The purpose of this study was to describe the relationships among perceptions of privacy, powerlessness, and subjective sleep characteristics in hospitalized adults with coronary heart disease. Thirty subjects, 48 to 92 years old who were hospitalized for suspected or confirmed coronary heart disease, completed three questionnaires. Negative relationships were found between patient privacy and powerlessness (r = -.44) and between powerlessness and the subjective sleep characteristics of sleep effectiveness (r = -.30). Feelings of powerlessness were negatively related to total number of days of (r = -.50) and number of days in the Coronary Care Unit (CCU) (r = -.41). The number of days in the CCU was positively related to sleep disturbance (r =.30). Age was negatively related to patient privacy (r = -31) but positively related to powerlessness (r =.33) and sleep supplementation (r =.35). A better understanding of the hospital environment enhances the planning of nursing care for hospitalized patients.

No description available.

No description available.

The primary interest of this investigation concerned the self-injurious thoughts and behaviors (SITBs) of inpatient adolescents. Previous researchers have provided descriptive information regarding either automatic (or intrinsic) and social components using the Self-Injurious Thoughts and Behaviors Interview (SITBI). However, the presence and trends of these components have not firmly been established, suggesting the need to explore this area further. Eighty-two adolescent inpatients were selected and interviewed using the SITBI to evaluate the predictive ability of self-reported self-injurious behavior with regard to social and automatic, negative and positive functions. Results showed that depending on the type of thought or behavior displayed one could discern the motivation behind their actions. Automatic-Negative was seen to have the strongest relationship across all SITB behaviors while Automatic-Negative was not found to be relatively low compared to other SITB behaviors. Both Social-Positive and Social-Negative were found to be present in moderate relationships compared to Automatic in general.

The purpose of the study was to describe the relationship between in-home health care services for elderly patients who were recently discharged from inpatient care and re-hospitalization rates. The design was descriptive and the hypothesis was that the provision of in-home health care services would mitigate a decline in the health status, of an elderly patient, following discharge from inpatient care and prevent re-hospitalization.

[Truncated abstract] Physical healthcare uses a suite of tools for measuring response to treatment. However, reliable systems of regular patient monitoring are rare in mental healthcare. Mental health services often measure a treatment response from pre- to post- therapy, yet measurement between those occasions is less common. This omission is problematic since arguably there is a need for an alarm system in psychotherapy (Andrews & Page, 2005). A substantial minority of patients do not experience reliable change following treatment, and a small proportion deteriorates (Hansen, Lambert, & Forman, 2002; Newnham, Harwood, & Page, 2007). Without monitoring, it is not always possible to know which patients are progressing poorly. Since the publication of Howard and colleagues' (1996) proposal that patient progress be monitored routinely during therapy and the results fed back to clinicians to direct treatment, this monitoring regime has garnered attention in the United States and Europe (Lambert, 2007; Lutz, et al., 2006). Findings in outpatient psychotherapy have demonstrated that providing real-time feedback on patient progress to clinicians and patients significantly improves clinical outcomes for those patients demonstrating a negative response to treatment (Harmon et al., 2007; Lambert et al., 2001; Lambert et al., 2002). What is not yet apparent is how these processes would generalize to inpatient and day patient (i.e. patients attending hospital for a whole day of treatment) psychiatric care. Inpatients often present with greater severity and are treated in an intensive setting. ... Deviations from this expected pattern would highlight possible differences between inpatient and outpatient care. To develop an appropriate system for monitoring patient progress, it was important to first define clinically significant recovery in inpatient psychiatric care, and provide criteria for clinicians to judge outcome in routine practice (Newnham, Harwood, & Page, 2007). Second, a quick and easy-to-administer system of progress monitoring and real-time feedback was developed to enhance treatment decision making (Newnham, Hooke, & Page, 2009). Third, the system was evaluated to determine clinical effectiveness. Using the World Health Organization’s Wellbeing Index, a program for monitoring patient progress and providing feedback to clinicians and patients was established at Western Australia's largest private psychiatric service. The sample consisted of 1308 consecutive inpatients and day patients whose primary diagnoses were predominantly depressive (67.7%) and anxiety (25.9%) disorders. Feedback to patients and clinicians was effective in reducing depressive symptoms (F (1,649) = 6.29, p<.05) for those patients at risk of poor outcome, but not effective in improving wellbeing (F (1,569) = 1.14, p>.05). The findings support the use of progress monitoring and feedback in psychiatric care to improve symptom outcomes, but raise questions about changes in wellbeing during psychotherapy. The effectiveness study was conducted as a historical cohort trial, consistent with quality improvement efforts, and replication with a randomized controlled design is warranted. Feedback of progress information appears to be an important process within psychotherapy, and further investigation of the means by which clinicians and patients use that information is necessary.

The abstract on the file is incorrect, use the the one in the system as it summerizes the full text. / This attempted to describe factors contributing to sleep deprivation in the a multidisciplinary intensive care unit in KwaZulu-Natal Province. A quantitative, descriptive research design was adopted and structured interviews were conducted with 34 adult patients. Most factors contributing to these patients' sleep deprivation are basic physiological needs. Much can be done to enhance patients' abilities to sleep if noise (from alarms, monitors, televisions, telephones and footsteps) could be controlled, patients' pain would be managed effectively, doctors would visit the patients regularly, doctors and nurses use lay terms when talking to patients. Visible clocks and windows will help patients to maintain time orientation. Friendly, approachable and respectful nurses who introduce themselves to the patients help' to reduce patients' stress levels and improve their abilities to sleep. / Health Sciences / M.A. (Health Studies)

The abstract on the file is incorrect, use the the one in the system as it summerizes the full text. / This attempted to describe factors contributing to sleep deprivation in the a multidisciplinary intensive care unit in KwaZulu-Natal Province. A quantitative, descriptive research design was adopted and structured interviews were conducted with 34 adult patients. Most factors contributing to these patients' sleep deprivation are basic physiological needs. Much can be done to enhance patients' abilities to sleep if noise (from alarms, monitors, televisions, telephones and footsteps) could be controlled, patients' pain would be managed effectively, doctors would visit the patients regularly, doctors and nurses use lay terms when talking to patients. Visible clocks and windows will help patients to maintain time orientation. Friendly, approachable and respectful nurses who introduce themselves to the patients help' to reduce patients' stress levels and improve their abilities to sleep. / Health Sciences / M.A. (Health Studies)

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Esta pesquisa é fruto de inquietações e questionamentos da pesquisadora em uma UTI geral/adulto, seu campo de ação clínica. A questão que norteou a pesquisa buscou compreender a experiência de uma equipe de saúde em uma UTI/geral adulto. A interrogação inicial desdobrou-se em novas perguntas: como as ações da equipe podem ser complementares no contexto da UTI, cuja prioridade é salvar a vida do paciente, considerando, também, o cuidado integral do paciente. Como a equipe lida com as questões da morte e do morrer em seu cotidiano de trabalho, e quais as repercussões dessa experiência no modo como acontecem as intervenções junto ao paciente e familiares? Quais os prejuízos decorrentes da fragmentação do saber na modernidade, nas ações da equipe de saúde na situação de intervenção em uma UTI geral/ adulto. E quais as possíveis contribuições da ação clínica do psicólogo, fundada numa perspectiva fenomenológica existencial, no modo de funcionar da equipe de saúde. A dissertação está organizada em três artigos: dois teóricos e um empírico. O primeiro artigo teórico, trata da ação de uma equipe de saúde em UTI, teve como metodologia a pesquisa bibliográfica. Em seu desenvolvimento, busca traçar o surgimento da UTI e a evolução da assistência hospitalar ao doente grave, ressaltando os eminentes personagens da história do intensivismo; caracteriza o modelo atual de UTI no Brasil e descreve como a equipe multiprofissional foi se estabelecendo neste contexto de ação; apresenta, ainda, o cotidiano de trabalho da equipe e o quanto sua rotina é atravessada pelas questões da vida e da morte. O segundo artigo, também com metodologia bibliográfica, enfoca o acontecer da equipe de saúde em uma Unidade de Terapia Intensiva. Para tanto, aborda a fragmentação do saber na modernidade e sua ressonância na prática do profissional de saúde, delineando o fenômeno da hiperespecialização e as relações disciplinares; além disso, demarca a ação do psicólogo na equipe da UTI, numa perspectiva da fenomenologia existencial. Por fim, o terceiro artigo foi desenvolvido a partir de uma pesquisa qualitativa de cunho fenomenológico. A questão da pesquisa, vinculada aos objetivos da dissertação, foi trabalhada em um encontro com seis profissionais de saúde que fazem parte de equipes multidisciplinares em um Centro de Terapia Intensiva de um hospital da rede privada na cidade de Recife, cujos dados foram analisados a partir da Analítica de Sentido de Critelli. Como resultado observou-se que uma única área de conhecimento não pode dar conta da complexidade do fenômeno do adoecimento; que o trabalho em equipe exige colaboração, de modo que as ações no campo possam revelar uma fusão de horizontes, com possibilidades para o iniciar de uma outra/nova compreensão da ação em con-junto.

Made available in DSpace on 2017-06-01T18:08:40Z (GMT). No. of bitstreams: 1 dissertacao_josemary_costa.pdf: 1358075 bytes, checksum: f08c82f557d08e3c315127ab5d5433a1 (MD5) Previous issue date: 2012-11-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research is the result of concerns and questions of the researcher in a general ICU / adult, in his field of clinical action. The question that guided the research sought to understand the experience of a team of health care at ICU / general adult. The paper is organized into three parts: two theoretical papers and empirical one. The initial interrogation lead us to new questions: how the team's actions may be complementary in the context of the ICU, whose priority is to save the patient´s life, considering also the holistic care of the patient. As the team deals with issues of death and dying in their daily work, and what the repercussions of this experience happen in the way the interventions with the patient and family? What are the negative effects of fragmentation of knowledge in modernity, the actions of the health team in a position to intervene at the ICU / general adult. And what are the possible contributions of the psychologist's clinical action based on an existential phenomenological perspective, mode of functioning of the health team. The first theoretical paper deals with the action of a health team in the ICU, had the methodology literature.About the development outlines around the emergence of the historical evolution of the ICU and hospital care to the ill person, emphasizing the prominent characters in the history of intensive care. It also aims to characterize the current model of ICU in Brazil and it describes how the multidisciplinary team was establishing itself in this context of action. It also displays the daily work of the team and how your routine is crossed by the issues of life and death. The second article, also with the methodology literature, focuses on the happening of the health team at intensive care unit. To do so, addresses the fragmentation of knowledge in modernity and resonances in the practice of health professionals outlining the phenomenon of hyperdisciplinary and relationships. Moreover, the action marks the psychologist in ICU team perspective of existential phenomenology. Finally, the third article was developed from a qualitative study of a phenomenological. The question of research, linked to the aims of the dissertation, was crafted in a meeting with six health professionals who are part of multidisciplinary teams in the intensive care unit of a private hospital network in the City of Recife and the data were analyzed from the Analytical Sense Critelli. As a result it was observed that a single area of knowledge does not account for the complexity of the phenomenon of illness that requires teamwork, collaboration, so thatthe actions in the field may prove a "fusion of horizons" with possibility to start another /new understanding of action in a set. / Esta pesquisa é fruto de inquietações e questionamentos da pesquisadora em uma UTI geral/adulto, seu campo de ação clínica. A questão que norteou a pesquisa buscou compreender a experiência de uma equipe de saúde em uma UTI/geral adulto. A interrogação inicial desdobrou-se em novas perguntas: como as ações da equipe podem ser complementares no contexto da UTI, cuja prioridade é salvar a vida do paciente, considerando, também, o cuidado integral do paciente. Como a equipe lida com as questões da morte e do morrer em seu cotidiano de trabalho, e quais as repercussões dessa experiência no modo como acontecem as intervenções junto ao paciente e familiares? Quais os prejuízos decorrentes da fragmentação do saber na modernidade, nas ações da equipe de saúde na situação de intervenção em uma UTI geral/ adulto. E quais as possíveis contribuições da ação clínica do psicólogo, fundada numa perspectiva fenomenológica existencial, no modo de funcionar da equipe de saúde. A dissertação está organizada em três artigos: dois teóricos e um empírico. O primeiro artigo teórico, trata da ação de uma equipe de saúde em UTI, teve como metodologia a pesquisa bibliográfica. Em seu desenvolvimento, busca traçar o surgimento da UTI e a evolução da assistência hospitalar ao doente grave, ressaltando os eminentes personagens da história do intensivismo; caracteriza o modelo atual de UTI no Brasil e descreve como a equipe multiprofissional foi se estabelecendo neste contexto de ação; apresenta, ainda, o cotidiano de trabalho da equipe e o quanto sua rotina é atravessada pelas questões da vida e da morte. O segundo artigo, também com metodologia bibliográfica, enfoca o acontecer da equipe de saúde em uma Unidade de Terapia Intensiva. Para tanto, aborda a fragmentação do saber na modernidade e sua ressonância na prática do profissional de saúde, delineando o fenômeno da hiperespecialização e as relações disciplinares; além disso, demarca a ação do psicólogo na equipe da UTI, numa perspectiva da fenomenologia existencial. Por fim, o terceiro artigo foi desenvolvido a partir de uma pesquisa qualitativa de cunho fenomenológico. A questão da pesquisa, vinculada aos objetivos da dissertação, foi trabalhada em um encontro com seis profissionais de saúde que fazem parte de equipes multidisciplinares em um Centro de Terapia Intensiva de um hospital da rede privada na cidade de Recife, cujos dados foram analisados a partir da Analítica de Sentido de Critelli. Como resultado observou-se que uma única área de conhecimento não pode dar conta da complexidade do fenômeno do adoecimento; que o trabalho em equipe exige colaboração, de modo que as ações no campo possam revelar uma fusão de horizontes , com possibilidades para o iniciar de uma outra/nova compreensão da ação em con-junto.