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Hasan K, Kayum S. Patient Experience and Satisfaction with Orthopedic Services at a Community (Rural) Setting Hospital-How Is It Different from Urban Setting. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2024; 12:209-215. [PMID: 39193539 PMCID: PMC11348020 DOI: 10.3390/jmahp12030017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/30/2024] [Accepted: 07/26/2024] [Indexed: 08/29/2024]
Abstract
Patient experience and satisfaction are the keystones in evaluating the effectiveness of clinical care in musculoskeletal medicine. Although all orthopedic settings work on the same principles of providing safe and quality health care, community hospitals represent a unique environment. There may be key differences with regard to patient experience between these settings. Accessibility to care, choices of provider, personalized care, availability of and access to resources, cultural and social variances, and waiting times are a few of the many elements that may impact patient experience and satisfaction. This narrative review aims to explore the core differences in these settings and how they can reflect on patient experience and satisfaction.
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Affiliation(s)
- Khalid Hasan
- Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Shahin Kayum
- Department of Orthopedics, University of Toronto, Toronto, ON M5T 1P5, Canada
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2
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Wijlens KAE, Witteveen A, Beenhakker L, Siemerink EJM, Achterkamp R, Siesling S, Vollenbroek-Hutten MMR, Bode C. Face and content validity of a holistic assessment questionnaire to assess cancer-related fatigue after breast cancer. FATIGUE : BIOMEDICINE, HEALTH & BEHAVIOR 2024; 12:293-307. [PMID: 39290853 PMCID: PMC11404859 DOI: 10.1080/21641846.2024.2389007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/28/2024] [Indexed: 09/19/2024]
Abstract
Background and objective Cancer-related fatigue (CRF) affects the quality of life after breast cancer. In a previous study, we developed a 72-item questionnaire that assesses CRF from a holistic point of view; named the Holistic Assessment of CRF (HA-CRF) questionnaire. The current study assessed the face and content validity of the HA-CRF questionnaire. Methods Using a mixed-method approach, ten breast cancer survivors (BCS) did a cognitive walkthrough of the HA-CRF via an app followed by a semi-structured interview about relevancy and essentiality (qualitative). In addition, ten health care professionals (HCPs) assessed the relevancy, clarity, and essentiality of each item via a questionnaire (quantitative). Results BCS indicated minor textual improvement for four items and six items were not completely clear. The app was considered easy to use and the HC-CRF was on average completed in 18 minutes. The HA-CRF questionnaire provided openness about fatigue and gave the feeling of being heard. The items were helpful and induced self-awareness. HCPs indicated 71% of items being very clear or minor revisions proposed by the minority, with 64% of items being essential and 92% considered relevant. Conclusions The HA-CRF showed good face and excellent content validity. Further research is needed to assess its ability to monitor in daily life.
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Affiliation(s)
- Kim A E Wijlens
- Department of Biomedical Signals and Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Annemieke Witteveen
- Department of Biomedical Signals and Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Lian Beenhakker
- Department of Biomedical Signals and Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Ester J M Siemerink
- Department of Internal Medicine, ZiekenhuisGroep Twente, Hengelo, The Netherlands
| | - Reinoud Achterkamp
- Department of Oncology Rehabilitation and Pain, Roessingh Rehabilitation Center, Enschede, The Netherlands
| | - Sabine Siesling
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Department of Biomedical Signals and Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Medisch Spectrum Twente, Enschede, The Netherlands
| | - Christina Bode
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
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3
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Shaban M, Mohammed HH, Gomaa Mohamed Amer F, Shaban MM, Abdel-Aziz HR, Ibrahim AM. Exploring the nurse-patient relationship in caring for the health priorities of older adults: qualitative study. BMC Nurs 2024; 23:480. [PMID: 39010101 PMCID: PMC11247866 DOI: 10.1186/s12912-024-02099-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/17/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Person-centered care (PCC) is critical in addressing the diverse health priorities of older adults. Nurses play a pivotal role in implementing PCC, yet the nuances of the nurse-patient relationship in outpatient settings remain underexplored. This study aimed to gain insights into nurses' experiences, challenges, and strategies in caring for older adults through the lens of PCC. METHODS A qualitative descriptive design was employed, involving semi-structured interviews with 12 registered nurses from outpatient clinics serving older adults. Thematic analysis was conducted following the principles of trustworthiness and credibility. RESULTS Five main themes emerged: (1)Understanding and Implementing Person-Centered Care (PCC) (2) Experiences in Older Adult Care, highlighting the significance of trust-building, adapting care approaches, interdisciplinary collaboration, and emotional rewards; (3) Challenges in Care Delivery, including resource constraints, navigating family dynamics, keeping up with medical advances, and emotional strain; (4) Impact on Care Quality, encompassing consistency in care, patient satisfaction, professional development, and ethical considerations; and (5) Coping Strategies, such as peer support, work-life balance, reflective practice, and resilience building. CONCLUSIONS The study underscores the complexities and rewards of the nurse-patient relationship in caring for older adults in outpatient settings. Nurses face formidable challenges but employ various coping strategies to maintain high-quality, person-centered care. Findings have implications for nursing practice, education, policy, and future research, emphasizing the need for supportive environments, continuous professional development, and recognition of the critical role nurses play in addressing the health priorities of the aging population.
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Affiliation(s)
| | | | | | | | - Hassanat Ramadan Abdel-Aziz
- Department of Nursing, College of Applied Medical Sciences in Al-Kharj, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Gerontological Nursing Department, Faculty of Nursing, Zagazig University, Zagazig, Egypt
| | - Ateya Megahed Ibrahim
- College of Nursing, Prince Sattam bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
- Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said, Egypt
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May M, Milrad SF, Perdomo DM, Czaja SJ, Jutagir DR, Hall DL, Klimas N, Antoni MH. Videoconference-delivered group Cognitive Behavioral Stress Management for ME/CFS patients who present with severe PEM: A randomized controlled trial. FATIGUE : BIOMEDICINE, HEALTH & BEHAVIOR 2024; 12:101-122. [PMID: 38736736 PMCID: PMC11086677 DOI: 10.1080/21641846.2024.2306801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/15/2024] [Indexed: 05/14/2024]
Abstract
Background In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), post-exertional malaise (PEM) is associated with greater distress and symptoms. Cognitive Behavioral Stress Management (CBSM) has demonstrated beneficial effects for ME/CFS and may mitigate stress-related triggers of PEM. We tested a virtual CBSM intervention to increase access, and we report on its effects on stress and symptoms in ME/CFS patients with severe PEM. Methods Data were from a randomized controlled trial (NCT01650636) comparing 10-week videoconference-delivered group CBSM (V-CBSM, n=75) to a 10-week Health Information active control (V-HI, n=75) in Fukuda criteria ME/CFS patients (71 classified as highPEM, 79 lowPEM). Linear regression explored PEM-by-Treatment interactions on overall symptom frequency and intensity, perceived stress, and fatigue-specific interference and intensity, at 5-month follow-up. Logistic regression tested V-CBSM effects on 5-month PEM status. Analyses controlled for age, gender, race/ethnicity, mode of symptom onset, and time since diagnosis. Results The sample was middle-aged (47.96±10.89 years), mostly women (87%) and non-Hispanic White (65%), with no group differences on these variables or baseline PEM. For highPEM patients, V-CBSM (versus V-HI) demonstrated medium to large effects on follow-up symptom frequency, symptom intensity, fatigue interference, and fatigue intensity (p's < .05) and trending to significant reductions in perceived stress (p =.07). Differences were not evident for lowPEM patients. Treatment predicted follow-up PEM status at a trend (p = .058), with patients receiving V-CBSM demonstrating half the risk of highPEM classification versus V-HI. Conclusions V-CBSM demonstrates benefits for ME/CFS patients presenting with severe PEM and may reduce the expression of PEM over time.
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Affiliation(s)
| | | | | | | | | | | | - Nancy Klimas
- Nova Southeastern University, Miami VA Medical Center
Geriatric Research Education and Clinical Center
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Tsadok-Cohen M, Rosenblum S, Cohen Elimelech O, Ferrante S, Meyer S. "You Need to Set a Daily Schedule": Understanding Successful Aging via Three-Sided Viewpoints. Healthcare (Basel) 2023; 11:3005. [PMID: 37998497 PMCID: PMC10671344 DOI: 10.3390/healthcare11223005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 years or older, older adults' family members, and health professionals) and 18 interviews with older adults (older adults Mage = 71.7 years, Standard Deviation = 4.62). The transcripts were analyzed using constructivist grounded theory principles. Three categories were identified for successful aging: (a) engagement with life, including social participation, fixed/flexible schedule, time, and meaningful occupation; (b) self-management abilities, including producing daily schedules, independence, and initiation/striving toward goals; and (c) diversity among older adults, including their views on retirement, being active or not, and their dreams/values/goals. Considering the diverse nature of older adults, recognizing the importance of life engagement and self-management abilities emphasizes the necessity for an occupation-based, self-tailored approach to enable successful aging.
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Affiliation(s)
- Michal Tsadok-Cohen
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Abba Khoushy Ave 199, Haifa 3498838, Israel; (S.R.); (O.C.E.)
| | - Sara Rosenblum
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Abba Khoushy Ave 199, Haifa 3498838, Israel; (S.R.); (O.C.E.)
| | - Ortal Cohen Elimelech
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Abba Khoushy Ave 199, Haifa 3498838, Israel; (S.R.); (O.C.E.)
| | - Simona Ferrante
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milano, Italy;
| | - Sonya Meyer
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ariel 40700, Israel;
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van den Houdt SCM, Widdershoven J, Kupper N. Patient and healthcare professionals' perceived barriers and facilitators to the implementation of psychosocial screening in cardiac practice: A Delphi study. Gen Hosp Psychiatry 2023; 85:104-113. [PMID: 37862959 DOI: 10.1016/j.genhosppsych.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Psychosocial risk factors contribute to the incidence and progression of coronary heart disease (CHD). Psychosocial screening may identify individuals who are at risk and aid them with getting appropriate care. To successfully implement psychosocial screening in the cardiology practice, the current study aims to identify key barriers and facilitators to its implementation and evaluate their perceived importance among health care professionals (HCPs) and patients. METHODS We took a modified 3-round Delphi study approach to gain insight into key determinants that could either impede or ease implementation. Round 1 gathered data from HCPs (n = 9; cardiologists, medical psychologists, cardiac nurses) and CHD patients (n = 21), which we transcribed verbatim, coded, and processed into unique determinants. In rounds 2 and 3, participants were asked to select the most relevant determinants and rank them based on importance. Subsequently, determinants were classified by implementation level. RESULTS Patients were generally more positive towards screening. HCP barriers included time-constraints, disruption of primary activities, and limited knowledge on psychosocial risk and screening, while patient barriers were commonly related to accessibility and patient characteristics (e.g., health literacy, motivation). Facilitators of both groups mainly pertained to the use of the screener and follow-up care, such as increasing the accessibility and the benefits of the screener. CONCLUSION Barriers may be targeted by enhancing the effects of the facilitators. Increasing the accessibility to the screener and interventions, improving information provision, and appointing a contact person to oversee the screening process may ease the screening and care process for both patients and HCPs.
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Affiliation(s)
- Sophie C M van den Houdt
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands
| | - Jos Widdershoven
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands; Department of Cardiology, Elisabeth-TweeSteden hospital, the Netherlands
| | - Nina Kupper
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands.
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Jagan S, Mohd Daud TI, Chia LC, Saini SM, Midin M, Eng-Teng N, Ratnasingam S. Evidence for the Effectiveness of Psychological Interventions for Internalized Stigma among Adults with Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5570. [PMID: 37107852 PMCID: PMC10138403 DOI: 10.3390/ijerph20085570] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 05/11/2023]
Abstract
In recent years, psychological interventions have been used to alleviate internalized stigma in people with schizophrenia spectrum disorders, but outcomes have been inconsistent. The aim of this review was to examine the existing evidence regarding this matter. Four electronic databases (EMBASE, MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials) were searched from inception until 8 September 2022, using appropriate strategies. The eligibility, quality, and strength of evidence of each study were all evaluated against the predetermined standards. Further quantitative analyses were performed using the RevMan software. A total of 27 studies were included in the systematic review. Eighteen studies with extractable data for meta-analysis yielded a statistically significant overall effect (Z = 3.00; p = 0.003; 95% CI: -0.69 [-1.15, -0.24]; n = 1633), although there was considerable heterogeneity (Tau2 = 0.89; Chi2 = 303.62, df = 17; p < 0.00001; I2 = 94%). Subgroup analyses for Narrative Enhancement and Cognitive Therapy (NECT) produced a statistically significant and highly homogenous effect (Z = 3.40; p = 0.0007; 95% CI: -0.44 [-0.70, -0.19]; n = 241; Tau2 = 0.00; Chi2 = 0.14, df = 2 (p = 0.93); I2 = 0%). In conclusion, the majority of the psychological interventions are successful in lowering levels of internalized stigma, especially NECT, and interventions that integrate multiple therapies may be more beneficial.
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Affiliation(s)
- Shankar Jagan
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
- Department of Psychiatry & Mental Health, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak 93586, Malaysia
| | - Tuti Iryani Mohd Daud
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Lip Choy Chia
- Department of Psychiatry and Mental Health, Hospital Keningau, Peti Surat 11 Jalan Apin-Apin, Keningau 89007, Malaysia
| | - Suriati Mohamed Saini
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Ng Eng-Teng
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur 56000, Malaysia
| | - Selvasingam Ratnasingam
- Department of Psychiatry & Mental Health, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak 93586, Malaysia
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Gorenberg J, Tierney S, Wong G, Turk A, Libert S, Potter C, Eccles K, Forster S, Husk K, Chatterjee HJ, Webster E, McDougall B, Warburton H, Shaw L, Mahtani KR. Understanding and Improving Older People's Well-Being through Social Prescribing Involving the Cultural Sector: Interviews from a Realist Evaluation. J Appl Gerontol 2023:7334648231154043. [PMID: 36724235 DOI: 10.1177/07334648231154043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Social prescribing is a non-clinical approach to addressing social, environmental, and economic factors affecting how people feel physical and/or emotionally. It involves connecting people to "community assets" (e.g., local groups, organizations, and charities) that can contribute to positive well-being. We sought to explain in what ways, for whom, and why the cultural sector can support social prescribing with older people. We conducted semi-structured interviews with 28 older people (aged 60+) and 25 cultural sector staff. The following nine concepts, developed from interview data, progressed the understanding of tailoring cultural offers, which came from our previous realist review-immersion, buddying, café culture, capacity, emotional involvement, perseverance, autonomy, elitism, and virtual cultural offers. Through tailoring, we propose that older people might experience one or more of the following benefits from engaging with a cultural offer as part of social prescribing-being immersed, psychological holding, connecting, and transforming through self-growth.
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Affiliation(s)
- Jordan Gorenberg
- Nuffield Department of Primary Care Health Sciences, 6396University of Oxford, Oxford, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, 6396University of Oxford, Oxford, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, 6396University of Oxford, Oxford, UK
| | - Amadea Turk
- Nuffield Department of Primary Care Health Sciences, 6396University of Oxford, Oxford, UK
| | - Sebastien Libert
- Nuffield Department of Primary Care Health Sciences, 6396University of Oxford, Oxford, UK
| | - Caroline Potter
- Nuffield Department of Population Health, 6396University of Oxford, Oxford, UK
| | - Kathryn Eccles
- Oxford Internet Institute, 6396University of Oxford, Oxford, UK
| | - Shona Forster
- Department of Psychiatry, 6396University of Oxford, Oxford, UK
| | - Kerryn Husk
- Peninsula Medical School, 6633University of Plymouth, Plymouth, UK
| | | | - Emma Webster
- Gardens, Libraries and Museums, 6396University of Oxford, Oxford, UK
| | - Beth McDougall
- Gardens, Libraries and Museums, 6396University of Oxford, Oxford, UK
| | - Harriet Warburton
- Gardens, Libraries and Museums, 6396University of Oxford, Oxford, UK
| | - Lucy Shaw
- Gardens, Libraries and Museums, 6396University of Oxford, Oxford, UK
| | - Kamal R Mahtani
- Nuffield Department of Primary Care Health Sciences, 6396University of Oxford, Oxford, UK
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Archambault L, Bertrand K, Perreault M. Problematic Opioid Use: A Scoping Literature Review of Profiles. Subst Abuse 2022; 16:11782218221103581. [PMID: 35923179 PMCID: PMC9340351 DOI: 10.1177/11782218221103581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Problematic opioid use can be defined as opioid use behaviors leading to social, medical, or psychological consequences. In some instances, people presenting problematic opioid use can also meet criteria for an opioid use disorder. A growing body of literature highlights different types of people who use opioids, with contrasting characteristics and initiation patterns. In recent years, dynamic trends in opioid use have been documented and studies have demonstrated a shift in profiles. Methods: A scoping literature review was conducted to identify profiles of people presenting problematic opioid use, in order to support the development of tailored interventions and services. Results: Nine articles met the inclusion criteria. Five classifications emerge from the literature reviewed to distinguish types of people presenting problematic opioid use, according to: (1) the type of opioids used, (2) the route of opioid administration, (3) the level of quality of life, (4) patterns of other drugs used, and (5) dependence severity. While samples, concepts, and measurement tools vary between studies, the most salient finding might be the distinct profile of people presenting problematic use of pharmaceutical-type opioids. Discussion and Conclusions: This scoping review highlights that few studies address distinctive profiles of people presenting problematic opioid use. Geographical and chronological differences suggest that local timely assessments may be needed to tailor the service offer to specific needs. Scientific Significance: Future studies should focus on providing a deep understanding of distinct experiential perspectives and service needs, through exploratory quantitative and qualitative designs.
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Affiliation(s)
- Léonie Archambault
- Douglas Research Center and Université de Sherbrooke, Montréal, QC, Canada
| | - Karine Bertrand
- Institut universitaire sur les dépendances and Université de Sherbrooke, Longueuil, QC, Canada
| | - Michel Perreault
- Douglas Research Center and McGill University, Montréal, QC, Canada
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Faber JS, Al-Dhahir I, Reijnders T, Chavannes NH, Evers AWM, Kraal JJ, van den Berg-Emons HJG, Visch VT. Attitudes Toward Health, Healthcare, and eHealth of People With a Low Socioeconomic Status: A Community-Based Participatory Approach. Front Digit Health 2021; 3:690182. [PMID: 34713165 PMCID: PMC8521920 DOI: 10.3389/fdgth.2021.690182] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/04/2021] [Indexed: 12/04/2022] Open
Abstract
Low socioeconomic status (SES) is associated with a higher prevalence of unhealthy lifestyles compared to a high SES. Health interventions that promote a healthy lifestyle, like eHealth solutions, face limited adoption in low SES groups. To improve the adoption of eHealth interventions, their alignment with the target group's attitudes is crucial. This study investigated the attitudes of people with a low SES toward health, healthcare, and eHealth. We adopted a mixed-method community-based participatory research approach with 23 members of a community center in a low SES neighborhood in the city of Rotterdam, the Netherlands. We conducted a first set of interviews and analyzed these using a grounded theory approach resulting in a group of themes. These basic themes' representative value was validated and refined by an online questionnaire involving a different sample of 43 participants from multiple community centers in the same neighborhood. We executed three focus groups to validate and contextualize the results. We identified two general attitudes based on nine profiles toward health, healthcare, and eHealth. The first general attitude, optimistically engaged, embodied approximately half our sample and involved light-heartedness toward health, loyalty toward healthcare, and eagerness to adopt eHealth. The second general attitude, doubtfully disadvantaged, represented roughly a quarter of our sample and was related to feeling encumbered toward health, feeling disadvantaged within healthcare, and hesitance toward eHealth adoption. The resulting attitudes strengthen the knowledge of the motivation and behavior of people with low SES regarding their health. Our results indicate that negative health attitudes are not as evident as often claimed. Nevertheless, intervention developers should still be mindful of differentiating life situations, motivations, healthcare needs, and eHealth expectations. Based on our findings, we recommend eHealth should fit into the person's daily life, ensure personal communication, be perceived usable and useful, adapt its communication to literacy level and life situation, allow for meaningful self-monitoring and embody self-efficacy enhancing strategies.
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Affiliation(s)
- Jasper S. Faber
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Isra Al-Dhahir
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Thomas Reijnders
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Niels H. Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
| | - Andrea W. M. Evers
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jos J. Kraal
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - H. J. G. van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus Medical Center (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
- Capri Cardiac Rehabilitation, Rotterdam, Netherlands
| | - Valentijn T. Visch
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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11
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Minvielle E, Fourcade A, Ricketts T, Waelli M. Current developments in delivering customized care: a scoping review. BMC Health Serv Res 2021; 21:575. [PMID: 34120603 PMCID: PMC8201906 DOI: 10.1186/s12913-021-06576-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 05/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. METHODS Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included "care customization", "personalized service and health care", individualized care" and "targeting population" in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. RESULTS We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. CONCLUSIONS There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.
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Affiliation(s)
- Etienne Minvielle
- i3-Centre de Recherche en Gestion, Institut Interdisciplinaire de l’Innovation (UMR 9217), École polytechnique, Batiment Ensta, 828, Boulevard des Maréchaux, 91762 Palaiseau Cedex, France
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Aude Fourcade
- Institut Gustave Roussy, 114, rue Edouard Vaillant, 94800 Villejuif, France
| | - Thomas Ricketts
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA
| | - Mathias Waelli
- MOS (EA 7418), French School of Public Health, Rennes, France
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Druică E, Mihăilă V, Burcea M, Cepoi V. Combining Direct and Indirect Measurements to Assess Patients' Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010152. [PMID: 31878246 PMCID: PMC6981560 DOI: 10.3390/ijerph17010152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 12/31/2022]
Abstract
Introduction: Patients' satisfaction was extensively researched over the last decades, given its role in building loyalty, compliance to treatment, prevention, and eventually higher levels of wellbeing and improved health status. Patients' feedback on the perceived quality of health services can be incorporated into practice; therefore, understanding factors and mechanisms responsible for patients' satisfaction allows providers to tailor targeted interventions. Method: A questionnaire assessing patients' perception of the quality of health services was administered to a country-representative sample of 1500 Romanian patients. Using a partial least squares-path modeling approach (PLS-PM), with cross-sectional data, we developed a variance-based structural model, emphasizing the mediating role of trust and satisfaction with various categories of health services. Results: We confirmed the mediating role of trust in shaping the relationship between the procedural accuracy of health professionals, along with the perceived intensity of their interaction with patients, and patients' experienced quality of the health services. We confirmed the mediating role of satisfaction by the categories of services in the relationship between waiting time on the premises, attention received, and the perceived reliability of the information received, as predictors, and the experienced quality of the health services. In addition, indirect assessment of patients' satisfaction is a good predictor for direct assessment, thereby affirming the idea that the results of the two types of evaluations converge. Discussions: One of the most efficient solutions to increase both patients' satisfaction and their compliance is to empower the communication dimension between patients and health practitioners. Given the non-linear relationships among variables, we advocate that, unless the nature of the relationships between satisfaction and its predictors is understood, practical interventions could fail. The most relevant variable for intervention is the degree of attention patients perceive they received. We suggest three methods to turn waiting time into attention given to patients.
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Affiliation(s)
- Elena Druică
- Centre for Research in Applied Behavioural Economics, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania; (E.D.); (V.M.)
| | - Viorel Mihăilă
- Centre for Research in Applied Behavioural Economics, Faculty of Business and Administration, University of Bucharest, 030018 Bucharest, Romania; (E.D.); (V.M.)
| | - Marin Burcea
- Faculty of Business and Administration, University of Bucharest; 030018 Bucharest, Romania;
| | - Vasile Cepoi
- The Romanian Authority for Quality Assurance in Healthcare, 060022 Bucharest, Romania
- Correspondence:
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