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Biomedical subjects

M Crotty

Publications and source records attributed to M Crotty.

At least 37 records · Page 2Linked to original sources
PubMed1995

An international comparison of the estimated effect of the aging of the population on the major cause of disablement, musculoskeletal disorders.

OBJECTIVE: To illustrate quantitatively the effect of the aging of the population on the prevalence of chronic disorders by comparing the projected frequency of musculoskeletal (MSK) disorders in 3 comparatively "young" countries, Australia, Canada, and the United States, and 3 comparatively "old" countries, France, the United Kingdom, and Sweden. METHODS: Age specific rates for MSK disability in Canada were applied to World Bank population estimates and projects to estimate prevalence rates and numbers of persons with MSK disability in the years 1985, 2000, 2010, and 2020. RESULTS: The age structure of the populations affected baseline rates for MSK disability. Increases in both prevalence and numbers affected are expected for all countries between 1985 and 2020, up to a 34% increase in prevalence in Canada, and an 88% increase in numbers in Australia. CONCLUSION: The aging of the population is likely to result in a disproportionate increase in the number of people with chronic disabling disorders, which will be taking place against a background of a decreasing or static number of young adults, with implications for meeting needs for health care and community support.

Adolescent↗
PubMed1994

The psychosocial and clinical status of younger women with early rheumatoid arthritis: a longitudinal study with frequent measures.

A longitudinal study of 75 young women (median age 43 yr) with early RA was performed with psychological, clinical and functional status measured every 4 months for up to 44 months. The aim was to describe functional changes, and to estimate the association between psychosocial variables and function in the early years after diagnosis. Function was measured by the Stanford Health Assessment Questionnaire (HAQ) and improved on average by about 10% per year with most improvement occurring over the first year. Pain and psychosocial variables also improved over time. There was still a residual improvement in HAQ with time of about 4% per year not accounted for by changes in these measured variables. When examined over time, psychosocial variables were as important as disease and pain in determining function. The results suggest interventions based on the importance of maintaining social relationships could impact on function.

Adolescent↗
PubMed1993

Clinical rheumatology training of Australian medical students. A national survey of 1991 graduates.

OBJECTIVE: To describe Australian medical graduates' knowledge, experiences and practical training in rheumatology and their attitudes towards rehabilitation and disability. DESIGN: Cross-sectional survey of all interns at randomly selected hospitals in each State. PARTICIPANTS: 382 Australian interns at 12 hospitals surveyed in the first week of their 1991 internship. RESULTS: New interns demonstrated little experience with soft tissue rheumatism, with only 45% reporting they had examined a patient with bursitis and 22% one with epicondylitis. There was considerable dissatisfaction with the teaching of assessment of low back pain, regardless of the amount of formal rheumatology teaching the graduates had experienced, with only 22% rating it as good or excellent. There was little evidence that students are exposed to the social dimensions of chronic illness; only 32% of students reported that they had been shown how to assess a patient's psychological adjustment to illness. Only 22% felt competent at assessing disability and handicap and less than half of the graduates studied had ever attended a clinic where there was a physiotherapist. Graduates who had never been attached to either a rheumatology ward or an outpatients clinic (17%) were less likely to have examined a patient with gout (P < 0.001), osteoarthritis (P < 0.01), or chronic low back pain (P < 0.05), and were more likely to report dissatisfaction with training in rheumatology. CONCLUSION: This survey suggests that there are significant problems in the training of medical students in musculoskeletal disorders, particularly in relation to the assessment of disability and the appreciation of psychosocial factors.

Adult↗
PubMed1993

Curriculum issues related to the newly developed nursing diploma courses.

This paper discusses the findings related to curriculum issues in the newly developed nursing diploma courses. The study, of which this aspect is a part, explored the emerging role of the nurse teacher within the new programmes in England. Data were collected by a Delphi Survey followed by in-depth interviews with a sample of the Delphi respondents. The findings from the interviews revealed that the six colleges involved had all adopted a process approach to the development of their new curricular. The educational philosophy and the curriculum approach in each college focused on the development of the individual and the adult theory of learning. A strategy for curriculum evaluation was found to be in the early stages of development for which no model or framework had been identified.

Curriculum↗
PubMed1993

The changing role of the nurse teacher.

This paper concludes a series on the findings from a study on the emerging role of nurse teachers in Project 2000 programmes. The various aspects of the study, including the literature review and methodology, have been previously discussed (Crotty & Butterworth 1992, Crotty 1992, Crotty 1993a,b,c,d). This paper highlights the main findings and suggests recommendations regarding the key issues to be addressed in the future role and preparation of the nurse teacher. The study revealed two major changes which are contrary to the expectations of Project 2000. These are firstly, the teaching of academic subjects by nurse teachers, and secondly, the rejection of clinical teaching involving 'hands on care' by nurse teachers.

Delphi Technique↗
PubMed1993

The emerging role of the British nurse teacher in Project 2000 programmes: a Delphi survey.

The findings of a three-round Delphi survey, conducted to explore the role of the British nurse teacher as it emerges within Project 2000 programmes, are discussed. The panel of experts comprising 201 grade 2 nurse teachers was drawn from the 25 of the 28 colleges in England who had implemented Project 2000 between September 1989 and April 1991. The findings highlight the complex and multifaceted role of the nurse teacher and the changes which are occurring in the role. Currently, the main changes are related to teaching and learning activities. These emphasize the depth, level and specialist nature of the teaching, and teaching on a variety of courses at diploma and degree level. Assessment activities are given the highest overall rating as important, and recruitment activities the lowest, in both the current and future roles. Educational management and administrative activities are found to be numerous and currently do not appear to be declining. The few changes that have occurred to the administrative areas have been replaced with similar activities. Another important area for the future was perceived to be research activity. In view of the developing partnership with higher education in the United Kingdom, this is not a surprising finding.

Delphi Technique↗
PubMed1993

Clinical role activities of nurse teachers in Project 2000 programmes.

This paper presents the findings related to the clinical role activities of nurse teachers in Project 2000 programmes. Data were collected by a Delphi survey of 25 colleges of nursing that had implemented Project 2000 between September 1989 and April 1991. The findings from the Delphi survey were explored more fully through in-depth interviews with a sample of the respondents. The findings identified a very strong commitment of the respondents to a clinical liaison role. But they did not perceive their role to be one of teaching students through 'hands on care'; they felt this was the role of the qualified staff in the clinical areas. The respondents considered it important to maintain their clinical credibility through theoretical updating rather than being able to perform as an expert practitioner.

Clinical Competence↗
PubMed1993

The influence of educational theory on the development of nurse training to education in the United Kingdom.

This paper discusses the development of nurse training to education from its historical apprenticeship-style approach to the current position of professional education through diploma-level programmes. The influence of education theory on nurse training over the years is explored. The slowness of the transition from training to education is shown to have been dependent on the view of what is considered as appropriate preparation for the role. Historically, one can see that it was expedient that preparation for the role began as training, and the development to education was thwarted by the lack of resources, the shortage of nurses, and the medical and political ideologies of the day. The implementation of Project 2000, with students being supernumerary to the workforce, and the programme being educationally led, created the need for the development of professional education from the traditional training model.

Curriculum↗
PubMed1993

Will facilitators be acceptable in Australian general practice? A before and after feasibility study.

AIM: To describe the impact of the 'facilitator model' of promotion on two Australian general practices. METHOD: Attitudes and health promotion levels were evaluated before and after the facilitator worked with two practices. RESULTS: Simple changes to patient records were the most successful. CONCLUSION: Facilitators are acceptable and long term organisational changes can be achieved.

Australia↗
PubMed1992

The perceptions of nurse teachers regarding the preparation for their role in Project 2000 programmes.

This paper discusses the findings related to the perceptions of nurse teachers regarding the preparation for their role in Project 2000 programmes. Data were collected by utilising three rounds of a Delphi survey with a panel of experts made up of Grade 2 nurse teachers. The panel of 201 respondents was obtained from 25 of the 28 colleges of nursing and midwifery that had implemented Project 2000 between September 1989 and April 1991. The profile of the respondents revealed that 68% work in general nurse courses, 18% in mental health, 8% in mental handicap and 6% in child care. Over half of the respondents hold a degree related to health care and over a quarter are studying for one. The findings suggest that the nurse teachers working in Project 2000 programmes consider their teacher preparation course an important means of preparation for the activities within their role. Degree and diploma courses are also considered important along with additional professional qualifying courses and subject related courses. What did not appear evident was any preparation for the many specific activities they carry out apart from teaching. Experience came out strongly as an important means of preparation for all the activities. Staff development programmes were said by 52% of respondents to be organised within their colleges and perceived by many as an important means of preparation.

Attitude of Health Personnel↗
PubMed1992

The emerging role of the nurse teacher in Project 2000 programmes in England: a literature review.

This paper explores the literature on the role of the nurse teacher in the United Kingdom, in order to support a research study on the role of the nurse teacher as it emerges in Project 2000 programmes in England. Explicit within the reform of nurse education is a change in the role of the teacher. It is being influenced, first, by the creation of colleges of nursing and midwifery and their links to higher education, secondly, by the content and academic level of the course and, thirdly, by the supernumerary status of the student. Studies carried out on the activities nurse teachers undertake highlight the complex and multifaceted nature of the role. Excessive paper work, meetings and lack of autonomy are given as dissatisfying aspects of their work leaving only a small proportion of their time for classroom and clinical teaching. The literature suggests that the nurse teacher is required in Project 2000 to be a nurse, a teacher, a graduate in a specialist subject and clinically and academically credible. The study, which is mentioned briefly in this paper, will critically analyse the key components of the role of the nurse teacher as it emerges in the Project 2000 courses in England. The methodology and findings will be discussed in a later paper.

Counseling↗
PubMed1990

The perceptions of students and teachers regarding the introductory module of an enrolled nurse conversion course.

This study sets out to explore the perceptions of students' and their teachers' regarding the Introductory Module of a course to convert Enrolled Nurses to Registered General Nurses. The course has been developed as a joint venture with two local Schools of Nursing as an experiment in joint course management. An illuminative evaluation approach has been adopted utilising the techniques of observation, questionnaires and interviews, in order to provide information by a variety of means upon which the course management team can base their future decisions regarding the course. The findings suggest that the introductory module was perceived by the students and teachers as a valuable learning experience. Issues specific to the course which were highlighted included the need for the involvement of the course teachers from each School of Nursing in the teaching programme, the introduction of negotiated student learning, a joint approach to the assessment of theory and practice and a modification of the maternity and community care experience. General issues related to the students as mature learners included the need for pre-course preparation for the students, the assessment of individual learning needs, the inclusion in the content of essay writing skills and stress management and the need for a comprehensive staff development programme for the teaching staff. The study highlighted the need for evaluation of nurse education programmes and teaching methods in order to provide professional accountability and to ensure nurse education practice is research-based.

Curriculum↗
PubMed1989

Using an alternative model to design a registered general nurse curriculum.

This paper suggests that in view of the recent changes in nurse education an alternative to the behavioural objectives model may need to be considered for designing a Registered General Nurse curriculum. The Foundation Module of a programme is used as an example to show that a process approach could be an appropriate alternative.

Adult↗
PubMedDate not supplied

Home rehabilitation for older adults with fractured hips: how many will take part?

Rehabilitation at home is a new 'technology' which has been promoted as an efficient alternative to hospital rehabilitation for older patients with conditions such as fractured hip. In Australia, no formal description of elderly patients with fractured hips likely to be eligible for home rehabilitation has been made and the acceptability of such services is unclear. Using information obtained prospectively from a consecutive sample of 188 patients with a fractured hip we describe the characteristics of older adults who were eligible for a trial examining home versus hospital rehabilitation. While staff assessed 36% of patients as eligible, only 20% were both eligible and agreeable. Reasons for refusal to participate included a preference for inpatient rehabilitation (26%), family reluctance (26%) and anxiety regarding the ability to manage at home (16%). Our results suggest that home rehabilitation is suitable for the least disabled group but is still unacceptable to many elderly patients and their families. As the population ages and hip fractures increase, home rehabilitation in its current form will have little impact on future bed needs.

Aged↗
PubMedDate not supplied

Planned homebirths in South Australia 1976-1987.

Homebirths booked with a group of general practitioners and midwives in South Australia in 1976-1987 are described using data obtained from midwives' and hospital records. The births represented 84.7% of all births occurring at home in South Australia in 1984-1987, as assessed by official birth registrations. Of the 799 women intending to deliver at home, 136 (17.0%) required transfer to hospital before or during labour. A further 38 mothers or babies (4.8%) required transfer after delivery. The women tended to be of a relatively high socioeconomic status and older age distribution when compared with women who had hospital births as identified from the State perinatal data collection. Some had recognised pregnancy risk factors. They had lower frequencies of ultrasound examination, induced labour, epidural analgesia, episiotomy, forceps delivery and caesarean section, and a low frequency of use of oxytocics for the third stage. Their rates of postpartum haemorrhage and, in particular, perinatal mortality were higher. Potential sources of risk and difficulty in homebirth care and evaluation of this care are identified and an approach to providing an effective homebirth service is proposed.

Adolescent↗
PubMedDate not supplied

Collaboration in nursing education.

The process of development of a collaborative link between the United Midlands College for Nursing and Midwifery and Coventry Polytechnic is described. The process, which began early in 1990, has already brought benefits for the staff and students of both institutions. Evaluation of the arrangement will be ongoing, and will take into account national and regional developments in funding and organising nursing and midwifery education.

Education, Nursing↗