Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 4 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 5 uppsatser.

Thesis ((M.S.)?)--University of Michigan, (1993?).

Thesis ((M.S.)?)--University of Michigan, (1993?).

Abstract The aim of the study was to describe Finnish patients' experiences of the regulation of personal privacy in hospital with the concept 'personal space'. The central topics of interest included the personal space and it's preservation. The right of self-determination while inpatients in hospital enables the patient to preserve personal space. Patients' experiences of personal space and it's preservation were examined by describing the significance of the preservation of personal space, other factors connected with personal space preservation, patients' means to protect their personal space preservation in the interaction with nursing staff, and the tactile, auditory, visual, and olfactory failure of personal space preservation. Patients' personal space was observed from the point of view of triangulation, and quantitative and qualitative data were integrated in the research. The purpose was to provide fresh knowledge in Finnish nursing science on patients' personal space and it's preservation in hospital, as well as to introduce the factors and concepts connected with the phenomenon of personal space to a wider public. The research material was collected in the internal medicine wards of a university hospital. The collection of data was carried out by means of a structured interview (N = 250) and the observation (N = 25) of interactive situations between patients and nursing staff. The structured questions of the interviews were analysed in the software SPSS for Windows 10.1.2. The results were presented as frequency and percentage distributions. The averages used were the mean, the mode, and the median. Cross-tabulation and Spearman's correlation coefficient were used to find out the correlation between variables. The significance of sum variables measuring auditory, visual, and olfactory invasion was tested by means of the t-test on independent groups, the one-way variance analysis, Mann-Whitney's U-test, and χ2-independence test. The open questions of the interviews and the observations were analysed with deductive-inductive content analysis. Patients' right of self-determination in relation to the nursing procedures on their own body was best implemented among the young and more educated patients. The patients protected their personal space with verbal messages related to pain and the right of self-determination, and with non-verbal messages related to body positions, gestures, expressions, eye contact as well as its avoidance, and to the use of hospital screens. The screens were used for the protection of one's own privacy and intimacy, but also for the protection of co-patients' privacy and intimacy. For the majority of the patients, the inviolability of their tactile and olfactory space were particularly important. The personal space had been invaded tactily, auditorily, and olfactorily. Significant factors affecting the experience of personal space were the patient's sex and age, the size of the patient room, the patient's coping capability in hospital, the number of treatments, and mood during hospitalisation. The failure of personal space preservation made the patients feel, above all, hurt and treated as objects. The patients found it justified for the nursing staff to touch them when assisting, but also thought that unnecessary extra taction does not belong to nursing practice. Taction by the nursing staff was mainly experienced as gentle and pain-reactive, as well as respectful of the patient's body. / Tiivistelmä Tutkimuksen tarkoituksena oli kuvata suomalaisten potilaiden kokemuksia yksityisyyden säätelystä sairaalassa henkilökohtaisen tilan avulla. Mielenkiinnon kohteina olivat henkilökohtainen tila ja sen säilyminen. Potilaan itsemääräämisoikeuden toteutuminen hoidon aikana mahdollistaa henkilökohtaisen tilan säilymisen. Potilaiden kokemuksia henkilökohtaisesta tilastaan ja sen säilymisestä selvitettiin kuvaamalla henkilökohtaisen tilan säilymisen merkityksellisyyttä, henkilökohtaisen tilan säilymiseen yhteydessä olevia tekijöitä, potilaiden keinoja suojata henkilökohtaisen tilansa säilyminen ja henkilökohtaisen tilan säilymisen taktiilista, auditiivista, visuaalista ja olfaktorista epäonnistumista. Potilaan henkilökohtaista tilaa tarkasteltiin triangulaation näkökulmasta ja tutkimuksessa yhdistettiin kvantitatiivinen ja kvalitatiivinen aineisto. Tutkimuksen tavoitteena oli saada uutta suomalaista hoitotieteellistä tietoa potilaan henkilökohtaisesta tilasta ja sen säilymisestä sairaalassa sekä tehdä tunnetuksi henkilökohtaisen tilan ilmiöön liittyviä tekijöitä ja käsitteitä. Tutkimuksen aineisto kerättiin yliopistollisen sairaalan sisätautien klinikan vuodeosastoilla. Aineisto kerättiin strukturoidulla haastattelulla (N = 250) ja havainnoimalla (N = 25) potilaan ja hoitotyöntekijän välisiä vuorovaikutustilanteita. Haastattelujen strukturoidut kysymykset analysoitiin SPSS for Windows 10.1.2 -ohjelmalla. Tulokset esitettiin frekvenssi- ja prosenttijakaumina. Keskilukuina käytettiin keskiarvoa, moodia ja mediaania. Muuttujien välisten riippuvuuksien selvittämiseksi käytettiin ristiintaulukointia ja Spearmanin korrelaatiokerrointa. Auditiivista, visuaalista ja olfaktorista loukkaamista mittaavien summamuuttujien merkitsevyyden testaamiseksi käytettiin riippumattomien ryhmien t-testiä, yksisuuntaista varianssianalyysiä, Mann-Whitneyn U-testiä ja χ2-riippumattomuustestiä. Haastattelujen avoimet kysymykset ja havainnoinnit analysoitiin deduktiivis-induktiivisella sisällön analyysillä. Potilaiden itsemääräämisoikeus suhteessa omaa kehoa koskeviin hoitotoimenpiteisiin toteutui parhaiten nuorten ja enemmän koulutettujen potilaiden kohdalla. Potilaat käyttivät henkilökohtaisen tilansa suojaamiseksi erilaisia kipuun ja itsemääräämisoikeuteen liittyviä verbaalisia viestejä ja kehon asentoihin, eleisiin, ilmeisiin, katsekontaktiin ja sen välttämiseen sekä väliverhojen käyttämiseen liittyviä nonverbaalisia viestejä. Väliverhoja käytettiin suojaamaan omaa yksityisyyttä ja mahdollistamaan oma intimiteettisuoja, mutta myös suojaamaan potilastoverin yksityisyyttä ja mahdollistamaan hänelle intimiteettisuoja. Potilaat kokivat merkityksellisenä erityisesti taktiilisen ja olfaktorisen tilan säilymisen loukkaamattomana. Henkilökohtainen tila oli tullut loukatuksi taktiilisesti, auditiivisesti ja olfaktorisesti. Henkilökohtaisen tilan kokemiseen merkityksellisenä olivat yhteydessä potilaan sukupuoli, ikä, potilashuoneen koko, selviytymiskyky sairaalassa, hoitokertojen määrä ja mieliala sairaalassa. Henkilökohtaisen tilan säilymisen epäonnistuminen aiheutti potilaille etenkin pahaa mieltä ja itsen kokemista esineeksi. Potilaat oikeuttivat hoitotyöntekijän kosketuksen autettaessa, mutta turha ja ylimääräinen kosketus ei kuulu hoitotyöhön. Hoitotyöntekijän kosketus koettiin pääasiallisesti hellävaraiseksi, kivut huomioon ottavaksi ja kehoa kunnioittavaksi ja arvostavaksi.

The purpose of this study was to explore nurse-patient encounters from the perspective of the Home Healthcare Registered Nurse. A qualitative descriptive design was used to collect data from a purposive sample of 20 home healthcare registered nurses from Connecticut, Massachusetts, and Rhode Island currently or previously employed as a home healthcare nurse. Four themes and one interconnecting theme emerged from the data: Objective Language; Navigating the Unknown; Mitigating Risk; Looking for Reciprocality in the Encounter; and the interconnecting theme of Acknowledging Not All Nurse-Patient Encounters Go Well. One goal of the study was to propose an empirically informed definition of what constituted a difficult encounter. An important early finding was that the terms difficult patient and difficult encounter were not generally used by study participants. HHC RNs voiced a preference for objective and nonjudgmental language to communicate outcomes of nurse-patient encounters. Three types of HHC RN-patient interactions emerged from the data, with constructive encounters the norm and non-constructive or destructive encounters less frequent. A constructive encounter is when two or more human beings, the nurse on the one side, and the patient, caregiver, or both on the other, interact to achieve a mutually agreed upon outcome. A nonconstructive encounter is when one or more human beings obstruct efforts to achieve at least one positive outcome. A destructive encounter is when one or more human beings direct anger at or physically aggress toward another human being. Strategies to promote reciprocality are routinely employed during HHC RN-patient encounters, but HHC RNs who miss cues that a strategy is ineffective or failed may be at risk in the home. Study data lend support to key concepts, assumptions, and propositions of Travelbee’s (1971) Human-to-Human Relationship Model. Study results provide a foundation for further research to increase the understanding, recognition, and development of empirically derived responses to non-constructive or destructive encounters such that HHC RNs are safe and best able to meet patients’ healthcare needs.

Bakgrund: Språkbarriärer i hälso- och sjukvården har blivit alltmer förekommande då invandringen och migrationen ökat. Vikten av Kommunikation, jämlik vård, patientsäkerhet och patienters erfaranheter framförs. Syfte: Syftet med litteraturstudien var att belysa sjuksköterskors erfarenheter av språkbarriärer i vården. Metod: En allmän litteraturöversikt genomfördes enligt Fribergs (2017) analysmodell. 10 vetenskapliga artiklar som analyserades varav 9 var kvalitativa och en kvantitativ artikel. Artiklar hämtades från databaserna PUBMED, CINAHL Complete och Medline med följande sökord: nurse perception, nurse-patient-relations, nurse experience och language barriers. Resultat: Resultatet visade att vårdkvaliteten påverkades negativt av språkbarriärer, resultatet påvisade även risk för patientsäkerheten. Sjuksköterskor tillämpade olika sätt för att besegra språkhindren. Litteraturstudiens resultat presenteras utifrån dessa huvudkategorier: språkbarriärer leder till osäkerhet, frustration och oro, att kommunicera genom tolk, att tala samma språk och alternativa kommunikationsmedel. Sammanfattning: I denna litteraturöversikt har sjuksköterskors erfarenheter av språkbarriärer i vården belysts samt hur det påverkar omvårdnaden. För att uppnå jämlikhet och kunna ge personcentrerad vård till patienter så bör sjuksköterskan ha en kulturell kompetens samt förstå innebörden av kulturell omvårdnad. Det är viktigt att kunna utbilda framtida sjuksköterskor och etablerade sjuksköterskor om språkbarriärer samt om mångkulturell omvårdnad. / Background: Language barriers in health care have become increasingly common as immigration and migration have increased. The importance of communication, equal care, patient safety and patient’s experiences of language barriers are presented. Aim: The purpose of the literature study was to shed light on nurse’s experiences of language barriers in care. Method: A general literature review was conducted according to Fribergs (2017) analysis model. 10 scientific articles were analyzed of which 9 were qualitative and one quantitative article. Articles were retrieved from the databases PUBMED, CINAHL Complete and Medline with the following keywords: nurse perception, nurse-patient-relations, nurse experience and language barriers. Results: The results showed that the quality of care was negatively affected by language barriers and risked patient safety. Nurses applied different ways to overcome language barriers. The results of the literature study are presented based on these main categories: Language barriers lead to uncertainty, frustration and anxiety, to communicate through an interpreter, to speak the same language and alternative means of communication. Summary: In this literature review, nurses' experiences of language barriers in care have been highlighted, as well as how it affects nursing. In order to achieve equality and be able to provide person-centered care to these patients, the nurse should have a cultural competence and be able to understand the meaning of cultural nursing. It is important to be able to train future nurses and established nurses about language barriers and about multicultural nursing.

Bakgrund: Den äldre individen kommer att bli en allt större grupp av befolkning. Med en stigande ålder ökar även risken av att drabbas av en eller flera sjukdomar, vilket kommer att ställa högre krav på sjukvården. Svensk lag säger att vården har en skyldighet att främja patientens integritet, delaktighet och självbestämmande, dock brister detta inom vården av de äldre. Många komplexa sjukdomstillstånd hos en äldre person gör att omvårdnaden behöver ges utifrån patientens individuella behov. Personcentrerad omvårdnad handlar om ett partnerskap mellan individen och vårdpersonalen, där individen sätts i centrum för vården. Syfte: Att belysa den äldre patientens upplevelse av vård utifrån ett personcentrerat perspektiv. Metod: Examensarbetet är utformat som en litteraturöversikt. Artiklar söktes fram via databaserna CINAHL och PubMed, 13 artiklar med kvalitativ metod valdes ut. Resultat: Resultatet visade att det fanns likheter och skillnader i hur den äldre upplevde sin vård: Dessa upplevelser kunde delas in i tre huvudkategorier, nämligen självbestämmande, delaktighet och integritet. Den äldre patienten hade en längtan efter självständighet och självbestämmande, dock slogs detta tillbaka på grund av en tids- och kompetensbristande vård. De äldre hade en önskan om att vara delaktiga i sin vård, där relationen och kommunikationen var en viktig grund för att skapa delaktighet. Många av de äldre kände sig ej bekräftade som en unik individ av omvårdnadspersonalen. Slutsats: För att kunna främja de äldres roll i en personcentrerad vård måste ett helhetsperspektiv och ett personcentrerat förhållningssätt appliceras, där den äldre respekteras som en unik individ. Med den äldre individen i centrum för sin vård, stärks dennes rätt till självbestämmande, delaktighet samt integritet, som i sin tur kan leda till en ökad livskvalité. / Background: The elderly is a group that will be a major part of the population in the future. With increasing age, the risk of suffering from one or more diseases increases, which will place higher demands on healthcare. Swedish law states that healthcare has an obligation to promote patient integrity, participation and self-determination, but this is invalid in the care of the elderly. Many complex illnesses in an elderly person necessitate nursing based on the patient's individual needs. Person-centered nursing is about a partnership between the individual and healthcare staff, where the individual is at the center of care. Aim: To highlight the elderly patient's experience of care based on a person-centered perspective. Method: A literature review was conducted and the data was found in the databases CINAHL and PubMed, 13 articles with qualitative method were selected. Result: The results showed that there were similarities and differences in how the elderly patient experiences their care. These experiences can be divided into three main categories: self-determination, participation and integrity. The elderly patient had a longing for independence and self-determination, however, this was reversed due to a lack of time and competence shortage. The elderly had a desire to be involved in their care, where the relationship and communication were an important basis for creating participation. Many of the elderly did not feel confirmed as a unique individual of nursing staff. Conclusion: In order to promote the role of the elderly in their care, must a holistic perspective and a person-centered approach be applied, where the elderly is respected as a unique individual. With the older individual at the heart of his care, his right to self-determination, participation and integrity is strengthened, which in turn can lead to an increased quality of life.