Perceived Effects (perceived + effects)

Distribution by Scientific Domains


Selected Abstracts


Graduate Medical Education Downsizing: Perceived Effects of Participating in the HCFA Demonstration Project in New York State

ACADEMIC EMERGENCY MEDICINE, Issue 2 2001
Linda L. Spillance MD
Abstract. Objective: Financial support for graduate medical education (GME) is shrinking nationally as Medicare cuts GME funds. Thirty-nine hospitals in New York State (NYS) voluntarily participated in a Health Care Financing Administration demonstration project (HCFADP),the goal of which was to reduce total residency training positions by 4-5%/year over a five-year period, while increasing primary care positions. The objective of this study was to determine the effect of downsizing on emergency department (ED) staffing and emergency medicine (EM) residency training. Methods: Structured interviews and surveys of NYS program directors (PDs) were conducted in October,December 1999. Simple frequencies are reported. Results: One hundred percent of 17 PDs completed the interviews and seven of 12 participants in the HCFADP returned surveys. Twelve of 17 programs participated in HCFADP and two programs downsized outside HCFADP. Seven of 12 participants lost EM positions. Six of 12 programs were forced to exclude outside residents from rotating in their ED, leading to a need for one participating program and one non-participating program to find alternative sites for trauma. Five of 12 institutions provided resident staffing data, reporting a reduction in ED resident coverage in year 1 of the project of 9-40%. Programs compensated by increasing the number of shifts worked (4/12), increasing shift length (1/12), decreasing pediatric ED shifts (1/12), decreasing elective or research time (2/12), and decreasing off-service rotations (4/12). Six departments hired physician assistants or nurse practitioners, two hired faculty, and two hired resident moonlighters. Six of 12 programs withdrew from HCFADP and returned to previous resident numbers. Eight of 12 PDs thought that they had decreased time for clinical teaching. Conclusions: A 4-5% reduction in residency positions was associated with a marked reduction in ED resident staffing and EM residency curriculum changes. [source]


The perceived effects of holiday-taking upon the health and wellbeing of patients treated for cancer

INTERNATIONAL JOURNAL OF TOURISM RESEARCH, Issue 3 2003
Philippa Hunter-Jones
Abstract The role that holidays play within health and wellbeing has been addressed infrequently within academic research. Much of the work that does exist has tended to focus upon illnesses or health complaints arising as a consequence of travel. Any beneficial health effects of travel largely have been neglected. This paper reports the empirical findings of a qualitative study conducted to determine the perceived effects of holiday-taking upon the health and wellbeing of a group of cancer patients, a population ignored by the tourism community. Four perceived effects are identified relating to personal health, social effectiveness, personal identity and regaining independence, and the implications of these findings discussed. Copyright © 2003 John Wiley & Sons, Ltd. [source]


Operating room nurses' perceptions of the effects of physician-perpetrated abuse

INTERNATIONAL NURSING REVIEW, Issue 3 2010
B.L. Higgins rn
HIGGINS B.L. & MACINTOSH J. (2010) Operating room nurses' perceptions of the effects of physician-perpetrated abuse. International Nursing Review57, 321,327 Background:, Operating room (OR) nurses experience abuse perpetrated by physicians; however, little research has been conducted to examine nurses' perceptions of the effects of such abuse. Aims:, The aim of this research was to understand participants' perceptions of physician-perpetrated abuse on their health and ability to provide patient care. Materials/Methods:, In this qualitative descriptive study, ten operating room nurses working in Eastern Canada participated in open-ended, individual audiotaped interviews that were transcribed for analysis using Boyatzis' method for code development. Results:, Three categories of factors contributing to abuse were developed. The first, culture of the OR, included environment and hierarchy. The second, catalysts of abuse, included nurses' positions and experience as well as non-nurse factors such as resources and interpersonal relationships among physicians. The third category, perceived effects, included psychological, physical and social health consequences for nurses. Effects on patient care consisted of safety and potential challenges to access. Discussion:, Nursing practice implications included mentoring, support and accountability for action. Educational implications related to interdisciplinary education and increased education on communication, assertiveness, and awareness of abuse. Implications for research included studying perceptions of other health-care providers including physicians, studying recruitment and retention in relation to abuse, and studying other abuse in health care such as horizontal violence. Conclusion:, We suggest a proactive approach for empowering OR nurses to address abuse and an increased focus on interdisciplinary roles. [source]


PARTNER AWARENESS REGARDING THE ADULT SEQUELAE OF CHILDHOOD SEXUAL ABUSE FOR PRIMARY AND SECONDARY SURVIVORS

JOURNAL OF MARITAL AND FAMILY THERAPY, Issue 2 2003
Noelle S. Wiersma
This qualitative study investigates factors that may facilitate or impede awareness within couples regarding the sequelae of chuildhood sexual abuse for adult females and their partner. Six couples were interviewed about perceived effects of the abuse for self and partner and their perceptions regarding their awareness of these effects. Transcribed data were analyzed using grounded-theory methodolgy. Emergent themes regarding potential barriers to and facilitators of agreement are outlined in the context of the expressive and receptive abilities and motivations of each partner in communicating about the abuse. Preliminary implications for marriage and family therapy and further research are provided. [source]


Organizational structures that support internal program evaluation

NEW DIRECTIONS FOR EVALUATION, Issue 120 2008
Michael T. Lambur
This chapter explores how the structure of large complex organizations such as Cooperative Extension affects their ability to support internal evaluation of their programs and activities. Following a literature review of organizational structure and its relation to internal evaluation capacity, the chapter presents the results of interviews with 10 selected Extension evaluators. Four structures for evaluation in Extension organizations are identified: (1) a separate evaluation unit, (2) within an administrative unit, (3) within a program area, and (4) within an academic department or school. The interviews addressed the philosophy and approach to program evaluation, what evaluators do, the perceived effects of organizational structure on evaluation, and reflections on the optimal structure for program evaluation in Extension. Several conclusions are presented: the evaluation function should be associated with a high administrative level in the organization, locating the evaluation function in program units appears to be preferred, roles and responsibilities of internal evaluators need to be clearly specified, internal evaluators need to work closely with administration and management to carry out their roles effectively and to incorporate evaluation into organizational decision making, and internal evaluators often assume other roles beyond their primary role as evaluator. © Wiley Periodicals, Inc. [source]


Attachment and spousal caregiving

PERSONAL RELATIONSHIPS, Issue 1 2001
JUDITH A. FEENEY
A community sample of 362 married couples participated in a study of attachment and spousal caregiving, which combined qualitative and quantitative components. The qualitative component focused on actual experiences of caregiving, assessed by participants' semi-structured accounts of a situation involving their role as caregiver for their spouse. Attachment styles and their underlying dimensions (comfort with closeness, anxiety over relationships) were related to the type of support provided, the coping strategies used in the situation, caregivers' feelings about the quality of their care, perceived effects on the couple bond, and the emotional tone of the accounts. The quantitative component tested a theoretical model of factors predicting willingness to provide care for the spouse if he or she should become dependent in later life. Measures of attachment and caregiving styles, attachment to spouse, and anticipated burden provided reliable prediction of willingness to care. The results support the conceptualization of attachment and caregiving as interrelated features of marital bonds, and they have important implications for patterns of family caregiving. [source]