a better understanding regarding the concept of interaction. It is therefore proposed that roleplay and seminar, concerning interaction, should be included in nursing education. Further research needs to be done to examine how patients and professional practice nurses, reflects of interaction, in order to be able to clarify current guidelines. The increased knowledge is considered to contribute to improved quality of care, better working environment and increased well-being for both nurses and patients.
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Carteaux, Guillaume. "Optimisation des interactions patient-ventilateur en ventilation assistée : intérêt des nouveaux algorithmes de ventilation." Thesis, Paris Est, 2015. http://www.theses.fr/2015PESC0027/document.
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En ventilation assistée, les interactions patient-ventilateur, qui sont associés au pronostic, dépendent pour partie des algorithmes de ventilation. Objectifs : Caractériser l'intérêt potentiel des nouveaux algorithmes de ventilation dans l'optimisation des interactions patient-ventilateur : 1) en ventilation invasive, deux modes et leurs algorithmes nous ont semblé novateurs et nous avons cherché à personnaliser l'assistance du ventilateur en fonction de l'effort respiratoire du patient au cours de ces modes proportionnels : ventilation assistée proportionnelle (PAV+) et ventilation assistée neurale (NAVA) ; 2) en ventilation non-invasive (VNI) nous avons évalué si les algorithmes VNI des ventilateurs de réanimation et des ventilateurs dédiés à la VNI diminuaient l'incidence des asynchronies patient-ventilateur. Méthodes : 1) En PAV+ nous avons décrit un moyen de recalculer le pic de pression musculaire réalisée par le patient à chaque inspiration à partir du gain réglé et de la pression des voies aériennes monitorée par le respirateur. Nous avons alors évalué la faisabilité clinique d'ajuster l'assistance en ciblant un intervalle jugé normal de pression musculaire. 2) Nous avons comparé une titration de l'assistance en NAVA et en aide inspiratoire (AI) en se basant sur les indices d'effort respiratoire. 3 et 4) En VNI, nous avons évalué l'incidence des asynchronies patient-ventilateur avec et sans l'utilisation d'algorithmes VNI : sur banc d'essai au cours de conditions expérimentales reproduisant la présence de fuites autour de l'interface ; en clinique chez des patients de réanimation. Résultats : En PAV+, ajuster le gain dans le but de cibler un effort respiratoire normal était faisable, simple et souvent suffisant pour ventiler les patients depuis le sevrage de la ventilation mécanique jusqu'à l'extubation. En NAVA, l'analyse des indices d'effort respiratoire a permis de préciser les bornes d'utilisation et de comparer les interactions patient-ventilateur avec l'AI dans des intervalles d'assistance semblables. En VNI, nos données pointaient l'hétérogénéité des algorithmes VNI sur les ventilateurs de réanimation et retrouvaient une meilleure synchronisation patient-ventilateur avec l'utilisation de ventilateurs dédiés à la VNI pour des qualités de pressurisation par ailleurs identiques. Conclusions : En ventilation invasive, personnaliser l'assistance des modes proportionnels optimise les interactions patient-ventilateur et il est possible de cibler une zone d'effort respiratoire normale en PAV+. En VNI, les ventilateurs dédiés améliorent la synchronisation patient-ventilateur plus encore que les algorithmes VNI sur les ventilateurs de réanimation, dont l'efficacité varie grandement selon le ventilateur considéréDuring assisted mechanical ventilation, patient-ventilator interactions, which are associated with outcome, partly depend on ventilation algorithms.Objectives: : 1) during invasive mechanical ventilation, two modes offered real innovations and we wanted to assess whether the assistance could be customized depending on the patient's respiratory effort during proportional ventilatory modes: proportional assist ventilation with load-adjustable gain factors (PAV+) and neurally adjusted ventilator assist (NAVA); 2) during noninvasive ventilation (NIV): to assess whether NIV algorithms implemented on ICU and dedicated NIV ventilators decrease the incidence of patient-ventilator asynchrony.Methods: 1) In PAV+ we described a way to calculate the muscle pressure value from the values of both the gain adjusted by the clinician and the airway pressure. We then assessed the clinical feasibility of adjusting the gain with the goal of maintaining the muscle pressure within a normal range. 2) We compared titration of assistance between neurally adjusted ventilator assist (NAVA) and pressure support ventilation (PSV) based on respiratory effort indices. During NIV, we assessed the incidence of patient-ventilator asynchrony with and without the use of NIV algorithms: 1) using a bench model; 2) and in the clinical settings.Results: During PAV+, adjusting the gain with the goal of targeting a normal range of respiratory effort was feasible, simple, and most often sufficient to ventilate patients from the onset of partial ventilatory support until extubation. During NAVA, the analysis of respiratory effort indices allowed us to precise the boundaries within which the NAVA level should be adjusted and to compare patient-ventilator interactions with PSV within similar ranges of assistance. During NIV, our data stressed the heterogeneity of NIV algorithms implemented on ICU ventilators. We therefore reported that dedicated NIV ventilators allowed better patient-ventilator synchronization than ICU ventilators, even with their NIV algorithms engaged.Conclusions: During invasive mechanical ventilation, customizing the assistance during proportional ventilatory modes with the goal of targeting a normal range of respiratory effort optimizes patient-ventilator interactions and is feasible with PAV+. During NIV, dedicated NIV ventilators allow better patient-ventilator synchrony than ICU ventilators, even with their NIV algorithm engaged. ICU ventilators' NIV algorithms efficiency is however highly variable among ventilators
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Janols, Rebecka. "Tailor the system or tailor the user? : How to make better use of electronic patient record systems." Licentiate thesis, Uppsala universitet, Avdelningen för människa-datorinteraktion, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-156888.
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Health care organisations are extremely complex because they consist of heterogeneous groups of people (clinical professions, patients, managers), use advanced technology (medical devices and patient record systems), and apply many organisational and clinical routines. When introducing Electronic Patient Record systems (EPR) in health care organisations, all these aspects get affected. Using a sociotechnical perspective is necessary in order to get a "successful" EPR usage. The aim of my PhD studies is to provide health care organisations with knowledge and insights into how they can improve their organisation and practice in relation to usage of EPR systems. In my research I have used a grounded theory methodology for studying, analysing and reflecting on how electronic patient record systems are used by professionals in their practice. Studies have been conducted during a 2.5 years collaborative research project. Within the studied health care organisation there are differing opinions if an EPR system is mainly a technical system or a tool to support the clinical organisation. This conceptual division leads to an uncertainty in who is responsible for the proper function of the EPR system and have a major effect for the clinicians in their clinical practice. During the research seven potential problems areas, mandate, usability, education, participation, improvements, support and evaluation have been identified as crucial for the health care organisation to manage to achieve an effective EPR usage. The main results are 1) The health care organisation needs to establish a problem-solving strategy that questions the reasons behind the problems occurred, 2) The different stakeholder groups need to interact, create a better understanding for each other's perspective and agree on the same goal for the EPR system, 3) The clinical organisation needs help to improve their clinical practice in relation to the EPR system, 4) The EPR deployment and usage affect the clinicians in different ways. Their attitude towards the EPR system is dependent on the usability of the EPR system, the deployment process, their experience of participation, education, support and possibilities to improve the system.
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Couillard, Nathalie. "Rôle du pharmacien dans le suivi thérapeutique des patients sous zidovudine." Paris 5, 1993. http://www.theses.fr/1993PA05P089.
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Rosander, Camilla, Åza Glingfors, and Cecilia Nordén. "Sjuksköterskors beskrivning av faktorer som kan påverka vårdrelationen med patienter med borderline personlighetsstörning och självskadebeteende." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap, HV, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-18252.
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Att skapa en god vårdrelation mellan sjuksköterska och patient är en förutsättning för att patienten ska kunna delta och vara motiverad till att förbättra sin psykiska hälsa. Patienter med borderline personlighetsstörning (BPD) och självskadebeteende är patientgrupper som omnämns med en negativ attityd inom psykiatrisk omvårdnad. Vårt syfte med studien är sjuksköterskors beskrivning av faktorer som kan påverka vårdrelationen med patienter med BPD och självskadebeteende. Metoden är systematik litteraturstudie där sökning av vetenskapliga studier har gjort i databaserna OneSearch beta, Medline , Cinahl och PSYC-info. Studierna granskades utifrån modifierade kvalitetbedömningsprotokoll. Data analyserades, granskades och bygger på ramen för innehållsanalys. Resultatet visade att patienter med BPD och patienter med självskadebeteende skapade känslor av bl.a. frustration och hopplöshet hos sjuksköterskor. Känslorna skapades av att inte kunna ge adekvat vård pga. resursbrist, kompetensbrist och brist på tillit från patienterna. Att inte vara överens i arbetsgruppen skapade känslor som påverkade patienternas vård negativt. Vår förhoppning är att fler studier kan göras, och resultaten tydliggöras för att få ökad kvalité på arbetet inom psykiatrisk omvårdnad för främst dessa patientgrupper.
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Digan, John. "Are the counselling skills nurses learn in training apparent in their everyday interactions with patients and carers?" Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/are-the-counselling-skills-nurses-learn-in-training-apparent-in-their-everyday-interactions-with-patients-and-carers(e0c2fba5-d651-4c44-b509-55433538d2df).html.
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This research evaluates whether nurses working in general hospital settings utilise the counselling skills they are taught during their initial nurse training when they practice as qualified nurses. A narrative enquiry methodology was used to gather stories about everyday nurse patient interactions from eight nurses working in a variety of general hospital settings. The stories were tape recorded and transcribed before being subjected to qualitative descriptive analysis, a variant of content analysis, which yielded a number of themes. The analytical process incorporated the use of a hermeneutic circle to reinforce the reliability of the analysis and three types of skill were identified within the narratives. The narratives suggest that nurses do use counselling skills regularly when interacting with patients and carers, in particular the skills of information giving and empathy. These skills are inter-related in nursing practice and their usage stems from the personal experiences of the nurses involved rather than any training received prior to their qualifying as registered practitioners. While the sample size is relatively small the findings might suggest there could be some worth in further research to determine the relational skills possessed by those wishing to enter nurse training. This type of investigation has a resonance with current calls for reform of nurse education and might allow for training in the area of interpersonal skills to become more personalised. Ethical permissions were obtained from NRES, the Ethics committee of the United Lincolnshire Hospitals Trust and the University of Manchester.
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Shen, Yu-Ming [Verfasser], and Ulrich [Akademischer Betreuer] Mansmann. "Graphical presentation of patient-treatment interaction elucidated by continuous biomarkers / Yu-Ming Shen ; Betreuer: Ulrich Mansmann." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2016. http://d-nb.info/1121507816/34.
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Bristowe, Katherine. "A Linguistic Analysis of Doctor-Patient Interaction in a Teaching Hospital : The Outpatient Plastic Surgery Consultation." Thesis, University of Essex, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.520081.
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Gao, Hao. "Carotid plaque stress analysis by fluid structure interaction based on in-vivo MRI : implications to plaque vulnerability assessment." Thesis, Brunel University, 2010. http://bura.brunel.ac.uk/handle/2438/4731.
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Stroke is one of the leading causes of death in the world, resulting mostly from the sudden rupture of atherosclerotic plaques. From a biomechanical view, plaque rupture can be considered as a mechanical failure caused by extremely high plaque stress. In this PhD project, we are aiming to predict 3D plaque stress based on in-vivo MRI by using fluid structure interaction (FSI) method, and provide information for plaque rupture risk assessment. Fluid structure interaction was implemented with ANSYS 11.0, followed by a parameter study on fibrous cap thickness and lipid core size with realistic carotid plaque geometry. Twenty patients with carotid plaques imaged by in-vivo MRI were provided in the project. A framework of reconstructing 3D plaque geometry from in-vivo multispectral MRI was designed. The followed reproducibility study on plaque geometry reconstruction procedure and its effect on plaque stress analysis filled the gap in the literature on imaging based plaque stress modeling. The results demonstrated that current MRI technology can provide sufficient information for plaque structure characterization; however stress analysis result is highly affected by MRI resolution and quality. The application of FSI stress analysis to 4 patients with different plaque burdens has showed that the whole procedure from plaque geometry reconstruction to FSI stress analysis was applicable. In the study, plaque geometries from three patients with recent transient ischemic attack were reconstructed by repairing ruptured fibrous cap. The well correlated relationship between local stress concentrations and plaque rupture sites indicated that extremely high plaque stress could be a factor responsible for plaque rupture. Based on the 20 reconstructed carotid plaques from two groups (symptomatic and asymptomatic), fully coupled fluid structure interaction was performed. It was found that there is a significant difference between symptomatic and asymptomatic patients in plaque stress levels, indicating plaque stress could be used as one of the factors for plaque vulnerability assessment. A corresponding plaque morphological feature study showed that plaque stress is significantly affected by fibrous cap thickness, lipid core size and fibrous cap surface irregularities (curvedness). A procedure was proposed for predicting plaque stress by using fibrous cap thickness and curvedness, which requires much less computational time, and has the potential for clinical routine application. The effects of residual stress on plaque stress analysis and arterial wall material property characterization by using in-vivo MRI data were also discussed for patient specific modeling. As the further development, histological study of plaque sample has been combined with conventional plaque stress analysis by assigning material properties to each computational element, based on the data from histological analysis. This method could bridge the gap between biochemistry and biomechanical study of atherosclerosis plaques. In conclusion, extreme stress distributions in the plaque region can be predicted by modern numerical methods, and used for plaque rupture risk assessment, which will be helpful in clinical practice. The combination of plaque MR imaging analysis, computational modelling, and clinical study/ validation would advance our understandings of plaque rupture, prediction of future rupture, and establish new procedures for patient diagnose, management, and treatment.