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Dissertations / Theses on the topic 'Medical personnel and patient Australia'

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Published: 10 December 2022
Last updated: 29 January 2023

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1

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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2

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 informants
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3

Wentzell, Natasha. "Improving the measurement of patient safety : development of a new patient safety climate survey /." Halifax, N.S. : Saint Mary's University, 2008.

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4

Holman, Grady Talley Thomas Robert Evans. "Patient handling restrictions & conditions." Auburn, Ala., 2007. http://repo.lib.auburn.edu/2007%20Fall%20Dissertations/Holman_Grady_7.pdf.

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5

Ding, Chunyan. "Medical negligence law in transitional China a patient in need of a cure /." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43913696.

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6

Nimmo, Graham R. "Materialities of clinical handover in intensive care : challenges of enactment and education." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21540.

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The research is situated in a busy intensive care unit in a tertiary referral centre university hospital in Scotland. To date no research appears to have been done with a focus on handover in intensive care, across the professions involved, examining how handover is enacted. This study makes an original contribution to the practical and pedagogical aspects of handover in intensive care both in terms of the methodology used and also in terms of its findings. In order to study handover a mixed methods approach has been adopted and fieldwork has been done in the ethnographic mode. Data has been audio recorded and transcribed and analysed to explore the clinical handovers of patients by doctors and nurses in this intensive care unit. Texts of both handover, and the artefacts involved, are reviewed. Material from journals, books, lectures and websites, including those for health care professionals, patients and relatives, and those in industry are explicated. This study explores the role of material artefacts and texts, such as the intensive care-based electronic patient record, the whiteboards in the doctors’ office, and in the ward, in the enactment of handover. Through analysis of the data I explore some of the entanglements and ontologies of handover and the multiple things of healthcare: patients, information, equipment, activities, texts, ideas, diseases, staff, diagnoses, illnesses, floating texts, responsibility, a plan, a family. The doing of handover is framed theoretically through the empirical philosophy of Mol’s identification of multiple ontologies in clinical practice (Mol, 2002). Each chapter is prefaced by a poem, each of which has relevant socio-material elements embedded in it. The significance of the findings of the research for both patient care and clinical education and learning is surfaced.
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7

Wong, Lai-cheung. "A study of hospice care : [factors affecting] communication between the health care professionals and the patients /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13409475.

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8

Rutledge, Thomas. "Psychological response styles and cardiovascular health : confound or independent risk factor?" Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0002/NQ34622.pdf.

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9

Poznanski, Carol A. "An analysis of nursing personnel staffing patterns and patient falls on two medical units /." Staten Island, N.Y. : [s.n.], 1987. http://library.wagner.edu/theses/nursing/1987/thesis_nur_1987_pozna_analy.pdf.

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10

Ding, Chunyan, and 丁春艳. "Medical negligence law in transitional China: a patient in need of a cure." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B43913696.

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11

Aagard, Erik A. "A pre-design study of patient and medical professional atitudes and reactions towards the colors of medical scrubs." Columbus, Ohio : Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1218038251.

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12

Fu, An-Chen Brooks John M. "The influence of local area physician supply on the dispersion of care among Medicare patients with a consistent diagnosis." [Iowa City, Iowa] : University of Iowa, 2009. http://ir.uiowa.edu/etd/360.

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13

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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14

Breslin, Jonathan M. Gedge Elisabeth Boetzkes. "A care-based model of the physician-patient relationship /." *McMaster only, 2003.

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15

Abdul, Rouf P. V. "Exploring patient and health professional use, views and attitudes towards complementary and alternative medicines during pregnancy." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=228640.

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The aim of this doctoral research was to explore CAM use in pregnancy from the perspectives of pregnant women and health professionals. The research was conducted in four phases: a systematic review of the published literature from 2008-2012; cross sectional surveys of two cohorts of women during the first and last trimester; and a cross sectional survey of health professionals (midwives, obstetricians, anaesthetists) at Aberdeen Maternity Hospital. The systematic review reported a significant proportion of women used CAM during pregnancy with prevalence rates ranging from 5.8% to 74.2%. The study of health professionals identified that more than 30% of respondents have prescribed, referred or advised the use of CAM to pregnant women. The main associated factor for CAM use was, 'personal use of CAM', with an odds ratio of 8.26 (95% CI 3.09–22.05; P < 0.001). Two thirds of women (63%) reported using CAM, excluding vitamins and minerals, during early pregnancy. The independent predictors of CAM use identified were: use by family and friends (OR 4.1, 95% CI 2.3–7.3, p < 0.001); ethnicity (non-white British) (OR 3.4, 95% CI 1.8–6.8, p < 0.001); and use prior to pregnancy (OR 2.4, 95% CI 1.2–4.8, p = 0.014). Two thirds of women (61.4%) reported using CAM, excluding vitamins and minerals, during the third trimester. The independent associated factors for CAM medicine use identified were: CAM use before pregnancy (odds ratio [OR] 4.36, 95% confidence interval [CI] 2.39–7.95, P<0.001); a university education (OR 2.41, 95% CI 1.46–4.0, P<0.001), and CAM use by family or friends (OR 2.36, 95% CI 1.61–3.47,P<0.001). The lack of an evidence based approach together with the reliance on the advice of family and friends is of concern given the lack of robust data of efficacy and safety. To date, four peer reviewed papers from this doctoral research have been published.
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16

Svenaeus, Fredrik. "The hermeneutics of medicine and the phenomenology of health : steps towards a philosophy of medical practice /." Linköping : Tema, Univ, 1999. http://www.bibl.liu.se/liupubl/disp/disp99/arts187s.htm.

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17

Wong, Lai-cheung, and 黃麗彰. "A study of hospice care: [factors affecting] communication between the health care professionals and thepatients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1992. http://hub.hku.hk/bib/B31977182.

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18

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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19

Beaulieu, Anne. "The truth of the trace : constructing the power of the medical image." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=26637.

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This thesis traces the developments of imaging technologies used for medical diagnosis. Giddens' sociological theory of modernity serves as a basis for the consideration of the bureaucratisation of medicine and the use of the patient file as source of information about health. The importance of 'inscriptions', in relation to scientific knowledge and power, is analysed through Bruno Latour's theory. Donna Haraway's call to rethink objectivity, not as a quality of universal knowledge, but as a given point of view, also influence the approach of this discussion of diagnostic practices.
The author demonstrates the need for abstract concepts of patient and disease to achieve modern medicine. The links between theoretical notions (anatomical pathology, in particular) and diagnostic practices, as well as the concept of objectivity underlying the use of technology to gather information about health are examined. The effects of the biostatistical method used to evaluate health are also discussed. Finally, the importance of context in the experience of illness is noted.
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20

Slade, Catherine Putnam. "Does patient-centered care affect racial disparities in health?" Diss., Atlanta, Ga. : Georgia Institute of Technology, 2008. http://hdl.handle.net/1853/22569.

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Thesis (Ph. D.)--Public Policy, Georgia Institute of Technology, 2008.
Committee Chair: Robert J. Eger III, Ph.D.; Committee Member: Christopher M. Weible, Ph.D.; Committee Member: Gregory B. Lewis, Ph.D.; Committee Member: Monica M. Gaughan, Ph.D.; Committee Member: Valerie A. Hepburn, Ph.D.
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21

Tierney, Shirley J. "Nursing Unit Staffing: An Innovative Model Incorporating Patient Acuity and Patient Turnover: A Dissertation." eScholarship@UMMS, 2010. https://escholarship.umassmed.edu/gsn_diss/18.

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Changes in reimbursement make it imperative for nurse managers to develop tools and methods to assist them to stay within budget. Disparity between planned staffing and required staffing often requires supplemental staffing and overtime. In addition, many states are now mandating staffing committees to demonstrate effective staff planning. This retrospective quantitative study developed an empirical method for building nursing unit staffing plans through the incorporation of patient acuity and patient turnover as adjustments towards planning nursing workload. The theoretical framework used to guide this study was structural contingency theory (SCT). Patient turnover was measured by Unit Activity Index (UAI). Patient acuity was measured using case mix index (CMI). Nursing workload was measured as hours per patient day (HPPD). The adjustment to HPPD was made through the derivation of a weight factor based on UAI and CMI. The study consisted of fourteen medical, surgical, and mixed medical-surgical units within a large academic healthcare center. Data from 3 fiscal years were used. This study found that there were significant, but generally weak correlations between UAI and CMI and HPPD. The method of deriving a weight factor for adjusting HPPD was not as important as the decision-making relative to when to adjust planned HPPD. In addition, the measure of unit activity index was simplified which will assist researchers to more easily calculate patient turnover. As a result of this study, nurse managers and will be better able to adjust and predict HPPD in cases where benchmarking has been problematic. Data-driven adjustments to HPPD based on UAI and CMI will assist the nurse manager to plan and budget resources more effectively.
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22

Park, Louisa. "The influence of effective communication between patients and health professionals on patients' perceptions of quality of care, health outcomes, and treatment compliance /." [St. Lucia, Qld.], 2006. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19741.pdf.

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23

Callahan, Timothy C. "Challenging medicine's humiliations : the need to re-educate the practitioners /." Thesis, Connect to this title online; UW restricted, 2000. http://hdl.handle.net/1773/7738.

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24

Tornero, Mary Carolyn. "Improving patient satisfaction with a major healthcare organization." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1406.

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25

Boyce, Rosalie A. "Resource acquisition and resistance to change at National Hospital for Mothers and Babies : a case study into the implications of medical dominance." Thesis, Queensland University of Technology, 1989. https://eprints.qut.edu.au/36382/1/36382_Boyce_1989.pdf.

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This research project is an expost case study analysis of the failed attempt of a small allied health professional department (dietitians) in a large public hospital to achieve a substantial increase in resources. The research utilizes a qualitative case study approach in which the researcher was an active and leading participant in the case events. The case study research methodology is critically reviewed and justified in terms of its applicability, objectivity and limitations. The case study investigates a five year (1983 - 1988) period at the National Hospital for Mothers and Babies (NHMB) . A detailed description of the case setting, the planning and change processes used by the dietitians, and the response of NHMB management are presented. This material provides the empirical data for analysis. An interdisciplinary approach from theoretical paradigms such as sociology, economics and organisational psychology are utilized in order to provide a complementary analysis. The NHMB case study is a single case with embedded units of analysis. The units selected for examination are presented in the form of an analysis of critical issues influencing the outcome of the resource acquisition process. From an analytical perspective the research concentrates on the implications of substantial resource acquisition goals in an emerging profession (dietitians) under the direct control of a dominant profession (medicine) in the hospital setting. A set of complementary hypotheses are developed and assessed in terms of their ability to adequately explain the case events from a theoretical perspective. The first hypothesis proposes that theories of medical dominance are able to explain case events on an organisational scale. The remaining hypotheses are located at the microanalytical level. The second hypothesis postulates that the actions of the dietitians to commence an aggressive campaign for additional resources can be explained as an adaptive behaviour in an environment of conflicting expectations. The third hypothesis contends that the dietitian's failure to achieve the desired resource objectives is able to be explained by assessing the levels of power able to be exercised by the dietitians relative to other actors in the case. The review of relevant literature and subsequent analysis of significant issues impacting on the outcome of the resource acquisition objectives suggests support for the hypotheses.
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26

Kaufman, David R. "Representation and utilization of information during the clinical interview in medicine." Thesis, McGill University, 1987. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59603.

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This study evaluated the ability of subjects at 3 levels of expertise, expert physicians, residents and medical students, in the acquisition, representation, and utilization of patient information in the context of solving a complex medical problem. Each subject interviewed a volunteer medical outpatient and was subsequently requested to provide a differential diagnosis. The doctor-patient dialogue was analyzed using cognitive methods of discourse analysis. These methods were used to characterize differences in the content and nature of the history-taking process and in the development of problem representations. The study characterized differences at two levels of representation, observations and findings. Observations are the minimal semantic units of the doctor patient discourse. Findings are higher order units that derive meaning in specific medical contexts.
Differences were found between groups of subjects in the accuracy of diagnoses and in the qualitative nature of representations. These differences were manifested most clearly in terms of a series of efficiency measures designed to characterize the ability of subjects to generate findings. In general, the expert physicians were more selective in the elicitation and processing of critical and relevant findings. An attempt is made to characterize these differences in terms of the strategies used to acquire and represent patient information.
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27

Thobias, Anna. "Exploration of factors associated with poor adherence among patients receiving antiretroviral therapy at Katutura State Hospital Communicable Disease Clinic in Khomas region, Namibia /." Online access, 2008. http://etd.uwc.ac.za/usrfiles/modules/etd/docs/etd_gen8Srv25Nme4_2455_1273775841.pdf.

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28

Webb, Janet Marie. "Information about primary care physicians considered most useful by managed health care consumers." CSUSB ScholarWorks, 1997. https://scholarworks.lib.csusb.edu/etd-project/1370.

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29

Smith, Barbara. "A constructive view of the non-compliant patient: Understanding barriers to compliance and proposed solutions." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1654.

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The health care industry is currently experiencing many changes. Managed care is altering the way health care is delivered through advances in technology and new approaches in financing. As part of this transition, importance will be placed on patients becoming better consumers and participants in determining their health care service needs. The focus of this study is on the non-compliant patient and the many factors that revolve around this topic.
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30

Hamilton, Sarah. "Negotiating roles and making claims as a patient in the psychiatric consultation : a frame analysis." Thesis, University of Sussex, 2014. http://sro.sussex.ac.uk/id/eprint/48726/.

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My thesis develops an understanding of patient role and identity performances in psychiatric consultations. Recent increased attention to shared-decision making and patient-centred care in psychiatry is in large part influenced by changing ideas about the doctor-patient relationship, challenging power discrepancies and reconsidering notions of ‘expert' and ‘lay' contributions. Previous work surrounding this field has mostly focused on psychiatrists' talk, asking ‘how can psychiatrists improve shared-decision making skills?' While important, I argue that this focus is at odds with the principles behind shared-decision making by failing to consider patients' own performances in their talk with psychiatrists. I re-analyse recorded interactions in 92 psychiatric consultations with patients prescribed anti-psychotic medication. Drawing on the work of Goffman, I identify frames which are negotiated throughout the consultations and explore how these shape the roles and ‘footing' adopted by patients. I demonstrate techniques used by patients to maintain a balance between making credible and influential claims and maintaining an acceptable patient role. Finally I consider the impact of family members attending these consultations. I explore how they collaborate and compete with patients in making claims, and the impact of their presence on patients' own performances. The thesis makes the case for considering patients as active participants in constructing the interaction in psychiatric consultations and the need to understand the work being undertaken by patients to construct their place in the immediate discourse and in their wider social connections. It moves towards developing this understanding by providing a detailed review of various techniques seen in this data set. In using a frame analysis it also provides a relatively new perspective on considering discourse and demonstrates how this kind of approach can be useful when analysing institutional talk.
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31

Oswald, Sharon. "A retrospective case note analysis of the recognition and management of deteriorating patients prior to critical care admission." Thesis, University of Stirling, 2017. http://hdl.handle.net/1893/27289.

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This study explores the use of early warning scores (EWS) in deteriorating patients. These are widely used tools to measure vital signs and highlight abnormal physiology in acutely unwell patients. Measurements of the process in the management of the deteriorating patient includes time to first assessment of such patients. The level of clinician involved in the subsequent management is also investigated to determine whether escalation of care was appropriate. This work is a retrospective case note analysis of the recognition and management of deteriorating patients prior to critical care admission. Research Questions 1. What violations in the optimum process are associated with sub-optimal recognition and management of deteriorating patients and delayed critical care admission in patients triggering early warning scores in acute care wards? 2. Are there independent variables which can predict the delay in the recognition and management of deteriorating patients and subsequent critical care admission? Methods The literature was reviewed to determine the optimum process of recognition and management of deteriorating patients in acute care wards. A data collection tool was then specifically designed and locally validated to extract objective data from the case records. A sample of 157 patients admitted to critical care from acute wards over a 6 month period were included in the study. The case records were then retrospectively reviewed and information was extracted using the data collection tool. Results The accuracy and frequency of early warning scores were measured and findings demonstrated that 59% of Early Warning Scores (EWS) were miscalculated. The most frequent of those miscalculated were the intermediate scores (4 or 5) (error rate - 52%) followed by the higher scores (6 or more) (error rate - 32%). The least frequently miscalculated were the lower scores (0 -3) (error rate 15%). Descriptive data from the sample such as age, ward, diagnosis, time of hospital admission, time and day of transfer / EWS triggering were included. From the total case records reviewed, 110 patients had abnormal Early Warning Scores (4 or more) and were included in the inferential data analysis. The independent variables related to the processes objectively measurable in the recognition and management of deteriorating patients were included. After descriptive analysis the independent variables were cross-tabulated with the dependent variable using Pearson chi-square. The dependent variable was identified from the literature. This was whether time from triggering an abnormal EWS to critical care admission was delayed more than 6 hours. The subsequent predictor variables were then entered in to a binary logistic regression model for statistical analysis using SPSS version 21 software. Binominal Logistic Regression Analysis identified three significant variables predicting delay of the recognition and management of deteriorating patients. • Frequency of EWS measurement not increased appropriately • Length of stay prior to critical care admission 12-36 hours • If no consultant review during 6 hours of abnormal EWS Implications for Future Practice This study highlights areas of risk in the detection of patients’ clinical deterioration in acute wards. These findings should guide quality improvement to prevent unnecessary morbidity and mortality. As a key area of patient risk included the lack of frequency and accuracy of EWS measurements, staff education is required to ensure staff are given the appropriate knowledge to understand the use of the tool. Regular review of the frequency of measurement is also required as this was statistically significant in the delay to critical care admission. The high risk time from admission of 12-36 hours needs further investigation. This study also highlights the need for senior decision makers to be involved in the care of deteriorating patients to improve outcomes.
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32

Lauria, Ivone Do Carmo. "Contribution à une méthodologie de l'étude des représentations sociales: une approche des relations structurelles et interpersonnelles en milieu hospitalier." Doctoral thesis, Universite Libre de Bruxelles, 1997. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/212102.

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33

Lee, Susan Fiona. "Controlling involvement to promote confidence in pallative care decisions a grounded theory from the patient's perspective /." Connect to thesis, 2006. http://portal.ecu.edu.au/adt-public/adt-ECU2006.0021.html.

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34

Allen, Sheldon. "The feasibility of implementing brief motivational interviewing in the context of tuberculosis treatment in South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2006. http://hdl.handle.net/10019.1/4867.

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Digitized using a Konica Minolta 211 PCL Scanner. 300dpi (OCR).
Thesis (MA (Psychology))--University of Stellenbosch, 2006.
AFRIKAANSE OPSOMMING: Hierdie studie ondersoek die uitvoerbaarheid van die implementering van 'n benadering genaamd Kort Motiverende Onderhoud (KMO) in die konteks van die behandeling van tuberkulose (TB) in Suid-Afrika. TB is 'n ernstige bedreiging vir wereldwye gesondheid en is nog nie onder beheer gebring nie, ten spyte van die feit dat dit geneesbaar is. Sedert die beskikbaarheid van effektiewe medisyne-middels, is die oorsaak vir die voortdurende verspreiding van die siekte gesien as 'n probleem van gebrekkige deurvoerbaarheid van die behandeling. Hierdie eng begrip van die epidemie is deur die psigologiese en sosiale wetenskappe, asook andere, verbreed. Daar is baie debatering oor en om die onderwerp van deurvoerbaarheid en die internasionale TB beheer beleid, bekend as Direkte Observerings-Behandeling, Kortkursus (DOBK). Sekere deskundiges argumenteer dat DOBK 'n onvoldoende respons is tot die uitdaging van die verbetering van deurvoerbaarheid en die kontrolering van TB. Dit skyn asof die meelewende aspekte van die TB behandeling nagelaat word in die TB beleide en protokol en sommige beweer dat hierdie faktor sowel as gebrekkige aandag aan ander sistemiese faktore verantwoordelik is vir swak programuitvoering. Suid-Afrika is 'n voorbeeld hiervan, waar die kommunikasie tussen verpleegsters en TB pasiente beskryf word as outoriter, verpleegstergesentreerd en taakgeorienteerd. 'n Pasientgesentreerde benadering (PGB) is 'n wyse waarop die pasientversorger kommunikasie en die bevredigingsvlak van die pasient bevorder word en sommige promoveer dit as a wyse om die behandelingsdeurvoerbaarheid en genesingsuitkomste te verbeter. Die uitdaging is egter dat die konsep van 'pasientgesentreerdheid' op verskeidenheid van wyses geinterpreteer en geimplimenteer kan word. KMO is 'n PGB tot kommunikasie wat bestem is om 'n gees van samewerking te bevorder en om mense se gemengde gevoelens oor gedragsverandering by te le. KMO as 'n aanpassing van Motiverende Onderhoudvoering, is 'n spyskaart van konkrete vaardighede of middels wat gesondheidsvoorsieners in onderhoude rakende geneeskundige gedragsverandering kan gebruik. KMO is gebaseer op teoriee oor gedragsverandering en word gebruik in 'n wye verskeidenheid van genesingsbehandeling, insluitende deurvoerbaarheidsbehandeling. Alhoewel dit selde in minder ontwikkelende lande toegepas is en nog nooit in TB, is KMO suksesvol toegepas in ander besige kontekste vir gesondheidsvoorsiening. Die ontwerp van die huidige studie oor die lewensvatbaarheid van KMO in die konteks van TB behandeling in Suid-Afrika het ontstaan uit die ontwerp van 'n groter studie wat ander intervensies vir 'n PGB ingesluit het. Die doelstellinge van die huidige studie was om die konteks te beskrywe en wat gebeur het gedurende die intervensietydperk en om die uitvoerbaarheid van KMO te verduidelik.
ENGLISH ABSTRACT: This thesis explores the feasibility of implementing an approach called Brief Motivational Interviewing (BMI) in the context of tuberculosis (TB) treatment in South Africa. TB is a serious threat to global health and has not been controlled despite the fact that it is curable. Ever since effective drugs became available, continued spread of the disease has been understood as a problem of poor adherence to treatment. This narrow understanding of the epidemic has been broadened by psychological and social science perspectives among others. There has been much debate around the topic of adherence and the international TB control policy known as Directly Observed Treatment, Short-course (DOTS), as some suggest that it is an incomplete response to the challenge of improving adherence and controlling TB. The caring aspects of TB treatment seem to be neglected in TB policies and protocols, and some argue that this and the lack of attention to other systemic factors are responsible for poor programme performance. South Africa is an example of this, where the communication between nurses and TB patients has been described as authoritarian, nursecentred and task-oriented. A patient-centred approach (PCA) is a way of improving patient-provider communication and patient satisfaction, and some promote it as a way of improving treatment adherence and health outcomes. The challenge, however, is that the concept of 'patient-centredness' can be interpreted and implemented in a variety of ways. BMI is a PCA to communication that is designed to promote a spirit of collaboration and resolve people's mixed feelings about behaviour change. An adaptation of Motivational Interviewing, BMI is a menu of concrete skills or tools that health providers can use in consultations about health behaviour change. BMI is based on theories about behaviour change and has been used to address a wide variety of health behaviours, including treatment adherence. Although seldom applied in less developed country settings and never before applied in TB, BMI has been successfully applied in other busy health care settings. The design of the present study of the feasibility of BMI in the context of TB treatment in South Africa evolved within the design of a larger study that included other interventions designed for a PeA. The present study aims were to describe the context and what happened during the intervention period and to describe BMI's feasibility. Using elements of participatory action research, BMI communication training was developed and implemented with TB staff based in four urban primary health care facilities. A grounded theory approach was used to describe the dynamics of the implementation process and generate a theory about what made BMI more or less feasible in this context. A multidisciplinary team contributed to the study design. Data were gathered largely through participant observation, focus groups and key informant interviews and generated volumes of diverse materials including field notes, training materials, video and audio-taped interactions. The data were analysed using the inductive approach to grounded theory analysis promoted by Glaser (1992) and relied on theoretical sampling and constant comparative analysis. The quality and trustworthiness of the data were ensured through an emphasis on researcher reflexivity and triangulation of the perspectives of different materials, participants and health facilities. The study was implemented as a pilot BMI training process at one facility in Port Elizabeth (Eastern Cape Province) followed by expanded training targeting TB staff of three facilities in Cape Town (Western Cape Province). Data analysis resulted in a categorised description of the research settings, the interactions and relationships among patients, providers, managers and researchers, the training interventions and the way participants responded to it during each phase of the process. Although seemingly similar at the outset, analysis began to show that dynamics of implementation at each facility were complex and multidimensional. The categories that were generated during each cycle of implementation were used to shape the categories selected for the next. Examining the categories across the four health facilities yielded a grounded theory with seven core categories regarding the role of: (1) the personal qualities of the TB staff involved, (2) the way staff moved in and out of the TB service, (3) the leadership, hierarchy and staff dynamics in the health facilities, (4) the pressurised working conditions of TB staff, (5) the poverty of patients, (6) mismatches between the TB programme's protocols and BMI, and (7) the capacity of staff to innovate and improve care. These findings are discussed in terms of the way they respond to the study's research questions and the way the grounded theory categories relate to each other. Their significance is understood from a social constructivist perspective as bound within the context of the study. The findings are also compared to the theoretical perspectives included in the study design and new literature on the diffusion of innovations in service organisations. Recommendations are made for future context-focused research and adherence related intervention development. If interventions like BMI are to be implemented successfully in contexts such as those included in this thesis, policy-makers and managers need to consider the ways in which working conditions, policies and protocols and patient poverty may be counter-productive, and focus on the innovative potential of health staff and teams for delivering patient-centred care.
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35

Skett, Kim A. "Meeting the challenge : The female carers' perspective of managing dyspnoea." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2004. https://ro.ecu.edu.au/theses/807.

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The aim of this descriptive, explorative study was to describe the lived experience of informal carers providing care within the home, to a family member who has lung cancer and the symptom of dyspnoea. Many studies have highlighted the stressors associated with care provision, but no studies have focused on the experience associated with caring for a family member who is dyspnoeic. Ten carers were interviewed regarding their experiences of providing care to the family member during the palliative phase of the illness and while the family member was experiencing the symptom of dyspnoea. Analysis of the initial data highlighted differences in issues identified by nurses and carers, therefore, two Registered Nurses were interviewed to determine how the perceptions of the carers needs differ between the carer and the nurse. Data was collected using unstructured, in-depth interviews which were audio-taped. All data was analysed and common themes identified. Three key themes emerged from the data: developing skills, sustaining the carer and meeting the challenge. In addition to these themes, "developing relationships" emerged as the underpinning concept that supports the themes. The double ABCX model of adaptation and adjustment was used to determine how the carers' perceptions of the stressor and their coping resources influence the process of adaptation. Recommendations have been developed from the findings and are directed towards clinical practice issues, education of carers and areas for further nursing research. The aim of this descriptive, explorative study was to describe the lived experience of informal carers providing care within the home, to a family member who has lung cancer and the symptom of dyspnoea. Many studies have highlighted the stressors associated with care provision, but no studies have focused on the experience associated with caring for a family member who is dyspnoeic. Ten carers were interviewed regarding their experiences of providing care to the family member during the palliative phase of the illness and while the family member was experiencing the symptom of dyspnoea. Analysis of the initial data highlighted differences in issues identified by nurses and carers, therefore, two Registered Nurses were interviewed to determine how the perceptions of the carers needs differ between the carer and the nurse. Data was collected using unstructured, in-depth interviews which were audio-taped. All data was analysed and common themes identified. Three key themes emerged from the data: developing skills, sustaining the carer and meeting the challenge. In addition to these themes, "developing relationships" emerged as the underpinning concept that supports the themes. The double ABCX model of adaptation and adjustment was used to determine how the carers' perceptions of the stressor and their coping resources influence the process of adaptation. Recommendations have been developed from the findings and are directed towards clinical practice issues, education of carers and areas for further nursing research.
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36

Griffiths, Debra. "Agreeing on a way forward management of patient refusal of treatment decisions in Victorian hospitals /." full-text, 2008. http://eprints.vu.edu.au/2036/1/griffiths_debra_thesis.pdf.

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The purpose of this study is to investigate and develop a substantive theory, of the processes adopted by nurses and medical practitioners when patients with serious illness refuse medical treatment. The study seeks to identify the main constraints confronting nurses and medical practitioners and to explain the key factors that moderate the processes of dealing with refusal decisions. Using a grounded theory method, a sample of 18 nurses and 6 medical practitioners from two public hospitals in Melbourne were interviewed. In addition, observations and documentary evidence were utilised. The basic social psychological problem shared by nurses and medical practitioners is conceptualized as Competing Perspectives: Encountering Refusal of Treatment, which reflects the diverse perceptions and beliefs that confront participants when patients decide to forgo therapy. In utilizing the grounded theory method of analysis, it is recognised that participants deal with this problem through a basic social psychological process conceptualized as Endeavouring to Understand Refusal: Agreeing on a Way Forward. This core variable represents the manner in which participants, to varying extents, deal with the situations they face and it incorporates the various influences which moderate their activities. Endeavouring to Understand Refusal: Agreeing on a Way Forward comprises a series of three transitions. The first involves a struggle for participants to come to terms with, or even recognize that patients are rejecting treatment. The second transition illustrates the varied responses of participants as they interact with patients, relatives and each other, in order to clarify and validate decisions made during episodes of care. The third transition reflects the degree to which patients and family members are incorporated into treatment decisions, and highlights a shift in emphasis, from a focus on the disease state, to the patient as a person with individualistic thoughts and wishes. The remaining social processes evident in the study consist of four categories. The first, Seeking Clarification, embodies exploration undertaken by participants and their recognition that treatment is actually being refused. The second category, Responding to Patients and Families, demonstrates the level of expertise of participants communicating, and their ability to encourage reciprocity in the professional-patient relationship. The third category, Advocating, highlights the extent and manner in which patient and family wishes are promoted to members of the treating team. The fourth category, Influencing, reveals the ability of participants to utilize a degree of authority or power in order to shape particular outcomes. The findings also indicate that over arching the core variable and categories are various contextual determinants that moderate the way nurses and medical practitioners deal with patient refusal of treatment. These determinants are categorized into three main influences: The Context of Work, describes the of the environment and organisational factors pertinent to public hospitals; Beliefs and Behaviours, illustrates the perceptions of, and values held, by four key groups involved in decisions, namely, nurses, medical practitioners, patients, and family members; and Legal and Ethical Frameworks, examines the existing principles that support or guide professional practice in situations where patients with serious illness refuse medical treatment.
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37

Nestel, Debra. "Communication skills for medical students, doctors and dentists : a programme evaluation /." Thesis, Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19657468.

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38

Hardy, Jennifer Lynette. "Healthcare providers communication mechanisms using a case management model of care implications for information systems development, implementation & evaluation /." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060731.120940/index.html.

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39

Slade, Catherine Putnam. "Does Patient-Centered Care affect Racial Disparities in Health?" Digital Archive @ GSU, 2007. http://digitalarchive.gsu.edu/pmap_diss/24.

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This thesis presents a challenge to policy initiatives that presume that patient-centered care will reduce racial disparities in health. Data from the Medical Expenditure Panel Survey were used to test patient assessment of provider behavior defined as patient-centered care according to the National Health Disparities Report of the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Results indicated patient-centered care improves self-rated health status, but blacks still report worse health status than whites experiencing comparable patient-centered care. Further, black-white differences in patient-centered care had no affect on health status. Rival theories of black-white differences in health, including social class and health literacy, provided better explanations of disparities than assessment of provider behaviors. These findings suggest that policies designed to financially incentivize patient-centered care practices by providers should be considered with caution. While patient-centered care is better quality care, financial incentives could have a negative effect on minority health if providers are deterred from practices that serve disproportionate numbers of poor and less literate patients and their families. Measurement of the concept of patient-centered care in future health disparities research was also discussed.
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40

Devreux, Isabelle. "Relationship between staff satisfaction, productivity and patient satisfaction: a study in physical rehabilitation services." Doctoral thesis, Universite Libre de Bruxelles, 2012. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209609.

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La satisfaction du patient et du personnel sont considérés comme des indicateurs importants afin de mesurer la qualité dans le secteur hospitalier.

Dans les services de revalidation, les rencontres thérapeutes-patients présentent une valeur significative par le temps consacré, l'approche thérapeutique mais également la relation qui découle du processus de soin.

L'objectif de la recherche fut d'évaluer la satisfaction du personnel travaillant dans les services de revalidation physique (thérapeutes et techniciens ou assistants) et les différents variables démographiques ou liés à l'environnement du travail ainsi que la satisfaction des patients traités dans ces services.

Une analyse transversale par questionnaire a permis de mesurer la satisfaction au travail et les éléments de productivité dans les services de revalidation. Simultanément, une enquête concernant la satisfaction des patients a été réalisée dans ces mêmes départements. La recherche fut effectuée au sein de dix centres hospitaliers au moyen d'un questionnaire d'enquête commun basé sur le modèle " Effort- Reward Imbalance" ou “déséquilibre efforts-récompenses” et des informations complémentaires sur les conditions de travail ont étés collectées au moyen de questionnaires spécifiques. L’étude met en évidence des variables démographiques tells l'âge, la nationalité, le niveau d'éducation, ainsi que la charge travail et les types de cas traités comme facteurs significatifs influençant le stress au travail.

Les résultats confirment une corrélation positive entre le stress au travail par le déséquilibre Efforts-Récompenses et la performance quantitative (productivité) des thérapeutes en revalidation. Il est basé sur la satisfaction des thérapeutes en fonction des heures de travail, du nombre moyen de patients par jours ainsi que des mesures de productivité élevées du département. En ce qui concerne les récompenses perçues comme positives, le soutien du médecin et du superviseur apparaissent comme facteurs de motivation importants. Il a été également déterminé que les thérapeutes appréciaient la participation et l’expression de son opinion dans la gestion thérapeutique du patient. Bien qu’une corrélation entre la satisfaction des patients et le degré de stress au travail des thérapeutes n’ait pas été démontrée, ces deux mesures varient de manière significative en fonction des types d’hôpitaux et du degré de « Over-commitment » des thérapeutes dans leur travail.

Les déterminants essentiels de la satisfaction des patients en revalidation apparaissent toutefois liés à l’intervention du thérapeute tel que sa capacité à rassurer le patient ou la qualité de l’information liée au plan de traitement et doivent être considérés dans l’approche thérapeutique en revalidation.

Les résultats de l’étude ont permis de concevoir un modèle systémique de satisfaction et de stress au travail résumant les éléments liés de manière significative au déséquilibre des efforts et récompenses dans les services de revalidation physique et qui pourrait inspirer les directeurs ou gestionnaires hospitaliers a promouvoir une atmosphère de travail positive.

Patient and staff satisfaction are considered as important indicators to monitor quality in healthcare. In rehabilitation services the patient and therapist encounters are of significant value by the amount of time, the therapeutic approach but also the personal relations in the care process. The aim of the research was to evaluate the staff job satisfaction in physical rehabilitation services and the related variables as well as its correlations to patients’ satisfaction.

A cross sectional survey approach in the rehabilitation services has measured the job satisfaction and the related elements of productivity. Simultaneously a survey of the patients’ satisfaction was performed. As the research in the physical rehabilitation services was conducted in ten different health care facilities of the Jeddah region, a common assessment tool was utilized based on the Effort Reward Imbalance (ERI) model and complementary information were collected using specifically developed survey questionnaires. Socio-demographic variables such as age, nationality, work specialty, educational levels, as well as the caseload and workload appeared also as significantly influencing job satisfaction.

The findings confirmed a positive correlation between the Effort Reward Imbalance and the quantitative performance (productivity) of the rehabilitation staffs. It is supported by the level of job satisfaction of the therapists which is related to the number of patients per day, caseload, hours of work and high productivity measures. From the aspects of positive rewards, the role of the supervisor and doctors appear as important motivators. It was also found that therapists valued the fact of being given the opportunity to participate and discuss opinions in the patient management and quality improvement.

While no evidence confirmed a positive correlation between patients’ satisfaction about the rehabilitation treatments and the staff job satisfaction, both measured patients’ and staff satisfaction varied significantly according to the hospital type and the degree of Over-commitment.

Essential determinants of patients’ satisfaction appeared however related to the therapists' input, such as the ability to reassure or the quality of information given in the treatment plan and have to be taken into account when delivering the patients’ care.

All the results allowed the design of a systemic model of staff job satisfaction resuming the significant related elements of effort and reward in the rehabilitation services and could be utilized to inspire the hospital leaders, managers and executive directors to promote a healthy work life environment based on a valued human resources approach.


Doctorat en Sciences de la santé publique
info:eu-repo/semantics/nonPublished

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41

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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42

Liddle, Keir. "The impact of leadership on the delivery of high quality patient centred care in allied health professional practice." Thesis, University of Stirling, 2018. http://hdl.handle.net/1893/28081.

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The Healthcare Quality Strategy for NHS Scotland, relates its overall vision of healthcare quality to six dimensions of care as: Safe, Efficient, Effective, Equitable, Timely and Patient Centred. Patient Centred Care also underpins many subsequent policies such as the management of Long Term Conditions (Scottish Government, 2008) and the Chief Medical Officers Realistic Medicine report (Barlow, et al., 2015) Leadership styles and associated policies and procedures are often assumed to inhibit or encourage the delivery of quality Patient Centred Care and the NHS invests millions of pounds per year in Leadership training. At a clinical team and management level there are behaviours and initiatives that can arguably have positive and negative impacts on the ability of individual practitioners to provide quality Patient Centred Care. However there have been no attempts to empirically test the association between (good) Leadership and quality Patient Centred Care. Without any evidence of such a relationship, NHS investment of substantial resources may be misguided. Additionally, much of the focus of research in both Leadership and Patient Centred Care has focused on medical practitioners and nurses. There is little research that focuses on the impact of allied health professionals' (a term describing 12 differing health care professional groups representing over 130,000 clinicians throughout the United Kingdom) practice on the quality of person centred care and how this is affected by Leadership structures and styles. This study aimed to explore whether there is a direct or indirect link between (transformational) Leadership and achieving the delivery of high quality Patient Centred Care (PCC) in allied health professional (AHP) practice. Aim The aim of this thesis was to explore whether it was possible to empirically demonstrate a relationship between Leadership (good or bad) and Patient Centred Care, and to do this in relation to Allied Health Professional practice. Research questions I. Is there a relationship between Transformational Leadership and Patient Centred Care in AHP practice? II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? III. Do local contexts influence the ability of leaders to support Patient Centred Care? Study one Study one was designed to answer research question one: exploring the relationship between transformational Leadership and Patient Centred Care using survey design. Two groups of Allied Health Professionals were selected to take part in the study: Podiatrists and Dieticians. Clinical team leaders from across 12 Podiatry teams and 12 Dietetic teams completed a survey composed of measures of transformational Leadership and self-monitoring. Clinicians from these teams were also be asked to complete questionnaires on their perception of their clinical leaders’ transformational Leadership skills. This allowed comparison of self-assessed Leadership and team assessed Leadership. Clinicians were also asked to collect patient experience measures from 30 of their patients. Study Two Study Two was designed to answer research questions 2 and 3: how do AHPs conceptualise Leadership and how do they view the link between Leadership and their ability to deliver Patient Centred Care; and how might local context impact on professional Leadership and therefore its potential to enable or inhibit Patient Centred Care. In depth interviews were conducted with clinicians and clinical team leaders to explore the barriers and facilitators to effective Leadership, teamwork and the provision of quality care. Interviews were conducted with 21 Podiatrists and 12 Dieticians and analysed using a framework analysis approach. Results I. Is there a relationship between Patient Centred Care and transformational Leadership in AHP practice? The theory that there is a link between transformational Leadership and Patient Centred Care was confirmed. A significant relationship was discovered for the dietetics group linking Transformational Leadership with patient centred quality of care measures. There was also a relationship in the podiatry group that was suggestive of a relationship. II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? AHP’s in both groups had broadly similar conceptualisations of Leadership and both groups played down the role of Leadership in the delivery of Patient Centred Care. A far more salient factor in achieving the delivery of high quality Patient Centred Care for the AHP’s interviewed was professional autonomy. III. Do local contexts influence the ability of leaders to support Patient Centred Care? A number of contextual issues related to both Patient Centred Care and Leadership were identified from the qualitative analysis. These were centred on systemic factors, relating to management and bureaucracy, and individual factors, such as relationships within teams. In Podiatry a major shift in the context of care was ongoing during the study, namely a greater emphasis on encouraging patients to self-care. This affected the relationships between patients and Podiatrists, and Podiatrists and managers, in a way that Podiatrists felt it negatively impacted on their ability to provide quality Patient Centred Care. Conclusion A weak relationship was observed between Transformational Leadership styles and the delivery of Patient Centred Care in two Allied Health Professional groups. Professional autonomy was identified as being more likely to facilitate delivery of person centred care. Organisational issues and intervening policy directives can impact on the delivery of Patient Centred Care, regardless of Leadership. Recommendations Further work exploring the link between Leadership and Patient Centred Care is required. The concept of professional autonomy should be fostered within Leadership programs to enhance delivery of Patient Centred Care. The impact of individual policies, such as moves towards more self-care, on quality criteria need to be more fully considered. Whilst such policies may make care more efficient, there may be negative consequences for other quality care criteria, such as Patient Centred Care.
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43

Griffiths, Debra. "Agreeing on a way forward: management of patient refusal of treatment decisions in Victorian hospitals." Thesis, full-text, 2008. https://vuir.vu.edu.au/2036/.

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The purpose of this study is to investigate and develop a substantive theory, of the processes adopted by nurses and medical practitioners when patients with serious illness refuse medical treatment. The study seeks to identify the main constraints confronting nurses and medical practitioners and to explain the key factors that moderate the processes of dealing with refusal decisions. Using a grounded theory method, a sample of 18 nurses and 6 medical practitioners from two public hospitals in Melbourne were interviewed. In addition, observations and documentary evidence were utilised. The basic social psychological problem shared by nurses and medical practitioners is conceptualized as Competing Perspectives: Encountering Refusal of Treatment, which reflects the diverse perceptions and beliefs that confront participants when patients decide to forgo therapy. In utilizing the grounded theory method of analysis, it is recognised that participants deal with this problem through a basic social psychological process conceptualized as Endeavouring to Understand Refusal: Agreeing on a Way Forward. This core variable represents the manner in which participants, to varying extents, deal with the situations they face and it incorporates the various influences which moderate their activities. Endeavouring to Understand Refusal: Agreeing on a Way Forward comprises a series of three transitions. The first involves a struggle for participants to come to terms with, or even recognize that patients are rejecting treatment. The second transition illustrates the varied responses of participants as they interact with patients, relatives and each other, in order to clarify and validate decisions made during episodes of care. The third transition reflects the degree to which patients and family members are incorporated into treatment decisions, and highlights a shift in emphasis, from a focus on the disease state, to the patient as a person with individualistic thoughts and wishes. The remaining social processes evident in the study consist of four categories. The first, Seeking Clarification, embodies exploration undertaken by participants and their recognition that treatment is actually being refused. The second category, Responding to Patients and Families, demonstrates the level of expertise of participants communicating, and their ability to encourage reciprocity in the professional-patient relationship. The third category, Advocating, highlights the extent and manner in which patient and family wishes are promoted to members of the treating team. The fourth category, Influencing, reveals the ability of participants to utilize a degree of authority or power in order to shape particular outcomes. The findings also indicate that over arching the core variable and categories are various contextual determinants that moderate the way nurses and medical practitioners deal with patient refusal of treatment. These determinants are categorized into three main influences: The Context of Work, describes the of the environment and organisational factors pertinent to public hospitals; Beliefs and Behaviours, illustrates the perceptions of, and values held, by four key groups involved in decisions, namely, nurses, medical practitioners, patients, and family members; and Legal and Ethical Frameworks, examines the existing principles that support or guide professional practice in situations where patients with serious illness refuse medical treatment.
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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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Finn, Michael P. "Perceptions of discharge planning needs : A study of discharge planning in the mental health setting." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1995. https://ro.ecu.edu.au/theses/1158.

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Major mental disorder, with prolonged periods of dysfunction that require long term care, is an issue of concern amongst mental health professionals. Although substantial effort and resources are devoted towards returning mentally ill individuals to the community, one of the most distinctive and consistent features of the persistently mentally ill (PMI) is their high rate of readmission to hospital. Existing studies into discharge planning revealed that no research had been undertaken to determine if this is the case in Western Australia. This study sought to investigate perceptions of discharge planning held by patients, carers, nurses and allied health workers involved in discharge preparation in a major metropolitan psychiatric hospital operated by the Health Department of Western Australia. Eighty one subjects were selected from the four principal groups involved in care in this mental health setting, consisting of patients ( n = 21 ), carers ( n = 20 ), nurses ( n = 22 ) and allied health workers ( n = 18 ). Perceptions of discharge planning of these subjects were evaluated and compared using the Discharge Priorities Rating Scale. Farran, Carr & Maxson's model of goal congruence in discharge planning was used to guide this study. Significant differences were found to exist in the perceptions of discharge planning between patients, carers, nurses and allied health workers. Differences in perceptions are seen to have a detrimental effect on the discharge planning process, resu1ting in unnecessary and frequent readmission to hospital and the perpetuation of institutional dependency. Whilst the results of this study can only be applied to similar institutions, the findings are relevant for the persistently mentally ill who have patterns of frequent readmissions across the public and private mental health service settings. The results obtained indicate that nurses can facilitate effective discharge planning practices by adopting a more assertive role in the hea1th care team, in communicating patients' and their carers' concerns and promoting a more collaborative approach to care.
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46

Fowler, Rebecca. "Grand Canyons: Authoritative Knowledge and Patient-Provider Connection." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc799543/.

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In 2011, African Americans in Tarrant County, Texas experienced an infant mortality rate of 14.3 per 1,000 live births. The leading cause of infant mortality in Tarrant County is prematurity and maternal nutritional status. Both maternal under-nutrition and over-nutrition are known risk factors for premature birth. Improving maternal nutrition, by reducing rates of gestational diabetes and preeclampsia, and by increasing consumption of essential prenatal vitamins and nutrients, is a road to decreasing preterm birth in African Americans. This qualitative study, based on both anthropology and public health theory, of the nutrition behavior of a group of African American expectant mothers and the experience of their health care providers and co-facilitators had a goal to provide a foundation for future development of nutrition behavior research and education for this specific population. The main finding of this study was the substantial gap of lived experience and education between the patients and their providers and co-facilitators, which hinders delivery of care and the patients’ acquiescence to nutrition recommendations. The discrepancies between the authoritative knowledge of the providers and the bodily knowledge of expectant mothers were responsible for the ineffectiveness of nutrition recommendations.
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47

Terkildsen, Sheryl Ramona. "End of life nursing education consortium grant implementation project." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2324.

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This project addressed the continuing education needs of nursing staff and other health care professionals for delivering competent and compassionate palliative or end of life care. The scope of the project included, writing a grant application, training and certification by the end of life Nursing Education Consortium and implementing an education program for staff at the Loma Linda Veterans Affairs medical center.
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48

Alvarez, George Francisco Centre of Health Informatics UNSW. "Interruptive communication patterns in the intensive care unit ward round." Awarded by:University of New South Wales. Centre of Health Informatics, 2006. http://handle.unsw.edu.au/1959.4/23430.

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Medical error and patient safety have become important issues. It is clear that medical error is more influenced by systemic factors rather than human characteristics. Communication patterns, in particular interruptive communication, maybe one of the systemic factors that contribute to the burden of medical error. Objective: An exploratory study to examine interruptive communication patterns of healthcare staff within an intensive care unit during ward rounds. Methods: The study was conducted in a tertiary hospital in Sydney, Australia. Nine participants were observed individually, for a total of 24 hours, using the Communication Observation Method (COM). The amount of time spent in conversation, the number of conversation initiating and number of turn-taking interruptions were recorded. Results: Participants averaged 75% [95% confidence interval 72.8-77.2] of their time in communication events during ward rounds. There were 345 conversation-initiating interruptions (C.I.I.) and 492 turn-taking interruptions (T.T.I.). C.I.I. accounted for 37% [95%CI 33.9-40.1] of total communication event time (5hr: 53min). T.T.I. accounted for 5.3% of total communication event time (56min). Conclusion: This is the first study to specifically examine turn-taking interruptions in a clinical setting. Staff in this intensive care unit spent the majority of their time in communication. Turn taking interruptions within conversations occurred at about the same frequency as conversation initiating interruptions, which have been the subject of earlier studies. These results suggest that the overall burden of interruptions in some settings may be significantly higher than previously suspected.
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49

Brereton, John. "An evaluation of introducing advanced airway skills in the Western Australian Ambulance Service." University of Western Australia. Emergency Medicine Discipline Group, 2004. http://theses.library.uwa.edu.au/adt-WU2005.0065.

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[Truncated abstract] Objective: To investigate the demographics, success rate of application, nature and frequency of complication and the survival outcome of patients receiving advanced airway management in the pre-hospital setting. Design: Prospective observational cohort study. Participants: Patients who were attended to by St. John Ambulance Paramedics in the Perth Metropolitan area and selected regional areas within Western Australia. The patients were unconscious, unresponsive with no gag reflex and where application of an advanced airway would improve ventilation. Methods: Ambulance Paramedics received mannequin training within the classroom environment on the techniques for the application of the Endo-Tracheal Tube and the Laryngeal Mask Airway. The indication for the application of an advanced airway was any patient whose ventilation may be improved by intubation. These patients would be either deeply unconscious and areflexic, long term transport, severely injured (especially head injured) or cardiac arrest patients. Results: ... Paramedic assessment demonstrated that 14 (7.4%) 3 patients had an improvement in outcome. Of the 14 patients, 5 (2.7%) cardiac arrest patients survived to discharge from hospital compared to a 2.1 % survival rate for all cardiac arrest cases attended by the WAAS in 2002. Conclusion: Ambulance Paramedics can successfully apply an advanced airway apparatus in the pre-hospital environment. There was no statistical significance to demonstrate whether the introduction of advanced airway skills was beneficial or detrimental to patient survival outcome.
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50

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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