Living with inflammatory bowel disease (IBD) affects physical, psychological and social dimensions, limiting the ability to engage in daily activities. Persons with IBD may need frequent and lifelong contacts with the healthcare (HC), highlighting the importance of quality care. High quality HC for persons with IBD involves a partnership between the HC professionals and the person living with the disease. Information is essential, the more a person knows about their disease, the more concordant and satisfied with their treatment they are likely to be. The overall aim of this thesis was to describe the knowledge need, life situation and perception of HC among persons living with IBD, in order to develop a questionnaire to evaluate the quality of HC. This thesis is based on three studies that are presented in four papers. Qualitative methods were used to describe aspects of life situation in relation to the disease, whereas quantitative method was used to develop a questionnaire measuring quality of care. Study I and II have an inductive qualitative design. In study I, qualitative interviews with 30 people were performed to describe the knowledge need and experience of critical incidents in daily life while living with IBD. The interviews in study I were analyzed using content analysis (results presented in Paper I) and critical incident technique (results presented in Paper II). In study II, the perceptions of HC among persons living with IBD was explored in five focus group interviews and two individual interviews, in total n=26. Study III aimed to develop and evaluate a questionnaire, measuring quality of care among persons with IBD, including 318 persons with IBD and 8 professionals. The knowledge need among persons with IBD focused on managing symptoms and course of the disease and learning to assimilate the information in order to manage everyday life. Losing bowel control was of great concern for most of the informants in the study. Many of the informants said that “the bowel ruled their life” and that it influenced them to a great extent in their daily lives. The perception of HC among persons with IBD meant being met with respect and mutual trust, receiving information at the right time, shared decision-making, competence and communication, access to care, accommodation, continuity of care and the pros and cons of specialized care. The quality of care questionnaire QoC-IBD was constructed in five dimensions, building on the results from Study I and II. The dimensions were trust and respect, decision-making, information, continuity of care and access to care consisting of 21 questions in total. QoC-IBD is a short, self-administrated questionnaire that measures experiences of healthcare among persons with IBD with promising validity and reliability. To improve quality of care, HC is recommended to consider individual care needs and take the person’s daily life and social context into account. The QoC-IBD questionnaire measures the subjective experience of quality of care. Further testing in clinical practice is necessary to evaluate if QoC-IBD can be used to evaluate the care given and areas of improvement in HC for persons living with IBD.

Darbo tikslas - ištirti žinių apie šiuolaikinę kontracepciją poreikį slaugytojams ir akušeriams. Tyrimo metu siekta: įvertinti slaugytojų ir akušerių nuomonės apie kontracepciją ir įrodymais pagrįstos medicinos duomenų skirtumus; išsiaiškinti ir palyginti slaugytojų ir akušerių žinių apie šiuolaikinę kontracepciją panaudojimą praktinėje veikloje; išsiaiškinti slaugytojų ir akušerių nuomonę apie jų svarbą, lytinio švietimo ir informavimo kontracepcijos klausimais, veikloje. Tyrimo hipotezė - akušerių žinios apie šiuolaikines kontraceptines priemones yra geresnės negu slaugytojų. Atliktas vienmomentis kiekybinis tyrimas, taikant apklausos metodą, kurio metu naudota autorės sudaryta nestandartizuota anketa. Apklausoje dalyvavo 220 respondentų (107 akušeriai, 111 slaugytojai ir 2 asmenys nurodė kitą profesiją) dirbančių Kauno miesto sveikatos priežiūros įstaigose ir jų skyriuose, kurie dirba su moterimis ir kuriems gali tekti konsultuoti kontracepcijos klausimu. Duomenims analizuoti naudota statistinė analizė. Atliekant statistinę duomenų analizę analizuoti tik slaugytojų ir akušerių duomenys. Tyrimo rezultatai: vertinant teiginius apie kontracepcijos poveikį slaugytojos įvertino teisingai 3 iš aštuonių, o akušerės 5 iš aštuonių teiginių. 76,4 proc. respondentų atsakė, jog domisi naujovėmis apie kontracepciją. 60,5 proc. respondentų jų nuomone žino kas yra įrodymais pagrįsta medicina/praktika. 69,5 proc. apklaustųjų jaučia poreikį įgyti daugiau žinių kontracepcijos tema... [toliau žr. visą tekstą] / Research goal – to analyse the need of information about modern contraceptics for nurses and midwives. Study aims were: assess the differences between the opinions of nurses and midwives and the evidence-based actual data about contraceptics; to find and compare the application of information about contraception by the nurses and midwives in working environment; to gauge the significance placed upon them by the nurses and midwives in sex education concerning contraception. Hypothesis – midwives have a higher knowledge base concerning modern contraception than nurses. Public quantitative research has been conducted using a survey method, in which authors’ non-standardised questionnaire has been used. In total, 220 respondents have participated (107 midwives, 111 nurses and 2 people of other profession) from Kaunas city’s health care establishments and their subsidiaries, in which female patients are present or come to and in which some sort of consultation regarding contraception could be done. The data has been analysed with statistical tools. In the data analysis, only the data concerning nurses and midwives has been analysed. Research results: in the evaluation task of presented statements upon contraception, nurses have answered 3 out of 8 correctly; midwives have answered 5 out of 8 correctly. 76,4 per cent of respondents have stated that they show interest into the new modern contraception methods. 60,5 per cent of respondents claim to know what is evidence-based... [to full text]