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- Berben, L, et al.
(författare)
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Which interventions are used by healthcare professionals to enhance medication adherence in cardiovascular patients? : A survey of current clinical practice
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:1, s. 14-21
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Tidskriftsartikel (refereegranskat)abstract
- Background Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice.Aim To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions.Method A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management.Results Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence.Conclusion Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence.
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- Hommerberg, Charlotte, 1960-
(författare)
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Persuasiveness in the discourse of wine : The rhetoric of Robert Parker
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The primary purpose of this study is to explore a case of remarkably powerful contemporary rhetoric, namely Robert Parker’s wine writing, which has had an unprecedented impact in the world of prestigious wine for more than two decades. Parker, an American autodidact who gave up his career in law to become a fulltime wine critic, is considered the most influential critic of all time. This background motivates the approach of the current enquiry, which targets the persuasiveness in Parker’s writing. The investigation strives to bring to the fore both explicit and implicit elements of his wine reviews that have the potential to contribute to rhetorical success.The material selected for analysis comprises a corpus of reviews extracted from Parker’s extensive bulk of wine writing. The texts are studied against the backdrop of socio-cultural and institutional frames. Considerable importance is assigned to the fact that the reviews occur within a strictly specialized field of discourse with a highly conventionalized configuration.This hermeneutic enquiry approaches the topic from three analytical perspectives, designed to highlight persuasiveness in representations, argumentation and appraisal. The presentation reports on schematic patterns in Parker’s discourse as well as close interpretation of individual texts. The analysis of representations shows that both visual and verbal representations contribute to the persuasiveness of the text. The argumentative exploration of Parker’s discourse, which is assisted by the analytical tools of pragma-dialectics, demonstrates that the reviews involve rational argumentation on several subordinate levels, given in support of assessments and recommendations. Finally, the perspective of appraisal draws on the analytical resources provided by the Appraisal model to shed light on the way in which the audience is positioned to respond with respect to emotional, associative and perceptual values. The results indicate that the persuasiveness of Parker’s discourse arises as a result of concordance among an intricate array of interrelated factors. The audience is recurrently demonstrated to play a crucial role as co-constructors of the message.The present study also has methodological outcomes, presenting a novel combination of analytical methods to perform contextually situated discourse analysis. In addition, the material is allowed to challenge the theoretical ideas and notions that are addressed.
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- Jaarsma, Tiny, et al.
(författare)
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Sexual counselling of cardiac patients : nurses´ perception of practice, responsibility and confidence
- 2010
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 9:1, s. 24-29
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cardiac patients may experience problems with sexual activity as a result of their disease, medications or anxiety and nurses play an important role in sexual counselling. We studied the practice, responsibility and confidence of cardiac nurses in the sexual counselling of these patients.Method: An adapted version of the nurses' survey of sexual counselling of MI patients was administered during a scientific meeting of the Council on Cardiovascular Nursing and Allied Professionals within the European Society of Cardiology.Results: Most of the 157 cardiovascular nurses (87%) who completed the survey felt responsible to discuss sexual concerns with their clients, especially when patients initiated a discussion. However in practice, most respondents rarely addressed sexual issues. The items that nurses reported to counsel patients were closely related to the cardiac disease, symptoms and medications and seldom more sensitive subjects (e.g. foreplay, positions). Nurses estimated that their patients could be upset (67%), embarrassed (72%) or anxious (68%) if they were asked about sexual concerns. One-fifth of the nurses felt they had insufficient knowledge and 40% sometimes hesitated to discuss sexual concerns with clients because they might not know how to answer questions. Additional education on sexuality was significantly related to being more comfortable and active in sexual counselling.Conclusion: Although cardiac nurses feel responsible and not anxious discussing patients' sexual concerns, these issues are not often discussed in daily practice. Nurses might need more knowledge and specific practical training in providing information on sexual concerns and sexual counselling to cardiac patients.
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