Dissertations / Theses on the topic 'Physicians (General practice) Diseases'
To see the other types of publications on this topic, follow the link: Physicians (General practice) Diseases.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Physicians (General practice) Diseases.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Nelson, Mark 1957. "Aspects of pharmacological management of hypertension in general practice." Monash University, Dept. of Epidemiology and Preventive Medicine, 2002. http://arrow.monash.edu.au/hdl/1959.1/7923.
Full text
2
Holt, Jackie. "Psychological distress amongst general practitioners /." [St. Lucia, Qld.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17113.pdf.
Full text
3
Hays, Richard B. "Improving standards in rural general practice /." St. Lucia, Qld, 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17837.pdf.
Full text
4
Moorhead, Robert George. "Communication skills training for general practice." Title page, contents and abstract only, 2000. http://web4.library.adelaide.edu.au/theses/09MD/09mdm825.pdf.
Full textAbstract:
Bibliography: leaves 554-636. Examines aspects of teaching medical students communication skills at a time when they are entering their clinical years. Integrates reports of 12 data-gathering exercises centred on medical student communication skills with the international literature, and with the author's reflections as an experienced educator and G.P. Recommends that communication skills training in a general practice setting should be a crucial factor in all future training of medical students.
5
Buhler, Patricia Lynn. "Prenatal care : a comparative evaluation of nurse-midwives and general practitioners." Thesis, University of British Columbia, 1985. http://hdl.handle.net/2429/24489.
Full textAbstract:
The practice of midwifery by those other than physicians is illegal in Canada and despite recommendations of nursing, medical and consumer groups, no trials evaluating the effectiveness of the nurse-midwife as a member of the modern obstetrical team have occurred here. To demonstrate a nurse-midwifery model, four nurse-midwives provided primary care to forty-seven childbearing women and their families over a twenty-two month period in a maternity teaching hospital. This clinic presented a unique opportunity for comparing the prenatal care provided by nurse-midwives with that of general practitioners who attended deliveries in the same setting. Utilizing a retrospective chart audit, case control study design, the nurse-midwife cases (NM cases) were each matched to two general practitioner controls (GP controls) through the use of the hospital's prenatal data base. The matching characteristics included low risk status, date of delivery, age, parity, gravidity, previous pregnancy losses and census tract income. Prenatal criteria that had been developed and tested in "The Burlington Randomized Clinical Trial of the Nurse Practitioner" for assessing the quality of care were reviewed and updated for this study. With these criteria two blinded abstractors audited the prenatal record forms of all the subjects and scored them as either "superior", "adequate" or "inadequate".
Seventy-seven percent of the records of the NM cases received a
"superior" score, where as 60% of the GP controls' records received an
"inadequate" score [mathematical formula omitted] Overall, the general
practitioners' records indicated more erratic care than those of the nurse-midwives. Although the physicians met most of the initial assessment criteria, they failed to meet the criteria that evaluated the ongoing routine assessment process by recording an inadequate number of prenatal visits (36%), or by omitting urine test results (38$) and blood pressure readings (21%). No differences were found in variables relating to labour and delivery with the exception of the incidence of episiotomies. The results indicate that nurse-midwives as part of an obstetrical team are able to provide safe prenatal care to a low risk population in a Canadian urban context, and that their records are thorough and more consistent than those of general practitioners.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
6
McCleary, Nicola. "Relationships between perceived decision difficulty, decision time, and decision appropriateness in General Practitioners' clinical decision-making." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=229003.
Full textAbstract:
The aim of this project was to use patient scenarios (clinical/case vignettes) to explore three aspects of General Practitioners' (GPs') clinical decision-making: how difficult decisions are perceived to be, the time taken to make decisions, and the appropriateness of decisions relative to evidence-based clinical guideline recommendations. A systematic review synthesised the results of published scenario studies. A secondary analysis of scenario studies which investigated antibiotic prescribing for upper respiratory tract infection (URTI) and x-ray referral for low back pain was performed. Relationships between the three aspects of decision-making were investigated, and scenario and GP characteristics associated with these aspects were identified. An online scenario study further refined these relationships for two specific URTI types: sore throat and otitis media. Cognitive processes involved in clinical decision-making were investigated in a Think-Aloud interview study, where GPs verbalised their thoughts while making prescribing decisions for URTI scenarios. There was some evidence that inappropriate antibiotic prescribing for URTI was associated with greater decision difficulty and longer decision time. Decisions made using a more effortful cognitive process may therefore be less likely to be appropriate. Illness durations of four or more days and, in otitis media, unilateral ear examination findings were related to inappropriate prescribing. Based on these results, suggestions have been made for informing the design of interventions to support GPs in making appropriate decisions. A secondary aim was to provide an overview of the methodology and reporting of scenario studies. The systematic review indicated a lack of consistency in methodologies, while reporting is often inadequate. Formats less similar to real consultations (e.g. written scenarios) are commonly used: the results of studies using these formats may be less likely to reflect real practice decision-making than studies using more realistic formats (e.g. videos). Based on these findings, methodological recommendations for scenario studies have been developed.
7
Askew, Deborah Anne. "A study of research adequacy in Australian general practice /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18717.pdf.
Full text
8
Louw, Charmaine. "General practitioners' familiarity attitudes and practices with regard to attention deficit hyperactivity disorder in children and adults." Thesis, Link to the online version, 2006. http://hdl.handle.net/10019/433.
Full text
9
Blaney, David. "The learning experiences of general practice registrars in the South East of Scotland." Thesis, University of Stirling, 2005. http://hdl.handle.net/1893/2003.
Full textAbstract:
To train to be a general practitioner in the U.K. a doctor must spend two years in hospital training posts and one year in general practice as a general practice registrar (GPR). Concern has been expressed in the literature about both the duration and adequacy of general practice training. A literature review identified that there was limited knowledge of and understanding about the learning experiences of GPRs. The aim of the study was to describe and interpret the learning experiences of GPRs in the South East of Scotland during their year in general practice. The methodology was derived from Denzin's concept of Interpretivism and involved in depth interviews over time with GPRs and thick description to capture and interpret the GPRs learning experiences. Two cohorts of 24 GPRs were recruited, cohort one ran from September 2002 to July 2003 and cohort two from September 2003 to August 2004. The GPRs were interviewed on three occasions during their year. In addition to the interviews six GPR focus groups and six GP trainer focus groups were held over the period December 2002 to September 2003. 21 GPRs in cohort one completed all three interviews and 20 GPRs in cohort two. All the participating GPRs completed at least two interviews. The results were interpreted within the educational concept of the curriculum. Four main curricula were identified during the GPR year: these were the formal, assessment, individual and hidden. Each independently contributed to the GPRs learning and also interacted synergistically at various times during the year. In the last quarter of the year there was a tension between the requirements of the assessment and individual curricula. The individual curriculum which was composed of the GPRs clinical experiences and in particular epiphanies was the main driver of GPR learning. Epiphanies were identified by GPRs as having the most significant impact on their learning. Central to this learning was the contribution of their general practice trainer who supported their learning both through the development of the practice learning environment and the promotion of reflection and self directed learning. GPR learning during the year was an iterative process, which involved a reflective and supported interaction between the GPR, their clinical experiences, epiphanies and their trainer. Through this process the GPRs became self directed and reflective learners and developed individual learning networks which led to changes in the way they practiced medicine. This process also led to the socialisation of their learning and promoted their integration into the culture of working general practice, through which they were exposed to the working realities of life as a general practitioner and these experiences had a critical effect on their future career choice. A number of important policy implications were identified which have implications for the present and future direction of training for general practice. The process of thick description and the longitudinal nature of the study allowed for a new interpretation of the learning experiences of GPRs and added to the knowledge and understanding of how GPRs learn during their training.
10
Proude, Elizabeth Marjorie. "HIV/STD Prevention in General Practice." University of Sydney. Public Health, 2002. http://hdl.handle.net/2123/838.
Full textAbstract:
This thesis examines aspects of the prevention of sexually transmitted diseases (STDs) in the Australian community, with a particular emphasis on HIV/AIDS in the context of general practice (or primary care settings). The work has four broad aims: i) To describe the primary prevention of sexually transmitted diseases, following from the arrival of the HIV/AIDS pandemic in Australia ii) To describe HIV/STD risk behaviour iii) To summarise previously known evidence of interventions to reduce risk and to raise awareness of HIV and other sexually transmitted diseases iv) To contribute new evidence addressing the potential of the general practitioners' role in HIV/STD prevention The first chapter gives a brief review of the history of HIV/AIDS from its discovery in the United States of America to its appearance in Australia and New Zealand, and discusses the Australian response strategies, both initial and continuing, to confine the epidemic. Specifically, the arrival of HIV/AIDS gave rise to increasing awareness of sexually transmitted diseases, which hitherto, although sometimes chronic, were rarely fatal. The public health risk of HIV necessitated swift government action and led to wider acceptance of publicity about sexual behaviour. Although the thesis does not concentrate solely on HIV, this is still an emphasis. This chapter provides useful background to ensuing chapters. Chapter Two provides an overview of behavioural risk in sexually transmitted diseases. It gives a review of risk factor prevalence studies, and introduces risk behaviour and cognitive models of behaviour change, as applied to STD risk. Sexual behaviour is a complex social interaction, usually involving more than one person, and relying on the personality and behaviour patterns intrinsic to the individuals taking part. It is therefore perhaps more challenging to alter than behaviour which is undertaken alone, being dependent on the behaviour and intentions of both parties. Moreover, comprehensive assessment of sexual risk behaviour requires very detailed information about each incident. Its private nature makes accurate data difficult to obtain, and sexual risk behaviour is, correspondingly, difficult to measure. Chapter Three reviews the effectiveness of interventions tested in primary health care settings to reduce sexual risk behaviour. The candidate uses a replicable method to retrieve and critique studies, comparable with standards now required by the Cochrane Collaboration. From 22 studies discussed, nine health interventions were short, 'one-shot', efforts owing to limited time, resources and other practical constraints. This review demonstrates the scarcity of interventions with people who may be perceived as 'low-risk'. Only four interventions were carried out in community health centres and two in university health clinics. One of the university interventions showed no change in sexual behaviour in any of three arms of the intervention (Wenger, Greenberg et al 1992) while the other showed an increase in condom use in both groups, although the intervention group's self-efficacy and assertiveness also improved (Sikkema, Winett & Lombard 1995). The rationale for the intervention, where given, is described. Chapter Four analyses the content, format and quality of sexual health information brochures available in New South Wales at the time of the candidate's own planning for an interventional study. One of the most effective ways to disseminate information widely is by the use of educational literature, especially when the subject material is potentially sensitive or embarrassing to discuss in person. In this chapter, the candidate reviews the literature available at the time of designing the intervention used in Chapter Five. Readability, attractiveness, clarity and the accurate presentation of facts about sexually transmitted disease risk are examined for each pamphlet. Forty-seven pamphlets were scored according to the Flesch formula, and twenty-four of these scored in the 'fairly' to 'very difficult' range. There was, therefore, a paucity of easy-to-read material on these subjects. Chapter Five evaluates a general practitioner-based counselling intervention to raise awareness of sexually transmitted diseases and to modify HIV/STD risk behaviour. While adults aged 18-25 are less likely than older cohorts to have a regular general practitioner or to visit often, most people visit a general practitioner at least once a year. This could provide an opportunity for the general practitioner to raise preventive health issues, especially with infrequent attendees. As the effectiveness of an opportunistic intervention about sexual risk behaviour was yet to be tested, the candidate designed an innovative randomised controlled trial to raise awareness of risk and increase preventive behaviour. The participation rate was 90% and 76% consented to followup; however the attrition rate meant that overall only 52% of the original participants completed the follow-up questionnaire. The intervention proved easy and acceptable both to GPs and to patients, and risk perception had increased at three months' follow-up; however this occurred in both the control (odds ratio 2.6) and the intervention group, whose risk perception at baseline was higher (odds ratio 1.3). In order to establish some markers of risk in the general population, Chapter Six analyses data resulting from questions on sexual behaviour asked in the Central Sydney section of the NSW Health Survey. The candidate advocated for inclusion of relevant questions to determine some benchmarks of sexual risk behaviour and to provide an indication of condom use among heterosexuals. Although limited in scope as a result of competing priorities for questions in the survey, results demonstrate that, while a small percentage of people were at risk, those with higher levels of partner change or of alcohol use were the most likely to always use condoms. Specifically, 100% of those with more than four new partners in the last 12 months had used condoms with every new partner. In addition, 'heavy' alcohol users were more likely to report condom use every time with new partners (odds ratio 0.34). To furnish data to inform future planning of educational activities for general practitioners, Chapter Seven presents the results of a survey of Central Sydney general practitioners' opinions and current practices in HIV risk reduction with in the broader context of sexually transmitted disease prevention. The general practitioner is in an ideal position to provide information and advice, especially if future research affirms the impact of such advice on STD risk behaviour. General practitioners in this study said they would be slightly more likely to discuss sexual health matters with young patients than with older ones (p=0.091), but this was not significant. The most cited barrier to discussing sexual health was inadequate remuneration for taking time to do so (over 50% gave this reason). The next most cited obstacle was difficulty in raising the subject of STDs or HIV in routine consultations, but this reason was given by less than half the sample. Forty-six percent had participated in continuing medical education programs in STDs, HIV/AIDS, or hepatitis diagnosis or management; 32% of GPs had patients with HIV, and 55% of all GPs indicated they would like more training in management and continuity of care of HIV patients. Approximately half (51%) wanted more training in sexuality issues, including sexual dysfunction. Chapter Eight reviews the whole thesis and discusses future directions for the research agenda.
11
Simkin, Sarah. "End-of-Career Practice Patterns of Primary Care Physicians in Ontario." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/35777.
Full textAbstract:
Incomplete understanding of attrition from the physician workforce has hampered policy-makers’ efforts to achieve optimal alignment of the supply of physicians with population demand for medical services. This longitudinal study of Ontario primary care physicians uses health administrative data to characterize changes in physicians’ practice patterns over time. We examined the workload and scopes of practice of 21,240 physicians between 1992 and 2013. We found that physicians reduce their workloads gradually as they age, retiring from clinical practice at an average age of 70.5. Furthermore, we found that 60% of family physicians who stop providing comprehensive primary care continue to provide clinical services for an average of three years, with reduced workloads, before retiring fully. Our findings clarify the process of physician attrition from the workforce and will help to improve estimates of attrition and make physician workforce planning more accurate and effective.
12
Young, Megan. "General practitioners' familiarity with and practices related to haemochromatosis /." [St. Lucia, Qld.], 2003. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe17037.pdf.
Full text
13
Braunack-Mayer, Annette. "General practitioners doing ethics : an empirical perspective on bioethical methods /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phb8253.pdf.
Full text
14
Visser, Henriette. "An exploration of the nature of a private general medical practice as a social system : a case study." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/884.
Full textAbstract:
This research study explores in general the nature of a private general medical practice [PGMP] and whether analysis of the PGMP as a social system can lead the Group Dynamics Practitioner towards developing interventions that will enhance group effectiveness in the PGMP support staff group. The main assumption is that, through the application of a framework of analysis based on that of G. C. Homans and the AGIL functional prerequisites developed by T. Parsons, a structured analysis of the external and internal variables that impact on the PGMP as a social system can be undertaken. The findings of the analysis would lead to the formulation of interventions that would improve the performance effectiveness of the PGMP as a social system. Following a two-questionnaire survey of 17 practices that provided demographic information as well as soft skills training needs, a single PGMP was identified for the case study. Data pertaining to the group as a social system were collected, and by using direct observation, content analysis and a sociometric test, the practice support staff sub-system, being the main focus of this research, could be analysed. By linking the findings to the elements of the framework of analysis, areas of ineffective group functioning could be identified and interventions suggested. This research indicates that the choice of soft skills is associated with the nature and size of the practice, as well as the dynamics of the sociometric patterns characteristic of the relations within the practice support staff subsystem; that while some practice support staff have preferences for sociometric task and socio-emotional relations outside their work clusters, these seem to serve as a buffer against clique forming, thus enhancing the function of integration within the social system as a whole; and that the physical practice layout, and the interaction dynamics that it creates, tend to hinder integration between the members of the practice support staff group, as a social subsystem.
15
Backlund, Lars. "General practitioners' decision-making on drug treatment of hypercholesterolaemia /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-672-3/.
Full text
16
Munro, Neil Macarthur. "Postgraduate attachment to general practice : influence on doctors’ future career intentions." Thesis, University of Sussex, 2011. http://sro.sussex.ac.uk/id/eprint/6915/.
Full textAbstract:
Recruitment of medical graduates to general practice careers in the UK, as in other developed countries, remains challenging. Currently general practice attracts fewer doctors than health care planners anticipate will be needed to meet the burgeoning health needs of an ageing population. Understanding the factors that influence doctors in their career choices is important to manpower planners, the profession and society as a whole. A two year postgraduate foundation programme for all doctors was introduced into the UK in 2006. One of its main intentions was to provide doctors with postgraduate clinical attachments that would assist them in making informed career choices. This has resulted, for the first time, in large numbers of recent medical graduates experiencing several specialties before applying for specialty specific training programmes. The main aim of this thesis was to assess the influence of a four month postgraduate attachment in general practice in the second foundation year on doctors' career intent. It was hypothesised that the attachment would have a positive impact on recruitment to general practice careers. This hypothesis was tested using a combined quantitative and qualitative approach. A literature review examined career decision making in medicine. It was divided chronologically into sections covering decision making at school, university and in the early postgraduate years. In addition a section focussed on decision making in careers other than medicine. A validated career inventory (sci 59) measuring change in career preference was selected for use in this study. The output is in the form of career rankings among 59 medical specialties. In addition, a semi-structured interview questionnaire was developed based on themes emerging from the literature review and was refined following piloting. Interviews were recorded, transcribed and thematically analysed using NVivo 7. The study was conducted in the Kent, Surrey and Sussex Deanery between 2005 and 2008. Participants (n=225) included all doctors whose second foundation year programme included a four month attachment in general practice. They were sent a sci 59 questionnaire at the beginning of their attachment and a further questionnaire at the end. Those responding to both questionnaires were invited to take part in an interview. 112 participants completed sci 59 questionnaires at the beginning and end of their 4 months attachment. Initial analysis demonstrated a small, statistically non-significant improvement in career intent towards general practice. Using a measure that reflects movement in ranking between the two questionnaires, further analysis showed a small, statistically significant, improvement in the ranking of general practice among participants who had low initial rankings for general practice. 30 participants were interviewed. Placements in general practice during the second foundation year were generally regarded in a very positive light. Doctors particularly valued ongoing relationships with patients as well as involvement with local communities. They commented on the high quality of supervision and the structured learning environment of their attachments. General practice was also seen as a better lifestyle option than other main specialties as well as offering flexible working opportunities. New findings included the observation that career ranking for general practice improved following a four month postgraduate attachment in general practice among those less inclined to general practice as a career in the first place. Thematic analysis of transcribed interviews revealed enhanced respect, among foundation doctors, for general practice as a career option irrespective of their own eventual career intent. This improved regard for general practice among doctors intent on specialising may be important in the context of persisting disparagement of general practice by some students, clinicians and teachers. It may also be helpful in engendering mutual respect and more effective working relationships between specialists and generalists in the future.
17
Schwarz, Imogen University of Ballarat. "(Re)creating spaces within rural general practice : women as agents of change at the organisational and practitioner levels." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/12764.
Full textAbstract:
This thesis examines how women, as agents of change, contest the male-dominated structures at the organisational and practitioner levels of rural medicine in Australia. The premises for this study are that females now outnumber males as medical graduates and general practice trainees, yet women are significantly less likely than men to occupy rural and remote practice positions in Australia. Furthermore, the organisation of medicine remains strongly patriarchal. A feminist qualitative design underpins this empirical study involving: in-depth interviews with seventeen women activists and thirteen rural women general practitioners; grounded theory analysis of transcribed interviews; and interpretation of findings through a feminist poststructural lens. Findings uncover the gendered organisational and practitioner environment through which change is negotiated. At the organisational level, male exclusionary practices – played out through the ‘male as norm’ and the ‘problem is women’ discourses – position women in highly contradictory ways and marginalise their voices. Yet simultaneously, activists are challenging entrenched interests through individual and collective strategies of change which include: initiating gender-awareness projects; claiming legitimacy by using male-centred tactics and women-defined discourses; developing female-friendly initiatives; and mentoring of and building alliances between women. At the practitioner level, results reveal how women’s everyday lives as rural general practitioners are shaped by oppositional tensions. However, beyond the struggle of ‘fitting in’, women are altering rural medicine by (re)shaping meanings and (re)constructing work practices. Furthermore, their narratives suggest that rural spaces are integral to ways women carve out women-defined practice. A key innovation of this thesis is analysis of change at dual levels, both organisational and practitioner. This thesis marks a significant advancement upon the usual themes that attend only to the marginalisation of women and rural areas. It highlights the transformative process through which women (re)create the discursive spaces of rural general practice.Doctor of Philosophy
18
Schwarz, Imogen. "(Re)creating spaces within rural general practice : women as agents of change at the organisational and practitioner levels." University of Ballarat, 2005. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/15386.
Full textAbstract:
This thesis examines how women, as agents of change, contest the male-dominated structures at the organisational and practitioner levels of rural medicine in Australia. The premises for this study are that females now outnumber males as medical graduates and general practice trainees, yet women are significantly less likely than men to occupy rural and remote practice positions in Australia. Furthermore, the organisation of medicine remains strongly patriarchal. A feminist qualitative design underpins this empirical study involving: in-depth interviews with seventeen women activists and thirteen rural women general practitioners; grounded theory analysis of transcribed interviews; and interpretation of findings through a feminist poststructural lens. Findings uncover the gendered organisational and practitioner environment through which change is negotiated. At the organisational level, male exclusionary practices – played out through the ‘male as norm’ and the ‘problem is women’ discourses – position women in highly contradictory ways and marginalise their voices. Yet simultaneously, activists are challenging entrenched interests through individual and collective strategies of change which include: initiating gender-awareness projects; claiming legitimacy by using male-centred tactics and women-defined discourses; developing female-friendly initiatives; and mentoring of and building alliances between women. At the practitioner level, results reveal how women’s everyday lives as rural general practitioners are shaped by oppositional tensions. However, beyond the struggle of ‘fitting in’, women are altering rural medicine by (re)shaping meanings and (re)constructing work practices. Furthermore, their narratives suggest that rural spaces are integral to ways women carve out women-defined practice. A key innovation of this thesis is analysis of change at dual levels, both organisational and practitioner. This thesis marks a significant advancement upon the usual themes that attend only to the marginalisation of women and rural areas. It highlights the transformative process through which women (re)create the discursive spaces of rural general practice.Doctor of Philosophy
19
Boer, Shaeema. "Challenges in the design of a smart phone (mobile) application for general practitioners: an interaction design approach." Thesis, Cape Peninsula University of Technology, 2014. http://hdl.handle.net/20.500.11838/1313.
Full textAbstract:
Thesis submitted in fulfilment of the requirements for the degree
Master of Technology: Design
in the Faculty of Informatics and Design
at the Cape Peninsula University of Technology
2014If a patient arrives at a general practice whether with a scheduled appointment or at random during office hours, the general practitioner should be able to assist the patient’s with direct access to the patient folder which is stored at the office. What this research study focuses on is the accessing of patient information when the general practitioner is not at the office (usually after working hours). The research study takes place within the Durbanville suburb of Cape Town, South Africa. Interaction design is used as a framework to develop a solution by using smartphone technology.
20
Furler, John. "Chronicity and character : patient centredness and health inequalities in general practice diabetes care /." Connect to thesis, 2006. http://repository.unimelb.edu.au/10187/52.
Full textAbstract:
This study explores the experiences of General Practitioners (GPs) and patients in the management of type 2 diabetes in contemporary Australia. I focus on the way the socioeconomic position of patients is a factor in that experience as my underlying interest is in exploring how health inequalities are understood, approached and handled in general practice. The study is thus a practical and grounded exploration of a widely debated theoretical issue in the study of social life, namely the relationship between the micro day-to-day interactions and events in the lives of individuals and the broad macro structure of society and the position of the individual within that. There is now wide acceptance and evidence that people’s social and economic circumstances impact on their health status and their experiences in the health system. However, there is considerable debate about the role played by primary medical care. Nevertheless, better theoretical understanding of the importance of psychosocial processes in generating social inequalities in health suggests medical care may well be important, as such processes are crucial in the care of chronic illnesses such as diabetes which are now such a large part of general practice work. I approach this study through an exploration of patient centred clinical practice. Patient centredness is a pragmatic, idealised prescriptive framework for clinical practice, particularly general practice. Patient centredness developed in part in response to critiques of biomedicine, and is premised on a notion of a more equal relationship between GP and patient, and one that places importance on the context of patients’ lives. It contains an implicit promise that it will help GP and patient engage with and confront social disadvantage.
21
Weller, David P. "The pursuit of better health: what is the role of the general practitioner /." Title page, contents and synopsis only, 1990. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmw448.pdf.
Full textAbstract:
Thesis (M.P.H.)--University of Adelaide, Dept. of Community Medicine, 1991.Result of a research project undertaken within the Department of Primary Health Care, Flinders Medical Centre ... part of a larger study which has been funded by the Research Into Drug and Alcohol Advisory Committee of the Commonwealth Department of Health. Typescript (Photocopy). Includes bibliographical references.
22
Schembri, Sharon T. "Consumer understanding of professional service quality : a phenomenographic approach /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18920.pdf.
Full text
23
Duchatteau, Duco C. "Burnout among Dutch general practitioners: An empirical study of the determinants of physician burnout." Thesis, University of Bradford, 2016. http://hdl.handle.net/10454/17377.
Full textAbstract:
This study aims to examine to what extent Dutch GPs are at risk for burnout, and to identify personal, professional and practice related characteristics that are associated with high burn out scores. In the extant literature, physicians are identified as professionals who are high risk for burnout. In the past decade, working conditions for general practitioners (GPs) in the Netherlands have changed for the worse. There are no recent data on GP burnout in the Netherlands. Although much is known in the literature about factors that are associated with burnout and the role job demands and resources play in getting burned out, the extent to which these findings apply in the context of Dutch GPs is unknown.
This study is designed as a quantitative, survey based, empirical study. An invitation to complete an online survey was sent to 4,000 GPs in the Netherlands, of whom close to 1,300 participated in this study (33% response rate). The data were analysed using IBM SPSS 22.0. The data analysis consisted of a descriptive analysis of the data with an emphasis on the outcome of burnout measurements, as well as an inferential analysis of the data with an emphasis on the association between respondents’ characteristics and burnout measurements.
The results from this study indicate, that one in seven practicing Dutch GPs could be classified as burned out with fulltime working GPs reporting an average working week of 62 hours. According to the findings, the amount of hours worked per week is the most important determinant of emotional exhaustion. Variation in emotional exhaustion, depersonalisation and professional efficacy can to a large extent be explained by variation in demands (administrative burden, work-home conflict, psychological job demands) and resources (decision latitude, co-worker support and home support). Increased job demands are predominantly associated with emotional exhaustion, while a scarcity of resources predominantly leads to increased depersonalisation and reduced professional efficacy. The findings demonstrate, that a bigger job size, more hours worked and a more responsible position held, are associated with higher experienced demands, which is in turn associated with unfavourable burnout scores, particularly increased emotional exhaustion. Working in a group setting, being professionally active outside of one’s own practice and being in a relationship were found to be associated with increased resources, which is in turn associated with favourable burnout scores, particularly decreased depersonalisation and increased professional efficacy.
Based on the findings of this study, three recommendations for government bodies, healthcare providers and other healthcare stakeholders were formulated: 1) Reduce the length of the working week, predominantly by reducing the number of allocated patients per GP. This recommendation implies an increase in the GP workforce; 2) Undertake a comprehensive analysis of the quantity, type and purpose of administrative duties currently performed by GPs and trim unnecessary paperwork and bureaucracy within the GP practice and 3) Increase co-worker support, either within the GP practice or by using the existing collegiate support infrastructure.
24
Cooper, Carolyn Ellen May. "Death is something to be avoided the psychodynamics of end-of-life planning for the general practitioner /." [Hawthorn, Vic.] : Swinburne University of Technology, 2008. http://hdl.handle.net/1959.3/36677.
Full textAbstract:
Thesis (PhD) - Australian Graduate School of Entrepreneurship, Swinburne University of Technology - 2008.Submitted as partial fulfilment of the requirements for the degree of Doctor of Philosophy, Australian Graduate School of Entrepreneurship, Swinburne University of Technology, 2008. Bibliography: p. 357-371.
25
Mitchell, Geoffrey Keith. "The effect of case conferences between general practitioners and palliative care specialist teams on the quality of life of dying people /." [St. Lucia, Qld.], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18557.pdf.
Full text
26
Penrose-Wall, Jonine Public Health & Community Medicine Faculty of Medicine UNSW. "Evaluating five models of dissemination of NHMRC 'Guideline depression in young people for GP's' through divisions of general practice." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2003. http://handle.unsw.edu.au/1959.4/20445.
Full textAbstract:
Background: Dissemination of evidence-based mental health clinical practice guidelines had not been studied in Australia prior to the National General Practice Guideline Implementation Program. This naturalistic research reports ten national interventions designed to disseminate the NHMRC 1997 Clinical Practice Guideline Depression in Young People for GPs (GDIYP-GP) through 123 Divisions of General Practice. The guideline covered depression and suicide in young people aged 13 to 20 years. Aim: To evaluate a 'coordinated link agent' and 'enhanced packaged approach' for disseminating a national guideline by engaging 20 Divisions in using 5 dissemination models and to measure Divisions' capacities in performing unfunded local dissemination to GPs. Method: An Implementation Kit was the main national intervention, housing the guidelines and 5 models: Education by the Division; Education by an external provider; 3) Clinical Audit; 4) Segmented Formats and 5) Appraisal. Five studies are reported: 1) an organisational census on guideline-related practices in all topics; 2) a Case Study Database of 3 consecutive interviews of 51 participating Divisions; 3) a Guideline Appraisal study of 9 cohorts of doctors; 4) a Clinical Audit study of 54 doctors involving 1200 patients; and 5) a 'Segmented Formats' documentary analysis of Division communications on GDIYP-GP. Results: Prior dissemination by most Divisions was administrative mail outs rather than planned programs. In all, 70 instead of the pilot 20 organisations participated (57% of the sector) using 10,000 guidelines: 45 participated by 7 weeks and 71 by 35 weeks and the majority used multiple active strategies showing fidelity to the Kit. Education by the Division, Segmented Formats and Appraisal were the most adopted models. GDIYP-GP was acceptable and relevant to the majority of Divisions and to 9 samples of doctors. Conclusion: Divisions are one appropriate system through which evidence-based mental health guidelines can be disseminated to general practitioners. Uptake can be rapid using a flexible enhanced package approach with link-agent support. 3-6 months is needed for organisations to begin effective interventions. Divisions reorient their approach with guidance toward evidence-based dissemination but Division and practice barriers
27
Linger, Barry Thomas. "What primary care physicians need to know about attention-deficit hyperactivity disorder a Delphi of experts and a content analysis /." Morgantown, W. Va. : [West Virginia University Libraries], 1998. http://157.182.199.25/etd/templates/showETD.cfm?recnum=279.
Full textAbstract:
Thesis (Ed. D.)--West Virginia University, 1998.Title from document title page. Document formatted into pages; contains x, 126 p. Includes abstract. Includes bibliographical references (p. 81-87).
28
André, Malin. "Rules of thumb and management of common infections in general practice /." Linköping : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-5183.
Full text
29
Liu, Chaojie. "Closing the gap between policy and reality : a study of community health services in Chengdu and Panzhihua /." Access full text, 2003. http://www.lib.latrobe.edu.au/thesis/public/adt-LTU20050303.102952/index.html.
Full text
30
McCall, Louise 1965. "Can continuing medical education in general practice psychiatry aid GPs to deal with common mental disorders ? : a study of the impact on doctors and their patients." Monash University, Faculty of Education, 2001. http://arrow.monash.edu.au/hdl/1959.1/8363.
Full text
31
Irvine, Alastair D. J. "Time preferences and the patient-doctor interaction." Thesis, University of Aberdeen, 2018. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=238373.
Full textAbstract:
Patients' non-adherence to treatment is a widespread phenomenon in healthcare. Time preferences (how individuals value outcomes over time) are one cause for non-adherence. Using quasi-hyperbolic discounting, two options in the future are weighted consistently. However, when the early option becomes available the weighting changes. This creates the potential for non-adherence. The agency relationship that exists between patients and doctors implies hidden information. When the patient's time preferences are hidden from the doctor, the doctor must choose how to recommend treatments. Exploring how doctors make treatment decisions when time preferences are hidden from them, and how this impacts adherence, is therefore important. The first contribution of the thesis is to outline a model of the patient-doctor interaction incorporating quasi-hyperbolic discounting and hidden information. This shows that doctors should adapt to non-adherence when the probability a patient is present-biased is large enough. Secondly, a national survey of Scottish GPs explores whether doctors have different time preferences for themselves or their patients. Doctors do have the same private and professional time preferences, but value the health state differently between frames. Lastly, a laboratory experiment tests whether students in the role of a doctor adapt to non-adherence in the way predicted by the model. Students find the socially optimal level of treatment on average. Adaptation is stronger when using a performance payment, and results did not vary along demographic characteristics. The thesis highlights the importance of the patient-doctor interaction for generating nonadherence, not just patient preferences. It also shows that GPs' private time preferences may suitably substitute their preferences for patients. Finally, it points towards potential incentives for doctors to improve patient outcomes.
32
Howrie, Paul. "How general practitioners and aged care workers perceive incidences of elder abuse." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2000. https://ro.ecu.edu.au/theses/1351.
Full textAbstract:
As the Australian population is expanding and ageing, there is an associated need for a focus to be placed on the Individual rights of elderly people, and for the general populus to be made more aware of areas related to our older generation. Elder abuse, as an area of concern, developed as an offshoot of investigations into child abuse and general domestic violence, and initially surfaced in the 1970s and 80s. Some sections of the medical profession were made specifically aware of the problem initially in 1975, through a letter that was sent to the British Medical Journal. However, throughout some of the literature, GPs have been criticised about their level of awareness of the issue of elder abuse, and for their lack of involvement in this area. The purpose of this study was to explore how General Practitioners and Aged Care workers perceive incidences of elder abuse. Due to the limited amount of research which has been undertaken on elder abuse within Australia, the study looked at exploring the issue rather than trying to measure its cause, or trying to identify the extent of the problem. The study investigated the perceptions of general practitioners (GPs) toward the area of elder abuse, and looked further to explore how general practitioners were perceived by aged care workers. The approach used for data collection consisted of circulating 100 mailed out questionnaires to general practitioners within metropolitan Perth, and follow up face-to-face interviews with some of the respondents to this questionnaire. Additionally, face-to-face interviews were also held with key informants who worked in the aged care industry, to ascertain their perceptions of elder abuse. The mailed questionnaires were analysed by adding the frequencies of responses given to each question. The data from the face-to-face doctor interviews and the key informant interviews were transcribed verbatim from the tape recordings and then assessed by looking for consistent regularities from each response made, therefore using a cross-case analysis. From this analysis, patterns emerged in the data, from which themes were developed. The recommendations from the data suggest that a clear and concise definition of elder abuse needs to be developed, to assist in clearly Identifying the prevalence of the problem. The data further recommended the need for an awareness campaign on the area of elder abuse to be undertaken. This should focus on raising the awareness of the possible characteristics of individuals who are vulnerable to being abused, as well as the characteristics of likely perpetrators of abuse. This study also recommended that a coordinated approach to dealing with the area of elder abuse should be developed, which should include the development of specific roles that should be undertaken by professional and non-professionals. Training of people across the Human Services field in the area of elder abuse, and in particular, GPs, social workers and paraprofessionals who work with elderly people, was identified as a recommendation of the study. Areas of training should include: awareness of the problem's existence; providing people with the required skills to detect cases of abuse; providing insight to referral agencies who may be able to assist; having a clear and exhaustive list of interventions to use to assist with addressing the problem; and having knowledge of the characteristics that abused individuals, and perpetrators are likely to have. This study also Identified that more research is required to ascertain if the amount of time which GPs spend with elderly people, is sufficient for them to identify cases of elder abuse, and if the allocated time from Medicare is adequate for GPs to Identify elder abuse.
33
Miranda, de Sousa Dias Miguel. "Novel Approaches for Molecular Diagnosis of Genetic Diseases by Next Generation Sequencing: Application to Breast Cancer and Retinitis Pigmentosa in the Clinical Practice." Doctoral thesis, Universitat Autònoma de Barcelona, 2014. http://hdl.handle.net/10803/133297.
Full textAbstract:
En la pràctica clínica actual existeix una demanda creixent d’estudis moleculars de malalties genètiques. Generalment, la detecció de mutacions patològiques en gens candidats consisteix en la seqüenciació directa dels exons i les zones intròniques flanquejants mitjançant el mètode de Sanger, el qual es basa en una electroforesi capil·lar i requereix l’amplificació prèvia de cada fragment d’ADN en una reacció de PCR individual. Així, l’anàlisi de gens formats per molts exons com BRCA1 i BRCA2, associats a càncer de mama i ovari, implica un elevat nombre de reaccions de PCR i seqüenciació, i esdevé una tasca molt costosa en termes de temps i diners. D’altra banda, l’estudi de malalties monogèniques genèticament heterogènies, com és el cas de la Retinosi Pigmentària autosòmica dominant (RPad), pot requerir l’anàlisi de més de 20 gens per tal d’identificar la causa molecular de la malaltia. Tot i així, només un 20-30% dels pacients amb RPad són diagnosticats molecularment ja molts gens i mutacions associades a la malaltia són encara desconeguts.
D’aquí que l’ús de les tècniques de seqüenciació massiva d’ADN o seqüenciació de nova generació (NGS) sigui una pràctica cada vegada més habitual en els laboratoris de genètica molecular. Per a l’estudi de diversos pacients en paral·lel o per a analitzar exomes complets amb la finalitat de trobar nous gens associats a RPad, existeixen grans plataformes de seqüenciació massiva. No obstant, l’elevat cost i la gran capacitat d’aquestes plataformes es tradueix en una pèrdua de flexibilitat a l’hora de satisfer la necessitat de molts laboratoris de genètica, que sovint han d’analitzar la mostra d’un o pocs individus en un temps i amb un cost raonablement reduïts. Com a conseqüència, les empreses tecnològiques que treballen amb equips de NGS han introduït al mercat petites plataformes adaptades a l’ús clínic. Una d’aquestes plataformes, el GS Junior, ha demostrat amb èxit el seu potencial per al diagnòstic en laboratoris de genètica molecular. Amb la mateixa tecnologia bàsica que el GS 20 i GS FLX, la plataforma GS Junior utilitza les tècniques de PCR en emulsió i piroseqüenciació, però suposa una menor despesa tant de posada en marxa com de funcionament.
Aquest treball de recerca té com a objectiu provar i posar a punt tecnologies de NGS per tal d’obtenir diagnòstics moleculars a uns costos assumibles. Amb aquesta finalitat i per a l’estudi dels gens BRCA1 i BRCA2, es va idear un protocol de PCR llarga associat a dos mètodes enzimàtics de fragmentació d'ADN per tal d’obtenir biblioteques d’ADN preparades per a ser analitzades amb NGS. A més, es van assajar diferents mètodes basats en PCR llarga, multiplex o en emulsió, i en captura d’ADN per a detectar mutacions causants d’RPad.
A més, aprofitant la reducció del preu per megabase seqüenciada, també es va fer seqüenciació massiva de l’exoma. L'eficiència de les diferents metodologies avaluades ha permès crear nous protocols de treball que ja han estat implementats en la rutina del laboratori. Per tal de caracteritzar nous gens associats a RPad, es va utilitzar la NGS per analitzar un array de captura de 448 gens candidats en diverses famílies i l’exoma complet d’una d’elles. Es va observar que els pacients analitzats presentaven un gran nombre de variants. Per a poder establir el paper d’aquestes variants com mutacions causants de la malaltia, és imprescindible efectuar la segregació familiar; per tant, la validació dels resultats només es podia aconseguir en famílies amb almenys dos individus afectats i un membre no afectat. D’aquesta manera, en la seqüenciació de l’exoma, es van trobar més de 150 variants genètiques que podrien ser les causants de la RPad en la família.Molecular testing of genetic diseases is in increasing demand in routine clinical practice. Medical analysis of candidate genes to characterize the mutation that causes a disease currently requires amplification of the exonic and flanking sequences by PCR as a previous step to individual PCR fragment capillary electrophoresis sequencing (Sanger sequencing). BRCA1 and BRCA2, which are associated with the risk of breast cancer, are large genes with a high number of exons, and therefore involve a considerable number of individual PCRs and sequencing reactions to cover the coding and flanking sequences of both genes, which is a very costly and time consuming task. On the other hand, in genetically heterogeneous monogenic diseases such as autosomal dominant Retinitis Pigmentosa (adRP), mutation screening may be required in more than 20 genes in order to establish the molecular cause of the disease. Even so, using these expensive approaches, just 20-30% of adRP patients can be molecular diagnosed due to the fact that the mutation associated with the disease is yet unknown in more than 60% of all adRP cases Hence the use of massive DNA sequencing or next generation sequencing (NGS) technologies is a vital practice within any clinical genetic laboratory. Large next-generation platforms are indicated for this task. Likewise, for the analysis of the whole exome to characterise new genes associated with adRP and/or for extensive patient surveys, these large platforms are also required. However, the cost and extremely large capacity of these platforms results in a loss of flexibility regarding the needs of many genetics laboratories where it is sometimes necessary to analyse samples from only one or just a few individuals in a reasonably short time. In consequence, technologic firms participating in the NGS marketspace have introduced smaller NGS platforms adapted for clinical use. One such platform, the GS Junior, has successfully proven its potential for molecular diagnosis in molecular genetics laboratories. Sharing the same core technology as the GS 20 and the GS FLX, the GS Junior platform exploits similar emulsion PCR and pyrosequencing approaches, but with lower set-up and running costs. Accordingly, this research work aims for the successful management of NGS technologies in order to offer advanced molecular diagnosis services at assumable costs. As a result, a Long-Range (LR) -PCR approach associated with two distinct enzymatic DNA shearing methods was devised in order to prepare DNA libraries for NGS to achieve molecular testing of the large BRCA1 and BRCA2 genes. Furthermore, different methods based on LR, multiplex, emulsion PCR, or targeting DNA gene capture were assayed to detect mutation-causing adRP. In addition, and taking the advantage of the significant price reduction per Megabase sequenced, the whole exome analysis method was also put to the test. The efficiency of the distinct methodologies used for NGS in routine clinical practice was evaluated resulting in new diagnostic protocols based on this research work, which are already introduced at a clinical routine level. In order to characterize novel genes associated with adRP, NGS was used. 448 candidate genes array and the whole exome analysis approach were carried out. It was demonstrated that the analysed patients showed a large number of variants. To characterize these variants as a disease-causing mutation, segregation in the family is mandatory. Thus, validation of results only can be achieved in families with at least two affected and one unaffected member. In this case, more than 150 genetic variants putative causing of adRP were obtained in one family.
34
Yarkiner, Zalihe. "Developing longitudinal models for monitoring chronic diseases in computerised general practice (GP) records : a case study in chronic kidney disease (CKD)." Thesis, Kingston University, 2015. http://eprints.kingston.ac.uk/34536/.
Full textAbstract:
Analysis of longitudinal data is a rapidly growing field of statistical analysis, in response to the increasing availability of longitudinal datasets in many disciplines. Longitudinal studies are becoming more popular as they allow investigation of the same individuals over time, and where both within-individual and between-individual differences can be examined. Since the study of change over time is necessary in many areas, longitudinal studies and meaningful analysis of longitudinal data is essential. The health sector is one such area where longitudinal research is playing an increasingly important role. The aim of this research is to examine statistical methodologies for the analysis of longitudinal medical data, specifically General Practice (GP) records. All General Practices (GPs) in England and Wales are now computerized and routinely record detailed patient information, hence providing a rich longitudinal dataset. This research investigates new techniques and adaptations of existing methodologies to understand and explain patterns of change and the natural development and treatment of chronic diseases within routinely collected GP data. The data used here, although taken from a raw sample of 129 General Practice records, have been subjected to some cleaning and recoding in places, hence it should be considered as a secondary data source. Through out the data driven applications presented, different sub¬samples of the original dataset have been used. For the main part the full cleaned sample of 876951 patients is used where possible. Smaller samples ranging between 472 and 58675 patients are used depending on the outcome of interest and the availability of valid observations for the various applications employed. Mainly regression-based techniques, in two broad categories, were used to analyse the repeated measurements from each patient in our dataset. Firstly, linear and generalized mixed modelling approaches were used, whereas in the second phase of the project, the applications of semi-parametric and non-parametric approaches were investigated. The case study of particular interest in this research project is the incidence and progression of chronic kidney disease (CKD). There is a lack of knowledge and understanding of the natural history ofCKD and its progression over time. This project aims to address these issues. The advanced statistical models used in this research quantify how kidney function, assessed using estimated Glomerular Filtration Rate (eGFR), changes with respect to time and how other factors, including other related medical conditions (known as co-morbidities of CKD), affect kidney function and its change over time. The techniques and approaches used in this study are motivated by mixed model designs. The decline of kidney function as time progresses for typical CKD patients is observed to be non-linear. The type of nonlinear mixed models developed in this project do not assume that the decline of eGFR over time is linear, and hence are better able to model the progression of CKD than more traditional linear models. As a consequence, the proportion of the total variation in the outcome that can be explained by considering the patient level factors is tripled through the use of these non-linear models, showing they have much greater explanatory power than previous, simpler statistical models. The disease under study is Chronic Kidney Disease (CKD) but the methodologies should also be applicable other chronic, progressive diseases.
35
Hoosen, Aslam Goolam. "Exploring the actions of general practitioners on abnormal findings identified by registered nurses conducting home comprehensive geriatric assessments (CGA)." Thesis, 2011. http://hdl.handle.net/10413/11090.
Full textAbstract:
Background: In South Africa there data is lacking on the health of the older
population. This study aims to report on actions taken by general practitioners on
abnormal blood pressure, blood glucose and osteoporosis screen identified by
registered nurses, conducting home based visits to older clients.
Methods
An agency piloted the Comprehensive geriatric assessment (CGA) tool in an urban
affluent population. In this cross sectional secondary study analysis, 465 participants
aged 60 years and over had a nurse visit in their homes and a subsequent General
Practitioner (GP) visit. The prevalence of specific geriatric problems was assessed as
well as the frequency of initiated procedures by the GP. This study will focus on
initiated actions by the General Practitioners in response to abnormal blood
pressures, blood glucose, and osteoporosis screen.
Results
Frequency tables were utilised to identify prevalence of the abnormal blood
pressures, blood glucose and osteoporosis screen. . Abnormal blood pressures were
detected (230/465, 49%) of the subjects , the GP initiated actions on only 15/465
(3.2%) of clients. Abnormal blood sugars were detected 106/465 (23%) of the GP
initiated actions on 23/465 (5%) of clients. Clinical risk factors for the development of
osteoporosis were detected in 252 /465 (54%) subjects GP initiated actions on 11/465
(3%)
Conclusion
This study explored the relationships between comprehensive geriatric assessment
and subsequent GP actions and found using the CGA in this population will be
successful in identifying abnormal health findings which will enable intervention.
However, due to challenges in the communications and marketing of this service, GP’s
were not well informed of their role and did not act on majority of the abnormal
findings detected by nursesThesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.
36
Mohammed, Mohammed A., Sayed C. El, and T. Marshall. "Patient and other factors influencing the prescribing of cardiovascular prevention therapy in the general practice setting with and without nurse assessment." 2012. http://hdl.handle.net/10454/6102.
Full textAbstract:
BACKGROUND: Although guidelines indicate when patients are eligible for antihypertensives and statins, little is known about whether general practitioners (GPs) follow this guidance. OBJECTIVE: To determine the factors influencing GPs decisions to prescribe cardiovascular prevention drugs. DESIGN OF STUDY: Secondary analysis of data collected on patients whose cardiovascular risk factors were measured as part of a controlled study comparing nurse-led risk assessment (four practices) with GP-led risk assessment (two practices). SETTING: Six general practices in the West Midlands, England. PATIENTS: Five hundred patients: 297 assessed by the project nurse, 203 assessed by their GP. MEASUREMENTS: Cardiovascular risk factor data and whether statins or antihypertensives were prescribed. Multivariable logistic regression models investigated the relationship between prescription of preventive treatments and cardiovascular risk factors. RESULTS: Among patients assessed by their GP, statin prescribing was significantly associated only with a total cholesterol concentration >/= 7 mmol/L and antihypertensive prescribing only with blood pressure >/= 160/100 mm Hg. Patients prescribed an antihypertensive by their GP were five times more likely to be prescribed a statin. Among patients assessed by the project nurse, statin prescribing was significantly associated with age, sex, and all major cardiovascular risk factors. Antihypertensive prescribing was associated with blood pressures >/= 140/90 mm Hg and with 10-year cardiovascular risk. LIMITATIONS: Generalizability is limited, as this is a small analysis in the context of a specific cardiovascular prevention program. CONCLUSIONS: GP prescribing of preventive treatments appears to be largely determined by elevation of a single risk factor. When patients were assessed by the project nurse, prescribing was much more consistent with established guidelines.
37
Jellie, Clara. "The impact of medico-legal issues on general practice care and policy initiatives." Master's thesis, 2001. http://hdl.handle.net/1885/147623.
Full text
38
Moorhead, Robert George. "Communication skills training for general practice / Robert George Moorhead." Thesis, 2000. http://hdl.handle.net/2440/38376.
Full textAbstract:
Bibliography: leaves 554-636.637 leaves
Examines aspects of teaching medical students communication skills at a time when they are entering their clinical years. Integrates reports of 12 data-gathering exercises centred on medical student communication skills with the international literature, and with the author's reflections as an experienced educator and G.P. Recommends that communication skills training in a general practice setting should be a crucial factor in all future training of medical students.
Thesis (M.D.) -- University of Adelaide, Dept. of Psychiatry, 2000
39
Knight, John. "Overcoming practitioner resistance to health informatics systems in general practice medicine." 2009. http://arrow.unisa.edu.au:8081/1959.8/92488.
Full textAbstract:
This thesis results from a multi-method study into why GPs in Australia resist the adoption of technology capable of collecting, amalgamating and potentially transferring patient health data outside their practice. Findings indicate effective strategies to overcome GP resistance and improve diffusion of such technology should emphasise patient benefits rather than change to the GP role.
40
Thondhlana, Sylivia Shamiso. "Knowledge, utilisation and perceptions of the chiropractic profession by general practitioners in Harare, Zimbabwe." Thesis, 2018. http://hdl.handle.net/10321/3071.
Full textAbstract:
Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Chiropractic, Durban University of Technology, Durban, South Africa, 2018.Background: There have been an increased number of patients using complementary alternative medicine (CAM), including chiropractic care. All population age groups are utilising chiropractic treatment for various ailments. Research has shown that general practitioners have limited knowledge and perception about chiropractic in many countries. Their perception towards other health care professionals is important, particularly in their role as gatekeepers in the health care system. The current perception in Zimbabwe is thought to be no referral of patients between general practitioners and chiropractors and a low degree of knowledge amongst general practitioners about chiropractic. Aim: The aim of this study was to determine the knowledge, utilisation and perceptions of general practitioners in Harare, Zimbabwe. Objectives: • To establish the knowledge about chiropractic amongst general practitioners in Harare, Zimbabwe. • To determine perceived role and utilisation of chiropractic by general practitioners in Harare, Zimbabwe. • To determine the relationships, if any, between knowledge, perception, and utilisation of chiropractic by general practitioners in Harare, Zimbabwe. Methods: The study was a descriptive, quantitative, cross-sectional study using a structured questionnaire adapted from similar studies. The questionnaire was validated by means of a focus group discussion. The survey was conducted on a random sample of 72 general practitioners practising in the Avenues area of Harare, Zimbabwe. A single stage sampling techniques was used to select participants from a list of 88 registered general practitioners from the Medical and Dental Practitioners Council of Zimbabwe who met the inclusion criteria. Questionnaires were provided to general practitioners who were in private practice in the Avenues area of Harare, Zimbabwe at the time of the study by the researcher. The data collected was analysed using the Statistical Package for Social Science (SPSS)® 2.4 (IBM, Armonk, NY. USA) software at a statistical significance of p<0.05. Pearson’s correlation was used to assess the relationship between continuous variables, while the t test was used to copmare the mean scores between independent binary variables. Results: Many of the participants had some kind of knowledge regarding chiropractic modalities, areas of chiropractic specialisation but only a few had adequate knowledge and a good perception of it. General practitioners who were knowledgeable about chiropractic tended to have a positive perception and were more likely to refer patients to a chiropractor. A response rate of 54.5 percent was achieved. Most of the respondents tended to be in the age group of 35-54 and most were female (54.2 percent). Over 90 percent of the participants referred patients with musculoskeletal complaints to physiotherapists while only 16.67 percent referred to chiropractors. More than 65 percent of the participants responded that they knew something about chiropractic, and of these almost 50 percent obtained their information from the media. Over 80 percent of the participants who knew something about chiropractic thought that extremities, neuro-musculoskeletal system, rehabilitation and sports injuries were areas chiropractors can specialise in. Almost all the participants who knew something about chiropractic were aware of adjustments or manipluation of joints as modalities of chiropractic treatment. Majority (75.8 percent) of the participants who knew something about chiropractic thought that chiropractic could help selected conditions, while only 3 percent felt it was not effective and 21.2 percent felt they were not informed enough to comment. GP’s surveyed considered chronic back pain (91 percent), sports trauma (85 percent), shoulder/knee problems (79 percent), arthritis (76 percent), back and pelvic problems during pregnancy (70 percent), nerve root entrapment (70 percent) and carpal tunnel syndromme (70 percent) as some of the appropriate conditions for chiropractors to treat. Forty two percent of the GP’s referred patients to chiropractors mostly on both the patient’s request and their own judgment. The main reason for not referring patients to chiropractors cited by most (70 percent) of the GPs was limited knowledge about chiropractic care. There was a statistically significant and moderately high positive correlation between knowledge and perception scores (r=0.668). This study suggests that GP’s who have a higher degree of knowledge about chiropractic tend to have a positive perception of chiropractic. There was a non-significant difference in knowledge between those who refer patients and those who do not (p=0.425). In this study knowlegde about chiropractic did not significantly influence referral to chiropractors. There was however a statistically significant difference in perception between those who refer patients and those who do not (p=0.006). The perceptions were higher in those who refer patients compared to those who do not refer patients. Perceptions were found to determine utilisation rather than knowledge even though there was a correlation between the two.
M
41
Martin, Carmel. "The care of chronic illness in general practice." Phd thesis, 1998. http://hdl.handle.net/1885/147963.
Full text
42
Maharajh, Dheepa. "A survey to determine the perceptions of general practitioners and pharmacists in the greater Durban region towards homoeopathy." Thesis, 2005. http://hdl.handle.net/10321/2192.
Full textAbstract:
Mini-dissertation'submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban Institute of Technology, 2005.Homoeopathy in South Africa is a relatively new health profession, and there seems to be limited awareness of homoeopathy amongst the public and healthcare authorities. The national health care system in South Africa is currently undergoing major restructuring, with the focus on primary health care. The homoeopathic community needs to reflect on its role in public health care. However, in order to gain acceptance and understanding from other health care professions, meaningful research needs to be conducted. There is an urgent need to investigate the views of conventional health care professionals towards homoeopathy. A survey method was employed to investigate the perceptions of homoeopathy of two major groups in the medical community in the Greater Durban area: General Practitioners (GPs) and pharmacists. The study was carried out by using a questionnaire as a measuring tool. The sample of GPs was drawn from the medical pages of the Durban Telephone Directory (October 2003/2004) and the sample of pharmacists was drawn from the Durban Yellow Pages (October 2003/2004). A total of 484 questionnaires were distributed and a total of 155 responses were received. The percentage of return of questionnaires was 32,02%. The original sample size was 370 for GPs and 114 for pharmacists. A total of 97 GPs and 58 pharmacists responded. The response rate was 26,22% for GPs and 50,87% for pharmacists.
M
43
Maharaja, Archish. "Use of the electronic health record in private medical practices." 2009. http://digital.library.duq.edu/u?/etd,102653.
Full text
44
Penrose-Wall, Jonine. "Evaluating five models of dissemination of NHMRC 'Guideline depression in young people for GP's' through divisions of general practice /." 2003. http://www.library.unsw.edu.au/~thesis/adt-NUN/public/adt-NUN20041027.092241/index.html.
Full text
45
Braunack-Mayer, Annette Joy. "General practitioners doing ethics : an empirical perspective on bioethical methods / Annette Braunack-Mayer." 1998. http://hdl.handle.net/2440/19348.
Full textAbstract:
Bibliography: p. 379-394.xi, 394 p. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 1988
46
Carbone, Daniel R. "Information systems in general practice: a framework to implement the management and prevention of chronic diseases." Thesis, 2009. https://vuir.vu.edu.au/15211/.
Full textAbstract:
The aim of this research project was to develop an implementation framework for the prevention and management of chronic diseases in general practice. Chronic diseases - or conditions as it is also commonly known, like Diabetes, Asthma, Cardiovascular Disease, etc., are persistent or recurring illnesses or impairments lasting for years that cannot be cured, however some can be prevented from becoming a chronic disease. Unfortunately, millions of chronic diseases sufferers worldwide end up dying prematurely and in many cases unnecessarily due to lack of appropriate care.
47
Carbone, Daniel R. "Information systems in general practice a framework to implement the management and prevention of chronic diseases /." 2009. http://eprints.vu.edu.au/15211/1/daniel_Carbone.pdf.
Full textAbstract:
The aim of this research project was to develop an implementation framework for the prevention and management of chronic diseases in general practice. Chronic diseases - or conditions as it is also commonly known, like Diabetes, Asthma, Cardiovascular Disease, etc., are persistent or recurring illnesses or impairments lasting for years that cannot be cured, however some can be prevented from becoming a chronic disease. Unfortunately, millions of chronic diseases sufferers worldwide end up dying prematurely and in many cases unnecessarily due to lack of appropriate care.
48
Ismail, Hanif, and S. Kelly. "Lessons learned from England’s Health Checks Programme: using qualitative research to identify and share best practice." 2015. http://hdl.handle.net/10454/14061.
Full textAbstract:
YesThis study aimed to explore the challenges and barriers faced by staff involved in the delivery of the National Health Service (NHS) Health Check, a systematic cardiovascular disease (CVD) risk assessment and management program in primary care. Data have been derived from three qualitative evaluations that were conducted in 25 General Practices and involved in depth interviews with 58 staff involved all levels of the delivery of the Health Checks. Analysis of the data was undertaken using the framework approach and findings are reported within the context of research and practice considerations. Findings indicated that there is no ‘one size fits all’ blueprint for maximising uptake although success factors were identified: evolution of the programme over time in response to local needs to suit the particular characteristics of the patient population; individual staff characteristics such as being proactive, enthusiastic and having specific responsibility; a supportive team. Training was clearly identified as an area that needed addressing and practitioners would benefit from CVD specific baseline training and refresher courses to keep them up to date with recent developments in the area. However there were other external factors that impinged on an individual’s ability to provide an effective service, some of these were outside the control of individuals and included cutbacks in referral services, insufficient space to run clinics or general awareness of the Health Checks amongst patients. The everyday experiences of practitioners who participated in this study suggest that overall, Health Check is perceived as a worthwhile exercise. But, organisational and structural barriers need to be addressed. We also recommend that clear referral pathways be in place so staff can refer patients to appropriate services (healthy eating sessions, smoking cessation, and exercise referrals). Local authorities need to support initiatives that enable data sharing and linkage so that GP Practices are informed when patients take up services such as smoking cessation or alcohol harm reduction programmes run by social services.
49
Laurence, Caroline Olivia Mary. "Overseas trained doctors in rural and remote Australia: do they practise differently from Australian trained doctors?" 2008. http://hdl.handle.net/2440/49903.
Full textAbstract:
Over the last seven years the recruitment of overseas trained doctors (OTDs) has formed a significant part of Australia’s policy to address the medical workforce issue of geographic maldistribution to ensure that communities in rural and remote Australia have access to adequate general practice (GP) services. This policy has not been without problems, particularly in the areas of assessment of skills and qualifications, appropriate orientation and integration into Australian communities, and retention of these doctors within rural and remote communities. To date there has been little evidence-based research on the role of OTDs in the medical workforce in Australia. This study explores the service provision and quality of care provided by OTDs using the 5 Year OTD Scheme as the case study. In doing so, it assesses the adequacy of this strategy and discusses the implications for future workforce policies and programs. A mixed method design was used in the study. The quantitative component involved secondary analysis of Medicare Australia data for all OTDs participating in the 5 Year OTD Scheme in 2002 and all Australian trained doctors (ATDs) practising in rural and remote Australia in the same year. A log Poisson regression model was used to assess the interactive effect of the various GP characteristics, such as age, sex, experience and practice location with OTD/ATD status on the rate of a particular service item per patient, adjusted for patient age and sex. The qualitative component involved two focus groups with OTDs which were used to help explain the relationships between variables found in the quantitative component of the study. Template analysis was used to identify themes from the focus group. Significantly different rates per patient between OTDs and ATDS were found across most service items and GP characteristics examined. The greatest variation was found among items relating to in-surgery consultations and non-surgery consultations such as nursing home visits. Fewer differences were found between groups relating to pathology, imaging or procedural services. Analysis of surrogate quality items identified few differences between OTDs and ATDs. The focus group identified a number of other factors that influenced their patterns of service and accounted for some of the differences identified in the quantitative analysis. These factors included knowledge of the health care system in Australia, cultural and communication influences, health conditions of patients, patient and community attitudes, remuneration influences and training influences. These had varying degrees of influence on their patterns of service. The reasons for the differences found between OTDs and ATDs are partially explained by the characteristics of the GPs examined and partially explained by other external influences that relate to the particular circumstances of the OTDs, such as knowledge of the Australian health care system and cultural and communication issues. Understanding the nature of practice is central to ensuring appropriate professional support measures. The study findings highlight the need for a targeted training program for OTDs that address the areas that have the greatest influence on patterns of service to ensure that rural and remote communities receive the same quality of service from OTDs as provided by ATDs.http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1320385
Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008
50
Laurence, Caroline Olivia Mary. "Overseas trained doctors in rural and remote Australia: do they practise differently from Australian trained doctors?" Thesis, 2008. http://hdl.handle.net/2440/49903.
Full textAbstract:
Over the last seven years the recruitment of overseas trained doctors (OTDs) has formed a
significant part of Australia’s policy to address the medical workforce issue of geographic
maldistribution to ensure that communities in rural and remote Australia have access to
adequate general practice (GP) services. This policy has not been without problems,
particularly in the areas of assessment of skills and qualifications, appropriate orientation and
integration into Australian communities, and retention of these doctors within rural and
remote communities.
To date there has been little evidence-based research on the role of OTDs in the medical
workforce in Australia. This study explores the service provision and quality of care provided
by OTDs using the 5 Year OTD Scheme as the case study. In doing so, it assesses the
adequacy of this strategy and discusses the implications for future workforce policies and
programs.
A mixed method design was used in the study. The quantitative component involved
secondary analysis of Medicare Australia data for all OTDs participating in the 5 Year OTD
Scheme in 2002 and all Australian trained doctors (ATDs) practising in rural and remote
Australia in the same year. A log Poisson regression model was used to assess the interactive
effect of the various GP characteristics, such as age, sex, experience and practice location
with OTD/ATD status on the rate of a particular service item per patient, adjusted for patient
age and sex.
The qualitative component involved two focus groups with OTDs which were used to help
explain the relationships between variables found in the quantitative component of the study.
Template analysis was used to identify themes from the focus group.
Significantly different rates per patient between OTDs and ATDS were found across most
service items and GP characteristics examined. The greatest variation was found among
items relating to in-surgery consultations and non-surgery consultations such as nursing home
visits. Fewer differences were found between groups relating to pathology, imaging or
procedural services. Analysis of surrogate quality items identified few differences between
OTDs and ATDs.
The focus group identified a number of other factors that influenced their patterns of service
and accounted for some of the differences identified in the quantitative analysis. These
factors included knowledge of the health care system in Australia, cultural and
communication influences, health conditions of patients, patient and community attitudes,
remuneration influences and training influences. These had varying degrees of influence on
their patterns of service.
The reasons for the differences found between OTDs and ATDs are partially explained by the
characteristics of the GPs examined and partially explained by other external influences that
relate to the particular circumstances of the OTDs, such as knowledge of the Australian health
care system and cultural and communication issues. Understanding the nature of practice is
central to ensuring appropriate professional support measures. The study findings highlight
the need for a targeted training program for OTDs that address the areas that have the greatest
influence on patterns of service to ensure that rural and remote communities receive the same
quality of service from OTDs as provided by ATDs.Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008