Thesis (M.H.A.)--University of Michigan, 1963.

Thesis (M.H.A.)--University of Michigan, 1963.

State run public guardianship programs are legally mandated to provide custodial care for persons deemed incapacitated by the courts. Historically, the majority of state wards were elderly women residing in skilled nursing facilities. Today, those demographics are rapidly changing. This new incapacitated cohort has become less institutionalized, with a rising number of persons who have entered the program with criminal records and who continue to commit crimes. This exploratory study focuses on incapacitated persons (IP) with criminal behaviors in order to seek what intervention(s) might reduce their criminal activity. Relying on routine activity theory, differing levels of supervision were compared to those persons institutionalized 24 hours per day. The results of the study indicated that as levels of residential supervision decrease, criminal activities significantly increase. This study can assist administrators of public guardianship programs better understanding the supervisory needs of their incapacitated citizens as well as improve safety precautions for their respective communities.

Background. Research shows that 91.2% of inpatients at forensic psychiatric wards have a history of drug use and a third of those patients use drugs frequently. To be able to confront and address patients with substance abuse on the ward, the working staff needs to have adequate competence concerning the ability to understand who the patients are. Aim. The aim of this study was to explore how the working staff use their competence when interacting with patients who are influenced by drugs on forensic psychiatric wards. Method. The study was conducted in the western parts of Sweden and at three forensic psychiatric wards. The study was designed after a qualitative design and based on an empirical approach with interviews. The data was collected by interviewing a total of six informants through semi-structured interviews. The interviews were analysed using a qualitative content analysis. Results. The result ended up in eight themes, showing that informants in this study used their competence to recognize substance abuse, to help the patients navigating around potential dangers and create a caring relation. Further they trusted their experience, but all informants requested further education. Conclusion. The informants in this study expressed that they had good strategies in terms of supporting and rehabilitating patients with substance abuse. All informants requested further education about preventing relapse, knowledge about drug abuse and knowing how to work after a relapse.

The purpose of this study or survey is to discover facts that might show the religious, social, and economic activities or practices of the returned missionaries of the Church of Jesus Christ of Latter-day Saints who now live in the Garland Ward of the Bear River Stake, Utah.

<p>This research examines the opinions and viewpoints of former Crown Wards regarding the Assessment and Action Record (the AAR), which is the main documentation associated with the Looking After Children approach implemented for use with all children in care by the Ministry of Children and Youth for the Province of Ontario. This documentation, which consists of hundreds of questions and a research-based, check-list format, forms a significant component of the contact that Children’s Service Workers with Children’s Aid Societies have with children in care. Crown Wards, because they are in the permanent care of their Society, are subjected to the AAR yearly throughout their time in care. Open-ended interviews were conducted with four former Crown Wards from three separate Children’s Aid agencies in southwestern Ontario. While the findings did not bear out the anticipated overt criticism of the AAR documentation, what was salient was the hope that all of the information they gave over the years was being put to good use (that it might help themselves and other Crown Wards), that these former Crown Wards were not aware that they could decline to answer the AAR questions in whole or in part, and that the AAR document is felt to be too long and repetitive. In addition, issues of automatic compliance by children in care with requests made by CAS personnel became a discomforting theme.</p> / Master of Social Work (MSW)

Many existing hospitals have problems with their ward layouts. However, the increase in construction costs and the decrease in the number of hospitals have made renovation more economical than building new facilities. Compounding the problem of inefficient floor layouts is the increasing severity of cases treated on an inpatient basis. This research was designed to evaluate the problems faced by nurses working on long corridor patient wards in Montgomery Regional Hospital in Blacksburg, Virginia. It was shown in the study and through previous studies in the literature that these types of wards have physical design problems that affect adversely nurses’ activities in patient care. This study used a time travel method to evaluate the amount of time the nurses spent traveling between the nurses’ station, patient rooms, and other functional areas. Nurses’ perspectives concerning their physical environment and layout were also studied using a questionnaire. It was found that the travel time on the ward was directly related to the geometry of the ward. It was also shown that the total travel time was dependant on the number of patients in the ward. The average amount of time nurses spent traveling in Ward-A was more than the average time they spent in patient rooms. The average time the nurses spent traveling in Ward-B was less than the average time they spent in patient rooms. In addition to a discussion of the time travel data the study also posed several design solutions to problems found in Montgomery Regional Hospital. / Master of Science

Bakgrund: Att som förälder skapa anknytning till sitt nyfödda barn som vårdas på neonatalavdelning kan vara en utmaning. Sjukhusmiljön kan begränsa interaktionen mellan föräldrar och barn. Familjecentrerad vård betonar relationen mellan sjuksköterskan, föräldrar och barn för att tillgodose barnets omvårdnad. Syfte: Att beskriva föräldrars upplevelser av anknytning till deras nyfödda barn på neonatalavdelning. Metod: Litteraturstudie med beskrivande design. Studierna granskades enligt mall från SBU och analyserades med konventionell innehållsanalys enligt Hsieh &amp; Shannons metod. Resultat: Litteraturstudien resulterade i tre kategorier starka känslor som hindrar anknytning, faktorer som påverkar anknytning och neonatalavdelning. Sex subkategorier identifierades. Traumatisk förlossning, Negativa känslor, sjuksköterskans betydelse för föräldrarollen och anknytning, fysisk närhet, fysiska barriärer/medicinsk utrustning och en hindrande miljö. Föräldrar upplevde olika känslor som påverkade anknytning. Genom samarbete med sjuksköterskan ökade självförtroendet hos föräldrar. Att hålla sitt barn var någonting föräldrar betonade viktigt för anknytningsprocessen. Miljön på avdelningen och kring barnet var även av vikt. Slutsats: Det fanns olika faktorer som påverkade föräldrars anknytning till deras barn. Genom information och stöd från sjuksköterskan kunde föräldrar vara delaktig i vården av deras barn och anknytningen förbättrades. Det var av betydelse att sjuksköterskor hade kunskap om upplevelser av anknytning. Fysisk kontakt och tillgång till barnet utan hinder att förhålla sig till underlättade föräldrars upplevelse av anknytningsprocessen. / Background: As a parent, creating a connection with your newborn child, who is cared for in the neonatal ward, can be a challenge. The hospital environment can limit the interaction between the parent and child. For the care of the child, a focus on the family emphasizes the relation between nurse, parent and child. Aim: To describe the experience of a parents attachment to their newborn child, who is cared for in the neonatal unit. Method: Literature study with descriptive design. The studies were reviewed with a template from SBU and analysed by a conventional content analysis using the Hsieh &amp; Shannon’s method. Results: The literature study resulted in three categories. Strong emotions that prevented attachments, factor’s that affected attachment and neonatal ward. Six subcategories were identified. Traumatic childbirth, negative emotions, the nurse's importance to parental role and attachment, physical proximity, physical barriers/medical equipment and hindering environment. The Parents experienced different emotions affecting attachment. Through cooperation with the nurse, the self-confidence of the parents increased. Holding their child was something that parents emphasized as important for the attachment process. The environment in the ward and around the child was also important. Conclusion: There were a number of factors that affects the parents attachments to their child. The attachment improves by participation in the care following information and support from the nurse. Physical contact with and access to the child without obstacles facilitated the parents experience in the attachment.

Bakgrund: Många patienter har behov av palliativ vård innan de avlider. I Sverige finns idag flera olika alternativ för specialiserad palliativ vård. Dessa räcker dock inte till för att vårda alla palliativa patienter vilket leder till att sjuksköterskor som arbetar på somatiska vårdavdelningar på sjukhus ofta möter dessa patienter. Syfte: Att beskriva sjuksköterskors upplevelser av att ge palliativ vård till patienter som vårdas på somatiska vårdavdelningar. Metod: Studien genomfördes som en litteraturöversikt där 15 artiklar ingick i resultatet. Datainsamling har gjorts i databaserna Cinahl, PubMed och Web of Science. Resultat: Sjuksköterskor upplevde att kommunikationen vid vård av palliativa patienter var svår på flera sätt. Rädsla att bemöta existentiella frågor, tidsbrist och en dysfunktionell kommunikation mellan vårdpersonal upplevdes som svårigheter för sjuksköterskorna. Detta ledde till att sjuksköterskor upplevde ett stort behov av utbildning och kompetensutveckling. Slutsats: Ett stort utbildningsbehov finns hos sjuksköterskor då de upplever många svårigheter i att vårda palliativt. För att kunna utveckla denna vårdform på somatiska avdelningar behövs mer utbildning och forskning inom området. / Background: Many patients are in need of palliative care before they die. In Sweden there are several different options for specialized palliative care today. However, the specialized palliative care units are not sufficient to care for all patients in need of palliative care which leads to that nurses working at somatic wards in hospitals frequently encounter these patients. Aim: To describe nurses experiences of giving palliative care to patients in somatic hospital wards. Method: The study was conducted as a review. Data-collection was performed using the databases Cinahl, PubMed and Web of Science, resulting in the inclusion of 15 articles. Results: When caring for palliative patients, the nurses experienced communication to be difficult in many respects. Experienced difficulties for the nurses were fear to meet existential issues, lack of time and dysfunctional communication between professionals. Nurses experienced a major need for education and updating of skills. Conclusion: As palliative care implies a lot of challenges and difficulties, there is a need of specialized training. In order to develop care in somatic wards more education and research is required in this area.

<p>The welfare of the elderly population is one of the most important goals of the public health services. At macro level the Swedish National Board of Health and Welfare state that the premier goal is for elderly people to have dignified and comfortable lives. They should have a life with a sense of value and feel confident. These ethical values which are expressed on macro level or as normative ethics are expected to prevail at micro level. In our study the micro level is the caring encounter between the elderly patient, next of kin and nurses. Ethical values and morals are important aspects that influence the quality of care, videlicet in empiric ethics.</p><p>The aim of study (I) was to identify and describe the ethical values experienced by the older person in the daily interaction with nurses in a ward for older people during caring encounters. In study (II) the aim was to identify and describe the governing ethical values that next of kin experience in interaction with nurses who care for elderly patients at a geriatric clinic. Study (I) which was an empirical observational study included follow-up interviews. Twenty-two older people participated voluntarily. In study (II) interviews with fourteen next of kin were conducted. In both studies Constant comparative analysis, the core foundation of grounded theory was used.</p><p>Five categories; Being addressed, receiving respect, desiring to participate, increasing self-determination and gaining self-confidence formed the basis for the core category in study (I): Approaching. Approaching concerns the way people become closer to each other in a physical space .It also includes how people become closer to each other in a dialogue, which involves verbal or bodily communication. Approaching indicates the ethical values that guide nurses in their caring encounters with older people. This ethical value is noted by the older person and has an individual value, as well as leading to improved quality of their care. The older person will be confident and satisfied with the caring encounter if the desired components in the nurse’s approaching are exhibited.</p><p>Four categories were identified in study (II): Receiving, showing respect, facilitating participation and showing professionalism. These categories formed the basis of the core category: “Being amenable”, a concept identified in the next of kin’s description of the ethical values that they and the elderly patients perceive in the caring encounter. Being amenable means that the nurses are guided by ethical values; taking into account the elderly patient and next of kin. Nurses who focus on elderly patients’ well-being as a final principle will affect next of kin and their experience of this fundamental situation.</p>