Magister Artium - MA / Background: Physiotherapists are involved in the management of patients in the cardiothoracic Intensive Care Unit (ICU). Patient and family perception of care has become an important measure in evaluating the quality of care, including care in the intensive care setting. Overall Aim: To explore and describe the family and patient perception of physiotherapy care rendered in a public sector cardiothoracic ICU in the Western Cape, South Africa. Method: This study was conducted in two phases. Phase 1 (scoping review) identified and described available outcomes for measuring family perception of ICU care by searching six databases from inception to the 20th June 2018. Results from the scoping review informed the discussion schedule for the first primary study of Phase 2. Phase 2 (two exploratory descriptive qualitative primary studies) explored and described i) family perception and ii) patient perception of physiotherapy care in a cardiothoracic ICU. Audio-taped, individual face to face semi-structured interviews were conducted with family and patient participants that met the inclusion and exclusion sampling criteria (purposive sampling). Data was transcribed verbatim and analysed using deductive-inductive thematic content analysis. The data was coded, categorised and themes were generated. Trustworthiness of the data was ensured through methods addressing credibility, dependability, confirmability and transferability. Results: A total of ten full text studies were included in the scoping review. Included studies were published between 2006 and 2017, were conducted in both developed and developing countries, in different ICUs (except cardiothoracic ICU)and all used different quantitative outcome measures to measure family perception of ICU care. Thirteen cardiothoracic ICU patients and their respective family members partook in the studies describing patient and family perception of cardiothoracic ICU physiotherapy care. The median patient age was 62 years; the mean ICU length of stay 6 days and the median family age was 55. Themes arising from the family perception of care data analysed included: i) understanding of physiotherapy care (the role of the physiotherapist, perceived benefit of physiotherapy and communication), family involvement in physiotherapy care (physical presence during physiotherapy sessions and decision-making), and satisfaction of physiotherapy ICU care. Themes arising from patient perception of care data analysed included: i) Physiotherapy management of patients, ii) The Physiotherapists – skill, iii) knowledge and professionalism, iv) Continuity of Care, v) Tangibility, vi) Physiotherapy benefits, vii) Decision-Making, viii) Communication, ix) Satisfaction of Physiotherapy ICU care. Overall, family and patients were satisfied with the physiotherapy care in the cardiothoracic ICU. However, there were areas of improvement such as the understanding of physiotherapy care, communication, family involvement in the physiotherapy care and decision-making. Conclusion: While there are multiple quantitative measures for measuring family perception of ICU care there is no “gold” standard measure that has been identified. A qualitative measure and research design would allow richer in-depth information on family perception of ICU care. The findings from the family and patient perception of cardiothoracic ICU physiotherapy care are influenced by many factors. While family and patients perceive cardiothoracic ICU physiotherapy care both positively and negatively, the majority of patient and family were satisfied overall with the care the patient received. Family perception of ICU physiotherapy care should be evaluated in order to identify areas for improvement in quality of care and could add to the body of evidence in ICU physiotherapy practice.

Made available in DSpace on 2016-03-15T19:39:49Z (GMT). No. of bitstreams: 1 Joao Roberto de Souza Silva.pdf: 210530 bytes, checksum: 45a77a087e6bcddf55eabc30660bb5e1 (MD5) Previous issue date: 2011-11-17 / Fundo Mackenzie de Pesquisa / The process of health and education of children with development disorders is extremely complex and interdependent. The interdisciplinary presents itself as an alternative to building a model that enables discussions that may lead to new proposals for action and intervention beyond the boundaries imposed by specialties, thereby setting the conceptual and methodological parameters that can assist in diagnosis and intervention. Cerebral Palsy is described as a non-progressive brain injury. Its main characteristic motor dysfunction, however, may in some cases, have cognitive delay, language or sensory. The aim of this study was to investigate the type of care received by children up to 08 years with a Cerebral Palsy and know the perception of an interdisciplinary approach in meeting these people from the reports of their mothers. The method is characterized by a clinical study - qualitative data collection was done through their group interview sessions with mothers lasted approximately ninety minutes. The results were obtained through content analysis. The interaction between the professionals who serve the child is perceived and translated by mothers as an attempt to form interdisciplinary teams, but with multidisciplinary practices, or are teams composed of professionals from different areas of health, but without integration and collaboration effective among the specialties. Due to the complexity of the context of cerebral palsy, interdisciplinary theory and practice become a fundamental and necessary to intervene with these children. Continue exploring and deepening other aspects of interdisciplinary, with the ultimate goal of providing a service more suited to children with Cerebral Palsy and their families, as well as other disorders should be a priority in development planning, conduct and training of professionals in the areas of health and education. / O processo de saúde e educação de crianças com Distúrbios do Desenvolvimento é extremamente complexo e interdependente. A interdisciplinaridade apresenta-se como alternativa de construção de um modelo que possibilite discussões que podem resultar em novas propostas de ação e intervenção para além das fronteiras impostas pelas especialidades, estabelecendo, assim, parâmetros conceituais e metodológicos que possam colaborar com o diagnóstico e a intervenção. A Paralisia Cerebral (PC) é descrita como uma lesão encefálica não progressiva. Tem como principal característica a disfunção motora, porém, pode, em alguns casos, apresentar defasagem cognitiva, de linguagem ou sensorial. O objetivo deste estudo foi investigar o tipo de atendimento recebido por crianças até 08 anos com PC e conhecer a percepção sobre a interdisciplinaridade no atendimento dessas pessoas a partir do relato de suas mães. O método caracteriza-se por um estudo clínico qualitativo, a coleta de dados foi feita por meio de sessões de entrevista grupal com as mães com duração de aproximadamente noventa minutos. Os resultados foram obtidos por meio da análise de conteúdo. A interação entre os profissionais que atendem a criança é percebida e traduzida pelas mães como uma tentativa de formação de equipes interdisciplinares, porém, com práticas multidisciplinares, ou seja, são equipes compostas por profissionais de diferentes áreas da saúde, mas sem uma integração e colaboração efetivas entre as especialidades. Devido à complexidade do quadro da paralisia cerebral, a teoria e a prática interdisciplinar tornam-se fundamentais e necessárias para uma intervenção junto a estas crianças. Continuar explorando e aprofundando outros aspectos da interdisciplinaridade, com o objetivo final de proporcionar uma assistência mais adequada às crianças com PC e suas famílias, assim como os demais Distúrbios do Desenvolvimento deve ser prioridade no planejamento, conduta e formação de profissionais das áreas da saúde e da educação.

Esta pesquisa teve como objetivo conhecer a percepção de familiares de potenciais doadores sobre os motivos considerados para recusar a doação dos órgãos e tecidos para transplante. Para compreender a percepção dos familiares optou-se por realizar uma pesquisa qualitativa, segundo a modalidade \"estrutura do fenômeno situado\". Como forma de desvelar o fenômeno foram entrevistadas oito famílias, utilizando as seguintes questões norteadoras: \"Como foi a tomada de decisão para recusar a doação dos órgãos e tecidos para transplante do seu familiar falecido?\" e \"Quais os motivos considerados para recusar a doação?\". Após a obtenção das descrições, os discursos foram analisados individualmente, sendo feita a análise ideográfica, resgatando os seguintes temas e subtemas: \"Relatando a internação do familiar\", \"Vivenciando a perda do familiar\": \"Recebendo a informação da morte encefálica e a solicitação da doação\", \"Sofrendo com a perda do familiar\"; \"Decidindo pela recusa da doação dos órgãos\": \"Conversando sobre doação\", \"Respeitando a decisão tomada\"; \"Apresentando os motivos de recusa da doação dos órgãos\": \"A crença religiosa\", \"A espera de um milagre\", \"A não compreensão do diagnóstico de morte encefálica e a crença na reversão do quadro\", \"A não aceitação da manipulação do corpo\", \"O medo da reação da família\", \"A inadequação da informação e a ausência de confirmação da morte encefálica\", \"A desconfiança na assistência e o medo do comércio de órgãos\", \"A inadequação no processo de doação\", \"O desejo do paciente falecido, manifestado em vida, de não ser um doador de órgãos\" e \"O medo da perda do ente querido\". Buscou-se desvelar, pela análise nomotética, as convergências e divergências das unidades de significado interpretadas, em direção a estrutural geral do fenômeno. As proposições que emergiram revelaram que a essência do fenômeno \"A recusa familiar no processo de doação de órgãos e tecidos para transplante\" foi desvelada como vivenciar uma situação de choque e desespero com a internação do familiar, de desconfiança com a solicitação da doação dos órgãos, de negação da morte encefálica, de sofrimento e desgaste diante da perda do ente querido, de conflitos familiares para a tomada de decisão e de múltiplas causas para a recusa da doação / This research had as its target learn the perception of potential donator`s familiy on the considered reason for the organs and tissues donation refusal for transplant. In order to understand the family perception a qualitative research was chosen, according to the modality \"situated phenomena structure\". In way of unveil the phenomena eight families were interviewed, having these questions as a guide:\"How was the decision taken in order to refuse the organs and tissues donation for tranplant of your deceased next of kin?\" and \"Which are the reasons weight for the donation refuse?\". After getting the descriptions, the speech were individually analysed, where a ideographic analysis was taken, recovering the folowing themes and sub themes : \"Telling next of kin as in patient\", \"Witness the next of kin\'s loss\": \"Receiving the encephalic death information and the solicitation for donation\", \"Suffering the next of kin\'s loss\"; \"Taken the organs and tissues donation refuse\": \"Talking about donation\", \"Regarding the taken decision\"; \"Presenting the refusal organs and tissues donation reasons\": \"The religious belief \", \"A hope of miracle\" , \"The encephalic death diagnosis missuderstood and the believe of a reversion of the situation\", \"Disagreement on the body maneuver\", \"The worry of the family\'s reaction\", The information ineffectuality and the lack of the encephalic death confirmation\",. \"The assistance mistrust and the fear of organs market\", \"The deficiency of donation process\", \"The person\'s willing not to be an organ donator when alive\" and \"The fear of loosing the dearest next of kin\". Through out of the nomothetic analysis, the meaningfull units convergency and divergency been taken, directed to the general structure phenomena. The propositions which appeared shown that the phenomena essence \"The family refusal on the organs and tissues donation for transplant\" was unveiled as been trought a shock situation and disperation with the next of kin in patient situation, mistrust because of the organs and tissue donation requesting, the denying of encephalic death, suffering and exhausting before the loss of the beloved one, family conflicts in way of taken the decision and the multiple causes of organ and tissues donation refuse

Esta pesquisa teve como objetivo conhecer a percepção de familiares de potenciais doadores sobre os motivos considerados para recusar a doação dos órgãos e tecidos para transplante. Para compreender a percepção dos familiares optou-se por realizar uma pesquisa qualitativa, segundo a modalidade \"estrutura do fenômeno situado\". Como forma de desvelar o fenômeno foram entrevistadas oito famílias, utilizando as seguintes questões norteadoras: \"Como foi a tomada de decisão para recusar a doação dos órgãos e tecidos para transplante do seu familiar falecido?\" e \"Quais os motivos considerados para recusar a doação?\". Após a obtenção das descrições, os discursos foram analisados individualmente, sendo feita a análise ideográfica, resgatando os seguintes temas e subtemas: \"Relatando a internação do familiar\", \"Vivenciando a perda do familiar\": \"Recebendo a informação da morte encefálica e a solicitação da doação\", \"Sofrendo com a perda do familiar\"; \"Decidindo pela recusa da doação dos órgãos\": \"Conversando sobre doação\", \"Respeitando a decisão tomada\"; \"Apresentando os motivos de recusa da doação dos órgãos\": \"A crença religiosa\", \"A espera de um milagre\", \"A não compreensão do diagnóstico de morte encefálica e a crença na reversão do quadro\", \"A não aceitação da manipulação do corpo\", \"O medo da reação da família\", \"A inadequação da informação e a ausência de confirmação da morte encefálica\", \"A desconfiança na assistência e o medo do comércio de órgãos\", \"A inadequação no processo de doação\", \"O desejo do paciente falecido, manifestado em vida, de não ser um doador de órgãos\" e \"O medo da perda do ente querido\". Buscou-se desvelar, pela análise nomotética, as convergências e divergências das unidades de significado interpretadas, em direção a estrutural geral do fenômeno. As proposições que emergiram revelaram que a essência do fenômeno \"A recusa familiar no processo de doação de órgãos e tecidos para transplante\" foi desvelada como vivenciar uma situação de choque e desespero com a internação do familiar, de desconfiança com a solicitação da doação dos órgãos, de negação da morte encefálica, de sofrimento e desgaste diante da perda do ente querido, de conflitos familiares para a tomada de decisão e de múltiplas causas para a recusa da doação / This research had as its target learn the perception of potential donator`s familiy on the considered reason for the organs and tissues donation refusal for transplant. In order to understand the family perception a qualitative research was chosen, according to the modality \"situated phenomena structure\". In way of unveil the phenomena eight families were interviewed, having these questions as a guide:\"How was the decision taken in order to refuse the organs and tissues donation for tranplant of your deceased next of kin?\" and \"Which are the reasons weight for the donation refuse?\". After getting the descriptions, the speech were individually analysed, where a ideographic analysis was taken, recovering the folowing themes and sub themes : \"Telling next of kin as in patient\", \"Witness the next of kin\'s loss\": \"Receiving the encephalic death information and the solicitation for donation\", \"Suffering the next of kin\'s loss\"; \"Taken the organs and tissues donation refuse\": \"Talking about donation\", \"Regarding the taken decision\"; \"Presenting the refusal organs and tissues donation reasons\": \"The religious belief \", \"A hope of miracle\" , \"The encephalic death diagnosis missuderstood and the believe of a reversion of the situation\", \"Disagreement on the body maneuver\", \"The worry of the family\'s reaction\", The information ineffectuality and the lack of the encephalic death confirmation\",. \"The assistance mistrust and the fear of organs market\", \"The deficiency of donation process\", \"The person\'s willing not to be an organ donator when alive\" and \"The fear of loosing the dearest next of kin\". Through out of the nomothetic analysis, the meaningfull units convergency and divergency been taken, directed to the general structure phenomena. The propositions which appeared shown that the phenomena essence \"The family refusal on the organs and tissues donation for transplant\" was unveiled as been trought a shock situation and disperation with the next of kin in patient situation, mistrust because of the organs and tissue donation requesting, the denying of encephalic death, suffering and exhausting before the loss of the beloved one, family conflicts in way of taken the decision and the multiple causes of organ and tissues donation refuse

As the United States' baby boom generation ages, the future of nursing home care becomes increasingly important. Through this study the researcher seeks to understand quality in nursing home care from the family's perspective. Surveys were collected at one North Texas nursing home, and data were analyzed to determine how gender and level of family involvement impact their concept of quality. Further, the information in this study is aimed at clarifying if interventions, specifically empowered CNA teams, have an impact on how family members view quality. Findings are identified and recommendations for future study are made.