Die digitale Transformation im Gesundheitswesen ermöglicht durch die Entwicklung zahlreicher neuer Technologien und Standards eine zunehmend individualisierte, bedarfsgerechte und berufsgruppenübergreifende Versorgung von Patienten. Diese neue Generation von Digital Health Innovationen – die Digital Health Generation Alpha (in Anlehnung an die korrespondierende Alterskohorte) – erfüllt Informations‑, Kommunikations- und Interoperabilitätsanforderungen entlang des gesamten Versorgungsprozesses, die aufgrund von abgegrenzten Leistungs- und Zuständigkeitsbereichen sowie Vergütungsregelungen oft eine unüberwindbare Hürde dargestellt haben. Im Beitrag werden mit der i) Pfadorientierung, ii) Patientenorientierung und -einbeziehung, iii) Qualitätsorientierung und iv) Integrationsfähigkeit vier zentrale Gestaltungsdimensionen von Digital Health Innovationen der Generation Alpha vorgestellt. Diese werden literaturgestützt aufgearbeitet und deren praktische Umsetzung anhand einer Fallstudie im Bereich der Versorgung von Patienten mit Multipler Sklerose aufgezeigt. Zentrale Leitfragen, konkrete Umsetzungsmaßnahmen und literaturgestützte Gestaltungsziele werden anhand eines prototypischen Vorgehensmodells beschrieben. Anhand der Fallstudie werden anschließend Implikationen für die zukünftige Digital Health Agenda abgeleitet, welche insbesondere für die Realisierung innovativer Werteversprechen und deren Integration in komplexe Zielumgebungen des Gesundheitswesens notwendig sind. / Through the development of numerous new technologies and standards the digital health care transformation progressively enables an individualized, need-based, and interprofessional treatment provision. The new generation of digital health innovations—in analogy to the age cohorts, the digital health generation alpha—can therefore fulfill information, communication, and interoperability tasks along the entire care process, that previously often represented an insurmountable challenge. The four design dimensions of digital health generation alpha are introduced: i) pathway orientation, ii) patient orientation and involvement, iii) quality orientation, and iv) integration capability. These are first discussed on basis of current literature and their practical utilization is then demonstrated in a case study on patients with multiple sclerosis. A process model for pathway development is presented that incorporates the four design dimensions and transforms a treatment process into a digital, participative, and integrated care model. Central guiding questions, concrete implementation measures and literature-based design goals are described based on the process model. Finally, implications for the future digital health agenda are derived, which are particularly necessary for the realization of innovative value propositions and their integration into complex healthcare target environments.

Problem-based learning (PBL) was developed for use in medical education to incorporate more active, learner-centered instruction. Central to problem-based learning is the problem, which in medical education is usually case a case presentation, revealed in stages to allow learners to form and research learning objectives. The purpose of this study was to identify themes present across the PBL cases, including the patient-centeredness of the cases. Content analysis was used to examine 62 PBL cases that comprised the first and second years' core curriculum at a public medical school. The cases included a patient population similar to the local population, but care was more hospital-centric than would be expected from the actual patterns of medical utilization in the United States. Analyzing along two axes of patient-centeredness, the PBL cases demonstrated a good understanding of the patient (knowing the patient), but other qualities such as shared decision making was not as exemplified. Medical educators can use the results to understand elements that contribute to patient-centeredness and apply the analysis framework to evaluate future cases.

Bakgrund: Användning av digital rådgivning ökar snabbt och teknologin utvecklas konstant. Distriktssköterskor ska driva utvecklingen framåt och arbeta med att förbättra omvårdnad. Digital rådgivning är en del i förbättringsarbetet och kan förbättra omvårdnadsarbetet och vården genom att öka möjligheterna att erbjuda personcentrerad vård och på sikt mer jämlik vård. Syfte: Att beskriva distriktssköterskors upplevelser av att arbeta med digital rådgivning. Metod: Kvalitativ studie med induktiv ansats. Datainsamlingen genomfördes med två semistrukturerade fokusgruppsintervjuer, med totalt nio deltagare, som analyserades med kvalitativ innehållsanalys med manifest ansats. Resultat: Analysen resulterade i tre kategorier.Verksamhetens betydelse i arbetet med digital rådgivning; Hur verksamheten är upplagd samt hur arbetsresurser fördelas har stor betydelse för upplevelsen av att arbeta med digital rådgivning. Möjligheter och utmaningar för att kunna arbeta patientsäkert; Det finns möjligheter att arbeta patientsäkert, till exempel underlättade det om alla systemets funktioner används. Att kunna se bilder var positivt, men den icke-verbala kommunikationen saknades. Potential för att kunna ge tillgänglig och nära vård; Digital rådgivning underlättade för att kunna ge tillgänglig och nära vård. Distriktssköterskor såg digital rådgivning som en del av framtiden. Slutsats: Digital rådgivning har förutsättningar att öka tillgängligheten till vård men det krävs en bra arbetsmiljö och tillräckligt med resurser, vilket verksamheten har ansvar för, samt ytterligare utbildning och utveckling för att kunna arbeta mer patientsäkert. Det finns behov av fortsatt forskning gällande digital rådgivning, både från personal- och patientperspektiv.

The purpose of the study was to determine how professional nurses perceive their roles in patient centered care in various units, in three regional hospitals in Mpumalanga Province. The main objectives of this study were to determine * whether the working environment in provincial hospitals is supportive of patient centered care * what factors could hinder the provision of patient centered care * the extent to which patient centered care is provided to patients in provincial hospitals * professional nurses' perception of their role in patient-centered care The researcher used the descriptive exploratory method. A questionnaire with closed and open-ended questions was used to collect data from professional nurses in the three hospitals. Seventy- two (72) respondents returned the completed questionnaires. The findings indicated that the professional nurses perceived patients' and nurses' lack of knowledge as the biggest hindrance to patient centered care. Patients and relatives seemed to be less involved in their own care and the lack of information given to patients by professional nurses subsequently contributed to patients' inability to make / Health Studies / M.A. (Health Studies)

The purpose of the study was to determine how professional nurses perceive their roles in patient centered care in various units, in three regional hospitals in Mpumalanga Province. The main objectives of this study were to determine * whether the working environment in provincial hospitals is supportive of patient centered care * what factors could hinder the provision of patient centered care * the extent to which patient centered care is provided to patients in provincial hospitals * professional nurses' perception of their role in patient-centered care The researcher used the descriptive exploratory method. A questionnaire with closed and open-ended questions was used to collect data from professional nurses in the three hospitals. Seventy- two (72) respondents returned the completed questionnaires. The findings indicated that the professional nurses perceived patients' and nurses' lack of knowledge as the biggest hindrance to patient centered care. Patients and relatives seemed to be less involved in their own care and the lack of information given to patients by professional nurses subsequently contributed to patients' inability to make / Health Studies / M.A. (Health Studies)

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Made available in DSpace on 2014-07-29T15:04:38Z (GMT). No. of bitstreams: 1 dissertacao nilde.pdf: 578642 bytes, checksum: c81be58c892df249786559538371fba5 (MD5) Previous issue date: 2007-12-12 / Humanizing healthcare assistance has become an emergent theme being discussed over decades, and in the most recent years such debates have become more intense regarding how to take more effective actions on care by valuing the human condition. Nurses are considered a key element to visibility of humanized care in the hospital setting due to their sensitivity to the perception of patient s subjectivity and for having the sense of care solidified under ethical humanistic values as the existential reason of their profession. This is a qualitative descriptive exploratory study aimed at analyzing the concept on humanized care the nurses working in hospital assistance have. It was conducted in a school hospital, located in Midwestern Brazil, with the participation of 27 nurses acting on inpatients direct assistance. Data was collected through semi-structured individual interviews and were submitted to the content thematic analysis.Thus, we have come up with four main categories and their subcategories revealing the respondents perception concerning care humanization in the hospital context, namely: conception of humanized care; caregivers conception under the humanized assistance perspective; the paradox of the humanized care in the hospital setting; echoes of the Permanent Education Project on relative practice and concepts to the humanizado care. By the end of this study, we have noticed that nurses have various perceptions concerning this issue, correlating, however, the humanized care to holistic approach regarding patients assistance. The ethical humanistic principles were described by all the respondents when expressing humanization of care related to feelings such as love, empathy, presence, communication, and attention. They identified at the institution several aspects favoring or making it harder the effectiveness of humanized care, however, they have stressed the internal availability of staff and their valuing in the humane dimension, through symmetric respect and dialogue between workers and managers as determinant to humanizing process. We present the continuing education project of the institution which aims at discussing the humanization of assistance in the hospital ambit as an important initiative enabling changes in staff concepts and attitudes in what patient care regards. Thus, some outcomes have been assessed so that these project contributions can be highlighted in the construction of concepts and practices related to humanizing care among nurses participating in such activities. In general, throughout the research we could see that the institution can count on committed, responsible, sensitive nurses motivated to contribute to the effectiveness of humanized care. Thinking about the complexity of the assistance humanization process, we become aware that implementing humanized care in the hospital setting requires a long way demanding successful strategies, not always easy, but feaxible. / A humanização da assistência em saúde é um tema emergente que vem sendo discutido há décadas e nos últimos anos essas discussões têm se intensificado no sentido de tornar efetivas as ações do cuidado valorizando a condição humana. Consideramos o enfermeiro elemento-chave para a visibilidade do cuidado humanizado no ambiente hospitalar por ser um profissional sensível à percepção da subjetividade do paciente e por ter o cuidado solidificado em valores ético-humanistas como razão existencial da profissão. Este estudo, de natureza descritivo-exploratória, com abordagem qualitativa, teve como objetivo geral analisar a concepção sobre cuidado humanizado pelos enfermeiros que atuam na assistência hospitalar. Foi desenvolvido em um hospital universitário, localizado na região Centro-Oeste do Brasil, com a participação de 27 enfermeiros atuantes na assistência direta à pessoa internada. Os dados foram coletados por meio de entrevista individual semi-estruturada e foram submetidos à análise temática de conteúdo. Dessa forma, foram construídas quatro categorias principais e subcategorias, que revelaram a percepção dos participantes sobre a humanização do cuidado no contexto hospitalar, assim nomeadas: concepção do cuidado humanizado; concepção de cuidador na perspectiva da humanização da assistência; o paradoxo do cuidado humanizado no ambiente hospitalar; ressonâncias do Projeto de Educação Permanente sobre conceitos e práticas relativos ao cuidado humanizado. Ao finalizarmos este estudo, verificamos que os enfermeiros têm percepções diversas sobre a temática, correlacionando, entretanto, o cuidado humanizado ao holismo na assistência ao paciente. Os princípios ético-humanistas foram apontados pela totalidade dos entrevistados ao expressarem a humanização do cuidado relacionada a sentimentos de amor, empatia, presença, comunicação e atenção. Identificaram na instituição, vários aspectos que favorecem ou dificultam a efetividade do cuidado humanizado, entretanto, destacaram a disponibilidade interna do profissional e a valorização dele na sua dimensão humana, por meio do respeito e diálogo simétrico entre os trabalhadores e gestores como determinantes para processo de humanização. Apresentamos o Projeto de Educação Permanente da instituição, que tem entre seus objetivos, discutir a humanização da assistência no âmbito hospitalar como uma iniciativa importante que possibilita mudanças de conceitos e atitudes dos profissionais frente ao cuidado dos pacientes. Dessa forma, alguns resultados foram analisados no sentido de apontar a contribuição desse projeto na construção de conceitos e práticas relativas à humanização do cuidado entre os enfermeiros que participaram de suas atividades. De modo geral, no transcorrer da pesquisa, vimos que a instituição conta com profissionais de enfermagem comprometidos, responsáveis, sensíveis e motivados a contribuir no sentido de tornar efetiva a prática do cuidado humanizado. Pensando na complexidade do processo da humanização da assistência, temos a clareza que implementar o cuidado humanizado no ambiente hospitalar, requer uma longa trajetória, que demanda estratégias exitosas, nem sempre fácies, mas possíveis de serem alcançadas.

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The subject of this diploma thesis is the involvement of users of psychiatric care in the process of planning and realization of psychiatric care reform at the macro level of policy making. The aim of the research is to describe and understand this involvement. In the research are describer possibilities of participation in the phases of involvement, its form, purpose, formal regulation of opportunities, expectations of respondents, perceived power and barriers in involvement. The data was collected during interviews with key actors and studies of relevant documents. The results relate to the theoretical concepts of coproduction, patient-oriented care, strategic and human rights documents (the Convention on the Human Rights of People with Disabilities). The element of power is described through the typology of Sherry Arnstein's participation ladder. Evidence of interviews indicates elements of tokenism and disadvantages. There is a low (one-person) representation of users in reform bodies, lack of time for discussion in consultative bodies, lack of information and lack of capacity (people, time, resources) for greater development of patient organizations. Respondents have identified barriers as the socio-economic situation, lack of capacity for macro-level involvement, mental health constraints or...

Stroke is a leading cause of disability worldwide, and access to rehabilitation is crucial for recovery. This study examines the potential of digital technologies to improve the rehabilitation experience of stroke survivors in Scania, Sweden. The use of digital tools and telerehabilitation in stroke rehabilitation in Scania remains largely unexplored. Through qualitative interviews with 12 stroke survivors, 1 stroke survivor relative, and 6 healthcare professionals, this study identifies four key themes that play a significant role in the rehabilitation process: Access to care and rehabilitation, Motivation, Psychological and emotional needs, and Social support net. Based on these findings, the study proposes several "digital suggestions" to improve the rehabilitation process, including utilizing digital physio- and occupational therapy and improving alignment between various digital systems within the region. The study emphasizes the importance of individual adaptation in stroke rehabilitation, which aligns with the overarching goal of Swedish healthcare to provide patientcentered care. The findings of this study can inform future work with digital opportunities in Scania's stroke care and rehabilitation, potentially leading to better outcomes for stroke survivors.