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Biomedical subjects

J Litt

Publications and source records attributed to J Litt.

8 recordsLinked to original sources
PubMed2000

Factors impacting on shared care working relationships between practice nurses and general practitioners: a literature review.

Practice nurses have worked in general practice for many years yet little is known or published in Australia about their work. Recent health care reforms in Australia, particularly the establishment of the Divisions of General Practice and various best-practice innovations linked to the National GP Strategy have seen an increase in the role of practice nurses. Despite this GPs in Australia are cautious about the role of practice nurses. Much of this caution arises from reform in general practice in Britain particularly the establishment of fund-holding for general practice. This article reviews the literature on practice nurses in Britain and Australia within the framework of the health reforms in general practice in both countries.

Adult↗
PubMed2000

The role of the practice nurse. An exploratory study.

AIM: There is little research on the role of the practice nurse in Australia. However, there is some evidence that practice nurses are no longer primarily receptionists, but rather function as nurses. This article reports on a small qualitative study that set out to identify areas of effective shared care between general practitioners and practice nurses. METHOD: Semistructured interviews were conducted with general practitioners and practice nurses in eight general practices. A general practitioner who did not employ a practice nurse and a general practitioner and two nurse practitioners at a Community Health Centre were also interviewed. RESULTS: It was found that general practitioners and practice nurses have established effective working relationships that enhance patient care. Shared care was not found, except to some extent in the area of wound care. CONCLUSION: Most GPs and practice nurses interviewed believed that the current funding model, requiring GPs to sight all patients before a fee can be claimed, restricts the potential use of practice nurses' expertise, for example with patients returning for routine blood tests or blood pressure monitoring, or wound dressing. A change to the current model would have implications for the education and accreditation of practice nurses.

Australia↗
PubMed1992

Patient perceptions of continuity of care: is there a socioeconomic factor?

This study aimed to assess perceptions of continuity of care by patients from different socioeconomic areas using focus group interviews augmented by postal replies. Patients were randomly selected from two contrasting primary medical care locations: a middle class suburb and a less affluent suburb in Adelaide, South Australia. The Ethnograph was used to analyse the content of the interviews and postal responses. Analysis used the framework described by Curtis and Rogers in the USA and Freeman in the UK. The response rate was much lower from the lower socioeconomic group (5% focus group; 20% when postal replies included). They emphasized access factors and importance of records, and alleged situations where they were taken too casually and their problems were not dealt with. Those from the middle class area (response rate 25%) emphasized interpersonal ('art of care') factors and were more likely to use their presenting problem as a criterion to decide whether they needed to postpone the problem to a time when they could see their personal doctor. Focus groups can be useful evaluation tools in general practice, but oversampling of lower socioeconomic groups is needed. Continuity of care should be considered as an aid to consistent quality of care, rather than its essence. Well controlled intervention-outcome studies in different types of practice organization in differing socioeconomic situations will increase our understanding of continuity of care.

Adult↗
PubMed1983

Choriocarcinoma of the mesosalpinx masquerading as congestive heart failure: ultrastructural observations of the tumor.

A 45-year-old woman suffered from hypertension and congestive heart failure for 5 months. She was found to have a choriocarcinoma of the left mesosalpinx. The final event was, in all probability, a massive pulmonary tumor embolus which occurred shortly after removal of the uterus and adnexae. The tumor was studied by immunohistochemical methods as well as ultrastructurally, and the findings are illustrated and described.

Adnexal Diseases↗
PubMedDate not supplied

Biological markers and social differentiation: crack babies and the construction of the dangerous mother.

Crack mothers-particularly African American and Latina women-have been constructed as maternal villains who actively and permanently damage their offspring. Many women have been arrested or lost parental rights to their children because of child neglect charges. Despite this panic, recent medical and legal research indicates that reports of damage to the fetus have been greatly exaggerated. This article examines the ongoing questions in medical publications about crack babies. The authors connect the search for biological markers of cocaine use during pregnancy to a new cultural conception of a bio-underclass. The conclusion considers medical developments and controversies in the broader context of class and racial divisions and reproductive politics in the United States.

Attitude to Health↗