Šeimos gydytojai ir bendruomenės slaugytojai bendradarbiaudami su šeimomis, kuriose auga vaikai su Dauno sindromu, savo praktikoje susiduria su pakankamai sudėtingomis situacijomis, kuomet tenka pasirūpinti ne tik vaiko su negalia poreikiais, bet taip pat ir visa šeima. Gimus vaikui su negalia, kai šeima yra pasimetusi ir išgyvena sunkų laikotarpį savo gyvenime, tenka į tai jautriau atsižvelgti ir stengtis jiems padėti prisitaikyti prie naujų gyvenimo sąlygų, nes nėra geresnio būdo padėti vaikui, kaip stiprinti tėvų galimybes tai padaryti jiems patiems. Specialistų bendradarbiavimas su šeima, padedant susiorientuoti pagalbos sistemoje ir atrasti tinkmiausius pagalbos būdus, yra pagrindas siekiant visapusiškos gerovės vaikui bei abipusio pasitenkinimo teikiamų paslaugų kokybe. / Family doctors and community nurses, collaborating with families raising children with Down syndrome, encounter quite complicated situations in practice, when they must take care not only for the needs of the disabled child, but for the whole family as well. After the birth of a child with a disability, when the family is confused and experiencing difficult period, there appears a great need of external sensitivity and assistance for the family to adapt to new conditions of its life, because there is no better way to help the child, as to enhance parents’ ability to do it by themselves. Professionals’ collaboration with the family, by helping to orientate in the support system and to find the most suitable ways of support, is the basis for a comprehensive welfare of the child and for mutual satisfaction with quality of services provided.

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Effective communication in the doctor-patient relationship is an essential component to proper diagnosis and treatment (Gordon & Gerber, 2010). While a greater focus on improving doctor-patient communication needs to be addressed, nowhere is it more important than in interactions between geriatric patients and general practitioners. This study analyzes and synthesizes the findings of 16 selected socio-medical journal articles that report on the views of geriatric patients’ needs and desires when interacting with general practitioners. The findings of this study contribute a geriatric perspective to the current debate regarding patient-centred care and also identify communication barriers and facilitators that can be avoided or used by physicians when interacting with geriatric patients. By bringing together multiple socio-medical qualitative studies that look at geriatric patients’ perspectives, this research seeks to create an evidence base that is valued by both medical practitioners and policy-makers. / Thesis (Master, Cultural Studies) -- Queen's University, 2013-09-27 14:34:32.474

This study examines the way people use online resources within their personal healthcare practices to better understand how individuals manage their health issues in the age of the Internet. It specifically addresses the extent to which the Internet is used as an information database and associated patterns of use, whether the Internet represents a source of support or enables a supportive encounter and the implications of using the Internet as part of the health management across relationships with medical professionals and oneself. Using a sequential mixed methods design, the data was gathered within a larger multidisciplinary research project conducted in East York, Ontario. An initial quantitative analysis of 350 surveys describes Internet usage. The qualitative analysis of the 86 follow-up interviews of people recounting their personal health management processes demonstrated the importance of social networks, subjective health status and Internet user-style. The facile ability to engage with health information is transforming definitions and experiences of health and relationships with medical professionals. Examining medical encounters mindful of the aspects of trust, power, knowledge and privilege reveals an evolution to the doctor-patient relationship brought about by both information and personal empowerment. Using the Internet reinforces primary relationships and points to the development of new relationships that are sought at moments of meaningful life events or circumstances. New types of connections are being built across the Internet based on shared experiences, health concerns and health identities. Applying Actor Network Theory furthers an understanding of how search engines and online resources can emerge as actors in health information seeking and health management processes. Internet use is now a part of everyday life and is no longer limited to affluent early adopters as the gaps between those with access diminish in urban Canada. While its use is becoming intrinsically linked to health management it is not a panacea for improving health outcomes. As the populations’ collective health knowledge increases, so does the presumption that health management is a personal imperative. This notion that the achievement of good health is an individual responsibility or the theory of Healthism, frames the interpretation of the large percentage of the sample indicating they are striving to become healthier. Social workers need to acknowledge the place of the Internet within its practice and to balance the emphasis on individualized health management with the perspective that health outcomes reflect community mores. It is important for social workers to treat the Internet as a medium of relationships and for social workers to become knowledgeable about what these connections can provide in terms of support and information and what the limitations and risks of these relationships can be.

This study examines the way people use online resources within their personal healthcare practices to better understand how individuals manage their health issues in the age of the Internet. It specifically addresses the extent to which the Internet is used as an information database and associated patterns of use, whether the Internet represents a source of support or enables a supportive encounter and the implications of using the Internet as part of the health management across relationships with medical professionals and oneself. Using a sequential mixed methods design, the data was gathered within a larger multidisciplinary research project conducted in East York, Ontario. An initial quantitative analysis of 350 surveys describes Internet usage. The qualitative analysis of the 86 follow-up interviews of people recounting their personal health management processes demonstrated the importance of social networks, subjective health status and Internet user-style. The facile ability to engage with health information is transforming definitions and experiences of health and relationships with medical professionals. Examining medical encounters mindful of the aspects of trust, power, knowledge and privilege reveals an evolution to the doctor-patient relationship brought about by both information and personal empowerment. Using the Internet reinforces primary relationships and points to the development of new relationships that are sought at moments of meaningful life events or circumstances. New types of connections are being built across the Internet based on shared experiences, health concerns and health identities. Applying Actor Network Theory furthers an understanding of how search engines and online resources can emerge as actors in health information seeking and health management processes. Internet use is now a part of everyday life and is no longer limited to affluent early adopters as the gaps between those with access diminish in urban Canada. While its use is becoming intrinsically linked to health management it is not a panacea for improving health outcomes. As the populations’ collective health knowledge increases, so does the presumption that health management is a personal imperative. This notion that the achievement of good health is an individual responsibility or the theory of Healthism, frames the interpretation of the large percentage of the sample indicating they are striving to become healthier. Social workers need to acknowledge the place of the Internet within its practice and to balance the emphasis on individualized health management with the perspective that health outcomes reflect community mores. It is important for social workers to treat the Internet as a medium of relationships and for social workers to become knowledgeable about what these connections can provide in terms of support and information and what the limitations and risks of these relationships can be.

This thesis is an exploration of professional behaviour in health care settings, using a Model of Treatment Engagement that is developed as a tool for ethics critique. The Model is tested and refined using data on: a psychiatric ???treatment??? carried out on over 1,127 occasions in a 15 - 40 bed non-acute hospital during the period 1961-1979; the problematic withdrawal of all life-support from a 37 year old man who had suffered acute brain trauma some five days previously, in a tertiary hospital in March 2000; and a clinical experiment recently proposed for the emergency setting and intended to encompass five hospitals and the NSW Ambulance Service. In each case, the Model proves useful in identifying the shift from the treatment paradigm and the ethical imperative of ensuring the patient (or his/her agent) appreciates the difference between what is proposed and what would normally be done. It reveals how doctors who dealt with the patient but did not decide on treatment contributed to ethically troublesome practice. It clarifies how having multiple doctor players in the treatment situation gave rise to the need to suppress dissenting views. Doctors who were close enough to the action to comprehend its nature, by not dissenting, reinforced the problematic choice for the actor and validated it in the eyes of observers. The lack of dissent at the level of doctors working under supervision, appeared to be a function of institutional arrangements. At the consultant level, there was evidence of pressure to concur from other consultants and indirect evidence of a fear of ostracism. The public responses in the two modern cases point to there being a strong idea in Sydney???s medical community that dissent should not be publicly displayed once a decision on how to treat has been made. I conclude there are two steps to reviewing ethically problematic treatment situations. The first consists of identifying the shift from the treatment paradigm. The second consists of establishing why the problematic choice is translated into action. The Treatment Engagement Model is put forward as a useful tool for both these analyses.

Errata pasted onto front fly leaf. / Bibliography: leaves 329-355. / xx, 361, [15] leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Studies the expansion of postgraduate education in Australia, particularly the research degree. Analyses the credentialling role of the postgraduate degree and the influence of overseas models of postgraduate education. Argues that the changing relationship between the state, the universities and the research sector has had a strong impact on the postgraduate sector. / Thesis (Ph.D.)--University of Adelaide, Dept. of Education, 1998

This study explores the experiences of General Practitioners (GPs) and patients in the management of type 2 diabetes in contemporary Australia. I focus on the way the socioeconomic position of patients is a factor in that experience as my underlying interest is in exploring how health inequalities are understood, approached and handled in general practice. The study is thus a practical and grounded exploration of a widely debated theoretical issue in the study of social life, namely the relationship between the micro day-to-day interactions and events in the lives of individuals and the broad macro structure of society and the position of the individual within that. There is now wide acceptance and evidence that people’s social and economic circumstances impact on their health status and their experiences in the health system. However, there is considerable debate about the role played by primary medical care. Nevertheless, better theoretical understanding of the importance of psychosocial processes in generating social inequalities in health suggests medical care may well be important, as such processes are crucial in the care of chronic illnesses such as diabetes which are now such a large part of general practice work. I approach this study through an exploration of patient centred clinical practice. Patient centredness is a pragmatic, idealised prescriptive framework for clinical practice, particularly general practice. Patient centredness developed in part in response to critiques of biomedicine, and is premised on a notion of a more equal relationship between GP and patient, and one that places importance on the context of patients’ lives. It contains an implicit promise that it will help GP and patient engage with and confront social disadvantage.

Thesis (D.Min.)--Dallas Theological Seminary, 2006. / Includes abstract. Includes bibliographical references (leaves 98-101).

Thesis (M.S)--State University of New York at Binghamton, Decker School of Nursing, 2007. / Includes bibliographical references.