Thesis (Ph. D.)--Ohio State University, 2003. / Title from first page of PDF file. Document formatted into pages; contains x, 97 p. Includes bibliographical references (p. 88-97). Available online via OhioLINK's ETD Center

Class of 2012 Abstract / Specific Aims: The objective of this study is to first assess whether student pharmacist interns feel they can gauge patient health literacy levels with confidence, second to assess which methods are used most commonly in practice by student pharmacists to assess patient health literacy, and third to determine what techniques student pharmacist interns most often employ to communicate more effectively to patients with low health literacy. Methods: The questionnaire consisted of questions about demographics, and knowledge/experiential based questions. Key questions were: How well do you feel you are able to assess patient health literacy? How often do you use the following techniques to assess patient health literacy? (Observe contextual clues, Observe patient word pronunciation, Observe patient willingness to talk, Assess by demographics) When counseling low health literacy patients, how often do you use the following communication techniques? (Speak slowly, Give extra written material, Repeat information, Ask patient to repeat information, Ask if patient understands English, Avoid complicated medical terms). The answers to these questions are measured on a likert scale. Data from the questionnaire was analyzed using one sample t tests and paired t tests. Main Results: Regarding the first primary objective, on a scale of 1 to 5, with confidence measured 3 or greater and no confidence measured 2 or less, student intern pharmacists are statistically significantly confident in their ability to gauge patient health literacy (p< 0.001). There is no statistically significant difference in confidence in ability to gauge patient health literacy between males and females. The method student pharmacist interns used for assessing patient health literacy with the highest average use was observing patient willingness to talk (3.65 +/- 1.01) followed by observing patient word pronunciation (3.57 +/- 0.97), assessing patient demographics (race, age, ability to pay, culture, gender) (3.23 +/- 1.16) and observing contextual clues (patients identify pills by color, asks to be read to, etc) (3.04 +/- 1.04). There was no statistically significant difference between observing patient willingness to talk versus observing patient word pronunciation (p=0.55). There is a statistically significant difference between observing patient willingness to talk versus assessing patient demographics (p=0.011). The technique for improving communication with patients with low health literacy with the highest average use was avoiding complicated medical terms (3.97 +/- 0.95) followed by speaking slowly (3.91 +/- 0.89), repeating information (3.85 +/- 0.73), giving extra written material (3.02 +/- 1.36), asking patients if they understand English (2.85 +/- 1.21) and asking patients to repeat information. (2.39 +/- 1.02). There is a statistically significant difference between avoiding complicated medical terms and giving out extra written material (p<0.001) and speaking slowly and giving out extra written material (p<0.001). Conclusions: We conclude that students pharmacists working as interns are quite confident in their ability to assess patient health literacy, that observing patient willingness to talk is be the most commonly used method to assess patient health literacy, and that avoiding complicated medical terms is be the most commonly used technique student pharmacist interns use to communicate more effectively with patients who have low health literacy.

This thesis deals with the criminal aspects of the patient's status as an injured party in the provision of health care. Author especially characterizes the criminal relationships between patients and health care facilities, their contents and background. In the first part of the thesis the author provides a legal framework for the health law, especially in the area of national and international law. It deals with crucial laws directly governing the healthcare law, and laws that are related to health law and greatly affect it. In the field of international law, the author deals mainly with the European Convention on Human Rights and the Convention on Biomedicine. At the level of the national rights of the author touches the area of constitutional order, in particular the Charter of Fundamental Rights and Freedoms as well as the partition law, which describes the particular treatment of health law, criminal law and civil law. In the second part of the thesis the author first defines the basic concepts and fundamental institutes occurring in health care. Eventually, the author of the second part focuses on the actual relationship between the patient and the medical facility where the first for the understanding of the issues dealing with the historical evolution of this relationship and later...

Thesis (Ph. D.)--West Virginia University, 2008. / Title from document title page. Document formatted into pages; contains x, 179 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 153-164).

Depression is a common mental health disorder and is a major contributor to the overall global burden of disease. Improving the instruments that are used to detect and assist in the diagnosis of depression is of importance due to the impact that the disorder has on the individual and society. The study aimed to explore and improve the measurement of depression. Seventy-one participants’ results on the PHQ-9 (that measures frequency of depressive symptoms) and the Borg CR scale® (measuring intensity of depressive symptoms) were analysed. It was also of interest to measure mental health patients’ (n = 16) self-rated depression and compare it to mental health staffs’ (n = 7) observer-rated depression. The overall correlation between intensity and frequency of depressive symptoms was found to be positively strong (r =. 695), the Borg CR scale showed high internal consistency when used for measuring intensity of depressive symptoms (.846), self-reported depression was lower than observer-rated depression (p = .167). In addition, inter-individual differences in frequency and intensity of depressive symptoms were also examined. Overall, the outcome of this study showed that intensity of depressive symptoms can differ considerably between individuals, despite similar overall depression scores.

Personer som drabbats av depression återfaller/återinsjuknar ofta en eller flera gånger i livet. Forskning har visat att b la demografiska faktorer, residualsymtom och insomni är prediktorer för återfall. Syftet med studien var därför att undersöka betydelsen av demografiska faktorer, residualsymtom och insomni för nivån av depression 6-12 månader efter avslutad behandling på en psykiatrisk specialistmottagning. Urvalet var alla patienter som diagnosticerats med depression eller recidiverande depression och genomgått KBT-terapi under perioden 2008 – september 2013, och som hade uppföljningsdata vid sex eller tolv-månader, vilket sammanlagt var 111 patienter. Beroendevariabel var resultat på formuläret Patient Health Questionnaire (PHQ-9). Resultaten visade att patienter med residualsymtom inte försämrades signifikant mellan eftermätningen och uppföjningsmätningen, ett fynd som inte överensstämmer med forskning på området. Regressionsanalyser visade ingen signifikant påverkan av kön, ålder och utbildningsnivå på senare nivå av depression vid uppföljningsmätning. Däremot visade regressionsanalyser att sömnbesvär, mätt med formuläret Insomnia Severity Index (ISI), vid framför allt eftermätning hade ett samband med senare nivå av depression vid uppföljningsmätningen. Resultaten indikerade att kvarstående sömnbesvär då behandlingen avslutades predicerade senare nivå av depression. Slutsatsen är att ett tillägg av en sömnintervention för de patienter som har insomni då behandlingen avslutas kan minska sannolikheten för återfall i depression. Då många patienter saknade uppföljningsdata kunde inga säkra slutsatser dras.

<p>The focus of this research is the experiences of patients with regard to social and health services factors that contribute to delays in seeking treatment for tuberculosis. The goal of this&nbsp / research study was to do an explorative study in order to establish the experiences of patients with regard to social and health services factors that contribute to delays in seeking treatment for Tuberculosis. The objectives to meet the goal were an exploration and description of patients&rsquo / experiences with regards to social and health service factors contributing to delays in seeking&nbsp / treatment for Tuberculosis. Another goal was to make recommendations on social and health service factors that contribute to patients&rsquo / delays in seeking treatment based on the findings. The research study had been of a qualitative nature exploring patients&rsquo / experiences of social and health services factors that contribute to delays in seeking treatment for Tuberculosis. Qualitative&nbsp / research was used in this study using semi-structured interviews with an interview guide. Data analysis was done according to the eight steps as recorded in Tesch in Creswell (1994: 155). The&nbsp / findings of this research were or include social factors contributing to patients&rsquo / delays in seeking treatment for TB. There were four categories related to social factors namely socio-economic,&nbsp / substance abuse, psycho-social and interpersonal relations factors. The findings also indicated that there were health service factors contributing to patients&rsquo / delay in seeking treatment for TB.&nbsp / These include quality of health care services, attitudes of medical staff and other medical conditions treatment. It was concluded that social and health services, as mentioned indeed contribute to patients&rsquo / delays in seeking treatment for Tuberculosis. Recommendations for practice included better case detection, treatment and health education. In order to address the various social&nbsp / factors as described above it is necessary to treat TB holistically and include a social worker as part of the multidisciplinary team.</p>

Patient-centred care is the gold standard of health care, yet in practice, problems prevail. The use of the ‘expert patient’ in health professional education is one form of learning patient-centred care. A gap in the literature regarding how the use of ‘expert patient’ in health professional education promotes patient-centred care was acknowledged in current research. With Queen’s University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board approval, a sample of Queen’s University MScOT students participated in a qualitative study with the following research question: “How does the students’ experience of interacting with the ‘expert patient' (‘XP’) relate to learning regarding client-centred practice (CCP)?” Three objectives were proposed: 1. Describe the OT students’ experience of interacting with the ‘expert patient’, 2. Describe the students’ learning regarding client-centered practice, 3. Identify the conditions particular to the ‘expert patient’ experience that led to learning regarding client-centered practice. In-depth interviews were conducted with the students subsequent to their ‘expert patient’ experience. Analysis revealed three conditions that together provided the foundation for student experiential learning regarding client-centred practice: interaction with particular persons with stable disability known as ‘expert patients’; students’ requirement to evaluate them and thus ‘experience power’; and explicit opportunities for ‘directed reflection and discussion’. Questions were raised for researchers, health care professional educators and health care professionals regarding the potentially transformative nature of engaging in unfamiliar contexts with openness to learning. The thesis allowed insight into the lived experience of OT students learning with ‘expert patients’; and the admiration, discomfort, humility and gratefulness they experienced while gaining a sense of the meaning of collaboration, respect for autonomy and recognition of expertise. Implications of the research impact all stakeholders in health professional education. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-04-15 08:39:19.094

The lifetime prevalence of clinical depression in patients living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is approximately 22% compared to 3% to 10% in the primary care population. The nursing practice problem at the project site concerned nurses' lack of knowledge and understanding of procedures to help ensure that all patients living with HIV/AIDS were properly screened for depression and referred for further evaluation and treatment. The purpose of this project was to implement a staff education module to address the use of the PHQ-9 screening tool to identify depression in people diagnosed with HIV/AIDS. The theoretical framework for this educational module was the theory of planned behavior. The practice-focused question explored the extent to which the implementation of an evidence-based practice education model in a primary care clinic treating patients living with HIV/AIDs would increase staff knowledge on the use of the PHQ-9 tool to screen for depression. A staff education project incorporating a pretest and posttest design was conducted to determine whether a significant change existed in the test scores of the participants between the pretest and the posttest. After completion, the posttest measures showed an improvement of 35%. The implications of this project for social change might include improvement in the knowledge, attitudes, and practices of the nurses in the treatment of depression in adults living with HIV/AIDS.

Effective risk communication is essential in the field of health to ensure patients understand the information being presented to them by medical professionals and appreciate the level of risk involved in treatments. Cardiovascular disease, being the leading cause of death worldwide, is relevant to consider when examining risk communication in a health setting. Those afflicted with cardiovascular ailments are both high in number and exposed to information communicating risk. This research aims to identify presentation formats that are more effective communicating risk information to recovering cardiovascular patients at the University of Ottawa Heart Institute. The formats’ effectiveness is measured by gauging the population’s understanding of the material and perception of the information as it relates to risk and motivation. The research draws on Max Weber’s concept of rationality and subsequent scholars who developed social judgment theory, the heuristic-systematic model, expected utility theory, protection motivation theory, and the extended parallel process model. Utilizing an experimental research design, risk information handouts and questionnaires are distributed to, and completed by, a stratified sample of cardiovascular disease patients. Effective presentation formats are examined, and the results identify comparatively effective presentation formats for minimizing and maximizing risk perception. The results also identify presentation formats’ impact on a patient’s level of motivation to avoid / indulge in behaviours that may maximize or minimize risk. The results, synthesized herein, suggest a model (communicative cardiovascular physician-patient model of message preparation-perception), which may contribute to the effectiveness of risk communication between physicians and cardiovascular disease patients.