992 resultados para patient beliefs


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Beliefs about the rightness or wrongness of engaging in various antisocial acts, referred to here as nonnative beliefs legitimizing antisocial behaviour (nblab), have been shown to playa role in the emergence oflater antisocial behaviour. The current study represented an attempt to understand whether parental monitoring and parent-child attachment have differential relationships with these antisocial nonnative beliefs in adolescents of different temperaments. The participants, 7135 adolescents in 25 high schools (ages 10- 18 years, M = 15.7) completed a wide-ranging questionnaire as part of the broad Youth Lifestyle Choices - Community University Research Alliance project, whose goal is to identify and describe the major developmental pathways of risk behaviours and resilience in youth. Two aspects of monitoring (monitoring knowledge and surveillance/tracking), attachment security, and two measures of temperament (activity level and approach) were examined for main effects and in interactions as predictors of adolescent nonnative beliefs. All of these measures were based on adolescent self-ratings on either 3- or 4-point Likert-type scales. Several important results emerged from the study. Males were higher than females in nblab; parental monitoring knowledge and adolescent attachment security were negatively related to nblab; and temperamental activity level was positively related. Monitoring knowledge, the strongest of the predictors, was much more strongly related to nonnative beliefs than was parental surveillance/tracking, supporting the contention that it is how much parents actually know, and not their surveillance efforts, that predict adolescent nonnative beliefs. A surprising finding that is of the utmost importance was that, although several of the interactions tested were significant, none were considered to be of a meaningful magnitude (defined as sr^ > .01). The current study supported the suggestion that normative beliefs legitimizing antisocial behaviour are multiply determined, and the results were discussed with respect to the observed differential relations of parental monitoring, parent-child attachment, temperament, age, and gender to antisocial normative beliefs in adolescents. Also discussed were the need to test other parenting, temperament, and other variables that may be involved in the development of nblab; the need to directly test possible mechanisms explaining the links among the variables; and the usefulness of longitudinal research in determining possible directions of causality and developmental changes in the relationships.

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This paper presents education research as vital to addressing the issues faced by adults living with cancer. This qualitative study looked at philosophies of practice for cancer patient education. It was about understanding how values and beliefs shape the way program planners and managers operationalize their knowledge of adult education and how this has significant impact on meeting the needs of those touched by cancer. Improved technology has extended life expectancy, so that Canadians living with cancer, or even dying with cancer now spend less time in direct medical care. The notion of cancer as simply a medical concern is outdated. This study found that informational and support needs of adults living with cancer are often unmet, ignored or unknown. This research investigated a community-based education initiative that is inviting, accessible, and promotes a sense of hope. More specifically, this case study uncovered factors contributing to the success of Wellspring, a grass-roots cancer patient support centre which has been recognized nationally for its ability to effectively meet the diverse non-medical supportive care needs of as many cancer patients and caregivers as possible. Therefore, Wellspring was selected as a case study. Educating people to take charge of their own lives and supporting them in making informed decisions about their lifestyle choices made Wellspring part of a social action movement that focused on improving social attitudes toward people living with cancer. Results of this descriptive inquiry and philosophical inquiry evolved into data that was used to devise an organic model of community-based education that encompasses Adler's (1993) four dimensions of philosophy within a socio-cultural context.

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This research evaluates the effect of combined care nursing on three outcomes: i) patient satisfaction; ii) staff satisfaction; and iii) quality of care. Oakville-Trafalgar Memorial Hospital was in the early planning stages of changing to combined care nursing from the traditional method of providing separate postpartum and nursery care to mothers and babies. The opportunity existed to evaluate formally the change to combined care. There were three hypotheses to be investigated. Data were collected from four sources: patient surveys, staff surveys, informal interviews, and internal hospital documents. Both quantitative and qualitative data were analyzed. The surveys were administered on three different occasions to patients and staff. Other sources of data included informal interviews with patients and staff who responded to the surveys, and chart audits.The study findings revealed that the majority of respondents had increased levels of satisfaction and perceptions of increased quality of care following implementation of combined care. These findings, related to combined care and the role of change in its implementation and evaluation, indicate that there are no right or easy answers about how to make new ideas become reality in a smooth, pleasant way.

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The conceptualization of childhood has changed over the centuries and appears to be undergoing further change in our post-modern culture. While the United Nations Convention on the Right of the Child is designed to give children everywhere basic human rights while taking into consideration their special needs, no recent research has examined adult attitudes toward those rights. In an attempt to understand the attitudes adults hold regarding autonomy rights and to look for some factors that could predict those attitudes, the current study considers values, parenting style, emotions and the issue of parent status as possible predictor variables. A total of 90 participants took part in the research, which had both written and interview components. Results generally failed to establish a reliable set of predictors. However, some interesting information was obtained regarding the endorsement of children's autonomy rights and some general conclusions were reached about our view of children and their rights at the end of the twentieth century.

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The relationship between maternal beliefs about children's externalizing behaviors (EB) and the frequency of their children's EB was investigated. The sample of 71 consisted of two groups of mothers of children between 8-12 years of age. The Clinic group consisted of 35 mothers of children referred to a Children's Clinic due to externalizing behavior problems. The School group consisted of 36 mothers of children attending elementary school. Mothers completed questionnaires measuring parental beliefs and the frequency of their children's EB. Results showed that mothers' endorsement of authoritarian parenting was positively related to children's EB scores. A U-shaped relationship was found between mothers' relationship-centered goals and children's EB scores. Parent-centered goals and children's EB scores were positively correlated only in the clinic group. Mothers'-hostile attribution scores were positively related to their children's EB scores in both groups. Mothers with low perceived parenting scores were associated with higher children's EB scores in both groups. Overall, results revealed potential clinical implications. Parenting programs that change parenting goals, attributions, and ii Parental Beliefs sense of parenting control, which in turn influences parenting behavior, may influence the frequency of their children's externalizing behaviors.

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Obtaining mothers' perspectives and descriptions of incidents in which their child(ren) said or did something that influenced the mothers' values, beliefs, and/or social or cultural practices, that is, the content of socialization, was the primary aim of this research. Bakhtin's (2004) metatheoretical account of dialogism was used to frame this study. From a dialogic perspective utterances (for example, the utterances of children in the present study) are events or acts and are presented as one way to view the process of socialization. In part this purpose, and the decision to utilize a qualitative research orientation, was to address a call (Lollis & Kuczynski, 1997) for qualitative or microanalytic analyses to help elucidate the processes of socialization. Mothers (N=10) in this study were able to provide descriptions of incidents in which their child(ren) said or did something that influenced the mother and hence we have some description of the concept of bidirectionality, a well accepted, but undertheorized concept in developmental psychology. While the concepts of multiple sources of influence and contexts are salient areas of research in parent-child socialization, and were mentioned in the informants reporting these areas did not appear to be as salient in the mothers' accounts. Emotions and the meaning mothers 'derived' from the interactions did, however, take much more prominence in the described incidents.

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This study examined the cultural health beliefs in diabetes education amongst the Aboriginal population within a city in Southern Ontario. The purpose was to contribute to the development of a culturally relevant diabetes handbook as well as to delivery styles within current diabetes education programs. To this end, a focus group was conducted with Aboriginal men and women between the ages of 18-70 years with type 2 diabetes. Participants were recruited from 2 Aboriginal community centres and an Aboriginal health centre in a city in Southern Ontario. Themes were drawn from the analysis of the focus group transcripts and combined with the findings from the research literature. The major themes that merged were drawn from Eurocentric and Aboriginal theories. The results were a set of recommendations on the type of format for diabetes educational programs such as traditional group activities, variety of electronic format, and culture specific educational resources. The emergent results appear to provide some important insights into program planning for diabetes education centres within Aboriginal communities.

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Introduction: Canada’s aging population is diverse and this diversity will continue to grow for the next two decades (Government of Canada, 2002; Katz, 2005; Statistics Canada, 2010). Objective: to examine the relationship between dementia family caregivers’ traditionally-based beliefs about caregiving, their caregiving experience, and their well-being. Method: exploratory secondary data analysis of cross-sectional survey data from 76 community caregivers of persons with dementia in Ontario. Results: traditional values for caregiving was independently associated with coping resources and health status but not depression symptoms. Caregiver self-efficacy and social support both partially mediated the relationship between beliefs about caregiving and caregiver health status. Discussion: Findings from this exploratory study are consistent with stress process models of culture and caregiving. The finding that self-efficacy was associated with traditional values and that it mediated the relationship between traditional values and caregiver well-being is new to the literature.

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Despite recent well-known advancements in patient care in the medical fields, such as patient-centeredness and evidence-based medicine and practice, there is rather less known about their effects on the particulars of clinician-patient encounters. The emphasis in clinical encounters remains mostly on treatment and diagnosis and less on communicative competency or engagement for medical professionals. The purpose of this narrative study was to explore interactive competencies in diagnostic and therapeutic encounters and intake protocols within the context of the physicians’, nurses’, and medical receptionists’ perspectives and experiences. Literature on narrative medicine, phenomenology and medicine, therapeutic relationships, cultural and communication competency, and non-Western perspectives on human communication provided the guiding theoretical frameworks for the study. Three data sets including 13 participant interviews (5 physicians, 4 nurses, and 4 medical receptionists), policy documents (physicians, nurses, and medical receptionists) and a website (Communication and Cultural Competency) were used. The researcher then engaged in triangulated analyses, including N-Vivo, manifest and latent, Mishler’s (1984, 1995) narrative elements and Charon’s (2005, 2006a, 2006b, 2013) narrative themes, in recursive, overlapping, comparative and intersected analysis strategies. A common factor affecting physicians’ relationships with their clients was limitation of time, including limited time (a) to listen, (b) to come up with a proper diagnosis, and (c) to engage in decision making in critical conditions and limited time for patients’ visits. For almost all nurse participants in the study establishing therapeutic relationships meant being compassionate and empathetic. The goals of intake protocols for the medical receptionists were about being empathetic to patients, being an attentive listener, developing rapport, and being conventionally polite to patients. Participants with the least iv amount of training and preparation (medical receptionists) appeared to be more committed to working narratively in connecting with patients and establishing human relationships as well as in listening to patients’ stories and providing support to narrow down the reason for their visit. The diagnostic and intake “success stories” regarding patient clinical encounters for other study participants were focused on a timely securing of patient information, with some acknowledgement of rapport and emapathy. Patient-centeredness emerged as a discourse practice, with ambiguous or nebulous enactment of its premises in most clinical settings.

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While bullying prevention programs appear to be decreasing the number of bullying incidents overseas, bullying prevention programs here in Canada have not been proving as effective. Evaluations of bullying prevention programs often focus on the outcomes and neglect to examine the training regimen for teachers. As teachers are on the front lines of bullying prevention programs, the current study explored teachers’ beliefs about the various types of bullying, their perceptions of their own abilities (e.g., teacher bullying prevention efficacy (TBPE), self-concept, and theory of mind) to implement bullying prevention initiatives, and how the school climate may influence their efficacy beliefs. Participants in the current study were 61 Canadian teachers (n = 51 women), predominantly from Ontario. Participating teachers represented all elementary division levels (primary, junior, and intermediate). Participants’ teaching experience ranged from zero years of teaching (pre-service) to 28 years of experience (M = 10.50, SD = 7.35). It was found that participants reported a relatively high TBPE score, which was related to their likely intervention in cyberbullying situations but not for other forms of bullying situations. It was found that teachers were most likely to intervene in physical bullying than verbal, relational, and cyberbullying, respectively. TBPE was influenced by the school climate. Teachers’ scores on the theory of mind scale was not a significant indicator of any teachers’ bullying beliefs. Analyses exploring the relationship between bullying beliefs and self-concept, morality predicted teachers TBPE scores and the likelihood of intervention. Teachers’ recommendations for bullying prevention training and school bullying prevention programs were explored. Results are discussed in terms of implications for practice and future research.

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The purpose of this study was to explore how a leading Ontario hospital operationalizes their Patient Declaration of Values (PDoV) in policy and in practice. This was a single case study, which took place in a leading patient-centred Ontario hospital. The study included 18 individual interviews with employees and patient experience advisors, as well as, document analysis of strategic planning reports (n=10). Five themes emerged: (1) setting the stage, (2) inspiring change, (3) organizational structures, (4) organizational and environmental barriers, and (5) reflection and improvement. This study has highlighted the role of the PDoV within a leading Ontario hospital. It lends itself to providing a process with core strategies for creating change in an acute health care organization; to embed a culture of patient and family centred care.

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This paper exploits the term structure of interest rates to develop testable economic restrictions on the joint process of long-term interest rates and inflation when the latter is subject to a targeting policy by the Central Bank. Two competing models that econometrically describe agents’ inferences about inflation targets are developed and shown to generate distinct predictions on the behavior of interest rates. In an empirical application to the Canadian inflation target zone, results indicate that agents perceive the band to be substantially narrower than officially announced and asymmetric around the stated mid-point. The latter result (i) suggests that the monetary authority attaches different weights to positive and negative deviations from the central target, and (ii) challenges on empirical grounds the assumption, frequently made in the literature, that the policy maker’s loss function is symmetric (usually a quadratic function) around a desired inflation value.

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Problématique : La collaboration entre infirmières et médecins est un élément crucial lorsque la condition des patients est instable. Une bonne collaboration entre les professionnels permet d’améliorer la qualité des soins par l’identification des patients à risques et l’élaboration de priorités dans le but de travailler à un objectif commun. Selon la vision des patients et de leur famille, une bonne communication avec les professionnels de la santé est l’un des premiers critères d’évaluation de la qualité des soins. Objectif : Cette recherche qualitative a pour objectif la compréhension des mécanismes de collaboration interprofessionnelle entre médecins et infirmières aux soins intensifs. L’étude tente également de comprendre l’influence de cette collaboration sur la communication entre professionnels/ patients et famille lors d’un épisode de soins. Méthode : La collecte de données est réalisée par le biais de 18 entrevues, qui ont été enregistrées puis retranscrites. Parmi les entrevues effectuées deux gestionnaires, six médecins et infirmières, et enfin dix patients et proches ont été rencontrés. Ces entrevues ont été codifiées puis analysées à l’aide du modèle de collaboration interprofessionnelle de D’Amour (1997), afin de déterminer les tendances de collaboration. Pour terminer, l’impact des différentes dimensions de la collaboration sur la communication entre les professionnels/ patient et famille a été analysé. Résultats : Médecins et infirmières doivent travailler conjointement tant avec les autres professionnels, que les patients et leur famille afin de développer une relation de confiance et une communication efficace dans le but d’établir des objectifs communs. Les patients et les familles désirent rencontrer des professionnels ouverts qui possèdent des talents de communicateur ainsi que des qualités interpersonnelles. Les professionnels doivent faire preuve de transparence, prendre le temps de donner des explications vulgarisées, et proposer aux patients et aux familles de poser leurs questions.