No description available.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 154-162). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

Thesis (M.S.)--Cornell University, August, 2008. / Vita. Includes bibliographical references (leaves 48-58).

Habschr. Bern, 1973.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 47-01, page: . Adviser: Wendell C. Taylor. Includes bibliographical references.

Thesis (M. N.)--Memorial University of Newfoundland, 1997. / Bibliography: leaves 87-95.

This study used the research method of phenomenology to elicit the patient's perspective of the illness experience following a myocardial infarction (MI). The purpose of studying this experience was to gain an understanding of what it meant to men and women to have a MI, what the learning needs were following a MI, and how these learning needs were met. It was proposed that patients would view the illness experience differently from health professionals, thus the patients would identify different learning needs. Anderson's (1985) adaptation of Kleinman's health care system framework was used to conceptualize this problem. Three males and two females, ranging in age from 42 to 77 years, participated in the study. Data were collected through 11 in-depth interviews. From analysis of this data significant statements were extracted to provide a description of the phenomenon under study. The findings of this study suggest that health professionals and patients do view the MI experience from different perspectives. The emphasis of the patients on understanding the MI experience from the reality of their world is reflected in their attempts to rationalize the occurrence of the MI and their desires to know more about their own MI, prognosis, and treatment. In order to plan patient education that will assist post-MI patients in their recovery health professionals must assess patients individually for their: (1) beliefs regarding risk factors and causes of MI; (2) desire for Information; (3) preference for method of instruction; and, (4) preference for timing of education. / Applied Science, Faculty of / Nursing, School of / Graduate

Psychoeducational interventions are designed to assist clients to learn about their condition, to enhance their self-care practices, to promote well-being and prevent complications and to ultimately maintain or improve their life quality. Although results of individual and of meta-analytic studies supported the beneficial effects of psychoeducational interventions on multiple health-related outcomes for various client population, investigators expressed concerns regarding the quality of single-study reports. The most important criticism is the lack of explicit reference to a theoretical model guiding the design of the study, the selection of expected outcomes of the interventions, and lack of explicitly stated causal linkages between interventions and outcomes. In this research project, a comprehensive framework was developed and empirically tested as a model for evaluating the effectiveness of psychoeducational interventions, namely self-help classes, uncertainty management, and a combined intervention. Direct and moderating effects of extraneous variables (personal characteristics, severity of illness and resources), intervening variable (state anxiety) and intervention variables (components of psychoeducation and strength of intervention) on outcome variables (cognitive, behavioral, psychological and quality of life) were hypothesized. An experimental repeated measures design was used to test the hypothesized effects. Fifty-six women with breast cancer receiving adjuvant therapy were randomly assigned to one of the experimental groups. Data were collected at six points in time. Hierarchical linear modeling approach was used to analyze the data. Results indicated that although the interventions were effective in producing desired changes in selected outcomes, their effects were moderated by various extraneous and intervening variables. Education, sense of mastery, symptom extension, work status, size and use of social support strengthened the effects of the interventions, while trait anxiety, marital status, and number of symptoms experienced weakened the effects of the interventions on cognitive, behavioral, and psychological outcomes. Based on these findings, clinicians are encouraged to attend to the mode of delivery, intensity, and timing for implementation of the intervention, and to the characteristics of the intervener and clients, when planning, implementing, and evaluating psychoeducational interventions.

Introdução: Sabe-se que pacientes e famílias beneficiam-se de orientações educativas no período de pós-operatório de revascularização miocárdica. Deste modo, desenvolver uma ferramenta de ensino para ser utilizado neste período contribui para o melhor conhecimento sobre o autocuidado no domicílio, otimiza a recuperação e diminui o estresse destes indivíduos comum nesta etapa. Existem diversas ferramentas de ensino utilizadas para a orientação do paciente/família antes da alta hospitalar, entretanto, no Brasil, a produção de materiais fundamentados com orientações fidedignas e significativas, com a participação da população alvo, de expertise na área de cardiologia e com rigor metodológico para a construção destas ferramentas, ainda representa uma lacuna na produção do conhecimento. Objetivos: O objetivo geral desta pesquisa foi elaborar uma ferramenta educativa que auxilie no autocuidado de paciente revascularizado e família após a alta hospitalar e os específicos foram sistematizar, identificar, estruturar o conteúdo da ferramenta educativa e validar a adequação da linguagem, conteúdo e ilustrações da mesma com a participação de paciente/familiares e peritos em cardiologia. Método: Trata-se de um estudo de abordagem metodológica que contou com a participação de 35 pacientes/famílias e oito peritos na primeira fase e na terceira fase oito pacientes/famílias e peritos. Estes foram representados por enfermeiros, cardiologista clínico, fisioterapeuta, nutricionista, farmacêutico clínico, psicólogo. A construção se deu em três diferentes fases: na primeira organizou-se o conteúdo da cartilha mediante a revisão da literatura, a coleta de informações entre o grupo de paciente/família e entre os peritos em cardiologia; na segunda se deu a construção da ferramenta educativa piloto baseada nos dados da fase anterior, tendo como base as informações coletadas e sistematizadas pelos princípios teóricos de Orem e organizadas pelo referencial metodológico de Pasquali; a terceira fase consistiu da apresentação da ferramenta educativa piloto aos pacientes/familiares e peritos em cardiologia para validação do conteúdo, linguagem e ilustrações com a utilização de um instrumento desenvolvido para este fim. Após conclusão desta etapa foram realizadas a construção da ferramenta educativa aperfeiçoada, a diagramação e a impressão da versão final. Resultados: Os itens que foram frequentemente identificados para inclusão na ferramenta se referem ao uso correto dos medicamentos e as alternativas para conter os gastos com estes, cuidados com a alimentação, com a dieta e com o uso de bebidas alcoólicas, realização de atividades físicas e atividades de vida diária, cuidados com a ferida operatória, identificação de intercorrências e direcionamento à serviços de saúdes, retorno à consulta médica e orientações sobre adaptação psicológica e enfrentamento das dificuldades no pós-operatório. Conclusão: A construção e validação da ferramenta educativa focada no autocuidado, poderá ser útil em pesquisas futuras para aumentar as estratégias de enfrentamento dos pacientes/famílias e otimizar o planejamento da alta pelos profissionais da saúde. / Introduction: It is well known that patients and families benefit from educational orientations while recovering from coronary artery bypass graft surgery (CABG). Therefore, developing a teaching tool to be used during this period contributes to a better understanding of self-care at home, optimizes recovery, and decreases stress, a symptom common to these individuals at this stage. There are several teaching tools used to guide the patient/ family prior to discharge. However, in Brazil, the production of materials based on reliable guidelines, with the participation of the target population and experts in cardiology, and adequate methodology still represents a gap in knowledge production. Objectives: The general objective of this research was to develop an educational tool to assist in the self-care of patients undergoing CABG and their families after discharge. Specific objetives were to systematize, identify, and structurize the content of an educational tool and validate the appropriateness of language, content and illustrations, with the participation of patients/families and experts in cardiology. Method: This is a study of methodological approach that included the participation of 35 patients/families and eight experts in the first phase, and eight patients/families and experts in the third phase. The experts were represented by nurses, clinical cardiologists, physiotherapist, dietician, clinical pharmacist, and a psychologist. The construction took place in three different phases: in the first phase the contents of the booklet were organized through a review of the literature and collection of information from the group of patients/families and among experts in cardiology; in the second phase an educational pilot tool was constructed based on data from the previous phase, with the information collected and systematized by the theoretical principles of Orem and organized by the methodological framework of Pasquali; the third phase consisted of the presentation of the pilot educational tool for patients/families and experts in cardiology for validation of content, language and graphics, using a tool developed for this purpose. This led to the construction of an improved educational tool with a revised layout, and the final version was printed. Results: The items that were frequently identified for inclusion in the tool refer to the correct use of medications and alternatives to contain spending on these, nutritional care, use of alcohol, physical activities and activities of daily living, wound care, identifying and targeting the complications of home health services, return to medical consultation, and guidance on psychological adjustment and coping difficulties postoperatively. Conclusions: The construction and validation of an educational tool focused on self-care may be useful in future research to increase the coping strategies of patients/ families and optimize discharge planning by health professionals.

Aim. The overall aims of this study were to develop a tailor-made educational intervention and to examine its effectiveness on short- and longer-term outcomes among Chinese patients with traumatic limb fractures who had undergone surgery. / Background. Fracture limb and undergoing surgery is the common problem after injury. It is the most common source of pain and anxiety and research continues to demonstrate a high prevalence of unrelieved pain in injured patients who have undergone surgery. Patient's belief in pain is the major barrier in pain management. Strategies directed to have appropriate educational interventions are urgently needed to improve patient outcomes for those suffering acute pain after surgery for traumatic limb fracture. / Conclusion. The C-BEI was effective in terms of reducing the pain barrier, providing post-operative pain relief, reducing anxiety, and improving sleep satisfaction in patients with fractured limbs during their first week of hospitalization after surgery. This study has generated evidence supporting the use of a C-BEI in acute pain management. / Method. The study was conducted in the orthopaedic wards of two regional hospitals in Hong Kong and comprised two phases. In phase one, qualitative interviews were conducted with twenty-six Chinese patients who had traumatic limb fractures and were undergoing surgery regarding their experiences of and beliefs about pain management. Ten orthopaedic nurses were also interviewed about their perceived pain management practices and the barriers that prevented better pain control among patients. The findings from these qualitative interviews were used to develop a cognitive behavioural approach educational intervention (C-BEI). C-BEI was used to enhance knowledge of pain, modify their beliefs about pain management and promote positive coping thoughts and behaviour. The C-BEI consisted of two sessions. The first was a 30-minute session comprised a combination of patient education and breathing relaxation exercise and conducted at T0 (1 day before surgery). A 30-minute reinforcement session was conducted at day 7 after surgery (T3). / Results. A total of 125 participants completed the study, with 62 in the experimental group and 63 in the control group. The participants were homogenous in terms of demographic data (P > 0.05) and baseline clinical characteristics (p > 0.05). The short-term outcomes (from T0 to T3) for the participants in the experimental group were a statistically significant with lower pain barrier (p = .003), lower level of pain (p = .003), lower level of anxiety (p < .001), and better sleep satisfaction (p = .001) than the control group. The experimental group had a significantly higher frequency of analgesic use at T2 (p < .001) and better self-efficacy in pain management at T3 (p = .011) than the control group. There were no statistically significant differences in the total length of stay in hospital, although the mean length of stay was shorter in the experimental group than in the control group (8.1 day VS 10.1 days). For longer-term effects, the C-BEI was effective at the post-operative stage in anxiety reduction ( p = .002) and sleep satisfaction improvement (p = .002). There were no statistically significant differences for the VAS pain level, GSE scores, physical health summary component (PCS) and mental health summary component (MCS) of the SF36 between two groups over three months, although the experimental group had better scores in the mental health dimension. Findings of the process evaluation showed that most participants perceived the C-BEI as effective in enhancing their knowledge on pain management and the use of analgesics, and helping them to cope with pain, the could sleep better and regain self-control. / The main study was conducted in phase II which consisted of outcomes and process evaluation. A quasi-experimental design of two groups' pre-test and post-test between subjects was employed for the outcomes evaluation. All participants in the experimental group received the C-BEI and usual care, whereas those in the control group received usual care only. The short-term outcomes were treated as primary outcomes and evaluated in terms of the participants' pain barrier score, pain level (Visual Analogue Pain Scale: VAS, anxiety level (State-Trait Anxiety Inventory:STAI), sleep satisfaction, self-efficacy in pain management (General Self Efficacy Scale: GSE), and frequency of analgesic use. All of which were measured at T0, T1 (day 2), T2 (day 4), and T3 (day 7) after surgery. The total length of stay in hospital of the two groups was also compared. Longer-term outcomes were further evaluated over three months at T4 (1 month) and T5 (3 months), and included the VAS pain level, STAI, sleep satisfaction, GSE and health-related quality of life (SF36).The intention-to-treat method was adopted. The process evaluation involved a qualitative study using telephone interviews. / Wong, Mi Ling, Eliza. / Adviser: Sally Chan. / Source: Dissertation Abstracts International, Volume: 71-01, Section: B, page: 0231. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 256-278). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese.