742 resultados para Healthcare reform
Resumo:
Objective: This Student Selected Component (SSC) was designed to equip United Kingdom (UK) medical students to engage in whole-person care. The aim was to explore students' reactions to experiences provided, and consider potential benefits for future clinical practice.
Methods: The SSC was delivered in the workplace. Active learning was encouraged through facilitated discussion with and observation of clinicians, the palliative team, counselling services, hospital chaplaincy and healing ministries; sharing of medical histories by patients; and training in therapeutic communication. Assessment involved reflective journals, literature appraisal, and role-play simulation of the doctor-patient consultation. Module impact was evaluated by analysis of student coursework and a questionnaire.
Results: Students agreed that the content was stimulating, relevant, and enjoyable and that learning outcomes were achieved. They reported greater awareness of the benefit of clinicians engaging in care of the "whole person" rather than "the disease." Contributions of other professions to the healing process were acknowledged, and students felt better equipped for discussion of spiritual issues with patients. Many identified examples of activities which could be incorporated into core teaching to benefit all medical students.
Conclusion: The SSC provided relevant active learning opportunities for medical students to receive training in a whole-person approach to patient care.
Resumo:
Primary objective: To investigate the attitudes of healthcare professionals towards individuals with traumatic brain injury (TBI) and their relationship to intended healthcare behaviour.
Research design: An independent groups design utilized four independent variables; aetiology, group, blame and gender to explore attitudes towards survivors of brain injury. The dependent variables were measured using the Prejudicial Evaluation and Social Interaction Scale (PESIS) and Helping Behaviour Scale (HBS).
Methods and procedures: A hypothetical vignette based methodology was used. Four hundred and sixty participants (131 trainee nurses, 94 qualified nurses, 174 trainee doctors, 61 qualified doctors) were randomly allocated to one of six possible conditions.
Main outcomes and results: Regardless of aetiology, if an individual is to blame for their injury, qualified healthcare professionals have more prejudicial attitudes than those entering the profession. There is a significant negative relationship between prejudice and helping behaviour for qualified healthcare professionals.
Conclusions: Increased prejudicial attitudes of qualified staff are related to a decrease in intended helping behaviour, which has the potential to impact negatively on an individual's recovery post-injury.
Resumo:
Welfare to work has received less attention in devolution studies than other policy sectors. Drawing on Hall’s (1993) ‘orders of change’ model as an analytical framework, this paper addresses this deficit. The devolution settlement and constitutional question in Northern Ireland limit the likelihood of radical departure from ‘parity’ with Great Britain but differences are emerging.
Resumo:
Welfare-to-work policy in the UK sees ‘choice’ regarding lone parents’ employment decisions increasingly defined in terms of powers of selection between options within active labour market programmes, with constraints on the option of non-market activity progressively tightened. In this paper, we examine the wider choice agenda in public services in relation to lone-parent employment, focusing on the period of welfare reform following the 2007 Freud review of welfare provision. Survey data is used to estimate the extent to which recent policies promoting compulsory job search by youngest dependent child age map onto lone parents' own stated decision-making regarding if and when to enter the labour market. The findings indicate a substantial proportion of lone parents targeted by policy reform currently do not want a job and that their main reported reason is that they are looking after their children. Economically inactive lone mothers also remain more likely to have other chronic employment barriers, which traverse dependent child age categories. Some problems, such as poor health, sickness or disability, are particularly acute among those with older dependent children who are the target of recent activation policy.
Resumo:
Background: Uptake of influenza vaccination represents a simple marker of proactive care of older people. However, many still do not receive the vaccine. To understand this challenge better, we investigated the relationship between patient characteristics (demographic, physical and psychological health, and health service use) and vaccination uptake in a sample of community-dwelling older people in two adjacent but differently structured healthcare systems (Northern Ireland (NI) and the Republic of Ireland (RoI)). Methods: 2,033 randomly selected community-dwelling older adults (65 years and older) were interviewed in their homes. Results: Rates of uptake were 78% in NI and 72% in RoI. Uptake was greater with older age (odds ratio (OR) 1.6, 95% confidence interval (CI) = 1.3-2.1, p
Resumo:
Background: Acute stroke care is shaped by healthcare policies. Differing policies in similar populations allow for assessment of policy impact on health and healthcare outcomes. Aims: To compare stroke presentation and hospital care in two adjacent healthcare systems with differing healthcare policies. Methods: Interviews and chart review of consecutive acute stroke admissions in Northern Ireland (n=103) and the Republic of Ireland (n=100). Results: Marked regional contrasts were evident for key aspects of hospital care. Northern Ireland performed significantly better on 15 of 16 quality of care (Sentinel Audit) items. Delivery on standards was significantly better in Northern Ireland for early assessment (Northern Ireland 72%; Republic of Ireland 54%, p
