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1
Patterson, Jan. "Consumers and complaints systems in health care /." Title page, contents and summary only, 1996. http://web4.library.adelaide.edu.au/theses/09PH/09php3174.pdf.
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Sinclair, Andrew James, and n/a. "The primary health care experiences of gay men in Australia." Swinburne University of Technology, 2006. http://adt.lib.swin.edu.au./public/adt-VSWT20060713.084655.
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The present research, consisting of two studies, was designed to examine the
primary health care experiences of gay men in Australia and assess doctors? attitudes and
training with regard to gay men and their health care. In the first study, 195 gay men were
surveyed regarding their health issues and their primary health care experiences. The
most important health concerns of gay men were stress and depression followed by
HIV/AIDS, body image disorder and other sexually transmissible infections. Including
those participants who were unsure, approximately one-half reported experiencing
homophobia and almost one?quarter reported experiencing discrimination in the
provision of health care. Despite this, respondents were generally satisfied with their
primary health care, although respondents felt that all GPs should receive additional
undergraduate medical education regarding gay men?s health. In the second study, 25
doctors (13 gay specialists and 12 non-gay specialists) were surveyed regarding their
knowledge of gay men?s health and their comfort working with gay men. Non-gay
specialist GPs were less comfortable treating gay men, reported poorer communication
and were more homophobic than their gay specialist counterparts. Further, doctors
perceived their medical education regarding gay men?s health has been inadequate.
Together, the results of the two current studies suggest that disclosure of sexuality is an
important issue for both gay men and doctors, and has the potential to impact on the
quality of health care that gay men receive. In order to improve the level of disclosure,
the pervasiveness of homophobia and discrimination in primary health care must be
reduced. Finally, the results indicate that medical education must be updated to reflect
current knowledge regarding the health issues of gay men. Failure to address these issues
will condemn gay men to continued health inequality.
3
McGuiness, Clare Frances. "Client perceptions : a useful measure of coordination of health care." View thesis entry in Australian Digital Theses Program, 2001. http://thesis.anu.edu.au/public/adt-ANU20020124.141250/index.html.
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Lo, Oi-sheung Anne. "A study of different perspectives on the quality of health care and its implication for medical social service /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13417496.
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Walker, Annette Clare, of Western Sydney Nepean University, and Faculty of Nursing and Health Studies. "Nurse and patient work: comfort and the medical-surgical patient." THESIS_FNHS_XXX_Walker_ A.xml, 1996. http://handle.uws.edu.au:8081/1959.7/286.
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This grounded theory study investigates the experiences and perceptions of comfort and discomfort of hospital patients admitted for medical-surgical conditions, with a focus on the post-accute stage of hospitalisation. In-depth post-discharge interviews were conducted with seventeen English speaking adults who had been admitted to nine Australian hospitals. A substantive theory of finding comfort and of managing discomfort was generated. Processes of self-talk (anticipating, interpreting, accepting, making allowances and maintaining perspective) and self-care (self-help and seeking help, which involved accommodating to the level and type of help available through deferring, avoiding, persisting or desisting) were used to find comfort and to manage discomfort. The study has implications for nursign practice, management, research and education. Existing practice in the areas of assessment, communication, individualised care planning and the management of discomfort need to be strengthened if nursing care is to make a difference for this category of patient. The study revealed that integrated caring by nurses perceived by informants as 'experts', contributed most to the experience of finding comfort and managing discomfort in this group of informantsDoctor of Philosophy (PhD)
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Wollin, Judy A. "A comparative study of aspects of health care valued by residents with multiple sclerosis and staff at a residential setting." Thesis, Queensland University of Technology, 1993. https://eprints.qut.edu.au/36811/1/36811_Digitised%20Thesis.pdf.
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This research was undertaken in response to the implementation of a program of de-institutionalisation under the auspices of the Disability Services Act 1986, involving people with Multiple Sclerosis {MS) . The impact of de-institutionalisation on people with MS has not been researched before in Australia.
The aim of the research was to identify and compare aspects of health care valued by people with Multiple Sclerosis and staff at an assisted accommodation unit in suburban Australia.
The research participants included the residents and staff of a residential centre for people with MS. Elements of quantitative and qualitative research methods were used. Data were collected using unstructured interviews and sequential questionnaires. These data were analysed using recurrent theme identification technique.
The research shows that the current program of deinstitutionalisation has resulted in changes affecting both residents and staff. The findings of the research were similar for both groups, who wish to see the Centre remain as much as possible as it is, with in-house services continued. Changes resulting in the abolition or reduction of services are not supported by either group.
While the overall objectives of the Disability Services Act 1986 are supported by residents and staff, the major conclusion of the study is that its implementation should more closely reflect the needs of people with MS already living in an assisted accommodation unit.
7
Sims, Hazel Jane. "A case study of pressure group activity in Western Australia: Medical care of the dying bill (1995)." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1220.
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When the Australian Labor Party member for Kalgoorlie, Ian Taylor, presented his Private Member's Bill - the Medical Care of the Dying Bill (1995), he laid the foundation for this thesis. Mr Taylor introduced his Bill to the Western Australian Legislative Assembly on 28 March 1995. The Bill codified the terminally ill patient's right to refuse medical treatment, which clarified common law. This thesis attempts to overcome the dearth of literature in Western Australian lobbying concerning conscience-vote issues. It also identifies the key issues in understanding political lobbying, the form of pressure group activity that takes place and why certain groups respond in different ways. The pressure groups selected for this case study are examined, classified and evaluated resulting in a prescription for lobby group activity for similar conscience-vote issues. According to the Bill's sponsor, Ian Taylor, the legislation was needed to deal with the inconsistencies in common law of the medical treatment of terminally ill people. The Law Reform Commission in its 1991 Report on Medical Treatment for the dying, stated that there was a need to deal with the issue in Western Australia. Due to the advances in medical treatment practices in the past 50 years, doctors can prolong the life of patients for whom there is no cure. The major problem, however, is the Criminal Code: doctors and care providers can be at risk of prosecution and conviction if the patient's wishes are respected and medical treatment is withdrawn, leading to the patient's death. At present there is a general common law right to refuse medical treatment. According to Mr Taylor, the difficulty lies in the fact that in Western Australia, the common law is overridden by the Criminal Code. The Bill also highlighted the role of palliative care and the treatment of the dying. The opinion of most pressure groups was that the rights of terminally ill patients should be protected and enhanced. Of the groups selected for this case study, only the Coalition for the Defence of Human Life objected to the Bill. Other groups supported the principles of the Bill, while some hoped for voluntary euthanasia legislation and others gave tacit approval. Of all the groups the L. J. Goody Bioethics Centre distinguished itself as a key organisation which tended to monopolise political influence. Media exposure of the issue was high, particularly in The West Australian. The "right to die" issue was canvassed and often was reported with references to euthanasia. At the same time the Northern Territory legislation, the Rights of the Terminally Ill Bill (1995), was receiving much media attention. The issue of euthanasia was necessarily discussed in the context of national and international arenas. The political masters of thought on citizen participation and group theory were introduced early in the thesis. John Locke, Jean -Jacques Rousseau, James Madison, Alexis de Tocqueville, Thomas Paine and John Stuart Mill provided valuable insight into the nature of modern political thought on this interesting aspect of political activity. Contemporary political writers such as Trevor Matthews. Dean Jaensch and Graham Maddox were also consulted. The eight pressure groups selected for the study were the: • West Australian Voluntary Euthanasia Society Inc. • Coalition for the Defence of Human life • Australian Medical Association (WA Branch) • Australian Nursing Federation (WA Branch) • L. J. Goody Bioethics Centre • Silver Chain Nursing Association Inc. • Uniting Church of Australia • Anglican Church of Australia Information from the groups formed a significant part of this thesis. An attempt was made in the conclusion to ascertain the effectiveness of the various strategies utilised by the pressure groups and provide an insight into lobbying practices. Ultimately, though, the contentious Bill was not given a third reading. Nor was it debated in the Legislative Council. At one stage it was considered likely that the Bill would be recommitted to parliament. The monitoring of the Medical Care of the Dying Bill (1995) undertaken in this thesis, indicates that this would have been a lengthy and divisive process.
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Chalmers, Jane. "The oral health of older adults with dementia." Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phc438.pdf.
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Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.
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Brudevold, Christine. "Assessment of capitated contract medicine arrangements in Hong Kong : an example of financial incentives and managed care in an unregulated environment /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B20906791.
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Haghshenas, Abbas Public Health & Community Medicine Faculty of Medicine UNSW. "Negotiating norms, navigating care: the practice of culturally competent care in cardiac rehabilitation." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/32280.
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BACKGROUND Increasingly, it is recognised that the unique needs of people from culturally and linguistically diverse backgrounds (CaLDB) should be addressed within a framework of cultural competence. To date, there are limited data on the issues facing CaLDB patients in the Cardiac Rehabilitation (CR) setting. Appreciation of an individual???s values, attitudes and beliefs underpins negotiation of behaviour change in the CR setting. Therefore an understanding of patient and professional interactions is of key importance. OBJECTIVES The focus of this study has been to undertake an exploration of CR service delivery to people from culturally and linguistically diverse backgrounds, using Arabic speaking people as an exemplar of a CaLDB group. More broadly, this research project has sought to identify factors, which influence the practice of health professionals towards CaLDB patients, and to develop a model for evaluation of culturally competent health care in the CR setting. The study sought to achieve these aims by addressing the following research questions: 1. In what way do health practitioners in CR adjust their treatment and support to accommodate the perceived needs of CaLDB communities? 2. In what way do factors (such as individual and organisation perspectives) influence the adjustment of clinical practice and service delivery of CR practitioners; and what are practitioners??? and patients??? perception of barriers and facilitators to service delivery? 3. To what level are CaLDB patients satisfied with CR services? This study design is comprised of the following elements: (1) interviews with health practitioners and Arabic speaking background patients as an exemplar of CaLDB patients; (2) review of policy and procedure documents and medical records; and (3) field observation. METHOD This thesis embraces a qualitative approach as the primary method of investigation to align with the exploratory and descriptive nature of the study. The main methods used in the study were: in depth interviews with health professionals and patients; field observations; appraisal of relevant documents and consultation with expert panels. Study samples were selected through a purposive sampling strategy.Data were analysed using the method of content analysis, guided by the research questions. FINDINGS In total, 25 health professionals (20 female and 5 male) and 32 patients (21 male and 11 female) were interviewed. The method of qualitative content analysis was used for data analysis. Data analysis revealed four major themes: 1) The challenging context; 2) Tuning practices; 3) Influencing factors; and 4) Goodness of fit. The study demonstrated a challenging context for CR delivery, both from the perspective of patients and health professionals. Data reveal a process of reflection, negotiation, and navigation of care by CR health professionals in an effort to understand and meet the diverse needs of CALDB patients. CONCLUSION On the basis of the study findings, a process-oriented model of tuning practice to achieve cultural competence in CR delivery is proposed to inform policy, research and clinical practice.
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McNamara, Laurence James. "Just health care for aged Australians : a Roman Catholic perspective /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm1682.pdf.
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MURPHY, CATHRYN LOUISE School of Health Services Management UNSW. "INFECTION CONTROL IN THE AUSTRALIAN HEALTH CARE SETTING." Awarded by:University of New South Wales. School of Health Services Management, 1999. http://handle.unsw.edu.au/1959.4/17600.
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1,708 members of the Australian Infection Control Association were surveyed to describe the practices of Australian infection control practitioners. The study details the methods infection control practitioners use to co-ordinate and measure nosocomial infections as clinical outcomes of Australian infection surveillance and control programs. Administrators' and clinicians' perceptions of the elements and infrastructure of infection surveillance and control programs and the role of the infection control were measured in 316 hospitals in New South Wales, Australia. A literature review found that the development of Australian infection surveillance and control programs is behind that of U.S.A and the United Kingdom. The survey of the infection control practitioners identified that their role and duties varied between facilities as did the time allocated to infection control tasks. The survey of infection control practitioners demonstrated variation in their levels of skill, education and experience. Infection control practitioners' use and application of evidence and associated skills was examined and found to be limited in relation to clinical decision making and policy development. The survey also examined the methods infection control practitioners use to undertake surveillance of nosocomial infections. The methods reported indicated non-standard approaches to surveillance activity. A survey of administrators and clinicians in NSW hospitals was undertaken to identify variation in administrator and clinician perceptions and to describe their level of support for recommended essential infrastructure and criteria for infection surveillance and control programs and the role of the infection control practitioner in accordance with Scheckler's model. The survey indicated divergent views regarding the role of the infection control practitioner and the essential elements of infection surveillance and control programs. The study identified that education of infection control practitioners is necessary to facilitate standard approaches to co-ordinating infection surveillance and control activity. The development of Australian infection surveillance and control programs require a strategic alliance between stakeholders. to define essential elements of infection surveillance and control programs. In addition, the role of the infection control practitioner must be defined before key stakeholders can agree on the minimum skills, qualifications and experience required by an infection control practitioner.
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McCreanor, Victoria Helen Rarity. "Identifying high-value care for coronary artery disease in Australia." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/130756/1/Victoria_McCreanor_Thesis.pdf.
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This project compared the cost-effectiveness of drug therapy, stents and surgery for Australian patients with heart disease, modelling their long-term treatment trajectories, costs and health outcomes. It showed that drug therapy is high-value and that the health system, and Australians, would benefit from targeted rather than routine use of stents. This research provides policy recommendations to reduce the use of low-value care and increase the use of high-value care for Australian patients with heart disease.
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Sinclair, Andrew. "The primary health care experiences of gay men in Australia." Connect to this title online, 2006. http://adt.lib.swin.edu.au/public/adt-VSWT20060713.084655/.
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Geoghegan, John. "What do RNs working in hospital aged care units identify as the positive and negative aspects of aged care nursing?" View thesis, 2006. http://handle.uws.edu.au:8081/1959.7/19352.
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Thesis (M.Sc.(Hons) Health) -- University of Western Sydney, 2006.A thesis submitted for examination for the degree of Master of Health Science (Hons) to the University of Western Sydney, College of Health and Science, School of Nursing. Includes bibliography.
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Forsyth, Rowena Public Health & Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.
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Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.
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Andersson, Kerstin. "Oral health in old age : perceptions among elderly persons and medical professionals /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-816-9/.
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Chau, So-wah Francis. "Assess the feasibility of having an insurance-like national-scale health service in Hong Kong /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14710419.
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Sorensen, Ros Public Health & Community Medicine Faculty of Medicine UNSW. "The dilemma of health reform : managing the limits of policymaking, managerialism and professionalism in health care reform." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2002. http://handle.unsw.edu.au/1959.4/33194.
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Hospitals worldwide are under pressure to perform and models abound to remedy poor performance. Reform, however, is contested, uneven and slow. One reason is that few models address a core issue in reform: the management of clinical work. A further reason is that stakeholder groups, specifically policymakers, managers and clinicians, limit opportunities for collaborative problem solving as they seek to impose their own frame of reference in the struggle for control. I hypothesise that performance will be relatively better in hospitals that have in place strategies of agreement to set the objectives of reform, such as participative problem identification, problem solving and decision making, together with a method to manage clinical work. This hypothesis was tested in twelve public hospitals in three Australian states between 1999 and 2001 using both quantitative and qualitative research methods. Government and hospital policy documents were assessed and semi-structured interviews were conducted to gauge the attitudes and practices of managers and clinicians regarding health care reform. The results of the research show that hospitals with inclusive strategies for change, principally strategies of agreement, joint education and skills development, team-based incentives to direct and reward effort and a method of clinical work management, performed better than those without. Findings indicate that policy was developed and communicated as a rational top-down process that tended to exclude diverse views. Although the effect of different jurisdictional policy processes on hospital performance was not clear, they had considerable impact on the environment of reform. Cost containment and patient safety dominated as policy objectives. These alone did not engage clinician interest or address service quality. The connection between the quality of care and its cost did not appear to be understood. Organisational structures and processes necessary to support reform, that is communication forums for objective setting and performance review, integrated clinical and corporate accountability systems and organisational capacity building were not in place in the majority of hospitals studied. An organisational model of clinical work management was developed to improve cost-effectiveness by balancing clinical autonomy and clinical accountability based on the research results.
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Carter, Robert C. (Robert Charles) 1950. "The macro economic evaluation model (MEEM) : an approach to priority setting in the health sector." Monash University, Dept. of Management, 2001. http://arrow.monash.edu.au/hdl/1959.1/8672.
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Macfarlane, Chelsea E., University of Western Sydney, and School of Applied Social and Human Sciences. "A comparison of the predictors of hepatitis B vaccination acceptance amongst health care and public safety workers in Australia." THESIS_XXX_ASH_MacFarlane_C.xml, 2001. http://handle.uws.edu.au:8081/1959.7/784.
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This thesis examines the results of a hepatitis B vaccination questionnaire study that was completed by medical officers, nurses, carers of the developmentally disabled, and correctional officers in the Greater Western Sydney area of New South Wales, Australia. The main aim of the study was to contrast these four high risk occupational groups for their acceptance of hepatitis B vaccination, seroconversion status, and behavioural, attitudinal, motivational and institutional determinants of their vaccination status. The results of the thesis revealed that medical officers and nurses were the most likely to be tested and vaccinated for seroconversion, while DD carers and correctional officers had the largest number of Not Vaccinated respondents. The findings of the questionnaire are discussed in some detail. It is also suggested that groups differ in the degree of hepatitis risk anxiety they experience as well as the degree of control felt over their health status. A number of indications for personal, institutional and governmental interventions to increase vaccination levels are discussed.Doctor of Philosophy (PhD)
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Macfarlane, Chelsea Elizabeth. "A comparison of the predictors of hepatitis B vaccination acceptance amongst health care and public safety workers in Australia /." View thesis, 2001. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031222.150943/index.html.
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Thesis (Ph.D.) -- University of Western Sydney, 2001."A thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, University of Western Sydney" Bibliography : leaves 193-208.
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Conrad, Michael Dean, and Anna Kampanartsanyakorn. "Advanced practice nursing health care needs assessment in an underserved community." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2336.
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The purpose of this study was to gain information about the community health care needs through a comprehensive assessment. This information will allow providers to identify services and groups of people where the biggest gap exists in receiving needed health care services. This may provide the basis for the design of an advanced practice preventative health intervention for the community.
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Beasley, Emily Louise. "Survey assessment of treatment outcomes in adult tinnitus patients receiving tinnitus retraining therapy /." Full-text of dissertation on the Internet (2.52 MB), 2010. http://www.lib.jmu.edu/general/etd/2010/doctorate/beasleel/beasleel_doctorate_04-21-2010.pdf.
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Alexander, Kathy. "Promoting health at the local level : a management and planning model for primary health care services /." Title page, contents and introduction only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09pha376.pdf.
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Murtagh, Madeleine Josephine. "Intersections of feminist and medical constructions of menopause in primary medical care and mass media: risk, choice and agency." Title page, table of contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phm9851.pdf.
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Includes bibliographical references (leaves 254-288). Examines language used by general practitioners and in mass media to ask 'what are the implications of constructions of menopause for health care practice and public health for women at menopause?'. Presents the findings of qualitative analysis of semi-structured interviews with nine general practitioners working in rural South Australia and qualitative and quantitative analyses of 345 south Australian newspaper articles from 1986 to 1998.
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Stuart, Rhonda Lee 1963. "Nosocomial tuberculous infection : assessing the risk among health care workers." Monash University, Dept. of Epidemiology and Preventive Medicine, 2000. http://arrow.monash.edu.au/hdl/1959.1/9004.
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Ohtsuka, Thai, and thai_ohtsuka@hotmail com. "Impact of cultural change and acculturation on the health and help seeking behaviour of Vietnamese-Australians." Swinburne University of Technology, 2005. http://adt.lib.swin.edu.au./public/adt-VSWT20051013.095125.
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This study investigated the influence of cultural change and acculturation on
health-related help seeking behaviour of Vietnamese-Australians. Using convenience
sampling, 94 Vietnamese-Australians, 106 Anglo-Australians, and 49 Vietnamese in Vietnam participated in the study. Beliefs about health and health-related help-seeking behaviours were assessed through measures of common mental health symptoms, illness expression (somatisation, psychologisation), symptom causal attributions (environmental, psychological, biological), and choice of help seeking (self-help, family/friends, spiritual, mental health, Western medicine, Eastern medicine).Vietnamese-Australian data was compared with that of the Anglo-Australian and Vietnamese-in Vietnam. Results revealed that the help seeking behaviours and health related cognitions of Vietnamese-Australians, while significantly different from those of Anglo-Australians, were similar to those of Vietnamese in Vietnam. Specifically, both Vietnamese groups were less likely than Anglo-Australians to somatise and
psychologise or attribute the cause of symptoms to environmental, psychological or biological causes. However, the two Vietnamese groups were not different from each other in their style of illness expression or in their symptom causal attributions. The Vietnamese-Australians reported experiencing more mental health symptoms than the Vietnamese in Vietnam but fewer than the Anglo-Australians. In relation to help seeking, the Anglo-Australians chose self-help more than the Vietnamese, but there were few other differences between the cultural groups.
To investigate the influence of acculturation on health-related beliefs and help seeking behaviour, Vietnamese-Australians were compared according to their modes of acculturation (integration, assimilation, separation, and marginalisation). Generally, results showed a distinct pattern of response. Those with high levels of acculturation towards the Australian culture (the integration and the assimilation) were found to be most similar (in that they scored the highest in most areas measured) to the Anglo-Australians, while few differences were found between the separated and the
marginalised groups. Further, cultural orientation was a powerful predictor of help
seeking. In that, original cultural orientation predicted selection of help seeking from
Western and Eastern medicine, whereas, the host cultural orientation was a more robust predictor of the other variables. However, neither cultural orientation predicted preference for mental health help. Finally, the study found that, although the combination of symptom score, modes of illness expression, and symptom causal
attribution were strong predictors of choice of help seeking of Vietnamese-Australians,
acculturation scores further improved predictive power. The results were discussed in terms of the various limitations and constraints on interpretation of this complex data set.
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Mills, David. "The role of goal setting in the diabetes case management of aboriginal and non-aboriginal populations in rural South Australia /." Title page, table of contents and abstract only, 2005. http://web4.library.adelaide.edu.au/theses/09MD/09mdm6571.pdf.
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Thesis (M.D.)--University of Adelaide, Dept. of General Practice, 2005.Includes publications published as a result of ideas developed in this thesis, inserted at end. "April 2005" Includes bibliographical references (leaves 210-242).
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D'Arrietta, Louisa, and n/a. "An investigation of the information needs and information-seeking behaviour of general practitioners in their delivery of patient care to the elderly on the Gold Coast." University of Canberra. Information, Language & Culture, 1994. http://erl.canberra.edu.au./public/adt-AUC20060426.164122.
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The study investigated the self-reported information needs and
information-seeking behaviour of 143 general practitioners in their delivery
of patient care to the elderly on the Gold Coast.
The study sought to obtain an information profile in order to begin
discussion on the need for possible infrastructures that may need to be
considered in any planning strategies concerned with access to and
provision of relevant, accurate and timely information to general
practitioners which affects their delivery of patient care to the growing
number of elderly patients.
A ten-page questionnaire utilising both structured and unstructured
questions was returned by 61.9 percent of the survey population.
Demographic characteristics indicated that respondents were representative
of general practitioners in Australia.
Respondents frequently needed information with 40 percent requiring it '1 -
4 times a week' and 78 percent 'once a month or more often'. Information
on medical fact was required most frequently, 29 percent, medical opinion
27 percent, and non-medical information 23 percent.
The study found support for the proposition that computerised information
systems need to be enhanced and made widely known and available to
general practitioners to assist them in obtaining information that they need
in delivery of patient care to the elderly. There is a great need by these
general practitioners for non-medical information as well as medical
information. Therefore, the development of a database of non-medical
information containing information on local agencies and services is of high
priority.
Library information delivery services should also be de-institutionalised in
terms of lifting restrictions to services provided to enable general
practitioners greater access to information. Library services should aim to
provide remote access to information via telephone, fax and modem with
emphasis on value added services aimed at solving a particular specific
information need as well as straight-out bibliographic search services and
document delivery services.
Continuing medical education in the form of CME courses, conferences and
meetings should focus on specific information needs of general practitioners
in this area of patient care to the elderly. The need for information on
cardiology, orthopaedics, dermatology, physiotherapy, podiatry,
pharmaceutical benefits, home help, Meals-on-Wheels and nursing home
placement were areas of particular interest identified by respondents in this
study.
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Bennett, Paul J. "An investigation into the health related outcomes of surgery performed by Fellows of the Australian College of Podiatric Surgeons." Thesis, Queensland University of Technology, 1999. https://eprints.qut.edu.au/36746/1/36746_Digitised%20Thesis.pdf.
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Health care providers in the United States, United Kingdom and Australia debate the need for expanding the role of podiatrists' to include the surgical care of foot problems. Paradoxically, during a twelve month period from July 1995 to June 1996, Fellows of the Australian College of Podiatric Surgeons (FACPS) performed over 1,500 individual surgical operations on approximately 785 Australians.
Few prospective investigations of podiatric surgeon outcomes have been conducted, none of which have taken place in Australia. More particularly, no studies have used valid psychometric instruments to measure the effects of care provided on patients' "health related quality of life". The research contained in this thesis deals with the conceptualisation, development and validation of a new health status instrument: the Foot Health Status Questionnaire. This instrument has been developed with the specific intent of investigating the impact of FACPS on patients' health related quality of life.
One hundred and forty-two subjects treated by eleven Fellows for orthopaedic, neurological or integumentary systems diseases of the foot were recruited into a six month long quasi-experimental repeated measures (time series) study. The study identified that the vast majority of subjects (more than 92%) who underwent foot surgery experienced significant improvements' in a range of health related quality of life dimensions and indicated that they would undergo their procedure again. In particular, a MANCOVA analysis demonstrated that subjects' reported reduced levels of foot pain, increased levels of physical function, improved general foot health perception and footwear related quality of life, up to six months after their respective operations.
Adverse effects of surgery identified in this study include a significant short-term functional disability for subjects' undergoing orthopaedic correction of foot problems and, in the immediate post operative phase, a significant reduction in social function for all three groups of subjects'. Generic measures of General Health and Vitality, as captured by the Short Form 36 health status instrument, were unaffected by Fellows treatment. This study did not identify any significant short to medium term morbid outcomes.
Assessment of patients' satisfaction with surgery one, three and six months postoperatively reflected a general under-reporting of the beneficial effects of foot surgery. These findings support the premise that; specific health related quality of life measures provide significant explanatory power about the outcomes of care compared with the more traditional approach of evaluating patient satisfaction with surgery.
In summary, it has been recommended that podiatrists, like other health care professionals, use recognised methods to determine whether their care meets professional standards and to generate evidence to prove that it does. This research contributes to meeting this important public health need.
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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.
Full textAbstract:
[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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Cato, Denys, and mikewood@deakin edu au. "An examination of the 'all hazards' approach to disaster management as applied to field disaster management and pre-hospital care in Australia." Deakin University. School of Health Sciences, 2002. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20051017.140738.
Full textAbstract:
Disasters, emergencies, incidents, and major incidents - they all come back to the same thing regardless of what they are called. The common denominator is that there is loss of life, injury to people and animals and damage and destruction of property.
The management of such events relies on four phases:
1. Prevention
2. Preparation
3. Response
4. Recovery
Each of these phases is managed in a different way and often by different teams. Here, concentration has been given to phases 2 and 3, with particular emphasis on phase 3, Response.
The words used to describe such events are often related to legislation. The terminology is detailed later. However, whatever the description, whenever prevention is not possible, or fails, then the need is to respond. Response is always better when the responders are prepared. Training is a major part of response preparation and this book is designed to assist those in the health industry who need to be ready when something happens. One of the training packages for responders is the Major Incident Medical Management and Support (MIMMS) Course and this work was designed to supplement the manual prepared by Hodgetts and Macway-Jones(87) in the UK.
Included is what the health services responder, who may be sent to an event in which the main concern is trauma, should know. Concentration is on the initial response and does not deal in any detail with hospital reaction, the public health aspects, or the mental health support that provides psychological help to victims and responders, and which are also essential parts of disaster management.
People, in times of disaster, have always been quick to offer assistance. It is now well recognised however, that the 'enthusiastic amateur', whilst being a well meaning volunteer, isn't always what is needed. All too often such people have made things worse and have sometimes ended up as victims themselves. There is a place now for volunteers and there probably always will be. The big difference is that these people must be well informed, well trained and well practiced if they are to be effective.
Fortunately such people and organisations do exist. Without the work of the St John Ambulance, the State Emergency Service, the Rural Fire Service the Red Cross and the Volunteer Rescue Association, to mention only a few, our response to disasters would be far less effective.
There is a strong history of individuals being available to help the community in times of crisis. Mostly these people were volunteers but there has also always been the need for a core of professional support. In the recent past,
professional support mechanisms have been developed from lessons learned, particularly to situations that need a rapid and well organised response.
As lessons are learned from an analysis of events, philosophy and methods have changed. Our present system is not perfect and perhaps never will be. The need for an 'all-hazards approach' makes detailed planning very difficult and so there will probably always be criticisms about the way an event was handled. Hindsight is a wonderful thing, provided we learn from it. That means that this text is certainly not the 'last word' and revisions as we learn from experience will be inevitable.
Because the author works primarily in New South Wales, many of the explanations and examples are specific to that state. In Australia disaster response is a State, rather than a Commonwealth, responsibility and consequently, and inevitably, there are differences in management between the states and territories within Australia. With the influence of Emergency Management Australia, these differences are being reduced. This means that across state and territory boundaries, assistance is common and interstate teams can be deployed and assimilated into the response rapidly, safely, effectively and with minimum explanation. This text sets out to increase the understanding of what is required, what is in place and how the processes of response are managed.
By way of introduction and background, examples are given of those situations that have occurred, or could happen.
Man Made Disasters has been divided into two distinct sections. Those which are related to structures or transport and those related directly to people. The first section, Chapter 3, includes:
Transport accidents involving land, rail, sea or air vehicles.
Collapse of buildings for reasons other than earthquakes or storms.
Industrial accidents, including the release of hazardous substances and nuclear events.
A second section dealing with the consequences of the direct actions of people is separated as Chapter 4, entitled 'People Disasters'. Included are:
Crowd incidents involving sports and entertainment venues.
Terrorism
From Chapter 4 on, the emphasis is on the Response phase and deals with organisation and response techniques in detail.
Finally there is a section on terminology and abbreviations. An appendix details a typical disaster pack content.
War, the greatest of all man made disasters is not considered in this text.
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Capp, Stan, and kimg@deakin edu au. "The Geelong Community's Priorities and Expectations of Public Health Care." Deakin University. School of Health Sciences, 2001. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20040505.114253.
Full textAbstract:
Abstract
This thesis set out to achieve the following objectives:
(1) To identify the priorities and expectations that the Geelong community has of its public health care system.
(2) To determine if there is a common view on the attributes of a just health system.
(3) To consider a method of utilising the data in the determination of health care priority setting in Barwon Health.
(4) To determine a model of community participation which enables ongoing input into the decision making processes of Barwon Health.
The methodology involved a combination of qualitative and quantitative research. The qualitative work involved the use of focus groups that were conducted with 64 members of the Geelong community. The issues raised informed the development of the interview schedule that was the basis of the quantitative study, which surveyed a representative sample of 400 members of the Geelong community. Prior to reporting on this work, the areas of distributive justice, scarcity and community participation in health care were considered. The research found that timely access to public hospitals, emergency care and aged care services were the major priorities; for many people, the cost was less relevant than a quality service. Shorter waiting times and increased staffing levels were strongly supported. Increased taxes were nominated as the best means of financing the health system they sought. Community based services were less relevant than hospital services but health education was supported. An egalitarian approach to resource distribution was favoured although the community was prepared to discriminate in favour of younger people and against older people. There was strong support for the community to be involved in decision making in the public health care system through surveys or focus groups but very little support was given to priorities being determined by politicians, administrators and to a lesser extent, medical professionals.
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Kelman, Christopher William, and christopher kelman@cmis csiro au. "Monitoring Health Care Using National Administrative Data Collections." The Australian National University. National Centre for Epidemiology and Population Health, 2001. http://thesis.anu.edu.au./public/adt-ANU20020620.151547.
Full textAbstract:
With the inevitable adoption of information technology into all areas of human pursuit, the potential benefits for health care should not be overlooked. In Australia, details of most health care encounters are currently recorded for administrative purposes. This results in an impressive electronic data-bank that could provide a national resource for health service evaluation.
¶
Evaluation of health services has become increasingly important to provide indicators of the benefits, risks and cost-effectiveness of treatments. However, if administrative data are to be used for this purpose, several questions must first be addressed: Are the current data collections accessible? What outcome measures can be derived from these data? Can privacy issues be managed? Could the quality of the data be improved? Is the existing infrastructure adequate to supply data for evaluation purposes? Could the existing system provide a basis for the development of an integrated health information system?
¶
The aims of the project were:
· To examine the potential for using administrative data to generate outcome measures and surveillance indicators.
· To investigate the logistics of gaining access to these data for the purpose of research. This to be achieved within the current ethical, political and financial framework.
· To compare the Australian health-service data system with the current international state-of-the-art.
· To develop suggestions for expansion of the present system as part of an integrated health record and information system. This system to manage patient records and provide data for quality management, treatment surveillance and cost-effectiveness evaluation as a routine activity.
¶
The thesis is presented in two parts. In the first part, a historical cohort study is described that involved patients with implantable medical devices. The potential to evaluate outcomes was investigated using all national health-service information currently available in electronic form. Record linkage techniques were used to combine and augment the existing data collections. Australias national health databases are to varying degrees, amenable to such linkage and cover doctor visits, pharmaceuticals, hospital admissions and deaths. The study focused on medical devices as an illustrative case but the results are applicable to the routine assessment of all medical and surgical interventions.
¶
For the Australian Medical Devices study, the records of 5,316 patients who had medical device implants in 1993-94 were selected from the archives of a major private health insurer. Five groups of medical implants were studied: heart valves, pacemakers, hips, vascular grafts and intra-optic lenses. Outcomes for these patients, including death, re-operation and health service utilisation, were compared and analysed.
¶
A comparison study was performed using data from the Manitoba Health database in Winnipeg, Canada. Manitoba provides a very similar demographic group to that found in Australia and is an example of a prototype integrated-health-information system. One of the principal advantages for research is that personally identified data about medical and hospital services are collected for all patients. Selection bias is eliminated because individual consent is not required for this type of research and all selected patients could be included in the study.
¶
The two studies revealed many barriers to the use of administrative data for health outcomes research. Service event data for the Australian cohort could be collected but only after long delays and hospital morbidity data were not available for the entire cohort. In contrast to the situation in Australia, the Manitoba data were both accessible and complete, but were lacking in detail in some areas.
¶
Analysis of the collected data demonstrated that without the addition of clinical data only general indications of trends could be deduced. However, with minimal supplementary clinical data, it was possible to examine differences in performance between brands of medical devices thus indicating one of the uses for this type of data collection.
¶
In the second part of the thesis, conclusions are presented about the potential uses and limitations of the existing system and its use as a basis for the development of a national Integrated Health Record and Information System (IHRIS). The need for the establishment of a systemic quality management system for health care is discussed.
¶
The study shows that linked administrative data can provide information about health outcomes which is not readily available from other sources. If expanded and integrated, the system that is currently used to collect and manage administrative data, could provide the basis for a national health information system. This system would provide many benefits for health care. Benefits would include the monitoring, surveillance and cost-effectiveness analysis of new and existing treatments involving medical devices, drugs and surgical procedures. An integrated health information system could thus provide for both clinical and administrative needs, while in addition providing data for research.
¶
Unfortunately, in Australia, the use of administrative data for this purpose is not currently feasible. The principal barrier is the existence of a culture within the Australian health care system which is not supportive of research and is deficient in quality and safety measures.
¶
Recent initiatives by both the Commonwealth and state governments have supported the introduction of measures to improve quality and safety in health care. It is argued here that an Integrated Health Record and Information System (IHRIS) would provide an essential component of any such scheme. The results of this study have important policy implications for health care management in both the administrative and clinical domains.
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Balnave, Nikola Robyn. "Industrial Welfarism in Australia 1890-1965." University of Sydney. Work and Organisational Studies, 2002. http://hdl.handle.net/2123/572.
Full textAbstract:
This thesis examines industrial welfarism in Australia from 1890 to 1965. This period witnessed the gradual spread of the welfarism movement throughout Australian industry as employers sought ways to increase productivity and control in the face of external challenges. Once reaching its peak in the immediate post-War period, the welfarism movement was gradually subsumed as part of the increasing formalisation of personnel management. Waves of interest in welfare provision coincided with periods of labour shortage and/or labour militancy in Australia, indicating its dual role in the management of labour. Firstly, by offering benefits and services beyond that made necessary by the law or industrial awards, welfarism was designed to create a pool of good quality workers for management to draw from. Secondly, managers sought to enhance their control over these workers and their productive effort, using welfarism as a technique to build worker consent to managerial authority. This could be achieved through subtle methods aimed at boosting loyalty and morale, or through more direct programs designed to increase worker dependency on the company. In both ways, individual and collective worker resistance could be minimised, thereby reinforcing managerial prerogative. Despite its adoption by a variety of companies, a number of economic, political and institutional factors limited the extent of industrial welfarism in Australia. These include the small-scale of most enterprises prior to the Second World War, state involvement in the area of industrial relations and welfare provision, and the strength of organised labour. While the welfarism movement did not reach the heights experienced overseas, it nonetheless provided an important contribution to the development of formal labour management in Australia.
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McCullough, Kylie. "The delivery of Primary Health Care in remote Australian communities: A Grounded Theory study of the perspective of nurses." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2018. https://ro.ecu.edu.au/theses/2153.
Full textAbstract:
Around 85% of Australia’s landmass is remote and sparsely populated. Across these vast areas of desert, wilderness and tropical islands, nurses provide the majority of health care services. The residents of Australia’s remote communities have poorer health status than their metropolitan counterparts. The proportion of Indigenous people is high and health and social disadvantage is widespread. The characteristics of each remote community are unique and often reflect challenges associated with distance to tertiary health services and limited health resources. As a result, nursing practice within this context is very different to other nursing contexts. Despite recognition of Primary Health Care (PHC) as a comprehensive model of acute and preventative care well suited to areas of high health and social need, there is little known about how nurses use the PHC model in practice and research pertaining to this nursing context is limited.
This study was conducted from a Constructivist Grounded Theory perspective to generate a substantive theory. Data were collected through 23 telephone interviews and an expert reference group.
This study adds previously unknown information to the body of work about remote area nursing. The context of providing PHC in a remote setting was described as social with a focus on illness prevention and equality of care. Participants described personal satisfaction as a feeling of making a difference to the health and wellbeing of the community. However, the core issue participants faced was the inability to provide PHC. Four conditions that impacted on the core issue, were described as: understanding of the social world of the remote community, availability of resources, clinical knowledge and skill and, shared understanding and support. The process labelled doing the best you can with what you have emerged as the way participants dealt with the inability to provide PHC. The process involved four primary activities: facilitating access to health care, continually learning, seeking understanding, and home‐making in a work environment. The outcome of this process was considered to be making compromises to provide PHC.
This study proposes a substantive theory to understand and explain Australian remote nursing practice. Recommendations include further exploration, testing and refinement of the substantive theory. The implications for practice include development of education and support programs and the findings promote the case for providing additional resources to health services in remote areas in order to support nurses in providing PHC.
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Murphy, Mary Denise. "Living with asthma in Australia : an anthropological perspective on life with a chronic illness." University of Western Australia. School of Anatomy and Human Biology, 2005. http://theses.library.uwa.edu.au/adt-WU2005.0070.
Full textAbstract:
[Truncated abstract] In Australia, asthma is a common chronic illness, which often requires complex treatment regimens. This study used an anthropological perspective to explore the experience of people living with asthma, with the specific aim of contributing to the health care programs offered to people living with asthma. The study was conducted in an Australian city (Perth, Western Australia). The foci of the study were Australian lay people, from the general community, living with asthma, and a small number of non- English speaking Vietnamese-Australian migrants. Some spouses of the Australians and biomedical practitioners were also included. Questionnaires, and particularly indepth interviews, were used to explore the explanatory models of asthma for doctors and lay people with the condition. The explanatory models of the doctors focused primarily on assessing and treating the physiological dimension of asthma, and educating patients. The explanatory models for lay people with asthma reflected their everyday reality: in addition to its impact on their physical health, asthma affected their daily life, social roles and participation, and their personal identity. Placing the experience of asthma in this wider perspective showed that the Australians used practical reasoning to make a trade-off between using medication, such that they felt safe from `attacks? and could `do all they wanted to do?, and minimising their `dependence? on potentially harmful medications. Responding to acute episodes involved a risk assessment in which people weighing the health risk of waiting against the social risk of seeking help unnecessarily. For the Vietnamese- Australians, caring for asthma was strongly shaped by their social position as non- English speaking migrants. They lacked access to information about asthma and to specialist care. They had sufficient medication, but were ill-informed about how to use their medicines effectively and safely: in general, the Vietnamese people were overmedicated but under-serviced in the care of their asthma. Beyond explanatory models, the Australian participants (lay people and doctors) shared a cultural model of asthma as a chronic illness. This Australian cultural model shaped the experience and care of asthma. It included concepts such as framing the past as an adjustment process, and the present as `living normally? with asthma. Taking care of asthma was expressed as `taking control? of asthma, so a person could minimise the illness and still be healthy. The Vietnamese-Australians did not share this cultural model of asthma as a chronic illness, as reflected in their expression of the hardship asthma created in limiting their ability to work hard for their family, and how they expected a cure for their condition from biomedicine. The Australians also shared a cultural model of health that was derived, in part, from the health promotion messages that are targeted at lay people. These promotional messages were the basis of a morality in health: people shared an implicit understanding that a person deserved health, and assistance when ill, when he/she displayed the required self-discipline in performing health behaviours.
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Leon, de la Barra Sophia. "Building research capacity for indigenous health : a case study of the National Health and Medical Research Council : the evolution and impact of policy and capacity building strategies for indigenous health research over a decade from 1996 to 2006." University of Sydney, 2007. http://hdl.handle.net/2123/3538.
Full textAbstract:
Master of PhilosophyAs Australia’s leading agency for funding health research (expending over $400 million in 2006), the National Health and Medical Research Council (NHMRC) has a major responsibility to improve the evidence base for health policy and practice. There is an urgent need for better evidence to guide policy and programs that improve the health of Indigenous peoples. In 2002, NHMRC endorsed a series of landmark policy changes to acknowledge its ongoing role and responsibilities in Indigenous health research—adopting a strategic Road Map for research, improving Indigenous representation across NHMRC Council and Principal Committees, and committing 5% of its annual budget to Indigenous health research. This thesis examines how these policies evolved, the extent to which they have been implemented, and their impact on agency expenditure in relation to People Support. Additionally, this thesis describes the impact of NHMRC policies in reshaping research practices among Indigenous populations.
40
Day, Julie A. "Behavior of family practice residents in screening and treating at-risk patients for high blood cholesterol." Virtual Press, 1999. http://liblink.bsu.edu/uhtbin/catkey/1136701.
Full textAbstract:
This study was designed to answer the following research questions: "Are those at risk for coronary heart disease being screened for high blood cholesterol?" and "Are those with high blood cholesterol being treated according to the national guidelines?" The importance of early detection and treatment of high blood cholesterol is vital for preventive health care. A chart review of patient records was conducted to determine the behavior of the family practice residents. From the analysis of data it was determined that the residents screened their patients 83.0% of the time and when compared with national guidelines, treated those patients identified with high blood cholesterol 52.8% of the time. Third year residents screened their patients more (88.7%) for blood cholesterol than first (82.1%) or second (74.7%) year residents. Male residents screened a higher percent of their patients (84.8%) than female residents (75.0%).Department of Physiology and Health Science
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McGonigle, T. Hope. "Surveying for sexuality in cyberspace sexual orientation and stage of change for cervical cancer screening /." Connect to this title online, 2003. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1061318216.
Full text
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Mussett, Janis. "An analysis of quality practices and business outcomes in Western Australian hospitals." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2000. https://ro.ecu.edu.au/theses/1651.
Full textAbstract:
This study aimed at identifying aspects of health care organisational management and activities that produced the highest level of quality care. A Literature review was conducted to determine the most successful quality activities currently used in a wide variety of industries. Using the findings of this review a questionnaire and interview questions were designed to identify factors associated with successful quality activities I health care organisations. Four Western Australian hospitals that were believed to have effective quality activities were randomly selected as a hospital from each of the following categories. A private hospital accredited by the Australian Council on Health Care Standards. A country hospital that had 100% patient satisfaction and a city hospital with above 96% patient satisfaction assessed by the State wide Government Patient Satisfaction with Care Survey. A hospital that the Health Department of Western Australia considered had best practice in Quality Activities. Each of these hospitals was matched with a control hospital. Data was collected through direct observation of a questionnaire and interviews with people in predetermined health service employment positions and the completion of one randomly selected supplier interview for each of the eight health services studied. The questionnaire was supplied to a range of staff members and interviews were conducted with these employees and hospital goods or service suppliers. Data was analysed using qualitative evaluation, frequency distribution and a factor analysis. Results obtained in this study identified that the most important factors required to produce the most profitable and highest quality of health care were a culture of caring, providing employees with enough time to complete their work and having effective organisation wide communication. A Quality Care Model for use in Health Services was created based on the research findings. When used this model of quality activities should provide customer satisfaction and a high standard of cost effective health care service.
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Helen, Maureen. "Other people's country: A memoir; and, Developing a trustworthy narrator: An essay." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2006. https://ro.ecu.edu.au/theses/1796.
Full textAbstract:
This thesis comprises two interrelated sections. The first section is a substantial piece of creative writing, which l have cailed 'Other People's Country: A Memoir, in the genre of travel memoir, and an essay. The memoir borrows techniques from fiction, drama and poetry to tell a story of a middle-aged, middle-class city nurse, who travels to a remote settlement at the edge of the Western Desert of Western Australia to provide health care for a fluctuating population of around 400 people, for whom English is a third or fourth language.
Writing that includes stories about vulnerable people from another culture, whose lives have touched those of the writer, demands sensitivity to differences, as well as an ethical approach. Writing about Aboriginal people also demands an awareness of what is appropriate when writing about cultural material. To achieve the voice of a trustworthy narrator is a challenge that faces all writers of narrative non-fiction, including memoir. The truth is subjective; perception is unreliable; memory can be distorted; error slips in unwittingly; deliberate falsification is possible. In spite of all this, a writer of memoir makes a contract with the reader that the story is significant, and that it is the writer's truth, told as honestly as possible. The pivotal concern of this thesis is the question, 'What are some of the important considerations for a memoirist who is attempting to develop the voice of an ethical and trustworthy narrator writing about experiences encountered when living and working within an unfamiliar culture?
The second part of the thesis is an essay which develops a theoretical framework in response to some of the major dilemmas I encountered in this undertaking. It embraces memory, aspects of Aboriginal vulnerability, and ethics through which to explore the concepts of truth and honesty in memoir-writing.
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Geoghegan, John, University of Western Sydney, College of Health and Science, and School of Nursing. "What do RNs working in hospital aged care units identify as the positive and negative aspects of aged care nursing?" 2006. http://handle.uws.edu.au:8081/1959.7/19352.
Full textAbstract:
This study reports the positive and negative aspects identified by registered nurses (RNs) working with older people in public hospital aged care units and was conducted in 4 public hospitals in Sydney, Australia. Qualitative data using questionnaires and telephone interviews was collected from 26 female and 4 male RNs of which 46% (n 14) had worked in an aged care unit for 10 years or more. The participants identified positive perceptions within three major themes: a genuine liking of older people; the stories older people tell and the complexity of the older patient’s illnesses. Positive responses were a focus as it was identified that this was a gap in the literature which required addressing at the time. These findings are significant and have implications for nursing practice for several reasons: Data was collected exclusively from RNs and focused on their positive perceptions about aged care nursing in public hospitals. Participants reported a genuine liking for older people. Patients’ telling their stories was reported by 60% (n 18) of participants as being interesting in their work and meaningful to the patient and should be considered more as a therapeutic process during hospitalisation to assist support and enhance patient outcomes and therapy. The participants reported that aged care nursing is complex, rewarding and requires mature nurses, with current nursing knowledge and skilled in the art of caring for older people. These findings can be used to improve recruitment and retention of RNs within aged care nursing.Master of Health Science (M.Sc.(Hons) Health)
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Patterson, Jan. "Consumers and complaints systems in health care / Jan Patterson." Thesis, 1996. http://hdl.handle.net/2440/19008.
Full textAbstract:
Bibliography: leaves 463-496.ix, 497 leaves ; 30 cm.
This thesis explores the dimensions of the actions of consumers, governments and service providers influential in contributing to the climate of reform in the health care area in Australia and the subsequent developments. There are clearly defined consumer models of complaints-handling for the health area, ascertainable from examination of the broader context of the development of the consumer movement and consumer organisations ; and specifically drawing on the common elements from the contribution of the consumer movement in health. A consumer model for complaints-handling at the local level is proposed.
Thesis (Ph.D.)--University of Adelaide, Dept. of Community Medicine, 1997?
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Sidorenko, Alexandra A. "Health insurance and demand for medical care : theory and application to Australia." Phd thesis, 2001. http://hdl.handle.net/1885/109953.
Full textAbstract:
Private health insurance plays an important role in Australian health care
finance, complementing the universal health insurance system, Medicare,
established in 1984. The road to the current health insurance system was long and
winding, filled with political passions and debates. This study covers the major
historical steps leading to the introduction of Medicare, and analyses specific
features of the Australian private health insurance sector.
After the recent policy change, regulations of the private health insurance
industry were somewhat eased, and a new range of benefits permitted to be
provided. This thesis seeks to analyse the likely effects of the policies, and develops
a theoretical model which adds to the existing literature on the demand for health.
Studies of demand for medical care and health insurance constitute an
important part of the health economics literature. Grossman’s theory of demand for
health has become a major framework for the analysis. Generalisations of the
Grossman model to incorporate uncertainty about health status and insurance
against medical expenditure are major challenges for theoretical economists
working in this area. This thesis proposes a new dynamic continuous time
stochastic optimisation model of demand for medical care, in which uncertainty
about health and wealth is modelled by correlated Wiener processes. Consumption
and leisure decisions are included in the model. A health insurance contract with
coinsurance rate is introduced in this model, and a two-stage procedure of choosing
an optimal ex-ante coinsurance rate, and optimal ex-post amount of medical care,
consumption and leisure is discussed.
The theoretical model is then applied to the 1993-94 Household Expenditure
Survey, Australia. Even though the full structure of the model cannot be tested on
this dataset, some empirical evidence is found in support of the new theoretical
model. A two-part bivariate probit model and quantile regression analysis allowed
the estimation of the income elasticity of demand for medical care and health
insurance, which was shown to vary with income. To study the quantitative effect
of the recent policy change based on the new theoretical model, a finer level of data
is needed.
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Brennan, David S. (David Simon) 1961. "Factors influencing the provision of dental services in private general practice / by David S. Brennan." 1999. http://hdl.handle.net/2440/19533.
Full textAbstract:
Bibliography: p. 320-341.xvii, 341 p. : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Addresses the documented variation in dental service rates and the questions of appropriateness of care arising from this variation. Examines the association of services provided with dentists, practice and patient factors. Based on a survey pf private general practice dentists who provided a data log for one typical day.
Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 2000
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Rogers, G. D. "Feeling queer : can a primary health care approach mitigate health inequity experienced by homosexually active South Australian men ?" 2005. http://hdl.handle.net/2440/37819.
Full textAbstract:
Health inequity refers to differences in health status between populations ( health inequalities ) that are unnecessary and avoidable and, additionally, are considered unfair or unjust. The history of the concept is reviewed and the mechanisms by which inequity affects health surveyed, with a focus on multi - level models of health production. The origins and development of the Primary Health Care approach is then considered with an emphasis on the Australian setting and on HIV / AIDS policy. The construct of homosexuality is then explored and concepts of sexual attraction, ' orientation ', identity and behaviour differentiated. What is known about the health characteristics of homosexually active men in the First World is then surveyed by means of a systematic literature review. It is concluded that there is evidence that they are affected by substantial health inequality in a range of areas including mortality, suicidality, depressive disorders, anxiety disorders, report of childhood sexual abuse and problematic substance use. Few of these inequalities have been confirmed in the Australian context, however, and almost none have been confirmed specifically in South Australia. The background to the development of a Primary Health Care programme focused on homosexually active men, is then described. The baseline health characteristics of the programme ' s cohort of 542 homosexually active South Australian men ( including their sexual behaviour in the context of HIV transmission ) are described and compared with other samples of men to identify inequalities. It is concluded that men in the cohort were subject to health inequality in a wide range of health parameters including mortality, suicidality, sexually transmitted infections, depressive and anxiety disorders, levels of substance use and self - rated health on the short - form 36 ( sf36 ) instrument. The relationships between these characteristics and factors indicative of disadvantage and victimisation are then explored. It is concluded that many of the health inequalities identified were related to sociohistorical factors such as emotional withdrawal by one ' s father, low income, unemployment, reduced educational attainment, and recent experience of violence and abuse from strangers. It is argued that some of these factors can be considered to be examples of unfairness and injustice and that, as a consequence, at least some of the health inequality experienced by this population is also health inequity. The elements of the Primary Health Care programme devised to meet the needs of homosexually active men is described and the trajectory of health characteristics of its participants over three time points is examined. 210 homosexually active men had reached Second Review, an average of thirty - six months after enrolment, by the time of analysis. Among this group, significant sustained improvement in a range of health outcomes, including prevalence of depressive disorders, sf36 scores and rate of recent suicidal ideation, is reported in association with involvement in the programme. Participant ' s subjective satisfaction with the programme is then described and their beliefs about the causes of their improved health explored using a qualitative methodology. It is concluded that the programme had largely met the needs of participants and they believed that it had been responsible for their improved health. Limitations of the study are considered and discussed. Limitations of the investigation to identify health inequality include questions of external validity arising from the absence of a perfect comparator group and concerns with construct validity related to the possibility of geographical and cultural variation in definitions of ' homosexually active men '. In the investigation to determine the extent to which health inequalities were also examples of inequity, issues of conclusion validity are discussed particularly in relation to multiple comparisons and the balance between Type I and Type II errors. In the evaluation of the impact of the Primary Health Care programme, there are concerns about internal validity resulting from the absence of randomisation and an uncontrolled design. The components of this issue are discussed and some support for internal validity is found in the reported subjective beliefs of participants about the cause of their health improvement and the outcomes of critical reflection by the programme team. The implications of the findings for policy, practice and further research are explored. It is argued that the health inequity experienced by people of sexual diversity will require profound social change for complete resolution. In the meantime, however, focused Primary Health Care with a community of sexual diversity has the potential to mitigate the health inequity its members experience and to help them to survive and function while they wait for a fairer and kinder society.Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2005.
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Rogers, Gary David. "Feeling queer : can a primary health care approach mitigate health inequity experienced by homosexually active South Australian men ?" Thesis, 2005. http://hdl.handle.net/2440/37819.
Full textAbstract:
Health inequity refers to differences in health status between populations ( health inequalities ) that are unnecessary and avoidable and, additionally, are considered unfair or unjust.
The history of the concept is reviewed and the mechanisms by which inequity affects health surveyed, with a focus on multi - level models of health production. The origins and development of the Primary Health Care approach is then considered with an emphasis on the Australian setting and on HIV / AIDS policy.
The construct of homosexuality is then explored and concepts of sexual attraction, ' orientation ', identity and behaviour differentiated. What is known about the health characteristics of homosexually active men in the First World is then surveyed by means of a systematic literature review. It is concluded that
there is evidence that they are affected by substantial health inequality in a range of areas including mortality, suicidality, depressive disorders, anxiety disorders, report of childhood sexual abuse and problematic substance use.
Few of these inequalities have been confirmed in the Australian context, however, and almost none have been confirmed specifically in South Australia.
The background to the development of a Primary Health Care programme focused on homosexually active men, is then described. The baseline health
characteristics of the programme ' s cohort of 542 homosexually active South Australian men ( including their sexual behaviour in the context of HIV transmission ) are described and compared with other samples of men to identify inequalities. It is concluded that men in the cohort were subject to health inequality in a wide range of health parameters including mortality, suicidality, sexually transmitted infections, depressive and anxiety disorders,
levels of substance use and self - rated health on the short - form 36 ( sf36 ) instrument.
The relationships between these characteristics and factors indicative of disadvantage and victimisation are then explored. It is concluded that many of the health inequalities identified were related to sociohistorical factors such as
emotional withdrawal by one ' s father, low income, unemployment, reduced educational attainment, and recent experience of violence and abuse from strangers. It is argued that some of these factors can be considered to be examples of unfairness and injustice and that, as a consequence, at least some of the health inequality experienced by this population is also health inequity.
The elements of the Primary Health Care programme devised to meet the needs of homosexually active men is described and the trajectory of health
characteristics of its participants over three time points is examined.
210 homosexually active men had reached Second Review, an average of thirty - six months after enrolment, by the time of analysis. Among this group, significant sustained improvement in a range of health outcomes, including prevalence of depressive disorders, sf36 scores and rate of recent suicidal ideation, is reported in association with involvement in the programme.
Participant ' s subjective satisfaction with the programme is then described and
their beliefs about the causes of their improved health explored using a qualitative methodology. It is concluded that the programme had largely met
the needs of participants and they believed that it had been responsible for their improved health.
Limitations of the study are considered and discussed. Limitations of the investigation to identify health inequality include questions of external validity arising from the absence of a perfect comparator group and concerns with
construct validity related to the possibility of geographical and cultural variation in definitions of ' homosexually active men '. In the investigation to determine the extent to which health inequalities were also examples of inequity, issues of conclusion validity are discussed particularly in relation to multiple comparisons and the balance between Type I and Type II errors.
In the evaluation of the impact of the Primary Health Care programme, there are concerns about internal validity resulting from the absence of randomisation and an uncontrolled design. The components of this issue are discussed and
some support for internal validity is found in the reported subjective beliefs of participants about the cause of their health improvement and the outcomes of critical reflection by the programme team.
The implications of the findings for policy, practice and further research are explored. It is argued that the health inequity experienced by people of sexual diversity will require profound social change for complete resolution. In the
meantime, however, focused Primary Health Care with a community of sexual diversity has the potential to mitigate the health inequity its members experience and to help them to survive and function while they wait for a fairer and kinder society.Thesis (Ph.D.)--University of Adelaide, School of Population Health and Clinical Practice, 2005.
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Cochrane, Susan Frances. "The personal interest and decision-making about medical treatment." Phd thesis, 2006. http://hdl.handle.net/1885/150997.
Full text