Melbourne School of Population and Global Health - Theses
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ItemA residency training programme in family medicine for the United Arab Emirates( 1997)The purpose of this study is the development of a residency based vocational training programme in Family Medicine. The starting point is United Arab Emirates medical graduates. Many will have been undergraduates at the United Arab Emirates University, but some will have done their medical courses at universities in other Gulf States or overseas. It is an essential study because there is not a programme available at this time in Family Medicine and largely untrained, expatriate medical practitioners with a basic MB BS or equivalent degree conduct family practice. (From introduction)
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ItemThe usage of psychotropic medications by family caregivers( 1996-07)This is a randomly selected, cross-sectional, population based study of women caring for family or friends who are elderly or have a long-term illness or disability. The purpose of the study was to investigate the usage of psychotropic medications by carers in order to identify predictors of usage of these medications relating to the caring situation. Data collected in 1993 by the Carers’ Program in the state of Victoria, Australia was used for statistical and qualitative analysis. The data base consisted of 157 carers and 219 non-carers. Women who had the main caring role for a relative or friend with a disability for at least 4 hours per week were selected for the study. Women who were living with a partner or children or both and had the main responsibility for household tasks but were not caring for someone with special needs were selected as the comparison group. Using this group of non-carers allowed direct comparison of carers and non-carers to be made and to identify the difference that the role of caregiving to someone with special needs makes when compared with usual family care responsibilities.
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ItemPleasure and poison: the meanings and practices of alcohol use in women's everyday lives( 1997-04)Within Australia, research on women and alcohol has been predominantly focussed on either large scale surveys of women’s consumption or on alcohol problems studies within treatment populations. Such research mainly draws upon the biomedical understandings of the body and the disease model of alcoholism. In contrast, this study examines the meanings and practices of alcohol use within the social contexts of women’s everyday lives. Alcohol is viewed as a part of life rather than as an excess or problem.
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ItemBreastfeeding experiences among employed women in Chiang Mai: complexities of combining women's roles( 1997-11)The purpose of this study is to investigate the experience of breastfeeding practices among employed mothers in Chiang Mai, Thailand. Chiang Mai is the second largest city following Bangkok (Thailand capital). Growth and development of Chiang Mai is rapid in terms of social and economic changes. Many women work outside the home as well as perform housework, and thus dual roles are common. Labour force participation for women in the childbearing years has increased rapidly, particularly in the non-agricultural sector. The demands of the formal labour market in the urban setting mean that most mothers must leave their children when they are working. These circumstances make combining reproductive and productive roles difficult, with possible implications for the breastfeeding relationship. Previous studies have produced ambiguous and contradictory findings about the links between employment and breastfeeding. (For complete abstract open document)
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ItemThe role of the general practitioner in postnatal care: an early intervention study( 1997)This thesis deals with the role of the general practitioner (GP) in postnatal care, especially the provision of and the most appropriate timing for the traditional postnatal check-up. Chapter 1 discusses the origins of postnatal care, the common morbidities, the lack of formal research in the area and the opportunity that the routine postnatal check-up presents to general practitioners. Chapter 2 shows, by the analysis of routinely collected Medicare data, that a mother and baby will have 7.7 visits (on average) to a GP in the six months after birth and many women will attend a GP for their routine postnatal check-up. Given the frequent contacts that GPs have with mothers and babies a Statewide postal survey of 1104 general practitioners was used to obtain their views towards postnatal care. The main findings are presented in Chapter 3. Most GPs are involved in postnatal care. Female GPs have different views from male GPs as to what should take place at the routine postnatal check-up. Overall, GPs are placing too much emphasis on routine examination and neglecting many of the common problems, both physical and emotional. Many GPs lack confidence to deal with common postnatal problems. GPs provide many visits in the early weeks prior to the traditional check-up. Some GPs believed that an earlier timing for the traditional postnatal check-up might improve maternal health. Chapter 4 reports on a randomised controlled trial designed to test whether a visit to a GP one week after discharge resulted in improved maternal health, as measured by the Edinburgh Postnatal Depression Scale (EPDS), the Short Form 36 (SF 36) subscales, self-report items about physical and emotional health and items about satisfaction with the check-up. Whilst the change in timing of the check-up resulted in less routine examination and more time to talk there were no differences in maternal health between the groups. The survey of general practitioners and the randomised controlled trial of an early postnatal check-up revealed a number of problems with the current postnatal check-up. To explore these problems further the findings of the GP survey are compared with the experiences of women in the standard care group of the trial. These findings are reported in Chapter 5 and indicate that many women experience problems after childbirth and some may consult a GP about the problems. However, only the minority of women will rate the GP as 'very helpful'. Many women are dissatisfied with their postnatal check-up and the current postnatal check-up is not focussed on the common problems. Whilst the traditional postnatal check-up provides an opportunity for the general practitioner to improve maternal health, this is not likely at present. If GPs are to have a role in improving maternal health a new approach to the postnatal check-up is needed. Chapter 6 provides a framework for a postnatal check-up in general practice, which might make that difference.
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ItemEthnospecific health and care: a critical ethnographic study of a Greek nursing home( 1999)This abstract examines how a Greek ethnospecific nursing home functions – situated within a health care system that operates within an English-language, and Anglo/ Australian derived culture. The nursing home was examined within a critical science paradigm guided, however, by Bourdieu’s reflexive sociology. Critical ethnography as a research method was combined with Greek forms of speech in order to accommodate Greek women’s forms of social interaction and oral culture and to avoid imposing an alien research process on participants. Group discussions, formal and informal interviews, participant observation in a variety of forms and document examination were the approaches used to collect data in the field. A key and controversial finding of this inquiry is that the delivedry of ethnospecific aged care is heavily constrained and ultimately undermined – by the policies and practices of the Australian and dominant culture that was transposed in the nursing home, via the distribution of capital that privilege dominant groups in Australia. Because of this residents and carers remained structurally excluded from participation and decision making processes and located at the bottom of the institutional hierarchy. This inevitably helped, particularly in regards to Greek women carers, and domestic staff, including Greek speaking registered nurses, not only to maintain but increase their negative ethnic experiences, historical oppression and exploitation. Nevertheless, ethnospecific care was provided to the residents at the cultural expressive level reflecting larger society’s tolerance of a conservative multiculturalism. Significant Greek cultural care, was mediated through the Greek carers, domestic staff and residents dispositions (habitus) that contextualised their interactions, relationships and practices, enabling their past (and because of this themselves) to live in the present in a meaningfull and dynamic way. For this reason, ethnospecific services, even when constrained by external socio-cultural and political hegemony, has more to offer the Greek aged than do mainstream aged care services.