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1
Basu, Rashmita. "Healthy lifestyle, disease prevention and health care utilization". Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Dissertations/Fall2009/r_basu_112309.pdf.
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Annear, Peter Leslie, e mikewood@deakin edu au. "Healthy markets - Heathly people? Reforming health care in Cambodia". Deakin University. School of Health Sciences, 2001. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050825.134836.
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Health care reform has been described as a global epidemic. This thesis deals with nature and experience of health care reform in developing countries. Increasing privatisation, economic transition, and structural adjustment have provided the context for health system changes. Different approaches to reform have been developed by international organisations such as the World Bank, WHO and UNICEF. What has driven national health care reforms? Are such policies really appropriate to developing countries? Has a consensus now emerged in relation to international health policy? Has a new health care model appeared? The study of health care reform in Cambodia is a timely opportunity to investigate the implementation of health care reform under extreme conditions. These conditions include a legacy of genocide, long-term conflict, political isolation, and economic transition. This case study uses both qualitative and quantitative methods and multiple sources of data to analyse the reform program. The study reinforces the conclusion that, under conditions of extreme poverty, market based reforms are likely to have limited positive impact. Rather, understanding the cultural conditions that determine demand, delivering health care of a satisfactory quality, providing appropriate incentives for health practitioners, and supporting services with adequate public funding are the prerequisites for improved service delivery and utilisation. Cambodia's strategy of integrated district health service development and universal population coverage may provide an instructive example of reform. Emerging policy issues identified by this case study include the fundamental role of equity in service provision, the influence of the social determinants of health and illness and interest in the appropriate use of evidence in international health policy-making.
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Skånér, Ylva. "Diagnosing heart failure in primary health care /". Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-784-3/.
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Spears, Amanda. "The Healthy People 2010 criteria for the care of children with special health care needs an effective national policy for meeting mental health care needs? /". CONNECT TO ELECTRONIC THESIS, 2007. http://dspace.wrlc.org/handle/1961/4128.
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Tansathitaya, Vimolmas. "Selected Health Related Factors and Behaviors among Southeast Asian Immigrants: Tobacco, Mental Health, Healthy Neighborhood Factors, and Health Care Utilization". University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1552391701300341.
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Holsapple, Susan Wilt. "Heal this health care experiences of gay men /". Related Electronic Resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2005. http://wwwlib.umi.com/cr/syr/main.
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Haas, Marion Ruth. "Benefits of health care beyond health: an exploration of non-health outcomes of health care". University of Sydney. Public Health, 2002. http://hdl.handle.net/2123/854.
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Recent interest in identifying and measuring health outcomes represents an advance in our understanding of how health care for individuals should be evaluated. However, the concept of health outcomes has mainly focussed on improvements in health status. Non-health outcomes of health care may also be important to patients. In this thesis, four tasks were undertaken with the aim of identifying non-health outcomes and establishing the extent of their relevance and importance to patients. First, the illness experience literature was reviewed to identify potential non-health outcomes. Seven categories of non-health outcomes were identified: information, being treated with dignity, being able to trust the health care provider, having distress recognised and supported, participating in decision making, legitimation and reassurance. Second, to gain an in-depth understanding of these concepts, topic-specific literature was reviewed and synthesised. Third, in order to confirm how relevant and important the concepts were to patients, a qualitative study was conducted with each of two different groups of health service users. Broadly, patients considered that all the non-health concepts were relevant, although the extent to which they were important varied. Fourth, to test the relative importance of the seven concepts, a Stated Preference Discrete Choice experiment in the context of general practice was conducted. This study showed that most people thought their GP demonstrated behaviour likely to result in the production of non-health outcomes. The results showed that although all the non-health outcomes were, to some extent, preferred by respondents, trust was most important, followed by legitimation and recognition of and support for emotional distress. Once again, these results point to the importance of context in the evaluation of health care from the patient's perspective. While still being perceived as positive aspects of health care, the provision of information and acting autonomously or participating in decisions about their health care were the non-health outcomes considered least important by patients
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Mbuzi, Vainess Banda. "Understanding Indigenous people’s experiences of acute health care with a focus on heart health". Phd thesis, Australian Catholic University, 2020. https://acuresearchbank.acu.edu.au/download/40626310ee5a3fd6023840c44f246c2c91a0e6cda381bd74a9f0e71e00725fec/16415877/Mbuzi_2020_Indigenous_People%27s_Experiences_Focus_On_Heart_Health.pdf.
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Overview
The program of research presented in this thesis was designed to increase understanding of the central issues related to Indigenous peoples’ hospitalisation experiences. Emphasis was given to Indigenous peoples’ cardiovascular health care. This area was chosen because cardiovascular disease has been described as one of the major contributors to the health disparity between Indigenous and non-indigenous peoples in Australia. This was of interest to me because the main study setting is a cardiothoracic hospital. This hospital is the largest referral centre for cardiac conditions in Queensland, surrounding states, and neighbouring countries, including Papua New Guinea.
This program of research comprised four studies. The first study, a metasynthesis, was undertaken to gather a worldwide perspective of Indigenous peoples’ experiences of acute care. In the second study, a narrative inquiry was undertaken. It focused on Indigenous Australians’ experiences of acute cardiac care. The third study was a systematic review. It adopted a broader perspective to investigate the effectiveness of Australian Indigenous cardiovascular health programs. The final study, an autoethnography, utilised reflective inquiry to examine issues related to researching with Indigenous people.
Background
There are many explanations given to explicate sources of health disparities for Indigenous people. Most of the factors have their roots in past colonialism and its policies. Past practices by former Australian governments devalued the Indigenous culture, tortured individuals both physically and psychologically, and effectively marginalised the Indigenous population. Indigenous people still experience elements of tacit and overt discriminatory practices within the healthcare system. A range of cultural and Indigenous-specific factors also impact Indigenous health in a negative way. As a result, Australian Indigenous people encounter noteworthy health inequalities when compared to non-Indigenous Australians. In recognition and response to this disparity in health status, the Australian government launched a “Close the Gap” campaign in 2008. The campaign attempts to narrow the health differences and life expectancy, while also considering other factors that impact Indigenous health such as education and employment opportunities.
Coming to hospital is a challenge for most Indigenous Australians. In Australia, Indigenous people are often geographically isolated in scattered settlements, and living in relatively small communities, leading to fragmented services and support for health and social programs. They are isolated both geographically and culturally when they come to hospital. In most cases, they have to relocate in order to access the services they need. This experience can be overwhelming due to the different culture of hospital practices and world views of healthcare professionals, who are mainly from westernised backgrounds. In most healthcare settings, Indigenous peoples’ culture and views of health have not been integrated into mainstream health. In a way, Indigenous people are forced to leave their way of life at home and adapt to western culture when hospitalised. This can cause discomfort for Indigenous people in many ways. As a result, some avoid accessing health services even when such services are needed and are available to them.
A few aspects of Indigenous culture may be presented in hospital settings but usually at tokenistic or symbolic levels. This includes items such as flags at the front of the hospital and Indigenous paintings on display. Health professionals’ attitudes, as well as the hospital policies that guide their practice, do not usually accommodate Indigenous values into practice. Bedside manners and ward practices have remained the same for many years – fashioned and practiced in the ways of the dominant culture.
In Australia, cardiovascular disease is known to constitute one of the major single causes of ill health and death for Indigenous peoples. As a result, it contributes significantly to life expectancy differentials between this population and other Australians. Indigenous Australians suffer major gaps in health status even when compared with other Indigenous peoples in other first-class nations. This includes Indigenous peoples from Canada, New Zealand and the United States of America. Health practitioners, therefore, need to be aware and proactively act on the underlying causes of poor health outcomes among Indigenous people.
Methods
Four studies were conducted over the period of this program of research using qualitative and quantitative research methods. The first study was a metasynthesis of qualitative research studies. Its aim was to investigate current evidence of Indigenous peoples’ hospital experiences in order to summarise current knowledge. Systematic procedures were employed to retrieve studies from the period between 2000 to 2016. The review process was conducted following Joanna Briggs Institute (2014) guidelines for conducting systematic review and synthesis of qualitative data.
The second study utilised narrative inquiry, a qualitative methodology in which face to face interviews were used to enable participants to recount their experiences of hospitalisation. Narrative inquiry was selected specifically because it involves storytelling, which is culturally familiar to Indigenous people. The aim was to explore Indigenous peoples’ experiences of hospitalisation of acute cardiac care. To accomplish this, data were collected using a purposeful sample of Indigenous cardiac participants: all Indigenous patient participants had been hospitalised for acute cardiac care.
The third study was a systematic review. Its aim was to investigate the effectiveness of cardiovascular health care programs designed for Indigenous Australians. Analysis of the strategies that were used to achieve successful outcomes was conducted. Studies that used experimental designs and reported interventions or programs explicitly aimed at improving Indigenous cardiovascular health were considered for inclusion. The search period was between 2008 to 2017.
The fourth study was an autoethnography. This study involved use of personal diary-based data and reflective inquiry to present a researcher perspective of the experience of conducting research with Indigenous people. The aim was to share the experience to inform others of aspects for consideration when conducting research with Indigenous participants. The purpose was to offer a true picture of conducting research from my perspective. The study enabled examination of the interplay of my personal, social, professional life and how these impact on my clinical and research practice.
Findings
The metasynthesis revealed that overall, Indigenous peoples, worldwide, have remained in a disadvantaged position when it comes to their health and wellbeing. Several factors were identified that contribute to widespread inequality in Indigenous healthcare. It was increasingly clear that current healthcare systems are not effectively working well in addressing Indigenous peoples’ health needs.
The findings of the narrative inquiry indicated that three themes characterised Indigenous peoples’ experiences of hospitalisation which were as follows: the impact of the past, reality of the present, and anticipating the future in Australia. Hospitalisation remains a challenge for Indigenous peoples. This is due to a sense of dislocation and lack of cultural and spiritual aspects to care, as well as the persisting poor relational interactions encountered.
Quantitative research studies that implemented interventions targeted for management of cardiac conditions among Indigenous population within Australia were included in the systematic review. The results revealed that there were limited published studies targeted specifically towards Indigenous Australians’ cardiac health improvement. However, positive outcomes were reported in terms of achieving clinical targets. Physical aspects such as blood pressure reduction, exercise attendance, and enhancing cardiac health knowledge in biomedical interventions for the Indigenous communities were the main focus.
The autoethnography revealed that with adequate preparation and involvement of Indigenous people the research process can be made easier. Again, because of past experiences which have led Indigenous people to be over researched with little feedback to them; researching this population group is challenging. Most researchers in the past have conducted research that has not effectively benefited the community. In some cases, research outcomes have misrepresented participants through use of methodologies that are not appropriate for Indigenous peoples. It is not unusual for Indigenous peoples to view the word “research” as a “dirty” word that brings uncomfortable feelings. In some instances, Indigenous participants have not seen its benefits of the research or understood the outcomes.
Conclusions
In summary, the program of research appraised current evidence. Further, it presented new knowledge that can inform and support practitioners in their quest to progress Indigenous peoples’ healthiness and welfare. Highlighting issues from Indigenous peoples ’perspectives can facilitate development of a better understanding of issues that impact their experiences with healthcare institutions. Such revelations can help in the identification of limitations faced by health professionals or constraints they encounter in the delivery of healthcare among Indigenous people. This could assist in revealing issues that are barriers to being effective in designing and implementing effective strategies to improve Indigenous health and wellbeing. Further research is warranted to follow up on the issues identified in this research.
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Sanchez, Collado Irene. "The impact of providing informal care on carer well-being, retirement, and health". Thesis, University of York, 2017. http://etheses.whiterose.ac.uk/20049/.
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This thesis includes a series of case studies exploring the impact of providing informal (unpaid) care on the well-being, retirement decisions, and physical and mental health outcomes of carers. We use a representative sample of the UK population and informal carers from eighteen waves of the British Household Survey (BHPS). Analysis is undertaken from an economic and micro-econometrics perspective, using a variety of econometric techniques tailored to the specific questions and data in each study. The first chapter introduces the topics and provides descriptive statistics of the sample of carers in BHPS. In the second chapter, we study the impact of providing informal care on happiness and life satisfaction and calculate monetary values for informal care for each of these subjective well-being measures and by gender. We find monetary values of around £18 per extra hour of informal care provided per week for men and women in our preferred model, although values vary with the well-being measure, the measure of informal care, and the estimation method used. In chapter three we study whether the decision to retire before the State Pension Age is affected by the intensity of the informal care provided by men and women. We find that the probability of retirement is around twice as high for carers than for non-carers. Chapter 4 analyses the impact of providing informal care on caregiver ́s health, using a variety of health measures: GHQ, SF-6D, health conditions and self-assessed health. We find a small but negative effect of providing informal care on both the physical and mental health of informal carers. With these analyses, we aim to contribute to the literature by providing evidence on the impact of informal caring on carers to inform policy towards them and those they care for.
10
Bataineh, Hana. "An Empirical Investigation of Unmet Health Care, Health Care Utilization and Health Outcomes". Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36492.
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This thesis is comprised of three chapters that empirically examine two important areas in health economics: access to health care and health outcomes.
The first chapter explores the impact of health care utilization on unmet health care needs (UHC) using four biennial confidential master files (2001-2010) of the Canadian Community Health Survey and applying an instrumental variables (IV) approach to deal with the endogeneity of health care utilization. The presence of drug insurance and the number of physicians in each health region are used to identify the causal effect. I find a clear and robustly negative relationship between health care use and unmet health care needs; individuals who are more likely to report unmet health care needs are those who use the health care system less frequently. One more visit to a family doctor, specialist or a medical doctor on average, decreases the probability of having unmet health care needs by 7.1, 4.6 and 2.8 percentage points, respectively. Further analysis by sub groups reveals that the impact of health care utilization on UHC is larger for females in comparison to males, rural residents in comparison to urban dwellers and those with low household income rather than high.
The second chapter of this thesis examines whether the presence of the unmet health-care (UHC) needs has an adverse effect on health outcomes using the National Population Health Survey, a nationally representative longitudinal data set spanning 18 years. I pay close attention to the potential endogeneity of this problem. Five direct and indirect measures of health-related outcomes are examined. I find clear and robust evidence that the presence of UHC either two-years previously or anytime in the past, affects negatively the current health of the individual – controlling for a host of other influences. For instance, reporting UHC in the previous cycle reduces the probability of being in excellent or very good health and in good mental health, respectively by 8.1 and 1.2 percentage points; it reduces the HUI3 score by 2.9 percentage points and increases the expected number of medications used by 11%. Further analysis by looking at the effect of UHC when it was due to accessibility reasons, reveal that the effect of UHC because of accessibility reasons on health outcomes is larger than the one of the overall UHC, but the difference is small in general.
Finally, the third chapter of this thesis examines the link between social networks and access to health care utilization, focusing particularly on the probability of having a regular family doctor. Unlike previous work that uses cross sectional data, I use panel data from the National Population Health survey to control for unobserved heterogeneity. Access to a regular family doctor is modeled using the dynamic random effects probit model, which makes it possible to explore the dynamics of access to a regular family doctor– for instance, the role played by past access status to a family doctor in predicting current access. In particular, I use the dynamic random effects probit model that controls for both unobserved heterogeneity and for initial conditions effects. I find robust evidence of a highly statistically significant relationship between social capital and the probability of having a regular family doctor. Although the marginal effects are modest, the results from all model specifications show that there is clear evidence that individuals with high levels of tangible, affection, emotional, social interaction, who live with spouse only or with spouse and children are more likely to have a regular family doctor, whereas those living alone are less likely to have a regular family doctor. The results also reveal that past access to a family doctor is an important determinant for both current and future access. The predicted probability of having a regular family doctor is about 18 percentage points (or 20%) higher for individuals who had a family doctor in the previous period, relative to those who did not. In addition, I find that unobserved heterogeneity accounts for about 25% of the variation in accessing a regular family doctor and is significantly correlated with the access to a family doctor over my long panel.
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Mykhalovskiy, Eric. "Knowing health care / governing health care exploring health services research as social practice /". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0018/NQ56249.pdf.
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Szende, Agota. "Equity in health and health care in Hungary : health status, finance, and delivery of health care". Thesis, University of York, 2003. http://etheses.whiterose.ac.uk/14056/.
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Haas, Marion. "The benefits of health care beyond health an exploration of non-health outcomes of health care /". Connect to full text, 2002. http://hdl.handle.net/2123/854.
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Thesis (Ph. D.)--University of Sydney, 2002.Includes tables and questionnaires. Title from title screen (viewed Apr. 28, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Public Health and Community Medicine, Faculty of Medicine. Includes bibliography. Also available in print form.
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Batross, Deana J. "Correlation of Health Related Quality of Life and Health Literacy Levels in Patients with Heart Failure". Otterbein University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1461096576.
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Wood, David L., e R. Nathawad. "Health Care Transition". Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/5155.
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Schultz, Sarah Robinson. "Health coverage without health care unmet mental health care needs among the publicly insured /". Connect to Electronic Thesis (CONTENTdm), 2009. http://worldcat.org/oclc/457147003/viewonline.
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Rhodes, Christine Amanda. "The agency of service user and carer engagement in health and social care education". Thesis, University of Huddersfield, 2014. http://eprints.hud.ac.uk/id/eprint/23682/.
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Service user and carer involvement in health and social care education in the UK has gained momentum over the last two decades, largely driven by consumerist and democratic ideologies. This is reinforced by the health and social care regulatory bodies such as the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC). This thesis presents a series of eight peer reviewed papers that have focussed on the agency of service user and carer involvement in health and social care education. The accompanying commentary draws the papers together and locates them within an overarching theoretical framework, ‘The Ladder of involvement’. This portfolio of evidence demonstrates a coherent approach that draws on underlying philosophies and theoretical underpinnings and displays contribution to knowledge in five distinct sections: Contribution to the literature with new findings, location of the findings within the current literature, location of the findings within the theoretical framework, contribution to the refinement and development of theory and contribution to dialogue and debate. The key message from the studies undertaken as part of this portfolio of evidence is that service user and care involvement in health and social care education enhances student learning and influences their future practice. However, there must be a well-developed infrastructure within higher education institutions that recognises the complexities of user involvement for the key stakeholders. There is a pressing need for additional research to further substantiate the benefit of user involvement for all parties concerned, in order for user involvement to take its place as a core component of health and social care education.
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Blanton, Sandra. "Justice in Health Care Access Measuring Attitudes of Health Care Professionals". TopSCHOLAR®, 2000. http://digitalcommons.wku.edu/theses/714.
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To measure attitudes toward justice in access to health care services in managed care plans in a convenience sample of medical professionals at Clark Memorial Hospital in Jeffersonville, Indiana. Methods. A sixteen item, self-administered instrument based on Morreim's four concepts of justice in health care access was administered to 147 health care professionals, representing physicians, allied health, and hospital administration. SPSS was used to analyze the results. Results. The attitudes of the respondents were negative toward managed care. They did not feel that managed care had been a positive development in the United States or that managed care had improved access to preventive care or improved primary care. On the survey instrument, respondents scored highest on the scale measuring fairness to individual patients. Conclusion. In a convenience sample of health care professionals at Clark Memorial Hospital in Jeffersonville, Indiana, equity in distributing access to health care among individual patient needs was found to more closely meet their expectations of justice in health care access. There were no differences found across occupational groups in their responses to the two scales. There were differences in attitudes toward managed care among occupational groups.
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Lymer, Ulla-Britt. "Blood exposure in health care : health care workers' and patients' experiences /". Linköping : Univ, 2004. http://www.bibl.liu.se/liupubl/disp/disp2004/med874s.pdf.
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Donato, Francis A. "Reforming health care through managed care". Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1995. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1995.Source: Masters Abstracts International, Volume: 45-06, page: 2939. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 91-92).
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Al-Yaemni, Asmaa Abdullah. "Does universal health care system in Saudi Arabia achieve equity in health and health care?" Thesis, University of Liverpool, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.526777.
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Farrell, Kathy, e University of Lethbridge Faculty of Education. "Health care professionals' perceptions of health promotion". Thesis, Lethbridge, Alta. : University of Lethbridge, Faculty of Education, 1996, 1996. http://hdl.handle.net/10133/34.
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The concept of health promotion is an alternative and emerging orientation. Here the belief is that all people have strengths and are capable of determining their own needs, finding their own answers, and solving their own problems. Most health care professional have been educated in the medical model of health. In this model,
the health care professional, especially the physician, plays an active part as an expert on disease; the patient or client has essentially a passive role, and the disease rather than the person is the focus. The role of health care professionals in health promotion is an important one and will continue to expand with the new focus of the province of Alberta's health system. The focus of that system, and other health systems in Canada and abroad, is increasingly upon health promotion rather than disease treatment. The purpose of this study was to determine the perceptions of a variety of health care professionals working in the community and in the hospital setting relating to health promotion. The study takes a non-experimental approach utilizing a descriptive design. All professional staff including registered nurses, occupational therapists, recreational therapists, physiotherapists, respiratory therapists, social workers, dental workers, nutritionists, speech-language pathologists, and physicians working in Palliser Health Authority were asked to participate in the survey. Two hundred and thirteen staff responded to a questionnaire desgined to reflect their perceptions on the importance of health promotion, determinants of health, principles of health promotion, and skills and knowledge of health promotion. Staff were also asked to identify health promotion activities occuring at their work site, possible barriers to health promotion, and what was needed regarding training and support. Some of the major findings include: 1) Staff perceive health promotion to be an important part of their job. However staff working in the community perceive health promotion to be more important than those working in the hospital. Physicians were the least positive about questions pertaining to the importance of health promotion. 2) Staff perceive that the purpose of health promotion is to strengthen peoples' control over their health, but responses also indicate uncertainty concerning how control is to be defined and effected. 3) When asked to identify health promotion activities at their work site, the majority of staff pointed to the provision of information to individuals and groups. Community development was listed by very few staff. 4) When staff were asked to identify barriers to health promotion they identified the following in the order: lack of resources, old attitudes about health and health promotion, lack of support from the organization and doctors, lack of knowledge/education, and lack of communication between health care workers.v, 101 leaves : ill. ; 28 cm.
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Liebe-Harkort, Carola. "Oral Health Care and Humanitarian Health Praxis". Thesis, Röda Korsets Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2276.
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Background: Oral and dental diseases is a major part of the global disease burden. Poor oral health has a significant impact on the general well-being of people. In contrast with prior decades high rates of oral diseases may be found in low- and middle income countries. Populations that are particularly vulnerable are more likely to develop poor oral health. As a consequence of human distress related to war, poverty and natural disasters the accomplishments of humanitarian aid organizations has a direct impact on people´s health and well-being. Purpose: The aim of the present study is to examine the International Red Cross and Red Crescent Movement as well as Doctors without borders concerning documents and guidelines on oral health. A further aim is to explore the knowledge of oral health related topics of delegates from the International Federation of the Red Cross and Red Crescent Societies (IFRC). Method: The study is designed as a literature review and a questionnaire survey. Results: Within the International Red Cross and Red Crescent Movement and Doctors Without Borders there are a limited number of guidelines on oral health and they are rarely mentioned in the same documents as non-communicable diseases (NCDs). The responses of the study revealed that the participants generally have a limited knowledge about measures on oral health in the IFRC. Conclusion: Both the literature review and the questionnaire survey study confirms that there is an absence of clear and specific guidelines on oral health care related activities within IFRC.Bakgrund: Mun- och tandsjukdomar utgör en stor del av den globala sjukdomsbördan. Dålig mun- och tandhälsa har en stark påverkan på det allmänna välbefinnandet. I motsats till tidigare, ses idag höga frekvenser av karies även i låg- och medelinkomstländer. Populationer vilka befinner sig i extra utsatta kontexter löper större risk att utveckla dålig munhälsa. Som en följd av mänskligt lidande i form av händelser relaterade till krig, fattigdom och naturkatastrofer har aktiviteter utförda av humanitära hjälporganisationer en direkt inverkan på hälsa och välbefinnande. Syfte: Syftet med föreliggande studie är att studera dokument och riktlinjer rörande munhälsa inom Internationella Röda korset och Röda halvmånen och Läkare utan gränser. Ett ytterligare syfte är att undersöka kunskapen om hälsorelaterade frågor kring munhälsa hos delegater från Internationella federationen för Röda Korset och Röda Halvmånen (IFRC). Metod: Studien är utförd som en litteratur-sammanställning och som en enkätundersökning. Resultat: Inom Internationella Röda korset och Röda halvmånen samt Läkare utan gränser återfinns begränsat antal riktlinjer rörande oral hälsa vilka dock sällan nämns i samma dokument som icke-smittsamma sjukdomar (NCDs). Av enkätsvaren i studien framgår det att de medverkande generellt har en begränsad kunskap kring åtgärder rörande munhälsa inom IFRC. Konklusion: Deltagarna i denna studie bekräftar resultaten i litteraturstudien om en avsaknad av tydliga och konkreta riktlinjer för munhygienrelaterade aktiviteter inom IFRC.
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McGriff, Aisha Kamilah. "Healthy Bodies Matter: Analysis of the Disclosure of Race and Health Care on WebMD.com". Bowling Green State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1447584802.
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Marshall, Emily Gard. "Universal health care? : access to primary care and missed health care of young adult Canadians". Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/30948.
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Prevalence of missed health care by life course stage is examined with a critique of the
measure of missed care. Canadians reporting missed care has increased from 4.2% in
1995 to 12.5% in 2001. Research questions: 1. Who reports missed care in Canada? 2.
What are the relationships among life course stages, social support, predisposing,
enabling and need factors to the reporting of missed care? 3. What is the role that life
course stages play in the relationships among social support, predisposing, enabling, and
need factors? 4. What kinds of health care are Canadians reporting they missed? 5. What
reasons are provide for missing care?; and 6. Who accesses primary care and what is the
relationship to reporting missed care? Methods: Analysis was done using the Canadian
Community Health Survey Cycle 2.1. Nested multiple logistic regression models explore
the relationships among variables of interest predicting missed care. Results: Young
adults (18-30) are more likely to report missed care compared to other age groups and
are least likely to have a regular doctor. Social support is most significantly protective
against missed care for young adults. Weak sense of belonging to a local community
and lower income are stronger predictors of missed care for young adults. Young adults
differ from others in the reasons they report for missed care (i.e., more likely to report
cost as a barrier). Discussion: It's not clear if the difference between young adults and
other life course stages is in actual missed care or expectations of primary care. Yet, the
literature on emerging adulthood invites curiosity about how delayed adulthood leaves
them in less stable, financially insecure, socially and institutionally isolated situations
that have subsequent consequences for primary care access. Changes in models of
primary care have led to a decline in comprehensive care and more drop-in clinics; while,
not having a regular doctor is associated with missed care. If patterns of inadequate
primary care access established in young adulthood are perpetuated in later life, this may
foretell undesirable consequences for the health of Canadians. A new model for
measuring unmet health care needs is proposed.Graduate and Postdoctoral Studies
Graduate
26
Damore, Deborah Rose. "H.H.S.C. Spiritual Health Care Centre, integrated spiritual health care graduate academic programme". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0015/MQ55440.pdf.
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Babaie, M. H. "Inequities in health and health care between provinces of Iran : promoting equitable health care resource allocation". Thesis, University of Salford, 2014. http://usir.salford.ac.uk/30807/.
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Investigation of the influence of public expenditure on health lends support to the opinion that equitable distribution of financial resources would help to reduce inequities in health. This thesis set out to establish inequities in access to health care and health outcomes across the provinces of Iran and explore equitable resource allocation models to contribute to the reduction of health inequities. Inequities were measured based on the relationship between a range of health indicators and socioeconomic status in the provinces. Information on mortality, morbidity, and socioeconomic factors were taken respectively from the Death Registration System, Health Profile in Iran (2003), and Iran's 2006 census. There were significant relationships between mortality and socioeconomic indicators across the provinces, with the larger rates of mortality in the worst-off provinces. Coronary risk factors (diabetes, high serum cholesterol) were significantly associated with socioeconomic factors; with higher prevalence of the risk factors in the well-off provinces. There were also significant relationships between access to health services (hospital delivery and vaccination) and socioeconomic status; with lower access in the worst-off provinces. The resource allocation models based on population size and age/sex structure changed the health expenditure in favour of the well-off provinces to contribute to the reduction of inequities in morbidities. However, models based on mortality and deprivation changed the expenditure towards the worst-off provinces, in order to bridge the inequities in mortality and access to health services. Equity targets set, based on a combination of age/sex, mortality, and deprivation, indicated that nineteen provinces had received a share of expenditure higher than the equity target, with the largest in Mazanderan and seven provinces received a share lower than the target, with the largest in Tehran. A five-year plan was developed to move the expenditure from the hyper-financed provinces to the under- financed ones.
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Spilsbury, Karen. "Who cares? : a case study to explore health care assistants' jurisdiction in a hospital setting". Thesis, City University London, 2004. http://openaccess.city.ac.uk/8408/.
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Changes to the work of registered nurses (RNs) has generated increasing concern about the ways in which HCAs are used and the basis for the division of nursing work tasks and roles. The theoretical and empirical foundations upon which these divisions lie are often weak. Empirical data are often lacking, or of sufficiently poor quality to be questioned. This thesis seeks to understand the division of work between HCAs and RNs in adult general care in one acute NHS hospital. The thesis makes use of an interactionist perspective to frame the study's examination of the micro-social processes surrounding the daily negotiation of HCAs' work. In doing so, connections are made to the wider (macro) processes that influence nursing work. An in-depth case study approach using documents, survey, interviews, focus groups and participant observation was used to collect data on the demographic and biographic characteristics of HCAs; their perceptions of their work; the nature of observed work; the ways in which their work is supervised; their interactions with other nurses; and RNs' perspectives of HCA work. National, professional and organisation policy expectations emphasise the HCA role as one of assisting RNs under their supervision. This study reveals significant deviation from these policy goals. The workplace arena - and the negotiations that take place in it — actively shapes HCAs' work and yet policy makers often appear to disregard this characteristic. Differing amounts of power associated with the occupational groups in hospitals influence the nature and outcome of work-related negotiations at the organisational level - the results of these negotiations are variable, and lead to dynamic patterns of use, non-use and misuse of the HCA resource. These patterns led to some unintended outcomes: a resentful workforce, the creation of gaps in the application of nursing care, and traditional quality assurance mechanisms left wanting.
29
Sewell, Claire. "The emergence of the carer : mental health care in England and Wales, c. 1946-1999". Thesis, University of Warwick, 2015. http://wrap.warwick.ac.uk/69153/.
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This thesis examines the emergence of the family carer in English and Welsh mental health care, from the inception of the National Association for the Parents of Backwards Children in 1946 until the publication of the National Strategy for Carers in 1999. Rather than being primarily concerned with the day-to-day experiences of these family care-givers, the focus of this thesis, drawing upon Professor Ian Hacking’s theories as a starting point, is on the history of ideas and the emergence of the family carer as a category. With specific reference to familial care of relatives with a mental illness or a learning disability, I consider how and why the term ‘carer’ did not come into widespread usage until the 1980s. As the British government moved towards an explicit policy of deinstitutionalisation and community care in the 1960s, concern was raised that care in the community would in reality mean care by the family. For some this was a concern because they were worried about the well-being of the affected families, whilst for others they were concerned about the potential pathological impact of the family. Through this qualitative study of the family carer, I argue that whilst families have cared for relatives with mental illnesses and learning disabilities for centuries, during the post-war years this role was discussed, acknowledged, politicised, negotiated, and challenged to a much greater extent. Indeed, by 1999 family carers were recognised in their own right rather than exclusively in relation to the person they cared for. The story of the emergence of the family carer contributes to, and in some respects destabilises, current literature on the histories of mental health care, community care, the family, the psychosocial, the welfare state, and voluntary action.
30
Claassens, Mareli Misha. "Responsibility in health care". Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/4280.
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Snyder, Hannah. "Health Care Customer Creativity". Doctoral thesis, Linköpings universitet, Logistik- och kvalitetsutveckling, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-125723.
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Crafting and stimulating service innovation is considered a main research priority and remains a challenge for service providers. One suggested component of stimulating service innovation is customer creativity. Customers who adapt, modify and transform services or products to better suit themselves are increasingly being recognized as a source of competitive value and innovation. It has been proposed that understanding and supporting the customer’s value creating practices is the key to creating and sustaining value over time in health care. Health services directly address a customer’s well-being and have a significant impact on his or her quality of life. In these types of services, the service outcome is highly dependent on the activities of the individual customer. Health care services often require customers to participate extensively, over long periods of time, with limited support and control. Health services also stretch far beyond the particular service setting into the customer’s daily life. While research, policy, and legislation have all emphasized the active role of health care customers, such customers have traditionally had few opportunities to design their health care services. Nevertheless, health care customers solve health-related problems and engage in self-care and medical decision-making on a day-to-day basis, although this creativity is often unknown to the service provider. To understand how health care customers can enable service innovation, this thesis seeks to conceptualize and investigate the concept of customer creativity in health care. The thesis focuses on customer creativity, not only as an outcome, but also as a dynamic and contextualized process that can be enhanced. The thesis combines insights from health care research with service and innovation research to provide build a framework for health care customer creativity. Building on five papers, the research develops an understanding for health care customer creativity. The individual papers are based on systematic literature reviews as well as empirical data in the form of customers’ ideas for service innovation collected through diaries. The results of the thesis suggest that despite the negative nature of the service, health care customers are creative. Given the opportunity, health care customers can provide creative ideas and solutions on a multitude of aspects, both within and outside the health care setting. This provides the potential to view the health care experience through the customers’ eyes and take part in their creativity in spheres where the service providers have not traditionally had any access. This thesis contributes to the literature by providing a framework for health care customer creativity that recognizes the concept as a complex interplay of factors operating at the individual, contextual, and situational levels. The proposed framework specifies the health care specific factors upon which customer creativity depends, with the intention of positing potential research directions and developing an enriched theory of health care customer creativity.
32
Polaha, Jodi. "Primary Care Behavioral Health". Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6676.
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Chou, Caroline. "Selfies for Health Care". Scholarship @ Claremont, 2019. https://scholarship.claremont.edu/cmc_theses/2277.
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Presently, self-tracking applications are used to help patients with chronic illness management. For example, applications ask users to track mood through online diaries or snap photos of their food content in order to analyze patterns correlated to their chronic disease. Although these health care applications are on the market today, there still exists a fundamental challenge in motivating participants to consistently update and enter information. Therefore, the focus of this thesis is on reducing the fatigue from using these applications. Pulling from user social media data will almost completely eliminate the capture burden placed on participants, since users will only have to continue to use social media as they regularly do.
Instead of analyzing manually inputted data, patterns can be found between social media data and chronic diseases. A Microsoft Research team found indicators in public user Twitter data associated with the onset of a depressive episode. They were able to create a predictor tool, predicting the onset of a depressive episode, with 70 percent accuracy. Using this research alongside expert feedback, our aim is to design an interface used by both clinician and patient that will provide them with a timeline marking spikes in Twitter indicators correlated to a patient’s depressive episode.
34
Ling, Meng-Chun. "Senior health care system". CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2785.
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Senior Health Care System (SHCS) is created for users to enter participants' conditions and store information in a central database. When users are ready for quarterly assessments the system generates a simple summary that can be reviewed, modified, and saved as part of the summary assessments, which are required by Federal and California law.
35
Ahmed, Rukhsana. "Assessing the role of cultural differences on health care receivers' perceptions of health care providers' cultural competence in health care interactions". Ohio : Ohio University, 2007. http://www.ohiolink.edu/etd/view.cgi?ohiou1178244318.
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Pammer, Christoph. "Quality of Care in Austria and Switzerland : ein Projektvorschlag /". Graz, 2004. http://www.public-health-edu.ch/new/Abstracts/PC_29.03.05.pdf.
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Åhs, Annika. "Health and Health Care Utilization among the Unemployed". Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7193.
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The number of persons who are not employed has increased in Sweden since the early 1990s. Unemployment has been found to influence health, especially when unemployment rates are low. The extent to which unemployment affects health when unemployment is high is less clear, and this needs to be further studied. To improve health in the population, the health care system should offer equal access to health care according to need. It is important to study whether the employment status hinders the fulfilment of this goal.
This thesis is based on four papers: Paper I and II aimed at analysing self-rated health versus mortality risk in relation to employment status, during one period of low unemployment and one period of high unemployment. Paper III and IV assessed the use of medical health care services and unmet care needs among persons who were unemployed or otherwise not employed. The goal was to analyse what health problems lead people to either seek or abstain from seeking care, and what factors encumber or facilitate this process.
The overall results indicate that being unemployed or outside the labour force was associated with an excess risk of poor self-rated health, symptoms of depression, mental and physical exhaustion and mortality. The differences in self-rated health between the unemployed and employed were larger when unemployment levels were high, than when they were low. More groups of the unemployed were also afflicted with poor health when unemployment was high. Thus, poor health among the unemployed seems to be a public health problem during high levels of unemployment. Lack of employment was related to abstaining from seeking care, despite perceiving a need for care, and this was related to psychological symptoms. To deal with the needs of the unemployed and others who are outside the labour force it would be useful to develop and implement interventions within the health care system. These should focus on psychological and psychosocial problems. Future research should analyse how to facilitate health-promoting interventions among persons who are not anchored in the labour market.
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Åhs, Annika. "Health and health care utilization among the unemployed /". Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7193.
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Howard, Shevon Naomi. "Health literacy program proposal for health care workers". Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10145339.
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Health information literacy influences patient health outcomes, yet almost 90% of adults struggle to understand health information. This study explored the impact of an education course in health literacy on healthcare professionals’ methods of providing information to patients in order to increase effective communication and improve patient outcomes. This study drew from an integrated theoretical framework that suggests development and validation of tools to measure health literacy. Access to and understanding of reliable, high-quality health care information equalizes many other variables that impact health outcomes, including age, economic class, and cultural background. This study analyzed survey data collected from 2 doctors, 2 nurse practitioners, and 1 staff nurse selected based on their expertise and experience working with patients. They completed a learner- centered course, in which learners interact and instructors provide feedback. Based on survey responses, the participants strongly supported implementing the proposed education module. Four of the 5 experts agreed that a course in health literacy will help health care workers recognize and address patients with low health literacy. Limited health literacy is associated with poor health outcomes and higher health care costs. This type of literacy requires a complex group of reading, listening, analytical, and decision- making skills, and the ability to apply these skills to health situations. The results of this study may guide educators to effectively communicate with patients, increase health literacy, and improve patient outcomes.
40
Fike, Verinda Jean Esther. "Health insurance and health care access in China". CONNECT TO ELECTRONIC THESIS, 2008. http://dspace.wrlc.org/handle/1961/5527.
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Wu, Yaping. "Essays on health care financing and health services". Thesis, Toulouse 1, 2014. http://www.theses.fr/2014TOU10007.
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Le monde dépense une part significative et en augmentation constante de ses ressources sur les soins de santé. Les débats sur les modèles de financement des soins de santé et sur les méthodes de paiement des praticiens se déroulent dans le monde. Néanmoins, il n’existe toujours pas de consensus sur le choix idéal des mécanismes de financement. Cette thèse vise à contribuer aux débats sur le financement des soins de santé et sur la politique des services de santé. Le chapitre premier examine la règle de compensation non-linéaire optimale des praticiens, le principe selon le paiement à la performance, le paiement à l’acte et la capitation en présence à la fois l’antisélection et l’aléa moral au niveau de l’offre. Nous avons trouvé que lorsque l’aléa moral est le seul problème, le paiement à l’acte ne peut que conduire à la substitution de la quantité de traitement par rapport à l’effort du praticien, ce qui est inefficace. En conséquence, le paiement à l’acte ne devrait être utilisé dans ce cas. Toutefois, lorsque l’aléa moral se combine au problème de l’antisélection, un screening efficace requiert une utilisation continue du système de paiement à l’acte pour les praticiens à faible productivité et un moindre recours au système du paiement à la performance. L’élaboration de l’utilisation du paiement améliore le screening. Nous apportons des arguments sur l’analyse critique des points faibles du paiement à l’acte. Et, plus important encore, nous établissons les raisons de l’utilisation continue du paiement à l’acte malgré le fait que de sérieux problèmes concernant ce système aient été largement reconnus. Le chapitre deux analyse le problème du contrat trilatéral entre le payeur, le patient et le praticien, lorsque le praticien et le patient peuvent s’entendre pour exploiter des opportunités avantageuses à l’un et à l’autre. En prenant pour hypothèse qu’un transfert secondaire entre le patient et le praticien est exclu, nous analysons le problème de la mise en place du mécanisme où le praticien et le patient soumettent la réclamation du diagnostic au payeur par un jeu de déclaration. Nous en déduisons aussi le schéma optimal de l’assurance et du paiement pour le patient et le praticien. Le schéma optimal de l’assurance et du paiement qui est collusion-proof (faible) est tel que l’un des deux dise la vérité ; mais l’arbitrage du payeur est différent selon les différentes manières qu’il choisit pour répartir les incitations entre le patient et le praticien. De plus, nous montrons que si le payeur parvient à demander aux deux parties de présenter le diagnostic de manière séquentielle, l’avantage du pouvoir de veto du second agent permet au payeur de réaliser le meilleur résultat. Mon domaine d’étude secondaire traite de l’économie du développement. Le troisième chapitre a pour but d’examiner si la migration des villages vers les villes entraîne une éviction des contrats informels de partage de risque et conduit des ménages à une moindre (auto-)assurance de consommation des villages Thai. Pour ce qui concerne la motivation théorique, notre idée est que la migration peut être utilisée comme un contrat d’investissement réalisé à l’avance entre le ménage et l’enfant. Le ménage investit en payant d’avance en échange de versements futurs dépendants des circonstances, ce qui change le processus de revenus du ménage. Pour l’estimation, nous avons utilisé le tableau de Townsend Thai Annual Surveys (1997-2010). L’hypothèse d’aucun biais de sélection est rejetée au niveau du marché de l’assurance du village, ce qui conforte notre conjecture selon laquelle la migration change le statut de partage des risques des ménages à l’intérieur du village. Lorsque les biais sont corrigés, nos résultats montrent que la migration entraîne une éviction du partage des risques informels dans le village et conduit même à une diminution de l’(auto)assurance de consommation des ménages ThaiThe world spends a significant and increasing share of its resources on health care. The debates on the models of health care financing and the methods of payment for the physician continue all over the world. Nevertheless, there is still no consensus on the ideal choice of financing mechanisms. This thesis aims at contributing to the debates on the health care financing and health service policy. Chapter one examines the optimal non-linear compensation rule of physicians under pay-for-performance, fee-for-service and capitation in the presence of both adverse selection and moral hazard on the supply side. We found that when moral hazard is the only problem, fee-for-service can only lead to the substitution of treatment quantity to physician’s effort, which is inefficient. Consequently, fee-for-service payments should not be used in this case. However, when moral hazard is combined with the adverse selection issue, an efficient screening requires a continued use of fee-for-service for the lower productivity physicians and less pay-for-performance. The design of the use of fee-for-service effectively improves screening. We provide an argument for the criticism on the shortcomings of fee-for-service. More importantly, we also provide a rationale for the continued use of fee-for-service payment even though the serious problems with fee-for-service have been widely acknowledged. Chapter two analyzes the three-party contracting problem among the payer, the patient and the physician when the patient and the physician may collude to exploit mutually beneficial opportunities. Under the hypothesis that side transfer is ruled out, we analyze the mechanism design problem when the physician and the patient submit the claim to the payer through a reporting game. We also derive the optimal insurance payment scheme for the patient and the physician. The insurance payment scheme which is (weak) collusion-proof is such that it is sufficient that one of them tells the truth ; but the payer’s trade-offs are different when he chooses different manners of splitting incentives between the patient and the physician. Moreover, we show that if the payer is able to ask the two parties to report the diagnosis sequentially, the advantage of the veto power of the second agent allows the payer to achieve the first best outcome. My secondary field is Development Economics. The third chapter examines whether migration crowds out informal risk-sharing contracts and leads to less consumption insurance for households in Thai villages. For the theoretical motivation, our idea is that migration may be used as a cash-in-advance contract between the household and the child. The household invests upfront in exchange for future state-contingent remittance which changes the income process of the household. For the estimation, We use the panel from Townsend Thai Annual Surveys (1997-2010). The hypothesis of no selection bias is rejected at within village insurance market level, which supports our conjecture that migration changes the risk-sharing status of households within village. After the bias are corrected, our results show that migration crowds out informal risk-sharing within village and even leads to less consumption insurance for households in Thai villages
42
Olesen, Pauline. "Care for health : A health centre in Tomtebogård". Thesis, Umeå universitet, Arkitekthögskolan vid Umeå universitet, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-160051.
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Lin, Gwan-Ling. "THE TRANSITION FOR HEALTH CARE AMONG YOUNG ADULTS WITH CONGENITAL HEART DISEASE". Case Western Reserve University School of Graduate Studies / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=case1333378156.
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Wright, Pamela Leshel. "Development of a Home Health Transitional Care Program for Elderly Heart Failure". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/613.
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Ineffective transitional care programs for ensuring the continuation of care from the hospital setting to the home setting often result in rehospitalization for elderly heart failure patients age 65 and older. The purpose of this project was to develop a home health transitional care program for elderly patients transitioning from inpatient settings to home settings using care bundles consisting of evidence-based practices to reduce preventable rehospitalizations within 30 days of discharge. The home-based chronic care model, which provides a foundation for home health's integral role in chronic disease management by ensuring patient-centered evidence-based care, guided the development of this program. The developmental process elicited feedback from a team of home health advisory members, 3 home health experts, and 2 health care consumers who may use this program in the future. The readability of the program was at a 5th grade level for easy comprehension. A 3-item survey was given to 2 members from the target population, and a 5-item survey was given to 3 content experts to evaluate the transitional program. The advisory members were asked to read and provide feedback on the transitional care program. Data were analyzed using descriptive statistics to obtain a content validity ratio score of 1.00. Findings suggested universal agreement on the content of the transitional care program, which was developed as a resource tool to provide evidence-based care bundle interventions from scholarly literature. Implications for social change include improving the outcomes of elderly heart failure patient by providing home health care agencies with a comprehensive transitional care program to prevent avoidable rehospitalizations and help patients effectively manage the disease.
45
Cremer, Mary Ellen. "Voluntary giving for rural health care: the Sweet Grass County Health Care Foundation". Thesis, Montana State University, 1991. http://etd.lib.montana.edu/etd/1991/cremer/CremerM1991.pdf.
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The purpose of this thesis is to identify factors influencing community support for rural hospitals. Hospitals in rural areas are liable to experience unfavorable financial situations in the near future. Data from a specific fund drive were utilized to develop a model of voluntary giving that may be helpful in predicting the success or failure of other similar drives for the purpose of providing support to these hospitals. Results indicate that voluntary giving is consistent with economic utility maximization theory.
46
Benzarti, Emna. "Home Health Care Operations Management : Applying the districting approach to Home Health Care". Phd thesis, Ecole Centrale Paris, 2012. http://tel.archives-ouvertes.fr/tel-00718914.
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Within the framework of economic constraints and demographic changes which the health care sector is confronted to, the Home Health Care (HHC) which has been created sixty years ago, has known an important growth during this last decade. The main objective of this alternative to the traditional hospitalization consists in solving the problem of hospitals' capacity saturation by allowing earlier discharge of patients from hospital or by avoiding their admission while improving or maintaining the medical, psychological and social welfare of these patients. In this thesis, we are interested in the operations management within the HHC structures. In the first part of this thesis, we develop a qualitative analysis of the operations management in the HHC context. More specifically, we identify the complexity factors that operations management has to face up within this type of structures. For each complexity factor, we discuss how it can affect the organization of the care delivery. These factors pertain to the diversity of the services proposed, the location of care delivery, the uncertainty sources, etc. Thereafter, we survey operations management based models proposed in the literature within the HHC context. Based on this literature review, we identify several emerging issues, relevant from an organizational point of view, that have not been studied in the literature and thus represent unexplored opportunities for operations management researchers. In the second part of this thesis, we are interested in the partitioning of the area where the HCC structure operates into districts. This districting approach fits the policies of improvement of the quality of care delivered to patients and the working conditions of care givers as well as costs' reduction. We begin by proposing a classification of the different criteria that may be considered in the districting problem. We then propose two mathematical formulations for the HHC districting problem for which we consider criteria such as the workload balance, compactness, compatibility and indivisibility of basic units. After that, we present a numerical analysis of the computational experiments carried out on randomly generated instances to validate these two models. We also present two possible exploitations of these models and propose two extensions to these basic formulations. After formulating the problem with a static approach, we also develop a dynamic extension which allows the integration of the different variations that can be observed within the activities of an HHC structure from period to period. We then introduce a new partitioning criterion that concerns the continuity of care evaluated on the basis of two sub-criteria. Depending on the preferences of the decision-makers concerning the sub-criteria related to the continuity of care in the districting problem, we then distinguish three scenarios for which we propose the associated mathematical formulations.
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Marine, Marjorie Butler. "Marketing health care services for a preventive health care agency : a categorical study". Virtual Press, 1987. http://liblink.bsu.edu/uhtbin/catkey/530368.
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The purpose of the study was to determine the needs of one marketing segment of clients seen in a contraceptive clinic in the Midwest. The marketing segment targeted for study was women with positive Pap smears. A comparison group of women with negative Pap smears was sampled from the same clinic during the time frame July 1, 1982, to July 1, 1984.Nine research questions were investigated. Responses have been reported relative to the following questions:1. Does the incidence of positive Pap smears depend on the presence of cervical infection a woman may have?2. Does the incidence of positive Pap smears depend on whether or not a woman smokes?3. Does the incidence of positive Pap smears depend on the type of contraceptive (pill or barrier) used by a woman?4. Does the incidence of positive Pap smears depend number of abortions experienced by a woman?5. Does the incidence of positive Pap smears depend on the number of pregnancies experienced by a woman?6. Does the incidence of positive Pap smears depend on whether the woman is white or black?7. Does the incidence of positive Pap age of the woman?8. Does the incidence of positive Pap smears depend on the smears depend on whether the woman is married or not?9. Does the incidence of positive Pap smears depend on the educational status of the woman?Five conclusions were drawn from findings of the study and were confined to the population for the study, clients of the selected clinic:1. Women with positive Pap smears are more likely to have infections than women with negative Pap smears.2. Women who have had abortions are more likely to have positive Pap smears.3. The incidence of positive Pap smears is associated with pregnancies; that is women with one or more pregnancies are more likely to have positive Pap smears.4. A higher proportion of black women have positive Pap smears than white women.5. Women with less education have more positive Pap smears than women with higher levels of education.Department of Educational Administration and Supervision
48
Toth-Pal, Eva. "Computer decision support systems for opportunistic health screening and for chronic heart failure management in primary health care /". Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-435-8/.
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Donner, B. "Mainstream in-patient mental health care for people with learning difficulties : service user and carer experiences". Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1444626/.
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Government guidelines stress the importance of service user views when assessing and developing quality healthcare provision. This review examines what is known about the experience of being admitted and staying on a mainstream psychiatric ward from the perspective of the patient. The review firstly provides a context to the main body of literature by discussing relevant factors such as stigma and ethnicity. In depth examination of the three main areas relevant to the experience of service users is then discussed. This includes overall key research, the studies on coercion and those focussing on treatments. Both quantitative and qualitative studies are examined along with relevant methodological issues. This review highlights the diverse nature of user views as well as how important it is to listen to people on the receiving end of help.
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Wright, Trudy, e n/a. "Primary health care : the health care system and nurse education in Australia, 1985-1990". University of Canberra. Education, 1994. http://erl.canberra.edu.au./public/adt-AUC20061110.171759.
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Primary health care as a model for the provision of health services was
introduced by the World Health Organization In the mid 1970s. Initially
viewed as a means of health promotion and advancement of wellness in
developing countries., it was soon to be adopted by industrialised countries to
assist in relieving the demand on acute care services. This was to be achieved
through education of the community towards good health practices and the
preparation of nurses to practice in the community, outside of the acute care
environment Australian nurses were slow to respond to this philosophy of
health care and this study has sought to examine why this is so. It has been
found that there are a multitude of reasons for the lack of action In the decade
or more following the Declaration of Alma Ata and the major Issues have been
identified and elaborated.
Some of the major reports of the time that were associated with and had some
Influence on health care and nurse education have been examined to identify
recommendations and how much they support the ethos of primary health
care. These include the Sax committee report of 1978 and a submission by
the Department of Employment and Industrial Relations In 1987.
As part of the investigation, nursing curricula from around Australia in the
mid 1980s have been examined to determine the degree of the primary health
care content according to guidelines recommended by the World Health
Organization. It was found that generally at that time, there was a deficit In
the preparation of undergraduate students of nursing for practice In the area
of primary health care when the world, including industrialised nations, was
making moves towards this model of health care delivery.
Factors Influencing the slow response of nursing have been examined and
finally recommendations for further studies have been put forward.