Thesis (Ph. D.)--Henry W. Bloch School of Business and Public Administration and Dept. of Sociology. University of Missouri--Kansas City, 2005. / "A dissertation in public affairs and administration and sociology." Advisor: Robert D. Herman. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed June 23, 2006. Includes bibliographical references (leaves 194-204 ). Online version of the print edition.

Bakgrund: Långvarig smärta innebär stora negativa konsekvenser för samhället i form av ökade sjukskrivningstal och mindre delaktighet i samhället. Patienter med neuropatisk smärta upplever att de inte får den hjälp de önskar. Hälso- och sjukvården har ett ansvar att stödja dess patienter till att uppnå upplevd hälsa trots lidande och sjukdom. Syfte: Att beskriva patienters upplevelser av att leva med neuropatisk smärta. Metod: Litteraturöversikt där datamaterialet består av tio kvalitativa artiklar ur ett patientperspektiv. Resultat: Resultatet visas i två huvudteman; neuropatisk smärta, en ständig kamp i vardagen och bemötande i hälso- och sjukvården samt fem underteman; acceptansens betydelse för hantering av smärta, inverkan på relationer, inverkan på dagliga aktiviteter, vårdens bristande kunskap och förståelse,  vägen till smärtlindring , en utmaning. Resultatet visar att neuropatiska smärtan påverkar många delar av livet. Upplevelser av negativa konsekvenser både inom arbetslivet, familjelivet och sociala aktiviteter. För att uppnå livskvalitet krävs acceptans av smärtan. Konklusion: Patienter med neuropatisk smärta bör förstås i ett helhetsperspektiv och utifrån den komplexa smärtupplevelsen de har. Hälso- och sjukvården har stora möjligheter till förbättringsarbete för att bemöta dessa patienter och bidra till en ökad livskvalitet. Detta kan ske genom ett aktivt och intresserat lyssnade för att få en förståelse för patientens livssituation.

Thesis (Ph.D.)--Georgetown University, 2008. / Includes bibliographical references.

Abstract Ensuring of Respite Care Services in the Česká Lípa Region after Releasing of Patients from Hospital The goal of this thesis is to map the scope, the quality and further relationships of respite care in the Česká Lípa region in case of patients released from hospitals for whom a respite care is indicated, to find shortcomings of the systém and to propose optimal solutions of problems. There were two hypotheses set: H1: Sufficient respite care services are not provided to clients at weekends, H2: Consecutive respite care is not duly indicated by physicians to all clients released from hospitals who need it. The theoretical part of the thesis describes characteristics of respite care, its meaning and the process of ins development. The research was carried out trough the questioning method, using questionnaires and anasysis of documents. The other part of the thesis presents the results of performed quantitative research. These results were acquired by means of evaluation of questionnaires. The anasysis of acquired data confirmed both the supposed hypotheses. The discussion elucidates some problems related to the given theme and the conclusion of the thesis recommends some measures to improve the quality and continuity of providing the respite care services in the Česká Lípa region. The results of the thesis may inspire the existing as well as newly established respite care agencies to increase the quality of respite care.

Bakgrund: Utmattningssyndrom (UMS) är ett folkhälsoproblem, överrepresenterat av kvinnor. Patientgruppen tenderar att mötas av misstro i vården. Patienterna befinner sig ofta i kris och har svårt att acceptera sin situation. Sjukdomstillståndet innefattar oftast skam och skuld. För att minska lidande krävs att vårdpersonal värnar om kvinnornas hälsa och tillfrisknande, genom ett bemötande som ökar patienternas känsla av sammanhang, empowerment och delaktighet. Syfte: Syftet med studien var att belysa kvinnors upplevelser av bemötande i vården då de drabbats av UMS. Metod: En studie av sex självbiografier. Självbiografierna analyserades utifrån Lundman och Hällgren Granheims (2017) kvalitativa innehållsanalys. Resultat: Resultatet påvisade vikten av att bli väl bemött samt vikten av att få ett professionellt stöd i vården. Dessa aspekter grundade sig på kvinnornas upplevelser av att bli sedda, tagna på allvar och delaktiga i sin vård, samt vikten av att få stöd, rätt diagnos och behandling samt att mötas av kunnig personal. Resultatet påvisar både negativa och positiva aspekter. Slutsats: En slutsats är att det finns ett behov av ökad förståelse för betydelsen av bemötande i vården. En förståelse som innebär ökad förmåga att bemöta kvinnornas utsatthet samt att lindra deras lidande, vilket omfattar vårdpersonal i allmänhet och sjuksköterskor i synnerhet. / Background: Burnoutsyndrome is a public health problem, overrepresented by women. The patient group tends to be met with mistrust in care. The patients are often in crisis and have difficulty accepting their situation. The disease state usually includes shame and guilt. To reduce suffering, healthcare professionals are required to care for women's health and recovery, through a treatment that increases patients' sense of context, empowerment and participation. Purpose: The purpose of the study was to shed light on women's experiences of treatment in care when they were affected by burnoutsyndrome. Method: A study of six autobiographies. The autobiographies were analyzed based on Lundman and Hällgren Granheim's (2017) qualitative content analysis. Results: The results showed the importance of being well treated and the importance of receiving professional support in care. These aspects were based on the women's experiences of being seen, taken seriously and involved in their care, as well as the importance of receiving support, the right diagnosis as well as the importance of being met by knowledgeable staff. The results show both negative and positive aspects. Conclusion: One conclusion is that there is a need for an increased understanding of the importance of treatment in healthcare. An understanding that involves increased ability to respond to women's vulnerability and to alleviate their suffering, which includes healthcare professionals in general and nurses in particular.

Social workers in this study describes various experiences of the assessments of interventions for children and adolescents. Social workers experience of the many different situations where an assessment of best effort must be made on the basis of BBIC, which is the Social Services investigation records. To make this assessment, the Social workers need social assistance and support of their colleagues and manager. Knowledge mixed with experience is also an important part when it comes to being professional and not let emotions control that could otherwise be happened when the social worker meets and builds relationships with clients. Social workers are also those who will decide which achievement the client needs from the needs. We use systems theory, Hasenfeld´s theory of human services organizations  and Lipsky´s grassroots bureaucrats to analyze how social worker work with clients of different experiences, knowledge and some of their own personal values for the various operations. The efforts in our work we have examined is traditional familycare and MTFC (Multi dementional Treatment Foster Care), we have found that there are different arguments for different actions, but the assessments are made virtually the same assessment model. There are requirements that govern the operation of which is matched with the objectives and resources administration. Social worker also believes that social work is a game where we do not know how the results will be.

<p>Social workers in this study describes various experiences of the assessments of interventions for children and adolescents. Social workers experience of the many different situations where an assessment of best effort must be made on the basis of BBIC, which is the Social Services investigation records. To make this assessment, the Social workers need social assistance and support of their colleagues and manager. Knowledge mixed with experience is also an important part when it comes to being professional and not let emotions control that could otherwise be happened when the social worker meets and builds relationships with clients. Social workers are also those who will decide which achievement the client needs from the needs. We use systems theory, Hasenfeld´s theory of human services organizations  and Lipsky´s grassroots bureaucrats to analyze how social worker work with clients of different experiences, knowledge and some of their own personal values for the various operations. The efforts in our work we have examined is traditional familycare and MTFC (Multi dementional Treatment Foster Care), we have found that there are different arguments for different actions, but the assessments are made virtually the same assessment model. There are requirements that govern the operation of which is matched with the objectives and resources administration. Social worker also believes that social work is a game where we do not know how the results will be.</p>

Introduction: Oropharyngeal tumours belong to the most common malignancies situated in the head and neck area. In the past, their incidence has been associated with classical risk factors (smoking and alcohol use). In the recent years, the increase of oropharyngeal carcinomas resulting from HPV (human papilloma virus) infection incidence has been observed. The change of their aetiology also implies a number of clinical differences, the most important being a significantly better survival prognosis in patients with HPV+ carcinomas. Aims: The main goal of this thesis was to characterize correctly patients with oropharyngeal carcinomas and to identify different specifics of nursing intensive care for these patients. Methods: The quantitative prospective study involved 30 patients following their surgical treatment of oropharyngeal carcinoma, hospitalised in an intensive care unit. The patients were divided into 3 groups: HPV+ non-smokers, HPV+ smokers, HPV- smokers. Results: The study confirmed the demographic differences between individual patient groups. The HPV+ non-smokers group is characterized by a lower age in average, which is significantly reflected in a reduced duration of hospital stay. In addition, opioid administration rate, infection rates and postoperative complications incidences are...

This thesis describes a three year study which explored perceptions and experiences of being involved in self care and perceptions of control and self-efficacy over time amongst patients receiving a six month course of chemotherapy treatment for colorectal cancer. The study was underpinned by Leventhal’s Self Regulation Model and aimed to explore how patients undergoing chemotherapy for colorectal cancer perceived the meaning of self care, what they did as part of their self care in managing the effects of their treatment and whether this changed between the beginning and end of their six month course of chemotherapy. The study also set out to explore the relationship between patients’ perceptions of control and self efficacy and their involvement in self care. The study adopted a patient focussed, mixed method, longitudinal approach for complementarity and expansion purposes in which the qualitative findings formed the focus of the investigation, supplemented by the quantitative findings. This was important to provide a greater breadth and range to the study and to obtain a realistic understanding of patients’ perceptions and experiences of being involved in self care during their six month course of chemotherapy treatment and the influence of their perceptions of control and self efficacy on their involvement in self care. Thirty one patients participated in the study and data were collected using qualitative semi structured interviews (with a subsample of patients who participated in the study) and quantitative questionnaires (Illness Perception Questionnaire-revised and the Strategies Used by People to Promote Health) and prospective self care diaries with the full study sample. Data were collected at several time points over the course of patients’ chemotherapy treatment (beginning, middle and end of treatment) and were analysed and integrated in accordance with Tashakkori and Teddlie (1998)’s guidance for integrating qualitative and quantitative findings in a mixed methods study. The study findings revealed that the use of a mixed method, longitudinal study design was a valuable approach for understanding patients’ involvement in self care during chemotherapy for colorectal cancer and the influence of factors, such as their perceptions of control, on their subsequent involvement in their self care. In particular, the principal findings suggested that self care held a range of meanings to the patients in this study. Principally, patients’ self care consisted of two components; physical self care, carried out to manage the physical impact of undergoing treatment, and emotional self care, carried out to manage their emotional response to being diagnosed with, and undergoing treatment for, cancer. The findings suggested that there was no association between patients’ perceptions of control and the degree of self care that they carried out identified in the quantitative analysis. However, in the qualitative analysis, it was revealed that patients’ perceptions of control were likely to influence their attitudes towards their active involvement in self care and the importance with which they viewed this role. In particular, patients who considered themselves to have a high degree of control during their treatment were more likely to believe that they could limit the impact of the treatment through their own actions, that being actively involved in their self care was important and were interested in taking on this role, and that they would use a greater range of self care strategies in helping to manage the impact of their treatment. Conversely patients who considered themselves to have a lower degree of control during their treatment were less likely to believe that they could limit the impact of the treatment through their own actions, that their active involvement in self care was important and were less likely to expect to take on an active role, preferring to leave the management of treatment-related effects to health professionals, whom they regarded as being the “experts”. The findings from this study have implications for nursing practice because they reinforce the importance of the listening to the patient’s experience and how this approach can contribute to a fuller and more accurate understanding of how patients become involved in their self care and the factors that influence this. This is important so that nurses can provide holistic care, tailored to meet their patients’ self care needs and preferences, and to encourage partnership working between patients, nurses, allied health professionals and other agencies in promoting involvement in self care. The findings also have implications for theories relating to self care in emphasising the importance of patient centred models of care and for Leventhal’s Self Regulation Model in adding further support for the components of the model yet also offering a greater understanding of how the model fits with patients’ emotional responses to the effects of illness and its’ treatments. Finally, the study findings have implications for future research, calling for further research to focus on the meaning of constructs such as self care and control from the patients’ perspective and to further explore the use of the mixed methodology in researching and understanding patients’ involvement in self care and the factors that influence this.

Youth who are placed in the Multidimensional Treatment Foster Care (MTFC) program come from families with multiple risk factors. The MTFC program is based on social learning theory, which posits that youth learn from modeling those in their environment. It is unclear whether motivation for social learning decreases over time. Past research has indicated that there is an efficacious time period for treatment in the MTFC program (6 to 9 months). The purpose of this quantitative study was to examine the behavior effects of remaining in treatment foster care for an extended length of time. This was measured through pre- and posttreatment scores on the Children's Functional Assessment Rating Scale (CFARS) and specific negative behaviors tracked through the Foster Parent Daily Report. Archival data were used for a sample of 34 youth placed in an MTFC program in a northwestern state. The repeated measures ANOVA results demonstrated increased scores on the CFARS from intake to exit date. Regression analysis indicated that the behaviors of arguing and defiance were observed at higher instances for youth in the MTFC program longer than 6 to 9 months. There were no significant findings related to the behavior of destructiveness/vandalism and the length of stay. The implications for social change include social workers being able to move youth out of MTFC sooner. Also, if behaviors are targeted and treated successfully as youth, then there is a decreased likelihood of the youth having negative and criminal behavior as adults.