847 resultados para patient-nurse relationship


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Children and adolescents now communicate online to form and/or maintain relationships with friends, family, and strangers. Relationships in “real life” are important for children’s and adolescents’ psychosocial development; however, they can be difficult for those who experience feelings of loneliness and/or social anxiety. The aim of this study was to investigate differences in usage of online communication patterns between children and adolescents with and without self-reported loneliness and social anxiety. Six hundred and twenty-six students aged between 10-16 years completed a survey on the amount of time they spent communicating online, the topics they discussed, the partners they engaged with, and their purposes for communicating over the Internet. Participants were administered a shortened version of the UCLA Loneliness Scale and an abbreviated sub-scale of the Social Anxiety Scale for Adolescents (SAS-A). Additionally, age and gender differences in usage of the aforementioned online communication patterns were examined across the entire sample. Findings revealed that children and adolescents who self-reported being lonely communicated online significantly more frequently about personal things and intimate topics than did those who did not self-report being lonely. The former were motivated to use online communication significantly more frequently to compensate for their weaker social skills to meet new people. Results suggest that Internet usage allows them to fulfill critical needs of social interactions, self-disclosure, and identity exploration. Future research, however, should explore whether or not the benefits derived from online communication may also facilitate lonely children’s and adolescents’ offline social relationships.

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Purpose: In this research we examined, by means of case studies, the mechanisms by which relationships can be managed and by which communication and cooperation can be enhanced in sustainable supply chains. The research was predicated on the contention that the development of a sustainable supply chain depends, in part, on the transfer of knowledge and capabilities from the larger players in the supply chain. Design/Methodology/Approach: The research adopted a triangulated approach in which quantitative data were collected by questionnaire, interviews were conducted to explore and enrich the quantitative data and case studies were undertaken in order to illustrate and validate the findings. Handy‟s (1985) view of organisational culture, Allen & Meyer‟s (1990) concepts of organisational commitment and Van de Ven & Ferry‟s (1980) measures of organisational structuring have been combined into a model to test and explain how collaborative mechanisms can affect supply chain sustainability. Findings: It has been shown that the degree of match and mismatch between organisational culture and structure has an impact on staff‟s commitment level. A sustainable supply chain depends on convergence – that is the match between organisational structuring, organisation culture and organisation commitment. Research Limitations/implications: The study is a proof of concept and three case studies have been used to illustrate the nature of the model developed. Further testing and refinement of the model in practice should be the next step in this research. Practical implications: The concept of relationship management needs to filter down to all levels in the supply chain if participants are to retain commitment and buy-in to the relationship. A sustainable supply chain requires proactive relationship management and the development of an appropriate organisational culture, and trust. By legitimising individuals‟ expectations of the type of culture which is appropriate to their company and empowering employees to address mismatches that may occur a situation can be created whereby the collaborating organisations develop their competences symbiotically and so facilitate a sustainable supply chain. Originality/value: The culture/commitment/structure model developed from three separate strands of management thought has proved to be a powerful tool for analysing collaboration in supply chains and explaining how and why some supply chains are sustainable, and others are not.

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Franchising has been widely accepted as an effective way to conduct and expand businesses. However, a franchise system is not a guarantee of success in the market. A successful franchise system should rely on a close and strong franchising relationship. Franchising is an important relationship management business. Franchising arrangements normally last for a number of years, so the franchisor and franchisee in the arrangement relationship are usually motivated to cooperate with each other. In addition, highly loyal franchisees may be obtained through a successful long-term franchising relationship. Over the last few decades, there has been a tremendous wave of interest in franchising relationships. However, little research has been conducted to determine the reasons for long-term franchising relationships. As a result, this study focuses on the important elements that might lead to a successful long-term franchising relationship. This study attempts to examine empirically three essential constructs (relationship quality, cooperation and customer loyalty), which might lead to successful long-term franchising relationships between franchisees and franchisors among the convenience stores in Taiwan. Mailed questionnaires were utilised to collect the research data. A total of 500 surveys were mailed randomly to the manager/supervisor of convenience stores’ franchisees among the four main franchisors (7-ELEVEN, Family, Hi-Life and OK) in Taiwan. The final sample size is 120, yielding a response rate of 24 per cent. The results show that relationship quality positively influences the cooperative relationships between franchisors and franchisees. Relationship quality is also positively correlated with franchisees’ loyalty. Additionally, the results indicate that the cooperative relationships between franchisors and franchisees are significantly associated with franchisees’ loyalty.

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Background Diagnosis and treatment of cancer can contribute to psychological distress and anxiety amongst patients. Evidence indicates that information giving can be beneficial in reducing patient anxiety, so oncology specific information may have a major impact on this patient group. This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and/or radiation therapy in the cancer care centre of a large tertiary Australian hospital. Methods The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system. Historically, most orientation programs at this cancer centre were conducted by one nurse. A randomised controlled trial has been designed to test the effectiveness of an orientation program with bundled interventions; a face-to-face program which includes introduction to the hospital facilities, introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies. The aim is to orientate patients to the cancer centre and to meet the health care team. We hypothesize that patients who receive this orientation will experience lower levels of anxiety and distress, and a higher level of self-efficacy. Discussion An orientation program is a common health care service provided by cancer care centres for new cancer patients. Such programs aim to give information to patients at the beginning of their encounter at a cancer care centre. It is clear in the literature that interventions that aim to improve self-efficacy in patients may demonstrate potential improvement in health outcomes. Yet, evidence on the effects of orientation programs for cancer patients on self-efficacy remains scarce, particularly with respect to the use of multidisciplinary team members. This paper presents the design of a randomised controlled trial that will evaluate the effects and feasibility of a multidisciplinary orientation program for new cancer patients.

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Hourly rounding in the acute hospital setting has been proposed as an intervention to increase patient satisfaction and safety, and improve the nursing practice environment, but the innovation has not been adequately tested. A quasiexperimental pretest post-test non-randomized parallel group trial design was used to test the effect of hourly patient comfort rounds on patient satisfaction and nursing perceptions of the practice environment, and to evaluate research processes and instruments for a proposed larger study. A Patient Satisfaction Survey instrument was developed and used in conjunction with the Practice Environment Scale of the Nursing Work Index. Results on patient satisfaction showed no significant changes. Significant changes were found for three of the five practice environment subscales. Consistent with the aim of a pilot study, this research has provided important information related to design, instruments and process that will inform a larger sufficiently powered study.

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A five-section questionnaire was mailed to all 234 authorised Australian nurse practitioners in late 2007. An 85% response rate was achieved (202 responses). Respondents had a mean age of 47.0 years and 84.2% were women. Only 145 nurse practitioners (72% of respondents) reported being employed in Australia at the time of the census. Emergency nurse practitioners were the most commonly employed nationally (26.9%). Nearly one third of employed nurse practitioners reported that they were still awaiting approval to prescribe medications despite this being a core legislated skill. Over 70% stated that lack of Medicare provider numbers and lack of authority to prescribe through the Pharmaceut ical Benef its Scheme was extremely limiting to their practice. These findings are consistent with the international literature describing establishment of reformative

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The most frequently told story charting the rise of mass schooling should be fairly familiar to most of us. This story normally centres around the post-enlightenment social changes of the late 18th and early 19th centuries, and details how society slowly became more caring and more humane, and how we all decided that rather than simply being fodder for the mills, all children – including those from the working-classes - had the right to an education. The more civilised we became, the more we pushed back the school leaving age, until we eventually developed schools which clearly reflected the values and ambitions of the wider community. After all, are school not simply microcosms of society at large? In addition to this, the form that modern schooling takes is regarded as an unproblematic part of the same story. Of course we should organise our learning in the way we do, with the emphasis on formalised learning spaces, graded curricula, timetables of activities, various forms of assessment, and a clear hierarchy of authority. These features of the contemporary education merely reflect the fact that this is self-evidently the best system available. After all, how else could education possibly be organised?

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Research on outcomes from psychiatric disorders has highlighted the importance of expressed emotion (EE), but its cost-effective measurement remains a challenge. This article describes development of the Family Attitude Scale (FAS), a 30-item instrument that can be completed by any informant. Its psychometric characteristics are reported in parents of undergraduate students and in 70 families with a schizophrenic member. The total FAS had high internal consistency in all samples, and reports of angry behaviour in FAS items showed acceptable inter-rater agreement. The FAS was associated with the reported anger, anger expression and anxiety of respondents. Substantial associations between the parents' FAS and the anger and anger expression of students was also observed. Parents of schizophrenic patients had higher FAS scores than parents of students, and the FAS was higher if disorder duration was longer or patient functioning was poorer. Hostility, high criticism and low warmth on the Camberwell Family Interview (CFI) were associated with a more negative FAS. The highest FAS in the family was a good predictor of a highly critical environment on the CFI. The FAS is a reliable and valid indicator of relationship stress and expressed anger that has wide applicability.

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Emotional eating has been identified as a factor that promotes the development and maintenance of obesity and hinders its treatment. This study investigated the relationship between unsatisfied basic needs and emotional eating, including the mediating factors of self-esteem and coping strategies. The results from a survey of 136 obese individuals indicated support for a significant relationship between basic need satisfaction and emotional eating, with a mediating effect of negative coping strategies. These findings extend previous research and provide guidance on how to help individuals who engage in emotional eating by focusing on developing more adaptive coping strategies.

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Cognitive-energetical theories of information processing were used to generate predictions regarding the relationship between workload and fatigue within and across consecutive days of work. Repeated measures were taken on board a naval vessel during a non-routine and a routine patrol. Data were analyzed using growth curve modeling. Fatigue demonstrated a non-monotonic relationship within days in both patrols – fatigue was high at midnight, started decreasing until noontime and then increased again. Fatigue increased across days towards the end of the non-routine patrol, but remained stable across days in the routine patrol. The relationship between workload and fatigue changed over consecutive days in the non-routine patrol. At the beginning of the patrol, low workload was associated with fatigue. At the end of the patrol, high workload was associated with fatigue. This relationship could not be tested in the routine patrol, however it demonstrated a non-monotonic relationship between workload and fatigue – low and high workloads were associated with the highest fatigue. These results suggest that the optimal level of workload can change over time and thus have implications for the management of fatigue.

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Children and adolescents are now using online communication to form and/or maintain relationships with strangers and/or friends. Relationships in real life are important for children and adolescents in identity formation and general development. However, social relationships can be difficult for those who experience feelings of loneliness and social anxiety. The current study aimed to replicate and extend research conducted by Valkenburg and Peter (2007b), by investigating differences in online communication patterns between children and adolescents with and without selfreported loneliness and social anxiety. Six hundred and twenty-six students aged 10-16 years completed a questionnaire survey about the amount of time they engaged in online communication, the topics they discussed, who they communicated with, and their purposes of online communication. Following Valkenburg and Peter (2007b), loneliness was measured with a shortened version of the UCLA Loneliness Scale (Version 3) developed by Russell (1996), whereas social anxiety was assessed with a sub-scale of the Social Anxiety Scale for Adolescents (La Greca & Lopez, 1998). The sample was divided into four groups of children and adolescents: 220 were “non-socially anxious and non-lonely”, 139 were “socially anxious but not lonely”, 107 were “lonely but not socially anxious”, and 159 were “lonely and socially anxious”. A one-way ANOVA and chi-square tests were conducted to evaluate the aforementioned differences between these groups. The results indicated that children and adolescents who reported being lonely used online communication differently from those who did not report being lonely. Essentially, the former communicated online more frequently about personal things and intimate topics, but also to compensate for their weak social skills and to meet new people. Further analyses on gender differences within lonely children and adolescents revealed that boys and girls communicated online more frequently with different partners. It was concluded that for these vulnerable individuals online communication may fulfil needs of self-disclosure, identity exploration, and social interactions. However, future longitudinal studies combining a quantitative with a qualitative approach would better address the relationship between Internet use and psychosocial well-being. The findings also suggested the need for further exploration of how such troubled children and adolescents can use the Internet beneficially.

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There has been an extended engagement with how young people experience policing, with a focus on the intersection between policing and indigeneity, ethnicity, gender, and social class. Interestingly, sexuality and/or gender diversity has been almost completely overlooked, both nationally and internationally. This paper reports on LGBT youth service providers’ accounts about police and LGBT young people interactions. It overviews the outcomes of semi-structured interviews with key LGBT youth service providers in different regions of Brisbane, Queensland. As the first qualitative engagement with these issues from the perspective of service providers, it highlights not only how LGBT young people experience policing, but also how service providers need to ‘work the system’ of policing to produce the best outcomes for LGBT young people.

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Purpose Increased physical activity in colorectal cancer patients is related to improved recurrence free and overall survival. Psychological distress after cancer may place patients at risk of reduced physical activity; but paradoxically also act as a motivator for positive lifestyle change. The relationship between psychological distress and physical activity after cancer over time has not been described. Methods A prospective survey of 1966 (57% response) colorectal cancer survivors assessed the psychological distress variables of anxiety, depression, somatisation, cancer threat appraisal as predictors of physical activity five, 12, 24 and 36 months post-diagnosis 978 respondents had valid data for all time points. Results Higher somatisation was associated with greater physical inactivity (Relative risk ratio (RRR) =1.12; 95% CI=[1.1, 1.2]) and insufficient physical activity (RRR=1.05; [0.90, 1.0]). Respondents with a more positive appraisal of their cancer were significantly (p=0.031) less likely to be inactive (RRR=0.95; [0.90, 1.0]) or insufficiently active (RRR=0.96). Fatigued and obese respondents and current smokers were more inactive. Respondents whose somatisation increased between two time periods were less likely to increase their physical activity over the same period (p<0.001). Respondents with higher anxiety at one time period were less likely to have increased their activity at the next assessment (p=0.004). There was no association between depression and physical activity. Conclusions Cancer survivors who experience somatisation and anxiety are at greater risk of physical inactivity. The lack of a clear relationship between higher psychological distress and increasing physical activity argues against distress as a motivator to exercise in these patients.

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OBJECTIVES: To quantify the driving difficulties of older adults using a detailed assessment of driving performance and to link this with self-reported retrospective and prospective crashes. DESIGN: Prospective cohort study. SETTING: On-road driving assessment. PARTICIPANTS: Two hundred sixty-seven community-living adults aged 70 to 88 randomly recruited through the electoral roll. MEASUREMENTS: Performance on a standardized measure of driving performance. RESULTS: Lane positioning, approach, and blind spot monitoring were the most common error types, and errors occurred most frequently in situations involving merging and maneuvering. Drivers reporting more retrospective or prospective crashes made significantly more driving errors. Driver instructor interventions during self-navigation (where the instructor had to brake or take control of the steering to avoid an accident) were significantly associated with higher retrospective and prospective crashes; every instructor intervention almost doubled prospective crash risk. CONCLUSION: These findings suggest that on-road driving assessment provides useful information on older driver difficulties, with the self-directed component providing the most valuable information.