published_or_final_version / Psychiatry / Master / Master of Philosophy

Enrollments of international students have increased dramatically in the last several decades. The delivery of health care to these students has become a topic of study for college health care providers and medical researchers across the country. The purpose of this study was to explore how Asian international students cope with illness while in school at Oregon State University. Interviews were held with international students from Japan, Korea, China and selected health care providers from the Oregon State University health center. Information was sought describing health care issues, and perspectives on medical care. The interplay between the student's perspectives and experiences and those of health care providers was explored as they revealed the role of culture in the cross-cultural medical situation. In contrast to other findings I maintain that it is the effects of culture, that is, the envisioning of different realities, in similar situations, that affect both patients and practitioners in the cross-cultural medical encounter. American core cultural values, in conjunction with a biomedical paradigm, formulate a base from which university health care providers interpret their clinical reality. Asian international students bring with them to the medical encounter a different paradigm that, for them, provides a definitive view of illness and health care. It also is grounded in meanings learned from cultural experiences. The anthropological views presented here are powerful and of considerable value in clinical settings because they assist individuals in moving beyond culture-bound realities in order develop a pluralistic perspective that validates the existence of different illness realities in the cross-cultural medical encounter. / Graduation date: 1994

The shortage of healthcare workers and doctors in the developing world compared to the developed world is a problem, and will continue to be so, due to the continual migration of qualified professionals and the inability of the state to remedy these shortfalls. A shortage of healthcare workers and specialist doctors will seriously hamper the Government’s National Health Insurance (NHI) plan, as well as the sustainability of the private health care sector. In addition, the duration of medical training in South Africa is exceptionally long. The three major hospital groups and other private corporates have over the last number of years taken limited initiative to fund education projects in conjunction with the academic institutions. However, these projects have been poorly focused and have been managed in an unstructured and detached manner. There is a desire from the private sector to get involved in these projects on a much larger scale through more formalised structures. Given this background, the primary objective of this research is to develop a business model for medical subspecialty training to complement the current academic subspecialty training in South Africa. A trial model for training subspecialists in reproductive medicine was developed as a first attempt to address the threatening shortages and training duration. This trial programme is the basis of this research. A two-phased process was used in collecting data. In Phase 1 data was collected from stakeholder groups. The results of this survey assisted in generating variables to include in the measuring instrument for the survey in Phase 2. In Phase 2 the perceptions and expectations of sub-specialists (reproductive subspecialists and cardiologists) regarding sub-specialty training was collected. The results of the demographic variables confirm the aging profile of subspecialist and the need to ensure succession. The results further showed that cardiologists and reproductive subspecialist expectations of the training of subspecialists are very similar except for their expectations on the training duration. Reproductive subspecialist respondents agreed more than cardiology subspecialist respondents that the training duration is too long. The biggest gap between perceptions and expectations is also with the factor training. The results showed that the expectations of subspecialists are not met for training. From these results a business model for the training of medical subspecialists is proposed. This proposed business model can play a complementary role to the existing state controlled system and form the bases of Public Private Partnerships (PPP) in medical training. This proposed business model will fit a developing country were the focus is on primary healthcare, with financial and capacity constraints. The proposed model would require role players to bring about change to accommodate a larger scale Public Private Partnership (PPP) to ensure the implementation of the model. The proposed decentralised business model for training subspecialists would allow the trainee subspecialist to practise as a specialist thus maintaining an acceptable income, and enable an expedited completion and lead to a wider dissemination of medical expertise that can be delivered in a wider national foot print. It further will provide for a structured Public Private Partnership.

This study addressed cultural factors that prevent Hispanic diabetics from getting diagnosed early, controlling their glycemic levels, and obtaining appropriate transportation, health insurance, and better education on nutrition.

The purpose of this study was to explore and describe the perceptions of registered nurses about patient-friendly health services rendered within an ambulatory care setting in the King Abdulaziz Medical City, Riyadh (KAMC-R), Kingdom of Saudi Arabia. A qualitative, explorative, descriptive and contextual design was used. Fifteen registered nurses (one male and 14 female) voluntarily participated in this study. The data collection process comprised of semi-structured individual interviews with the participants to explore what they perceived to be patient-friendly health services. The obtained data were analysed using Van Mannen’s thematic analysis method. The emerging empirical data identified four themes, three categories and nine subcategories; a literature control was incorporated to validate the findings. The study findings revealed that the participants identified cultural differences as a quintessential obstacle in rendering patient-friendly health services in the study context. Professional yet patient-friendly communication proved to be a challenge as did ambulatory care flow. This had the potential to compromise patient-friendly health services. Meeting the patients’ needs was acknowledged. However, the needs, goals and values of patientfriendly healthcare services were perceived differently by the patients on the one hand and the registered nurses on the other and this affected the process of interaction and delivery of patient-friendly care. Despite the fact that the registered nurses daily experienced ongoing challenges which compromised patient-friendly health services, they were aware and committed to deliver patient-friendly health services. The process of scientific inquiry concluded with the limitations of the study and recommendations were made based on the findings. / Health Studies / M.A. (Heath Studies)

MHealth is an upcoming area promising to contribute benefits to health service delivery. The purpose of this study was to identify and describe the rate of mHealth utilisation as well as opportunities for mHealth and the barriers to use at one central hospital in Zimbabwe. A quantitative, descriptive, cross-sectional study was undertaken at the central hospital. Data collection was done using structured questionnaires. The entire population of medical doctors at the hospital (N=42) were the respondents of the research. The 18 mHealth activities were chosen from a possible of 101 available. The most used as well as the least used mHealth activities were identified and the reasons for use or lack of use were identified. The study revealed that 75% of the activities were currently being used and 95% had the potential of future use by medical doctors. This study highlights the potential of mHealth from medical doctors’ perspective. / Health Studies / M. A. (Public Health)

The purpose of this study was to explore and describe the perceptions of registered nurses about patient-friendly health services rendered within an ambulatory care setting in the King Abdulaziz Medical City, Riyadh (KAMC-R), Kingdom of Saudi Arabia. A qualitative, explorative, descriptive and contextual design was used. Fifteen registered nurses (one male and 14 female) voluntarily participated in this study. The data collection process comprised of semi-structured individual interviews with the participants to explore what they perceived to be patient-friendly health services. The obtained data were analysed using Van Mannen’s thematic analysis method. The emerging empirical data identified four themes, three categories and nine subcategories; a literature control was incorporated to validate the findings. The study findings revealed that the participants identified cultural differences as a quintessential obstacle in rendering patient-friendly health services in the study context. Professional yet patient-friendly communication proved to be a challenge as did ambulatory care flow. This had the potential to compromise patient-friendly health services. Meeting the patients’ needs was acknowledged. However, the needs, goals and values of patientfriendly healthcare services were perceived differently by the patients on the one hand and the registered nurses on the other and this affected the process of interaction and delivery of patient-friendly care. Despite the fact that the registered nurses daily experienced ongoing challenges which compromised patient-friendly health services, they were aware and committed to deliver patient-friendly health services. The process of scientific inquiry concluded with the limitations of the study and recommendations were made based on the findings. / Health Studies / M. A. (Heath Studies)

MHealth is an upcoming area promising to contribute benefits to health service delivery. The purpose of this study was to identify and describe the rate of mHealth utilisation as well as opportunities for mHealth and the barriers to use at one central hospital in Zimbabwe. A quantitative, descriptive, cross-sectional study was undertaken at the central hospital. Data collection was done using structured questionnaires. The entire population of medical doctors at the hospital (N=42) were the respondents of the research. The 18 mHealth activities were chosen from a possible of 101 available. The most used as well as the least used mHealth activities were identified and the reasons for use or lack of use were identified. The study revealed that 75% of the activities were currently being used and 95% had the potential of future use by medical doctors. This study highlights the potential of mHealth from medical doctors’ perspective. / Health Studies / M. A. (Public Health)

This project was an assessment of elderly health care needs and access. Three urban San Bernardino communities in zip codes 92405, 92410, and 92411 were targeted. The assessment was structured according to King's theoretical construction of community as a multilevel interaction between personal, interpersonal and social systems. The components of the assessment included digital photographs, web-based internet assessments, key informant interviews, and community business visits.

The system of care for persons suffering from mental retardation is in a state of upheaval. Considering the mentally handicapped as holistic beings, this study explored and assessed the needs of those residing in the community of District 22 (sub-district 222), KwaZulu-Natal, thus facilitating the planning of care and care facilities for these individuals to enable them to function optimally in the community. To accomplish this purpose, specific objectives were formulated. A quantitative, exploratory and descriptive study based on Maslow's hierarchy of needs theory was carried out, using 167 respondents. The study revealed that despite being mentally retarded, they were still regarded as valuable members of the community, their needs did not differ from the needs of others in the rest of the world and that mental retardation is still rated low in the prioritization of health problems, hence the lack of resources and support needed for the rehabilitation of such persons. / Health Studies / M.A. (Health Studies)