Browsing by Subject "Quality of Health Care"

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    An audit of diabetic care provided to patients conducted by a doctor-nurse team in a general practice
    (1998) Navsa, Desiree Miriam; Schweitzer, B
    Introduction: I am a general practitioner in solo practice in Athlone. I work closely with a qualified nursing sister. Many of the patients we attend to have non-insulin dependent diabetes mellitus. Aim: To implement change in the management of our patients with diabetes by developing a protocol for future improved care. Objective: To assess the quality of care provided to patients with (NIDDM), by a doctor - nurse team in private general practice. Method : The study was quantitative and qualitative and consisted of 3 sections : 1) an internal audit based on the retrospective examination of patients' medical records, 2) a questionnaire which was administered to determine patients' knowledge of their disease and 3) a focus group interview which centred around patients' experience of the disease and feelings about the service provided. The interview was audio taped. Findings: Problem areas identified were sub-optimal record keeping; poor attendance and infrequent eye and foot examinations; patients' knowledge of their disease was limited; certain aspects of doctor-patient and patient-family relationships that may impact negatively on care; fears and anxieties relating to the disease and perceptions oflocus of control as external.
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    Building the capacity of policy-makers and planners to strengthen mental health systems in low- and middle-income countries: a systematic review
    (2016) Hanlon, Charlotte
    Abstract Background Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. Methods We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Results Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. Conclusions This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches.