141 research outputs found
Book Review: Primary Care Ethics
The original can be found at http://www.ijic.org/index.php/ijic/issue/view/27Primary Care Ethics is one of those books that healthcare
professionals will share with their colleagues
because it brings together a range of experiences that
are often discussed informally with their peers, but
rarely addressed in clinical training. It is not intended
as a textbook of medical ethics, but rather a series of
essays that are insightful, thought provoking, and
informative in raising awareness of the complex issues
we face in our practice, and application of theories and
concepts in understanding our decision-making. Reading
the chapters is like eavesdropping on an intelligent
conversational debate among healthcare practitioners
The health of the aged in India
Because of declining fertility, the proportion of the aged in the Indian population has risen. Although the rise has been modest, as shown by an increase in the population over 60 years of age from 5.5 to 7.0 per cent between 1951 and 1995, by the latter date, India’s experience with 65 million people of this age is unusual. The paper employs data on persons 65+ years of age drawn from the 42nd Round of the National Sample Survey, and for the analysis subdivides them into three age groups, 60-64, 65-69 and 70+. It is shown that, among population over 60 years of age, 10 per cent suffer from impaired physical mobility and 10 per cent are hospitalized at any given time, both proportions rising with increasing age. Of the population over 70 years of age, more than 50 per cent suffer from one or more chronic conditions. The very limited support provided to the old by goverment is brought out by the fact that even in Karnataka, one of the states with the most generous provision, only 15 per cent of persons over 65 years of age receive any type of pension
Primary care ethics
No abstract available
Organisational developmental approaches in primary care
In their Stream Six report, Professors Dunbar and Reddy investigated the contribution of approaches to organisational change in optimising the primary healthcare workforce. Organisational Development (OD) could be thought of as facilitating change for human beings. This Stream Ten report is a story about change and therefore improvement in healthcare. OD forms part of the examples of change we describe. Other important components include use of electronic medical records and performance measurement.The research reported in this paper is a project of the Australian Primary Health Care Research Institute which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research Evaluation and Development Strategy
The TrueBlue study : is practice nurse-led collaborative care effective in the management of depression for patients with heart disease or diabetes?
Background: In the presence of type 2 diabetes (T2DM) or coronary heart disease (CHD), depression is under diagnosed and under treated despite being associated with worse clinical outcomes. Our earlier pilot study demonstrated that it was feasible, acceptable and affordable for practice nurses to extend their role to include screening for and monitoring of depression alongside biological and lifestyle risk factors. The current study will compare the clinical outcomes of our model of practice nurse-led collaborative care with usual care for patients with depression and T2DM or CHD.Methods: This is a cluster-randomised intervention trial. Eighteen general practices from regional and metropolitan areas agreed to join this study, and were allocated randomly to an intervention or control group. We aim to recruit 50 patients with co-morbid depression and diabetes or heart disease from each of these practices. In the intervention group, practice nurses (PNs) will be trained for their enhanced roles in this nurse-led collaborative care study. Patients will be invited to attend a practice nurse consultation every 3 months prior to seeing their usual general practitioner. The PN will assess psychological, physiological and lifestyle parameters then work with the patient to set management goals. The outcome of this assessment will form the basis of a GP Management Plan document. In the control group, the patients will continue to receive their usual care for the first six months of the study before the PNs undergo the training and switch to the intervention protocol. The primary clinical outcome will be a reduction in the depression score. The study will also measure the impact on physiological measures, quality of life and on patient attitude to health care delivered by practice nurses.Conclusion: The strength of this programme is that it provides a sustainable model of chronic disease management with monitoring and self-management assistance for physiological, lifestyle and psychological risk factors for high-risk patients with co-morbid depression, diabetes or heart disease. The study will demonstrate whether nurse-led collaborative care achieves better outcomes than usual care.<br /
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