Download or read book Phenomenological Study of the Lived Experience of New Graduate Nurses Caring for Hospitalized Patients Living with Dementia written by Geline Buenconsejo and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Title. Phenomenological Study of the Lived Experience of New Graduate Nurses Caring for Hospitalized Patients Living with Dementia. Purpose. This study explored new graduate nurses' lived experiences in caring for hospitalized patients living with dementia. Background. The first twelve months of transitioning from student to professional nurse in acute care settings are the most stressful, emotionally challenging, and mentally exhausting for new nurses striving to apply newly acquired skills into practice. Some of the most challenging patients for nurses to care for are hospitalized patients living with dementia (PtLWD). With the projected increase in the number of patients with dementia in hospitals, it is imperative to understand the challenges nurses face when providing safe and effective care to PtLWD. Methods. Using the hermeneutic phenomenology approach, as influenced by Heidegger and Gadamer, eleven new graduate nurses were recruited from a hospital in southern California. The lived experience of each participant was collected through remotely conducted semi-structured interviews and by using open-ended questions. Transcribed interviews were read and analyzed using the Braun and Clarke's (2006) linear, 6-phased method, to interpret meanings and arrive at an understanding of the essence of the participants' lived experiences. Findings. The thematic analysis yielded nine overall themes addressing two lines of inquiry. The themes discovered in the first line of inquiry included protecting patient's universal rights, ensuring patient safety and well-being, complex care delivery experience, fostering therapeutic nurse-patient relationship, nurse's positive adaptation and role transition. In the second line of inquiry, the themes included preservation of human connections, feeling inadequate and experiencing personal distress. The themes were analyzed over time and articulated into a cogent phenomenological lived experience. Implications for Research. Study findings suggest that further research is needed to establish a better onboarding process among new graduate nurses caring for hospitalized PtLWD and support the need to initiate advanced care planning as soon as the diagnosis of dementia is identified. This study contributes to the body of knowledge by providing deeper meaning and purpose, enhancing understanding of the new graduate nurses' roles, and recognizing their feeling as they provide care to hospitalized PtLWD.

Download or read book Nurses Experiences Caring for Patients with Dementia written by Vicki C. Earle and published by . This book was released on 2003 with total page 208 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Lived Experience of Registered Nurses Providing Care to Patients with Dementia in the Acute Care Setting written by Dina J. Carner and published by . This book was released on 2004 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Neighbourhood nursing written by Elzana Odzakovic and published by Linköping University Electronic Press. This book was released on 2019-12-20 with total page 129 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Recent policy is marked by a shift towards enabling people with dementia to remain at home and in their neighbourhoods, yet little is known about the wider perspective of neighbourhood as an everyday place of connection, practice and meaning in the lives of people with experience of dementia. Aims: The aim of this thesis is twofold. The first aim is to explore the neighbourhood as an everyday place for people with experiences of dementia. The second aim is to explore neighbourhood as a place for practice. Methods and Designs: Five studies are included in the thesis with both quantitative and qualitative designs. Study I had a cross-sectional exploratory and descriptive design. A total cohort of 17, 405 people with a dementia diagnosis were identified and matched with data about home care services and housing, and were then associated with socio-demographic factors in three county councils: Östergötland, Stockholm and Västerbotten. Study II had a phenomenological design; 14 community-dwelling people diagnosed with dementia in the County of Östergötland participated using walking interviews. Study III had an inductive and exploratory qualitative design including 14 community-dwelling people living alone with dementia in England, Scotland and Sweden involving multiple data collection methods. Study IV had an inductive and explorative qualitative design that included 22 people with the lived, personal and professional experiences of dementia and used semi-structured individual and group interviews. Study V had an inductive and explorative qualitative design where the perspectives of 18 participants (registered and specialist nurses) were included using shadowing as the main method for data collection. Findings: In study I, 72% of the cohort was living in ordinary housing and 28% in special housing of the total of 17, 405 people with a dementia diagnosis. Overall, 52% of 17, 405 people with dementia in three county councils (Östergötland, Stockholm and Västerbotten) were living alone. Study II revealed that walking in the neighbourhood was an integral part of their day-to-day activities that helped them to manage life with dementia. Connection to nature by being outdoors was a restorative practice for people living with dementia. Neighbourhood was often described as a social context, although some participants living alone revealed that their social contacts were mainly staff working in municipal home care. In study III, participants across all three field sites channelled their efforts to stay connected to the neighbourhood into creating new ways of maintaining social networks and relationships. By participating in several activities (provided in the United Kingdom by the third-sector and charitable groups, and in Sweden, by the municipalities), bonds of friendship were created. However, the impact of stigma surrounding dementia was highlighted by the participants, which caused experiences of involuntary solitude or loneliness. Despite the impact of stigma, participants took control over their lives by searching for new daily social connections in the neighbourhood and were by no means passive in the face of the challenges in everyday life. In study IV, the participants discussed how dementia was stigmatized in the community. People living with dementia were often not being respected as active citizens with their own resources in the community. Being socially active in a group or in public spaces were strategies to maintain a social role in the community. Participants with different experiences of dementia wanted the day care centres and teams to be more centrally involved in person-centred care and health-promoting improvements. Finally, in study V, participants struggled with the commonly held view of their role and their workplace within the health care system, interpreting it as being invisible, as if placed in a black box. The tasks and responsibilities of the participants were shifting to assistant nurses, neighbours and family members according to the socio-economic level of the municipality. Nonetheless, the participants were clearly part of the neighbourhood. The findings of this thesis have been integrated into a combined thematic analysis based on the five studies to reach an overall representation of people’s experiences of neighbourhood as an everyday place and a place for practice in the context of dementia. Five main themes (and three sub-themes) emerged from the analysis: (1) walkable attachment to the lived neighbourhood; (2) daily activities promote health and well-being; (3) opportunities for social connections; (4) just treat us as active citizens; (5) neighbourhood: a place for practice. The analysis suggested the neighbourhood was not only described as a walkable, social and citizenship arena in the context of dementia; it was also a place where practice was ongoing around the clock (studies II, III, IV and V) because most of the people with dementia are living in ordinary housing (study I). Conclusion: The thesis presents a new foundation and knowledge to understand neighbourhood as a place for everyday life and practice by applying a new lens for understanding. The neighbourhood can be understood as a place linked by connections that people actively searched out, and where the meaning of place emerges via movement of the body through the world. It is also a site where practices support everyday life for people with dementia, especially for those living alone with dementia. This points to the need to re-think nursing practice, where “neighbourhood nursing” as a formal model with a lifeworld perspective has to be established in dialogue with citizens. Bakgrund: Den senaste samhällsutvecklingen och de politiska ambitionerna har utgått alltmer från att göra det möjligt för personer med demenssjukdom att bo kvar allt längre i sina hem och grannskap. Trots denna utveckling finns det lite kunskap utifrån det bredare perspektivet om grannskapet som en vardaglig plats för relationer, omvårdnad samt vilken mening det har för personer som har erfarenhet av demens. Syfte: Syftet med avhandlingen var för det första att undersöka grannskapet som en plats i vardagen för personer som har erfarenheter av demens, och för det andra, att undersöka grannskapet som en plats för omvårdnad. Design och metod: Avhandlingen inkluderar fem delstudier med både kvalitativ och kvantitativ design. Studie I hade en explorativ och beskrivande tvärsnittsdesign. Totalt ingick det 17 405 personer med en demensdiagnos som identifierades och samkördes med information av hemtjänstinsatser och boende. Denna informationen förenades sedan med de socio-demografiska faktorerna i de tre regionerna Östergötland, Stockholm och Västerbotten. Studie II hade en femenologisk design som inkluderade 14 personer som bodde i ett eget boende med en demensdiagnos i Östergötlands län och som deltog i ´promenad intervjuer´. Studie III hade en induktiv och beskrivande kvalitativ design vilket inkluderade 14 personer som bodde ensamma i ett eget boende med en demensdiagnos i England, Skottland och Sverige. De 14 personer som bodde i ett eget boende med en demensdiagnos i Studie III deltog i flera datainsamlingsmetoder. Studie IV hade en induktiv och beskrivande kvalitativ design som inkluderade 22 personer med levda, personliga och professionella erfarenheter av demens som deltog i semistrukturerade individuella och gruppintervjuer. Slutligen, Studie V hade också en induktiv och beskrivande kvalitativ design där 18 deltagare (legitimerade sjuksköterskor och specialistsjuksköterskor) inkluderades skuggning som är den huvudsakliga metoden för datainsamlingen. Resultat: I Studie I fann vi att 72 % av den totala befolkningen av 17 405 personer med en demensdiagnos bodde i ordinärt boende och 28 % i särskilt boende. Sammantaget bodde 52 % av de 17 405 personerna med demens i singelhushåll i de tre regionerna Östergötland, Stockholm och Västerbotten. Studie II påvisade att promenader i grannskapet var en betydelsefull del av deras dagliga aktiviteter som hjälpte personer med en demensdiagnos att hantera ett liv med demens. Att vara utomhus i naturen medförde att personer med demens knöt an till naturen och genom det återhämtade sig. Grannskapet beskrivs ofta som ett socialt sammanhang, även om vissa deltagare som bodde ensamma berättade att deras sociala kontakter främst var med personalen som arbetade i den kommunala hemsjukvården (och hemtjänsten). I studie III beskrev personer med demens i England, Skottland och Sverige hur de ansträngde sig för att hålla kvar kontakten med grannskapet men också hur de skapade nya sätt att upprätthålla och hitta nya sociala nätverk och kontakter. Dessa vänskapsband skapades genom att delta i olika aktiviteter (som tillhandahålls i England av tredje sektorn och välgörenhetsgrupper, och i Sverige, av kommunerna). Även effekterna av stigmatiseringen kring att leva med demens betonades av deltagarna, de beskrev detta som en orsak till ofrivillig ensamhet. Trots påverkan av stigmatiseringen tog personerna med demens, kontroll över sina liv, genom att finna nya dagliga sociala kontakter i grannskapet. Personer med demens är intressearde av att anta nya utmaningarna i vardagen. I studie IV diskuterade personerna med olika erfarenheter av demens hur demenssjukdomen som ett stigmatiserat tillstånd i samhället påverkade dem. De ansåg att deltagarna som lever med en demensdiagnos ofta inte respekterades som aktiva medborgare med sina egna resurser i samhället. Personerna med olika erfarenhet av demens framhöll också att vara socialt aktiv i en grupp eller i offentliga rum var strategier för att upprätthålla en social roll i samhället. Förutom betydelsen av det sociala livet påpekade personerna med olika erfarenheter av demens att de skulle önska att dagverksamheterna och demensteamen skulle utgå mer utifrån person-centrerad vård och hälsofrämjande förhållningssätt. Slutligen, i studie V observerades det hur legitimerade sjuksköterskor och specialistsjuksköterskor kämpade med den vanligt förekommande synen på deras profession och arbetsplatsen inom hälso-och sjukvården som gav sig uttryck som osynlig. Deras uppgifter och ansvar hade även förändrats och allt mer hade överlåtits till undersköterskor, grannar och familjemedlemmar och kommunernas socioekonomiska status hade betydelse. Legitimerade sjuksköterskor och specialistsjuksköterskorna var en självklar del av grannskapet. Resultaten av denna avhandling har integrerats i en sammansatt tematisk analys baserad på de fem studierna för att nå en övergripande representation av människors upplevelser av grannskapet som en plats för det dagliga livet och omvårdnad med utgångspunkt utifrån erfarenheter av demens. Analysen resulterade i fem huvudteman (och tre underteman): (1) anknytning till det existerade grannskapet via promenader (2) dagliga aktiviteter främjar hälsa och välbefinnande; (3) möjligheter för sociala kontakter; (4) behandla oss som aktiva medborgare; (5) grannskapet som en plats för omvårdnad. Grannskapet beskrivs inte bara som en framkomlig, social medborgarskapsarena i relation till demens, utan var även en plats där sjuksköterskepraxis pågick dygnet runt (studierna II, III, IV och V) eftersom de flesta personer som lever med demens bor i ordinärt boende (studie I). Konklusion: Avhandlingen presenterar ett nytt underlag och ny kunskap för att förstå grannskapet som en plats för dagligt liv och omvårdnad genom att använda ett nytt perspektiv för att få förståelse. Grannskapet kan förstås som en plats förenad genom förbindelser som människor aktivt söker efter och där betydelsen av grannskapet inträder genom kroppens rörelse ut mot världen. Det är också en plats där omvårdnad sker som i sin tur stödjer vardagslivet för personer med demens, särskilt för dem som lever ensamma med demens. Detta visar på behovet av att tänka om i praktiken vad det gäller omvårdnaden, där ”omvårdnad i grannskapet” som en modell med ett livsvärldsperspektiv behövs i dialog med medborgarna. Pozadina: Nedavni trend demencije ogleda se u ovome da osobe koje žive sa demencijom ostanu u kući ili u susjedstvu, ali još uvijek nije poznato mnogo u široj perspektivi koju nude ta susjedstva kao svakodnevno mjesto povezivanja, medicinske njege, te samog značaja u životu onih koji žive sa demencijom. Ciljevi: Cilj je istražiti susjedstvo kao svakodnevno mjesto boravka za ljude koji žive od demencije, te kao drugo istražiti susjedstva kao mjesta gdje bi se pružala medicinska njega. Metode i dizajni: Ukupno pet studija uključeno je u rad sa kvantitativnim i kvalitativnim dizajnom. Studija I imala je istraživački i opisni dizajn. Populacija od 17. 405 ljudi sa dijagnozom demencije bila je identifikovana, te usklađena sa podacima o kućnoj njezi i mjestu prebivališta, a zatim povezana sa tri općine: Östergötland, Štokholm i Vasterboten. Studija II imala je fenomenološki dizajn gdje je 14 osoba koje žive sa demencijom u porodičnoj kuci učestovalo u Östergötlandu u intervju pri šetnji. Studija III imala je induktivni i istraživački kvalitativni dizajn koji je uključivao 14 ljudi iz porodičnog domaćinstva koji žive sami sa demencijom u Engleskoj, Škotskoj i Švedskoj, uključujući više metoda prikupljanja podataka. Studija IV imala je induktivni i istraživački kvalitativni dizajn koji je obuhvatio 22 osobe koje žive, ili imaju lično i profesionalno iskustvo sa demencijom, gdje su se koristili pojedinačni i grupni intervju. Studija V imala je induktivni i istraživački kvalitativni dizajn gdje je uljućeno ukupno 18 medicinskih sestara, a kao glavna metoda za prikupljanje podataka korištena je metoda praćenja i posmatranja. Završni rezultati: U studiji I, 72% od 17. 405 ljudi koji su imali demenciju živjeli su porodičnim kućama a 28% u starački domovima. Ukupno 52% od 17. 405 ljudi koji žive sa demencijom u tri općine su Östergötland, Štokholm i Vasterboten žive sami. Studija II otkrila je kako svakodnevna šetanja je sastavni dio njihovih aktivnosti koje su im pomogle u životu sa demencijom. Može se reći da je boravak na otvorenom, te povezivanje sa prirodom je vrlo praktično za ljude koji žive sa demencijom. Susjedstvo je često opisano kao socijalni kontekst, iako su neki učesnici u istraživanju koji žive sami otkrili kako je njihov jedini društveni kontakt bio sa uposlenicima kućne njege. U studiji III učesnici ispitivanja u Engleskoj, Škotskoj i Švedskoj su sve svoje napore da ostanu povezani sa susjedstvom kako bi stvorili nove načine koji bi pomogli stvaranje novih veza i odnosa. Učestvovanjem u nekoliko aktivnosti (koje su u Velikoj Britaniji omogućile dobrotvorne i slobodne organizacije, a u Švedskoj općine) stvorene su veze i prijateljstva. Međutim, utjecaj predrasuda povezanih s demencijom, što su i naglašavali sudionici, vodilo je kao iskustvu samoće i usamljenosti. Uprkos utjecaju predrasuda, učesnici su preuzeli kontrolunad svojim životima, te su tražili nove svakodnevne društvene veze u susjedstvu, ne pokazujući tako pasivnost prema svakodnevnim izazovima s kojima se susreću. U studiji IV učesnici su razgovarali o predrasudama o demenciji u zajednici. Ljudi koji žive sa demencijom često nisu uvaženi kao aktivni članovi koji mogu doprinijeti zajednici. Kako bi održali svoje uloge u zajednici vrlo je bitno da ostanu društveno aktivni. Učesnici sa različitim iskustvom demencije izrazili su želju da se centri za svakodnevnu njegu i timovi više baziraju kao unapređenju njege i zdravlja, kao i da se akcenat stavi na osobu za demencijom. Na kraju, u studiji V medicinske sestre su se borile sa općeprihvaćenim stavom o njima i njihovoj ulozi, te njihovom radnom mjestu u sistemu zdravstvene zaštite, opisujući to kao nevidljivo. Zadaci i odgovornosti medicinskih sestara prebacivali su se na pomoćne sestre, komšije i članove porodica prema društveno-ekonomskom nivou opštine. Unatoč tome, medicinske sestre su očito bile dio susjedstva. Iskustva, odnosno pronalasci u ovoj tezi integrisani su u kombinovanu analizu prema pet tematski obrađenih studija, kako bi se dostigao sveobuhvatan prikaz iskustava u susjedstvu kao svakodnevnom mjestu, te mjestu zdravstvene podrške u kontekstu demencije. Iz ove analize pojavilo se pet glavnih tema (kao i tri podteme): (1) povezanost sa susjedstvom; (2) svakodnevne aktivnosti promovišu zdravlje i dobrobit; (3) mogućnosti za socijalne veze; (4) tretiranje kao aktivne građane; (5) susjedstvo je mjesto za medicinske prakse neprekidno traju. Analize pokazuju kako se susjedstvo ne opisuje samo kao prohodno, socijalno i građansko polje u kontekstu demencije, već kao i mjesto gdje medicinske prakse neprekidno traju (studije II, III, IV i V), jer većina ljudi s demencijom žive u običnom domaćinstvu (studija I). Zaključak: Teza predstavlja nove temelje i znanja, kako bi se lakše razumio pojam susjedstva kao svakodnevnog mjesta za život, kao i njege kroz nove objektive razumijevanja. Susjedstvo bi se moglo shvatiti kao mjesto spojeno vezama koje ljudi aktivno potražuju gdje se značenje mjesta spaja sa kretanjem tijela kroz svijet. To je također mjesto gdje je svakodnevno obezbjeđena njega za ljude koji žive sa demencijom, posebno za one koji žive sami. Ovo ukazuje na potrebu da se preispita medicinska praksa, gdje se ‘’njega u susjedstvima’’ kao formalni model sa životnom perspektivom treba uspostaviti u dijalogu sa građanima.

Download or read book The Experiences of People Living with Dementia in Acute Care Environments written by Shannon Ferguson and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Increased life expectancy and the population of seniors are growing rapidly which comes with an expected rise in acute hospital care needed. Nearly one quarter of hospital in-patients have dementia and caring for this population will be a significant part in the provision of health care services. The current knowledge base is through the perspectives of health care professionals and shows that the hospital culture, and environment, produces negative effects for people with dementia who are hospitalized. The effects of the stigma of dementia have not been studied in this environment specifically. The aim of this research was to explore the experiences of people with dementia in the acute care environment, paying particular attention to stigma and exploring if, and how stigma was a factor in people's experiences. This qualitative study employed hermeneutic phenomenology that focused on the lived experience from the perspectives of people with dementia. Semi-structured interviews, and a focus group discussion was conducted with participants that included two men with early dementia and their care partners, one woman with early dementia, and two care partners caring for their spouses who were residing in long-term care facilities. The central overarching theme revealed throughout the continuum of care was stigma related to both age and dementia. Additionally, the findings reveal stigma to be present in system issues and the interpretation of stigma is very individual. Finally, enhancing care, revealed the critical role that advocacy played and how the culture of hospital care was understood. The use of the four structures of phenomenology showcased how the body, the hospital, relationships, and sense of time, interacted in making meaning in the acute care experience of the participants. The findings revealed unique knowledge provided from detailed experiences of the participants where illness, age and dementia, influenced perceptions of stigma, and how stigma further impacts the perception of care and ultimately, how it is experienced and understood, by people with dementia and their care partners. These insights may provide areas where stigma can be tackled through the perspectives of those being stigmatized and draw much needed attention to facilitating change in the approach to care within the acute care system for people with dementia.

Download or read book Experiences of Hospitalized Patients with Dementia written by Samantha Bainbridge and published by . This book was released on 2012 with total page 64 pages. Available in PDF, EPUB and Kindle. Book excerpt: People with dementia are hospitalized for a variety of reasons. The combination of dementia with additional health conditions creates a unique challenge to caregivers in acute care settings. There is a dearth of information available to provide guidance to the nursing staff caring for these patients. This integrated review of the literature examined the experiences of hospitalization from the perspective of the older adult with dementia, the family caregiver, and the patient care staff. Results showed a limited body of literature that addressed hospital experiences of people with dementia and those of family and professional caregivers. Additionally, few studies addressing this topic have been conducted in the United States. The primary finding from this study is that better communication is needed between nursing staff, patients, and their family caregivers. Nurses should carry out detailed assessments of cognition and pain in all elderly patients, and strive to provide appropriate palliative and end-of-life care. Dementia- specific training for all staff members may help to promote a better understanding of patients with dementia. Lastly, further research into the experiences of hospitalized dementia patients is needed, with a focus on acute care settings within the United States.

Download or read book New Graduate Nurses and Dementia Care In Acute Care written by Benjamin Hartung and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: With the increasing older adult population, new graduate nurses will be providing care for patients with dementia more frequently and should be supported to care for this population during their transition period. Purpose: The purpose of this thesis was to explore the experiences of new graduate nurses providing care for patients with dementia in acute care environments. Methods: An interpretive descriptive qualitative study explored eleven Ontario new graduate nurses' experiences providing dementia care in acute care environments. A thematic analysis was conducted. Findings: The thematic analysis resulted in three themes and several sub-themes: building of vision and values, clash of vision and values, and "make do with what you have". Discussion and Conclusion: Facilitators to providing dementia care in acute care were supportive colleagues and early exposure to dementia care. The barriers identified were similar to the barriers experienced by nurses in the literature.

Download or read book Experience of Admitting a Spouse Into Long Term Care written by Annmarie Bernier and published by . This book was released on 2007 with total page 92 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is a descriptive phenomenological study researching the lived experience of admitting a spouse with dementia into a long term care facility.

Download or read book Dissertation Abstracts International written by and published by . This book was released on 2006 with total page 860 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Dementia in Prison written by Joanne Brooke and published by Routledge. This book was released on 2020-12-06 with total page 143 pages. Available in PDF, EPUB and Kindle. Book excerpt: This innovative volume exposes dementia as a condition that the aging prison population is increasingly facing. Going beyond exploring the need to understand dementia within prison populations, it argues that healthcare workers and prison staff must ensure that prisoners developing dementia during their sentence are identified and supported. Dementia in Prison covers three key areas: • Healthcare services in prison settings and how these affect the rapidly aging prison population, • The human rights of prisoners with dementia, alongside the ethics of healthcare in this environment, • The current state of support for prisoners with dementia and any recommendations for future assessment, diagnosis, and policies. This provocative book will be invaluable to scholars in the fields of public health, criminology and medical sociology as well as nurses and prison staff.

Download or read book Master s Theses Directories written by and published by . This book was released on 2004 with total page 324 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Education, arts and social sciences, natural and technical sciences in the United States and Canada".

Download or read book Lived Experience for Registered Nurses of Busyness During Elder Care written by Kim Wylie and published by . This book was released on 1996 with total page 237 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Phenomenological Study of Older Home Health Nurses Lived Experience with the Implementation and Usage of a Computerized Clinical Documentation System written by Theresa M. Turk and published by . This book was released on 2009 with total page 220 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Lost in Translation written by Alison Marie Rowe and published by . This book was released on 2007 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Meta Ethnography written by George W. Noblit and published by SAGE. This book was released on 1988-02 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt: How can ethnographic studies be generalized, in contrast to concentrating on the individual case? Noblit and Hare propose a new method for synthesizing from qualitative studies: meta-ethnography. After citing the criteria to be used in comparing qualitative research projects, the authors define the ways these can then be aggregated to create more cogent syntheses of research. Using examples from numerous studies ranging from ethnographic work in educational settings to the Mead-Freeman controversy over Samoan youth, Meta-Ethnography offers useful procedural advice from both comparative and cumulative analyses of qualitative data. This provocative volume will be read with interest by researchers and students in qualitative research methods, ethnography, education, sociology, and anthropology. "After defining metaphor and synthesis, these authors provide a step-by-step program that will allow the researcher to show similarity (reciprocal translation), difference (refutation), or similarity at a higher level (lines or argument synthesis) among sample studies....Contain(s) valuable strategies at a seldom-used level of analysis." --Contemporary Sociology "The authors made an important contribution by reframing how we think of ethnography comparison in a way that is compatible with the new developments in interpretive ethnography. Meta-Ethnography is well worth consulting for the problem definition it offers." --The Journal of Nervous and Mental Disease "This book had to be written and I am pleased it was. Someone needed to break the ice and offer a strategy for summarizing multiple ethnographic studies. Noblit and Hare have done a commendable job of giving the research community one approach for doing so. Further, no one else can now venture into this area of synthesizing qualitative studies without making references to and positioning themselves vis-a-vis this volume." -Educational Studies

Download or read book Whispers and Song written by Sian Wareing-Jones and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Quality of End of Life Care Among Nursing Home Residents with Alzheimer s Disease and Related Dementia Impact of Patient Safety Culture and State Regulations written by Jessica Orth and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nursing home (NH) quality of care has improved across several measures following national efforts to increase transparency. Indicators of resident functioning and health status and facility characteristics across NHs are available to the public, allowing NH quality to be assessed, providing incentives for quality improvement, and resulting in better resident outcomes. And still, concerns exist about medical errors, adverse events, and inadequate quality improvement in NHs. There are few validated measures to assess variations in end-of-life (EOL) NH care and we know little about care outcomes among dying NH residents. Among the most vulnerable at the EOL are residents with Alzheimer’s disease and related dementia (ADRD). In addition to declines in physical functioning, residents with ADRD experience changes in cognition, memory problems, and lack of autonomy that require additional health care services and supports at the EOL. Nearly 70% of NH residents age 65 years and older die with ADRD. Evidence shows differences in care patterns among NH residents with and without ADRD, but we are yet to fully understand why differences exist, how outcomes are impacted, and ways to improve quality of care at the EOL. While we remain unable to alter the clinical progression of ADRD, we can change and improve how we care for NH residents with ADRD at the EOL. NH patient safety culture (PSC) is an important area for improvement in health care. Measured domains of PSC include staffing, training and skills, non-punitive response to mistakes, and handoffs, among others. As NHs seek to improve measures of care quality, it is important to understand the role of PSC when caring for residents. The overall objectives of this dissertation were to: 1) examine variations in EOL care and outcomes (place of death, death with pressure ulcers, potentially avoidable hospitalizations, and hospice use during the last 90 days of life) among residents with mild, moderate, and severe ADRD and identify associations with NH and market characteristics; 2) examine associations between NH PSC and EOL care and outcomes among NH residents with ADRD; 3) assess the extent to which state policies for NH care such as Medicaid payment rates and minimum NH nurse staffing requirements moderate relationships between NH PSC and EOL care and outcomes among NH residents with ADRD; and 4) examine whether within-facility differences in EOL care and outcomes exist between residents with and without ADRD and whether NH PSC contributes to such differences for these two groups of residents. Research Design and Methods: This dissertation was a cross-sectional study. The samples included long-stay residents with ADRD, age 65 years and older, who died in the NH or hospital shortly after discharge. For Objective 1, the sample included 191,435 decedents with ADRD from one of 14,618 US NHs. For Objectives 2 and 3, the sample included 11,957 decedents with ADRD from one of 800 NHs. Decedents without ADRD were added to this sample in Objective 4, resulting in 11,957 decedents with ADRD and 4,849 decedents without ADRD from one of 802 NHs. ata were employed from national Medicare claims, Minimum Data Set, public datasets, and a national survey of NH PSC. This dissertation used descriptive analyses and multivariable logistic regression, controlling for resident, NH, market, and state-level characteristics, and with NH random effects (Objectives 1-3) or NH fixed effects (Objective 4), to estimate effects. Results: Objective 1: As ADRD severity increased, adjusted rates of in-hospital deaths and potentially avoidable hospitalizations decreased (17.0% to 6.3%; 11.2% to 7.0%), while adjusted rates of dying with pressure ulcers and hospice use increased (8.2% to 13.5%; 24.5% to 40.7%). Decedents with moderate and severe ADRD in for-profit NHs had 16.0% and 13.0% higher likelihoods of in-hospital deaths. In NHs with Alzheimer’s special care units, likelihoods of in-hospital deaths, dying with pressure ulcers, and potentially avoidable hospitalizations were significantly lower. As ADRD severity increased, higher licensed nurse staffing was associated with 14.0%-27.0% lower likelihoods of potentially avoidable hospitalizations. Increased NH market competition was associated with higher likelihood of hospice use and lower likelihood of in-hospital deaths among decedents with moderate ADRD. Objectives 2 and 3: Residents with ADRD in NHs with higher PSC scores for the domain of communication openness had lower odds of in-hospital death; this effect was stronger in NHs located in states with higher minimum NH nurse staffing requirements. NH PSC was not statistically significantly associated with dying with pressure ulcers, potentially avoidable hospitalizations, or hospice use among residents with ADRD. Medicaid payment rates did not moderate relationships between NH PSC and EOL care and outcomes among NH residents with ADRD. Objective 4: Residents with ADRD were 24.0% less likely to die in-hospital, 25.0% less likely to die with pressure ulcers, and 17.0% less likely to experience a potentially avoidable hospitalization in the last 90 days of life compared to residents without ADRD residing in the same facility. There were no statistically significant within-facility differences in hospice use between residents with and without ADRD. PSC domains related to teamwork, staffing, and nonpunitive response to mistakes were especially important for residents with ADRD. Conclusions and Implications: In summary, findings from this dissertation suggest that EOL care and outcomes among NH residents with ADRD are better in NHs with Alzheimer’s special care units and with higher PSC scores. The general lack of overlap in significant NH PSC domains across the measures of EOL care and outcomes is intriguing and highlights the complexity of EOL care and the need for a multifaceted approach to EOL care in NHs. Findings from this dissertation can help guide NH leaders, policy makers, and researchers in strategies to improve EOL care and outcomes by identifying key areas of focus in efforts to enhance NH PSC and improve EOL care for residents. Future research is needed to develop meaningful interventions that may promote these goals, as well as understand NH care practices associated with the presence of Alzheimer’s special care units promoting higher-quality EOL care.