980 resultados para Unmet needs


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This paper compares and contrasts the career experiences and development needs of 334 British quality managers compared with Australian quality managers based on two Australian surveys. The quality managers in both countries brought wide functional experience to their roles, with many coming in particular from production and operations and general management. In their current roles major sources of job satisfaction for managers in both countries were improving efficiency and problem solving, whereas aspects of employee relations was a source of least satisfaction. Both groups of quality managers utilised a very limited range of quality tools, the most popular being brainstorming, control charts and Pareto analysis, with virtually no mention of more sophisticated tools like Six sigma, which is in stark contrast to American managers. Also British and Australian managers showed little awareness in terms of their development needs for a broader background in quality, which could disadvantage their companies in global markets.

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This note is a comment on Chinyio, E.A., Olomolaiye, P.O., Kometa, S.T. and Harris, F.C. (1998) A needs based methodology for classifying construction clients and selecting contractors, Construction Management and Economics, 16(1), 91± 8, which describes research aimed at classifying clients by their needs rather than by the traditional public/private/developer approach. The paper also proposes a new method of selecting contractors by matching clients’ needs to contractors’ ability to satisfy them. The note offers constructive criticism of some aspects of the analysis.

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A growing number of older adults are admitted to hospitals, and information is needed on how age-related functional decline affects nursing care needs of this population. This study compared the functional status at admission and total nursing care needs of three age groups of older inpatients. A 12-month retrospective audit was performed on the records of 225 patients in a private metropolitan hospital. The three groups of patients were matched on diagnosis. Findings revealed that older patients were significantly more dependent, had greater total nursing care needs, and were less likely to be discharged to home, indicating that in addition to medical diagnoses, age-related differences of older patients’ functional status at admission and inpatient nursing care needs should be factored into staff workloads and funding of nursing care. The finding that significantly fewer of the older patients returned home must be considered when reviewing health care policy and services.

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This paper focuses on the information needs and behaviours of senior citizens and their carers in the community. Two case studies concerning elderly stroke patients and their carers are described and discussed. Analysis of the case study data reveals a number of themes including the actual information needs and information behaviours of the senior citizens, the importance of proxy information seekers and advocates and the need for usable, accessible and useful tool to support the needs of care recipients. A preliminary framework is developed that highlights important aspects of supporting the information needs of care recipients and carers in community aged care. Finally we suggest opportunities for technology interventions that address various information needs of senior citizens in the community.

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Although significant advances have been made in the treatment of serious disease, there remains much scope for assisting young people in adjusting to life with a chronic medical condition. Commonly, chronically ill young people experience lower emotional well being than their healthy peers. Conventional approaches to promoting emotional well being have involved referring young people and their families to an appropriate public mental health service or psychologist/psychiatrist in private practice. However, there is increasing interest in the use of peer support programs. Support groups such as the ChIPS program aim to promote positive adjustment to chronic illness by bring together young people facing similar circumstances. It is maintained that by increasing connections between chronically ill young people, emotional well being can be enhanced.

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Aim: This paper will describe the rationale for, and importance of, psychological interventions for young people early in the course of bipolar disorder.
Methods: Emerging literature in this field will be discussed in addition to describing specific clinical challenges and opportunities with this population.
Results: In order to be more developmentally appropriate for young people with bipolar disorder, eight aspects of clinical work which may require modification were identified.
Conclusions: The evidence base for the effectiveness of psychological interventions for people diagnosed with bipolar disorder is growing. However, some aspects relating to working with adults with bipolar disorder require modification to be effective in working with young people early in the course of the disorder.

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Background: Prostate cancer is the most common male cancer in developed countries and diagnosis and treatment carries with it substantial morbidity and related unmet supportive care needs. These difficulties may be amplified by physical inactivity and obesity. We propose to apply a multimodal intervention approach that targets both unmet supportive care needs and physical activity.

Methods/design: A two arm randomised controlled trial will compare usual care to a multimodal supportive care intervention “Living with Prostate Cancer” that will combine self-management with tele-based group peer support. A series of previously validated and reliable self-report measures will be administered to men at four time points: baseline/recruitment (when men are approximately 3-6 months post-diagnosis) and at 3, 6, and 12 months after recruitment and intervention commencement. Social constraints, social support, self-efficacy, group cohesion and therapeutic alliance will be included as potential moderators/mediators of intervention effect. Primary outcomes are unmet supportive care needs and physical activity levels. Secondary outcomes are domain-specific and healthrelated quality of life (QoL); psychological distress; benefit finding; body mass index and waist circumference. Disease variables (e.g. cancer grade, stage) will be assessed through medical and cancer registry records. An economic evaluation will be conducted alongside the randomised trial.

Discussion: This study will address a critical but as yet unanswered research question: to identify a populationbased way to reduce unmet supportive care needs; promote regular physical activity; and improve disease-specific and health-related QoL for prostate cancer survivors. The study will also determine the cost-effectiveness of the intervention.