Rozprawy doktorskie: „Community care”

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Schablon, Kai-Uwe. "Community care /". Marburg : Lebenshilfe-Verl, 2009. http://d-nb.info/992279488/04.

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Mason, Jay Roger. "An elder care community". Thesis, Virginia Polytechnic Institute and State University, 1992. http://hdl.handle.net/10919/52122.

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The following exploration represents a search for clarity and meaning in the formative work of a young architectural designer. Solving the design problem to create a viable community of elders integrated into the chosen site was merely the ostensible goal. The deeper task was to become more literate with the materials and tools of the architect's trade and develop a confidence with the language and grammar of architecture. I wanted to develop an understanding of not just a single building type or a particular site condition, but to grow in more fundamental terms toward learning a way of building. This desire may be inherent in every good design, but I wanted to bring the idea of it to the surface and focus on the principles behind the architectural decisions. I believe the confidence and vitality which the architect combines with the philosophical, technical and pragmatic constraints of a project to make great architecture are products of a thorough understanding of one's personal beliefs. My own attempt to organize thoughts and attitudes into a body of reference toward an understanding of that belief structure follows on the remaining pages. In the process as well as in the final result I have moved closer to a literacy in architecture, if only by gaining insight into the motivations which have guided my hand.
Master of Architecture

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Carriere-Laboucane, Jeannine. ""Kinship care: A community alternative to foster care"". School of Native Human Services, 1997. http://142.51.24.159/dspace/handle/10219/470.

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I realized the importance of kinship connection and family preservation the first time I met one of my birth family members at age twelve. As an adopted child, I often felt I was living in a borrowed state of being. In someone else's family, borrowing someone else's name and culture. Meeting my birth family and recognizing my connection to the Metis community gave me a sense of belonging for the first time in my life.

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Thompson, Diane. "The social and political construction of care : community care policy and the 'private' carer". Thesis, University of Bedfordshire, 2000. http://hdl.handle.net/10547/233629.

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This thesis presents a retrospective critique of the social and political construction of 'informal care' within community care policy from the period of the late 1970s to the mid 1990s. The thesis considers the question of the degree of 'choice' available to informal carers to say 'no' to caring, or aspects of caring, within the reforms' positioning of informal care as the first line of support for adult dependants. The critique focuses on subjectivity, difference, agency and choice. A theoretical and methodological synthesis is developed between feminist post-structuralism, feminist critiques of mainstream social policy, and feminist theory and research, within which a qualitative in-depth interview study with informal carers is situated. The critique is then expanded through the development of a 'Q' Methodology study with a larger cohort of informal carers. The research identified gendered generational differences between the carers, and a 'burden' of care imposed as an outcome of consecutive governments' attempts to residualise welfare. The older carers' levels of agency and choice were severely curtailed. However, the younger female carers were more able to resist the drive of the community care reforms, their counter discourses being based on a new emergent notion of 'rights'. The direction of community care policy was found to be out of step with how the carers within this study perceived their responsibilities and 'obligations'. The thesis argues that whilst post-modernism may have constrained the capacity of governments and reconstituted our understanding of 'care', it has not done so to the extent that we are no longer prepared to make demands for 'care' from and by the state.

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Wood, Lisa. "Green care in the community". Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14996/.

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There is a growing body of evidence to suggest that community based horticultural projects can be effective interventions for people experiencing mental health difficulties. Such programmes have been shown to provide a wide range of benefits, including increased confidence and self-esteem, improved mood, extended social networks as well as the development of new skills and a circadian rhythm. Whilst there is now considerable evidence demonstrating the beneficial outcomes of group gardening, there is a lack of understanding as to how psychological processes that contribute towards therapeutic outcomes might be affected by these interventions. This study explored experiences of community gardening programmes in order to better understand how attendance may affect the psychological health of people experiencing mental distress. In particular, it sought to understand the impact of nature on psychological experience during group attendance. Eleven people experiencing mental health difficulties were interviewed about their experiences of attending community gardening groups. The study adopted an ethnomethodological approach to constructionist grounded theory, in order to develop a framework within which participant experiences could be understood. Findings suggested that key processes of feeling safe, letting go, (re-)connecting and finding place provided mechanisms of positive psychological change. Fundamental to each process were changes in construal of, and relationships with, others, nature and importantly, the self, within the gardening group contexts. An increased sense of identification with other people and non-human nature, and the development of empathy and compassion, appeared to be key psychological processes which may account for the positive impact on participants’ mental health. Directions for future research and implications for future clinical interventions are suggested.

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梁振聲 i Chun-sing Anthony Leung. "Old People's community: care home". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B31985919.

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McAree, D. P. "Women's health : community pharmacy care". Thesis, Queen's University Belfast, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391103.

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Keenan, Michaela. "Housing, citizenship, and community care". Thesis, University of Ulster, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.232849.

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Leung, Chun-sing Anthony. "Old People's community : care home /". Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25950368.

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Meebunmak, Yaowaluck. "Community mental health care in Thailand: Care management in two primary care units". Thesis, Meebunmak, Yaowaluck (2009) Community mental health care in Thailand: Care management in two primary care units. PhD thesis, Murdoch University, 2009. https://researchrepository.murdoch.edu.au/id/eprint/6502/.

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Thailand faces increasing mental health problems, however mental health services are limited. In particular, mental health services provided in communities across the country are not clearly structured. Research in regard to community mental health care is rare. The purpose of this study was to explore mental health care management in two primary care units (PCUs) in Thailand in order to understand the ways they operate within Thai communities. The specific objectives were to identify mental health care practices and roles of health providers, models of care and influences on mental health care practices in the two PCUs as case studies. An ethnographic approach using participant observation, semi-structured interview, quantitative questionnaire and document analysis was used in gathering data. The participants were seven nurses and three public health workers practising in the PCUs. Findings enhanced understanding in the context of two PCUs located in communities of the Northern and Central Thailand. Both were local health centres providing a wide range of health services based on the principles of primary health care (PHC). The PCUs were operated without mental health specialists, however nurses were the main resource in providing mental health care in terms of primary and secondary prevention. Primary prevention was provided through counselling sessions, drug prevention activities and seniors clubs. In addition, the health providers conducted activities of mental health promotion towards particular risk groups after assessing risks. They also gave support to mental health and normal cases that had possible mental health problems. Secondary prevention was provided in home visits, primarily in giving injections. The health providers played four main roles as educator, consultant, agent and manager in primary and secondary prevention. There was no single model of mental health care practice provided in the PCUs. Information derived from the present study showed a variety of models underpinning care practices. The nursing process was clearly adopted, as well as integrated care, community participation, collaboration and consultation, and using standard guidelines. Personal knowledge and interest in mental health were mentioned as an important factor in practising mental health care. Environmental factors such as adhering to policy, being family-oriented, being mindful of economic factors, using Buddhist Principles to guide interactions, guarding against occupational risks, maintaining a teamwork approach and the lack of specialists appeared to be factors influencing mental health care. This study contributes to the body of knowledge of community mental health care management in Thailand. The findings suggest implications for practices, education, and policy making to improve quality of care.

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Achmat, Asma. "Professional health care workers' experiences of care at two Community Day Clinics on the Cape Flats". University of the Western Cape, 2016. http://hdl.handle.net/11394/4896.

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Magister Artium (Social Work) - MA(SW)
Primary Health Care (PHC) is the cornerstone of health care globally, nationally and locally and, therefore, should be regarded as the foundation of health care provision. In South Africa, Community Day Clinics (CDCs) are part of the bouquet of services that is being offered at a PHC level. There are various factors that generate inconsistency in the provision of care to people accessing these CDCs. The purpose of this study was to identify and explore how these factors impact on the care practices that health care professional’s provide. Research suggests that the majority of health care workers are women, who play a double role as carers in their professional and private lives. Therefore, the political ethics of care, a feminist theoretical approach, was utilized to understand care practices in these health settings. The aim of the study was to develop an in-depth understanding of the care practices of health care workers at two CDC facilities on the Cape Flats. A qualitative research methodology was used to explore and identify the phenomenon under study. The research project followed an explorative and descriptive research design, as the researcher sought to understand the care practices of health care workers and how their values and ethics further influenced care practices at these two CDC settings. The data was gathered using semi-structured one-on-one interviews, and later analysed using qualitative thematic analysis. The research findings were grouped in terms of the values entrenched in the political ethics ofcare, which are attentiveness, responsibility, competence, responsiveness and trust. The research findings identified various aspects that, either negatively or positively, impact on these values. Finally, recommendations were made to management, as well as care workers. These recommendations were in terms of implementing care services that are attentive to service-users and care-workers; providing a service that takes into consideration the value of responsibility; the provision of competent services; and finally creating trusting relationships within the CDC.

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Draper, J. "An experiment in community antenatal care". Thesis, University of Cambridge, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.598641.

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Xu, Shaoqiu. "Chromatic systems for the care community". Thesis, University of Liverpool, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406631.

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Jones, Roger Hugh. "Self care and primary care of dyspepsia". Thesis, University of Southampton, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241615.

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Singh, Dorian. "Accessing health care : barriers to care in a Romanian Roma community". Thesis, University of Oxford, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.669918.

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Mamaila, Tshifhiwa. "Community-based care for HIV/AIDS orphans". Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-01312006-092356.

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Songpaisan, Yupin. "Community oral health care projects in Thailand". Malmö, Sweden : Dept. of Cariology, Faculty of Odontology, Lund University, 1994. http://books.google.com/books?id=ZAxqAAAAMAAJ.

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Gooding, Lewis D. "Care, community and the mental health nurse". Thesis, University of East Anglia, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399844.

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Wilson, Stephen Francis. "New models of multidisciplinary community health care". Thesis, The University of Sydney, 2005. http://hdl.handle.net/2123/895.

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This thesis consists of a series of studies of new models of multidisciplinary community health care in four compartments. These compartments are acute, subacute, outpatient and maintenance care. The purpose of the individual studies is to demonstrate the benifits of munltidisciplinary community health care in delivering alternatives to current practice by replacing hospital care or improving traditional community care.

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Wilson, Stephen Francis. "New models of multidisciplinary community health care". University of Sydney, 2005. http://hdl.handle.net/2123/895.

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Doctor of Philosophy(PhD)
This thesis consists of a series of studies of new models of multidisciplinary community health care in four compartments. These compartments are acute, subacute, outpatient and maintenance care. The purpose of the individual studies is to demonstrate the benifits of munltidisciplinary community health care in delivering alternatives to current practice by replacing hospital care or improving traditional community care.

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Turnbull, Deborah Anne. "Community Wildlife Care Education by Wildlife Carers". Thesis, Griffith University, 2014. http://hdl.handle.net/10072/366940.

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It has been suggested that the most important role of volunteer wildlife carers in not the rehabilitation and release of native animals, but the incidental public education they provide. The problem for me, a wildlife carer and educator, was the lack of any information about the public or community education role of wildlife carers. The aim of this thesis, therefore, is to describe the community education role of wildlife carers. At a later time, the ultimate goal is to provide adequate carer training in this area. In order to examine community education by wildlife carers I asked carers what they do that they believe to be environmental community education. Using interpretive inquiry as my guiding methodology, and interview and questionnaire as data collection tools, I invited wildlife carers to share with me their stories of community or environmental education. Twenty-two wildlife carers from across Queensland, Australia told me about their experiences educating the general public about wildlife. The resulting research narrative was cumulative, with various versions of the emerging narrative being offered back to participants and the wider wildlife caring community to ensure I was telling their story truthfully. I used the stories from my wildlife carer participants and related literature to describe a new construct: community wildlife care education. The emergence of this new construct provides the basis for the distinctive contribution that this thesis makes to community, wildlife and care education. Community wildlife care education has social, temporal and spatial dimensions but it is the social dimension that is dominant. Informal learning encounters between wildlife carers and members of the public are social. Our first experiences of care as humans are social. Care is expanded through the temporal and spatial dimensions, including the development of care for wildlife.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Education and Professional Studies
Arts, Education and Law
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Hannigan, Pamela Ann. "The psychological impact of a community care project on elderly care recipients and their care givers". Thesis, University of Ulster, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.274102.

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Chesterman, John Francis. "Community care experiments for frail older people : two care management programmes evaluated". Thesis, University of Kent, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396377.

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Okeyo, Ida. "Community care workers in TB care: identifying and meeting their information needs". Thesis, Rhodes University, 2016. http://hdl.handle.net/10962/4211.

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According to the 2015 World Health Organisation global tuberculosis report, South Africa had 155,473 new TB cases in the last year, 61% of whom were HIV-positive. The tuberculosis (TB) epidemic in South Africa has resulted in the increasing use of community care workers (CCWs) for the management and supervision of TB patients on treatment. CCWs are increasingly being deployed to address the shortages of healthcare workers. CCWs supervising TB patients often act as information providers, advising and counselling patients on general care and medication use. Their effectiveness depends on appropriate knowledge, adequate training and access to good quality information about TB and TB medicines. The hypothesis for this study was that user-friendly, simple, illustrated information can enhance TB knowledge of CCWs, as well as serve as a practice tool in facilitating their counselling and education of patients. A conceptual framework was used to guide the development of an intervention to test this hypothesis through the following objectives: exploring the roles and TB information needs of CCWs working with TB patients; evaluating baseline TB knowledge and health literacy levels of CCWs; developing simple, illustrated information materials to address CCW TB information needs; and assessing the influence of the information materials on TB knowledge and practice of CCWs. Six CCWs from Grahamstown Hospice and 25 CCWs from six primary healthcare clinics in Grahamstown participated in the study, which was conducted in three main phases. Phase 1 began with focus group discussions and individual semi-structured interviews with 14 CCWs to explore their perceptions regarding their roles in TB care and their information needs. This was followed by individual interviews with all 31 CCWs using a structured questionnaire to collect quantitative data on health literacy and establish baseline TB knowledge. For Phase 2, the design of an A5 booklet was informed by the findings from Phase 1 and contained information about TB and TB medication. Pictograms were designed using a rigorous, iterative design process and were included in the booklet which was translated into isiXhosa and Afrikaans. The booklets were individually distributed to CCWs during an information session in which the topics in the booklet were discussed. Three months after completion of Phase 2, individual follow-up interviews were conducted with all CCWs to measure post-intervention TB knowledge. Focus group discussions or semi-structured interviews were conducted with 19 of the CCWs to explore the role and impact of the information materials on everyday CCW practice. Qualitative data were transcribed and analysed thematically by developing codes and identifying themes. Quantitative results were analysed using the t-test, Pearson Chi-square and a Z-test of proportions at a 0.05 level of significance. The conceptual framework provided a useful lens through which to view, and reflect on, the interaction between the elements of the healthcare system in relation to the results obtained. CCWs associated their roles in TB control with helping patients and having an impact in patients’ lives which they perceived as being meaningful. The good relationships with patients noted by study CCWs, as well as the appreciation they received from patients, contributed to their confidence and belief that they were well positioned and able to positively influence health outcomes. This study found that CCWs in the healthcare system were disadvantaged by the lack of support and supervision, deficiencies in training and lack of information materials, all of which reflect a negative interaction between CCWs with the healthcare system. Use of the booklet resulted in an improvement in CCW knowledge about the disease, TB medication, MDR and XDR-TB and HIV/AIDS and TB co-infection. The mean knowledge score significantly increased from 76.1% at baseline to 85.4% at follow up showing that the use of the booklet had a positive impact on TB knowledge. Poor knowledge areas were identified as being related to TB medication-related knowledge and drug-resistant TB, highlighting the need for additional intervention to improve knowledge in these areas. The health literacy level of CCWs, which was assessed using the modified Newest Vital Signs– South Africa test, showed that the majority of CCWs had only marginal health literacy, indicating the need for wider assessment of health literacy within CCWs, and the need to tailor training and information materials to cater for their health literacy levels. The pictorial-based, simple booklet tailored for CCWs was also found to enhance confidence in decision making, and reduce their uncertainty when confronted with difficult care scenarios. CCWs were enthusiastic about the inclusion of pictograms which were reported to enhance recall of TB information and understanding of text. The booklet also served as a patient educational tool, where it reportedly improved communication and had a positive effect on the CCW-patient interpersonal relationship. The simplicity of the booklet and the inclusion of pictograms resulted in a user-friendly appealing information source for patients. Factors contributing to the success of the booklet can be attributed to paying attention to CCW information needs, involving CCWs in the design process, translating the booklet into local dialect, ensuring simplicity of the text and including pictograms that had undergone a rigorous design process. This study was the first to design TB information materials targeted specifically for CCWs that were also suitable as patient education materials. The study demonstrated that these information materials can have a positive outcome on CCW roles in TB care by improving their knowledge and facilitating patient communication and education.

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Garchar, Kimberly Kay. "A dying community : a Roycean critique of the medical community at the end of life /". view abstract or download file of text, 2006. http://proquest.umi.com/pqdweb?did=1232405801&sid=3&Fmt=2&clientId=11238&RQT=309&VName=PQD.

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Thesis (Ph. D.)--University of Oregon, 2006.
Typescript. Includes vita and abstract. Includes bibliographical references (leaves 175-179). Also available for download via the World Wide Web; free to University of Oregon users.

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Jewkes, Rachel Katherine. "Meanings of 'community' in community participation in health promotion". Thesis, King's College London (University of London), 1994. https://kclpure.kcl.ac.uk/portal/en/theses/meanings-of-community-in-community-participation-in-health-promotion(b6de367c-b093-4d06-a81b-42bb9746d344).html.

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From, Ingrid. "Experiences of health and care, when being old and dependent on community care". Licentiate thesis, Karlstad University, Faculty of Social and Life Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-1307.

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Oxley, Donna J. "Constructing care in the community together : a discourse analysis of care planning meetings". Thesis, University of East London, 2011. http://roar.uel.ac.uk/3499/.

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Objectives: The Care Programme Approach (CPA) is the official framework for care for adults with severe mental health problems in England. Research on interactions in health settings have explored key concepts of patient-centred care, shared decision-making and the biopsychosocial model. Discourse analysis has been used to examine interactions in both health and mental health care. However, research on the CPA has largely been based on service outcome measures and interviews with service providers. This study aimed to explore discursive constructions of service users' difficulties and therapeutic interventions in CPA meetings and documentation in community mental health settings; how potentially different viewpoints are negotiated; and the differences and similarities between the meetings and documentation. Method: Audiorecordings of six CPA meetings and their resultant CPA documents were collected from a Community Mental Health Team and an Early Intervention Service. A discourse analysis at the micro level, using a Discursive Psychology framework, and at the macro level, using a Foucauldian Discourse Analysis framework was conducted. Results: An account of constructions of services users' difficulties, causes and risk factors, care as medicine and care as managing the practicalities of everyday living was produced. Rhetorical devices were used to create consensual explanations of difficulties and decisions about medicine; tensions and disagreements were not recorded in CPA documents. Discourses of a medical model of difficulties were implicit and explicit in both teams, although discourses of a biopsychosocial model were also apparent in the Early Intervention Service. The complexity of participants negotiating discourses about the value of paid employment and discourses of illness were evidenced in all meetings. Conclusions: Discourse analysis provided a useful means to explore CPA meetings and documentation. The primacy of the medical model, even within biopsychosocial accounts, and the goals of shared decision making within a recovery framework are discussed and clinical, policy, and research implications are explored.

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Welschhoff, Anja. "Community Participation and Primary Health Care in India". Diss., lmu, 2007. http://nbn-resolving.de/urn:nbn:de:bvb:19-69547.

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Kelleher, Killarney, University of Western Sydney i Faculty of Health. "Evaluation of the Cottage Community Care Pilot Project". THESIS_FH_XXX_Kelleher_K.xml, 1999. http://handle.uws.edu.au:8081/1959.7/743.

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The outcomes of a child protection/family support programme, the Cottage Community Care Pilot Project, were evaluated in this study. The evaluation employed a non-equivalent comparison group design of 'at risk' consenting first-time mothers in the perinatal period with babies up to 6 weeks of age. Ninety-three families were recruited and 58 of these were matched with a trained volunteer home visitor. Analysis of assessment items and questionnaires, reviews of hospital records and the Department of Community Services Child abuse and neglect notification register and focus groups with mothers and volunteers provided the information used in this study. The CCCP had an impact on particular aspects of family function, certain infant and maternal health indices and the families' use of community services, but its contribution to reducing the incidence of child abuse and neglect is less clear. Client and volunteer feedback indicated support for the programme. While home visitation by trained volunteers is not proposed as the total answer for effective child protection or family support, the findings of this evaluation suggest that there is a place for similar programmes.
Master of Science (Hons)

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Kelleher, Larni. "Evaluation of the Cottage Community Care Pilot Project /". View thesis View thesis, 1999. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030519.145848/index.html.

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Thesis (M.Sc.) (Honours) -- University of Western Sydney, Macarthur, 1999.
A thesis presented to the University of Western Sydney, Macarthur, in partial fulfillment of the requirements for the degree of Master of Science (Honours), March, 1999. Bibliography : leaves 117-125.

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Sturgess, Ian K. "Pharmaceutical care provision to community dwelling elderly patients". Thesis, Queen's University Belfast, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268313.

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Grainger-Rousseau, T. "Contributions of the community pharmacist to patient care". Thesis, Queen's University Belfast, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.317506.

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Turrell, Adrian R. "Consensus, collaboration and community care for elderly people". Thesis, Loughborough University, 1990. https://dspace.lboro.ac.uk/2134/12205.

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This Chapter introduces the key issues addressed by this Thesis, and the method by which they are explored, The Thesis was stimulated by experiences of statutory carers as a volunteer supporting elderly people living in the community, My observations of these carers (such as social workers, district nurses, home helps and G.P.s) and the support they provided to elderly people in the community suggested .that there as a fundamental contradiction between, on the one hand, their avowal of the virtue of maintaining elderly people at home for as long as possible (in the 'spirit' of community care policy) and, on the other hand, their ability and willingness to collaborate to achieve this end, To explain this situation, this Thesis explores three aspects of the theory and practice of community care for elderly people: I the historical and conceptual diversity of community care policies in England and Wales as revealed by government publications over the period 1800-1982 and a range of professional and academic literature; I the degree to which community care policies have been officially regarded as dependent upon inter-agency and inter-professional collaboration, and whether in practice community care practitioners have lent such policies their support and agreed on their meaning and implications

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Thornell, Margaret Louise. "A Community-Oriented Solution to Access to Care". Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10829714.

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Access to primary health care services is a significant issue for many communities seeking to improve the health of their populations. This single case study describes the 12-year journey of 2 adjoining rural counties in 2 states towards meeting the primary and specialty care needs of the uninsured and underinsured population. Data were triangulated using historical documents, first-person interviews, and health utilization data. The community leadership moved through various models including a free clinic and a university-sponsored health center before finally establishing a federally qualified health center, which now serves 40,000 citizens in these counties. The site is now hosting new programs funded by research grants in alliance with area universities. Success is contributed to an unwavering desire to provide a medical home for the underinsured and underinsured, a shared vision, recognition that continued success was dependent on a funding source, recognition that practices and processes must be in place to assist with navigation for those in need of services to seek care at the appropriate venue, and a belief that the infrastructure built to provide care was sustainable. All participants recognized the importance of funding for sustainability. Positive social change has occurred from the emergence of a multidisciplinary center to serve the community’s uninsured and underinsured, thus improving access to care, management of chronic conditions, and access to behavioral health professionals. Findings from this study may inform other communities faced with similar problems and can inform legislators of the importance of federally qualified health centers in the provision of health care to vulnerable populations.

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Fillmore, Elbourne Heather. "An evaluation of intermediate care in the community". Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/206517/.

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This study is a result of one not-for-profit organization’s aim to develop and evaluate a new approach to intermediate care (IC) by drawing together three separate enterprises; a not-for-profit charitable organization, a primary health care trust and local referring hospitals and social care providers in order to design a new service. This research describes and examines the factors that influenced the success (or not) of this IC service during its first two years of functioning. Using a single descriptive case study a detailed account of the innovation journey that a multidisciplinary team (MDT) underwent as they developed and implemented their own unique model of person-centred intermediate care (PCIC) within a community based nursing home facility is provided. The study describes the workings of the unit and details the service users’ outcomes and their perceptions of the care that they received on this unit. Through the use of a mixed methods, concurrent triangulation, design quantitative data (i.e. assessments of functional ability and length of stay (n= 94)) and qualitative data (i.e. semi-structured interviews-staff (n=12), service users (n=94)) were collected in order to generate thick description which allowed for an in-depth explanation of how a new event (PCIC in a nursing home) was integrated into the culture of the facility. This design allowed the data, once analysed, to be discussed from different viewpoints in order to simultaneously address the confirmatory and exploratory aims of the study. The results of this research provide the field of IC and the practice community with a detailed account of the successes and challenges that one MDT’s experiences during their innovation journey whilst crafting and successfully implementing PCIC within a community based nursing home facility. This study also exposed the staff’s use of emotional labour in order to successfully deliver their model of PCIC.

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37

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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Johnston, Corrine W. "Whither the community in community health centres?, the limits of primary care reform". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0005/NQ41181.pdf.

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Higham, Patricia. "Relationships of elderly people in residential care". Thesis, Cranfield University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309590.

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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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Puntis, Stephen Robert. "Continuity of care and clinical outcomes in the community care of patients with psychosis". Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:8a6866ca-1288-4d55-a213-f9445e13254f.

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Continuity of care in mental health care is considered both an important objective of NHS policy and vital to clinical practice. However, it remains poorly defined and there is little research into its association with outcomes. Mental health services are unique in their ability to legally compel patients to adhere to treatment in the community and there has been no research into how this may affect continuity. My thesis aims to critically appraise the definition of continuity of care and systematically review the literature on its association with outcomes. It also measures its association with readmission by conducting a longitudinal study, and measures the association between community compulsion and continuity of care. The literature review confirmed that continuity of care is best understood as the process of care of an individual patient over time. This is perceived by both the patient and providers of care as comprehensive, consistent, and connected. The systematic review found little evidence for an association between continuity of care and outcomes but that this may be due to persisting variation in both measures and outcomes. Results from the longitudinal study suggested that better continuity was associated with both better and worse hospital outcomes. Community compulsion had no association with continuity of care. My findings suggest that patient follow-up has improved considerably in the last three decades and, because of this, some traditional measures of continuity may be redundant. Measures of frequency of contact do not accurately measure the flexible, assertive practice that is a feature of current services. Continuity of care is useful as an indicator of the process of care but for it to be an effective research tool there needs to be a radical change in the way it is measured. Current mental health services are characterised by separation and specialisation into different components of care. Therefore, the most useful measures of continuity of care may be ones which successfully measure how it can be maintained between these services.

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Lim, Byungwoo. "Towards the development of care management in community care for elderly people in Korea". Thesis, Boston Spa, U.K. : British Library Document Supply Centre, 1999. http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.264574.

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Stockwell-Smith, Gillian Barbara. "‘Shared Care’ An Early-Intervention, Self-Management and Empowerment Approach to Community Dementia Care". Thesis, Griffith University, 2015. http://hdl.handle.net/10072/366764.

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Dementia is a progressive, life limiting condition that, as cognitive and functional capacity decline, has an increasing impact on the health and quality of life of the person with the condition and their family caregivers (AIHW, 2012). It is a condition that is cloaked in stigma and misunderstanding, factors that have the potential to isolate those living with the condition from sources of practical and emotional support (Alzheimer's Australia, 2012). Recent advances in the treatment of dementia have not resulted in a cure or substantially altered the disease progression, which accentuates a need for early psychosocial intervention (Prince, Bryce, & Ferri, 2011). A proactive approach with interventions offered at the beginning of the disease/care trajectory is seen as a way to develop the coping resources of the person with dementia and their caregiver, to prevent or delay progression into a more dependent or critical period (Bates, Boote, & Beverley, 2003; Clare, Kinsella, Logsdon, Whitlatch, & Zarit, 2010; Moon & Betts Adams, 2012). Early-intervention also creates a window of opportunity for involving the person with dementia whilst they are still able to participate in planning discussions (Alzheimer's Australia NSW, 2012; Cooper et al., 2012; Whitlatch, Judge, Zarit, & Femia, 2006).
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
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Gamiet, Shamila. "Health professionals' perceptions of rehabilitation care workers". Thesis, University of the Western Cape, 2015. http://hdl.handle.net/11394/5246.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
People with disabilities (PWD) often come from disadvantaged communities and struggle to access health and rehabilitation, education and employment. This leads to poorer health outcomes, lower education achievements, and higher rate of unemployment in comparison to people without disabilities. Therefore there is a need to empower PWD to remove all barriers which prevent them from participating in all aspects of their communities. In South Africa, 5% of the population is disabled and in a worldwide review conducted on access to rehabilitation services, it was reported that South Africa provided 21% to 40% of the disabled population with rehabilitation services. In 2012 the Department of Health (DOH) trained a new cadre of community health worker (CHW) in the field of rehabilitation in order to improve PWDs‘ access to health services. As a result, health professionals in the Western Cape became concerned about the role of this new cadre of rehabilitation care worker in PHC and CBS. The aim of this study was therefore to explore health professionals‘ perceptions of the newly trained rehabilitation care workers (RCWs). Q methodology was selected as an appropriate research design to meet the objectives of this study as it can be used to analyse opinions, perceptions and attitudes. The study population consisted of all the health professionals who engaged with the RCWs in the clinical workplace during their clinical practice module. A convenient sample of sixteen health professionals participated in this study. Ethics approval was obtained to conduct this study and all participants gave written consent to participate in this study. The researcher gathered all the viewpoints of the health professionals regarding the new rehabilitation care workers (RCWs) by conducting focus group discussions and document analysis. Statements were then drawn up based on the health professionals' viewpoints. The participants then ranked these statements from strongly agree to strongly disagree on a Q data score grid, in a process called Q sorting. The completed Q data score grids, called Q sorts, were then entered into PQMethod software programme for statistical and factor analysis. From the results of this Q analysis, two factors emerged which were analysed and interpreted. A factor is representative of participants with similar opinions. The participants loading onto Factor one and Factor two shared similar opinions of the RCWs. The results indicated that the participants were of the opinion that RCWs‘ role would be to strengthen primary health care (PHC) and community-based rehabilitation (CBR) and promote the participation of PWD in society. The results suggested that the RCWs were capable of improving the quality of life of PWD by empowering PWD to become actively involved in all aspects of community life. The participants felt that the RCWs would be included in the health system by working at intermediate care centres (facility-based) and in the community (home-based). However, the participants agreed that the RCWs must work under the direct supervision of qualified health professionals. Participants loading onto Factor one and Factor two further agreed that RCWs worked well in the structured environment of intermediate care health facilities. They felt that it would be beneficial for RCWs to be employed at these health facilities as the RCWs reduced the workload of the health professionals. From the results, it was also found that health professionals were of the opinion that the RCWs displayed positive attitudes and good professional behaviour in the clinical environment. Health professionals however identified gaps in the knowledge of the RCWs and a lack of skills to perform certain tasks. However, health professionals agreed that the RCWs' skills will develop and improve with time and exposure. This study showed that health professionals had positive perceptions of the RCWs and this could indicate that RCWs will be well accepted by health professionals as part of the PHC team. This could lead to the effective utilisation of RCWs in community-based rehabilitation. Recommendations can be made to the developers and implementers of the RCW training curriculum to make adjustments to the curriculum so as to address the lack of knowledge and skills in certain aspects of health and disability. It can further be recommended that South Africa's National DOH capitalise on these positive perceptions and train more RCWs to extend rehabilitation and health services to more underserved communities. This will assist the South African Government in ensuring that more PWD receive rehabilitation and become included in all aspects of their communities as is envisaged in the 2020/2030 health plan.

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McGuire, Margaret Maher. "Community postnatal care provision in Scotland : the development and evaluation of a template for the provision of woman centred community postnatal care". Thesis, University of Glasgow, 2001. http://theses.gla.ac.uk/1184/.

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The specific objectives of the study were to: 1. Investigate women's perceptions and experiences of postnatal care; 2. Examine the current pattern of postnatal care provision in terms of clinical outcomes (maternal and neonatal) and maternal satisfaction; 3. Evaluate the new model in terms of clinical outcomes (maternal and neonatal) and maternal satisfaction; 4. Compare the outcomes of both models; and 5. Evaluate midwives' perceptions of both models of care. There were no difference between the two Phases in terms of clinical outcomes (maternal and neonatal) midwifery and maternal satisfaction. In both stages of the study, the average day of postnatal discharge was day three, the mean number of postnatal visits was 4.2, and the average number of midwives to visit a woman was two. Women were very satisfied with the community postnatal care provided by midwives, although concerns were expressed about hospital postnatal care. All women agreed that community postnatal care was an important service and would choose to have the midwife visit her in their own home rather than attend health or drop in centres. Midwives applied aspects of the new template of postnatal visiting and were more likely to visit low risk women three times following introduction of the ne template. There was not change in community of carer. Findings of focus group discussions highlighted that women were not prepared for motherhood and the postnatal period. Women stated that the educational support antenatally and in the postnatal ward did not meet their expectations and needs.

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Quesada, Cordero Carolina Maria. "Caring for Sexuality and Reproduction: Experiencing community based care and state-run health care in a Ngöbe indigenous community in Costa Rica". Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/18644.

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The Ngöbe are an indigenous group that resides in the north of Panama and the south Pacific region of Costa Rica. This thesis uses the ethnographic method to examine indigenous Ngöbe women’s practices and experiences of sexual and reproductive health care in a rural community in the southern region of Costa Rica. Indigenous Ngöbe women from El Bajo seek social and medical care practices provided by the community and the state-run health care facility. In their search for well-being, health care seekers consider diverse possibilities within their kin relationships, the community resources, and the state-run health care facility. This thesis also analyses the practices of health care professionals and the subjectivities associated with their work as well as the policies and discourses impacting the state-run sexual and reproductive health care actions, which influences the process of receiving/providing care. This thesis treats care as a practice that is informed by the logics of relationality and individuality. These logics are located in what Bourdieu terms habitus and as such are related to action and not to conscious reasoning. These logics highlight the individual’s relationship to their kin, their community and the environment, as well as the individual’s autonomy in relation to society and nature. These logics inform the practices of both health care professionals and Ngöbe indigenous women and, as a result, the two groups display different combinations of these logics which exist in the form of a spectrum. The actors’ positionalities play a role in shaping the logics within the structure in terms of gender, ethnicity, class, geographic location, and access to biomedical knowledge. Thus, the logics of relationality and individuality are combined in multiple ways; and in the process of exercising their agency people navigate the spectrum according to their possibilities ―social, economic, etc.― based on their positionality within the structure. This thesis follows a comprehensive understanding of women’s exercise of agency through resistance, the inhabiting of norms, and connection and belonging. Consequently, the main focus here is on the Ngöbe women of this community and their experiences and practices of sexual and reproductive health care.

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Huang, Song-Lin. "Towards a different mixed economy of care in Taiwan? : public domiciliary care for elderly people living alone". Thesis, University of Newcastle Upon Tyne, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289264.

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Hungerford, Gabriela Marie MS. "Characterizing Community-Based Usual Mental Health Care for Infants". FIU Digital Commons, 2016. http://digitalcommons.fiu.edu/etd/2609.

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Infants who experience multiple risk factors, such as preterm birth, developmental delay, and low socioeconomic status, are at greater risk for mental health problems. Mental health interventions for infants typically target infants from high-risk groups, and there is strong evidence that some intervention programs for infants can prevent long-term negative outcomes and promote long-term positive outcomes. Despite emerging research and federal initiatives promoting early intervention, minimal research has examined community-based mental health services during infancy. Improving the effectiveness and efficiency of routine care requires close examination of current practices. The current study characterized current usual care practices in infant mental health through a survey of mental health providers. Provider, practice, and client characteristics, provider use of intervention strategies and intervention programs, and provider attitudes toward and knowledge of evidence-based practices are described. Study findings are discussed in the context of previous usual care research. Implications and directions for future research are discussed.

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Voytenko, Vitaliy L. "Community-based care in Ukraine a pastoral training program /". Theological Research Exchange Network (TREN) Access this title online, 2005. http://www.tren.com.

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Jones, Huw Scott. "Ageing, caregiving and community care : an ethnographic case study". Thesis, Royal Holloway, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.362779.

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