Florence Nightingale used the principles of patient-centered care as the foundation for nursing practice. Today, patient-centered care delivery is part of the healthcare reform process that extends interprofessionally throughout all settings of healthcare in the United States (U.S.). Patient satisfaction measurement is one primary determinant of effective patient-centered care. The standardized Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and methods is a nation-wide tool used to measure patient satisfaction. However, this method of patient satisfaction assessment relies on recollections of patients’ hospital experiences and requires accurate memory and recall. This study sought to examine the effect of the memory-experience gap on patients’ perceptions of their hospital experiences and address this research question: Are there any statistical differences between in-hospital and two-week post-discharge perceptions of patient-centered care as measured with HCAHPS patient satisfaction ratings on (a) the composite scores for communication with nurses, communication with physicians, communication about medicines, pain management, staff responsiveness, (b) the individual scores for the hospital environment’s cleanliness and quietness, and the inclusion of patient and family preferences in the plan of care, and (c) the overall global rating score? The design was a non-experimental, prospective, descriptive correlational study. The setting was a 255-bed regional hospital that serves individuals from eight surrounding rural counties in southern middle Tennessee. The case-mix contained diverse individuals with multiple economic, environmental, physical, social and spiritual dynamics. A convenience sample of 82 adult patients ages 26 - 93 represented mainly Caucasian females with mostly cardiovascular and respiratory illnesses who had a minimum one-day stay.

This thesis describes a qualitative study exploring the use of critical care diaries from the experiences and perspectives of patients, family members and nurses in a Scottish Intensive Care Unit (ICU). Diaries are currently used in some ICUs across Europe, the UK, Australia and other countries to help patients come to terms with the experience of critical illness. Started in the ICU, the diary is written at the bedside by nurses and family members providing an account of what happened when the patient was in ICU. Following discharge, the diary is handed over to the patient for them to read and refer to during their recovery. Therefore, the diary is used by different people, at different times and in different ways throughout the critical illness journey. However, until recently, research has mainly focused on the diary being read by the patient after ICU as an aid to recovery with little known about family members and nurses despite them being the main authors during the time in ICU. This doctoral research was designed to explore critical care diaries from multiple perspectives and experiences to gain a greater understanding of the different ways in which diaries can be used. Furthermore, it is the first known research study in this area to have been undertaken in NHS Scotland where the use of diaries remains a relatively new practice. The theoretical perspective of Symbolic Interactionism helped to inform the development and design of the research study. A focused ethnographic approach was taken to explore the use of critical care diaries from the different groups identified, during and after a stay in ICU. The setting was an Adult ICU in Scotland where diaries were being used as part of a follow up service for patients and family members after ICU. Data were collected from February 2013 to June 2014. Semi-structured interviews were the main method of data collection. A purposive sampling strategy was adopted to recruit participants in triads with a related patient, family member and nurse involved in their care during the time in ICU. This is a novel and unique approach to research in this area. Four complete triads and two incomplete triads were recruited giving a total of sixteen interviews with four patients, six family members and six nurses. Interviews were supplemented with a small number of formal observations of nurses carrying out diary related activities (n=9) and field notes from time spent at the site. Transcribed interview data were analysed using a thematic approach, uncovering five main themes: (1) Information; (2) Communication; (3) Emotion; (4) Person Centered and (5) Gender. The concept of ‘Stories as joint actions’ developed by the sociologist Ken Plummer in 1995 was used as a framework to discuss and explain the findings. Diaries were found to support information sharing and facilitate communication interactions between nurses, family members and patients in the ICU as well as promoting and demonstrating a person centered approach to care. Emotional support was experienced by family members from writing in and reading the diary during the time in ICU whereas patients experienced emotional support from reading diary entries after the time in ICU. However emotional effort was associated with reading and writing in the diary during and after the time in ICU for patients, family members and nurses. Male family members were found to be less likely to write in the diary compared to female family members. Factors such as gender and literacy appeared to influence diary use however this requires further investigation. A new conceptual model ‘Critical Care Diaries as Joint Actions’ was created to address the complex nature of experiences with critical care diaries. Exploring the use of diaries from multiple perspectives and experiences has provided valuable insight into the different ways in which diaries are used during and after the time in ICU demonstrating that although the diary is primarily written for the patient, family members, nurses and patients use the diary in different ways to support their needs and others needs throughout the experience of critical illness.

Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and family engagement, their experiences from the advisor program, and what is most meaningful to them. A phenomenological design was employed with a purposeful sample of 19 interview respondents drawn from 5 different advisory councils. Data analysis consisted of interpretive phenomenological analysis and a detailed, in-depth account of participant experiences. Transcripts from semi structured face-to-face interviews were collected, coded, validated by member checking, and triangulated with emergent themes. Emergent themes included patient/family advisors' descriptions of patient and family engagement within the patient family advisory councils and organizational efforts most meaningful to patient/family advisors. The results of this study may help create social change by improving the standards and quality of patient and family engagement by preparing health care professionals to better meet the needs of health care consumers.

Introdução: As primeiras relações desde a concepção do ser humano, são carregadas de sentimentos e fantasias relacionadas ao filho esperado, um bebê sadio e que traz muita expectativa e idealização. Poucos são os estudos sobre a reação paterna durante a gestação, principalmente quando esta traz consigo o diagnóstico de malformação fetal. O nascimento de um bebê impõe mudanças na relação homem e mulher, mesmo que o projeto de um filho tenha sido pensado pelo casal. Conhece-se a possibilidade de intervir de maneira precoce para que pai-feto malformado estabeleçam vínculos saudáveis desde o momento do diagnóstico, contribuindo para a prevenção do adoecimento desta interação e melhora na qualidade de vida da família. Objetivo: Investigar a participação paterna no pré-natal de gestações com e sem diagnóstico de malformação fetal. Método: Estudo transversal e prospectivo, de caráter quantitativo e qualitativo. Participaram da amostra 70 homens que espontaneamente acompanharam as gestantes no pré-natal na equipe de Medicina Fetal, no ambulatório do Hospital de Clínicas de Porto Alegre (HCPA). O grupo caso (35 participantes) com diagnóstico de malformação fetal, independente do tipo de malformação, da idade materna, da paridade, da idade gestacional e tempo de relacionamento do casal e o controle (35 participantes) sem diagnóstico de malformação fetal, mas com diagnóstico de doença materna. A coleta se deu no período entre dezembro de 2014 e dezembro de 2015. Os instrumentos utilizados foram Parental Bonding Instrument - PBI; Escala de Modos de Enfrentamento do Problema – EMEP; Inventário de Percepção de Suporte Familiar IPSF; Entrevista semidirigida para coleta de dados sociodemográficos. Resultados: A média de idade paterna foi de 33,5 anos (± 9,5) do grupo caso e de 27,6 anos (±4,4) no grupo de controle, Ensino Médio Completo, primeiro casamento e uma média de três anos de relacionamento nos dois grupos. O choque e tristeza foram as principais reações paternas diante do diagnóstico de malformação fetal. A estratégia de enfrentamento “Foco no Problema” (EMEP), a qualidade de apego/relação parental predominou a base no “Cuidado” ao invés do “Controle ou Superproteção” (PBI) e a percepção do pai sobre a relação com a família associada ao “Fator Afetivo/Consciente” (IPSF). Apesar de, nas escalas, o fator “Religioso” não ter se destacado, na análise qualitativa das verbalizações foi este o conteúdo que predominou. Conclusão: O choque e a tristeza foram as principais reações diante do diagnóstico de malformação fetal. O foco no Problema e o foco na Emoção, associados a uma base de Cuidado e com a percepção do suporte familiar relacionada ao fator Afetivo/Consciente levam a pensar em um novo modelo paterno. O fator Religioso e o acolhimento da equipe foram destaques na análise qualitativa. A necessidade de cuidado, escuta e acolhimento do pai de um bebê com diagnóstico de maformaçao fetal, possibilita o preparo para a chegada, e muitas vezes, a imediata perda do filho. Os pais desse estudo conseguiram expressar seu afeto sem medo ou vergonha. Estamos diante de um modelo de pai que tende a se mostrar mais em termos afetivos, um modelo mais voltado ao cuidado na relação, não apenas focado nas questões financeiras. Contudo, cabe à mulher e à equipe multiprofissional lhe dar esse espaço, estimulando e permitindo ao homem, dentro das suas características, o desenvolvimento das habilidades de cuidador. / Introduction: The first relations since the conception of a human being, are loaded with feelings and fantasies related to the expected child, a healthy baby, and that brings a lot of expectations and idealization. There are few studies on paternal reaction during pregnancy, especially when it brings the diagnosis of fetal malformation. The birth of a baby requires changes in male-female relationships, even if it has been planned by the couple. The possibility of intervening at an early stage exists so that parent- fetus malformed might establish healthy ties from the very moment of diagnosis, contributing to the prevention of any illness regarding the interaction and improvement in the quality of family life. Objective: To investigate the paternal participation in prenatal pregnancies with and without a diagnosis of fetal malformation. Method: Cross-sectional and prospective study, quantitative and qualitative. The sample 70 men who spontaneously accompanied pregnant women in prenatal care in the team of fetal medicine at the clinic of the Hospital de Clínicas de Porto Alegre (HCPA). The case group (35 participants) with a diagnosis of fetal malformation, regardless of the type of malformation, maternal age, parity, gestational age and couple relationship of time and control (35 participants) without a diagnosis of fetal malformation, but diagnosis of maternal disease. The collection was carried out in the period between December 2014 and December 2015. The instruments used were the Parental Bonding Instrument - PBI; Coping Mode Scale Problem - EMEP; Inventory IPSF Family Support Perception; Semistructured interview to collect sociodemographic data. Results : The mean paternal age was 33.5 years ( ± 9.5 ) in the case group and 27.6 years ( ± 4.4 ) in the control group, Complete High School , first marriage and an average of three year relationship in both groups. The shock and sadness were the main fathers' reactions to the diagnosis of fetal malformation. The coping strategy " Focus on Problem " (EMEP ), the quality of attachment / parental relationship predominated based on " care " instead of " control and overprotection " ( PBI) and the perception of the father on the relationship with the associated family the " Affective Factor / Conscious " ( IPSF ) . Although, the scales, the "Religious" factor have not been highlighted in the qualitative analysis of verbalization was this content that prevailed. Conclusion: Shock and sadness were the main reactions to the diagnosis of fetal malformation. Focus on the problem and focus on emotion, associated with a care base and the perception of family support related Affective factor/Aware lead to think about a new paternal model. The Religious Factor and the host team were featured in the qualitative analysis. The need for care, father listening and host a baby diagnosed with fetal malformation enables the preparation for the arrival, and often the immediate loss of the child. The parents of this study were able to express their affection without fear or shame. We are facing a parent model that tends to show more emotional terms, a friendlier model care in the relationship, not only focused on financial issues. However, it is up to the woman and the multi-professional team give you that space, encouraging and allowing the man within its characteristics, the development of caregiver skills.

The purpose of this thesis is to identify common themes presented in several illness narratives with specific attention paid to the relationship between patients and their physicians and patients and their families. Only illness narratives written in America and Western Europe were used for this thesis so the topic could be narrowed to the experience within the western biomedical field. While most research on illness narratives focuses on defining illness and illustrating the importance of introspective work, this thesis identifies patterns in a way that can shape the future treatment of chronically ill patients. This thesis also allows me to creatively explore a personal illness narrative, reinforcing these themes and contributing to the discussion of what physicians and families can do to make the illness experience more bearable for the patient.

Family members of surgical patients experience anxiety due to lack of consistent communication during the surgical process. Attending to the needs of the surgical patient's family members is an important factor easily forgotten in a busy clinical arena. The purpose of this project was to decrease the surgical patient's family member's anxiety by providing family members with timely and consistent information regarding the patient's progress through surgery. The theoretical foundation used was general systems theory showing that a change in one part of a system leads to change in the whole system with the use of improved communication and feedback. The key question asked was whether an electronic information system could provide additional information in conjunction with personal interaction to reduce the family member's anxiety. The project design was a prospective, randomized, posttest design in a single-center study using the State-Trait Anxiety Inventory Survey for Adults (STAI). The sample size was 80 surgical patients' family members. Results using the Wilcoxon-Rank-Sum test indicated that the addition of an electronic information display was unable to reduce STAI scores. The medians for the State portion of the survey were .823 across all categories for both the control and intervention groups. The medians for the Trait portion of the survey for both the control and intervention groups were .118 with p >05. Although the data suggests retaining the null hypothesis, a significant social change was the staff's heightened awareness of the surgical patient's family's vulnerability and the need for communication during the perioperative phase.

Introdução: As primeiras relações desde a concepção do ser humano, são carregadas de sentimentos e fantasias relacionadas ao filho esperado, um bebê sadio e que traz muita expectativa e idealização. Poucos são os estudos sobre a reação paterna durante a gestação, principalmente quando esta traz consigo o diagnóstico de malformação fetal. O nascimento de um bebê impõe mudanças na relação homem e mulher, mesmo que o projeto de um filho tenha sido pensado pelo casal. Conhece-se a possibilidade de intervir de maneira precoce para que pai-feto malformado estabeleçam vínculos saudáveis desde o momento do diagnóstico, contribuindo para a prevenção do adoecimento desta interação e melhora na qualidade de vida da família. Objetivo: Investigar a participação paterna no pré-natal de gestações com e sem diagnóstico de malformação fetal. Método: Estudo transversal e prospectivo, de caráter quantitativo e qualitativo. Participaram da amostra 70 homens que espontaneamente acompanharam as gestantes no pré-natal na equipe de Medicina Fetal, no ambulatório do Hospital de Clínicas de Porto Alegre (HCPA). O grupo caso (35 participantes) com diagnóstico de malformação fetal, independente do tipo de malformação, da idade materna, da paridade, da idade gestacional e tempo de relacionamento do casal e o controle (35 participantes) sem diagnóstico de malformação fetal, mas com diagnóstico de doença materna. A coleta se deu no período entre dezembro de 2014 e dezembro de 2015. Os instrumentos utilizados foram Parental Bonding Instrument - PBI; Escala de Modos de Enfrentamento do Problema – EMEP; Inventário de Percepção de Suporte Familiar IPSF; Entrevista semidirigida para coleta de dados sociodemográficos. Resultados: A média de idade paterna foi de 33,5 anos (± 9,5) do grupo caso e de 27,6 anos (±4,4) no grupo de controle, Ensino Médio Completo, primeiro casamento e uma média de três anos de relacionamento nos dois grupos. O choque e tristeza foram as principais reações paternas diante do diagnóstico de malformação fetal. A estratégia de enfrentamento “Foco no Problema” (EMEP), a qualidade de apego/relação parental predominou a base no “Cuidado” ao invés do “Controle ou Superproteção” (PBI) e a percepção do pai sobre a relação com a família associada ao “Fator Afetivo/Consciente” (IPSF). Apesar de, nas escalas, o fator “Religioso” não ter se destacado, na análise qualitativa das verbalizações foi este o conteúdo que predominou. Conclusão: O choque e a tristeza foram as principais reações diante do diagnóstico de malformação fetal. O foco no Problema e o foco na Emoção, associados a uma base de Cuidado e com a percepção do suporte familiar relacionada ao fator Afetivo/Consciente levam a pensar em um novo modelo paterno. O fator Religioso e o acolhimento da equipe foram destaques na análise qualitativa. A necessidade de cuidado, escuta e acolhimento do pai de um bebê com diagnóstico de maformaçao fetal, possibilita o preparo para a chegada, e muitas vezes, a imediata perda do filho. Os pais desse estudo conseguiram expressar seu afeto sem medo ou vergonha. Estamos diante de um modelo de pai que tende a se mostrar mais em termos afetivos, um modelo mais voltado ao cuidado na relação, não apenas focado nas questões financeiras. Contudo, cabe à mulher e à equipe multiprofissional lhe dar esse espaço, estimulando e permitindo ao homem, dentro das suas características, o desenvolvimento das habilidades de cuidador. / Introduction: The first relations since the conception of a human being, are loaded with feelings and fantasies related to the expected child, a healthy baby, and that brings a lot of expectations and idealization. There are few studies on paternal reaction during pregnancy, especially when it brings the diagnosis of fetal malformation. The birth of a baby requires changes in male-female relationships, even if it has been planned by the couple. The possibility of intervening at an early stage exists so that parent- fetus malformed might establish healthy ties from the very moment of diagnosis, contributing to the prevention of any illness regarding the interaction and improvement in the quality of family life. Objective: To investigate the paternal participation in prenatal pregnancies with and without a diagnosis of fetal malformation. Method: Cross-sectional and prospective study, quantitative and qualitative. The sample 70 men who spontaneously accompanied pregnant women in prenatal care in the team of fetal medicine at the clinic of the Hospital de Clínicas de Porto Alegre (HCPA). The case group (35 participants) with a diagnosis of fetal malformation, regardless of the type of malformation, maternal age, parity, gestational age and couple relationship of time and control (35 participants) without a diagnosis of fetal malformation, but diagnosis of maternal disease. The collection was carried out in the period between December 2014 and December 2015. The instruments used were the Parental Bonding Instrument - PBI; Coping Mode Scale Problem - EMEP; Inventory IPSF Family Support Perception; Semistructured interview to collect sociodemographic data. Results : The mean paternal age was 33.5 years ( ± 9.5 ) in the case group and 27.6 years ( ± 4.4 ) in the control group, Complete High School , first marriage and an average of three year relationship in both groups. The shock and sadness were the main fathers' reactions to the diagnosis of fetal malformation. The coping strategy " Focus on Problem " (EMEP ), the quality of attachment / parental relationship predominated based on " care " instead of " control and overprotection " ( PBI) and the perception of the father on the relationship with the associated family the " Affective Factor / Conscious " ( IPSF ) . Although, the scales, the "Religious" factor have not been highlighted in the qualitative analysis of verbalization was this content that prevailed. Conclusion: Shock and sadness were the main reactions to the diagnosis of fetal malformation. Focus on the problem and focus on emotion, associated with a care base and the perception of family support related Affective factor/Aware lead to think about a new paternal model. The Religious Factor and the host team were featured in the qualitative analysis. The need for care, father listening and host a baby diagnosed with fetal malformation enables the preparation for the arrival, and often the immediate loss of the child. The parents of this study were able to express their affection without fear or shame. We are facing a parent model that tends to show more emotional terms, a friendlier model care in the relationship, not only focused on financial issues. However, it is up to the woman and the multi-professional team give you that space, encouraging and allowing the man within its characteristics, the development of caregiver skills.

Introdução: As primeiras relações desde a concepção do ser humano, são carregadas de sentimentos e fantasias relacionadas ao filho esperado, um bebê sadio e que traz muita expectativa e idealização. Poucos são os estudos sobre a reação paterna durante a gestação, principalmente quando esta traz consigo o diagnóstico de malformação fetal. O nascimento de um bebê impõe mudanças na relação homem e mulher, mesmo que o projeto de um filho tenha sido pensado pelo casal. Conhece-se a possibilidade de intervir de maneira precoce para que pai-feto malformado estabeleçam vínculos saudáveis desde o momento do diagnóstico, contribuindo para a prevenção do adoecimento desta interação e melhora na qualidade de vida da família. Objetivo: Investigar a participação paterna no pré-natal de gestações com e sem diagnóstico de malformação fetal. Método: Estudo transversal e prospectivo, de caráter quantitativo e qualitativo. Participaram da amostra 70 homens que espontaneamente acompanharam as gestantes no pré-natal na equipe de Medicina Fetal, no ambulatório do Hospital de Clínicas de Porto Alegre (HCPA). O grupo caso (35 participantes) com diagnóstico de malformação fetal, independente do tipo de malformação, da idade materna, da paridade, da idade gestacional e tempo de relacionamento do casal e o controle (35 participantes) sem diagnóstico de malformação fetal, mas com diagnóstico de doença materna. A coleta se deu no período entre dezembro de 2014 e dezembro de 2015. Os instrumentos utilizados foram Parental Bonding Instrument - PBI; Escala de Modos de Enfrentamento do Problema – EMEP; Inventário de Percepção de Suporte Familiar IPSF; Entrevista semidirigida para coleta de dados sociodemográficos. Resultados: A média de idade paterna foi de 33,5 anos (± 9,5) do grupo caso e de 27,6 anos (±4,4) no grupo de controle, Ensino Médio Completo, primeiro casamento e uma média de três anos de relacionamento nos dois grupos. O choque e tristeza foram as principais reações paternas diante do diagnóstico de malformação fetal. A estratégia de enfrentamento “Foco no Problema” (EMEP), a qualidade de apego/relação parental predominou a base no “Cuidado” ao invés do “Controle ou Superproteção” (PBI) e a percepção do pai sobre a relação com a família associada ao “Fator Afetivo/Consciente” (IPSF). Apesar de, nas escalas, o fator “Religioso” não ter se destacado, na análise qualitativa das verbalizações foi este o conteúdo que predominou. Conclusão: O choque e a tristeza foram as principais reações diante do diagnóstico de malformação fetal. O foco no Problema e o foco na Emoção, associados a uma base de Cuidado e com a percepção do suporte familiar relacionada ao fator Afetivo/Consciente levam a pensar em um novo modelo paterno. O fator Religioso e o acolhimento da equipe foram destaques na análise qualitativa. A necessidade de cuidado, escuta e acolhimento do pai de um bebê com diagnóstico de maformaçao fetal, possibilita o preparo para a chegada, e muitas vezes, a imediata perda do filho. Os pais desse estudo conseguiram expressar seu afeto sem medo ou vergonha. Estamos diante de um modelo de pai que tende a se mostrar mais em termos afetivos, um modelo mais voltado ao cuidado na relação, não apenas focado nas questões financeiras. Contudo, cabe à mulher e à equipe multiprofissional lhe dar esse espaço, estimulando e permitindo ao homem, dentro das suas características, o desenvolvimento das habilidades de cuidador. / Introduction: The first relations since the conception of a human being, are loaded with feelings and fantasies related to the expected child, a healthy baby, and that brings a lot of expectations and idealization. There are few studies on paternal reaction during pregnancy, especially when it brings the diagnosis of fetal malformation. The birth of a baby requires changes in male-female relationships, even if it has been planned by the couple. The possibility of intervening at an early stage exists so that parent- fetus malformed might establish healthy ties from the very moment of diagnosis, contributing to the prevention of any illness regarding the interaction and improvement in the quality of family life. Objective: To investigate the paternal participation in prenatal pregnancies with and without a diagnosis of fetal malformation. Method: Cross-sectional and prospective study, quantitative and qualitative. The sample 70 men who spontaneously accompanied pregnant women in prenatal care in the team of fetal medicine at the clinic of the Hospital de Clínicas de Porto Alegre (HCPA). The case group (35 participants) with a diagnosis of fetal malformation, regardless of the type of malformation, maternal age, parity, gestational age and couple relationship of time and control (35 participants) without a diagnosis of fetal malformation, but diagnosis of maternal disease. The collection was carried out in the period between December 2014 and December 2015. The instruments used were the Parental Bonding Instrument - PBI; Coping Mode Scale Problem - EMEP; Inventory IPSF Family Support Perception; Semistructured interview to collect sociodemographic data. Results : The mean paternal age was 33.5 years ( ± 9.5 ) in the case group and 27.6 years ( ± 4.4 ) in the control group, Complete High School , first marriage and an average of three year relationship in both groups. The shock and sadness were the main fathers' reactions to the diagnosis of fetal malformation. The coping strategy " Focus on Problem " (EMEP ), the quality of attachment / parental relationship predominated based on " care " instead of " control and overprotection " ( PBI) and the perception of the father on the relationship with the associated family the " Affective Factor / Conscious " ( IPSF ) . Although, the scales, the "Religious" factor have not been highlighted in the qualitative analysis of verbalization was this content that prevailed. Conclusion: Shock and sadness were the main reactions to the diagnosis of fetal malformation. Focus on the problem and focus on emotion, associated with a care base and the perception of family support related Affective factor/Aware lead to think about a new paternal model. The Religious Factor and the host team were featured in the qualitative analysis. The need for care, father listening and host a baby diagnosed with fetal malformation enables the preparation for the arrival, and often the immediate loss of the child. The parents of this study were able to express their affection without fear or shame. We are facing a parent model that tends to show more emotional terms, a friendlier model care in the relationship, not only focused on financial issues. However, it is up to the woman and the multi-professional team give you that space, encouraging and allowing the man within its characteristics, the development of caregiver skills.

The thesis deals with the problematic of satisfying the needs of long-term hospitalized patients. The objective of the thesis is to find out, how individual needs of long-term hospitalized patients differ in connection with the duration of their stay. To what extent are their needs satisfied and how much are family members involved in satisfying the needs of their relatives.

The diploma thesis deals with a problematic of management of the nursing care by a patient with intracranial hemorrhage. Most of the patients who survive intracranial hemorrhage stay permanently reliant on the care from others. That is why it is so important for this care to be as qualitative as possible and to have a fluent continuity. The aim of the thesis was to find out what is the role of a nurse by the patient with intracranial hemorrhage, then also find out, if the nurses know the warning signs of a worsening state of such patient, how do they cooperate with his/her family and what are the possibilities of the following care. In the empirical part of the diploma thesis, qualitative-quantitative research was used. For a complex view on a management of nursing care, the chosen technique of research was semi-structured questionnaire with patients with intracranial hemorrhage and non-standardized questionnaire with nurses who take care of these patients. For the quantitative part of the research, two hypotheses to two aims of the diploma thesis were set. Both hypotheses weren't proven by statistical methods. For qualitative research, four research questions were set. The respondents described the role of a nurse, especially in helping the patient, in rehabilitation and in also her role in educating the patient. Addressed respondents agreed on appropriate and swift reactions of the nurses in case the state of the patient starts to worsen. The cooperation of nurses and families is according to the patients without problems. It showed in the interviews with respondents, that there is a problem with insufficient awareness of the patients about the existing possibilities of following care. The outcome of the diploma thesis is a coherent educational material about nursing care by a patient with intracranial hemorrhage, which can serve to either the students or the nurses taking care of these patients.