Dissertations / Theses on the topic 'Family medicine Australia Evaluation'
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Basden, Jeri Ann, Ivy A. Click, and Fred Tudiver. "Developing a Role-Specific 360 Evaluation." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/6398.
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Tudiver, Fred, Ivy A. Click, Patricia Ward, and Jeri Ann Basden. "Evaluation of a Quality Improvement Curriculum for Family Medicine Residents." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/6370.
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BACKGROUND AND OBJECTIVES: East Tennessee State University’s (ETSU) Department of Family Medicine initiated Quality Improvement (QI) training in its three residency programs in 2008. The purpose of the project was to develop, implement, and assess a formal curriculum and experiential learning process to train family medicine residents in QI knowledge and skills. METHODS: Family medicine faculty members received training in QI theory and design. Rising second-year residents received a daylong workshop on the basics of QI principles. Residents worked in teams to develop and implement QI projects. Self-assessed QI proficiency was measured prior to and immediately following the workshop. QI knowledge was assessed with the Quality Improvement Knowledge Application Tool (QIKAT) at baseline and following project completion. RESULTS: Two groups of residents (n=37) received training and completed at least 1 year on their projects. Analyses revealed that residents’ self-assessed QI proficiency improved after receiving a day-long training workshop and was consistent for both groups of resident training. Application of QI knowledge as assessed by the QIKAT did not improve following QI project participation in resident Group 1 but did improve in resident Group 2. CONCLUSIONS: A formal QI curriculum was successfully developed and implemented into three family medicine residency programs. Residents’ QI knowledge and skills improved following training and experience conducting QI projects. Faculty and resident commitment to the program and competing time demands proved challenging to the introduction of QI training. Future studies should assess residents’ sustained learning and translating QI residency experiences into practice.
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Brummel, Mark, Reid B. Blackwelder, J. Moore, Glenda Stockwell, and Beth Anne Fox. "Rapid Resident Skills Evaluation Using the Integrated OSCE." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6934.
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Poerio, Loretta. "An evaluation of police training in handling domestic violence situations." Title page, contents and abstract only, 1991. http://web4.library.adelaide.edu.au/theses/09PM/09pmp745.pdf.
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Hammed, Shaza Mohammed Abo'Ouf. "An evaluation of family engagement with a family-based paediatric obesity intervention programme." Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/8541/.
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Kligler, Benjamin, Mary Koithan, Victoria Maizes, Meg Hayes, Craig Schneider, Patricia Lebensohn, and Susan Hadley. "Competency-based evaluation tools for integrative medicine training in family medicine residency: a pilot study." BioMed Central, 2007. http://hdl.handle.net/10150/610034.
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BACKGROUND:As more integrative medicine educational content is integrated into conventional family medicine teaching, the need for effective evaluation strategies grows. Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning. This paper presents the results from the implementation of direct observation and treatment plan evaluation tools, as well as the results of two Objective Structured Clinical Examinations (OSCEs) developed for the program.METHODS:The direct observation (DO) and treatment plan (TP) evaluation tools developed for the IFM program were implemented by faculty at each of the six sites during the PGY-4 year (n = 11 on DO and n = 8 on TP). The OSCE I was implemented first in 2005 (n = 6), revised and then implemented with a second class of IFM participants in 2006 (n = 7). OSCE II was implemented in fall 2005 with only one class of IFM participants (n = 6).Data from the initial implementation of these tools are described using descriptive statistics.RESULTS:Results from the implementation of these tools at the IFM sites suggest that we need more emphasis in our curriculum on incorporating spirituality into history-taking and treatment planning, and more training for IFM residents on effective assessment of readiness for change and strategies for delivering integrative medicine treatment recommendations. Focusing our OSCE assessment more narrowly on integrative medicine history-taking skills was much more effective in delineating strengths and weaknesses in our residents' performance than using the OSCE for both integrative and more basic communication competencies.CONCLUSION:As these tools are refined further they will be of value both in improving our teaching in the IFM program and as competency-based evaluation resources for the expanding number of family medicine residency programs incorporating integrative medicine into their curriculum. The next stages of work on these instruments will involve establishing inter-rater reliability and defining more clearly the specific behaviors which we believe establish competency in the integrative medicine skills defined for the program.
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Oz, Saba. "Usability Testing Of A Family Medicine Information System." Master's thesis, METU, 2012. http://etd.lib.metu.edu.tr/upload/12614716/index.pdf.
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Healthcare is an important part of life in most societies that attract a significant amount of public investment. Primary healthcare is a fundamental branch of the healthcare system where patients and doctors initially meet. Family Medicine Information Systems are developed in an effort to ease the daily work of family doctors with the help of information technology. Such systems are generally used for handling critical tasks such as managing health records of patients, monitoring pregnancy and keeping track of children&rsquos vaccination. Like any medical information technology, the usability of such systems is a vital concern for enabling efficient and effective primary healthcare operations. Family Medicine is a recently established practice in Turkey and there are a number of systems in service to aid the daily work of family doctors. However, none of these systems have been subjected to a systematic usability analysis. In this study, a usability analysis of a popular Family Medicine Information System used in Turkey is conducted. By combining several usability evaluation techniques, the study identified several important usability issues and provided recommendations for further improving the system. The main usability issue observed in the system was the overall complexity of the information presented at the main interface that often confused and misled the users. In order to address this problem, it is suggested that features related to the most frequent family medicine operations should be placed on the main screen, whereas remaining features should be organized under auxiliary pages with clear navigation aids.
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Sprivulis, Peter Carl. "Evaluation of the prehospital utilisation of the Australasian Triage Scale." University of Western Australia. Emergency Medicine Discipline Group, 2004. http://theses.library.uwa.edu.au/adt-WU2004.0055.
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[Truncated abstract] Background : Triage systems have evolved from battlefield casualty prioritisation tools to integral components of civilian emergency care systems over the last 50 years. There is significant variation in prehospital triage practices in Australia and little research has been undertaken to validate the triage systems used. There is considerable evidence to support the use of the Australasian Triage Scale (ATS) for triage in the emergency department setting and the ATS is used ubiquitously for emergency department triage in Australasia ... Conclusions : The findings of this thesis support integrating prehospital ATS allocations with emergency department triage processes. It is concluded that Paramedics apply the ATS similarly to nurses ... Allocations to ATS 1, 2 and 3 and most ATS 4 allocations by paramedics are valid when compared to nurse ATS allocations. Australasian Triage Scale category 5 is used inappropriately by paramedics and should be used rarely, if at all, by paramedics. The reliability of paramedic and nurse ATS allocations is sufficient to warrant a trial of the omission of retriage of ambulance presentations at Perth metropolitan emergency departments. However, early nursing assessment of a small proportion of ATS 3 patients may be required to ensure timely assessment for some mistriaged bone fide ATS 2 patients. Paramedic ATS allocations appear sufficiently reliable and valid to warrant a trial of their use as part of a two-tier trauma team activation system ... The implementation of standardised training between paramedics and nurses based on current Australasian College for Emergency Medicine guidelines is recommended. The implementation of paramedic triage audit, including comparison of paramedic ATS allocations with nurse ATS allocations may improve reliability between paramedics and nurses, and particularly the reliability of ATS 4 and ATS 5 allocations. Prehospital ATS allocations may prove useful in prehospital casemix analysis, the evaluation of prehospital service delivery and for prehospital research. Research opportunities include actual trials of the integration of prehospital use of ATS with emergency department triage and trauma system activation, and the evaluation of the ATS as a prehospital casemix and performance evaluation tool. Research into alternative triage tools to the ATS for use in the prehospital environment and into the impact of standardised triage training is also suggested.
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Shepherdson, Robyn, Jennifer Funderburk, Nadiya Sunderji, Nadiya Sunderji, and Jodi Polaha. "Program Evaluation Intensive: Practical Training in Selecting Measures and Data Collection Methods to Obtain Useful Outcome Data." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/6546.
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Do you need help determining appropriate measures and feasible data collection methods for program evaluations within integrated primary care? In this 3-hour preconference workshop, leaders from CFHA’s Research & Evaluation Committee and Families, Systems, & Health journal will provide practical training in conducting rigorous program evaluations. This workshop will help you identify appropriate measures to answer your key questions as well as data collection methods that balance quality and feasibility. This workshop is designed for those who are planning, conducting, or revising a program evaluation, as attendees will apply the material to their own personal projects within interactive small groups.
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Lilly, C., S. Henderson, Jodi Polaha, and R. Weierbach. "Evaluation of a Blended Behavioral Telehealth Model in a Rural Health Clinic: A Patient and Provider Perspective." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6588.
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Jayatilaka, Jennifer A. "An investigation of family literacy practices of eight families with preprimary children and a family literacy program conducted in a low socio-economic area." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/991.
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Study of the research literature showed that literacy skills are socialised in young children along with their learning of oral language. This socialisation process occurs within a child's home environment long before they enter formal schooling. Family literacy has been shown to have the potential to impact powerfully on children's perceptions about literacy use through role models and support provided by various family and community members. Literacy activity is often deeply embedded in daily family practices. For some children, differences between home and school literacy practices can occur. Where this mismatch occurs for children in low socio economic homes the problems associated can be compounded. In the present study a formative experimental design was used to investigate and describe some of the literacy practices of eight families living in a low socio-economic environment as identified by the parents of children attending a preprimary centre. Some family literacy programs designed to reduce the effect of the literacy mismatch between home and school have been found, in research literature, to be unsuitable for certain communities because of their inability to address the needs of individual families. The present study reports on the results of a family literacy program jointly planned by the teacher/researcher and parents of eight families from a low socio-economic community. It describes the nature of the family literacy program and the perceptions of the program held by the eight participants. Issues arising from this family literacy program design are highlighted and some implications for educational practice and further research are presented.
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Sisson, Evan M., McKenzie L. Calhoun, and Michael A. Crouch. "Dyslipidemia: Contemporary Evaluation and Management." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6874.
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After much anticipation, new dyslipidemia guidelines have been published by the American College of Cardiology (ACC) and American Heart Association (AHA). The guidelines are a major shift from specific lipid goals to a focus on risk reduction. All pharmacists will need to be familiar with these guidelines in order to provide optimal patient care.
Like all ASHP eReports, this is a brief and straightforward presentation of what you need to know about dyslipidemia treatment, the new guidelines, and where you can turn for deeper understanding of the context. Dyslipidemia: Contemporary Evaluation and Management addresses pathophysiology, clinical presentation, diagnosis, and disease classification, general treatment principles, non-pharmacological treatments, pharmacotherapy, monitoring, clinical controversies, and future treatment, references, and web resources.
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Jenkins, Louis S. "The development and evaluation of a portfolio of learning in the workplace for postgraduate family medicine education in South Africa." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86358.
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Thesis (PhD)--Stellenbosch University, 2014.ENGLISH ABSTRACT: A portfolio of learning is one way of showing evidence of performance over a period of time. Worldwide, the need for social accountability and health services reforms has led to an increased interest in competency-based medical education with specific outcomes. Postgraduate training increasingly focuses on life-long adult learning, placing emphasis on close supervision with feedback and workplace-based assessment. South Africa, although better resourced, faces many similar socio-political and health services challenges as the rest of Africa. The democracy is less than 20 years old, with 80% of the previously disadvantaged population now having access to health services. In this new era medical schools have aligned their curricula to focus on patient-centred primary health care. The huge demand for appropriately trained family physicians has become a national priority. Subsequently, the College of Family Physicians of the Colleges of Medicine of South Africa developed a national exit examination for postgraduate family medicine training. One component of the examination is the submission of a satisfactory portfolio of learning. The aim of this thesis was to develop a national portfolio for postgraduate family medicine education in South Africa. It needed to be valid, acceptable, useful for learning, and be assessed in a reliable way. The research process involved a collaboration with registrars, supervisors and programme managers from all eight medical schools in the country over four years and culminated in the first national portfolio for family medicine in the country. The thesis was done by way of publication, which involved four articles being published in international journals, outlining the development, implementation and assessment of our portfolio. Content and construct validity of the draft portfolio was established through a Delphi process. Subsequently, the portfolio was implemented at all eight medical schools. Workshops over two years at all the universities facilitated implementation and provided feedback on the use of the portfolio across the country. After implementation of this initial portfolio, the acceptability, educational impact, and usefulness for assessment were evaluated through a national survey and in-depth interviews. A portfolio assessment tool was developed and its reliability was established for the overall score. The assessment tool has also been implemented nationally. The portfolio’s requirements have made the expectations and challenges of workplace-based learning and assessment more visible, with supervision, safe learning environments and more user-friendly learning and assessment tools needing further research.
AFRIKAANSE OPSOMMING: ‘n Portefeulje met bewyse van opleiding is een manier om bevoegdheid en prestasie oor ‘n periode van tyd te demonstreer. Sosiale verantwoordelikheid en hervormings in gesondheidsdienste wêreldwyd het gelei tot vaardigheids-gebaseerde mediese opvoeding met spesiefieke uitkomste. Nagraadse opleiding fokus toenemend op lewenslange volwasse leermetodes met ‘n groot klem op nabye toesig, terugvoer en werksgebaseerde evaluasies. Alhoewel Suid-Afrika beter toegerus is as meeste lande in Afrika, staar die land baie soortgelyke sosiaal-politiese en gesondheids uitdagings in die gesig. Met die jong demokrasie van 20 jaar het 80% van mense wat voorheen nie toegang gehad het tot goeie gesondheidsdienste nie nou wel toegang. Mediese skole het hul kurrikulums aangepas om te konsentreer op pasient-gefokusde primêre gesondheidsorg. Die Kollege van Huisartse van die Kolleges van Geneeskunde van Suid-Afrika het ‘n nasionale eksamen vir nagraadse opleiding in huisartskunde in die land geimplementeer. Een van die komponente van die eksamen behels die inhandiging van ‘n bevredigende opleidingsportefeulje. Die doel van hierdie tesis was om ‘n nasionale portefeulje vir nagraadse opleiding in huisartskunde in Suid-Afrika te ontwikkel. Die portefeulje moes geldig en aanvaarbaar wees, asook nuttig vir leer en ook op ‘n betroubare manier evalueer kon word. ‘n Proses van samewerking tussen kliniese assistente, toesighouers en programbestuurders van al agt mediese skole in die land oor ‘n periode van vier jaar het die eerste nasionale opleidingsportefeulje vir huisartskunde in Suid-Afrika die lig laat sien. Hierdie is ‘n tesis by wyse van publikasie deur vier artikels wat in internasional journale verskyn het, wat die ontwikkeling, implementering, en evaluering van die portefeulje beskryf. Die geldigheid van die inhoud en samestelling van die portefeulje was ontwikkel deur ‘n Delphi proses. Nadat die portefeulje geimplementeer was, was die aanvaarding, leerimpak en nuttigheid vir evaluering ondersoek deur ‘n nasionale opname en in-diepte onderhoude. Werkswinkels by al die universiteite het die geldigheid en implemetering van die portefeulje verder versterk. ‘n Instrument om die portefeulje te evalueer was ontwikkel en in gebruik geneem landwyd, en betroubaarheid van die totale telling was bewerkstellig. Die behoeftes van die portefeulje het die verwagtinge en uitdagings van werksgebaseerde opleiding en evaluering meer sigbaar gemaak, met toesighouding, veilige leeromgewings en meer gebruiksvriendelike leer- en evalueringsinstrumente as areas identifiseer wat aangaande navorsing benodig.
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Boon, Johannes Marinus. "Procedures performed by family physicians in hospital practice in a developing country (South Africa) an evaluation of clinical anatomy competence /." Pretoria : [s.n.], 2009. http://upetd.up.ac.za/thesis/available/etd-07292009-093644/.
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Mospan, Courtney M., Rick Hess, Reid B. Blackwelder, Susan Glover, and Chris Dula. "A Two-Year Review of Suicide Ideation Assessments Among Medical, Nursing, and Pharmacy Students." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6904.
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Suicide is the 10th leading cause of death in the U.S. and has increased in prevalence during the past 15 years. Patients who attempt suicide are more likely to have contact with their primary care provider than a mental health provider in the month before attempting suicide, highlighting the need for competency in suicide ideation (SI) assessment. The Communications Skills for Health Professionals is an interprofessional course involving first-year medical, nursing, and pharmacy students. Specific instruction regarding assessment of SI was delivered through an online module and later practiced by students with standardized patients (SP). A final Objective Structured Clinical Examination featured an SP with depression, but without SI, though an assessment of SI was indicated. Three hundred fifty six interviews were reviewed and 55.1% (196/356) of students assessed for SI. Across professions, 65.5% (93/142) of medical students, 52.5% (32/61) of nursing students, and 46.4% (71/153) of pharmacy students performed an assessment. Medical students’ SI assessment was highest across the groups (p = 0.001), while pharmacy students’ SI assessment was lowest (p = 0.004). Results suggest that additional educational strategies should be developed and implemented to increase SI assessment performance in all professions, but especially in pharmacy students.
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Marquis, Ruth. "A qualitative evaluation of a bereavement service: An analysis of the experiences of service consumers and providers." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1994. https://ro.ecu.edu.au/theses/1681.
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Human service evaluation has become an important consideration in service delivery due to an increased demand for accountability by funding bodies. Time constraints, financial constraints and political interests, however, influence the implementation and outcomes of evaluation projects. As a result, quantitative methods are most frequently used. Information obtained as the result of quantitative studies which are politically expedient may present a superficial view of a program and overlook the fundamental issues of program delivery which are important to participants. Identification of the valued aspects of program involvement and areas of unmet need from participants' perspectives may remain unknown as a result of seeking information on predetermined and routine program processes in order to maintain the 'status quo'.
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Gifford, Valerie, Britton Niles, Inna Rivkin, Catherine Koverola, and Jodi Polaha. "Continuing Education Training Focused on the Development of Behavioral Telehealth Competencies in Behavioral Healthcare Providers." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6744.
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Introduction: Telehealth allows behavioral health care and specialty services to be extended to rural residents. Telehealth is an important resource for the Alaskan healthcare system, which is tasked with providing services to culturally diverse populations living in remote areas. Training competent providers to deliver telehealth services is vital for the implementation of successful telehealth programs. Yet, the literature is lacking in the area of provider behavioral telehealth competency training.
Methods: This study assessed the impact of a Behavioral Telehealth Ethical Competencies Training program on 16 behavioral health providers' development of behavioral telehealth competency. A total of 14 competencies were developed, which required participants to understand the roles and responsibilities of a behavioral telehealth coordinator working at the distal site as well as the roles and responsibilities of the therapist. Video vignettes evaluating the 14 competencies, self-reported competence surveys and follow-up surveys of progress on telehealth goals were utilized to assess effects of the training.
Results: Results indicated participants' behavioral telehealth competencies increased following training. Participants reported positive perceptions regarding their competency, and achieved progress on the majority of behavioral telehealth goals set during the training.
Conclusions: This study provides a baseline for developing a best practice model for behavioral telehealth service delivery by identifying specific provider competencies for administering effective behavioral telehealth services. A unique continuing education training model, led by content experts including university professors and Alaska Native Elders, incorporating behavioral telehealth, rural ethics, cultural competency and vicarious trauma training is described. Lastly, this study details the use of an innovative video vignette assessment instrument for evaluating the effectiveness of continuing education training.
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Menaglio, Darryl Frank. "Aims, separation and attitudinal factors in mediation: An exploratory investigation." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1327.
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The general aim of this research was to explore issues regarding mediation in family law about which there appears to be uncertainty. Study I investigated: (a) what stakeholders (practitioners and separated spouses) believe the aims of mediation should be; (b) what they believe are the effects of the separation factors, that is, perceived mutuality (whether the decision to separate was made by one or both spouses), perceived status (whether spouses view themselves as Ieavers, lefts or neither), and the attribution and strength of blaming someone for the decision to separate on attitudes towards engaging in mediation; and (c) stakeholders' views of the importance of the attitudinal factors (i.e. hope, expectation and commitment) for reaching agreement. The attitudinal factors were derived from Janis and Mann's (1977) theory of decision making. Study 2 investigated the operation of the separation and attitudinal factors in separated spouses attending mediation and the influence of specific biographical variables on these factors. The biographical variables were duration of separation, duration of marriage, gender and referral type. In Study I, 67 stakeholders (42 practitioners and 25 separated spouses) were of the opinion that spouses learning techniques to be able to resolve future disagreements should be the most important aim of the four aims of mediation suggested to them. Currently, the Family Law Act 1975 does not recognise this aim, though the finding is consistent with contemporary views of what the aim of mediation should be. Stakeholders also agreed that the separation factors substantially affect attitudes towards engagement in mediation and that the attitudinal factors are very important for reaching agreement. These findings are consistent with theories that suggest the separation factors influence engagement in mediation (Brown, 1985; Emery, 1994) and that the attitudinal factors are important for reaching agreement (Weitzman & Weitzman, 2000). In Study 2, 315 separated spouses (160 females, 155 males) attending court ordered (n = 150) and voluntary (n = 135) mediation responded to a questionnaire that sampled their biographical variables and the separation and attitudinal factors. Small significant χ2 measures (p < .001) revealed that the separation factors were associated. Specifically, when separated spouses perceived the decision to separate was non- mutual, they also were likely to perceive themselves as left or leavers. Those in the non-mutual, left group were more likely to blame and the majority of these were males. Analysis of a moderate significant Kendall rank correlation coefficient (p < .001) for the association between hope and commitment and weak/negligible associations between these factors and expectation revealed that separated spouses reported high levels of hope and commitment hut did not necessarily expect to reach agreement. Separated spouses who were court ordered were more likely to blame intensely (r = .24, p < .01), were less committed (w = .14, p < .001) and less expecting (w = .43, p < .001) to reach agreement than those who attended voluntarily. Expectation of reaching agreement was highest within 6 months of the decision to separate, while strength of blame for the decision to separate was most intense in those who were court ordered and those attending mediation within 6 months of the decision to separate. Implications of the findings for policy makers, assessment of separated spouses' readiness to engage in mediation and theory to guide mediation practice are discussed.
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Haber, Meirav. "Program Evaluation of a Pilot Project Using the Family Art Assessment to Support Clinical Treatment." Digital Commons at Loyola Marymount University and Loyola Law School, 2012. https://digitalcommons.lmu.edu/etd/101.
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This study explores the use of Helen Landgarten’s family art assessment in helping to inform therapists’ work with families. The study endeavors to evaluate a pilot project in which director of the Helen B. Landgarten Art Therapy Clinic, Dr. Paige Asawa, MFT, ATR-BC, implemented the Landgarten family art assessment at a local clinic with five families and involved family track clinicians through observation and discussion to inform their clinical treatment of families. Through program evaluation using a survey and an art-based research procedure, the study investigates family track clinicians’ experiences, recommendations, and opinions of the family art assessment. Ten family track clinicians participated in program evaluation in this study. A quantitative and qualitative analysis of participants’ survey answers and art responses served to solidify whether these clinicians found the family art assessment project beneficial to their clinical work with families. A synthesis of the literature, survey analysis, and art analysis reveals the value of having art therapists conduct family art assessments as an informative consultation for clinicians assessing and treating families. Study results may contribute to more formal inclusion of the family art assessment in assessment procedures at this local clinic. These results hold valuable implications for redefining the role of the art therapist as assessment expert, using art therapy to promote collaboration among mental health professionals, and ultimately improving the quality of clinical family care.
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Highsmith, McKenzie Calhoun, Jesse Gilreath, Peter Bockhorst, Kathleen White, and Beth Bailey. "Evaluation of an Innovative Transitional Care Clinic in an Interprofessional Teaching Practice." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/ijhse/vol7/iss1/5.
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During transitions of care, great opportunity exists for miscommunication, poor care coordination, adverse events, medication errors and unnecessary healthcare utilization costing billions of dollars annually. An Interprofessional Transitions of Care (IPTC) clinic was developed utilizing a Family Medicine team that included physicians, nurses, a clinical social worker, and a clinical pharmacist. The purpose of this study was to determine if utilization of an IPTC clinic prevented hospital readmission, and to identify factors that predict most benefit from an interprofessional approach to transitions of care. A retrospective chart review of 1,001 patients was completed. A treatment group (TG) of 501 patients were offered IPTC clinic appointments following hospital discharge. A control group (CG) of 500 patients were hospitalized and received traditional follow-up prior to development of the IPTC clinic. Traditional follow-up typically consisted of an automated appointment reminder and a physician office visit. Outcomes assessed included 30-day hospital readmission of TG versus CG, and whether patient characteristics predisposed specific patient groups to attend IPTC appointments or benefit more from IPTC participation. Compared with CG, patients who completed an IPTC appointment were 48% less likely to be readmitted to the hospital within 30 days. Patients with congestive heart failure and cellulitis particularly benefited from IPTC. Telephone contact within two business days of discharge was the greatest predictor of patients attending an IPTC appointment. These results demonstrate that an interprofessional approach to transitions in care effectively addresses this high risk for error and high cost time in the continuum of care.
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Farmer, Cortney, Havya Dave, Zachary Sumpter, Patricia Conner, and Amanda Stoltz. "OUTPATIENT EVALUATION & MANAGEMENT BILLING AND CODING: DEVELOPMENT OF ENDURING CURRICULUM FOR PGY1 RESIDENT EDUCATION IN A RURAL FAMILY MEDICINE PRACTICE." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/162.
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Accurate Evaluation and Management (E&M) billing and coding is an essential skill for medical clinicians. Consequences of incorrect E&M billing and coding include delayed patient treatment, delayed reimbursements from third party payers, and even charges of insurance fraud. The accuracy of billing and coding is especially salient in practices whose patient population is covered primarily by Medicare/Medicaid, as is the case in many Northeast Tennessee clinics. Despite the importance of accurate E&M billing and coding, recently graduated physicians moving into their first year of residency are often under-informed regarding proper billing and coding. Much of their knowledge about the process is picked up piecemeal over the course of their residency. The purpose of this study is to educate incoming post-graduate year one (PGY1) medical residents on the E&M billing and coding system for a rural Family Medicine clinic. During their first month as PGY1 resident physicians, participants were given a survey to assess their knowledge of E&M billing and coding for outpatient encounters. Participants then attended an educational session on this topic and received handouts that they could reference in the future. The participants were then surveyed again. Data analysis is currently underway. A repeated measure t-test will be utilized to determine if the educational session and informational handouts led to a statistically significant increase in PGY1 resident knowledge of E&M billing and coding. It is expected that participants will show significant knowledge gains as a result of the educational training. This research has important implications for medical resident training, particularly in rural practices that treat large populations covered by Medicare/Medicaid.
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Ho, Andy Hau Yan. "Health promoting palliative care through higher education reform : development and evaluation of a new humanities course in thanatology." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/33917/.
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Under a socio-cultural backdrop where death and loss is heavily stigmatized and community resources for the dying and the bereaved are lacking, Hong Kong requires a public health approach for empowering its people to become active participants in the governance of mortality. “Health-promoting palliative care” (HPPC) translates the hospice ideals of total person care into much broader public health languages and practices, focusing not only on palliation but also prevention, harm reduction, community action, policy advocacy, and most importantly, education and research. Despite their significance, life and death education and Thanatology research has received little attention in Hong Kong. The recent General Education (GE) reform for tertiary institutions, which aims to nurture students’ creativity and civility through the liberal arts, provides a timely opportunity to actualize HPPC. The current study provides a formative account of the development and implementation of a new thanatology course, “The Last Dance: Understanding Death and Dying” offered by the University of Hong Kong, and critically examines its efficacy for reducing negative death perceptions and enhancing positive life attitudes among a group of undergraduate students. Adopting a mixed methods research design and a holistic approach to education evaluation, it utilizes: 1) a quantitative pretest-posttest survey to assess course effectiveness with the standardized tools of Death Attitude Profile-Revised, Meaning-in-Life Scale and Spirituality Scale, as well as a series of ad hoc items on traditional death taboos and death preparedness behaviors; and 2) a qualitative analysis of 100 randomly selected students’ reflective writings for identifying factors that facilitate effective learning. Results from paired-sample t-test with 85 students who have successfully completed the pretest-posttest survey provide robust evidence that The Last Dance was effective in significantly reducing students’ fear of death, death avoidance tendency, and taboo beliefs that oppress death, while promoting active participation in the governance of mortality through increased death preparedness behaviors. Moreover, The Last Dance was found to be effective in enhancing students’ sense of meaning in life, spirituality and interconnectedness. Framework analysis of Students’ reflective writing revealed 12 themes that illuminate the specific learning contents, pedagogy activities, key attitudinal and behavioral changes, as well as significant learning outcomes which supported the quantitative results. These 12 themes were organized into four categories: 1) “Mortality Matters”, which includes Consideration of Palliative Care and Euthanasia, Expression of Death via Arts and Media, and Exploration of Death Rituals and Spirituality; 2) “Teachable Moments” which includes Multi-Media Lectures, Funeral Home Visitation, and Examination of life; 3) “Shifting Perspectives”, which encompasses Cultivating Insights, Renewing Meaning, and Applying Knowledge; and 4) “Ego Awakening” which encompasses Normalization of death, Appreciation of Life, and Recognition of Common Humanity. These 4 categories and their respective 12 themes together form a “Thanatology Pathway to Transformative Growth”, highlighting the vital significance of carefully integrating stimulating learning contents with engaging pedagogical activities for developing an effective and holistic thanatology curriculum; one that focuses not only on skills and knowledge transfer, but also on cultivating life appreciation and compassionate living through an enhanced understanding of death, dying and bereavement.
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Brereton, John. "An evaluation of introducing advanced airway skills in the Western Australian Ambulance Service." University of Western Australia. Emergency Medicine Discipline Group, 2004. http://theses.library.uwa.edu.au/adt-WU2005.0065.
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[Truncated abstract] Objective: To investigate the demographics, success rate of application, nature and frequency of complication and the survival outcome of patients receiving advanced airway management in the pre-hospital setting. Design: Prospective observational cohort study. Participants: Patients who were attended to by St. John Ambulance Paramedics in the Perth Metropolitan area and selected regional areas within Western Australia. The patients were unconscious, unresponsive with no gag reflex and where application of an advanced airway would improve ventilation. Methods: Ambulance Paramedics received mannequin training within the classroom environment on the techniques for the application of the Endo-Tracheal Tube and the Laryngeal Mask Airway. The indication for the application of an advanced airway was any patient whose ventilation may be improved by intubation. These patients would be either deeply unconscious and areflexic, long term transport, severely injured (especially head injured) or cardiac arrest patients. Results: ... Paramedic assessment demonstrated that 14 (7.4%) 3 patients had an improvement in outcome. Of the 14 patients, 5 (2.7%) cardiac arrest patients survived to discharge from hospital compared to a 2.1 % survival rate for all cardiac arrest cases attended by the WAAS in 2002. Conclusion: Ambulance Paramedics can successfully apply an advanced airway apparatus in the pre-hospital environment. There was no statistical significance to demonstrate whether the introduction of advanced airway skills was beneficial or detrimental to patient survival outcome.
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Watson, Paula. "Feasibility evaluation and long-term follow up of a family-based behaviour change intervention for overweight children (GOALS)." Thesis, Liverpool John Moores University, 2012. http://researchonline.ljmu.ac.uk/6116/.
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Childhood obesity is the most serious public health challenge of the 21st century. Whilst evidence supports a family-based lifestyle approach to childhood obesity treatment, research is needed to understand how interventions work and how practitioners can effectively support families to sustain behavioural changes in the long-term. This thesis evaluated the feasibility of a family-based behaviour change intervention for overweight children (GOALS) and explored the psychosocial process of long-term behavioural change in families with overweight children. Study 1 measured the impact of GOALS on the body composition, lifestyle behaviours and self-perceptions of children and parents who completed the intervention. A complete case analysis (n=70) showed a significant 6-month reduction in child BMI SOS (-0.07, p < 0.001) that was maintained at 12-month follow up. There was a significant year-on-year increase in the proportion of children reducing BMI SOS (42.9% year 1, 62.5% year 2, 80% year 3, p < 0.05) and a strong positive relationship between parent and child BMI change (r = .479, p < 0.001). Parents reported positive changes to their own and their children's physical activity and diet. BMI SOS reduction during the intervention was associated with improved global self-esteem and perceived physical appearance at 12 months. Study 2 explored the experiences of families six weeks into the 18-session intervention through focus groups with parents and children. Motivators to attend GOALS included the non-judgemental approach, being in the same boat as others and child enjoyment. The whole family approach was perceived positively and families used BCTs both as a core component of GOALS and to facilitate their behaviour change at home. As well as the challenges of living with childhood overweight, families described a lack of support from extended family members and a perceived need for on-going professional support. Study 3 followed up 15 families 3-5 years after they attended GOALS. Child and parent BMI was collected and parents took part in a semi-structured interview to explore their perceptions of "success" and their experiences of changing physical activity and eating behaviours. Mean child BMI SOS change from baseline was -0.47 for the 14 families who had completed GOALS. The majority of families perceived positive long-term outcomes, but these were not always aligned with actual child weight change. The most "successful" families placed a priority on changing child weight-related behaviours and parents took responsibility for these changes. While weight-control was a conscious process for these families, it was not necessarily made a "big issue" and parents used practices of an authoritative nature to facilitate change. Physical activity had become a way of life for the children, and mothers had reached a stage of feeling in control of their own weight. This is the first UK childhood obesity treatment study to follow children up beyond 12 months, and the first known study worldwide to employ qualitative methods to explore parental perceptions of long-term success. Findings provided a unique insight into the process of long-term behavioural change for overweight children and raised questions about the way "success" is defined following participation in childhood obesity treatment. Recommendations are made to enhance the delivery of family-based childhood obesity treatment and policy-makers are urged to adopt a multilevel approach to tackling childhood obesity, with child weight management care pathways that recognise the heterogeneity of familial needs. Further research is required to substantiate the impact of GOALS, and to prospectively explore the process of behavioural change in overweight children and the familial factors that serve as moderators in this process.
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Teterina, Evgeniya, L. Foye, Judy G. McCook, L. Reed, A. Nelson, M. Edens, M. Martinez, Anthony DeLucia, and Ivy Click. "Stress Evaluation and Reduction in a Rural Middle School Population." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/7179.
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Grobbelaar, Cornelis Johannes (Nelis). "Exploring programme design, evaluation of programme performance and describing the clinical outcomes of a public sector based ARV treatment programme in a semi-rural area in the Western Cape over the past 6 years. (2004-2010)." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/80460.
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Thesis (MFamMed)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Background: A national roll-out of antiretroviral therapy in the public sector was started in 2004, and Paarl was one of the first sites to start these services in the Western Cape. Operational research is required to guide the continuous improvement of such services. This research aimed to describe the characteristics of the treatment cohort started at TC Newman CDC’s ARV clinic in Paarl, to determine the retention in treatment rate and to assess the clinical and virological outcomes. Methods: A retrospective descriptive and observational study was done at the TC Newman ARV clinic in Paarl. All adult HIV positive patients that were started on antiretroviral therapy in the given time period were included. Patient and treatment data had been collected in an electronic database (e-register) and were extracted and analysed. Results: Starters: Out of the 2469 patients that were enrolled for ARV treatment between February 2004 and December 2010, 2254 started locally (the rest transferred in). 64% of them were female (decreasing rate over the years). Strugglers: By June 2011 51.5% of patients were still on ARVs, 6.9% patients had died, 16.7% had been ‘transferred out’and 24.7% were reported as ‘Lost to Follow-up’. 40% of the attrition of the cohort occurred in the first 6 months, 70% in the first 18 months. Stayers: Of the 1172 patients retained after start at TC Newman CDC, 1023 (87.3%) were still on Regime 1 and 149 (12.7%) on Regime 2. Conclusions: The results of this treatment cohort (mortality, treatment retention and regimen durability) equal those in other published treatment cohorts, although very limited comparable data are available. However, the high ‘lost to follow-up’ rate is of concern and needs further investigation. Changes in the programme structure and environment tend to have an immediate effect on initiation numbers of new patients.
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Dawahare, Mollie Y. "PROMOTING HEALTHY HOME-COOKED FAMILY MEALS: EVALUATION OF A SOCIAL MARKETING PROGRAM TARGETING LOW-INCOME MOTHERS." UKnowledge, 2016. http://uknowledge.uky.edu/foodsci_etds/43.
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Objective: Evaluate how a social marketing approach compares to traditional nutrition education curriculum for promoting behavioral changes related to eating and food.
Design: Nonequivalent comparison group, entry-exit design. Participants from 12 Kentucky counties assigned either comparison or pilot group. Comparison group received traditional nutrition education curriculum and pilot group received the social marketing program, Cook Together, Eat Together (CTET) curriculum. EFNEP’s Behavior Checklist and 24-Hour Dietary Recall were administered at entry and exit of the 8-week programs.
Participants: Females (18-72 years of age) from families eligible to receive SNAP benefits (n=64 comparison group participants, n=60 pilot group participants).
Intervention: Comparison group completed an 8-week standard lesson and pilot group completed CTET program in varying time frames (1-8 weeks).
Main Outcome Measures: Eating behavior changes between entry and exit for comparison versus pilot.
Analysis: Quantitative data were analyzed using independent and paired t-tests with significance of P≤ 0.05 and 0.10.
Results: Groups were demographically similar. Both had significant differences in entry and exit scores for Behavior Checklist and 24-Hour Recall (P≤ 0.05).
Conclusion and Implications: Positive behavior change was observed in both comparison and pilot groups. A social marketing program proves to be a promising approach to nutrition education.
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Mash, Rachel A. "Agents of change : the implementation and evaluation of a peer education programme on sexuality in the Anglican church of the Western Cape." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17836.
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Thesis (PhD)--Stellenbosch University, 2011.ENGLISH ABSTRACT: INTRODUCTION Religion is important in Africa and many churches are involved in HIV ministry. Prevention programmes, however, are less frequent in the church setting and there is little evaluation of them. If an effective model is found, it can contribute to HIV prevention efforts in Sub-Saharan Africa. This study was conducted in the Cape Town Diocese of the Anglican Church. Fikelela, an HIV/AIDS project of the Diocese, developed a 20-session peer education programme (Agents of Change) aimed at changing the risky sexual behaviour of youth. Workshops were also aimed at parents. A literature review was conducted looking at three areas: 'theories of behaviour change', 'adolescent sexual relationships' and 'religion and HIV'. A conceptual framework for the programme was developed by integrating findings from the literature review. The aim of this research was to evaluate the effectiveness and functioning of the programme, to develop a best practice model and to make recommendations for the use of the programme in the wider church. METHODS Outcome mapping was used to integrate an approach to the design, monitoring and evaluation of the programme. Changes in project partners, key project strategies and organisational practices were all monitored. Project partners were defined as peer educators, facilitators, young people, clergy and parents. Monitoring allowed an in-depth understanding of which aspects of the programme worked. Evaluation was designed as a quasi-experimental study that compared non-randomly chosen intervention and control groups. 1352 participants took part at base-line, 176 returned matched questionnaires in the intervention groups and 92 in the control groups. Reported changes in attitudes, knowledge and sexual behaviour were compared between the two groups. RESULTS The main factors leading to the success of the programme were: a well developed curriculum and programme, effective training camps, the support given by facilitators to peer educators, ongoing mentoring and training, role modelling by peer educators, a participatory style of education and positive peer pressure within a strong church based social network. Challenging the church.s negative attitude to condoms was also important. The weakest areas of the programme were amongst clergy and parents and in challenging media messages and norms on gender. The project impact evaluation showed significant differences at baseline between genders in terms of sexual beliefs and behaviour. There was no significant impact of religiosity on sexual activity. The programme was successful at increasing condom usage (Condom use score 3.5 vs. 2.1; p=0.02) and reduced sexual debut (9.6% vs. 22.6%; p=0.04). There was increased abstinence amongst the intervention group, but it did not reach statistical significance (22.5% vs. 12,5%; p=0.25). There was no effect on the number of partners (Mean 1.7 vs. 1.4; p=0.67). CONCLUSIONS Implementation: The programme should be promoted as a youth development programme rather than an HIV prevention programme. Priority should be given to churches in communities with the highest HIV rates. The target group should include younger teens. Peer educators should be selected by peers not by adults. Strategies: The strategies of training camp and quarterly gatherings are effective, but a new strategy needs to be devised to impact the parents. Content: The programme should build self-efficacy amongst the youth, develop a critical consciousness about sexual health, provide positive messages rather than fear-inducing ones, address sexual coercion and persuasion, explore the linking of condom use with trust, address inter-generational sex and promote community outreach and advocacy activities. The programme is effective and meets the threshold of evidence required to be rolled out. It should be rolled out through the Anglican Church with its estimated membership of two million and could be adapted for other denominations as well.
AFRIKAANSE OPSOMMING: INLEIDING Godsdiens is belangrik in Afrika en talle kerke is betrokke by HIV-bediening. Voorkomingsprogramme is egter ongewoon in die kerkomgewing en die evaluering daarvan vind selde plaas. Indien 'n effektiewe voorkomingsprogram model gevind kan word, behoort dit 'n belangrike bydrae te lewer tot HIV infeksie voorkomingspogings in Sub-Sahara Afrika. Hierdie studie is gedoen onder die lidmate van die Kaapstadse Biskoplike gebied van die Anglikaanse Kerk. 'n Bestaande HIV/VIGS projek van die Biskoplike gebied, genaamd Fikelela, het 'n 20-sessie portuurgroepopvoedingsprogram (Agente van Verandering) ontwikkel wat gemik is op die verandering van riskante seksuele gedrag onder die jeug. Daar was ook werkswinkels gemik op ouers. 'n Voorstellingsraamwerk vir die program is ontwikkel deur die integrasie van gedragsveranderingsteorieë met bewyse ten opsigte van verandering van seksuele gedrag onder adolossente en die invloed van godsdiens op adolossente seksualiteit. Die doelwit van hierdie navorsing was om die doeltreffendheid en funksionering van die program te evalueer, 'n optimale praktiese model te ontwikkel en aanbevelings vir die gebruik van die program aan 'n wyer sirkel van kerke te maak. METODES Uitkomskartering is gebruik om 'n benadering tot die ontwerp, waarneming en evaluering van die program te integreer. Alle veranderinge in projekvennote, sleutelprojekstrategieë en organisatoriese handelinge is waargeneem. Projekvennote is gedefinieër as portuurgroepopvoeders, fasiliteerders, jongmense, leraars en ouers. 'n Diepgaande begrip van watter aspekte van die program gewerk het, is bewerkstellig. Die evaluasie was ontwerp as 'n prospektiewe bykans-eksperimentele studie wat nie-lukraak gekose intervensiegroepe en kontrolegroepe vergelyk het. Daar was1352 deelnemers by aanvang, 176 afgepaarde vraelyste is teruggestuur in die intervensiegroepe en 92 in die kontrolegroepe. Veranderings in houdings, kennis en seksuele gedrag wat gerapporteer is, is tussen die twee groepe vergelyk. RESULTATE Die hooffaktore wat tot die sukses van die program gelei het, was: 'n goed ontwikkelde kurrikulum en program, effektiewe opleidingskampe, ondersteuning aan portuurgroepopvoeders deur die fasiliteerders, deurlopende raadgewing en opleiding, portuurgroepopvoeders as rolmodelle, 'n deelnemende styl van opvoeding en positiewe groepsdruk binne 'n sterk kerkgebaseerde sosiale netwerk. Die uitdaging van die kerk se negatiewe houding teenoor kondome was ook belangrik. Die swakste areas van die program was onder die leraars en ouers en in die uitdaging van media boodskappe en norme aangaande geslagskwessies. Die evaluering van die projekimpak het betekenisvolle verskille op grondslag tussen geslagte in terme van seksuele geloof en gedrag getoon. Daar was geen betekenisvolle impak van godsienstigheid op seksuele aktiwiteit nie. Die program was wel suksesvol in die toename van kondoomgebruik (p=0.02) en verhoging in ouderdom van eerste seksuele optrede (p =0.04), maar het geen impak in toename van geheelonthouding onder dié wie alreeds seksueel aktief is (p=0.25) of op die aantal seksmaats (p=0.67) gewys nie. GEVOLGTREKKING Implementering: Die program moet eerder as 'n jeug-ontwikkelingsprogram, as 'n HIV-voorkomingsprogram bemark word. Kerke in gemeenskappe met die hoogste HIV-koers moet voorkeur geniet. Die teikengroep moet jonger tieners insluit. Portuurgroepopvoeders moet deur portuurgroepe self aangewys word en nie deur volwassenes nie. Strategieë: Die strategieë van opleidingskampe en kwartaalikse byeenkomste is effektief, maar nuwe strategieë word benodig om 'n impak op ouers te maak. Inhoud: Die program behoort self-doeltreffendheid onder die jeug te bou, 'n kritiese bewustheid oor seksuele gesondheid te ontwikkel, eerder positiewe as vrees-gebaseerde boodskappe aan te bied, seksuele dwang en oorreding aan te spreek, die verband tussen kondoomgebruik en vertroue te verken, intergenerasie-seks aan te spreek en gemeenskapsuitreik- en aanbevelingsprogramme te bevorder. Die program is effektief en voldoen aan die verlangde bewyse ten einde aangewend te kan word.Met sy geskatte lidmaatskap van twee miljoen behoort die Anglikaanse Kerk dit aan te wend en kan dit ook vir ander denominasies aangepas word.
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Ho, Kwok Ming. "Use of prognostic scoring systems to predict outcomes of critically ill patients." University of Western Australia. School of Medicine and Pharmacology, 2008. http://theses.library.uwa.edu.au/adt-WU2009.0101.
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[Tuncated abstract] This research thesis consists of five sections. Section one provides the background information (chapter 1) and a description of characteristics of the cohort and the methods of analysis (chapter 2). The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system is one of commonly used severity of illness scoring systems in many intensive care units (ICUs). Section two of this thesis includes an assessment of the performance of the APACHE II scoring system in an Australian context. First, the performance of the APACHE II scoring system in predicting hospital mortality of critically ill patients in an ICU of a tertiary university teaching hospital in Western Australia was assessed (Chapter 3). Second, a simple modification of the traditional APACHE II scoring system, the 'admission APACHE II scoring system', generated by replacing the worst first 24-hour data by the ICU admission physiological and laboratory data was assessed (Chapter 3). Indigenous and Aboriginal Australians constitute a significant proportion of the population in Western Australia (3.2%) and have marked social disadvantage when compared to other Australians. The difference in the pattern of critical illness between indigenous and non-indigenous Australians and also whether the performance of the APACHE II scoring system was comparable between these two groups of critically ill patients in Western Australia was assessed (Chapter 4). Both discrimination and calibration are important indicators of the performance of a prognostic scoring system. ... The use of the APACHE II scoring system in patients readmitted to ICU during the same hospitalisation was evaluated and also whether incorporating events prior to the ICU readmission to the APACHE II scoring system would improve its ability to predict hospital mortality of ICU readmission was assessed in chapter 10. Whilst there have been a number of studies investigating predictors of post-ICU in-hospital mortality none have investigated whether unresolved or latent inflammation and sepsis may be an important predictor. Section four examines the role of inflammatory markers measured at ICU discharge on predicting ICU re- 4 admission (Chapter 11) and in-hospital mortality during the same hospitalisation (Chapter 12) and whether some of these inflammatory markers were more important than organ failure score and the APACHE II scoring system in predicting these outcomes. Section five describes the development of a new prognostic scoring system that can estimate median survival time and long term survival probabilities for critically ill patients (Chapter 13). An assessment of the effects of other factors such as socioeconomic status and Aboriginality on the long term survival of critically ill patients in an Australian ICU was assessed (Chapter 14). Section six provides the conclusions. Chapter 15 includes a summary and discussion of the findings of this thesis and outlines possible future directions for further research in this important aspect of intensive care medicine.
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Nygren, Peggy. "Exploring the Effects of Multi-Level Protective and Risk Factors on Child and Parenting Outcomes in Families Participating in Healthy Start/Healthy Families Oregon (HS/HFO)." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1513.
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While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy Families Oregon (HS/HFO) home visitation program (treatment group) who completed a follow-up phone survey at the child’s 12 month birthday (n = 405). Families were offered HS/HFO services prenatally after meeting risk screening eligibility criteria on the New Baby Questionnaire (NBQ). Program mothers having received at least one home visit (n = 248) were included in the final analyses. Families had an average of 3.1 (SD = 1.2) NBQ risk factors at enrollment and 83% reported having trouble paying for basic needs. Families received an average of 16 home visits in the first 6 months of the program. Thirty-one percent of mothers were aged 19 or younger, 60% were White and Non-Hispanic, 31% were Hispanic, and 9% were another race/ethnicity. Hierarchical regression models with main effects (RFI, PFI, race) and an interaction term (RFI X PFI) were developed to predict eight outcomes. Interaction effects models were not significant. Five RFI main effects were significant: higher RFI scores were associated with greater likelihood of child welfare involvement, greater parenting stress, less favorable scores on child health and well-being, lower parent responsiveness and ii acceptance, and less supportive learning environments. One PFI main effect was significant: higher PFI scores predicted lower parenting stress. A trend level result showed higher PFI scores were associated with less child welfare involvement. Race was significant in two models: White/Non-Hispanic families were more likely to have a home visitor report child welfare involvement and had more frequent parent-child activities compared to other race/ethnicity families. Unpacking the results with separate single risk factor (12 items) and protective factor (10 items) regression models followed. Results showed parent’s prior family history of maltreatment and younger maternal age predicted child welfare involvement (home visitor report), while protection was seen for those with access to housing support. Social support and family functioning protectors were linked to lower parenting stress, while maternal depression showed the opposite finding. Better scores on a child health and well-being measure were seen with higher neighborhood cohesion and greater participation in HS/HFO; in contrast, neighborhood violence and frequent mobility were linked to worse scores. Developmentally supportive home environments were seen for families participating in additional parent support programs, in which the mother had greater knowledge of infant milestones and behavior, and if the family had access to housing supports. Unemployment proved to be associated with less enriched home environments. In summary, there was no support for the cumulative PFI in buffering risk for negative outcomes in this model. The RFI was also a more robust predictor of outcomes compared to the PFI in the main effects models. Overall, study findings provide some evidence for the utility of specific protective factors, as well as cumulative and specific single risk factors, for screening families for effectively targeting services and guiding the conceptual development of program and evaluation formats.
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Abdolahi, Beta S. "An Evaluation of Comprehensive Projects Used in an Expressive Arts Workshop for Cancer Patients and Survivors." Digital Commons at Loyola Marymount University and Loyola Law School, 2020. https://digitalcommons.lmu.edu/etd/910.
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This research project examines an array of art prompts and projects that have been used in program-based art making workshops to facilitate creative expression amongst those who have been impacted by a cancer diagnosis. The review of literature emphasizes the value of this research, as the field of healing arts programs/expressive arts workshops in cancer care is varied and sparse. While there is substantial research that indicates art therapy to be a highly valued and accepted clinical intervention used in cancer care, there is little research that focuses on the specific role of art making with cancer patients/survivors and even less research on program-based art making workshops. As an artist and cancer survivor, this research incorporates my lived experiences to inform the cataloging, evaluation, and analysis of five art projects completed and used as inspiration for a program-based art-making workshop. The artworks included are an altered book, a cloth doll, a paper mask, a wooden box, and a Styrofoam head. The five central themes that arose from these five particular projects include that they were fun/engaging, encouraged play/experimentation, increased self-understanding, fostered the need to creatively express unexpressed emotions, and offered a sense of pride/accomplishment. This preliminary research project suggests that a broader investigation is needed in order to gather a deeper understanding of the impact of program-based expressive arts workshops as a healing modality with this patient population.
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DeSanto, Lara, Sarah Han, and Cecilia Sánchez. "Evaluating Standardized Assessments’ Ability to Capture Lived Experience of Cancer Patients and Survivors in Art Therapy Groups." Digital Commons at Loyola Marymount University and Loyola Law School, 2021. https://digitalcommons.lmu.edu/etd/954.
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This paper explores the use of quantitative assessments typically used in research to evaluate experiences of cancer patients and survivors receiving group art therapy services. Literature exploring program evaluation as a methodology, how current research selects standardized measurement tools for the evaluation of art therapy interventions with adult cancer patients and survivors, and on the efficacy of art therapy with this population is reviewed.
Quantitative and qualitative data were collected from four participants, who were clients in two eight-week art therapy groups. Quantitative data were collected in the form of pre- and post-test measurements using six commonly used standardized quality of life assessment tools. Qualitative data were collected via focus groups and art responses. Quantitative data were analyzed to identify general trends in the pre- and post-test measures, demonstrating that no significant positive shifts in symptoms or well-being were documented in the tests. Qualitative data were then analyzed to identify six prominent themes, including the impact of the COVID-19 pandemic on the participants’ experience of the tests, the participants’ perceived personal value of the tests, pre- and post-test measures as containment of experience, art responses as accurate representations of the benefits of art therapy, participants’ passion for art therapy, and participants’ feelings that standardized tests did not accurately capture their experience in the group. These findings were then examined in the context of the literature reviewed, and it was concluded that while standardized assessments have a valuable place in research, they do not effectively capture the lived experience of participants in art therapy groups. Furthermore, future research should continue to explore the value of qualitative research, including that which uses art-making, in evaluating art therapy programs and effectiveness.
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Summers, Michael. "Great expectations : a policy case study of four case management programs in one organisation /." Connect to thesis, 2007. http://repository.unimelb.edu.au/10187/2182.
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Four different case management programs delivered by UnitingCare Community Options (UCCO) in the eastern suburbs of Melbourne were examined against the expectations of case management as a policy solution to a range of perceived policy problems at the micro-, meso- and macro-levels. The micro-level expectations were related to client and family experiences of the service system and outcomes. At the meso-level expectations were focused on perceived service delivery problems such as poor matching of services to the needs of ‘complex’ clients including a lack of integration, flexibility and responsiveness to clients’ needs and preferences. Perceived macro-level policy problems were concerned with a variety of issues including increasing rates of institutionalisation, increasing costs to governments, lack of economic efficiency and the desire to create market or quasi-market conditions in the community care service delivery sector. (For complete abstract open document)
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Patterson, Andrea M. "Evaluating The Effects of an Educational Lifestyle Modification Intervention on Blood Pressure in Adults With Prehypertension." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/496.
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The purpose of this project was to evaluate the effectiveness of an educational lifestyle modification (LM) intervention on blood pressure (BP) among adults with prehypertension. Prehypertension is a precursor to hypertension (HTN) and is a public epidemic in the United States. Approximately 68 million (31%) U.S. adult’s aged ≥18 years have hypertension. Hypertension can cause significant target organ damage, lead to coronary heart disease, heart failure, stroke, and kidney failure. Early identification and the primary treatment of persons with prehypertension with LM have the potential to minimize the progression and delay the onset of comorbidities associated with hypertension. This quality improvement project retrospectively reviewed changes in blood pressure for a small sample (n=5) of patients diagnosed with prehypertension who received education about modifying lifestyle behaviors according to nationally accepted clinical practice guidelines. Blood pressure measurements were extracted from the medical record beginning at the time of the education through a three month period. Descriptive data indicates that all five patients had a decrease in systolic and diastolic blood pressure. The median systolic blood pressure at baseline was 129 mmHg decreasing to 121 mmHg at end of study period. The median diastolic blood pressure was 86 mmHg decreasing to 76 mmHg. Integration of lifestyle modification education and subsequent blood pressure monitoring during a routine primary care visit is feasible and may help motivate patients to implement changes and subsequently reduce blood pressure. Future studies should include identifying strategies for improving patient participation.
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Liljeroos, Maria. "Caring needs in patient-partner dyads affected by heart failure : An evaluation of the long-term effects of a dyadic psycho-educational intervention." Doctoral thesis, Linköpings universitet, Avdelningen för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-133182.
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Introduction: As medical treatment has improved, patients with heart failure (HF) now live longer and care mostly takes place at home with partners providing the main assistance. Taking care of an ill or disabled individual imposes a well-documented burden on the partner’s healthrelated quality of life. The awareness of partners’ burdensome situation is increasing, but few interventions have targeted the needs of patientpartner dyads with HF. The results have been inconclusive and give no clear guidance on how interventional programmes should be designed to improve both patient and partner outcomes. Aim: The overall aim of this thesis was to evaluate the effects of a psychoeducational intervention delivered to patient-partner dyads with HF during long-term follow-up, and to explore the dyads’ perceived caring needs. Methods: The thesis is based on four papers that used both quantitative and qualitative data. Study I and II used a randomized controlled design with a follow-up assessment after 24 months including 155 patientpartner dyads. The control group received care as usual. The intervention group received care as usual, and in addition they participated in the nurse-led psycho-educational intervention. Data was collected using questionnaires before and 24 months after the intervention, in order to determine the long-term effects on patients and partners regarding health related quality of life, perceived control, symptoms of depression and partners’ caregiver burden (I, II). A conceptual health promotion model inspired the intervention. To describe how the model was applied, a qualitative approach analysing nurses’ documentation of the sessions with 71 dyads in the intervention group (III) was used. Study IV has an explorative design. To further explore the dyads’ perceived caring needs, focus groups interviews with 19 patient-partner dyads with heart failure (IV) were performed. Results: The intervention did not have any significant effect on physical or mental health- related quality of life, depressive symptoms, or perceived control over the heart failure among the dyads (I) or caregiver burden in the partners (II) after 24 months. Furthermore, time to first event did not differ significantly between the dyads in the intervention group and the control group (I, II). As for the partners, both the intervention and control group reported decreased physical health between the baseline assessment and the 24-month follow-up (I). The intervention was composed of three components; 1) cognitive 2) supportive, and 3) behavioural component. The analysis of the nurses’ documentation confirmed the coverage of all the components and the analysis revealed a vide range of caring needs among the dyads (III). The dyads described a need to learn about HF to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital and both the patient and the partner need to be present at the clinic visits. Meeting others who are in the same situation and sharing the burden in nurse-led group sessions was proposed as an opportunity to support each other and others (IV). Conclusions: Over the 24-month follow-up period, the intervention had a neutral effect on health- related quality of life, depressive symptoms and perceived control over the HF among the dyads, and on partners’ caregiver burden. Considering the fact that partners serve as a critical extension of the formal healthcare system, and that both patients and partners ask for more support, it will become crucial to find new ways to support dyads affected by heart failure. This thesis may be viewed as a first step in trying to understand dyads’ perceived caring needs, and it can serve as a guide in clinical work and when designing new dyadic interventions.
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Liedberg, Gunilla. "Women with fibromyalgia : Employment and daily life." Doctoral thesis, Linköping, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5184.
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Prorok, Jeanette C. "Evaluation of a Dementia Education Program for Family Medicine Residents." Thesis, 2010. http://hdl.handle.net/10012/5262.
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Background: Dementia diagnosis and management is increasing in importance in the training of future family physicians. This research evaluated the effects of a dementia education program on family medicine residents’ knowledge, attitudes and confidence with respect to dementia assessment and management. A questionnaire was developed and validated for these purposes. Additionally, a focus group was conducted with family physicians to generate recommendations for improving dementia education in family medicine residency programs.
Methods: The questionnaire consisted of a knowledge-based component, a component ascertaining preferences working with various age groups, and an attitudinal/comfort component. Test-retest reliability was assessed, in addition to validity by way of cognitive interviews. A content validity matrix was also completed.
Family medicine residents participating in the dementia education program were asked to complete the questionnaire at baseline, interim and following program completion. Willing residents also participated in program feedback interviews. After approximately three months, residents completed the questionnaire for long-term follow-up. Differences in scores were examined between the participants and a comparison group of family medicine residents without program exposure. Qualitative data from the feedback interviews and the focus group were transcribed and analyzed for common themes.
Results: Each questionnaire component demonstrated high internal consistency (Cronbach’s α: 0.83-0.91) and high intraclass correlation coefficients (0.74-0.91). Residents who had participated in the program scored significantly higher on the knowledge component compared to residents who did not, in addition to reporting greater comfort. Qualitative data indicated that residents found the program to be a valuable part of their residency education. Focus group results indicate that family physicians recommend the provision of early positive experiences facilitated by mentors, through a competency-based curriculum.
Discussion: The developed questionnaire is a reliable measure for assessing dementia knowledge, attitudes and confidence. Results from the dementia education program show that it is effective in improving family medicine residents’ knowledge on dementia diagnosis and management, as well as in increasing comfort levels. Qualitative data from feedback interviews indicate strong endorsement of the program by its participants. Recommendations generated from the focus group were found to be relevant to dementia education and potentially more broadly to geriatric education.
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Martin, Carmel. "The care of chronic illness in general practice." Phd thesis, 1998. http://hdl.handle.net/1885/147963.
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Hamilton, Joanne. "A curriculum needs assessment of the Family Medicine Residency Program at the University of Manitoba." 2010. http://hdl.handle.net/1993/4214.
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The College of Family Physicians of Canada, responsible for accreditation of residency programs, prescribe ‘The Four Principles of Family Medicine’ and the 27 competencies derived from them, as the curricular framework for Canadian family medicine residencies. The literature reveals little about the development of the Four Principles of Family Medicine. This study was conducted to determine the degree to which each competency was considered relevant to clinical practice and learned by recent graduates of the University of Manitoba Family Medicine program. For the 27 competencies, the ratings of graduates were similar to those of family medicine experts as the competencies were generally viewed as moderately important and frequently used. Graduates reported being well prepared in most of the competencies. This supports the use of the Four Principles of Family Medicine as a curricular framework for family physician trainees in Canada.
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Stacey, Anne F. "Enhancing the health of informal carers : implications for general practice, policy and public health in the 21st century / by A.F. Stacey." 2002. http://hdl.handle.net/2440/21860.
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"June 2002"Bibliography: p. 347-360.
xiii, 360, [200] p. : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (M.Med.Sc.)--University of Adelaide, Dept. of Public Health, 2002
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Stacey, Anne F. "Enhancing the health of informal carers : implications for general practice, policy and public health in the 21st century / by A.F. Stacey." Thesis, 2002. http://hdl.handle.net/2440/21860.
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Grech, Carol Margaret. "Coronial inquiries into fatal adverse events in South Australian hospitals : from inquest to practice / Carol Grech." 2004. http://hdl.handle.net/2440/22153.
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"October 2004"Includes bibliographical references (leaves 313-337)
x, 337 leaves : ill. (col.), maps (col.) ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2004
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Grech, Carol Margaret. "Coronial inquiries into fatal adverse events in South Australian hospitals : from inquest to practice / Carol Grech." Thesis, 2004. http://hdl.handle.net/2440/22153.
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Braunack-Mayer, Annette Joy. "General practitioners doing ethics : an empirical perspective on bioethical methods / Annette Braunack-Mayer." 1998. http://hdl.handle.net/2440/19348.
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Bibliography: p. 379-394.xi, 394 p. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 1988
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Gilley, Tim. "Enhancing learning in early childhood within the family: evaluation of practice and theory in a multi-cultural context." Thesis, 2002. https://vuir.vu.edu.au/15286/.
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This thesis provides an analysis of a particular approach to enhancing learning in early childhood within the family. It involves an evaluation of practice and theory in an
educationally disadvantaged and multi-cultural community. The Home Instruction Program for Preschool Youngsters (HIPPY) has a 30 year history and was inttoduced into Australia in 1998 by the Brotherhood of St Laurence. It is a two-year intensive program with four and five-year-old children and their families. Current understanding of the importance of learning in the early years, and intensive adult-child communication, explain why programs such as HIPPY which engage parents as teachers of their young children can be effective.
Early learning experiences are at home. Later programs in school often appear to be inadequate to redress early disadvantage because they intervene too late and lack the
resources to provide the necessary adult-to-child input. The research reported here was an evaluation of the second intake of 33 children (32 families) into HIPPY in Australia. A triangulation research method involved (a) participant observation of the program, (b) interviews with stakeholders, and (c) an assessment of children in the program and in a matched comparison group. Direct testing and teacher assessment of children was undertaken in the areas of general development, literacy, numeracy and school behaviour during the children's first and second years of schooling. The research findings indicated that the program was well implemented at a number of different levels and that the overseas model can be successfully implemented in multi-cultural Australian conditions. The approach to the diverse language backgrounds of families was a major area of successful adaptation from the standard model. Both qualitative and quantitative data analysis indicated that the program enhanced children's school progress. The study identified lessons for future evaluation studies of the program in Australia. The research findings indicate an
encouraging start for HIPPY in Australia. In broader terms, the study points to the potential importance to disadvantaged children of well implemented home-based early childhood education programs.
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Davies, Michael John. "The role of commonsense understandings in social inequalities in health : an investigation in the context of dental health / Michael Davies." 2000. http://hdl.handle.net/2440/19680.
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Bibliography: leaves 203-219.219 leaves : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Concerned with the contribution of commonsense understandings of disease to social differentials in health outcomes. Argues that understandings in part reflect the social circumstances of an individual and mediate preventive activities and use of services, thereby influencing health outcomes. These are examined using the specific health outcomes of tooth loss and tooth decay.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2000
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Davies, Michael John. "The role of commonsense understandings in social inequalities in health : an investigation in the context of dental health / Michael Davies." Thesis, 2000. http://hdl.handle.net/2440/19680.
Full textAbstract:
Bibliography: leaves 203-219.219 leaves : ill. ; 30 cm.
Concerned with the contribution of commonsense understandings of disease to social differentials in health outcomes. Argues that understandings in part reflect the social circumstances of an individual and mediate preventive activities and use of services, thereby influencing health outcomes. These are examined using the specific health outcomes of tooth loss and tooth decay.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2000
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Klafke, Nadja. "Interpersonal factors impacting the decision to (continue to) use complementary and alternative medicine (CAM) in men with cancer: a mixed-methods study." Thesis, 2014. http://hdl.handle.net/2440/97249.
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There has been an increase in the use of Complementary and Alternative Medicine (CAM) in cancer populations, with reported higher prevalence rates in women than in men. Men with a variety of cancers have been understudied in CAM research, as well as the contribution and involvement of their significant others, like close family members or/and close friends. The aim of this thesis was to investigate the use of CAM in men after a diagnosis of cancer. Specifically, the research aimed to explore how significant others impact on men’s decisions to (continue to) use CAM, how they negotiate, talk, and practice CAM in everyday life, and how this affects their interpersonal relationship. A mixed methodological approach with two independent but related studies addressed the research aims: one quantitative study (survey) and one qualitative study (semi-structured interviews). The results are presented in two published and three submitted papers that contribute to our understanding of CAM use in men affected with cancer and how their CAM uptake is shaped by their social networks. Paper one reports the results of an integrative review of the literature, and indicates that significant others of patients with cancer often act as information seekers, advocates, and/or role models in patients’ decision-making about CAM. Despite the limited number of reviewed studies about familial involvement available, the results suggest that there may be important interpersonal consequences following patients’ decision to use or not use CAM, that need to be further explored. Paper two reports the results from the Study 1 survey involving 403 Australian men affected with cancer, a convenience sample of consecutive patients visiting two public and two private outpatient cancer clinics in Metropolitan Adelaide. The results indicate that the majority of male cancer patients (61.5%) have experience with CAM at some point during their cancer treatment, while more than half of the study sample (52.9%) were currently using CAM whilst receiving conventional medical treatment. It was also shown that family were the most frequent providers of information about CAM, and were significantly more often involved in patients’ discussions about CAM use than medical professionals. Papers three, four, and five report the results of Study 2, involving qualitative analysis of 43 semi-structured interviews with 26 men and 24 significant others, thereby exploring in-depth participants’ perceptions and experiences of CAM. Paper three indicates that men with cancer use CAM for individual and social/interpersonal reasons, a unique category augmenting those previously discussed in the literature. Discourse analysis highlighted how the interpersonal dimension impact on men’s decisions to uptake CAM, and how the use of CAM functions to connect the male cancer patient with his social network. Paper four reports on the variations of significant others’ involvement in men’s CAM uptake and maintenance, and indicates that CAM is sometimes practised as a shared and/or private activity in everyday life. The shared practice of CAM was associated with interpersonal benefits, working to strengthen the bond between men and their significant others, but there were instances when men expressed a need to practice CAM as a private activity. It was found that CAM benefited both men and their significant others to reduce uncertainty and to regain control. Paper five reports on how regular and habitual male CAM users integrate CAM routines and CAM rituals in their everyday life. The discursive analysis illustrates how CAM routines provide male cancer patients with certainty and control. By contrast, CAM rituals function for cancer patients and their significant others as a means to create and maintain meaning, thereby working to counter fear and uncertainty consequent upon a diagnosis of cancer. In summary, the results of these studies have shown that the majority of men with a variety of cancers use CAM in addition to conventional cancer care. Family members and/or close friends are a significant source of influence in men’s CAM uptake and maintenance. The interactions about CAM between men and their significant others functioned to help them to connect with each other or strengthen their social bond, and constitute a beneficial effect of CAM use. In addition, it was found that regular CAM use helped men and their significant others to regain control and to reduce uncertainty. These findings may help healthcare professionals to better understand how interpersonal processes impact on men’s CAM decisions. The results might also be translated into clinical practice, for example, in designing supportive cancer care programmes tailored specifically to men affected with cancer, with or without involvement of their significant others.Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2014
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Mhlambi, Sibusiso D. L. A. "Disability grant assessments at Nqutu, Kwazulu-Natal." Thesis, 1994. http://hdl.handle.net/10413/7515.
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Ricardo, Jéssica Andreia Rodrigues. "Evaluation of the prevalence of Chronic Obstructive Pulmonary Disease in patients of General Practice and Family Medicine in the Health Administration of the Central Region of Portugal." Master's thesis, 2020. http://hdl.handle.net/10316/97817.
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Trabalho Final do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaIntrodução: A DPOC é uma condição frequente a nível global, com elevada morbilidade e mortalidade associadas. Os sintomas para esta doença podem ser facilmente ignorados, estando associada a uma elevada percentagem de sub-reconhecimento e subdiagnóstico. O conhecimento da prevalência da DPOC e da importância dos seus fatores associados na população permitem uma melhor gestão de recursos médicos.Objetivos: Determinar a prevalência de DPOC em pacientes de Medicina Geral e Familiar na Administração Regional de Saúde (ARS) do Centro de Portugal e analisar a correlação de fatores associados.Métodos: Estudo observacional, dados relativos a pacientes codificados com a ICPC-2 de DPOC (R95) recolhidos de forma anónima a partir da base de dados da ARS do Centro.Resultados: 24148 indivíduos identificados com DPOC, prevalência calculada em 2,57/100 000, a maioria dos pacientes com mais de 65 anos (73,7%; n=17805), 60,2% (14544) do sexo masculino e 39,8% (9604) do sexo feminino. O IMC estava registado em apenas 15470 indivíduos, o FEV1 % em 1921, e UMA em 8957. Foram identificadas correlações negativas entre idade e IMC e idade e FEV1 %.Discussão: A prevalência foi significativamente mais alta em homens. A idade foi identificada como fator de risco para esta condição. Idade mais avançada foi também associada a FEV1 % e IMC mais baixos, ambos constituindo critérios de pior prognóstico. Houve uma falta considerável de registos realizados pelos clínicos relativamente aos doentes codificados para DPOC. Conclusão: Forte associação entre DPOC e género masculino e grupos etários mais velhos. A falta de registos requer melhorias na documentação feita por clínicos em cuidados de saúde primários.
Background: COPD is a common condition worldwide, with significant morbidity and mortality associated. Symptoms of this disease can be easily over-looked, accounting for the elevated level of under-recognition and underdiagnose. Knowledge of the prevalence of COPD and the significance of its associated factors in the population enables better management of medical resources.Objectives: Establish the prevalence of COPD in patients of General Practice and Family Medicine in the Regional Health Administration of Central Portugal and analyze the correlation of associated factors. Methods: Observational study, with data regarding patients coded with the ICPC-2 of COPD (R95) gathered anonymously from the Portuguese Health database.Results: 24148 individuals identified with COPD, prevalence calculated in 2,57/100 000, most of the patients were older than 65 years (73,7%; n=17805), 60,2% (14544) were male and 39,8% (9604) were female. BMI was registered only in 15470 individuals, FEV1 % in 1921, and pack-years in 8957. Negative correlations found between age and BMI and age and FEV1 %. Discussion: Prevalence was significantly higher in men. Age was identified as a risk factor for this condition. Higher age was also associated with lower FEV1 % and BMI, both being criteria for worst prognosis. There was a considerable lack of registrations made by the clinicians regarding the patients coded for COPD.Conclusion: Strong association of COPD with male gender and older age groups. The lack of registrations demands for an improve of the documentation made by clinicians in Primary Care Units.