摘要:

AbstractAn Early Discharge Programme (EDP) for medically uncomplicated obstetric patients operated from three hospitals in Sydney's western suburbs. A number of women who were eligible for this programme declined to take part. This study investigated the reasons why some women chose to remain longer in hospital rather than go home early with domiciliary midwifery support.The results showed a lack of awareness and information about the EDP, particularly among women from non‐English speaking backgrounds. A substantial proportion of the women had no help with housework or child‐care and would have used the EDP if home help was available. One characterstic which distinguished EDP participants from EDP non‐participants was parity; a higher proportion of women who chose not to take early discharge were first‐time mothers.In order to increase participation rates, women should be provided with more information about the EDP and home help should be made available to those

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00151.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe difficulties of developing theoretically sound and practically useful models of primary health care team effectiveness are described. Three models of team effectiveness: the goal model; the internal process model; and the systems resource model are discussed in relation to the work of primary health care team (PHCTs). The value of the constituency approach is also examined and it is suggested that this is the most appropriate model for the situations of PHCTs.This paper describes an application of the constituency approach in developing measures of effectiveness for PHCTs. Results yielded effectiveness criteria in four major areas: consumer outcomes; quality of care; team viability; and organizational issues. The disadvantages of the constituency model are explored and the next steps in research towards developing a model of PHCT effectiveness is indicated.

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00152.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis paper summarizes information about expenditures for people with chronic illness as a function of their psychosocial adjustment to illness.Three studies are discussed: two prospective baseline surveys and one historic cohort analytic study. Each was conducted between 1988 and 1993 in Southern Ontario, Canada in tertiary centres which were treating patients recently referred to a specialty medical clinic for one of 13 types of chronic physical illnesses.All three studies used the same measures: The Psychosocial Adjustment to Illness Scale‐Self Report (PAIS‐SR) (Derogatis&Lopez 1983) and the Health and Social Service Utilization Inventory (Browneet al.1990) which translates utilization into a measure of dollar expenditure for utilization.Poor adjustment to chronic illness exceeded the importance of disease severity and levels of disability in explaining a disproportionate level of expenditures for a subgroup of people (34–55%) attending specialty medical clinics. The cost of providing more comprehensive health and social care for this group could be less than the amount spent in maintaining their poorly adjusted state by providing only medical

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00153.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis paper describes two projects which targeted citizens as key players in the well‐being and mental health of local communities and have tapped the mutual aid resources of informal helping networks. One of these projects was implemented with people who had mental health problems, many of whom were homeless and dependant drug users, in Quebec's inner city. Two professional workers, who were experienced in neighbourhood interventions (a psychologist and an educator) and a researcher were employed for a period of 28 months (from September 1989 to December 1991). The other project was implemented within the context of primary care for a wide range of health and social problems in a rural LCCS (Local Centre for Community Services). A social worker, who specialized in rural network intervention, was employed for 2 years. The same research team worked on both of the projects.The main objective of both projects was the development and testing of a method of intervention which aimed to encourage citizen involvement, both in promoting the physical and mental health of those suffering from transitory problems, and in the rehabilitation process of those suffering from severe social or mental health problems. In order to accomplish that objective, the professional workers made themselves visible and accessible in the community. The projects generated two very different models of intervention. The inner city model of intervention was tied closely to pivotal citizens and placed a great emphasis on the helper‐therapy principle. The rural model was founded on network intervention, mutual aid being more relevant for marginal people. Even though these models of intervention embody provincial and federal government policies, professionals are far from ready and able to change their practice accordin

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00154.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractRecent changes in health policy in the United Kingdom have emphasized the key importance of a collaborative and multidisciplinary approach to the organization of health care. These changes have resulted in the formulation of programmes of shared care involving professionals from all areas of institutional and community practice. This paper critically explores the literature relating to shared care between hospital consultants and general practitioners (GPs) in the UK. The paper takes as its focus some clinical conditions for which shared care arrangements have been put into effect, and the implications of shared care for prescribing practice are discussed.

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00155.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00156.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Book Reviews in this ArticleReview article‐Children, parents, the state and the Childrent Act.Social Justice and Children in Care.Working with Children and the Children Act: A Practical Guide for the Helping ProfessionsHealth Research in Practice: Polltical, Ethical and Methodological Issues.Disability or Health Problems: A Guide to Employment Services and Scheme

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00157.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY