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At least 829 records · Page 46Linked to original sources

PubMed1987

Psychiatric symptoms, social disablement and illness behaviour.

In this paper we investigate the relationship between social performance and the use of medical services, and to what extent this is independent of clinical disorder. In a sample of adults living in Camberwell, South London, social disability and clinical disorder were both predictive of service use. Those subjects who were admitted to psychiatric day-patient or inpatient facilities were found to show the highest levels of both types of impairment, followed by psychiatric outpatients. People who had seen their general practitioner because of their 'nerves' were less impaired than those in touch with the specialist psychiatric services but had significantly poorer social performance and a higher level of clinical disorder than people not in contact with medical services at all. When the severity of clinical disorder was controlled, however, levels of social performance no longer discriminated between the different groups of service users, except that psychiatric outpatients remained significantly more socially disabled than the general practice group.

Activities of Daily Living↗

PubMed1997

Perspective on the integration of substance user needs assessment and treatment planning.

In the 1970s and 1980s, several techniques for assessing the needs for substance user treatment were developed. Generally these techniques relied upon the data developed from large-scale data-gathering systems, originally designed to assess the capacity of the substance user treatment system nationwide. The need assessment techniques generally require making estimates of the prevalence of substance use disorders in the population and then applying them to the national utilitization experience. As first attempts often do, these approaches tended to simplify complex problems and tended to rely too heavily on the only available data. The result was that they tended to reify current practice rather than to define best practice. In the 1990s, new challenges face those attempting to assess needs for substance user services. As a result of the last decade's emphasis on cost containment, new concepts have challenged traditional views of needs assessment. This paper will discuss those new concepts and their impact on the needs assessment endeavor. In particular, the impact of the concept of medical necessity will be examined.

Cost-Benefit Analysis↗

PubMedDate not supplied

Managing the 'unmanageable': training staff in the use of dialectical behaviour therapy for borderline personality disorder.

Ninety-four staff from a regionally based mental health service and associated health and human services completed a two-day workshop introducing dialectical behaviour therapy, with a smaller number also undertaking advanced training. Survey and focus group data were collected on participants' demographics, attitudes, knowledge and experience of working with persons with this disorder, prior to and at one-month and six-months following completion of the introductory workshops. Quantitative and qualitative findings indicated that involvement in the training program was a positive experience for the majority of participants, with knowledge regarding detection and treatment and staff attitudes toward consumers being improved following exposure to the principles and practice of dialectical behaviour therapy. Discourse analysis of the focus group interview data pre- and post-training indicated a significant shift in the meanings staff associate with borderline personality disorder, with a pervasive therapeutic pessimism being displaced by more optimistic understandings and outlooks. Improved therapeutic outlook is likely to have positive implications for staff engagement with service users with borderline personality disorder. While this article provides a brief overview of the findings of the survey, the main purpose is to report the findings of the focus group interviews.

Adult↗

PubMed1997

The nursing process--a method of collecting evidence?

This paper questions whether or not the nursing process can be a valid method of collecting evidence on which to base nursing care. The author asserts that it can, but only if the service user is involved in the entire process.

Data Collection↗

PubMed2003

Lesbian health and the assumption of heterosexuality: an organizational perspective.

This study used a qualitative research design to explore hospital policies and practices and the assumption of female heterosexuality. The assumption of heterosexuality is a product of discursive practices that normalize heterosexuality and individualize lesbian sexual identities. Literature indicates that the assumption of female heterosexuality is implicated in both the invisibility and marked visibility of lesbians as service users. This research adds to existing literature by shifting the focus of study from individual to organizational practices and, in so doing, seeks to uncover hidden truths, explore the functional power of language, and allow for the discovery of what we know and--equally as important--how we know.

Canada↗

PubMed1999

[Work expansion and teamwork in the clinical examination department].

Changes in hospital management and examination rooms are needed along with revisions of medical laws and medical fees. Clinical examination engineers should improve hospital management by implementing user service, cost performance and effective use of skills to ensure proper treatment.

Interprofessional Relations↗

PubMedDate not supplied

The future for mental health nursing.

In February 1998 200 mental health nurses attended the RCN third European Mental Health Nursing Conference in Belfast. This paper reports on a delegate questionnaire concerning issues of resourcing, personal safety, skill mix and commissioning. The findings indicate that mental health nurses remain under threat from physical assault. However, the link between human resourcing, skill mix and threatening behaviour appears not to be one which practising nurses associate with their work area. Not surprisingly, there was a definite perception that purchasers of current services have no real understanding of the needs of service users or providers.

Attitude of Health Personnel↗

PubMedDate not supplied

The effectiveness of services for people with learning disabilities.

The government white paper The New NHS has placed emphasis on service effectiveness and expects it to be measured. Clinical governance is expected to provide robust internal mechanisms for this. A National Institute for Clinical Effectiveness will provide a lead on clinical and cost-effectiveness and a Commission for Health Improvement oversee the quality of clinical services (Department of Health, 1997). Signposts for Success (NHS Executive, 1998) sets out good practice guidance for commissioners and providers of health services for people with learning disabilities. This states that its aim is to deliver 'person-centred services, equality of access, support to use services and social inclusion', person-centred services being defined as those that put 'service users' wishes and needs at the centre'. This article looks at how one trust is trying to meet these requirements following this guidance.

Benchmarking↗

PubMed2000

Physicians' advice to quit smoking. The glass remains half empty.

BACKGROUND: We explored the relationships between advice from a physician to quit smoking and an array of respondents' characteristics, including sociodemographic factors, health status, health insurance status, physician continuity, and intensity of smoking. METHODS: We examined data from the nationally representative 1996-1997 Community Tracking Study Household Survey. We used multivariate logistic regression to model receipt of cessation advice in a sample of 8229 smokers aged 18 years and older who made at least one visit to a physician in the past year. RESULTS: Less than 50% of the subjects reported receiving cessation advice. Advice was less likely for patients who were younger, men, African American, uninsured, healthier, lower health care services users, or lighter smokers, and more likely for those with military health insurance, who attended hospital outpatient clinics, or who belonged to health maintenance organizations. CONCLUSIONS: Physicians continue to miss opportunities to provide smoking cessation advice, a potentially lifesaving intervention. Given the adverse health consequences of tobacco use and the demonstrated benefit of advice to quit, physicians need to improve their cessation counseling efforts.

Adolescent↗

PubMed2000

Reconfiguring services. Slow motion.

A scheme to reconfigure mental health services took 10 years from agreement in principle to the opening of the new unit. A plan to finance it under the private finance initiative had to be abandoned when the private investor pulled out. The original design was substantially altered in response to service users' requests. The trust allocated 1 per cent of the budget for artworks in the new unit.

Architecture↗

PubMed2000

[The mission of the Director General of the Ministry of Health].

In France, the health and solidarity department of Employment and solidarity Ministry have just been re-organised. The Directory General of the department of Health is experiencing a complete revision of its functions and organisation. This article presents the public health context which has been taken into account for this new organisation and explains its main principles and strategic orientations. The new organisation chart is clarified. It is made up by two departments and seven under-directions. Up to now, control and administrative supervision were predominant among Health General Direction functions. They are now oriented to administrate missions prioritizing the function of health doctrines' elaboration, of programmation, animation and coordination. As the guarantor of sanitary security, the Health General Direction has also to impulse a new partnership which does not only include health professional, social and health organisation and the economic actors: citizen in general and service users in particular have to be included to promote health democracy.

Administrative Personnel↗

PubMedDate not supplied

[Developing the hospital's mission to facilitate organizational change: limits and possibilities].

The author begins by discussing the field of General Administration Theory vis-à-vis the defining role of "organizational goals" within an overall change process in organizations. While admitting the validity of some challenges raised by certain authors who deny the possibility of establishing a "single" direction for the organization by explicitly outlining its formal or official goals, the author presents and discusses his experience in defining the mission in the health sector as a way to implement organizational goals. This definition is meant as a strategy to improve communications among health team members and to a culture of responsibility when dealing with health service users.

Consumer Behavior↗

PubMed2000

Elderly people. Old testament.

Primary care groups need to address the needs of elderly people. Elderly people and their carers should be consulted about services. Elderly service users can be enthusiastic participants in consultation initiatives.

Aged↗

PubMedDate not supplied

[Evaluation of the quality control system in blood transfusion service].

INTRODUCTION: Implementation of quality system improvement at the Blood Transfusion Institute Novi Sad, included adjustments in practice to the request of ISO 9001 standard. Quality improvement must be a permanent activity of the Institute. The audit is a management tool for monitoring the quality assurance system and is either a quality audit or a medical audit. A well planned, comprehensive quality audit covers each activity of the Blood Transfusion Institute. The procedures may be internal or external. INTERNAL AUDIT: Quality manager is responsible for annual internal quality audits. The purpose of internal audits is to check the efficiency of the quality system in terms of realization of quality policy, fulfullment of designed targets and implementation of quality system documents. An internal quality audit is performed in accordance with the procedure and audit findings are reported to the management in a form of internal quality report as a part of quality system review. The findings must be communicated to all persons responsible for the controlled area. Quality manager can initiate an internal quality audit whenever it is realized that problems about the quality system have occurred. Audits are conducted by the quality manager or an audit team. The accurate list of internal auditors is kept in the Institute archive. MEDICAL AUDIT: Medical audit carried out by a transfusion committee, evaluates the quality of blood transfusion for determining the degree of compliance with established local or national guidelines, in order to promote optimal transfusion practice. CONCLUSION: Audits are not only used for determining further quality management activities, but also make basis for creating and maintenance of excellent relations with product and service users. Considering all this, Blood Transfusion Institute exceeds the requirements of ISO 9000 standards series.

Blood Transfusion↗

PubMed2001

Hospital inquiries. The listening blank.

The major failures reported in the Bristol inquiry have been highlighted in most hospital inquiry reports over the past 30 years. The tendency to victimise the whistleblower has characterised virtually all inquiries. Inadequate leadership, isolation, system failures, poor communication and disempowerment of staff and service users are the common themes. While organisational reform is essential, the real challenge is to change behaviour. And this depends on the example of senior staff.

Communication↗

PubMed2000

Producing benchmarks for clinical practice.

Clinical benchmarking has huge potential for improving health care. Students exploring benchmarks for fundamental and essential aspects of care produced a number of interesting key factors and continuums of care. A significant feature of the development of the Department of Health benchmarks has been the inclusion of service users.

Benchmarking↗

PubMedDate not supplied

A guide to risk assessment.

Mental health service users experience increased risk in relation to a number of specific problems, including an increased risk of suicide, self-injury, neglect, exploitation (physical, financial or sexual) and violence towards others. Risk assessment is linked to the practice of risk management, whereby a mutually agreed plan, aimed at reducing identified risks, is negotiated with the individual concerned. The plan incorporates specific therapeutic strategies and is a collaborative, interactive and dynamic process rather than something that is 'done to' the person. Although risk assessment is a core nursing skill, it needs to occur within the multi-professional context and involves other relevant disciplines.

Humans↗

PubMed2004

Evidence-based practice, research and anorexia: the what, the whys and the hurdles.

This article debates the merits of an evidence-based approach to the management of anorexia nervosa, addressing arguments as to why such a professional endeavor is important, as well as examining current hurdles to its realization. Obstacles to evidence-based practice in this field include the quality of research, as well as barriers produced by practitioners and service users, each of which are reviewed. A number of the problems highlighted in this discussion, relating to anorexia, apply to psychiatric research in general. Consequently, this article includes issues of interest to those whose field of expertise is not necessarily individuals with eating disorders.

Anorexia Nervosa↗