SEARCH · PubMed Health

Results for “Service user”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources

PubMedDate not supplied

Providing culturally competent health services for ethnic minorities.

This article discusses the findings of a scholarship project aimed at gaining an understanding of the health needs of African and Caribbean older people and determining how these service-users perceive their needs are being met. It found that while practitioners were generally keen to provide a culturally appropriate service, some users thought their knowledge, attitudes and skills, particularly in communication, were a major source of concern.

Africa↗

PubMed1995

A needs-led approach to hospital resettlement.

Reports on an inter-agency initiative in Wakefield that used a needs-led case management approach for the resettlement of 32 former users of long-term hospital mental health services. Reviews the programme using headings provided by the values which underpinned local mental health services, namely, that services should endeavour to be appropriate, acceptable, accessible, effective/efficient and equitable for service users. The main objective of the programme was achieved--32 former users of hospital mental health services were resettled. Issues were, however, raised concerning the extent to which the programme could be described as needs-led. Concludes that there is still much to learn about the application of case management within the British health context.

Community Mental Health Services↗

PubMed1997

Sharing medication information with patients.

Prompted by its user members, the Salford adult mental health services clinical audit group decided to review the information on medication available to clients. Here Mick Renoden, a service user on the clinical audit group with a 22 year history of contact with mental health services, describes his own experiences with clinicians and medication. Then Jeff Withington reports the results of a survey of users' views, which revealed a strong demand for information about medication that could be easily understood and trusted, and led to the production of a range of leaflets.

Adult↗

PubMed2006

Severe and persistent mental illness: a useful definition for prioritizing community-based mental health service interventions.

OBJECTIVE: There is a lack of consensus on the identification of seriously mentally ill patients (SMI). This study investigates the external and predictive validity of an operationalized definition for the severity and persistency of mental illness applied to a sample of service users attending a community mental health service. METHOD: The definition is based on the fulfilment of dysfunction (GAF < or = 50) and illness duration (> or = 2 yrs) criteria. The study was conducted with a two-year longitudinal design. External and predictive validity of the SMI definition were assessed against the diagnosis of psychosis. RESULTS: Our data show evidence for an overall high predictive and external validity of the SMI definition and high sensitivity in predicting those with high burden of mental illness. CONCLUSIONS: In order to identify people with high levels of psychiatric burden, the SMI working definition seems to be more useful than that simply based on diagnostic criteria.

Adult↗

PubMed2001

Mental health service provision in England.

OBJECTIVE: To describe mental health service provision for adults of working age in England. METHOD: Services in an inner London area are described so as to illustrate current patterns of service organization in England. National trends are then discussed. RESULTS: Despite relatively low public expenditure, substantial progress has been made in deinstitutionalization and development of comprehensive community-based services. Persisting difficulties include high staff turnover, a minority of patients. who do not engage with community services, user and carer dissatisfaction with emergency services, and social exclusion because of stigma. Recent government policy advocates resolving some of these problems using new service models such as assertive outreach and crisis teams. CONCLUSION: Closure of the large asylums has largely been accomplished. England is now entering a new phase in community service development, with a range of innovative developments aimed at resolving problems still encountered after the initial phases of integrated community service development.

Adult↗

PubMed2005

Perspectives on disability in Afghanistan and their implications for rehabilitation services.

Twenty years of conflict has severely disrupted the infrastructure and economy of Afghanistan. Disability levels are high and much of the population has little access to health facilities. Re-establishing and strengthening rehabilitation services is therefore an important country priority. The aims of this study were to explore perceptions of the nature of disability in Afghanistan and to identify implications for the development of rehabilitation services. Over a 4-week period, interviews and focus groups, supplemented by field observations, were held with a range of service users and other stakeholders (including physiotherapist service providers and representatives of the Afghan Disability Committee) in the districts of Kabul and Herat. Data analysis identified three core themes in discussions with respondents: the nature of disability, causes of disability and rehabilitation priorities for people with disability (PWD). Afghan society distinguishes between traumatic and congenital disability, but disability awareness is much greater for persons with traumatic disability. This group enjoys much greater representation in disabled people's organizations. There is a strong cultural responsibility to care and provide for PWD rather than to encourage independence. Healthcare professionals reflect a medical model in their attitudes towards PWD. A key priority of PWD is economic. There is a low understanding of rehabilitation practice by PWD and medical staff. Training for rehabilitation workers and wider health professionals needs to reflect greater emphasis on a social model of disability. Public awareness and enablement of people with congenital disability needs to be raised.

Afghanistan↗

PubMed2004

Developing methods for systematic reviewing in health services delivery and organization: an example from a review of access to health care for people with learning disabilities. Part 2. Evaluation of the literature--a practical guide.

OBJECTIVES: To develop methods to facilitate the 'systematic' review of evidence from a range of methodologies on diffuse or 'soft' topics, as exemplified by 'access to health care'. DATA SOURCES: Twenty-eight bibliographic databases, research registers, organizational websites or library catalogues. Reference lists from identified studies. Contact with experts and service users. Current awareness and contents alerting services in the area of learning disabilities. REVIEW METHODS: Inclusion criteria were English language literature from 1980 onwards, relating to people with learning disabilities of any age and all study designs. The main criteria for assessment was relevance to Guillifords' model of access to health care which was adapted to the circumstances of people with learning disabilities. Selected studies were evaluated for scientific rigour then data was extracted and the results synthesized. Quality assessment was by an initial set of 'generic' quality indicators. This enabled further evidence selection before evaluation of findings according to specific criteria for qualitative, quantitative or mixed-method studies. RESULTS: Eighty-two studies were fully evaluated. Five studies were rated 'highly rigorous', 22 'rigorous', 46 'less rigorous' and nine 'poor' papers were retained as the sole evidence covering aspects of the guiding model. The majority of studies were quantitative but used only descriptive statistics. Most evidence lacked methodological detail, which often lowered final quality ratings. CONCLUSIONS: The application of a consistent structure to quality evaluation can facilitate data appraisal, extraction and synthesis across a range of methodologies in diffuse or 'soft' topics. Synthesis can be facilitated further by using software, such as the microsoft 'access' database, for managing information.

Adult↗

PubMedDate not supplied

Caring for people with depression.

BACKGROUND: Mental health care has recently become a government priority, and depression is a very common mental health problem. Many people feel that the mode of treatment used is less important than the effective delivery of care and intensity of follow up. The authors of this study devised a questionnaire to elicit the views of a small sample of mental health professionals and service users on the quality of current services. CONCLUSION: Most respondents felt that there is room for improvement in mental health services. Perceptions of the needs of people with depression focused on care, rather than on specific interventions. The voluntary sector was rated highly in caring for people with depression. Greater awareness among professionals of self-help organisations was seen as beneficial.

Attitude of Health Personnel↗

PubMed2003

Chest physicians' and microbiologists' awareness and demand for drug monitoring in the treatment of TB.

There is a role for therapeutic drug monitoring (TDM) to achieve the optimum therapeutic concentration of anti-tuberculous drugs. This work aimed to determine the current awareness of TDM in TB control among chest physicians and to estimate the demand for this service. Responses from a sample of chest physicians in the West Midlands revealed that 60% were aware of TDM and 33% had used it. Responses were received from half of a UK group of microbiologists who reported a median of nine requests in the past year. It appeared that more was known about services for rifampicin and streptomycin than other first-line drugs. There appears to be a need for both increased awareness among potential service users and for coordination of assay services.

Antitubercular Agents↗

PubMedDate not supplied

Evaluation of a family care centre in NSW.

To evaluate the Mt Druitt Family Care Centre a number of variables were measured: clients' anxiety and confidence before and after attendance, feedback on their experiences at the Centre and mothercraft skills and abilities on disengagement. Forty-one new clients whose ages reflected those of the area's child-bearing population participated. Most frequently reported presenting problems were: children not sleeping, concern with play activities and feeding difficulties. After attending the Centre there was a significant increase in the confidence levels and a decrease in anxiety levels of the service users. Most reported satisfaction with the service.

Child↗

PubMed1998

Drug users' views of drug service providers.

In Britain, there are a wide range of agencies providing many types of service to drug users. Such provision, it is argued, should be monitored and evaluated in the same way as provision to other client groups. To this end, the paper focuses on one aspect of drug service evaluation; users' views of service providers. Semi-structured qualitative interviews were conducted with 124 illicit drug users in rural, urban and inner city areas of Scotland and the respondents' comments were analysed inductively using the software package, Winmax. The study revealed three main findings. First, there was a high level of consensus amongst users regarding desired and undesired provider characteristics; and these characteristics held regardless of agency type. Secondly, users simultaneously retained different expectations of the different agencies and did not consider these agencies to be interchangeable. Thirdly, gender differences in attitudes to, and use, the different providers were apparent. The paper concludes that it is necessary to recognize the fundamental role that process factors, particularly providers' attitudes, play in terms of drug users' overall perception and evaluation of services. Additionally, although agencies should aim to provide a broad range of flexible forms of assistance, providers are not interchangeable and the continued development of a flexible mixture of interactive drug services and providers is recommended. Finally, drug users do not provide the definitive statement about the value of drug service provision. Nevertheless, their views and experiences are an important aspect of service evaluation and consequently deserve careful attention from policy, practice and research.

Journal Article↗

PubMed1998

Using a WWW-based mail user agent for secure electronic mail service for health care users.

WWW-based user interface is presented for secure electronic mail service for healthcare users. Using this method, communications between an electronic mail (WWW) server and users (WWW browsers) can be performed securely using Secure Socket Layer protocol-based Hypertext Transfer Protocol (SSL-HTTP). The mail can be encrypted, signed, and sent to the recipients and vice versa on the remote WWW server. The merit of this method is that many healthcare users can use a secure electronic mail system easily and immediately, because SSL-compatible WWW browsers are widely used and this system can be made available simply by installing a WWW-based mail user agent on a mail server. We implemented a WWW-based mail user agent which is compatible with PEM-based secure mail and made it available to about 16,000 healthcare users. We believe this approach is effective in facilitating secure network-based information exchange among medical professionals.

Computer Communication Networks↗

PubMed2001

Woman-centred care.

Changes over the past decade have emphasised the individual service user and their relationship with the health service. Within the maternity services this has been interpreted as woman-centred care a result of key initiatives; the Winterton Report (House of Commons, 1992. Maternity Services. Second Report of the Health Committee (Winterton Report), Vol. 1. HMSO, London) and Changing Childbirth (DoH, 1993a, Changing childbirth: reports of the expert maternity group parts 1 & 2. HMSO, London). Changing Childbirth outlined key principles of the maternity services and the need for the woman (and her partner, if she wishes) to be the focus of care. The key principles are choice, continuity and control. High quality care depends on the recognition of individuals as having unique needs which continues to be reflected within contemporary policy documents (DoH, 1997, The new NHS: modern and dependable. HMSO, London). This paper presents findings related to the provision of woman-centred care from a national research and development study. The study design incorporated (i): a national survey which was undertaken with midwives, midwife supervisors and doctors; and (ii): in-depth case studies in which information was obtained through interviews with midwives, midwife supervisors, educators, managers, doctors and mothers. Midwives, at all levels, are involved in changing maternity service provision and adapting to new systems of care which aim to increase continuity of care and carer for the woman. The researchers sought to understand how woman-centred care was interpreted and experienced in practice. The findings have been used to identify the continuing educational needs of midwives, and to develop an open learning educational package to meet identified need. The curriculum was designed to enhance the move towards the provision of a more integrated woman-centred service.

Adult↗

PubMed2005

An evaluation of the domiciliary occupational therapy service in palliative cancer care in a community trust: a patient and carers perspective.

In the past 20 years there has been considerable growth in the provision of palliative care services. The shift in emphasis from hospice and hospital care to the development of community services has been significant. This enables people to be cared for at home and is in keeping with Government agenda. While this may be beneficial for the patient and fit in with the wishes of the family, it is likely to put heavy demands on the coping resources of individual carers. The views of service users are of paramount importance when discussing service evaluation and patient, family and carer empowerment. This research presents the findings of an evaluation of the domiciliary occupational therapy service provided for patients in the palliative stage of cancer care in North and West Belfast from the perspective of the patients and carers. For the purpose of this study, the palliative stage of cancer care is defined as the point from which the patient is no longer responsive to curative treatment, until death. A sample of 30 patients and their primary informal carers were selected using purposive sampling. A structured interview was carried out with both the patients and their carers to obtain views. Results suggest that although both patients and their carers value the service provided and report high levels of satisfaction, there are gaps identified in service provision and a lack of clear information among patients and their carers about the role of the occupational therapist and the range of services they can provide. There is a need to build upon the good work being done by domiciliary occupational therapists in the area of palliative cancer care and increase education and resources to ensure that a patient-centred, holistic, approach to care is used, addressing both the needs of the patient and their carers.

Activities of Daily Living↗

PubMed2002

Performance of diagnosis-based risk adjustment measures in a population of sick Australians.

OBJECTIVE: Australia is beginning to explore 'managed competition' as an organising framework for the health care system. This requires setting fair capitation rates, i.e. rates that adjust for the risk profile of covered lives. This paper tests two US-developed risk adjustment approaches using Australian data. METHODS: Data from the 'co-ordinated care' dataset (which incorporates all service costs of 16,538 participants in a large health service research project conducted in 1996-99) were grouped into homogenous risk categories using risk adjustment 'grouper software'. The grouper products yielded three sets of homogenous categories: Diagnostic Groups and Diagnostic cost Groups. A two-stage analysis of predictive power was used: probability of any service use in the concurrent year, next year and the year after (logistic regression) and, for service users, a regression of logged cost of service use. The independent variables were diagnosis gender, a SES variable and the RESULTS: Age, gender and diagnosis-based risk adjustment measures explain around 40-45% of variation in costs of service use in the current year for untrimmed data (compared with around 15% for age and gender alone). Prediction of subsequent use is much poorer (around 20%). Using more information to assign people to risk categories generally improves prediction. CONCLUSIONS: Predictive power of diagnosis-base risk adjusters on this Australian dataset is similar to that found in IMPLICATIONS: Low predictive power carries policy risks of cream skimming rather than managing population health and care. Competitive funding models with risk adjustment on prior year experience could reduce system efficiency if implemented with current risk adjustment technology.

Adolescent↗

PubMed1996

Planning the development of cystic fibrosis gene carrier screening.

OBJECTIVES: It is now possible to test individuals to assess their cystic fibrosis gene carrier status and a range of strategies for screening the population have been piloted. The objective of this research was to develop a planning framework which health care planners and purchasers can use to assess the overall quantifiable outcomes and direct costs resulting from a year of alternative screening strategies and the ways costs and outcomes evolve over time. Beyond broader ethical and clinical considerations the information provided by such a framework is needed to support decisions surrounding the development of screening programmes. DESIGN: Operational Research modelling techniques were used to develop the planning framework. To help illustrate the framework it was then used to assess the quantifiable outcomes and direct costs of three of the main alternative screening strategies: from antenatal clinics, '2-step' screening where females are tested first followed by a screening invitation to the partners of female carriers, and 'couple' screening where both partners must agree to be tested at the outset; and from primary practice clinics 'active' contact of attenders. Quantifiable outcomes are defined as the number of individuals informed of their carrier status and the number of carriers, carrier couples, and affected fetuses detected. Direct costs are those associated with the recruitment and testing of individuals and the subsequent counselling of any gene carriers or carrier couples identified. Results are based on services for a resident population of 250,000 at two time points, year one and a year at 'steady state'. RESULTS: The resultant framework estimates the number of individuals tested using data on the size of the target population, the proportion of that population alerted to the screening service, and the proportion who agree to be tested when approached. Given service users, prevalence data are used to assess service outcomes. Given the number of individuals approached and the subsequent demands for services, service costs can be estimated. Preliminary results indicate that in the short-term health care purchasers and planners who favour screening are likely to opt for antenatal strategies. Although the high coverage of the primary practice strategy leads to high outcomes in year one, relative to the antenatal strategies, it also leads to very high costs. At 'steady state', cost and outcome differences between the strategies are less marked. CONCLUSION: This paper provides a framework which can be used to provide information to support decision-making surrounding the development of screening services. The methodology fills an important void in the literature and complements research elsewhere by health economists and by geneticists and their research colleagues. Preliminary findings based upon use of the approach demonstrate the need for continued research to further refine and improve the methodology.

Community Health Planning↗

PubMed1968

Developing of methodologic tools for planning and managing library services: 3. Standardized inventories of library services.

A standardized procedure was developed for eliciting those details of a library's service policies that are important to its users and for recording the data by checking appropriate categories on a form. This inventory procedure covers the entire spectrum of user services and accommodates a wide range of policies. The inventory was originally designed for use by trained interviewers in largescale surveys of academic medical libraries. However, it is also suitable for other kinds of libraries, and the Interview Guide and Checklist can be used for a self-survey by library staff. In addition to survey use, the inventory has a variety of educational, administrative, managerial, and research applications. A method for weighting the categorical inventory data to reflect the relative desirability of different policies makes it possible to calculate scores indicating how a library's policies compare with those of an "optimal" library. An analogous inventory of the services a library provides to other libraries was developed for surveying major backup resources in the medical library system.

Consumer Behavior↗

PubMed2002

[Nature of community pharmacy in home care].

To analyze the reason why home care service which community pharmacists provide has not been effectively utilized, a questionnaire on home care services was submitted to 472 home care service users, 215 general practitioners, 10 visiting nurses and 153 home-helpers, and 75 community pharmacists. We were interested in whether or not gaps existed between users' needs, practitioners' demands, and pharmacists' awareness of professional responsibility to pharmacy services. Also, we were interested in whether or not gaps existed in awareness of the importance of cooperation with community pharmacists and influencing factors between practitioners and home-helpers and visiting nurses. The main results were as follows: users and practitioners considered that counseling about home care and welfare services by community pharmacists was important and home visiting was not so important. However, pharmacists considered that home visiting was important and counseling about home care and welfare services was not so important. Therefore, gaps existed between users' needs, practitioners' demands, and pharmacists' awareness of professional responsibility to pharmacy services. Practitioners' awareness of the importance of cooperation with community pharmacists in comparison to that of other professionals was low as well as that of home-helpers, and visiting nurses. However, over 70% of them recognized the necessity of home visiting services by pharmacists. As far as factors influencing the awareness of the importance of cooperation with community pharmacists, practitioners' recognition to home visiting by pharmacists was higher than that of home-helpers and visiting nurses. However, expectations regarding community pharmacists' participation in home care services was higher than that of practitioners.

Aged↗