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Biomedical subjects

R S Barbour

Publications and source records attributed to R S Barbour.

7 recordsLinked to original sources
PubMed1996

Should obstetricians see women with normal pregnancies? A multicentre randomised controlled trial of routine antenatal care by general practitioners and midwives compared with shared care led by obstetricians.

OBJECTIVE: To compare routine antenatal care provided by general practitioners and midwives with obstetrician led shared care. DESIGN: Multicentre randomised controlled trial. SETTING: 51 general practices linked to nine Scottish maternity hospitals. SUBJECTS: 1765 women at low risk of antenatal complications. INTERVENTION: Routine antenatal care by general practitioners and midwives according to a care plan and protocols for managing complications. MAIN OUTCOME MEASURES: Comparisons of health service use, indicators of quality of care, and women's satisfaction. RESULTS: Continuity of care was improved for the general practitioner and midwife group as the number of carers was less (median 5 carers v 7 for shared care group, P<0.0001) and the number of routine visits reduced (10.9 v 11.7, P<0.0001). Fewer women in the general practitioner and midwife group had antenatal admissions (27% (222/834) v 32% (266/840), P<0.05), non-attendances (7% (57) v 11% (89), P<0.01) and daycare (12% (102) v 7% (139), P<0.05) but more were referred (49% (406) v 36% (305), P<0.0001). Rates of antenatal diagnoses did not differ except that fewer women in the general practitioner and midwife group had hypertensive disorders (pregnancy induced hypertension, 5% (37) v 8% (70), P<0.01) and fewer had labour induced (18% (149) v 24% (201), P<0.01). Few failures to comply with the care protocol occurred, but more Rhesus negative women in the general practitioner and midwife group did not have an appropriate antibody check (2.5% (20) v 0.4% (3), P<0.0001). Both groups expressed high satisfaction with care (68% (453/663) v 65% (430/656), P=0.5) and acceptability of allocated style of care (93% (618) v 94% (624), P=0.6). Access to hospital support before labour was similar (45% (302) v 48% (312) visited labour rooms before giving birth, P=0.6). CONCLUSION: Routine specialist visits for women initially at low risk of pregnancy complications offer little or no clinical or consumer benefit.

Clinical Protocols↗
PubMed1995

Responding to a challenge: nursing care and AIDS.

Those providing nursing services have been at the forefront in responding to the AIDS epidemic. This paper poses the question as to what extent AIDS work makes unique demands of nursing staff. It explores the implications of AIDS-related nursing work and considers these within the broader context of the role of nurses and their work environment. Although intense, many of the demands of AIDS-related work are also features of nursing in other contexts. There is thus potential to draw on already formulated training responses and to contribute significantly to ongoing debates about nursing and nurse education.

Acquired Immunodeficiency Syndrome↗
PubMed1995

The implications of HIV/AIDS for a range of workers in the Scottish context.

Although there have been a great many surveys of staff members' attitudes to HIV/AIDS, there has been relatively little research which has focused on their actual responses to and experiences of AIDS-related work (Barbour, 1994a). In addition, much of the published work on AIDS workers assumes that the demands of this work are self-evident, contingent upon client contact, and unique to this area of work. The research findings presented here suggest that these assumptions may be unfounded and certainly do not provide a complete picture of what AIDS work involves for staff members. Although some of the stressors reported by workers related to concerns explored in existing literature they did not always experience these anticipated demands as being especially problematic. Workers also reported experiencing problems in responding to demands from more unexpected quarters, such as organizational aspects of the work, rather than those stemming from the nature of contact with clients. Moreover, many of the demands were not unique to HIV/AIDS, but are features of other types of work. In devising training programmes for AIDS workers educators need to be alert to the often overlooked potential of pre-existing training programmes in operation in other specialties. Many of the demands cited by workers as problematic related to the newness of such demands in the light of their own employment histories rather than to HIV/AIDS work itself, suggesting that individualized training packages might be more appropriate. In relation to the retention of staff, it is crucial that the many rewards which pertain to this area of work are acknowledged and capitalized upon.

Adult↗
PubMed1995

Using focus groups in general practice research.

Recent years have seen a growing recognition of the appropriateness of qualitative methods in family practice. This has been paralleled by an upsurge of interest in focus group discussions as a method. Drawing on the experience of using focus groups with general practice teams as one component of a multi-method study this paper explores emergent orthodoxies regarding the use of focus groups and reviews the contribution which this method can make to research in general practice.

Family Practice↗
PubMed1994

The impact of working with people with HIV/AIDS: a review of the literature.

This review describes and discusses research on the experiences of professionals and volunteers who work face-to-face with people with HIV/AIDS. Although there is a rapidly growing body of research which examines the attitudes and experiences of staff involved in HIV/AIDS service provision, this work has, as yet, failed to produce a comprehensive picture of the ways in which the demands of HIV/AIDS-related work differ from those of other fields of work. Because studies have differed considerably, both in terms of focus and methods, few systematic comparisons between the experiences of different professional groups have been made. Research must have a comparative focus if we are to begin to distinguish those demands which are unique to HIV/AIDS from those to which satisfactory responses may have already been developed in parallel fields of work. Much of the work to date has assumed that the demands inherent in AIDS work are self-evident, but has failed to contextualize AIDS work in relation to other fields of service provision, the personal circumstances and career paths of workers, and the organizational structure within which work takes place. The studies have provided very little information about the process of adaptation to AIDS work and the rewards which may offset some of the stresses and demands of the work. This review attempts to provide a comprehensive overview of the research which has been carried out in relation to workers in different locations responding to different epidemic patterns and demands on services. It also attempts to contextualize the demands of HIV/AIDS-related work by comparing the demands and responses reported with regard to other types of work and makes recommendations for future research.

Adaptation, Psychological↗
PubMed1991

AIDS-related attitudes and knowledge among attenders at a Scottish family planning clinic.

AIDS-related attitudes and knowledge of 1,970 family planning clinic attenders were examined using a self-completion questionnaire. Attitudes towards testing varied depending on the sex, age and marital status of respondents. Knowledge of HIV transmission routes was generally good, although the fact that those most likely to be at risk of infection--the younger respondents and those not currently in steady relationships--were the least well-informed gives some cause for concern. Since family planning consultations are frequently the only contact these young sexually active individuals have with the health service the opportunities for health education on HIV/AIDS afforded by regular attendance at these clinics should be capitalized upon.

Acquired Immunodeficiency Syndrome↗