This study examined the relationship between performance in a leveled token economy for emotionally disturbed adolescents and posttreatment level of functioning six months after discharge from the target program. The target program for the study is an acute care psychiatric hospital which specialized in the treatment of adolescents with both emotional and substance abuse problems. Previous literature on the outcome of token economy treatment programs however for they adolescents have generally been favorable have typically not examined level of functioning as an outcome criteria.

The health care requirements of older people admitted to acute hospitals and their need for nursing care have been identified in current literature as problematic. Hospital organisations which are medically oriented and more focused on implementing programs directed by economics, efficiency and effectiveness may be unsupportive of nursing practices based on a professional value system. There is a need, therefore, to examine how health care structures that tend to promote cost containment and a technical imperative, impact on the professional capability of nurses to provide the standard of care required by acutely ill older hospitalised patients. The collected data, analysed thematically, indicates that the nurses were knowledgeable and potentially competent in providing the standard of technical and functional care required by older adults in hospital. However, although nurses articulated that they wanted to provide the quality of care needed by acutely ill older patients, they nevertheless admitted they were optionalising this care because of constraints in the health care system.While the nurses’ constructions revealed they believed technical tasks took up most of their time during shifts, it is evident during the observations that this was not the case. Through the use of Giddens’s (1984) Structuration Theory, a very different picture began to unfold about the incongruence about was said, and what was actually done. The significance of this study is that the incongruence found between the nurses’ knowledge and their actions has been revealed. / Doctor of Philosophy (PhD)

I Sverige föds ca 90 000 barn per år och cirka 10 % behöver vård på en neonatalavdelning. Orsakerna till det kan vara många, men vanligt är att barnen som drabbas, är för tidigt födda och då är extra utsatta pga. sin omognad. Syftet med studien var att ta reda på pappans upplevelse att vårda sitt barn på en neonatalavdelning. En kvalitativ forskning med innehållsanalys som metod valdes. Sju stycken pappor som hade vårdat sitt barn på en neonatalavdelning intervjuades med en frågeställning ”Hur upplevde du att vårda ditt barn på en neonatalavdelning”? Resultatet delades in i tre kategorier som ”vilja skapa anknytning till sitt barn”, ”känsla av otillräcklighet” och ”behov av att känna trygghet” med tillhörande underkategorier. I studien framkom att pappan tycker att det är viktigt att få vara nära barnet och vill gärna ta ansvar för vården. De var mycket nöjda med vården och hade tillit till vårdpersonalen men upplevde att de skulle velat haft mer stöd.  Det framkom även att de tyckte att det var frustrerande att vilja vara på flera ställen samtidigt. Med denna studie hoppas författarna kunna öka kunskapen som ska främja ett individuellt anpassat stöd för en bättre omvårdnad av det nyfödda barnet. / In Sweden, about 90 000 children per year are born and about 10% of these need to be taken care in neonatal intensive care unit. The causes can be many, but the most common reason is that the children who suffer, are prematurely born and are extra vulnerable due to their immaturity. The purpose of the study was to find out the father's experience of caring for their child in a neonatal intensive care unit. A qualitative research using content analysis method was chosen. Seven fathers who had to provide care of their child in a neonatal department were interviewed with a question "How you did your experience to take care for your child at a neonatal department?" The results were divided into three categories such as "like to create ties to their child," "sense of inadequacy" and "need to feel safe" with its sub-categories. The study revealed that the father thinks that it is important to be close to the child and would like to take responsibility for the health care. They were very satisfied with the care and had trust in the caregivers, but felt that they would have had more support. The fathers also experienced frustration of the wish to be in several places simultaneously. In this study, the authors hope to raise awareness to promote a personalized support for a better care of the newborn baby.

Bakgrund: BB vården i de västerländska länderna har genomgått stora förändringar desenaste decennierna. Trots detta visar studier på att ett stort antal kvinnors inte är nöjda medden vård de fått efter barnets födelse. Syfte: Syftet med denna litteraturöversikt är att beskrivanyförlösta kvinnors upplevelser i samband med BB vård på sjukhus. Metod: Enlitteraturöversikt baserad på tio vetenskapliga artiklar med både kvalitativ och kvantitativmetod. Resultat: Fyra huvudteman framkom vid analysen av artiklarna; information,vårdorganisation och vårdmiljö, bemötande och attityder samt stöd. Det visade sig finnasväldigt många olika faktorer som påverkade kvinnors upplevelser av BB vården. Dessa kundevara mer eller mindre betydelsefulla för olika kvinnor. Kunskapen om detta kan bidra till attvårdpersonalen får en ökad förståelse för att varje nyförlöst kvinna är en unik individ medegna specifika önskemål och behov och att BB vården inte får generaliseras. Diskussion: Densjukhusförlagda BB vården måste bedrivas så att den uppfyller kravet på god vård. Detta föratt förhindra att nyförlösta kvinnor upplever onödigt vårdlidande. / Background: Postnatal care in western countries has undergone major changes in recentdecades. Despite this, studies show that many women are not satisfied with the care theyreceived after the birth. Objective: The purpose of this literature review is to describewomen's experiences of postnatal hospital care. Method: A literature review based on tenscientific articles in both qualitative and quantitative approach. Result: Four major themesemerged from the analysis of the articles; information, health care organization and healthcare environment, encounter and attitudes and support. It proved to be very many differentfactors that influenced women's experiences of postnatal care. These could be more or lessimportant for different women. Knowledge of this can contribute to health care professionalswith a better understanding of that each woman that recently given birth is a unique individualwith their own specific wants and needs and that postnatal care can not be generalized.Discussion: The postnatal hospital care must be conducted so that it meets the requirement ofgood care. This is to prevent unnecessary care suffering among women that recently givenbirth.

Adaptation to role transitions can have various outcomes. Health and demographic characteristics as well as environmental control have been shown to affect the transition to the role of patient. The acutely ill elderly's adaptation to the role of hospitalized patient has not been measured from the elderly patient's perspective. This study utilized a random sample of 176 hospitalized elderly medical-surgical patients and the patients' registered nurses to examine the relationships among demographic and health characteristics, latitude of choice and elderly hospitalized patient adjustment. Patients were excluded who had been in ICU for more than 24 hours, had decreased mental status, or were judged to be too physically ill to participate. The study used an adaptation of the Latitude of Choice Scale (a measure of environmental control) developed by Hulicka and colleagues, a nurse-rated hospitalized patient adjustment scale developed by Cicirelli, and an adaptation of the adjustment scale for patients' self-assessment. Results from a series of multiple regression analyses indicate that, taken as a group, neither demographic nor health characteristics predict environmental control, as measured by the adapted version of the Latitude of Choice Scale (LOC). However, one individual health characteristic, length of time since last hospitalization, was a negative predictor of LOC. Further, the results indicate that taken as a group, health and demographic characteristics, along with patient LOC scores are not predictive of either nurse or patient-rated adaptation. The individual health characteristic "patient acuity rating" did negatively predict both nurse and patient-rated adjustment scores. Nurse-rated patient adjustment scores were also negatively predicted by the participants' prior number of hospitalizations. A paired-t test indicated that patients rated themselves significantly better adjusted than did their nurses. This finding was judged to be clinically unimportant because of the small real difference in the mean scores. Random-effects ANOVA found no significant variance between nurses' ratings of patients. / Graduation date: 1991

<p>I Sverige föds ca 90 000 barn per år och cirka 10 % behöver vård på en neonatalavdelning. Orsakerna till det kan vara många, men vanligt är att barnen som drabbas, är för tidigt födda och då är extra utsatta pga. sin omognad. Syftet med studien var att ta reda på pappans upplevelse att vårda sitt barn på en neonatalavdelning. En kvalitativ forskning med innehållsanalys som metod valdes. Sju stycken pappor som hade vårdat sitt barn på en neonatalavdelning intervjuades med en frågeställning ”Hur upplevde du att vårda ditt barn på en neonatalavdelning”? Resultatet delades in i tre kategorier som ”vilja skapa anknytning till sitt barn”, ”känsla av otillräcklighet” och ”behov av att känna trygghet” med tillhörande underkategorier. I studien framkom att pappan tycker att det är viktigt att få vara nära barnet och vill gärna ta ansvar för vården. De var mycket nöjda med vården och hade tillit till vårdpersonalen men upplevde att de skulle velat haft mer stöd.  Det framkom även att de tyckte att det var frustrerande att vilja vara på flera ställen samtidigt. Med denna studie hoppas författarna kunna öka kunskapen som ska främja ett individuellt anpassat stöd för en bättre omvårdnad av det nyfödda barnet.</p><p> </p> / <p>In Sweden, about 90 000 children per year are born and about 10% of these need to be taken care in neonatal intensive care unit. The causes can be many, but the most common reason is that the children who suffer, are prematurely born and are extra vulnerable due to their immaturity. The purpose of the study was to find out the father's experience of caring for their child in a neonatal intensive care unit. A qualitative research using content analysis method was chosen. Seven fathers who had to provide care of their child in a neonatal department were interviewed with a question "How you did your experience to take care for your child at a neonatal department?" The results were divided into three categories such as "like to create ties to their child," "sense of inadequacy" and "need to feel safe" with its sub-categories. The study revealed that the father thinks that it is important to be close to the child and would like to take responsibility for the health care. They were very satisfied with the care and had trust in the caregivers, but felt that they would have had more support. The fathers also experienced frustration of the wish to be in several places simultaneously. In this study, the authors hope to raise awareness to promote a personalized support for a better care of the newborn baby.</p>

<p>Bakgrund: BB vården i de västerländska länderna har genomgått stora förändringar desenaste decennierna. Trots detta visar studier på att ett stort antal kvinnors inte är nöjda medden vård de fått efter barnets födelse. Syfte: Syftet med denna litteraturöversikt är att beskrivanyförlösta kvinnors upplevelser i samband med BB vård på sjukhus. Metod: Enlitteraturöversikt baserad på tio vetenskapliga artiklar med både kvalitativ och kvantitativmetod. Resultat: Fyra huvudteman framkom vid analysen av artiklarna; information,vårdorganisation och vårdmiljö, bemötande och attityder samt stöd. Det visade sig finnasväldigt många olika faktorer som påverkade kvinnors upplevelser av BB vården. Dessa kundevara mer eller mindre betydelsefulla för olika kvinnor. Kunskapen om detta kan bidra till attvårdpersonalen får en ökad förståelse för att varje nyförlöst kvinna är en unik individ medegna specifika önskemål och behov och att BB vården inte får generaliseras. Diskussion: Densjukhusförlagda BB vården måste bedrivas så att den uppfyller kravet på god vård. Detta föratt förhindra att nyförlösta kvinnor upplever onödigt vårdlidande.</p> / <p>Background: Postnatal care in western countries has undergone major changes in recentdecades. Despite this, studies show that many women are not satisfied with the care theyreceived after the birth. Objective: The purpose of this literature review is to describewomen's experiences of postnatal hospital care. Method: A literature review based on tenscientific articles in both qualitative and quantitative approach. Result: Four major themesemerged from the analysis of the articles; information, health care organization and healthcare environment, encounter and attitudes and support. It proved to be very many differentfactors that influenced women's experiences of postnatal care. These could be more or lessimportant for different women. Knowledge of this can contribute to health care professionalswith a better understanding of that each woman that recently given birth is a unique individualwith their own specific wants and needs and that postnatal care can not be generalized.Discussion: The postnatal hospital care must be conducted so that it meets the requirement ofgood care. This is to prevent unnecessary care suffering among women that recently givenbirth.</p>

Thesis--University of Minnesota. / Photocopy of typescript. Ann Arbor, Mich. : University Microfilms International, 1977. -- 21 cm. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves [119]-125).

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Background: Falls are one of the most common and serious problems facing the elderly and are known to be associated with significant mortality, morbidity, decreased functioning and premature institutionalization. In Hong Kong, the prevalence of falls among community-dwelling older adults is 19.3%. Moreover, the incidence of falls among older people in institutions is almost three times the fall rates for the community-dwelling elderly. Institutional falls are regarded as common adverse events in hospitalized older patients. Significant mortality, morbidity and healthcare costs associated with institutional falls led institutions to recognize falls as a high-priority safety risk for hospitalized patients. This demonstrated the significance of providing the health care providers with an evidenced-based practice guideline of an effective multifactorial fall prevention programme in order to prevent in-patient falls. Objectives: The objectives of the study are to systematically review and present the best evidence for the effectiveness of multifactorial fall prevention interventions in reducing falls in hospitals, to translate the reviewed evidence and to develop evidence-based practice guidelines for the multifactorial fall prevention programme as well as to develop a plan for implementing and evaluating the multifactorial fall prevention programme. Methods: The relevant literature was searched by several electronic databases. The related literature was then retrieved, reviewed and synthesized. The quality assessment of the studies was performed according to the methodological checklist for controlled trials designed by the Scottish intercollegiate Guideline Network (SIGN). Evidenced-based practice guidelines for the multifactorial fall prevention programme were then synthesized according to the findings of the reviewed literature, while the implementation potential being assessed in terms of transferability, feasibility and the cost-benefit ratio. Results: Five studies were identified according to the inclusion and exclusion criteria set. “Evidence-based guidelines of fall prevention programme for hospitalized older patients” were formulated based on the review of the selected studies. Fourteen recommendations of the evidence-based guidelines are formulated and graded according to the grading system of Scottish Intercollegiate Guidelines Network (SIGN). The evidence-based recommendations can offer nurses and other health care professionals the standards and strategies required for implementing multifactorial fall risk assessment and multifactorial fall prevention interventions, including environmental modifications, knowledge, medication reviews and exercise. A communication plan for various parties in hospitals including a pilot test for determining the feasibility of the innovation and an evaluation plan to determine the effectiveness of the fall prevention programme were subsequently developed. Conclusion: This study reviewed evidence for the effectiveness of the multifactorial fall prevention programme in reducing the incidence of falls, translated the reviewed evidence and developed evidence-based guidelines for a multifactorial fall prevention programme, which can provide the health care practitioners with an evidence-based approach in fall risk assessment and management so as to prevent in-patient falls. / published_or_final_version / Nursing Studies / Master / Master of Nursing