Background: Patients with schizophrenia often lack both self-knowledge and disease insight. They are frequently withdrawn, show less interest in their surroundings and have a slight social disability in handling their everyday life, all of which led to decreased capability of expressing their needs. The focus tends to be on the diagnosis and not the persons themselves. The nursing they get is often incomplete and is hence not patient centered. The imbalance in the relations between the nurse and the patient with schizophrenia increases the nurses’responsibility to achieve a good standard of nursing and a secure care for the patients. Aim:The purpose is to describe nurses’ experiences of meeting patients with schizophrenia admitted to inpatient psychiatric care. Method: General literature studies with a qualitative approach where the data was analyzed by thematic analysis. Results: Three themes wereidentified: the nurses’ personal treatment and approach, the nurses’ co-operation and relationsto the patient and the nurses experience and knowledge. Conclusion: The nurses’ experiences were that personal treatment and approach are essential to achieve a good standard of nursing. Lack of experience and knowledge were identified as barriers to achieve alliances and cooperation. Nurses expressed that lack of knowledge and adequate education negatively affected their views on patients with schizophrenia.

Research has shown that Family Centered Care (FCC), or a partnership between parents and health care professionals, has a positive impact on child outcomes when a child is hospitalized and post discharge as well as on psychosocial wellbeing for the family as a whole (Glang, McLaughlin, & Schroeder, 2007; Harrison, Romer, Simon, & Schulze, 2007; Bamm & Rosenbaum, 2008; An & Palisano, 2014; Foster, Whitehead, & Maybee, 2010). However, throughout the literature it is evident that FCC principles, including parent participation, are not being implemented effectively in pediatric inpatient rehabilitation, leading to a disparity between what theory and evidence supports and what is seen in actual practice (An & Palisano, 2014; Aarthun & Akerjordet, 2012; Foster et al., 2010; Arcuri, McMullan, Murray, & Silver, 2015). The aim of this doctoral project was to better understand the factors that are influencing this problem as well as explore evidence-based solutions to this problem. A literature review on these topics was used to develop an educational program for pediatric occupational therapists called Engaging Families: A Continuing Education Course on Family Centered Care Principles and Practice. Engaging Families is a two-day training course educating pediatric occupational therapists on FCC strategies and implementation of these strategies in order to effectively incorporate parents in their child’s inpatient occupational therapy process.

No description available.

Patients with brain injuries can encounter several neurological symptoms that affect physical and psychological functioning. This change in function can impact sexual health and intimacy. Patients with brain injuries who are referred to acute rehabilitation hospitals spend three hours a day in therapy. These patients develop rapport with their occupational therapy practitioners (OTPs) who are in a unique position to address sexual health and intimacy concerns. There is limited research on occupational therapy (OT) interventions for sexual health and intimacy with adults after brain injury. This paper proposes an application program that addresses sexual health and intimacy education for patients with brain injuries receiving occupational therapy. The smartphone application, Comfort, will assist occupational therapists to overcome barriers to include sexual health and intimacy in client-centered and occupation-based care.

Background: From 2002-2011, there were over 17,000 shootings in Philadelphia. "Turning Point", Temple University Hospital's violence intervention program, takes advantage of the teachable moment that occurs after violent injury. In addition to receiving social work services, Turning Point patients watch their trauma bay resuscitation video and a movie about violence, meet with a gunshot wound survivor and an outpatient case manager, and undergo psychiatric assessment. The purpose of this study was to determine the efficacy of Turning Point in changing attitudes toward guns and violence among victims of penetrating trauma. Methods: This prospective randomized study was conducted from January-June 2012. Patients who sustained a gunshot or stab wound were randomized to Standard of Care, which involved social work services only, or Turning Point. The Attitudes Toward Guns and Violence Questionnaire was administered to assess attitude change. Analysis was performed with the Wilcoxon signed-rank test. A p < 0.05 was significant. Results: A total of 40 out of 159 patients with gunshot or stab wounds were enrolled and completed the study in its entirety. The most common reason for exclusion was anticipated length of stay being less than 48 hours. The two groups were similar with respect to most demographics. Unlike the Standard of Care group, the Turning Point group demonstrated a 44% reduction in its Aggressive Response to Shame, a 33% reduction in its Comfort with Aggression, and a 20% reduction in its overall proclivity toward violence. Conclusion: Turning Point is effective in changing attitudes toward guns and violence among victims of penetrating trauma. Continued enrollment and longer follow-up are necessary to determine if this program can have a long-lasting impact and truly be a turning point in patients' lives. / Public Health

Yes / Purpose: The chief objective of the study is to understand that how different demographic variables and repeated availing of service from the same doctor or same hospital shapes the overall perception of healthcare service quality and satisfaction among inpatients admitted in private hospitals in an emerging economy. Methodology: A self-administered, cross-sectional survey of inpatients using a questionnaire translated into Hindi and Gujarati. The data was collected from 702 inpatient from 18 private clinics located in three selected cities from Western India. Findings The results indicate that experience with hospital administration, doctors, nursing staff, physical environment, hospital pharmacy and physical environment is significant predictor of inpatient satisfaction. Physical environment was found to be significantly associated with satisfaction only among female inpatient. It was also found that repeat availing of services either from the same hospital or doctor does not increases patient satisfaction. The feasibility, reliability and validity of the instrument that measures major technical and non-technical dimensions of quality of healthcare services were established in the context of a developing country. Originality/Value: The study makes important contribution by empirically investigating the inpatient assessment of healthcare service quality based upon their demographic information and repeated availing of services to understand how repeat visit shapes the service quality perception.

Mental health is a growing concern for adolescents. Billions of dollars are spent annually on mental services for youth. Many adolescents experience abuse, suicidal ideations, psychotic disorders, substance abuse, and other challenges. Recurring inpatient psychiatric hospitalizations are increasing among adolescents. The recurring admissions impact adolescents significantly socially, psychologically, and financially. Social workers are a vital part of this treatment process from admission to discharge. The research question asked what were the issues and challenges social workers encounter when conducting discharge planning with adolescents receiving recurring inpatient psychiatric treatment. The purpose for this doctoral project was to carefully examine the discharge planning process while identifying ways social workers can positively impact the process. Key concepts for this project were adolescent, inpatient hospitalization, recurring hospitalization, and discharge planning. Systems theory was used to inform the project. This action research study allowed social workers to share their experiences and perspectives about the role of social workers in discharge planning. Seven participants were identified using purposive sampling. One focus group provided data for project. Data analysis consisted of in vivo and process coding. Four participant-inspired themes identified related to issues and challenges in discharge planning include (a) adequate resources, (b) insurance restrictions, (c) rapport with adolescents, and (d) parental participation. Social work practice and positive social change implications include establishing follow-up protocol for all adolescent discharges from inpatient settings and increasing the use of encouragement and engagement strategies for rapport building with adolescents.

The management of patients hospitalised with diabetes mellitus is neglected in South Africa. The research on which this thesis is based assessed factors contributing to glycaemic control as well as evaluated an intervention aimed at improving of such control in diabetic inpatients. A survey of doctors and nurses measuring their perceptions, knowledge and attitudes regarding care of diabetic inpatients was done. This indicated a need for special training in inpatient diabetes care, where 90.5% of respondents realised that diabetes is a serious condition and 92.2% valued the importance of tight glycaemic control. Despite these perceptions, the knowledge of doctors and nurses caring for diabetic inpatients was suboptimal. A before and after study regarding an intervention to improve glycaemic control of diabetic inpatients consisted of a training programme and the introduction of an inpatient management protocol. The mean blood glucose on day one of admission after the intervention was significantly higher than before the intervention (p < 0.001). A significant improvement in mean blood glucose from day 1 to day 7 of hospitalisation was seen after the intervention (p < 0.001), which was not significant before (p = 0.33). The proportion of patients achieving glycaemic control did not significantly differ before and after the intervention (43.0% versus 43.7%, p = 0.97). A double blind randomised controlled trial to assess superiority of Ringer’s lactate solution compared to 0.9% Sodium chloride solution in the normalisation of pH in patients with diabetic ketoacidosis was done. The outcome of this study indicated that the time to normalisation of venous pH (pH > 7.32) (HR: 1.863, CI: 0.937 to 3.705, p = 0.758) was not significantly different between the two resuscitation fluid groups The time to reach a blood glucose of 14 mmol/L was significantly longer in the Ringer’s lactate group (p = 0.044) and patients needed significantly more insulin (p = 0.02). The overall conclusion of this study is that there is no significant benefit in using Ringer’s lactate solution as initial resuscitation fluid compared to the currently advised 0.9% Sodium chloride solution. / Thesis (PhD)--University of Pretoria, 2012. / Internal Medicine / unrestricted

Bakgrund: Tidigare forskning visar att patienter med psykossjukdomar får ett negativt bemötande i den somatiska slutenvården. Sjuksköterskors fördomar och bristande kunskap är något som kan inverka på omvårdnaden, en inställning som präglar samhället i stort både i nutid och historiskt sett. Förutsättningar för en personcentrerad omvårdnad innebär en relation av tillit och trygghet något som sjuksköterskor ofta saknar kunskap och erfarenhet att tillgodose i mötet med patienter med psykossjukdomar. Syfte: Att ur ett sjuksköterskeperspektiv beskriva upplevelser av att bemöta patienter med psykossjukdom inom den somatiska slutenvården. Metod: En litteraturöversikt har gjorts för att belysa hur sjuksköterskor upplever bemötandet av patienter med psykossjukdom inom den somatiska slutenvården. Resultatet baserar sig på tolv vetenskapliga artiklar varav sju var kvalitativa och fem kvantitativa vilka analyserades enligt Fribergs (2012) metod för resultatanalys. Resultat: Resultatet tyder på att sjuksköterskor upplever brister i kunskap, erfarenhet, stöd och tid. Negativa inställningar som frustration och rädsla är vanligt förekommande. Slutsats: Sjuksköterskor efterlyser en vidare utbildning i psykiatrisk omvårdnad för att undanröja negativa attityder i bemötandet av patienter med psykossjukdomar. Även tidsbrist upplevs som ett betydande problem i omvårdnaden. / Background: Previous research shows that patients with psychotic illnesses receive a negative attitude in somatic inpatient care. Nurses´ prejudices and lack of knowledge is something that can affect the care. This attitude characterizes society in general, both today and historically. Preconditions for a person-centered care implies a relationship of trust and confidence. Nurses often lack the knowledge and experience to accommodate in the meeting with patients with psychotic illnesses. Objectives: From a nurse perspective describe nurses’ experiences of encounters with patients with psychotic illness in somatic inpatient care. Methods: A literature review was used to highlight nurses' perceived treatment of patients with psychotic illness in somatic inpatient care. The results are based on the twelve peer-reviewed articles, seven were qualitative and five were quantitative, these were analyzed according to Friberg (2012) method for analysis of results. Results: The results show that nurses are experiencing gaps in knowledge, experience, support and time. Negative attitudes such as frustration and fear are common. Conclusions: Nurses request increased education in psychiatric nursing to eliminate the negative attitudes in treatment of patients with psychotic illnesses. Lack of time is also considered to be a significant problem in nursing.

There are theoretical and methodological difficulties in measuring the concepts of quality of care and patient satisfaction, and the conditions associated with these concepts. A theoretical framework of patient satisfaction and a theoretical model of quality of care have been used as the theoretical basis in this thesis. Aim. The overall aim was to describe and explore relationships between person-related conditions, external objective care conditions, patients’ perceptions of quality of care, and patient satisfaction with care in hospital. Methods. Quantitative and qualitative methods were used. In the quantitative study (I-III), 528 patients (83.7%) from eight medical, three surgical and one mixed medical/surgical ward in five hospitals in Norway agreed to participate (10% of total discharges). Data collection was conducted using a questionnaire comprising four instruments: Quality from Patients’ Perspective (QPP); Sense of Coherence scale (SOC); Big Five personality traits – the Single-Item Measures of Personality (SIMP); and Emotional Stress Reaction Questionnaire (ESRQ). In addition, questions regarding socio-demographic data and health conditions were asked, and data from ward statistics were included. Multivariate statistical analysis was carried out (I-III). In the qualitative study 22 informants were interviewed (IV). The interviews were analysed by conventional content analysis. Main findings. Patients’ perceptions of quality of care and patient satisfaction ranged from lower to higher depending on whether all patients or groups of patients were studied. The combination of person-related and external objective care conditions explained 55% of patients’ perceptions of quality of care (I). 54.7% of the variance in patient satisfaction was explained, and the person-related conditions had the strongest impact, explaining 51.7% (II). Three clusters of patients were identified regarding their scores on patient satisfaction and patients’ perceptions of quality of care (III). One group consisted of patients who were most satisfied and had the best perceptions of quality of care, a second group of patients who were less satisfied and had better perceptions, and a third group of patients who were less satisfied and had the worst perceptions. The qualitative study revealed four categories of importance for patients’ satisfaction: desire to regain health, need to be met in a professional way as a unique person, perspective on life, and need to have balance between privacy and companionship (IV). Conclusions. Patients’ perceptions of quality of care and patient satisfaction are two different concepts. The person-related conditions seem to be the strongest predictors of patients’ perceptions of quality of care and patient satisfaction. Registered nurses need to be aware of this when planning and conducting nursing care. There is a need of guidelines for handling over‑occupancy, and of procedures for emergency admissions on the wards. The number of registered nurses on the wards needs to be considered. Healthcare personnel must do their utmost to provide the patients with person‑centred care.