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Patients’ perceptions of actual care conditions and patient satisfaction with care quality in hospitalAbrahamsen Grøndahl, Vigdis January 2012 (has links)
There are theoretical and methodological difficulties in measuring the concepts of quality of care and patient satisfaction, and the conditions associated with these concepts. A theoretical framework of patient satisfaction and a theoretical model of quality of care have been used as the theoretical basis in this thesis. Aim. The overall aim was to describe and explore relationships between person-related conditions, external objective care conditions, patients’ perceptions of quality of care, and patient satisfaction with care in hospital. Methods. Quantitative and qualitative methods were used. In the quantitative study (I-III), 528 patients (83.7%) from eight medical, three surgical and one mixed medical/surgical ward in five hospitals in Norway agreed to participate (10% of total discharges). Data collection was conducted using a questionnaire comprising four instruments: Quality from Patients’ Perspective (QPP); Sense of Coherence scale (SOC); Big Five personality traits – the Single-Item Measures of Personality (SIMP); and Emotional Stress Reaction Questionnaire (ESRQ). In addition, questions regarding socio-demographic data and health conditions were asked, and data from ward statistics were included. Multivariate statistical analysis was carried out (I-III). In the qualitative study 22 informants were interviewed (IV). The interviews were analysed by conventional content analysis. Main findings. Patients’ perceptions of quality of care and patient satisfaction ranged from lower to higher depending on whether all patients or groups of patients were studied. The combination of person-related and external objective care conditions explained 55% of patients’ perceptions of quality of care (I). 54.7% of the variance in patient satisfaction was explained, and the person-related conditions had the strongest impact, explaining 51.7% (II). Three clusters of patients were identified regarding their scores on patient satisfaction and patients’ perceptions of quality of care (III). One group consisted of patients who were most satisfied and had the best perceptions of quality of care, a second group of patients who were less satisfied and had better perceptions, and a third group of patients who were less satisfied and had the worst perceptions. The qualitative study revealed four categories of importance for patients’ satisfaction: desire to regain health, need to be met in a professional way as a unique person, perspective on life, and need to have balance between privacy and companionship (IV). Conclusions. Patients’ perceptions of quality of care and patient satisfaction are two different concepts. The person-related conditions seem to be the strongest predictors of patients’ perceptions of quality of care and patient satisfaction. Registered nurses need to be aware of this when planning and conducting nursing care. There is a need of guidelines for handling over‑occupancy, and of procedures for emergency admissions on the wards. The number of registered nurses on the wards needs to be considered. Healthcare personnel must do their utmost to provide the patients with person‑centred care.
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A reforma psiquiÃtrica como projeto inacabado: por uma crÃtica da clÃnica e da polÃtica / The psychiatric reform as an unfinished project: by a critique of the clinic and politicsRaquel Rubim da Rocha GuimarÃes 00 September 2018 (has links)
nÃo hà / O presente estudo pretende discutir as implicaÃÃes das CondiÃÃes de Cuidado sobre o modo de cuidar em um Centro de AtenÃÃo Psicossocial (CAPS) no municÃpio de Fortaleza. As CondiÃÃes de Cuidado discutidas aqui sÃo inspiradas nos estudos da filÃsofa Judith Butler, compreendendo-as como entidades nÃo estÃticas, porÃm, instituiÃÃes e relaÃÃes sociais reproduzÃveis que sustentam e apreendem determinadas vidas. Esta pesquisa qualitativa utilizou como mÃtodo de anÃlise e coleta de dados o DiÃrio de Campo, que nÃo se limita ao registro dos dados, mas, convoca o pesquisador a se implicar com o campo atravÃs da escrita, tornando-se uma ferramenta de registro, afetaÃÃo e interlocuÃÃo. Foram utilizadas extensas anotaÃÃes sistemÃticas e gravaÃÃes das reuniÃes de equipe (denominadas Roda de Conversa) durante sete encontros semanais. Ao longo do trajeto de pesquisa sÃo apontadas as mudanÃas metodolÃgicas necessÃrias à entrada da pesquisadora no campo prÃtico, redefinindo todo o objetivo inicial. Buscou-se pautar as anÃlises sob a Ãptica da Psicologia Social CrÃtica na interlocuÃÃo com diferentes autores da Reforma PsiquiÃtrica de cunho antimanicomial. Nesta direÃÃo, tornou-se importante um resgate histÃrico para compreensÃo das mudanÃas nas polÃticas de assistÃncia à saÃde mental brasileira desde o final da dÃcada de 1970, sinalizando, inclusive, as mudanÃas tÃcnicas assistenciais a partir de 2015, com a mudanÃa na gestÃo da CoordenaÃÃo-Geral de SaÃde Mental, Ãlcool e Outras Drogas, apontadas por alguns trabalhadores e estudiosos da SaÃde Mental, como retorno Ãs prÃticas manicomiais. Em seguida sÃo apresentadas as reuniÃes de forma sequencial, com a proposta de tornar mais fÃcil a leitura e a compreensÃo do desenho da pesquisa. A partir deste capÃtulo e da demarcaÃÃo de algumas temÃticas, foram traÃadas e discutidas trÃs categorias de anÃlise: Acolhimento em SaÃde Mental, Apatia e Adoecimento do Trabalhador do CAPS e CondiÃÃes de Cuidado. As crÃticas elaboradas estiveram comprometidas com a proposta da âdesinstitucionalizaÃÃoâ, importante conceito para o movimento de transformaÃÃo do cuidado. Por Ãltimo, sÃo tecidas consideraÃÃes pertinentes para que a Reforma se torne um projeto permanente de questionamento das aÃÃes de cuidado e suas interseÃÃes com as condiÃÃes polÃtico-sociais.
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