摘要:

AbstractImmunization coverage is a cause for concern in both developed and developing countries. In New Zealand immunization uptake rates have been estimated at less than 60% for children under the age of 2 years old. A qualitative exploration of knowledge, experiences and concerns appeared necessary to supplement the quantitative data and offer some explanations for low uptake.Focus groups and individual interviews were held with primary child caregivers in Auckland, a major multi‐cultural metropolis of New Zealand. A total of 67 parents took part of whom 97% were mothers. Discussion focused on identifying the knowledge and experiences participants had of childhood diseases and immunizations, and on their concerns. Interview data were analysed following construction of role ordered and conceptually clustered matrices.The results demonstrated limited knowledge and a lack of experience regarding childhood diseases. Some mothers conceptualized immunization using a metaphor of ‘protection’. Others perceived immunization as socio‐politically driven and were distrustful of immunization campaigns. Many mothers faced a dilemma about immunization and were highly anxious. There was a greater concern about the side effects of immunization than about the side effects of childhood diseases. This may reflect a ‘developed world’ view with a difference between the concerns of white middle class mothers, and those mothers from the Pacific Islands, where common childhood diseases are more endemic.Predominantly the onus for immunization lay with mothers and this was not considered to be sufficiently recognized by health service providers. Personalized programmes designed to meet the needs of mothers are required to complement existing population oriented immunization

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1995.tb00008.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractDifferences between Family Health Services Authorities (FHSAs) in practice nurse activities are described and interpreted, using the results of postal questionnaires to all practice nurses in England and Wales in late 1992. There were an estimated 15000 practice nurses of whom 12589 (85%) returned a completed questionnaire, which asked about 30 tasks, including domiciliary visits, carried out by practice nurses; employment conditions, professional qualifications, experience, and clinical grading; and practice characteristics.The proportion of nurses undertaking four out of five tasks varied by a factor of two or more across FHSAs. Just over a third (39%) of the variation in nurses' activities could be explained by professional and practice characteristics. The analysis distinguished between FHSAs where nurses were more likely to engage in tasks requiring diagnostic and clinical skills, including assisting with minor surgery, and FHSAs where nurses were more likely to conduct domiciliary visits, help with chronic disease management, and provide advice on welfare benefits, incontinence and health promotion. The former FHSAs were characterized by larger practices with four or more partners employing several nurses, training practices, and practices with a manager. The latter group was characterized by smaller inner city or urban practices, including single‐handed partnerships, and practices often employing one nurse. The 1990 general practitioner (GP) contract boosted nurses' involvement in those activities attracting new payments but its impact on their roles and responsibilities was mediated by their professional skills and experience and the type of practice where they worked.The contribution of practice nursing to the delivery of primary and community health care varies considerably. Further research is required to find out whether role diversity reflects uncertainty about the appropriate use of their skills. FHSAs need to develop a variety of strategies to support and promote practice nursin

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1995.tb00009.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThis paper addresses the nature of alcohol detoxification in the context of community‐based centres. The social and health care features of detoxification in such services are identified. Practical aspects of working within the guidelines and spirit of theNational Health Service and Community Care Act(Department of Health 1990), implemented in April 1993, are also suggested. The paper also discusses issues and criteria for emergency and non‐emergency admission which under the Act remain indistinct. Finally a strategy which reflects the interrelationship of the health and social care needs of people undergoing detoxification is put forward as a basis for funding placements within such servi

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1995.tb00010.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThe National Health Service and Community Care Act 1990 signalled an explicit shift away from a service‐driven to a needs‐led pattern of delivery for both health and social care. However, a definitive meaning of ‘need’ is elusive. Where the work of health and social care agencies is related closely, as in community care, recognition and careful handling of different approaches to need is important for effective inter‐sectoral collaboration and supply of appropriate care to service users. This paper examines three dimensions of need: theory, policy and practice. Some key components of the theoretical debate about the meaning of ‘need’ are explored briefly, particularly in relation to health, and a set of questions is extracted that underpin the construction of need in policy and practice. These questions are then applied to a comparison of policy guidance documents for needs assessment for health and social (community) care. While the documents demonstrate some similarities in their view of need, there are also material differences. These differences have implications for the supply of services at the boundary between health and social care, some examples of which are discussed. Given a lack of consensus in defining and measuring need, the paper concludes with a framework of key questions which could enable purchasers and providers of health care to be more explicit about the bases upon which ‘needs‐led’ services are de

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1995.tb00011.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractWe used data on respondents 60 years of age and above (n= 2111,54% women) from a nationwide Norwegian health survey. In all, 186 (8.8%) of the respondents received home help. The data demonstrate that home help tends to be provided as a supplement to formal care, i.e. home nursing, as well as to informal support from relatives, neighbours and friends. High age, being of female gender and living alone were strongly associated with the provision of home help in bivariate analyses. A negative relationship existed between income and receiving home help, but this association only existed for subjects under 70 years of age. The home help clients, more frequently than those without home help, reported having functional problems, suffering from chronic illnesses, and consulting a doctor due to disease. They also reported poorer self‐perceived health, more frequent symptoms of depression or anxiety, and more frequent loneliness. Multivariate analyses identified age, impaired ability to do housework, living alone, difficulties in using public transportation, poor perceived health and suffering from chronic illnesses or impairments as explanatory variables for being a recipient of home help. The results demonstrate that the home help clients represent a particularly frail group of elderly peopl

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1995.tb00012.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1995.tb00013.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Review article—Race and ethnicity and social care, Patricia Ellis BSc PhD, Head of School of Social Studies, University of Luton, Park Square, LutonRace and Health in Contemporary Britain, by Waqar Ahmad (Ed.) Open University Press, Buckingham. 1993, £12.99, 247pp. ISBN 0‐335‐15697‐5.Age, Race and Ethnicity, by Ken Blakemore, by Margaret Boneham Open University Press, Buckingham. 1994, £13.99, 154pp. ISBN 0‐335‐19086‐3.Women and Mental Health: an Information Pack of Mental Health Services for Women in the United Kingdom, by Caroline Harding, by Jan Sherlock, by David Cooper MA CSWLecturer in Applied Social Studies, Department of Applied Social Studies, University of Wales SwanseaGood Practice in Mental Health Publications, London. 1994, £14.95, 100pp. ISBN 0‐948445‐39‐4.Family Evaluation: A Psychological Approach, by Luciano L'Abate SAGE Publications, London. 1994, £14.95, 188pp. ISBN 0‐8039‐4239‐7., by Bill Young MB ChB DCH MRCP MRCPsychSenior Registrar in Child and Adolescent Psychiatry, Tavistock Clinic, LondonCollaborative Care. Interprofessional, Interagency and Interpersonal, by Sally Hornby, by Paul Simic BA(Hons) MSc DipPSW/CQSWResearch fellow, Centre for Primary Care Research, University of Manchester, ManchesterBlackwell Scientific Publications, Oxford. 1994, £14.99, 188pp. ISBN 0‐632‐03725‐3.Implementing Community Care, by Nigel Malin Open University Press, Buckinghamshire, 199

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1995.tb00014.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY