Zugl.: Trier, Univ., Diss., 2008

Etthundratrettio miljoner läkemedelsförpackningar säljs årligen i Sverige. Varje förpackning inkluderar en bipacksedel om det specifika läkemedlet. Bipacksedeln är utformad utifrån EU-direktivet 92/27EEC. Cirka trettio procent av alla läkemedelsanvändare läser bipacksedeln. Anledningen till varför patienterna inte läser den, beror på att bipacksedelns text är svår läsa och förstå. Ungefär femtio procent av alla patienter förstår medicinska instruktioner. Det beror på individens utbildningsnivå, lägre utbildning gör det svårare att förstå kontexten i en text. Syftet med studien var att konstatera bipacksedelns värde och om denna främjar god läkemedelsanvändning. Metoden som användes var att söka efter vetenskapliga artiklar som objektivt svarade på syftet. Resultatet konstaterade att nyttan av en bipacksedel uppnås genom att folk läser den. Studier har visat att bipacksedeln blir mer läsvänlig om den innehåller ett mer lättförståeligt språk, färgade avsnitt, text med större bokstäver och symboler. Det kostar 100 till 130 miljoner kronor att producera bipacksedlar. En studie har visat att följsamheten av läkemedelsbehandling inte påverkas av bipacksedeln. Det har även konstaterats att bipacksedlar ibland kan minska följsamheten för behandlingar, eftersom de kan avskräcka patienter från att ta läkemedlet. Muntlig läkemedelsrådgivning har visat sig ge bättre följsamhet för patienter än enbart skriftlig information. Kombinationen av muntlig och skriftlig information har visat sig ge bäst informationsförståelse. De 130 miljoner kronorna bör därför möjligen investeras i att ge bättre muntlig information till patienter. För vidare studier bör en mer detaljerad information kring läkemedlens effekt lyftas fram tydligare i bipacksedlarna.

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Magister Scientiae (Medical Bioscience) - MSc(MBS) / Background: Veterinary medicines play an imperative role in the diagnosis, prevention and treatment of animal diseases. Many veterinary stock remedies in South Africa are available to the public without the intervention or supervision of a veterinarian or healthcare worker. Therefore, the accompanying package insert with product information and directions for use is central in promoting the safe and effective use of stock remedies. Information such as the dosage, warnings, precautions and storage instructions are essential to assist the user in their treatment decision-making. While local regulatory authority guidelines prescribe and control the minimum information that should be available in the package insert or product label, it is questioned whether the information contained in package inserts of products on the market complies with these regulatory requirements. Methodology: Using simple random sampling of veterinary stock remedies, 159 package inserts or product labels from various animal health companies were selected and evaluated against the prescribed labelling guidelines of the local regulatory authority responsible for the registration and control of stock remedies. The contents of each package insert or label in the sample were assessed for the presence of the prescribed information statements and were accordingly classified as non-compliant, partially compliant or compliant. Results: Among the 159 package inserts, 48 were for antimicrobials, 49 for ectoparasiticides, 44 for anthelmintics and the remaining 18 for endectocides. It was observed that none of the package inserts met all of the criteria and that the package inserts were inadequate in many aspects. The average percentage of compliance was 69.43%, with a range of 36.21% to 87.93%. Conclusion: The study indicated that many package inserts do not fully comply with the prescribed regulatory guidelines and that information related to the safe and appropriate use of stock remedies is insufficient.

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Bakgrund: Ögonsjuksköterskor möter många patienter med diabetesretinopati, vilkakan vara utmanande för ögonsjuksköterskorna då det förekommer att patienter saknar sjukdomsinsikt. Det leder till svårigheter att få patienten delaktig i sin vård, men även att ge tillräckligt med information då patienten även kan vara orolig vid dessa möten. Syfte: Syftet med studien var att undersöka ögonsjuksköterskors upplevelser av att informera patienter med diabetesretinopati. Metod: En kvalitativ studie med semistrukturerade intervjuer användes där totalt sju ögonsjuksköterskor från Västra Götalandsregionen och Region Halland deltog. Resultat: Analysen resulterade i två huvudkategorier Bygga en relation och Behov av kunskap. De fem subkategorierna var Ögonsjuksköterskans roll, Patienternas delaktighet, Brist på sjukdomsinsikt, Patienternas oro och rädsla samt Vikten av information. Konklusion: Resultatet visade att ögonsjuksköterskorna upplevde att det är av vikt att informera och även få patienten delaktig i sin vård då patienternauttrycker en rädsla och oro. Studien kan vara ett stöd för ögonsjuksköterskorna infördessa möten och vidareutveckla dem både utifrån ett sjuksköterske- och patientperspektiv. I vidare forskning vore det av intresse att få en fördjupad kunskap om patienternas upplevelser av ögonbottenfotografering samt information i samband med den. / Background: Ophthalmic nurses meet many patients with diabetic retinopathy. These meetings can be challenging for the ophthalmic nurses as some patients lack insight about the disease, which makes it difficult to get the patient involved and provide enough information as the patient may also be worried at these meetings. Aim: The aim of the study was to investigate ophthalmic nurses’ experiences of informing patients with diabetic retinopathy. Method: A qualitative study with semi-structured interviews was used where seven ophthalmic nurses from Västra Götaland Countyand the Halland County participated. Results: The analysis resulted in two main categories Building a Relationship and Need for Knowledge and five subcategories; The Ophthalmic Nurse's role, Patient participation, Lack of disease insight, Patients' anxiety and fear and The importanceof information. Conclusion: The results showed that the ophthalmic nurses felt that it was important to inform and also get the patient involved in their care as the patients express fear and anxiety. The study can be a support for the ophthalmic nurses in these meetings and further develop them from both a nurse and patient perspective. In further research, it would be of interest to gain an in-depth knowledge of patients´ experiences of fundus photography and the information they receive.

The purpose of the study was to investigate the perception of given information at discharge from a urological ward at Akademiska sjukhuset, and to investigate whether the patients had searched for information themselves after discharge.   The study is an empirical cross -sectional study with descriptive design. All the patients inscribed as urologic patients, discharged to their home during month of March 2009, were asked to participate in the study (in total 82 patients), which led to 57 participants. The data collection method was an interview over the phone, with 20 structured questions. The interview form was sent by mail to the patients after the discharge from the ward, the authors thereafter called the participants at home and performed the interview within 10-20 days after discharge.   The most common concerns for surgical patients after discharge are wound care, pain management, daily activity, the detection of complications, handling symptoms, elimination and quality of life. This study shows that 72 % of the participants considered the given information as sufficient for handling their self-care at home. The lack of information experienced by the participants concerned daily activity, eventual complications that may occur and pain management. The majority of the discharge information was given in the patient room.   Postoperative complications that occur after discharge can be expensive for the society and is a cause of unnecessary suffering for the patient, therefore the patient need to understand what to be observant of after discharge. This requires that both doctors and nurses provide relevant information for each individual patient. / Syftet var att undersöka patienters uppfattning av information given vid utskrivning från en urologisk vårdavdelning på Akademiska sjukhuset samt att undersöka om patienterna själva sökt information efter utskrivningen.   Studien är en empirisk tvärsnittstudie med deskriptiv design. Alla patienter inskrivna som urologpatienter, som skrevs ut till hemmet från en urologisk vårdavdelning under mars månad 2009 tillfrågades att delta (sammanlagt 82 patienter), 57 patienter deltog. Som datainsamlingsmetod användes en telefonintervju med 20 strukturerade frågor. Frågorna skickades hem till patienterna efter hemgång och författarna ringde sedan upp patienterna i hemmet och genomförde intervjun.   De områden som kirurgiska patienter upplever störst bekymmer för efter utskrivning från sjukhuset är sårvård, smärthantering, daglig aktivitet, att upptäcka komplikationer, symtomhantering, elimination och livskvalitet. Studien visar att 72 % av deltagarna tyckte att den information de fått var tillräcklig för att sköta sin egenvård. Den information som saknats har varit inom områdena daglig aktivitet, eventuella komplikationer som kan uppstå och smärtlindring. Majoriteten av utskrivningssamtalen ägde rum på patientsalen.   Postoperativa komplikationer som uppträder efter utskrivning kan bli kostsamma för samhället och är källa till onödigt lidande för patienten, patienten behöver därför förstå vad denne skall vara uppmärksam på efter hemgång. Detta ställer krav på både läkare och sjuksköterskor att ge information som är relevant för varje individuell patient.

Submitted by Rosivalda Pereira (mrs.pereira@ufma.br) on 2017-07-19T19:10:18Z No. of bitstreams: 1 RicardoCosta.pdf: 8300627 bytes, checksum: 1b02c04a1a94111338012bbd4c2b4e6f (MD5) / Made available in DSpace on 2017-07-19T19:10:18Z (GMT). No. of bitstreams: 1 RicardoCosta.pdf: 8300627 bytes, checksum: 1b02c04a1a94111338012bbd4c2b4e6f (MD5) Previous issue date: 2017-04-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / The typography is shown as a primary element when it comes to the transmission of reports via text. In the case of patient information leaflets, typography and its bad articulation can result in an inefficient readability and thus the misunderstanding of the information contained therein (Hammerschmidt, 2014, p. 218). Therefore it is understood that the research in question is relevant because it seeks to understand how the typographic articulation adopted in the mobile application MedSUS impacts on reading the patient information leaflets and comprehension. For this, a usability test was performed with smartphone with regular users (patients) in order to evaluate the readability and readability of texts found in the medication package inserts. A cooperative evaluation was then carried out with technical users (medical) to find relevant problems related to the MedSUS application interface. As a result, there was an improvement of satisfaction of regular users regarding the use of the application with the improved typographic aspects and the technical users evaluated as being of low utility the application in question for the use in medical care. Finally, recommendations are presented for the use of typography in the presentation of texts of drug inserts in mobile application MedSUS. / A tipografia se mostra como elemento primordial quando se trata da transmissão da informação através de texto. Em se tratando de bulas de medicamentos, a tipografia e sua má articulação podem resultar em uma ineficiente leiturabilidade e assim no mal entendimento das informações ali contidas (HAMMERSCHMIDT, 2014, p. 218). Por isso entende-se que a pesquisa em questão é relevante pois visa compreender como a articulação tipográfica adotada no aplicativo móvel MedSUS impacta na leitura das bulas de medicamentos e na compreensão das mesmas. Para isso, foi realizado um teste de usabilidade com smartphone com usuários comuns (pacientes) com o objetivo de avaliar a legibilidade e leiturabilidade dos textos encontrados nas bulas dos medicamentos. Em seguida foi realizada uma avaliação cooperativa com usuários técnicos (médicos) que visou encontrar problemas relevantes e relacionados à interface do aplicativo MedSUS. Como resultados, obteve-se uma melhora na satisfação dos usuários comuns com relação ao uso do aplicativo com os aspectos tipográficos aperfeiçoados e os usuários técnicos avaliaram como sendo de baixa utilidade o aplicativo em questão para o uso em atendimento médico. Por fim, são apresentados recomendações para o uso da tipografia na apresentação de textos das bulas de medicamentos no aplicativo móvel MedSUS.

SAMMANFATTNING Bakgrund De allt kortare vårdtiderna inom sjukvården ställer höga krav på patientinformationen som ges pre- och postoperativt. Forskning visar att patienternas informationsbehov inte alltid överensstämmer med mängden information som ges. Patienter upplever ofta att informationen som ges är otillräcklig och saknar relevans. God pre- och postoperativ information har många fördelar, då den leder till såväl ökad trygghet som bättre förutsättningar i det postoperativa förloppet.   Syfte Syftet med denna studie var att undersöka hur kirurgiska patienter vid en hudmottagning och en urokirurgisk vårdavdelning uppfattade den pre- och postoperativa information de fick i samband med kirurgi.   Design Studien var en enkätstudie med kvantitativ ansats och inkluderade 30 respondenter.   Resultat Resultatet visade att huvuddelen av patienterna uppgav att de hade läst den skriftliga informationen de fick. De hade också uppfattat att informationen var lättillgänglig. Majoriteten tyckte att den totala mängden information var tillräcklig. Vidare svarade majoriteten att de hade fått tillräcklig information om smärtlindring under vårdtiden. Hälften av respondenterna angav att de hade fått tillräcklig information om hur de kunde förebygga komplikationer. Ungefär hälften uppgav att de inte hade fått tillräcklig information om sårvård.   Slutsats Av resultatet drogs slutsatsen att patientinformationen som ges på de två enheterna verkar vara lättförståelig och tillräckligt omfattande, dock finns utrymme för förbättring, framförallt inom området komplikationer och sårvård. / ABSTRACT Background The shorter length of stay in hospitals place greater demands on the patient information that is given pre- and postoperative. Research shows that the amount of given information does not match with the patients’ informational needs. Patients often experience the given information as inconclusive and irrelevant. Good pre- and postoperative information has many benefits. It leads both to an increased sense of security and to better postoperative outcomes.   Purpose The purpose of the current study was to explore how surgical patients at a dermatology outpatient facility and an acute care urological surgery ward perceived the pre- and postoperative information in connection with the surgery.   Design The study was a quantitative survey and included 30 participants.   Findings The results showed that the majority of the patients stated that they had read the written pre- and postoperative information that they had received. They had also perceived the information as easily available. The majority of the patients reported that the total amount of the information was sufficient. Furthermore, the majority also replied that they had received sufficient information about relieving their pain during the hospital stay. Half of the subjects stated that they had received enough information about how to prevent complications. Half of the subjects claimed that they had not received enough information about wound care.   Conclusions Based on the results, it could be concluded that the patient information that was given at the two clinics appears to be easily understood and sufficiently extensive, though there is room for improvement, especially within the area of complications and wound care.

The overall aim of this thesis was to study participants' understanding of clinical cancer trials, and their motivation for participation. Of particular interest was the question of whether the patients hoped for a cure resulting from the trial. The thesis was based on four studies and used three methods: interviews, a questionnaire, and empirical bioethics. The results of Study I indicated that the participants in phase 1 trials understood most of the information provided, but were unaware of both the very small potential for treatment benefit, and the risk of harm. Patients in phase 3 trials had a good understanding of the trial, except regarding side effects and their right to withdraw. Some found it hard to ask questions and felt they needed more information (Study III). The participants in phase 1 trials were strongly motivated by the generally unrealistic hope for therapeutic benefit (Study I). When the chances of a cure are minuscule, as for participants with end-stage cancer in phase 1 trials, hope can play an important, positive role and offer meaning to one’s remaining life. However, hope for an unrealistic outcome could also deprive patients of an opportunity to spend their remaining lives, as they would otherwise choose (Study II). The participants in phase 3 trials indicated that their motivation for participation was multifaceted; the most common motivations included hope of therapeutic benefit, altruism, access to extra clinical examinations or better care, and a wish to repay society for the help they had received (Study III). After stratifying and analysing the motivation data by gender, age, education and previous experience of trial participation, males and those aged ≥65 years were significantly more motivated to participate out of a desire to reciprocate the help they had received, either because of a sense of duty or because their families or friends considered that they should attend (Study IV). In conclusion, the informed consent process seems to work relatively well, with good results within most subgroups. However, patients with end-stage cancer who are participating in phase 1 trials are a vulnerable group as they have very little potential for treatment benefit coupled with a tangible risk of harm.