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41	Communication dynamics in producing effective patient care : a case study at Stanger Hospital’s diabetes clinic in Kwazulu-Natal, South Africa Moola, Sabihah 03 1900 (has links) Text in English / Interactive health communication between the health-care professional (HCP) and patient relationship for diabetes health-care positively contributes to patient-centred care. Hence individual patient concerns are addressed and catered for in the medical system. The purpose of this study was to analyse in-depth how HCP-patient relationships and HCP-HCP teamwork dynamics positively contribute to effective diabetes patient care and treatment adherence. Different health communication models and theories were reviewed and a conceptual framework was developed from the literature. A qualitative case study approach was used to collect data at Stanger Hospital’s diabetes clinic. Data was collected using three different methods, namely in-depth interviews with HCPs and patients individually, observations conducted at the clinic analysing both the HCPs and patients, and finally, documentation that emerged as a third data collection method where patient files and diabetes educational material were analysed at the clinic. Triangulation by means of the three methods ensured that reliable, valid and credible data was collected in the field. Diabetes health-care and treatment management are affected by the social context/social system which includes family and culture. These social factors are acknowledged as core in the literature. However, a single comprehensive health communication model did not exist solely in this regard. The data indicated that at the Stanger Hospital’s diabetes clinic, patient-centred (individual tailor-made treatment plans) care was only implemented after patients had defaulted treatment for reasons linked to their social circumstances. The findings of the study indicate that teamwork was favoured in the HCP-HCP relationship at the diabetes clinic, and that this made a positive contribution to effective diabetes patient care. HCPs were overburdened at the clinic since patient numbers were high and there were staff shortages. The patients’ empirical data indicated that interactive communication positively contributed to their medical concerns being catered for at the diabetes clinic, but this tended to occur only after non-adherence. Patients required care and support from HCPs in order to learn to accept diabetes and manage their illness. / Sociology / D. Litt. et Phil. (Sociology) Interactive health communication Persuasive communication Communication exchange Cognitive Psychological Social system/context Family Culture HCP-patient relationships HCP-HCP teamwork Biomedical Biopsychosocial Apartheid medicine Patient-centred care Communication dynamics Diabetes Treatment adherence Public health-care Case study 362.1964620096844 Stanger Regional Hospital -- Case study
42	From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times MacLeod, Suzanne 26 March 2014 (has links) As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive. / Graduate / 0452 / 0680 / 0351 / macsuz@shaw.ca social determinants of health social exclusion crisis discourse Alzheimer's Alzheimer Society of Canada Suzanne MacLeod Susan Strega Donna Jeffery poststructural poststructuralism admission to long-term care funding for long-term care acute care aging demographic BC Psychogeriatric Association biomedical British Columbia Canada Health Act collective social responsibility competition corporate profit corporatization deresponsibilization elder friendly elderly citizens family caregivers Foucault found poetry genealogy of power knowledge incompetent Ministry of Health moral economics pharmaceutical bed blocker stigmatized tsunami absent-person action plan aging population alternative discourse apocalyptic demography appropriate archaeology archaeology of knowledge archaeological British Columbia burden Canada caregiver charity charitable collective collective car community community care condition of possibility conditions of possibility corporate counter-discourse dementia dementia care dementia policy dementia social policy dependent depoliticize discourse discourse analysis disruptive discourse economic burden economics economy elder emergency epidemic exclusion fear-monger Foucauldian found poem genealogy genealogical health authority health care health care staff health care system health policy document healthy lifestyle home and community care homogenization homogenize hospital imaginaries imaginary incapable individual responsibility individualism knowledge long-term care material effect materiality of discourse media moral panic national strategy neoliberal neoliberalism neoliberal rationality not prepared object objectification other person-centered people living with dementia person living with dementia persons living with dementia person with dementia poem poetic representation poetry policy policies political politics power power knowledge power relations private privatize privatization productivity of dominant discourse public health care residential care resistance responsibility responsibilization rising tide safety net shift costs to caregivers responsibility social policy imaginary social well-being social work social worker solidarity specialized stakeholder state stigma subject matter expert taxpayer threat unprepared unproductive voluntary volunteer wait time wave social policy
43	From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times MacLeod, Suzanne 26 March 2014 (has links) As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive. / Graduate / 0452 / 0680 / 0351 / macsuz@shaw.ca social determinants of health social exclusion crisis discourse Alzheimer's Alzheimer Society of Canada Suzanne MacLeod Susan Strega Donna Jeffery poststructural poststructuralism admission to long-term care funding for long-term care acute care aging demographic BC Psychogeriatric Association biomedical British Columbia Canada Health Act collective social responsibility competition corporate profit corporatization deresponsibilization elder friendly elderly citizens family caregivers Foucault found poetry genealogy of power knowledge incompetent Ministry of Health moral economics pharmaceutical bed blocker stigmatized tsunami absent-person action plan aging population alternative discourse apocalyptic demography appropriate archaeology archaeology of knowledge archaeological British Columbia burden Canada caregiver charity charitable collective collective car community community care condition of possibility conditions of possibility corporate counter-discourse dementia dementia care dementia policy dementia social policy dependent depoliticize discourse discourse analysis disruptive discourse economic burden economics economy elder emergency epidemic exclusion fear-monger Foucauldian found poem genealogy genealogical health authority health care health care staff health care system health policy document healthy lifestyle home and community care homogenization homogenize hospital imaginaries imaginary incapable individual responsibility individualism knowledge long-term care material effect materiality of discourse media moral panic national strategy neoliberal neoliberalism neoliberal rationality not prepared object objectification other person-centered people living with dementia person living with dementia persons living with dementia person with dementia poem poetic representation poetry policy policies political politics power power knowledge power relations private privatize privatization productivity of dominant discourse public health care residential care resistance responsibility responsibilization rising tide safety net shift costs to caregivers responsibility social policy imaginary social well-being social work social worker solidarity specialized stakeholder state stigma subject matter expert taxpayer threat unprepared unproductive voluntary volunteer wait time wave social policy

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