The patient-physician relationship is established when a doctor provides care for their patient. This interpersonal interaction consists of perspectives on health issues, treatment plans, confidentiality, and support. Trust is also a component of the patient-physician relationship. Existing findings show that patient-physician trust is critical for achieving compliance and higher satisfaction rates with medical care (Cohen, 2002). Previous studies have investigated the physician's emotional intelligence as a factor in patient-physician trust, as well as the health locus of control on outlook, religious viewpoints on patient outcomes, and vulnerable attachment styles on the patient trust of the patients in determining the patient-physician trust. However, this study addresses the collective role of these variables from the patient's perspective in the patient-physician relationship. Past literature focuses on the physician's perspective and health outcomes. This study aims to understand how college students as patients view their relationship with their physicians. Consistent with existing literature, it was concluded that higher scores on emotional intelligence, internal health locus of control, and ease of vulnerability were associated with higher levels of patient-physician trust. However, a significant association between religious locus of control and patient-physician trust was not found. These findings regarding patients from the population of college students can inform college administrators to develop and implement plans to enhance the quality of care that physicians provide for college students. Further research can then be conducted to optimize these factors and ultimately improve the patient-physician relationship.

Background and Purpose: Just over 15% of children under 18 years of age in the UnitedStates, or approximately 11.2 million children, are estimated to have special healthcare needs.Although children with special healthcare needs (CSHCN) make up a small percentage of thepediatric population, they account for over one third of pediatric medical care. Parental attitudesregarding immunization play a significant role in vaccination rates among children. The purposeof this research is to explore parental attitudes regarding immunization of CSHCN.Methods: This qualitative study focused on parental perceptions and beliefs aboutimmunizations for CSHCN. Sixteen participants, who were parents of CSHCN from onepediatric specialty care clinic participated in focus groups. Institutional review board approvalwas received prior to data collection.Results: While the purpose of this study was to determine the attitudes of parents ofCSHCN regarding immunizations, analysis revealed parents simply wanted to share their lifeexperiences rearing these children, with issues of immunization being secondary. Participantsdescribed the experience of caring for their CSHCN related to isolationism and the weight ofresponsibility as leader of their childs care. Additionally, the majority of parents thatparticipated viewed childhood vaccinations in a positive light. Parents acknowledged that it wasimportant for their own children to receive vaccines. Participants also recognized that it wasimportant for the community to be vaccinated in order to protect their child. However, the desirefor individualized care, at times, caused parents to disregard the immunization schedulerecommended by Center for Disease Control and Prevention.Conclusions: Health care providers can be effective and influential members of the healthcare team by engaging in community based education about vaccines, building trustingrelationships with parents and helping parents understand the need to follow the recommendedschedule for immunizations.

BakgrundSjuksköterskans primära ansvar är omvårdnad. I takt med att den äldre befolkningen ökar i antal ställs större krav på akutmottagningar som förväntas ombesörja vården av dessa äldre människor. Detta ställer stora krav på sjuksköterskan som ska bedriva akutsjukvård och parallellt tillgodose äldre patienters omvårdnadsbehov. SyfteSyftet med denna litteraturöversikt var att beskriva sjuksköterskors erfarenheter av omvårdnaden av äldre patienter på akutmottagningen. MetodDetta examensarbete har genomförts som en strukturerad litteraturöversikt med inslag avliknande metodik som används vid systematiska översikter. Databaserna som användesvar CINAHL och Pubmed. Litteraturöversikten är baserad på tio artiklar där fem är kvalitativa, två är kvantitativa och tre är mixad metod. ResultatI resultatet av denna litteraturöversikt framträder två huvudkategorier; sjuksköterskans utmaningar och komplexiteten av att vårda äldre patienter som presenteras med tillhörande underkategorier. SlutsatsAkutmottagningar bedriver akutsjukvård där tidsbrist, resursbrist och hög arbetsbelastning är ett faktum. Sjuksköterskorna står inför stora utmaningar när äldres mest grundläggande omvårdnadsbehov måste prioriteras bort för att vårda de mest akut sjuka och skadade patienterna. De äldre patienterna beskrivs som komplexa där kognitiv nedsättning och samsjuklighet medför svårigheter för sjuksköterskorna att vårda denna patientgrupp. Dessutom är inte akutmottagningens miljö anpassad för den äldres patientens behov. / BackgroundNurse´s primary responsibility is nursing care. As the elderly population increases in number, the demands become greater on the emergency department that provide care for elderly people. This places great demands on the nurse who must provide emergency medical care and at the same time meet the nursing needs of elderly patients. AimThe aim of this study was to describe nurses´ experiences of caring for elderly patients in the emergency department. MethodThis essay has been carried out as a structured literature review with elements of similar methodology used in systematic reviews. The databases that were used were CINAHL and PubMed. This literature review is based on ten articles where five are qualitative, two are quantitative and three are mixed methods. ResultsThe results of this literature review show three main categories: Nurse´s challenges, the complexity and the environment of the emergency department which was presented with associated subcategories. ConclusionsEmergency departments provide emergency medical care where lack of time, resources and high work is a fact. Nurses are faced with great challenges when the most basic nursing needs of the elderly patients must be prioritized away to care for the most acutely ill and injured patients. The elderly patients are described as complex, where cognitive impairment and comorbidity make it difficult for the nurses to care for this patient group. In addition, the environment of the emergency department is not adapted to the needs of the elderly patients.

No description available.

Background: The etiology of pulmonary disease is complex and influenced by various factors, resulting in a significant public health issue, with 16 million Americans living with chronic obstructive pulmonary disease (COPD) and 24 million with asthma, and cases are on the rise. The purpose of this study was to explore demographic, health status, and lifestyle behaviors with pulmonary disease so patterns of risk can be understood and inform interventions. Methods: This cross-sectional study utilized the National Inpatient Sample Data from 2019 (NIS 2019). The predictor variables consisted of: demographics (age (18+), sex, race), health status (obesity, depression, diabetes), lifestyle behaviors (smoking, alcohol use, and aspirin use), and the outcome variable was pulmonary disease. To ensure accuracy, the data was weighted by the variable discharge weight (DISCWT), and chi-square analyses and ANOVA tests were conducted to determine the independence of categorical and numerical predictor variables. Descriptive statistics were conducted for all variables, simple and multiple logistic regression analyses were performed to identify factors that contribute to the likelihood of having pulmonary disease. Results: The sample of the NIS 2019 data included 6,043,654 cases of which, 22.65% of inpatients had pulmonary disease. The collective sample demographic characteristics were: mean age of 58.4 years, and more than half of inpatients were females (57.05% compared to 42.95% males). In terms of health, 17.75% of the sample were obese, 28.8% had diabetes, and 14.25% were depressed. Within the collective sample, 16.8% of inpatients reported smoking, 9.09% drank alcohol, and 14.51% consumed aspirin (long-term (current) use of aspirin). Results of the multivariate statistical analyses reveal that individuals who were obese were 68.3% more likely to have pulmonary disease compared to non-obese patients (aOR = 1.683, CI 1.679-1.686, pConclusion: Results of our study provide important insights between pulmonary disease and associated risk patterns. As pulmonary symptoms have risen in the wake of the COVID-19 pandemic, there is an urgent public health need to explore disruption of risk pathways to avoid overwhelming fragile global healthcare systems.

Thesis (M.Pharm. (Pharmacy Practice)) -- University of Limpopo, 2022 / Developing countries face huge challenges in provision of pharmaceutical care whereas some developed countries have developed and implemented measure to improve pharmaceutical care through collaborative practices. Collaborative patient care is referred to as the cooperative work or practice by healthcare professionals assuming complementary roles and sharing responsibilities for decision making and problem solving to formulate and furnish quality patient care. Pharmaceutical care is governed by the principles and philosophy of patient centred pharmacy practice, where the main responsibilities, roles or action of a pharmacist are based on patient care. Collaborative pharmaceutical care practice for outpatient requires collaborative action of a pharmacist with other healthcare practitioners. Pharmacist-medical practitioner collaborative care practice is one of the recently emerging aspects in developing countries’ hospitals such as in South Africa which can enhance patient care. Method A qualitative study using semi-structured interviews was conducted with a purposeful sample of 8 pharmacists and 9 medical practitioners at Mankweng Hospital in Limpopo province, South Africa. In the study we used audiotaped interviews that were transcribed exactly as said and analysed using thematic content analysis. Results Three main themes emerged from the study’s interview analysis, description of the current relationship and collaborative practices; the perspective of the pharmacists and medical practitioners on collaboration; the barriers affecting pharmacist-medical practitioner collaboration; and recommendations on the ways, strategy and model to improve pharmacists-medical practitioner collaboration. This highlighted that the relationship among pharmacists and medical practitioners is moderate and there a need for improvement in the relationship. The recommendations range from established xv educational and interactional platforms, improved resource supply, clarity in terms of roles and responsibilities and enhanced managerial structures and functions. Conclusion The current relationship among pharmacists and medical practitioners is moderate. There is still a need for improvement in the relationship to achieve quality collaborative practice for pharmaceutical care in outpatient.

Bakgrund Psykisk ohälsa utgör ett omfattande folkhälsoproblem. Primärvården spelar en avgörande och alltmer betydelsefull roll i att tillgodose behov och behandla patienter med psykisk ohälsa samtidigt som den främjar välbefinnande. Med sin kapacitet har primärvården möjlighet att erbjuda en holistisk och integrerad vård som adresserar både fysiska och psykiska hälsotillstånd simultant. Hur patienter bemöts inom primärvården kan vara av avgörande betydelse för deras framtida hälsa; en mindre gynnsam upplevelse kan förändra patientens förtroende för vården och potentiellt resultera i att de avstår från att söka vidare vård för sina psykiska besvär. Syfte Syftet med litteraturöversikten var att beskriva hur patienter med psykiskohälsa upplever primärvården. Metod En litteraturöversikt med åtta publicerade originalartiklar. Insamlingen av data utfördes i databaserna CINAHL Complete och PubMed samt genom manuell sökning. Artiklarna analyserades utefter Fribergs analysmetod. Resultat I resultatet identifierades tre övergripande teman; stigmatisering, vårdrelationens betydelse och möjlighet till delaktighet. Stigmatiseringen upplevde patienterna kom från både vårdgivare och samhället, och där en känsla av inre skam ledde till att färre sökte vård. En god vårdrelation, präglad av medkänsla och respekt, förbättrade patienternas upplevelser och minskade stigmatiseringen. Delaktighet i vården påverkades av finansiella och sociala hinder samt brist på samordning mellan olika vårdinstanser. Patienter efterfrågade längre och mer tillgängliga möten för att kunna bygga förtroendefulla relationer och få adekvat stöd. Slutsats Patienter med psykisk ohälsa som tillhandahållit hjälp inom primärvården beskriver både positiva och negativa vårdupplevelser. En god vårdrelation inkluderar kommunikation och delaktighet, medan negativa upplevelser ofta relateras till stigmatisering och fördomar. Det är viktigt att främja positiva vårdrelationer med respekt och lyhördhet för att förbättra vården för denna patientgrupp. / Background Mental health constitutes a significant public health issue. Primary care plays a significant and increasingly important role in meeting the needs and treating patients with mental health problems while also promoting well-being. With its capacity, primary care has the potential to offer holistic and integrated care that addresses both physical and mental health conditions simultaneously. How patients are treated within primary care can be crucial for their future health; a less favorable experience can alter the patient's trust in care and potentially result in them refraining from seeking further care for their mental health problems. Aim The purpose of the literature review was to describe how patients with mental health issues experience primary care. Method A literature review comprising eight published original articles was conducted. Data collection was carried out in the CINAHL Complete and PubMed databases, as well as through manual searching. The articles were analyzed using Friberg's analysis method. Results The results identified three overarching themes: stigmatization, the significance of the relationship in health care, and opportunities for participation. Patients experienced stigma from both healthcare providers and society, and a sense of internal shame led to fewer seeking care. A good healthcare relationship, characterized by compassion and respect, improved patients' experiences, and reduced stigmatization. Participation in care was influenced by financial and social barriers as well as a lack of coordination between different healthcare providers. Patients requested longer and more accessible meetings to build trusting relationships and receive adequate support. Conclusions Patients with mental health problems who received care within primary care services describe both positive and negative care experiences. A good relationship includes communication and participation, while negative experiences are often related to stigmatization and prejudice. It is important to promote positive relationships with respect and responsiveness to improve care for this patient group.

Bakgrund: Långvarig smärta är ett komplext sjukdomstillstånd som kräver särskilda rehabiliteringsåtgärder. Ofta tillämpas ett interdisciplinärt arbetssätt vid smärtrehabilitering. Teamarbete är en viktig aspekt av det interdisciplinära arbetet. Det finns fortfarande ett begränsat antal studier som undersöker fysioterapeutens upplevelser av interdisciplinärt teamarbete. En studie som undersöker fysioterapeuters perspektiv kan bidra till ökad förståelse och kunskap inom området.   Syfte: Att undersöka fysioterapeuters upplevelser av teamarbete inom interdisciplinär rehabilitering vid långvarig smärta.  Metod: En kvalitativ studiedesign baserad på fem semistrukturerade intervjuer med fysioterapeuter som arbetat mellan ett och tolv år inom smärtrehabilitering bearbetades med kvalitativ innehållsanalys.  Resultat: Den kvalitativa innehållsanalysen resulterade i fyra kategorier och 15 underkategorier. De fyra huvudkategorierna som identifierades var följande: vikten av kommunikation vid teamarbete, organisatoriska förutsättningar som bidrar till gott samarbete, samspel en viktig grund för teamarbete och professionella och sociala färdigheter som påverkar teamarbete.  Konklusion: Resultatet från studien överensstämmer med tidigare forskning inom närliggande områden. Framgångsfaktorer vid kliniskt teamarbete kan vara utarbetade strukturer för kommunikation som reflektion och att sitta i närheten av varandra inom teamet. Olika synsätt och förändringar i teamets sammansättning kan försvåra teamarbete. För att främja ett effektivt teamarbete krävs det att individen kan samspela med andra professioner samt besitter både professionella och sociala färdigheter. / Background: Chronic pain is a complex condition that requires special attendance. Interdisciplinary care is a frequently used method in chronic pain rehabilitation. Teamwork is an important part of interdisciplinary care. Previous research considering physiotherapists' experiences in chronic pain rehabilitation is of limited extent. Hence, a study examining this topic could be of value. Purpose: The study's purpose was to explore physiotherapists' teamwork experiences in interdisciplinary rehabilitation of chronic pain.   Method: A qualitative design with semi-structured interviews was employed. Five physiotherapists that have been working in chronic pain rehabilitation between one to twelve years were recruited using convenient sampling. Qualitative content analysis was conducted to analyze the data.   Results: Four main categories and 15 subcategories were identified. The main categories described the importance of communication in teamwork, organizational structures and factors that influence teamwork, interplay between individuals in the team and how professional and social skills impact teamwork.   Conclusion: The findings in this study have previously been confirmed in studies conducted in related research areas. Well-designed structures for communication such as reflection and also having workspace close to each other within the team are suggestions for creating good teamwork. Different viewpoints among team members could be a barrier for effective teamwork as well as changes in the team constellation. An efficient teamwork is promoted when the individuals in the team are possessing both professional and social skills.

Yes / The uptake of advance care planning (ACP) is particularly low among people with dementia. This may reflect barriers to communication between professionals, patients and families in the face of lack of consensus about the process. This study aimed to methodically investigate consensus views of how ACP should be explained and carried out with people with dementia. A three-round Delphi study explored views of how and when ACP should be addressed, what should be covered, who should be involved and why rates of ACP are low. Seventeen participants took part comprising family members, old age psychiatrists and policy makers. Thirty-two items reached consensus. The panel agreed on 11 different areas for discussion. They concurred that ACP was best addressed after the person has come to terms with the diagnosis when the individual feels ready to do so. There was a consensus view that the process should be couched in terms of ‘certain possibilities’. Consensus items emphasised personal choice and autonomy, while also prioritising the need to discuss financial aspects and to include spouses. There was no consensus that professionals should be involved, although the panel viewed them as carrying some responsibility for low uptake. It is suggested that ACP should include general discussion of values as well as coverage of specific points. Professionals need to offer discussion and information on ACP, but also make clear that the patient has the right to choose whether to pursue ACP or not.

No / This study aims to review the biosciences component of preregistration nursing programmes in higher education institutions across the UK through the experiences and perceptions of lecturers involved in nursing education. Studies suggest that some qualified nurses lack confidence in explaining the bio-scientific rationale for their clinical practice. Biosciences can be difficult to understand and integrate into clinical decision-making and require protected time within preregistration nurse education. In the absence of explicit national guidelines, it is unclear as to the depth and extent biosciences are taught across different institutions and the level achieved at the point of registration. A survey approach was adopted to generate quantitative and qualitative feedback. Data were collected using a semi-structured questionnaire seeking the experiences and views of lecturers involved in teaching biosciences to nursing students across the UK. Data received from 10 institutions were analysed using descriptive statistics and thematic analysis. Lecturers reported that the hours of taught biosciences ranged from 20-113 hours, principally within the first year. This represents between 0.4-2.4% of time within a preregistration nursing programme (4600 hours). Large group lectures predominate, supplemented by smaller group or practical work, and online materials. The biosciences are assessed specifically in half the institutions surveyed and as part of integrated assessments in the rest. In relation to student feedback, all respondents stated that students consistently requested more time and greater priority for biosciences in their programme. This survey suggests that the number of hours spent teaching biosciences is minimal and varies widely between higher education institutions. All respondents expressed concern about the challenges of teaching difficult bio-scientific concepts to large groups in such a limited time and called for greater clarity in national guidelines to ensure that all nurses are adequately educated and assessed in bioscience subjects. Failure to understand the biosciences underpinning care has implications for safe and competent nursing.