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Mental Health Services Research

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❶In some schools around the country serious obstacles such as those mentioned above are more commonplace than others, and less serious problems are routine.


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In the presentation, we will discuss data analysed with the methodology of Interpretative Phenomenological Analysis IPA , focusing on the embodied reflexive becoming of the interactions with the participants. The main findings indicate that the experience of affect and positive or negative emotions of mental health professionals in their work with refugee clients can have an intense emotional impact which is conducive to the development of psychological resilience, while fostering greater self-awareness and meaning attributed to their work and life in general.

Another important finding involved an urgent call advanced by the participants for supervision by experienced on the field professionals in order to cope with the affects in the field.

This in turn affected the researcher in a number of ways such as being a bit hesitant or worried before meeting with the participants. Therefore, we propose reflexively that both the precarious work conditions in the refugee context of Greece and the intense emotional impact of participants can affect the participants into assuming an apprehensive stance concerning their participation in the study and self-disclosing, which in turn brings to light the many ways that precarious work conditions in Greece can influence the research procedure.

Providing effective mental health services requires knowledge about and cultural competence across a wide array of beliefs and practices. This study provides an example of a successful project to improve public mental health service This study provides an example of a successful project to improve public mental health service delivery in an Amish community. County boards of mental health in a rural area of Northeast Ohio contacted researchers in to provide assistance in reaching the Amish community because of a concern that mental health services were not being utilized by the Amish population.

Following meetings with community leaders, changes were made to improve the relationships of service providers and public funding agencies with the local Amish community, disseminate information about mental health concerns and services, and improve accessibility to mental health services. Contribution of the voluntary sector to mental health crisis care in England: Timely access to the right kind of support for people experiencing a mental health crisis can be problematic.

The voluntary sector VS plays a key role in providing support and enabling access, but there is a knowledge gap The voluntary sector VS plays a key role in providing support and enabling access, but there is a knowledge gap concerning its contribution and interface with public services in mental health crisis care. This study aims to address this.

The study has three empirical elements: Data collection will involve interviews with commissioners; VSO and NHS or local authority providers; and focus groups with people who have experience of VSO crisis support, both service users and carers; and mapping the crisis trajectory of 10 service users in each study site through narrative interviews with service users and informal carers to understand the experience of VSO crisis care and its impact.

Ethical review by the Health Research Authority will be required for the case study research once the sites have been identified from the first two elements of the study. A range of methods including a policy seminar, publication in academic journals and a tool kit for commissioners and practitioners will be produced to maximise the impact of the findings on policy and practice. The objective of this article is to discuss the strategies used by different groups of people who hear voices, to cope with such experience.

This is an ethnographic study carried out with Italian groups of voice listeners. The workshop Mapping new voices: This workshop aims to explore a range of issues, including: A cross-sectional study design was used to examine the associations of ethnic identity, acculturation, and psychiatric service utilization among Wave 2 respondents of the National Epidemiologic Survey on Alcohol Related Conditions with Weighted multivariable regression analyses were conducted to examine the relationships between ethnic identity, acculturation, and month psychiatric service utilization.

Pre operatif merupakan persiapan pasien sebelum dilakukan tindakan operasi, pada tahap ini pasien sering mengalami kecemasan. Kecemasan merupakan respon fisiologis dan psikologis individu terhadap keadaan yang dianggap mengancam karena Kecemasan merupakan respon fisiologis dan psikologis individu terhadap keadaan yang dianggap mengancam karena akan di operasi.

Rasa cemas ini dapat menyebakan kegagalan atau penundaan tindakan operasi. Untuk mengurangi kecemasan tersebut maka diperlukan dukungan dari keluarga. Dukungan keluarga yang diberikan keluarga itu sendiri yakni berupa informasi, motivasi, instrumental dan emosional. Penelitian ini bertujuan untuk mengetahui hubungan dukungan keluarga dengan kecemasan pasien pre operatif di RSU Sari Mutiara Medan. Jenis penelitian ini adalah jenis penelitian analitic corellational dengan pendekatan cross sectional.

Sampel dalam penelitian ini sebanyak 36 orang, tehnik pengambilan sampel yaitu purposive sampling. Disarankan kepada kelurga untuk selalu memberikan dukungan bagi anggota keluarga pre operatif sehingga dapat mengurangi kecemasan yang dialami anggota keluarga pre operatif.

The objective of the MindsTogether project has been to provide decision makers with evidencebased information about effective models for mental health and addiction services. The project consisted of a literature review, expert interviews, general public survey, and focus group work with experts by experience.

A draft of the effective mental health and substance abuse service models was openly available for comments on the Ota kantaa public participation portal. Emphasising service models that are evidence-based or established good practices is highlighted as a key perspective in the report. The opportunities to reform mental health and substance abuse services that new operating models, which are person-centred and support inclusion and peer experience, have created also emerges as a main finding.

Existing evidence supports integration of basic mental health and substance use services with primary care. A multi-stakeholder approach, which includes complementary services provided by the third sector, is recommended. According to the analysis, investing in mental health services and mental health promotion enables a significant reduction of indirect costs, like production costs, caused by mental health problems.

At given times, this office will also provide:. Some schools with a large student immigrant population may offer immunization clinics with community health organizations American Academy of Pediatrics, Annual vision and dental screenings and referrals are most valuable to those families who would otherwise not seek this preventive health care American Academy of Pediatrics, In some schools, a specially trained nurse may provide physical examinations for those students who may have no other way to get this well-child health care.

The school health office can also provide preventive counseling services to students, addressing such concerns as cigarette smoking, drugs and alcohol, HIV and AIDS, eating disorders, issues having to do with puberty and adolescence, and health-related learning disorders.

Some students may have behavioral and health concerns School Health Services Overview In most areas of the country, the role and scope of school health services have evolved according to the changing social environment of the population. Applications The School Health Office The staff of the school health office provides the core services of screening, diagnostic treatment, and health counseling services within the school.

At given times, this office will also provide: Administrative data can efficiently provide quality and outcomes indicators for defined populations and for health systems. Other applications of administrative data include assessing efficiency, timeliness, and equity.

The limitation is that there are many health conditions and health outcomes that cannot currently be measured using administrative data. Survey questionnaires are routinely used to obtain information on patient satisfaction in health plans. Information on the impact of health conditions on health and functional status has to come from the patient. This may be obtained at the time of a visit or hospitalization. However, to assess patient outcomes of care, systematic followup of patients after the completion of treatment is generally required.

This can be done using mail questionnaires, telephone interviews, or in-person interviews. The HSR field has developed health-status and quality-of-life measures that can be used no matter what health conditions the patient has.

Effectiveness research relies on a range of data sources. Some are routinely collected in the process of medical care and patient billing.

Efficient strategies for examining effectiveness may use administrative data to examine a limited set of data on all patients, and a statistically representative sample of patients for in-depth analysis using data from chart abstracts and survey questionnaires.

HSR research tools can be applied in clinical settings to improve clinical practice and patient outcomes. These tools are used as part of quality improvement programs in hospitals, clinics, and health plans. Two examples illustrate applications to improve quality-of-care performance. For many chronic medical conditions, clinical research has evaluated the efficacy of diagnostic methods and treatment interventions.

As a result, evidence-based reviews of research literature can provide a basis for establishing quality-of-care criteria against which to judge current practice. In a national study of quality of medical care, it was found that only 55 percent of patients received evidence-based treatments for common disorders and preventive care. For each quality criterion, a classification was applied to determine if the quality-of-care deficiency was one of underuse, overuse, or misuse.

Greater problems were found with underuse 46 percent than with overuse 11 percent. Quality of care varied by condition: Overall, only about half of recommended care was received, frequently due to underuse of services. Researchers have sought to identify why rates of conformance with evidence-based treatments are low. Frequently cited barriers to evidence-based practice include physician disagreement with the evidence, perception that patients will not accept treatment, low ratings of self-efficacy as a provider of the treatment, and difficulty of integrating the evidence-based treatment into existing practice.

The described data sources and methods can be applied in clinical settings to assess conformance to evidence-based quality criteria and provide feedback to clinicians. If electronic health records are available, the feedback and reminders may be directly incorporated into the medical record and seen by the clinician at the time of a visit.

Intermountain Health Care utilizes its electronic health records to monitor adherence to evidence-based quality standards and to provide decision support to clinicians when seeing patients.

This strategy has contributed to substantial improvements in their quality performance. In , the Managed Health Care Association, an employer organization, brought together a group of employers and their health plan partners who were interested in testing the OMS concept in health plans. The methodology chosen was for each of 16 health plans to identify all adult enrollees with at least two diagnoses of asthma over the previous 2 years.

A stratified sample was chosen with half of the enrollees having more severe asthma e. Each adult received a questionnaire asking about their asthma treatment and health status. Followup surveys were done in each of 2 successive years to track changes over time. The findings were compared to national treatment recommendations for adult asthma. Approximately half of adults with asthma reported having the information they needed to avoid asthma attacks, to take appropriate actions when an asthma flare-up occurs, and to adjust medications when their asthma gets worse.

Health plans used the baseline findings to develop quality-improvement interventions, which varied across health plans. Followup surveys of the patient cohort provided feedback to health plans on their success in improving asthma treatment and outcomes over time.

This chapter has provided a definition and history of the field of health services research and discussed how this field is examining quality-of-care issues and seeking to improve quality of care. Comparisons of current practice to evidence-based standards with feedback to clinicians and the integration of patient-reported outcomes are two examples of how HSR tools can be used to provide quality-improvement information for health care organizations. These examples utilize multiple data sources, including medical records, patient surveys, and administrative data.

The opportunities for nurse researchers to provide invaluable contributions to the growing field of health services research are innumerable. Turn recording back on. National Center for Biotechnology Information , U. Show details Hughes RG, editor. Chapter 8 Health Services Research: Scope and Significance Donald M. Author Information Donald M. Background The provision of high-quality, affordable, health care services is an increasingly difficult challenge.

This was expanded upon in by AcademyHealth, the professional organization of the HSR field, with the following definition, which broadly describes the scope of HSR: History of Health Services Research The history of HSR is generally considered to have begun in the s and s with the first funding of grants for health services research focused on the impact of hospital organizations.

Goals for Health Services and Patient Outcomes The goal of health services is to protect and improve the health of individuals and populations. Patients should not be harmed by health care services that are intended to help them. Subsequent research has found medical errors common across all health care settings.

Effective care is based on scientific evidence that treatment will increase the likelihood of desired health outcomes. Evidence comes from laboratory experiments, clinical research usually randomized controlled trials , epidemiological studies, and outcomes research.

The availability and strength of evidence varies by disorder and treatment. Failure to provide timely care can deny people critically needed services or allow health conditions to progress and outcomes to worsen.

Health care needs to be organized to meet the needs of patients in a timely manner. Health care services should be personalized for each patient, care should be coordinated, family and friends on whom the patient relies should be involved, and care should provide physical comfort and emotional support. The health care system should benefit all people. The evidence is strong and convincing that the current system fails to accomplish this goal. The IOM report, Unequal Treatment , 32 documented pervasive differences in the care received by racial and ethnic minorities.

The findings were that racial and ethnic minorities are receiving poorer quality of care than the majority population, even after accounting for differences in access to health services.

Evaluating the Quality of Health Care HSR evaluation of quality of care has proven to be an inexact science and complex, even though its definition is relatively simple: Structure of Health Care The structure of health care broadly includes the facilities e. Process of Care The interactions between the health care providers and patients over time comprise the process of health care.

Outcomes of Care The value of health care services lies in their capacity to improve health outcomes for individuals and populations. Public Health Perspective on Health Services Another perspective on health care services comes from the field of public health in which preventive health services are conceptualized at three levels: Methodologies and Data Sources Used in Health Services Research The interdisciplinary character of HSR draws on methods and data sources common to the many disciplines that form the intellectual underpinnings of the field.

Efficacy and Effectiveness An important distinction is made between efficacy and effectiveness of health services. Methods for Effectiveness Research A variety of methods are used to examine effectiveness of health services. RCT and Policy Research RCT study methods can be used to compare the effectiveness and costs of services across randomly assigned representative population groups. Health insurance experiment Probably the first application of RCT methods in effectiveness research was undertaken in the s as a health insurance experiment.

Comparing Effectiveness and Costs Across Nonequivalent Groups A range of statistical methods can be used to compare nonequivalent groups i. Data Sources for Effectiveness Research A range of data sources is used in effectiveness research, including administrative and billing data, chart reviews and electronic health records, and survey questionnaires.

Administrative and billing data Health care providers generally have administrative and billing data systems that capture a limited and consistent set of data on every patient and service provided. Evidence-based treatment For many chronic medical conditions, clinical research has evaluated the efficacy of diagnostic methods and treatment interventions.

Conclusion This chapter has provided a definition and history of the field of health services research and discussed how this field is examining quality-of-care issues and seeking to improve quality of care. Improving information services for health services researchers: National Academy Press; Harvard University Press; Report on health services research. Strategic choices for a changing health care system. Health Administration Press; Methodological advances in health serivces research.

Health services research methods. Delmar Publishers, Inc; Improving health policy and management: Agency for Healthcare Research and Quality. National health care quality report. Department of Health and Human Services; National health care disparities report.

Department of Health and Human Services. Government Printing Office; Nov, Centers for Medicare and Medicaid Services. Medicare demonstration shows hospital quality of care improves with payments tied to quality. Disentangling physician sex and physician communication style: Epub May 4. PMC ] [ PubMed: Am J Public Health.

Averill RF, Goldfield N. The causal texture of organizational environments. The evolution of organizational environments. Committee on the Costs of Medical Care. The five-year program of the committee on the costs of medical care. The social transformation of American medicine: Coalition for Health Services Research. Federal funding for health services research.

Committee on Quality of Health Care in America. Crossing the quality chasm: To err is human: Anell A, Willis M. International comparison of health care systems using resource proviles. Bull World Health Organ.

Sochalski J, Aiken LH. Accounting for variation in hospital outcomes: Starfield B, Shi L. Policy relevant determinants of health: Toward higher-performance health systems: Evaluating the quality of medical care.

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In most areas of the country, the role and scope of school health services have evolved according to the changing social environment of the population. School health services' main objectives are. View Mental Health Services Research Research Papers on for free.