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Achieving therapeutic clarity in assisted personal body care: professional challenges in interactions with severely ill COPD patients.

https://arctichealth.org/en/permalink/ahliterature155622
Source
J Clin Nurs. 2008 Aug;17(16):2155-63
Publication Type
Article
Date
Aug-2008
Author
Kirsten Lomborg
Marit Kirkevold
Author Affiliation
Department of Nursing Science, Institute of Public Health, Aarhus University, Aarhus, Denmark. kl@nursingscience.au.dk
Source
J Clin Nurs. 2008 Aug;17(16):2155-63
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Adaptation, Psychological
Adult
Attitude of Health Personnel
Baths - nursing - psychology
Clinical Competence
Communication
Denmark
Dyspnea - etiology
Helping Behavior
Hospitals, University
Humans
Middle Aged
Negotiating - psychology
Nurse's Role - psychology
Nurse-Patient Relations
Nursing Methodology Research
Nursing Staff, Hospital - education - organization & administration - psychology
Patient Care Planning - organization & administration
Patient Participation - methods - psychology
Pulmonary Disease, Chronic Obstructive - nursing - psychology
Qualitative Research
Questionnaires
Severity of Illness Index
Abstract
This paper aims to present a theoretical account of professional nursing challenges involved in providing care to patients suffering from chronic obstructive pulmonary disease. The study objectives are patients' and nurses' expectations, goals and approaches to assisted personal body care.
The provision of help with body care may have therapeutic qualities but there is only limited knowledge about the particularities and variations in specific groups of patients and the nurse-patient interactions required to facilitate patient functioning and well-being. For patients with severe chronic obstructive pulmonary disease, breathlessness represents a particular challenge in the performance of body care sessions.
We investigated nurse-patient interactions during assisted personal body care, using grounded theory with a symbolic interaction perspective and a constant comparative method.
Twelve cases of nurse-patient interactions were analysed. Data were based on participant observation, individual interviews with patients and nurses and a standardized questionnaire on patients' breathlessness.
Nurses and patients seemed to put effort into the interaction and wanted to find an appropriate way of conducting the body care session according to the patients' specific needs. Achieving therapeutic clarity in nurse-patient interactions appeared to be an important concern, mainly depending on interactions characterized by: (i) reaching a common understanding of the patient's current conditions and stage of illness trajectory, (ii) negotiating a common scope and structuring body care sessions and (iii) clarifying roles.
It cannot be taken for granted that therapeutic qualities are achieved when nurses provide assistance with body care. If body care should have healing strength, the actual body care activities and the achievement of therapeutic clarity in nurses' interaction with patients' appear to be crucial.
The paper proposes that patients' integrity and comfort in the body care session should be given first priority and raises attention to details that nurses should take into account when assisting severely ill patients.
PubMed ID
18710375 View in PubMed
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[A dynamic medical record is invaluable for high-quality care].

https://arctichealth.org/en/permalink/ahliterature187688
Source
Lakartidningen. 2002 Oct 24;99(43):4280-2
Publication Type
Article
Date
Oct-24-2002

[Appropriate use of hospital days in medical wards].

https://arctichealth.org/en/permalink/ahliterature171305
Source
Ugeskr Laeger. 2006 Jan 3;168(1):25-9
Publication Type
Article
Date
Jan-3-2006
Author
Lisbeth Rasmussen
Dorte Münter
Charlotte Bøttcher
Oli Jacobsen
Kiss Larsen
Henrik Marcussen
Marianne Kleis Møller
Peter Nørregaard
Bente Nørskov
Author Affiliation
pqlr@stofanet.dk
Source
Ugeskr Laeger. 2006 Jan 3;168(1):25-9
Date
Jan-3-2006
Language
Danish
Publication Type
Article
Keywords
Denmark
Efficiency, Organizational
Europe
Health Services Misuse
Hospital Departments - statistics & numerical data - utilization
Humans
Internal Medicine
Length of Stay
Patient Admission
Patient Care Planning - organization & administration
Utilization Review - methods
Waiting Lists
Abstract
This study evaluated the incidence of inappropriate use of bed days in Danish medical wards using the European Appropriateness Evaluation Protocol (AEP). Several European countries have used the AEP to assess the appropriateness of hospitalisation days.
The study was carried out in four Danish medical wards from October 2004 to January 2005. On pre-selected days a doctor and nurse performed case record analyses of all hospitalised patients with registration of the AEP criteria. To assess activities during the entire day, the screening comprised activities from the previous day.
Altogether, 738 patients were reviewed. On average, 32.1% of hospitalisation days on the four wards were assessed as inappropriate (range 19.2-39.2%). Lack of alternative facilities (different outpatient services, rehabilitation, home nursing, etc.) and internal waiting time for diagnostic tests were the most common causes of inappropriate bed use. 6.4% of bed days were considered appropriate from a clinical point of view even though no AEP criteria were met.
In order to reduce the number of inappropriate hospital days, it is necessary to optimise the cooperation with the primary health care sector and ensure immediate availability of diagnostic tests.
PubMed ID
16393558 View in PubMed
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[A project in Uppsala. Improved care of cancer patients under treatment with antineoplastic agents]

https://arctichealth.org/en/permalink/ahliterature25157
Source
Lakartidningen. 1990 Jul 25;87(30-31):2428-31
Publication Type
Article
Date
Jul-25-1990

Are family-centred principles, functional goal setting and transition planning evident in therapy services for children with cerebral palsy?

https://arctichealth.org/en/permalink/ahliterature139257
Source
Child Care Health Dev. 2012 Jan;38(1):41-7
Publication Type
Article
Date
Jan-2012
Author
J. Darrah
L. Wiart
J. Magill-Evans
L. Ray
J. Andersen
Author Affiliation
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada T6G 2G4. johanna.darrah@ualberta.ca
Source
Child Care Health Dev. 2012 Jan;38(1):41-7
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta
Attitude to Health
Cerebral Palsy - rehabilitation
Child
Child Health Services - organization & administration
Child, Preschool
Delivery of Health Care, Integrated - organization & administration
Family Health
Focus Groups
Health Services Research - methods
Humans
Interinstitutional Relations
Occupational Therapy - organization & administration
Parents - psychology
Patient Care Planning - organization & administration
Physical Therapy Specialty - organization & administration
Professional-Family Relations
Abstract
Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada.
Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes.
All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports.
Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite attending the same programme. Standardized programme processes and policies may provide a starting point to ensure that all families have equitable opportunities to participate in their child's rehabilitation programme.
PubMed ID
21083684 View in PubMed
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Being prepared for the unprepared: a phenomenology field study of Swedish prehospital care.

https://arctichealth.org/en/permalink/ahliterature129598
Source
J Emerg Nurs. 2012 Nov;38(6):571-7
Publication Type
Article
Date
Nov-2012
Author
Birgitta Wireklint Sundström
Karin Dahlberg
Author Affiliation
School of Health Sciences and Research Centre PreHospen, University of Borås, The Prehospital Research Centre in Western Sweden, Borås, Sweden. birgitta.wireklint.sundstrom@hb.se
Source
J Emerg Nurs. 2012 Nov;38(6):571-7
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Ambulances - organization & administration
Emergency Medical Service Communication Systems - organization & administration
Emergency Medical Services - organization & administration
Female
Humans
Male
Medical Errors - prevention & control
Patient Care Planning - organization & administration
Professional-Patient Relations
Risk Management - organization & administration
Sweden
Abstract
This paper presents a study of prehospital care with particular focus on how ambulance personnel prepare themselves for their everyday assignments.
The caring science field study took a phenomenological approach, where data were analyzed for meaning. Two specialist ambulance nurses, three registered nurses, and six paramedics participated.
The previously known discrepancy between in-hospital care and prehospital care was further interpreted in this study. The pre-information from an emergency medical dispatch (EMD) center provides ambulance personnel with basic expectations as to what they will have to take care of. At the same time that they maintain their certainty and control, our major findings indicate that prehospital care in emergency medical service requires the personnel to be prepared for an open and flexible encounter with the patient; to be prepared for the unprepared, i.e., to be open and to avoid being governed by predetermined statements.
Our findings suggest that the outcomes of good prehospital care affect patient security. The seemingly time-consuming dialogue with the patient facilitates understanding and decision-making regarding the patient's medical needs, and it is comforting to the patient. The ambulance personnel need to be well prepared for this task and fully understand that the situation might differ considerably from the information provided by the EMD centers. All objective information is of great value in this care context, but ultimately it is the patient who provides reliable information about her/his own situation.
PubMed ID
22088772 View in PubMed
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Better care and better teaching. New model of postpartum care for early discharge programs.

https://arctichealth.org/en/permalink/ahliterature192402
Source
Can Fam Physician. 2001 Oct;47:2027-33
Publication Type
Article
Date
Oct-2001
Author
M J Yaffe
B. Russillo
C. Hyland
L. Kovacs
E. McAlister
Author Affiliation
McGill University, Montreal, Que. myaffe@po-box.mcgill.ca
Source
Can Fam Physician. 2001 Oct;47:2027-33
Date
Oct-2001
Language
English
Publication Type
Article
Keywords
Family Practice - education
Female
Humans
Infant, Newborn
Internship and Residency
Length of Stay
Models, organizational
Nursing Assessment
Outpatient Clinics, Hospital - organization & administration
Patient Care Planning - organization & administration
Patient care team
Perinatal Care - methods - organization & administration
Postnatal Care - methods - organization & administration
Program Evaluation
Quebec
Abstract
Rapid postpartum discharge has reduced opportunities to detect early newborn or parenting problems and to teach neonatal assessment and maternal postpartum care to medical trainees.
Development of a program to not only ensure adequate care of mothers and newborns after early hospital discharge, but also to teach outpatient assessment skills to family medicine residents.
In an urban, secondary care, university-affiliated teaching hospital predominantly training family medicine residents, an interdisciplinary committee created and supervised a neonatal and maternal postpartum assessment program. Newborn infants and their mothers are seen by a family physician, a family medicine resident, and a nurse within 48 hours of discharge, after which care is assumed in the community by the child's primary care physician. An assessment protocol developed by the interdisciplinary group promotes standardized mother and child care and a structured learning experience for trainees.
Rapid follow up of early discharged infants and their mothers can be facilitated by a program of standardized assessment by a roster of pooled, interacting family physicians and nurses. When this assessment occurs in a teaching milieu, a comprehensive learning experience can be combined with defined objectives that emphasize and encourage newborn and maternal assessment for ambulatory patients.
Notes
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PubMed ID
11723597 View in PubMed
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115 records – page 1 of 12.