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Rebecca Carman Lesley Andrew Amanda Devine Jacques Oosthuizen 《Australian and New Zealand journal of public health》2019,43(6):563-569
Objective: To identify behavioural barriers of service provision within general practice that may be impacting the vaccination coverage rates of Aboriginal children in Perth, Western Australia (WA). Methods: A purposive developed survey was distributed to 316 general practices across Perth and three key informant interviews were conducted using a mixed‐methods approach. Results: Of the surveyed participants (n=101), 67.4% were unaware of the low vaccination coverage in Aboriginal children; 64.8% had not received cultural sensitivity training in their workplace and 46.8% reported having inadequate time to follow up overdue child vaccinations. Opportunistic vaccination was not routinely performed by 30.8% of participants. Key themes identified in the interviews were awareness, inclusion and cultural safety. Conclusion: Inadequate awareness of the current rates, in association with a lack of cultural safety training, follow‐up and opportunistic practice, may be preventing greater vaccination uptake in Aboriginal children in Perth. Cultural safety is a critical component of the acceptability and accessibility of services; lack of awareness may restrict the development of strategies designed to equitably address low coverage. Implications: The findings of this study provide an opportunity to raise awareness among clinicians in general practice and inform future strategies to equitably deliver targeted vaccination services to Aboriginal children. 相似文献
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Lesley Gittings 《Culture, health & sexuality》2016,18(8):936-950
Caring is typically constructed as a feminised practice, resulting in women shouldering the burden of care-related work. Health-seeking behaviours are also constructed as feminine and men have poorer health outcomes globally. Employing men as carers may not only improve the health of the men they assist but also be transformative with regards to gendered constructions of caring. Using semi-structured interviews and observational home visits, this study explored the techniques that community care workers employ when working with male clients. The empirical analysis draws on the perspectives of eight care workers and three of their male clients from the Cape Town area. Interviews reveal how care workers and clients perform and negotiate masculinities as they navigate hegemonic masculine norms that require men to act tough, suppress emotions and deny weakness and sickness. Both parties bump up against ideals of what it means to be a man as they strive to provide care and receive support. Community care workers avoid rupturing client performances of hegemonic masculinities which inhibit confession and support. To do this, they use techniques of indirectly broaching sensitive subjects, acting in a friendly way and being clear about the intention of their work. 相似文献
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Lesley B Milgrom Jo Ann Brooks Rong Qi Karen Bunnell Susie Wuestfeld Daniel Beckman 《American journal of critical care》2004,13(2):116-125
BACKGROUND: Acute pain is common after cardiac surgery and can keep patients from participating in activities that prevent postoperative complications. Accurate assessment and understanding of pain are vital for providing satisfactory pain control and optimizing recovery. OBJECTIVES: To describe pain levels for 5 activities expected of patients after cardiac surgery on postoperative days 1 to 6 and changes in pain levels after chest tube removal and extubation. METHODS: Adults who underwent cardiac surgery were asked to rate the pain associated with various types of activities on postoperative days 1 to 6. Pain levels were compared by postoperative day, activity, and type of cardiac surgery. Pain scores before and after chest tube removal and extubation also were analyzed. RESULTS: Pain scores were higher on earlier postoperative days. The order of overall pain scores among activities (P < .01) from highest to lowest was coughing, moving or turning in bed, getting up, deep breathing or using the incentive spirometer, and resting. Changes in pain reported with coughing (P = .03) and deep breathing or using the incentive spirometer (P = .005) differed significantly over time between surgery groups. After chest tubes were discontinued, patients had lower pain levels at rest (P = .01), with coughing (P = .05), and when getting up (P = .03). CONCLUSIONS: Pain relief is an important outcome of care. A comprehensive, individualized assessment of pain that incorporates activity levels is necessary to promote satisfactory management of pain. 相似文献
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Jaccoud arthropathy (JA), now most commonly associated with systemic lupus erythematosus (SLE), is widely perceived as a benign joint deformity that is radiographically nonerosive and that confers little if any disability. Advances and accessibility of imaging modalities such as ultrasound (US) are challenging the complacency in perceiving SLE-JA and SLE arthritis as benign processes. Prompted by a patient with SLE-JA in which joint erosion was detectable on US but not evident on radiograph, this review assesses the potential utility of US to guide management and promote understanding of SLE arthritis and its poorly understood pathogenesis. 相似文献