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Research directions for specialist practice

Accident and Emergency Nursing 2000年第4期8卷 214-222页

作者： Heartfield, M. University of South Australia Division of Health Sciences Adelaide SA North Terrace Australia

Emergency nursing is a specialist area of practice that demands particular knowledge and skills. This paper reports on a study to identify the research directions necessary to advance emergency nursing as a specialist area of practice. Nurses working in nine Australian hospital emergency departments responded to questions about current research practices, and the research priorities necessary to inform the development of knowledge and practice in the evolving specialty of emergency nursing. Forty-four core topics considered relevant to the knowledge base of emergency nursing were identified by nurses who were directly involved in providing patient care. The highest ranked topics were clustered into four priority areas for further research. The key areas for further research are education needs and opportunities, specialist roles of triage, trauma and practitioner, and nurses' coping mechanisms. Discussion of these topics is framed by the increasing specialisation of nursing practice, thus this paper aims to encourage consideration and debate about the research based development of the specialty of emergency nursing. © 2000 Harcourt Publishers Ltd.

关键词：适应心理学医务工作者的态度澳大利亚证明临床工作能力/标准德尔菲技术教育程度急症护理/教育急症护理/组织和管理健康知识态度实践卫生工作重点职务说明需求估价/组织和管理护理教育研究护理评价研究护理研究/教育护理研究/组织和管理护理人员医院/教育护理人员医院/心理学问卷调查人类

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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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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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The transtheoretical model and cervical screening: Its application among culturally diverse communities in Queensland, Australia

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Ethnicity and Health 1999年第4期4卷 259-276页

作者： Kelaher, Margaret Gillespie, Amaya G. Allotey, Pascale Manderson, Lenore Potts, Helen Sheldrake, Michelle Young, Margaret Div. of Health Policy and Management Joseph L Mailman Sch. of Pub. Health Columbia University New York NY 10032 600 W 168th St United States

Objectives. To apply the Transtheoretical Model of Behaviour Change (TTM) to cervical cancer screening to determine and report on the level of support required by different language and cultural groups in Queensland to enhance participation. The model consists of six stages: Pre-contemplation (no intention to be screened, no past action), Contemplation (intention to be screened, no past action), Action (intention to be screened, initial screening), Maintenance (intention to be screened, regular screening), Relapse (no intention to be screened, initial screening) and Relapse Risk (no intention to be screened, regular screening). Design. Focus groups and structured interviews were used to classify women in terms of the model and collect information regarding knowledge, health service contact barriers and enhancing factors and sources of information in relation to cervical cancer screening. The sample was recruited by bi-cultural workers for each community using snowball techniques. Results. The interview sample consisted of Australian South Sea Islanders, Chinese, German, Greek and Moslem women. There was no evidence of significant differences in TTM stage according to ethnicity. Women who intended to be screened in the future were more likely to have positive decisional balance scores and higher knowledge scores than women who did not. Women who had had Pap tests were significantly more likely to have received information from their general practitioner (GP) than women who had not had Pap tests. Women in Action and Maintenance were also more likely to have had their last Pap test by a female GP compared to women in relapse categories. Women in Pre-contemplation were more likely than women who had Pap tests to agree that they would travel a long way to see a practitioner who spoke their own language. Conclusion. Classification based on the model was supported both by the decisional balance scale and measures of knowledge. Women in earlier stages of the model were more

关键词：中国/人种学文化多样性移民(移出和移入) 集中研讨小组德国/人种学希腊/人种学健康行为/人种学健康知识态度实践伊斯兰教/心理学普查/心理学普查/利用模型心理学需求估价/组织和管理大洋洲世系人群/心理学病人接受卫生保健的程度/人种学病人接受卫生保健的程度/统计学和数值数据昆士兰问卷调查社会支持宫颈肿瘤/诊断成年人女(雌)性人类中年人

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State hospitals in the new millennium: rehabilitating the "not ready for rehab players".

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New directions for mental health services 1999年第84期1999卷 35-46页

作者： Stuve, P. Menditto, A.A. Department of Psychiatry and Neurology School of Medicine University of Missouri United States

Over the past ten years, FSH has seen the initial implementation of the SLP grow from a single ward in the maximum-security forensic unit to include three additional wards within that unit, two wards on the medium-security forensic unit, and two wards within the general adult psychiatric service. There are now four FSH group homes, which admit clients from the hospital's forensic as well as nonforensic populations. Six to eight clients live in each home and function in a relatively self-sufficient manner, and many more (including forensic clients) have been discharged from the group homes and now live independently in the community. They work in supported employment or competitive job settings and manage their own households. Several of our discharged clients even return to visit us from time to time. The FSH administration remains solidly committed to being a rehabilitation-ready facility. We have had a number of positive outcomes over the years (Baldwin and others, 1992;Beck and others, 1991;Beck and others, 1997;Finnell, Card, and Menditto, 1997;Menditto, Baldwin, O'Neal, and Beck, 1991;Menditto, Valdes, and Beck, 1994;Menditto and others, 1996;Menditto, Beck, and Stuve, in press;Pestle, Card, and Menditto, 1998), and we regularly host visitors from other state hospitals seeking consultation on how to make their own facilities rehabilitation-ready. Recently, we were featured on a segment of the nationally broadcast medical education program psychLINK (Glazer, 1998), where it was suggested that rehabilitation programming models such as ours represent the future of state hospitals. The "Not Ready for Rehab Players" think so too.

关键词：医院外治疗预测司法精神病学/组织和管理医院信息系统/组织和管理医院精神病/发展趋势医院州立/发展趋势精神障碍/康复密苏里需求估价/组织和管理组织目标规划制订成年人人类

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Rural health: a human right.

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The Australian journal of rural health 1999年第4期7卷 202-205页

作者： Sidoti, C. Human Rights and Equal Opportunity Commission Sydney NSW Australia

Focuses on health as a human right for people in rural towns and remote areas in Australia. Basic human rights; Need for including people in the bush in human rights coverage; Health problems in the bush.

关键词：澳大利亚卫生政策缺医地区需求估价/组织和管理大洋洲世系人群病人辩护农村卫生乡村卫生服务人类

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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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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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Development of competency-based university health promotion courses.

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Promotion & education 2000年第1期7卷 33-38,65页

作者： Howat, P. Maycock, B. Jackson, L. Lower, T. Cross, D. Collins, J. van Asselt, K. Centre for Health Promotion Research School of Public Health Curtin University Perth Western Australia Australia

The Curtin University Centre for Health Promotion Research, in conjunction with the Australian Association of Health Promotion Professionals (AAHPP), the National Heart Foundation of Australia and the Health Department of Western Australia, co-ordinated a project to ascertain competencies required for personnel working in health promotion.

关键词：澳大利亚基于能力的教育/组织和管理课程教育专业/组织和管理健康促进需求估价/组织和管理专业能力/标准规划制订大学人类

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