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Delphi technique: one cycle of an action research project to improve the pre-registration midwifery curriculum

NURSE EDUCATION TODAY 1999年第6期19卷 495-501页

作者： Fraser, DM Univ Nottingham Acad Div Midwifery Sch Human Dev Fac Med & Hlth SciQueens Med Ctr Nottingham NG7 2UH England

Facilitating a unified interpretation of new or re-designed curricula can be problematic in multi-sited universities. This paper discusses the use of the Delphi technique when implementing an innovative pre-registration midwifery curriculum. It formed one of the action research cycles of the author's doctoral study and was used in an attempt to seek the views of all midwife teachers and achieve a critical mass consensus. The most important issues that emerged from the Delphi process were grouped into four categories. These four categories (the teacher's base site, communications, staff development and administration issues) formed the agenda for a staff away day. The outcome of the process was the generation of a list of priorities and actions for curriculum implementation and the identification of ways in which staff development needs might be met more effectively. An unexpected, but equally important, outcome was the way it helped with team building and agreement on positive actions for its further development. (C) 1999 Harcourt Publishers Ltd.

关键词：医务工作者的态度课程/标准德尔菲技术教育护理研究生/标准全体教工护理院校卫生服务研究/方法助产学/教育需求估价/组织和管理助产士/教育助产士/心理学护理教育研究/方法问卷调查人类

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Understanding and controlling response bias in needs assessment studies

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EVALUATION REVIEW 1999年第4期23卷 399-417页

作者： Calsyn, RJ Winter, JP Univ Missouri St Louis MO 63121 USA

This study demonstrated that estimates of agency awareness in the typical needs assessment study are probably inflated by a response bias labeled "agency awareness overclaiming." Over- claimers (respondents who reported being aware of fictitious agencies) reported being aware of more real agencies than other respondents. Estimates of agency awareness may also be biased, because certain segments of the population were more likely to exhibit agency awareness overclaiming. Age was positively correlated with overclaiming, and African Americans were more likely to exhibit agency awareness overclaiming than Caucasians. General overclaiming was correlated with agency awareness overclaiming, but social desirability and acquiescence were not.

关键词：非洲裔美国人/心理学年龄因素觉知偏倚(流行病学) 教育考核欧洲大陆世系人群/心理学健康知识态度实践密苏里需求估价/组织和管理问卷调查可重复性结果性别因素社会性愿望成年人老年人女(雌)性人类男(雄)性中年人

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Assessment of chronic care need and use

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GERONTOLOGIST 2000年第4期40卷 390-396页

作者： Branch, LG Duke Univ Ctr Aging & Human Dev Durham NC 27710 USA

Focuses on the assessment of gerontological chronic care need and use. Distinction between need and demand; Comparison between basic and instrumental activities of daily living; Proposed approach to the assessment of ... 详细信息

关键词：日常生活活动慢性病/心理学慢性病/治疗老年人身心健康评价老年人保健服务/统计学和数值数据长期医疗/统计学和数值数据模型心理学需求估价/组织和管理病人接受卫生保健的程度/心理学病人接受卫生保健的程度/统计学和数值数据社会工作/组织和管理美国老年人人类

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Challenges and opportunities in psychiatric-mental health nursing

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NURSING OUTLOOK 2000年第5期48卷 238-239页

作者： Valentine, NM Dept Vet Affairs Washington DC USA Amer Psychiat Nurses Assoc Washington DC USA Amer Coll Mental Hlth Adm Pittsburgh PA USA

Nurs Outlook 2000;48:238-9.

关键词：预测职务说明精神卫生服务/组织和管理需求估价/组织和管理临床护理医生/组织和管理组织改革人员选用/组织和管理精神病护理学/教育精神病护理学/组织和管理人类

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The biosciences in the pre-registration nursing curriculum: staff and students' perceptions of difficulties and relevance

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NURSE EDUCATION TODAY 1999年第3期19卷 215-226页

作者： Jordan, S Davies, S Green, B Univ Coll Swansea Sch Hlth Sci Swansea SA2 8PP W Glam Wales Univ Coll Swansea Sch Hlth Sci Swansea W Glam Wales

This paper considers the problematic position of the biological sciences in pre-registration nurse education -'The Bioscience Question'. There is no consensus and little research on the appropriate content and depth of bioscience knowledge required by nurses. Attempts to apportion curriculum time for the biosciences are confounded by the difficulty experienced by nursing students with this area. Within one university department, a survey was undertaken to investigate the perceptions of pre-registration students, and their teachers, of the teaching and learning of biological science, in comparison with other areas of the curriculum. Our findings concur with others that the biosciences are a source of disproportionate difficulty and anxiety to nursing students. Among the students, but not the lecturers, there was some, by no means universal, support for the suggestion that these problems could be reduced by a reallocation of curriculum time in favour of the biosciences. Although it was agreed that bioscience theory should be related more closely to nursing practice, there was no evidence that this lessened the students' difficulties with the subject. In contrast to lecturers, students felt the biosciences to be one of the areas of the pre-registration curriculum most relevant to clinical practice.

关键词：适应心理学医务工作者的态度生物学/教育课程/标准教育护理学士/标准全体教工护理院校需求估价/组织和管理护理教育研究问卷调查学生护理/心理学时间因素人类

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The Medicare Critical Access Hospital program: The first year

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JOURNAL OF RURAL HEALTH 1999年第1期15卷 61-66页

作者： Reif, SS Ricketts, TC Univ N Carolina Sheps Ctr Hlth Serv Res Chapel Hill NC 27599 USA

The Medicare Critical Access Hospital (CAH) program, part of the Balanced Budget Act of 1997, is a nationwide limited service hospital program. Structured interviews were conducted in August and September 1998 with key people in state offices of rural health, state hospital associations, departments gf health or departments of facility licensing in all 50 states to assess their progress in the development of the CAH program. The majority of states expressed interest in the CAH program. Twenty-one states were moving formally toward involvement in the program. States that had developed or were in the process of developing a state plan estimated that between 183 to 227 hospitals would convert to CAHs in the next one to two years. States that were the most successful with plan de development appeared to be states that participated in the Essential Access Community Hospital/Rural Primary Care Hospital program, states where there was dialogue about the possibility of a limited service hospital program and states with widespread support in the state. A pressing need for most states is for reliable fiscal consulting or analysis that could be applied to individual hospitals that are considering conversion to CAHs. The CAH program shows promise for successful implementation based on its early results.

关键词：预算/立法和法学卫生服务易得程度/组织和管理卫生服务研究医院公立/经济学医院公立/组织和管理医院乡村/组织和管理医院慈善/经济学医院慈善/组织和管理缺医地区 Medicare/组织和管理需求估价/组织和管理试点项目初级卫生保健/组织和管理规划制订方案评价预期支付系统/组织和管理问卷调查偿还途径/组织和管理美国人类

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Are there need-based geographical differences between international medical graduates and US medical graduates in rural US counties?

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JOURNAL OF RURAL HEALTH 1999年第1期15卷 26-43页

作者： Mick, SS Lee, SYD Univ Michigan Sch Publ Hlth Dept Hlth Management & Policy Ann Arbor MI 48109 USA

The objectives of this study are to compare the rural location of international medical graduates (IMGs) and U.S. medical graduates (USMGs) by specialty (primary care vs. specialty care) according to geographical measures of need. This study utilized a cross-sectional survey using the 1997 American A;Medical Association Physician Masterfile for all active post-resident allopathic physicians aln the Area Resource File (ARF) (Bureau of Health Professions, 1996) for all active post-resident osteopathic physicians irt 1995 in the rural U.S. physician work force (N=69,065). Allopathic physician ZIP code location was matched to county data using the ARF. The key measure was the difference in proportions between USMGs and LMGs in each state's rural counties characterized by need: high infant mortality, low socioeconomic status, high proportion of nonwhite population, high proportion of population 65 years and older, and low physician-to-population ratio. Primary care and specialty care rural physicians were studied separately. A disproportion of IMGs were located in needy rural counties of more states than were USMGs. Further, IMG disproportions were generally larger than USMG disproportions when they existed. Disproportions of IMGs tended to be located more often in the central and south census regions. Disproportions of specialty care IMGs were more frequent and of greater magnitude than those of primary care IMGs. Variations in the relative and absolute numbers of IMGs and USMGs among the states was wide. Services delivered by active post-resident primary care and specialty care IMGs appeared to be disproportionate to their overall number compared with USMGs in numerous needy rural counties. The extent of the IMG "safety net" presence differed, however, by the criteria used. Still, proposed limits on IMG entry into U.S. residency training may create long-term problems of access to rural physician services absent policies to induce USMGs or midlevel practioners to locate

关键词：人口普查横断面研究外国医学研究生/供应和分配卫生服务易得程度/组织和管理卫生服务研究健康状况指标缺医地区需求估价/组织和管理骨病医学/人力医师/供应和分配初级卫生保健/人力居住特征乡村卫生服务/人力社会经济因素专业医学/人力美国人类

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Health and the 1999 Regional Australia Summit.

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The Australian journal of rural health 2000年第1期8卷 52-57页

作者： Humphreys, J.S. School of Health and Human Sciences La Trobe University Bendigo Victoria Australia

The Regional Australia Summit brought together 282 invited delegates from all parts of Australia. The aim of the Summit was to develop partnerships between the government, business and community sectors to deliver a better future for regional, rural and remote areas facing significant change. Health was one of 12 themes discussed at the Summit. Five key health priorities were identified;the need to change the dominant metropolitan mind-set, improve access to health-care services, improve service provision and workforce training, ensure equitable resource allocation, and adopt a population health approach. The ultimate success of the Regional Australia Summit will be gauged over time by the extent to which the health, wellbeing and prosperity of rural, remote and regional Australians has been improved, and existing problems and issues addressed. Nonetheless, the Summit is a significant event because it addresses issues at the highest level of government, emphasises coordination and the adoption of an intersectoral approach, and recognises the need to empower local communities and build partnerships between the government, corporate and community sectors.

关键词：澳大利亚社区网络卫生政策卫生工作重点机构间关系国家卫生规划需求估价/组织和管理乡村卫生服务全面质量管理/组织和管理人类

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Capitation funding in Australia: Imperatives and impediments

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Health Care Management Science 2000年第2期3.0卷 77-88页

作者： Peacock, Stuart Segal, Leonie Health Economics Unit Centre for Health Program Evaluation Monash University West Heidelberg Vic. 3081 PO Box 477 Australia

Health service funding mechanisms are pivotal in the pursuit of health system objectives, as they provide strong financial incentives for actors in the system to achieve policy goals. Underpinning funding mechanisms is a set of key economic principles, or objectives, that should guide their design and use: efficiency, equity, and accountability. The Australian health system has historically performed relatively poorly in relation to these objectives, with evidence of inefficiencies, inequities, and poor accountability in many areas of health services. The primary cause of these shortcomings may lie in the complex set of funding and delivery arrangements at the State and Federal levels of government. Potentially significant improvements in the performance of the health system would be available from the integration of the funding and delivery of services within a single tier of government, coupled with the development of a national weighted capitation approach to funding. To develop a national capitation funding model a number of unique factors require consideration, including the current fragmentation of services, the role of the private sector, the needs of indigenous populations, and the effects of rurality. The data available to develop a capitation model is of a level of detail and quality not readily found elsewhere. If policy statements promoting efficiency, accountability, and particularly equity are to be actively pursued, a national capitation model based on robust methods should become a cornerstone of Australian health system reform. © Baltzer Science Publishers BV.

关键词：澳大利亚按人收费/组织和管理卫生保健提供联合/组织和管理效率组织筹资政府/组织和管理卫生保健改革/组织和管理卫生服务易得程度/标准管理医疗规划/组织和管理模型组织管理国家卫生规划/组织和管理需求估价/组织和管理全面质量管理/组织和管理人类

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The perceptions of nurse teachers, student nurses and preceptors of the theory-practice gap in nurse education

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NURSE EDUCATION TODAY 2000年第6期20卷 499-505页

作者： Corlett, J Univ Abertay Dundee Sch Social & Hlth Sci Dundee DD1 1NJ Scotland

The theory-practice gap has been the subject of much debate within nursing. Issues include: where the gap is, whether it is a positive or negative phenomenon and whether attempts should be made to bridge it. This paper describes a research study adopting an innovative approach to exploring the theory-practice gap by investigating it from the perspectives of three different groups: nurse teachers, student nurses and clinical preceptors. Combining the perceptions of these diverse groups has allowed a more complete picture of the theory-practice gap to emerge than is possible when examining it from one group's perspective alone. Twenty-three group interviews were conducted and content analysed to identify common themes. Mutual concerns were identified by all groups: shortness of clinical placements, sequencing of theory and practice, lack of collaboration between clinical areas and educational institutions and the lack of clarity regarding link teacher roles. All interviewees felt a theory-practice gap does exist, and whilst this could be viewed positively as a means of developing students' problem-solving skills, attempts should be made to minimize its impact. Ways to achieve this include: the development of an innovative curriculum allowing closer sequencing of theory and practice, evaluating the effect length of clinical placement has on knowledge and skill acquisition, improving collaboration between clinical areas and educational institutions and developing preceptors' lecturing roles. (C) 2000 Harcourt Publishers Ltd.

关键词：医务工作者的态度临床工作能力/标准信息交流合作行为课程/标准教育护理学士/标准全体教工护理院校集中研讨小组大不列颠导师/心理学需求估价/组织和管理护士作用护理教育研究护理方法学研究护理理论导师制/标准规划制订方案评价定性研究问卷调查学生护理/心理学人类

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