The focus of this study is the development and implementation of the Iterative Needs Assessment/Evaluation Model for use as part of an English curriculum reform project at a four-year university in Japan. Three questions were addressed in this study: (a) what model components were necessary for use in a Japanese university setting; (b) what survey instruments would work with such a model; and (c) what needs would the stakeholders in the project report? The site for the study was a mid-sized private, four-year university in Japan. Set as an instrumental case study (Stake, 1998), multiple methods and sources were employed. Stakeholders in the project included university students (n = 1533), teaching staff (n = 33), university administrators and staff (n = 5), and domain experts (n = 7). Data collection included the use of questionnaires, unstructured and semi-structured interviews, and systems and materials analyses. Questionnaires were developed and analyzed using Rasch analysis. The Needs Assessment/Evaluation Model was assessed using a modified version of the Checklist for Judging the Adequacy of an Evaluation Design (Sanders & Nafziger, 1985). Implementation of a full iteration of the Model indicated that use of the Iterative Needs Assessment/Evaluation Model could guide the development and evaluation of the English language program. As part of the study, valid survey instruments that can continue to aid the assessment of needs for and evaluation of the courses were developed. Data from multiple sources indicated a difference in the perception of needs between stakeholders. The processes followed through the development and application of the Iterative Needs Assessment/Evaluation Model served to incorporate these different perceptions into a cohesive language program curriculum. / CITE/Language Arts

The present study implemented Mobilizing for Action through Planning and Partnerships (MAPP), a comprehensive, multi-component, strategic planning model and tool, in the New River Valley (NRV), Virginia to mobilize the NRV community to improve its own health status and the quality of life of its residents. The current mixed methods study represents one of the first to utilize MAPP in southwest Virginia and Virginia and is the most comprehensive community health needs assessment and strategic planning effort to date in the NRV. Through MAPP, the NRV community strived to determine the most effective ways to achieve optimal community health by considering its unique circumstances and needs, prioritizing public health system issues, identifying resources, and then developing integrated plans and forming effective partnerships for strategic action. The NRV MAPP process provided a solid framework for creating a community-driven needs assessment and strategic planning approach and initiative that brought together diverse public, private, non-profit, and voluntary organizations/agencies, businesses, faith communities, academia, local government, community members, and others who shared the commitment to and had a role in the NRV community's health and overall well-being. The current study also reviews the specific findings, summarizes the benefits and successes, and highlights lessons learned (including challenges and limitations) from the NRV MAPP experience, as well as makes recommendations for current practice and future research. Additionally, it provides a step-by-step overview of the entire MAPP process for potential users as applied to a real-world community, specifically the NRV. / Ph. D.

No / Previous attempts to involve African and African-Caribbean communities in a city in north England in identifying and assessing their health needs have been largely unsuccessful. A comprehensive literature review highlighted that research on Africans and African-Caribbeans is limited and uneven, and dominated by studies focusing on cardiovascular disease, diabetes, mental health and blood disorders. Health information on these communities is largely based on immigrant mortality statistics derived from national datasets. This paper highlights how participatory approaches to community participation and engagement were used in the assessment of the health needs of culturally diverse minority communities as a means of reducing health disparities. The study sought to overcome the shortcomings of traditional techniques for health needs assessment by testing a novel method of rapid participatory appraisal using a triangulation approach to ensure that all perspectives were addressed. The research adopted a mixed-methods strategy comprising distinct phases: a comprehensive review of the literature, a qualitative needs assessment involving representatives of the African and African-Caribbean communities using meta-planning, and a review of health service provision. The approach used in the study was efficient, rapid and feasible for the African and African-Caribbean people to use in obtaining data from their peers. The findings showed a convergence between areas of need identified by health providers and community members in this appraisal, and between these results and other published literature. However, there was a divergence on the extent of change necessary, with institutional responses stressing alterations within existing systems, and community members recommending the establishment of targeted services for African and African-Caribbean communities run by ethnically matched staff.

No / Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition worldwide and is associated with significant mortality. This paper gives an overview of the relevant literature regarding care needs in advanced COPD from the perspective of the patient or carer, and aims to explore the appropriateness of a palliative care approach in this group. Publications revealed that patients with COPD have a high symptom burden that impacts on quality of life and social functioning. Information provision in COPD is often lacking and the implications of diagnosis and prognosis are not routinely discussed. The impact on families and carers is considerable, many patients have significant care requirements which can affect family relationships. Although patients with COPD have regular contact with health services, access to specialist services and palliative care is poor. This paper highlights the need for increased provision for palliative care in COPD, alongside dedicated education and training for health professionals, and continued research to identify the most appropriate ways of delivering this care.

This thesis addressed the following research activities: (1) Developing and evaluating the usability of an adult age-independent online assessment tool that includes health care related content and is centered on the needs and capabilities of both older and younger users and, (2) Developing adult age-independent design guidelines. An online tool, which was developed for a previous study, was revised according to the results of the previous study and preliminary development activities based upon the user requirements of older adults (50 years or older). The online assessment tool was also tested with younger adults (between 18 and 35 years of age) to determine the differences between younger and older adults. Subsequent to these activities, a final tool that captured the needs of both older and younger adults was developed and evaluated for usability. According to the usability testing results, a design guideline set for an adult age-independent Online Needs Assessment Tool was developed and revisions were conducted in order to develop the final Online Needs Assessment Tool. The results of these studies, along with the tools developed, provide online survey and interface designers information on older and younger adult user requirements. They provide a knowledge resource for older and younger user healthcare information needs and information about the usability of one online assessment tool to accommodate both older and younger adult users. They also assist interface designers to proliferate and to facilitate more rapid application development / Master of Science

Yes / Background: There are a number of limitations to the present primary eye care system in the UK. Patients with minor eye conditions typically either have to present to their local hospital or GP, or face a charge when visiting eye care professionals (optometrists). Some areas of the UK have commissioned enhanced community services to alleviate this problem; however, many areas have not. The present study is a needs assessment of three areas (Leeds, Airedale and Bradford) without a Minor Eye Conditions Service (MECS), with the aim of determining whether such a service is clinically or economically viable. Method: A pro forma was developed for optometrists and practice staff to complete when a patient presented whose reason for attending was due to symptoms indicative of a problem that could not be optically corrected. This form captured the reason for visit, whether the patient was seen, the consultation funding, the outcome and where the patient would have presented to if the optometrists could not have seen them. Optometrists were invited to participate via Local Optical Committees. Results were submitted via a Google form or a Microsoft Excel document and were analysed in Microsoft Excel. Results: Seventy-five percent of patients were managed in optometric practice. Nine and 16% of patients required subsequent referral to their General Practitioner or hospital ophthalmology department, respectively. Should they not have been seen, 34% of patients would have presented to accident and emergency departments and 59% to their general practitioner. 53% of patients paid privately for the optometrist appointment, 28% of patients received a free examination either through use of General Ophthalmic Service sight tests (9%) or optometrist good will (19%) and 19% of patients did not receive a consultation and were redirected to other providers (e.g. pharmacy, accident and emergency or General Practitioner). 88% of patients were satisfied with the level of service. Cost-analyses revealed a theoretical cost saving of £3198 to the NHS across our sample for the study period, indicating cost effectiveness. Conclusions: This assessment demonstrates that a minor eye condition service in the local areas would be economically and clinically viable and well received by patients.

No description available.

This thesis focuses on service utilisation among children with mild ID and their families, their needs for support and their experiences of support. Aims The overall aim of the thesis was to explore and describe service utilisation patterns among families of children with mild ID from a systems perspective. Methods A cross-sectional, descriptive and comparative quantitative design was used to describe the extent of service utilisation among 84 children with mild ID and their families (paper I and II). The types and number of services utilised were investigated in relation to the child’s age, gender and school setting. Data concerning the services utilised were collected from the organisational records of social services and paediatric habilitation units. In paper III, a descriptive questionnaire design was used to describe the support needs of families of 38 children with mild ID. A confirmatory design was used to examine the relation between family needs for support and (a) parental self-efficacy and (b) parents’ control over services. A confirmatory design was also used to examine the relation between parents’ experiences of the helpfulness of the support and (a) parental self-efficacy and (b) parents’ control over services. In paper IV a longitudinal, comparative and confirmatory design was used to investigate whether social service utilisation patterns differ over time when children with mild ID in self-contained classes are compared with those integrated into mainstream classes (n=405). Results In total, 60% of the families utilised paediatric habilitation services, and 40% of the families used disability-related services provided by social services. The most commonly utilised services were services concerned support outside of the home, such as respite care and services to improve children’s participation in society. Approximately 25% of the families utilised social problems-related services provided by social services. The most commonly utilised services concerned those to support parents in their parenting roles and financial assistance. In contrast to older children, younger children were more likely to utilise paediatric habilitation services. Older children utilised a higher number of disability-related service types provided by social services. Few differences were found between males and females. The majority of families did not utilise such services that are provided by social services. It was rare for families to use both disability-related services and those that address social problems during the same year. Commonly reported family needs concerned information about what services are available for their child, their child's impairment, how to respond to their child's behaviour and how to teach their child skills. Other common needs included access to parent support networks, to find suitable leisure activities for the child, and more alone time for parents. In contrast to families with mothers who did not participate in paid work, families with mothers who were employed expressed a lower requirement for support such as counselling, contact with other parents of children with impairments, more friends and more alone time for parents. Similar results werefound for families with mothers with higher levels of education. Parents with higher levels of perceived self-efficacy reported a lower need for information, as did also parents with higher levels of control over services. Parents with higher levels of control over services experienced the support as being more helpful. Children with mild ID who attended self-contained classes were more likely to utilise paediatric habilitation services than children integrated in mainstream classes. The same pattern was found for utilisation of disability-related services provided by social services. Integrated children who changed school setting to attend self-contained classes were more likely to begin to utilise disability-related services in comparison with those children who continued to be integrated. The former also had a higher likelihood of increasing the number of disability-related service types utilised. Conclusions In addition to disability-related problems, families of children with mild ID may also be at a higher risk of experiencing social problems when compared with the general population. Furthermore, very few families utilised both disability-related services and services addressing social problems. This implies that collaboration flaws exist between those professionals concerned with child welfare services and those concerned with disability-related services. A strong predictor of service utilisation was the type of school setting: children attending self-contained classes had a higher rate of service utilisation than those attending mainstream classes. This indicates that service systems outside of school are designed to collaborate with groups of pupils in special classes rather than individual children in mainstream classes. The strong need for information by families indicates that an ecological framework should be used to identify those factors that affect information availability and effectiveness. To increase parents’ perceived level of control over services, HSO professionals need to work in a capacity building manner with the explicit goal to enhance parental self-efficacy.

Thesis (MPhil)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: Reliable and valid methods of studying needs of communities are an essential tool in the development of those communities. This study looks at different ways in which community needs could be assessed and uses two of those methods in assessing needs of the Langa community. The findings are that for a successful needs assessment, the key is, to identify a method or a combination of methods appropriate to the issues and to one's goals and resources, and implementing it well. Queeney (1995) states that one must always choose a technique that will give accurate results of the community being studied, and resources used should be cost-effective. Langa was chosen as a case study because of its diverse socia-economic structure. The type of housing that one occupies is indicative of the socioeconomic background of that person. The housing types found in Langa are shacks, hostels, public houses and private houses. The methods used in the Langa area for this study were the key informant approach and the survey approach. The key informant approach was used with community leaders in Langa while a survey was conducted with sampled dwelling units in the area. The reason for using the two methods was to get a more comprehensive picture of community needs in the area. Key informant approach Representatives of 10 of the 15 community organisations operating in the Langa area were interviewed. Priority needs for the community differed according to the organisation that key informants represented. Survey approach The total number of people interviewed using the survey approach was 425. Of the total number respondents living shacks, approximately 40% were in full time employment. In public housing, it was approximately 47% of the respondents. The private houses had by far the highest number of respondents in full time employment (73%) followed by hostels at 59%. The high number for private housing was not surprising considering that the occupants were mostly government employees. People in shacks did not have access to basic services. However, their first priority was housing. This was the same as the priority in the overcrowded migrant labour hostels. In public housing the priority need was jobs. Private housing dwellers mentioned housing for shack dwellers as their first priority. The close proximity of shack dwellers to private housing made private housing private housing dwellers aware of the conditions under which people in shacks live. Recommendations Most of the community organisation in the Langa area existed because of a need that was identified by the community. The priority needs cited by representatives of the various organisations were needed by the Langa community. In the survey approach housing and jobs were the main priorities. Priority needs raised by key informants as well as survey respondents need to be addressed urgently to ensure the development of the Langa community. / AFRIKAANSE OPSOMMING: Betroubare en geldige tegnieke vir die bestudering van die behoeftes van gemeenskappe vorm In essensiële deel van die ontwikkeling van gemeenskappe. Hierdie studie ondersoek die verskillende wyses waarop gemeenskap behoeftes gemeet kan word en gebruik twee van hierdie metodes om behoeftes van die Langa gemeenskap te bepaal. Die bevindinge toon dat die belangrikste komponent vir In suksesvolle behoefte opname, die identififsering van In metode of kombinasie van metodes geskik vir die situasie is, as ook die suksesvolle implementering daarvan. Queeney (1995) stel dat die navorser altyd In tegniek moet kies wat akkurate bevindinge sal voortbring en ook koste-effektief is. Langa is gekies as In gevallestudie vanweë die diverse sosio-ekonomiese struktuur. Die tipe behuising van In okkupant is In indikator van die sosioekonomiese agtergrond van die individu. Die behuising tipes in Langa is tydelike wonings, hostelle, losieshuise as ook privaat wonings. Die metodes wat in Langa gebruik is vir hierdie studie is die sleutel informant metode as ook In opname. Die sleutel informant metode is gebruik met die gemeenskapsleiers terwyl In opname uitgevoer is in geselekteerde areas van Langa. In Kombinasie van metodes is gebruik om In meer omvattende beskrywing van die gemeenskapsbehoeftes in die omgewing te verskaf. Sleutel informant tegniek Daar is onderhoude gevoer met 10 verteenwoordigers van die 15 gemeenskapsorganisasies in Langa. Die prioritisering van behoeftes het gewissel afhangende van die organsisasie. Opname Daar is onderhoude gevoer met 425 persone tydens die opname. Naastenby 40% van die respondente woonagtig in tydelike behuising, het In voltydse betrekking. Vir respondente woonagtig in losieshuise was dit naastenby 47% van die respondente. Respondente in privaat wonings toon die hoogste persentasie respondente met 'n voltydse betrekking (73%) gevolg deur die hostel inwoners teen 59%. Die hoë persentasie vir privaat wonings is nie verbasend aangesien die inwoners meestal regerings amptenare is. Die inwoners van tydelike behuising het nie toegang tot basiese dienste nie. Hulle eerste prioriteit is dus behuising. Behuising is ook 'n prioriteit vir die inwoners van die oorbevolkte hostelle. In die publieke woning sector was die prioriteit behoefte werksgeleenthede. Die respondente in hierdie sector het ook aangetoon dat behuising vir die inwoners van tydelike behuising 'n prioriteit vir hulle is. Die nabyheid van die tydelike behusing het die inwoners van privaat wonings meer bewus gemaak van hulle omstandighede. Aanbevelings Die grootste gedeelte van die gemeenskapsorganisasie in Langa het ontwikkel uit 'n behoefte wat die gemeenskap geïdentifiseer is. Die bevindinge van die opname het getoon dat behuising en werksgeleenthede die hoofprioriteite is. Die belangrikste behoeftes wat in hierdie studie geïdentifiseer word moet dringend aangespreek word.

Thesis (MSc (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Spinal cord injury is a devastating sudden cause of disability which renders a person paralyzed and dependent on care immediately after the incident. A person who has suffered a spinal cord injury requires an intensive rehabilitation program to achieve physical independence as well as reintegration into the community. The aim of this study was to evaluate the rehabilitation program for patients with complete paraplegia at the Netcare Rehabilitation Hospital, a 120 bed private rehabilitation facility in Johannesburg, where rehabilitation for patients with physical disabilities is offered by an interdisciplinary team. The rehabilitation program was evaluated in terms of effectiveness including the degree of physical independence the patients achieved and how well the program prepared patients for successful integration into the community. The Functional Independence Measure (FIM), a standardized outcome measure that measures certain physical and cognitive functions and the Needs Assessment Checklist (NAC), an instrument designed to assess if the rehabilitation program is geared towards the patients’ individual needs were used as outcome measure. FIM scores were determined on admission and discharge and NAC scores were determined at discharge. A convenient, consecutive sample of sixteen patients with complete paraplegia (ASIA A), with a neurological level between T1 and T12, formed the study population. Consistently high FIM and NAC scores in the area of physical functioning suggested that the rehabilitation program at Netcare Rehabilitation Hospital was effective in terms of providing patients with physical independence. However, NAC results showed that the patients were not completely ready to reintegrate back to their communities. Areas that were identified as particularly problematic were knowledge on follow up health care services in the community, readiness for work and accessibility of the home and work environments. Therefore it is recommended that the rehabilitation team re-evaluate the program and incorporate strategies with the aim to improve it’s effectiveness in terms of preparing patients for community reintegration. It is also recommended that further research is conducted to assess the current success rate with regards to community reintegration and determine challenges to re-integration in order to assist with program panning. / AFRIKAANSE OPSOMMING: ‘n Spinaalkoordbesering is ‘n skielike oorsaak van gestremdheid wat die persoon verlam en afhanklik van sorg laat direk na die voorval. ‘n Persoon wat ‘n spinalkoordbesering opdoen benodig ‘n intensiewe rehabilitasie program om weer fisies onafhanklik te wees en ook om hom/haar voor te berei om weer by die gemeenskap in te skakel. Die doel van hierdie studie was om die rehabilitasie program by die Netcare Rehabilitasie Hospitaal, ‘n 120 bed private rehabilitasie fasiliteit in Johannesburg, waar rehabilitasie vir fisies gestremde persone deur ‘n interdissiplinere span aangebied word, te evalueer. Die program is geevalueer in terme van twee uitkomste naamlik, die graad van fisiese onafhanklikheid wat die pasiënte behaal en tot watter mate die program pasiente voorberei vir herintegrasie in die gemeenskap Die “Functional Independence Measure” (FIM), ‘n gestandaardiseerde uitkoms skaal wat sekere fisiese en kognitiewe funksies meet en die “Needs Assessment Checklist” (NAC), `n instrument wat ontwikkel is om te evalueer of rehabilitasie programme pasiente se spesifieke behoeftes aanspreek. Is gebruik om the rehabilitasie program te evalueer. Die FIM is met toelating en ontslag voltooi en die NAC is met ontslag voltooi. ‘n Steekproef van sestien pasiente met volledige spinaalkoordletsels (ASIA A) tussen T1 en T12 het die studie populasie gevorm. Deurgans hoë FIM en NAC tellings vir fisiese funksionering het daarop gedui dat die rehabilitasie program by die Netcare Rehabilitation Hospital effektief is in terme van fisiese onafhanklikheid van pasiente. Aan die ander kant het die NAC tellings daarop gedui dat die program minder suksesvol is wat betref die voorbereiding van pasiente vir gemeeskapsintegrasie. Spesifieke probleem areas sluit in kennis van waar om opvolg gesondheidssorg in die gemeenskap te bekom, gereedheid vir werk en toeganklikheid van die huis en werksomgewing. Daar word aanbeveel dat die rehabilitasie span by Netcare Rehabilitasie Hospitaal die program herevalueer om die effektiwiteit van die program in terme van die voorbereiding vir gemeenskaps herintegrasie te verbeter. Dit word ook aanbeveel dat ‘n opvolg studie gedoen word om die huidige sukses ten opsigte van gemeenskaps herintegrasie te evalueer en sruikelblokke te identifiseer ten einde die span the help met program beplanning.