Bakgrund:Hjärtsvikt är en sjukdom som blir vanligare vid stigande ålder och cirka 250 000 svenskar är drabbade (Hjärt-lungfonden, 2016). Patienter ska enligt Patientlagen (SFS 2014:821; SFS 1982:763) få information om sitt hälsotillstånd, vilka former av undersökningar, vilken vård som kan användas, förväntade behandlingsförlopp, riskerna och eftervård. Patienten får inte alltid nödvändig information. Bristen på information kan bero på allt från patientens okunskap till vårdgivarens tidsnöd på grund av hög arbetsbelastning. Syfte: Att undersöka sjuksköterskornas sätt att informera och olika perspektiv på innehållet på den information som förmedlas till patienter med hjärtsvikt på en kardiologisk slutenvårdsavdelning. Metod:En deskriptiv intervjustudie med kvalitativ ansats och innehållsanalys. Resultat: Resultat visar att den information som förmedlas till patienter med hjärtsvikt kan se olika ut beroende på vilken sjuksköterska som ger informationen. Slutsats:Informationen sjuksköterskor förmedlar till patienter med hjärtsvikt varierar beroende på patientens kunskap, hälsotillstånd, intresse och grad av kognitiv förmåga. Dock kan hög arbetsbelastning förhindra sjuksköterskan att ge individuellt anpassad information. / Background: Heart failure is a condition that becomes more common with age, and about 250 000 Swedes are affected (Heart-Lung Foundation, 2016). Patients should, under the Patient Act (SFS 2014: 821, SFS 1982: 763), obtain information on their health status, the types of treatment, what care may be used, the expected course of treatment, risks and aftercare. The patient does not always get the necessary information. The lack of information may depend on everything from the patient's lack of knowledge to the caregiver's shortage of time, because of the heavy workload. Aim: To investigate the nurses' ways of informing and different perspectives on the content of the information conveyed to patients with heart failure in a cardiologic healthcare department. Method: A descriptive interview study with qualitative approach and content analysis. Results: Results show that the information given to patients with heart failure may vary depending on the nurse who provides the information. Conclusion: The information nurses convey to patients with heart failure vary depending on the patient's knowledge, state of health, interest and degree of cognitive ability. However, high workload can prevent the nurse to provide personalised information.

Patient education often aims to activate behaviours for health management. Assumptions of a fundamental desire for information and learning as a pre-requisite for self-management are countered by the fact that some patients refuse or selectively attend to health information. The complex and emotional context surrounding illness and disease may reduce the patient’s openness or willingness to engage with information. Perceptions of a non-compliant, resistant or difficult patient are accompanied with little understanding of the underlying factors. The goal of this research was to explore the cognitive and emotional factors underlying the patient’s readiness to learn or cognitively engage with information regarding diabetes management. This study was conducted using Interpretative Phenomenological Analysis, which draws from the educational experiences of patients with diabetes and interprets their narratives within the context of existing research and theory. A maximum variation sample of 19 adults with Type II diabetes from a primary care clinic and a tertiary care hemodialysis unit participated in an interview. Three main themes emerged: underlying incongruence in knowledge, thoughts and beliefs; relational talking; and negotiating control. Themes converged on the essence of ‘distance’ between the patient’s lifeworld and the disease and its management. When considered in relation to cognitive dissonance and psychological distance theories, psychological adjustment and relational challenges were revealed. Adjustment involved reconciling difference and dissonance at various points during diabetes management. Distance also threatened the adjustment process and in some cases generated defensive reactions. Adjustment and relational challenges have a bearing on the early stages of the learning process. Differentiating the message according to concrete and abstract information may be more conducive to a staged learning process and offer a more tangible understanding of ‘finding common ground’ within patient-centered communication. These factors underlying readiness to learn have been reported by patients with diabetes and require further consideration for tailoring communication and education to support person-centred care and self-management. / October 2016

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

by Li Ho Cheung, William. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 82-88). / Abstracts in English and Chinese. / Abstract --- p.ii / Acknowledgements --- p.vi / Table of Contents --- p.vii / List of Tables --- p.viii / List of Appendices --- p.x / Chapter Chapter 1 : --- Introduction and Literature Review --- p.1 / Chapter Chapter 2 : --- Method --- p.31 / Chapter Chapter 3 : --- Results --- p.48 / Chapter Chapter 4 : --- Discussion --- p.60 / Reference --- p.82 / Appendices --- p.89

Veterans are at increased risk for developing mental illnesses because of separation from families, distressing experiences in the military, and previous injury to the brain. Approximately 30% of U.S. veterans returning from war suffer from post-traumatic stress disorder (PTSD). The incidence of acute PTSD is reduced when victims are aware of the condition and its associated factors. Through education and screening, the project bridged the gap between deployment of military veterans and treatment of PTSD in this population by addressing whether screening veterans and providing an educational process affected veterans' early PTSD recognition and treatment. The project study addressed the impact of staff education on identifying undiagnosed PTSD among veterans at the project site. The project was guided by the adult learning theory that was applied to fit the self-efficacy model. Data collection included screening of 99 veterans by clinic staff members using the PTSD checklist. Staff members also completed pretests and posttests before and after the education program. Results indicated that staff members demonstrated increased knowledge of the PTSD from pretest (50%) to posttest (93%). Of the veterans screened in the project, 30(30%) tested positive for PTSD and were referred to psychiatrists for treatment and medication to ameliorate the symptoms. Findings may be used to encourage implementation of PTSD screening and education in health care organizations ensuring positive social change by veterans suffering from PTSD and the care they need early in the progression of PTSD development.

Stroke continues to plague the United States, affecting 795,000 people annually. Although stroke mortality has decreased, the overall incidence of stroke appears essentially unchanged. With a population that is projected to increase in age and stroke risk over the next 10-15 years, this is concerning. Current stroke prevention education may not be adequately tailored to community learning needs. Analyzing existing demographic data within electronic medical records may allow healthcare systems to identify high-risk neighborhoods by geocoding stroke diagnoses and then completing a qualitative analysis within the target community of specific stroke knowledge deficits. That information may then inform stroke prevention education for that neighborhood. A descriptive, exploratory approach was used to identify a community with a high incidence of stroke using geocoded demographic data from patients coding out with a stroke diagnosis. Qualitative interviews conducted within the community yielded the following themes: fragmented knowledge of stroke causes and risk factors, unawareness of hypertension and diabetes as significant risk factors for stroke, knowing but experiencing challenges to engaging in healthy practices—specifically, diet and exercise, and financial barriers to healthcare resources. While most of the participants had adequate healthcare coverage and reported regular interactions with a primary healthcare provider, this community continued to experience a higher incidence of stroke than surrounding neighborhoods. The findings of this study highlighted specific challenges to stroke prevention that may inform future stroke prevention initiatives. Future research in other communities using this approach may provide additional insights into the specific knowledge deficits unique to communities, as well as revealing patterns and trends in stroke prevention knowledge. Approaching stroke prevention education using only data obtained from large registries may provide a broad overview of knowledge deficits, but lack the specificity necessary to effectively address stroke knowledge needs at the community level. Recognizing the challenges inherent with behavior modification for implementing lifestyle changes should also be considered when designing future stroke education. Harnessing technology in the form of web applications, text messaging, and email for maintaining communication with patients may improve effectiveness of stroke prevention interventions. Implementing a comprehensive health promotion program that addresses specific community needs with tailored health education and behavioral support may lead to decreased incidence of cerebrovascular disease in this community and provide a model for managing other preventable diseases. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2019. / FAU Electronic Theses and Dissertations Collection

Low health literacy levels put patients at greater risk for poorer compliance and access to care, which leads to worse patient outcomes. Nurses must understand health literacy to improve health literacy for their medical surgical patient population. It is necessary for a formal education program on this topic. The purpose of this project was to increase medical surgical nurses' awareness and knowledge of the importance of health literacy and to introduce the REALM-SF tool to assess a patient's literacy level, allowing a nurse to better individualize the education provided to the patient. Lewin's change management theory was key in the development of this project with attention to his three stages of change acceptance. The practice focus question was, "Will medical-surgical nurses show an improvement in their knowledge of health literacy when comparing measurement of knowledge pre education and immediately post education?" The HL-SF12 for registered nurses tool was used to collect data for this project as a pre- and post-implementation knowledge assessment. Thirty-one medical surgical nurses participated in this education session. The results of this analysis show that there is a significant gap in medical-surgical nurses' knowledge of health literacy. However, all participates showed a significant increase in their scores from pretest to posttest after the educational module, which signifies that this education program was successful. Assessing health literacy is a major step towards improving the delivery of patient education by nurses and assists the patients in the management of their medical problems. All of this leads to positive social change by making sure that the education provided by the nurses is understood and received well by the patients and their families.

Acute decompensation of chronic heart failure is common and results in many patients being re-hospitalized every year (Jancin 2008). One of four voluntary core measures deployed by the Joint Commission for evaluation of quality of heart failure care in hospitals is heart failure discharge instructions, also called core measure HF1. Although the core measure is a widely disseminated standardized measure related to discharge education, there is little evidence about its impact on patient or readmission outcomes. The purpose of this study was to determine the relationship between the completion of heart failure discharge instructions as defined by the Joint Commission core measure HF1 in a single site, 500 bed tertiary hospital population in the Upper Midwest and the primary endpoint of subsequent readmission to the hospital 30, 90, 180 and 365 days following an index discharge for primary diagnosis of heart failure. Secondary endpoints included hospital readmission charges and total hospital readmission days per year. Patient characteristics, clinical characteristics, unit factors and index visit utilization variables were controlled. This study also described the relationship between nursing unit factors and completion of HF1. A retrospective, descriptive design, and analyses using primarily generalized linear models, were used to study the relationship of HF1 to utilization outcomes (readmission, hospital days and cost) and unit context (discharge unit and number of inter-unit transfers). Individual level retrospective demographic, clinical, administrative and performance improvement data were used (n = 1034). Results suggested a weak and non-significant association of completion of the core measure HF1 bundle and readmission within 30 days for all cause readmissions (p = .22; OR 1.32), and no association with HF to HF readmissions at 30 days. There was an inverse association 2 after 6 months for all cause readmission, and after 90 days for HF to HF readmission. There was a non-significant trend toward a relationship to total hospital days, but no relationship of HF1 to total annual charges. The study did find a significant relationship between type of discharge nursing unit and HF1 completion, and type of discharge unit and readmission. The discharge nursing unit was quite consistently and strongly related to all cause readmissions in binary (p = .029: OR 1.58) and counts analyses (p = .001; OR 1.52), but was not related to the subset of HF to HF readmissions. The study concludes that there is limited relationship between HF1 and 30 day all cause hospital readmission and total readmission days, but a stronger relationship between HF1 and discharge from a cardiology specialty unit. There was also a relationship between cardiology discharge unit and reduction in all cause readmissions.

"March 2003" Includes bibliographical references (leaves 61-68). Appendices: Publications arising from the research portfolio. 1. Conducting a systematic review -- 2. The effectiveness of mechanical compression devices in attaining hemostasis after removal of a femoral sheath following femoral artery cannulation for cardiac interventional procedures : a systematic review -- 3. Effectiveness of mechanical compression devices in attaining hemostasis after femoral sheath removal Contains three separate research projects, presented as separate reports, but all related to one area of interest - interventional cardiology. Seeks to identify effective femoral sheath removal practices after interventional cardiac procedures and determine patient's perceptions of the education prior to and after interventional procedures.

"March 2003" / Includes bibliographical references (leaves 61-68). / 1 v. (various pagings) : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Contains three separate research projects, presented as separate reports, but all related to one area of interest - interventional cardiology. Seeks to identify effective femoral sheath removal practices after interventional cardiac procedures and determine patient's perceptions of the education prior to and after interventional procedures. / Thesis (D.Nurs.Sc.)--University of Adelaide, Dept. of Clinical Nursing, 2003