Thesis (M.H.A.)--University of Michigan, 1959.

M.A. / This study explores the narratives of two South African women, who have previously been admitted as patients, to various psychiatric institutions in Gauteng. In particular, this study focuses on the women’s perceptions of the ward round process, within the context of hospitalisation. An attempt has been made to explore the wider context of the ward round and hospitalisation, by examining the medical model, its philosophy and the various problems associated with the medical model. The concepts of power, respect and pathologising discourse in particular, are focussed on. The study suggests that an ecosystemic model might serve as a useful alternative to the medical model in addressing the above-mentioned problems. This research was conducted in the form of an inquiry, within the context of a social constructionist perspective. As such, the research methodology employed is also based within the social constructionist paradigm. The themes raised in the conversations with the participants, are seen to be a social co-construction, which has evolved between the researcher and the participants. The social constructionist approach also means that the researcher has applied a reflexive stance, whereby narratives of the participants and the researcher, are linked to a reflection of the content and the various processes that took place within the context of the research. The narratives of the participants suggest that ward rounds are seen to be useful and necessary, but that within the context of the ward round, issues such as respect and transparency are important and should be taken into account. It is stressed within the context of this research, that these findings are localised and specific. As such they can not necessarily be seen to reflect the ‘truths’ of all people, who have experienced the process of ward rounds within the context of hospitalisation.

MPH, Faculty of Health Sciences, University of the Witwatersrand / Introduction: The study analysed the admission trends at six adult medical wards in a regional hospital in Gauteng over 2005 and 2007. Methods: This was a retrospective analysis of data from admission ward registers and patient case notes. Information obtained included age, gender, duration of stay, clinical outcomes and disease profile. The study population comprised of all patients admitted to the adult medical wards at Tambo Memorial Hospital for the period 1 January 2005 to 31 December 2005 and 1 January 2007 to 31 December 2007. Results: The number of medical admissions increased by 2.07% during the years of study. The male admissions were slightly higher than the female admissions. The mean age of male patients decreased from 42.30 years to 40.41 years. In contrast the mean age for female patients increased from 38.00 years to 40.50 years. The average length of stay decreased from 6.16 days to 5.33 days. The younger age groups (15-34 years of age) accounted for the majority of admissions. Based on the ICD 10 coding, infectious and parasitic diseases accounted for the majority of the admissions followed by respiratory disorders. Tuberculosis became the most frequent diagnosis and was prevalent in the younger age groups followed by pneumonia. Hypertension was a common diagnosis in the older age groups (55 years and older). As was expected the majority of patients (86-95% in 2005 and 80.24% in 2007) were discharged home but a considerable number of patients were transferred to other institutions. Importantly, a decrease in the mortality rate from 4.02% to 0.03% was also demonstrated. Conclusions: An increase in the number of patient’s admissions, a decrease in the average length of stay and a decrease in mortality rate were noted during the study period. Changing trends with regards to gender, age and disease profile were also observed. The challenges and recommendations identified by the study will provide valid information that would be meaningful to hospital management as well as potential users such as budget planners, resource allocators and efficient referral pathways designers.

This grounded theory study investigates the experiences and perceptions of comfort and discomfort of hospital patients admitted for medical-surgical conditions, with a focus on the post-accute stage of hospitalisation. In-depth post-discharge interviews were conducted with seventeen English speaking adults who had been admitted to nine Australian hospitals. A substantive theory of finding comfort and of managing discomfort was generated. Processes of self-talk (anticipating, interpreting, accepting, making allowances and maintaining perspective) and self-care (self-help and seeking help, which involved accommodating to the level and type of help available through deferring, avoiding, persisting or desisting) were used to find comfort and to manage discomfort. The study has implications for nursign practice, management, research and education. Existing practice in the areas of assessment, communication, individualised care planning and the management of discomfort need to be strengthened if nursing care is to make a difference for this category of patient. The study revealed that integrated caring by nurses perceived by informants as 'experts', contributed most to the experience of finding comfort and managing discomfort in this group of informants / Doctor of Philosophy (PhD)

Thesis (Ph. D.)--York University, 1997. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 219-225). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ22926.

Thesis (Ph.D.)--Virginia Commonwealth University, 2009. / Prepared for: Dept. of Health Administration. Title from title-page of electronic thesis. Bibliography: leaves 182-192.

Background: Health care settings are generally regarded as stress inducing environments. Stress can alter the immune response, impair wound healing and create a greater risk for asthma, diabetes, gastrointestinal disorder and myocardial infarction. Beginning in the 1980s and 1990s, there has been increasing interest in healing environments and evidence-based design concepts. Yet, there has been little progress developing healing environments and using evidence-based design for psychiatric inpatient units, a uniquely stressful environment. Psychiatric units today continue to use designs such as caged in outdoor patio areas that resemble facilities that incarcerate rather than facilities which reduce stress and facilitate healing. The purpose of this systematic literature review was to identify design features that are evidence-based which can be used to create an optimal inpatient psychiatric patient room by: (1) analyzing the research literature for evidence of architectural and design elements that could be used in the inpatient psychiatric care setting to reduce stress and improve the well-being; (2) identifying design elements that are consistent with accreditation and licensing standards for inpatient psychiatric units; and (3) designing a psychiatric inpatient room that has evidence-based elements to reduce stress and improve well-being. Methods: A systematic literature review was conducted to identify factors in the inpatient healthcare environment that support an optimal healing environment. The PICO question for this review was what design factors in the inpatient healthcare environment support an optimal healing environment? A search of five databases and a hand search of reference lists were conducted. The search included studies from 1980 to the present, original research conducted on inpatient units with adult patients that investigated an intervention with an outcome that promotes a healing environment. Experimental, quasi-experimental, non-experimental, systematic literature reviews and expert opinions were sought and evaluated using a scale to analyze scientific rigor and research quality. Results: A total of 6,874 articles were identified in the search. Seventy-six articles were eligible for full text screening. After review of the full text, 38 articles were determined to be eligible for evidence analysis. After removing 11 inadmissible articles due to poor quality, 27 articles were included in the final synthesis. The search found research on eight hospital design features which may support optimal healing environments: artwork (n = 7), building configuration (n = 2), finish materials (n = 7), interior details (n = 6), lighting (n = 11), nature and view (n = 8), noise (n = 10), room configuration (n = 6). More than 50% of the research on optimal healing environments used quasi-experimental and non-experimental designs with rare use of experimental research designs. Overall, the quality of the research on optimal healing environments is not high, but results were reasonably consistent across studies. Conclusions: Evidence suggests seven design features for healing inpatient psychiatric environments, including: (a) single rooms, (b) calm, naturalistic and domestic artwork or photographs, (c) east facing windows, (d) plants, (e) acoustic ceiling tiles, (f) patient rooms removed from noise producing unit areas and (g) a window view of nature. These seven recommendations were examined for consistency with existing Arizona statutes and industry standards for behavioral health care environments. Recommendations found to be inconsistent with these statutes and standards were modified to reach congruency with the statutes and guidelines, and then an evidence-based design of a psychiatric inpatient room design was formulated and is illustrated. Future research on interventions to create healing environments at the greatest scientific rigor is needed along with measurement techniques to quantify stress responses to the environment.

Thesis PlanA (M.S.)--University of Wisconsin--Stout, 2007. / Includes bibliographical references.

Thesis (Ph.D.)--University of Melbourne, Dept. of Postgraduate Nursing, 2002. / Typescript (photocopy). Includes bibliographical references (leaves 236-259).

Thesis (M.H.A.)--University of Michigan, 1968.