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Client Groups (client + groups)
Selected AbstractsThe times they are a changinJOURNAL OF NURSING MANAGEMENT, Issue 5 2009Cert Ed, MIKE THOMAS PhD Aim, A discussion paper outlining the potential for a multi-qualified health practitioner who has undertaken a programme of study incorporating the strengths of the specialist nurse with other professional routes. Background and rationale, The concept and the context of ,nursing' is wide and generalized across the healthcare spectrum with a huge number of practitioners in separate branches, specialities and sub-specialities. As a profession, nursing consists of different groups in alliance with each other. How different is the work of the mental health forensic expert from an acute interventionalist, or a nurse therapist, from a clinical expert in neurological deterioration? The alliance holds because of the way nurses are educated and culturalized into the profession, and the influence of the statutory bodies and the context of a historical nationalized health system. This paper discusses the potential for a new type of healthcare professional, one which pushes the intra- and inter-professional agenda towards multi-qualified staff who would be able to work across current care boundaries and be more flexible regarding future care delivery. In September 2003, the Nursing and Midwifery Council stated that there were ,more than 656 000 practitioners' on its register and proposed that from April 2004, there were new entry descriptors. Identifying such large numbers of practitioners across a wide range of specialities brings several areas of the profession into question. Above all else, it highlights how nursing has fought and gained recognition for specialisms and that through this, it may be argued client groups receive the best possible ,fit' for their needs, wants and demands. However, it also highlights deficits in certain disciplines of care, for example, in mental health and learning disabilities. We argue that a practitioner holding different professional qualifications would be in a position to provide a more holistic service to the client. Is there then a gap for a ,new breed' of practitioner; ,a hybrid' that can achieve a balanced care provision to reduce the stress of multiple visits and multiple explanations? Methods, Review of the literature but essentially informed by the authors personal vision relating to the future of health practitioner education. Implications for nursing management, This article is of significance for nurse managers as the future workforce and skill mix of both acute and community settings will be strongly influenced by the initial preregistration nurse education. [source] Validation of a client-based clinical metrology instrument for the evaluation of canine elbow osteoarthritisJOURNAL OF SMALL ANIMAL PRACTICE, Issue 6 2009C. A. Hercock Objective: To validate a disease-specific client-based clinical metrology instrument (questionnaire) for dogs with chronic osteoarthritis of the elbow joint. Materialsand Methods: This was a prospective cohort study involving 26 dogs with chronic osteoarthritis of the elbow with 24 associated clients. Validity (face and criterion), reliability and responsiveness of the metrology instrument (named "Liverpool Osteoarthritis in Dogs [elbow]") were tested in a sequence of studies. Face validity involved use of international peer review. Reliability was assessed using a test-retest scenario with a two week interval; peak vertical force as measured by a force platform was used as an external standard measure. Responsiveness was tested with a two week, single-blinded placebo-controlled intervention using a licensed non-steroidal anti-inflammatory drug. Results: The reliability of Liverpool Osteoarthritis in Dogs (elbow) in the test-retest scenario was good; intraclass correlation coefficient is 0·89, 95 per cent confidence interval 0·75 to 0·95, compared with intraclass correlation coefficient 0·92, 95 per cent confidence interval 0·74 to 0·98, for peak vertical force. Responsiveness testing indicated that the "net" effect size (allowing for placebo effect) for Liverpool Osteoarthritis in Dogs (elbow) was 0·13 compared with (,)0·18 for the force platform. Criterion validity for Liverpool Osteoarthritis in Dogs (elbow) against peak vertical force was poor; Spearman's rank correlation is ,0·24 (P=0·30). Clinical Significance: Liverpool Osteoarthritis in Dogs (elbow) was considered reliable with satisfactory responsiveness. The poor criterion validity suggests a mismatch between force platform peak vertical force and client perceptions of lameness. This instrument requires further validation in larger studies with alternative client groups and alternative therapeutic interventions, but this initial validation suggests that Liverpool Osteoarthritis in Dogs (elbow) is worthy of continued investigation. [source] Levels of empathy in undergraduate occupational therapy studentsOCCUPATIONAL THERAPY INTERNATIONAL, Issue 3 2010Ted Brown Abstract Empathy is an important attribute for occupational therapists in establishing rapport and in better understanding their clients. However, empathy can be compromised by high workloads, personal stressors and pressures to demonstrate efficacy. Occupational therapists also work with patients from a variety of diagnostic groups. The objective of this study was to determine the extent of empathy and attitudes towards clients amongst undergraduate occupational therapy students at one Australian University. A cross-sectional study was undertaken using a written survey of the Jefferson Scale of Physician Empathy (JSPE) and the Medical Condition Regard Scale. Overall, a strong level of empathy was reported amongst students. Four medical conditions that occupational therapists work with (stroke, cerebral palsy, traumatic brain injury and depression) were held in high regard. Substance abuse, however, was held in comparatively low regard. Overall, the year of study appeared to have no significant impact on the students' empathy. Despite having a lower reported empathy level than found in health professions from other studies using the JSPE, occupational therapy students were found to have a good level of empathy. Of concern, however, was the bias reported against the medical condition of substance abuse, highlighting that the there may be a need to reinforce that patients from this diagnostic group are equally deserving of quality care irrespective of their clinical condition. Recommendations for future research include completing a longitudinal study of occupational therapy students' empathy levels and investigating the empathy levels of occupational therapists working with different client groups. Limitations of the study include the convenience sampling of occupational therapy students enrolled at one university which limits the generalizability of the results to groups of participants with similar characteristics. Copyright © 2010 John Wiley & Sons, Ltd. [source] Engaging client groups differently: A standardized approach to performance improvementPERFORMANCE IMPROVEMENT, Issue 9 2009Timothy E. LaMacchio Moving clients past counterproductive approaches to improving performance requires performance improvement (PI) professionals to work differently. They must collaboratively engage clients in anticipating and solving problems. It calls for a user-friendly and explicit PI process that drives results. This proactive engagement promotes a shared view and language of the PI process. It enables PI professionals and clients to work jointly with common tools to improve performance, make everyday decisions, and achieve business results. [source] The Clinical Value Compass: Achieving Benchmarking and Quality Improvement in Aged CareAUSTRALASIAN JOURNAL ON AGEING, Issue 1 2000Michael Woodward Quality measurement and benchmarking in aged care presents several challenges. A model which addresses this by linking four dimensions of outcomes has been developed - the Clinical Value Compass (CVC). A CVC was developed for stroke rehabilitation and measured across four sites. The CVC was well accepted by the treatment teams and proved practical to measure. The results revealed differences in practices and client groups that led to a closer analysis of processes and subsequent changes in these processes. Remeasuring of the CVC is required to demonstrate improved outcomes arising from these process changes. [source] Development of a client-generated health outcome measure for community nursingAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2000Rhonda Griffiths Objective:To develop a client-generated outcome measure for use in community nursing. Method:Participants for the study were identified from the case load of community health nurses, from a nursing home service and from residents of a retirement village. All participants had a diagnosis of venous leg ulcer (VLU) and/or type 2 diabetes. Preliminary development of the measure involved focus groups of community clients and health professionals, and pilot testing of an existing quality of life (QoL) measure, the Patient-Generated Index. The resulting Client-Generated Index was tested for reliability and validity. Results:The Pearson's correlation coefficient between administration of the CGI at T1 and T2 was 0.526 (n=51; p=0.0001). The CGI correlated significantly with four of eight dimensions of the SF-36, and with pain as a clinical marker for VLU r=0.54 (p=0.001). Overall, participants with VLU reported a lower QoL (mean CGI score 2.8) compared to those with diabetes (mean CGI score 4.1). Conclusions:The CGI was developed to measure outcomes in community health settings. Some measures of its reliability and validity are demonstrated and further research is needed to validate the instrument using other client groups. Implications:If routine assessment and evaluation is to contribute to measures of outcome, the instruments need to be concise and acceptable to health care providers. The CGI has all these properties. [source] Profile of occupational therapy practice in rural and remote South AustraliaAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 5 2008Kobie Boshoff Abstract Objective:,The aim of this report is to discuss the results of a questionnaire conducted with occupational therapists providing services in rural and remote South Australia. It is envisaged that the results will be of interest to health professionals working in country areas of Australia. The questionnaire aimed at capturing descriptive information from these therapists in regards to the type of services they deliver and the strategies they employ to deliver services, including information on human resources and staff retention. Design and methods:,A questionnaire sent to occupational therapy managers and yielded a 44% response rate. Results:,Results provide descriptive information on the services provided, for example, the vast geographical areas covered. Respondents described the challenges they face in service delivery and these include the wide range of services to diverse client groups, high client,therapist ratio and limited human resources. Examples of strategies used are less labour-intensive service delivery models, multi-skilling of staff, networking and use of problem-solving techniques. Most perceived their services to be addressing client needs and they felt supported in their roles by other occupational therapists and their organisations. Conclusions:,Occupational therapists working in rural and remote South Australia are overcoming the challenges identified in this questionnaire by implementing innovative strategies. [source] | ||||||||||