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Title: The quality and characteristics of child primary health care services in Malta : is there a role for the paediatric nurse practitioner?
Authors: Gauci, Gilbert
Keywords: Primary health care -- Malta
Child care -- Malta
Medical care -- Evaluation -- Malta
Pediatric nursing -- Malta
Issue Date: 2010
Citation: Gauci G. (2010). The quality and characteristics of child primary health care services in Malta : is there a role for the paediatric nurse practitioner? (Master's dissertation).
Abstract: Background to the study: This research study intends to shed light on the Maltese primary health care system for children and their families by making use of the Primary Care Assessment Tool - Child Edition. The introduction of the paediatric nurse practitioner in the Maltese primary health care setting was also explored for its role as being the stepping stone to meet the health care needs of tomorrow. The primary care score and the primary care extended score consents a particular primary health care system to be compared with another. This score could eventually be used for benchmarking purposes between primary health care systems. Paediatric nurse practitioners have been shown to offer a beneficial service and fill the gap in health care provision. In this situation they would supplement physician services, and in some extents they could function as a surrogate of physicians. By working as a team, the physician and the paediatric nurse practitioner might be able to assume more responsibility for patients than each working separately. Method: A descriptive, cross-sectional, retrospective survey was carried out. Data was collected using a structured face-to-face interview which was administered to 200 parents/guardians who attended the paediatric accident and emergency department at Mater Dei Hospital between the months of March and April 2010. After appropriate translation of the original tool to the Maltese language, the reliability of the tool was assessed and was found to be more than 0.60, indicating a satisfactory reliability. Results: All the participants identified themselves with a particular place or a particular doctor. Utilisation of primary care by children and their families is quite satisfactory in Malta. Since local health centres and the paediatric accident and emergency departments are open every day providing twenty-four hour service, the accessibility score could have been misled, despite the positive accessibility result. Continuity of primary care is also quite strong, although health providers lack the knowledge with regards to the parents/guardians financial situation. Coordination of care had the lowest score and could be attributed since locally no referral is needed to visit a specialist and also no information system exists to date that allows online exchange of information between health providers and also between primary and secondary care. Comprehensiveness of primary care also had low scores and findings suggest that health providers need to step beyond the biomedical model so as to address their patients' emotional, social, and developmental needs. Family-centered care was found to be highly valued by local primary health care providers and with regards to community orientation, the score indicated that providers also extend the care to the people in the community whose health care needs are not being met. It was also found that primary health providers have a strong ability to communicate between and among cultures. Conclusion: Various gaps were found in the present primary health care system for children and their families. The paediatric nurse practitioner was shown to offer various beneficial services so as to fill these gaps. Finally, a number of recommendations are drawn up to serve as guidelines for management purposes, health education and research.
Appears in Collections:Dissertations - FacHSc - 2010
Dissertations - FacHScHSM - 2010

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