In this thesis, I explored the relationship between patient experience of wait time for consultation and scheduled surgery, type of illness (orthopaedic or cardiac), and descriptions of time using qualitative methodology. Thirty two patients awaiting orthopaedic or cardiac surgery were recruited by surgeons in Saskatoon, Saskatchewan during the period of September 2009 to November 2010. Those patients awaiting orthopaedic surgery were interviewed when the decision to treat was made and again at the midpoint of their waiting period. Cardiac surgery patients were interviewed after their angiography and consent to surgery, and again the day prior to surgery. Patients were asked about their perceptions of time while waiting, maximum acceptable wait time for consultation and surgery, and the effects of waiting. Interpretative phenomenology (1) was the method and data were analysed using interpretative phenomenological analysis.Participant suffering, the meaningfulness given to the experience, and the agency participants felt they had over the waiting period determined the lived duration of time experience. Participants considered pain, mobility restriction, disease progression and lethality of condition to be the primary determinants of wait time maximums. Waiting effects included restriction, uncertainty, resignation, coping with waiting, and opportunity. Few subtle differences between groups emerged indicating other variables may be more relevant to the quality of waiting experience. Participant suggestions for improving experience consisted of managing patient conditions and navigating the system. The findings suggest uncertainty in illness impacts the quality of wait time experience. The study denotes the experience of waiting for scheduled surgery is complex and not necessarily a linear relationship between greater symptom severity and less tolerance for wait time.

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Bakgrund: Anorexia nervosa är en sjukdom där självsvält leder till undervikt. Personer med sjukdomen har en störd kroppsuppfattning vilket påverkar självkänslan. Symtom är låg kroppsvikt, kraftig viktnedgång, psykisk ohälsa och utebliven mens. Behandling innefattar förebyggande arbete samt akuta psykiatriska och somatiska insatser. Anorexia nervosa kan behandlas inom öppenvård, dagvård eller slutenvård. Syfte: Syftet med denna studie var att beskriva individers erfarenheter av att vårdas för anorexia nervosa inom slutenvård. Metod: En litteraturstudie baserad på åtta kvalitativa artiklar. Sökningar är gjorda i CINAHL with Full Text och PubMED. Ytterligare sökningar gjordes i Medline, PsycINFO och AMED, dock utan relevanta träffar. Resultat: I resultatet återfanns tre teman och åtta subteman. Teman var “Kontrollförlust och önskan om delaktighet”, “Jämlika relationer och stöd” samt “Ansvar och lärande för livet”. Konklusion: Anorexia nervosa är en komplicerad sjukdom att vårdas för. Vårdpersonal behöver förstå patienters upplevelser av vården för att kunna ge bästa möjliga vård. Förståelsen kan bidra till en personcentrerad vård i mötet med dessa patienter. / Background: Anorexia nervosa is a disease where self-starvation leads to underweight. People with the disease have a disturbed body image which affects their self-esteem. Symptoms include low body weight, excessive weight loss, mental illness and absent periods. Treatment includes prevention along with acute psychiatric and somatic interventions. Anorexia nervosa can be treated in outpatient care, day care or inpatient care. Aim: The aim of this study was to describe individuals’ experiences of being treated for anorexia nervosa in inpatient care. Method: A literature review based on eight qualitative research articles. A literature search was conducted in CINAHL with Full Text and PubMed. Searches were also conducted in Medline, PsycINFO and AMED but no further hits were found. Results: The analyze identified three major themes and eight subthemes. The themes were “Loss of control and a desire for participation”, “Equal relationships and support” and “Responsibility and learning for life”. Conclusion: Anorexia nervosa is a complex disease to be treated for. Nursing staff must understand patients’ experiences of care to be able to give the best care possible. This understanding can contribute to a patient-centered care in the meeting with these patients.

Consolidation of Acute Care Surgical Services (ACSS) as a response to multiple challenges in providing timely and high-quality emergency services is a growing interest among healthcare policymakers. However, very little is known about patient experiences within this system. This study explores patient perceptions of their acute care surgical experiences within a consolidated ACSS program. A qualitative study guided by the tenets of Appreciative Inquiry was conducted. Data were collected by means of semi-structured interviews and personal stories. Thirteen participants were involved, seven females and six males of varying ages; all underwent emergency surgeries including appendectomy, cholecystectomy, and small bowel obstruction surgery. Findings suggest that clear and effective communication, excellent nursing care, timely access to surgical services, continuity of care, patient safety, transfer to an Acute Care Surgical (ACS) site, communication regarding transportation, and process of admission to an ACS site play important roles in patient experiences within a consolidated ACSS.

ackground. There are a number studies related to patients’ satisfaction with health care. Since the Baltic States regained independence in 1990, a reform of the health care system took place in which a serious consideration is paid to health care quality. Patients' views are becoming increasingly important in the current health system. They provide information on effectiveness of healthcare and how it may be improved.The main objective of this study was to investigate inpatients experiences with the care and treatment given in Klaipeda hospitals in order to improve the quality of care and patients’ satisfaction. Material and methods. A cross-sectional survey with questionnaires was made. The subjects of the investigation were patients (from 18 years old), hospitalized in internal and surgery departments in different Klaipeda city hospitals. The survey questions were divided into sections that broadly followed the patient's experience in the hospital. The analyses included descriptive statistics, interrelationship analysis between the different characteristics, and multiple logistic regression to estimate Odds for each of the independent variables in the model.Results. The study shows that 60-80 % of the respondents were satisfied with different parts and aspects of health care services. Satisfaction with getting enough time for discussion with the doctor was higher for younger, male and employed patients. Those from the city needed more understandable explanation from doctor about health condition or treatment plan. Doctors listened more to male patients compare to female. Those results were statistically significant. Conclusions. Majority of the patients were satisfied with hospitalization order in Klaipeda hospitals. Better physician communication skills can improve patient satisfaction and clinical outcomes. Physicians could more effectively facilitate patient involvement by more frequently using partnership-building and supportive communication. Hospital cleanliness is quite important factor to overall satisfaction with hospital care. Waiting time is a significant component of patient satisfaction and depends from patients’ characteristics and their behavior. Different aspects of reception can influence patients’ satisfaction and must be considered. Information about continuity of the treatment were needed more for patients with an increased need for follow up, younger and living alone patients. It is important to provide the setting customers expect and create an environment that meets or exceeds customer needs for safety, security, support, competence, physical comfort, and psychological comfort. / <p>ISBN 91-7997-146-6</p>

Consolidation of Acute Care Surgical Services (ACSS) as a response to multiple challenges in providing timely and high-quality emergency services is a growing interest among healthcare policymakers. However, very little is known about patient experiences within this system. This study explores patient perceptions of their acute care surgical experiences within a consolidated ACSS program. A qualitative study guided by the tenets of Appreciative Inquiry was conducted. Data were collected by means of semi-structured interviews and personal stories. Thirteen participants were involved, seven females and six males of varying ages; all underwent emergency surgeries including appendectomy, cholecystectomy, and small bowel obstruction surgery. Findings suggest that clear and effective communication, excellent nursing care, timely access to surgical services, continuity of care, patient safety, transfer to an Acute Care Surgical (ACS) site, communication regarding transportation, and process of admission to an ACS site play important roles in patient experiences within a consolidated ACSS.

Ätstörningar har blivit mer välkäntoch är en återkommande sjukdominom vården. En ohälsosam relation till mat finns i alla åldrar och relationen till mat utgör stor del av människors liv. Syfte: Syftet var att belysa hur patienter med ätstörningupplever vården. Metod: Studien är en allmän litteraturstudie där en innehållsanalys använts för att få framresultatet. Resultat: Resultatet består av tre ämnen:relationer, behandling och kunskap. Relationen med vårdpersonalen upplevdes hastorbetydelse för patienternas återhämtning. Inför behandlingen upplevde patienterna ambivalens,därför var det viktigt att patienterna fick vara delaktiga. Vårdpersonalens erfarenheter och kunskap innebar vägledning för patienterna att ändra sittbeteende. Konklusion: Relationer är behandlingensgrund och vårdpersonalen behöver ge ett braförstaintryck hos patienterna eftersom detförsta intrycket tenderaratt hålla sig kvar hos patienterna. Kontinuitet i vårdpersonalskapartrygghet och förtroende. Patienterna belyste vikten av att bli hörda och attindividenbakom ätstörningenuppmärksammades. Deupplevde ambivalens mot behandling då de var rädda att förlorakontrollen över ätstörningen, genom delaktighet upplevde patienterna en personcentrerad vård. Kunskap och erfarenheter hos vårdpersonalen belystes vara en viktig beståndsdel i behandlingen av ätstörningar. / Eating disorders are well-known and is a reoccurring concept within health care. An unhealthy relationship towards food is found within all ages, and the relationship to food constitutes a large part of human’s lives. Purpose: The purpose was to shed light on how patients with eating disorders experience health care. Methods: The study is a literature study where a content analysis was used. Results: The results consist of threesubjects: relationships,treatment and knowledge. The relationship to the care personnel was experienced to have a big impact on the patient’s recovery. Before treatment the patients experienced ambivalence, therefore it was important for them to be included in the treatment process. The care personnel’s experiences and knowledge meant guidance for the patients to change their behavior. Conclusions: Relationships are the foundation for thetreatment process and the care personnel should make a good first impression as it stays with the patients. Continuity among the personnel created safety and trust. The patients highlight the importance of being heard and seen as individuals. Patients experienced ambivalence towards treatment as they were afraid to lose control over the eating disorder. Knowledge and experience among the care personnel was an important part of the treatment.

Bakgrund: Dialysbehandling är den vanligaste behandlingsmetoden för patienter i de senare stadierna av njursvikt, som är en allt vanligare sjukdom i världen. Det finns därför ett ökande behov för vårdpersonal och samhället i stort att lära sig om denna patientgrupp, för att på bästa möjliga sätt kunna möta deras behov. Syfte: Syftet är att beskriva patienters upplevelse av att genomgå dialysbehandling. Metod: Detta arbetes design är en litteraturöversikt bestående av 16 artiklar från databaserna PubMed och CINAHL. Resultat: Patienter berättade om kroppsliga besvär i samband med dialysbehandlingen. Fokuset i det de berättade låg dock på förlusten i vardagen efter påbörjad behandling, att ständigt tvingas anpassa sitt liv efter behandlingen och förlusten av sin forna identitet som resultat av detta. Slutsats: Upplevelserna som patienterna beskrev verkade ändras över tid, och vårdpersonal i sin yrkesroll kan ha inverkan på hur denna process utvecklas. / Backgrund: Dialysis is the most common form of treatment for patients suffering from end stage renal disease, an increasingly common ailment throughout the world. As such, there is a growing need for health care personell and society at large to learn about this group of patients to provide the best care possible. Aim: The aim of this study is to describe the experiences of patients undergoing dialysis. Method: The design of this study is a literature review consisting of 16 articles aquired from databases PubMed and CINAHL. Result: Patients described physical issues related to the treatment. But patients stories focused on the loss of everyday life, always having to shape their lives around the treatment, och the loss of their former identity as a result. Conclusion: The experiences described by patients seemed to change over time, and healthcare personell play a role in how this process develops.

Background: People are living longer and more people suffer from age-related illnesses. Multiple illness is when a person have more than one disease. It is a high flow of patients on the emergency departments. The nurses work conditions are stressful and this causes less time for the nurses to take care of patients. Purpose: Describe older people with multiple illnessess experience of seeking care in emergency departments. Method: A systematic literature study with descriptive synthesis with a qualitative approach based on Evans (2002). Results: The results is based on two different main themes. One main theme was “left to ones own destiny” with two related subthemes “feel forgotten” and “feel uncertain”. Another identified main theme was “give over the responsibility to staff” with two related subthemes “feel safe” and “feel seen”.   Conclusion: Older people with multiple illness are a vulnerable group of patients and they have a desire for contact of staff and to feel safe. When staff are safe in their profession, the older people with multiple illness feel seen from the staff. Then the older people also feel that their self-consciousness is strengthened. Keywords: Elderly patients, emergency department, multiple illness, patient experiences and qualitative study.

Bakgrund: Hälso-och   sjukvårdslagen betonar vikten av att vården utformas och genomförs   tillsammans med patienten så långt det är möjligt. Vid personcentrerad vård   står personen i centrum och är delaktig i utformningen av sin vård och   behandling. Vid självvald inläggning bedömer personen själv behovet av   inläggning på slutenvården. Syfte: Syftet   var att undersöka patienters upplevelser av behandlingsmodellen självvald   inläggning. Metod: Systematisk   litteraturöversikt enligt Whittemore och Knafl integrativa metod har använts.   Kvalitativa artiklar inhämtades från databaserna PubMed, Cinahl och   PsychInfo. Totalt inkluderades nio artiklar i resultatet. Resultat: Analysen   resulterade i två huvudteman och sju kategorier som belyser patientens   upplevelse av självvald inläggning. Strukturen kring självvald inläggning,   där patienterna betonade vikten av trygghet och förebyggande åtgärder vid   psykisk ohälsa. Patienternas upplevelser av vårdmiljön och inflytandet i sin   vård-och behandling. I det andra temat framkom patienternas upplevelser av   personalens kompetens vid självvald inläggning, det upplevde attityder och   kunskapsbrist hos det som arbetar med interventionen. Det belyser även   bemötandet av personalen i samband med självvald inläggning. Slutsats: Litteraturöversikten   kan vara ett stöd till personal som arbetar inom psykiatrisk vård och som har   möjlighet till att arbeta med självvald inläggning eller önskar få mer  kunskap om patienters upplevelser av behandlingsmodellen i enlighet med   personcentrerad vård. / Background:  The Health Care Act emphasizes the importance of the   care being designed and implemented together with the patient as far as   possible. In person-centered care, the person is at the center and   participates in the design of their care and treatment. In self-admission,   the person assesses the need for hospitalization himself. Aim: The purpose was to investigate patients' experiences of the treatment   model self-admission. Method: A systematic literature   reviews according to Whittemore and Knafl integrative method has been used.   Qualitative articles were obtained from the databases PubMed, Cinahl and   PsychInfo. A total of nine articles were included in the result. Results: The analysis resulted   in two main themes and seven categories that illustrate the patient's   experience of self-admission. The structure of self-admission, in which   patients emphasized the importance of safety and preventive measures in   mental illness. Patients' experiences of the care environment and the   influence in their care and treatment. In the second theme, the patients'   experiences of the staff's competence in self-admission, it experienced the   attitudes and lack of knowledge of those working with the intervention. It   also illustrates the approach of the staff in connection with self-admission. Conclusion: The literature review may be supportive to staff working in psychiatric   care and who have the opportunity to work with self-admissions or wish to   gain more knowledge about patients' experiences of the treatment model in   accordance with person-centered care.