published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Darbo tikslas – įvertinti Naujagimiui palankios ligoninės principų įtaką pacienčių pasitenkinimui sveikatos priežiūros paslaugomis. Uždaviniai: 1) įvertinti pacienčių lūkesčius ir pasitenkinimą sveikatos priežiūros paslaugomis Kauno medicinos universiteto klinikų gimdymo stacionare įgyvendinant naujagimiui palankios ligoninės principus. 2) įvertinti pacienčių lūkesčius ir pasitenkinimą sveikatos priežiūros paslaugomis Vilniaus miesto universitetinės ligoninės gimdymo stacionare. 3) palyginti pacienčių lūkesčius ir pasitenkinimą sveikatos priežiūros paslaugomis gautomis Kauno medicinos universiteto klinikose ir Vilniaus miesto universitetinės ligoninėje gimdymo stacionaruose. Tyrimo metodika. Tyrimas buvo vykdomas 2009 m. vasario – kovo mėn.. Atrinktoms moterims, gimdžiusioms Kauno Medicinos Universiteto Akušerijos ir ginekologijos klinikoje ir Vilniaus miesto Universitetinės Antakalnio ligoninės moterų klinikoje, paštu buvo išsiųsti klausimynai. Išsiųsta 640 anketų, atsako dažnis – 94,4 proc. Anketinių duomenų analizei naudotas kompiuterinis SPSS 13.0 statistinis versijos paketas. Rezultatai. Kauno Medicinos Universiteto Klinikų gimdymo stacionare moterų lūkesčiai tapatūs su Naujagimiui palankios ligoninės principais. Jos patenkintos suteikiamomis komforto sąlygomis, teikiama informacija, aukštu medicininio personalo žinių lygiu. Vilniaus miesto universitetinės ligoninės gimdymo stacionare moterys atskirtos nuo savo naujagimių, neužtikrinta sėkmingo žindymo pradžia... [toliau žr. visą tekstą] / Aim of the study – to evaluate influence of Baby-Friendly Hospital Initiative (BFHI) on patients satisfaction with health services. Objectives: 1) to evaluate patients expectations and satisfaction with health services at Kaunas University Hospital birth center which is implementing BFHI; 2) to evaluate patients expectations and satisfaction with health services at Vilnius University Hospital birth center; 3) to compare patients expectations and satisfaction with health services at Kaunas University Hospital and Vilnius University Hospital birth centers. Methods. The study was conducted in February–March 2009. Selected sample of women who underwent deliveries at Kaunas University Hospital (Department of Obstetrics and Gynecology) and at Vilnius University Hospital (Women Clinic of Antakalnis Hospital) received questionnaires via mail. Altogether 640 questionnaires were sent, the response rate reached 94.4%. Statistical data analysis was performed using „SPSS for Windows 13.0“ software. Results. Patients expectations at Kaunas University Hospital birth center meets the BFHI principles. Women are satisfied with provided comfort, information, and high competence of medical staff. At Vilnius University Hospital birth center women are separated from their babies, therea are no conditions for successful inititation of breastfeeding, poor staff communication. Conclusions. The comparison of patients expectations at Kaunas and Vilnius universities hospitals birth centers revealed no... [to full text]

The "International Classification of Functioning, Disability and Health" (ICF) is a model that classifies health and health-related function. Of the ICF domains, least is known about participation. Although a few measures have been developed in English that tap the construct "Participation", none exist in Spanish. The Reintegration to Normal Living (RNL)-Index is the measure of reference to evaluate participation. The general objective of the present study was to translate, culturally adapt, and assess the psychometric properties the RNL-Index in Spanish for use in Spain. The translation and the cultural adaptation of the RNL-Index consisted of a five-step process, leading to the Spanish version of the RNL-Index (SRNL-Index). Psychometric evaluation consisted of a cross-sectional study design, with a longitudinal design used for test-retest evaluation. Thirty-two subjects with stroke and 36 with total knee arthroplasty completed the SRNL-Index twice, as well as the Six Minute Walk Test (6MWT), the Short-Form 36 Health Survey (SF-36), and for stroke subjects, the Barthel Index (BI). Descriptive statistics, one-way analysis of variance and post-hoc t tests were calculated, as well as Cronbach's alpha, Pearson's, and Intraclass correlation coefficients. The SRNL-Index was found to be internally consistent. Test-retest reliability was quite poor, being moderately low for the TKA sample and moderate for the stroke sample. Discriminant validity was demonstrated by the correlations between the SRNL-Index's Perception of Self and Daily Activity subscales with the Mental and Physical Component Summary scores of the SF-36. The SRNL-Index has convergent validity as shown by the high correlations between of the SRNL-Index and the 6MWT. Known-groups validity was shown in people with stroke grouped by Barthel Index scores, and in both samples when grouped according to gait speed. The SRNL-Index demonstrated acceptable validity and internal reliability for subjects with stroke and total knee arthroplasty. However, further studies are needed to reassess external validity, reliability, and responsiveness in other populations and other Spanish-speaking countries.

<p>The development and provision of equitable and acceptable standard of health services to all segments of the population has been the major objective of the 1993 Ethiopian National health policy. However, community based studies on satisfaction with public health care facilities reveal that the majority of the population are not satisfied with the services provided predominantly as a result of the long waiting times. Studies done on private health facilities on the contrary reveal that patients are satisfied with the service delivered within short waiting times in these clinics. Even though the speculated waiting time is thought to be long among the public health care facilities and short in private clinics, the actual waiting and service times have not been measured and compared. Aim: To determine the waiting and service times among the public and private health care facilities and measure the perceptions of &ldquo / acceptable&rdquo / waiting time among the providers and clients. Materials and methods: A cross sectional observational study using quantitative techniques was carried out amongst patients and staff at selected public and private health care facilities in Gondar District. Stratified sampling method was used to select facilities. All patients visiting the selected facilities and all staff who provided service to patients on the day of the study were included in the time-delimited sample. Data was collected by research assistants and health workers from all patients attending the health care facility by registering the arrival and departure time of each patient to the facility and to each service point on a patient flow card. Then data was cleaned and captured by a specific Waiting and Service Time database. Descriptive statistics was done on waiting and service times for each facility and this was summarized for each public and private health facility by using tables and graphs. Finally a comparison was made for private and public health facilities by using Wilcoxon-mann-whitney non parametric tests.</p>

The aims of the present thesis were: * To investigate how women patients with borderline personality disorder (BPD) perceive their suffering, quality of life and encounter with psychiatric care (paper 11 and III). * To describe BPD patients' and psychiatric professionals' perceptions of receiving and giving dialectical behavioural therapy, DBT (paper I). * To investigate how starting treatment of BPD patients with DBT affected the psychiatric professionals' experience of occupational stress and professional burnout (paper IV) Due to the different types of research questions the thesis deal with, it uses a mix of qualitative and quantitative research methods. In two of the studies (11 and 111) the main methods were qualitative. Data from free format questionnaires, individual- as well as group interviews and biographical texts, were analysed with content analysis or a hermeneutic approach. In study Ill the methods were quantitative. A summated rating scale measuring healthrelated quality-of-life (HRQOL) was analysed with descriptive and inferential statistics. In study IV quantitative and qualitative methods were combined. Two burnout inventories were analysed with descriptive and inferential statistics, and data from free format questionnaires and group interviews were analysed with qualitative content analysis. The main findings were that BPD patients suffer to an extent that is often unendurable, leading to deliberate self-harm (DSH) and suicide attempts to relieve suffering or just try to get away from it all (paper 11). In study Ill the BPD patients showed significantly poorer quality-of-life (even physical) than normal population controls of comparable age. The suffering, suicide attempts, DSH and poor quality-of-life (paper 11 and 111) put the patients in a position of voluntarily or involuntarily getting involved with psychiatric care. Study II revealed a double role of the psychiatric care in relation to BPD patients. On one hand, psychiatric professionals can add to the suffering by not being understanding and being disrespectful, on the other hand they can be helpful and relieve suffering by being respectful, understanding and validating. There was a clear relationship between the patients' experience of validation and the experience of being helped. DBT seems (both from the patients' and psychiatric professionals' perspective) to be a treatment with a philosophy, content and structure being able to relieve BPD patients suffering and helping them to independence and a bearable life-situation (paper I). Study IV confirms previous findings that psychiatric professionals experience treatment of self-harming patients as profoundly stressful. DBT was seen as stressful in terms of learning demands, but decreased the experience of stress in the actual treatment of the patients due to its high degree of structure and specific techniques. The DBT team-work and supervision were felt to be supportive, as was one particular facet of DBT, namely mindfulness training which some professionals felt also improved their handling of other work stressors not related to DBT. This finding also corresponds to BPD patients' perceptions of the mindfulness component in DBT, which they reported as particularly helpful (paper 1). It should be noted that the patient samples in the thesis may be considered as a "worse off" subgroup among BPD patients, as they usually entered special treatment programs after a period of escalating symptoms, which standard psychiatric services had had difficulties handling. The rather small number of participants and the lack of equivalent andlor concurrent control groups in the quantitative studies limit the generalization of the results.

Diss. (sammanfattning) Stockholm : Karol inst., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Umeå : Univ., 2005. / Härtill 4 uppsatser.

Thesis (Ph.D.)--University of Melbourne, Dept. of General Practice and Centre for Health and Society, 2007. / Typescript. Includes bibliographical references (leaves 252-278).

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.