Background: With the increasing older adult population, new graduate nurses will be providing care for patients with dementia more frequently and should be supported to care for this population during their transition period. Purpose: The purpose of this thesis was to explore the experiences of new graduate nurses providing care for patients with dementia in acute care environments. Methods: An interpretive descriptive qualitative study explored eleven Ontario new graduate nurses’ experiences providing dementia care in acute care environments. A thematic analysis was conducted. Findings: The thematic analysis resulted in three themes and several sub-themes: building of vision and values, clash of vision and values, and “make do with what you have”. Discussion and Conclusion: Facilitators to providing dementia care in acute care were supportive colleagues and early exposure to dementia care. The barriers identified were similar to the barriers experienced by nurses in the literature.

<p>Ontario’s Regional Cancer Programs provide an organized system of adjuvant treatment and follow-up care in its 13 Regional Cancer Centres. For breast cancer patients in particular, these centres become a part of daily activities, as appointments over five years of cancer care result in patients repeatedly accessing these centres at varying frequencies over their treatment periods. The experience of seeking out and receiving care has grown to incorporate cancer care services that exist on a variety of spatial scales, in both formal and informal environments (e.g. support groups, workshops). This study focuses on the role of geography in health behaviors and care experiences of breast cancer patients. Individual interviews were conducted with patients (<em>n=</em>23) attending the Juravinski Cancer Centre in Hamilton, Ontario about their care experiences in their community, and the location and organization of the centre. Rosenstock’s (1966) health belief model and Bandura’s (1986) social cognitive theory informed the analysis of patient satisfaction and produced attitudes that impact the likelihood of health action. Results demonstrated that patients were generally satisfied with their interactions with health care providers and the design and location of the centre. Parking and perceived disconnect between the centre and community health care providers (e.g. family doctors) were identified as being sources of patient dissatisfaction. Patients made sense of their care experience through ‘routinization’ – fixed times and predictable intervals – of travel and appointment schedules. Satisfaction with accessibility to health care providers when at home (e.g. call-in services) appeared to impact at-home adherence to medication and suggested lifestyle changes. Uptake of community support services depended on patient perceptions of need, suitability and proximity, but went largely unused. Patients’ understanding of their care experiences highlight the need to give greater consideration to geography and the physical care environment in the future planning of breast cancer care services.</p> / Master of Arts (MA)

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-10-09T12:17:11Z No. of bitstreams: 1 Amanda Riccioppo Slaviero.pdf: 891232 bytes, checksum: 54b6b68e96a4f6b5450f064118965d99 (MD5) / Made available in DSpace on 2017-10-09T12:17:11Z (GMT). No. of bitstreams: 1 Amanda Riccioppo Slaviero.pdf: 891232 bytes, checksum: 54b6b68e96a4f6b5450f064118965d99 (MD5) Previous issue date: 2017-09-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Pontifícia Universidade Católica de São Paulo - PUCSP / The present work derived from the care of three patients who have common traits in their histories; all three suffered from adaptive faults to their needs during their early childhood. This theoretical-clinical study seeks to explore the themes of the primary care environments and regression to dependence in the care of traumatized patients, more specifically, those who suffered traumas early on during their first years. The purpose is to deepen the investigation about the consequences of these failures and its implications on other future object relations. I intend to discuss styles of analytical settings and clinical interventions that favour primary symbolization forms and creation of a potential space which allows re-signifying and reconstructing the experiences that could not be properly lived in early childhood. To understand the demands and to meet the needs of these patients, who present failures in the structuring and constitution of the self, this work proposes transference management forms, configuring the notion of therapeutic regression developed by Winnicott. This work discusses the need for such patients to be sustained to be able to re-launch their development process into new bases and a new beginning of psychic life / O presente trabalho apresenta os desdobramentos de três casos de pacientes que sofreram falhas adaptativas às suas necessidades durante a primeira infância. Trata-se de um estudo teórico-clínico que busca explorar a temática dos ambientes de acolhimento primário e da regressão à dependência nos atendimentos de pacientes traumatizados, de modo a aprofundar a investigação acerca das consequências dessas falhas e suas implicações nas demais relações de objeto. Foram abordados temas como o estilo de setting analítico e a intervenção clínica que favorecem as formas de simbolização primária e a criação de um espaço potencial que permita ressignificar e reconstruir aquilo que não pôde ser vivido na primeira infância. Também foram propostas formas de manejo transferencial para compreender as demandas e atender às necessidades desses pacientes com falhas na estruturação do eu e na constituição do self, configurando a noção de regressão terapêutica desenvolvida por Winnicott. Discutiu-se ainda a necessidade de tais pacientes serem sustentados de forma a relançar o seu processo de desenvolvimento em novas bases e um novo começo de vida psíquica