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Byrt, Sarah. "Social, medical and geographical aspects of the provision of community pharmacy services in rural West Wales." Thesis, University of Wales Trinity Saint David, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683168.
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Wagstaff, Christopher. "Experiences of disengagement from mental health services : an interpretative study." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/6980/.
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Whilst there is evidence of a range of effective treatments available for people with severe mental health problems (SMHP), people frequently disengage from mental health services (MHS). This thesis investigates experiences of disengagement of people with SMHP and comprises two studies: 1) semi-structured interviews to elicit the experiences of people with SMHP and a history of disengagement from MHS; and 2) building on those findings, focus groups with staff from assertive outreach teams (specialising in providing care for people with SMHP and a history of disengagement). The participants were those perceived as the most disengaged from MHS yet they were willing to engage with the research. Interpretative phenomenological analysis was used to develop themes for individual participants and then across the participants. Disengagement from MHS was part of a wider experience of a limited connection to social structures, including an ambivalent and complex relationship with MHS. There was a sense of sadness in all aspects of the participants’ experience but they had developed strategies to reinforce personal resilience and to reassert personal identity. The findings of this thesis can be employed to better understand the context of disengagement from MHS and consequently better inform future engagement with this client group.
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Gordon, Roberta June. "Pregnant women's perception and application of health promotion messages at community health centres." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.
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Magill, Julia Rose. "No contest : theorizing power through aspects of health and social care policy in the wake of the demise of the internal market in NHS Wales." Thesis, University of South Wales, 2011. https://pure.southwales.ac.uk/en/studentthesis/no-contest(d7482313-4e9a-4498-a729-3318e07be8fe).html.
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Following in the footsteps of Neitzsche (1968) and Foucault (1980), Clegg et al (2006) and Haugaard and Clegg (2009) have argued that power is the most central concept in the analysis of organization and organizing. The desirability of further developing the theorization of power in health and social care policy in the United Kingdom has been identified in a number of recent publications (Hunter, 2008; Crinson, 2009; Ham, 2009). This critical overview analyzes relative power to connect policy at the macro level (ending the internal market in NHS Wales) with specific policy issues encompassed by the four projects within the portfolio on: • locality commissioning; • delayed transfers of care; • governance, incentives and integration; and • safeguarding adults. The contribution to knowledge that flows from this critical overview: identifies that theorizing power in health and social care policy may help to explain apparent disconnections between policy intent and the effect of policy in practice in the context of post-devolution Wales; • suggests that, at its most extreme, neglecting to take into account the role of power in the design, implementation and review of policy in this particular policy arena becomes a matter of life and death; and • proposes that exploring power in health and social care policy through Foucauldian-informed critical discourse analysis of relative power could to some extent facilitate translation of policy aspirations into practice.
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Belt, Leslie Marie, and Leslie Paul Schellbach. "Perceptions of mental health services among marines." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3141.
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Horsfall, Debbie, of Western Sydney Hawkesbury University, Faculty of Social Inquiry, and School of Social Ecology. "The subalterns speak: a collaborative inquiry into community participation in health care." THESIS_FSI_SEL_Horsall_D.xml, 1997. http://handle.uws.edu.au:8081/1959.7/636.
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This thesis is about change, community and the health system. It is about women. It is about challenging the status quo and advocating for and with the less powerful. It is about fore grounding previously silenced voices, valuing the subjugated knowledge of people other than those who make the decisions. Many voices are woven together, including those of the author, community health workers, non-government agency workers, people who use community health services, and members of the public. This is a narrative of a group of people researching the issue of community participating in community health, concentrating on the Blue Mountains district of NSW. The inquiry centred on the premise that community participating is both desirable and achievable. The group spoke to over 100 people, and the conclusion was reached that, while community participation is promoted by the NSW Health Department, at present it is an idea that has not been thought through, is ill defined, and lacks support in practice. Debates about health and illness take place within a medical discourse, and there must be a reorientation to viewing health as a social phenomenon if community participation in decision making is to occurDoctor of Philosophy (PhD)
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Sharples, Rosemary. "Negotiating 'normal' : space, illness and identity in an alternative mental health resource in Montreal." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=19743.
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This thesis investigates different spaces in the lives of a group of adults living with long-term mental illness in Montreal. In particular, it is interested in exploring the role and functions of an alternative mental health resource that they all attend, using their narratives as the basis of meaning construction. My intention is to illuminate the complex interplay of identity, social participation, and physical place itself in the 'space' of experience for individuals. The way that a description of one of these elements is often in relationship with the other two, and that these connections can be useful in understanding descriptions of experiences by individuals, which, in David Morris' terms occur in a, "realm beyond language" (1997:p29). Finally, the concept of the 'border' is proposed as a tool to reexamine culture, identity and space, and one that is particularly useful in the context of self-help groups.
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Nicholson, Laura. "The health, support needs, access to healthcare services and social exclusion of adults with intellectual disabilities living in rural areas : a rural-urban comparison." Thesis, University of Glasgow, 2012. http://theses.gla.ac.uk/3738/.
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Background: Almost all intellectual disabilities research is conducted in urban areas, and very little is known about the population of adults with intellectual disabilities living in rural areas. It is important to know whether there are significant rural-urban differences, in order to provide appropriate services and address inequalities. In particular, the general rural population is known to be disadvantaged with respect to access to healthcare and social exclusion. Adults with intellectual disabilities are also disadvantaged in these areas, and therefore adults with intellectual disabilities living in rural areas may have a double disadvantage. Method: A sample of adults with intellectual disabilities living in a rural area on the West Coast of Scotland participated in a face-to-face semi-structured interview; their medical notes were also accessed. Demographics, healthcare, access to services, daytime opportunities, access to community facilities, recent contact with others, the quality of personal relationships, and area deprivation by postcode were measured. Data were already available for a pre-existing urban sample. Data were analysed using direct comparison and binary logistic regression. Results: A representative sample of adults with intellectual disabilities from rural (n=39) and urban (n=633) areas were compared. There were no significant rural-urban differences over a wide range of variables including: age, gender, ethnicity, level of intellectual disabilities, mental ill health and common co-morbidities such as mobility, visual impairment, incontinence and epilepsy. Both direct comparison and binary logistic regression showed the rural sample to have had significantly more contact with primary (Odds Ratio = 4.02, 95% CI 1.56 -10.35, P = 0.004) and secondary health care (OR = 3.93, 95% CI = 1.81 – 8.55, P = 0.001.) Participants from rural areas were significantly more likely to have any regular daytime opportunity (Odds Ratio = 10.8, 95% CI = 2.3 – 51.5) including employment (OR = 22.1, 95% CI = 5.7 - 85.5) and attending resource centres (OR = 6.7, 95% CI = 2.6 – 17.2) than were participants from urban areas. They were also more likely to have been on holiday (OR = 17.8, 95% CI = 4.9 – 60.1); however, were less likely to use community facilities on a regular basis. Participants from urban and rural areas had a similar number of contacts with other people in a wide range of situations, but the quality of relationships may have been less close in rural areas. Finally, rural participants lived in significantly less deprived areas (Mann Whitney U = 7826, Z = -3.675, P ≤ 0.001). Conclusion: There were no significant demographic and health differences between the rural and urban samples. The study was underpowered with respect to some of these findings, and some results may reflect a Type II error. Nevertheless this is an important negative finding. Contrary to original hypothesis, the rural sample was found to have better access to healthcare services, had better opportunities and lived in less deprived areas than adults with intellectual disabilities living in urban areas. However, the results suggest that the rural sample may not have held such positive or close relationships, and this may be important when considering the subjective experience of social exclusion. Additional qualitative sub-study: A qualitative sub-study investigated the difficulties experienced with recruitment to the original study. 10 semi-structured telephone interviews were held with professionals who had helped with recruitment. These were transcribed verbatim and anonymised, then analyzed using the Framework approach. A number of themes arose, including participant factors (interview anxiety, worry about negative feedback), the importance of the researcher (using a personal approach, meeting potential participants prior to recruitment) and motivators (enjoyment of the research interview (participant), obtaining a medical assessment (carer)). The themes were then used to generate strategies to improve recruitment to intellectual disabilities research: these include the research team applying a more personal approach, and considering motivators for both participants and carers. The findings of this study have implications in terms of both time and money. However, successful recruitment is essential to intellectual disabilities research, and the results can be used by intellectual disabilities researchers to review and improve their recruitment processes.
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Anderson, Lynda May. "Privacy needs of women hospitalized for gynecological surgery." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28720.
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This phenomenological study was designed to explore the privacy needs of gynecological patients, as perceived by the clients during hospitalization, for the purpose of adding to knowledge and understanding of patients' privacy.
Data were collected through sixteen in-depth interviews with eight recently hospitalized patients. The interviews were tape-recorded and transcribed verbatim for each participant.
Data were analyzed using Giorgi's (1975) procedure. Analysis of participants' accounts revealed that privacy was important to participants' maintenance of their self-identity. Characteristics of privacy that participants identified as helping to maintain their self-identity included providing time alone for contemplation and helping to control interactions with others. Participants reported that privacy was important for their comfort during situations involving nursing care, basic needs and social interactions with others. Participants suggested that even though they reduced their expectations of privacy during the hospital stay, their privacy needs in hospital were at times still not met. Factors within the hospital setting that contributed or detracted from participants' hospital privacy included behavior of the nurses, doctors, roommates and the physical environment of the hospital. Participants
indicated that nurses were the main factor in meeting privacy needs especially while caring for participants and participants' roommates.
The findings of this study indicated that participants were willing to trade some privacy for health care. However, participants still valued privacy and considered it important during their hospital stay.
There is a lack of research on privacy and acute care hospitalization. Recommendations for further nursing research, nursing practice, nursing education and nursing administration, based on the findings of this study, are presented in the final chapter of the study.Applied Science, Faculty of
Nursing, School of
Graduate
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Reynolds, Gillian. "Accessibility and consumer knowledge of services for deaf adolescents." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1977.
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The percentage of deaf and hard of hearing people who need mental health crisis services is similar to the percentage of the general population needing such services. Yet, coordinated mental services for deaf and hard of hearing individuals are virtually nonexistent. People who are deaf and hard of hearing, like everyone else, find themselves, from time to time, in need of mental health services.
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Terry, Rachel Elizabeth. "The Influence of Sense of Community on the Relationship Between Community Participation and Recovery for Individuals with Serious Mental Illnesses." PDXScholar, 2017. https://pdxscholar.library.pdx.edu/open_access_etds/3679.
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The Community Mental Health Act of 1963 launched the deinstitutionalization movement, whereby individuals with serious mental illnesses were released from psychiatric hospitals and began living and receiving mental health care in the community (Carling, 1995). However, these actions have not necessarily integrated those individuals into all aspects of community life (Dewees, Pulice, & McCormick, 1996). This is unfortunate because people with serious mental illnesses frequently report that community integration is not only important to them, but that it also aids in reducing symptoms and promoting recovery (Townley, 2015). Although past research suggests that receiving mental health care in the community has a positive impact on symptom management, the influence of other community factors (e.g., sense of community, community participation) has yet to be fully explored (Segal, Silverman, & Temkin, 2010). Furthermore, there is lack of understanding as to how these community factors influence other aspects of recovery, such as mental and physical health. As such, the goal of the current study is to better understand the association between community participation and recovery by investigating sense of community as a potential mediating factor between community participation, psychological distress, mental health, and physical health. Data were collected from 300 adults with serious mental illnesses utilizing community mental health services in the United States. Results indicated that sense of community partially mediated the association between community participation and mental health, as well as psychological distress, and fully mediated the association between community participation and physical health. Implications include contributing to the current knowledge base about the role of community factors in recovery and informing future interventions aimed at promoting community integration of adults with serious mental illnesses.
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Helsper, Linda Pearl. "Identifying community specific barriers to prenatal care services." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1451.
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The intent of this research project was to discover the barriers that exist in this community when a woman attempts to access prenatal care. A concern for the well being of the children in the community and a belief in the importance of early intervention to enhance outcomes inspired the idea for this project.
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Majors-Stewart, Natalie Nicole. "Factors that contribute to the reluctance of mental health treatment seeking among African Americans." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3302.
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Laroche, Vincent. "Complementarite de l'action charitable et etatique : l'exemple des fondations hospitalieres." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33053.
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The presence of hospital foundations inside a public healthcare system raises the question of whether they are charitable organisations doing charitable acts and how they differ from state institutions. A charitable act is based on the notion of gift. A gift relationship, compared to a commercial relationship, is founded on sharing and mutual responsibility rather than common interests. Among friends and relatives, giving reveals strong and lively relationships. In modern society, giving also takes place between strangers. It reveals strong community ties. The charitable sector, including hospital foundations, is the most common form of giving among strangers. Those who participate in this sector show a high level of involvement in many sectors of society and have strong community ties. State action takes place irrespective of the quality of community ties, although it ultimately depends on it. Charitable action complements state action. However, state action remains essential since charity is alien to the concepts of justice and equity.
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Cuevas, Adolfo Gabriel. "Exploring Four Barriers Experienced by African Americans in Healthcare: Perceived Discrimination, Medical Mistrust, Race Discordance, and Poor Communication." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/615.
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For many health conditions, African Americans bear a disproportionate burden of disease, injury, death, and disability compared to European Americans. African Americans also use health services less frequently than do European Americans and this underuse of services contributes to health disparities in the United States. Studies have shown that some disparities are present not as a result of poor access to care, but, to a certain extent, as a result of the experiences patients have at their doctors' offices. It is, therefore, essential to understand African American patients' perspectives and experiences with healthcare providers. Past studies have shown that four barriers affect the quality of patient-provider relationships for African Americans: perceived discrimination, medical mistrust, race discordance, and poor communication. The studies, however, have not looked at how these barriers manifest when African Americans speak about their perspectives and experiences with health care providers. This project was a secondary data analysis of qualitative data provided by adult African American community members from Portland, Oregon with diabetes or hypertension or both, each of whom participated in one of 10 focus groups. The focus groups were conducted as part of a study that applied community based participatory research (CBPR) principles to understand patients' experiences with their doctors. Using a deductive approach, this analysis enhanced the understanding of how the barriers play a role in patient-provider relationships. Further, the analysis showed how the barriers are interrelated. In learning African American patients' experiences and perspectives on these four key barriers, the investigator proposes recommendations for healthcare providers as to how they can best deliver quality care for African Americans.
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Smith, Lesley-Ann. "'Mad, bad and dangerous to know' : exploring the everyday spaces of older, mental health service users." Thesis, University of Northampton, 2012. http://nectar.northampton.ac.uk/5423/.
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The area of mental health distress is one that crosses many disciplines including; psychiatry, critical psychiatry, psychology, critical psychology, history, politics, economics, philosophy, sociology, culture and human geographies (Thrift, 2006). Consequently, there are a complex set of issues to consider when discussing the experiences of being a mental health service user. Notwithstanding this diversity, such representations of mental health have a tendency to position service users as a fairly homogenous and static group of bodies – in other words, they are the stable ‘other’ (Conradson, 2005; Parr, 2000). As a way of exploring the complexity, this thesis sets out to explore the multiplex constituents and heterogeneous ways in which daily service user life is played out within everyday mental health spatial contexts. These spaces incorporate the psychiatric institution, the mental health day centre and the home. Using interviews, ethnography, poetry and visual ethnographies, service users’ experiences are analysed by exploring the relational aspects of the discursive and the non-discursive, such as receiving a diagnostic label and subsequent treatments and the ways in which these practices permeate the embodied and spatial experiences of every day service user life. This corpus of research data suggests that rather than the experiences of mental health distress operating as a stratified set of factors awaiting analysis, there were divergent accounts incorporating positivity, negativity and ambivalence in the ways which service users made meanings of their daily lives (Brown & Tucker, 2010). Consequently, this thesis is framed around the ontological realms of creativity, potentiality and of becoming within and through space (Deleuze & Guattari, 2004; Massumi, 2002). Finally, some implications of the current political changes and how these may impact upon daily service user life are discussed to highlight that mental health service users’ are always on the move.
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Singh, Shail. "The effects of perceived discrimination on Samoan health." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3260.
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The purpose of this study was to examine the effect of perceived discrimination on Samoan health. This study employed purposive data collection and was conducted quantitatively using a questionnaire format, which measured everyday perceived discrimination, depression, and physical health.
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Bambani, Nomfezeko. "The utility of Weingarten's witness positions in the understanding of compassion fatigue in people who care for their own family members with AIDS." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1004465.
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This paper explores the utility of Weingarten's (2003) witness positions in the understanding of compassion fatigue in people who care for their own family members with AIDS. The research is embedded in Weingarten's theory of witnessing and narrative theory and practice. The literature review explores the shift from hospital-based care to community/home-based care which has led to family members assuming the role of caring for their family members with AIDS, an overview of the effects of caring for AIDS patients on caregivers and an overview of Weingarten's (2003) theory of witnessing with special emphasis on the witnessing positions and their consequences. Interviews, based on narrative theory and practice in which Weingarten's theory is rooted, gave access to the participants' experiences, which were then analysed and interpreted through a framework developed from the witnessing theory. This article demonstrates the utility of Weingarten's (2003) theory of witnessing to people who are caregivers to their own family members with AIDS. I argue that witness positions occupied by caregivers during witnessing determine whether the caregivers will experience compassion fatigue. The negative consequences related to compassion fatigue that will be reviewed could probably be prevented through active, intentional, compassionate witnessing.
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Kirk, Alice Joy. "The effect of explanatory style on the coping strategies of women in recovery." CSUSB ScholarWorks, 2008. https://scholarworks.lib.csusb.edu/etd-project/3366.
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Lea, Emma J. "Moving from meat : vegetarianism, beliefs and information sources." Connect to this title online, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phl4335.pdf.
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Includes bibliographical references (leaves 327-346). A random population survey and a survey of vegetarians were conducted to examine South Australians' beliefs about meat and vegetarianism. Meat beliefs, barriers and benefits of vegetarianism, meat consumption, personal values, use of and trust in sources of food/nutrition/health information and demographic variables were measured.
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Gottberg, Kristina. "Studies of people living with multiple sclerosis in Stockholm county : evaluation of methods for data collection and aspects of functining and use of health care services /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-784-7/.
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Sousa, Vera Lucia Frazão de. "Suporte social e qualidade de vida de mulheres climatéricas coronarianas." Pontifícia Universidade Católica de São Paulo, 2018. https://tede2.pucsp.br/handle/handle/21774.
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In the process of human aging, the modifications are inherent to the phases of life and with respect to female aging, climacteric and consequently menopause, constitutes an event that accentuates their perception and / or self-perception. Coronary heart disease can be one of the consequences of the climacteric, compromising the quality of life of women who are at this stage. Epidemiology has shown that the heart attack kill both the women and the men and kill the women more in the climacteric period. Physical symptoms, emotional problems or social support problems may present themselves and negatively impact a daily life marked by the accumulation of roles (professionals, marriages, caregivers). The recognition of this complexity of events coupled with the fact that my professional activity as a social worker is focused on attending coronary climacteric women, answered for the interest in researching how issues inherent to female aging (focusing on the climacteric and its developments) impact the quality of life and also how social supports can contribute to the greater well-being of these women. The general objective that guided my research was therefore to study the relationship between social support and its impact on the quality of life of coronary climacteric women treated at the Dante Pazzanese Institute of Cardiology (IDPC / SUS). Among the specific objectives, the following should be highlighted: demographic and socioeconomic profiles, identify their self-perception of quality of life; as well as their social support and analyze how these variables are articulated. For that, I carried out a literature review pertinent to this topic based on data collected in a field survey performed with 52 women attending the IDPC. The results of this discussion allowed me not only to ratify my initial hypothesis that a good social support positively impacts the women‘s quality of life in this stage, but also to point out a propositional way to potentiate social actions as a fundamental part of a project to improve health for them
No processo de envelhecimento humano, as modificações são inerentes às fases da vida e, no que diz respeito ao envelhecimento feminino, o climatério e, consequentemente, a menopausa, constitui um acontecimento que acentua sua percepção e/ou autopercepção. A doença coronariana pode se configurar como um dos desdobramentos do climatério, comprometendo a qualidade de vida de mulheres que se encontram nessa etapa. A Epidemiologia tem mostrado que o enfarto mata tanto a mulher quanto o homem e mata mais a mulher no período climatérico. Sintomas físicos, problemas emocionais ou relativos ao suporte social podem nele se apresentar e impactar negativamente um cotidiano já marcado por acúmulo de papéis (profissionais, matrimoniais, cuidadoras). O reconhecimento dessa complexidade de eventos, aliada ao fato de que minha atividade profissional como assistente social está voltada ao atendimento de mulheres climatéricas coronarianas, incentivou-me a pesquisar de que modo questões inerentes ao envelhecimento feminino (com foco no climatério e seus desdobramentos) impactam a qualidade de vida e, também, como os suportes sociais podem contribuir para um maior bem-estar dessas mulheres. O objetivo geral que orientou minha pesquisa foi estudar a relação entre suporte social e seu impacto na qualidade de vida de mulheres climatéricas coronarianas atendidas no Instituto Dante Pazzanese de Cardiologia (IDPC/SUS). Entre os objetivos específicos, destacam-se: estudar o perfil demográfico e socioeconômico dessas mulheres; identificar sua autopercepção de qualidade de vida, bem como de seu suporte social e analisar de que modo tais variáveis se articulam. Para tal, realizei uma revisão da literatura pertinente a essa temática, tomada como base para discutir dados coletados em uma pesquisa de campo, realizada com 52 mulheres atendidas no IDPC. Os resultados dessa discussão permitiram-me não apenas ratificar minha hipótese inicial de que um bom suporte social impacta positivamente na qualidade de vida de mulheres nessa etapa, como também indiciar um caminho propositivo para potencializar ações sociais como parte fundamental de um projeto para melhorar a saúde
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Garde, Maria Salomé. "Mentally ill homeless and companion pets." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2186.
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The present study assessed the relationship between mentally ill homeless and their companion pets and questioned if the pets acted as a barrier for them to receive shelter and other services. The study also sought to find if pets acted as a communication tool between this population and society. themselves because they are mentally vulnerable and victims of a mental disorder.
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Carlisle, Patricia A. "Meaning in distress : exploring religion, spirituality and mental health social work practice in Northern Ireland." Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/21736.
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This empirical study explores if, and how, religion and spirituality are relevant subjects for those experiencing mental distress in Northern Ireland (NI) and how, if at all, the subject is engaged with in mental health social work practice. Although there is some controversy in United Kingdom based research regarding the apparent benefit of religion and spirituality within mental health, service user research and literature suggests its importance within recovery. Literature on religion, spirituality and social work practice suggests the need to examine the social and political processes which persist around this subject in social work practice (Henery, 2003; Wong and Vinsky, 2009). This examination is appropriate given the role of religion within the political conflict in NI, the impact of the conflict upon social work practice (Campbell et al, 2013), the high incidence of mental ill health in NI and the apparent role of religion and spirituality within mental distress. This study considers how mental health social workers may engage with this subject within their practice not only as an aspect of service users’ identity but also within post conflict Northern Ireland. The study methodology and design drew upon narrative theory and grounded theory. I interviewed twelve mental health service users and twelve mental health social workers, and half of the participants from each group also took part in a follow-up telephone interview. All of the participants were invited to bring an object which expressed what religion and spirituality meant to them. Analysis explored the views and experiences of mental health service users and social workers about religion and spirituality, within specific aspects of the wider social field. Service user and social worker participants’ accounts suggested that whilst the role of religion and spirituality within mental distress was recognised, its inclusion in mental health social work practice was marked with questions of legitimacy. Some of these questions were explicitly framed within the conflict, whilst others were less so. The study found that although religion was associated with politics, sectarianism and violence, its role, and that of spirituality, as an aspect of identity and meaning-making, appeared to be underdeveloped. Two key findings are of particular note. 10 Firstly that service user participants had their own ‘hierarchy’ of religious and spiritual expression, which on occasion appeared to result in their being critical of other service users’ expressions. Secondly, some service users preferred to keep their spirituality to themselves as a strategy of empowerment. In addition the study also found that service users viewed the mental health professional relationship as focusing upon medical aspects of their care, for example physical health and medication management, with no scope to explore religion, spirituality and mental distress. Thus questions of legitimacy focused around the notion of privacy and whether talking about religion and spirituality within the mental health service user and social worker relationship was too sensitive, given its association with sectarianism. Furthermore, mental health service users were concerned about how a disclosure of religion and / or spirituality within mental distress would be viewed by the mental health professional: would it be viewed as indicative of deteriorating mental health? Overall the study identified a significant gap between how service users draw upon spirituality and / or religion within mental distress, and the space given to this within mental health social work practice. This gap is due to a myriad of factors ranging from the social worker’s biography, to wider issues around how religion and spirituality are conceptualised in contemporary society. This study also highlights the continuing impact of the Northern Ireland conflict on frontline social work provision. There is a need for policymaking to acknowledge the ambivalence that exists around spirituality and religion in mental health social work practice due to the conflict and other relevant factors. Finally, support is needed for practitioners and service users to acknowledge this aspect of mental well-being in a manner that gives service users choice about its inclusion in their mental health care.
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Nhavoto, José António. "Integration of Mobile Technologies with Routine Healthcare Services in Mozambique." Doctoral thesis, Örebro universitet, Handelshögskolan vid Örebro Universitet, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-56948.
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Mobile technologies are emerging as one way to help address health challenges in many countries, including in Least Developed Countries. Mobile technology can reach a large share of the population but in order to provide effective support to healthcare services, technology, information collection and dissemination, and work processes need to be well aligned. The thesis uses a design science methodological approach and mixes qualitative and quantitative data analysis to address the question of, How can mobile technologies be effectively integrated with routine healthcare services? The study concerns the design, implementation, and evaluation of a mobile technology-based system, called SMSaúde, with the aim of improving the care of patients with HIV/AIDS and tuberculosis in Mozambique. The work started with the elicitation of functional and user requirements, based on focus group discussions. An important challenge, as in many mHealth interventions, was the integration with routine healthcare services and the existing IT systems, as well as developing a scalable technical structure. The system has now been in routine use since 2013 in more than 16 healthcare clinics in Mozambique. Evaluation was done by a randomised controlled study. Analysis of patient records showed that retention in care in urban areas was significantly higher in the intervention group than in the control group. In a user study both patients and health professionals were very positive to the system. The thesis contributes to research by demonstrating how information system artefacts can be constructed and successfully implemented in resource-constrained settings. The practical contributions include the designed artefact itself as well as improved healthcare practices and mHealth policy recommendations.
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Wikström, Daniel, and Ida Sandeberg. "Accessibility, With or Without Colour : A qualitative look on existing accessibility guidelines for colour vision deficiency and its effect on Swedish e-health services." Thesis, Tekniska Högskolan, Jönköping University, JTH, Datateknik och informatik, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-48237.
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Purpose WCAG is a set of guidelines to assist in developing websites accessible for everyone, for example people with colour vision deficiency (CVD). However, there are few guidelines relevant for CVD and with increasing dependant on websites the importance of accessibility on these websites increases as well. The purpose of the research study is therefore to investigate the impact the relevant guidelines for CVD in WCAG 2.1 has on Swedish health care websites and what the consequences are for people who live with CVD. Method An initial literature study was conducted to gain knowledge of previous findings and also evaluate the best approach for the research study. The research study is based on a qualitative approach to gain a deep understanding of the area and to gain insight into the feelings and experiences of the people affected. The methods used to gain the necessary knowledge are an evaluation of 1177.se and e-tjanster.1177.se also observations and interviews around these two websites. Findings The results show that WCAG 2.1 has a positive impact on Swedish health care websites, as well as on users with CVD. From evaluations, interviews and observations it is concluded that 1177.se and e-tjanster.1177.se are easy to perceive for people with CVD. Implications This research study was limited to the mobile version of the websites. However, the results could be different if the research was conducted on the desktop version due to the different structure of the websites and the inclusion of a cursor on desktop. The evaluation could have been affected by the sampling of pages while the interviews and observations should not have been. Limitations The research study was limited to Swedish health care website 1177.se and its subdomain etjanster. 1177.se. Further it was decided to evaluate the mobile version of these websites, although the elements should look similar on desktop and mobile. While not the initial intention, due to over representation of red-green CVD the study was also limited to people with red-green CVD. Also, the experience of browsing the web on a mobile device was considered to reduce the variables for frustrations. Further research For further research, another selection of WCAG guidelines could be considered to evaluate etjanster. 1177.se since the results shows that 1177.se’s and e-tjanster.1177.se's weaknesses seems to be in the structure of the website. A study researching the “blue-yellow colour blindness” compared to websites could contribute with new, relevant knowledge as well.
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Dhar, Sohini. "Religiosity, Spirituality and Attendance at Religious Services among Recreational Drug Users: A Sub-Analysis of the Drugnet Survey." TopSCHOLAR®, 2010. http://digitalcommons.wku.edu/theses/181.
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This study is a sub-analysis ofthe previously collected cross-sectional DRUGNET survey data. The sample included 1,178 current users of illicit drugs and 389 former users. This study was delimited to U.S. citizens, aged 18 years and older, who completed the DRUGNET survey (n =1,567). DRUGNET was a descriptive online survey of self - reported attitudes and behaviors among a group of adult, self - identified drug users (i.e., not drug abusers). The purpose of the sub-analysis was to explore the importance of religion, spirituality, and religious service attendance in the context of an otherwise normal healthy adult life. Moreover, it also looked into potential patterns of association between aspects of religiosity/spirituality and illicit drug use. The study explored if there was a relationship between the strength of a respondent's spiritual or religious beliefs and the patterns of their recreational drug use. A canonical correlation analysis was conducted using self-rated spirituality, self-rated religiosity, and attendance at services as variables on the left (entered in MANOVA as dependent variables) and self-reported use of six groups of drugs as variables on the right (entered in MANOV A as covariates). One significant function was found, which showed that attending religious services and importance of religion were negatively associated with the use of alcohol, marijuana, cocaine, and hallucinogens. That is, people who reported a higher level of religiosity and who attended religious services were less likely to use these psychoactive drugs.
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Colby, Jason Wayne. "The effects of housing on the biological, psychological, and sociological functioning of homeless persons with Human Immuno Deficiency Virus/Acquired Immuno Deficiency Syndrome." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2379.
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The purpose of the study was to assess the impact of housing services on the bio-psycho-social functioning of homeless persons with HIV/AIDS. Ideally, taking a homeless person with HIV/AIDS and returning them to a healthy state would be a goal of any social service intervention.
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Featherstone, Lisa. "Breeding and feeding: a social history of mothers and medicine in Australia, 1880-1925." Australia : Macquarie University, 2003. http://hdl.handle.net/1959.14/38533.
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Thesis (PhD)--Macquarie University, Division of Humanities, Department of Modern History, 2003.Bibliography: p. 417-478.
Introduction: breeding and feeding -- The medical man: sex, science and society -- Confined: women and obstetrics 1880-1899 -- The kindest cut? The caesarean section as turning point -- Reproduction in decline -- Resisting reproduction: women, doctors and abortion -- From obstetrics to paediatrics: the rise of the child -- The breast was best: medicine and maternal breastfeeding -- The deadly bottle and the dangers of the wet nurse: the "artificial" feeding of infants -- Surveillance and the mother -- Mothers and medicine: paradigms of continuity and change.
The late nineteenth and early twentieth centuries saw profound changes in Australian attitudes towards maternity. Imbibed with discourses of pronatalism and eugenics, the production of infants became increasingly important to society and the state. Discourses proliferated on "breeding", and while it appeared maternity was exulted, the child, not the mother, was of ultimate interest. -- This thesis will examine the ways wider discourses of population impacted on childbearing, and very specifically the ways discussions of the nation impacted on medicine. Despite its apparent objectivity, medical science both absorbed and created pronatalism. Within medical ideology, where once the mother had been the point of interest, the primary focus of medical care, increasingly medical science focussed on the life of the infant, who was now all the more precious in the role of new life for the nation. -- While all childbirth and child-rearing advice was formed and mediated by such rhetoric, this thesis will examine certain key issues, including the rise of the caesarean section, the development of paediatrics and the turn to antenatal care. These turning points can be read as signifiers of attitudes towards women and the maternal body, and provide critical material for a reading of the complexities of representations of mothers in medical discourse.
Mode of access: World Wide Web.
478 p
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Horsfall, Debbie. "The subalterns speak: a collaborative inquiry into community participation in health care." Thesis, View thesis, 1997. http://handle.uws.edu.au:8081/1959.7/636.
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This thesis is about change, community and the health system. It is about women. It is about challenging the status quo and advocating for and with the less powerful. It is about fore grounding previously silenced voices, valuing the subjugated knowledge of people other than those who make the decisions. Many voices are woven together, including those of the author, community health workers, non-government agency workers, people who use community health services, and members of the public. This is a narrative of a group of people researching the issue of community participating in community health, concentrating on the Blue Mountains district of NSW. The inquiry centred on the premise that community participating is both desirable and achievable. The group spoke to over 100 people, and the conclusion was reached that, while community participation is promoted by the NSW Health Department, at present it is an idea that has not been thought through, is ill defined, and lacks support in practice. Debates about health and illness take place within a medical discourse, and there must be a reorientation to viewing health as a social phenomenon if community participation in decision making is to occur
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Wass, Sofie. "The importance of eHealth innovations : Lessons about patient accessible information." Doctoral thesis, Internationella Handelshögskolan, Högskolan i Jönköping, IHH, Informatik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-38045.
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Access to digital information and communication has an increasing importance in both the work of healthcare professionals and in patients’ everyday life and has transformed what we do and how we carry out activities. It changes the way in which healthcare is delivered, how information is exchanged within and between organizations and how patients and other actors access and manage information. Currently, innovation is imperative in the healthcare sector and today there is a focus on how different eHealth services can improve healthcare. With increased access to various eHealth services, there is a need to know more about the impact of eHealth innovations on healthcare. The aim of this thesis is to acquire more knowledge about eHealth innovations in healthcare. The focus is on prerequisites to realize innovative eHealth services and eHealth services that provide patients with access to health information. The theoretical background addresses innovation, services and business models. This thesis is a compilatory work and includes five qualitative research papers. The first study is an interview study, the second is a literature review and the remaining three are case studies. The data collection consisted of interviews, surveys, workshops and secondary data collected from documents. The interview study and the case studies were performed in the Swedish eHealth setting. The research contributes to our understanding of eHealth innovations with insights on prerequisites to realize eHealth innovations and knowledge on patient accessible information. The first study provides a classification of prerequisites that need to be considered to realize innovative eHealth services. When dealing with eHealth services, organizational and sematic interoperability are still a challenge, and they transcend organizational boundaries. This thesis provides knowledge on the recent trend of opening up electronic health records to patients. The knowledge derived from the studies on patient accessible electronic health records show that there is a discrepancy between the perceptions of patients and healthcare professionals. The thesis concludes that patients feel more involved and that the patient-professional relationship improves with patient access to electronic health records, whereas healthcare professionals have concerns about how patients will manage access to health information. This thesis also provides empirical insights on how business models can be represented in a public eHealth setting. By viewing public eHealth services as social innovations, the thesis contributes to the research on business models in a public healthcare setting by incorporating societal value into the representation of the business model. The research in this thesis contributes to research in health informatics by discussing issues related to eHealth innovations and patient accessible information. Its practical importance lies in identifying issues that are important when discussing eHealth initiatives and the implications of giving patients online access to their electronic health record.
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Nygren, Peggy. "Exploring the Effects of Multi-Level Protective and Risk Factors on Child and Parenting Outcomes in Families Participating in Healthy Start/Healthy Families Oregon (HS/HFO)." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1513.
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While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy Families Oregon (HS/HFO) home visitation program (treatment group) who completed a follow-up phone survey at the child’s 12 month birthday (n = 405). Families were offered HS/HFO services prenatally after meeting risk screening eligibility criteria on the New Baby Questionnaire (NBQ). Program mothers having received at least one home visit (n = 248) were included in the final analyses. Families had an average of 3.1 (SD = 1.2) NBQ risk factors at enrollment and 83% reported having trouble paying for basic needs. Families received an average of 16 home visits in the first 6 months of the program. Thirty-one percent of mothers were aged 19 or younger, 60% were White and Non-Hispanic, 31% were Hispanic, and 9% were another race/ethnicity. Hierarchical regression models with main effects (RFI, PFI, race) and an interaction term (RFI X PFI) were developed to predict eight outcomes. Interaction effects models were not significant. Five RFI main effects were significant: higher RFI scores were associated with greater likelihood of child welfare involvement, greater parenting stress, less favorable scores on child health and well-being, lower parent responsiveness and ii acceptance, and less supportive learning environments. One PFI main effect was significant: higher PFI scores predicted lower parenting stress. A trend level result showed higher PFI scores were associated with less child welfare involvement. Race was significant in two models: White/Non-Hispanic families were more likely to have a home visitor report child welfare involvement and had more frequent parent-child activities compared to other race/ethnicity families. Unpacking the results with separate single risk factor (12 items) and protective factor (10 items) regression models followed. Results showed parent’s prior family history of maltreatment and younger maternal age predicted child welfare involvement (home visitor report), while protection was seen for those with access to housing support. Social support and family functioning protectors were linked to lower parenting stress, while maternal depression showed the opposite finding. Better scores on a child health and well-being measure were seen with higher neighborhood cohesion and greater participation in HS/HFO; in contrast, neighborhood violence and frequent mobility were linked to worse scores. Developmentally supportive home environments were seen for families participating in additional parent support programs, in which the mother had greater knowledge of infant milestones and behavior, and if the family had access to housing supports. Unemployment proved to be associated with less enriched home environments. In summary, there was no support for the cumulative PFI in buffering risk for negative outcomes in this model. The RFI was also a more robust predictor of outcomes compared to the PFI in the main effects models. Overall, study findings provide some evidence for the utility of specific protective factors, as well as cumulative and specific single risk factors, for screening families for effectively targeting services and guiding the conceptual development of program and evaluation formats.
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Yule, Elisa W. "Practicing across cultures : perspectives of expatriate professionals." Phd thesis, Faculty of Health Sciences, 2008. http://hdl.handle.net/2123/7734.
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Dourgnon, Paul. "Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé." Phd thesis, Université Paris Dauphine - Paris IX, 2013. http://tel.archives-ouvertes.fr/tel-00912417.
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En dépit des objectifs énoncés de respect du principe d'équité horizontale, on observe des inégalités sociales dans la consommation de soins des pays dotés de systèmes de santé socialisés.Cette thèse se propose, au travers de quatre études, de contribuer à l'analyse des politiques publiques dans le système de santé, du point de vue de l'équité de recours aux services de santé. L'introduction propose des éléments descriptifs des inégalités sociales de recours aux soins en France ainsi que des principaux mécanismes qui, à l'intérieur du système de santé français, peuvent en être à l'origine.Le premier chapitre étudie les liens entre barrières financières à l'accès aux soins et état de santé. Il montre que le fait de renoncer à des soins pour des raisons financières est associé à un état de santé futur plus détérioré.Le deuxième chapitre propose une analyse de l'interaction médecin-patient et de son rôle dans la formation des inégalités de recours aux soins. Nous étudions les catégorisations opérées par les médecins au sujet de leurs patients en fonction de leurs situations sociales. Nous montrons ensuite les relations entre ces catégorisations et les pratiques observées.Un troisième chapitre collige deux études portant sur la réforme du médecin traitant. La première propose une analyse de la réforme et de son contexte, en particulier le rôle des différents acteurs. La seconde propose une étude des conséquences de la réforme sur l'accès financier aux soins de spécialistes
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Chidubem, Michael Ebere. "Formats for storytelling by caregivers for sharing knowledge in home-based health care." Thesis, Cape Peninsula University of Technology, 2012. http://hdl.handle.net/20.500.11838/1326.
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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, 2012Home-Based Health Care (HBHC) is the provision of health services and social assistance to individuals in their homes. It is an indispensable service to communities in need; presently in South Africa, these health care services are provided by local non-profit and non-governmental organizations. It is mainly targeted at poverty-stricken and under resourced communities and is an important aspect of healthcare in South Africa. A lot of communities in South Africa are still under-resourced and live in impoverished conditions. This is reflected in poor living standards characterized by unemployment, uneasy access to basic amenities, unequal distribution of wealth, poor medical facilities in rural communities, etc. The prevalence of the HIV/AIDS endemic has also worsened the situation. However, the South African government has constantly supported initiatives to enhance better healthcare in rural communities. This research presents a case study of caregivers working in Du Noon, an informal settlement in Western Cape, South Africa. Du Noon is overpopulated and home to lots of foreigners who have migrated in search of better living standards thus stretching an already over-burdened community. Naturally, this development supports poor health practices which encourage the spread of diseases within the community. Health facilities do not sufficiently cater for the ever-increasing healthcare demands and as such lots of people depend on NGOs such as SALT (Sharing Abundant Life Together) who through the help of caregivers and community workers have been providing for some of the healthcare needs of the Du Noon community since 2000. Findings reveal that although caregivers in this community have lots of stories to share about their work practices, they do not have a platform to share these stories. This research focuses on identifying processes involved in capturing these stories and moderating them into educative and entertaining visual contents for the purpose of sharing the stories within the community. Using qualitative research methods, empirical and field study provides the needed data as well as understanding of the multi-dynamism of this community. Data analysis is done through interpretive methods for the purpose of understanding the data collected and analysed during the research process. Finally, as a possible research contribution, the research concludes by examining how other technology can enhance the storytelling experience using interaction design methods that enables caregivers participate in the entire design process. Suggestions are also given as to direction for further research within the subject area.
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Blaber, Zlatinka N. "Hybrid professional identities and 'calculative practices' : the case of GPs in the English National Health Service acute care commissioning." Thesis, University of Essex, 2015. http://repository.essex.ac.uk/16269/.
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The objective of this research is to contribute to knowledge and understanding by exploring: first, the professional identities of English General Practitioners (GPs) and other clinicians in the newly-formed Clinical Commissioning Groups (CCGs) and second, their level of involvement in CCG ‘calculative practices’ (Miller, 1990, 2001). The institutional field studied is acute care, i.e. hospital, commissioning in contemporary England. To achieve its objective, this thesis asks four research questions: 1) ‘How appropriate is it for clinicians to be involved in CCG acute care commissioning?’ 2) What motivates clinicians to assume leadership roles in CCGs?’ 3) How involved are clinicians in CCG calculative practices?’ and 4) To what extent do hybridity and calculative practices affect clinicians’ professional identities in CCGs?’ The theoretical framework used is based on the concept of ‘calculative practices’ and elements of the Institutional Logics Theory (ILT). This research employs three research methods – documents’ content analysis, semi-structured, in-person interviews, and non-participant observation of CCG meetings with the public and NHS conferences. The interview subjects are NHS managers and accountants, as well as clinicians. This thesis answers the four research questions and then proposes some additional, incidental to this research findings and contributions to policy/legislation and practice. In conclusion, this study deliberates on the viability of the purchaser-provider split of the early 1990s that established the foundations and raison d’être of CCG commissioning and dwells on the possibility that one day the general taxation-funded and free at the point of service National Health Service (NHS) in England may cede its way to a US-inspired model of full blown privatisation.
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Forsyth, Rowena Public Health & Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.
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Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.
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Mulonya, Rodrick K. A. R. "The political economy of development aid: an investigation of three donor-funded HIV/AIDS programmes broadcast by Malawi television from 2004 to 2007." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1002926.
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Development aid in most of the developing countries can sometimes compromise the principles of public service broadcasting (PSB). This may be true when reflected against the tension between donor financed programmes in Malawi and the mandate of Television Malawi (TVM). Although the donor intentions are noble, the strings attached to the funding are sometimes retrogressive to the role of PSBs. A case in point is how donors dictate terms on the HIV/Aids communication strategies at TVM. Producers receive money from donors with strings attached on how the money should be used and accounted for. If producers deviate they are sanctioned through withholding funding, shifting schedules and reducing the funding frequency. The donors also dictate who to interview on what subject, how to conduct capacity building. Some scholars have researched much on the impact of commercialisation of the media. This study is a departure from these traditional interferences; it interrogates the interest of philanthropy tendencies by international donors in the three chosen HIV/Aids programmes broadcast by TVM. The study investigates the extent of pressure exerted by donors on the producers of HIV/Aids programmes in Malawi. Thus, the study seeks to illicit specifics in the power relationship between the donor and the producer hence the study employs the political economy of development aid as applied to the public service broadcasting and communication for development. The study employed qualitative research methods and techniques (in-depth interviews, case study and document analysis). The study reveals how donor ideologies dominate the Aids messages-content output of the texts constructed. The study argues that cultural alienation of the Malawian audiences retards efforts of donors in combating HIV infection rate.
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Birouste, Guilhem. "Les usages médicaux du social : Médecine générale et inégalités." Thesis, Montpellier 1, 2014. http://www.theses.fr/2014MON10030/document.
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La France est caractérisée par un bon état de santé global et d'importantes inégalités sociales de santé. Le renouveau d'intérêt pour ces dernières est l'occasion de questionner une définition univoque centrée sur les résultats au détriment des procédures, dans un pays qui a axé ses politiques de lutte sur le système de soins. La médecine générale y a une place particulière par son apparition récente en tant que spécialité universitaire et la nécessité de se définir qui s'ensuit. Elle est décrite tout à la fois comme pivot du système de soins, agent de santé publique ou chantre d'une relation inter-individuelle et d'une prise en charge globale. Si la médecine est fondée sur les données de la science, elle est aussi une profession prudentielle en ce qu'elle prend en compte des situations singulières, générant de l'incertitude dans la pratique. Parmi les sources de singularité, l'aspect social, tant du patient que du médecin, est à considérer. Dans sa pratique, ce dernier éprouve cependant une diversité de social. Tantôt obstacle à son activité professionnelle et vu comme extérieur au médical, tantôt élément apparenté aux données de la science par l'épidémiologie, il peut aussi être une brique de la construction individuelle du patient sur laquelle s'appuyer, conduisant parfois à une moralisation des conduites et des identités. Les caractéristiques sociales du médecin sont quant à elles souvent oubliées, comme s'il était neutre ou simple représentant de la science. C'est pourtant dans l'interaction entre ces deux mondes que se jouent aussi les inégalités sociales de santé et tout se passe comme si le médecin ne pouvait bien soigner que ses semblablesFrance is characterized by a good overall health status and high social inequalities in the health sector. The renewed interest in health inequalities is the opportunity to question a unique definition focused on results at the expense of processes, in a country where policies on tackling inequalities are based on the health care system. General practice has a particular position in this system, as a new academic speciality, which still needs to figure out how to define itself. It is described simultaneously as a heath care system gatekeeper, a public health officer or an advocate for inter-individual relationship and holistic care. While medicine is based on scientific evidence, it is also a prudential profession as it considers singular situations, generating uncertainty in practice. Among singular sources, social characteristics of both patients and doctors have to be considered. However, in their practice, physicians experience a diversity of social. Sometimes a barrier to the professional activity and considered external to the medical world, sometimes considered as part of scientific evidences by epidemiology, it could also be considered as a component of the individual construction of the patient on which the physician can rely, with the potential to lead to a moralization of behaviours and identities. The physician's social characteristics are often omitted, as if doctors were neutral or mere representatives of science. It is however in the interaction between these two worlds that social determinants of health inequalities can be found, and it seems that a physician could only provide good care to patients sharing the same similarities
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Mojapelo, Tshepiso D. "The lived experiences of single teenage mothers in Botswana : a phenomenological study." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1997. https://ro.ecu.edu.au/theses/890.
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This study was designed to explore-the lived-experiences of single teenage mothers in Botswana, as perceived by them. The participants were teenage mothers who had to leave school due.to pregnancy. They had either completed year one in secondary school or were in year two. Their ages ranged between 16 and 19 years. The ages of their babies range from five to 10 months, with the exception of one child who was three years old. All teenage mothers came from low socio-economic backgrounds with families whose parents were either not working, or were working in the lowest paying jobs as cleaners or drivers. Some were from single parent families with the mother working as a cleaner in government offices. They all lived in the high population density area of Gaborone such as Old Naledi and Broadhurst Self Help Agency, where many illicit behaviours are observed. The study• is undertaken through a phenomenological approach which is guided by the reality of lived experiences to a theoretical construct. This research was conducted to uncover young single experiences .concerning motherhood.
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Suzuki, Tsudoi. "Comparative analysis of depression in homeless populations." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2393.
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The purpose of this project was to find out whether or not there were specific factors that made homeless people depressed. Finding depression factors will help to establish strategies and programs that would prevent homeless people from being depressed. The current study tested the hypothesis that basic needs and education are needed to help in factoring depression.
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Di, Donato Josephine J. "Factors influencing the health-related quality of life of children with spina bifida." Thesis, Queensland University of Technology, 2001. https://eprints.qut.edu.au/36779/1/36779_Digitised%20Thesis.pdf.
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Health-related quality of life is emerging as an important area of health research as disease-oriented descriptions of health give way to positive concepts. The health-related quality of life of children with spina bifida is often described in terms of the nature and severity of their medical condition. In this thesis it was hypothesised that factors other than their medical condition influences health-related outcomes. In fact, the dependency on medical care services to monitor and manage their condition throughout childhood and beyond was identified as a potential determinant of healthrelated quality of life. The aims of the research were to describe the healthrelated quality of life of children with spina bifida and characterise the impact of utilisation and experience with medical care services on reports of health-related quality of life.
The research was conducted in two parts. Part A addressed issues related to the measurement of quality of life in child populations and specifically examined the psychometric properties of the main quality of life instrument (the Child Health Questionnaire - CHQ) in a sample of children with spina bifida. It was found that tests were consistent with other studies of similarly chronic conditions and on this basis the CHQ could be used reliably and validly in a sample of children with spina bifida.
Part B consisted of three studies designed to examine possible determinants of health-related quality of life in children with spina bifida. In Study One, 115 parent respondents participated in a mail questionnaire to obtain a baseline measure of quality of life in children with spina bifida. In this study clinical and sociodemographic characteristics were examined. The major findings were: the health-related quality of life of children with spina bifida was generally the poorest when compared to reports of other groups of children; aspects of physical health were more likely to be associated with clinical factors; and age differences were observed when psychosocial aspects of health were examined. In Study Two, relationships between functional independence, satisfaction with and utilisation of medical services on reports of health-related quality of life were examined. The data collection methods included an initial face-to-face interview during scheduled clinic appointments to obtain data about functional independence and satisfaction with care. This was then followed by a phone interview within a few days of the visit to obtain a report of health-related quality of life. A sample of 71 families and data related to eighty-six episodes of care contributed to the data collection for this stage of the research. The key findings were: Firstly, severity influenced the physical functioning aspect of health-related quality of life outcomes only and in this study the findings did not suggest that severity was an important determinant of functioning at a psychosocial level. Secondly, it was expected that greater functional independence would translate into higher mean quality of life scores (i.e. better quality of life) across both physical and psychosocial domains. However, the summary measure of functional independence did not appear to be as influential as the measures related to service utilisation and patient satisfaction when one inspects the size of the regression coefficient in these relationships. Thirdly, relationships between health-related quality of life and use of hospital-based services and satisfaction with these services suggest that it is important to distinguish between different types of services and different aspects of satisfaction, as the results in this study suggest they have a differential effect on quality of life. Finally, in terms of the factors that were found to be determinants of specific quality of life domains, the findings in this study seem to reflect a biopsychosocial rather than a biomedical perspective on health. That is, factors other than the medical severity of spina bifida appeared to explain differences in quality of life and it was the psychosocial aspects rather than physical functioning aspects that were primarily affected.
In Study Three, the health-related quality of life of participants from Study One was re-assessed after fifteen months. It was found that changes in health reaching statistical significance were physical functioning, behaviour and mental health. Utilisation of medical services did not appear to influence change in quality of life scores (except for visits to the Accident and Emergency Department and radiological investigations on the mental health score). However these findings should not be discounted altogether as clinically, any change may have utility in assessing the impact of particular methods of treatment/rehabilitation. While medical care services make an important contribution to improving the health status of children with spina bifida this finding suggests that there are other factors influencing healthrelated quality of life which were not measured in this research.
It is recommended that, the information provided by health-related quality of life measures may be an important adjunct to traditional measures of therapeutic evaluation.
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Turnbull, Deborah Anne. "Psychosocial issues in implementing mammography screening in Australia." Phd thesis, Faculty of Arts, 1992. http://hdl.handle.net/2123/8575.
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Bassetto, Gustavo Xavier. "O idoso e a proteção normativa da saúde." Pontifícia Universidade Católica de São Paulo, 2018. https://tede2.pucsp.br/handle/handle/21127.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
This paper analyzes the historical evolution of health and elderly standards, the influence of international events on Brazilian norms, the recognition of the right to health as a fundamental right, the Brazilian health system from the Federal Constitution of 1988, norms the protection of the elderly and their health. The effectiveness of norms for the protection of the rights of the elderly can be determined by indicators from the political matrix and its objectives
Este trabalho analisa a evolução histórica das normas de saúde e do idoso, as influências frente aos acontecimentos internacionais nas normas brasileiras, o reconhecimento do direito à saúde como um direito fundamental, o sistema de saúde brasileiro a partir da Constituição Federal de 1988, as normas de proteção à pessoa idosa e à sua saúde. A efetividade das normas de proteção dos direitos da pessoa idosa pode ser apurada por indicadores a partir das matrizes políticas e de seus objetivos
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Erstad, Ida. "The resurgence of tuberculosis in South Africa: an investigation into socio-economic aspects of the disease in a context of structural violence in Grahamstown, Eastern Cape." Thesis, Rhodes University, 2007. http://hdl.handle.net/10962/d1002653.
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This thesis is an investigation into the socio-economic constraints that influence the decisions of tuberculosis sufferers in the health seeking process and therapeutic management of tuberculosis in Grahamstown, the Eastern Cape. It is shown that structural violence influences experiences and perceptions of tuberculosis at all levels. Management of tuberculosis in the formal health sector is explored at local levels and related to national and global strategies of health care. The role of health workers, and particularly voluntary health workers, is explored and it is shown that they work within a context of growing burden of sickness and co-infections and a lack of government commitment to deal with increasing TB and HIV incidences. Kleinman’s notion of explanatory models is explored and it is evident that although knowledge of the aetiology of tuberculosis is well-known to patients and general members of the communities, they are nevertheless victims of increased stigmatisation and marginalisation as a result of illness. The importance of social support in curing tuberculosis is explored using Janzen’s concept of therapy managing groups. Social capital is a fundamental component in adhering to biomedical therapy, but is commonly weak among the structurally poor. The availability of temporary social grants for people living with TB influences health seeking behaviour. In a context of structural poverty the sick are faced with what Nattrass terms “perverse incentives”, having to choose between the right to health and the right to social security, both guaranteed in the South African Constitution, for him/herself and dependants. Although adherence to biomedical therapy is essential in curing tuberculosis, it is shown throughout this thesis that ignoring wider structural causes of disease limits the patient’s ability to get well. The ethnography shows that the right to health is a social and economic right which is not the reality for most South Africans.
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Hreinsson, Julius, and Yonathan Woldearegay. "Internationalization of health care services : Networking aspects." Thesis, Uppsala universitet, Företagsekonomiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-243306.
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Principles of business management are increasingly being used to analyze health care systems. Conceptualizing health care as business networks offers the possibility to apply the ARA model of Actors, Resources and Activities to understand the functioning of the system. We have used this model to study the phenomenon of networking in cross-border care using Uppsala University Hospital as a research case. The aim of the study was to understand actor’s perceptions of networking activities and how these related with international sales of health care services. We collected primary data through five interviews with managers involved in internationalization and a survey study with 26 managers at the hospital. Secondary data on patient flows and research activity was collected from hospital and university records. The main actors identified in the health care networks are doctors with professional identity being an important facilitating factor. Patient´s role as active participators in the system is increasing while researchers, innovators and key opinion leaders are also important. Networking activities consist of knowledge transfer via lecturing, meetings and external consulting activities. Resources in the form of supporting clinics, research centers and administrative services correlate positively with the level of internationalization. The study identifies networking activities as important for internationalization and cross-border sales of health care services. We conclude that the ARA model is a valuable instrument for analyzing cross border activities and internationalization of health care.
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Slattery, M. "Demographic aspects of resource allocation to Health Services." Thesis, University of Southampton, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.374235.
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Korda, Rosemary. "Socioeconomic inequalities in health care in Australia : differential impacts on mortality and inequalities in the use of services." Phd thesis, 2008. http://hdl.handle.net/1885/150898.
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Simelane, Mandla Collen. "Socio-economic and socio-cultural factors influencing people's involvement and participation in the animal health service at Madinyane." Diss., 2001. http://hdl.handle.net/2263/29057.
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Davies, Michael John. "The role of commonsense understandings in social inequalities in health : an investigation in the context of dental health / Michael Davies." 2000. http://hdl.handle.net/2440/19680.
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Bibliography: leaves 203-219.219 leaves : ill. ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Concerned with the contribution of commonsense understandings of disease to social differentials in health outcomes. Argues that understandings in part reflect the social circumstances of an individual and mediate preventive activities and use of services, thereby influencing health outcomes. These are examined using the specific health outcomes of tooth loss and tooth decay.
Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2000