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Patient-care skills in medicine have become more important over time to promote the health and well-being of patients. It has become critical to research how medical schools can best teach students patient-care skills. This is a mixed-method study on the experiences of first and second-year Boston University School of Medicine students and faculty about the relationship between their medical school curriculum and patient-centered care skills including communication, empathy, and the cultural context of care. Patient-centered care and its accompanying skills (empathy, communication, and cultural context of care) are supported and developed at the Boston University school of Medicine. These skills are promoted through curricular adaptation influenced by changing concerns within biomedicine. As well as Doctoring 1 and 2 courses, their patient-actor events, and the development of students’ professional physician identity. Methods will include participant observation and review of curriculum and program documents. This study also includes surveying first and second-year students and in-depth interviews with students and faculty. The conclusion of this study is the importance of evaluating medical school curriculum as it relates to patient-centered care skills, and particularly how those skills are utilized in the clinical world.

Bakgrund Missfall drabbar ca 20% av alla kvinnor med bekräftade graviditeter i Sverige. Den vanligaste orsaken till missfall är kromosomavvikelser hos fostret. Riskfaktorer för missfall är bland annat om kvinnan har diabetes mellitus eller en sköldkörtelsjukdom som inte är medicinskt välinställd. Även livsstilsrelaterade riskfaktorer föreligger. Vid missfall kan kvinnan uppleva en känsla av att sakna kontroll och hjälplöshet. Ett missfall kan upplevas traumatiskt och förlusten kan påverka kvinnan under en längre tid. Viktiga omvårdnadsåtgärder som lyfts upp är information om vem kvinnan kan kontakta och allmän information, samt även att vara lyhörd som sjuksköterska. Syfte Syftet var att belysa kvinnors upplevelse av omvårdnad vid missfall.​ Metod En litteraturöversikt som inkluderat 7 kvalitativa artiklar samt 3 artiklar med mixad metod. Litteratursökningen genomfördes i databaserna Cinahl complete och PubMed. Resultat Resultatet presenteras i tre huvudteman: Vårdmiljön skapar oro och ovisshet, Vikten av omvårdnadsinformatik och Vikten av psykosocialt stöd. Resultatet visar bland annat på att kvinnor upplevde att väntan på svar kring diagnostiseringen av missfallet skapade ångest och oro, medan snabb hantering och behandling värdesattes. Även en bristande medkänsla från sjuksköterskor i samband med missfall framkom och bristande information kring missfall samt att många kvinnor kände att de lämnades frågandes efter ett missfall. Slutsats Trots vissa positiva upplevelser av omvårdnad vid missfall, såsom tydlig information och emotionellt stöd från sjuksköterskor, var de negativa upplevelserna övervägande. Kvinnor upplevde en otrygg vårdmiljö, bristande bemötande och bristande information. Kvinnor efterfrågade mer information samt tydlig och direkt kommunikation samt uppföljning. Den känslomässiga hanteringen av förlusten upplevdes lättare om sjukvårdspersonal hade ett bemötande med medkänsla då det upplevdes som tröstande. / Background Miscarriage affetcs around 20% of all women with confirmed pregnancies in Sweden. The most common cause of miscarriage is chromosomal abnormalities in the fetus. Various diseases can consitute risk factors, such as diabetes mellitus or thyroid disease that’s not medicaly well-controlled. Lifestyle-related risk factors also exist. During a miscarriage, the women can experience a sense of lacking control and helplessness. A miscarriage can be perceived as traumatic and the loss can impact the woman for an extended period. Essential nursing measures that were highlighted include providing information about who the women can contact and general information. Additionally, being attentive as a nurse is important. Aim The aim was to enlighten women’s experience of nursing care in the context of miscarriage. Method A literature review including 7 qualitative atricles and 3 articles with mixed method. The literature search was conducted in the databases Cinahl complete and PubMed. Results The results are presented in three main themes: The healthcare environment creates anxiety and uncertainty, The importance of nursing informatics and The importance of psychosocial support. The findings indicated, among other things, that women experience anxiety and worry during the wait for diagnostic results of the miscarriage, quick handling and treatment was valued. A lack of compassion from nurses in connection with miscarriage was evident, leaving many women with unanswered questions after a miscarriage.​ Conclusions Despite some positive experiences of care during miscarriage, such as clear information and emotional support from nurses, the negative experiences were dominant. Women perceived an insecure care environment, inadequate treatment och lack of information. Women sought more information as well as clear and direct communication and follow-up. The emotional handling of the loss was perceived easier if the nurses approached it with compassion, as it was found to be comforting.

‎Nursing is a trusted profession aimed at delivering quality, patient-centered care perceived by patients as caring and satisfactory. While empiric care components are measurable as associated with clinical outcomes, patients’ perceptions of care are increasingly important in determining satisfaction with the patient care experience. Not clearly defined, nor empirically measurable, the “art” of nursing is taking on increasing importance as a component of satisfaction with the patient experience. The purpose of this integrative literature review was to review the literature in order to find common themes influencing determination of the art of nursing on patient satisfaction in acute care settings. Fourteen studies were selected and reviewed after a search of CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ERIC, MEDLINE, PsycARTICLES, and PsycINFOCINAHL databases. Four themes that emerged: building a relationship with the patient; conducting a thorough assessment of the patient; meaningful communication with the patient, and availability of nurses for their patients. The findings suggest that the art of nursing, as grounded in the demonstration of nursing care behaviors, is a component of patients’ satisfaction with the provision of care. This evidence-based knowledge is transferable to efforts in modifying nursing practices that exemplify patient-centered care.

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<p><strong>Objective: </strong>The objective of this thesis is to identify the approaches to patient-centered care provision currently employed by clinicians and to identify patient perspectives of patient-centeredness in relation to pain and disability following distal radius fracture. This thesis includes a scoping review of patient-centered care frameworks and models, as well as a prospective cohort study.</p> <p><strong>Rationale: </strong>Patient-centered care provision has been linked with positive health outcomes, improved patient satisfaction, and reduced health costs. A uniform approach to patient-centered care in rehabilitation has yet to be developed primarily due to the breadth and scope of practice. Understanding current approaches to patient-centered care and patient perspectives on this care can serve as a foundation to future discussions on the development of a rehabilitation-specific approach to patient-centered care provision.</p> <p><strong>Data sources: </strong>Frameworks and models of patient-centered care provision were located via electronic database searches. The extracted frameworks and models were compared based on how they described strategies on achieving the three tenets of patient-centered care: communication, partnership, and health promotion. A prospective cohort study provided patient perspectives on patient-centeredness, pain, and disability following distal radius fracture at baseline and at three months post distal radius fracture in 129 patients.</p> <p><strong>Methods: </strong>Frameworks and models on patient-centered care provision were extracted from articles and placed in data summary tables for comparison and review. Information on how these frameworks and models described strategies for communication, partnership, and health promotion was collated and reviewed. The patients’ perceptions of patient-centeredness, pain, and disability were determined from responses to the Patient Perceptions of Patient-Centeredness Questionnaire and the Patient Rated Wrist Evaluation. Outcome measure responses were analyzed to measure change over time (Wilcoxon Rank Sum and T-Test analyses) and to identify relationships (Pearson correlations).</p> <p><strong>Results: </strong>The scoping review found 19 articles, from which 25 patient-centered care frameworks or models were identified. All frameworks and models reported strategies on achieving effective communication, partnership, and health promotion. The prospective cohort study revealed significant correlations between patient perspectives of patient-centeredness and pain and disability following distal radius fracture. This suggests that positive experiences with patient-centered care provision are correlated with reduction in pain and improvement in function following an acute orthopaedic injury.</p> <p><strong>Implications: </strong>Until a rehabilitation-specific approach to patient-centered care provision is developed, rehabilitation clinicians can be confident that selection of one of the currently employed frameworks or models of patient-centered care will reflect the three tenets of patient-centered care provision. Adopting one of these patient-centered approaches to care provision likely will result in positive health outcomes.</p> / Master of Science Rehabilitation Science (MSc)

Bakgrund: Kroniska venösa bensår är en vävnadsskada i form av svårläkta hudsår som är lokaliserade nedanför knäleden och är orsakade av försämrat blodflöde i venerna. Trots att många människor drabbas av återkommande, smärtsamma och resurskrävande sår är de en medicinskt lågprioriterad grupp. Syfte: Syftet var att beskriva hur det är att leva med venösa bensår. Metod: En litteraturöversikt baserat på tio vetenskapliga originalartiklar. För artikelsökningen använde vi oss av databaserna Cinahl Complete och PubMed. Analysen utfördes inspirerad av Fribergs metod. Resultat: Analysen av artiklarna ledde till tre temaområden: somatiska besvär, psykosocialt lidande och omgivningens förhållningssätt Slutsats: Personer med bensår upplever betydande fysiskt och emotionellt lidande, inklusive smärta, skamkänslor och social isolering. Dessa patienter är beroende av vårdpersonal och anhöriga, och behöver en holistisk vård med fokus på både såret och den mänskliga aspekten. Ytterligare forskning behövs särskilt kring relationen mellan bensårspatienter och deras närmaste familj. / Background Chronic venous leg ulcers are tissue injuries in the form of hard-to-heal skin sores located below the knee, caused by impaired blood flow in the veins. Despite affecting many individuals with recurrent, painful, and resource-intensive sores, they are a medically low-priority group. Aim The aim was to describe what it is like to live with venous leg ulcers. Method A literature review based on ten scientific articles. The databases Cinahl Complete and PubMed was used in search for the articles. The article analysis was based on Friberg's analysis model. Results The analysis of the articles resulted in three thematic areas: somatic symptoms, psychosocial suffering, and the attitudes of the surroundings. Conclusions Individuals with leg ulcers experience significant physical and emotional suffering, including pain, feelings of shame, and social isolation. These patients depend on healthcare professionals and relatives, requiring holistic care that addresses both the wound and the human aspect. Further research is particularly needed regarding the relationship between leg ulcer patients and their immediate family.