摘要:

AbstractThis paper contains an overview of the first Scottish community care plans in relation to the assessment of population needs. As in England and Wales, authorities have used a variety of approaches, ranging from ‘hard data’ such as demographic information and prevalence rates, to ‘soft data’, including consumer surveys and consultation with users and carers. The aggregation of individual assessments is recognized as an important, but as yet largely undeveloped, tool. Both the potential and the limitations of these various methods are discussed. Overall, the emphasis on outcomes desired by government does not appear in the plans. Given the scale and complexity of the task, however, and the poor history of joint planning, it is suggested that the focus within the plans on introducing new structures and processes is a necessary first step. Specifically in relation to assessing population needs, however, the plans have adopted a baseline which it may be difficult to shift in futur

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00143.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe health care needs of people with learning difficulties living in the community are in danger of being ignored. Discussion of such needs is inhibited by a fear of ‘remedicalization’, that is, returning to a domination of a medical model of health in the lives of people with learning difficulties. In a new synthesis of the literature, this paper reviews evidence that health care needs are not being met. It considers the potential for a more effective Primary Health Care (PHC) service through better interprofessional collaboration between Primary Health Care Teams (PHCTs) and Community Learning Difficulty Teams (CLDTs). The meaning of collaboration, in theory and practice, is explored, and the reasons it can be difficult to achieve are discussed. Finally, ways in which improvements in PHC for people with learning difficulties can be attained are sugges

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00144.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThis paper illustrates the usefulness of regular monitoring for an area‐based system of long‐term care for elderly people and people with a disability by presenting data which describe the combined effects of de‐institutionalization and population ageing.Data were collected between 1985 and 1989 in Solna, Sweden by means of annual surveys involving registraion of received services and assessment of needs and disability.The sample, (n=2026 year 1, n=1755 year 5), were all the residents of Solna, who, on the day of the survey, were in receipt of long‐term public medical and/or social services care from the public sector. Data were collected on demographic variables, actual and appropriate levels of care. The class of disability was based upon five different measures of disability.The number of long‐term care hospital and nursing home beds were reduced by 23% whilst the number of people aged over 85 in the area increased by 31%. This development had effects on all levels of care. Actual development of resources fell short of those projected according to population trends, by 15–35% depending on level of care. The proportion of clients, who were ‘under‐served’, in the sense that they received a lower level of care than assessed as appropriate by the responsible staff, more than doubled during the period‐increasing from 10(n=2026) to 21% (n=1755). Domiciliary services were actually reduced and concentrated on fewer clients with more severe disabilities. There was a general increase in the prevalence and severity of disability in all levels of care except sheltered housing. Incontinence showed the most rapid increase.The findings of this study demonstrate the importance of providing decision‐makers with quantitative data which reflect trend

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00145.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractProviders of community health and social services to families with young children are aware of increasing poverty in particular localities and amongst particular social groups. They are also aware that their own sphere of influence which they could previously activate on behalf of their clients is diminishing. Community midwives, health visitors, social service workers and workers in voluntary sector organizations in two areas of Greater Manchester were asked about the needs of young children and their carers and their own role in fulfilling some of those needs. They located the difficulties facing their clients in both the structural constraints of poverty and in individual histories and capabilities. In so doing they construct a model of how social welfare is managed personally which has implications for the way in which they understand their own role as providers of health and social services. The study on which this paper is based was concerned with the role of 'social support’ in the lives of families deemed to be ‘in need’, from the perspective of workers. The study shows that while service providers understand and emphasize the value and importance of certain types of support in the lives of their clients, time restrictions and a delimitation of their role lead them, in certain contexts, to devalue their role in providing such support. At the same time, in order to make sense of, and give meaning to, the limits of the support they feel able to provide, they draw on notions of self‐help and dependency arguing that, ideally, people should not rely on formal service provision for their suppor

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00146.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe objective of this study is to describe the dietary habits of overweight elderly people with Type II diabetes; a social psychological process which identifies strategies used to adhere to a weight loss dietary regimen is described. Twenty informants were recruited through physicians who practice at a private, non‐profit hospital in the San Francisco Bay Area in the United States. The sample ranged in age from 65 to 85 years (mean 72.5). Interviews which lasted about 1 hour were conducted in the hospital or at home and were tape‐recorded and transcribed. The qualitative data from the transcripts were analysed using constant comparative analysis (Glaser&Strauss 1967). The basic social‐psychological process, 'struggling’, was identified in this study which described the process of elderly obese people with Type II diabetes managing a dietary regimen. These elderly people were struggling with information about the dietary regimen; with the integration of the meanings and interpretations of a dietary regimen with prior beliefs and dietary habits; and with an image of someone who has not achieved a perceived ‘ideal weight’. Strategies used by elderly people with diabetes in the process of struggling involved ‘figuring it out,‘forging a fit, and ‘coming to terms on one's own. Conditions which eased the process of struggling were: the quality of health care available (information and support), mobility of the informant, the disease course and complications, and other multiple chronic illnesses. The notion of ‘compliance’ or ‘adherence’ must be re‐examined. If self‐care is what health professionals are promoting, then the strategies presented here, such as supplementing information, tailoring the regimen and protesting change may well be what eased these informants’ struggles. Process‐oriented research is needed to increase our understanding of the effects of social interaction on health behaviours. Interventions must include an ongoing assessment of the individual's perception of the meaning of the disease within the

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00147.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.tb00148.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Book Reviews in this ArticleCommunity Health Nursing‐Promoting the Health of Aggregates.Primary Helath Care: Medicine in its Place.Legislative Action to Combat the World Tabacco Epidemic.Adolescent Sexual Behaviour and Childbearing.Back From the Wellhouse: Discussion Papers on Sensory Impairment and Training in Community Ca

ISSN:0966-0410    

DOI:10.1111/j.1365-2524.1994.tb00149.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.tb00150.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY