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 541 records · Page 30Linked to original sources

PubMed2006

Place and provision: mapping mental health advocacy services in London.

The National Health Service (NHS) Executive for London carried out an investigation in 2002 as part of their wider mental health strategy to establish whether existing mental health advocacy provision in the city was meeting need. The project took a two-part approach, with an emphasis on, (a) mapping the provision of advocacy services and, (b) cartographic mapping of service location and catchments. Data were collected through a detailed questionnaire with service providers in collaboration with the Greater London Mental Health Advocacy Network (GLMHAN) and additional health and government sources. The service mapping identified some key statistics on funding, caseloads and models of service provision with an additional emphasis on coverage, capacity, and funding stability. The questionnaire was augmented by interviews and focus groups with commissioners, service providers and service users and identified differing perspectives and problems, which informed the different perspectives of each of these groups. The cartographic mapping exercise demonstrated a spatially-even provision of mental health advocacy services across the city with each borough being served by at least one local service as well as by London wide specialist schemes. However, at local level, no one borough had the full range of specialist provision to match local demographic need. Ultimately the research assisted the Advisory Group in providing commissioning agencies with clear information on the current status of city-wide mental health advocacy services, and on gaps in existing advocacy provision alongside previously unconsidered geographical and service dimensions of that provision.

Focus Groups↗

PubMed2004

Social services and the Single Assessment Process: early warning signs?

Following the publication of policy documents such as the NHS Plan and the National Service Framework for Older People, health and social care agencies in the UK have been charged with devising and implementing a Single Assessment Process by April 2004. Although service users and carers are often frustrated at having to give the same information to many different professionals, this paper cites research which raises significant doubts about the present capacity of social services departments to deliver on this government initiative. Based on telephone interviews with 25 local authorities, this paper describes the findings of research into the use of dependency measures in residential and nursing care. Although this research was conducted prior to the introduction of the Single Assessment Process, the study suggests that some local agencies may lack the expertise and skills to develop effective assessment tools/scales and that considerable Developmental work may be required to prepare organisations for April 2004.

Aged↗

PubMed2006

Help seeking for substance use problems in two American Indian reservation populations.

OBJECTIVES: This study examined the extent and types of help seeking (biomedical, traditional, and 12-step groups) for substance use problems in two American Indian reservation populations by using data from the American Indian Service Utilization, Psychiatric Epidemiology, Risk, and Protective Factors Project (AI-SUPERPFP). This study also sought to understand the correlates of such help seeking, including measures of need, demographic characteristics, spirituality, and ethnic identity. METHODS: AI-SUPERPFP, completed between 1997 and 2000, was a cross-sectional probability sample survey. Altogether 2,825 tribal members, aged 18 to 54 years, representing two tribal groups living on or near their home reservations, were randomly sampled from the tribal rolls. Response rates averaged 75.3 percent. The primary outcome measure was help seeking in the past year for substance use problems, which was further divided into help seeking from biomedical services, traditional healing sources, and 12-step programs. RESULTS: Help-seeking rates were high, with 13 percent of the population and 38 percent of those with diagnoses of substance use disorders in the past year having sought services for alcohol or drug problems in the preceding 12 months. Correlates of help seeking included variables related to need for services (substance use disorders, tobacco use, and mental and physical health problems), marital status, and spirituality. Slightly more than half of service users sought help from formal biomedical providers; use of traditional healing and 12-step programs was also common. Need and spirituality variables best differentiated among the users of the three modalities. CONCLUSIONS: Help seeking for alcohol and drug problems was common in these communities, with traditional healing and 12-step resources as essential components of the local service ecologies.

Adolescent↗

PubMed2005

Early maladaptive schemas and adult attachment in a UK clinical population.

OBJECTIVES: Both insecure attachment style and early maladaptive schemas have been associated with mental health difficulties. This study aimed to investigate how schemas relate to attachment style classification in mental health service users. A further aim was to investigate the nature of the relationship between psychological distress, common psychological difficulties, and attachment style. METHOD: Participants were 72 people in contact with mental health services who completed the short form of Young's schema questionnaire, a measure identifying their attachment style (experience of close relationships), and the clinical outcomes in routine evaluation (CORE; Evans et al., 1998) outcome measure. RESULTS: Overall, 81% of the participants had an insecure attachment style. The fearful group were the most distressed across several domains of the CORE, followed by the preoccupied group. Schemas differed significantly according to attachment style grouping, with the fearful group possessing the greatest degree of maladaptive schemas, followed by the preoccupied group. Discriminant function analysis identified differing patterns of schemas associated with attachment style. CONCLUSIONS: The results supported the relevance of both attachment style and maladaptive schemas to individuals with mental health difficulties. Importantly, several aspects of the individuals' symptoms and difficulties and their schemas were meaningfully related to their adult attachment style. Limitations included the small number of dismissing individuals identified, the problems of self-report in this area, and the absence of information about the quality of participants' current relationships.

Adjustment Disorders↗

PubMed2004

Fear, black people and mental illness: a vicious circle?

The relationships between black communities and the mental health (MH) services are fraught. Paradoxically, black communities receive the MH services they don't want, but not the ones they do or might want. Black people mistrust and often fear services, and staff are often wary of the black community, fearing criticism, and not knowing how to respond, are fearful of black people, in particular, young black men. The situation is fueled by prejudice, misunderstanding, misconceptions and sometimes racism. The present paper describes the findings of a study to explore the issues in greater depth. The study was premised on a belief that there are 'circles of fear' which lead to poorer treatment of black communities. A purposive sampling approach was used to seek out groups and individuals in whom the 'circles of fear' were likely to be evident. The findings suggest that there are fears which impact negatively on the interaction between black communities and MH services. Two major themes emerged in this study, i.e. the sources of fear and the consequences of fear. Sources of fear included perceptions of MH services, attitudes to mental illness and diagnosis, and experiences of hospital care. The impact of fear included limited trust, limited engagement and delayed help-seeking behaviour. The study concludes that these fears mar the interactions between these communities and MH services, affect help-seeking behaviour adversely, and lead to restrictive and punitive interventions. Progress will only be made in breaking the 'circles of fear' if there is a systematic change in the experience of black services users at each point in the care pathway.

Adult↗

PubMed2005

Involving patients and their carers in educating and training practitioners.

PURPOSE OF REVIEW: We summarize and discuss recent work that highlights the role of patients and carers in educating practitioners in the light of earlier findings. RECENT FINDINGS: In today's National Health Services in the UK, a changing value base is emerging based on the participation of practitioners, patients and carers, with each group contributing to the education and training of healthcare professionals. The role of patients and carers in education is changing as the value of their experience and expertise is acknowledged. Now professionals are more actively recognizing that service users can contribute usefully to teaching in more unique ways, as 'experts' in their illness. They bring different perspectives and ways of thinking that can instill a new dimension to delivering healthcare services and training. Their expertise is defined by experience, and this different perspective gives them a unique role in teaching. They represent a potential teaching resource for medical education that is grossly underutilized. SUMMARY: Patients and carers are experts in their particular circumstances and blending their expertise with that of professionals is likely to contribute to the best outcome in a particular situation. They are a valuable resource as potential teachers at all stages of medical education.

Journal Article↗

PubMed2006

Scaling up health interventions in resource-poor countries: what role does research in stated-preference framework play?

Despite improved supply of health care services in low-income countries in the recent past, their uptake continues to be lower than anticipated. This has made it difficult to scale-up those interventions which are not only cost-effective from supply perspectives but that might have substantial impacts on improving the health status of these countries. Understanding demand-side barriers is therefore critically important. With the help of a case study from Nepal, this commentary argues that more research on demand-side barriers needs to be carried out and that the stated-preference (SP) approach to such research might be helpful. Since SP techniques place service users' preferences at the centre of the analysis, and because preferences reflect individual or social welfare, SP techniques are likely to be helpful in devising policies to increase social welfare (e.g. improved service coverage). Moreover, the SP data are collected in a controlled environment which allows straightforward identification of effects (e.g. that of process attributes of care) and large quantities of relevant data can be collected at moderate cost. In addition to providing insights into current preferences, SP data also provide insights into how preferences are likely to respond to a proposed change in resource allocation (e.g. changing service delivery strategy). Finally, the SP-based techniques have been used widely in resource-rich countries and their experience can be valuable in conducting scaling-up research in low-income countries.

Editorial↗

PubMed2005

Telephone interviewing in healthcare research: a summary of the evidence.

Increasing numbers of healthcare researchers in the UK are using telephone interviews in their research. In this paper, Elizabeth Smith summarises the context in which the method is used to target purposive samples of service users or patient, carers, clinicians and other staff, or key individuals in the field of inquiry. The aim is to gain detailed and specific data about perceptions, experiences and views of healthcare services. It is useful to identify the circumstances under which the advantages and disadvantages of telephone interviewing have been realised to contextualise concerns about the quality of the data compared to other methods and provide practical advice for researchers considering using the method.

Humans↗

PubMed1993

Severely and persistently mentally ill patients in Italy: an overview of epidemiological and psychosocial findings.

The aim of this paper is to provide an overview of epidemiological, clinical and psychosocial characteristics of patients needing long-term treatment. The data concerned the following aspects: prevalence and incidence from the five best-established Italian psychiatric case registers; needs for care; psychosocial and clinical outcome as assessed by means of follow-up studies; social disability and relatives' perceived burden. The one-year prevalence rate of "long-term users" is consistent in Northern Italy, higher in Middle Italy and lower in Southern Italy. The incidence rate was found to be around 4 per 100,000. Even in a community oriented mental health service, users' needs for care are only partially met. A good psychosocial outcome was found associated with the use of social and/or vocational skills training, while the average number of days per year of hospitalization in a psychiatric department was found associated with poor outcome. A moderate degree of social disability was found among patients needing long-term treatment. The resulting family burden presented to a marked or very marked degree in more than 50% of the relatives.

Activities of Daily Living↗

PubMed2006

Supply and demand: estimating the real need for care while meeting the 48 hour waiting time target in a genitourinary medicine clinic by a closed appointment system.

AIM: To attempt to assess demand for access to sexual health services in a community where a "closed" appointment system operates in the local genitourinary medicine (GUM) clinic. SETTING: A large GUM clinic serving a provincial city in England. Appointments for new episodes are available only 1 or 2 days ahead. Service user complaints about repeated difficulty in getting through to book a visit prompted a review of all methods of access. METHODS: A prospective review of all calls received in the departmental telephone booking service was performed. Temporary extra staff manned a cascade sequence of telephone lines and recorded all calls and caller characteristics such as age and declaration of symptoms. All attempts to book an appointment in person, by written referral, or by telephone in a period of 5 working days were also logged. This total demand was compared with the actual capacity and maximum theoretical capacity of the clinic during the same time period. RESULTS: 626 appointments would be required in the working week to accommodate all patients within 48 hours of requesting to be seen. 84% of all calls requested a new appointment, and 77% all new appointment requests were by phone. There were 181 new appointments available; 72% of those requesting an appointment could not be seen. The clinic was working at 103% capacity. To accommodate demand at this quiet time of the academic year, the GUM service would need to increase capacity by 3-4-fold. CONCLUSIONS: Closed appointment systems in GUM services may produce an apparent "improvement" in waiting times to 48 hours, but many callers are not able to book an appointment at all. Demand for GUM services outstrips capacity to an extent that internal efficiency savings cannot hope to address.

Adult↗

PubMed2003

[Satisfaction of need for health services among pensioners with reformed health care].

The objective of this study was to determine the demand for health services and to assess the level of satisfaction of these needs in the new, reformed health care system with reference to pensioners and old age pensioners. The survey was carried out over the period of 4 months among patients undergoing a cure in the Municipal Sanatorium in Nałeczów. The group consisted of people with chronic diseases, among which cardiovascular system diseases were the leading ones. All the respondents were pension services users. The study results show that patients at older age, chronically ill or disabled, limited the realization of their health needs and did not begin proper treatment, due to difficult access to health services and bad financial situation. The changes introduced in the functioning of health system during the reform period did not trigger the improvement of medical care in the population of pensioners.

Aged↗

PubMed2004

[Risk of HIV/AIDS infection. Access and utilization of health services in a migrant community].

The recent trend concerning HIV/AIDS infection in Portugal has been worsening, with a total of 18995 cases of infection notified by the end of 2001. African immigrants are generally regarded as a particularly vulnerable group to this problem. Data on health service utilisation also indicates that they are under -- represented among service users, particularly for Sexual and Reproductive Health. The main objectives of this study were to characterise the resident population, to identify and understand knowledge, attitudes and practices regarding HIV/AIDS problems, and obstacles to service utilisation. The study was conducted among individuals aged fifteen years and above, living in a migrant community in the Greater Lisbon area. Data has been collected through community surveys and collective interviews. Results suggest that existing beliefs, attitudes and knowledge may, though indirectly, increase the risk for infection among the residents of the study area. Some of the factors that may act as deterrents to service utilisation are identified. The results of the study stress the need for government health policies and activities from other agencies focusing on improved access to health services for ethnic minorities, as well as intervention programs tailored specifically towards the needs of each community.

Acquired Immunodeficiency Syndrome↗

PubMed1994

[Applications of the quality control program in diagnostic radiology. Confirmation of results, clinical and managerial benefits].

The Health Physics Department developed and implemented a QA program to test the X-ray equipment in Policlinico S. Orsola-Malpighi, Bologna, Italy. The program was aimed at achieving "total quality" in diagnostic radiology. To this purpose, suggestions were taken from: the code of practice of the leading international committees; our personal experience over several years in measuring and evaluating radiologic equipment and finally data relative to the maintenance procedures for radiologic equipment. The Integrated Quality Assurance Program (IQAP) manages two different quality control sub-procedures: the first one (QF) monitors equipment performance with a view to providing more pieces of diagnostic information and to reducing both patient and staff dose; the other one (QG) plans maintenance service to reduce running costs. QF included: i) practical tests for X-ray equipment; ii) analysis, interpretation and comparison of results; iii) tolerance limits. QG provided information on: i) inventory; ii) user-service relationship; iii) suitability of any corrective actions. The data relative to the last four years are reported in the text. The regular and correct use of this integrated protocol is very useful to monitor the factors affecting image quality and to improve diagnostic radiology. Finally, the protocol allowed us to plan our "yearly maintenance contracts" better and to save money on running costs.

Program Evaluation↗

PubMed2001

Users' views on hospital and home care for acute illness in childhood.

This mainly qualitative study compared 40 families' experience of hospital and home care. This is one aspect of a randomised, controlled trial, which aimed to evaluate the clinical and cost effectiveness of a paediatric hospital at home service (HAH) for acute illness in children. This paper builds upon previous work that has aimed to examine parents' and children's views as service users. Forty families from a larger sample population took part in structured interviews. Eleven children aged 5 to 12 years took part in semistructured interviews. A drawing technique was the chosen method of augmentation in the children's interviews. Research findings showed that HAH is an acceptable alternative to hospital care where there are essentially nursing needs. Thirty-six (90%) parents and seven children stated a clear preference for HAH. The parents' preference was based on a perception that their child's illness wasn't serious or life threatening and therefore could be managed at home with appropriate support from health professionals. The social and financial costs of hospital care compared with HAH were the other main drivers, rather than a comparison of the quality of nursing care of their child.

Acute Disease↗

PubMed1994

Service providers and users discover the Internet.

Although the Internet has evolved over more than twenty years, resources useful to health information professionals have become available on the Internet only recently. A survey conducted by the Regional Medical Libraries of the National Network of Libraries of Medicine in the fall of 1993 indicates that libraries at academic institutions are much more likely to have access to the Internet (72%) than are libraries in hospital environments (24%). Health information professionals who take on the challenge and exploit the Internet's resources find rewards for themselves and their clients. The basic electronic mail capability of the Internet allows colleagues to collaborate, communicate, and participate in daily continuing education. Internet terminal and file-transfer capabilities provide improved access to traditional resources and first-time access to new electronic resources. Through the Internet, online catalogs are available worldwide, and document delivery is faster, cheaper, and more reliable than ever before. Institutions can make organizational, full-text, online, and publication information available through Internet tools such as direct file-transfer protocol (FTP), menu-based Gopher, and hypertext-based Mosaic. The National Library of Medicine (NLM) is among organizations finding new ways to provide service through the Internet. NLM now uses electronic mail to communicate with users, FTP service to distribute publications, and tools such as Gopher and Mosaic to distribute publications and graphics and connect users to online services. The Internet allows service providers and health sciences information professionals to work in a rich, new medium whose potential is just beginning to be explored. At the same time, its characteristics--including lack of formal organization, standards, quality control, and permanence--pose a challenge.

Computer Communication Networks↗

PubMed2005

A census-based socio-economic status (SES) index as a tool to examine the relationship between mental health services use and deprivation.

This paper discusses the development and application of a socio-economic status (SES) index, created to explore the relationship between socio-economic variables and psychiatric service use. The study was conducted in a community-based mental health service (CMHS) in Verona, Northern Italy, utilising service use data from 1996. An ecological SES index was constructed through a factor analysis from 1991 Census data, at census block level. Three factors reflected the following domains: the educational-employment sector (with four components), the relational network (with three components) and the material conditions (with three components). All service users were assigned a SES value, according to their place of residence in 1996. When these data were explored spatially, using ArcView 8.3, an association was observed between socio-economic deprivation and psychiatric service use. The SES index was then successfully validated using occupational status at the individual level. This study confirms the usefulness of developing and validating an ecological census-based SES index, for service planning and resource allocation in an area with a community-based system of mental health care.

Community Mental Health Services↗

PubMed2003

Asylum blues: staff attitudes towards psychiatric nursing in Sarawak, East Malaysia.

This paper draws upon findings from an ethnographic study of psychiatric service users in a psychiatric institution in Sarawak, East Malaysia. Findings focus primarily on the accounts of nursing staff in relation to attitudes towards psychiatric work and patients. These indicate that despite a rhetoric of decentralized services, a custodial 'asylum' model continues to influence the care of patients at many levels. Negative professional attitudes towards patients lead to issues of both moral and physical containment. However, an associated attitude of stigma and prejudice towards mental illness impacts upon how attractive a career in psychiatric nursing is perceived to be by respondents, subject to gender differentials.

Anthropology, Cultural↗

PubMed1997

Community care services for the mentally ill: consumers' views.

In this study a broadly representative sample of clients in the City of Westminster, receiving Care in the Community for reasons of mental ill-health, were interviewed regarding their experiences of, and levels of satisfaction with, services provided. The results reveal the vulnerability of services users, the benefits of community care, the high regard the majority have for their helpers, the limitations imposed by scarce resources, and the negative effects of only loose co-ordination between health and social services. Respondents also provide a rich source of data on how services might be improved.

Community Mental Health Services↗