Various Areas Of Healthcare Research Articles

The use of the computerized version of quality of life and health status questionnaires in a community sample in southern Brazil.

Computerized data collection is an efficient process and well accepted by patients with different disorders. Although computer-based systems have been used to assess health status and quality of life in various areas of healthcare, there is a lack of studies to investigate the effectiveness of these instruments in Brazil. The aims here were to assess the usability of the Portuguese-language versions of the Personal Health Scale (PHS) and the Multicultural Quality of Life Index (MQLI) in southern Brazil and to determine the correlation between these two questionnaires. This was a cross-sectional community-based survey in which participants completed computerized versions of these two questionnaires. In a survey conducted in 16 different locations, 458 volunteers completed both questionnaires. Pearson correlation coefficients were generated between the scores of the two questionnaires. The inclusion criteria allowed all volunteers who were able to understand the questions in both questionnaires to participate in the study. The percentage of proper data collection via the computerized versions of the two questionnaires combined was 97.45%. A significant correlation (P < 0.01) between the PHS and the MQLI was observed. The computerized versions of the PHS and MQLI demonstrated efficient data collection patterns during the field survey trials. Health-related issues were significantly correlated with the overall experience of wellbeing and quality of life. The computerized versions of the PHS and MQLI are valid tools for research and clinical use in Brazil.

Telecare advice.

NHS Local has launched an online package to help staff create business cases for the introduction of technology to provide health care at home. The toolkit offers suggestions, information and advice about realising ideas and gives examples of technological improvements in various areas of health care, such as those concerning asthma, coronary heart disease and neurological conditions.

Aggression and violence against health care workers in Germany - a cross sectional retrospective survey

BackgroundAlthough international scientific research on health issues has been dealing with the problem of aggression and violence towards those employed in health care, research activities in Germany are still at an early stage. In view of this, the aim of this study was to examine the frequency and consequences of aggressive behaviour towards nurses and health care workers in different health sectors in Germany and to assess the need for preventive measures.MethodsWe conducted a cross-sectional retrospective survey. Nurses and health care workers from two nursing homes, a psychiatric clinic and a workshop for people with disabilities were interviewed using a standardised questionnaire. The sample covered 123 individuals (response rate 38.8%). The survey assessed the frequency, the type and the consequences of aggressive behaviour, and social support in connection with coping with aggression in the workplace. Odds ratios (OR) and 95% confidence intervals (CI) for putative risk factors which may influence the stress induced by aggression at the workplace were calculated using conditional logistic regression.ResultsDuring the previous twelve months 70.7% of the respondents experienced physical and 89.4% verbal aggression. Physical aggression more frequently occurred in nursing homes (83.9% of the employees) and verbal aggression was more common in the psychiatric clinic (96.7% of the employees). The proportion of the individuals affected in the workshop for people with disabilities was lower (41.9% and 77.4% respectively). The incidents impaired the physical (55%) and emotional well-being (77.2%) of the employees. The frequency of incidents (weekly: OR 2.7; 95% CI 1.1-6.4) combined with the lack of social support (OR 2.8; 95% CI 1.2-6.6) increased the probability of higher stress due to aggression.ConclusionsThis study corroborates previous reports of frequent physical and verbal aggression towards care workers in the various areas of health care. The present study highlights differences between various areas of health care in Germany and the aggravating effect of prevention neglect such as missing social support at the workplace. Therefore our data suggest the need for improved target group specific prevention of aggressive incidents towards care workers and the need for effective aftercare in Germany.

Innovations in the Utilization of Health Information Technology in Psychiatric Services

There is ever-increasing activity in applying information technology to various areas of healthcare, including mental health. Examples of innovations include applications in screening, treatment, clinical decision support, communication and coordination, telemedicine, Internet-based education and services, public health research, training and education, and bioinformatics. Issues and challenges include protection of privacy, managing narrative free text, assessing the reliability of information found online, and mitigating impact on clinical workflow. While many of the innovations described will not be fully realized until national information systems reach a larger scale, many are having a positive impact on mental healthcare today.

Developing the First Dental Care Pathway: The Oral Health Assessment

In this paper the authors define the concept of care pathways and explain what they are and how they have been applied in various areas of healthcare. The authors discuss the benefits of the care pathway approach and outline the first national dental NHS (clinical) care pathway and its link to National Institute for Clinical Excellence (NICE) guidance on dental recall intervals. The authors go on to explain that as a result of one of the key recommendations of Options for Change, the concept of care pathways will be extended to the primary dental services of the NHS. The first care pathway will be the Oral Health Assessment (OHA). The authors describe the development of, and rationale for, the OHA and provide details of its planned introduction. The authors conclude that the OHA should act as the initial interface between the primary care team and the dental patient. In so doing it should enable a change in the focus of care, from treatment-based to more prevention-led, personalised care appropriate to the specific needs of individual patients.

Variation, Certainty, Evidence, and Change in Dental Education: Employing Evidence‐Based Dentistry in Dental Education

Variation in health care, and more particularly in dental care, was recently chronicled in a Readers Digest investigative report. The conclusions of this report are consistent with sound scientific studies conducted in various areas of health care, including dental care, which demonstrate substantial variation in the care provided to patients. This variation in care parallels the certainty with which clinicians and faculty members often articulate strongly held, but very different opinions. Using a case-based dental scenario, we present systematic evidence-based methods for accessing dental health care information, evaluating this information for validity and importance, and using this information to make informed curricular and clinical decisions. We also discuss barriers inhibiting these systematic approaches to evidence-based clinical decision making and methods for effectively promoting behavior change in health care professionals.

Focus Groups in Physiotherapy Evaluation and Research

The focus group is a form of group interview that is widely used in qualitative social science and market research. It has been applied in various areas of health care, especially health promotion and consumer satisfaction. Hitherto, little use seems to have made of this technique in physiotherapy. This paper explores the methodological characteristics of the focus group in relation to other methods of survey research, and examines some of its strengths and weaknesses. The nature and quality of focus group data are discussed, and the difficulty of obtaining individual, as opposed to collective, data is considered. It is emphasised that the group dynamics that occur within the focus group are crucial to the appropriateness or otherwise of this technique. An illustrative case study from physiotherapy is presented, concerning the construction of a patient-oriented outcome measurement tool. In conclusion, it is argued that the focus group technique, if used judiciously, offers considerable potential in physiotherapy evaluation and research.

Observations from the program on chronic mental illness.

The Robert Wood Johnson Foundation (RWJF) Program on Chronic Mental Illness has come to an end. Launched in December 1986, it was the foundation’s first multisite national venture into mental health care. The program sought to establish improved systems of care for persons with serious and long-term mental disorders in nine major cities across the country. Now, almost six years later, the grant period has ended, and it is time to take stock. The nine demonstration programs are still intact, with more than 250 staff in place at the sites. Throughout the program’s lifetime it received $22.5 million in RWJF grant funds, $9 million in foundation loan funds to stimulate housing development, and 1,200 Section 8 housing certificates, issued by the U.S. Department of Housing and Urban Development (HUD). One view of the impact of this program is offered by Howard Goldman and his colleagues, based on a formal evaluation funded by RWJF and a consortium of federal agencies.’ But there is another view of the program’s impact: the subjective impressions of the national program office staff and the staff at the nine demonstration sites. This perspective has been enriched by RWJF’s style of grant management, which is to fund a partnership between the national program office (typically in a university) and the demonstration sites. Instead of awarding the grant and coming back later to assess the results, RWJF requires that each demonstration site develop its program in collaboration with the national program staff. The national office maintains constant contact with the sites to monitor progress and solve immediate problems and carries out numerous site visits, with special conferences among the sites and other direct contact as needed. This management style affords the national program staff an intimate view of the demonstration sites and an opportunity to compare them as they face common situations.