Patient satisfaction is an outcome of care that represents the patient's judgment on the quality of care. An important aspect of quality affecting patient's judgment can be attributed to patients' expectations and experiences regarding nursing care according to type of unit. The purpose of this study was to examine differences between patients' perceptions of satisfaction with nursing care in critical care units and medical units in one Midwestern hospital.The conceptual framework was "A Framework of Expectation" developed by Oberst in 1984, which asserted that patients have expectations of hospitals and health care professionals regarding satisfaction and dissatisfaction with care. The instrument used to measure patient satisfaction was Risser's Patient Satisfaction Scale, with three dimensions of patient satisfaction: (a) Technical-Professional, (b) Interpersonal-Educational, (c) Interpersonal-Trusting. The convenience sample included 99 patients50 from critical care units and 49 from medical wards. Participation was voluntary. The study design was comparative descriptive and data was analyzed using a t-test.The demographic data showed that the majority of patients had five or more admission. About one-third of the patients were 45-55, 56-65, 66-75, respectively. Findings related to the research questions were that: (a) 84 percent of the respondents rated overall satisfaction in the satisfactory to excellent range, (b) results of a t-test showed significant differences in overall patient satisfaction with patients being more satisfied with care in critical care units. Significant differences were found in three subscales with critical care being more satisfied. No relationship was found between patient satisfaction and age/and/or type of unit.Conclusions were that in both medical and critical care units patients were more satisfied with Technical-Professional and Interpersonal-Trusting than with Interpersonal-Educational. Also noted was that patients in the units where nurse-to-patient ratio was higher participants perceived that nurses had more time, energy and ability to meet patient expectation. Implications call for analysis of nurse/patient ratio in relation to patient satisfaction and nurses in relation to patient education as well as patient's perceptions of getting their needs met. / School of Nursing

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>

Bakgrunn: Studien tar utgangspunkt i resultatet av en brukerundersøkelse om pasient-tilfredshet ved fysioterapipoliklinikken, Avdeling for Fysikalsk Medisin og Rehabilitering, Ullevål universitetssykehus i2003. Resultatet: av denne studien var at pasienter med et ikke-skandinavisk morsmål var signifikant mindre tilfredse med behandlingen enn øvrige pasienter. Hensikten med studien var å undersøke hvilke faktorer som er viktige for å oppnå pasienttilfredshet blant pasienter med et ikke-skandinavisk morsmål. Metode: Materialet besto av pasienter som hadde avsluttet sin behandling for en langvarig muskel-skjelettlidelse. De fleste hadde kommet fra Asia. De hadde ikke brukt tolk. Kvantitative og kvalitative forskningsmetoder samt en metodetriangulering ble benyttet. Tretti pasienter ble inkludert i den anonyme spørreskjemaundersøkelse. To fokusgruppe- intervjuer, ett med kvinner og ett med menn, ble gjennomført. Fenomenografi ble benyttet. Resultat: Det var i store trekk sammenfallende funn i den kvantitaive og kvalitative undersøkelsen. I spørreskjemaundersøkelsen var resultatetat eldre pasienter var mer fornøyde enn yngre. Det var ingen forskjell mellom kjønnene. Mange pasienter var ikke blitt bedre av behandlingen, men mange var likevel fornøyde. Det som betydde mest for tilfredsheten var at informasjonen og kommunikasjon var god, at fysioterapeuten var dyktig og hadde nok tid til pasienten. Lokalene, utstyr, etc hadde mindre betydning. Konklusjon: Resultatet indikerte at i tillegg til bedring av tilstanden var informasjon, kommunikasjon og tilstrekkelig med tid viktige faktorer for tilfredsheten blant disse pasientene. Dette er det viktig å ta hensyn til ved behandling av pasienter med fremmed kultur og språk / Background: This study is a follow up of a patient survey study done in the Physiotherapy outpatient clinic, Department of Physical Medicine andRehabilitation, Ullevaal university hospital, 2003. The previous study showed that patients with a non- Scandinavian mother tongue were less overall satisfied with the treatment than other patients. Purpose: of this study was to find out why patients with a non- Scandinavian mother tongue were less overall satisfied with the treatment than other patients, and to assess with which factors the patients were most dissatisfied and how the patients had experienced the treatment. Methods: The material consisted of patients who had finished their physiotherapy treatment for muscle skeleton diseases. Most of them came from Asia. Both quantitative and qualitative (phenomenography) research methods were used. In the patient survey 30 patients were included. Another four patients were included in focus group interviews. Results: Older patients were more satisfied than younger. There was no significant association between gender and satisfaction. The main dissatisfaction factor was no improvement following treatment. However, many patients were satisfied despite that there had not been any improvement. Other factors that had impact on the overall satisfaction were communication, professional skills, information, enough time and expectations. Facilities and equipment were of less importance. Conclusion: The results indicate that in addition to improved condition, communication, information and enough time were of great importance for patient satisfaction. These factors should be taken into consideration while treating patients with foreign culture and language / <p>ISBN 978-91-85721-01-6</p>

Darbo tikslas. Įvertinti Kauno miesto bedarbių nuomonę apie prieinamumą sveikatos priežiūros paslaugoms ir pasitenkinimą jomis. Tyrimo metodika. Tyrimas buvo atliekamas Kauno mieste 2012 m. kovo – balandžio mėnesį. Tiriamąjį kontingentą sudarė tuo laikotarpiu Kauno teritorinėje darbo biržoje besilankantys darbo neturintys, darbingo amžiaus asmenys. Iš viso gautos 448 tinkamai užpildytos anketos (atsako dažnis – 58,0 proc.). Statistinė duomenų analizė buvo atlikta naudojant SPSS programos 17.0 versiją. Rezultatai. Dauguma (61,1 proc.) bedarbių savo sveikatą vertino teigiamai, tačiau ilgalaikiai bedarbiai vertino ženkliai blogiau, negu trumpalaikiai. 45,1 proc. bedarbių neoficialiai mokėjo už sveikatos priežiūros paslaugas. Ilgalaikiai bedarbiai statistiškai reikšmingai dažniau turėjo finansinių sunkumų perkant reikiamus vaistus, lyginant su trumpalaikiais. Ketvirtadalis respondentų teigė patyrę diskriminaciją iš sveikatos priežiūros personalo. Dauguma pacientų palankiai vertino (58,2 proc.) paslaugų teikimą pirminėje sveikatos priežiūros gydymo įstaigose Ilgalaikiai bedarbiai kritiškiau vertino pasitenkinimą sveikatos priežiūros paslaugomis nei trumpalaikiai. Privačioje sveikatos priežiūros įstaigoje prisiregistravę respondentai, buvo labiau patenkinti suteiktomis paslaugomis, negu valstybinėje įstaigoje. Išvados. Dauguma darbo neturinčių asmenų, teigiamai atsiliepė apie sveikatos priežiūros paslaugų prieinamumą ir gydytojo – paciento bendravimo apsektus, tačiau pasitenkinimas... [toliau žr. visą tekstą] / Aim of the study. To evaluate satisfaction and accessibility to health care services among unemployed population in Kaunas city. Methods. The data was collected in cross – sectional study, in 2012. We received 448 filled-in questionnaires (response rate – 58.0%) from unemployed persons, who were attending the Kaunas labor market office (Lithuania). The statistical analysis of data was performed using statistical package SPSS Statistics 17.0. Results. The majority (61.1 %) of unemployed evaluated their health positively. However, long–term unemployed persons rated their health status more negatively, then short term unemployed ones. 45.1% of unemployed made non–official payments to health care providers. Long-term unemployed has experienced more financial difficulties in purchasing the necessary medication, compared with short–term ones. One quarter of respondents reported episodes of discrimination from health care staff. The majority of unemployed (58.2 %) were satisfied with health care services. Short–term unemployed were more satisfied with health care, then long–term ones. Clients of private medical health care facilities were more satisfied with the quality and accessibility of health care service, comparing with those from public health units. Conclusions. The majority of respondents were satisfied with quality of health care services. Higher satisfaction has been observed among short-term unemployed, comparing with long–term ones. The results showed that short–term... [to full text]

Darbo tikslas: Įvertinti skausmo klinikų teikiamų paslaugų prieinamumą ir pasitenkinimą pacientų požiūriu. Tyrimo metodika: Tyrimas buvo atliktas Vilniaus, Kauno, Šiaulių ir Alytaus skausmo klinikose. Tyrimas vyko 2013 gegužės – 2013 gruodžio mėnesiais. Tyrimo metu atlikta anoniminė anketinė pacientų apklausa. Statistinei analizei tinkamos grįžo 363 anketos. Atsako dažnis 95,5 proc. Statistinė tyrimo duomenų analizė atlikta SPSS 17.0 programa ir Excel 2007 programa. Rezultatai: Didžioji dalis pacientų (73,3 proc.), norėdami pasiekti artimiausią skausmo kliniką užtrunka mažiau, nei vieną valandą. Vizito pas skausmo klinikų specialistus 44,6 proc. respondentų laukė 2-4 savaites, tačiau 15,4 proc. pacientų turėjo laukti ilgiau kaip mėnesį. Atvykus konsultuotis, beveik ketvirtadaliui (23,7 proc.) konsultacija vėlavo iki 30 minučių, o 7,7 proc. už durų laukė ilgiau nei pusvalandį. Pati dažniausia problema respondentams norint pasiekti skausmo klinikas buvo sveikatos būklė. Beveik pusė tyrimo dalyvių (48,8 proc.) liko labai patenkinti, o daugiau kaip trečdalis (39,1 proc.) – patenkinti skausmo klinikų paslaugomis. Nepatenkintų skausmo klinikų paslaugomis nebuvo. Visi tyrimo dalyviai teigiamai įvertino skausmo klinikų specialistų kompetenciją ir gydymo kokybę. Labiausiai patenkinti buvo gydytojo onkologo siųsti pacientai. Kuo trumpesnis laikas nuo registracijos iki vizito pas gydytoją, ar pas gydytoją patenkama paskirtu laiku, bei trumpiau laukiama eilėje prie kabineto, tuo... [toliau žr. visą tekstą] / Aim: To evaluate the pain clinics‘ provided services in terms of the accessibility and satisfaction in patients‘ opinion. Methods: The study was carried out in Vilnius, Kaunas, Siauliai and Alytus pain clinics. The study took place in May 2013 - December 2013. The study carried out an anonymous questionnaire survey of patients. For statistical analysis returned 363 suitable questionnaires. The response rate was 95.5 percent. Statistical data analysis was performed using SPSS 17.0 and Excel 2007 programs. Results: To reach the nearest pain clinic for the majority of patients (73.3 percent) takes less than one hour. For a visit to the pain clinic 44.6 percent of respondents waited for 2-4 weeks, but 15.4 percent of patients had to wait longer than a month. Upon arrival to consult, for almost a quarter (23.7 percent) of patients consultation was delayed for up to 30 minutes, and 7.7 percent of patients waited outside the door for more than half an hour. The most common problem for respondents to arrive to pain clinics was the state of health. Almost half of the survey participants (48.8 percent) were very pleased , and more than one-third (39.1 percent) were pleased with pain clinics‘ services. There was no discontentment with the services of pain clinics. All study participants positively evaluated the pain clinics‘ specialists‘ competence and quality of care. Most satisfied were patients sent by an oncologist. The shorter the time from registration to the doctor‘s visit, or... [to full text]

Mode of access: World Wide Web. / Thesis (Ph. D.)--University of Hawaii at Manoa, 2004. / Includes bibliographical references (leaves 86-97). / Electronic reproduction. / Also available by subscription via World Wide Web / xv, 97 leaves, bound ill. 29 cm

Syfte: Studiens syfte var att undersöka vad patienterna har för upplevelser av sjukvården, samt vilka förbättringar de föreslår. Metod: Undersökningsgruppen bestod av 50 patienter som svarat på de öppna frågorna i en nationell patientenkät. Svaren analyserades med kvalitativ innehållsanalys. Resultat: Analysen av materialet resulterade i fem kategorier och elva underkategorier. De fem kategorierna bestod av: bemötande, sjukhusmaten, vårdmiljön under sjukhusvistelsen, in- och utskrivning samt väntetider under vårdtiden och samarbete mellan professioner. Patienter som vårdades inom slutenvården ansåg att det bemötande de erhöll i huvudsak varit gott, men att det förekom vissa negativa attityder som bör förändras till det bättre. Förbättringar av måltider och sjukhusmiljön önskades, dessa områden upplevdes otillfredsställande. Vidare föreslogs förbättringar rörande information och kommunikation. Dessa två faktorer spelade, enligt patienter, roll för hur trygga de kände sig inom vården. Väntetiderna upplevdes vara alltför långa och patienterna önskade att dessa ska bli kortare. Slutsats: Patienterna i denna studie hade både positiva och negativa upplevelser av slutenvården, samt föreslog förbättringar på ett antal områden. Detta resultat, samt framtida patientundersökningar, kan vara ett underlag för sjuksköterskors kvalitetsförbättringsarbete i den kliniska verksamheten då det identifierar områden i behov av förbättring. / Aim: The aim of this study was to examine patients’ experiences of health care, and which improvements they propose. Method: The study group consisted of 50 patients who answered the open-ended questions in a national patient satisfaction questionnaire. The patients’ answers were analyzed with qualitative content analysis. Results: The analysis resulted in five categories and eleven subcategories. The five categories were:  social interaction with staff, hospital food, hospital environment during the stay, admission, discharge and delays and collaboration with other professions. Patients who received hospital care generally considered themselves treated well by staff, but some experienced negative attitudes from staff which leaves room for improvement. Other areas considered dissatisfying were the hospital food and the hospital environment. Furthermore, suggestions were made concerning the improvement of information and communication. These factors, according to patients, affect whether they feels safe or not when receiving health care. Patients also expressed that waiting times and delays were too long, and ought to be shortened. Conclusion: Patients in this study had both positive and negative experiences of their hospital stay. They suggest improvements in several areas. These results, together with future patient satisfaction surveys, can develop a basis for nurses to improve the quality of care in clinical practice since they identify areas in need of improvement.

Women and men’s experiences and needs in relation to induced abortion, and their views on the prevention of unintended pregnancies were explored through questionnaire studies at 10 and13 Swedish women’s clinics (Papers I–IV). Among 798 women in age range 14 – 49, 35% had experience of at least one previous abortion, and in the age range 20 – 49, 41%. The risk factors for repeat abortion were having children (Odds Ratio [OR] = 2.57), lack of emotional support (OR 2.09), unemployment or sick leave (OR 1.65), tobacco use (OR 1.56), and low educational level (OR 1.5). Among 590 men in age range 16 – 63, 32% had been involved in at least one previous abortion. The risk factors were, being a victim of violence or abuse (OR 2.62), unemployment or sick leave (OR 2.58), and having children (OR 2.0). Tobacco use was common, among both women (33%) and men (50%), and among those with repeat abortion 41% and 57%, respectively. Some considered societal efforts important for prevention, (Paper I–II). Overall care-satisfaction (Paper III) was high (74% of women and 52% of men). For women, factors associated with high care-satisfaction were being well treated by the staff (OR 11.78), sufficient pain relief (OR 3.87), adequate information about the gynaecological examination (OR 2.25), suitable contraceptive counselling (OR 2.23), and accessibility to the clinic by phone (OR 1.91). For men, the factors were being well treated by the staff (OR 5.32) and adequate information about the abortion procedure (2.64). Existential experiences and needs related to abortion were investigated among 499 women. Three components were identified (Paper IV): existential thoughts (61% of women), existential practices (48%), and humanisation of the foetus (67%). A higher presence of existential components correlated with difficulty in deciding to abort and poor psychological wellbeing after the abortion. Interviews with 24 women and 13 men on their experiences and needs related to home abortion and views on the prevention of unwanted pregnancies revealed two overarching themes (Paper V). Home abortion increased autonomy: both women and men demonstrated self-care ability. However, autonomy was related to dependence: the desire to be treated with empathy and respect on equal terms and receive adequate information adapted to individual needs. They were motivated to avoid a subsequent abortion, but planned contraceptive follow-ups were rare. Both individual and societal challenges were implied: women and men experiencing repeat abortion appeared more disadvantaged and abortion involved complex aspects beyond medical procedures and routines. Thus, abortion care should be continuously evaluated to ensure care satisfaction, safety, and contraceptive adherence. Preventive efforts would include work opportunities, sex and relationship education, and cheap and effective contraceptives. Minimising differences between socioeconomic groups is important, and both individuals and society should share the responsibility for these efforts. / De senaste åren har kvinnor fått ökade möjligheter att välja mellan olika abortprocedurer, vilket medfört att andelen medicinska aborten har ökat och utgör 89% av alla inducerade aborter före utgången av graviditetsvecka 9. Den medicinska aborten kan avslutas i hemmet om kvinnan så önskar och inga hinder finns. Generellt finns begränsad kunskap om kvinnor och framför allt män som är involverade i en abort. Socialstyrelsens register ger endast information om; vilken vecka aborten avslutas i, abortmetod (medicinsk/ kirurgisk), kvinnans ålder, kommuntillhörighet, antal barn och tidigare aborter. Det innebär att det finns begränsad möjlighet att undersöka eventuella skillnader mellan olika grupper. En relativt hög andel (40%) av de abortsökande kvinnorna har erfarenhet av att ha gjort minst en tidigare abort, men kunskap om den gruppen är begränsad. Det övergripande syftet med den här avhandlingen var att undersöka kvinnors och mäns upplevelser och behov i samband med en abort och deras syn på förebyggande insatser. Kvantitativa och kvalitativa metoder har använts i de olika delarbetena (I– V) samt teoretiska modeller som utgår från folkhälso- och omvårdnadsperspektiv. Samtliga studier är godkända av den regionala etikprövningsnämnden i Uppsala. Delarbete I–IV bygger på resultat från en multicenter studie som genomfördes 2009, där 10 och 13 svenska kvinnokliniker deltagit. Syftet med delstudie I och II var att undersöka riskfaktorer för upprepad abort bland kvinnor och män. Två enkäter (kvinna/man) delades ut på kliniken i samband med att kvinnorna sökte för abort. Enkäten besvarades av 798 kvinnor efter genomgången abort. Männen som var involverade i graviditeten blev tillfrågade att delta i studien av kvinnorna och 590 män besvarade enkäten. Separata frankerade kuvert bifogades, vilket möjliggjorde att kvinnorna och männen kunde besvara enkäten oberoende av varandra. Resultatet i delarbete I och II visade att 35% av 798 kvinnor i åldern 14 – 49 hade erfarenhet av minst en tidigare abort och den andelen var högre i åldern 20 – 49; 41%. Upprepad abort var associerat med; att ha barn (Odds Ratio [OR] = 2.57), brist på emotionellt stöd (OR 2.09), att vara arbetslös eller sjukskriven (OR 1.65), rökning/snusning (OR 1.56), och låg utbildningsnivå (OR 1.5). För de 590 männen i åldern 16 – 63 hade 32% erfarenhet av minst en tidigare abort. Upprepad abort var associerat med; att ha varit utsatt för våld eller tvång (OR 2.62), att vara arbetslös eller sjukskriven (OR 2.58), och att ha barn (OR 2.0). Daglig tobaksanvändning var vanligt förekommande bland både kvinnor (33%) och män (50%), men vanligare bland dem med erfarenhet av upprepad abort (41%/57%). Konkreta åtgärder som kvinnor och män med aborterfarenhet efterfrågar i det förbyggande arbetet är fler arbetstillfällen, mer och bättre kvalitet på sexoch samlevnadsundervisningen i skolan, hög tillgänglighet till billiga och effektiva preventivmedel samt kvalificerad rådgivning. Slutsatserna i delarbete I och II är att kvinnor och män med erfarenhet av en abort löper hög risk för en upprepad abort. Personer med erfarenhet av upprepad abort är mer socioekonomiskt utsatta. Att minska skillnader mellan olika socioekonomiska grupper kan därför vara av betydelse i det förebyggande arbetet med oönskade graviditeter. Delarbete III syftade till att undersöka hur nöjda kvinnor och män upplevt vården i samband med en inducerad abort samt att identifiera faktorer som har samband med en hög grad av tillfredsställelse med vården. De flesta var nöjda med vården, men en fjärdedel (26%) av kvinnorna och nästan hälften av männen (48%) var inte helt nöjda. Den viktigaste faktorn för hög tillfredsställelse med vården var att ha fått ett gott bemötande bland både kvinnor (OR 11.78) och män (OR 5.32). Andra faktorer av betydelse var för kvinnorna att ha fått tillfredsställande; smärtlindring (OR 3.87), information om den gynekologiska undersökningen (OR 2.25), och preventivmedelsrådgivning (OR 2.23), samt att det var lätt nå kliniken via telefon (OR 1.91). För männen var även information om abortproceduren en viktig faktor för deras totala tillfredsställelse med vården (2.64). Slutsatserna i delarbete III är att en fjärdedel av kvinnorna och varannan man inte var helt nöjda, vilket indikerar att abortvården kan förbättras, speciellt avseende männen. Bland både kvinnor och män, är ett positivt bemötande från personalen den viktigaste faktorn för en tillfredsställande upplevelse av vården i samband med abort. Delarbete IV syftade till att undersöka förekomsten av existentiella tankar, känslor och handlingar bland 499 kvinnor som gjort en abort. Genom faktoranalys identifierades olika existentiella komponenter relaterade till en inducerad abort. Resultatet visade att sex av tio kvinnor hade existentiella tankar om livet, döden, mening och moral. Nästan hälften av kvinnorna uppgav att de hade behov att genomföra en symbolisk handling i relation till aborten, och 67% tänkte på fostret i termer av ett barn. Högre grad av existentiella faktorer korrelerade med större svårighet att fatta beslut om abort, och ett sämre psykiskt välbefinnande efter aborten. Slutsatserna i delarbete IV är att existentiella känslor, tankar och handlingar i samband med abort är vanligt förekommande. Detta är för vårdpersonalen en utmanande aspekt som inte självklart inkluderas i abortvården och dess styrdokument. Syftet med delarbete V, som var en kvalitativ studie, var att undersöka kvinnors och mäns upplevelser och behov i samband med hemabort. Syftet var även att belysa deras syn på samhälleliga åtgärder för att förebygga oönskade graviditeter. Kvinnorna rekryterades från fem olika kvinnokliniker och männen tillfrågades om att delta i studien genom kvinnorna. Tjugofyra kvinnor och 13 män intervjuades via telefon. Innehållsanalysen mynnande ut i två övergripande teman; autonomi som beskriver att beslutet om abort och valet av metod var väl genomtänkt av kvinnan, men oftast med stöd av partner. Hemmiljön ökade deras integritet och kontroll, vilket också underlättade deras möjligheter att fritt uttrycka och dela känslor; beroende som beskriver kvinnors och mäns önskan att bli behandlade med värdighet och respekt och att få tillfredsställande information som är individuellt anpassad för deras behov. Resultatet indikerar att hemabort ställer höga krav på vårdpersonalens kommunikationsförmåga. Kvinnor och män var motiverade att förebygga en ny oönskad graviditet men ett planerat återbesök var ovanligt. I det förebyggande arbetet av oönskade graviditeter ansågs fast arbete, förbättrad kommunikation/utbildning och subventionerade preventivmedel som viktigt. Slutsatserna i delarbete V är att hemabort ökar kvinnors och mäns autonomi, men samtidigt finns ett uttalat beroende av att vårdpersonalen utformar vården individuellt och med respekt för olika livssituationer. Rutiner och uppföljning bör därför kontinuerligt utvärderas för att säkerställa både kvaliteten av abortvården men också följsamheten i användningen av preventivmedel. Oönskade graviditeter och aborter är inte frågor som enbart berör kvinnor eller hälso- och sjukvården, det är större än så, ett delat ansvar som berör både individer och samhället.

Includes one computer disk in Work 6 format. / System requirements for accompanying computer disk: Mackintosh or IBM-compatible computer. Other requirments: Microsoft Word 6 or compatible Word Processor. / Bibliography: leaves 241-270. / xiii, 270, [47] leaves ; 30 cm. + 1 computer disk (3 1/2 in.) / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Graduate School of Management, 1999

The optimal manner in which to train nephrologists has not been studied. The objectives of this research were to determine:- 1. The educational and historical basis underpinning the Australian nephrology training program. 2. The drivers surrounding a career choice in nephrology. 3. What constitutes an ???ideal??? nephrologist and how nephrologists spend their work time, thereby identifying skills and attributes to be fostered in training. 4. Impediments to training, including examination of the available workforce. Five sub studies were undertaken, utilising a combined quantitative and qualitative approach (mixed methods): 1) A national Basic Physician Trainee (BPT) questionnaire, 2) a national nephrology workforce study, and in-depth interviews of: 3) nephrology patients, 4) nephrology trainees and 5) practicing nephrologists. New findings arising from this research reveal: doctors choose nephrology as a career if exposed to the specialty in a positive manner with good role models, however, there are a range of modifiable factors that make nephrology unattractive to many BPTs; workload is high, impacting negatively on training and trainee recruitment; Nephrologists spend most time in the management of dialysis and transplant patients but have a range of other roles in day to day practice, essential information to develop a competency based training program; availability of nephrologists for training is suboptimal and will likely worsen; Patients and doctors apply and weight parameters differently when defining an ???ideal nephrologist???. Both groups believed that specialist knowledge remains an essential requirement but patients focused more on good communication skills. This research provides evidence that the training program should incorporate training in advanced communication and basic research skills and promotion of an holistic approach to patient care. There is no formal alignment of training with assessment. Trainees and nephrologists believe that feedback is critical to learning, yet the assessment process is not underpinned by sound educational principles. This can be rectified using the findings of this research in conjunction with curriculum development and performance assessment. This research should provide an approach to the examination of training that is applicable to many internal medicine specialties. Importantly, nephrology training can now be improved with sound educational principles, underpinned by the findings of this research.