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Biomedical subjects

M W Calnan

Publications and source records attributed to M W Calnan.

13 recordsLinked to original sources
PubMed2004

Public trust in health care: the system or the doctor?

OBJECTIVES: To examine how the public assess trust in health care in England and Wales. DESIGN: Postal structured questionnaire in cross sectional survey. SETTING: Random sample of people on the electoral register in England and Wales. SUBJECTS: People aged 18 and over. MAIN OUTCOME MEASURES: General levels of trust and confidence in health care. RESULTS: The response rate was 48% (n = 1187). The mean level of confidence (trust) in the healthcare system was 6.0 out of a score of 10. Levels of distrust appeared relatively high with at least 356 (30%) respondents reporting little or very little trust for 28 of 32 specific aspects of health care. The highest levels of distrust were found in relation to how the health service was run and financed, particularly waiting times and the implication of cost cutting for patients. Statistical analysis by univariable linear regression of the specific determinants of generic assessments of public trust (confidence) suggested that the key aspects were patient centred care and levels of professional expertise. Being covered by private health insurance was also a key determinant of levels of public trust. CONCLUSION: Public assessment of trust tends to address the views of care at the micro level. Policy makers concerned with the erosion of public trust need to target aspects associated with patient centred care and professional expertise.

Adolescent↗
PubMed2001

The reprofessionalisation of community pharmacy? An exploration of attitudes to extended roles for community pharmacists amongst pharmacists and General Practioners in the United Kingdom.

In the light of recent developments within the British National Health Service some sociologists have suggested that the medical profession's status is under threat. They have specified a range of factors contributing to this state of affairs, such as the new consumerism; however, it is thought that attempts by other, related occupations at reprofessionalisation are particularly significant in this trend. It may be possible to understand recent initiatives at extending community pharmacists' role within this framework. This paper suggests that while community pharmacy is developing strategies to enhance its professional status, it is not so much an attempt at usurping general practitioners'(GPs) (primary care doctors') role as a bid for survival, especially on the part of the rank and file. However, GPs do not necessarily see the initiatives in this light. Although many GPs are accommodating some changes in community pharmacy, they also perceive some of the initiatives as a threat to their autonomy and control, this was especially evident in representative bodies such as the Local Medical Committee. Doctors' accommodating attitudes were qualified with traditional attitudes of dominance such as 'limitation' and 'exclusion'. Such attitudes could prevent community pharmacy from achieving professional status. However, there is also evidence that pharmacists themselves contribute to this situation because many of them also attribute ultimate authority to doctors. Moreover, they are held back by internal occupational divisions particularly between retail pharmacists and employee pharmacists, with the former being the most insecure.

Attitude↗
PubMed1998

The patient's perspective.

The paper outlines the context in which patient's views have been emphasized and the evidence from survey research about the criteria users employ to evaluate health care. Evidence from qualitative research shows that users are ambivalent about modern medicine and are particularly sceptical about the value of drugs and medicine.

Attitude to Health↗
PubMed1987

List sizes and use of time in general practice.

The claim that list sizes in general practice should continue to fall towards a national average of 1700 patients rests heavily on the assumption that the extra time available to doctors would be used mainly for longer consultations, resulting in better standards of care. Evidence suggests, however, that the time is more likely to be used to increase rates of consultation in surgeries and home visits and to reduce the length of the working week. A national, random sample of 2104 principals in general practice in England and Wales were questioned about their allocation and use of time. The response rate was 67%, and no large biases in response were detected. The smaller their personal list size the less time general practitioners spent on all aspects of their work and the higher their rates of consultation and home visiting. The effects of further reductions in list sizes would be haphazard, being differentially distributed across the range of list sizes. Longer consultations would probably result, but most of the extra time would probably be used in higher rates of consultation in surgeries and home visits and some would be taken as free time.

Appointments and Schedules↗
PubMed1985

Explaining attendance at a breast-screening clinic.

This paper describes an analysis of the social, psychological and demographic factors associated with attendance/non-attendance at a clinic providing mammography and an examination carried out by medically-trained staff. Six hundred and fifty-four women aged 45-64 were interviewed approx. 1 month before they received an invitation to attend for breast screening. Seventy-two percent of these women subsequently attended the clinic. In all 30 different variables were measured. The attender could best be characterised as someone who previously used other types of preventive health service, felt vulnerable to breast cancer and saw breast screening as being beneficial. The implications of these and other findings are discussed.

Breast Neoplasms↗
PubMed1984

Explaining attendance at a class teaching breast self-examination.

Using the health belief model as an organizing frame-work, variables were examined that might predict attendance at a class teaching breast self-examination. The results show that various health belief dimensions are among the best predictors although other strong predictors are identified and some modifications to the health belief model are proposed.

Attitude to Health↗
PubMed1984

Explaining participation in programmes for the early detection of breast cancer: a comparative analysis.

A trial to evaluate different methods for the early detection of breast cancer is being carried out in the United Kingdom. Its success depends, in part, upon achieving a high rate of participation. The study presented here examines and compares the health beliefs, health behaviour and socio-demographic characteristics of attenders and non-attenders at (i) a breast screening clinic, and (ii) a class teaching breast self-examination (BSE). The results show that attenders at one or other of the two services had much in common. However, attenders at the class appeared to be motivated by stronger feelings of vulnerability to breast cancer than attenders at breast screening. Also, differences in social class and educational background were found to be associated with attendance/non-attendance at the BSE class, but not associated with attendance at the breast screening clinic.

Aged↗
PubMed1983

Compliance with a class teaching breast self examination.

As part of the evaluation of a class teaching breast self examination (BSE), a sample of women were interviewed shortly before they were invited to attend the class and again one year later. A comparable sample in a different "control" district were interviewed twice in the same way. The interviewers inquired about the practice of breast self examination (BSE) and about beliefs about breast cancer. The findings enable changes in behaviour and beliefs among those who attended and did not attend the class and among women in the control district during the same year to be compared. Women who attended the class showed a more pronounced improvement in BSE practice compared with non-attenders and with the control group. The improvement was in BSE technique rather than the frequency with which it was carried out.

Attitude to Health↗
PubMed1976

Suspected poisoning in children. Study of the incidence of true poisoning and poisoning scare in a defined population in North East Bristol.

The distinction between true and suspected poisoning in children has not been made clear in previous work on childhood poisoning. A study of suspected poisoning in children under 15 years of age in a defined population of North East Bristol from November 1970 to July 1973 carried out by the Health Education Council Medical Research Division included 53,000 child-years at risk. The number of suspected poisonings was 3-4/1000 population aged under 15 years per year, with a higher incidence in younger age groups. Detailed investigation of the circumstances of the accidents carried out by a multidisciplinary team showed that at least 65%, and possibly as many as 78% were poisoning scares and not true poisoning. The evidence used by the casualty doctor and by the parents to diagnose poisoning was explored, and in many cases was circumstantial. Children with fathers in nonmanual occupations were over-represented. This may reflect differences in patterns of utilization behaviour rather than true differences in incidence.

Accidents, Home↗