In the United States, approximately 46 million people have doctor diagnosed arthritis and arthritis is the leading cause of disability. Arthritis is used to describe over 100 rheumatic diseases. The most common forms of arthritis are osteoarthritis, rheumatoid arthritis, gout and lupus. Physical activity has recently been recommended for individuals with arthritis. Moderate and vigorous physical activity was assessed within this study. The primary goal was to assess the associations between arthritis, physical activity and other variables found to be associated with physical activity participation in the general population. The secondary goal was to assess the association between healthcare provider communication about exercise and participation in physical activity among those with a diagnosis of arthritis. BRFSS (2007) data and SPSS v.16 was utilized for data analysis. Results indicate the odds in favor of participating in moderate physical activity increase when a healthcare provider suggests physical activity for individuals with arthritis. This outcome stresses the significance of healthcare providers communicating the benefits of physical activity to individuals with arthritis and the general public.

Įvadas. Pertvarkant pirminės sveikatos priežiūros (PSP) įstaigų tinklą, siekiama gerinti sveikatos priežiūros paslaugų prieinamumą, priimtinumą ir kokybę. Todėl, aktualu periodiskai tirti pacientų požiūrį į sveikatos priežiūros paslaugų prieinamumą bei priimtinumą įvairioms socialinėms grupėms. Darbo tikslas: nustatyti ir įvertinti pacientų požiurį į sveikatos paslaugų prieinamumą bei priimtinumą Varėnos pirminės sveikatos priežiūros įstaigoje ir jų ryšius su socialiniais demografiniais veiksniais. Tyrimo metodika. 2006.03.01 – 2006.03.10 laikotarpiu VšĮ Varėnos PSP centre buvo atliekama anoniminė anketinė pacientų apklausa. Apklausoje dalyvavo VšĮ Varėnos PSP centre(miesto gyventojai) ir jo filialuose (kaimo gyventojai) besilankantys pacientai. Buvo išdalinta 280 anketų, atsakė – 208 respondentai (atsakas – 74 proc.). Statistinė duomenų analizė atlikta SPSS 9 versijos programiniu paketu. Rezultatai. Pagrindinis šeimos gydytojo pasirinkimo motyvas yra gydytojo profesionalumas, žinios ir patirtis (72,6 proc.).Centre sveikatos priežiūros paslaugų teritorinis, finansinis, organizacinis ir informacinis prieinamumas buvo geresnis negu jo filialuose.Visi centro pacientai per vieną valandą pasiekdavo PSP įstaigą, tuo tarpu filialų – tik 54,1 proc. respondentų (p<0,05). 32,3 proc. centro respondentų buvo finansiškai pajėgūs įsigyti vaistus, o filialų – tik 15,6 proc. (p<0,05). Prie registratūros langelio ilgiau negu 15 min. laukė 11,1 proc. centro respondentų, o filialų – 26... [toliau žr. visą tekstą] / Introduction. The reorganization of the network of primary healthcare (PHC) institutions is aimed at the improvement of the accessibility, acceptability, and quality of healthcare services. For this reason, periodical investigations of the patients’ attitude towards the accessibility and acceptability of healthcare services to various social groups are relevant. The aim of the study was to determine and evaluate patients’ attitudes towards the accessibility and acceptability of healthcare services in Varėna district primary healthcare unit, and to evaluate the relationships of these attitudes with socio-demographic factors. The methods of the study. During the period of March 1, 2003 to March 10, 2006, we performed an anonymous questionnaire-based inquiry of patients at Public institution Varėna PHC center. The participants of the inquiry were patients who visited Public institution Varėna PHC center (patients living in the city) and its branch offices (patients living in the countryside). In total, 280 questionnaires were distributed, 208 of which were returned (the response rate was 74%). Statistical analysis of the obtained data was performed using the SPSS v. 9 software package. Results. The main motive for the choice of the family physician was the physician’s professionalism, knowledge, and experience (72.6% of answers). The territorial, financial, organizational, and informational accessibility of services at the PHC center was better than in its branch offices... [to full text]

Darbo tikslas – išanalizuoti gydytojų ir slaugytojų įsipareigojimą organizacijai ir jį lemiančius veiksnius. Darbo uždaviniai: 1. nustatyti darbuotojų įsipareigojimo organizacijai lygį ir jį lemiančius veiksnius; 2. palyginti gydytojų ir slaugytojų įsipareigojimą darbui; 3. įvertinti demografinių veiksnių įtaką darbuotojų įsipareigojimui organizacijai. Tyrimo metodika. Tyrimui buvo naudojamas ištisinės anketinės apklausos metodas. 2008 m. gegužės mėn. išdalinta 161 anketa Raseinių apskrities ligoninėje dirbantiems gydytojams ir slaugos specialistams, iš kurių sugrįžo nesugadintos 140. Atsako dažnis 87%. Gauti duomenys apdoroti ir analizuoti naudojant statistinį duomenų analizės paketą SPSS 12.0. Hipotezės apie dviejų požymių nepriklausomumą tikrinamos naudojant χ2 (chi kvadrato) kriterijų. Rodiklių skirtumai laikyti statistiškai reikšmingi, kai p<0,05. Rezultatai. Aukščiausias buvo gydytojų emocinis ir normatyvinis įsipareigojimai (5,67), o slaugytojų atitinkamai – 5,62 ir 5,59. Bendras respondentų pasitenkinimo ligoninės veikla vidurkis siekė 5,41±1,38 balo. Aukščiausiai vyrai vertino ligoninės motyvavimo sistemą, o moterys – emocinį įsipareigojimą, žemiausiais balais moterys įvertino tęstinį įsipareigojimą, o vyrai – vadovavimą ligoninei. Didelį darbo stažą (virš 21 metų) turintys respondentai buvo labiau įsipareigoję organizacijai nei mažiau laiko dirbantys Raseinių ligoninėje darbuotojai. Vyresnio amžiaus (virš 56 metų) respondentai visas įsipareigojimo organizacijai... [toliau žr. visą tekstą] / Aim of the study – to analyze organizational commitment of physicians and nurses and to determine the factors influencing it. Objectives: 1. To determine the level of organizational commitment of the workers and factors influencing it; 2. To compare organizational commitment of physicians and nurses; 3. To evaluate the influence of demographical factors on workers' organizational commitment. Methods. The method of continuous questionnaire was used in this research. In May of 2008 161 questionnaires were distributed to the physicians and nurses of Raseiniai district hospital. 140 were returned undamaged. Rate of response was 87%. The collected data was processed and analyzed using the package of statistical data analysis SPSS 12.0. Hypotheses on independence of two markers were checked using χ2 (chi square) criterion. The difference in rates was thought to be statistically important when p<0,05. Results. Emotional and normative commitments of physicians turned out to be the highest (5,67), while nurses' respectively had it as 5,62 and 5,59. Overall average of respondents' satisfaction with the hospital's activities reached 5,41±1,38 points. Men rated motivation system of the hospital as the highest, while women said it was emotional commitment; women rated continuous commitment as lowest, while men stated it was hospital's management. Respondents with big work experience (over 21 years) were more committed to the organization than these with less work experience in... [to full text]

Social life, and particularly health care delivery, in a small isolated community is more complex and nuanced than has been reflected in much of the literature on physician retention, which has never extended the notion of the “workload” past the physician’s formal role in the health care setting. Despite having been acknowledged by provincial and national government policies, few of what Anderson and Rosenberg (1990) describe as “unidimensional solutions” have resolved the “multidimensional issues” of physician retention in northern Canada. This thesis employs a qualitative framework to investigate the practice and lifestyle experiences of general practitioners on the Queen Charlotte Islands (Haida Gwaii) to provide a local analysis of physician retention problems experienced by isolated communities. By including both physicians and community members as key informants, the project attempts to determine whether a difference exists between physicians’ perceptions of place and their roles and the voiced expectations of the communities they serve. The research uses a combination of in-depth interviews and questionnaires with physicians (n=6) and community members (n=12) to determine the various roles played by a physician in a small community. It queries whether the community in question expects physician to take up roles outside of the medical space, whether physicians are influenced by these expectations and whether these may contribute to the cessation of practice in remote communities. This thesis examines not only health care-related factors involved in medical practice, but also the informal settings of the community at large, including the general interactions that are incorporated into a physician’s character in a close-knit and isolated place. The findings of the thesis demonstrate that there are significant gaps between what community members and physicians believe is reasonable behaviour and the reality of physicians’ experiences in their respective island communities. The lack of boundaries perceived by physicians in their communities often leads to social isolation, which has the opposite intended effect of respite, instead leading to further disengagement from the local community, finally resulting in a decision to locate elsewhere. / Thesis (Master, Geography) -- Queen's University, 2009-09-26 18:55:16.51

Purpose: The purpose of this thesis was to perform a scoping review of the current literature and available clinical practice guidelines to generate an understanding of the primary health care needs of women following treatment for breast cancer. Methods: Based on an extensive scoping review of the literature, research findings regarding the complications of breast cancer treatments and corresponding primary care interventions were synthesized. Additionally, validation of the findings of the scoping review was performed through semi-structured interviews with two primary care physicians and three post-treatment breast cancer patients. Results: Eleven broad categories related to the primary health care needs of women after undergoing treatments for breast cancer were identified. These included concerns related to: surgical complications, lymphedema, gynecologic and menopausal symptoms, psychosocial issues, additional primary cancers, cardiovascular implications, osteoporosis, lifestyle changes, fatigue, cognitive dysfunction, and pregnancy. Additionally, it was determined that the majority of existing clinical practice guidelines for breast cancer were outdated, and related to cancer detection and treatment as opposed to survivorship care. Summary: Findings from the scoping review and interviews demonstrate the vast range of primary care needs of women after undergoing treatment for breast cancer. Additionally, these results highlight the critical need for the development of a comprehensive set of current clinical practice guidelines which target primary care physicians and are specifically focused on the survivorship needs of women following breast cancer treatment. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2011-07-22 16:09:35.682

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The increasing impact of technology on health care has raised some important questions. This study is undertaken to examine how the predominance of a scientific approach to medicine and health care undermines other crucial aspects of the relationship between patients and care givers. / The role and function of language and its relationship to the ascription of human agency in the clinical setting is discussed. A patient's understanding and interpretation of the meaning of illness or disease requires a dialogue between patient and care giver such that the patient's agential horizons are incorporated into the decision-making process. A review is called for, therefore, of the dominance given to the technological over the human agential dimensions of decision-making in the health care environment.

This thesis considers the rationalization of health care in Canada. It focuses on the conflicting roles modern physicians play in our system, acting as both patient advocate and social agent. It begins by tracing the origin of both of these duties. It then examines the ethical, professional, and legal issues which arise in the limited circumstances where front-line physicians must participate in the rationing of health care. It offers a framework for resolving the double agent dilemma and states five interlocking recommendations which are the building blocks of the resolution.

The goal of this thesis is to investigate the literature on physician-assisted death (PAD) in the United States and argue for the legalization of PAD. This thesis discusses the historical and contemporary legal literature of PAD as well as the concerns voiced by opponents of PAD. This thesis addresses the concerns of PAD opponents and invalidating some concerns and and attenuating others. Proper implementation of PAD is proposed via Mandatory Psychiatric Review (MPR) and other psychological services. Further improvements needed in PAD policy are discussed as well as the current benefits of PAD.

Purpose: To examine the relationship between social engagement (SE) and health care use (HCU) in baby-boomers (age 45-64) and older adults (65+). Methods: Data from the Wellness Institute Services Evaluation Research III was used. SE was assessed using measures of formal, informal, and civic activities. HCU was assessed using administrative health care records (hospital use and length of stay, overall general and family physician use). Results: Higher formal SE indicated higher contact with physicians in general, higher hospital visits, and longer lengths of stay in hospital. Higher informal SE indicated shorter lengths of stay. Results were found while controlling for demographic variables, chronic conditions, and self-rated health. Older adults had higher HCU overall, compared to baby-boomers. Conclusion: While further research is necessary, this study has implications in determining the impact that certain types of SE can have on the health care system for different age groups.