This descriptive study utilized semi-structured interviews and observations to examine the experiences of hospitalized school-age children, and explore the potential of a live, closed-circuit television program as a psychosocial intervention. Among findings, Phase I data from 16 subjects indicates a) concern with painful medical procedures, particularly intraveneous (IV) injections, b) a desire for more information, especially concerning medical equipment, c) a variety of responses to social issues among subjects, d) the importance of activities, and e) the central role of the hospital playroom. Phase II data indicates that live, closed-circuit television can provide ambulatory and room-bound children opportunities for making choices, social interaction, participation, and information on their environment. Conclusions and implications are included.

published_or_final_version / Social Work / Master / Master of Social Work

The purpose of this study was to assess if preterm infants receiving an intervention of intermittent human tactile contact would demonstrate clinical improvement over infants who did not receive the intervention. A quasi-experimental design was used with 26 infants between 28 and 32 weeks gestation. Hands were placed on the infants' heads and lower backs for a total of 36 minutes of tactile contact a day for 10 days. Findings indicated a significant gain in mean body weight for both groups between Day 0 and Day 10. Also, there was a significant decrease in mean hematocrit in the control group between Day 0 and Day 10. On Day 10, experimental infants had a significantly higher mean number of apneic and bradycardic episodes than control infants. There were no significant mean differences between the groups for body weight, body temperature stability, oxygen variance, or hematocrit. Data suggest that gentle human touch may be correlated with desireable outcomes. Further research is necessary.

Two related program evaluations of the mental health system in Puerto Rico are conducted. Initially, research is carried out in two state psychiatric hospitals involving an organizational analysis of relevant systems variables as they impinge upon effective institutional functioning. In this scheme hospital effectiveness is predicted by success in achieving formally prescribed goals and in the adequacy of resource utilization. The basic assumption is that the psychiatric hospital reflects the patterning of reciprocal and interdependent behaviors of individuals which form a larger all-important pattern. The hospitals are studied by means of a questionnaire administered to staff to ascertain perceptions of the work environment, communication and coordination processes, overall hospital organization, and the treatment environment. The results of organizational functioning are presented in a profile analysis plotting institutional means over ten functional dimensions. Individual component variables are converted into standard scores and broken down by staff sub-groups. Each institution and staff sub-group differs uniquely across the dimensions. Overall the results point to excessive staff frustration and disillusionment with the organization's functions, and a treatment environment limited in patient autonomy, socio-emotional interaction, and therapeutic content. The complementary study of first releases from these hospitals examines background and performance characteristics of a sample of patients in an effort to distinguish those who complied with aftercare referrals from those who did not, and those who were readmitted from those still in the community one year after release. Bivariate analysis of the relationship between each of the two dependent variables and the several demographic and treatment variables at each hospital reveals that the strongest differentiation of compliers from non-compliers is having been active in pre-hospital outpatient care, while the extent of use of aftercare was the strongest predictor of remaining in the community. Implications for policy and for further research in mental health service delivery are discussed.

This study examined the relationship between performance in a leveled token economy for emotionally disturbed adolescents and posttreatment level of functioning six months after discharge from the target program. The target program for the study is an acute care psychiatric hospital which specialized in the treatment of adolescents with both emotional and substance abuse problems. Previous literature on the outcome of token economy treatment programs however for they adolescents have generally been favorable have typically not examined level of functioning as an outcome criteria.

The health care requirements of older people admitted to acute hospitals and their need for nursing care have been identified in current literature as problematic. Hospital organisations which are medically oriented and more focused on implementing programs directed by economics, efficiency and effectiveness may be unsupportive of nursing practices based on a professional value system. There is a need, therefore, to examine how health care structures that tend to promote cost containment and a technical imperative, impact on the professional capability of nurses to provide the standard of care required by acutely ill older hospitalised patients. The collected data, analysed thematically, indicates that the nurses were knowledgeable and potentially competent in providing the standard of technical and functional care required by older adults in hospital. However, although nurses articulated that they wanted to provide the quality of care needed by acutely ill older patients, they nevertheless admitted they were optionalising this care because of constraints in the health care system.While the nurses’ constructions revealed they believed technical tasks took up most of their time during shifts, it is evident during the observations that this was not the case. Through the use of Giddens’s (1984) Structuration Theory, a very different picture began to unfold about the incongruence about was said, and what was actually done. The significance of this study is that the incongruence found between the nurses’ knowledge and their actions has been revealed. / Doctor of Philosophy (PhD)

I Sverige föds ca 90 000 barn per år och cirka 10 % behöver vård på en neonatalavdelning. Orsakerna till det kan vara många, men vanligt är att barnen som drabbas, är för tidigt födda och då är extra utsatta pga. sin omognad. Syftet med studien var att ta reda på pappans upplevelse att vårda sitt barn på en neonatalavdelning. En kvalitativ forskning med innehållsanalys som metod valdes. Sju stycken pappor som hade vårdat sitt barn på en neonatalavdelning intervjuades med en frågeställning ”Hur upplevde du att vårda ditt barn på en neonatalavdelning”? Resultatet delades in i tre kategorier som ”vilja skapa anknytning till sitt barn”, ”känsla av otillräcklighet” och ”behov av att känna trygghet” med tillhörande underkategorier. I studien framkom att pappan tycker att det är viktigt att få vara nära barnet och vill gärna ta ansvar för vården. De var mycket nöjda med vården och hade tillit till vårdpersonalen men upplevde att de skulle velat haft mer stöd.  Det framkom även att de tyckte att det var frustrerande att vilja vara på flera ställen samtidigt. Med denna studie hoppas författarna kunna öka kunskapen som ska främja ett individuellt anpassat stöd för en bättre omvårdnad av det nyfödda barnet. / In Sweden, about 90 000 children per year are born and about 10% of these need to be taken care in neonatal intensive care unit. The causes can be many, but the most common reason is that the children who suffer, are prematurely born and are extra vulnerable due to their immaturity. The purpose of the study was to find out the father's experience of caring for their child in a neonatal intensive care unit. A qualitative research using content analysis method was chosen. Seven fathers who had to provide care of their child in a neonatal department were interviewed with a question "How you did your experience to take care for your child at a neonatal department?" The results were divided into three categories such as "like to create ties to their child," "sense of inadequacy" and "need to feel safe" with its sub-categories. The study revealed that the father thinks that it is important to be close to the child and would like to take responsibility for the health care. They were very satisfied with the care and had trust in the caregivers, but felt that they would have had more support. The fathers also experienced frustration of the wish to be in several places simultaneously. In this study, the authors hope to raise awareness to promote a personalized support for a better care of the newborn baby.

Bakgrund: BB vården i de västerländska länderna har genomgått stora förändringar desenaste decennierna. Trots detta visar studier på att ett stort antal kvinnors inte är nöjda medden vård de fått efter barnets födelse. Syfte: Syftet med denna litteraturöversikt är att beskrivanyförlösta kvinnors upplevelser i samband med BB vård på sjukhus. Metod: Enlitteraturöversikt baserad på tio vetenskapliga artiklar med både kvalitativ och kvantitativmetod. Resultat: Fyra huvudteman framkom vid analysen av artiklarna; information,vårdorganisation och vårdmiljö, bemötande och attityder samt stöd. Det visade sig finnasväldigt många olika faktorer som påverkade kvinnors upplevelser av BB vården. Dessa kundevara mer eller mindre betydelsefulla för olika kvinnor. Kunskapen om detta kan bidra till attvårdpersonalen får en ökad förståelse för att varje nyförlöst kvinna är en unik individ medegna specifika önskemål och behov och att BB vården inte får generaliseras. Diskussion: Densjukhusförlagda BB vården måste bedrivas så att den uppfyller kravet på god vård. Detta föratt förhindra att nyförlösta kvinnor upplever onödigt vårdlidande. / Background: Postnatal care in western countries has undergone major changes in recentdecades. Despite this, studies show that many women are not satisfied with the care theyreceived after the birth. Objective: The purpose of this literature review is to describewomen's experiences of postnatal hospital care. Method: A literature review based on tenscientific articles in both qualitative and quantitative approach. Result: Four major themesemerged from the analysis of the articles; information, health care organization and healthcare environment, encounter and attitudes and support. It proved to be very many differentfactors that influenced women's experiences of postnatal care. These could be more or lessimportant for different women. Knowledge of this can contribute to health care professionalswith a better understanding of that each woman that recently given birth is a unique individualwith their own specific wants and needs and that postnatal care can not be generalized.Discussion: The postnatal hospital care must be conducted so that it meets the requirement ofgood care. This is to prevent unnecessary care suffering among women that recently givenbirth.

Adaptation to role transitions can have various outcomes. Health and demographic characteristics as well as environmental control have been shown to affect the transition to the role of patient. The acutely ill elderly's adaptation to the role of hospitalized patient has not been measured from the elderly patient's perspective. This study utilized a random sample of 176 hospitalized elderly medical-surgical patients and the patients' registered nurses to examine the relationships among demographic and health characteristics, latitude of choice and elderly hospitalized patient adjustment. Patients were excluded who had been in ICU for more than 24 hours, had decreased mental status, or were judged to be too physically ill to participate. The study used an adaptation of the Latitude of Choice Scale (a measure of environmental control) developed by Hulicka and colleagues, a nurse-rated hospitalized patient adjustment scale developed by Cicirelli, and an adaptation of the adjustment scale for patients' self-assessment. Results from a series of multiple regression analyses indicate that, taken as a group, neither demographic nor health characteristics predict environmental control, as measured by the adapted version of the Latitude of Choice Scale (LOC). However, one individual health characteristic, length of time since last hospitalization, was a negative predictor of LOC. Further, the results indicate that taken as a group, health and demographic characteristics, along with patient LOC scores are not predictive of either nurse or patient-rated adaptation. The individual health characteristic "patient acuity rating" did negatively predict both nurse and patient-rated adjustment scores. Nurse-rated patient adjustment scores were also negatively predicted by the participants' prior number of hospitalizations. A paired-t test indicated that patients rated themselves significantly better adjusted than did their nurses. This finding was judged to be clinically unimportant because of the small real difference in the mean scores. Random-effects ANOVA found no significant variance between nurses' ratings of patients. / Graduation date: 1991

<p>I Sverige föds ca 90 000 barn per år och cirka 10 % behöver vård på en neonatalavdelning. Orsakerna till det kan vara många, men vanligt är att barnen som drabbas, är för tidigt födda och då är extra utsatta pga. sin omognad. Syftet med studien var att ta reda på pappans upplevelse att vårda sitt barn på en neonatalavdelning. En kvalitativ forskning med innehållsanalys som metod valdes. Sju stycken pappor som hade vårdat sitt barn på en neonatalavdelning intervjuades med en frågeställning ”Hur upplevde du att vårda ditt barn på en neonatalavdelning”? Resultatet delades in i tre kategorier som ”vilja skapa anknytning till sitt barn”, ”känsla av otillräcklighet” och ”behov av att känna trygghet” med tillhörande underkategorier. I studien framkom att pappan tycker att det är viktigt att få vara nära barnet och vill gärna ta ansvar för vården. De var mycket nöjda med vården och hade tillit till vårdpersonalen men upplevde att de skulle velat haft mer stöd.  Det framkom även att de tyckte att det var frustrerande att vilja vara på flera ställen samtidigt. Med denna studie hoppas författarna kunna öka kunskapen som ska främja ett individuellt anpassat stöd för en bättre omvårdnad av det nyfödda barnet.</p><p> </p> / <p>In Sweden, about 90 000 children per year are born and about 10% of these need to be taken care in neonatal intensive care unit. The causes can be many, but the most common reason is that the children who suffer, are prematurely born and are extra vulnerable due to their immaturity. The purpose of the study was to find out the father's experience of caring for their child in a neonatal intensive care unit. A qualitative research using content analysis method was chosen. Seven fathers who had to provide care of their child in a neonatal department were interviewed with a question "How you did your experience to take care for your child at a neonatal department?" The results were divided into three categories such as "like to create ties to their child," "sense of inadequacy" and "need to feel safe" with its sub-categories. The study revealed that the father thinks that it is important to be close to the child and would like to take responsibility for the health care. They were very satisfied with the care and had trust in the caregivers, but felt that they would have had more support. The fathers also experienced frustration of the wish to be in several places simultaneously. In this study, the authors hope to raise awareness to promote a personalized support for a better care of the newborn baby.</p>