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Perceived Need (perceived + need)

Distribution by Scientific Domains

Medical Sciences	68%
Humanities and Social Sciences	9%
Business, Economics, Finance and Accounting	9%
3 Other Domains	14%

Selected Abstracts

Four Bases of Family Business Successor Commitment: Antecedents and Consequences

ENTREPRENEURSHIP THEORY AND PRACTICE, Issue 1 2005
Pramodita Sharma
Although successor commitment toward family business has been identified as a key desirable attribute, commitment has been treated as a unidimensional construct in family business research. Drawing on the organizational commitment literature, we propose four bases of successor commitment to family firm,affective (based on perceived desire), normative (based on perceived sense of obligation), calculative (based on perceived opportunity costs involved), and imperative (based on perceived need). A model of antecedents and expected behavioral outcomes of each of these bases of commitment is developed. Related propositions are presented, as are the contributions to the literature, research and practical implications. [source]

Teaching received in caries prevention and perceived need for Best Practice Guidelines among recent graduates in Finland

EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 1 2004
Miira M. Vehkalahti
The present study evaluated teaching that recent graduates in Finland had received in caries prevention and their perceived need for updated Best Practice Guidelines. A two-page questionnaire was mailed to all dentists in Finland who had graduated from 1995 to 1998 (n = 390). After one reminder, the response rate was 46%. The closed questions covered teaching in 14 caries-preventive methods and its suggestions as to when and on whom to apply such methods. Each dentist's own opinion on the three most important methods for caries prevention in patients with various types of dentition was sought in open questions. The respondents reported that at dental school, on average 12.5 (SD = 2.4) of 14 aspects of caries prevention were covered in theoretical teaching, 5.5 (SD = 3.8) in demonstrations and 8.5 (SD = 3.0) in clinical training. The top four methods teaching suggested for every patient were toothbrushing (100%), use of fluoridated toothpaste (99%), interdental cleaning (98%), and use of xylitol (97%); followed by fluoride varnish (77%) and fissure sealants (54%). The three caries-preventive methods the respondents felt to be most useful were the same for all types of dentitions, in order of importance: (i) toothbrushing and use of fluoridated toothpaste, (ii) supplementary use of fluorides at home and (iii) healthy dietary habits, in particular, avoidance of sucrose. As regards clinical work, such teaching had served the respondents' real-life needs in patients' caries prevention either extremely (44%) or moderately (54%) well; 91% said, however, that they would benefit from nationwide Best Practice Guidelines. In conclusion, the recent graduates' emphasis on patient-active methods in caries prevention may indicate a change in the current policy favouring patient-passive methods. [source]

Developing an instrument to support oral care in the elderly

GERODONTOLOGY, Issue 1 2003
Yasunori Sumi
Abstract Background: The dramatic increase in the number of dependent elderly in developed countries has created a great need for their improved oral care. However, optimal oral care by caregivers is not possible because of time constraints, difficulty involved in brushing other individuals' teeth, lack of co-operation, and the lack of perceived need. Therefore, the development of an effective instrument simplifying and supporting oral care to relieve the strain on caregivers is a matter of some urgency. Purpose: In order to clean the mouths of elderly dependent patients, we have developed a new oral care support instrument (an electric toothbrush in combination with an antibacterial-agent supply and suction system). The purpose of the present study was to develop and evaluate a new oral care support instrument. Methods: a) Plaque removal study: The plaque- removing ability of this new instrument in 70 outpatients was compared with the Plak Control D9011 (Braun Gillette Japan Inc.) as a control by means of the Turesky modification of the Quigley and Hein plaque index, b) Clinical study: The subjects were 10 dependent elderly who received oral care using the new oral care support instrument for two weeks. The plaque and gingival indices were used for clinical evaluations. Results: a) Plaque removal study: Brushing with the new oral care support instrument removed significantly more plaque than with the Plak Control D9011. b) Clinical study: The new oral care support instrument allows a more effective removal of dental plaque and shows a significant improvement in the gingival indices in dependent elderly. Conclusion: It is concluded that the new oral care support instrument is effective and can be recommended for oral care in the dependent elderly. [source]

Can a publicly funded home care system successfully allocate service based on perceived need rather than socioeconomic status?

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2007
A Canadian experience
Abstract The present quantitative study evaluates the degree to which socioeconomic status (SES), as opposed to perceived need, determines utilisation of publicly funded home care in Ontario, Canada. The Registered Persons Data Base of the Ontario Health Insurance Plan was used to identify the age, sex and place of residence for all Ontarians who had coverage for the complete calendar year 1998. Utilisation was characterised in two dimensions: (1) propensity , the probability that an individual received service, which was estimated using a multinomial logit equation; and (2) intensity , the amount of service received, conditional on receipt. Short- and long-term service intensity were modelled separately using ordinary least squares regression. Age, sex and co-morbidity were the best predictors (P < 0.0001) of whether or not an individual received publicly funded home care as well as how much care was received, with sicker individuals having increased utilisation. The propensity and intensity of service receipt increased with lower SES (P < 0.0001), and decreased with the proportion of recent immigrants in the region (P < 0.0001), after controlling for age, sex and co-morbidity. Although the allocation of publicly funded home care service was primarily based on perceived need rather than ability to pay, barriers to utilisation for those from areas with a high proportion of recent immigrants were identified. Future research is needed to assess whether the current mix and level of publicly funded resources are indeed sufficient to offset the added costs associated with the provision of high-quality home care. [source]

,Pig-Sticking Princes': Royal Hunting, Moral Outrage, and the Republican Opposition to Animal Abuse in Nineteenth-and Early Twentieth-Century Britain

HISTORY, Issue 293 2004
Antony Taylor
This article locates monarchy in the debates arising out of the anti-animal abuse campaigns of the nineteenth and early twentieth centuries. Through a close examination of urban republican criticisms of monarchy, it seeks to question the role of royalty as the custodian of shared national values concerning animal welfare. It demonstrates that hostility to monarchy based on its role in encouraging and patronizing hunting belongs to a long tradition. Much hostility to royalty crystallized around the royal patronage of fox-hunting and of pheasant-shooting. The nineteenth-century precedents for recent concerns about the visible presence of royal figures on the hunting-field articulated many of the component elements of a republican position. For many urban radicals the connection of reigning monarchs with the hunt demonstrated the dysfunctional nature of royal existence, the limitations of royalty's attainments, and the perceived need by monarchs to satisfy the baser, more carnal urges arising from a life devoted to indolence and pleasure. This article shows that hunting, as a marker of a robust masculinity and of the opulence of royalty, brought the reform community into collision with supporters of the monarchy, and provided an example of royal ritual that failed to work in the interests of the throne. The article concludes by revealing the connections between the land debate, criticisms of the royal house, and animal welfare politics in the late nineteenth and early twentieth centuries. [source]

Fatigued Elderly Patients With Chronic Heart Failure

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003
Anna Ehrenberg
PURPOSE To compare descriptions of fatigue based on the NANDA characteristics from interviews with elderly people with congestive heart failure (CHF) and data recorded by nurses at a Swedish outpatient heart failure clinic. METHODS Patients were screened for moderate to severe CHF. A total of 158 patients were interviewed using a revised form of the Fatigue Interview Schedule (FIS) based on the NANDA characteristics. Of these patients, half (n= 79) were offered visits at a nurse-monitored heart failure clinic. Nursing documentation of fatigue at the heart failure clinic was reviewed based on the NANDA characteristics and compared with the content in the patient interviews. FINDINGS Tiredness was documented in 43 (75%) records and indicated in 36 patients based on patient scores on the FIS (X,= 5.5; range 1,9). The most frequently recorded observation related to fatigue was the symptom emotionally labile or irritable, followed by notes on lack of energy and decreased performance. Patients' descriptions of their fatigue were expressed as a decreased ability to perform and a perceived need for additional energy. Results indicated poor concordance in patients' descriptions and record content concerning fatigue. Whereas patients emphasized the physical characteristics of fatigue, nurses emphasised the emotional features. Decreased libido was linked to fatigue according to the patients but not according to the nurses' records. Whereas cognitive characteristics of fatigue occurred rarely in the records, they were more frequent in the patient interviews. DISCUSSION Symptoms such as irritability and accident-proneness may be seen as manifestations of the patients' experiencing the need for more energy or a feeling of decreased performance. These consequences of being fatigued, rather than the different dimensions of fatigue, seemed to have been easy for the nurses to observe and document. Earlier studies indicate that poor observation, medication, and diet in patients with heart failure might partly be explained by cognitive impairment. CONCLUSIONS Findings of this study highlight the need for nurses to pay attention to the experience of fatigue in patients who suffer from CHF, and to validate their observations with the patients own expressions. Using the patients' words and expressions and the diagnostic characteristics of fatigue in recording can support the nurses in developing both understanding of patients living with CHF and strategies to help patients cope with their restricted ability in daily life. [source]

The Construction of Normal Expectations

JOURNAL OF INDUSTRIAL ECOLOGY, Issue 2 2008
Consumption Drivers for the Danish Bathroom Boom
Summary The gradual upward changes of standards in normal everyday life have significant environmental implications, and it is therefore important to study how these changes come about. The intention of the article is to analyze the social construction of normal expectations through a case study. The case concerns the present boom in bathroom renovations in Denmark, which offers an excellent opportunity to study the interplay between a wide variety of consumption drivers and social changes pointing toward long-term changes of normal expectations regarding bathroom standards. The study is problem-oriented and transdisciplinary and draws on a wide range of sociological, anthropological, and economic theories. The empirical basis comprises a combination of statistics, a review of magazine and media coverage, visits to exhibitions, and qualitative interviews. A variety of consumption drivers are identified. Among the drivers are the increasing importance of the home as a core identity project and a symbol of the unity of the family, the opportunities for creative work, the convenience of more grooming capacity during the busy family's rush hours, the perceived need for retreat and indulgence in a hectic everyday life, and the increased focus on body care and fitness. The contours of the emerging normal expectations are outlined and discussed in an environmental perspective. [source]

A Study of Corporate Disclosure Practice and Effectiveness in Hong Kong

JOURNAL OF INTERNATIONAL FINANCIAL MANAGEMENT & ACCOUNTING, Issue 1 2001
Simon S. M. Ho
The recent economic turmoil in Asia has led to a wider recognition of the importance of corporate transparency and disclosures in financial dealings. The objective of this study is to provide comprehensive and up-to-date evidence of current practice and perceived effectiveness of corporate disclosure of listed companies in an emerging economy,Hong Kong. The study compares the perceptions of chief financial officers (CFOs) and financial analysts about a variety of information flow, disclosure and capital market efficiency issues. It also seeks to determine whether there is a perceived need for increased financial reporting regulations and to what extent this and other alternative means might improve market functioning. While both subject groups believed that a majority of firms only adopt a conservative one-way disclosure strategy and the existence of a communication gap, analysts perceived a much higher need than CFOs for increased financial reporting regulations. Neither group thought that enhancing disclosure requirements alone would suffice to close this gap. Instead, they suggested an improvement in the quality of the communication and disclosure processes through means such as choosing more appropriate communication media, formulating a more proactive disclosure strategy, enhancing investor relationship, and voluntarily reporting more information desired by users. [source]

Citizenship and The State

PHILOSOPHY COMPASS (ELECTRONIC), Issue 6 2009
M. Victoria Costa
This study surveys debates on citizenship, the state, and the bases of political stability. The survey begins by presenting the primary sense of ,citizenship' as a legal status and the question of the sorts of political communities people can belong to as citizens. (Multi)nation-states are suggested as the main site of citizenship in the contemporary world, without ignoring the existence of alternative possibilities. Turning to discussions of citizen identity, the study shows that some of the discussion is motivated by a perceived need for citizens to have a sense of political belonging, on the assumption that such a sense promotes political activity and has other personal and social benefits. But there are serious problems with the strategy of understanding the relevant sense of belonging in terms of identification with the nation-state. The study explores a more promising way to generate this sense of belonging. First, societies should function, to a sufficiently high degree, in accord with political principles of justice and democratic decision making. Second, there should be a general consensus on political principles among citizens, as well as high levels of engagement in democratic deliberation. [source]

Perceived Health Needs of Urban African American Church Congregants

PUBLIC HEALTH NURSING, Issue 5 2001
Kathleen A. Baldwin Ph.D.
Theory-based assessment of congregant expectations and needs should be conducted prior to beginning a parish nurse program. However, no such assessments are found in the literature. Using Andersen's Health Access Model as a framework, investigators conducted interviews with 117 randomly selected congregants in five urban African American churches to describe their perceived needs and expectations. Causing most concern were the following: (a) symptoms of illness,high blood pressure (50.4%), dental problems (43.6%), and back pain (41%); and (b) health habits/risks,weight (75%), exercise (63%), and diet (63%). Younger adults were significantly more concerned about all aspects of their health than their older counterparts. Women were significantly more likely to express concern about health habits and health risks than males. No significant relationship was found between perceived need and access to care. Although terming health care services "adequate", congregants expressed many unmet health needs. This seemingly contradictory finding may illuminate a concrete role for the parish nurse, i.e., addressing personal health care concerns not alleviated by the current "adequate" health care delivery system. This study's significance lies not only in providing programming guidance, but also in theoretical insights into the role of the parish nurse. [source]

Shifting the culture of continuing medical education: What needs to happen and why is it so difficult?

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2000
Angela Towle PhD Faculty of Medicine
Abstract A revolution in health care is occurring as a result of changes in the practice of medicine and in society. These include changing demographics and the pattern of disease; new technologies; changes in health care delivery; increasing consumerism, patient empowerment, and autonomy; an emphasis on effectiveness and efficiency; and changing professional roles. The issues raised by these changes present challenges for the content and delivery of the whole continuum of medical education. The ways in which continuing medical education (CME) needs to respond to these challenges are outlined. The Informed Shared Decision Making (ISDM) Project at the University of British Columbia is used as a case study to illustrate some of the practical problems in providing CME that address these current trends in health care, is effective, and is attractive to physicians. Two particular problems are posed: how to respond to a demonstrated need when there is no perceived need on the part of physicians and how to enable change agents on the margins to develop allies and get ownership from stakeholders and opinion leaders on the inside. Two strategies for change are discussed: the substantive incorporation of CME into the continuum of medical education and the involvement of patients in the planning and delivery of CME. A final challenge is raised for the leaders of CME to define and agree what "shifting the culture of CME" means and to make a commitment of time and energy into making it happen. [source]

International Emergency Medicine: A Review of the Literature from 2007

ACADEMIC EMERGENCY MEDICINE, Issue 9 2008
Adam C. Levine MD
Abstract The subspecialty of international emergency medicine (IEM) continues to grow within the United States, just as the specialty of emergency medicine (EM) continues to spread to both developed and developing countries around the world. One of the greatest obstacles, however, faced by IEM researchers and practitioners alike, remains the lack of a high-quality, consolidated, and easily accessible evidence-base of literature. In response to this perceived need, members of the Emergency Medicine Resident Association (EMRA) International Emergency Medicine Committee, in conjunction with members of the Society for Academic Emergency Medicine (SAEM) International Health Interest Group, have embarked on the task of creating a recurring review of IEM literature. This publication represents the third annual review, covering the top 30 IEM research articles published in 2007. Articles were selected for the review according to explicit, predetermined criteria that included both methodologic quality and perceived impact of the research. It is hoped that this annual review will act as a forum for disseminating best practices, while also stimulating further research in the field of IEM. [source]

A study examining inter-rater and intrarater reliability of a novel instrument for assessment of psoriasis: the Copenhagen Psoriasis Severity Index

BRITISH JOURNAL OF DERMATOLOGY, Issue 2 2008
J. Berth-Jones
Summary Background, There is a perceived need for a better method for clinical assessment of the severity of psoriasis vulgaris. The most frequently used system is the Psoriasis Area and Severity Index (PASI), which has significant disadvantages, including the requirement for assessment of the percentage of skin affected, an inability to separate milder cases, and a lack of linearity. The Copenhagen Psoriasis Severity Index (CoPSI) is a novel approach which comprises assessment of three signs: erythema, plaque thickness and scaling, each on a four-point scale (0, none; 1, mild; 2, moderate; 3, severe), at each of 10 sites: face, scalp, upper limbs (excluding hands and wrists), hands and wrists, chest and abdomen, back, buttocks and sacral area, genitalia, lower limbs (excluding feet and ankles), feet and ankles. Objectives, To evaluate the inter-rater and intrarater reliability of the CoPSI and to provide comparative data from the PASI and a Physician's Global Assessment (PGA) used in recent clinical trials on psoriasis vulgaris. Methods, On the day before the study, 14 dermatologists (raters) with an interest in psoriasis participated in a detailed training session and discussion (2·5 h) on use of the scales. On the study day, each rater evaluated 16 adults with chronic plaque psoriasis in the morning and again in the afternoon. Raters were randomly assigned to assess subjects using the scales in a specific sequence, either PGA, CoPSI, PASI or PGA, PASI, CoPSI. Each rater used one sequence in the morning and the other in the afternoon. The primary endpoint was the inter-rater and intrarater reliability as determined by intraclass correlation coefficients (ICCs). Results, All three scales demonstrated ,substantial' (a priori defined as ICC > 80%) intrarater reliability. The inter-rater reliability for each of the CoPSI and PASI was also ,substantial' and for the PGA was ,moderate' (ICC 61%). The CoPSI was better at distinguishing between milder cases. Conclusions, The CoPSI and the PASI both provided reproducible psoriasis severity assessments. In terms of both intrarater and inter-rater reliability values, the CoPSI and the PASI are superior to the PGA. The CoPSI may overcome several of the problems associated with the PASI. In particular, the CoPSI avoids the need to estimate a percentage of skin involved, is able to separate milder cases where the PASI lacks sensitivity, and is also more linear and simpler. The CoPSI also incorporates more meaningful weighting of different anatomical areas. [source]

International Emergency Medicine: A Review of the Literature from 2006

ACADEMIC EMERGENCY MEDICINE, Issue 12 2007
Adam C. Levine MD
The field of international emergency medicine (IEM) has grown rapidly over the past several decades, with a rise in the number of IEM fellowship positions, sustained growth in the international sections of major emergency medicine organizations, and an increase in the range of topics included under its rubric. One of the greatest obstacles to the continued growth of IEM remains the lack of a high-quality, consolidated, and easily accessible evidence base of literature. In response to this perceived need, members of the Emergency Medicine Residents' Association IEM Committee, in conjunction with members of the Society for Academic Emergency Medicine International Health Interest Group, embarked on the task of creating a recurring review of IEM literature. This article reviews 25 IEM research articles published in 2006. Research articles were selected for the review according to explicit, predetermined criteria that included both methodological quality and perceived impact of the research. It is the authors' hope that this annual review will act as a forum for disseminating best practices while also stimulating further research in the field of IEM. [source]

International Emergency Medicine: A Review of the Literature

ACADEMIC EMERGENCY MEDICINE, Issue 2 2007
Adam C. Levine MD
The field of international emergency medicine has grown rapidly over the past several decades, with an increase in the number of interested individuals and in the range of topics included under its rubric. One of the greatest obstacles, however, faced by international emergency medicine researchers and practitioners alike remains the lack of a high-quality, consolidated, and easily accessible evidence base of literature. In response to this perceived need, members of the Emergency Medicine Residents' Association International Emergency Medicine Committee, in conjunction with members of the Society for Academic Emergency Medicine International Interest Group, embarked on the task of creating a recurring review of international emergency medicine literature. Articles for this first annual review, covering research published in 2005, were selected according to explicit, predetermined criteria that included both methodological quality and perceived impact of the research. It is our hope that this annual review will act as a forum for disseminating best practices, while also stimulating further research in the field of international emergency medicine. [source]

Predictors of dental care utilization among working poor Canadians

COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 3 2009
V. E. Muirhead
Abstract,,, Objective:, This study used the Gelberg,Andersen Behavioral Model for Vulnerable Populations to identify predictors of dental care utilization by working poor Canadians. Methods:, A cross-sectional stratified sampling study design and telephone survey methodology was used to collect data from a nationally representative sample of 1049 working poor individuals aged 18 to 64 years. Working poor persons worked ,20 h a week, were not full-time students and had annual family incomes <$34 300. A pretested questionnaire included sociodemographic items, self-reported oral health measures and two dental care utilization outcomes: time since their last dental visit and the usual reason for dental visits. Results:, Hierarchical stepwise logistic analyses identified independent predictors associated with visiting the dentist >1 year ago: male gender (OR = 1.63; P = 0.005), aged 25,34 years (OR = 2.05; P = 0.02), paying for dental care with cash or credit (OR = 2.31; P < 0.001), past welfare recipients (OR = 1.65; P = 0.03), <21 teeth (OR = 4.23; P < 0.001) and having a perceived need for dental treatment (OR=2.78; P < 0.001). Sacrificing goods or services to pay for dental treatment was associated with visiting the dentist within the past year. The predictors of visiting the dentist only when in pain/trouble were lone parent status (OR = 4.04; P < 0.001), immigrant status (OR = 1.72; P = 0.006), paying for dental care with cash or credit (OR = 2.71; P < 0.001), a history of an inability to afford dental care (OR = 1.62; P = 0.01), a satisfactory/poor/very poor self-rated oral health (OR = 2.10; P < 0.001), number of teeth <21 (OR = 2.58; P < 0.001) and having a perceived need for dental treatment (OR = 2.99; P < 0.001). Conclusions:, This study identified predisposing and enabling vulnerabilities that jeopardize the dental care-seeking practices of working poor persons. Dental care utilization was associated with relinquishing spending on other goods and services, which suggests that dental care utilization is a competing financial demand for economically constrained adults. [source]

Parental Effort in Relation to Structural Plumage Coloration in the Mountain Bluebird (Sialia currucoides)

ETHOLOGY, Issue 9 2007
Susan L. Balenger
Indicator models of sexual selection suggest that costly ornaments signal reliable information regarding an individual's quality to potential mates. In species that produce altricial offspring, the amount of parental care provided by both males and females can impact reproductive success. The Good Parent Hypothesis proposes that ornamentation in biparental species can act as an honest signal of parental ability to potential mates. We tested this hypothesis using the mountain bluebird (Sialia currucoides), a sexually dichromatic, socially monogamous species in which both sexes have structurally based ornamental plumage coloration. A male's plumage color predicted neither the rate at which it provisioned nestlings nor brood growth rate. The same was true for females. We also found no indication of assortative mating by color or body condition. Feeding rates within pairs were positively correlated, which we suggest may be due to pairs responding similarly to the perceived needs of nestlings or to local area prey availability. In sum, our results do not support the Good Parent Hypothesis as an explanation for the evolution of ornamental plumage color in mountain bluebirds. We suggest alternative hypotheses for the evolution of ornamental plumage color in this species. [source]

Psychosocial Care Needs of Children With Recent-Onset Asthma

JOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING, Issue 1 2007
Angela M. McNelis
PURPOSE.,To examine psychosocial care needs of children with recent-onset asthma. DESIGN/METHODS.,Data were collected over 2 years from 63 children ages 8,14 years. RESULTS.,Children's need for attention to specific aspects of their asthma care remained high over the 2 years, as did their perceived needs for information and support and their concerns and fears. PRACTICE IMPLICATIONS.,Children have many needs, and healthcare professionals may not be providing care that addresses these needs. The Child Report of Psychosocial Care can be used as a quick tool to assess and guide interventions related to specific areas of need. [source]

Ethics in Neuroscience Graduate Training Programs: Views and Models from Canada

MIND, BRAIN, AND EDUCATION, Issue 1 2010
Sofia Lombera
Consideration of the ethical, social, and policy implications of research has become increasingly important to scientists and scholars whose work focuses on brain and mind, but limited empirical data exist on the education in ethics available to them. We examined the current landscape of ethics training in neuroscience programs, beginning with the Canadian context specifically, to elucidate the perceived needs of mentors and trainees and offer recommendations for resource development to meet those needs. We surveyed neuroscientists at all training levels and interviewed directors of neuroscience programs and training grants. A total of 88% of survey respondents reported general interest in ethics, and 96% indicated a desire for more ethics content as it applies to brain research and clinical translation. Expert interviews revealed formal ethics education in over half of programs and in 90% of grants-based programs. Lack of time, resources, and expertise, however, are major barriers to expanding ethics content in neuroscience education. We conclude with an initial set of recommendations to address these barriers which includes the development of flexible, tailored ethics education tools, increased financial support for ethics training, and strategies for fostering collaboration between ethics experts, neuroscience program directors, and funding agencies. [source]

The development of a user-led clinical service for newly diagnosed rheumatoid arthritis patients.

MUSCULOSKELETAL CARE, Issue 4 2004
An action research study
Abstract Objective: To identify the clinical services required to meet the perceived needs of patients within the first 6,12 months following a diagnosis of rheumatoid arthritis in an orthopaedic NHS trust. Methods: An action research methodology was utilized. Twenty three newly diagnosed patients were asked to complete a questionnaire focusing on their needs at the time of diagnosis. The content included reactions to diagnosis, physical and psychological implications and clinical services that were required. A sub-sample of patients (n = 6) participated in an interview to explore these issues in more depth. A questionnaire was also distributed to 14 members of the multidisciplinary team (MDT) to ascertain their views on the purpose, content, and provision of a clinical service for newly diagnosed patients. Results: Eighteen patients agreed to take part (M:F, 9:9, age range 23,74 years, mean age 52.3 years, mean disease duration from diagnosis 16 weeks). Data from the questionnaires and interviews led to the following themes being identified: pre-diagnosis anxiety and fear, the impact of the diagnosis, physical and psychological implications of the diagnosis, and issues related to control perceptions. There was concordance between the MDT and the patients regarding impact of the disease and the need for information. Areas of the service that were identified independently by patients related to the importance of the period of time pre-diagnosis while awaiting the hospital appointment, and employment issues. Conclusions: This study has identified the impact of RA in the early stages of pre- and post- diagnosis on physical, psychological and social functioning and has consequently informed service development. Copyright © 2004 Whurr Publishers Ltd. [source]