No description available.

This study investigates health care providers’ perceptions and practice in culturally sensitive care. 8 in-depth interviews were conducted with health care providers that lasted an average of 25 minutes. The findings revealed that health care providers tend to understand culturally sensitive care within the patient-centered care perspective. Their practice of culturally sensitive care is partially limited by language barriers, cultural barriers, and limited trainings in cultural sensitivity, while interpreting services, verbal and nonverbal communication strategies, collaborations with colleagues and self-education promote their practice of it. These findings underscore the importance of acknowledging health care providers’ influences in promoting culturally sensitive care, and the necessity of offering adequate amount of teachings and trainings in cultural sensitivity at health care programs and hospitals.

Bakgrund: Vårdmiljön kan beskrivas som det fysiska rummet, atmosfären och genom vårdkulturen som råder på vårdavdelningen. Problem: Vid vistelse på sjukhus kan känslor av förlorad kontroll och autonomi uppstå vid en omkullkastat tillvaro. Vad är då betydelsefullt i vårdmiljön för att patienten ska uppleva god hälsa i en annars främmande miljö? Det behövs ökad kunskap om vårdmiljöns betydelse för patientens hälsa. Syfte: Syftet var att skapa en översikt av vårdmiljöns betydelse för patientens hälsa och välbefinnande. Metod: Allmän litteraturöversikt med tio utvalda artiklar. Tre med kvantitativ ansats, sex med kvalitativ ansats och en med mixmetod. Resultat: Patienter önskade integritet och personligt utrymme i vårdmiljön. Musik och konst, samt gemensamma ytor i vårdmiljön skapar förutsättningar för att tillfredsställa patientens sociala och medmänskliga behov, vilket ökar glädje och välbefinnande. Dagsljus, fönster och naturinslag i vårdmiljön hade positiv effekt på patientens hälsa. Gott bemötande och vårdkultur i vårdmiljön gav patienterna trygghet och bidrog till förtrogna relationer med vårdpersonalen. Litteraturöversikten visar att vårdmiljön har betydelse för patientens hälsa. Slutsats: En välplanerad och genomtänkt fysisk vårdmiljö, i kombination med en god vårdkultur, kan optimera förutsättningarna för att främja hälsa hos patienten. / Background: The care environment can be described as the physical space, the atmosphere and through the care culture that prevails in the care ward. Problem: What is important in the care environment for the patient to experience good health? There is a need for increased knowledge about the importance of the care environment for the patient's health. Aim: The aim of this study was to create an overview of the importance of the healthcare environment for the patient's health and well-being. Method: General literature review with ten articles. Three with quantitative approach, six with qualitative approach and one with mix method. Results: Patients wanted privacy and personal space in the care environment. Music and art, as well as common areas in the care environment create conditions for satisfying the patient's social and human needs. Daylight, windows and natural elements in the care environment had a positive effect on the patient's health. Good treatment and care culture in the care environment gave the patients security. The literature review shows that the care environment is important for the patient's health. Conclusions: A well-planned and well-thought-out physical care environment, combined with a good care culture, can optimize the conditions for promoting the patient's health.

No description available.

<p>The main purpose of the present study was to obtain an in-depth understanding of what the final phase of life was like for a group of gravely ill and dying cancer patients, with focus on autonomy, dependency and quality of life. The specific aims were to: 1) describe the patients' autonomy and how the attitudes of relatives and staff promoted/hindered patient participation in decision-making, 2) describe how the patients assessed their quality of life in two care cultures, 3) describe how members of the care team prognosticated the patients' remaining survival time, and 4) investigate continuity of care site in two different care cultures during the patients' final month of life. The theoretical framework consisted of Weisman's concept of an appropriate death, and an ethical perspective based on a dialogical ethic and truthfulness.</p><p>The study comprised 56 consecutively selected adult cancer patients. Data was collected via retrospective interviews with relatives, quality of life assessments by the patients, prognoses/motivations from members in the care team, and register data on the utilisation of forms of care. Both qualitative and quantitative methods were used. </p><p>Four categories respecting autonomy were found; the dying patients exercised their autonomy as self-determiners, co-determiners, delegators and nonparticipators. The co-determiners and delegators practised "shared autonomy" in interaction with relatives and staff, and a dialogue characterised by truthfulness was typical of the interplay. In the assessment of quality of life, half of the patients assessed themselves as satisfied/somewhat satisfied with their situation. The "cognitive-" and "emotional functioning" differed least from that of a normal population, while "physical-", "role functioning" and "global health status/quality of life" differed most. The prognosticated and the actual remaining survival time were in agreement for 19/51 patients (± 0.5 months). Some resistance to prognosticating emerged. The members of the care team used different forms of knowledge to motivate their prognostication. Continuity in terms of care site was fairly high for the majority of dying patients. To a great extent, organisational and structural factors determined the choice of care form. </p>

The main purpose of the present study was to obtain an in-depth understanding of what the final phase of life was like for a group of gravely ill and dying cancer patients, with focus on autonomy, dependency and quality of life. The specific aims were to: 1) describe the patients' autonomy and how the attitudes of relatives and staff promoted/hindered patient participation in decision-making, 2) describe how the patients assessed their quality of life in two care cultures, 3) describe how members of the care team prognosticated the patients' remaining survival time, and 4) investigate continuity of care site in two different care cultures during the patients' final month of life. The theoretical framework consisted of Weisman's concept of an appropriate death, and an ethical perspective based on a dialogical ethic and truthfulness. The study comprised 56 consecutively selected adult cancer patients. Data was collected via retrospective interviews with relatives, quality of life assessments by the patients, prognoses/motivations from members in the care team, and register data on the utilisation of forms of care. Both qualitative and quantitative methods were used. Four categories respecting autonomy were found; the dying patients exercised their autonomy as self-determiners, co-determiners, delegators and nonparticipators. The co-determiners and delegators practised "shared autonomy" in interaction with relatives and staff, and a dialogue characterised by truthfulness was typical of the interplay. In the assessment of quality of life, half of the patients assessed themselves as satisfied/somewhat satisfied with their situation. The "cognitive-" and "emotional functioning" differed least from that of a normal population, while "physical-", "role functioning" and "global health status/quality of life" differed most. The prognosticated and the actual remaining survival time were in agreement for 19/51 patients (± 0.5 months). Some resistance to prognosticating emerged. The members of the care team used different forms of knowledge to motivate their prognostication. Continuity in terms of care site was fairly high for the majority of dying patients. To a great extent, organisational and structural factors determined the choice of care form.

Made available in DSpace on 2014-12-17T14:47:06Z (GMT). No. of bitstreams: 1 FernandaCM_DISSERT.pdf: 1137756 bytes, checksum: 7cb24bccd724ebccb062ea10fea94d2d (MD5) Previous issue date: 2014-02-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Popular practices correspond to the resources used by households, lay people and popular therapists, whose perception of knowledge is constructed in the everyday. In this context, the sick child can become vulnerable to be dependent on a family caregiver, who often decide to employ popular practices. Thus, the child care should be shared between carer and health professional. However, they know little about the resources that the family uses to detect a grievance in infant. Therefore, the present research aimed to analyse the use of popular practices by caregivers of children with zero to five years old. We conducted an exploratory and descriptive study with a qualitative approach, together with 15 caregivers of children who were treated at the Joint Unit Felipe Shrimp, located in Natal, Rio Grande do Norte, Brazil. To select the participants, they should be age and above 18 years; be caregivers of children up to five years of age; and reside in the area ascribed the Joint Unit Felipe Shrimp. The data collection took place between September and October 2013, through in depth interview. This step was preceded by the approval of the Health Department of the city of Natal; the direction of the Joint Unit Felipe Shrimp; as well as, the Committee on Ethics in Research from the Federal University of Rio Grande do Norte with Certificate of Presentation and Consideration Ethics, No 15467013.8.0000.5537. Furthermore, the interviewees formally authorized their participation in the research by signing the consent form. The data were treated according to the technique of content analysis in the form of thematic analysis according to Bardin. This process, four categories emerged: "Types of popular practices used in the care of the child"; "Source of information of popular practices"; "Results obtained with popular practices"; "Factors that hinder the adoption of common practices." The results showed the use of popular practices by caregivers in the case of illness to children such as the homemade preparations with medicinal plants and folk healers. The family environment was referenced as the main learning space and spread of popular practices, which are influenced by cultural relations present in this context. As to the results obtained with popular features, the caregivers said to be satisfactory, and this triggers a feeling of confidence and acceptability of such measures. It is concluded that the use of popular practices in child care persists in everyday most of the participants, despite the hegemony of allopathic therapy. The caregivers stated that such practices are effective and easy to obtain, being secured in context by popular culture. In addition, health professionals, especially nurses, were seldom mentioned by the caregivers as to the information concerning popular resources used by them, which suggests the weakness in dialogic process of negotiating practices between both of them / As pr?ticas populares correspondem aos recursos utilizados pelas fam?lias, pessoas leigas e terapeutas populares, cuja apreens?o do saber se constr?i no cotidiano. Nesse contexto, a crian?a doente pode se tornar vulner?vel por estar na depend?ncia de um cuidador familiar, o qual, muitas vezes decide empregar pr?ticas populares. Assim, o cuidado ? crian?a deveria ser compartilhado entre cuidador e profissional de sa?de. Entretanto, estes pouco sabem sobre os recursos que a fam?lia emprega ao perceber algum agravo no infante. Diante disso, a pesquisa em apre?o objetivou analisar o uso de pr?ticas populares por cuidadoras de crian?as com zero a cinco anos de idade. Realizou-se um estudo explorat?rio e descritivo, com abordagem qualitativa, junto a 15 cuidadoras de crian?as, que eram atendidas na Unidade Mista de Felipe Camar?o, localizada no munic?pio de Natal, Rio Grande do Norte, Brasil. Para escolha das participantes, estas deveriam ter idade igual ou superior a 18 anos; ser cuidadora de crian?a(s) com at? cinco anos de idade; e, residir na ?rea adscrita da Unidade Mista de Felipe Camar?o. A coleta de dados ocorreu entre os meses de setembro e outubro de 2013, por meio da entrevista em profundidade. Esta etapa foi antecedida pela anu?ncia da Secretaria de Sa?de do munic?pio de Natal; da dire??o da Unidade Mista de Felipe Camar?o; bem como, do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, com Certificado de Apresenta??o e Aprecia??o ?tica, n? 15467013.8.0000.5537. Al?m disso, as entrevistadas autorizaram formalmente a participa??o na pesquisa, atrav?s da assinatura do Termo de Consentimento Livre e Esclarecido. Os dados foram tratados conforme a t?cnica de An?lise de Conte?do na modalidade de an?lise tem?tica, segundo Bardin. Deste processo, emergiram quatro categorias: Tipos de pr?ticas populares utilizadas nos cuidados com a crian?a ; Fonte de informa??es das pr?ticas populares ; Resultados obtidos com as pr?ticas populares ; Fatores que dificultam a ado??o de pr?ticas populares . Os resultados revelaram a utiliza??o de pr?ticas populares pelas cuidadoras, nos casos de adoecimento da crian?a, a exemplo: das prepara??es caseiras com plantas medicinais e da rezadeira. O ambiente familiar foi referenciado como principal espa?o de aprendizado e propaga??o das pr?ticas populares, as quais s?o influenciadas pelas rela??es culturais presentes nesse contexto. Quanto aos resultados obtidos com os recursos populares, as cuidadoras afirmaram ser satisfat?rios, e isto desencadeia um sentimento de confian?a e aceitabilidade de tais medidas. Conclui-se, que o uso de pr?ticas populares no cuidado ? crian?a persiste no cotidiano da maioria das fam?lias estudadas, apesar da hegemonia da terapia alop?tica. As cuidadoras afirmaram que tais pr?ticas s?o eficazes e de f?cil obten??o, estando asseguradas no seu contexto pela cultura popular. Al?m disso, os profissionais de sa?de, sobretudo os enfermeiros, foram pouco citados pelas cuidadoras quanto ?s informa??es referentes aos recursos populares utilizados por elas, o que sugere a fragilidade no processo dial?gico e de negocia??o de pr?ticas entre ambos

The aim of this study is to explore and describe the coping skills of registered nurses in a changed working environment. The research is conducted in the City Health clinics. The objectives of the study are: &#61623; to identify strategies which nurses use to cope with the changes in the health care services; &#61623; to explore appropriate support systems that will enhance the coping skills of registered nurses in clinics in the City Health Department; and &#61623; to deduce guidelines on how to support staff from the literature study and the results of the research. The research problem is the following: nurses in primary health care facilities do not adequately cope with major changes in health care delivery. A qualitative approach for the research was chosen. Personal interviews and focus group discussions were used to identify the coping skills of registered nurses. Data analysis was done manually. Transcriptions of recordings of the individual interviews and group discussions were done. Themes were organized and categorized into meaningful links and relationships. The findings indicate that the following factors improve the coping skills of registered nurses: &#61623; team-work and support; &#61623; to voice your opinion when necessary and good communication between staff; &#61623; regular breaks during working hours; &#61623; inherent factors for example strong spiritual and emotional strength that assist registered nurses to cope; &#61623; family support; &#61623; the provision of quality care is rewarding; &#61623; the assistance and support from the church (congregation); &#61623; the effective re-organisation of health services; &#61623; continuous support programs for staff; and &#61623; continuous education to develop skills of registered nurses. / Advanced Nursing -- Psychological aspects / M.A.

The aim of this study is to explore and describe the coping skills of registered nurses in a changed working environment. The research is conducted in the City Health clinics. The objectives of the study are: &#61623; to identify strategies which nurses use to cope with the changes in the health care services; &#61623; to explore appropriate support systems that will enhance the coping skills of registered nurses in clinics in the City Health Department; and &#61623; to deduce guidelines on how to support staff from the literature study and the results of the research. The research problem is the following: nurses in primary health care facilities do not adequately cope with major changes in health care delivery. A qualitative approach for the research was chosen. Personal interviews and focus group discussions were used to identify the coping skills of registered nurses. Data analysis was done manually. Transcriptions of recordings of the individual interviews and group discussions were done. Themes were organized and categorized into meaningful links and relationships. The findings indicate that the following factors improve the coping skills of registered nurses: &#61623; team-work and support; &#61623; to voice your opinion when necessary and good communication between staff; &#61623; regular breaks during working hours; &#61623; inherent factors for example strong spiritual and emotional strength that assist registered nurses to cope; &#61623; family support; &#61623; the provision of quality care is rewarding; &#61623; the assistance and support from the church (congregation); &#61623; the effective re-organisation of health services; &#61623; continuous support programs for staff; and &#61623; continuous education to develop skills of registered nurses. / Advanced Nursing -- Psychological aspects / M.A.

Bakgrund: Bedside-överrapportering är avsedd för att möjliggöra patienternas delaktighet och vara ett personcentrerat tillvägagångssätt där patienternas expertinformation tillvaratas. I tidigare forskning beskriver sjuksköterskorna patienterna som en oanvänd resurs i överrapporteringar (icke bedside). Dessutom erfar sjuksköterskorna tidsbrist och att rapporter var ofullständiga. Patienterna uppskattade i sin tur bedside-överrapportering eftersom de upplever en större kontroll och delaktighet. Dock erfars en utmaning kring känslig information och konfidentialitetsfrågor. Problem: Sjuksköterskorna har en central roll i att möjliggöra patienternas delaktighet och deras erfarenheter anses kunna bidra till en bättre förståelse för utmaningar och möjligheter i bedside-överrapportering. Syfte: Att skapa en kartläggning av sjuksköterskornas erfarenheter av bedside-överrapportering. Metod: Allmän litteraturöversikt för att skapa en översiktlig bild grundad i en analys av 10 artiklar. Resultat: Sjuksköterskorna erfor att patienterna blev mer delaktiga vid bedside-överrapportering och att personcentrerad vård främjades eftersom patienterna hamnade i fokus. Sjuksköterskorna beskrev även utmaningar i bedside-överrapporteringar i huruvida konfidentilitet och integritet röjdes samt avbrott och tidsbrist. Trots detta sågs även förbättringar som att överrapporteringarna erfors bli mer korrekt och komplett och kommunikationen ansågs förbättrad. Utöver detta upplevde sjuksköterskorna sig mer nöjda. Slutsats: Sjuksköterskorna uttryckte en förbättring i patientdelaktighet, personcentrering, kommunikation och rapportering. Dock fanns hinder i patientdelaktighet och problem gällande tidsaspekten och konfidentialitetsfrågor. / Background: Bedside handoff is a person-centred approach that aims to enable patient-participation and ensure the patients’ expert information is utilised. In earlier research nurses describe patients to be an unused resource. Furthermore, nurses find that lack of time and incomplete reports are problems in patient handoffs. Patients appreciate bedside handoffs because they feel more involved and in control. However, there is a perceived challenge concerning sensitive information and confidentiality issues. Problem: Nurses have a crucial role in enabling patient participation and their experiences are considered to help form a greater understanding of the challenges and possibilities relating to bedside handoffs. Purpose: To create an overview of nurses’ experiences of bedside handoff. Method: General literature review to create an overview founded in the analysis of 10 articles. Results: Nurses experienced that patients became more involved with bedside handoffs and that person-centred care was promoted because patients became the focus. Nurses also described challenges with bedside handoff in whether confidentiality and integrity were jeopardised. Moreover, challenges such as interruptions and lack of time were found. Despite this, improvements were also seen such as a more accurate and complete report, and improvements in communication. In addition, nurses felt more satisfied using bedside handoff. Conclusion: Nurses experienced an improvement in patient-participation, person-centred care, communication and in the report itself. However, there were barriers to patient-participation, time limits and confidentiality issues.