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Own Decisions (own + decision)
Selected AbstractsAttitudes of Egyptian nursing home residents towards staying in a nursing home: a qualitative studyINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 4 2009Thomas Boggatz RN Aim., The aim of this study was to identify the attitudes of Egyptian nursing home residents towards staying in a nursing home and to differentiate between various types of these attitudes. Background., The number of older persons in Egypt who require nursing care is increasing. In response, nursing homes in bigger cities like Cairo were founded, although family care seems to be the prevalent norm. Methods., Semi-structured guideline interviews were performed with 21 residents from four different nursing homes in Cairo. Interviews were analyzed using qualitative content analysis. Findings., One category of resident was those who were sent to the nursing home by persons closely related to them. Another category made their own decision to move to a nursing home. Relationships with social networks and self-help abilities are factors of importance in influencing decision-making. Conclusion., Nursing homes in Egypt fulfil different functions for different types of older persons. Charitable institutions are a last resort for those with no income and a disrupted social network. For better-off older persons, nursing homes may provide the benefits of socialising with peers and receiving medical treatment. [source] Peri-operative management of anti-platelet agentsANZ JOURNAL OF SURGERY, Issue 7-8 2009Samer Hermiz Abstract Background:, Increasing numbers of patients treated with anti-platelet agents are presenting for non-cardiac surgery. We examined the peri-operative management of anti-platelet therapy in patients undergoing elective non-cardiac surgery and the process by which patients received instructions. Methods:, We interviewed and collected outcome data on 213 consecutive patients aged ,45 years presenting for elective non-cardiac surgery at our institution over a 6-week period regarding the peri-operative management of anti-platelet and warfarin therapy. Results:, Anti-platelet therapy was prescribed in 22.5% and warfarin in 5.2% of the study subjects. Aspirin was stopped peri-operatively in 55.3%, while clopidogrel was stopped in the sole patient treated with this. The frequency of anti-platelet agent discontinuation was similar for major and minor surgery. Warfarin was discontinued prior to surgery in all cases. Only 54.2% of those treated with anti-platelet therapy recalled being given instruction regarding pre-operative management of their anti-platelet therapy compared with 90.9% of patients treated with warfarin (P= 0.04). In the absence of instructions, a number of patients made their own decision to stop their aspirin pre-operatively. Post-operatively, only 37% recalled receiving instructions regarding restarting anti-platelet therapy. As a result, three patients failed to do so. In contrast, all those treated with warfarin received clear post-operative instructions. Conclusion:, Peri-operative anti-platelet management and communication with patients appears to be sub-optimal. There is a need for standardized processes whereby informed decisions regarding peri-operative anti-platelet therapy are made and communicated clearly to the patients. [source] Dental hygienists' work environment: motivating, facilitating, but also tryingINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2010A Candell To cite this article: Int J Dent Hygiene,8, 2010; 204,212 DOI: 10.1111/j.1601-5037.2009.00420.x Candell A, Engström M. Dental hygienists' work environment: motivating, facilitating, but also trying Abstract:, The aim of the present study was to describe dental hygienists' experiences of their physical and psychosocial work environment. The study was descriptive in design and used a qualitative approach. Eleven dental hygienists participated in the study and data were collected during spring 2008 using semi-structured interviews. The material was analysed using qualitative content analysis. The results showed that the dental hygienists experienced their work environment as motivating and facilitating, but at the same time as trying. The three categories revealed a theme: Being controlled in a modern environment characterized by good relationships. Motivating factors were the good relationship with co-workers, managers and patients, seeing the results of your work, having your own responsibility and making your own decisions. The new, pleasant and modern clinics, good cooperation between co-workers and varying duties were described as facilitating factors. The trying factors, as described by the dental hygienists, were above all being controlled by time limits or by some elements of the work, such as teamwork. The dental hygienists also felt stress because appointments were too-short. To conclude, the participants described their work environment as trying in several ways, despite the modern clinics and good relationships. [source] Evidence-based practice and the professionalization of dental hygieneINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 4 2004Sandra J Cobban Abstract: The application of knowledge is fundamental to human problem solving. In health disciplines, knowledge utilization commonly manifests through evidence-based decision making in practice. The purpose of this paper is to explore the development of the evidence-based practice (EBP) movement in health professions in general, and dental hygiene in particular, and to examine its relationship to the professionalization agenda of dental hygiene in Canada. EBP means integrating practitioner expertise with the best available external evidence from research. Proponents of EBP believe that it holds promise for reducing a research,practice gap by encouraging clinicians to seek current research results. Both the Canadian and American Dental Hygienists Associations support practice based on current research evidence, yet recent studies show variation in practice. Professionalization refers to the developmental stages through which an organized occupation passes as it develops traits that characterize it as a profession. The status conferred by professionalization privileges a group to make and monitor its own decisions relative to practice. Dental hygiene's success in acquiring attributes of a profession suggests that transformation to a profession is occurring. This paper compares the assumptions and challenges of both movements, and argues the need for a principal focus on the development of a culture of evidence-based dental hygiene practice. [source] Metasynthesis: withdrawing life-sustaining treatments: the experience of family decision-makersJOURNAL OF CLINICAL NURSING, Issue 2 2009Mary Ann Meeker Aim., The present study was undertaken to synthesise findings from qualitative investigations of family participation in decisions to withdraw and/or withhold life-sustaining treatment from a seriously ill family member. Background., As a consequence of increasing effectiveness and sophistication of available medical interventions, death is commonly preceded by a decision to withdraw or withhold potentially life-sustaining treatments. These decisions take place in a bioethical context characterised by the preeminence of self-determination, but patients are typically too ill to make their own decisions. Thus, family members are called upon to participate in these morally consequential decisions on the patient's behalf. Design., Metasynthesis Method., Metasynthesis is a form of inquiry that provides for integration of qualitative studies' findings to strengthen knowledge for practice and advance theoretical development. This metasynthesis was conducted using the constant comparative methods of grounded theory. Results., Family members engage in a process of participation in decision-making that is comprised of three major categories: reframing reality, relating and integrating. Surrogates used both cues and information as they reframed their understanding of the patient's status. Relationships with providers and with other family members powerfully influenced the decision-making process. Integrating was characterised by reconciling and going forward. This part of the process has both intrapersonal and interpersonal aspects and describes how family decision-makers find meaning in their experience and move forward in their lives. Conclusions., This synthesis provides a more comprehensive and empirically supported understanding of family members' experiences as they participate in treatment decisions for dying family members. Relevance to clinical practice., This metasynthesis provides evidence to improve family care during treatment withdrawal/withholding decision-making and a theoretical model that can be used to guide creation of clinical practice guidelines. Through increased understanding of family members' experiences, clinicians can more effectively support family decision-making processes. [source] | ||||||||||