摘要:

While there is an international trend toward lowering infant mortality, the United States ranks 19th among industrialized nations. In Arizona, as across the nation, a large and increasing number of low birth weight (LBW) infants are being delivered. This number is viewed with alarm as LBW is associated with infant mortality; however, LBW may be preventable in many cases if mothers receive adequate prenatal care. Despite recognition that absent or inadequate prenatal care is an important risk factor, a large number of women deliver without such care. In Arizona, the percentage of women delivering at a large metropolitan public hospital without prenatal care doubled in a 2‐year period, reaching 14% (764 women). The majority of these women were of low socioeconomic status. The purpose of this study was to explore the reasons given by women delivering at this hospital for not seeking prenatal care. It was determined that a qualitative methodology was most appropriate; thus, an interview guide was developed with both demographic and open‐ended probing questions. Fifteen respondents‐5 Caucasian, 8 Latino (5 Spanish‐speaking only), 1 Afro‐American, and 1 Native American—participated in the interviews. The data were transcribed from taped interviews and studied using content analysis. Eleven barriers were identified and sorted into two categories: internal and external. Internal barriers identified by the women were attitudes associated with low motivation, knowledge deficits, fear, and fatigue. External barriers elicited were finances, transportation, system difficulties, lack of support, lack of child care, missed work, and insufficient time. These barriers are the same as those identified in other studies conducted over the past 10 years related to barriers to prenatal care. This study differs from prior ones in that it addresses programmatic and social issues related to the

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1994.tb00924.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1994.tb00925.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The problem investigated in this project was the identification of need for and desire to hire nurse practitioners in a rural western state. Participants included licensed nurse practitioners, nurse administrators of licensed agencies, and licensed physicians in the state of Nevada. The survey examined the participant groups' views of the need for and their desire to hire nurse practitioners. The findings showed differences among the groups in relation to their education levels and whether they were practicing in rural or urban areas. The most pronounced finding was the indicated need for more information related to the role and functions of nurse practitioners before hiring them. Recommendations for future study are also included.

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1994.tb00926.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Current health care delivery systems in the United States have led to high cost, uneven quality, less than universal coverage, undue emphasis on a medical/clinical model, and scant attention to primary care and prevention. In the context of health care reform, a new strategy is introduced that reverses present trends and incentives, called managed outcomes. This strategy is not specific to any particular health care delivery system. Managed outcomes encourages experimentation and flexibility in the design of health care systems and fosters primary care, health promotion, and disease prevention models. It links purchasing decisions to established specific and measurable goals that can provide quality and cost‐effective services to improve healt

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1994.tb00927.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1994.tb00928.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1041-2972    

DOI:10.1111/j.1745-7599.1994.tb00929.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY