PubMed Health⌕ Search

Biomedical subjects

Ian D Couper

Publications and source records attributed to Ian D Couper.

6 recordsLinked to original sources
PubMed2006

Suicide and attempted suicide: the Rehoboth experience.

INTRODUCTION: St Mary's Hospital in Rehoboth, Namibia, attends to all individuals who have health problems that are considered serious by the community. The aim of this study was to describe the existing suicide management approach in Rehoboth. METHOD: Clinical charts of all patients who attended St Mary's Hospital Rehoboth were manually collected and reviewed. In the process, analysis of the past records of patients of Rehoboth who exhibited the risk factors and/or were diagnosed and treated for suicide and/or attempted suicide for a predetermined period of 1 January to 31 December 2001 was undertaken. RESULTS: A total of 45 individuals were found to have attempted and/or committed suicide out of a total of 12 910 patient visits for the period. Of these, 51% were admitted, 7% were referred out and 42% were treated as out patients. Sixty-three per cent of the people used prescribed and over the counter drugs for attempting suicide. The words suicide or attempted suicide were not commonly used by healthcare providers in Rehoboth. Incidentally, HIV/AIDS did not seem to be associated with the patients who attempted suicide in this community. CONCLUSIONS: While there was no particular strategy in place in Rehoboth to deal with suicide and parasuicide, the emergency care for patients who attempted suicide in Rehoboth was apparently adequate, with no deaths in the hospital. However, the lack of a clear, coordinated multidisciplinary management approach to the survivors of a suicide attempt appeared to be a serious gap in management. It is also recommended that an appropriate name, code, recording and reporting system for suicide and attempted suicide should be adopted for use by health care personnel in Namibia in order to more accurately document the level of suicidal activity in the country.

Adolescent↗
PubMed2006

What interventions do South African qualified doctors think will retain them in rural hospitals of the Limpopo province of South Africa?

INTRODUCTION: In South Africa, the health system faces a variety of problems, such as an overall shortage of and misdistribution of healthcare workers. The Department of Health in South Africa has attempted to address the shortage of rural doctors by introducing various interventions, including an increase in salaries, introduction of scarce skills and rural allowances, the deployment of foreign doctors, and upgrading of clinics and hospitals. Despite these, the maldistribution of doctors working in South Africa has not improved significantly. This attests to the multifactorial nature of this problem and to the fact that intensive and sustained efforts are needed to rectify it. Few South African studies have been undertaken to establish the needs of rural doctors in South Africa and to seek possible solutions to their problems. While a number of studies have identified some of the major problems, much still needs to be done. Innovative ways to address this crisis are urgently needed. The main objectives of this study were to identify interventions as proposed by doctors in the rural Limpopo province of South Africa and to develop recommendations based on these. METHODS: This study utilised a descriptive qualitative design using a semi-structured questionnaire. Ten doctors from rural hospitals within all six districts of the Limpopo province were randomly selected and interviewed. RESULTS: Themes recommended included: increasing salaries and rural allowances; improving rural hospital accommodation; ensuring career progression; providing continuing medical education; increasing support by specialist consultants; improving the physical hospital infrastructure and rural referral systems; ensuring the availability of essential medical equipment and medicines; strengthening rural hospital management and increasing the role of doctors in management; improving the working conditions; establishing private-public collaborations with private general practitioners; increasing rural doctors' leave allocations; ensuring adequate senior support for junior doctors; improving rural hospital environments and providing recreational facilities; assisting rural doctors' families, and providing recognition and appreciation for the work rural doctors do. CONCLUSION: The resolution of one isolated factor without improving the host of push factors currently present in the health system is unlikely to lead to significant improvements in the retention of rural doctors. The results of this study can be used to assist the Limpopo Department of Health to identify the most pressing needs of rural doctors in the province. A number of interventions are suggested by rural doctors that they feel would retain them in their current rural practices. The recommendations include various interventions involving different levels of the healthcare system. It also recommends an incentive package for doctors willing to serve longer term in rural hospitals.

Adult↗
PubMed2005

Management of district hospitals--exploring success.

INTRODUCTION AIM: The aim of the study was to explore and document what assists a rural district hospital to function well. The lessons learned may be applicable to similar hospitals all over the world. METHOD: A cross-sectional exploratory study was carried out using in-depth interviews with 21 managers of well-functioning district hospitals in two districts in South Africa. RESULTS: Thirteen themes were identified, integrated into three clusters, namely 'Teams working together for a purpose', 'Foundational framework and values' and 'Health Service and the community'. Teamwork and teams was a dominant theme. Teams working together are held together by the cement of good relationships and are enhanced by purposeful meetings. Unity is grown through solving difficult problems together and commitment to serving the community guides commitment towards each other, and towards patients and staff. Open communication and sharing lots of information between people and teams is the way in which these things happen. The structure and systems that have developed over years form the basis for teamwork. The different management structures and processes are developed with a view to supporting service and teamwork. A long history of committed people who hand over the baton when they leave creates a stable context. The health service and community theme cluster describes how integration in the community and community services is important for these managers. There is also a focus on involving community representatives in the hospital development and governance. Capacity building for staff is seen in the same spirit of serving people and thus serving staff, all aimed at reaching out to people in need in the community. The three clusters and thirteen themes and the relationships between them are described in detail through diagrams and narrative in the article. CONCLUSION: Much can be learned from the experience of these managers. The key issue is the development of a team in the hospital, a team with a unified vision of giving patients priority, respecting each other as well as patients, and working in and with the community to achieve optimal health care in the district hospital.

Attitude of Health Personnel↗
PubMed2003

Rural hospital focus: staffing.

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends both regional interests and local culture. While RRH is already publishing peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to augment our already comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region. First, then, in what RRH hopes will become a regular feature, is a series of articles from the prominent South African rural doctor, Professor Ian Couper. This article first appeared in South African Family Practice 2000; 22 (5), and is reproduced here in its original form, with kind permission of both publisher and author. This article introduced a regular column feature in SAFP, 'Rural hospital focus', and was entitled 'Staffing'.

Journal Article↗
PubMed2002

Working abroad.

Explore the source record for details and available documents.

Editorial↗