Magistrinio darbo pavadinimas „Vaikų hiperkinezinių sutrikimų šiuolaikinė slauga” Darbo vadovė: VU MF Psichiatrijos klinikos Vaikų psichiatrijos ir socialinės pediatrijos centro docentė Sigita Lesinskienė Darbo autorė: VU MF slaugos magistartūros II kurso S. Bakutytė Vilniaus Universitetas Medicinos Fakultetas, Vidaus ligų pagrindų ir slaugos katedra Darbo metodika. Tyrime dalyvavo 40 vaikų tėvų, kurių vaikai ambulatoriškai gydosi paskirtais psichostimuliatorių grupės preparatais (PGP) (Ritalin'u ® ar Concerta XL®). Atlikta pusiau struktūrizuota tėvų apklausa telefonu VUVL filialo Vaiko raidos centro Vaikų psichiatrijos skyriuje gydytų vaikų, kuriems diagnozuotas HS ir pradėtas gydymas psichostimuliatorių grupės preparatais (PGP). Anketa sudaryta iš dviejų dalių: pirma anketos dalis susideda iš 32 klausimų, kuri buvo sudaryta savarankiškai, ir antra anketos dalis – vaistų šalutinių poveikių vertinimo skalė (Russel A. Barkley and Kevin Murphy „SIDE EFFECTS RATING SCALE“). Duomenys apdoroti statistikos programa SPSS for Windows v. 9 bei “MS Exel 2002” programa. Darbo rezultatai. Daugiausia tyrime dalyvavo 11-15 m. amžiaus vaikų, kurie sudarė 75% visų tiriamųjų, t.y. 30 iš 40 vaikų. Berniukams HS diagnozuojamas ir gydymas skiriamas dažniau nei mergaitėms, tai sudarė atitinkamai 87,5% ir 12,5%. Vaikai stacionare pradėti gydyti psichostimuliatorių grupės preparatais (PGP): Ritalin‘u® ir Concerta XL® atitinkamai (23 berniukai - 57,5% ir 17 mergaičių – 42,5%). Du trečdaliai vaikų po... [toliau žr. visą tekstą] / SUMMARY Master‘s degree: Contemprorary nursing of children with hyperactive disorder Work tutor: VU MF Psichiatrijos klinikos Vaikų psichiatrijos ir socialinės pediatrijos centro docentė Sigita Lesinskienė Work author: student of the II course of master nursing speciality, Sandra Bakutytė Methodology. In this research participate 40 child parents, who children dispensary take psycho-stimulants group preparations (Ritalin or Concerta). This research accomplished parents interview by telephone, who children diagnosed ADHD and medicated psycho-stimulants group preparations in Child evolution centre children psychiatrical department of VUVL affiliate. Questionnaire made of two parts: first questionnaire part consist of 32 questions, which made independently, and second questionnaire part – medicine side effects rating scale (Russel A. Barkley and Kevin Murphy “Side effects rating scale”). Information processed by statistical programme SPSS for Windows v. 9 and “MS Exel 2002”. Results. The most part in the research participate 11 – 15 years old child, which consist 75%, it is 30 of 40 children. ADHD for boys is diagnosing and healing often than girls, it takes accordingly 87,5% and 12,5%. Children in stationary medicated psycho-stimulants group preparations: Ritalin and concerta accordingly 23 boys – 57,5% and 17 girls – 42,5%. Two-thirds of child after medical continues psycho-stimulants usage dispensary, but more than half 25 (62,5%) of all child medicines takes not regular, it... [to full text]

Darbo tikslas - įvertinti pacientų nuomonę apie bendruomenės slaugytojos teikiamas slaugos paslaugas namuose. Tyrimo metodika. Darbe naudoti kiekybiniai tyrimo metodai. Buvo atliekama anketinė apklausa Kauno rajono šeimos sveikatos klinikoje, kurioje dalyvavo 131 šioje įstaigoje besilankančių pacientų. Tyrimo duomenų statistinei analizei buvo naudotas SPSS 17.0 for Windows duomenų apdorojimo paketas. Rezultatai: Dažniausiai pacientai nurodo, jog jų būklė yra gera arba patenkinama. Apytiksliai trečdaliui pacientų yra nustatytas neįgalumas, iš jų daugiau nei pusei nustatytas didžiausias darbingumo lygis. 31,3% tiriamųjų nurodė, jog jiems kyla sunkumų atvykti į gydymo įstaigą, o dažniausios to priežastys – ilgos eilės pas gydytoją (39%), per silpna sveikata (22%) bei sunkumai lipti laiptais (22%). Nustatyta, jog dažniausiai namuose pacientus slaugo šeimos nariai (100%) ir tik ketvirtadalį – bendruomenės slaugytojai. Medicinines paslaugas namuose dažniausiai teikia gydytojas, o net trečdalis tiriamųjų iš viso nekviečia jokio medicinos darbuotojo į namus. Tyrimu nustatyta, jog tik 12,2% tiriamųjų per pastaruosius 2 metus naudojosi bendruomenės slaugytojo paslaugomis namuose. Jiems dažniausiai buvo suteiktos tokios paslaugos: pulso skaičiavimas, kraujo spaudimo matavimas, kraujo ėmimas tyrimams, vaistų peržiūra ir bendravimas. Visas jiems suteiktas paslaugas pacientai vertina labai gerai arba gerai, jų kokybę vertina gerai. Buvo pastebėta, jog nuo asmenų įgalumo/neįgalumo... [toliau žr. visą tekstą] / The research aimed to assess patients’ opinion about community nursing services provided at home. Methodology applied in the investigation. The research used quantitative methods. A survey was carried out at a Family Health Clinic in Kaunas district. 131 subjects attending the clinic participated in the research and answered a questionnaire. The results of the study were statistically analyzed using software SPSS 17.0 for Windows package. Results: In most cases the patients indicated that their health state was good or satisfactory. Approximately one third of the patients were disabled and more than half of them possessed the maximum work capacity. 31,3% of the subjects stated that they face difficulties with the arrival to the clinic. The most common causes were as following: long lines at doctor’s office (39%), a weak health (22%) and difficulties to climb the stairs (22%). It was determined that most of the patients were generally nursed by family members (100%) and only one fourth - by community nurses. Moreover, a doctor usually provided medical services at home and one third of the subjects did not invite any medical officers to their homes. The research revealed that only 12,2% of the subjects had used the community nursing services during the past two years. They received the following services: pulse rate measurement, blood sampling tests, drug monitoring and communication. The provided services were rated as very good and good. The patients commended the quality... [to full text]

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This qualitative study using a phenomenological design, aimed at exploring and describing and exploring the experiences of HIV positive clients defaulting Isoniazid Preventive Therapy services in the Bhisho Primary Health Care Services. The emphasis was on the factors leading clients to default. An in- depth unstructured face to face interviews were done on 14 participants from 4 clinics or facilities under Bhisho Primary Health Care Services. From the respondents’ responses it can be noted that work and family related issues, ignorance of patients, side effects, and negligence of nurses and denial of HIV status were identified as reasons for defaulting. Having knowledge about the treatment and health providers’ attitudes to patients also played a role in patients defaulting their treatment.Many suggestions were then put forward by the respondents to curb defaulting among patients. These included the use of text message reminders, not to discrimination HIV patients because of their status, to use consulting rooms for privacy and also nurses and caregivers to control their attitudes when dealing with patients.

Readmission of mental healthcare users is a global challenge and concern which is associated with high costs. Readmission has negative effects as it is believed to promote dependency, demoralize patients and cause workload for staff. Re-admissions also bring a burden to caregivers and affect the caregiver’s health. In the light of this background, the aim of the study was to explore and describe factors enhancing readmission of mental health care users (MHCUs) to a mental health unit in East London as described by their caregivers. The objectives of the study were to: explore factors enhancing readmission of mental health care users in a mental health unit in East London as described by their caregivers and to document recommendations elicited from the findings of the study. A qualitative approach was used to collect and analyze data. The study used a descriptive and explorative design. Sampling was done using the purposive non-probability method. Unstructured face- to- face interviews were conducted using an interview guide. Fifteen (15) caregivers of MHCUs who had been readmitted to a mental health unit in East London were interviewed .The interviews were recorded and transcribed verbatim. The findings of this study suggest that non adherence to treatment, refusing to take treatment, defaulting treatment, denial, indulging in substance abuse, stigma, effects of disease, violence and aggressive behavior are the factors enhancing readmission of MCHUs to a mental health unit in East London. A better understanding of readmission of MHCUs can lead to early intervention and early planning of care. It is envisaged that psycho education, home visits and collaboration of clinic staff with hospital staff may decrease readmission of mental health care users in this unit.

The continued increase in morbidity and mortality of hypertensive patients in Alice in the Eastern Cape Province, prompted the researcher to investigate the effectiveness of lifestyle modification intervention on hypertensive patients. High morbidity and mortality rates of hypertensive patients are occuring in spite of hypertensive patients being taught about lifestyle modification (De Haan, 2006:55). According to the fifth South African Guidelines (2011:60), hypertension is a global health burden affecting developed and developing countries including South Africa. In 2003, the South African District Health Statistics showed that in the Eastern Cape, 221 females over 15 years of age and 101 males over 15 years of age had moderate hypertension and 92 males over 15 years had severe hypertension. Hypertension is a `silent killer` because it seldom gives rise to any symptoms (De Haan, 2006:66). The objectives of the study were to: investigate the effectiveness of lifestyle modification intervention on hypertensive patients, and to determine the strategies used in order to ensure the effectiveness of lifestyle modification by hypertensive patients. The research question was: what is the level of effectiveness of lifestyle modification on hypertensive patients in Alice? A descriptive quantitative research design was used in this study. This design allowed the researcher to investigate the effectiveness of lifestyle modification of hypertensive patients in Alice area. A convenience sample was used to sample the target population for the study on the criteria and a total of 169 respondents served as a size of the sample. A pre-test of the tool was carried out on 16 participants to validate the tool before the actual data collection commenced. Ethical approval was obtained from University of Fort Hare, the Department of Health, as well as Victoria Hospital and clinics. Data were collected by means of self-administered questionnaires. The Statistical Package for Social Science (SPSS) version 21.0 software for windows reference was used to analyse the data. The results were presented in tables, graphs and pie charts. The results revealed that 77% (n=125) reported to know nothing about hypertension. Twenty three percent of the participants (n=37) knew about hypertension, they mentioned that it is when the heart has too much blood that is overloading the heart due to problems of the heart, then the blood flow through the heart is disturbed. Furthermore participants stated that it is important that every hypertensive patient engage in lifestyle modification. The study recommended that the Department of Health should emphasise the use of Hypertension Guidelines where all nurses in public clinics should be trained in educating and doing counselling to all hypertensive patients, including those who are pre-hypertensive that are visiting the clinics. Health education about risk factors and complications of hypertension must be done. All patients visiting public clinics must be educated regardless of their problems.

Pflegeheime sehen sich mit einer steigenden Komplexität konfrontiert, die Unsicherheiten bei der Entscheidungsfindung schürt und die Risikobewältigung erschwert. Rechnung getragen werden muss hierbei zum einen der wirtschaftlichen Überlebenssicherung der Unternehmung und zum anderen der Sicherstellung von Pflegequalität und Vermeidung von Risiken, die die Gesundheit und das Wohlbefinden der Pflegeheimbewohner gefährden. Menschen mit Demenz mit ihren spezifischen Bedürfnissen gebührt hierbei eine besondere Aufmerksamkeit: Anpassungsschwierigkeiten an das Pflegeheimsystemaufgrund von kognitiven Einschränken sind sowohl aus pflegerischer als auch aus betriebswirtschaftlichen Risikogesichtspunkten von Interesse und erfordern besondere Anstrengungen bei der Risikobewältigung im Rahmen eines ganzheitlichen Risikomanagements. Voraussetzung für die Implementierung und erfolgreiche Nutzung eines solchen Risikomanagements ist, dass sich die Akteure in den Pflegeheimen Klarheit darüber verschaffen, was sich hinter einem Risiko verbirgt und welche Situationen als risikohaft einzustufen sind. Hier zeigen sich zwischen den Fachdisziplinen häufig unterschiedliche Risikoverständnisseund Risikostrategien, die ein effektives Risikomanagement beeinträchtigen können. An dieser Stelle setzt das Forschungsvorhaben an; es spiegelt pflegerische und ökonomische Risikosichtweisen im Hinblick auf Bewohner mit Demenz und konkretisiert Barrieren, die die Risikobewältigung in Pflegeeinrichtungen erschweren. In Anlehnung an Meuser und Nagel (2005) bilden Experteninterviews mit Pflegefachkräften und Einrichtungsleitungen die Datenbasis für die Beantwortung der Frage, wie sich das Spannungsfeld von Pflege und Ökonomie bei der Betrachtung von Risiken in der Stationären Altenhilfe unter besonderer Berücksichtigung von Menschen mit Demenz äußert ohne dabei ethische Aspekte zu vernachlässigen. Die inhaltsanalytische Textauswertung erfolgt nach der Methode von Mayring (2002), jeweils separat für die pflegerische und ökonomische Risikoperspektive und mündet in einer Gegenüberstellung und Diskussion der gemeinsamen und unterschiedlichen Herangehensweisen im Hinblick auf die demenzbezogene Risikothematik. In der ergänzend durchgeführten quantitativen Befragung sämtlicher Pflegeeinrichtungen in Niedersachsen und Nordrhein-Westfalen wird parallel zur qualitativen Hauptuntersuchung der Entwicklungsstand zum Risikomanagement in der Praxis abgefragt. Der Umgang mit Risiken und Ansätze zur Risikolenkung in Einrichtungen der Stationären Altenhilfe stehen im Mittelpunkt dieser deskriptiven Untersuchung. Die durch die Arbeit erzeugte Plattform lädt dazu ein, disziplinübergreifend über demenzspezifische Risiken zu diskutieren. Sie legt die Basis für ein integriertes Risikomanagementmodell für Einrichtungen, in denen pflegerische und ökonomische Risiken von Interesse sind. Gleichzeitig schafft die Arbeit eine Momentaufnahme zum Risikomanagement im Bereich der Stationären Pflege, so dass die Ableitung von Handlungsempfehlungen für die Praxis möglich wird.

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