ABSTRACT
Chronic diseases are one of the greatest challenges that health systems facing with them today. Recently, patient participation is considered as a key element in chronic care models. However, there are few studies about participation of patients with chronic disease in caring activities. The aim of this study was to identify the factors, which are relevant to patient participation and the nature of participation in caring activities. A qualitative approach with a basic theory method was used in this study. 22 persons including 9 patients, 8 nurses, and 5 family members were recruited using purposeful and theoretical sampling in three hospitals affiliated with Iran University of Medical Sciences. Data were collected with semi-structured interview and participant observation. Constant comparison was used for data analysis. Findings of this study indicated that participation of patients with chronic disease in nursing care is a dynamic and interactive concept that occurs between nurse, patient and family member in a care-servicing system. The core theme of this study was [convergence of caring agents] that included four categories: adhering, involving, sharing and true participation. This study suggests a pyramid model for explaining patient participation. Participation occurs in different levels, which depends on the factors related to caring agents
Subject(s)
Humans , Nursing Care , Chronic DiseaseABSTRACT
The appropriate use of the hospital information computer networks and its acceptance by the health care personnel can improve the quality of health care services and decrease the expenses. This study investigated the views, attitudes and satisfaction of the nurses and clinical personnel about the effectiveness of hospital information system on some medical activities. This analytical study investigated the behavior, satisfaction and attitudes of 120 nurses, auxiliary nurses and secretaries working in the outpatients and admitting wards of the educational and medical center of Amir al-momenin in Semnan about the effectiveness of hospital information system on some of the caring activities during 2006 to 2007. Data were collected by a questionnaire whose reliability and validity were approved by investigating in scientific texts and test-retest. The questionnaire was filled by the personnel who had more than 3 years working experience. Data were analyzed by descriptive and inferential statistics method with p=0.05. Most of the personnel [80%] were using their wards' computer systems several times a day. They agreed with availability of appropriate health care information [55%], reduction of errors [45.8%], better supervision on patients' treatment process [28%], and improvement of the treatment results by using information systems [15%]. These personnel believed that information system made it easier to search prescribed medicines [50%], and to find the patients difficulties [20%]. In general, 52 subjects were satisfied by the effectiveness of system in some health care activities of the clinical wards and a few [4] were completely satisfied by that. There was a significant relation between the personnel satisfaction with HIS effectiveness on the patient caring process and the satisfaction with user-friendliness of the systems and the medical ward [p<0.05]. The results showed that less than half of the clinical wards personnel were relatively satisfied with the effectiveness of HIS on the patients caring activities. To make this system more effective on the patients health care activities, the system should be in harmony with the dynamic nature of health care process. Therefore, it is recommended to use advanced hardware systems such as PDAs and laptops and voice recognition software's to facilitate data entry in the clinical wards, as well as developing legal methods to prevent redundancy in nurses' daily activities