Thesis (M.D.S.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 61-68).

Thesis (Ph. D.)--University of North Texas, Aug.,, 2009. / Title from title page display. Includes bibliographical references.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009. / Härtill 4 uppsatser.

Heart Failure readmissions (HFR) significantly contribute to all cause hospital readmissions rates. Current evidence on the effectiveness of interventions for reduction of HFR is inconclusive. Recent research suggests that nurses’ emotional intelligence (EI) may be associated with better patient outcomes. The purpose of this study was to examine if nurses’ EI is significantly related to HFR and if that relationship is mediated through patient satisfaction with care. One hundred and thirty six Registered Nurses were recruited from 11 in-patient units at a large teaching hospital in the south eastern United States. Two surveys were mailed to eligible participants; the Bar-On Emotional Quotient Inventory 2.0 and a demographic survey. Patient satisfaction was measured with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The unit of observation for the analysis of the current study was the individual nursing unit with monthly measures for 14 months. Nurses EI was assessed at a single point in time and served as the basis for the data collected. Results of one-way ANOVA showed a non-significant small trend of higher total EI being associated with lower rates of HFR. The generalized estimating equation model was used to account for correlated observations and revealed a greater non-significant likelihood for higher total EI to translate to no HFR. Results of Pearson’s correlations found non-significant positive correlations between nurses total EI and the patient satisfaction items of rate hospital, nurses’ courtesy and respect, nurse listening, nurse explaining, and nurse communication. The linear mixed model to account for correlated observations showed small non-significant trends for total nurse EI and all patient satisfaction items. Results of one-way ANOVA showed no association between patient satisfaction and HFR. When accounting for correlated observations, increases in total nurse EI were not significantly associated with the predicted odds of no HFR. In conclusion, the examination of the aims in this study demonstrated results that were in the expected direction but not at the level expected. The findings of this study indicate that there is a need to further examine how nurses’ EI may influence patient outcomes.

INTRODUCTION: Healthcare needs among homeless populations are difficult to meet within the scope of a standard healthcare model. A street medicine model addresses the specific needs of those experiencing homelessness; healthcare professionals seek to build trust and rapport with people who are living unsheltered by taking their clinical practice to the streets. The street medicine program evaluated in this study provides primary and behavioral care in a metropolitan area in the Southeastern United States. AIM: This program evaluation aimed to answer the following questions: how has the street medicine program affected the perceptions of ill-health and access to healthcare among its current patients? Further, how would the current patients of the street medicine program rate their satisfaction with the program and are they aware of all available services? METHODS: Using a mixed methods approach, 40 semi-structured interviews and participant observations were conducted with patients of the street medicine program. Participants were asked to rate their satisfaction with the program and their overall health status on a 5 point Likert scale. Informed by Consensual Qualitative Research (CQR) analysis methods, the qualitative data were transcribed and coded. All quantitative analyses were done using SPSS. RESULTS: Overall, 70% of participants rated their satisfaction with the street medicine program as excellent (n=28). For self-rated health status, there was a normal distribution across the Likert scale with 43% reporting their overall health status as moderate (n=17). Using CQR, four key domains emerged from the qualitative data: community trust, rapport building, needs addressed, and needs not addressed. These domains encompassed specific participant responses. Examples include: heard about the street medicine program through word of mouth (community trust), team showed kindness (rapport building), received diagnosis and treatment (needs addressed), and needing help getting into housing (needs not addressed). CONCLUSION: Overall, this study validated the effectiveness of the street medicine program in building trust and rapport with its patients. Satisfaction with the street medicine was high across patients. This study contributes information regarding patient experiences within an alternate healthcare model serving a highly vulnerable population.

Background: Various follow-up studies show that there are deficiencies in the care of patients affected by stroke. In order to provide good care according to the National Board of health and welfare and national guidelines for stroke care systematic quality audits need to be carried out. Purpose: To investigate if the local guidelines for stroke care in Örebro County are followed and to explore how people with stroke experience care and rehabilitation in hospital, primary care and community. Method: Primary health care records were reviewed using quality indicators in the local stroke guidelines. Samples of patients were obtained from the County´s three hospitals. Differences between men and women, younger and older, were analysed with chi-squared test. Eleven people were interviewed about their experiences of care, rehabilitation, support and participation. The interviews were analysed with qualitative content analysis. Result: 123 records were reviewed and for 69% referrals had been sent to the primary health care. Of the referred patients 78% were followed up within 6 months. Men were treated in significantly higher extent with lipid-lowering medicines compared with women, and people below 75 years in significantly higher extent than those over 75 years. Diagnosis was significantly more frequent registered in records for younger people. The interviewed people were at large satisfied with the hospital care. Those who lived in municipal residents enjoyed company of the staff and the other people living there but could also feel restricted by the ward routines and partially lose their autonomy. Some experienced the primary health care as a security while others experienced a lack of follow-up despite the fact that it happened.  Several felt not involved in the health care planning, but instead relied on staff´s judgement. Conclusion: Quality indicators were met in large in the primary health care but there were differences between gender and between older and younger. People were generally satisfied with care but they did not feel involved in the health care planning. People living in municipal  residents experienced some shortcomings and described loss of autonomy.

There is little evidence that Health Technology Assessment (HTA) is much used in dentistry. Dental implant technology is an example of innovative oral health technology. The objectives of this research were to gather the evidence needed for the assessment of overdenture implant treatment so that both patients and dental practitioners can make informed decisions about this technology. These objectives included 1) investigating what types of dental clinicians adopt and provide dental implants 2) determining the effect of the clinicians' experience in the provision of implant supported prostheses and 3) measuring the patients' preference in provision of mandibular 2-implants overdenture technology. / For the first part, a cross-sectional survey was sent to all licensed Canadian Dentists to measure the adoption and provision of implant technology. For the second part, we used the data on the first 140 edentulous elders who were enrolled in a randomized controlled clinical trial to compare the effects of mandibular conventional (CD) and 2-implant overdentures (IOD) on nutrition. The change in patient ratings of satisfaction after treatment, laboratory costs and the number of unscheduled visits were compared. For the last part, edentulous elders (N=36) who were wearing maxillary dentures and either a mandibular conventional denture (CD, n=13) or a two-implant overdenture (IOD, n=23) participated in this study. Participants' preference was measured during a 20-minute interview. / Multivariate regression analysis on the data from the first part of the study shows that the Dentist's gender, province of practice, specialty, and whether they practice alone or in association with other practitioners, are significantly associated with the adoption of implant technology (p<0.05). It is also shown that there was no difference in satisfaction scores for either prosthesis between the groups treated by experienced specialists or new dentists. Furthermore, it is shown that IOD wearers were willing to pay three times more than the current cost of conventional dentures for implant prostheses (p<0.05). / Overall, the results of this study 1) inform decision makers on what types of clinicians provide implant technology and 2) suggest that, with minimal training, all dental clinicians irrespective of their specialty, can provide successful implant overdenture prostheses that edentulous patients are willing to pay for.

Mini-dissertation in partial compliance with the requirements for the Masters Degree in Technology: Homoeopathy, in the Department of Homoeopathy at the Durban University of Technology, 2008. / Within healthcare, patient satisfaction is a combination of need, expectation and the experience of care being provided. Patient satisfaction is an intermediate outcome, and is an important measure of the quality of the overall care provided. Healthcare which does not satisfy the patient is usually less effective, because less satisfied patients tend not to comply with instructions, they take longer to follow up with appointments and they have a poor understanding of their medical condition (Wilkin, Hallam and Dogget, 1994; AI-Assaf, 1998). The provision of overall quality healthcare for patients is a key motivation for many service providers. Therefore, determining the level of patient satisfaction forms a very important part of managing and fulfilling the patients' healthcare needs (Smith, 2001a). Furthermore, surveys of patient satisfaction form an essential role in assessing public opinion of the service provided. Thus, the evaluation of the service provided by a clinic can be reflected in the degree of satisfaction perceived by individuals receiving the services as elicited by a patient perception survey. This study assess patient’s perception of the service provided at the Homoeopathic Day Clinic (HDC) at the Durban University of Technology (DUT). The use of a self-administered questionnaire to establish patient satisfaction was applied. No names were required and all data has been kept strictly confidential. This information will subsequently be used to improve the quality of the service offered at this facility and increase the degree of patient satisfaction experienced. The sample group of the first 100 patients that consulted the HDC at the DUT between July and November 2007 that voluntarily participated in this study were included in the study by means of convenience sampling.In this study there is generally a high degree of satisfaction with the healthcare and services provided. Areas of particularly high satisfaction are related to patients’ arrival to the clinic where they were both promptly and politely greeted, as well as in relationship to the approachability/friendliness of the Homoeopathic student, and the instructions given on how to take the medicine. Areas that revealed lower degrees of satisfaction are advertising, both in media and by signage, as well as the accessibility of the clinic for disabled patients.

Background: During the 1980s, the fear of HIV spread over the world. Health professionals'attitudes to patients with HIV, was negatively impacted because of their fear to be infected.Patients with HIV have therefore,during disease history's first two decades, experienced stigma and discrimination in the response from health professionals. Because of the increasing knowledge of HIV it is of interest to study patients' contemporary experiences of the encounter with health professionals. Aim:To explore how patients with HIV experiencing the meeting with health professionals. Method:Literature study with seven qualitative and three quantitative articles. Results:Two themes were found; to be discriminated and to be powerless and extradited. To be discriminated describes that patients in several cases been treated differently than others, by health professionals.To be powerless and extradited describes that patients are not allowed tobe involved in their care and they have distrust to health care providers.Conclusion:Patients with HIV experience discrimination, excessive precautions and ignorance which cause a care suffering. It is important that the nurse is aware of the deficiencies in the treatment to work towards a good care relationship.There is a great need for further research regarding to explore how patients with HIV experiencing the treatment from health professionals.

<p><span style="font-size: 8pt / " text-align:="" font-family:="" color:="">The edentulous jaw is a common feature in elderly patients that had lost their teeth during life due to local reasons such as poor oral hygiene and dental caries as well as periodontal disease. Hence these patients are the victims of biological phenomenona that lead to difficulties in different aspects of patient comfort with dentures. Clinicians are always concerned to minimize these difficulties and increase patient comfort through manufacturing a proper prosthesis to substitute for the loss of the natural teeth as well as the surrounding structures for optimum satisfaction and improved quality of life of the patient. The aim of this study was to evaluate patient satisfaction regarding function and aesthetics with conventional mandibular dentures and implant retained mandibular overdentures in denture wearers.</span></p>