The patient-doctor relationship (PDR) as perceived by the patient is an important concept in primary care and psychotherapy. The PDR Questionnaire (PDRQ-9) provides a brief measure of the therapeutic aspects of the PDR in primary care. We assessed the internal and external validity of the German version of the PDRQ-9 in a representative crosssectional German population survey that included 2,275 persons aged$14 years who reported consulting with a primary care physician (PCP). The acceptance of the German version of this questionnaire was good. Confirmatory factor analysis demonstrated that the PRDQ-9 was unidimensional. The internal reliability (Cronbach’s a) of the total score was .95. The corrected item-total correlations were$.94. The mean satisfaction index of persons with a probable depressive disorder was lower than that of persons without a probable depressive disorder, indicating good discriminative concurrent criterion validity. The correlation coefficient between satisfaction with PDR and satisfaction with pain therapy was r = .51 in 489 persons who reported chronic pain, indicating good convergent validity. Despite the limitation of low variance in the PDRQ- 9 total scores, the results indicate that the German version of the PDRQ-9 is a brief questionnaire with good psychometric properties to assess German patients’ perceived therapeutic alliance with PCPs in public health research.

Tekniken är en stor del av dagens samhälle. Allt fler tjänster och saker blir digitaliserade, nu även sjukvården. Denna avhandling kommer att introducera dig till e-hälsa och hur digitaliseringen av sjukvården påverkar relationen mellan doktor och patient samt vilka förtroendeproblem som kan uppstå.E-hälsopplikationerna behöver vara användarvänliga och enkla att använda för patienterna. Patienterna behöver känna sig trygga och säkra. För att undersöka användarupplevelsen i de olika kanalerna jämförde vi de två olika flödena: personligt möte med videosamtal.Det finns många olika leverantörer av e-hälsoapplikationer i Sverige, Kry och Min Doktor är två av de mest populära. Digitaliseringen av sjukvården påverkar inte bara patienterna utan läkarna är lika involverade. För att få en läkares åsikt ställde vi ett par frågor till läkare om bedömning av patienter via videosamtal. Ett frågeformulär gjordes för att samla in information om patienternas förhållande, användning och erfarenhet av e-hälsoapplikationer.Frågeformuläret visade att det finns delade åsikter om e-hälsoapplikationerna. Vissa patienter tror att e-hälsapplikationerna kommer att gynna samhället och kan själva tänka sig att använda en e-hälsoapplikation för mindre åkommor. Andra patienter är starkt emot e-hälsa och de flesta av dem instämmer i att det är ett slöseri med skattepengar. En annan vanlig orsak emot e-hälsa är att patienter tycker att deras åkommor är för komplexa eller att de inte litar på att läkaren ger dem korrekt vård genom en applikation. / Technology is a big part of today's society. At this time more things and services become digitized, now even healthcare. This thesis will introduce you to e-health and how to digitize healthcare will affect the doctor-patient relationship and the trust issue that may occur. E-Health applications need to be user-friendly and easy to use. The user needs to feel comfortable and safe. To investigate the cross-channel user experience we compared the two different flows: in-person appointment and video conference. There are many different providers for e-health applications in Sweden, most popular are Kry and Min Doktor. This digitizing not only affects the patients, but the doctors are also equally involved. We questioned doctors about their approach towards assistance through an application. A questionnaire was done to gather information about the patient's relationship and usage of e-health applications. The questionnaire showed that there are some divided opinions regarding e-health applications. Some patients think that e-health applications will benefit society and may use an e-health application for minor complaints. Other patients are strongly against e-health, and most of them agree that it is a waste of tax money. Another common reason against e-health is that patients think that their complaints are too complex or that they do not trust the doctor to provide them the accurate assistance through an application.

Indiana University-Purdue University Indianapolis (IUPUI) / The treatment of chronic diseases requires patient adherence to medical advice. Nonadherence worsens health outcomes and increases healthcare costs. Consultations with a virtual physician could increase adherence, given the shortage of healthcare professionals. However, if the virtual physician is a computer animation, acceptance of its advice may be hampered by the uncanny valley effect, a negative affective reaction to human simulations. Two experiments were conducted to investigate the impact of the virtual physician on patients’ adherence. The first study, a 2 ´ 2 ´ 2 between-groups posttestonly experiment, involved 738 participants playing the role of a patient in a hypothetical virtual consultation with a doctor. The consultation varied in the doctor’s Character, Outcome, and Depiction. Character, Outcome, and Depiction were designed to manipulate the doctor’s level of warmth, competence, and realism. The second study, a 2 ´ 5 between-groups experiment, involved 441 participants assuming a patient’s role in a similar hypothetical virtual consultation with a doctor. The experiment varied the doctor’s Character and Depiction. These independent variables were designed to manipulate the doctor’s level of warmth and eeriness. The first study found that warmth and competence increased adherence intention and consultation enjoyment, but realism did not. On the contrary, the computer-animated doctor increased adherence intention and consultation enjoyment significantly more than the doctor portrayed by a human actor. The enjoyment of the animated consultation caused the doctor to appear warmer and more real, compensating for his realism inconsistency. In the second study, Depiction had a nonsignificant effect on adherence intention, even though the computer animated doctor was perceived as eerier than the real human. The low-warmth, high-eeriness doctor prompted heuristic processing of information, while the high-warmth doctor prompted systematic processing. This pattern runs counter to the literature on persuasion. The doctor’s eeriness, measured in a pretest, had no significant effect on adherence intention via the heuristic-systematic model. Although virtual characters can elicit the uncanny valley effect, they were comparable to a real person in increasing adherence intention, adherence and health behavior. This finding should encourage the development and acceptance of virtual consultation to address the shortage of healthcare professionals. / 2023-11-03

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Shortly after Charles Dickens's A Christmas Carol was released in 1843, a tradition of adaptation began which has continued seemingly unabated to the present day. Consequently, the tale has become so widely known that one is arguably as likely to have first encountered the iconic miser Scrooge through any number of audio-visual adaptations as through the original work itself. Significant critical attention has been paid to the nature of Scrooge's drastic change from miser to philanthropist. Many would argue that the change, happening both literally and figuratively overnight, is not representative of a genuine psychological transformation. On Christmas day, 2010, Stephen Moffat, Show-runner of the popular sci-fi series Doctor Who, became the latest adapter of the classic tale, with a Christmas themed episode of the series titled Doctor Who: A Christmas Carol. This paper addresses the Scrooge Problem, or the debated legitimacy of Scrooge's transformation. A study of A Christmas Carol and Doctor Who: A Christmas Carol reveals that Dickens in fact represents a genuine transformation based on one primary concept, time as a cyclical journey. This concept accommodates Dickens's belief in the transformative power of childhood memory and the nature of sympathy. Scrooge's transformation is brought to pass in part through his evolving understanding of the nature of time, a phenomenon which becomes even more apparent in Doctor Who: A Christmas Carol.

Kompetensområdet sjuksköterskans arbetsledning av omvårdnadsarbetet är ett tämligen outforskat ämne. Mer kunskap om läkare- och undersköterskors syn på vad som innefattas i sjuksköterskans arbetsledning skulle kunna bidra till ett bättre samarbete som på sikt kan gynna omvårdnadsarbetets utveckling och därigenom även patienten. Syftet med studien är att få ökad kunskap om läkare och underskö-terskors syn på vad som innefattas i kompetensområdet sjuksköterskans arbets-ledning av omvårdnadsarbetet. Metoden som användes var en empirisk intervju-undersökning där urvalet bestod utav fyra läkare och fyra undersköterskor. Mate-rialet analyserades med innehållsanalys, inspirerad av Burnard (1991). Resultatet utmynnade i följande huvudkategorier: Överblick, samarbete och yttersta om-vårdnadsansvaret. Resultatet visade att det som informanterna ansåg innefattas i sjuksköterskans kompetensområde arbetsledning av omvårdnadsarbetet i stor ut-sträckning stämde överens med uppgifter som benämns under huvudområdet ar-betsledning i Socialstyrelsens kompetensbeskrivning för legitimerad sjuksköterska (2005) men att rollen som arbetsledare av omvårdnadsarbetet inte var självklar och erkänd av alla informanterna. / Leadership in nursing is a relatively unexplored area of research. Further knowl-edge about doctors and staff nurses’ views on what is included in this area could gain development in nursing and thereby the qualities of patient care. The aim of this study is to gain further knowledge about doctors and assistant nurses’ views on what is included in the area of leadership in nursing. The method used was semi-structured interview. The selection of informants was four doctors and four assistant nurses. The analysis method was thematic content analysis inspired by Burnard (1991). The analysis resulted in the following main categories: General view, ability of cooperation and main responsibility. The result showed that doc-tors- and assistant nurses' views on what was included in the area of leadership in nursing to a large extent was congruent to job assignments written in The National Board of Health and Welfare’s competence description for registered nurses. However, the leadership role of nursing was not obvious and acknowledged by all the informants.

Ett stort antal patienter söker information på Internet för att fatta olika beslut ochförbereda sig för olika procedurer. Syftet med denna studie var att belysa hälsoochsjukvårdsinformation på Internet. Metoden var en litteraturstudie baserad på11 vetenskapliga artiklar. Resultatet visar att validerade utbildnings- ochinformationsprogram på Internet kan bidra till förbättring av patienternasegenvård. Det framkommer att dialogen mellan Internet informerade patienter ochprofessionen har ändrats. Internet anses generellt vara en resurs och stöd, menpatienterna kan uppleva det svårt att finna och förstå hälso- ochsjukvårdsinformation. Brister i kvalitén på vissa webbsidor som handlar om olikahälso- och sjukdomstillstånd förekommer. Kvalitetskontroller av webbsidor börgöras. Konklusion: Hälsoinformation på Internet har kommit för att stanna. Ominformationen har hög kvalitet och utformningen av Internetsidan möterpatienternas behov kan detta leda till att patienterna blir mer aktiva ochvälinformerade. Därmed får de mer makt och bättre resultat av sin egenvård. / A large number of patients are seeking information on the Internet to makedifferent decisions and prepare for various processes. The purpose of this studywas to highlight health information on the Internet. The method was based on aliterature review of 11 scientific articles. The result show that validated trainingand information programs on the Internet can contribute to the improvement ofpatients´ self-care. It appears that the dialogue between the Internet informedpatients and the profession has changed. The Internet is generally considered to bea resource and support, but patients can experience it difficult to find andunderstand health information. Deficiencies in the quality of some Web pagesrelated to various health and medical conditions exist. Quality controls on Webpages should be done. Conclusion: Health information on the Internet has come tostay. If the information is of high quality and the design of the Internet page meetpatients ' needs, this can lead to patients becoming more active and wellinformed.Thus, they get more power and better results from their self-care.

A March 1866 issue of The Lancet observes, "If a newspaper were in want of a startling story with which to enliven a dull copy in the 'off season,' it could not do better than select one with the heading "'Buried Alive'"("Premature Interment" 295). Stories of being buried alive gave readers of all backgrounds a thrill. However, the stories frustrated the medical and scientific communities who were quick to dismiss the threat of live burial as a possibility in a modern world. Drawing on the literary history of "buried alive" stories and medical knowledge surrounding death signs and catalepsy, this thesis explores how two of L.T. Meade's stories from her Stories from the Diary of a Doctor series engages with the "buried alive" literary tradition in favor of nineteenth-century debate for death certification reform. Through applying common tropes found within the "buried alive" literary tradition, Meade's Diary of a Doctor stories address the most pressing concerns surrounding death certification reform in a way that engage contemporary readers' interest while emphasizing the need for legislative change.

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