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Thesis (M.S)--University of Florida, 2005. / Typescript. Title from title page of source document. Document formatted into pages; contains 35 pages. Includes Vita. Includes bibliographical references.

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The thesis is focused on comparason of approach of the medical and social staff to the HIV positive patients, the percentage of the infected in population, the possibilities and the use of the treatment.

Background: Patients seek care at an emergency department (ED) due to different care needs and diagnoses. The number of patients that visit the ED increases annually which leads to an increased waiting time and the visit gets overwhelming for the patient. The nurse has a leading role in the treatment and care of the patient in the ED. Purpose: To describe the patient's experience of the nurse's treatment at an ED. Method: A literature review compiled based on scientific articles searched from the databases Cinahl, Pubmed and Psycinfo. Relevant keywords have been used to find articles that answers the purpose of the literature review. Results: Results in this literature review are based on 16 scientific articles, 7 quantitative and 9 qualitative. It was important with accuracy of treatment when assessing the patient during triage. The patient’s perception´s is that information and good treatment are important to get a more positive experience. To be seen, acknowledged and being a part of your own care leads to reduced anxiety and insecurity in the patient. The nurse’s treatment and communication with the patient during the waiting period was of great importance to the patient's experience. Patients that are accompanied by relatives to the ED feels more secure during the waiting time and in communicating with nurses because they considered their relatives where helpful in remembering information and keeping in contact with the nurse. Conclusion: By making small changes in nursing care such as closer supervision and increased information, patient´s experience of nurse’s treatment can be improved. / Bakgrund: Till akutmottagningen kommer patienter med olika omvårdnadsbehov och diagnoser för att få hjälp. Antalet patienter som söker akut sjukvård ökar årligen, detta leder till att väntetiden på akutmottagningen blir lång och upplevelsen omtumlande. På akutmottagningen har sjuksköterskan en ledande roll i bemötande och omvårdnad av patienten. Syfte: Att beskriva patientens upplevelse av sjuksköterskans bemötande på en akutmottagning. Metod: En litteraturöversikt sammanställd utifrån vetenskapliga artiklar sökta från databaserna Cinahl, Pubmed och Psycinfo. Relevanta sökord har använts för att hitta artiklar som svarar på litteraturöversiktens syfte. Resultat: Resultatet har baserats på 16 vetenskapliga artiklar, 7 kvantitativa och 9 kvalitativa. Det var viktigt med noggrannhet av bemötande vid bedömning av triage. Patientens uppfattning är att information och bra bemötande är viktigt för att få en positiv upplevelse. Att bli sedd, bekräftad och göras delaktig i omvårdnaden leder till minskad ångest och osäkerhet hos patienten. Sjuksköterskans bemötande och kommunikation med patienten under väntetiden hade stor betydelse för patientens upplevelse. Patienter som har anhöriga med sig till akutmottagningen upplever en ökad säkerhet under väntetiden och vid sjuksköterskans bemötande. Patienterna ansåg att anhöriga fanns till som hjälp med att komma ihåg information och hålla kontakten med sjuksköterskan. Slutsats: Genom att göra små förändringar i omvårdnadsarbetet som tätare tillsyn och ökad information kan patienters upplevelse av sjuksköterskans bemötande förbättras.

Psychosocial support is said to be an inherent component of nursing care and a major focus of palliative care. Literature exists which outlines perceptions of the psychosocial needs of patients and how psychosocial support should be provided. However, there is a lack of empirical evidence on how psychosocial support is operationalised in practice. This study provides a valuable and substantial new contribution to the evidence on the psychosocial needs expressed by patients in a hospice ward and how nurses immediately respond to these needs within their everyday practice. A study gathering data via observations with matched interviews of patients and nurses, organisational, documentary, and demographic variables, was conducted over an eight month period. Thirty-eight nurses (registered and auxiliary) and 47 patients were included in a maximum variation sampling strategy. Data was analysed using constant comparative qualitative techniques. Patients expressed a wide variety of psychosocial needs, often only signalling them whilst receiving care for other reasons. Considering these needs in relation to Maslow’s (1943) hierarchy of needs suggests that in-patients more commonly express prerequisites to physiological care and ‘lower level’ safety needs rather than the more thoroughly researched and espoused ‘higher’ level psychosocial needs. The nurses reacted to these psychosocial needs with a range of responses which indicated a diminishing level of immediate support: ‘dealing’, ‘deferring’, ‘diverting’ and ‘ducking’. The majority of the nurses were observed using each of these responses at some point during data collection. A variety of the responses were used for each type and context of psychosocial need. These responses were influenced by the ward’s workplace culture. This study demonstrates a requirement for more thorough consideration of the true psychosocial needs of patients, which appear to vary dependent on the context of care. Consideration should be v given to workplace culture and its influence over psychosocial support, with nurses being supported to expand their response repertoire so that patients’ psychosocial needs are acknowledged more. Increasing nurses’ knowledge of the reality of psychosocial support through education and research will encourage formalisation of the place of psychosocial support in the planning, documentation and provision of care. This study shows that ward nurses can offer psychosocial support as an inherent component of their everyday work. Findings derived from this research indicate that developing an understanding of how patients express psychosocial needs in practice, through a consideration of Maslow’s (1943) hierarchy of needs, may increase recognition and support of psychosocial needs and enable nurses to respond more comprehensively.

Background: As patients with multiple sclerosis (MS) require lifelong treatment, optimization of therapy with respect to efficacy and safety is needed to limit long-term disease progression. Patients with MS also need a range of health-related services. Satisfaction with these as well as treatment is clinically relevant because satisfied patients are more likely to adhere to therapy. The aim of this study was to determine the status of patient satisfaction and of healthcare services in 70 specialized MS centres in Germany. Methods: In 2011, patients with MS responded to a questionnaire, which solicited clinical and demographic information, as well as patients’ perceptions of their overall situation and their satisfaction with treatment. Results: Of 2791 patients surveyed, 81.9% had relapsing-remitting MS with mild disability [mean (standard deviation) Expanded Disability Status Scale score: 2.6 (1.8)]. Disease activity data were collected from 2205 patients, of whom 57.6% had remained relapse-free during the preceding 12 months. However, 38.9% had experienced one or more relapses, most of whom (67.3%) while receiving immunomodulatory treatment. About one-third of the patients indicated that they were more dissatisfied with their overall situation compared with the time before diagnosis. However, many patients (58.3%) were satisfied with their existing medication. Overall, 72.8% of patients would prefer oral to injectable treatments, assuming there was no difference in their efficacy. Conclusions: A substantial proportion of patients experienced breakthrough disease on treatment and may potentially benefit from a change of therapy. Although largely satisfied with treatment, most patients with MS would choose oral over injectable treatments.

The United States experiences opioid addiction at epidemic levels. In 2012, the National Institute of Drug Abuse reported that 23.1 million Americans were in need of addiction treatment services, although only 2.5 million were enrolled in treatment. Following an amendment to the Drug Addiction Treatment Act of 2000 (Public Law 106-310), advanced practice nurses were qualified as providers who could bridge the healthcare gap in treatment access. The purpose of this project was to determine the interest of advanced practice nurses in (a) prescribing buprenorphine and (b) establishing guidelines that would allow them to do so. This quantitative project used a 10-question Internet-based survey with a convenience sample of 95 nurses (recruited online) who were currently practicing in advanced nursing roles. Social media platforms, including Facebook, were used to recruit participants. The survey included questions about expanding the scope of practice in addiction treatment and establishing guidelines that would allow nursing knowledge and expertise to be used in outpatient opiate addiction treatment. Critical social theory and Kingdon's theory of policy analysis were applied to support the project. The Survey Monkey data analysis tool was used to generate descriptive statistics, which demonstrated respondents' support for an expanded scope of practice. If the recommendations of this project are adopted by national legislation, increased accessibility to addiction treatment services will save millions of dollars in justice system, healthcare system, employment, and societal costs. Nursing policy advocates nationally can apply these results to support efforts to expand scope of practice to include prescribing buprenorphine.