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 1,567 records · Page 87Linked to original sources

PubMed2003

The needs of older people with mental health problems according to the user, the carer, and the staff.

BACKGROUND: Individual assessment of needs has been recognised as the most appropriate way to allocate health and social care resources. These assessments, however, are often made by the staff or by a carer who acts as an advocate for the user themselves. Little is known about how these proxy measures compare to how individual patients perceive their own needs. AIM: The aim of this study was to measure and compare ratings of need for older people with mental health problems by the older person themselves, their carer, and an appropriate staff member. METHOD: One-hundred and one older people were identified from various mental health services and 87 users, 57 carers, and 95 staff were interviewed using the Camberwell Assessment of Need for the Elderly (CANE) to identify met and unmet needs. RESULTS: Users identified significantly fewer of their needs (5.5) than either staff (8.1) or carers (8.3) did, but this difference was accounted for by people with dementia reporting less needs. Users identified fewer psychological or social needs (e.g. daytime activities, company, or carer distress) than staff or carers did. The average Kappa indicating level of agreement between staff and user was 0.52, between user and carer was 0.53, and between carer and user was 0.58. This showed only a fair level of reliability between different ratings of need. CONCLUSIONS: User perspectives should be given a high priority when assessing individual needs. Fears that assessment of need would be unduly time-consuming or would simply reflect individual demands should be allayed. A user-based assessment will assist healthcare providers to prioritise needs according to what the user themselves consider to be most important, beneficial, and acceptable to them. Reliance solely on assessment by staff or carers may not lead to the most equitable or appropriate use of services.

Aged↗

PubMed1977

Contraceptive method continuation according to type of provider.

A study was undertaken at the main PROFAMILIA clinic in Bogota, Colombia to compare the effectiveness of nurses and physicians in the delivery of family planning services. Contraceptive method continuation was the major outcome variable in this analysis. Clients were randomly assigned to physicians or nurses on their first visit and for the duration of care. On all revisits, data were collected pertaining to method prescribed, side effects, pregnancy, and method changes. There was a field survey at eight months to locate clinic drop-outs and determine their contraceptive use status. There were no significant differences in method continuation between clients who received services from physicians and those who received services from nurses. At nine months, the overall continuation of the first method prescribed was 79.1 per cent in the physicians' group and 75.8 per cent in the nurses' group (t = 1.057, p greater than .20). When controlling for first method used, the IUD users in the physicians' group had a continuation rate of 86.1 per cent and in the nurses' group 84.0 per cent (t = 0.556, p greater than .50). Of the pill users who received services from physicians, 78.1 per cent were continuing at nine months and 74.3 per cent of the pill clients in the nurses' group were continuing at nine months (t = 0.573, p greater than .50). There were no differences in pregnancy rates, side effects rates, and method change rates between the two groups. It may be concluded that these nurses were as effective as physicians in the delivery of family planning services.

Adult↗

PubMed1990

Smoking and consistently high use of medical care among older HMO members.

Smoking behavior of consistently high and low users of medical care services were compared in two groups of older health maintenance organization (HMO) members continuously enrolled for five years and a subgroup who were continuously enrolled for 10 years. Smokers and former smokers, combined, were more likely than never-smokers to be consistently high users of ambulatory services (52 percent vs 34 percent in the five-year group, and 45 percent vs 30 percent in the 10-year group).

Aged↗

PubMed1991

Towards user power.

In the first of two articles, Vivien Lindow says managers of mental health services should consult their users by facilitating some form of patients' group.

England↗

PubMed1998

Adoption of security and confidentiality features in an operational community health information network: the Comox Valley experience--case example.

Since 1993, a budding community health information network (CHIN) has been in operation in the Comox Valley in Canada. A general hospital and three multi-doctor clinics are linked electronically. The clinics operate without paper charts using a comprehensive clinic information system. The link is provided by RSALink, a commercial message exchange service, based on Health Link, a system developed at the University of Victoria (McDaniel et al., Can. Med. Inform. 1 (1994) 40-41; McDaniel, Dissertation, University of Victoria, Canada, 1994). Health Link is a highly adaptable message exchange service with rich functionality. Despite this, the system is used exclusively to receive laboratory results transmitted by the hospital's laboratory system (RSAStat). The results are deposited in the patient data base of a commercial clinic information system (CliniCare). This case is instructive because the users' selection of services available through Health Link allows us to observe the preferences in this informational sophisticated environment. Laboratory data transmission is appreciated as highly beneficial. The reliability, security and ample privacy protection and authentication features of Health Link, in contrast, are used in a black box mode and are not consciously exploited. This is consistent with our experience of the use of other systems which have operated for a substantial time, essentially without serious protection features. Our experience suggests that security and confidentiality features are exploited only to the extent that they do not require additional effort or conscientious intervention. This puts the system provider in the difficult position of either offering interactive systems that nobody will use, or providing automated features that nobody is aware of and that are therefore not used to full advantage--if at all.

British Columbia↗

PubMed1992

[Delivery at the parents' and children's premises].

Developed countries have reduced maternal mortality to a minimum, and there is a very low perinatal risk. This is still far from the reality in many developing countries. In the evaluation of health care for mother and child, all professionals involved should consider their focus. The use of technology, and the premises and information shared with the users should be open to revision, in order to provide services that are user-friendly, and to ensure low risk for parents and children.

Developing Countries↗

PubMed1997

The Balmain Hospital General Practice Casualty: an alternative model of primary health care provision.

The Balmain Hospital General Practice Casualty is a unique casualty style service, staffed and run by local general practitioners. It is a joint initiative of the Central Sydney Area Health Service and the Division of General Practice, Central Sydney Area, and is jointly funded by the Area Health Service and the Commonwealth. The casemix seen and type of services provided suggest that the service is intermediate between that provided by general practitioners and that provided by emergency departments. The service is well accepted by patients and local general practitioners. A number of benefits are seen by both service providers and users in terms of continuity of care and increased general practitioner skills.

Budgets↗

PubMedDate not supplied

[Evaluation of the efficacy of the "Spazi Giovani" of family clinics. Results of 3 ASL services of the City of Milan].

"Spazio Giovani" is a service offered once a week by many Family Counselling Services and aimed at addressing the needs of tenagers and young people who can access it free of charge and without booking an appointment. This kind of services started in the Eighties to address the needs of young people who were sexually active and often not accessing conventional services. The objective of this study has been to assess how attitudes for unprotected sex and at risk sex behaviours decrease in a population attending the Youth Corner on a regular basis in comparison with the same attitudes and behaviours in a group of first-time users of the service over a six month period. The research, involving 301 teen and young females showed significant differences in protected behaviours between the two groups. No significant differences in attitudes were put in evidence by the study.

Adolescent↗

PubMed2004

The meanings of cancer and perceptions of cancer services among South Asians in Luton, UK.

Recent research has suggested that there is limited awareness of and information about cancer and cancer services among South Asian communities. This study explores the meanings of cancer and perceptions of cancer services among South Asians living in Luton. Six single-sex focus groups were conducted among the three main South Asian groups in Luton: (1) Punjabi-speaking Muslims originating from Pakistan (Pakistani Punjabi); (2) Sylheti-speaking Muslims originating from Bangladesh (Bangladeshi Sylheti); and (3) Punjabi-speaking Sikhs originating from the Indian Punjab (Indian Punjabi). Overall, it was found that the information relating to cancer for South Asian communities was limited. Participants in the study expressed a keen desire for this information to be made available via their community social networks. This lack of information resulted in low levels of awareness about cancer and related issues. Cancer was often perceived as an incurable disease, a reflection of the fact that access to appropriate services had been experienced at a relatively late stage of the illness. Informed education, therefore, is clearly essential to influence how people manage cancer and access cancer services. This paper describes the challenges that service providers and users face in ensuring effective and informed awareness.

Adolescent↗

PubMed1994

Is there a market for regional units in child and adolescent psychiatry?

BACKGROUND: An analysis of the demand for the services of a sub-regional Family and Young Persons Unit which offers both in-patient and out-patient treatment for children and adolescents with psychiatric, emotional or psychological problems was performed. METHODS: Interviews were held and questionnaires were sent to representatives of the principal and potential users of the service both within the local district and beyond. RESULTS: The results demonstrated unmet demand for outpatient services but only limited demand for in-patient services in some districts. The role of market research in the new National Health Service and some of the difficulties of applying it are discussed. The implications of the findings for both the Family and Young Persons Unit and for child and adolescent psychiatry are considered. CONCLUSION: It is concluded that the effect of the market may be to bring about the closure of regional units unless there is intervention to protect them.

Adolescent↗

PubMed2004

Accessing hard-to-reach populations: the illicit drug market as a workplace of the outreach worker in Puerto Rico.

This descriptive paper reports findings from a formative research study on the drug market as a workplace of the outreach worker in Puerto Rico, and outlines strategies used by outreach workers to enable them to work effectively in these sites. Data were collected via outreach worker focus groups and participant observations at drug market sites. A social system theoretical model was used for analyzing data on drug market sites, and results are reported in terms of three basic social system components: structure, culture, and process. The authors recommend utilizing outreach workers as part of prevention and treatment teams in organizations providing services to drug users, as well as other hard-to-reach populations such as street sex workers and the homeless.

Community-Institutional Relations↗

PubMed2001

Mediated computer search services relative to instruction services: a survey of one health sciences library.

To assess the quality and usefulness of one health sciences library's mediated computer search service, a survey was undertaken to determine satisfaction rates, why users do or do not use the service, and how useful the service is perceived to be in comparison to instructional service. Satisfaction rates were high, with users indicating librarian expertise and time/cost savings as the main reasons for using the service. Non-users indicated that they preferred to do their own searching, and many were unaware of the service. Though a majority of respondents do not currently use the service, surprisingly a majority of respondents placed significant value on the mediated search service in relation to instruction.

Attitude to Computers↗

PubMed1984

Home care for patients with suspected myocardial infarction: use made by general practitioners of a hospital team for initial management.

Two hundred and sixty three general practitioners were offered the use of a hospital based service consisting of a medical senior house officer, a nurse attached to a coronary care unit, and a specially equipped ambulance estate car to help with the initial management of patients with suspected myocardial infarction who might be suitable for home care. One hundred and sixty nine general practitioners registered as potential users of this service; during 22 months they called the hospital team to see 271 patients, 235 of whom the team suspected had indeed suffered a myocardial infarction. During the same period, however, these general practitioners also admitted 317 patients with suspected myocardial infarction directly to hospital. Other general practitioners admitted 323 patients and deputising doctors 258. A further 529 patients with suspected infarction were admitted without the intervention of a general practitioner. Of the patients seen by the team, 54 required immediate admission to hospital; 17 of the remaining patients who initially appeared suitable for home care later required admission to hospital. In a large city such as Nottingham the provision of hospital based facilities to help general practitioners with home management is unlikely to make an appreciable impact on the overall pattern of care of patients with suspected myocardial infarction.

Aged↗

PubMed1996

Methadone maintenance treatment and HIV risk-taking behaviour among injecting drug users in Berlin.

STUDY OBJECTIVE: To determine whether methadone maintenance treatment (MMT) is effective in reducing the levels of HIV risk-taking behaviour (borrowing and lending of injection equipment, irregular condom use) among injecting drug users (IDUs), and to identify independent predictors of the borrowing of used syringes. DESIGN: Cross sectional study of IDUs in MMT and not in MMT, using standardised interviews for collection of sociodemographic and behavioural data, and laboratory tests for detecting HIV antibodies. SETTING AND PARTICIPANTS: The 612 IDUs were recruited at different services for drug users such as treatment centres, walk in agencies, a hospital, and on the streets. MAIN RESULTS: Of all IDUs, 41% had borrowed and 34% had passed on used injection equipment in the previous six months. In univariate analysis, IDUs receiving MMT had injected less frequently and were significantly less likely to borrow and lend syringes. In logistic regression analysis, MMT was protective against the borrowing of syringes (adjusted odds ratio 0.36, 95% confidence interval 0.2, 0.8), but not against syringe lending nor against sexual risk behaviour (i.e., numbers of sex partners, lack of condom use). Important independent predictors of the borrowing of syringes were injecting drug use in prison, use of sedatives, and sex with another IDU in the previous six months. CONCLUSIONS: MMT may play a significant role in reducing the levels of borrowing of syringes among IDUs. However, additional prevention measures are needed which should specifically address sexual risk behaviour and target subgroups of IDUs with high levels of needle sharing, such as IDUs who have been in prison and and those who are sedative users.

Adult↗

PubMed1999

Health-related service utilization and HIV risk behaviors among HIV infected injection drug users and crack smokers.

This study was designed to assess utilization of health-related services and HIV risk related behaviors by HIV infected drug users one year prior to and two years following the availability of Ryan White Title I funding. Using a cross-sectional design, a total of 777 drug injectors and crack smokers from five US cities were surveyed, over three waves of data collection, about their use of drug treatment, medical services, housing, mental health, and case management and about their sex and drug-related risk behaviors. For all service categories and in each wave, including the year prior to Title I funding, HIV risk behaviors were lower among those who used health-related services, with the exception of housing. Use of services did not increase significantly following the disbursement of Title I funds except for housing and case management. These findings suggest that it may be necessary to increase the attractiveness of health-related services, not just funding for services, for HIV infected substance abusers.

Adult↗

PubMed2001

Strategies for disseminating evidence-based practices to staff who treat people with serious mental illness.

Evidence-based practices have not been widely implemented in real-world treatment settings for several reasons, including existing state laws, administrative policies, funding priorities, advocates' concerns, and program staffing. Dissemination strategies focus largely on program staffing and the question of why treatment teams that are responsible for assisting people with serious mental illness fail to use evidence-based practices. In a review of the research literature, two barriers to staff dissemination emerge: individual service providers lack the necessary knowledge and skills to assimilate these practices, and certain organizational dynamics undermine the treatment teams' ability to implement and maintain innovative approaches. Three sets of strategies are useful for overcoming these barriers and fostering dissemination: packaging evidence-based practices so that specific interventions are more accessible and user-friendly to service providers; educating providers about relevant knowledge and skills; and addressing the organizational dynamics of the team to facilitate the implementation of innovations. Research on dissemination is relatively new and is less well developed than the clinical and services research enterprise that has led to evidence-based practices. Implications for future studies are discussed.

Chronic Disease↗

PubMed2004

A comprehensive system of pharmaceutical care for drug misusers.

This article outlines the evolution of a community pharmacy-based supervised consumption of methadone program in Grater Glasgow. The formalization of this program in 1994 promoted full patient compliance with the methadone regimen and reduced seepage of the drug to the illicit market. 184 of the area's 215 community pharmacies now dispense methadone for the treatment of opiate dependence. Of these, 173 have a supplementary contract with the local health board to supervise the consumption of methadone on their premises. In addition 15 of "methadone" pharmacists are involved in the provision of a pharmacy based needle exchange scheme. This has been shown to be the most efficient and cost effective method of delivering clean injecting equipment to injecting drug users in the Greater Glasgow area. Glasgow's pharmacists' have now been involved in the methadone and needle exchange programs for more than ten years. The support needed by pharmacists and the steps that have been put in place to provide this level of commitment are described. The development of the Glasgow pharmacy based services to drug users has had a major impact on practice elsewhere in the United Kingdom.

Journal Article↗

PubMedDate not supplied

[Experience and knowledge about climateric and menopause in women in Mexico City].

OBJECTIVE: To know the experiences and knowledge about climateric and menopause in a group of women covered by Instituto Mexicano del Seguro Social (IMSS). The purpose was to contribute for planning some strategies to increase seeking for medical care at these periods of life. MATERIAL AND METHODS: Descriptive survey study in a randomized sample of women aged 50-59 years, currently users of medical services in family medicine system of IMSS en Mexico City, with a confidence interval of 95%. RESULTS: Mean age at menopause was 47.8 years. Most frequent climateric symptoms were: hot flushes (70.9%), depression (60.2%), insomnia (53.5%) and menstrual disturbances (37.8%). 51.1% of women seeked medical care due to climateric symptoms but only 12.1% received treatment, majority hormonals (81.6%). Past users were 14.9% and they received hormones too in 87.8%. In this survey, 83.8% of women had some knowledge about main symptoms of climateric and 90.1% knew about osteoporosis but only 37.2% had some knowledge about cardiovascular risk after menopause. The prevention of osteoporosis and coronary disease was associated with calcium and exercise; only in 1% with use of hormonals. CONCLUSIONS: It exists an acceptable level of information about climateric syndrome and postmenopausal osteoporosis in these women, but it is low for risk of cardiovascular disease. Probably, their information is got from the mass media communication and did not for the activities of medical institutions in health education.

Age Factors↗