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31.
This paper describes the basic elements of practice development and management within the academic medical setting. These include assessment of the market environment, both in the community and within the medical setting, product development, marketing, budget basics, quality, managed care negotiations, and finding time to do research in a financially-driven health care system. 相似文献
32.
In this paper, we examine the termination of children's mental health services. Analyses were based on the 901 families in the Fort Bragg Evaluation Project who participated at Wave 1 and Wave 2 six months later. The project compared a full continuum of care provided at a demonstration site with traditional care at two comparison sites. The results showed that in most cases families and providers were partners in decisions to terminate treatment. About half of the clients self-terminated or were terminated solely at the discretion of the provider. Providers tended to play a more dominant role in terminating restrictive services; families played a more central role in terminating outpatient care. Regardless of initial psychopathology, children in single-headed households, whose parents were dissatisfied with services, did not expect their child to cooperate with treatment and did not expect treatment to help their child, were more likely to terminate care than others. While the Demonstration site had significantly fewer terminations, the sites did not differ with regard to the reasons for termination, who participated in termination decisions, or the factors that affected the likelihood to terminate care. Of most interest, mental health outcomes among children who had terminated all care did not vary by reasons for termination or by who participated in the termination decision. 相似文献
33.
John E. Carr G. Andrew H. Benjamin 《Journal of clinical psychology in medical settings》1997,4(2):143-153
Health care reform has put increasing pressure on faculty of medical schools to become self-supporting. Opportunities for clinical revenue will decrease, but psychologists who are able to generate research funding will become increasingly competitive, albeit as mercenaries, i.e., capable of paying their own way plus generating a profit to support departmental operations and educational programs. Changes in the health care system signal an end to psychiatry's paternalistic relationship to psychology and present opportunities for psychology proactively to influence its future role in health care. Research, political action, and revised scientific mission, models, and roles represent important strategies in the redefining of psychology as a basic science and major profession in health care. 相似文献
34.
After a short introduction into the changing nature of our society and organizations, we outline two kinds of flexibility of labor: qualitative flexibility, that is the degree to which people who work in or for a certain organization can and do perform different tasks, and quantitative flexibility, that is, varying the quantity of personnel and their working hours. Then, the different ways in which we organize our work and organizations are dealt with in terms of quantitative and qualitative flexibility. Next, we survey these ways of organizing on the degree to which they moderate the positive individual outcomes, or individual goals, of work. It can be concluded that quantitatively flexible work, besides some minor positive consequences, may have serious negative consequences for one's well-being, health, and personal development, while qualitative flexibility may have many more advantages, though it may lead to a devastating task overload. Last, we explore some ways to alleviate these negative effects. 相似文献
35.
The purpose of the study was to investigate occupational stress among Chinese factory workers (N=342), from three cities of South East China, using the shortened version of the Occupational Stress Indicator (OSI)-2. The
results showed that the reliabilities and predictive validity of the OSI-2 subscales and other subscales used for the study
were reasonably high. Quite a high percentage of workers perceived high work pressure. The main sources of stress were intrinsic
to the job; and the coping strategies that were most frequently used to tackle stress were “control” methods. In addition,
“satisfaction on environmental condition” seemed to be a common predictor for job satisfaction, and mental and physical well-being.
The logical relationships between job satisfaction, mental well-being and physical well-being in Chinese workers have provided
support to the findings obtained in Western countries. 相似文献
36.
Joseph Engelberg 《Integrative psychological & behavioral science》1997,32(2):143-148
This study is concerned with dynamic processes that underly the rapid, degenerative changes associated with the “dying” stage
of the multicellular organism's life cycle. The interaction between negative and positive feedback cycles is discussed: negative
feedback cycles underly the superstability characteristic of health and illness. When negative feedback cycles fade in the
dying phase of life, positive feedback cycles, previously held in check by the negative feedback cycles to which they had
been coupled, rise explosively, driving physiologic variables from their normal values towards extremes. This results in the
rapid downturn that we associate with dying—an accelerating disintegration terminating in death. A medical case history is
analyzed. 相似文献
37.
Recent federal policy has highlighted historically underrecognized women's health issues. Women comprise the majority of the population, especially the elderly. Women's health care needs, utilization patterns, and outcomes vary from those of men, and often among each other. Primary health care services for women are multidisciplinary and emphasize prevention, education, and early intervention as well as treatment. Psychologists and other primary health care providers can collaborate to provide their services in a cost-effective manner that optimizes quality of care and comprehensive health care. 相似文献
38.
James R. Rodrigue Russell G. Hoffmann Arista Rayfield Celia Lescano Wendy Kubar Randi Streisand Christine G. Banko 《Journal of clinical psychology in medical settings》1995,2(1):89-107
We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research. 相似文献
39.
F. Suzanne Talbert Peggy J. Wagner Lorraine C. Braswell Sakina Husein 《Journal of clinical psychology in medical settings》1995,2(2):133-148
The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician. 相似文献
40.
Beatriz Staghezza-Jaramillo M.P.H. Hector R. Bird M.D. Madelyn S. Gould Ph.D. Glorisa Canino Ph.D. 《Journal of child and family studies》1995,4(4):399-418
This paper examines those children receiving mental health services in Puerto Rico, their demographic and psychosocial characteristics, and describes service providers and nature of facilities. The survey was done on a probability sample of children ages 4 through 16 across the island of Puerto Rico (N=777). Need for services was clinically defined as presence of a DSM-III diagnosis and functional impairment. The overall rate of service utilization for Puerto Rican children was 6% (26.2% of definite cases and 5.1% of probable cases). In most cases services were provided by psychologists and/or social workers, and they were mainly provided in schools and general medical facilities. In over 60% of the children assessed as cases, who did not receive services, the reason, given by the parent was that they considered the problem not serious. Factors associated with service utilization were measures of psychopathology, teacher's perceived need, and parental rates of criticism and hostility. These findings suggest that there is a need for more research on the motivating factors for service use (impairment and parental criticism). Teachers could benefit from receiving special training to help them readily recognize behavioral problems in children, communicate them to parents and set up services alternatives. 相似文献