Health care professionals have begun to view family members as an integral part of the healing process and the well-being of patients in the intensive care unit. The needs of family members may be varied, and nurses must become attuned to the family members' needs and acquire skills to direct interventions toward identifying and meeting those needs. The aim of the research study was to explore and identify the perceptions of family members' needs and to ascertain if those needs were perceived as met or unmet by the family members of patients housed in the intensive care units. The hypothesis proposed that a gap exists between identified needs of family members visiting intensive care patients and their perceptions of needs as being met or unmet. Data analysis included quantitative and qualitative methods.

No description available.

No description available.

The goal of this investigation was to assess service use, self-management strategies, and health status of older adults (60+ years) with perceived need who sought assistance from the Virginia Medicaid Elderly and Disabled Consumer-Direction (EDCD) waiver services. A sequential explanatory mixed method design was used to address the overall research question: How do older adults manage unmet needs? Using health services data from two independent State agencies, regression techniques were used to examine predictors of service use, hospitalization, and mortality among 1,008 individuals. A purposive subsample of eight rural-dwelling waiver-ineligible individuals was identified for follow-up semi-structured telephone interviews to explore self-management strategies for confronting functional care needs. Waiver-ineligible individuals were at risk for hospitalization and mortality; rural-dwelling individuals were more likely to be waiver-ineligible and had increased risk of mortality. Analysis of interviews revealed individuals had ongoing unmet needs and relied on family and community services and used internal and external strategies to manage them; plans were not in place should their health continued to decline. For this group of near-risk older adults who are waiver-ineligible and do not have financial means to pay for more help, accessible preventive services are necessary to reduce risk of adverse health outcomes. Policymakers are encouraged to advocate for preventive services that assist individuals before care needs become unmanageable. Agencies responsible for service delivery need to target efforts toward this group, particularly those residing in rural areas. Researchers must continue forging partnerships that permit use of health services data to identify when and how older adults use services, and explore how self-management strategies influence health and functioning over time. / Ph. D. / The purpose of this research was to advance understanding of help-seeking behaviors of lowincome older adults who were deemed ineligible to receive state-funded assistance. I used health services data from two independent state agencies to assess factors associated with service use and health status; follow-up interviews were conducted to explore self-management strategies of rural older adults with unmet needs. Older adults who did not receive help were at increased risk for hospitalization and mortality compared to individuals who received helped. Rural older adults were significantly more likely to not receive help and were at increased risk for mortality, placing them in a vulnerable position. Interviews with rural-dwelling older adults that were not receiving help highlighted the challenges associated with living with unmet needs but demonstrated resilience through their use of physical and psychological coping mechanisms to navigate daily challenges and maintain health and well-being. They had to deal with numerous difficulties performing instrumental activities of daily living (IADL); mobility was an underlying problem that led to subsequent IADL limitations, such as difficulty with household chores and meal preparation. Policymakers need to advocate for services that allow older adults to address preemptively their care needs before they become unmanageable. Ensuring the availability of services for near-risk older adults who are proactive in addressing their functional care needs would benefit individuals and caregivers on whom they rely. Such services not only support older adults’ health, functioning, and well-being but may be cost-effective for public programs. Policies should reduce unmet needs among older adults by increasing service access in rural communities because even if services exist, they may not be available to this near-risk population of older adults.

Résumé: Introduction: Cette étude s’intéresse à l’expérience de soins de patients aînés de 70 ans et plus atteints de cancer entourant une visite à l’urgence. Elle repose sur plusieurs résultats d’études démontrant que ces personnes présentent des besoins spécifiques non comblés, les amenant à utiliser les services d’urgence pour y répondre. Peu d’études se sont intéressées à leur expérience de soins et encore plus rarement dans le contexte d’une visite à l’urgence. But : Mieux comprendre l’expérience de soins des patients aînés atteints de cancer entourant une visite à l’urgence. Cette étude comprend quatre objectifs soit : 1) établir le profil des patients de 70 ans et plus ayant consulté l’urgence pour un problème lié à leur cancer dans les 12 mois précédant l’étude; 2) identifier les raisons et les facteurs amenant ces patients à consulter les services d’urgence; 3) identifier les stratégies de coping utilisées avant d’aller à l’urgence et 4) décrire l’expérience de soins de ces patients à l’urgence. Méthode: Une étude à devis mixte simultané a été entreprise. Une analyse descriptive des bases de données administratives a été réalisée pour documenter le profil sociodémographique, clinique et l'utilisation des services des patients aînés atteints de cancer de 70 ans et plus qui ont visité l'urgence d'un centre hospitalier au Québec, le Canada (n = 792, Objectifs 1-2). Ensuite, des entrevues semi-structurées ont suivi (n = 11) et ont été analysées par une analyse de contenu en profondeur (Objectifs 2, 3, & 4). Résultats: Un total de 792 patients aînés atteints de cancer ont visité l'urgence pour un total de 1572 visites. Les raisons de consultation les plus fréquentes étaient de nature respiratoire (15,8%), digestive (13,4%) et les troubles cardiovasculaires (8,2%). Plus de la moitié des visites était réalisée de jour. L’anxiété, les problèmes d’accessibilité et la détérioration importante de la santé étaient des facteurs qui influençaient le recours aux services d’urgence. Les patients ont été en mesure de déployer une multitude de stratégies de coping pour faire face à leurs problèmes de santé. Par ailleurs, l’expérience de soins est un processus unique, vécu de manière très individuelle. Conclusion: Cette étude décrit l’expérience de soins de patients aînés atteints de cancer à l’urgence et souligne plusieurs domaines d’amélioration des services en périphérie de l’urgence, mais aussi au sein même du service d’urgence. / Abstract: Introduction: Older cancer patients are known to have specific unmet needs due to the complexity of their health care, leading them to use emergency services. However, it is known that emergency rooms are not well-suited to the needs of the elderly. Few studies have focused on the health care experience of older cancer patients and even less so in the context of emergency room (ER) visits. Purpose: This study aims to better understand the experience of older cancer patients in the context of ER visits for unexpected health deterioration related to cancer. We sought to: 1) establish the profile of patients aged 70 years and older who made ER visits for problems related to their cancer in the 12 months preceding the study; 2) identify the reasons and factors that motivate older patients with cancer to make ER visits; 3) identify coping strategies used by older cancer patients prior to ER visits; and 4) describe the health care experience of older cancer patients in the context of ER visits. Methods: A concurrent mixed-method design was used. Descriptive analysis of administrative databases was first conducted to document the socio-demographic, clinical, and service utilization profile of elderly cancer patients aged 70 years and older who visited the ER of a hospital in Québec, Canada (n = 792, Objectives 1-2). Semi-structured interviews were subsequently conducted (n = 11) and then analysed using in-depth content analysis (Objectives 2, 3, & 4). Results: The sample of 792 older cancer patients made a total of 1,572 ER visits. The most frequent medical reasons for ER visits were respiratory (15.8%) and digestive (13.4%) concerns, and cardiovascular conditions (8.2%). Content analysis of the qualitative data suggested that older cancer patients made most of the ER visits when experiencing high levels of anxiety, when other cancer care services were unavailable, or because of a serious life-threatening health condition. Patients were able to use a variety of coping strategies to deal with health issues. Furthermore, the care process is experienced uniquely for each individual. Conclusion: This study describes the health care experience of older cancer patients in the context of ER visits and suggests areas of improvement both outside of and within emergency services.

<p>Bakgrund: Idag finns det cirka 40 000 individer som har diagnosen schizofreni i Sverige. Schizofreni innebär psykisk ohälsa i form av bland annat hallucinationer, vanföreställningar samt apati och passivitet, vilket leder till en försämrad livskvalitet. Syfte: Syftet med litteraturstudien var att belysa upplevelsen av livskvalitet hos patienter med diagnosen schizofreni. Metod: Studien utfördes som en allmän litteraturstudie där sju vetenskapliga artiklar, som var relevanta till syftet, valdes ut, kvalitetsgranskades och analyserades. Resultat: Resultatet delades in i fem olika rubriker. Det visade sig att svåra symtom, civilstatus, socialt nätverk, otillfredsställda behov och ekonomi alla vara direkt relaterade till livskvaliteten hos patienter med schizofreni. Slutsats: Förbättrade levnadsförhållanden betyder inte nödvändigtvis förbättrad livskvalitet. Många faktorer bland annat trygg och lugn omgivning, bra ekonomi och ett bra socialt nätverk påverkar livskvaliteten. Därför bör sjukvårdspersonal tillgodose patienternas behov på ett adekvat sätt och därmed bidra till en förbättrad livskvalitet.</p> / <p>Background: About 40 000 individuals in Sweden lives with the diagnose schizophrenia. Schizophrenia involves psychiatric disease with symptoms such as hallucinations, delusions, apathy and passivity, which lead to a decline in quality of life. Purpose: The purpose of the study was to elucidate the experience of quality of life in patients with schizophrenia. Method: The study was conducted as a literature review where seven scientific articles were chosen, critically reviewed and analysed. Result: The result was divided in to five different categories. Severe symptoms, marital status, social network, unmet needs and economy appeared to be all directly related to quality of life in patients with schizophrenia. Conclusion: Improved living conditions do not necessarily improve quality of life. Many factors including security, quiet environment, good economy and a good social network affects the quality of life. Therefore, health care professionals should meet patient needs in an adequate manner and thus contribute to an improved quality of life.</p>

<p>The first objective of this study is to show if diffusion of contraception in areas of traditional high fertility has gone through profound changes. Indeed, we would like to know if contraceptive behaviours have evolved because of new fertility perceptions and also because partners now have greater freedom to make choices in a relationship. The second objective of this study is not only to highlight the levels and trends of contraception and the factors influencing their use (government policies, role of family planning, etc.) in developing countries, but also to consider the population of unmet-needs of contraception. Indeed, the level of contraceptive use depends obviously on users, but also on non-users with no needs and non-users with unsatisfied needs. The understanding of this last category of females is essential to a more accurate estimation of contraception levels, and, therefore for the estimation of fertility levels. This study analyses the contraceptive use in several developing countries in Africa and highlights the unsatisfied needs of contraception, to understand why such needs exist. To do so, we shall analyse available demographic data for thirty-five African countries by using the available Demographic and Health Surveys (DHS), from the 1980&rsquo / s to 2000&rsquo / s considering the DHS I, DHS II, DHS III and DHS IV. This great variety of surveys, seventy-nine in total, permits one to compare levels of contraception and &ldquo / unmet-needs&rdquo / from country to country. The surveys also, make it possible to compare the evolution over time of specific countries or specific regions, and to subsequently comprehend the determining factors of contraceptive use or non-use.</p>

Bakgrund: Idag finns det cirka 40 000 individer som har diagnosen schizofreni i Sverige. Schizofreni innebär psykisk ohälsa i form av bland annat hallucinationer, vanföreställningar samt apati och passivitet, vilket leder till en försämrad livskvalitet. Syfte: Syftet med litteraturstudien var att belysa upplevelsen av livskvalitet hos patienter med diagnosen schizofreni. Metod: Studien utfördes som en allmän litteraturstudie där sju vetenskapliga artiklar, som var relevanta till syftet, valdes ut, kvalitetsgranskades och analyserades. Resultat: Resultatet delades in i fem olika rubriker. Det visade sig att svåra symtom, civilstatus, socialt nätverk, otillfredsställda behov och ekonomi alla vara direkt relaterade till livskvaliteten hos patienter med schizofreni. Slutsats: Förbättrade levnadsförhållanden betyder inte nödvändigtvis förbättrad livskvalitet. Många faktorer bland annat trygg och lugn omgivning, bra ekonomi och ett bra socialt nätverk påverkar livskvaliteten. Därför bör sjukvårdspersonal tillgodose patienternas behov på ett adekvat sätt och därmed bidra till en förbättrad livskvalitet. / Background: About 40 000 individuals in Sweden lives with the diagnose schizophrenia. Schizophrenia involves psychiatric disease with symptoms such as hallucinations, delusions, apathy and passivity, which lead to a decline in quality of life. Purpose: The purpose of the study was to elucidate the experience of quality of life in patients with schizophrenia. Method: The study was conducted as a literature review where seven scientific articles were chosen, critically reviewed and analysed. Result: The result was divided in to five different categories. Severe symptoms, marital status, social network, unmet needs and economy appeared to be all directly related to quality of life in patients with schizophrenia. Conclusion: Improved living conditions do not necessarily improve quality of life. Many factors including security, quiet environment, good economy and a good social network affects the quality of life. Therefore, health care professionals should meet patient needs in an adequate manner and thus contribute to an improved quality of life.

<p>The first objective of this study is to show if diffusion of contraception in areas of traditional high fertility has gone through profound changes. Indeed, we would like to know if contraceptive behaviours have evolved because of new fertility perceptions and also because partners now have greater freedom to make choices in a relationship. The second objective of this study is not only to highlight the levels and trends of contraception and the factors influencing their use (government policies, role of family planning, etc.) in developing countries, but also to consider the population of unmet-needs of contraception. Indeed, the level of contraceptive use depends obviously on users, but also on non-users with no needs and non-users with unsatisfied needs. The understanding of this last category of females is essential to a more accurate estimation of contraception levels, and, therefore for the estimation of fertility levels. This study analyses the contraceptive use in several developing countries in Africa and highlights the unsatisfied needs of contraception, to understand why such needs exist. To do so, we shall analyse available demographic data for thirty-five African countries by using the available Demographic and Health Surveys (DHS), from the 1980&rsquo / s to 2000&rsquo / s considering the DHS I, DHS II, DHS III and DHS IV. This great variety of surveys, seventy-nine in total, permits one to compare levels of contraception and &ldquo / unmet-needs&rdquo / from country to country. The surveys also, make it possible to compare the evolution over time of specific countries or specific regions, and to subsequently comprehend the determining factors of contraceptive use or non-use.</p>

Philosophiae Doctor - PhD / The first objective of this study is to show if diffusion of contraception in areas of traditional high fertility has gone through profound changes. Indeed, we would like to know if contraceptive behaviours have evolved because of new fertility perceptions and also because partners now have greater freedom to make choices in a relationship. The second objective of this study is not only to highlight the levels and trends of contraception and the factors influencing their use (government policies, role of family planning, etc.) in developing countries, but also to consider the population of unmet-needs of contraception. Indeed, the level of contraceptive use depends obviously on users, but also on non-users with no needs and non-users with unsatisfied needs. The understanding of this last category of females is essential to a more accurate estimation of contraception levels, and, therefore for the estimation of fertility levels. This study analyses the contraceptive use in several developing countries in Africa and highlights the unsatisfied needs of contraception, to understand why such needs exist. To do so, we shall analyse available demographic data for thirty-five African countries by using the available Demographic and Health Surveys (DHS), from the 1980's to 2000's considering the DHS I, DHS II, DHS III and DHS IV. This great variety of surveys, seventy-nine in total, permits one to compare levels of contraception and 'unmet-needs' from country to country. The surveys also, make it possible to compare the evolution over time of specific countries or specific regions, and to subsequently comprehend the determining factors of contraceptive use or non-use. / South Africa