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Title from title page of PDF (University of Missouri--St. Louis, viewed March 9, 2010). Includes bibliographical references (p. 52-61).

Thesis (M.H.A.)--University of Michigan, 1957.

Thesis (Ph. D.)--Northwestern University, 1977. / Also issued in print.

Thesis (Ph. D.)--Northwestern University, 1977. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.H.A.)--University of Michigan, 1957.

Thesis (M.S.)--University of Michigan, 1990.

Thesis (M.S.)--University of Michigan, 1990.

The research objective was: to determine (a) the extent of the present involvement of neonatal intensive care nurses in technology assessment, (b) their perceptions of the technologies with which they worked, and (c) their perceptions of requirements for improvements in the technology assessment process. Nurses and senior staff (nursing s.u perv.i sors, NICU consultants and training officers) ln the neonatal intensive care units (NICUs) of five hospitals in London were included in the study sample. They completed questions regarding new medical technologies in general and NICU technologies in particular. Nurses and senior does not prepare Further, in some training regarding staff believed that nurses' training them adequately for new technologies. instances, nurses had not received a new technology prior to using it. Neither nurses nor senior staff were fully aware of formal processes for technology assessment in their hospitals, but did identify informal processes. While a small minority of the nurses had been directly involved in decisions regarding the new technologies, more than half had made recommendations. The nurses considered their level of involvement unsatisfactory, and believed (as did the senior staff) that their hospital could improve its procedures for purchasing, introducing and using new technologies. Most of the nurses who were planning to remain in neonatal intensive care were dissatisfied with their involvement and with their hospital's methods for adopting new technologies. One-third of the nurses and most of the senior staff identified examples of nurses' having contributed to the development and adaptation of new equipment and procedures, either formally or informally. The impacts considered most significant by nurse participants were: job stress, increased ethical, legal or social concerns, and decreased reliance on clinical judgment or skills of nurses.

Bakgrund: När sjukvården till stor del förlitar sig på medicinsk teknik och läkemedelsbehandling är det lätt att omvårdnadsåtgärder som syftar till att förebygga och lindra lidande inte ges tillräckligt utrymme. Intensivvårdsdelirium är ett förhållandevis outforskat område inom barnintensivvården. Idag finns inga riskskattningsinstrument översatta till svenska.   Syfte: Syftet var att studera barns beteenden när de vårdades på en barnintensivvårdsavdelning. Dessutom undersöktes om dessa beteenden kunde användas för att besvara frågor från ett engelskspråkigt riskskattningsinstrument för delirium.   Metod: Studien utfördes som en fokuserad etnografisk observationsstudie där sju patienter på en barnintensivvårdsavdelning observerades under tre timmar vardera. Utifrån observationernas fältanteckningar gjordes en innehållsanalys med fokus på manifest innehåll. I ett andra steg utfördes en deduktiv analys där kategorierna från fältanteckningarna jämfördes mot frågor från riskskattningsinstrumentet för delirium.   Resultat: Innehållsanalysen av fältanteckningarna resulterade i åtta kategorier som representerade barnens beteende under observationerna: reagerar på vårdhandling, förmedlar fysiska behov, förmedlar smärta, svarar på fråga, sysselsätter sig själv, stimuleras av underhållning, uppmärksammar omgivningen och väcks av stimuli. Den deduktiva innehållsanalysen visade att fyra av de åtta frågorna från riskskattningsinstrumentet kunde besvaras med hjälp av kategorierna.   Slutsats: Urvalet bestod av en homogen subgrupp där inga beteenden med tydlig koppling till risk för delirium kunde observeras. Miljörelaterade riskfaktorer för delirium i form av frekventa vårdhandlingar, höga ljud och störd sömn förekom. Trots att denna grupp patienter inte visade tecken på delirium kan förebyggande av dessa störningar leda till minskat vårdlidande. Barnintensivvården kan ytterligare minska vårdlidande genom att öka föräldrarnas möjligheter att vara hos sitt sjuka barn dygnet runt. / Background: Nursing and preventive measures may be overlooked when health care in large relies on medical technology and medical treatment. Intensive care delirium is a relatively unexplored area in pediatric intensive care. There are currently no risk assessment tools translated to Swedish.   Aim: The objective was to study children's behaviour when they were cared for in a pediatric intensive care unit. In addition, it was questioned whether these behaviours where able to answer questions originating from an English language risk assessment tool for delirium.   Method: Using focused ethnographic observation seven patients were observed during three hours each. Content analysis was performed on the field notes from the observations with focus on manifest content. As a second step, a deductive analysis compared the categories with questions from the risk assessment tool for delirium.   Findings: The content analysis of field notes resulted in eight categories which represented the children’s behavior during the observations: reacting to care, expressing physical needs, expressing pain, answering question, occupying oneself, stimulated by entertainment, observing the surroundings and awakened by stimulus. The deductive analysis showed that four of the eight questions from the risk assessment tool could be answered with the categories.   Conclusion: The selection consisted of a homogenous subgroup where no obvious behaviors related to risk of delirium was observed. Environmental risk factors for delirium such as frequent care related interventions, loud noise and disturbed sleep where observed. Despite that, prevention of these disturbances could reduce health care related suffering even though this group of patients did not show signs of delirium. Pediatric intensive care units can further reduce healthcare related suffering by enabling families to be present with their sick child during all hours of the day and night.