N/A / Thesis / Master of Science (MS)

Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1999. / Appendum consists of last two leaves. Copies of author's previously published articles inserted. Bibliography: leaves 241-283.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 5 uppsatser.

Congestive heart failure (CHF) is one of the leading causes of hospitalisation, morbidity and mortality in the UK. The incidence and prevalence of CHF is expected to increase due to the aging population and improved survival in heart disease. Exercise has been recognised as a valuable treatment and has proved to be beneficial in CHF. The present study applied the Theory of Planned Behaviour (TPB) and the Commonsense Model of Self-regulation to fitness, daily activity and medication-adherence in elderly patients with CHF. The study was in parallel with a randomised controlled trial of a 3-month exercise programme. A TPB questionnaire was used at baseline and at 3 months. Illness representations were assessed by IPQ-R at baseline. Fitness (measured by 6 minute walk test) and daily activity (measured by an accelerometer) were assessed at baseline, 3 and 6 months. ACEI-adherence (assessed by measuring serum ACE level) was assessed at baseline. The main findings from 81 CHF patients (mean age = 81 years) showed that Subjective norm (SN) was the only predictor of Intention (IN1) at baseline; Attitude, Perceived behavioural control (PBC) were predictors of INT at 3 months; fitness was predicted by PBC at 3 months. The exercise intervention led to significant changes in Attitude and PBe. The finding also indicated that the participants were more likely to attribute their illness to Chance, BiolOgical factors and God. Identity and Illness coherence predicted fitness, and Consequences predicted daily activity. Participants who believed that their illness was chronic or serious were less likely to adhere to ACEI medication. Conclusion: both the TPB and IPQ-R were useful instruments to predict behaviours in elderly patients with CHF. The IPQ-R had a greater predictive power than the TPB in this population. Illness representations may play a role in influencing the formation of intention as background factors.

This thesis examines the retention of best practices by clinicians after the implementation of an integrated care pathway for patients with congestive heart failure. While the literature suggests there are many reasons why the implementation of best practices is difficult, there is little information on the sustainability of best practices once implemented.<p>Using a qualitative research design guided by Rogers theory of Diffusion of Innovations the researcher interviewed seven clinicians who participated in the implementation of the pathway. A thematic analysis revealed several themes that ran throughout participants responses. <p>While the participants indicated they see value in best practices, they also identified barriers to getting that knowledge into practice and keeping it there. A spectrum of factors, including individual autonomy, time, resources, organizational support and the organization of the system all played a role.<p>In the end, participants revealed that although small pieces of the pathway remain in practice, the pathway itself is no longer used by clinicians to manage patients with congestive heart failure.

This thesis examines the retention of best practices by clinicians after the implementation of an integrated care pathway for patients with congestive heart failure. While the literature suggests there are many reasons why the implementation of best practices is difficult, there is little information on the sustainability of best practices once implemented.<p>Using a qualitative research design guided by Rogers theory of Diffusion of Innovations the researcher interviewed seven clinicians who participated in the implementation of the pathway. A thematic analysis revealed several themes that ran throughout participants responses. <p>While the participants indicated they see value in best practices, they also identified barriers to getting that knowledge into practice and keeping it there. A spectrum of factors, including individual autonomy, time, resources, organizational support and the organization of the system all played a role.<p>In the end, participants revealed that although small pieces of the pathway remain in practice, the pathway itself is no longer used by clinicians to manage patients with congestive heart failure.

No description available.

Dissertation (Ph.D.)--Auburn University, 2006. / Abstract. Includes bibliographic references.

Thesis (M.S.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains vii, 36 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 33-36).

Thesis (Ph.D.) - University of Queensland, 2004. / Includes bibliographical references.