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Dissertations / Theses on the topic 'Nursing advocacy'
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Bell, Bertha Roslyn. "Client advocacy in nursing: A contemporary perspective." W&M ScholarWorks, 1987. https://scholarworks.wm.edu/etd/1539618496.
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The purpose of this study was to determine whether or not Winslow's typology of definitions of client advocacy in nursing accurately and comprehensively represented the manner in which registered nurses defined the role. The author also hoped to explore contextual factors influencing the lack of consensus among nurses of the client advocacy role.;A survey questionnaire was developed and submitted to a random sample of nurses registered to practice in the state of Virginia. The sample population was asked for a definition of and a clinical situation describing client advocacy. A Likert scale was used to determine the degree of agreement of the sample population with Winslow's typology as well as clincial practice situations developed by the author.;Survey data revealed Winslow's typology of definitions represent the manner in which a substantial number of respondents defined client advocacy. Demographic and professional data of the sample population was obtained and analyzed. There was no substantial relationship between these variables and the opinions of client advocacy definitions.;The relationship to two factors, the development of the code of ethics and the nurse-physician relationship, were examined. All versions of the code of ethics contain elements of client advocacy behaviors. The lack of consensus among nurses of the client advocate role is related to male-female role conflicts and the desire of the nursing profession to attain full-fledged professional status.;Further investigation is indicated to determine if the current lack of consensus among nurses of the client advocate role, is an indication of the process of role change the profession must experience to realize the acceptance of any one definition of the client advocate role.
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Jurns, Carolyn Sue. "Promoting Policy Advocacy in Nursing via Education." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3688.
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Nurses have a professional, ethical, and social responsibility to advocate for optimal healthcare and an optimal professional environment. However, nurses often default on that responsibility. Leadership at a national nursing organization's state affiliate (SNO) perceived a need to optimize its members' policy advocacy. To meet that need, the Policy Advocacy Toolkit for Nurses (PATN) was developed for this doctoral project. The evidence-based PATN relied on established theories and frameworks, notably Knowles' adult education theory and Kingdon's multiple streams approach; research specific to this project; evidence from other researchers, healthcare organizations, and government websites; and input from a statistician, nursing education experts, and SNO personnel. The PATN's creation had 2 research questions. The first research question asked what SNO members' motivators and barriers to advocacy were. Chi square tests of survey results addressing this issue found significant relationships between advocacy levels and perceived speaking skills (χ2[4, N = 176] = 30.435, p = .000), understanding of SNO's daily advocacy activities (χ2[4, N = 176] = 17.814, p=.001), and understanding of policy creation (χ2[4, N = 176] = 33.830, p = .000). The second research question asked if the PATN's design was significantly improved after incorporating SNO design-stakeholders' input. A paired sample t test revealed no significant difference (p>.05) in the PATN with the stakeholders' input added. Details for evaluating the PATN's sustained effect on political astuteness, as offered in this doctoral project, were provided to the SNO. The PATN, evidence-based and built on the perceived needs of its intended users, should promote positive social change by promoting nurse advocacy.
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Lindeman, Sandra, and Andinsson Helena Josefsson. "Sjuksköterskan som patientens förespråkare : En litteraturstudie som beskriver faktorer som påverkar sjuksköterskan i rollen som förespråkare." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1422.
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Bakgrund: Sjuksköterskan har enligt kompetensbeskrivningen och ICN:s etiska kod ett ansvar att förespråka patienten. Begreppet advocacy myntades i USA under 1970-talet och sedan dess har begreppet diskuterats i litteraturen. Advocacy innebär att sjuksköterskan ska kunna uttyda patientens önskemål, kommunicera med patient och närstående, försäkra sig om patientens säkerhet, respektera och beskydda patientens rättigheter och tala samt agera på uppdrag av patienten. Syfte: Syftet är att beskriva faktorer som påverkar sjuksköterskan i rollen som patientens förespråkare. Metod: En litteraturstudie baserad på 13 vetenskapliga artiklar, varav tio kvalitativa och tre kvantitativa. Resultat: Författarna fann i det analyserade materialet, fyra huvudfaktorer som på olika sätt påverkade sjuksköterskan i rollen som förespråkare. Dessa huvudfaktorer är sjuksköterskan som person, sjuksköterskeprofession, samarbetet med läkaren och arbetsmiljön. I en av de analyserande studierna återfanns även anhöriga som en faktor. Diskussion: Att sjuksköterskan själv är en faktor som är viktig för patientvården är något som Jean Watson belyser i sin omvårdnadsteori. Hon menar att omsorgen inte får det utrymme den bör ha inom vården men också i övriga samhället och att det leder till svårigheter för bevarandet av den ursprungliga mänskliga omsorgen. Att stärka professionen och se den skild från det medicinska området är därför viktigt. Författarna menar att även om sjuksköterskan själv är en viktig faktor kommer hon likväl behöva en stödjande miljö för att orka och våga agera utifrån sina värderingar som person och profession fullt ut.Background: The nurse has, according to the description of competence and the ethical code of ICN, a responsibility to advocate the patient. The idea of advocacy was coined in the USA during the 1970s and since then it has been discussed in the literature. Advocacy means that the nurse should be able to interpret the wishes of the patient, to communicate with the patient and his/hers relatives, to assure the safety of the patient, to respect and protect the rights of the patient and to speak and act on behalf of the patient. Aim: The aim is to describe factors that affect the nurse in her role as the patient’s advocate. Method: A literature review based on 13 research reports, of which ten are qualitative and three quantitative. Result: In the analyzed material the authors’ found four factors, which in different ways affected the nurse in her role as advocate. These factors are the nurse as a person, the nursing profession, the cooperation with the doctor, and the working environment. In one of the analyzed studies the family of the patient was also found as a factor. Discussion: That the nurse herself is an important factor for the care of the patient is something that Jean Watson illustrates in her nursing theory. She argued that human care do not get the space it should have in health care but also in the rest of society and that it leads to difficulties for the preservation of the original human care. To strengthen the profession and to view it as separated from the medical area is therefore important. The authors mean that even if the nurse in herself is one important factor she will, however, need a supportive environment to be able to fully sustain and dare to act according to her values as a person and profession.
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Lennquist, Montan Kristina. "Sjuksköterskan som patientens advokat - En litteraturstudie om "advocacy in nursing"." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25962.
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Syftet med denna studie var att genom analys av tillgänglig litteratur inom området advocacy in nursing klarlägga innebörden av begreppet advocacy sett från sjukvårdens synpunkt, vem/vilka som skall ha funktionen som advocate i sjukvården, hur advocacy i praktiken bäst skall beskrivas inom sjukvården samt hur den som skall ha rollen som advocate bäst skall utbildas och föreberedas för sin uppgift. Som metod användes studium och analys av en selektion av tillgänglig litteratur inom området med speciell inriktning mot den egentliga innebörden av begreppet advocacy, argument för och emot sjuksköterskans funktion i rollen som advocate, hur advocacy bäst skall integreras och tillämpas i vårdprocessen och hur den som har rollen som advocate bäst skall förberedas för den. Resultat av litteraturstudien visade brist på enhetlig definition av begreppet advocacy, vilket skapar svårigheter att analysera och jämföra erfarenheter inom området. Även om motargument beskrevs, talade all erfarenhet inom området i denna studie för att sjuksköterskan är den mest lämpade att ha denna roll. Risken för att sjuksköterskan vid fullgörande av denna uppgift hamnar i en konfliktsituation mot övrig vårdpersonal betonades genomgående i denna litteratur, illustrerande betydelsen av att advocacy utförs som ett teamarbete med stöd och medverkan av all personal även om sjuksköterskan har huvudrollen. Behovet av utbildning för uppgiften framfördes genomgående, men inga konkreta förslag på utformning eller omfattning av sådan utbildning kunde identifieras. Konklusion: Begreppet advocacy in nursing är på väg att bli väl etablerat i vårdprocessen och sjuksköterskan har redan identifierats som den som bör ha denna roll. Fortsatt forskning inom området är angelägen för att ligga till grund både för metodik och utbildning inför uppgiften. Bättre och mer enhetlig definition av begreppet krävs för fortsatt vetenskapligt arbete.
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Houser, Andrea. "Facilitating Political Advocacy in Baccalaureate Education Programs in a Southeastern State." Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10639015.
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By virtue of position, academic nurse leaders face many challenges including those related to preparing students for clinical practice as well as the demands of meeting curriculum and accreditation standards. Included in accreditation requirements, the American Association of Colleges of Nursing mandates inclusion of political advocacy in baccalaureate nursing education programs. Recognizing a void in the literature for political advocacy in nursing education, this basic qualitative research study explored the experiences of academic nurse leaders with political advocacy. The primary purpose of this basic qualitative research study was to explore the experiences of nursing department chairperson’s experiences with political advocacy in baccalaureate nursing education. Eight academic nurse leaders consented to take part in the study to answer the primary research question: How do nursing department chairpersons facilitate political advocacy in a BSN nursing program? Data collection occurred using semistructured interviews. Three themes emerged from the data: (a) experience as nurse and leader, (b) communication, and (c) the concept of political advocacy. Findings of this study add to the growing body of knowledge on political advocacy in baccalaureate nursing education and offers academic nurse leaders resources to develop communicative action for strategic dialogue to facilitate nursing political advocacy in baccalaureate nursing education.
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Dinsmore, Kimberly R., and L. Lee Glenn. "Assessment of Learning Orientation: A Potential Tool in Advocacy and Policy Making." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7551.
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Stamey, Jessica, and L. Lee Glenn. "Critique and Appraisal of a Study on the Attitudes Towards Organ Donor Advocacy Scale." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/7496.
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Excerpt: The recent study by Floden, Lennerling, Fridh, Rizell and Forsberg [1] concluded that using the Attitude Towards Organ Donor Advocacy Scale (ATODAS) is ready for use in future research studies because it has good psychometric properties for measuring ICU nurses’ attitudes towards advocacy on behalf of potential and actual organ donors. However, that conclusion is not supported by the data in the study because of lack of evidence of measurement validity
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McDonald, Sally. "Reporting misconduct : A descriptive study of whistleblowing in nursing." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1210.
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This research examined the effects of whistleblowing and non-whistleblowing on nurses in Western Australia. A descriptive survey design was used to explore the physical, emotional and professional effects experienced by nurses who blew the whistle and nurses who did not blow the whistle on misconduct. This study also examined the effective and ineffective coping behaviours reported by participants. A questionnaire was developed based on Lazarus and Folkman's Stress/Coping model and mailed to 500 nurses in Western Australia. Of these, 100 returned the completed questionnaire, indicating a response rate of 20%. Ninety-five respondents wereincluded in the study; 70 were self-identified as whistle blowers and 25 were self-identified as non-whistle blowers. Results indicated that nurses experienced stress induced physical and emotional problems from being involved in a whistleblowing situation. Data also suggested that severe professional reprisals occurred if the nurse reported misconduct, but there were few professional consequences if the nurse remained silent. A majority of whistleblowers tried problem-focused coping behaviours and reported four of them to be effective. A majority of non-whistleblowers tried emotion-focused coping behaviours and reported all of them to be ineffective. The conclusions reached from this research are: (I) Whistleblowing situations are stressful and may cause physical and emotional problems whether one blows the whistle or not. (2) Blowing the whistle on misconduct can be professionally damaging, whereas remaining silent will probably not affect one's career. (3) Blowing the whistle on misconduct will probably not change, or stop, the misconduct. (4) Remaining silent may result in more feelings of unworthiness and guilt than speaking up. (5) Problem-focused behaviours are the most effective coping behaviours in whistleblowing situations.
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Malkin, Lisa Sohl. "Patients' and significant others' satisfaction with nursing activities in oncology ambulatory settings." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/558093.
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Beaty-Edwards, Dawn Tanesha. "ETHICS AT THE BEDSIDE: ADVOCACY FOR THE PATIENT AND THE COST." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/563468.
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Urban BioethicsM.A.
As a healthcare professional at the bedside, it has been very difficult to advocate for the patient while all parties involved cannot respect what the patient wants. Four out of five Americans do not have an advance directive. The history and court cases that have led the country to make patient’s right to make their own healthcare decisions has been decades in the making, yet still bring daily challenges within the healthcare system. When a patient’s wishes are not being honored, medical futility may lead to moral distress and compassion fatigue. Institutions provide multidisciplinary teams to address these issues, but if a patient’s capacity or competence is in question, their voice may not be heard. The toll on the healthcare provider and the patient can be permanently damaging, causing many nurses to leave the profession all together. I will attempt to determine the barriers to implementing the patient’s wishes, address the syndrome of moral distress among healthcare professionals, and attempt to offer solutions to promote well rounded, patient-centered care.
Temple University--Theses
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Gallo, Maria L. "Nursing advocacy and the accuracy of intravenous to oral opioid conversion at discharge in the cancer patient." [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003235.
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Gallo, Maria L. R. N. O. C. N. "Nursing Advocacy and the Accuracy of Intravenous to Oral Opioid Conversion at Discharge in the Cancer Patient." Scholar Commons, 2009. https://scholarcommons.usf.edu/etd/1978.
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Pain is a common problem for cancer patients at home and when hospitalized. Pain interferes with all aspects of a patient's life including sleep, appetite, sexual desire, emotion and productivity. The under-prescribing of opioids can lead to uncontrolled pain in cancer patients. This study examined nursing advocacy related to pain management and the accuracy of the intravenous (IV) to oral (PO) opioid conversion at discharge in cancer patients.
Retrospective chart audits were done on 50 cancer patients. The physicians in the charts surveyed who prescribed the discharge medications consisted of a mix of hematologist/oncologists, surgeons and internists/hospitalists in a southwest Florida community. Fifty nurses were also surveyed and asked how comfortable they are in advocating for their patient's pain control and how often they actually advocate for proper pain management. This was done in the same southwest Florida hospital.
The most common cancer diagnoses of the patient subjects were colorectal cancer and esophageal/lung cancer. The results of this study show that an overwhelming majority of cancer patients (47 of 50), received doses that were not accurately converted from intravenous to oral opioids at the time of discharge from the hospital. This conversion was based on the Johns Hopkins Opioid Conversion Tool. Nurses in general reported that they are comfortable in advocating for their patients' pain control, but more so in more autonomous areas of practice such as intensive care.
The results were overwhelming in the direction of poor control of patient pain. This study leads to the need for further research in the important area of pain control for cancer patients. It also indicates the need for additional education for physicians and nurses about pain control and opioid conversion.
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Zhang, Yiyun Arayan Trangarn. "An economic evaluation on the new cooperative medical scheme (NCMS) financing : a case study of Meedu county, Yunnan province, China /." Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd415/4938053.pdf.
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MacDonald, Jo-Anne Thérèse. "Priority Setting and Policy Advocacy for Community Environmental Health: A Comparative Case Study of Three Canadian Nursing Associations." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23419.
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This thesis examined factors that influence three Canadian Nursing Associations’ priority setting and policy advocacy for community environmental health (CEH). The research questions that guided the study were: (a) how do the nature and scope of nursing organizations’ engagement for CEH policies differ according to provincial and federal contexts? and (b) how do nursing organizational factors and external system factors influence the priority-setting and policy advocacy choices for CEH policy? To answer these questions I undertook a qualitative comparative case study. The research was guided by epistemological and methodological principles of interpretative description and informed by whole-systems socio-ecological theory and institutional theory. Data were collected through participant interviews (n=41) and document review. Guided by framework analysis and the use of descriptive and conceptually-oriented matrices, cases were analyzed using an iterative and inductive approach to identify case patterns. These case patterns were then compared to identify cross-cutting factors that influence the Nursing Associations’ priority setting and policy advocacy for CEH. Key findings are represented in an integrated conceptual framework. Nursing Associations’ priority setting and policy advocacy are embedded in a dynamic policy field whereby structures and institutional pressure both create opportunities and narrow the Nursing Associations’ options for engaged CEH advocacy. The findings lead to recommendations for practice, policy, and research that have relevance for the profession, nursing associations, and policy decision-makers.
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Cafasso, Mandi. "Advocacy: A Vital Step in Attaining Full Practice Authority for the Advanced Practice Registered Nurse." Otterbein University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1429220363.
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Cheng, Shuk-wah, and 鄭淑樺. "An evidence-based advocacy intervention for women survivors of intimate partner violence in a public health setting." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48335241.
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Intimate partner violence (IPV) is a global public health problem and occurs in all countries including Hong Kong. Women are significantly more likely to report being victimized by intimate partner than men. IPV can result in high personal and social costs in terms of personal health consequences, burden on the medical care and loss productivity for the society. Early and effective interventions for women survivors of IPV are utmost importance. Increasing the safety behaviours education to abused women is one of the aims of advocacy interventions that may prevent further abuse and increase the safety and well-being of those women. It is crucial for nurses to assess the effectiveness of the advocacy intervention in order to apply the best evidence into practice in the local settings. However, there are no specific interventions or guidelines for women survivors of IPV are available in Hong Kong local healthcare system including the STD clinics or the Social Hygiene Clinics. In this dissertation, a translational nursing research related to an effective advocacy intervention for women survivors of IPV is described.
The purposes of this study are (1) to conduct a systematic literature review on interventions to increase safety behaviours for women survivors of IPV; (2) to summarize and synthesize the data from the identified literatures; (3) to assess the implementation potential of the proposed innovation on advocacy intervention; (4) to develop an evidence-based practice guideline; (5) to develop an implementation plan; and (6) to develop an evaluation plan to assess the effectiveness of the proposed evidence-based guideline.
A systematic literature search was conducted and a total of nine studies were identified in the review. The level of evidence and critical appraisal of each selected study was criticized by using the grading system of Scottish Intercollegiate Guideline Network (SIGN). After the integrative review, the implementation potential of the proposed innovation on advocacy intervention for women survivors of IPV was assessed in terms of different aspects, including target audience and setting, transferability, feasibility and cost-benefit ratio. Then an evidence-based guideline was developed based on the level of evidence with grades of recommendation stated. For the implementation plan was divided into two parts, the communication plan and the pilot study plan. After communicating with the different identified stakeholders and providing proper training programme to the innovators, a pilot study test was carried out for concrete information on the feasibility of the proposed innovation. Finally, an evaluation plan was designed to evaluate the effectiveness of the proposed innovation.
The aim of this dissertation is to increase the safety behaviours of the target population and to reduce further abuse. With the implementation of the evidence-based advocacy intervention, the women client’s knowledge on safety-promoting behaviours should be improved significantly thus to improve their health and also to increase their safety.published_or_final_version
Nursing Studies
Master
Master of Nursing
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Northfield, Sarah. "The palliative care referral decision-making process in the acute cancer setting: Nurses' advocacy behaviours and the factors influencing these behaviours." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/117347/2/Sarah_Northfield_Thesis.pdf.
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This thesis explored the actions cancer nurses take to advocate for the referral of patients with advanced cancer to Specialist Palliative Care Services (SPCS). The study identified cancer nurses frequently advocated for referrals to SPCS if they had positive beliefs and the scope of practice to directly refer to the service. This study confirms cancer nurses make an important contribution to the palliative care referral decision-making process by engaging in a range of advocacy activities. Barriers associated with engaging appropriately skilled nurses need to be addressed, by introducing education processes and supportive policies.
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Vanhook, Patricia M., Trish Aniol, John Orzechowski, and Grace Titilayo Babalola. "Nurses Forming Legal Partnerships to Meet the Needs of the Underserved in Rural America." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7414.
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The impetus for the recognition of the need for legal partners in healthcare came from Boston City Hospital in 1993. The hospital provided care to the largest uninsured and underinsured population in the New England states. The pediatric patients were noted by Dr. Barry Zuckerman to have difficulty in recovering from medical illnesses. He linked their inability to improve their health to poor housing, food insecurity, and basic social determinants of health. His hiring of a part-time lawyer led to a national movement for the development of medical-legal partnerships. The American Bar Association, the National Center for Medical-Legal Partnerships at George Washington University in Washington, DC and the American Academy of Pediatrics formed the first national medical-legal partnership in 2007. Joint resolutions were passed for members to become partners with the other professional colleagues to “address the legal and social issues affecting patient health and well-being.” The American Bar Association resolution led to the creation of the Medical-Legal Partnership Pro Bono Project. In 2015, the East Tennessee State University College of Nursing nurse-led community health center was awarded a small grant from the National Nurse Centers Consortium to participate in the development of a medical-legal partnership. The health center is staffed by Nurse Practitioners who provide health care for the underserved in northeast Tennessee. The patients are diverse and include homeless, migrants, residents of public housing, uninsured, and underinsured. Partnering with the Tennessee Justice Center in Nashville, Tennessee, the nurse-led medical legal partnership improved lives of pediatric patients, adults, pregnant women across the state, and advocacy rights for those who cannot speak for themselves.
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Andrade, Raquel Dully. "Em defesa da saúde da criança: o cuidado de enfermagem e o direito à saúde no contexto da atenção primária." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/22/22133/tde-05112012-204502/.
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As práticas de saúde necessitam ser fortalecidas com a atuação dos profissionais e dos sujeitos na construção de planos de responsabilização, para maior integralidade da atenção e do exercício do direito à saúde, destacando-se aqui as ações em favor da criança, um ser especialmente vulnerável na sua própria advocacia. O objetivo do presente estudo foi compreender as experiências de enfermeiros que atuam em unidades de saúde da família na perspectiva do cuidado e da defesa do direito à saúde, buscando novos subsídios para a constituição de práticas e saberes no contexto da atenção primária em saúde da criança. Trata- se de uma investigação de natureza qualitativa, numa perspectiva hermenêutica, a partir de entrevistas semiestruturadas gravadas com 14 enfermeiros que atuam na Estratégia Saúde da Família no município de Passos-MG, com análise temática dos dados. Os resultados foram agrupados nos seguintes temas: A puericultura como momento de defesa, A visita domiciliar como parte das ações no contexto de defesa, Parcerias Positivadas e Não Positivadas, Componentes da competência do enfermeiro no processo de defesa da criança. As narrativas dos enfermeiros retrataram várias formas e experiências de defesa da saúde da criança, com ênfase nos aspectos sobre avaliação da criança, identificação de situações vulneráveis para a criança, dificuldades na abordagem e condução dos casos, observação e intervenção para o cuidado da criança em casa, apreensão de situações de privação, o uso de álcool e drogas pelos pais e ou familiares, a comunicação entre os profissionais e os serviços, lacunas nas relações de parceria, limites na integralidade e intersetorialidade das ações na rede, interação e envolvimento com a criança e sua família, conhecimentos para melhoria do cuidado e da advocacia em saúde. Nas experiências narradas pelos enfermeiros emergiram complexidades e intersubjetividades, demonstrando a necessidade de fortalecimento do apoio entre profissionais e serviços, sob pena de uma condição de maior vulnerabilidade para as crianças. Os potenciais da relação entre as áreas da saúde e do direito foram destacados, com possibilidades de empoderamento da clientela atendida. Entre os componentes da competência do enfermeiro destacaram-se as habilidades de comunicação e interação, envolvimento e empatia, responsabilidade e conhecimento teórico-prático. Uma análise contextual dos resultados fortaleceu a importância do território e a necessidade de sua valorização na rede municipal, com vistas à articulação dos serviços e políticas públicas. O desempenho do enfermeiro na estratégia saúde da família envolve comprometimento e aprimoramento de saberes e práticas para defender e proteger os sujeitos. Nesse processo, a iniciativa, a habilidade e a ação de defesa implicam no estabelecimento de interações intersubjetivas para efetivar o cuidado e a advocacia em saúde. Na saúde da criança os enfermeiros devem ser agentes públicos imbuídos de observação e intervenção para respeitar, proteger e efetivar os direitos humanos na proteção da saúde da criança de modo integral e longitudinal.Health practices need to be strengthened by the performance of professionals and subjects in the construction of responsibility plans, in order to have greater integrality of care and the practice of the right to health, here pointing out the actions in favor of the child, a being especially vulnerable in its own advocacy. The aim of this present study was to understand the nurses\' experiences who work at family\'s health units in the perspective of care and the defense of the right to healthcare, searching for new subsidies to the constitution of practices and knowledge in the context of primary care in child\'s health. It is an investigation of qualitative nature, in a hermeneutic perspective, from semi structured interviews recorded with fourteen nurses who work at Estratégia de Saúde da Família in Passos-MG, using thematic analysis of the data. The results were put together according to the following themes: Child welfare as defense time, Family visiting as part of the actions in the context of defense, Positive and Non-Positive Partnerships, Components of the nurse\'s competence in the process of the child\'s defense. The nurses\' speeches have showed several ways and child\'s health defense experiences, emphasizing the aspects about the child\'s assessment, identifying vulnerable situations for the child, difficulties in the approach and conduct of the cases, observation and intervention for the child care at home, understanding of privation situations, parents or relatives who drink alcohol or take drugs, the communication between professionals and services, gaps in the partnership affairs, limits in the integrality and inter sectoriality of the actions in the system, interaction and involvement with the child and family, knowledge for the improvement of care and health advocacy. Complexities and inter subjectivities have emerged from the experiences told by the nurses, showing the need for support strengthening between professionals and services, under penalty of a greater vulnerability for the children. The potentials of the relations among the health care areas and rights were highlighted, counting with the empowerment of the clients who were seen. Among the components of the nurse\'s competency, it can be pointed out the abilities in communication and interaction, involvement and empathy, responsibility and theoretical and practical knowledge. A contextual analysis of the results has strengthened the territory importance and the need of its valorization in the municipal system, having in mind the articulation of the services and public policies. The performance of the nurse in the family health strategy implies in compromising and improvement of knowledge and practices in order to defend and protect the subjects. In this process, the initiative, the ability and the defense action imply in the establishment of inter subjectivities in the effectiveness of care and the health advocacy. The nurses, in the child health, have to be public agents committed with observation and intervention in order to respect, protect and put in effect the human rights in the protection of the child\'s health as an integral and longitudinal way.
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Lindahl, Berit. "Möten mellan människor och teknologi : berättelser från intensivvårdssjuksköterskor och personer som ventilatorbehandlas i hemmet." Doctoral thesis, Umeå universitet, Omvårdnad, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-495.
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The overall aim of this thesis is to illuminate meanings of the relation between human beings, technology and care, as narrated by critical care nurses and people in need of home mechanical ventilation (HMV). The data are based on narrative research interviews with six intensive care nurses (I), 13 people who were about to start HMV (II), these 13 people were interviewed for a second time six to eight months after HMV had started (III), and nine persons with more than two years HMV experience (IV). The text was analysed using a phenomenological-hermeneutic research method as described by Lindseth and Norberg. The method is developed from the writings of the French philosopher Paul Ricoeur. The findings illuminate meanings of nursing care in an intensive care unit (I) as undertaking the role of advocacy as a caring response to another human being. The basic condition for this caring response depends on the nurses' openness and sensitivity to the needs of patients or patients' next of kin. The nurses were aware of the influence of technology and tried to modify its negative effects. Meanings of becoming dependent on HMV (II) are interpreted and metaphorically expressed as "to get one's breath" and "to hold one's breath" respectively. On the one hand, breathing ensures the cellular oxidation process within the body, but on the other hand there can be "shortness of breath" in "spiritual breathing", and starting HMV will influence patients' whole life situation, body and spirit. After using a ventilator six to eight months, meanings of a life dependent on a ventilator was interpretd as either a closure or an opening of the lived body to oneself, other people and the world. This interpretation is illustrated by two images. A life on a ventilator at home is not to be seen as static being. On the contrary, it is a being which moves and changes over time. Being dependent on a ventilator and living at home, as narrated by adults with more than two years of HMV experience (IV), was interpreted as being able to rise above yourself and your personal boundaries in order to live a good life. These meanings are bound up with experiencing a vital force and interdependency, and despite fragility being able to reach others and the outside world. Design and function of technology had an impact on the lived body. The comprehensive understanding of the four articles (I-IV) unfolded meanings of the relation between human beings, technology and care, as an interchange and a creation of physical and spiritual energy among humans and between human and technology. It could be an experience of the lived body being filled with as well as emptied of energy. This interpretation points at a call for the caring personnel to be attentive and to listen to the voices of the lived body in health and illness, and to bear witness to those who suffer. Technology acts between the person and the world and in order to be embodied, technology must be "transparent", i.e. beautiful and fit to its use.
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Mattsson, Ellinor, and Emma Gellerbrant. "Barns erfarenheter av delaktighet och förberedelse : en enkätstudie om smärtsamma procedurer inom barnsjukvård." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-411554.
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Bakgrund: Enligt barnkonventionen har barn som vistas inom hälso- och sjukvården rätt till delaktighet i sin vård genom anpassad information samt att få att uttrycka sina åsikter i alla frågor som rör dem. Insättning av perifer venkateter och blodprovstagning är smärtsamma procedurer som barn utsätts för inom barnsjukvården. Inför dessa procedurer är det viktigt att barn får goda förberedelser. Syfte: Studiens syfte var att undersöka och beskriva barns erfarenheter av delaktighet inför och under insättning av perifer venkateter och blodprovstagning. Metod: Studien genomfördes som en kvantitativ enkätstudie. Enkäterna besvarades av 47 barn i åldrarna åtta till arton år, som hade genomgått insättning av perifer venkateter alternativt lämnat venösa eller kapillära blodprov på Falu lasarett eller Akademiska barnsjukhuset i Uppsala. Resultat: Tjugoen procent av barnen fick inte lokalbedövning och 20% blev aldrig tillfrågade om önskemål i samband med smärtsamma procedurer. De barn som uppgav att personalen inte hade berättat hur de smärtsamma procedurerna skulle gå till hade lägre ålder i median jämfört med de barn som personalen berättade för (9 år versus 14 år, p=0,006). Ju högre barnen skattade att de förstått informationen de fått på en tiogradig skala desto högre skattade de att de kunde säga stopp om något var för påfrestande eller gjorde för ont i samband med smärtsamma procedurer (r=,430, p=0,004). Slutsats: Alla barn ska tillfrågas om önskemål och erbjudas lokalbedövning inför smärtsamma procedurer. Sjukvårdspersonal ska ge barn anpassad information oavsett ålder vilket främjar barns möjlighet att säga stopp om de upplever proceduren som för påfrestande. Sjukvårdspersonal måste visa extra lyhördhet gentemot barn med lägre ålder.Background: According to the Convention on the Rights of the Child, children receiving healthcare have the right to personalized information and to have their opinions expressed on all issues that concern them. Peripheral intravenous cannulation and blood sampling are painful procedures that children are subjected to in pediatric care, and prior to these procedures it is important that children receive good preparation. Objective: The aim of the study was to investigate and describe children’s experiences of participation before and during peripheral intravenous cannulation and blood sampling. Method: The study was a quantitative survey. The questionnaires were answered by 47 children aged eight to eighteen years, who had experienced peripheral intravenous cannulation or venous/capillary blood test at the hospital in Falun or at the Children’s Hospital in Uppsala. Results: Twenty-one percent of the children did not receive local anesthesia and 20% were never asked for their preferences in connection with painful procedures. The children who stated that they were not informed by the healthcare professionals regarding the painful procedures were of younger age compared to the children that were informed (9 years versus 14 years, p=0,006). The higher the children rated on a 10-degree scale that they understood the information, the higher they also rated that they could tell the healthcare professionals to stop if the painful procedures was too demanding or too painful (r=,430, p=0,004). Conclusion: All children should be asked for their preferences and be offered local anesthesia for painful procedures. Healthcare professionals should provide the children with appropriate information regardless of the age of the child, which promotes the child’s ability to tell the healthcare professionals to stop if they experience the procedures as too demanding. Healthcare professionals should be more aware when caring for younger children.
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McCready, Geneviève. "Actions politiques d’infirmières francophones canadiennes afin d’améliorer les conditions de vie des personnes et communautés : une approche historique et une ethnographie collaborative en sciences infirmières." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/40705.
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D’après les écrits scientifiques, les infirmières auraient du mal à exercer leur pouvoir d’influence dans le but de modifier les politiques en faveur de la santé. Ces difficultés vécues par des infirmières en santé communautaire importent puisque d’une part, les actions politiques sont nécessaires à la réduction des inégalités sociales qui minent la santé des populations et d’autre part, ces infirmières constituent des témoins privilégiées des conditions de vie nuisibles.
Cette thèse doctorale s’intéresse aux conceptions et pratiques en matière d’action politique chez des infirmières francophones canadiennes exerçant en santé communautaire. Son regard porte spécifiquement sur les contextes du travail des infirmières qui influencent leurs pratiques. Les objectifs sont :
- Décrire les conceptions des infirmières francophones canadiennes quant à l’action politique en santé communautaire;
- Témoigner des pratiques des infirmières francophones canadiennes pour améliorer les conditions de vie des personnes et communautés;
- Rendre compte des éléments contextuels qui touchent les pratiques infirmières en matière d’action politique.
L’étude présente deux volets : une enquête historique réalisée dans le Bulletin des gardes-malades catholiques du Canada entre 1934 et 1959, et une ethnographie collaborative menée auprès de 21 infirmières travaillant dans un Centre de santé communautaire.
Les résultats montrent l’attachement des infirmières aux valeurs de justice sociale et de respect de la dignité humaine. Certains savoirs infirmiers – tels que les savoirs éthiques, la défense de l’accès aux soins et les soins de proximité – sont mis en danger par la domination dans le réseau de la santé du modèle biomédical et de la reddition de comptes. Les résultats mettent en évidence le rôle joué par les organisations en santé dans l’avènement d’opportunités pour les infirmières de mener des actions permettant de perpétuer leurs pratiques d’équité. Ces constats mènent à l’élaboration de pistes émancipatrices pour la profession infirmière.
En somme, cette thèse jette un nouveau regard sur l’héritage du savoir infirmier francophone au Canada. Elle rend compte de la diversité des actions politiques chez les infirmières et questionne les obstacles contemporains à l’exercice de ce rôle.
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Kleman, Carolyn Cable. "A PATH ANALYSIS OF TRUST IN NURSES, SOCIAL SUPPORT, PATIENT SELF-ADVOCACY, PSYCHOLOGICAL DISTRESS, AND PHYSICAL SYMPTOMS IN PATIENTS WITH CHRONIC HEART FAILURE." Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent150513325871688.
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Eklund, Anna Josse. "Sjuksköterskor som patienters företrädare : Med huvudsakligt fokus på företrädarskap för äldre patienter i kommunal hälso- och sjukvård." Doctoral thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-16127.
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The overall aim was to study nurses’ and managers’ attitudes towards micro social patient advocacy (I) and factors related to patient advocacy (II, III) with the main focus being on advocacy in the care of older patients in community health care together with psychometric testing of the instrument 'Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy' (IV). Methods: A quantiative cross-sectional study and a qualitative study were carried out. Nurses (n=207) and managers (n=23) in community health care responded to a questionnaire about patient advocacy, nursing competence, personal traits, quality of care and organisational climate (I, II, IV). Nurses' (n=18) perceptions of influencers of patient advocacy was studied in a phenomenographic study (III). The results showed that nurses and managers reported positive attitudes to patient advocacy (I, II), especially for patients unable to speak for themselves (I). Two areas of nursing competence (Performing the nursing process, Supervision and cooperation) and a dimension of quality of care of older patients were positively associated with attitudes towards patient advocacy (II). Two organisational dimensions were, negatively (dynamism) respectively positively (playfulness), associated with attitudes towards patient advocacy. The nurses' perceptions of influencers of patient advocacy consist of three hierarchically related levels: The nurse's character traits, The nurse’s bond with the patient and The organisational conditions (III). The Swedish version of APAS-AMIA consists of 33 items in a four-factor structure (APAS-AMIA/SE): Support patients’ beliefs and decision-making, Safeguard patients' health care, Support patients to communicate their wishes and Respect patients’ wishes not to participate in decisions regarding care (IV). Conclusions: Maintaining the continuing professional competence of nurses is important, and is ensuring the organisational prerequisites to enable nurses' advocacy for patients.Det övergripande syftet var att studera sjuksköterskors och chefers attityder till mikrosocialt företrädarskap för patienter (I), faktorer relaterade med företrädarskap (II, III) med huvudsakligt fokus på företrädarskap för äldre patienter inom kommunal hälso- och sjukvård samt psykometriskt testa instrumentet Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy (IV). Metod: En kvantitativ tvärsnittstudie och en kvalitativ studie genomfördes. Sjuksköterskor och chefer (n=230) i kommunal hälso-och sjukvård besvarade frågor om företrädarskap, yrkeskompetens, personlighet, vårdkvalitet och organisationsklimat (I, II, III). Sjuksköterskors (n=18) uppfattningar av vad som påverkar företrädarskap studerades i en fenomenografisk studie (III). Resultat: Sjuksköterskor och chefer rapporterade positiva attityder till företrädarskap (I, II), framför allt för oförmögna patienter (I). Två områden av yrkeskompetens (Att utföra omvårdnadsprocessen, Arbetsledning och samarbete) liksom en dimension av kvalitet i vården av äldre var positivt associerade med attityder till företrädarskap (II). Två organisatoriska dimensioner var negativt (livfullhet) respektive positivt (lekfullhet) associerade med attityder till företrädarskap. Sjuksköterskors uppfattningar av vad som påverkar företrädarskap omfattar tre hierarkiskt relaterade nivåer: Sjuksköterskans karaktärsdrag, Sjuksköterskans förhållande till patienten och Arbetsplatsens beskaffenhet (III). Den svenska versionen av APAS-AMIA omfattar 33 påståenden i en fyrfaktorstruktur (APAS-AMIA/SE): Stödja patienternas önskemål och beslutsfattande, Värna om patienternas vård, Stödja patienterna att kommunicera sina önskemål och Respektera patienternas önskemål om att inte delta i beslut (IV). Konklusioner: Sjuksköterskors yrkeskompetens bör upprätthållas för att de ska ha förutsättningar att företräda patienter. Det är viktigt att skapa organisatoriska förutsättningar för att sjuksköterskor ska kunna etablera en relation till patienten som underlag till företrädarskap.
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Huggins, Michael. "GAY MEN AND SATISFACTION WITH HEALTH CARE INTERACTIONS." UKnowledge, 2019. https://uknowledge.uky.edu/nursing_etds/50.
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The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care differed by each characteristic; 3) assess relationships between each potential predictor of satisfaction and the level of satisfaction; and, 4) determine the relationship between each predictor and satisfaction after controlling for the most significant covariate(s).
A quantitative study was conducted in which 42 adult gay men participated. The author hypothesized that gay men who reported lower levels of depression, higher self-rated physical and mental health, lower levels of anxiety, higher self-advocacy scores, lower levels of internalized homophobia, and stronger evaluations of patient-provider communication would report more positive satisfaction with health care interactions. The hypothesis was supported by results of this research.
This research established that variables with the strongest effect on gay men’s satisfaction with health care interactions were whether the patient had revealed his sexual orientation to the provider, how he rated his anxiety, and how he rated the quality of communication with his provider.
These results emphasize the importance of health care providers’ awareness of specific psychosocial factors that influence communication during care of gay men, who understand their sexual orientation places them at a disadvantage when receiving health care services. Despite the pursuit of equitable, high quality, and satisfying health care, its achievement has been hampered by barriers that gay men encounter. Understanding those barriers while addressing health related needs of gay men will be important for providers who seek to improve satisfaction with health care interactions.
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Hörnfeldt, Katarina, and Ulrica Johnsson. "Hur vårdrelationen etableras preoperativt för god personcentrerad vård : En litteraturstudie med syntes från Fundamentals of Care." Thesis, Uppsala universitet, Anestesiologi och intensivvård, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-446670.
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Bakgrund: Vårdrelationen som etableras mellan patienten och specialistsjuksköterskan inom anestesi i det tidsbegränsade preoperativa mötet är en förutsättning för att specialist-sjuksköterskan ska kunna ge personcentrerad vård. Det har tidigare inte studerats hur vårdrelationen etableras utifrån ramverket Fundamentals of Care i den preoperativa kontexten. Syfte: Att beskriva hur vårdrelationen etableras i det tidsbegränsade preoperativa mötet mellan patienten och specialistsjuksköterskan inom anestesi utifrån Fundamentals of Care. Metod: Litteraturstudie med systematisk ansats. Deduktiv innehållsanalys enligt Elo och Kyngäs. Resultat: Studiens resultat visar hur vårdrelationen kan etableras i det preoperativa mötet, beskrivet utifrån Fundamentals of Care, vilket inte gjorts tidigare. Resultatet visade på kunskap, erfarenheter, sinnen och förmågor som anestesisjuksköterskan behövde besitta för att etablera vårdrelationen. Det som kan lyftas fram var anestesisjuksköterskans speciella kommunikationsförmåga, mentala närvaro, metoder för att lugna patienten, olika sätt att visa fysisk närvaro samt hennes simultankapacitet för att etablera vårdrelationen preoperativt. Ramverket Fundamentals of Care gjorde det möjligt att överföra tidigare forskning för att beskriva etablerandet av vårdrelationen. Fortsatt fördjupning och forskning inom detta område skulle kunna ligga till grund för praktisk vägledning för specialistsjuksköterskan inom anestesi. Slutsats: Studien visar hur det är möjligt att etablera en vårdrelation i det tidsbegränsade preoperativa mötet mellan patienten och specialistsjuksköterskan inom anestesi, för att ge personcentrerad vård. Resultatet kan ses som en introduktion eller underlag för diskussion för nyexaminerade anestesisjuksköterskor om hur hon kan etablera en vårdrelation i det preoperativa mötet med patienten.Background: The relationship established preoperatively between the patient and the nurse anesthetic specialist is a prerequisite for the nurse specialist to give person-centered care. The establishment of the caring relationship has not earlier been investigated using the Fundamentals of Care framework in the perioperative context. Aim: To describe the establishment of the relationship between the nurse anesthetic specialist and the patient within a limited period in the preoperative setting using Fundamentals of Care. Method: Literature review with a systematic approach. The collected data was analyzed with a deductive approach according to Elo and Kyngäs. Result: The result of the study shows how the establishment of the caring relationship in the preoperative setting, described from Fundamentals of Care, which have not been done before. The result brings forth knowledge, experiences, senses, and abilities that the nurse anesthetist needed to possess to establish the caring relationship. Skills worth mentioning are her specific communication skills, her mental attendance, methods of calming the patient, different ways of showing physical presence and her simultaneous capacity for establishing the perioperative relationship. The framework Fundamental of Care itself made it possible to transfer former research to describe the establishment of a caring relationship. Furthermore, in-depth research in this area could be the basis to practical guidance for the nurse anesthetist. Conclusions: The study shows how it is possible to establish a caring relationship between the patient and the nurse anesthetist within the limited period in the preoperative setting in order to deliver person-centered care. The result can be an introduction or basis for discussion for the new graduate nurse anesthetist about the establishment of a caring relationship in the preoperative meeting with the patient.
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Millette, Brenda E. McNamara. "An exploration of advocacy models and the moral orientation of nurses." 1989. https://scholarworks.umass.edu/dissertations/AAI8917382.
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Advocacy has been identified as a key function of the professional nurse. This study was designed to explore and describe nurses' preferences regarding three advocacy models. The relationship of advocacy preference to demographic factors and the moral orientation of selected subjects was also explored. Phase one of this study identified participant's preference for client, physician, or institutional advocacy in three ways. Nurses (N = 222, out of 500) ranked and rated the models and responded to a case. The first two hypotheses predicted that nurses would prefer client advocacy and that those with this preference would most likely be older women with more education in a management position in a community setting. In phase two, hypotheses three and four predicted that nurses preferring client advocacy would express a moral orientation of caring and that the nurse preferring the institutional advocate model would express a moral orientation of justice. Twenty-four subjects were interviewed, twelve subjects from each category: institutional and client advocacy. The results were analyzed for moral orientation using Gilligan's protocol. Gilligan's model of moral development and orientation framed the interpretation of the subject's reported moral dilemmas. The majority of the respondents ranked and rated client advocacy as preferred. However, most subjects selected a response to the case which was an institutional advocate's response. Staff nurses expressed more disagreement with both institutional and physician advocacy than nurse managers did. Nurses from the hospital setting most often preferred the responses of the institutional advocate. Eleven of the interview subjects labeled "client advocates" expressed one of the caring orientations and were more likely to be inactive staff nurses. Five of the interview subjects labeled "institutional advocates" expressed a "mostly justice" orientation and were likely to be active nurse managers. Six others expressed one of the caring orientations. From these findings it appears that though client advocacy may be preferred conceptually, implementation in practice may require clarification and investigation. It also appears that the caring orientation is readily apparent in the "client advocates." The ramifications of the moral orientation of nurses in practice and the effect of orientation on nurses' ethical dilemmas need to be investigated further.
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Hultén, Tua, and Osobi Malin Andersson. ""Man blir behandlad som en andra klassens medborgare, eller inte ens det” : En intervjustudie om vårdpersonals bemötande – upplevelser från personer med missbruksproblematik." Thesis, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2586.
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Bakgrund: Individer med narkotikamissbruk tillhör en stigmatiserad grupp som löper stor risk att drabbas av ohälsa och därför kan förväntas ha mycket kontakt med hälso- och sjukvården. Studier har visat att sjuksköterskor har negativa attityder och försämrat bemötande gentemot denna grupp. Syfte: Syftet var att beskriva vilka upplevelser personer med aktivt eller tidigare narkotikamissbruk haft av bemötande från sjuksköterskor och annan vårdpersonal samt deras inställning till hälso- och sjukvård. Metod: En intervjustudie med kvalitativ ansats genomfördes. Resultat: Analysen av intervjuerna resulterade i fyra teman: Stigmatiserande bemötande, Motarbetande bemötande, Attityder till hälso- och sjukvården och Mänskligt bemötande är gott bemötande. Slutsatser: Deltagarna i den här studien har inom hälso- och sjukvården upplevt negativt bemötande kopplat till deras aktiva eller tidigare missbruksproblematik. Negativt bemötande mot en utsatt grupp kan leda till förstärkt utanförskap, känslor av maktlöshet och ökad risk för ohälsa. Med ökad kunskap kan sjuksköterskan ge bättre bemötande vilket skulle kunna ha hälsofrämjande effekt. Implikationer: Mer specifikt utbildningsinnehåll om beroende och narkotikamissbruk behövs både på grundutbildningen och som fortbildning för redan verksamma sjuksköterskor för att denna patientgrupp ska få ett bättre bemötande.Background: Individuals with drug abuse belong to a stigmatized group at high risk of ill-health and can therefore be expected to be in much contact with health care. Studies have shown that nurses have negative attitudes and deficient encounter towards this group. Aim: The aim was to describe what experiences persons with present or former drug abuse has had regarding encounters with nurses and other health care personnel and also their attitude regarding health care. Method: An interview study with a qualitative approach was conducted. Result: The analysis of the interviews resulted in four themes: Stigmatizing encounters, Opposing encounters, Attitudes regarding health care and Humanly encounters are good encounters. Conclusions: The participants in this study have experienced negative encounters in health care related to their present or former drug abuse. Negative encounters towards an exposed group can lead to strengthened exclusion, feelings of powerlessness and increased risk of illness. With enhanced knowledge, the nurse can provide better encounters which could have a health promoting effect. Implications: More specific education about addiction and drug abuse is needed both in the undergraduate program and as further training for practicing nurses in order to give this patient group a better encounter.
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Guay, Martine. "La pratique infirmière en procréation médicalement assistée au sein d’un établissement de santé québécois : une étude autoethnographique." Thesis, 2019. http://hdl.handle.net/1866/24542.
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Problématique : L’infertilité – considérée par l’Organisation mondiale de la santé (OMS) comme une maladie du système reproducteur – affecte de plus en plus d’hommes et de femmes, soit un couple sur six en âge de procréer au Canada et au Québec. Elle a un impact sur le bien-être physique et mental des patient.e.s, souvent stigmatisé.e.s et isolé.e.s socialement parce que, pour plusieurs, l’infertilité demeure un sujet tabou. L’infertilité est traitée en procréation médicalement assistée (PMA) où les patient.e.s-familles sont accompagné.e.s par des infirmières dont la pratique est complexe et diversifiée, mais méconnue. But : L’étude avait pour but d’explorer la pratique infirmière en PMA dans un établissement de santé québécois. Méthode : Le devis retenu est une autoethnographie où l’étudiante-chercheuse a mis à profit son expérience comme patiente et comme infirmière en PMA. Des entretiens semi-dirigés, une observation participante et un journal de terrain ont été employés pour la collecte des données. Une analyse thématique a été réalisée. Résultats : L’expérience des patient.e.s-familles en infertilité est au cœur de la pratique infirmière et l’une des principales dimensions de cette pratique est le soin relationnel, peu importe les sphères d’activités auxquelles les infirmières sont affectées au sein de la clinique. Les autres dimensions rapportées sont le leadership/advocacy, l’apprentissage/enseignement, la collaboration et les interventions techniques. Ces résultats correspondent à l’expérience de l’étudiante-chercheuse, tant à titre de patiente que d’infirmière en PMA. Retombées : L’étudiante-chercheuse a documenté la pratique infirmière en PMA, mettant en valeur une méthode peu usitée en sciences infirmières : l’autoethnographie.Problem: Infertility – classified by the World Health Organization (WHO) as a reproductive system disease – affects an ever-increasing number of women and men. Today, one couple out of six of reproductive age struggles with this condition in Canada and in Quebec. It has an impact on the patients’ physical and psychological well-being, often leaving both partners stigmatized and socially isolated as infertility remains a societal taboo for many. Infertility can be treated via Assisted Reproduction Technologies (ART) where the patients-families are cared for by fertility nurses, whose practice is both complex and diversified, but remains little-known. Purpose: This study explores the field of fertility nursing as it is practised in a Quebec healthcare institution. Method: The student-researcher chose to do an autoethnography in order to draw from her own experience as both a fertility nurse and a fertility patient. Semi-directed interviews, participant observation and field journal were used to collect data. A thematic analysis of data then followed. Results: The patients-families’ infertility experience is at the heart of the fertility nurse’s practice and relational care is the main dimension of that practice, regardless of which nursing activities are assigned to them in the clinic. These other dimensions were also reported : leadership/advocacy, learning/teaching, collaboration and technical interventions. These results coincide with the student-researcher’s experience, both as a fertility patient and as a fertility nurse. Impact: The student-researcher documented the practice of fertility nursing and showcased a method rarely used in nursing science: autoethnography.
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Tomas, Nestor Petrus Namulo. "Factors contributing to the negative behaviours of nurses in a specific public health care facility in Namibia." Diss., 2017. http://hdl.handle.net/10500/24427.
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It is important for nurses to show acceptable behaviour when interacting with the patients. The purpose of this study was to explore and describe the factors that contribute to nurses’ negative behaviour when rendering patient care and to determine the effects of nurses’ behaviour on patient outcomes.
The study used a non-experimental explorative and descriptive quantitative design. Data collection was done using a structured questionnaire. The sample comprised of 64 respondents which consisted of 25 registered nurses and 39 enrolled nurses.
The study found that besides the known contributing factor, that is, the shortage of nurses, further identified contributing factors to nurses’ negative behaviour when rendering patient care are failure to retrain nurses identified with negative behaviours, poor condition of employment and patients’ behaviours and cultural beliefs. These results suggested a need to train more nurses, improve conditions of employment, as well as support and retrain nurses identified with negative behaviours.Health Studies
M.A. (Public Health)
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Legault, Alain. "La transformation du rôle de représentante d’aidantes familiales pendant l’hébergement de leur parent atteint de démence : une théorisation ancrée." Thèse, 2004. http://hdl.handle.net/1866/581.
Full textAbstract:
L'hébergement en centre de soins de longue durée d'un parent âgé atteint de démence marque une transition pour les personnes qui occupent un rôle d’aidant familial principal. Ces personnes, principalement des femmes, poursuivent leur engagement après l’hébergement et souhaitent être impliquées dans les décisions concernant les soins offerts à leur parent. Souvent l'hébergement survient au moment où la personne âgée n'est plus en mesure, compte tenu de ses déficiences cognitives, d'exprimer clairement ses besoins; les aidantes accordent alors une place centrale au rôle de représentante de leur proche hébergé.
Cette étude avait pour but d’expliquer la transformation du rôle de représentante chez des aidantes familiales dont le parent atteint de démence vit dans un centre d’hébergement et de soins de longue durée (CHSLD). La méthode qualitative de la théorisation ancrée a été retenue pour expliquer ce processus social. Les résultats obtenus reposent sur 14 entrevues en profondeur réalisées auprès de filles dont le parent atteint de démence était hébergé depuis plus de six mois dans un CHSLD. Ces aidantes ont été sélectionnées selon une procédure d’échantillonnage théorique et l’analyse des données a été réalisée à partir de la transcription intégrale des entrevues en suivant trois niveaux d'analyse, soit la codification ouverte, axiale et sélective.
Une proposition théorique, générée par voie inductive, met en lumière trois processus intermédiaires interreliés expliquant la transformation du rôle de représentante pendant l’hébergement du proche : 1) l’intégration dans le milieu ; 2) l’évaluation de la qualité des soins et 3) le développement de la confiance envers le milieu d’hébergement. Plus précisément, les aidantes déploient différentes stratégies d’intégration dans le milieu d’hébergement, soit l’établissement de relations de réciprocité et d’une collaboration avec le personnel soignant, ainsi que l’utilisation d’un style de communication diplomatique. Parallèlement, elles évaluent la qualité des soins en trois étapes : jugement, pondération et action. Finalement, une relation de confiance avec les membres du personnel de l’établissement se développe en lien avec cinq facteurs spécifiques, soit les premières impressions, la comparaison avec d’autres CHSLD, l’intérêt démontré par le personnel envers le proche, le fait d’être entendue et prise au sérieux et la transparence du milieu d’hébergement. Ces trois processus contribuent au bien-être du parent hébergé et à celui de l’aidante. Le développement de la confiance étant associé aux deux autres processus intermédiaires ainsi qu’au bien-être de l’aidante, il est le processus central de la théorie contextuelle qui émerge de cette recherche.
Cette étude contribue au développement des connaissances, notamment en fournissant plusieurs éléments inédits de compréhension du processus de transformation du rôle de représentante des aidantes familiales, de même que des pistes pour soutenir ces aidantes dont le parent, souffrant de démence, n’est plus en mesure de prendre des décisions. La théorie contextuelle proposée dans le cadre de cette étude constitue les prémices d’une théorie de niveau intermédiaire portant sur le rôle de représentant des aidants familiaux dans le contexte plus général du système de santé. Des études réalisées dans d’autres contextes de soins et auprès d’aidants de proches vulnérables ayant d’autres types d’affections sont ainsi recommandées.The institutionalization of an elderly parent, suffering from dementia, represents a transition for the primary family caregiver. Following the institutionalization, that person, mainly a female caregiver, pursues her engagement and wants to be involved in the parent’s care decision making. The admission often takes place when, due to cognitive impairment, the elderly is no longer able to clearly articulate his or her needs. At this point, family caregivers assume the central role of advocate, voicing the needs of their institutionalized relative. The purpose of this qualitative study was to explain, using a grounded theory approach, the social process of transformation of family caregivers’ advocacy role after nursing home admission of a relative suffering from dementia. Fourteen daughters, taking care of their cognitively impaired mother or father living in a nursing home for more than six months, were interviewed using a semi-structured interview guide. Participants were selected according to a theoretical sampling strategy. Transcribed verbatim was analyzed according to three analytical procedures: open coding, axial coding and selective coding. An inductively generated theoretical proposition reveals three interrelated processes to explain the transformation of the family caregiver advocacy role: 1) integration in the nursing home; 2) quality of care assessment; and 3) trust building. Caregivers use various strategies for their integration in the nursing home, namely establishing collaborative and reciprocal relationships with staff members and using a diplomatic style of communication. They simultaneously assess the quality of care following three steps: appraisal, valuation, and action. Finally, they build a trustful relationship with the health care team along five factors: the first impression, the comparison with other nursing homes, the interest shown by the staff towards the relative, the fact of being listened to and taken seriously by the staff, and the transparency of the institution. These three processes contribute to the well-being of the relative as well as with the well-being of the caregiver. As trust is related to most factors identified, it was identified as the core variable of the emergent theory proposed in this study. This study contributes to further our understanding of an important family role after nursing home admission of an elderly parent, i.e. the advocacy role. It suggests ways to support these caregivers whose cognitive impaired parent is not able to take his or her own decisions. The situation-specific theory proposed in this study lays the foundations of a middle-range theory on the advocacy role of family caregivers in the health care system. Further studies are needed in other care settings and with caregivers dealing with relatives affected by other ailments.