Vårdcentraler har under de senaste 15 åren anställt kuratorer psykologer och psykoterapeuter som kan erbjuda samtalsbehandling. Vid utvärdering av samtalen visar resultaten friskare patienter som bidrar till lägre vårdkostnader. Biologiska, psykologiska och sociala funktionerna blir centrala i mötet med patienten och hur dessa funktioner påverkar beskrivningen av problemet men också effekten utifrån funktionsnivå i relation till närstående. Vårdcentralen är första linjens vårdgivare från mödra- till äldrevård. Då förändring sker hos patienten påverkas helheten/nätverket. Syftet med studien var att undersöka hur patienter önskade då det gällde att ta med sina närstående och vilken öppenhet/erfarenhet fanns hos samtalsbehandlarna, inom primärvården, att bjuda in nätverket till samtalsbehandlingen? Via enkäter ställdes frågor till patienter och samtalsbehandlare som analyserades i huvudsak på ett kvantitativt sätt.  I resultatet framkom att närmare hälften önskade att ha med sig någon från sitt nätverk till samtalen. Övriga patienter önskade inte familjens deltagande utan beskrev den egna samtalskontakten som viktig. De flesta samtalsbehandlare beskrev att de erbjöd par- och familjesamtal. Syftet, med par- och familjesamtal, skiljde sig mellan respondenterna. Studien pekar på att familjen bjuds in som resurs vid något tillfälle för att få utvidgad information och utökad förståelse kring patientens livssituation. Några respondenter beskrev att samtalen bearbetade interaktionen mellan paret eller familjemedlemmarna. En mindre grupp patienter har haft par- eller familjesamtal. De beskrev att det varit behjälpligt och att de arbetat med samspelet mellan individerna som bidragit till ett positivt behandlingsresultat. / Over the last 15 years counselors, psychologists and psychotherapists are the professions hired for counseling in the Swedish primary care centers. Evaluations of the treatments show healthier patients and lower health care costs. Biological, psychological and social functions are central in counseling, since these features affect the description of the problem and the effect based on the level of functioning in relation to the partner and relatives. The primary care facilities are the first-line of caregivers, from maternal - to elderly care. When circumstances change for the patient, the whole family-network surrounding him/her is affected. The purpose of this study was to investigate what patients thought of bringing their relatives into counseling, and with which openness and what experience counselors invited the network to take part? The respondents answered questions in a survey, and the data was analyzed mainly in a quantitative fashion. The results showed that approximately half of the respondents wanted someone from their family-network to participate in the counseling. The other patients did not want their families’ participation, and thought of their own connection to the counselor as essential. The majority of the counselors claimed to offer couples and family counseling. The aim of the couple and family counseling differed between the respondents. The study suggests that the family is invited as resource at any time to get extended information and enhanced understanding of the patient's life situation. Some respondents described the counseling as processing of the interaction between the couple or the family members. A few patients said they had had couple or family counseling. They described it as being helpful and that working with the communication had been a contributing factor to the favorable outcome.

Darbo tikslas. Įvertinti VšĮ Alytaus poliklinikos psichikos sveikatos centro pacientų lūkesčius dėl teikiamų paslaugų, informuotumą bei pasitenkinimą paslaugomis. Darbo uždaviniai: Išsiaiškinti VšĮ Alytaus poliklinikos psichikos sveikatos centro pacientų lūkesčius dėl teikiamų paslaugų; įvertinti pacientų informuotumą apie psichikos sveikatos centre teikiamas paslaugas; nustatyti pacientų požiūrį į teikiamas paslaugas ir jas teikiančius specialistus. Tyrimo metodika. Anoniminė anketinė psichikos sveikatos centro pacientų apklausa atlikta 2012 m. Išdalintos 410 anketų, visos jos grąžintos užpildytos. Duomenų statistinė analizė atlikta SPSS 20 programa. Kokybinių požymių palyginimui ir ryšių vertinimui taikytas χ2 arba Fišerio tikslusis kriterijus. Kokybinių požymių poriniams palyginimams taikytas z kriterijus. Statistinės hipotezės tikrintos, esant reikšmingumo lygmeniui α=0,05. Skirtumai ar ryšiai vertinti kaip statistiškai reikšmingi, kai p<0,05. Rezultatai. Daugumai pacientų, besilankančių psichikos sveikatos centre labai svarbus teigiamas personalo požiūris, bendradarbiavimas su gydytoju norint gauti informaciją apie savo sveikatos būklę bei teikiamą gydymą, galimybė gauti papildomas paslaugas, reikalingas paslaugas gauti laiku, taip pat pacientai tikėjosi, kad psichikos sveikatos centro aplinka bus maloni bei švari. Medikų pagarba svarbesnė pasirodė moterims negu vyrams. Vyresniems pacientams buvo svarbiau gauti numatytas paslaugas laiku bei tikėtis gauti... [toliau žr. visą tekstą] / Aim of the study: evaluate patients wishes, information and satisfaction for received services in Alytus policlinic mental health centrum. Objectives of the study: clarify patients wishes for services provided in Alytus policlinic mental health centrum; evaluate patients informatikon for these services; set patients attitude to provided services and medical staff. Material and methods: A survey of patients using an anonymous questionnaire was conducted in 2012. 410 questionnaires were distributed and all returned back. Statistical data analysis was performed using “SPSS 20 for Windows” statistical software. Associations were tested using chi-square and z-test. Statistical significance level was set at p<0.05. Results. Most of the patients want possitive staff attitude to themselves, cooperation with doctor to achieve information about their health status and treatment, also a possibility to get extra services, get services on time. They also suspected that environment in mental health center will be nice and cousy. Respect of medical staff was more important for women than for men. For older patients was more important to get services on time more than to get information about their health status. The request to get extra services emphasized more pensioners and people with higher education. Most of respondents specify a request of quiet, relaxing environment in cabinets and simply registration proccess. The biggest part of respondents received information was clear and... [to full text]

Bakgrund: Barn har rätt att vara delaktig i sin vård och för att få barnet delaktigt är kommunikation viktigt. BHV-sjuksköterskan möter barn och behöver ha kunskap om hur de görs delaktiga, vilket också står i FN:s barnkonvention. Syfte: Syftet med studien var att belysa BHV-sjuksköterskans erfarenheter av att göra barn delaktiga vid hälsobesök på BVC. Metod: Studien analyserades med kvalitativ innehållsanalys. Semistrukturerade intervjuer användes och åtta BHV-sjuksköterskor intervjuades. Resultat: Resultatet i studien visar att BHV-sjuksköterskan använder olika arbetssätt för att göra barnet delaktigt. I resultatet framkom ett tema, två huvudkategorier och sex underkategorier. BHV-sjuksköterskan gör barnet delaktigt genom att hon skapar en tillitsfull relation till barnet och det görs när hon är lyhörd och flexibel. Slutsats: Studiens resultat visar att BHV-sjuksköterskan behöver kunna skapa en tillitsfull relation till barnet för att kunna göra barnet delaktigt. Barnets delaktighet kan begränsas av olika faktorer som till exempel tidsbrist. BHV-sjuksköterskan arbetar på olika sätt beroende på vilket barn som kommer och anpassar situationen efter barnets behov. / Background: Children have the right to be involved in their care and communication is important to make the child involved. The child health nurse needs to have knowledge about how to involve children, which is also stated in the UN Convention of the Rights for Children. Aim: The aim of this study was to illustrate the child health nurses' experiences of involving children in health visits at the child health centre. Method: The study was analyst through content analysis. Eight child health nurses were interviewed with semi structured interviews. Results: The findings show that the child health nurse use different approaches to make the child involved. In the result a theme emerged, two categories and six subcategories. The child health nurse makes the child involved when she builds a trusting relationship and it is done when she is responsive and flexible. Conclusion: The results of the study show that the child health nurse needs to be able to create a trusting relationship with the child to make the child involved. Child participation can be limited by various factors such as lack of time. The child health nurse work in different ways depending on the children coming and adapt the situation to the child's needs.

Currently, between 21.9 and 23 million veterans have served in the United States armed forces. Of those, 2 million are women, and of those, only 6.5% use the Veterans Health Administration system. These females often suffer from physical and mental health disorders, and overall impaired quality of life (QOL), rendering their healthcare needs complex. Seeking, and providing care in this specialty area may become overwhelming not only for the women seeking the care, but also for healthcare systems that are unfamiliar with the specific needs of this population. A retrospective medical records review was completed of 51 female veterans between the ages of 40 and 60 years, and who attended a women’s health specialty clinic in a women’s health center in the VA healthcare system. This center provides comprehensive women’s health services to female veterans. By attending this center, female veterans are having most if not all of their healthcare needs met in one location. Some of the services provided at the center include: primary care; gynecology; other gender specific health care needs; mental health care; and social assistance among other issues that may be associated with the overall QOL and depression. Despite this study having a small sample size (n = 51), the participants were ethnically diverse: White (52.9%); African American (29.4%); Hispanic/Latino (15.7%); and Asian/Pacific Islander (2%). The overall results of this study reveal that female veterans who attend this clinic, have significantly lower baseline scores for QOL when compared to a North American population reference value. Means and standard deviation for total Menopause Rating Scale (MRS) score were; (n = 51, M = 21.2, SD = 9.2) compared to the North American women population reference values (n = 1,376, M = 9.1, SD = 7.6), z = 9.41, p < .0001, cohens d = 1.31. These results were significantly lower for all MRS subsets. The higher the means and standard deviation, the lower the QOL. A paired sample t-test indicated significant improvement in QOL after treatment in QOL (t = 7.80, p < .0001), and depression levels (t = 3.74, p < .0001) among female veterans attending the women’s health specialty clinic. Forward stepwise multiple linear regression models were fit to explore the association between the following variables and the outcomes of QOL and depression levels: low socioeconomic status (SES); number of deliveries; years of service; and military sexual trauma (MST). The only predictor that appeared to be significantly associated with higher MRS scores at baseline was a history of MST (β = .363; t = 2.44; p = 0.02). Higher MRS scores can be interpreted as lower QOL among female veterans. Despite the complexities and unique needs of female veterans, the findings of this study suggest that timely, comprehensive and gender specific healthcare can significantly improve overall QOL and depression levels. In addition, further studies are need to assess what other variables may have a direct association with QOL, depression levels, and overall health of female veterans.

Bakgrund: Sexuell hälsa innebär bland annat ett fysiskt, emotionellt, mentalt tillstånd och socialt välbefinnande i relation till sexualitet. Attityder till äldres sexuella hälsa har förändrats och de äldre tillåts njuta av sin sexualitet. Positiva och negativa aspekter gällande äldre människors sexuella hälsa pekar på att skillnader finns mellan män och kvinnor. Syfte: Att undersöka hur distriktssköterskor uppfattar att samtala om sexuell hälsa med äldre människor på vårdcentral. Metod: Metoden i denna studie är kvalitativ med en fenomenografisk ansats. Data samlades genom individuella intervjuer med öppna frågor. Resultat: Resultatet visade sju beskrivningskategorier: Det är ett känsligt ämne att samtala om, Det är inte en rutin att samtala om sexuell hälsa, Att ha en förutfattad mening i mötet med de äldre, Det är ett relevant ämne att samtala om, Brist på kunskap i ämnet, Att samtala med män och kvinnor skiljer sig åt och Dessa samtal är mer relevanta vid läkarbesök. Efter resultatet presenteras ett utfallsrum. Konklusion: Slutsatsen är att sexuell hälsa är ett känsligt ämne att samtala om. Det behövs fler rutiner för distriktssköterskor på vårdcentral och möjlighet till utbildning för att utöka kunskapen inom detta ämne. / Background: Sexual health consists of physical, emotional, mental and social well-being in relation to sexuality. Attitudes towards elderly’s sexual health have changed, and elder are allowed take pleasure in their sexuality. Positive and negative aspects concerning elderly people’s sexual health suggests that there are differences between men and women. Purpose: To investigate how district nurses perceive their dialogues about sexual health with elderlies. Method: The method in this study is of qualitative character through a phenomenographical approach. Data was collected during individual interviews with open-ended questions. Result: The results revealed seven categories of description; It is a sensitive topic to discuss, It is not of routine to talk about sexual health, Preconceptions when meeting elderlies, It is a relevant subject to talk about, Insufficient knowledge regarding the subject, Dialogues with men and women differ and these dialogues are more relevant during visits to physicians. After the result, an outcome space is presented. Conclusion: The conclusion labels sexual health as a sensitive speech topic. There is a need for additional routines for district nurses at health centers along with the possibility to extend the knowledge in this field.

Detta är ett examensarbete inom informationsdesign med inriktning rumslig gestaltning. Studien har skett på Vårdcentralen Linden i Katrineholm, där patienter har svårt att hitta till rätt väntrum. Syftet med mitt examensarbete har varit att förtydliga orienterbarheten till väntrummen på vårdcentralen. Ett gestaltningsförslag ska skapas som ska underlätta för patienter att hitta till rättväntrum. I studien har metoder som rumsanalys, enkäter och kvalitativa intervjuer använts för att få en uppfattning om patienters upplevelser på vårdcentralen. Genom metoderna visade det sig att bl.a. många föredrog att få information omväntrum när man är på plats. Resultat från litteraturstudier och insamlad empirin har därefter lett till ett gestaltningsförslag som ska fungera som en röd tråd från incheckning till väntrummen. / This is a thesis in Information Design with a focus on Spatial Design. The study has been done in Vårdcentral Linden, a health centre in Katrineholm, where patients have been experiencing difficulty finding their way to the right waiting room. The purpose of this thesis has been to improve orientation to the waiting rooms in the health centre. A design proposal will be made to make it easier for patients to find the right waiting room. In this study, methods such as space analysis, surveys and interviews have been used to get an idea of the patient’s experiences at the health centre. The methods showed that, for instance, many people preferred to get information about waiting rooms while on the spot. Results from literature studies and analysis of collected data have subsequentlyled to a design proposal that will act as a “red thread” from the check-in area to the waiting rooms.

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No description available.

Doctor of Philosophy / Department of Family Studies and Human Services / Anthony Jurich / Ann Murray / Despite the intensified research efforts into the field of Infant Mental Health and Marriage and Family Therapy, a truly systemically designed program has not been developed. This formative evaluation study illuminates the design phase, its developmental process, and the professional staff member’s experience of this newly implemented “Options” program. I focused specifically on Crawford County Community Mental Health Center’s innovative systemic approach to issues related to infant mental health. In this body of work, I describe the process of creating this innovative approach, identified how the program originators made decisions about their approach and how the approach is being operationalized on a daily basis by interviewing the clinicians, who are providing the services and the administrators who created and oversee the program. I utilized a qualitative approach in the design, transcription categorization, and data analysis. This formative evaluation used the “flashback approach” to tell the story of the evaluation findings, this included an Executive Summary. This study’s exploration yielded a clearer understanding of the developmental process of the infant mental health program and its initial implementation. The results of this evaluation revealed that there are a number of core program components (three levels of focus: child and family, program, and community and catchment area) that were organized and clearly disseminated throughout the staff. The interviews revealed that the program has encountered problematic issues including; policy and procedural agreements and mandates, staff turnover, program ownership and funding limitations. It grew increasingly clear that the value of the program’s positive impact on families outweighed the perceived hassle of establishing and implementing the program. This evaluation produced a number of program recommendations for program perpetuation and potential improvements. The program recommendations addressed the challenges facing the “Options Program” are explained. The future research implications of this formative evaluation are enumerated.

O objetivo deste trabalho foi analisar a demanda das queixas músculo-esqueléticas, neurológicas e respiratórias em adultos no setor de recepção espontânea e pronto atendimento do serviço de saúde do adulto de em uma Unidade Básica de Saúde. O delineamento foi do tipo transversal e a população base constituída pelos usuários matriculados do Centro de Saúde Escola Butantã (CSEB) atendidos na recepção espontânea da unidade no período de março de 2010 a maio de 2011. A população efetivamente estudada foi composta por 1023 indivíduos. Os dados foram coletados de usuários que buscaram o serviço em quatro períodos da semana, 2 matutinos e 2 vespertinos. A caracterização das queixas foi realizada através de um questionário com dados demográficos e motivo da procura por atendimento. Os dados deste estudo mostraram que a maioria dos usuários que frequentam apresentam as seguintes características: pertencem ao sexo feminino (71,2%), estão na faixa etária de 31 a 60 anos (50%), são solteiros (31,6%), são aposentados (14,2%), residem no jardim São Remo (32,7%), apresentam queixas em vários sistemas (77,1%). Nas áreas mais diretamente relacionadas à fisioterapia, o sistema musculoesquelético é o mais acometido (14,4%) e dentro deste as dores na coluna são as mais prevalentes (31%). Avaliando as razões de chance de ocorrência de queixas músculo-esqueléticas com relação ás variáveis sócio demográficas, encontrou-se que a idade foi independentemente associada esta queixa. Pessoas com idade entre de 40 a 59 anos tem maior associação com essas dores músculo-esqueléticas do que as mais velhas e mais novas / The aim of this study was to analyze the demand of musculoskeletal, neurological and respiratory complaints, in adults in the sector of spontaneous reception and responsiveness of the health service of a Basic Health Unit The design was a crosssectional and population-based made by registered users of the Center for Health Butantã (CSEB) attended in the reception spontaneous unit from March 2010 to May 2011. The population studied consisted of 1023 individuals. Data were collected from users seeking service in periods of four weeks, two morning and two afternoons. The characterization of the complaints was conducted through a questionnaire with demographic data and reasons for the demand for care. Data from this study showed that most users who attend have the following characteristics: are women (71.2%) are aged 31 to 60 years (50%) are single (31.6%) are retired (14.2%) reside in the garden San Remo (32.7%), complain in several systems (77.1%). In the areas most directly related to physical therapy, the musculoskeletal system is the most affected (14.4%) and the backache are the most prevalent complaint (31%). Assessing the odds ratios of occurrence of musculoskeletal complaints in regard to the sociodemographic variables, it was found that age was independently associated with this complaint. People aged 40 to 59 years have the greatest association with musculoskeletal pains than the older and newer