摘要:

AbstractA health needs assessment project, based in four districts of the North Western Region, has recently investigated the health and social care needs of older people with vision problems. The research project had two stages. In the first, different perspectives on service needs for this client group were gathered through a process of triangulation, involving a literature review, a local survey, a clinical assessment linked to the local survey, secondary analysis of routinely collected health service data, interviews with service providers and focus groups with actual or potential service users. This provided information on‘need’, clinically defined, subjectively defined (both qualitatively and quantitatively) and defined in terms of demand for services. It also provided a picture, albeit partial, of the present pattern of service provision for older people with vision problems. The second stage explored the implications of the information collected for the commissioning of services for this group. The study findings are presented here. We have used the International Classification of Impairments, Disabilities and Handicaps (ICIDH) (WHO 1980) as a framework both to consider the nature and scale of need and to discuss appropriate interventions in relation to these ne

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00235.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThis paper presents the results of a survey of the practice of primary care in the Israeli kibbutz, a unique social setting. Its aims were: (1) to obtain basic data on physicians living in kibbutzim; (2) to examine the functioning of the kibbutz health care system; and (3) to learn how the kibbutz physician perceives the system.A mail survey, using a 125‐item questionnaire, was conducted of all 251 physicians identified as living in a kibbutz. Completed forms were received from 124 physicians (49.4%), 33 of whom are kibbutz members. Data on the physicians and on the kibbutzim in which they live show this to be a representative sample. Results are presented showing characteristics of these physicians and their involvement with patients and how health care is delivered.The discussion centres on three issues raised by study of kibbutz physicians which may have clear implications for primary care practitioners throughout the world: the relationship of the practitioner and her/his family to the community in which she/he works and lives; the potential for expansion and deepening of the scope and role of general practice; and the problematic question of the nurse‐primary care physician relations

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00236.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractMeeting the needs of people within the community who have learning disabilities and exhibit challenging behaviour and who may have an associated mental health problem raises particular policy questions. The provision of effective community services for people with this particular combination of complex needs requires a skilled workforce. Issues of definition, of assessment and diagnosis, of therapeutic interventions and service models should be addressed and resolved in order to plan and implement a strategy for meeting both health and social care needs of this client group.This paper aims to provide a general overview of these issues, bringing together material on the four separate concerns, and to draw the American literature to the attention of a wider audience. This work was originally carried out as part of a wider project on staff training provision and training standards in 1992. The objectives are to identify: (1) definitions of challenging behaviour and mental health problems in relation to people with learning disabilities; (2) therapeutic interventions for meeting these needs; (3) models of service provision for people with these needs; (4) the implications for developing a skilled workforce to meet this particular combination of needs.Definitions of challenging behaviour are varied and general, and the diagnosis of mental illness in people with learning disabilities appears to be less well developed in the UK than in the USA. Those whose needs include both learning disability and mental health problems are at risk of losing out in the provision of services for either category. There is a wide variety of theoretical and practical responses to behavioural problems in the context of two differing models of service provision for people with these needs‐the‘compus’ model and the‘ordinary life’ model. Professional tensions with regard to both therapeutic responses and service models must be resolved if people with this particular combination of complex needs are to receive a comprehensive, needs‐led service provided by an appropriately skille

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00237.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe Health Services Research Unit, University College of North Wales, Bangor is evaluating the care provision and outcomes for a cohort of 63 long‐stay psychiatric patients from the North Wales Hospital, Denbigh. Hospital closure is being phased in up to 1995 with reprovision of mental health services in the community. The paper reports on the care process in two specially designed community living schemes and assesses the outcomes for 34 patients from the cohort 12 months after discharge from hospital. The results show some positive outcomes with the majority resettled in well‐resourced care settings. Levels of client dependency show significant improvement in these schemes, with increases in social activity, community skills and speech skills. The majority of clients have reacted well to changes in care provision and report a number of improvements in their quality of life. It is concluded that long‐stay hospital clients need continuing high levels of support if care in community settings is to be succe

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00238.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00239.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00240.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00241.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Book reviewed in this article:Review article: Disability and the familyPast DueWith This BodyDevelopment of Infants with Disabilities and the FamiliesThe Aftermath of Stroke: the Experience of Patients and their FamiliesSex after Stroke IllnessAssessing Health Needs Using the Life Cycle Framework

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00242.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1993.tb00243.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY