共查询到20条相似文献,搜索用时 15 毫秒
1.
Allison Thomson Simon Morgan Kim Henderson Amanda Tapley Neil Spike John Scott Mieke van Driel Parker Magin 《Australian and New Zealand journal of public health》2014,38(6):542-547
Objectives: Chlamydia screening is widely advocated. General practice registrars are an important stage of clinical behaviour development. This study aimed to determine rates of, and factors associated with, registrars' chlamydia testing including asymptomatic screening. Methods: A cross‐sectional analysis of data from Registrars Clinical Encounters in Training (ReCEnT), a cohort study of registrars' consultations. Registrars record details of 60 consecutive consultations in each GP‐term of training. Outcome factors were chlamydia testing, asymptomatic screening and doctor‐initiated screening. Results: Testing occurred in 2.5% of 29,112 consultations (398 registrars) and in 5.8% of patients aged 15–25. Asymptomatic screening comprised 47.5% of chlamydia tests, and 55.6% of screening tests were doctor‐initiated. Chlamydia testing was associated with female gender of doctor and patient, younger patient age, and patients new to doctor or practice. Asymptomatic screening was associated with practices where patients incur no fees, and in patients new to doctor or practice. Screening of female patients was more often doctor‐initiated. Conclusions: GP registrars screen for chlamydia disproportionately in younger females and new patients. Implications: Our findings highlight potential opportunities to improve uptake of screening for chlamydia, including targeted education and training for registrars, campaigns targeting male patients, and addressing financial barriers to accessing screening services. 相似文献
2.
3.
4.
Aim: To examine Australian private practice dietitians' relationships with general practitioners and practice nurses as a factor that influences dietetic referrals. Methods: Semistructured telephone interviews and an online survey were conducted with Australian private practice dietitians (n = 52 and n = 90, respectively) between April and May 2008. Semistructured questionnaires were conducted with general practitioners (n = 11) and practice nurses (n = 12) from the ‘GP Access’ Division of General Practice between March and July 2007. Results: General practitioners' relationships with dietitians were believed to be the primary influencing factor on referral, provided by 81% of survey dietitians and 25% of interview dietitians. The most common means of initially forming relationships with general practitioners were face‐to‐face introduction (48%) and introductory letters (37%). Patient feedback via letter, fax or email was the most popular method of maintaining relationships with general practitioners (77%). Meeting with general practitioners in person was believed to be the most effective activity in building relationships with general practitioners and increasing referral rates (42%). Referral was made easier for general practitioners by providing paper (37%) or electronic (19%) referral forms and contact details (19%). The majority of general practitioners and dietitians believed that the ‘Allied Health Services Under Medicare’ made it easier to refer to a dietitian. Conclusions: Dietetic referrals can be encouraged through good relationships between general practitioners, practice nurses and dietitians. Private practice dietitians would benefit from cultivating relationships with general practitioners and practice nurses through personal contact and providing good patient feedback. 相似文献
5.
6.
7.
8.
9.
The association between patient activation and self‐care practices: A cross‐sectional study of an Australian population with comorbid diabetes and chronic kidney disease
下载免费PDF全文
![点击此处可从《Health expectations》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Edward Zimbudzi BSc RN MIH Clement Lo MBBS PhD FRACP Sanjeeva Ranasinha M Epi MSc Peter G Kerr MBBS PhD FRACP Helena Teede MBBS FRACP PhD Rowan G Walker MBBS FRACP MD MPH Greg Johnson B Pharm Dip Hosp Pharm MBA Greg Fulcher MBBS MD FRACP Sophia Zoungas MBBS PhD FRACP 《Health expectations》2017,20(6):1375-1384
10.
People with complex health and social needs, including tri‐morbidity and homelessness, are challenging for modern healthcare systems. These clients have poor health and social outcomes. They tend to use available health resources inefficiently, with fragmented, uncoordinated use of multiple health and social care services. Increasing access for these clients to well‐supported general practice care may be an effective response to these challenges. The aim of this study was to explore client experiences of, and attitudes to, community‐based healthcare, and general practice in particular, to identify opportunities to improve healthcare provision. Five focus groups with a total of 20 men currently experiencing homelessness were facilitated by the corresponding author in an inner‐city homeless hostel. Discussions were transcribed, coded and analysed thematically. The analysis was informed by earlier focus group discussions with community‐based homeless healthcare providers. Participants reported reluctance to engage with healthcare providers outside times of perceived crisis, and experiences of stigma and dismissive care. Some participants were sceptical of the motivations of health and social care providers, including general practitioners. Presentations with physical and psychological pain featured prominently in participant accounts. Three key themes identified important aspects of client experiences of community‐based healthcare which indicate potential areas for improvement. These themes were as follows: the relative invisibility and low salience of general practice compared to hospital‐based emergency and inpatient services; discontinuity within community‐based healthcare and across transitions between community‐based and other healthcare; and inconsistent and unsatisfactory general practitioner responses to physical and psychological pain. These responses included apparent over‐prescribing, under‐prescribing and short‐term ‘band‐aid’ responses. Generalist medical expertise was valued in general practitioners, but not consistently experienced. A number of challenges and opportunities exist, at both individual and system levels, for general practice to realise its potential to deliver effective, compassionate and efficient care to clients experiencing homelessness. 相似文献
11.
12.
Ben Sellar PhD Carolyn M. Murray Mandy Stanley PhD Hugh Stewart M. App. Sc. . BEd Helene Hipp MEd Susan Gilbert‐Hunt M. Hlth. Sc. . Dip. COT 《Australian Occupational Therapy Journal》2018,65(1):35-44
Background
Curriculum mapping involves systematic charting of programme content against professional competencies. This process can reveal strengths, gaps and redundancies within educational programmes.Methods
Curriculum mapping occurred using intended learning (ILOs) as documented in individual courses and linking them to units and elements within the occupational therapy minimum competency standards (ACSOT) and Miller's Framework of competency. Five occupational therapy academics and two impartial research assistants identified links between ILOs and units and elements of the ACSOT. Analysis of each course in the curriculum was completed by two reviewers. A systematic protocol was developed that enabled a transparent process and resolution of discrepancies between reviewers.Results
There were many links (47% of total) between the documented curriculum and ACSOT Unit 1 Professional attitudes and behaviours. The other six units of the ACSOT had between 5% (Unit 7) and 16% links (Unit 3). No links were made between ILOs and the elements of evaluation (4.4), cessation (3.7) and quality assurance of services (7.3). Difficulties mapping ILOs to units and elements revealed inconsistencies in specificity and language in the ILOs and also ambiguities and gaps within the standards themselves. Mapping against Miller's framework showed a steady increase in performance expectations of students across the four years levels.Conclusion
Curriculum mapping is recommended for critical reflection about content of occupational therapy programmes and to review pedagogical approaches. This process revealed strengths and weaknesses of the occupational therapy curriculum being mapped but also revealed insight into the current ACSOT that may inform future iterations. 相似文献13.
14.
15.
16.
OBJECTIVES: To evaluate a unique pre-registration house officer (PRHO) rotation involving half a week in general practice over a 4-month period. House officers' and supervisors' views were sought on the value of this type of rotation. DESIGN: Qualitative study using semi-structured interviews. SETTING: A four-partner postgraduate training practice in a deprived urban part of North-east England. SUBJECTS: Pre-registration house officers and supervisors. RESULTS: House officers gained in educational and clinical terms from their period in general practice. They had a high level of individual supervision and teaching and encountered a wider spectrum of illness than in hospital. They found certain aspects of general practice stressful. The supervision required was greater than that needed for a registrar. The supervision of house officers requires support and possibly further education for the supervisor. CONCLUSIONS: General practice can provide valuable supervised experience at this stage of a doctor's career. 相似文献
17.
18.
Aim: To examine current Australian dietetic practice in the management of gestational diabetes, to identify models of dietetic care and to determine the need for national evidence‐based dietetic practice guidelines for gestational diabetes. Methods: A 55‐item cross‐sectional survey of Australian dietitians practicing in the area of gestational diabetes was undertaken. Participants were recruited via Dietitians Association of Australia interest group membership, public and private hospital maternity and diabetes services across Australia. The survey examined dietetic service provision, interventions, management recommendations, postnatal care, current guideline use and the perceived need for Australian evidence‐based dietetic management guidelines. Results: A total of 220 eligible dietitians participated in the survey. The majority (77%) reported that all women with gestational diabetes attending their service were referred to a dietitian. Group (33%) and individual consults (93%) were provided and 67% provided one to two dietetic consults per client. Fifty‐four per cent (54%) believed that their service currently offered adequate antenatal dietetic interventions and 8% adequate postnatal follow up for women with gestational diabetes. There were differences in the implementation of medical nutrition therapy by Australian dietitians in regards to nutrient recommendations. However, consistency was seen in key components of nutrition education. Dietitians perceived that there was a need for evidence‐based gestational diabetes dietetic practice guidelines (86%) and nutrition recommendations (87%). Conclusion: The survey results strongly indicate there is a need for evidence‐based gestational diabetes practice guidelines and nutritional recommendations and provide baseline data for future practice of Australian dietitians working in gestational diabetes. 相似文献
19.
Post‐pyloric feeding tube placement in critically ill patients: Extending the scope of practice for Australian dietitians
下载免费PDF全文
![点击此处可从《Nutrition & Dietetics》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Rosalie Yandell Marianne Chapman Stephanie O'Connor Alison Shanks Kylie Lange Adam Deane 《Nutrition & Dietetics》2018,75(1):30-34