Background: No spine-specific educational tool has been developed using input from all relevant stakeholders, including patients. Purpose: The objective of this study was to determine the information needs of lumbar microdiscectomy patients. Methods: Qualitative methods with thematic analysis was used. Focus groups were conducted with: 1) preoperative microdiscectomy patients; 2) postoperative microdiscectomy patients; 3) spine surgeons; 4) spine fellows; 5) orthopaedic surgery residents; 6) anesthesiologists; 7) surgeons’ administrative assistants; and, 8) preoperative assessment team. Results: Major information needs were related to: anesthesia, surgical procedure details and postoperative course. Patients desire information on postoperative course much more than surgeons perceive. Desired attributes of information tools as well as patient factors that influence the extent of information shared by surgeons were determined. Information resources should be given to patients as soon as they are deemed surgical candidates. Conclusions: Microdiscectomy patients desire more information than currently provided to them – in particular postoperative-related information.

Background: No spine-specific educational tool has been developed using input from all relevant stakeholders, including patients. Purpose: The objective of this study was to determine the information needs of lumbar microdiscectomy patients. Methods: Qualitative methods with thematic analysis was used. Focus groups were conducted with: 1) preoperative microdiscectomy patients; 2) postoperative microdiscectomy patients; 3) spine surgeons; 4) spine fellows; 5) orthopaedic surgery residents; 6) anesthesiologists; 7) surgeons’ administrative assistants; and, 8) preoperative assessment team. Results: Major information needs were related to: anesthesia, surgical procedure details and postoperative course. Patients desire information on postoperative course much more than surgeons perceive. Desired attributes of information tools as well as patient factors that influence the extent of information shared by surgeons were determined. Information resources should be given to patients as soon as they are deemed surgical candidates. Conclusions: Microdiscectomy patients desire more information than currently provided to them – in particular postoperative-related information.

The Limited English Proficiency (LEP) population in the United States requires interpreters in order to receive appropriate medical care. However, interpreters are not used consistently in clinical encounters. This study aims to identify the barriers that interfere with providing this service, as well as to propose some possible ways of overcoming these barriers. A systematic review of the literature was conducted using Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. Twenty articles that presented barriers to interpreter use were identified. These barriers referred to either professional interpreters or ad hoc interpreters, or were general barriers. The barriers to professional interpreter use most frequently identified related to cost. Most of the cost-related barrier citations were found in studies conducted in the U.S. The barriers to ad hoc interpreter use most frequently identified related to concern about the interpreters ability to interpret. I determined that appropriate provision of interpreters to the LEP community would require four elements: 1) The consistent use of professional interpreters, and the elimination of ad hoc interpreter use. 2) Research into the possible financial benefits that may arise from increased interpreter use, and how the cost of providing interpreters may be offset by the widespread benefits of using them. 3) Professionalization of interpreter services, with quality assurance and standardized training and evaluation of interpreters. 4) Increased education and training for patients and providers about the language services that are available and how to access them, and about how to work with an interpreter efficiently and effectively. One possible solution that would allow the implementation of all of the above elements is a national interpretation service.

Includes bibliographical references.

Bakgrund: Diabetes är sjukdom som kan leda till sänkt livskvalitet och lidande för personen som drabbats men även till höga kostnader för samhället. Behandlingen kan bestå av en kombination av läkemedel och livsstilsförändringar, där sjuksköterskan stödjer vårdtagarna genom att undervisa och främja deras empowerment. Forskning visar att det är vanligt förekommande att personer med diabetes har låg följsamhet till sin behandling vilket kan leda till sämre blodsockerkontroll samt ökad risk för diabetesrelaterade komplikationer. Syfte: Syftet var att beskriva faktorer som påverkar följsamheten till behandling vid diabetes typ 2. Metod: En litteraturöversikt där tolv kvantitativa artiklar sammanställdes. Resultat: Högre ålder verkar vara en faktor som främjar följsamheten medan lägre ålder innebär lägre följsamhet. Vårdtagarens uppfattning om sjukdomen och behandlingen visade sig också påverka följsamheten. Personens förmåga att ta läkemedel påverkade följsamheten, där minnesproblematik framstår som ledande orsak till låg följsamhet. Socialt stöd och delaktighet i behandlingen samt patientundervisning är andra faktorer som främjar följsamheten. Slutsats: Litteraturstudien visar på faktorer som sjuksköterskan kan uppmärksamma för att identifiera personer som har risk för låg följsamhet och tidigt sätta in åtgärder. Undervisning och stöd är omvårdnadsåtgärder som skulle kunna påverka vårdtagarnas följsamhet positivt. / Background: Diabetes means lower quality of life amongst the ones that suffer from the disease and it also means high costs for society. The treatment consists of a combination of drugs and lifestyle changes where the nurse supports the patient by providing patient education and promoting empowerment. Research has shown that diabetes patients have a low adherence to treatment which may lead to poorer glucose control and an increased risk of diabetesrelated complications. Purpose: The purpose was to describe factors that contributes to non-adherence in persons that are treated for diabetes type 2. Method: A literature review where twelve quantitative articles where analyzed. Results: Older age seems to be a factor that contributes to adherence while younger age seems to predict non-adherence. The persons view and understanding of the disease and treatment seems to influence the adherence. The ability to take medication seems to be important, with memory problems as a leading cause for non-adherence. Social support, patient participation and patient education are other factors that promotes adherence. Conclusion: This literature review shows factors that can be used by the nurse to identify persons in risk of non-compliance and thereby take action early. The nurse’s measures, such as education and support, may have a positive impact on adherence to treatment.

No description available.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

No description available.

No description available.

Inguinal hernia repair (IHR) is a common ambulatory surgery procedure performed in Canada, after which many patients experience moderate to severe pain. Limited research has been found that examines interventions to reduce pain following ambulatory surgery, and none specifically for patients undergoing IHR. This trial evaluated the effectiveness of an individualized Hernia Repair Education Intervention (HREI) for patients following this ambulatory surgery. Participants (N= 82) were randomized to either the intervention or usual care group pre-operatively in the pre-admission clinic. The HREI included a booklet about managing pain and face-to-face session to discuss its content, and two telephone support calls (before surgery and 24 hours after surgery). The primary outcome was WORST 24 hour pain intensity on movement on post-operative day 2. Secondary outcomes included pain intensity at rest and movement, pain–related interference with activities, pain quality, analgesics taken, and adverse effects at post-operative days 2 and 7. At day 2, the intervention group reported significantly lower scores for all pain intensity outcomes, including WORST 24hr pain on movement (t (df) = 4.7 (73), p< 0.001), WORST 24 hr pain at rest (t (df) = 3.8 (73), p < 0.001), pain NOW at rest (t (df) = 3.3 (73), p = 0.001) and on movement (t (df) = 3.4 (73), p = 0.001). Also on day 2, pain-related interference scores for the intervention group were lower than the usual care group but not significantly different with the bonferroini correction (t (df) = 2.1 (73), p=0.04). The intervention group took significantly fewer opioids on day 2 (t (df) = 3.0 (73), p=0.004). Although there were no differences in any of the pain or interference outcomes on day 7, 36% (n=26) of the total sample reported moderate-severe pain at day 7. Constipation was the adverse effect identified most often, by both groups, on both days 2 and 7.This intervention was effective at post-operative day 2 but revisions need to be made to the intervention to assess for outcomes over a longer period of time.