Thesis (Ph. D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed June 23, 2008). Includes bibliographical references (p. 159-172).

Thesis (M.S.)--University of Michigan, 1983.

Thesis (M.S.)--University of Michigan, 1983.

The purpose of this study was to explore the utilization patterns of elderly women in a nurse managed clinic (NMC). A convenience sample of 20 women, 65 and older, attending an NMC completed an questionnaire and an interview. A pilot study guided the development of the questionnaire. Interrater reliability was performed to enhance the reliability of the pattern categories developed from the interviews. The findings of this research were that elderly women utilized this NMC for: physical assessment and monitoring; health care information; evaluating a physical need; referral; emotional support; socialization; convenience; cost; familiarity/comfort; health care need; and reliability. Satisfaction was the main component of the clients' perception of their visit to the NMC. Conclusions reached were that utilization of this NMC was based mainly on perceptions of health care needs and that cost, convenience, and familiarity influenced clients in choosing this clinic in addition to their primary care provider.

Diss. (sammanfattning) Umeå : Umeå universitet, 2009. / Härtill 5 uppsatser.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2007. / Source: Masters Abstracts International, Volume: 46-01, page: 0339. Adviser: Cynthia L. Chappell. Includes bibliographical references.

Source: Masters Abstracts International, Volume: 46-03, page: 1373. Advisers: Robert J. Hardy; Asha S. Kapadia. Includes bibliographical references.

The venous ulcer has high rate of recurrence and chronicity and is the main chronic injury of lower limbs. It causes changes in the lives of people affected because it demands care to optimize the healing, which requires that the people with venous ulcers seek for health care. Thus, it is justified interest in to know the therapeutic itinerary, in other word, the route that people do for cares and treatments. This study is based in anthropological literature and it had as theoretical support the model of Health Care System proposed by Arthur Kleinman. The question was: How is it build the therapeutic itinerary of people with venous ulcers in outpatient service of the Hospital Universitário de Santa Maria, Rio Grande do Sul, Brazil? And it aimed to describe the therapeutic itinerary of people with venous ulcers attended in outpatient service of the Hospital Universitário de Santa Maria, Rio Grande do Sul, Brazil. This project integrates macroproject "Attention to patients with venous ulcers: implications for the nursing care" of Research Group "Care, Nursing and Health" of the Universidade Federal de Santa Maria. It was field, qualitative, descriptive and exploratory research. The participants were 14 people with venous ulcers attended in the outpatient service - Ward I of the hospital. The data collection occurred between January and February 2013 through semi-structured interviews. The data were subjected to content analysis. The permission to realization of study was requested by Education and Research Direction of the Hospital and the research project examined by the Ethics Committee of Universidade Federal de Santa Maria, being registered with number 23081.007762/2011-41. It was considered the guidelines that involve human research, contained in Resolution 196/96 of the National Health Council. The results emerged categories which are presented in the form of articles. Article 1: Therapeutic itinerary of people with chronic health conditions: an integrative review; Article 2: Therapeutic itinerary: trend in nursing theses and dissertations; Article 3: Aspects addressed about venous ulcers in nursing theses and dissertations; Article 4: Therapeutic itinerary of people with venous ulcers in ambulatory care; Article 5: Influence of social support networks in the therapeutic itinerary of people with venous ulcers. Thus, it is expected that this research contribute to the deepening of understand of subject and to enable new understandings to the nursing, especially for health care aimed at socio-cultural reality of people with venous ulcers. / A úlcera venosa possui elevada taxa de recidiva e cronicidade e é a principal lesão crônica de membros inferiores. Causa mudanças na vida das pessoas acometidas, pois demanda cuidados para otimizar a cicatrização, o que exige que as pessoas com úlceras venosas busquem por cuidados à saúde. Assim, justificou-se o interesse em conhecer o itinerário terapêutico, ou seja, o percurso que as pessoas fazem por cuidados e tratamentos. Este estudo se embasou na literatura socioantropológica e teve como suporte teórico o modelo de Sistema de Cuidados à Saúde proposto por Arthur Kleinman. A questão norteadora foi: Como se constrói o itinerário terapêutico de pessoas com úlceras venosas assistidas no serviço ambulatorial do Hospital Universitário de Santa Maria, Rio Grande do Sul, Brasil? E objetivou-se descrever o itinerário terapêutico de pessoas com úlceras venosas assistidas no serviço ambulatorial do Hospital Universitário de Santa Maria, Rio Grande do Sul, Brasil. Este projeto integra o macroprojeto Atenção aos usuários com úlcera venosa: implicações para o cuidado de Enfermagem do Grupo de Pesquisa Cuidado, Saúde e Enfermagem da Universidade Federal de Santa Maria. Pesquisa de campo, qualitativa, descritiva e exploratória. Os participantes foram 14 pessoas com úlceras venosas assistidas no serviço ambulatorial - Ala I do referido hospital. A coleta de dados ocorreu no período de janeiro e fevereiro de 2013, por meio de entrevistas semiestruturadas. Os dados foram submetidos à análise de conteúdo. A autorização para a realização da pesquisa foi solicitada à Direção de Ensino e Pesquisa do hospital e o projeto de pesquisa analisado pelo Comitê de Ética em Pesquisa da Universidade Federal de Santa Maria, sendo registrado com o número 23081.007762/2011-41. Considerou-se as diretrizes que envolvem pesquisas com seres humanos, contidas na Resolução 196/96, do Conselho Nacional de Saúde. Como resultados surgiram categorias, as quais são apresentadas no formato de artigos. Artigo 1: Itinerário terapêutico de pessoas com condições crônicas de saúde: revisão integrativa; Artigo 2: Itinerário terapêutico: tendência em teses e dissertações da enfermagem; Artigo 3: Aspectos abordados sobre úlcera venosa em teses e dissertações da enfermagem; Artigo 4: Itinerário terapêutico de pessoas com úlcera venosa em assistência ambulatorial; Artigo 5: Influência das redes sociais de apoio no itinerário terapêutico de pessoas com úlcera venosa. Dessa forma, espera-se que essa pesquisa possa contribuir para o aprofundamento do conhecimento da temática e possibilitar novas compreensões para a atuação da enfermagem, em especial, para um cuidado de saúde voltado à realidade sociocultural das pessoas com úlcera venosa.

Chronic obstructive pulmonary disease (COPD) is a major health problem in the United States. Acute exacerbations of COPD are primarily responsible for the physical, psychological and economic burden of this disease. Early identification and treatment of exacerbations is important to improve patient and healthcare outcomes. Little is known about how patients with COPD recognize an impending exacerbation and subsequently decide to seek treatment. The purpose of this qualitative descriptive study was to explore and describe symptom recognition and treatment delay in individuals experiencing an acute exacerbation of chronic obstructive pulmonary disease (COPD). Leventhal’s Common Sense Model of illness representation undergirded this study. Using semi-structured interviews, adults hospitalized with an acute exacerbation of COPD were asked to describe their symptom experience and self care behaviors, including treatment seeking, in the days to weeks prior to hospitalization. Data analysis revealed one main theme: Recognizing, responding and reacting to change, and six subthemes: Something’s coming, Here we go again, Seeking urgent treatment, Riding it out, Not in charge anymore and My last day that richly described the COPD exacerbation experience. The study revealed that patients experience an illness prodrome prior to exacerbation and have a recurrent exacerbation symptom pattern that was self-recognized. Treatment seeking was most influenced by the speed and acuity of exacerbation onset, severity of breathlessness, fears of death, nature of patient-provider relationship and the perception of stigmatization during prior healthcare encounters. These findings are important for the development of interventions to improve patient recognition and management of COPD exacerbations in the future.

SAMMANFATTNING Bakgrund  Upplevelsen av hälsa och välbefinnande är beroende av hur miljön vi befinner oss i är utformad. Ett av sjuksköterskans ansvarsområden är att se efter att vårdmiljön uppfyller patientens behov. Vårdmiljön kan utformas av flera olika aspekter såsom ljud, ljus och natur vilka alla har förmågan att kunna skapa en känsla av trygghet. Sjukvårdsreformatorn F. Nightingale menade att den fysiska miljön var lika viktig som den psykiska och sociala omgivningen för att återfinna hälsa samt förebygga sjukdomar.  Syfte  Syftet med denna litteraturöversikt var att beskriva aspekter i vårdmiljön som främjar patientens välbefinnande.  Metod  Metoden som valdes för denna studie var en icke-systematisk litteraturöversikt. Databassökningar gjordes i PubMed, CINAHL, Academic Search Elite samt manuella sökningar. Ett urval av 17 vetenskapliga artiklar gjordes efter noggrann granskning. Artiklarna som användes var både kvalitativa och kvantitativa, dessa har kvalitetsgranskats med hjälp av Sophiahemmets Högskolas bedömningsunderlag. Integrerad dataanalys användes som metod.  Resultat  En hälsofrämjande vårdmiljö påverkar patientens välbefinnande och autonomi under tiden de vårdas på sjukhus. Det första intrycket vid besök på sjukhus är det som utgörs av den fysiska miljön. Vidare framkom att enkelrum ledde till minskat buller, bättre sömn samt stärkt socialt stöd och personlig integritet. Fönster och utsikt över naturen skapade en känsla av fridfullhet då naturen kunde hjälpa till att stärka patientens inre kraft genom distraktion. Naturligt ljus ökade välmåendet och förbättrade sömnen. En välkomnande vårdmiljö med ”mysighetsfaktor” och avskildhet ökade känslan av hemtrevlighet vilket förbättrar välbefinnandet hos patienterna och ökade dessutom närvaron av anhöriga vilka utgjorde ett stort stöd för patienterna.  Slutsats  Genom en ökad kunskap om vårdmiljöns betydelse för patientens välbefinnande, kan åtgärder vidtas för hur allmänna utrymmen utformas. Vårdmiljön kan antingen stödja eller hindra patientens återhämtningsprocess och har kapaciteten att främja patientens livskvalitet. Denna studie ger en inblick i vårdmiljöns betydelse och bidrar med lärdomar som vidare kan tillämpas i vårt framtida kliniska arbete inom professionen.  Nyckelord: Patienters nöjdhet, patientens acceptans av vård, patienter, miljödesign, vårdmiljö. / ABSTRACT Background  The design of the environment affects our experience of health and well-being. One of the nurse's responsibilities is to ensure that the care environment meets the patient's needs. The care environment can be designed by several different factors such as sound, light and nature. All with a capacity to provide a feeling of security. According to healthcare reformer F. Nightingale, the physical environment was equally important to the psychological and social environment in order to regain health and prevent disease.  Aim  The purpose of this literature review was to describe aspects of the care environment that promote the patient’s well-being.  Method  The method used was non-systematic literature review. Database searches were performed in PubMed, CINAHL, Academic Search Elite as well as manual searches. A selection of 17 scientific articles was made after careful review. The articles were of both quantitative and qualitative research methods, these have been quality checked with the help of Sophiahemmet University’s assessment data. They were analysed based on the integrated data analysis method.  Results  A health-promoting care environment affects the patient's well-being and autonomy while they are being cared for in hospital. The first impression when visiting a hospital is that of the physical environment. Furthermore, it turned out that single rooms led to reduced noise, better sleep and strengthened social support and personal integrity. Windows and views of nature created a feeling of peace as nature could help strengthen the patient's inner power through distraction. Natural light as well as artificial light increased the well- being and improved sleep. A welcoming care environment with a “cosiness factor” and privacy increased the feeling of homeliness, which improves the well-being of the patients and also increased the presence of relatives who constituted a great support for the patients.  Conclusion  Through increased knowledge on the importance of the care environment for the well- being of the patient, measures can be taken focusing on the design of public spaces in this environment. The care environment can either support or hinder the patient's recovery process and has the ability to promote the patient’s quality of life. This study provides an insight into the importance of the care environment and contributes with lessons that can be further applied in our future clinical work within the profession.  Keywords: Patient satisfaction, patient acceptance of health care, patients, environment design, health facility environment.