Registered nurses (RNs) have a significant role in communicating health information to patients. The problem addressed in this study was RNs roles with health literacy and communicating health information using words that the patient understands. This study found that ambulatory RN perspectives on their roles in health literacy and patient communication may improve health outcomes and optimal wellness. The purpose of this qualitative study was to examine and describe ambulatory RN perspectives on their roles in health literacy and patient communication, as these are necessary components linked to better health outcomes. The conceptual framework for this study was the nurse role effectiveness model. Fifteen RNs participated in face-to-face, structured, interviews using open-ended questions to contribute perspectives on health literacy roles and nurse-patient communication. Data analysis consisted of Miles and Huberman's methodology to code, extract, sort, review, generalize, and examine for themes. Emergent themes and key findings of this study may improve the gap in knowledge regarding ambulatory RN perspectives on health literacy roles and patient communication, as well as more awareness of the term health literacy, increased formal training on the concepts of health literacy, and techniques to formally assess patients' understanding of health information. An opportunity exists to bridge the gap between RN knowledge of health literacy roles and patient communication. Positive social change implications for health services include promoting RN health literacy roles and strategies for effective communication to promote patient behavior changes for optimal wellness.

This study explores the experiences of General Practitioners (GPs) and patients in the management of type 2 diabetes in contemporary Australia. I focus on the way the socioeconomic position of patients is a factor in that experience as my underlying interest is in exploring how health inequalities are understood, approached and handled in general practice. The study is thus a practical and grounded exploration of a widely debated theoretical issue in the study of social life, namely the relationship between the micro day-to-day interactions and events in the lives of individuals and the broad macro structure of society and the position of the individual within that. There is now wide acceptance and evidence that people’s social and economic circumstances impact on their health status and their experiences in the health system. However, there is considerable debate about the role played by primary medical care. Nevertheless, better theoretical understanding of the importance of psychosocial processes in generating social inequalities in health suggests medical care may well be important, as such processes are crucial in the care of chronic illnesses such as diabetes which are now such a large part of general practice work. I approach this study through an exploration of patient centred clinical practice. Patient centredness is a pragmatic, idealised prescriptive framework for clinical practice, particularly general practice. Patient centredness developed in part in response to critiques of biomedicine, and is premised on a notion of a more equal relationship between GP and patient, and one that places importance on the context of patients’ lives. It contains an implicit promise that it will help GP and patient engage with and confront social disadvantage.

THESIS (D.N.P. (Doctor of Nursing Practice))--School of Nursing, University of San Francisco, 2009. / Bibliography: leaves 41-43 (first series)

Treatment of head and neck cancer with radiation therapy is associated with adverse side effects to the oral cavity and surrounding areas. These complications include mucositis, mucosal fibrosis and atrophy, salivary gland dysfunction, increased risk of dental caries, increased susceptibility to infections, tissue necrosis, taste dysfunction, and muscular and/or cutaneous fibrosis. The often permanent nature of the radiation-induced damage necessitates the maintenance of a strict oral care program, involving frequent flossing and brushing in addition to daily fluoride applications, for the rest of the patient's life. An additional concern among patients with head and neck cancer is the use of tobacco and alcohol. Both are known risk factors in the development of head and neck cancers and failure to abstain from either after diagnosis increases the risk for relapse and development of secondary cancers. The present study was a longitudinal investigation of several factors that may influence patients' consistency in following their prescribed oral care program and abstaining from alcohol and tobacco use, including, but not limited to, patient satisfaction with the doctor-patient communication, patient coping, and patient illness perceptions. The study examined an integrative model seeking to explain patient adherence to the oral care regimen as well as tobacco and alcohol use. While results were inconclusive with respect to the model, there were several interesting findings, which were consistent with previous literature examining doctor-patient communication and illness perceptions among other cancer populations. Results from this study suggested that both satisfaction with doctor-patient communication and coping play an important role in forming patients’ illness perceptions. Furthermore beliefs about the severity of oral complications emerged as a predictor of oral care at follow-up. / text

Aim: The overall aim of this thesis was to describe and explore how sexuality, body image and HRQoL were affected in patients treated for hematologic malignancies, and their need for support. A further aim was to describe nurses’ conceptions of dialogues about sexuality. Methods: Ten nurses in cancer care (I) and twelve patients were interviewed (II). Data were analysed according to phenomenography (I-II). Data were also collected from patients (≥45 years) included consecutively: at baseline (n=32), one month (n=25; III-IV) and six months (n=20; IV) after treatment. Three instruments were used: SAQ-S, BIS and EORTC QLQ-C30. The data were analysed statistically. Main findings: The nurses (I) conceived that they should talk about sexuality with cancer patients, but usually did not due to their own attitudes, lack of knowledge about sexuality, communication skills and environmental conditions. The patients (II) experienced negative effects on sexual function and sexual relationship due to affected strength and sexual desire. The patients’ sexuality, body image and HRQoL were affected during (II-III) and one month after treatment (III-IV). Patients recovered with regard to these issues within six months, except for sexual relationship (IV). However, when the disease and side effects were experienced as severe, thoughts about and interest in sexuality were overshadowed, and the need or wish for support related to this issue was low (II). Sexuality and body image seemed to influence changes in HRQoL (IV). Conclusion: Patients above the age of 45 treated for hematologic malignancies with chemoimmunotherapy experienced problems related to sexuality, body image and HRQoL. However, as sexuality was found to be of low priority due to concerns for life when the disease and side effects were severe, support must be timely and individualized. Patient-centered care, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory, is suggested. / Sexuality is to a large extent seen as a private and sensitive topic by both patients and nurses in cancer care. The patients in this thesis were above the age of 45 and treated with chemo- or chemoimmunotherapy for hematologic malignancies. They experienced affected sexuality, body image and HRQoL during and after treatment. The importance of sexuality was low and sexuality seemed to be overshadowed when the disease and side effects were experienced as severe. Few patients described that information might have been helpful.  In order to avoid violating patients’ integrity, one challenge is to identify patients who ascribe importance to sexuality and who also want support regarding sexuality. One way is to organize care in a patient-centered way, with patients continuously meeting a nurse guided by the idea of holistic individual nursing care throughout the care trajectory. Furthermore, nurse educators’ need to acknowledge this area and the health care leaders should provide nurses opportunities to discuss attitudes and personal barriers to sensitive issues such as sexuality

This study explores the experiences of General Practitioners (GPs) and patients in the management of type 2 diabetes in contemporary Australia. I focus on the way the socioeconomic position of patients is a factor in that experience as my underlying interest is in exploring how health inequalities are understood, approached and handled in general practice. The study is thus a practical and grounded exploration of a widely debated theoretical issue in the study of social life, namely the relationship between the micro day-to-day interactions and events in the lives of individuals and the broad macro structure of society and the position of the individual within that. There is now wide acceptance and evidence that people’s social and economic circumstances impact on their health status and their experiences in the health system. However, there is considerable debate about the role played by primary medical care. Nevertheless, better theoretical understanding of the importance of psychosocial processes in generating social inequalities in health suggests medical care may well be important, as such processes are crucial in the care of chronic illnesses such as diabetes which are now such a large part of general practice work. I approach this study through an exploration of patient centred clinical practice. Patient centredness is a pragmatic, idealised prescriptive framework for clinical practice, particularly general practice. Patient centredness developed in part in response to critiques of biomedicine, and is premised on a notion of a more equal relationship between GP and patient, and one that places importance on the context of patients’ lives. It contains an implicit promise that it will help GP and patient engage with and confront social disadvantage.

Thesis (Ph.D.)--Flinders University, School of Nursing and Midwifery. / Typescript bound. Includes bibliographical references: (leaves 358-375) Also available online.

Thesis (Ph. D.)--University of Hong Kong, 1998. / Vol. 1 in two parts. Includes bibliographical references.

Thesis (M.A. (African Language Studies)) - Rhodes University, 2009.

Thesis (Ph. D.)--Oregon State University, 2007. / Printout. Includes bibliographical references (leaves 142-151). Also available on the World Wide Web.