The purpose of this study was to examine the orthodontic patient experience with braces compared to Invisalign® by means of a large-scale Twitter sentiment analysis. A custom data collection program was created to collect tweets containing the words “braces” or “Invisalign.” A hierarchal Naïve Bayes sentiment classifier was developed to sort the tweets into one of five categories: positive, negative, neutral, advertisement, or not applicable. Among the 419,363 tweets applicable to orthodontics collected, users posted significantly more positive tweets (61%) than negative tweets (39%) (p-value = ® tweets (p-value=0.4189). In conclusion, Twitter users express more positive than negative sentiment about orthodontic treatment with no significant difference in sentiment between braces and Invisalign® tweets.

Background: Approximately 2,8 million surgical procedures were performed in Sweden 2016. After surgery, patients experienced different degrees of postoperative pain. Under treated postoperative pain created great suffering for patients, delayed the recovery after surgery and could increase the risk of complications. Therefore, it is of importance to explore and describe patients’ experiences regarding pain in conjunction with surgery, in order to improve postoperative pain relief from a nursing perspective. Aim: To describe how patients experience postoperative pain and pain relief. Method: A literature review was conducted in which four qualitative studies and three quantitative studies were included. The studies were subjected to assurance of quality and Friberg’s three-step analysis was used. Results: Two categories and eight subcategories emerged. The two categories were (1) The time before surgery and (2) The time after surgery. The categories illustrated how patients experienced postoperative pain and pain relief before and after surgical procedures. Conclusion: Patients had previous experiences, expectations, knowledge and beliefs about postoperative pain and pain relief that affected their experiences before surgery. After the procedure, patients' difficulty in communicating, their participation, the attitudes of healthcare professionals and the degree of attendance of the nurse were important experiences related to postoperative pain and pain relief.

Thesis advisor: Danny G. Willis / Purpose: The purpose of this qualitative research was to describe the phenomenon of privacy as experienced and conceptualized by patients who participated in the CenteringPregnancy model of group healthcare. Background: In healthcare, privacy is an ethical and legal right. Healthcare providers have an obligation to protect patient privacy and confidentiality. Group healthcare is an innovative approach that brings together a group of patients with a team of providers, offering the opportunity for holistic, integrated, and coordinated healthcare. Group healthcare challenges how healthcare providers manage privacy and confidentiality. Knowledge about patients’ experiences of privacy during group healthcare such as CenteringPregnancy is fundamental to developing an understanding of the risks and benefits incurred during group healthcare visits. Research focused on uncovering the patient experience of privacy within the context of group healthcare can provide useful direction for improving the patient care experience and health outcomes. Research Questions: 1) What is the privacy experience of women who participated in CenteringPregnancy? 2) How does the patient experience of privacy in a group healthcare setting differ from the experience of privacy during individual care? Methods: This qualitative research used phenomenography to examine the experiences of privacy for 15 women who participated in CenteringPregnancy at a large multisite, multispecialty healthcare practice. Results: Four main concepts related to privacy were identified. My Privacy: Agency of the Self emerged as the primary conception of privacy for both group and individual care settings. My Provider: Protecting My Privacy focused on the critical role of the group facilitator in protecting confidentiality and establishing group privacy. The Dynamics of Group Privacy encompassed the relational processes of trusting, respecting, and sharing. Benefits of Participating in Group Healthcare included friendship, comradery, learning, and relief of feelings of isolation, fear, and anxiety. Conclusions: Women’s experiences of privacy within the context of CenteringPregnancy were positive. Findings can guide recruitment efforts and the facilitation and management of the group environment. Healthcare providers can offer a full description of privacy within group healthcare settings as part of recruitment and informed consent and emphasize the shared responsibility for group privacy among all members in the group. / Thesis (PhD) — Boston College, 2015. / Submitted to: Boston College. Connell School of Nursing. / Discipline: Nursing.

Background: Acute inpatient stays are decreasing. Evidence for music therapy in mental healthcare exists but practice varies. Short admissions and therapy frequency (usually weekly), limit access, yet acceptability of increased frequency to patients is unknown. Research to model processes and outcomes of intensive provision may identify how best to provide for acute contexts informing clinical practice and future research. Methods: 114 patients admitted to hospital with acute mental health problems were recruited. Patients attended group music therapy 1-3 times per week during admission. Repeated measures assessing patient experiences, session appraisal, motivation and commitment were completed. Questionnaire thematic analysis identified important processes which were coded from session recordings. Multilevel modelling was used to examine associations between music therapy components, session appraisal, motivation, commitment and subsequent attendance. End of therapy interviews with 16 patients explored changes experienced and views on therapy frequency. Results: Attendance was 3 times greater for patients with 3 sessions per week. The majority found increased frequency acceptable and beneficial. Processes of engagement, emotional expression and social connection suggested active music-making, synchrony and singing to be important for group cohesion. Singing was significantly associated with appraisal and motivation. Musical initiation by group members was associated with motivation and commitment. All three outcomes were associated with each other, with session appraisal and increased frequency independently associated with subsequent attendance. Patient attributions for change included creativity, experiential learning and therapist directed reflective discussions. Conclusion: Intensive group music therapy is acceptable to the majority of patients, perceived as beneficial and increases access. Intensive provision is associated with greater engagement and positive experiences, which in turn, are associated with group commitment. Patient experiences can inform practice. Further research should examine effectiveness of intensive provision. Therapists should continue to prioritise engagement through active music-making and singing, and services consider implementation of intensive provision.

Bakgrund: Tillit ställer förväntningar på att sjuksköterskan i sin profession ska vara trovärdig mot alla patienter. Tillit inom omvårdnaden ger potential till att utveckla en relation mellan sjuksköterska och patient där sjuksköterskan har en större möjlighet att få fram viktig information som kan vara avgörande för patientens hälsa. Syfte: Att beskriva patienters upplevelser av att känna tillit till sjuksköterskan. Metod: Studien gjordes som en allmän litteraturstudie med systematiska sökningar där resultatet är baserat på 10 vetenskapliga artiklar. Databearbetningen resulterade i fyra kategorier som belyser vad patienten upplever är tillit till sjuksköterskan; Att bli sedd, Att få tid, Att bli respekterad och Att bli hörd. Resultat: Resultatet visar att patienten upplever tillit när hen blir sedd vilket kan bidra till att patienten upplever trygghet och hen känner sig involverad i sin egenvård. Genom att få tid kan patienten känna att sjuksköterskan förstår att ett förtroende inte kan stressas fram. När patienten känner sig respekterad av sjuksköterskan upplever hen sig som mer jämlik vilket får patienten att känna sig betydelsefull. När patienten känner att hen blir hörd fördjupas relationen mellan dem och patienten upplever att förhållandet är ömsesidigt. Slutsats: Tilliten till sjuksköterskan kan vara grunden för hur patienten upplever sitt vårdförlopp. Det kan bidra till att patienten får en tydligare förståelse om den omvårdnad som sjuksköterskan utför. Vidare forskning kring patienters upplevelser av tillit är viktigt och skulle kunna bidra till utveckling inom vården. / Background: Trust poses expectations that the nurse in his profession should be credible to all patients. Trust in nursing provides the potential for developing a relationship between nurse and patient in which the nurse has a greater opportunity to provide important information that can be crucial to the patient's health.  Aim: To describe patients' experiences of trusting the nurse. Method: The study was conducted as a general literature review with systematic searches where the result is based on 10 scientific articles. Data processing resulted in four categories that highlight what the patient experiences is trusting the nurse; To be seen, to get time, to be respected and to be heard. Results: The result shows that the patient experiences trust when being seen, which can help the patient feel safe and feel involved in his or her own care. By getting time, the patient can feel that the nurse understands that trust can not be stressed. When the patient feels respected by the nurse, he experiences more equality, which makes the patient feel important. When the patient feels that they are heard, the relationship between them is deepened and the patient perceived that the relationship was mutual. Conclusion: Trust in the nurse may be the basis for the patient's perception of care. This can help the patient gain a clearer understanding of the nursing care performed by the nurse. Further research on the patient's experience of trust is important and could contribute to development in health care.

Background: Research has shown that staff-patient relationships within secure forensic services appear to be influenced by an ethos of institutional control, most evident in the tensions of developing meaningful therapeutic relationships while continuing to maintain high levels of security. In an attempt to address the perceived deficits in these relationships, the development of a positive therapeutic milieu was proposed within a high security hospital. Novel therapeutic interventions, known as Ward-Talking-Groups (WTGs), were introduced as a first step towards the development of this milieu. It was also recognised that research exploring the efficacy of psychological interventions for the treatment of psychotic symptoms have exclusively focused on community based settings or general psychiatric hospitals. Although the findings from these reviews have some utility within a forensic psychiatric population, this population also have a number of co-occurring complex needs that inevitably impact on treatment outcomes. Objective: The primary study aimed to explore in detail patients' experiences of being part of their WTGs. A systematic review was also conducted to review the existing literature regarding the efficacy of psychological interventions for the treatment of psychotic symptoms in individuals with forensic needs. Methods: For the primary study, semi-structured interviews were conducted with ten male participants detained within a high security hospital. The data was transcribed and analysed using Interpretative Phenomenological Analysis. For the systematic review, using predefined inclusion and exclusion criteria, eight databases were searched, selected journals were hand searched and two grey literature databases were searched to identify relevant studies. 9 Results: For the primary study, three themes emerged from the data: Coming together as a unit; Liberty Vs. Control, and Facing something new. For the systematic review, eight studies fulfilled the inclusion criteria for review, with relevant information from each study being extracted and tabulated. The identified studies were scored against quality criteria. Discussion: For the primary study, the findings highlight the importance of patients being able relate to other people within their WTG, with the challenges and benefits of this being at the forefront of participants' minds. Participants described an increased sense of liberty within their WTG, while being acutely aware this was within the context of a high security hospital. Participants' feelings towards the introduction of their WTG appeared to be split; some felt ambivalence towards them, while others were open-minded about them. Reflecting on the introduction of their WTGs, participants shared the view that more information about them was necessary. However, they differed in their approach to seeking this out. For the systematic review, overall findings from the review papers tentatively suggest there is some evidence for the efficacy of psychological interventions in the treatment of psychotic symptoms in individuals with forensic needs. Clinical implications, strengths and limitations, and future research possibilities are outlined for both the empirical study and systematic review.

In 2011, Medicare patients represented the largest share of total readmissions and health costs when compared to all other patient categories. Because patient-centered care drives the use of health services, the U.S. Patient Protection and Affordable Care Act outlined improving the patient experience to reduce readmission rates; however, the relationship between patient experience and readmissions is not well understood. Grounded in systems theory, the purpose of this correlational study was to determine if the relationship between patient experience and readmission rates in Medicare Shared Savings Program accountable care organizations. Data from the Consumer Assessment of Healthcare Providers and Systems survey were gathered from the Centers for Medicare and Medicaid datasets to analyze patient experience measurements and readmission rates, while accounting for variation among Medicare service regions, number of assigned beneficiaries, and performance year. Using multiple linear regression to analyze the data, the model was used to predict Medicare's all-condition readmission rate (per 1000), R-²= .242, F (13, 634) 15.59, p < .001. The research question was answered partially; variation in the patient experience domain did not support all hypotheses. Because the Medicare population represents the fastest growing patient population within the U.S. health care system, continuous evaluation of policy and performance provides an evidence-based analysis to health administrators and providers who have pivotal roles in the creation of positive social change. Findings may be used to improve quality and service while reducing costs, which contributes to the sustainability of the U.S. Medicare program and its beneficiary population.

Background: The patient meets nurses in the emergency department that provide both nursing and has medical skills. The care that the patients are receiving should be individually adjusted. The care is shaped by the individual meeting with the patient according to the nursing theorist Orlando. There are large variations between the number of patients in an emergency department and it sets high demands on the staff, both physically and mentally. When the emergency department is highly loaded there is a priority for medical care and psycho-social and aesthetic aspects will have to wait. It´s often an impossibility to be able to sit down with the individual patient and talk for a while. Aim: The purpose of this study was to describe the patient´s perceptions of nurse’s treatment at an emergency department. Method: Ten scientific papers from the years 1999 – 2010 have been used in our literature review in which the similarities and differences are compared. Result: The result of the analysis resulted in three titles, environment affects the integrity, that patients well-being are satisfied and the nurse information affects patient’s experience. Conclusion: Whether the communication turned out well between patient and nurse influenced how the patient experienced the visit at the emergency department.

Bakgrund: Cancer är en folksjukdom och varje timme diagnostiseras sex personer. För att ge bästa möjliga omvårdnad till kvinnor med cancer krävs kunskap om både sjukdomen och om hur patienten vill bli bemött. Enligt lag är sjukvårdspersonal skyldig att utforma vård i samråd med patienten. Dock har vetenskaplig forskning bevisat att det finns skillnader i hur patienter upplever sin omvårdnad och hur sjuksköterskor tror att patienter vill ha sin omvårdnad. Syfte: Syftet var att beskriva cancerdiagnostiserade kvinnors upplevelser av omvårdnad från sjukvårdspersonal. Metod: Metodtriangulering genomfördes för att få ett så brett resultat som möjligt. Studiens ena del är en litteraturstudie (overview) av vetenskapliga artiklar (n=14) och den andra delen är en empirisk studie av bloggar (n=11). Resultat: De två delarna presenterades var för sig i två huvudkategorier och fem subkategorier. Diskussion: I diskussionen lyfts tre centrala fynd fram; känslan av hopplöshet, trygghet och lidande i omvårdnad. Slutsats: Alla patienter är unika med egna subjektiva upplevelser och erfarenheter. Sjukvårdspersonal bör ta detta i beaktande för att kunna möta patienten och hans/hennes önskemål på bästa sätt. / Background: Cancer is an endemic disease that six people are diagnosed with every hour. For good nursing care to women with cancer both knowledge about the disease and how the patient wants to be treated is required. In accordance to the law health care professionals is required to design care in consultation with the patients. Scientific research has proven that there are differences in how patients perceive their care and how nurses believe that patients want their care. Objective: The objective was to describe how women diagnosed with cancer experience nursing from health care professionals. Method: To obtain the broadest possible outcome a methodtriangulation was conducted. One part of the study is a literature review (overview) of scientific articles (n=14) and the second part is an empirical study of blogs (n=11). Results: The results were presented separately in two major categories and five subcategories. Discussion: The discussion highlighted three key findings: the sense of hopelessness, security and suffering in nursing. Conclusion: All patients are unique with their own subjective experiences. Health care professionals should take this into consideration in order to meet the patient and his/her needs the best way possible.

Aim: The aim of this study was to describe how patients with acute illness experience their given care in the emergency department. Method: A literature review of ten studies where differences and similarities were analyzed. These studies had been published between the years of 2000 and 2011. Results: The analysis showed a lack of sufficient care concerning patients’ subjective experiences. The researchers found three themes that specifically stood out when studies that had already been made were researched. These themes played an important role in care in the emergency department and insufficient attention to these from the staff could lead to a negative impact on patients’ experiences. The themes were: patients’ participation, patients’ need of communication and information and waiting period. The result showed that a lack in these presented themes could cause feelings of distress, frustration and irritation among patients. Because of this they often used different kinds of strategies to get more involved in their own caring process. Conclusion: The conclusion of this study was that there is a lack of resources within the emergency department where lack of personnel is the most forthcoming reason to patients’ negative experiences. There was however ways for the nurses to improve patients’ experiences within the emergency department by using Travelbee’s philosophy. This was to better interact and understand the patients’ lived experiences as a whole. Every patient is unique and by using proper communication, nurses can understand the patients’ whole life situation and by that, improve the quality of care.