Benefits of comprehensive health care for improving health outcomes in women.

The American Psychological Association Health Care for the Whole Person Task Force was formulated to provide a rationale for integrating behavioral health services in primary care. Collectively, the task force called for a transformation of the biomedical system into one based on the biopsychosocial model. This article is a summary of the Women's Health Committee position paper that reviewed contextual factors in women's health, provided recommendations for clinical service action, and recommended an integrated primary health care system to address women's health needs. This article provides a vision of integrated care and a practical guide for psychology practitioners as they collaborate with other health care providers and health policy groups to improve health outcomes for women over the life course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The selective impairment of the perception of first-order motion by unilateral cortical brain damage

The report of an international experts' committee, recently invited by the Ministry of Health to review Greece's health care system, recommended the creation of a network of family doctors, reimbursed on a capitation basis. The committee also proposed that family doctors should manage a budget for the purchase, on behalf of their patients, of specialist and hospital services and drugs. The author examines the exportability of the fundholding experience from Britain to a country in which health care organization is very different, social health insurance is fragmented, private health care is large and growing, ambulatory health care services are provided by specialists, and behavioral-cultural factors cast doubt on the consequences of the proposed change. An attempt to implement fundholding in Greece is likely to have effects opposite to those intended. The more humble task of tackling the inequities and inefficiencies of the present system should be the starting point of all future reform projects.     

Valuing a practice for a partnership

The hot topic from Capitol Hill in Washington to Capitol Hill in Jefferson City is health care reform. President Clinton started the ball rolling during the campaign in 1992 by including health care reform in his platform. He continued the effort after his election by appointing his wife, Hillary, to chair a task force to present an outline for federal legislation. Since the package was presented to Congress, there has been much discussion, lobbying, and rumoring about the implications of health care reform and what it could mean to all of us as dentists. On the home front, Governor Carnahan has introduced legislation in Missouri to reform the health care system. This effort is known as the Missouri Health Assurance Plan (H.B. 1622). Missouri Dental Association members are vitally concerned about the impact of health care reform on their practice, their taxes, their relationship with their patients and employees, and on their ability to seek out health care services since each member is also a consumer of health care. This article represents answers to some of the questions being asked by MDA members in order that they might be more aware of the activities by the MDA, the ADA, and other levels of organized dentistry relating to health care reform.     

Development of a perioperative nursing diagnoses flow sheet

Traditionally, health care professionals in the preoperative, intraoperative, and postoperative phases of care have used perioperative records that focus on the technical aspects of the care provided (eg, blood pressure, pulse measurements; equipment used) and leave room for only short narratives to document nursing care. Such formats often do not document the multitude of activities or interventions perioperative nurses provide. The question raised at the DePaul Health Center, St Louis, was: "Where do we document our nursing diagnoses and plan of care?" The response was to create a nursing diagnosis task force that investigated the feasibility of a form professional nurses could use in all phases of patient care. This investigation led to the development, implementation, and universal use of a perioperative nursing diagnoses flow sheet within the surgical services department.     

Public and private responsibility for mental health services: A report on the Tennessee task force.

The "privatization" of mental health services during the last decade has literally reshaped the way state and county departments of mental health go about fulfilling their statutory responsibilities. In Tennessee, a conference and later a task force examined the implications of this trend for the future. Two issues came to the forefront: Is it appropriate or possible for the private sector to take over the delivery of all mental health services, and if so, who will ensure that the poor receive adequate care? The Tennessee task force concluded that the privatization trend is appropriate and should be encouraged by government. It further concluded that government is ultimately responsible for ensuring access to care for the poor and uninsured although private facilities should provide some free care. Government best serves the poor by providing them the financial means to purchase care from private providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quality management for psychology services in health care facilities.

Describes a model of quality management, designed by a task force of the Canadian Psychological Association, to meet revised standards of the Canadian Council on Health Facilities Accreditation for psychology services. The incorporation of aspects of Continuous Quality Improvement, Total Quality Management, Indicators, and Benchmarking are discussed in relation to their application to psychology services in health care facilities. The Quality Management Model is based on the assumptions that everyone wants to do their job well and improve in their job performance; that the improvement in the quality of services is everyone's responsibility; and that psychological service provision in a health care facility involves complex linkages between providers, suppliers, and customers. The model also assumes that the major problems affecting quality of service are usually those same linkages, or the customers themselves; and that identifying and monitoring these linkages is crucial to understanding how to improve quality. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Research and practice in health psychology.

The task force on research and practice in health psychology responded to three presentations on important issues. It was posited that clinical health psychology may represent the ideal specialty for scientist-practitioner training. There are exciting, important questions regarding health problems, health policy, and health treatment systems needing interdisciplinary research. Health psychologists are uniquely prepared to take a leadership role due to their training in both research and service delivery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The managed care backlash and the task force in California

Signs of a managed care backlash in California are increasing. This paper reports and interprets the recently completed work of the California Managed Health Care Improvement Task Force, focusing on the managed care backlash and the state's regulatory response. Although cost containment was a contributing factor, the causes of and solutions to the backlash differ among consumers, physicians, health care workers, politicians, and health plans. The recommendations of the task force could improve the market for health insurance. However, lasting solutions to the profound problems causing the backlash will require fundamental cultural and systemic change.     

Transforming Mental Health Care for Children and Their Families.

In April 2002, the President's New Freedom Commission on Mental Health was created by executive order to study the mental health care delivery system in our nation and to make recommendations for improvements so that individuals with serious mental disorders can live, work, learn, and fully participate in their homes and communities. In its report, "Achieving the Promise: Transforming Mental Health Care in America," the commission provided strategies to address critical infrastructure, practice, and research issues. This article focuses on the work of the commission's Subcommittee on Children and Families, describing its vision for mental health service delivery for children and providing suggestions for strengthening community-based care for youths with or at risk of behavioral health disorders. Training, research, practice, and policy implications for psychologists are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Supraannular aortic root enlargement in patients with small aortic annulus: efficacy and safety

In response to several women who presented with postpartum depression in 1 year, a group of nurses developed a task force made up of hospital nurses, obstetricians, psychiatrists, pediatricians, family practitioners, lactation specialists, home care nurses, and mental health counselors. The purposes of this task force were to educate health care professionals about postpartum depression, to help identify women who might be affected, and to develop interventions for adjusting to parenthood. This article details the evolution of that task force, and how it has assisted not only the women but also the health care providers involved.     

Shipboard women''s health care: provider perceptions

Women have served aboard auxiliary U.S. Navy ships as integrated members of the shipboard work force since 1978. In 1994, women first started serving aboard combatant ships with the inclusion of women in the work force of the aircraft carrier USS Dwight D Eisenhower (CVN 69). The provision of the highest standard of medical care for both men and women is a priority at all levels in the U.S. Navy. This study assesses the perceptions of shipboard health care providers regarding their ability to provide adequate women's health care. This evaluation was performed by conducting a personal interview with the senior health care provider of each of 32 ships on which women are integrated members of the work force. Medical department representatives reported that most ships have training programs for birth control (90.6%), sexually transmitted diseases (96.9%), and the Navy pregnancy policy (84.4%). Health care providers also reported limitations in available supplies (i.e., contraceptives, pregnancy tests, and sexually transmitted disease tests).     

Reconceptualizing Health: A Response to Romanow and Marchildon (2003).

The Commission on the Future of Health Care in Canada (CFHCC) is to be congratulated for addressing the tension among various levels of government regarding health-care funding. The CFHCC also took the progressive step of creating the National Health Council, a body charged with ensuring greater accountability in health care. Psychologists have argued for decades that treatment decisions should be guided by a consideration of what works for whom and under what conditions. In our response to Romanow and Marchildon (see record 2003-09748-001), we argue that funding of health services in Canada has failed to heed this recommendation and the scientific evidence in support of the efficacy of psychological interventions for a wide range of health conditions. Despite remarkable advances in healthcare delivery, Canada's health-care system continues to be funded based on an outdated model of disease and illness. Romanow and Marchildon are to be applauded for their broad conceptualization of health and the role of various health professionals in advancing the health of Canadians. Unfortunately, this recognition did not make its way into the report of the CFHCC to the extent needed to make Canada's health system truly progressive. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Report of the Task Force on the Role of Psychology in the Criminal Justice System.

The American Psychological Association's Board of Social and Ethical Responsibility for Psychology (BSERP) commissioned a Task Force on the Role of Psychology in the Criminal Justice System to examine the ethical dilemmas faced by psychologists working with police, court, correctional, and juvenile justice agencies. In this final report, the task force makes 10 recommendations regarding the ethical practice of psychology in these areas. Both ethical issues that the criminal justice system creates for psychologists and those that psychologists create for the criminal justice system are addressed. Under the former are issues relating to the psychologist's loyalty (e.g., confidentiality) and competence (e.g., the effectiveness of services). The most controversial issue faced by the criminal justice system is the use of psychologists as decision makers in the confinement and release of individual offenders (e.g., indeterminate sentences). (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief intervention, treatment, and recovery support services for Americans who have substance use disorders: An overview of policy in the Obama administration.

The Obama Administration plans to reinvigorate the U.S. system of care for substance use disorders through new health insurance parity regulations, the historic health care reform law (formally known as “The Affordable Care Act of 2010”), and the President's National Drug Control Strategy. Parity regulations and health care reform will significantly expand the availability of health insurance, and the proportion of health insurance plans that provide adequate benefits for substance use disorder care. The President's National Drug Control Strategy and Fiscal Year 2011 budget request make investments that will build on this foundation, including broad dissemination of screening, brief intervention and referral to treatment (SBIRT) techniques, integration of care for substance use disorders into Federally Qualified Health Centers and the Indian Health Service, augmentation of reentry programs and drug courts, creation of a pay for performance treatment quality initiative, and expansion of the Access to Recovery voucher program. Collectively, these policies will improve the quantity and quality of substance use disorder care and thereby promote public health and public safety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confirmatory factor analysis of the Consumer Assessment of Health Plans Study (CAHPS) 1.0 core survey.

The National Consumer Assessment of Health Plans Study (CAHPS) Benchmarking Database was used to assess the factor structure and invariance of the CAHPS 1.0 Core Survey. Separate analyses were conducted with Latino and non-Latino Caucasian consumers drawn from commercial and Medicaid sectors (N?=?15,092). Results demonstrated that the 23 CAHPS 1.0 report items measure consumer reports of experiences with 5 aspects of health plan performance: Access to Care, Timeliness of Care, Provider Communication, Health Plan Consumer Service, and Office Staff Helpfulness. Four items assessed global ratings of care. Analyses revealed an identical pattern of fixed and free factor loadings across all samples. Magnitude of factor loadings and correlations among factors was essentially equivalent within a common health service sector. A higher order factor analysis revealed that rating and reports of care showed marked convergence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarification and elaboration on evidence-based practice in psychology.

Responds to comments by D. C. Wendt and B. D. Slife (see record 2007-13085-019), P. H. Hunsberger (see record 2007-13085-020), and R. B. Stuart and S. O. Lilienfeld (see record 2007-13085-021) regarding the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. The goal of the task force was to create a scheme that would suggest how evidence should be used to design and offer services that will benefit patients and to assure the public and the health care system that psychologists are providing evidence-based services. There were and will continue to be many scientific and philosophical issues inherent in any such enterprise, and agreement by all psychologists with every aspect of EBPP may not be possible. Nevertheless, the APA's EBPP policy and the report that accompanied it are remarkably inclusive of various perspectives while remaining unambiguous about the need to use evidence in a way that leads to effective services. What is needed at this point are clinically relevant evidence and investigations of how such evidence can be used to best benefit those served by psychological interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care reform: The 1993–1994 evolution.

Health care costs in the US continue to increase, as does the number of individuals who lack health care coverage. The magnitude of these critical problems assures that reform of the health care system will continue to be debated over the next decade. Increasing health care costs are associated with increased complexity of services and a greater number of health care providers. As health costs increase and the number of individuals covered by private insurance decreases, states will face increasing pressure to develop effective methods of providing coverage for those without health insurance. Employer mandates will be viewed as one method of extending health coverage. Psychologists must be involved in policy issues so as to ensure the utilization of psychological knowledge and attention to psychological and behavioral health needs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Ontario Health Care Evaluation Network and the Critical Care Research Network as vehicles for research transfer

Facilitating the successful and consistent use of research results to support health care decisions is a formidable task. Barriers to effectively transferring the results of research into the decision-making process have been created between practitioners and researchers, who traditionally have worked in isolation from each other. The need for them to work cooperatively to break down these barriers is paramount as changes within the health care environment increase. The Ontario Health Care Evaluation Network (OHCEN) and the Critical Care Research Network (CCR-Net) have attempted to address these concerns by bringing together teams of researchers, practitioners, and administrative personnel with the purpose of equipping them with tools to meet oncoming health care challenges.