This study is about what adolescents with cancer think about their life situation, the support they get, and the information they receive about their illness. The data for this qualitative and descriptive study were collected in 3 focus group interviews with 20 adolescents aged 13 to 18 years attending a cancer adjustment camp. Interpretation was based on the method of inductive content analysis. The adolescents' experiences of their current situation were analyzed into 5 categories: views on life here and now, negative experiences of self because of the illness, resources recognized in self, difficulties caused by the illness in relation to life around them, and resources identified in the world around. They made very little, if any, conscious effort to plan ahead for the future. The information received by the adolescents concerned their illness and its treatment here and now, various practical matters, as well as the future impacts of the illness and its treatments. Most of this information focused on the here and now, whereas the adolescents' information needs were mainly oriented to the future. As for the adolescents' chances to take part in making decisions about their care and life, the analysis yielded 6 categories: joint decision making, inadequate chances for decision making, independent decision making, illusion of decision making, reluctant to make decisions, and excluded from decision making. Finally, the adolescents' hopes for improvement were focused on staff activities, physical care facilities, chances to discuss and work through their experiences of the illness, and the support received from society.
The hospital is an environment which accomodates the elderly persons and in which these last have to make trainings at one time when they are not in full possession with all their physical, psychological and cognitive capacities. They can then live there humiliating situations which generate feelings of discomfort, embarrassment and shame. The presence of interveners not very warm, lacking compassion lack and impressed negative prejudices towards the elderly patients, is another factor which is added to lead them not to feel at ease, involving, inter alia, consequences a fall of their self-esteem. However the affective touch is a strategy which would have the potential to act on the personal value of the elderly patients and to thus improve their self-esteem. It is with a view to popularize the use of the affective touch in practice nurse that a study was carried out in order to check its effects on the self-esteem of the elderly patients. The results confirm that the emotional touch influences positively the self-esteem of the elderly patients. The authors of the study thus recommend the systematization of the affective touch in nursing practice.
With the predicted increase in the age of Canada's overall population, it is estimated that by 2020, up to 75% of nurses' time will be spent with older adults. It is recognized that care of older adults occurs in a cultural context in which the older members of society are poorly valued, often referred to as ageism. Based on the premise that attitudes affect behavior and knowledge acquisition, a comparative cross-sectional study using the Attitudes Toward Old People scale measured nursing students' attitudes at different points in a baccalaureate nursing program. Although analysis of variance revealed no significant differences in students' attitudes during the 4 years, post hoc analysis revealed a drop in positive attitudes and a rise in negative attitudes at the beginning of the second and fourth years of the baccalaureate program.
The main purpose of this study was to reach a deeper understanding of factors influencing the attitudes toward organ donation and other procedures with the dead body. From a survey of 400 inhabitants of Uppsala, a city in the middle of Sweden, concerning attitudes toward transplantation issues, 38 individuals with different attitudes toward donation of their own organs were selected for follow-up interviews. From the interviews, more than 600 statements concerning motives and reactions to medical procedures with the dead body were listed. These statements were summarized in 20 motive categories, in which 17 the nature of the motives were negative to organ donation and three promoting such a procedure. The categories were then analyzed and interpreted within a frame of reference of psychodynamic defense theory. In several cases it was possible to relate them to common death anxiety defenses. Six different motive complexes were extracted. These are called (1) illusion of lingering life; (2) protection of the value of the individual; (3) distrust, anxiety and alienation; (4) respecting the limits set by Nature or God; (5) altruism; and (6) rationality. Individuals not willing to donate their own organs were judged as either (a) reacting out of strenthened death anxiety defenses, or (b) as having a special outlook on life, where the idea of what is 'natural' was emphasized. The adverse reactions of the positive attitude group were seen as initial reactions perceived as derivations of common death anxiety defenses and weakened when confronted with altruistic and fact-stressing arguments. In the 'undecided group' of 14 persons, 11 arrived at a definite opinion. Seven decided for organ donation when their mistaken beliefs were corrected or when they took time to work through their initial uneasiness, while 4 persons actually were clearly negative. Three still remained uncertain. The stability of these attitudes seems to be high, often being experienced as a part of one's philosophy of life.
Geriatric educators are faced with several different challenges. The rapid growth of aged population in the Western world has led to a growing need for health and social services and thus, an increased need for trained professionals in this field. In addition, new learning theories and activating learning methods have achieved wide acceptance in academic medicine. How has geriatric education applied these new learning methods? In this article we review the current status of academic geriatric education in Western countries in these respects. We especially review the literature of how geriatric training has been experimenting with the new learning methods.
We identified all cases in Finland (population of 5 million) with a diagnosis of schizophrenia born between 1940 and 1969, using four national computerised registers with high reliability. A sample of 397 families was identified in a genetically homogeneous internal isolate (population of 18,000) in northeastern Finland with high prevalence for schizophrenia and an LOD score of 3.8 in chromosome 1. Our aim was to examine with Operational Criteria Checklist for Psychotic Illness (OCCPI) factor analysis the psychotic and affective signs and symptoms of schizophrenia in this genetically homogeneous population, and compare them with findings from individuals with schizophrenia from multiplex families from the whole country. After collecting all original case notes, we made DSM-IV consensus diagnoses and completed OCCPI ratings on a lifetime basis. For the factor analysis, we accepted 190 patients with a diagnosis of schizophrenia. In addition, 466 schizophrenia patients from 147 multiplex families from the whole country were included in the analysis. The OCCPI factor analysis resulted in four factors: "delusions and hallucinations" and "negative" factors, plus two affective ("manic" and "depressive") factors. We compared the pattern of symptoms among three patient groups: isolate patients who were the only affected individuals in their family, isolate patients who had affected family members, and patients from the whole country with affected family members. We found no clear differences among these groups. However, there were significant differences in the frequency of individual OCCPI items between the study groups. Findings in this schizophrenia OCCPI phenotype study suggest that the clinical picture of schizophrenia in a genetically isolated and homogeneous population closely resembles our nationwide findings in Finland.
Falling is common among older adults, often resulting in decreased functional ability and quality of life. To understand processes underlying the fall/health and well-being relationship, it is important to identify psychosocial mediators. The current study examined the impact of falling on subsequent physical health, negative emotions and physical activity among 231 young-old (
To investigate beliefs concerning medication among patients and pharmaceutical specialists (3 or 5 years of higher education).
The Beliefs about Medicines Questionnaire (BMQ)-General, which assesses beliefs about medicines in general, was used.
For the analyses, 141 (response rate 82%) and 136 (response rate 79%) questionnaires from the patients and pharmaceutical specialists, respectively, were included. The results showed a statistical significant difference between patients and pharmaceutical specialists in beliefs about medicines. Whereas the patients expressed a more negative attitude about medicines (stronger beliefs about medicines as being harmful and less favourable) the pharmaceutical specialists expressed the contrary. However, the pharmaceutical specialists had stronger concerns regarding over-use of medicines as compared to the patients.
Patients and pharmaceutical specialists expressed different views regarding medications. To achieve concordance in the pharmaceutical care process, pharmaceutical specialists need to exchange information about patients' experiences and not take for granted that they share their views regarding medications.
The pharmaceutical specialists should elicit the patient's concerns about the prescribed medications and be aware of that non-adherence is often the result of the patients making rational decisions about their treatment.
Systematic preventive health checks in primary care have been introduced in several countries. The Danish Health Service does not provide this service, but health checks are nevertheless being conducted unsystematically. Very little is known about the GPs' experience with this service.The purpose of our study is to describe GPs' attitudes towards and concerns about providing preventive health checks and to describe their experiences with the health checks that they provide in daily practice.
A qualitative descriptive study was conducted based on three semi-structured focus group interviews with 16 GPs from Central Region, Denmark. The focus group interviews took place at the Department of Public Health, Section for General Practice, Aarhus University in November 2010.
We found that the participating GPs all conducted some kind of preventive health checks, but also that there was great diversity in the content. The GPs were somewhat ambivalent towards health checks. Many GPs found the service beneficial for the patients. Concurrently, they had reservations about promoting ill-health, they questioned whether the health checks were a core mission of primary care, and they were concerned whether the health checks would benefit the "right" patients. The GPs felt a need for further documentation of the benefits for the patients before a possible future implementation of systematic health checks. Some GPs found that health checks could be performed in other settings than general practice.
Our study revealed that health checks are performed differently. Their quality differs, and the GPs perform the health check based on their personal attitude towards this service and prevention in general. Our analysis suggests that the doctors are basically uncertain about the best approach. Our study also uncovers the GPs' reservations about inducing negative psychological reactions and decreased well-being among the health check participants. Further studies are needed to disclose where these concerns emerge.
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