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1
Elster, Judi. "Healthy Lifestyle Practice Among Online Health Psychology Graduate Students." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7637.
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Research focused on health behaviors of online graduate students is sparse. Health psychology graduate training prepares individuals to share health information with others; the information may be more credible if they present a healthy appearance. The present study tested concepts from social cognitive theory (general perceived self-efficacy) and self-determination theory (autonomy, competence, and relatedness basic needs) to determine predictive value for graduate students’ engaging in health behaviors. Participants were 121 (29 health psychology group, 92 other programs group) online graduate students who lived in the United States and attended the same online university, recruited from multiple social media sources. The study used a static comparison quasi-experimental design to examine data from an online survey. Data were analyzed using Pearson correlation, chi-square tests for independence, independent samples t-tests, ANOVA, MANOVA, and binary logistic regression. The health behaviors did not differ between the two graduate student groups. General perceived self-efficacy, autonomy, relatedness, and competency mean scores did not predict engaging in health behaviors. A significant negative correlation for the total sample was found between autonomy and body mass index. Positive social change may result from research focused on the best means to encourage health psychologists to regularly engage in health behaviors to the extent of Centers for Disease Control and Prevention recommended levels. By internalizing and modeling good health, health psychologists will add credibility to their message and help to mitigate the connection between premature death from chronic disease due to lack of engaging in a voluntary healthy lifestyle.
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Caelli, Kathleen. "Health to health promotion : transforming health experience into nursing practice." Thesis, Curtin University, 1998. http://hdl.handle.net/20.500.11937/605.
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In contemporary Western nursing, the notion of health is considered a basic concept in all nursing theory, yet the many nursing theorists have failed to express unanimity in their various descriptions of health. This situation exists even while the achievement of health is generally identified as the goal or purpose of nursing. In Australia, the requirement that nurses become health-promoting practitioners assumes that nurses understand health in positive ways, which can be translated into nursing practice. Given the myriad definitions of health, confusion among nurses about the nature of health as it is to be promoted appeared possible, even probable.This phenomenological research aimed to illuminate the nature of nurses' understandings of health and the ways such understandings are translated into nursing practice. The purpose of the study was to describe and interpret nurses' experiences of health, and their experiences of giving health care to someone in their care, in order to illuminate the nature of health for nurses and in nursing.The manner in which this research was carried out was informed by the human science approach to phenomenology described by van Manen, which is derived from the traditions of Husserl, Heidegger and Merleau-Ponty. Thus, the inquiry was grounded in the hermeneutic phenomenological philosophical perspective, which began with the work of Husserl who recognised the need to return to the grounding of truths in human experience. The thesis is informed by two views of phenomenology. The first involves the traditional approach to phenomenology advocated by the European phenomenological philosophers while the second approach is referred to by Silverman as arising from 'American continental' philosophy.Data were generated from multiple audiotaped interviews with each of nine participants, and from personal reflection and journalling undertaken by the researcher during the research process. The dual data analyses were guided by the phenomenological approach of van Manen and by that of various nursing scholars who have used phenomenological methodology as it has evolved from American continental philosophy. These analyses included several levels of reflection undertaken by the researcher and each of the participants in the study to illustrate the nature of health in nurses' lives and in nursing.The nature of health, as revealed through the original experience of the participants, was disclosed as manifest in the lives of the participants with most descriptions conveying a sense of contentment that showed as feelings of happiness, feeling alive, complete, energised and optimistic. Health also revealed itself as transient in nature, passing quickly and without notice into and out of the lives of most of the participants. Although obvious in some ways, health simultaneously eluded clear description and, even at the completion of the exploration with each participant, was characterised by an atmosphere of elusiveness. For all the participants, health was an embodied phenomenon with a common element of energy and a sense of wellbeing. These, together with a sense that life was manageable and achievable gave to it a distinctive spirit, even while the spirit simultaneously helped to make life manageable and achievable and thus contributed to health. For all of those who participated, health presented as having the ability to transform their emotional responses to daily life events in such a way that it made those events more acceptable and the tasks of life more achievable.Although health showed as a physical, embodied state which was expressed as vitality and energy, it could not be separated from the mental / emotional state. As it was described, the following leitmotifs of health were lexically revealed: Health: A different encounter for each person, Health described as peace, Health described as feeling good about oneself, Health described as balance, Health as energy, Health as vitality and zest, Health described as happiness and/or contentment, Health described as quality of life, The 'picture of health', Health described as dignity, and Health as the unknown or the inexpressible.The nature of health-focused care in nursing showed as caring, rapport building and support, ever dependent on the social relationship that develops between each nurse-carer and the individual to whom they offer care. However, clear relationships between the meanings of health for the nurses in the study and the way they gave health care could not be elucidated. These relationships have not been identified because of the individualistic nature of health-focused care as these nurses have described it. For this reason, this research makes a strong plea for continued dialogue about the relationships between health and health-focused care in nursing.
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Caelli, Kathleen. "Health to health promotion : transforming health experience into nursing practice." Curtin University of Technology, School of Nursing, 1998. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=10531.
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In contemporary Western nursing, the notion of health is considered a basic concept in all nursing theory, yet the many nursing theorists have failed to express unanimity in their various descriptions of health. This situation exists even while the achievement of health is generally identified as the goal or purpose of nursing. In Australia, the requirement that nurses become health-promoting practitioners assumes that nurses understand health in positive ways, which can be translated into nursing practice. Given the myriad definitions of health, confusion among nurses about the nature of health as it is to be promoted appeared possible, even probable.This phenomenological research aimed to illuminate the nature of nurses' understandings of health and the ways such understandings are translated into nursing practice. The purpose of the study was to describe and interpret nurses' experiences of health, and their experiences of giving health care to someone in their care, in order to illuminate the nature of health for nurses and in nursing.The manner in which this research was carried out was informed by the human science approach to phenomenology described by van Manen, which is derived from the traditions of Husserl, Heidegger and Merleau-Ponty. Thus, the inquiry was grounded in the hermeneutic phenomenological philosophical perspective, which began with the work of Husserl who recognised the need to return to the grounding of truths in human experience. The thesis is informed by two views of phenomenology. The first involves the traditional approach to phenomenology advocated by the European phenomenological philosophers while the second approach is referred to by Silverman as arising from 'American continental' philosophy.Data were generated from multiple audiotaped interviews with each of nine participants, and from personal reflection and journalling undertaken ++by the researcher during the research process. The dual data analyses were guided by the phenomenological approach of van Manen and by that of various nursing scholars who have used phenomenological methodology as it has evolved from American continental philosophy. These analyses included several levels of reflection undertaken by the researcher and each of the participants in the study to illustrate the nature of health in nurses' lives and in nursing.The nature of health, as revealed through the original experience of the participants, was disclosed as manifest in the lives of the participants with most descriptions conveying a sense of contentment that showed as feelings of happiness, feeling alive, complete, energised and optimistic. Health also revealed itself as transient in nature, passing quickly and without notice into and out of the lives of most of the participants. Although obvious in some ways, health simultaneously eluded clear description and, even at the completion of the exploration with each participant, was characterised by an atmosphere of elusiveness. For all the participants, health was an embodied phenomenon with a common element of energy and a sense of wellbeing. These, together with a sense that life was manageable and achievable gave to it a distinctive spirit, even while the spirit simultaneously helped to make life manageable and achievable and thus contributed to health. For all of those who participated, health presented as having the ability to transform their emotional responses to daily life events in such a way that it made those events more acceptable and the tasks of life more achievable.Although health showed as a physical, embodied state which was expressed as vitality and energy, it could not be separated from the mental / emotional state. As it was described, the following leitmotifs of health were lexically revealed: Health: ++
A different encounter for each person, Health described as peace, Health described as feeling good about oneself, Health described as balance, Health as energy, Health as vitality and zest, Health described as happiness and/or contentment, Health described as quality of life, The 'picture of health', Health described as dignity, and Health as the unknown or the inexpressible.The nature of health-focused care in nursing showed as caring, rapport building and support, ever dependent on the social relationship that develops between each nurse-carer and the individual to whom they offer care. However, clear relationships between the meanings of health for the nurses in the study and the way they gave health care could not be elucidated. These relationships have not been identified because of the individualistic nature of health-focused care as these nurses have described it. For this reason, this research makes a strong plea for continued dialogue about the relationships between health and health-focused care in nursing.
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Williams, Stacey L. "LGBTQ Mental Health and Practice." Digital Commons @ East Tennessee State University, 2019. https://youtu.be/wiCoDgasv4Q.
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Holmes, Catherine Ann, University of Western Sydney, of Science Technology and Environment College, and School of Environment and Agriculture. "Healthy marketplaces: insights into policy, practice and potential for health promotion." THESIS_CSTE_EAG_Holmes_C.xml, 2003. http://handle.uws.edu.au:8081/1959.7/502.
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The World Health Organization (WHO) has been implementing the Healthy Marketplace initiative in the market setting of developing countries since 1997. This initiative forms part of the Healthy Cities strategy and is reinforced through the Ottawa Charter for Health Promotion. The WHO Food Safety Division has indicated that every city in the WHO Healthy City program will eventually also have a Healthy Marketplace program. This is despite the absence of any published guidelines for facilitating program implementation, a clearly articulated Healthy Marketplace concept, and a dearth of meaningful program evaluations. This thesis set out to explore the views and experiences of in-country stakeholders involved in a Vietnamese Healthy Marketplace program. It also set out to examine the roles and perceptions of experts engaged in the design and delivery of programs across the developing world. Through an iterative and post-positivist research methodology, this inquiry collected and analysed data from five key sources: documents, detailed questionnaires, semi-structured interviews, and observations and reflections. The findings revealed that various and even conflicting program concepts and aims existed across and within groups, having significant implications for practice. The settings approach was not the dominant approach to health promotion in the Vietnamese market, but rather a 'top-down' topic-based approach dominated as the mechanism for program delivery. Consequently, numerous challenges have been identified for Healthy Marketplace policy and practice. The challenges are prefaced on the adoption of a settings approach, and include the need for : market communities to set their own agendas; the program target audience to be redefined; increased power sharing across stakeholders; the re-education of professionals; the sharing of knowledge; and the adequate resourcing of Healthy Marketplace programsMaster of Science (Hons)
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Holmes, Catherine Ann. "Healthy marketplaces : insights into policy, practice and potential for health promotion /." View thesis, 2003. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031031.160623/index.html.
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Warrick, Rona Lee, and rona warrick@deakin edu au. "Motherhood and health: Perception and practice." Deakin University, 1995. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20070614.112804.
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Sykes, Catherine Marie. "Health promotion : evaluation, discourse and practice." Thesis, City University London, 2001. http://openaccess.city.ac.uk/7782/.
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This dissertation for the Degree of Doctor of Psychology (Health) presents three pieces of work: 1) A Re-analysis of a Systematic Review of Psychological Interventions Used to Aid Smoking Cessation; 2) Evaluation and Discourse Analysis of the EC's Health Promotion Programme; 3) A consultancy case study: Evaluation of Educational Needs Assessment Methods Used in General Practices in Barking and Havering and Redbridge and Waltham Forest. The theme that ties these three pieces of work together is evaluation. The re-analysis of the systematic review of psychological methods for smoking cessation shows how errors can be made in evaluation and how different researchers can obtain different results in what is considered to be a method that reduces bias and produces an accurate picture of `evidence' to inform health policy and practice. The evaluation of the EC's Health Promotion Programme gives insight into a case study of an evaluation to inform health promotion policy at an European level. This piece of work presents the results of an independent evaluation. It highlights unexpected difficulties of drawing conclusions from data such as the practical problems of obtaining data and also the pressures that may come from the commissioners of evaluations. The discourse analysis of the Health Promotion Programme reveals how current discourses in health promotion may compel health promotion practitioners to carry out a certain type of evaluation in which in truth they may have little understanding or commitment. As a result, the practice of evaluation becomes a formality or ritual which is a burden to carry out. A panel of health promotion expert assessors found a lack of acceptable evaluation of projects that were funded by the European Commission. This suggests that if evaluation can be avoided, it will be. The same themes of lack of understanding, commitment and time for evaluation were unveiled in the case study. The consultancy case study evaluated educational needs assessment methods used in general practices. The use of evidence-based practice requires that practitioners understand how to evaluate research and incorporate it into their practice. This needs more emphasis in the education and training of health professionals. However there has been a move away from the more didactic approach to education in primary care to one of listening to people's needs and preferred methods of learning. At the same time the ubiquitous need to evaluate to find the best method prevails. This is regardless of obvious limitations to the interpretation of findings. In this case study, it seemed as though the evaluation was an after-thought, rushed to satisfy some other group higher up the hierarchy in the health authority. Similarly, the discourse analysis pointed to a situation in which the Commission's services are constructed as superior, thus leaving no mechanism to question their knowledge or ways of working. While there may be efforts on one level to encourage a two-way flow of information and knowledge, on another level, a construction of decision-makers as being superior means that information and knowledge only flow one way, top down. All three pieces of work have shown that practical limitations restrict the interpretation of evaluations. Lack of time, incomplete data, commitment and knowledge of evaluation revealed here lead to questions about the possibility and desirability of evidence-based health promotion. For evaluation to advance, there is a need for a better understanding of its purpose and for it to have more meaning for all of the stakeholders involved. This requires a rethink concerning evaluation methods in health promotion that recognise the restraints of evaluation and start inquiry from this premise.
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Chang, Pei-Jen. "Factors influencing occupational health nursing practice." Thesis, King's College London (University of London), 1994. https://kclpure.kcl.ac.uk/portal/en/theses/factors-influencing-occupational-health-nursing-practice(117dd5b4-81ff-45dd-8966-3ea83809c449).html.
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Fraser, Simon Charles Alexander. "Health status measurement in surgical practice." Thesis, University of Edinburgh, 1993. http://hdl.handle.net/1842/19763.
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In the last hundred years, improved social conditions and advances in medical science has rendered previously fatal conditions curable. Modern surgical practice is now too complex to be measured by mortality and morbidity alone. Subjective, patient derived outcome measures are slowly gaining influence in other fields. Health status, or Quality of Life (QoL), measurement has not been widely adopted in surgical practice. To test the hypothesis that Health status measures, scientifically applied, provide important additional information to the surgeon, the techniques were applied to three diverse areas of surgical practice as models for broader application. Chemotherapy for advanced breast cancer patients Chemotherapy has little effect on survival in patients with advanced breast cancer. UICC response and toxicity criteria are used to measure outcome and QoL measurement is a rarity. Using a diary developed to make QoL measurement simpler, a randomised trial was mounted to compare QoL scores in patients receiving two regimens of differing toxicity. Psychological screening for Non Specific Abdominal Pain Patients with Non Specific Abdominal Pain (NSAP) are significant consumers of surgical resources but a psychological contributor is often suspected. In a prospective study, 131 patients aged 14-40 admitted with acute abdominal pain were assessed using the General Health-30 (GHQ) and Hospital Anxiety and Depression (HAD) questionnaires, and a structured interview. Health status after minor surgery Fifty seven general surgical patients having day-surgery completed three questionnaires, the NHP the HAD scale and the GHQ before surgery and after 6 months. A success was reported by 78%, improved health by 64% and improved QoL by 69%.
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Christianson-Silva, Paula. "The influence of doctor of nursing practice education on nurse practitioner practice." Thesis, The University of Arizona, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3702907.
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Nurse practitioners (NPs) have been undergoing a rapid transition in their entry-level degree, from Master of Science in Nursing (MSN) to Doctor of Nursing Practice (DNP). At this time, it is important to establish research evidence on the effects of doctoral education on NP practice. Therefore, a qualitative study of practicing NPs that have returned for the DNP degree was conducted. The purpose was to describe NPs' perceptions of their DNP education, and particularly its influence on their professionalism and patient care. A literature review and evidence synthesis process showed that the available body of research provides little insight into the question of how DNP education affects NP practice; therefore, qualitative description methodology was used to describe this phenomenon. The research questions that guided the study were: 1) What changes do practicing NPs describe about their clinical practice after the experience of completing a DNP?; and, 2) What are the NPs' perceptions of and concerns about the influences of their DNP educational experience on their clinical practice? Two published models and the DNP Essentials (AACN, 2006) informed and guided the data collection and analysis process. Purposive sampling and analyses continued concurrently until data saturation was achieved. Ten DNP prepared NPs were interviewed, and there was wide variation in the sample. The overarching theme Growth into DNP Practice summarizes the participants' perceptions of the changes that have occurred as a result of their DNP educational experience. Four major themes that support the overarching theme are: (a) Broader Thinking and Work Focus; (b) New Knowledge and Interests; (c) New Opportunities; and, (d) "Doctor" Title an Asset. Conceptual categories under each major theme are described. Participants were overwhelmingly positive about the influences of their DNP education on their practice, but the role of the DNP graduate in knowledge translation has yet to be fully operationalized.
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Mykhalovskiy, Eric. "Knowing health care / governing health care exploring health services research as social practice /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0018/NQ56249.pdf.
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Rochut, Julie. "Health care supply, payment system and medical practice : evidence from obstetric practice." Paris, EHESS, 2010. http://www.theses.fr/2010EHES0017.
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Une part importante des accouchements sont réalisés par césarienne en Europe et dans le monde. Les objectifs de cette thèse sont de mettre en évidence les déterminants non médicaux, notamment économiques et financiers, expliquant le développement de cette pratique, ainsi que ses conséquences sur la santé des femmes après l'accouchement, en lien avec d'autres facteurs comme la concentration locale des structures hospitalières. Notre analyse se concentre sur deux pays: la France et la Suisse. Dans la première partie de la thèse, nous mettons en évidence l'influence de deux déterminants non médicaux: le système de paiement et le comportement des médecins obstétriciens. Nous montrons que le financement à l'acte et le nombre d'obstétriciens influencent la pratique de la césarienne. La hausse du taux de recours à la césarienne entre 2003 et 2006 peut être principalement imputée aux évolutions des caractéristiques des hôpitaux et des patients. TI peut indiquer que les pratiques de codage évoluent pour justifier un recours accru à la césarienne. Suivant la stratégie d'identification de Shelton Brown III, nous trouvons un impact potentiel de la demande de loisir des médecins obstétriciens sur la pratique de la césarienne d'urgence. La deuxième partie de la thèse est consacrée à l'étude de la qualité des soins en obstétriques. Nous analysons l'impact de la césarienne sur la survenue de complications obstétricales et l'impact de la concentration des soins sur la qualité des soins en obstétrique. La césarienne peut être un facteur ( complications obstétricales et la concentration des naissances a un impact négatif sur la qualité de soins en obstétriqueA significant share of deliveries are performed by Cesarian section (C-section) in Europe and j many developed and developing countries. The aims of this thesis are to highlight the non medical, especially economic and financial, incentives that expIain the use of C-section, as well as the medical consequences of C-section on women's health, in regard with other factors of obstetrical care quality such as hospital concentration. Our analysis focus on two countries, France and Switzerland. In the first part of the thesis, we show the influence of two non medical factors on to C-section use, namely the hospital payment system and the obstetricians behaviour, especially their demand for leisure. We show payment system and the number of obstetricians have an impact on C-section use and that the rise of C-section rate between 2003 and 2006 is mainly caused by changes in hospitals and patients features. Yet, it can show that obstetricians change their coding practises to justify the use of certain practice. Using Shelton Brown III identification strategy, we found a potential impact of obstetricians leisure preference on the use of C-section, demand for leisure has a significant impact on the resort to emergency C-section. The second part of the thesis deals with obstetric care quality , using swiss and french data to study the impact of C-section on the patients' probability of having an obstetric complication and the influence of concentration between hospitals on the quality of obstetric care. We find there are risks entailed by C-section on obstetric complications. We find that hospital concentration has a negative impact on obstetric care quality
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Robinson, Rachel Elizabeth. "Living knowledge : embodied health care research practice /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/11187.
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Robotham, Anne. "The grading of health visitor fieldwork practice." Thesis, University of Wolverhampton, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366149.
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Farquhar, Jean Clare. "Lesbian sexual health : deconstructing research and practice." Thesis, London South Bank University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298022.
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Moohan, R. "Connected health : applications in community pharmacy practice." Thesis, Queen's University Belfast, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.680058.
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As the population ages, the use of information technology and telecommunications in healthcare delivery (often known as Connected Health, telehealth or e-health) has been proposed as a means of providing . patient-centred care to those with chronic conditions. Little research has been conducted into the involvement of community pharmacists in Connected Health delivery. This thesis aimed to investigate the potential role of community pharmacists in the delivery of Connected Health services. A systematic content analysis of print media was performed to explore reporting of Connected Health in UK and US newspapers. A qualitative interview study was conducted with community pharmacists and key stakeholders in Canada and Northern Ireland to gather their views on community pharmacist involvement in Connected Health. Informed by the latter qualitative study, an online questionnaire was distributed to community pharmacists in Northern Ireland to explore their views regarding their potential role in Connected Health. Finally, a feasibility study was carried out, in which community pharmacists sent patients mobile telephone medication reminders and remotely monitored their blood pressure . . Connected Health was positively reported by the print media in the US and the UK. Community pharmacist and key stakeholder interviewees were supportive of community pharmacist involvement in Connected Health, believing it would extend and promote ' their role. However, they had concerns regarding appropriate remuneration. Similar views were obtained from community pharmacist questionnaire respondents. The feasibility study showed that a community pharmacy-based Connected Health programme could be successfully implemented on a small scale. Participants involved were positive about community pharmacist involvement in Connected Health. Community pharmacist involvement in Connected Health has the potential to improve patient outcomes and ease pressure on the health service. However, barriers such as funding and general practitioner acceptance would need to be overcome and a sound evidence base established before routine pharmacist involvement becomes a reality.
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Projo, Nucke Widowati Kusumo. "Dual practice in developing country health system." Thesis, Paris 1, 2019. http://www.theses.fr/2019PA01E012.
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Le terme «médecin à double pratique» dans cette recherche désigne les médecins qui travaillent dans des établissements de santé publics appartenant au gouvernement et qui exercent en même temps une pratique privée. Nous utilisons la combinaison d’un double régime et de mécanismes d’assurance dans l’analyse pour rendre compte de la décision du patient d’avoir accès à un établissement de santé et de la décision du médecin concernant le lieu de travail dans plusieurs situations: pas de double pratique - pas d'assurance, pas de double pratique avec assurance, double pratique sans assurance et double pratique avec assurance. La dernière question justifie la situation dans laquelle la situation offre le plus grand avantage en prenant le bien-être total provenant de l’utilité du patient, des revenus du fournisseur, de la compagnie d’assurance et du transfert gouvernemental. Nous considérons deux types de bien-être; le premier est le bien-être à long terme où le prix et la qualité ont plus de temps pour s'adapter à leur équilibre. La seconde est le bien-être à court terme où nous examinons l’effet immédiat de la présence d’une double pratique ou d’une double assurance dans le système, en maintenant le prix et les qualités constantsThe term of “dual practice physician” in this research refers to physicians who work in public health care facility owned by government and at the same time also engaged in private practice. Part one will analyse the relationship between public and private provider under dual practice regulation in term of price and quality setting in the public facility. This theoretical work is vital to link dual practice from demand and supply side that appears in Part two and Part three. The research wants to answer particular questions on how a private provider selects its price and quality level after knowing the public price and quality set by government under dual practice compared to non-dual practice regulation. The model also emphasizes the existence of insurance scheme in the system. Health care access enhancement in developing country usually takes one of two forms increasing the supply through allowing physicians to have dual jobs and increasing financial access through insurance coverage
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Senore, Carlo. "Smoking cessation in general practice." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22803.
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Available evidence from RCTs shows that GPs' counselling can be effective in reducing smoking prevalence and that some specific features of the intervention (for example the offer of follow-up visits) may enhance its effectiveness. The impact of such preventive activity, however, is dependent not only on intervention characteristics, but also on factors related to the recipients (smokers) and the providers (physicians). Paper 1 explores the role of pre-treatment factors in predicting quitting following GPs' counselling among 861 smokers enrolled in the Turin smoking cessation trial. Social support and smoke free environment reinforce the impact of GPs' counselling, which is less effective for more addicted smokers and for women. Counselling might be more effective, if GPs would take advantage of information on individuals' experience of behavioral change to tailor their message. Paper 2 compares a group of smokers (N = 965), who were invited to participate in the Turin smoking 1 cessation trial, to a matched sample of smokers (N = 277), listed in the files of 42 GPs collaborating in the trial. The patients in the second set were potentially eligible for recruitment, but were not invited to participate. Estimates of the effect of individual characteristics on patient recruitment indicate that GPs focused their efforts on heavier and diseased smokers. As this tendency may dilute the impact of their anti-smoking action, more effective educational strategies should be implemented when planning preventive interventions.
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Latter, Susan Marianne. "Health education and health promotion : perceptions and practice of nurses in acute care settings." Thesis, King's College London (University of London), 1994. https://kclpure.kcl.ac.uk/portal/en/theses/health-education-and-health-promotion--perceptions-and-practice-of-nurses-in-acute-care-settings(ad41c917-a4f4-4db4-9e02-2f20555f91b5).html.
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The aim of this study was to examine nurses' perceptions and practice of health education and health promotion in the acute care setting. Ward sisters (n=132) working on acute wards in nine District Health Authorities were interviewed using a semi-stuctured schedule. Data were collected on perceptions of health education and health promotion, nurses' role in these activities, and factors influencing nurses' health education and promotion practice on the ward. Data were analyzed using a combination of qualitative and quantitative methods. In the second phase of the study, three wards were selected as case studies of nurses' practice. Data collection methods employed to describe nurses' practice included: non-participant observation, audio-recording of nurse-patient interactions, self-administered questionnaires and reflective field notes. A largely qualitative approach was taken to the analysis of these data. The findings from the interviews indicated that the ward sisters had limited understandings of the meaning of health education and health promotion and nurses' roles in these activities. Findings from the case study wards as a whole suggested that nurses' health education and promotion practice was generally extremely limited, although there were some differences between wards in the extent of this evolution. A number of factors may help explain these findings. These include: nurses' knowledge and skills in health education and health promotion, the philosophy, organization and management of care adopted, and the extent to which these offer opportunities for empowerment in nursing. It is suggested that nurses' perceptions and practice can be conceptualized with reference to a continuum of health promoting nursing practice, and that only limited progress has been made towards nurses' full potential. It is argued that if nurses are to develop their health promoting practice, a philosophical shift in nursing is necessary. Together with the acquisition of appropriate knowledge and skills, this may empower nurses to realise their potential.
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Skånér, Ylva. "Diagnosing heart failure in primary health care /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-784-3/.
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Lundy, Shaun James. "Professional ethics in occupational health & safety practice." Thesis, Middlesex University, 2013. http://eprints.mdx.ac.uk/13712/.
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This thesis provides a critical evaluation of a real world project involving the researcher as leader of a review and subsequent development of a new Code of Conduct for the world’s largest health and safety body, the Institution of Occupational Safety Health (IOSH, 2011). The health and safety profession in the UK has seen many changes over the last 10-years, in particular a stronger focus on degree education, continual professional development (CPD) and Chartered Practitioner status. In addition to these progressive changes the profession has also seen a rise in the negative media coverage regarding reported risk aversion in decision-making processes. In response to the negative media and at the request of the conservative party, then in opposition, Lord Young led a complete review of health and safety in Great Britain(Young, 2010). More recently, the Government requested a further independent review into health and safety legislation (Löfstedt, 2011). Since the publication of these reports there have been calls for more rigorous competence standards for consultants and a move towards more industry led self-regulation. This has seen IOSH placed in a strong influencing position, albeit with added scrutiny of its own regulation of members. The researcher led a critical review of the existing Code as part of an IOSH standing Committee, the Profession Committee (PC) that has the responsibility among other things for examining allegations of misconduct. The project was conducted as action research and was divided into 4 cycles or stages. Stage 1 involved the critical review and benchmarking of the existing Code against other Codes using an adaptation of the PARN criteria. Stage 2 involved the consultation process for the development of a new Code. This included the researcher’s role as leader of the project and an evaluation of misconduct cases reviewed by the PC. Stage 3 involved semi-structured interviews of practitioners to explore experiential accounts of ethical issues from practice to inform the guidance on the Code. Finally, Stage 4 involved the concluding consultation and consolidation of all the stages for presentation of the revised Code to IOSH Council for approval. The project reinforced the benefits of applying a systematic approach for the development of professional body documentation. It also revealed the value of applying a flexible iterative methodology in the real world environment to prevent the project from diverging from its real world objectives. The outcome of the project has been positively received by IOSH. A new Code was produced with guidance and a revised disciplinary procedure that is fit for purpose and adaptable to change through the use of robust development and broad consultation processes. It is anticipated that these changes will make a significant contribution to the wider profession and practice. An ethical decision making model was developed from the findings and includes a dissemination strategy for the profession.
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Hunt, Matthew Robert. "Ethics of health care practice in humanitarian crises." Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=40710.
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Humanitarian emergencies and natural disasters can overwhelm the capacity of local and national agencies to respond to the needs of affected populations. In such cases, international relief organizations are frequently involved in the provision of emergency assistance. Health care professionals play a key role in these interventions. This practice environment is significantly different from the context of health care delivery in the home countries of expatriate health care professionals. Clinicians who travel from a developed nation to a resource-poor setting where a humanitarian crisis has occurred experience a shift of professional, social, cultural and regulatory environments. In this dissertation I examine the ethics of health care practice in humanitarian work. I evaluate the literature of global bioethics, global health ethics and the ethics of humanitarian assistance, and consider the contributions of various ethics frameworks and normative approaches. I also develop a set of questions to guide health care professionals as they address ethically complex issues arising in clinical practice during humanitarian crises. In the empirical component of this research program I use Interpretive Description methodology to examine the moral experience of health care professionals in humanitarian relief work, and clinician experiences of resources and constraints for addressing ethical issues in humanitarian settings. Building upon the inductively derived findings, I argue for strategies and approaches that humanitarian organizations, project teams, and health care professionals can adopt to respond to the ethics of this field of practice. I also provide a critical review of Interpretive Description methodology. The research presented in this dissertation makes an important contribution to the ethical analysis of health care practice in humanitarian work.En contexte d’urgences humanitaires et de sinistres naturels, la capacité des agences locales et nationales à répondre aux besoins des populations affectées est lourdement entravée. Dans ces situations de crise, des organismes internationaux d'aide humanitaire sont souvent impliqués pour offrir leur assistance. Les professionnels des soins de santé jouent un rôle important dans ces interventions. Ces contextes singuliers de pratique pour ces professionnels de la santé expatriés diffèrent beaucoup de l’environnement familier dans lequel ils évoluent dans leur pays d’origine. Les cliniciens qui sont transportés d’un pays développé à des régions dévastées par des crises humanitaires vivent des changements d’environnement professionnel, social, culturel et juridique souvent drastiques. Dans ce projet de thèse, j'examine l'éthique de la pratique en santé dans des zones de crises humanitaires. En premier lieu, j’effectue une recension critique de la littérature consacrée à la bioéthique globale, à l’éthique de la santé globale et à l’éthique humanitaire en vue d’identifier la contribution de certains modèles éthiques et d’approches normatives sur les problèmes qui me préoccupent. Je développe également une série de questions destinée aux professionnels de la santé pour les aider à mieux analyser la nature des enjeux moraux auxquels ils sont confrontés, de même que pour orienter leur processus décisionnel face aux dilemmes rencontrés. Le volet empirique de ce programme de recherche examine l’expérience morale des professionnels des soins de santé en contexte de travail humanitaire, ainsi que les expériences des cliniciens des ressources et des contraintes pour aborder les enjeux moraux en situation de crise humanitaire. Je propose des stratégies et des approches que les organismes humanitaires, les équipes locales d’intervenants, ainsi que les professionnels de la santé peuvent développ
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Bhutta, Sadia M. "Health education practice in primary classrooms in Pakistan." Thesis, University of Oxford, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.432110.
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Goding, Lois. "An investigation into intuition and health visiting practice." Thesis, University of Reading, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367383.
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Lindh, Falk Annika. "Interprofessional Collaboration in Health Care : Education and Practice." Doctoral thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-132962.
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Background: Interprofessional collaboration is of global interest for addressing to the complex health care needs and improving patient safety in health care. Professionals have to develop collaborative skills and the ability to share knowledge. Interprofessional education describes learning activities where students learn with, from and about each other to improve collaboration. The dimension of interprofessional collaboration is complex and includes different collaborative competencies to bring about the best for the patients. To become a professional, often understood as someone exerting expertise within a specific field of practice, involves a learning process that challenges the boundaries of the professions. Boundaries are not only barriers, but also places that increase learning. There is a complexity to studying the phenomenon of interprofessional collaboration and learning regarding how it occurs in education and health care practice. By using a sociomaterial perspective on practice, it is possible to more robustly explore the collaborative context. Aim: The overarching aim of the thesis has been to explore interprofessional collaboration and learning in health care education and in interprofessional health care practice. More specifically, the research questions in the thesis were answered in two studies regarding how professional knowledge is developed and shared in interprofessional undergraduate health care education and in interprofessional health care practice. Methods: A questionnaire was distributed to students from a medicine, nursing, physiotherapy and occupational therapy programme who participated in a two-week period of practice at an Interprofessional Training Ward in Linköping. The data was analysed quantitatively to explore how female and male students experienced their professional identity formation. The open-ended responses were analysed using a sociomaterial perspective on practice. An ethnographic study was conducted in a hospital setting during a period of one year, during which two interprofessional teams were observed. A theory-driven analysis was made using a sociomaterial perspective on practice, and this provided a lens through which the nature of interprofessional collaboration and knowledge sharing could be observed. Findings: The main findings from the questionnaire showed that the practice architectures of the Interprofessional Training Ward, prefigured practices where different professional responsibilities were enacted in ways that were reproducing expected and unexpected roles in a traditional health care practice. That disrupted the students´ practical and general understandings of professional responsibilities and the nature of professional work including their professional identity formation. The findings from the ethnographic study showed different patterns of how knowledge was shared among professionals in their daily work practice as it unfolded, like chains of actions. The patterns arose through activities where collaboration between professionals was planned beforehand, and at other times it arose in more spontaneous or responsive ways. Due to the way the activities were arranged, the nursing assistants were totally or partially excluded from the collaborative practices. Conclusions: The way that educational and health care practices were arranged had an influence on the patterns of interactions between the students as well as the professionals. The arrangement at the Interprofessional Training Ward enabled and constrained the possibilities for students to learn professional and interprofessional competencies. Professional practices in health care hung together through chains of actions that influenced interprofessional collaboration and learning. The relations between human actors, material objects and artifacts are of importance for understanding interprofessional practices.
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Betz, Cecily, Lisa S. O'Kane, Wendy M. Nehring, and Marie L. Lobo. "Systematic Review: Health Care Transition Practice Service Models." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6518.
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Background: Nearly 750,000 adolescents and emerging adults with special health care needs (AEA-SHCN) enter into adulthood annually. The linkages to ensure the seamless transfer of care from pediatric to adult care and transition to adulthood for AEA-SHCN have yet to be realized.
Purpose: The purpose of this systematic review was to investigate the state of the science of health care transition (HCT) service models as described in quantitative investigations.
Methods: A four-tier screening approach was used to obtain reviewed articles published from 2004 to 2013. A total of 17 articles were included in this review.
Discussion: Transfer of care was the most prominent intervention feature. Overall, using the Effective Public Health Practice Project criteria, the studies were rated as weak. Limitations included lack of control groups, rigorous designs and methodology, and incomplete intervention descriptions.
Conclusion: As the findings indicate, HCT is an emerging field of practice that is largely in the exploratory stage of model development.
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Harvey, Emma Louise. "Attitudes to obesity : health professionals' views and practice." Thesis, University of Leeds, 1999. http://etheses.whiterose.ac.uk/234/.
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The purpose of this thesis was to study health professionals' views and practice in relation to overweight and obesity. In particular, the aims were: to explore the key cognitions of health professionals, with a view to describing their obesity stereotype and related attitudes; to explore the same cognitions among dieters; to compare and contrast the views of health professionals and dieters; to explore the relationship between health professionals' cognitions and practices; and to investigate the way in which health professionals' practice may be improved. Four studies were undertaken. The first was a survey of health professionals' views of overweight and obese people, compared to their views of smokers. In an independent, factorial design, participants responded to questions about moderately or extremely overweight people, or moderate or heavy smokers. Two hundred and fifty-five health professionals took part. Health professionals' beliefs and attitudes were mixed, but of the four groups, attitudes towards obese people were most negative. The obesity stereotype appeared to be differentiated from the overweight stereotype by perceptions of reduced self-esteem, sexual attractiveness and health. The second study examined dieters' cognitions of overweight and obesity. In another independent, factorial design, dieters' views about moderately or extremely overweight people were examined as a function of their own body weight (normal weight, moderately and extremely overweight). Two hundred and three people participated. The findings showed that dieters of different body weights had the same kinds of cognitions about both overweight and obese people. The key cognitions underpinning the overweight stereotype among dieters were that mood-related factors were viewed as important in causing overweight, and that overweight people were seen as ordinary people, but with reduced self-esteem, sexual attractiveness and health. A direct comparison of health professionals' and dieters' responses was undertaken using data from Studies 1 and 2. There were many similarities in the perceptions of the two groups, but dieters tended to have slightly more traditional views of the causes of overweight (mood, lack of willpower) and the responsibilities of overweight people. The pattern of attitudes for both groups was mixed, but health professionals' responses were more likely than dieters' to be influenced by the level of severity of the weight problem. The third study explored the relationship between cognitions and practices among 187 dietitians. Respondents' views of overweight were similar to those of the health professionals in the first study. In addition, belief that a lack of willpower was important in causing obesity (but not general attitudes or beliefs about responsibility) was associated with a number of reported practice choices. The final study investigated strategies for improving health professionals' management of obesity and the delivery of health care for overweight and obese people, through a systematic review of the evidence. Twelve studies were included, but due to the limited quality of many of the studies, there is currently very little information on how obesity practice may be improved and whether this will result in improved outcomes for patients. Overall, the findings indicate that cognitions about overweight and obese people were mixed. Although some negative perceptions may exist among health professionals, these may be less negative than previously documented. Significant level effects among health professionals suggest that where they exist, they are more likely to be directed at obese people than moderately overweight people. As obese people are at a greater health risk, the implications for improving practice need to be explored in detail. The findings of the systematic review suggest that where practice does need to be improved, currently very little is known about what strategies may be effective.
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SOARES, ADRIANA DE OLIVEIRA. "SOCIAL SERVICE AND MENTAL HEALTH: THE DEVELOPMENT OF A PRACTICE OR PRACTICE IN DEVELOPMENT?" PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2006. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=9543@1.
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CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICOA presente dissertação traz uma reflexão sobre a prática do Serviço Social em sua relação com o campo da saúde mental, a partir do discurso dos assistentes sociais inseridos nos serviços de saúde mental do município de Niterói. O estudo, de cunho qualitativo, buscou conhecer como vem se desenvolvendo a prática do Serviço Social na Saúde Mental, suas especificidades, desafios e contribuição para um campo que se reconhece como interdisciplinar. Para tal, reportamo-nos para a história da profissão e sua relação com este campo de atuação, refletindo sobre os marcos teóricos do Movimento da Reforma Psiquiátrica brasileira e suas implicações na prática profissional. Com apoio na Sociologia das Profissões, procurou-se compreender o processo de profissionalização do Serviço Social, os desafios e entraves enfrentados por seus profissionais no campo em questão. A analise realizada evidencia que os profissionais entrevistados consideram que o Campo da Saúde Mental lhes exige uma atitude de maior flexibilidade para com suas intervenções, o que não deixa de ter seu preço, na medida em que implica em uma indefinição quanto à posição ocupada pela profissão no referido campo.
This present dissertation brings forward a reflection about the practice of Social Service and its connection with the mental health field, taking as a starting point the speech of social workers that are involved in mental health services in the city of Niterói. This study, of quantitative purpose, has sought to know how the practice of Social Service has developed in Mental Health, its specifications, challenges and contribution to a field that is known for its interdisciplinary quality. To accomplish it, we refer back to the history of the profession and its relation with this field, reflecting on the theoretical marks of the Brazil`s Movement for Psychiatric Reform and its implications in professional practice. We have sought to understand the process of the professionalization of Social Service, the challenges and hindrances faced by their professionals in the Mental Health field with the help of the Sociology of Professions. The analysis undertaken shows that interviewed professionals consider that the Mental Health field demands a more flexible attitude in their interventions, which indicates they have to pay a price, given that it means to not have the position they occupy defined in the referred field.
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Robinson, K. S. M. "The social construction of health visiting." Thesis, London South Bank University, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.379049.
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Patterson, Elizabeth, and E. Patterson@mailbox gu edu au. "Primary Health Care Nursing: A Case Study Of Practice Nurses." Griffith University. School of Nursing, 2000. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030228.104735.
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In 1978, Primary Health Care (PHC) was formally recognised, in the Declaration of Alma-Ata, as the key to achieving the World Health Organisation's goal of 'Health For All by the Year 2000' (HFA). PHC was seen as the solution to the inadequate illness management systems that had developed throughout the world. It was hoped that PHC would address some of the major inequalities in health observed both within and between countries by its balanced system of treatment and disease prevention. The WHO envisaged that PHC would take place as close as possible to where people live and work and be the first element of a continuing health care process. Additionally, health service collaboration and multi-professional partnerships were expected to replace professional boundaries and competition. Shortly after the Declaration of Alma-Ata, the World Health Organisation, supported by national and international nursing bodies, proposed that nurses would be the driving force behind the HFA movement as active partners in inter-professional teams, leaders in health care and resources to people rather than resources to other health professionals. In the ensuing years, although community health nurses were acknowledged by the government and the nursing profession as key players in PHC in Australia, practice nurses (nurses who are employed in general medical practices) were not identified within this group. Hence, it appeared as though these practice nurses were 'invisible', not considered important to PHC in Australia, or simply overlooked as a major influence on population health. The purpose of this study was to describe the current role of these nurses and to identify and analyse the factors that influenced their scope of practice and hence their contribution to PHC. The research was conducted as a case study of practice nurses in one Division of General Practice in southeast Queensland. The study was influenced by the constructivist paradigm of inquiry and utilised a complementary sequence of quantitative methods followed by qualitative investigation. The first stage of the study comprised a telephone followed by mail survey of general practitioners and practice nurses employed within the Division. This was followed by a second stage, which involved group and individual interviews of key informants and was supported by document review and observation. The study revealed that the practice nurse role is essentially one of assistant to the general practitioner wherein the nurse undertakes basic assessment procedures to aid the medical diagnosis, carries out delegated therapeutic procedures, and contributes to the administrative functioning of the practice. Autonomous nursing initiatives, which appear to be largely opportunistic and incidental to delegated activities, include physical and emotional support of patients, clarification and reinforcement of medical instructions, and the provision of health education. The practice nurse's role, and hence contribution to PHC, was found to be constrained by a number of factors. These factors include the current funding arrangements for general practice, the view that practice nurses are an option rather than a necessity, the general practitioners' control of the practice setting, the appropriation of nursing work to medical receptionists, the lack of professional development opportunities, and the practice nurses' passive acceptance of their circumstances. However, both general practitioners and practice nurses appreciate the value of nursing services in general practice and GPs would sanction the employment of more nurses, if given financial incentives, especially for the purpose of preventive care. The majority of practice nurses believe their role should be expanded to include autonomous functioning while most of the GPs were amenable to some extension of nursing practice but reticent or opposed to any independent interventions. There appears a need in Queensland for courses to prepare practice nurses for advanced practice if they want to expand their role in PHC beyond that of assistants to GPs. It would also seem to be in the nurses' interests to initiate a professional association of practice nurses as a vehicle to explore other issues relevant to their professional development. In addition, if PNs want to expand their role they will need to demonstrate improved patient outcomes and cost effectiveness.
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McHenry, Kristen L. "Safe Practice." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2535.
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Purkis, Mary Ellen. "Bringing 'practice' to the clinic : an excavation of the effects of health promotion discourse on nursing practice in a community health clinic." Thesis, University of Edinburgh, 1993. http://hdl.handle.net/1842/20127.
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Health promotion is investigated as a concept which has intruded into debates about nursing practice. Review of the literature on health promotion reveals two major problems with the way in which the relationship between theory and practice is conceptualized in nursing literature. A critical review reveals that 'power' has received inadequate treatment and an absence of critical debate regarding the conceptualization of action as a social accomplishment in accounts of nursing practice. The argument is advanced that much research into nursing practice is currently based on functionalist frameworks influencing not only decisions made regarding changes in practice but, more importantly, the way in which the field of practice is conceptualized as a research 'site'. The thesis advances a theoretical position which addresses these problems by keeping action as a social accomplishment and power in the foreground of a study of nursing practice. The position draws on Giddens' structuration theory (1976, 1984), which offers an explanatory locus for an analysis of social action. Foucault's writings on 'procedures of power' (1963/1973, 1975/1977, 1978/1991) are used to situate the study as an investigation of how knowledge of action has implications for constituting viable interests in practice settings. Ethnographic methods are employed, generating contextualized accounts of nursing practice in one setting: a community health clinic. Transcribed interactions between nurses and clients were drawn on as the primary source for interpretation. Interpretations were cross-checked first with observational fieldnotes and secondly with interviews conducted with nurses and clients after the clinic interactions. 'Conversation' is excavated as a strategy-in-use by nurses conducting immunization clinic visits. The analysis demonstrates that nurses are presently in the process of instituting a new 'nstitution' (Lyotard, 1979/1984) in their accomplishment of work in this setting. This has the effect of moving parents out of the home and into the clinic, a move which has implications for the 'fracturing' of the parent-child life-world.
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Jeannie, Goff M. "Diabetes Distress: Transforming a Practice." Otterbein University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1596205210617564.
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Davis, Meagan Chase. "Adolescent Depression Screening in Primary Care Practice." Thesis, The University of Arizona, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13864970.
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Purpose: The purpose of this DNP quality improvement project was to increase primary care provider knowledge about indications for adolescent depression screening.
Background: Approximately 13.3% of adolescents experienced depression in the past year. In Oklahoma alone, rates are increasing, with depression totaling 60% of all mental health illness among adolescents. Primary care providers see approximately 75% of adolescents; however, mental health conditions are missed 84% of the time. Current clinical guidelines recommend screening for adolescent depression during wellness visits or when risk factors are present.
Methods: The providers of interest were nurse practitioners, physicians, and physician assistants providing primary care to children between the ages of 12 and 17 in a private pediatric practice group consisting of three clinics. The Model for Improvement guided the process of developing, implementing, and evaluating an educational intervention through use of a pre-test/post-test quantitative design. An email invited participants to complete an anonymous pre-test survey to evaluate knowledge and beliefs surrounding adolescent depression, then view an educational presentation on adolescent depression and screening guidelines, then complete a post-survey to evaluate any changes in knowledge and intention to screen. Results were shared with clinic representatives to help refine the education for future testing cycles and other clinic sites.
Results: Data collection took place over one week. Five providers completed both the pre-test and post-test surveys. Provider knowledge scores significantly increased 29% after participating in the education and self-reported knowledge on screening increased.
Conclusions: DNP quality improvement projects like this help develop strategies to increase best practices, leading to improved patient outcomes. Nurse-led improvement programs like this contribute to healthcare literature and the advancement of the nursing profession by developing patient-centered interventions applicable to a wide variety of providers. Results may be used to develop strategies to increase and align provider practices with best standards to help promote early identification and treatment of adolescents with depression.
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Dulaney, Kristina. "Perinatal Mental Health: Screening, Integrated Practice, and Community Resources." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/8858.
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Duncan, Susan Maxine. "Ethical conflict and response in community health nursing practice." Thesis, University of British Columbia, 1989. http://hdl.handle.net/2429/27333.
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The purpose of the study was to describe the types of ethical dilemmas experienced by community health nurses and their responses to them. Specifically, the research questions directed the identification of those clinical situations which contained the dilemmas, the inherent ethical conflicts, the nurses' responses to them, and the forces influencing their occurrence. Due to the exploratory nature of the study, a descriptive survey was selected as the research method. The Critical Incident Technique (Flanagan, 1954) and the Model for Critical Ethical Analysis (Curtin, 1978) were the basis for the development of the data collection guide. The CHNs who received copies of the guide were asked to describe in writing the practice situations which had contained dilemmas and their responses to them.
Thirty CHNs practicing in communities throughout B.C participated by completing and returning their responses to the guides. Their written responses indicated they were able to identify common practice situations which had contained ethical dilemmas. Furthermore, these nurses were able to identify the conflicts which had existed for them, their feelings, and their experiences with the decision-making process.
Content analyses of the nurses' responses resulted in three categories of dilemmas - clients' rights, system interaction, and nurses' rights. Within these categories, the dilemmas are characterized by one or more ethical conflicts which resulted in difficult choices for the nurses. During data analysis, the situations were further analyzed to identify underlying ethical themes and influential forces. The ethical themes underlying the nurses' dilemmas fundamentally involved conflicts between the principles of autonomy, beneficence and justice. Additionally, human rights and value conflicts are relevant in situations where the nurses are caring for high-risk client groups; interacting with the health care team; and asserting their own rights as employees, professional nurses, and citizens. Key restraining and driving forces influenced the CHNs' experience with the dilemmas. Restraining forces included policy, and a lack of interdisciplinary collaboration. Driving forces included supportive nursing leadership, consultants from other disciplines, nursing knowledge and skill, the nurse-client relationship and most importantly the nurses' interaction with colleagues. These CHNs saw their role as one of an advocate for their clients. Although the ethical dilemmas described by this sample of CHNs are not notably different from those experienced by nurses in other settings, the way in which these nurses experience them is influenced by unique features of their role. These unique features result from the CHN's position in the health care system. The CHN is often a primary contact for clients, and therefore often assumes a role in initiating and coordinating referrals to social workers, physicians, and others. Furthermore the independent nature of community health nursing practice increases their needs for collaboration with others who are often removed from their setting of practice. Finally, because this group of nurses see clients in their natural community settings, they have an awareness of community health conditions which are determinants of health. Based on these findings, implications for community health nursing practice, nursing education, and nursing research are proposed.Applied Science, Faculty of
Nursing, School of
Graduate
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McGrath, Alicia University of Ballarat. "Changing rural general practitioner practice : evaluating health assessment uptake." University of Ballarat, 2003. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12770.
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The Enhanced Primary Care Package aimed to improve health and quality of life through enhancing primary health care for those over 75 years, Aboriginal and Torres Strait Islanders over 55 years and those with chronic conditions and multidisciplinary needs. A multi-level approach was implemented to promote the package. West Vic Division of General Practice conducted the General Practice Education Support and Community Linkages implementation program for the package in Western Victoria and focused on health assessments for those over 75 years. This research investigated what factors affected change in rural general practitioner practice through surveying general practitioners and collecting Health Insurance Commission data prior to and following the program. Patients were also interviewed to determine acceptance of health assessments and nurse involvement. The program increased awareness, but had little effect on increasing uptake, as only 53% of general practitioners began undertaking health assessments. However the general practitioners indicated an increased frequency of health assessment prescription. Health Insurance Commission data suggested an immediate increase in the use of the assessments, however the rate fluctuated and then declined. Lack of sustained uptake of the program was not associated with remuneration, as 77% of general practitioners did not regard finance as a barrier. Respondents’ major barrier was time (40% pre-education, 73% post-education). This data reflected a rural environment where general practitioners face competing priorities, time constraints, workforce shortage and long consultation lists. A notable change did however occur from practice nurse employment as the involvement of a practice nurse generally resulted in patient satisfaction with the assessment. It was apparent that a complex multifaceted and longer-term view is needed to address factors which limit rural general practitioners’ ability to change. This needs to be addressed at the Commonwealth level and not in isolation in order to produce an integrated framework to enhance and promote, rather than demand change.Master of Applied Science
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McGrath, Alicia. "Changing rural general practitioner practice : evaluating health assessment uptake." University of Ballarat, 2003. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/14607.
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The Enhanced Primary Care Package aimed to improve health and quality of life through enhancing primary health care for those over 75 years, Aboriginal and Torres Strait Islanders over 55 years and those with chronic conditions and multidisciplinary needs. A multi-level approach was implemented to promote the package. West Vic Division of General Practice conducted the General Practice Education Support and Community Linkages implementation program for the package in Western Victoria and focused on health assessments for those over 75 years. This research investigated what factors affected change in rural general practitioner practice through surveying general practitioners and collecting Health Insurance Commission data prior to and following the program. Patients were also interviewed to determine acceptance of health assessments and nurse involvement. The program increased awareness, but had little effect on increasing uptake, as only 53% of general practitioners began undertaking health assessments. However the general practitioners indicated an increased frequency of health assessment prescription. Health Insurance Commission data suggested an immediate increase in the use of the assessments, however the rate fluctuated and then declined. Lack of sustained uptake of the program was not associated with remuneration, as 77% of general practitioners did not regard finance as a barrier. Respondents’ major barrier was time (40% pre-education, 73% post-education). This data reflected a rural environment where general practitioners face competing priorities, time constraints, workforce shortage and long consultation lists. A notable change did however occur from practice nurse employment as the involvement of a practice nurse generally resulted in patient satisfaction with the assessment. It was apparent that a complex multifaceted and longer-term view is needed to address factors which limit rural general practitioners’ ability to change. This needs to be addressed at the Commonwealth level and not in isolation in order to produce an integrated framework to enhance and promote, rather than demand change.Master of Applied Science
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Shim, Margaret Cheng-Sim. "Embracing cultural diversity in occupational therapy mental health practice." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq39592.pdf.
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Jones, Indra. "Reflective practice and the learning of health care students." Thesis, University of Hertfordshire, 2009. http://hdl.handle.net/2299/3471.
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Reflective practice, though ill-defined, has become an accepted educational concept within many health care disciplines particularly in nursing. Subsequently it has become benchmarked within Paramedic Sciences as a professional requirement for continuing education and clinical practice. However, despite the vast literature in nursing and the increasing growth of reflective practice in paramedic curricula it is unclear how it influences the students’ learning in preparation for graduate practice as future reflective practitioners. This research explored ‘to what extent does reflective practice in the paramedic curriculum influence the students’ academic and clinical learning leading to graduate practice’? A mixed methods approach with cohort samples of undergraduate health care students comprised four studies including surveys and non-participant observations of clinical simulation that were conducted in a university learning environment. The results showed overall that Paramedic students believed that they understood reflective practice and perceived it to be useful for their academic studies and clinical practice; although this is probably influenced more by formal teaching rather than the result of their own views. Students were able to describe reflective practice in ideal theoretical terms and were positive towards it regardless of their individual learning styles. However, in a clinical context, they applied it differently with significant emphasis on technical reflection. Evidence of the nature of reflective practice as it occurred during and after clinical simulation scenarios highlights a need for revised approaches to existing learning/teaching strategies with paramedic students. An extended understanding and refinement of reflective practice concepts including a new pedagogic framework to promote enhanced reflectivity are proposed. This theoretical framework is designed to accommodate reflective learning for both personal and collaborative learning related to curriculum outcomes. The use of clinical simulation for the development of reflective practice in the paramedic curriculum is supported with recommendations for further studies in academic and clinical settings.
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Richardson, Samuel Starr. "Quality-based payment in health care: Theory and practice." Thesis, Harvard University, 2013. http://dissertations.umi.com/gsas.harvard:11142.
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Quality-based payment in healthcare—also known as pay-for-performance—is a popular policy intervention aimed at improving healthcare quality. However, there has been little theoretical work characterizing the underlying quality problem or the interaction between pay-for-performance and existing payment mechanisms. Furthermore, there is little empirical evidence that pay-for-performance has a substantial effect on healthcare quality.
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Royle, Jane. "Quality assurance : the implications for specialist health promotion practice." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300824.
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Frost, Jeana (Jeana H. ). 1973. "Visualizing health : imagery as data for changing personal practice." Thesis, Massachusetts Institute of Technology, 2001. http://hdl.handle.net/1721.1/61116.
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Thesis (S.M.)--Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2001.Includes bibliographical references (leaves 60-63).
This thesis is about diabetics and their theories about their health practices. Daily decisions, such as eating and exercise habits, have clear consequences for a diabetic's health, yet many of them fail to change their behavior patterns despite knowing facts about the disease. I assumed that they might change their practices if the relationship between their actions and their blood glucose levels was made explicit. To do this, I introduced photography into diabetes diagnosis, asking people to collect images of their daily activities to complement their glucose monitoring. By combining quantitative glucose measurements with qualitative portraits of action, I hoped to make the relationship between physiology and behavior an object for discussion and reflection. More so, I hoped that diabetics who viewed these data would begin to develop new interpretations of their lifestyles that would ultimately lead to healthier activities. I will discuss studies conducted in diabetes education courses and a set of visualization tools that I designed to help people see correlations between glucose data and photographs of activity. The results of these studies suggest that photographing activities may have the potential to change the ways that diabetics understand and deal with their health.
Jeana Frost.
S.M.
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Park, Jennifer S. "Assessing Spiritually Competent Practice Across Mental Health Graduate Students." Thesis, Regent University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3739778.
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Standards for integration of spirituality and religion within mental health training continue to be ambiguous. Although increased attention has incorporated such diversity into multiculturalism, proficiency remains inadequate among non-religiously affiliated individuals and institutions. This study examined competence levels utilizing the Revised Spiritual Competence Scale II (SCS-R-II) and the Spiritual and Religious Competency Assessment (SARCA). Participants were 125 students attending accredited counseling, psychology, and social work schools in the United States. Counselor trainees scored highest on both measures as did students with very strong personal religious affiliation and attendees of Christian affiliated schools. Implications and future recommendations are discussed.
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Freedman, Rosie. "Applying health psychology to clinical services, policy and practice." Thesis, City, University of London, 2014. http://openaccess.city.ac.uk/18053/.
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Background: When a loved one is admitted to intensive care it can be a traumatic experience for the patients’ relatives. Poor communication and lack of information from intensive care unit (ICU) staff members can have a negative impact on how relatives cope on an ICU and in the months following the experience. There is a need for interventions to improve these aspects and prepare relatives for what to expect on the ICU using a combination of written and verbal information. Aims To conduct two separate but overlapping qualitative studies. Study 1: To explore how patients’ relatives experience an ICU, their needs during this time, their knowledge and understanding regarding decision making for patients who lack capacity, and their psychological needs on ICU. Study 2: To develop and pilot an intervention for patients’ relatives on the Critical Care Units (CCUs) at King’s College Hospital (KCH), to help them cope with the experience. Method and Design: In study 1 data was obtained from semi-structured interviews with ten ex-ICU patients’ relatives recruited via a national charity, and ten nurses and consultants from the CCUs at KCH. In study 2 data was obtained via a focus group of nine senior nurses, from KCH. Data generated from both studies was used to develop the intervention which comprised an information booklet and verbal guide. The intervention was delivered by nurses to patients’ relatives on the Medical and Surgical CCUs for two weeks. Ten CCU staff members were interviewed about how the intervention had been received by patients’ relatives. Data was analysed using thematic analysis. Results: Study 1 identified themes related to the importance of good communication with staff, the need for relatives to receive clear and honest information about their loved one, and about the ICU. Findings suggest that relatives lack knowledge and understanding about decision-making for patients who lack capacity and may need to be informed of this process at an early stage preferably in written form. Relatives and staff may also benefit from an ICU based counselling service. The focus group in Study 2 provided feedback on appearance, content and delivery of the booklet which informed the final draft. After the pilot, staff reported positive feedback from relatives and provided encouraging and constructive feedback about the booklet. Findings suggest the booklet has the potential to help patients’ relatives cope on the ICU but continued use and testing would better determine its efficacy. Patients’ relatives need to feel supported, well informed, and involved on the ICU. Including information about the decision making process in an information booklet may improve relatives’ understanding and acceptance of this issue. The booklet should be an adjunct to verbal communication from staff and be one of a range of resources accessible to patients’ relatives on the ICU. Keywords: intensive care; critical illness; patients’ relatives; communication; information provision; coping; decision-making; mental capacity; intervention; psychology.
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Brooks, Robert. "Occupational practice in children and young people's mental health." Thesis, University of Huddersfield, 2016. http://eprints.hud.ac.uk/id/eprint/30195/.
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Introduction The use of occupation in occupational therapy has been regularly debated in the profession’s literature. More recently there has been a shift to consider occupation as the core construct of occupational therapy, which informs assessments, interventions and outcomes; this can be described as occupational practice. Studies exploring occupational practice have been limited; this study has sought to address this gap. Methods This was a mixed methods study. First, a United Kingdom survey of occupational therapy practice in children and young people’s mental health was conducted (n=27). The survey findings were analysed using descriptive statistics. The survey was used as a sampling platform for the second stage of the study. Underpinned by an ethnographic approach, the second study used an observer of participant, interview and document collection methods to explore occupational practice (n=2). A grounded theory approach was taken to data analysis. Findings The participants of the survey were 89% female, 49% were at a senior grade and 68% had been qualified for over 10 years. 81% worked in Child and Adolescent Mental Health Services tier 3 or 4. 52% participants had an undergraduate degree in occupational therapy; 64% had no further specialist formal qualifications. Additional training in sensory integration therapy was reported by 34% of participants. The Model of Human Occupation was identified as the most frequently used model of practice. The Sensory Profile was the most regularly used assessment. The participants reported that their interventions commonly focused on talking style therapies, psycho-education and group work. The ethnographic study revealed a tension at the study sites between the medical psychological and occupational practice discourses. To manage this tension, the participants used a generic and profession-specific practice to negotiate being ‘one of the team’ and being a ‘real occupational therapist’. Enacting occupational practice included using the Model of Human Occupation, referrals for occupational problems, conducting assessments of occupation, concluding occupational formulations, and using occupation as an intervention. Interventions were characterised as ‘talking about doing’ or ‘doing occupation’ and utilised strategies such as modelling, goal setting and setting a challenge. Conclusion The survey has offered a snapshot of occupational therapy practice. This may help the profession understand the demography and practices of the participants. The Occupational Practice Model for Children and Young People’s Mental Health, which has emerged from the ethnographic findings of this study, is presented as a tool to guide the use of occupation at the level of theory, perspective and intervention. Further qualitative studies are recommended to support the study findings and a systematic review is suggested to examine occupational therapy interventions in the field.
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Hussey, Louise. "Work-related ill-health as determined in General Practice." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/workrelated-illhealth-as-determined-in-general-practice(0921a844-c8e9-432a-a0d9-d6a4b684441f).html.
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Introduction: Work-related ill-health and resulting sickness absence is detrimental to the employees themselves, the employer and the national economy as a whole. To reduce the risk of work on health, information about causal factors and sectors at risk must first be gathered. General practice had been referred to as the ‘blind spot’ in occupational health as so little was known about work-related ill-health seen by GPs. The principal aim of this thesis was to estimate the incidence of work-related ill-health in the UK/GB as determined in general practice, to critically compare general practice reporting with other data sources and to evaluate the incidence and sickness absence burden of work-related ill-health. Methods: Data on incident cases of work-related ill-health and sickness absence were collected from GPs reporting to a UK-wide surveillance scheme (The Health and Occupation Reporting network in General Practice (THOR-GP)), and compared to information from other sources. To enable the calculation of incidence rates, THOR-GP population denominator information was gathered and characterised using Census information based on patient and practice postcode. Results were presented as a series of four peer-reviewed published papers and an additional chapter exploring the calculation of incidence rates.Results: The work-related ill-health diagnoses reported by GPs were mainly musculoskeletal (53%) and mental ill-health (30%). Overall, half the cases were issued with sickness certification. The proportion of cases issued with sickness certification differed by diagnosis; 79% of psychological cases had certified time away from work and these conditions were responsible for the majority of sickness absence days certified (56%) however these cases were rarely referred to secondary care (1%). Industries operating within the public and financial sectors had the highest incidence rates of work-related mental ill-health and correspondingly the highest rates of sickness absence. Industries with the highest proportions of self-employment had the lowest rates of sickness absence. When compared to reports from occupational physicians (OPs), GP information was more representative of the employed population of the UK, whereas OP data concentrated on industries covered by occupational health services. Incidence rates based on clinical specialists’ reports were much smaller than GP rates and biased by severity and referral patterns. Rates based on self-reported (SWI) data were higher than GP rates due to greater inclusivity; however diagnoses were unsubstantiated by medical opinion. The THOR-GP population denominator was characterised using approximately a million patient postcodes (and linking these to Census data) from over a hundred GPs. These population estimates compared well with those based on the practice postcode and enabled the calculation of incidence rates of work-related ill-health for this and (with weighting methods) the GB population. Rates of work-related ill-health were highest for those employed within construction and agriculture.Conclusion: This thesis has shown how the systematic collection of work-related ill-health data from GPs adds to the knowledge base about the distribution and determinants of work-related ill-health (and sickness absence) within the UK/GB workforce. This work also contributes to knowledge relating to the ‘primary care denominator problem’ in calculating rates of incidence from general practice.
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Munzner, Michele. "Health Literacy and Discharge Planning in Social Work Practice." ScholarWorks, 2020. https://scholarworks.waldenu.edu/dissertations/7945.
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Low health literacy is a public health crisis, currently, there is limited research on social worker engagement with the low health literate patient. The research questions for this study examined health literacy knowledge in medical social workers and how their MSW curricula built their knowledge of health literacy. It also explored challenges that arise when discharge planning for patients with low health literacy. It also asked what social workers can do to aid patients with limited health literacy during the discharge planning process. This basic qualitative research study used criterion sampling and was informed by the socioecological model. Data collection used 2 focus groups of 12 medical social workers comprised of 11 females and 1 male. Data analysis occurred by categorizing the data then classifying the data into themes based on the research question. Key findings include: (a) social workers have a medium to high level of health literacy; (b) MSW curricula would benefit from health literacy knowledge; and (c) challenges occur in discharge planning with people with low health literacy that include overall knowledge and attitudes of health literacy, sociodemographic variables, and lack of preventative health. Recommendations include standardizing healthcare social worker roles and providing educational opportunities in MSW curricula on health literacy. Implications for social change include improved health outcomes, empowering individuals to take personal responsibility for their healthcare which in the long run can help them overcome chronic disease and other health related anomalies. Social change may be seen with hospital health literacy screening to reduce hospital readmissions decreasing individual healthcare costs and reduce societal healthcare costs.
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Allison, Robert W. "Transcultural awareness in nursing practice." Honors in the Major Thesis, University of Central Florida, 1998. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/18.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Nursing