Dissertations / Theses on the topic 'Health services'
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Sheppard, Lorraine. "Service quality in professional health services /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phs5495.pdf.
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Thesis (Ph. D.)--University of Adelaide, Graduate School of Management, 1999.Includes one computer disk in Work 6 format. System requirements for accompanying computer disk: Mackintosh or IBM-compatible computer. Other requirments: Microsoft Word 6 or compatible Word Processor. Includes bibliographical references (leaves 241-270).
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Bell, Louise. "Developing service quality and auditing in health services." Thesis, University of Kent, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310272.
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Oppong-Odiseng, Amma C. K. "Adolescent health : problems, needs, services and service providers." Thesis, Keele University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.339846.
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Introduction There is a paucity of knowledge regarding adolescent's preferences for care. The health related problems they face have implications for individuals and nations. Objectives To determine the health problems and needs of adolescents, their knowledge, use of, and preferences for health related services and service providers. Study design A descriptive study involving a two-stage probability sample. An interview schedule was designed for data collection. Setting Eight randomly selected main-stream high schools in Stoke-on-Trent, England. Subjects One hundred and eleven males and 142 females aged 14 and 15 years between 1 st April and 30th June 1994. Results The adolescents had unmet problems and needs relating to lifestyle and risk-taking behaviour, sexual and reproductive health, and emotional problems, influenced by socio-economic and legislative factors. Services were used primarily for physical problems. Knowledge of the location and opening times of two local contraceptive services for adolescents was poor (10/253,4%). Factors they associated with confidentiality were identified. Preferences for service providers varied with the nature of the problem. The girls were more likely to give advice to peers regarding substance abuse, and issues relating to sexual and reproductive health, and expressed a greater preference for advice from peers on these issues. The services the adolescents wanted to see provided were appropriate to their needs and reflected a holistic concept of health. Conclusions • The Health of the Nation targets will not be met unless these problems and needs are addressed. • Potential intervention points for health promotion are being missed. • Local services must be widely advertised. • Adolescents need specific reassurance from service providers that their care will be confidential. • Positive actions adolescents are prepared to take need reinforcing. • Peer counselling programmes might be expected to have a greater positive impact on girls. • Adolescents' opinions regarding service provision must be taken into account.
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Jones, Andrew Peter. "Health service accessability and health outcomes." Thesis, University of East Anglia, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.296338.
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Peltomaa, M. (Miira). "User-centric service design in mobile health care services." Master's thesis, University of Oulu, 2019. http://jultika.oulu.fi/Record/nbnfioulu-201906052408.
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Abstract. The growing age of populations brings widespread problems for a range of services, including health care services. Another challenge is the areas of dispersed settlement and decreasing population in rural areas. Urbanization and movement to the larger cities after employment, education, and services has led to decreasing the services in the remote areas even further. In the changing needs of the requirements and challenges of health care entities the use of mobile health care services may provide many benefits to the systems to develop flexible and adjustable health services to citizens. With the help of mobile health care services, the requirements of ever-changing service needs may be responded more efficiently than traditional onsite health care centers.
The purpose of this study is to understand the opportunities of user-centric service design and practices in the design processes of mobile health care services. In the future, mobile health care services may potentially be a medium for implementing the health and social service delivery as one of the standard mediums in order to reduce inconsistencies between habitant areas in Finland. By designing user-centric services with methods that leave room for ongoing development and improvement of mobile health care services.
The nature of the study is a qualitative case study. The research phenomenon is approached by semi-structured interviews, to define practicalities in the planning of a mobile health care services. The target group of the interview is particularly chosen participants from representative organizations from both private and public health sector.
The results of the study confirm the adaptability of user-centric service design in mobile health care services. It also reveals many practical aspects regarding the design process and the possibilities in co-design activities. More precisely, this study suggests that the user of the service can be included in all stages of service design process of mobile health care services in several ways — from defining the need to the implementation and ongoing development. The user-centricity in the context of this study means the users of the service that are involved in the service operations along its way — including employees and other encounters to the service.
The results of the study contribute to the model of service design by assessing its suitability to designing mobile health care services with user-centric approach, and gathering concrete practices of those methods.
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Jerdén, Lars. "Health-promoting health services : personal health documents and empowerment." Doctoral thesis, Umeå universitet, Epidemiologi och folkhälsovetenskap, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1401.
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In 2003, the Swedish Parliament adopted a national public health policy that included the domain - “A more health-promoting health service”. Strategies and tools are needed in the work to reorient health services. Personal health documents are documents concerning a person’s health, and are owned by the individual. Several studies that have evaluated such documents indicate that they could be of interest in health-promotion work. However, there is insufficient knowledge concerning personal health documents that target adolescents, and little is known about the feasibility of such documents in a Swedish cultural context. The concept of empowerment is gaining increased interest for health services, but the associations between empowerment, self-rated health and health behaviour are sparsely studied. The overall aim of the thesis is to explore a strategy - empowerment - and a tool - personal health documents - that might facilitate the work of the public health goal of a health-promoting health service. Specific aims are to examine the feasibility of using personal health documents in health promotion; to examine professionals’ experiences of working with health promotion and personal health documents; to examine the association between personal health documents and self-reported health behaviour change; and to examine the perception of empowerment in relation to self-rated health and health behaviour among adolescents. Two personal health documents that targeted adults and adolescents were developed and evaluated. Distribution to adults in different settings was compared in a cross-sectional study (n = 1 306). Adolescents received the document in school, and surveys were performed at baseline and after one year (n = 339). Practical use and attitudes by document owners were studied by questionnaires. Teachers (n = 69) answered a questionnaire, and community health nurses were interviewed (n = 12). The interviews also explored nurses’ experiences of working with health promotion in general, and were analysed by qualitative methodology. Adolescents’ empowerment was examined by a questionnaire (n = 1 046). Most participants reported reading in the documents; writing in the documents varied between 16% (distribution in occupational health) and 87% (adolescents). The health document was perceived as useful by 35% of the adolescents. Factors significantly related to personal usefulness were being born outside Sweden, experiencing fair treatment by teachers, being a non-smoker and having a positive school experience. Community health nurses were striving for a balance of being a doer of practical, disease-oriented tasks and a health-promotion communicator. The structural organisation in health care centres was important for their work with health promotion and the health document. Teachers were generally in favour of continued work with the document. In different settings, between 10% and 26% of adults reported changes in their health situations as a result of reading the booklet. Self-reported changes in health situations were less likely using postal distribution, and there were no significant differences between the other types of distribution. Adolescents with low empowerment scores reported poorer self-rated health and more risk-taking behaviours such as smoking and binge drinking. To conclude, personal health documents are feasible to use in different settings. Health promotion in health services needs active support from leaders as well as adequate support systems. Findings suggest that personal health documents can be tools for promoting self-reported lifestyle changes among adults in different settings. There is a close relation among adolescents between low empowerment in the domain of health, low self-rated health and health behaviours such as binge drinking and smoking.
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Jerdén, Lars. "Health-promoting health services : personal health documents and empowerment /." Umeå : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1401.
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Oh, Youngho. "Demand for health services in Korea: Equity in the delivery of health services /." The Ohio State University, 1997. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487945015618772.
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Sun, Xiao Ming. "Health access and health financing in rural China." Thesis, Keele University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263121.
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Wu, Yaping. "Essays on health care financing and health services." Thesis, Toulouse 1, 2014. http://www.theses.fr/2014TOU10007.
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Le monde dépense une part significative et en augmentation constante de ses ressources sur les soins de santé. Les débats sur les modèles de financement des soins de santé et sur les méthodes de paiement des praticiens se déroulent dans le monde. Néanmoins, il n’existe toujours pas de consensus sur le choix idéal des mécanismes de financement. Cette thèse vise à contribuer aux débats sur le financement des soins de santé et sur la politique des services de santé. Le chapitre premier examine la règle de compensation non-linéaire optimale des praticiens, le principe selon le paiement à la performance, le paiement à l’acte et la capitation en présence à la fois l’antisélection et l’aléa moral au niveau de l’offre. Nous avons trouvé que lorsque l’aléa moral est le seul problème, le paiement à l’acte ne peut que conduire à la substitution de la quantité de traitement par rapport à l’effort du praticien, ce qui est inefficace. En conséquence, le paiement à l’acte ne devrait être utilisé dans ce cas. Toutefois, lorsque l’aléa moral se combine au problème de l’antisélection, un screening efficace requiert une utilisation continue du système de paiement à l’acte pour les praticiens à faible productivité et un moindre recours au système du paiement à la performance. L’élaboration de l’utilisation du paiement améliore le screening. Nous apportons des arguments sur l’analyse critique des points faibles du paiement à l’acte. Et, plus important encore, nous établissons les raisons de l’utilisation continue du paiement à l’acte malgré le fait que de sérieux problèmes concernant ce système aient été largement reconnus. Le chapitre deux analyse le problème du contrat trilatéral entre le payeur, le patient et le praticien, lorsque le praticien et le patient peuvent s’entendre pour exploiter des opportunités avantageuses à l’un et à l’autre. En prenant pour hypothèse qu’un transfert secondaire entre le patient et le praticien est exclu, nous analysons le problème de la mise en place du mécanisme où le praticien et le patient soumettent la réclamation du diagnostic au payeur par un jeu de déclaration. Nous en déduisons aussi le schéma optimal de l’assurance et du paiement pour le patient et le praticien. Le schéma optimal de l’assurance et du paiement qui est collusion-proof (faible) est tel que l’un des deux dise la vérité ; mais l’arbitrage du payeur est différent selon les différentes manières qu’il choisit pour répartir les incitations entre le patient et le praticien. De plus, nous montrons que si le payeur parvient à demander aux deux parties de présenter le diagnostic de manière séquentielle, l’avantage du pouvoir de veto du second agent permet au payeur de réaliser le meilleur résultat. Mon domaine d’étude secondaire traite de l’économie du développement. Le troisième chapitre a pour but d’examiner si la migration des villages vers les villes entraîne une éviction des contrats informels de partage de risque et conduit des ménages à une moindre (auto-)assurance de consommation des villages Thai. Pour ce qui concerne la motivation théorique, notre idée est que la migration peut être utilisée comme un contrat d’investissement réalisé à l’avance entre le ménage et l’enfant. Le ménage investit en payant d’avance en échange de versements futurs dépendants des circonstances, ce qui change le processus de revenus du ménage. Pour l’estimation, nous avons utilisé le tableau de Townsend Thai Annual Surveys (1997-2010). L’hypothèse d’aucun biais de sélection est rejetée au niveau du marché de l’assurance du village, ce qui conforte notre conjecture selon laquelle la migration change le statut de partage des risques des ménages à l’intérieur du village. Lorsque les biais sont corrigés, nos résultats montrent que la migration entraîne une éviction du partage des risques informels dans le village et conduit même à une diminution de l’(auto)assurance de consommation des ménages ThaiThe world spends a significant and increasing share of its resources on health care. The debates on the models of health care financing and the methods of payment for the physician continue all over the world. Nevertheless, there is still no consensus on the ideal choice of financing mechanisms. This thesis aims at contributing to the debates on the health care financing and health service policy. Chapter one examines the optimal non-linear compensation rule of physicians under pay-for-performance, fee-for-service and capitation in the presence of both adverse selection and moral hazard on the supply side. We found that when moral hazard is the only problem, fee-for-service can only lead to the substitution of treatment quantity to physician’s effort, which is inefficient. Consequently, fee-for-service payments should not be used in this case. However, when moral hazard is combined with the adverse selection issue, an efficient screening requires a continued use of fee-for-service for the lower productivity physicians and less pay-for-performance. The design of the use of fee-for-service effectively improves screening. We provide an argument for the criticism on the shortcomings of fee-for-service. More importantly, we also provide a rationale for the continued use of fee-for-service payment even though the serious problems with fee-for-service have been widely acknowledged. Chapter two analyzes the three-party contracting problem among the payer, the patient and the physician when the patient and the physician may collude to exploit mutually beneficial opportunities. Under the hypothesis that side transfer is ruled out, we analyze the mechanism design problem when the physician and the patient submit the claim to the payer through a reporting game. We also derive the optimal insurance payment scheme for the patient and the physician. The insurance payment scheme which is (weak) collusion-proof is such that it is sufficient that one of them tells the truth ; but the payer’s trade-offs are different when he chooses different manners of splitting incentives between the patient and the physician. Moreover, we show that if the payer is able to ask the two parties to report the diagnosis sequentially, the advantage of the veto power of the second agent allows the payer to achieve the first best outcome. My secondary field is Development Economics. The third chapter examines whether migration crowds out informal risk-sharing contracts and leads to less consumption insurance for households in Thai villages. For the theoretical motivation, our idea is that migration may be used as a cash-in-advance contract between the household and the child. The household invests upfront in exchange for future state-contingent remittance which changes the income process of the household. For the estimation, We use the panel from Townsend Thai Annual Surveys (1997-2010). The hypothesis of no selection bias is rejected at within village insurance market level, which supports our conjecture that migration changes the risk-sharing status of households within village. After the bias are corrected, our results show that migration crowds out informal risk-sharing within village and even leads to less consumption insurance for households in Thai villages
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Baker, Stephanie. "Staff and service user experiences of forensic mental health services." Thesis, University of Warwick, 2017. http://wrap.warwick.ac.uk/90135/.
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This thesis consists of three chapters. Chapter one is a systematic review of the qualitative literature examining the experiences of clinicians working in mental health services with forensic service users (FSU). Following systematic searches and a process of quality assessment, a total of 14 articles were included and their findings were systematically compared. Staff members experienced both positive and negative emotional responses to their work, there are conflicting aspects to their role and additional challenges within the organisational context. Implications for clinical practice and further research are discussed. Chapter two uses Interpretative Phenomenological Analysis (IPA) to consider the experiences of FSUs diagnosed with Personality Disorder (PD) in Forensic Services and the meaning given to recovery within their accounts. The findings discuss the disempowered position of FSU participants and suggest that feeling safe within relationships in their environment is important for those with this diagnosis. There was evidence in their accounts of attempts to establish new identities but there also appeared to be multiple barriers to this. Chapter three offers a reflective account of the researcher’s experience of carrying out this study. It demonstrates the reflexive strategies used that allowed the competing subjective roles alongside that of ‘researcher’, to be examined and their influence on the research process explored.
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Greene, Joseph Harrison. "Development of a social service program for college health services." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1869.
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The initial development of a social services program in a college health setting is presented, with discussion regarding causes, methods, and outcomes. Both empirical and anecdotal data which were influential in the initial formation of the program are reviewed, in the context of an examination of the research literature relating to this area. The actual development and implementation of the program is followed through its first year of existence. Outcomes are presented in the form of qualitative data analysis and case studies. Discussion of the results and recommendations for both future research and improvements to the program are presented.
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Devkota, Bhimsen. "Rebel health services in Nepal." Thesis, University of Aberdeen, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540471.
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The Unified Communist Party of Nepal-Maoist established its own health services within its bastion areas during the decade long (1996-2006) conflict. This study captured a fresh opportunity to examine the Maoist health workers and their services, to explore their numbers, motives and trajectories, and to assess perspectives and responses of the key actors for their assessment, rehabilitation and integration within the primary health system. The study used a mixed methods approach. Data were obtained by using self-administered questionnaires (n=197), semi-structured interviews (n=32) and key informant interviews (n=20). The Maoist health workers regard themselves as capable of delivering health services in rural communities. They claim that their movement was decisive in overthrowing the previous repressive regime and in establishing a republic opening up avenues for people’s democracy, state restructuring and progressive health reforms in the country. The government of Nepal however lacks information on their number, qualities career motivation and integration incentives. Their limited skills and partisan interests could be an obstacle for their recognition and absorption. The military and political agenda has prevailed over the issue of optimal absorption of the Maoist health workers and health services redevelopment. Despite having some institutional provisions for health worker assessment and accreditation and capacity for absorption, there has been no national discussion of what kind of rehabilitation and integration model is appropriate for them. This study suggests that the post-conflict settlement of the Maoist health services provides an opportunity to reorient Nepal’s health services and to recognise the role of the health sector as a bridge for peace.
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Gage, Heather. "Papers in health services research." Thesis, University of Surrey, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.417521.
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Pusateri, Cassandra G. "Mental Health Services in Appalachia." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/3160.
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Sills, Margaret Vivienne. "Adult perceptions of influences on personal health and change : a study of health educators and non-health educators." Thesis, King's College London (University of London), 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.284803.
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Brazier, John Edward. "Valuing health benefits : the development of a preference-based measure of health for use in the economic evaluation of health care from the SF-36 health survey." Thesis, University of Sheffield, 1997. http://etheses.whiterose.ac.uk/5997/.
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The main aim of the research was to develop a preference-based measure of health from the Short Form-36 (SF-36) Health Survey for valuing health-related quality of life on a 0 to 1 scale in order to calculate Quality adjusted life years (QALYs). Before undertaking the empirical work, reviews were undertaken of the justification for the QALY approach, existing preference-based measures for deriving QALYs and the rationale for looking at the SF-36. The methods of the research were as follows. The SF-36 was reduced and simplified to form a six dimensional health state classification (SF-6D) amenable to valuation. One hundred and sixty five patients, health professionals, managers, and students valued a sample of health states defined by the SF-6D using the visual analogue scale (VAS) and standard gamble (SG) techniques to elicit preferences. There were 1,357 VAS and 1,037 SG health state valuations after adjustment and exclusions for major inconsistencies. Models for predicting median and mean VAS and SG health state values from the SF-6D were estimated from these data by multivariate techniques. A set of additive models were selected on the basis of goodness of fit and parsimony. More complex specifications did not improve the models. Initial applications of algorithms based on these models to five data sets suggested this new preference-based measure retained much of sensitivity of the SF-36 at the milder end of the of the illness spectrum. The preference-based algorithms can be used to transform SF-36 data collected in a clinical trial (with costs) into information suitable for assessing the cost-effectiveness of health care interventions. The adoption of these algorithms has the potential to considerably extend the application of economic evaluation in health care.
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Ruston, Annmarie. "Implementation of preventive health policies in the field of sexual health : an examination of the influence of health professionals in the implementation of the Health of the NationStrategy-HIV/AIDS and Sexual Health Key Area." Thesis, University of Kent, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310165.
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Jormfeldt, Henrika. "Dimensions of Health among Patients in Mental Health Services." Doctoral thesis, Lund University, Sweden, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-16873.
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Empirical studies focusing on the subjective experience of health among patients in contact with the mental health services are rare and most questionnaires are based on a medical model that emphasizes objectively observed disease-oriented health indicators. In studies I and II perceptions of the concept of health among patients and nurses in mental health services were explored and described using a phenomenographic approach. The perceptions and description categories that emerged from these studies were transformed into a number of items forming a questionnaire intended to measure subjectively experienced health among patients in mental health services. In study III, a randomly selected sample was used to test the psychometric properties of the new Health Questionnaire. A factor analysis revealed three factors labelled Autonomy, Social Involvement and Comprehensibility. The purpose of study IV was to examine the construct validity of the Health Questionnaire. The hypothesis was that subjectively experienced health would be positively associated to self-esteem, empowerment and quality of life, and negatively associated to psychiatric symptoms, perceived stigmatization experiences and perceived attitudes of devaluation and discrimination. This hypothesis was mainly confirmed insofar that overall health was positively correlated to self-esteem, empowerment and quality of life and negatively correlated to symptoms, attitudes of devaluation and discrimination and rejection experiences. The results of this thesis show that health is more than just an absence of disease and support a focus on health promotion interventions in mental health care.Medicine doktorsexamen
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Montgomery, Scott Mackay. "The relationship of unemployment with health and health behaviour in young men." Thesis, City University London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.336792.
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Hennessy, Deborah. "Mothers and health visitors." Thesis, University of Southampton, 1985. https://eprints.soton.ac.uk/402124/.
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Thomas, Karen Anne. "The National Health Service contract for pharmaceutical services 1995 to 1998." Thesis, University of Portsmouth, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368471.
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Goldberg, Looney Lisa. "Military Service Members’ and Veterans’ Preferred Approach to Mental Health Services." VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3608.
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Mental health services are greatly underutilized by military service members and veterans. Among the reasons for this underutilization is that the services offered may not be a good fit for the specific problems facing service members/veterans and/or their families. The current study presented service members with descriptions of several approaches to treatment and asked them to indicate the likelihood of using each. Service members indicated the highest likelihood for using self-directed services, followed by individual treatment with a professional. They reported being least likely to use group approaches. These results may inform decisions about the implementation and dissemination of information about existing and new services.
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Rodgers, Jacqueline. "Healthy lives? : how the lives of people with learning difficulties affect their potential for health." Thesis, University of Bristol, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.336894.
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Munro, Catherine A. M. "Developing a dialogue on health : user involvement in health and health services." Thesis, University of Glasgow, 2008. http://theses.gla.ac.uk/291/.
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In common with other areas of public services, recent years have seen a shift in the National Health Service (NHS), with increased power and authority transferring from professionals towards the users of services. As a result, user involvement has come to form a central element of government policy on public services, and health in particular, with a series of specific policy commitments to give users a stronger voice and to involve them in the health service having been published by both the Westminster and Scottish parliaments. These seek to increase users’ involvement in making decisions about their own care and treatment, in examining and improving the quality of services and in policy and planning activity. In doing so, this policy aspires to respond to the changing culture of personal and societal expectations of health and the health service; to build democratic participation in the difficult targeting and rationing decisions faced by health agencies and, thus, to help renew public trust and strengthen confidence in the NHS. These are ambitious aims with far-reaching implications as they represent a transformation in the interaction between users, health professionals and health policy makers. This thesis examined how this policy has been understood and implemented in the NHS by exploring the scope, relevance and quality of the user involvement processes available in three health service settings. In order to develop a better understanding of the issues in user involvement it explored the nature of user participation; the character of user representation and the barriers and facilitators to user involvement in maternity, gynaecological oncology and mental health services. The study examined the response to this policy within these three settings; the functioning of existing user involvement mechanisms and their capacity to involve users in determining their individual health care and in shaping health services and policy to their definition of need. From this examination it defined the key features of a model process for user involvement within the professional service culture and organisational ethos of the NHS. The study then drew conclusions on the capacity of these current user involvement processes to deliver on the policy directive to develop both individual treatment and health services in ways that are responsive and accountable to users. Finally, the thesis identified those areas that require further research before proposing the lessons for the further development of this significant and potentially influential policy directive.
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Jefferies, Natalie. "Young people moving on from child and adolescent mental health services to adult mental health services." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3715/.
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There is a sound evidence base on the effects of the therapeutic alliance on outcome in psychotherapy for adults. In comparison, there is a smaller amount of literature on the effects of the therapeutic alliance on outcomes for adolescents. Adolescents rarely are seen individually for therapy and instead are often seen by family therapists as part of a system with other members of the family. At present, it is uncertain what the effects of the therapeutic alliance on outcome for adolescents in family therapy are. This paper presents a systematic review that aims to investigate the effects of the therapeutic alliance on outcome in adolescents in family therapy and what factors influence the therapeutic alliance with adolescents in family therapy. A systematic review of electronic databases was carried out using a quality assurance checklist adapted from the American Academy of Neurology Clinical Practice Guidelines (2004). This checklist was used as it assessed aspects of the studies’ theoretical basis, design, measures, analysis and results. Eleven studies met the inclusion criteria and were reviewed. The findings of this review suggest that the therapeutic alliance affects outcome for adolescents in family therapy. The presence of identifiable features of the therapeutic alliance, such as task, goal and bond can strengthen the therapeutic alliance with adolescents. Research into this area is still in its preliminary stages. However, important factors have been identified that affect outcome. Further research is necessary before more substantial claims of the therapeutic alliance on outcome can be made. The limitations of this review are presented, followed by clinical, training and supervision implications and suggestions for future research.
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Harley, Judith Ann. "Mental Health Consumers' Perspectives on Traditional Mental Health Services Versus Peer-Run Services: A Qualitative Study." Ashland University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ashland1352125523.
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Jallow, M., Melanie Haith-Cooper, Jae Hargan, and M.-C. Balaam. "A systematic review to identify key elements of effective public health interventions that address barriers to health services for refugees." Springer, 2021. http://hdl.handle.net/10454/18444.
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YesAim: Refugees often face barriers to accessing health services, especially after resettlement. The aim of this study is to identify key elements of effective public health interventions that address barriers to health services for refugees. Methods: Key online databases were searched to identify studies published between 2010 and 2019. Six studies met the inclusion criteria: two qualitative, one quantitative and three mixed-methods studies. An adapted narrative synthesis framework was used which included thematic analysis for systematic reviews. Results: Five themes were identified: peer support, translation services, accessible intervention, health education and a multidisciplinary approach. Conclusion: These key elements identified from this review could be incorporated into public health interventions to support refugees’ access to health services. They could be useful for services targeting refugees generally, but also supporting services targeting refugee resettlement programmes such as the Syrian resettled refugees in the UK. Future research is needed to evaluate the impact of public health interventions where these elements have been integrated into the intervention.
The full-text of this article will be released for public view at the end of the publisher embargo on 23 Mar 2022.
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Appleton, Jane Victoria. "An examination of health visitors' professional judgements and use of formal guidelines to identify health needs and prioritise families requiring extra health visiting support." Thesis, King's College London (University of London), 2002. https://kclpure.kcl.ac.uk/portal/en/theses/an-examination-of-health-visitors-professional-judgements-and-use-of-formal-guidelines-to-identify-health-needs-and-prioritise-families-requiring-extra-health-visiting-support(ca51ddec-dab0-4f85-b817-da01454eece4).html.
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Milner, Susan Joan. "Health in the high street : an evaluation of a community based health promotion projects." Thesis, Northumbria University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.240622.
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MoyseÌs, Simone Tetu. "The impact of health promotion policies in schools on oral health in Curitiba, Brazil." Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313826.
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Ziglio, Erio. "Uncertainty and innovation in health policy : the Canadian and Norwegian approaches to health promotion." Thesis, University of Edinburgh, 1985. http://hdl.handle.net/1842/19439.
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Jones, Siobhan. "Adolescent engagement in mental health services." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14807/.
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Despite older adolescence being a risk period for the development of mental health concerns, mental health service engagement is low amongst 16-18 year olds. As therapeutic attendance is linked to clinical outcome, it is important to understand engagement in this population. There is a paucity of research looking specifically at the older adolescent engagement phenomenon. Previous qualitative research into adolescent experiences has provided rich and detailed results. Ten 16-18 years olds, engaged in Child and Adolescent Mental Health Services, were recruited from two London-based services. Each young person was interviewed in order to understand their personal experience of engaging in mental health services. Interviews were transcribed and underwent Interpretative Phenomenological Analysis. Analysis produced twelve subthemes subsumed within five superordinate themes: engagement begins at help seeking, strength of inner resolve, evolution of the self, in the clinic room, and, existing within service walls: physical and policy-based boundaries. Themes are discussed in detail. Conclusions are drawn in relation to previous theory and research. When considering 16-18 year understandings of the engagement phenomena, key elements include: clinician and service developmental appropriateness, negotiation of developmental tasks in relation to engagement, experience of the physical building environment, and awareness of service policy limitations. Suggestions for clinical practice in relation to engagement facilitators and threat are made, and recommendations for future research proposed.
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Curtis, Kathryn. "Mental health services and American expatriates." Manhattan, Kan. : Kansas State University, 2008. http://hdl.handle.net/2097/670.
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Lovell, Jonathan. "Self-disclosure in mental health services." Thesis, University of York, 2017. http://etheses.whiterose.ac.uk/19278/.
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Sharing lived experience of mental health experiences by mental health practitioners is a topic of increasing relevance in statutory UK mental health settings, in part because of the rise in recent years of the employment of peer workers who share their lived experience by default. Literature to date has suggested that self-disclosure can have a range of benefits and risks, but existing studies have tended to focus on general rather than mental health disclosure, have not taken place in statutory settings, have studied a narrow section of the workforce, or have used analogue methodology. The current study used quantitative and qualitative methods through surveys and focus groups to explore statutory UK mental health practitioners’ and service-users’ views about the helpfulness of sharing personal mental health lived experience versus other types of lived experience. Service-users indicated that personal mental health lived experience was the most helpful disclosure topic, was valued when disclosed by all types of qualified practitioner, but it was shared least often. Practitioners who rate disclosure as helpful may be more reflective than practitioners who rate disclosure as unhelpful. Practitioners may be deterred from disclosing by a range of pressures, including risk of negative disclosure effects; adherence to therapeutic models; negative judgements from colleagues; pre-qualifying training; and perceived direction from professional codes of conduct and ethics. Despite perceived risks associated with hypothetical disclosure, most practitioners disclosed to some extent. Respondents gave almost 500 examples of real life disclosures which were almost exclusively helpful. It is recommended that practitioners are afforded greater autonomy, respect and permission to make decisions about disclosure without fear of judgment about professionalism. Training and guidance may be beneficial to help practitioners make best use of disclosures in statutory mental health service delivery.
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Murphy, K. "Recovery-orientation in mental health services." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11184/.
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Policy initiatives are calling for mental health services to change their ways of working to prioritising the promotion of service users’ personal recovery. This requires a major re-negotiation of working practices and the relationship between service users and staff/services and their respective social positions. Preliminary research has shown that change has been problematic. The present study aimed to explore the construction of recovery and the positioning of service users and staff during the adoption of recovery-oriented practices in a community support and recovery team. Transcripts of two rounds of focus groups with service users (n=9) and staff (n=5) held six months apart, service user care plans and Recovery Star notes were analysed using a Foucauldian Discourse Analysis. The study found that recovery was constructed as clinical/medical and personal recovery, at different times and in tension with each other. These constructions positioned service users as dependent, passive and hopeless or empowered and hopeful, and staff as helpless or facilitative. It was also apparent that a discourse of personal recovery was not available to service users. Staff oscillated between the constructions of recovery as medical and personal resulting in different subject positions and opportunities for action. The study concluded that adopting a recovery-orientation in services should lead to service users being positioned as more influential in decisions about their treatment and modes of support from the service, and services less likely to dictate their treatment. However, this can only happen if the recovery-orientation constitutes a widely shared discourse with all its assumptions and associated practices. The problematic aspects of the medical discourse and how it can position people socially and how those positions impact on the potential for personal recovery needs to be highlighted.
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Lindelow, Magnus. "Utilization of health services in Mozambique." Thesis, University of Oxford, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.410989.
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Grainger, Roger. "Implicit religion and health care." Thesis, University of Cambridge, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316645.
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Waters, Elizabeth. "Measuring child health and wellbeing." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270153.
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Maclean, John Ross. "Telemedicine in remote health care." Thesis, University of Aberdeen, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.264331.
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This thesis offers a review of the historical development of telemedicine services in remote health care. It addresses the professional concerns in practising medicine in isolated conditions, and the advances in telecommunications technology since the telephone was invented. It also examines the application of telemedicine in remote environments across the world, such as in indigenous communities, remote industrial work sites and at scientific bases in Antarctica. At its most exotic, a review is offered of the health care for space crews. The literature review highlights a number of concerns about the state of the art knowledge on remote health care services. These concerns are the minimal training requirements of individuals who act as health care practitioners in the remote environment, the additional training requirement upon the advising medical practitioner, and the design of a system for the collection of clinical information from the patient. In response to the above a two year study was conducted. Quantitative and qualitative observation of remote health care consultations was undertaken. The environments studied were simulation cases occurring in the UK and Antarctica, and real cases presenting on oil installations in the North Sea. The study results answer the original concerns about the training levels, data collection and communications components of a remote health care service. In addition, they offer valuable input towards the design of a telemedicine model for remote health care. The telemedicine model is presented as a framework upon which future developments in the field of telemedicine may be approached.
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Tatar, Fahreddin. "Privatisation and Turkish health policy." Thesis, University of Nottingham, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.356998.
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Anderson, Claire Wynn. "Health promotion by community pharmacists." Thesis, King's College London (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299776.
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Domapielle, Maximillian K. "Extending health services to rural residents in Jirapa District : analyses of national health insurance enrolment and access to health care services." Thesis, University of Bradford, 2015. http://hdl.handle.net/10454/14803.
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This thesis sheds light on differences in health insurance enrolment determinants and uptake barriers between urban and rural areas in the Jirapa district of Ghana. The National Health Insurance Scheme in Ghana has made significant progress in terms of enrolment, which has had a commensurate increase in utilization of health care services. However, there are challenges that pose a threat to the scheme’s transition to universal coverage; enrolment in the scheme has not progressed according to plan, and there are many barriers known to impede uptake of health care. Interestingly, these barriers vary in relation to locality, and rural residents appear to carry a disproportionate portion of the burden. A mixed method approach was employed to collect and analyse the data. On the basis of the primary qualitative and quantitative results, the thesis argues that the costs of enrolling and accessing health care is disproportionately higher for rural residents than it is their urban counterparts. It also highlights that the distribution of service benefits both in terms of the NHIS and health care in the Jirapa district favours urban residents. Lastly, the thesis found that whereas rural residents prefer health care provision to be social in nature, urban residents were more interested in the technical quality aspects of care. These findings suggest that rural residents are not benefitting from, or may not be accessing health services to the extent as their urban counterparts. Affordability, long distance to health facilities, availability and acceptability barriers were found to influence the resultant pro-urban distribution of the overall health care benefit.
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Waddington, Catriona Jane. "Health economics in an irrational world - the view from a regional health administration in Ghana." Thesis, University of Liverpool, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.317275.
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Mykhalovskiy, Eric. "Knowing health care / governing health care exploring health services research as social practice /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0018/NQ56249.pdf.
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Yan, Nicole, and 甄錦樺. "Exploring health in China's rural villages: apublic health field exercise." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46943821.
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Beatty, Kate, Michael Meit, Emily Phillips, and Megan Heffernan. "Rural Health Departments: Capacity to Improve Communities' Health." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6838.
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Local health departments (LHD) serve a critical role in leveraging internal and community assets to improve health and equity in their communities; however, geography is an important factor when understanding LHD capacity and perspective. LHDs serve a critical role in leveraging internal and community assets to improve health and equity in their communities; however, geography is an important factor when understanding LHD capacity and perspective. Data were obtained from the NACCHO 2013 National Profile of Local Health Departments Study. LHDs were coded as “urban”, “micropolitan”, or “rural” based on Rural/Urban Commuting Area codes. Results demonstrate that rural LHDs differed from their urban counterparts. Specifically, rural LHDs relied more heavily on state and federal resources and have less access to local resources making them more sensitive to budget cuts. Rural LHDs also rely more heavily on clinical services as a revenue source. Larger rural LHDs provide more clinical services while urban health departments work more closely with community partners to provide important safety net services. Small rural LHDs have less partners and are unable to provide as many direct services due to their lack of human and financial resources. LHDs residing in urban communities were 16.6 times (95% confidence interval [CI], 5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to seek PHAB accreditation than rural LHDs.
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Fandi, M. M. "The impact of retirement migration on health care demand and resource allocation in Lancaster Health District." Thesis, Lancaster University, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.372537.
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Chambers, Derek W. "A qualitative study of nurse's health beliefs and how these impact on their health education practices." Thesis, University of Huddersfield, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327148.
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This study investigates the ways in which nurses socially construct their health value systems and the ways in which they interpret their nursing practices. On the basis of the contradictions uncovered by the research, a new approach to health education is suggested, structured around a Lived Experience Model of Health Education the core of which is an intensified reflective practice. The model seeks to build the capacity for critical practice, closely integrating theory and practice, into nurses' modes of constructing a lay ideology based on their clinical and personal experience. Herein lies a fundamental difference between this model and other health education models, which have tended to be too narrowly focused on the individual and as a result have perpetuated a victim blaming ideology. The thesis begins with a desk study of the British dimension of a coming international crisis in the funding of public health, to which the general response has been a shift away from state support for bio-medically dominated health systems to systems based on the central concepts of health promotion and health education. The desk study argues that in Britain this has become as much an ideological issue as a practical one, with liberal notions of free market individualism prominent in public policy, and relevant sociological findings played down. Before embarking on the field study, the thesis considers whether or not a Health Locus of Control study might give enough insight into the basis for nurses' health education practices to explain why many nurses seem resistant to change, and therefore why perhaps they have had so little effect on patterns of social morbidity. This was rejected partly because of the methodological problems uncovered in a range of prior Locus of Control studies, but mainly because the method offers no way of engaging with sociologically identified inequities in morbidity and mortality rates. Nor was it felt that standard quantitative methods of research would enable the study to explore the complex ideological issues involved in nurses' social constructions of health. The decision was taken to employ a methodology based around qualitative interviews using the method of hierarchical focusing, which allows the interviewer to probe seamlessly matters at different levels of generality and specificity. In the field work study the general ideological tendency revealed in the desk study is shown to have a marked effect on nurses' constructions of their roles as health practitioners. The subjects, a group of experienced nurses, were asked a number of questions concerning their views of what constituted good and poor health and the causes for this. When the transcripts of the interview recordings were analysed using content analysis, it was clear that much of what was said was logocentric and heavily influenced by bio-medical discourse in spite of the subjects talking freely about holistic nursing. In fact there were contradictory and anomalous messages throughout the transcripts, so it was decided to subject these to a form of discourse analysis which revealed the existence of two opposing value positions held without any feeling of contradiction by a number of respondents: a holistic view - the public account, and a victim-blaming view - the private account. In order to gauge the effect of such views on nursing practice a further group of experienced nurses was given a series of nursing vignettes to analyse. The results showed that there appear to be two types of nurses: a reflexive group that is able to take on the complex issues involved in caring in the postmodern context and one, much the larger group, whose members have failed to resolve the contradictions in the prevailing ideology, who tend to fall back on victim-blaming and on bio-medical perspectives. Of course, this needs much more research to establish as a general pattern. However, there was enough clear evidence of ideological influences blocking the development of nurses' understanding and health practices to suggest the need for a new way of working with trainee nurses, much more sharply aimed at the development of critical consciousness in the practice situation. All the lessons of the research have been incorporated in the design of the new model.
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Florin, Dominque Anne. "How does science influence policy? Health promotion for coronary heart disease by general practitioners." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286480.
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