摘要:

AbstractThe three main questions dealt with in this article are: ‘why have community participation in planning?’ ‘what is community participation?’ and ‘how can community participation be practised?’ Planning in this context should be understood in a strategic sense as social policy development and implementation at a regional level. In answer to the first question, two common approaches to social planning and their shortcomings are briefly discussed, with reference to a taxonomy from Alan Walker's bookSocial Planning, A Strategy for Socialist Welfare.1Community participation in social planning is a key characteristic of an alternative approach which addresses or avoids altogether the fundamental shortcomings of the other two. Issues of the practice of community participation in regional planning are examined through a description and analysis of the planning process undertaken by the Western Metropolitan Region of the Health Department Victoria. Some general conclusions regarding current trends in policy formation and public sector administration are

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00204.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractKnowledge of the health status of, and patterns of health care service utilization by rural Australian communities, is scant. This deficiency limits attempts to formulate policies designed to bring about efficient, effective and equitable delivery of health care services. This article reports the results of a health interview survey conducted in the Wimmera region of Victoria during spring 1984. The results demonstrate not only that patterns of morbidity in rural areas differ from the Australian average, but also that the health status of rural dwellers is worse than that of most Australians. Evidence suggests that while accessibility is not the most significant determinant of utilization of health care services, distance from services does affect propensity to use them.

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00205.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractMatched samples of homosexually active men were obtained using identical sampling methods in a city of one million people in 1986 and 1988. Data indicated that reported sexual behaviours had significantly changed in the direction of safer sex, particularly oral sex without ejaculation, anal sex with a condom (both insertive and receptive), which increased in frequency, and analingual and digitoanal receptive practices, wet kissing, and anal receptive intercourse generally, which decreased. Reported sources of education for both samples were primarily gay media and gay organisations. These data, with some caveats concerning design and comparability of samples, suggest that behavioural change in the appropriate direction has occurred in homosexually active men, and that gay organisations and media have been perceived as the most common source of information on safer sex in this population.

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00206.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Abstract“Your Pregnancy” is a health information booklet distributed to all pregnant women in New Zealand free of charge. Evaluation of the accessibility, acceptability, and effectiveness of the booklet was undertaken. Two groups of women were surveyed 4 ‐ 5 months after their first babies were born. The first group of women (n=281) was surveyed before the booklet was introduced and the second group (n=267) after its distribution. The overall response rate was 79 per cent. Accessibility of the booklet was assessed from the survey of the second group of women. The majority of women received the booklet eventually, but only 62 per cent in the first trimester. Of those women who received the booklet, 73 per cent passed it on to others. Evaluation of the bookletd's acceptability was undertaken by calling for submissions from professional and lay groups (n=41) on all aspects of the booklet and from analysis of responses to the second survey. The booklet was generally acceptable to women and health professionals. Effectiveness of the booklet was gauged by comparing the two groups of women on the extent to which their needs for information had been met, the ease with which they could question others about their pregnancy, locus of control, self‐care and self‐knowledge. The only variable which showed a change between the two surveys was an improvement in the extent to which women's needs for information had

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00207.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractSocial disadvantage is an entrenched feature of contemporary New Zealand society and has a deleterious influence on health. Traditional health promotion activities, with their focus on the individual, have had only a limited impact. The World Health Organization is fostering a new approach to health promotion based on the Ottawa Charter, the two most important strategies being: building healthy public policy and strengthening community action. The new health promotion has great potential, especially with its emphasis on ‘empowerment’, but as yet only indirect evidence supports the effectiveness of this approach. Several current New Zealand community‐based initiatives hold promise for the future and three of these are discussed. The greatest challenge is to ensure that the ‘empowering’ approach to health promotion continues to be developed by Area Health Boards and that this type of health promotion becomes a major priority at all levels of society. As social scientists, we need to support this approach and assist in the production of evidence to show whether it is capable of redressing the health effects of social dis

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00208.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractA health survey of 484 persons aged 14 to 89 years was conducted in Sydney's western suburbs in May 1987. Its aims included a description of preventive activities undertaken by medical practitioners and an assessment of the community's perception of the doctor's role in health promotion. Ninety‐three per cent reported visiting a doctor in the previous year and 31 per cent of respondents reported having contact with a general practitioner the fortnight before the survey, either for their own health or that of another. Eighty per cent of respondents reported having had their blood pressure measured in the previous year and 63 per cent of female respondents aged 18 years and over who had not had a hysterectomy reported having had a Pap smear in the last five years. However, few respondents reported receiving any lifestyle‐related advice at their most recent doctor visit and 77 per cent said that the food they are was rarely or never discussed with their doctor. Despite this low level of advice, doctors and nurses were perceived to be the most important source of health information by nearly half the respondents. Strategies for increasing the involvement of doctors in health promotion are discus

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00209.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractWemicke's encephalopathy (WE) is a serious disease resulting from excessive alcohol intake. As well as the disastrous consequences for the individual, patients with WE place a heavy burden for continuing care on the community. Australia appears to have a higher rate of WE than other western countries, probably due to differences in the consumption patterns of alcoholic beverages. Unlike most other western countries, Australia does not fortify flour with thiamin. On the other hand the USA does fortify flour and has higher thiamin intakes and lower rates of WE.In Australia it has been proposed that thiamin be added to alcoholic beverages. Given that technical problems related to stability, taste and absorption can be solved, the fortification of a substance which is potentially harmful, raises serious problems for health educators. The labeling of alcoholic beverages as ‘vitamin enriched’ could result in changes in the community's beliefs about alcohol and in increased alcohol consumption.The nutrition and education implications of this proposal are discussed. The conclusion is drawn that Australia should follow the example of other western countries and fortify flour with thia

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00210.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThe community nursing practice research project reports the results of a mailed questionnaire survey of nurses employed outside hospitals and nursing homes in Victoria in 1985. Two 10 per cent random samples stratified across practice areas were selected from listings of community nurses providing detailed employment information to the Victorian Nursing Council. An 84 per cent response rate was obtained from these listings yielding 689 responses. This paper reports that part of the study relevant to job entry, job satisfaction, job mobility and perceived career options as well as educational preparation.One half of community nurses entered community nursing after five years of hospital experience. The major reasons for choosing employment in community health nursing were its conditions of work, its autonomy and a dissatisfaction with hospital nursing, rather than a specific orientation to community nursing. These can be appreciated in terms of competing demands by the nurse's family life and her sense of growing professional maturity.Job satisfaction was high, with 87 per cent of nurses in the study population being satisfied or very satisfied. Only one quarter considered opportunities for career advancement to exist in their practice area. In the event only one fifth of nurses regarded promotion as important. The high levels of job satisfaction and the low importance attached to promotion are explicable given the nature of female employment and dissatisfaction with hospital nursing. Despite this high level of job satisfaction, one third of nurses believed they would not be nursing in five years time. Less than one third of nurses felt there was adequate opportunity for advancement in their practice area.Fifty per cent of community nurses were aged over 40 (the majority of these are in the maternal and child health and medical clinic groups) and some had the non‐nursing educational standards that would be expected given this age composition. Overall 61 per cent of nurses believed that their basic nursing education was an adequate preparation for community nursing at least at a beginning level. However, a perceived need for preparation beyond a beginning level existed given that 83 per cent perceived regular ongoing in‐service education to be essential. No more than 29 per cent however supported either a post‐basic in‐service course, a Diploma in Community Health Nursing, or a Bachelor degree in Applied Science with a major in Community Health Nursing or other college program as being essential. It was considered that the non‐academic nature of the educational background of the majority of nurses was the principal reason for these findings. It was concluded that planning for future development in community nursing, especially with regard to the appropriate educational preparation and career structure, should recognise the current experiences and expectations of nurses. These, however, are likely to change with the introduction of college‐based nursing. They may also be affected by the current absence of an adequate career structure in most community nursing pra

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00211.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThis paper provides estimates of the utilisation rates of acute care (short‐stay) hospitals, by age and sex, for the Australian population. Separation and bed‐day rates per 1000 persons for public. Repatriation and private hospitals in 1985 have been estimated by age group, for each sex, in each State and Territory in Australia.The Australian Base Grant, negotiated between the Commonwealth, States and Territories in the new Medicare Agreements, distributes funds for the care and treatment of Medicare patients in public hospitals. The national bed‐day utilisation rates reported in this article, have been used as the basis for population weights to allocate these funds.This paper presents the data and methods used to derive these weights, and examines the differences between them and the actual State and Territory utilisation patterns in 1985.The impact of population ageing on the overall utilisation rates for acute hospitals in Australia is exa

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00212.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

AbstractThe public immunisation programs of 14 local government councils in Sydney's Western Region were examined to determine those variables which might predict an effective program.Independent variables included the demographic characteristics of the populations being served, as well as relevant aspects of each council's clinic program and administrative input. The dependent variables were three indices of immunisation reflecting the proportion of the 0–5 population reached by the public immunisation service. One variable, the amount of staff time spent on administration, was best able to explain the variance in public clinic immunisation rates across the local government areas. Components of effective staff time were examined and the results are discussed in relation to the planning and promotion of public immunisation program

ISSN:0314-9021    

DOI:10.1111/j.1753-6405.1989.tb00213.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY