Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2008. / Title from first page of PDF document. Includes bibliographical references (p.66-68).

Thesis (M.S.)--University of Michigan, 1985. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1985. / eContent provider-neutral record in process. Description based on print version record.

The aim of this study was to analyse the role of the registered nurse in the management of pro re nata (PRN) medication in a care home (nursing) for older people. Studying PRN medication provides insights into the role of the nurse in care homes (nursing) who act as assessor, decision maker and evaluator in residents' care. It also provides a lens by which to explore how residents and their carers interact and participate in day-to-day care decisions about residents' health. The case study draws on ethnography. It is a multi-method study, using documentary and medication reviews, observations and interviews to answer the research questions. Thirty-four residents were recruited to the study and 60 care home staff. Findings showed that 88.2% of residents (n=30) were prescribed PRN medication and that all residents were on a minimum of 1 and a maximum of 7 medication. During each 28-day MAR sheet period between 35 and 44 PRN prescriptions were written. They contributed 12.7% of all medication prescribed, accounting for between 1.2 and 1.5 medication per resident. Nurses were found to administer PRN medication, but a finding of this study was that this activity could be delegated to carers who were identifying resident needs. There was some evidence of resident engagement but this was often a three-way process between resident, GP and family or resident, carer and nurse. A percentage of medication that could have been PRN were routinely prescribed. Observations also identified that nurses would decide not to administer routine medication in certain circumstances and that this was directly related to their assessment of the resident. The process of medication management was dominated by the regulations and governance processes of the care home. Observations and interviews found that care home staff recognised and affirmed residents' pain but did not take action for analgesia to be administered. They were familiar with the use of pain assessment tools for older people living with dementia and had received training in dementia care. Many of the staff were also able to interpret signs and symptoms of a resident's distress. Nevertheless, their preoccupation with meeting internal and external regulator standards was a barrier to addressing residents' needs. This is the first study that has looked at an aspect of medication management to understand how nurses and care home staff work for and with residents to moderate and address their health care needs. It suggests that additional training in aspects of medication management and resident assessment may not be able to address deeper seated issues of autonomy and how the nursing role is understood and enacted in care home settings.

Basic theoretical standpoints: This Dissertation has been focused on problems on functional changes and illnesses in old age and seniors' activation. An aging of the population is constantly growing in developed countries of which could be deducted naturally increasing interest in this issue. Health care staff is confronted with greater number of elderly people thus as very important aspects are the ability of nurses to recognize their needs and to look at the old age as a natural part of human life. The support of seniors' self-care and their activation should be the main objective of health care staff. Aims of the Dissertation: Three aims were identified to find out specific problems of nursing care with communications between the nurse and the elderly, to examine options of their activation such as a prevention of communications barriers and lastly to discover nurses' knowledgeable regarding the seniors' activation in the context of effective leadership communication. Following research questions for these targets were established: What are the most common problems that nurses deal with regarding the activation in communication in nursing care homes for elderly? What are the possibilities of seniors' activation as prevention of complications in communications in nursing care homes for elderly? What the nurses' skills are regarding seniors' activation in communications in nursing care homes for elderly? Methodology: This Dissertation "Problems of seniors' activation in the context of nursing care communication in nursing care homes for elderly" is composed according to qualitative research method laid out in two parts. The first one, data collection was implemented by depth semi-structured interviews with nurses from nursing care homes for elderly. The exact transcription of the interviews were analysed by open-coding technique, codes were sorted into categories a arise subcategories, arranged into clear diagrams. Covert surveillance method was used as a second part of this research. Those records were entered into the observation chart and then subsequently described. The research took place from 12th February to 20th April 2015. Results: This research shows that all nurses know specific problems of communication with seniors in the context of their care in nursing care homes for elderly, who are also psychologically stressful for them. It also shows that greater number of nurses deemed seniors' activation as activation programs only provided by nursing care homes for elderly. The elderly, according to some senior nurses, are due to deterioration of their mental or physical condition without any activation. Almost all nurses are educated in the seniors' activation and communication by seminars and lectures organized by nursing care homes for elderly which are paid by the employer. All nurses considered their education in activation and communication area as a contribution to increase knowledge and improve nursing care. During this second phase was found that four out of ten nurses performed almost the entire care of the morning hygiene for seniors without their help. Some of the nurses neglected to ask whether seniors would wish to perform their own hygiene without their help. Therefore four nurses do not activate seniors during the morning hygiene and some nurses communicate with seniors inappropriately. Conclusion:We think that nurses should have more education in activation and communication area. Their education will mainly bring theoretical knowledge that helps them to deal with problematic situation in nursing care for elderly. The outcome of this Dissertation was meeting with head nurses from nursing care homes for elderly where we presented our results gained by this research. They promised to consult it with rest of the nurses and to implement other seminar on seniors activation with communication.

In this thesis I present a narrative that describes and analyses the contested and moving boundaries in adult social care through the lens of three enduring themes: the health and social care interface; hospital discharge and NHS continuing health care; and eligibility for adult social care. The thesis draws upon a range of my published work undertaken from 2002-2011, and this in turn reflects a wider body of work undertaken from the 1980s onwards. The thesis is developed from my work which comes from a distinctive model of independent research and analysis, combining original empirical fieldwork and evaluation with detailed policy analysis and commentary. The publications are principally derived from research studies and evaluations commissioned from me by the Department of Health; by the Commission for Social Care Inspection (CSCI), and by the Putting People First Consortium and the Social Care Institute for Excellence (SCIE). This thesis examines the problematic boundaries between adult social care (particularly in the care of older people), and the NHS which have been in evidence since the creation of the two systems, and the extent to which these boundaries are contested and fluid over time. I argue that the location of the boundary is of great significance because of the consequences not merely for respective organisational responsibilities and budgets, but also - importantly - for individual service users and their families. The thesis was written on the cusp of the introduction of major legislation in social care, with the Care Act 2014 due for phased implementation from April 2015. It is an opportune moment to consider how and to what extent the Act offers the prospect of stabilising the shifting sands of the landscape of adult social care.

Bakgrund: Demenssjukdom drabbar ofta äldre personer och innebär förlust av kognitiva förmågor och orsakar stort vårdbehov. En åldrande befolkning leder till ökat behov av vårdboenden. Vården skall vara personcentrerad och såväl fysisk som psykosocial vårdmiljö är viktiga delar som kan påverka personens välmående och beteenden. Syfte : Att beskriva hur vårdmiljön påverkar personer med demenssjukdom. Metod : En litteraturöversikt grundad i kvalitativa (n=7), mixade (n=2) samt kvantitativa (n=8) studier. Analysen fokuserade på likheter och olikheter i artiklarnas resultat relaterat till hur fysisk och psykosocial vårdmiljö påverkade personer med demenssjukdom. Som ett steg i analysen skapades två teman och fem subteman för att överskådligt presentera viktiga resultat i forskningsmaterialet. Resultat: Resultaten visar att fysisk och psykosocial vårdmiljö påverkar personer med demenssjukdom. Arkitektur, inredning, sensoriska inslag, gemensam vårdfilosofi samt meningsfullhet har alla betydelse för möjligheten till autonomi och självbestämmande. Slutsats: Demenssjukdom är inte en sjukdom som drabbar alla på exakt samma sätt utan leder till många olika sorters symtom och begränsningar. Den kognitiva nedsättningen påverkar möjligheten till autonomi, integritet och själv-bestämmande. Eftersom personer med demenssjukdom påverkas individuellt av den fysiska och psykosociala vårdmiljön är ett personcentrerat synsätt en förutsättning för att kunna uppnå god omvårdnad med bibehållen livskvalité. / Background : Dementia often affects older people and involves loss of cognitive abilities and causes great care needs. An ageing population leads to an increased need for nursing accommodation. Care should be person-centered and physical as well as psychosocial care environment are important elements that can affect the person's wellbeing and behaviors. Aim : To describe how the care environment affects people with dementia. Method : A literature review based on qualitative (n =7), mixed (n =2) and quantitative (n =8) studies. The analysis focused on similarities and differences in their results related to the physical and psychosocial environment affecting people with dementia. As a step in the analysis, two themes and five subthemes were created to clearly present key findings in the research material. Results: The results show that the physical and psychosocial care environment affects people with dementia. Architecture, interior design, sensory elements, common care philosophy and meaningfulness are all important for the possibility of autonomy and self-determination. Conclusion: Dementia is not a disease that affects everyone in exactly the same way but leads to many different kinds of symptoms and limitations. The cognitive reduction affects the possibility of autonomy, integrity and self-determination. Since people with dementia are individually affected by the physical and psychosocial care environment, a person-centered approach is a prerequisite for achieving good care with a maintained quality of life.

The main purpose of this study is to research about how the staff at a residental care home strives to make the unaccompanied youths feel like they are a part of the society in Sweden. The purpose is also to explain how the staff at the care home legitimises their integrating actions. To accomplish the purpose, a qualitative approach was made; four staffs and three youths were interviewed at a care home in the southern part of Sweden. The theoretical approach were: social integration and social exclusion. The theoretical concepts in this study were: rules, norms, social norms and moral norms. The findings of this study was that the staff, mentors and the guardians of the youths were people that helped them understand the ”new” society by teaching them the mutual norms, values and attitudes in the society. The norms, rules and routines that were taught at the care home, were interpreted as social and moral norms that sets the framework of a ”correct behavior” in a given situation. To make the system of norms appear as legitimate to the youths, the staff explained why the norms are important to internalize as well as explaining what could happen if you would go against them. In this way, the youths corrected their behavior in relation to what the staff mediated and to what they thought was important themselves. To understand how the society works, including learning the norms, values and behaviours, were according to the staff a way for the youths to create a good start into the Swedish society.

The aim of this diploma thesis was to describe information about SARS-CoV-2 virus and coronavirus disease (COVID-19), to evaluate the course of the disease in the Home with a special regime in Břevnice, in which the epidemic took place at the beginning of the first wave of COVID-19 pandemic in spring 2020. Another goal was to perform an antibody analysis and evaluate the obtained data. I divided the diploma thesis into three main parts: theoretical, experimental and discussion. In the theoretical part, I worked with the literature and described information related not only to COVID-19, but also to other serious infections caused by human coronaviruses. In the experimental part, which I performed in the immunological laboratory of the Department of Joint Laboratories at Havlíčkův Brod Hospital, I dealt with the issue of the clinical course of the disease, the severity of the disease and possible consequences after the infection. I also dealt with methods for the determination of antibodies, the principles of which are described in Chapter 4.5. The diagnostic methods and procedures used are described in Chapter 5.3 Laboratory Assays. From the obtained data, I prepared graphs and tables and processed data on the clinical course of the infection in the Břevnice Home, both for the clients and the...