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1
Hung, Lillian Mei. "Co-creating person-centred care in acute care." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/63363.
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Patients with dementia in acute care often experience poor outcomes, as nurses and
other staff in hospitals are not equipped to provide good dementia care. Person-centred care
has been recognized as the best practice for dementia care, but its application in hospital
environments remains unclear. This action research involved patients with dementia, a team
of staff members, and public advisors to co-create changes in a medical unit.
The objectives of the project were to: (a) develop person-centred care in a medical
unit, (b) explore ways to support the involvement of patients with dementia in research, (c)
examine the processes of staff engagement for bringing together staff from different
disciplines to co-inquire, and (d) evaluate the impact of research on the process of change
and identify the lessons learnt to inform practice, education, policy, and research. Various
methods were used such as: interviewing patients with dementia, focus group sessions with a
team of inter-disciplinary staff, and participant observations.
In this thesis, I argue for a new positive and collaborative approach that views change
as a continuous process. In the past, the problem-focused model that sees change as fixing
people has largely failed with regards to advancing practice developments in dementia care.
An important outcome of this research is the heuristic guide ‘Team Engagement Action
Making’ (TEAM), which can be used to support teams to engage staff in co-creating positive
change. The results of this study indicate that appreciative inquiry is a useful strategy for
engaging people on a team to learn together and to co-create a better future of care. The
findings also suggest that more attention should be paid to the dynamic inter-connection of
research and practice, rather than just one or the other. The results demonstrate that action
research can affect the process of change by generating positive energy, attitude change, and momentum for action activities in the unit and beyond. Future research should further
explore strategies that would maximize the potential of bringing patients, families,
researchers, and practitioners to work together for positive change. Supplementary material : http://circle.library.ubc.ca/handle/2429/63499Applied Science, Faculty of
Nursing, School of
Graduate
2
Cole, Min. "Implementation of Person-Centered Care [PCC]." Thesis, University of North Texas, 2005. https://digital.library.unt.edu/ark:/67531/metadc1505202/.
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To meet the growing demand for community-based adult services (CBAS) adult day health care (ADHC) programs, it is important these programs make the necessary modifications in their systems of care to embrace a person-centered care (PCC) model. This study was designed to create an assessment to determine a community-based CBAS/ADHC program's readiness to meet the new federal standards as determined by the program's current operational evidence and by center participants', their families' as well as staff's perspectives. This was measured by self-report of access to the community, choice of setting, individual rights, autonomy and independence, choice of services and supports, center accessibility as well as their needs and preferences in the practice. Results will assist similar CBAS/ADHCs in identifying the necessary modifications within their own program to continue as a certified licensed entity and remain a viable agency.
3
Flesner, Marcia K. "Person centered care : a model for nursing homes /." free to MU Campus, others may purchase, 2003. http://wwwlib.umi.com/cr/mo/fullcit?p3091924.
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4
Strollo, Jennifer Miranda. "Direct Care Staffs’ Experiences and Perceptions of Person-Centered Care Training." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7756.
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Many long-term care (LTC) facilities within the United States have replaced the institutional model of care with one that accepts person-centered care (PCC) as the guiding standard of practice. Quality training ensures that direct care staff have the skills and the knowledge in the delivery of quality PCC. However, many nurses and nursing assistants have expressed the desire for further training in PCC practices to effectively deliver quality care. The purpose of this study was to explore the types and length of training and education provided based on the perceptions and experiences of direct care staff related to their implementation of PCC practices. The theoretical framework for this study consisted of Rogers’ PCC approach theory and philosophy. A qualitative interpretative phenomenological design was used to examine the perceptions of training and education of 20 certified nursing assistants using semistructured interviews. Once the interviews were conducted and transcribed, the data were coded into superordinate themes that stemmed from participant responses. Themes of PCC practices, teaching modalities, learner type, length, and introduction of training were identified as a result of the data analysis. The data also revealed that it is important for LTC facilities to be aware of how they are providing PCC education and training to their staff so that they may provide their residents with quality individualized care that emphasizes the whole person. Study findings may inform LTC administrators, leaders, and managers on the deliverance of effective training and educational practices when implementing PCC models within their facilities. The results may also spur national LTC organizations to refocus their core beliefs, values, and culture towards a culture that considers the whole person.
5
Heston, Jennifer L. "The Role of Direct Care Workers in Person-Centered Home Care." Miami University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=miami1491987309873559.
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6
Mills, Ian James. "The delivery of person centred care in general dental practice." Thesis, Exeter and Plymouth Peninsula Medical School, 2018. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.758419.
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Person-centred care (PCC) is recognised as one of the key domains in measuring quality within health care, with patient feedback playing an increasingly important role in assessing the level of service delivered. This has been developed within the general medical services in the UK through the Quality Outcomes Framework and a similar model within general dental practice is currently being piloted. Measurement of PCC as an indicator of quality is likely to be highly relevant within the new Dental Quality Outcomes Framework (DQOF) and the Care Quality Commission key lines of enquiry toolkit. It is important that we are able to understand what we aim to measure before we can consider implementing a tool with which to measure it. This research project aims to understand what is meant by the term "person-centred care” in relation to general dental practice, with the intention that the findings may subsequently be used to inform development of a suitable tool to accurately measure PCC in the future. The research strategy was based on a systematic review and the use of qualitative methods to explore the views of patients and dentists towards PCC in dentistry. The systematic review identified a limited body of research associated with PCC in dentistry, with no studies involving the views of patients. This limited information was used in conjunction with the findings from my qualitative research to identify the key features which are relevant to the delivery of PCC in general dental practice. These features were categorised as relational and functional aspects of care. Relational aspects of care were considered to be closely aligned to the provision of PCC and viewed as an integral feature of its successful delivery. Four dimensions of relational aspects of care were identified: • Connection • Caring attitude • Communication • Control Two sub-categories of functional aspects of care were identified as physical environment and healthcare system, and these were considered to be influencing factors in the delivery of PCC. A provisional model of PCC was developed based on fhe research findings from the patient interviews and introduced during the dentist interviews. It is suggested that future research should include testing of this model to allow refinement and validation.
7
Hill, Heather, and heatherhill@hotkey net au. "TALKING THE TALK BUT NOT WALKING THE WALK: BARRIERS TO PERSON CENTRED CARE IN DEMENTIA." La Trobe University. School of Public Health, 2004. http://www.lib.latrobe.edu.au./thesis/public/adt-LTU20041215.100826.
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While the concept of person-centred care in dementia has been around for 15 years or more and has attracted much interest and enthusiasm, aged care facilities continue to have difficulty in actually implementing and maintaining person-centred practices. In this study I explore the experience of one aged care facility in order to identify the barriers to changing care practice. The research took place in an ethno-specific (Jewish) aged care facility, Star of David, which was in the process of setting up a program for its residents with dementia based on person-centred principles. The methodology used in the research study was ethnographic, involving participant observation and interview, with a particular focus on a limited number of participants: four residents and their families, four senior staff, four personal care attendants and the executive director. Interviews were also conducted with staff members from three other aged care facilities. The findings showed that Star of David was unable to bring about substantial change in its care practices, while the external interviews and the literature suggest that other facilities have similar difficulties. I identify three major types of barrier: procedural barriers within the institution itself; (government) policy; and barriers relating to hegemonic values and beliefs which underpin established health care practice. These three types of barrier interact with and reinforce one another. I conclude that if we are to change care practice in institutions, we must address all of these barriers at the same time. Finally, I suggest that person-centred care itself, which continues to place emphasis on professional service provision, may only be the beginning of necessary change. In order to be truly person-centred, we need to move towards a more community based or public health approach which recognizes the need of all persons to be treated both as significant individuals and accepted as part of a community.
8
Ashburner, Charlotte Hill. "Person-centered care : using systemic and psychodynamically informed action research." Thesis, City University London, 2005. http://openaccess.city.ac.uk/8476/.
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This paper describes a three-year action research project, aimed to support staff in recognising and responding to loss of personhood in a continuing care setting. The context of this study was a National Health Service (NHS) nursing home for the long term care of older people. Interventions used to support this development included the collection and sharing of residents' life histories, weekly team supervision meetings for staff, an action learning set for managers, and monthly external supervised meetings for both the action researcher and senior manager. This paper reports on the processes and outcomes of change achieved and the learning gained from working in a collaborative way with staff. Given that current policy indicates the need for person-centred care (Department of Health 2001a), this study provides a possible mechanism for putting it into practice, through a systems and psychodynamically informed approach.
9
Cole, Min. "Implementation of Person-Centered Care (PCC): A Descriptive Case Study." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1505202/.
Full textAbstract:
To meet the growing demand for community-based adult services (CBAS) adult day health care (ADHC) programs, it is important these programs make the necessary modifications in their systems of care to embrace a person-centered care (PCC) model. This study was designed to create an assessment to determine a community-based CBAS/ADHC program's readiness to meet the new federal standards as determined by the program's current operational evidence and by center participants', their families' as well as staff's perspectives. This was measured by self-report of access to the community, choice of setting, individual rights, autonomy and independence, choice of services and supports, center accessibility as well as their needs and preferences in the practice. Results will assist similar CBAS/ADHCs in identifying the necessary modifications within their own program to continue as a certified licensed entity and remain a viable agency.
10
Hughes, LaTonya Dickerson. "The Nurse and Certified Nursing Assistant Perception of Person-Centered Care." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6585.
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Over the last decade, long-term care facilities have transitioned from institutional care models that focus on person-centered care, in which the resident is the center of the care. The purpose of this study is to explore the nurse and certified nursing assistant perception of the person-centered care services they deliver. Jean Watson's theory of human caring is the theoretical framework that guided this study. The theory focusing on the human caring experiences and person-centered care is being characterized as a caring feeling. The carative factors of Watson's theory, the fundamental concept of caring, has been associated with improved outcomes for the resident and the caregiver. Using a phenomenology research design, 3 focus groups of 15 nurses and 10 certified nursing assistants (CNA), working in a long-term care facility, were asked questions to describe their perception of person-centered care. The responses from the 25 participants were stored and organized using Nvivo. The thematic analysis revealed that the nurses and CNAs perceived person-centered care to include the caring and compassionate approach taken when care is being delivered. The participants also shared that person-centered care included involving the resident in decision making through communicating openly and developing relationships. The discussions revealed that 8 carative factors influenced their understanding, with the main factor being the creative problem-solving method for decision making. The �ndings from this study have the potential to impact positive social change at the organizational level, influencing the delivery of care within long-term care settings.
11
Ndeutchoua, Laure Bertille. "Facilitating Person-Centered Care for People with Intellectual and Developmental Disabilities." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3186.
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The patient centered care (PCC) model is recommended by the Institute of Medicine for individuals with intellectual and developmental disabilities. The problem identified in this quality improvement (QI) project was that PCC practices had not been included in the training curriculum within the organization. Framed within the plan-do-study-act model of QI, the purpose of this project was to develop an educational initiative on PCC that included a curriculum plan, a pretest/posttest, a protocol, a revision of the training policy, and an implementation and evaluation plan. Drawing upon the evidence-based literature and using a team approach, a curriculum plan on PCC practices was developed which included a pretest/posttest to evaluate staff knowledge on the curriculum before and after the training. Three content experts from the committee approved the curriculum and validated the pretest/posttest items. The content validation index was 0.99 showing that each item reflected the content and objectives of the curriculum. As well, a training protocol was developed which identified the steps for provision of the curriculum to maintain consistency for all users. The training policy was revised to set expectations for all staff for the incorporation of the PCC practices into the organization. This initiative will be implemented into the organization using Kurt Lewin’s model of change to guide PCC practices. A recommendation was made to add a small section on “people’s first language” to the training to preserve patients’ dignity and respect during communication. This project contributes to social change by promoting PCC practices among healthcare workers thus limiting healthcare disparities and improving access for persons with intellectual developmental disabilities.
12
Ross, Helen. "Understanding and achieving person-centred care in an acute medical ward setting." Thesis, Sheffield Hallam University, 2015. http://shura.shu.ac.uk/20799/.
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Person-centred care is a concept often referred to in healthcare. However, it is unclear how it applies to everyday clinical practice. This qualitative study aimed to explore how the concept was understood and achieved in an acute medical ward setting in order to identify potential areas for development related to research, education and practice. The research design was influenced by an interpretive approach with the aim of accessing the meanings that participants assigned to the phenomenon of person-centred care and making this evident to others. A purposive sampling strategy identified 21 participants. These consisted of seven registered nurses, four student nurses, three healthcare support workers, three allied health professionals, two professional development co-ordinators and two nursing lecturers, who all took part in either individual or paired semi-structured interviews. Gathering data from this range of practitioners adds new perspectives to the body of knowledge on person-centred care. Data were analysed using Framework Analysis, which resulted in a model of person-centred care being developed iteratively as a result of data analysis, a priori knowledge of the researcher and the findings of the literature review. The study findings emphasise that all elements of the model; organisational culture, the philosophy of the care environment, characteristics of relationships, personal qualities of staff and principles of person-centred care interlink with each other to indicate what needs to be in place for person-centred care to be achieved. The model also provides a possible structure to inform the planning of future development within education and practice. The study outcomes identify potential areas for development within research, education and practice. These include, working towards a shared vision of person-centred care in the study setting by using work based activities in order to identify ongoing development needs; the testing and evaluation of the use of the model of person-centred care in practice and education and the investigation of the feasibility of conducting a health economic study to explore the cost-benefit of providing person-centred care in acute care settings.
13
Kelson, Elizabeth Ellen. "Challenges of person-centred dementia care : a critical ethnography of culture change in long-term care." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/44261.
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To address shortcomings in traditional long-term residential care (LTRC), facilities are increasingly adopting person-centred care (PCC) approaches. Despite the proliferation of PCC models and discourses, there is limited understanding in gerontology of how such approaches are experienced on the ground. This dissertation addresses this gap through an ethnographic study of Cedar Grove, a large facility located in an urban centre in Western Canada that is undergoing culture change. During 12 months of fieldwork, I explored the range of issues this organization encountered as it endeavours to maintain the “person” at the centre of care. The purpose of this study is to contribute empirical data on how this orientation shapes daily life for residents, families, staff and administrators.
This study is informed by the literatures of PCC and personhood theory, and it draws on a conceptual framework integrating critical, feminist and Foucauldian gerontology. It analyzes care across personal, interpersonal, and organizational levels, and considers the broader social-political-economic context of LTRC. Data generation employs multiple methods: participant observation, Dementia Care Mapping (DCM), group meetings, individual interviews, researcher-produced photographs, and a review of relevant organizational and policy documents.
Findings reveal organizational tensions between ideals of safety and PCC, multifaceted challenges to relational care, and the importance of everyday activity toward social inclusion. Data suggest five key implications: 1) Intersectionality highlights residents’ disparate access to social inclusion and ways to support more heterogeneous populations, 2) Increased access to unstructured, everyday activity might address boredom and foster meaning in residents’ lives, 3) Job descriptions might better prioritize social care and flexibility in work roles to better address issues of time constraints, workload, and resident acuity, all of which challenge PCC, 4) Organizational support for narrative-based biography is vital to overcoming systemic barriers to its use in practice. Finally, 5) A methodological implication of this study relates to how DCM facilitated insight into residents’ non-verbal expressions of personhood and bodily, affective communications. The mobilization of this research to practice during fieldwork highlights DCM’s ability to convey positive practice skills in a way that supports uptake, positively impacting residents’ quality of life.
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Boström, Eva. "Proximity and distance : challenges in person-centred care for diabetes specialist nurses in primary health care." Doctoral thesis, Umeå universitet, Institutionen för omvårdnad, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-80908.
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Background Type 2 diabetes demands self-management over time, to maintain health and reduce the risk for diabetes complications. However, despite efforts, many persons with type 2 diabetes are not reaching the treatment targets. In diabetes, person-centred care and group education are recommended. Diabetes specialist nurses (DSNs) working in primary healthcare have an important role in supporting patients with type 2 diabetes in their self-management to adapt to the demands of the disease in everyday life. Therefore, it is important to explore the DSNs’ professional role and their experiences of practising person-centred care. The overall aim of the thesis was to explore the professional role of DSNs in primary healthcare, and to describe their experiences of person-centred diabetes care. Methods The thesis includes three studies with qualitative, and one with a quantitative, approach. Data collection consisted of focus group interviews, individual interviews, observations, and questionnaires. Qualitative content analysis and statistics were used in the analysis. In studies I and II, 29 and 31 DSNs participated, respectively. In study III, 10 DSNs and 44 persons with type 2 diabetes participated. Lastly, in study IV, 10 DSNs participated. Results The results in the thesis showed that DSNs have a complex and multifaceted professional role that entails striving to be an expert, a fosterer, a leader, an executive, and a role model, which they found challenging. The DSNs perceived high job demands, such as decision-making and learning. The thesis also showed that the interaction between DSNs and persons with type 2 diabetes shifted from empowerment to authority struggles during group support sessions based on person-centred care. The experience of person-centred care was described as enriching, but DSNs also expressed ambivalence, related to an altered professional role. Conclusion There is a desire by DSNs to be close to persons with type 2 diabetes, although they have several challenges to fulfil, which makes it difficult to uphold a relation with proximity; thus, distance is also present. Even though person-centred care is recommended in healthcare, and despite DSNs’ efforts to practise PCC, the result of this thesis shows that it also implies an altered professional role for DSNs that has to be addressed.Diabetes intervention in Västerbotten, DIVA 2
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Mcintosh, Catriona. "Person centred care in neurorehabilitation : current research and how it can be developed." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/person-centred-care-in-neurorehabilitation--current-research-and-how-it-can-be-developed(843ffbca-62f0-49b3-b4ce-a71749274bd0).html.
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This thesis aimed to critique the research on person centred care (PCC) in neurorehabilitation, and consider how PCC in this setting can be further developed. Paper One reviews the extant literature on PCC in neurorehabilitation. The literature search returned 27 papers, which were critiqued for quality, how they conceptualised PCC, how they practiced PCC and the feasibility of PCC. Conceptualisations of PCC used varied from narrow conceptualisations of PCC as participation in goal setting, to broader ones which also incorporated issues such as shared decision making, outcomes, respect and emotional support. Similarly, methods of practicing PCC primarily used goal setting, with a minority of papers addressing outcomes and communication aspects of PCC. The review found that PCC is feasible for neurorehabilitation, with important benefits for clients and professionals. Providing PCC in neurological rehabilitation can be challenging and the literature review discusses ways to overcome barriers to PCC. The literature review highlights the need for methods to assess and develop PCC which are suitable for people with and without cognitive impairments. Paper Two addresses this need, by presenting research investigating the feasibility of using Dementia Care Mapping (DCM) on a neurorehabilitation ward. DCM is an observational method aims to document the quality of care from the perspective of the patient. DCM was found to be feasible for use on a neurorehabilitation ward, as shown by the suitability of the coding system. Q-methodology was used to assess staff perceptions of DCM. This further supported DCM feasibility, with staff reporting that DCM provided useful information for staff that they could use to improve the care they provided. DCM required some minor amendments in order to be used in a hospital rehabilitation environment and further amendments could improve its suitability for use in neurorehabilitation settings. Paper Three is a critical appraisal of both the literature review and research paper. The strengths and weaknesses of the use of both DCM and Q-methodology are critiqued, and consideration given to the limitations of the research.
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Caspar, Sienna. "The influence of information exchange processes on the provision of person-centred care in residential care facilities." Thesis, University of British Columbia, 2014. http://hdl.handle.net/2429/46316.
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Purpose: The movement away from task-oriented care toward the consistent provision of person-centred care (i.e., care based on residents??? needs and preferences) is widely recognized as the goal of the residential care culture change movement. The purpose of this study was to explore why the attainment of this goal has remained elusive for many residential care facilities (RCFs), despite significant effort to alter practice.
Methods: I conducted an institutional ethnography to explore the textually mediated work processes that influence the day-to-day work practices of front-line care staff in RCFs. The social organization of RCFs was explored through the observation of resident care attendants??? (RCAs') practices and the interaction of those practices with institutional texts. The data were derived from three RCFs and included 104 hours of naturalistic observation, 76 in-depth interviews, and document analysis.
Results: Practical access to institutional texts containing care-related information was dependent on job classification. Regulated healthcare professionals (e.g., RNs) frequently accessed these texts to exchange information. Although RCAs provided 80% of the care to residents, in all sites studied, they lacked practical access to the institutional texts that contained important information relevant to the residents??? individualized care needs and preferences (e.g., assessments, care plans, social histories). The RCAs primarily received and shared information orally; however, the organizational systems in the facilities studied mandated the written exchange of information and did not formally support an oral exchange. Consequently, the oral exchange of care information was largely dependent upon the quality of the RCAs' working relationships with one another and especially with management. Implications: Access to detailed knowledge of residents??? needs and preferences is fundamental to the provision of person-centred care. The transfer of this knowledge to and between front-line care staff is dependent upon the quality of the relationships managers develop with and among RCAs. Initiatives aimed at building supportive and collaborative work teams are essential to the inclusion of RCAs in the care planning process and to the attainment of the goal of person-centred care.
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O'Hanlon, Katie. "Improving person-centred care in acute healthcare settings : an investigation of care mapping in the clinical neurosciences." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/improving-personcentred-care-in-acute-healthcare-settings-an-investigation-of-care-mapping-in-the-clinical-neurosciences(7d58b60c-1fde-4291-a043-fb6673210194).html.
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This thesis considers the provision of person-centred care (PCC) in acute healthcare. In recent years it has been increasingly recognised that healthcare should be delivered in a person-centred manner and that staff should receive training and support in relation to this. There is a growing body of literature investigating the potential benefits of PCC in relation to both patient and service level outcomes. Paper one of this thesis is a systematic review of the literature examining staff training interventions for improving PCC in acute healthcare settings. The findings offer preliminary support for the positive impact of such training interventions on patient and service level outcomes in hospital environments. The research in this area is not of a uniformly high standard and this paper concludes that further research in this area is required. Paper two is an examination of a modified version of Dementia Care Mapping (Care Mapping – Neurorehabilitation: DCM-NR), an observational tool for measuring and improving PCC. Results provide evidence of the feasibility and validity of DCM-NR in a range of Clinical Neuroscience settings. Future research should examine the impact of DCM-NR on person-centred practices over time.The critical reflection paper considers both the systematic review and the empirical study. It aims to consider both the strengths and limitations of the research, challenges encountered, clinical implications and highlights areas for future research.
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Louw, Brenda, and Linda Vallino. "Person Centered Cleft Care: Evolutionary Practice by Giving Our Clients a Voice." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7756.
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Cattoor, Erin. "The Effectiveness of Cares Dementia Training Modules on Delivery of Person Centered Care Inside a Memory Care Unit| Utilizing the Cares Observational Tool." Thesis, University of Missouri - Columbia, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13877136.
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This study compared the efficacy of using online dementia training modules on both direct and non-direct care providers in long-term care settings and how this impacted their delivery of Person Centered Care (PCC), as well as their knowledge of caring for residents with a diagnosis of Alzheimer Disease (AD), dementia. Traditional educational opportunities for staff working specifically with demented residents inside Memory Care Units (MCU) were investigated, along with an alternative approach of training all staff (to include direct and non-direct care providers). The option of utilizing online dementia training modules for all staff was then evaluated by using an observational Person Centered Care tool, to see if education had made an impact on interactions between staff and the demented residents that they care for. This study utilized a single-group, repeated measures design to test a 10-week, standardized and computerized set of 10 interactive training modules in a 60-bed MCU . Fifty-one observations were made between MCU residents and staff and included in this study, employing a single-group pre-post-posttest design. The findings suggest that online dementia training modules may be beneficial for both knowledge and delivery of PCC to staff in MCUs who care for residents with a diagnosis of AD.
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Nelson, Heather McKay. "What Matters Most: PASSPORT Home Care Aides' Views on Ohio's Initial Steps to Implement Person-centered Care." Miami University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=miami1429869685.
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Scales, Kezia. "Doing what makes sense : locating knowledge about person-centred care in the everyday logics of long-term care." Thesis, University of Nottingham, 2014. http://eprints.nottingham.ac.uk/13941/.
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Addressing criticisms of the routine-driven, task-oriented, depersonalising nature of conventional services, and reflecting a broader trend across health and social care, person-centred care has become the watchword for quality in long-term care for older people in recent years. Person-centred care requires recognising the unique personhood of each individual regardless of their physical or mental capacity. Efforts to realise this approach depend largely on the non-professional nursing staff who deliver the majority of direct care in this context. However, little is known about how new knowledge, including ideas and evidence about person-centred care, translates into the daily practices of this cadre of staff, who have little formal training, low job status, and limited access to traditional forms of research dissemination and knowledge exchange. Building on the existing knowledge-translation literature, therefore, the aim of this study was to explore the mechanisms of knowledge translation about person-centred care among care assistants in long-term care. The objectives were to examine how these staff develop their understanding of person-centred care; identify the personal and contextual factors involved; and explore what can be learned about person-centred care from their current practices. The study used ethnographic methods, including 500 hours of participant observation, in-depth interviews, and document analysis, to conduct case studies of two private nursing homes located in the East Midlands and the north-eastern United States. Without claiming to demonstrate causality, extending the research across two policy settings did facilitate the identification of pertinent issues within and beyond each individual facility. Data analysis was informed by practice theory, which provided an alternative to the individualist assumptions which characterise popular representations of long-term care, on the one hand, and, on the other, structural explanations that renounce individual agency altogether. From this theoretical perspective, drawing in particular on Bourdieu‘s theory of practical logic and the neo-institutional concept of institutional logics, this study identified how the interconnection of particular practices within each setting produced different situated understandings and implementation of person-centred care. A key finding was that care assistants' individualised knowledge about each resident, obtained through their direct daily care, represented an important form of symbolic capital in this field. Their willingness or reluctance to share such knowledge, consequently, corresponded to the extent to which other practices, including communication and teamwork, supported or threatened this limited source of power. The second, related finding was that care assistants derived from this individualised knowledge a certain amount of autonomy, or discretion, over the organisation and delivery of daily care. This discretion, together with the agency that care assistants exercised in navigating different institutional logics in this context of care – which was the third main finding – signified a potential nexus of practice change. Conversely, new knowledge or ideas that undermined this limited discretion and agency tended to engender denial or resistance. As the population ages, demand for long-term care for older people is increasing exponentially, prompting concerns about the capacity and sustainability of this sector. One significant area of concern is workforce recruitment, retention, and competence. This study, located at the intersection of research on long-term care and knowledge translation, contributes to efforts to address these concerns by identifying opportunities for intervention in education, training, and support, in order to build a workforce that is equipped to provide high-quality, evidence-based, person-centred care for older people throughout the years ahead.
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Stock, Debbie G. "Exploring Person-Centered Accountability as a Complementary Approach to Regulatory-Centered Accountability| An Action Research Study." Thesis, Northcentral University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3728217.
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Accountability in healthcare tends to dominate discussions focused on improving the quality of care, the experience of patients, pay-for-performance, and engaging employees to produce positive performance outcomes. Organizational leaders are held to answer to external regulatory agencies about performance outcomes based on prescribed standards. Frequently, these agencies adopt a punitive approach by imposing rewards and penalties for achieving or failing to meet the performance standards. Furthering the challenges, organizational leaders are expected to model accountability, hold employees accountable, and be a source for inspiration and motivation. The purpose of this qualitative action research study was to examine person-centered accountability (PCA), or the use of positive leadership, positive practices, and positive emotions, as a complementary approach to regulatory-centered accountability (RCA). Six workshops influenced by appreciative inquiry, a practice period, participant journals, interviews and the use of a portable biofeedback device to measure positive emotions were all utilized to develop an understanding of participant’s experiences and perceptions about the value of PCA and RCA. Participants were clinical and non-clinical leaders at a Midwest medical center. Results from this study revealed the participants’ perception about the holistic and interdependent nature of PCA and RCA. Integrating PCA and RCA requires a change in philosophies as well as day-to-day accountability practices. Leaders and employees need to use both PCA and RCA to improve performance outcomes, therefore, it is important to create an organizational reset to change beliefs about accountability, build leadership capacity, and invest in employees. Future research is needed to evaluate the long-term impact of PCA and RCA on performance outcomes in and out of healthcare.
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Corner, Lynne. "Developing approaches to person-centred outcome measures for older people in rehabilitation settings." Thesis, University of Newcastle Upon Tyne, 1999. http://hdl.handle.net/10443/629.
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The rationale for this study was the need to bring a social science perspective to developing approaches for person-centred outcome measures in rehabilitation settings for older people. To date this field has largely been dominated by clinicians and the biomedical model of impairment, disability and handicap. Qualitative methods (findings from focus group discussions informed later focus interviews with individuals) were used to establish and explore the views of older people about a range of issues linked to conceptualising outcome, including participating in decisions regarding their health, to examine how older people made judgements, what they valued and prioritised, what their expectations were, how care was experienced and how changes are sustained over time. Symbolic interactionism and grounded theory provided the overall theoretical approach to the methods used. A distinction is made between older people's 'public' and 'private views'. This analytical distindon provides the framework within which the accounts are explored and presented in the thesis. The public accounts focus on the social and moral obligations associated with the experience of being an older citizen. The thesis explores the role of reciprocity, justice and conscience in these accounts. The private accounts reveal the wide range and diversity of opinion and experiences that exist. Three groups of people were identified: empowered, reluctant collaborators; and dominated. It is argued that future best practice for outcome evaluation in health and social care professionals will need to explore the private views of older people in greater depth. Institutionalised ageism and structured dependency are major barriers to empowering older people to participate in identifying outcomes. Until these issues are recognised and resolved, more meaningful participation in the identification and method of assessment of outcomes is unlikely. The findings should be of relevance to researchers, to users of health services and to clinicians working in rehabilitation settings for older people.
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Khan, Tasrina. "Staff and Family Perspectives Regarding Person Centered Care for Adults With Intellectual Disability." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6593.
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Individuals with intellectual disabilities often require additional support in performing daily activities as compared to individuals without intellectual disabilities. New York's Office for Developmental Disabilities developed the eight hallmarks of person centered planning to help individuals with intellectual disabilities understand the options available to them regarding care and support and to advocate for themselves and their rights. Researchers have yet to articulate how guardians and professional care providers of individuals with intellectual disabilities experience person centered planning in day habilitation. Thus, using a qualitative phenomenological approach, 5 direct care staff and 5 guardians of individuals with intellectual disabilities were interviewed to understand their perspectives on the 8 hallmarks of person centered planning. The conceptual framework of this study was Piaget's theory of constructivism and Bandura's theory of social learning. I used the Colaizzi method for phenomenological analysis. Following that I used the NVivo 11 qualitative data analysis software package for finding common themes. The results of this study showed that guardians and professional care providers desired more communication and training about the 8 hallmarks of person centered planning to provide the greatest benefit to individuals with intellectual disabilities. Implications for further training of staff and families, and tracking the outcomes of the eight hallmarks of person centered planning for quality of life in clients could result in policy changes for the frame of care offered to people with intellectual disability.
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Boden, Christopher. "Older people and 'person-centred' podiatry : a critical evaluation of two models of care." Thesis, University of Gloucestershire, 2007. http://eprints.glos.ac.uk/1989/.
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Older people are often portrayed as a disadvantaged and silent group in society, whose views have been largely ignored. Demographic studies suggest the number of people over 75 years of age, as a percentageo f the population in coming years is likely to substantially increase, which will place greater demands on healthcare services. In the last two decades, health policy has focused on delivering high quality services based on individuals' needs, with a greater emphasis placed on individuals being involved in decisions about their care. This policy direction has facilitated a change in power relationships between patients and professionals and will require providers of healthcare to focus on delivering 'patient-centred' care at times and places that meet individual's needs and expectations. The aim of this researchw as to evaluatet he current medical model provision of NHS podiatry with the biopsychosocial model which claims to provide 'holistic', patient-centredc are. An important aim of this research was to provide a greater and more informed understandingo f what older people communicate about their 'lived' experiences, the significance of those experiences on care-seeking and their expectations of appropriate podiatry care. The research was undertaken with older people living in east Gloucestershire, who were 75 years old or over, and had requested NHS podiatry. The study was underpinned by a qualitative methodology, strengthened by a desire to change current clinical practice and inform health policy. The research methodology included involvement of participants in an innovative reminiscence technique, and as a consequence the 'podiatry patient career' was constructed. The texts generated from the participants were examined using an interpretative phenomenological analysis to ensure a 'person-centred' focus because it was imperative to hear the voices of the 'Participants' and not just the medical model 'patients' narrative. A portrait was revealed of older people who were conscious of their position in the life course and their own mortality, together with the effect this had on how they conducted their lives. The participants' raised consciousness of their 'self' affected their expectations, feelings, and interaction with others. For many of the participants there appeared a vicious circle of impending frailty that led to a diminishing circle of contacts which had an effect on their wider social activities and relationships. At this stage, participants perceived a resolution of their foot-care needs to be of great value and importance in maintaining their well-being which, assisted by the podiatrist, resulted in a handing over of the responsibility for their care. The conclusion is that neither model delivers 'person-centred' care to meet participants' expectations and foot-care needs. A new model is presented where differing and changing priorities, at different times of the participant's lived world will be relevant to meet their expectations and needs. The research concluded that the requirement for podiatry care can be taken as an early indicator of failing independence. The importance of the participant podiatrist relationship was also identified as cental to the delivery of 'person-centred' podiatry. The research findings depict older people who want to be involved in their care rather thm being 'a burden to the state. Recognition is also given to the changing nature of caring relationships in the next decade, and how NHS podiatry services will have to profoundly transform if they are to deliver a holistic, person-centred service in the future.
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Löfgren, Karolina, Susanna Sjöberg, and Linnea Neugebauer. "Vietnamese nursing students` perception of person-centered care. : A Minor Field Study in Vietnam." Thesis, Hälsohögskolan, Jönköping University, HHJ, Avd. för omvårdnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-48700.
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Summary Background: Person-centred care is a concept which aims to achieve quality in health care. Person-centred care is about taking the patient's own story into account and creating a partnership between all involved parties. Aim: Exploring nursing students` perception of person-centred care in Vietnam. Method: This study is a qualitative study with a semistructured interview guide. It has a deductive approach with a directed content analysis. Twelve nursing students were interviewed in this study. Result: The result showed that communication, nurses' knowledge, mutual respect, cooperation and family’s experienced knowledge about the patient were identified as important parts of the participants perceptions about person-centred care in Vietnam. Challenges such as time constraints and misunderstandings were shown to be a repeating problem. Conclusion: The nursing students' perception about implementing person-centred care in Vietnam is positive, but there are challenges in applying this in practice. The number of patients related to the number of nurses is uneven, which may lead to problems in Vietnam regarding person-centered care.
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Hill, Heather. "Talking the talk but not walking the walk : barriers to person centred care in dementia /." Access full text, 2004. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20041215.100826/index.html.
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Thesis (Ph.D.) -- La Trobe University, 2004."A thesis submitted in total fulfillment of the requirements for the degree of Doctor of Philosophy, School of Public Health, Faculty of Health Sciences, La Trobe University, Bundoora." Research. Includes bibliographical references (leaves 343-362). Also available via the World Wide Web.
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Mullay, Steve. ""They're just who they've always been" : the intersections of dementia, 'person-centred care', and cultural contexts in Scottish Care Homes." Thesis, University of Aberdeen, 2013. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=227117.
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This thesis documents a study which set out to explore the links between culture, dementia and long-term residential care in Scotland. A key aim of the work was to gain insights into manifestations of individual formative culture as part of selfhood in people with dementia in care homes, and how service providers take account of this in constituting „person-centred‟ care processes (which are claimed by virtually every such provider in Scotland). Another aim was to explore the contexts influencing care processes at individual care home/theoretical/government policy levels. Lastly, as a study with a „critical‟ bent, it set out to provide suggestions for future research based on the conclusions reached. In doing this, it involved six care homes, three of which were in large urban centres and three of which were in a remote island group. Sixteen social care workers and nurses took part, as did eleven care home residents with significant dementia. An ethnographic approach to data gathering and analysis, combined with a poststructural discourse analysis in interpreting initial findings, represented the research methods used. It was found that culture as an aspect of selfhood is a much more reducible phenomenon than is represented by traditional metanarratives of diversity, and failure to take account of this can have substantial implications for „person-centred care‟(especially for people who are progressively losing the ability to adapt to new sociocultural environments because of cognitive impairment). Failure to acknowledge these very individual formative sociocultural contexts in people with dementia who are in long-term care, may lead to a failure to acknowledge personhood. Conclusions revolve around the assertion that accepted discourses of cultural diversity, combined with other socially-located discourses linked to the residential care home sector, combine to produce environments in which „knowing the person‟ (and knowing the sociocultural contexts which help define that person), often do not feature highly in so-called „person-centred‟ approaches.
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Coleman, Carissa K. "The development and evaluation of an interpersonal person-centered care intervention for geriatric nurse aides." Diss., Wichita State University, 2010. http://hdl.handle.net/10057/3646.
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Person-centered caregiving is a construct that is currently being defined and
operationalized in the gerontology literature and in long-term care. The goal of this study was to
further define interpersonal person-centered care by developing and pilot testing a training
intervention for geriatric nurse aides. The training was developed to incorporate content
regarding person-centered behaviors, knowing the residents, and understanding relationships.
Specific materials used in the training were videos to model person-centered care, personalized
resident videobiographies, and personalized videos of caregiving interactions between the nurse
aides and the residents. The pilot testing of this intervention was implemented by using a quasiexperimental,
waitlist control design in two nursing homes, Catholic Care and St. Joseph. The
outcome measures included two behavioral observation measures for assessing person-centered
care: the Person-Centered Care Inventory and the Global Behavioral Scale. Additional outcome
measures included: dyadic measures of relational closeness and relationship satisfaction, nurse
aide job satisfaction, and resident satisfaction with care. The findings indicate that the training
intervention was successful in increasing both the nurse aides’ and residents’ sense of
relationship closeness, as well as their relationship satisfaction. However, the nurse aides’
person-centered caregiving behaviors care did not increase reliably. One explanation may be
that the sampling of the nurse aides’ caregiving behaviors was too small to provide an adequate
test of the hypothesized increase. It is possible that relationship closeness increased as a result of
the combination of encouraging the nurse aides and residents to think of themselves as being in a
relationship as well as the specific content of the training intervention.Thesis (Ph.D.)--Wichita State University, College of Liberal Arts and Sciences, Dept. of Psychology
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Larsson, Ingrid. "Person-centred care in rheumatology nursing in patients undergoing biological therapy : An explorative and interventional study." Doctoral thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-20924.
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Aim: The overall aim was to explore and evaluate rheumatology nursing from a person-centred care perspective in patients undergoing biological therapy. Methods: This thesis focuses on patients with chronic inflammatory arthritis (CIA) who were undergoing biological therapy at a rheumatology clinic in Sweden. Papers I and II had an explorative descriptive design with a phenomenographic approach. The 40 participants were interviewed about their dependence on or independence of a nurse for the administration of their infusions or injections. Paper III had a randomized controlled design involving 107 patients in the trial. The objective of the intervention was to replace every second monitoring visit at a rheumatologist-led clinic by a visit to a nurse-led rheumatology clinic, based on person-centred care. Paper IV had an explorative descriptive design with a qualitative content analysis approach. Interviews were conducted with 20 participants who attended the nurse-led rheumatology clinic. Findings: Dependence on a rheumatology nurse for administration of intravenous infusions was described as invigorating due to the regular contact with the nurse, which provided security and involvement (paper I). Independence of a nurse for subcutaneous injections was understood by the patients in different ways and was achieved by struggling to cope with injecting themselves, learning about and participating in drug treatment (paper II). Patients with stable CIA receiving biological therapy were monitored by a nurse-led rheumatology clinic without any difference in outcome when compared to monitoring carried out at a rheumatologist-led clinic, as measured by the Disease Activity Score 28. Replacing one of the two annual rheumatologist outpatient follow-up visits by a visit to a nurse-led clinic for the monitoring of biological therapy was found to be safe and effective (paper III). A nurse-led rheumatology clinic, based on person-centred care, added value to the follow-up care of patients with stable CIA undergoing biological therapy by providing a sense of security, familiarity and participation (paper IV). Conclusions: This thesis contributes a valuable insight into person-centred care as the core of rheumatology nursing in the area of biological therapy. The rheumatology nurse adds value to patient care when she/he gives patients an opportunity to talk about themselves as a person and allow their illness narrative to constitute a starting point for building collaboration, which encourages and empowers patients to be an active part in their biological therapy and become autonomous. A nurse who provides person-centred care and keeps the patients’ resources and needs in focus serves as an important guide during their healthcare journey.
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Wareing-Jones, Sian. "Whispers and song : a phenomenological inquiry to discover nurses' lived experience of person-centred dementia care." Thesis, Queen Margaret University, 2016. https://eresearch.qmu.ac.uk/handle/20.500.12289/7389.
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Person-centred is now a widely used term to describe much dementia care in the UK and Jersey. This existential hermeneutic phenomenological research seeks to discover the lived experience of person-centred dementia care for nurses in Jersey and through this, the essences and meanings of person-centred care. It is grounded in Merleau-Ponty’s ideas of embodiment for being in the world and Buber’s primacy of relationships and includes complimentary ideas within Lévinas, Gendlin and Vanier’s philosophies. Its methodology is inspired predominantly by van Manen, it is hermeneutic in its interpretive and poetic stance and is existential in its focus on nurse’s lived experiences. Eight nurses, working in care homes and specialist dementia care units, took part in semi-structured interviews which were recorded and transcribed. Deep immersion into these texts followed using the six existentials of corporeality, relationality, temporality, spatiality, materiality and mood, proposed by van Manen and Todres, as lenses to get closer to the participants’ lived experiences, essences and meaning of person-centred dementia care. This research has been amongst the first to use six existentials for data analysis; it demonstrates the accessibility of this methodology for counsellors from its parallels with therapy; it demonstrates the potential of poetry and metaphor images to uncover the essences and meanings of phenomena; and its enhanced focus on the experience of person-centred care reveals considerable rhetoric in the use of the term in mission statements and care philosophies. This research shows that the term, and the models and frameworks associated with it, are not well understood, indicating the need to embrace a new understanding of person-centred care from the macro context to individual practitioners; the need for more effective training, education and practice development together with new support structures for nurses and better communication throughout the services. It also proposes a new vision focussed more on ‘caring’ than ‘care’ and for a uniting Jersey Dementia Strategy to help refine and define systems, policy, practice and care.
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Selleby, Daniel. "Enhancing the person-centered care system through digital communication tools by applying a user-centered approach to a hospital environment." Thesis, Malmö universitet, Fakulteten för kultur och samhälle (KS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-23450.
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Digital technologies are becoming increasingly common tools in our daily lives. We use it for finding information, but also to communicate with people all over the world. With a vision to strengthen Swedish healthcare's digital resources, Sweden has made major efforts in this area. Improved living conditions have changed the demographic situation as people grow older, which in turn places higher demands on healthcare efficiency. Being able to meet these demands has made digitalization of healthcare increasingly important, but also demonstrating new challenges such as participation, transparency and usability. The purpose of this study has been to investigate if communicative tools can be created to facilitate nurses work with person-centred care and to enhance patients' positive experiences of their own care. The study is based on interviews and observations with nurses working within orthopaedic sections and employees working in facility management as well as administration within the hospital. The results show that digital solutions can be effective tools for enhancing person-centered care, but with automated solutions the physical encounter between nurses and patients can be reduced. The concepts that have been developed are two mobile applications. They were developed with the intention to make it easier for nurses to document and communicate patients' activity and care plans.
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Anehem, Jenny. "Personcentrerat klimat inom högspecialiserad hjärtsjukvård." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26508.
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Bakgrund: Den personcentrerade vården är en strategi för att jämna ut patientens underläge som uppstår när hen besöker sjukvården. Vården ska vara individuellt anpassad och patienten ska respekteras för sina behov, och vården ska präglas av att patienten ska ses som människa och inte som den sjukdom hen bär. En personcentrerad miljö baseras på evidens, delaktighet och erfarenhet och patienten involveras genom sin livsberättelse avseende tidigare upplevelser och förväntningar på miljön. I denna miljö bedömer vårdgivaren vilka behov som finns hos personen. Det personcentrerade klimatet är den fysiska och psykosociala miljön där den personcentrerade vården bedrivs. Syfte: Syftet med denna studie var att undersöka personcentrerat klimat på en avdelning som bedriver högspecialiserad hjärtsjukvård.Metod: Kvantitativ design med enkätstudie. Patienterna tilldelades mätinstrumentet Person-centred Climate Questionaire – Patient version (PCQ-P). I studien ingick patienter vid Verksamhetsområde Thoraxkirurgi och Kärl vid Skånes Universitetssjukhus i Lund. De patienter som inkluderades hade genomgått hjärtkirurgi och vårdades postoperativt på Thoraxkirurgiavdelningen i Lund. Sammanlagt inkluderades 53 patienter i studien.Resultat: Det upplevda personcentrerade klimatet som helhet (maxpoäng för PCQ-P) visade ett resultat med medianvärdet 91,0 (maxpoäng 102).Medianvärdet för subdimensionen Climate of Safety var 58,0 (maxpoäng 60), för subdimensionen Climate of Everydayness 18,0 (maxpoäng 24), samt 16,0 för subdimensionen Climate of Hospitality (maxpoäng 18).Inga signifikanta skillnader kunde ses i upplevt personcentrerat klimat utifrån kön, vårdtid eller ålder.Slutsats: Personcentrerat klimat kan existera på en avdelning för högspecialiserad hjärtsjukvård och är en viktig förutsättning för att kunna ge en personcentrerad vård. Det är därmed också ett viktigt mått på patienternas nöjdhet med den vård de får.Background: Person-centered care is directed towards the person with an illness and not the disease in the person. The care should be individually adapted, and the patient should be respected for his or her needs. A person-centered environment is based on evidence, participation and experience. The patient is involved through his or her life narrative, involving past experiences and expectations of the environment. In this environment, the healthcare provider performs an assessment of the needs of the person. The person-centered climate is the physical and psychosocial environment in which the person-centered care is conducted.Aim: The aim of this study was to investigate person-centered climate in a highly specialized toracic department.Design: A Cross-sectional study. Method: Quantitative design by a survey using the instrument Person-centred Climate Questionnaire – Patient version (PCQ-P). The patients were included after cardiac surgery and were hospitalized at the Transplant and Heart Department in Lund. A total of 53 patients were included in the study.Results: The perceived person-centered climate (total score for PCQ-P) showed a result of the median value of 91.0 (maximum score 102). The median value for the subdimension Climate of Safety was 58.0 (maximum score 60), for the subdimension Climate of Everydayness 16.0 (maximum score 24) and for subdimension Climate of Hospitality 16.0 (maximum score 18). No significant differences was found in perceived person-centered climate due to sex, hospital time or age.Conclusion: A person-centred climate is an important prerequisite for being able to provide a person-centred care, thus also an important measure of patient satisfaction with the care they receive.
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Hart, Rebecca Marie. "Hart's Home Away From Home: An Integrative Approach to Dementia Care." Miami University / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=miami1311203360.
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Denham, Sara Helen. "A case study exploration of approaches to the delivery of safe, effective and person centred care at two rural community maternity units." Thesis, Robert Gordon University, 2015. http://hdl.handle.net/10059/1372.
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Background: This research explores whether rural Community Maternity Units (CMUs) contribute to NHS Scotland’s Quality Ambitions of safe, effective and person centred care. Currently there is no available recent evidence regarding the quality of this particular model of care in a rural setting. This research makes an important contribution given that most women are encouraged to access local maternity services. Design: An exploratory case study was used with a hermeneutic phenomenological approach to the qualitative data collection and analysis. Quantitiative data were collected and analysed to provide descriptive statistics. Methods: The study was conducted in three phases. In phase one a retrospective medical records review was undertaken to provide quantitative data on the care provided. Phase two was an observation of team meetings, interviews with staff and focus groups with stakeholders in roles aligned to the provision of care at the CMUs. In phase three observations of clinical encounters and interviews with women informed by aide memoire diaries were used. Findings: Maternity services provided by the CMU teams achieved a consistently high standard of safety and effectiveness when measured against national guidelines, standards and other evidence. The stakeholders appreciated the ability within these small teams to provide local, accessible services to women with effective support when required from tertiary services. The women valued person centred and relationship based continuity of antenatal carer, provided by compassionate named midwives, but were disappointed by the discontinuity when complications occurred. Conclusions: The CMUs’ physical position within the community, smallness of scale and the midwifery team’s ethos of normality within a socially based but medically inclusive service facilitated local access for most women to maternity care. This service provision addressed NHS Scotland’s Healthcare Quality Strategy of improving health and reducing inequalities for the people of Scotland. The role of the named midwife was key to providing high quality care by maintaining connections across contextual boundaries for women experiencing normal and complicated pregnancies. This research provides an original contribution to the study of rural maternity service provision in Scotland to help inform future sustainability and service development of rural CMUs.
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Robinson, Lisa. "Engaging Personhood at End of Life: A Qualitative Study of Nurses’ Practice in Acute Care." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/38584.
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The acute care setting is designed to provide short-term care for people who require treatment for a severe episode of acute illness and exacerbations of chronic conditions. Yet, more than half of Canadians die in acute hospitals every year. Evidence shows that nurses in acute care units feel limited in their ability to provide quality end-of-life care due to a variety of factors. As a result, the needs of patients that are dying are often overlooked, which can cause them to experience a loss of identity and control, as well as suffering at the end-of-life; a unique time in one’s life trajectory marked by significant changes in personhood. Personhood is the philosophical underpinning of the frequently used concept ‘person-centered care’ – one of the fundamental ideologies of nursing and a central concept in palliative care. An interpretive description design was used to explore the following research question: What do nurses’ stories reveal about the ways in which they engage, or fail to engage, with personhood in end-of-life care in acute care units? To appreciate the culture in which participant stories were situated, a literature review of acute care culture, end-of-life care in acute care units, and the concept of personhood was conducted. Eight nurses from an acute medical-surgical ward of a tertiary care hospital in Eastern Ontario were interviewed for this study. Thematic analysis was used to analyze the data, which elucidated tensions between participants’ ability to enact ethical end-of- life care reflective of their values and the contextual constraints of working in a culture of biomedicine. Exploring these tensions provided insight on the nuances and complexities of navigating ethical end-of-life care in an acute care setting as well as implications for nursing practice, education, and research with particular attention to promoting moral communities in acute care that value personhood and biomedicine equally.
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Acraman, Clive. "Developing dialogic learning in children's health and social care teams through the use of person centered thinking." Thesis, University of Central Lancashire, 2012. http://clok.uclan.ac.uk/6579/.
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This action research study reports on the development of a process for dialogic learning underpinned by Person Centred Thinking and the use of Person Centred Planning Tools (PCPTs). This learning occurred in three separate but associated teams delivering family support services to children and their families. The aim of this study was to explore and attain an understanding of how the use of these tools and processes would affect the process of organisational learning in the three settings. It is believed to be the first time PCPTs have been used in this context. Facilitated action learning supported the use of Person Centred Thinking to attend to and decipher the challenges of the daily working practices and collaborative relationships of the three teams. This appreciative and inclusive methodology supported the development of a ‘common language’, which, where successful, helped to embed a system of whole service dialogic learning. This model of change management distinguishes the process used in this study from other interventions. Where successful, leadership was central to successful implementation of dialogic learning in the teams and their ambition to become learning organisations. The importance of the individual actions taken by the leaders and their use of power was influential to the outcome of the study. The synergy created by the synthesis of Person Centred Thinking and dialogue in the teams with good leadership, suggests that the dialogic learning emanating from it has perceptible and noteworthy connections for, and to, organisational learning. The original contribution to knowledge from this study is the development of a theoretical understanding of how person centred practices when embedded into teams can transform and positively augment ways of working. Specifically it posits how dialogic learning practices provide the culture and context to facilitate individual and team growth and understanding through organisational learning.
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Gibbard, Isabel Mary. "Clients' experiences of change in cognitive behavioural therapy and person-centred therapy in primary care : a qualitative analysis." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/clients-experiences-of-change-in-cognitive-behavioural-therapy-and-personcentred-therapy-in-primary-care-a-qualitative-analysis(f8d68779-0119-45da-8e89-50a48a61fccc).html.
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The aim of this qualitative research project was to investigate the experiences of clients who had received Cognitive Behavioural Therapy (CBT) and Person Centred Therapy (PCT) in primary care. The rationale for the investigation was to inform the assessment and referral process whereby prospective clients are assigned to the two different therapies. A total of 16 clients responded to an invitation to attend an unstructured interview (PCT = 9; CBT = 7) to talk about their experiences of therapy. The resulting transcripts were analysed using Grounded Theory methodology. Transcripts were broken down into meaning units and conceptualised as categories, using the constant comparison method. The categories were integrated, a core category conceptualised and a theory generated. A comparison of the accounts revealed similar and contrasting experiences. The main categories (eg Accessing therapy, Engaging with the therapy) could be organised in the chronological order of the client`s journey through therapy. All participants entered therapy with a particular view of reality. In successful therapy this view changed and they went on to manage their lives in a more constructive way. Participants attributed this change to different elements of the therapy (categorised as It did the trick) which brought about a new understanding (categorised as The key). Where therapy was unsuccessful this did not occur. The mechanism of change was personal to the individual and did not appear to be specific to either therapy. Some of the mechanisms appeared to be consistent with the therapy received (eg. Carrying out tasks, in the CBT group). Others appeared counterintuitive (eg. Putting me straight, in the PCT group). The differences and similarities in the participant`s experiences appeared to be due to the therapist and client`s capacity to respond to each other in order to make the therapy “work.” The Core Category, Reciprocal Responsiveness, was chosen to explain this. The findings also suggest that the ability of the therapist and client to respond to each other will affect the outcome of therapy. The theory was constructed that the outcome of therapy is determined by the occurrence of a sufficient degree of Reciprocal Responsiveness. This study has implications for the assessment process as the findings suggests that, when making a referral, it may be helpful, to take into account the potential client`s activity and responsiveness rather than relying solely on diagnosis. It also contributes to the growing body of literature emphasising the importance of therapist responsiveness to the individual needs of the client, rather than strict adherence to one therapeutic approach. The study is limited to two therapies within primary care. Future studies may consider clients experiences within other settings and with other therapeutic approaches.
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Hermesch, Abigail Grace. "Involving direct care workers in preference-informed care planning: Association with turnover and retention." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1594649084718307.
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Odmyr, Tobias, and Linda Olsson. "Flyktingars upplevelser av mötet med hälso- och sjukvården : Att inte kunna göra sin röst hörd." Thesis, Högskolan Väst, Avdelningen för omvårdnad - grundnivå, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-10669.
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Background: More people than ever before are now seeking refuge from war and terror in other countries (UNHCR, 2016). This has as a consequence that the health care in many Western countries faces new patient categories which don’t speak the language and are culturally different from what health professionals are familiar with. Ethical considerations are important, since being misunderstood and not met with dignity or respect can cause care-related suffering. This may increase the suffering already experienced due to loss of security, family and friends. Aim: To illustrate refugees’ experiences in the contact with health care. Method: This is a literature-based, qualitative study. 15 articles were selected to investigate refugees’ experiences of health care. The analysis resulted in 2 themes, each containing 3 subthemes. Results: The main themes that emerged were: Feeling acknowledged and respected, and Overcoming language and cultural barriers. The result mainly reveals that language barriers are common, and that refugees consider it important to be seen as individuals, which is not always the case in health care. Conclusion: The challenge in caring for refugees as a nurse consists in ensuring there is a common understanding. While being aware of a patient’s history, it is also important to see the individual in a person-centered approach.Att bryta upp från familj och allt man känner sig trygg med försätter människan i en utsatt position. Den vilsenhet detta medför skapar ett lidande. Som sjuksköterska är det viktigt att vara medveten om detta. Författarna till detta litteraturbaserade arbete har studerat 15 vetenskapliga artiklar där flyktingars perspektiv av olika vårdmöten står i fokus. Resultatet visar att flyktingar upplever språket som det största problemet i mötet, men att även deras kultur och religion spelar in i vad de tycker är en bra vård. I många fall känner flyktingar sig förbisedda eller diskriminerade. Detta har i många fall att göra med att de inte blir bemötta som individer utan ses som en del av en annan kultur. För att undvika problem med språkförbistringar är det att föredra att anlita tolk. Detta är emellertid inte helt problemfritt. Tolkar påverkar mötet på olika sätt beroende på vem patienten är. Studiens resultat visar att många flyktingar föredrar en tolk av samma kön. Det bidrar till att de lättare kan öppna upp sig och att intima situationer, exempelvis avklädning, inte blir så svåra att hantera. Samma förhållanden råder när det gäller kön på vårdpersonal. Att undersökas av någon av motsatt kön kräver att detta upplevs som ofrånkomligt och väl förankrat. De upplevelser som har med kultur och religion att göra varierar mellan flyktinggrupper och enskilda personer. De berör hur man vill bli bemött och behandlad. Det visar sig att patienterna i många fall är ovana vid ett personcentrerat förhållningssätt. Att utveckla ett sådant förhållningssätt är dock viktigt, eftersom brister i detta gör att flyktingarna känner sig diskriminerade och förbisedda. Det kan även leda till att de går miste om viktig information om sin sjukdom och rekommenderade behandling. Om sjuksköterskor tillämpar personcentrerad vård där patientberättelsen och partnerskap ligger till grund kan vårdlidande undvikas.
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Howarth, M. L. "Being believed and believing in : the impact of delegitimation on person centred care for people with chronic back pain." Thesis, University of Salford, 2012. http://usir.salford.ac.uk/27328/.
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Chronic back pain is an under researched area; the complexities of unseen pain in particular, present challenges to the sociological assumptions made about the concept of ‘sickness’. The lack of ‘visible’ signs and symptoms means that some people are left without a diagnosis. If left undiagnosed, their experience of chronic back pain becomes delegitimized and could result in the erosion of self-esteem, self-identity and personhood. Undiagnosed chronic back pain can undermine a person’s moral self through disrupting the person’s biography and self –esteem. Ultimately, people with chronic back pain need person centred approaches to care that support the restoration of the self. The aims of this study were to generate a theory of person-centred care predicated on the experiences of people who have chronic back pain. The research design was influenced by a constructivist paradigm, which underpinned a Grounded Theory methodological approach. A purposive sampling strategy identified 17 people with chronic back pain and 4 multi-professional teams who were involved in their care. Semi-structured interviews with people who have chronic back pain, and the multi-professional teams captured the experience of person-centred care and explicated meaning about its key concepts. Data were analysed using a constant comparative approach through which theoretical sensitivity developed and eleven categories emerged. The ‘conditional partnership’ became a core category, which formed a substantive theory to explain the experience of person-centred care. The key findings highlight the significance of legitimation on the chronic back pain experience and exposes the impact that ‘delegitimation’ has on the individual’s ability to mobilise resources and manage their pain effectively. This thesis presents the conditional partnership as a theory which explains the relationship needed to support person centred care. The theory suggests that person centred care for people with chronic back pain is underpinned by a conditional partnership which is made up of three conditions; being believed, believing in and non-maleficence which represent the expected conditions of health care and by health care.
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Liljeholm-Baroudi, Torun. "Mötta förväntningar och skattad livskvalitet : En korrelativ studie av mål och utfall efter axeloperation." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-21947.
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Sambandet mellan patienters förväntningar inför axeloperation och i vilken utsträckning dessa påverkar den upplevda nöjdheten är inte entydigt. Positiva förväntningar är viktiga samtidigt som orealistiskt höga förväntningar kan ge lägre patientnöjdhet. Uppföljning utifrån individens upplevelse är viktig för att följa resultat och öka patientnöjdheten i en personcentrerad vård. Syftet med denna studie var att redogöra för en grupp axelopererade patienters mål inför operation, måluppfyllelse efter ett år och undersöka eventuella samband mellan olika förväntningar och grad av måluppfyllelse. Syftet var också att beskriva upplevd livskvalitet före och ett år efter operation, korrelera skattad livskvalitet och måluppfyllelse efter ett år samt undersöka eventuella skillnader i skattade värden beroende på bakgrundsfaktorer. Metoden var en korrelerande prospektiv registerbaserad studie. Huvudresultatet visade hög grad av patientnöjdhet både för skattad livskvalitet och uppfyllelse av personligt mål, sambandet mellan dessa värden var starkt. Smärtfrihet var den vanligaste förhoppningen. Signifikant samband mellan olika förväntningar och uppnått mål sågs i grupperna ¨återgå till arbete¨ och ¨smärtfri nattetid¨. Kvinnor skattade signifikant lägre värden än män före operation men ingen signifikant skillnad kan ses vid ettårsuppföljningen. Slutsatsen var att undersökningsgruppen inför operation hade höga förväntningar och att dessa i stor utsträckning uppnåtts. Likaså sågs tydlig ökning i skattad livskvalitet. Minskad smärta/smärtfrihet var tydligt den viktigaste förväntan inför operation. Denna utvärdering av patientens upplevelse av måluppfyllelse och livskvalitet kan ge återkoppling i arbetet för att stärka och utveckla en personcentrerad vård.The correlation between the expectations before shoulder surgery and to which extent they affect patient satisfaction is not unambiguous. Positive expectations are important whilst unrealistic expectations could lead to reduced patient satisfaction. Follow up based on the experiences of the individual is important to follow results and increase patient satisfaction in a person centred care. The aim of this study was to narrate the preoperative goals and the fulfilment of these goals after one year for a group of patients who had undergone shoulder surgery and to investigate the eventual relationship between different expectations and degree of goal fulfilment. The aim was also to describe the perceived life quality before and one year after surgery, to correlate perceived life quality and goal fulfilment after one year and to examine eventual differences in assessed values due to demographic factors. The method was a correlative prospective register based study. The main result showed high degree of patient satisfaction for both assessed life quality and fulfilment of personal expectations, the correlation between these values where strong. Relief of pain was the most common expectation. Significant correlation between expectations and goal assessment where seen in the groups ¨return to work¨ and ¨relief of nocturnal pain¨. Women assessed significant lower values than men before operation but no significant differences where seen at the follow-up after one year. The conclusion was that the study population had high preoperative expectations and that these where fulfilled to a great extent. An explicit increase in perceived life quality was also seen. Relief or reduction of pain was clearly the most important expectation before surgery. This evaluation of patients’ sense of goal fulfilment and perceived life quality might give feed back in the work to strengthen and generate a person centred approach.
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Carlsson, Lisa, and Sanna Hogland. "Sjuksköterskans ledarskap för en personcentrerad vård : En litteraturstudie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-84940.
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Bakgrund Antalet äldre som behöver hemsjukvård ökar. Sjuksköterskan är omvårdnadsledare som ska leda teamet i strävan att uppnå personcentrerad vård hos den äldre. Syfte Syftet med denna uppsats var att sammanställa forskning om sjuksköterskans ledarskap med fokus på faktorer som påverkar personcentrerade processer inom hemsjukvård av äldre. Metod Metoden var en litteraturstudie där artiklar söktes i databaserna CINAHL, PudMed och PsycINFO. Efter diskussion om artiklarnas innehåll, kvalitetsgranskades relevanta artiklar och sju artiklar valdes ut och analyserades. Resultat Resultatet beskrivs utifrån tre kategorier som var att öka medvetenheten om personcentrerad vård, gensvar av personcentrerad vård och hinder i ledarskapet. Resultatet visar att sjuksköterskans ledarskap har inverkan på huruvida en personcentrerad vård uppnås eller inte. Slutsats Litteraturstudien visar att sjuksköterskans ledarskap kan påverka genomförandet av personcentrerad vård. Mer kunskap och utbildning samt tillgång till ett ramverk behövs hos all vårdpersonal för att kunna förstå vad personcentrerat arbetssätt innebär.
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Telenius, Lina, and Victoria Vartanian. "Patienters upplevelser av bemötande på akutmottagningar : en litteraturstudie." Thesis, Högskolan Väst, Avdelningen för omvårdnad - grundnivå, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-15817.
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Background The emergency department is intended for people with acute illness or injuries. In the acute phase and in urgent situations, the focus of the healthcare staff is not always on attendance and respectful treatment or care. Instead, quick handling and strict schedules are prioritized. As a result, communication and information fail and the patients' basic needs are overlooked. Consequently, the healthcare staff might be perceived as indifferent and rude. This uncaring encounter leaves the patients feeling vulnerable, abandoned and disrespected. The absence of communication and respectful treatment may have adverse effects on the patients' well-being. Aim The aim of this study was to describe patients' experiences of treatment in emergency departments. Method A literary study was made using 9 articles with a qualitative approach. Results Two themes were identified: the patients' experiences of being noticed in emergency departments and the patients' experiences of the meaning of communication in emergency departments. The themes had two subthemes each: not to be seen, to feel confirmed, lack of information and the importance of communication in health care. Conclusion The absence of caring encounters and lack of information contributes to negative experiences in the emergency departments and is the cause of great suffering in patients.Denna studie hade som syfte att undersöka patienters upplevelser av bemötande när de sökte vård på akutmottagningar. Resultatet visade att patienter hade svårigheter i att tala om varför de sökte vård, då personalen upplevdes som ifrågasättande och nonchalanta. Patienterna kände sig bortglömda i väntrummet då det var långa väntetider samt att de inte informerades tillräckligt. Detta resulterade i att känslor av otrygghet, rädsla och oro belystes. De patienter som däremot informerades, uppmärksammades av personalen samt där personalen bjöd in patienten till delaktighet i sitt vårdbesök, upplevde ett gott bemötande. Denna studie visar att patienter upplevde brister i bemötandet på akutmottagningar och att personcentrerad vård värderades högt av patienterna för att känna en trygghet till vården. Att inte bli respektfullt bemött resulterar i ett onödigt lidande för patienten. Vården som bedrivs på akutmottagningen är inriktad på allvarliga skador och åkommor, där personalen har som ansvar att bedöma, sortera och prioritera så att de allvarligaste skadorna hanteras först. En del av sjuksköterskan ansvar på akutmottagningen är att uppmärksamma patientens psykosociala behov, likaledes är hennes ansvar att prioritera patienters fysiska behov. Studiens resultat påvisade att patienter upplevde brister kring dessa ansvarsområden. Patienter som sökte vård på akutmottagningen upplevde ångest och oro då de saknade kunskap om sitt förändrade hälsotillstånd och var beroende av kontinuerlig information. För att ge patienten en positiv upplevelse av sitt besök så kan personcentrerad vård vara en ingång. Personcentrerad vård innebär en kärnkompetens för sjuksköterskor och belyser vikten av att tillsammans med patienten bilda en relation och ett partnerskap för att patienten ska kunna uppleva delaktighet i sin egen vård. Genom delaktighet kan patienten på ett bättre sätt hantera och begripa sin situation. Den metod som använts är en litteraturstudie. Kvalitativ forskning har granskats för att skapa en överblick av tidigare forskningsresultat kring detta ämne. Studiens syfte var att undersöka patienters upplevelser och därför valdes kvalitativ forskning, då denna forskningsmetod rekommenderas för granskningar av upplevelser.
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Gustafsson, Christopher, and Tobias Hansson. "Livet efter en genomgången hjärtinfarkt : Den förändrade vardagen." Thesis, Högskolan Väst, Avdelningen för omvårdnad - grundnivå, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-15443.
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Background: The number of people suffering from myocardial infarction in Sweden is decreasing, despite this the prevalence is high. Being diagnosed with myocardial infarction results in medical interventions, lifestyle changes and eventual pharmacological treatment to prevent relapse. Aim: The aim of this study was to describe patients' experience of life after amyocardial infarction. Method: A literature-based study was used, based on ten qualitative articles. The articles were analyzed in a five step-model, which resulted in three main-themes and sixsub-themes. Results: The results present life after myocardial infarction as difficult to understandand manage. This could be related to their physical and mental changes, which resulted in fear and anxiety that affected their everyday lives through experienced limitations. Fatigue where also a contributing factor in the limitations of everyday life due to energyloss. This was hard to handle without support from both relatives and health care professionals. It was essential to be meet as a unique human and not reduced to a diagnosis. Life became more valuable through the survival and gave the individuals a second chance with different priorities. Some adjusted to the lifestyle changes, while others were reluctant. Returning to work where seen as an indicator for being healthy and a return to life as before. Conclusion: To establish well-being and security through nursing, a holistic approach that is the basis of person-centered care helps nurses to see the individual situation.I Sverige minskar antalet personer som drabbas av hjärtinfarkt trots detta är förekomsten fortfarande hög och ca 5800 avlider varje år. Hjärtinfarkten medför både fysiska och psykiska förändringar hos den drabbade. Syftet med denna litteraturstudie är att belysa patienters upplevelse av livet efter en genomgången hjärtinfarkt. I studiens resultat framkom det att både män och kvinnor såg situationen och livet efter en hjärtinfarkt som svår att hantera, då både kroppen och hjärtat inte längre upplevdes pålitligt. Detta resulterade i rädsla och oro som begränsade det vardagliga livet. Personerna upplevde att det var svårt att tolka kroppsliga signaler, vilket gav en osäkerhet som resulterade i ångest och katastrof tankar om döden. Detta medförde även att de inte vågade anstränga sig fysiskt. Känslor som ilska, frustration och nedstämdhet upplevdes på grund av den mentala och fysiska utmattningen som var svår att förstå. Personerna kunde inte utföra vardagsaktiviteter i samma utsträckning som innan hjärtinfarkten, vilket resulterade i en känsla av passivitet. Det utrycktes även ett behovav stöd från anhöriga och vårdpersonal för att klara av sin situation och det vardagligalivet. Vårdpersonalens bemötande och agerande var avgörande för hur patienterna förstod informationen som gavs, deltog i rehabilitering och klarade att genomföra nödvändiga förändringar när det gäller ohälsosamma levnadsvanor. Vårdpersonalens förmåga att skapa en trygg atmosfär tillsammans med att se patienten som människa var viktigt för att uppnå välbefinnande. Anhöriga sågs som en resurs för personerna då de kunde avlasta vardagssysslorna samtidigt som de lyssnade, vilket gav trygghet och välbefinnande hemma. Patienter upplevde att familjen satt för höga krav och fick då stödet från vänner. Partnerrelationen kunde påverkas genom den minskade sexuella relationen som grundade sig i rädsla för de fysiska förändringarna och upplevdes svårt att prata om med partnern. Livet efter en hjärtinfarkt beskrevs som en ny chans till livet där nya värderingar uppstod. Personerna upplevde att arbetsgivarens attityd och förståelse för situationen var avgörande för fortsatt sjukskrivning. För att kunna möta patientens unika behov och skapa välbefinnande genom omvårdnad, är personcentrerat förhållningssätt lämpligt för att vidhålla en helhetssyn på patienten och inte bara det fysiologiska tillståndet.
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Chapman, Hazel Margaret. "The health consultation experience for people with learning disabilities : a constructivist grounded theory study based on symbolic interactionism." Thesis, University of Chester, 2014. http://hdl.handle.net/10034/620698.
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Aims. The aim of this study was to explore the effects of the health consultation experience for people with learning disabilities, particularly in terms of their self-concept Background. Annual health checks have been introduced as a reasonable adjustment for health providers to make in meeting the needs of people with learning disabilities, who experience significantly poorer health outcomes than the general population. Evaluation of the health consultation from the service user perspective can inform this service provision. Design. A constructivist grounded theory approach, based on symbolic interactionism, was used to explore the meaning of the health consultation experience for the person with learning disabilities, and its effects on their sense of self. Methods. Purposive and snowballing sampling was used to recruit 25 participants with learning disabilities through a GP practice, self-advocacy groups and a health facilitator. Nine individual interviews, three interviews with two participants, three focus groups (n=7, n=5 and n=3), and an audio-recorded health check consultation were carried out (with two participants interviewed twice and four attending two focus groups), as well as a member check used to assess the resonance of the findings. Data collection was undertaken in different primary care trusts across the north west of England. Data were subjected to constant comparative analysis, using a symbolic interactionist approach, to explore all aspects of the health consultation experience and its effects on the self. Findings. Current expectations, attitudes and feelings about health consultations were strongly influenced by previous experience. Participants negotiated their own reality within the consultation, which affected their self-concept and engagement with their health care. Respectful and secure health professional – service user relationships, developed over time, were central to an effective consultation. Perspectives on the consultation, and engagement within it, were co-constructed with a companion, who could help to promote the personhood of the service user with support from the health professional. Anxiety, embarrassment and felt stigma were identified as significant barriers to communication and engagement within the consultation. Conclusions. People with learning disabilities have similar health consultation needs and expectations to other people, but may have more difficulties in engaging with the process and building trusting relationships with the health professional, due to previous negative experiences, anticipated stigma and loss of self within health settings leading to a fear of disclosure. This, combined with difficulties in communication and cognitive processing, results in less satisfactory outcomes persisting over time. The effects of triadic consultations are generally positive, particularly where relatives or health facilitators are involved. However, continuity of companion as well as health professional is needed, and more service user engagement should be supported. Fundamental attitude change by health professionals, supported by specific educational initiatives to enhance their understanding of the service user perspective, is needed to reduce health inequalities. Participatory research by people with learning disabilities should inform future health care practice.
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Balfour, Liezl. "Implementation and evaluation of a clinical pathway for non-invasive ventilation in critical care : a person-centred practice development approach." Thesis, University of Pretoria, 2020. http://hdl.handle.net/2263/79586.
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Introduction: Non-invasive ventilation (NIV) is an alternative method for
providing safe mechanical ventilatory assistance to adult patients
presenting with acute respiratory failure. Internationally the utilisation of
NIV has increased by 400% during the past decade. The clinical pathway
for NIV was collaboratively developed by the multidisciplinary team in the
critical care unit in 2012, but implementation into practice did not realise
as anticipated. As the burden of chronic disease rises in South Africa, the
healthcare system is under pressure to provide evidence-based and costeffective
care to more patients. Avoiding endotracheal intubation reduces
the patient’s risk of complications which lengthens the hospitalisation
period and the cost of hospitalisation. The utilisation of clinical pathways
in the South African context is limited.
Aim: The overall aim of the study was implementation and evaluation of
the outcomes of a person-centred clinical pathway for non-invasive
ventilation in the critical care unit.
Research methodology: Mixed method design through a personcentred
practice development approach utilising emancipatory action
research. Several data collection methods are used throughout the
phases of the study. A critical realist worldview was held which
incorporated the principles of a person-centred approach through
collaboration, inclusion and participation. The study was conducted in
three interdependent and interrelated phases. During Phase 1, the
culture of the critical care units was assessed using a validated 37-item
questionnaire to establish the perceptions of the critical care nurses
related to evidence implementation. A total of twenty-three registered
nurses participated. Additionally, the content of the clinical pathway was
adapted following a rigorous literature review in collaboration with the
internal facilitators and validated via a Delphi with critical care experts.
Phase 2 was dedicated to the collaborative development of an implementation strategy for the implementation of the clinical pathway in
the critical care unit. During Phase 3, the outcomes of the implementation
of the clinical pathway for NIV was evaluated.
Findings: The collaborative utilisation of a person-centred practice
development approach for the implementation and evaluation of the
clinical pathway for NIV, aided the researcher in identifying moral injury
amongst critical care nurses, which inhibits the implementation of
research evidence into practice.Thesis (PhD)--University of Pretoria, 2020.
Nursing Science
PhD
Unrestricted
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Le, Thao. "Person-centered training to promote quality of care to skilled nursing facility residents affected by dementia| A grant proposal." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10024098.
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Individuals diagnosed with dementia make up the majority of the population in skilled nursing facilities (SNFs). Certified Nursing Assistants (CNAs) are the primary caretakers of older adults living in SNFs. The purpose of this grant project was to write a proposal for funding to provide Person-Centered Care (PCC) training to help CNAs enhance their skills to better enhance the quality of life of older adults living with dementia in SNFs.
The goal of PCC training is to help CNAs better understand the signs and symptoms of Alzheimer’s and dementia, improve communication skills, and provide strategies to manage the behavioral and psychological symptoms of dementia. Previous research on PCC has found it to be effective in improving the quality of care of older adults who are affected by dementia and who are living in nursing homes.
Actual submission or funding of the grant was not required for the successful completion of this project.
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Hassanali, Nilam, and Edvardsson Beatrice. "Varför kvinnor fortsätter att röka under graviditeten : En litteraturöversikt." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-25758.
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Bakgrund: Kvinnor som röker kan drabbas av minskad fertilitet och det kan ta längre tid för dem att bli gravida. Forskning visar att rökning i samband med graviditet bland annat kan leda till missfall, låg födelsevikt och plötslig spädbarnsdöd. En stor andel av dessa kvinnor är medvetna om riskerna rökning under graviditet kan medföra men trots det fortsätter de att röka. Om vårdgivaren är medveten om de bakomliggande faktorerna till kvinnornas rökbeteende kan hen erbjuda kvinnan en individanpassad omvårdnad. För att kunna erbjuda rätt vård är personcentrerad omvårdnad viktigt. Syfte: Syftet var att beskriva vad som gör att kvinnor fortsätter röka under graviditeten. Metod: Litteraturöversikt med en beskrivande design av både kvalitativa och kvantitativa studier. Resultat: Nio faktorer som påverkar kvinnans fortsatta rökbeteende under graviditeten har hittats. Faktorerna är: nikotinberoende, relationsrelaterade problem, stress, behov av egentid och avslappning, partnern, brist på kunskap och motivation, sociala nätverk, förträngning samt bristande stöd från vårdgivaren. Slutsats: Det är viktigt att sjuksköterskan förstår varför en kvinna väljer att röka under graviditetsperioden. Förstår sjuksköterskan vad som ligger bakom rökbeteendet hos den gravida kvinnan kan det bli lättare för hen att erbjuda rätt vård.+
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Lövgren, Erica, and Jennie Rockman. "Ett personcentrerat arbetssätt i arbetsterapeutiska interventioner : En litteraturöversikt." Thesis, Luleå tekniska universitet, Institutionen för hälsa, lärande och teknik, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-86294.
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Bakgrund: Ett personcentrerat arbetssätt är en grund inom arbetsterapeutiska verksamheter, där varje person har ett unikt utgångsläge inom sina sociodemografiska faktorer och personliga preferenser, vilket kan påverka personers utförande av aktiviteter och delaktighet i det vardagliga livet. Syfte: Att granska och sammanställa hur personer som har deltagit i arbetsterapeutiska interventioner samt arbetsterapeuter upplever ett personcentrerat arbetssätt, för att få förståelse för svårigheter och möjligheter med detta arbetssätt. Metod: En kvalitativ litteraturöversikt av tidigare forskning. Resultat: Resultatet presenteras under rubrikerna och underrubrikerna: Hur personer som har deltagit i arbetsterapeutiska interventioner upplever ett personcentrerat arbetssätt; Svårigheter och möjligheter i samarbetet, Arbetsterapeuters upplevelser av ett personcentrerat arbetssätt; Svårigheter och möjligheter i samarbetet samt:Organisatoriska svårigheter och möjligheter med ett personcentrerat arbetssätt. Slutsats: En ökad förståelse för begreppet personcentrering behövs genom ytterligare studier, detta skulle bidra till mer kunskap om begreppets innebörd och hur det bör implementeras i svenska arbetsterapeutiska verksamheter.Background: A person-centered approach is a foundation in occupational therapy activities, where each person has a unique starting point within their sociodemographic factors and personal preferences, which can affect people's performance of activities and participation in everyday life. Aim: To examine and compile how people who have participated in occupational therapy interventions and occupational therapists experience a person-centered approach, to gain an understanding of difficulties and opportunities with this approach. Method: A qualitative literature review of previous research. Results: The result are presented under the headings and subheadings: How people who have participated in occupational therapy interventions experience a person-centered approach; Difficulties and opportunities in the collaboration, Occupational therapists' experiences of a person-centered approach; Difficulties and opportunities in the collaboration and: Organizational difficulties and opportunities with a person-centered approach. Conclusion: An increased understanding of the concept of a person-centered approach is needed through further studies, this would contribute to more knowledge about the meaning of the concept and how it should be implemented in Swedish occupational therapy.