Aim of the study was to investigate the present demand for in-patient nursing care service in Kaunas city. Methods: Analysis of the medical documents (patient’s file) and waiting lists at 4 Kaunas city nursing and supportive care hospitals was done: patients were studied according to their age, location, social and medical indications for hospitalization and their repeated registration on the waiting list. Microsoft Excel program and SPSS statistical package was used to analyze the results. The results: 95 per of patients in nursing and supportive care institution and 94,7 per those on the waiting lists are Kaunas citizenry. Examination of medical diagnoses of hospitalized patients revealed the neurological disease as a common: encephalophathy - 34,4 per and stroke – 18,4 per. 23,6 per of patients with post-stroke diagnosis and 19,5 per of oncology patients are on the waiting list. 36,1 per of patients at hospital were at the age of 81 - 90 y. Children take care of 57,5 per of the hospital patients, the strangers – of 12,7 per. The long waiting list for entering nursing and supportive care institution revealed the great demand for in-patient nursing care service in Kaunas city: 1845 names were put on it at the period of 1st of June, 2003 to 31st of May, 2004. However, double, treble or even fourfold registration of the same patient makes this statistic doubtful. After the additional selection of names the more realistic waiting lists consisted of 1441. 154 patients from... [to full text]

Dissatisfaction with medical information is a common problem among patients. There is also evidence that patients lack information that physicians believe they have given to the patient. The aims of this study were to 1) survey patients' subjective need for, and satisfaction with, the information that they received during their hospital stay 2) develop and evaluate systematic routines for giving information to the patients and also communication and collaboration between the medical and nursing staff concerning the satisfaction of the patients' need for information. The study was an intervention project and the research perspective was organizational psychology. Survey study. The patients experienced a considerable need for medical information, especially about the examination results and prognosis. The patients' need for information regarding prognosis was the least satisfied. Intervention 1. A general improvement of the information to the patients occurred when the systematic routines were established. The patients' subjective need for information was unchanged throughout two years. Their satisfaction with information, after an initial improvement, did not increase throughout these two years. There was low correlation between the patients' and their physicians' estimations concerning the patients' need for information on diagnosis, prognosis and examination results. Likewise, concerning the adequacy of that information. Intervention 2. Communication and collaboration between the medical and nursing staff included a system for assessment and solution of the patients' information problems. Problem-solving took place at a multidisciplinary team conference (MTC). Medical problems were better elucidated than the patients' psychological problems. After training of registered nurses (RN) as conference chairpersons, the patients need for information was better understood. The staff reported 42 information problems after training compared to two before. For half of the information problems decisions were discussed on steps to be taken in order to satisfy the patients' need for information. A year after the system for assessment and solution of information problems was established, the patients were more satisfied with information about examinations and their results and on information about medication (p&lt; 0.05). Further, new norms for the patients' need for information were established and a change was initiated. The results are discussed with regard to how and why patients' shall have information, by whom and to whom information shall be given, when and where information shall be given and which content it shall have. / <p>S. 1-56: sammanfattning, s. 57-137: 4 uppsatser</p> / digitalisering@umu

A concept of "total patient care" was developed in Hong Kong to enhance public hospital services. The development of this concept aimed to resolve two major concerns about patient care delivery. First, for historical reasons, there were differences among public hospitals in their emphases on the scientific medicine and social aspects of caring. Secondly, the health care system was under pressure to change due to rising expectations, in particular to an increasing number of patients requiring complex care in the community. The purposes of this study were (1) to investigate the historical influence on the development of patient services and (2) to examine the determinants affecting the development of new initiatives. The path-finding process to shift care practice from a traditional institutional orientation to a person-centred approach was studied through a focal point of study in all 38 public hospitals, serving a population of 6.3 millions. An analysis of the "successful" examples of the implementation of the concept of total patient care was initially conducted. The subsequent development of a variety of hospital patient care models was traced back to the different origins of patient care orientations through collecting views of hospital stakeholders and the support provided for patients outside the hospitals. A pluralistic approach, which involved site visits, interviews, focus group discussion and survey, was chosen to understand the complexity of historical influence and contemporary determinants in the development of the totality of patient care. A "mapping" method was adopted to analyse the data reflected different levels of concerns. The findings in this study indicated that, technological and financial factors often identified as the more important determinants in development of health care system, might have ignored the historical development of the hospitals and health traditions in the community in the development of totality of patient care. This study suggested that influences of these informal factors, as experienced in a Chinese community, would likely to continue and diffuse the goal of a planned policy. Formalisation of the informal and community involvement in formal hospital settings, through a concept of total patient care, had resulted in the consolidation of some diversified experience in the support of a diversified range of patient needs. The strengthening of a hospital-community linkage was highlighted as a possible solution to bring a full transformation of patient care into a model of totality.

Research Doctorate - Doctor of Philosophy (PhD) / Despite the emergence of smoking care guidelines and best practice recommendations over the past 13 years, it has been suggested that smoking care is not routinely provided in hospitals. Although there is a relatively large body of evidence regarding the prevalence of patient smoking cessation after hospitalisation and the effectiveness of interventions to increase cessation levels, much less is known regarding the prevalence of best practice smoking care routinely provided in hospitals or the effectiveness of interventions to increase such care provision. This thesis seeks to address these deficiencies in the evidence base. In particular this thesis aimed to: 1. Examine the prevalence of hospital smoking care in the international and Australian contexts. This is addressed via a literature review of studies that have reported the level of smoking care delivered routinely in hospitals and a survey of hospital managers in New South Wales, Australia. 2. Examine the effectiveness of interventions to increase the routine delivery of smoking care in hospitals. This is addressed via a literature review of studies that have reported the effect of an intervention on smoking care levels, and via the implementation of a quasi-experimental study that was designed to increase the hospital-wide delivery of a broad range of smoking care elements. 3. Propose recommendations for future practice and research regarding the routine provision of hospital smoking care. This thesis consists of six chapters that address the above aims. Each of the chapters has been written as a relatively distinct report in the style of a journal article. The approach has been adopted to facilitate the reading of the thesis, and results in some repetition in some chapters. At the time of submission, two papers based on the chapters of this thesis have been published in peer-reviewed journals. A further two papers are under editorial review.

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

Dissertation (Ph.D.)--University of South Florida, 2007. / Title from PDF of title page. Document formatted into pages; contains 90 pages. Includes vita. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1988.

Thesis (Ph. D.)--University of Missouri--Columbia, 1998. / "May 1998." Typescript. Vita. Includes bibliographical references (leaves 104-107). Also available on the Internet.

Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1987. / "A research report submitted in partial fulfillment of the requirements for the degree ..."