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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.

First, Do No Harm: Institutional Betrayal in Healthcare

Smith, Carly 27 October 2016 (has links)
Seeking healthcare is an act of trust: patients reveal private information, pain, and vulnerability to physicians who have specialized knowledge and skills. Patients may endure risk and uncertain treatment outcomes based on the assurance of a trusted physician. Physicians’ professional oaths compel them to protect patients’ welfare first, and the power imbalance in these relationships is tolerable precisely because of the bond of trust. When this trust is protected, it is a powerful tool: patients are more engaged, benefit more from medical interventions, and are healthier overall. Yet these healthcare relationships are contained within larger institutions – hospitals, insurance companies, government programs – that may circumscribe physicians’ abilities to protect patients’ trust to the fullest and even contribute to negative medical experiences. Because trust and vulnerability characterize patients’ interactions with healthcare institutions, institutional actions and inactions that contribute to negative medical experiences constitute institutional betrayal. In this dissertation I address this largely unexamined issue in healthcare research by drawing on research and theory in trauma psychology. I report the results of a study based on the survey responses of 707 American adults. Institutional betrayal in healthcare was reported by two-thirds of the participants and predicted lower trust in participants’ own physicians, doctors in general, and healthcare organizations. These negative effects were more pronounced for patients who reported higher levels of trust in healthcare institutions prior to the betrayal and did not seem to be influenced by a general tendency to trust others. However, the effects of institutional betrayal on trust in healthcare organizations were buffered by trust in one’s own physician. Institutional betrayal also predicted worse physical health and increased symptoms of depression, dissociation, and post-traumatic distress – both directly and through disengagement from healthcare. Consistent with betrayal trauma theory, participants who experienced institutional betrayal were five times more likely to report some difficultly remembering that betrayal and negative medical experiences. This unawareness may allow patients to continue to seek necessary medical care, even in the presence of institutional betrayal. In order to understand what contributes to patient trust and engagement in healthcare and why some patients experience worse mental and physical health outcomes, institutional betrayal must be taken into account.

Navigating the Complex Healthcare System

Jaishankar, Gayatri, Tolliver, Matthew 01 February 2018 (has links)
No description available.

The impacts of adopting large touch screens and tablets with access  to electronic healthcare records

Al-Omaishe, Allaa January 2015 (has links)
In the last decade modern information technology systems have been introduced to healthcare in order to improve it. The aim of this study is to present the impact of such information system’s adoption on patient safety and efficiency within healthcare. Interviews, observations along with literature study were conducted in order to study the impact of the adoption on patient safety and efficiency at hospital’s wards where a new information system is implemented. The conclusion of this study is that such information technology systems can improve patient safety. However it is believed that the information technology system can improve efficiency in some aspects such as the communication among medical care personnel while other aspects within efficiency can be achieved if some improvements are made. Moreover the ability to access Electronic Healthcare Records is considered to be important to improve the medical care, which can increase patient safety.

The Effect of Health News on the Citizens' Medical Care Seeking Behavior

Chou, Chen-Yu 08 September 2009 (has links)
There is not sufficient information in the market of medical service. Whether the public has adequate information is the key to the choice of healthcare seeking. Due to the shift of medical environment, rise of consumer¡¦s awareness and respect to patient¡¦s right, the public is concerned about their health and right. Becoming customer-oriented, the industries of medical service start to emphasize the management of customer¡¦s needs and provide appropriate products and service in order to achieve hospital¡¦s sustainable operation and development. This research aims to explore people¡¦s needs of medical seeking from the health news offered by medical institutes and to probe into the influence of health news on choice of medical seeking. Furthermore, the difference of people¡¦s medical seeking behavior of different demographic characteristics and health condition would also be discussed. This research adopts the quantitative survey method of questionnaire to collect data of outpatients in the over 15 age group on a regional hospital in Kaohsiung City. We received 381 valid questionnaires totally and 352 surveys are usable. The valid sample returns-ratio is 92.3%. The results for statistical analysis show that the rank order of demands on issues of news for people¡¦s seeking medical care are listed as follows according to the assisting extent of healthcare provider: ¡§The new trend of health and diseases¡¨, ¡§novel treatments or technique,¡¨ ¡§information of healthcare and hygienic education,¡¨ ¡§introduction of new equipment and facility,¡¨ ¡§medical discovery,¡¨ and ¡§doctor introduction or profession¡¨. The average mean of the required level marks above 4¡§satisfaction¡¨. (The score 5 is the highest.) By excluding other factors, it achieves levels of significance in aspects of health news path and health news issues on explanation of each dimension of people¡¦s medical seeking behavior. Health news shows significant effect on people¡¦s medical seeking behavior. The standardized coefficient is analyzed for further check that health news path and health news issues are positive predictable variables in each dimensions of people¡¦s medical seeking behavior. It implies that for people¡¦s medical seeking behavior, the higher the health news path uses and the higher the demand of health news requires, the stronger the influence on people¡¦s medical seeking behavior. In the discussion of the difference of people¡¦s medical seeking behavior of different demographic characteristics and health condition, it shows that gender, age, level of education, occupation, medical seeking under discomfort, commercial medical insurance, health condition and frequency of medical seeking in recent month would intervene how health news influence people¡¦s medical seeking behavior. By logistic regression analysis, it is found that level of education, coverage on newspapers, hospital handouts, introduction of new equipment and facility and medical discovery are possible predictors of the purpose of medical seeking. On the other hand, easy to choose of healthcare seeking , critical illness, frequency of medical seeking in recent month, coverage on newspapers and medical discovery are possible predictors of the site of medical seeking. In addition, age, level of education, medical seeking under discomfort, health condition, hospital website, community healthcare service and public relationship activity are possible predictors of the frequency of medical seeking. The conclusion of this research could be adopted by the hospital manager and the public relations practitioner for reference as they intend to release health news.

Back-end development of mobile application for the collection of dietary data

Bäck, Fredrik January 2012 (has links)
Smartphones are used by incredibly many people, and in 2011 there where a total of 491.4 million units soled worldwide. This makes it a relevant technique for performing dietary studies when the test patients are on the move. This thesis shows how to create a back end environment for an Android application with existing techniques linked together, using MSSQL database, Visual Studio Web Service, web pages and C# classes and ASP.NET security. The back end development is used in a dietary study on Gothenburg University, butcould be applied on many similar back end projects using databases and server development.Techniques used in this thesis are: REST (Representational State Transfer) -client implementation and development inside the Android application, using HTTP methods to set and get information from the server and database, and JSON-format to read and transferinformation in an easy and understandable way, both from the Android application and from the database. FileMaker is also used in this project as a third part programme tovisualise the information in the database.

A Middleware of Wireless sensor networks for Home healthcare monitoring application : Design and implementation based on multiple module of data acquisition

Tang, Jun January 2013 (has links)
With the continued increases in the global population, a serious problem will occur in relation to an ageing population. The reason for this is that a significant number of elderly people may suffer from serial chronic diseases making it difficult for them to live independently and thus they pose a significant economic burden for both themselves and for their government. In order to solve this problem, more and more E-healthcare applications are being designed. In addition, a wide range of medical sensors exist, which can monitor almost all the important physiological parameters of the human body. However, different sensors may use different communication protocols, data units and formats. Additionally, the elderly may use more than one E-healthcare application at the same time and this can lead to problems if there is more than one data source. The project “A Middleware of Wireless sensor networks for Home healthcare monitoring application” is designed to solve these problems.  The focus of this report is on the design and implementation based on multiple modules of data acquisition. There are four data acquisition modules which include the ZigBee module, 6LowPAN module, Wi-Fi module and a Bluetooth module. Thus, multiple data acquisition module middleware supports the sensor by means of ZigBee, 6LowPAN, Wi-Fi and Bluetooth. The tasks of the middleware are to collect packets from sensors, perform data processing and mapping and then displaying as real-time data and finally transmitting the data to the remote server.

Chaoulli v. Québec (Attorney General): Understanding Provincial Reactions to the Decision

Sadler, Daniel J. January 2007 (has links)
This thesis focuses on provincial reactions to the Supreme Court decision on 5 June 2005, Chaoulli v. Quebec (Attorney General). In this decision, the Court struck down the government of Québec’s ban on private insurance for publicly-insured services, on the grounds it violated the Québec Charter of Human Rights and Freedoms, while the decision on the Canadian Charter ended in a 3:3 tie with one abstention. It is the purpose of this research to examine the reactions of each provincial government to the decision in an attempt to understand why each province responded in its chosen manner. In order to make this determination, four hypotheses were constructed in order to test four separate variables: court interference, current law, ideology, and political calculation. These hypotheses were tested against provincial reactions in the media, legislatures, court documents, and E-mail administered questionnaires. This research finds that each hypothesis had some success in predicting provincial reactions to the decision, with a government’s current law and ideology proving to be the most accurate predictors. Based on the evidence gathered, three conclusions were arrived at: first, a government’s law and its ideology will often predict how a government will behave; second, that governments are open to Supreme Court decisions in the area of health care, and, finally, that if provincial governments were to make the decision to increase the role of the private sector in health care, political leaders would require public opinion be in support of such a decision rather than act solely on an ideological predisposition to greater private sector involvement.

Improvement of RFID tracking accuracy for a personnel tracking system in healthcare

Bian, Chao 08 1900 (has links)
Radio Frequency Identification (RFID) technology has been widely adopted by different industries for various purposes. While implementing a RFID system for personnel tracking in an industrial environment, such as a hospital, the tracking accuracy is not always satisfactory due to incorrect placement of RFID hardware, coarse system configuration or environment. This thesis proposes comprehensive optimization methods for improving the tracking accuracy of a RFID system for personnel tracking. The improvement is achieved from four perspectives including RFID data cleaning, experimental design, data fusion and simulation modeling. This research is based on a case study carried out in a local community hospital where a RFID system for personnel tracking has been implemented. Through applying the optimization methods, the tracking accuracy of the RFID system has been improved to 87.33%. The thesis provides a guideline for the hospital and other similar application environment to implement improvement methods on a RFID tracking system.

Engineering Incentives in Distributed Systems with Healthcare Applications

Pope, Brandon 1984- 16 December 2013 (has links)
U.S. healthcare costs have experienced unsustainable growth, with expenditures of $2.5 trillion in 2009, and are rising at a rate faster than that of the U.S. economy. A major factor in the cost of the U.S. healthcare system is related to the strategic behavior of system participants based on their incentives. This dissertation addresses the challenge of designing incentives to solve problems in healthcare systems. Principal agent theory and Markov decision processes are the primary methods used to construct incentives. The first problem considered is how to design contracts in order to align consumer and provider incentives with respect to preventive efforts. The model consists of an insurer contracting with two agents, a consumer and a provider, and focuses on the trade off between ex ante moral hazard and insurance. Two classes of efforts on behalf of the provider are studied: those which complement consumer efforts, and those which substitute with consumer efforts. The results show that the provider must be given incentives when the consumer is healthy to induce effort, and that inducing provider effort allows an insurer to save on incentives given to the consumer. The insurer can save on the cost of incentives by using a multilateral contract compared to the bilateral benchmark. These savings are illustrated by an example showing which model features affect the savings achieved. The second problem addresses the decision to provide knowledge to consumers regarding the consequences of health behaviors. The model developed to address this second problem extends the literature on incentives in healthcare systems to consider dynamic environments and includes a behavioral model of healthcare consumers. By using a learning model of consumer behavior, a policy maker's knowledge provision problem is transformed into a Markov decision process. This framework is used to solve for optimal knowledge provision policies regarding behaviors affecting coronary health. Sensitivity analysis shows robust threshold features of optimal policies. The results show that knowledge about smoking should be provided at most health and behavior states. As the cost of providing knowledge increases or aptitude for behavioral change decreases, fewer states are in the optimal knowledge provision policy, with healthy consumers dropping out first. Knowledge about diet and physical activity is provided more selectively due to the to uncertainty in the health benefits, and the time delay in accrued rewards.

Implicit or Explicit: : Understanding the role of Information Technology in Co- Creational Workshop Results

Holmlund, Jeanette, Schimmer, Robyn January 2014 (has links)
The demand for increased efficiency and patient-centered care has been influencing the development of healthcare in Sweden, and information technology has an important role in that process. Developing and implementing systems for public healthcare have proven to be a great challenge. One way to address this challenge is open innovation and co-creation. While there are a lot of studies focusing on innovation processes, there is little research regarding how technology is presented in the results. We have studied a co-creational workshop that focused on putting new perspectives on the use of information technology in healthcare. The workshop resulted in eight concepts which have been analyzed in terms of how technology is expressed. The results were categorized into implicit and explicit use of technology and this categorization indicates that the implicit use of technology is of the bricolage kind. By being both implicit and bricolage-like, the concepts hold qualities that make them more likely to be integrated into existing workplaces.

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