The scope of this project is an examination of medical compliance for the Hispanic patient with End State Renal Disease.

No description available.

One of the challenges fairly common in motivational interviewing is patient resistance to health behavior change. Hence, automated dialog systems aimed at counseling patients need to be capable of detecting resistance and appropriately altering dialog. This thesis focusses primarily on the development of such a system for automatic identification of patient resistance to behavioral change. This enables the dialogue system to direct the discourse towards a more agreeable ground and helping the patient overcome the obstacles in his or her way to change. This thesis also proposes a dialogue system framework for health behavior change via natural language analysis and generation. The proposed framework facilitates automated motivational interviewing from clinical psychology and involves three broad stages: rapport building and health topic identification, assessment of the patient’s opinion about making a change, and developing a plan. Using this framework patients can be encouraged to reflect on the options available and choose the best for a healthier life.

The problem of this study was to compare and evaluate two methods of teaching medication compliance to an elderly population with a variety of medical problems, cultural backgrounds, and educational levels. Eighty patients over 65 years old who were attending clinic at a county health care facility participated in the study and were randomly placed into two groups. The Medication Knowledge and Compliance Scale was used to assess the patients' medication knowledge and self—reported compliance. Group I (control) received only verbal teaching. Group II (experimental) received verbal teaching as well as a Picture Schedule designed to tailor the patients' medication schedule to their daily activities. Each patient was re—evaluated two to three weeks later. Medications were also counted at each visit and prescription refill records were examined. Knowledge and compliance did increase significantly among all 80 participants. Patients in Group II demonstrated a significantly greater increase in compliance than Group I but did not show a greater increase in knowledge. Patients in Group II also improved compliance as evidenced by their prescription refill records. This study demonstrates that even though significant barriers to learning exist, knowledge and compliance can be significantly improved when proper teaching techniques are utilized.

The present study demonstrates the effectiveness of combining medication packaging, verbal and graphical feedback, and pill count probes on increasing medication compliance. Eight chronic adult outpatients were randomly assigned to one of two conditions: (a) a regimen card medication packaging system, and (b) a 7- day baggie medication packaging system. A staggered group treatment design was used to ascertain whether either of the two special packaging systems was effective relative to baseline and reversal conditions (using the standard medication vial) in increasing medication compliance behavior among both over-and undercompliant outpatients. Results indicated that the use of the special packaging of medication in combination with the behavioral techniques of verbal and graphical feedback aided in improving compliance in 4 out of 8 noncompliant outpatients.

Bakgrund: Bristande följsamhet till läkemedelsbehandling är en vanlig företeelse som kan ha konsekvenser på individ-, grupp- och samhällsnivå. Sjuksköterskan har ett ansvar över den farmakologiska omvårdnaden och att stödja patientens följsamhet och adaption, vilket kräver en god relation. Relationen äventyras dock av frustration och fördomar som kan uppstå i sjuksköterskan relaterat till att patienten inte följer behandlingsplanen. En djupare förståelse och öppenhet för patientens erfarenheter, bekymmer och förhållningssätt kan bidra till den ömsesidiga tillit och förståelse som krävs för att bilda en effektiv vårdande relation med patienten. Syfte: Syftet med denna litteraturstudie var att belysa patienters perspektiv på följsamhet till behandling, med fokus på ordinerad läkemedelsbehandling. Metod: Strukturerad litteraturstudie med inslag av den metodologi som används för systematiska översikter. Resultat: Fynden beskriver en mångfald av perspektiv på följsamhet inklusive de synsätt, erfarenheter och förutsättningar som lägger grunden för hur patienten förhåller sig och beter sig i relation till sin ordinerade läkemedelsbehandling. Fyra teman identifierades; Patienten skapar en förståelse, Att genomgå en läkemedelsbehandling, Människan i sin kontext och Att anpassa sig till sin livssituation. Slutsats: Följsamhet till läkemedelsbehandling involverade flera interagerande ämnen som patienter hade varierande upplevelser av och förhållningssätt till; läkemedel, sjukdom, partnerskap i vården, självbild, världsbild, social identitet, välbefinnande, överlevnad och egenmakt. I samtliga fall var följsamhetsbeslut vägledda av personliga prioriteringar och baserade på de erfarenheter och uppfattningar som är unika för varje person. Följsamt beteende berodde på förmåga, medvetenhet och i viss mån förståelse. Följsamhet till läkemedelsbehandling korrelerade inte alltid med framgångsrik hantering av sjukdom och hälsa. Sjuksköterskor skulle kunna bistå patientens anpassning genom att främja delaktighet, ge goda förutsättningar för ett välgrundat beslutsfattande, och genom att stödja patientens förmåga att leva sitt liv efter sina egna preferenser och prioriteringar. För att uppnå detta är det essentiellt att etablera ett öppensinnat, hänsynsfullt och personcentrerat partnerskap med patienten. / Background: Medication non-adherence is a common phenomenon that can have consequences on an individual, group and societal level. The nurse has a responsibility for the pharmacological care and to support the patient's compliance and adaptation, which requires a good relationship. However, the relationship is jeopardized by frustration and prejudice that may arise in the nurse related to the patient not following the treatmentplan. A deeper understanding and openness to the patient's experiences, concerns and approaches can contribute to the mutual trust and understanding required to form an effective caring relationship with the patient. Aim: The aim of this literature study was to illustrate patients' perspectives on treatment adherence, with a focus on adherence to prescribed medication. Method: Structured literature study with elements of the methodology used for systematic reviews. Results: The findings describe a diversity of perspectives on compliance, including the views, experiences and conditions that lay the foundation for how the patient relates to and behaves around their prescribed medication. Four themes were identified; The patient creates an understanding, To go through pharmacotherapy. The person in their context and To adapt to one’s life situation. Conclusions: Medication adherence involved several interacting topics that patients had varying experiences of and ways of relating to; medication, disease, partnership in healthcare, personal and social identity, worldview, sense of well-being, survival and empowerment. In all cases, adherence decisions were guided by personal priorities and based on experiences and perceptions unique to that person. Adherent behavior depended on ability, awareness and, to some extent, comprehension. Medication adherence did not always correlate with successful management of illness and health. Nurses could assist the patient's adaptation by facilitating participation, providing good conditions for informed decision-making, and by supporting the patient's ability to live their life according to their own preferences and priorities. To achieve this, it is essential to establish an open-minded, considerate and person-centered partnership with the patient.

Introduktion: Tidigare forskning visar att det finns flera olika faktorer som bidrar till följsamhet vid läkemedelsbehandling av psykisk sjukdom, både möjligheter och svårigheter. En viktig uppgift som psykiatrisjuksköterskan har i mötet med patienter som lider av psykisk sjukdom är att psykiatrisjuksköterskan ska motivera patienten till att ta emot rekommenderad läkemedelsbehandling. Det är av värde att göra en översikt gällande aktuell forskning kring omvårdnadsmetoder och åtgärder som kan vidtas av psykiatrisjuksköterskan för att motivera patienter med psykisk sjukdom till följsamhet vid läkemedelsbehandling. Syfte: Syfte med denna studie är att undersöka hur sjuksköterskor inom psykiatrisk vård kan motivera personer med psykisk sjukdom till följsamhet vid läkemedelsbehandling. Metod: Metoden för detta examensarbete var litteraturöversikt bestående av 21 vetenskapliga artiklar, varav 14 kvantitativa, 5 kvalitativa och två med mixad metod. Vid litteratursökningenanvändes databaserna Pubmed och CINAHL. Resultat: Analysen av data resulterade i fyra kategorier (figur 3) vilket beskriver hur en sjuksköterska inom psykiatrisk vård kan motivera patienter med psykisk sjukdom tillföljsamhet vid läkemedelsbehandling. Dom fyra kategorierna blev: Den terapeutiska relationen och stöd från anhöriga vid följsamhet till läkemedelsbehandling, Psykoedukation för följsamhet till läkemedelsbehandling, Följsamhetsterapi för läkemedelsbehandling och Andra interventioner för att motivera till följsamhet vid läkemedelsbehandling. Slutsats: Det finns flera olika omvårdnadsinterventioner som specialistsjuksköterskan i psykiatrisk vård kan använda sig av för att motivera patienten att ta emot läkemedel och följa rekommenderad läkemedelsbehandling. Dessa omvårdnadsinterventioner överensstämmer med Roys anpassningsteori där Roy beskriver sjuksköterskans roll i patientens anpassningsförmåga och hur sjuksköterskan hjälper individer att hitta strategier för att hantera olika situationer samt ger individer möjligheter och stöd om behovet finns / Introduction: Previous research has shown that there are several different factors that contributes to adherence to drug treatment of mental illness, both opportunities and difficulties. An important task that the psychiatric nurse has in the meeting with patients suffering from mental illness is that the psychiatric nurse should motivate the patient to accept recommended drug treatment. It is of value to make an overview of current research on the different methods and measures that can be used by the psychiatric nurse to motivate patients with mental illness to adherence to drug treatment. Aim: The aim of this study is to investigate on how nurses in psychiatric care can motivate people with mental illness to adherence to drug treatment. Method: The method for this thesis was a literature review consisting of 21 scientific articles, of which 14 quantitative, 5 Qualitative and two with mixed method. The databases Pubmed and CINAHL were used in the literature search. Results: The analysis of the data resulted in four categories (figure 3), which describes how a nurse in psychiatric care can motivate patients with mental illness to adherence to drug treatment. The four categories were: The therapeutic relationship and support from relatives to motivate adherence to drugtreatment, Psychoeducation for adherence to drug treatment, Adherence therapy for drug treatment and Other interventions to motivate adherence to drug treatment. Conclusion: There are several different nursing interventions that the specialist nurse in psychiatric care can use to motivate a patient to receive medication and follow recommended drug treatment. These nursing interventions are consistent with Roy's adaptation theory where Roy describes the nurse's role in the patient's adaptation capability and how the nurse helps individuals find strategies to handle different situations and gives individuals opportunities and support if needed.

INTRODUKTION OCH SYFTE: Tidigare studier av kooperation och ortodonti har visat att ett av de bästa sätten att öka patienternas kooperation är genom att övervaka användningstiden och påminna patienten om att använda sin apparatur. Den här pilotstudiens syfte var att undersöka om någon utav två olika typer av påminnelser objektivt ökar användningstiden vid behandling med avtagbar apparatur eller inte.MATERIAL OCH METOD: 18 patienter i åldrarna 9-14 års ålder från en patientpopulation som behandlades vid avdelningen för Ortodonti, Odontologiska Fakulteten på Malmö Högskola, deltog i studien. Patienterna hade olika typer av bettavvikelser som gjorde dem behandlingsbara med antingen van Beek eller expansionsplåt. Patienterna placerades slumpmässigt in i en av tre grupper, alarm, kalender eller kontrollgrupp. Användningstid registrerades objektivt med en TheraMon®-timermodul som placerades inuti den ortodontiska apparaturens akrylbas.RESULTAT: Alarm-gruppen hade högst genomsnittlig användningstid. Kontrollgruppen hade något lägre användningstid än alarmgrupppen och kalendergruppen hade minst genomsnittlig användningstid. Det var skillnad på de olika behandlingstyperna, då behandlade med expansionsplåt hade bättre genomsnittlig användningstid än patienter behandlade med van Beek. Data testades för statistisk signifikans med Anova och t-test, ingen statistisk signifikans fanns.KONKLUSION: Den här studiens resultat tyder på att en påminnelse i form av ett alarm verkar vara bättre på att öka patienters kooperation än en kalender eller ingen påminnelse alls. Detta indikerar att det finns ett underlag för att i framtida studier vidare undersöka hur påminnelser via mobiltelefon påverkar compliance, till exempel påminnelse via en app. Patienter som behandlas med expansionsplåtar verkar ha en bättre compliance än patienter behandlade med van Beek-aktivatorer, därför bör framtida fokus läggas på att förbättra kooperationen hos patienter som behandlas med van Beek-aktivatorer. Framtida studier bör endast innefatta en typ av ortodontisk apparatur, till exempel van Beek. Fler patienter krävs i framtida studier för att säkerställa statistiskt signifikanta resultat. / INTRODUCTION AND PURPOSE: Earlier studies on compliance and orthodontics have shown that one of the best ways to increase compliance is by supervising the wearing time. Compliance can also be increased by reminding the patient to use the removable appliance. This pilot study aims to investigate if any of two kinds of reminders objectively increase the compliance during orthodontic treatment with removable appliances or not.MATERIALS AND METHODS: 18 patients between 9-14 years of age were selected from a patient population attending the department of Orthodontics, Faculty of Odontology, Malmö University. They presented different types of malocclusion which made them candidates for treatment with either van Beek-appliances or expansion plate. The patients were randomly placed in one of three groups; alarm, calendar or control group. Wearing time was objectively collected from the TheraMon®-module placed inside the acrylic base of the appliances. After the data collecting-phase was finished the data was tested with Anova and t-test to determine whether there was a significant difference between the groups.RESULTS: The alarm group had the highest average wear time. The control group had slightly lower average wear time than the alarm group, and the calendar group had the least amount of average wear time. There was a difference in average wear time between van Beek and expansion plate, with van Beek having a lower average wear time than expansion plate. Patients treated with expansion plates were more cooperative than patients treated with van Beek appliances. When data was tested for significance, no statistical significance was found.CONCLUSION: The study concludes that an alarm type of reminder appears to be better at improving wear time than a calendar or no reminder at all. This indicates that for future studies there might be a reason to develop a reminder for patients, for example an app. The study concludes that patients with expansion plates appear more cooperative than patients using van Beek appliance, so therefore focus should be on improving cooperation for patients using these types of appliances. This study shows that future studies should use one type of appliance, e.g. van Beek. More patients are needed in future studies to achieve statistical significant results.

The purpose of this study was to analyse the tracking systems used to identify patients with tuberculosis who missed a clinic appointment at primary health care facilities in Waterberg District. A quantitative descriptive correlation design was used to determine if there was an association between the tracking systems used and the defaulter rates. Data was collected using a questionnaire with nurses from 46 primary health care facilities, defaulter rates were accessed from the ETR.Net and the two sets of data were correlated. The results showed that the blue folder yielded the lowest mean defaulter rate while the green card yielded the highest mean defaulter rate. Nurses were unaware of the true defaulter rate in their facilities as they underestimated these rates. They therefore did not implement relevant intervention strategies to recall patients or find ways to improve the tracking systems used to reduce the defaulter rate in their health facilities. / Health Studies / M.A. (Health Studies)

The introduction of Antiretroviral (ARV) treatment has allowed for many children living with human immunodeficiency virus (HIV) to survive to adolescence. However for this to be a reality adherence to treatment is important. Many studies suggest that during adolescence adherence can be very challenging. However not much research has been done within the South African context to understand what HIV positive adolescents are experiencing, particularly in relation to ARV adherence. The aim of this research study was to explore the experiences of adolescents on antiretroviral therapy (ART) in order to understand what helps them to adhere to their medication and the challenges that they may have with adherence. This was achieved by carrying out 5 semi-structured in-depth interviews with HIV positive adolescents on ARVS at a shelter for HIV positive women and children in Johannesburg. A thematic content analysis was used to analyse the transcribed interviews. The results indicated several factors that both assist with adherence and those that challenge adherence. The participants reflected on the importance of full disclosure which increases their understanding of the importance of adherence, having people they trust whom they can confide in and who also support them to take and adhere to the ARVs, and having a positive experience at the hospital when they go for their regular checkups. Certain defence mechanisms adopted by the adolescents to help them cope with living with HIV and having to take medication every single day of their lives were also identified. The fact that acceptance is a process was also suggested by the research findings. The challenges the adolescents face were those of stigma and a fear of being rejected, bad experiences associated with taking medication, such as the negative side effects and the disruption of their leisure time, and negative experiences from going to the hospital. This study yielded some rich information that may aid in understanding what adolescents are experiencing and facing which may inform future research studies on this topic and policies which may assist with an increase in adherence.