Patients' Experience of Hospitalization for Surgery: Implications for Nursing Care (Phenomenology, Human Science).

The need to underst and the way patients' view the care they receive is important if we are to improve that care. Florence Nightingale was among the first to make this point. She also said it was difficult to obtain this information. This study was done to obtain a better underst and ing of how surgical patients experience hospitilization. I conducted a Human Science, phenomenologically based study. I interviewed nine men and women about their hospitilization for surgery. In addition I also analyzed my own hospitalization experience. Three common themes emerged from these interviews: the need to know and the fear of knowing; the fear of death; and the impact of caring. The importance of these themes was confirmed both by their appearance in this study across a diversity of different surgical procedures in different hospitals and by their appearance in a thematic analysis of articles in 84 years of nursing journals. The implications of these findings for the education of nurses and their practice is presented.Ph.D.NursingUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/160109/1/8422211.pd

Explanatory models of diabetes: Patient practitioner variation

Most cases of diabetes, a complex disorder that requires many lifestyle changes, can be controlled if persons adhere to their prescribed regimen. However, compliance is difficult to attain. Differences in explanatory models between client and practitioner have been suggested as one reason for non-compliance in several disorders. In this ethnographic investigation, individual explanatory models were elicited from persons with diabetes and from health professionals working with these patients. Professionals described models of diabetes in general and their model of a particular patient's diabetes. A composite professional model was constructed and compared with each of the patients' models. The models were most congruent regarding treatment. Etiology, pathophysiology, and severity had less congruence, and time and mode of symptom onset were least congruent. The Spearman correlation coefficient showed a positive but non-significant association of explanatory model congruence between professionals and patients with normal glycosylated hemoglobin levels. Patients and professionals seem to emphasize different domains; patients emphasized difficulties in the social domain and the impact of diabetes on their lives while staff saw diabetes primarily as a pathophysiological problem with impact on patients' physical bodies. This study's importance rests on its clear articulation of significant differences between patients' and staffs' models even when they are similar in demographic characteristics.explanatory models diabetes