Context guides illness-identity: a qualitative analysis of Dutch university students' non-help-seeking behavior

The purpose of this article is to develop a context-based and identity-centered perspective on help-seeking. Recent approaches have indicated the inability of conventional models of help-seeking to account for the non-utilization of health care services in situations for which services, resources and information are adequately provided. We address this non-utilization from a perspective that explores the interactions between notions of health, illness, and identity formation, especially in highly transitional situations in which people are confused about their identity and sense of belonging. More specifically, we explore the non-utilization of health care services by Dutch university students. The results of 36 in-depth interviews show that the help-seeking behaviors of university students are closely associated with questions about identity, forms of agency, and styles of self-presentation, and are deeply influenced by the uncertain social and cultural context in which students are inserted. For example, being a 'normal' student was often regarded as more important than solving health problems, and stress was repeatedly portrayed as a constant and inevitable condition of everyday student life, giving a common language to express the burdens of the shared student experience. Some students even romanticized health problems. Eventually students with serious health problems avoided accessing health services.     

Ethical and legal issues confronting college health.

More than 11 million students currently attend institutions of higher education in the United States. While this segment of the population traditionally constitutes a young, healthy cohort, experience demonstrates that college and university health services play a critical role in assuring student health maintenance, completion of school, consumer health education, and the development of sound health practices and behaviors. In examining institutional policies and protocols governing the support and the delivery of student health services, several critical ethical issues emerge from both a macro and micro orientation. As university and college resources become more scarce and budget decreases increase, institutions are reestablishing priorities. Oftentimes, the question of continued support of campus based health services is raised. Suggestions range from discontinuing their operation, to dramatic decreases in their services, to requiring them to become fully self-sufficient (i.e., through mandatory prepayments or fee-for-services mechanisms and elimination of general fund support). At a macro level, such discussions raise issues associated with social justice and whether the universities and colleges should serve in a loco parentis (paternalistic) role. This essay more specifically addresses several micro issues that directly impinge on the delivery of health services to millions of college and university students.     

大学生因病休学原因分析

目的探讨高校学生休学原因,为做好在校大学生的卫生保健工作提供科学依据。方法对2004年9月-2008年12月我校在校大学生的学籍资料及学生休学登记表进行调查分析。结果在校大学生共55 677人,因病休学270人,休学率4.85‰;休学原因居前2位的是精神心理疾患(占45.19%)和传染病(占30.74%);男生休学率高于女生,差异有统计学意义(χ2=23.43,P<0.01)。理工科学生休学率高于文科,差异有统计学意义(χ2=12.95,P<0.01)。结论大学生因病休学状况令人担忧,加强心理健康和传染病防治是降低大学生休学率的重点。     

Interpersonal Relations Between Health Care Workers and Young Clients: Barriers to Accessing Sexual and Reproductive Health Care

Interpersonal relations between health care providers and young clients have long being cited as an important element for improving client up take of services, satisfaction and overall health outcomes. In an era of HIV and AIDS this forms a critical determinant to young people accessing sexual and reproductive health care. This study explores to what extent interpersonal relations form a barrier to young peoples access to and satisfaction of health services. The study draws on data from 200 client exit interviews and four in-depth interviews conducted with university students and university health care staff in Kwazulu-Natal, South Africa. While young people are aware of the importance of utilising STI, HIV and family planning services they experienced barriers in their relationship with providers. This served as a deterrent to their use of the health facility. Adequate training in interpersonal relations for youth-friendly service provision is essential in helping overcome communication problems and enabling providers to interact with young clients at a more personal level.     

The role of context in establishing university clinics

Healthcare systems have a vested interest in employing work-ready graduates. The challenge for universities is to find ways to provide workplace learning that incorporates student education and high quality patient care. Inland areas of Australia, similar to other rural locations globally, experience additional challenges including a relatively high incidence of ill health, increasing demand for health services, chronic workforce shortages and ageing of the existing rural health workforce. In this paper, we conceptualise and describe the research findings related to context from a consultative enquiry into university clinics conducted in 2008. Interview participants were drawn from twenty university clinics in Australia and New Zealand. A consistent theme throughout the interviews was tensions that arose between the role of education and healthcare provision within university clinics. Many interview participants described ways they managed these tensions to meet the expectations of students, educators and the community. The patient supply is the most critical factor in the context of university clinic operations. It is vital to both the educator and the healthcare provider roles. In inland areas with sparse populations a number of strategies, such as outreach clinics, hospital or health centre- based clinics and multi-disciplinary sites, will have to be developed if university clinics are to operate effectively for students and patients.     

A student health HMO as a partnership model within an academic medical center

The Department of Family Practice, College of Medicine, in partnership with the University of Illinois at Chicago, was responsible for the reorganization of the Student Health Service into a health maintenance organization (HMO), Campus Care. Historically, the two campuses of the University of Illinois at Chicago operated student health as an infirmary model. Reorganization of student health into the Campus Care HMO provided expanded health care services to students, preserved more health care dollars in the university system, and provided a nonincremental increase in the size and responsibility of the Department of Family Practice. One year's experience showed that while the capitation was low compared with standard HMOs, the variable and less frequent use of services by the student population resulted in a fiscally viable operation. Numerous transition difficulties were encountered, including the need for rapid systems conversion within a complex university system, reeducation of students as well as traditional university-based practitioners for operation in a managed care system, and the rapid expansion of a small family practice department. The positive experience of the University of Illinois at Chicago supports the notion that family practice is better suited to providing student health care than other primary care disciplines. Three issues are paramount to success: (1) approval, support, and protection by higher level administration from university territorialism, (2) a core family practice faculty with strong leadership and experience in high-volume clinical activity, and (3) a close examination of financial resources in light of expected utilization.     

大学生因病休学原因分析

目的探讨高校学生休学原因,为做好在校大学生的卫生保健工作提供科学依据。方法对2004年9月-2008年12月我校在校大学生的学籍资料及学生休学登记表进行调查分析。结果在校大学生共55677人,因病休学270人,休学率4．85‰;休学原因居前2位的是精神心理疾患（占45．19％）和传染病（占30．74％）;男生休学率高于女生,差异有统计学意义（X^2=23．43,P〈0．01）。理工科学生休学率高于文科,差异有统计学意义（X^2=12．95,P〈0．01）。结论大学生因病休学状况令人担忧,加强心理健康和传染病防治是降低大学生休学率的重点。     

How satisfaction with hospital field work affects social work students' willingness to accept employment in hospital settings.

This study of 238 social work students in 27 hospital field work programs examined how student satisfaction with field work affects their willingness to accept employment in host hospitals. Job willingness was positively correlated with five measures of student satisfaction. Factors predictive of each measure were identified. Findings suggest strategies that can be used by hospital social work managers and field work supervisors to enhance student satisfaction with the field work experience, in order to maximize the benefit of providing field work education as a way of recruiting graduating students for employment in hospital settings.     

Violence victimization among Finnish university students: Prevalence,symptoms and healthcare usage

The present study examined the prevalence of various forms of violence victimization among university students in Finland. Violence victimization was analyzed in relation to physical and mental health symptoms, and the use of student healthcare services. A cross-sectional Student Health Survey was performed as a national postal survey for Finnish university students in 2004. In the next phase of the study, an additional postal survey regarding violence victimization was sent to those who had answered the original survey, which resulted in a sample of 905 students. It was found that violence victimization and violence-related health issues were markedly prevalent among Finnish university students. The students reported multiple forms of violence and injury demonstrating the diversity of violence victimization. Male and female victims differed both in the amount and type of symptoms, and in their relationship to the abuser/offender. Violence victimization and gender had a significant main effect on specific symptoms, while no interaction effect was found. The data also showed that violence victimization is overrepresented among frequent healthcare users. These findings have implications for clinical practice and public policy. The present findings provide useful information for policy makers and healthcare professionals concerning the health effects of violence in accordance with the use of healthcare services. More specifically, this information should be taken into consideration when planning student healthcare and could serve as a guideline for student healthcare management.     

Foodborne outbreak of Group A rotavirus gastroenteritis among college students--District of Columbia, March-April 2000

On March 31, student health services at a university in the District of Columbia (DC) notified the DC health department that an increased number of students had become ill with acute gastroenteritis beginning March 29. Some ill students reported eating tuna or chicken salad sandwiches from dining hall A on campus. On March 31, the DC health department initiated an outbreak investigation. This report summarizes results of the investigation, which indicated that group A rotavirus transmitted by food was the cause of the outbreak.     

A interdisciplinary community partnership for health professional students: a service-learning approach

This paper presents a qualitative approach to studying the reflective learning experiences of health professional students after they participate in an interdisciplinary community-based healthcare course. Over a 2-year period, health professional students from various health-related disciplines voluntarily took an interdisciplinary community-based health course offered at an urban, mid-Atlantic, private university. Through didactic and experiential opportunities, students in the course learned the importance of providing health care services to underserved populations at urban community-based sites. Throughout the semester, students kept journals, completed community response forms, and participated in documented class discussions. A research team of health professional faculty applied constant comparative analyses to the journal entries and community site-visit response forms. Four central themes were identified as the students engaged in learning experiences at various community sites: (1) the need for preventive healthcare; (2) the importance of health services and resources; (3) the awareness of student attitude and behavioral changes; and (4) increased awareness of student and client expectations for health care services. Interpretations of these findings and recommendations for future research are presented.     

International Students At An American University: Health Problems And Status

Eighty-eight international students enrolled at the University of Toledo were surveyed in order to ascertain their health care needs since arriving at the university. This study of the health status of international students indicated that the four leading problems experienced since arriving at the university were fatigue, homesickness, headaches and colds. Fatigue and colds were more commonly reported by students from Latin America than those from Asia or the Middle East.
Both community health services and the university health service are not used by a majority of international students. Friends and the telephone book yellow pages arc the most commonly used sources for finding a physician if one becomes sick. The drug store was indicated as being the place the international students would go for medicine if they became sick.
The findings of this study suggest that international students must be oriented to the health services available in the community and at the university health service. A health education program needs to be conducted to inform these students about personal health practices and available services.     

高校公费医疗超支的原因与对策

目的 探讨广东高校公费医疗超支的原因及对策.方法 设计调查表,对广东各高校医院院长就调查表的内容进行访谈,对访谈结果进行统计分析.结果 公费医疗超支最严重的高校达2 600万元/年,各高校离休人员人均超支53 873.26元/年,退休人员人均超支3 394.57元/年,在职职工人均超支-121.55元/年,学生人均超支-14.99元/年.结论 广东高校公费医疗超支现象日益严重,推行医疗保险制度是解决公费医疗超支的有效途径,发展社区卫生服务是有效手段.     

高校公费医疗超支的原因与对策

目的探讨广东高校公费医疗超支的原因及对策。方法设计调查表,对广东各高校医院院长就调查表的内容进行访谈,对访谈结果进行统计分析。结果公费医疗超支最严重的高校达2600万元/年,各高校离休人员人均超支53873.26元/年,退休人员人均超支3394.57元/年,在职职工人均超支-121.55元/年,学生人均超支-14.99元/年。结论广东高校公费医疗超支现象日益严重,推行医疗保险制度是解决公费医疗超支的有效途径,发展社区卫生服务是有效手段。     

Evaluation of the early integration of university students to health services

The authors evaluated the actions of Nursery School students in health services as a Teaching-Learning Method. Fifty-three students of the first year of Nursery School studying epidemiology were put in seventeen health Centers of Divinópolis Health System during five months, one time by week, to learning the discipline. The researchers concluded that when the actions and limits of the student practices are clearly defined never the university student's use in Health Services will be a mistake.     

学生标准化病人在助产专业实习前技能培训中的应用效果

目的 探讨学生标准化病人在助产专业实习前技能培训中的应用效果.方法 选取该院即将实习的2017级三年制助产专业两个班级学生98名,其中1班50名学生为试验组,2班48名学生为对照组.试验组应用学生标准化病人(SSP)模式培训,对照组应用该院常规实习前综合技能培训.结果 技能培训结束后分析两组学生培训之后的实训成绩(病例...     

The team concept in supervised practice: benefits for students and preceptors

Economic pressures in health care today make it difficult for many practitioners to provide educational opportunities for dietetic students. Staff members at practice settings, with increased responsibilities on the job, stipulate limitations on the numbers of students and request that they be better prepared. Dietetic educators are faced with maintaining the quality of supervised practice, particularly for new students, in spite of reduced availability of practice settings and time limitations of staff preceptors. An option is the multiple assignment--a technique in which students function as a team. Three students, each with a set of specialized objectives, cooperate in the care of one patient: One is the doer, one is the resource person, and one is the evaluator. This methodology was adapted to dietetics, and a pilot project was conducted in a hospital setting. Three student teams (nine students), three clinical preceptors, and one faculty member participated. Students achieved at high levels and demonstrated great satisfaction in their supervised practice. For staff preceptors, the team approach reduced student-related time involvement by one-half and promoted the quality of student performance. Guidelines for further application of the model are given.     

临床实习生对非直属附属医院教学管理满意度调查

目的通过分析高校非直属附属医院本科实习生对医院教学管理的满意度,为完善医院临床本科实习生教学和管理工作提供参考。方珐制定临床本科实习生对医院管理、科室管理及带教老师教学满意度调查问卷,对河北省人民医院130名临床本科实习生进行现场的问卷调查,结果学生的总体满意度较高,但医院的教学设备、学生管理、带教教师教学水平还有待完善。结论应加强医院的教学设备建设、临床实习生管理和改善带教教师的教学方法。     

Student Satisfaction with Field Placement

Students' perceptions of their field placements rarely are taken into account in the literature on field practicum and supervision. This survey of MSW students at a southern university examines factors associated with student satisfaction with field agency, field instructor, and field learning. The survey covers student and agency characteristics, learning goals and structure, supervision, and school-agency linkages. Students associated the quality of supervision and relevance of learning most highly with satisfaction in their placement experiences. Being treated as a professional in the agency, school-agency linkages, student characteristics, and amount of time engaged in specific social work activities were found not to be major factors in student satisfaction with field work.