Dissertations / Theses on the topic 'Physician and patient Sexual behavior'
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Mostade, S. Jeffrey. "Components of internalized homophobia, self-disclosure of sexual orientation to physician, and durable power of attorney for health care completion in older gay men." Connect to this title online, 2004. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=kent1100874865.
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Werner, Dana Marie. "The Predictors of Physician-Patient Discussions of Sexual Health with Older Adults." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/246.
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The number of adults aged 65 years and over has been rising quickly, as has the rate of new onset sexually transmitted diseases within this population. Discussions of sexual health between physicians and older adults are currently lacking in frequency and effectiveness. Using the foundation of stereotype embodiment theory, the purpose of this study was to identify the factors that predict frequency of discussing sexual health with older adult patients. A comparative sample of geriatric physicians and family practitioners completed 2 researcher-developed questions and the Sexual Health Care Scale-Attitude tool that assessed their stereotype beliefs toward discussing sexual health with older adults using the 4 subscales--personal, patient, environmental, and colleague--and the frequency with which they discussed sexual health with their older adult patients. It was hypothesized that non-ageist attitudes would increase the frequency of discussions, and increase the personal factors, such as comfort level, of having such discussions. Multiple regression analysis and the chi-square test were used in data analysis. Frequency of sexual health discussions with older adult patients was dependent upon the physician type, age and gender, and how well the physician believed he or she had been educated to discuss sexual health with older adults. Comparatively, the geriatric physicians had more frequent discussions of sexual health with older adults than the family practitioners. The implications for social change include identifying the need for more specialized physician training in discussing sexual health with older adults to improve overall physical and emotional well-being of older adults and the study's recommendations for future research.
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Gillmore, Elizabeth Hardy Sprowls. "Improving patient satisfaction by training emergency department physicians to respond to patient behavior." Diss., This resource online, 1993. http://scholar.lib.vt.edu/theses/available/etd-06062008-171308/.
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Colton, Jana. "Sex and the Elderly: What Physicians Should Know About Their Older Patients." Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08072007-102501/.
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This study is intended to explore how physicians can best help their older patients attain a better quality of life through sexual healthcare by eliciting older patients perceptions and experiences regarding their sexual health needs and what role their physician should play in meeting those needs. Participants consisted of individuals and couples over the age of 65 recruited from a continuing care retirement community and from a VA Geriatric Clinic. Twenty in-depth, one-on-one interviews were conducted, and transcripts were analyzed using qualitative methodology. Analysis of transcripts revealed a broad range of findings including seniors perceptions of: the definitions of sexual activity and sexual health, their own sexual status, their own sexual health needs, the barriers to meeting their sexual health needs, and the ageist beliefs of others and themselves. This study exposed older patients self-perceived sexual health needs and the barriers to having those needs met; this knowledge should help physicians improve the quality of life for their senior patients through improved sexual health care.
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Santana-Cebollero, DeAnna. "Physician Well Being and Patient Satisfaction Among Employed Physicians." ScholarWorks, 2014. https://scholarworks.waldenu.edu/dissertations/167.
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Understanding physician well-being may help prevent physician burnout, improve the quality of care they provide to their patients, reduce medical errors, and improve patient satisfaction. Using the biopsychosocial-spiritual theory as the conceptual framework, this quantitative study examined the relationship between: (a) physician well-being and patient satisfaction, (b) physician gender and physician well-being, (c) primary care providers' and specialists' well-being, (d) patient satisfaction based on physician specialty, and (e) the duration of practice and physician well-being. All of the 87 employed physicians in a Florida regional hospital were invited to respond to a physician well-being questionnaire; a response rate of 58.4% was achieved. Patient satisfaction information was obtained through archived data of 4,500 patient surveys. Data were analyzed utilizing linear regression to examine the relationship between patient satisfaction and duration of physicians' practice, with the dependent variable, physician well-being. Two logistic regression analyses were utilized to examine (a) differences between physician well-being, gender, and specialty; and (b) differences between patient satisfaction and physician specialty. There were no significant relationships evident; however, it was speculated that the nonsignificance may be due to the small available sample of physicians. Future research on physician well-being may use the current findings to refine the conceptual framework and increase the understanding of how physician well-being can prevent physician burnout, improve the quality of care they provide to their patients, reduce medical errors, and improve patient satisfaction. Future research in this area will have the potential to increase the quality of patient care that will address positive social change.
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Collins, Blanche C. "The association between 2002 office Chlamydia screening rates, physician perception, and physician behavior." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2006. https://www.mhsl.uab.edu/dt/2007r/collins.pdf.
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Spitulnik, Jay J. "Physician Collaboration and Improving Health Care Team Patient Safety Culture: A Quantitative Approach." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6486.
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Studies have found links between physician relationships with nurses, patient safety culture, and patient outcomes, but less is known about a similar link between physician relationships with allied health professionals (AHPs), patient safety culture, and patient outcomes. The purpose of this exploratory quantitative, survey study was to investigate whether physician interactions with AHPs contribute to improved patient-safety culture, AHP empowerment, and self-efficacy. Based on a theoretical framework consisting of structural empowerment, psychological empowerment, and self-efficacy, it was hypothesized that self-efficacy is predicted by structural and psychological empowerment and self-efficacy predicts a positive patient safety culture. The AHP Survey of Physician Collaboration was constructed using psychometrically sound items from instruments that have studied similar phenomena. A purposive sample with 95 respondents consisted of occupational and physical therapists currently working in hospitals. Pearson Product-Moment correlation, standard multiple regression analysis, independent groups t-tests, and one-way between groups analyses of variance were employed. Although the survey results did not indicate a statistically significant relationship between psychological empowerment and patient-safety culture, findings in this study indicated that patient-safety culture has a significant positive correlation with structural empowerment and self-efficacy. Structural empowerment and self-efficacy were found to significantly predict patient-safety culture. The results did not show differences based on gender, profession, age, or years of service. By illustrating the nature of the relationship between physicians and AHPs, the results of this study can affect social change through enhancing the ability to reduce the number of preventable negative health outcomes in hospitals.
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Butler, E. Sonny. "The Role of Information in the Selection Process of a Primary Care Physician." Thesis, University of North Texas, 1993. https://digital.library.unt.edu/ark:/67531/metadc279148/.
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There is a paucity of information about the various factors that influence the selection of primary care physicians. Also, the relative significance of these factors is not known, making it difficult to properly address ways to improve the information flow to patients when they select a primary care physician.
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Marshall, Emily Gard. "Understanding and overcoming barriers in the physician-patient relationship related to the sexual health of adolescent women in Amherst, Nova Scotia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0016/MQ57310.pdf.
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Cheun, Jacquelyn Joann. "How eHealth Literacy Impacts Patient-Provider Relationships: A Study on Trust, Self-Care, and Patient Satisfaction." Thesis, University of North Texas, 2017. https://digital.library.unt.edu/ark:/67531/metadc1011860/.
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It has been well established, in the literature, the association between low health literacy rates and poor health outcomes. With the increase of technology dependence, more people are using the internet to look up health information. Research has shown that shared decision making between providers and patients can improve patients' health outcomes. This research aims to examine whether electronic health (eHealth) literacy impacts patient-provider relationships. This research will also examine how geography specifically state residency impacts eHealth literacy rates. Data collected from a national sampling of online health and medical information users who participated in the Study of Health and Medical Information in Cyberspace (N=710) is used to construct structural equation models from SPSS AMOS v. 20.0. After path analysis, the results shown that white males with higher education were more likely to have higher eHealth literacy rates and that eHealth literacy rates are associated with better self-care, higher patient satisfaction and increased trust in provider. Also, state residency does not have an impact on eHealth literacy rates. eHealth literacy will be significant in patient-provider relationships. Program development should be established on focusing on eHealth literacy across the lifespan. Also, it will be important to review federal policy on technology disbursements in order to achieve national goals on eHealth literacy rates.
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Navaratnam, Prakash. "Predictors of the prescribing of asthma pharmacotherapy in the ambulatory patient population of the United States." Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1171582748.
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Dyck, Loren R. "Resonance and Dissonance in Professional Helping Relationships at the Dyadic Level: Determining the Influence of Positive and Negative Emotional Attractors on Effective Physician-Patient Communication." Case Western Reserve University School of Graduate Studies / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=case1270512589.
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Lucan, Sean C. "Patient age, number and type of clinical encounters, and provider advice to quit smoking : BRFSS 2000 /." [New Haven, Conn. : s.n.], 2004. http://ymtdl.med.yale.edu/theses/available/etd-08182004-163750/.
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Khawaja, Masud S. "The Mediating Role of Positive and Negative Emotional Attractors between Psychosocial Correlates of Doctor-Patient Relationship and Treatment Adherence in Type 2 Diabetes." Case Western Reserve University School of Graduate Studies / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1283995516.
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Coidakis-Barss, Christina. "INTERPROFESSIONAL TEAMS IN HEALTHCARE: A MIXED-METHODS STUDY." Case Western Reserve University School of Graduate Studies / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=case1428068372.
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Folligah, Jean-Pierre K. "Determining Perceived Barriers Affecting Physicians' Readiness to Disclose Major Medical Errors." Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10811358.
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Medical errors have been detrimental in the field of medicine. They have impacted both patients and doctors. While physicians recognized that error disclosure was an ethical and professional obligation, most remained silent when mistakes happened for different reasons. Guided by the theory of planned behavior and Kant's deontological theory, the purpose of this quantitative study was to investigate the perceived barriers affecting physicians' willingness to report major medical errors. An association was tested between the independent variables physician fear of disclosure of errors, organizational culture toward patient safety, physician apology, professional ethics and transparency, physician education, and the dependent variable physician willingness to disclose major medical errors. Using a cross-sectional method, 122 doctors out of 483 surveyed, completed the online and paper-based survey. Multiple linear regression and descriptive statistics models were used to analyze and summarize the data. The results showed there was a statistically significant relationship between the independent variables organizational culture toward patient safety, physician apology, professional ethics and transparency, and physician education and the dependent variable physician willingness to disclose major medical errors. There was no relationship between the independent variable fear of disclosure of errors and the dependent variable. The findings added to the knowledge base regarding barriers to physicians' medical errors disclosure. The results and recommendations could provide positive social change by helping hospitals raising doctors' awareness regarding major medical errors disclosure.
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Nigro, Silvia Maria Balieiro. "Qualidade de vida, adolescência e doença crônica." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5169/tde-02082018-101428/.
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INTRODUÇÃO: Novas abordagens terapêuticas possibilitaram a sobrevida de crianças com doenças graves permitindo que atinjam a adolescência. O impacto da doença crônica no adolescente afeta seu desenvolvimento e qualidade de vida. OBJETIVO: Analisar a percepção de adolescentes com doença crônica acerca das interações da sua condição de saúde com as peculiaridades biopsicossociais da adolescência e seu impacto na qualidade de vida, identificando as estratégias de enfrentamento utilizadas, e avaliar os escores de resiliência e qualidade de vida.MÉTODOS: O estudo qualiquantitativo transversal e exploratório, envolveu 31 adolescentes (12-18 anos) em tratamento de doenças crônicas no ambulatório de especialidades pediátricas do Departamento de Pediatria da Faculdade de Ciências Médicas da Santa Casa de São Paulo. Coleta de dados utilizou: autoavaliação, questionário sociodemográfico, WHOQOL-BREF, RS14-Escala e grupos focais.RESULTADOS: Idade média dos participantes foi 15,1±1,5 anos, 20 adolescentes eram do sexo feminino (64,5%) e 11 masculino (35,5%). A percepção da qualidade de vida por autoavaliação não variou em relação ao sexo, grupo etário, ano letivo perdido e grau de escolaridade dos pais. Menores escores de resiliência estavam associados ao atraso escolar. Os adolescentes com doença crônica percebem suas limitações e experimentam o desenvolvimento pessoal a partir do processo de adoecimento e tratamento, que gera sentimentos ambíguos como revolta pelo desconforto e dor, em contraste com a auto-percepção do desenvolvimento de resiliência. Valorizam de modo ambivalente a rede de suporte representada pela família e amigos. Destacam sentimentos de constrangimento referentes à imagem corporal e seus efeitos sobre a autoestima. Apreciam as oportunidades de lazer como esporte, mídias e atividades relacionadas à música. Reconhecem os relacionamentos sociais e têm vínculos e modelos entre amigos, família e parceiros. Atividades básicas como comer e dormir foram consideradas fatores de promoção de bem-estar. Os adolescentes com doenças crônicas têm projetos de vida, sonhos mágicos e planos reais que remetem a futuras profissões no campo da saúde e cuidado. CONCLUSÕES: A despeito da doença crônica, os adolescentes que participaram do estudo têm sonhos, desejos e comportamentos sociais esperados nesta fase do ciclo vital. A doença crônica tem impacto na sua socialização e escolarização. Aqueles com maiores escores de resiliência tiveram menos atraso escolar. Desenvolvem comportamentos sociais adaptativos e contam com apoio de pais e amigos. Desejam e têm condições de participar do seu processo terapêuticoINTRODUCTION: New therapeutic approaches have made possible for children with serious diseases to live up until adolescence. The impact of a chronical disease in an adolescent affects its development and quality of life. OBJECTIVE: to analyze the perception of adolescents with chronical diseases of the interactions of their life conditions with the biopsychosocial peculiarities of the adolescence and its impact in their quality of life, indicating strategies utilized and evaluating resilience and quality of life scores.METHODS: the qualiquantitative, transversal and exploratory study involved 31 adolescents (12-18 years old), who have been having treatment of their chronical diseases in the pediatric specialties ambulatory of the Pediatrics Department of the Medical Sciences School of Santa Casa of São Paulo. The data collect involved: auto evaluation, sociodemographic questionnaires, WHOQOL-BREF, RS-14-scale and focus groups.RESULTS: the participants were 15 years old in average (±1,5), there were 20 adolescents female gender (64,5%) and other 11 (35,3%) male. Their perception of quality of life in their auto evaluation did not vary according to their gender, age, lost school year or degree of education of their parents. The lowest resilience scores were associated with school delay. The adolescents notice their limitations and try the social development through the process of sickening and treatment, generating ambiguous feelings like revolt and pain, contrasting with their auto-perception of the development of resilience. They value ambivalently the support network composed of family and friends. They highlight feelings of embarrassment due to their corporal image and their impacts on the self-stem. They appreciate leisure opportunities like sports, medias and music. They acknowledge their social relationships and their models among friends, family and partners. Basic activities like eating and sleeping were considered promoting factors of well-being. The adolescents with chronical disease have life projects, magical dreams and real plans that remit to future careers in health and care fields.CONCLUSIONS: In spite of their chronical diseases, the adolescents studied have dreams, desires and social behaviors expected of them in their age range. However, their condition impacts on their socialization and education. Those with lower resilience scores had less school delay. The adolescents develop social adaptive behaviors e count on their friends and family support. They wish and have conditions to participate of their therapeutic process
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Chizanga, Tongai Aldridge. "The impact of HAART on sexuality and medicine taking behaviours among people living with HIV/AIDS in Grahamstown." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1003228.
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Introduction: Adherence to Highly Active Antiretroviral Therapy (HAART) is critical for optimal therapeutic outcomes. A possible factor in adherence is the impact of HAART on sexual functioning. Methods: A mixed methods approach was used. A cohort of 14 people living with HIV/AIDS (PLWHA) in Grahamstown was identified. Two semi-structured interviews and two structured questionnaires were administered. In-depth interviews were conducted with two HIV counsellors in so as to obtain a different perspective on the topics. The theoretical framework used three health behaviour models: the Health Belief Model, Leventhal‘s Common-Sense Model of self regulation and the Transtheoretical model. Results: The participants were between 27 and 49 years old and had been on HAART for between 9 months and 10 years. Six participants were support staff members from Rhodes University and eight from the Raphael Centre – a local NGO which assists PLWHA.In most of the participants HAART was associated with increased libido and improved sexual functioning (sexual activity and sexual enjoyment). The use of alcohol increased risky sexual behaviour. Issues of adherence were seemingly not directly affected by the effects of HAART on sexuality. PLWHA, especially women, face challenges related to their sexuality, some of which are not directly related to their illness and treatment. The fear of transmitting drug resistant HIV or getting re-infected, stigma, disclosure issues,difficulties negotiating for safe sex among women, HAART-related lipodystrophic changes that affect one‘s sense of self and unmet reproductive needs are some of the problems that were reported. The men‘s dislike for condoms was overt and blatant. Discussion: Being diagnosed with HIV and reaching a point where treatment is requiredare life-changing events. Making decisions about one‘s life (including adherence to HAART, alcohol use and knowingly partaking in risky sexual encounters) become all the more significant in the context of AIDS. Intentional non-adherence is informed by the individual‘s assessment of the costs and benefits of taking treatment. Cultural influences,gendered power relations and misconceptions strongly influence sexual behaviours. Conclusion: The general lack of attention among health care providers concerning issues related to PLWHA‘s sexuality and reproductive issues needs to be addressed. Insights fromthe theoretical models should be integrated with empirical findings in designing adherence interventions.
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"Medical malpractice: effect on physician behavior and patient health." Tulane University, 2005.
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In this dissertation, I estimate the effect of medical malpractice on health care delivery in the United States. In particular, I focus on the effect of medical malpractice on physician behavior and health outcomes of the patients. The National Practitioner Data Bank (NPDB) has been combined with the Nationwide Inpatient Sample (NIS). Malpractice claims frequency and severity are used as measures of medical malpractice risk in each state While estimating defensive medicine in obstetrics, physician behavior is modeled as a fixed effects logit. Results suggest that a higher degree of malpractice risk increases the probability of C-section delivery. Overall, there is no evidence of defensive medicine. In fact, marginal benefit of additional resource use is higher than its marginal cost While analyzing the effect of medical malpractice on physician behavior and health outcomes for AMI patients, I find that an increase in medical malpractice risk leads to a reduction in resource use and improvement in health outcome for patients with less severe medical conditions. For patients with more severe medical conditions, medical malpractice is associated with a reduction in health expenditure and no increase in mortality. Therefore, I find no evidence of defensive medicine for AMI patients While analyzing the effect of medical malpractice risk on health outcomes for patients suffering from for five common medical conditions, I find that an increase in claims frequency improves mortality for patients suffering from stroke, hip fracture, pneumonia, or CHF. Medical malpractice does not affect mortality for patients suffering from GI hemorrhage. Severity of medical condition of the patient is an important factor in determining the effect of medical malpractice on health outcomes The policy implications are that medical malpractice serves its purpose as a deterrent to less than optimal care. Overall, we find that medical malpractice improves health outcomes for a majority of medical conditions. Reducing medical malpractice risk may reduce this benefit. This means that reforms aimed at reducing medical malpractice risk faced by physicians and hospitals could lead to a decline in the quality of care providedacase@tulane.edu
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(9073700), Svetlana N. Beilfuss. "Essays on Patient Health Insurance Choice and Physician Prescribing Behavior." Thesis, 2020.
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This dissertation consists of three chapters. The first chapter, Inertia and Switching in Health Insurance Plans, seeks to examine health insurance choice of families and individuals employed by a large Midwestern public university during the years 2012-2016. A growing number of studies indicate that consumers do not understand the basics of health insurance, make inefficient plan choices, and may hesitate to switch plans even when it is optimal to do so. In this study, I identify what are later defined as unanticipated, exogenous health shocks in the health insurance claims data, in order to examine their effect on families' plan choice and switching behavior. Observing switches into relatively generous plans after a shock is indicative of adverse selection. Adverse retention and inertia, on the other hand, may be present if people remain in the relatively less generous plans after experiencing a shock. The results could help inform the policy-makers about consumer cost-effectiveness in plan choice over time.
Physicians’ relationships with the pharmaceutical industry have recently come under public scrutiny, particularly in the context of opioid drug prescribing. The second chapter, Pharmaceutical Opioid Marketing and Physician Prescribing Behavior, examines the effect of doctor-industry marketing interactions on subsequent prescribing patterns of opioids using linked Medicare Part D and Open Payments data for the years 2014-2017. Results indicate that both the number and the dollar value of marketing visits increase physicians’ patented opioid claims. Furthermore, direct-to-physician marketing of safer abuse-deterrent formulations of opioids is the primary driver of positive and persistent spillovers on the prescribing of less safe generic opioids - a result that may be driven by insurance coverage policies. These findings suggest that pharmaceutical marketing efforts may have unintended public health implications.
The third chapter, Accountable Care Organizations and Physician Antibiotic Prescribing Behavior, examines the effects of Accountable Care Organizations (ACOs). Physician accountable care organization affiliation has been found to reduce cost and improve quality across metrics that are directly measured by the ACO shared savings program. However, little is known about potential spillover effects from this program onto non-measured physician behavior such as antibiotic over-prescribing. Using a two-part structural selection model that accounts for selection into treatment (ACO group), and non-treatment (control group), this chapter compares physician/nurse antibiotic prescribing across these groups with adjustment for geographic, physician, patient and institutional characteristics. Heterogeneous treatment responses across specialties are also estimated. The findings indicate that ACO affiliation helps reduce antibiotic prescribing by 23.9 prescriptions (about 19.4 percent) per year. The treatment effects are found to vary with specialty with internal medicine physicians experiencing an average decrease of 19 percent, family and general practice physicians a decrease of 16 percent, and nurse practitioners a reduction of 12.5 percent in their antibiotic prescribing per year. In terms of selection into treatment, the failure to account for selection on physician unobservable characteristics results in an understating of the average treatment effects. In assessing the impact of programs, such as the ACO Shared Savings Program, which act to augment how physicians interact with each other and their patients, it is important to account for spillover effects. As an example of such spillover effect - this study finds that ACO affiliation has had a measurable impact on physician antibiotic prescribing.
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Sheu, Jong-Yih, and 許忠逸. "Influences of Patient Faithfulness and Physician Characteristics on Physicians’ Prescribing Behavior in Outpatient Settings." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/56962126406757358469.
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碩士國立臺灣大學
公共衛生碩士學位學程
100
Abstract Objectives: Chronic patient visiting a physician with long-term continuity, also called patient faithfulness, is deemed a better healthcare model for outpatient services. It not only builds up trust between patients and physicians but also increases patients’ satisfaction with the quality of care. However, whether patient faithfulness contributes to physician’s prescribing behavior, and if yes, to what extent and in what way, which lacks quantitative data to validate and support. This study aims to investigate how patients’ faithfulness, by taking into account physicians’ characteristics, correlates with physicians’ prescribing behaviors. Methods: This study basically follows a cross-sectional design, using “non-specific essential hypertension” as the example to explore the above relationships. Patient faithfulness was measured by continuity of visiting a specific doctor from January 2009 to December 2010, a total of 80 physicians and their 27,128 prescription records during the above period of time were included in this study. Physician characteristics were measured by their prescribing practices and socio-demographic factors. Using SAS9.2, the data analysis was carried out by the methods ofχ2 test, F test, and multiple logistic analysis. Results: Patients who are female and with older age were less likely to visit physicians in a continuous basis, i.e., with lower level of faithfulness. To physicians with greater level of faithfulness, physicians tended to prescribe fewer drugs, give fewer sub-diagnoses, fill longer prescription days, and dispense Chronic Illness Prescription Slip. In general, physicians who were older in age were apt to influence by patients’ faithfulness. On the contrary, physicians holding higher positions were less influenced by patients’ faithfulness. Moreover, patient-physician communication depended more on physicians’ characteristics rather than patients’ faithfulness. Conclusions: Patient faithfulness leads to a greater control of disease, decrease visits, reduce total prescription items, and also increase prescription with longer period of time. As a result, patient faithfulness enhances the efficiency in NHI resource consumption. Particularly, patients’ faithfulness significantly affected physicians who were older and senior in practices. Notably, however, improved patient-physician communication might not be generated through visiting a physician with long-term continuity. Findings from this study can inform the government in the development of faithful patient policy.
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Chen, Shian-Ju, and 陳相如. "The Study of the Treating Behavior and Physician-Patient Relationship--Under the View of the Transaction Cost." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/25441490951123450572.
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碩士國立雲林科技大學
企業管理系碩士班
93
The main purpose of this study is to investigate that when physicians face environment uncertainty, patients’ behavior uncertainty, and medical outcome uncertainty, they will perceive higher level of transaction cost. If physicians have medical malpractice experience, it may reinforce the transaction cost perception of physicians. In such situation, physicians may adopt defensive medicine, but the way is not good for patients. Therefore, physicians may take more positive way such as improving the relationship with patients. When physicians improve their service quality and reinforce communication with patients, physicians will attract more patients and get better performance. On the other hand, treating behavior belongs to the high-contact service, physicians may incline to offer higher service quality to their patients. Moreover, this research suggests that medical malpractice experience of physicians affect physicians’ treating behavior indirectly. It will raise physicians’ perception of transaction cost first, and then physicians will change their behavior to decrease their risk perception, such as adopting defensive medicine, improving service quality, or reinforcing communication with their patients.
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Hu, Hung-Kang, and 胡弘鋼. "The association between indicators for primary care quality based upon physician''s behavior and patient''s perception." Thesis, 2004. http://ndltd.ncl.edu.tw/handle/45241976670592822270.
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碩士中國醫藥大學
醫務管理研究所
92
As observing the international trend of health care delivery system and the National Health Insurance program in Taiwan, It is found the role of the primary care in the health care system becomes more important. Thus, the issues about how to assess the quality of primary care become more important, as well. Department of Health, Executive Yuan, Taiwan R.O.C. circularized “Plan For Ensuring Care Quality For Western Medicine Global Budget Payment Method Of National Health Insurance“ in June 2001 and executed in July 2001. This plan hopes to develop feasible indexes to assess quality of primary care. Thus it is seen that to develop indexes to assess quality of primary care is one of the important issues of health policy at present. The primary objective of the study is to examine the association between outcomes for quality of primary care based upon physician’s behavior, assessed by “Medical record abstract form” (MRAF) and based upon patients’ perception, assessed by Chiness-version Primary Care Assessment Tool (PCAT) using “multitrait-multimethod matrix”. We hypothesize that the similar concept of domains measured by Chiness-version PCAT and MARF should be related to each other. The secondary objective is to compare quality of primary care, assessed by Chiness-version PCAT and MARF between hospital and primary clinics. For these purposes,a total of 400 patients aged over 18 years old at the department of family medicine of the China Medical University Hospital and 401 outpatients from clinical setting of the primary care physicians who had practiced at front place were recruited from July 2003 to August 2003. Face-to-face interviews were administered and we abstracted these patients’ medical record with MRAF. The respondent rate is 78.59% at the department of family medicine of the China Medical University Hospital and 85.68% at clinical setting. The results show that the expected association between Chiness-version PCAT and MRAF are scale of first contact-utilization and patient visit rate to the primary physician, the scale of ongoing care and comprehensive information, and scale of coordination of care and referral for hospital sample, and scale of ongoing care and comprehensive information, and scale of coordination of care and referral for the clinical sample. Other hypothesized associations didn’t observed. All sidnificant negative relationship between Chiness-version PCAT and MRAF are out of expectation. The significant associations of primary care score and primary care expend score of Chiness-version PCAT that we don’t expect are family history score and comprehensive information of the MRAF. The expected significant associations observed in the study imply that Chiness-version PCAT has good construct validity. In addition, MRAF can be a systematic method to collect data and a practical tool for assessing quality of primary care. Hence we suggest that Chiness-version PCAT and MRAF can be used together to get complete information about the quality of primary care. For future research, it should study how to combine Chiness-version PCAT and MRAF as a unique index for assessment of quality of primary care in evaluation of health policy and types of primary care orgnizations.
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Nigro, Tracey Lynn Bilan. "The associations between psychologists' attachment patterns and their experiences with clients, including sexual attraction and sexual contact : a national survey." 2004. http://hdl.handle.net/1828/751.
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Anderson, Carita Michelle. "Managing feelings of sexual attraction in therapy an instructional program for therapists-in-training /." 2001. http://books.google.com/books?id=73NHAAAAMAAJ.
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Masetshaba, Musa. "Experiences of long-term highly active antiretroviral treatment by adolescents in Tembisa, Gauteng Province." Thesis, 2016. http://hdl.handle.net/10500/22520.
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Adolescence is a significant period of change in physical and psychosocial development of human beings. Being HIV positive and growing up on a dynamically multifaceted HAART treatment, adds to the complexity of adolescence. This study was aimed at exploring the nature of experiences of adolescents who are on long-term Highly Active Antiretroviral Therapy (HAART) in Tembisa, Gauteng province. The study is based on a qualitative research method using in-depth semi-structured open-ended interviews and a focus group for data collection. The sample consisted of seven individual adolescent participants, three parents, guardians and caregivers, as well as 11 health care professionals. The thematic data analysis and the phenomelogical analysis methods were used to analyse data qualitative data while descriptive statistics were used to analyse quantitative biographical data.
The study findings cover the negative and positive experiences and the perceived role of HAART treatment over a long period of time. The predominant themes identified from adolescent participants were disclosure of HIV positive status and the stigma surrounding a positive status, early childhood experience of parental death, challenges of taking HAART treatment, factors influencing adherence and non-adherence to HAART treatment, and lastly, the impact of religion on HAART treatment adherence. The findings suggest that adolescents who are on HAART treatment over an extended period of time experience drug fatigue. Drug fatigue has far-reaching implications for the health of an adolescent, as it has a higher likelihood that poor adherence or even complete refusal to take HAART treatment will occur. Poor adherence or refusal to take HAART treatment will most likely lead to cross infection and further spread of HIV and AIDS.
A recommendation was made to include the establishment of a youth and adolescent-friendly centre by the hospital – one that is designated for the provision of tailored adolescent services and sensitive to adolescent developmental stages so as to minimise the likelihood of infected adolescents falling through the health care cracks. The introduction of a hospital-based school, an education unit run by dedicated and qualified facilitators focusing on aiding hospitalised learners with catch-up scholarly programmes, was a further recommendation. It was further recommended that reproductive health care needs of adolescents who grow up on HAART treatment be given attention in further research.Psychology
Ph.D. (Psychology)
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VRZALOVÁ, Monika. "Role sestry ve screeningu deprese u seniorů." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-260905.
Full textAbstract:
The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.