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Biomedical subjects

P Baume

Publications and source records attributed to P Baume.

At least 19 recordsLinked to original sources
PubMed1999

Suicides in an Australian inpatient environment.

Associated stressful life events both within and outside the hospital environment may contribute to the high-risk environment. The cohort studied here was hospitalized for a significant psychiatric problem, a factor which puts them in the high-risk category. When the severe psychiatric diagnosis is combined with a significant stressful life event, the risk of suicide is increased significantly.

Adult↗
PubMed1998

Elective admission policies in New South Wales public hospitals.

OBJECTIVE: To assess the existence and content of elective admission policies in New South Wales acute public hospitals. METHODS: A questionnaire was sent to managers of all acute public hospitals (n = 76). Copies of elective admission policies were sought from respondents. Results were analysed with EpiInfo 5.01b and policy content by thematic analysis. RESULTS: Survey response was 91% (69/76). Policies existed in 71% (49/69) of hospitals. Of these, 96% (47/49) disseminated their policy, with 23% (11/47) disseminating it at least annually, 41% (19/47) only when updated, and 32% (15/47) infrequently, with one policy being new (2%) and one hospital not stating its frequency (2%). Policy compliance was assessed in 86% (42/49) of hospitals and guidelines reviewed periodically in 92% (45/49) of hospitals. Twenty per cent (10/49) of the policies had been developed since a departmental instruction of May 1994. Of the 20 acute hospitals with no policy, 75% (15/20) were rural and 85% (17/20) thought they should have a policy. Analysis of policy content revealed emphases on resource availability and clinical need as determinants of elective admission, an institutional rather than a patient focus, and a high level of senior nurse manager involvement in admission decisions in rural hospitals. CONCLUSIONS: Despite a specific departmental instruction, nearly one-third of hospitals still had no admission policy 18 months later. This could be indicative of miscommunication between hospitals and NSW Health or perceived irrelevance of department guidelines by hospital managers. Existing policies were mostly institutionally focused and dominated by perceived resource limitations. NSW Health might consider other medico-social factors and manager involvement in future policy development.

Admitting Department, Hospital↗
PubMed1998

Suicide on the Internet: a focus for nursing intervention?

The Internet is a means for people who do not know each other to share information to their mutual benefit or harm. Whereas electronic communication without censorship has its benefits, the net has not escaped the attention of people contemplating suicide. If mental health nurses are to assist vulnerable people who surf the net in search of encouragement to complete suicide, they need to know about Internet resources on suicide and to understand how suicide fatalities influence the behaviours of vulnerable people who express suicidal ideation in cyberspace. The importance of suicide modelling, ambivalence, group death wishes, suicide notes and related research is considered. Mental health nurses are invited to consider the implications for suicide prevention.

Adult↗
PubMed1997

End-of-life decisions in Australian medical practice.

OBJECTIVE: To estimate the proportion of medical end-of-life decisions in Australia, describe the characteristics of such decisions and compare these data with medical end-of-life decisions in the Netherlands, where euthanasia is openly practised. DESIGN: Postal survey, conducted between May and July 1996, using a self-administered questionnaire based on the questionnaire used to determine medical end-of-life decisions in the Netherlands in 1995. PARTICIPANTS: A random sample of active medical practitioners from all Australian States and Territories selected from medical disciplines in which there were opportunities to be the attending doctor at non-acute patient deaths, and hence to make medical end-of-life decisions. MAIN OUTCOME MEASURE: Proportion of Australian deaths that involved a medical end-of-life decision, using ratio-to-size estimation based on the sampled doctors' responses to the questionnaire. The response rate was 64%. RESULTS: The proportion of all Australian deaths that involved a medical end-of-life decision were: euthanasia, 1.8% (including physician-assisted suicide, 0.1%); ending of patient's life without patient's concurrent explicit request, 3.5%; withholding or withdrawing of potentially life-prolonging treatment, 28.6%; alleviation of pain with opioids in doses large enough that there was a probable life-shortening effect, 30.9%. In 30% of all Australian deaths, a medical end-of-life decision was made with the explicit intention of ending the patient's life, of which 4% were in response to a direct request from the patient. Overall, Australia had a higher rate of intentional ending of life without the patient's request than the Netherlands. CONCLUSIONS: Australian law has not prevented doctors from practising euthanasia or making medical end-of-life decisions explicitly intended to hasten the patient's death without the patient's request.

Adult↗
PubMed1997

Cybersuicide: the role of interactive suicide notes on the Internet.

As we approach the new millennium a new dimension in interactive communications has arrived. The internet is one such medium, and while it remains a relatively new form of information sharing, it has not escaped the attention of vulnerable young people. This paper discusses the internet resources on suicide and the issue of interactive suicide notes. Case examples of interactive notes followed by suicide fatalities are used to illustrate the potential influence of the internet on those who wish to share their suicidal ideation with others. Issues to do with modeling, ambivalence, group death wishes, research, and ethics are discussed. Finally, some recommendations are made for further studies.

Adolescent↗
PubMed1997

The pricing of nursing care.

Despite the poor performance of the general economy, the health care industry in Australia has experienced constant growth for several decades. Overall, Australia's expenditure on health is relatively high and, with an increasingly aged population, this expenditure is not likely to decrease. With the current concerns over cost-containment in the health sector it is important to assess the value of nursing care in economic terms. This paper explores the issue of valuing of nursing care within the framework of the Australian Health Care System. Questions are posed of nurses as to whether they are prepared to confront the realities of the health care arena and whether they are ready to value nursing practice in terms of economic value. As well as answering these questions, the paper argues that nursing costs are not sufficiently reimbursed under the current Australian health benefits, and that this poor estimation of the worth of health care may stem from the historical and social influences of nursing and the care provided by nurses. The paper concludes that the Australian health care system is clearly no longer static and that the public cannot afford to support the costs associated with a growing health care industry. Moreover, nursing can no longer afford not to be viewed as an entity in it's own right. A greater awareness of nursing's output will result if organisational or institutional changes are encouraged for the benefit of the Australian society, as a whole, as well as for the nursing profession.

Attitude to Health↗
PubMed1996

Death and medicine.

Explore the source record for details and available documents.

Attitude to Death↗