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McCabe, Helen, i res cand@acu edu au. "The Ethical Implications of Incorporating Managed Care into the Australian Health Care Context". Australian Catholic University. School of Philosophy, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp48.29082005.
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AIMS Managed care is a market model of health care distribution, aspects of which are being incorporated into the Australian health care environment. Justifications for adopting managed care lie in purported claims to higher levels of efficiency and greater ‘consumer’ choice. The purpose of this research, then, is to determine the ethical implications of adapting this particular administrative model to Australia’s health care system. In general, it is intended to provide ethical guidance for health care administrators and policy-makers, health care practitioners, patients and the wider community. SCOPE Managed care emerges as a product of the contemporary, neo-liberal market with which it is inextricably linked. In order to understand the nature of this concept, then, this research necessarily includes a limited account of the nature of the market in which managed care is situated and disseminated. While a more detailed examination of the neo-liberal market is worthy of a thesis in itself, this project attends, less ambitiously, to two general concerns. Firstly, against a background of various histories of health care distribution, it assesses the market’s propensity for upholding the moral requirements of health care distributive decision-making. This aspect of the analysis is informed by a framework for health care morality the construction of which accompanies an inquiry into the moral nature of health care, including a deliberation about rights-claims to health care and the proper means of its distribution. Secondly, by way of offering a precautionary tale, it examines the organisational structures and regulations by which its expansionary ambitions are promoted and realised. CONCLUSIONS As a market solution to the problem of administering health care resources, the pursuit of cost-control, if not actual profit, becomes the primary objective of health care activity under managed care. Hence, the moral purposes of health care provision, as pursued within the therapeutic relationship and expressed through the social provision of health care, are displaced by the economic purposes of the ‘free’ market. Accordingly, the integrity of both health care practitioners and communities is corrupted. At the same time, it is demonstrated that the claims of managed care proponents to higher levels of efficiency are largely unfounded; indeed, under managed care, health care costs have continued to rise. At the same time, levels of access to health care have deteriorated. These adverse outcomes of managed care are borne, most particularly, by poorer members of communities. Further, contrary to the claims of its proponents, choice as to the availability and kinds of health care services is diminished. Moreover, the competitive market in which managed care is situated has given rise to a plethora of bankruptcies, mergers and alliances in the United States where the market is now characterised by oligopoly and monopoly providers. In this way, a viable market in health care is largely disproved. Nonetheless, when protected within a non-market context and subject to the requirements of justice, a limited number of managed care techniques can assist Australia’s efforts to conserve the resources of health care. However, any more robust adoption of this concept would be ethically indefensible.
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Campos, Marta Sofia Branquinho de. "Health care needs and resources distribution: how to allocate financial resources in primary care trust?" Master's thesis, NSBE - UNL, 2011. http://hdl.handle.net/10362/10059.
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A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and EconomicsMaking a good allocation of the resources available is crucial to ensure a good operation of the system. In Portugal the allocation of resources in Primary Care Trust was made, mainly by historical values. In the last year, the Central Administration of the Health System proposed a new way of allocating the financial resources in Primary Care Trust. The goal of this study is to find different possibilities for allocating the financial resources in Primary Care in Portugal. We use data from the Central Administration of the Health System. The Proposal uses linear and quantile regressions, having the per capita costs as a dependent variable. Finally, it was decided on what rule would be better, looking at an economical and statistical criterion.
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Beecham, Jennifer Kate. "Community mental health services : resources and costs". Thesis, University of Kent, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319222.
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Sundquist, Kristina. "Individual health, neighborhood characteristics, and allocation of primary health care resources /". Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-595-6/.
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Gore, Alexis D. "Management of Athletes’ Medications". The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1250529602.
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Plews, Caroline Margaret Coatsworth. "Clients' reports of the work of health visitors in the child health clinic and during home visits". Thesis, University of Hull, 2001. http://hydra.hull.ac.uk/resources/hull:4626.
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This study examines clients' reports of aspects of a single child health clinic visit and of a home visit by the health visitor. There are two foci of the thesis. First: recall; value and use of the advice/information selected by the client as the most important; second, an exploration of the meaning of support identified by some clients.Seven health visitors participated in the research, which incorporated two studies. In the first study, the researcher observed the content of discussions between 100 clients and the health visitor in child health clinics. These clients were then interviewed at home and asked questions about the advice/information received from the health visitor during theirprevious visit to the child health clinic.For the second study, information was recorded by the health visitor describing the content of 149 home visits. Clients were interviewed at home and asked similar questions regarding advice/information received from the health visitor. In addition, those clients who described receiving support were asked to describe the meaning to them of this aspectof the visit.Data analysis for both studies included descriptive and inferential statistics and content analysis.Findings from both studies indicate that recall of advice/information is related to the amount of advice/information given to the client. This may have implications for the amount of advice/information that health visitors are encouraged to provide.Advice/information received from the health visitor was generally valued and used by the mothers in both studies. Clients appeared most likely to be dissatisfied when topics had been raised which they had no interest in discussing. It is suggested that that there may be correspondence between some clients' descriptions of support, and taxonomies of social support found in social support literature. An exploration of health visiting work employing the concepts of social support is recommended.
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Kiracho, Elizabeth Ekirapa. "Equity in the allocation of primary health care resources in Uganda". Master's thesis, University of Cape Town, 2006. http://hdl.handle.net/11427/8915.
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Alanko, Eira. "Delivery care in Quang Ninh province, Northern Vietnam : resources and access to safe care". Thesis, Högskolan Dalarna, Omvårdnad, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:du-3681.
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Every mother and child has the right to survive childbirth which requires skilled birth attendants together with referral and available emergency obstetric care (EmOC). The objective of the study was to describe delivery care routines at different levels in the health care system in Quang Ninh province, Northern Vietnam. The design was cross sectional using a structured questionnaire. Two districts in Quang Ninh province with 40 Community Health Centres (CHC), three district hospitals and one region hospital was included in the study, in total 138 (CHC n=105 and hospitals n=33) health care providers participated. In our study 20% (CHC) of the health care providers assisting deliveries at CHC were midwives and health care provider’s in our study further report to have assisted at less then 10 deliveries/year (81% of respondents at CHC). Findings show that the health care provider’s routines and care for women during labour and delivery vary and that there is a need for re-training and that women in labour should be cared for by health care providers with adequate training like midwifery. In our study CHC had poor resources to provide basic or comprehensive EmOC. Our findings indicate that there is a need for re-training in delivery care among health care providers and since the number of deliveries at CHC is few they should be handled by someone who is a skilled birth attendant. Our findings also show a variation in care routines during labour and delivery among health care providers at CHC and hospital levels and this also show the need for re-training and support from proper authorities in order to improve maternal and newborn health.
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Glover, Gloria. "Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, and Quality of Care". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7142.
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The value-based purchase requirement of the Patient Protection and Affordable Care Act puts pressure on hospital leaders to control cost while improving quality of care. The resource dependency theory was the theoretical framework for this correlational study. Archival data from the Centers for Medicare and Medicaid Services collected from 166 acute care urban hospitals for the Fiscal Year 2016. Multiple linear regression analysis was used to determine the relationship between nursing salaries per patient day, cost of uncompensated care as a percentage of net patient revenue, percentage of net income from patient services, and overall patient satisfaction for quality of care received. The multiple regression analysis results indicated the model as a whole to significantly predict overall patient satisfaction for quality of care for the Fiscal Year 2016, F (3,162) = 13.788, p = .000, and R2 = .203. In the final model, all 3 independent variables significantly predicted overall patient satisfaction for quality of care. Nursing salaries per patient day and percentage of net income from patient services were significant positive predictors of overall patient satisfaction for quality of care. Nursing salaries per patient day (� = .366, t = 5.120, p = .000) accounted for a higher contribution to the model than percentage of net income from patient services (� = .169, t = 2.374, p = .019). The cost of uncompensated care as a percentage of net patient revenue displayed a significant negative relationship with overall patient satisfaction for quality of care (� = .176, t = 2.458, p = .015). The implications of this study for positive social change include the potential to enhance the quality of care for patients while maintaining local hospitals' financial viability.
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Vega-Romero, Roman Rafael. "Health care and social justice evaluation : a critical and pluralist approach". Thesis, University of Hull, 1999. http://hydra.hull.ac.uk/resources/hull:7955.
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This thesis proposes a critical, systemic and pluralist approach to evaluating health programs. It examines ways in which efforts to promote equality and plurality are undermined by the application of foundationalist and universal conceptions of social justice and evaluation. This approach is developed within the current debate taking place in the field of Critical Systems Thinking, particularly in the area of the evaluation of social and health programs. It is argued that the potential for equality and plurality in Western societies goes beyond the questions of economic exploitation, military, cultural and political oppression and encompasses the relation between power and knowledge which is inherent in rationalities governing the formulation, the implementation and the operation of health programs. The thesis offers an alternative view of social justice that conciliates equality with plurality, and promotes these values through an evaluative procedure. Using Foucault's philosophy, it is proposed that a nonfoundationalist conception of social justice should be understood in terms of the interactions between three areas of human activity, namely knowledge, morality, and techniques and technologies of government. As regards the possibilities for developing a non-foundational and non-universal evaluative judgement, the thesis assumes a decentered conception of truth in the analysis of society and morality, and acknowledges the role of power as factor of generalisation or diversification of truth. Thus complexes of power-knowledge-morality are at the centre of our evaluative judgements of social justice. In order to encourage equality and plurality, this thesis proposes a rationale for evaluation that includes three main methodological guidelines: a decentered conception of critique regarding the problems and negative effects of a health program (unfolding in reverse); the promotion of subjectivity (autonomy, diversity, solidarity) through self-knowledge and self-regulation of desires (folding); and participation in the reordering of society through an ethical and political process of decision-making (ethical and political unfolding of the situated truths of the subjects). The processes are designed to interrelate and iterate in a complex way. They should include the exploration, choice and combination of methods and/or their parts, and of the strategic positions in scientific and ethical discursivities by thinking critically and acting in a situated and participative way.
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Newton, Benjamin Robert. "Facing scarce health resources in the future: from reform to rationing". Thesis, Boston University, 1998. https://hdl.handle.net/2144/27732.
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Boston University. University Professors Program Senior theses.PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
2031-01-02
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Abbott, Katherine Harris. "BLENDING RESOURCES: INFORMAL NETWORKS AND HEALTH CARE UTILIZATION BY FRAIL MALE VETERANS". online version, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=case1118329438.
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Chilvers, R. "Planning framework for human resources for health for maternal and newborn care". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2014. http://researchonline.lshtm.ac.uk/2124342/.
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With approximately 1.3 billion births estimated to be taking place globally over a decade up to 2020, the demand for maternal and newborn health (MNH) workforce continues to be a key aspect of public health service delivery. Human resources for health (HRH) projection models can contribute the quantitative evidence required for policy design for education commissioning and distribution of skilled personnel. To date, HRH supply and requirement projection models have not been developed specifically for system-based subnational planning within maternal and newborn care. In addition, current methodologies are often limited to national level and have a professional silo approach to considering the workforce, with informing policy and planning as a secondary consideration. The aim of this thesis was to fill the gap through improved understanding of the role of HRH projections for policy and development of a new model for projecting the future MNH clinical teams with spatial equity and system perspective at the centre of the planning framework. The specific objectives were to • review the literature for strengths and limitations for current HRH planning and outline the main components of an evidence-informed MNH-HRH planning framework with relevance to subnational contexts and MNH systems • translate the main components into a working prototype as a spreadsheet-based model to estimate and MNH-HRH requirements and supply for each occupation • apply the MNH-HRH planning model in three countries from low to high income contexts and critique the implications for future research and development in this field. Following the construction of a new planning framework, a working prototype called the ‘MNH.HRH Planning App’ was developed. The spreadsheet-based model was applied using secondary data sources to England, Bangladesh, and Ethiopia which have varied health systems, levels of spatial disaggregation and HRH structures for MNH care. The thesis concludes by highlighting the implications of the new planning framework for the future development of a web-based MNH.HRH Planning App, potential for engaging policy-makers for evidence-informed planning and contributes to the wider discourse on the use of quantitative projection models for planning the future human resources for healthcare.
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Bakhashwain, Abdullah Saeed. "Acceptance and utilisation of primary health care in Jeddah City, Saudi Arabia". Thesis, University of Hull, 1995. http://hydra.hull.ac.uk/resources/hull:3798.
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The provision of health services to all the population is one of the highest priorities in many governments' agenda, because the health system, education and social security are important indicators of the level of development of a state. However, the provision of health services to cover all the population is not easy, particularly in many developing counnies, which lack human and financial resources. In 1978, at Alma - Ata WHO and UNICEF jointly declared the primacy of the primary health care ( PHC) approach for achieving the WHO's social goal, " health for all the people by the year 2000". Since then, PHC has become a major concern on national and international levels. Saul Arabia one of the countries which has adopted and implemented the PHC approach.This study explores the implementation of the PHC approach, the utilisation of health services delivered at the health centres and health awareness in Jeddah, a major urban centre in Saudi Arabia, where public and private health services co-exist and compete, and where traditional medicine is still used and practised. A sample comprising both utilisers of the PHC centres and non- utilisers were questioned about their health practices, beliefs and attitudes, and an attempt was made to determine whether socio- economic and demographic characteristics were significantly related to utilisation and health awareness. No single pattern of attitude or behaviour was found to be consistently related to socio-economic or demographic characteristics. However, the findings indicate the general significance of education.The nature of service provision was found to affect satisfaction and a need was found to improve the quality of the health service and to remove bureaucratic barriers which impede utilisation. Although many aspects of PHC are successfully implemented, there is evidence of misunderstandings of the approach by both consumers and providers, which limits both utilisation and satisfaction. In particular providers and users still prioritises curative above preventive medicine, health education is still neglected, and the potential of the media in this respect is under-exploited.Finally, traditional medicine was found to be used and practised, but the finding; indicate there is not necessarily a conflict between the two systems. They appear to be used in a complementary way, and them may be scope for integration.
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Grubb, Penelope Ann. "The impact of information technology upon primary health care in Great Britain". Thesis, University of Hull, 1991. http://hydra.hull.ac.uk/resources/hull:4567.
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This is a study of the impact of information technology on health care in Great Britain. Its major aim is to identify means by which information technology may improve the quality of health care in specific areas within the health services.The study concentrated upon general practice and was split into three stages. The first was a survey of general practice computing, conducted to give an overview of the use of computers in general practice. Following this, was a more detailed study of general practice miniclinics. The final stage was an in-depth investigation into the use of computers in the care and treatment of diabetes.
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Walsh, Michael Paul. "Critical systems thinking, dialogue and quality management in the National Health Service". Thesis, University of Hull, 1995. http://hydra.hull.ac.uk/resources/hull:3900.
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This thesis considers quality in the National Health Service (NHS), the theories of dialogue, critical systems thinking, and quality - and how these domains can be related together to produce a new concept of quality called critical quality.A quality gap is identified between what the NHS produces and what the public requires of it. It is argued that this gap is unfair because of the generally unequal access of stakeholders to decisions about quality in the NHS. It is suggested that only through dialogue can the gap be reduced in size in a non-oppressive way.Principles of dialogue are derived from Habermas's (1991a,b) theory of communicative action and applied to interest group relationships using Grant's (1989) insider/outsider model. It is argued that critical systems thinking can be enhanced by embedding interventions within processes of dialogue, and that the analysis of insider/outsider relationships in situations can guide the use of critical systems thinking in creating dialogues.Three modes of quality management are identified (strategic, normative and critical). It is argued that the requirements and needs of the public cannot be met by an NHS that is dominated by strategic and normative quality. Instead critical quality, defined as the specification of services by mediation through dialogue between stakeholders, is advocated as a fairer mode of quality management for the NHS.An NHS quality dialogue (the Trent Quality Initiative) is evaluated. Dialogue is found to have occurred both within and between meetings. Two modes of peer group participation are identified (main dialogue vs meta-dialogue) and two general approaches to the implementation of critical quality in the NHS (incremental vs radical). Finally critical quality in public welfare services is discussed and a research agenda outlined for dialogue, quality and critical systems thinking.
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Jutan, Norma M. "Home care in Ontario: Allocation of limited resources and the needs of light-care clients". Thesis, University of Waterloo, 2006. http://hdl.handle.net/10012/2806.
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There is the desire amongst elderly Canadians to remain living at home, maintaining their independence. As the population ages, the health care system is faced with the challenge of allocating limited resources. Home care in Ontario is provided through Community Care Access Centres (CCAC) or Community Support Agencies (CSA). This study made comparisons among CSA clients (using the interRAI-Community Health Assessment, n=796), a sub-population of CCAC clients with lighter-care needs (n=8163) and all other CCAC clients (n=31,078), both using the Minimum Data Set-Home Care (MDS HC). The majority of clients in all groups were female, widowed, and spoke English as their primary language. CCAC clients had more health conditions than did CSA clients. Light-care CCAC clients received less hours of formal support than other CCAC clients and were less likely to have informal support caregivers who reported caregiver burden. Between 1998 and 2005, Ontario provided services to an increasingly impaired home care population, although overall impairment among home care client remained low. For the purposes of benchmarking, MDS HC data from Ontario was compared with MDS HC data from 11 European countries and was found to fall within the range of the other countries in terms of average impairment level of home care clients. Logistic regression was used to predict the likelihood of receiving CCAC services. Not being self-reliant, having decline in activities of daily living, having experienced falls, self-reporting one's health to be poor and reporting less loneliness were all correlates for CCAC service use. Implications and direction for future research were discussed.
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Tolliver, Robert Matthew, Deborah Thibeault, Gayatri Bala Jaishankar, Karen E. Schetzina i Jodi Polaha. "Linking Families to Resources: Assessing Social Determinants of Health in Pediatric Primary Care". Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5033.
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Background/Rationale: The American Academy of Pediatrics recommends universal surveillance of social determinants of health in primary care. Addressing these determinants is likely crucial to reducing extant health disparities. Such screening in urban pediatric primary care has been shown to increase access to relevant resources for families when combined with provider training in using a community resource binder (Garg et al., 2007). However, resources in more rural areas are often scarce and helping families navigate a complex resource system often requires a more individualized approach. Additionally, in an increasingly screener heavy pediatric environment, social determinant screeners that are comprehensive but brief are needed to reduce the burden on both patients and providers.
Methods/Results: A brief TEAM Care social determinants screener protocol was developed to meet the needs of families presenting to ETSU Pediatrics. Our clinic serves primarily low income families, many of which live in ruralareas. During the first eight months of data collection, 2043 TEAM Care screeners were administered at annual well child checks. The prevalence of caregiver endorsed concerns was as follows: financial concerns impacting ability to pay for food, housing, or utilities (7%), transportation problems (4%), caregiver depression (4%), concerns about caregiver drug/alcohol use (2%), domestic violence (1%), and literacy problems (1%). 13.4% of caregivers endorsed at least one concern on the screener. Caregivers who endorsed a concern were provided individualized resources via a warm handoff or phone call by integrated social work interns. Interns were available on an ongoing basis to check in with families, adjust resource recommendations as needed, and coordinate care with the child’s primary care physician. Our poster will report on an anticipated 3000 TEAM Care screeners collected during the first year of administration.
Conclusion: Last year at CFHA, we reported the initiation of the TEAM Care Screener, modeled after the WE CARE Screener (Garg et al., 2007) and designed to screen for social determinants of health in pediatric primary care via six items. Previous preliminary reports of this study included data from approximately 1000 screeners. A one year report of the TEAM Care screener will be completed in September 2017, making it ideal timing to present at CFHA in October 2017. We anticipate reporting prevalence data from 3000 screeners and incorporating results from a provider satisfaction survey of the screener process. The TEAM Care screener process was designed to maximize efficiency for families and providers, and the addition of social work interns ensures that families who endorse needs receive individualized help. A future goal is to more systematically follow up with families to determine how many were connected to recommended resources.
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Mubangizi, Deus Bazira. "The public-private mix health care resources distribution implications for equity : Kampala district, Uganda". Master's thesis, University of Cape Town, 2002. http://hdl.handle.net/11427/9447.
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Bibliography: leaves 93-97.While in sociology, choice and equity have always co-existed; this has not been a subject of attention in the health care market. Following promotion of the public- private mix in the health care sector, there have been concerns that the pursuit of efficiency might compromise equity in accessing health care services. The main concern for this study was that the resulting relative health care resources distribution following public-private interaction has equity implications at the household level. Kampala district in Uganda was used to investigate this concern. Data collected from a household survey, key informant interviews and secondary data on health care resources distribution, was analyzed using STATA statistical package. The study findings indicated that the private health care sector in Uganda has grown in size and that it caters for more people in Kampala district than the public health care sector. The findings further indicated that households use private services due to the perceived high quality of services, availability of drugs, availability of doctors and other health workers and the nearness of private providers. On the other hand, public health services where used or preferred was due primarily to availability of doctors. Other findings indicated that there was a relationship between provider choice/use and the distribution of health care resources particularly; health workers and health care facilities. This applied both at household level and geographically. Utilization of health services also varied with distribution of the same resources. Private provider use was not solely dependent on income and hence ability to pay, but on other factors related to service characteristics such as perceived quality. The findings further show that there are inequities in financing health care services with low-income groups paying relatively more than high- income groups. The study proposes to policy makers a monitoring mechanism of the variables and outcome measures, both at household and sectoral level, in order to minimize inequities in access to health care. The study also recommends that a comprehensive regulatory framework needs to be set up to promote and control the activities of the private health sector in Uganda.
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Ellis, Jeremy Charles. "Medical informatics : the generic interchange of comprehensive health data". Thesis, University of Hull, 1999. http://hydra.hull.ac.uk/resources/hull:4636.
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The objective of this project was to study the area of generic transfer of comprehensive medical data.The work presented in this thesis had as its main premise the belief that generic transfer of comprehensive medical data will help towards the goal of better healthcare particularly in an environment of shared care. It studied the main methods of data transfer available at present, and as a result carried out an in depth review of one such method adopted by the National Health Service (NHS). Criticism of this method was made. These criticisms lead on to the development of an alternative method of generic data transfer based on an emerging European standard for the storage of medical data. This in turn led on to the consideration of data in legacy systems. Finally, an evaluation of the developed method was undertaken.
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Munnoch, Robert Alexander. "Bio-signal data gathering, management and analysis within a patient-centred health care context". Thesis, University of Hull, 2017. http://hydra.hull.ac.uk/resources/hull:16445.
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The healthcare service is under pressure to do more with less, and changing the way the service is modelled could be the key to saving resources and increasing efficacy. This change could be possible using patient-centric care models. This model would include straightforward and easy-to-use telemonitoring devices and a flexible data management structure. The structure would maintain its state by ingesting many sources of data, then tracking this data through cleaning and processing into models and estimates to obtaining values from data which could be used by the patient. The system can become less disease-focused and more health-focused by being preventative in nature and allowing patients to be more proactive and involved in their care by automating the data management. This work presents the development of a new device and a data management and analysis system to utilise the data from this device and support data processing along with two examples of its use. These are signal quality and blood pressure estimation. This system could aid in the creation of patient-centric telecare systems.
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Heinrich, Stephanie, i Hermann-Josef Gertz. "German adaptation of the Resources for Enhancing Alzheimer’s Caregiver Health II". Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-137169.
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Barker, Wendy Vanessa. "Enhancing independence and the quality of life of older people through intermediate care : a mixed methods evaluation". Thesis, University of Hull, 2008. http://hydra.hull.ac.uk/resources/hull:6674.
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Arabiat, Diana H. "An investigation into the psychological wellbeing of children and young people with cancer in Jordan". Thesis, University of Hull, 2007. http://hydra.hull.ac.uk/resources/hull:12531.
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Now treatment of paediatric malignancies is capable of extending the life of children with cancer, there is an increase move toward investigating the quality of life and needs experienced by children and young people diagnosed with cancer. Although earlier investigations examined differences in adjustment among children with cancer and their healthy counterparts, the results of these studies were inconclusive, and there is a considerable lack of studies of the psychological wellbeing of children in the Middle East. In this thesis, two central themes are examined: first, the psychological status of children and young people with cancer in Jordan as indicated by their quality of life and symptoms of anxiety and depression; second, patterns of communication of cancer diagnosis in families caring for children with cancer, to develop a better understanding of Jordanian children's experience with cancer. Fifty eight children and young people and their mothers attending the paediatric oncology services in Jordan participated in this study. In an attempt to explore their psychological wellbeing in greater detail, the study involved another group of fifty six children and young people with chronic illness and a control group of sixty four healthy peers. Three assessment tools were translated into Arabic, piloted and tested for reliability and validity at a number of schools all over Jordan. Then, the tools were administered to the three groups. Participating children and young people were asked to complete self-reported depression and anxiety scales, as well as an instrument to measure the quality of life. Thirty seven mothers of children and young people with cancer completed a self-report measure of stress, anxiety and depression. Mothers were also asked during the interview about the amount of information they shared with their children and their satisfaction with the way the cancer diagnosis was communicated to their children. The results showed that children and young people with cancer function at a very similar level to children and young people without cancer. There were no significant differences on the measure of depression, between the scores of children and young people with cancer, chronic illness and the healthy group. On the quality of life measure, the healthy group scored significantly higher than the children and young people in the other two groups. At the same time, the healthy group scored significantly higher on the anxiety measure. It is suggested that children and young people with cancer are able to cope with their illness because they utilise defensiveness as an adaptive mechanism, since higher scores for defensiveness were associated with lower scores for child-reported depression and anxiety in this group and a significant difference in the level of defensiveness exists between the three groups. This supports previous findings. In addition to these results, this thesis shows that exploring children's and young people's psychological distress in a culture where this is not recognised provides the researcher with a number of concerns. The influence of Arab culture and religion on Jordanian children and young people, the communication patterns of cancer diagnosis, the wisdom of their elders, and the importance of their family result in reluctance to show emotion or to question decisions made on their behalf. The results of quantitative findings and contextual information from the interviews in this thesis go some way to demonstrate the impact that cancer can have on both the patient and family in the Jordanian culture. The child's quality of life can be compromised by the illness. Moreover, communication of the diagnosis of illness has a detrimental effect on both child's and mother's psychological wellbeing.
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Chen, Yanhua. "Developing and validating a scale to study mentors' behaviour in nursing education". Thesis, University of Hull, 2015. http://hydra.hull.ac.uk/resources/hull:15413.
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Aim To study the conceptualization of mentors‘ behaviour and develop and validate a scale based on that to assess students‘ expectation and measure mentors‘ actual performance. Background In the field of clinical nursing education in China, mentors are struggling with student mentoring as no national guidelines exist and proper training is unavailable and nursing students are suffering from a low quality of learning and negative experiences. Design A mixed methods exploratory sequential design. Methods At the development and validation stage eleven steps were taken; mixed methodology was used, including focus group and cross-sectional survey with a large sample from China (n=669); in data analysis both classical test theory (exploratory and confirmatory factor analysis) and item response theory (Mokken scale analysis) were conducted. Results Mentorship in nursing was conceptualized as a model with three correlated factors, i.e. professional development, facilitating learning and psychosocial support, which was guided by the theoretical framework generated through 46 studies and supported by exploratory factor analysis, confirmatory factor analysis and Mokken scale analysis. Conclusion This new scale based on this conceptulization is reliable, valid and scalable, which is supported by a wide range of psychometrics. It has shown good content validity according to review by nine mentor experts from the UK, stability over time, homogeneity in content, differentiability between extreme groups and hierarchical properties of mentors‘ behaviour in importance and reliability and moderate precision of ordering students‘ expectation. Therefore the mentorship in clinical nursing education is conceptualized as a three–correlated factor model and it is hierarchical in importance. This scale could find utility in nurinsg education in China.
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Tweheyo, Ritah. "Exploring how women negotiate pregnancy in respect to food behaviours and weight status : an interpretative phenomenological study". Thesis, University of Hull, 2016. http://hydra.hull.ac.uk/resources/hull:14556.
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This study is a longitudinal exploration of women’s eating behaviours and weight status during motherhood starting from pre-conception, through pregnancy and into the early postpartum period. The study aimed to explore how women negotiate pregnancy in the context of food and weight status using IPA. The rationale was to capture from the diverse voices of different women what is important to them at these different time points and collectively how this informs behaviour in the motherhood journey. The participants consisted of three different, randomly selected sample sets of women 20- 40 years. Focus groups were carried out with 10 never pregnant women, followed by serial individual interviews with five currently pregnant women, and five women who had recently given birth, interviewed at 2 different time points. The findings highlight a change in women’s priorities described in superordinate themes along the motherhood cycle. Women’s priorities changed starting in pre-conception with a strong sense of self and realisation of limited time for childbearing, to focussing on the baby at the expense of the self, during and after pregnancy. The findings strongly show that women’s eating has emotional, biological and gendered meanings during the transition to motherhood. Socialisation, social events, expectations and peer support also strongly influenced how women negotiated conflict in this continuum. There are tensions in the postpartum period between the new focus on the baby (emerging during pregnancy), which prescribes healthful eating, and the stresses of a new motherhood lifestyle which reverts women to emotional eating (present preconceptually). In negotiating these tensions, women adopt the digital discourse as part of self-support behaviours in addition to trust and desire for the support of HCPs and significant others. The findings have implications for lifestyle interventions that acknowledge these tensions, women’s priorities and their coping strategies.
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Crockett, Cassandra E. "Knowledge, access, and utilization of health care resources by minority residents in rural areas". Connect to this title online, 2006. http://etd.lib.clemson.edu/documents/1175186281/.
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Harper, Paul Robert. "Operational modelling for the planning and management of healthcare resources". Thesis, University of Southampton, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.249668.
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Adindu, Anthonia U. "The effect of incongruity on quality of health information systems : Bama, Nigeria PHC case study". Thesis, University of Hull, 1995. http://hydra.hull.ac.uk/resources/hull:3692.
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Generally, organisations mobilise information from varying sources on which policies, plans, objectives and organisational management are predicated. indeed, everyone within organisation needs information to perform tasks, it is thus indispensable and its use so pervasive that a methodical approach for collection and processing is imperative. In health care organisations, involved with people and life, this is even of greater significance, in many instances allowable margin of error is narrow and can be devastating.Accurate and reliable information in clinical care for example cannot be compromised.On the other hand, adequate assessment of health services quality,effectiveness and efficiency depends on quality of information generated by the system, that is, accurate, relevant, timely, understandable and complete information. To achieve this, appropriate system design and operation is essential. Adoption of primary health care (PHC), in many developing countries in response to the Global 2000, necessitated establishment of chanisms for monitoring and evaluating effectiveness of services and programmes.Accordingly, in 1986 PHC was adopted in Nigeria, concomitantly, system monitoring and evaluation or the PHC Management Information System was effexted.The information system was envisaged to ameliorate the lack of reliable health information that has persisted since nception of modern health services in Nigeria. Findings in this and other studies indicate that existing health information systems have failed to provide accurate and reliable information, systems of data generation and processing are ineffective.The aim of this was to identify and understand factors that have contributed to the seemingly intractable and insalubrious information problem within the Nigerian health care system. It would be a herculean task for a lone researcher to undertake study of the entire health system, within resource and time limitations, data collection was therefore narrowed to the PHC level. Quality of the PHC management information system was assessed, with Bama Local Government as a case study. Focus was on understanding the information system's structure from a broad perspective to include, policies, objectives,established procedures; physical, material and human resources, in terms of their quality and quantity.Data collection was carried out using both qualitative and quantitative techniques. The structure, process and outcome models provided a framework for in-depth data collection, through observation, interview, review of records and administration of questionnaire, as well as for organisation and analysis of research data. The PHC MIS was followed through, from the village, health facility, local government, state and national levels.Study results suggest general ineffectiveness due to pervasive incongruity in the information system. In the first instance design of the MIS did not reflect information needs of community health workers and the community in general,who to the most part limited appreciation of the MIS structure, objectives to be achieved. Local and regional information need was not delineated, data collected had little relevance to local information needs, resource for systems operation was abysmal, skilled personnel and training provided severely inadequate.Consequently, data collection and processing was hampered, information produced often inaccurate, untimely, immense, irrelevant and unreliable. Data collected were neither analysed nor utilised. The information system was short of being integrated since 60% of functional units within the PHC department as well as related health organisations in the community ran parallel information systems.Research data point to serious incongruity in the organisation and management of the information system. Incongruity that resulted from factors within the organisation as well derived from events within the wider social environment, which however culminated in an effective and dysfunctional information system.Chapters one to three of the thesis deal with conceptual issues related to management information systems, organisational design and quality respectively. In chapter four methodological issues surrounding data collection were discussed. Empirical data and analysis are presented are presented in chapters five to seven. In chapter eight, an attempt was made to develop a model of organisational incongruity, applied to explicate research findings.Chapter nine focuses on measures toward establishment of an effective PHC information system in Nigeria, contributions of this study and suggestions for future research.
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Al-Ghamdi, Mohammad Ali. "Knowledge, attitude and practice of hospital senior and middle management towards health care quality programs in eastern Saudi Arabia". Thesis, University of Hull, 2007. http://hydra.hull.ac.uk/resources/hull:5843.
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Quality programs are not new to Saudi hospitals. The first known quality program was started in ARAMCO Hospital in 1982. Besides the Ministry of Health, the main provider of health care, more than 15 providers share in the delivery of the health care in Saudi Arabia. Quality activities being sporadic, with no national control, the programs depend'heavily on the top management commitment and support. The success of quality programs varies among the different health care providers. Hence the need to investigate the knowledge, attitude and practice of the senior and middle managers (HSMM) towards quality programs. The findings of their investigation could throw some light on some incorrect concepts and explain the reasons behind the ineffective practice of quality. Two studies were conducted simultaneously for this research. A descriptive study to investigate the knowledge, attitude and practice of the HSMM, for which two data collecting tools were used. The HSMM self administered questionnaire was completed by the HSMM of 20 selected hospitals in the Eastern Saudi Arabia; 173 HSMM responded to the study giving response rate of 86.5%. The other tool used for the descriptive study was a check list completed by the researcher on each studied hospital. The other part of this research was the action research aimed at exploring the amount of the support HSMM extends to these activities in order to enhance quality services in their hospitals. The study revealed that a majority of senior and middle managers had enough knowledge to initiate very promising quality programs, but there seemed to be a problem with their attitude on quality which affected the implementation of the quality program. Attending training courses on quality subjects made a significant difference to the general information, factor enhancing quality program, causes of quality program failure and the ranking of HSMM towards quality programs. Combining all of these significant variables and classifying them based on their relation with the patient, quality program and staff gave a clear indication that most were related to attitude. The study concluded " that the input and the output of the hospital had less impact on quality programs compared to the process reflected by the knowledge, attitude and practice of the HSMM. Recommendations cover the input, output and the process of quality programs, with more emphasis on the process. The HSMM should pave the way for a quality culture in the hospital which pays proper attention to the development of the skills of the staff and their orientation to the quality environment.
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Jaishankar, Gayatri Bala, Jodi Polaha Jones, Deborah Thibeault, Robert Matthew Tolliver, V. Morris, A. Johnson i Karen E. Schetzina. "A Team Care Screening Tool to Address Social Determinants of Health in a Pediatric Primary Care Clinic". Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/5034.
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Mfuko, Ncedo. "An assessment of primary health care services from the : perspective of the recipients in the Khayelitsha community health centre". Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3124_1305890834.
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The general aim of this study is to undertake an assessment of the health care service provision in the Khayelitsha Community Health Centre taking into consideration the underlying principles of the Primary Health Care. More specific objectives include: an overview and discussion of the framework approach to primary health care and its use
the documentation of the practice of primary health care in the Khayelitsha Community Health Centre
an analysis of the results and findings which will highlight the obstacles in the pursuit of a better primary health care service. The perspective of the patients and nurses will be solicited and examined with a view to highlighting factors that facilitate and constrain the delivery of service
and finally to draw conclusions and make recommendations.
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Thoresen, Stian Ho Yong. "Health care challenges and human resources for health in Thailand : migrations, social and political tensions, and human rights implications". Curtin University of Technology, School of Social Work and Social Policy, 2008. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=118405.
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The global shortage of human resources for health and the brain drain of health care professionals exacerbate health care challenges in many small and medium sized economies, including efforts to curb the HIV/AIDS pandemic. This research investigated attitudes, perceptions, and dynamics among health care students and professionals in Thailand related to human resources for health, migration, inequitable distribution between rural and urban areas as well as between the public and private sector, and influences on migration ambitions. This included contemporary social and political parameters. Perceptions and attitudes among health care students and professionals were explored through a questionnaire survey and semi-structured interviews with health care professionals. Additional interviews with key-informants encapsulated contemporary events, dynamics, adversities, and challenges specific to the Thai context. It is argued that both the right to health care and health care professionals’ right to free movement must be protected and upheld. This research adds to the knowledge and insight into the specific health care challenges in Thailand and reflections upon the sustainability of the health care system; both in light of these health care challenges and the principles of sustainability as proposed by The World Commission on Environment and Development, the Brundtland Report (1990). It will enhance the scope from which health care, manpower expansion, and reform is pursued. Any approach to stem the exodus of health care professionals must recognise the rights of all stakeholders, including health care professionals and health care consumers, and all stakeholders must be engaged in the pursuit of sustainable health care through the principles of sustainable development and global sustainability.
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Philip, Ajith John. "An assessment of equity in geographical allocation of resources relative to need, in public primary healthcare services in the Northern Cape in South Africa". Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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This study aimed to contribute to the current debate around equity in health care resource allocation by measuring the current allocation of resources, relative to need in the Northern Cape. It also discussed the level of inequities in health financing/expenditure and staffing at the primary health care level between different districts of the Northern Cape.
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Ramnath, Kalawatie. "Regime characteristics and health policy reform in the post-colonial state: a comparative case study of the influence of regime characteristics on health human resources policy and policy reform processes in Guyana, Jamaica and Trinidad and Tobago, 1970-1990". Thesis, University of Hull, 1998. http://hydra.hull.ac.uk/resources/hull:3763.
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In this dissertation, I examine and compare the influence of the following regime characteristics -strength, stability, ideology, democracy and survival/maintenance - on post-colonial health human resources policy processes within one sub-region: the Commonwealth Caribbean; with special reference to Guyana, Jamaica and Trinidad and Tobago (hereinafter called Trinidad) between 1970 to 1990. As I want to comparatively assess the role of these characteristics in post-colonial policy processes, I shall in this chapter place my study within the context of colonial regime characteristics, society and reform processes, assessing its possible influences on post-colonial political developments. This forms the basis of my analysis of policy within these three `post-colonial' states during the 1970s and 1980s. Section One describes the paradox of health and health human resources status in the Commonwealth Caribbean during the 1970s and 1980s. In Section Two, I describe the area under study. In Section Three, I examine possible linkages with the nature of power and reform under colonial regimes. In Section Four, I analyse the influence of regime characteristics on policy processes by assessing health policy outcomes of postwar reform. I begin with an examination of the contradictory status of Commonwealth Caribbean health and health human resources development in the 1970s and 1980s.
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Stericker, Stephen. "Collaborating for children's mental health : a study of the experiences of health and social care practitioners and managers working within different models of service integration". Thesis, University of Hull, 2009. http://hydra.hull.ac.uk/resources/hull:2723.
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The fragmented history of collaboration across health and social care is an acknowledged problem in public services in the United Kingdom. For several decades Government policy documents have recommended improved collaboration to tackle problems associated with people's satisfaction with the quality of public services, the perceived lack of communication across agencies and service inefficiency as a result of the duplication of activities.Too often the establishment of collaborative structures and processes are mistaken for the realisation of collaborative activity, overlooking the need to nurture identity, relationships and interdependence. This thesis adopts a qualitative methodology to explore the experiences of health and social care practitioners and managers working within interagency and inter-professional teams providing family support and guidance in relation to children's mental health and emotional well being.There is limited knowledge of the complexity of interagency and inter-professional relationships and the conceptual frameworks that could improve our understanding of the behaviours of people working within, and across, health and social care. This research focuses upon understanding how collaboration is organised at the level of teams, concentrating on models and levels of team integration. Such an approach allows the study of how interagency and inter-professional teams are structured and any impact upon the nature and development of relationships between the people working within such environments. In so doing, this research connects conceptual frameworks located within both organisational and social theories.This thesis identified many of the benefits and challenges of integrated team working and concluded that higher levels of satisfaction were experienced by people working within more integrated team structures. The relevance of social identity theory is discussed as managers' and practitioners' experiences were explained as an expression of their need to belong to something which could take the form of an agency, a team and/or a profession. This suggests that, if the public policy goals of collaboration are to be realised, there is a need for practical strategies that pay attention to nurturing relationships, interdependence and building positive social identities within the workplace. Indeed the history of failed collaboration might be explained by a neglect of the people issues.
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Al-Nahdi, Abdullah Ahmed Waridan. "Computer deployment in the health services of developed and developing countries : a comparative case study of the UK and Oman". Thesis, University of Hull, 1998. http://hydra.hull.ac.uk/resources/hull:6972.
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Organisations are increasingly deploying and using computer technology in various ways, involving the allocation of large amounts of capital and human resources. However, in many cases, computer deployment has been accompanied by failure, particularly in health care services. Therefore, information technology has raised grave questions, misunderstanding, fears, and hostility. This study emphasises the importance of computer deployment and development in developed and developing countries' health care services with examples from advanced and less advanced nations. It describes strategy development for IT/ISs using information system methodologies and explores the development of ISs strategy in the NHS in the light of fundholding and the internal market. A number of problems that commonly influence the success or failure of computer deployment and development are identified. These issues are explained through two case studies: the Omani health system and General Practices (GPRs) in the UK, which have introduced computers. The research focuses on five main sets of issues related to computer deployment and utilisation in health care: strategic planning; computer utilisation; computer fears; computer impact; and computer technical problems and performance. Users' overall satisfaction with systems in use is also considered. Data collection was carried out using two surveys. One survey was conducted in GPRs in Humberside and the other conducted in Royal Hospital and Sultan Qaboos University Hospital in Oman. Data sources included observations, review of relevant documents, such as reports, research papers and manuals, structured and non-structured interviews with selected users and a questionnaire. A number of conclusions can been drawn from this study: firstly, computer deployment, utilisation and development still faces problems in both the systems studied, more especially the Omani system. Secondly, GPRs have carried out strategic planning for computer deployment and utilisation and are prepared to use information system methodology for IT/IS strategy and there is a plan to use this for competitive advantage but Omani hospitals did not set a constructive strategic plan for their systems. Thirdly, the main problems of computer failure are related to human issues rather technical issues. The most important of these human issues are the style of the leadership planning, poor utilisation of computer applications, lack of skills and poor training. Finally, the results of the survey suggested that though the respondents were aware of the potential of computer technology, the problems of computer fears, training and lack of skills were experienced, and often, few individuals possessed computing knowledge. The author suggests several points to be considered: 1) that any thinking about computer deployment and development should employ appropriate information system development methodologies; 2) the decisions on computer deployment, use and development should be made by a special committee that has expertise in IT matters; 3) good strategic planning for computer deployment, use and development; should be connected to the organisation's overall strategy and 4) there is a need of mandate review for such development and planning. With these points in mind the researcher presents a diagram to help improving strategic planning and development of IT/IS methods with particular emphasis on the Omani environment.
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Alshammasi, Abdrabalamir Abbas Abdullah. "The influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia". Thesis, University of Hull, 1986. http://hydra.hull.ac.uk/resources/hull:5105.
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In this thesis I examine the influence of economic, political and socio-cultural factors on the development of health services in Saudi Arabia. There are four main parts and a conclusion. In Part One I review the situation in developing countries. Many commentators have argued that economic factors, and to some extent political factors, are the main determinant of health services development in developing countries. Socio-cultural factors are generally neglected in these analysis. In this thesis I redress the balance by examining the relationship between economic, political and socio-cultural factors in the development of the Saudi health care system.In Part Two I analyse the Saudi resource situation. Although the health service is not considered a priority in the overall Saudi development strategy, the government provides generous financial resources for its development. However, non-financial resources remain a problem. Relatively abundant financial resources can provide a short-term solution to some of the resource shortages, such as the lack of skilled manpower, but the use of expatriate health personnel may have unanticipated negative consequences.In Part Three I examine the resource allocation process. The Saudi political system contains a mixture of modern and traditional elements, and the decision making process is affected by traditional social relationships. The King and public bureaucrats play a key role in the allocation process, but local leaders and Governors have wide scope to influence their decisions. While health provision is not a political issue in the country, it contributes to the social cohesion between the government and the general public.In Part Four I examine the influence of socio-cultural factors on the development of the Saudi health service. In the Saudi society socio-cultural factors affect the behaviour of individuals in their interaction with the health system. For example, the annual pilgrimage to Mecca by millions of moslems from all over the world presents a formidable challenge to health authorities. Health authorities accept the importance of socio-cultural factors, and respond by compromising policies. In the conclusion I consider the policy and theoretical implications of the study. In particular I examine the need for the formal recongnition and incorporation of socio-cultural factors into health policy decision making. This would lead to the generation of alternative policy options which complement other options based on economic and political considerations. The socio-cultural oriented approach can contribute significantly to the improvement of the long term prospect for health services in Saudi Arabia, and developing countries generally.
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Wong, Nga-man, i 黃雅敏. "Quality evaluation of geriatric health information on Yahoo! Answers : a cross-cultural comparative study". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193007.
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Given the increases on global ageing population, popularity of social Q&A sites and the level of geriatric health concerns from family caregivers, it raises the uncertainty about the quality of health information on social Q&A sites for family caregivers of elderly. The purposes of this study are to evaluate the quality of geriatric health information on social Questions and Answers (Q&A) sites: Yahoo! Answers from registered nurses’ perspective, to identify the structural patterns of questions and answers vary in quality and to discover the cultural aspects in relation to the findings. A total of 60 question-answers set is retrieved from regional Yahoo! Answers sites, including Australia, Canada, UK & Ireland, US, Hong Kong, Mainland China and Taiwan. 126 English answers and 112 Chinese answers are examined.
Through a mixed method approach, results show that the overall information quality provided in Chinese group is relatively poorer than those of English. About 40% of questioners form both groups are not capable of judging the best answer among choices. In terms of structural patterns, questioners from both language groups are less capable of asking questions with clear focuses. 4 structural patterns, including Chinese and English answers with good and poor quality, are identified. Furthermore, cultural differences are found to have a significant impact on the level of information quality in social Q&A site. Finally, recommendations to corresponding social sectors are made for improving the current information quality of social Q&A sites in future.published_or_final_version
Library and Information Management
Master
Master of Science in Library and Information Management
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Safranyik, Gina Diane Michelle. "Macro-allocation of health care resources, a computer simulation comparing a utilitarian and a deontological approach". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0016/MQ48204.pdf.
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Maglalang, Dale Arvy Dagar. "Buffering Effects of Job and Personal Resources on the Health and Well-Being of Care Workers:". Thesis, Boston College, 2020. http://hdl.handle.net/2345/bc-ir:108923.
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Thesis advisor: Erika L. SabbathThe care industry is encountering a critical demand for care workers in the formal and informal sectors. As a result, the healthcare industry is strained from the increasing shortage of workers and capacity in facilities. Moreover, there is a desire among the aged to age in place, thus, care provided in the home and community is also on the rise. The requisite for care workers in the U.S. suggests that this population is vulnerable to job and personal demands in the workplace that are associated with negative health outcomes such as poor sleep and burnout. The purpose of this three-paper dissertation is to evaluate the moderating effects of job and personal resources on the health and well-being of nurses and patient care associates (PCAs) in the formal sector and Filipina care workers in the informal sector. The first two papers used the Boston Hospital Health Workers Study, a longitudinal study that was established in 2006 to examine the working organization and condition, behaviors, and health outcomes among healthcare workers from two large hospitals in the same health system in Boston. The first paper (N=845) used a mixed methods approach and used logistic regression analysis to examine the association of discrimination and short sleep and interaction terms to assess the buffering effect of people-oriented culture between discrimination and short sleep. The qualitative section used a combination of grounded theory and thematic analysis of interviews of unit nurse directors (N=16) to gain an in-depth understanding of how discrimination transpires in the workplace and the resources available to address discrimination and poor sleep among care workers. The second paper (N=874) evaluated the association of job and personal demands and burnout using logistic regression. Interaction terms were implemented to assess the buffering effect of workplace flexibility between job and personal demands and burnout. The third paper used semi-structured interviews of Filipina care workers in New England (N=14). A combination of grounded theory and thematic analysis were used to analyze the qualitative data. In Paper 1, findings showed that people-oriented culture did not buffer the relationship of discrimination and short sleep. However, people-oriented culture slightly attenuated the association of discrimination and odds of short sleep. Qualitative findings illuminated that discrimination transpired among co-workers in relation to their job titles and while numerous job resources are available, these resources do not necessarily address discrimination and promotion of inclusivity. In the second paper, workplace flexibility moderated the relationship between married healthcare workers without children and odds of burnout. Moreover, there are significant associations between active (high demand, high control) and high strained (high demand, low control) workers with perceived low workplace flexibility and odds of burnout. In the third paper, qualitative findings highlighted that Filipina care workers are tasked with multiple job responsibilities that are associated with abuse and injuries and personal demands of providing financial care to their family and saving face from divulging difficult experiences. While job resources like job contracts are helpful in lowering the likelihood of abuse, lack of government oversight facilitated violence in the workplace. Filipina care workers found support through community organizations and advocating for themselves and other fellow care workers. Findings from this study suggest that organizational policies and practices play a role in attenuating poor health outcomes among care workers but not all experience these policies and practices equally. Barriers such as not acknowledging discrimination directly and providing specific resources to discrimination, differing control in the workplace because of job title and racial and gender identities, and reporting abuse and violence in the workplace outweighing the cost of the demand to provide the needs for family members prevent care workers from being able to fully benefit from these policies and practices. Nevertheless, while structural changes take time, unit managers in formal settings and employers in informal settings can address these inequities in their specific settings to improve the health and well-being of care workers. This dissertation will assist the field of social work to advocate for federal, state-level, local, and organizational policies to be implemented in the workplace that will adjust to the needs of healthcare and domestic workers. Furthermore, the study can also inform future interventions to integrate effective organizational policies that reduce poor sleep quality and burnout among care workers
Thesis (PhD) — Boston College, 2020
Submitted to: Boston College. Graduate School of Social Work
Discipline: Social Work
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Sullivan, Margaret Frances. "Asthma Management In Millenial College Students: Attitudes and Perceptions of Resources". The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1306339582.
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Tosh, Amy Elizabeth. "CCHSA accreditation An instigator for change and a motivator for health human resources: A case study of a health region in Alberta". Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/27188.
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There are many unanswered questions regarding the influence and effectiveness of accreditation programs on healthcare services. Many participants advocate the value of the process and site reform and success experienced as a result of sharing in a program. However, there are many health service providers who have not chosen to participate. This single case study has been initiated as an opportunity to investigate the impact of an accreditation program on a health region and examine the consequences and results of the process on that organization. This study specifically focuses on the impact the process has on teams within the health organization. This report will be used in a broader multi-case study comparison to view similarities and differences in the results of accreditation.
The site of this specific case study was an Alberta Health Region. The accreditation process was undertaken in this region for the first time in the history of the organization under the regional model. (Abstract shortened by UMI.)
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Petrou, Stavros. "Examining QALY's : analysing the use of quality adjusted life years in the allocation of health care resources". Thesis, University of St Andrews, 1992. http://hdl.handle.net/10023/13344.
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This thesis examines the use quality adjusted life years (QALY'S) in the allocation of health care resources. It is divided into three broad sections. The first section discusses how health status measurement techniques can be used to derive the utility values incorporated into QALY'S. The second section uses one health status measurement instrument, the Rosser-Kind Classification of Illness States, to estimate the QALY'S gained by patients who have undergone hip and knee joint replacement surgery. It is shown that the Rosser-Kind Classification of Illness States is as effective in measuring the health-related quality of life of these patients as more detailed questionnaires. In addition, it is found that further research is required before any generalisations concerning the acceptability of retrospective data can be made. A third important result is that there are significant improvements in health- related quality of life following both types of surgery, with the highest Rosser- Kind rating scores achieved after the first year following knee replacement surgery and after the second year following hip replacement surgery. The third section of the thesis performs an extensive sensitivity analysis on the widely-quoted cost utility estimates for seven medical procedures, calculated by Gudex (1986). The estimates are shown to be sensitive to Gudex's conversion of health outcome data into the Rosser-Kind Classification, her assumptions concerning the survival period / life expectancy following each of the medical procedures and the selected discount rate. A more in depth analysis is then performed on the cost utility estimate for one of the seven procedures, ceftazidime treatment of cystic fibrosis. It is demonstrated that the health outcome and cost assumptions underlying the cost utility estimate for this procedure are not supported by the medical literature. Finally, the thesis raises a number of issues for discussion.
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Hurtado, Maria R. "PEDIATRIC PALLIATIVE CARE: UNMET NEEDS FOR MENTAL HEALTH RESOURCES OF PARENTS OF CHILDREN WITH LIFE-THREATENING DISEASES". CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/208.
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Due to the demanding structure of caring for a child with a life-threatening disease (LTD), parents experience psychosocial distress. Studies have shown that stress in parents of children with LTDs can be increased by unmet needs or fragmented care and may be mitigated by coordinated and comprehensive care. Limited literature exists about unmet needs of parents of children with LTDs and the barriers they encounter to accessing mental health resources within pediatric palliative care (PPC) programs. This research study applied quantifiable descriptive methods including a purposive sample of ninety-eight (98) PPC and other pediatric practitioners through the distribution of anonymous online surveys in order to examine unmet needs for mental health resources as they relate to parents of children with LTDs who experience psychological distress exacerbated from psychosocial stressors of care giving. Influenced by Andersen’s predisposing, enabling, and need factors, this study found that PPC practitioners perceived parents encountering waitlists and/or denials when referred to community mental health resources as demonstrating resistance against seeking help.
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Crowe, Mary Lind. "Allocation of Health Care Resources at the Point of Care: An Exploratory Study of the Perceptions and Decision Making of Nurse Practitioners Delivering Primary Care Services in Community Clinics". University of Akron / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=akron1333401296.
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Headley, Jamila A. "Opening the black box : the politics of allocating public resources for health in Barbados". Thesis, University of Oxford, 2013. http://ora.ox.ac.uk/objects/uuid:216717df-4f7a-4e8d-a219-27560ff245e5.
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Within the field of public health, there has been increasing interest in the factors that influence national priorities in health in low- and middle-income countries (LMICs), where resources are often particularly scarce and decision-making processes are often ad- hoc. Understanding how priorities are set in these countries necessitates a look at the process concealed in the black box that transforms policy inputs into outputs. However, rigorous health policy analysis of macro-level priority setting in LMICs is rare. Using a case study approach, this thesis explores the drivers of priority for primary health care, sanitation and HIV/AIDS over the past five decades in Barbados. To do this I use process tracing techniques, drawing on analysis of public expenditure on health from 1960 to 2010, in-depth interviews with key policy actors, non-participant observation, archives, media reports, parliamentary records and other documents. I argue that powerful individual policy actors or 'policy entrepreneurs' act as necessary drivers of macro-level priority setting in Barbados, although they do not single- handedly determine the outcomes. In particular, I find that these actors are successful in generating priority when they are able to propagate powerful framing ideas and can effectively navigate the policy context by seizing windows of opportunity and managing negative constraints. Moreover, because resources are scarce, their ability to mobilize external financial support is also important. In particular, this thesis stresses the fact that allocating public resources for health is a political process and suggests that it is best explained by considering a set of interrelated factors. In doing so, it illustrates the utility of health policy analysis in helping to open the black box of macro-level priority setting in LMICs more broadly.
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Russell, Steven John. "Can households afford to be ill? : the role of the health system, material resources and social networks in Sri Lanka". Thesis, London School of Hygiene and Tropical Medicine (University of London), 2001. http://researchonline.lshtm.ac.uk/682239/.
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Household ability to pay (ATP) for health care services has become a critical policy issue in developing countries because of changes to health system financing and delivery that are likely to impose higher illness cost burdens on poor households. The research presented in this thesis was driven by widespread concern about ATP among different policy actors, and by the fact that conceptual and empirical understanding of the issue remains poorly developed. The thesis uses a conceptual framework for assessing ATP that is, at its core, concerned with the implications that illness costs and related coping strategies have for household livelihoods. The main research objectives were to measure the household costs of illness, examine the types of asset (e. g. financial, social) that are mobilised to cover illness costs, and to evaluate the impact of these illness cost burdens and coping strategies on household livelihoods in the medium term. In so doing, the thesis aimed to identify factors which make households robust or vulnerable to illness costs which development agencies might support. Research was conducted in two low-income communities in Colombo, Sri Lanka. A survey of 423 households was carried out to obtain a profile of illness, treatment actions and illness costs in the two communities, and to identify case study households. The main part, of the research was to follow 16 case study households for eight months, which enabled in-depth investigation of treatment seeking behaviour, expenditure patterns, asset strategies and their impact on household livelihoods. The main findings of the research were ' that free public provision of health services protected poor households from high treatment -costs. In particular, public tertiary hospitals protected households against potentially catastrophic treatment costs associated with inpatient care. This enabled households to access treatment without adopting risky coping strategies. However, aspects of the health system failed to protect households from illness costs, and in a context of low and insecure incomes, illness costs did not have to be high to exceed daily budgets and undermine ability to meet basic food needs. Consequently, households often required additional resources to meet illness costs, and people's financial and social resources were shown to be important factors influencing ability to manage illness costs. However, the research also found that income-poor households had weak social resource endowments which forced them into riskier borrowing or asset strategies. Policy actions to support household assets are examined.
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Lalloo, Ratilal. "Equity and the allocation of health care resources at district level: lessons from as a case study in Mitchells Plain". Thesis, University of the Western Cape, 1994. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7259_1181558917.
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LaPrade, Keith. "Effective Nurse Recruitment Methods for Long-Term Care Facilities". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7550.
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Nurse recruitment is a challenge for long-term care (LTC) leaders. Some owners of LTC businesses lack knowledge of how to attract, market, and hire qualified nurses to help ensure success. The purpose of this multiple case study was to explore the methods and strategies LTC leaders used to recruit nurses. The target population consisted of leaders of 3 LTC facilities who were responsible for recruiting nurses. This selection was based on findings that organization leaders experienced a downsizing of more than 20% of their personnel. The conceptual framework was the motivation-hygiene theory. Working conditions were influenced by Herzberg's 2-factor principles of job dissatisfaction. I focused on analyzing the participant data, public documents, and performance outcomes that demonstrated the effectiveness of participant recruitment strategies. Data were collected from semistructured interviews. I compared the motivational hygiene theory factors that influenced employee job satisfaction and dissatisfaction identified with the conceptual framework and any new studies published since beginning my study. Results of data coding and analysis revealed 3 major themes: communicating job descriptions to new LTC recruits, hiring for nurseâposition fit to address turnover, and making the position attractive by offering competitive wages and benefits. Successful recruiting strategies included ensuring nurse position fit, contacting qualified candidates, and work conditions designed to meet candidates' needs, expectations, and requirements. Results of this study might contribute to social change by providing recruitment strategies to ensure quality nursing services in LTC and strategies necessary to sustain business operations.