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Care Culture (care + culture)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Is good ,quality of life' possible at the end of life?

JOURNAL OF CLINICAL NURSING, Issue 4 2001
An explorative study of the experiences of a group of cancer patients in two different care cultures INFORMATION POINT: Factor analysis
,,The purpose of this paper was to explore how a group of gravely ill patients, cared for in different care cultures, assessed their quality of life during their last month of life. ,,The study material comprised quality of life assessments from 47 cancer patients, completed during their last month of life. Two quality of life questionnaires, the EORTC QLQ-C30 and a psychosocial well-being questionnaire, were used. The data were treated in accordance with instructions for the respective questionnaires, and the results are presented primarily as means, mostly at the group level. Assessments from patients in two different care cultures, care-orientated and cure-orientated, were compared. ,,The results show that despite having an assessed lower quality of life in many dimensions than people in general, several patients experienced happiness and satisfaction during their last month of life. ,,,Cognitive functioning' and ,emotional functioning' were the dimensions that differed least from those of the general population, and ,physical functioning', ,role functioning' and ,global health status/quality of life' differed the most. ,Fatigue' showed the highest mean for the symptom scales/items. ,,There was a tendency for those cared for in the cure-orientated care culture to report more symptoms than those in the care-orientated care culture. An exception to this was ,pain', which was reported more often by those in the care-orientated care culture. ,,The implications of the results are discussed from different angles. The significance of knowledge concerning how patients experience their quality of life is also discussed with respect to the care and the planning of care for dying patients. [source]

Values and evaluation in health care

JOURNAL OF NURSING MANAGEMENT, Issue 3 2001
A. Sarvimäki PHD RN
The purpose of this paper is to broaden the view of evaluation in health care by ,problemizing' the concepts of quality and evaluation and relating them to a more general discussion of values. The discussion of the concept of quality shows that the concept of quality is often vague or contradictory and that the relationship between quality and costs is problematic. The discussion is broadened by studying quality and evaluation from the viewpoint of four categories of values: scientific values, aesthetic values, ethical values and economic values. The authors also show that values, in addition to constituting the basis for evaluation, actually guide the whole process of care. Values are explicit and implicit elements of the care culture and the individual's action system. The authors conclude that the four value categories could be used to study which values actually guide the care process in real situations. [source]

Medical Error and Patient Safety: Understanding Cultures in Conflict

LAW & POLICY, Issue 2 2002
Joanna Weinberg
Evidence documenting the high rate of medical errors to patients has taken a prominent place on the health care radar screen. The injuries and deaths associated with medical errors represent a major public health problem with significant economic costs and erosion of trust in the health care system. Between 44,000 and 98,000 deaths due to preventable medical errors are estimated to occur each year, making medical errors the eighth leading cause of death in the United States. However, the recent prominence of the issue of safety or error does not reflect a new phenomenon or sudden rift in the quality of health care (although it is a system fraying at the edges). Rather, the prominence of the issue reflects a radical change in the culture of health care, and in how relationships within the health care system are structured and perceived. In this paper, I discuss the multiple factors responsible for the change in the culture of health care. First, the culture has shifted from a clinician cantered system, in which decision making is one,sided, to a shared system of negotiated care between clinician and patient, and, often, between administrator or payer. Second, the nature of quality in health care has changed due to the geometric increase in the availability of technological and pharmaceutical enhancements to patient care. Third, the health care culture continues to rely on outdated models of conflict resolution. Finally, the regulatory structure of health system oversight was set in place when fee,for,service care governed physician,patient relationships and where few external technologies were available. In the current health care culture, that structure seems inadequate and diffuse, with multiple and overlapping federal and state regulatory structures that make implementation of patient safety systems difficult. [source]

The political role of illness narratives

JOURNAL OF ADVANCED NURSING, Issue 6 2000
Jurate A. Sakalys PhD RN
The political role of illness narratives Cultural criticism is used to describe the political role of autobiographical illness narratives or pathographies. In expressing the subjective experience of illness, authors of pathographies illuminate ideological differences between patient and health care cultures, reveal the dominance of health care ideologies, and explicate patients' moral and political claims. The contributions of these literary works to nursing practice provide direction for relational restructuring. Gadow's concept of the relational narrative is proposed as a way to restore patient subjectivity and agency and establish the dialogue necessary for cultural pluralism in nursing and health care. [source]