PubMed Health⌕ Search

Biomedical subjects

S Horrocks

Publications and source records attributed to S Horrocks.

9 recordsLinked to original sources
PubMed2006

Preferences for aspects of a dermatology consultation.

BACKGROUND: General practitioners with special interests (GPSIs) are increasingly being used to provide dermatology services in the U.K. Little is known about U.K. dermatology patient attitudes to proposed variations in secondary care service delivery or the values they attach to aspects of the care they receive. OBJECTIVES: To quantify preferences for different attributes of care within dermatology secondary care services. METHODS: Attributes of care that are important to dermatology patients were derived using in-depth qualitative interviews with 19 patients at different points in the care pathway. A discrete choice experiment using 'best-worst scaling' was sent by post to 119 patients referred to secondary care dermatology services and suitable for GPSI care who had agreed to participate in research. RESULTS: Four attributes were derived from the qualitative work: waiting, expertise, thorough care and convenience. For the discrete choice experiment, 99 patients returned questionnaires, 93 of which contained sufficient data for analysis. All attributes were found to be quantitatively important. The attribute of greatest importance was expertise of the doctor, while waiting time was of least importance. Respondents were willing to wait longer than the current 3 months maximum to receive care that was thorough, 2.1 months to see a team led by an expert and 1.3 months to attend a consultation that is easy to get to. CONCLUSIONS: Although the need to reduce outpatient waiting times is a key policy driver behind the expansion of GPSI services, this does not appear to be the most important issue for patients. The thoroughness with which the consultation is provided and the expertise of the clinician seen are higher priorities.

Attitude to Health↗
PubMed2002

Health and social factors for health visitor caseload weighting: reliability, accuracy and current and potential use.

The reliability and validity of data collection and recording for a health visitor caseload weighting system operating in a large combined acute and community trust in Bristol was examined. Client families were recruited from all participating (service) health visitors and were interviewed by a research health visitor attached to the project. The presence or absence of 28 health needs factors, selected for their known impact on health in the longer term, was subsequently compared with the service health visitor's own caseload records and with the computer record derived from them. Substantial differences were determined in the records obtained between the service and research health visitors and between the written and computerised records. Whilst the mean total score recorded for each family by the service health visitor was 2.0, the average of the differences in the total number of health factors recorded by the service and research health visitors was 1.9. Discrepancies were mostly associated with differences in interpretation of definitions, knowledge of recent events, changing circumstances and issues of confidentiality. Health factors at particular risk of being misinterpreted and those associated with other health factors were identified in order to propose a reduced factor set with greater inherent reliability and validity. At the level of the ward, the caseload weighting score, as currently defined, is highly correlated with standard deprivation indices in widespread common use. The results of this study indicate the need for users of the caseload weighting data to decide on the primary function of this data set - area-based community profiling or identification of at-risk client families in the community. This decision will inform further efforts to identify the most useful factors, tighten definitions, streamline data collection and train health visitors in their use. Interpretation of data will be facilitated by a scientifically developed scoring system. This work will assist trusts, both locally and nationally, in rationalising their allocation of health visiting activities to areas of greatest need.

Community Health Nursing↗
PubMed2002

Do children with non-malignant life-threatening conditions receive effective palliative care? A pragmatic evaluation of a local service.

INTRODUCTION: A service established in October 1998 aimed to provide nursing and psychological support in the community to families with children who have non-malignant life-threatening illnesses. The purpose of this study was to conduct a pragmatic evaluation of the service. METHODS: A before and after study design was used. It incorporated an administered questionnaire survey of carers of children at the time of referral and again after six months, a postal survey of health professionals and an audit of nursing and psychology records. RESULTS: Twenty-nine families were recruited. The children had a wide range of needs. Prior to the service, nearly half were rated by their main carer as experiencing considerable distress. Perceived problems were as frequently due to emotional or practical care needs as due directly to their physical illness. Information and nursing care needs appeared to be improved and distress rating was slightly reduced after the involvement of the service. However, problems with equipment and respite needs were not improved. In general, families were satisfied with central aspects of the service. CONCLUSIONS: The service appears to meet most of the expectations of both families and health professionals. However, recommendations include improvement of communication, the provision of a 24-h service and of respite care.

Adolescent↗
PubMed2000

Hunting for Heidegger: questioning the sources in the Benner/Cash debate.

This paper uses the Cash/Benner debate as an example of how important philosophical arguments can be hidden due to the use of secondary sources. Nurse academics can get lost in arguments about the secondary sources when there is a much more important issue lurking in the background. This paper argues that Benner's philosophy is not grounded in Heidegger but Dreyfus's interpretation of Heidegger. This has the consequence that Heidegger's ontological difference is collapsed and that her nursing ideas are weakened because of this.

Existentialism↗
PubMed2000

Assessment of health status at two years of very low birthweight infants--clinical governance.

Aims to establish a mechanism to determine prospectively the health status at two years of babies who weighed less than 1.5 kg at birth, born and receiving neonatal intensive care in North Wales. Maternal and neonatal data on all babies discharged from each of the three units in North Wales meeting this criteria were collated by the study coordinator. A mechanism for review of the health status at two years, corrected for gestational age, was established using the data set recommended by a working group convened by the National Perinatal Epidemiology Unit and Oxford Regional Health Authority. The procedures developed and the outcome data, for a two year cohort of babies born in 1995 and 1996, are reported. Concludes that prevalence of severe disability was similar to that found in other studies, with a considerable number exhibiting impaired growth and delay in speech development.

Child Development↗