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There is a growing interest in the impact of waiting for surgery, a common experience for many Canadians. Pain and psychological symptoms prior to surgical management are frequently problems for women with gynaecological conditions, however minimal research was found to investigate pain and psychological symptoms in these women prior to surgery. Also pain is recognized to increase healthcare utilization, but this has not been previously examined in this population. The objectives of this research project were to examine levels of pain, psychological factors associated with pain and frequency of healthcare utilization due to pain in a population of women waiting for gynaecological surgery, predominantly undergoing hysterectomies. Four hundred and twenty nine women in a tertiary care centre in southeastern Ontario were included in the study. Anxiety was measured using the State Trait Anxiety Inventory (STAI), depression with the Centre for Epidemiologic Studies Depression Scale (CES-D), somatization using the Seven Symptom Screening Test (SSST) and catastrophizing was measured using an abbreviated coping strategies questionnaire (CSQ). Pain was assessed using the Brief Pain Inventory (BPI). Women also reported on their healthcare utilization for pain over the past 12 months. The length of wait was obtained from hospital waiting data. Results showed a moderate to severe pain intensity score occurred in 30.5% of women and a moderate to severe interference score in 31.5%. Being younger, married, employed and with high trait anxiety were factors associated with higher rates of healthcare utilization. High levels of depression, somatization and catastrophizing were associated with higher pain intensity and interference scores. This study supports the need for preoperative assessment of physical and psychological symptoms in women waiting for gynaecological surgery. Improving patients’ health prior to surgery will potentially reduce their healthcare demands on a financially constrained healthcare service. / Thesis (Master, Nursing) -- Queen's University, 2009-09-25 12:31:28.298

<p>The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively.</p>

The New Zealand health system is two-tiered with elective treatments are performed by both publicly funded state hospitals and by private hospitals. Publicly funded operations are rationed using a prioritisation system which was introduced in 1998 to curtail expanding waiting lists for elective surgery. One of the aims of the new booking system was to generate national tools for prioritising patients in order to improve the equality of access to public elective surgery throughout New Zealand. However, priority scoring systems were not implemented in a consistent manner and access to elective surgery remains very unequal. Despite large media attention and a high public profile, waiting times have attracted little research in medical geography or within the wider social sciences community. The subject has been partly reserved for public health commentators within the medical field, who have found that variation in waiting times has much to do with the referral practices of physicians, the management of waiting lists by District Health Board (DHB) staff and the amount of private practice that occurs within each district. Most notably several studies have identified that in areas associated with high private admissions, patients tend to suffer higher waiting times for the same procedures in the public hospital system. This study examines the performance of the New Zealand Booking System (NZBS) during the years 2004 to 2007 to assess the equitable delivery of publicly funded elective surgery procedures. Waiting times (NBRS) and admissions (NMDS) datasets were sourced from the New Zealand Health and Information Service (NZHIS) of The Ministry of Health. Mean and Median waiting times were compared spatially between each of New Zealand’s 21 DHBs, compared with Australian waiting times and then broken down into five common medical specialties. Waiting times were then analysed by ethnicity, level of material deprivation and other individual factors using data from the 2006 New Zealand Census. Finally, rates of admissions were calculated for the public and private hospital sectors during the study period. These were used to correlate waiting times results with the amount of private practice in each DHB. ACC cases were extracted from the dataset to avoid bias in waiting times as much of this work is contracted out to the private sector and not subject to lengthy waiting times for treatment. A number of medical specialists and hospital administrators were interviewed to discuss results, explain prioritisation tools and management practices. Results showed large variations in the median waiting times of New Zealand DHBs. A north south gradient is observed in which southern DHBs suffer longer waits for care. Vastly better results were observed for Australian public hospitals than those seen in New Zealand. For waiting times as determined by individual factors, Maori and Pacific Island patients and those from lower socio-economic backgrounds suffered longer waiting times nationwide although, in certain DHBs inequalities for access to elective surgery were exacerbated. However, ethnic differences were more pronounced than socio-economic variations. Admissions results showed significant positive correlations between the amount of private practice and the waiting times experienced in each DHB which are supported by previous research. Feedback from interviews confirmed inconsistency in the use of scoring tools, manipulation occurring on behalf of the DHB management to achieve performance goals set by the Ministry of Health and provided some further explanation of the other quantitative results. Access to elective surgery is determined partly by location of residence, ethnicity, deprivation and where hospital resources are located but most importantly by the willingness to pay for treatment within the private hospital sector and the ability to manipulate the public prioritisation system.

Den här studien är ett examensarbete inom informationsdesign med inriktning rumslig gestaltning. Arbetet omfattar tio veckor av studier som har resulterat i en rapport samt ett gestaltningsförslag. Fokus i studien har varit på att undersöka vilka funktioner som bör tydliggöras i väntrummet på ungdomshälsan i Uppsala. Efter litteraturstudier och insamling av empirisk data har ett designförslag tagits fram. I designförslaget har väntrumsytan utökats. En ny planlösnings syftar till att skapa förutsättningar för både integritet och öppenhet. Ett färgkoncept i väntrummet bidrar till att ungdomarna lättare kan orientera sig samtidigt som informationen om yrkesgrupperna, på ungdomshälsan, synliggjorts. / This study is a thesis in information design, focusing on spatial design. The thesis includes ten weeks of study, which has resulted in a report and a design proposal. The aim of the thesis has been to study the functions that need to be clearer in the waiting room in the adolescence healthcare center in Uppsala. The design proposal is based on literature studies and the collection of empirical data. In the design proposal the waiting room area in the adolescence healthcare center has been made larger, with a new spatial plan that aims to create opportunities for both privacy and openness. A colour concept makes it both easier for the young people to orientate in the waiting room as well as enhancing visual information about the available professions.

Background: With an increased understanding of dialysis-treated patients' experiences of waiting for a kidney transplant, the nurses can adjust their care based on patient's individual needs. A changed life situation that requires regular treatment and limiting the patient in their daily life makes it important that the nurse understands the patient's mood and is there to support. Aim: The aim of this study was to highlight the experiences of dialysis-treated patients waiting for a kidney transplant. Method: A literature study based on qualitative research. Friberg ́s five-step model was used for analyze of the articles and results in three main themes and six sub- themes. Results: This result showed that dialysis-treated patients awaiting a kidney transplant experienced both physical and mental barriers and stress. They experienced limitations in daily life as loss of freedom and financial difficulties. The patients' feelings oscillate between hope and uncertainty like an emotional roller coaster and they find support in their relatives, healthcare professionals or in their religion. Conclusion: The experiences of waiting for a kidney transplant are relatively similar, but strategies to get trough this process varies. Common for all patients were that it was a demanding and stressful time. Therefore it is important that nurses pay attention and adapt the care for each individual.

Magister Public Health - MPH / The aim of the study was to measure patient waiting and service times, describe the causes of high waiting time as well as to determine staff and patient derived norms on waiting times at the Manzini Regional Hospital HIV Clinic. Literature reviewed show that complaints regarding long waiting time have been effectively dealt with through patient flow analysis studies, which measure patient waiting and service times as well as other characteristics. A descriptive cross sectional quantitative survey methodology was undertaken using a time-delimited sample of all patients attending the HIV clinic over one week and all the staff who were in contact with the patients. Waiting time tracking instruments and short questionnaires were used to collect data from both patients and staff. Data were analysed quantitatively. / South Africa

Introduktion/Bakgrund: Transplantation är en livräddande behandling som erbjuds när ingen annan behandling leder till förbättrat tillstånd. Organbristen är idag större än utbudet som finns för organ. Väntelistan för att få ett nytt organ är lång och som konsekvens av detta kan individer avlida innan transplantation. Det finns levande och avlidna donatorer, där levande donatorer behöver öka i antal för att utveckla möjligheten till fler organtransplantationer. Det är angeläget att sjuksköterskan tillgodoser andliga, existentiella, sociala och psykiska behov i lika stor utsträckning som fysiska behov avseende omvårdnadsinterventioner. Syfte: Undersöka hur individer beskriver väntan på en organtransplantation. Metod: Litteraturstudien har framställts genom Polit och Beck’s (2017) nio steg och är systematiskt utformad genom datainsamling från databaserna Cinahl, PubMed och PsycINFO. Resultatet inkluderar elva vetenskapliga artiklar, varav nio kvalitativa och två kvantitativa studier. Resultat: I litteraturstudien identifierades fyra kategorier; en evig kamp, brist på frihet, det okända och livet med andra som beskriver väntan. Slutsats: Litteraturstudiens resultat beskriver upplevelser av både negativ och positiv karaktär. Begränsningar i livet är främst vad som påverkar välbefinnandet hos individer och bidrar även till psykologiska utmaningar. Väntetiden är en individuell upplevelse där information och stöttning från sjuksköterskan är angeläget för att förebygga ohälsa.

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13421号 / 論医博第2229号 / 新制||医||1052(附属図書館) / (主査)教授 伊達 洋至, 教授 大鶴 繁, 教授 中山 健夫 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Consider a sequence (Formula presented.) of i.i.d. uniform random variables taking values in the alphabet set {1, 2,…, d}. A k-superpattern is a realization of (Formula presented.) that contains, as an embedded subsequence, each of the non-order-isomorphic subpatterns of length k. We focus on the (non-trivial) case of d = k = 3 and study the waiting time distribution of (Formula presented.). Our restricted set-up leads to proofs that are very combinatorial in nature, since we are essentially conducting a string analysis.